Background/Aims: The shortage of donor liver hinders the development of liver transplantation. This study aimed to clarify the poor outcomes of functionally marginal liver grafts (FMLs) and provide evidence for the improvement of ischemia-free liver transplantation (IFLT) after FML transplantation. Methods: Propensity score matching was used to control for confounding factors. The outcomes of the control group and FML group were compared to demonstrate the negative impact of FMLs on liver transplantation patients. We compared the clinical improvements of the different surgical types. To elucidate the underlying mechanism, we conducted bioinformatic analysis based on transcriptome and single-cell profiles. Results: FMLs had a significantly greater hazard ratio (HR: 1.969, P=0.018) than did other marginal livers. A worse 90-day survival (Mortality: 12.3% vs. 5.0%, P=0.007) was observed in patients who underwent FML transplantation. Patients who received FMLs had a significant improvement in overall survival after IFLT (Mortality: 10.4% vs 31.3%, P=0.006). Pyroptosis and inflammation were inhibited in patients who underwent IFLT. The infiltration of natural killer cells was lower in liver grafts from these patients. Bulk transcriptome profiles revealed a positive relationship between IL-32 and Caspase 1 (R=0.73, P=0.01) and between IL-32 and Gasdermin D (R=0.84, P=0.0012). Conclusions FML is a more important negative prognostic parameter than other marginal liver parameters. IFLT might ameliorate liver injury in FMLs by inhibiting the infiltration of NK cells, consequently leading to the abortion of IL-32, which drives pyroptosis in monocytes and macrophages.

Objective To evaluate the macular visual function of patients with myopic choroidal neovascularization (MCNV) before and after intravitreal injection of conbercept.Methods A prospective,uncontrolled and non-randomized study.From April 2017 to April 2018,21 eyes of 21 patients diagnosed as MCNV in Shanxi Eye Hospital and treated with intravitreal injection of conbercept were included in this study.There were 9 males (9 eyes,42.86％) and 12 females (12 eyes,57.14％),with the mean age of 35.1 ± 13.2 years.The mean diopter was-11.30 ± 2.35 D and the mean axial length was 28.93 ± 5.68 mm.All patients were treated with intravitreal injection of conbercept 0.05 ml (1+PRN).Regular follow-up was performed before and after treatment,and BCVA and MAIA micro-field examination were performed at each follow-up.BCVA,macular integrity index (MI),mean sensitivity (MS) and fixation status changes before and after treatment were comparatively analyzed.The fixation status was divided into three types:stable fixation,relatively unstable fixation,and unstable fixation.The paired-sample t-test was used to compare BCVA,MI and MS before and after treatment.The x2 test was used to compare the fixation status before and after treatment.Results During the observation period,the average number of injections was 3.5.The logMAR BCVA of the eyes before treatment and at 1,3,and 6 months after treatment were 0.87±0.32,0.68±0.23,0.52±0.17,and 0.61 ±0.57,respectively;MI were 89.38 ± 21.34,88.87 ± 17.91,70.59 ± 30.02,and 86.76 ± 15.09,respectively;MS were 15.32 ± 7.19,21.35 ± 8.89,23.98 ± 11.12,22.32 ± 9.04 dB,respectively.Compared with before treatment,BCVA (t=15.32,18.65,17.38;P＜0.01) and MS (t=4.08,3.50,4.26;P＜0.01) were significantly increased in the eyes 1,3,and 6 months after treatment.There was no significant difference in the MI of the eyes before treatment and at 1,3,and 6 months after treatment (t=0.60,2.42,2.58;P＞0.05).Before treatment and at 1,3,and 6 months after treatment,the proportion of stable fixation were 28.57％,38.10％,38.10％,33.33％;the proportion of relatively unstable fixation were 47.62％,47.62％,52.38％,57.14％ and the proportion of unstable fixation were 23.81％,14.28％,9.52％,9.52％,respectively.The proportion of stable fixation and relatively unstable fixation at 1,3 and 6 months after treatment were higher than that before treatment,but the difference was not statistically significant (x2=1.82,1.24,1.69;P＞0.05).Conclusion BCVA and MS are significantly increased in patients with MCNV after intravitreal injection of conbercept.

Objective To study the clinical value of electronic bronchoscope in diagnosis and treatment of recurrent dyspnea in neonates.Method From October 2014 to October 2017,the clinical data of recurrent dyspnea receiving electronic bronchoscopy examination and treatment in the neonatal intensive care unit of our hospital were retrospectively selected.Their clinical characteristics and treatment effects were summarized and analyzed.Result A total of 171 infants of neonatal recurrent respiratory infections were examined using electronic bronchoscope.The top four causes included endo－tracheo－bronchitis in 78 cases (45.6%), laryngomalacia, and tracheobronchomalacia in 22 cases (12.9%), airway stenosis in 14 cases (8.2%) and esophagotracheal fistula in 12 cases ( 7.0%).The complications of intraoperative and postoperative included decline of percutaneous oxygen saturation and /or heart rate (20.5%, 35/171), mucosal bleeding (12.3%, 21/171 ), and fever after bronchoalveolar lavage.Electronic bronchoscopy examination confirmed all the 171 neonates′diagnosis and some of them recovered after corresponding treatment.78 cases of infants with endo－tracheobronchitis were all cured.22 cases of laryngomalacia and tracheobronchomalacia and nine patients with airway stenosis improved and were discharged after treatment . One patient with subglottic stenosis received bronchoscopic holmium laser ablation therapy and the airway significantly expanded.No re－stenosis was found during follow－up.Conclusion Electronic bronchoscopy is an important method to determine the cause of recurrent dyspnea in newborns , and it′safe,reliable and can play a therapeutic role in some neonates.

Objective To observe the characteristics offundus autofluorescence (FAF) in patients with polypoidal choroidal vasculopathy (PCV) before and after intravitreal ranibizumab injections.Methods A retrospective case series.Seventeen patients (17 eyes) including 11 males and 6 females were enrolled in this study.Best corrected visual acuity (BCVA),FAF and indocyanine green angiography examination were performed on all eyes.The eyes were divided into hypo-autofluorescence group (8 eyes) and mixed autofluorescence group (9 eyes) according to the fluorescence degree.There was no differences of BCVA between two groups (t=2.403,P=0.072).A11 eyes received monthly intravitreal ranibizumab injections for 3 months followed by an as-needed reinjection schedule.All eyes were followed up for 12 months.FAF was performed at the 3rd,6th and 12th month after first treatment.The changes of FAF characteristics and BCVA before and after treatment were observed.Results Before the treatment,the PCV lesions showed two distinct FAF patterns:the confluent hypo-autofluorescence at the polypoidal lesions and the granular hypo-autofluorescence at branching choroidal vascular networks (BVN).During the treatment,the abnormal FAF area of the whole lesions in all eyes reduced and gradually returned to normal.At the 3rd month after treatment,the central hypo-autofluorescence of polyps was surrounded by a hyper-autofluorescence ring,and with time,the ring was weakened or eliminated.However,all the hypo-autofluorescence findings in BVN at baseline were unchanged during the follow-up period.There was no significant differences in BCVA between hypo-autofluorescence group and hyper-autofluorescence group at different follow-up times (t=2.674,2.862,2.250;P=0.058,0.052,0.081).At final follow-up,5 eyes (62.5％) in hypo-autofluorescence group and 3 eyes (33.3％)in hyper-autofluorescence group had increased BCVA,the different was not significant (P=0.347).Conclusions Before the treatment,there were the central hypo-autofluorescence of polyps and circumferential hypo-autofluorescence ring or confluent hypo-autofluorescence.After the treatment,the autofluorescence of polyps increased and then gradually returned to normal.

The application of micro-lectures in higher medical education is still in a stage of exploration.The au-thors applied the micro-lectures with the traditional teaching method in the teaching of physiology, and conducted a questionnaire survey about it.In this article, the authors summarized the developing process, the students’attitude and the video production of micro-lectures, and compared the micro-lecture with traditional teaching method and MOOCS.At last, they gave some suggestions about application of micro-lectures in higher medical college.

Physiology experiment can effectively stimulate the enthusiasm of the students to explore the scientific truth by providing the opportunity to observe real physiological phenomena,analyze,discuss and solve practical problems.Lab-based learning (LBL) and theory teaching have complementary advantages,promoting each other and can maximize the use of teaching resources.During the process of physiological LBL,training of students' thinking ability by creating problem situation,inspiration and guidance,carrying out exploring experiments can develop students' intelligence,promote innovation,improve the teaching effect.

Objective To explore the feasibility using aluminum tripolyphosphate as the synthesis of aspirin model instead of sulfuric acid catalyst. Methods The thermodynamic functions of the reaction system of salicylic acid and acetic anhydride were calculated according to the Benson group contribution method and Joback group contribution method.The enthalpy change,entropy and Gibbs free energy along with the change of temperature as well as the influence of the molar rate of reactants on the equilibrium conversation rate were also studied.Results In the temperature range of 298.15 K to 358.15 K,the reaction enthalpy was less than zero,and was exothermic reaction,and increase of temperature was not conducive to the reaction.The improvement of mole ratio of salicylic acid and acetic anhydride was helpful to improve the equilibrium conversation rate.The theoretical conversion rate could reach 99.58% when the mole ratio of salicylic acid and acetic anhydride was 3.Conclusion From the viewpoint of thermodynamics, the reaction is practical and feasible.

Thought and consciousness of experimental design were carried in the experimental teaching and the classical physiological experiments were merged. Innovational design and practice were penetrated through the whole experimental class. After consulting literature, designing experi-ments, observing the phenomenon, dealing with the data and summurizing the results, the designers experienced the basic research procedure, got the innovate results, gained the chance to further study and improved the innovative capability.

Objective To observe effects of problem-based learning(PBL) combined with case-based study (CBS)teaching mode in clinical teaching in intensive care unit(ICU). Methods Students from ICU of Fangcun Branch of Guangdong Provincial Hospital of Traditional Chinese Medicine from March 2011 to February 2012 were divided into treatment group (31 cases, with PBL combined with CBS teaching mode) and control group (34 cases, with the traditional teaching mode). Scores of two groups were compared and analyzed and questionnaire survey was conducted in treatment group. Data were processed by SPSS 13.0 statistical software. Measurement data were compared by t-test and data of heterogeneous variance were compared by rank-sum test. Results Treatment group achieved better scores ((85.26 ±5.96) in theory examination and (80.59 ±7.33) in case-analyzing examination) compared with those of control group ((79.17 ±7.31) in theory examination and (76.02 ±9.27) in case-analyzing examination)(P<0.05). PBL combined with CBS teaching mode can stimulate learning interests but it was lack of systematization; most students did not volunteer to speak. Conclusion PBL combined with CBS teaching mode has certain advantages in ICU clinical teaching.

In medical physiology experiment courses, the students observe the functions and learn the rules of biological body, in order to improve their abilities of scientific observation, practice and reflection. Emotion control means willpower to manage emotion, which is the regular psychological response when we deal with issues. Integrating the emotion control education to professional education is imperative to elevate the general quality of medical students.