Objective To investigate the types of ultrasonographic appearance of post-hepatectomy in operative position. Methods The data about operative manner,operative position, type of plugger in residul cavitity of 176 cases who underwent hepatic operation,were collected. Their ultrasonographic findings of post-operative liver in operative position in different phrases after operation were analyzed retrospectively. Results The main appearance was: ① Absence of partial hepatic lobe or hepatic segment; ② anechoic area with thin wall or mixed mass in operative position; ③ conformation of irregular high-echo conglomeration in operative position, irregular wall thickeness and inhomogenous internal echoes appeared in anechoic area and mixed mass in operative position, color Doppler twinking artifact appeared around some plugger and residual cavity which made by curettage and aspiration technique with time passing by. Conclusions Ultrasonographic appearance of post-hepatectomy in operative position varies with different operative manner, operative position, resected area, and Absence or existence of plugger in residual cavity, different type of plugger in residual cavity.

Objective To evaluate the value of high frequency color Doppler ultrasound in diagnosis of malignant tumor in the parotid gland.Methods High frequency ultrasound was used to observe shape and internal echo texture of tumor,color Doppler flow imaging(CDFI) was added to observe blood flow signal,peak systolic velocity(PSV) and resistance index(RI) were measured by pulsed wave Doppler, and lymphonodus around parotid gland were examined.Results The features of ultrasonography included round,lobulated and irregular shape.Three types of boundary were clear but not smooth,unclear,irregular and invasive.Internal echo texture included low and irregualr echo,cystic echo,spot like and intensive echo,honey comb like echo.CDFI showed spet like,stick like blood flow signal.PSV and RI were 4.6 17.5 cm/s,and 0.69 1.14 .Eight cases were misdiagnosed for benign tumor,the correspondent rate was 87.1% .Conclusions The high frequency ultrasonogram of malignant tumor in the parotid gland were similar and specific,adding the CDFI,PSV,RI and lymphonodus examination around the parotid gland may help to improve the diagnostic accuracy.

BACKGROUND:Internal fixation is commonly used in an early stage of intertrochanteric fractures of the aged worldwide, and can apparently reduce complications and fatality rate. The commonly used internal fixators contain proximal femoral nail anti-rotation and dynamic hip screw, whose comparison is current research hotspot.
OBJECTIVE: To evaluate the hip function and stability after internal fixation with proximal femoral nail anti-rotation and dynamic hip screw in repair of intertrochanteric fractures of the aged.
METHODS:A total of 64 aged patients with intertrochanteric fractures were enroled in this study, and assigned to dynamic hip screw group (n=30) and proximal femoral nail anti-rotation group (n=34). The fracture reduction and healing were evaluated using anterioposterior and lateral X-ray films. Operation time, intraoperative blood loss, complication rate, healing time and postoperative hip function were compared and analyzed between the two groups, and then assessed in accordance with Sander’s scoring system.
RESULTS AND CONCLUSION:Compared with dynamic hip screw group, operation time, intraoperative blood loss, healing time and complication rate after treating unstable intertrochanteric fracture (Tronzo-Evans III, IV and V types) showed significant advantages in the proximal femoral nail anti-rotation group (P < 0.05). Hip function restored better, and the complication rate of stable intertrochanteric fracture (Tronzo-Evans I and II types) was lower after treatment in both groups (P > 0.05). These data show that the effects of proximal femoral nail anti-rotation were better than that of dynamic hip screw for treatment of intertrochanteric fractures, and hip function recovered better. Moreover, proximal femoral nail anti-rotation had biomechanical stability, especialy for unstable fracture.

[Abstract ] Enhanced recovery after surgery (ERAS) is a kind of multi-discipline technology which is based on evidence-based medicine and aims to optimize the current peri-operative management, reduce the stress and complications during the periopera-tive period and enhance recovery aftery surgery.The introduction and successful practice and generalization of ERAS promote the trans-formation of medical quality management thought, innovation of the clinical technologies and patients'rehabilitation process.In the era of ERAS, we should make efforts to promote the medical quality management by fully using new technologies from the aspects of impro-ving the understanding, strengthening team work and optimizaing information support.

Through the doctor group, the questionnaire survey to understand what the doctor online habits situ-ation of network communication, doctors and patients, the effect of the real network environment for medical diag-nosis and treatment, news media under the network environment on the influence of the doctor and the doctor group about web development comprehensive view of the impact of the doctor-patient relationship.Points out that the current network environment brings to the doctor-patient relationship: the influence of the Internet become some doctors information update and the accumulated knowledge source, network has become an important platform inter-action some doctors and patients, doctors need to deal with an increasing number of network patients, the doctor-shave reactive shifts to the media negative reports.

The apparent digestibilities of two preparations of corn as staples in men were estimated during March and April in 1979. Seven healthy adult men, who lived in this region for many years, were accustomed to eat corn as their staple diets. Each of the two preparations from the same batch of corn was used in the experiment. One preparation was "cooked corn meal" and the other was Jian-bing, the latter was considered the better way of cooking. Other ingredients of food in these two test diets were the same. During the test periods, the volunteers ate the test diets and drank boiled water ad lib, but the quantities were recorded. No other foodstuffs and drinks were allowed. The nutritive values of test diets were sufficient to meet the subjects' physiological needs. The 12 days period was divided into adaptative and testing periods of three days each for the two kinds of test diets. During the test periods, the total foodstuffs and the volunteers' faeces were analysed for the contents of water, anhydrates, total ni- trogen, crude fat, ash and fiber in the samples. From the data obtained, the apparent digestibilities of anhydrates, total nitrogen and crude fat ware calculated. Urine nitrogen was analysed and the nitrogen balance was calculated. The body weight at the beginning and the end of test periods were measured.The apparent digestibility (%) of anhydrates was 93.31?0.393 and 94.79 ? 0.578, total nitrogrn 84.60 ? 0.843 and 87.77 ? 1.080 and crude fat 86.32 ? 1.296 and 94.68 ? 0.838 in cooked corn meal diet and the corn flour Jian-bing diet respectively. The apparent digestibility in corn Jian-bing diet was higher statistically than that of cooked corn diet. Body weights fluctuated within the normal range. The nitrogen balances of all subjects were positive and the difference of nitrogen balance studies between the two test diets was not statistically significant.The results of the experiment suggest that, the differences of apparent digestibility between two diets was mainly due to the methods of preparation, Jian-bing being better than cooked corn diet in human nutrition.

Objective To investigate the clinical characteristics and its prognostic factors for hilar cholangiocarcinoma with exairesis .Methods The clinical data of 58 cases of hilar cholangiocarcinoma were ret-rospectively analyzed .The Kaplan-Meier method was used to estimate the overall survival and disease specific survival rates for these patients .And the factors that may influence the prognosis and survival of patients were an -alyzed using univariate(log-rank test)and multivariate Cox proportional hazard models .Results The median survival time was 22 months for all patients .The 1-,3-and 5-year survival rates were 76%,40%and 21%, respectively.Univariate analysis showed that preoperative albumin (P=0.002),intraoperative blood loss (P=0.039),surgical method(P =0.006),histologic differentiation(P =0.001),portal vein encroached(P =0.014),surgical margin(P=0.020)were correlated factors for postoperative survival duration .Multivariate analy-sis by Cox Proportional Hazard Model showed that surgical method (P=0.022),histologic differentiation(P=0.020)were independent prognostic factors for patients with Hilar cholangiocarcinoma excised .Conclusion Low albumin leve,intraoperative blood loss more than 500 mL,low degree of tumor differentiation,portal vein en-croached ,radical surgery ,positive surgical margin are risk factors for total survival of Hilar cholangiocarcinoma .

BACKGROUND:The non-specific immune suppression method is generaly used for treatment of systemic lupus erythematosus, but poor prognosis, such as infection and high recurrence rate, exists.
OBJECTIVE:To evaluate the therapeutic effect of bone marrow mesenchymal stem cel transplantation on systemic lupus erythematosus in mice.
METHODS:Sixteen mice with systemic lupus erythematosus were equivalently randomized into control and experimental groups, or then subjected to passage 3 bone marrow mesenchymal stem cel transplantation or the equal volume of normal saline via the tail vein, respectively. Mouse urine samples were colected to detect urine protein levels by Bradford method. Blood samples from the tip of the mouse tail were extracted to detect serum anti-ds-DNS antibody concentration by radioimmunoassay. Mouse kidney tissues were taken and observed pathohistologicaly through hematoxylin-eosin staining and immunohistochemistry staining under microscope. Flow cytometry was used to detect the expression of CD4+CD25+T cels in the inner canthus blood, fresh spleen and thymus.
RESULTS AND CONCLUSION:Within 10 weeks after cel transplantation, the urine protein levels in the two groups were gradualy increased, and the rising velocity was higher in the control group than in the experimental group. From the 4th to 10th week, the urine protein levels in the experimental group were significantly lower than those in the control group (P < 0.05). In the control group, lymphocyte infiltration was visible in the kidney tissues with a few of plasmocytes, and pathological findings showed the mice presented with interstitial nephritis; in the experimental group, the mice had no pathological changes in the kidney. In the two groups, immune complexes were found in the mesangial area, which showed a patch-like distribution in the control group and a punctate distribution in the experimental group; the relative proportion of the occupied area in the experimental group was significantly lower than that in the control group. The expression level of CD4+CD25+T cels in the blood and thymus were significantly higher in the experimental group than the control group (P < 0.05), and the expression level of CD4+CD25+T cels in the spleen was slightly higher in the experimental group than the control group with no significant difference (P > 0.05). The serum anti-ds-DNA antibody concentration in the experimental group was significantly lower than that in the control group (P < 0.05). Taken together, bone marrow mesenchymal stem cel transplantation can improve the pathological damage in systemic lupus erythematosus mice, and has a certain therapeutic effect on systemic lupus erythematosus.