According to the reality of outpatient clinic service,expanding the service items,laying off solid foundation,making the working procedures more concrete in details and establishing suitable polices,the professionalization of specialists and special diseases in outpatient clinic of multiple branches hospital,even resources of outpatient clinic of multiple branches hospital,diversified service pattern of outpatient clinic,refined outpatient clinic service procedure,informationization of treatment procedure of outpatient service,and different requirements of people of different levels are realized.

Objective To observe the therapeutic effect of hyaluronic sodium product (SHP) on osteoarthritis(OA).Methods Three hundreds and forty-eight cases were diagnosed as OA and five hundred-eighty knee joints damage caused by OA were treated by intracavitary injection of SHP once a week for three consecutive weeks.The changes of the number of patients with clinical symptoms (joint pain,swelling of joint and with or without difficulty in up and down stairs) and the laboratory test results were compared before and after the treatment.Results It showed that there was a significant difference of the changes of the number of patients with clinical symptoms and laboratory test results before and after the treatment,(P

Objective To study the changes in interleukin-32 (IL-32) in rats with Klebsiella bacillus pneumonia and approach its significance. Methods Seventy-two Sprague-Dawley(SD)rats were divide into control group,model group and experimental group by the method of random digits table,then the experimental group was subdivided into 4 hours and 1,3 and 5 days experimental subgroups(each n=6). The rat model of Klebsiella bacillus pneumonia was established by injection of 0.3 mL Klebsiella bacterial suspension into the trachea. Before the establishment of the model in the experimental group,IL-32 inhibitory agent,protease activated receptor-2(PAR2) was injected into the abdominal cavity. After model establishment,at different time points,blood was collected via tail vein to observe the changes in serum levels of IL-32,tumor necrosis factor-α(TNF-α),IL-6 and IL-8 in all the groups. The lungs were removed and stained with hematoxylin-eosin(HE)method to investigate the histopathological changes of the lung tissues under the light microscope. Results Compared to the control group, with the prolongation of time the levels of IL-32,TNF-α,IL-8 and IL-6 were increased gradually in the model group,and reached their peaks at 3 days〔IL-32(ng/L):84.40±28.24 vs. 18.57±3.86,t=5.544,P=0.002;TNF-α(ng/L):79.27±14.64 vs. 17.82±3.86, t=9.994, P=0.000;IL-8(ng/L):55.85±10.90 vs. 16.66±3.76,t=8.544, P=0.000;IL-6(ng/L):56.65±2.57 vs. 28.48±2.11,t=19.693,P=0.000〕;PAR2 could inhibit above indexes significantly,there was statistical difference at 3 days compared with the model group〔IL-32(ng/L):54.13±6.68 vs. 84.40±28.24,t=2.560,P=0.046;TNF-α(ng/L):49.12±3.56 vs. 79.27±14.64,t=4.901,P=0.003;IL-8 (ng/L):22.95±2.52 vs. 55.85±10.90,t=7.204,P=0.000;IL-6(ng/L):36.49±2.63 vs. 56.65±2.57,t=13.443, P=0.000〕. Under the light microscope,the inflammatory changes in the lung tissue in experimental group were milder than those in the model group. Conclusion As a pro-inflammatory cytokine,IL-32 can induce the production of TNF-α,IL-6 and IL-8,and the inhibition of IL-32 production may play a role in suppression of the development of Klebsiella bacillus pneumonia.

AIM: To study the anti-inflammatory effect of the Antivirus Oral Liquid(AOL) in experimental rabbit conjunctivitis model. METHODS: Rabbit's staphococcus aureus conjunctivitis models and cantharides tincture conjunctivitis models were made to observe different groups of animals' symptom of eye stimulation,negative rate of bacteria and conjunctiva histopathology.And then AOL compared with the effect of amphemycin gutta or Shumu(gutta.) RESULTS: It showed that AOL possessed significant anti-inflammatory effect on bacterial conjunctivitis.The negative rate of bacteria was more than 90% after being given AOL for 4 days successively.Compared with the models group,the hyperemia and edemda were markedly relieved.The result showed that AOL possessed significant anti-inflammatory effect on irritable conjunctivitis.The hyperemia and edema were markedly relieved at the second day after being given AOL,and the inflammatory symptoms had almost disappeared after being given AOL for 4 days successively. CONCLUSION: AOL has a good effect on the therapy of staphylococcus aureus conjunctivitis and cantharides tincture.

Objective To investigate the value of MRI in diagnosis of congenital cystic lung disease.Methods The MRI was per-formed in 105 fetuses with congenital cystic lung disease.Subjects were classified into two groups including group A (the gestational age ranged from 12-20 w)and group B (the gestational age>20 w).The MRI and ultrasonography characteristics,as well as path-ologic diagnosis were compared.Results Among 105 cases,there were 80 cases of congenital cystic adenomatoid malformation (CCAM)(including 23 cases of typeⅠ,38 cases of typeⅡ and 1 9 cases of typeⅢ),18 cases of bronchopulmonary sequestration (BPS),5 cases of congenital lobar emphysema,1 case of bronchogenic cyst,and 1 case was BPS with CCAM.In group A,MRI can diagnose the majority of the anomalies (41/45),ultrasonography can diagnose anomalies of 39 cases.There was no significant differ-ence of diagnostic accuracy between the two methods (P >0.05).In group B,compared with ultrasonography,MRI could diagnose more cases accurately (58 vs 52),with statistical significance (P <0.05).Conclusion MRI is a reliable method in diagnosing con-genital cystic lung disease;MRI can provide more useful information for the cases in the gestational age >20 w compared with ultra-sonography.

Objective To explore prophylactic bilateral internal iliac arteries balloon occlusion in treating pernicious placenta previa complicated with placenta implantation before cesarean section.Methods Data of 32 patients with pernicious placenta previa complicated with placenta implantation underwent prophylactic bilateral internal iliac arteries balloon occlusion(Balloon Group)were analyzed retrospectively.40 patients with pernicious placenta previa complicated with placenta implantation without treatment of prophylactic bilateral internal iliac arteries balloon occlusion(Control Group)were selected.The mean blood loss and infusion amount during the operation,operative time,newborn Apgar score were compared between the two groups.Results The mean blood loss and infusion amount during the operation,operative time,newborn Apgar score of balloon group was superior to the control group and the difference was significant.All mothers and infants were healthy detected by clinical checking on 3-6 months after birth.Conclusion Prophylactic bilateral internal iliac arteries balloon occlusion is a safe and effective treatment before cesarean section used in pernicious placenta previa complicated with placenta implantation,and worthy of further promotion.

Objective To investigate the postoperative complications of ex vivo liver resection combined with autologous liver transplantation in the treatment of end-stage hepatic alveolar echinococcosis at high altitude and related prevention and treatment strategies. Methods Surgical data and follow-up data were collected from 11 patients with end-stage hepatic alveolar echinococcosis who underwent autologous liver transplantation in Qinghai People's Hospital from January 2013 to March 2019, and intraoperative and postoperative conditions were analyzed. Results All 11 patients underwent autologous liver transplantation successfully, without intraoperative death, among whom 2(18.18%) underwent hemi-extracorporeal hepatectomy and 9 (81.82%) underwent total extracorporeal hepatectomy. For the reconstruction of the retrohepatic inferior vena cava, 2 patients (18.18%) underwent reconstruction with the autologous great saphenous vein, 4 patients (36.36%) underwent reconstruction with artificial vessels, and the autologous retrohepatic inferior vena cava was preserved in 5 patients (45.45%). For biliary reconstruction, 8 patients (72.73%) underwent choledochoenterostomy and 3 (27.27%) underwent choledochocholedochostomy. The main postoperative complications of the 11 patients included bleeding in 2 patients (18.18%), bile leakage and abdominal infection in 4 patients (36.36%), bilioenteric anastomotic stenosis in 1 patient (9.09%), thrombus in 2 patients (18.18%), pulmonary infection and pleural effusion in 2 patients (18.18%), and echinococcosis recurrence in 1 patient (9.09%). Of all 11 patients, 2 (18.18%) died during the perioperative period, and the other 9 patients (81.82%) were improved and discharged. Conclusion Bleeding, biliary complications, and infection are the main causes of death in patients undergoing autologous liver transplantation at high altitude. An accurate understanding of surgical indication, careful multidisciplinary evaluation before surgery, superb operation during surgery, standardized surgical procedures, and fine perioperative management are the key to reducing perioperative mortality, avoiding and reducing postoperative complications, and achieving good long-term survival in patients undergoing autologous liver transplantation.

Objective     To study the correlation of preoperative hemoglobin amount with venous thromboembolism (VTE) after surgical treatment of bronchiectasis and the clinical significance. Methods     A retrospective study was performed on patients with bronchiectasis who underwent surgical treatment in our center from June 2017 to November 2021. The differences in blood parameters between the VTE patients and non-VTE patients were compared. The relationship between preoperative hemoglobin and VTE was confirmed by quartile grouping and receiver operating characteristic (ROC) curve. Results     A total of 122 patients were enrolled, including 50 males and 72 females, with a mean age of 52.52±12.29 years. The overall incidence of VTE after bronchiectasis was 9.02% (11/122). Preoperative hemoglobin amount (OR=0.923, 95%CI 0.870-0.980, P=0.008) and D-dimer amount (OR=1.734, 95%CI 1.087-2.766, P=0.021) were independent influencing factors for VTE after bronchiectasis. The incidence of VTE after bronchiectasis decreased gradually with the increase of preoperative hemoglobin amount. The area under the ROC curve (AUC) of postoperative D-dimer alone was 0.757, whereas the AUC of postoperative D-dimer combined with preoperative hemoglobin amount was 0.878. Conclusion     Low preoperative hemoglobin is an independent risk factor for postoperative VTE. Postoperative D-dimer combined with preoperative hemoglobin amount has a better predictive performance compared with postoperative D-dimer alone for postoperative VTE.