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Biliary tract cancer is a group of malignancies which originate from biliary epithelium, and adenocarcinoma is the main pathological type. Although surgical resection is the only radical treatment strategy, most biliary tract cancer patients are diagnosed at locally advanced stage or with distant metastasis. Biliary tract cancer is highly resistant to the conventional chemoradiotherapy and the emerging immunotherapy including immune checkpoint inhibitors, owing to the suppressive immune microenvironment. In a whole view, this paper discussed the anti-tumor and tumor-promoting immune responses of the various immune cells and stromal cells in the immune microenvironment of biliary tract cancer, as well as their correlation with prognosis. The understanding of the whole view of immune microenvironment in biliary tract cancer patients could further inform the design of clinical trials of immunotherapy or combination therapy.
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OBJECTIVE@#To carry out prenatal diagnosis for a fetus with absent nasal bone by using cytogenetic and molecular techniques.@*METHODS@#Chromosomal karyotyping, single nucleotide polymorphism array (SNP-array) and fluorescence in situ hybridization (FISH) assays were applied for the diagnoses. Peripheral blood samples were also taken from the parents for chromosomal karyotyping and FISH analysis.@*RESULTS@#The fetus was found to have a 46,XX,add(21)(p11.2) karyotype, and SNP-array has revealed a 11.3 Mb duplication at 21q22.12q22.3 (hg19: 36 762 648-48 093 361), which was confirmed by FISH. Both parents were found to be normal by chromosomal karyotyping and FISH analysis. The fetus was ultimately found to have a karyotype of 46,XX,der(21)t(21;21)(p11.2;q22.1), resulting a de novo partial trisomy of 21q22.1.@*CONCLUSION@#Combined use of various techniques has enabled accurate prenatal diagnosis and genetic counseling for the fetus.
Subject(s)
Female , Humans , Pregnancy , In Situ Hybridization, Fluorescence , Karyotyping , Nasal Bone , Prenatal Diagnosis , Trisomy/geneticsABSTRACT
<p><b>OBJECTIVE</b>To investigate the current quality of life in children with chronic diseases, and to explore the impact of transition readiness on quality of life.</p><p><b>METHODS</b>A total of 332 children with chronic diseases from two children's hospitals in Shanghai, China were enrolled. A self-designed demographic questionnaire, Pediatric Quality of Life Inventory 4.0 Generic Core Scales (PedsQL4.0), and Self-Management and Transition to Adulthood with Rx=Treatment (STARx) Questionnaire were used to evaluate transition readiness and quality of life.</p><p><b>RESULTS</b>The children with chronic diseases had a significantly lower total quality of life score than the national norm (74.66±15.85 vs 81.81±12.03; P<0.001). Doctor-patient communication and health care responsibilities (the child's abilities to take care of himself/herself and adaptation to the process of diagnosis and treatment from childhood to adulthood) were positively correlated with the scores on each dimension of quality of life (P<0.05). Duration of disease, time of absence from school within six months, and the number of types of drugs taken orally were negatively correlated with the total quality of life score (r=-0.172, -0.236, and -0.280; P<0.05). The residence (urban or rural area), monthly family income, parents' educational level, and father's occupation had significant influence on children's quality of life (P<0.05). The hierarchical multiple regression analysis revealed that doctor-patient communication and health care responsibilities led to a 14.3% increase in the explanation of the total variation in quality of life (P<0.001).</p><p><b>CONCLUSIONS</b>Quality of life is not satisfactory in children with chronic diseases. Two domains of transition readiness, namely the abilities to communicate with health providers and health care responsibilities, are major factors influencing quality of life in these children.</p>
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Objective To describe the anxiety of caregivers and condition management of preschool asthma children ,and analyze the relation?ship between anxiety and disease management. Methods A total of 208 caregivers of asthma children from two hospitals in Shanghai were select?ed using convenient sampling,and surveyed by self?rating anxiety scale(SAS),condition management ability scale and condition management diffi?culty scale. Results The score of SAS were negatively correlated with the condition management ability and positively correlated with the condi?tion management difficulty. Hierarchical regression analysis showed that the model explained 26.6%amount and 35.1%amount of variation respec?tively. Conclusion The anxiety of caregiver of children with asthma may affect the disease management. Future interventions should be strength?ened on the caregivers'psychological problems,so as to improve disease management and control asthma more effectively.
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Flap endonuclease 1 (FEN1) is an endonuclease that catalyzes invasive reaction. It can be used in signal-amplification reaction-based nucleic acid assay. However, the application of FEN1 is hampered due to the lack of detailed protocols to express and purify the enzyme, and to quantify the enzyme activity. In this paper, the DNA fragment coding the gene of FEN1 from Archaeoglobus fulgidus was synthesized, and inserted into the plasmid of pET24a(+) to express recombinant FEN1 with His-tag. After optimizing the expression, detailed expression protocol of FEN1 was obtained by culturing the recombinant E. coli at 37 ℃ with 200 r/min of shaking for 8 h, followed by inducing with 0.05 mmol/L IPTG at 37 ℃ for 11 h. The purified recombinant FEN1 with the molecular mass of 38 kDa was obtained by Ni-affinity chromatography. Moreover, we developed a accurate quantification method with fluorescence-labelled probes. Finally, the recombinant FEN1 was used in real-time PCR coupled with high specific invader assay for aldh2 gene genotyping to obtain the correct typing results, indicating that the recombinant FEN1 can be used in gene polymorphism detection. We provide a reliable enzyme for developing invasive reaction-based nucleic acid assay.
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<p><b>OBJECTIVE</b>To explore the inhibitory effect of migration-inducing gene 7 (Mig-7) gene silencing induced by retroviral-mediated small hairpin RNA (shRNA) on vasculogenic mimicry (VM), invasion and metastasis of human hepatocellular carcinoma (HCC) cells in vitro.</p><p><b>METHODS</b>Two target sequences (Mig-7 shRNA-1 and Mig-7 shRNA-2) and one negative control sequence (Mig-7 shRNA-N) were synthesized. The recombinant retroviral vectors carrying Mig-7 shRNA were constructed, and HCC cell line MHCC-97H were transfected with Mig-7 shRNA-1, Mig-7 shRNA-2, Mig-7 shRNA-N, or the empty vector, or treated with 125 µg/mL recombinant human endostatin (ES). Mig-7 expression in the treated cells was detected using semi-quantitative PCR and Western blotting. The inhibitory effect of Mig-7 silencing on VM formation was investigated in a 3-dimensional cell culture system; the changes in cell adhesion, invasion and migration were assessed with intercellular adhesion assay, Transwell invasion assay and Transwell migration assay, respectively.</p><p><b>RESULTS</b>The expression of Mig-7 at both mRNA and protein levels decreased significantly, VM formation, invasion and metastasis were suppressed, while intercellular adhesion increased significantly in MHCC-97H cells in Mig-7 shRNA-1 and Mig-7 shRNA-2 groups (P<0.05); such changes were not observed in cells transfected with Mig-7 shRNA-N or the empty vector, nor in cells treated with ES.</p><p><b>CONCLUSIONS</b>Mig-7 silencing by retroviral-mediated shRNA significantly inhibits VM formation, invasion and metastasis and increases the intercellular adhesion of the HCC cells, while ES does not have such inhibitory effects.</p>
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<p><b>OBJECTIVE</b>To compare the cleaning effect of automatic cleaning machine and manual cleaning on coupling type surgical instruments.</p><p><b>METHODS</b>A total of 32 cleaned medical instruments were randomly sampled from medical institutions in Putuo District medical institutions disinfection supply center. Hygiena System SUREII ATP was used to monitor the ATP value, and the cleaning effect was evaluated.</p><p><b>RESULTS</b>The surface ATP values of the medical instrument of manual cleaning were higher than that of the automatic cleaning machine.</p><p><b>CONCLUSION</b>Coupling type surgical instruments has better cleaning effect of automatic cleaning machine before disinfection, the application is recommended.</p>
Subject(s)
Disinfection , Reference Standards , Durable Medical Equipment , Reference Standards , Fluorescence , Surgical Equipment , Reference StandardsABSTRACT
Objective Tongue shape and motion is one of the important references for tongue diagnosis.However, current tongue image objectification of tongue diagnosis cannot express the characteristics of tongue.Methods In order to increase shape and dynamic information about the tongue, the methods of key frame selection and linear interpolation were used to tongue 3D dynamic visualization reconstruction model on the basis of 3D static visual model.For the convenient use of the tongue 3D dynamic visualization model, this paper put forward a model of 3D dynamic visualization interaction system which was realized based on DirectX.Results The 3D dynamic visualization model not only had a static visual model of texture and depth information, but also could intuitively describe the tongue motion.Conclusions It provides a method for the auxiliary tongue diagnosis of traditional Chinese medicine (TCM).
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Objective To investigate the prevalence of urticaria among children aged 2-6 years in Nanjing city.Methods A questionnaire survey was carried out in children aged 2-6 years in 5 main districts of Nanjing City.Results The number of valid questionnaires was 13 610,accounting for 92.8％ of total respondents.Among the 13 610 respondents,1 116 were diagnosed as urticaria,including 565 boys and 551 girls,with the total prevalence rate being 8.54％.No significant difference was observed in the prevalence rate of urticaria between boys and girls (8.49％ vs.8.60％,x2 =0.04,P =0.832) or among children of different age groups (x2 =1.84,P =0.17).The prevalence of urticaria increased with age,and positively correlated with parents' educational level (rs =0.96,P =0.000).Children born in urban areas showed higher prevalence of urticaria than those in rural areas (8.79％ vs.5.56％,x2 =13.98,P =0.000).Conclusions The prevalence of urticaria has increased among children aged 2-6 years in recent years.More studies should be carried out to investigate into the pathogenesis and relevant factors of urticaria,so as to facilitate its prevention and treatment.
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Objective: To optimize the formulation of ginsenoside Rg3 self-emulsifying drug delivery by Box-Behnken experimental design (BBD) and evaluate its quality. Methods: Formulations were optimized using design of experiments by employing a 3-factor, 3-level BBD. Independent variables studied were the emulsifier, co-emulsifier, and the oil phase. The dependent variables were drug loading and average particle size. Through the BBD software, the response surface plots were drawn and the polynomial of influence of each factor index was obtained. Finally the formula optimization was obtained and the efficiency, droplet size, and dissolution rate of self-emulsifying drug delivery were investigated. Results: Optimum prescription was as follows: emulsifier [RH-400-Triton X-100 (1∶1)], co-emulsifier (isopropanol), and the oil phase (ethyl oleate). The optimum proportion was 3∶1.475∶0.5. The optimized ginsenoside Rg3 self-emulsifying drug delivery could fully emulsify in 5 min and the average drug loading was 917.53 μg/mL, average particle size was 111.6 nm. The dissolution degree in vitro of the formulations showed that the release rate and level were apparently superior to the conventional capsules. Conclusion: The observed responses are in close agreement with the predicted values of the mathematic models, and the BBD is suitable for optimizing ginsenoside Rg3 self-microemulsifying drug delivery.
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Objective To investigate the prevalence of atopic dermatitis (AD) among children aged 2-6 years in Nanjing city.Methods A questionnaire survey was carried out in children aged 2-6 years in 7 main districts of Nanjing City.Results A total of 13 061 children were investigated,among which,768 were diagnosed as AD,including 410 boys and 358 girls.The prevalence rate of AD was 5.88％ (95％ CI,5.48％-6.28％) in total,6.16％ (95％ CI,5.59％-6.74％) in boys and 5.59％ (95％ CI,5.02％-6.15％) in girls.Higher prevalence rate of AD was observed in boys compared with girls,and in children whose place of birth was in urban areas compared with those in rural areas.In addition,the prevalence rate of AD increased with age and with the rise in parental educational level.Conclusions Rapid economic development has dramatically changed life habits,dietary structure and residential environment of people,which can influence the prevalence of AD.
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PURPOSE: The aim of the study was to evaluate the efficacy and safety of combining sorafenib with chemotherapy in patients with human epidermal growth factor receptor 2 (HER2)-negative advanced breast cancer. METHODS: MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, American Society for Clinical Oncology abstracts, and European Society for Medical Oncology abstracts were searched. Randomized clinical trials that compared the efficacy and safety of sorafenib plus chemotherapy in patients with HER2-negative advanced breast cancer with placebo plus chemotherapy were eligible. The endpoints were progression-free survival (PFS), overall survival (OS), time to progression (TTP), duration of response (DOR), overall response rate (ORR), clinical benefits, and adverse effects. The meta-analysis was performed using Review Manager 5.2.6 (The Nordic Cochrane Centre), and the fixed-effect model weighted by the Mantel-Haenszel method was used. When considerable heterogeneity was found (p<0.1), further analysis (subgroup analysis, sensitivity analysis, or random-effect model) was performed to identify the potential cause. The results are expressed as hazard ratios or risk ratios, with their corresponding 95% confidence intervals. RESULTS: The final analysis included four trials comprising 844 patients. The results revealed longer PFS and TTP, and higher ORR and clinical benefit rates in patients receiving sorafenib combined with chemotherapy compared to those receiving chemotherapy and placebo. OS and DOR were similar in the two groups. Meanwhile, the incidence of some adverse effects, including hand-foot skin reaction/hand-foot syndrome, diarrhea, rash, and hypertension, were significantly higher in the sorafenib arm. CONCLUSION: Sorafenib combined with chemotherapy may prolong PFS and TTP. This treatment was associated with manageable toxicities, but frequent dose interruptions and reductions were required.
Subject(s)
Humans , Arm , Breast Neoplasms , Breast , Diarrhea , Disease-Free Survival , Drug Therapy , Exanthema , Hypertension , Incidence , Medical Oncology , Odds Ratio , Population Characteristics , ErbB Receptors , Skin , Treatment OutcomeABSTRACT
<p><b>OBJECTIVE</b>To observe the efficacy of polyglycoside of Tripterygium wilfordii(GTW) in preventing postoperative recurrence of Crohn disease(CD).</p><p><b>METHODS</b>Thirty-nine post-operative CD patients in whom all of the diseased gut had been removed from January 2005 to December 2006 were enrolled in a randomized, placebo-controlled trial. The patients took GTW(21 cases) or SASP(18 cases) in two weeks after operation. Crohn disease activity index(CDAI), ESR and CRP were collected at week 0, 13, 26, 52 or at the onset of symptoms. Ileocolonoscopy was performed at the end of the trial or at the onset of symptoms.</p><p><b>RESULTS</b>One patient in GTW group and 2 patients in SASP group were lost and 2 patients in GTW were excluded from the trial for non-compliance. Clinical recurrence was ascertained in one patient (5.6%) received GTW and in four (25.0%) received SASP. Four of eighteen patients in GTW(22.2%) had endoscopic recurrence compared with nine of sixteen(56.2%) in SASP. There were significant differences between the two groups(P<0.05).</p><p><b>CONCLUSION</b>Tripterygium wilfordii showed good efficacy in preventing recurrence of postoperative CD which can maintain remission and prevent recurrence.</p>
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Crohn Disease , Drug Therapy , Drugs, Chinese Herbal , Therapeutic Uses , Glycosides , Therapeutic Uses , Phytotherapy , Postoperative Period , Secondary Prevention , Treatment Outcome , TripterygiumABSTRACT
Objective To investigate the effects and mechanisms of 5-aza-2'-deoxycytidine (5-Aza-CdR) on endometrial cancer cell.Methods In vitro experiments of 5-Aza-CdR were done using human endometrial cancer cell line HEC-1B.Evaluation of cellular proliferation and apoptosis was ascertained respectively using trypan blue exclusion and flow cytometry.RT-PCR and methylation specific PCR(MSP) was done to detect the expression of RASSF1 A mRNA and methylation status of RASSF1 A promoter of HEC-1B cell line.Results (1) The status of cellular growth and apeptosis of HEC-1 B cell line:the growth inhibition effects of 5-Aza-CdR on HEC-1B cell line were both concentration-dependent (P ＜ 0.01) and time-dependent(P ＜0.01),as well as the apoptosis rate of HBC-1-B cell line depended on the dose of 5-Aza-CdR obviously(P ＜0.01).(2)The expression of RASSF1A mRNA of HEC-1B cell line:RASSF1A mRNA was expressed in HEC-1B cell after 5-Aza-CdR treatment,but it was undetectable before the treatment.In the groups with different concentration of 5-Aza-CdR (0.05,0.1,1,5,10 nmol/ml),the expression of RASSF1A mRNA was respectively 0.074±0.004,0.105±0.004,0.167±0.006,0.334±0.005,0.484±0.007,which were remarkably different from the group without 5-Aza-CdR(the expression of RASSF1A mRNA was 0;P ＜ 0.01).(3) The hypermethylation of RASSF1A promoter of HEC-1B cell line:the hypermethylation of RASSF1A promoter was detected in HEC-1B cell line.The status of hypermethylation was decreased after treatment with 5-Aza-CdR of 0.05,0.1,1,5 nmol/ml,meanwhile,both methylation bands and demethylation bands were observed by methylation specific PCR.After the treatment with 5-Aza-CdR of 10 nmol/ml the hypermethylation was absent absolutely.Conclusions (1) In HEC-1B cell line,5-Aza-CdR can inhibit cell proliferation and induce cell apopotosis.(2) 5-Aza-CdR can renew the expression of RASSF1A mRNA of HEC-1B cell line and reverse the hypermethylation of RASSF1A promoter.
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<p><b>OBJECTIVE</b>To evaluate the efficacy and safety of subcutaneous injection of recombinant human interleukin-2 (Proleukin) in the treatment of metastatic renal cell carcinoma (RCC).</p><p><b>METHODS</b>Forty-one patients with pathologically confirmed metastatic RCC after radical nephrectomy were enrolled into this study. Two or four consecutive cycles of subcutaneous injection of rhLL-2 were given, with each cycle duration of five weeks consisting of 4 weeks of treatment and one week of rest. The rhLL-2 was injected twice daily subcutaneously at a dose of 9 MIU on D1-D5 during week one, then 9 MIU twice daily on D1-D2 and followed by 9 MIU daily on D3-D5 during week 2-4. Patients were evaluated after the second cycle of treatment. If an objective response or stable disease was observed, the patient would receive another two cycles of treeatment.</p><p><b>RESULTS</b>Of the 41 patients, the overall objective response rate was 17.1% (95% confidence interval, 5.6% to 28.6%) with a complete response (CR) rate of 0.0% and partial response rate (PR) of 17.1%. However, nineteen patients (46.3%) still had a stable disease (SD), and 15 (36.6%) had progressed disease (PD). The disease control rate was 63.4% and the median time to progression (mTTP) was 6 months. The 1-year survival rate was 71.2% with a median overall survival (mOS) rate of 22.5 months. Among 36 PP population, the overall objective response rate was 19.4% (95% confidence interval, 6.5% to 32.3%) with CR rate of 0.0% and PR rate of 19.4%. Sixteen patients(44.4%) had stable disease, and 13 (36.1%) progressed disease. The disease control rate was 63.9%. The 1-year survival rate was 66.7% with a median time to progression of 6 months. The median overall survival (mOS) had not reached yet. The follow-up data showed that the long term survival of the patient who responsed to the IL-2 therapy can be prolonged. Severe toxicity (> or = grade III) was rarely observed. Grade I or II toxicities such as fatigue (100.0%) and fever (82.9%) were frequently observed but reversible.</p><p><b>CONCLUSION</b>Subcutaneous injection of recombinant human interleukin-2 may prolong the survival of patients with a metastatic renal cell carcinoma. This regimen is tolerable with rare severe toxicities.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Antineoplastic Agents , Therapeutic Uses , Carcinoma, Renal Cell , Drug Therapy , General Surgery , Disease Progression , Fatigue , Fever , Follow-Up Studies , Injections, Subcutaneous , Interleukin-2 , Therapeutic Uses , Kidney Neoplasms , Drug Therapy , Pathology , General Surgery , Lung Neoplasms , Nephrectomy , Proportional Hazards Models , Recombinant Proteins , Therapeutic Uses , Remission Induction , Survival RateABSTRACT
<p><b>OBJECTIVE</b>To investigate the mRNA expression of severe acute respiratory syndrome-associated coronavirus (SARS-COV) functional receptor, angiotensin-converting enzyme 2 (ACE2), in human femoral head and conjunctiva, and explore the possible entry route of SARS-COV in human femoral head.</p><p><b>METHODS</b>ACE2 mRNA in human femoral head was detected by nested RT-PCR with human beta actin gene as the positive control.</p><p><b>RESULTS</b>The mRNA of human beta actin gene could be amplified efficiently in all the tissue samples. The mRNA of human ACE2 was expressed efficiently in the normal lung tissue, but not in the cartilage and cancellous bone under the weight-bearing area of the femoral head.</p><p><b>CONCLUSION</b>SARS-COV can not infect the femoral head tissue and lead to avascular necrosis of the femoral head directly by the spike glycoprotein, and mechanism of the virus for causing avascular necrosis needs further investigation.</p>
Subject(s)
Humans , Femoral Neck Fractures , Metabolism , Femur Head , Metabolism , Gene Expression , Peptidyl-Dipeptidase A , Genetics , RNA, Messenger , Genetics , Receptors, Virus , Genetics , Reverse Transcriptase Polymerase Chain Reaction , Severe acute respiratory syndrome-related coronavirus , MetabolismABSTRACT
<p><b>BACKGROUND</b>Bacterial pneumonia in the recipients of liver transplantation (LTX) is a common postoperative complication influencing the prognosis greatly. In this article, the diagnosis and treatment of bacterial pneumonia in 33 LTX recipients are reported.</p><p><b>METHODS</b>From February 1999 to January 2003, a total of 103 patients underwent allogeneic LTX at our center; afterwards, a retrospective analysis was made on their postoperative clinical manifestations, including symptoms (expectoration, panting and fever), sign (rale), results of laboratory examinations (white blood cell count and sputum culture of tracheal secretions or pleural fluid culture), and chest X-ray films. The following data of the pneumonia and non-pneumonia groups were collected, and the rank sum test (SPSS 11.0, Wilcoxon's method) was used to analyze the duration of postoperative respirator utilization and the volume of pleural effusion through pleurocentesis or pleural drainage.</p><p><b>RESULTS</b>In the 103 patients, 33 experienced 53 episodes of bacterial pneumonia during their hospital stay after transplantation, 14 of them (42.42%) had more than three manifestations of the seven mentioned above. The pathogens causing bacterial pneumonia included Pseudomonas aeruginosa (17.48%), Klebsiella pneumoniae (15.53%), Acinetobacter baumannii (10.68%), and Staphylococcus aureus (7.77%). Amilkacin, tienam, ciprofloxacin, vancomycin, etc. were the antibiotics of choice against those bacteria. Acute rejection occurred during the treatment of bacterial pneumonia in 16 patients, and 5 of them died. Wilcoxon's rank sum test of the data indicated that the pneumonia group had longer duration of postoperative ventilator treatment and larger volume of pleural effusion than the non-pneumonia group (P < 0.05).</p><p><b>CONCLUSIONS</b>The clinical manifestations of pneumonia after LTX might be atypical, and special attention should be paid to the respiratory symptoms and signs within 2 months after LTX. Whenever the diagnosis of bacterial pneumonia is confirmed, consideration should be given to reasonable use of antibiotics and regulation of immunity in addition to other routine therapies.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Anti-Bacterial Agents , Therapeutic Uses , Liver Transplantation , Pneumonia, Bacterial , Diagnosis , Drug Therapy , Allergy and Immunology , Postoperative Complications , Diagnosis , Drug Therapy , Allergy and Immunology , Retrospective StudiesABSTRACT
<p><b>OBJECTIVE</b>To assess the diagnosis and treatment of invasive lung aspergillosis after liver transplantation.</p><p><b>METHODS</b>Routine sputum culture was performed. Itraconazole and fluconazole were used to prevent fungal infection prophylactically. Amphyotericin B was only used on aspergillosis. In 54 patients receiving, liver transplantation, 3 patients with lung aspergillosis were reviewed.</p><p><b>RESULTS</b>Of the 3 patients 2 died and 1 recovered.</p><p><b>CONCLUSIONS</b>Over-immunosuppression is a main risk factor for aspergillosis. Amphotericin B is still the best choice for the treatment of aspergillosis and its gradual, interrupted, low concentration administration, cooperated with itraconazole can ease the side effects.</p>