Objective To evaluate the clinical efficacy of silybin combined with nucleotides in the treatment of viral hepatitis associated with nonalcoholic fatty liver disease (NAFLD).Methods 88 viral hepatitis patients with NAFLD were randomly selected into the clinical research,and they were divided into groups according to the order of treatment.Among them 44 cases of single number were the control group treated with nucleoside(acid) drugs,44 cases of double number were the observation group treated with silibinincombined silybin combined with nucleoside(acid).The therapeutic effect after the end of the course of treatment were was evaluated.Results The effective rate in the observation group was 90.91％,which that in the control group was 70.45％,the difference was statistically significant (x2 =8.87,P ＜ 0.05).The ALT,AST,r-GGT after treatment of the observation group were (37.14 ± 3.56) U/L,(30.45 ±3.35) U/L,(51.65 ± 3.46) U/L,which were significantly reduced than before treatment(t =8.01,8.72,7.80,all P ＜ 0.05),and the differences were significant compared with the control group (t =7.57,8.34,7.29,all P ＜ 0.05).The TG,TC of blood lipid indexes indices after treatment of the observation group were (1.48 ±0.26) mmol/L,(5.18 ± 0.86)mmol/L,which were significantly lower than those before treatment (t =7.62,8.14,all P ＜ 0.05),and the differences were significant compared with the control group (t =7.10,7.55,all P ＜ 0.05).Conclusion The combination of silybin and nucleotides in the treatment of viral hepatitis with NAFLD has significant effect,can significantly improve the clinical symptoms and liver function indicators,and gradually restore the level of blood lipids,it is worthy of promoting the application.

Objective:To observe the effect of Notch signal inhibitor DAPT (γ-secretase inhibitor ) on the pathological changes of atherosclerosis mice and the immune balance of Treg/Th17.Methods:24 ApoE knockout C57BL mice were randomly divided into blank group,model group and DAPT group.The blank group were fed with normal diet ,the model group and the experimental group were fed with high fat diet.After 5 weeks of feeding,the mice in the experimental group were injected with DAPT [100 mg/(kg· d),re-suspended in DMSO],and the other two groups were injected with the equivalent amount of DMSO .After another 5 weeks,pathological changes of the mice in each group were analyzed by HE staining .ELISA was used to detect the level of IL-17 in plasma,and the propor-tion of splenic Treg/Th17 cells in each group was detected by flow cytometry .Results:HE staining results showed that the model group had obvious plaque formation and foam cell formation ,which showed that the AS model was successfully prepared .The degree of arterial disease in the DAPT group was significantly less than that in the model group .The plasma levels of IL-17 in the blank group , model group and DAPT group were(293.94±28.59),(454.05±172.68) and (335.40±89.57) pg/ml,respectively .The percentages of Treg cells in the blank group,model group and DAPT group were(3.80±0.56)%,(2.54±0.38)%and(4.73±0.64)%,respective-ly.The Th17 cell subsets of mice in the blank group , model group and DAPT group were ( 3.46 ±0.23 )%, ( 4.52 ±0.85 )% and (1.38±0.37)%,respectively .Conclusion:DAPT decreased the plasma level of IL-17 in AS mice,inhibited the differentiation of Th17 cell subsets,and promoted the differentiation of Treg ,and reduced the atherosclerosis by changing the Treg/Th17 cells immune balance.

ObjectiveTo explore the changes of systemic inflammatory response syndrome (SIRS)after cardiopulmonary resuscitation to provide basis for clinical prevention and treatment. MethodsForty rabbits were divided into the sham-operated group; the cardiac arrest for 4 minutes, 5 minutes and 6 minutes groups randomly (random number). Then the rabbits were anaesthetized, retrograde tracheal intubated .The cardiac arrest were induced by aphysia to all rabbits except the sham-operated group and the cardiopulmonary resuscitation were performed after 4, 5 and 6 minutes. The physiological parameters were evaluated at 24, 48, 72, 96 and 120 h after cardiac arrest. The serum samples were taken at the same to detect the level of tumor necrosis factor-α (TNF-α), C-reactive protein (CRP) and white blood cell.The data were analysed by repeated measure variance. ResultsThe SIRS were presented at all cardiopulmonary resuscitation groups after 24 h of cardiac arrest. Compared to the sham-operated group, the level of TNF-α and CRP in resuscitation groups was significantly increased ( P ＜ 0. 01 ). To the group arrested for 4 minutes, the SIRS were higher at 24 ～ 48 h and dissipated at 72 h. To the groups arrested for 5 or 6minutes, SIRS were lasted for 96 h. ConclusionsSIRS is easy to recover if resuscitation was taken within 4 minutes after cardiac arrest. After 5 minutes, SIRS is severe and hard to recover. Serum TNF-α is a sensitive marker to evaluate SIRS and can be used as the supplymentary diagnosic marker of SIRS to providing early treament and prevention.

Objective To assess the efficacy of orthotopic liver transplantation (OLT) for hepatocellular carcinoma (HCC) and the effect of recipient selection on postoperative survival. Methods The clinical data of 63 patients with primary HCC receiving OLT in this hospital from June 2000 to February 2007 were retrospectively analyzed. The cumulative survival rate after transplantation was analyzed by the Kaplan-Meier method. Results The 1-, 3- and 5-year cumulative survival rates of the 63 patients were 77.4%, 59.3%, 48. 9%, respectively. The rates in conformation with Milan criteria, UCSF criteria and beyond UCSF criteria were 93.8%, 80.8%, 80.8%; 92.1%, 79.2%,79.2%; 29.2%, 8.3%, 0, respectively. The 1-, 3-, 5-year cumulative recurrent rate of patients meeting Milan criteria, UCSF criteria and beyond UCSF criteria was 6.2%, 15.5%, 19. 2%; 7. 9%,15.9%, 20. 8% ; 70. 8%, 87. 5%, 91.7%, respectively (P＜0.01). However, tumor recurrence and survival rates were similar for patients meeting UCSF and Milan criteria (P＞0. 05). Conclusion Expansion of OLT criteria is justified for HCC and does not adversely impact the posttransplant prognosis by the UCSF criteria as compared with the Milan criteria.

Objective To study the relationship between obstructive sleep apnea syndrome(OSAS) in the elderly and the occurrence and development of arrhythmia. Methods A total of 120 OSAS patients and 40 normal controls were selected and their polysomnography(PSG) or dynamic blood oxygen and analyzed holter were monitored. Results The total number of the reduction in apnta hypopnea index (AHI) and arterial orygen saturation (SaO 2) over 0.04 and the lasted period during SaO 20.05), while the incidences of the intermediate and serious groups significantly increased(P