Objective To evaluate and analyse the prognostic factors of cerebral glioma treated with radiotherapy. Methods Records of 162 patients with cerebral glioma. Cox model was used for univariate and multivariate analysis. Results Mean follow- up time was 30 months, 14 patients relapsed, and 45 patients died. Univariate analysis showed that histologic grade, histologic type, Karnofsky performance state before radiotherapy, extent of resection, and age were significant predictors in association with overall survival rate of patients with glioma. Multivariate analysis showed that histologic grade, histologic type, age, Kamofsky before radiotherapy, extent of resection,and radiotherapy technology were independent prognostic factors of glioma. Conclusion Low grade, AC and OD, age≤40 years, Kamofsky >80 before radiotherapy, and total resection axe independent factors for predicting better survival of glioma patients.

Objective To explore the clinical application value of the serum GP73 detection in the diagnosis of hepatocellular car-cinoma(HCC).Methods The expression level of serum GP73 protein was quantitatively detected by ELISA,including 52 cases of healthy individuals,45 cases of non-hepatic disease,43 cases of viral hepatitis B,20 cases of liver cirrhosis and 30 cases of HCC;The levels of GP73 were compared among the 5 groups.Serum a-fetoprotein(AFP)level in the HCC patients was detected by electro-chemilumnescence(ECL)method.The area of receiver operating curve(ROC),sensitivity and specificity of GP73 and AFP for diag-nosing HCC were calculated.Results The serum level of GP73 was (58.57 ± 35.64)ng/mL in the non-hepatic disease group, (70.36±49.88)ng/mL in the viral hepatitis B group,(114.47±51.27)ng/mL in the liver cirrhosis group and (251.37±95.6)ng/mL in the HCC group,which in the patients was significantly higher than(34.03±15.20)ng/mL in the healthy control group,the differences had statistical significance(P <0.05);The serum GP73 level in the HCC group was significantly higher than that in the other groups with statistical difference(P <0.01);The positive detection rate of serum GP73 in the HCC group was 76.7%,which was significantly higher than 3.12% in the non-HCC group,the difference had statistical significance(χ2 =108,P <0.05);The sen-sitivity and specificity of GP73 for diagnosing HCC were 75.1% and 94.9% respectively,which were significantly higher than those of the AFP(52.3% and 86.6%).Conclusion GP73 could be to become a better serum marker for diagnosing HCC.

Recently the cases that doctors or hospitals show indifferently or unconcerned towards patients in mortal danger occur repeatedly,which can not be contained simply by moral condemnation and restraint.Considering its social hazards and correlated ancient and modern legislations,it is a direct and effective way to criminalize this immoral behavior.However,doctors' or hospitals' indifference towards patients in mortal danger is not an isolated issue,but closely correlated with other social contradictions and conflicts.Therefore,a fine social assistance system of medical service is still in great need so as to comprehensively solve this problem.

Objective To explore operation method,key technique and clinical therapeutic effect of laparoscopy assisted vaginal hysterectomy. Methods Retrospective analysis was conducted on operation method and post operative clinical data of SO cases had LAVH ( LAVH group) , 60 cases had total abdominal hysterectomy (TAH group) and 60 cases had transvaginal hysterectomy ( TVH group), treated from October 2009 to December 2010. Results The blood loss during operation,time to first flatus,incidence of postoperative pyrexia,hospitalization day,time of getting out of bed in LAVH group were (101. 6±6. 2)ml, (22. 9±6. 1 ) min,2% ,0,(5.0 ±1.5)d,(25. 1±5.3)h; the 7 indices in TAH group were (174.0 ±6.9)ml,(35.3±4.3) min,10%,3.3%,(8.5±1.6)d,(56.4±.6.1)h; and the 7 indices in the TVH group were (189.0±8.2) ml, (26.0±8.2)min,6.7%,1.7%,(7.8±3.5)d,(49.4±3. 8) h. The numbers in LAVH group were all lower than those in TAH group and TVH group ( Ps < 0. 05 ). Conclusion LAVH has advantages of less operation blood loss,less injury to body and sooner recovery,less complications compared with TAH and TVH. This is a safe and effective operation type,which is worth of popularizing.

Objective To study the correlation between serum hepatocyte growth factor and Urinary viable tubular cells count in patients with acute renal failure and to evaluate the clinical significance.Methods Serum HGF levels were determined by ELISA and the number of viable tubular cells in urine was determined by trypan blue in 25 patients with ARF at the stages of oliguria,polyuria and convalescence.The relationship between serum HGF levels,the number of viable tubular cell and renal function was studied.Results Compared with the 9th day from the occurrence of ARF,the HGF levels in the serum increased significantly at the 1th day in the ARF patients.There was significant positive correlation between BUN or SCr and the serum HGF in urine in patients with acute renal failure.Conclusion Serum HGF in ARF patients increased significantly and tended to rise at first but dropped afterwards,which reflected the course of renal injury and the recovery of renal epithelial cells.The detected viable tubular cells in urine were an early predictive indication of renal function recovering in ARF patients.

Pulmonary embolism(PE)is a relatively common cardiovascular emergency.Haemodynamic instability is the characteristics of massive pulmonary embolism,with a mortality as high as 20%.The goals of PE treatment are to remove the thromboembolic obstruction rapidly,exert beneficial effects on haemodynamic parameters and save the lives of patients.Haemodynamic and respiratory support is of vital importance in some critically ill patients with PE.The basic treatment is anticoagulation,the methods of which are different for PE during pregnancy,among cancer patients,with right heart thrombi and with heparin-induced thrombocytopenia.

OBJECTIVE To investigate drug resistance status of Klebsiella pneumoniae and offer scientific basis for reasonable usage of antibiotics. METHODS Drug resistance was analyzed by using K-B method.The(ESBLs) producing strains detected by disc confirmed test. RESULTS The frequency of(ESBLs)-producing K.pneumoniae isolates was 25.8% in our hospital.All of the 128 strains were susceptible to imipenem.And the resistant rates to ciprofloxacin and amikacin were about 10.9%,the resistant rate to other 6 antibiotics were all above 40%. CONCLUSIONS It is important to supervise drug resistance of clinical isolates in hospital and we should try our best to prevent nosocomial outbreak and surveillance.

Objective To identify the possible risk factors for esophageal delayed bleeding after endoscopic submucosal dissection ( ESD ) of early esophageal carcinoma and precancerous lesions. Methods Data of 281 patients with early esophageal carcinoma and precancerous lesions treated by ESD were reviewed. Risk factors for esophageal delayed bleeding were investigated by univariate analysis and logistic multivariable regression analysis. Results Esophageal delayed bleeding occurred in 22 patients ( 7. 83%) . Univariate analysis showed there was significant difference between delayed bleeding group and non?delayed bleeding group in regard of age ( P=0. 046 ) , lesion size ( P=0. 013 ) , and lesion infiltration depth( P<0. 001 ) . Together with three factors above, the intraoperative bleeding ( P=0. 068 ) was also analyzed by Logistic multivariable regression analysis which showed only infiltration depth was the independent risk factor of early esophageal carcinoma and precancerous lesions treated by ESD( P=0. 002, OR=6. 88,95%CI:1. 07?39. 28) . Conclusion Patients older than 60 years and diameters more than 3 cm might be prone to delayed bleeding, but the direct factor is infiltration depth. The deeper lesions infiltrate, the delayed bleeding is more likely to occur.

Objective To evaluate the relationship between relative perfusion rate assessed with power Doppler imaging (PDI) and microvessel density (MVD), as well as expression of vascular endothelial growth factor (VEGF) in bladder carcinoma. Methods The transrectal ultrasound (TRUS) blood flow signal of bladder carcinoma was preoperatively detected with color Doppler imaging in 45 patients, and the relative perfusion rates were obtained for analysis. MVD and the expression of VEGF of excised tumor were assessed immunohistochemically. Results There were correlation between relative perfusion rate and MVD, the expression of VEGF. MVD and the expression of VEGF were related to pathologic grade and the invasiveness of tumor tissues. The expression of VEGF in bladder carcinoma was positively correlated to the tumor interstitial vascular density. Conclusion Combination of PDI and immunohistochemical parameters is useful for evaluating the angiogensis of bladder carcinoma from a different point of view.

Gliomas is the primary intracraniai tumors.It is mainly principle that treatment with surgery followed a comprehensive treatment.As the growth of glioma infiltrating,difficult surgical resection of all clean and easy to relapse,so post-operative adjuvant radiation therapy occupie an important position.In order to explore for brain glioma effect,mainly on the gliomas means of the status and progres with various radiation therapy and radiotherapy combined with chemotherapy.