Objective　To investigate the diagnosis and treatment of acute rejection of orthotopic liver transplantation (OLT). Methods　From July 1999 to April 2000, two piggyback liver transplantations were performed on two patients with Wilson's disease. Results　Cyclosporine A, azathioprine and methylprednisolone were the baseline immunosuppression management. Acute rejection occured 5 times in the 2 patients. The correct diagnosis was obtained through clinical inspection, liver function test and biopsy. The rejections were controlled by intensive steriod therapy plus OKT3 or FK506. Conclusions　Clinical inspection and liver function test can suggest the episode of acute rejection in time. Hepatic biopsy is the key point for diagnosis of acute rejecton, Reasonable use of immunosppression is critical for the treatment.

Objective To evaluate the clinical results of proximal humeral internal locking sys-tem(PHILOS)self-locking plates in treatment of proximal humeral fractures. Methods There were 35 patients including 19 males and 16 females(at mean age of 53.5 years,ranging from 29 to 92 years)with proximal humeral fractures treated with PHILOS plate.According to the Neer's classification sys-tem,there were two-part fractures in 19 patients,three-part fractures in 15 and four-part fractures in 1.Surgery was performed with PHILOS serf-locking plate via dehopectoral approach.All patients were fol-lowed up for mean 18.9 months(6-46 months)and evaluated by using Constant score and X-rays. Re-suits X-rays proved that all fractures got good reduction and complete healing during 8-12 weeks.The latest Constant scores was mean 89.5 points(82-94 points).There were no complications including plate loosing.humenral head necrosis or gleno-humeral ioint osteoarthritis. Conclusion PHILOS plate is a good choice for treatment of proximal humeral fractures because of its advantages including easy operation,stable fixation,good clinical results and few complications.

Objective To explore the effects of comprehensive nursing on the psychological stress state and quality of life in patients with severe acute pancreatitis. Methods A total of 90 severe acute pancreatitis patients in the First Affiliated Hospital of Harbin Medical University from January 2011 to January 2013 were randomly admitted to either observation group or control group. The patients of control group adopted routine care model and the patients of observation group received integrated care. The mental state and quality of life of the two groups were evaluated by the Hamilton Anxiety Scale ( HAMA ) and the concise Health Questionnaire (SF-36). Results After the intervention, two groups of HAMA scale score was significantly improved compared with before treatment, but the degree of the observation group′s improvement was more obvious(P <0. 05). Before and after the intervention, there was no significant difference in the quality of life of the control group (P>0. 05). The patients of observation group was significantly improved than before treatment,the difference between the two groups was statistically significant ( P < 0. 05 ). Conclusions The implementation of comprehensive nursing can improve in the mental state and quality of life of patients with severe acute pancreatitis treated by comprehensive nursing mode, and promote the recovery of physical function and improve the curative effect.

Objective To explore the Effects of nursing model on anxiety and sleep of laparoscope cholecystectomy ( LC) patients based on story theory. Methods Totally 50 cases of LC patients were divided into the observation group and the control group according to convenience sampling method, with 25 cases in each group. Patients in the control group received routine nursing care, while patients in the observation group received nursing intervention based on the the story theory. Self-rating Anxiety Scale ( SAS) and Pittsburgh Sleep Quality Index ( PSQI ) were used to evaluate patients′ anxiety and sleep status before and after the intervention. The plasma cortisol concentration of patients in two groups were compared before and after the intervention.Results The SAS score in the observation group after surgery was (33.76±4.62);the PSQI score was (8.28±1.54);the plasma cortisol concentration was (17.35±6.32) ng/mL, and they were all lower than the data in the control group. Repeated measurement anova showed that the differences of SAS score, PSQI score and plasma cortisol concentration in two groups at different time were significant ( Ftime=12.230,16.512,18.041;P<0.05) , and in a downward trend. The nursing effect in the observation group was superior than that in the control group.Conclusions The nursing model based on story theory could significantly improve the anxiety and sleep of LC patients, which was conducive to the rehabilitation of patients after surgery.