Objective To explore the essential of cerebroprotein hydrolysate injection in the manage-ment of epidemic encephalitis B.MethodsTwo hundred and thirty-two patients with epidemic ence-phalitis B were randomly divided into two groups,one hundred and twenty-six patients in treating group,and one hundred and six patients in controlled group.Beside the conventional and symptomatic therapy,the patients in treating group received the management of cerebroprotein hydrolysate injection 10 mL+5% glucose solution 250 mL,iv drip,qd for 5 d and those in controlled group received the management of interferon?1b 1 MIU,sc,qd for 5 d.ResultsThe total clinical effective rates in treating group and controlled group were 94.6% and 82.6% respectively,there were remark-ably differences between two groups(P

Objective To observe the effects of total paracentesis with normal saline intravenous infusion on portal hemodynamics in refractory ascites of liver cirrhosis.Methods One hundred and forty-two cirrhotic patients with tense ascites were divided into two groups at random.Eighty-seven patients (group A) were treated by total paracentesis with normal saline intravenous infusion beside conventional therapy and diuretics;55 patients (group B) were treated with conventional therapy and diuretics.Results The total effective rate in ascites was 67.8% in group A and 23.6% in group B,P

This guidelines summarize and evaluate all available evidence-at the time of the writing process-on a particular issue , with the aim of assisting physicians in selecting the best management strategies for an individual pa-tient with given condition , taking into account the impact on outcome , as well as the risk-benefit ratio of particular diagnostic or therapeutic means. Guidelines and recommendations should help physicians to make decisions in their daily practice. However , the final decisions concerning an individual patient must be made by the responsible physi-cian(s). A great number of guidelines have been issued in recent years by the European Society of Cardiology (ESC) , as well as by other societies and organizations. ESC guidelines represent the official position of the ESC on a given topic and are regularly updated.

ObjectiveTo explore the occupational needs of hand injury patients and the effects of activity-based analysis and occupation-based interventions. MethodsFrom January, 2021 to June, 2022, 212 patients who accepted occupational therapy for wrist-hand injury in Rehabilitation Center of the First Affiliated Hospital of Nanjing Medical University were interviewed using Canadian Occupational Performance Measure (COPM) to collect the activities that they wanted to do, needed to do, were expected to do, but unable to do. Two senior occupational therapists conducted the activity analysis of the summarized needs, identified occupational components, designed a purposeful occupation-based intervention program, and evaluated the performance and satisfaction using COPM. ResultsA cumulative total of 84 occupational needs were proposed, covering five major domains: work, basic activities of daily living, instrumental activities of daily living, leisure and sleep. The activities mostly impaired involved using computer (8.28%), using chopsticks (6.42%), wringing towels (6.25%), travelling on transport (4.90%) and lifting heavy objects (4.73%). The performance and satisfaction improved after treatment (t > 16.572, P < 0.001). ConclusionThe occupational needs are culturally specific for local hand injury patients; the use of an activity-based analysis and occupation-based intervention is effective on meeting the occupational needs.

Objective To develop a new model for predicting recurrence after liver transplantation for hepatocellular carcinoma (HCC) beyond Milan criteria based on related preoperative and postoperative indicators. Methods A retrospective analysis was performed for the clinical data of the patients with HCC beyond Milan criteria who underwent orthotopic liver transplantation for the first time in Tianjin First Central Hospital from August 2014 to July 2018, and according to the presence or absence of recurrence during follow-up, the patients were divided into recurrence group and no-recurrence group. The t -test or the Mann-Whitney U test was used for comparison of continuous data between groups, and the chi-square test or the Fisher's exact test was used for comparison of categorical data between groups. The Kaplan-Meier method was used to plot survival curves, and the log-rank test was used for comparison of survival curves. Univariate and multivariate Cox proportional hazards regression analyses were used to identify the risk factors for recurrence-free survival after surgery. A new model was developed for recurrence after liver transplantation in the patients with HCC beyond Milan criteria based on the risk factors identified. The area under the receiver operating characteristic curve (AUC) was used to evaluate predictive performance, and the Hosmer-Lemeshow test was used to assess the goodness of fit of the model. Results A total of 117 patients with HCC beyond Milan criteria were enrolled in this study, with a median follow-up time of 24 (1-74) months. A total of 53 patients (45.3%) experienced recurrence after surgery, among whom 52 (98.1%) had recurrence within 3 years after surgery, with a median time to recurrence of 6 (1-52) months. The Cox proportional hazards regression analysis showed that preoperative serum alpha-fetoprotein (AFP) >769 ng/mL, neutrophil-lymphocyte ratio (NLR) >3.75, and ki67 index >0.25 were independent risk factors for recurrence-free survival after liver transplantation. The model established based on these three risk factors had an AUC of 0.843, with good sensitivity (88.7%) and specificity (70.3%). The optimal cut-off value was selected according to the maximization of Youden index, and then the patients were divided into low-risk group (0-1 point) and high-risk group (1.5-4 points). The log-rank test showed that the low-risk group had significantly higher 3-and 5-year recurrence-free survival rates than the high-risk group (84.1%/72.0% vs 10.9%/10.9%, χ 2 =29.425, P < 0.001). Conclusion Liver transplantation for HCC beyond Milan criteria should be performed with caution, and the predictive model established based on preoperative AFP, NLR, and ki67 index can accurately assess the indication for liver transplantation in such patients.