Hepatic failure following partial liver resection is a major complication and a cause of perioperative mortality for patients with primary liver cancer. Today, many different tests have been established for liver function evaluation. These tests contain conventional tests and quantitative tests.Furthermore, we should combine them to precisely evaluate hepatic functional reserve.

Peroxisome proliferator-activated receptors (PPARs)are ligand-activated nuclear tran-scription factors,playing an important role in the regulation of glucose and lipids metabolism,inflamma-tion response,proliferation and differentiation.Some drugs targeted on PPARs,such as lipid-lowering and antidiabetic drugs have been developed.Some PPAR agonists were found carcinogenic in animal experi ments,including PPAR αagonist fibrates,PPARγagonist thiazolidinediones,PPARα/γdual ago-nist compounds,and PPARδagonist compounds for clinical development.PPARαagonist carcinogenicity is associated with PPAR receptor activation that regulates lipid metabolis m,and leads to lipids abnormali-ties and increase by peroxisome oxidase in reactive oxygen species (ROS),causing DNA damage. Kupffer cells can generate ROS by NAD PH oxidase that pro motes hepatocyte proliferation and inhibition of apoptosis.PPARγagonist carcinogenicity is generally caused by bladder stone.The carcinogenicity of PPAR agonists to humans has not been confirmed,but the carcinogenic potential of these drugs can-not be ignored.

Objective To investigate the clinical value of CT scanning combined with ultrasound technique in diagnosis of malignant bone tumor.Methods 100 patients with malignant bone tumor were randomly divided into control group(50 cases with CT scan),and observation group (50 cases received CT scanning combined with ultrasound technology).The diagnostic accuracy rate,tumor bone formation and destruction of bone,periosteal reaction and soft tissue mass were compared between the two groups.All results were judged by the results of MR.Results Diagnostic accuracy rate of the observation group was 80.0％ (40/50),which was significantly higher than 64.0％(32/50) in the control group (x2 =4.65,P ＜ 0.05).In observation group,diagnosis of bone destruction in 60 cases,the tumor bone formation 10cases,83 cases of periosteal reaction and soft tissue mass in 40 cases,those in the control group were 40 cases,5 cases,62 cases,30 cases,the differences between the two groups were statistically significant(x2 =4.86,5.71,6.21,5.22,all P ＜ 0.05).Conclusion The combination of CT and ultrasound in the diagnosis of malignant bone tumors had high diagnostic accuracy rate,and could guide clinical treatment.

At present,hepatectomy are recognized as the firsttreatment option for hepatocellular carcinoma (HCC).However,the patients have high frequency of recurrence after operation.In China,Most of the patients with HCC are related to chronic hepatitis B infection.The hepatitis B virus(HBV) factors such as:genotype,status of hepatitis B e antigen,HBV DNA level in serum and HBV DNA level in liver tissue influence the recurrence of tumors.Antiviral therapy,especially interferon therapy may be the effective method to prevent recurrence.HBV status also can influence the recurrence rate after transplant.

Objective To observe the influence of heating method (or temperature control strategy) on the concentration of main active components in extracts from Radix Salviae Miltiorrhizae. Methods Common chromatographic peak area and the contents of Salvianolic acid B in three kinds of extracts obtained by 3 kinds of heating methods were compared. Results With the content of extracts extracted by the first heating method as the baseline, content of salvianolic acid B in extracts extracted by the second heating method was decreased 21.73 percent and that by the third method decreased 55.44 percent. Conclusion Quality of Salvianolic acid extracts can be affected greatly by temperature range and temperature control strategy. It is important to strictly control the heating method for the exaction of heat- sensitive active compounds from Chinese herbs.

Objective To observe the clinical efficacy of Eureklin in the treatment of progressive cerebral infarction in young and middle-aged people outside the thrombolytic time window (the onset time was more than 6h).Methods From March 2016 to March 2019,120 young and middle-aged patients with progressive brain infarction who admitted to the neurology department of Chaonan Minsheng Hospital were selected and all patients were confirmed by cranial CT or MRI.They were divided into two groups by random drawing method.Clinical conventional therapy was applied in the control group (60 cases),and on the basis of conventional treatment,Eureklin intravenous drips was used in the treatment group (60 cases).Before and after treatment 14d,the national institutes of health stroke scale(NIHSS),daily living ability scale(ADL) were used to assessment of neurological impairment and Barthel index in patients.At the same time,the drug side effects and adverse reactions were observed.Results After treatment,the NIHSS score in the conventional treatment group[(3.4 ± 0.3)points] was lower than that in the Eureklin group[(4.1 ± 0.4) points],and the ADLscore in the conventional treatment group [(67.5 ± 24.8) points] was higher than that in the Eureklin group[(57.8± 26.7) points],the difference was statistically significant(t =0.014,0.003,all P ＜ 0.05).The total effective rate of the treatment group [83.33％ (50/60)] was higher than that of the control group [71.67％ (43/60)],the difference was statistically significant (x2 =3.596,P ＜ 0.05).At the same time,no serious adverse reactions were found in the Eureklin treatment group.Conclusion For young and middle-aged patients with progressive cerebral infarction outside the thrombolytic time window,the application of Eureklin can improve the patients' symptoms of neurological dysfunction,improve the ability of daily life,and without serious adverse events such as bleeding,which is worthy of clinical application.

Objective To study the mechanism of the hyperuricemia among the middle and elderly populations. Methods Serum uric acid, creatinine (Cr), blood urea nitrogen (BUN), fasting gluose (FG), total cholesterol (TC), triglyceride (TG) were detected in 1073 subjects with hyperuricemia and 1235 subjects with normal serum uric acid as control of middle and elder groups. Results The means of Cr, BUN, FG, TG ,TC in hyperuricemia were significantly higher than those in the control group,respectively (males: t′ =7. 508,P ＜0.05;t′ =9. 484,P ＜0.05;t=6.208,P＜0.05;t′ =7.055,P ＜0.05;t = 5. 097,P ＜0.05;females;t′ = 11.221,P ＜0.05;t′= 8.314,P ＜0.05 ;t =5. 641 ,P ＜0.05 ;t′ =8. 328 ,P ＜0.05 ;t =7. 227 ,P ＜ 0.05). In males,the mean of the BUN; FG and TG were significant different among the different age groups (the control group: F = 3. 500, P ＜ 0.05; F = 5. 607, P ＜0.05 ;F =3. 378,P ＜0.05 ;the hyperuricemia group: F= 15.400,P ＜0.05 ;F =5. 111 ,P ＜0.05 ;F = 11. 143 ,P ＜0.05), the positive rate of BUN, Cr, FG and TG were significant different among the different age groups (control group:χ2 = 17. 112,P ＜ 0.05;χ2 =7. 807,P ＜0.05 ;χ2 = 17. 829,P ＜0.05;χ2=8.433,P ＜0.05; hyperuricemia group:χ2 =35. 587,P ＜0.05 ;χ2 =83. 005 ,P ＜0.05 ;χ2 =41. 639,P ＜0.05 ;χ2 =31. 466,P ＜0.05). In the same age group,the mean and the positive rate of BUN and Cr were significantly higher in the hyperuricemia group than in the control group(P ＜ 0.05). The mean of TG was significantly higher in every age group of the hyperuricemia group than controls (P ＜ 0.05), but the positive rate had no significant differences in the age group of ≥ 70 years (P ＞0.05). The mean and the positive rate of FG and TC were significant differences in middle age group between the hyperuricemia and the control group (P ＜ 0.05), but were no differences in elder age group(P ＞ 0.05). In females,the mean and positive rate of Cr, BUN, FG,TG and TC were significant different in different age groups of the controls(BUN:F = 13. 759,P ＜0.05;χ2 = 19. 491 ,P ＜0.05; FG: F = 13. 554,P ＜0.05;χ2 = 33. 438,P ＜0.05;TG:F= 18. 160,P ＜0.05;χ2 = 16. 978,P ＜0.05;TC: F = 37. 647,P ＜0.05;χ2 =60.547,P ＜0.05) ,but in the hyperuricemia group that were only significant difference in BUN, Cr and TC (BUN:F = 5. 830, P ＜ 0.05; χ2 =11.941,P＜0.05;Cr:F=4.057,P ＜0.05;χ2 =20.097,P＜0.05;TC:F=7.934,P ＜0.05;χ2 = 16.405,P ＜0.05). In same age group compared of all the indices were similar with male. Conclusions The mechanism of serum uric acid increasing are different in middle age and elderly age. In middle age, it is metabolic disturbance. However,in elderly age it is descending of the kidney function.

Objective To explore the change of serum thyroid hormone related indicators and the probability of occurrence of thyroid dysfunction abnormality in the patient with type 2 diabetes mellitus(T2DM).Methods 86 patients with T2DM and 61 age-matched and gender-matched individuals with healthy physical examination as controls were selected and detected serum FT3,FT4 and TSH by the electrochemiluminescence method Results The serum FT3,FT4 and TSH in the T2DM group were 5.09 pmol/L, 17.32 pmol/L and 2.81 mIU/L respectively;which in the normal control group were 4.99 pmol/L,17.24 pmol/L and 2.71 mIU/L respectively,the differences between the two groups had no statistical significance(P >0.05).Among 86 cases of T2DM,29 cases had the serum abnormal TSH with the abnormal rate of 33.7%,which in the control group was 14.8% with statistical difference between the two groups(P <0.05).Among T2DM patients,the TSH abnormal rate of in females was 42.1%,which was higher than 17.2% in males.Conclusion The serum thyroid hormone detection is necessary for the T2DM patients,especially female pa-tients,which is conducive to early screening,prevention and treatment.

Peroxisome proliferator-activated receptors (PPARs) are a family of nuclear hormone receptors belonging to the steroid receptor superfamily. Three PPAR isoforms, PPAR?, PPAR? (also known as PPAR?) and PPAR? have been found in the mouse. They can activate expression of many genes, including those involved in lipidmetabolism. PPAR? is ubiquitously expressed, but the level of expression differs markedly between different cell types. PPAR? is expressed in skeletal muscle at 10- and 50-fold higher levels compared with PPAR? and PPAR?, respectively. A role for PPAR? in skeletal muscle is to increase the genes expression with relation to oxidative metabolism. In order to determine the molecular mechanisms governing PPAR? gene expression in muscle, a 2 kb 5′ flanking region was cloned and analyzed. The DNA fragment is able to transcribe GFP in COS7 cells. Dual luciferase assay is used to quantify promoter activity. Deletion analysis of the 2 kb PPAR? promoter fragment in COS7 and NIH 3T3 cells shows that the proximal promoter sequence, nt -197 to +120, confers basal transcriptional activity of the mouse PPAR? gene. Computational analysis of putative cis-acting elements located within the ～2.0 kb mouse PPAR? 5′-flanking sequence was performed using the TRANSFAC database and MatInspector software and 4 potential MEF2A binding sites were found. And there is a potential binding site sharing 100% identity with positive element of MEF2A in the proximal promoter (nt -261). Co-transfection experiments of the PPAR? promoter reporter and pMEF2A expression plasmid (pMEF2A) showed that MEF2A significantly enhanced transcription activity of PPAR? promoter in NIH 3T3. Moreover, the enhancive effect depended on the concentration of plasmid pMEF2A transfected into cells. The results suggested that MEF2A may enhance transcription activity of the PPAR promoter in muscle cells.

Objective To investigate the clinical features,therapeutic approach and prognosis of focal nodular hyperplasia (FNH) of the liver. Methods Clinical data of 34 FNH patients confirmed by operation were analyzed retrospectively. Results Focal nodular hyperplasia of the liver was found mainly in males (67. 6% ) , Mean nodular size was significantly smaller in men than women. Most of the patients (64.7%) had no significant clinical symptoms. Tumor markers including CA19-9 and A-fetoprotein were within normal range. MRI is helpful to achieve a more accurate diagnosis of the disease, correct preoperative diagnosis rate was 54. 5%. All patients underwent liver resection with no recurrence within 17 - 134 months of follow up. Conclusions FHN of the liver is benign in entity. If a definite diagnosis can be obtained preoperatively, observation follow-up are recommended. Hepatectomy is indicated when there is a suspicion of malignancy.