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 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.

Objective:To search for the optimum formula for the self emulsification of evening primrose oil. Methods: Through solubility experiment, orthogonal screen and drawing phase diagram, taking the degree of emulsifying, the volume of the rest oil and emulsion particle size as parameters,the oil, non ionic surfactant and flux for the optimum formulation were screened. Results: In the formulation of evening primrose oil, taking Tween 85 as the non ionic surfactant and propylene glycol as the co surfactant can get the best effect of emulsifying. Conclusion: The optimum formula for self emulsification of evening primrose oil is evening primrose oil, Tween 85 and propylene glycol,with their proportion being 5∶7∶3.

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 .

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 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 clinical significance of procalcitonin(PCT) in the diagnosis of bacterial infection in burn pa‐tients .Methods Among 169 burn patients ,96 cases were bacterial infection confirmed by blood ,secretion and puncture fluid culture and 73 cases were non‐bacterial infection .PCT ,WBC and hyper sensitive C reactive protein (hs‐CRP) were detected .The diagnostic values in bacterial infection were compared among these 3 indexes and the relationship between PCT level and burn degree was fur‐ther studied .Results Serum PCT ,WBC and hs‐CRP levels in the bacteria infection group were obviously higher than those in the non‐bacterial infection group(P<0 .05);the sensitivity ,specificity ,positive predictive value and negative predictive value of PCT were 90 .63% ,89 .04% ,91 .58% and 87 .84% respectively ,which indicated that PCT had higher diagnostic value than WBC and hs‐CRP .The PCT level was positively correlated with the degree of burn degree .Conclusion Serum PCT ,WBC and hs‐CRP in the burn patients with bacteria infection are greatly increased .PCT as the marker of bacterial infection has the higher sensitivity and specificity than WBC and hs‐CRP in the diagnosis of bacteria infection .

Objective To investigate the expressions of ALCAM,IL-17RA and PIK3CA in patients with non-small cell lung cancer,and to investigate the correlation between the above-mentioned indexes and patients′ prognosis.Methods A total of 65 patients with non-small cell lung cancer admitted to the third People′s Hospital in Liaocheng City were selected and were served as study objects.Immunohistochemical staining(S-P) method was used to detect the expression of ALCAM,IL-17RA and PIK3CA in tissues to analyze the difference of expression between different pathological parameters.And 65 patients were followed up after the operation to compare the survival time of patients in the negative expression group and the positive expression group,and to analyze the correlation between ALCAM,IL-17RA and PIK3CA and the prognosis of the disease.Results Among the 65 cases of patients,47 cases were positive for ALCAM with the positive rate of 72.3%,34 cases were positive for IL-17RA with the positive rate of 52.3%;31 cases were positive for PIK3CA with the positive rate of 47.7%.There was significant difference in the expression of ALCAM,IL-17RA and PIK3CA in patients with different pathological types,TNM staging and lymph node metastasis(P<0.05).There was no significant statistical difference in the expression of patients with different genders and ages(P>0.05).The median survival time of patients with positive results of ALCAM,IL-17RA and PIK3CA were lower than those of negative group,and the differences were statistically significant(P<0.05).Conclusion The expression of ALCAM,IL-17RA and PIK3CA increased in non-small cell lung cancer tissues to remind the higher degree of malignancy and poor prognosis.