Objective To evaluate the clinical and pathological features and treatment of primary hepatocellular carcinoma invading on to the bile duct.[WT5”HZ]Methods [WT5”BZ]39 cases of hepatocellular carcinoma of icteric type were collected in our hospital.[WT5”HZ]Results [WT5”BZ]The incidence was 6% in all hepatocellular carcinoma patients.Preoperative correct diagnosis was achieved in only 33% of the 39 cases.The positive diagnostic rate of B ultrasound and CT was 88% and 80%respectively,and 49% of cases suffered from intraportal thrombi concomitantly.[WT5”HZ]Conclusion [WT5”BZ]Preoperative correct diagnosis depends on image test,hepatectomy with biliary duct drainage is the mainstay for treatment.

Objective To study the clinical features and treatment on hepatocellular carcinoma(HCC) with obstructive jaundice as primary symptom. Method We collected 39 cases of patients of HCC with obstructive jaundice as primary symptom in our hospital,the clinical features and treatments were studyed.Results The incidence of such patients was 6.3% in all HCC patients and all patients were operaed;the positive diagnostic rate of B ultrasonud and T was 88.2% and 80% respectively ,it was 48.7% in cases with intraportal thrombi.Conclutions Preperative correct diagnosis depends on image test,hepatectomy with biliary duct drainage is the mainstay for treatment .

Objective To explore the relationship of college students among death attitude,self-respect,and locus of control character.Methods Death attitude questionnaire,Rosenberger self-respect questionnaire and locus of control Inclination questionnaire were administered to 442 college students chosen by random sampling.Results ①Death attitudes order:death neutrality(3.78±0.62),death escape(2.90±0.77),terror of death(2.71±0.73),approach acceptance (2.49 ± 0.69) and escape acceptance (2.44 ± 0.84).② Different self-respect gradation students displayed significant difference on the terror of death,death neutrality,approach acceptance and escape acceptance (P＜0.05) ;and different character students displayed significant difference on the terror of death,death escape and escape acceptance(P＜0.05).③Self-respect had significant positive correlation with death neutrality (P＜0.01),while had negative correlation with terror of death,death escape,approach acceptance and escape acceptance (P＜0.01);and locus of control character had significant positive correlation with death fear and escape acceptance(P＜0.01).④Self-respect,locus of control character,health condition,discussions over death situation,and meaning of life have a degree of forecasting power over death attitude.Conclusion There is a close correlation among death attitude,self-respect,locus of control character.

In recent five years,brain imaging studies suggested that internet addicts' neural pathway have abnormalities in reward circuits,executive control system,and decision-making system when they are in resting state or induced state.For internet addicts,in the aspect of reward circuits,they showed decreased metabolism level when undergoing a resting-state fMRI scan,and enhanced reward sensitivity as well as decreased loss sensitivity when functioning.In the aspect of executive control system,the related brain areas were associated with reduced white matter integrity and disrupted functional comnectivity in resting-state.When the task was internet-related,internet addicts showed enhanced executive control function.However,when the task was not internet-related,they showed reduced executive control function.In the aspect of decision-making system,reduced cortical thickness in related brain areas was found when internet addicts are in resting-state,and they possess high impulsivity and high risk tendency when they are in induced state.These findings are consistent with the conclusions of substance addicts which are based on the research of brain imaging,therefore,we preliminary think the internet addiction is a new type of addictive mental disorder.

Objective To investigate the roles of endoscopic biopsy and third ventriculostomy in the diagnosis and treatment of pineal region tumors in children. Methods Endoscopic biopsy and third ventriculostomy were performed in 9 pediatric patients with pineal region tumors. Results Successful third ventriculostomy, confirmed by MRI, was performed in 9 cases of children with obstructive hydrocephalus. No complications were found in all patients. Conclusion Endoscopic biopsy and third ventriculostomy are effective neuroendoscopic procedures in minimally invasive preferential management of pineal region tumors.

Risk factors of hyperamylasemia in 152 diabetic ketoacidosis(DKA)patients who had no acute pancreatitis were examined.Serum levels of hemodiastase,natrium,kalium,chlorine,calcium,phosphonium,creatinine,carbon dioxide combining power,osmotic pressure,blood glucose,blood lipids and uric acid were measured.With hemodiastase and other 14 factors as independent variables,the multiple linear regression analysis was performed and the partial regression coefficient was estimated.Blood glucose,serum natrium,osmotic pressure and triglyceride entered the regression equation,and their partial coefficients were 10.26,10.35,2.21 and 8.00,respectively.The constant quantitv was -2162.06.Compared with amylase-normal group,hyperamylasemia group showed statistically significant difference in blood glucose,serum natrium,osmotic pressure and triglyceride levels.Higher blood glucose and triglyceride might be the primary causes of hyperamylasemia.

Objective To evaluate the clinical and radiological results of locking plate for treatment of proximal humerus frac‐tures and the efficacy of anatomical healing of tuberosities .Methods A total of 57 patients with proximal humerus fractures were treated with locking‐plate from July 2008 to March 2012 .A standardized radiological evaluation was conducted .Patients were divid‐ed into two groups :group A (anatomical healing of tuberosities) with 31 cases and group B (without anatomical healing of tuberosi‐ties) with 26 cases .Clinical assessment was performed using the Neer rating scale .Results Considering the entire sample ,the mean Neer score was 87 .96 ± 5 .06 points ,the excellent rate was 94 .74℅ .Comparing these parameters in the two groups ,group A was significant higher in the Neer scores and the range of movement than that of group B (P<0 .05) ,there was no statistic differences in the scores of pain and function (P>0 .05) .Conclusion the locing plate for treatment of complex proximal humerus fractures has a high subjective satisfaction rate .A good functional result depends on anatomical reestablishment of proximal humerus anatomy , particularly the healing of the greater tuberosity .

Objective To explore the difference between interval storage and continuous storage of dynamic imagines in contrast enhanced ultrasound (CEUS) quantitative analysis. Methods Two CEUS were performed for each of fifteen participants using interval storage and continuous storage of dynamic images. A number of parameters were analyzed including rising time (RT), time to peak (TTP), mean transit time (MTT), maximum intensity (IMAX), and area under the curve (AUC). The disk usage and time consumpation were also compared for analysis. Results There were no differences in RT, TTP, MTT, IMAX, AUC between the two groups (t=1.028, 1.012, 0.558, 0.223, 0.556, P=0.322, 0.329, 0.586, 0.826, 0.587). There was significantly positive correlations between them (r=0.989, 0.992, 0.867, 0.865, 0.947, all P<0.05). The disk usage in interval storage group was about 1/3 of that in contiunous storage group. And the interval storage method could saved 25-30 min in each case. Conclusion Interval storage is worthy for further clinical application on the groud of its disk usage sparing and less time consumpation without compromising the image quality for analysis.

[ ABSTRACT] AIM:To explore the effect of dexmedetomidine ( DEX) on the CCAAT/enhancer-binding protein-homologous protein ( CHOP) pathway during lung ischemia-reperfusion ( I/R) in mice.METHODS:C57BL/6J male mice were randomly divided into sham operation group ( sham group) , lung ischemia/reperfusion group ( I/R group) , ischemia/reperfusion +normal saline group ( I/R+NS group ) and ischemia/reperfusion+dexmedetomidine group ( I/R+DEX group) .Dexmedetomidine was infused intraperitoneally with 25 μg/kg for 30 min prior to the ischemia period in I/R+DEX group, the normal saline was administrated with the same volume of dexmedetomidine in I/R+NS group.After fini-shed the 3 h-reperfusion period , the left lung tissues were harvested to determine lung wet/dry weight ( W/D) , the total lung water content ( TLW) , and index of quantitative evaluation for alveolar damage ( IQA) .Morphological observation and terminal-deoxynucleotidyl transferase mediated nick end labeling ( TUNEL) were applied to evaluate the structure changes and the apoptosis index (AI) of the lung tissues.The expression of CHOP and glucose-regulated protein 78 (GRP78) at mRNA and protein levels in the lung tissues was detected by Western blot and RT-PCR.RESULTS:Compared with sham group, the W/D, TLW, IQA, AI, the mRNA and protein expression of CHOP and GRP78 obviously increased, and the left lung tissues structure were damaged more obviously both in I/R group and I/R+NS group.Compared with I/R group, the W/D, TLW, IQA, AI and the protein and mRNA expression of CHOP in I/R+DEX group decreased, the injury of the left lung tissue structures induced by I/R in I/R+DEX group were also alleviated .CONCLUSION:DEX alleviates the
lung I/R injury, which may be related to inhibition of apoptosis mediated by CHOP pathway.

Objective To study the pathological alterations,such as oxidative stress,cell proliferation and insulin resistance,especially autophagy,in Alzheimer' s disease (AD) complicated with type 2 diabetes (AD + T2DM).Methods The mouse models of T2DM,AD and AD + T2DM were used in the study,and totally 80 mice were divided into four groups:control group,T2DM group,AD group and AD + T2DM group.Morris water maze was applied to test the ability of learning and memory among the above mentioned groups.In the meantime,insulin resistance index,the expression of insulin receptor substrate 2,oxidative stress,cell proliferation and autophagy were observed with chemical analysis,immunofluorescent labeling,transmission electron microscopy and Western blotting.Results On day 4,the difference of time to find Morris water maze in control group,T2DM group,AD group and AD + T2DM group ((26.08 ±4.93) s,(38.46 ± 4.07) s,(47.32 ± 5.86) s,(53.01 ± 6.12) s,F =2.454,P =0.025) was statistically significant,and the time in AD + T2DM group was longer than that in AD group (t =-3.624,P =0.033).Compared with control group,insulin resistance occurred in T2DM group,AD group and AD + T2DM group (4.35 ± 0.48,16.12 ± 3.57,7.03 ± 3.11,18.78 ± 5.06,F =5.602,P =0.009),and the reduction of insulin receptor substrate 2 expression,the oxidative stress reaction,neural proliferative suppression and autophagy (F =418.344,222.514,436.250,113.934,23.772,35.469,all P ＜ 0.05) were induced in T2DM group,AD group and AD + T2DM group,which were more serious in AD + T2DM group than in AD group (t =-2.796,21.723,-8.041,9.037,-4.403,-32.011,-26.593,all P ＜0.05).Conclusion AD + T2DM mice suffered more serious cognitive impairment than AD and T2DM mice.The oxidative stress levels of AD + T2DM mice were upregulated,and thus led to the inhibition of cell proliferation,eventually leading to promotion of autophagy.