Treatment for Crohn's disease usually involves medication,however,with chronic intestinal inflammation,damaged intestine become fibrotic and finally resulted in bowel obstruction,which need surgical management.In recent years,the basic research,diagnosis and treatment of Crohn's disease have made tremendous progress.Under the new treatment strategies and technical conditions,surgical technologies and concepts for bowel obstruction caused by Crohn's disease have been markedly changed.Surgeons should cooperate with clinicians from the departments of gastroenterology,endoscopy,imaging examination and pathology,and the indications and timing for surgical treatment should be strictly controlled.Damage control surgery,fast track surgery and laparoscopic surgical techniques have also been commonly used,which are effective for improving the efficacy of surgical treatment of bowel obstruction caused by Crohn's disease.

Organ transplantation is the optimal treatment for patients with an end-stage organ disease.The induction of donor-specific tolerance is necessitatd because of severe side-effects of immunosuppression and chronic rejection of the transplanted organ that defy management.Bone marrow infusion and costimulatory blockade are considered to be the most effective strategies to induce immune tolerance.This review briefly discusses the mechanism and clinical application of immune tolerance induced by bone marrow infusion combined with costimulatory blockade.

Objective To evaluate effect of propofol on the first spike latency-amplitude curve of rat inferior colliculus neurons and to find out mechanisms that propofol leds to the disappearance of auditory nerve electrophysiological .Methods 43 healthy specefic pathogen free(SPF) grade sprague dawley(SD) rats(weighing 200-250 g) were used to established wakeful animal models by ventilating with animal respirator after infusing vecuronium .A microelectrode was penetrated in the inferior colliculus (IC) ,and then research first spike latency-amplitude(FSL-A) using a Tucker-Davis Technologies System 3(TDT3) before and after intraper-itoneal injection of propofol 100 mg/kg of each 10 minutes interval .Results CFs ranging from 2 .5 to 44 kHz .An acoustic response of neurons showed offset response ,the remaining 42 neurons showed onset response .r2 of FSL-A curve equations are significant difference between administered propofol before and after 10 minutes(P<0 .05) ,all of them are larger than 0 .95(P<0 .05) .FSL-A curve after administration can shift the lower curve and coincident with the previous administration in the same rat .Conclusion Propofol affect auditory information transmission by convert localization of FSL-A curve of rat inferior colliculus neurons ,but does not change the meaning of the information encoded .

Objective To investigate the prognostic factots by analyzing clinicopathologlcal characteristics of 972 cases of colonic carcinoma. Methods Clinical and pathological data of 972 patients with colonic carcinoma treated surgically were studied by univariate and multivariate analysis,survival rate was calculated by life-table method and compared by Log-rank test. Results The univariate analysis indicated that the predictors of survival were age,perioperative blood transfusion, perioperative carcinoembryonic antigen(CEA)level,tumor gross type,depth of tumor invasion,lymphatic invasion,liver metastasis,extrahepatic metastasis,local recurrence、peritoneal seeding,pathological type,TNM stage and type of lymph node clearance.The multivariate analysis indicated that the independent predictors of suivival were age,periopemtive CEA level,tumor gross type,lymphatic invasion,liver metastasm,extrahepatic metastasis,local recurrence、peritioneal seeding,pathological type,type of lymph node clearance and TNM stage. Confclusions Lymphatic invasion is the most important independent prognostic factor of patients with colonic carcinoma treated surgically.

Objective:To study percutaneous transhepatic gallbladder drainage(PTGD) under color Doppler ultrasound in critically ill patients with acute calculus cholecystitis.Methods:A paracentetic needl was stuck into the cholecyst after going straight through 1.5-2.5 cm hepar under color Doppler ultrasound.The operator took out the bullet core,put in a guide wire,extracted the needl,inserted a central venous catheter along the guide wire,and then drew out the bile and clusised the cholecyst with metronidazole until the extracted fluid was clear and bright.Results:PTGD immediately relieved the pain in the of upper right quadrant in all the patients.Body temperature and WBC descended obviously 24 hours and returned to normal 5 days after the operation. Conclusion:Color Doppler ultrasound guided PTGD,easy to perform and with few complications and high suness rate,is an returned effective and reliable procedure for critically ill patients who are intolerant of cholecystectomy or for whom the operation is difficult to perform.

Object To establish a new method to determine protocatechualdehyde in Maodongqing Sustained- release Tablet. Methods The RP- HPLC method was applied with CH3OH and 1 % acetic acid as mobile phase, flowrate at 1.0 mL/min, and detection wavelength at 312 nm. Results In the range from 11.7 ng to 140.4 ng, protocatechualdehyde was in a good line with peak area, r=0.99995, the average recovery ratio was 96.41 % , RSD=1.04 % (n=5). Conclusions It was the first time to establish the RP- HPLC method to determine and control the protocatechualdehyde in Maodongqing Sustained- release Tablet with accuracy and a good reproducibility.

[Objective] To optimize the preparation technology of Maodongqing Drop Pill (MDP). [Methods] Orthogonal design was used to observe the influence of preparation conditions such as dry extract content, dry extract gram size, gel forming matrix and cooling agents on the quality of MDP. [Results] MDP made under the optimized conditions was good in shape, and color and luster, and not adhesive, indicating the good quality of the product. [Conclusion] This optimized preparation technology of MDP is simple with satisfied technique parameters and is suitable for mass production in the enterprises.

Objective To investigate the expression of the long non-coding RNA (IncRNA) H19 in the serum of patients with acute pancreatitis and its clinical significance.Methods A total of 82 patients who were diagnosed with acute pancreatitis in Emergency Department and Department of General Surgery in Shenyang Emergency Center from January 2013 to December 2015 were enrolled,and 20 healthy subjects were enrolled as normal controls.Peripheral blood samples were collected from the patients with acute pancreatitis and healthy subjects,the serum was separated,and RNA was extracted.Real-time PCR was used to measure the expression of lncRNA H19,and the correlation between the expression of H19 and other clinical and pathological parameters was analyzed.The t-test was used for comparison of continuous data between groups,and the chi-square test was used for comparison of categorical data between groups.The receiver operating characteristic (ROC) curve was used to evaluate the value of lncRNA H19 in the diagnosis of acute pancreatitis.Results The acute pancreatitis group had a significantly higher H19 expression level in serum than the healthy control group (t =2.364,P =0.020).The severe acute pancreatitis group had higher expression of lncRNA H19 than the mild acute pancreatitis group (t =2.111,P =0.037),and the patients with a Balthazar CT grade above grade C had significantly higher relative expression of lncRNA H19 than those with CT grade ≤ C (t =2.312,P =0.022).The ROC curve showed that H19 measurement helped with the diagnosis of acute pancreatitis with an area under the ROC curve of 0.752 (95％ CI:0.636-0.867,P ＜ 0.01).Conclusion Patients with acute pancreatitis have increased expression of IncRNA H19 in serum,and therefore,H19 has certain clinical significance in the diagnosis of acute pancreatitis and the evaluation of disease severity.

Objective To study the influence of different dosage forms on the release rate of total salvianolic acid of sus- tained-released Danshen extract preparations.Methods With salvianolic acid B as the standard,uhraviolet spec- trophotometry and the release test were applied to determine the accumulated release rate of total salvianolic acid of sus- tained-released Danshen extract preparations(R1～R9)of 9 different dosage forms and to evaluate the release behav- ior of sustained-released Danshen extract preparations in vitro.Results The accumulated release rate of total sal- vianolic acid in R7 was the best,and the in vitro release behavior was consistent with Higuchi equation:M_1/M_∞= 0.363 4t~(1/2)-0.1656,r= 0.996 2.Conclusion R7 is the first choice dosage form for the preparation of the sus- tained-released Danshen extraction preparations.

Objectives: To study the ameliorated effect of recombinant growth hormone on protein metabolism in chronic abdominal infection. 　Methods: 20 patients were divided randomly into two groups. Patients in the control group received TPN only for 10 days, while patients in the GH groups received both rGH(13.5u/d) and TPN for 10 days. Sepsis Score grade and detection of serum Growth Hormone (GH), Insulin like growth factor-1 (IGF-1), and Insulin like growth factor binding protein- 3(IGFBP-3) were carried out on day 0 and day 11, Serum albumin, prealbumin, transferring, fibronectin and C-reaction protein were detected on day 0, day 3, day 7 and day 11, Nitrogen balance and 24-hour urine creatinine secretion were assayed daily. 　Results: GH, IGF-1 and IGFBP-3 in the GH group on day 11 were significantly higher than those in the GH group on day 0 and those in the control group on day 11, Serum albumin, prealbumin, transferring and fibronectin increased, while C-reaction protein decreased when patients were undertaken GH treatment, Nitrogen balance ameliorated and accumulative total nitrogen balance in the GH group was significantly higher than that in the control group, while 24-hour urine creatinine secretion decreased. 　Conclusions: Recombinant growth hormone can ameliorate protein metabolism in chronic abdominal infection. IGF-1 plays important role in the ameliorated effect of recombinant growth hormone on protein metabolism in chronic abdominal infection.