The Yangtze River Economic Belt is the main rice producing area in China.The rice industry chain is the agricultural pillar industry chain of this economic belt and it is the key to ensuring national food security and...The Yangtze River Economic Belt is the main rice producing area in China.The rice industry chain is the agricultural pillar industry chain of this economic belt and it is the key to ensuring national food security and promoting comprehensive rural revitalization.This study discusses the entire rice industry chain in the Yangtze River Economic Belt from the national rice production functional zones,agricultural product quality and safety,national famous and excellent new agricultural products,national specialty agricultural products,"China's good grain and oil"products,and national advantageous characteristic industrial clusters.Then,it discusses the geographical indications of rice and its products in this economic belt from geographical indication products,geographical indication trademarks,agricultural geographical indications,geographical indication standards,geographical indication special indications,national geographical indication product protection demonstration zones,and Chinese geographical indication products protected by the European Union.In addition,it analyzes the five main problems between geographical indications and public brands,such as the limited use of geographical indication specific signs and the imperfect intellectual property protection system for geographical indications.Finally,it proposes eight strategies,including promoting the high-quality development of the entire rice industry chain,creating a geographical indication regional public brand for rice and its products,and implementing geographical indication protection projects.展开更多
In the study, analysis was made on present situation and development measures of geographical indications and cultural heritage protection of famous teas in Hubei Province. In addition, 8 related suggestions were prop...In the study, analysis was made on present situation and development measures of geographical indications and cultural heritage protection of famous teas in Hubei Province. In addition, 8 related suggestions were proposed as well.展开更多
AIM Endoscopic pancreatic sphincterotomy is less widely practiced than biliary sphincterotomy, in part because of the lack of firm data regarding its indications and safety. In addition, recent reports of ductal and ...AIM Endoscopic pancreatic sphincterotomy is less widely practiced than biliary sphincterotomy, in part because of the lack of firm data regarding its indications and safety. In addition, recent reports of ductal and parenchymal changes occurring after pancreatic stenting raise concerns about the standard practice of stent placement at the time of pancreatic sphincterotomy. We report our experience with pancreatic sphincterotomy and describe the use of a technique involving overnight nasopancreatic drainage rather than stenting.METHODS We reviewed the records of the 164 pancreatic sphincterotomies performed on 160 patients at our institution between January 1, 1991, and October 1, 1996, comparing procedures done with overnight nasopancreatic catheter placement with those done with stenting or no drainage. We also examined the longterm clinical outcome of patients after pancreatic sphincterotomy.RESULTS Of the 164 sphincterotomies, 98 were done with overnight nasopancreatic drainage, 50 with stent placement, and 16 with no drainage. Complications (all pancreatitis) were significantly more frequent in the group with no drainage (125%) as compared with those with drainage (07%); P<0003. Nasopancreatic drainage was as safe as stent placement, with no complications after 98 procedures. Pancreatic sphincterotomy was effective when used as primary therapy, with 64% of patients so treated experiencing complete and longlasting resolution of symptoms after the procedure.CONCLUSION Pancreatic sphincterotomy is safe and effective, although pancreatic drainage is required to reduce the incidence of pancreatitis. Overnight nasopancreatic drainage is the method of choice, as it carries as low a complication rate as stent placement, but without the need for a repeat procedure, and presumably without the risk of ductal and parenchymal damage.展开更多
Gas hydrate, mainly composed of hydrocarbon gas and water, is considered to be a clean energy in the 21st century. Many indicators such as BSRs （Bottom-Simulating Reflections）, which are thought to be related to gas...Gas hydrate, mainly composed of hydrocarbon gas and water, is considered to be a clean energy in the 21st century. Many indicators such as BSRs （Bottom-Simulating Reflections）, which are thought to be related to gas hydrate, are found in the South China Sea （SCS） in recent years. The northeastern part of the SCS is taken as one of the most potentials in the area by many scientists. It is situated in the conjunction of the northern divergent continental margin and the eastern convergent island margin, whose geological settings are much preferable for gas hydrate to occur. Through this study, brightness temperature anomalies recorded by satellite-based thermal infrared remotely sensed images before or within the imminent earthquake, the high content of hydrocarbon gas acid-degassed from subsurface sediment and the high radioactive thermoluminescence value of subsurface sediment were found in the region. Sometimes brightness temperature anomalies alone exist in the surrounding of the Dongsha Islands. The highest content of hydrocarbon gas amounts to 393 μL methane per kilogram sediment and the highest radioactive thermoluminescence value is 31752 unit; their geometric averages are 60.5 μL/kg and 2688.9 unit respectively. What is more inspiring is that there are three sites where the methane contents are up to 243, 268 and 359μL/kg and their radioactive thermoluminescence values are 8430, 9537 and 20826 unit respectively. These three locations are just in the vicinity of one of the highest confident BSRs identified by predecessors. Meanwhile, the anomalies are generally coincident with other results such as headspace gas anomaly in the sediment and chloride anomaly in the interstitial water in the site 1146 of Leg 184. The above-mentioned anomalies are most possibly to indicate the occurrence of gas hydrate in the northeastern SCS.展开更多
Endoscopic submucosal dissection(ESD) is the most advanced and representative technique in the field of therapeutic endoscopy and has been used for the treatment of gastrointestinal neoplasms,including early gastric c...Endoscopic submucosal dissection(ESD) is the most advanced and representative technique in the field of therapeutic endoscopy and has been used for the treatment of gastrointestinal neoplasms,including early gastric cancer.The major difference and advantage of ESD compared to existing endoscopic resection techniques,such as endoscopic mucosal resection(EMR) and polypectomy,are the width and depth of the resection.Newly developed cutting devices,distal attachable endoscopic accessories,and an advanced electrosurgical unit have helped to overcome the limitations of therapeutic endoscopy in terms of lesion size,location,presence of fibrotic scarring,and accompanying ulcers.As a result,the indications for ESD have been expanded from the classical indication for EMR and polypectomy,and there is now support for a further expansion of ESD indications.At present,the most critical factor to consider in the decision of whether to perform ESD is the probability of unexpected lymph node metastasis.The guidelines for ESD are continually being updated and debated.In this review,we discuss the strengths and weaknesses of the expanded guidelines,based on evidence found in the literature.展开更多
Twenty years after its introduction, computed tomographic colonography (CTC) has reached its maturity, and it can reasonably be considered the best radiological diagnostic test for imaging colorectal cancer (CRC) and ...Twenty years after its introduction, computed tomographic colonography (CTC) has reached its maturity, and it can reasonably be considered the best radiological diagnostic test for imaging colorectal cancer (CRC) and polyps. This examination technique is less invasive than colonoscopy (CS), easy to perform, and standardized. Reduced bowel preparation and colonic distention using carbon dioxide favor patient compliance. Widespread implementation of a new image reconstruction algorithm has minimized radiation exposure, and the use of dedicated software with enhanced views has enabled easier image interpretation. Integration in the routine workflow of a computer-aided detection algorithm reduces perceptual errors, particularly for small polyps. Consolidated evidence from the literature shows that the diagnostic performances for the detection of CRC and large polyps in symptomatic and asymptomatic individuals are similar to CS and are largely superior to barium enema, the latter of which should be strongly discouraged. Favorable data regarding CTC performance open the possibility for many different indications, some of which are already supported by evidence-based data: incomplete, failed, or unfeasible CS; symptomatic, elderly, and frail patients; and investigation of diverticular disease. Other indications are still being debated and, thus, are recommended only if CS is unfeasible: the use of CTC in CRC screening and in surveillance after surgery for CRC or polypectomy. In order for CTC to be used appropriately, contraindications such as acute abdominal conditions (diverticulitis or the acute phase of inflammatory bowel diseases) and surveillance in patients with a long-standing history of ulcerative colitis or Crohn’s disease and in those with hereditary colonic syndromes should not be overlooked. This will maximize the benefits of the technique and minimize potential sources of frustration or disappointment for both referring clinicians and patients.展开更多
Objective To investigate the clinical applications of coronary CT angiography in patients with suspected coronary artery disease and identify factors that affect CT findings. Methods Medical records of patients suspec...Objective To investigate the clinical applications of coronary CT angiography in patients with suspected coronary artery disease and identify factors that affect CT findings. Methods Medical records of patients suspected of coronary artery disease over a period of 12 months from a tertiary teaching hospital were retrospectively reviewed. Patient age, sex （male/female）, duration of symptoms and abnormal rates of coronary CT angiography scans were analysed to investigate the relationship among these parameters. The patients by age were characterized into five groups： under 36 years, 36-45 years, 46-55 years, 56455 years and more than 66 years, respectively; while the duration of symptoms was also classified into five groups： less than one week, one week to one month, one to three months, three to six months and more than six months. Results Of the 880 patient records reviewed, 800 met the above study criteria. Five hundred and forty nine patients demonstrated abnormal CT findings （68.6%）. There was no significant difference in the percentage of abnormal CT findings based on patient sex and the duration of symptoms （P = 0.14）. The abnormal rates of coronary CT angiography, however, increased significantly with increasing age （P 〈 0.001）; with patients over 65 years of age 2.5 times more likely to have an abnormal CT scan relative to a patient under 45 years. A significant difference was found between abnormal coronary CT angiography and the duration of symptoms （P = 0.012）. Conclusions Our results indicate coronary CT angiography findings are significantly related to the patient age group and duration of symptoms. Clinical referral for coronary CT angiography of patients with suspected coronary artery disease needs to be justified with regard to the judicious use of this imaging modality.展开更多
The development of endoscopic treatment technology has further promoted the minimally invasive treatment of early gastric cancer(EGC).Endoscopic treatment has achieved better therapeutic effects in terms of safety and...The development of endoscopic treatment technology has further promoted the minimally invasive treatment of early gastric cancer(EGC).Endoscopic treatment has achieved better therapeutic effects in terms of safety and prognosis and is the preferred treatment method for patients who meet the indications for endoscopic treatment.However,the consequent problem is that some patients receiving endoscopic treatment may undergo non-curative resection,and the principle of follow-up management for non-curative resection patients deserves further attention.In addition,there are still debates on how to improve the accuracy of clinical staging,select a reasonable treatment method for patients who meet the expanded indications for endoscopic treatment,manage patients with positive endoscopic surgical margins,conduct research on function-preserving surgery,and manage the treatment of EGC under the current situation in China.Consequently,we aim to review current indications for endoscopic submucosal dissection of EGC in order to better inform treatment options.展开更多
This paper studies the geographical indication resources of Xinjiang and their distribution in administrative regions,national grain production functional zones,protected zones for production of major agricultural pro...This paper studies the geographical indication resources of Xinjiang and their distribution in administrative regions,national grain production functional zones,protected zones for production of major agricultural products,advantageous areas of Chinese characteristic agricultural products,and national advantageous characteristic industrial clusters.It analyzes the main problems existing in the protection of intellectual property rights of geographical indications.Besides,it discusses the strategies for the protection of intellectual property rights of geographical indications in the autonomous region and the building of regional public brands in the contest of the strategy of strengthening the country with intellectual property and rural revitalization strategy.Finally,it comes up with recommendations,including collecting and sorting out the human factors and natural factors of geographical indications of famous,excellent and special products,strengthening the protection of geographical indications of Xinjiang cotton and its products,enhancing the protection of geographical indications of grain and oil crops and sugar beet,implementing the protection of geographical indications for products with special needs for ethnic minorities,building national geographical indication product protection demonstration areas,formulating national and international standards for geographical indication products,and take full advantage of the EU-China Agreement on Cooperation on and Protection of Geographical Indications to actively participate in the EU protection of geographical indications.展开更多
Pancreatic sphincterotomy serves as the cornerstone of endoscopic therapy of the pancreas. Historically, its indications have been less well-defined than those of endoscopic biliary sphincterotomy, yet it plays a defi...Pancreatic sphincterotomy serves as the cornerstone of endoscopic therapy of the pancreas. Historically, its indications have been less well-defined than those of endoscopic biliary sphincterotomy, yet it plays a definite and useful role in diseases such as chronic pancreatitis and pancreatic-type sphincter of Oddi dysfunction. In the appropriate setting, it may be used as a single therapeutic maneuver, or in conjunction with other endoscopic techniques such as pancreatic stone extraction or stent placement. The current standard of practice utilizes two different methods of performing pancreatic sphincterotomy: a pull-type sphincterotome technique without prior stent placement, and a needle-knife sphincterotome technique over an existing stent. The complications associated with pancreatic sphincterotomy are many, although acute pancreatitis appears to be the most common and the most serious of the early complications. As such, it continues to be reserved for those endoscopists who perform a relatively high-volume of therapeutic pancreaticobiliary endoscopic retrograde cholangio-pancreatography.展开更多
1.Objectives The Mohe Basin in Heilongjiang,China has a NEE thrust nappe belt,which was assembled by the root zone,middle thrust zone and thrust front,north-south and north-east normal faults with three tectonic activ...1.Objectives The Mohe Basin in Heilongjiang,China has a NEE thrust nappe belt,which was assembled by the root zone,middle thrust zone and thrust front,north-south and north-east normal faults with three tectonic activities of the Middle Jurassic to. Eocene,the Miocene,and the Early to Middle Pleistocene. The middle thrust zone and thrust front has a large number of folds,thrust faults,fractures and glutenites,which are the major structures of gas hydrate accumulation in the Mohe Basin.展开更多
Paul Sugarbaker＇s procedural description in this paper （1）comes from the pioneer and master of this area. His original description of peritoneal cancer index （PCI） and cytoreduction score （CC） is also fundament...Paul Sugarbaker＇s procedural description in this paper （1）comes from the pioneer and master of this area. His original description of peritoneal cancer index （PCI） and cytoreduction score （CC） is also fundamental to selection of patients and intraoperative assessment. PCI is calculated by dividing展开更多
Nutritional support is essential in patients who have a limited capability to maintain their body weight.Therefore,oral feeding is the main approach for such patients.When physiological nutrition is not possible,posit...Nutritional support is essential in patients who have a limited capability to maintain their body weight.Therefore,oral feeding is the main approach for such patients.When physiological nutrition is not possible,positioning of a nasogastric,nasojejunal tube,or other percutaneous devices may be feasible alternatives.Creating a percutaneous endoscopic gastrostomy(PEG)is a suitable option to be evaluated for patients that need nutritional support for more than 4 wk.Many diseases require nutritional support by PEG,with neurological,oncological,and catabolic diseases being the most common.PEG can be performed endoscopically by various techniques,radiologically or surgically,with different outcomes and related adverse events(AEs).Moreover,some patients that need a PEG placement are fragile and are unable to express their will or sign a written informed consent.These conditions highlight many ethical problems that become difficult to manage as treatment progresses.The aim of this manuscript is to review all current endoscopic techniques for percutaneous access,their indications,postprocedural follow-up,and AEs.展开更多
AIM To present our results on the use of a single rod instrumentation correction technique in a small number of patients with major medical co-morbidities.METHODS This study was a prospective single surgeon series. Pa...AIM To present our results on the use of a single rod instrumentation correction technique in a small number of patients with major medical co-morbidities.METHODS This study was a prospective single surgeon series. Patients were treated with single rod hybrid constructs and had a minimum 2-year follow-up. Indications included complex underlying co-morbidities, conversion of growing rods to definitive fusion, and moderate adolescent idiopathic primarily thoracic scoliosis with severe eczema and low body mass index(BMI).RESULTS We included 99 consecutive patients. Mean age at surgery was 12.8 years(SD 3.5 years). Mean scoliosis correction was 62%(SD 15%) from 73°(SD 22°) to 28°(SD 15°). Mean surgical time was 153 min(SD 34 min), and blood loss was 530 mL(SD 327 mL); 20% BV(SD 13%). Mean clinical and radiological follow-up was 3.2 years(range: 2-12) post-operatively. Complications included rod failure, which occurred in three of our complex patients with severe syndromic or congenital kyphoscoliosis(3%). Only one of these three patientsrequired revision surgery to address a non-union. Our revision rate was 2%(including a distal junctional kyphosis in a Marfan's syndrome patient).CONCLUSION The single rod technique has achieved satisfactory deformity correction and a low rate of complications in patients with specific indications and severe underlying medical conditions. In these children with significant co-morbidities, where the risks of scoliosis surgery are significantly increased, this technique has achieved low operative time, blood loss, and associated surgical morbidity.展开更多
Background It has been reported that the mitochondrial respiratory dysfunction (MRD) is important mechanisms affecting the heart failure (HF) pathogenesis.We sought to evaluate the potential role of MRD of peripheral ...Background It has been reported that the mitochondrial respiratory dysfunction (MRD) is important mechanisms affecting the heart failure (HF) pathogenesis.We sought to evaluate the potential role of MRD of peripheral blood mononuclear cells (PBMC) in HF severity prediction in patients with cardioverter-defibrillator implantation indications.Methods In this single-center study patients with HF of New York Heart Association (NYHA) Ⅰ-Ⅲ functional class (FC) and cardioverter-defibrillator implantation indications underwent transthoracic echocardiography (TTE) and MRD assessment using PB-MC.Mitochondrial respiration rate (MRR) indicators (pyruvate+malate+adenosine diphosphate;succinate+adenosine diphosphate;pyruvate+malate–adenosine diphosphate[V4.1];succinate–adenosine diphosphate) were calculated.Correlations between HF NYHA FC,TTE and MRR indicators were evaluated.Based on our data,we developed a risk model regarding HF severity.Results Of 53 (100.0%) HF patients,33 (62.3%) had mild exercise intolerance (1stgroup) and 20 (37.7%) had moderate-to-severe exercise intolerance (2ndgroup).Patients with mild exercise intolerance were likely to have a higher V4.1(P<0.001) values.V4.1was independently associated with moderate-to-severe exercise intolerance in univariate and multivariate logistic regression (OR=0.932,95%CI:0.891–0.975,P<0.001).Conclusions The severity of HF is associated with PBMC mitochondrial respiratory dysfunction in patients with cardioverter-defibrillator implantation indications.Our HF severity risk model including V4.1parameters is able to distinguish patients with mild and moderate-to-severe exercise intolerance.Further investigations of their predictive significance are warranted.展开更多
AIM:To analyze the changing trends in penetrating keratoplasty(PKP)indications.METHODS:This retrospective study included all patients with PKP between 2006 and 2017.Patients were classified using histological diagnose...AIM:To analyze the changing trends in penetrating keratoplasty(PKP)indications.METHODS:This retrospective study included all patients with PKP between 2006 and 2017.Patients were classified using histological diagnoses.Our groups were as the following:pseudophakic or aphakic bullous keratopathy,regraft,acute necrotizing and ulcerative keratitis,keratoconus,Fuchs'dystrophy,corneal dystrophy other than Fuchs',corneal scar,other diagnoses and failed endothelial keratoplasty graft.Additionally,two different time-periods(2006-2012 and 2013-2017)were analysed.RESULTS:Totally 1721 histological analyses of 1214 patients were available for review.The diagnoses were pseudophakic or aphakic bullous keratopathy in 487(28.3%),regraft in 443(25.7%),acute necrotizing and ulcerative keratitis in 313(18.2%),corneal scar in 153(8.9%),keratoconus in 140(8.1%).Fuchs'dystrophy in 61(3.5%),corneal dystrophy other than Fuchs'in 46(2.7%),other diagnoses in 44(2.6%)and failed endothelial keratoplasty graft in 34(2.0%)cases.From the first to the second analysed time-period,incidence of acute necrotizing and ulcerative keratitis,corneal scar,Fuchs'dystrophy increased(P<0.032 for all)and incidence of keratoconus significantly decreased(P=0.015).CONCLUSION:Pseudophakic or aphakic bullous keratopathy is the leading indication for PKP,followed by regraft and acute necrotizing and ulcerative keratitis.展开更多
Objective:To explore the clinical application rules of Láogōng(劳宫PC8)by analyzing the comparison and contrast of the practice with this acupoint in ancient times and in present.Methods:Relevant literature befo...Objective:To explore the clinical application rules of Láogōng(劳宫PC8)by analyzing the comparison and contrast of the practice with this acupoint in ancient times and in present.Methods:Relevant literature before October 1,1949 was selected from Chinese Medical Code(Fifth Edition)and Compilation of Moden Chinese Medicine Journals and literature published after October 1,1949 was screened from China National knowledge Infrastructure(CNIK),Wanfang Data Knowledge Service Platform(Wanfang),VIP Chinese Journal Service Platform(VIP),Chinese BioMedine Database(CBM),Pubmed Database,and Web of Science.After screening,SQL Server database was established.The complex network analysis was conducted by using Gephi and the cluster analysis was performed by SPSS Statistics.Results:Before October 1,1949,Lráogōng(劳宫PC8),on a single use or with a match of Dàlíng(大陵PC7),Guānyuán(关元CV4),and Zúsānlǐ(足三里ST36),was mainly used for treating ozostomia and edema due to pregnancy.However,Láogōng(劳宫PC8),on a single use or with a match of Yǒngquán(涌泉KI1),Hégǔ(合谷L14)and Nèiguān(内关PC6)was commonly for the treatment of toothache and the sequelae after wind stroke after October 1 st,1949.Conclusion:Láogōng(劳宫PC8)is mainly used to treat local disorders or diseases pertaining to the pericardium meridian.The single-point therapy was commonly applied before October 1 st,1949,while a combination of other points is more common afterwards and the scope of indication expands,with its application for psychiatry disorders,pain diseases and emergent diseases.Acupoints on the same meridian of Láogōng(劳宫PC8),ying-spring points,the back-shu points and combination between and the upper and the lower are dominated in the selection of supplementary points.The supplementary acupoints with the highest frequency of use were specific acupoints,including five-shu points,yuan-source points,front-mu points,etc。展开更多
AIM: To review the indications of penetrating keratoplasty(PK) and anterior lamellar keratoplasty(ALK) at Qingdao Eye Hospital, Shandong Eye Institute, Qingdao, China, from 2010 to 2017. METHODS: The data of all patie...AIM: To review the indications of penetrating keratoplasty(PK) and anterior lamellar keratoplasty(ALK) at Qingdao Eye Hospital, Shandong Eye Institute, Qingdao, China, from 2010 to 2017. METHODS: The data of all patients undergoing PK or ALK from January 2010 to December 2017 was retrospectively reviewed, with the indications during 2010-2013 and 2014-2017 compared. RESULTS: A total of 1869 eyes were included, among which 1405 eyes(75.2%) had PK and 464 eyes(24.8%) had ALK. The leading indications were suppurative keratitis(36.8%), keratoconus(15.5%), herpes keratitis(13.1%), and regraft(10.5%). In eyes undergoing PK, the top four indications were suppurative keratitis(38.7%), herpes keratitis(15.3%), keratoconus(12.6%), and regraft(12.5%) during 2014-2017, with the proportion of suppurative keratitis and herpes keratitis decreased while regraft and keratoconus increased compared with 2010-2013. In eyes with ALK, suppurative keratitis(30.8%), keratoconus(24.1%), corneal dystrophies and degenerations(10.6%), and corneal dermoid tumor(9.7%) were the top four indications, and there was no significant difference for the proportion of each indication between 2010-2013 and 2014-2017. CONCLUSION: Suppurative keratitis is the most common indication for PK and ALK at Qingdao Eye Hospital during 2010-2017, followed by keratoconus, herpes keratitis, and regraft. In eyes treated with PK, the proportion of suppurative keratitis and herpes keratitis decrease while regraft and keratoconus increase during 2014-2017 compared with 2010-2013.展开更多
Background and Aims: Diagnostic colonoscopy allows exploration of the colonic mucosa. Indications are multiple. The purpose of this work was to describe the indications and to report the lesions observed during colono...Background and Aims: Diagnostic colonoscopy allows exploration of the colonic mucosa. Indications are multiple. The purpose of this work was to describe the indications and to report the lesions observed during colonoscopy at the General Hospital of Douala. Methods: This was a cross-sectional study with retrospective data collection over a period of 7 years (January 1, 2010 to January 31, 2017). The data collected from the reports were socio-demographic characteristics, indications and lesions observed at colonoscopy. Binary logistic regression allowed us to identify the independent risk factors associated with the presence of tumors and polyps. Results: We included 719 exams. The main indications were rectorrhagia (29.5%), abdominal pain (25.9%) and constipation (17.8%). A colonic lesion was found in 60.1% of cases. A colorectal tumor accounted for 10.3% of cases. Factors independently associated with colonic tumor were complete colonoscopy (aOR: 0.167 95% CI [0.096 - 0.289], p Conclusion: The presence of weight loss, abdominal or rectal mass should motivate the realization of a complete colonoscopy in search of a colorectal tumor. The most observed lesions remain hemorrhoids, polyps and diverticulosis of the colon.展开更多
AIM: To assess our experience with the use and management of everolimus-based regimens post-liver transplantation and to redefine the potential role of this drug in current clinical practice.METHODS: From October 1988...AIM: To assess our experience with the use and management of everolimus-based regimens post-liver transplantation and to redefine the potential role of this drug in current clinical practice.METHODS: From October 1988 to December 2012, 1023 liver transplantations were performed in 955 patients in our Unit. Seventy-four patients(7.74%) received immunosuppression with everolimus at some time post-transplantation. Demographic characteristics, everolimus indication, time elapsed from transplantation to the introduction of everolimus, doses and levels administered, efficacy, side effects, discontinuation andpost-conversion survival were analyzed. RESULTS: Mean age at the time of conversion to everolimus was 57.7 ± 10 years. Indications for conversion were: refractory rejection 31.1%, extended hepatocellular carcinoma in explanted liver 19%, post-transplant hepatocellular carcinoma recurrence 8.1%, de novo tumour 17.6%, renal insufficiency 8.1%, severe neurotoxicity 10.8%, and others 5.4%. Median time from transplantation to introduction of everolimus was 6 mo(range: 0.10-192). Mean follow-up post-conversion was 22 ± 19 mo(range: 0.50-74). The event for which the drug was indicated was resolved in 60.8% of patients, with the best results in cases of refractory rejection, renal insufficiency and neurotoxicity. Results in patients with cancer were similar to those of a historical cohort treated with other immunosuppressants. The main side effects were dyslipidemia and infections. Post-conversion acute rejection occurred in 14.9% of cases. The drug was discontinued in 28.4% of patients.CONCLUSION: Everolimus at low doses in combination with tacrolimus is a safe immunosuppressant with multiple early and late indications post-liver transplantation.展开更多
基金Supported by Social Science Foundation of Hubei Province (HBSKJJ20243227),Doctoral Initiation Project of Hubei University of Science and Technology (BK201819).
文摘The Yangtze River Economic Belt is the main rice producing area in China.The rice industry chain is the agricultural pillar industry chain of this economic belt and it is the key to ensuring national food security and promoting comprehensive rural revitalization.This study discusses the entire rice industry chain in the Yangtze River Economic Belt from the national rice production functional zones,agricultural product quality and safety,national famous and excellent new agricultural products,national specialty agricultural products,"China's good grain and oil"products,and national advantageous characteristic industrial clusters.Then,it discusses the geographical indications of rice and its products in this economic belt from geographical indication products,geographical indication trademarks,agricultural geographical indications,geographical indication standards,geographical indication special indications,national geographical indication product protection demonstration zones,and Chinese geographical indication products protected by the European Union.In addition,it analyzes the five main problems between geographical indications and public brands,such as the limited use of geographical indication specific signs and the imperfect intellectual property protection system for geographical indications.Finally,it proposes eight strategies,including promoting the high-quality development of the entire rice industry chain,creating a geographical indication regional public brand for rice and its products,and implementing geographical indication protection projects.
基金Supported by Project of Scientific and Technological Innovations by Ministry of Culture(2011021)Foundation Project of Humanities and Social Sciences of Education Department (11YJA850019)Project supported by "11th Five-Year Plan" of Hubei Socia Sciences Foundation ([2010]274)~~
文摘In the study, analysis was made on present situation and development measures of geographical indications and cultural heritage protection of famous teas in Hubei Province. In addition, 8 related suggestions were proposed as well.
文摘AIM Endoscopic pancreatic sphincterotomy is less widely practiced than biliary sphincterotomy, in part because of the lack of firm data regarding its indications and safety. In addition, recent reports of ductal and parenchymal changes occurring after pancreatic stenting raise concerns about the standard practice of stent placement at the time of pancreatic sphincterotomy. We report our experience with pancreatic sphincterotomy and describe the use of a technique involving overnight nasopancreatic drainage rather than stenting.METHODS We reviewed the records of the 164 pancreatic sphincterotomies performed on 160 patients at our institution between January 1, 1991, and October 1, 1996, comparing procedures done with overnight nasopancreatic catheter placement with those done with stenting or no drainage. We also examined the longterm clinical outcome of patients after pancreatic sphincterotomy.RESULTS Of the 164 sphincterotomies, 98 were done with overnight nasopancreatic drainage, 50 with stent placement, and 16 with no drainage. Complications (all pancreatitis) were significantly more frequent in the group with no drainage (125%) as compared with those with drainage (07%); P<0003. Nasopancreatic drainage was as safe as stent placement, with no complications after 98 procedures. Pancreatic sphincterotomy was effective when used as primary therapy, with 64% of patients so treated experiencing complete and longlasting resolution of symptoms after the procedure.CONCLUSION Pancreatic sphincterotomy is safe and effective, although pancreatic drainage is required to reduce the incidence of pancreatitis. Overnight nasopancreatic drainage is the method of choice, as it carries as low a complication rate as stent placement, but without the need for a repeat procedure, and presumably without the risk of ductal and parenchymal damage.
文摘Gas hydrate, mainly composed of hydrocarbon gas and water, is considered to be a clean energy in the 21st century. Many indicators such as BSRs （Bottom-Simulating Reflections）, which are thought to be related to gas hydrate, are found in the South China Sea （SCS） in recent years. The northeastern part of the SCS is taken as one of the most potentials in the area by many scientists. It is situated in the conjunction of the northern divergent continental margin and the eastern convergent island margin, whose geological settings are much preferable for gas hydrate to occur. Through this study, brightness temperature anomalies recorded by satellite-based thermal infrared remotely sensed images before or within the imminent earthquake, the high content of hydrocarbon gas acid-degassed from subsurface sediment and the high radioactive thermoluminescence value of subsurface sediment were found in the region. Sometimes brightness temperature anomalies alone exist in the surrounding of the Dongsha Islands. The highest content of hydrocarbon gas amounts to 393 μL methane per kilogram sediment and the highest radioactive thermoluminescence value is 31752 unit; their geometric averages are 60.5 μL/kg and 2688.9 unit respectively. What is more inspiring is that there are three sites where the methane contents are up to 243, 268 and 359μL/kg and their radioactive thermoluminescence values are 8430, 9537 and 20826 unit respectively. These three locations are just in the vicinity of one of the highest confident BSRs identified by predecessors. Meanwhile, the anomalies are generally coincident with other results such as headspace gas anomaly in the sediment and chloride anomaly in the interstitial water in the site 1146 of Leg 184. The above-mentioned anomalies are most possibly to indicate the occurrence of gas hydrate in the northeastern SCS.
文摘Endoscopic submucosal dissection(ESD) is the most advanced and representative technique in the field of therapeutic endoscopy and has been used for the treatment of gastrointestinal neoplasms,including early gastric cancer.The major difference and advantage of ESD compared to existing endoscopic resection techniques,such as endoscopic mucosal resection(EMR) and polypectomy,are the width and depth of the resection.Newly developed cutting devices,distal attachable endoscopic accessories,and an advanced electrosurgical unit have helped to overcome the limitations of therapeutic endoscopy in terms of lesion size,location,presence of fibrotic scarring,and accompanying ulcers.As a result,the indications for ESD have been expanded from the classical indication for EMR and polypectomy,and there is now support for a further expansion of ESD indications.At present,the most critical factor to consider in the decision of whether to perform ESD is the probability of unexpected lymph node metastasis.The guidelines for ESD are continually being updated and debated.In this review,we discuss the strengths and weaknesses of the expanded guidelines,based on evidence found in the literature.
文摘Twenty years after its introduction, computed tomographic colonography (CTC) has reached its maturity, and it can reasonably be considered the best radiological diagnostic test for imaging colorectal cancer (CRC) and polyps. This examination technique is less invasive than colonoscopy (CS), easy to perform, and standardized. Reduced bowel preparation and colonic distention using carbon dioxide favor patient compliance. Widespread implementation of a new image reconstruction algorithm has minimized radiation exposure, and the use of dedicated software with enhanced views has enabled easier image interpretation. Integration in the routine workflow of a computer-aided detection algorithm reduces perceptual errors, particularly for small polyps. Consolidated evidence from the literature shows that the diagnostic performances for the detection of CRC and large polyps in symptomatic and asymptomatic individuals are similar to CS and are largely superior to barium enema, the latter of which should be strongly discouraged. Favorable data regarding CTC performance open the possibility for many different indications, some of which are already supported by evidence-based data: incomplete, failed, or unfeasible CS; symptomatic, elderly, and frail patients; and investigation of diverticular disease. Other indications are still being debated and, thus, are recommended only if CS is unfeasible: the use of CTC in CRC screening and in surveillance after surgery for CRC or polypectomy. In order for CTC to be used appropriately, contraindications such as acute abdominal conditions (diverticulitis or the acute phase of inflammatory bowel diseases) and surveillance in patients with a long-standing history of ulcerative colitis or Crohn’s disease and in those with hereditary colonic syndromes should not be overlooked. This will maximize the benefits of the technique and minimize potential sources of frustration or disappointment for both referring clinicians and patients.
文摘Objective To investigate the clinical applications of coronary CT angiography in patients with suspected coronary artery disease and identify factors that affect CT findings. Methods Medical records of patients suspected of coronary artery disease over a period of 12 months from a tertiary teaching hospital were retrospectively reviewed. Patient age, sex （male/female）, duration of symptoms and abnormal rates of coronary CT angiography scans were analysed to investigate the relationship among these parameters. The patients by age were characterized into five groups： under 36 years, 36-45 years, 46-55 years, 56455 years and more than 66 years, respectively; while the duration of symptoms was also classified into five groups： less than one week, one week to one month, one to three months, three to six months and more than six months. Results Of the 880 patient records reviewed, 800 met the above study criteria. Five hundred and forty nine patients demonstrated abnormal CT findings （68.6%）. There was no significant difference in the percentage of abnormal CT findings based on patient sex and the duration of symptoms （P = 0.14）. The abnormal rates of coronary CT angiography, however, increased significantly with increasing age （P 〈 0.001）; with patients over 65 years of age 2.5 times more likely to have an abnormal CT scan relative to a patient under 45 years. A significant difference was found between abnormal coronary CT angiography and the duration of symptoms （P = 0.012）. Conclusions Our results indicate coronary CT angiography findings are significantly related to the patient age group and duration of symptoms. Clinical referral for coronary CT angiography of patients with suspected coronary artery disease needs to be justified with regard to the judicious use of this imaging modality.
基金Beijing Municipal Science&Technology Commission,No.D171100006517003 and No.Z181100001718223Research Foundation of Beijing Friendship Hospital,Capital Medical University,No.Y2018-3+1 种基金Beijing Municipal Administration of Hospitals Incubating Program,No.PX2020001Digestive Medical Coordinated Development Center of Beijing Hospital Authority,No.XXX0102.
文摘The development of endoscopic treatment technology has further promoted the minimally invasive treatment of early gastric cancer(EGC).Endoscopic treatment has achieved better therapeutic effects in terms of safety and prognosis and is the preferred treatment method for patients who meet the indications for endoscopic treatment.However,the consequent problem is that some patients receiving endoscopic treatment may undergo non-curative resection,and the principle of follow-up management for non-curative resection patients deserves further attention.In addition,there are still debates on how to improve the accuracy of clinical staging,select a reasonable treatment method for patients who meet the expanded indications for endoscopic treatment,manage patients with positive endoscopic surgical margins,conduct research on function-preserving surgery,and manage the treatment of EGC under the current situation in China.Consequently,we aim to review current indications for endoscopic submucosal dissection of EGC in order to better inform treatment options.
基金Supported by Foundation for Key Program of Hubei Province(LX201827)。
文摘This paper studies the geographical indication resources of Xinjiang and their distribution in administrative regions,national grain production functional zones,protected zones for production of major agricultural products,advantageous areas of Chinese characteristic agricultural products,and national advantageous characteristic industrial clusters.It analyzes the main problems existing in the protection of intellectual property rights of geographical indications.Besides,it discusses the strategies for the protection of intellectual property rights of geographical indications in the autonomous region and the building of regional public brands in the contest of the strategy of strengthening the country with intellectual property and rural revitalization strategy.Finally,it comes up with recommendations,including collecting and sorting out the human factors and natural factors of geographical indications of famous,excellent and special products,strengthening the protection of geographical indications of Xinjiang cotton and its products,enhancing the protection of geographical indications of grain and oil crops and sugar beet,implementing the protection of geographical indications for products with special needs for ethnic minorities,building national geographical indication product protection demonstration areas,formulating national and international standards for geographical indication products,and take full advantage of the EU-China Agreement on Cooperation on and Protection of Geographical Indications to actively participate in the EU protection of geographical indications.
文摘Pancreatic sphincterotomy serves as the cornerstone of endoscopic therapy of the pancreas. Historically, its indications have been less well-defined than those of endoscopic biliary sphincterotomy, yet it plays a definite and useful role in diseases such as chronic pancreatitis and pancreatic-type sphincter of Oddi dysfunction. In the appropriate setting, it may be used as a single therapeutic maneuver, or in conjunction with other endoscopic techniques such as pancreatic stone extraction or stent placement. The current standard of practice utilizes two different methods of performing pancreatic sphincterotomy: a pull-type sphincterotome technique without prior stent placement, and a needle-knife sphincterotome technique over an existing stent. The complications associated with pancreatic sphincterotomy are many, although acute pancreatitis appears to be the most common and the most serious of the early complications. As such, it continues to be reserved for those endoscopists who perform a relatively high-volume of therapeutic pancreaticobiliary endoscopic retrograde cholangio-pancreatography.
文摘1.Objectives The Mohe Basin in Heilongjiang,China has a NEE thrust nappe belt,which was assembled by the root zone,middle thrust zone and thrust front,north-south and north-east normal faults with three tectonic activities of the Middle Jurassic to. Eocene,the Miocene,and the Early to Middle Pleistocene. The middle thrust zone and thrust front has a large number of folds,thrust faults,fractures and glutenites,which are the major structures of gas hydrate accumulation in the Mohe Basin.
文摘Paul Sugarbaker＇s procedural description in this paper （1）comes from the pioneer and master of this area. His original description of peritoneal cancer index （PCI） and cytoreduction score （CC） is also fundamental to selection of patients and intraoperative assessment. PCI is calculated by dividing
文摘Nutritional support is essential in patients who have a limited capability to maintain their body weight.Therefore,oral feeding is the main approach for such patients.When physiological nutrition is not possible,positioning of a nasogastric,nasojejunal tube,or other percutaneous devices may be feasible alternatives.Creating a percutaneous endoscopic gastrostomy(PEG)is a suitable option to be evaluated for patients that need nutritional support for more than 4 wk.Many diseases require nutritional support by PEG,with neurological,oncological,and catabolic diseases being the most common.PEG can be performed endoscopically by various techniques,radiologically or surgically,with different outcomes and related adverse events(AEs).Moreover,some patients that need a PEG placement are fragile and are unable to express their will or sign a written informed consent.These conditions highlight many ethical problems that become difficult to manage as treatment progresses.The aim of this manuscript is to review all current endoscopic techniques for percutaneous access,their indications,postprocedural follow-up,and AEs.
文摘AIM To present our results on the use of a single rod instrumentation correction technique in a small number of patients with major medical co-morbidities.METHODS This study was a prospective single surgeon series. Patients were treated with single rod hybrid constructs and had a minimum 2-year follow-up. Indications included complex underlying co-morbidities, conversion of growing rods to definitive fusion, and moderate adolescent idiopathic primarily thoracic scoliosis with severe eczema and low body mass index(BMI).RESULTS We included 99 consecutive patients. Mean age at surgery was 12.8 years(SD 3.5 years). Mean scoliosis correction was 62%(SD 15%) from 73°(SD 22°) to 28°(SD 15°). Mean surgical time was 153 min(SD 34 min), and blood loss was 530 mL(SD 327 mL); 20% BV(SD 13%). Mean clinical and radiological follow-up was 3.2 years(range: 2-12) post-operatively. Complications included rod failure, which occurred in three of our complex patients with severe syndromic or congenital kyphoscoliosis(3%). Only one of these three patientsrequired revision surgery to address a non-union. Our revision rate was 2%(including a distal junctional kyphosis in a Marfan's syndrome patient).CONCLUSION The single rod technique has achieved satisfactory deformity correction and a low rate of complications in patients with specific indications and severe underlying medical conditions. In these children with significant co-morbidities, where the risks of scoliosis surgery are significantly increased, this technique has achieved low operative time, blood loss, and associated surgical morbidity.
文摘Background It has been reported that the mitochondrial respiratory dysfunction (MRD) is important mechanisms affecting the heart failure (HF) pathogenesis.We sought to evaluate the potential role of MRD of peripheral blood mononuclear cells (PBMC) in HF severity prediction in patients with cardioverter-defibrillator implantation indications.Methods In this single-center study patients with HF of New York Heart Association (NYHA) Ⅰ-Ⅲ functional class (FC) and cardioverter-defibrillator implantation indications underwent transthoracic echocardiography (TTE) and MRD assessment using PB-MC.Mitochondrial respiration rate (MRR) indicators (pyruvate+malate+adenosine diphosphate;succinate+adenosine diphosphate;pyruvate+malate–adenosine diphosphate[V4.1];succinate–adenosine diphosphate) were calculated.Correlations between HF NYHA FC,TTE and MRR indicators were evaluated.Based on our data,we developed a risk model regarding HF severity.Results Of 53 (100.0%) HF patients,33 (62.3%) had mild exercise intolerance (1stgroup) and 20 (37.7%) had moderate-to-severe exercise intolerance (2ndgroup).Patients with mild exercise intolerance were likely to have a higher V4.1(P<0.001) values.V4.1was independently associated with moderate-to-severe exercise intolerance in univariate and multivariate logistic regression (OR=0.932,95%CI:0.891–0.975,P<0.001).Conclusions The severity of HF is associated with PBMC mitochondrial respiratory dysfunction in patients with cardioverter-defibrillator implantation indications.Our HF severity risk model including V4.1parameters is able to distinguish patients with mild and moderate-to-severe exercise intolerance.Further investigations of their predictive significance are warranted.
文摘AIM:To analyze the changing trends in penetrating keratoplasty(PKP)indications.METHODS:This retrospective study included all patients with PKP between 2006 and 2017.Patients were classified using histological diagnoses.Our groups were as the following:pseudophakic or aphakic bullous keratopathy,regraft,acute necrotizing and ulcerative keratitis,keratoconus,Fuchs'dystrophy,corneal dystrophy other than Fuchs',corneal scar,other diagnoses and failed endothelial keratoplasty graft.Additionally,two different time-periods(2006-2012 and 2013-2017)were analysed.RESULTS:Totally 1721 histological analyses of 1214 patients were available for review.The diagnoses were pseudophakic or aphakic bullous keratopathy in 487(28.3%),regraft in 443(25.7%),acute necrotizing and ulcerative keratitis in 313(18.2%),corneal scar in 153(8.9%),keratoconus in 140(8.1%).Fuchs'dystrophy in 61(3.5%),corneal dystrophy other than Fuchs'in 46(2.7%),other diagnoses in 44(2.6%)and failed endothelial keratoplasty graft in 34(2.0%)cases.From the first to the second analysed time-period,incidence of acute necrotizing and ulcerative keratitis,corneal scar,Fuchs'dystrophy increased(P<0.032 for all)and incidence of keratoconus significantly decreased(P=0.015).CONCLUSION:Pseudophakic or aphakic bullous keratopathy is the leading indication for PKP,followed by regraft and acute necrotizing and ulcerative keratitis.
文摘Objective:To explore the clinical application rules of Láogōng(劳宫PC8)by analyzing the comparison and contrast of the practice with this acupoint in ancient times and in present.Methods:Relevant literature before October 1,1949 was selected from Chinese Medical Code(Fifth Edition)and Compilation of Moden Chinese Medicine Journals and literature published after October 1,1949 was screened from China National knowledge Infrastructure(CNIK),Wanfang Data Knowledge Service Platform(Wanfang),VIP Chinese Journal Service Platform(VIP),Chinese BioMedine Database(CBM),Pubmed Database,and Web of Science.After screening,SQL Server database was established.The complex network analysis was conducted by using Gephi and the cluster analysis was performed by SPSS Statistics.Results:Before October 1,1949,Lráogōng(劳宫PC8),on a single use or with a match of Dàlíng(大陵PC7),Guānyuán(关元CV4),and Zúsānlǐ(足三里ST36),was mainly used for treating ozostomia and edema due to pregnancy.However,Láogōng(劳宫PC8),on a single use or with a match of Yǒngquán(涌泉KI1),Hégǔ(合谷L14)and Nèiguān(内关PC6)was commonly for the treatment of toothache and the sequelae after wind stroke after October 1 st,1949.Conclusion:Láogōng(劳宫PC8)is mainly used to treat local disorders or diseases pertaining to the pericardium meridian.The single-point therapy was commonly applied before October 1 st,1949,while a combination of other points is more common afterwards and the scope of indication expands,with its application for psychiatry disorders,pain diseases and emergent diseases.Acupoints on the same meridian of Láogōng(劳宫PC8),ying-spring points,the back-shu points and combination between and the upper and the lower are dominated in the selection of supplementary points.The supplementary acupoints with the highest frequency of use were specific acupoints,including five-shu points,yuan-source points,front-mu points,etc。
基金Supported by the National Natural Science Foundation of China (No.81500703)the Natural Science Foundation of Shandong Province (No.ZR2015YL027)the Innovation Project of Shandong Academy of Medica Sciences
文摘AIM: To review the indications of penetrating keratoplasty(PK) and anterior lamellar keratoplasty(ALK) at Qingdao Eye Hospital, Shandong Eye Institute, Qingdao, China, from 2010 to 2017. METHODS: The data of all patients undergoing PK or ALK from January 2010 to December 2017 was retrospectively reviewed, with the indications during 2010-2013 and 2014-2017 compared. RESULTS: A total of 1869 eyes were included, among which 1405 eyes(75.2%) had PK and 464 eyes(24.8%) had ALK. The leading indications were suppurative keratitis(36.8%), keratoconus(15.5%), herpes keratitis(13.1%), and regraft(10.5%). In eyes undergoing PK, the top four indications were suppurative keratitis(38.7%), herpes keratitis(15.3%), keratoconus(12.6%), and regraft(12.5%) during 2014-2017, with the proportion of suppurative keratitis and herpes keratitis decreased while regraft and keratoconus increased compared with 2010-2013. In eyes with ALK, suppurative keratitis(30.8%), keratoconus(24.1%), corneal dystrophies and degenerations(10.6%), and corneal dermoid tumor(9.7%) were the top four indications, and there was no significant difference for the proportion of each indication between 2010-2013 and 2014-2017. CONCLUSION: Suppurative keratitis is the most common indication for PK and ALK at Qingdao Eye Hospital during 2010-2017, followed by keratoconus, herpes keratitis, and regraft. In eyes treated with PK, the proportion of suppurative keratitis and herpes keratitis decrease while regraft and keratoconus increase during 2014-2017 compared with 2010-2013.
文摘Background and Aims: Diagnostic colonoscopy allows exploration of the colonic mucosa. Indications are multiple. The purpose of this work was to describe the indications and to report the lesions observed during colonoscopy at the General Hospital of Douala. Methods: This was a cross-sectional study with retrospective data collection over a period of 7 years (January 1, 2010 to January 31, 2017). The data collected from the reports were socio-demographic characteristics, indications and lesions observed at colonoscopy. Binary logistic regression allowed us to identify the independent risk factors associated with the presence of tumors and polyps. Results: We included 719 exams. The main indications were rectorrhagia (29.5%), abdominal pain (25.9%) and constipation (17.8%). A colonic lesion was found in 60.1% of cases. A colorectal tumor accounted for 10.3% of cases. Factors independently associated with colonic tumor were complete colonoscopy (aOR: 0.167 95% CI [0.096 - 0.289], p Conclusion: The presence of weight loss, abdominal or rectal mass should motivate the realization of a complete colonoscopy in search of a colorectal tumor. The most observed lesions remain hemorrhoids, polyps and diverticulosis of the colon.
文摘AIM: To assess our experience with the use and management of everolimus-based regimens post-liver transplantation and to redefine the potential role of this drug in current clinical practice.METHODS: From October 1988 to December 2012, 1023 liver transplantations were performed in 955 patients in our Unit. Seventy-four patients(7.74%) received immunosuppression with everolimus at some time post-transplantation. Demographic characteristics, everolimus indication, time elapsed from transplantation to the introduction of everolimus, doses and levels administered, efficacy, side effects, discontinuation andpost-conversion survival were analyzed. RESULTS: Mean age at the time of conversion to everolimus was 57.7 ± 10 years. Indications for conversion were: refractory rejection 31.1%, extended hepatocellular carcinoma in explanted liver 19%, post-transplant hepatocellular carcinoma recurrence 8.1%, de novo tumour 17.6%, renal insufficiency 8.1%, severe neurotoxicity 10.8%, and others 5.4%. Median time from transplantation to introduction of everolimus was 6 mo(range: 0.10-192). Mean follow-up post-conversion was 22 ± 19 mo(range: 0.50-74). The event for which the drug was indicated was resolved in 60.8% of patients, with the best results in cases of refractory rejection, renal insufficiency and neurotoxicity. Results in patients with cancer were similar to those of a historical cohort treated with other immunosuppressants. The main side effects were dyslipidemia and infections. Post-conversion acute rejection occurred in 14.9% of cases. The drug was discontinued in 28.4% of patients.CONCLUSION: Everolimus at low doses in combination with tacrolimus is a safe immunosuppressant with multiple early and late indications post-liver transplantation.
