Objective To explore the effect of the recombinant plasmid pcDNA3.1/C-sis on fulminant hepatic failure (FHF) in rats.Methods 48 h after recombinant plasmid pcDNA3.1/C-sis being imported into rat liver by using the method of fluid mechanics,FHF in rats was induced by endotoxin (LPS)+D-galactosamine (D-GaIN).With fluorescence quantitative PCR and Western blotting,C-sis expression was tested.The apoptosis of rat liver was detected by using HE staining and measuring Caspase-3 activity.The expression changes of Bcl-2 and Bax were examined through using Western blotting.The mortality rate of rats was calculated during 24 h observation period.Resnlts Compared with the normal control group and FHF+ empty plasmid group,C-sis mRNA and protein expression levels were increased significantly in the FHF+C-sis plasmid group,there were statistically significant differences (P＜0.01).Compared with the normal control group,the apoptotic hepatocytes were increased in the FHF + Ringer's solution injection group and FHF+ empty plasmid group;compared with FHF+ empty plasmid group,the apoptotic hepatocytes in the FHF+C-sis plasmid group were decreased.Compared with the normal control group,Caspase-3 expression level was increased in the FHF+ Ringer's solution injection group (P＜0.01);compared with the FHF+ empty plasmid group,Caspase-3 expression level in the FHF+C-sis plasmid group was decreased (P＜0.05).Compared with the normal control group,Bcl-2 expression level was decreased significantly (P＜0.01),and Bax expression level was increased significantly (P＜0.01) in the FHF+Ringer's solution injection group;compared with the FHF+ empty plasmid group,the Bcl-2 expression level was increased (P＜0.05),and Bax expression was decreased (P＜0.05)in the FHF+C-sis plasmid group.During the 24 h observation period,all rats in the normal control group were alive;the mortality rates of the FHF+ Ringer's solution injection group and FHF+ empty plasmid group were 70.0％ and 80.0％ respectively,while that of the FHF+C-sis plasmid group was only 20.0％.Conclusion C-sis gene could inhibit FHF in rats induced by LPS+D-GalN.

Objective To explore clinical feasibility of liver transplant from child of brain death to adult, to summarize the clinical experiences that a child of brain death transplants liver to an adult. Methods The recipient was a 39-year-old woman patient with primary hepatic carcinoma and posthepatitis cirrhosis (decompensation stage); while the donor was a 8-old-year child of brain death because of brain neoplasms. Donated liver was gained by the method of en bloc multivisceral procurement in a short time; the operative method was classic orthotopic liver transplantation. The postoperative managements included immunosuppression, prevention of infection, hepatic protection, and other relevant supports etc. Results The transplantation operative duration was 6 hours, after which not only did the recipient survive but also her body functioned well including the liver part, with no severe postoperative complications. Conclusions The technology of transplanting livers from children to adults is feasible. The key to ensure the success of transplant operation is systematic preoperative evaluation, excellent operative technique, and perfect postoperative treatment.

Objective To explore the clinical application of renal replacement therapy in renal transplan-tation from donation after citizen's death(DCD).Methods A total of 41 cases of the patients with renal replace-ment therapy after renal transplantation from DCD from January 2013 to December 2016 were involved,of which 14 cases received peritoneal dialysis,21 intermittent hemodialysis(IHD)and 6 continuous renal replacement ther-apy(CRRT).The therapeutic effect and complications of three renal replacement therapies were retrospectively ana-lyzed. Results After dialysis treatment,the concentration of blood BUN,Crea,and potassium was significantly lower than that before the treatment(P<0.05);the difference of Crea and BUN before and after the treatment in IHD and CRRT group was higher than that in peritoneal dialysis group(P<0.05)but there was no statistically sig-nificant difference between IHD and CRRT group(P > 0. 05). Conclusion The renal replacement after kidney transplantation from DCD should be based on the patient's condition,which is the key to protect their kidneys even to save patients'lives.

Objective To summarize the preliminary experience of donor liver protection and function evaluation for organ donation after citizen's death. Methods Clinical data of 35 donors from organ donation after citizen's death and 33 recipients were retrospectively analyzed. Donor liver procurement and clinical prognosis of the recipients were summarized. According to serum level of sodium ion (serum sodium) before organ procurement, all recipients were divided into the serum sodium <155 mmol/L, 155-160 mmol/L and 161-180 mmol/L groups. The incidence of liver graft dysfunction early after liver transplantation was statistically compared among three groups. Results In 35 donors,27 cases were Chinese type Ⅱ and 8 cases were Chinese type Ⅲ. Thirty-three donor livers were used for liver transplantation, and the remaining 2 cases of donor livers were excluded due to congestive cirrhosis. In 33 liver transplantation recipients, 30 cases were successfully recovered. The liver function was gradually restored at postoperative 7-14 d, and normal liver function was obtained during long-term follow-up. Postoperatively, 3 recipients died including 2 cases dying from portal vein thrombosis and 1 case from pulmonary infection complicated with multiple organ failure. The incidence of early liver graft dysfunction of the recipients after liver transplantation was 18%, 23% and 4/5 in the serum sodium <155 mmol/L, 155-160 mmol/L and 161-180 mmol/L groups, respectively. Statistical significance was observed between the 161-180 mmol/L and <155 mmol/L groups (P<0.05). Conclusions Timely protection of donor liver, accurate evaluation and maintenance of liver function play a pivotal role in enhancing the utilization rate of donor liver, maintaining liver function and yielding good efficacy for transplantation.

Objective To develop a new botox-like polypeptide with anti-wrinkle and anti-aging functions, which will be used in the field of cosmetics and dermatology. Methods A series of new peptide compounds were synthesized via modifying the structure of SYN-AKE by peptide synthesis technology. Simulating muscle contraction by using co-culture model of human muscle cells and mouse embryonic spinal cord neurons to test the effects. Results Six new synthetic peptides were selected. The results showed that the muscle contraction frequency was lowered by adding C19 H30 N5 O4 compound than adding SYN-AKE in 1 min(P<0.05). Conclusion C19H30N5O4 is expected to become a new cosmetic peptide raw material and dermatology drug in the field of anti-wrinkle and anti-aging.

Objective To explore the feasibility of extracorporeal membrane oxygenation (ECMO) in protecting the donor liver in donation after citizen's death. Methods Clinical data of 16 donors and recipients undergoing liver transplantation using ECMO to protect the donor liver were retrospectively analyzed. The effect of ECMO on different indicators of the donors was evaluated. The liver function and clinical prognosis of the recipients after liver transplantation were observed. Results Compared with the time before ECMO, the heart rate, total bilirubin (TB), alanine transaminase (ALT) and aspartate transaminase (AST) of the donors after ECMO were significantly reduced, whereas the systolic blood pressure, diastolic blood pressure and partial pressure of arterial oxygen (PaO₂) were remarkably increased (all P < 0.05). The liver function of the recipients was properly recovered after liver transplantation, and gradually restored normal at postoperative 7 to 28 d. Postoperative complications occurred in 3 recipients, including delayed liver function recovery in 1 case, biliary tract stenosis in 1 case and portal vein thrombosis in 1 case. Among them, the patient with portal vein thrombosis died after secondary operation, and the other 2 patients were recovered and discharged after symptomatic treatment. Conclusions The hemodynamics, liver function and other indicators of donors from donation after citizen's death are significantly improved after ECMO, and the liver function of the recipients also recover well.

Objective To evaluate the effect of self-management program in patients with rheumatoid arthritis(RA).Methods Self-management of RA patients was performed using a chronic disease self-management program (CDSMP).The health status,overall function,disease activity index,joint swelling and tenderness,joint pain score were analyzed at 12 and 24 weeks.Results At 12 and 24 weeks,health status,overall function,disease activity index,joint swelling and tenderness,joint pain score showed significant differences in two groups.Conclusion Self-management program may reduce complications,restore joint functions and improve social interactions,and improve quality of life.

Objective To evaluate the effect of self-management program in patients with rheumatoid arthritis(RA).Methods Self-management of RA patients was performed using a chronic disease self-management program (CDSMP).The health status,overall function,disease activity index,joint swelling and tenderness,joint pain score were analyzed at 12 and 24 weeks.Results At 12 and 24 weeks,health status,overall function,disease activity index,joint swelling and tenderness,joint pain score showed significant differences in two groups.Conclusion Self-management program may reduce complications,restore joint functions and improve social interactions,and improve quality of life.

Objective To explore the availability and safety of ileal ureter replacement combined with ileal augmentation cystoplasty in treating ureteral stenosis with contracted bladder.Methods From August 2015 to November 2018,three patients who underwent ileal ureter replacement combined with augmentation cystoplasty were treated with ileal ureter replacement combined with augmentation cystoplasty.There were 1 male and 2 females with the age ranging from 34 to 55 years (mean 39 years).Two patients suffered from left ureter stenosis,and one patient had stenosis on the both sides.The length of the ureter stenosis ranged from 6 to 18 cm (mean 9.8 cm).The preoperative bladder capacity ranged from 60 to 150 ml (mean 103.3 ml).In the surgery,part of ileum was used to replace the ureter,and the distal intestine was made into U-shape to enlarge the bladder.Results All operation were completed successfully.The operation time ranged from 220 to 400 min (mean 303.0 min),and the blood loss ranged from 150 to 500 ml (mean 283.3 ml).Laparoscopic surgery was performed in 1 case and open surgery in 2 cases.Three weeks after the surgery,the bladder volume underwent cystography ranged from 300 to 400 ml (mean 360.0 ml).Three months after the surgery,the postvoid residual urine volume ranged from 20 to 50 ml (mean 33.3 ml).Postoperative frequency and urgency of urine were completely relieved in 1 case,alleviated in 2 cases.Flank pain was completely relieved in 1 case,and alleviated in 2 cases postoperatively.The serum creatinine of 2 patients mildly increased after the surgery,while 1 patient remained stable.For complications,1 patient had urinary infection,and 1 patient suffered from metabolic acidosis.Conclusions Ileal ureteral replacement combined with augmentation cystoplasty can be the choice of treatment for long segment ureteral stenosis and enlarge the bladder simultaneously.The postoperative complications and the kidney functions should be regularly followed up.

Micronutrients (MNs), including vitamins and trace elements, play an indispensable role in human metabolism, immune function and other aspects. Due to the chronic microinflammation and long-term chemoradiotherapy, patients with malignant tumors often suffer from malnutrition, resulting in different degrees of MNs deficiency. In severe cases, MNs deficiency is closely related to the adverse clinical outcomes. Therefore, reasonable MNs supplementation is of great significance in improving the prognosis and quality of life of patients with tumors. Recently, multiple guidelines have made recommendations on the application of MN supplementation in various clinical settings, providing evidence for the standardized MN supplementation in patients with malignant tumors.