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 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

With the internationalization of nursing education,one major project facing higher nursing education is to foster lots of high quality nursing specialists,with properties of international vision,development prospect,and adaptation to international nursing positions.Chongqing Medical University engaged in reforming and implementation of talents culturing and yielded significant effect along with the main competency ideology of humanistic caring,critical thinking,evidence-based nursing,practicing and international competition.

Objective To investigate the relationship between acute biliary pancreatitis (ABP) and anomalous pancreaticobiliary duetal union (APBDU). Methods 131 patients with ABP were enrolled to test the serum total bilirubin (TB), alanine amintransferase (ALT), aspartate amintransferase (AST), alkaline phosphates (ALP), γ-glutamyl transferase (γ-GT). All the patients received medical treatment, and then these tests were performed again. Thereafter, all the patients underwent selective surgery and intra-operative cholangiography was performed to observe the pancreaticobiliary duetal union. Results 27 patients (20.6%) with APBDU were found in 131 patients. Among them, 8 cases (29.6%) was B-P subtype (TypeⅠ), 16 cases (59.3%) was P-B subtype (TypeⅡ) , and the remaining 3 cases was mixed subtype (TypeⅢ). A significant decrease of ALT, AST, ALP, γ-GT after non-surgical treatment in both group of APBDU and NAPBDU was noted (P＜0.05). The serum levels of ALT, AST,γ-GT in APBDU patients were (71.81± 23.19) U/L, (47.85±27.87) U/L, (52.86±31.49) U/L, respectively; and in NAPBDU patients were (51.96±15.40) U/L, (40.77±16.58) U/L, (34.86±26.47) U/L. The difference was statistically significant (P＜0.05). Condusions APBDU is an important etiology of ABP.

Objective To observe the protective effect of Vdvet-feeling on phlebitis in rabbit ears induced by Fluorouracil.Methods The models of Fluorouracil induced phlebitis in rabbit ears were established.24 rabbits were randomized into three groups:group A used Velvet-feeling for wet dressing,group B was the blank control group C was coated with Hirudoid.The vein was assessed before and after the intervention,and the changes in appearance of vein and the occurrence of phlebitis were observed.The samples of local vein and surrounding tissues were cut off 24 hours after intravenous injection of Fluorouracil and were made pathological sections,HE staining.The pathological damage degree of the vein and surrounding tissues were evaluated by light microscopy.Results The degree of phlebitis in group A and C were lower than group B,there was significant difference.There was significant difference between group A and C at the degree of phlebitis,especially in infiltration of inflammatory cells of vessel wall and perivascular edema.Conclusions Early application of the Velvet-feeling or Hirudoid coating were better in prevention of Fluorouracil induced phlebitis,and wet dressing of Velvet-feeling was better than Hirudoid coating.

Objective To investigate the association between polymorphism of TNFα-308 and mutations of HBV C region in patients with chronic HBV infection. Methods Ninety-five patients with chronic HBV infection were recruited in the study. The single nucleotide polymorphism(SNP) of TNFα-308 Was determined by restriction fragment length polymorphism(RFLP). Mutations of nt1762/1764, nt1896, nt1899, nt1862, as60, aa87 and as97 in HBV C region were detected by direct sequencing after PCR amplification. Mutations of the above points among different genotypes were compared by Fisher's exget test. Results Three different genotypes G/G(63/95, 66.3%), G/A(28/95, 29.5%) and A/A(4/95, 4.2%) were found in TNFα-308 site. The rates of mutations of aa87 and aa97 points in patients with G/G, G/A and A/A genotype were 39.3%(24/61), 11.5%(3/26) and 50.0% (2/4), respectively(F=7.658, P<0.05);while the mutation rates of nt1762/1764, nt1896, nt1864, nt1899 and aa60 were of no statistical significance among different genotypes(F=0.669, 1.542, 1.123, 2.420 and 0.966, P>0.05). Conclusion Compared with G/G genotype, antigenicity of HBV may be more stable in patients with TNFα-308 G/A genotype, which is beneficial to HBV clearance.

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.