Objective To explore the histological morphological features of complications following liver transplantation. Methods In 639 patients with complications following liver transplantation, the percutaneous liver biopsy tissues were stained by HE method. Van Gieson, Masson, PAS, reticulin and immunohistochemical staining were performed. HBsAg, HBcAg, HCVAg, CMV-EA, CMV-LA, CMV pp65, EBVAg and the expression of CK19 were detected. The rejection was graded according to Banff standard and scored with RAI.Results 906 times of liver biopsies in 639 cases were performed. Acute cellular rejection (ACR) was most commonly seen in 386 cases ( 42.61 %), followed by complication of biliary tract (251 cases, 27.70 %), drug-induced liver damage (72 cases, 7.95 %), CMV infection (55 cases, 6.07 %), infection or recurrence of hepatitis virus (B or C) (45 cases, 4.97 %), ischemia-reperfusion injury (42 cases, 4.64 %), chronic rejection (32 cases, 3.53 %), obstruction of efferent tract (6 cases, 0.66 %), recurrence of the primary affection (5 cases, 0.55 %), and non-function of live grafts (4 cases, 0.44 %). The complications in 8 cases were difficult to diagnose ( 0.88 %). Compared with the previous report of complications, the incidence rate of ACR was decreased and that of complication of biliary tract and drug-induced liver damage increased in this study. Conclusion Percutaneous liver biopsy is valuable for the diagnosis of complications. It provides the evidence of settling plan of treatment and improves the survival rate.

Objective To explore oligodendrocyte selective vulnerability in gray matter area and the effect of subhypothermia after transient forebrain ischemia in gerbils.Methods The gerbils model of forebrain ischemia was induced by 15 min bilateral carotid occlusion.All gerbils were divided randomly into sham operation group,ischemic reperfusion group and subhypothermia treatment group (32.5?0.5℃).Immunohistochemistry for cell specific antigens (transferrin,TF) was used to identify oligodendrocyte.Results The density of TF positive oligodendrocyte in the cortex at 1～2 days reperfusion following ischemia decreased remarkably (P

Objective To explore the relationship between reactive astrogliosis and delayed neuronal ischemic tolerance by preconditioning ischemia in gerbil hippocampal CA 1 region.Methods All gerbils were divided randomly into sham operation group,cerebral ischemia group and preconditioning ischemia group and preconditioning ischemia plus subsequent ischemia group. Transient forebrain ischemia model was induced by bilateral carotid occlution in gerbils. Immunohistochemistry for cell specific markers (glial fibrillary acidic protein(GFAP)was used to identify astrocyte.Results The numbers of GFAP positive astrocyte in hippocampal CA 1 region increased slightly at 1~7days following preconditioning ischemia, but increased significantly at 28 days after preconditioning ischemia ( P

Objective To determine the tumor clonal origin of diffuse hepatocellular carcinoma (D-HCC) and clinical outcome after liver transplantation. Methods Fourteen D-HCC patients who underwent liver transplantation in the Tianjin First Central Hospital between August 2004 to November 2012 were evaluated retrospectively. Their clinical characteristics and data of disease-free survival postoperatively were gathered. Twelve loss of heterozygosity sites (LOH) on high frequency microsatellite were selected. The tumor clonal origin of D-HCC was assessed by the means of PCR-SSCP. Results Of 14 D-HCC patients, intrahepatic metastasis (IM) occurred in 11 cases (11/14), and IM with multicentric occurrence (MO) occurred in 3 cases (3/14). The disease-free survival time was 4.5 to 37.4 months, and the median time was 8.7 months. Conclusion The most frequent tumor clonal origin of D-HCC was IM. Liver transplantation may be the effective treatment for D-HCC.

OBJECTIVETo evaluate the clinical efficacy of electroacupuncture (EA) combined with transperineal injection of botulinum toxin-A (BTX-A) on neurogenic bladder caused by spinal cord injury.

METHODSOne day af ter surgery, 35 cases of spinal cord injury accompanied with neurogenic bladder were randomly divided into a BTX-A plus EA group (20 cases, group A) and a BTX-A group (15 cases, group B). The two groups were both treated with regular rehabilitation training of bladder function and injection of 200 IU (4 ml) BTX-A through perineum external urethral sphincter; the group A was additionally treated with EA at Zhongji (CV 3), Guanyuan (CV 4), Shenshu (3BL 23), Huiyang (BL 35) and Baliao (Shangliao (BL 31), Ciliao (BL 32), Zhongliao (BL 33), Xialiao (BL 34)), once a day, 40 min per treatment. The treatment was given 6 times per week for 4 weeks. The urination status in two groups before and after treatment was observed, and urodynamics examination and urethral pressure test were also made.

RESULTSAfter 4-week treatment, mean times of urinary incontinence, mean urethral catheter output, pressure of bladder and volume of urinary incontinence were all improved in two groups (all P<0.05), which were more significant in the group A (all P<0.05). The residual urine, maximum bladder capacity, maximum urethral closure pressure and maximum urine flow rate were all improved in two groups after treatment (all P<0.01); the improvement of residual urine, maximum bladder capacity, maximum urethral closure pressure in the group A was more significant than that in the group B (all P<0.05).

CONCLUSIONElectroacupuncture com bined with transperineal injection of BTX-A could effectively improve the urination dysfunction in patients with neurogenic bladder after spinal cord injury.

Adolescent ; Adult ; Botulinum Toxins, Type A ; administration & dosage ; Combined Modality Therapy ; Electroacupuncture ; Female ; Humans ; Injections ; Male ; Middle Aged ; Spinal Cord Injuries ; complications ; Treatment Outcome ; Urinary Bladder, Neurogenic ; drug therapy ; etiology ; physiopathology ; therapy ; Urination ; Young Adult

Objective To observe the effect of scalp acupuncture plus body weight support treadmill (BWST) training on motor function and ambulation of lower limbs in spastic cerebral palsy. Method Sixty-six eligible subjects with cerebral palsy were divided by using random number table into group A (n=20), group B (n=23), and group C (n=23). Group A was intervened by regular rehabilitation training, group B was by BWST in addition to the treatment given to group A, and group C was intervened by scalp acupuncture in addition to the treatment given to group B. The dimension D and E of Gross Motor Function Measure (GMFM) scale and Activities of Daily Living (ADL) were adopted for evaluation before treatment and after 3-month treatment. Result Before treatment, there were no significant differences in comparing the indexes among the three groups (P>0.05). After 3-month treatment, the D-dimension scores of GMFM were respectively (25.38±4.85), (29.54±5.70), and (32.37±6.58) in the three groups; the E-dimension scores were respectively (55.35±11.64), (60.80±12.47), and (65.74±13.50); the ADL scores were (60.24±14.49), (68.25±13.74), and (76.30±14.58); the scores were significantly increased in all three groups after intervention (P＜0.01), and the D-dimension and E-dimension scores of group B and C were significantly higher than those of group A (P＜0.05), and the scores of group C were significantly higher than those of group B (P＜0.05). Conclusion Scalp acupuncture plus BWST can improve the motor function and walking ability of lower limbs in spastic cerebral palsy, and thus enhance of ADL of the patients.

Objective To study the effect of isokinetic strength training on upper limb motor function and activities of daily living (ADL) in stroke patients with hemiplegia. Methods From January to December, 2016, 56 stroke patients with hemiplegia were randomly di-vided into control group and observation group equally. Both groups received routine rehabilitation training, and the observation group ac-cepted hemiplegic limb flexor and extensor muscle isokinetic strength training in addition, for four weeks. They were assessed with Fugl-Meyer Assessment-upper limb (FMA-UL), modified Ashworth Scale (MAS), modified Barthel Index (MBI) and biomechanical index-es of elbow flexion and extension with Biodex System-4 before and after treatment. Results The scores of FMA and MBI improved after treatment (t>7.083, P<0.001) in both groups, and improved more in the observation group than in the control group (t>2.369, P<0.05). The peak torque, total work and average power at 60°/s and 120°/s angular velocity of both flexor and extensor improved in both groups (t>2.149, P<0.05), and those of the extensor improved more in the observation group than in the control group (t>2.027, P<0.05), except the peak torque at 60°/s angular velocity. Conclusion Isokinetic strength training can improve the motor function of upper limbs and activities of daily living in stroke patients with hemiplegia.

Objective To explore the effect of sling exercise therapy (SET) for improving the balance and walking ability of patients with incomplete paraplegia.Methods The 37 patients were randomly divided into two groups:19 patients in the observation group and 18 cases in the control group.Both groups were given conventional rehabilitation training,including bridge training on the mat,kneeling position training,sit-stand training and orthosis walking training.The observation group was additionally provided with sling exercise therapy with multi-point,muhi axis sling suspension supine,prone with a neutral lumbar spine,supine with pelvic elevation and in a lateral position like an arch.Before the treatment and 6 weeks after the treatment,trunk control tests (TCTs) were administered.The Berg balance scale (BBS) and Holden's walking function classification were used to assess the subjects' balance and walking ability.Results There were no significant differences in the two groups' average TCT and BBS scores before the treatment.After 6 weeks of treatment the average scores of both groups had increased significantly,with a significantly bigger increase observed in the observation group.After the treatment,the average Holden classification of the observation group was significantly superior to that of the control group.Conclusion SET in addition to conventional rehabilitation training can significantly improve the balance and walking ability of patients with incomplete paraplegia.It is worthy of application in clinical practice.

Objective To investigate the effect of portal vein ligation combined with in situ splitting on liver regeneration in rats .Methods Seventy-five healthy male Sprague-Dawley rats were selected and randomly assigned into sham operation group ( S) , portal vein ligation group ( PVL) and portal vein ligation combined with in situ splitting group ( ALPPS) .On 1 d, 3 d, 7 d, 10 d, 14 d after operation , the hepatic regeneration rate ( HRR) of right median lobe was calculated , the serum alanine aminotransferase ( ALT) , aspartate aminotransferase (AST), IL-6, HGF, VEGF were detected.mRNA of IL-6, HGF, TNF-α, TGF-βwas assayed by real-time PCR, and the hepatic proliferating cell nuclear antigen ( PCNA) labeling index was evaluated by immunohistochemistry .Results Comparing with PVL group , the HRR of the right median lobe obviously increased on day 3, 7, 10 and 14 in ALPPS group (P<0.05), and ALT and AST level were increased on 1 d (P<0.05).On day 1 and 3, the content of serum IL-6, HGF and VEGF were all in-creased in ALPPS group [(70.7 ±14.6) pg/ml vs.(134.2 ±31.4) pg/ml; (0.70 ±0.04) ng/ml vs. (0.74 ±0.02) ng/ml;(82.1 ±12.6) pg/ml vs.(103.5 ±14.7) pg/ml], respectively (P<0.05).The mRNA expression of IL-6, HGF, TNF-α, TGF-βand the PCNA labeling index were also increased in ALPPS group in comparison with those in PVL group on day 1 and 3 (P<0.05).All the indexes in the two groups were all higher than those in the group S ( P<0 .05 ) .Conclusions Portal vein ligation combined with in situ splitting could significantly enhance liver regeneration .The possible mechanisms were related to the inflammation reaction and stress response caused by in situ splitting and up-regulation of cytokines in the regenerating lobe after portal vein ligation combined with in situ splitting , especially IL-6, HGF and TNF-α.

Objective To identify the long-term survival of patients with hepatic carcinoma who received hepatitis B surface antigen (HBsAg) positive donor livers.Method A total of 195 patients were enrolled in the study.They were all diagnosed as having hepatic carcinoma with malignant thrombus in portal vein pre-operation and received liver transplantations between 1999 and 2014.The long-term survival between the patients who received HBsAg positive grafts and those who received HBsAg negative grafts was compared.Result There were no differences in ages,preoperative tumor stages and postoperative mortality between the two groups.There was significant difference in survival time between the two groups (Z=-2.038,P =0.042),with the median survival time of 8.83 months (2.50-24.80 months) in HBsAg positive graft group and 13.12 months (6.50-27.65 months) in HBsAg negative graft group,respectively.The long-term survival rate in HBsAg positive graft group was 48％ and that in HBsAg negative graft group was 34.7％ (P =0.740,x2 =0.110).However,the proportion of deaths due to recurrence of tumor was high to 75.8％ in all causes.Conclusion To prolong the survival time,it is safe and feasible to receive HBsAg positive donor livers in patients with hepatic carcinoma in late stage.However,tumor recurrence was still the main causes of deaths in patients post-operation because of the advanced tumor conditions pre-operation.