Objective: To study the efficiency and prognosis of preoperative transcatheter arterial chemoembolization(TACE)treatment in patients with hepatocellular carcinoma(HCC)after hepatectomy. Methods: The clinical pathological data of 479 patients with resectable HCC from 1998 to 2007 were analyzed retrospectively. Fifty patients had preoperative TACE, 379 cases had not and others were lost of follow up or dead. Clinical pathological data, tumor-free survival rate and overall survival rate after hepatectomy were analyzed. Results: There was a significantly difference in the age and the tumor grade between the groups, other clinical pathological factors were no difference. The preoperative TACE group was younger than non-TACE group (?2=6.228, P=0.012), And had lower tu-mor grade, more tumor necrosis (?2=53.874, P=0.000). The disease tumor-free survival rate and overall survival rate were no difference between the groups (?2=0.736, P=0.391;?2=0.000, P=0. 995). Conclusions: For the unresectable HCC patients by one-stage operation, the preoperative TACE treatment has no adverse effect. However, tumor-free survival rate and overall survival rate are similar to non-TACE group.

This paper discussed the detection of tumor micrometastasis, and analysed the influence of chemotherapy and blood transfusion on the immunity of tumor patients. Chemotherapy and blood transfusion can increase the opportunity of tumor metastasis. By analysing the mechanism of the treatment of tumor with traditional Chinese medicine, the author put forward the new method about eliminating tumor micrometastasis with traditional Chinese medicine.

OBJECTIVE To evaluate the anti-vertigo effect of phencynonate hydrochloride. METHODS To detect the improvement of phencynonate hydrochloride on cerebral blood flow, a rat model wa s es?tablished with bilateral common carotid arteries occlusion. Phencynonate hydrochloride 0.1-4.0 mg·kg-1 was ig given, twice a day for three consecutive days and the alteration of cerebral blood flow was measured with laser Doppler flowmetry. Rotating acceleration equipment was used to provocate mouse vertigo for 30 min, and the spontaneous locomotor activities were tested for occurrence of vertigo in mice. Phencynonate hydrochloride 1.4-5.6 mg·kg-1 was ig given before rotating acceleration. Gastric phenol red emptying rate was used to determine the anti-nausea effect of the test drug in mice 30 min after phencynonate hydrochloride 1.4-8.4 mg·kg-1 was ig given. RESULTS The cerebral blood flow of the rat model with bilateral common carotid arteries occlusion was reduced significantly after 24 h (P<0.01). Compared with the model group, phencynonate hydrochloride (0.5, 2.0 and 4.0 mg · kg-1) increased the cerebral blood flow in a dose-dependent manner in rats with cerebral ischemia (P<0.01). The spontaneous locomotor activities were significantly reduced after vertigo stimulation in mice (P<0.05). Compared with the model group, phencynonate hydrochloride (2.8 and 5.6 mg · kg-1) increased the movement distance and speed of vertigo mice (P<0.05). Phencynonate hydrochloride (2.8, 5.6 and 8.4 mg·kg-1) inhibited the gastric emptying of mice (P<0.05). CONCLUSION Phecynonate hydrochloride can improve the cerebral blood flow and locomotor activities in vertigo rats, while inhibiting gastric emptying, which points to the therapeutic potential of phencynonate hydrochloride for vertigo in clinic.

Objective To observe the efficacy of atorvastatin and irbesartan in the treatment of early diabetic nephropathy and the influence on serum cystatin C and adiponectin,thus to improve clinical outcomes.Methods 80 patients with early diabetic nephropathy met the inclusion criteria were randomly divided into observation group (40 cases)and control group(40 cases).All patients were given conventional diabetes comprehensive intervention, the control group then was given irbesartan 150mg/d,qd,the observation group was given atorvastatin on the basis of control group,20mg/d,qd,both two groups were treated for 12 weeks.The FBG,HbA1c,renal function indication (Scr,BUN,UAER),lipid parameters indication(TC,TG),cystatin C,adiponectin were detected.DBP,SBP were detected by 24h ambulatory blood pressure.Results The DBP,SBP,Scr,BUN,UAER,TC,TG,cystatin C,adiponec-tin of the observation group after treatment were lower than before treatment(P <0.05 or P <0.01).The BUN,TC, TG of the control group had no significant changes before and after treatment (P >0.05).The DBP,SBP,Scr,BUN, UAER,TC,TG,cystatin C,adiponectin of the observation group after treatment were lower than the control group (P <0.05 or P <0.01).Conclusion Atorvastatin combined with irbesartan can effectively control blood pressure, has overall improvement in glucose and lipid metabolism,effectively reduce adiponectin,inhibit glomerular dysfunc-tion,improve kidney function,it is a good method for prevention and treatment of early diabetic nephropathy.

Objective To summarize the manifestation of pediatric eosinophilic gastroenteritis by ultrasound and discuss the diagnostic value of ultrasonography in pediatric eosinophilic gastroenteritis. Methods The ultrasonic appearances of 31 cases of pediatric eosinophilic gastroenteritis confirmed by clinics and pathology were reviewed and analyzed. Results Nineteen of 31 cases were observed in association with eosinophilic infiltration of other organs which were diagnosed as idiopathic hypereosinophilic syndrome.Eosinophilic cystitis was the most common among the complications(89.4%,17/19).Twelve of 31 cases were diagnosed as eosinophilic gastroenteritis without complications.The endoscopic appearances of eosinophilic gastroenteritis were nonspecific which include erythematous,hyperemia edema,and partiality erosion changes.Endoscopy demonstrates increased numbers of eosinophils in the propria of stomach and the duodenum.Ultrasound features of the gastroenteritis appeared diffuse or the parts of gastrointestinal tract.The most common sites of eosinophilic gastroenteritis were the stomach and duodenum.Involvement of muscle layer and serosal layer showed wall thickening of cyclic annular and uniformity.Ultrasound might show nodular or irregular thickening of the folds in the gastric antrum when the submucosa were thickening.The mucosal layer involvement was not easy to be found by ultrasound.The echo of serous layer and submucosa associated with the disease stage.The thickening of surrounding omentum and mesenteric tissue,echo enhancement and nonspecific hyperplastic mesenteric lymph nodes infiltrated with eosinophils might be present.Eosinophilic ascites could often be detected.Conclusions Ultrasound has obvious advantages in the diagnosis of pediatric eosinophilic gastroenteritis,and the ultrasonic changes of pediatric eosinophilic gastroenteritis are characterized.Ultrasonography can provide the possible diagnosis when combined with inflammatory of other organs,especially cystitis inflammatory changes.

Sixty cases of pseudobulbar palsy were treated by puncturing Shuigou (GV 26), Lianquan (GV 23), Fengchi (GB 20), Wangu (GB12), Yifeng (TE 17),Tongli (HT 5), Neiguan (PC 6) and Fenglong (ST 40)with the needling technique to refresh mind and open orifice, and by puncturing the retropharyngeal wall and palatine arch, plus training of swallowing function, the total effective rate reached 95.0%.

AIM:To evaluate the influence of scutellarin on the expression of vascular endothelial growth factor ( VEGF) in high glucose-treated human retinal pigment epithelial cell line ARPE-19 and to observe the effects of scutellarin on the protein expression of VEGF, p-ERK and VEGFR2 in the retinas of type II diabetic rats.METHODS: Cultured ARPE-19 cells were divided into normal control group, scutellarin group, high glucose group and high glucose+scutellarin group.The protein levels of VEGF, p-ERK and VEGFR2 were measured by Western blot.The VEGF release in ARPE-19 cells was detected by ELISA.Normal rats were randomly divided into normal control group and scutellarin group.Diabetic rat model was established by feeding with high-fat diet and injecting with streptozocin, and randomly divided into diabetes group and diabetes treated with scutellarin group.After 16 weeks, the eyes were removed.The morphological changes of the retinas were observed under light microscope with HE staining, and histopathological score was recorded.The expres-sion of VEGF in the retinas was observed by the method of immunohistochemistry.RESULTS:Compared with normal con-trol group, the protein levels of VEGF, p-ERK and VEGFR2 in the ARPE-19 cells decreased in scutellarin group, but in-creased in high glucose group.The histopathological score of the retinas showed significant difference among diabetes group, diabetes treated with scutellarin group and normal control group, and no significant difference between normal con-trol group and scutellarin group was observed.The expression of VEGF increased in diabetic group and was significantly higher than that in scutellarin treatment group (P<0.05).CONCLUSION:Scutellarin inhibits the increased protein le-vels of VEGF, p-ERK and VEGFR2 in ARPE-19 cells, and decreases the expression of VEGF in the retinas of diabetic rats.The suppression of the diabetic retinopathy development by scutellarin may be partly involved in the ERK/MAPK pathway.

Objective To investigate nurses' organizational career management and job satisfaction in the third-grade class-A hospital,and analyze the relationship between them.Methods A total of 576nurses were recruited by two-stage stratified random sampling method from four third-grade class-A hospitals.They were investigated with Nurses' Organizational Career Management Questionnaire and Job Satisfaction Scale.Results The mean score of nurses' organizational career management and job satisfaction was(2.94±0.52)and(3.32±0.46).There were significant differences on the scores of job satisfaction in nurses with different ages,nursing age,shift,posts,professional tifles,departments,monthly income and type of hospitals.Nurses' organizational career management was positively correlated to job satisfaction.After controlling for the demographic variables,the overall state of organizational career management could explain 34.2 percent for the variances of job satisfaction respectively.Conclusions It is suggested to pay close attention to nurses' organizational career management and take effective career management measures to improve nurses' job satisfaction so as to stabilize the nursing team and retain the excellent nurses.

OBJECTIVE To investigate the pathogen distribution and antimicrobial resistance in ventilator-associated pneumonia(VAP) in intensive care unit(ICU) of our hospital and provide reference for clinical treatment.METHODS Among 135 patients with VAP in ICU of our hospital,pathogens distribution and resistance rate from sputum culture were analyzed retrospectively.RESULTS Among 188 strains of isolated pathogens in 135 patients,the Gram-negative bacteria accounted for 74.5%,the Gram-positive bacteria 14.4% and the fungi were 11.2%.The predominant pathogens were Pseudomonas aeruginosa(19.7%),Stenotrophomonas maltophilia(18.6%),Klebsiella pneumoniae(16.0%),and Acinetobacter baumannii(14.4%),Staphylococcus aureus(10.6%),Candida albicans(9.6%).The percentage of meticillin-resistant S.aureus(MRSA) was 95.0% and no vancomycin-resistant S.aureus isolate was detected out.Sensitive antibiotics were cefoperazone/sulbactam,imipenem/cilastatin,fluconazole etc.CONCLUSIONS The multi-drug resistant Gram-negative bacilli are the main pathogens in VAP in ICU of our hospital.Cefoperazone/sulbactam and imipenem/cilastatin can be used as first empirical antibiotics for patients with VAP in ICU of our hospital.

Objective To explore the effect of I kappa B kinase (IKK) on liver during hepatic ischemia reperfusion (HIR) in rats.Methods Wister rats were divided randomly into HIR group in which hepatic reperfusion was given after 60 minutes of ischemia by interruption of the arterial and portal venous blood supply to the left lobes and middle lobes of the liver; HIR + PDTC treatment group in which PDTC (120 mg/kg) were injected via the dorsum vein of penis before ischemia reperfusion; and sham control group in which midline laparotomy was performed without vascular occlusion and treatment.Expression levels of IKK were measured with In situ hybridization(ISH).The NF-κB activities were determined with EMSA.Expression levels of TNF-α were measured with immunohistochemistry (IH).Serum levels of ALT were measured.Results Expression level of IKK was increased markedly from 0 to 12h and peaked 6h after reperfusion in HIR group.NF-κB was activated 0 ～ 12h after reperfusion and activities of NF-κB were maximal 6h after reperfusion in HIR group rats compared with sham control group.Expression level of TNFα was increased markedly from 0 to 12h and peaked 6h after reperfusion in HIR group.Serum levels of ALT were increased significantly after reperfusion in H1R group.Expression level of IKK was lowered markedly in HIR + PDTC group from 0 to 12h after reperfusion.NF-κB activities were significantly lower in HIR +PDTC group than in HIR group from 0 to 12h after reperfusion.Expression level of TNF-α was lowered markedly in HIR + PDTC group as compared with HIR group from 0 to 12h after reperfusion.Serum level of ALT was decreased significantly after reperfusion in HIR + PDTC group as compared with HIR group.Conclusion HIR can activate IKK-β which promotes the activation of NF-κB,then NF-κB results in upregulation transcription of TNF-α gene which gives rise to the release of other inflammatory cytokines and triggers uncontrolled inflammatory response,and induces hepatic injury.Blocking IKK-NF-κB pathway may be an effective approach to checking the generation and development of ALI,PDTC plays important prophylaxis and treatment roles in hepatic injury after HIR.