Objective To evaluate the effect of sevoflurane preconditioning on intestinal injury in the patients undergoing resection for liver cancer.Methods Forty patients of both sexes,aged 20-60 yr,weighing 5075 kg,of ASA physical status Ⅱ or Ⅲ (liver function Child-Pugh grade A),undergoing resection for right liver cancer,were randomly divided into 2 groups (n =20 each):sevoflurane preconditioning group (S group) and control group (C group).Anesthesia was induced with target-controlled infusion of propofol and remifentanil.Tracheal intubation was facilitated with cisatracurium.Anesthesia was maintained with target-controlled infusion of propofol and remifentanil.S group inhaled sevoflurane with the end-tidal concentration of 2.0％ for 30 min starting from the end of intubation,followed by washout.Before induction (T0),immediately after hepatic portal was clamped (T1),at 1,3 and 6 h after occlusion of hepatic portal was released (T2-4) and at 24 h after operation (T5),arterial blood samples were obtained for determination of serum tumor necrosis factor-alpha (TNF-α),intestinal fatty acids binding protein (Ⅰ-FABP) and D-lactate levels.Results The concentrations of serum TNF-α and D-lactate started to rise at T2,peaked at T4,and started to decline at T5,and the serum Ⅰ-FABP concentrations started to rise at T2,peaked at T3,and started to decline at T4 in the two groups.The concentrations of serum TNF-α,Ⅰ-FABP and D-lactate were significantly lower in S group than in C group.Conclusion Sevoflurane preconditioning can inhibit inflammatory responses and reduce intestinal injury in the patients undergoing resection for liver cancer.

Objective To study effects of hepatic microcirculation and hepatic function using low dose HSS40 preoperation on the partial hepatectomy patients.Methods Sixty-five partial hepatectomy patients were randomly divided into study group (32 cases with HSS40,4 mL/kg,in 30 min) and control group (33 cases with RL,4 mL/kg,in 30 min).Patients of two groups were monitored in liver microcirculation,hepatic function parameters at different times before and after the infusion.Results Compared with the study group,the control group were more infusion (2400 ± 1650) mL and blood transfusion (550 ± 190) mL,the differences were statistically significant (P ＜0.05).Control group of nitric oxide (NO) T3 time(17.84 ± 6.26) μmol/L in the preexpansion compared with preoperative T0 time(38.06 ± 9.34) μmol/L and the study groupT3 time (36.37 ± 9.15) μmol/L was significantly decreased (P ＜ 0.05),and endothelin (ET) (T3 time 185.16 ± 41.34 pg/mL) was significantly higher (P ＜ 0.05),and the study group(T3 time 99.75 ± 30.31 pg/mL) than the control group variation amplitude,time later,the difference was statistically significant (P ＜ 0.05) ; Control group ALT,AST,DBLI,TBLI rise after preexpansion (P ＜ 0.05),and significantly higher than the study group (P ＜ 0.01),and the study group than the control group variation amplitude,time later,differences were statistically significant (P ＜ 0.05) ; while no significant changes in the concentration ALB two groups,the difference was not statistically significant difference (P ＞ 0.05).Conclusion Using low dose HSS40 preoperation on the partial hepatectomy patients can improve cardiovascular stability,protective effect on ischemia-reperfusion injury of liver,can increase the tissue perfusion,and improve the hepatic microcirculation,better able to maintain the stability of the liver function.

Background Animal model of fungal keratitis is an available tool to the experimental study of the pathogenesis mechanism of fungal keratitis. Current modeling methods of fungal keratitis include corneal scratching, corneal stroma injection and corneal surface lens methods. But these methods still have their own shortages. Objective This experiment was to create a fungal keratitis animal model by modifying corneal surface lens method. Methods Modified animal models of fungal keratitis were created by modified corneal surface lens method in 12 general adult New Zealand white rabbits. The filter papers soaked 108 spores / ml or A106spores / ml of spergillus fumigatus suspension were attached on the de-epithelial cornea surface and fixed with contact lens and tarsorrhaphy for 2 days, and the filter paper with physiological saline was used as control group. The symptoms of anterior segment were examined under the slit lamp in 3 ,7 and 14 days after surgery and scored based on the criteria of Dong. Corneal scraping was stained with 10% potassium hydroxide and calcofluor white stain to observed mycelium under the fluorescence microscope. Corneal tissue sections were examined by hematoxylin-eosin staining and periodic acid Schiff staining under the light microscope. The use of animal followed the Standard of Association for Research in Vision and Ophthalmology. Results Fungal keratitis models were successfully established in 6 eyes and 4 eyes in 108 spores/ml group (6/6) and 106 spores/ml group respectively. The symptom was more severer and score was higher in the eyes of 108 spores/ml group than that in 106 spores/ml group. At 3 and 7 days after surgery,the symptom scores of fungal keratitis models were higher than those of control group from 3 through 7 days with the statistically significant difference (P<0. 01) and the symptom scores of 108 spores/ml group were significantly higher than those of 106 spores/ml group (P<0. 01). At 14 days after surgery, the symptom scores of 108 spores/ml group were still higher than those of control group (P<0. 05). Fungal hyphae was seen in the corneal scrapes in 108 spores/ml group and 106 spores/ml group respectively from 3 through 7 days after surgery. Inflammatory cell infiltration, stroma cells necrosis and fungal hyphae were presented in 108 spores/ml group, and the corneal neovascularization could be observed in 108 spores / ml group 14 days later. Fungal culture revealed the positive outcome in both 3 and 7 days after surgery in 108 spores/ml group,but in 106 spores/ml group,the positive result was only in the 3rd day. Conclusion Modified corneal surface lens method is more feasible and sample in the model of Aspergillus keratitis. This animal model of Aspergillus keratitis is practical for the further study of fungal keratitis.

Objective To assess these in a consecutive series of patients with ICC treated surgically. Methods A retrospective study was conducted on 189 ICC patients undergoing surgery.Surgical results and survival were evaluated and compared among different subgroups of patients.Univariate and multivariate analyses were performed to identify prognostic factors.Results R0,R1,R2 resection and exploratory laparotomy were obtained in 63,84,31 and 11 patients,respectively.The overall 5 -year survival rates for the entire cohort were 16.8%,with corresponding rates of 26.3% for patients with R0 resection;14.3% for patients with R1 resection;6.8% for patients with R2 resection;and 0.0% for patients with an exploratory laparotomy.Independent factors for poor survival included positive resection margin,multiple tumors,beta - catenin nuclear expression and lymph node metastasis. Conclusion R0 resection offers the best possibility of long -term survival,but the chance of a R0 resection is low when surgery is performed for potential resectable ICC.Patients with characteristics of beta -catenin nuclear expres-sion,multiple tumors and lymph node metastasis are indicated to surgery which is needed to be further studied.

Objective To analyze the ultrasound features of ultrasonograpy-false-positive benign thyroid nodules in 37 cases. Methods With pathology results as the golden standard, thirty-seven patients with forty-six nodules were misdiagnosed as thyroid cancer by ultrasonography. The pre-operative diagnosis of ultrasonography were retrospectively reviewed and analyzed. Results Among forty-six thyroid nodules, twenty-one nodules had a diameter of 10.0 mm or smaller, while the other twenty-five nodules had a diameter of larger than 10.0 mm. In all forty-six thyroid nodules, the pre-operative ultrasonography found the majority of nodules with 3 or more than 3 malignant signs. The forty-six thyroid nodules showed solid (89.1%, 41/46), cystic-solid (10.9%, 5/46), marked hypoechogencity (87.0%, 40/46), ill-defined margin (56.5%, 26/46), calcification (76.1%, 35/46),microcalcification and macrocalcification), and taller-than-wide shape (30.4%, 14/46). The thyroid imaging reporting and data system (TI-RADS) lexicon was introduced to describe the lesions:forty-one nodules were categorized as TI-RADS 4c and 5 nodules were categorized as TI-RADS 5. On histology, these misdiagnosed thyroid nodules revealed severe fibrosis, hyalinization and calcification. The ultrasonic images were complicated and difficult to be differentiated from thyroid cancer. Conclusion Benign thyroid nodules with fibrosis, hyalinization, hemorrhage and calcification will lead tothe significant change on lesions' morphology, echo intensity and internal structure. When the benign and malignant signs ultrasound co-existed in a single thyroid nodule, benign thyroid nodules might be easily misdiagnosed as thyroid cancer.

Objective: To study the effect of water extracting and alcohol extracting process to anthraquinone content in Rhubarb. Methods: Choosing water and different concentration of alcohol as the solvent, the effect of permeating time, the extracting time, the degree of extracting, the amount of solvent and concentration of alcohol to total, conjugated, and deoxidized anthraquinone content were determined by orthogonal test. Results: Using water as the solvent, the degree of extracting is the significant factors to total anthraquinore with ( P

Objectives To investigate the clinical profile and prognosis of hemophagocytic syndrome (HPS). Methods A retrospective study was carried out to analyze the clinical features and laboratory findings in 28 children with HPS. Fisher's exact probability method and Logistic multivariate regression were used to explore the prognostic risk factors.. Results HPS was clinically characterized by prolonged fever (100%), hepatomegaly (64.29%),and other minor features including respiratory symptoms (53.57%), splenomegaly (50%), hydrops of multiple serous cavity (42.86%), lymphadenectasis (32.14%), jaundice (17.85%), skin rash (14.29%), central nervous system involvement (14.29%), and alimentary tract hemorrhage (10.71%). Labo-ratory data showed that 1iver dysfunction, pancytopenia, coagulation abnormalities, disseminated intravascular coagulation, hy-pertriglyceridemia, decreased number of natural killer cells and hyponatremia were prominent. The etiological analysis indicated that infection associated hemophagocytic syndrome was most common (60.71%), in which EB virus associated HPS was pre-dominant, accounting for 64.71%. Significant difference was observed in the difference of albumin,blood urea nitrogen and acti-vated partial thromboplastin time between death and survival cases (P<0.05). The Logistic regression multivariate analysis showed that hypoalbuminemia was an independent prognostic factor. Conclusions There are various underlying diseases and clinical manifestations for HPS. The lower level of serum albumin is an independent prognostic factor. A prompt diagnosis and treatment is very important for HPS prognosis due to the rapid progression and high mortality.

Objective To investigate the effect of metformin ( MET) on learning and memory behavior in HFD-induced insulin-resistant rats.Methods Thirty male Sprague-Dawley (SD) rats were divided into three groups to receive either a normal diet (Control group) or a high-fat diet (two HFD groups) for four weeks(HFD+MET).From two HFD groups, one received vehicle ( HFD group ) alone and other MET administration ( HFD+MET group ) .MET was dissolved in drinking water at a concentration of 2 mg/ml.All rats were subjected to the glucose tolerance test ( GTT) and behavioral tests using the elevated plus maze ( EPM ) , open field test ( OFT ) , Morris water maze ( MWM ) test and the step-through passive avoidance test ( PA) after four-week consecutive MET treatment .Blood samples were collected for determination of glucose. Results MET attenuated the glucose resistant condition and improved cognitive behavior in MWM and PA, vs the HFD group. Conclusion MET can improve the impaired learning and memory behavior in HFD-induced insulin-resistant rats.

Objective To explore the risk factors and the recurrence of spontaneous bacterial peritonitis after taking intestinal probiotics.Methods Fifty-six patients with spontaneous bacterial peritonitis were randomly divided into control group and probiotics group,and each group were 28 cases.Patients in control group were treated by regular hepatoprotective drug,while in probiotics group were administrated with Jinshuangqi orally,every time 0.5 g × 4 tablets,2 times a day besides regular hepatoprotective drug.The course of the treatment was for 3 months.The symptoms and other risk factors,and the relief time were recorded.Results Incidence of spontaneous bacterial peritonitis in probiotics group and control group were 21.4％ and46.4％ respectively(x2 =3.784,P ＜ 0.05).Rate of gastric ulcer were 17.9％ and 42.9％ respectively and the difference was significant(x2 =4.139,P ＜ 0.05).The relief time of fever in probiotics group was (2.52 ± 0.78) d,lower than that of control group ((4.21 ± 1.34) d,t =2.029,P ＜ 0.05).Meanwhile the relief time of abdominal tenderness was (4.02 ± 0.96) d in probiotics group,and (6.34 ± 1.27) d in control group (t =2.433,P ＜ 0.05).Conclusion Intestinal probiotics treatment can significantly reduce the recurrence rate of spontaneous bacterial peritonitis,shorten the relief time of each symptom and reduce the incidence of other risk factors.

Objective To explore the clinical effect of the treatment for fresh achilles tendon rupture by modified double Kessler suture with S type incision .Methods Totally 21 cases of fresh achilles tendon rupture were admitted into our hospital from January 2012 to Decem-ber 2015, and they were treated by S type incision modified double Kessler suture within 7 days (averagely 4.1 days).Observed the postop-erative complications and evaluated the efficacy with Arner-Lindholm.Results All the 21 patients were followed for 6 to 24 months ( aver-agely 12 months).There was no incision infection ,necrosis, re-fracture of achilles tendon and other complications .There were 16 cases of excellent and 5 cases of good , with the excellent and good rate of 100% through the Arner-Lindholm evaluation criteria .Conclusion Modified double Kessler suture with S incision for the treatment of fresh achilles tendon rupture is conducive to early functional exercise ,and it can obtain satisfactory clinical efficacy .