Carcinoma, Hepatocellular ; surgery ; Hepatectomy ; Humans ; Liver Neoplasms ; surgery ; Neoplasm Recurrence, Local ; surgery ; Reoperation

Resident doctor is the beginning period of a doctor career. Resident standardization training is the basement period for the clinical ability training and is the important part for medical students after graduation education. Vascular ultrasonography belongs to ultrasound medicine and has its own discipline characteristics. The diagnosis accuracy of vascular ultrasonography largely depends on the accumulation of basic knowledge of multiple clinical sciences , standardization of operation techniques and especially the accurate application of hemodynamic theory. According to the discipline characteristics of vascular ultrasonography, we train the residents from the following five aspects: basic theory knowledge, operation techniques, clinic thinking ability, sciences research ability, communica-tion and team work ability. On the basis of practice, we explore the establishment of standardized training mode for medical professionals of vascular ultrasnography in China, training practical, innova-tive and independent talents, to provide reference for improving the professional level of vascular ultra-sound in our country.

The mentorship for young college instructorspolicy is aiming to provide an individual training for the young teachers to improve their teaching skills efficiently. In this article, the advantages for improving the young teachers teaching ability through the fundamental teaching, scientific research quality and clinical practice were briefly discussed.

Objective To establish the prevalence of renal involvement in a large group of patients with type 2 diabetes and evaluate several risk factors of early stages and advanced stages of albuminuria. Methods Five hundred and sixty-six patients(265 males, mean age:57.8?13.3 years, diabetes duration 8.35?6.4 years;301 females, mean age:60.0?12.4 years, diabetes duration 9.9?7.3 years) from the endocrinology unit of Beijing Tongren hospital were included in this study. Urinary albumin excretion rate(UAER),age ,diabetes duration, arterial blood pressure, body mass index(BMI),waist to hip ratio(WHR),fasting blood glucose(FBG),HbA1c,lipid profile were evaluated. Results The prevalence of microalbuminuria, macroalbuminuria was 24.6% and 16.8% respectively. On logistic regression analysis, using the presence or absence of microalbuminuria as dependent variable, arterial blood pressure and, fasting blood glucose were included in the model in both males and females. When analyzing patients with microalbuminuria vs those with macroalbuminuria, in females, arterial blood pressure and triglycerides were included in the model. In males, only blood pressure was included in the mole. Conclusions High fasting blood glucose and arterial blood pressure were independent risk factors of microalbuminuria in type 2 diabetic patients .High arterial blood pressure and disorder in lipid profile were independently associated with macroalbuminuria.

Objective To examine the serum von Willebrand factor (vWF) and soluble Pselectin levels in patients with non-valvular atrial fibrillation (NVAF), and to observe the influence of beta-blocker treatment on endothelial function and platelet activation in NVAF patients. Methods The 25 subjects, 17 males and 8 females, with persistent NVAF and left ventricular ejection fraction (LVEF)≥50%, were enrolled in NVAF group. Those with myocardial infarction, cardiomyopathy or hyperthyroidism were excluded. Another 35 subjects with sinus rhythm were as control (age,gender and LVEF matched with NVAF group, and with similar cardiovascular diseases). Serum vWF and soluble P-selectin levels were tested by enzyme-linked immunosorbent assay. Results The serum vWF level was significantly higher in NVAF group than in control group [(1945.2±111.3) g/L vs. (1862.3±101.6) g/L, P＜0.05]. However, there was no significant difference in serum soluble P-selectin level between NVAF group and control group [(24.32±9.21) g/L vs. (24.68±11.70) g/L, P＞0. 05]. After administration of beta-blocker, a down-regulation was found in serum vWF level [(1758. 3±152. 4) g/L, P＜0. 01], but not in soluble P-selectin level [(21.05±8. 94) g/L, P＞0. 05]. There was no relationship between serum level of vWF and soluble P-selectin (r=-0.008,P＞0. 05). Conclusions High serum level of vWF is found in patients with persistent NVAF as compared with control, indicating endothelial damage/dysfunction in those patients. After administration of beta-blocker, serum level of vWF drops dramatically in NVAF patients, indicating possible endothelial function protection of beta-blocker.

Objective To explore the efficacy, safety,time of drug taking effect and therapeutic dosage of sertraline in treatment of child emotional disorder. Method One hundred and forty-seven patientswith child emotional disorder were treated by sertraline and the efficacy rate, therapeutic dosage, the time of drug taking effect and adverse reaction was analyzed retrospectively. Results One hundred and thirty-seven patients were regular visited under supervision of a physician. Two months after treatment, the efficacy rate was 80.3%(110/137) and the rate of adverse reaction was 5.8%(8/137). The therapeutic dosage of sertraline was (47.9 + 19.0) mg/d. The time of drug taking effect was (20.4±13.2) d. The therapeutic dosage of sertraline in obsessive-compulsive disorder [(58.7±26.2) mg/d] was significantly higher than that in depression[(43.6±14.0) mg/d],anxiety disorder[(44.4±10.6) mg/d] and phobia[(43.5±15.5) mg/d](P < 0.01 ). The time of drug taking effect in depression[( 14.0±6.1 ) d] was significantly shorter than that in obsessive-compulsive disorder[(26.6±16.3) d,anxiety disorder [(22.3±13.9) d] and phobia [(21.4±12.8) d] (P <0.01). Conclusions Sertraline is an efficient and safe medicine in treatment of child emotional disorder. Its adverse reaction is slight and most patients can tolerate. But it takes higher therapeutic dosage in obsessive-compulsive disorder and the time of drug taking effect is earlier in depression than in other disorder.

Objective To analyze the epidemiology of the emergency medical service in Urumqi City in 2011.Methods All patients from 120-Ambulance Center of Urumqi City admitted from January 1,2011 through December 30,2011 were enrolled for prospective study.Descriptive analysis the gender,age,race,underlying diseases,the peak of calling,the time taken by ambulance and so on.Results The 120-Ambulance Center answered overall 53786 callings,the callings of effective answer were 47260,while the ineffective answers were 6526 accounting for 13.8％,and the average number of answer per day was 147.The ratio of male to female was 1.61:1 ; the number of callings from Han nationality was predominant accounting for 68.87％ (37043 callings),and the number of callings from Weiwuer nationality was next to that from Han nationality.The five most common emergency problems were traffic injury,acute cardiovascular diseases,cerebro-vascular diseases,trauma and poisoning.There was no significant difference in monthly number of emergency cases during the 12 months of 2011,and the average monthly number of emergency cases was ranged in 2500-3500.The peak time of answering occurred in 10:00 am-13:00 pm、16:00 pm-18:00 pm、21:00 pm-24:00 pm; the ages of patients were dominant in the population of 20-29 years old、30-39 years old and 70-79 years old.Conclusions We should lay the emphasis on the most common diseases,the peak of answering,and the most vulnerable population,in order to come across with the theoretical and practical evidence to the relevant public health bureau for the improvement of transport mode carried out by 120-Ambulance Center in Urumqi City.

Objective To investigate the value of BISAP scoring system in predicting the severity of acute pancreatitis.Methods Medline,EMBASE,Science Direct,Springer link,CBM,Cnki,Wan fang and VIP database were retrieved by computer between January 2000 and March 2013,and articles of BISAP score system in predicting the acute pancreatitis were collected according to strict inclusion criteria.Quality assessment was made by QUADAS scale.Meta-Disc1.4 software was used to analyze the heterogeneity of included articles and perform quantitative synthesis,as well as calculate the pooled sensitivity and specificity,positive likelihood ratio,negative likelihood ratio,and draw the ROC curve,and the results were presented with 95％ CI.Results A total of 11 articles were included,and there were 7 Chinese articles and 4 English articles.According to QUADAS scale,there were 4 articles of A grade,5 articles of B grade,2 articles of C grade.There were 6 studies using 2 as BISAP cut-off value,and 9 articles using 3 as cut-off value,while 4 studies using 2 cut-off values.Pooled analysis showed diagnostic odds ratio of 8.03 (95 ％ CI 5.66-11.38) when cut-off value was 2,and diagnostic odds ratio of 7.49 (95％ CI 5.35-10.49) when cut-off value was 3.There were moderate heterogeneity in both groups (I2 =63.3 ％,P =0.018; I2 =56.1％,P =0.019).When BISAP cut-off value was 2,the pooled analysis of sensitivity,specificity,positive likelihood ratio,negative likelihood ratio and area under curve (AUC) were 59％ (95％ CI56％-63％),82％ (95％ CI 80％-83％),3.50 (95％ CI2.96-4.14),0.45 (95％ CI0.36-0.56) and0.82; and when BISAP cut-off value was 3,the corresponding values were 44％ (95％ CI41％-47％),90％ (95％ CI 89％-91％),4.59 (95％ CI 3.31-6.37),0.64 (95％ CI 0.61-0.68) and 0.64.The former had a high sensitivity,low specificity and large AUC,while the latter had a low sensitivity,high specificity and small AUC.Conclusions The best cut-off value of BISAP in predicting SAP is 2.When cut-off value is 2,the misdiagnosis rate is low,and the false positive rate is in the acceptable range,which is suitable for clinical application.

Objectives:To observe the effect of rhGH in the treatment of chronic wasting diseases. Methods:Twenty two cases of chronic wasting diseases needing nutrition support were chosen,including 10 cases of COPD,12 cases of cerebral infarction or cerebral hemorrhage with decubital ulcer in recovery phase.They were in the age of 60～75,in combination with morderate malnutrition.These patients were divided into control group and experimental group.In the experimental group,rhGH(4.5 U/d) was given hypodermically for 10 days.Serum albumin,prealbumin,transferin,24 h urea nitrogen in urine,the surface area of decubital ulcer and mental state were monitored before and after the treatment. Results:In the experimental group,many nutritional indices were increased markedly,24 h urea nitrogen excretion was decreased,the healing of decubitus was faster and mental state was better when compared with control group. Conclusions:The rhGH plays an important role in improving the nutritional status and mental state in patients with chronic wasting diseases. On the base of supplying enough nutrients, rhGH can promote anabolism,reduce the excretion of urea nitrogen in urine, accelerate the healing of decubital ulcer and improve the prognosis.

Doctor-patient trust is the core and foundation of harmonious doctor-patient relationship, because our country is at the stage of social transformation and deepening medical reform, various problems make the doctor-patient relationship unoptimistic, and there appeared crisis of confidence between doctors and patients. This arti-cle analyzes the current situation of doctor -patient trust in our country, based on the clarification of doctor -patient trust. It also comb the researches focused on doctor-patient trust evaluation on the basis of domestic and foreign literature. It is expected to provide a reference to the future evaluation of doctor-patient trust, to improve the level of trust between doctors and patients, and to build a harmonious doctor-patient relationship.