Liver failure （LF） is a great trouble to the majority of patients due to its severe onset， many complications， difficult treatment， poor prognosis and other characteristics. This disease is liver injury caused by infection， hepatotoxic substances， autoimmunity， circulation disorders and other factors. It is a group of common clinical symptoms mainly manifested by coagulation disorders， jaundice， hepatic encephalopathy， ascites， and so on. In traditional Chinese medicine， it falls under the categories of "tympanites"， "jaundice" and other diseases. At present， the research progress of Western medicine in the treatment of LF is slow， and its clinical application effect is still not ideal. In contrast， traditional Chinese medicine has a long history in the treatment of this disease， with over thousands of years of clinical practice and verification. It is characterized by exact efficacy and fewer side effects. The pathological mechanism of LF is extremely complex， involves a variety of signaling pathways， and is mainly related to inflammation， oxidative stress， liver fibrosis， cell apoptosis and other processes. In recent years， many studies have shown that traditional Chinese medicine can intervene in the occurrence and development of LF by mediating relevant signaling pathways in vivo， but there is still a lack of relevant summary. Therefore， this review summarized several signaling pathways related to the intervention of traditional Chinese medicine in LF by referring to and sorting out relevant literature worldwide， including nuclear factor kappa B （NF-κB）， mitogen-activated protein kinase （MAPK）， phosphatidylin-ositol-3-kinase/protein kinase B （PI3K/Akt）， transforming growth factor-β/ drosophila mothers against decapentaplegic proteins （TGF-β/Smads）， and nuclear factor erythroid 2-related factor 2/heme oxygenase-1 （Nrf2/HO-1）， and elaborated the specific mechanism of their intervention in LF. This paper aims to provide practical and effective pathways and corresponding mechanisms for the treatment of LF by traditional Chinese medicine， and to provide new ideas and a theoretical basis for the clinical treatment of LF and further scientific research.

Aim The key genes for necroptosis in atherosclerosis were screened by bioinformatics methods and verified with the help of in vitro experiments to provide new strategies for the prevention and treatment of atherosclerosis from the perspective of necroptosis.Methods Genes related to atherosclerotic plaques were downloaded from GEO da-tabase,and genes related to necroptosis were downloaded from GeneCards database and intersected to obtain atherosclerotic necroptosis genes,and the mechanism of action and signalling pathways of the genes were further analysed by GO and KEGG enrichment analysis,and the protein-protein interaction(PPI)network was constructed and screened for key genes.Finally,macrophages were treated with oxidized low density lipoprotein(oa-LDL)at a final concentration of 100 mg/L,and the expression of key genes was detected by RT-PCR and Western blot.Results A total of 81 atherosclerotic nec-roptosis genes were obtained.GO and KEGG enrichment analyses revealed that they were mainly enriched in the positive regulation of endopeptidase activity,IκB kinase(IKK)/nuclear factor-KB(NF-κB)signalling,and autophagy signalling pathway.Five key genes including HSPA8,STAT3,HMOX1,SQSTM1 and FAS were obtained by using five computa-tional methods of Cytoscape software cytoHubba plug-in.Compared with the normal control group,the HMOX1 gene was highly expressed in THP-1 macrophages treated with ox-LDL(P＜0.05),while the expression of the HSPA8,STAT3,SQSTM1 and FAS genes showed no significant changes(P＞0.05);the HMOX1 and SQSTM1 genes were highly expressed in RAW264.7 macrophages treated with ox-LDL(P＜0.05),while HSPA8,STAT3 and FAS genes showed no significant changes(P＞0.05).The expression of HMOX1 protein in THP-1 macrophages was also increased.Conclusion HMOX1 may be the key gene of atherosclerotic necroptosis,and it is expected to become a new target for the prevention and treatment of atherosclerosis.

Objective:To explore the effect of postpartum evidence-based rehabilitation nursing program in primiparas.Methods:From January 2019 to March 2021, convenience sampling was used to select primiparas who gave birth in the Obstetrics Department of the Second Affiliated Hospital of Wenzhou Medical University as the research subject. The primiparas who were hospitalized from January to December 2019 were set as the control group ( n=80) , and the primipara who were hospitalized from January 2020 to March 2021 were set as the research group ( n=94) . The control group received routine rehabilitation nursing, while the research group received postpartum evidence-based rehabilitation nursing. The health status and pelvic floor function of primiparas were compared between the two groups. Results:The total incidences of primiparas in the research group were lower than those in the control group in terms of difficulty in breastfeeding, incompatibility with the role of mother, indifferent family attitude, anxiety and depression, mastitis, urinary retention, urinary incontinence and constipation, and the difference was statistically significant ( P<0.05) . After intervention, the pelvic floor muscle voltage of classⅠ andⅡ muscle fibers in primiparas in the research group was higher than that in the control group, and the difference was statistically significant ( P<0.01) . Conclusions:Postpartum evidence-based rehabilitation nursing program can help improve maternal health and improve pelvic floor function.

Objective To study the clinical efficacy of hyperbaric oxygen therapy in the treatment of middle-aged and elderly patients with acute cerebral infarction and their effects on M-CSF,ox-LDL and sICAM-1.Methods A total of 100 elderly patients with acute cerebral infarction who were treated in our hospital were divided into control group and study group according to the random number table method,with 50 cases in each group.The patients in the control group were treated with conventional therapy,and the patients in the study group were treated with hyperbaric oxygen therapy.The levels of serum markers,nerve defect function and cerebral cerebral blood flow (CBF),cerebral blood volume (CBV) were observed and compared between the two groups before and after treatment.Results After treatment,the levels of M-CSF,ox-LDL and sICAM-1 in the two groups were lower than treatment before,and study group was lower than the control group (P ＜ 0.05);The total clinical outcomes was higher in the study group than that in the control group (P ＜ 0.05).After treatment,the CBF and CBV levels of the two groups were higher than treatment before,and the study group was higher than the control group(P ＜0.05).Conclusion Hyperbaric oxygen therapy in the treatment of the elderly with acute cerebral infarction can effectively reduce the expression of M-CSF,ox-LDL,sICAM-1,reduce cerebral vascular injury,inhibit the formation of thrombosis,improve the function of nerve deficit,relieve the insufficient of oxygen supply,so it is worthy of clinical promotion.

Objective To study the clinical efficacy of hyperbaric oxygen therapy in the treatment of middle-aged and elderly patients with acute cerebral infarction and their effects on M-CSF,ox-LDL and sICAM-1.Methods A total of 100 elderly patients with acute cerebral infarction who were treated in our hospital were divided into control group and study group according to the random number table method,with 50 cases in each group.The patients in the control group were treated with conventional therapy,and the patients in the study group were treated with hyperbaric oxygen therapy.The levels of serum markers,nerve defect function and cerebral cerebral blood flow (CBF),cerebral blood volume (CBV) were observed and compared between the two groups before and after treatment.Results After treatment,the levels of M-CSF,ox-LDL and sICAM-1 in the two groups were lower than treatment before,and study group was lower than the control group (P ＜ 0.05);The total clinical outcomes was higher in the study group than that in the control group (P ＜ 0.05).After treatment,the CBF and CBV levels of the two groups were higher than treatment before,and the study group was higher than the control group(P ＜0.05).Conclusion Hyperbaric oxygen therapy in the treatment of the elderly with acute cerebral infarction can effectively reduce the expression of M-CSF,ox-LDL,sICAM-1,reduce cerebral vascular injury,inhibit the formation of thrombosis,improve the function of nerve deficit,relieve the insufficient of oxygen supply,so it is worthy of clinical promotion.

Objective To investigate the clinical value of albumin (Alb) in the diagnosis of neonatal intrahepatic cholestasis caused by citrin deficiency (NICCD).Methods A retrospective analysis was performed for the clinical data of 90 children with NICCD who visited Children's Hospital of Fudan University from January 2007 to December 2014,and according to the content of Alb,these children were divided into Alb ＜ 30 g/L (LA) group with 20 children and Alb ≥ 30 g/L (NA) group with 70 children.The clinical manifestations,results of laboratory examination,results of blood tandem mass spectrometry and urine gas chromatographymass spectrometry,and gene detection results were compared between the two groups.The t-test and the chi-square test were used for statistical analysis..Results There were significant differences between the LA group and the NA group in splenomegaly degree (3.28±1.95 cm vs 1.92t1.06 cm,P =0.030),aspartate aminotransferase/alanine aminotransferase ratio [3.15 (0.38-5.93) vs 2.14 (0.26-6.67),P =0.010],activated partial thromboplastin time (53.27±11.68 s vs 45.06±9.79 s,P =0.003),and international normalized ratio (1.92±1.35 vs 1.29±0.33,P=0.001).The SLC25A13 mutation 1851_854de14 was associated with Alb (22 =4.76,P =0.025).Conclusion As for the children with Alb ＜ 30g/L who are highly suspected of having NICCD,SLC25A13 gene detection and blood/urine mass spectrometry should be performed as early as possible,in order to initiate intervention treatment as soon as possible,prevent and treat complications,and improve prognosis.

Objective PSGL-1 is specifically expressed in leucocytes.The aim of this study was to explore the changes of myeloid-derived suppressor cells (MDSCs) in the spleen and bone marrow in PSGL-1-deficient mice.Methods PSGL-1 -/-mice were used in the experiment.After identification of the offsprings, flow cytometry was used to test the expression of CD11b and Gr-1 in C57 and PSGL-1 -/-mice.Results Compared with the C57 mice, the expression of MDSCs was up-regulated in the PSGL-1-deficient mice ( P <0.001).Conclusion The expression of MDSCs is upregulated in PSGl-1-deficient mice.

OBJECTIVE: To study the efficacy of treatment with microsurgery in combination with local injection of type A botulinum toxin for vocal process granuloma. METHOD: 28 patients with vocal process granuloma received endotracheal intubation under general anesthesia. The lesion was removed with micro-scissor and CO2 laster under a self-retaining laryngoscope and microscope. The incision and mucous membrane surrounding the wound was closed with 8-0 absorbable suture. 4-point injection of botulinum toxin type A 8-15 u was then performed along the thyroarytenoid muscle and arytenoid muscle of the same side. Postoperative medication was administered based on disease causes. RESULT: All patients experienced vocal cord dyskinesia of the injected side 2-3 days after surgery. At 1 month after the surgery, wound healing was good in all the 28 patients, and the vocal cord movement was limited at the injected side. At 3 months, movement of the bilateral vocal cords was normal, and the vocal cord process mucosa was smooth. Patients were followed up for more than a year, and only one patient had recurrence in 2 months after surgery. The cure rate was 96. 4%. CONCLUSION Combination of laryngeal microsurgery and type A botulinum toxin local injection can shorten the treatment course of vocal process granuloma.
Anesthesia, General ; Botulinum Toxins ; administration & dosage ; Granuloma ; drug therapy ; surgery ; Humans ; Injections ; Intubation, Intratracheal ; Laryngeal Mucosa ; Laryngeal Muscles ; Laryngeal Neoplasms ; drug therapy ; surgery ; Laryngoscopes ; Larynx ; Microsurgery ; Postoperative Period ; Recurrence ; Vocal Cords ; Wound Healing

BACKGROUNDAnterior glottic web is one type of laryngeal stenosis. Previous surgical methods had some drawbacks, such as large surgical trauma, long postoperative recovery time, and multiple-stage surgery. This study aimed to explore better treatment to repair anterior glottis web.

METHODSWe performed vocal cord mucosal flap procedure on 32 patients with anterior laryngeal webs. All subjects received vocal cord scar releasing and vocal cord mucosal flap repair and suture under general anesthesia with selfretaining laryngoscope.

RESULTSAll 32 patients completed surgery in one stage, without postoperative laryngeal edema, difficulty in breathing, or other complications. After the surgery, the anterior commissure of vocal cords recovered to a decent triangle shape in 28 patients; however, in four patients there were 2 to 3 mm adhesion residuals on the anterior ends of the vocal cords, accompanied by scar appearance of bilateral vocal cords. The GRB score, voice handicap index scores, and maximum phonation time score significantly improved in all patients after the surgery. There was no evidence of recurrent laryngeal webbing in the 6-month follow-up.

CONCLUSIONVocal cords mucosal flap repair surgery has the advantages of less trauma, quick recovery, and significant improvement of the voice in the treatment of laryngeal webs.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Female ; Humans ; Laryngeal Diseases ; surgery ; Male ; Middle Aged ; Surgical Flaps ; Suture Techniques ; Vocal Cords ; surgery ; Young Adult

Objective To evaluate the efficacy of the intensity modulated radiotherapy in early stage cervical cancer with vaginal stump recurrence after surgery.Methods A retrospective concurrent comparative study included 60 patients with vaginal recurrence after surgery in early stage cervical cancer.30 cases of the experimental group were treated with intensity-modulated radiotherapy (IMRT),and 30 cases of the control group were treated with conventional radiotherapy.The efficacy and complications between two groups were compared after 3 treatment cycles.Results Of 30 patients in experimental group,22 patients achieved complete remission,7 had partial and 1 progressed.But in the control group,14 had complete remission,5 reached partial remission,7 were stable and 4 progressed.The effective rates were 96.67 ％ (29/30) and 63.33 ％ (19/30),respectively,in the experimental and control group,which showed statistical significance (P =0.009).In the experimental group,there were 1 case with grade 1 radiation cystitis and 1 case with grade 1 radiation proctitis.In the control group,there were 3 cases of vaginal-rectal fistula,1 case of grade 3 radiation proctitis,2 cases of grade 2 radiation cystitis and 2 cases of grade 1 radiation proctitis.Conclusions IMRT for treating vaginal recurrence of early cervical cancer achieves satisfactory short-term effect.In comparison with conventional radiotherapy,IMRT has higher efficacy but less side effects.