BACKGROUND: Rat model of orthotopic liver transplantation is a very valuable model for experimental study in liver transplantation including organ preservation, tissue ischemia-reperfusion injury, allograft rejection and immune tolerance mechanism. Stable liver transplantation animal model is the basis of the related experimental studies. However, its experimental operation is long and boring, especially performed by a single operator under direct vision. OBJECTIVE: To investigate the operation techniques to establish a stable rat model of orthotopic liver transplantation by a single operator under direct vision. METHODS: The orthotopic liver transplantation was performed using two-cuff method in 50 pairs of rats. We exposed the abdominal cavity fully, perfused the donor liver through abdominal aorta without flipping donor liver; suprahepatic inferior vena cava was in vivo cut down using one-step method, without diaphragm ring; the suprahepatic inferior vena cava was anastomosed with single-row suture, and the cuff of portal vein was installed by fixing the blood vessel forceps on rubber. Hepatic artery was not reconstructed. Fluid replacement was administered to maintain hemodynamic stability in rats after operation. RESULTS AND CONCLUSION: The donor operative time was (36.2± 2.5) minutes, donor liver trimming time was (12.2± 1.5) minutes, receptor operative time was (45.6 ± 3.5) minutes, suprahepatic inferior vena cava anastomosis time was (10.1 ± 2.1) minutes, portal vein cuff time was (1.5 ±0.9) minutes, infrahepatic inferior vena cave cuff time was (1.1 ± 0.6) minutes, anhepatic phase was (15.1 ± 2.2) minutes. The success ratio of the operation was 100% and the survival rates within 1 week and 1 month were all 100%. It is indicated that the key factors of a successful model were stable anesthesia, good donor liver perfusion, adequate exposure, skilled microsurgical technology and vascular anastomosis technique.

ObjectiveTo compare therapeutic effects of the bone-guided tissue regeneration in combination with a composite bovine-derived xenograft versus flap surgery only on intra-bony defects in elderly patients with periodontal disease. MethodsThirty elderly patients with periodontal disease were randomly divided into two groups. One group was treated by the bone-guided tissue regeneration in combination with a composite bovine-derived xenograft (experimental group). The other group was treated by flap surgery only (control group). Probing depth (PD)and clinical attachment level (AL) were determined before surgery and six months after treatment in two groups. The change of bone amount was also determined before surgery and six months after treatment through computer-assisted densitometric image analysis(CADIA). ResultsThe changes of PD and CADIA were (3.8+1.7)mm, (20. 3+11.1)g/mm2 in experimental group and were (2.5+1.1)mm, (9.4+8. 6)g/mm2 in control group. The differences between two groups were significant (P.＜0. 05). The change of AL was (3.5+ 1.6)mm in experimental group, compared with control group(2. 3 1.7)mm, which showed more obvious regeneration of alveolar bone (P＜ 0. 01). ConclusionsGuided tissue regeneration in combination with a composite bovine-derived xenograft appears to be more effective than flap surgery only for intra-bony defects in elderly patients with periodontal disease.

Objectives To explore the long-term prognosis, treatment (especially dietary treatment) of classic maple syrup urine disease. Methods The complications and dietary treatment were observed by follow-up study of a classic MSUD patient. Results The patient have obvious damage in nervous system. However, reasonable dietary leucine tolerance therapy after the neonatal period can effectively reduce the metabolic crisis and complications. A mutation in BCKDHB gene was detected in the patient by genetic testing. Conclusion It is suggested that dietary restriction and monitoring of branched-chain amino acids are helpful to reduce the development of acute metabolic crisis and complications and improve the quality of life.

AIM:To evaluate the efficacy and safety of the regimen based on platinum compound plus docetaxel in the treatment of advanced esophageal carcinoma as first-line drug,and to further explore prognostic factors of advanced esophageal carcinoma by survival analysis.METHODS:From August 2006 to October 2008,36 patients with advanced esophageal carcinoma were enrolled in the study,and non-randomly assigned to docetaxel 75 mg/m2 in the first day every 3 weeks,combined with cisplatin 25 mg/m2 in the first day to third day or in the first day to forth day(DT,n=27),or with carboplatin AUC=5 on day 1(CT,n=9).RESULTS:The curative and toxic side effects were evaluated to the 36 patients.There were 1 complete respone,17 partial respone,11 no changes and 7 progressive disease in 36 patients with total response rate of 50.00%.The response rates of DT,CT regimen were 59.26% and 22.22%(P=0.121).The major side effects were nausea-vomiting,all side effects were reversible by symptomatic treatment.After a median follow-up of 8.70 months,the overall median survival was 10.50 months(95% CI 7.36 to 13.64 months).The COX univariate regression analysis suggested there was no correlation with sex,age and the hemoglobin of before chemotherapy with existence.But there was statistical significance between the behavior state of chemotherapy and the existence(P=0.036).CONCLUSION:The regimen based on platinum compound plus docetaxel is tolerable and more effective as a first-line treatment for advanced esophageal carcinoma.Patients with good performance status before chemotherapy indicates good prognosis and it is an independent factor affecting survival for advanced esophageal carcinoma.

Objective To explore the effects of extrinsic and intrinsic recognition loading on gait in patients with Parkinson disease.Methods Eight patients with Parkinson disease and six control subjects were instrutted to walk with extrinsic and intrinsic recognition loading respectively.The gait parameters in two conditions were measured with three-dimension motion analysis equipment.FAB scale and Stroop Test were used as the evaluation of executive function.Results The velocity(cm/s),the cadence(step/min),single support and swing phase(%)in the audition stimulates condition in the patients group((113.4±14.32)step/min,(78.90±16.35)cm/s,(40.50±2.58)%,(40.50±2.58)%)were significantly better than those in the calculation condition(respectively(91.27±15.54)step/min,(63.79±21.49)cm/s,(37.95±2.61)%,(37.95±2.61)%).In the calculation condition,the coefficients of variability in stride length,swing and sinfle support phase were significantly higher in the patient group(respectively(6.69±3.99),(8.56±5.69),(8.56±5.69))than in thecontrol group(respectively(3.23±1.34),(5.02±2.54),(5.02±2.54));in the audition condition,except that,the coefficients of variability in step length and velocity also were significantly higher in the patient group(respeetively(11.92±5.86),(6.89±4.98))than the control group(respectively(7.35±3.32),(2.5±1.53)).In the patients group,the score of FAB(15.63±1.51)was lower and error rates of Stroop test(0.087±0.056)was higher than those in the control group(respectively(17.67±0.52),(0.027±0.03))significantly.The error rate of stroop-3 was significantly negative correlated with the gait variables of patient group in the calculation condition.Conclusion The extrinsic audition stimulates has lower effect on the gait of patients of Parkinson's disease than the intrinsic recognition loading.

Objective To compare the therapeutic effects in respect of ventilatory response and the change of hemodynamics of two modes of mechanical ventilation [ proportional assist ventilation (PAV) vs.Bi-level positive airway pressure ventilation (BiPAP) ] on patients with acute cardiogenic pulmonary edema (ACPE).Methods Thirty-two patients diagnosed as ACPE were recruited from May 2008 to April 2009.After conventional therapy ( cardiotonic,diuretic,vasodilators,oxygen) were ineffective for half an hour,32 patients were randomly divided into three groups:control group ( 12 cases kept conventional treatment without mechanical ventilation),BiPAP group ( 12 cases were treated with BiPAP mode of non-invasive mechanical ventilation plus conventional treatment) and PAV group (8 cases were treated with PAV mode of non-invasive mechanical ventilation along with conventional treatment ).Results PaO2,RR and oxygenation index were improved significantly in three groups after 1 hour treatment ( P ＜ 0.05 ).While PaO2 and oxygenation index in noninvasive ventilation groups were higher than those in control group ( P ＜0.05 ).The time required for amelioration of dyspnea in noninvsaive ventilation groups was shorter than that in control group ( P ＜ 0.05 ).The peak airway pressure and the index of degree of comfort ( VAS score,auxiliary respiratory muscles score) in PAV group were lower than those in BiPAP group (P ＜ 0.05 ).Conclusions Both modes of noninvasive mechanical ventilations could improve the oxygenation and relief of dyspnea in patients with ACPE.PAV and BiPAP had the similar effect in patients with ACPE.The synchronization and comfort in PAV group were better than those in BiPAP group.The PAV mode of noninvasive mechanical ventilation was well accepted by patients with ACPE.

.This study is to investigate the analgesic effect produced by intrathecal injection (ith) of oxysophoridine (OSR) and the mechanism of GABAA receptor. Warm water tail-flick test was used to detect the analgesic effect of OSR (12.5, 6.25, and 3.13 mg.kg-1 ith) and to observe the influence of GABA (gamma aminobutyric acid) agonist or antagonist on the analgesic effect of OSR in mice. Immunohistochemistry method were used to detect the influence of OSR (12.5 mg.kg-1, ith) on the GABAARalpha1 protein expression in spinal cord. The results obtained covers that OSR (12.5 and 6.25 mg.kg-, ith) alleviates pain significantly with the warm water tail-flick test (P<0.05, P<0.01), the rate of pain threshold increases by 68.45%; GABA and muscimol (MUS) produces analgesic synergism together with the OSR, picrotoxin (PTX) and bicuculline (BIC) antagonize the analgesic effect of OSR; OSR (12.5 mg.kg-1, ith) significantly increase the positive number of GABAARalpha1 nerve cell in spinal cord (P<0.01) and significantly decrease the average grey levels (P<0.01). In conclusion, OSR intrathecal injection has significant analgesic effect. And GABAA receptor in spinal cord is involved in the analgesic mechanism.

Objective To investigate the relationship between the genetic polymorphisms of glutathione S-Transferase M1,T1 and the susceptibility to sporadic colorectal adenocarcinoma(SCRAC) and smoking and alcohol consumption in Chinese Hans.Methods Multiplex polymerase chain reaction (M-PCR) was used in the study of genetic polymorphisms of GSTM 1,T1 gene.Logistic analysis was performed to elucidate the roles of GSTM1,GST1,smoking and alcohol.Results The null GSTM1,T1 genotypes could increase the susceptibility to SCRAC(OR=1.711,95% CI:1.043～2.805;OR=1.734,95% CI:1.057～2.843),but smoking and alcohol consumption made no significant effect on SCRAC(OR=0.584,95% CI:0.356～0.958;OR=0.378.95% CI:0.217～0.657).Further stratification of the SCRAC patients by chnical features showed that there were no relationship between the GST M1,T1 genotype and the age of the SCRAC patients.But the frequency of null GSTM1 genotype was significantly associated with distal colon adenocarcinoma (P=0.021),colorectal adenocarcinoma of Dukes C classification (P=0.003) and poor difierentiation (P=0.020),respectively.The frequency of null GSTF1 genotype was only higher in colorectal adenocarcinoma of Dukes C classification(P=0.041).No relationship was found between the location,the degree of differentiation and the frequency of null GSTF1 genotype(P＞0.05).Furthermore,the frequencies of homozygous deletion in GSTM1,T1 genes were found to be significantly increased in SCRAC patients than those in healthy controls(38.9%VS25.7%.P=0.023).Conclusion The GST genotype is strongly correlated with SCRAC incidence in Chinese Hans.The null GSTM1,T1 genotypes can enhance the genetic susceptibility to SCRAC.while smoking and alcohol consumption have no significant effect on the susceptibility to SCRAC.

PurposeTo evaluate the existence and extent of magnetic resonance(MR) artifacts caused by frequently used metallic dental materials and to compare the influence of different MRI sequences on artifacts.MethodsA total of 22 kinds and 25 metallic dental samples were tested with 1.5 T MR imager and gradient-echo sequence. Spin-echo and fast spin-echo were added to parts of these samples. Results Of all the 25 metallic dental samples, 11 including gold, amalgam, and silver point did not produce artifact. Titanium alloy and porcelain product fused in metal had mild artifacts. Whereas the remaining 12 samples such as the retention pin and pivot pin showed severe artifacts. Artifacts produced by retention pin, nickel chromium crown and so on were less severe on fast spin-echo. ConclusionsAttention should be paid to some of the metallic dental materials, which could cause severe MR artifacts and image degradation, when undergoing face,jaw and head MR examination. Artifacts can be alleviated by using proper metallic materials or choosing proper imaging sequence and parameters.

Objective To discuss the curative effects of alfacalcidol combined with losartan potassium tablets in the treatment of early diabetic nephropathy (EDN).Methods 90 EDN patients in our hospital were chosen and randomly divided into the observation group and control group (45 cases in each group).The control group was given losartan potassium tablets treatment,while the observation group was given alfacalcidol combiend with telmisartan treatment.All the two groups were treated for 3 months.Before and after treatment,the fasting blood glucose (FBG), 24h urine trace albumin quantitative (UAER),24h urine protein (24h pro),serum creatinine (SCr),25 -hydroxyl vitamin D [2 5 (OH )D ],blood calcium (Ca2+),potassium (K+),glycosylated hemoglobin (HbA 1 C )and serum inflammatory factors[C-reactive protein (CRP),tumor necrosis factor alpha (TNF-α),interleukin-6 (IL-6 )] were observed,and the correlation between 25 (OH)D and UAER,24h pro was analyzed.At the same time,the clinical curative effects and adverse reactions during treatment were evaluated.Results In the observation group,the total effective rate was 93.3%,which was significantly higher than 71.1% in the control group (χ2 =7.601,P<0.05).In the two groups after treatment,the FBG,HbA1c,blood Ca2+and K+had no significant changes (all P>0.05).After treatment,Scr,24h pro and UAER in the two groups were all significantly reduced compared with before treatment (P<0.05),and 24h pro and UAER in the observation group were significantly lower than those in the control group (t=6.296,11.530,all P<0.05),but Scr had no statistically significant difference between two groups (t=0.331,P>0.331).After treatment,25(OH)D in the observation group decreased significantly compared with before treatment (t=12.000,P<0.05),which was significantly higher than that in the control group after treatment (t=11.278,P<0.05).Compared with before treatment,25(OH)D in the control group had no significant change after treatment (t=0.436,P>0.436).Pearson correlation analysis showed that 25 (OH)D level was negatively correlated with 24h pro and UAER (r=0.483,0.778,all P<0.05 ).In the two groups after treatment,the CRP, TNF-αand IL-6 levels significantly reduced (P<0.05 ),which in the observation group decreased more obviously (all P<0.05).In the two groups,no serious adverse events were found,the difference was not statistically significant (χ2 =0.212,P >0.151 ).Conclusion Alfacalcidol combined with losartan potassium tablets can significantly reduce the proteinuria levels of EDN patients and inflammation,which has better clinical curative effects and higher safety.