Objective:To explore the hemostatic mechanism of Jianpi Yiqi Shexue decoction(JYSD)by regulating vascular factors in an immune thrombocytopenia(ITP)mouse model.Methods:An ITP mouse model was established by the passive-immune modeling method,and inter-ventional drugs used were prednisone tablets and JYSD.The platelet count;vascular activity-related factors vWF,VCAM-1,and TM;and VEGF and bFGF were used as observational indicators.Results:On the 8th day of administration,compared with the model group,platelet counts in the prednisone and JYSD groups increased(both P＜.001).Compared with the control group,the levels of vWF,VCAM-1,and TM in the other groups were lower(all P＜.05).The VCAM-1 level in the JYSD group was higher than that in the prednisone group(P=.012),but without significant difference compared with the model group(P=.051).The TM level in the JYSD group was the lowest(vs.the model group,P=.047;vs.the prednisone group,P=.006).Compared with the control group,the IOD values of VEGF and bFGF in the other three groups were lower(all P＜.01).The IOD values of VEGF in the prednisone and JYSD groups were both higher than those in the model group(P=.002 and P＜.001,respectively).The IOD values of bFGF among the model,prednisone,and JYSD groups were not statistically significant(P＞.05).Conclusion:A vascular factor disorder is involved in the pathogenesis of ITP.JYSD can increase the platelet count,upregulate VEGF expression,and reduce the TM level.JYSD has the same effect as prednisone tablets in regulating platelet,vWF,VEGF,and bFGF,with a stronger effect in normalizing VCAM-1 and TM levels.The hemostatic mechanism of JYSD is closely related to the effective balance of vascular factors.

With the development of technology and instruments, more and more giant liver tumors have been resected under laparoscopy. Compared with traditional approach hepatectomy, anterior hepatectomy is more suitable for laparoscopic resection of huge liver tumors, and it is also more in line with the " tumor-free principle" when it is used in the resection of liver malignant tumors. Our team summarized the experiences and lessons of laparoscopic hepatectomy and communicated with domestic and foreign experts to form a set of single center standardized process of laparoscopic anterior right hepatectomy, which is summarized as follows.

Objective: To explore the impacts of the imaging positions on the sagittal tilt of the pelvis and the imaging parameters of the hip joint. Methods: From December 2015 to October 2016, a total of 78 female DDH patients (DDH group) who received Bernese periarticular osteotomy were enrolled, aged 28.41±9.91 years (range 18-49 years) with 135 hips. There were 21 cases on one side and 57 cases on both sides. Another 26 female volunteers without spinal and hip disease were enrolled as the control group, aged 23.54±5.58 years (range 18-49 years) with 52 hips. X-ray films of the anterior and posterior pelvis were performed in both groups. The pelvic sagittal tilt was evaluated by measurement (pubic symphysis to sacrococcygeal distance, PSSC), with lateral center-edge angle of Wiberg (LCEA), Tönnis angle (TA), and Sharp angle (angle of Sharp, SA) assessed the degree of hip dysplasia and assessed the horizontal positional relationship between the femoral head and the acetabulum using tear drop distance (TD). All data were measured twice by two measurers independently. The correlation between hip parameters and X-ray position was analyzed. Results: The average PSSC in the supine and standing positions of the control group were 53.73±16.22 mm and 36.45±14.21 mm, respectively with significant difference-17.28±8.07 mm (t=-10.913, P=0.000). The PSSC of the supine and standing positions of the DDH group were 56.76±13.54 mm and 48.62±15.44 mm, respectively with significant difference-8.13±13.02 mm (t=-5.516, P=0.000). The PSSC of the standing DDH group was larger than that in the control group. There was no significant difference in the PSSC between the two groups in the supine position. Furthermore, there were no significant difference in the supine and standing PSSC between the unilateral and bilateral DDH patients (P>0.05). In the control group, the hip in supine and standing position, LCEA averaged 30.33°±4.69° and 29.70°±3.83° (P>0.05), and TA averaged 4.05°±3.51° and 4.36°±3.07° (P>0.05), respectively. SA averaged 40.53°±4.34° and 41.79°±3.16° (P>0.05), and TD averaged 6.80±0.98 mm and 6.65±1.30 mm (P>0.05), respectively. In the DDH group, the hip in supine and standing positions, LCEA averaged 3.07°±12.07° and 1.69°±12.11° (P<0.05), and TA averaged 22.62°±9.31° and 23.82°±9.45° (P>0.05), respectively. SA averaged 48.01°±4.68° and 48.49°±4.74° (P>0.05), respectively, and TD averaged 10.51±3.51 mm and 10.93±4.23 mm (P>0.05), respectively. Conclusion From supine to standing, the pelvis backward is the main trend in sagittal plane. In standing, the pelvis of female DDH patients is forward contrast with normal women. There was no difference in pelvic tilt between unilateral and bilateral DDH patients. Female DDH patients from the supine to standing, hip coverage decreased, while the femoral head appeared horizontally outward. The hip joint of DDH patients is unstable.