Liver transplantation has become an effective and routine treatment for end-stage liver diseases with the employing of new immunosuppressants and surgical techniques. The characteristics of our country's liver transplantation are as follows: the indication for liver transplantation consists mainly of HBV related end-stage liver diseases, patients with liver cancer beyond Milan criteria account for a high rate, and donor origin is not definite. The author thinks that liver transplantation in our country should emphasize basic clinical research, such as prevention of HBV reinfection and tumor relapse after liver transplantation, employing of marginal donor, organ function protection, immunology of liver transplantation, and specific infection around liver transplantation.

With the development of hardware and software in engineering,the medical robotic techniques makes up for the shortage of conventional laparoscopy,and has good prospect in the field of surgery.In this paper,the application of medical robotic techniques in digestive surgery was focused.Extraneous medical robotic system and intrinsic miniature medical robot are 2 main categories.Most digestive operations,such as cholecystectomy,pancreaticoduodenectomy,lobectomy,antireflux surgery could be carried out by the extraneous medical robotic system,and the intrinsic miniature medical robot is still under research.Benefiting from the cooperation of the surgeons and the engineers,it is certain that the medical robotic techniques could play a more important role in digestive surgery.

Caudal-type homeoboxgene transcription factor 2 is one member of the caudal- related homeobox family,is a transeription factors important in intestinal epithelial development and in the differentiation and maintenance of the intestinal phenotype.In adulthood,these two proteins are strictly confined to the gut and are predominantly expressed by the epithelium of the small intestine and colon,but not by the normal epithelium of the oesophagus and stomach.In intestinal metaplasia,caudal-type homeohoxgene transcription factor 2 upregulation can be a direct effect of injurious agents on epithelial cells and/or can be due to the inflammatory environment of EpM,exposure to acid and/or bile acids may activate caudal-type homeoboxgene transcription factor 2 expression in human esophageal epithelial cells through promoter demethylation,and ectopie caudal-type homeoboxgene transcription factor 2 expression in esophageal squamous epithelia.It has been suggested to play an important role with retinoic acid,MUC2,p63 gene,BMP4 and many other factors working together to promote the development of this process in intestinal metaplasia and cancers.

With the development of minimally invasive surgery,great developments have been made in laparoscopie techniques and digestive endoscopy.However,laparoscopy may cause injury by abdominal puncture,and digestive endoscopy is a painful examination for patients and is difficult to localize the tumor.Magnetic anchor makes use of magnetic attraction in positioning,and it improves laparoscopy and endoscopy by external magnetic field or magnetic handle.Nowadays,combined application of magnetic anchor and laparoscope and endoscope in the treatment of digestive diseases has been accepted by many medical centers,and further researches need to be carried out to realize the aim(small trauma,little pain and quick recovery)of minimally invasive surgery.

Caudal-related homeobox transcription factor (CDX-2) is selectively localized in the fetal and adult mu-cosal epithelial nuclei of normal small and large intestines.CDX2 plays an important role in the regulation of cell proliferation and differentiation of the intestinal epithelium. Ec-topic expression of CDX-2 in the stomach, esophagus and other hollow organs might be a cause of intestinal metaplasia and adenocarcinoma. CDX-2 is expressed in both cultured and primary gallbladder carcinoma cells, and dysplasia.CDX2 is not detected in normal gallbladder and biliary tract mucosa. Ectopic CDX2 expression is an early event in gallbladder carcinogenesis. The frequency of CDX-2 expression is significantly higher in well-differentiated type than in the moderately and poorly differentiated tumors. The present study clearly showed that MUC2 expression in intestinal differentiation was dependent on the nuclear expression of CDX-2 in intraductal papillary neoplasia of the liver (IPNL)and mucinous intrahepatic cholangiocarcinoma (ICC) in the same manner as in the gastric mucosa and Barrett s esophagus. CDX-2 may also be a key factor in gallbladder carcinogenesis with intestinal differentiation and is a useful immuno-histochemical marker of intestinal differentiation in intestinal metaplasia of the gallbladder. CDX2-dependent regulation of cell proliferation may be an important factor in defining prognosis of patients with BTC.

Objective To compare the characteristics of endogenous ouabain(EO) secretion with the other adrenocortical hormones and determine the effects of angiotensin Ⅰ (Ang Ⅰ ), and adrenocorticotrophin(ACTH) on the secretion of EO. Methods EO was measured by radioimmunoassay from primary cultured bovine adrenocotical cells (BAC). Results ①Ouabain was determined in the media of cultured BAC. Both EO and aldosterone secretion were decreased from the outer to inner layer of the cultured adrenal cortex, and the responses to Ang Ⅰ and ACTH were higher than that in the mid layer (P ＜0. 05) and inner layer (P ＜0. 01). Cortisol secretion was activated by Ang Ⅱ or ACTH was significantly higher in the mid layer and in the inner layer than that in the outer layer. ②The time-course experiment showed that the gradually rising amounts of aldosterone and cortisol could be determined dur ing the continuous incubation to 48h with or without Ang Ⅰ or ACTH. However, EO did not increase continuously af ter 24h of incubation in the basal secreting situation and after 12h of incubation in the stimulating situation by Ang Ⅱ or ACTH. ③There were obvious drops in aldosterone and cortisol secretion from 3rd day during a 21 day-period cell culture, but the peak secretion of ouabain was in 7th day. Conclusion It suggests that the secretory mechanism might be different between EO and aldosterone or cortisol. Also, Ang Ⅱ and ACTH might be involved in the regulation of EO secretion.

Abstract?AlM: To observe the anterior chamber angle shape of patients with diabetic retinopathy ( DR) at different stages using OCT, and to explore a more sensitive and accurate glaucoma preventing measure.?METHODS: A total of 613 cases of DR patients were divided into proliferation phase group ( 353 cases ) and background phase group ( 260 cases ) , another 100 cases of patients with only diabetes were selected as control group. OCT was used to detect the anterior chamber angle related parameters, including angle opening distance ( AOD) , trabecular-iris space area ( TlSA) , angle recess area ( ARA ) , anterior chamber depth ( ACD ) and anterior chamber angle ( ACA) .?RESULTS: There were significant difference among AOD500, AOD750, TlSA500, TlSA750, ARA500 and ARA750 of control group, proliferation phase group and background phase group ( P< 0. 01 ). The proliferation phase group was the lowest, AOD500, AOD750, TlSA500, TlSA750, ARA500 and ARA750 were 0. 60 ± 0. 22mm, 0. 78 ± 0. 39mm, 0. 22 ± 0. 12mm2 , 0. 45 ± 0. 19mm2 , 0. 29 ± 0. 18mm and 0. 46 ± 0. 15mm, respectively. There were significant difference among ACA500, ACA750, ACD500 and ACD750 of control group, proliferation phase group and background phase group ( P< 0. 01 ). The proliferation phase group was the lowest, ACA500, ACA750, ACD500 and ACD750 were 30. 29o ± 8. 19o, 21. 20o ± 7. 40o, 2. 32 ± 0. 23μm and 2. 52±0. 16μm, respectively. ln addition, ROC results indicated that all these indices exert significant difference on evaluating the stage of DR. ?CONCLUSlON: Anterior chamber angle shape detected using OCT can reflect the change of retinopathy. OCT is an accurate and simple technique for detecting DR staging.

ObjectiveTo investigate the sequelae and relative factors of sensation disorders of lateral skin of the incision after total knee arthroplasty (TKA) and to explore its effect on knee function.MethodsThirty-six patients (53 knees) who underwent TKA were continuously selected in this study.The length of the incision and the area of sensation disorders of skin around the incision were measured 1 week postoperatively.The area of sensation disorders of skin around the incision was measured again 1.5 years postoperatively,and the range of motion of the knee and the knee society score (KSS) were recorded.ResultsAll of the patients presented with objective hypesthesia of lateral skin of the incision.Twenty-six (72％) patients existed subjective numbness,whose areas of hypesthesia were larger than those of patients without subjective numbness.The average area of hypopselaphesia and average area of hypalgesia were(36.43±14.71) cm2 and (69.62±23.48) cm2,respectively.Both of them had positive correlation with the length of the incision (r=0.303,P=0.04; r=0.318,P=0.03).One and a half years postoperatively,besides 5 patients recovered completely,all other patients existed no hypopselaphesia,and the average area of hypalgesia was(8.55±4.56)cm2,which was statistically different with that 1 week postoperatively(t=2.553,P=0.012).The KSS score was lower in patients with subjective numbness than that in patients without subjective numbness (t=2.066,P=0.044).ConclusionThe hypesthesia of lateral skin of the incision is common after TKA,which can recover partially or completely over time.All patients should be advised of this complication as part of their informed consent before TKA.

Objective To search for triterpene glycoside with new structure. Methods We studied the sea cucumber Colochirous anceps belonging to the family cucumariidea with many chromatography methods and found a new sulfated triterpene glycoside, which structure was established by a combination of spectroscopic analysis (IR, UV, ESI-MS and 2D-NMR), chemical transformations and other chemical evidence. Results and Conclusion The new sulfated triterpene glycoside was isolated and named Colochiroside A (1) .

This paper reports the nursing care of 12 patients with idiopathic scoliosis treated with halo-pelvic traction preoperatively which focused on breathing training, traction frame management. One patient suffered from temporary brachial plexus injury and four cases suffered from superior mesenteric artery syndrome. With 14-21 day's traction and nursing care, the correction rate of Cobb angle was 35%-50%,the forced vital capacity was improved by 25%,and all the patients received orthomorphia surgery in time. It is suggested that the patients with severe idiopathic scoliosis treated by halo-pelvic traction could take out-of-bed activity freely. It could not only relieve pain and reduce mental pressure, but also improve the safety of orthomorphia surgery.