Objective To explore the technique and feasibility of using 1.5 T MR guided radiofrequency ablation (RFA) of hepatic malignant tumor. Methods Twenty three patients with 44 malignant lesions in liver confirmed by pathology were treated with 1.5 T MR guided RFA using MR compatible multipolar RF electrode. Only patients refusing open surgery or suffering from unresectable lesions were included. Of these, 11 patients had primary hepatic carcinoma and 12 patients had hepatic metastases. The mean maximal diameter of lesions was (3.3 ± 1.8)cm. Postoperative MR was performed; the ablation zone covered and exceeded 0.5 to 1.0 cm to the margin of initial tumor was considered successful. Results All ablations were successful and lesions created by radio frequency were large enough to cover the initial tumor volume in all cases. No severe complications such as biliary fistula, perforation of diaphragmatic muscle,postoperative jaundice and pneumothorax were encountered. The mean operative time was (93 ± 33 ) min.The RF electrodes appeared in MRI as low signal structure. The ablation lesions were well-defined hyperintensity in T1 WI and hypo-intensity with a thin rim of high signal intensity on T2WI and DWI. Conclusion 1.5 T MR guided RFA of hepatic malignant tumor is an effective and safe technique.

Results showed that its action was satisfactory.Theclinical effects of all three kinds of disease were betterthan that of the control group,especially on the im-provement of deficiency of blood and Qi(P

Objective To study direct economic loss of healthcare-associated infection (HAI)in hospitalized children with acute respiratory infection (ARI),and the influence in satisfaction degree of children’relatives.Methods Clinical data of 1 039 children with ARI in a pediatrics ward between April 1,2012 to March 31,2013 were analyzed retrospective-ly.50 patients with HAI were in case group and 50 patients without HAI were in control group.The difference in medical cost and the degree of satisfaction of children’s relatives were compared between two groups.Results Medical cost of pa-tients in case group was significantly higher than control group([P 25 - P 75 :￥3 095.54 - ￥4 779.48]vs [P 25 -P 75 :￥1 744.14-￥2 382.07],Z =5.89,P <0.01).The expenses in medicine,laboratory examination,diagnosis and treatment,and nursing in case group were all higher than control group,there were significant differences between two groups(all P <0.01 );Hospitalization day of case group was significantly longer than control group ([P 25 -P 75 :9 d-15 d]vs[P 25 -P 75 :6 d-8 d],Z =5.79,P <0.01 ).Satisfaction degree of patients’relatives in case group was significantly lower than control group (Z =8.22,P <0.01).Conclusion HAI occurred in ARI children can increase medical cost,prolong length of hospital stay and decrease satisfaction degree of patients’relatives.

Objective To summarize the characteristics of epidemiology,clinic and radiography of mycoplasma pneumoniae pneumonia(MPP) in children.Methods Two hundred and one MPP patients were selected as our subjects who hospitalized in Kailuan General Hospital Affiliated to Hebei United University from Jan.to Dec.2013.All clinical data were recorded.Results Of 412 children with pneumonia,201 children were developed MPP(48.97％).There was significant difference among different age groups regarding of MPP incidence rate(x2 =62.04,P ＜ 0.05),and the highest incidence was in school-age group(71.59％).There was significant difference among the different month,and the MPP cases were more occurred at January,July,September,October and November.The main clinical manifestations were cough (201cases,100％),fever(136 cases,67.66％),moist rales (168 cases,83.58％),breathing (58 casses,28.86％).And parts of children (23.38％) were complicated with extra pulmonary symptoms.The blood WBC of most MPP patients were without obvious increase and blood WBC of 136 cases(67.66％) was less than 10 × 109/L.The cases with hsCRP (＜ 5 mg/L or-10 mg/L) accounted for 36.32％ or 22.39％.Imaging examination results showed that 64 cases were with bronchovascular shadow,73 cases with spot and schistic shadow,64 cases with lobar pneumonia and 3 cases with pleural effusion.Conclusion Clinicians sholud make the early diagnosis and treatment of MPP based on epidemiology,clinical and image comprehensive characteristics of MPP.

Objective:Renal involvement in primary Sjogren′s syndrome (pSS) has been considered rare, and recent studies have shown that there was a large difference in the prevalence of the disease, which has been reported to range from 0.03% to 67%. The meta-analysis was to determine the prevalence of renal involvement in pSS patients.Methods:The study on pSS renal involvement was conducted in Pubmed, Embase and Cochrane Library from January 2002 to May 2019. After logarithmic conversion of the prevalence rate, meta-analysis of random effect model was carried out to explore the prevalence of pSS renal involvement. Subgroup analysis and meta regression analysis were used to explore the source of heterogeneity. We also performed sensitivity analysis and assessments of publication bias by Begger′s test.Results:The meta-analysis included eighteen observational studies of 8 888 participants. The result in random effects model showed that the combined prevalence was 9.0% (95% CI: 6.0%-12.0%), with significant heterogeneity between these studies ( I2=97%, P<0.01). The source of heterogeneity was explained by a stratified analysis of region, type of study, and the diagnostic criteria for renal involvement. Sensitivity analysis showed that the result was robust and Begger′s test did not detect the presence of publication bias. Conclusions:The prevalence of renal involvement in pSS is 9.0%. Due to huge heterogeneity, large multicenter prospective studies will be needed to determine its prevalence and the relationship between pSS and kidney.

Objective To investigate the knowledge, attitude and behavior of patients with non-alcoholic fatty liver disease ( NAFLD) , and analyze the relevant factors and problems, in order to promote the establishment of patient′s health behavior and quality of life. Methods A total of 100 patients with non-alcoholic fatty liver disease in gastroenterology clinic had been selected by convenient sampling method, and were used self-designed questionnaire which contained the knowledge, attitude and behavior of patients with NAFLD to survey and analyzed them. Results A total of 100 questionnaires were surveyed and collected (100% collective rate). NAFLD patients had 59. 37% accuracy for fatty liver disease relevant knowledge, attitudes accounting for 89. 00% accuracy, behavior 44. 54%. There were statistically significant between patients′knowledge and attitude (r=0. 295, P<0. 05), knowledge and behavior (r=0. 295, P<0. 05), and without statistical significance between attitude and behavior (r =0. 700, P >0. 05). Conclusions The knowledge of patients with NAFLD still needs to be improved, and the attitudes and lifestyle behaviors need further guidance. Nurses play a significant role in improving the patient′s cognitive level and helping patients establish a correct attitude, correct bad habits, and improve quality of life.

The present study evaluated the application of three dimensional echocardigraphy (3DE) in the diagnosis of atrial septal defect (ASD) and the measurement of its size by 3DE and compared the size with surgical findings. Two-dimensional and real-time three dimensional echocardiography (RT3DE) was performed in 26 patients with atrial septal defect, and the echocardiographic data were compared with the surgical findings. Significant correlation was found between defect diameter by RT3DE and that measured during surgery (r=0.77, P<0.001). The defect area changed significantly during cardiac cycle. Percentage change in defect size during cardiac cycle ranged from 6%-70%. Our study showed that the size and morphology of atrial septal defect obtained with RT3DE correlate well with surgical findings. Therefore, RT3DE is a feasible and accurate non-invasive imaging tool for assessment of atrial septal size and dynamic changes.
Echocardiography, Three-Dimensional ; Heart Septal Defects, Atrial/*diagnosis ; Heart Septal Defects, Atrial/*pathology ; Heart Septal Defects, Atrial/surgery ; Young Adult

The present study evaluated the application of three dimensional echocardigraphy (3DE) in the diagnosis of atrial septal defect (ASD) and the measurement of its size by 3DE and compared the size with surgical findings.Two-dimensional and real-time three dimensional echocardiography (RT3DE) was performed in 26 patients with atrial septal defect,and the echocardiographic data were compared with the surgical findings.Significant correlation was found between defect diameter by RT3DE and that measured during surgery (r=0.77,P<0.001).The defect area changed significantly during cardiac cycle.Percentage change in defect size during cardiac cycle ranged from 6%-70%.Our study showed that the size and morphology of atrial septal defect obtained with RT3DE correlate well with surgical findings.Therefore,RT3DE is a feasible and accurate non-invasive imaging tool for assessment of atrial septal size and dynamic changes.

Objective:To understand intensive care unit(ICU)doctors'opinions and suggestions on implementing palliative care,and provides a reference basis for the implementation of palliative care in Chinese ICU.Methods:A purposive sampling technique was used to conduct one-on-one semi-structured interviews with 11 ICU doctors.Colaizzi's phenomenological analysis method was utilized to code,classify,interpret,and comprehensively analyze the interview data.Results:A total of 4 themes and 18 sub-themes was extracted,including cognitive biases toward palliative care,the belief that implementing palliative care in the ICU has significant humanistic implications(palliative care practice is the most perfect embodiment of medical humanities,palliative care in the ICU can alleviate patient pain and reduce invasive operations,palliative care can achieve comfortable care for ICU patients,palliative care focuses on maintaining the dignity of ICU patients,palliative care can pay attention to the inner voice of ICU patients,and implementing palliative care will help to more effectively allocate resources),difficulties faced by ICU in carrying out palliative care(lack of clarity in relevant policies at the legal level,closed management environment in the ICU,insufficient manpower in the ICU and lack of palliative care professional team,inadequate understanding of ICU patients'families,lack of death education,not included in medical insurance payments,and lack of communication skills of young doctors),strategies to promote the development of palliative care in the ICU(ICU palliative care can be piloted first,the development of ICU palliative care screening tools will help with the development of palliative care,the palliative environment and the handling of death procedures can be further optimized,and the application and implementation of scientific methods to shorten the gap between evidence and practice of palliative care).Conclusions:The integration of palliative care and ICU in China is still blank.The significance of implementing palliative care in ICU should be emphasized,ICU doctors'knowledge and skills of palliative care should be improved from multiple perspectives,patient preference should be emphasized to improve the knowledge and acceptance of palliative care of ICU patients'families,and the promotion of palliative care in ICU clinical practice should be pioneered and piloted.