Objective To summarize the experience of establishing a split liver transplantation pig model using extracorporeal normothermic machine perfusion (NMP).Methods Twenty miniature pigs were purchased with ten as donors and another ten as receptors.The graft was spliced along Taira line and the right half was reserved for transplantation.Hemodynamics and bile production volume were monitored,and blood biochemical and blood gas analysis indicators were detected during machine perfusion.Pathological change was observed by HE stain.Hemodynamics during liver transplantation,5-day survival rate and the cause of death were recorded.Results Hemodynamic,biochemical and blood gas analysis indicators remained stable during NMP.All receptor pigs were successfully extubated and awake after surgery.Two receptors died on the second day after the operation.The 5-day survival rate was 80％.Conclusion The split liver transplantation pig model using extracorporeal normothermic machine perfusion is feasible and appropriate,and it lays the foundation for further investigation.

Ischemia reperfusion injury (IRI) is a multistep pathophysiological process involving a complex of multi-factors.To alleviate the IRI is of great importance in clinical liver transplantation,especially for marginal donor livers.This article overviewed the protective strategies and the latest progress for alleviation of IRI in three stages of liver transplantation,which includes liver procurement,preservation and reperfusion.

Objective To approach the effect of blocking the JAK-STAT signal pathway in the treatment of rat's rheumatoid arthritis.Methods Thirty-six arthritis rat models,which had arthritis index more than 2 scores,were built successfully by Department of Rheumatology and Immunology,the First Affiliated Hospital of China Medical University,and they were divided into model group one and two,low dose of AG490 group,middle dose of AG490 group,high dose of AG490 group and leflunomide group.Besides,6 rats were treated as normal control group.And they were given normal sodium 1 mL,AG490 1、5、10 mg/(kg?d)and leflunomide 10 mg/(kg?d) by intraperitoneal injection or intragastric administration,then all the rats were sacrificed after 44 days.After that,compared the weight,arthritis index,the volume of toe,pathological score,and the change of p-STAT1,p-STAT3.Results The arthritis of model group developed rapidly,and the arthritis index,the volume of toe increased obviously,and the expression of p-STAT1 and p-STAT3 increased and the body weight decreased,all of which had significant meaning compared with that of control group.The body weights of rats in low dose group of AG490 were heavier than that of control group,the symptom of arthrocele in low dose group of AG490 was lighter than that of control group,and could inhibited the activation of JAK-STAT signal pathway in some degree,but the arthritis index numbers and the pathological score had no significant difference from that of model group.The body weights,arthritis index,the volume of toe and pathological score in middle dose group of AG490 improved obviously(P

Objective To evaluate the clinical efficacy of percutaneous transhepatic biliary drainage (PTBD) and pcrcutaneous transhcpatic insertion of biliary stent (PTIBS) for malignant biliary obstruction.Methods PTBD or PTIBS were performed in 56 patients with malignant biliary obstruction, which were aused by hepatic carcinoma (n = 14), biliary duct carcinoma (n = 11), gallbladder carcinoma (n = 5),stomach carcinoma accompanied with metastasis of lymph node (n = 14), carcinoma of ampulla (n = 1 ) or carcinoma of pancreatic head (n = 11 ). The diagnosis was confirmed by ultrasonography, CT or MRI in all patients. The obstructed site was well identified, including high obstruction in 19 patients and lower obstruction in 37 patients. Based on the imaging findings, suitable interventional procedure was employed.Results PTBD or PTIBS were performed successfully in all 56 patients, of them PTBD was adopted in 11,PTIBS in 40 and both PTBD and PTIBS in 5. The serum total bilirubin decreased from (295.65±152.86)μmol/L before the procedure to (151.05 ± 107.36) μmol/L after the procedure, (P < 0.01 ). Postoperative infection could affect the fading of jaundice (P < 0.01 ), but the location of the obstruction carried no relationship with the fading of jaundice (P = 0.063). Conclusion Both PTBD and PTIBS are safe and effective palliative therapies for malignant biliary obstruction, which can markedly relieve patient of jaundice,improve the quality of life and elongate the survival period.

Objective To explore the effect of the JAK/STAT signal pathway on the apoptosis-related gene in the synovial tissue of rat rheumatoid arthritis (RA).Methods Fifty rat models of collagen-induced arthritis,whose arthritis index was more than 2,were divided into the model group,the low dose of AG490 group,the medium dose of AG490 group and the high dose of AG490 group.In addition,6 rats were treated intraperitoneal injection.Then,the arthritis index and the change of apoptosis-related genes were compared.Multiple-sample average was analyzed by single-factor x2 test and LSD-t or Tamhane's T 2 test were used for two-two comparison.Results The arthritis index of the model group increased evidently,and the apoptosis inhibitor Bcl-2,Bcl-xl gene and protein expression was up-regulated,which was significantly different when compared with that of the control group(0.931±0.035 vs 0.351±0.024,0.920±0.037 vs 0.271±0.029,0.322±0.047 vs 0.230±0.031 ).The expression of apoptosis promoting factor Bax wasslightly up-regulated.The blockage of JAK/STAT pathway cotld down-regulate the expression levels of the gene and protein of survivins Bcl-2 and Bcl-xl,and up-regulate the gene and protein expressions of Bax.Conclusion In the process of RA development,apoptosis inhibitor Bcl-2,Bcl-xl gene and protein expression is up-regulated.JAK/STAT signal transduction pathway regulates the apoptosis process.

By reviewing the status of domestic intellectual property right and patent in particular the authors pointed out that the key of increasing the number of patents and patent quality is to promote the trans formation of research achievements and the management of research achievements.Based on the framework scheme of the transformation chain of research achievements.four major stages of patent management were described，which contained ①the planning and design of patent index in the initial management of research achievement，②the forming and outputting of patents in the management of the formation of research a chievement and patent forming，③implementing and industrialization of patents in the stage of industrializing of research achievement and patent，④realizing the maximum efficiency of patents and establishing patent net in the stage of research extension and patent implementing.

Bronchial asthma is the most common chronic respiratory disease in children.With the increasing use of inhaled corticosteroids, asthma deaths in the world have decreased by nearly two thirds.Mortality of childhood asthma is very low, ranging from 0 to 0.7/100 000, however, most of risk factors of asthma death could be avoidable.Risk factors of asthma death include poor asthma control, poor treatment compliance, insufficient medicine prescribed by doctors, insufficient monitoring of lung function, mental and psychological problems, food allergy, insufficient recognition and treatment of asthma exacerbation, improper use of β 2-receptor agonist, insufficient application of asthma action plan, et al.The mortality and risk factors of asthma in children were reviewed, which could support further improving asthma management strategies.

Objective To investigate the joint action mechanism of structural empowerment, psychological empowerment and job satisfaction of nursing staff in China,and probe into a joint action mechanism of such structure and empowerment on their satisfaction.Methods Totally 300 nurse specialists from secondary and tertiary hospitals in Anhui province were selected in a convenience sampling for investigation,by means of a general information questionnaire,Minnesota Satisfaction Questionnaire,Conditions of Work Effectiveness Questionnaires-Ⅱ and Psychological Empowerment Scale.Results The nurses′job satisfaction were positively associated with both their total scoring and individual dimensions of the structural empowerment and psychological empowerment.As shown in the structural equation modeling,the model (the pathway from structural empowerment to nurses′ job satisfaction and the mediating effect of psychological empowerment are significant)fitted the data well. Conclusions Nursing managers can use the empowerment theory to fully leverage their management advantages,creating a desirable environment for the nursing staff at large.

Objective To explore the incidences of ventilator-associated pneumonia (VAP)in intensive care units (ICUs)in China.Methods From October 2013 to September 2014,46 hospitals in 12 provinces and cities were se-lected to participate in the study,all patients admitted to ICUs were included,the incidences of VAP were surveyed and compared with data from the U.S.National Healthcare Safety Network (NHSN).Results A total of 17 358 patients were surveyed,the total patient-days were 176 096 d,the total catheter-days were 91 448 d,813 patients developed VAP,the incidence of VAP was 8.89/1 000 catheter-days,VAP mainly occurred in general ICUs (76.74%);the incidences of VAP were varied with patients in different types of ICUs,ranging from 4.50/1 000 catheter-days to 32.79/ 1 000 catheter-days.Conclusion The incidence of VAP in patients in ICUs at 46 hospitals in China is significantly higher than that reported by NHSN,even higher than the P90 .