Early small hepatocellular carcinoma (SHCC) can be cured by surgery and interventional operation to improve the survival rate of paitents,so the accurate diagnosis of SHCC is of great significance.Presently,the dynamic contrast-enhanced MR scan could only obtain single arterial phase imaging by single breath hold,and it had breathing motion artifact because of the long scanning time.The early arterial transient enhancement of SHCC was easy to be misdiagnosed.The CAIPIRINHA-Dixon-TWIST-VIBE (CDT-VIBE) sequence couldobtain high-quality multiple arterial phases images and hepatic arterial dominant (HAD) images in short-time scanning.And it could not only detect small focal lesions which were difficult to find by other imaging examination,but also find the start enhanced difference between lesions which were relevant to lesions property and blood supplement.The CDT-VIBE has a high clinical value in diagnosis and treatment of SHCC.The research progresses of CDT-VIBE in diagnosis of SHCC was reviewed in this article.

Objectives This research explored the characteristics of changes in the serum metabolic profile of preeclampsia pregnancy(PE) to establish the disease distinguish model and screen characteristic metabolic markers with potential diagnostic value for preeclampsia.Methods From August 2014 to January 2016,samples in three groups were collected at Tianjin Third Central Hospital.Thirty-one clinically diagnosis patients with preeclampsia,25 normal pregnancy women and 29 healthy volunteers of childbearing age were enrolled.Ultraperformance liquid chromatography-mass spectrometry (UPLC-MS) was used to analyze serum metabolites of PE group (31 patients with preeclampsia),P group (25 normal pregnancy women) and Normal group (29 healthy volunteers of childbearing age).Nonparametric test analyzes were used to analyze the data and find the specific metabolites.Results This research established the principal component analysis (PCA) and orthogonal partial least squares-discriminant analysis (OPLS-DA) disease distinguish model for PE group,P group and Normal group.To distinguish PE group,P group and Normal group,15 characteristic metabolites were identified.Eight kinds of glycerol phospholipid (including 7 kinds of hemolysis phosphatidyl choline and 1 kind of lysophospholipids acid) and 1 kind of sphingomyelin in PE group were higher than that of normal pregnancy group.The difference had statistically significant(Z of the metabolites were 2.32,3.34,3.21,2.60,2.22,3.40,3.58,5.84,2.70 respectively,all P<0.05).1,25-Dihydroxyvitamin D3-26,23-lactone and 24-Oxo-1alpha,23,25-trihydroxyvitamin D3 in PE group were higher than that of P group and Normal group,which had a statistics difference (Z of the metabolites were 2.01,3.89,3.26,2.34 respectively,all P<0.05).Conclusions Metabolomics distinguish model has a good ability to distinguish PE group,P group and Normal group.Serum characteristic metabolites can successfully reflect the status of fat,calcium and phosphorus metabolism of preeclampsia patients and provide high value for prediction,diagnosis and treatment.

OBJECTIVE:Tosum up the condition of theoretical teaching and experimental teaching of the Processing of Chinese Materia,and to provide referencefor the reform of teaching model of the Processing of Chinese Materia. METHODS:Teaching soft-ware,teaching video and other modelrn teaching methods were used to enrich the content in theory teaching;linking theory with practice was used to stimulate students'interest in learning;scientific research achievement was introduced in teaching to train stu-dents' scientific research thinking;the teaching model of traditional confirmative experiment teaching was reformed by increasing de-signing experiment hours and score;the traditional usual performance evaluation method was changed by replacing with evaluation method of formative,and it was used for evaluation. RESULTS:The students not only learned theoretical knowledge,but also cul-tivated their ability to analyze and solve problems,changing from passive learning to active learning,so that it has made satisfacto-ry teaching effect. CONCLUSIONS:The traditional concept should be changed in teaching of the Processing of Chinese Materia, paying attention to the combination of scientific research and teaching;improve the situation of the designing experiment in the present undergraduate experimental teachingto stimulate students interest in learning,enhance students'practical ability,and im-prove the quality of teaching.

Objective By summing up monitoring data of human brucellosis in Qinghai Province from 2000 to 2012, to evaluate epidemiological dynamics and analyze prevalence trend. Method Monitoring data of human brucellosis in Qinghai Province from 2000 to 2012 were collected, epidemiological characteristics including prevalence condition, area and population distribution were analyzed by descriptive epidemiology method. Results Totally 38 578 persons were examined from 2000 to 2012. The number of persons infected with brucellosis was 1 209, the infection rate was 3.34%;the number of patients diagnosed with human brucellosis was 344, the prevalence rate was 0.89%. New cases had occurred since 2006, and there were 158 new cases diagnosed with brucellosis. The prevalence rates in cities and areas of agriculture and pasture were 2.93%(78/2 663), 1.18%(33/2 806) and 0.70%(233/33 109), respectively. The ages of developing brucellosis ranged from 10 to 72 years old. The prevalence rates of biological pharmaceutical producers and the herdsman were [18.13%(196/1 081)] and [6.13%(353/5 763)], respectively. The prevalence rate of human brucellosis in Han nation was the highest [4.61%(467/10 140)], followed by Tibet [3.60%(443/12 318)], Mongolia [2.53%(211/8 342)], Tu [2.22%(110/4 953)] and Hui [2.09%(59/2 825)], and the differences were statistically significant (χ2 = 102.493, P < 0.01). Conclusion The prevalence state of human brucellosis in Qinghai Province is in a increasing trend, and new cases are increasing.

Objective:To explore the predictive value of the recurrence risk estimator at 90-days(RRE-90) score combined with lipoprotein-associated phospholipase A2 (Lp-PLA2) and high sensitivity C-reactive protein(hs-CRP) in the recurrence risk of acute atherosclerotic cerebral infarction.Methods:Totally 400 patients with acute atherosclerotic cerebral infarction who were hospitalized for the first time in neurology department were followed up for 90 days.However, 8 cases were lost and 392 cases were included finally.According to recurrence or not, 64 cases were divided into recurrence group and 328 cases into non-recurrence group.The RRE-90 score was applied to all the participants and the levels of Lp-PLA2 was detected by enzyme-linked immunosorbent assay, the levels of hs-CRP was detected by immunoturbidimetry.The ROC curve was used to analyze the predictive value of RRE-90 score combined with Lp-PLA2 and hs-CRP for the recurrence risk of acute cerebral infarction.Results:Compared with the non-recurrence group(RRE-90: (3.07±1.01)score, Lp-PLA2: (103.53±8.11)μg/L, hs-CRP: (4.07±1.48)mg/L), the levels of (RRE-90 score: (4.11±0.78)score, Lp-PLA2: (121.52±13.95)μg/L, hs-CRP: (12.40±2.46) mg/L)in the recurrence group of cerebral infarction were significantly higher ( P<0.05, P<0.01). Compared with RRE-90 score (0.705), Lp-PLA2 (0.697), hs-CRP (0.622), RRE-90 score combined with Lp-PLA2 (0.752), RRE-90 score combined with hs-CRP (0.746), RRE-90 score combined with Lp-PLA2 and hs-CRP (0.782) had the largest area under the curve for predicting recurrence of cerebral infarction within 90 days, with statistical significance( P<0.05), sensitivity was 87.8%, specificity was 89.6%. Conclusion:RRE-90 score combined with Lp-PLA2 and hs-CRP detection can further improve the accuracy of predicting recurrence within 90 days in patients with cerebral atherosclerotic infarction, and the predictive value is high.

Objective To investigate whether the mechanism of action of electro-acupuncture in MPTP-induced Parkinson's disease(PD)model mice is related to neuroinflammation mediated by the forkhead box protein O1(FoXO1)/NOD-like receptor heat protein structural domain-related protein 3(NLRP3)signaling pathway.Methods Thirty mice were randomly divided into control(Ctrl),model(MPTP),and electro-acupuncture(EA)groups,with 10 mice in each group.PD mouse model was prepared by intraperitoneal injection of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine(MPTP)30 mg/(kg·d)for 7 d consecutively.Behavioral changes of mice were observed by open field and pole-climbing experiments;α-synuclein(α-syn)expression in the substantia nigra of the midbrain was observed by immunohistochemistry;FoXO1,NLRP3,ASC,and Caspase-1 were deter-mined by Western blot;and the expression of inflammatory factors such as tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β)was detected by ELISA in the substantia nigra of the midbrain.Results Mice in the MPTP group showed significant behavioral deficits,with a significant increase in midbrain substantia nigra α-syn(P＜0.01),elevated levels of Iba-1,FoXO1,NLRP3,ASC,and Caspase-1 proteins(P＜0.05 and P＜0.01,respectively),and a significant increase in the levels of TNF-α,and IL-1β(P＜0.01).The treatment of EA was effective in improve the dyskinesia of PD mice,improve motor balance and coordination(P＜0.01),reduce the abnormal aggregation of α-syn(P＜0.01),reduce the abnormal activation of microglia,and alleviate neuroinflammation(P＜0.05).Conclusion Electro-acupuncture may play a protective role in PD by modulating FoXO1/NLRP3 pathway-mediated neuroinflammation.

Objective To construct scientific and standardized perioperative anesthesia health education content and improve the cooperation degree of perioperative anesthesia for patients undergoing surgery. Methods From March to October 2017, on the basis of reading the literature, through qualitative interviews with nurses of the Anesthesiology Department of a Class Ⅲ Grade A hospital and 20 patients receiving general anesthesia, a draft of perioperative anesthesia health education content was formed. 17 anesthesia medical experts and 8 anesthesia nursing experts from 11 provinces in China were consulted and revised for 2 rounds by Delphi method.Results The recovery rates of pre-survey and two rounds of expert consultation papers were 100％, and the authority of experts was 0.896. The coordination of expert opinions by using Kendall Harmony Coefficient had statistical significance (P<0.001). The perioperative anesthesia health education content with 2 first-level entries, 10 second-level entries and 60 third-level entries was constructed.Conclusions A scientific and standardized content of perioperative anesthesia health education has been initially formed, but it needs to be applied to clinical practice to further verify whether it is universal, generalized and easy to operate.

This is a complicated and difficult case. The onset symptom of a 62-year-old male was recurrent intestinal obstruction. Ileocecal and ileocolic operation was done twice. Massive gastrointestinal bleeding occurred due to giant fistula of descending duodenum, which connected to ileocolic anastomosis. After consultation by multidisciplinary team, jejunal-feeding tube was placed to provide enteral nutrition. With general condition improving, duodenal fistula repair and involved bowel resection were performed. Postoperative pathology confirmed Crohn's disease. The patient was treated with thalidomide and recovered well during follow-up.

Alzheimer's disease (AD) is the most common form of dementia in the elderly, and there is no specific treatment to stop or reverse its progression. Mild cognitive impairment (MCI) is an important entry point for early diagnosis and prevention of AD. More and more studies have explored the risk factors and biomarkers for conversion from MCI to AD, and a series of risk prediction models have been established. This article analyzes and summarizes the different predictors and risk prediction models so as to provide basis for early identifying the high-risk group of AD, managing the controllable risk factors, and providing references for the selection and improvement of these models.

Objective? To explore the effects of seamless nursing management model in transition of intensive care unit (ICU) patients. Methods? From February 2017 to January 2018, we selected 128 patients discharged from ICU within one week in the Second Hospital of Harbin Medical University by convenience sampling. All of the patients were divided into control group and observation group with the method of the random number table, 64 cases in each group. Control group carried out routine nursing management model, while observation group implemented seamless nursing management model with assessment before roll-out, family members communication, doctor-nurse handover and goods handover of patients. And then, we investigated the rate of return to ICU of patients discharged from ICU within 72 hours, cases of telephone counseling in departments and patient satisfaction between two groups. Results? After implementing seamless nursing management, the rate of return to ICU and cases of telephone counseling in departments of patients in observation group were 3.13% (2/64) and 6.25% (4/64) respectively lower than those in control group; the patient satisfaction of observation group was 96.88% (62/64) higher than that of control group; the differences were all statistical (χ2=5.89, 18.29, 8.02;P＜0.05). Conclusions? Seamless nursing management model makes transitional care for patients discharged from ICU complete and scientific which improves satisfaction patients discharged from ICU and has a positive effect on improving nursing work efficiency and quality.