Objective To investigate the clinicopathologic features and prognostic analysis of intrahepatic mucinous cholangiocarcinoma (IMCC) and intrahepatic cholangiocarcinoma (ICC).Methods The retrospective cohort study was adopted.The clinicopathological data of 20 patients with IMCC and 51 patients with ICC who were admitted to the Fujian Provincial Hospital from March 2003 to March 2014 were collected.The observation indicators included (1) clinicopathologic features:gender,age,clinical symptoms (fever,jaundice,abdominal pain and peritoneal effusion),preoperative laboratory examination [alanine transaminase (ALT),aspartate transaminase (AST),direct bilirubin (DBil),carcinoembryonic antigen (CEA),CA19-9 and alphafetoprotein (AFP)],operation methods (radical resection,palliative resection) and pathological features (tumor location,lymph node metastasis,vascular invasion and pathological stage).(2) The follow-up of outpatient examination and telephone interview was performed to detect the survival of patients up to March 2015.Measurement data with normal distribution were represented as x-± s and comparison between groups was analyzed using t test.Count data were analyzed using the chi-square test.The survival curve was drawn by Kaplan-Meier method,and the survival rate was analyzed using the Log-rank test.Result The numbers of patients with fever,jaundice,elevated level of AST and DBil,lymph node metastasis,vascular invasion and numbers of patients with stage 0,Ⅰ,Ⅱ,Ⅲ,Ⅳ were 13,11,10,11,3,1 and4,6,2,6,2 with IMCC,12,10,9,2,22,36 and 0,14,5,3,29 with ICC,respectively,showing statistically significant differences in the above indicators (x2=10.830,8.639,7.672,25.059,8.036,24.765,26.601,P ＜ 0.05).All the patients were followed up for a median time of 14 months (range,1-118 months).The survival time and 1-,3-,5-year survival rates were (55 ± 8)months,94.4％,44.0％,16.7％ in 20 patients with IMCC and (30 ±6) months,36.5％,12.5％,4.0％ in 51 patients with ICC,respectively,showing a statistically significant difference (x2 =8.126,P ＜ 0.05).Conclusion The patients with MICC are more easily complicated with fever,jaundice and liver dysfunction,while they have less lymph node metastasis and vascular invasion,earlier pathological stage and better prognosis compared with patients with ICC.

OBJECTIVETo investigate the accurate and individual treatment of temporomandibular joint(TMJ) injury based on 3D digital technology.

METHODSMaxillo-mandibular model was made using rapid prototyping technology based on the pre-operation 3D CT results. According to the 3D digital measurement results, TMJ concepts were ordered and the prosthesis was used to simulate the replacement surgery on the model. Then the joint replacement surgery was performed afterward.

RESULTS(1)After total replacement of TMJ, no pain happened and mouth open was not limited. Three months later, the joint position was normal and stable. The month open width was 4 cm. (2)After condyle replacement, primary healing was achieved with complete survival of bone graft. No edema was seen. Symmetric facial appearance was satisfactory.

CONCLUSIONSBilateral individual prosthesis for total TMJ or condyle replacement is an ideal method for TMJ injury.

Arthroplasty, Replacement ; methods ; Bone Transplantation ; Computer-Aided Design ; Humans ; Imaging, Three-Dimensional ; methods ; Joint Prosthesis ; Mandible ; Prosthesis Design ; methods ; Range of Motion, Articular ; Temporomandibular Joint ; anatomy & histology ; injuries

Objective To investigate the diagnosis and treatment of mucin-producing intrahepatic biliary tumor (MPIBT).Methods We retrospectively analyzed the clinical,radiologic,surgical and pathologic findings of 16 MPIBT cases from January 2004 to December 2011.Results There were six men and ten women,age ranged from 44 to 69 years (mean 60 years).Clinical presentation included jaundice with abdominal dull pain in 5 patients,acute cholangitis in 4 patients,painless jaundice in 2 patients,upper abdominal dull pain in 3 patients,no obvious symptoms in 1 patient,body weight loss more than 5 kg within 3 months in 5 patients.The most characteristic appearance of MPIBT on magnetic resonance cholangiopancreatography were asymmetry of intrahepatic bile duct dilatation and the dilatation in both extraand intrahepatic bile duct distal to the hepatic mass and not sudden interruption in extrahepatic bile duct.The primary tumor located in the left hepatic bile duct in 15 cases,in the right hepatic bile duct in one.13 MPIBT cases received hemihepatectomy and extrahepatic bile duct resection and Roux-en-Y anastomosis was done in 8 cases,3 received palliative biliary drainage.Pathologically 13 was papillary adenocarcinoma and 3 was papillary adenoma.The 1-,2-,3-year survival rates for the 16 MPIBT patients were 81％,66％,56％,respectively.Conclusions MPIBT had no specific clinical manifestations,MRCP might be an effective means for the diagnositic strategy and assessment of tumor extension before surgery,radical resection was the first choice of treatment,palliative biliary drainage could prolong the survival time.

Objective To study the influence of hemodialysis on inflammatory state and immune function by analyzing the change of serum protein components in uremic patients before and after hemodialysis.Methods 75 cases of uremic patients confirmed by the Nephrology from October 2013 to May 2014 were selected as the observation group,and 15 healthy volun-teers at the same time as the control group.Then the serum protein electrophoresis pattern of observation group beford the first hemodialysis,after the first hemodialysis,after one month’s treatment and control group were compared with each oth-er.Results In the observation group before and after the first hemodialysis,the ALB levels were lower,α1 and α2 globulin levels were higher than those in control group.There was a statistically significant between the observation group before and after the first hemodialysis and control group (P <0.001).After the first hemodialysis,there were differences inα1 globulin levels compared with before the first hemodialysis (P <0.01).ALB was no significant difference after one month’s hemodi-alysis compared with before the first hemodialysis,andα1,α2 globulin were significantly reduced and the difference was sta-tistically significant (P <0.001),ALB was lower than the control group and was statistically significant (P <0.001).After one month’s hemodialysis,the levels ofγglobulin were higher than those in control group,before the first hemodialysis and after the first hemodialysis.There were significant differences (P <0.001 or P <0.01).Conclusion Regular and effective hemodialysis can improve inflammatory state and immune function of uremic patients.

Objjetive To study the application effect of self-made double lumen catheter in intestinal fistula after abdominal surgery.Methods This study included 28 patients of abdominal surgery with intestinal fistula,all the patients used self-made double cavity drainage tube drainage.The postoperative treatment of patients with intestinal fistula and complications,and effect of self-made double lumen catheter application in abdominal fistula after the operation were evaluated.Results 15 cases of intestinal fistula after abdominal operation received self-made double lumen catheter,the average hospitalization time,average time of extubation were (14.59 ± 3.78)d,(8.08 ± 2.03)d,respectively,which were significantly shorter than those of the control group (t =2.555,3.444,all P ＜ 0.05).After treatment,the total satisfaction rate of the observation group was 100.00％,which was significantly higher than 61.54％ of the control group,and the difference was statistically significant (x2 =7.023,P ＜ 0.05).Conclusion The patients with intestinal fistula after abdominal surgery used self-made double cavity drainage tube,the drainage effect is significant,it can shorten the hospitalization time and extubation time,significantly improve the quality of life of patients,with high patients ' satisfaction,it is worthy of popularization and apilication.

Objective:To compare acquired immune deficiency syndrome (AIDS) related knowledge, attitudes, behaviors and their influencing factors among college students in different years in Beijing, and to provide evidence for targeted health education among college students in future.Methods: College students were selected by the stratified cluster sampling method, and a questionnaire survey was conducted among college students in year 2006 and 2016 in Beijing.The sample sizes were 1 800 and 3 001 college students, respectively.The contents of the questionnaire included: socio-demographic characteristics, AIDS related knowledge, AIDS related attitude, sex intercourse and its related risk behaviors, condom use intension, and AIDS related health education.Results: Compared with the year 2006, the average AIDS knowledge scores of college students in year 2016 dropped from 12.78±1.95 to 11.90±2.56 (t=12.91, P<0.05), and the correct answer rates of questions in the knowledge part were decreased, too.Except for belief on condom use, the college students were more negative on AIDS related attitude and self-efficacy in year 2016 than in year 2006.Among the students who had sex experience, the rates of commercial sex [17.65% (33/187) vs.6.53% (16/245), χ2=13.003, P<0.001] and the rates of homo-sexual intercourse [15.43% (29/188) vs.4.13% (10/242), χ2=16.356, P<0.001] were higher in year 2016 than in year 2006.The main way for the students seeking pornographic information was changed from books to internet (41.15%) in 2016 compared with the year 2016.In 2016, the influencing factors of intention on condom use were male (OR=0.713), self-efficacy of condom purchase (OR=0.876), never received sex education before college (OR=0.752), self-efficacy of condom use (OR=1.135), belief of condom use (OR=1.775), and attitude towards AIDS patients (OR=1.136).Conclusion: AIDS related knowledge, attitudes and behaviors among college students have been changed, AIDS related health education should be designed and improved based on new characteristics of college students.AIDS health education in colleges should pay more attention to sex attitude and sex responsibility and self-protection awareness among college students as well.

This article reviews the current status, assessment tools, influencing factors, and intervention measures of self-management behavior of intestinal symptoms in patients with rectal cancer undergoing anal preservation surgery, in order to provide reference for further research and nursing practice on self-management of intestinal symptoms after rectal cancer anal preservation.

Objective To investigate the clinical efficacy of pericardial devascularization (PCDV) combined with splenectomy and partial gsstric fundus resection (PGFR) in the treatment of portal hypertension-induced severe gastric varices complicated with gastrorenal shunt (GRS).Methods The retrospective cross-sectional study was conducted.The clinicopathological data of 18 patients with portal hypertension-induced severe gastric varices complicated with GRS who were admitted to the Fujian Provincial Hospital from January 2010 to December 2015 were collected.According to the stage of technical development,open surgery or laparoscopic surgery was selected based on patients' and their family's wishes.Observation indicators:(1) surgical and postoperative recovery situations;(2) postoperative pathological examination;(3) follow-up and survival.The follow-up using outpatient examination and telephone interview was performed once every 3 months within 1 year postoperatively and once every 6 months after 1 year to detect long-term complications and survival up to June 2017.The reexaminations of gastroscopy,enhanced scan of X-ray computed tomography (CT) on the epigastric region or magnetic resonance imaging (MRI) were done at 1 month postoperatively for detecting resection of fundus ventriculi varicosity.Measurement data with normal distribution were represented as (x)±s.Measurement data with skewed distribution were described as M (range).The survival rate was calculated by the Kaplan-Meier method.Results (1) Surgical and postoperative recovery situations:18 patients underwent successful PCDV combined with splenectomy and PGFR,including 12 with open surgery and 6 with laparoscopic surgery (1 with conversion to open surgery due to intraoperatively uncontrollable bleeding).There was no perioperative death.The operation time,volume of intraoperative blood loss,recovery time of gastrointestinal function,time of postoperative drainagetube removal and duration of hospital stay were (192± 20) minutes,(280± 30) mL,(33 ±6) hours,8 days (range,5-9 days),8 days (range,5-12 days) in 12 patients with open surgery and (208±40)minutes,(210±10)mL,(28±5)hours,7 days (range,5-26 days),7 days (range,5-10 days) in 6 patients with laparoscopic surgery,respectively.One patient with laparoscopic surgery had intraoperative condensed erythrocyte infusion with 2 U.Seven,1,0 patients with open surgery and 4,1,1 patients with laparoscopic surgery were respectively complicated with pleural effusion,delayed gastric emptying and pancreatic leakage in level A,and they were cured by conservative treatment.(2) Postoperative pathological examination:results of postoperative pathological examination in 18 patients showed that a large number of varicose veins in the mucous and seresal layers of gastric fundus and moderate or severe hepatic cinr hosis.(3) Follow-up and survival:18 patients were followed up for 8-78 months with a median time of 39 months.The gastroscopy and enhanced scan of X-ray CT at 1 month postoperatively showed that no varicose veins in the gastric fundus.During the follow-up,there was no recurrence of gastric varices with GRS and esophageal stenosis.Of 4 patients with portal vein thrombosis,1 died of portal hypertensive gastropathy-induced upper gastrointestinal bleeding due to stop taking warfarin,and other 3 patients had portal vein patency by warfarin therapy.One patient was complicated with liver cancer at 32 months postoperatively and received radiofrequency ablation therapy.Two patients died,including 1 dying of hepatic failure at 35 months postoperatively and 1 dying of advanced liver cancer at 54 months postoperatively.The 1-,3-and 5-year overall survival rates of 18 patients were respectively 93.8％,84.4％ and 70.3％.Conclusion The PCDV combined with splenectomy and PGFR is safe and effective in the treatment of portal hypertension-induced severe gastric varices with GRS,with a dissemination value for appropriate patients.

Objective:To estimate the incidence and mortality rates of prostate cancer in China in 2015.Methods:The data from 501 cancer registries in China collected by the National Cancer Center were reviewed and evaluated, and the qualified data were included in the final analysis. According to the national population data in 2015, the nationwide incidence and mortality of the prostate cancer were estimated. Chinese standard population in 2000 and world Segi′s population were used to calculate the age-standardized (ASR) incidence and mortality rates (ASR China and world, respectively).Results:After data review, the data reported by 368 registries were included in the final analysis, covering a total population of 309 553 499, accounting for 22.52% of the national population at the end of 2015. There were 72 thousand new prostate cancer cases estimated in China in 2015, with a crude incidence rate of 10.23/100 000. The ASR China and ASR world are 6.59/100 000 and 6.47/100 000, respectively, which is the sixth incidence of male malignant tumor.The estimated number of prostate cancer death was 3.07 thousand in China in 2015, with a crude mortality rate of 4.36/100 000; The ASR China and ASR world mortality rates were 2.61/100 000 and 2.65/100 000, respectively, which is the tenth leading cause of death in male malignant tumor.The ASR China incidence and mortality of prostate cancer in males were higher in urban areas (8.40/100 000 and 3.11/100 000) than those in rural areas (4.16/100 000 and 1.90/100 000). The incidence and mortality rates in the eastern areas (8.54/100 000 and 2.99/100 000) were higher than those in the central (5.28/100 000 and 2.34/100 000) and western areas (5.32/100 000 and 2.37/100 000) of China.Conclusions:The incidence and mortality rates of prostate cancer in China are lower than the global average, but there is an increasing trend. The incidence and mortality of prostate cancer in China have obvious regional differences.

In order to help improving mental attention and sensory integration ability of mental retarded children, this paper proposes an interactive eyes-brain-hands coordination training system. This system realizes the principle of seeing, thinking and moving of hands by an interactive operation between the computer software custom icons and a touch control panel, so it can improve cognitive function and activity of daily living. The results show this training platform has a high degree of application and acceptance, and provides a portable training method for mental retarded children.