Objective To study the classification, its incidence and some related factors of neurological complications after liver transplantation.Methods 166 cases of orthotopic liver transplantation were retrospectively studied. The classification and the incidence of the neurological complications were analyzed. In addition, the patients were divided into two groups, according to whether they suffered from neurological complications or not, to study the difference of related factors, which included gender, age, primary disease, type of operation procedure, operation time, non-hepatic time, ischemia time of donor liver, blood loss, blood infusion and immunosuppressive regimen.Results Neurological complications occurred in 28 cases (32 times), which included encephalopathy, seizure, stroke, infection of central nervous system, serious para-pyramidal syndrome and peripheral neuropathy. The total incidence was 16.9 %. Between the neurological complication group and non-neurological-complication group, no difference was found in gender, age, type of operation procedure, operation time, non-hepatic time, ischemia time of donor liver, blood loss, blood infusion and immunosuppressive regimen, but the neurological complications were closely related with primary diseases. The incidence of neurological complications was 30 % in acute liver failure, followed by post-hepatitis B liver cirrhosis (21 %), primary liver carcinoma (17.8 %), Wilson disease (16.7 %) and primary biliary liver cirrhosis (12.5 %). Interestingly as a sole complication disease, the incidence of encephalopathy in acute liver failure was 15 %, that was much higher than that in other primary disease. So was the peripheral neuropathy, which was 10 % in primary liver carcinoma.Conclusions The neurological complication is a kind of serious disease with high incidence after liver transplantation. Its onset may have some relationships with the primary liver disease.

Objective To evaluate clinical effects of using axonal repair technique (cell surgery) for the treatment of peripheral nerve injuries. Methods 12 patients with 13 injured peripheral nerves were treated with axonal repair technique of soaking the stumps of the nerve in a modified Collins fluid, freezing the stumps with liquid nitrogen, trimming the solidified stumps with a sharp blade, coapting the nerve with glue and two stitches of epineurium, so that the injured peripheral nerves were repaired at the axonal level. The postoperative evaluation was performed at an average of 9.7 months. Results In four of 12 cases operated upon with contralateral C 7 nerve root transfer(C 7 to ulnar nerve), regenerating axons had reached to the ipsilateral sternoclavicular joint or axilla at postoperative 4-7 months, so that the second stage of contralateral C7 nerve root transfer procedure could be performed. In five cases of which the accessory nerves were transferred to suprascapular nerves, the strength of supra-and infraspinatus of 3 patients had recovered to MRC 3-4 at postoperative 16 months, and that of the other two, to MRC 1-2 at 12 months. In one case undergoing the second stage procedure of contralateral C 7 nerve root transfer (ulnar nerve to median nerve), the flexor carpi radialis showed some nerve regeneration shown in EMG at postoperative 4 months. In one case of which phrenic nerve was transferred to the musculocutaneous nerve (the nerve graft 8 cm), the biceps showed some nerves regeneration shown in the EMG 15 months postoperatively. In one patient for whom two digital nerves were repaired, the protective sensation had recovered 3 months postoperatively. Conclusion Axonal repair technique is an effective and practical way for the treatment of peripheral nerve injury.

Objective To study the effect of extract of leave ginkgo biloba (EGb) for protection of the motor and sensory neurons axotomy-induced in rats. Methods Thirty male Sprague-Dawley rats weighing 180－ 220 g (8－ 9 weeks of age), were randomly divided into control group and EGb24/6 group. Models of sciatic nerve injury were established by transection of left sciatic nerve at 0.5 cm away from the points of muscular innervation. The proximal stump of sciatic nerve was double ligated to inhibit nerve regeneration. The distal end of the nerve was implanted into the biceps femoris. Then 2 ml of normal saline was given to control group, and 2 ml of EGb24/6 to the EGb24/6 groups daily. The rats were sacrificed in 7,14,28 days after surgery respectively, and then 4％ paraformaladehyde was perfused transcardially. The L4－ 6 spinal cord and L5 dorsal root ganglion (DRG) were harvested. HE staining and CV technique were used for detection of the motor neurons and compared with contra-lateral side. TUNEL technique was used for detection of apoptotic motor and sensory neurons. Eletron microscopic technique was used for observation of change of L5 DRG neurons. Result The number of motor neurons was significantly higher in EGb24/6 group in each postoperative period than that in control group (P

Objective To evaluate the clinical diagnosis of gastric stromal tumors and the safety and feasibility with laparoscopic wedge resection.Methods The clinical data of diagnosis and treatment were retrospectively analyzed in 43 cases diagnosed as gastric stromal tumors by endoscopyic ultrasonography.Results Thirty-six cases were successful by laparoscopic surgery success rate being 83.7%.Endoscopic ultrasonography diagnosis rate was 69.0%.The positive rate of CD117 and CD34 in postoperative diagnosis of gastrointestinal stromal tumor wasl00%.The mean post-operative hospital stay was 5 days.Conclusion Endoscopyic ultrasonography can be selected as a main method for clinical diagnosis of gastric stromal tumors and laparoscopic resection was safe and feasible.

Objective:To investigate the expression of HIF-1? and VEGF and the correlation with pathological score of synovium in adjuvant-induce-arthritis rat knee joint.Methods:Models of adjuvant arthritis(AA) in rats were made successfully,the arthral pathological score was calculated,production of HIF-1? and VEGF protein was assayed by histoimmunochemical staining at different stage after CFA inoculation.Results:The HIF-1? and VEGF concentration in experimental group were higher than that in control group,and there was significant difference(P

Purpose　To observe exogenous epidermal growth factor (EGF) influence upon sensory neurons axotomy-induced and change ultra-structure of sensory.　Methods　Eighteen male Sprague-Dawely rats weighing 180-200 g(8-9 weeks of age)were randomly divided into two groups.One as control,the other was treated with EGF.Sciatic nerve injury model was set up by transecting left side sciatic nerve at 0.5 cm away from performed muscle.The proximal stump of sciatic nerve was ligated to inhibit nerve regeneration.Then 5 μl of normal saline in the control groups and an equal volume of EGF solution (containing 10 μg EGF) in the EGF treated groups were injected into the proximal of ligated nerve.The rats were sacrificed in 7,14,28 days of operative intervals respectively and transcardialy perfused with 4% para-fromaladehyde.The L5 dorsal root ganglion(DRG) were harvested.Eletromicroscope technique was used to observe the changes of L5 DRG sensory neurons axotomy-induced.　Results　A series of changes happened in the control group.The size of the nucles decreased.Nucleoplasm was scattered.The nucleolus was pale.Edema,loss of crest and matrix was found in the mitochondria. Satellite cells detached from the soma.The ultrastructure of L5 DRG sensory neurons in EGF groups get near to normal following nerve injury.　Conclusions　EGF could protect sensory neurons.

Objective:To investigate the expression of HIF-1 and VEGF and the correlation with pathological score of synovium in adjuvant-induce-arthritis rat knee joint.Methods: Models of adjuvant arthritis(AA)in rats were made successfully, the arthral pathological score was calculated, production of HIF-1α and VEGF protein was assayed by histoimmunchemical staining at different stage after CFA inoculation.Results:The HIF-1α and VEGF concentration in experimental group were higher than that in control group, and there was significant difference (P＜0.01).And correlation between them was significantly(P＜0.01), similar with pathological score of synovium(P＜0.01).Conclusion:HIF-1α and VEGF play important roles in the development and progression of synovium of knee joint in AA rat.The interaction of them promote development and progression of neonatal vascular in synovium.

Objective To invcstigate the value of preoperative imaging morphologic classification in solitary small hepatocellular carcinoma treated by RFA.Methods The clinical data of 73 patients with small hepatocellular carcinoma who rcccivcd radiofrequency ablation at the Affiliated Drum Tower Hospital of Medical School of Nanjing University from January 2008 to December 2012 were analyzed retrospectively.The lesions were classified into three types according to gross appearance in preoperative contrast-enhanced computed tomography (CT):single nodular type (type 1);single nodular with extranodular growth type or confluent multinodular type (type 2);infiltrating type (type 3).Thc clinicopathological features of patients with 3 types of tumors were compared by statistical methods.Patients were followed up via outpatient examination and telephone interview up to August 2014 or death.Results There were 24 cases of type 1,35 cases of type 2,14 cases of type 3,and the proportion were 20.2％,32.9％,47.9％,19.2％,respectively.The preoperative alpha-fetoprotein of type 3 was significantly higher than othcr types.The disease-free survival time of the three types were (37.2 ± 3.3) months,(20.9 ± 4.0) months,(14.4 ±4.9) months.The prognosis of the irregular types (type 2,type 3) is poor than the regular types (type 1).The overall survival time were (72.5 ± 4.7) months,(66.2 ± 7.3) months,(31.2 ± 5.3) months.The type 3 was the worst.The results of univariate analysis showed that morphologic classification,preoperative AFP,tumor size were related factors affecting the prognosis of patients (P ＜ 0.05).The results of multivariate analysis showed that morphologic classification was the independent risk factors affecting the prognosis of patients (P ＜ 0.05).Conclusion The preoperative imaging morphologic classification is the independent risk factors affecting the prognoses of patients with small HCC,which is help to choose the best treatment for patients with small hepatocellular.

Objective To provide the anatomic basis of flap which was anatomized to the ankle by Anatomy study of vascular net around ankle joint.Methods 32 lower limbs were infiltrated into red emulsion;4 perfusions of lower limbs,artery;2 cases of radiography;1 lower limb was infiltrated into black ink.Application anatomy was observed the origin,track-way,branches and configuration in ankle and foot.Results The blood provision in ankle includes three parts;All the patients recovered well after treatment by careful flap-design.Conclusion The vascular net around anatomy of the ankle can provide help for the design,the choice and the operation of ankle's,tissue flap,and the function's,recovery after surgery.

To produce specific antibodies against malachite green ( MG) , one special hapten was synthesized and characterized, and conjugated to carrier protein as immunogen. The immunogen showed excellent reactogenicity and immunogenicity. One specific monoclonal antibody (mAb, named MG-DA4-C7) with high sensitivity and specificity for MG in indirect competitive enzyme-linked immunoassay ( icELISA ) was screened. The isotype was IgG1 and the light chain was κ type. After optimization of ELISA conditions, the proposed icELISA showed a 50% inhibition value ( IC50 ) of 0. 96 μg/L, a linear range ( IC20-IC80 ) of 0. 1-8. 1 μg/L and a limit of detection ( LOD, IC10 ) of 0. 05 μg/L for determination of MG. The assay showed cross-reactivity of 18. 1%, 26. 5% with crystal violet and brilliant green, respectively, and negligible cross-reactivity with other metabolites of MG (<0 . 1%) . The average recoveries of MG from spiked fish samples were from 87. 3% to 107. 3%. Good correlation (R2=0. 999) was obtained between the results of icELISA and those of liquid chromatography-tandem mass spectrometry analysis. The proposed icELISA is suitable for the determination of MG in fish samples in a simple and sensitive manner.