Marginal liver donor,a way to expand the liver pool,has been maximized in the unique position due to the shortage of donors.But the definition of marginal donor liver varies from center to center and the standard is very complex.With the enhancement of organ perfusion solution,preservation methods and surgical techniques,the edge donor criteria are also gradually expanding.What decision should we make,facing such clinical controversies.This paper makes a review on the marginal liver donor in the donation after citizen deceased,so as to improve its clinical application.

In order to supply some reference about the construction of network course of physiology, we summed up the establishing experience from the course design, construction and application.

Vascular complications after liver transplantation can seriously threaten the survival of patients.In the preoperative assessment and postoperative monitoring of patients' vascular conditions,although the digital subtraction angiography (DSA) is the golden standard for vascular lesion diagnosis,but not the first choice due to traumatic lesions.In some clinical circumstances,DSA can only be used when Doppler ultrasound,spiral CT,and MRI are not applicable,and in most cases DSA is used for treatment rather than diagnosis.This article reviewed the current interventional treatment of vascular complications to stress the important role of DSA in diagnosis and treatment of related complications after liver transplantation.

Objective:To optimize the processing technology of prepared Morinda officinalis based on nystose content. Methods:Orthogonal experiments and the nystose determination method in Chinese Pharmacopoeia (2010 edition) were used to optimize the pro-cessing technology. A Welch AQ-C18(250 mm ×4.6 mm,5 μm)chromatographic column was applied with methanol-water(3∶97)as the mobile phase, the column temperature was at 25℃, the flow rate was 0. 8 ml·min-1 , the injection volume was 10μl, and the drift tube temperature was at 40℃ with low temperature atomization. Results:The linearity of nystose was good within the range of 0. 214 8-0. 644 4 mg·ml-1 and the recovery was 99. 5%(RSD=3. 5%,n=6). Conclusion: On the basis of nystose content determination, the optimal processing technology of prepared Morinda officinalis is as follows:liquorice of 4%, stir fry time of 15min and the boiling pot temperature of 200℃.

Inflammatory bowel disease is thought to be regulated by the balance between Th1 and Th2 cytokines secreted by T cells, and NF-kappaB p65 also plays a predominant role in the intestinal inflammation. We evaluated the potency of oxymatrine, one of active components of Sophora Root, in inhibiting the immune responses and inflammation in 2,4,6-trinitrobenzene sulfonic acid (TNBS)-induced colitis. The inflammation was markedly ameliorated in the oxymatrine-treated rats. The level of IL-2 was increased and that of IL-10 was decreased in colon tissue in the rat model, which was reversed by the treatment of oxymatrine. Moreover, the elevated expression of NF-kappaB p65 in colon tissue in the model was also improved by oxymatrine treatment. Our results suggest that oxymatrine might be beneficial for the abnormal immune responses and inflammation by regulating the unbalance of Th1 and Th2 cytokines secretion and inhibiting the expression of NF-kappaB p65 in colon tissue.

Objective To investigate the clinical value of glypican-3 (GPC3) in the diaganosis of hepatocellular carcinoma (HCC),the contents of GPC3 in the serum and tissues of HCC patients were detected.Methods ELISA and immunohistochemical staining were applied to detect GPC3 expressing level in the serum and tissues in 79 cases with HCC,35 cases with post-hepatitis cirrhosis and 30 normal liver specimens and the resuits were compared.The influential factor of GPC3 content in the patients with HCC was analyzed by logistic regression model.Results The serum level of GPC3 in patients with HCC was (143.02±40.26) μg/L which was signifcantly higher than that in patients with post-hepatitis cirrhosis [(6.15±4.31) μg/L] and healthy controls [(4.47±3.22) μg/L] (all P ＜ 0.01).The expression levels of GPC3 was signifeantly higher in post-hepatitis cirrhosis tumor-adjacent tissue and tumor-distant tissue.The expression levels of GPC3 was significantly positively correlated with tumor presence of distant mestasis (x2 =13.182,P ＜ 0.0) and clinical stage (x2 =4.250,P ＜ 0.05),and not correlated with sex,age,tumor size and the level of AFP inserum (P ＜ 0.01).Conclusion GPC3 is specific the diagnosis of HCC.The joint diagnosis of GPC3 and AFP will improve the sensitivity of HCC.Therefore,GPC3 could as a biomarker for evaluating HCC condition and prognsis.

Objective To assess the feasibility and clinical results of video-assisted high anterior transcervical approach (Smith-Robinson) in treatment of spinal lesions of the craniovertebral junction. Methods Between April 2007 to October 2009, nineteen consecutive patients with spinal lesions of the craniovertebral junction were included in the study. There were 9 males and 10 females aged from 16 to 62 years old with a mean of 32 years. The primary pathologies included 4 cases with chronic odontiod fracture, 2 cases with purely irreducible atlantoaxial dislocation, 6 cases with os odonteideum, 1 case with Marfan synd rome, 1 case with primary basilar invagination from Kippel-Feil syndrome, 3 case with axis tumor and 1 case with irreducible rheumatoid atlantoaxial dislocation. All of the patients underwent combined video-assisted high anterior transcervical procedure and posterior fixation at one-stage. The anterior procedure included atlantoaxil release and reduction (8 cases), odontoidectomy (8 cases), and intralesional extracapsular excision and reconstruction (3 tumor cases). The posterior technique were C1-C2 pedicle screw fixation (13 cases), C1-C3 pedicle screw fixation (2 cases), and occipitalcervical fusion (4 cases). Results Anatomical reduction was achieved in eight cases with anterior release and reduction. Tumors were completely removed in three cases with axial tumor. The mean follow-up was 14 months (6-36 months). All of them achieved solid bone fusion. In the 14 patients with symptoms of spinal cord dysfunction, the average Japanese Orthopaedic Association (JOA)score had improved from 9.1±3.3 preoperatively to 14.1±2.9 postperatively. The improvement rate was excellent for 7 cases, good for 5 cases, fair for lcase and poor for 1 case. One patient experienced leakage of cerebrospinal fluid which was resolved by bioprotein gelatin blocking and lumbar subarachnoid continuous drainage within 1 week. Dysphagia which occurred in 3 cases responded well to dexamethason and mannitol.No infection and hardware failure were observed. Conclusion Video-assisted high anterior transcervical procedure is a safe and effective alternative for treating spinal lesions in the craniovertebral junction.

Objective To study on the value and safety of early endoscopic retrograde cholangiopan-creatography (ERCP)and endoscopic sphincterotomy (EST) in acute biliary pancreatitis. Methods Ninety-two patients with acute biliary pancreatitis underwent early ERCP (within 72 hours) and received endoscopic therapy (ERCP group). Another 40 patients with acute biliary pancreatitis were treated conservatively without ERCP (control group). The disappearance of abdominal pain, decrease of serum amylase level, the mean days and costs of hospitalization and complications were observed in all patients. Results In ERCP group, all patients were performed EST, stones in 72 choledocholithiasis patients had been removed with net-basket or air pocket. Ten cases of severe acute biliary pancreatitis received endoscopic pancreatic duct stents drainage. Ninety two cases of acute biliary pancreatitis received endoscopic nasal catheter bile drainage. The days of the disappearance of abdominal pain, the decrease of serum amylase levels, the cost of the hospitalization and the days of the hospitalization were significantly shorter in the early ERCP group than in the control group. The mortalities in ERCP and control group were 8. 3% and 33. 3% respectively. Conclusion Early ERCP endoscopic therapy is a safe procedure has the superiorities in lowering the mortality, hospital days and expense.

The effects of Wumeiwan (WMW) on TNF-alpha, IL-6, IL-8, IL-10 and NF-kappaBp65 in rats with ulcerative colitis (UC) were investigated, the curative effectiveness of WMW vs salicylazosulfapyridine (SASP) was compared, and the action mechanism was analyzed. Fifty-Six Sprague-Dawley (SD) rats were randomly divided into four groups (n=14 in each group, with equal ratio of male and female): normal control group, model group, SASP group, and WMW group. Except normal control group, the rat UC models in the remaining three groups were established using the method of 2.4-dinitrochlorobenzene (DNCB) immunization and acetic acid local enema. The rats in model group, SASP group, and WMW group were treated with distilled water, SASP, and WMW respectively. The changes in the symptoms and signs were observed, and levels of IL-6, IL-8, TNF-alpha, IL-10 and the expression of NF-kappaBp65 in the colonic tissues were statistically analyzed. The results showed that the levels of IL-6, IL-8, and TNF-alpha were significantly increased (P<0.01), while those of IL-10 significantly reduced (P<0.01) after establishment of rat UC models as compared with normal control group. The levels of IL-6, IL-8, and TNF-alpha were obviously lower, but the level of IL-10 was obviously higher in WMW and SASP groups than those in model group (P<0.05). The levels of IL-6, IL-8, and TNF-alpha were lower, while the level of IL-10 was higher in WMW group than in SASP group. NF-kappaBp65 was expressed negatively or weakly in normal colonic tissues. The positive expression rate of NF-kappaBp65 in WMW group and SASP group was obviously lower than in model group (P<0.01), and there was significant difference between WMW group and SASP group (P<0.05). It was concluded that rat UC model was established successfully. WMW could up-regulate the expression of IL-10, down-regulate the expression of TNF-alpha, IL-6, IL-8, and inhibit the NF-kappaBp65 activity to adjust immune function, indicating WMW had better curative effects on UC in rats.

ObjectiveTo summarize the echocardiographic diagnosis, clinical classification and prognosis of different types of fetal congenital cardiac malformation (FCMH).MethodsThe echocardiography sonogram characteristics for 429 cases with FCMH were summarized and analyzed by pathological findings and postnatal following-up.ResultsThe incidence of FCMH was 1.3% (429/33 800). In one hundred and seventy-seven caese of single structure malformation, there were 5 cases of Atrial septal defect and 55 cases of interventricular septal defect (34.5%, 61/177). The others including (116 cases): 10 cases of single atrium and 34 cases of single ventricle, 20 cases of Ebstein’s anomaly, 11 cases of tricuspid atresia and 6 cases of pulmonary atresia with intact ventricular seprum, 20 cases of pulmonary stenosis, 10 cases of coarctation of aortic arch and 4 cases of interruption of aortic arch, 1 case of pulmonary artery sling. In two hundred and thirty-three cases of symphysic teratism, there were 41 cases of double-outllet right or left ventricle (17.5%, 41/233) and Tetralogy of Fallot (40 cases, 17.2%, 40/233). The others (152 cases) including: 16 cases of complete and 18 cases of corrected transposition of great arteries, 38 cases of atrioventricular septal defect, 30 cases of truncus arteriosus persistens, 8 cases of total and 10 cases of partial abnormal pulmonary venous drainage, 14 cases of hypoplastic right heart and 6 cases of left heart syndrome, 9 cases of pulmonary artery atresia with ventricular septal defect, 2 cases of plysplenia and 1 case of plenia syndrome. Nineteen cases of instructure cardiac anomalies including 16 cases of heart tumor and 3 cases of endocardial ifbroelastosis. Nine cases were missed diagnosis and 7 cases were misdiagnosis. A total of 136 cases couldn′t be cured with an unfavorable outcome. Nighty three cases with severe FCMH could be cured. Fifty four cases needed emergent treatment postnatal, and 146 cases with mild abnormality.ConclusionsFetal congenital malformation of heart diagnosed by antenatal echocardiography is valuable for guiding the clinical decision in prevetion and treatment it can also reduce perinatal mortality with congenital malformation of heart.