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Panax ginseng is reputed to be capable of replenishing healthy Qi and bolstering physical strength, and P. notoginseng can resolve blood stasis and alleviate pain. P. ginseng and P. notoginseng are frequently employed to treat ischemic heart diseases caused by blockages in the heart vessels. Mitochondrial dysfunction often coexists with abnormal mitochondrial morphology, and mitochondrial plasticity and dynamics play key roles in cardiovascular diseases. In this study, primary neonatal rat cardiomyocytes were exposed to 4 hours of hypoxia(H) followed by 2 hours of reoxygenation(R). MitoTracker Deep Red and Hoechst 33342 were used to label mitochondria and nuclei, respectively. Fluorescence images were then acquired using ImageXpress Micro Confocal. Automated image processing and parameter extraction/calculation were carried out using ImagePro Plus. Subsequently, representative parameters were selected as indicators to assess alterations in mitochondrial morphology and function. The active compounds of P. ginseng and P. notoginseng were screened out and identified based on the UPLC-Triple-TOF-MS results and mitochondrial morphometric parameters. The findings demonstrated that RS-2, RS-4, SQ-1, and SQ-4 significantly increased the values of three key morphometric parameters, including mitochondrial length, branching, and area, which might contribute to rescuing morphological features of myocardial cells damaged by H/R injury. Among the active components of the two medicinal herbs, 20(R)-ginsenoside Rg_3, ginsenoside Re, and gypenoside ⅩⅦ exhibited the strongest protective effects on mitochondria in cardiomyocytes. Specifically, 20(R)-ginsenoside Rg_3 might upregulate expression of optic atrophy 1(OPA1) and mitofusin 2(MFN2), and ginsenoside Re and gypenoside ⅩⅦ might selectively upregulate OPA1 expression. Collectively, they promoted mitochondrial membrane fusion and mitigated mitochondrial damage, thereby exerting protective effects on cardiomyocytes. This study provides experimental support for the discovery of novel therapeutic agents for myocardial ischemia-reperfusion injury from P. ginseng and P. notoginseng and offers a novel approach for large-scale screening of bioactive compounds with cardioprotective effects from traditional Chinese medicines.

In this study, we sought to quantify the effect of planting structure change on fertilizer input and environmental cost in Chongqing and develop scientific and rational strategies for chemical fertilizer reduction. Based on the crop fertilizer quota standard and large sample farmer survey data under the medium productivity level in Chongqing, we evaluated and analyzed the application reduction potential and environmental benefits of fertilizer with the difference method and life cycle assessment. The results showed that:① since Chongqing became a municipality directly under the central government (1997), Chongqing crop planting structure had greatly changed, and the proportion of food crop (rice, corn, wheat, bean, and potato) decreased by 21%. The area of fruits and vegetables increased from 3.36×10 5 hm 2 to 1.05×10 6 hm 2 , and their proportion increased by 20%. ② Nearly 55% of fertilizers had been consumed by vegetable (37%) and citrus production systems, and 11%, 12%, and 12% of fertilizers were consumed by rice, corn, and potato, respectively. ③ The total fertilizer reduction of the Chongqing planting industry could reach up to 1.69×10 5 tons during the period of "the 14th Five-Year Plan," with a fertilizer reduction potential of 18.6%. The fertilizer reduction potential (reduction amount) of rice, corn, citrus, and vegetables would reach 0.3% (2.9×10 2 tons), 12% (1.45×10 4 tons), 21% (3.65×10 4 tons), and 30% (1.18×10 5 tons), respectively. On the other hand, the rape system was insufficient in phosphorus potassium fertilizers, and the corn tended to be insufficient in potash fertilizer. ④ The current production level was low, and the nitrogen loss, greenhouse gas emissions, and eutrophication potential in the planting industry of Chongqing reached 1.81×10 5 tons (N), 1.43×10 7 tons (CO 2 -eq), and 1.74×10 5 tons (PO 4 -eq). With the increase in the realization degree of the crop quota standard (60%-100%), the reactive nitrogen loss, greenhouse gas emissions, and eutrophication potential decreased by 14.9%-24.9%, 10.1%-16.7%, and 13.8%-23%, respectively. The structure of the planting industry in Chongqing significantly changed, the total fertilizer consumption in Chongqing tended to decline gradually, and the fertilization intensity of commercial crops stayed at a high level. The agricultural fertilizer reduction potential and the reactive nitrogen and greenhouse gas emission reduction potential were large, especially for citrus and vegetable production systems. However, it is also necessary to pay attention to insufficient corn potash fertilizer and rape phosphorus potassium fertilizer investment and carry out collaborative promotion of fertilizer reduction.

Objective: To compare and analyze the clinicopathological features and significance for indications of different types of antiviral therapy in chronic hepatitis B (CHB). Methods: Clinical data of 861 CHB cases who received liver biopsy, had hepatitis B virus (HBV) DNA-positive (> 30 IU/ml) and met the indications for antiviral therapy from January 2014 to December 2019 were included. Liver pathological changes and their correlation with clinical characteristics were compared and analyzed. According to different data, t -test, analysis of variance, nonparametric test, χ 2 test, Ridit and logistic regression analysis were used for statistical analysis. Results: Most of the cases (72.24%) had remarkable pathological damage. The degree of liver fibrosis was higher in the normal than the abnormal group ( P <0.001). 17.54% cases had hepatic steatosis. The vast majority of cases (97.33%) had positive hepatitis B surface antigen (HBsAg), while only 50.87% had positive hepatitis B core antigen (HBcAg). The positive correlation factors affecting the severity of liver histopathology were alkaline phosphatase level, while the negative correlation factors were positive HBcAg staining, albumin and platelet level. The degree of liver inflammation and fibrosis had statistically significant differences with different HBcAg staining levels ( χ 2 =44.142 and 102.386, respectively; P <0.001), and the severity was more apparent in the negative group. Conclusion: There exist differences in clinicopathological features for indications of different types of antiviral therapy in patients with CHB. Liver function test range is inconsistent with degrees of hepatic histological severity. The positive and intensity of liver tissue HBcAg staining, and albumin and alanine aminotransferase levels have negative correlation with disease severity.

Heavy metal contamination is one of the main factors causing ecological and environmental degradation. Soil contamination by heavy metals decreases soil quality, reduces agricultural productivity and quality, and even threatens human health. Therefore, optimizing remediation strategies for soils polluted with heavy metals is of great significance for high-yield, good-quality, and sustainable agriculture. Numerous domestic and foreign scholars have carried out a large number of studies on the phytoremediation of heavy metal contaminated soils. However, the remediation efficiency may be restricted by soil and climatic/environmental conditions. The synergistic remediation of microorganisms and plants is considered an effective means to improve metal remediation efficiency under environmental stresses. Metal-resistant plant growth-promoting bacteria (PGPB) not only promote plant growth and its resistance to biotic (e.g., phytopathogens, etc.) and abiotic (e.g., drought, salinity, extreme temperatures, heavy metals, etc.) stresses but also alter meal bioavailability in soils and metal toxicity in plants, thereby improving phytoremediation efficiency. In this paper, the mechanisms involved in promoting plant growth and its stress tolerance, and affecting metal bioavailability by metal-resistant PGPB, were systematically summarized. Furthermore, research progress on the application of PGPB in ecological restoration in recent years was extensively reviewed.

Objective: To investigate the effect of whole-process case management based on service process design on patients undergoing total knee arthroplasty (TKA) in areas including pain, function, satisfaction, and complications., Methods: A total of 204 patients who underwent unilateral TKA between April 2021 and March 2022 at the Department of Orthopedics, West China Hospital, Sichuan University were enrolled. By using a random number table, the patients were randomly assigned to two groups, 102 in the general case management group (group G) and 102 in the whole-process case management group (group W). Patients in group G received traditional perioperative case management, while those in the whole-process case management group received integrated case management optimized on the basis of the service process design. The two groups of patients were studied through comparison of their general data, Visual Analogue Scale (VAS) pain score, knee flexion and range of motion, Hospital for Special Surgery (HSS) knee score, the 18-item Patient Satisfaction Questionnaire Short Form (PSQ-18), ability to climb stairs, and complications at 3 days and 3, 8, and 12 weeks after TKA., Results: There was no significant difference between the two groups in patient general information or baseline data collected at the time of enrollment ( P >0.05). There was no significant difference in HSS score, joint range of motion, and VAS pain score between the two groups before the surgery and 3 days after the surgery ( P >0.05). However, the HSS score, joint range of motion, and VAS pain scores of group W were significantly superior to those of group G at 3, 8 and 12 weeks after the surgery (all P <0.05). In addition, group W demonstrated significantly better ability to climb up and down stairs than that of group G at 12 weeks after the surgery ( P < 0.001). In terms of satisfaction, patients in group W were significantly more satisfied than those in group G at 3 days, and 3, 8, and 12 weeks after the surgery ( P <0.001)., Conclusion: Whole-process case management based on service process design has a positive effect of relieving pain, increasing range of motion, improving function, increasing satisfaction, and reducing complications in patients undergoing TKA., (Copyright© by Editorial Board of Journal of Sichuan University (Medical Sciences).)

Objective: To identify rare variants in exon and exon-intron boundary of containing NLR family CARD domain protein 4 (NLRC4) in type 1 diabetes (T1DM) patients, and to explore their effects on gene function. Methods: A total of 508 T1DM patients and 527 healthy controls in the Department of Metabolic Endocrinology, Second Xiangya Hospital of Central South University from August 2017 to September 2020 were selected. The case group included 264 males and 244 females, and the age [ M ( Q 1 , Q 3 )] was [27 (11, 43)] years. The control group included 290 males and 237 females, and their age［ M （ Q 1 ， Q 3 ）］was [47 (36, 60)] years old. Identification of rare variants in exons of NLRC4 gene in T1DM patients and healthy controls was performed and verified by next-generation sequencing and sanger sequencing. The NLRC4 gene wild-type and mutant plasmids were constructed and transfected into 293T cells. Western blot (WB) was used to detect the expression of NLRC4 protein and cleavage products of pro-cysteinyl aspartate specific proteinase(procaspase-1). Cycloheximide (CHX) was added to 293T cells transfected with wild-type or mutant NLRC4 plasmid to detect the degradation of NLRC4 protein. The localization of NLRC4 protein was detected by immunofluorescence, and the concentration of IL-1β in the cell supernatant was detected by enzyme-linked immunosorbent assay (ELISA). Results: The sequencing results showed that 4 patients and 2 healthy controls had a heterozygous variant c.208C>T in exon 3 of the NLRC4 gene. Two patient had a heterozygous variant c.1564T>C in exon 4, and 1 patients had c.1219G>C in exon 4. These three variants might be pathogenic variants in T1DM. In 293T cells transfected with NLRC4 wild-type and c.208C>T、c.1564T>Cc.1219G>C mutant plasmids, the expression level, degradation rate, localization of NLRC4 protein and the content of cleavage products of procaspase-1 did not change significantly. However, the concentration of IL-1β secreted by 293T cells transfected with c.1219G>C and c.208C>T plasmid [ M ( Q 1 , Q 3 )] was 15.25 (12.98, 17.52) and 15.44 (13.81, 17.07) ng/L, respectively, which was lower than 18.70 (16.59, 20.81) ng/L of 293T cells transfected wild-type plasmid ( P =0.020, 0.010). Conclusions: NLRC4 gene rare variants c.208C>T, c.1564T>C and c.1219G>C may not change the protein expression, degradation and localization, but c.208C>T and c.1219G>C may inhibit the secretion of IL-1β. This result suggests that NLRC4 rare variants may have an impact on gene function.

Angong Niuhuang Pills(AGNHP) are effective in clearing heat, removing the toxin, and eliminating phlegm for resuscitation. Clinically, it is widely used to treat various diseases such as febrile convulsion due to heat attacking pericardium, but its therapeutic effects on heart failure(HF) have not been well recognized. In this study, the profiles of differential metabolites regulated by AGNHP were identified by ultra-high performance liquid chromatography-quadrupole time-of-flight mass spectrometry(UPLC-Q-TOF-MS). The underlying mechanism of AGNHP against HF was illustrated based on the integrated analysis of pharmacological data and metabolic molecular network. The HF model was induced by isoproterenol in mice. After oral administration of AGNHP for one week, cardiac functions in HF mice were evaluated by echocardiography, and serum samples of mice were collected for metabolomics analysis. Eight differential metabolites of AGNHP against HF were screened out through partial least square discriminant analysis(PLS-DA) and input into MetaboAnalyst for the analysis of metabolic pathways. Moreover, the critical metabolic pathways regulated by AGNHP were enriched according to the potential targets of major compounds in AGNHP. After AGNHP treatment, the recovered index of relative content of some metabolites underwent cross-scale fusion analysis with therapeutic efficacy data, followed by &quot;compound-reaction-enzyme-gene&quot; network analysis. It is inferred that the anti-HF effects of AGNHP may be attributed to the metabolism of arachidonic acid, amino acid, glycerophospholipid, and linoleic acid. The cross-scale polypharmacological analysis method developed in this study provides a new method to interpret scientific principles of AGNHP against HF with modern technologies.

The freeze-drying technique, characterized by low-temperature processing, is especially suitable for sensitive volatile oils with thermal instability. However, there are few studies focusing on the retention of volatile oils in the processing of freeze-dried preparations. This study evaluated the effects of different addition methods(adsorption, emulsification, solid dispersion, and inclusion) on the retention rate of the main components in peppermint oil, aiming to explore the application feasibility of freeze-dried preparations of volatile oils. Firstly, the addition method was determined based on the retention rates of menthol in four freeze-dried preparations. Secondly, an orthogonal test was designed to optimize the preparation process based on the characteristics of the preferred addition method. The results showed that the most suitable preparation form of peppermint oil was inclusion with beta-cyclodextrin(β-CD), and the retention rate of menthol in freeze-drying was 86.36%. According to the two-step preparation process of inclusion and freeze-drying, we introduced the product of inclusion rate and retention rate, i.e., comprehensive retention rate, to determine the optimum processing parameters. The results showed that β-CD/oil ratio of 7∶1, inclusion temperature of 40 ℃, and inclusion time of 2 h were the optimum processing parameters. The product prepared with these parameter had the comprehensive retention rate of 68.41%, retention rate of 92.53%, and inclusion rate of 73.93%. The inclusion compound was white powder with significantly increased solubility. The pre-paration process based on cyclodextrin inclusion in this study is stable and reliable and provides a new idea for ensuring the efficacy and stability of volatile components in freeze-dried preparations.

Objective: To analyze the liver pathology, clinical characteristics and influence factors in patients with chronic hepatitis B virus (HBV) infection in immune tolerant phase (IT). Methods: The clinical data of 273 patients in IT phase who underwent liver biopsy from January 2015 to December 2019 were included in this study. The correlation between liver pathological changes and clinical features was analyzed. Results: There were 43 cases (15.75%) with liver histologic activity ≥ G2, 30 cases (10.99%) with liver fibrosis ≥ S2, and 55 cases (20.15%) with liver pathology ≥ G2 and/or ≥ S2. A total of 17.95% patients had liver steatosis. The majority (98.17%) of tissue samples were positive for HBsAg staining, while only 79.49% were positive for HBcAg. The characteristics of liver pathology were comparable in men from women patients. The differences of G and S were not statistically significant according to different HBsAg positivity, while those were statistically significant according to different HBcAg positivity. By univariate and multivariate analysis, the independent risk factors of pathological severity were HBcAg intensity, HBeAg level, and age. However, the differences of liver histologic activity and fibrosis were not statistically significant between those younger than 30 years old group from those older than 30 years old, neither between those younger or older than 40. Although the diagnostic value of liver inflammation and fibrosis 5 (LIF-5) was better than that of aspartate aminotransferase-to-platelet ratio index (APRI) and fibrosis 4 score (FIB-4), three diagnostic models for predicting the pathological severity were not strong enough (all area under the curves<0.8). Only the specificity of LIF-5 for predicting≥ G2, ≥ G2 and/or ≥ S2 was over 80%. Conclusions: Approximately 20% patients with chronic HBV infection in IT phase have progressive liver inflammation or fibrosis. The intensity of liver HBcAg and HBeAg level are negatively correlated with the severity of disease. The diagnostic models or most clinical indicators have low predictive effect for chronic HBV infections in IT phase.

Qishen Yiqi Dripping Pills(QSYQ) are used clinically to treat various myocardial ischemic diseases, such as angina pectoris, myocardial infarction, and heart failure; however, the molecular mechanism of QSYQ remains unclear, and the scientific connotation of traditional Chinese medicine(TCM) compatibility has not been systematically explained. The present study attempted to screen the critical pathway of QSYQ in the treatment of myocardial ischemia by network pharmacology and verify the therapeutic efficacy with the oxygen-glucose deprivation(OGD) model, in order to reveal the molecular mechanism of QSYQ based on the critical pathway. The key targets of QSYQ were determined by active ingredient identification and target prediction, and underwent pathway enrichment analysis and functional annotation with David database to reveal the biological role and the critical pathway of QSYQ. Cell counting Kit-8(CCK-8), lactate dehydrogenase(LDH), and Western blot tests were launched on high-content active ingredients with OGD cell model to reveal the molecular mechanism of QSYQ based on the critical pathway. The results of network pharmacology indicated that QSYQ, containing 18 active ingredients and 82 key targets, could protect cardiomyocytes by regulating biological functions, such as nitric oxide biosynthesis, apoptosis, inflammation, and angiogenesis, through TNF signaling pathway, HIF-1 signaling pathway, PI3 K-Akt signaling pathway, etc. HIF-1 signaling pathway was the critical pathway. As revealed by CCK-8 and LDH tests, astragaloside Ⅳ, salvianic acid A, and ginsenoside Rg&#95;1 in QSYQ could enhance cell viability and reduce LDH in the cell supernatant in a concentration-dependent manner(P&lt;0.05). As demonstrated by the Western blot test, astragaloside Ⅳ significantly down-regulated the protein expression of serine/threonine-protein kinase(Akt1) and hypoxia-inducible factor 1α(HIF-1α) in the HIF-1 signaling pathway, and up-regulated the protein expression of vascular endothelial growth factor A(VEGFA). Salvianic acid A significantly down-regulated the protein expression of upstream phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha(PIK3 CA) and downstream HIF-1α of Akt1. Ginsenoside Rg&#95;1 significantly down-regulated the expression of HIF-1α protein and up-regulated the expression of VEGFA. The therapeutic efficacy of QSYQ on myocardial ischemia was achieved by multiple targets and multiple pathways, with the HIF-1 signaling pathway serving as the critical one. The active ingredients of QSYQ could protect cardiomyocytes synergistically by regulating the targets in the HIF-1 signaling pathway to inhibit its expression.

Objective: To establish the luciferase immunoprecipitation system assay (LIPS) to test tetraspanin 7 autoantibody (TSPAN7A) and evaluate its value in Chinese type 1 diabetes (T1D) patients. Methods: Renilla luciferase-tagged TSPAN7 plasmids were transfected into 293T cells to obtain Renilla luciferase-tagged TSPAN7 fusion protein. The cell lysate was incubated with sera overnight, followed by addition of protein A-agarose and extensive wash. Finally, the substrate of Renilla luciferase was added and luminescence was detected. Sera from 100 T1D patients [64 males and 36 females,with a mean age of (28±16) years], 119 type 2 diabetes (T2D) patients [78 males and 41 females,with a mean age of (47±12) years] and 98 healthy volunteers [55 males and 43 females,with a mean age of (28±12) years] from the Department of Metabolism and Endocrinology of the Second Xiangya Hospital, Central South University from 2014 to 2017, were tested by LIPS to evaluate the frequency of TSPAN7A. Radioligand binding assay (RLA) was used to test glutamic acid decarboxylase autoantibodies (GADA), protein tyrosine phosphatase-2 autoantibodies (IA-2A) and zinc transporter 8 autoantibodies (ZnT8A). Results: The frequencies of GADA, IA-2A, ZnT8A and TSPAN7A in T1D patients were 72.0%, 40.0%, 29.0% and 25.0%, respectively. After Bonferroni correction, the positivity of TSPAN7A was lower than GADA ( P <0.001), but similar with IA-2A ( P =0.035) and ZnT8A ( P =0.630). The positivity of TSPAN7A in T1D patients was significantly higher than that in T2D (0.84%, P< 0.001) and in healthy controls (1.02%, P< 0.001). In combination with TSPAN7A, the positivity of islet autoantibodies in T1D patients increased from 82% to 85%. There was no significant difference in clinical characteristics between TSPAN7A-positive T1D and the other three islet autoantibodies-positive patients. Conclusion: This study succeeded in establishing LIPS method to assay TSPAN7A. Moreover, TSPAN7A are valid islet autoantibodies for T1D patients in China.

Objective: To investigate the value of ultrasound in the diagnosis and preoperative evaluation of cystic hepatic echinococcosis. Methods: The data of 59 patients (102 lesions) with cystic hepatic echinococcosis confirmed by surgical pathology and serological examination in the Fifth Medical Center of PLA General Hospital from January 2018 to December 2019 were retrospectively analyzed, including 23 males and 36 females; age13 to 64 (42±6) years. The ultrasonographic manifestations were classified, and the involvement of the lesions in the blood vessels and bile ducts was determined. The coincidence rate between ultrasound diagnosis of hepatic echinococcosis and surgical pathology was compared, and the accuracy, sensitivity and specificity of ultrasounic diagnosis of hepatic echinococcosis were analyzed. Results: Ultrasound showed 12 CE1 type lesions, 24 CE2 type lesions, 16 CE3a type lesions, 6 CE3b type lesions, 34 CE4 type lesions, and 10 CE5 type lesions. The coincidence rates of hydatid ultrasound and surgical pathological classification were 91.66% (11/12), 95.80% (23/24), 93.75% (15/16), 83.33% (5/6), 91.17% (31/34) and 100.00% (10/10), respectively. Ultrasound diagnostic efficiency analysis: the accuracy of classification was 94.12%, the sensitivity was 96.94%, and the specificity was 25%. Among the characteristic ultrasound manifestations, the gyrus sign and the polycystic sign were the most frequent, followed by homogeneous thickening of the cyst wall, double wall, separation of the inner cyst wall, and thick wall calcification. There were significant differences between ultrasound in the determination of lesions involving blood vessels and bile ducts and intraoperative findings (all P< 0.05). Conclusion: Ultrasound could clearly diagnose cystic hepatic echinococcosis, could better display the imaging characteristics of the disease, and had important clinical significances in indicating the evolution of the disease and determining the involvement of the lesions in the blood vessels and bile ducts.

In order to explore the physiological responses of root system of different drought-resistant cotton varieties to drought and their relationships with biomass, we examined the effects of drought stress on root vigor, antioxidant enzyme activities and anatomic structure (duct diameter, number) and biomass of different drought-tolerant varieties, including the drought-inolerant variety 'Xinluzao 17' (L17) and the drought-tolerant variety 'Xinluzao 22' (L22). Both varieties were grown under soil column cultivation conditions, with conventional irrigation (CK), mild drought (W 1 ) and moderate drought (W 2 ) treatments. The results showed that drought stress caused significant reductions in soluble protein (SP) content, root vigor (RV), the number of cork layers, the number of rhizome ducts, the diameter of the ducts in both varieties. The higher root MDA content, CAT, POD and SOD activities in response to drought led to reduction of aboveground dry mass. Compared with that of L17, SP content, 0-40 cm and 80-120 cm soil layer RV, the number of cork layers, the number of rhizome ducts, the diameter of ducts, and the aboveground dry mass of L22 all signi-ficantly increased. Under the W 2 treatment, the RV decrease of L22 was 26.2% lower than that of L17, and CAT, POD, SOD activities and the thickness of cortex were 43.6%, 6.9%, 25.4%, 19.9% higher than that of L17. There were positive correlations between dry mass and RV, SOD, POD, the number of cork layers, the diameter and number of rhizome ducts. Therefore, cotton variety with strong drought tolerance could maintain higher root activity, cork layer number, the diameter of rhizome ducts, and number under drought conditions, and thus promote the accumulation of aboveground biomass, which was the physiological mechanism for their stronger drought tolerance.

Gansu province,which spans the Yangtze river,is in the upper reaches of the Yellow river and located at the intersection of the Qinghai-Tibet plateau,the Inner Mongolia plateau and the Loess plateau. All of these areas are highly respected by doctors of all ages as they have enriched the resources of traditional Chinese medicines. In the interaction between the heavens and the earth,the interaction between the people and the future has been passed down to the present. As one of the abbreviations of Gansu province, &quot; Long&quot; is not only the symbol and representative of the Gansu region,but also the symbol of the authentic medicinal materials in Gansu. This paper sorts out the evolution of the name &quot; Long&quot; medicines,the development status and development limitations of &quot; Long&quot; medicines. It is believed that although the production areas of authentic medicinal materials in Gansu have changed in different historical periods,the core varieties have been used ever since. Today,with the great development of the Chinese medicine industry,Gansu province pays attention to the limitations of the current regional and technological competitiveness in the province,and gives full play to its own advantages,which can help the &quot; Long&quot; medicines stand out among the medicinal materials. Furthermore,it lays the foundation for the development of the industry and the application of high quality Chinese herbal medicines in clinical practice.

Presently, nonalcoholic fatty liver disease has become the most common pathogenic factor of chronic liver disease worldwide that can lead to the occurrence of hepatocellular carcinoma (HCC). Lipid metabolism in cancer cells is closely related to tumorgenesis, invasion and metastasis, and thus acts as one of the hallmark of cancer cells. Lipolipomics is an important branch of metabolomics, which has been adapted recently in the study of HCC for analysis of the structure and function of lipid components by chromatography and mass spectrometry. Fatty acids, glycerides, glycerophospholipids, sphingolipids, and sterol are significantly different in HCC tissues or serum. Therefore, it contributes to the diagnosis, determination of prognosis, mechanistic study and targeted therapy of HCC.

Single-pass intestinal perfusion( SPIP) is the common carrier of biopharmaceutics classification system( BCS) to study compound permeability. With the application and deepening study of BCS in the field of traditional Chinese medicine( TCM),SPIP model is becoming more and more common to study the intestinal absorption of TCM ingredients. Based on the limitations of the SPIP model in some researches on TCM permeability,it was speculated in this study that aglycone may be more suitable than the glycoside to study the intestinal absorption problem by using SPIP model. Furthermore,applicability of aglycone components was analyzed and evaluated. In this study,with quercetin,daidzein,formononetin,genistein and glycyrrhetinic acid used as research objects,the quantitative study of SPIP was used to evaluate the intestinal permeability of these aglycones and to predict the effective permeability coefficient( Peff) and absorption fraction( Fa) in human body. By combining studies comparison and analysis on multiple permeability research methods and prediction of human body absorption of aglycones in physiological-based pharmacokinetic models,this paper can further illustrate that the SPIP model is a good tool for studying the permeability of aglycones and predicting human absorption,which can provide data foundation and theoretical reference for researches on SPIP technique and BCS in intestinal absorption of TCM ingredients.

An anaerobic sequencing batch reactor(ASBR)was used to treat low-substrate simulated wastewater with NH 4 + -N and NO 2 - -N concentrations of (25.00±0.40) mg·L -1 and (33.00±0.60) mg·L -1 , respectively. The COD concentrations were controlled at 5.00, 15.00, 30.00, and 50.00 mg·L -1 by adding sodium acetate, and its effects on start-up of anaerobic ammonia oxidation (ANAMMOX) were investigated under the temperature of 30℃. The results showed that ① The start-up of ANAMMOX could be achieved successfully after 74, 94, 106, and 129 days. The nitrogen removal efficiency was optimum when the COD concentration was between 15.00 and 30.00 mg·L -1 . In the steady phase, the average effluent concentrations of NH 4 + -N were 1.98 and 1.89 mg·L -1 , the average effluent concentrations of NO 2 - -N were below 0.62 mg·L -1 , and the average effluent concentrations of TN were 2.37 and 2.28 mg·L -1 . ② The average contribution of heterotrophic denitrification to nitrogen removal decreased to 4.78%, 9.59%, 10.21%, and 36.50%, respectively, during start-up process. The average contribution of ANAMMOX to nitrogen removal gradually increased to 95.22%, 90.41%, 89.79%, and 63.50%, respectively. ③ The activities of ANAMMOX exceeded denitrification activities at 44, 76, 86, and 114 days, respectively, which finally reached 0.700, 0.690, 0.670, and 0.510 mg·(g·h) -1 , and the denitrification activities were 0.110, 0.130, 0.240 and 0.410 mg·(g·h) -1 , respectively. Thus, the research results have provided references for the application of ANAMMOX to engineering.

To investigate the effects of plastic film mulching and nitrogen fertilizer application on CH 4 emissions from a vegetable field, static opaque and gas chromatography methods were applied, and in situ field observations of a chili-radish rotation system, from May 2014 to April 2016, were carried out in the Key Field Station for Monitoring of Eco-Environment of Purple Soil of the Ministry of Agriculture of China in the farm of Southwest University in Chongqing. Eight treatments were set up in the field experiment:control routine (no N application and no plastic film mulching) (NN0), control mulching (FN0), low N routine (NN1), low N mulching (FN1), conventional N routine (NN2), conventional N mulching (FN2), high N routine (NN3), and high N mulching (FN3). The characteristics and influencing factors of CH 4 emissions and the changes of soil carbon and nitrogen composition from all treatments were studied. The results showed that there was no significant difference in the CH 4 emissions from the vegetable fields between the mulching methods. From May 2014 to April 2016, the annual average cumulative absorption of CH 4 in nitrogen-free, low-nitrogen, medium-nitrogen, and high-nitrogen vegetable fields under film-mulching cultivation was 28.96, 51.90, 43.43, and 34.41 mg·m -2 , respectively. The average annual cumulative uptake of CH 4 under conventional planting was 40.76, 63.56, 62.77, and 21.92 mg·m -2 , respectively. Different nitrogen application gradients had no significant effect on CH 4 emissions from vegetable fields. There was a significant positive correlation between CH 4 uptake and soil temperature, and a significant negative correlation between CH 4 and soil water content. Plastic film coverage accelerated the mineralization of soil carbon in the pepper season, but there was no significant effect in the radish season.

Objective: To explore the relationship between environmental factors as urinary cadmium and type 2 diabetes mellitus (DM) in adults. Methods: Case-control study was adopted, including 166 cases and 427 controls. General characteristics of the subjects were collected by a structured questionnaire. FPG, biochemical indexes and urinary cadmium (UCd) were detected respectively, while UCd was corrected with creatinine. Unconditioned logistic regression model was applied to analyze the relationship between UCd and DM. Results: Levels of UCd appeared higher in cases with the following characteristics as: having primary school education ( P =0.016), being female ( P =0.013), being non-smokers ( P =0.014) or non-alcoholic ( P =0.025), and with BMI>25.00 kg/m(2) ( P =0.040, P =0.025) than those appeared in the control group. Same results were shown in the 60-69 years ( P =0.024) old group. Data from the unconditional logistic regression analysis showed that family history of DM ( OR =3.19, 95 %CI : 1.45-7.03), education status ( OR =1.50,95 %CI : 1.08-2.08) and UCd ( OR =1.61, 95 %CI : 1.08-2.41) were influencing factors on DM. Conclusion: A close association between UCd and DM was noticed. UCd appeared a risk factor on DM that called for setting up related prevention program to reduce the exposure of Cd and to control the risk on DM.

To investigate the effects of plastic film mulching and nitrogen fertilizer application on N 2 O emissions from a chili-radish rotation system, field observations were conducted in situ from May 2014 to April 2016 in the Key Field Station for Monitoring of Eco-Environment of Purple Soil of the Ministry of Agriculture of China in the farm of Southwest University in Chongqing. Static opaque and gas chromatography was used to determine emissions. Eight treatments were set up in the field experiment:control routine (no N application and no plastic film mulching; NN0), control mulching (FN0), low N routine (NN1), low N mulching (FN1), conventional N routine (NN2), conventional N mulching (FN2), high N routine (NN3), and high N mulching (FN3). The characteristics and influencing factors of N 2 O emissions and the changes of soil carbon and nitrogen composition across all treatments were examined. The results demonstrated significant differences in N 2 O emissions from the vegetable fields between mulching and no mulching treatments. The mean N 2 O flux under no mulching was significantly greater than that of mulching during the chili growing season ( P <0.05), but the opposite was true during the radish growing season ( P <0.05). During the experimental period, the average annual cumulative N 2 O emissions from nitrogen-free, low-nitrogen, medium-nitrogen, and high-nitrogen vegetable plots under mulching treatment were 244.91, 730.49, 903.32, and 1865.45 mg·m -2 , respectively; the average annual cumulative N 2 O emissions under no mulching treatment were 221.48, 840.33, 1256.50, and 1469.67 mg·m -2 , respectively. The N 2 O emissions from vegetable plots with different N application gradients showed an increase in N 2 O emissions from vegetable plots as N application increased. By calculating the N 2 O emissions coefficient, it was determined that the N 2 O emissions coefficient was reduced to a certain extent under mulching treatment during the chili season, while there was no obvious trend in the radish season. From May 2014 to April 2015, the N 2 O emissions coefficients of low-nitrogen application under two mulching treatments were both the highest under the same mulching levels during the chili growing season, but they were both the highest in the high-nitrogen application under two mulching levels during the radish growing season. From May 2015 to April 2016, the highest N 2 O emissions coefficient was observed in the high-nitrogen application under two mulching treatments during the chili season; however, the lowest values were observed in the low-nitrogen application under two mulching treatments during the radish growing season. Such results may be related to the duration of plastic film mulching and the type of plant. The N 2 O fluxes were both significantly positively correlated to the content of soil N and soil temperature. Plastic film mulching can increase the soil N to a certain extent and can therefore can affect N 2 O emissions.

Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose.

The discovery of the complete ammonia-oxidizing microbes, Comammox Nitrospira , had fundamentally changed our perspective on traditional nitrification. The microbe also played a potentially under-appreciated role in the biogeochemical N cycle and provided a new dimension for the research of nitrification. To investigate the abundance of Comammox in different ecosystems was urgently needed. In the present study, three treatments with different quantities of fertilization in a paddy soil (blank control, NPK and 1.5 NPKS) to investigate the nitrification and amoA gene abundance for nitrifying microorganisms, especially for the complete ammonia oxidizing bacteria (Comammox Nitrospira ). The results showed that:① Both Comammox Clade A and Comammox Clade B were detected in all three treatments, and the abundance of Comammox Clade A were 9.0×10 7 , 1.7×10 8 , 7.2×10 8 copies·g -1 (dry soil), respectively, and for Comammox Clade B were 1.5×10 7 , 1.2×10 7 , 1.7×10 7 copies·g -1 (dry soil), respectively. ② The abundances of both ammonia-oxidizing archaea (AOA)in the three fertilizers was 1.5×10 7 -1.2×10 8 copies·g -1 (dry soil), and the ammonia-oxidizing bacteria (AOB) in the three fertilizers was 2.0×10 5 -9.3×10 7 copies·g -1 (dry soil), lower than the abundance of the Comammox. The ratio of Comammox to AOA was 7.2, and the ratio for Comammox to AOB was 524.4 for blank control, were greater than NPK and 1.5 NPKS treatments. ③ The ratio of Comammox Clade A to Comammox Clade B showed an increasing trend with the increase in fertilizer application, at 6.1, 14.4 and 43.1, respectively. ④ For NPK and 1.5 NPKS treatments, Comammox Clade A amoA gene copies were 1.9 and 8.0 times higher than that of the blank control treatment respectively, and the numbers for AOA significantly increased to 3.2 and 7.2 times that of the blank control. The AOB gene copy numbers increased by two orders of magnitude compared with the blank control. In addition, the nitrification potential increased with the increase in N fertilizer application; however, the effects of different fertilizer treatments on Comammox Clade B were not significant. Results indicated that Comammox was widely distributed in the neutral purple paddy soil and was higher in abundance than AOA or AOB, which implied that Comammox-especially Clade A-may contribute to the nitrification of paddy soil.

Objective: To analyze the recent postoperative and long-term postoperative complications of open-splenectomy and disconnection in patients with portal hypertension. Methods: There were 1 118 cases with portal hypertension who underwent open splenectomy and azygoportal disconnection from April 2010 to September 2015 at Department of Surgery, People's Liberation Army 302 Hospital. Retrospective case investigation and telephone follow-up were conducted in October 2016. All patients had history of upper gastrointestinal bleeding before operation. Short-term complications after surgery were recorded including secondary laparotomy of postoperative abdominal hemostasis, severe infection, intake disorders, liver insufficiency, postoperative portal vein thrombosis and perioperative mortality. Long-term data including postoperative upper gastrointestinal rebleeding, postoperative survival rate and incidence of postoperative malignancy were recorded, too. GraphPad Prism 5 software for data survival analysis and charting. Results: Postoperative short-term complications in 1 118 patients included secondary laparotomy of postoperative abdominal hemostasis(1.8%, 21/1 118), severe infection(2.9%, 32/1 118), intake disorders(1.0%, 11/1 118), liver dysfunction (1.6%, 18/1 118), postoperative portal vein thrombosis(47.1%, 526/1 118)and perioperative mortality(0.5%, 5/1 118). After phone call following-up, 942 patients' long-term data were completed including 1, 3, 5 years postoperative upper gastrointestinal rebleeding rate(4.4%, 12.1%, 17.2%), 1, 3, 5-year postoperative survival rate(97.0%, 93.5%, 90.3%); the incidence of postoperative malignant tumors in 1, 3 and 5 years were 1.7%, 4.4% and 6.2%. Conclusions: Reasonable choosing of surgical indications and timing, proper performing the surgery process, effective conducting perioperative management of portal hypertension are directly related to the patient's short-term prognosis after portal hypertension. Surgical intervention can reduce the rates of patients with upper gastrointestinal rebleeding, improve survival, and do not increase the incidence of malignant tumors.

A field experiment was conducted in the Key Field Station for Monitoring of Eco-Environment of Purple Soil of the Ministry of Agriculture of China in the farm of Southwest University in Chongqing. Static opaque chamber and gas chromatography methods were used to study the effect of plastic film mulching on CH 4 and N 2 O emissions characteristics from a rice-rapeseed crop rotation in situ for one year. The results showed that CH 4 and N 2 O emissions are mainly concentrated in the early stages of the growth of each crop and there is a clear seasonal variation of CH 4 emissions during the rice growing period and N 2 O in the rapeseed growing period. The CH 4 flux changed from -0.45 to 1.90 mg·(m 2 ·h) -1 and the N 2 O flux varied between -46.1 and 2040.7 μg·(m 2 ·h) -1 over the entire year. Plastic film mulching was found to increase the total emissions of CH 4 and N 2 O, with the total CH 4 emission of(27.22±4.48) kg·hm -2 over the entire year, which is 26.22% higher than that of the non-mulching treatment(19.93±0.56) kg·hm -2 . The total amount of N 2 O emissions under film mulching treatment increased 16.6% from (11.27±2.77) kg·hm -2 under no mulching treatment to (13.14±0.82) kg·hm -2 . The results analyzed for soil moisture and soil temperature showed that mulching significantly increased the soil moisture during the rapeseed season, while there was no obvious correlation with soil temperature (at depths of 5 cm and for the surface temperature) for each crop season. During the rapeseed growing season, CH 4 and N 2 O emissions negatively correlated with soil moisture and has a significant negative correlation during the seedling period with film mulching treatment. Moreover, under the two treatments, the correlation between CH 4 and N 2 O emissions and soil temperature was negligible. This study indicates that plastic film mulching impacts CH 4 and N 2 O emissions at different growth stages of the crops, which changes the proportion of the emission of the two gases over the whole growth period, and promotes the emission of CH 4 and N 2 O in the rice-rapeseed system. In the time scale of 100 years, the integrated global warming potentials (GWP) of CH 4 and N 2 O emission under plastic film was a CO 2 equivalent of 4213.00 kg·hm -2 compared with that under conventional treatment of 3454.17 kg·hm -2 . Conventional emits 22.0% less CO 2 , indicating that plastic film mulching is not an effective measure for carbon sequestration.

Considering the common cropping system (chili-radish rotation) in Southwest China, the objective of this study is to explore the effect of plastic film mulching on N 2 O flux, N 2 O concentrations in the soil profile, soil temperature, and humidity from a vegetable field. The method of the static opaque chamber was used and the experimental period lasted for one year. The results showed that the average flux of N 2 O was 1000.0 μg·(m 2 ·h) -1 in the conventional treatment and 400.6 μg·(m 2 ·h) -1 in the film mulching treatment during the chili growing period. The N 2 O flux of the film mulching treatment was significantly lower than that of conventional treatment ( P <0.05). However, in the radish growing season, the N 2 O flux of the film mulching treatment was higher than that of conventional treatment, but the difference between the two treatments was not significant ( P >0.05). N 2 O concentrations in the soil profile of the two treatments both increased with the increase in soil depth. The N 2 O concentrations showed significant correlations among the different soil profiles of each treatment; meanwhile, there was also a significant correlation between soil N 2 O concentrations at the same soil depth in different treatments. There was a significant positive correlation between the N 2 O concentration in different profiles and N 2 O fluxes in surface soils in the conventional treatment, but the N 2 O flux under the plastic mulching film treatment was only positively correlated with the N 2 O concentrations of 30 cm deep soil. The soil moisture and temperature observations showed that the effect of plastic film mulching on soil temperature was more significant in summer and the soil moisture was more prominent in autumn and winter. However, the results of the correlation analysis and principal component analysis showed that N 2 O emissions were mainly determined by the distribution of nitrogen in the soil and were affected by the change in soil total nitrogen content in the conventional treatment but N 2 O emissions were more sensitive to the variation in soil inorganic nitrogen in the film mulching treatment.

Objective: To study the clinical characteristics of sepsis with systemic capillary leak syndrome(SCLS) and to evaluate the therapeutic effect and clinical significance of fluid therapy adjusted timely in these patients. Methods: The clinical data of 34 patients with sepsis and SCLS in the Department of Hepatobiliary Surgery ICU of General Hospital of People's Liberation Army General Hospital from July 2014 to January 2016 were retrospectively analyzed.There were 21 males and 13 females, aged from 21 to 74 years, with an average age of 56.3 years.Primary disease as follows: 18 cases with severe acute pancreatitis, 7 postoperative cases of subtotal hepatectomy, 5 postoperative cases of pancreatoduodenectomy, 4 postoperative cases of cholelithiasis.These patients were divided into survival group and death group according to their 28-day survival status.The clinical data including C-reactive protein(CRP), platelets (PLT), brain natriuretic peptide (BNP), the level of arterial blood lactic acid(LAC), oxygenation index(PaO 2 /FiO 2 , OI), net fluid balance(NFB) and norepinephrine dosage(NE) were collected and compared between two groups at three different intervals(day 1-3, day 4-6, day 7-9). The measurement data and numeration data were statistically analyzed with t test and χ 2 test respectively to explore the inherent characteristics of the disease evolution and its clinical significance. Results: The survival group ( n =23)and the death group( n =11)had no significant difference in the characteristics of basic clinical characters.The condition of the survival group and the death group were both in progress in 1-3 days period manifested as increased CRP( t =-0.473, P =0.640) and BNP levels( t =0.140, P =0.895), decreased PLT counts( t =-0.505, P =0.620) in the inflammatory response, decreased LAC( t =-1.008, P =0.320) and OI level ( t =-2.379, P =0.020)in tissue perfusion index, and positive fluid balance(NFB: t =0.910, P =0.370), required NE( t =-0.853, P =0.400) to maintain effective perfusion pressure with systemic edema in both groups.There was no significant difference of all these clinical parameters between the two groups.The patients' condition of the survival group reached a plateau phase, whereas all relative indicators of the death group implied significant aggravation and deterioration of systemic infection(CRP: t =-3.438, P =0.000; PLT: t =1.649, P =0.110; BNP: t =-10.612, P =0.000), tissue perfusion (LAC: t =-11.305, P =0.000; OI: t =2.743, P =0.010)and tissue edema NFB( t =-4.257, P =0.000) and NE( t =-7.956, P =0.000) in 4-6 days period.In the last 7-9 days period the patients' condition of the survival group took a turn for improvement, yet the condition of the death group continued to deteriorate, refractory septic shock developed and multiple organ dysfunction syndrome followed afterwards inevitably(CRP: t =-10.036, P =0.000; PLT: t =6.061, P =0.000; BNP: t =-10.119, P =0.000; LAC: t =-24.466, P =0.000; OI: t =13.443, P =0.010; NFB: t =-8.345, P =0.000; NE: t =-7.121, P =0.000). Conclusions: The condition of patient with sepsis and SCLS would be improved markedly at the critical turning point around 7-9 days period since the effective systemic treatment began.If the infection does not be significantly constrolled and SCLS still remains in a sustained extravasation period in 7-9 days, the prognosis of these patients may be worse and the mortality may be higher than that of the patients mentioned before.

Using the static opaque chamber method and choosing a chili-radish cropping system, a field experiment, located in the Key Field Station for Monitoring of Eco-Environment of Purple Soil of the Ministry of Agriculture of China in the farm of Southwest University in Chongqing, was conducted in situ for one year. Mulching and non-mulching treatments were set in the field, and the seasonal variation of CH 4 flux and CH 4 concentrations in the soil profile and the seasonal changes in soil moisture and temperature were observed for different treatments to explore the effect of plastic film mulching on soil moisture and temperature. The results showed that plastic film mulching can significantly improve the surface soil temperature during the pepper growing season in spring and summer ( P <0.01), but no significant difference was seen during the radish growing season in autumn and winter ( P >0.05). The soil moisture of the plastic film mulching treatment was significantly higher than that of no mulching in the radish growing season ( P <0.05), but no significant difference was observed for the pepper growing season ( P >0.05). During the whole observation period and under the condition of plastic film mulching and conventional planting, the CH 4 flux from soil had no significant seasonal variation under all treatments, and the mean CH 4 fluxes were -7.64 μg·(m 2 ·h) -1 and -9.00 μg·(m 2 ·h) -1 , respectively. The cumulative CH 4 emissions for plastic film mulching and conventional planting were -0.54 kg·hm -2 and -0.64 kg·hm -2 , respectively, in the whole observation period, and all the treatments showed a net absorption of CH 4 for the whole observation period. The results showed that the plastic film mulching could weaken the ability of CH 4 as a sink of the CH 4 for the whole observation period. The CH 4 concentrations in different soil profiles were in the order 10 cm>20 cm>30 cm, and the concentrations of CH 4 change patterns in different soil layers were almost identical during the whole observation period. The CH 4 concentrations at the depths of 20 cm and 30 cm under the plastic film mulching soil were significantly lower than those under no mulching soil ( P <0.05), but no significant difference was observed for the depth of 10 cm ( P >0.05). Correlation analysis showed that, under the plastic film mulching conditions, CH 4 flux and the 5 cm geothermal showed significant positive correlation ( P <0.05), but CH 4 flux and soil moisture showed significant negative correlation ( P <0.05). However, under the conventional cultivation conditions, there were no correlations between CH 4 flux and the 5 cm geothermal or soil moisture. There was also significant positive correlation between CH 4 concentration in the 10 cm and 20 cm depth soil layers with the CH 4 concentration in surface soil ( P <0.01), and the CH 4 concentration in the 30 cm depth soil layer had significant positive correlation with the surface soil temperatures and the 5 cm geothermal. There was no significant correlation between soil CH 4 concentration and soil water content.

Objective: To investigate the characteristics of spectrum and drug resistance of pathogens causing sepsis in patients with severe acute pancreatitis(SAP). Methods: The clinical data of 63 SAP patients with sepsis admitted in Department of Hepatobiliary, People's Liberation Army General Hospital from January 2014 to December 2015 were retrospectively studied. There were 47 males and 16 females, aged from 22 to 73 years, with an average age of (52±11)years. Samples were collected mainly from: (1)pancreatic and peripancreatic necrosis and abdominal drainage; (2)bile; (3) blood or deep venous catheter; (4) sputum and tracheal catheter and thoracic drainage; (5) urine. Strain identification and drug-resistance test were preformed on positive specimens. Results: Of 244 pathogenic isolates, mainly derived from abdominal cavity(36.0%), blood stream (14.0%), central venous catheter(11.8%), necrotic tissue(9.1%) and sputum(8.1%); 154(63.1%) were gram-negative bacteria, 68 cases(27.9%) were gram-positive bacteria and 22 cases(9.0%) were fungi respectively. The top six common pathogens isolated were E . coli(16.0%), E .faecium and faecalis(15.2%), P .aeruginosa(10.7%), K .pneumonia(9.8%), Acinetobacter baumanni(8.2%), Stenotrophomonas maltophilia(5.3%)respectively. The detection rate of E . coli and K . pneumonia extended-spectrum β-lactamases(ESBL) was 84.6%(33/39) and 70.8%(17/24), the resistance rate to imipeniem was 12.8% and 25.0%, to cefperazone-sulbactam was 28.2% and 29.2%. As to P . aeruginosa and Acinetobacter bacillus, the resistance rate to imipeniem was 50.0% and 75.0%, to cefperazone-sulbactam was 42.3% and 70.0%; Stenotrophomonas maltophilia was completely resistant to cefperazone-sulbactam, but sensitive to minocycline, SMZ-TMP with the resistance rate less than 40.0%. Gram-positive bacterium strains mainly included E . faecium(38.2%, 26/68), E .faecalis(16.2%, 11/68) and Staphylococcus(35.3%, 24/68) which maintained high sensitivity to vancomycin, teicoplanin and linezolid, there was only one isolate resistant to vancomycin. Candida were the sole pathogens of fungal infections, sensitive to common antifungal drugs overall. Conclusions: The gram-negative bacteria are the predominant pathogens mainly including ESBL-producing isolates( E .coli and K . pneumonia) and non-fermentation bacteria( P .aeruginosa and Acinetobacter bacillus) causing sepsis in SAP. The infection rate and drug-resistance rate of these two kinds of pathogens are relatively higher.

Objective: To investigate the therapeutic efficacy and safety of laparoscopic radiofrequency ablation (LRFA) for specific-location hepatocellular carcinoma. Methods: To retrospectively analyze 496 patients with specific-location hepatocellular carcinoma treated with LRFA from January 2010 to January 2015 in our hospital. There was a total of 652 hepatic lesions with a mean diameter of (2.8±1.3) cm including 397 cases with single lesion and 99 cases with multiple lesions. The hepatic lesions were adjacent to major hepatic vessels, hepatic hilar region, diaphragmatic dome, gallbladder, or gastrointestinal tract and on the surface of the liver, respectively. Results: The 496 patients with 652 hepatic lesions were treated with LRFA successfully.The mean operation time was (48.2±9.6) minutes and the mean LRFA time per lesion was (30.3±8.6) minutes. No severe complications such as bleeding, bile leakage, gastrointestinal tract damage, diaphragmatic injury and liver function failure occurred after operation. The complete necrosis rate of the specific-location hepatocellular carcinomas was 78.4% (389/496) in one month after RFA, partially necrosis rate was 21.6% (107/496) and overall necrosis rate was 100%. In addition, the 1- and 3-year overall survivals (OS) were 95.6% and 88.5%, and progression free survivals (DFS) were 87.9% and 80.8%, respectively. Conclusions: LRFA is a safe, effective, economic and minimally-invasive therapeutic approach for patients with specific-location hepatocelluar carcinoma and has good clinical application value.

Objective: To compare the clinicopathological features and prognosis of pancreatic cystic neoplasms (PCN) between male and female patients. Methods: A total of 325 patients with histological confirmed PCN from January 2010 to October 2015 were enrolled. The clinicopathological features, laboratory examination, imaging features, treatment and prognosis were analyzed. Results: Of the 325 patients diagnosed as PCN, 104 were male and 221 were female. The average age of male patients was significantly higher than that of female patients (55.0±12.7 vs 47.9±13.4 years, P <0.001), however, the average tumor size of male patients was smaller than that of female patients (3.9±2.7 vs 4.9±3.0 cm, P =0.004). The location of PCN in male patients was predominantly located at pancreatic head and neck, and majority of male patients were mucinous cystic neoplasms. 1-year, 3-year and 5-year survival rates of patients with PCN were 98.5%, 92.6%, and 87.5%, respectively. 1-year, 3-year and 5-year survival rates of male patients were 97.8%, 84.9%, and 77.8%, however, those of female patients were 98.8%, 96.5%, and 92.2%, respectively. Female patients had better prognosis than male patients (χ 2 =5.543, P =0.019). Elevated CA19-9 (χ 2 =3.843, P =0.050), perineuronal invasion (χ 2 =6.250, P =0.012) and lymph node metastasis (χ 2 =4.529, P =0.033) were important prognostic factors for malignant mucinous cystic neoplasm. Conclusions: Male patients had low incidence of PCN, and were more common for mucinous cystic neoplasm. The long-term outcome of malignant PCN was poor. Even with complete resection, male patients still had worse prognosis. Close follow-up is recommended especially for male patients.

Objective: To summarize the 23-year experience of laparoscopic biliary surgery in General Hospital of PLA and evaluate the application of laparoscopic surgery in the treatment of biliary diseases., Methods: We retrospectively analyzed the clinical data of 11 419 consecutive patients with biliary diseases undergoing laparoscopic surgery from April, 1992 and December, 2014. The disease spectrum was compared between patients treated before December 31, 2003 and those treated after the time point., Results: The 11419 patients receiving laparoscopic surgery accounted for 56.3% of the total patients undergoing biliary surgeries during the 23 years, including 4701 male and 6718 female patients with a mean age of 50.9∓13.2 years (6-93 years). Most (80.83%) of the patients received laparoscopic surgery for gallbladder stones, and 12.53% patients had the operation for gallbladder polyps. The laparoscopic operation rate was 84.81% in patients with gallbladder stones and 34.91% in patients with extrahepatic bile duct stones, but remained low in patients with biliary carcinoma. In laparoscopic operations, laparoscopic cholecystectomy was the most frequent (96.18%) followed by operations for extrahepatic bile duct stones, in which primary suture accounted for 1.38%, traditional T tube drainage for 0.90% and laparoscopic transcystic duct exploration for 0.72%. For malignant tumors, laparoscopic technique was used mainly for the purpose of exploration (0.34%). The application of laparoscopic technique in biliary surgery tended to increase after the year 2004, especially for benign gallbladder diseases and extrahepatic bile duct stones (P<0.05)., Conclusion: Laparoscopic technique in biliary surgery is gradually replacing the traditional open operation and becomes the gold standard for the treatment of benign biliary diseases.

Objective: To discuss the significance of three-dimensional reconstruction as a method of preoperative planning of laparoscopic radiofrequency ablation(LRFA)., Methods: Thirty-two cases of LRFA admitted from January 2014 to December 2015 in Department of Hepatobiliary Surgery, Chinese People's Liberation Army General Hospital were analyzed(3D-LRFA group). Three-dimensional(3D) reconstruction were taken as a method of preoperative planning in 3D-LRFA group.Other 64 LRFA cases were paired over the same period without three-dimensional reconstruction before the operation (LRFA group). Hepatobiliary system contrast enhanced CT scan of 3D-RFA patients were taken by multi-slice spiral computed tomography(MSCT), and the DICOM data were processed by IQQA(®)-Liver and IQQA(®)-guide to make 3D reconstruction.Using 3D reconstruction model, diameter and scope of tumor were measured, suitable size (length and radiofrequency length) and number of RFA electrode were chosen, scope and effect of radiofrequency were simulated, reasonable needle track(s) was planed, position and angle of laparoscopic ultrasound (LUS) probe was designed and LUS image was simulated.Data of operation and recovery were collected and analyzed. Data between two sets of measurement data were compared with t test or rank sum test, and count data with χ(2) test or Fisher exact probability test.Tumor recurrence rate was analyzed with the Kaplan-Meier survival curve and Log-rank (Mantel-Cox) test., Results: Compared with LRFA group ((216.8±66.2) minutes, (389.1±183.4) s), 3D-LRFA group ((173.3±59.4) minutes, (242.2±90.8) s) has shorter operation time(t=-3.138, P=0.002) and shorter mean puncture time(t=-2.340, P=0.021). There was no significant difference of blood loss(P=0.170), ablation rate (P=0.871) and incidence of complications(P=1.000). Compared with LRFA group ((6.3±3.9)days, (330±102)U/L, (167±64)ng/L), 3D-LRFA group ((4.3±3.1) days, (285±102) U/L, (139±43) ng/L) had shorter post-operative stay(t=-2.527, P=0.016), less post-operation ALT changes (t=-2.038, P=0.048) and post-operative TNF-α changes(t=-2.233, P=0.027). Disease-free survival between two groups was significantly different (χ(2)=4.049, P=0.046). Disease-free survival of 12 months survival rates were 77.6% and 65.7% in 3D-LRFA group and LRFA group, respectively.The median disease-free survival was 16.0 months in LRFA group and over 24.0 months in 3D-LRFA group., Conclusions: Three-dimensional model of liver reconstruction based on image information is a powerful tool in liver surgery planning.It helps to simulate tumor location and vital tubular structure, make plan for interventional treatment, and therefore mean puncture time and operation time is shortened, influence on liver function is reduced, hospital stay is decreased and DFS is prolonged.

Objective: To explore the changing trend and clinical significance of disease spectrum of biliary surgery among 30 years in PLA General Hospital., Methods: We retrospectively analyzed the clinical data of 21 189 consecutive patients with biliary diseases in PLA General Hospital between January 1985 and December 2014 according to the inclusion criteria. Taking 5 years as a research group, all patients were divided into 6 groups, and then the 30 years of the disease spectrum of biliary surgery was described., Results: (1) From January 1985 to December 2014, the PLA General Hospital performed 21 189 cases of patients with biliary surgery diseases, including 9 460 cases of male, 11 729 cases of female (female∶male=1.24∶1). The average age was 52.1±13.5 years old (6-98 years). (2) Of the all cases, the most patients was cholelithiasis, accounting for 65.26%, and gallbladder stones accounting for 53.61%. The following disease was cholangiocarcinoma, accounting for 12.79%, and hilar cholangiocarcinoma accounting for 5.95%. (3) From the perspective of disease spectrum changing trend, the proportion of patients with cholelithiasis were decreased gradually, from 74.9% to 65.2%, while the proportion of patients with cholangiocarcinoma showed a gradual upward trend, rising from 6% to 14% (P<0.05); and the proportion of bile duct cystic dilatation and gallbladder carcinoma shared a gradual increase(P<0.05), however, the variation of proportion of gallbladder polyps and biliary stricture were not statistically significant (P>0.05). (4) In patients with cholelithiasis, the proportion of patients with gallbladder stones increased gradually from 71.9% to 82%, while the proportion of patients with bile duct stones decreased gradually from 28.1% to 18%. There was no statistical significance in the proportion of different types of cholangiocarcinoma patients (P>0.05) (40% of the patients with hilar cholangiocarcinoma, 25% of the intrahepatic cholangiocarcinoma, and 35% of the extrahepatic cholangiocarcinoma)., Conclusion: With the time changing, the disease spectrum of biliary surgery has also changed. The proportion of patients with cholelithiasis, especially the patients with bile duct stones, was declining gradually, and the proportion of patients with cholangiocarcinoma was increasing gradually.

Objective: To explore clinical results of posterior debridement combined with atlantoaxial fusion for upper cervical Tuberculosis. Methods: From March 2007 to April 2012, 8 patients with upper cervical Tuberculosis underwent posterior debridement combined with atlantoaxial fusion in our hospital were selected for retrospective analysis. 3 cases were males and 5 females, aged 29-65 (43.5±13.2) years. According to the pedicle destruction, using different screws (pedicle screw or laminar screw) fixation.In the preoperative and final follow-up, Japanese Orthopaedic Association score (JOA) and neck disability index (NDI) were used to evaluate neurological function and calculate improvement rate JOA score. At final follow-up, clinical efficacy was evaluated by Odom's grade. situation of internal fixation, fusion of upper cervical were assessed by imaging examination. During follow-up, complications were documented and analyzed. Results: Postoperatively 12 months, all bony fusion were achieved. Tuberculosis were reached clinical cure in 12-18 months. The JOA score increased from 10.5±2.0 preoperatively to 15.6 ±1.1 in final follow-up( P <0.05), and the NDI decreased from 29.9 ± 6.2 preoperatively to 8.6±1.6 ( P <0.05). At last follow-up, according to Odom's standard, excellent were obtained in 6 cases (75.0%), good 1 cases (12.5%) and ordinary 1 case (12.5%). No severe complications was documented during follow-up. Conclusions: The treatment of posterior debridement combine with atlantoaxial fusion, and structure grafting and local anti-Tuberculosis drug using intraoperative, not only could obtain reliable clinical efficacy, completely removal of lesions, but also obtain strong stability, which plays an important role in the treatment of cervical tuberculosis.

In order to investigate the effect of long-term (1991—2013) K fertilizer deficiency and surplus on potassium-bearing mineral and K nutrition of purple soil-soil primary, clay mineral composition and potassium (K) nutrition were determined on the long-term experiment of fertility and fertilizer efficiency in neutral purple soil by using X-ray diffraction (XRD) analysis technique. Five soil samples were selected from soil samples library for soil mineral analysis, including original soil, which preserved in 1991 before the experiment carrying out; K deficient treatment for 12 years and 22 years, which means no K fertilizer was applied during 1991—2003 and 1991—2013, respectively; and K surplus treatment for 12 years and 22 years, which means excess K fertilizer was applied during 1991—2003 and 1991—2013, separately. The result showed that, soil potassium-bearing primary mineral, such as mica, potassium feldspar, had apparently weathered and slaked for the K deficient treatment and the weathered extent gradually aggravated following fertilization ages, demonstrating fertilization for 22 years<12years

Objective: To compare the clinicopathological characteristics and prognosis of patients with small (≤5 cm) solid pseudopapillary neoplasm of the pancreas (SPN) and those with large (>5 cm) SPNs., Methods: We retrospectively analyzed the clinical characteristics, laboratory findings, radiological features, treatment and prognosis of 148 patients with histologically confirmed SPN between August, 2006 and December, 2014 and compared the data between patients with small SPNs (≤5 cm) and those with large SPNs (>5 cm)., Results: In the large SPN group, the female-to-male ratio was significantly higher than that in small SPN group (61/8 vs 56/23, P=0.009) and the patients were significantly younger in large SPN group (28.3±12.3 vs 33.0±11.4 years, P=0.016). Small SPNs (≤5 cm) typically presented as inhomogeneous solid or cystic tumors, while large SPNs (>5 cm) often appeared as homogeneous solid and cystic tumors, but they did not show any significant difference in aggressive behaviors (P=0.288). The 5-year disease-free survival of patients with small SPNs was 100%, and the 1-, 3-, and 5-year disease-free survival of patients with large SPNs was 98.6%, 94.9%, and 89.3%, respectively (P=0.030), showing no significant differences in the overall survival between the two groups., Conclusion: Small SPNs and large SPNs have different clinical characteristics. Even with complete resection, tumors larger than 5 cm are more likely to have tumor recurrence and metastasis, and close follow-up is recommended for these patients.

Objective: To describe the clinicopathological characteristics and prognostic factors of mucinous cystic neoplasm(MCN)., Methods: One hundred and thirteen patients with MCN comfirmed by histological examination admitted in People's Liberation Army General Hospital from January 1994 to June 2015 were analyzed, including 21 male and 92 female patients with mean age of (50.2±14.5) years. Forty-eight patients had incidental discovery of their cystic neoplasm for another reason, 65 patients were symptomatic, and abdominal pain or distension was main clinical symptom. Among 113 patients with MCN, 75 cases were MCN with dysplasia, and 38 cases were MCN with invasive carcinoma. Wilcoxon test and χ(2) test, et al were used to analyzed the data, respectively., Results: MCN was mostly located in body and tail of pancreas.Sex, mean age, clinical symptom, tumor size, and CA19-9 showed significant difference between MCN with dysplasia and MCN with invasive carcinoma (all P<0.05). The presence of a solid component (χ(2)=32.460, P=0.000)and main pancreatic duct dilation(χ(2)= 5.729, P=0.022) were significantly associated with malignancy. Fifty-eight patients with dysplasia were followed up, only one patient occurred tumor recurrence. Thirty-one patients with malignancy were followed up, among which there were 22 patients dead, 1-, 3-, 5-year survival of MCN with malignancy was 76.9%, 56.5%, 36.6%, respectively. Lymphatic metastasis and tumor recurrence were important prognostic factors of MCN with malignancy(both P<0.05)., Conclusions: MCN is most affected by old female with no specific symptom, most tumors are located at the body and tail of the pancreas.MCN with dysplasia have excellent prognosis underwent surgery. Even with complete resection, the long-term survival of MCN with malignancy is not satisfied.

Objective: To investigate the relationship between plasma cytochrome P450 3A4 (CYP3A4) 894C>T gene polymorphism and the risk of recurrence of adverse cardiac events after percutaneous coronary intervention (PCI) in patients with acute coronary syndrome (ACS)., Methods: A total of 275 patients with ACS received standard dual antiplatelet therapy and PCI. Platelet aggregation rate (PAR) was detected in each patient before and 7 days after administration of the anti-platelet drugs. Single nucleotide polymorphism of CYP3A4 gene 894C>T was detected with PCR and microarray technique. The number of coronary artery lesions was determined by PCI and the Gensini score was calculated. The patients were followed up for 3-12 months after discharge., Results: No significant difference was found in CYP3A4 gene polymorphism between patients with clopidogrel resistance (CR group) and those without CR (NCR group) (P>0.05). Multivariate logistic regression analysis showed that CYP3A4 gene 894C>T polymorphism was not correlated with CR in patients with ACS (OR 1.359, P>0.05). During the follow-up, the incidence of cardiovascular events was significantly higher in CR group than in NCR group (P<0.05), but this difference was not related to the mutation type of 894C>T locus of CYP3A4 gene., Conclusion: The CYP3A4 gene 894C>T polymorphism is not associated with the effect of anti-platelet therapy and the risk of cardiovascular event in patients with ACS following PCI.

Objective: To explore the change in serum adiponectin levels and its significance in children with Kawasaki disease (KD)., Methods: Forty-five KD patients were enrolled in this study, including 18 with coronary artery lesions (CAL group) and 27 without coronary artery lesions (NCAL group). Twenty healthy children were recruited to the control group. Enzyme-linked immunosorbent assay was used to measure serum adiponectin levels, and an automatic biochemical analyzer was used to measure the levels of triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C)., Results: The serum adiponectin levels in the CAL and NCAL groups were significantly lower than in the control group during the acute phase, subacute phase, and recovery phase (P<0.01), with lower levels observed during the acute phase and subacute phase (P<0.01). Compared with the NCAL group, the CAL group had significantly higher serum levels of adiponectin during the acute phase and recovery phase (P<0.05). The levels of TC, HDL, and LDL in the NCAL and CAL groups were significantly lower than in the control group (P<0.05). The levels of serum adiponectin in KD patients were positively correlated with the levels of TC, TG, and C-reactive protein and the occurrence of CAL (r=0.31, 0.30, 0.34, and 0.35, respectively; P<0.05)., Conclusions: Children with KD have metabolic disorders of blood lipids and reduced serum adiponectin levels. Reduced serum adiponectin levels may be the result of systemic inflammation, while increased adiponectin levels may be closely associated with the occurrence of CAL.

Objective: To study the protective effect of Ligustrazine Injection (LI) against cisplatin-induced ototoxicity and to explore its mechanism., Methods: Thirty healthy adult guinea pigs were randomly divided into three groups, 10 in each group, i.e., the normal control group, the cisplatin group, and the LI group. Guinea pigs in the normal control group were intraperitoneally injected with normal saline at 3 mL/kg for 7 consecutive days. Those in the cisplatin group were intraperitoneally injected with cisplatin at 3 mg/kg for 7 consecutive days. Those in the LI group were intraperitoneally injected with LI at 140 mg/kg for 7 days, but cisplatin (3 mg/kg) was intraperitoneally injected from the opposite side starting from the 4th day. Brainstem auditory evoked potential (BAEP) was performed in all animals before and after injection. All animals were sacrificed after the final testing under anesthesia and their cochleas collected. Half the cochleas of each group were collected for silver nitrate staining of cochlear basilar membrane stretched. The other half the cochleas of each group made into paraffin sections to observe the apoptosis of cochlea cells by TUNEL method and the expression levels of c-Jun detected by immunohistochemistry., Results: There was no statistical difference in the difference of BAEP threshold among the 3 groups before injection (P > 0.05), but the BAEP threshold increased in the cisplatin group and the LI group (P < 0.05). Besides, it was higher in the cisplatin group (P < 0.05). In the cisplatin group, most hair cells were missing, spiral ganglion cells obviously decreased, more TUNEL positive cells occurred, and the expression of c-Jun was stronger. But the aforesaid impairment in the LI group was obviously lessened (P < 0.05)., Conclusions: LI showed certain antagonist effect on cisplatin-induced ototoxicity. Its mechanism might be associated with scavenging oxygen radicals of the cochlea tissue, improving the microcirculation, and fighting against apoptosis.

Re-wetting was one of the most common forms of abiotic stresses experienced by soils. To investigate the effects of soil re-wetting rate on phosphorus (P) leaching and the relationship between soil microbial biomass carbon (MBC) and forms of P in leachate; five kinds of neutral purple soils of different fertilizer treatments were analyzed using simulating lab test at re-wetting rate of 0 h, 2 h, 4 h, 24 h and 48 h. The results showed that: (1) The lowest content of MBC appeared at the rate of 2 h during the soil re-wetting process, and the content of MBC increased with the reducing re-wetting rate. (2) Slower re-wetting helped to enhance soil microbial activity and the enhancement effect of organic fertilizer with NPK fertilizer (MNPK) was more significant. (3) The P leaching events of all fertilizer treatments occurred mainly at rapid re-wetting rates such as 0 h, 2 h, 4 h. Slower re-wetting was an important measure to prevent P leaching especially for the soils applied with chemical fertilizers, and it was of great significance in the field management of P. (4) Dissolved organic phosphorus (DOP) was the primary leaching part in leachate, and the variation range of ratio of total dissolved phosphorus (TDP) to total phosphorus (TP) and DOP to TP was 35.42%-85.99% and 29.74%-78.58% respectively. (5) With the reducing of re-wetting rate, significant negative correlation was observed between MBC and TP, TDP as well as DOP in the leachate (P < 0.05). To sum up, it was speculated that the P in soil leachate mainly came from soil microorganisms.

Abnormal proliferation of vascular smooth muscle cells (VSMCs) plays an important role in several pathological processes of cardiovascular diseases. In this study, the effects of XCT790, a potent and selective inverse agonist of estrogen-related receptor alpha (ERRalpha), on rat VSMCs proliferation and related signal pathways were investigated. The proliferative activity of VSMCs was determined by CCK-8 assay. The mRNA levels of ERRalpha, PGC-1alpha, OPN and MCAD were assayed by RT-PCR. The protein levels of ERRalpha, ERK2 and p-ERK1/2 were evaluated by Western blotting. ELISA was used to assess the protein expression of VEGF. The results showed that XCT790 (5-20 micromol x L(-1)) inhibited rat VSMCs proliferation, and the expression of ERRalpha and its target genes, as well as p-ERK1/2, were also inhibited. XCT790 inhibited VSMCs proliferation in a dose-dependent manner at the dose range from 5 to 20 micromol x L(-1) and in a time-dependent manner at the dose range from 10 to 20 micromol x L(-1). These findings demonstrate that XCT790 inhibits rat VSMCs proliferation by down-regulating the gene level of ERRalpha and thus inhibiting the ERK signal pathway, suggesting that ERRalpha may be a novel potential target for therapeutic approaches to inhibit VSMCs proliferation, which plays an important role in several cardiovascular diseases.

Objective: To systematically analyze and compare the clinical characteristics of orthopedic inpatients in Lushan and Wenchuan earthquake, so as to provide useful references for future earthquakes injury rescue., Methods: Based on the orthopedic inpatients in Lushan and Wenchuan earthquakes, the data of the age, gender, injury causes, body injured parts and speed of transport were classified and compared., Results: The duration of patients admitted to hospital lasted long and the peak appeared late in Wenchuan earthquake, which is totally opposed to Lushan earthquake. There was no significant difference in the patient's age and gender between the two earthquakes. However, the occurrence rate of crush syndrome, amputation, gas gangrene, vascular injury and multiple organ dysfunction syndrome (MODS) in Wenchuan earthquake was much higher than that in Lushan earthquake. Blunt traumas or crush-related injuries (79.6%) are the major injury cause in Wenchuan earthquake, however, high falling injuries and falls (56.8%) are much higher than blunt trauma or crush-related injuries (39.2%) in Lushan earthquake. The incidence rate of foot fractures, spine fractures and multiple fractures in Lushan earthquake was higher than that in Wenchuan earthquake, but that of open fractures and lower limb fractures was lower than that in Wenchuan earthquake., Conclusion: The rapid rescue scene is the cornerstone of successful treatment, early rescue and transport obviously reduce the incidence of the wound infection, crush syndrome, MODS and amputation. Popularization of correct knowledge of emergency shelters will help to reduce the damage caused by blindly jumping or escaping while earthquake happens.

Objective: To explore the long-term postoperative complications of Warshaw operation for distal pancreatectomy with preservation of spleen., Methods: Retrospectively analyzed the clinical data of distal pancreatectomy on 84 cases between January 2006 and January 2012. Among them, 35 patients underwent Warshaw operation for distal pancreatectomy with preservation of spleen and another 23 had distal pancreatectomy with Kimura operation. All of them were followed up., Results: All procedures were successful. There was no perioperative mortality. During the follow-up period, 2 patients undergoing Warshaw operation were lost. The median follow-up period was 2.6 years (range: 0.75-6.75). Twenty-six patients with the recent neuroimaging data showed: 5 patients were diagnosed of splenic infarction and the incidence rate was 19.2% (5/26) and 6 with gastric varices and the incidence rate was 23.1% (6/26). But none of them developed gastrointestinal hemorrhage or splenic abscess., Conclusion: The Warshaw operation for distal pancreatectomy with preservation of spleen may increase the risk of long-term postoperative complications so that its operative indication must be strictly mastered.

Objective: To explore the clinical application of laparoscopic distal pancreatectomy (LDP) in hepatobiliary operations., Methods: The clinical data of LDP from 25 cases from June 2008 to December 2011 were retrospectively analyzed. Among them, 9 patients underwent LDP with excision of spleen while another 16 patients had LDP with preservation of spleen. And during the same period, 42 patients undergoing open distal pancreatectomy were selected into the control group. And the patient data of two groups were compared., Results: All of them underwent successfully LDP. Among 16 patients with preservation of spleen, 11 patients undergone the Kimura procedure while another 5 undergone the Warshaw operation. The operative duration was (4.5 ± 1.2) hours, volume of blood loss (256 ± 188) ml, length of incision (4.6 ± 0.9) cm, mean time of oral food taking (1.5 ± 0.9) days and mean postoperative hospital stay (7.1 ± 1.9) days. Pathological examinations showed benign tumor (n = 20), malignant tumor (n = 4) and borderline tumor (n = 1). The mean data of LDP group was significantly less than that of open distal pancreatectomy group in terms of anal exsufflation time, length of incision, postoperative hospital stay time and complication rate, etc. (P < 0.05). Four patients were diagnosed of post-LDP pancreatic fistula (3 A level vs 1 B level) and all of them became cured after conservative treatment. There was no mortality., Conclusion: As a safe and feasible procedure, LDP is worthy of wider applications.

This study was purposed to investigate the correlation of absolute lymphocyte count (ALC) in peripheral blood of de novo multiple myeloma (MM) patients with clinical characteristics, therapeutic efficacy and prognosis. The clinical data of 34 de novo patients with MM in our hospital from January 2002 to August 2011 were analysed retrospectively. According to ALC, patients were divided into ALC < 1.3×10(9)/L (n = 15) group and ALC ≥ 1.3×10(9)/L (n = 19) group. The correlation of incipient ALC levels of de novo MM patients with clinical data such as sex, age, type of MM, bone destruction, clinical staging and grouping, levels of LDH, β(2)-MG, creatinine and albumin, as well as therapeutic efficacy was analysed. The results showed that ALC was (0.4 - 2.9)×10(9)/L (median ALC was 1.3×10(9)/L) in untreated patients. The effective rate of therapy was 20% in ALC < 1.3×10(9)/L group while it was 57.9% in ALC ≥ 1.3×10(9)/L group. There was statistical difference in effective rate between two groups (χ(2) = 4.9696, P < 0.05). Compared with the ALC ≥ 1.3×10(9)/L group, the percentage of the CD4 and CD4/CD8 ratio were reduced and the percentage of the CD8 increased (P < 0.05). But no significant differences were found in sex, age, type of MM, bone destruction, clinical staging and grouping, levels of LDH, β(2)-MG, creatinine and albumin in those patients (P > 0.05). It is concluded that ALC in de novo patients with MM may be used as the important indication for analysing therapy effect and prognosis.

Objective: To summarize the clinical experience with diagnosis and treatment of intrahepatic biliary cystadenoma (IBCA)., Methods: We retrospectively analyzed the data of 10 consecutive IBCA cases treated in our department in light of the characteristics of the epidemiology, radiology, lab tests, pathology and prognostic., Results: The patients are all female with an average age of 48.9 (16-73) years. The number of asymptomatic, slightly symptomatic and severe symptomatic patients was 4, 4 and 2, respectively. Radiological examination showed segmented cystic lesions in all the cases with an average diameter is 13.3∓4.9 cm. The incidence of segmentation, papillary or nodular hyperplasia, and calcification within the lesions was 90%, 60% and 20%, respectively. Macroscopic examination of the specimen showed compartmentation in the lesions, and microscopically, the lesions all showed lining of cubic or columnar epithelium on the inner wall with ovary-like or fibrous stroma. Complete resection of the tumor was achieved in 8 cases and partial resection was performed in 2 cases. The patients were followed up for a mean of 55.3 (12-164) months, and none of the patients with complete tumor resection showed recurrence, while both of the two patients with partial resection had postoperative recurrence., Conclusion: IBCA is a rare cystic lesion occurring primarily in middle-aged women. The preoperative diagnosis of this disease relies primarily on radiological evidences, and a complete resection of IBCA may prolong the patient survival.