Jaundice occurs in 19%-40% of the hepatocellular carcinoma (HCC) patients. HCC associated jaundice may be divided into hepatocellular and icteric types in terms of its underlying pathophysiology. The jaundice of icteric type is caused by obstruction of the bile duct through cancer embolus, blood clot, biliary sludge, tumor compression or infiltration. Jaundice and epigastric discomforts are the main clinical manifestations. In the present case, severe acute pancreatitis and acute cholangitis presenting as initial complaints of icteric type HCC were quite rare. A tumor located at the central lobe of the liver and a cancer embolus at the lower part of the common bile duct (CBD) were detected by CT scan. Curative resection of HCC with CBD exploration eradicated both the tumor and the embolus, and no recurrence was found after a 36 month follow-up.

Objective To discus the diagnosis,favorabl management and diagnosis of pilocytastrocytoma.Methods Provided by the information from CT,MRI and operation,we try to discus and confirm the characteristics of this tumor.Results Pilocytastrocytoma commonly occurs in 20 years old or younger.The most frequent location involve by tumor were cerebellum.The most common presenting sympton was increased intracranial pressure,and then cerebellum symptoms such as incoordination.Final diagnosis made depending on mainly pathology.We found the relationship between prognosis and the extent of surgical removal.Conclusions Pilocytastrocytoma usually occur in children and adolescent.The most common site of these tumors are the cerebellum.And the more complete extent of surgical removal,the better prognosis.So it was called as "benign" tumors.If pilocyticastrocytoma were subtotally excised,the addition of postoperative irradiati could significantly prolong survival.

Objective To investigate the security and effect of endovascular stents placement in treating atherosclerotic stenosis of the iliac arteries.Methods 15 cases with iliac arterial stenosis caused by atherosclerosis were treated by a big amount of thrombolysis in combination with iliac arterial stent placement.The length of lesions was from 4.3 cm to 9.5 cm(mean of 6.7 cm),the claudicant distance was from 100 m to 300 m(mean of 185 m).Clinical follow-up included CT angiography,color Doppler sonography and clinical evaluation with the ankle-brachial index(ABI).Results Eighteen stents were placed in 18 limbs of 15 patients.The technical successful rate was 100%.The clinical symptoms(claudication or the rest pain)were improved,and ABI increased from 0.25?0.18 to 0.85?0.15 after stent implantation in all cases.All the patients were followed up for 3~47 months,one patient was death during the follow-up periods because of brain stem ischemic stroke.All patients maintained uninterrupted stent patency until the final follow-up.Conclusion Iliac arterial stent placement is a safe treatment with favorable long term patency for treating arterial stenosis caused by atherosclerosis.

Objective To investigate the status quo of new allocated nurses to master relevant knowledge of blood specimen collection.Methods 197 new allocated nurses and young nurses within 5 working-years were included and the new allocated nurses accepted knowledge training of blood specimen collection.Differences in training effect between nurses with different work experience and education background were analyzed.Results Average score of new allocated nurses before training was lower than young nurses,while after training,there was no difference between them.The training score of new allocated nurses did not correlate with their background before and after training.Conclusions In order to improve the quality of testing and prompt development of new nurses,the department of clinical nursing should strengthen the relevant training about knowledge of blood specimen collection in new allocated nurses.

Objective Chronic atrial fibrillation (AF) results in dedifferentiation of atrial cardiomyocytes that plays an important role in the perpetuation of AF.In this study,we aimed to investigate the changes of titin and α-smooth muscle actin (α-SMA) after long time of AF reversal.Methods Twenty-four goats were randomized into four groups:(1) sinus rhythm (SR),(2) 3 months AF (3-mo AF),(3) 3 months SR after 3 months AF (3-mo post AF),(4) 6 months SR after 3-mo AF (6-mo post AF),with 6 in each group.By pacing on the anterior bottom of left atria appendage (LAA),we established a goat model of chronic AF.Atria effective refractory period (AERP) was measured with electrophysiological methods.Ultra-structure was studied with echocardiography,light and electron microscopy.Titin and α-SMA protein expressions were determined by Western blot.Results The animals underwent high rate pacing on LAA for a mean of 42.23±21.70 days before presenting AF.Electrophysiological analysis revealed that AERP completely resumed in 3-mo post AF goats.Echocardiography displayed that the size of left atrium resumed almost in 6-mo post AF goats (P＜ 0.01).Pathological and electron microscopic examination revealed the disorder of myofibrils,augmentation of intercellular space,myolysis,accumulation of glycogen,and numerous bigger mitochondria among atrial cardiomyocytes in 3-mo AF goats.They recovered mostly in 6-mo post AF goats.Western blot showed that the band density of titin significantly reduced in 3-mo AF goats compared to SR ones [1826±319 vs 5012±854,P＜0.01].In 3-and 6-mo post AF goats,titin increased gradually and it reversed completely in 6-mo post AF goats (3841±601 and 4523±833 respectively,P ＜ 0.01).Conversely,the band density of α-SMA was significantly higher in 3-mo AF goats (5324±948) than in SR ones (1619± 271,P＜0.01).In 3-and 6-mo post-AF goats,α-SMA decreased gradually,and it recovered mostly in 6mo post AF goats (4437± 792 and 2205±540 respectively,P＜0.01,).Conclusions These data indicate that the reversal of dedifferentiation of atrial cardiomyocyts is a very slow process,and it is definitely essential for normal cardiac function.

Objective To analyze research literature about integration of the body and the spirit; To understand the research status of this classical theory.Methods Relevant articles about integration of the body and the spirit in CNKI, Wanfang Data, VIP-Chinese Scientific and Technological Journal Data were searched, and bibliometric analysis with NoteExpress3.0, Bicomb2.0 and SPSS19.0 software was used to analyzed the data.ResultsA total of 156 efficient articles were retrieved. The number of published articles increased, but the core author group had not yet been formed. The number of cited articles was low. The study hot spots mainly focused on TCM constitution, the subject of health preservation, TCM basic theories, and psychosomatic medicine.Conclusion Domestic studies on integration of the body and the spirit are still in the initial stage. Research number should be increased, meanwhile, innovation and quality should be emphasized.

Objective:To investigate the reason for the adhesion of vocal cord after CO_2 Laser laryngeal surgery.Method:One hundred and nineteen patients who were untaken CO_2 Laser laryngeal microsurgery.Result: Among 119 cases,9 cases of bilateral vocal cord paralysis, 42 cases of vocal cord polyps and 3 cases of precancerous laryngeal lesions did not show vocal cord adhesion after CO_2 Laser laryngeal microsurgery.Contrarily, one of 5 cases with laryngeal stenosis, 5 of 41 cases with laryngeal papilloma and 6 of 19 cases with laryngeal carcinoma shew the adhesion of vocal cord after CO_2 Laser laryngeal microsurgery.Conclusion:Through selecting the appropriate patient and surgery spot, processing correctly during and after surgery, using the suitable dosage of laser and reducing the heat radiation, the adhesion of vocal cord can be avoided after CO_2 Laser laryngeal surgery.

ABSTRACT:The virulence genes ,hemolytic and antibiotic resistance characteristics from 19 isolated Streptococcus suis se‐rotype 2 in Anhui Province were investigated in this study .The PCR method was developed for detecting cps2J ,mrp ,ep f and sly gene;the plate method and micro‐ELISA were developed for detecting the hemolytic type and hemolytic titer ;the K‐B method was developed for detecting antibiotic resistance of 25 kinds of antibiotics .Results showed that there were 11 strains with the dominant virulence genotype of cps2J+ /mrp+ /ep f+ /sly+ accounting for 57 .9% .All strains were α‐hemolysis orβ‐hemolysis ,with hemolytic titer of 1∶4 to 1∶128 .Strains sensitive to rifapentine ,ceftazidime ,florfenicol and cefazolin was existed in high frequency with the sensitive rates for 84 .2% ,and the resistance to doxycycline ,tetracycline ,bacitracin and sul‐famethoxazole was existed in high frequency with the resistance rates for 82 .9% .The multi‐antibiogram typing was doxycyc‐line ,tetracycline ,bacitracin and sulfamethoxazole account for 63 .2% .In conclusion ,the distribution of virulence genes of S .suis 2 Anhui isolates was similar with that of domestic reported strains ,and there was some differences with that of over‐seas reported strains .CPS ,MRP ,EPF and SLY are important virulence factors and the incompleteness of sly gene had no effect to its haemolyticus .The multi‐antibiotic resistance of S .suis 2 Anhui isolates was serious .There is difference for anti‐biogram typing between S .suis 2 Anhui isolates and those in other areas .

Molecular nuclear medicine is a new subject that uses nuclear medicine technology to study the changes of molecular level in organisms in order to understand their functional changes. 2021 Radiological Society of North America annual meeting has more than 40 academic reports on molecular nuclear medicine. The main content includes new tracers and new imaging methods in tumors (prostate cancer, breast cancer, rectal cancer, etc.) and other diseases (Coronavirus Disease 2019 (COVID-19), Alzheimer′s disease, Parkinson′s disease, etc.). This article reviews the relevant research progress.

Bronchopulmonary dysplasia(BPD)is a chronic respiratory disease characterized by alveolar and pulmonary microvascular dysplasia.It happens in premature infants, which is a major cause of death and long-term complications in premature infants.Chest radiology examination is essential for BPD, which not only reveals main radiological features such as pulmonary hyperinflation, pulmonary fibrosis and atelectasis, but also evaluates the severity and progression.These provide significant information for clinical treatment and follow-up study of children with BPD.