Objective To describe the MR imaging features and pathologic findings of hepatic angiomyolipoma (HAML), and to evaluate the utility of MR imaging in diagnosis of this tumor. Methods The MR imaging features of eight patients with HAMLs confirmed pathologically were analyzed retrospectively and correlated with pathologic findings. Results Eight patients had a solitary hepatic mass, five (mixed type HAML) of which were diagnosed correctly, and two (1 myomatous type HAML and 1 angiomatous type HAML) of which were diagnosed as hepatic adenoma and focal nodular hyperplasia, and one (mixed type HAML) with hemorrhage and multiple cystic change was mistaken for malignant tumor. Six cases of mixed type HAML exhibited heterogeneously high signal intensity on T 1 and T 2WI. The high signal intensity on T 1WI in five cases disappeared completely after using fat saturation, and most part of the high signal intensity in one case disappeared and some of the high signal intensity remained unchanged after using fat saturation, and multiple cystic change within this mass was detected. One myomatous type HAML and one angiomatous type HAML showed hypointensity on T 1WI and hyperintensity on T 2WI. Multiphase dynamic Gd DTPA enhanced MR scanning was performed in six patients and all those masses showed strong enhancement during arterial phase, and four of which showed moderate enhancement and two slight enhancement during portal venous and delayed phase. Pseudocapsule detected in five cases showed slight enhancement on portal venous and (or) delayed phase. Conclusion MR imaging can reveal the characteristic findings of mixed type HAML and accurate preoperative diagnosis can be made.

To disscus the characteristics of leukorrhea treatment of the four great famous doctors in Jin-Yuan Danasty, including the recognition of etiopathogenisis and pathogenesis, the view of determination of treatment based on differentiation of symptoms and signs, therapeutical principle and medication. LIU Wan-su believed fireheat was the important factor leading to illness. He firstly advocated differentiating symptoms and signs of leukorrhea with heat and treating it by clearing away heat evil and eliminating damp. ZHANG Zi-he considered the leukorrhea due to humid-heat flowing down to small intestine. He advocated lowing heart fire and tonifying kidney yin as the therapeutical method of leukorrhea with emetic and purgation method. LI Dong-yuan considered the injury of qi of the spleen and stomach was the main factor, so he diagnosed and treated leukorrhea on basis of the spleen and stomach. ZHU Dan-xi deemed leukorrhea happened when damp and sputum obstructed the spleen, so he thought that deprived the evil wetness was the fi rst and important method of treating leukorrhea.

Objective:To discuss the application of water-aided colonoscopy in the enteroscopy, and compare with traditional air insufflations colonoscopy so as to analyze the efficacy and safety of clinical enteroscopy.Methods: 248 patients accepted with non-anesthesia colonoscopy were enrolled in this study and they were divided into two groups (water-aided group,n=124, air insufflations group,n=124) as the random number table. All clinical data of two groups were collected, and the bowel preparation statuses of patients was evaluated when the colonoscopes were taken out. During detection, the success rate of intubation, the entrance time of colonoscope, the withdrawal time of colonoscope and the total time of examinations were recorded. After detection, the pains score of patients were recorded and evaluated, and a series of auxiliary operation in the process, such as the change of body position, abdominal compression and the adjustment for hardness were recorded. Results: The differences of bowel preparation status scores of left colon, transverse colon, right colon and the whole colon between two groups were not statistically significant(t=0.98,t=0.85,t=1.07,t=1.51;P>0.05). The difference of success rate of intubation between two groups was no significant(x2=0.73,P>0.05). The entrance time, the withdrawal time of colonoscope and the total time of intubation of water-aided group were significantly higher than these of air insufflations group, while the VAS of water-aided group was significantly lower than that of air insufflations group(t=5.78,t=3.85,t=5.64, t=10.25;P<0.05). Besides, there were no significant differences in the usage rates of abdominal compression, hardness adjustment and total usage rate of auxiliary operation between two groups(t=0.92,t=1.58, t=2.07;P>0.05).Conclusion: The water-aided colonoscopy can relieve pain of patients, and it doesn't affect the success rate of intubation for cecum.

Objective:To analyze the clinical efficacy of POEM treating patient with achalasia of cardia and observe the risk factor of effecting curative efficacy.Methods: 66 patients with achalasia of cardia who were treated by using POEM were enrolled in this study, and series of indicators of esophagus dynamics including LESRP, LESP, LESRR and LESL were detected in pre and post operation. Clinical symptom score system(Eckardt score) of achalasia of cardia was adopted to evaluate the effect of surgical treatment for patients at the pre and post operation 7d, and the diameter of widest part of esophagus at pre and post operation 7d were detected. The incidence rate of pneumoderm, substernal ache, pulmonary infection, pleural effusion, tunnel bleeding, postoperative reflux and esophageal perforation and other complications were analyzed and the relative risk factors of effecting curative effect were observed.Results: The LESRP and LESP of patients with achalasia of cardia of post-operative 7d were significantly lower than that of pre-operative 7d(t=12.74,t=17.56,P<0.05), while the LESRR and LESL of post operative 7d were significantly higher than that of pre-operative 7d(t=9.10,t=14.86,P<0.05) , respectively. And the Eckardt score and widest diameter of post-operative 7d were significantly lower than that of pre-operation(t=19.49, t=7.83,P<0.05), respectively. Besides, the incidence rate of complication of patients in post-operation was 48.48％. As the results of Logistic regression, age, Chicago type and Ling type were the risk factors that affect curative effect of POEM for achalasia of chardia. And as the analysis, the prognosis was better when the patient's age was less than 60 years, Chicago II type and Ling type.Conclusion: POEM can significantly improve the indicators of esophagus dynamics, and the complication will be few and the curative effect will be exact in middle and short term of post-operation by using this method. Therefore, it is a safe and effective surgical mode.

Objective To study the relationship between the functional gastrointestinal disease of children and food allergies,and recent prognosis.Methods 108 children with functional gastrointestinal disease were selected as the observation group,at the same time 36 healthy cases were selected as control group.ELISA was used to detect IgG antibody concentration and total IgE level in ten kinds of allergy food.The different methods were used to guide the patients' diet,the improved quality were oberseved in the two groups after 3 ～6 months.Results In the observation group 108 cases of children with functional gastrointestinal disease,1 ～ 10 kinds of inequality of food allergen specific IgG children have increased in 90 cases,accounting for 83.3％,whereas the control group had 9 cases,only accounting for 25.0％ (x2 =20.87,P ＜ 0.05).In the observation group,the foods with highest sensitivity were milk,egg white/yellow,respectively for 84 patients (77.8％) and 60 cases (55.6％).Serum total IgE level between the observation group and control group had no significant difference (P ＞ 0.05).17 cases (15.7％) within one month,the symptoms were improved,13 cases (12.1％) in three months,the symptoms were improved,the symptoms of 21 cases (19.4％) were not improved after 3 months.The total effective rate was 80.6％.Conclusions Children with functional gastrointestinal decease is easily to occur allergy caused by different food,and IgG antibody level can correctly reflect the relationship between them,reasonable diet can improve the symptoms of functional gastrointestinal disease.

Objective To observe the expression of cytotoxicity and receptors on NK cells in breast cancer,and investigate the impact of soluble MICA(sohble MHC class Ⅰ-related molecules A,sMICA) on NK cells receptors expression and cytotoxicity.Methods ELISA was used to examine the sMICA in peripheral blood.The expressions of activated receptor(NKG2D),killer inhibitory receptor (KIR)(CD158b) and NK cells were identified by flow cytometry(FCM).Cytotoxicity of NK cells to breast cancer were tested by MTT.Results sMICA was (205.36±71.27)ng/L in breast cancer patients and 81.6 % samples were detected.There were positive correlations between sMICA levels with breast cancer stages.There were no difference of NK cells percentage between breast cancer and healthy person.The cytotoxicity of NK cells and expressions of NKG2D were obviously lower in breast cancer with sMICA(+) than in healthy person,but CD158b was higher in healthy person.After cultured with sMICA,NK cells cytotoxicity decreased from(76.2±6.7)% to(48.4±4.1)% and the expression of NKG2D reduced from(92.5±7.1)% to (62.5±6.4)%,but the the expression of CD158b increased from(10.6±3.2)% to (43.6±3.4)%.IL-15 up regulated the expression of NKG2D and NK cells cytotoxicity,but decreased the expression of CD158b by co-culturation with IL-15 and sMICA in sMICA+ patients with breast cancer.Conclusion sMICA reduced the expression of NKG2D and increased the expression of Kill,which lead to the down regulation of NK cells cytotoxicity.IL-15 can reverse this effect.

Objective To evaluate the theoretical knowledge level of Chinese nursing students based on the problem-based learning(PBL)versus traditional teaching methods. Methods Databases including CNKI (1979-2013.03),VIP (1989-2013.03)and Wanfang (1982-2013.03)were searched (up to March,2013)for controlled studies comparing PBL and traditional teaching methods. The quality of included studies was critically evaluated and the data were analyzed by Stata 10.0 software. Results A total of 659 articles were retrieved but only 22 were included. Meta-analyses showed that there were significant differences between PBL and traditional teaching methods in improving theoreti-cal knowledge of nursing students(SMD merge=0.79,95%CI(0.55,1.03),P=0.000). Conclusions PBL can improve the theoretical scores of Chinese nursing students. However,the above conclusion needs to be confirmed by more large-scale randomized controlled trials of higher quality due to the limitation of studies include in this paper.

Objective To construct the tranfected cell expressing the human CXCR4 gene and to identify the effect on its immigration. Methods Total RNA was isolated from peripheral blood monouclear cell (PBMC),the full-length CXCR4 gene was amplified by RT-PCR and was inserted into plasmids PBudCE4.1 which have two promtors, after the identification by digestion and sequencing,the recombinant was transfected into K562 cell by lipofectamineTM2000. After screening culture by zeocin, stable transfected K562 cell line was established, and transcription and exression of CXCR4 were checked by flow cytometry; the chemotactic activity of K562 cell transfected and untrandfected CXCR4 was analyzed by Transell plate. Results The eukaryotic expression plasmid PBudCE4.1/ CXCR4 was constructed successfully. The stable trasfected K562/CXCR4 cell lines which highly express CXCR4 was established,the chemotactic activity of K562/CXCR4 was increased significiantly than K562. ConclusionCXCR4 transfected K562 cell line was successfully established, and it can make the basis for the further research on mechanism of extramedullary infiltration in leukemia.

Objective To study the efficacy of chemotherapy combined with immunotherapy in treatment of middle and advanced stage non-small cell lung cancer and improvement of patients'life quality.Methods 140 patients with middle and advanced stage non-small cell lung cancer treated from Mar .2012 to Mar.2014 were in-cluded and they were randomly divided into two groups:the observation group(70 cases)and the control group(70 cases).The observation group took chemotherapy combined with immunotherapy , while the control group took chemotherapy treatment alone .Patients'life quality , treatment effects and changes in immune indexes were co-mared between the two groups .Results The improvement rate of life quality of the observation group (90.0%) was significantly higher than that of the control group (58.6%), and the difference had satistical significance (P<0.05).The response rate of the observation group (88.6%) was significantly higher than that of the control group(70.0%), and the difference had statistical significance (P<0.05).The increasement rate of CD3 +, CD4 +, CD8 +cells, as well as CD4 +/CD8 +cells was significantly higher in the observation group than in the control group, and the difference had statistical significance (P<0.05).Conclusion Chemotherapy combined with immunotherapy in teatment of patients with middle and advanced non-small cell lung cancer has obvious effect, high safety, and high clinical value .

The earthquake always results in a great number of the injured and disabled patients.So timely and effective psychological rehabilitation interventions are very helpful,especially for those survivors to relieve their psychological traumatic response caused by the earthquake,and renew their healthy psychological situation.The present article analyzes the chief psychological symptoms and influencing factors of the injured and disabled patients after the earthquake,and further provides some principles and strategies for the psychological rehabilitation,such as how to cope with the early stress response(anxiety,depression,self-abasement,and so on),or how to deal with the social phobia.