A liver transplant invol ves more medical aspects than complex surgery,with different characteristics than general surgery.The medical risks the patient disputes focus on the informed consent rights.Analysis of dispute causes,especially through the relevant study of jurisprudence,suggests that we should be highly sophisticated with informed consent rights.to prevent disputes and improve the quality of clinical diagnosis and treatment.

BACKGROUND:Currently the ultrasound-guided continuous femoral nerve block has been widely used as a postoperative analgesia method after knee replacement surgery, but there are stil some technical and practical details issues to be studied. OBJECTIVE:To evaluate the effect of ultrasound-guided imaging and safety evaluation of different puncture techniques and needle choice in the ultrasound-guided continuous femoral nerve block after total knee arthroplasty.METHODS:One hundred and sixty patients undergoing total knee arthroplasty were randomly divided into four groups, with 40 cases in each group. Continuous femoral nerve block was done after general anesthesia induction. Patients in each group were respectively punctured using 20 G needle (diameter 1.1 mm) out-of-plane approach, 20 G needle (diameter 1.1 mm) in-plane approach, 18 G needle (diameter 1.3 mm) out-of-plane approach, and 18 G needle (diameter 1.3 mm) in-plane approach. Patient-control ed analgesia pump was used 30 minutes before the end of surgery. The operating time of continuous femoral nerve block was recorded. The visual analogue scale scores at rest, active functional exercise and continuous passive movement state on 6, 24, 48, 72 hours after total knee arthroplasty were estimated. The presses of the pump, time of first walk, daily walk times and complication of continuous femoral nerve block were observed. RESULTS AND CONCLUSION:The operating time of continuous femoral nerve block in group D was shorter than that in other groups (P<0.05). There was no difference of visual analogue scale scores, the presses of the pump, time of first walk, and daily walk times among each group. The incidence of puncture site pain in group C was higher than that in other groups (P<0.05). The best ultrasound imaging was obtained by using 18 G needle in-plane approach for ultrasound-guided continuous femoral nerve block after total knee arthroplasty, and the complication incidence was not increased.

Objective] To introduce Professor He Jialin's experence in treating abdominal mass with infertility. [Method] Through years of clinical learning from teacher, summarized the teacher's academic thoughts and the experiences of diagnosis and treatment. It expounds her special clinical experience from etiology and pathogenesis, fundamental law of treatment, medication characteristic, and classical proven cases. [Result] The disease covers a broad range. The typical syndromes are damp heat, phlegm, blood stasis. And blood stasis is most important. The fundamental law of treatment includes strengthening the body resistance, removing blood stasis, reducing phlegm and resolving masses, regulating menstruation. Doctor He combined traditional Chinese and western medicine, considering the comprehensive, combined with the individual constitution, emphasized the selection of herbal medicine with multiple functions. The clinical effect in the proven cases was amazing. [Conclusion] Professor He had rich experience treating abdominal mass with infertility, which might be used as reference data in clinical medicine.

The concentration of cytosol receptors for estrogen(ERc).progestin(PRc).and androgen(ARc)were deterimined in the tissue specimens of uterine myoma,uterine myoadenopa-thy,and postmenopausal uterus and of normal endometrium and myometrium as well.It was found that the concentration of ERc.PRc and ARc was significantly higher in myomatous tissue than in normal myometrium.Remarkable difference existed of the concentration of sex steroid receptors between normal endometrium and adenomyosis tissue.Postmenopausal uterine tissue still retained high concentration of ERc.PRc and ARc.In addition,the regulation of sex steroids in these pathological conditions was discussed.

Objective To study effects of the intrathymic injection of allohepatic cells on intestinal allograft.Methods Adult male DA and PVG rats,7-9 week old,were used as donors and recipients,respectively.The ectopic small howel transplantations were performed one week after intrathymic injection of hepatic cells without use of any immunosuppressants.The surgical procedures were carried out in a such manner that portal vein was anastomosed with 1eft renal vein by the cuff,aorta was anastomosed with superior mesenteric artery with its aortic patch.Results The donor liver ceils could survive in the recipient thymus for 3 weeks.The small intestinal allograft showed severe rejection and donor died one week after intrathymic injection of hepatic cells,but the hepatic cells could survive within the thymus at this time.Conclusion The intrathymic injection of allohepatic cells could not induce immune tolerance of the recipient to the same donor small intestinal graft.

[Objective] To clear up Ms. He Jialin's recipe cases in treating gestation diseases, sum up her diagnosis and treatment thought and medication principle. [Method] Make mutual corroboration of doctor He's medical prescriptions and TCM classical theories and formulae, to explore He's experience of diagnosis and theoretic origin. [Result] Doctor He has rich experience in diagnosing and treating gestation diseases, with clear thought, and principle-method-recipe-medicines, wel-founded, closely observing disease development, considering the situation, using drugs as military forces, with consolidate steps. [Conclusion] Doctor He diagnosing refractory diseases, learning from ancient but not rigidly adhering to ancient, ful y embodies the treating principletoxic drugs'good effect on diseased body.

AIM: To observe the clinical effect of amniotic membrane transplantation and penetrating keratoplasty in the treatment of atheromatous corneal ulcer.
METHODS: Thirteen patients ( 13 eyes ) diagnosed atheromatous corneal ulcer from February 2009 to May 2014 in our hospital were retrospectively analyzed. Surgical treatment including amniotic membrane transplantation and penetrating keratoplasty were used to deal the patients with no effects of drugs. All patients were followed up for 4mo to 2a ( mean 8mo ) after surgery. Visual acuity, healing and recipient of ulcer were examined.
RESULTS:There patients were treated conservatively with corneal ulcer slowly healing, healing time was 14~35 ( 21±12. 1 ) d. Seven cases were treated with amniotic membrane transplantation, 2 cases were treated with penetrating keratoplasty, 1 case of corneal ulcer perforation and lost light perception received enucleation of eyeball. Corneal ulcer were cured in patients performed amniotic membrane transplantation and penetrating keratoplasty. All patients had no recurrence during the follow-up period.
CONCLUSION:Atheromatous corneal ulcer is difficult to be cured by conservative treatment. Most patients need operation treatment. Amniotic membrane transplantation and penetrating keratoplasty can be performed to deal with atheromatous corneal ulcer and abtain satisfactory effect. But amniotic membrane transplantation is relatively simple and easy, and it is suitable for promotion in primary hospitals.

AIM: To investigate the preliminary clinical observation of excimer laser phototherapeutic keratectomy ( PTK ) assisted by anterior segment optical coherence tomography ( OCT ) in the treatment of non II type granular corneal dystrophy.
METHODS: A retrospective case series were studied. Totally 8 patients ( 12 eyes ) who were diagnosed as granular corneal dystrophy underwent PTK from April 2011 to January 2013 in our hospital. All patients were excluded from the II type granular corneal dystrophy ( Avellino corneal dystrophy ) by the Avellino corneal dystrophy rapid diagnostic kit and underwent preoperative anterior segment OCT examination, so as to determine the lesion morphology and depth, and used to guide the setting of PTK parameters. They were followed up for the complications after operation, postoperative recurrence, the recovery of visual acuity.
RESULTS: All patients were followed up for 6-12mo, average 9mo after operation. All patients' best corrected visual acuity were significantly improved, superficial corneal opacity lesions were effectively removed, and the corneal opacity recurrence or serious Haze were not found during the follow-up period after operation.
CONCLUSION: In patients with non type II granular corneal dystrophy, PTK assisted by anterior segment OCT can be accurate, effective removal of corneal lesions, obtain good effect after operation.

Objective To study the relationship between gastrin and c-myc, c-fos expression in colorectal cancerous tissue and the mechanism of gastrin effect on colorectal cancer.Methods The gastrin and c-myc, c-fos expression in 48 cases of colorectal cancerous tissue and cancer-adjacent mucosa were detected with immunohistochemistry techniques. Results　The positive rate of gastrin in colorectal cancerous tissue was 39.58%. The rate of the well differentiated adenocarcinoma was higher than that of the poorly differentiated and mucinous adenocarcinoma(P＜0.05). The positive rates of c-myc and c-fos in colorectal cancerous tissue were higher than those in cancer-adjacent and normal mucosa. The positive rate of c-myc and c-fos in the group with gastrin positive expression were 78.94% and 73.68%, higher than those in the group with negative gastrin expression(37.93% and 31.04%). Conclusion Some of colorectal cancer cells formed and secreted gastrin through autocrine. The increase of c-myc, c-fos etc oncogene expression probably stimulate the cancer cells proliferation.

Glaucoma is a group of irreversible blind eye diseases with specific optic nerve damage and visual field defect. Early diagnosis and treatment of glaucoma is vital for prognosis, but difficult in clinical practice. Macular ganglion cell complex thickness(mGCC) consists of the inner three layers of retina:retinal nerve fiber, ganglion cell and inner plexiform layers, which is glaucoma target tissue so to be measured the thickness of the mGCC as better indicator for early diagnosis in glaucoma. Optical coherence tomography ( OCT ) is a non-contact, good repeatability technique to obtain fast high- resolution images from the anterior and posterior segments of the eye, and it has been widely used in ophthalmology. Spectral- domain ( SD ) OCT allows a higher image resolution and can measure the thickness of mGCC thickness, providing new parameters for the early diagnosis of glaucoma.