Purpose:To compare old and new clinical staging of primary liver cancre. Methods:317 cases of primary liver cancer(PLC) patients,hospita lized and dead,were investigated retrospectively for overall median survival and survival after various therapies,according to various stages,and therapies and comparison among groups and test of median survival were carried out. Results:Survival in patients with new stage Ⅱa+Ⅱb or old Ⅱw ere significantly longer than newⅢa+Ⅲb or oldⅢ, but no significant differenc es were observed between new stageⅡa+Ⅱb and oldⅡ , or new stage Ⅲa+Ⅲb and oldⅢ. Median survival by new staging , decreased in peoper order from stageⅡ a ,Ⅱb , Ⅲa to Ⅲb respectively, significant different was found only between s tage Ⅲa and Ⅲb but not betweenⅡa andⅡb . Survival decreased respectively fr om interventional treatment ,systemic chemotherapy and palliative therapy;the in terventional treatment group did much better than the palliative group but no si milar differences were observed in the other groups. Conclusions:New clinical staging of PLC did not show significan t superiorly over the old one as judged by median survival.It can be questioned whether basing on largest diameter is less than 5/10 cm or more than 10 cm to di stinguish Ⅱa and Ⅱb is valid.Interventional treatment should be applied as soo n as possible to prolong survival whether it be the new or old clinical staging.

Pachychoroid disease is a relatively novel concept proposed in ophthalmology in recent years, which describes a series of pathological conditions including chronic persistent choroidal thickening and choroidal vasodilatation, with choroid blood capillary layer capacity attenuation, choroidal vasodilation, focal or disseminated choroidal thickening, progressive retinal pigment epithelial dysfunction and choroid retinal neovascularization as characteristic symptoms.Nowadays, the definition of pachychoroid disease has gradually changed from the previous emphasis on the simple thickening of choroid to the morphological description of complex pathological conditions.The clinical manifestations of certain pachychoroid diseases have been clearly described including central serous chorioretinopathy (CSC), pachychoroid neovasculcularization (PNV), polypoid choroidal vasculopathy (PCV), focal choroidal excavation (FCE), peripapillary pachychoroid syndrome (PPS). These entities have certain characteristic choroidal vasculopathy, which may represent different clinical manifestations of the same type of pachychoroid diseaseor indicate that they have similarpathogenesis .In this article, the existing literature and recent findings about pachychoroid disease, as well as the classification and treatment of pachychoroid diseases spectrum were summarized and discussed.

Objective To explore the effect of dietary knowledge of diabetes on the readmission rate on patients with type 2 diabetes mellitus. Methods Totally 334 patients of type 2 diabetes from Suzhou finished the general information and the questionnaires of knowledge of diabetes diet. The impacts of knowledge of diabetes dietary on their readmission rates were also analyzed. Results Both whether having hypoglycemia or not and the score of diabetes dietary knowledge were associated with readmission rate within half a year. Those having low blood sugar (B=1.276, P<0.01) and higher score of diabetes dietary knowledge (B = 0.049, P = 0.006) had higher readmission rate. Further analysis showed that patients with low blood sugar getting higher score of diabetes dietary knowledge had higher hospital admission rate (P = 0.01). Conclusions The readmission rate of type 2 diabetes mellitus patients was impacted by hypoglycemia occurrence and the familiarity degree of diabetes diet knowledge. So it′s important to further explore the causes and make the reasonable intervention to reduce the readmission rate.

Objective To investigate the feasibility and effect of intentional occlusion of the left subclavian artery (LSA) in endovascular aortic repair EVAR of thoracic aortic disease.Methods The cases,who needed occlusion of the LSA in EVAR of thoracic aortic disease,were examined cerebral circulation,carotid artery,vertebral basilar artery and circle of Willis.If the vertebral artery had a good blood pathway,and carotid artery and circle of Willis had no stenotic,we occluded the LSA directly in EVAR,and observed the brain and upper limb ischemia complications postoperation.Results Among 40 cases who were occluded the LSA directly in EVAR,28 cases were successful with no neurological complications and left upper limb ischemia symptoms postoperation,12 patients with mild symptoms of subclavian steal syndrome and neurdogical complications,but none required and secondary surgical intervention.Conclusions Prior to intentional LSA occlusion,attention must be paid to potential supraaortic variants and pathologies.Only in this way,it was safe and effective to occlude the LSA in EVAR of thoracic aortic disease.

Objective To evaluate the efficacy of immediate and delayed postoperative removal of urethral catheters Methods Randomized controlled trials and quasi-experiment trails of immediate and delayed postoperative removal of urethral catheters were collected in the databases such as CENTRAL, PubMed, OVID, China National Knowledge Infrastructure (CNKI), China Biology Medicine disc (CBM), VIP, Wanfang Data, etc. Data were analyzed by RevMan 5.3 version.after heterogeneity analysis,pooled risk ratio (RR) with 95%confidence interval (95%CI) using both fixed and random effect models were estimated. Results Ten randomized controlled trials (RCTs) were included. The results of Meta-analysis indicated that immediate urinary catheter removal was associated with a lower incidence of urinary tract infections (RR=0.29, 95%CI 0.15 to 0.56, P=0.000 3), positive urinary culture (RR=0.31,95%CI 0.16 to 0.59, P=0.000 2) compared with the delayed removal group and seven studies recommended removal of the indwelling urinary catheter immediately after hysterectomy. While, there was a higher risk of re-catheterization (RR=4.56, 95%CI 2.93 to 7.08, P<0.01)in the immediate removal group. Seven studies recommended removal of the indwelling urinary catheter immediately after hysterectomy. Conclusions Removal of the indwelling urinary catheter immediately after hysterectomy was recommended.

Objective To discuss the experience of open heart operation on beating in complex and severe congenital heart diseases. Method This kind of operation was put to use in 48 cases of the heart diseases in order to observe the effect of myocardial protection, prevention from air embolism,exposure of the operative field, and cardiopulmonary bypass. Results Operation field exposure was clear enough to finish the manipulation. One cases was eventiful postoperatively and died(2.08%). Conclusion Open heart operation on beating with slight hypothermia might have much feasibility in the part of complicated and severe congenital heart diseases.

Objective To introduce the Filial Values Index (FVI) scale and form Chinese FVI scale and evaluate reliability and validity of the scale. Methods Formed the Chinese FVI to investigate 98 caregivers for chronic heart failure patients. SPSS18.0 software was adopted to analyze the reliability and validity of the scale. Results The content validity of Chinese FVI scale was 0.89,and two common factors were extracted by exploratory factor analysis which could explained 68.91% of the total variance (P <0.01). The Cronbach α coefficient of the overall scale and each dimension was between 0.89-0.94, and the retest reliability was 0.97. Conclusions Chinese FVI scale had good reliability and validity, which can be used for evaluation of domestic caregivers filial piety values for chronic heart failure patients.

Background: Dysimmunity plays a key role in diabetes, especially type 1 diabetes mellitus. Islet-specific autoantibodies (ISAs) have been used as diagnostic markers for different phenotypic classifications of diabetes. This study was aimed to explore the relationships between ISA titers and the clinical characteristics of diabetic patients. Methods: A total of 509 diabetic patients admitted to Department of Endocrinology and Metabolism at the Affiliated Hospital of Nantong University were recruited. Anthropometric parameters, serum biochemical index, glycosylated hemoglobin, urinary microalbumin/creatinine ratio, ISAs, fat mass, and islet β-cell function were measured. Multiple linear regression analysis was performed to identify relationships between ISA titers and clinical characteristics. Results: Compared with autoantibody negative group, blood pressure, weight, total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), visceral fat mass, fasting C-peptide (FCP), 120 minutes C-peptide (120minCP) and area under C-peptide curve (AUCCP) of patients in either autoantibody positive or glutamate decarboxylase antibody (GADA) positive group were lower.Body mass index (BMI), waist circumference, triglycerides (TGs), body fat mass of patients in either autoantibody positive group were lower than autoantibody negative group. GADA titer negatively correlated with TC, LDL-C, FCP, 120minCP, and AUCCP.The islet cell antibody and insulin autoantibody titers both negatively correlated with body weight, BMI, TC, TG, and LDL-C. After adjusting confounders, multiple linear regression analysis showed that LDL-C and FCP negatively correlated with GADA titer. Conclusion Diabetic patients with a high ISA titer, especially GADA titer, have worse islet β-cell function, but less abdominal obesity and fewer features of the metabolic syndrome.

Dysimmunity plays a key role in diabetes, especially type 1 diabetes mellitus. Islet-specific autoantibodies (ISAs) have been used as diagnostic markers for different phenotypic classifications of diabetes. This study was aimed to explore the relationships between ISA titers and the clinical characteristics of diabetic patients.

Dysimmunity plays a key role in diabetes, especially type 1 diabetes mellitus. Islet-specific autoantibodies (ISAs) have been used as diagnostic markers for different phenotypic classifications of diabetes. This study was aimed to explore the relationships between ISA titers and the clinical characteristics of diabetic patients.