Objective To explore the diagnosis value of ilneven inside sign in small hepatocellular carcinoma.Methods Uhrasonography was performed on 100 echogenic areas in livers.to view uneven inside sign in them.And to compare with the clinicopathological characteristics.Results Around all the echogenie areas,there were 90with the uneven inside sign.85 echogenic areas were small hepatocellular carcinoma.There were 10 without the Lineven inside sign.4 echogenic areas were hepatocellular carcinoma.Conclusion The uneven inside sign has high value in diagnosis of small hepatocellular carcinoma.

Objective To observe the effects of ganoderma lucidum polysaccharide(GLP) on intestine mucosal barrier function and tumor necrosis factor-α(TNF-α)in hemorrhagic shock rabbits. Methods Thirty healthy Japanese white rabbits were divided into three groups by random number table:sham operation group, resuscitation/reperfusion with normal saline(NS)group(NS group)and resuscitation/reperfusion with GLP group (GLP group). The hemorrhagic shock models were reproduced by being bled from the femoral artery to the mean arterial pressure(MAP)of 30-40 mmHg(1 mmHg=0.133 kPa)within 10 minutes and kept maintaining at this MAP level for 40 minutes. Then,the anti-shock therapy was given. The rabbits in NS group were immediately and quickly resuscitated with reperfusion of their shed blood and intravenous drip of NS in a volume equal to 2-fold of the volume of the shed blood. The rabbits in GLP group were dealt with the same means as NS group except NS was replaced by 1%GLP. The rabbits in sham operation group were only cannulated and maintained in a status of blood pressure measurement,but without bloodletting and resuscitation. The TNF-α content,the number of positive bacterial culture of blood bacteria were observed at the time before shock(S0),40 minutes after shock(S40)and 40 minutes and 90 minutes after resuscitation/reperfusion(R40,R90),respectively in the three groups. The serum endotoxin level and the TNF-αcontent in intestinal mucosa were examined at R90. Under the light microscopy,the pathological changes of intestinal mucosa were examined,and the score of the mucosal damage was evaluated by the criteria of Chiu method. Results ①Before shock,the results of blood bacterial culture of all animals in three groups were negative. With the extension of time,the positive rates of blood bacteria were increased gradually at R40 and R90 in NS and GLP groups,showing increment of bacterial translocation,but the levels at R40 and R90 were significantly lower in GLP group than those in NS group at the same time points(number of rabbits at the time of R40:2 vs. 4,at the time of R90:4 vs. 6,both P<0.05). Escherichia coli was the most common positive bacteria in the blood;the other positive bacteria were sequentially less and less,Enterococcus,Lactobacillus acidophilus and Staphylococcus aureus. Compared with sham operation group,the serum endotoxin levels of NS and GLP groups were significantly higher at R90(kU/L:1.823±0.963,1.361±0.529 vs. 0.064±0.036,both P<0.05). ② Under the light microscope,it was shown that in NS group the mucosal villi were edematous,the sub-epithelial space was widened,and there was infiltration of neutrophils and lymphocytes. The damage of intestinal mucosa in GLP group was obviously milder than that in the NS group. The Chiu scores of GLP and NS groups were significantly higher than that of sham operation group;meanwhile,Chiu score of GLP group was lower than that of NS group(1.44±0.64 vs. 3.79±1.23,P<0.05).③Along with extension of ischemia and reperfusion time,TNF-α contents in NS and GLP groups were gradually increased significantly,the peak value being at R90,meanwhile,the levels in both groups were significantly higher than the level of sham operation group,and the TNF-α content in plasma of GLP group was lower than that of NS group〔A value:33.350±7.950 vs. 85.080±4.330,P<0.05〕. Compared with sham operation group,the TNF-αcontents in intestinal mucosa of NS and GLP groups were higher than the level in sham operation group,meanwhile,TNF-αcontent in intestinal mucosa of GLP group was lower than that of NS group〔A value:96.38±8.59 vs. 167.73±12.32, P<0.05〕. Conclusion In the salvage process of resuscitation-reperfusion,GLP can protect intestinal barrier function in rabbits with hemorrhagic shock,and its effect may be related to antagonizing the release of TNF-α.

Objective To explore the diagnosis value by acoustic halo sign in hepatocellular carcinoma.Methods Ultrasonography was performed on 88 echogenic areas in livers,to view the acoustic halo sign around them.And to prepare with the clinicopathological characteristics.Results Around all the echogenic areas,there were 51 with the acoustic halo sign,50 echogenic areas were hepatocellular carcinoma.There were 37 without the acoustic halo sign,18 echogenic areas were hepatocellular carcinoma.Conclusion The acoustic halo sign has high value in diagnosis of hepatocellular carcinoma.

Objective To explore the issues of everyday expenses list used in the cadre wards and find out countermeasures for the purpose of reducing medical disputes and improving the patients’satisfaction.Method Seventy-four patients admitted in our department from July to September 2012 were set as control group,where an investigation was conducted to find out the issues in the practical use of every expenses list and corresponding measures were worked out and used in observation group,which included 78 patients admitted in the department from October to December 2012.The two groups were compared in terms of self-paid articles, re-recording of missed expenses,failure to timely refunding,charging by other means,disagreement on curative nursing items and unclear items for charging.Result The observation group was significantly better than the control in self-paid articles,re-recording of missed expenses and failure to timely refunding(all P<0.05).Conclusions There are some issues in the use of everyday expenses list in the cadre wards.We should take corresponding countermeasures to ensure the interests of the hospital and the patients and the enhanced degree of patients’comfort.

Objective To explore the effect of dexmedetomidine on the stress and immunologic function in the patients undergoing uterectomy,and to provide an evidence for the medication in clinical anesthesia.Methods A total of 60 hysteromyoma patients who needed uterectomy were selected.All the patients were in ASAⅠ-Ⅱlevel. The patients were divided into observation group (n=30)and control group (n=30)according to administration of different types of drugs. Before anesthesia, the patients in observation group were given dexmedetomidine (l μg·kg-1 )with a concentration of 4 g· L-1 for 10 min,while the patients in control group were given equal normal saline.The induction was performed 10 min after infusion pump.Sevoflurane and fentanyl were used for maintaining during the anesthesia.The blood samples of the patients in two groups before entering the operation room (T0),2 h after operation (T1),and extubation after operation (T2)were collected.The serum cortisol (COR)and interleukin-2 (IL-2)concentrations,plasma T lymphocyte subpopulations and NK levels were detected. Results The differences of COR and IL-2 concentrations at T0 between two groups were not statistically significant (P >0.05).The COR concentrations at T2 in two groups were significantly higher than those at T0 (P <0.05). The COR concentration at T2 in observation group was significantly lower than that in control group (P <0.05). The serum IL-2 concentration was gradually decreased with the prolongation of time observation in two groups.The serum IL-2 concentration in observation group was significantly higher than that in control group (P <0.05).The differences of CD3+ ,CD4+ ,CD8+ ,CD4+/ CD8+ ,and NK levels at T0 between two groups were not statistically significant (P >0.05).The differences of CD8+ level in each time point between two groups were not statistically significant (P > 0.05).The CD3+ ,CD4+ ,CD4+/ CD8+ , and NK levels at T1 and T2 in control group were significantly lower than those at T0 (P < 0.05 ). The CD3+ , CD4+ , CD4+/ CD8+ , and NK levels at T2 in observation group were significantly higher than those in control group (P <0.05).Conclusion Dexmedetomidine assisting anesthesia can alleviate the postoperative stress reaction,and reduce the effect of anesthesia and operation wound on the cellular immune function.It is beneficial for the postoperative rehabilitation.

Objective:To provide scientific basis for the clinical diagnosis and treatment of allergic rhinitis by observation of curative effect of treatment to allergic rhinitis by azelastine hydrochloride nasal spray combined with desloratadine .Methods: One hundred and twenty-nine patients with allergic rhinitis were randomly divided into two groups: an experimental group and a control group.The control group was treated by azelastine hydrochloride nasal spray .The experimental group was treated by azelastine hydrochloride nasal spray and desloratadine 5 mg per night.One period of treatment for each group is 4 weeks.Results:the cure rate of the experimental group was 93.85%and 81.25%in control group, with a great difference between them (P<0.05);The incidence rate of adverse drug reactions (ADR)of the former and the latter were 10.77%and 7.81%(P>0.05).Conclusion:azelastine hydro-chloride nasal spray combined with desloratadine can treat patients with allergic rhinitis effectively and safely .It can increase the total effective rate and improve present ’s symptoms.It has great value in clinical application .

Objective To investigate the relationship between maternal serum lipid levels and newborn weight in pregnant women with single positive diabetic screening test. Methods On the basis of 75 g oral glucose tolerance test (OGTT), 406 pregnant women during 24-28 gestational week whose 50 glucose challenge test (GCT)≥7.8 mmol/L were separated to gestational diabetes mellitus (GDM) group with 115cases, gestational impaired glucose tolerant (GIGT) group with 60 cases,and GCT (+) group with 231 cases.The serum levels of total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C),low density lipoprotein cholesterol(LDL-C), apolipoprotein A1 (ApoA1) and apolipoprotein B (ApoB) were measured at the same time. Results Serum TG concentration was significantly higher in GDM group than that in GIGT group and GCT(+) group(P＜0.01).The level of HDL-C, ApoB in GDM group were lower than those in GIGT group and GCT(+) group (P＜0.01). In the 231 women with positive diabetic screening but normal glucose tolerance who delivered at term, the incidence of macrosomia was significantly higher in those with TG levels higher than 3.5 mmol/L (25.0%, 11/44) than in mothers who TG levels were lower than 3.5mmol/L (11.2%, 21/187) (P=0.017). Multiple regression analysis (stepwise) showed that the independent risk factors of macrosomia was the level of TG and ApoB (F=7.677,P=0.006;F = 7.842,P = 0.001 ).Conclusion Among pregnant women with single positive diabetic screening test,maternal serum TG and ApoB are independently associated with neonatal birth weight.

In order to solve the problem of the basic and clinical problems in medical education,Stomatological College of Chongqing Medical University has introduced early clinical education modes through the social practice of volunteer activities since 2009.The teaching modes of Come early into department come early into department and contact early with the patients and a combination of come early into department+contact early with the patients+community dental service were performed.A total of 525 students and 120 teachers in this program were investigated,more than 70％ of the teachers believed the students were improved obviously in doctor-patient communication,clinical practice,and teamwork spirit.Most of teachers and students approved of a combination of come early into department+contact early with the patients+community dental service,which is worth popularizing.

Objective To comprehensively analyze the effect and various detection indicators of leucocyte depletion suspended red blood cells(RBC) prepared by different storage time and different manufacturers of leucocyte depletion instrument to provide some decision-making basis for peers .Methods Two hundreds and forty bags of suspended RBC(1 ,1 .5 ,2 U) prepared from whole blood by 4 manufacturers were randomly collected and preserved in (4 ± 2)℃ dedicated refrigerator according to different specifica-tions .Then the sterile quick-release connector was used to take 240 leucocyte depletion suspended RBC samples of same specifica-tions and different shelf lives of 0 ,7 ,14 ,21 ,28 ,35 d by different manufacturers .Their capacity ,hematocrit ,leukocyte residues ,plas-ma free hemoglobin content and hemoglobin content were detected ,and the hemolysis rate at the end of shelf life was calculated .Re-sults The effect of leucocyte depletion suspended RBC by the same manufacturer had no statistical difference among different spec-ifications (P>0 .05);the capacity and plasma free hemoglobin content in the same specification had statistical difference among difference among different manufacturers (P<0 .05);the free hemoglobin and hemolysis rate at the end of shelf life in the same manufacturer had statistical difference among different preserving time (P<0 .05) .Conclusion By comprehensive considering the results of indexes of capacity ,hematocrit ,filter time ,free hemoglobin content and hemolysis rate ,our station chose the Shandong Weigao and Fresenius disposable leucocyte depletion plastic bags for ensuring the leucocyte depletion effect ,and safety and efficacy of RBC transfusion .

Thebasic ideas for developingChinese herbal specimens databaseand its specific processes were described, the problems in its development were pointed out with measures put forward for their solution.