Objective This prospective study was performed to evaluate the role of oral glucose toler-ance test(OGTF) in evaluating the preoperative status and postoperative complications of patients with hepa-tocellular carcinoma. Methods One hundred and twenty-eight patients with primary hepatic carcinoma (PHC) were divided into 3 groups according to the resection, in which the resection of no more than 1 seg-ment called group A, the resection of 1-2 segments called group B, the resection of more than 2 segments called group C. OGTT, routine liver function tests and Child-Pugh classification were performed in these pa-tients preoperatively. The postoperative complications were also recorded. Results Blood glucose lever of 60 min and 120 min after glucose loading test in Child B (11.23 mmol/L ± 2. 78 mmol/L, 11.79 mmol/L± 3.48 mmol/L) were significantly higher than that in Child A (8.56 mmol/L±2. 36 mmol/L, 6. 78 mmol/L ±1.60 mmol/L,P <0.01) ,but the blood glucose lever of 0 min and 30 min showed no difference. The rate of diagonis of DM in Child B was 28. 30% ,which was higher than Child A(13.33% ,P =0. 035). The OG-TT results for the L-shaped curve showed that postoperative complications were significantly higher than that of type I and P in group A and B. I-shaped and L-shaped were found ascites in group C. The cases with jaun-dice all showed L-shaped curve. When the patients' OGTT curve was P -shaped, the ascites production rate was no significantly different in these three groups. With the increase of the removal in liver, ascites produc-tion rate increased evidently in I-type and L-type(P < 0. 05). Conclusions OGTT is worthwhile to assess hepatic function reserve and postoperative complications for patients with PHC. Combination of OGTT and Child-Pugh classification has higher predictive value on hepatic function reserve.

Objective To explore the indications of conservative treatment and to explore the laparotomy for children with abdominal trauma,so as to improve the diagnosis and treatment of abdominal injury in children.Methods This retrospective review included 89 children who had an abdominal trauma which was classified according to the injury situation.Results (1)Of 25 patients with hepatic injury,1 underwent surgery.Among the 48 patients with splenic injury,46 cases were treated successfully by conservative treatment,only 1 underwent splenectomy and another adopted splenic neoplasty.Fourteen patients suffered from gastrointestinal injury,and 4 of them underwent emergency laparotomy,however a delayed perforation of digestive tract occurred in 1 child when he was in hospital 4 days later.Eight cases of pancreatic trauma were treated successfully by conservative treatment,the same as 6 cases of renal and adrenal contusion.One child with uterus and bladder injury was atopted emergency surgical treatment.(2) Unlike adults,conservative management of hepatic and splenic injuries was successfully applied to the vast majority of children.Operative treatment ought to be carried out when hemodynamic stability could not be maintained despite a continuous intravenous fluids and blood transfusion,or when the total amount of blood transfusion exceeds 40 ml/kg.(3)CT was very useful for children with gastrointestinal injury,especially for one cannot stand for abdominal X-ray examination.Operative treatment ought to be carried out timely in those with pneumoperitoneum or abdominal distension.We should pay particular attention to the possibility of delayed perforation.(4)In general,pancreatic injury could be treated conservatively except the ones with pancreatic rupture.(5)Children with bladder and uterine injury often suffered from severe trauma,and needed to be operated timely.Conclusion Children with abdominal injury should be highly valued in primary hospital.Internal bleeding caused by substantial organ injury is the leading cause of death in children,and the delayed diagnosis and treatment of the injured cavity organs is another important cause of the death.Therefore,early accurate diagnosis,active treatment,comprehensive treatment of severe combined injuries and complications are the key to successful treatment of such patients.

Objective To investigate the morbidity of anomalous coronary origin from the opposite coronary sinus, which may cause sudden death of young athletes in Chinese population.And to identify the imaging characteristics of this anomaly and its clinical significance combined with literature review.Methods The computed tomographic coronary angiography (CTCA) database at TEDA International Cardiovascular Hospital was reviewed.All of the patients diagnosed with isolated anomalous origin of a coronary artery from the opposite sinus of valsalva (anomalous origin of coronary artery, AOCA) and subsequent coursing between the pulmonary artery and the aorta were collected from 14 343 Chinese individuals.The location of anomalous coronary origin, the shape and course of the proximal ectopic arterial segments were identified.The nonatherosclerostic stenotic caliber of the segments and the angle between the ectopic coronary artery and the adjacent aortic wall were assessed.Results Seventy-four patients of AOCA (including the left or right single coronary artery) were diagnosed using CTCA.Among the 74 cases, the potentially serious course of the ectopic coronary artery between the pulmonary artery and the aorta were identified in 59 individuals.Fifty-six cases of ectopic right coronary with interarterial course (anomalous origin of right coronary artery, AORCA) and three patients with anomalous origin of the left coronary artery (AOLCA) were found, including two cases judged as potentially serious origin of either single left coronary artery (n=1) or single right coronary artery (n=1).The morbidity of the potentially serious anomalous origin of coronary artery in Chinese population was established as 4.1‰ (59/14 343).In the subgroup of AORCA, the lumen of initial ectopic segment was frequently compressed and stenotic.In 29 cases (52.7%) the stenosis of the lumen were more than 50%, and in 3 cases (5.4%) the stenosis of the ectopic coronary artery were more than 70%.The incidence of AORCA was 17.7 times higher (56/3) than that of AOLCA in Chinese population.Conclusions Nowadays CTCA is considered the most useful imaging technique in identifying the origin, shape and course of ectopic initial segment of the coronary artery.The significance of these anatomic characteristics, that may induce sudden death in Chinese young athletes, need to be investigated further.

Objective To evaluate the causation and management of complications caused by enteral nutrition (EN)after stomach cancer surgery.Methods The clinical data of 195 gastric cancer patients which used EN after surgery were analyzed retrospectively from September 2002 to April 2008 in our hospital.Results Among the 195 patients,29(14.87%)developed abdominal distention,17(8.71%)diarrhoea,Six(3.07%)metabolic complica tions,three anastomotie leakage,1 patient with colon perforation.Conclusion These complications caused by EN after stomach cancer surgery associated with the stress of surgery,the speed and concentration of nutrition infusion, patients'metabolic conditions and other related factors.

Objective To find frontal lobe-amygdala functional connections in different age paragraph female patients with bipolar disorder. Methods The FMRI date were acquired from 30 patients with bipolar disorder aged 13 to 25 years old and 30 age-and education level-and gender-matched health controls.FMRI was also conducted on 30 patients with bipolar disorder aged 26 to 45 years old and 30 age-and education level-and gender-matched health controls.The date was calculated by using MATLAB based DPARSF software. Results Compared with corresponding health controls, the lobe-amygdala functional connections significantly decreased in patients aged 13 to 25 years but remained unchanged in patients aged 26 to 45 years old. Conclusions The decrease in the frontal lobe-amygdala functional connections decreased in female patients aged 13 to 25 years old may be related to the underdevelopment in vulnerable immature brain.In contrast, the frontal lobe-amygdala functional connections in female patients aged 26 to 45 years old remain intact.