Objective To explore the postoperative observation and nursing of double intervention therapy in patients with hepatocellular carcinoma accompanying hypersplensim.Methods The nursing of 30 patients with hepatocellular carcinoma accompanying hypersplensim who received hepatic arterial embolization combined with partial splenic embolization was retrospectively analyzed.Adverse events and nursing experience were summarized.Results All patients had varying degree of fever,abdominal pain,nausea,vomiting and other side effects.The tumor size was reduced and white blood cells and platelets increased to varying degrees.Hypersplenism was relieved after treatment,and serious complications didn't occur.All 30 cases were discharged.Conclusions In double interventional therapy for hepatocellular carcinoma accompanying hypersplenism,nurses must closely observe the disease and take measures to treat the postoperative side effects and serious complications,and promote the rehabilitation of patients.

Interventional management was performed in 10 patients with hemorrhage following hepatic biliary and pancreatic surgery.The super-selection arterial embolization was performed in 9 patients using gelfoam pledgets (n =6 ) or metal coils (n =3 ),the procedure was combined with local infusion of reptilase; 1 case was managed by local infusion of reptilase alone.Selective angiography revealed the pseudoaneurysm in 3 cases,contrast media extravasation in 6 cases; in 1 case no obvious bleeding site was found The interventional treatment was successful and hemorrhage stopped in all patients,including one case with reptilase alone with a successful rate of 10/10.The results indicate that interventional treatment is a safe and effective method for hemorrhage following hepatic biliary and pancreatic surgery.

Objective To present one case of bronchial artery aneurysm successfully treated with endovascular interventional procedure and review literature. Methods A 67-year-old man was diagnosed with mediastinal bronchial artery aneurysm accompanied with tuberculous pleurisy by chest imaging. The aneurysm was treated via transcatheter bronchial artery embolization combined with endovascular stent-graft placement in the thoracic aorta under DSA guidance. Results Postprocedural angiography showed satisfactory exclusion of the aneurysm and no endolead. Conclusion Interventional therapeutic management of bronchial artery aneurysm is feasible and accurate.

Objective To systematically evaluate the performance of the Sysmex CS2000i Automatic Blood Coagulation Analysis System .Methods According to the standards of the Clinical and Laboratory Standards Institute (CLSI) ,the precision ,accuracy ,lin‐earity ,biological reference interval and carry‐over rates of the Sysmex CS2000i Automatic Blood Coagulation Analysis System were detected ,meanwhile the detections of 5 clinical specimens were compared between this system and the Sysmex CA 1500 Automatic Blood Coagulation Analysis System .Results The intra‐assay precision coefficient of variation (CV) ,inter‐day precisions CV carry‐over rate ,accuracy and linearity of plasma prothrombin time ,activated partial thromboplastin time ,fibrinogen and D‐dimmer detec‐ted by the Sysmex CS2000i Automatic Blood Coagulation Analysis System were all consistent with the quality target requirements of our laboratory .Conclusion The Sysmex CS2000i Automatic Blood Coagulation Analysis System has better performance in vari‐ous aspects ,the detection results could be used for the clinical diagnosis and treatment of related diseases .

ObjectiveTo investigate and compare the efficacy, safety, and cost effectiveness in the treatment of painful osteoporotic vertebral compression fractures ( OVCFs ) with percutaneous vertebroplasty (PVP) and kyphoplasty(PKP). MethodsSeventy-two patients (96 vertebrae) with painful OVCFs were treated by PVP (n ＝34) or PKP (n ＝38) under radiological monitoring. After bone biopsy needle into the compressed vertebra, bone cement (polymethylmethacrylate) was injected in PVP group, and that was inserted followed by the inflation of vertebra to create cavities in PKP group. The fluoroscopy time, total amount of bone cement injected, and cost were recollected respectively. The score of visual analogue scale point( VAS, 10-point scale)was determined at before the procedures, and 24 hours, one week, and one month after the procedures.Pain relief and complications were observed.The Cobb angle and vertebral heights of the anterior, middle, and posterior border were measured pre-and post-operative. ResultsThe two procedures were technically successful in all patients. The follow-up ranged from 1. 0 to 34. 0 months [mean time, (8. 9 ±3.2) months]. The Mean fluoroscopy time of treating per vertebra in PVP group was ( 11. 1 ± 10. 6 ) min, which was significant shorter than that ( 23.5 ± 13. 0) min in PKP group( P ＜0. 05 ).The mean total cost per patient was (5127. 2 ± 502.3 ) yuan in PVP group, which were strikingly lower than that(32 301.4 ±3204. 6) yuan in PKP group (P ＜0. 05).(3)There was no significant difference( P ＞0. 05 ) in average cement volumes in PVP group [ (4. 9 ± 1.1 ) ml]and PKP group [ (5.4 ± 1.7 ) ml]. Pain relief of was observed in 94. 1％ (32/34) of PVP group and in 92. 1％ (35/38) of PKP group. The score of VAS at pre-operation was (8. 3 ±0. 4 vs 7.9 ±0. 8) ,and at post-operative 24 h (2. 9 ±0. 9 vs 2. 8 ± 1. 2),1 week (2.6 ± 0. 9 vs 2.6 ± 1. 1 ), and 1 month (2.6 ± 0. 9 vs 2. 5 ± 1.3 ) were no difference at PKP and PVP group(P ＜0.05). There was significant difference between pre- and post-operative time point in each group. The Cobb angle, anterior and middle height of vertebra was corrected in both PVP and PKP group. In PVP group, the preoperative Cobb angle, anterior and middle height of vertebra was (24. 2 ± 3.8 )°,( 19. 1 ± 1.4) mm, (25. 2 ± 1.0) mm, which was significant different ( P ＜ 0. 05 ) from that of ( 19.4 ±3.9)°, (21.0 ± 1.5) mm, (27.0 ± 1.2) mm at pre-operation.In PKP group,there was significant difference (P ＜ 0. 05 ) in the preoperative Cobb angle, anterior and middle height of vertebra [(25. 1 ±5.0)°vs(10.7 ±2.8)°, (19.5 ± 1.5) mm vs (24.3 ± 1.9) mm, (25.4 ± 1.1) mm vs (29.7 ±1.3) mm, respectively]. As to the above index, the overall correcting effect in PKP was much better than that in PVP( P ＜0. 05 ). Cement leakage occurred in 9 cases in PVP group and 3 cases in PKP group ( P ＜0. 05 ) but no symptoms. There were no major complications during operation in the two groups. Conclusion PVP and PKP are effective and safe in the treatment of painful OVCFs but PVP is more cost effective than PKP.

Graft copolymerization is one of the most effective methods to improve the performance of pullulan and extend its applications. This paper attempts to review the recent progresses in the preparation and application of graft copolymers of pullulan as pharmaceutical carriers from different synthesized polymers and the properties of graft copolymers of pullulan. The problems of pullulan based graft copolymers in drug release system are expounded, and the future development in this field direction is presented.

A new analytical method has been developed for the simultaneous determination of CrⅢand CrⅥusing on-line sample pretreatment valve-switching ion chromatography. The organic matrix in leather was removed by using a reverse-phase column as the pretreatment column. Before injection, EDTA was added into sample solution to react with the CrⅢto form anion which could absorb visible light strongly. After injection, the ions separated by the pretreatment column were received in a collection loop. Then the ions were delivered into an analytical column and separated. CrⅥ then was derived with the derivatization reagent 1, 5-diphenylcarbazide ( DPC) , and detected together with CrⅢ-EDTA complex by a UV-Vis detector. Under the optimum conditions, the linear range of the method for CrⅢ and CrⅥ was 0. 3-10 mg/L (r=0. 9991) and 0. 05-2 mg/L ( r = 0. 9992 ), whereas detection limits ( S/N = 3 ) were 80. 78 μg/L and 6. 67 μg/L, respectively. The recoveries were in the range of 88. 7%-108. 5% with the relative standard deviations for retention time and peak area less than 3%. The method could be applied to determine CrⅢ and CrⅥ in leather and cloth effectively and quickly.

OBJECTIVE:To systematically review therapeutic efficacy of Haikun shenxi capsule in the treatment of chronic renal failure (CRF).METHODS:Retrieved from Central,PubMed,EMBase,CJFD,CBM,VIP and Wanfang database,randomized clinical trials (RCTs) about Haikun shenxi capsule combined with routine treatment (trial group)vs.single routine treatment (control group) in the treatment of CRF were collected.Meta-analysis was performed by Rev Man 5.3 software after screening literature,extracting data and evaluating quality by using risk bias evaluation of Cochrane collaboration network.RESULTS:A total of 10 RCTs were included eventually,involving 704 patients.The results of analysis showed that compared to general therapy,Haikun shenxi capsule could improve total effective rate [RR =4.42,95 ％ CI (2.70,7.22),P＜ 0.001],and could reduce SCr[MD =-140.37,95 ％ CI (-191.72,-89.03),P＜ 0.001],BUN[MD =-5.49,95 ％ CI (-8.36,-2.63),P＜ 0.001] and 24 h-Upro [MD =-0.43,95 ％ CI (-0.62,-0.23),P＜ 0.001],with statistical significance.CONCLUSIONS:The clinical efficacy of Haikun shenxi capsule in the treatment of CRF is good and significantly improve related indexes of renal function.

Objective To explore the effectiveness and compliance of ketogenic-diet(KD) treatment for infantile spasm(IS).Methods Ninety-eight IS patients who were treated with KD in Wuhan Children's Hospital from March 2009 to June 2015 were analyzed by using retrospective case-control study,the patients were divided into 4 groups:newly diagnosed IS patients group (group A,including 24 patients),one antiepileptic drug (AEDs) failure IS patients (group B,including 28 patients),two and more AEDs failure IS patients (group C,including 29 patients),and two or more AEDs combined with ACTH failure IS patients(group D,including 17 patients).The spasm-free andretention rates after 3,6 and 12 months KD treatment were compared among these groups.Results Overall retention rate was 80.6％ (79/98 cases),69.4％ (68/98 cases),and 42.9％ (42/98 cases)at 3,6,12 months,respectively.The 3-month retention rate in group A,B,C and D was 83.3 ％ (20/24 cases),78.6％ (22/28 cases),82.7％ (24/29 cases) and 76.4％ (13/17 cases) respectively,and there was no significant difference among these groups (P ＞ 0.05).The 6-month retention rates in each group was 75.0％ (18/24 cases),67.9％ (19/28 cases),68.8％ (20/29 cases) and 65.0％ (11/17 cases) in sequence,and there was also no significant difference among these groups(P ＞0.05).The 12-month retention rate was 54.2％ (13/24 cases),21.4％ (6/28 cases),48.3％ (14/29 cases) and 52.9％ (9/17 cases) in group A,B,C and D in sequence,the 12-month retention rate of group B was significantly lower than that of other 3 groups,and the differences were statistically significant(x2 =5.973,4.508,4.727,all P ＜ 0.05),and there was no significant difference among the A,C,D groups (all P ＞ 0.05).The spasm-free rate at 3,6,12 months of KD treatment was 19.4％ (19/98 cases),20.4％ (20/98 cases),30.6％ (30/98 cases).The 3-month spasm-free rate in A,B,C,D groups were as follow:41.7％ (10/24 cases),14.3％ (4/28 cases),10.3％ (3/29 cases),11.8％ (2/17 cases),respectively.The 3-month spasm-free rate in group A was significantly higher than that of other 3 groups,and the differences were statistically significant (x2 =10.238,9.219,6.697,all P ＜ 0.05),but there was no significant difference among the B,C,D groups (all P ＞ 0.05).The 6-month spasm-free rates were 41.7％ (10/24 cases),14.3％ (4/28 cases),13.8％ (4/29 cases),and 11.8％ (2/17 cases) in group A,B,C and D in order,and the spasm-free rate in group A was significantly higher than that of other 3 groups,and the differences were statistically significant(x2 =4.924,5.249,4.298,all P ＜ 0.05),but there was no significant difference among the A,C,D groups (all P ＞ 0.05).The 12-month spasm-free rates were 54.2％ (13/24 cases),21.4％ (6/28 cases),24.1％ (7/29 cases),and 23.5 ％ (4/17 cases) in group A,B,C and D,and the spasm-free rate in group A was significantly higher than that in other 3 groups,and the differences were statistically significant(x2 =8.354,7.923,4.364,all P ＜ 0.05),but there was no significant difference among the A,C,D groups (all P ＞ 0.05).Conclusions The spasm-free rate of KD therapy for newly-diagnosed IS is higher than that of IS patients whose drug-therapy failed.KD therapy may be the top priority for IS patients and part of those patients whose drug-therapy failed can still get seizure-free with KD diet.

Objective: To evaluate the success rate during ultrasound-guided percutaneous nephrolithotomy (PCNL) and analyze the reasons of puncture failure. Methods: A retrospective analysis was performed based on the data of 58 patients who underwent ultrasound-guided PCNL by 4 experienced urologists(10 years' experience of PCNL and more than 80 cases per year)in our center from August 2018 to November 2018. Of all the 58 patients, there were 36 males and 22 females (aged from 22 to 73 years) with the mean age of 51 years. The calculi ranged from 9 mm to 93 mm, with the average of 26.5 mm. The separation of renal collecting system ranged from 5 mm to 30 mm, with the average of 15.1 mm. All of the 58 patients underwent one-stage PCNL and the numbers of punctures, the numbers of percutaneous tubes and the reasons for failure were recorded. Results: All percutaneous tubes and surgeries were established and done successfully. Of all the 118 punctures, 74 punctures succeeded by detecting the urine and 68 surgery tracts were established (6 punctures failed because of the dilation). The total puncture success rate was 62.7%(74/118). Of the total 74 successful punctures, 56.8%(42/74)succeeded at the first puncture, 28.4%(21/74)succeeded at the second puncture and 14.9%(11/74)succeeded at least after three punctures. The success puncture rate of the 4 urologists were 59.2%(29/49), 64.1%(25/39), 66.7%(16/24), 66.7%(4/6)respectively, and there were no statistical differences between the puncture success rates of the urologists (P=0.679). Each channel needed 1.7 punctures on average. Fouty-four punctures failed without detecting the urine, including 20 failed punctures because of the puncture tract deviation, 17 punctures without seeing the urine after the core needle being removed, 7 punctures no display on the ultrasound imagine. There were 33 punctures to be tubeless while other 35 indwelling the nephrostomy tubes. Five nephrostomy tubes' position were different with the preoperationally predicted position which means the discrepancy rate was 14.3%(5/35). One patient had complications and classified as Grade II or above on the modified Clavien Grading System of aerothorax. Conclusions The puncture success rate during ultrasound-guided PCNL is not satisfied. The main reasons of puncture failure are the deviation of puncture tract, unclear imaging of puncture tract and other unclear reasons( puncture needle went too deep or superficially or tip of the needle embedded into the stone).