Objective To study the value of helical multi-phase contrast scanning in the preoperative evaluation of cholangiocarcinoma hilar.Methods Pre-and post-contrast CT scanning of upper abdomen were performed in 26 cases with hepatic portal cholangiocarcinoma.Arterial phase scan of the whole liver began at 30 s after initial injection of contrast medium and the portal venous phase scan started at 70 s.15 of 26 cases underwent additional delayed phase scans began at 3~4 min.Thin thickness(3~5 mm)scanning of hepatic portal was used in each post-contrast phase scanning.The location,size,enhancement patterns of the lesions and the extent of the tumor involvement were observed and surgical resecetability was evaluated.Results All of 26 lesions were detected in helical multi-phase contrast scanning. 16 lesions enhanced on the arterial phase. On the portal venous phase, all lesions were enhanced and marked enhancement was seen in 19 lesions. Prolonged enhancement was seen in 15 lesions on the delayed phase scanning. The accuracy of evaluating surgical respectability was 84.62%. Conclusion Multi-phase contrast scanning combined with thin thickness scanning can demonstrate obviously the location and enhanced patterns of hepatic portal cholangiocarcinoma, the accuracy in evaluating surgical respectability is improved, and it is helpful in choosing the preoperative treatment program and assessing the prognosis.

OBJECTIVE To improve efficiency and quality of antibiotic drug usage in order to assure patients′ security of antibiotic drug usage. METHODS Inducted by strengthening security quality of medical treatment,we are bring antibiotic drug usage into medical quality management by using information technique,training medical workers,putting antibiotic drug into different classifications and surveillancing the usage of antibiotic drug.Moreover,we develop significant basic study for clinic to improve the level of rational use of drug. RESULTS Frequency and number of days for drug usage were reduced by putting measures into effect and inspecting numbers and sorts of drug usage.At the same time,we instituted individualized drug using scheme to critical patients,thereby many critical patients were retrieved. CONCLUSIONS Rational use of drug is a system project which must redeploy all enthusiasm and take comprehensive measures to fight for a safe,effective,economical goal in our work.

Objective To investigate the relationship between electrolyte level change with prognosis in the patients with craniocerebral injury.Methods A total of 360 patients with craniocerebral injury in this hospital during 2012-2015 were selected as the research subjects and divided into the mild craniocerebral injury group (171 cases),moderate craniocerebral injury group(104 cases)and severe craniocerebral injury group(85 cases) according to the Glasgow coma scale.The severe craniocerebral injury group was further divided into the high level blood sodium subgroup(73 cases)and stable level blood sodium subgroup(12 cases)according to the lev-el of blood sodium,meanwhile 70 persons undergoing healthy physical examination were selected as the control group.The plasma electrolyte levels(blood sodium,potassium,chloride)in each group were detected within 5 d after admission.Then the results were statistically analyzed.Results Compared with the control group,the blood sodium,potassium and chloride levels had no statistical difference between the mild and moderate craniocerebral injury groups(P>0.05).The blood sodium and chloride levels in the severe craniocerebral inju-ry group were higher than those in the mild and moderate craniocerebral injury groups,the difference was sta-tistically significant(P<0.01).The blood potassium level had no statistical difference between the mild,mod-erate and severe craniocerebral injury groups with control group(P>0.05).In the severe craniocerebral injury group,there were 58 cases(79.45%)of death in the high level blood sodium subgroup and 4 cases(33.33%) of death in the stable level blood sodium subgroup,the difference was statistically significant(P<0.01).Con-clusion Clinically monitoring the blood sodium level change in the patients with craniocerebral injury,espe-cially severe craniocerebral injury,is conducive to the disease recovery.