Objective To investigate the relationship between the distribution of abdominal adipose tissue and metabolic abnormality in the patients with metabolic syndrome (MS). Methods 108 patients (MS 70 cases, essential hypertension (EH) 22 cases and type Ⅱ diabetes mellitus (T2DM) 16 cases) were enrolled in this study. The visceral adipose (VA) and subcutaneous adipose (SA) were measured with computerized tomography (CT), the ratio of VA/SA was calculated and the correlation between them was analyzed. Results (1) The VA value in MS group was significantly higher compared to both T2DM and EH groups (P

OBJECTIVE To compare the results of plasma scalpel assisted uvulopalatopharyngoplasty(UP PP) under local anesthesia(PS)with radiofrequency volumetric tissue reduction(RF)in the treatment of obstructive sleep apnea/hypopnea syndrome (OSAHS). METHODS Sixty-nine and 79 patients were treated with PS and RF respectively. They were followed-up for 6 and 12 months after operation and the outcomes of the 2 surgical methods were compared. RESULTS The improvement rates at 6 months after PS and RF were 85.5 % and 83.5 % respectively. There was no significant difference between the 2 methods. The improvement rates at 12 months after PS and RF were 78.3 % and 49.3 % respectively. The difference was significant. No major complication was found. CONCLUSION The long-term outcome of PS is better than that of RF. PS surgery may be comparable with surgery under general anesthesia in some special cases.

Objective To explore clinical feasibility of liver transplant from child of brain death to adult, to summarize the clinical experiences that a child of brain death transplants liver to an adult. Methods The recipient was a 39-year-old woman patient with primary hepatic carcinoma and posthepatitis cirrhosis (decompensation stage); while the donor was a 8-old-year child of brain death because of brain neoplasms. Donated liver was gained by the method of en bloc multivisceral procurement in a short time; the operative method was classic orthotopic liver transplantation. The postoperative managements included immunosuppression, prevention of infection, hepatic protection, and other relevant supports etc. Results The transplantation operative duration was 6 hours, after which not only did the recipient survive but also her body functioned well including the liver part, with no severe postoperative complications. Conclusions The technology of transplanting livers from children to adults is feasible. The key to ensure the success of transplant operation is systematic preoperative evaluation, excellent operative technique, and perfect postoperative treatment.

Objective To approach the correlation of the left ventricular function in elderly patients with acute myocardial infarction (AMI) at low-risk factor. Methods Forty-five elderly patients hospitalized for AMI were registered, including 20 patients who were underwent emergency percutaneous coronary intervention (PCI) after the onset of AMI and 25 patients who received conservative non-invasive therapies. These 45 cases all received echocardiography(ECHO) examination in the 4th and 24th week after acute myocardial infarction. Results In the PCI group, end-diastolic volume index (EDVI) and end-systolic volume index (ESVI) had significant difference (P0.05) after therapy; WMSI was higher than PCI group (P

A 32-year old male who had liver cirrhosis accompanying with chronic renal insufficiency (uremia) was suffered from homochronous allograft transplantation of liver-kidney. The blood and other tissue typing were in concord between the donor and recipient. The liver transplantation took typical orthotopic transplantation technique while the kidney transplantation took general operation method to place the transplanted kidney at the recipient's right lilac fossa. Daclizumab was taken for the immunity induction treatment before transplantation while the trigeminy of tacrolimus+mycophemocate mofeil+methylprednisolone were taken as immunosuppressant after transplantation. The transplanted liver and kidney recovered well which could work at once without any serious complications after transplantation, suggesting that combined liver-kidney transplantation was an effective treatment method for homochronous function failure of liver and kidney characterizing by perfect tissue typing, excellent operation skill, reasonable usage of immunosuppresant being the key point of success for transplantation.

Objective To study the long-term effect of administration(6 months) with transient receptor potential vanilloid 1(TRPV1) agonist capsaicin on contractile reactivity of thoracic aorta in C57BL/6J mice.Methods Tow-month-old male C57BL/6J mice were received normal diet group(n=12) or capsaicin group(normal diet plus capsaicin,n=12).Tail-cuff systolic blood pressure(SBP) was examined at the baseline and at the end of the intervention.After 6-month treatment period,carotid artery blood pressure and heart rate were determined by catheterization,and the aortic contractile response was examined using isometric myograph(Danish Myotech Technology,Denmark).Plasma levels of renin,angiotensin Ⅱ(Ang Ⅱ) and aldosterone were determined.Vascular smooth muscle cells(VSMC) were obtained from thoracic aorta of mice and cultured.Angiotensin Ⅱ type 1 receptor(AT1R) protein expression was detected by western blot.Calcium imaging was detected in cultured VSMC using the fluorescent dye technique.Results Systolic blood pressure,invasive carotid artery blood pressure and heart rate have no difference between two groups.No differences was found in PE-induced contraction response in thoracic aorta;while Ang Ⅱ induced contractility of aortic ring was lower in mice with capsaicin than control group [capsaicin:(37.5?1.6)% vs(59.8?1.4)%,P

Objective To explore the clinical application of renal replacement therapy in renal transplan-tation from donation after citizen's death(DCD).Methods A total of 41 cases of the patients with renal replace-ment therapy after renal transplantation from DCD from January 2013 to December 2016 were involved,of which 14 cases received peritoneal dialysis,21 intermittent hemodialysis(IHD)and 6 continuous renal replacement ther-apy(CRRT).The therapeutic effect and complications of three renal replacement therapies were retrospectively ana-lyzed. Results After dialysis treatment,the concentration of blood BUN,Crea,and potassium was significantly lower than that before the treatment(P<0.05);the difference of Crea and BUN before and after the treatment in IHD and CRRT group was higher than that in peritoneal dialysis group(P<0.05)but there was no statistically sig-nificant difference between IHD and CRRT group(P > 0. 05). Conclusion The renal replacement after kidney transplantation from DCD should be based on the patient's condition,which is the key to protect their kidneys even to save patients'lives.

Objective To summarize the preliminary experience of donor liver protection and function evaluation for organ donation after citizen's death. Methods Clinical data of 35 donors from organ donation after citizen's death and 33 recipients were retrospectively analyzed. Donor liver procurement and clinical prognosis of the recipients were summarized. According to serum level of sodium ion (serum sodium) before organ procurement, all recipients were divided into the serum sodium <155 mmol/L, 155-160 mmol/L and 161-180 mmol/L groups. The incidence of liver graft dysfunction early after liver transplantation was statistically compared among three groups. Results In 35 donors,27 cases were Chinese type Ⅱ and 8 cases were Chinese type Ⅲ. Thirty-three donor livers were used for liver transplantation, and the remaining 2 cases of donor livers were excluded due to congestive cirrhosis. In 33 liver transplantation recipients, 30 cases were successfully recovered. The liver function was gradually restored at postoperative 7-14 d, and normal liver function was obtained during long-term follow-up. Postoperatively, 3 recipients died including 2 cases dying from portal vein thrombosis and 1 case from pulmonary infection complicated with multiple organ failure. The incidence of early liver graft dysfunction of the recipients after liver transplantation was 18%, 23% and 4/5 in the serum sodium <155 mmol/L, 155-160 mmol/L and 161-180 mmol/L groups, respectively. Statistical significance was observed between the 161-180 mmol/L and <155 mmol/L groups (P<0.05). Conclusions Timely protection of donor liver, accurate evaluation and maintenance of liver function play a pivotal role in enhancing the utilization rate of donor liver, maintaining liver function and yielding good efficacy for transplantation.

Objective To explore the feasibility of extracorporeal membrane oxygenation (ECMO) in protecting the donor liver in donation after citizen's death. Methods Clinical data of 16 donors and recipients undergoing liver transplantation using ECMO to protect the donor liver were retrospectively analyzed. The effect of ECMO on different indicators of the donors was evaluated. The liver function and clinical prognosis of the recipients after liver transplantation were observed. Results Compared with the time before ECMO, the heart rate, total bilirubin (TB), alanine transaminase (ALT) and aspartate transaminase (AST) of the donors after ECMO were significantly reduced, whereas the systolic blood pressure, diastolic blood pressure and partial pressure of arterial oxygen (PaO₂) were remarkably increased (all P < 0.05). The liver function of the recipients was properly recovered after liver transplantation, and gradually restored normal at postoperative 7 to 28 d. Postoperative complications occurred in 3 recipients, including delayed liver function recovery in 1 case, biliary tract stenosis in 1 case and portal vein thrombosis in 1 case. Among them, the patient with portal vein thrombosis died after secondary operation, and the other 2 patients were recovered and discharged after symptomatic treatment. Conclusions The hemodynamics, liver function and other indicators of donors from donation after citizen's death are significantly improved after ECMO, and the liver function of the recipients also recover well.

Objective:To explore the current status of surgery for portal hypertension to grasp current status and future development of surgery in China.Methods:This study is jointly sponsored by China Hepatobiliary & Pancreatic Specialist Alliance & Portal Hypertension Alliance in China (CHESS).Comprehensive surveying is conducted for basic domestic situations of surgery for portal hypertension, including case load, surgical approaches, management of postoperative complications, primary effects, existing confusion and obstacles, liver transplantation(LT), laparoscopic procedures and transjugular intrahepatic portosystemic shunt(TIPS), etc.Results:A total of 8 512 cases of portal hypertension surgery are performed at 378 hospitals nationwide in 2021.Splenectomy plus devascularization predominated(53.0%)and laparoscopy accounted for 76.1%.Primary goal is preventing rebleeding(67.0%) and 72.8% of hospitals used preventive anticoagulants after conventional surgery.And 80.7% of teams believe that the formation of postoperative portal vein thrombosis is a surgical dilemma and 65.3% of hospitals practiced both laparoscopy and TIPS.The major reasons for patients with portal hypertension not receiving LT are due to a lack of qualifications for LT(69.3%)and economic factors(69.0%).Conclusions:Surgery is an integral part of management of portal hypertension in China.However, it is imperative to further standardize the grasp of surgical indications, the handling of surgical operation and the management of postoperative complications.Moreover, prospective, multi-center randomized controlled clinical studies should be performed.