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.

Vibrio parahaemolyticus is a major pathogen frequently found in seafood. Rapid and accurate detection of this pathogen is important for the control of bacterial foodborne diseases and to ensure food safety. In this study, we established a one-pot system that combines uracil-DNA glycosylase (UDG), loop-mediated isothermal amplification (LAMP), and clustered regularly interspaced short palindromic repeats (CRISPR)/CRISPR-associated protein 12b (Cas12b) for detecting V. parahaemolyticus in seafood. This detection system can effectively perform identification using a single tube and avoid the risk of carry-over contamination.
Vibrio parahaemolyticus/genetics* ; Uracil-DNA Glycosidase/genetics* ; Hot Temperature ; CRISPR-Cas Systems ; Food Safety

OBJECTIVE To prepare cinnamaldehyde （CA） loaded liposomes bilayer-modified by bovine serum albumin （BSA）/chitosan （CTS）（BSA/CTS-Lip-CA） in order to improve the sustained-release effect and storage stability of the nanoparticles. METHODS Firstly，cinnamaldehyde loaded liposomes （Lip-CA）and blank liposomes （Lip-Blank）were prepared by thin film dispersion method. Then chitosan modified cinnamaldehyde loaded liposome （CTS-Lip-CA）and BSA/CTS-Lip-CA were obtained by electrostatic adsorption. Finally ， the prepared liposomes were characterized ， and their in vitro release characteristics and storage stability were investigated. RESULTS The particle size of BSA/CTS-Lip-CA was （177.8±4.0）nm and the Zeta potential was （－15.6±1.5）mV；they were in spherical shape ；FTIR analysis showed that the modification of BSA and CTS had no effect on the internal structure of liposomes. The results of in vitro drug release characteristics showed that the cumulative release of Lip-CA ，CTS-Lip-CA and BSA/CTS-Lip-CA within 10 hours were 82.9％，74.1％ and 72.9％ respectively. The results of storage stability showed that after 30 days of storage ，the particle sizes of Lip-CA ，CTS-Lip-CA and BSA/ CTS-Lip-CA were （134.2±2.1），（151.7±0.4），（164.8±1.5）nm；the retention rates of model drug CA were 65.4％，82.5％ and 90.2％ respectively. CONCLUSIONS BSA/CTS-Lip-CA is successfully prepared. It has a certain sustained-release effect and can improve the storage stability of the drug to a certain extent.

Objective: The aim of this study was to compare the efficacy and safety of metformin/thiazolidinediones (TZDs) / glucagon-like peptide 1 (GLP-1) analogs (triple therapy) with conventional glucose-lowering therapy(conventional therapy) for patients with type 2 diabetes and metabolic syndrome. Methods: A prospective randomized-controlled 26-week study was carried out. A total of 82 patients with type 2 diabetes and metabolic syndrome were randomized to receive either triple therapy protocal or just conventional therapy, altogether with 41 cases in each group. Results: HbA_1C value was significantly reduced in triple therapy group versus the conventional therapy group [(2.23±1.75)% vs (1.48±1.59)%, P<0.05]. Values of body mass index, waist circumference, and visceral fat area were significantly reduced in triple therapy group as compared to those of conventional therapy group [(2.50±1.81 vs 0.92±1.82)kg/m², (6.75±4.92 vs 1.66±3.25)cm, (24.10±19.10 vs 10.02±20.10)cm², all P<0.01, respectively]. Control rates of HbA_1C and fasting plasma glucose for triple therapy were higher than those for conventional therapy (both P<0.05). No hypoglycemia occurred in triple therapy group. Subjects receiving triple therapy experienced more frequent gastrointestinal side effects than those in conventional therapy group (18.87% vs 3.92%, P<0.05). The most common side event was mild nausea (90%). Conclusion Combination therapy with metformin/TZDs/GLP-1 analogs had statistically significant advantages in the control of body weight, waist circumference, and visceral fat area in addition to the control of blood glucose over conventional glucose-lowering therapy in our patient cohort, it seems to be an optimized therapeutic regimen for patients with type 2 diabete and metabolic syndrome.

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 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 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.

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