Portal vein tumor thrombus (PVTT) influence the prognosis of hepatocellular carcinoma.The development of PVTT is a multi-factor,multi-part process.According to anatomic features of the portal vein in the liver and tumor thrombus of HCC developing modes,a uniform tumor thrombus types system (typesⅠ -Ⅳ) is recommended.Multi-modal therapy based on surgery,interventional therapy and radiotherapy can improve the curative effect enormously.

Acetazolamide, a sulfonamide-derived medication, is frequently used in the treatment of various types of glaucoma. But this kind of medicine is associated with acute angle closure glaucoma. This paper is a review for the researches of this rare adverse reaction at internal and abroad. It can prompt more ophthalmologists to understand and pay attention to this rare adverse reaction of acetazolamide and sulfonamides derived drugs. Then the doctor will make accurate diagnosis, timely treatment and grasp the right operation opportunity and reduce the occurrence of postoperative complications ultimately.

Mind map is a kind of thinking tool, which draws the mind′s thoughts through words and pictures and can be applied instudy,life and work.Through biblio-metrological analysis, this study finds that domestic application of mind map in nursing focuses on fields such as nursing teaching, clinical nursing management and health education. The study and application of mind map in domestic nursing field are only in the beginning and exploration stage, lacking experimentation and evaluation study under the guidance of scientific methods, both the depth and breadth of research are yet to be improved.

Objective To reveal the change tendency of serum osteopontin(OPN) in carcinogenesis and development of gastric cancer(GC), and explore the usefulness of serum OPN in the diagnosis of GC and the differential diagnosis of early GC and advanced GC.Method Serum OPN levels were detected by enzyme-linked immunosorbent assay, including 70 advanced GC, 24 early GC, 47 dysplasia, 42 intestinal metaplasia, 46 chronic superficial gastritis patients and 38 normal controls.Results Serum OPN level in GC group (57.03 ng/ml) was significantly higher than those in other groups.Serum OPN level in advanced GC group (66.05 ng/ml) was significantly higher than that in early GC group (41.93 ng/ml), serum OPN level in early GC group was significantly higher than those in dysplasia, intestinal metaplasia and chronic superficial gastritis, and serum OPN level in the latter three groups was significantly lower than that in normal controls (P

Objective To evaluate the clinical effect and safety of umbilical cord ligation in the fetocide of complicated monochorionic multiple gestations.Methods From January 2009 to December 2012,clinical data of 18 women with complicated monochorionic multiple gestations who experienced intrauterine percutaneous umbilical cord ligation in Peking University Third Hospital were collected.Among the patients,6 were selective intrauterine growth restriction (1 with type Ⅰ,4 with type Ⅱ,1 with type Ⅲ) ; 4 were acrania or hydropic twins; 4 were aeardiac twins,2 were complicated triplet gestation; 1 was twin-twin transfusion syndrome with right ventricular dysplasia and 1 was monochorionic diamniotic (MCDA) with caesarean section history.The procedure was performed under both endoscopic and sonographic guidance.The gestational age at the time of the procedure were 17-27 +6 weeks.The procedure and perinatal outcome were analyzed.Results (1) The procedure was performed successfully in all the 18 cases.The average duration of the procedure was 63 min (24-156 min).The blood loss was 7.6 ml (5-20 ml).The mean gestational age at the time of the procedure was 20 weeks (17-27 +6 weeks).The average birth weight of the neonates was 2441 g(1000-3400 g).(2) There were 20 fetuses survived.Two fetuses had cardiac anomalies and were terminated in the following 2-3 weeks.Intrauterus fetal demise occured in 3 twin reverse arterial perfusion syndrome (TRAP) cases 3-14 weeks after the procedure.1 case delivered as early preterm birth at 28 weeks and the neonate died of respiratory distress syndrome (RDS) and hypoxie-ischemicencephalopathy (HIE).Fourteen neonates were in healthy and normal development by 3-51 months' followup.(3) Fourteen cases delivered at more than 28 weeks (28-38 weeks,averagely 33 + 1 weeks).The gestational weeks were prolonged by 5-21 weeks (averagely 13 +4 weeks).Among them,3 case were early preterm birth (28-33 weeks) and 3 were late preterm birth (34-36 weeks).Conclusion Percutaneous umbilical cord ligation is a reliable technique for the fetocide of complicated monochrionic mutilple gestations,especially for monochronic monoamniotie pregnancies.

Objective In order to further improve the noninvasive measurement precision of human blood glucose and achieve clinical requirements,experiments were conducted to measure human blood glucose by a novel measurement method our group proposed.Methods The blood flow of the tested parts was stopped by pressure,and dynamic distribution of transmission spectra was measured by time-correlated single-photon counting (TCSPC) technology under the dual wavelength light incident.Oral glucose tolerance test (OGTT) was conducted on three human subjects,and the early arriving photons were selected by Laplace transform.Meanwhile,the human blood glucose concentration was measured using the Roche glucose meter.Results The best curve fitting was got when the Laplace parameter was 1Gs-1 (determining parameter R2=0.0922).Conclusions The experimental results showed that better measurement accuracy can be obtained by selecting appropriate Laplace parameter,and noninvasive measurement of human blood glucose under flow control of time gate was feasible.

0.05).Amplitudes of OPs and b wave were significantly decreased after experiment in STZinduced diabetic group(P

AIM:To analyze the accuracy and the influencing factors of LAMBDA100 retinometer in predicting the visual acuity of cataract patients with high axial myopia after phacoemulsification.METHODS: The retinal visual acuity was measured in 91 patients with 91 cataract eyes by LAMBDA100, and compared with the best corrected visual acuity 2wk after operations.If differences of predictive visual acuity and postoperative visual acuity between the two logarithmic visual acuity chart was within 2 lines, it was considered consistent.RESULTS: The total compliance rate was 62%, the false positive rate was 2%,the false negative rate was 36%.The predictive accuracy was affected by lens opacity, the deeper opacity, the lower accuracy.The predictive accuracy of eye with axial length ≥32mm was significantly lower than that of eye with axial length <32mm, the difference was statistically significant (P<0.05).The predictive accuracy rate of group that preoperative best corrected visual acuity was ≥4.0 was 75%;the predictive accuracy rate of group that preoperative best corrected visual acuity was <4.0 was 49%, the difference was statistically significant (P<0.05).CONCLUSION: LAMBDA100 can be used as an assistant tool for predicting postoperative visual acuity in immature stage cataract of patients with high myopia.The eye axial length, the degree of visual acuity and lens opacity can influence the predicting accuracy.

Objective To investigate the clinical and pathological features of anorectal malignant melanoma ( AMM) .Methods The clinical pathological and follow-up data of 7 cases of anorectal malignant melanoma were collected.The clinical and histopathological features and immunophenotype were analyzed .Results Among the 7 cases, 5 cases were female, 2 cases were male, aged 50-68 years, the average was 61 years.The tumors located in the lower rectum in 1 cases, 2 cases of teeth near the line , 4 cases of anal anus .The structure and morphology of the cancer cells were diverse .The organizational structures were mainly diffuse , focal and acinar .The cellular morphologies were mainly epithelioid , spindle and lymphocyte like .And the results of IHC showed the expression of the following three markers, vimentin, S-100 and HMB45, were strongly positive in cancer cells.However, the expression of CK , EMA and LCA were negative .And 2 cases of CEA expression were positive , LI Ki-67 was 20%-50%.Conclusions Anorectal malignant melanoma is one kind of rare malignant tumor and its characteristic morphology , immunophenotype could be helpful for diagnosis and differential diagnosis .

Objective To analyze clinical characteristics of patients with gastrointestinal bleeding (GIB)and the death-related risk factors.Methods A retrospective analysis Was conducted in 414 patients hospitalized for GIB during a 16-year period of 1994 to 2009.Logistic regression analysis identified predictors of mortality.Results The mean age of the 414 patients is 83.5 years old,ranging from 65 to 96years old.The main causes of GIB were peptic ulcer(33.1%,137/414),gastroduodenal mucosal erosion (28.5%,118/414)and tumor(21.0%,87/414).The main symptom was melena(71.0%,294/414).Drugs that induced GIB were mainly non-steroidal anti-inflammatory drugs,including aspirin(11.1%,46/414),acetaminophen(8.9%,37/414)and indomethacin(1.9%,8/414).14%of patients(58/414) died of GIB in 30 days.The proportion of drug-induced GIB and gastroduodenal mucosal erosion caused GIB had increased significantly during the period of 2004 to 2009(P<0.05).Analysis of 30-day mortality risk showed advanced age,low diastolic blood pressure,high heart rate,low hemoglobin levels at presentation and hemorrhage volume in dead GIB elderly patients were significantly different compared with GIB elderly patients alive.Presence of severe comorbidity(heart failure and renal failure)and caused by cirrhosis and portal hypertension in GIB elderly patients were the only independent predictors of 30-day mortality (P<0.001).Conclusion Death of GIB patients occurred predominantly in elderly patients with severe comorbidities and systemic conditions at presentation.