Overexpression of Protein Phosphatase 2 Regulatory Subunit B"Alpha Promotes Glycolysis by Regulating Hexokinase 1 in Hepatocellular Carcinoma / 生物医学与环境科学（英文）

Objective@#To investigate the regulatory relationship of Protein Phosphatase 2 Regulatory Subunit B"Alpha ( PPP2R3A) and hexokinase 1 ( HK1) in glycolysis of hepatocellular carcinoma (HCC).@*Methods@#In HepG2 and Huh7 cells, PPP2R3A expression was silenced by small interfering RNA (siRNA) and overexpression by plasmid transfection. The PPP2R3A-related genes were searched by RNA sequencing. Glycolysis levels were measured by glucose uptake and lactate production. QRT-PCR, ELISA, western blot and immunofluorescence assay were performed to detect the changes of PPP2R3A and HK1. Cell proliferation, migration and invasion assay were used to study the roles of HK1 regulation by PPP2R3A.@*Results@#RNA sequencing data revealed that PPP2R3A siRNA significantly downregulated the expression of HK1. PPP2R3A gene overexpression promotes, while gene silencing suppresses, the level of HK1 and glycolysis in HCC cells. In HCC tissue samples, PPP2R3A and HK1 were colocalized in the cytoplasm, and their expression showed a positive correlation. HK1 inhibition abrogated the promotion of glycolysis, proliferation, migration and invasion by PPP2R3A overexpression in liver cancer cells.@*Conclusion@#Our findings showed the correlation of PPP2R3A and HK1 in the glycolysis of HCC, which reveals a new mechanism for the oncogenic roles of PPP2R3A in cancer.

Preparation of Indium Oxide Functionalized Multiwalled Carbon Nanotube Adsorbent for Detection of Preservatives in Food Samples / 分析化学

In2O3nanoparticles-modified multiwalled carbon nanotubes (In2O3-MWCNTs) were successfully prepared as solid phase extraciton (SPE) adsorbent for the determination of three food preservatives(benzoic acid,sorbic acid,and methylparaben) in beverage samples coupled with high performance liquid chromatography (HPLC).Because of the large surface area and amount of hydroxyl groups on the surface of In2O3nanoparticles,In2O3nanoparticles could interact with specific functional groups.In2O3-MWCNTs adsorbent was prepared based on the large surface area of In2O3and superior thermal and chemical stability of MWCNTs.The obtained adsorbent was characterized via transmission electron microscope (TEM),thermogravimetric analysis (TGA),and Fourier transform-infrared (FT-IR) spectroscopy.Several experimental parameters affecting the extraction efficiency were investigated by single-factor experiments,such as adsorbents amount,sample volume,eluent volume,sample pH,and eluent type.The first four factors were then further evaluated by means of a Taguchi's L16(44) orthogonal array experimental design.According to the results of orthogonal array experiment,the optimal conditions were chosen as follows: 0.15 g of adsorbent amount,5.0 mL of sample volume,0.6 mL of ACN-H2O (60:40,0.1% formic acid,V/V) as eluent,and sample pH 4.0.Under the optimum conditions,the LODs (S/N=3) and LOQs (S/N=10) for three preservatives were in the range of 0.004-0.012 μg/mL and 0.012-0.038 μg/mL,respectively.The recoveries ranged from 70.2% to 109.4%.The method is rapid,sensitive,and suitable for the determination of preservatives in food samples.

Risk Factors for Preoperative Anxiety and Depression in Patients Scheduled for Abdominal Aortic Aneurysm Repair / 中华医学杂志(英文版)

Background@#Perioperative emotional disorders of patients underwent abdominal aortic aneurysm (AAA) repair is an emerging area of study, and preoperative mental distress of those patients remains poorly understood. The aim of this study was to investigate the prevalence and identify the risk factors of preoperative anxiety and depression in patients scheduled for AAA repair.@*Methods@#A total of 189 patients who underwent elective AAA repair between 2015 and 2016 were included in this study. These patients were preoperatively evaluated by Hospital Anxiety and Depression Scale (HADS). Demographics and anxiety and depression scores of the patients were documented. Logistic regression was used to identify the independent risk factors of preoperative anxiety and depression.@*Results@#A total of 150 AAA patients were included in final analysis. Of these 150 patients, 44 patients (29.3%) had borderline anxiety or clinical anxiety, and 42 patients (28.0%) were found to have borderline or clinical depression. Female (odds ratio [OR]: 2.81, 95% confidence interval [CI]: 1.08-7.26), the American Society of Anesthesiologists (ASA) Grade 3/4 (OR: 4.34, 95% CI: 1.13-16.68), higher education (OR: 1.44, 95% CI: 1.02-2.04), and abdominal or back pain (OR: 3.08, 95% CI: 1.20-7.87) were identified as significant independent risk factors of abnormal HADS-anxiety in overall patients; and higher level of education (OR: 1.87, 95% CI: 1.16-3.01) was predictive of anxiety in patients planned for endovascular aortic repair. Besides, higher body mass index (BMI) (OR: 1.18, 95% CI: 1.04-1.33) and abdominal or back pain (OR: 3.93, 95% CI: 1.70-9.11) were predictive of abnormal preoperative HADS-depression in overall patients.@*Conclusion@#As for patients scheduled for AAA repair, female, higher ASA, higher level of education, and symptom may be independent risk factors for preoperative anxiety, and symptom and higher BMI may predict preoperative depression.

Effectiveness of Secundum Atrial Septal Defect Occlusion with the Septal Occluder through Right-chest Small Incision: Clinical Analysis of 140 Cases / 中国医学科学院学报

Objective To evaluate the feasibility and effectiveness of secundum atrial septal defect(ASD)occlusion with the septal occluder through right-chest small incision. Methods The clinical data of 140 secundum ASD patients (47 males and 93 females) aged 3-63 years who were treated in our center from August 2004 to July 2014 were retrospectively analyzed. The diameter of ASD was 6 to 36 mm. Under general anesthesia, all patients underwent intraoperative transtsophageal echocardiography (TEE), during which no associated cardiac deformity was found. All patients received ASD occlusion via a small incision (3-4 cm) at the right anterior chest. The occluders were released with the help of TEE. Results The atrial septal defect closure was successfully completed in 134 cases. Six cases received surgical closure of ASD after the failure of occlusion. The reasons of conversion included postoperative dislodgement of occlusion device (n=2, both were central type with large size) and technically unsuitable for occlusion (n=4, in whom residual shunt was found in 2 case, sieve pore type in 1 case, and intraoperative dislodgement in 1 case). All of these 6 patients were treated surgically under cardiopulmonary bypass. No dislocation of the device or atrial shunt was found within 3 to 48 months after the operation. Conclusion Occlusion via small chest incision of ASD under TEE guidance without cardiopulmonary bypass is a safe, minimally invasive, effective, and convenient treatment and worth clinical application.

A retrospective analysis of abdominal acupuncture for casino workers with sleep disorder in chronic fatigue syndrome / 国际中医中药杂志

Objective To retrospectively analyze the effect of abdominal acupuncture for the casino workers with sleep disorder in chronic fatigue syndrome and analyze the correlation between them.Method 65 patients were all from the Acupuncture Department of Health Center of the Black Sand, Macao Health Bureau, 2011 October to 2013 January, who were diagnosed with sleep disorder in chronic fatigue syndrome and in accordance with the inclusion criteria. They were received abdominal acupuncture treatment for 4 weeks. Pittsburgh sleep quality index(PSQI) and Fatigue Assessment Instrument(FAI)were adopted to evaluate the effect before treatment 、after treatment and one month follow-up. Multiple regression analysis model was used to analyze the correlation of each factor of FAI and PSQI. Results Compared with before treatment (13.78± 3.23), the total score of PSQI after treatment(8.66 ± 4.26)and follow-up(8.26 ± 4.66) were significant decreased(P<0.05);the score of 6 dimensions(sleep quality, Time to fall asleep, sleep time, sleep efficiency, sleep disorders daytime function) after treatment and follow-up were significant decreased(P<0.05),compared with those before treatment;the FAI score after treatment (92.60±14.64) and follow-up(90.75±14.75) were significant lower(P<0.05)than those before treatment (147.55±7.03) .Multiple regression analysis showed that 4 dimensions of PSQI (sleep quality, sleep time, sleep disorders, daytime function)had close relationship with FAI score(r=0.373~0.702, P<0.05). Conclusion Abdominal acupuncture can improve the casino workers' sleep disorder in chronic fatigue syndrome and is worth of further study.

Sleep disorder treated mainly with flying needling therapy: a clinical randomized controlled research / 中国针灸

<p><b>OBJECTIVE</b>To observe the clinical efficacy on sleep disorder in the intervention of flying needling therapy and compare the efficacy difference among flying needling therapy, estazolam and non-acupoint acupuncture.</p><p><b>METHODS</b>Three hundred and fifteen cases of sleep disorder were randomized into a flying needling group (110 cases), an estazolam group (107 cases) and a non-acupoint acupuncture group (98 cases). In the flying needling group, the flying needling therapy was applied to Sanyinjiao (SP 6), Anmian (EX HN22), Shenmen (HT 7) and so on. Additionally, vitamin B1 was prescribed for oral administration and the intradermal needle method was given at the Back-shu points. In the estazolam group, estazolam was prescribed for oral administration. Also the non-acupoint acupuncture and the acupoint sticking therapy on the Back-shu points were given additionally. In the non-acupoint acupuncture group, the non-acupoint acupuncture, oral administration of vitamin B1 and the acupoint sticking therapy on the Back-shu points were applied. The treatment of 2 weeks were required in all the groups. The efficacy and the score of PSQI (Pittsburgh sleep quality index) were observed in the 2-week follow-up visit.</p><p><b>RESULTS</b>The total effective rate in the flying needling group was 84.1% (90/107), which was superior to 59.7% (62/104) in the estazolam group and 25.0% (24/96) in the non-acupoint acupuncture group (both P < 0.05). In the follow-up observation, the score of each item and the total score of PSQI were lower apparently than those before treatment in each group (all P < 0.05), and those in the flying needling group were lower apparently than those in the other two groups (all P < 0.05).</p><p><b>CONCLUSION</b>The flying needling therapy as the chief therapeutic method effectively improves the sleep quality for the patients with sleep disorder, which is apparently superior to estazolam and non-acupoint acupuncture.</p>

Professor CHEN Quan-xin's experience for treatment of insomnia: regulating spirit and quieting heart to help sleep / 中国针灸

This article describes the experiences of professor CHEN Quan-xin, an old famous TCM doctor, in the treatment of insomnia. He believes that insomnia stems from incoordination between nutrient qi and defensive qi and deficient cultivation of cardiac spirit, and treatment of insomnia need to regulate spirit and quiet heart coherently. Painless acupuncture method of Chen's flying needling is adopted including to select Shenmen (HT 7), Sanyinjiao (SP 6) and Anmian (Extra) as the main points and take special needling technique and grading reinforcing and reducing manipulations. During treatment, he pays attention to understanding patients' psychological and mental status through "watching one's expressions and weighing his words carefully".

Iodine nutrition survey of children aged 8 to 10 in coastal and non-coastal areas of Rizhao city Shandong province / 中国地方病学杂志

Objective To investigate the iodine nutritional status of children aged 8 to 10 in both costal and non-costal areas of Rizhao city Shandong province,and provide a basis for scientific supplementation of iodine.Methods In 2009 and 2010,townships of Lanshan and Donggang were chosen as survey points which situated close to the coast,the counties of Wulian and Juxian that were more than 50 kilometers away from the coast were selected as controls.The iodine concentration of drinking water in every village and water supply point was determined.At the county level,5 to 9 towns were selected according to their sub-area positions of east,west,south,north and center,4 villages were selected in each chosen township,8 - 15 households were selected in each chosen village,edible salt from the households was collected; 5 primary schools were selected in each chosen township,60 students aged 8 - 10 were selected to take thyroid examination in each chosen school.Twenty copies of urine samples were collected from the 60 students to detect the iodine concentration.Iodine in drinking water was tested by cerous sulfate catalytic spectrophotometry,in iodized salt by direct titration,in urine by arsenic-cerium contact method,and thyroids were examined by palpation.Results Totally 3483 copies of drinking water samples,1164 copies of edible salt samples,and 476 copies of urine samples were tested,and a total of 1200 children aged 8 to 10 were investigated; and the ratio of water iodine frequency distribution ≤ 10 μg/L (in costal and non-costal area) accounted for 90.03％ ( 1011/1123 ) and 91.10％ (2150/2360),respectively,the medians of water iodine were 5.6 and 4.2 μg/L,respectively; the iodine medians of edible salt were 29.03 and 29.99 mg/kg,respectively; the consumption rates of qualified iodized salt were 96.77％ (569/588) and 97.05％ (559/576),respectively; total goiter rates were 1.17％(7/600) and 1.33％(8/600),respectively; the medians of urinary iodine were 144.05 and 159.15 μg/L,respectively; the percentages of urinary iodine that bellow 100 μg/L were 26.58％ (63/237) and 22.59％ (54/239),respectively; between 100 - 300 μg/L were 66.75％ (158/237) and 64.02％ (153/239),respectively;above 300μg/L were 6.75％ (16/237)and13.39％ (32/239),respectively.ConclusionsThe costal of Rizhao is an iodine deficient area.The current popularity of household's consumption of qualified iodized salt is suitable.The levels of iodine nutrition of children aged 8 to 10 is appropriate,which met the national standard of elimination of iodine deficiency disorders (IDD).There is no iodine excess.There are no significant differences in levels of iodine nutrition between costal and non-costal areas on the premise that the same iodized salt is supplied in both the areas,and there is no need to make differentiated supply of iodized salt.

Augmented hepatic regeneration of living donor liver graft by intraportal insulin administration / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the effect of postoperative intraportally administration of insulin on hepatic regeneration in adult patients underwent living donor right lobe liver transplantation (LDLT).</p><p><b>METHODS</b>From July 2005 to September 2007, 15 right lobe LDLT adult recipients voluntarily receiving posttransplant intraportal insulin administration, without postoperative vascular and bile duct complications, without immune rejection, with more than 1 month survival and complete clinical data were enrolled in this study as intraportal insulin-therapy group (Group I). Another consecutive 15 right lobe LDLT adult recipients meeting the upwards referred criteria were enrolled in as non-insulin-therapy control group (Group NI). Recipients in Group I were treated postoperatively with intraportal insulin infusion, as follows: a 18-gauge catheter was inserted into right gastro-omental vein during surgery, regular insulin was administered just after the operation at the rate of 2 units/hour for 7 days. Liver function and serum insulin level were measured at before-operative day 1, postoperative day (POD) 7 and 30. Graft volume (GV) were measured during operation, and at POD 7 and 30.</p><p><b>RESULTS</b>The rate defined as ratio of POD 7 GV/operation GV in Group I was higher than that of Group NI [(186.1 +/- 35.4)% vs. (160.6 +/- 22.1)%, P < 0.05]. The rate defined as ratio of POD 7 GRWR/operation GRWR was also higher in Group I than Group NI [(179.0 +/- 35.8) % vs. (156.6 +/- 18.5%, P < 0.05], whereas significant differences were not appeared between two groups in terms of regeneration rates at POD 30. Serum levels of total bilirubin, aspartate aminotransferase and alanine aminotransferase in Group I were lower than that in Group NI at POD 7 (P < 0.05). Significant differences were not presented between two groups in terms of post-transplant serum insulin levels and total insulin dosage by subcutaneous administration and venous injection (P > 0.05).</p><p><b>CONCLUSIONS</b>These results suggest that intraportal insulin administration could augment liver graft regeneration during the first postoperative week.</p>

Outcomes of adult-to-adult living donor liver transplantation: a single center experience / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Since January 2002, adult-to-adult living donor liver transplantation (AALDLT) has gained increasing popularity in China in response to the shortage of cadaveric donor livers. This study presents a detailed analysis of the outcomes of AALDLT in a single center.</p><p><b>METHODS</b>A total of 70 patients underwent AALDLT at our center between January 2002 and January 2007. Among these, 67 patients received a right lobe graft without the middle hepatic vein and 3 patients received dual grafts. Three-dimensional volumetric computed tomography, magnetic resonance imaging with angiography and cholangiography were performed preoperatively. Recipient operation time, intraoperative transfusion requirement, length of intensive care unit stay, length of hospital stay, liver function tests, coagulation tests and surgical outcomes were routinely investigated throughout this study.</p><p><b>RESULTS</b>All donors survived the procedure with an overall complication rate of 15.3%. Overall recipient 1-year survival and complication rates were 87.1% and 34.2%, respectively. Among the 70 cases, average graft recipient weight ratio was 0.94% (0.72% - 1.43%) and average graft volume/standard liver volume ratio was 46.42% (31.74% - 71.68%). All residual liver volumes exceeded 35%. Liver function and coagulation recovered rapidly within the first 7 days after transplantation.</p><p><b>CONCLUSIONS</b>AALDLT is a safe procedure for the donors and an effective therapy for patients with end-stage liver disease. Patient selection and timely decision-making for transplantation are essential in achieving good outcomes. With accumulation of experience in surgery and clinical management, timely feedback and proper modification, we foresee better outcomes in the future.</p>

Evaluation of the effect of living donor liver transplantation on the treatment of severe hepatitis / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To evaluate the effect of living donor liver transplantation on the treatment of severe hepatitis.</p><p><b>METHODS</b>18 patients with severe hepatitis received liver transplantation (transplanted severe hepatitis group), 28 patients with sever hepatitis received non surgical treatment (non-transplanted severe hepatitis group), and 30 patients with end stage liver cirrhosis (without cancer) received liver transplantation (transplanted cirrhosis group). The vital sign, blood coagulation, and renal function were monitored during operation. After liver transplantation, patients received immunosuppressive therapy (including tacrolimus or cyclosporine A, mycophenolate, mofetil and corticosteroids), intensive care, antiviral therapy (including lamivudine and HBIg) and other treatments (including restoration of liver function and prevention of blood coagulation). Pre-operation data, operation procedure, liver function, renal function and the operation complications of three groups were compared, and survival rate at 1, 6 and 12 months after operation was followed.</p><p><b>RESULTS</b>There was no significant difference in the operation time, warm ischemia time, hypothermic ischemia time and Graft-to-recipient weight ratio between the two transplantation groups. The blood loss volume and blood transfusion volume in the transplanted severe hepatitis group were higher than that those in the cirrhosis transplantation group (t = 0.001, 0.004). The levels of TBil, ALT and AST at day 7 after operation were (100.5 +/- 96.4)mumol/L, (215.3 +/- 195.7) U/L , (209.8 +/- 188.6) U/L in the transplanted severe hepatitis group, and (53.3 +/- 31.9)mumol/L, (56.3 +/- 22.1) U/L, (51.3 +/- 13.5) U/L in the transplanted cirrhosis group (t = 0.017, 0.021, 0.004). However, there was no significant difference in the levels of Alb and Cr between these two groups (P > 0.05). Survival rate was 88.89%, 83.33% 83.33% in the transplanted severe hepatitis group, and 96.67%, 93.33% 93.33% in the transplanted cirrhosis group at 1, 6 and 12 months after transplantation.</p><p><b>CONCLUSION</b>Living donor liver transplantation is one of effect ways for the treatment of severe hepatitis.</p>

Hepatic arterial reconstruction and complications management in adult-to-adult living donor liver transplantation / 中华外科杂志

<p><b>OBJECTIVE</b>To explore the experience of hepatic arterial reconstruction and its management of complications in adult-to-adult living donor liver transplantation (A-A LDLT) using right lobe liver grafts.</p><p><b>METHODS</b>From January 2002 to July 2006, 50 of A-A LDLT using right lobe liver grafts were performed. All arterial anastomosis were performed to protect the donor hepatic arterial supply, in which donor right hepatic artery was sutured to recipient right hepatic artery in 24 patients, to recipient proper hepatic artery in 12 patients, to recipient left hepatic artery in 3 patients, to recipient common hepatic artery in 2 patients, to recipient aberrant right hepatic artery arising from superior mesenteric artery in 2 patients. Interpositional bypass using autogenous saphenous vein was performed between donor right hepatic artery and recipient common hepatic artery in 2 patients. Bypass was done between donor right hepatic artery and recipient abdominal aorta using autogenous saphenous vein in 2 patients and using stored cadaveric iliac vessels in 2 patients respectively. The diameter of donor right hepatic artery is between 1.5-2.5 mm, microsurgical technique was used under the magnified lobe of 3.5 times and operative microscope of 5-10 times.</p><p><b>RESULTS</b>In these series, hepatic artery thrombosis (HAT) occurred in 2 recipients on 1st and 7th days following A-A LDLT (4%), which were revascularized with autogenous saphenous vein between donor right hepatic artery and recipient abdominal aorta immediately, HAT in 1 recipient occurred one and a half month following A-A LDLT, but no symptom was presented. No hepatic artery stenosis and aneurysm occurred during follow-up period. No death related to hepatic artery complications occurred. All recipients were followed up from 2 to 52 months (mean follow-up 9 months). 1-year survival rate was 92%.</p><p><b>CONCLUSIONS</b>Proper anastomotic vessel choose and use of microsurgical technique in hepatic arterial reconstruction would reduce significantly the incidence of hepatic artery complications and provide an excellent graft survival following A-A LDLT.</p>

Excision and reconstruction of anomalous portal venous branching in adult-to-adult right lobe living donor liver transplantation / 中华外科杂志

<p><b>OBJECTIVE</b>To discuss the techniques for excision and reconstruction of anomalous portal venous branches (APVB) in adult-to-adult right lobe living donor liver transplantation (A-A RL LDLT).</p><p><b>METHODS</b>From February 2002 to April 2007, 70 cases of A-A RL LDLT were performed. Preoperative three-dimensional computed tomography of the donor revealed the configurations of hepatic artery, portal vein and hepatic vein. Nine donors had anomalous portal venous branching (APVB). The APVB were type II (trifurcation) in 7 cases and type III in two. Except the excision of APVB with a common opening by a narrow bridge of main portal vein tissue in one type II donor, all the right APVB were transected on the principal of donor priority: right APVB being excised approximately 2-3 mm from the confluence while leaving the donor's portal vein intact. In type II APVB, the donor portal venous branches were transected with separate two openings and reconstructed as double anastomoses in 4 cases, with separate two openings joined as a common orifice at the back table and reconstructed as single anastomoses in 2 cases, and with one common opening with narrow-bridge of tissue and reconstructed as single anastomoses in 1 case. In type III APVB, the APVB were transected with separate two openings and were reconstructed by double anastomoses in 1 case and by a new technique named U-shaped vein graft interposition in the another one.</p><p><b>RESULTS</b>There were no vascular complications such as portal vein stricture or thrombosis, hepatic artery stricture or thrombosis and hepatic vein outflow stricture in all 9 recipients transplanted with grafts with APVB. Only the type II APVB donor undergoing a excision of APVB with a common opening by a narrow bridge of main portal vein tissue developed portal vein thrombosis on the third postoperative day and underwent thrombectomy followed by repair with vein patch plasty. The velocity of blood flow in the U-graft was normal.</p><p><b>CONCLUSIONS</b>It is feasible and safe of APVB excision on the principal of donor priority and reconstruction including double anastomoses and the novel U-graft interposition in A-A RL LDLT, and has a good outcome without increasing the management difficulty.</p>

Evaluation of living donor liver transplantation for patients with hepatocellular carcinoma / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To evaluate the donor risks and potential recipient benefits of living donor liver transplantation (LDLT) for adult patients with hepatocellular carcinoma (HCC).</p><p><b>METHODS</b>From January 2002 to December 2006, a total of 27 LDLT for HCC patients were performed in our center, of which 25 received right lobe grafts and 2 received dual grafts. The clinical and follow-up data of these 27 recipients and 29 donors were analyzed retrospectively.</p><p><b>RESULTS</b>Of the 29 donors, the overall complication rate was 17.24% (5 cases). Two cases (6.90%) experienced major complications (one with intra-abdominal bleeding and one with portal vein thrombosis) and three cases (10.34%) experienced minor ones (fat necrosis and infection of the surgical skin wound in one, pleural effusion in another and transient chyle leakage in the third). All donors were fully recovered and returned to their previous work. No recipients developed small-for-size syndrome. The overall HCC patients survival rate at 1- and 3-years was 84.01% and 71.40%, respectively, similar to that of patients undergoing LDLT for various nonmalignant diseases during the same period (P > 0.05).</p><p><b>CONCLUSION</b>Although further study is needed to fully assess the risks and benefits of LDLT for the HCC patients and donors, our present results preliminarily suggest that LDLT offers an acceptable chance and duration of survival in patients with HCC, and it is a relatively safe procedure.</p>

Clinical observation on abdominal acupuncture plus Madopa for treatment of Parkinson's disease / 中国针灸

<p><b>OBJECTIVE</b>To find out an effective therapy for Parkinson's disease.</p><p><b>METHODS</b>Sixty cases were randomly divided into an abdominal acupuncture group and a control group, 30 cases in each group. The abdominal acupuncture group were treated with Madopa and abdominal acupuncture at Zhongwan (CV 12), Xiawan (CV 10), Qi-hai (CV 6) and Guanyuan (CV 4), etc. ; and the control group were treated with Madopa.</p><p><b>RESULTS</b>After treatment of 3 courses, the effective rate was 90.0% in the abdominal acupuncture group and 83.3% in the control group with a significant difference between the two groups (P<0.05).</p><p><b>CONCLUSION</b>Abdominal acupuncture combined with Madopa can elevate therapeutic effect of Madopa and reduce adverse effects of Madopa for the patient of primary Parkinson's disease.</p>

Clinical study of adult to adult living donor liver transplantation: a report of 56 cases / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the ways to ensure the safety of donors and recipients in adult-to-adult living donor liver transplantation (A-ALDLT).</p><p><b>METHODS</b>From January 2002 to September 2006, 56 A-ALDLT were performed in our division, including 52 cases of right lobe graft were obtained without medial hepatic vein (MHV) and 4 cases of dual grafts (1 case using two left lobes, 3 cases using 1 right and 1 left lobe). The most common diagnoses were hepatitis B liver cirrhosis (62.5%) and hepatocellular carcinoma (30.4%) in recipients. Among them, 10 cases scored more than 25 with the model of end-stage liver disease (MELD) scoring system. Triphasic liver computed tomography were used for reconstruction of hepatic vessels and to calculate total liver and right liver volumes in donors. Various innovative surgical techniques were adopted too.</p><p><b>RESULTS</b>From the 58 living donors, 55 right lobes and 3 left lobes were obtained. The 55 right lobe grafts were obtained without medial hepatic vein, weighed 400 approximately 860 g (median 550 g). The ratio of graft volume to recipient standard liver volume ranged from 31.7% to 71.7% (median 45.4%). All donors' remnant liver volumes were over 35% of the total liver volume. There was no donor mortality, but 7 (12.5%) donors experienced complications. Of the 56 recipients, with a follow-up period of 2 approximately 52 months (median 11 months), 15 (26.8%) developed complications and 4 (7.2%) died within 3 months post operation. The 1-year actual survival rate was 92.8%.</p><p><b>CONCLUSIONS</b>When preoperative CT volume shows remnant liver volume is greater than 35% of the total liver volume, and graft volume to recipient's standard liver volume ratio is over 40%, A-ALDLT using right lobe graft is a safe procedure for both donors and recipients, otherwise the dual graft liver transplantation should be considered.</p>

Liver transplantation for chronic hepatitis B patients with lamivudine monotherapy or lamivudine combined with individualized low-dose hepatitis B immunoglobulin treatment / 中华肝脏病杂志

<p><b>OBJECTIVE</b>The aim of this study was designed to evaluate the outcomes of liver transplant recipients with chronic hepatitis B (CHB) receiving either lamivudine monotherapy or lamivudine combined with individualized low-dose hepatitis B immunoglobulin (HBIG) therapy.</p><p><b>METHODS</b>A total of 111 liver transplant recipients with CHB were divided not randomly into two groups according to the availability of HBIG before liver transplantation (LT). Thirty-two patients received lamivudine monotherapy (100 mg/d) and 79 patients received lamivudine (100 mg/d) combined with individualized low-dose HBIG (intramuscular administration) to maintain the titer of antibody to hepatitis B virus (HBV) surface antigen (anti-HBs) not less than 100 U/L. The patients were followed-up for a median time of 32 months (1 to 88 months).</p><p><b>RESULTS</b>In the lamivudine monotherapy group, 5 patients hepatitis B relapsed (3/5 developed YMDD mutants of HBV), with 1-, 2-, and 3-year cumulative recurrence rates of 7.1%, 14.3% and 17.9% and survival rates of 87.5%, 84.4% and 74.6%. In the lamivudine and HBIG combination therapy group, 2 patients hepatitis B relapsed (2/2 developed YMDD mutants of HBV), with 1-, 2-, and 3-year cumulative recurrence rates of 0, 1.8% and 5.7% (P < 0.01) and survival rates of 83.5%, 80.9% and 77.6% (P > 0.05).</p><p><b>CONCLUSIONS</b>Compared with lamivudine monotherapy, lamivudine combined with individualized low-dose HBIG can further reduce the recurrence risk of hepatitis B in liver transplant recipients. This combined therapy could be used as a rational strategy for prophylaxis of hepatitis B recurrence in such patients.</p>

Hepatic venous outflow reconstruction in adult right lobe living donor liver transplantation without middle hepatic vein / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>It is difficult and challenging to reconstruct hepatic venous outflow in adult right lobe living donor liver transplantation (LDLT) without the middle hepatic vein (MHV). Excessive perfusion of the portal vein and venous outflow obstruction will lead to acute congestion of the graft, ultimately resulting in primary nonfunction. Although various reconstruction patterns have been explored in many countries, there is currently no clear consensus. In this study we describe a technique to prevent "chocking" of the graft at the outflow anastomosis with the inferior vena cava (IVC) in LDLT using right lobe graft without the MHV.</p><p><b>METHODS</b>A retrospective analysis was conducted on clinical data from 55 recipients undergoing LDLT using right lobe grafts without the MHV or reconstruction of hepatic venous outflow. The donor's right hepatic vein (RHV) was anastomosed with a triangular opening of the recipient IVC; the inferior right hepatic vein (IRHV), if large enough, was anastomosed directly to the IVC. The great saphenous vein (GSV) was used for reconstruction of significant MHV tributaries.</p><p><b>RESULTS</b>No deaths occurred in any of the donors. Of the 55 recipients, complications occurred in 6, including hepatic vein stricture (1 case), small-for-size syndrome (1), hepatic artery thrombosis (1), intestinal bleeding (1), bile leakage (1), left subphrenic abscess and pulmonary infection (1). A total of three patients died, one from small-for-size syndrome and two from multiple system organ failure.</p><p><b>CONCLUSIONS</b>The multiple-opening vertical anastomosis was reconstructed with hepatic vein outflow. This technique alleviates surgical risk of living donors, ensures excellent venous drainage, and prevents vascular thromboses and primary nonfunction.</p>

Neuronavigation guidance for motor cortex stimulation in resection of gliomas involving the precentral gyrus / 中华显微外科杂志

Objective To explore surgical treatment of gliomas involving the motor eloquent area. Methods Twelve cases of gliomas involving precentral gyrus were underwent awake surgery procedures assis- ted with neuronavigation and brain functional mapping by cortical electrical stimulation.Results Eleven ca- ses acquired accurate location of both lesions and eloquent areas by neuronavigation and direct cortical stimula- tion.7 cases of motor cortices and 2 cases of motor speech centers were confirmed during the operation.Re- section,verified by postoperative MRI,was total in 8 cases (66.7%) and subtotal in 4 patients.Histological examination revealed an infiltrative glioma in all cases (8 low grade astrocytomas,2 high grade astrocytomas and 2 glioblastoma).Four patients had no postoperative deficit,while the other 8 patients were impaired, with,in all cases except one,complete recovery in 7 days to one month.Conclusion Direct cortical elec- trical stimulations and awake surgery offer a reliable,precise and safe method,allowing functional mapping es- pecially useful in case of infiltrative cerebral tumors in eloquent areas.This technique allows improvement in the quality of tumoral resection and concurrently a minimization of the risk of definitive postoperative neurologi- cal deficit.

Safety of donor of right lobe graft in living donor liver transplantation / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the safety of donors of right lobe graft.</p><p><b>METHODS</b>We retrospectively studied 13 living donors of right lobe graft from January 2002 to June 2005. The right lobe grafts were obtained by transecting the liver on the right side of the middle hepatic vein. Liver transection was done by using an ultrasonic dissector without inflow vascular occlusion. The standard liver volume and the ratio of left lobe volume to the standard liver volume were calculated.</p><p><b>RESULTS</b>The mean blood loss was 490 ml. The mean blood transfusion was 440 ml. In the perioperative period the mean albumin administered was 85 g. One donor had portal vein trifurcation, two had a right posterior bile duct and a right anterior bile duct draining into the left bile duct, respectively. One had bile ducts from left lateral and left internal segment and right duct draining into common hepatic duct. On postoperative day 1 the donors' liver functions were found impaired to some extent, but all the indices rapidly returned to the normal level at the end of the first week. Postoperative complications included 1 case of abdominal bleeding, 2 wound steatosis and 1 chyle leak. There was no donor mortality. All donors are well and have returned to their previous occupations.</p><p><b>CONCLUSIONS</b>The donation of right lobe graft for adult living donor liver transplantation is safe provided that the patency of the remnant hepatic vasculature and bile duct is ensured, the volume of the remnant liver exceeds 30% of the total liver volume, and there is no injury to the remnant liver.</p>