Objective To investigate the clinical efficacy of domestic terlipressin in the treatment of type II hepatorenal syndrome (HRS -II).Methods A total of 25 HRS -II patients admitted to our hospital from November 2011 to June 2014 were recruited into the treatment group,and 28 HRS -II patients treated with dopamine before 2011 were recruited into the control group.Patients in the treatment group were randomly divided into two subgroups:one subgroup (n =12)was given terlipressin once every 8 h,and the other subgroup (n =13) was given terlipressin once every 12 h.Both groups received albumin (Alb)infusion to expand the blood volume before treatment with terlip-ressin or dopamine,and the course of treatment was 7 days.The improvement in clinical symptoms,levels of blood urea nitrogen (BUN), serum creatinine and electrolytes,urine volume,changes in liver function,and ascites disappearance in the two groups before and after treat-ment were compared.Comparison of categorical data between the two groups was made by χ2 test,and comparison of continuous data was made by t test.Results Patients in the control group showed no obvious symptom relief,but those in the treatment group had varying de-grees of improvement in clinical symptoms.Neither group had significant changes in liver function and serum sodium level after treatment. The treatment group had significantly more patients whose ascites volume had decreased from large to medium than the control group (χ2 =5.705,P <0.05).There was a slight but not significant decrease in the levels of BUN and serum creatinine in the control group after treat-ment with dopamine (all P >0.05),whereas the urine volume showed significant difference after the treatment (t =15.534,P <0.01). The treatment group showed significant differences in the levels of BUN and serum creatinine and urine volume after terlipressin treatment (t=11.535,9.941,and 19.685,respectively;all P <0.01),and significant differences in those levels were also observed compared with the control group after dopamine treatment (t =7.317,9.284,and 9.839;all P <0.01).Larger changes in BUN,serum creatinine,and urine volume were observed in the subgroup receiving terlipressin every 8 h than in that receiving terlipressin every 12 h,but the differences were not significant (all P >0.05).Patients treated with terlipressin had mild and tolerable adverse reactions.Conclusion The domestic terlipressin combined with albumin infusion has good clinical efficacy and mild adverse effects in treating HRS -II.Its clinical application is highly recommended.

Objective To detect the feasibility of patients with specific behaviors in the facial trauma clinical teaching. Method 47 medical students were randomly divided into experimental group ( n = 22 ) and control group(n=25). Students from experimental group at least dealed with 5 ～ 10 facial trauma patients with specific behaviors, while specific behaviors patients in control group were not more than 2. Teaching results were compared. Results There was no significant difference in operation test scores between the two groups ( (84.68 ±3.41 ) vs ( 83.96 ± 3.46 ), P = 0. 476 ). Composite score of teachers in the experimental group was significantly higher than that in control group( (90.09 ± 5.69 ) vs (83.48 ± 5.19), P ＜ 0.01 ). The results of questionnaire survey showed that two in five self-assessment results were higher in the experimental group(P ＜ 0. 01 ). Conclusion Medical students are more appropriately involved in treating special behaviors patients, which can improve the overall quality of students. Teaching with special behaviors patients has good effect, and is feasible.

Objective:To observe the effects of the Increasing-Energy and Renewing-Wisdom granule on vascular dementia(VD) patients. Methods:42 VD patients were divided randomly into 2 groups. The patients in treatment group administered the Iincreasing-Energy and Renewing-Wisdom granule. The patients in control group administered piracetam. All the patients were treated for 3 months. Results: The patients' scores of HDS, MMSE, Wechsler (order), MQ in the treatment group were higher than those before the study (P

Objective:To assess the life quality of the patients with tongue cancer after operation.Methods:80 cases of tongue cancer following surgery during 1994 to 1998 were reviewed with questionaire.Scords of University of Washington Quality o f Life (UW-QOL) were analysed to evaluate their life quality.Results:(1) 3-year survival rate was 72.5%,higher survival rate was observed in the patients with I and II stage lesion than those with Ⅲ and Ⅳ stages.(2) 58 cases of survivers had UW-QOL average score of 618. Some patients had serious disability in mastication, swallowing,speaking and shoulder movement.(3)Patients retaining mandible or with skin flap repair had higher quality of life than the others.Conclusion:Following surgery,tongue cancer patients still maintain comparatively high quality of life.Reconstruction of mandibular or tongue is very importent for the life quality of the patients.

Objective With the social and economic advancement, the morbidity of breast hypertrophy is increasing. Inverted T technique was the traditional breast reduction mammaplasty method. It left severe scar after operation. The aim of this study was to introduce our experience about breast reduction with pure liposuction that significantly reduced the operative scar after operation. Methods After using tumescent anesthesia, a small incision about 5 mm was performed at inframammary fold for proper selected patients, The entire breast and subcutaneous fat were thoroughly suctioned with small caliber cannulas for breast reduction. No surgical excision was applied. Compression garment was applied after the operation. Results A total of 11 patients were successfully treated. Only one patient had a unilateral seroma that was responded to multiple aspiration. All the patients were satisfied with the results. The morphology was good. The texture of the breast was improved. Conclusion Reduction mammaplasty with pure liposuction is simple and effective for those who had mild to moderate breast hypertrophy with no severe ptosis and more fatty tissue. The scar is invisible. It deserves to be recommended.

Objective To investigate the expression of protein kinase CK2α in thyroid carcinoma SW579 cells and its significance.Methods SW579 cells and Hacat cells were cultured in vitro and the expression levels of protein kinase CK2α mRNA and protein in SW579 cells and Hacat cells were measured by reverse transcription-polymerase chain reaction (RT-PCR) and Western blotting.Moreover,CK2 activity was also measured.Results It was showed that the mRNA (0.92 ±0.01 vs 0.52 ±0.02,t =19.24,P ＜0.01)and protein(0.98 ±0.01 vs 0.37 ±0.02,t =24.14,P ＜0.01) expression of protein kinase CK2αwere significantly stronger in SW579 cells relative to Hacat cells.Conclusions Formation and development of thyroid carcinoma may be in connection with the overexpression of protein kinase CK2α.

Objective To investigate the expression of angiotensinⅡ (Ang Ⅱ ) and its type 1 receptor (AT1) in circulation, placenta and kidney of the rots preeclampsia. Methods Preedampsia rat model was developed by inhibitor of nitric oxide synthase (L-NAME). The systolic blood pressure (SBP), 24 h urine protein, hepatic and renal function were compared among the precelampsia group, the normal pregnant group and nonpregnant control group. The kidney tissue was observed by light microscopy. ELISA and radioimmunoassay were used to detect Ang Ⅱ in rat plasma and kidney homogenate respectively. Placental AT1 was measured by Westem blot. The level of kidney AT1 was evaluated by immunohistochemistry and Western blot. Results In preeclampsia rats, SBP and 24 h urine protein were significantly higher compared with control groups. Compared to normal pregnant group, plasma Ang Ⅱ of preeclampsia rats was much higher [(0.706±0.086) ng/L vs (0.540±0.085) ng/L, P＜0.05]; placental AT1 was increased by 46%(P＜ 0.05); kidney Ang Ⅱ was decreased signigicantly [(65.543±40.634) ng/g vs (165.543±33.078) ng/g, P＜0.05]. The expression of ATI in kidney of preeclampsia rats was reduced evidently,which was only 33% of normal pregnancy group and 59% of nonpregnant control greup,respeetively (P＜0.05). Conclusions In preeclampsia rat model, the circulating Ang Ⅱ is increased, the placental RAS isactivated, while the kidney BAS is suppressed. The underlying mechanism of proteinuria and kidney damage associated with this phenomenon in preeclampsia needs further research.

Objective The vertical mammaplasty improves the breast morphology,and reduces the operative scar.However,the nipple-and-areola complex (NAC) has the risk of necrosis on those severe patients.In this report,we performed the vertical incision scar reduction mammaplasty based on Würinger's horizontal septum to reduce the NAC necrosis possibility.Methods Typical Lejour mosque-dome design was performed.The inferior part of glandular tissue and skin were excised.The NAC was elevated to normal position with medial-superior pedicle based on the horizontal septum.The breast morphology was modified with lateral and medial glandular pillar suturing using nonabsorbent thread.For reducing the vertical scar,the lower breast flap was thinned to induce the skin contraction.Results 27 patients with breast hypertrophy were operated from May 2009 to October 2012.1 patient had unilateral breast reduction,and 6 patients with 8 breasts had partial wound dehiscence.They were treated conservatively with topical dressings.No complete NAC necrosis occurred.Conclusions The vertical reduction mammaplasty based on Würinger's horizontal septum is a safe and effective approach,and the NAC necrosis possibility is reduced with this procedure.

Objective To introduce the clinical manifestations and treatment methods of concealed penis, which is relative rare in plastic surgery. Methods Vertical preputiotomy was performed. The hypoplastic tissuely was excised. After that, there was no prepuce redundant, so that no prepuce excision was needed. Results 7 patients were treated. All were satisfied with the results. Conclusion Concealed penis should be distinguished from phimosis. Circumcision should be avoided in concealed penis patient.

Objective To explore the impacts of preeclampsia and the different extent of proteinuria on maternal and perinatal outcomes.Methods The retrospective analysis was conducted according to the perinatal clinical data of preelacmpsia,pregnancy-induced hypertension in pregnant women and normal pregnant women from the Fifth People's Hospital of Shanghai,excluding twins,diabetic mellitus and patients with chronic kidney disease previously.Patients were divided into three groups on the basis of their conditions:① preeclampsia patients (A group,220 cases); ② patients with gestational hypertension (B group,189 cases); ③ normal pregnant (C group,220 cases).Patients with pre-eclampsia according to the degree of proteinuria were further divided into three subgroups:A1:patients with mild proteinuria (n =109); A2:patients with moderate proteinuria (n =72); A3:patients with severe proteinuria (n =39).Results Compared with the other two groups,the patients in A group had higher blood pressure,serum creatinine,uric acid,cesarean section rate,perinatal prematurity,stillbirth,fetal distress and neonatal asphyxia in preeclampsia group.However,the serum albumin level,eGFR,neonatal birth weight,length and Apgar scores were lower in A group compared with B and C group (P ＜ 0.05).In three subgroups,serum creatinine level,uric acid level,cesarean section rate,perinatal prematurity and fetal distress were significantly increased in A3 group compared with A1 group,while the serum albumin level,eGFR,gestational age and neonatal birth weight were obviously lower in A3 group than in A1 group (P ＜ 0.05).In patients with preeclampsia,24 h urinary protein was negatively related with the levels of serum albumin and eGFR (P ＜ 0.05),and positivly related with the blood pressure,serum creatinine and caesarean production rate (P ＜ 0.05).Large amounts of proteinuria was a risk factor of adverse outcome for pregnant patients with preeclampsia (OR =2.899,P ＜ 0.05).Conclusions Preeclampsia patients with large amount of proteinuria have poor maternal and perinatal outcomes.Massive proteinuria is a risk factor of adverse outcome for patients with pre-eclampsia.