Objective To objectively evaluate the endpoint ot transcatheter arterial chemoembolization (TACE) using two dimensional color-coded digital subtraction angiography (2D-ccDSA).Methods Retrospective analysis of twenty-four patients diagnosed with hepatocellular carcinoma (HCC),treated by TACE and evaluated by post-processed 2D-ccDSA.All patients were examined by DSA before and after TACE procedure,all these DSA series were converted into color-code images,the time density curve (TDC) was derived from the 2D-ccDSA imaging.Time-to-peak (TTP) was measured for the ostia of the catheter,the origin of the tumor feeding artery (TFA) and the embolized site of the TFA; maximal TDC enhancement was measured for selected spots of the tumor parenchyma.The tumor blood supply time (TBST) for pre and post-TACE was calculated accordingly.Data were interpreted with paired t test using SPSS.Results The TTP of the ostia of the catheter and the origin of the tumor feeding artery (TFA) before TACE were (3.47 ± 0.96) and (4.09 ± 1.09) s,after the TACE were (3.49 ± 1.02) and (3.78 ± 1.05) s,respectively.There was no statistical difference between the pre-and post-procedural TTP of the two landmarks (t values were 0.10 and 1.15,P values were 0.92 and 0.26).TTP at the embolized site of the main TFA were [(4.62± 1.16) and (5.59± 1.57)s]for pre and post-TACE,the tumor blood supply time (TBST) was greatly delayed compared with that after the TACE procedure [(1.82± 1.10)s and (0.52±0.41)s].The mean maximal TDC enhancements of the tumor parenchyma areas were (3.03±0.88)units before TACE and (1.10±0.67)units after TACE.The differences were all statistically significant (t values were 3.32,6.04 and 8.93,respectively,P＜0.01) Conclusion It is feasible to use 2D-ccDSA to objectively assess the endpoint of TACE procedures.

OBJECTIVE:To establish an overall teaching evaluation system for clinical pharmacology with PBL(problem-based learning) mode. METHODS:The teaching evaluation system was established by“Delphi”method,and it has been applied to 270 students at China Medical University in 2013-2014. RESULTS:According to the result of test score,PBL method can improve abil-ity of analyzing medical records,while formative evaluation indicates most of the students are satisfied with class response.And PBL method also can enhance student’s skill of clinical practice,broaden the knowledge an so on. CONCLUSIONS:The evaluation sys-tem was comprehensive with contents,systematic and objective,and it also can provide an effective feedback in teaching,which can accelerate the optimization of the teaching mode and improve the quality of education.

OBJECTIVE:To explore the role of clinical pharmacists participating in drug therapy for patients with severe infec-tions. METHODS:Clinical pharmacists participated in drug treatment for a patient with tropical candidemia and assisted physicians to adjust anti-infective treatment plan. According to the results of blood culture,clinical pharmacists suggested Piperacillin sodium and tazobactam sodium for injection 3.75 g,ivgtt,q8 h+Caspofungin acetate for injection 50 mg (initial dose of 70 mg),ivgtt, qd,for symptomatic treatment;increased the daily dose of Caspofungin acetate for injection to 50 mg,ivgtt,bid due to plasma ex-change;Caspofungin acetate for injection 50 mg,ivgtt,qd+Amphotericin B for injection 0.1 mg/kg,ivgtt,qd for anti-infective plan due to the possible“contradiction”of echinocandins;closely monitored ADR,such as allergy,erythra,renal function injury. RE-SULTS:Physicians adopted the suggestions of clinical pharmacists,vital sign of patient kept stable,and tropical candidemia was not detected in the blood culture;the patient was transferred to general ward for further treatment. CONCLUSIONS:Based on the results of blood calture,clinical symptoms and the characteristics of drug effects,clinical pharmacists participated in the treatment for the patient with severe infection,retrieved related treatment guideline,assisted physicians to adjust anti-infective plan and close-ly monitored possible ADR so as to guarantee the effectiveness and safety of anti-infective treatment.

Objective To investigate the impaired characteristics of working memory in Parkinson's disease patients with depression and the recovery status of working memory after antidepressant treatment.methods Totally 60 cases were enrolled in this study and divided into three groups:30 Parkinson's disease patients with depression (PD-D),15 Parkinson's disease patients without depression (PD) and 15 persons without Parkinson's disease as normal controls.All subjects were evaluated with Wechsler Memory Scale (WMS-R) audio-visual span,Tower of Hanoi (TOH) and Wisconsin Card Sorting Test (WCST).30 PD-D patients were randomly divided into two subgroups:routine treatment subgroup (8 weeks levodopa therapy) and antidepressant combined treatment subgroup (8 weeks levodopa + citalopram therapy).The evaluation of Hamilton Depression Scale (HAMD),WMS-R audio-visual span,TOH and WCST were performed on these two groups before and after treatment.Result s① There were significant differences comparing PD-D and PD groups with the normal control group in scores of WMS-R,TOH and WCST indicators (P<0.05).There were significant differences in WMS-R visual span,accuracy rate and speed of TOH,as well as the percent errors and percent perseverative responses of WCST comparing PD-D group(11.88±5.91,0.420±0.345,0.408±0.334,0.882±0.253,0.565±0.229) with PD group (15.87±5.21,0.768±0.167,0.634±0.232,0.493±0.161,0.327±0.122) (P<0.05).② Before and after treatment in PD-D routine treatment subgroup,there were significant differences in digital memory and audio-visual memory of WMS-R((6.73±3.72,5.95±3.13) vs (3.77±2.16,1.91±1.58)),accuracy rate of TOH(0.45±0.26 vs 0.23±0.13),as well as percent errors((-0.58±0.17) vs (-0.37±0.14)),percent perseverative responses((-0.32±0.15) vs (-0.14±0.09)),percent conceptual level responses(0.38±0.09 vs 0.13±0.07) and number of categories completed(3.27±1.56 vs 1.06±0.91) of WCST(P<0.05).③ After 4-week treatment and 8-week treatment,there were significant differences in HAMD score comparing PD-D antidepressant combined treatment group(16.33±2.72,10.27±2.66) with PD-D routine treatment group(21.73±2.28,18.4±2.47) (P<0.05).Conclusion Comparing Parkinson's disease patients without depression,the impaired working memory is more serious and extensive in Parkinson's disease patients with depression.Antidepressant treatment can improve the working memory of Parkinson's disease patients with depression.

Objective To study the anti-oxidative stress effects of benazepril and candesartan.Methods SHRs of 12 weeks old were given benazepril(10 mg/kg?d,n=9)or candesartan(4 mg/kg?d,n=9)or combina- tion(Ben:10 mg/kg?d+Can:4 mg/kg?d)for 12 weeks.The tail arterial pressure was measured every two weeks.At end of study,pathological changes in the thoracic aorta,activity of SOD,serum contents of NO and hydroxy radicals,plasma Ang Ⅱ and cGMP,eNOS and P22~(phox)protein expressions in aortic tunica intima were de- termined.Results The thoracic aorta wall was thickened markedly in SHRs,and blood pressure,hydroxy radi- cal,Ang Ⅱ and P22~(phox)protein expression were increased significantly,while the serum NO,level of cGMP and eNOS expression were decreased.Benazepril(Ben)or Candesartan(Can)inhibit the thickening of vessel wall, enhance the activity of SOD(Ben:68.7?2.1,Can:65.6?4.2 vs SHR:48.8?3.2 U/mL,P

Objective To-identify the factors associated with radiation-induced liver disease (RILD) and to describe the probability of RILD using the Lyman normal tissue complication(NTCP) model for primary liver carcinoma(PLC) treated with hypofractionated conformal therapy (CRT).Methods A total of 109 PLC patients treated with hypofractionated CRT were prospectively followed according to the Child-Pugh classification for liver cirrhosis,93 patients in class A and 16 in class B.The mean dose of radi- ation to the isocenter was (53.5?5.5) Gy,fractions of (4.8?0.5) Gy,with interfraction interval of 48 hours and irradiation 3 times per week.Maximal likelihood analysis yielded the best estimates of parameters of the Lyman NTCP model for all patients;Child-Pugh A and Child-Pugh B patients,respectively.Results Of all the patients,17 developed RILD (17/109),8 in Child-Pugh A(8/93 ) and 9 in Child-Pugh B(9/ 16).By multivariate analysis,only the Child-Pugh Grade of liver cirrhosis was the independent factor (P= 0.000) associated with the developing of RILD.The best estimates of the NTCP parameters for all 109 pa- tients were n=1.1,m=0.35 and TD_(50) (1)=38.5 Gy.The n,m,TD_(50) (1) estimated from patients with Child-Pugh A was 1.1,0.28,40.5 Gy,respectively,compared with 0.7,0.43,23 Gy respectively,for patients with Child-Pugh B.Conclusions Primary liver cancer patients who possess Child-Pugh B cirrho- sis would present a significantly greater susceptibility to RILD after hypofractionated CRT than patients with Child-Pugh A cirrhosis.The predominant risk factor for developing RILD is the severity of hepatic cirrhosis in the liver of PLC patients.

The paper reviewed the history and characteristics of the public hospital reform in China. Based on the theories of corporate governance, it made analysis and comments on existing roadblocks and reform attempts in such hospitals, proposing a public hospital governance model in line with the general reforms made in China's healthcare system sector.

Adolescent ; Adult ; Automobile Driving ; China ; Electrocardiography ; Female ; Heart ; physiopathology ; Humans ; Male ; Middle Aged ; Noise, Occupational ; adverse effects ; Occupational Exposure ; adverse effects ; Stress, Psychological ; etiology ; physiopathology ; Vibration ; adverse effects

Objective To explore the clinical value and safety of early enteral nutrition support in patients after liver transplantation.Methods We retrospectively analyzed the clinical data of 86 cases who used early enteral nutrition support therapy after liver transplantation between January 2008and October 2011.All of patients were uproot the gastric tube at the first day after the operation,and gradual to the normal diet.The patients who used parenteral nutrition support therapy were as the control group(n＝112).Then we compared the data of patients in the two groups.Results The early enteral nutrition is more useful to the patients after liver transplantation than intravenous nutrition [In the seventh day after the operation,the control group's ALT was (45.2 ± 12.9) U/L,AST was (40.2±9.4) U/L,ALBwas (35.6±2.5) g/L,P＜0.05].The early enteral nutrition also can decrease hospital stay and hospital costs [(14.2±3.4) d,P＜0.05].Conclusion The early enteral nutrition is useful and safe to the patients after liver transplantation.

With the global development of medical information standard, construction work of traditional Chinese medicine (TCM) information standard system has been promoted rapidly. The framework of ancient Chinese medical literature clinical terminology classification standardization is one of the foundations of TCM language system. Its research will further promote and perfect TCM information standard system. We have adhered to the connection among ancient TCM classification framework, modern TCM and western medicine classification framework. Exploration on framework construction of ancient Chinese medical literature clinical terminology classification standardization was based on previous work of Chinese medicine clinical terminology classification and code standard, reference frame structure of SNOMED CT, research findings of classification standard framework of Chinese medicine clinical terms, andQian Jin Fang.