Eighty-two patients with unresectable primary hepatic carcinoma were divided randomly into 4 groups. Twenty patients (group A) were treated with hepatic artery ligation and embolization. Twenty-three patients (group B) were treated with whole liver moving strip irradiation. Eighteen (group C) were treated with hepatic artery ligation and embolization and portal vein perfusion chemotherapy. Twenty-one (group D) were treated with the therapy as the group C and the whole liver moving strip irradiation. All were followed-up to 12～37 months. The 1-year survival rates of these four groups were 25.0%(5/20), 13.0%(3/23), 33.3%(6/18) and 61.9%(13/21), respectively. The authors believe that combined treatment of group D is recommended for advanced and unresectable primary hepatic carcinoma.

Objective To investigate the effects of nuciferine on hyperlipidemia in mice and to clarify the molecular mechanism. Methods Mice were divided into three groups according to the diet: normal control group ( n=10 ) , model control group (n=10), and the intervention group (n=10). The normal control group was treated with common diet (ANI-76A feed:12. 4% fat, 68. 8% carbohydrate, 18. 8% protein). The model control group was induced with high fat diet (37. 1% fat, 42. 4% carbohydrate, 20. 5% protein). The intervention group was supplemented with 0. 5% nuciferine based on high fat diet. The mice were allowed free access to food and water for a total of 10 weeks. Several indices were analyzed in the 3 groups, including the body weight, serum lipid, lipid metabolism key enzyme, oxidative stress and metabolic pathway. Results Our results suggested that the high-fat diet-induced animal models developed obesity and dyslipidemia (P<0. 05). The body weight [(33.97±3.46) g vs. (27. 62±2. 87) g] and the serum lipid[(2. 73±0. 26) g vs. (1. 91±0. 21) g] were significantly decreased in the intervention group compared to the model control group (P<0. 05), except for the hypertriglyceridemia (P>0.05).Theactivityofhepaticlipidmetabolismkeyenzymes[(4.15±1.26) U·mL-1vs.(9.01±1.34) U·mL-1] andthe activity of hepatic lipase and lipoprotein lipase[(8.12±3.07) U·mL-1 vs.(13.48±3.75) U·mL-1] were elevated.Oxidative stress was also affected by nuciferine (P<0. 05). Mechanism study suggested that lipid synthesis genes (like SREBP-1c, FAS, SCD-1 and PPAR gamma mRNA) were up-regulated by high fat diet (P<0. 05), and the lipid oxidation metabolism genes, PPARαand CPT-1a mRNA, were down-regulated (P<0. 05), while the intervention group treatment reversed these changes (P<0. 05). Conclusion Nuciferine can improve hyperlipidemia, which might be related to the regulation of enzyme activity, oxidative stress and the changes of lipid synthesis and oxidative metabolism.

Objective:To study the effect of bronchoscope lavage on the inflammatory mediators and pulmonary function of patients with refractory pneumonia.Methods:100 cases of patients with refractory pneumonia who were treated in our hospital from January 2010 to December 2015 were selected and randomly divided into two groups,the control group was treated with routine clinical treatment,and the observation group was treated with bronchoscope lavage.The curative effect and the changes of inflammatory mediators and pulmonary function of the two groups after treatment were compared.Results:After treatment,the effective rate of observation group was 90.00％(45/50),which was significantly higher than that of the control group (76.00％,38/50) (P＜0.05);the levels of endotoxin,IL-6,TNF-2 and LPO in the bronchoalveolar lavage fluid of both groups were significantly decreased (P＜0.05),which were decreased more significantly in the observation group (P＜0.05),the pulmonary function of both groups were significantly improved(P＜0.05),which improved more significantly in the observation group(P＜0.05).Conclusions:Bronchoscope lavage had good therapeutic effect on the patients with refractory pneumonia,it could effectively reduce the level of inflammatory mediators and improve the lung function.

Objective To study the relation between the TCM constitution and the lung function of asthmatic bronchitis children to lay a foundation to apply the TCM constitution theory in preventing and treating children asthmatic diseases.Methods Following the Zhu's method,120 asthmatic bronchitis children were divided into normal constitution,phlegm-damp constitution,qi deficiency constitution,internal heat constitution,and both qi and yin deficiency constitution.Based on the Su's method,the cases were classified into balance constitution,lung-spleen Ⅰ constitution,lung-spleen Ⅱ constitution,spleen-kidney Ⅰ constitution,and spleen-kidney Ⅱ constitution.Their lung function was tested and the TPTEF /Te and VPTEF/Ve of each constitution were analyzed.Results Of the 120 cases,37 ones (30.8%) were qi deficiency constitution;33 ones (27.5%) were phlegm-damp constitution;and 60 ones (50.0%) were lung-spleen Ⅱ constitution.Compared with those with normal constitution,the cases with the phlegm-damp constitution,qi deficiency constitution,internal heat constitution,and both qi and yin deficiency constitution had significantly lowered TPTEF/Te and VPTEF/Ve (P

Objective To study the clone sequencing and expression of fibroblast growth factor 10(Fgf10) gene in corneal opaci-ty (B6-Co) mouse .Methods Normal mice mate with B6-Co mice ,the skin tissue separation from B6 and B6-Co mice at embryo 16 . 5 d ,total RNA extraction and reverse transcription ,the target gene was fragment amplification by RT-PCR ,connection with T vec-tor ,transformed to competent cells ,selection positive clone ,sequencing analysis .The gene expression in B6-Co mice was detected by real-time PCR .Results The base A inserted between 1 914 and 1 915 in Fgf10 gene by sequencing .The expression of Fgf10 was significant down regulation in B6-Co mice by real-time PCR(P< 0 .05) .Conclusion Fgf10 is relevant with phenotype of B6-Co mouse ,and the regulation mechanism was expected further study .

With the increasing incidence rate of nonalcoholic fatty liver disease (NAFLD) in Western developed countries and rich regions of China year by year, the treatment methods for NAFLD have been constantly improved and NAFLD has become a research hotspot. As an important physiological structure of the liver, liver sinus endothelial cells (LSECs) play an important role in the development and progression of NAFLD. This article summarizes the mechanism of action of LSECs in the pathogenesis of NAFLD, which included the following aspects: LSEC capillarization occurs in nonalcoholic fatty liver and promotes steatosis; meanwhile, LSECs contribute to oxidative stress in nonalcoholic steatohepatitis (NASH) and is a major effector of liver inflammation in NASH, thus promoting liver fibrosis; in addition, angiogenesis is highly stimulated and promotes NAFLD-related hepatocellular carcinoma in NAFLD. However, the role of LSECs in NASH-associated liver cirrhosis has not been validated, which needs to be further clarified to provide new ideas and directions for treatment.

In the case of intracranial hemorrhage,coders tend to ignore the cause of intracranial hemorrhage in the cod-ing,whether it is spontaneous intracranial hemorrhage or intracranial hemorrhage caused by trauma,and the coding of the two is completely different in ICD-10.The former is classified as I60-I62 while the latter is classified as S06.Different etiology will also enter different DRG groups when DRG is included.When determining the cause,the site of intracranial hemorrhage should be determined whether it is subarachnoid hemorrhage,or epidural/subdural hemorrhage or cerebral parenchymal hemorrhage,be-cause different bleeding sites have different codes in ICD-9-CM-3 when performing blood removal in cranial swelling.The classifi-cation of epidural hematoma removal was on 01.24,subdural or subarachnoid hematoma removal was on 01.31,and intracerebral parenchymal hematoma removal was on 01.39.The removal of intracranial hematoma is usually divided into cone craniotomy,skull trepanation and drainage and traditional craniotomy according to different operation methods.The operation process of these three operations is obviously different,and coders need to understand the characteristics of the three operations to achieve accurate classification.In the DRG grouping,the disease code is different from the surgical code and the DRG group will be different.Through understanding the definition and etiology of intracranial hematoma removal,the coding ideas of intracranial hematoma re-moval were analyzed,so as to improve the professional ability of coders and ensure the accuracy of DRG data.

Objective:To observe the effect of Xueniaoan tablets on the expression of complement regulatory protein CR1 in IgA nephropathy rats. Methods:Totally 36 SD rats were randomized into the normal group,the model group and Xueniaoan group after 4-day adaptive feeding. Complex method was used to establish IgA nephropathy model,and Xueniaoan group was given Xueniaoan at the dose of 7.0 g·kg-1during the 10thweek and the 12thweek,while the normal group and the model group were fed with normal saline, and the administration course was 3 weeks. The 24-h urine protein was detected,CR1 in red blood cells was detected by ELISA,the renal pathological changes were observed under a light microscope after HE staining,and the expression of CR1 was detected by immu-nohistochemistry. Results:Compared with that in the model group,the 24-h proteinuria in Xueniaoan group was significantly reduced, the number of red blood cell CR1 increased significantly (P<0.05), CR1 in renal tissue increased and the renal tissue injury was light. Conclusion:Xueniaoan tablets can delay the renal damages in IgA nephropathy rats through promoting the expression of CR1.

Objective:To evaluate whether underdilated stent could reduce the occurrence of hepatic encephalopathy (HE) after transjugular intrahepatic portosystemic shunt (TIPS) creation.Methods:A total of 197 patients with decompensated liver cirrhosis, who had underwent TIPS creation at Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, were analyzed retrospectively, including 110 males and 87 females with age 25-79 (54±11) years old. Uncovered and covered stents with 8 mm diameter were implanted in all subjects, and then dilated by balloon catheters with 6 mm or 8 mm diameter. The patients were divided into two groups, including underdilated group (6 mm, n=105) and control group (8 mm, n=92).Kaplan-Meier curves were used to illustrate cumulative rate of HE, and the differences were assessed with the log-rank test. Multivariate analyses with a Cox regression model were conducted to explore the risk factors for HE. Results:During a median follow-up period of 29 (12-54) months, 16 (15.2%) patients developed HE in the underdilated group and 27 (29.3%) patients in the control group. There was a significant difference in the cumulative rate of HE ( P=0.014), but no statistical differences were found in terms of variceal rebleeding, shunt dysfunction and survival between the two groups ( P=0.608, P=0.659, P=0.968). In multivariated analysis, group assignment (underdilated vs. control, HR=0.291, 95% CI 0.125-0.674, P=0.004) was identified as an independent risk factor for HE after TIPS creation. Conclusion:Underdilated TIPS could reduced the risk of HE compared with completely dilated TIPS, with comparable risk of variceal rebleeding, shunt dysfunction and mortality. And it is worthy of applying this technique to a large sample of patients in clinical practice.

Objective:To explore the effect of enriched environment on pain sensitivity, anxiety- and depressive-like behavior in selective nerve injury(SNI) rats model and its potential mechanism.Methods:A total of 36 male clean grade SD rats aged 6-8 weeks were randomly divided into three groups( n=12 in each group): sham operation+ standard environment group (sham group), SNI+ standard environment group (standard environment group), SNI+ enriched environment group (enriched environment group). The rat model of neuropathic pain was established by SNI.The rats in the enriched enviroment group were placed in an enriched enviroment 7 days before operation until 21 days after operation.The paw withdraw threshold(PWT) and paw withdraw latency (PWL) were performed to assess hyperalgesia.The open field test, elevated plus maze test, novelty suppressed feeding test and forced swimming test were used to assess anxiety and depression like behavior.The expressions of cAMP response element binding protein (CREB), p-CREB, brain-derived neurotrophic factor (BDNF), postsynaptic density-95 (PSD-95) and neuroligin 2 (NLGN2) were detected by Western blot.The expression of CREB and BDNF in contralateral ACC were measured by immunofluorescence.GraphPad prism 8.0 and SPSS 23.0 were used for data analysis.One way ANOVA was used for inter group comparison, repeated measurement ANOVA was used to analyze PWT and PWL results, and Tukey test was used for pairwise comparison. Results:(1) In PWT and PWL experiments, the interaction effect between group and time, group main effect and time main effect of PWT were significant ( F=13.4, 39.6, 369.6, all P<0.05), and the interaction effect between group and time, group main effect and time main effect of PWL were significant ( F=3.8, 10.3, 58.8, all P<0.05). Compared with sham group, PWT((8.0±3.5) g, (2.4±1.4) g, (2.3±1.1) g, (2.2±1.6) g, (1.6±0.5) g) and PWL((8.6±1.3) s, (7.3±1.5) s, (7.9±1.0) s, (6.6±1.1) s, (7.7±1.4) s) in standard environment group decreased at each time point (all P<0.05). (2) Compared with sham group, the number of entrying into the central area (1.3±1.7), the time of entrying into the central area((1.6±1.3) s), the proportion of entering open arms ((8.0±7.8) %) and the proportion of time in the open arms ((1.3±1.2) %) all significantly decreased in standard environment group ( t=4.585, 5.423, 4.682, 5.202, all P<0.05). The eating latency ((365.2±94.4) s) and immobility time ((127.6±24.3) s) dramatically increased ( t=6.008, 14.290, both P<0.05). The number and time of entrying into central area of enriched environment group were both higher than those of standard environment group(both P<0.05), while the eating latency and immobility time of enriched environment group were both lower than those of standard environment group(both P<0.05). (3) Compared with sham group(CREB: (1.6±0.2), (0.8±0.5); BDNF: (0.8±0.5), (1.0±0.4)), the expression of CREB ((1.8±0.1), (1.5±0.2)), BDNF ((0.9±0.6), (1.4±0.3)) in spinal cord and ACC of standard environment group increased (spinal: t=3.283, 4.989; ACC: t=5.502, 4.257, all P<0.05). The expression of PSD-95 ((1.6±0.2), (1.0±0.2) and NLGN2 ((1.5±0.5), (1.1±0.2)) also increased in ACC of standard enviroment group ( t=4.257, 2.214, both P<0.05). Compared with standard environment group, the expression of CREB (1.3±0.3), BDNF (0.7±0.4), PSD-95(1.0±0.3) and NLGN2(1.1±0.4) in spinal cord of enriched environment group decreased ( t=5.007, 2.166, 2.358, 2.322, all P<0.05). The expression of PSD-95(1.2±0.3) and NLGN2(1.1±0.2) also decreased in ACC of enriched environment group ( t=2.674, 2.944, both P<0.05). However, the expression of p-CREB (1.7±0.6) and BDNF (2.4±0.2) increased in ACC ( t=4.180, 7.610, P<0.05). Conclusion:Enriched environment can improve neuropathic pain and anxiety- and depressive-like behavior in SNI rats, which may be related to the change of synaptic plasticity in spinal cord and ACC.