Objective To observe the clinical efficacy of three types of drainage in the treatment of malignant obstructive jaundice.Methods 84 patients with malignant obstructive jaundice were selected,40 cases were treated with bridge drainage,24 cases were undergone percutaneous transhepatic cholangial drainage(PTCD) and 20 cases were treated with Roux-En-Y anastomosis.The changes of total bilirubin and direct bilirubin were detected 1,3,7 and 14 days after operation.Results The total bilirubin and direct bilirubin after 1,3,7 and 14 days had significantly decreased compared with pre-treatment(P ＜0.05),the decline rates in bridge drainage group were faster than the other two groups (P ＜ 0.05).Conclusion The three types of drainage for treating malignant obstructive jaundice have exact effect,and the bridge drainage can reduce the bilirubin to lower levels more quickly than the other two methods.

Objective:To design a software to read and display CT and RT structure and draw a new contour without treatment planning system (TPS).Methods: In order to display the contour information drawn by doctors, the first step was to match CT images and RT structure then the same screen rendering of CT and RT structures could be applied. In order to add contour in RT structure obtaining the coordinates interactively, connecting coordinate points were the essential steps. Then a unique identity was given in the area of that contour to ensure its unique results. Results: The software successfully read and displayed CT and RT structures and drew a new contour without TPS.Conclusion: In this study, the software establishes a basis to improve the precision of the radiotherapy dose.

Objective To analyze the characteristic of articles, authors and citations in Journal of Clincal Neurology from 2008 to 2015.Methods The data about articles, authors and citations in Journal of Clincal Neurology from 2008 to 2015 were analyzed by bibliometrics method.Results There were 1623 papers published in Journal of Clincal Neurology during the 2008 to 2015 years.The average number of articles per issue was 33.8.The average number of article per paper was 0.424.The papers with funded projects were 432 (26.6%).The first authors were mainly come from Jiangsu, Shandong, Beijing, Shanghai and Hebei, etc.The average cooperation degree was 4.17, and the average co-author rate was 95.81%.The average rate of the papers with citation was 93.96%, and the total number of citations was 18708.The citations were mainly come from foreign language (74.3%) and journals (97.7%).The average Price index was 37.72%.Conclusion Journal of Clincal Neurology is an academic journal of high quality, with strong influence in field of clinical neurology.

An innovative approach,named associating liver partition and portal vein ligation for staged hepatectomy (ALPPS),has made possible a marked increase in future liver remnant (FLR) over a short period of time,and has challenged the concept of unresectability.To date,ALPPS has been employed for a variety of primary and metastatic liver tumors from many centers across the world.Many technical variations of ALPPS have been described.However,much controversy has surrounded this procedure,and many problems remain to be solved,such as the reasons for rapid hypertrophy,the technical feasibility,safety and long-term oncologic outcomes,and the result compared with the conventional two-stage hepatectomy.These aspects are needed to be evaluated further in large-scale studies.We believe that the ALPPS procedure will has much room for further development.

Mantle cell lymphoma (MCL), is a disease with high heterogeneity, which is insensitivity to the chemotherapy and presents poor prognosis. Appearance of the Bruton tyrosine kinase (BTK) targeted inhibitors, such as ibrutinib, provides novel treatment strategy for MCL. This review focused on the latest achievements of BTK inhibitors in MCL treatment.

Sarcopenia is a major clinical characteristic of cancer cachexia .The main pathophysiologic mechanism of sarcopenia related to cancer cachexia is abnormality between anabolic and catabolic pathways of muscle mediated by chronic inflammation .The major treatments for sarcopenia in cancer cachexia currently in-clude hormone therapy , nutrition support , exercise therapy , and other medications , which could not effectively prevent muscle loss or enhance muscle function .Better understanding of the pathogenetic processes of cancer cachexia-related sarcopenia may help in finding targets for an effective therapy .

Objective To determine the risk factors for postoperative acute kidney injury (AKI) in the patients undergoing cardiac transplantation.Methods Forty patients with end-stage heart failure (both sexes) , aged 13-66 yr, weighing 45-84 kg, of ASA physical status Ⅳ or Ⅴ (NYHA Ⅲ or Ⅳ), undergoing heart transplantation, with normal kidney function before operation, were selected.According to whether or not AKI occurred within 7 days after operation, the patients were divided into either AKI group or non-AKI group.Factors including age, gender, body weight, complications (including hypertension and diabetes mellitus), preoperative blood glucose, hemoglobin, serum creatinine, cardiac output, ejection fraction, pulmonary arterial systolic pressure, intraoperative cardiopulmonary bypass (CPB) time, transfusion of allogeneic red blood cells, and urine volume within 24 h after operation were recorded.The risk factors of which P values were less than 0.05 would enter the multivariate logistic regression analysis to stratify postoperative AKI-related risk factors for this type of patients.Results A total of 39 patients were enrolled in this study.Of the 39 patients, 14 patients suffered from AKI after operation, and the incidence was 36％.The results of logistic regression analysis showed that preoperative pulmonary hypertension and CPB time ＞ 180 min were the independent risk factors for AKI after cardiac transplantation.Conclusion Preoperative pulmonary hypertension and CPB time＞180 min are the independent risk factors for postoperative AKI in the patients undergoing cardiac transplantation.

analysis on 103 cases of spontaneous pneumothorax patients between September, 2012 and December,2014. Then the patients were randomly divided into two groups according to the different therapies on pulmonary bulla, 52 in GIA surgical stapler group and 51 in ligature group. Comparison: The postoperative situations of the two groups.Results: The operation time and intraoperative bleeding volume of observation group are obvious less than control group(t=7.58,t=16.87;P<0.01), but oxygen saturation of observation group is obvious higher than control group(t=1.34,P<0.01). The operation fee of observation group is obvious higher than control group(t=38.26, P<0.01).2 cases of postoperative recurrence in observation group(3.84%), but 10 cases in control group(19.60%).The two recurrence rates have statistical significance(x2=4.77,P<0.05). The postoperative complications incidence is 5.77% in observation group,but 21.56% in control group.The two The postoperative complications incidences have statistical significance(x2=5.47,P<0.05).Conclusion: As opposed to ligature, under the therapy for spontaneous pneumothorax with GIA surgical stapler by thoracoscopy, the operation time is shorter, intraoperative bleeding volume is less, and recurrence rate is lower in 2 years. Ligature fits the sporadic pulmonary bulla patients.

Described in this paper is the application of electronic medical records, hand-holding mobile terminals,bid data collection and analysis, and data security in medical quality control.

Objective To evaluate the clinical efficacy and safety of modified anti -tuberculosis scheme in the treatment of tuberculous meningitis.Methods 60 cases with tuberculous meningitis were randomly divided into two groups.We enrolled 30 patients in each group.The traditional anti -tuberculosis group used traditional anti -tuberculosis scheme with isoniazid,rifampicin,pyrazinamide,streptomycin,and the modified anti -tuberculosis group was given isoniazid,rifampicin,pyrazinamide,levofloxacin,the treatment course of tuberculous meningitis was 12 months.The efficacy and safety through clinical manifestations and laboratory examinations,the dynamic changes of cerebrospinal fluid were evaluated by statistical methods.Results The total effective rate of the modified anti -tuberculosis group was significantly higher than the traditional anti -tuberculosis group(86.6% vs.63.3%,χ2 =4.36,P <0.05).The cerebrospinal fluid routine and biochemical index in the modified anti -tuberculosis group were obviously superior to the traditional anti -tuberculosis group after treatment(all P <0.05).There was no significant difference in the incidence of adverse reactions between the two groups(26.6% vs.16.7%,χ2 =0.88,P >0.05).Conclusion Levofloxacin combined with other first -line anti -tuberculosis drugs,glucocorticoids,dehydration and other comprehensive measures improved brain function for the treatment of tuberculous meningitis is recommended.