In recent years, with the development of organ preservation, surgical techniques, perioperative management and immunosuppression regimens, the success rate of liver transplantation and survival rate of the recipients have been significantly enhanced. Liver transplantation has become the optimal treatment for patients with end-stage liver disease. However, biliary complications still commonly occur after liver transplantation, especially biliary anastomotic stricture. Severe biliary anastomotic stricture will not only increase the cost of treatment, but also lead to graft loss and even affect the survival rate of recipients. Therefore, timely diagnosis and treatment of biliary anastomotic stricture play a significant role in improving the survival rate of liver transplant recipients. In this article, the risk factors, clinical symptoms, diagnosis and treatment of biliary anastomotic stricture after liver transplantation were reviewed, aiming to provide novel ideas for the research, diagnosis and treatment of biliary anastomotic stricture after liver transplantation, and further enhance clinical efficacy of liver transplantation and the quality of life of recipients.

Objective To study the efficacy and safety of bronchial artery embolization(BAE)with tris-acryl gelatin microspheres(TAGM)combined with platinum spring coil with fiber(microcoils)in the treatment of acute severe hemoptysis caused by bronchiectasis.Methods A retrospective analysis of 48 patients with bronchiectasis was performed.After the lesion vessels were confirmed by angiography,the distal capillary bed was embolized with TAGM(300-500 μm),the middle blood flow was embolized with microcoils according to the diameter of the small artery,and then the proximal vessels were embolized with TAGM(500-700 μm)again.In patients with pulmonary artery/vein fistula,appropriate TAGM(500-700 μm)was selected according to the size of the fistula and the blood flow velocity,followed by dense embolization with multiple microcoils.The complete occlusion of the lesion vessel was confirmed again by arteriography after embolization.Results The overall success rate of operation was 95.83％.There were 36 patients with immediately stopped bleeding,6 cases with effective treatment,4 cases with improved treatment,1 case with invalid treatment due to the leakage of the responsible blood vessel,which was improved after the second embolization.There was 1 case died in surgery due to sudden massive hemoptysis,choking and suffocation.During the 3-51 months follow-up,1 patient died due to sudden massive hemoptysis;4 patients had recurrent hemoptysis due to poor control of infection and collateral circulation,which were controlled after reemboliza-tion,and 1 patient with bronchiectasis and pulmonary tuberculosis had repeated hemoptysis caused by multiple pulmonary lesions and severe pulmonary infection,performing on four times embolization.There was no patient with recurrent hemoptysis occurring recanalization of primary embolized vessel.During the follow-up,the overall survival rate was 97.87％,and the hemoptysis control rate was 87.23％.Conclusion TAGM combined with microcoils is safe and effective in the treatment of acute massive hemoptysis,which has good short-term effect and long-term prognosis.

Objective:To compare the safety and efficacy of laparoscopic and open hepatectomy for hepatolithiasis.Methods:Between January 2014 and May 2020, the clinicopathological data of 254 patients with hepatolithiasis who underwent laparoscopic or open hepatectomy at the First Department of Hepatobiliary Surgery,Affiliated Hospital of North Sichuan Medical College were collected retrospectively. There were 74 males and 180 females with age of (56±8) years (range: 38 to 77 years). Of the 254 patients, 162 underwent laparoscopic surgery (laparoscopic group) and 92 underwent open surgery (open group). Propensity score matching(PSM) was performed to match baseline characteristics of the two groups,and then the perioperative results and follow-up efficacy were compared between the two groups. The t-test, Mann-Whitney U test, χ 2 test or Fisher′s exact probability method was used to compare the perioperative data and follow-up results of the two groups after matching, respectively. Results:Each group had 63 patients after PSM with well-balanced baseline characteristics. There was no statistic difference in the type of hepatectomy,combined common bile duct exploration rate,T tube drainage placement rate,operation time,intraoperative transfusion rate,intraoperative accidental injury rate,initial and final stone clearance rate,and stone recurrence rate between the two groups. However,compared with the open hepatectomy group, the laparoscopic group had significantly lower intraoperative blood loss ( M(IQR))(300(175)ml vs. 350(145)ml, Z=3.227, P=0.001),shorter postoperative hospital stay((10.6±4.1)days vs. (14.0±4.0)days, t=4.634, P<0.01),shorter time to postoperative oral intake ((1.8±1.1)days vs. (2.9±1.6)days, t=4.556, P<0.01), and lower postoperative complication rate (25.4%(16/63) vs. 49.2%(31/63), χ2=7.635, P=0.006). Conclusion:Laparoscopic hepatectomy is safe and effective for hepatolithiasis with the advantages of less intraoperative blood loss,lower postoperative complications and faster postoperative recovery.

Objective:To compare the safety and efficacy of laparoscopic and open hepatectomy for hepatolithiasis.Methods:Between January 2014 and May 2020, the clinicopathological data of 254 patients with hepatolithiasis who underwent laparoscopic or open hepatectomy at the First Department of Hepatobiliary Surgery,Affiliated Hospital of North Sichuan Medical College were collected retrospectively. There were 74 males and 180 females with age of (56±8) years (range: 38 to 77 years). Of the 254 patients, 162 underwent laparoscopic surgery (laparoscopic group) and 92 underwent open surgery (open group). Propensity score matching(PSM) was performed to match baseline characteristics of the two groups,and then the perioperative results and follow-up efficacy were compared between the two groups. The t-test, Mann-Whitney U test, χ 2 test or Fisher′s exact probability method was used to compare the perioperative data and follow-up results of the two groups after matching, respectively. Results:Each group had 63 patients after PSM with well-balanced baseline characteristics. There was no statistic difference in the type of hepatectomy,combined common bile duct exploration rate,T tube drainage placement rate,operation time,intraoperative transfusion rate,intraoperative accidental injury rate,initial and final stone clearance rate,and stone recurrence rate between the two groups. However,compared with the open hepatectomy group, the laparoscopic group had significantly lower intraoperative blood loss ( M(IQR))(300(175)ml vs. 350(145)ml, Z=3.227, P=0.001),shorter postoperative hospital stay((10.6±4.1)days vs. (14.0±4.0)days, t=4.634, P<0.01),shorter time to postoperative oral intake ((1.8±1.1)days vs. (2.9±1.6)days, t=4.556, P<0.01), and lower postoperative complication rate (25.4%(16/63) vs. 49.2%(31/63), χ2=7.635, P=0.006). Conclusion:Laparoscopic hepatectomy is safe and effective for hepatolithiasis with the advantages of less intraoperative blood loss,lower postoperative complications and faster postoperative recovery.

Objective:To optimize key parameters based on microwave assisted rapid staining technique for ultrathin section and establish a rapid ultrathin section preparing method .Methods:Ultrathin sections were stained respectively with 1% uranium acetate (UA) and lead citrate (LC) for different duration at various microwave power using microwave tissue processor. Then transmission electron microscope (TEM) photographs of cellular ultrastructure were taken and analyzed. The optimized single staining parameters were decided and combined to investigate the optimal microwave assisted UA and LC double staining conditions. The rapid staining effects of ultrathin sections were verified in different viruses including human adenovirus 5 (HAd5), herpes simplex virus (HSV), H1N1 influenza virus, enterovirus 71(EV-A71)human infected cells samples.Results:The optimized microwave assisted rapid ultrathin section staining parameters are: UA for 30 s and LC for 20 s at power 200 W or UA for 30 s and LC for 30 s at 300 W using microwave tissue processor.1∶6 dilution of original LC concentration could still work well through microwave assistance. The parameters can be extended and applied to domestic microwave ovens, and the optimized staining parameters are UA for 30 s and LC for 30 s at 320 W.Conclusions:The optimized parameters of microwave assisted rapid ultrathin section staining were obtained and can be applied in not only cell samples but also different virus ultrathin sections.

Objective To explore the recyclability and safety of Celect retrievable filter placement in the prevention of pulmonary embolism in patients with deep venous thrombosis(DVT).Methods The data of 120 DVT patients with Celect retrievable filter were collected from the Second Hospital of Shanxi Medical University from August 2015 to March 2017 and analyzed retrospectively. The Celect filter was placed in the inferior vena cava(IVC)at the inferior margin of the renal vein for 1 to 2 cm by puncturing the contralateral femoral vein or right internal jugular vein.The filter retrieve risk was assessed within 8 weeks after being implanted. The filters would be recovered through the right jugular vein when meeting the recovery standard, and the retrieve methods included conventional method, removing the guide wire into a loop trap method and guiding wire into a loop combined with balloon assisted method.The perforation of the vena cava was observed and the tilt angle of the filter was measured.The success rate of Celect filter retrieve was evaluated by the Kaplan-Meier method. Results Celect filters were successfully implanted in 120 patients with DVT.The IVC filters were implanted through femoral vein in 111 patients and 2 cases via right internal jugular vein.No complications,asymptomatic pulmonary embolism and related death was found in all patients.Twenty four patients did not reach the standard of filter retrieve,and were follow-uped.Ninety six cases were treated with Celect retrievable filter,among which,93 cases were successfully recovered with the filter indwelling time ranging from 7 to 144 days and the median being 50 days.The failure of the filter retrieve occurred in 3 cases because of the serious tilt of the filter or the encapsulation of filter by inferior vena cava thrombus.Perforation of vena cava with no clinical symptoms occurred in 21 cases.Filter tilt was found in 35 cases,among which,15 cases had inclined angle>15 degrees or the recovery hook closed to the IVC wall.Thirteen cases with filter tip or recovery hook attached to the wall were successfully removed by using the guide wire into a loop or trap guide wire into a loop combined with balloon assisted method instead of routine removal method.The retrieve rate was 100% when the retention time of Celect filter in the body was within 106 days. Conclusion Celect retrievable filter can be implanted in DVT patients with long retrieve time window and high retrieve rate,but the filter inclination rate and vena cava perforation rate are high.

Objective To analyze the effect of endoscopic middle turbinate angioplasty on postoperative nasal function and olfaction in patients with chronic sinusitis and nasal polyp.Methods Clinical materials of 80 patients with chronic sinusitis and nasal polyps were analyzed retrospectively,and they were divided into control group and research group,40 cases in each group.Control group was treated with endoscopic partial middle turbinate resection,while research group was treated with endoscopic middle turbinate angioplasty.Clinical efficacy,nasal function,olfactory function,SNOT-20CV score,and Lund-Kennedy scoring and complications were compared between two groups.Results Total effective rate of the research group was significantly higher than the control group (P ＜0.05).Before operation,nasal airway resistance and minimal nasal cross-section to anterior nostril distance (DCAN),nasal minimum cross-sectional area (NMCA),nasal volume (NCV),SNOT-20 CV,nasal endoscopic Lund-Kennedy scores showed no significant differences between two groups (P ＞ 0.05).After operation,nasal airway resistance and DCAN and SNOT-20 CV,nasal endoscopic Lund-Kennedy scores decreased significantly in both groups,and these indexes in research group were significantly lower than the control group (P ＜ O.05).The NMCA and NCV increased significantly in both groups,and these indexes in research group were significantly higher than control group (P ＜ 0.05).There was no significant difference in incidence rate of postoperative complications between the two groups (P ＞ 0.05).Conclusion Endoscopic middle turbinate angioplasty is effective in treating chronic sinusitis patients with nasal polyp,which can effectively relieve nasal obstruction and promote nasal function and the sense of smell.

Objective To analyze the effect of endoscopic middle turbinate angioplasty on postoperative nasal function and olfaction in patients with chronic sinusitis and nasal polyp.Methods Clinical materials of 80 patients with chronic sinusitis and nasal polyps were analyzed retrospectively,and they were divided into control group and research group,40 cases in each group.Control group was treated with endoscopic partial middle turbinate resection,while research group was treated with endoscopic middle turbinate angioplasty.Clinical efficacy,nasal function,olfactory function,SNOT-20CV score,and Lund-Kennedy scoring and complications were compared between two groups.Results Total effective rate of the research group was significantly higher than the control group (P ＜0.05).Before operation,nasal airway resistance and minimal nasal cross-section to anterior nostril distance (DCAN),nasal minimum cross-sectional area (NMCA),nasal volume (NCV),SNOT-20 CV,nasal endoscopic Lund-Kennedy scores showed no significant differences between two groups (P ＞ 0.05).After operation,nasal airway resistance and DCAN and SNOT-20 CV,nasal endoscopic Lund-Kennedy scores decreased significantly in both groups,and these indexes in research group were significantly lower than the control group (P ＜ O.05).The NMCA and NCV increased significantly in both groups,and these indexes in research group were significantly higher than control group (P ＜ 0.05).There was no significant difference in incidence rate of postoperative complications between the two groups (P ＞ 0.05).Conclusion Endoscopic middle turbinate angioplasty is effective in treating chronic sinusitis patients with nasal polyp,which can effectively relieve nasal obstruction and promote nasal function and the sense of smell.

OBJECTIVETo understand the toxic effects of manganese exposure on health by measurement of manganese concentration and occupational health inspection among workers in an enterprise exposed to manganese, and to provide a basis for occupational disease control.

METHODSThe air concentrations of manganese in 12 workplaces where workers often stayed were measured by typical sampling; occupational health inspection was performed among a total of 538 workers in the enterprise by cluster sampling.

RESULTSThe average concentrations of manganese in the workplace from 2011 to 2013 were 0.179 mg/m(3), 0.122 mg/m(3), and 0.082 5 mg/m(3), respectively, indicating a significant decrease in manganese level within the three years by rank-sum test (P < 0.05). The results of health inspection showed that 165 (30.7%) out of 538 workers had abnormal indices, and the incidence of autonomic nervous system abnormalities reached 32.7% (176/538). There was no correlation between manganese concentration in the workplace and the incidence of abnormal indices in health inspection, while the manganese concentration in the workplace was positively correlated with the incidence of autonomic nervous system symptoms (r = 0.718, P < 0.05).

CONCLUSIONThe manganese concentration in the workplace is positively correlated with the incidence of autonomic nervous system symptoms. Early exposure to a low level of manganese can induce functional changes and potential damages in the nervous system.

Humans ; Incidence ; Manganese ; analysis ; Nervous System ; drug effects ; physiopathology ; Occupational Diseases ; chemically induced ; epidemiology ; Occupational Exposure ; analysis ; Occupational Health ; standards ; Workplace

This study was aimed to establish an experimental mouse model of combined transgenic inhibition of both multifunctional Ca(2+)/calmodulin-dependent protein kinase II (CaMKII) and inward rectifier potassium current (Ik1), and to observe whether the specific inhibition of both CaMKII and Ik1 can bring about any effects on cardiac remodeling. Mice were divided into 4 groups: wild type (WT), CaMKII inhibited (AC3-I), Ik1 inhibited (Kir2.1-AAA) and combined inhibition of both CaMKII and Ik1 (AC3-I+Kir2.1-AAA). Mice in each group received electrocardiogram (ECG) and echocardiography examination. ECG in the condition of isoproterenol (ISO) injection was also checked. The whole cell patch clamp technique was used to measure Ik1 and the transient outward potassium current (Ito) from enzymatically isolated myocytes of left ventricle. In the condition of basal status, no significant changes of heart rate, PR interval and QRS interval were observed. No mouse showed ventricular arrhythmias in all of the 4 groups. After ISO injection, each group presented no significant ventricular arrhythmias either. The indexes measured by M-mode (motion-mode) and two-dimensional echocardiography had no significant differences among the four groups. Ik1 in AC3-I group was significantly higher than those in other three groups (P < 0.01) because of the results brought about by CaMKII inhibition. Among the latter three groups, both Kir2.1-AAA group and AC3-I+Kir2.1-AAA group had a significant reduced Ik1 compared with that of WT group, which was due to the Ik1 inhibition (P < 0.01). Ito in AC3-I group was higher than that of the other three groups (P < 0.01), but there were no significant differences in Ito among WT, Kir2.1-AAA and AC3-I+Kir2.1-AAA groups. Thus, combined transgenic myocardial CaMKII and Ik1 inhibition eliminated the up-regulation of Ik1 in CaMKII inhibited mice, and had no effects on cardiac remodeling including heart structure and function as well as arrhythmias at the basic and ISO conditions. The results of this study may provide a basis for the further investigation of combined inhibition of CaMKII and Ik1 in pathogenic cardiac remodeling.
Animals ; Arrhythmias, Cardiac ; Brugada Syndrome ; Calcium-Calmodulin-Dependent Protein Kinase Type 2 ; physiology ; Cardiac Conduction System Disease ; Disease Models, Animal ; Electrocardiography ; Heart ; physiology ; Heart Conduction System ; abnormalities ; Heart Ventricles ; Isoproterenol ; Mice ; Mice, Transgenic ; Patch-Clamp Techniques ; Potassium Channels, Inwardly Rectifying ; physiology ; Up-Regulation ; Ventricular Remodeling