Objective:To survey the prevalence of internet addiction disorder(IAD)of vocational college freshmen and analyze its relationship to their childhood abuse and neglect.Methods:IAT,SCL-90 and CPANS were used to investigate 740 freshmen of Yongzhou Technical Vocational College.Results:The rate of IAD among 740 freshmen is 3.2%.The factor scores of IAD students were significantly higher than those of normal students(P

Objective:To explore the differences of depressive emotion among youth, middle age and the senile depressive cancer patients. Methods:96 depressive cancer patients were assessed with a self-developed data-collecting form, Beck Depression Inventory (BDI), Simplified Coping Style Questionnaire (CPS) and Dysfunctional Attitude Scale(DAS).Results:There were differences in the total scores of BDI and the factor scores of depression, feeling of failure, dissatisfaction, self-feeling of guilty, self-dislike, intention of suicide, irritability, hypoactivity, hyposexuality, feeling of being punished, self-blame, crying, pessimism preoccupied viewpoint and body-image disturbance among the three groups. Conclusion:There are differences among depressive cancer patients of different age periods.

It is well known that adolescent varicocele is one reason to induce the testicular hypotrophy and potential infertility.Its indication and methods of treatment are controversial.This review provides the recent progress in diagnosis and treatment of adolescent varicocele including the indications and methods of surgical treatment,as well as new information of future researcher in the areas.

Objective To understand the status quo of continuing medical education in different levels of hospitals in primary health technical personnel,and provide suggestions for the development of continuing medical education.Methods Questionnaire survey,Statistical analysis and Interview.Results Health technical personne of medical institutions at all levels in primary health technical personnel were generally more emphasis on continuing medical education,but the management system,input and the need are different in the different levels of hospital.Continuing medical education in the basic level hospitals is much lower than the high level hospitals.Conclusions We should strengthen the transformation of continuing education mode,put forward the practical development strategy,improve the level of medical education,and narrow the gap between different levels of hospitals,so as to achieve the purpose of common progress.

Objective To investigate the diagnosis and treatment of posterior fossa hemangioblastoma.Methods The data of 44 cases with posterior fossa hemangioblastoma verified by surgery and pathology were analyzed retrospectively.Results Preoperative definite diagnosis cases were 41.Total tumor removal was achieved in 37 cases. Four cases died of the operation.Conclusions Posterior fossa solid hemangioblastoma are still challenging neoplasmas.For this kind of tumor,biopsy and partial removal are forbidden,and this tumor is removed after devascularity of supply blood artery.CT and MRI are major preoperatively diagnosis method for posterior fossa hemangioblastoma. The application of special microsurgical technique can improve surgical efficacy.

Objective To investigate the value of multislice spiral CT in evaluating the parametrial invasion of cervical carcinoma. Methods 75 cases of FIGO staging II cervical carcinoma who had received the surgery were studied. Their imaging and the FIGO staging were analyzed retrospectively. Results For FIGO staging, the accuracy for evaluating the parametrial invasion was 53.3%(40/75), the rate of underestimation was 26.7%(20/75), the rate of overestimation was 20.0%(15/75); For CT, the accuracy of evaluating the parametrial invasion was 69.3%(52/75), the rate of underestimation was 14.7%(11/75), the rate of overestimation was 17.3%(13/75). In 40 cases, both FIGO staging and evaluation by CT were consistent with the surgical results. In 35 cases, FIGO staging was different from the surgical results. In 29 cases, evaluation by CT was different from the surgical results. In 10 cases, CT could correct the error of FIGO staging. Conclusion CT scan can acquire the multi-plane image, and can directly reflect the parametrial space. It is more accurate than FIGO staging, and is an important complement to FIGO staging.

Objective To investigate the clinical and pathological characteristics,surgical treatment strategy and prognosis of primary malignant neoplasms of the appendix.Methods The clinical data of 74 patients with primary malignant neoplasms of the appendix in our hospital from January 1982 to December 2012 were retrospectively studied.Results Among the 74 cases of primary malignant neoplasms of the appendix,carcinoids were the most common accounting for approximately 70％,adenocarcinoma accounting for 22％ and lymphoma accounting for 8％.The prognosis of primary malignant neoplasms of the appendix is rather poor,nainly because of patients' later presentetion.The overall 1,3,5-year survival rate is respectively 95％,74％,60％,the prognosis of carcinoid is good,while that of adenocarcinoma is poor.Conclusions The incidence of primary malignant neoplasms of the appendix is relatively low.It is difficult to diagnose preoperatively,and the diagnosis relies mainly on rapid intraoperative frozen section and postoperative pathology.

Objective To identify the prognostic factors for patients with intrahepatic cholangiocarcinoma.Methods The clinical data of 99 patients with intrahepatic cholangiocarcinoma who received surgical treatment at the Cancer Hospital of Tianjin Medical University from January 2000 to January 2010 were analyzed retrospectively.Lymph nodes at the hepatic portal and group 12,13 and 8 lymph nodes were resected.The range of hepatectomy was decided according to the size,location,number of tumor and the hepatic function.Patients were followed up every month within the first 6 months after operation,every 3 months at 6 months later,and they were followed up every half year at 2 years later.Patients who were suspected as with tumor recurrence or progression were followed up every month.All the patients were followed up till death or March of 2013.The survival was analyzed using the Log-rank test,and multivariate analysis was done using the COX regression model.Results Forty patients received hemi-hepatectomy,27 received extended hemi-hepatectomy,20 received segmentectomy,and 12 received hemi-hepatectomy + wedge resection.All the patients were followed up and the median time of follow-up was 33 months (range 21.1-44.9 months).The 1-,3-,5-year recurrence-free survival rates and total survival rates of the 99 patients were 64.6％,29.2％,22.7％ and 78.8％,46.4％ and 30.3％,respectively.The results of univariate analysis showed that hepatitis B or C virus infection,preoperative CA19-9 level,TNM staging,lymph node metastasis,microvascular invasion,number of nodules and Ro resection were risk factors influencing the recurrence-free survival time (Log-rank value =5.048,5.982,20.128,13.148,29.632,32.488,50.574,P ＜0.05).The peroperative CA19-9 level,TNM staging,lymph node metastasis,microvascular invasion,number of nodules and R0 resection were risk factors influencing the total survival rate (Log-rank value =4.302,17.267,11.756,23.840,36.411,47.126,P ＜0.05).There were significant differences in the recurrence-free survival time and total survival time between patients in different TNM stages (20 patients in stage Ⅰ,44 in stage Ⅱ,8 in stage Ⅲ and 27 in stage Ⅳ) (Log-rank value =20.128,17.267,P ＜0.05).There were significant difference in the recurrence-free survival time between patients in stage Ⅰ and Ⅲ,patients in stage Ⅰ and Ⅳ,and between patients in stage Ⅱ and Ⅳ (Log-rank value =10.807,19.368,6.347,P ＜ 0.05).There were significant difference in the total survival time between patients in stage Ⅰ and Ⅱ,patients in stage Ⅰ and Ⅲ,patients in stage Ⅰ and Ⅳ and between patients in stage Ⅱ and Ⅳ (Log-rank value =6.119,4.015,16.282,4.929,P＜0.05).There was no significant difference in the survival time between patients in other TNM stages (P ＞ 0.05).The results of multivariate analysis showed that TNM stage Ⅲ and Ⅳ,microvascular invasion,multiple nodules and R0 resection were independent risk factors influencing the recurrence-free survival time (RR =1.413,3.073,2.737,3.916,95％ confidence interval:1.119-1.784,1.837-5.140,1.338-4.207,1.849-8.291,P＜0.05) ; lymph node metastasis,microvascular invasion,multiple tumors and R0 resection were the independent risk factors influencing the total survival time (RR =2.025,2.948,0.327,3.494,95％ confidence interval:1.215-3.374,1.774-4.900,0.183-0.583,1.670-7.310,P ＜ 0.05).Conclusions TNM stage Ⅲ and Ⅳ,lymph node metastasis,microvascular invasion,multiple nodules,non-R0 resection shorten the recurrence-free survival time and total survival time of patients who received surgical resection for intrahepatic cholangiocarcinoma,and they are the main factors influencing the prognosis.R0 resection could improve the survival of patients with intrahepatic cholangiocarcinoma.

Objective To evaluate precise hepatectomy for liver metastases of colorectal cancer. Methods The clinical data of 85 patients with liver metastases of colorectal cancer who were admitted to the Cancer Hospital of Tianjin Medical University from October 2006 to October 2009 were retrospectively analyzed. Forty-two patients received precise hepatectomy(precise group) and 43 received routine hepatectomy (routine group). Evaluation of the hepatic and renal functions and detection of the tumors' condition were done before carrying out anatomical liver resection for patients in the routine group. Hepatic functional reserve of patients in the precise group was detected by indocyanine green excretion test. Hepatic artery, hepatic vein and portal vein were three-dimensionally reconstructed according to the data of computed tomography. The liver volume and residual liver volume of the patients were calculated. Hepatic resection was guided by intra-operative ultrasound in the precise group. Periand postoperative conditions and the results of follow-up of patients in the two groups were compared. All data were analyzed using the t test or chi-square test. Results No perioperative mortality was observed in the two groups.Time of hepatic blood flow occlusion and blood loss were (35±25)minutes and (685 ± 524) ml in the routine group, and (64±39) minutes and (486±360) ml in the precise group, respectively, with a significant difference between the two groups(t=4.116,-2.033, P＜0.05). The volumes of blood transfusion of the routine group and the precise group were (228±398) ml and (160±330)ml, respectively, with no significant difference between the two groups (t=-0.861, P＞0.05). The postoperaive levels of alanine transaminase at day 1 and day 7 were (672±284)U/L and (332±161)U/L in the routine group, and (344±158)U/L and (125 ±93) U/L in the precise group, respectively, with a significant difference between the two groups (t=-6.541,-7.232,P＜0.05). The length of hospital stay and postoperative mobidity were (18±10)days and 26% (11/43) in the routine group, and (12±6)days and 7%(3/42) in the precise group, respectively, with a significant difference between the two groups (t=- 3.915, x2=5.251, P＜0.05). The 1-year tumor recurrence rate and 1-year survival rate were 37% (16/43) and 88% (38/43) in the routine group, and 21% (9/42) and 93% (39/42) in the precise group, with no significant difference between the two groups (x2= 0.110, 0. 501, P＞0.05). Conclusion Precise hepatectomy is superior to routine hepatectomy in aspect of minimal trauma, quick recovery, efficacy and safety.

Objective:To discusse the clinical features of sarcomatoid hepatocellular carcinoma to improve the understanding of diagnosis and treatment for sarcomatoid hepatocellular carcinoma. Methods:Data including clinical features and follow-up from 8 pa-tients admitted in Tianjin Medical University Cancer Institute and Hospital from January 2009 to April 2014 were retrospectively ana-lyzed. Results: The average age of all patients was 56.6 years old, and the male-to-female ratio was 3:1. Preoperative CT or MRI showed specific characteristics but it was difficult to confirm diagnosis. Pathological and immunohistochemical examination revealed an expressed epithelial-like phenotype. All 8 patients had advanced local tumor invasion and high lymph node metastasis rates. These patients received surgery, and the median survival time was 10.8 months (3 months to 35 months). Conclusion:Diagnosis of sarcoma-toid hepatocellular carcinoma mainly depended on postoperative pathological examination. Immunohistochemistry was beneficial for sarcomatoid hepatocellular carcinoma diagnosis and differential diagnosis. Surgical treatment prolonged survival time, but the overall prognosis remained poor.