Objective To study the changes of liver function and its clinical significance during the treatment of hepatocellular carcinoma by hepatic arterial and segmental arterial embolization. Methods Hepatic arterial embolization (conventional LP-TAE) was performed in 52 cases of hepatocellular carcinoma and segmental arterial embolizational(segmental LP-TAE) was done in 33 cases. The main data of the change of liver function were reviewed in three days and six months after treatment. All cases were followed up for 1 to 5 years. Results The change of ALT, AST, ALP, TBIL in conventional LP-TAE were remarkably increased than that in segmental LP-TAE after three days (P=0.000). After six months by LP-TAE, the Child of liver function in segmental group decreased obviously lighter than that in conventional group (P=0.000). The survival rates at 1-, 3-, and 5-year were 90.9%, 60.6% and 30.3% in segmental LP-TAE, respectively, and 61.5%, 21.2% and 7.7%, in conventional LP-TAE, respectively (P =0.003, P =0.000, P =0.006). Conclusion Segmental LP-TAE possesses stronger anticancerous effect and much less damage to liver function. Segmental LP-TAE is obviously superior than conventional LP-TAE in long term effectiveness.

Objective:To explore the feasibility of using Hirsch index(H index) to evaluate the performance of academic papers published by medical talents.Methods:67 medical talents of Wuxi People′s Hospital Affiliated to Nanjing Medical University were enrolled in the study. The numbers of papers published and citations of these talents which have been included by PubMed, Chinese Citation Database, CNKI, Wanfang, and Baidu Scholar. The H value of these talents was calculated according to the list method proposed by Rousseau R. The H index was compared with the traditional evaluation indexes of scientific research performance, such as the number of papers published, the total number of citations and the average number of citations. Pearson test was used to explore the correlation between H index and traditional evaluation index.Results:The H value of 67 talents ranged from 1 to 14. Pearson test showed that the H index was significantly correlated with the total number of papers, the total number of citations and the average number of citations at the level of 0.01, and their Pearson value was 0.746, 0.932, and 0.648 respectively.Conclusions:As a new scientific research performance evaluation system, the H index is recommended in the evaluation of medical personnel, but it needs further and sustained optimization in terms of database inclusion timespan, research work timespan, and authors ranking limit among others.

BACKGROUND:Rehabilitation training equipments play an important role in the rehabilitation treatment. Because of poor muscle strength and joint mobility in patients, we must guarantee the safety of rehabilitation training equipments.
OBJECTIVE:To design a new suitable man-machine interface that ensures patients can use rehabilitation equipments and even parts of fitness equipments safely.
METHODS:Through user experience research, we found the flaws of the existing rehabilitation equipment. Depending on the principles of ergonomics, we designed a new man-machine interface for upper limb exercise through survey and computer-aided design.
RESULTS AND CONCLUSION:The new man-machine interface program achieves the rapid wear and discharge between patients and rehabilitation training equipment, and importantly, it can automatical y separate people from the equipment when the patient's body discomforts or equipment failure appears. What’s more, this man-machine interface can be promoted to other fitness equipments. As a result, rehabilitation training for patients wil be more convenient.

Objective To compare influences of enteral nutrition (EN) and parenteral nutrition (PN) on the inflammatory factors and immune functions in patients with systemic inflammatory response syndrome. Methods Totally 85 patients who were treated in the First Hospital of Shanxi Medical University, Shanxi Province People's Hospital, and Taiyuan Central Hospital from April, 2006 to April, 2010 were enrolled in this study and divided into EN group (n = 49) and PN group (n = 36) according to nutrition support modes. The changes of inflammatory factors and immune functions after nutritional supports were recorded and compared between these two groups. Results The weight, arm circumference, skin fold thickness of brachial triceps, total protein, and serum albumin were significantly improved on the 7th and 14th day after nutrition supports in both two groups compared with the baseline levels (all P ＜ 0.05). On the 14th day after nutritional support, the levels of total protein and serum albumin were significantly higher in EN group than in PN group. On the 7th and 14th day, the levels of tumor necrosis factor-α, Interleukin (IL)-8, and IL-1β in EN group were significantly lower than those in PN group and baseline levels (all P ＜ 0. 05). The blood CD4/CD8 and IgG in EN group were significantly increased compared with the baseline levels and those in PN group (both P ＜0. 05). Conclusions Both PN and EN can effectively improve the nutritional status of patients with SIRS. EN has superior effectiveness in EN group than in PN group in terms of improving nutritional status, ameliorating immune function, and reducing the release of inflammatory factors.

BACKGROUND:Digital three-dimensional model which can reflect the fine structure of the chambers inside heart not only enhances the understanding of cardiac physiology, but also provides basic medical data for the study of cardiac electrophysiology simulation and endocardial electrophysiological mapping navigation. OBJECTIVE:To construct the digital three-dimensional model of cardiac cavity from sectional data and in conformity with the actual anatomical structure. METHODS:Image segmentation was accomplished in MATLAB environment. Firstly, registration of human cardiac cavity slice dataset was realized. Secondly, classifying each composition was achieved by clustering method according to color characteristics of the image. Then, both cardiac cavity and related connected region was distinguished by region growing method. At last, the processed image was reconstructed through dedicated medical processing software into three-dimensional model of the cardiac cavity. RESULTS AND CONCLUSION:The proposed method could reconstruct quite exquisite three-dimensional model of the cardiac cavity. In models, left and right atrial and ventricular structure was clear. Aorta and superior vena cava were visible. Three tricuspid and mitral valve were also observed. Results indicated that reconstructed model can reflect the anatomical characteristics of cardiac cavity accurately, and provide basic medical data for the study on electrophysiological simulation and endocardial electric mapping.

Objective To investigate the expression of cardiac troponin-Ⅰ (cTnⅠ) levels in patients diagnosed with sepsis-associated myocardial dysfunction and explore the relationship between cTn Ⅰ and cardiac systolic and diastolic function.Additionally,we evaluated the prognostic value of cTn Ⅰ as a valuable biomarker.Methods We admitted 65 patients with sepsis.Using echocardiography,the ratio of early diastolic mitral inflow velocity to early diastolic mitral annulus velocity (E/e') and the left ventricular ejection fraction (LVEF) were measured as an evaluation index of left ventricular diastolic and systolic function,respectively.Patients were divided into a cardiac dysfunction and a normal cardiac function group.The cTn Ⅰ level was measured and compared between the two groups,and we determined the correlation between cTn Ⅰ levels and cardiac diastolic and systolic function.Based on assessment of 28-day mortality,cases were divided into a survivor and a death group.A receiver operating characteristic curve was constructed to predict the prognostic value of cTn Ⅰ.Results The cTn Ⅰ level in the cardiac dysfunction group was significantly higher than that observed in the normal cardiac function group (P ＜ 0.05) and showed a positive correlation with E/e'(r =0.421,P =0.008).However,there was no correlation noted between the cTn Ⅰ level and LVEF (P ＞ 0.05).Compared to the survivor group,the level of cTn]Ⅰ was significantly higher in the death group (P ＜ 0.05).The prognostic value of cTn Ⅰ area under the curve was 0.892,with a cut-off value of 0.82 ng/mL (sensitivity =88.0％ and specificity =82.5％).Conclusion The cTn Ⅰ level is noted to be significantly elevated in patients with sepsis-associated cardiac dysfunction and shows a positive correlation with left ventricular diastolic function.A cTn Ⅰ level ≥ 0.82 ng/mL can be used as a valuable predictor of mortality in patients with sepsis.

Objective:To investigate the effects of using a high monounsaturated fatty acid (MUFA) and low carbohydrate formula on blood glucose levels and diarrhea treatment effects in critically ill neurological patients.Methods:A self-controlled before-and-after study design was employed, with 13 patients admitted to the neurology intensive care unit (ICU) of the First Affiliated Hospital of Sun Yat-sen University from November to December 2023, who were treated with a high MUFA and low carbohydrate formula [Glucerna enteral nutrition (EN) preparation]. Changes in blood glucose parameters within 7 days before and after the use of Glucerna EN preparation were analyzed, including standard deviation ( SD) of blood glucose, mean blood glucose (MG), median blood glucose, mean amplitude of glycemic excursions (MAGE), largest amplitude of glycemic excursions (LAGE), coefficient of variation ( CV) of blood glucose, the incidence of hyperglycemia (> 7.8 mmol/L) and severe hyperglycemia (> 13.9 mmol/L), and daily insulin dose. Changes in total protein (TP), albumin (ALB), hemoglobin (Hb), C-reactive protein (CRP), and white blood cell count (WBC) were observed before and after intervention. Improvement in diarrhea symptoms, Hart diarrhea score, Bristol Stool classification score, and incontinence dermatitis classification were also analyzed before and after the use of Glucerna EN preparation. Results:A total of 13 critically ill neurological patients were enrolled, among whom 9 patients had a history of hyperglycemia and 8 patients had diarrhea symptoms. After intervention with Glucerna, the patients' SD of blood glucose, MG, median blood glucose, MAGE, LAGE, CV of blood glucose, incidence of hyperglycemia, incidence of severe hyperglycemia, and daily insulin dose were all lower than those before the intervention [ SD of blood glucose (mmol/L): 1.83±1.11 vs. 2.10±1.13, MG (mmol/L): 8.87±2.03 vs. 9.75±1.37, median blood glucose (mmol/L): 9.12±1.67 vs. 10.17±0.48, MAGE (mmol/L): 0.66±0.31 vs. 0.78±0.32, LAGE (mmol/L): 4.95±3.64 vs. 5.58±3.10, CV of blood glucose: 16.00% (11.00%, 28.50%) vs. 18.00% (12.50%, 27.50%), hyperglycemia incidence: 47.31% vs. 74.66%, severe hyperglycemia incidence: 6.08% vs. 6.71%, daily insulin dose (U): 5.25 (0.00, 32.59) vs. 20.76 (0.00, 66.88)], with a significant decrease in daily insulin dose after the intervention ( P < 0.05); TP, ALB, Hb, CRP and WBC showed no significant changes before and after the intervention with Glucerna EN preparation. The improvement time of diarrhea symptoms after intervention was (3.50±1.41) days, and the Hart diarrhea score on the seventh day after intervention (4.88±3.48 vs. 10.00±3.38) and the Bristol Stool classification score on the third and seventh days after intervention (5.87±0.35, 5.50±0.53 vs. 6.50±0.53) were significantly lower than before the intervention (all P < 0.05). Before the intervention with Glucerna EN preparation, the classification of incontinence dermatitis was mainly classified as Grade 2 severity (71.43%); after the intervention, it significantly improved by the seventh day, with Grade 1 being the main classification (57.14%). Conclusion:The high MUFA and low carbohydrate formula has a positive effect on blood glucose control and diarrhea treatment in critically ill neurological patients.