Objective To study the role of cover-stent and embolization in the treatment of hepatic artery pseudoaneurysm following liver transplantation.Methods 5 patients with hepatic artery pseudoaneurysm after liver transplantation were treated with cover-stent and embolization between May 2010 and July 2013.The clinical features,imaging findings and complications were reviewed.Results All the 5 patients with hepatic artery pseudoaneurysm were successfully treated.2 patients with intrahepatic pseudoaneurysm received embolization.Of the 3 patients with extrahepatic pseudoaneurysm,2 received cover-stent treatment,and 1 patient received embolization.No complications related to the interventional treatment were encountered.2 patients died from multi-organ failure one month after the interventional treatment.Conclusion Cover-stent and embolization were effective and safe to treat patients with hepatic artery pseudoneurysm following liver transplantations.

Objective To explore a new methodology for surgical treatment of severe retracted nipple in women. Methods 20 patients with inverted nipple and 4 recurred patients were involved in this study. Firstly, the site of neonipple tip was marked in the central part of the inverted nipple and its mean diameter usually was 1.2-1.5 cm. Then two shallow and deep triangular pedicled flaps were designed, respectively, in both superior and inferior areas near areola. With temporary traction of the nipple apex provided by a stay suture, the fibrotie bands underneath the nipple base might be cautious-ly released. Moreover, the shallow skin flaps should be about 0.5 cm in thickness and their blood sup-ply was from the subdermal arterial rete of the areola, which were used to cover and reconstruct the neck area of neonipple after a clockwise rotation and advancement simultaneously. While the deep fas-cia tissue flaps were revolved and advanced either horizontally to the opposite pedicle or upward to the inner tip through the tunnel underneath the nipple base in order to improve the height or width of the neonipple neck and prevent flattening as the supporting tissue and their blood supply was from some small perforating branch arteries in the deep part of mammary gland. Finally, purse-string suture was necessary in the base of neonipple which played a key role in avoiding recurrence of nipple inversion. Four vertical diamond-shaped excision-suturation treatment in neck area could make improvemts on the height of those stout and short nipples. Results In all 24 cases corrected by shallow and deep triangu-lar flaps rotation, after 3-6 months' follow-up, there were no complications related to surgery such as infection, hematoma, permanent sensory disturbance, or nipple necrosis, and postoperative recovery was rapid and uneventful. Especially, follow-up data revealed no evidence of recurrence of inversion and all patients were satisfied with their results. Conclusions Triangular flaps and fascia-tissue flaps in shallow and deep areola rotation is effective and easy to be popularized in correction of inverted nip-ple. This technique can improve both the diameter and height of the nipple, and certainly lower the re-currence rate of nipple inversion and achieve good aesthetic results.

Objective To evaluate the clinical value of bedside index for severity in acute pancreatitis (BISAP) and APACHEⅡ score in predicting the severity and organ failure of acute pancreatitis (AP).Methods One hundred eighty-five patients of AP admitted to Department of Gastroenterology of First affiliated Hospital of Soochow University from January 2012 to December 2014 were studied retrospectively.According to BISAP score, patients who were ≥3 points were considered as high risk group, while ＜3 points were considered as low risk group.According to APACHEⅡ score, patients who were ≥ 8 points were considered as high risk group, while ＜ 8 points were considered as low risk group.According to the criteria of Pancreatic Diseases Group of Chinese Society of Gastroenterology of Chinese Medical Association, the patients were diagnosed as mild acute pancreatitis (MAP), moderately severe acute pancreatitis (MSAP), and severe acute pancreatitis (SAP).The BISAP, APACHEⅡ scores were calculated and compared between MAP group and MSAP + SAP group, respectively.The incidence of MSAP + SAP between high risk group and low risk group was also compared.The area of ROC curve (AUC) was used to evaluate the ability of BISAP and APACHEⅡ scoring system for predicting the severity of AP and the multiple organ dysfunction syndromes (MODS).Results Among 185 patients, MAP was identified in 101 patients, MSAP in 76 patients and SAP in 8 patients.Twenty-five MSAP patients developed organ dysfunction, and all the 8 SAP patients developed organ dysfunction.The BISAP scores of MSAP + SAP group and MAP group were (1.43 ± 0.89), (0.38 ± 0.61),andAPACHⅡ scores were (2.45± 1.36), (0.87± 0.62), the scores of MSAP+ SAP group were significantly higher than those in MAP group (P ＜0.01).In the 137 patients of low risk BISAP group, there were 47 MSAP + SAP patients (34.3％), while in the 48 patients of high risk BISAP group, there were 37 MSAP + SAP patients (77.0％);in the 153 patients of low risk APACHEⅡ group, there were 56 MSAP + SAP patients (36.6％), while in the 32 patients of high risk APACHEⅡ group, there were 28 MSAP + SAP patients (87.5％);the incidence of MSAP + SAP patients was significantly higher in high risk group than that in low risk group (P＜0.01).The AUC of BISAP, APACHEⅡ for MSAP+ MAP was 0.804 (95％ CI 0.738 ～ 0.870), 0.794 (95％ CI 0.725 ～ 0.863), and the AUC for organ dysfunction was 0.758 (95％ CI 0.686 ～0.830), 0.781 (95％ CI 0.710 ～0.852) , and the difference between BISAP and APACHE Ⅱ was not statistically significant (P ＞ 0.05).Conclusions The BISAP has the prediction ability for AP severity and prognosis similar to APACHEⅡ , and it consists of only 5 parameters and can be completed in the first 24 h of admission, therefore it is worth of clinical application.

Objective To evaluate the medium and long-term therapeutic results of percutaneous transhepatic angioplasty for portal vein stenosis (PSV) following pediatric liver transplantation.Methods From Jan.2008 to Dec.2012,5 cases with PVS after pediatric liver transplantation received percutaneous transhepatic angioplasty.There were 3 male and 2 female cases ranging from 7 months to 8 year-old with the median age of 2 years and 10 months.The protopathy included 1 Carolis disease and 4 congenital biliary atresia.The therapeutic results were monitored by clinical follow-up and imaging examination.The clinical data,imaging examination and therapeutic results were analyzed.Results All interventions were performed successfully,and the treatment efficacy was 100％.One patient was diagnosed with earl-onset PVS at 0.5 month after liver transplantation.Four patients were diagnosed with late-onset PVS at 3-30 months after liver transplantation.The prestenotic portal venous average diameter was (2.3 ± 0.6) mm (1.2-3.0 mm),the degrees of stenosis were 70％-95％.The poststenotic portal venous average diameter was (9 ± 1) mm (8-10 mm) (t =32.560,P ＜ 0.05).The prestenotic portal venous average pressure gradient was (11.0 ± 3.2) mmHg (8-16 mmHg),and the poststenotic portal venous pressure gradient was(2.2 ± 1.5) mmHg(0-4.0 mmHg) (t =8.242,P ＜ 0.05).Postoperative follow-up was 10-66 months,the portal veins of all cases were patent,and patency rate was 100％.Conclusions Percutaneous transhepatic stent angioplasty is an effective and safe method for treatment of PVS following liver transplantation.Its medium and long-term patency rates are high.

Objective To evaluate the therapeutic effectiveness of percutaneous endovascular treatment of hepatic venous outflow obstruction (HVOO)after pediatric liver transplantation(LT).Methods From January 2008 to January 2013,10 children with obstruction of hepatic vein (HV) or inferior vena cava (IVC) anastomosis underwent percutaneous transluminal angioplasty (PTA) with balloon dilation or stent placement.The hepatic venous outflow obstruction occurred 10-455 days (median,125 days) after pediatric liver transplantation.According to the time of obstruction,the obstruction was divide into early onset (＜1 month) and late onset(＞1 month).The effectiveness of PTA was analyzed.Results Twenty-one procedures were performed.One treatment was ineffective,and technical and initial clinical success ratio was 95.2％ (20/21) and 70.0％ (7/10),respectively.In 3 cases with early onset after LT,operation was performed after unsuccessful PTA in 1 case.One patient who developed recurrent stenosis was treated with PTAS.The other patient died of acute rejection.Late onset after LT was found in 7 cases,who were treated with PTA or stent successfully.Conclusions In cases of venous outflow obstruction resulting from HV and/or IVC lesions after pediatric liver transplantation,percutaneous endovascular treatment with balloon dilation or stent placement is a safe and effective alternative treatment that results in midterm and long-term patency.Early-onset or hepatic veins combined with superior vena cava obstruction should be implanted with stents as early as possible.Late-onset or hepatic veins obstruction alone can be get better results with Balloon Dilatation.

Objective To explore the action mechanism of basic fibroblast growth factor (bFGF) on vascular smooth muscle cells (VSMCs) in spontaneously hypertensive rats (SHR).Methods Ts were obtained from SHR and SD rats.The aortic VSMCs were cultured in vitro by tissue explant method.VSMCs were treated with different concentration of exogenous bFGF (0 ng/ml,20 ng/ml,40 ng/ml,60 ng/ml,80 ng/ml,100 ng/ml) for 48 h,then cell proliferation was detected by 3 (4,5 dimethylthiazol)2,5 diphenyltetrazolium bromide (MTT) colorimetric assay.VSMCs from SHR in control group were treated with bFGF (100 ng/ml) for 48h.VSMCs from SHR in treatment group were treated with bFGF (100 ng/ml) plus Proteinkinase C(PKC) inhibitor (staurosporine) for 48 h.Results After treatment with different concentration (0 ng/ml,20 ng/ml,40 ng/ml,60 ng/ml,80 ng/ml,100 ng/ml) of bFGF for 48 h,the values measured by MTT colorimetric method were 0.402 ± 0.103,0.605 ±0.090,0.696 ± 0.131,0.812 ± 0.080,0.901 ± 0.065,1.056±0.078 respectively in aortic VSMCs from SD rats,and 0.404±0.065,0.507±0.078,0.608±0.057,0.704 ± 0.107,0.812 ± 0.097,0.908 ± 0.032 respectively in aortic VSMCs from SHR.Compared with control group,the values measured by MTT colorimetric method were decreased in treatment group (P＜0.05).The proliferative effect of bFGF in aortic VSMCs from SHR was attenuated after administration of PKC inhibitor staurosporine.Conclusions Exogenous bFGF administration promotes VSMCs proliferation in SHR and SD rats in a concentration-dependent manner.PKC plays an important role in the signal transduction mechanism in VSMCs proliferation by exogenous bFGF.

Objective To evaluate the therapeutic results of percutaneous transhepatic stent angioplasty in patients with portal vein stenosis following liver transplantation.Methods From 2005 to 2013,38 patients developed portal vein stenosis following liver transplantation.Percutaneous transhepatic angioplasty of the portal vein stenosis was performed on these patients.The results were monitored by clinical follow-up and imaging studies.Results Percutaneous transhepatic angioplasty was successful in these patients.Self-expanding metallic stents (n=7),balloon-expandable coronary stent (n=29),and membranous stent (n=1) were used.The follow-up period ranged from 3 to 90 months.Portal venous patency was maintained in 34 patients (one patient died due to multi organ failure,1 patient accepted a third liver transplantation because of biliary tract complication,and 1 patient received a repeat placement of a membranous tent because the portal vein stent was blocked by a tumor thrombus,and 1 patient developed stent restenosis).There was 1 patient who developed hemorrhage in the early postoperative period (2.63％).A diagnosis of hepatic artery hemorrhage was made by hepatic artery angiography and the patient was treated by interventional embolization.Conclusion Percutaneous transhepatic stent angioplasty is an efficacious and safe method to treat portal vein stenosis following liver transplantation.

This article presented our experience on transcatheter arterial chemoembolization (TACE) and portal vein embolization (PVE) before hepatic resection for huge hepatocellular carcinoma with cirrhosis.The preoperative future liver remnant/total estimated liver Volume (FLR/TELV) ratios of 5 patients were less than 40％,and preoperative TACE was implemented 3 weeks after PVE.In all these patients,right hepatectomy was successfully implemented.Preoperative TACE and PVE expanded the indication of hepatectomy,increased the safety of surgery and improved the curative rate.

Objective To explore the effect of praziquantel on schistosomal ovum granuloma in the lung of mice.Methods Forty-eight mice were divided into 4 groups.Group A:first,the mice were injected with schistosomal ova hypodermicly in abdomen and 10 days later,injected with schistosomal ova intravenously in the cauda;Group B:in addition to the injection of schistosomal ova as the same of Group A,the mice were administered with praziquantel [300 mg/(kg?d)] for 3 days from the last day of the intravenous injection of the ova;Group C:in addition to the injection of schistosomal ova as the same of Group A,the mice were administered with praziquantel(75 mg/kg,B.i.d.)for 5 days weekly until the mice were sacrificed;Group D:the same as Group C but praziquantel was given to the mice from the 29th after the intravenous injection of the ova.Three mice of each group were sacrificed on the 7th,14th,28th,56th day after the intravenous injection of the ova and the lung tissues were fixed with formalin and the slices were HE stained.Fifteen-thirty pieces of schistosomal ovum granuloma were examined and their areas were measured and the mean areas of each group were calculated and compared.Results On the 7th,14th and 28th days after the intravenous injection of the ova,the mean area of schistosomal ovum granuloma in Group C was significantly less than that in Group A,and there was a significant difference between the two groups,P 0.05.On the 56th day,the mean areas of schistosomal ovum granuloma in Group B,C,D were significantly less than that in Group A,all P

Objective To investigate the curative effect of auditory integration training (AIT) on autism spectrum disorders (ASD) in children with abnormal brainstem auditory evoked potential (BAEP).Methods 56 cases of ASD patients with abnormal BAEP were treated with AIT (aged 2-6 years).BAEP will be reviewed after each course of treatments until the test results were back to normal or had no obvious changes.Children' s core symptoms were evaluated by using autism behavior checklist (ABC) and the childhood autism rating scale (CARS) before and after treatments.Results 56 children accepted (1.95±0.92) courses of AIT.Compared with the data before AIT,CARS scores ((36.32± 3.54),(34.11 ± 3.12)),scores of the sensory factor((5.65±4.61),(4.28±4.11)) and the stereotypes factor of ABC were decreased significantly(P＜0.05).After treatments,BAEP of 29 cases (51.79％) went back to normal levels.The bilateral wave incubation periods on left side (Ⅰ:(1.81 ± 0.17) ms,(1.71 ± 0.12) ms,Ⅲ:(4.14 ± 0.18) ms,(4.07 ±0.17)ms,V:(6.09±0.23)ms,(5.97±0.22) ms)and right side (Ⅰ:(1.79±0.17) ms,(1.74±0.13) ms,Ⅲ:(4.15±0.16) ms,(4.07±0.16) ms,V:(6.06±0.23) ms,(5.99±0.26) ms) were significantly shortened (P＜ 0.05).Conclusion AIT can improve the functional handicap of auditory pathway in brainstem of ASD children,and the core symptoms of ASD.