Surgery is the main treatment for Cushing's syndrome.The disturbed metabolic consequences such as prolonged exposure to excessive glucocorticoid,high glucose and hypertension will add the risks and difficulties to surgery.This paper reviews the perioperative glucocorticoid replacement,correction of the hypercotisolaemia before operation,and prevention of complications after operation.

Objective To evaluate the effect of crisis prediction score nursing in reducing complication and nursing deficiencies in patients with myasthenia gravis complicated with thymoma.Methods 46 patients were randomly divided into the study group and the control group,the study group was given with crisis prediction score nursing,the control group was given with individual nursing.The postoperative complications incidence,hospitalization time,nursing defect rate,patient satisfaction were compared between two groups,and Osserman efficacy evaluation was implemented.Results Compared with the control group,postoperative complications (hemorrhage,pneumothorax,respiratory tract infections and myasthenia gravis crisis)rates and nursing defect rate in the study group were lower,hospitalization time shortened,and patients' satisfaction degree increased.Conclusions The crisis prediction score care can significantly reduce postoperative complications and nursing defect rate,which is important for patients' health.

0.05).But only 23 lesions(38.3%)showed high signal on T1WI.Conclusion:This research confirmed the MRI-guided HIFU equipment is useful to monitor the HIFU treatment and evaluate the curative effect accurately,which provids a basis for the latter treatment of liver tumors.

Child ; Humans ; Urolithiasis ; diagnosis ; therapy

Tamoxifen has shown definitive effect when used as the adjuvant hormonal treatment in women with estrogen-receptor-positive breast cancer. However, long-term use of Tamoxifen can induce fatty liver disease. It has been proposed that tamoxifen may act throught mechanisms such as inducing triacylglycerol accumulation in mitochondria, abnormal fatty acid oxidation, and antagonizing actions of estrogen on hepatic lipid metabolism. Therefore, it is necessary to monitor lipid profile and liver function, conduct regular ultrasonography and CT examination in patients receiving tamoxifen treatment. Replacing tamoxifen with toremifene oraromatase inhibitors, or using lipid-lowering medicines may help prevent tamoxifen-induced fatty liver disease.

To treat 30 patients with simple adiposis with needling of point Jiaji (Ex-B2, T3-L5), after 2 courses of treatment 12 got a marked curative effect, 15 got a curative effect, 3 got no effect, accounting for 10.0%. The total effective rate was 90.0%.

PurposeTo determine the correlation between expression of MHC classⅠon ovarian tumor cells and T-cell infiltration in vivo on ovarian tumor micro-environment.MethodsThirty three samples of primary epithelial ovarian carcers were analysed with flow cytometry for MHC class Ⅰ expression. Immunohistochemical analysis was performed using monoclonal antibodies that recognize leukocyte differentiation antigens ( LCA+ , CD3 + ) on cryostat sections of primary epithelial ovarian carcinoma. The results were compared with the expression of MHC class Ⅰ expression. ResultsClose correlation were revealed bewteen the expression of MHC class Ⅰ molecules and the numbers of infiltrating LCA+ positive cells ( r = 0. 846, P = 0. 000 1) and CD3 + cells ( r = 0. 738, P = 0. 000 1 ).ConclusionsExpression of MHC class Ⅰ molecules may influence the status of human immunosurveillance in tumor micro-environment on ovarian carcinoma and the assay may be helpful in selection patients for adoptive immnotherapy.

Kawasaki disease has been the major etiology of aquired heart problems in children. Mecha-nisms of Kawasaki disease are still unclear in the past years. Some Kawasaki disease patients were not responsive to intravenous immunoglobulin therapy. And corticosteroid therapy remains controversial in the treatment of Ka-wasaki disease. A few patients with Kawasaki disease presented severe systemic symptoms,and even died for it. It is difficult to evaluate the severity of coronary artery lesions and prognosis of Kawasaki disease. In this article, we reviewed some new concepts on diagnosis and treatments on Kawasaki disease.

Objective To investigate the protective effect and the mechanism of isoflurane preconditioning on rat brain tissue suffering from rat liver ischemia-reperfusion injury .Methods 75 SD rats were randomly divided into five groups, sham group (S group);ischemia-reperfusion group (I/R group): liver ischemia for 60 min, reperfusion for 120 min;isoflurane preconditioning group ( ISO group ): 60 min before liver I/R, ISO pretreatment for 30 min; CsA +ISO group;CsA ( MPTP specific blocker ) 50 mg/kg intravenous injection , the same as ISO group after 30 min; CsA group:CsA 50 mg/kg intravenous injection .30 min before I/R.The animals were killed 24 h after ischemia and their brain were excised for measurement of mitochondrial permeability transition pore ( MPTP) and calcium content in mitochondria .The measurement of content of S-100βprotein in serum before ischemia and 120min after reperfusion through the application of Elisa kit.Results The mitochondrial Ca2+concentration of I/R group(287.32 ±26.17)was higher than that in S group (198.54 ±21.02) and the ISO group (209.74 ±29.49) ( P <0.05), and Ca2 + concentration of CsA +ISO group (267.31 ±37.52) was higher than the ISO group (P <0.05);there was not statistical significance between I/R and CsA group(288.63 ±23.15)(P <0.05).MPTP were more opened in I/R group(△S:1.73 ±0.24)than that in S group (△S:2.36 ±0.35)and ISO group(△S:2.11 ±0.32)(P <0.05),but MPTP were more opened in CsA +ISO group than that in ISO group (P <0.05).The content of S-100βprotein in serum was significantly higher in I/R group than that in sham and ISO groups (P <0.05),and the content of S-100βprotein in serum was significantly higher in CsA +ISO group than in the ISO groups ( P <0.05 ) .Conclusion The liver ischemia-reperfusion may injury the brain of the rat and isoflurane preconditioning can protect the brain on the rat .The reduce of mitochondria calcium overload and inhibition of MPTP opening are involved in the mechanism .

With the rapid development of China's higher education and the intensified reforms in medical and health services,the problems and contradictions are increasingly prominent in ortho-pedic clinical teaching,especially how to improve medical interns' ability to read images. Picture archiving and communication system (PACS)plays an important role in academic education of medi-cal imaging. Case-based learning (CBL)is a team seminar teaching mode that is guided by cases, based on problems,targeted at students,and dominated by teachers. PACS and CBL were perfectly combined in orthopedic clinical teaching to improve teaching efficiency and the outcome was evaluat-ed through a questionnaire. Results showed that this teaching method inspired students' interests in learning,cultivated the orthopedic clinical way of thinking thus achieved better teaching effects.