Objective To summarize the experience in one case of adult-to-adult combined liver-kidney transplantation.Method In Sep.2007,one case of adult-to-adult liver-kidney transplantation from the same living donor was performed on a patient with liver cirrhosis (liver failure decompensation) and chronic renal failure (uremia).There was a donation of the right liver with the middle hepatic vein and right kidney in the same time from the living donor.The piggyback liver transplantation and ectopic kidney transplantation were performed for the recipient.Basiliximab and methylprednisolone were given for immune induction therapy in operation.Tacrolimus,MMF and prednisone were given for anti-rejection.There were hepatoprotective treatment,anti-infection treatment and nutritional support for the donor and recipient after operation.The follow-up period has now been more than five years.Result The donor and the patient were smooth in the perioperative period.The liver and kidney function of the donor is well so far.There was no significant influence on quality of life of the donor.The transplanted liver and kidney function of the recipient is well so far.There were no significant complications for the recipient.Conclusion The living liver-kidney transplantation is an effective means for the treatment of liver and kidney failure.The safety can be ensured for the donors that donate the right liver and one kidney simultaneously.

AIM:To investigate the role of miR-125b in regulating the sensitivity of CD133+ colorectal cancer cells to cisplatin.METHODS:The expression of miR-125b was detected by RT-qPCR in the routine SW480 cells and CD133+ SW480 cells.Flow cytometry analysis was performed to measure the percentage of CD133+ cell population in the SW480 cell line treated with miR-125b and cisplatin.MTT assay was performed to evaluate the effect of miR-125b on the cisplatin-induced cell death in the CD133+ SW480 cells.Bioinformatics and Western blot were performed to determine whether the expression of HAX-1 was regulated by miR-125b.JC-1 staining, Annexin V staining and Western blot analysis were used to study the pathway of apoptosis in the CD133+ SW480 cells co-treated with miR-125b and cisplatin.RESULTS:The expression of miR-125b was significantly lower in the CD133+ SW480 cells than that in the routine SW480 cells and normal colonic epithelial FHC cells.Treatment with cisplatin alone increased the percentage of CD133+ SW480 cell population.However, miR-125b significantly inhibited the enrichment of CD133+ cell population induced by cisplatin.In addition, the results of MTT assay showed that the anti-tumor effect of cisplatin was significantly enhanced when the miR-125b was transfected into the CD133+ SW480 cells.The results of Western blot indicated that the HAX-1 gene was the target of miR-125b.Furthermore, the apoptosis induced by the combination of miR-125b and cisplatin was dependent on the dysfunction of mitochondrial membrane, leading to the release of cytochrome C into the cytoplasm and the subsequently activation of apoptosis in the CD133+ SW480 cells.CONCLUSION:miR-125b increased the sensitivity of CD133+ colo-rectal cancer cells to cisplatin by down-regulating the expression of HAX-1.

Objective To determine the clinical value of MRCP for peroperative evaluation of donor biliary system in living donor liver transplantation (LDLT). Methods A total of 60 living donors for the LDLT were enrolled in this study. Of the 60 donors with a mean age of 32.2 (19-60), 50were male and 10 female. MRCP was performed before and cholangiography was done during the right lobectomy in these donors. The results of MRCP were compared with those of cholangiography to determine the value of MRCP for typing the biliary system in the donors. Results The preoperative MRCP showed that 40 donors were of type Ⅰ biliary tract, 12 of type Ⅱ , 5 of type Ⅲ and 3 of other types. The intraoperative cholangiography showed that the accordance rate of MRCP was 97.4%,91% and 89% for type Ⅰ , type Ⅱ and other types, respectively. The overall rate of accuracy of MRCP was 95% (57/60). Conlusion MRCP can show types of biliary tract in living donors for liver transplantation to provide evidence for plan of surgery.

Objective: To study the clinical therapeutic characteristics of myasthenia gravis (MG) with hyperthyroidism and the effects of surgical procedures for the patients. Methods:Subtotal thyroidectomy,thymectomy,and simultaneous subtotal thyroidectomy and thymectomywere performed on eleven patients with MG and hyperthyroidism. These patients were followedup after the operation. Results :The neck incisions were infected in two of seven type Ⅱ b patientsdue to trachestomy and the infected incisions were surgically healed. The MG symptoms of threecases (1 cases in type Ⅱ. and 2 cases in type Ⅱ b) relapsed in 3 to 6 months after subtotal thy-roidectomy. The MG symptoms of 2 cases (1 case in type Ⅱa and 1 case in type Ⅱ b) relapsed in 8to 12 months after thymectomy. Among six patients treated by simultaneous subtotal thyroidecto-my and thymectomy,the MG symptoms relapsed in a type I case 3 months after the operation,remitted in three case (1 case in type Ⅱ, and 2 cases in type Ⅱb) and improved in two type Ⅱ bcases since the operations. Conclusion:The simultaneous subtotal thymectomy and thyroidectomyfor patients with MG and hyperthyroidism might have better effects,although infective opportuni-ty of the neck incisions increased owing to trachestomy. However,the prognostic effects were notvery satisfactory whether simple subtotal thyroidectomy or thymectomy for the patients with MGand hyperthyroidism was performed.

Objective:To study the causes that resulted in delayed surgery for bronchial ruptures and the results.Methods:The cases with the bronchial ruptures by the delayed surgery last decade were retrospectively reviewed.The causes and unsatisfactory results were analysed.Results:The severe complications usually occurred after the delayed surgery and the results were not as satisfactory as those by early surgery.Conclusion:The bronchial ruptures ought to be operated in the early stage after being wounded.

Objective:To study the effect of microRNA (miR)-330-3p on hepatic ischemia-reperfusion injury (IRI) in mice, meanwhile, and to determine potential molecular mechanism.Methods:Eighty male C57BL/6 mice, aged 7-8 weeks, 23-25 g, specific pathogen free, were randomly divided into 8 groups (10 mice in each group) using random number table: reperfusion 2 h group, 6 h group, 12 h group, 24 h group, sham group, miR-330-3p agomir group (preoperative injection of agonist), miR-330-3p antagomir group (preoperative injection of inhibitor) and miRNA-NC group. Except for the sham group, the hepatic IRI model were established in mice. Polymerase chain reaction (PCR), Western blot and immunohistochemistry were used to detect the expression of miR-330-3p and phosphoglycerate mutase family member 5 (PGAM5), cleave caspase-1 and GSDMD. Luciferase reporter assay was performed to investigate whether miR-330-3p directly targets PGAM5. At the same time, AML12 cells were also treated with miR-330-3p mimics/inhibitor or PGAM5 siRNA, then the expression of PGAM5, NLRP3, cleave caspase-1 and GSDMD were detected by Western blot analysis.Results:Level of miR-330-3p gradually decreased after reperfusion, however, mRNA level of PGAM5 was increased thereafter ( P<0.05) as compared with the sham group. Serum level of AST and ALT were decreased in miR-330-3p agomir group while that of were increased in miR-330-3p antagomir group as a function of time following reperfusion, and the differences were statistically significant (all P<0.05). Cleave caspase-1 expression was decreased in miR-330-3p agomir group but was increased in miR-330-5p antagomir group ( P<0.05). Luciferase reporter assay was performed to determine PGAM5 was a target gene of miR-330-3p. SiRNA-mediated knockdown of PGAM5 decreased level of GAM5 (0.24±0.09), NLRP3(0.12±0.07), cleave caspase-1 (0.15±0.07) and GSDMD (1.08±0.08) as compared with the siRNA-NC group (1.17±0.14), (0.36±0.09), (0.68±0.09), (1.36±0.08), and the differences were statistically significant (all P<0.05). Conclusion:MiR-330-3p can alleviate hepatic IRI in mice, which may be related to inhibition of PGAM5-induced pyroptosis.

Objective To analyze the clinical and imaging data of patients with cerebral microbleeds after acute ischemic stroke (AIS) and to explore the related risk factors of cerebral microbleeds. Methods Seventy-six patients with AIS hospitalized in the Department of Neurology of Binhai Hospital, General Hospital of Tianjin Medical University from May 2015 to October 2016 were collected. All patients were divided into a positive group (32 cases) and a negative group (44 cases) according to whether there were micro-bleeds in the magnetic resonant imaging. The clinical and imaging data of the two groups were statistically analyzed, and the differences in risk factors related to microbleeds between the two groups were compared, and receiver operating characteristic curve (ROC) was drawn, the area under the ROC curve (AUC) was calculated to evaluate the predictive value of age, history of hypertension, and leukoaraiosis for cerebral microbleeds in patients with AIS. Results The age (years: 69.5±10.1 vs. 61.3±8.7), proportion of leukoaraiosis [59.4% (19/32) vs. 34.1% (15/44)] and history of hypertension [75.0% (24/32) vs. 29.5% (13/44)] in the positive group were all higher than those in the negative group (all P < 0.05). Correlation analysis showed that the more severe lacunar infarction, the higher the incidence of cerebral microbleeds (r = 0.278, P = 0.012). Logistic regression analyses showed that age [odds ratio (OR) = 5.11, 95% confidence interval (95%CI) = 3.25 - 12.20, P = 0.001), leukoaraiosis (OR = 4.62, 95%CI = 1.08 - 16.89, P = 0.019) and history of hypertension (OR = 9.28, 95%CI = 2.09 - 38.67, P = 0.003) were the related risk factors of cerebral microbleeds in patients with AIS. ROC curve analysis showed that age, history of hypertension could predict cerebral microbleeds in patients with AIS, with the area under ROC curve (AUC) were 0.751, 0.727 (all P < 0.05), 95%CI respectively was 0.634 - 0.868, 0.610 - 0.845, the sensitivity respectively was 59.4%, 75.0%, and specificity respectively was 84.1%, 70.5%. Conclusion The age, leukoaraiosis, and history of hypertension were related to the occurrence of cerebral microbleeds; the severity degree of lacunar infarction was positively correlated with the incidence of cerebral microbleeds; age and history of hypertension have certain predictive value for AIS.

Objective To invesgate the influence of mild hepatic macrovesicular steatosis to liver function recoveration and liver regeneration after right hemihepatectomy of the living liver donor.Methods The Medical record of 95 cases of living donor liver transplantation in our hospital between Oct 2008 to May 2009 were retrospectively analyzed, 15 donors were decteded have light macrovesicularsteatosis(20%～30%, 5 donors; 10%～19%, 10 donors) (group A),80donors have no hepatic steatosis(group B). Clinical date before operation and outcome after operation were compered. Results The average age, sex ratio,remmnent liver volume ratio, and with middle hepatic vein/without middle hepatic vein ratio had no significant differences between two groups(P=0. 870,P=0. 608,P=0. 928,P=0.196), but the body mass index(BMI) was significantly higher in group A than group B ( P = 0.013). After operation , the peak total bilirubin (TBIL) level and alanine aminotransferase(AST)were was significantly higher in group 1 than in group 2 (P=0. 039) ,the liver regeneration ratio had no significant difference after 15days of operation(P=0. 939). Multivariable analysis showed mild macrovesicular steatosis to be an independent risk factor for hyperbilirubinaemia (odds ratio 5.375(95%confidence interva 1.467-19. 6961); P=0. 011). Conclusions light macrovesicular steatosis is an independent risk factor for hyperbilirubinaemia. For the safe of the living liver donor, attentive evaluation should be done before operation to the living liver donors.

Objeetive To analyze the clinical efficacy of liver transplantation (OLT) for patients with hepatopulmonary syndrome (HPS).Methods From 2008 to 2013,420 adult patients underwent liver transplantation in our hospital.There were 91 patients with,and 329 patients without,HPS.The 5-year survival and mortality rates after OLT for the two groups were retrospectively analyzed.Results There were no significant differences between patients without and with HPS in age,primary disease,Child-Pugh score,MELD score,cold ischemia time and warm ischemia time.However,the differences on serum albumin [(29.6 ± 1.2) g/L vs.(26.4 ± 1.6) g/L] and blood oxygen pressure [(61.0 ±9.0) mmHg (1 mmHg =0.133 kPa) vs.(87.0 ± 6.0) mmHg] were significantly different (P ＜ 0.05).The 1-year cure rate was 65.9％ (60/91) in 91 patients with HPS after liver transplantation.The 1,3,5-year cumulative survival rates for patients without HPS were 97.3％,90.9％ and 80.3％,respectively,and the main causes of death were primary graft dysfunction,recurrent cardiovascular events and primary disease recurrence or tumors.The 1,3,5-year cumulative survival rates for patients with HPS were 65.9％,59.3％ and 56.0％,and the main causes of death were multiple-organ failure,pulmonary infection and cerebrovascular events.Kaplan-Meier survival curve analysis showed that the survival of patients with HPS was significantly lower than that of patients without HPS (P ＜ 0.05).Conclusions Liver transplantation is the most effective treatment for patients with HPS,but the short-term mortality rate is relatively high.We still need to learn more about HPS to improve the survival rate of patients with HPS after liver transplantation.

OBJECTIVETo explore the correlation among some biochemical indexes in the fluoride workers.

METHODSThe activities of superoxide dismutase(SOD), glutathione peroxidase (GSH-Px), catalase (CAT), alkaline phosphatase (AKP) and the level of calcitonin (CT), parathyroid hormone (PTH), IgG, IgA, IgM, Cu2+, Zn2+, Ca2+, Mg2+ and Se2+, F- in serum and in urine were measured in fifty male fluoride workers and fifty controls.

RESULTSThe levels of F-, CT, PTH, AKP and GSH-Px in serum and F- in urine in exposed group were significantly different from that in control group. Correlation analysis indicated that F- in urine and CAT(r = 0.3133, P < 0.05), CT and PTH(r = 0.5173, P < 0.01), Se2+ and CAT(r = 0.4354, P < 0.05) were positively correlated. There were significantly negative correlation between F- in serum and GSH-Px (r = -0.5202, P < 0.01) and positive correlation among Cu2+, Zn2+, Ca2+ and Mg2+ in serum.

CONCLUSION(1) Excess of fluoride may affect secretion of calcium adjusting hormone (CT, PTH); (2) Changes of AKP and GSH-Px may be regarded as health monitoring indexes; (3) The correlation of biochemical indexes plays an important role in studying the mechanism and the early prevention and treatment of industrial fluorosis.

Alkaline Phosphatase ; analysis ; Calcitonin ; analysis ; Catalase ; analysis ; Environmental Monitoring ; Fluorides ; toxicity ; Glutathione Peroxidase ; analysis ; Humans ; Male ; Occupational Exposure ; Parathyroid Hormone ; analysis ; Superoxide Dismutase ; analysis