Objective To study the state, feature and risk factors of bacterial infection in patients with liver cirrhosis, find out the influence of infection on prognosis, and provide scientific basis for its prevention and treatment. Methods Three hundred and twenty-three patients with liver cirrhosis were analyzed. The number of the patients with infection, the location of infection, clinical feature as well as the kind of pathogenic bacteria were analyzed. Unconditional Logistic regression analysis was used to assess the risk factors of bacterial infection. Results The overall infection rate was 39.94% (129/323),of which community acquired infection rate and nosocomial infection rate were 22.60% (73/323) and 17.34%(56/323) respectively. The most common location of infection in turn were respiratory tract,gastrointestinal tract, urinary tract,biliary tract and abdominal cavity. The main pathogenic bacteria was Gram-negative bacillus, most of which had drug resistance for cefquinome and quinolones. The risk factors related with bacterial infection included liver cancer, Child-Pugh class B and C grade of liver function, gastrointestinal tract bleeding, diabetes mellitus,invasive operations and the length of staying in hospital. Conclusions The incidence rate of infection in patients with liver cirrhosis is higher. Multiple factors are likely to affect the incidence rate of infection in patients with liver cirrhosis.

Objective To evaluate the significance of serum 8-hydroxy-deoxyguanosine acid ( 8-OHdG) in the diagnosis of nonalcoholic steatohepatitis ( NASH).Methods Patients or healthy subjects were enrolled at the Second Hospital of Tianjin Medical University and the Second People ′s Hospital of Tianjin from May 2013 to December 2015.A total of 41 patients with nonalcoholic fatty liver disease were enrolled in the study , including 20 nonalcoholic simple fatty liver ( NAFL) patients and 21 NASH patients whose diagnosis were proven by liver biopsy.The other 32 healthy subjects were studied as controls.Serum 8-OHdG, ALT, AST and GGT were tested.Nonalcoholic fatty liver disease activity score ( NAS ) and expression of 8-OHdG in liver was investigated between NAFL patients and NASH patients.The correlations between serum 8-OHdG and serum ALT , AST, GGT, and 8-OHdG in liver tissue in NASH group were investigated.In addition , the receiver operating characteristic ( ROC) curve analyses for ALT and 8-OHdG levels were performed in NAFL patients and NASH patients , and the cut-off value was determined.Results Serum 8-OHdG values in healthy controls , NAFL and NASH patients were (0.19 ±0.16) μg/L, (0.22 ±0.16) μg/L, (0.42 ±0.21) μg/L respectively.The serum 8-OHdG and serum ALT, GGT and 8-OHdG in liver tissue were all positively correlated in NASH group with respective correlation coefficient r values as 0.454 7, 0.382 9, and 0.497 6.AUC of 8-OHdG was 0.901 with cut-off value 0.39 μg/L.Its sensitivity was 88.3%and specificity was 81.5%, which were higher than those of ALT.Conclusion The value of serum 8-OHdG would be used as a marker for the diagnosis of NASH.

Objective To explore the clinical applicating and efficacy of free fibula osteomyocutane- ous flap in mandible defect reconstruction in osteoradionecrosis patients.Methods The mandible defects were reconstructed by free fibula flaps with or without muscle cuff.The soft tissue defects were repaired by skin paddles.Status of osteotomy in fibula and flap survival was recorded.The complication in recipient site and donor site,as well as mouth opening and occlusion were reviewed.Facial contour and chewing function after reconstruction were evaluated.Results Patients were followed up 3-16 months.4 free fibula flaps with muscle cuff and 5 without muscle cuff survived well.The size of mandible defects covered from 6cm to 17cm. And the harvested fibula flaps with length of 8.6-17cm were cut into 3 segments in 2 cases,and 2 segments in 5 cases.Fibula flap was divided into 2 segments and overlapped in 2 cases.No serious complication was oh- served in recipient site and donor site.Satisfying esthetic result and normal occlusiong of heath mandible were obtained in all cases.The degree of mouth opening was 2.5-3.3cm.Fair chewing function was revealed in re- constructive region after prosthesia repaired.Conclusion Free fibula osteomyocutaneous flap is relatively ideal reconstruction material of mandible defect in osteoradionecrosis patients for its high survival rate and well esthetic results.

Objective To study the clinical value of amplitude integrated EEG(aEEG),EEG reactivity,EEG patterns,and Glasgow Coma Scale(GCS) scores of predicting the prognosis in comatose patients with severe traumatic brain injury.Methods Sixty-four hospitalized comatose patients with severe traumatic brain injury were evaluated by aEEG,EEG reactivity,EEG patterns and GCS and followed up for one year to observe the prognosis of the patients.Results Accuracy of aEEG,EEG reactivity,EEG patterns and GCS in predicting outcomes of comatose patients with severe traumatic brain injury correctly classified as 73.4％,68.8％,73.4％,64.1％ respectively.The accuracy of GCS in evaluating the prognosis of comatose patients with severe traumatic brain injury was lower than that of the other three methods (P＜0.05).There were positive correlations among aEEG,EEG reactivity,EEG patterns,and GCS (r=0.574-0.843,P＜ 0.05).There were positive correlations between aEEG,EEG reactivity,EEG patterns,GCS and the patients' prognosis(r=0.647,0.609,0.621,0.532,P＜ 0.05).Conclusion As a new electroencephalographic technique,aEEG combined with EEG reactivity,EEG patterns,and GCS can be effectively used to evaluate the prognosis of STBI coma patients,which has a certain clinical value.

Objective To investigate the cancer death and distribution characteristics of residents in Cixian County. Methods In accordance with the norms of cancer registration, cancer death data from 2013 to 2017 in Cixian were collected and analyzed, and the crude cancer death rate, age-standardized mortality rates by the Chinese standard population (ASMRC), age-standardized mortality rates by the global standard population (ASMRW). Results From January 1st, 2013, to December 31st, 2017, 6 490 cases of cancer death were recorded. The average annual crude mortality rate was 202.88/100 000, ASMRC was 186.49/100 000, and the ASMRW was 189.02/100 000. The top 10 male mortality cancers were esophageal cancer, stomach cancer, trachea, bronchus and lung cancer, liver cancer, rectal cancer, cerebral nervous system cancer, colon cancer, leukemia, pancreatic cancer, and bladder cancer in order. The top 10 female mortality cancers were esophageal cancer, trachea, bronchus and lung cancer, stomach cancer, liver cancer, breast cancer, cervical cancer, colon cancer, brain, nervous system cancer, rectal cancer, and ovarian cancer. The age of death increased considerably from the age of 40 years. It increased with the increase in age and reached the peak at the age of 85 years. Conclusion Upper gastrointestinal cancer and lung cancer were the main cancers that threatened the residents of Cixian County from 2013 to 2017. Screening and comprehensive prevention of high-risk groups are still the main targets of cancer prevention and control.

Objective:To explore the mechanism of Ma-Xing Shi-Gan decoction combined with Xiao-Chai-Hu decoction (hereinafter referred to as " Sanyang combined treatment" ) in alleviating colon injury in mice infected with influenza virus by transcriptome sequencing technique.Methods:The mouse model of colonic injury caused by influenza virus was induced by intranasal drip of influenza A virus H1N1 suspension. The mice were divided into Control group, Model group, and Sanyang combined treatment (SCT) group. Model group and SCT group were fed with PBS and Ma-Xing Shi-Gan decoction combined with Xiao-Chai-Hu decoction respectively. Seven days later, the colon tissues of each group were taken, the colon length and pathological damage were observed, and the transcriptome was sequenced to screen the significantly different genes between the SCT group and model group for Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG) and Gene Set Enrichment Analysis(GSEA).Results:After the therapy with SCT, the length of the colon of mice was significantly improved and the pathological injury of the colon was reduced. There are 92 differentially expressed genes between the SCT group and the model group. GO analysis indicated that the differential genes were enriched in biological processes such as regulation of cytokine and chemokine production, inflammatory response, defense response, immune response, regulation of NF-κB inducing kinase(NIK)/Nuclear factor-κB(NF-κB) signal and Mitogen-activated protein kinase(MAPK) cascade, as well as cell components related to intestinal barrier such as brush border membrane, brush border and microvilli. KEGG analysis indicated that the differential genes were enriched in Toll-like receptor signaling pathway, intestinal immune network for IgA production, complement and coagulation cascade, and Peroxisome proliferator-activated receptor(PPAR) signaling pathway. GSEA indicated that the intestinal immune network for IgA production, PPAR signaling pathway, propionic acid metabolism and butyrate metabolism were significantly up-regulated after the intervention with SCT, while apoptosis and MAPK signaling pathway were significantly down-regulated.Conclusions:Sanyang combined therapy can protect the intestinal tract of mice infected with influenza virus mainly through immunity, inflammation and metabolism pathways.

Chronic heart failure is the terminal stage of various cardiovascular diseases， and cardiomyocyte apoptosis is the turning point of decompensation. Studies have shown that traditional Chinese medicine （TCM） could regulate apoptosis-related signaling pathways and factors and inhibit or up-regulate the expression of apoptosis-related proteins. Thus， TCM can reduce cardiomyocyte apoptosis， protect the myocardial tissue and improve the cardiac function， demonstrating remarkable clinical effects. In recent years， the research on the treatment of chronic heart failure based on the inhibition of cardiomyocyte apoptosis is increasing and becomes the current research hotspot. On the basis of literature review， this paper discovers that TCM regulates apoptosis factors and multiple signaling pathways to inhibit apoptosis and inflammation and delay the progression of chronic heart failure through classical pathways such as the death receptor pathway， the mitochondrial pathway， and the endoplasmic reticulum pathway. At the same time， the studies in this field have the following problems： Repeated studies with shallow， simple， and fragmented contents， treating animal models with TCM prescriptions without syndrome differentiation， treating diseases with drugs at only one concentration which is insufficient to indicate efficacy， and lacking comprehensive， holistic， and systematic studies on the relationships of apoptosis with inflammatory responses， pyroptosis， ferroptosis， and autophagy. In the future， more scientific， reasonable， comprehensive， and feasible experimental schemes should be designed on the basis of comprehensively mastering the research progress in this field， and the communication and cooperation between researchers in different disciplines should be strengthened. The specific pathological mechanism of cardiomyocyte apoptosis in chronic heart failure and the signaling pathways， active components， and action targets of TCM in inhibiting cardiomyocyte apoptosis in chronic heart failure should be elucidated. Such efforts are expected to provide sufficient reference for the clinical treatment of chronic heart failure.

Blast injury of the chest injury is the most common wound in modern war trauma and terrorist attacks, and is also the most fatal type of whole body explosion injury. Most patients with severe blast injury of the chest die in the early stage before hospitalization or during transportation, so first aid is critically important. At present, there exist widespread problems such as non-standard treatment and large difference in curative effect, while there lacks clinical treatment standards for blast injury of the chest. According to the principles of scientificity, practicality and advancement, the Trauma Society of Chinese Medical Association has formulated the guidance of classification, pre-hospital first aid, in-hospital treatment and major injury management strategies for blast injury of the chest, aiming to provide reference for clinical diagnosis and treatment.