Prebiotic saccharides polymerization improves the encapsulation efficiency, stability, bioaccessibility and gut microbiota modulation of urolithin A liposomes.

This work was to investigate the effect of four prebiotic saccharides gum arabic (GA), fructooligosaccharide (FOS), konjac glucomannan (KGM), and inulin (INU) incorporation on the encapsulation efficiency (EE), physicochemical stability, and in vitro digestion of urolithin A-loaded liposomes (UroA-LPs). The regulation of liposomes on gut microbiota was also investigated by in vitro colonic fermentation. Results indicated that liposomes coated with GA showed the best EE, bioaccessibility, storage and thermal stability, the bioaccessibility was 1.67 times of that of UroA-LPs. The UroA-LPs coated with FOS showed the best freeze-thaw stability and transformation. Meanwhile, saccharides addition remarkably improved the relative abundance of Bacteroidota, reduced the abundances of Proteobacteria and Actinobacteria. The UroA-LPs coated with FOS, INU, and GA exhibited the highest beneficial bacteria abundance of Parabacteroides, Monoglobus, and Phascolarctobacterium, respectively. FOS could also decrease the abundance of harmful bacteria Collinsella and Enterococcus, and increase the levels of acetic acid, butyric acid and iso-butyric acid. Consequently, prebiotic saccharides can improve the EE, physicochemical stability, gut microbiota regulation of UroA-LPs, and promote the bioaccessibility of UroA, but the efficiency varied based on saccharides types, which can lay a foundation for the application of UroA in foods industry and for the enhancement of its bio-activities.

The correlation between hemoglobin,monocyte to high density lipoprotein cholestero ratio and post-stroke cognitive impairment / 临床神经病学杂志

Objective The correlation between Hb content,monocyte to high density lipoprotein cholesterol ratio(MHR)and post-stroke cognitive impairment(PSCI)was analyzed,and the application value of Hb and MHR in assisting diagnosis and evaluation of PSCI was discussed.Methods The clinical data of first-time stroke patients admitted to the Rehabilitation Department of the Second Affiliated Hospital of Nanjing Medical University from January 2021 to December 2022 were collected.The patients were divided into PSCI group and post-stroke no cognitive impairment(PSNCI)group by using MMSE scores.The differences in serum related indicators between the two groups were analyzed to find the risk factors of PSCI.Results There were a total of 81 stroke patients,including 43 in the PSCI group and 38 in the PSNCI group.There were no statistically significant differences in gender,age,history of hypertension,diabetes,smoking,drinking history,white blood cell count,neutrophil count,lymphocyte count,platelet count,total cholesterol,triglyceride,high density lipoprotein cholesterol and low density lipoprotein cholesterol between the two groups.The Hb content in PSCI group was significantly lower than that in PSNCI group,and the MHR was significantly higher than that in PSNCI group(P＜0.05).Spearman correlation analysis showed that Hb was positively correlated with MMSE score of stroke patients(rs = 0.353,P＜0.05),and MHR was negatively correlated with MMSE score of stroke patients(rs =-0.325,P＜0.05).According to whether PSCI occurred as the dependent variable,the analysis showed that lower Hb content and higher MHR were independent risk factors for PSCI(OR =1.056,95%CI:1.025-1.088,P＜0.05;OR =0.059,95%CI:0.006-0.577,P＜0.05).The area under ROC curve of Hb in predicting PSCI in stroke patients was 0.76(95%CI:0.656-0.865).The area under ROC curve of MHR for predicting PSCI in stroke patients was 0.62(95%CI:0.497-0.742).Conclusions Hb content and MHR are significantly correlated with PSCI.The decrease of Hb content and the increase of MHR are independent risk factors for PSCI.Hb content and MHR have certain reference value for the prediction and diagnosis of PSCI.

Construction of a Genomic Bacterial Artificial Chromosome (BAC) Library for the Prawn Macrobrachium rosenbergii and Initial Analysis of ZW Chromosome-Derived BAC Inserts.

Knowledge on sex determination has proven valuable for commercial production of the prawn Macrobrachium rosenbergii due to sex dimorphism of the male and female individuals. Previous studies indicated that prawn sex is determined by a ZW-ZZ chromosomal system, but no genomic information is available for the sex chromosome. Herein, we constructed a genomic bacterial artificial chromosome (BAC) library and identified the ZW-derived BAC clones for initial analysis of the sex chromosomal DNA sequence. The arrayed BAC library contains 200,448 clones with average insert size of 115.4 kb, corresponding to ∼ 4× coverage of the estimated 5.38 Gb genome. Based on a short female-specific marker, a Z- and a W-fragment were retrieved with the genomic walking method. Screening the BAC library using a ZW-specific marker as probe resulted in 12 positive clones. From these, a Z-derived (P331M17) and a W-derived (P122G2) BAC clones were randomly selected and sequenced by PacBio method. We report the construction of a large insert, deep-coverage, and high-quality BAC library for M. rosenbergii that provides a useful resource for positional cloning of target genes, genomic organization, and comparative genomics analysis. Our study not only confirmed the ZW/ZZ system but also discovered sex-linked genes on ZW chromosomes for the first time, contributing to a comprehensive understanding of the genomic structure of sex chromosomes in M. rosenbergii.

Relationship between Blood Acetaldehyde Concentration and Psychomotor Function of Individuals with Different ALDH2 Genotypes after Alcohol Consumption / 法医学杂志

Objective To explore the change rules of blood ethanol and blood acetaldehyde concentration, the impairment of psychomotor functions of different acetaldehyde dehydrogenase （ALDH） 2 genotype individuals after alcohol consumption and the relationship among them. Methods The ALDH2 genotypes in seventy-nine healthy volunteers were obtained by SNaPshotTM method, then divided into ALDH2*1/*1 （wild type） and ALDH2*1/*2 （mutant type） group. After volunteers consumed 1.0 g/kg of alcohol, blood ethanol concentration and blood acetaldehyde concentration at a series of time points before and after alcohol consumption and psychomotor functions, such as, visual selective response time, auditory simple response time and tracking experiment were detected. Biphasic alcohol response questionnaires were collected. Results After alcohol consumption, ALDH2*1/*2 group's blood ethanol and blood acetaldehyde concentration reached the peak earlier than ALDH2*1/*1 group. Its blood acetaldehyde concentration was higher than that of ALDH2*1/*1 group, 1-6 h after alcohol consumption. The psychomotor functions, such as visual selective response time and auditory simple response time in ALDH2*1/*2 group were more significantly impaired than those in ALDH2*1/*1 group after alcohol consumption. There was no statistical significance between the two groups in excitement or sedation reactions （P>0.05）. Pearson correlation coefficient test showed that blood acetaldehyde concentration was related with psychomotor function. Conclusion There are significant differences between the psychomotor function of ALDH2 wild type and mutant type individuals after alcohol consumption estimated to be related to the difference in blood acetaldehyde concentration after alcohol consumption.

An unusual successful treatment with non-sulfonamides: primary cutaneous nocardiosis caused by Nocardia brasiliensis.

INTRODUCTION: Primary cutaneous nocardiosis is a rare suppurative or granulomatous inflammation disease caused by Nocardia infection. Because of nonspecific clinical findings, it is always misdiagnosed as common pyogenic infection. Sulfonamides have been the standard treatment for nocardiosis, but the outcome is always poor due to the high rates of misdiagnosis and refractoriness of the disease. CASES PRESENTATIONS: The presented cases are patients of acute suppurative cutaneous infection without involvement of other organs. We report four cases, of which two cases were localized cutaneous nocardiosis and the other two were lymphocutaneous type of nocardiosis. All cases were diagnosed with pus culture which turned out to be Nocardia brasiliensis. We report an improvement of primary cutaneous nocardiosis symptoms in the four patients treated with non-sulfonamides. All patients were cured and recovered without recurrence during follow-up. CONCLUSION: Our results suggest that non-sulfonamides are effective treatment for the patients with primary cutaneous nocardiosis who are resistant or intolerant to sulfonamides.

Comparison of methods for stable co-expression of different subtype drug-matabolizing enzymes in HepG2 cells by piggyBac transposon / 中国药理学与毒理学杂志

OBJECTIVE To study the methodology of achieving stable co-expression of drug-metab?olizing enzymes in the HepG2 cells by the piggyBac (PB) transposon system. METHODS N-terminal attachment of enhanced green fluorscent protein plasmid (pEGFP- N2) and 2A peptide linked recombinant PB transposon plasmid containing dual-genes encoding drug metabolizing enzymes cyto?chrome P450 3A4 (CYP3A4) and CYP2C19 (pPB-CYP3A4-2A-2C19) were transfected into HepG2 cells respectively by Lipofectamine?LTX reagent, GenJetTM (Ver.Ⅱ) reagent and Neon?Transfection System reagent, which were widely used for large-sized DNA fragments transfection. 48 h later, the transfection efficiency and cell toxicity were detected and compared between the three methods so as to find a method with relatively high efficiency and low toxicity for later transfection.Then,three groups of recombinant PB transposons-single-gene transposon (PB-CYP3A4), 2A peptide linked dual-gene transposon (PB-CYP3A4-2A-2C19) and multiple single-gene transposon mixture〔PB-CYP3A4, PB-CYP2C8, PB-CYP2A6, organic anion transporting polypeptide 1B1 PB transposon (PB-OATP1B1)〕-were transfected into HepG2 cells respectively with the above established method.The puromycin (Puro)-resistant and GFP positive cell clones were picked up and further cultured. The mRNA, protein and metabolic levels of drug-metabolizing enzymes in monoclonal cell lines were detected by quantitative real-time PCR,Western blotting and high performance liquid chromatography-tandem mass spectrometry respectively after screening by Puro and green fluorescence. Comparisons of different groups were made using statistical analysis. RESULTS The comparison of three different transfection methods indi?cated that the transfection efficiency of GenJetTMwas up to(94.2±2.5)% and (89.3±3.3)%,significantly higher than those of the other two methods (P<0.01), along with lower cytotoxicity. Then GenJetTMwas chosen for later transfection. In the Puro-resistant monoclonal cell lines of single transposon PB-CYP3A4,PB-CYP3A4-2A-2C19 groups,the mRNA,protein and enzyme activity levels of drug-metabo?lizing enzymes were significantly increased respectively.The recombinant transposon (PB-CYP3A4-2A-2C19) containing 2A peptide could achieve stable and efficient co-expression of two metabolizing enzymes CYP3A4 and CYP2C19,while the expression of drug-metabolizing enzymes remained unbal?anced and random in those of multiple single-gene transposon mixture group (PB-CYP3A4, PB-CYP2C8,PB-CYP2A6,PB-OATP 1B1)(CYP3A4 was expressed in some cell clones only).CONCLUSION GenJetTM could be an effective method for the PB recombinant transposon transfection into HepG2 cells, by which the PB transposon could mediate stable expression of drug-metabolizing enzymes. In terms of multi-gene expression,a low and unbalanced expression is found by multiple transposons co-transfection method,which is different from that by virus mediated method.In contrast,mono-PB trans?poson linked by 2A peptide can achieve stable expression of multi-genes.

Application of CT/MRI image registration and fusion combined with 3D printing technique in pre-surgical planning of refractory pelvic tumors / 上海交通大学学报（医学版）

Objective·To explore the value of applying CT/MRI image registration and fusion combined with 3D printing technique in pre-surgical planning of refractory pelvic tumors. Methods·A retrospective analysis was performed on the cases with refractory pelvic tumors admitted between March 2014 and December 2016 in Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine. CT/MRI examinations were performed as a routine pre-surgical procedure, and the resulting images were subject to rapid registration and fusion with the Medraw software in order to accurately determine the tumor boundaries and to be used as references in designing and making patient-specific tumor models, prostheses, and implants by 3D printing technique. Results·A total of 13 cases with refractory pelvic tumors were included in this study (8 cases of chondrosarcoma, 1 case of osteosarcoma with aneurysmal bone cyst, 1 case of dedifferentiated sarcoma, 1 case of fibrous connective tissue hyperplasia, 1 case of solitary fibrous tumor/hemangiopericytoma, and 1 case of metastatic squamous cell carcinoma) with an average age of (50.0±8.5) years. According to the Enneking classification,there were 2 cases in zone Ⅰ , 2 in zones Ⅰ + Ⅱ , 1 in zones Ⅱ + Ⅲ , 3 in zones Ⅰ + Ⅱ + Ⅲ , 1 in zones Ⅰ + Ⅱ + Ⅳ , 1 in zonesⅠ + Ⅱ + Ⅲ + Ⅳ , 1 in zones Ⅰ + Ⅳ , 1 in zones Ⅱ + Ⅳ , and 1 in zone Ⅳ. The mean maximal tumor diameter was (15.15±4.81) cm without implicating the pelvic blood vessels. Results from intraoperative frozen section at resection boundaries and the installation of prosthesis showed that the actual surgical procedure was consistent with the surgical planning based on the reported image fusion technique. Conclusion·CT/MRI image registration and fusion technique combined with 3D printing technique can accurately determine the resection boundary of pelvic tumors and assist in designing of individualized prosthesis model and surgical guide, which has a great value in pre-surgical planning and clinical treatment of refractory pelvic tumors.

Application of CT/MRI image registration and fusion combined with 3D printing technique in pre-surgical planning of refractory pelvic tumors / 上海交通大学学报（医学版）

Objective·To explore the value of applying CT/MRI image registration and fusion combined with 3D printing technique in pre-surgical planning of refractory pelvic tumors. Methods·A retrospective analysis was performed on the cases with refractory pelvic tumors admitted between March 2014 and December 2016 in Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine. CT/MRI examinations were performed as a routine pre-surgical procedure, and the resulting images were subject to rapid registration and fusion with the Medraw software in order to accurately determine the tumor boundaries and to be used as references in designing and making patient-specific tumor models, prostheses, and implants by 3D printing technique. Results·A total of 13 cases with refractory pelvic tumors were included in this study (8 cases of chondrosarcoma, 1 case of osteosarcoma with aneurysmal bone cyst, 1 case of dedifferentiated sarcoma, 1 case of fibrous connective tissue hyperplasia, 1 case of solitary fibrous tumor/hemangiopericytoma, and 1 case of metastatic squamous cell carcinoma) with an average age of (50.0±8.5) years. According to the Enneking classification,there were 2 cases in zone Ⅰ , 2 in zones Ⅰ + Ⅱ , 1 in zones Ⅱ + Ⅲ , 3 in zones Ⅰ + Ⅱ + Ⅲ , 1 in zones Ⅰ + Ⅱ + Ⅳ , 1 in zonesⅠ + Ⅱ + Ⅲ + Ⅳ , 1 in zones Ⅰ + Ⅳ , 1 in zones Ⅱ + Ⅳ , and 1 in zone Ⅳ. The mean maximal tumor diameter was (15.15±4.81) cm without implicating the pelvic blood vessels. Results from intraoperative frozen section at resection boundaries and the installation of prosthesis showed that the actual surgical procedure was consistent with the surgical planning based on the reported image fusion technique. Conclusion·CT/MRI image registration and fusion technique combined with 3D printing technique can accurately determine the resection boundary of pelvic tumors and assist in designing of individualized prosthesis model and surgical guide, which has a great value in pre-surgical planning and clinical treatment of refractory pelvic tumors.

The mutations ofGATA4andGATA6 in children with isolated atrial septal defect / 临床儿科杂志

ObjectiveTo identify mutations ofGATA4 andGATA6 genes in children with isolated congenital atrial septal defect (ASD).Methods From November 2012 to November 2013, 101 patients with ASD (99 unrelated patients and one twin) who were submitted to catheter-based intervention and 100 ethnicity-matched children without congenital heart disease, blood disorders and chromosomal abnormalities were enrolled. The blood was collected. The coding regions and lfanking regions of theGATA4 andGATA6 genes were ampliifed by polymerase chain reaction and sequenced using the dideoxvnucleotide chain termination technique, and then compared with the normal sequence in the Genbank.Results Two novel heterozygous missense GATA6mutations, c. G145A and c. G151A, were identiifed in 2 unrelated ASD patients, which were not present in the controls. These two mutations predicted the conversion of glycine into serine at amino acid residue 49 (G49S) and glutamate into lysine at amino acid residue 52 (K52E). A heterozygous missenseGATA6 mutation c.43 G>C, which caused a conversion from glycine to arginine, was found in 9 ASD patients and 7 controls. A single nucleotide polymorphism c.99G>T, which did not cause amino acid conversion inGATA4 gene, was found.ConclusionsGATA6 gene is an important transcription factor in heart development. The mutation ofGATA6 gene may cause the change of its transcriptional activity, and lead to ASD.

The research progress of GATA6 in heart development and isolated atrial septal defect / 临床儿科杂志

GATA6 transcription factor belongs to the GATA family and contains 2 conserved zinc ifnger DNA binding domains. GATA6 not only presents in embryonic tissues but also found in heart, lung and pancreas and is essential for the maintenance of their function.The present review focuses on the critical roles of GATA6 in heart development and atrial septal defect to provide theoretical basis for diagnosis and treatment of atrial septal defect.

Study on coronoid process of ulna osteotomy in the treatment of humerus condyle comminuted fracture in the elderly / 中华老年医学杂志

Objective To observe the clinical effects of coronoid process of ulna osteotomy and bilateral anatomic locking plate on humerus condyle comminuted fracture in the elderly.Methods 17 elderly patients with humerus condyle comminuted fracture were collected in department of orthopaedics in our hospital from July 2005 to December 2013 and graded into C2 (6 cases) and C3 (11 cases) according to the standard of the American society for the prevention of bone trauma.All patients were treated by coronoid process of ulna osteotomy and bilateral anatomic locking plate and accessed by Mayo elbow performance score (MEPS) at the last follow-up.Results Postoperative incision in all patients were healed,and X-ray showed fracture healing occurred at 10 to 24 weeks after coronoid process of ulna osteotomy (average of 14 weeks).No iatrogenic ulnar nerve injury and nonunion were found at the follow-up.The MEPS were excellent in 13 cases,well in 3 cases,ordinary in 1 case,and the excellent and good rate was 94.1％.Conclusions Coronoid process of ulna osteotomy and bilateral anatomic locking plate in the treatment of humerus condyle comminuted fracture in the elderly have good clinical effects with many advantages such as exposure clearly,early elbow joint function exercise and avoiding the aggravation of elbow joint osteoarthritis.

Effects of zhuhong ointment on MMPs activities and production by HSF / 中国中药杂志

HuaFu Shengji is the primary traditional Chinese medicine (TCM) therapy for treating chronic skin ulcer. The high activities of the protein enzyme in the wound fluids is one of the main cause of healing delay. In order to investigate the effect of TCM Zhuhong ointment for promoting wound healing. This research focused on its influence on matrix metalloproteinase (MMP) activities in wound fluids with TCM Yang syndromes, directly on the activated MMP-1,2 activities in vitro and on MMP-1,-2,-9 production by HSF. 8 wound fluid samples were collected, which were diagnosed Yang Syndromes in TCM. Wound fluid activities of MMP-2 and MMP-9 were measured by gelatin zymogram assay. MMP-1 and MMP-2 activities in vitro were measured by substrate cleavage. CCK-8 was used to observe the toxicity of Zhuhong ointment on HSF. MMP-1,-2,-9 production by HSF were detected by confocal microscope. Zhuhong ointment from 1 to 25 g x L(-1) obviously inhibited MMP-2 activity in wound fluid. When Zhuhong ointment was over 5 g x L(-1), it showed significantly inhibitory effect on wound fluid MMP-9 activity. In vitro study, when the mercury concentration was 320 mg x L(-1), Zhuhong ointment solution directly inhibited both MMP-1 activity and MMP-2. But mercury concentration from 0.51-2.56 mg x L(-1), it could activate MMP-1 activity, and from 0.51-64 mg x L(-1), activate MMP-2 activity instead. The mercury concentration when Zhuhong ointment saturated in DMEM was 39.6 mg x L(-1). When the mercury concentration was over 1.23 mg x L(-1), Zhuhong ointment showed toxicity to HSF. At 1.23, 0.62, 0.31 mg x L(-1) of mercury concentration, it increased MMP-1 expression by HSF, and at 1.23, 0.62 mg x L(-1), decreased MMP-2 expression. However, at 1.23, 0.62, 0.31 mg x L(-1), it decreased MMP-9 expression. At higher concentration, Zhuhong ointment can inhibit MMP-2, MMP-9 activities in wound fluid with dose-dependent way and show a direct inhibitory effect on activated MMP-1 and MMP-2 in vitro. But at a lower concentration, it showed two-way adjustment, with increased MMP-1, MMP-2 activities and its expression by HSF and decreased MMP-9 activity.

Arsenic trioxide regulates the production and activities of matrix metalloproteinases-1, -2, and -9 in fibroblasts and THP-1 / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The elevated matrix metalloproteinase (MMP) activity is an important cause of chronic wound healing failure. Arsenolite, whose main component is arsenic trioxide (As2O3), is a common traditional Chinese medicine wildly used in treating chronic wounds; it can remove necrotic tissue and promote tissue regeneration. This research was designed to evaluate the effects of As2O3 on production and activities of MMP-1, MMP-2 and MMP-9, and on regulation of its signal transduction pathway in human skin fibroblasts (HSFb) and human monocyte line (THP-1 cells) that were in an inflammatory state.</p><p><b>METHODS</b>We established three cell models; HSFb activated by TNF-α, THP-1 cells activated by phorbol 12-myristate 13-acetate (PMA) and an HSFb-THP-1 co-culture system. Three cell models was cultured with As2O3 for 24 hours. The levels of MMP-1, MMP-2, MMP-9, TNF-α and IL-1β in the cell culture supernatants were assayed by ELISA. The mRNA expressions of MMP-1, MMP-2 and MMP-9 were determined by RT-PCR. The activities of MMP-2 and MMP-9 were tested by Gelatin zymography assays. The phosphorylation levels of ERK1/2 and p38MAPK were assayed by Western blotting.</p><p><b>RESULTS</b>As2O3 inhibited the expression of MMP-1, MMP-2 and MMP-9 mRNA, the secretion and activity of MMP-1, MMP-2 and MMP-9 in HSFb and THP-1 cells in the inflammatory state (P < 0.05 and P < 0.01 respectively). It also inhibited the secretion of TNF-α and IL-1β in THP-1 cells and in the co-culture system (P < 0.05 and P < 0.01, respectively). It also decreased the phosphorylation of ERK1/2 and p38 MAPK in HSFb and THP-1 cells (P < 0.05 and P < 0.01, respectively).</p><p><b>CONCLUSIONS</b>As2O3, as a main component of arsenolite, can inhibit the production of MMPs by HSFb and THP-1 cells in an inflammatory state through inhibiting the release of inflammatory factors and the activation of the MAPK cascade pathway. This may be a possible mechanism for arsenolite healing chronic wounds.</p>

Clinical and pathological features of atypical teratoid/rhabdoid tumor in the central nervous system and diagnostic significance of INI1 expression in the tumor:report of one case / 中华神经医学杂志

Objective To investigate the clinical and pathological features of pediatric CNS atypical teratoid/rhabdoid tumor(AT/RT)and evaluate the role of INI1 antibody on the differential diagnosis and prognosis of AT/RT.Methods The clinical data and pathological features of 12-year-old boy with AT/RT were concluded.The protein expression of INI1 was detected by immunohistochemistry;follow-up was performed and relative documents of that disease were compared;the above data were retrospectively analyzed.Results Mioroanatomy showed typical teratoid cells and primitive mesenchymal cells in the tumor.Both of these 2 tumor components displayed positive reactions of vimentin and CD99.The SMA and EMA positive expressions were noted in the teratoid cells.Immunohistochemical staining demonstrated that INI1 antibody was nuclear negative in tumor cells,but positive within endothelial cells of the blood.Follow-up information showed the patient was dead 2 months after the operation.Conclusions CNS atypical AT/RT is highly aggressive tumor.The appearance of rhabdoid cells is its important morphologic features and its main differential diagnosis evidence.Mesenchymal components and the various results of immunohistochemical staining indicate that AT/RT tumor cells,having the character of the embryonal tumors,have various differentiation potential.The expression of INI1 antibody suggests that a mutation or deletion in the INI1 gene occurs in the tumor,which has important value in diagnosing and differentiating the tumor.

Clinical study of 28 patients with adult-to-infant living donor liver transplantation / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To summarize our experience in adult-to-infant living donor liver transplantation (A-ILDLT) and to analyze the efficacy and complications of A-ILDLT.</p><p><b>METHODS</b>The clinical data, surgical strategies and complications of 28 adult donors and infantile recipients who underwent A-ILDLT from April 2006 to December 2009 were retrospectively analyzed. These 28 patients (14 boys and 14 girls) aged from 80 days to 11.5 months with body weights of 3.08 to 10.3 kg at the time of operation . They suffered from biliary atresia with decompensated cirrhosis. The living donors were 15 mothers, 9 fathers, 3 grandma and 1 elder brother with ABO compatible with the infantile recipients. 27 Donor organs were the left lateral lobe grafts (segment II, III) and 1 graft was segment II. All patients were followed up for 5 to 24 months.</p><p><b>RESULTS</b>These grafts were orthotopically transplanted into the infantile recipients. The average length of stay was 9.3 days for the donor group without any complications. Postoperative immunosuppression included prednisone, Cyclosporin and mycophenolate mofetil (MMF). A total of 24 postoperative complications occurred in 20 recipients, including 5 vascular complications, 4 bleeding, 7 pneumonia, 2 bowel obstruction, 4 intestinal perforation and 3 rejection. Three recipients died of hepatic arterial thrombosis (HAT). The perioperative mortality rate of recipients was 10.7% (3/28) and the survival rate was 89.3% in peroperative period. One died of stricture of hepatic vein and 1 of accidental asphyxia during follow-up term. At present, 23 cases are still alive.</p><p><b>CONCLUSION</b>A-ILDLT has become an effective method to infants with end-stage liver disease. The postoperative vascular complication is the predominant cause of death.</p>

Gamma knife radiosurgery for cavernous malformations / 中国医学科学院学报

<p><b>OBJECTIVE</b>To evaluate the efficacy of Gamma knife surgery (GKS) in treating cavernous malformation (CM).</p><p><b>METHODS</b>From 1994 to 2001, 92 patients with 114 CMs were treated by GKS and then followed up for 2-8 years (mean 4.1+/-1.9). We analyzed the MRI features of CMs bleeding, efficacy of GKS, and the complications of treatment. Six pathological specimens after radiosurgery (1 from our group, 5 from other centers) were also assayed.</p><p><b>RESULTS</b>Among 43 patients who were treated by GKS to control their epilepsy, epileptic paroxysm was alleviated in 36 patients (83.7%), including 12 (27.9%) seizure-free. Rebleeding was confirmed in 9 patients (9.8%) by neuroimage, one of whom died. Transient symptomatic radiation edema occurred in 7 cases (7.6%) within 6-12 months after radiosurgery, and one patient underwent open surgery for cerebral decompression. The main pathological changes of cavernoma were coagulation necrosis and the vessels obliterated gradually after radiosurgery.</p><p><b>CONCLUSIONS</b>It is feasible to treat small and surgically high risk CMs by radiosurgery. The treatment has to be prudent in an acute bleeding and symptomatic progression. Optimal treatment timing and dose planning are prerequisites to reduce radiation-related complications. GKS is safe and effective to control the epilepsy caused by CMs, and also to bring down the rebleeding rate after a latency interval of several years.</p>

Clinical application of interventional therapy liver in orthotopic hepatic venous outflow obstruction following liver transplantation / 中华器官移植杂志

Objective To summary the clinical applied value of interventional therapy in hepatic venous outflow obstruction after orthotopic liver transplantation(OLT).Methods The clinical data of 27 patients suspect with hepatic outflow obstruction out of OLT patients were analyzed retrospec- tively.Most of them presented with liver dysfunction,like ascites,jaundice,or hydropsia of lower ex- tremity as BCS.These patients accepted venography and endovascular treatment if venous outflow ob- struction was found.Results By venography,one case of thrombus in inferior vena cava,one case of hepatic vein stenosis,13 cases of inferior vena cava stenosis(3 cases were associated with hepatic vein stenoses)were identified.Stent implantation was successfully performed on 10 patients,and balloon angioplasty on 4 patients.Rapid,dramatic resolution of symptoms was achieved in those patients. Hepatic vein restenosis occurred in one case 8 months after balloon dilatation,and treated with stent implantation.Inferior vena cava restenosis occurred in one case 2 years after balloon dilation,and trea- ted with another balloon expanding.Patients remained completely asymptomatic at 4 months to 5 years of follow-up.Conclusion The venacavographic balloon angioplasty and metallic stent replacement are safe and useful for post-OLT with venous outflow obstruction.