Recent studies have shown that complications of cirrhotic portal hypertension often involve multiple organs,which is called multiple organ dysfunction syndrome by some scholars.When muhiple organ failure occurs,there is a significant increase in patients'short-term death rate,and death rate is associated with the number of organs involved.This article briefly describes the physiopothologic mechanisms of portal hypertension and visceral vasodilation and summarizes the pathological changes of vital organs including the heart,lung,kidney,brain,and liver and related pathogenesis.At present,liver transplantation remains the most effective therapy,but it still has some shortcomings.It is pointed out that further studies are needed to investigate the mechanisms of action of each link in disease development,and more targets are needed in the future to prevent and treat multiple organ dysfunction syndrome in patients with liver cirrhosis.

Non-alcoholic fatty liver disease (NAFLD)is a clinical syndrome characterized by hepatic fat deposition, and not caused by chronic heavy drinking and other liver damage factors. The pathogenesis of NAFLD is associated with environmental,genetic,immune and other various factors. Early diagnosis is helpful not only for distinguishing between simple non-alcoholic fatty liver (NAFL)and non-alcoholic steatohepatitis (NASH),but also for grading the extent of NAFLD lesion and delaying its further development. This article reviewed the clinical research progress of non-invasive diagnosis and evaluation of NAFLD.

Objective To investigate the therapeutic effect and safety of albumin combination furosemide in treatment of eld cerebral hemorrhage patients,and provide evidence for clinical treatment of eld cerebral hemorrhage patients.Methods Two hundred eld cerebral hemorrhage patients were divided into control group (110 cases) and observation group (90 cases) by systematic sampling method.The two groups were given the monitor of vital signs,support of organ function,reduce of intracranial pressure and other conventional treatment,on the basis of which albumin (10 g,2 times/day) and furosemide (20 mg,intravenous injection) were given to observation group for 10 days.The levels of arterial blood lactate and vein serum C reactive protein (CRP) of 2 groups were compared at admission,treatment for 7 and 14 days.Moreover,the mortality rate of 2 groups at 14th day of treatment was also compared.Results There were no statistical differences in the condition of patients between the 2 groups at admission (P ＞ 0.05).The levels of arterial blood lactate of control group at treatment for 7 and 14 days were significantly higher than those of observation group [(2.56 ± 0.63) and (1.98 ± 0.65) mmol/L vs.(1.91 ± 0.70) and (1.28 ± 0.68) mmol/L],there were statistical differences between the 2 groups (P＜0.05).The levels of vein serum CRP of control group at treatment for 7 and 14 days were significantly higher than those of observation group [(120.02 ± 40.65) and (48.75 ± 30.11) mg/L vs.(60.52 ± 30.83) and (13.45 ± 6.02) mg/L],there were statistical differences between the 2 groups (P ＜ 0.05).The mortality rate at 14th day of treatment of control group was significantly higher than that of observation group [22.73％ (25/110) vs.13.33％ (12/90)],there was statistical differences between the 2 groups (P ＜ 0.05).Conclusion Albumin combination furosemide in treatment of eld cerebral hemorrhage patients can relieve the inflammatory reaction and decrease the mortality rate,it is expected to become the routine treatment in eld cerebral hemorrhage patients.

Objective To compare the clinical effect of small bone flap craniotony and skull drill drainage in treatment of hypertensive cerebral hemorrhage.Methods Ninety -eight patients with hypertensive cerebral hemorrhage were classified into group A and group B by random number table with 49 cases in each.Group A was used small bone flap craniotony,and group B was used skull drill drainage.The clinical effects between two groups were compared.Results The short-term total effective rate in group A was 83.7％(41/49 ),which was significantly higher than that in group B with 65.3％(32/49 )(P ＜ 0.05 ).The long-term good rate in group A was 55.1％(27/49),which was significantly higher than that in group B with 26.5％ (13/49) (P ＜ 0.05 ).Conclusion Both the short-term and long-term effective rate of small bone flap craniotony for hypertensive cerebral hemorrhage are better than skull drill drainage.

AIM: To investigate the antitumor effect and mechanism of trichosanthin (TCS) on melanoma B-16 cells. METHODS: (1) The injury of B-16 cells by trichosanthin was observed with SCGE and hoechst33258 staining method. (2) LCSM and specificity fluorescent probe Fluo-3/AM, H2DCF-DA, DAF-FM diacetate were applied to analyze the dynamic changes of Ca2+, ROS and NO in single cell cultured with TCS. Simultaneously, the relationship between ROS, NO and increase of Ca2+ was also revealed. RESULTS: (1)When treated with TCS (50 mg/L) for 3 h and 6 h, neither cytotoxicity assay nor SCGE showed the differences compared with control group. After 12 h incubation, specificity phenomena of DNA injury-comet tail appeared in SCGE and chromatin condensation even apoptotic body formation were seen by Hoechst33258 staining. (2) TCS (50 mg/L) evoked rapid enhancement of the production of Ca2+, ROS and NO in the cell and the differences between TCS and control group had statistical significance (P

Objectives To analyze the deployment of medical equipment and its impacts on medical services of hospitals.Methods Existing data collection,a survey of public hospitals and a chart review of acute myocardial infarction(AMI)inpatients were used to collect related data.Gini coefficients,Chi-square and multivariate model were used to analyze deployment of medical equipment and its impacts on medical services.Results The number of CTs and that of CTs per million population in Pudong new area were higher than those of MRIs and DSAs,and the distribution of CTs among districts in Shanghai was relatively equal(Gini coefficient was 0.20).But lack of DSAs in some public general hospitals had affected the AMI inpatient care.Conclusions Public hospitals and governments in China should keep at a balance the demand of medical services,deployment level of medical equipment,and financial affordability for the society,governments and hospitals.

Objective: To evaluate the cytotoxic effect of PEM? induced by HSPgp96 on anti-tumor in vitro. Methods; PEM? separated from mice induced by thioglycolate were divided into three groups randomly: Culture medium in control; LPS-induced group; HSPgp96-induced group. The production of NO, the cytotoxic effect to H22 cells and the morphologic change of PEM? were investigated separately by enzyme method, MTT assay and scanning electron microscope. Results: In vitro, HSPgp96 can increased NO production from PEM? of mice and significantly enhance the cytotoxic effect of PEM? to H22 cells as well as LPS. Conclusion: HSPgp96 can effectively induce the cytotoxic effect of PEM? on anti-tumor in which NO is one of the capital effective molecules in vitro.

Objective To explore ultrastructure and cytoskeleton characteristics of bone marrow-deftved mesenchymal stem cells (MSCs) in patients with systemic lupus erythematosus (SLE).Methods MSCs were isolated from bone marrow of 2 SLE patients and 2 healthy controls.Their ultrastrnctures were examined by transmission electron microscope (TEM).The expression pattern of actin and vinculin was assessed by laser confocal microscopy (LCM).Results MSCs in patients with SLE presented with signs of ageing and lots of autophagosome could be found in most of the cells.F-actin was aggregated and condensed at the:border of cytoplasm.Vinculin was arranged disorderly and condensed in the cytoplasm.Conclusion The change of uhrastructure and cytoskeleton patterns of bone marrow derived mesenchymal cells of SLE patients may play an important role in the abnormal proliferation of these cells in vitro.

In recent years, some scholars have put forward the “ascending” pathophysiology of cholestatic liver disease, especially in primary biliary cholangitis (PBC) and primary sclerosing cholangitis (PSC). According to this theory, cholestatic liver disease develops from the bottom to the top of the anatomical structure over time. Primary or early lesions are usually located in the “downstream” bile duct, with a major cause of immune-mediated biliary necrotizing inflammatory injury. When cholestasis occurs, the toxic effect mediated by bile salt will lead to the injury in the “upstream” liver parenchyma. Therefore, bile toxicity is of great importance during disease progression. According to this theory of “ascending” pathophysiology, there are different locations and causes of the disease in different disease stages, and therefore, it is necessary to establish a staging system for cholestatic liver disease and use different drugs in different stages, in order to use the existing drugs in a more effective manner and give directions for new drug development. However, there are still no early biochemical markers for cholestatic liver disease, and current clinical work should focus on the search for biomarkers with strong specificity and high sensitivity.

Objective: To observe the effect of electroacupuncture (EA) at different time points during the perioperative period on the recovery of gastrointestinal function after gastrointestinal malignant neoplasms surgery. Methods: Sixty-three patients who needed radical surgery for gastrointestinal tumors were randomized into a control group, treatment group 1 (postoperative EA group), and treatment group 2 (intraoperative and postoperative EA group). The control group received surgery and conventional Western medicine treatment, and treatment groups 1 and 2 received additional EA treatment at different time points. The initial flatus time after the surgery, visual analog scale (VAS) score at different time points after the surgery, the proportion of using patient-controlled analgesia (PCA) after the surgery, and the times of adding analgesics were observed in the three groups. Results: The initial flatus time after the surgery was earlier in treatment groups 1 and 2 than in the control group (P<0.05); the difference between treatment groups 1 and 2 was statistically insignificant (P>0.05). The VAS score was lower in treatment group 2 than in the control group at 6, 12, 24, and 72 h after the surgery (P<0.05); the VAS score was lower in treatment group 1 than in the control group only at 72 h after the surgery (P<0.05). There were no significant differences in the rate of using PCA among the three groups (P>0.05). Regarding the times of adding analgesics, it was less in treatment group 2 than in the control group at 12 h after the surgery (P<0.05). Conclusion: Either EA during and after the surgery or only after the surgery can hasten the initial flatus and boost the recovery of gastrointestinal function in patients after radical resection of gastrointestinal neoplasms. Successive EA during and after the surgery should be superior to postoperative EA regarding the analgesic effect after the surgery.