[Objective]To filter and optimize extractive technology of Qianliening granules.[Methods]The optimization extractive technology of Qianliening granules was investigated using orthogonal design with the availability component extracting from the drug as the index.[Results]The optimal condition for the extraction of Radix Astragali group was 10 folds amount of water,3 times,1.5 hours each time.The optimal condition for the extraction of Rheum officinal Baill.group was 6 folds amount of 60% alcohol,2 times,two hours and 1.5 hours each time.[Conclusion]The optimized extractive technology is scientific and efficient.

Objective To study the activity of hepatitis B virus and therapeutic efficacy of adefovir in chron-ic hepatitis B patients with colon cancer during operation period. Methods 50 chronic hepatitis B patients with co-lon cancer to be underwent colon resection were divided two groups at random, one group was given adcfovir (adefovir group), the other group not (control group), and therapeutic measure except antivirus is the same. HBV-DNA con-centration and liver functon of the patients were detected. Results Serum HBV-DNA concentration and ALT level of the patients was increased significantly at 1 week and 1 month after operation compared with that before operation in control group. Serum HBV-DNA concentration of the patients was decreased significantly at 1 week and 1 month after operation compared with that before operation in adefovir group. The ALT level of patients in adefovir group is signifi-cantly lower than that in control group. Conclusions Surgical procedure may result in HBV replication and antivirus treatment should be done perioperatively. Adefovir can inhibite replication of HBV and also improve the liver function of the chronic hepatitis B patients with colon cancer during operation.

Objective: TO verify through animal experiment the validity of chemical cholecystectomy . Methods: The experimental objects seven healthy juvenile pigs,hardener was infused into the gallbladder,after infusion the samples were collected by pathoiogical examination , according to the different duration under anesthestize. Reslts:The mucous destructive and digestive process remained with one week, the inflammatory reacton in two weeks,the chronic inflatoy reaction compained a a great deal of granu lation tissue and scar formation occurred in 4th-8th week,10 weeks latter,the inflmmatory reaction reduced ,and scar tissue formed. Conclusion: Chemical cholecystectomy is safe and reliable in clinical.

Objective:To explore and sum up diagnostic features and therapy for colorectal carcinoma with hepatic metastasis.Methods:48 cases of colorectal carcinoma with hepatic metastasis treated from Oct.1989 to Oct.1997.Results:The accuracy rates of ultrasound and CT were 18.2%,53.3% respectively.Of the 48 cases,10 cases underwent hepatectomies,10 cases ethanol injected to lives metastatic,8 cases chemotherapy via portal vein synchronously,8 cases intercurrent X-ray,12 cases abandon treatment.Conclusions:Colorectal carcinoma with hepatic metastasis is very difficult to diagnosis before operation,ultrasound and accuracy found on operation were the secure methods for diagnosis of colorectal carcinoma with hepatic metastasis.Hepatectoming is the first way for treating colorectal carcinoma with hepatic metastasis,others way are ethanol inject,chemotherapy via portal vein synchronously,interventional radiotogy,et al.

Objective:To evaluate the correlation between the prognosis of patients with hilar cholangiocarcinoma and the degree of bile duct dilatation in MRCP .Methods:The clinical data of 89 patients with hilar cholangiocarcinoma undergoing radical operation at Tianjin Nankai Hospital from Jan 2009 to Dec 2013 were analyzed retrospectively.Results:Tumor size ( P=0.024), Bismuth-Corlette classification ( P=0.048) and tumor stage ( P=0.013) were related factors of biliary dilatation. Tumor differentiation ( P=0.002), R 0 resection ( P=0.002) and biliary dilatation ( P<0.001) were independent predictors of disease-free survival (DFS). Conclusion:The imaging evaluation of the degree of biliary dilatation has a certain predictive value for the prognosis of patients with hilar cholangio-carcinoma.

Objective In order to solve the scaffold material and the cell source of the tissue engineering bile duct.This experiment was divided into two parts: ⑴To cultivate the vascular smooth muscle cell(VSMCs)in vitro and observe the cultivate status of the VSMCs in 3D environment of polylatic acid-polynlycolic acid(PLGA).⑵To explore the feasibility of differentiation of rat bone marrow stromal cells towards liver stem cells in vitro.Method ⑴To cultivate the VSMCs with PLGA(the film material with 3D material) after they were successfully cultivated,and to observe the cell growth status by inverted microscope,scanning electron microscope and MTT.⑵To culture rBMSCs in vitro by culturing the full bone marrow stem cells in a system containing hepatocte growth factor(HGF).The morphology of the cells was observed by inverted microscope,and the expressions of albumin,AFP were detected with ELISA and immunohistochemistry technique.Result ⑴The VSMCs growth is prosperous in vitro with good compatibility with PLGA.⑵After being cultured with HGF,the rBMSCs showed multilateral and ovary tansformation.The differentiated cells expressed albumin and AFP.Conclusion ⑴The VSMCs were successfully cultivated and purified in vitro and have good compatibility with PLGA.⑵ The rBMSCs have the ability to-differentiate into liver stem cells in vitro.The current studies provide the experimental basis for rBMSCs to differentiate into endothelial cells of the bile duct.

Objective To investigate the clinical efficacy and prognosis of lung transplantation in the treatment of cystic fibrosis (CF). Methods Clinical data of one patient with end-stage CF undergoing allogeneic bilateral lung transplantation were retrospectively analyzed. Clinical characteristics, diagnostic methods and treatment strategies of the CF recipient were summarized. Results The recipient had suffered from relevant symptoms since childhood including repeated cough and purulent sputum for 30 years, complicated with recurrent pulmonary infection combined with acute exacerbation, chronic sinusitis and extremely severe malnutrition. Prior to lung transplantation, the patient had to depend upon the invasive ventilator due to respiratory muscle weakness, and admitted to intensive care unit (ICU) for a long time. Imaging examination revealed multiple cystic columnar bronchiectasis accompanied with infection in bilateral lungs. The diagnosis of CF was further confirmed by sweat test and gene detection. The recipient underwent bilateral lung transplantation on August 17, 2017 and received rehabilitation treatment. The lung function was gradually restored to normal. The recipient had obtained the same quality of life to the healthy counterparts since the date of manuscript submission (over 2 years). Conclusions Lung transplantation is an efficacious treatment for end-stage CF, which can not only save patients' lives, but also significantly improve the quality of life of patients.

Acute cellular rejection (ACR) is a common complication after lung transplantation, which is mainly caused by the immune response of T lymphocytes recognizing the major histocompatibility complex on the cellular surface of grafts. It is currently considered as the main pattern of acute rejection. ACR is not only a direct cause of death of recipients, but also a high-risk factor for chronic rejection after lung transplantation. Nevertheless, it is a challenging task to deliver the diagnosis and treatment of ACR following lung transplantation. In this article, new progresses on the risk factors, pathogenesis, diagnosis and treatment of ACR in lung transplant recipients were summarized, aiming to improve the diagnostic and treatment efficiency of ACR and prolong the survival of recipients.

Acute kidney injury (AKI) is one of the common early complications after lung transplantation, which not only increases the short-term and long-term fatality of lung transplant recipients, but also significantly increases the incidence of long-term chronic renal insufficiency after surgery. In recent years, early AKI after lung transplantation has attracted high attention along with the rapid development of lung transplantation in China. In this article, research progresses on diagnosis, incidence, risk factors, prevention and treatment of early AKI after lung transplantation around the globe were reviewed, aiming to better identify the risk factors and poor prognosis of early AKI after lung transplantation, and provide theoretical and practical guidance for early clinical interventions.

Objective To analyze the risk factors and clinical prognosis of acute kidney injury (AKI) early after lung transplantation. Methods Clinical data of 155 recipients undergoing lung transplantation or combined heart-lung transplantation were retrospectively analyzed, and they were divided into the AKI group (n=104) and non-AKI group (n=51) according to the 2012 Kidney Disease: Improving Global Outcomes Clinical Practice Guideline. The incidence of AKI early after lung transplantation was summarized. The main indexes of recipients were collected. The risk factors of the occurrence of AKI early after lung transplantation were subjected to univariate and multivariate analysis. The clinical prognosis of lung transplant recipients was evaluated and the survival curve was delineated. Results The incidence of AKI early after lung transplantation was 67.1%(104/155), including 47 recipients with stage 1 AKI, 34 recipients with stage2 AKI and 23 recipients with stage 3 AKI, respectively. Sixteen recipients required continuous renal replacement therapy (CRRT) early after lung transplantation. Preoperative complication with diabetes mellitus, preoperative complication with pulmonary hypertension, intraoperative mean arterial pressure (MAP) < 60 mmHg, intraoperative massive blood transfusion, and treatment with excessive therapeutic concentration of tacrolimus (Tac) within postoperative 1 week were the independent risk factors for the occurrence of AKI early after lung transplantation. Up to the end of follow-up, 66 recipients (42.6%) died, including 50 recipients in the AKI group and 16 recipients in the non-AKI group. The cumulative survival rate in the AKI group was significantly lower than that in the non-AKI group (40% vs. 66%, P < 0.05). With the increase of AKI severity, the cumulative survival rate of lung transplant recipients was decreased. Conclusions AKI develops early after lung transplantation with high incidence and poor clinical prognosis. Preoperative complication with diabetes mellitus and pulmonary hypertension, intraoperative MAP < 60 mmHg and massive blood transfusion, and treatment with excessive therapeutic concentration of Tac within postoperative 1 week are the independent risk factors for the occurrence of AKI early after lung transplantation.