As one of the commonest postoperative complications after liver transplantation,fungal infection has a high incidence and mortality.Nowadays,the development of the organ transplantation technique in China has already entered into the era of donation after citizen's death (DCD).Donors of DCD are mainly derived from the patients after brain death,cardiac death or death of both brain and cardiac.These donors usually suffer from long-term hypotension,ischemia,anoxia and secondary recessive or dominant infections during emergency treatment.Hence,preventing the fungal infections in donor organs and recipients after transplantation plays an important role in improving the success rate of liver transplantation.This review focuses on the clinical significance of preventing fungal infection in DCD of liver transplantation.

Objective To evaluate the morphological characteristics of large and small infrarenal abdominal aortic aneurysm (AAA) with 64-slice spiral CT angiography (CTA). Methods Forty-five patients with infrarenal true AAA underwent CTA. The morphological characteristics of AAA were evaluated. The patients were divided into two groups: small AAA (diameter<5 cm, n=20) and large AAA (diameter≥5.0 cm, n=25). The clinical risk factors and morphological characteristics between small and large AAA were compared. The correlation between the size of AAA and the other morphological characteristics was analyzed. Results Compared to patients with small AAA, those with large AAA showed lower systolic blood pressure and larger prevalence of smoking (P＜0.05). The length of aneurysms body, diameter of proximal and distal neck, the prevalence of thrombus in posterior wall, and aneurysm wall calcification score in large AAA were significantly larger than those of small AAA (P＜0.05). The length of AAA was positively correlated with proximal neck angle (r=0.418, P＜0.01) and diameter (r=0.411, P＜0.01), whereas negatively correlated with entry angle (r=-0.478, P＜0.01)and proximal neck length (r=-0.562, P＜0.01). Conclusion The size of infrarenal AAA is associated with the other morphological characteristics.

Data mining technology has become a powerful tool in traditional Chinese medicine (TCM) research. In this paper, based on the principle and basic requirements of data mining, the mining methods and procedures were described. And then the application of data mining technology in Chinese medicine pair research was classified and summarized, such as the compatibility characters, characteristic pairs, dosage-effect relationship and property compatibility, which provide the direction and data base for modern research of Chinese medicine pair.
Cluster Analysis ; Data Mining ; methods ; Drug Interactions ; Drug Prescriptions ; Medicine, Chinese Traditional ; methods

Basic knowledge of forensic science is theoretical and abstract,therefore,confir-matory experiment teaching is often adopted in the experiment teaching. International education has become an important topic in medical colleges and universities. Forensic medicine is a compulsory subject for medical international students. This article discussed the exploration and practice in teach-ing forensic medicine for international students at Wenzhou Medical University,which included faculty constructing and training,encouraging whole English teaching by young teachers,applying heuristic interactive teaching and case teaching,establishing strict attendance and appraisal system and con-ducting comprehensive evaluation on medical teaching quality and teaching management.

Objective To explore the optimal cut-off points of body mass index(BMI),percentage of body fat(PBF) and body fat mass index(BFMI) for identification of cardiovascular risk factors clustering among elderly males. MethodsThe data of physical examinations from 1 052 Shanghai elderly males in 2007 were collected.The relationship between cardiovascular risk factors clustering and different strata of BMI,PBF and BFMI was analyzed.Receiver Operator Characteristic(ROC) curve analysis was employed to determine the optimal cut-points for identification of cardiovascular risk factors clustering,and area under curve(AUC) was worked out.The population attributable risk proportion(PARP) of risk factors clustering was calculated. Results Odds ratios of risk factors clustering tended to increase with BMI,PBF and BFMI.BMI≥24 kg/m2,PBF≥21% and BFMI≥5 kg/m2 were the cut-off points that had approximate sensitivity and specificity,and/or had the shortest distance in ROC curve.AUC of all the three indexes was larger than 0.5.Analysis of PARP indicated that BMI under 24 kg/m2,PBF under 21% and BFMI under 5 kg/m2 could prevent 27.1%,37.44% and 36.63% risk factors clustering,respectively. Conclusion BMI≥24 kg/m2,PBF≥21% and BFMI≥5 kg/m2 can well reflect the cardiovascular risk factors clustering among elderly males.

Objectives To detect the cord blood vitamin D level in neonates and to determine the association between the cord blood vitamin D level and neonatal outcomes. Methods A total of 223 eligible mother-and-singleton-offspring pairs were recruited. The information of mothers' pregnancy was collected by questionnaires. The weight, length, and head circumference of neonates were measured. The levels of 25(OH)D in cord blood of neonates and in blood of late pregnancy mothers were determined by chemiluminescence immunoassay. Results The median concentration of 25(OH)D in cord blood was 20.7 nmol/L, and 82.1% of neonate had vitamin D deficiency, and 12.1% had severe vitamin D deficiency (<10 nmol/L). The concentration of 25(OH)D in cord blood was consistent with that in blood of late pregnancy mother. The distribution of concentration of 25(OH)D in cord blood was significantly different in neonates in different seasons of birth (P<0.05). There were more cases <10 nmol/L in winter and spring. The concentration of 25(OH)D in cord blood had no significant associations with the incidences of low birth weight (LBW) and small for gestational age (SGA) (P>0.05). After the variables of sex, gestational age and birth season are controlled, the birth weight and head circumference were significantly different in neonates with different concentrations of 25(OH)D in cord blood (P<0.05). Conclusions The concentration of 25(OH)D in cord blood in term neonates was generally lower. The vitamin D status in neonates was consistet with that in their late pregnancy mothers. Cord blood 25(OH) D levels were associated with neonates' birth weight and head circumference, but it should be confirmed by larger sample size in the future.

Objective To investigate the therapeutic effect of the meso-cavo-atrial shunt (MCAS) in the treatment of combined Budd-Chiari syndrome (BCS). Methods The clinical data of 17 cases of combined BCS with all or bilateral hepatic vein occlusion and long range occlusion or obstruction of inferior vena cava (IVC) were admitted to the Qilu Hospital from February 2000 to May 2004. All patients were treated by MCAS with artificial blood vessels. The pre- and postoperative clinical symptoms, the IVC and portal venous (PV) pressures, the incidence of postoperative complications and the patency rate of the artificial vessels were analyzed. The survival of patients was analyzed using the Kaplan-Meier analysis, and the data were analyzed using the chi-square test and t test. Results No patient died during the perioperative period, and the symptoms of 15 patients disappeared or were relieved after operation, with a significant difference compared with those before operation (χ2 =9.78, P <0. 05 ). Three patients had complications after the operation. The postoperative PV and IVC pressures were decreased by 1.2 cm H2O (1 cm H2O =0.098 kPa) and 18.5 cm H2O, respectively. There were significant differences in the decrease of IVC and PV pressures ( t = 2.38, 3.06, P < 0.05 ). The 1-, 3-, 5-year survival rates were 16/17, 15/17 and 14/17, respectively, and the 5-year patency rate of the artificial vessels was 14/17.Conclusions MCAS can simultaneously relieve IVC and PV hypertension for patients with combined BCS. The postoperative complication rate was decreased, the 5-year survival rate and the patency rate of the artificial vessels were improved after the treatment, so MCAS is an optional surgical method for treating combined BCS.

Objective To discuss indications,operation method and clinical outcome of posterior short-segment pedicle fixation at the injured level for treatment of thoracolumbar spine fractures.Methods A total of 38 patients with thoracolumbar spine fractures were equally randomized to Group A(treated with classic short-segment pedicle screw fixation)and Group B(treated with short-segment pedicle screw fixation at the injured level)based on fixation methods(19 patients per group).Preoperative and postoperative JOA score,segmental lordosis(Cobb' s angle),R value(anterior fractured vertebral body height/mean normal vertebral body height×100%),VSA score and internal fixation condition were assessed and compared clinically.Results All patients were followed up for 6-37 months(mean 20.5 months),which showed no statistical difference upon Frankel scores of two operation modes,while the segmental lordosis,VAS score and R value in Group B were than those in Group A.There occurred nuts loosening in one patient and screw bending in one in Group A.There was no implant breakage,loosening or emersion in Group B.Conclusion Posterior short-segmental fixation at the injured level is an adequate and effective procedure for compression fractures and mild to moderate burst fractures of the thoracolumbar spine.

Objective To investigate the clinical effects of the modified Kock method of bladder re- construction with ileum,and to provide the objective basis for wide application of this technique.Methods A total of 51 patients with bladder cancer(T_2N_0M_0 stage tumor in 37 cases,T_3N_0M_0 stage tumor in 14; and pathologic gradeⅡ-Ⅲin all)were included.After radical cystectomy,modified Kock reconstruction of bladder with ileum was performed in them.The procedure consisted of preparing the segment of the ileum for reconstruction of the reservoir,anastomosing the low part of the neobladder with the urethra and regaining the original urinary conduit.Results The mean operative time was 6.5h(range,5.5-8.5h);mean in- traoperative blood loss was 650ml(range,300-1200ml),with blood transfusion in 31 cases.Perioperative complications included stress ulcer in 6 cases and urinary leakage in 1.The other 44 cases had no severe complications.Four cases died of cancer metastasis at 6-18 months after operation.During a follow-up of 8 -32 months,the other 47 cases recovered well and have been alive till now.Two cases had ureteral urine reflux with no impairment of renal function.The daytime urinary continent rate was 100%;and nocturnal uri- nary incontinence occurred in 6 cases.Conclusions The modified Koek reconstruction of bladder with il- eum can improve the patients'quality of life with fewer complications,therefore is a better treatment choice for infiltrative bladder cancer after radical eystectomy.

Objective To study local and systemic immune response in an animal model treated with recombinant hIFN-α-2b-BCG instillation. Methods The MB49 orthotopic bladder cancer model in C57BL/6 mice was established and treated separately with rBCG, wild BCG, wild BCG combined with IFN-α-2b and PBS as the control. The changes of lymphocyte subgroups in peripheral blood were analyzed with FCM, and mTNF-α and mIL-12 in peripheral blood of mice were detected with ELISA.Immunohistochemistry was carried out to detect the local immune reaction, T cell subsets and FAS, in bladder cancer after being treated with rBCG or wBCG. Results The content of CD4+ T lymphocyte was up-regulated in the rBCG group. The CD4+/CD8+ ratio of 2. 63 was up-regulated than pretreatment, significantly different than that of wBCG group(P＜0.05). ELISA assay showed that BCG significantly up-regulated the level of mTNF-α and mIL-12 in serum of orthotopie murine bladder cancer mice. The mTNF-α 806 pg/ml, mIL-12 860 pg/ml in rBCG group, was not significantly higher than those in wBCG group and combination group. The immunocompetent cell numbers with CD3, CD4,CD8 phenotype increased significantly in the tumor tissue of BCG treated group than the control(P＜0.05). The results of CD4+ in rBCG group and the combination group, and CD8+ in rBCG group were significantly higher than that of the wBCG(P＜0.05). The expression of Fas in tumor tissues treated with intravesical BCG was increased(P＜0. 05). Conclusions The recombinant IFN-α-2b-BCG can retrieve the disproportion of systemic lymphocyte subgroups, and increases Th1-type factors and local Fas expression in orthotopic murine bladder cancer. The recombinant IFN-α-2b-BCG is effective in regulating local and systemic immune reaction in orthotopic murine bladder cancer model.