Objective To evaluate the in vitro inhibitive activities of mycophenolic acid against hepatitis B virus in vitro. Methods The different concentrations of the test drugs in DMEM were added to the well with the monolayer growth of HepG2.2.15 cells. The culture medium was refreshed with DMEM containing the appropriate drugs every 3 days. At 3rd, 6th and 9th days, the supernatant was collected for HBsAg quantitative assay, total RNA was isolated from cells for RT-PCR and realtime-PCR assays. Results It was found no significant anti-HBV effect of mycophenolic acid on concentration of 2～250 ?g/ml, and mini inhibitory efficacy of HBV replication on concentration of 1250 ?g/ml. There was significant anti-HBV effect of lamivudine on concentration of 5 ?g/ml. When combined with lamivudine mycophenolic acid can significantly potentiate anti-HBV activities of lamivudine, and it can get maximal inhibition effect on concentration of 10 ?g/ml. Conclusions Mycophenolic acid could inhibit HBV replication and potentiate anti-HBV activities of lamivudine.

Objective To evaluate the in vitro inhibiting activities of interferon-alpha (INF-?) against hepatitis B virus (HBV). Methods HepG2 2 2 15 cells were treated with INF-?. At 3rd, 6th and 9th days after treatment, the supernatant was collected for HBsAg quantitative assay, and total RNA of the cells was isolated for RT-PCR and realtime-PCR assay of HBV mRNA. Results There were no significant differences in HBsAg titer and virus mRNA level at 3rd and 6th days between the experimental and control groups. At 9th day, HBsAg titer and virus mRNA level in INF-? group were significantly lower than those in control group. And 500IU/ml INF-? could get maximal inhibiting effect against HBV. Conclusion INF-? can inhibit transcription and expression of HBV gene in HepG2 2 2 15 cells, which indicated that INF-? can inhibit HBV replication directly.

Objective To evaluate the efficacy and safety of domperidone combined with flupentix-ol,melitracen ( deanxit ) and alprazolam in the treatment of functional dyspepsia .Methods One hundred and sixty patients with functional dyspepsia were randomly divided into the treatment group ( n =80 ) and the control group ( n =80 ) .The treatment group was given domperidone combined with flupentixol , meli-
tracen (deanxit) and alprazolam, and the control group was only given domperidone for 4 weeks.The im-provement of clinical symptoms such as stomach burn ,early enough, abdominal distension, sour regurgita -tion and eructation were evaluated by clinical symptom score .Results Compared with patients in the con-trol group, the rate of marked improvement and rates of improvement for patients in the treatment group were all better ( P <0.01).Furthermore, the adverse reaction is light .Conclusion The application of domp-eridone combined with flupentixol, melitracen ( deanxit ) and alprazolam is quite effective in treating patients with FD.

Objective To know the efficacy and safety of the blood sugar control by double-pump a-mong severe patients with duodenectomy. Methods Divided 60 severe patients with doudenectomy into the experimental group and the,control group randomly, there were 30 cases in each group. In the control group, pa-tients received intravenous infusion with the liquid containing glucose and neutral insulin (4g: 1 U), intravenous injection of 50U neutral insulin added into 50ml normal saline by micro-pump, the pump speed was In the ex-perimental group, sugar-containing liquid without insulin was infused within 24 hours by infusion pump with u-niform speed, a neutral insulin 50U mixed with 5Oral normal saline were injected by micro-pump according to the ratio fo glucose 4g: 1U neutral insulin through the same vein. Which also adjusted the pump speed according to maintaining blood sugar in the range of 4.4～8.3mmol/L. Compared the level of blood sugar control, treatment safety, efficacy and the workload of nurses between the two groups. Results The highperglycemic index and the time to achieve target values of blood sugar in the experimental group was shorter than in the control group respectively, while the time of keep blood sugar in idea level in the experimental group was longer than in the control group. There were no significant difference about incidence rale of hypoglycemia and workload of nurses between the two groups. Conclusions Double-pump can effective control blood sugar for severe patients with duodenectomy without burden nurses' workload, which is more reasonable than the traditional method.

Specific to the existing problems of uneven distribution of resources in the medical industry,especially the shortage of grass-root high-quality medical resources,the paper introduces the construction objective,overall architecture and construction contents of regional medical collaboration,and normalizes the medical service process through informationalized technological means,in order to promote standardized construction of the regional medical information system and information interconnection and intercommunication.

The paper elaborates on the construction concept ofHealthy Henan Health Service Cloud and introduces the project goals and system architecture.This platform effectively promotes the application and popularization of achievements in health informatization in Henan,enables the basic mass to experience the efficiency and convenience brought about by health informatization,and facilitates the monitoring and management by health administrative departments.

BACKGROUND:The incidence of intestinal necrosis during liver transplantation is low, and most of them abandon transplantation and thus leading to death. OBJECTIVE:To retrospectively analyze the reasons which result in smal intestinal necrosis during liver transplantation, and to explore the viable treatment options. METHODS:The clinical data of 207 patients were reviewed, two patients complicated with smal intestinal necrosis during liver transplantation. Case 1 underwent liver transplantation combined with necrotic smal bowel resection. Case 2 abandoned liver transplantation, and received conservative treatment. RESULTS AND CONCLUSION:Both of the two patients had preoperative portal system thrombosis. In Case 1, there was upper gastrointestinal bleeding before transplantation, and repeated application of hemostatic drugs could increase the thrombosis and thus resulting smal intestinal necrosis. At 10 days after liver transplantation, the patients complicated with intestinal fistula and were treated with fistulation. After fistulation, the patient suffered from abdominal cavity and lung infections. At 7 days after anti-infection treatment and immunosuppressant stopped, the infections were cured. At 40 days after fistulation, the intestinal fistula was healed and the patient was discharged after rehabilitation. After fol owed-up for 2 years, the patient was stil healthy living. The Case 2 suffered with mass ascites which lead to abdominal compartment syndrome, the intestinal venous disorders lead to extensive smal bowel necrosis. At 2 days after abandon the liver transplantation, the patient was dead because of multiple organ failure. The patients who waiting for liver transplantation had preoperative portal system thrombosis, abdominal pain and abdominal distention, should be pay attention to intestinal necrosis. Patients with smal bowel necrosis during liver transplantation can be cured with liver transplantation combined with necrotic smal bowel resection.

Objective To explore the method and effect of orbital lateral fat replacement combined with orbicularis oculi muscle flap for correction of severe upper eyelid depression with multiple eyelid.Methods From January 2014 to January 2017,26 patients with severe upper eyelid sag with multiple eyelid were treated in Department of Plastic Surgery,Huai'an Second People's Hospital,including 18 cases of multiple physiological sag eyelid,improper operation on the formation of 8 cases of multiple eyelid eyelid sag.All the patients adopt outside orbital fat reset with the orbicularis muscle flap folded for the treatment.Results The follow-up time was 6 months to 1 year,with an average of 8.5 months.23 patients with upper eyelid sag with multiple eyelid were rectified,3 cases of upper eyelid depression associated with multiple eyelid depression alleviated,multiple eyelid disappeared,including 5 cases of preoperative patients with mild ptosis,and symptoms improved after surgery.Conclusions The orbital lateral fat replacement combined with orbicularis oculi muscle flap folding is a safe and effective treatment for upper eyelid depression with multiple eyelid.

Objective To evaluate the role of calcineurin ( CaN)/nuclear factor of activated T cell cytoplasmic 4 protein ( NFATc4) signaling pathway in inflammatory responses in lung tissues of rats with ventilator-induced lung injury ( VILI) . Methods Twenty-four clean-grade healthy male Wistar rats, aged 5-8 weeks, weighing 220-250 g, were divided into 3 groups ( n=8 each) using a random number table method: control C (group C), VILI group and cyclosporine A plus VILI group (group CsA+VILI). The animals were anesthetized with pentobarbital and tracheostomized. The rats were mechanically ventilated for 6 h with the tidal volume set at 40 ml/kg and respiratory rate at 40 breaths/min to establish the model of VI-LI. The rats kept spontaneous breathing in group C. CaN specific inhibitor cyclosporine A 10 mg/kg was in-traperitoneally injected at 1 h before ventilation in group CsA+VILI. Rats were sacrificed immediately after ventilation, lung tissues were obtained and stained with hematoxylin and eosin to evaluate lung injury, broncho-alveolar lavage fluid was collected for determination of tumor necrosis factor-alpha ( TNF-α) , inter-leukin-1beta ( IL-1β) and IL-6 concentrations by enzyme-linked immunosorbent assay, and the lungs were removed for determination of the wet to dry weight ratio ( W/D ratio) , expression of intercellular adhesion molecule-1 ( ICAM-1) and vascular cell adhesion molecule-1 ( VCAM-1) ( by real-time polymerase chain reaction) , and expression of calcineurin and NFATc4 in lung tissues ( using Western blot ) . Results Compared with group C, the W/D ratio, lung injury scores and concentrations of IL-1β, IL-6 and TNF-αin BALF were significantly increased, and the expression of CaN, NFATc4, ICAM-1 mRNA and VCAM-1 mRNA was up-regulated in group VILI ( P＜0. 05) . Compared with group VILI, the W/D ratio, lung injury scores and concentrations of IL-1β, IL-6 and TNF-αin BALF were significantly decreased, and the expres-sion of CaN, NFATc4, ICAM-1 mRNA and VCAM-1 mRNA was down-regulated in group CsA+VILI ( P＜0. 05) . Conclusion CaN/NFATc4 signaling pathway mediates inflammatory responses in lung tissues of rats with VILI.

Objective:To report on 3 patients who presented with rupture of hepatic artery pseudoaneurysm after liver transplantation.Methods:From April 2010 to April 2019, 3 patients with hepatic artery pseudoaneurysm rupture after liver transplantation treated at the Department of Hepatobiliary and Pancreatic Surgery, Henan Provincial People's Hospital were studied. The possible causes, clinical manifestations, diagnosis and treatment were retrospectively analyzed.Results:Rupture of hepatic artery pseudoaneurysm occurred on the19th, 28th and 63th days after transplantation. The 3 patients all presented with hematochezia and abdominal pain, while 2 patients presented with hematemesis. Two patients had bile leakage and abdominal infection. All the 3 patients presented with fever. Patient 1 who was diagnosed by laparotomy died of liver failure. Patient 2 underwent interventional embolization of hepatic artery and died of liver failure also. Patient 3 underwent surgical resection of the pseudoaneurysm followed by hepatic artery reconstruction, but died of repeat abdominal hemorrhage.Conclusion:Hepatic artery pseudoaneurysm after liver transplantation has a long latent period and is difficult to diagnose at an early stage. Early detection of this life-threatening complication is the key to improve survival. Early treatment of biliary leakage, abdominal infection and other complications help to prevent development of pseudoaneurysms.