Objective:To investigate the clinical value of abdominal adipose volume in predicting early tumor recurrence after resection of hepatocellular carcinoma (HCC).Methods:The retrospective case-control study was conducted. The clinicopathological data of 132 HCC patients with tumor diameter ≤5 cm who were admitted to The First Affiliated Hospital of Army Medical University from December 2017 to October 2019 were collected. There were 110 males and 22 females, aged (51±4)years. All patients underwent resection of HCC. Preoperative computer tomography scanning was performed and the visceral and subcutaneous fats of patients were quantified using the Mimics Research 21.0 software. Based on time to postoperative tumor recurrence patients were divided to two categories: early recurrence and non-early recurrence. Observation indicators: (1) consistency analy-sis; (2) analysis of factors influencing early tumor recurrence after resection of HCC and construction of prediction model. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the t test. Measurement data with skewed distribu-tion were represented as M( Q1,Q3) or M(range), and comparison between groups was conducted using the Mann-Whitney U test. Count data were expressed as absolute numbers, and comparison between groups was conducted using the chi-square test or Fisher exact probability. Consistency analysis was conducted using the intragroup correlation coefficient (ICC) test. Multivariate analysis was performed using the binary Logistic regression model forward method. Independent risk factors influencing early tumor recurrence after resection of HCC were screened. The area under curve (AUC) of receiver operating characteristic (ROC) curve was applied to select the optimal cut-off value to classify high and low risks of recurrence. The Kaplan-Meier method was used to draw survival curve and calculate survival time. The Log-Rank test was used for survival analysis. Results:(1) Consistency analysis. The consistency ICC of abdominal fat parameters of visceral fat volume (VFV), subcutaneous fat volume, visceral fat area, and subcutaneous fat area measured by 2 radiologists were 0.84, 1.00, 0.86, and 0.94, respectively. (2) Analysis of factors influencing early tumor recurr-ence after resection of HCC and construction of prediction model. All 132 patients were followed up after surgery for 662(range, 292-1 111)days. During the follow-up, there were 52 patients with non-early recurrence and 80 patients with early recurrence. Results of multivariate analysis showed that VFV was an independent factor influencing early tumor recurrence after resection of HCC ( odds ratio=4.07, 95% confidence interval as 2.27-7.27, P<0.05). The AUC of ROC curve based on VFV was 0.78 (95% confidence interval as 0.70-0.85), and the sensitivity and specificity were 72.2 % and 77.4 %, respectively. The optimal cut-off value of VFV was 1.255 dm 3, and all 132 patients were divided into the high-risk early postoperative recurrence group of 69 cases with VFV >1.255 dm 3, and the low-risk early postoperative recurrence group of 63 cases with VFV ≤1.255 dm 3. The disease-free survival time of the high-risk early postoperative recurrence group and the low-risk early post-operative recurrence group were 414(193,702)days and 1 047(620,1 219)days, showing a significant difference between them ( χ2=31.17, P<0.05). Conclusions:VFV is an independent factor influen-cing early tumor recurrence of HCC after resection. As a quantitative indicator of abdominal fat, it can predict the prognosis of HCC patients.

OBJECTIVE:To strengthen the management of dismounting drugs in hospital and improve pharmacist working effi-ciency by designing and mading an oral dispending desk. METHODS:In order to solve the small number of placing dismounting drugs induced by small capacity of the desk and disorder placement of placing medicines in inpatient pharmacy,our pharmacists de-signed a new kind of oral dispensing desk that can solve the above problems,produced it and put it in the daily clinical work. The application effects were evaluated by comparing the number of placing drugs and deployment time of medical orders before and af-ter applying it. RESULTS:The designed oral dispensing desk included square slots in the bench,round slots on the side,operating table,multi-panel drawer and ordinary drawer,in which,the first two parts could be used for placing drugs with different shapes and different sizes,multi-panel drawer could place oral liquid,granules,etc. The total number of placing drugs was increased from 237 to 290,and the average deployment time of each medical order was shortened from(4.55±0.38)s to(3.52±0.16)s. CON-CLUSIONS:Application of new dispensing desk has not only solved the limited capacity of the desk,disorderly placing dismount-ing drugs,being difficult to locate and manage and other problems,but also improved the deployment speed of pharmacists and promoted standardized management of dismounting drugs.

Objective To explore the effect of mental nursing intervention on gastric cancer with liver metastasis patients treated with TACE sequential chemotherapy.Methods Sixty four gastric cancer patients with liver metastasis,no hopes of accepting operations,were included.All patients were divided into control group (32 cases) and observation group (32 cases).The former received routine nursing care and the later received extra mental nursing intervention.The anxiety,depression and quality of life in both groups were evaluated and compared.Results After extra mental nursing intervention,the SDS and SAS scores of the observation group [(41.6 ± 1.8) points and (41.6 ± 2.3) points] were significantly lower than those of the control group [(50.9 ± 1.9) points and (53.0 ± 3.5) points,P =0.040,P =0.036,respectively].The quality of life scores,including the physiological function,body pain,general self rating,vitality,social function,emotional function and mental health score were (45.26 ± 38.26)points vs (35.17 ± 33.65) points (P =0.044),(71.98 ± 17.36) points vs (63.01 ± 18.41) points (P =0.039),(55.59 ± 12.78) points vs (49.67 ± 12.43) points (P =0.048),(74.82 ± 14.23) points vs (55.61 ± 10.58) points (P =0.027),(75.47 ± 12.15) points vs (57.22 ± 14.78) points (P =0.031),(70.24 ± 22.00) points vs (45.92 ± 34.76) points (P =0.004),(78.31 ± 19.11) points vs (67.23 ± 11.96) points (P =0.037),respectively,the scores in the observation group were significantly higher than those in the control group (all P ＜ 0.05).Conclusion The extra mental nursing intervention on gastric cancer with liver metastasis patients,treated with TACE sequential chemotherapy,can not reduce the patients'negative mood,improve the patients'compliance with chemotherapy and the confidence to treatment,but improve the quality of patients'life effectively.

Objective To establish a molecular typing system of Staphylococcus aureus by using resolution melting for food-poi-soning fast tracing.Methods Primers were designed and synthesized according to the literature of VNTR in Staphylococcus au-reus ,and were used to perform molecular typing on the strains which had detected by PFGE,then 4 types of VNTRs were with higher discriminatory power were selected.On this basis,we established a molecular typing system for the detection of 59 Staphy-lococcus aureus isolated from food poisoning.Results The molecular typing system has good precision for detection.The standard deviation(s)of within-batch repetitive experiments were 0.03 -0.05 ℃,between-batch repetitive experiments were 0.04 -0.06℃,between-day repetitive experiments were 0.04-0.06 ℃.At the same time,the 59 strains of Staphylococcus aureus were divided into 19 types which were 11 epidemic clones and 8 sporadic clones.The correlation coefficient of Simpson was 0.916 4.Conclusion The molecular typing system for Staphylococcus aureus based on resolution melting was simple,fast and repeatable.It can be ap-plied to fast tracing and screen of Staphylococcus aureus in food poisoning.

Objective:To investigate the influence and mechanism of Portulaca extracts on Tumor Necrosis Factor -α(TNF-α), Interleukin-4(IL-4) in skins of rats with atopic eczema (AE).Methods:40 SD rats were randomly divided into normal control group , model group,Cortex Phellodendri group and Porulaca group.2,4-dinitrochlorobenzene was used on the right back of rat for making atopic eczema.21 days later , all animals were sacrificed , compared the weight of the same size of the eczema and healthy skin.The levels of TNF-αand IL-4 in rats skins were detected by immunohistochemical method.Results:The right back of rats in model group appeared obvious erythema ,erosion and leakage ,which meant the modeling succeeded.Compared with model group ,the swelling degree of Cortex Phellodendri group and Purslane group were significantly decreased ( P<0.01 ) ,compared with Cortex Phellodendri group ,the swelling degree of Purslane group were less than them ( P<0.05 ).The levels of TNF-α, in rats skins of normal control group , model group,Cortex Phellodendri group and Portulaca group were (6 652.66±1 190.94 ),(19 927.10±5 494.21 ), (7 515.13±877.66 ), (6 809.93±1 385.54).The levels of IL-4 were (5 378.44±1 685.01),(26 334.89±3 993.48),(7 814.84±1 751.38),(8 246.57± 975.08 ).Compared with model group ,the levels of TNF-α,IL-4 in rats skins of Cortex Phellodendri group and Purslane group were sig-nificantly decreased(P<0.01).Compared with positive drug group,the levels of TNF-α,IL-4 in rats skins of Purslane group were a little decreased(P<0.05).Conclusion:Purslane extracts has effect to treat atopic eczema ,its possible mechanism is by erducing the proinflammatory factor ,and moderating the anti-inflammatory factor and the ratio between them.

Objective Pancreas perfusion is an essential step in human islet isolation.To develop the new methods for introductal canulation,collagenase infusion and to observe their effects on islets isolation.Methods A total of 17 pancreases were digested from March 2005 to April 2010.The pancreases were distended by three methods:the standard method (n =3),the one-cannula method (n =11) and three-cannula method (n =3).In the standard group,the pancreases were completely cut into half at the mid-body.Two catheters were inserted into the main duct:one directed toward the tail and the other to the head.In the one-cannula method group,a long tube was inserted into the duct at the head,advancing to the tail In the three-cannula method group,pancreatic parenchyma was then minimally cut at the mid-body and three catheters were inserted into the main pancreatic duct:one at the head (the first catheter) and two at the mid-body,one toward the tail (the second catheter) and the other toward the head (the third catheter).The pancreases were digested by improved Ricordi technique.Ficoll continuous density/grads centrifuge method was performed to purify the islets.DTZ staining was adopted to identify islets and count islet equivalent (IEQ). AO/EB fluorescence examination was used to count active islet percentage.Static glucose stimulating test (SGS) in vitro was designed to estimate islet function and calculate SI.Results The distension volume of the threecannula method group was 1.24 rnl/g pancreas,and higher than the other groups (for the standard group:0.71 ml/g pancreas; for one-cannula method group:0.96 ml/g pancreas,P＜0.05).The yield of islet in the three-cannula method group and the one-cannula method group was 2514 and 2270 IEQ/g,which was significantly more than that in the standard group (1914 IEQ/g pancreas,P＜0.05).The purity and viability of the islets were 74 ％/79.3 ％,75.6 ％/79.4 ％ and 78.3 ％/84.0 ％ respectively in the three groups with the difference being not significant among the groups.SI in the one cannula method group (4.74) and the three-cannula method group (5.27) was significantly higher than that in the standard group (3.46).ConclusionThe three-cannula method improved collagenase infusion and the islet yields.

Objective To evaluate the effect of islet transplantation for patients with type 2diabetes mellitus (DM). Methods Since December 2007, 4 cases of islet transplantations were performed on 3 patients with type 2 DM and end-stage renal disease (ESRD). Two patients received simultaneous islet-kidney transplant from single-donor (SIK), and one received 2 consecutive islet transplants 5 months following kidney transplantion (IAK). All recipients given insulin with a dose of percutaneous transhepatic portal catheterization. Anti-CD25 monoclonal antibody was used as induction. For SIK, low-doses of Tacrolimus and sirolimus were used as maintenance immunosuppression protocol. For IAK, the maintenance protocol included cyclosporine and MMF.Insulin dose, the level of blood glucose, C-peptide and the value of HbA1 were observed. Results The first patient of SIKhad normal glucose level 3 days after surgery and became insulin independent within the first month, but insulin was administered gradually and the dose reduced to 1/3. The second patient of SIK died of bleeding and secondary infection of liver puncture site 5 days following operation, the blood glucose level recovered to normal 24 h after operation. The insulin dose of the patient of IAK was reduced to 1/2 after the first transplant. The patient became insulin free after the second operation. The level of fasting and postprandial C-peptide of the surviving recipients increased by 600 pmol/L. The value of HbA1 of the SIK was 6.7 %～7.3 %, while that of the IAK was 5. 5 %～ 5. 9 %. Conclusion Islet transplantation is an effective treatment for patients with type 2 DM.

Objective To summarize our experience in the liver transplantation from the donation after cardiac death (DCD).Methods The livers from three DCD donors (2 cases of brain trauma and 1 case of cerebral hemorrhage) were harvested according to the Guidelines for Donation after Cardiac Death in China.These grafts were orthotopically transplanted into three recipients including 2 cases of decompensative hepatic cirrhosis and 1 case of primary liver cancer.The warm ischemic time ranged from 7.5 to 10 min and the cold ischemic time was 4.5,8.2 and 6.5 h respectively.Postoperative immunosuppressive regimens included prednisone,FK506 and mycophenolate mofetil (MMF).Antibiotics and anticoagulatants were used accordingly.Results All of the 3 recipients obtained normal liver function within 3 weeks since the grafts were implanted without PNF,thrombosis and rejection.No postoperative complications occurred in 3 recipients during the follow-up period of 2 to 9 months with normal liver function.Conclusion The liver transplant from DCD donor showed good results in our center.Chinese group Ⅲ of DCD donor,UW score above the middle level and the short warm ischemic time are three keys ensuring the success of the liver transplant from DCD donors.

Objective To summarize the clinical experience of harvesting and using the kidneys from donation after cardiac death (DCD) donors.Methods Fourteen kidney transplantations were successfully performed on 14 patients with end-stage renal diseases.The kidneys were harvested from 7 volunteer donors (age 30～53 years) diagnosed with cardiac death,who were scored 19～23according to the University of Wisconsin donation after cardiac death evaluation.Primary diseases of the donors were cerebral hemorrhage,brain injury,ischemic cerebral vascular disease and brain tumor.Warm ischemia time ranged from 5 to 45 min,and cold ischemia time was 4.5 ～ 12.5 h.Results After transplantation,three patients had delayed graft function (DGF),one had primary non-function (PNF),and two patients developed acute rejection.In the patient with PNF,the transplanted kidney was removed one day after operation and the patient went back to hemodialysis.One patient with DGF was still in recovery with serum creatine 149 μmnol/L (within 3 months after operation).The above two cases both utilized the kidneys with 45 min of warm ischemia time.The rest 12 patients were discharged with normal renal function.Conclusion Under the condition of our country,kidneys strictly harvested from DCD donors can be used as one of the main sources of kidney grafts for kidney transplantation.

Objective To analyze the role of the introperative vessel Doppler sonographic evaluation of the hepatic artery and portal vein. Methods Intraoperative vessel Doppler sonograms of 116 patients were analyzed for peak systolic velocity of hepatic artery and blood flow of the portal vein.In patients having abnormal findings on sonography (peak systolic velocity of hepatic artery less than 30 cm/s, blood flow of the portal vein less than 800 ml/s), the vascular anastomoses were checked.Results Fourteen of 116 cases revealed less hepatic arterial peak systolic velocity than 30 cm/s. In 9 of the 14 cases, the hepatic arterial peak systolic velocity was normal after injection of 0. 5 % lidocaine into celic trunk root, and papaverine and 654-2 into artery, 3 of the 9 cases endured artery thrombosis. In the other 5 of the 14 cases, by-pass anastomoses were done, and the hepatic arterial peak systolic velocity was normal, and no hepatic arterial complication occurred. Five of 116 cases revealed less hepatic portal vein blood flow than 800 ml/rnin. 4 of the 5 cases revealed shunt between portal vein and vena cava. The blood flow was normal after ligation of the shunt, and thrombosis occurred in 1 case of the 4. The another 1 of the 5 cases was presented with portal vein thrombosis of grade m, and the blood flow remained lower than normal when side-to-side anastomosis was done after resection of thrombosis. Then vein by-pass of the superior mesenteric vein to portal vein with donor iliac vein was done, the blood flow became normal, and no complication occurred. Conclusions The vessel Doppler sonography during liver transplantation was of pivotal values in preventing and diagnosing vessel complications. For the patients with abnormal findings though intraoperative vessel Doppler sonography, the close monitoring should be done in order to find out vessel complication as