Ischemia.reperfusion injury of the liver consists of two distinct phases.The early phase occurs within 2 to 4 hours after reperfusion,which may be mainly induced by the increased production of oxygen radical species.The late phase results from inflammatory responses at 6 hours or more after reperfusion,leading to the progression of liver damage.The mechanism of IRIof the liver is a complex and muhifactorial process.The review outlines the current progress in the understanding of hepatic IRI from microcirculation,cellular,andmolecular levels,respectively.

In the course of the establishment of the basic medical insurance system, medical and health institutions at various levels are going to face the readjustment of functional orientation and transformation of the current pattern of medical setups will produce a far reaching effect on medical institutions. While “reducing burdens”, big hospitals must try actively to suit the needs of the medical market under the new circumstances, give full play to their strong points, such as high concentration of talents, knowledge and resources, and provide quality, high efficiency and high value added medical service. It must also be brought to peoples awareness that third tier hospitals are not just the supplement and extension of community medical service but should also serve as its guarantee and backing.

Objective To evaluate the prognostic value of plasma D dimer level in cancer thrombosis and vascular invasion assessment and to analyze the correlation between plasma D dimer level and the Pittsburgh modified TNM staging in patients with hepatocellular carcinoma for orthotopic liver transplantation. Methods The plasma D dimer level was quantitated using Golden method in 120 patients with hepatocellular carcinoma for orthotopic liver transplantation. Cancer thrombosis in trunk vein and microvascular invasion was diagnosed by pathology. The relationship between plasma D dimer level in different Child pugh’s classification patients and vascular invasion as well as the Pittsburgh modified TNM staging was analyzed with ? 2 test, factorial analysis of variance and q test by microsoft SPSS 9.0.Results In Child Pugh’s A, B and C patients, the difference of plasma D dimer level between patients with trunk vein cancer thrombosis and patients without vascular invasion was significant ( P 0.05). The differences of plasma D dimer level between patients with the Pittsburgh modified TNM Ⅰand Ⅱ tumor and patients with TNM Ⅲ tumor, and between patients with the Pittsburgh modified TNM Ⅰand Ⅱ tumor and patients with TNM Ⅳ tumor were significant ( P 0.05). Conclusion Plasma D dimer level, which increasing as upgrade of the Pittsburgh TNM staging, is useful in the vascular invasion and cancer thrombosis assessment in patients with hepatocellular carcinoma for liver transplantation, and the correlation was more significant as progression of vascular invasion and upgrade of Child pugh’s classification.

Objective To observe the development of endotoxemia and its treatment during swine orthotopic liver transplantation (OLT). Methods Blood perfusion was carried out in 12 swine OLT cases during anhepatic period. Results It was 0 18 EU/ml in anhepatic period and 0 48 EU/ml in reperfusion period in control group compared to 0 13 EU/ml and 0 13 EU/ml,respectively in activated charcoal perfusion group( P

Objective To investigate the clinical significance of c-myc、Bcl-2 protein expression, DNA ploidy and their relationship in breast cancer. MethodsWT5”BZ The expression of c-myc、Bcl-2 protein in 146 breast tumor tissues was examined by using immunohistochemical methods(S-P)and DNA ploidy in 72 cases of breast carcinoma by flow cytometry. ResultsKG1 Nuclear expression of c-myc protein was detected in 9 6% of tumors, and it was related to the DNA aneuploidy and prognosis. Cytoplasmic expression of c-myc protein was present in 91 8% of the carcinomas. Moderate to strong c-myc protein expression in cytoplasmic was associated with the positive status of ER. Bcl-2 protein was positive in 78 8% of cancers. Overexpression of Bcl-2 protein was associated with ER(+) status and the lack of axillary lymph node metastasis. DNA aneuploidy was found in 51 4% of 72 cancers, it was related to nuclear expression of c-myc protein and prognosis.WT5”HZConclusion Nuclear expression of c-myc protein and DNA ploidy are important prognostic factors.

Focusing on the requirements of visual traceability for reprocessing of reused medical devices under the background of deep integration of intelligent medical treatment, a quality and safety traceability system for disinfection of reused medical devices is developed. The multi-dimensional data of the reprocessing chain of reusable medical devices are acquired in real time by the RFID mobile terminal handset and stored temporarily. The data package is formatted based on LoRa protocol and uploaded to the management and control platform in multi-threaded transmission mode for in-depth analysis and traceability. The corresponding prototype system is developed. The first-line operation and maintenance test results show that the prototype system has strong cooperation, strong operation robustness, and obvious advantages in the identification rate and other layers of sterile equipment package.
Disinfection ; Radio Frequency Identification Device ; Technology

Objective:To compare the long-term clinical outcomes between cannulated screw internal fixation for stable femoral neck fractures and arthroplasty for unstable ones in the elderly patients.Methods:A retrospective study was conducted to analyze the 542 patients with femoral neck fracture who had been admitted to Department of Orthopedics and Traumatology, Beijing Jishuitan Hospital, Capital Medical University from May 2015 to April 2017. The 542 patients were divided into 2 groups based on fracture stability and treatment method. In the stable group (Garden type Ⅰ, type Ⅱ, and abduction compression type) of 121 cases who underwent cannulated screw internal fixation, there were 28 males and 93 females with a mean age of (77.6±8.1) years, and 20 cases of type Ⅰ, 101 cases of type Ⅱ, and 34 cases of abduction compression type by the Garden classification. In the unstable group (Garden type Ⅲ, type Ⅳ, and type Ⅱ with a posterior tilt angle >20°) of 421 cases who underwent arthroplasty, there were 130 males and 291 females with a mean age of (78.7 ± 6.9) years, and 14 cases of type Ⅱ, 403 cases of type Ⅲ, and 4 cases of type Ⅳ by the Garden classification. The postoperative mortality, reoperation rate, and mobility at the last follow-up were compared between the 2 groups.Results:There were no statistically significant differences in the baseline characteristics, except for serum albumin concentration and peripheral white blood cell count at admission, between the 2 groups, indicating comparability ( P>0.05). The hospital stay in the stable group [5.0 (4.0, 6.0)d] was significantly shorter than that in the unstable group [6.0 (5.0, 8.0)d], and the follow-up time for the stable group [54.4 (49.3, 58.7) months] significantly longer than that for the unstable group [52.2 (46.0, 59.3) months] ( P<0.05). A total of 158 patients (45 cases in the stable group and 113 cases in the unstable group) were lost to the last follow-up. At the last follow-up, the mortality in the stable group (18.4%, 14/76) was significantly lower than that in the unstable group (31.5%, 97/308), the reoperation rate in the former (15.8%, 12/76) significantly higher than that in the latter (3.6%, 11/308), and the capability of daily activities in the former (by the fracture mobility scoring: level 1 in 35 cases, level 2 in 13 cases, level 3 in 3 cases, level 4 in 2 cases, and level 5 in 1 case) significantly better than that in the latter (level 1 in 99 cases, level 2 in 47 cases, level 3 in 24 cases, level 4 in 22 cases, and level 5 in 5 cases) (all P<0.05). Conclusion:Compared with the arthroplasty for unstable femoral neck fractures, cannulated screw internal fixation for stable femoral neck fractures leads to a lower long-term mortality and a better capability of daily activities, but a significantly higher reoperation rate.