Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) is used for patients with advanced hepatocellular carcinoma who cannot tolerate major hepatectomy due to an insufficient future liver remnant,but the morbidity and mortality rate in the perioperative period are still high.Available studies indicate that damage control surgery variations such as laparoscopic procedure and associating radiofrequency/microwave ablation/liver tourniquet and portal vein ligation could improve the morbidity and mortality associated with ALPPS,as could portal vein embolization.However,randomized controlled trials are needed to determine benefits in technical variations.

Objective To explore the effect of dexmedetomidine preconditioning on antioxidant ability in Rats Brain with focal cerebral ischemia/reperfusion.Methods Forty-two healthy male SD rats,weighted 250-280 g,were randomly divided into three groups (n = 14):sham-operation group (group Sham):in which carotid artery was exposed but MCAO was not performed;ischemia/reper-fusion group(group IR):NS were injected intraperitoneally at 30 minutes before the MCAO;dexme-detomidine group (group Dex):dexmedetomidine 100 μg/kg were injected intraperitioneally injected at 30 minutes before the MCAO.Focal cerebral ischemia-reperfusion (IR)model in rats was made by transient occlusion of the middle cerebral artery occlusion (MCAO)using a nylon thread with rounded tip inserted into internal carotid artery and advanced cranially until resistance was met.MCAO was maintained for 2 hours followed by 24 hours reperfusion.Neurologic deficit scores(NDS),the infarc-tion volume as well as the activities of endogenous antioxidants (such as superoxide dismutase(SOD), glutathione peroxidase(GSH-PX),glutathione reductase (GR),catalase (CAT))in ischemic brain were evaluated 24 h after reperfusion.Results Compared to group Sham,the neurologic deficit scores and the infarction volume in group Dex and IR were significantly higher,but the concentration of SOD,GSH-PX,GR,CAT were significantly lower(P <0.05).Compared to group IR,however,the neurologic deficit scores and the infarction volume in group Dex were significantly lower,but the concentra-tion of SOD,GSH-PX,GR,CAT were significantly higher (P <0.05).Conclusion Dexmedetomidine can protect the brain from focal cerebral ischemia-reperfusion injury,and its mechanism maybe relate to preserving the activities of endogenous antioxidants.

Objective To explore the clinical value of prenatal screening by detecting α-fetoprotein(AFP),β-human chorionic gonadotrophin(β-HCG)and free estriol(u-E3)levels in the second trimester of pregnancy.Methods AFP,β-HCG and u-E3 were de-tected in 3 595 second trimester pregnant women by chemiluminescence.The risk value was calculated by combining with the factors of age,pregnant weeks,body weight,etc.Then the high-risk pregnant women were carried out the amniotic fluid cells chromosome karyotype analysis and B-ultrasonic examination.Results Among 3 595 pregnant women,the screening positive rates of Down′s syndrome(DS),Edward′s syndrome(ES)and neural tube defects(NTD)were 3.70%(133/3 595),0.11%(4/3 595)and 1.44%(52/3 595)respectively.In the prenatal screening,there were 189 cases of high risk pregnant women,among them 87 cases were per-formed the prenatal diagnosis of amniotic fluid cells chromosome karyotype analysis and B-ultrasonic examination,6 cases were defi-nitely diagnosed,in which 3 cases were DS,2 cases were NTD and 1 case was ES.Conclusion Prenatal screening is a non-invasive detection method and has the important clinical application value for avoiding the birth of DS,ES and NTD neonates.

Objective To study the expression and roles of miR-31-5p in acute myeloid leukemia (AML).Methods miR-31-5p in AML patients were evaluated by real-time PCR;THP-1 cells were transfected with the miR-31-5p mimic and control, respectively.The effects of over-expression of miR-31-5p were examined by CCK-8 and FACS analysis;Dual-luciferase and Western blot were performed to detect target gene HuR expression.The effects of knock-down of HUR were also examined by CCK-8 and FACS analysis.Results miR-31-5p was down-regulated in AML patients compared to the normal control.Over-expression of miR-31-5p in THP-1 cells reduces cell proliferation and accelerates monocytic differentiation.miR-31-5p could target HuR, and knock-down of HuR inhibits cell proliferation and attenuates monocytic differentiation in THP-1 cells.Conclusions miR-31-5p may regulate AML cell proliferation and monocytic differentiation by targeting HuR.

Precision medicine significantly promotes the diagnosis and treatment of various diseases,which also induces the revolution of evidence-based clinical practice guidelines,as well as multimodality therapy for hepatocellular carcinoma (HCC).In the application of the concept of precision medicine and evidence-based medicine,surgeons will concretize the precise surgery,establish an improved multimodality therapy for HCC,and ultimately achieve the goal of overall benefit.This is also a new task of surgeons in the precision medicine era.

The increasing need for ideal body shape makes more and more patients choose to receive different types of breast reconstruction surgery after mastectomy. Right now, it is a key problem for the multidisciplinary treatment to find an optimal sequence of comprehensive treatment from which those patients can receive the maximum benefits and a good balance between ideal body shape and satisfactory antitumor outcomes. This paper reviews the latest research advances in the effect of postoperative radiotherapy on breast shape after breast reconstruction, the sequential relationship between the replacement of the temporary tissue expander with the permanent breast prosthesis and postoperative radiotherapy, breast construction surgery, and radiotherapy techniques. To provide a basis for clinical practice, this paper proposes a flow chart for decision?making in reconstruction surgery and adjuvant treatment based on the current literature and clinical data.

OBJECTIVE:To observe the effects of the essential conditions of storage on quality of Semen Armenniacae Am_arum (SAA).METHODS:Gravimeteric and titration method were used and orthogonal design was adopted.RESULTS:Obvious effects of baking temperature and storage duration on content of amygdalin,temperature on acid value of SAA,temperature and humidity and storage duration on peroxide value of SAA were found.CONCLUSION:The best conditions of storing SAA are as follows:A1,B1,C3 and short storage duration.

Objective To observe the adsorption of fentanyl by different materials of the analgesic pump reservoir. Methods The concentrations of fentanyl in pump reservoirs,which were made by different materials （glass,silica gel,polyvinyl chloride,non polyvinyl chloride） were detected with the time by high-performance liquid chromatography. The measurement was repeated three times.Results Fentanyl concentration in these reservoirs decreased with time,which decreased 6.3% in silica gel reservoir （P0.05）,2.7% in non polyvinyl chloride（P0.05）,1.5% in PVC and 1.2% in glass bottles.Conclusion Fentanyl citrate will be adsorbed by different materials of analgesia pump reservoir within 72 h,and the adsorption sequence was silica capsule,non polyvinyl chloride,polyvinyl chloride,and glass bottles.

Glioma is the most malignant tumor in CNS， the effect of present therapy is poor. A important discovery in tumor molecular biology is that the activation of oncogene and inactivation of tumor suppressor gene play an important role in the mechanism of tumorgenesis. The advances in the study of tumor suppressor genes in gliomas were reviewed.

According to the financing characteristics of military hospitals and problems in financial management; financial statement, special fund, internal control and financial indicator are used to audit economic benefits of military hospital;so that military hospitals can maximize the realization of social profits while providing good health surport.