The application of enhanced recovery after surgery (ERAS) in hepatectomy is safe and feasible.The related researches of the clinical strategies of ERAS involved in colonic surgery instead of management of basic diseases of liver,and the influence of portal hypertension and hepatitis B virus infection on the ERAS has not been emphasized.According to the clinical strategies of ERAS in colon surgery,the basic diseases and the characteristics of liver were focused,and the clinical strategies of ERAS in the era of precision liver surgery were proposed.Through concerted efforts of the multidisciplinary team and a joint of surgeons,nurses and patients,the establishment of multicentre clinical studies under guidance of evidence-based medicine (EBM) will show clearly a development direction of the clinical strategies of ERAS in the era of precision liver surgery.

Objective To compare the clinical value of dynamic enhanced CT,MRI in differential diagnosis of adrenal tumors.Methods 62 patients with adrenal tumor by pathologically confirmed in our hospital were select-ed.All patients underwent unenhanced and dynamic enhanced CT,MRI examination.The qualitative and adrenal tumor localization diagnostic accuracy,the adrenal adenomas and non adenoma tumor clearance rate of the two meth-ods were compared.Results The accuracy of enhanced CT positioning,qualitative examination were 96.77%, 90.57%,respectively,which were slightly higher than those of the MRI enhancement(91.94%,86.79%),but the differences were not statistically significant (χ2 =0.479,0.376,all P >0.05).53 adrenal adenomas and 9 cases non-adenomas absolute and relative clearance rate clearance rate in enhanced CT 5 min delay time,the differences were statistically significant (t =2.962,2.018,all P <0.05).53 cases adrenal adenomas and 9 cases non adenoma clear-ance of correction in the enhanced MRI delay 5min,respectively (33.41 ±20.17)%,(14.74 ±12.16)%,the differ-ence was statistically significant (t =2.684,P <0.05).Conclusion Dynamic enhanced CT,MRI are good methods for differential diagnosis of adrenal tumors,two methods have location and qualitative diagnosis correct rate.So dynamic enhanced CT,MRI are reliable means of diagnosis of adrenal tumors.

Objective To evaluate the effects of pre-operative intra-arterial infusion chemotherapy on colorectal Cancer.Methods 35 patients with colorectal cancer,treated by surgery were divided into two groups randomly.There were 20 patients in group A(pre-operative intra-arterial infusion chemotherapy) and 15 in group B(control).Arterial contrast technique Was used in group A then mitromye in 10mg,5-Fu 1000mg epirubic in 60mg were given through Weidner way-Results Microveasel density in the center,surface of the tumor and adjacent tissue around the tunlor were (40.46±7.06),(52.27±18.40),(49.92±8.15) in group A,and (46.09±12.21),(73.44±22.06),(51.94±12.64)in group B.Microvessel density on the surface in group A was significantly lower than that of group B(P＜0.05),with no significance between the center and the adjacent tissue.Conclusion Pre-operative intraarterial infusion chemotherapy is able to reduce micro-vessel density on the surface of eolorectal tumor.

Objective:To evaluate our self-made distraction reductor used in the percutaneous minimally invasive treatment of calcaneal fractures.Methods:A retrospective study was conducted of the 32 patients (37 feet) who had been treated at Department of Orthopaedics, The First Affiliated Hospital to Chongqing Medical University from January 2017 to December 2019 for calcaneal fractures. They were 26 males and 6 females, aged from 20 to 67 years (average, 46.5 years). The height and length of the calcaneus were restored by our self-made tri-plane distraction reductor in all patients; the displaced fracture blocks were reset in a minimally invasive manner in patients with intra-articular fracture; final fixation was performed with a minimally invasive plate and screws. Time for reductor installation, operation time and intraoperative blood loss were recorded; complications, fracture union and reduction were observed; height, length and width of the calcaneus, ankle-hindfoot scores of American Society of Foot and Ankle Surgery (AOFAS), Maryland scores, and visual analogue scale (VAS) were recorded at the last follow-up; B?hler and Gissane angles were compared between pre- and post-operation.Results:All patients were followed up for 12 to 36 months (average, 17.2 months). Time for reductor installation averaged 5.0 min (from 3 to 8 min), operation time 91.5 min(from 70 to 110 min), and intraoperative blood loss 25.2 mL (15 to 50 mL). Superficial infection of traction track occurred in one patient and sural nerve injury in one patient. All fractures united without any reduction loss by the last follow-up. On average, the last follow-up observed a calcaneal height of 39.3 mm, a calcaneal length of 70.6 mm, a calcaneal width of 32.7 mm, an AOFAS score of 87.8, a Maryland score of 86.7 and a VAS score of 2.2. The calcaneal B?hler angle was recovered significantly from 3.7°±13.7° preoperatively to 25.8°±6.4° at the last follow-up, and the calcaneal Gissane angle from 112.2°±21.3° preoperatively to 125.8°±5.7° at the last follow-up ( P< 0.05). Conclusion:In percutaneous minimally invasive treatment of calcaneal fractures, application of our self-made tri-plane distraction reductor can lead to fine clinical efficacy.

Objective To observe the clinical efficacy of vacuum sealing drainage(VSD) in the treatment of large-area wound infection of earthquake casualty after amputation.Methods Seven patients with large-area wound infection of earthquake casualty after amputation received sustained VSD.Results After VSD for 7~26 days,with an average of 13 days,the wound infection in the 7 patients was controlled.No systemic toxicity was found.The result of wound bacterial culture was negative.Of the 7 patients,4 received phase Ⅱ suture,3 received phase Ⅱ skin graft,and all of the grafted skin survived.Conclusion Vacuum sealing drainage exerts certain effect in the treatment of large-area wound infection of earthquake casualty after amputation.

The ambulatory EEG recorder designed in this paper can continuously record 24-hour EEG signals on 18 channels. C8051F020, a kind of mixed-signal ISP FLASH MCU, controls all the functions such as sampling, storage and many others. The 12-bit ADC in C8051F020 samples the EEG signal amplified by the preamplifier. At the same time, the EEG signal of every channel can be selected through the keyboard to be displayed on LCD so that the working status can be detected. After the system is ready, the signals sampled during 24 hours are stored into the CompactFlash card as FAT16 files.

Objective To observe the therapeutic efficacy of continuous arterial infusion chemotherapy combined with radiofrequency hyperthermia in the treatment of patients with advanced colorectal cancer.Methods A total of 20 advanced colorectal cancer patients with various distant metastasis were treated by the combined continuous intra-arterial infusion chemotherapy and radiofrequency hyperthermia.For the chemotherapy,a dose of 200mg/m2 surface body area of calcium folinate(CF) was given for 1 to 3 days.80mg/m2 of cisplation was infused intravenously for the first day and repalced by etoposide Vp16,60mg/m2 for 1 to 3 days in patients with renal dysfunction.For intra-arterial infusion,a dose of 500mg/m2 5-FU was given for 72 hours.For patients with liver metastases,chemoembolization(ADM 30mg/m2+MMC 6mg/m2 mixed with ultra-lique fied lipiodol) was carried out.Radiof requency hyperthermia with a frequency of 41MHz was performed on the second day after chemotherapy.Results Response rates were as sessed by CT scan and ultrasonography.The overall response rate(CR+PR) of the cases was 70.0%.No serious side effect or complication was found in the course of chemotherapy.Local pain and lipid nodule were occasionally observed in some patients after hyperthermia.Conclusion Continuous intra-arterial infusion chemotherapy in combination with radiofrequency hyperthermia is an useful and safe method for the treatment of patients with advanced colorectal cancer.

Objective To approach the risk factors of bronchopulmonary dysplasia(BPD)with very low birth weight infants whose gestational age less than 32 weeks,thus it could provide a basis direction for prevention.Methods To summarize 70 neonates with BPD in October 2012 to October 2014 in our hospital, and randomly select 70 very low birth weight infants didn't have oxygen requirement of gestation age less than 32 weeks as control group.The perinatal risk factors,oxygen therapy and use caffeine were analyzed by using the statistical analysis of Chi-square test and logistic regression,so the risk factors and prevention direc-tion of BPD could be provided.Results Male gender were more prone to BPD(P ﹦0.000).Gestational age (P ﹦0.000)and birth weight(P ﹦0.002)were statistical lower in infants with BPD compared with no BPD.Family history of asthma,fetal distress,amniotic fluid turbidity,pulmonary hemorrhage,respiratory dis-tress syndrome,use of pulmonary surfactant,patent ductus arteriosus,intrauterine infection,ventilator time,na-sal continuous positive airway pressure /nasal intermittent positive pressure ventilation time,duration of oxy-gen therapy and use of caffeine were statistical significances (P 〈0.05,respectively).Logistic regression analysis demonstrated that gender(OR ﹦3.574,P ﹦0.003),gestational age≥28 weeks(OR ﹦58.665,P ﹦0.002), birth weight 〈1 250 g(OR ﹦36.453,P ﹦0.012)and ventilator time(OR ﹦703.696,P ﹦0.000)were independent risk factors for BPD infants.Using of caffeine(OR ﹦0.025,P ﹦0.010)and nasal continuous positive airway pressure/nasal intermittent positive pressure ventilation(OR ﹦0.004,P ﹦0.002)were protective factors for BPD infants. Conclusion The incidence of BPD could be reduced by strengthening prenatal care,minimizing intrauterine in-fection and preterm delivery,reducing the patent ductus arteriosus by strict fluid management,using mechanical ventilation rationally,choosing a non-invasive mechanical ventilation and caffeine.

Objective To observe expression of human beta-defensin-3 (HBD-3) in tissues around the infected artificial prostheses and investigate its value in treatment and diagnosis of periprosthetic joint infection (PJI).Methods According to clinical diagnosis,periprosthetic tissues and normal synovial membrane excised in operation were collected and divided into the following four groups:PJI group (n =13),aseptic loosening group (loosening group,n =9),spacer treatment group (treatment group,n =12),and normal group (n =15).HE staining was used to observe infiltration of inflammatory cells.Immunofluorescence staining was used to detect positive cells number and fluorescence intensity.Image-pro plus (IPP) 7.0C software was used to measure the average value of absorbance.Preoperative peripheral white blood cell count,erythrocyte sedimentation rate (ESR),and C-reactive protein (CRP) results were documented.Then,differences of those parameters were analyzed and compared among groups.Results HE staining revealed that all groups had different degree of inflammatory cell infiltration except for normal group.Immunofluorescence staining revealed that the most number of positive cells and highest fluorescence intensity existed in PJI group.Value of absorbance in PJI group was 0.430 ± 0.013,followed by 0.308 ±0.005 in loosening group,0.234 ± 0.009 in treatment group,and 0.089 ± 0.019 in normal group.Preoperative peripheral white blood cell count,ESR and CRP were the highest in PFI group,but were not significantly different among the remaining three groups.Conclusion HBD-3 is highly expressed in tissues around the prostheses which had infection or aseptic loosening,but its expression in response to infection and loosening has difference.

Objective To study the effect of thermo-radiotherapy on multidrug resistance (MDR) and levels of intracellular adriamycin (ADM) in tongue squamous cell carcinoma cell line Tca 8113 and its MDR cell line Tca 8113/CBDEA. Methods Samples of the two cell lines were treated with thermo-radiotherapy (42℃ for 0.5 h and 2 Gy of radiation). Four and 24 hours later, the expression of the MDR relative proteins P-glycoprotein (P-gp),multidrug resistance associate protein 1 (MRP1) and glutathione s-tranferase-π (GST-π) were detected using immu-nohistochemistry. Intracellular ADM concentrations were measured using an HTS 7000 Plus bioassay reader. Re-sults No change in the expression of P-gp was observed in the Tca 8113/CBDEA and Tca 8113 cell lines after 4 or 24 hours. Expression of MRP1 was not significantly altered in the Tca 8113/CBDEA cell line, but there was a signifi-cant drop in the Tca 8113 cell line 24 hours post-thermo-radiotherapy. Expression of GST-π was not altered in either the Tca 8113/CBDEA or the Tca 8113 cell line at 4 hours post-thermo-radiotherapy, but there was a significant de-crease at 24 hours. At both 4 and 24 hours, drug tolerance had decreased and intracellular drug concentration had in-creased significantly in both cell lines. Conclusions Thermo-radiotherapy can enhance the effects of chemotherapy and suppress the expression of MDR factors induced by radiation. The combination of hyperthermia and radiotherapy does not induce MDR.