OBJECTIVE To observe the changes of inflammatory factors after the hepatic cystic echinococcosis surgery and explore the intervention effect of ulinastatin on postoperative inflammatory factors. METHODS Sixty patients with hepatic cystic echinococcosis were selected and randomly divided into a control group and ulinastatin intervention group according to whether or not use ulinastatin. The peripheral venous blood was extracted in all the patients and the levels of IL-6, IL-8, IL-9, and IL-10 were detected by the ELISA method on the day before operation, 1 day, 3 days, 5 days and 7 days after operation, respectively. The data was statistical analyzed to detect the relationships between/among the inflammatory factors mentioned above and ulina-statin and time. RESULTS The variation of the levels of IL-6, IL-8, IL-9, and IL-10 were changed by the intervention of ulina-statin at different time. The differences of the levels of IL-6, IL-8, IL-9, and IL-10 between the ulinastatin intervention group and the control group were not significant on the day before operation, 1 day and 3 days after operation (t = -1.15 to 1.82, all P > 0.05), but the levels of IL-6, IL-8, IL-9, and IL-10 of the ulinastatin intervention group were significantly lower than those of the control group and there were statistically significant differences 5 days and 7 days after the operation (t = 3.22 and 23.51, both P<0.05) . CONCLUSIONS Ulinastatin has a good effect in inhibiting the inflammatory factors and can protect and repair the postoperative hepatic injury as well in patients with hepatic cystic echinococcosis.

In this work, a simple coating method was employed to prepare a highly stable graphene oxide (GO) membrane for oil-in-water emulsions separation. By using mussel inspired polydopamine (PDA) as covalent linker, mixed cellulose ester membrane (MCEM) was successfully modified with PDA layer by self-polymerize, then GO nanosheets were attracted onto PDA/MCEM by simple vacuum filtration method, lead to the formation of GO/PDA/MCEM. The as-prepared membranes were characterized by FT-IR, TEM, AFM and contact angle, respectively. The results indicated that GO layer was uniformly coated on the support, and GO/PDA/MCEM had a rough surface and good hydrophilic property. Attributing to both the high adhesive ability of PDA and possible covalent interaction between GO and PDA, GO/PDA/MCEM was highly stable by being immersed in water environment for 12 h. GO/PDA/MCEM was employed to separate Tween-80 stabilized oil-in-water emulsions, The results showed that the prepared GO/PDA/MCEM had effective separation performance and reusability in the oil-in-water emulsions filtration for four cycles. This study provided a feasible, simple and economical way to prepare a highly stable GO-based membrane for oil-in-water emulsions filtration.

OBJECTIVE:To evaluate the value of the three-dimensional visualization technology for the preoperative assessment of liver autotransplantation for end-stage hepatic alveolar echinococcosis.METHODS:A total of 8 patients with end-stage hepatic alveolar echinococcosis undergoing liver autotransplantation in Qinghai Provincial People's Hospital from May 2013 to July 2017 were collected. All cases received preoperative abdominal CT scanning and dynamic three-phase enhanced CT scanning, and the original CT data were transferred to the human 3D visualization virtual surgical planning system. The volumes of Echinococcus multilocularis and pre-resected liver were measured using the 3D visualization reconstruction, and the relationship between the lesion and the neighboring tissues was observed. The value of the 3D visualization technology for the preoperative assessment of liver autotransplantation for end-stage hepatic alveolar echinococcosis was assessed by comparing with the intraoperative findings.RESULTS:The 3D visualization reconstruction model clearly displayed the adjacent relationship between the lesions of end-stage hepatic alveolar echinococcosis and the neighboring tissues, and no significant difference was seen between the pre-resected liver volume in 3D visualization reconstruction model and the actually resected liver volume (t = 1.083, P > 0.05).CONCLUSIONS:3D visualization technology is feasible to develop a reasonable scheme for liver resection and vascular anastomosis for end-stage hepatic alveolar echinococcosis prior to liver autotransplantation, which may increase the success of surgery and improve the prognosis.

目的:观察青海地区肝囊性包虫病术后肝功能变化,观察乌司他丁对术后肝功能干预作用.方法:选取2016年5月-2017年12月我院收治的肝包虫病患者60例,随机分为对照组及乌司他丁干预组.所有患者于术前、术后1d、术后3d、术后5d及术后7d抽取外周静脉血,进行生化检验.比较乌司他丁干预组与对照组各观察指标在不同时点的浓度变化.结果:乌司他丁干预组与对照组AST、ALT比较,术后3d、5d、7d均有统计学差异(P＜0.05)、TBIL、DBIL术后7天差异有统计学意义(P＜0.01);相同干预方法术后不同时间点与术前比较AST、ALT、DBIL、DBIL均有统计学差异(P＜0.05).结论:乌司他丁对于术后肝损伤可以起到保护和治疗作用.

目的:探讨损伤控制性手术在西宁地区严重肝外伤救治中的临床应用价值.方法:分析笔者在青海省人民医院进修期间收治的64例严重肝破裂患者的临床资料,分为两组:确切手术组(28例)和损伤控制组(36例),比较两组平均手术时间、术后并发症、病死率及总住院时间等指标是否存在差异.结果:损伤控制组在平均手术时间、术中出血量、乳酸清除时间、体温恢复时间、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)恢复时间、并发症发生率、病死率及总住院时间等方面明显低于确切手术组,差异有统计学意义(P＜0.05).结论:在西宁地区,损伤控制性手术在严重创伤性肝破裂治疗中意义重大,可大大降低患者术后病死率及并发症发生率,值得临床推广应用.

In this study, a new imprinted electrochemical sensor for selectively detecting sunset yellow was developed based on glassy carbon electrode (GCE) modified by graphene oxide decorated with silver nanoparticles–molecular imprinted polymers (GO/AgNPs–MIPs). GO/AgNPs were firstly synthesized using self-assembly technology, and GO/AgNPs–MIPs were synthesized through surface imprinted technology by using GO/AgNPs as the substrate and sunset yellow as the template, respectively. The sensor was prepared by a drop-casting method. The synthetic materials were characterized by transmission electron microscope (TEM), Fourier transmission infrared spectra (FT-IR), and X-ray diffraction (XRD). The sensor was characterized by cyclic voltammetry (CV) and electrochemical impedance spectroscopy (EIS). The usage amount of GO/AgNPs–MIPs suspensions, solution pH, and accumulation time made an important difference in the process of detecting sunset yellow. Under optimal conditions, the peak current is linear to concentration of sunset yellow in the ranges of 0.1–0.6 and 0.6–12 μM, and the limit of detection was estimated to be 0.02 μM (S/N = 3). Finally, the proposed sensor was applied to detect sunset yellow in soft drinks with acceptable recovery, which demonstrated that the sensor could be used as a reliable and simple method for practical detection of sunset yellow.

Ce(III) ion-imprinted polymer (Ce(III)-IIP) grafted on Fe3O4 nanoparticles supported by SBA-15 mesopores microreactor was successfully synthesized via reversible addition-fragmentation chain transfer (RAFT) polymerization for selective removal of Ce(III) from aqueous solution. The characterization results suggest that the surface ion-imprinted polymer (IIP) synthesized by RAFT is a thin layer. Adsorption isotherm experiments indicated that Redlich-Peterson isotherm model best fitted the experimental data and the adsorption capacity of IIP was obviously higher than that of non-imprinted polymers (NIP) at the same conditions. The kinetics of adsorption followed the Thomas model. Moreover, competitive adsorption studies illustrated that Ce(III)-IIP offers the advantages of selectivity towards Ce(III) compared with NIP even in the presence of other metal ions. All above results indicated the potential application of Ce(III)-IIP for selective removal of Ce(III) from aqueous solution.

目的:研究肝包虫病的流行病学特点.方法:自制青海省肝包虫住院病历资料卡,对4家医院近6年的肝包虫病住院病历进行收集和整理,并认真填写资料卡,分析比较统计结果.结果:2006-2011年,共收集整理952例肝包虫住院病历,其中囊性肝包虫病患者人数多于泡性肝包虫病患者人数;女性患者人数多于男性人数;2011年的肝包虫病患者人数最多,发病表现为逐渐上升的趋势.结论:囊性肝包虫病是青海省肝包虫病的主要临床类型,肝包虫病的发生和年龄、地区、职业以及性别等因素有直接关系.

包虫病又称棘球蚴病,是一种人畜共患的寄生虫病,主要流行于西北地区.包虫病可发生于人体各脏器,多发于肝脏,其他部位包虫病较为罕见,我院1989-2012年共收治腹膜后及肌肉多发包虫3例.现总结报道如下.

Objective To discuss the selection of surgical procedure, the curative effect and the safety of resection for hepatic hemangioma. Methods Clinical data of 96 patients with pathologically confirmed hepatic hemangioma who received resection in the People's Hospital of Qinghai Province from January 2000 to December 2011, were analyzed retrospectively. There were 34 males and 62 females with the age of 28 to 67 years old and the median age of 47 years old. There were 69 patients with single lesion and 27 patients with multiple lesions. The informed consents of all patients were obtained and the ethical committee approval was received. The patients received resection of hepatic hemangioma, or segmental hepatectomy, lobectomy, hemihepatectomy and hepatic hemangioma ligation. The procedure, intraoperative bleeding, postoperative complications and recurrence were observed. Patients were followed up after being discharged from hospital and liver ultrasonography was applied to check whether there was hemangioma recurrence. Results All the patients underwent operation successfully without perioperative death. Of the 96 patients, 68 patients received resection of hepatic hemangioma, 3 patients underwent right hemihepatectomy, 1 patient underwent left hemihepatectomy, 5 patients underwent hepatic caudate labectomy, and 19 patients underwent segmental hepatectomy; 27 patients with multiple lesions underwent resection of major lesions firstly and then the smaller lesions were ligated. The median of intraoperative bleeding was 630(60-5700)ml. Pleural effusion was observed in 9 patients, bile leakage in 3 cases, subphrenic hydrops in 2 cases and incision infection in 1 case. All the patients were cured by conservative treatment. Sixty-nine patients were followed up for 1-3 years and no hemangioma recurrence was found. Conclusions Surgical resection is a safe and effective treatment for hepatic hemangioma, in which hemangioma resection is the most common approach. Liver hemangioma ligation is usually performed to deal with the smaller lesions in patients after the major lesions are resected. Key words: Hemangioma, cavernous; Liver neoplasms; Hepatectomy; Suture techniques

<正>病人男性,36岁,牧民。因左侧股部肿块10年于2011-03-24入院。肿块初起仅杏子大小,生长缓慢,无疼痛,入院时已增至拳头大小。查体:左侧股部中上1/3处皮下可扪及一12.0cm×8.0cm×8.0cm肿块,边界清,无触痛,触之囊性感,叩之有振颤感,局部皮温及颜色正常。包虫酶联免疫吸附试验阳性。彩超

Object:To deal with possibility and strategy of the non-operation treatment for severe acute pancreatitis(SAP) in clinic in Qinghai province.Methods:183 cases of SAP that meet the criteria set by The Pancreas Surgery Branch of Chinese Medical Association,2005,in our hospital were randomly assigned to operation group(n=64,to undergo surgery),or non-operation group(n=119).The effect of therapy,mortality and incidence of complications was compared between the both groups.Results:Of 183 cases of SAP,the recovery cases were 149(81.42%).The mortality and incidence of complications was 13.45% and 47.35% for the non-operation group,respectively,and 28.13% and 71.87% for operative group,respectively.There was a significant difference(P<0.05) between the non-operation and operation group.The therapy associated remarkably with the values of APACHE II for admission.Conclusion: Non-operation treatment of SAP may contribute to gain the satisfactory therapeutic efficacy.The early non-operation treatment is important to decrease of mortality for SAP.

1 病历摘要 男,44岁,藏族.7年前因"囊性肝包虫病"行肝包虫内囊摘除手术.1年前患者无明显诱因发现右上腹部一包块约鸡蛋大小,伴上腹部胀痛不适,右侧腰背部放射痛,休息后不缓解.入院查体:右上腹肋缘下可见一长约15 cm的陈旧性手术瘢痕,原手术瘢痕内下方、近剑突局部明显隆起,可触及一约12 cm×10 cm大小包块,边缘较清楚,质硬,活动度差,轻度压痛,无反跳痛,肝脾肋下末触及肿大,下腹部未触及异常包块,未扣出移动性浊音,肠鸣音正常.实验窒检查:肝包虫免疫试验阳性.腹部彩超示上腹部囊性包块(考虑包虫).

<正>甲状腺结节在临床上并非少见,曾有人估计约4%的成人可发生甲状腺结节。甲状腺结节的性质非常多样,包括单纯性甲状腺肿、Graves病、甲状腺炎、甲状腺腺瘤等良性病变,也包括甲状腺癌

目的:分析重症胰腺炎患者死亡原因。方法:选择我院1990年—2005年收治32例重症胰腺炎死亡患者的临床资料进行分析。结果:引起死亡的主要并发症为休克、ARDS、腹腔感染、术后出血、肠瘘。结论:早期防治各种并发症是降低重症胰腺炎患者死亡的关键。

重症急性胰腺炎是外科急重症之一,发病急,病情重,并发症多,病死率高达20%～30%[1].患者大多死于多器官衰竭和严重感染,治疗困难,迄今尚无统一的满意方案.我院在对该病综合治疗时,早期加生大黄粉灌肠,取得了良好的疗效,现报道如下:

目的:探讨西宁地区急性重症胰腺炎手术后的死亡原因。方法:分析我院1990年—2005年收治急性重症胰腺炎手术后死亡22例分析。结果:因呼吸窘迫综合征(ARDS)死亡81.8%(18/22),感染性休克死亡54.5%(12/22)。结论:重症胰腺炎手术后的死亡原因主要为ARDS和感染性休克。

为探讨手术在急性重症胰腺炎治疗中的作用,我们对1996年10月至2005年10月收治的183例急性重症胰腺炎患者的临床资料进行回顾分析,报告如下.

Objective To investigate the role of tumor necrosis factor alpha(TNF-α) and the influence of salvia miltiorrhiza on septic liver injury in the model of sepsis in rat induced by cecal ligation and puncture(CLP).Methods The male rats were divided randomly into four groups,e.g.control group(Control),sham operated group(Sham),model group and salvia miltiorrhiza interfered group.The changes of serum alanine transaminase(ALT) and TNF-α both in serum and hepatic tissue were observed consecutively.Results Comparing with Sham group,TNF-α level in CLP group began to increase at 12 hour and reached their peak at 24 hour.The advance in TNF-α level in Salvia group lagged behind CLP group and reached peak at 48 hour.The level both in serum and tissue in Salvia group was significant lower than that in CLP at 12 and 24 hour,respectively.Conclusion Increase of TNF-α levels involved the pathogenesis of acute septic liver injury.The interfering effects of Salvia miltiorrhiza for hepatocellular injury in sepsis may be via decreasing TNF-α production.