Early life exposure to Chinese famine and risk of digestive system cancer in midlife.

To investigate whether early-life exposure to the Great Famine of 1959-1961 in China was associated with the risk of digestive system cancer. The prospective cohort study involved 17 997 participants from the Kailuan Study (Tangshan, China) that began in 2006. All participants were divided into three groups based on their date of birth. The unexposed group (born from 1 October 1962 to 30 September 1964), fetal-exposed group (born from 1 October 1959 to 30 December 1961), and early-childhood-exposed group (born from 1 October 1956 to 30 December 1958). The Cox proportional hazards model was used to analyze the association between early famine exposure and digestive system cancer. During the mean follow-up period of (10.4 ± 2.2) years, a total of 223 digestive system cancer events occurred. Including 54 cases in the unexposed group (62.14/100 000 person-years), 57 cases in the fetal-exposed group (114.8/100 000 person-years), and 112 cases in the early-childhood-exposure group (122.2/100 000 person-years). After adjusting covariates, compared with the unexposed group, the HR and 95% CI were 1.85 (1.28, 2.69) for participants in the fetal-exposed group and 1.92 (1.38, 2.66) for participants in the early-childhood-exposed group. No interactions were observed in our study. After classifying digestive system cancers, the HR and 95% CI were 2.02 (1.03, 3.97) for colorectal cancer for participants in the fetal-exposed group and 2.55 (1.43, 4.55) for participants in the early-childhood-exposed group. The HR and 95% CI were (1.13, 3.83) of liver cancer for participants in the fetal-exposed group and 1.15 (0.63, 2.10) for participants in the early-childhood-exposed group. Early-life famine exposure was associated with a higher risk of digestive system cancer in adulthood. Fetal-exposed individuals might increase the risk of colorectal cancer and liver cancer, and early childhood-exposed might increase the risk of colorectal cancer.

Association of obesity with cardiovascular disease in the absence of traditional risk factors.

BACKGROUND: The association between obesity and cardiovascular disease (CVD) in people without traditional CVD risk factors is unclear. This study aimed to investigate the association of obesity with CVD and its subtypes in people without traditional CVD risk factors. METHODS: Based on the Kailuan cohort study, the included participants were divided into different groups according to levels of body mass index (BMI) and waist height ratio (WHtR), respectively. Multivariate Cox proportional hazard models were used to evaluate the associations. RESULTS: This study included 31,955 participants [men 63.99%; mean age (48.14 ± 3.33) years]. During a median follow-up period of 12.97 (interquartile range: 12.68-13.17) years, 1298 cases of CVD were observed. Compared with the normal BMI group, the hazard ratios (HRs) for CVD, stroke, and myocardial infarction (MI) in the BMI obese group were 1.31 (95% confidence interval [CI] 1.11-1.55), 1.21 (95%CI 1.01-1.46), 1.62 (95%CI 1.13-2.33), respectively. Compared with the WHtR non-obese group, the HRs for CVD, stroke, and MI in the obese group were 1.25(95%CI 1.11-1.41), 1.18 (95%CI 1.03-1.34), 1.57 (95%CI 1.18-2.09), respectively. There was an interaction between age and WHtR (P for interaction was 0.043). The association between WHtR and CVD was stronger in people under 60 years old, with a HR of 1.44 (95%CI 1.24-1.67). CONCLUSION: We found that obesity increased the risk of CVD in people without traditional CVD risk factors. The association of WHtR with CVD was stronger in people under 60 years old.

Adherence to the dietary approaches to stop hypertension diet and non-alcoholic fatty liver disease.

BACKGROUND AND AIMS: The evidence of the relationship between dietary approaches to stop hypertension (DASH) and non-alcoholic fatty liver disease (NAFLD) is limited. Thus, we conducted a cohort-based case-control study to examine whether adherence to the DASH diet was associated with lower NAFLD risk in China. METHODS: We included 11 888 participants (2529 incident NAFLD and 9359 non-NAFLD) from the Kailuan cohort with no history of hepatitis B/C infection and alcohol drinking. DASH score was calculated based on the energy-adjusted consumption of vegetables, fruits, dairy, beans, grains, meats, fat, sodium and beverage, collected by a validated food frequency questionnaire. We used Logistic regression analysis to determine the NAFLD's risk according to the DASH score. RESULTS: Higher DASH score was associated with lower risk of NAFLD. Compared with the lowest quintile of DASH score, the highest DASH quintile had a lower risk of occurring NAFLD, with odds ratio (OR) of 0.82 (95% confidence interval [CI]: 0.70-0.96) in the multivariate model. Stratified analysis showed that the inverse association was only observed in women (OR = 0.67, 95% CI: 0.48-0.94), and participants with overweight/obesity (OR = 0.79, 95% CI: 0.66-0.94), fasting blood glucose <6.1 mmol/L (OR = 0.80, 95%: 0.67-0.96), low density lipoprotein ≥3.4 mmol/L (OR = 0.71, 95% CI: 0.53-0.96), high density lipoprotein ≥1.0 mmol/L (OR = 0.81, 95% CI: 0.69-0.96), ALT < 40 U/L (OR = 0.79, 95% CI:0.67-0.93) and C-reactive protein ≥2.0 mg/L (OR = 0.56, 95% CI: 0.40-0.78). CONCLUSIONS: Adherence to the DASH diet was inversely associated with a lower risk of NAFLD in the Chinese population. DASH diet should be highly recommended, especially for women and people with overweight/obesity and a high CRP level.

Association Between Baseline Uric Acid and the Risk of Acute Pancreatitis: A Prospective Cohort Study.

OBJECTIVES: The aim of the study is explore the association between serum uric acid (UA) and acute pancreatitis (AP) risk in a Chinese population. METHODS: We included 124,316 participants who enrolled in the Kailuan cohort from 2006 to 2009. We fitted Cox models to estimate the correlation between UA and AP. RESULT: During an average follow-up of 11.97 years (standard deviation, 2.16 years), 396 AP developed. The incidence rates from quartile 1 to quartile 4 of AP were 20.76, 18.78, 30.58, and 36.79 per 100,000 person-years, respectively. Multivariate analysis showed a significantly increased risk in quartile 3 (hazard ratio [HR], 1.42; 95% confidence interval [CI], 1.05-1.91) and quartile 4 (HR, 1.61; 95% CI, 1.19-2.17) compared with quartile 1. The association may be modified by alcohol use (P for interaction = 0.017). The quartile 4 group with excessive alcohol consumption showed an enormously increased risk of AP (HR, 9.09; 95% CI, 1.18-70.21) than those without (HR, 1.46; 95% CI, 1.07-2.00). CONCLUSIONS: Elevated serum UA is an independent risk factor for AP. Surveillance of serum UA, especially among heavy drinkers, may be helpful for AP prevention.

Inhibition of matrix stiffness relating integrin ß1 signaling pathway inhibits tumor growth in vitro and in hepatocellular cancer xenografts.

BACKGROUND: Cancer development is strictly correlated to composition and physical properties of the extracellular matrix. Particularly, a higher matrix stiffness has been demonstrated to promote tumor sustained growth. Our purpose was to explore the role of matrix stiffness in liver cancer development. METHODS: The matrix stiffness of tumor tissues was determined by atomic force microscopy (AFM) analysis. In vitro, we used a tunable Polyacrylamide (PA) hydrogels culture system for liver cancer cells culture. The expression level of integrin ß1, phosphorylated FAK, ERK1/2, and NF-κB in SMMC-7721 cells was measured by western blotting analysis. We performed MTT, colony formation and transwell assay to examine the tumorigenic and metastatic potential of SMMC-7721 cells cultured on the tunable PA hydrogels. SMMC-7721 cancer xenografts were established to explore the anticancer effects of integrin inhibitors. RESULTS: Our study provided evidence that liver tumor tissues from metastatic patients possessed a higher matrix stiffness, when compared to the non-metastatic group. Liver cancer cells cultured on high stiffness PA hydrogels displayed enhanced tumorigenic potential and migrative properties. Mechanistically, activation of integrin ß1/FAK/ ERK1/2/NF-κB signaling pathway was observed in SMMC-7721 cells cultured on high stiffness PA hydrogels. Inhibition of ERK1/2, FAK, and NF-κB signaling suppressed the pro-tumor effects induced by matrix stiffness. Combination of chemotherapy and integrin ß1 inhibitor suppressed the tumor growth and prolonged survival time in hepatocellular cancer xenografts. CONCLUSION: A higher matrix stiffness equipped tumor cells with enhanced stemness and proliferative characteristics, which was dependent on the activation of integrin ß1/FAK/ERK1/2/NF-κB signaling pathway. Blockade of integrin signals efficiently improved the outcome of chemotherapy, which described an innovative approach for liver cancer treatment.

Preoperative Computed Tomography Imaging of the Pancreas Identifying Predictive Factors for the Progression of Grade A, or Biochemical Leak, to Grade B Postoperative Pancreatic Fistula Following Pancreaticoduodenectomy: A Retrospective Study.

BACKGROUND This retrospective study aimed to identify the predictive factors for the progression of grade A, or early biochemical leak, to grade B postoperative pancreatic fistula (POPF) following pancreaticoduodenectomy using preoperative computed tomography (CT) imaging of the pancreas. MATERIAL AND METHODS A total of 156 patients were analyzed retrospectively. Biochemical leakage occurred in 60 patients, who were divided into POPF progression and non-POPF progression groups. Perioperative parameters were collected. Univariate analysis and multivariate logistic regression analysis were done. For the parameters with statistical significance, the area under the curve (AUC) was calculated if possible and the predictive value was assessed. RESULTS Univariate analysis showed that main pancreatic duct diameter, postoperative complications (except POPF), prothrombin time (PT) and serum albumin on postoperative day 3, and pancreatic CT value were risk factors of POPF (P<0.05). Multivariate analysis showed that serum albumin and PT on postoperative day 3 and pancreatic CT value were independent risk factors of POPF (P<0.05). Lower postoperative albumin, lower pancreatic CT value, and longer PT were associated with a higher risk of POPF (P<0.05). The AUC of CT value was 0.808. CT value thresholds of 42.5 Hounsfield units (HU) and 41.5 HU were tied for the highest predictive performance, with Youden indices of 0.486 for both, and sensitivity of 79% and 71%, and specificity of 69% and 78%, respectively. CONCLUSIONS Preoperative laboratory investigations and CT imaging of the pancreas may identify factors associated with early biochemical leakage progressing to grade B POPF following pancreaticoduodenectomy.

Association between blood copper and nonalcoholic fatty liver disease according to sex.

BACKGROUND & AIMS: Nonalcoholic fatty liver disease (NAFLD) is a common disease with potential sex-based difference in the prevalence and prognosis. Copper deficiency may affect the antioxidant defense system and lead to the progression of NAFLD. This study aimed to evaluate the association between blood copper and NAFLD according to sex difference. METHODS: A case-control study of 1816 cases of NAFLD and 1111 sex- and age-matched control cases was conducted in Tangshan, China, from January 1, 2016, to December 31, 2017, based on the Kailuan cohort. In men and women, logistic regression analysis was separately applied to determine the risk of NAFLD, severity of NAFLD based on hepatic steatosis, the NAFLD fibrosis score, and fibrosis-4 score, for each quartile of blood copper with the lowest quartile as the reference. In addition, the effect of metabolic syndrome on the association between copper and NAFLD was assessed. RESULTS: In men, blood copper concentration was lower in the NAFLD group (mean ± SD: 0.617 ± 0.117 µg/mL) than in the control group (mean ± SD: 0.655 ± 0.133 µg/mL) (P < 0.001). After adjustment for possible confounders, the odds ratio of NAFLD at the highest quartile of copper compared to the lowest quartile was 0.57 (95% CI: 0.41-0.80) and the protective effect of higher blood copper was increased with the severity of NAFLD. In the results of stratified analysis, lower copper concentration was a significant additional factor that contributed to higher risk of NAFLD in male subjects with metabolic syndrome. However, no significant association was observed between copper and NAFLD in women with different characteristics, except an NAFLD fibrosis score < -1.455 and moderate hepatic steatosis. CONCLUSIONS: Higher copper levels achieved significant protective effect against NAFLD in men but not in women. Sex-specific intervention is a potential tool for the prevention of development of NAFLD.

Precise hepatectomy based on the optimized technique of hepatic blood flow occlusion combined with the curettage and cut technique by electrotome.

BACKGROUND: The aim of this study was to evaluate the outcome of precise hepatectomy based on the optimized technique of hepatic blood flow occlusion combined with the curettage and cut technique by electrotome. METHODS: Hospitalized patients with primary liver cancer treated in our hospital were included in this study and all patients (N.=61) were numbered according to the inclusion sequence and were randomized into group A and group B: 1) group A: precise liver resection by using simplified blocking combining with electrotome; 2) group B: precise liver resection by using half-hepatic occlusion + CUSA assisting liver parenchyma transection+ lower central venous pressure controlled by the anesthesiologist. Postoperative laboratory examination data (blood routine, liver function, renal function, blood coagulation function, AFP quantitation) were collected, including WBC, alanine aminotransferase (ALT), total bilirubin (TBIL), prothrombin time (PT), creatinine (Cr), abdominal drainage volume, intra-abdominal hemorrhage, bile leakage, blood transfusion, time of postoperative passage of gas by anus, and length between postoperation and discharge. RESULTS: Five days postsurgery, the value of WBC between groups A and B were not significant different (8.9±2.2 vs. 8.3±2.8, P>0.05). The ALT, PT, Cr, abdominal drainage volume, abdominal drainage volume, intra-abdominal hemorrhage, bile leakage, blood transfusion, and time of postoperative passage of gas by anus between group A and B were not significant different postoperatively, respectively. And also, the length between postoperation and discharge were not significant different between two groups. CONCLUSIONS: Precise hepatectomy based on the optimized technique of hepatic blood flow occlusion combined with the curettage and cut technique by electrotome works well. This technology has a low requirement for hospital's operation condition and anesthetist, so it carries out a new route for the wide application of precise liver resection in basal hospitals.

[Significance of high sensitivity C-reactive protein level for predicting risk of nonalcoholic fatty liver in type 2 diabetes mellitus patients].

OBJECTIVE: To investigate the significance of high sensitivity C-reactive protein (hsCRP) levels in serum for detecting type 2 diabetes mellitus (T2DM) patients at risk of developing nonalcoholic fatty liver (NAFLD). METHODS: Individuals with T2DM (n = 9489) were recruited from the Kailuan Company between 2006 and 2007 for the first phase of this community-based prospective cohort study. For the second phase of the study, the original cohort was recruited for follow-up (at two years from each subject's original enrollment date (baseline)). The total followed-up subjects (n = 2802; 2344 males, 458 females, 22-88 years old) were categorized into quartiles according to baseline measurements of serum hsCRP levels (less than or equal to 0.30, > 0.30-0.60, > 0.60-1.92 and > 1.92 mg/L) and used to determine the relationship between change in incidence rates of NAFLD and predictive value of baseline serum hsCRP levels by logistic regression analysis. RESULTS: Twenty-nine percent (n = 813) of the followed-up subjects developed NAFLD. The incidence (%) of NAFLD at the two-year follow-up had increased in conjunction with the level of serum hsCRP detected at baseline (quartile 1: 22.5%, 2: 27.3%, 3: 32.1%, and 4: 34.3%; all, P less than 0.01). It was found that the subjects in the highest quartile had an increased risk of NAFLD (odds ratio (OR) = 1.80, 95% confidence interval (CI): 1.42-2.28, P less than 0.01), as compared with those in the lowest quartile. Moreover, when the regression model was adjusted for baseline factors of age, sex, triglycerides, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, fasting serum glucose, and body mass index, the risk of NAFLD remained significantly higher for the highest quartile (vs. the lowest quartile; OR = 1.49, 95% CI: 1.16-1.91, P less than 0.01). CONCLUSION: Serum hsCRP levels may be predictive of development of NAFLD in individuals with type 2 diabetes mellitus. The risk of NAFLD increases in parallel with increasing levels of serum hsCRP.

[Evaluation of the fracture of nickel-titanium rotary Protaper during root canal preparation].

PURPOSE: To assess clinical application of Nickel-titanium(NiTi) rotary instruments Protaper in preparation of curved root canals. METHODS: 281 curved canals from 169 extracted molars were instrumented by Protaper rotary instruments using crown-down technique. An analysis was carried out regarding the relationship between the broken files and canal distribution,degree of curvature of canals, and the relationship between amount of the broken files and the duration was also included. SPSS18.0 software package was used for statistical analysis. RESULTS: A total of 43 kits files were used in the preparation of 281 curved root canals, and broken files often happened in canals with curvature of >30° and very complex canals. CONCLUSIONS: The fracture of NiTi instruments is closely related to the anatomy of the root cana1. With the use of NiTi rotary instruments Protaper, curved root canals can be prepared effectively. Meanwhile, the problem of instrument separation should be prevented.

[Connection of trigeminal nerve and facial nerve branches and its clinical significance].

In recent years, many anatomical researches have showed that there are common and extensive connections between the trigeminal nerve and the facial nerve.They are briefly outlined as follows: (1) The infraorbital nerve communicates with buccal branch of the facial nerve. (2) The auriculotemporal nerve of the trigeminal nerve communicates with the buccal, zygomatic,temporal branches and the upper divisions of the facial nerve. (3) The supraorbital nerve communicates with the zygomatic and temporal branches of the facial nerve. (4) The mental nerve communicates with the marginal mandibular branch of the facial nerve. (5) The buccinator nerve communicates with the zygomatic, buccal and marginal mandibular branches. These communications between the trigeminal nerve and facial nerve are probably related to several clinical signs, for example,some trigeminal neuralgia patients are complicated by facial spasm, some patients appeared spontaneous partial functional recovery of mimetic muscles following surgical resection of a considerable segment of the facial nerve (including a portion of its main trunk and the peripheral plexus), etc. The purpose of this article was to review the anatomical features and clinical significance of the communications between the trigeminal nerve and the facial nerve.

Laparoscopic and open splenectomy and azygoportal disconnection for portal hypertension.

AIM: To compare the outcomes of laparoscopic and open splenectomy and azygoportal devascularization for portal hypertension. METHODS: From June 2006 to March 2009, laparoscopic splenectomy and azygoportal disconnection (LSD) were performed on 28 patients with cirrhosis, bleeding due to portal hypertension, and secondary hypersplenism. Success was achieved in 26 patients. Demographic, intraoperative, and postoperative variables of the patients were compared. RESULTS: Success of laparoscopic splenectomy and azygoportal disconnection was achieved in all but two patients (7.14%) who required open splenectomy and azygoportal devascularization (OSD). The operation time was significantly longer in patients undergoing LSD than in those undergoing OSD (235 +/- 36 min vs 178 +/- 47 min, P < 0.05). The estimated intraoperative blood loss was much more in patients receiving OSD than in those receiving LSD (420 +/- 50 mL vs 200 +/- 30 mL, P < 0.01). The proportion of patients undergoing laparoscopic and open splenectomy and azygoportal disconnection who received transfusion of packed red blood cells during or after the operation was 23.08% and 38.46%, respectively (P < 0.05). The time of first oral intake was faster in patients after LSD than in those after OSD (1.5 +/- 0.7 d vs 3.5 +/- 1.6 d, P < 0.05). The hospital stay of patients after LSD was shorter than that of patients after OSD (6.5 +/- 2.3 d vs 11.7 +/- 4.5 d, P < 0.05). The pain requiring medication was less severe in patients after LSD than in those after OSD (7.69% vs 73.08%, P < 0.001). The overall complication rate was lower in patients after LSD than in those after OSD (19.23% vs 42.31%, P < 0.05). CONCLUSION: Laparoscopic splenectomy and azygoportal disconnection are the feasible, effective, and safe surgical procedure, and are advantageous over minimally invasive surgery for bleeding portal hypertension and hypersplenism.

[The neuromuscular toxicity and clinical application of adriamycin].

Adriamycin (doxorubicin) is commonly used in the treatment of malignant tumours. In recent years,retrograde adriamycin sensory ganglionectomy has been used in treatment of trigeminal neuralgia and has obtained good therapeutic effect. The mechanism of action, particularly, of the toxic effects with different medication methods and choice of doses for muscle cells and nerve cells is still unclear. This article reviewed the mechanism and feature of the toxicity of adriamycin effects on these cells and its advance in experimental study. The damage of adriamycin was highly selective and self-limited. The different effects of adriamycin with different administration routes and doses is also described. Adriamycin shows great potentiality in treatment of trigeminal neuralgia, facial spasm and some other neuromuscular diseases.

[Changes in voltage-gated potassium currents in the trigeminal neurons after a chronic constriction of infraorbital nerve.].

The purpose of this study was to establish a model of trigeminal neuralgia (TN) through an approach from lower edge of cheekbone and to observe the functional changes in the voltage-gated potassium currents in the cultured trigeminal ganglion (TG) neurons. Thirty Sprague-Dawley male rats were divided into two groups, the sham-operated (sham) group and the operated group. The TN model was carried out by using a chronic constriction injury of the infraorbital nerve (ION-CCI) from lower edge of cheekbone. Peripheral pain threshold test and whole-cell patch clamp recording were used to determine the difference between sham and ION-CCI rats. The withdrawal threshold of whisker pad in operated side of ION-CCI rat was decreased significantly from 6 d after operation and then maintained until 21 d, with the lowest on the 15th day. The threshold of whisker pad in non-operated side of operated rats was also decreased significantly compared with that in the sham group. Delayed rectifier potassium current (I(K)) in cultured ION-CCI TG neurons was decreased significantly compared with that in the sham group. Transient outward potassium currents (I(A)) in both operated and non-operated sides of TG neurons from ION-CCI rats were also reduced significantly compared with that in the sham group. The present study provided a new method of ION-CCI. In this model, the decrease of I(A) and I(K) might contribute, at least in part, to the decrease in mechanical pain threshold of whisker pad and the subsequent hyperalgia.

[The expression and significance of osteopontin and its receptor CD44v6 in oral squamous carcinoma].

OBJECTIVE: To study the clinical significance of osteopontin (OPN) and its receptor CD44v6 expression in oral squamous cell carcinoma (OSCC). METHODS: OPN and CD44v6 expression were examined in OSCC (n=59) and normal oral mucosa (n=12) by EnVision method, the staining-grade were quantitatively studied by multiple functional image analyzer. Their expression grade of different clinical and pathological index were statistically studied. RESULTS: OPN expression grade was significantly higher in OSCC than that in normal oral mucosa (P<0.05). Significant deviation of OPN expression grade was found between different clinical stages, as well as between the groups with or without cervical lymph node metastasis. The group with cervical lymphnode metastasis had higher expression than that of the group without lymph node metastasis (P<0.05). However, there was no significant deviation between the expression grade in well-differentiated group and moderate or poorly differentiated group. The expression of CD44v6 showed no correlation with that of OPN, nor any difference between OSCC and normal oral mucosa. CONCLUSION: OPN over expression was found in OSCC, and the expression level has correlation with the clinical staging and with cervical lymph node metastasis status. CD44v6 expression showed no difference between OSCC and normal oral mucosa nor any correlation with that of OPN.

[Local drug injection for the treatment of trigeminal neuralgia].

Trigeminal neuralgia is the most common facial pain syndrome,which remains a difficult condition to manage due to lack of knowledge on pathophysiological mechanisms. Local drug injection is a minimally invasive and useful technique to manage trigeminal neuralgia, with a high success rate and low incidence of morbidity. Although a large number of drugs have been used to treat trigeminal neuralgia, there still remains a great challenge to reduce the recurrent rates and complications both intra- or post- injections.

Reliability of the superficial venous drainage of the radial forearm free flaps in oral and maxillofacial reconstruction.

The aim of this article is to compare the superficial venous drainage system versus dual venous drainage system of radial forearm free flaps (RFFF) and its impact on flap survival. A total of 136 consecutive patients undergoing RFFF reconstruction for oral and maxillofacial surgical defects were reviewed retrospectively. In group l, both the superficial and deep veins were anastomosed to the neck recipient veins. In group 2, only the superficial vein was used for anastomosis. There were no statistical differences in venous problems between two groups (6/68 in group 1 vs. 5/68 in group 2, P = 0.75). The flap survival rate was 98.5% (66/68 in group 1 vs. 68/68 in group 2, P = 0.15). Although there are many theoretical advantages to dual venous drainage system anastomoses, they seem not to impact on flap survival in our experience.

[Evaluation of living donor liver transplantation for patients with hepatocellular carcinoma].

OBJECTIVE: To evaluate the donor risks and potential recipient benefits of living donor liver transplantation (LDLT) for adult patients with hepatocellular carcinoma (HCC). METHODS: 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. RESULTS: 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). CONCLUSION: 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.

Donor safety in adult living donor liver transplantation using the right lobe: single center experience in China.

AIM: To evaluate the safety of donors in adult living donor liver transplantation (LDLT) using the right lobe in a single liver transplantation center in China. METHODS: We investigated retrospectively 52 living donor liver resections performed from October 2003 to July 2006. All patients were evaluated by blood tests and abdominal CT. The mean donor age was 28.2 +/- 7.4 years. Residual liver volume was 42.1% +/- 4.7%. Mean operative time was 420 +/- 76.2 min; mean ICU stay, less than 36 h; mean hospital stay, 16.4 +/- 8.6 d; and mean follow-up period, 6 mo. RESULTS: There was no mortality. The overall complication rate was 40% (21 donors). Major complications included biliary leak in two, and pneumonia in 2 donors. Minor complications included mild pleural effusion in 12 donors, transient ascites in 6, mild depression in 4, intra-abdominal collections in 2, and wound infections in 1 donor. Residual liver volume did not affect the complication rate. None required re-operation. Return to pre-donation activity occurred within 5-8 wk. CONCLUSION: Right hemi-hepatectomy can be performed safely with minimal risk in cases of careful donor selection. Major complications occurred in only 7.7% of our series.

[A study of interleukin-10 gene polymorphism in irritable bowel syndrome].

OBJECTIVE: To investigate whether three diallelic polymorphisms at the position -1082, -819 and -592 in the promoter region of the IL-10 gene were associated with diarrhea-predominant irritable bowel syndrome (D-IBS). METHODS: The IL-10 gene -1082, -819 and -592 position polymorphisms were genotyped by amplification refractory mutation systems-polymerase chain reaction (ARMS-PCR) methods in 43 patients with D-IBS and 41 healthy subjects (HS). RESULTS: Compared with HS, D-IBS patients had a greater frequency of T/T genotype at IL-10 gene promoter -819 position (67.4% vs 39.0%, P < 0.05), the frequencies of -819 C/T and C/C genotype were not significantly different (23.3% vs 43.9% and 9.3% vs 17.1%, P > 0.05). D-IBS patients also had a greater frequency of -592 A/A genotype compared with HS (67.4% vs 39.0%, P < 0.05), the frequencies of -592 C/A and C/C genotype were not significantly different (23.3% vs 43.9% and 9.3% vs 17.1%, P > 0.05). No significant difference was found in genotype at IL-10 gene promoter -1082 position. The -819 T allele frequency in D-IBS was significantly higher than that in control (79.1% vs 61.0%, P < 0.05), whereas -819 C allele frequency in D-IBS was lower (20.9% vs 39.0%, P < 0.05). D-IBS patients also had a greater frequency of -592 A allele compared with HS (79.1% vs 61.0%, P < 0.05), -592 C allele frequency in D-IBS was lower (20.9% vs 39.0%, P < 0.05). No significant difference was found in -1082 G or A allele frequency. CONCLUSIONS: The presence of -819 T/T and -592 A/A genotype may be related to development of D-IBS.