Liver failure progresses rapidly,and patients with this disease are usually in a critical condition.The medical treatment of liver failure has unsatisfactory results,leading to a high mortality.How to accurately judge the prognosis of patients with liver failure according to their clinical manifestations and laboratory test results is a very good guide for clinical treatment strategies and donor liver allocation.The prognostic models for liver failure,such as CTP score,MELD and its derivative scoring system,KCH criteria,SOFA score,APACHE sco-ring system,SMSVH score,Clichy criteria,and ANN,are reviewed.These models are used to guide the development of clinical treatment strategies and screen out patients eligible for liver transplantation.In addition,the prognostic values of these models for liver failure and their differences are evaluated.

To describe and evaluate a refraction-derived method and a clinically derived method to calculate the correct corneal power for intraocular lens (IOL) power calculations after laser in situ keratomileusis (LASIK) and to compare the results to the commonly used history-derived method. Retrospective analysis were conducted in consecutive case from clinical practice. For each patient, we established the pre-LASIK and post-LASIK spectacle refraction, the pre-LASIK (K(pre)) and post-LASIK K readings (K(post)). We then calculated the pre- and post-LASIK refraction at the cornmeal plane and the amount of correction obtained by the refraction surgery (deltaSEQco). The cases were divided into two groups. Group I was used to derive two formulas. The values obtained with the two methods were compared with the K by history-derived method (K(c.hd) in group II to validate the results. The K values calculated by using the refraction-derived method (K(c.rd)) and the K values calculated using the clinically derived method (K(c.cd)) correlated highly with K(c.hd). The correct corneal power for intraocular lens (IOL) power calculations after LASIK can use refraction-derived method and clinically derived method instead of history-derived method when some refractive parameters are not available.

Objective: To explore the significance of Th17 in hepatocellular carcinoma, expecially with HBV infection.Methods:Cytometric bead array(CBA) was employed to detect 5 cytokines(IL-2,IL-4,IL-6,IFN-γ,IL-17A)from 39 tumor and non-tumor tissues of HCC and combined clinical data for comparative statistic analysis.Results:The expression of IL-2,IL-4,IFN-γin liver cancer tissue[(4.61±0.28),(3.37±0.58),(3.08±1.08)pg/ml,respectively] was significant lower than non-cancer tissue [(5.57±0.59),(3.77±0.70),(3.69±1.20)pg/ml,respectively].Otherwise,the expression of IL-6,IL-17A in cancer tissue [(280.09±254.68), (2.66±1.66) pg/ml, respectively] was higher than non-cancer [(6.58 ±1.92), (1.49 ±0.98) pg/ml, respectively].And,whatever cancer or non-cancer tissue,the expression of IL-17A in tissue[(3.45±1.86)pg/ml] with high HBV load (>1 000 U/ml) was significant higher than tissue with low HBV load[(1.97±1.16)pg/ml].Conclusion: IL-17A was highly expressed in HCC,and IL-2,IL-4,IFN-γmay inhibit its expression,and IL-6 may promote it.Hepatitis B virus infection may promote Th17 expression,thereby reducing patient′s prognosis.

Objective To investigate the roles of cystatin C (CysC) and serum creatinine (Scr) in acute renal injury of patients with shock. Method A total of 71 patients with shock, 42 male and 29 female, were enrolled from February 2006 to June 2007. Patients with kidney disease or renal insufficiency were excluded. All of patients were assigned to 4 groups as per the duration of shock. The blood samples were taken from patients for measurements of CysC and Scr during the periods of 1 hr,2 hr,and 4 hr of shock and 72 hr and 7 days after correction of shock. The corrected GFR (cGFR) and decreased GFR (dGFR) were calculated. The levels of Scr and dGFR could be used to classify the acute renal injury into stages according to the Acute Kidney Injury Diagnosis Criteria. The positive detection rates of different methods were compared. The levels of CysC, Scr and cGFR were statistically analyzed. Data were studied by using Pearson's correlation analysis, Results The elevation of CysC appeared sooner than that of Scr in all shock patients. Contrarily, the high level of CysC lowered to normal level much slower than that of SCR after correction of shock. The CysC increased 1 hour after shock. The GFR was negatively correlated with CysC and Scr, especially in the early stage of shock. Conclusions The renal dysfunction appears in the early stage of shock. The CysC assayed is more sensitive in the stage 1 of renal injury than Scr.

Changes of corneal properties induced by laser in situ keratomileusis (LASIK) results in low inaccurate intraocular pressure (IOP) readings by Goldmann applanation tonometry (GAT). Before and after LASIK, the applied value of IOP, measured by dynamic contour tonometry (DCT) in comparison to GAT, was evaluated. Before and 1, 4 weeks after LASIK, the IOP in 30 cases (60 eyes) was measured by GAT and DCT respectively. The obtained results were statistically processed by SPSS11.5 statistical software. The results showed that central corneal thickness (CCT) could affect GAT measurements but not DCT measurements. The comparison of IOP one and 4 weeks after LASIK revealed that the readings from GAT was separately decreased by 5.00 +/- 1.12 and 5.45 +/- 1.13 mmHg as compared with those before LASIK, while those from DCT had no significant difference. It was concluded that LASIK-induced changes of CCT could influence the accuracy of GAT measurements, but had no influence on those from DCT. DCT was more beneficial to the measurements of IOP in normal eyes and those subject to LASIK surgery.

BACKGROUND: Poly(ethylene glycol)-b-poly(L-lactide)-b-poly(L-glutamic acid) (PEG-PLA-PGL) tri-block copolymers have good applied foreground in constructing tissue engineering scaffold materials. Whether endothelial cells survive and grow on the materials has a direct influence on the application as a biodegradable material for the scaffold of endothelial cell vector.OBJECTIVE: To explore the cytocompatibility of PEG-PLA-PGL tri-block copolymers with human umbilical vein endothelial cells (HUVECs).DESIGN: Randomized control observation.SETTING: the Second Hospital of Jilin University.MATERIALS: The experiment was carried out in the Department of Pathobiology, School of Basic Medical Sciences, Jilin University from February to October in 2006. Human umbilical cord about 20 cm length came from one neonatal infant who was delivered normally after enough months in the Department of Gynecology and Obstetrics, the Second Hospital of Jilin University. Human umbilical cord was sampled in the informed consents of the infant's family member. The experimentation was authorized by the medical ethic committee of the hospital. PEG-PLA-PGL membranes were provided by Changchun Institute of Applied Chemistry, Chinese Academy of Sciences. Inverted microscope and phase-contrast microscope were bought from Olympus Company (Japan).METHODS: HUVECs cultivated and grew steadily, were inoculated onto PEG-PLA-PGL membranes, serving as the experiment group. While the culture medium without PEG-PLA-PGL membranes were taken as the control group.①Cytocompatibility of PEG-PLA-PGL membranes with HUVECs was evaluated by observing cellular growth through phase-contrast microscope.②The proliferation index of cells was detected by MTT method in 1, 3, 5 and 7 days after inoculation.MAIN OUTCOME MEASURES: ①Cytocompatibility of PEG-PLA-PGL membranes with HUVECs;②The proliferation index of cells in l, 3, 5 and 7 days after inoculationRESULTS: ①Cytocompatibility of PEG-PLA-PGL membranes with HUVECs: The observation result of phase contrast microscopy showed that, endothelial cells planted on the PEG-PLA-PGL membranes began to attach and stretch after being planted 4-6 hours. Three days later, cells grew in colonies rapidly, after 5 days, colonies began to fuse and seemed like cobble-stone. The cells were shuttle or polygon in shape after passages. There were no significant differences between the experiment and control group. Cells cultured on PEG-PLA-PGL membranes for 15 days grew in inserts with membranes, but they didn't grow into patches through scanning electron microscope.②The proliferation index of cells: No significant differences of the proliferation index of cells were detected by MTT method in 1, 3, 5 and 7 days after inoculation between experiment group and control group (P＞0.05).CONCLUSION: Endothelial cells grow well in PEG-PLA-PGL membranes, and the two have good cytocompatibility.

Objective To explore the value of ultrasound imaging in complications associated with venous catheterization.Methods Patients (n =853) underwent ultrasound imaging examination after venous catheterization.Ultrasonography manifestations of venous catheterization complications and clinical curative effect were analyzed and summarized.Results Phlebitis,thrombus and mechanical complications were found by ultrasound imaging examination.Pneumothorax,hemothorax,arterial puncture and hematoma were among the main mechanical complications.Among the 853 patients,85 cases (9.96％) were found to have complications by ultrasound examination,with 35 cases (4.10％) of phlebitis,26 cases (3.05％) of catheter-related thrombus and 24 cases (2.81％) of mechanical complications.Conclusions In summary,a variety of venous catheterization complications can be diagnosed using ultrasound imaging non-invasively,effectively and efficiently.Real-time ultrasound imaging examination can dynamically monitor the develop ment and evolution of venous catheterization complications and effectively evaluate outcomes.

Objective To explore the clinical value of CEUS guided biopsy of lymphoma in anterior mediastinum.Methods The data of 36 patients with lymphoma of anterior mediastinum underwent biopsy guided by CEUS and 36 patients by conventional ultrasound retrospectively.The successful rate of biopsy and rate of complication occurence were compared between the CEUS group and conventional ultrasound group.Results The successful rate of biopsy in CEUS group was 100％ (36/36),including 26 non-Hodgkin's lymphoma (NHL),10 Hodgkin's lymphoma (HL).The total times of puncture were 60 in 36 patients.The rate of complication occurrence was 11.11 ％ (4/36).The successful rate in conventional ultrasound group was 88.89％ (32/36),including 22 NHL,14 HL.The times of puncture were 91 in 36 patients.The rate of complication occurrence was 41.67％ (15/36).There were significant differences in successful rate and the rate of complication occurrence between two groups (x2 =4.235,8.651,P=0.040,0.003).Conclusion CEUS can reflect the microcirculation of lymphomas in anterior mediastinum,and can guide targeted biopsy.It can improve the successful rate of biopsy and reduce the complications.

Objective To explore the safety and clinical effect of the human acellular nerve allograft (hANG) for repairing peripheral nerve defects.Methods During November,2009 to October,2010,6 patients with 3 digital nerve defects and 3 radial nerve defects were repaired with hANG.During postoperation period,safety was evaluated by local wound response and laboratory testing,while the efficacy was evaluated by British Medical Research Council sensory function assessment standards,static 2-point discrimination (2PD) and Semmes-Weinstein monofilament testing.Results Three patients with 6 digital nerve defects received hANG transplant.The length of nerve graft was 20-50 mm(mean 30.8 mm).After followed up for 31-40 months,the excellent rate of 2PD was 66.7％.Two of 3 patients rahabilited as well as the normal.Three patients with radial nerve defects,whose length of nerve graft was 35-60 mm(mean 48.3 mm).The strength of extensor carpiradialis longus muscle had restored Ⅲ in 1 case,and other 2 cases had no restoration.Conclusion hANG is safe and effective for repairing peripheral nerve defects,especially for digital nerve defects.

Objective To assess nutritional risks in children with allergic proctocolitis induced by cow milk protein,and to observe the effects of the feeding strategies for them with different interventions in feeding,and then to identify the best time and the best way to modify feeding strategies according to different individual.Methods The effectiveness of different feeding interventions was retrospectively analyzed after 2 weeks in 171 cases with allergic proctocolitis induced by cow milk protein in Hunan Children's Hospital during the period of Jan.2012 to Jul.2013.Thirty-two cases received breast feeding (18.7％) and 139 cases received non-breast feeding (81.3％).Intervention methods:32cases with breast feeding received the same feeding method;among 139 babies with non-breast feeding group,36 were plus free amino acid (AAF) (21.1％),and 103 were plus the extensively hydrolyzed formula (eHF).The intervention formula changes were observed in 8,12 and 24 weeks,respectively,and nutritional risks in 0,3,6 months were assessed,respectively.Results There were 171 patients totally,male to female ratio was 1.5 to 1.0,and the average age was (4.1 ± 1.3) months.After 2 weeks,147 cases were notably effective,accounting for 86％,and in the breast feeding group 79.2％ of the patients were notably effective,and there was no significance compared with the AAF group and eHF group (P ＞ 0.05).The intervention formulation changes during the following 6 months were as follows:in 8 weeks,30 cases in the breast feeding group breastfeeding continued,2 cases turned to eHF feeding for the lack of breast milk,21 cases were fed with AAF (12.3％),85 cases with eHF (49.7％),and 35 cases with moderately hydrolyzed formula (20.5％) ;in 12 weeks:23 cases had breast feeding (13.5％),16 cases were fed with free amino acid formula powder (9.4％),56 cases with extensively hydrolyzed formula (32.7％),and 76 cases with moderately hydrolyzed formula (44.4％) ;in 24 weeks:21 cases (12.3％) had breast feeding,7 cases were fed with AAF(4.1％),13 cases with moderately hydrolyzed formula(7.6％),and 130 cases with normal formula(76.0％).The mean levels of the nutritional risks were assessed according to STAMP in 0,3,6 months respectively:breast feeding group [(1.69 ± 0.78) scores,(1.50 ± 0.88) scores,(1.53 ± 0.67) scores,P ＞ 0.05] ; AAF group [(1.72 ± 0.78) scores,(1.53 ± 0.88) scores,(1.53 ± 0.65) scores,P ＞ 0.05] ; eHF group [(1.80 ± 0.69) scores,(1.68 ± 0.68) scores,(1.66 ± 0.65) scores,P ＞ 0.05].Conclusions The nutrition risk levels in children with milk protein allergic proctocolitis are low,and different feeding interventions according to tolerance had no impact on the nutritional status ; Breast feeding could effectively avoid cow milk allergy,and symptoms of the children with allergic proctocolitis would be relieved after 2-week intervention,and more than half of children could gain part of immune tolerance after intervention for 3 months or more,so for the children with allergic proctocolitis induced by cow milk protein,routine formula feeding should be stopped after 3 months,and individualized feeding intervention can be carried out according to immune tolerance to relieve the financial burden.