The proper evaluation to the hepatic function can be used to decide the operative methods as well as the preparation of the operation.This can ensure the safety of the operation and the recovering after the operation.we also find that be tied in the intergation of Chinese and western medicine treats phase,may relieve patient's symptom within short time.This is also embody that the doctor of traditional Chinese medicine"Cures not disease".

Objective To explore the effect of reconstruction on old rupture of finger flexor tendon. Methods There were 30 patients (54 fingers) with old rupture of finger flexor tendon. The silica gel stick was implanted at the first stage. The palmaris longus tendon wrapped in the bioabsorbable membrane replaced the silica gel stick and was implanted at the second stage. The effectiveness was assessed by total active movement (TAM). Results There were 30 fingers as excellent, 20 fingers as good among 54 fingers of 30 patients. The percent of excellent and good was 92.6%. Conclusion Modified reconstruction is effective to prevent from tendon adhesion.

Objective To understand the etiology of acute hepatitis B (AHB) in adults and investigate the mechanisms of hepatic injury and viral clearance in AHB. Methods One hundred and twenty adult AHB patients were enrolled. Epidemiological and clinical data were collected from the case history records or face-to-face inquiry, and serum samples were collected during hospitalization and follow-up. To observe dynamic patterns of AHB etiology, the markers of hepatitis B virus (HBV) were detected by enzyme-linked immunosorbent assay (ELISA); the level of HBV DNA and HBV genotype were determined by real-time polymerase chain reaction (PCR). Enumeration data were analyzed by non-parametric rank sum test. Comparison between groups was done by t test and that between rates of samples was done by Pearson χ2 test. Results Serum HBV DNA was positive in 48.33% of patients at the time of diagnosis with mean level of 9.84×04 copy/mL, and became undetectable after 12.5 days on average. The median levels of serum alanine aminotransferase (ALT) were 1600 U/L and 1490 U/L in HBV DNA positive and negative groups, respectively (z=-0. 678, P=0. 498). However, the mean levels of serum ALT were (2058±123) U/L and (1393±139) U/L in groups of HBV DNA<1×104 copy/mL and>1×104 copy/mL, respectively, which was significantly different (t=-2.17, P=0. 049). Genotype B accounted for 52.5%, genotype C 42.5 and genotype B and C mixed type 5.0% in 58 patients with HBV DNA positive. Eight patterns of serum HBV markers were presented at first visiting. HBsAg(+), HBeAg(+), anti-HBc(+), anti-HBc IgM(+) and HBsAg(+), anti-HBe(+), anti-HBc(+), anti-HBc IgM(+) were the most common patterns, which accounted for 38.3% and 30.0%, respectively. The dynamic patterns of serum HBV markers of 28 AFIB patients were prospectively followed up. The rate of serum FIBsAg loss was 100. 0% and the median time of negative-conversion was 3 weeks. The cumulative positive rate of anti-HBs was 85.7% after 52 weeks of follow-up. The rate of serum HBeAg loss was 100.0%. HBeAg was negative in 53.6% of patients at first visiting and the rest of patients achieved negative within 4 weeks after onset. The positive rate of anti-HBe was 82.1% during 52 weeks of follow-up. Total anti-HBc (including IgG and IgM) was keeping positive in all patients within 52 weeks, and the negative rate of anti-HBc IgM was 39. 3% after followed up for 52 weeks. Conclusions Rapid HBV clearance andserum HBV marker conversion are significantly different between AHB and chronic hepatitis B.

Objective To investigate the pathogen culturing of the catheter related infection(CRI),cathe-ter related bloodstram infection(CRB)and risk factors after central venous catheter(CVC)of cardiovascular surgery in order to provide the beneficial reference.Methods From Jan 2005 to Dec 2005,a total of 300 cases central ve-nous cathers were determined,and the cusp of the catheters was determined by bacteria cultivation,and blood bacte-ria cultivation.Results The infection happened in 35 of 300 patients with inserted central venous catheter.The cusps of CRI rate was 11.7%.CRB rate was 1.7%.54.3%pathogens were gram-positive cocci,34.3% were gram-negative bacilli,11.4% were fungi.The most common strain were Staphylococcus epidermis,Staphylococcus aureus,Klebsiella pneumoniae,Pseudomonas aeruginose,and Candiadia albicans.The infection rate increased obviously when the dwelling time>6 d.Conclusion CRI and CRB are the most severe complication of CVC,and it is important to cut down the death with the early diagnosis and applying antibiotics rationally.

Objective To investigate the regulation on extracellular signal regulated kinase (ERK )1/2 and p38 signaling pathways and immune expression by moist exposed burn therapy/moist exposed burn ointment(MEBT/MEBO)in diabetic foot and their relationship ,to explore the repair mechanism of MEBT/MEBO on diabetic foot ulcers .Methods Totally 40 diabetic foot pa‐tients were treated by MEBT/MEBO ,to take wound tissue before and after treatment and detect the expression of ERK 1/2 ,p38 , MAPKK6 ,c‐myc ,Akt ,ATF2 ,IgA ,IgM ,IgG ,C3c and C4c by immunohistochemistry ,to investigate their relationship .Results Af‐ter treatment with MEBT/MEBO ,the area of foot wounds in 39 patients was reduced in different degree .Only one patient had no obvious change .14 patients(35 .00% ) were markedly effective ,25 patients(62 .50% ) and 1 patient(2 .50% ) were ineffective .Before andaftertreatment,allpositiveexpression,positiveimmunoreactivity(anyindex)andpositiveexpression(specificindex)ofsignal pathway molecules were statistically significant (P<0 .05) .While the positive rate of molecular expression in wound pathway in‐creased ,the positive expression rate of immune factor increased .Before treatment ,a small amount of immune factors were found in the wound tissue .After treatment ,the immune factors IgA ,IgM ,IgG ,C3c ,C4c were distributed widely and diffusely .Before treat‐ment ,the wound tissue showed a very small number of signal molecules .After treatment ,the signal pathway molecules MEBT/MEBO and p38 ,MAPKK6 ,c‐myc ,Akt ,ATF2 showed broad and diffuse distribution .Conclusion MEBT/MEBO may promote the expression of ERK1/2 and p38 signaling molecules and immune in diabetic foot ,p38 and ERK1/2 signaling pathway may promote the healing of diabetic foot wound by increasing the expression of immune .

Objective To investigate the effects and mechanism of interleukin 33 (IL-33) on renal tubular injury in mice with lupus nephritis.Methods Twelve-week-old female MRL/lpr mice were randomly divided into model group,IL-33 group and solvent control group with 10 rats in each group.Ten female MRL/MP mice of the same age were used as normal control group.The mice in IL-33 group were intraperitoneally injected with 100 μL of phosphate buffer saline (PBS),containing 2 μg of recombinant mouse IL-33,once a day for 14 days.The mice in control group and the model group were intraperitoneally injected with the same dose of PBS.All the mice were sacrificed at 14 weeks of age.Serum creatinine (Cr) and urea nitrogen (BUN) concentrations were determined by serum separation.The urine in 24 hours was collected testing urinary protein creatinine ratio and urinary protein quantification.The contents of E-cadherin,α-SMA,and JAK/STAT pathway signaling proteins,including JAK2,p-JAK2,STAT1,and p-STAT1,were detected by Western blot.Results The BUN,urinary protein creatinine ratio and urine protein level of the IL-33 group were significantly higher than those of the model group (all P＜0.05).The expression of renal tubular epithelial cells o-SMA in the IL-33 group was higher than that in the model group,and the difference was statistically significant (P＜0.05).Compared with the model group,the expression of E-cadherin in the tubular epithelial cells of IL-33 group decreased and the expression of p-JAK2 and p-STAT1 protein increased,and the differences were all statistically significant (all P＜0.05).Compared with the model group,the levels of JAK2 and STAT1 in IL-33 group change little,and the differences were not statistically significant (all P＞0.05).Conclusions IL-33 can cause tubulointerstitial lesions in lupus mice,and its mechanism may be related to the activation of JAK/STAT pathway.

Objective To explore the mechanism of Dahuanglinxian Capsule for intervening gallstone formation by regulating the expression levels of ABCB11 and ABCC2 mRNA and protein.Methods Forty male C57BL/6 mice were divided into the normal group(group N),model group (group M),ursodeoxycholic acid group (group U) and Dahuanglinxian Capsule treatment group (group D),10 cases in each group.The group N was fed with normal diet,while the group M,U and D were fed with lithogenic fodder for 8 weeks.Meanwhile the group U and D were given the medication intervention,once daily,for continuous 8 weeks of gavage.After successful modeling,mRNA and protein expression levels of ABCB11 and ABCC2 were detected by RT-PCR and immunohistochemistry.Results Compared with the other three groups,the expressions of ABCB11 and ABCC2 mRNA gene and protein in M group were significantly reduced(P＜0.01);while,there was no statistical difference in the expressions of ABCB11 and ABCC2 mRNA and protein between the group D and N(P＞0.05).Conclusion Dahuanglinxian Capsule can prevent the gallstone formation by regulating the expression of ABCB11 and ABCC2 mRNA and protein.

Objective: To investigate the effect of intrauterine intervention on severe primary fetal hydrothorax. Methods: Twelve cases with severe fetal primary hydrothorax who underwent prenatal intervention from January 2014 to December 2017 in Guangdong Women and Children Hospital were retrospectively reviewed. Results: The median gestational age of prenatal diagnosis was 30.8 weeks (24.0-33.0 weeks) . All cases were excluded congenital chromosomal abnormalities by prenatal diagnosis, and had no complications of pregnancy during prenatal diagnosis and had hydrothorax. Three cases (3/12) were right hydrothorax, the other 9 cases (9/12) were bilateral. Thoracoamniotic shunting was performed in 7 cases (7/12) . Thoracentesis was performed in 5 cases (5/12) , and the hydrothorax reappeared soon after operation in 4 cases, shunt placement was performed again. The hydrothorax was dissolved in 2 cases, released in 6 cases.Tube falling off occurred in 1 case,treatment was abandoned in 1 case and intrauterine fetal death happened in 1 case, and 1 case wasn′t rechecked by ultrasonic due to premature birth following thoracentesis. In 10 cases who had deliveries, 5 newborns (5/10) were premature, 6 newborns (6/10) underwent assisted mechanical ventilation, 8 newborns (8/10) underwent thoracic close drainage, all of them were discharged when hydrothorax resolved. Conclusions Antenatal intervention may improve the chance of survival in severe primary fetal hydrothorax. Thoracoamniotic shunting is the first-choice for the primary severe fetal hydrothorax.

Objective:To study the feasibility and safety in treatment of trauma to right posterior liver using laparoscopic surgery with patients in the left semiprone position.Methods:The clinical data of consecutive patients who were diagnosed to have trauma to the right posterior liver and were treated with laparoscopic surgery with patients in the left semiprone position at the Department of Hepatobiliary Surgery, the Affiliated Hospital of Youjiang Medical University for Nationalities between February 2016 and August 2020 were retrospectively analysed. The patients’ gender, age, mechanisms of injury, operative methods, operative time, amounts of abdominal effusion, degrees of liver injury, extents of intraoperative bleeding, amounts of postoperative drainage, lengths of postoperative hospital stay, and major postoperative complications were recorded and analyzed.Results:Among the 18 patients, there were 16 males and 2 females, aged (41.6±14.4) years. The mechanisms of liver trauma were caused by fall injury ( n=10), traffic accidents ( n=4), blunt injury ( n=2) and penetrating injury ( n=2). The levels of injuries were level Ⅲ in 16 patients and level Ⅳ in 2 patients. Laparoscopic suture repair was performed in 8 patients, partial hepatectomy in 4 patients, electrocoagulation hemostasis in 4 patients and ligation of bleeding vessels in 2 patients. All were successful in hemostasis. Abdominal effusion was (1 528.8±373.2) ml, intraoperative blood loss (80.6±16.7) ml, operation time (88.5±9.1) min, postoperative hospital stay 7 days and postoperative total drainage (93.8±13.6) ml. Ten patients were complicated with right pleural effusion, and they recovered with conservative treatment. There were no bile leakage, infection and other complications. Conclusion:Trauma to right posterior liver treated with laparoscopic with surgery patients in the left semiprone position had the advantages of adequate exposure which facilitated surgical hemostasis, resulting in minimal collateral damages and short hospital stay. The treatment was feasibility and safe.