The increased level of fibrinogen (Fg) is an independent factor that resulting in the occurrence of ischemic cardio-cerebrovascular diseases. The Fg level is correlated with heredity, age, sex, obesity, lipid, smoke, inflammation and infection, and the pathogenic effect of genetic factor has been increasingly receiving attention. In recent years, more than 10 FgBβ gene polymorphisms have been reported, among them, - 148C/T, - 455G/A, and - 854G/A are considered to be significantly correlated with the increased level of Fg, and may be one of the most key factors in influencing the genetic risk factors of the occurrence of ischemic cerebrovascular disease.

Point-of-care testing technology has been widely used in clinical practice, especially in the emergency department of intensive care unit, operating room, and so on.Clinicians should correctly select patients, standardize specimen collection and strict operation according to the indications of different POCT items, and correctly interpret the results of POCT based on the clinical characteristics of children and other auxiliary examination results, so as to guide clinical diagnosis and treatment.From the perspective of pediatric emergency, this review analyzed the application of POCT technology in infection-related indicators, etiology, coagulation indicators, myocardial injury, and so on.

Objective To test the anti-virus effect of inner silvered fiber and the influencing factors. Methods Under the given condition, the inactivation tests were conducted with the inner silvered fiber and virus suspension in which the polioviruses were used as the experimental subjects and HeLa Cells as the host cells. TCID50 was calculated before and after the inactivation in order to determine the virus-killing rate. Results The virus-killing rates of inner silvered fiber, exposed to the fluorescent lamp light at 37 ℃, for 5, 10, 30 and 60 minutes, were 73.10%, 96.84%, 99.99% and greater than 99.99% respectively, whereas in the dark, 37 ℃ for 30 minutes, the virus-killing rates was 78.47%. Conclusion Inner silvered fiber has a good efficiency of anti-virus.

The donated organ after cardiac death would undergo warn ischemia injury inevitably,and the incidences of primary non-function of donated organs,transplanted organ loss and ischemic-type biliary lesions were increased.It is a paramount research dilemma to devise how to avert,lessen and recover the warm ischemia organs after donation of cardiac death (DCD).Since February 2009,the Liver Transplantation Center of Guangzhou General Hospital of Guangzhou Military Command of PLA has applied the extracorporeal membrane oxygenation (ECMO) to protect the organs of DCD.The mechanism of recovering the donors from warm ishemia by ECMO has good prospects in the field of international organ donation,and it is an important method to solve the problem of donor shortage in China.Spreading the application range of ECMO in DCD and establishing the standard procedures and techniques in China is of great importance.

Objective To evaluate the clinical value of minimally invasive methods for non-anastomotic biliary stricture (NABS) after orthotopic liver transplantation.Methods The clinical data of 403 patients who underwent liver transplantation during recent 10 years in Liver Transplantation Center at General Hospital of Guangzhou Military Commanmol were analyzed retrospectively,and 13 patients with NABS were selected.The outcomes of 3 types of NABS patients treated by endoscopic retrograde cholangiopancreatography(ERCP) or percutaneous transhepatic cholangial drainage(PTCD) were compared and the indication for re-transplantation was identified.Results PTCD treatments of 4 patients were proved ineffective.The shortterm curative rate of minimally invasive treatments was 8/13.Five patients eventually required surgical treatments (re-transplantation in 4,Roux-en-Y anastomosis in 1).According to cholangiography results,NABS were divided into 3 types,namely hepatic bile duct strictures (n =4,type Ⅰ),multiple extra-hepatic and intrahepatic biliary strictures (n =7,type Ⅱ),intrahepatic biliary strictures (n =2,type Ⅲ).The success rates of minimally invasive treatment in 3 types of NABS were 3/4,4/7 and 1/2,respectively.Nearly half of type Ⅱ and type Ⅲ patients needed re-transplantation,which was more likely for those patients with hepatic artery stenosis (2/3).Conclusion NABS treated with minimally invasive methods are preferred.Based on the appearance of biliary stricture,type Ⅰ patients had the best prognosis.For those type Ⅱ and type Ⅲ patients who failed minimally invasive treatment,especially combined with hepatic arterial stenosis,surgical treatment should be timely,so as not to lose a chance for re-transplantation.

Objective To explore difficulties and countermeasures of laparoscopic cholecystectomy (LC) for treating huge gallstones. Methods Fifty-six cases of huge gallstones with a diameter of 2.0~5.3 cm (3.4?0.6 cm) were reviewed in respect of their clinical features and operative difficulties and countermeasures during laparoscopic cholecystectomy. Results The laparoscopic cholecystectomy was completed smoothly in 54 cases, with an operation time of 30~130 min (94.3?40.7 min). Conversions to open surgery were required in 2 cases because of acute suppurative cholecystitis. Moderate-to-severe adhesion was found in 41 cases (73%). White bile or absence of bile secretion was found in 23 cases (41%). There were 2 cases (4%) of small bile duct injuries in the gallbladder bed, 15 cases (27%) of liver tissue injures in the gallbladder bed, and 19 cases (34%) of intraoperative gallbladder leakage. No major bile duct injury or massive hemorrhage occurred. The postoperative hospitalization time was 3.6?1.5 days. Follow-up observations for 6~12 months (mean, 11 months) found that the symptoms disappeared and no complications were noted. Conclusions The difficulties during LC for huge gallstones lie in the thickening of the gallbladder wall that causes injuries of the liver tissue and small bile ducts in the gallbladder bed. Careful dissection and reservation of part of the gallbladder wall are effective methods to lower the incidence of complications.

Objective To investigate the clinical features of intrahepatic arteriovenous shunt(AVS) in patients with hepatic carcinoma. Method The clinical data including results of therapy of 538 hepatic carcinoma patients admitted between 1996 and 2001 were retrospectively reviewed. Results There were 71 cases of AVS altogether with 61 cases of arterio-portal shunt and 8 cases of hepatic arterio-venous shunt. Thirty out of 39 AVS cases with fistula formed between hepatic artery and main portal branch developed portal hypertension. The patients received a total of 84 sessions of transarterial chemotherapy and embolization(TACE) with a success rate of 61%(51 sessions).After TACE liver failure ensued in 3 cases. The mean survival time of these patients was 5.77 months. Conclusion Arterio-portal/venous fistula is a common complication among hepatic carcinoma patients which often predicts poor prognosis. A high percentage of AVS patients will not tolerate TACE and in which the portal hypertension will be exacerbated.

Objective To investigate the value of intraoperative choledochofiberscopy and B-ultrasonography for intrahepatic bile duct calculus. Methods After bile duct stone removal by routine instruments, choledochofiberscopy and B-ultrasonography were conducted for detecting and removing the residual cholelith in intrahepatic bile ducts. Results The incidence of residual cholelith was 29.8% (14 of 47) after stone removal by routine instruments, and it declined to 10.6% (5 of 47) ( ? 2=5.267, P

Photothermal therapy ( PTT) is a new treatment for cancer .Metal sulfide quantum dots can serve as good PTT agents thanks to their excellent optical , physical and chemical properties .This paper introduced the basic principles of PTT, evaluation methods and properties of quantum dots .Also, we reviewed the research progress in metal sulfide quantum dots, which have good infrared plasmon response capabilities and localized surface plasmon resonance effect in PTT .In combination with the characteristics of metal sulfide quantum dots , this review offered a vision of the physical and chemical processes which can be used in PTT and the developments of this novel cancer therapy offered a vision of the .

Objective To investigate the application value of procalcitonin(PCT) in fever of the patients with malignant tumor.Methods A total of 254 patients with malignant tumor complicating fever from January to October 2016 were collected and grouped after clearly diagnosing the causes of body temperature increase according to the clinical manifestations,laboratory examination and imaging examination results.The difference of PCT level was compared among various groups.Results Compared with tumor thermal group,the PCT level in the sepsis and non-sepsis groups was significantly increased(P<0.001).Moreover no matter which was bacterial infection,fungal infection or both mixed infection,the PCT level was significantly higher than that in the tumor thermal group;compared with the fungal infection group,the PCT level in the bacterial infection group was increased significantly(P<0.01).The PCT level distribution difference among the tumor thermal group,fungal infection group and bacterial infection group was statistically significant(P<0.01).The critical values of PCT for diagnosing fungal and bacterial infectious fever were 0.575,0.945 ng/mL respectively.The areas under ROC curve were 0.812(95%CI:0.805-0.934);0.951(95%CI:0.917-0.985).Conclusion It is priliminarily considered that PCT can serve as an effective clinical auxiliary diagnostic indicator for differentiating the fever cause in the patients with malignant tumor.