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The volcanic rocks hosting the iron deposits in the Aqishan–Yamansu metallogenic belt are sodium-rich. The geochronology, petrography, and geochemistry of minerals and sodium-rich rocks as well as the relationship between these rocks and the iron deposits are studied. Geochemically, the ore-hosting volcanic rocks are sodium-rich (the averages of Na2O and Na2O/K2O are 4.31 ​wt.% and 8.56, respectively) and belong to the calc-alkaline series. They are enriched in LREEs and LILEs (Ba, U, K, and Sr), but depleted in HFSEs (Nb, Ta, and Ti). SHRIMP zircon U–Pb dating of the crystal tuff in the Aqishan Formation and the dacite in the Tugutu Bulak Formation yields ages of 337.5 ​± ​2.3 ​Ma (n ​= ​15, MSWD ​= ​0.85) and 313.0 ​± ​3.3 ​Ma (n ​= ​13, MSWD ​= ​0.74), respectively, indicating that the sodium-rich volcanic rocks formed from the early–late Carboniferous. Electron microprobe data from plagioclases demonstrate that albites and/or oligoclases were formed in the basic–intermediate–acid volcanic rocks. Two stages of albitization are identified, and the latter is likely attributed to the dissolution of iron in the Aqishan–Yamansu belt. The sodium-rich volcanic rocks probably formed by the interaction between volcanic lava and seawater after volcanoes erupted on the seafloor; meanwhile, the albites formed by element substitution in a low-metamorphic environment. The spatiotemporal coupling relationship between sodium-rich volcanic rocks and iron deposits in the Aqishan–Yamansu belt is favorable. Iron dissolved from the dark minerals of basic–intermediate volcanic rocks through sodium metasomatism is one of the material sources for the iron deposits. Keywords: Sodium-rich volcanic rock, Geochronology, Rock geochemistry, Yamansu metallogenic belt, Eastern tianshan orogenic belt

Whether intra-myocardial delivery of hydrogel can prevent post-infarct heart failure (HF) in a long follow-up period, especially after it is degraded, remains unclear. In this study, Dex-PCL-HEMA/PNIPAAm (DPHP) hydrogel was delivered into peri-infarct myocardium of rat when coronary artery was ligated, while PBS was employed as control. Twelve weeks later, compared with control, left ventricle remodeling was attenuated and cardiac function was preserved; serum brain natriuretic peptide, cardiac aldosterone, and pulmonary congestion were suppressed in hydrogel group. Pro-fibrogenic mRNA increased in infarct area while decreased in remote zone, as well as hypertrophic mRNA. These data proves DPHP hydrogel suppresses ventricular remodeling and HF by promoting fibrotic healing in infarct area and inhibiting reactive fibrosis and hypertrophy in remote zone. Timely intra-myocardial hydrogel implantation is an effective strategy to inhibit post-infarct cardiac remodeling and have a long-term beneficial effect even after it has been biodegraded.

The Hongyuntan magnetite deposit, which is located in the Aqishan–Yamansu belt of Eastern Tianshan, Xinjiang, is hosted within Carboniferous submarine volcanic-sedimentary sequences. The deposit is characterized by five metallogenic stages: Stage I (garnet–diopside), Stage II (magnetite–tremolite–chlorite–pyrite), Stage III (magnetite–quartz–albite–actinolite), Stage IV (pyrite–quartz–epidote) and Stage V (hematite–limonite). Pyrite associated with magnetite formed during the Stage II has a Re-Os isochron age of 324 ± 31 Ma. Four types of fluid inclusions were observed in the mineral assemblages, namely, two-phase liquid and vapor inclusions, multi-phase daughter mineral-bearing inclusions, multi-phase CO2-bearing inclusions, and monophase vapor inclusions. Microthermometry data reveal that the ore-forming fluids evolved from high-temperature (average 532.5 °C) and high-salinity (average 26.9 wt% NaCleqv) fluids to moderate–low-temperature (average 203.6 °C) and low-salinity (5.07 wt% NaCleqv) fluids. Magnetite precipitation may have been greatly assisted by mixing and boiling in Stage II and Stage III, respectively. The hydrogen and oxygen isotopic values of Stage I garnet (δDV-SMOW = −107.9‰ to −76.7‰, δ18Ofluid = 6.4–10.7‰) and Stage III quartz (δDV-SMOW = −85.5‰ to −83.2‰, δ18Ofluid = 3.8–4.7‰) indicate that the ore-forming fluids were dominated by magmatic water, whereas fluid mixing occurred during Stage II (δDV-SMOW = −117.3‰ to −112.6‰, δ18Ofluid = 3.3–5.7‰) and Stage IV (δDV-SMOW = −115.2‰ to −58.5‰, δ18Ofluid = −1.3‰ to 4.5‰). The variable δ34S values of pyrite (−3.8‰ to 4.7‰) and δ18Omgt values of magnetite (−0.6‰ to 4.1‰) suggest that they were not sourced from a single reservoir. The Hongyuntan magnetite deposit is spatially and temporally associated with volcanism and may be genetically related to it. The fluid inclusions and isotopic compositions of this deposit indicate that its ore-forming fluid was derived from the exsolution of deep-seated magmas and that fluid mixing could have effectively triggered the deposition of ore-forming materials. Multiple periods of volcanic activity could have incorporated additional heat and ore metals into the ore-forming system. Based on our data, we conclude that the origin of the Hongyuntan magnetite deposit is related to the volcanism in the Carboniferous period.

e16140 Background: Hepatocellular carcinoma (HCC) is one of the most common malignancies and leading cause of cancer deaths worldwide. Biomarkers contribute to predict the response of targeted treatments and immunotherapy. Therapy directed toward homologous recombination deficiency (HRD) is now approved in ovarian and breast cancer, but the pattern of HRD is not clear in HCC. The HRD phenotype has been defined as the presence of a non-silent somatic mutation in homologous recombination-related (HRR) genes. Thus, we aimed to analyze the molecular characteristics of resectable HCC, including HRR genes. Methods: Matched tumor/normal DNA from resectable HCC patients (N = 53) were analyzed by whole exome sequencing (WES) or Acornmed panel with 808 cancer-related genes. Results: Overall, 94.3% (50/53) patients exhibited genetic alterations. TP53, ARID1A, PTEN and NBPF1 were the most commonly mutated genes in resectable HCC. In addtion, 35.9% patinets harbored at least one HRR genes mutation. The frequently mutated genes were BRCA2 (4.4%), BRCA1(4.0%), ATM (3.9 %), and RAD50 (3.8%). Interesting, frequency of HRR genes mutation in the Chinese cohort was higher than that in TCGA (35.9 % vs 20.9%). Analysis of carcinogenic pathways shown that ERBB and PI3K-AKT signaling pathway were the common signaling pathway. In resectable HCC, 32.08% (17/53) patients disclosed high TMB (highest 25%). Further analysis found that PTEN mutations were remarkably associated with low TMB (p < 0.05). Conclusions: This study contributes to understand the molecular characteristics of patients with resectable HCC, which will be useful to guide personalized therapy and promote the clinical management in this population. Furthermore, the study suggested that it is feasibility for resectable HCC patients received PARP inhibitors, DNA-damaging chemotherapies, and immune checkpoint blockade therapy.

The Hongyuntan deposit, which is one of the typical volcanic-hosted Fe deposits in the Aqishan–Yamansu metallogenic belt of the Eastern Tianshan Orogenic Belt, primarily consists of Fe and skarn minerals (especially garnet). Two generations (three types) of garnets were identified in the Hongyuntan deposit based on field and optical characteristics. Hongyuntan garnets are Fe-rich and belong to the grossular–andradite solid solution series (And = 50.99%–100.00%, average: 79.06%). Garnets of the first generation (Grt1) are massive aggregates and are fine-grained with well-developed oscillatory zonings. They have Type I (two-phase liquid and vapor) and Type II (multi-phase daughter mineral-bearing) fluid inclusions and experienced high temperature (540–560 °C) and salinity (9.2–63.2 wt% NaCl eqv) conditions. The Grt1 have high ΣREE, LfREE/HREE, δEu, U, Y, and high field strength element (HFSE: sum of Nb, Ta, Zr, and Hf) contents. Garnets of the second generation (Grt2) are vefin types and are characterized by irregular shapes with irregular zonings. Type A garnets of the second generation (Grt2-A) usually coexist with mafgnetite and have Type I and Type II fluid inclusions with relatively high temperature (480–500 °C) and salinity (9.5–36.6 wt% NaCl eqv) values. Compared to Grt1, Grt2-A have low And, U, and LREE/HREE together with medium ΣREE, δEu, HFSE, and Y contents. Type B garnets of the second generation (Grt2-B) usually coexist with epidote and quartz. They merely have Type I fluid inclusions with medium–low temperature (260–280 °C) and salinity (6.6–12.7 wt% NaCl eqv) values. Grt2-B have high And, δEu, and LREE/HREE contents but very low ΣREE, HFSE, and Y contents. The fluid inclusions and geochemical properties of the garnets indicate that the temperature, salinity, oxygen fugacity (fO2), and pH of the ore-forming fluid fluctuated, indicating Hongyuntan deposit likely experienced superimposed mineralization. Grt1 originated in a magmatic–hydrothermal fluid and formed through diffusive metasomatism under relatively high fO2, neutral pH, and low water/rock (W/R) ratio conditions. The reduced Fe and other siderophile elements in the ore-forming fluid, which formed Grt1, are believed to be the material basis for iron ores in the later main metallogenic stage. Grt2-A demonstrate the characteristics associated with transitional fluid, which most likely originated from the episodic hydrothermal supplies. However, the ore-forming fluid system gradually opened up during the crystallization of Grt2-B, and the decreasing temperatures and depletion of ore-forming materials were ultimately unfavorable for the deposition of magnetite.

The present clinical trial assessed the effect of double-dose administration of replication-deficient adenovirus-thymidine kinase and ganciclovir (ADV-TK/GCV) in patients with advanced hepatocellular carcinoma (HCC) who underwent liver transplantation (LT). Eighty-six patients with single tumor diameters5 cm or multiple tumors with diameters3 cm each, regardless of vascular invasion, were examined over a follow-up period of 61 months. All patients underwent orthotopic LT; 43 received LT only, and 43 received LT plus double-dose ADV-TK/GCV gene therapy (LT + ADV-TK/GCV). Recurrence-free survival (RFS) and overall survival (OS) rates, as well as therapeutic safety, were assessed. The RFS and OS rates in LT + ADV-TK/GCV patients at 3 years (55.9% and 60.3%, respectively) were significantly higher than those in the LT-only group (13.5% and 19.3%, respectively; p 0.001). LT + ADV-TK/GCV patients without vascular invasion showed significant improvement in RFS (73.7%) and OS (68.6%). LT + ADV-TK/GCV patients without extrahepatic vascular invasion experienced higher OS versus LT-only patients. Double-dose ADV-TK/GCV gene therapy combined with LT was safe and improved RFS and OS in advanced HCC patients without vascular invasion over the 5-year follow-up period. The potential to select patients with intrahepatic and extrahepatic vascular invasion for LT requires further confirmation.

We evaluated the clinical efficacy of tailoring tacrolimus dosage to cytochrome P450 (CYP) 3A5 genotype in liver transplant patients. One hundred patients who received tacrolimus-based therapy were included in the retrospective study in which the relationship between the tacrolimus blood trough concentration/dosage ratio and the CYP3A5 genotype of both donors and recipients was determined. Subsequently, 106 patients were continuously enrolled in a prospective study and followed-up for 6 months; the relationship between tacrolimus dosage and CYP3A5 genotype was also determined. Rates of acute rejection, hepatotoxicity, renal toxicity, neurotoxicity, hypertension, and hyperglycemia were compared between the groups. During the 6 months following liver transplantation, the mean tacrolimus concentration/dosage ratio among patients who did not have the CYP3A5*1 genotype and who received a transplant from a donor with the same genotype (24/100, 24% of patients) was higher than that among patients who did have the CYP3A5*1 genotype and/or had a donor with the same genotype (76/100, 76% of patients). In the second part of the study, the tacrolimus dosage was tailored to CYP3A5 genotype and 24 patients (22.64%) received a lower dose. There was an obvious decrease in acute rejection, hepatotoxicity, renal toxicity, neurotoxicity, hypertension, hyperglycemia, and Pneumocystis carinii infection among the latter group. A lower tacrolimus dose was suitable for about 25% of the liver transplant patients, as these patients did not have the CYP3A5*1 genotype and received a transplant from a donor with the same genotype. Tailoring the tacrolimus dosage according to the CYP3A5 genotype could reduce rejection and adverse effects.

Adriamycin (ADR) is a chemotherapeutic drug used to treat tumors in a clinical setting. However, its use is limited by a side effect of cardiotoxicity. Glibenclamide (Gli), an inhibitor of mitochondrial ATP-dependent potassium (K-ATP) channels, blocks the cardioprotective effects of mitochondrial K-ATP channel openers and induces apoptosis in rodent pancreatic islet β-cell lines. However, little is known about the role of Gli in ADR-induced cardiotoxicity. The present study was designed to investigate the impact of Gli on ADR-induced cardiotoxicity in rats. A total of 60 male Sprague-Dawley rats were divided into the following 4 groups: i) Control; ii) Gli; iii) ADR; and iv) Gli+ADR (n=15 in each). The rats in the ADR and Gli+ADR groups were treated with ADR (intraperitoneal, 2.5 mg/kg/week) for 6 weeks. The rats in the Gli and Gli+ADR groups received Gli at a dose of 12 mg/kg/day via gastric lavage for 30 days from the eighth week of the study. Following the completion of Gli treatment, cardiac function was assessed by echocardiography, and the rats were sacrificed. The hearts were subsequently harvested for analysis. The rats in the ADR group demonstrated significantly impaired cardiac function and increased levels of oxidative stress, endoplasmic reticulum stress (ERS) and apoptosis in the heart compared with rats in the control and Gli groups (without ADR treatment). These abnormalities were exacerbated by Gli in the Gli+ADR group. Gli treatment decreased cardiac function and significantly increased oxidative stress, ERS and apoptosis levels in myocardial tissues in rats treated with ADR. The findings indicated that Gli triggers oxidative stress-induced ERS, and thus exacerbates ADR-induced cardiotoxicity in rats.

The present study report two types of ultra-thin shellac fibers that were fabricated using a traditional single fluid electrospinning and a modified coaxial electrospinning. Ethanol was exploited as the solvent of shellac and also a sheath fluid of the coaxial process. A camera was used to observe the electrospinning processes and scanning electron microscope was taken to investigate the prepared shellac nanofibers. A single fluid electrospinning of 64% (w/v) shellac solutions not only clogged the spinneret now and then, but also resulted in fibers with a spindles-on-a-string morphology under a flow rate of 1.0 mL/h and an applied voltage of 12 kV. In sharp contrary, a coaxial electrospinning of 80% (w/v) shellac solutions (under a sheath and core flow rate of 0.2 and 0.8 mL/h, respectively, and an applied voltage of 12 kV) furnished linear nanofibers with an average diameter of 740 ± 60 nm. With the same outflows from the nozzles of spinneret, the ultrathine nanofibers from the modified coaxial process surpassed those from the single fluid process in terms of fibers’ morphology and size. The modified coaxial process described here expands the capability of electrospinning process and opens a new way to obtain thinner nanofibers with fine structural uniformity.

To explore the status and influencing factors of attitudes toward mental illness among minority freshmen and provide references for mental health education and service assistance in ethnic colleges, a questionnaire survey was conducted among 581 minority freshmen by using Mental Illness Emotional Scale, Stereotype Scale and Social Distance Scale from autumn of 2018 to next spring. The scores of minority freshmen on these scales were significantly higher than the theoretical median, which demonstrated that they did have negative attitudes. There were the significant main effect of nation on the anger and sympathy dimensions of Mental Illness Emotional Scale while the same results were found in the main effect of gender on the danger and suicidal behavior dimensions of Mental Illness Stereotype Scale and the main effect of nation on the dimension of dependence consciousness. Whether relatives or friends are mental illness patients had significant effect on the suicidal behavior dimension of Mental Illness Stereotypes Scale. Overall, attitudes toward mental illness were negative and some mental illness stigma phenomenon were found among minority freshmen; ethnic was an important factor affecting the attitudes of minority freshmen toward mental illness, and the inter-group contact with patients who suffer mental illness in life had a slight impact on the attitudes toward mental illness.

Background Acute-on-chronic liver failure (ACLF) is a severe clinical condition for which liver transplantation (LT) is the only curative option. However, there are little published data on risk factors and outcomes of LT for ACLF. Methods The objective of this study was to analyze preoperative, intraoperative, postoperative, and overall survival data on 100 consecutive cases with ACLF in order to try to determine for which patients LT are futile. Results One hundred consecutive patients with pathology-confirmed ACLF who underwent LT from June 2004 to September 2012 were enrolled. The preoperative data showed that all patients were in a serious condition with a median high model for end-stage liver disease (MELD) score of 32, total bilirubin of 440.20 umol/L, international normalized ratio (INR) of 3.012, and at least one organ dysfunction as assessed by a Sequential Organ Failure Assessment (SOFA) score of ≥9. The patients had either deceased or a living donor LT with an overall mortality of 20%. The 1-, 3-, and 5-year cumulative survival rates were 76.8%, 75.6%, and 74.1%, respectively, and graft 1-, 3-, and 5-y accumulative survival rates were 73.3%, 72.1%, and 70.6%, respectively. However, the area under receiver operating characteristic of SOFA score, MELD score, as well as Child-Pugh score were 0.552, 0.547, and 0.547, respectively. Conclusions Both deceased and living donor LT are effective therapeutic options for patients with ACLF and the short- and long-term survival rates are encouraging. It is important to conduct more prospective and multi-center studies to define preoperatively which patients would benefit from LT.

Intra-myocardial injection of hydrogel after myocardial infarction (MI) has been confirmed for preventing post-infarct ventricular remodeling (VR) in numerous studies. Meanwhile, VR or existed heart failure (HF) symptoms of patients with MI was improved after intra-myocardial injection of hydrogels in recent clinical trials. However, whether the injection of hydrogel immediately after MI can prevent post-infarct HF in a long follow-up period is unclear. In present study, MI was induced by permanent coronary artery ligation in SD rats. Immediately, 100μl Dex-PCL-HEMA/ PNIPAAm (DPHP) hydrogel solution was injected into the infarct border myocardium of experimental rats, while phosphate-buffered saline (PBS) was employed in control group. Twelve weeks later, compared with PBS group (n=11), echocardiography and hemodynamics showed left ventricle dilatation was attenuated (end-diastolic diameter 9.30±0.73 mm vs 10.74±0.57 mm, p p p p p p p

We examined the influence of the cytochrome P450 3A5 (CYP3A5) genes in both donors and recipients on the concentration-dosage ratio (C/D) of tacrolimus in Chinese liver transplant patients. Fifty-one adult liver transplant patients who received tacrolimus were included in this study. The CYP3A5 polymorphism in donors and recipients was determined at the time of transplantation, and tacrolimus-based immunosuppressive therapy was started based on each patient's genetic constitution. The relationship between the C/D of tacrolimus for 3 months after surgery and the CYP3A5 genotype was analyzed. A stepwise regression model was used to analyze the relationship between C/D of tacrolimus and genotype, time course, age, and liver weight in liver transplant patients. Three months after liver transplantation, C/D was both affected by the CYP3A5 genotype of both the donors and the recipients. The C/D of tacrolimus in patients with the CYP3A5*1 allele or carrying CYP3A5*1 allele in the liver was lower than that in CYP3A5*3/*3 patients with the CYP3A5*3/*3 genotype in the liver (P < 0.01). The CYP3A5*1 genotype in donors as well as in patients both contributes to interindividual variation in the C/D of tacrolimus in adult liver transplantation.

BACKGROUND Reading Chinese, a kind of ideogram, relies more on visual cognition. The visuospatial cognitive deficit of Chinese dyslexia is an interesting topic that has received much attention. The purpose of current research was to explore the visuopatial cognitive characteristics of Chinese dyslexic children by studying their eye movements via a picture searching test. METHODS According to the diagnostic criteria defined by ICD-10, twenty-eight dyslexic children (mean age (10.12 +/- 1.42) years) were enrolled from the Clinic of Children Behavioral Disorder in the third affiliated hospital of Sun Yat-sen University. And 28 normally reading children (mean age (10.06 +/- 1.29) years), 1:1 matched by age, sex, grade and family condition were chosen from an elementary school in Guangzhou as a control group. Four groups of pictures (cock, accident, canyon, meditate) from Picture Vocabulary Test were chosen as eye movement experiment targets. All the subjects carried out the picture searching task and their eye movement data were recorded by an Eyelink II High-Speed Eye Tracker. The duration time, average fixation duration, average saccade amplitude, fixation counts and saccade counts were compared between the two groups of children. RESULTS The dyslexic children had longer total fixation duration and average fixation duration (F = 7.711, P < 0.01; F = 4.520, P < 0.05), more fixation counts and saccade counts (F = 7.498, P < 0.01; F = 11.040, P < 0.01), and a smaller average saccade amplitude (F = 29.743, P < 0.01) compared with controls. But their performance in the picture vocabulary test was the same as those of the control group. The eye movement indexes were affected by the difficulty of the pictures and words, all eye movement indexes, except saccade amplitude, had a significant difference within groups (P < 0.05). CONCLUSIONS Chinese dyslexic children have abnormal eye movements in picture searching, applying slow fixations, more fixations and small and frequent saccades. Their abnormal eye movement mode reflects the poor ability and strategy of visual information processing.

Background. The aim of this study was to establish a hepatitis B virus (HBV) vaccination protocol among orthotopic liver transplantation (OLT) recipients under the coverage of a low-dose hepatitis B immunoglobulin (HBIG) combined with an antiviral agent prophylaxis protocol.Method. Two hundred OLT recipients were included in this study. The vaccine was injected at months 0, 1, 2, and 6. Low-dose HBIG combined with antiviral agent prophylaxis protocol was continued before reestablishment of active immunity against HBV in order to maintain a steady anti-HBs titer.Results. Active immunity against HBV was reestablished in 50 patients, for an overall response rate of 25%. Of the 50 patients, 24 discontinued HBIG without any HBV graft reinfection during a follow-up period of 26.13 ± 7.05 months. 21 patients discontinued both HBIG and antiviral agents during a follow-up period of 39.86 ± 15.47 months, and 4 patients among them appeared to be HBsAg positive. There was no recipient death or graft loss because of HBV reinfection.Conclusions. Vaccination preventing HBV reinfection for OLT recipients is feasible. The strategy withdrawal of HBIG with induction of active immunity against hepatitis B is reasonable for long-term survivors of OLT; however, discontinuation nucleoside analogues should be cautious.

To investigate the pathogenesis of ischemic-type biliary lesions (ITBLs) in post-liver transplant patients and the possible therapeutic mechanisms of sirolimus.The clinic data of 32 post-liver transplant patients with ITBLs from May 2004 to December 2010 was analyzed. There were including 25 male and 7 female patients with a median age of 46 years (ranging from 19 to 61 years). Patients were divided into those who received sirolimus (sirolimus group) and those who did not (control group). The expression of IL-2, FoxP3, and IL-10 in the portal area, liver function indexes, and bile duct injury score were assessed pre-ITBL, when ITBLs were identified, and after 6 months of sirolimus treatment.Compared with pre-ITBL optical density (OD) values, there was a significantly increase in IL-2 OD(0.138 ± 0.050 in control group and 0.141 ± 0.052 in sirolimus group), but not FoxP3 and IL-10 OD in both groups at the time ITBLs were diagnosed. After 6 months of treatment, the IL-2, FoxP3, and IL-10 OD values in the control group were not different from those when ITBLs were diagnosed. There was a significant reduction in post-therapy IL-2 OD(0.107 ± 0.043, t = 2.087, P = 0.044), and a significant elevation in FoxP3(0.213 ± 0.039) and IL-10 OD(0.187 ± 0.048) in sirolimus group as compared with those when ITBLs were diagnosed(t = -3.822 and -4.350, both P0.01). There was a significant increase in serum levels of ALT, AST, total bilirubin, γ-glutamyl transpeptidase and ALP at the time ITBLs were diagnosed compared with pre-ITBL levels in both groups. After 6 months of treatment, the above indexes had not changed in the control group, but significantly improved in the sirolimus group, and the bile duct injury score in the sirolimus group had significantly decreased(4.4 ± 2.4, Z = -2.568, P = 0.010). The 1-year and 3-year graft survival rates in the control group were 6/13 and 5/13, respectively, and 17/19 and 13/19, respectively, in the sirolimus group (χ(2) = 7.166, P = 0.007; χ(2) = 5.398, P = 0.020, respectively).Sirolimus can downregulate IL-2 expression and upregulate FoxP3 and IL-10 expression, thereby stimulating FoxP3+ Treg cells, suppressing immunopathological damage, and promoting epithelial repair in bile ducts.

AIM: To compare the incidence of early portal or splenic vein thrombosis (PSVT) in patients treated with irregular and regular anticoagulantion after splenectomy with gastroesophageal devascularization. METHODS: We retrospectively analyzed 301 patients who underwent splenectomy with gastroesophageal devascularization for portal hypertension due to cirrhosis between April 2004 and July 2010. Patients were categorized into group A with irregular anticoagulation and group B with regular anticoagulation, respectively. Group A (153 patients) received anticoagulant monotherapy for an undesignated time period or with aspirin or warfarin without low-molecular-weight heparin (LMWH) irregularly. Group B (148 patients) received subcutaneous injection of LMWH routinely within the first 5 d after surgery, followed by oral warfarin and aspirin for one month regularly. The target prothrombin time/international normalized ratio (PT/INR) was 1.25-1.50. Platelet and PT/INR were monitored. Color Doppler imaging was performed to monitor PSVT as well as the effectiveness of thrombolytic therapy. RESULTS: The patients’ data were collected and analyzed retrospectively. Among the patients, 94 developed early postoperative mural PSVT, including 63 patients in group A (63/153, 41.17%) and 31 patients in group B (31/148, 20.94%). There were 50 (32.67%) patients in group A and 27 (18.24%) in group B with mural PSVT in the main trunk of portal vein. After the administration of thrombolytic, anticoagulant and anti-aggregation therapy, complete or partial thrombus dissolution achieved in 50 (79.37%) in group A and 26 (83.87%) in group B. CONCLUSION: Regular anticoagulation therapy can reduce the incidence of PSVT in patients who undergo splenectomy with gastroesophageal devascularization, and regular anticoagulant therapy is safer and more effective than irregular anticoagulant therapy. Early and timely thrombolytic therapy is imperative and feasible for the prevention of PSVT.

To study the protective effects of nerve growth factor (NGF) and Danshen on hippocampal neurons in gerbils (Meriones unguiculatus) with global ischemia-reperfusion injury.Global ischemia-reperfusion model was established in 54 male Z:ZCLA gerbils by occlusion of the bilateral carotid arteries. The animal models were randomized into 3 groups to receive treatment with normal saline, NGF, and Danshen 30 min after the reperfusion. At 6 h, 3 and 7 days after the reperfusion, the survival of the hippocampal CA1 pyramidal neurons was observed using optical and electron microscopy, and immunohistochemistry was employed to detect the expressions of Bcl-2 and Bax in the neurons.Neuronal apoptosis was not observed in the hippocampus 6 h after the reperfusion, but at 3 and 7 days, the number of apoptotic neurons increased significantly in the CA1 region. Compared with normal saline, treatments with NGF and Danshen both significantly reduced the number of apoptotic neurons at 3 and 7 days. The number of apoptotic neurons showed no significant difference between NGF and Danshen treatment groups at 3 days, but at 7 days, the apoptotic cell number was significantly lower in NGF group (P0.05). Bcl-2 expression was the highest in NGF group, and its highest expression occurred at 6 h after the reperfusion; Bax expression was detected in saline group, and underwent no significant changes with the passage of time.Both NGF and Danshen show protective effects against global ischemia-reperfusion injury. NGF has a stronger protective effect than Danshen, and this finding provides experimental evidence for selecting appropriate protective agents in the treatment of ischemic brain damage.

Renal dysfunction caused by calcineurin inhibitor (CNI) after liver transplantation is a major complication among the long-term surviving recipients. Several studies have demonstrated that the adverse events could be prevented or avoided by mycophenolate mofetil (MMF)-based CNI reduced immunosuppressive protocol. In this retrospective study, we analyzed the middle-term effect of this regimen upon improving the CNI-associated renal dysfunction.124 OLT recipients' data within the recent three years were reviewed in this study.Renal dysfunction developed in 14 cases and its incidence was 11.29%. Five cases of them were from cyclosporine A (CsA) group and 9 from tacrolimus (TAC) group. The postoperative time ranged from 3-39 months with a mean follow-up duration of 19.26 +/- 9.30 months. The interval between renal impairment and surgery was 12.92 +/- 9.04 (1-31) months. CNI were reduced stepwise by about 55% in TAC group (TAC 2.60 +/- 1.14 mg/d vs 1.10 +/- 0.22 mg/d; t = 3.000, P = 0.040) and about 70% in CsA group (CsA 370 +/- 179 mg/d vs 105 +/- 27; t = 3.359, P = 0.028). Serum creatinine had decreased from 139 +/- 46 micromol/L to 122 +/- 46 micromol/L (t = 3.152, P = 0.004), 114 +/- 53 micromol/L (t = 4.180, P = 0.001) and 93 +/- 18 micromol/L (t = 4.721, P = 0.000) after administrating a mean MMF dose of 1.05 +/-0.15 g/d (0.5-1.5 g/d) for 1, 2 and 3 months respectively. And the creatinine clearance rate increased from 51.83 +/- 21.28 ml/min to 63 +/- 22 ml/min (t = -3.439, P = 0.004), 69 +/- 25 ml/min (t = -4.207, P = 0.001) and 79 +/- 25 m/min (t = -6.149, P = 0.000) during the corresponding period. Improvement was maintained within a follow-up period of 6.00 +/- 3.37 (3-14) months without major immunological or non-immunological side effects, except for 1 recipient from another institution who died of CNI-associated renal failure within 1 month after burst. 71.43% (10/14) of recipients achieved the normalization of serum creatinine and 21.43% (3/14) experienced a significant reduction in their serum creatinine levels. Conclusions MMF-based CNI reduced immunosuppressive protocol can improve substantially CNI-associated renal dysfunction after liver transplantation. And the long-term surviving recipients have excellent profiles of safety and tolerance.

To summarize the clinical data in preventing HBV recurrence after liver transplantation and explore a optimal individual protocol in prophylaxis of HBV recurrence.We retrospected outcomes in 195 recipients who underwent a liver transplantation for HBV-related liver disease between June 2004 and July 2008. According to the anti-virus protocol these recipients are divided into two groups as following: group A received a protocol of combination treatment of lamivudine with HBIG, and group B with combination treatment of adefovir with HBIG. With mean follow-up of 23.7 months, HBV recurrent rate was observed in overall and each group separately.A total of 195 liver transplant recipients were identified that met the study criteria. At the sixth and eleventh month after operation, HBV recurrence appeared in 2 recipients, each in two groups, which were due to LAM cessation and HBV mutation respectively. Recurrent rate was 0.6% in group A, 3.7% in group B and 1% in total. There was no significant difference in HBV recurrent rate between group A and B.Lamivudine combined with HBIg should be considered as a reliable method in preventing HBV recurrence after liver transplantation. Better outcomes can be achieved by individual anti-virus protocol and HBIg administration according to HBV status in recipient.

To research the clinical feasibility of emergency right lobe adult-to-adult live-donor liver transplantation in treating acute liver failure following severe hepatitis.Consecutive ten severe hepatitis patients (4 acute-on-chronic severe hepatitis and 6 acute severe hepatitis; 9 caused by HBV and 1 with drug-induced acute liver failure) underwent emergency right lobe adult-to-adult live-donor liver transplantation in our hospital from April 2007 to December 2007. The +/- s of model for end-stage liver disease score was 33.22 +/- 6.55. The outcomes of these recipients were prospectively analyzed.Among them, 8 ABO blood group were identical and 2 compatible. One was Rh sub-group negative. Except 2 recipients died (1 acute renal failure caused by veno cava thrombosis, 1 liver graft lose caused by hepatic artery thrombosis), the rest of recipients (80%) and all donors were safe. The mean graft-to-recipient weight ratio was (1.19 +/- 0.14)%, and graft volume to recipient estimated standard liver volume ratio was (65.13 +/- 8.75)%. Right lobe grafts with middle hepatic vein (MHV) 3 cases, without MHV 4 cases, without MHV but followed by V and VIII hepatic vein outflow reconstruction 3 cases. Encouraging outcome was achieved in this group of recipient: elevated serum creatinine, serum endotoxin, decreased serum prothrombin activity (PTA) and total bilirubin returned to normal about on postoperative day (POD) 3, POD 7, POD 14 and POD 28, respectively.Outcomes of emergency right lobe adult-to-adult live-donor liver transplantation for acute hepatic failure following severe hepatitis are fairly encouraging and acceptable. emergency right lobe adult-to-adult live-donor liver transplantation is an effective and life-saving modality for acute liver failure following severe hepatitis.

To assess the value of clinical application of ischemic preconditioning (IP) before hepatic vascular exclusion for resection of hepatocellular carcinoma (HCC) accompanied by cirrhosis and explore the possible mechanism underlying the protective effect of this maneuver.Thirty-four consecutive patients with resectable HCC were randomized into IP group to receive IP with a 5-min ischemia followed by 5-min perfusion before hepatic vascular exclusion and the control group with simply hepatic vascular exclusion. The liver function, hepatic Fas mRNA expression, caspase-3 activity, apoptosis of the hepatocytes were compared between the two groups.In the IP group, the aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels on postoperative day 1, 3 and 7 were all significantly higher than those of the control group (t=6.985, P0.01). The total bilirubin levels were also higher in the former group on postoperative day 3 and 7 (t=3.447, P0.05). The IP group had higher albumin levels on postoperative day 1 than the control group (t=3.360, P0.05). After 1 hour's reperfusion, the hepatic mRNA expression of Fas, caspase-3 activity and apoptotic sinusoidal endothelial cells were all significantly higher than those of the control group (t=3.771, P0.05).IP has a protective effect on liver function after hepatic resection with hepatic vascular exclusion in HCC patients, possibly due to the inhibition of hepatocyte apoptosis by down-regulating hepatic Fas mRNA expression and caspase-3 activity, and is a convenient technique applicable in such operations as hepatic transplants and hepatectomy.

目的:研究现阶段门静脉血栓的真实发生率和目前术后抗凝治疗的效果,并探讨血栓形成的原因及治疗方法.方法:对2008-06/2010-10收集的58例患者进行回顾性研究,根据患者术后是否发生血栓分为血栓组和非血栓组,对血栓发生率、部位、危险因素及抗凝效果进行了分析.结果:58例患者中,共有22例患者在术后发生了血栓,其中1例患者形成肠系膜上静脉血栓,5例患者术后形成脾静脉血栓,13例患者在门静脉系统的多个部位同时形成了血栓(混合性血栓).血栓的总体发生率为37.93%.血栓组和非血栓组患者在脾脏质量和术后门脉流速上存在显著差别(1464g±521gvs1071g±349g;7.74cm/s±1.92cm/svs15.59cm/s±2.84cm/s;均P 0.05).结论:血小板计数和脾脏质量是术后患者发生门静脉血栓的重要因素.早期使用低分子肝素、华法林进行全身抗凝能有效地预防肝炎肝硬化门静脉高压症脾切除术后门静脉系统血栓的形成,并极大地改善了这类患者的预后.