BACKGROUND: Biliary complications are a common cause of death in patients after liver transplantation, biliary endoscopic minimally invasive technique is gradually becoming an important tool to solve biliary complications following orthotopic liver transplantation.OBJECTIVE: To analyze the literatures on the biliary tract complications after liver transplantation, and to demonstrate a clear role of bile duct endoscopy in biliary complications.METHODS: Using "orthotopic liver transplantation, biliary complications, biliary tract, endoscope technique" in English for the search term, Pubmed database were searched between January 1980 and October 2008; Using "liver transplantation, biliary complications, bile duct cast, cholangioscopy" in Chinese for the search term, Vip Chinese Periodical Database and CNKI database were searched between 1994 and January 2009. Literature language was limited to English and Chinese. The studies related to bile duct injury-caused biliary complications after liver transplantation were included, while other research unrelated to biliary complications after liver transplantation were excluded.RESULTS AND CONCLUSION: A total of 52 literatures were screened out by the primary computer inspection, according to inclusion and exclusion criteria, 30 ones were involved for analysis. Biliary complications and vascular complications are considered as a common cause of death in patients after liver transplantation, particularly in biliary complications has become the major reason limiting the development of liver transplantation. Because of the difficulties on early recognition and treatment, the importance of the treatment for the complications in liver transplant patients is increasingly attracting more and more attention. Endoscopic operation technology and their subsidiary parts are improving, particularly therapeutic endoscopic retrograde cholangiopancreatography and biliary mirror technology are developing and continuously improving, biliary endoscopic minimally invasive technique is gradually becoming a major approach to solve biliary complications after orthotopic liver transplantation, The minimally invasive endoscopic diagnosis and treatment is an intuitive, reliable and credible means for the biliary complications after liver transplantation, serving as the most preferred method for diagnosing and treating biliary complications after liver transplantation.

BACKGROUND:Bioactive glass has good biocompatibility, which can promote the remineralization effects of demineralized enamel and enhance the resistance of enamel to erosion. OBJECTIVE:To evaluate the effect of bioactive glass toothpaste versus fluoride toothpaste on brushing abrasion of enamel after acid etching. METHODS:Fifty-six enamel specimens were prepared from bovine incisors, and were embedded in acrylic resin with exposed buccal surface. The exposed area was 6 mm×6 mm and two amalgam fil ings were placed into the enamel and polished. Al specimens were divided into seven groups with eight specimens each. In six groups, specimens were brushed with ordinary toothpaste, fluoride toothpaste, bioactive glass toothpaste immediately and 30 minutes after being eroded by the Sprite. The last one group was brushed with ordinary toothpaste without acid etching as control. The treatment course was cycled 60 times. The surface abrasion loss of the specimens between two amalgam fil ings compared with respective amalgam reference surfaces was final y observed and calculated under laser scanning confocal microscope. RESULTS AND CONCLUSION:The abrasion loss amount of teeth with no acid etching was significantly lower than that with acid etching (P<0.05). The abrasion loss amount of teeth brushed with bioactive glass toothpaste was less than that with fluoride toothpaste at the same brushing time (P<0.05). For the same toothpaste, the abrasion loss amount of teeth brushed 30 minutes after eroded was less than that bushed instantly after eroded (P<0.05). Use of bioactive glass toothpaste can effectively reduce enamel loss caused by acid etching and brushing. The loss amount can also be reduced by brushing teeth 30 minutes after acid etching.

Objective To evaluate miniature probe endoscopic ultrasonography (mEUS) in diagnosis of submucosal tumor (SMT) of upper digestive tract.Methods We observed 91 patients with SMT,and mEUS was performed to assess the lesions arised from the specific layer of the wall.Results Among all cases,leiomyoma was the most common,57 cases,found in esophagus more than in stomach;14 of cysts,9 of vascular lesions,5 of lipoma,and 2 cases of malignant stromal tumors.Malignant lesions and part of benign lesions were confirmed by histological examination.Conclusion mEUS is a simple,safe and effective method for SMT,and it can be clue to the location and nature of SMT.

Objective To explore the role of choledochofiberscopy in the diagnosis and treatment of biliary complication after orthotopic liver transplantation.Methods The patients with continuous biliary infection and obstructive jaundice in 6 cases subject to orthotopic liver transplantation were treated by choledochofiberscopy through T tube sinus tract. The findings from choledochofiberscope at different periods after operation were recorded.Results Three to five months after operation, there were a lot of flocs in the bile duct cavity under the choledochofiberscopy, and mucous membrane of bile duct was pale or coarse. On the postoperative month 6, 11 and 18, choledochofiberscopy revealed there were funicular, columned and brown biliary stones in bile duct cavity which mostly located in porta hepatis, and there existed stenosis in anastomotic stoma of bile duct to varying degrees; the wall of bile duct was coarse, with congestion of the mucous membrane. The flocs and stones could be extracted conveniently by the choledochofiberscope.Conclusion We can observe the transplanted liver’s bile duct through the T tube sinus tract by the choledochofiberscopy and treat the biliary complications conveniently.

Objective To study the long term results of thoracolumbar fractures treatment with AF (atlas fixator) pedicle system. Methods The clinical results of 60 cases of thoracolumbar fractures treated with AF pedicle system from 1996 2000 were analyzed retrospectively. Results The follow ups lasted from 3 to 6 years, averaging 4 years. The neurological function improved by at least 2 ASIA grades in 27 cases and by 1 ASIA grade in 33 cases. The correction of the vertebral body height averaged 95.1%, and the correction loss averaged 19.7%. Degeneration and narrowing of the disc space next to the fractured vertebrae were common, and correction loss was most evident at the upper disc spaces. Conclusions The AF pedicle system can achieve good long term clinical results for the recovery of neurological function and the vertebral body height. But the rates of implant failure and correction loss are still high probably due to deficiency of bone grafting and delayed implant removal.

Objective To compare the effects of intraoperative anesthetic management on im-mune function between enhanced recovery after surgery (ERAS)and traditional approach in laparo-scopic rectal surgery.Methods Clinical data of 90 laparoscopic rectal surgery in Shanxi Provincial People’s Hospital from January 2013 to January 201 5 were prospectively analyzed.90 cases (male 5 1 cases,female 39 cases,aged 48-70 years,ASA grade Ⅰ-Ⅲ)were randomly divided into two groups (n = 45 each)using a random number table:ERAS group (group A,n = 45 )and control group (group B,n = 45 ).In group A patients were treated with epidural general anesthesia,maintaining perioperative normothermia,perioperative goal-directed fluid therapy and patient controlled epidural analgesia,while in group B routine anesthetic management and patient controlled intravenous analgesia were used.The levels of blood CRP and IL-6,CD3 + ,CD4 + ,CD8 + ,CD4 +/CD8 + on the first day before operation,the first day and the third day after operation were recorded.Results The blood CRP and IL-6 levels in two groups were increased on the third day after operation(P <0.05), however the increase was more significantly in group A than in group B (P <0.05).Compared with the first day before operation,CD3 + ,CD4 + ,CD8 + and CD4 +/CD8 + levels in two groups were de-creased on the third day after operation(P <0.05),on the third day group A decreased significantly, which was more than that in group B(P <0.05).Conclusion In the relief of operative stress and the protection of immune function through enhanced recovery after surgery in anesthetic management.

Objective To analyze and verify the expression profiles of long non-coding RNAs (lncRNAs) in gastric cancer (GC) metastatic lymphonodus.Methods Microarray analysis was performed in 3 GC positive lymphonodus and 1 normal lymph node with Agilent Array platform to measure the expression levels of lncRNAs and mRNAs and to investigate the expression differences of lncRNAs in GC metastatic lymphonodus and normal lymphonodus, and hierarchical clustering used to screen out the differently expressed lncRNAs.15 up-regulated lncRNAs and 15 down-regulated lncRNAs were randomly chosen and RT-PCR was used to verify the expression differences.Results Comparing with normal lymphonodus, 353 lncRNAs and 547 mRNAs are up-regulated, but 464 lncRNAs and 562 mRNAs are down-regulated in GC metastatic lymphanodus as 6 times or more variation was found.The expressions of lncRNA OR3A4, LOC84740, FCGR1C and C21orf 96 were increased in GC metastatic lymphonodus, but lncRNA MSTO2P, LOC344595, TUG1, TYW3 and KRT8P10 decreased.Conclusions LncRNAs are aberrantly expressed in GC metastatic lymphonodus.

Objective To investigate the nursing points of endoscopic full-covered self-expanding removable metal stents (FCSERMS) implantation for bile duct anastomotic strictures after liver transplantation. Methods The clinical data of patients who were treated by endoscopic full-covered self-expanding removable metal stents implantation for bile duct anastomotic strictures after liver transplantation from January 2013 to July 2015 were retrospectively analyzed, and the nursing process were summarized. Results The group of 9 patients were successfully placed and removed with FCSERMS. There was no postoperative complication, such as stent migration, acute pancreatitis, biliary bleeding and intestinal leakage. All the bile duct strictures were relieved after FCSERMS removement. Followed up for 10-32 months, there was no symptom and sign of bile duct anastomotic stricture recurrent. Conclusions The key in nursing points of FCSERMS implantation for bile duct anastomotic strictures after liver transplantation are introducing the function of FCSERMS and therapeutic process to improve patient compliance, mastering the endoscopic operations, the placement and removal method of FCSERMS to short operation time, strengthening postoperative nasal bile duct care, paying attention to the observation, detection and treatment of postoperative complications after the metal stent placement and removement, as well as the continuing care during the period between placement and removment of FCSERMS.

ObjectiveTo observe the effect of ginsenosides Rb1 on cerebral blood flow of rat models with cerebral ischemia/reperfusion (I/R) injury, which could provide a new theory of cerebral protective mechanism about ginsenosides Rb1.Methods Twenty-four rats were randomly divided into sham-operation group, model group, normal saline control group and ginsenosides Rb1 group, 6 rats in each group. The middle cerebral artery occlusion (MCAO) model was established by thread embolism method. At the end of I/R, in the rat of ginsenosides Rb1 group, ginsenosides Rb1 40 mg/kg was immediately intraperitoneally injected, while in the rat of normal saline control group, an equal volume of normal saline was injected intraperitoneally. After I/R for 24 hours, the cerebral local amount of blood flow was measured, the rats' behavior score was observed, and the volume of cerebral infarction was monitored by 2, 3, 5-triphenyl tetrazolium chloride (TTC) staining.Results The percentage of volume of cerebral infarction [(64.23±8.12)% vs. 0%] and behavior score [3.0 (2.0-4.0) vs. 0 (0-0),P< 0.05] in model group were significantly higher than those in sham-operation group, while the cerebral local amount of blood flow in model group was obviously lower than that in sham-operation group (mL/min: 125.75±57.65 vs. 225.01±78.25,P< 0.05); Compared with the model group and normal saline control group, the percentage of volume of cerebral infarction [(23.62±8.74)% vs. (64.23±8.12)%, 56.72±8.92] and behavior score [0.5 (0.0-2.0) vs. 3.0 (2.0-4.0), 3.5 (1.0-4.0)] in the ginsenosides Rb1 group were significantly lower, the cerebral local amount of blood flow was markedly increased in the ginsenosides Rb1 group (177.25±75.36 vs. 125.75±57.65, 132.65±58.65,P< 0.05).Conclusion Ginsenosides Rb1 can increase the cerebral blood flow in rats with cerebral I/R injury, which maybe one of the mechanisms of cerebral protection of Ginsenosides Rb1.

Objective To investigate the expression and significance of β-catenin and p28GANK in residual hepatocellular carcinoma (HCC)cells after transcatheter arterial chemoembolization (TACE).Methods We collected forty-five cases of surgical specimens of hepatocellular carcinoma after TACE ( TACE group ) and thirty cases of surgery without any treatment (pure surgery group).The expression of β-catenin and p28GANK were detected by using immunohistochemical SP method and compared between the two groups .Results The positive expression of β-catenin and p28GANK in TACE group were 77.78%and 75.56%respectively,which were significantly higher than those in pure surgery group (46.67%and 53.33%respectively,P<0.05).In the residual hepatocellular carcinoma cells of TACE group ,the positive expression of β-catenin showed correlation with the positive expression of p28GANK(Φ=0.318,P =0.033).The high expression of β-catenin and p28GANK were closely related to portal vein thrombosis and distant metastasis (P<0.05).Conclusion The ex-pression of β-catenin and p28GANK in the residual hepatocellular carcinoma cells were increased significantly after TACE.The high expression of β-catenin and p28GANK were closely related to portal vein thrombosis and distant metastasis.The high expression of β-catenin and p28GANK may be one of the reasons of hepatocellular carcinoma invasiveness and metastasis .