ObjectiveTo summarize the complications after precise hepatectomy for primary liver cancer and explore the prevention experiences.MethodsThe clinical data of 120 primary liver cancer patients who underwent precise hepatectomy in Anhui Provincial Hospital from August 2008 to October 2011 were retrospectively analyzed.The common complications after hepatectomy and the management measures of the complications were studied.Results Related complications were found in 19 cases,including 7 cases of pleuraI effusion,3 cases of pneumonia,1 case of intra- abdominal hemorrhage,2 cases of up gastrointestinal bleeding,1 case of abdominal abscess,1 case of hepatic failure,1 case of bile leakage,2 cases of would infection,1 case of urinary tract infection.ConclusionsPrecise hepatectomy has characteristics of preoperative accurate assessment,intraoperative fine operation and postoperative excellent management,which reduce the incidence of postoperative complications.

Objective To investigate peripheral blood T lymphocyte subsets and NK cells changes in the diffuse large B cell lymphoma (DLBCL) patients before and after chemotherapy,and analyse the relationship between the results and treatment.Methods Collect the 47 patients venous blood of the effective treatment DLBCL by pathology.T lymphocyte subsets and NK cells were determined by flow cytometric.Analyse the results statistically significant difference before treatment,the second chemotherapy cycle and the fourth chenmotherapy cycle compared with 50 healthy control persons.Results The levels of CD3+,CD4+,CD4+/CD8+ NK cells in DLBCL patients before chemotherapy [(70.04±8.87)％,(42.79±6.06)％,(1.68±0.59)％,(14.40±6.02)％]were lower than healthy controls [(63.89±6.67)％,(32.72±5.77)％,(0.85±0.25)％,(9.95±5.24)％](P ＜ 0.05),and the level of CD8+ cells is higher than the healthy controls [(27.21 ±6.54)％ vs.(39.92±7.11)％](P ＜ 0.05).The levels of CD3+,CD4+,CD4+/CD8+ cells had significant difference between the second and the fourth chemotherapy cycle in DLBCL patients (P ＜ 0.05).The levels of CD3+,CD4+,CD8+,CD4+/CD8+,NK cells had significant difference between the fourth chemotherapy cycle DLBCL patients and the DLBCL patients before chemotherapy (P ＜ 0.05).Conclusion The DLBCL patients exist immunosuppression before chemotherapy.Peripheral T lymphocyte subsets and NK cells can be used as good reflect of the cellular immune function in DLBCL patients.Clinical parameters can be used for the immune function monitoring and providing guidance for the treatment options.

Objective: To investigate the compatible stability of ceftazidime and ormidazole chloride sodium injection with sequential intravenous dripping.Methods: The contents and the absorption curves of ceftazidime and ormidazole sodium chloride injection in the mixture were determined by UV.The appearance of the solution was observed and the pH value was determined.Results: With the quality ratio of ceftazidime to ormidazole at 1∶25, 1∶50 and 1∶100, the mixture color changed from light yellow to light pink in 40, 45 and 48 min, respectively, and gradually deepened with the extension of time.With the quality ratio of ormidazole to ceftazidime mixture at 1∶400, 1∶800 and 1∶1 600, the color was stable in 3 h.There were no evident changes in the appearance, pH, content and absorption curves.Conclusion: The solution containing ormidazole and ceftazidime might have changes in color.Clinical pharmacist suggests that ormidazole chloride sodium injection be given intravenously, and then sequentially followed by ceftazidime.

Objective:To observe the effects of Shen Hong Bu Xue Granule(SHBXG) on the expression levels of erythropoietin(EPO)mRNA in kidney tissue and granulocyte-macrophage colony-stimulating factor (GM-CSF) mRNA in bone marrow tissue of the mice with blood deficiency,and to investigate the protective effect of SHBXG on the blood deficiency mice and its mechanism.Methods:The mouse model of blood deficiency was established with acetylphenylhydrazine(APH) and cytoxan(CTX).A total of 60 mice were divided into blank control group,model group,Compound E-jiao Slurry group and low,middle,high doses of SHBXG groups(n=10).The serum,kidney and bone marrow tissues from all the mice were collected after 14 d consecutive administration.The levels of red blood cells(RBC),hemoglobin level(HGB),hematocrit(HCT),leukocytes(WBC),and platelet(PLT) in blood of the mice were detected by automatic blood analyzer;the levels of serum EPO and GM-CSF of the mice in various groups mice were detected by ELISA method;the expression levels of EPO mRNA in kidney tissue and GM-CSF mRNA in bone marrow tissue of the mice were detected by RT-PCR method.Results:The results of automatic blood analyzer showed that the levels of RBC,HGB,HCT,and PLT of the mice in Compound E-jiao Slurry group and different doses of SHBXG groups were increased significantly compared with model group (P<0.05 or P<0.01);the levels of WBC of mice in Compound E-jiao Slurry group and high dose of SHBXG group were increased significantly compared with model group(P<0.05).The ELISA results showed that the levels of serum EPO and GM-CSF of the mice in Compound E-jiao Slurry group and different doses of SHBXG groups were increased significantly compared with model group(P<0.05).The PC-PCR results showed that the expression levels of EPO mRNA in kidney tissue and GM-CSF mRNA in bone marrow tissue of the mice in Compound E-jiao Slurry group and middle and high doses of SHBXG groups were increased significantly compared with model group(P<0.05 or P<0.01).Conclusion:SHBXG could improve the blood deficiency symptom in the mice with blood deficiency,and its mechanism may be related to increasing the expression levels of EPO mRNA in kidney tissue and GM-CSF mRNA in bone marrow tissue of the mice.

Objective To observe the effects of the preconditioning of ulinastatin on GES-1 cell injury induced by oxygen and glucose deprivation (OGD). Methods GES-1 cells were cultured in vitro and divided into three groups: normal control group (group N), oxygen and glucose deprivation group (group O), and ulinastatin preconditioning group (group U). The OGD model of GES-1 cells were established by glucose-free medium and three-gas incubator for 6h. Ulinastatin was added to group U 12h before the deprivation of oxygen and glucose. The cell viability and apoptosis were determined by cck-8 and flow cytometry respectively. Western Blot was used to examine the protein expression of Caspase-3 and Cleaved Caspase-3. The TRPV1 mRNA expression was measured by quantitative real-time PCR. Results As compared with group N, the viability of GES-1 was decreased, the apoptotic rate and the expression of Caspase-3 and Cleaved Caspase-3 were increased, and the TRPV1 mRNA expression decreased greatly in group O (P < 0.05). As compared with group O, the aforementioned changes were significantly inhibited in group U. Conclusions Ulinastatin preconditioning could effectively inhibit GES-1 cell injury induced by OGD, which may be related to the inhibition of apoptosis and the upregulation of TRPV1 mRNA expression.

Objective:To evaluate the reliability and validity of the Chinese version of the Self-Regulatory Fa-tigue Scale (SRF-S)in Chinese young people.Methods:A sample of 553 young people from a university and a state-owned enterprise was administrated with the SRF-S,the Simplified Coping Style Questionnaire (SCSQ)and the Dual-Mode Self-Control Scale (DMSC-S).Item analysis was conducted to identify valid items and revise the scale.Then the construct validity of the revised scale was tested through confirmatory factor analysis.Finally,a sam-ple of 238 graduate students was retested two weeks later to examine the reliability of the scale.Results:Item analy-sis showed that the SRF-S had satisfactory item discrimination (r >0.38).Confirmatory factor analysis showed that the whole scale had a three-order factor and good construct validity (χ2 /df=5.08,RMSEA =0.09,NFI =0.90, NNFI =0.90,CFI =0.92,IFI =0.92,GFI =0.90)after removing 2 items with factor loadings lower than 0.32,and the range of factor loading was between 0.37 and 0.71.The SRF-S total and subscale scores were positively corre-lated with the scores of negative coping and poor control (r =0.25 -0.58,Ps <0.001),and were negatively associ-ated with the scores of positive coping and good self-Control (r =-0.22 --0.47,Ps <0.001).The Cronbach's αcoefficients were 0.84 for the total scale,and 0.64 to 0.69 for the three subscales,respectively;the test-retest relia-bility coefficients were 0.73 for the total scale,and 0.62 to 0.67 for the three subscales,respectively.Conclusion:It suggests that the Chinese version of SFR-S could be used as an effective and reliable tool for assessing self-regu-latory fatigue state among Chinese young people.

This study aims to determine a reasonable clinical staging standard for patients with esophageal carcinoma who were receiving non-surgical treatment. The patients were staged on the basis of the (2004 and 2009 editions of clinical staging stan-dards. The prognosis of patients with different staging standards, as well as the effect of gross tumor volume-tumor (GTV-T) on clinical T stage and prognosis, was observed. Methods:Data on 219 patients with esophageal carcinoma who were receiving radical radiothera-py were retrospectively analyzed. Prior to radiotherapy, all patients underwent examinations, including esophageal barium meal and po-sitioning CT scan, for use in the radiation treatment planning system to outline the target range and to calculate the volume of GTV-T. All patients were staged with the use of the aforementioned clinical staging standards. Prognostic outcomes of the patients were ob-served. Results:For all patients, the one-, three-, and five-year overall survival rates were 70.8%, 35.6%, and 20.7%, respectively. The survival curve resolution of patients who were staged with the use of the 2009 edition of clinical staging standards was better than that of the patients who were staged with the use of the 2004 edition. Survival difference was significant (χ2=29.497, P<0.001). The clinical T stage positively correlated with GTV-T (r=0.615, P<0.001). GTV-T could thus affect prognosis at different T stages. Conclusion:Both esophageal carcinoma clinical staging standards could reflect the prognosis of patients undergoing radiotherapy, but the 2009 edi-tion appeared more accurate than the 2004 edition.

Hepatectomy for huge hepatocellular carcinoma (HCC) is difficult due to its huge size and the compression and invasion to the surrounding tissues as well as the important vascular systems.Surgical resection of huge carcinoma in the caudate lobe is a big challenge for hepatobiliary surgeons because of its special location and complex anatomical structure.As the improvement of surgical techniques in recent years,especially the promotion of the concept of precision liver surgery,many surgeons begin to take the challenge of resection of huge HCC in the caudate lobe in a variety of ways.In April 2014,a male patient aged 58 years with huge HCC in the caudate lobe was admitted to the Anhui Provincial Hospital.Precision right hemihepatectomy combined with caudate lobectomy was performed on this patient without occlusion of the hepatic inflow,and the efficacy was satisfactory.The key techniques involved in this procedure were discussed in this article.

Objective To detect the expression of Mortalin in human hepatoma-derived cell lines and explore its effect on epithelial-mesenchymal transition in hepatocellular carcinoma (HCC) cell lines.Methods Six HCC cell lines and 1 normal liver cell line (L02) were chosen.The expression of Mortalin was detected using Western blot and real-time quantitative PCR (qPCR).The endogenous gene expression of Mortalin was inhibited by RNA interference (shRNA).Cell viability was detected using MTT assay and flow cytometry.The expression of Mortalin,E-cadherin and Vimentin were detected by Western blot and qPCR.The experiment was divided into three groups; blank,control,and shRNA.Results Mortalin was detected in Hep3B,MHCC97H,HepG2,and HCCLM3,but not in MHCC97L and L02.After 24 h transfection,GFP fluorescence showed that plasmid Mortalin shRNA was successfully transfected into MHCC97H cells.MTT assay indicated that cytotoxicity was 0％,2.5％,and 3.5％ in the blank,control,and shRNA group respectively.Similarly,flow cytometric showed that early apoptosis rates were 0.8％,4.5％,and 9.2％ in the blank,control,and shRNA group respectively.These results indicated that transfection did not cause severe cell damage.After 48 h of interference,Western blot and qPCR analysis showed that shRNA significantly inhibited the expression of Mortalin.Moreover,cells were collected after 24 h,48 h,72 h and 96 h of interference and analyzed for the relationship between Mortalin,E-cadherin and Vimentin by Western blot and qPCR.It was found that decreased expression of Mortalin was accompanied by elevated E-cadherin expression and reduced Vimentin expression.Conclusion Overexpression of Mortalin correlated with the metastatic phenotype of HCC cells and could promote epithelial-mesenchymal transition.

Objective:To study the pharmacokinetics of propranolol in Wistar rats after acute exposure to high altitude.
Methods:Fourteen male Wistar rats (200±20) g were selected. After administration of propranolol tablets (0.05 g/kg, i.g.), blood samples (3 mL) were collected at 0, 20, 40 min,1, 1.5, 2, 4, 6, 8, 12 and 24 h, respectively. The pharmacokinetic parameters were determined by LC-MS/MS and DAS 2.0 software.
Results:The main pharmacokinetic area under concentration-time curve (AUC), mean retention time (MRT), half-life (t1/2) and peak plasma concentration (Cmax) of propranolol were increased by 442.61%, 47.45%, 73.13%and 352.97%, respectively, whereas Tmax and clearance (CL) were decreased by 80.87%and 68.94%, respectively.
Conclusion:This study displays significant changes in the pharmacokinetics of propranolol under high altitude, which may provide evidence for clinical rational application of propranolol at high altitude.