PurposeWith the extensive use of percutaneous radiofrequency ablation (RFA) for the treatment of hepatic carcinoma (HC), the study of MRI findings and its clinical signiifcance after RFA of HC have important value and can improve the complete ablation rate.Materials and MethodsA retrospective analysis of post-procedure MRI ifndings of 79 patients (114 lesions) with HC were performed, the size of the lesion, the signal changes and enhancement condition were observed at the ifrst, fourth and seventh month after RFA; the two different ifndings of high signal ring on MRI T1WI and local recurrence rate were analyzed.ResultsOne month after RFA, peripheral region of RFA lesion showed high signal on T1WI, and slightly lower signal on T2WI, the size of lesions was slightly larger than pre-procedure, enhancement scan showed the thin homogeneous ring enhanced around the non-enhanced lesions; 4 months later, the size of lesions were relative stable and the periphery enhancement was weaken; 7 months later, the size of lesions were reduced and showed no enhancement. For recurrence lesions, the high signal ring was incomplete on TIWI, the incomplete area showed nodular enhancement on the arterial phase, and most of nodule showed slightly lower signal on the delay phase demonstrated a feature of quick wash-in and wash-out; 7 months after RFA, recurrence rate was 6.12% in patients with complete high signal ring and 43.75% in patients with incomplete high signal ring, the difference was statistically significant (P<0.05). The total survival rate and accumulated survival rate of the patients with complete high signal ring on T1WI were higher than the patients with incomplete ring, the difference was statistically signiifcant (P<0.05).ConclusionThere are characteristic ifndings of MRI examination of liver cancer after percutaneous RFA, observation of the integrity of high signal ring on T1WI image and ifnding of dynamic enhancement scan can early evaluate efifcacy of RFA guide the selection of treatment plan.

Objective To investigate the clinical curative effect of Prepenem for pathogen from cranial neu-rosurgieal patients with lower respiratory tract infection after traeheotomy and to provide basis for treatment of such pa-tients. Methods Thirty-two cranial neurosurgical patients with lower respiratory tract infection after tracheotomy were enrolled in the study with original empiric therapy with Prepenem. And the pathogenic bacteria in sputum from patients with lower respiratory tract infection after traeheotomy were stricdy identified and analyzed by automatic mi-croorganism analyzers. The clinical efficacy of Prepenem was identified after treatment. Results The straim of bacte-rial species(48) and funni(5) from 32 specimens were isolated. 15 strains were infected by one kind of bacteria and 38 strains were infected by two kinds of bacteria. Among the pathogen, gram-negative bacilli were about 64. 1% and Klebsiela pneumoniae (18. 8%)was the most predominant, gram-positive coccobacteria were about 26. 4% and Staph-ylococcus aureus(13.2%)was the most predominant,funni were about 9.4% and C. albicans (5.7%)was the most predominant. The drug sensitivity test showed that the ratio of drug resistance of bacteria isolated from sputum was high,but gram-negative bacilli were highly sensitive to imipenem. Staphylococcus aurens was sensitive to Nitrofuran-toin and Rifampicin. Satisfied clinical curative effect was shown by the de-escalation therapy for all patients. Conclu-sions Gram-negative bacili in cranial neurosurgical patients with lower respiratory tract infection after tracheotomy are the main pathogenic bacteria from lower respiratory tract infection, and Staphylococcus aureus are the main gram-positive cocci. So the drug sensitivity test of sputum should be done more often and antibiotics must be selected ac-cording to the drug sensitivity test. In general, this kind of infection can be controlled by prepenem effectively.

Objective To compare the efficacy of ureteroscopic lithotripsy(URL)combined with occlusion device and the supine and lithotomy position mini-invasive percutaneous nephrolithotomy(mPCNL)in the treatment of upper incarcerated ureteral stones. No difference could be found in age,sex and size of stones between the two groups. Method From Jan. 2014 to Dec. 2016 in our hospital,all cases of upper incarcerated ureteral stones were diviede into two groups:52 in ureteroscopic lithotripsy combined with occlusion device group and 45 in mini-inva-sive percutaneous nephrolithotomy group. Result The hospitalization and operation time in URL group were(5.5 ± 1.4)days and(53.3 ± 12.4)mins,which were significantly shorter than that in mPCNL group with(9.1 ± 3.2)days and(78.2 ± 14.1)mins,(P<0.05). There were no differences between mPCNL and URL groups in the success rate of operation(97.8% vs 94.2%,P > 0.05),stone clearance rate(100% vs 91.8,P > 0.05)and complication rate (4.4%vs 3.9%,P>0.05). Conclusion URL combined with occlusion device can obtain satifactory results as well as the supine and lithotomy position mPCNL in the treatment of upper incarcerated ureteral stones.

Objective To explore and analyze the influencing factors of family caregiving behavior and protective strategies in children with recurrent lower respiratory tract infection. Methods By reviewing the literature, a self-designed questionnaire for family caregiving behavior related to recurrent lower respiratory tract infection were adopted, including feeding behavior, hand hygiene, environmental factors, time of outdoor activities and family health-seeking behavior. Totally 206 cases with recurrent lower respiratory tract infection (the study group) and 206 cases with acute lower respiratory tract infection (the control group) were included and all cases were investigated by family caregiving behavior questionnaire. The influencing factors of family caregiving behavior of two groups were analyzed and compared. Results The feeding behavior in the study group was worse than that in the control group(χ2=5.14-14.76, P<0.05). There were significant differences in family health-seeking behavior (χ2=4.76, P=0.03), 49.50%(102/206) in the control group,38.8%(80/206)in the study group and passive smoking (χ2=5.70, P=0.02) between two groups. There was no significant difference between two groups in hand hygiene, time of outdoor activities, history of contacting with patients with respiratory tract infection, cold history (χ2=0.48-2.63, P>0.05). Conclusions We should guide parents to establish the right and reasonable family care behavior to effectively enhance children's physical fitness and disease resistance and to avoid exposure to infectious agents and harmful substances, reduce the occurrence of Recurrent Lower Respiratory Tract Infections.