Objective To explore the efficacy and safety of transjugular intrahepatic portosystemic shunt (TIPS) in the treatment of hepatorenal syndrome (HRS).Methods From January 2009 to December 2012,the clinical data of three type 1 HRS cases and five type 2 HRS cases received TIPS operation were collected.The volume of 24 h urine,liver and renal function,and the occurrence of complications of portal hypertension were recorded and followed-up.Wilcoxon rank sum test was performed for non-normal distributed measurement data.Results TIPS of all the patients was successful and combined with devascularization in four patients.Before operation,the serum creatinine and volume of urine was 204.0 (180.8,229.8) μmol/L and 810 (600,925) mL,seven days after operation was 160.7 (120.2,184.0) μmol/L and 1 300 (975,1 500) mL,respectively,and the differences were statistically significant (Z=-2.1 and-2.2,both P＜0.05).One month after operation,renal function of five patients recovered to normal.At the 7th day after operation,total bilirubin level of three patients increased and that of two patients decreased to the preoperative base line value at one month and three month.Mild or moderate hepatic encephalopathy occurred in three patients after operation and relieved after medicine treatment.At 6th month after operation,two of three type 1 HRS patients survived.Of five type 2 HRS patients,one received liver transplantation at 6th week after operation,three of the left four cases survived at the 6th month after operation.Conclusion After safety and efficacy were evaluated,TIPS may be one of the methods used for the treatment of HRS.

After the necessity of research on bio-entities was pointed out, the advances and status quo in research on the relation between bio-entities were analyzed with concrete ideas and project put forward for the research on bio-entities using scientometric methods according to thecitationrelation in bio-entities similar to that in litera-ture.This kind of research will promote and perfect the research on scientometric theory and practice, and open a new visual angle for the research on knowledge management .

Objective To explore the work value and its relation with vocational interest types among medical college students.Methods 352 medical college students were investigated by the Work Value Inventory and Medical Vocational Interest Inventory,and the results were analyzed statistically.Results The five highest scores of the work value items were 4.51±0.87,4.34±0.79,4.03±0.90,3.96±0.91,and 3.88±0.55,respectively.Among them,the factor of individual growth and development was the most important follows by the factor of compensation and reward,which had significant differences compared with the factor of social status and reputation included the five lowest scored items(P<0.01,P<0.05).There was no significant difference between male and female,while there were differences among students in various subjects and students with different occupational interest types.Conclusion The factor of individual growth and development is more important than other factors when medical student selecting vocation,and the vocational interest type has effect on the work value.

Objective To examine the positive rate of c-MET gene amplification in primary and lymph node-metastatic non-small cell lung cancer( NSCLC),and to explore their relationships. Methods From November 2011 to November 2013,147 cases of primary NSCLC consisting of 71 cases of paired lymph node-metastatic tumors and 47 cases of normal lung specimens as the control group were collected in General Hospital of Beijing Military Region. The c-MET gene copy number was examined by RT-PCR and the positive rate of c-MET gene amplification among NSCLC population was figured out,thus the consistency of c-MET gene ampli-fication in advanced primary NSCLC and associated lymph node-metastases and the relationship between c-MET gene amplification and clinical data were analyzed. Results The positive rate of c-MET gene amplification on primary tumor was 8. 84% (13 / 147). For those 71 paired cases,the positive rate on primary tumor was 8. 45%(6 / 71),with that of lymph node-metastases 18. 31%(13 / 71). Among the 71 cases,there were 8 cases whose metastases were positive but primary tumors negative and 1 case whose primary tumor was positive but metastases negative. It was of statistical significance between the two groups(McNemar test,χ2 = 4. 274, P = 0. 039). The positive rate of primary tumors could be predicted by lymph node-metastases(κ = 0. 464, P ﹤ 0. 001). The sensitivity was 83. 3% and the specificity was 87. 7% . Positive rate of c-MET amplification was higher in male and smoking patients with lymph node-metastases above N2 . Conclusion c-MET amplifica-tion test should be one of the routine genetic testing projects. The amplification on primary tumors is higher than that on lymph node-metastases,implying that metastases test can pick out more patients with indication. Metas-tases test can predict the amplification on primary focus,and it is an alternative way to guide the treatment of c-MET target medicine. Moreover,the clinical characteristic can be served as an indicator of positive c-MET am-plification.

Objective To evaluate the effect of the radiography in prediction of correction of scoliosis cooperated with clinical treatment.Methods 40 case of adolescent idiopathic scoliosis(AIS) with 45 structural curves were studied,preoperative X-films of standing,supine anterior-posterior and lateral plane,supine anterior-operation in thoracic and fulcrum-bending.Results The mean Cobb angle of pre-operation in thoracic and lumber curves were 43?and 22?,38?and 19?in fulcrum bending,37?and 19?in post-operation.In severe and moderate group the average Cobb angle were 52? and 22? in supine side-bending,49? and 19? in fulcrum bending,45? and 22? in post-operation.Conclusion The fulcrum-bending X-films can offer more information for clinic.

At present, immune checkpoint inhibitors (ICIs) are widely used in clinical, and the common adverse reactions include adverse reactions of skin, gastrointestinal tract, endocrine and liver. Adverse reactions to the lungs and heart are relatively rare, but can be fatal. Systemic steroid therapy is the main treatment for immune related adverse events (irAEs). If there is no response to steroid therapy, an immunomodulator may be considered. Understanding the incidence, pathogenesis, common types and treatment strategies of irAEs can provide theoretical basis for the safe application of ICIs in clinical practice.

Objective To investigate the effects of glutamine(Gln) and epidermal growth factor(EGF) on small intestinal repair in neonatal rats with necrotizing enterocolitis(NEC).Methods Forty neonatal rats of NEC model were divided into 5 groups:group A(control group),group B(NEC model),group C(NEC+Gln),group D(NEC+EGF+Gln).After NEC model of neonatal rats,all the neonatal rats were returned to their mothers.In the 4~(th) day,all the subjects were put to the death.Intestinal tissue located at the boundary of ileum and cecum was obtained to observe histological changes.Morphological changes were measured under a light microscope,and expression of proliferating cell nuclear antigen(PCNA) as an index of cell proliferation was observed using immunohistochemical staining and image analysis,expression of apoptosis was observed by TUNEL staining and image analysis.Results In group B,the histological lesions ranged was different,and was graded 3 score.In group C,D,the histological lesions ranged was graded 1 score.The number of(PCNA) in group B was lower than that in group A(P

Objective To explore the early diagnosis and treatment of Van Wyk-Grumbach syndrome (VWGS). Methods The clinical data of a child with VWGS were retrospectively analyzed. The related literatures were reviewed. Results Nine-year-old female presented with growth retardation and obesity for 3 years, combined with breast development for 6 months and vaginal bleeding for 3 month. The level of free thyroxine (FT4) was 0.46 ng/dL and thyrotropin (TSH)>150 mIU/L. The GnRH stimulation test showed that the gonad axis was not activated. The serum prolactin and estradiol were significantly increased. Bone age was delayed. Color Doppler ultrasound showed enlarged uterus and enlarged ovary, and ovarian cyst was seen. Pituitary MRI showed hyperplasia of the pituitary gland. The patient received the treatment of Euthyrox, and 2 months later, thyroid function was back to normal, ovaries were significantly reduced by reexamine of color doppler ultrasound, body weight was reduced by 6 kg, and there was no vaginal bleeding. Three months later, both ovaries returned to normal size, and pituitary MRI showed hyperplasia of adenohypophysis was improved. After 6 months, both of uterus and ovary were turn to normal size, ovarian cyst disappeared, and pituitary MRI showed normal. Conclusions VWGS is a rare complication of severe primary hypothyroidism untreated for long time and it mainly occurs in adolescent girls. Thyroid replacement therapy is effective.

Objective To evaluate the safety and efficacy of intranasal dexmedetomidine and nitrous oxide/oxygen inhalation sedation assisted in tooth extraction in elderly outpatients.Methods Sixty elderly patients who need tooth extraction were divided into two groups,with 30 patients in each group.The groupⅠwas treated with nitrous oxide/oxygen inhalation sedation,and the groupⅡwas treated with intranasal dexmedetomidine and nitrous oxide/oxygen inhalation sedation.Recording those signs basis val-ue(T0 ),during the injection(T1 ),during the extraction(T2 ),10 min after extraction(T3 ):vital signs,Ramsay sedation score,anxie-ty score,VAS pain score and patients′degree of satisfaction.Results In groupⅡ,patients′degree of satisfaction were significantly higher than groupⅠ(P<0.05)after operation.The VAS pain scores and anxiety scores of groupⅡwere significantly lower than groupⅠ in T1 and T2 (P<0.05).In T2 ,group Ⅱ had lower heart rates (P<0.05).In T2 ,Ramsay score of group Ⅱ was higher than group Ⅰ(P<0.01).Conclusion Intranasal dexmedetomidine and nitrous oxide/oxygen inhalation sedation can be a safe and effective anesthetic method in tooth extraction of elderly patients.

Objective To evaluate clinical feasibility of using a modified bio-material of femoral arterial and bi-caval femoral venous cannulae for children by investigating the blood compatibility and toxicological characteristics of the bio-material of the cannula.Methods The evaluation tests including hemolysis test,skin irritative test were performed in rabbits,and systemic acute toxic test was performed in mice.First,the haemolysis rate of this modified cannula bio-material was calculated by determination of absorptance conducted in vitro;second,the extracts of this material were prepared according to the national evaluation standards of medical bio-materials,and then the extracts were injected subcutaneously in rabbits to observe the histological responses of skin 72h after injection;finally the prepared extracts were injected intravenously into mice to observe the systemic responses 72h after injection.Results Hemolysis test showed that the hemolysis rate of the novel cannula bio-material was 1.58%,which was much lower than the international standard(5%).The blood compatibility of this material was also satisfactory.Primary skin test in rabbits showed no erythema,necrosis or edema in skin.Furthermore,acute systemic toxic test in mice showed no death and no loss of body weight,and no obvious abnormal response was observed 72h after injection.Conclusion The novel bio-material for femoral arterial venous cannulae for children meets the requirements of medical material property,and it can be clinically used.