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.

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 .

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

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 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

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 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.

Objective To assess the diagnostic performance of real-time contrast-enhanced ultra-sound Sonovuein diagnosing minute rabbit liver VX 2 tumors with diameter ≤10.0 mm.Methods Thir-ty New Zealand white rabbits inoculated with VX 2 tumor ( left, right lobe of each ) were examined by two-di-mensional ultrasound and CEUS .The contrast enhanced mode of small rabbit liver VX 2 tumors in different phase was observed and tumor in the rabbit's liver was pathologically verified .The diagnostic performances of two-dimensional US and CEUS in detecting the rabbit VX 2 tumors were analyzed and compared .Results Thirty-nine tumors were pathologically verified .The detection rates of small tumors by CEUS and two-di-mensional US were 12.8% and 79.5%, respectively , yielded significantly higher than that of 2-D US. Conclusion Real-time CEUS significantly improves the detection rates of small rabbit VX 2 liver tumors less than 10.0 mm in diameter .

objective To investigate preoperative donor and recipient assessment,choice of surgical options in living donor liver transplantation(LDLT).Methods The clinical data of 95 patients who underwent LDLT from January 1995 to October 2007 in our center were retrospectively analyzed.Of all,92 recipients were benign end-stage liver disease patients (including 45 patients with Wilson disease),and 3 were malignant hepatic carcinbma patients.Results Thirty-one fight lobes without middle hepatic vein(MHV),3 right lobes with MHV,51 left lobes with MHV.and 10 left lobes or left lateral lobes without MHV were obtained.All the donors recovered after operation. Recipients with benign end-stage liver disease were followed up for 1 to 86 months,and the 1-,3-,5-year accumulative survival rates were 89%(82 cases),78%(71 cases)and 73%(67 cases),respectively. The 1-,3-,5-year survival rates of patients with Wilson disease were 92%(42 cases),89%(40 cases)and 76%(34 cases),respectively. For the 3 patients with malignant hepatic carcinoma,2 died and 1 was alive and well. The copper metabolism was back to normal in both donors and recipients. Conclusions Establishment of a system for the safety of donors is basic for LDLT. The key to raise the recipients' survival rates is to choose the optimal surgical approach. LDLT is effective in treating Wilson disease.