Objective To explore the clinical characteristics of liver cirrhosis patients complicated with ischemic hepatitis . Methods The clinical data were reviewed retrospectively for 30 cirrhosis patients complicated with ischemic hepatitis from January 2008 to June 2013 in the intensive care unit of Dalian Sixth People′s Hospital .Results Ischemic hepatitis was identified in 1 .6% of the patients treated at the same period in ICU .In addition to the underlying disease including cirrhosis ,the patients also showed hypovolemic shock ,severe sepsis ,acute attack of chronic heart failure and acute respiratory distress syndrome . Acute increase of serum alanine aminotransferase(ALT) and aspartate aminotransferase(AST) was also reported in association with significant decrease of albumin .The patients were treated with comprehensive measures targeting shock ,infection ,heart failure ,respiratory failure ,and relevant symptoms .The overall mortality was 66 .7% (20/30) .The mortality was significantly higher in Child‐Pugh C cirrhotic patients than Child‐Pugh A or B patients .Conclusions The ischemic hepatitis in association with liver cirrhosis is mainly induced by hypovolemic shock ,severe sepsis ,heart failure ,and respiratory failure .Typical laboratory findings are sharp elevation of serum ALT and normalization after treatment . Liver cirrhosis complicated with ischemic hepatitis features high mortality ,particularly in Child‐Pugh C cirrhosis .

Objective To explore a reasonable and secure anesthesia induction in painless induced abortion.Methods 120 patients of painless induced abortion were randomly divided into six groups,control group was injected with Propofol 3.5mg/kg through vein,besides given Propofol 3.5mg/kg,other 5 groups were injected with ketamine 0.1mg/kg、0.2mg/kg、0.3mg/kg、0.4mg/kg、0.5mg/kg through vein respectively.The parameter of hemodynamics,effect of analgesia,time of unconsciousness,recovery time of consciousness,recovery time of orientation,incidence of respiratory depression,side effect,time of discharge from hospital were observed.Results The recorded time and incidence of side effect have statistical significance between group of ketamine 0.5mg/kg and group of ketamine 0.3mg/ks(P<0.05);effect of analgesia have statistical significance between group of ketamine 0.3mg/kg、0.4mg/kg、0.5mg/kg and control group.Conclusion Ketamine 0.3mg/kg combined with Propofol is an ideal choice of painless induced abortion.

Objective To examine the clinical features of sporadic patients with H7N9 avian influenzain Taizhou city of Zhejiang province and to characterize its viral genes.Methods Fifteen patients with H7N9 influenza infection confirmed by Zhejiang Provincial Centre for Disease Control and Prevention during January 201 4 and January 201 5 were included in the study.The basic diseases,poultry exposure history,clinical manifestation,laboratory examination,imaging features,treatment and outcome and viral gene sequencing were analyzed retrospectively.Results The first clinical symptoms were fever and cough in all patients,acuterespiratory distress syndrome(ARDS)occurred in 1 3 patients,the average time from onset to antiviral therapy was (7 ±2)d.Among 1 5 patients,9 survived and 6 died,including 2 died of multiple organ failure (MOF).The phylogenetic tree showed that there was highly homologous in hemagglutinin (HA)and neuraminidase(NA)genes between human H7N9 virus strains and poultry reference strains.The result of genetic sequencing indicated that human H7N9 virus strains had mutations at 226 (Q226L)sites in HA protein.Conclusions ARDS is likely to occur in patients with H7N9 viral infection,and early antiviral treatment usually leads to a good prognosis.With the occurrence of adaptive mutation in avian influenza virus H7N9,spread from poultry to the human beings may take place.