Objective To explore the efficacy of radiofrequency ablation (RFA) combined with splenectomy in patients with small hepatocellular carcinoma (sHCC) associated with hypersplenism.Metheds The data of 100 patients with sHCC associated with hypersplenism who received RFA or hepatectomy combined with splenectomy were analyzed retrospectively.The patients were divided into the observation group and the control group based on the intraoperative approach.Fifty-three patients who received RFA and splenectomy were in the observation group,and the remaining 47 patients who received hepatectomy and splenectomy were in the control group.Multiple intraoperative and postoperative factors were compared between the two groups.Results There were significant differences between the two groups in warm ischemia time,operation time,intraoperative blood loss,hospital stay,and amount of blood transfusion (P ＜ 0.05).The postoperative complication rate of the observation group (7.6％,4/53) was significantly lower than the control group (44.7 ％,21/47) (P ＜ 0.05).There were no significant differences in 1-,3-,and 5-year survival (respectively,100.0％,75.5％,and 67.9％ vs 97.9％,76.6％,and 68.1％) and in disease free survival (96.2％,57.5％,and 41.7％ vs 93.5％,58.3％,and 43.8％ respectively) between the two groups (P ＞ 0.05).Conclusion RFA combined with splenectomy can be considered as an alternative treatment for patients with sHCC associated with hypersplenism.

Objective:To study the effect of sufentanil combined with dezocine on the PCIA after abdominal operation. Methods:Totally 110 patients undergoing abdominal operation were randomly divided into the experimental group and the control group with 55 cases in each. The two groups were both treated with electronic analgesia pump for the PCIA after the operation. The control group was given dezocine 0. 3 mg·kg-1 ,and the experimental group was given sufentanil injections 0. 1 g·kg-1 plus dezocine 0. 3 mg·kg-1 . The VAS score,adverse drug reactions,Ramesay scores,press number of patient controlled analgesia,exhaust time,recovery time of bowel sounds and bowel audio rate index in the two groups were compared to evaluate the effect of PCIA. Results:All the observed in-dices in the experimental group were significantly better than those in the control group(P<0. 01). The incidence of adverse reactions in the experimental group was significantly higher than that in the control group(P<0. 01). Conclusion:Sufentanil combined with dezocine for the PCIA after abdominal operation shows significantly analgesic and sedative effects,and can notably improve the clinical symptoms,which is worthy of clinical application.

Objective To search the effective treatment for the female chronic pelvic pain.Methods The drugs of ?-receptor inhibitor,antianxietic,psychotherapy and proper movement were taken.It was six weeks for a course of treatment.Results Of the study group(48 cases),complete recovery were noted in 36 cases,remarkable improvement in 5 cases,remarkable inefficacy in 4 cases,the total curative rate was 91.66%,which was significantly better than the control group(60.42%).Conclusion It is an effective treatment for the female chronic pain.

Objective To evaluate the sensitivity and specificity of plain radiography in the diagnosis of vascular calcification in maintenance hemodialysis (MHD) patients. Methods Multi-slice computed tomography (MSCT) was used as the reference standard in the assessment of vascular calcification in MHD patients. A total of 54 MHD patients, 26 male and 28 female, mean age (60.4±13.3) years, underwent both MSCT and plain radiography of lateral abdomen and pelvis to evaluate abdominal aortic calcification, bilateral iliac and femoral artery calcification. Abdominal aorta was divided into upper and lower segment by L2-L3 intervertebral space. The severity of vascular calcification by MSCT was graded from score 0 to 5. Two independent radiologists analyzed the results of plain radiography and MSCT, and inter-observer agreements were calculated by using K statistics. Results According to the results of MSCT, the calcification rate of abdominal aorta was 86.1%, and the calcification rate of iliac and femoral artery was 74.5%. There was significant difference of the calcification rate between large artery and muscular arteries. Inter-observer agreement of calcification was excellent (K =0.864-0.893). Compared with MSCT, the specificity of plain radiography with regard to detection of abdominal aortic, iliac and femoral calcification were 100%. The sensitivity of plain radiography was different according to the different MSCT score, which was as follows: MSCT score ≥ grade 1: 60.2% and 24.8% for lateral abdomen radiography to detect abdominal aortic calcification and pelvic radiography to detect iliac, femoral calcification respectively; MSCT score ≥ grade 2: 76.9% and 43.5% respectively; MSCT score grade 3: 100% and 74.4% respectively. Conclusions The sensitivity of plain radiography in the assessment of vascular calcification increases with the severity of calcification. The sensitivity in the assessment of abdominal aortic calcification is higher than that of iliac and femoral artery calcification. Plain radiography can be used to detect moderate to severe vascular calcification in MHD patients.

Objective To explore the influence of resistive respiratory training for patients with chronic obstructive pulmonary disease(COPD) on rehabilitation effect.Methods According to the digital table,68 COPD patients were randomly divided into the observation group and control group,34 cases each group.The observation group were taken respiratory muscle training under the supervision of rehabilitation nurses for 8 weeks,and the respir-atory muscle training including shrinkage lip diaphragm breathing training and abdominal muscle resistance training. Before and after the abdominal muscle resistance training and training were given 1 h double nasal oxygen tube contin-uous low flow oxygen inhalation.The control group were taken pursed lips abdominal breathing training.In the two groups before treatment and 8 weeks after, the blood gas analysis ( PaO2 , PaCO2 ) , pulmonary function test ( FEV1 , FEV1/FVC%) and respiratory muscle function( MIP,MEP) were detected.Results After treatment,blood gas anal-ysis in the two groups comparison(tPaO2 =2.95,tPaCO2 =2.07),pulmonary function(tFEV1 =2.38,tFEV1/FVC%=2.04) and respiratory muscle physiology index(tMIP =6.40,tMEP =4.04),the differences were statistically (all P<0.05).In the observed group before and after treatment,blood gas analysis(tPaO2 =19.23,tPaCO2 =3.05),pulmonary function(tFEV1 =2.67,tFEV1/FVC%=4.19)and respiratory muscle physiology index(tMIP=9.09,tMEP=9.67) were compared,the differences were statistically(all P<0.01).Conclusion Respiratory mus-cle resistance training can improve COPD patients with respiratory muscle strength and endurance,and it has the cura-tive effect to improve pulmonary function.

Objective By analyzing the epidemiological characteristics of brucellosis in Shanxi Province,to provide a scientific basis in formulation of strategies for effective prevention and control of the disease.Method Surveillance data of human brucellosis from China Information System for Disease Control and Prevention between 2004 and 2013 were statistically analyzed by descriptive epidemiological method.The regional,time,age and sex,occupational distribution of brucellosis were analyzed.The prevalence trend of brucellosis in Shanxi Province was summarized.Results From 2004 to 2013,the total incidence presented a rising tendency and the highest reported incidence was 19.10/10 million in 2013.A total of 43 061 cases of brucellosis occurred in Shanxi Province.The average incidence of brucellosis was 12.52/10 million.Regional distribution range was relatively focused on the north areas of Shanxi Province,the number of reported cases of Datong City was the largest (12 157 cases),being 28.23％.The incidence of Shuozhou City was the highest (42.97/10 million).The epidemic was spreading through all county areas.The disease was found each month throughout the year,the obvious incidence peak seasons were between March and June.The disease was most commonly found in 15-64 age groups(87.19％,37 545/43 061).Occupation distribution of patients was mainly farmers (83.34％,35 887/43 061).Conclusions The situation of brucellosis epidemic in Shanxi Province is relatively serious;the reported incidence of brucellosis in Shanxi Province is in a rapid upward trend year by year,even highly active in some particular areas.Different regions should establish regional mechanisms for joint prevention and control and implement different prevention and control measures to comprehensively and sequentially control brucellosis.

Objective To evaluate the preoperative nutritional status of patients with gastric cancer by using patient-generated subjective global assessment (PG-SGA) its relationship with postoperative results.Methods Make a preoperative nutrition assessment by using PG-SGA for 87 patients with gastric carcinoma who can be treated with operation.Analyze the effects of the postoperative complication,survival rate and the hospitalization time on patients.Results The number of patients of this group who can process the preoperative nutrition assessment by using PG-SGA accounts for 100％ of the total.There are 37 patients with moderate or severe malnutrition before operation (account for 39.1％).The complication incidence of patients with moderate or severe malnutrition before operation and the patients with no or mild malnutrition are 52.9％ and 5.7％ separately (P ＜ 0.01).The sensitivity and specificity of PG-SGA score for predicting complications are 85.7％ and 75.8％ respectively.And we should implement the analysis of regression to verify that the PG-SGA grade is the independent risk factor of postoperative complication by applying multiple Logistic(P ＜ 0.01).The average hospital stays of patients with moderate or severe malnutrition before operation and the patients with no or mild malnutrition are (21 ± 6) d and (16 ± 4) d separately (P ＜ 0.01).Conclusion According to the PC-SCA results,patients with moderate or severe malnutrition before operation have increased susceptibility to complication and the extension of hospital stays after the operatiou.Therefore,it is important to supply the proper nutrition support to these patients.

BACKGROUND:Pulsed laser deposition synthesis technology has been used to prepare new nano-hydroxyapatite thin film coating by colagen deposition on artificial mechanical heart valve. OBJECTIVE: To investigate the toxicity of new nano-hydroxyapatite thin film on human umbilical vein endothelial cels. METHODS: Human umbilical vein endothelial cels were cultured with nano-hydroxyapatite film room-temperature leaching solution, nano-hydroxyapatite film high-temperature leaching solution, high-density polyethylene and phenol solution. Within 72 hours, cel growth was observed under the inverted phase contrast microscope. At 7 days after culture, cel proliferation and toxicity grading were detected using Cel Counting Kit-8. RESULTS AND CONCLUSION:At 24 hours after culture, cels grew wel, showed fusiform shape, and had strongrefraction in the nano-hydroxyapatite film room-temperature leaching solution, nano-hydroxyapatite film high-temperature leaching solution, high-density polyethylene groups, and no significant differences in cel morphology and number were detected among above groups. Cels in the phenol solution group were suspended, round, pyknotic and dead. At 48 hours, except phenol solution group, cel number increased significantly, and cel grew densely in other three groups. At 72 hours, cels grew strongly, and the gap became smal obviously. Within 7 days after culture, cel proliferation activity was not significant in the nano-hydroxyapatite film room-temperature leaching solution, nano-hydroxyapatite film high-temperature leaching solution, and high-density polyethylene groups, which was significantly higher than in the phenol solution group (P < 0.05). The toxicity of nano-hydroxyapatite film graded 0 to 1. These results suggested that nano-hydroxyapatite artificial mechanical heart valve has good histocompatibility, but no toxicity.

BACKGROUND:A new type of nano-hydroxyapatite artificial mechanical heart valve has been developed using pulsed laser deposition technology at the Department of Materials, Hefei University and Anhui Institute of Optics and Fine Mechanics, Chinese Academy of Sciences, China. OBJECTIVE:To investigate the compatibility of nano-hydroxyapatite artificial mechanical heart valve with human umbilical vein endothelial cels. METHODS:Human umbilical vein endothelial cels were in vitroisolated, cultured and passaged to the 2-4 generations, and then the cel suspension was inoculated onto the nano-hydroxyapatite artificial mechanical heart valve. After 3, 7, 12 days of culture, the cel growth on the artificial mechanical heart valve was observed under scanning electron microscope. In addition, the human umbilical vein endothelial cels were respectively cultured in room-temperature and high-temperature extract liquids of nano-hydroxyapatite artificial mechanical heart valve, high-density polyethylene and phenol solution extracts for 72 hours, and then, the proliferation of cels was detected by MTT method. RESULTS AND CONCLUSION:Under the scanning electron microscope, the human umbilical vein endothelial cels were fusiform- or polygon-shaped with protuberances adhered to the artificial mechanical heart value at 3 days of culture; the cels were stretched thoroughly and fused at 7 days of culture; and the cels were confluent to pieces that tightly overlaid the heart valve surface and the extracelular matrix was formed localy at 21 days of culture. Results from MTT test displayed that the nano-hydroxyapatite artificial mechanical heart valve had no cytotoxicity to the human umbilical vein endothelial cels, indicating a good cytocompatibility.

OBJECTIVE:To provide reference for promoting the development of related legislation work on ensuring pediatric drug use in China. METHODS:The legislation process of pediatric drug use in US,the effects of current Best Pharmaceuticals for Children Act and Pediatric Research Equity Act on pediatric drug use in US were intrduced and analyzed,suggestions on guarantee-ing the accessibility and safety on pediatric drug use in China were put forward. RESULTS & CONCLUSIONS:The policy6-month period of pediatric exclusive protectionin Best Pharmaceuticals for Children Act has motivated the enthusiasm of phar-maceutical companies developing pediatric studies,while it affects the marketing of generic drugs. Pediatric Research Equity Act has achieved remarkable effect in terms of ensuring the safety of pediatric drug use by forcing pharmaceutical companies to carry out pediatrics assessments,while there is no enough force for the marketed drugs that has not been widely used for children. En-couragement and enforcement are useful methods for promoting development of pediatric drug use. It is suggested to take measures like modifingone drug two formsin Prescription Management Regulations,accelerating approvals of related pediatric drugs on the premise that safety is guaranteed,implementing tax preference for related pharmaceutical companies that produced pediatric drugs,promoting the entry of drug reimbursement list and empowering CFDA to force pharmaceutical companies to implement pedi-atric studies to promote the accessibility and safety of pediatric drugs.