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Objective To analyze the distribution characteristics and drug resistance of pathogens in infected donors from organ donation after citizen's death. Methods Clinical data of 465 potential donors from organ donation after citizen's death were retrospectively analyzed. The airway secretion, urine and blood samples of all donors were cultured. The infection rate of the donors, the source and composition ratio of pathogens were summarized. The drug resistance of main Gram-negative and Gram-positive pathogens was analyzed. Results Among 465 donors, 330 cases were infected and the infection rate was 71.0%. Among the positive culture samples of all donors, lower respiratory tract samples accounted for 63.8%(292/458), 18.6%(85/458) for blood samples and 17.7%(81/458) for urine samples. A total of 512 pathogens were isolated, including 75.0%(384/512) of Gram-negative pathogens, 18.2%(93/512) of Gram-positive pathogens followed by 6.8%(35/512) of fungi. Klebsiella pneumoniae, Pseudomonas aeruginosa and Acinetobacter baumannii were the most common Gram-negative pathogens. Klebsiella pneumoniae was sensitive to quinolones, compound preparations containing β-lactamase inhibitor (piperacillin-tazobactam, cefoperazone sodium-sulbactam sodium) and carbapenem antibiotics, whereas less sensitive to cephalosporins. Pseudomonas aeruginosa was sensitive to β-lactams, quinolones and aminoglycosides. Acinetobacter baumannii was sensitive to polymyxin, tigecycline and amikacin, whereas resistant to the other antibiotics. No Gram-positive pathogens was resistant to vancomycin, linezolid and teicoplanin. Staphylococcus aureus and coagulase-negative staphylococci were the most commonly isolated Gram-positive pathogens, which yielded resistance rates of 36% and 87% to oxacillin sodium, and were generally resistant to penicillin and erythromycin. The resistance rate of Enterococcus faecalis to quinolones and erythromycin exceeded 90%, and 55% for high-concentration gentamicin. Conclusions The infection rate of organ donors from organ donation after citizen's death is relatively high, and the main infection site is lung. Gram-negative pathogens are the most commonly isolated strains, and certain strains tend to exhibit multiple drug resistance.
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Objective:To explore the effects of Shenling-Baizhu Powder combined with modified Guilu-Erxian Decoction on bone metabolism and inflammation response in osteoporosis patients. Methods:A total of 82 patients with osteoporosis of spleen-kidney deficiency, meeting the inclusion criteria in the hospital, were enrolled between June 2018 and October 2019. They were divided into observation group and control group by random number table method, 41 in each group. The control group was treated with oral calcium carbonate D3 tablets and alendronate sodium, while the observation group was treated with Shenling-Baizhu Powder combined with modified Guilu-Erxian Decoction on basis of control group. Both groups were treated for 6 months. Before and after treatment, scores of TCM symptoms were conducted. The bone mineral density (BMD) values of lumbar vertebra L 2-4, femoral neck and distal radius1/3 site were detected by dual-energy X-ray BMD analyzer. The levels of serum tartrate-resistant acid phosphatase 5b (TRACP 5b) and type I C-terminal cross linked peptide (CTX-I) were detected by electrochemiluminescence analyzer. The level of bone gla protein (BGP) was detected by radioimmunoassay. The levels of interleukin 6 (IL-6), interleukin 10 (IL-10), tumor necrosis factor α (TNF-α) and C-reactive protein (CRP) were detected by full-automatic biochemical analyzer. The adverse events during treatment were observed. And clinical curative effect was evaluated. Results:The differences in response rate between observation group and control group was statistically significant [95.1% (39/41) vs. 78.0% (32/41); χ2=5.145, P=0.023]. After treatment, scores of clinical symptoms (pain in back and loin, soreness and weakness of waist and knees, limb fatigue, debilitation, dizziness and tinnitus, frequent nocturia, loose stools, poor complexion) in observation group were significantly lower than those in the control group ( t=14.268, 10.732, 20.720, 7.564, 9.055, 15.975, 10.826, 6.552, all Ps<0.001). After treatment, BMD values of lumbar vertebra L 2-4 (0.89 ± 0.06 g/cm 3vs. 0.81 ± 0.04 g/cm 3, t=7.104), femoral neck (0.80 ± 0.08 g/cm 3vs. 0.72 ± 0.06 g/cm 3, t=5.122) and distal radius 1/3 site (0.65 ± 0.12 g/cm 3vs. 0.56 ± 0.14 g/cm 3, t=3.125) in observation group were significantly greater than those in the control group ( P<0.01). After treatment, levels of serum BGP and IL-10 in observation group were significantly higher than those in the control group ( t=3.875, 3.714, P<0.01), while levels of TRACP-5b, CTX-I, IL-6, TNF-α and CRP were significantly lower than those in the control group ( t=3.169, 5.849, 9.412, 4.606, 5.430, all Ps<0.001). Conclusion:Shenling-Baizhu Powder combined with modified Guilu-Erxian Decoction can improve clinical symptoms in patients with primary osteoporosis of spleen-kidney deficiency, increase BMD, regulate bone metabolism, alleviate inflammatory response and improve clinical curative effect.
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Objective@#To explore the clinical characteristics and long-term prognosis of recipients with end-stage autoimmune liver diseases (AILD) after liver transplantation.@*Methods@#A retrospective study was conducted. The data of 147 end-stage autoimmune liver diseases recipients who underwent liver transplantation admitted to department of liver transplantation of Tianjin First Center Hospital from January 2004 to August 2018 were collected. Patients were followed till March 1st, 2019. The postoperative survival was analyzed, the cumulative survival rate was estimated by the Kaplan-Meier survival curve, and the cause of death was analyzed. Postoperative rejection, recurrence of AILD, biliary complications, and hepatitis virus infection were also summarized.@*Results@#Among the 147 recipients, 25 were autoimmune hepatitis (AIH), 94 were primary biliary cholangitis (PBC), 14 were AIH overlapping PBC (AIH-PBC), 14 were primary sclerosing cholangitis (PSC). The 147 recipients were consisted of 22 males and 125 females, with a ratio of 1∶5.7, with a mean age of (53.2±10.1) years old. The average model for end-stage liver disease (MELD) score was 14.6±9.0. After a median follow-up of 49.0 months, 21 recipients died, and 126 recipients survived. The survival curve analysis showed that the 1-, 3-, 5- and 10-year cumulative survival rate was 98.6%, 94.0%, 84.6%, and 76.9%, respectively. The main cause of death was graft dysfunction, followed by graft failure and respiratory failure. Among the 147 recipients, 17 (11.56%) rejection occurred, 19 recurrence (12.93%) were diagnosed with liver biopsy, and of which 2 PBC recipients overlapped de novo AIH-PBC. Biliary complications happened in 37 recipients (25.17%). De novo hepatitis virus infection was found in 19 recipients (12.93%), including 14 with hepatitis B virus (HBV) and 5 with hepatitis C virus (HCV).@*Conclusions@#The majority patients of the end-stage of AILD were middle-aged and old women, and PBC was the most common. Liver transplantation is an effective treatment for end-stage autoimmune liver diseases with excellent prognosis. Postoperative immunosuppressant usage and recurrence should be emphasized.
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To explore the clinical characteristics and long-term prognosis of recipients with end-stage autoimmune liver diseases (AILD) after liver transplantation. Methods A retrospective study was conducted. The data of 147 end-stage autoimmune liver diseases recipients who underwent liver transplantation admitted to department of liver transplantation of Tianjin First Center Hospital from January 2004 to August 2018 were collected. Patients were followed till March 1st, 2019. The postoperative survival was analyzed, the cumulative survival rate was estimated by the Kaplan-Meier survival curve, and the cause of death was analyzed. Postoperative rejection, recurrence of AILD, biliary complications, and hepatitis virus infection were also summarized. Results Among the 147 recipients, 25 were autoimmune hepatitis (AIH), 94 were primary biliary cholangitis (PBC), 14 were AIH overlapping PBC (AIH-PBC), 14 were primary sclerosing cholangitis (PSC). The 147 recipients were consisted of 22 males and 125 females, with a ratio of 1∶5.7, with a mean age of (53.2±10.1) years old. The average model for end-stage liver disease (MELD) score was 14.6±9.0. After a median follow-up of 49.0 months, 21 recipients died, and 126 recipients survived. The survival curve analysis showed that the 1-, 3-, 5- and 10-year cumulative survival rate was 98.6%, 94.0%, 84.6%, and 76.9%, respectively. The main cause of death was graft dysfunction, followed by graft failure and respiratory failure. Among the 147 recipients, 17 (11.56%) rejection occurred, 19 recurrence (12.93%) were diagnosed with liver biopsy, and of which 2 PBC recipients overlapped de novo AIH-PBC. Biliary complications happened in 37 recipients (25.17%). De novo hepatitis virus infection was found in 19 recipients (12.93%), including 14 with hepatitis B virus (HBV) and 5 with hepatitis C virus (HCV). Conclusions The majority patients of the end-stage of AILD were middle-aged and old women, and PBC was the most common. Liver transplantation is an effective treatment for end-stage autoimmune liver diseases with excellent prognosis. Postoperative immunosuppressant usage and recurrence should be emphasized. sclerosing cholangitis; Liver transplantation; Prognosis
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Objective To employ image post-processing technique measuring splenic volume for evaluating the mitigation effect of end-stage liver disease patients complicated with different degrees of hypersplenism undergoing orthotopic liver transplantation .Methods For 55 end-stage liver disease patients with hypersplenism undergoing orthotopic liver transplantation ,the changes in splenic volume were measured before and after transplantation by image post-processing system Advantage Workstation 46 (AW46) and the changes of splenic thickness ,portal flow velocity and platelet counts observed during perioperative period .Results Postoperative splenic volumes of 55 recipients were (562 .90 ± 49 .16) cm3 ,significantly decreased than preoperative (850 .50 ± 77 .99) cm3 (P< 0 .05) and reduction ratio was (31 .70 ± 2 .76 )％ . Splenic thickness at different postoperative timepoints was significantly lower than that pre-operation (P< 0 .05) and stabilized at 1 month post-transplantation ; Splenic volume was positively correlated with splenic thickness ( r = 0 .78 , P < 0 .05 ) . Portal flow velocity at different postoperative timepoints increased significantly as compared with preoperative ( P < 0 .05) ,peaked at (380 .70 ± 21 .80) mm/s at 1 month post-transplantation ,declined and stabilized at 3 months post-transplantation . Platelet counts (PLT ) at different postoperative timepoints were significantly higher than those at pre-operation ( P < 0 .05 ) ,peaked (193 .40 ± 10 .36 ) × 109 /L at 2 weeks post-transplantation ,dropped and remained at 2 months post-transplantation ;Splenic volume was negatively correlated with PLT ( r = -0 .44 , P < 0 .05 ) . And hypersplenism recovery rate and recurrence rate within 10 months post-transplantation was (78 .79 ± 2 .29 )％ and (17 .75 ± 2 .31 )％ respectively .Conclusions Orthotopic liver transplantation can effectively alleviate hypersplenism for most end-stage liver diseases .Using image post-processing system ,splenic volume may be calculated and blood routine and ultrasound are simultaneously used for assessing the outcomes of liver transplantation on hypersplenism .
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Objective To discuss the modified eversion thrombectomy for portal vein thrombosis (PVT) in liver transplantation and the curative effectiveness.Methods All 613 cases complicated with PVT preoperation were given modified eversion thrombectomy,and there were 179,236,182 and 16 cases of PVT Yerdel grade Ⅰ,Ⅱ,Ⅲ and Ⅳ respectively.Results All 415 PVT patients of grade Ⅰ and Ⅱ received modified eversion thrombectomy and success rate was 100％.Among 182 PVT patients of grade Ⅲ received modified eversion thrombectomy (success in 176 cases,and failure in 6 cases).Sixteen PVT patients of grade Ⅳ received modified eversion thrombectomy (success in 13 cases and failure in 3 cases).The 1-year survival rate of PVT patients after surgical operation was 93.6％,and that of non-PVT patients was 94.6％ (P＞0.05).Conclusion Modified eversion thrombectomy could be adopted in PVT patients regarding to different Yerdel grades.
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Objective@#To evaluate the efficacy and safety of Xiaoaiping combined with chemotherapy in the treatment of advanced esophageal cancer.@*Methods@#This is a multi-center, randomized, open label and parallel controlled study. A total of 124 advanced esophageal cancer patients with Karnofsky Performance Status (KPS) score ≥60 and expected survival time≥3 months were enrolled. We adopted design and divided the patients into study and control group. The patients in study group received Xiaoaiping combined with S-1 and cisplatin. The control group received S-1 and cisplatin. Each group included 62 patients and 21 days as a treatment cycle. The efficacy and adverse events in patients of the two groups were observed and compared.@*Results@#57 patients in the study group and 55 in the control group were included in efficacy assessment. The response rate was 54.4% and 34.5% in the study group and control group, respectively(P<0.05). Disease control rates were 86.0% and 69.1%, respectively(P<0.05). The median progression-free survival (PFS) was 7.97 in the study group and 6.43 months in the control group(P<0.05). The median overall survival(OS) was 12.93 in the study group and 10.93 months in the control group(P<0.05). The most common adverse events in the two groups were nausea and vomiting, thrombocytopenia, anemia, neutropenia, liver damage, pigmentation, oral mucositis, renal impairment and diarrhea. The incidences of nausea, vomiting, thrombocytopenia, leukopenia, neutropenia and diarrhea in the study group were significantly higher than those in the control group(P<0.05).@*Conclusion@#Xiaoaiping combined with S-1 and cisplatin significantly increased response rate, and prolongedpatients′ survival in patients with advanced esophageal cancer.
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Objective To evaluate the clinical effect,the incidence of postoperative biliary complications and the survival of liver transplantation from Chinese donation after citizen's death (DCD).Methods The clinical characteristics of donors and recipients,survival of allografts and recipients,and postoperative biliary complications of 169 cases of DCD liver transplantation from October 2013 to June 2015 were analyzed retrospectively.Results The overall biliary complication rate was 8.28％ (14/169).There were 6 cases of ischemic cholangiopathy [3.55％ (6/169)].In 37 cases receiving donation after brain death liver transplantation,the incidence of biliary complications was 8.11％ (3/37),and ischemic biliary disease occurred in 1 case with the incidence being was 2.70％.In 132 cases of donation after cardiac death liver transplantation,biliary complication rate was 8.33 ％ (11/132),and there were 5 cases of ischemic biliary disease with the incidence being 3.79 ％.There was no significant difference in the incidence of bile duct complications of the recipients between brain death and cardiac death organ donation (P＞ 0.05).The 1-,2-,and 3-year survival rate of patients and grafts of donation after brain death was 94.5％,89.2％ and 83.7％,and 94.5％,86.5％ and 81.1％,respectively.The 1-,2-,and 3-year survival rate of patients and grafts of donation after cardiac death was 93.9％,88.6％ and 83.3％,and 91.7％,86.4％ and 80.3％,respectively.There was no significant difference in survival of recipients and grafts between brain death and cardiac death organ donation (P＞0.05).The mean warm and cold ischemia time of donation after cardiac death was 13.59 min and 3.32 h respectively.Conclusion The outcome of DCD liver transplantation is satisfactory.The incidence of overall biliary complications and ischemic biliary disease of cardiac death donor liver transplantation was close to that of brain death donor liver transplantation.
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Objective To establish a reliable approach for quantification of colony forming unit(CFU)of Mycobac-terium tuberculosis (M.tb)by measuring optical density(OD).Methods M.tb suspension H37Ra was prepared using low-power ultrasonic or glass bead beating methods,and was two-fold serially diluted,OD at 600nm (OD600)of each dilution ratio was measured respectively,OD600 and dilution curve were analyzed to determine the optimum approach for preparing bacterial suspension,linear range of OD600,as well as linear relationship between OD600 and CFU.Results OD600 was 0.1 -0.6,linear regression analysis of OD600 and dilution ratio within linear range revealed that correlation coefficient (R2 )of glass bead beating and low-power ultrasonic methods were 0.98 and 1 .00 respectively,both presented a good correlation,low-power ultrasonic method was better than glass bead beat-ing method,bacterial suspension dispersed more evenly.Linear regression analysis results of OD600 and CFU val-ues showed that the regression equation of glass bead beating method and low-power ultrasonic method were CFU=2.35×107 ×OD600+4.42×105 and CFU=3.26×107 ×OD600+6.89×105 respectively.Conclusion Low-power ultrasonic method is a good method for preparation of M.tb suspension,combined the measurement of OD600 value, it can be a reliable and rapid method for quantitative analysis of M.tb.
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With the establishment of reasonable selection criteria and continuous technical refinement, living donor liver transplantation (LDLT) has been widely performed in the world. Right-lobe LDLT has become the conventional procedure performed at many centers. In recent years, due to the considerations of donor safety, other graft types have become important choices for adult-adult LDLT, especially left-lobe LDLT, and good outcome has been achieved. Although the minimally invasive technique has certain technical and safety issues, it will play an important role in donor hepatectomy due to its unique advantages. At present, the research data for patients with hepatocellular carcinoma (HCC) are controversial, but LDLT can be applied in the treatment for these patients. The therapeutic regimens for LDLT should be selected on the basis of the individualized principle and comprehensive analysis of donor safety, surgical risk, and the recipient’s survival.
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Objective To construct a recombinant Bacillus Calmette-Guerin ( BCG ) vaccine strain, rBCG::Rv3478-pMV261, expressing the Rv3478 protein of Mycobacterium tuberculosis and to inves-tigate its immunogenicity.Methods The gene fragments encoding Rv3478 antigen were amplified by PCR and then respectively cloned into pMV261 and pET-28a vectors to construct the recombinant expression plas-mids (Rv3478-pMV261 and Rv3478-pET-28a).The Rv3478-pMV261 plasmids were transformed into the BCG cells to construct the rBCG vaccine strains, while the Rv3478-pET-28a plasmids were transformed into Escherichia coli BL21 strains for the expression of Rv3478 protein.Polyclonal antibodies were induced in mice upon the immunization with Rv3478 protein.The rBCG vaccine strains overexpressing Rv3478 protein were screened out with Western blot assay.The C57BL/6 mice were divided into four groups including the PBS treated group, BCG treated group, rBCG::pMV261 ( R0) treated group and rBCG::Rv3478-pMV261 ( R3) treated group.All mice were sacrificed in 4 or 12 weeks after immunization.Enzyme-linked immunos-pot assay ( ELISPOT) , ELISA and flow cytometry analysis were performed to evaluate the induced humoral and cell-mediated immune responses in mice.Results The Rv3478 protein was successfully expressed and could induce polyclonal antibodies in mice.High levels of IFN-γand TNF-αwere detected in mice treated with R3, indicating that the immunization with R3 enhanced the cellular immunity.Moreover, the ratios of CD4+to CD8+T cells and the percentages of CD44+CD62L+T cells were increased in mice upon the immuni-zation with R3.Conclusion The recombinant BCG vaccine strain overexpressing Rv3478 protein could in-duce stronger cell-mediated immune responses in mice.It might be have a great significance as a new tuber-culosis( TB) vaccine strain against TB infection in the future.
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Objective To investigate the protective effects of Trimetazidine(TMZ)on the ischemia reperfusion injury (IRI)of fatty liver in autotransplantation model. Methods Fatty liver model was established by feeding high fat diet. Male Wistar rats (n=30) were randomized into three groups;Sham group, TMZ group and Model group. Liver was autotransplanted in both TMZ group and Model group. Serum levels of ALT, SOD, MDA, Bcl-2 and activated Caspase-3 were assessed 6 hours after the operation. The pathological performances of liver were also determined. Results Compared with the Model group, serum levels of ALT,AST, MDA and SOD levels decreased significantly in the TMZ group(P<0.05). Serum level of Bcl-2 was higher while level of activated Caspase-3 was lower in TMZ group than those in Model group(P<0.05). Histo?logical assay and TUNEL staining showed reduced hepatocyte swelling and narrowed sinusoid as well as decreased hepatic apoptosis in TMZ group compared with Model group. Conclusion TMZ can reduce oxidative stress, promote the expression of Bcl-2 and inhibit the activation of Caspase-3, which all contribute to its protective effect on fatty liver with ischemia-re?perfusion injury.
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Objective To investigate the expressions of HBXIP and GRIM-19 in hepatocellular carcinoma tissues and their clinic significance. Methods Hepatocellular carcinoma tissue (n=42) and normal liver tissue (n=28) were collected from Tianjin First Central Hospital,immunohistochemistry was used to detect the expressions of HBXIP and GRIM-19 in these two groups. Results Rate of cells with positive expressions of HBXIP in hepatocellular carcinoma and normal liver tissues were 80.95%(34/42)and 42.86%(12/28)respectively;Rate of cells with positive expression of GRIM-19 in hepato?cellular carcinoma tissues and normal liver tissues was 40.48%(17/42)and 75.00%(21/28)respectively, and the difference between these two groups was statistically significant(P<0.05);The expression of HBXIP was higher but the expression of GRIM-19 was lower in poor differentiated and stageⅢ-IV cells than those in well and moderate differentiated cells and in stage I-II, cells. What′s more, the expression of GRIM-19 is higher in tissue without portal thrombosis than that in tissue with portal thrombosis. The expression of HBXIP was negatively correlated with GRIM-19 expression(rS=-0.400,P<0.01). Conclusion The abnormal expressions of HBXIP and GRIM-19 may play important roles in the process of development and metastasis of hepatocellular carcinoma.
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Objective To explore the role of VEGF positive expression in tumor tissue in the prognosis of liver transplantation for hepatocellular carcinoma (HCC).Method Fifty cases of liver transplant recipients with HCC confirmed immunohistochemically were enrolled in this study.The MaxVisionTM two-step method was applied to detect the expression of vascular endothelial growth factor(VEGF),and the microvessel density (MVD) was measured in para-cancerous tissues by using DAB staining.The correlation of the VEGF tumor tissue in tumor tissue with Child-Pugh,MELD,tumor diameter and number,differentiation,MVD,Milan criteria and UCSF criteria for HCC liver transplantation was analyzed.Result In the HCC tissue,the VEGF positive expression rate was 52％(26/50).The one-year survival of recipients positive and negative for VEGF was 78％ and 100％,respectively,and one-year recurrence rate was 32％ and 12％,respectively,with the difference being significant (P =0.043 and P =0.048 respectively).The expression of VEGF was associated with Child-Pugh,tumor diameter,MVD,Milan criteria and UCSF criteria (P＜0.05 for all).Logistic regression analysis showed that low differentiation and VEGF positive expression were independent prognostic factors for HCC recurrence after liver transplantation.Conclusion VEGF has a certain reference value to judge HCC invasiveness and prognosis of liver transplantation.
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Cancer stem cells located in specific microenvironment,that play an important role in the proliferation and metastasis of tumor cells.Hypoxia is one of the important features of tumor tissue microenvironment.A series of studies results show that the hypoxic microenvironment of tumor stem cells could promote tumor metastasis,which provides new clues for understanding tumor pathogenesis and tumors treatment.
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ObjectiveTo study the role of middle hepatic vein (MHV) on the early function and regeneration of the donor remnant liver in living donor liver transplantation (LDLT).Methods Between August 2007 and August 2008,66 LDLT were performed,36 without MHV (group A),and 30 with MHV (group B) in the donor liver.The donor operation time,intraoperative blood loss,postoperative hospital stay,serum bilirubin,international normalized ratio (INR),alanine aminotransferase (ALT) and albumin were analyzed.We measured the volume of remnant liver with CT scan at 2 weeks after operation,and compared the function and regeneration of the remnant liver between the two groups. Results At 2 weeks after operation,there was no significant difference (P=0.16) in the volume of remnant liver between group A (959.3±195.2 ml) and group B (883.7±155.5 ml).There was also no difference (P=0.62) in the regeneration rate of segment IV between group A (78.2 ％ ± 29.1 ％) and group B (82.7 ％ ± 40.4％).The serum bilirubin,INR and ALT in group B was significantly higher than group A immediately after liver transplantation,but there was no difference at 1 week after transplantation.ConclusionExtended right hepatectomy with MHV was safe,and did not significantly impact early liver function and regeneration in the donor.
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ObjectiveTo investigate the effect of living donor right liver graft transplantation (LDLT) with middle hepatic vein (MHV) on the early congestion and regeneration of the donor remnant liver.MethodsBetween August 2008 and August 2009,28 LDLT were performed with 11 LDLT without MHV (group A) and 17 LDLT with MHV (group B).The donor operative time,intraoperative blood loss,postoperative hospital stay,bilirubin,INR,and ALT level were recorded in detail.We measured the volume of remnant liver by means of CT scan 2 weeks after operation and compare the degree of congestion and regeneration of the remnant liver between the two groups.ResultsThere were 10 cases in group B and 0 cases in group A suffering from congestion at segment Ⅳ,and the difference was significant(P =0.006).In group B,6 cases in type Ⅰ and 4 cases in type Ⅱ developed congestion at segment Ⅳ,and the difference was significant(P=0.035).Two weeks post operation,the volume of segment Ⅳ in group B was smaller than in group A(P=0.005).The regeneration rate of segment Ⅳ in group B was smaller than in group A (P =0.007),on the contrary,the regeneration rate of segment Ⅰ - Ⅲ in group B was larger than in group A( P =0.008 ).But the regeneration rate of remnant liver was the same in both groups (P =0.63 ).ConclusionsThe right lobe hemihepatectomy with MHV does not damage the early liver function of the donor significantly.The segment Ⅳ of the remnant liver suffered from congestion and impeded the regeneration,but was compensated by the regeneration of segments Ⅰ - Ⅲ.
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Reversible protein phosphorylation regulates multiple biochemical events. Mycobacterium tuberculosis phosphatases play important roles in regulating the pathogen physiology and interference of host signaling. They are also involved in the evasion of host immune response and blockage of the phagosome-lysosome fusion. Selective inhibition of phosphatase represents an ideal new avenue of anti-tuberculosis drug design. In this paper, we update the progresses about the regulation network of Mycobacterium tuberculosis phosphatases including MptpA, MptpB, MstP, SapM and their inhibitors. These serve as the basis for further antituberculosis drug target.
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Objective To evaluate biliary digital imaging technology in determining the type of the intrahepatic bile duct anatomy and the transection plane of the duct in right lobe living donor liver transplantation(LDLT). Methods Mobile digital subtraction angiography was performed to show the intrahepatic bile duct anatomy of 66 liver transplant donor candidates. Combined with metal markers, the bile duct transection plane was defined. Comparing with the actual results, the effect of digital imaging technology in determining the intrahepatic anatomical variations and transection plane of the duct in LDLT was evaluated. Results Intrahepatic bile duct anatomical variations were showed in all donors by using digital imaging technology. type Ⅰ (classical type) was identified in45 cases (68.2%), type Ⅱ (with triple confluence, the simultaneous emptying of the right anterior segmental duct, right posterior segmental duct and left hepatic duct into the common hepatic duct) in 7 cases ( 10.6% ), type Ⅲ (no right hepatic duct stem, right posterior segmental duct draining into common hepatic duct) in 13 cases ( 19. 7% ), type Ⅳ (no right hepatic duct stem, right posterior segmental duct draining into left hepatic duct) in 1 case (1.5%), and type Ⅴ (complex variation ) in no case (0%). As a result, cases of type Ⅰ form a single anastomosis. In type Ⅱ, four cases formed double anastomoses, three cases formed single anastomosis with or without ductoplasty. In type Ⅲ, two anastomoses were formed in 9 cases, single anastomosis in 4 cases with ductoplasty. The case of type Ⅳ had double anastomoses. In all cases right lobe liver were harvested.Conclusions Biliary digital subtraction image combined with metal markers accurately defines intrahepatic bile duct anatomy and the transection plane, helping to reduce number of bile duct anastomosis, and contributes to safe graft harvesting.
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ObjectiveTo investigate the effects of selective splenectomy on modulation of portal vein flow and prevention of small-for-size syndrome (SFSS) in living donor liver transplantation.MethodsTwenty six recipients who received LDLT from September 2007 to March 2008 were reviewed.The data of the portal vein flow of these recipients were collected during the operation.Simultaneous splenectomy was performed in patients with portal blood flow ＞250 ml/(min · 100g).No splenectomy was performed when the portal blood flow was less than 250 ml/(min · 100g).The effect of selective splenectomy on modulation of portal vein flow and whether splenectomy prevented the occurrence of SFSS were analyzed.ResultsThe portal vein flow decreased significantly after splenectomy in 8 patients who received splenectomy (P＜0.01),No SFSS occurred in the patients with or without splenectomy.Actual graft-to-recipient weight ratio (GRWR) of patients with splenectomy was significantly smaller than those with no splenectomy (P=0.044).The portal vein flow of patients with splenectomy was much higher than those with no splenectomy (P＜0.01).ConclusionAccording to the portal blood flow,selective splenectomy in LDLT decreased the portal vein flow and prevented the incidence of SFSS.