Objective:To explore the relationship between serum lactate level and early prognosis after liver transplantation (LT) in children.Methods:Between January 1, 2018 and December 31, 2020, 675 pediatric LT recipients were recruited. Clinical data were retrospectively reviewed, early postoperative serum lactate level and clearance rate recorded and receiver operating characteristic (ROC) curve plotted for determining optimal cut-off values. The inter-group differences in early postoperative complications and patient/graft survival rates were compared.Results:According to ROC, blood lactate levels >1.99 mmol/L at 12 h postoperatively were associated with early postoperative graft loss (AUC 0.73, 95% CI: 0.62-0.84, P=0.01). Age and weight of recipients in high-level group were 7.17(5.70-10.40) month and 7.00(6.00-8.60) kg and both were significantly lower than those in low-level group [7.80(6.21-13.58) month and 7.20(6.45-9.00) kg]. The inter-group differences were statistically significant ( P=0.017, P=0.034). Blood plasma transfusion volume, red blood cell transfusion volume, portal vein pressure pre-closure, postoperative intensive care unit (ICU) stay, ventilator use time, early allograft dysfunction rate, early postoperative pulmonary infection rate and recipient mortality rate in high-level group were 400 (200-400) ml, 2.00 (2.00-4.00) U, (15.71±4.44) mmHg, 2.50(2.00-3.00) day, 3.81(2.47-8.50) hour, 22.95%(42/185), 16.76%(31/185) and 6.49%(12/185) respectively. The above values were significantly higher than those in low-level group 200(100-400) ml, 2.00 (2.00-3.00) U, (14.69±4.68) mmHg, 2.00(2.00-3.00) day, 3.53(2.34-6.12) hour, 14.69%(72/490), 11.02%(54/490) and 1.43%(7/490) respectively. The inter-group differences were statistically significant ( P<0.001, P=0.014, P=0.015, P=0.037, P=0.043, P=0.011, P=0.045 & P<0.001). The incidence of early postoperative acute cellular rejection was significantly lower in high-level group than that in low-level group [11.89%(22/185) vs 22.86%(112/490)]. The inter-group difference was statistically significant ( P=0.01). The 1/3-month cumulative survival rates of patient/graft were 94.6%, 94.1% and 92.4%, 91.4% in high-level group versus 99.2%, 98.6% and 99.0%, 98.4% in low-level group. There were significant inter-group differences ( P=0, P<0.000 1). With a rising level of lactate at 12 h postoperatively, risk of early graft loss and early recipient mortality spiked markedly ( P<0.05). Conclusions:Serum lactate level post-operation is a valid predictor of early prognosis after LT in children.

Objective:To explore the efficacy of reduced left lateral segment graft during pediatric living donor liver transplantation.Methods:From January 2014 to December 2019, 67 children aged under 1 year underwent living donor liver transplantation with reduced left lateral segment graft (RLLS group). Clinical data were analyzed retrospectively and compared with those of left lateral segmentgraft living donor liver transplantation (LLS group). The differences in basic profiles, postoperative complications and postoperative patient/graft survival rate were compared.They were divided into two groups according to whether graft/recipient weight ratio (GRWR) was more than 4%.And major postoperative complications and graft/recipient survival rates were compared.Results:Age, height and weight of recipients were significantly lower in RLLS group than those in control group ( P<0.05). However, donor weight, donor body mass index (BMI), estimated graft volume and proportion of fatty liver from donor were significantly higher than those in control group ( P<0.05). Operative duration, intraoperative blood loss and erythrocyte transfusion were significantly higher than those in control group ( P<0.05). No significant inter-group differences existed in average postoperative hospital stay, intensive care unit (ICU) stay duration or postoperative ventilator use time ( P>0.05); no significant inter-group difference existed in the incidence of such major surgical complications as hepatic artery thrombosis, portal vein stenosis and bile duct complications ( P>0.05). The 1/3-year cumulative survival rates of postoperative patients and grafts were 92.5%, 91.2% and 92.5%, 91.2% in RLLS group and 96.3%, 95.3% and 95.9%, 95.1% in LLS group respectively.There was no significant inter-group difference ( P<0.05). The rate of postoperative hepatic vein stenosis was significantly higher in GRWR>4% group than that in control group ( P<0.05). Conclusions:Due to a rapid progress of technology, living donor liver transplantation has achieved satisfactory outcomes in children with reduced left lateral segment graft.Whether or not performing reduction surgery should be judged comprehensively according to the matching of donors and recipients and blood flow of liver during operations.And GRWR>4% is not an implementation criterion.

Objective To investigate correlation between QT interval(QT),corrected QT interval(QTc) and metabolic syndrome(MS). Methods Residents who participated in our survey concerning atherosclerosis and related diseases conducted in Shenyang were included. They accomplished questionnaire,physical examination, laboratory tests and electrocardiography test. We divided them into MS group and non-metabolic syndrome (NMS)group according to International Diabetes Federation(IDF)diagnostic criteria for MS. QT interval was measured from the standard 12-lead electrocardiogram. QTc was calculated by using Bazett and Fridericia equations. We analyze correlation of QT ,QTc and MS. Results A total of 739 residents who were 35~64 years old were included. Individuals with MS had longer QTcB and QTcF than NMS group[(415.8 ± 31.9)ms vs.(410.1 ± 32.1)ms, (407.2± 29.1)ms vs.(402.6 ± 28.8)ms,P<0.05]. The more the number of abnormal MS parameters they had, the longer the QT,QTcB and QTcF they had. Regression analysis showed that QT was associated with serum potassium,smoking,blood glucose,and LDL,and QTcB and QTcF were associated with hypertension,waist circumference and blood potassium. Conclusions MS is associated with corrected QTc. Careful ECG monitoring among persons with MS for early detection of a long corrected QT interval may prevent severe and often fatal arrhythmias or sudden death.

Objective To explore the effects of residual renal function (RRF) on quality of life (QOL) in patients with continuous ambulatory peritoneal dialysis (CAPD),and analyze the factors influencing QOL.Methods One hundred and eighteen patients treated with CAPD for at least 3 months in No.455 Hospital of People's Liberation Army were enrolled.All patients were divided into two groups according to residual glomerular filtration rate (rGFR):the group with RRF [rGFR≥ 1 ml·min-1 · (1.73 m2)-1],and the group without RRF [rGFR ＜ 1ml · min-1 · (1.73 m2)-1].The demographic characteristics,laboratory data,cardiothoracic ratio,dialysis adequacy parameters,rGFR,blood pressure,urine volume,ultrafiltration volume and dialysis prescription were investigated.Patient's QOL was evaluated by Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36).Results There was no significant differences between the groups with and without RRF in the age,gender,causes of disease,complication,body mass index (BMI),systolic blood pressure (SBP),diastolic blood pressure (DBP),haemoglobin (Hb),cholesterol,triglyceride,high-density lipoprotein,low-density lipoprotein,normalized protein catabolic rate (nPCR) and cardiothoracic ratio (all P ＞ 0.05).Compared with the patients with RRF,PD duration,ultrafiltration volume,serum creatinine (Scr),calcium,phosphorus,C-reactive protein (CRP),parathyroid hormone (PTH) and peritoneal dialysis dose in the patients without RRF were significantly higher,and urine volume,serum albumin (Alb),potassium,and urea total Kt/V were significantly lower (all P ＜ 0.05).The patients without RRF had a significantly lower score in physical function and physical component summary as compared to the patients with RRF (all P ＜ 0.05).There was no significant differences in role physical,bodily pain,general health,vitality,social function,role emotional,mental health,mental component summary and SF-36 scores (all P ＞ 0.05).Simple linear regression showed that there was no correlation between rGFR and SF-36 scores (β=1.330,P=0.070).Multiple linear regression revealed that SF-36 scores were correlated with CRP (β=-0.477,P ＜ 0.001),Scr (β=0.020,P ＜ 0.001),cardiothoracic ratio (β=-57.823,P=0.004),Alb (β=0.772,P=0.016) and ultrafiltration volume (β=-0.006,P=0.031),but not correlated with rGFR (β=0.099,P=0.302).Conclusions PD patients without and with RRF perceived different scores in physical health,but their scores were similar in mental health and QOL.RRF was no related to QOL in PD patients.Chronic inflammation,fluid overload and malnutrition were the main factors that affect QOL.

Objective:To study the relationship between neutrophil to lymphocyte ratio (N/L) and traditional cardio‐vascular risk factors among community 35~64‐year‐old residents .Methods :A total of 1884 residents (548 males and 1336 females) from urban Shenyang city received baseline condition questionnaire on cardiovascular diseases and re‐lated diseases from Apr 2011 to Feb 2012. According to presence of cardiovascular risk factors or not ,subjects were divided into healthy control group (n=675) and risk factor group (n=1209);according to number of risk factors , risk factor group was further divided into one risk factor group (n=491) ,two risk factors group (n=263) and ≥3 risk factors group (n=455) .Morning blood sample and urine sample were retained to measure blood and urine rou‐tine ,blood glucose and blood lipid profile etc in all subjects .N/L was compared and analyzed among all groups .Re‐sults:Among patients with only one of following risk factors [hypertension ,diabetes mellitus (DM) ,dyslipidemia and obesity] ,N/L levels of patients with hypertension or DM were significantly higher than that of healthy control group [1.55(1.15 ,1.95) ,1.60(1.21 ,2.07) vs .1.45(1.09 ,1.91)] , P<0.05 both ,and there were no significant difference between any other one risk factor group and healthy control group , P>0.05 all .Among risk factor sub‐groups ,N/L level of ≥3 risk factors group was significantly higher than that of two risk factors group [1.57(1.16 , 2.04) vs .1.41(1.07 ,1.89) ,P<0.05] ,and there was no significant difference between any other two groups (P>0.05) .Conclusion:N/L significantly related to hypertension or DM ,and N/L level of ≥3 risk factors group was sig‐nificantly higher than that of two risk factors group ,N/L is helpful to assess risk of cardiovascular diseases .

ObjectiveTo investigate the clinical promoting effect of crossing nape electroacupuncture on the recovery of swallowing function and recovery from pulmonary infection in post-cerebral infarction patients with tracheotomy.MethodSixty post-cerebral infarction patients with cough reflex disorder and swallowing dysfunction associated with pulmonary infection receiving tracheotomy and tracheal intubation were subjects. They were allocated, using a random number table, to three groups, 20 cases each. In each group, the patients were enrolled in order of visits. The three groups were given the same basic treatment for fighting inflammation, resolving phlegm and improving blood supply. The crossing nape electroacupuncture group received bilateral points Fengchi (GB20), Yifeng (TE17), Dicang (ST4)-to-Jiache (ST6) and Lianquan (CV23) acupuncture with electrodes connected by left-right crossing. The acupuncture group received bilateral points Fengchi, Yifeng, Dicang-to-Jiache and Lianquan acupuncture without electrodes connected. The control group received basic treatment with Western drugs without acupuncture therapy. Observations were carried out using the Kubota’s water drinking test, the Toshima Ichiro Swallowing Assessment and the Clinical Pulmonary Infection Score. The clinical therapeutic effects were evaluated in the three groups.ResultThe therapeutic effects evaluated using the Kubota’s water drinking test and the Toshima Ichiro Swallowing Assessment were better in the crossing nape electroacupuncture group than in the acupuncture group and better in the acupuncture group than in the control group (P<0.05). The score of the Clinical Pulmonary Infection Score decreased in all the three groups. The promoting effect on recovery from pulmonary infection was marked in the crossing nape electroacupuncture group (P<0.01).ConclusionCrossing nape electroacupuncture has a marked improving effect on dysphagia in post-cerebral infarction patients with tracheotomy and tracheal intubation. It can promote recovery from pulmonary infection in post-cerebral infarction patients with cough reflex disorder receiving tracheotomy and tracheal intubation.

Objective To evaluate and compare the clinical effects of proximal femoral nail antirotation blade (PFNA) with reverse less invasive stabilization system-distal femur (LISS) in the treatment of proximal femoral fractures associated with coxa vara. Methods From June 2007 to June 2010, A retrospective study with more than 10 months follow-up of 46 patients with proximal femoral fractures associated with coxa vara underwent PFNA or reverse LISS were carried out, including 24 with PFNA and 22 patients with reverse LISS. The physical status of patient was evaluated according to the American Society of Anesthesiologists (ASA) score. After the operation, the operation duration and volume of blood loss were assessed in the two groups, respectively. At the last follow-up, full weight bearing time, fracture healing time, and neck-shaft angle discrepancy related to contralateral side without fracture of the each group were assessed, respectively.Functional recovery was evaluated according to Parker and Palmer mobility score. Results The average follow-up period was 11.2 months (range, 10-12). All the fractures healed successfully and reached bony union.There were no significant differences between PFNA group and reverse LISS group for the average ASA score, the average operating time, the average volume of intraoperative bleeding and Parker and Palmer mobility score. The patients were allowed full weight-bearing from 9.33 weeks after surgery in PFNA group and from 16.95 weeks in reverse LISS group. The patients reached bony union after 17.21 weeks after surgery in PFNA group and from 30.73 weeks in reverse LISS group. Comparing with PFNA group, neck-shaft angle discrepancy decreased in reverse LISS group. Conclusion The results of PFNA and reverse LISS in the treatment of proximal femoral fracture were satisfactory. The fracture treated by PFNA allowed earlier weight bearing. Reverse LISS could provide better support for neck-shaft angle to avoid coxa vara more effectively.

The present study was intend to clone and express the cDNA encoding Cyclophilin B (CyPB) of Schistosoma japonicum, its preliminary biological function and further immunoprotective effect against schistosome infection in mice. RT-PCR technique was applied to amplify a full-length cDNA encoding protein Cyclophilin B (Sj CyPB) from schistosomula cDNA. The expression profiles of Sj CyPB were determined by Real-time PCR using the template cDNAs isolated from 7, 13, 18, 23, 32 and 42 days parasites. The cDNA containing the Open Reading Frame of CyPB was then subcloned into a pGEX-6P-1 vector and transformed into competent Escherichia coli BL21 for expressing. The recombinant protein was renaturated, purified and its antigenicity were detected by Western blotting, and the immunoprotective effect induced by recombinant Sj CyPB was evaluated in Balb/C mice. The cDNA containing the ORF of Sj CyPB was cloned with the length of 672 base pairs, encoding 223 amino acids. Real-time PCR analysis revealed that the gene had the highest expression in 18-day schistosomula, suggesting that Sj CyPB was schistosomula differentially expressed gene. The recombinant protein showed a good antigenicity detected by Western blotting. Animal experiment indicated that the vaccination of recombinant CyPB protein in mice led to 31.5% worm and 41.01% liver egg burden reduction, respectively, compared with those of the control. A full-length cDNA differentially expressed in schistosomula was obtained. The recombinant Sj CyPB protein could induce partial protection against schistosome infection.
Animals ; Antigens, Helminth ; immunology ; Cloning, Molecular ; Cyclophilins ; biosynthesis ; genetics ; immunology ; DNA, Complementary ; genetics ; Escherichia coli ; genetics ; metabolism ; Genetic Vectors ; genetics ; Immunization ; Mice ; Mice, Inbred BALB C ; Recombinant Proteins ; biosynthesis ; genetics ; immunology ; Schistosoma japonicum ; genetics ; immunology ; Schistosomiasis japonica ; prevention & control ; Vaccines, Synthetic ; biosynthesis ; immunology

Objective To investigate the application of expanded p01ytetrafluoroethylene(ePTFE)grafts in upper arm to build arteriovenous aCCeSS for hemodialysis. Methods ePTFE graft vascular access was built in the upper arm in 20 uremia patients.Three operation strategies were applied according to the reference,including loop grafts connected axillary artery and axillary vein,straight graft connected axillary artery and elbow basilic vein,and bridge connected elbow brachial artery and axillary vein. Results Twenty operations were successful and after 6-8 weeks the fistula of all cases were used in hemodialysis.The blood flows were 220-300 ml/min without re-circulation found.Conclusion ePTFE graft arteriovenous vascular access in the upper arm could be an alternative for hemodialysis patients who are difficult to build native arteriovenous fistula.

Objective To assess the therapeutic effectiveness of monotherapy of adefovir dipivoxil (ADV) and lamivudine (LAM),or ADV administered in combination with LAM,in order to find the effective and secure therapy for decompensated cirrhosis patients following chronic hepatitis B. Methods Totally 64 decompensated cirrhosis patients following chronic hepatitis B were divided into 2 groups by using a prospective randomized grouping method. In group A,patients received the therapy of adefovir dipivoxil (10mg/d) combined with lamivudine (100mg/d); and in group B,a monotherapy of adefovir dipivoxil (10mg/d) was used. The period of treatment was 48 weeks. Levels of serum ALT,HBeAg and HBV-DNA were detected in week 12,24,36 and 48 respectively. The liver function was evaluated with Child scores on these time points. Data were analyzed by a blinded independent investigator. Results After 48 weeks treatment,HBV DNA negative conversion rate of the two groups were 87.1%and 78.8%.The virtual rate were 96.8% and 87.9%;HBeAg negative conversion rate were 83.9%,and 57.6%. HBeAg/anti-HBe seroconversion rates of the two groups were 41.9%and 24.2%. Normalization of serum ALT levels were observed in 96.8% patients of group A and 97.0% of group B. Conclusion The combination therapy of adefovir dipivoxil (ADV) and lamivudine (LAM) could reduce the occurrence of drug resistance,and increase the anti-viral effect. It is a secure management for chronic hepatitis B virus infection.