With the constant development of imaging-guided percutaneous tumor ablation technology, its safety and efficacy have been recognized by clinical physicians as well as by patients. It has played a more and more important role in the modern minimally- invasive treatment for liver tumors. However, great differences in technique level of operation, the experience of physician, the function of the equipment, and patient’s condition exist between different medical units. The therapeutic efficacy, recurrence rate and complication rate are also quite different from one hospital to another. In order to resolve the problems mentioned above and to further improve the clinical efficacy and safety of ablation therapy , the establishment of an agreement on ablation indication, treatment strategy of standardization and individualization, and standardized operation procedure and technique in China is mandatory at present. Besides, to formulate the license policy, to improve knowledge compensation from multiple clinical disciplines and to pay great attention to treatment standardization, etc. all are important means in order to improve the overall efficacy of liver tumor ablation in our country.

Recently radiofrequency ablaion(RFA)has been widely used for treating liver cancer,as it has the advantages of easy manipulation,safe,effective and causes only minor injury to the liver.RFA is suitable for patients with single and small hepatocellular carcinoma,in Child A or Child B classification,and without extrahepatie metastasis.Severe extrahepatic metastasis,such as tumor thrombus in the main portal vein,the main branch of portal vein and the hepatic vein are the contraindications of RFA.RFA is approached either via laparoscopy,celiotomy,or by ultrasound.The choice of procedure should be based on the tumor size and location,as well as the condition of blood supply.For tumor with the diameter≤3.0 cm,the efficacy of RFA is similar to that of hepatectomy.The common postoperative complications include intestinal perforation,abdominal hemorrhage,infection and needle tract seeding.Selecting the correct procedure according to the condition of the patient.correct manipulation,formalized therapeutic strategies and prepost training of surgeons are aspects that should not be overseen in the application of RFA.

Objective To study the correlation of social support and quality of life of psychiatric patients during rehabilitation period in order to improve the social support and the quality of life of psychiatric patients.Methods 126 cases of schizophrenia patients during rehabilitation period in our department from June 2010 to June 2011 were set as the rehabilitation group.The social support scale (SSRS) and the World Health Organization Quality of Life Rating Scale (World Health Organization Quality of Life with 100 questions,WHOQOL-100) were taken for the investigation and assessment.120 health cases in the same period were set as the control group.The indicators were compared between two groups.Results In the rehabilitation group,the ratings of the six areas were as followed:psychological domain was (11.27 ±3.20),the physical domain was (11.93 ± 2.80),the field of the independence was (12.14 ± 3.30),the field of social relations was(11.13 ± 2.30),the field of the environment was(12.48 ± 2.70),and the spiritual pillar was (10.35 ± 2.70),each field score was significantly lower than the control group,the difference was significant,with statistically significant.The subjective score in physiological field,social relations field and the environmental field were representative.The objective score in the field of social relations,the field of environment were representative.The score of support utilization in six areas was representative.The total support score in the psychological field,the independence field,the field of social relations and the environmental field were representative,the difference was statistically significant.Conclusions Social support is one kind of psychological intervention methods,it can improve and help patients to establish the confidence to overcome the disease,and it is of great significance in improving the quality of life of patients.

Objective To investigate the ultrasonographic features corresponding to classification of peripheral neuropathies in neurofibromatosis type Ⅰ.Methods Thirty-six patients with peripheral neuropathies and diagnosis of neurofibromatosis type I were enrolled in this study.Ultrasound appearance of peripheral neuropathies was analyzed and divided into four groups according to their pathological classifications.There were 19 males and 17 females with age between 7-47 years.High frequency or board frequency ultrasound probes were used for scanning.Results The ultrasound findings were varied based on different pathological classifications.Multiple nodular class(n=5) was presented as multiple nodes.Ultrasound demonstrated that tumors were multiple,oval or lobulated,and had well defined margin,and the echogenic of lesions was mainly hypoechoic.Plexiform class (n=12) was presented as cluster nodes along the peripheral nerve trunk.Ultrasound showed trunk nerves in extremities became thicker in a long range and lost the normal structure,and catenular or racemosum in shape.The echogenicity was hypoechoic.Diffuse class (n=14) was diffuse subcutaneous disease.Tumors range was infiltrative.The subcutaneous soft tissue was thicken and echogenicity was increased.The structure of nerve bundle was disturbed and associated with multiple hypoechoic nodes.Mixture class (n=5) was defined as mixture of multiple nodular class and plexiform class.In this group,diffuse disorders were co-existed with multiple nodes disorder.Conclusions The ultrasonographic appearances of peripheral nerve disorders in neurofibromatosis type I was closely corresponded to their pathological characters.And the ultrasonic examination would be helpful to diagnosis and provide important information for therapy.

Objective To investigate the role of new contrast agent and real time gray scale contrast tuned imaging in the evaluation of the perfusion and echogenicity of liver neoplasms and to discuss the diagnostic value.Methods Thirty five patients with unconfirmed liver neoplasms were enrolled in the study.Nine of them were diagnosed clinically,while the other 26 cases with pathological evidence through surgery or needle biopsy.Contrast agent SonoVue,Technos DU6 and CnTI technology were used.The contrast agents were delivered intravenously or through bolus injection.Results Timing of all phases following contrast injection in normal and cirrhotic liver was observed.And then the perfusion processs of liver neoplasms was recorded.Among the 23 cases of typical hepatocellular carcinoma(HCC),21 cases(91%) presented with early artery enhancement and immediate wash out,while the other 2 cases of small(

We reported 2 cases of descending neerotizing mediastinitis (DNM) and reviewed the related literatures. The etiology, clinical manifestations, imaging manifestations, diagnostic criteria and therapeutic strategies of DNM were discussed. It is concluded that descending necrotizing mediastinitis is a life-threatening disease with high mortality and is prone to be misdiagnosed. Early diagnosis, prompt application of sensitive broad-spectrum antibiotics and abscess drainage with proper surgical medality may improve the prognosis of DNM.

Early identification and effective treatment of hepatocellular carcinoma plays an important role in improving survival rate.The establishment of simple and effective procedures for early diagnosis, census methods, and effective minimally invasive treatment is an important project in China to improve the diagnosis and treatment level of liver cancer.Contrast-enhanced ultrasound plays an important role in the early diagnosis of liver cancer and radiofrequency ablation treatment.This article describes how contrast-enhanced ultrasound helps with the identification of small hepatocellular carcinoma and degree of tumor differentiation in patients with liver cirrhosis, as well as the differential diagnosis of hyperplasia/canceration and precancerous lesion.It also introduces the important role of contrast-enhanced ultrasound in standard radiofrequency ablation and development of therapeutic regimens and strategies and clarifies that it can be used before, during, and after radiofrequency ablation treatment.

Carcinoma, Hepatocellular ; surgery ; Catheter Ablation ; methods ; Humans ; Liver Neoplasms ; surgery ; Therapy, Computer-Assisted

Objective To study the expression and activation of signal transducer and activator of transcription 3(STAT3) in human nasopharyngeal carcinoma (NPC) tissues and its relation with the expression of latent membrane protein 1(LMP1) encoded by Epstein-Barr virus.Methods The expressions of LMP1,STAT3 and phosphated STAT3(p-STAT3) in 45 cases of NPC and 27 cases of chronic nasopharyngitis were studied by immunohistochemical method.Correlation between protein expressions was analyzed.Results The positive rates of LMP1,STAT3 and p-STAT3 in NPC were significantly higher than those in chronic nasopharyngitis(P0.05).Conclusion There are overexpression and abnormal activation of STAT3 protein in NPC tissues.LMP1 may play a role in the activation of STAT3.

Objective To investigate the value of clinical data used for conventional indications of initiating renal replacement therapy (RRT) such as serum creatinine (SCr),blood urea nitrogen (BUN) and acute renal injury (AKI) stage and in estimating the prognosis of critically ill patients with AKI.Methods A retrospective analysis of 258 AKI adult inpatients treated with continuous renal replacement therapy (CRRT) in ICU from Jan.2011 to Jan.2015.According to the outcomes,all subjects were divided into survival group (n =104)and death group (n =154).The general condition,AKI causes,results of renal function (urine output,SCr,BUN and AKI stage),homeostasis (acid-base balance and electrolyte level),severity of disease (APACHE Ⅱ score and SOFA score) and others were compared between two groups.Additionally,risk factors for the prognosis of critically ill patients with AKI were screened by the multivariate Cox's proportional hazard models and the receiver operating characteristic (ROC) curve.Results There were no significant differences in gender,age,primary disease,AKI causes,APACHE Ⅱ score,renal function (urine output,SCr,BUN and AKI stage),serum potassium level and phosphorus level between two groups before CRRT (P ＞ 0.05),but more patients in death group had severe sepsis (31.17％ vs.19.23％,P =0.033),lower pH value [(7.27 ±0.34)vs.(7.41 ±0.34),P =0.024] and higher level of lactate [(3.97 ±2.87) vs.s (2.64 ± 2.30),P =0.006].After the analysis with multivariate Coxg proportional hazard models,it was found that the levels of serum phosphorus (P =0.043) and lactate (P =0.009) were the independent risk factors for prognosis of critically ill patients with AKI,and other conventional indications for initiating RRT such as SCr,BUN,AKI stage,urine output,pH,bicarbonate level or potassium level were not closely associated with the prognosis of patients (P ＞ 0.05).Therefore,a composite of these six variables (pH,bicarbonate level,phosphorus level,potassium level,urine output and AKI stage) was analyzed.According to the analysis result of ROC curve,the diagnostic value of combined six different variables in predicting in-hospital mortality of AKI patients [area under the curve (AUC) 0.669,95％ CI:0.577-0.762] was almost as high as that of lactate (AUC:0.683,95％ CI:0.590-0.777),and significantly higher than SCr (AUC:0.460,95％ CI:0.358-0.562),BUN (AUC:0.469,95％ CI:0.366-0.571).Conclusions This composite of six different variables is more useful than any other conventional indications for initiating RRT in predicting post-AKI mortality.As a result,a composition of six different variables should be considered rather than any single variable alone for indication of initiating RRT in critically ill patients with AKI.