The past few years have witnessed a rapid development in liver transplantation in China and great achievement has been made. This review introduces the recent focuses on liver transplantation in China, including scoring for end-stage hepatic disease and liver transplantation, liver transplantation for hepatocellular carcinomas, liver re-transplantation, expanding of the donor pool, and post-operative long-term follow-ups.

Objective To determine the difference of macrophage RAW264.7 apoptosis induced by Brucella melitensis virulent strain 16M and attenuated strain M5-90 and elucidate the regulatory role of caspases 3,8 and 9.Methods The best multiplicity of infection (MOI) was determined through kinetic analysis of Brucella melitensis strain 16M and M5-90 induced mouse macrophages apoptosis(bacterium ∶ cell =100 ∶ 1,50 ∶ 1,10 ∶1).The infection model was established using the best MOI =50 ∶ 1.The numbers of in vivo bacteria by colony formation units were calculated after macrophages were infected for different times,including 2,4,8,12,24 and 48 h,and the infected cells were collected.The ratios of apoptosis were detected and the regulation of caspases 3,8 and 9 in apoptosis pathway was elucidated by flow cytometry.Results The numbers of 16M in vivo bacteria were 105.4,104.8,105.8,106.5,108.0 and 109.0,respectively and of M5-90 were 106.1,106.2,106.4,106.3,106.1 and 105.0,respectively.The number of in vivo bacteria of 16M was significantly increased than that of M5-90 after infected for 24 h to 48 h.The ratios of apoptosis induced by 16M after infected for 2,4,8,12,24 and 48 h was (2.67 ± 0.09)％,(13.13 ± 0.30)％,(6.56 ± 0.42)％,(6.49 ± 0.28)％,(16.07 ± 0.86)％ and (24.23 ± 1.67)％,respectively,and by M5-90 was (3.62 ± 0.02)％,(32.01 ± 2.59)％,(17.58 ± 0.44)％,(16.09 ± 0.10)％,(62.53 ± 2.70)％ and (85.53 ± 0.15)％,respectively,and by control group was [(1.90 ± 0.20)％,(1.92 ±0.16)％,(1.99 ± 0.03)％,(2.48 ± 0.11)％,(3.56 ± 0.07)％,(5.26 ± 0.33)％].The differences were statistically between groups in same time.The Brucella melitensis vaccine strain M5-90 was more powerful than virulent strain 16M in respect of inducing macrophage apoptosis after infected for 24 to 48 h.Twenty-four hours after infection,the expression of caspases 3,8 and 9 was (1.47 ± 0.05)％,(1.52 ± 0.02)％ and (2.47 ± 0.12)％,respectively,in control group and the expression was (9.70 ± 0.46)％,(6.08 ± 0.56)％ and (35.08 ± 1.64)％,respectively,after infected for 24 h induced by M5-90.The expression of caspases 3,8 and 9 was significantly higher than that control group (P ＜ 0.01).Twenty-four hours after given caspases 3,8 and 9 inhibitor,apoptosis rate in control group was (66.72 ± 1.28)％,in M5-90 group was (22.58 ± 0.55)％,(53.15 ± 1.85)％ and (29.18 ± 0.23)％,respectively,and compared with control group,apoptosis rate of caspases 3,8 and 9 was significantly lower(P ＜ 0.01).Conclusions Apoptosis of macrophage can be induced by Brucella melitensis virulent vaccine strain 16M and attenuated strain M5-90.M5-90 is stronger than that of strain 16M.Caspases 3,8 and 9 can regulate macrophage apoptosis after M5-90 infection.

Objective: To investigate the relation between ser um hyaluronic acid (HA) concentration and cryopreservation-reperfusion injury. Methods: The animals were randomly assigned to 3 groups: (1 ) group A: the control; (2) group B: liver allografts were stored in lactated R inger's solution (0℃) for 2 h before implantation; (3) group C:liver allografts were stored in lactated Ringer's solution (0℃) for 4 h before implantation. Th e serum sample and liver specimen were taken up at 2 h and 4 h after transplanta tion to detect the concentration of HA, AST and LDH, and to get pathologic obser vation. Results: Serum HA increased earlier and decreased more s hortly than AST and LDH after transplantation in group A. Serum HA increased sig nificantly in group B and C, much higher than that in group A(P<0.01). The i njury of vascular endothelium and the disorder of hepatic sinuses and hepatic lo b ules were observed in group B and C. In the specimen of 4 h in group C, evident infiltration of inflammatory cell was present. Conclusion: Cryopreservation leads to injury of endothelial cell and reperfusion aggravat es this injury. The serum HA concentration indicates the degree of cold ischemia -reperfusion injury.

Objective To detect the mutations of ATP2C1 gene in patients with Hailey-Hailey dis- ease (HHD).Methods PCR and direct sequencing were performed in 17 patients and 120 healthy controls to screen the mutations in the exons of ATP2C1 gene.Results Eight mutations were identified in nine probands, including three deletion mutations (nt1464-1487 del/nt1462-1485del,1523delAT,2375delTTGT),three splice site mutations (360—2A→G,1415—2A→T,2243+2T→C) and two missence mutations (C920T and G1942T).None of the above mutations was found in the controls.Conclusion Eight specific novel mutations were identified in nine probands of HHD,which could be causative factors of the disease.

OBJECTIVETo investigate the expression of heparanase mRNA and its relation with the clinicopathological features and angiogenesis in primary hepatocellular carcinoma (HCC).

METHODSExpression of heparanase mRNA was detected by RT-PCR in 51 HCC lesions, and microvessel density (MVD) was detected by immunohistochemical stain with a factor VIII-related monoclonal antibody.

RESULTSExpression of heparanase mRNA was shown in 49.0% (25/51) HCC lesions. The positive rate of heparanase expression in tumors larger than 3 cm (63.6%, 21/33) was significantly higher than those in smaller tumors (22.2%, 4/18; P < 0.01). Heparanase expression was more frequent in highly invasive tumors (70.0%, 14/20) compared with moderately invasive tumors (46.7%, 7/15) and low invasive ones (25.0%, 4/16; P < 0.05). Moreover, heparanase expression in tumors with high MVD (62.5%, 20/32) was significantly higher than those in tumors with low MVD (26.3%, 5/19; P < 0.05).

CONCLUSIONHeparanase mRNA expression may be important for the growth, invasion and angiogenesis of hepatocellular carcinoma.

Adult ; Carcinoma, Hepatocellular ; blood supply ; enzymology ; pathology ; Female ; Glucuronidase ; biosynthesis ; genetics ; Humans ; Liver ; enzymology ; Liver Neoplasms ; blood supply ; enzymology ; pathology ; Male ; Microcirculation ; pathology ; Middle Aged ; Neoplasm Invasiveness ; Neovascularization, Pathologic ; enzymology ; RNA, Messenger ; biosynthesis ; genetics ; Tumor Burden

Adult ; Aged ; Female ; Humans ; Liver Transplantation ; Male ; Middle Aged ; Prognosis

OBJECTIVETo observe the effect of glycoprotein receptor blockade tirofiban in acute anterior myocardial infarction patients without ST segment resolution after primary percutaneous coronary intervention (PCI).

METHODSFrom April 2006 to April 2008, 157 acute anterior myocardial infarction patients without ST segment resolution after PCI were randomly allocated to tirofiban (intravenous bolus 10 microg/kg followed by intravenous infusion of 0.15 microgxkg(-1)xmin(-1) for 48 h, n = 80) or equal volume saline (control group, n = 77). Baseline characteristics, PCI features and clinical outcomes during hospitalization, left ventricular ejection fractions (LVEF) and major adverse cardiac events (MACE, including death, re-infarction and target vessel revascularization) at 30 and 180 days after discharge were compared between the two groups.

RESULTSThe baseline clinical characteristics were comparable between the two groups. Compared to control group, the MACE rates and re-infarction rates at 30 days (6.3% vs.18.2%, P < 0.05; 1.3% vs.9.1%, P < 0.05, respectively) and 180 days (10.0% vs.23.4%, P < 0.05; 2.5% vs.10.4%, P < 0.05, respectively) were significantly reduced in tirofiban group. LVEF value was significantly higher in tirofiban group at 30 days and 180 days compared with those in control group [(51 +/- 6)% vs. (46 +/- 8)%, P < 0.05; (57 +/- 7)% vs. (50 +/- 9)%, P < 0.05]. Hemorrhagic complications were similar between the two groups.

CONCLUSIONUse of tirofiban for acute anterior myocardial infarction patients without ST segment resolution after PCI is safe and can significantly improve 30 and 180 days clinical outcomes after discharge.

Aged ; Angioplasty, Balloon, Coronary ; Anterior Wall Myocardial Infarction ; diagnosis ; drug therapy ; therapy ; Electrocardiography ; Female ; Humans ; Male ; Middle Aged ; Platelet Aggregation Inhibitors ; therapeutic use ; Prognosis ; Treatment Outcome ; Tyrosine ; analogs & derivatives ; therapeutic use

OBJECTIVETo identify the candidate genes within the putative susceptibility locus for systemic lupus erythematosus (SLE) at 12p12.3-13.2.

METHODSKLRC1 was selected as the candidate gene according to the results of previous gene chip studies. TaqMan real-time quantitative PCR was performed for detecting KLRC1 mRNA expression in 55 SLE patients and 30 controls.

RESULTS AND CONCLUSIONKLRC1 mRNA expression was significantly higher in the mononuclear cells and T cells of SLE patients than in the healthy controls (P<0.01), but showed no significant difference in the B cells. No obvious correlation was found between the SLE disease activity index (SLEDAI) and KLRC1expression level, suggesting that KLRC1 can be a probable candidate gene for SLE on 12p12.3-13.2, but which is not associated with the disease activity.

Adolescent ; Adult ; Asian Continental Ancestry Group ; genetics ; China ; Chromosomes, Human, Pair 12 ; genetics ; Female ; Gene Expression Profiling ; Genetic Predisposition to Disease ; Humans ; Lupus Erythematosus, Systemic ; ethnology ; genetics ; pathology ; Male ; Middle Aged ; NK Cell Lectin-Like Receptor Subfamily C ; genetics ; Reverse Transcriptase Polymerase Chain Reaction ; Severity of Illness Index ; Young Adult

Humans ; Immunosuppressive Agents ; administration & dosage ; therapeutic use ; Liver Transplantation ; methods ; Postoperative Period

Objective Compared with digital subtraction angiography(DSA),to evaluate the value of high-resolution contrast-enhanced three-dimensional magnetic resonance angiography(3D MRA) in defining hepatic arterial anatomy.Methods The data about abdominal high-resolution contrast-enhanced 3D MRA and DSA of 26 patients (24 patients with primary liver cancer,2 patients with metastatic liver tumor) was retrospectively analyzed.The display quality of different segmental hepatic artery was scored with 4 grades and the agreement between high-resolution 3D MRA and DSA was determined with the weighted Kappa statistic.The depiction of hepatic arterial anatomy/anomalies and vascular pathology on high- resolution 3D MRA was assessed and compared with DSA.Results With respect to display quality,there was good or fair correlation between high-resolution 3D MRA and DSA for the common hepatic artery (the mean score respectively was 3.96,3.96 and Kappa value 0.99),gastroduodenal artery (the mean score respectively 3.85,3.88 and Kappa value 0.85 ),right hepatic artery(the mean score respectively 3.92, 3.96 and Kappa value 0.65 ),left hepatic artery (the mean score respectively 3.77,3.92 and Kappa value 0.43 ),left gastric artery(the mean score respectively 3.73,3.85 and Kappa value 0.43 ),right anterior artery (the mean score respectively 3.35,3.70 and Kappa value 0.53),right posterior artery (the mean score respectively 3.31,3.73 and Kappa value 0.46)and 1V segment artery (the mean score respectively 2.92,3.46 and Kappa value 0.51 );Poor correlation was found for the Ⅱsegment artery (the mean score respectively 2.15,3.35 and Kappa value 0.18)and Ⅲsegment artery (the mean score respectively 2.19, 3.35 and Kappa value 0.21 ).Compared with DSA,18 normal hepatic arterial anatomy and 7 arterial anomalies were accurately demonstrated(accuracy ratio 96.1% (25/26)),the obliteration of gastroduodenal artery correctly depicted in 1 patient on high-resolution 3D MRA image.Conclusions High-resolution 3D MRA can provide accurate evaluation of hepatic artery and has the capacity of depicting hepatic segment artery.