In recent 20 years,liver transplantation has been rapidly developed in China,and the number of cases and patient outcomes have continued to improve.However,many problems emerged,such as mismatch of donor source and unbalanced distribution system,the research achievements lacking of innovation and core competitiveness,and clinical study level lags behind.In order to solve the problems mentioned above,the First Affiliated Hospital of Nanjing Medical University has carried out a series of work,such as expanding the donor pool,improving clinical technologies,and strengthening basic researches.

Objective To investigate a safe method for donor's hepatectomy in living donor liver transplantation (LDLT).Methods Of the 14 patients with endstage liver diseases undergoing LDLT successfully since Jan. 1995, 2 cases were subjected to extensive left lateral hepatetomy,10 to extensive left hepatetomy including middel hepatic vein and 2 to right hepatetomy. Results Bile leakge occurred only in one patients after removal of the T tube. All patients received a period of 1 month to 5 years. No complain was found. The function of the liver in all patients was normal. Conclusion The operative risk of donor hepatetomy is minimal if it is performed by experienced liver surgeons.

Carcinoma, Hepatocellular ; surgery ; Humans ; Liver Neoplasms ; surgery ; Liver Transplantation ; methods

Objective To investigate the value of retention rate of indocyanine green at fifteen minutes(ICGR15)during hemihepatectomy for evaluation of residual liver reserve function in patients with primary liver carcinoma.Methods During hemihepatectomy,ICGR15 was tested in 44 patients after the hepatic artery and portal vein of resected side were ligated.Child-Pugh score,Child-Pugh classification,and MELD score before operation were tested.After operation,the liver function condition was estimated.Results The incidence of liver dysfunction was significantly lower in ICGR150.05).ICGR15 and MELD score in normal liver function group were statistical lower than those in mild insufficiency of liver function group and severe insufficiency of liver function group(P

Objective To observe and classify endometrial wavelike activities in controlled ovarian hyperstimulation (COH) cycles,and to study their effect on assisted reproductive techniques(ART) outcomes in COH cycles.Methods Patterns of endometrium wavelike movements were described,then their percentages of the total endometrium movements were calculated and compared retrospectively in 57 infertile women who had undergone ART treatments with different outcomes.Results Five types of endometrial wavelike movements could be distinguished:No activity, random,positive,negative,and opposing endometrium movements.The frequencies and types of endometrial movements varied in COH cycles.Endometrium movements,especially negative movements more frequently appeared in non-conception group than in conception group.Conclusions Abnormal endometrium activity could be seemed as underlying mechanisms in some cases of unexplained infertility or ART failure.

Objective To evaluate living-related liver transplantation (LRLT) for the treatment of Wilson′s disease. MethodsBetween Jan. 2001 and Oct. 2003,LRLT was performed in 20 patients (mean age 11.1 years) of late staged Wilson′s disease. Among them emergency transplantation was performed in 3 patients. Donor livers were all from patient′s parents. ResultsSurgery was successful in all donors and recipients, liver function test and serum ceruloplasmin reached normal level one month after transplantation. One patient died of severe rejection. Discharged patients were followed up from 2～33 months (mean 18.9 months). [WT5”HZ]ConclusionsLiving related liver transplantation is an effective treatment for Wilson′s disease complicated with hepatic dysfunction.

In order To evaluate whether the parameters of spiral artery blood flow, as measured by transvaginal color Doppler, may be used to assess endometrium receptivity prior to embryo transfer (ET), a retrospective study of 94 infertile women who had undergone ART treatments with different outcomes (pregnant or nonpregnant) was done. Subendometrial blood flow was evaluated. The resistance index (RI), systolic/diastolic ratio (S/D) and pulsatility index (PI) were significantly lower in those who achieved pregnancy as compared with those who did not: 0.62+/-0.04 vs 0.68+/-0.04 (P<0.001), 2.66+/-0.33 vs 3.19+/-0.39 (P<0.01) and 1.15+/-0.17 vs 1.34+/-0.22 (P<0. 05), respectively. Furthermore, when RI>0. 2, PI>1. , and S/D>3. , no pregnancy occurred. These data suggest that the parameters of spiral artery blood flow could be used as a new assay in predicting endometrial receptivity before ET.
Arteries/ultrasonography ; Embryo Implantation/*physiology ; Embryo Transfer ; Endometrium/*blood supply ; Endometrium/*physiology ; Endometrium/ultrasonography ; Fertilization in Vitro ; Infertility, Female/physiopathology ; Regional Blood Flow ; Sperm Injections, Intracytoplasmic ; Treatment Outcome ; Ultrasonography, Doppler, Color

Objective To evaluate the clinical value of laparoscopic uItrasonography ( LUS) in u-rinary laparoscopic surgery .Methods In 6 cases of urological laparoscopic surgery , laparoscopic ultra-sound examination were taken , including 3 cases of simple renal cysts , 1 case of adrenal pheochromocyto-ma, 2 cases of hamartoma , were excised under the LUS guidance and the results were compared with the traditional simple laparoscopic surgery .Results With laparoscopic uItrasonography guidance , the bounda-ry and blood supply of cyst or tumor could be shown more clearly compared with trans -abdominal ultrasound . We could differ the tumors from dilated pelvis and renal calices , So the damage to the collecting system and renal blood vessels were avoided .With LUS guidance , tumors were excised more completely , so that re-mained tumor tissues would be avoided and normal renal tissues would be protected .Conclusion LUS may provide more precise surgical information and may play an important role guiding laparoscopic operation in urinary surgery .

Objective To observe the left lower limb great saphenous vein double backbone variations and then conclude correlated var -iation with articles and essays which can offer basic data reference for correlational research and treatment .Methods A male adult corpse fixed by 10%formalin was dissected , and the aberrant vessels were measured by digital caliper and Digimizer .Collected essays and articles about variation of great saphenous vein and its tributary on CNKI from January 1,2000 to May 1,2016.Results There were two major vein of left lower limb great saphenous vein from feet to foramen of saphenous vein of this corpse .The common variations of great saphenous vein and its tributary included variation of quantity and position .Conclusion The variations of great saphenous vein and its tributary do not exist alone.There are usually several variants exist together .So,taking an imaging examination before the operation of great saphenous varicose veins is the key of preventing vessels from injury and reducing the happening of complication .

Objective To evaluate the selection standard of donors of living related liver transplantation (LRLT). Methods From Jan. 1995 to Jul. 2003, 28 LRLT were performed. The preoperative examination, selection standard, postoperative complication were reviewed. Results There was no mortality for donors. Raw surface bleeding and biliary fistula occurred in one each case, and the complications were cured conservativery.Conclusions The key for LRLTlies in the safety of the donor. Living related liver transplantation is safe, while performed by a surgical team with well qualified expertise.