Pediatric liver transplantation has long been developed in the western world.Currently,favorable outcomes after liver transplantation have been achieved in pediatric recipients and the postoperative 5-year survival rate reached 80％ in western transplantation centers.In the mainland China,pediatric liver transplantation started quite recently and there is still a big gap compared with western centers.In addition,there is unbalanced development between adult and pediatric recipients due to surgical difficulties and undesirable outcomes following pediatric liver transplantation.The operation methods of pediatric liver transplantation include whole liver transplantation,reduced-size liver transplantation,living donor liver transplantation and split liver transplantation.Perioperative complications of pediatric liver transplantation mainly include portal vein thrombosis,hepatic artery thrombosis,intra-abdominal bleeding,infections,rejection,bile leakage and biliary strictures.While the long-term complications are infections,post-transplantation lymphoproliferative disorders,acute and chronic rejections caused by poor compliance with immunosuppressive therapy.Perioperative complications have been reduced recently thanks to improvement of surgical techniques.With the highly-prolonged survival period,long-term postoperative complications have been playing a significant role in recipients' survival rates.Management of long-term follow-up and compliance has been the next focus of pediatric liver transplantation.

Objective To investigate the clinical and pathological features of children malignant lymphoma.Method A retrospective study was carried out to analyse the clinical,laboratory and pathological data in 65 patients with malignant lymphoma.Results In the chidren malignant lymphoma,the incidence of nonHodgkin′s lymphoma(NHL) was more than that of Hodgkin′s disease(HL),the ratio of NHL to HL was 2.25∶1.The peak incidence of age was among 6 to 9 years old,the ratio of male to female is about(3.5∶1.)NHL of our children was mostly consised of lymphoblastic lymphoma,anaplastic large-cell lymphoma,diffuse large B-cell lymphoma and Burkitt′s lymphoma.The clinical manifestations were predominantly presented with peripheral nodes intumescing,mediastinal tumeur,abdominal tumeur,bone marrow infiltration.In patients with Hodgkin′s disease,mixed cellularity was the most common pathological category,and cervical painless lymphadenectasis was usually the initial signs in most patients,sometimes accompanied with infiltration of celiac lymph nodes,spleen and bone marrow.Conclusions NHL of our children differs from that of adult in the clinical feature and pathology,while HL of our patients is similar to adults.Since the prognosis of the malignant lymphoma is determined by its pathology,immunohistochemistry plays an important role in the diagnosis and differential diagnosis.J Appl Clin Pediatr,2006,21(3):160-161

AIM: To examine whether reactive oxygen species (ROS) is involved in the neuroprotection by mitochondrial ATP- sensitive potassium channel (mitoKATp) in rat hippocampal slices during hypoxia. METHODS: The technique of elec-trophysiology was used, and the latency to hypoxic depolarization (HD) and the amplitude of population spike (PS) in the stratum pyramidale of the CA1 region were measured. RESULTS: Pretreatment of the slices with diazoxide (DIA, a mitoKATP opener, at concentration of 300 ?mol/L) , prolonged the latency to HD, delayed the onset of PS disappearance and improved the recovery of PS after reoxygenation. The effects induced by DIA were attenuated by 5 - hydroxydecanoic acid (a mitoKATP blocker, at concentration of 200 ?mol/L). Pretreatment with N - 2 - mercaptopropionyl glycine (MPG, a ROS scavenger, at concentration of 500 ?mol/L), also abrogated the effects induced by DIA, while treatment of MPG alone had no effect on PS and HD. CONCLUSION: ROS participates in neuroprotection offered by mitoKATp opener during hypoxia.

Cholangiocarcinoma (CCA) is a malignant neoplasm derived from cholangiocytes. The incidence of CCA is only lower than that of hepatocellular carcinoma and ranked the second in liver malignant cancers. The prognosis of CCA patients is poor and most patients will die within a few months after diagnosis. CCA is related to various risk factors, including primary sclerosing cholangitis, cirrhosis, certain chemical agents and liver fluke. Establishment of proper animal models of CCA can not only be helpful for understanding the mechanisms of incidence and development, but also lay a solid foundation for developing novel treatment strategies. Common animal models of CCA include carcinogen-induced models, implantation models, operation models, and genetically engineered models.

Background:Acute hepatic failure( AHF)is a common pathophysiological process of end-stage liver disease with complex etiology,difficulty in diagnosis and high mortality rate. Aims:To investigate the protective effect of nicotinamide on AHF in mice. Methods:AHF model in mice was established by intraperitoneal injection with D-galactosamine 700 mg/kg and lipopolysaccharide 10 μg/kg. Fifty-four mice were divided into blank control group,nicotinamide control group, AHF model group and low,moderate,high dose(400,800,1 000 mg/kg)nicotinamide groups,levels of ALT,AST, TNF-α and IL-6 were determined,HE staining was used to examine hepatic histological injury,liver cell apoptosis was measured by TUNEL assay,and protein expression of Caspase-3 was detected by Western blotting. Another 40 mice were divided into AHF model group,saline group and low,moderate,high dose(400,800,1 000 mg/kg)nicotinamide groups,mortality rate was observed dynamically. Results:Compared with blank control group and nicotinamide control group,levels of ALT and AST were significantly increased(P<0. 05),infiltration of inflammatory cells and necrosis of cells and levels of TNF-α and IL-6 were significantly increased( P <0. 05 ),and apoptosis of liver cells and protein expression of Caspase-3 were significantly increased in AHF model group(P <0. 05). In groups pretreated with low, moderate and high dose nicotinamide,all the above-mentioned indices were significantly improved in a dose-dependent manner(P<0. 05). Survival rate in low,moderate,high dose nicotinamide groups was significantly higher than that in AHF model group(37. 5%,62. 5%,100% vs. 0%,P all <0. 05). Conclusions:Nicotinamide could protect mice from AHF via inhibiting inflammatory response and hepatocyte apoptosis,thereby increase the survival rate.

ObjectiveTo summarize the short-term effects o f Symmetry aortic co nnector in off-pump coronary artery bypass grafting (OPCAB) operation. MethodsTwo hundreds and four patients suffering from coronary artery d isease underwent OPCAB from September 2002 to June 2003. Among the 204 patients, saphenous vein grafts were used in 167 patients and Symmetry aortic connectors were adopted in 100 of them.ResultsOf 142 connectors used, 2 connectors fai led and manual r epairs were required in 3 cases because of anastomotic leakage, the success rate being 96 5% (137 of 142). The number of proximal anastomosis was (1 4?0 5) per case and the number of distal anastomosis (3 5?0 8) per case. The proximal a na stomotic blood flow was (46 5?22 3) ml/min. The fitting time for connectors w as (4 0?1 1) min, and anastomoses were all accomplished within 10 seconds. The op eration time was (3 2?0 4) hours. The operative death rate was 1% (1 of 100). R e-operation of thoracotomy was required in 1 case because of bleeding but not an astomotic bleeding. No myocardial infarction or stroke occurred in the peri-oper ative period. The postoperative drainage amount was (547?247) ml. The blood tra nsfusion rate was 36 0% (36 of 100). The postoperative hospital stay was (7 8 ?1 6) days.ConclusionsSymmetry aortic connector can be saf ely and effectively used in coronary artery bypass grafting operations, with satisfactory short-term clinical effects. The procedure may shorten operation time, avoid aortic clampi ng, and lower the incidence of stroke.

Objective To summarize the mid-term outcomes of minimally invasive direct coronary artery bypass (MIDCAB). Methods A series of 33 patients underwent MIDCAB from November 2000 to April 2003: 29 of them received MIDCAB only and 4 received the hybrid approach operation (combining MIDCAB of the left anterior descending artery with percutaneous coronary intervention of the remaining diseased coronary arteries). Out of the 33 cases, conventional MIDCAB was carried out in 25 cases, 4 underwent thoracoscopy-assisted operation and 4 received the surgery with the assistance of the AESOP robot system. Results No operation-related deaths or complications were seen in the study. The extubation time was (7.5?1.9) hours, the chest drainage volume was (274?197) ml, the blood transfusion rate 9.1% (3/33) and the postoperative hospital stay (6.9?1.7) days. Follow-up in all the 33 cases for (24.3?5.7) months revealed no long-term deaths and the recurrence rate of angina was 9.1% (3/33). Postoperative coronary angiography in 4 cases found 1 case of 50% stricture of anastomosis and 3 cases of anastomotic patency between the anterior descending artery and left internal mammary artery. Postoperative catheter revascularization was required in 2 cases (6%). Conclusions The mid-term outcomes of MIDCAB is satisfactory.

Objective To ascertain the optimum condition for extracting Rhizoma polygoni cuspidati and Radix angelicae sinensis with alcohol. Method With extract yield and the amount of polydatin as index,the primary factors of affecting the extraction were optimized. Result The optimum extraction condition was as follows:taking 60% alcohol as solvent,the meterials were refluxed and extracted two times with 10 and 8 times volume of alcohol for 1.5 h and 1.0 h,respectively. Conclusion The optimum extraction process provides an experimental basis for industrial production.