Anatomical hepatic segmentectomy is the treatment of choice for hepatolithiasis. However, in consideration of the volume of residual liver and the liver function, anatomical polysegmentectomy of the bilateral lobes for hepatolithiasis is restricted. Protection of the portal pedicles to the segments preserved and avoidance of ischemia/reperfusion injury to the residual liver parenchyma are critical steps during the operation.A female patient with hepatolithiasis and had a surgical history of choledocholithiasis removal and T-tube drainage received ana tomic polysegmentectomy with segments Ⅰ and Ⅳ preservation at the General Hospital of Kunming Medical College. During the operation, Portal pedicles to the segments Ⅰ , Ⅱ, right lobe,and segments Ⅱ and Ⅲ were isolated prior to liver parenchyma transection. Portal pedicles to segments Ⅰ and Ⅳ were protected under direct visualization. Hepatoduodenal ligament occlusion was not applied during liver parenchyma transaction. Segments Ⅱ- Ⅲ and Ⅴ-Ⅷ were anatomically resected, and segments Ⅰ ,Ⅳ were preserved with satisfactory vascularization. The patient recovered uneventfully and was discharged 14 days after the operation.

Objective To assess the effect of parent-child individual management in children with mycoplasma pneumonia and to provide guidance for improve the quality.Methods 482 children with mycoplasma pneumonia were divided into parent-child individual management group and conventional intervention group according to the time including the study.The parent-child individual management group used specially formulated for the mother and child management intervention + conventional measures.The conventional intervention group used conventional nursing neasures.The duration of hospitalization,hospitalization expense,depression,family members of patients satisfaction,curative effect,clinical index were compared between the two groups.Results Mter intervention,compared with the conventional intervention group,the duration of hospitalization,hospitalization expense decreased lower [length of stay:(12.08 ± 1.26) d vs.(15.82 ± 3.07) d,t =16.398,P =0.000;hospitalization expense:(641.57 ± 124.28) RM B vs.(896.72 ± 179.15) RM B,t =17.012,P =0.000],the maternal anxiety of the parent child individual management group reduced obviously [anxiety scores (34.21 ± 4.51) points vs.(43.29 ± 6.17) points,t =17.245,P =0.000] and the satisfaction of children of the parent-child individual management group improved obviously(most satisfaction rate:65.71％ vs.49.52％,x2 =10.663,P =0.001;satisfaction rate:27.14％ vs.29.25％,x2 =0.928,P =0.710;general satisfaction rate:5.71％ vs.16.04％,x2 =10.538,P =0.000;dissatisfaction:1.43％ vs.5.19％,x2 =3.552,P =0.060;total rate:92.86％ vs.78.77％,x2 =16.021,P =0.000).The efficacy of the parent-child individual management group improved obviously (inefficiency:7.14％ vs.21.22％,x2 =16.021,P =0.000;efficiency:17.19％ vs.21.21％,x2 =1.812,P =0.178;cure rate:73.33％ vs.53.30％,x2 =17.364,P =0.000;total effective rate:92.85％ vs.78.77％,x2 =16.021,P =0.000).The clinical indicators of the parent-child individual management group were improved obviously[pyretolysis days:(3.42 ± 1.46) d vs.(4.56 ±1.67) d,t =7.463,P =0.000;cough disappeared days:(8.72 ± 2.04) d vs.(10.29 ± 1.95) d,t =8.030,P =0.000;rales disappeared days:(3.96 ± 1.45) d vs.(5.87 ± 1.7 1) d,t =12.370,P =0.000].Conclusion The parent-child individual management in children with mycoplasma pneumonia has good effect on the hospitalization days,hospitalization expense,the satisfaction of children,the curative effect and the clinical indicators,it is worthy of clinical promotion.

Objective : To investigate the prevalence of occupational injury and identify its influencing factors among workers in a steel enterprise in Gansu Province, so as to provide insights into prevention of occupational injury among steel workers. Methods: Workers were sampled from a steel enterprise in Gansu Province using a cluster sampling method from January to March 2022, and participants' demographics, occupational history and occupational injury were collected using questionnaire surveys. The type of job and site and type of injury were analyzed among workers with occupational injuries, and factors affecting workers' occupational injuries were identified using a multivariable logistic regression model. Results: A total of 12 089 questionnaires were allocated and 10 725 valid questionnaires were recovered, with an effective recovery rate of 88.71%. The respondents included 9 412 males (87.77%) and 1 312 females (12.23%), and had a median age of 36.00 (interquartile range, 15.00) years. Junior college and above was the predominant educational level (6 056 workers, 56.47%), and the respondents had a median length of service of 10 (interquartile range, 11) years. The prevalence of occupational injury was 5.25% among respondents. Overhaul worker was the main type of job (11.90%), and object strike was the predominant type of occupational injury (18.25%), while the lower limb was the predominant site of injury (27.82%). Multivariable logistic regression analysis identified men (OR=2.464, 95%CI: 1.580-3.843), age (30 to 39 years, OR=2.561, 95%CI: 1.643-3.993; 40 to 49 years, OR=5.197, 95%CI: 2.679-10.079; 50 years and older, OR=10.620, 95%CI: 6.788-16.615), exposure to high temperature (OR=1.400, 95%CI: 1.165-1.683), operating equipment failure (OR=1.291, 95%CI: 1.048-1.591), absence of personal safety protection equipment (OR=1.555, 95%CI: 1.064-2.273) and safety behavior scores (OR=0.967, 95%CI: 0.937-0.996) as factors affecting occupational injuries among workers in a steel enterprise. Conclusions Men and overhaul workers are at a high risk of occupational injuries in this steel enterprise. Objectstrike is the predominant type of injury and lower limb is the main site of injury. The risk of occupational injuries is affected by gender, age, working environments, equipment status and safety behaviors.

Objective:To construct eukaryotic expression plasmids of pneumocystis carinii p55-v3 and p55-v0 antigenic genes and to identify their expression in COS-7 cells at mRNA level.Methods:Pneumocystis carinii total RNA was used as the template to amplify p55-v3 and p55-v0 antigenic gene by RT-PCR.The products were connected to pTA2 vector and then cloned in pVAX1 eukaryotic expression vector to construct recombinant plasmids as pVAX-p55-v3 and pVAX-p55-v0.After propagated in E.coli DH5α,the recombinant plasmids were transfected into COS-7 cells.After 24 h incubation,the RT-PCR was performed to identify the mRNA expression of p55-v3 and p55-v0 antigenic gene.Results:The recombinant plasmids were qualified by restrictive endonuclease digestion and sequencing.And when compared with that in GenBank,the homology of p55-v3 antigenic gene was 99.9% in nucleotides and 100% in amino acid.The homology between p55-v0 antigenic gene and the one reported previously in nucleotide and amino acid seguence were 99.8% and 100%.The results of RT-PCR confirmed that p55-v3 and p55-v0 antigenic genes were transfected into COS-7 cells successfully and the genes were expressed in the cells.Conclusion:In this study,the recombinant plasmids of pVAX-p55-v3 and pVAX-p55-v0 are conducted successfully and expressed in the COS-7 cells,which provide a basis for clarification of immunologic function of p55-v3 and study of DNA vaccine.

Objective To review clinical experience of free flap transferring in the reconstruction of head and neck defects. Methods Fifteen free anterolateral thigh flaps, 5 free deep inferior epigastric flaps and 3 free lateral arm flaps were used to reconstruct large area head and neck defects. Results All 23 free flaps were alive with good appearance. 1 case survived by performing embolectomy after suffering arterial crisis and delayed recovery of wound took place in 2 cases. Conclusion Free flap transplantation is an ideal choice for reconstructing large area cranio-facio-cervical defects.

We reviewed the metabolic studies on flavonoids of Radix Scutellariae, and found that intestinal flora has played a very important role in the metabolism on Radix Scutellariae. This provided the theoretical basis for studying the bioavailability and metabolic characteristics of Radix Scutellariae.

Objective To evaluate the influence of Chinese patent medicine Banlangen Granules and Ganmao Qingre Granules on war‐farin anticogulation effect during the process for treating acute upper respiratory tract infection in the postoperative patients with mechanical valve replacement in order to provide the theoretical reference for clinical medication .Methods The patient receiving mitral valve replace‐ment ,aortic valve replacement or double‐valve replacement and long term postoperative oral warfarin anticoagulation treatment were select‐ed ,moreover the symptoms of complicating acute upper respiratory tract infection occurred .The patients were divided into 2 groups ,30 cases in each group .The group A adopted oral Banlangen Granules ,while the group B was treated by oral Ganmao Qingre Granules .The treat‐ment course was 3 d .The International Normalized Ratio (INR) in the two groups was monitored before medication ,at 72 h after medication and at 72 h after drug withdrawal .Complicating bleeding or embolism reaction was observed .The INR values at various time points were compared between the two groups and the INR values in each group were compared among 3 time points .Results The INR values in the Banlangen Granules group had statistical differences between 72 h and other two time points ,and the INR values at the same time point had statistical difference compared with the Ganmao Qingre Granules group (P<0 .05);the INR value in the Banlangen Granules group had no statistical difference between before medication and at 72 h after medication(P>0 .05) .Thirty cases had no complication occurrence .The Ganmao Qingre Granules group had no statistical difference among various time points (P>0 .05) ,thirty cases had no complication occur‐rence .Conclusion The warfarin combined with Banlangen Granules causes the INR value increase ,while warfarin combined with Ganmao Qingre Granules has no impact on the INR value ,therefore which suggests that the combination use of warfarin and Banlangen Granules should be cautious in clinic .

Objective To systematically evaluate the efficacy and safety of amlodipine (A)/hydrochlorothiazide(H) versus val‐sartan(V)/hydrochlorothiazide(H) in treatment of essential hypertension .Methods Literature was retrieved online in Cochrane Li‐brary ,PubMed ,OVID ,MEDLINE ,EMBASE ,CBM ,CNKI ,VIP and Wan fang database up to November 2013 .Relevant magazines were retrieved manually .Quality of the included studies was assessed and Meta‐analysis was performed with RevMan 5 .2 software . Results Seven randomized controlled trials(RCTs) were finally included .Meta‐analyses showed that :in terms of lowering ABP ,V/H group was more effective than A/H group ,the difference was statistically significant (P<0 .05);there was no significant differ‐ence in the decreased value of clinic BP and the control rate of blood pressure between A /H group and V/H group(P>0 .05) .Ad‐verse events occurred less frequently with V/H group compared with A/H group ,the difference was statistically significant (P<0 .05) .Conclusion A/H treatment of essential hypertension is inferior to V/H ,and has more adverse events .

Objective To discuss the surgery procedure and treatment effect of reconstruction of the soft tissue of the thumb/finger defects by the second toe tibial toe pulp skin flap. Methods Ten patients with the soft tissue of pulp of the thumb/finger defects were treat by the same side of the second toe tibial toe pulp skin flap, all the patients have the soft tissue defect of finger pulp with exposed phalanx. Crush them in 4 cases, the machine cut wound in 6 cases. A fixed 2 cases, delayed operation 3-7d after injury to repair in 8 patients. The side of skin flap varied from 2.0 cm × 2.2 cm to 2.0 cm × 3.5 cm. Results Ten fingers in 10 cases all survived. Necrosis in edge part of the shin graft occurred in 2 cases, which was healed through changing of dressing. All cases were followed form 4 months to 16 months. The blood-supply, texture and elasticity of transferred flaps and the shape of fingers pulp were excellent. Good function recovery of the fingers was achieved. Pain and temperature sence were regained. Two point discrimination of the finger pulp was 5-9 mm.Primary healing occurred in all cases. It did not disturb dressing shoes and walking. Conclusion It is a reliable approach for soft-tissue coverage of the thumb/finger using the second toe tibial toe pulp skin flap based on distal perforators of digital artery or ulnar artery. The advantages include simply procedures, reliable blood supply without sacrificing main aneries and possibilities of sensoly recovery.

Objective To explore the clinical value of applying digital technology to make the course of toe vein clear before toe free flap transplantation for thumb reconstruction.Methods Before operation,scan the donor and recipient site by CT,and apply digital three-dimensional CT angiography reconstruction technology to got threedimensional images of the arteries and veins in the donor site for 22 various defected thumbs which were going to have toe free flap transplantation operation,thus indentifyed the types of FDMA and the distribution and course of the toe vein from June,2012 to March,2013.Used computer assisted anatomical modeling to analyze three-dimensional images of blood supply of the donor site and degree of defect of the recipient site and guide the operative design in the donor site according to the digital three-dimensional reconstruction technology.Conducted toe free flap transplantation for thumb reconstruction in accordance with the design.Results It shows that 64-slice dual-source spiral CT could well display the size,distribution and course of toe vein.The toe veins were clarified to two groups,deep one and superficial one whose diameter was larger and was the main reflux vein of the toe.Dorsal vein of the toe origind from venous plexus in the nail bed and it travels along the back of the toe to reach to the near side of metatarsophalangeal joint.And then it beeomes three to four dorsal metatarsal veins to infused dorsal venous arch of foot.The rule of its course was:centralize-decentralize-connect-decentralize again.The great saphenous vein origins from the inner side of dorsal venous arch of foot,rises along the crus before malleolus medialis and collect three larger tributaries:medial malleolar branches-anterior crural branch-outside crural branch.The small saphenous vein derives from the outside of dorsal venous arch of foot and winds behind lateral malleolus up to the back of the curs and infuses to the vein.Conclusion It is useful for venous return,reducing the incidence of vascular crisis by applying toe flap to reconstruct thumbs and clarifying the course and distribution of toe vein with the aid of digital three-dimensional technology to design operation,thus improving the survival rate of toe flap transplantation.