Objective:To evaluate the clinical value of MR cholangiopancreatography(MRCP) as the only imaging procedure in diagnosing biliary complications after orthotopic liver transplantation(OLT).Methods: The MRCP results were analyzed in 54 consecutive patients presented with clinical or biochemical signs of biliary complications after receiving OLT,and were compared with the findings eventually confirmed by surgery,direct cholangiography,and clinical follow-up.Two different MRCP snapshot techniques were applied: thick-slab T_(2)-weighted sequences and multi-section thin-slab T_(2)-weighted sequences.Results: Surgery,direct cholangiography,and clinical follow-up confirmed that 36 patients had biliary complications.MRCP had a sensitivity of 100%(36/36) in diagnosing biliary complications after OLT,with a positive predictive value of 91.7%(33/36),a false-positive rate of 5.56%(2/36),and an overall diagnostic accuracy of 94.4%(51/54).MRCP as the only imaging procedure achieved a specific diagnosis in 96.3%(52/54) of the patients in the present study.Only 2 patients required additional endoscopic retrograde cholangiopancreatography and percutaneous transhepatic cholecystostomy.Direct cholangiography was required only as a therapeutic procedure in 25.9%(14/54) of the patients.Conclusion: MRCP is an effective imaging procedure in the assessment of biliary complications after OLT.Direct cholangiography is not needed for diagnosis but should be reserved as a therapeutic procedure.

Objective To investigate the difference of IOL Master and A-ultrasound combined with corneal topography meas-urement in intraocular lens ( IOL) power calculation .Methods A total of 84 eyes of 60 cataract patients received phacoemulsification and intraocular lens implantation surgery were selected in Xiangya Hospital from March 2010 to September 2011.There were 57 eyes of 42 age-related cataract patients and 27 eyes of 18 complicated cataract patients .The patients were divided into IOL Master group and A ultrasound combined with corneal topography measurement group .Before surgery , in IOL Master group , axial length ( AL) and corneal curvature were measured with IOL Master , IOL power was calculated according to the Haigis , SRK/T formula and so on.At the same time the axial length ( AL) and corneal curvature were measured with A ultrasound combined with corneal topography respectively and IOL power was calculated by SRK/Ⅱ formula.In A ultrasound combined with corneal topography measurement group , axial length ( AL) and corneal curvature were measured with A ultrasound combined with corneal topography respectively , IOL power was calculat-ed according to the SRK/Ⅱformula.3 months postoperatively , all the patients were conducted refractive outcome and calculating mean absolute refractive error(MAE).Finally the data were analysed.Results ⑴In IOL Master group, before operation there was no sig-nificant difference in mean axial length between IOL Master and A-ultrasound measurement ( P >0.05 ) , while in the patients with AL>26 mm the axial length was (28.53 ±0.57)mm and (29.42 ±0.64)mm using IOL Master and A-ultrasound measurement respec-tively ( P <0.05).The mean corneal curvature was (42.12 ±0.31)D and (43.09 ±0.27)D using IOL Master and corneal topogra-phy measurement respectively ( P <0.01).The mean IOL power were (17.06 ±0.48)D and (16.37 ±0.56)D in IOL Master group and A ultrasound combined with corneal topography measurement group respectively ( P <0.05 ) .⑵3 months postoperatively , the MAE was (0.07 ±1.05)D and (0.16 ±0.81)D in IOL Master group and A-ultrasound combined with corneal topography measure-ment group( P <0.05) respectively.Conclusions In cataract patients with normal axial length , IOL Master and A-ultrasound com-bined with corneal topography have high consistency for axial length measurement and IOL power calculation .But in cataract patients with high myopia , IOL Master is more accurate for axial length measurement and IOL power calculation compared to A -ultrasound com-bined with corneal topography .

Objective To observe the effect of multiple interventions on secondary epilepsy patients.Methods 114 secondary epilepsy patients were randomly divided into the intervention group and control group with 57 cases in each group.The cases in the intervention group received multiple interventions including heath education,psychological treatment,safety nursing,overdose administration,early rehabilitation,discharge guide and so on besides usual nursing.While,the cases in the control group received usual nursing.The follow-up was performed for 6 months and the therapeutic efficacy of two groups was compared.Results After multiple interventions,the seizure frequency and trauma incidence rate decreased,compliance and quality of life increased in patients of the intervention group,and there was a significant difference compared with the control group(P<0.05).Conclusion Multiple interventions can decrease seizure frequency and increase compliance of treatment and quality of life of secondary epilepsy patients.

Objective To observe the effects of MPP+ on the expression of inhibin, activin and its receptor ⅡA and cell ability in PC12 cells of rats.Methods The changes of expression of activin?A, activin?B, inhibin? and receptorⅡA mRNAs were assayed by RT-PCR, the change of cell viability was detect by tyrpan blue exclusion method in cultured PC12 cells at 3 h,6 h,12 h,24 h after MPP+ was added and compared with control groups.Results The expression of activin?A, activin?B and activin receptorⅡA mRNAs in PC12 cells were down-regulated significantly after MPP+ administrated at every time point while the expression of inhibin? mRNA remained unchanged. The cell viability decreased at the points of 12 h and 24 h after MPP+ administrated.Conclusion MPP+ may cause the injury of PC12 cells by downregulating the expression of activin and its receptor.

Objective: To study the characteristics of suicides treated in the emergency department of a large general hospital in China, so as to provide relevant data for preventing suicide. Methods:Study the records of 183 suicides in the emergency department of XuanWu hospital during Jan 1st to Dec 31 of 2004. Result:Among all suicide cases, young people (aged 20 to 29 years) were the most (81cases, 44.3%); Females (n=147) outnumbered males (n=36, f:m=4.1:1); 170 (92.8%) cases had ingested poisons, among them, 119 used hypnotics or pesticides. The mortality was 3.3% (6/183), that of males (3/36=8.33%) was much higher than that of females (3/147=2.04%); Most of suicides happened during 18 to 24 o'clock(71cases, 38.8%)(P

[Objective] To explore the etiology and pathogenesis of rheumatoid arthritis from the perspective of the theory of Fuxie, so as to more comprehensively understand the rheumatoid arthritis, broaden the thinking of clinical diagnosis and treatment, and improve the clinical efficacy. [Methods] The theory of Fuxie theory was summarized, from the aspects of interpretation, theoretical origin, modern medical knowledge and so on, combined with the regularity of the pathogenesis of the pathogen, the etiology, pathogenesis and treatment of rheumatoid arthritis were discussed. [Results] Fuxie theory is originally derived from Huangdi Neijing, it is considered that Fuxie is divided into exogenous and endogenous Fuxie foxier, etiology of rheumatoid arthritis with hidden pathogenic objective basis, its pathogenesis with hidden pathogenic mechanism, the treatment principle and treatment method by pathogen consistentcy. [Conclusion] Understanding of rheumatoid arthritis, according to the characteristics and development of Fuxie disease transmission rules, can better grasp the nature of the disease, diagnosis and treatment of Fuxie theory of rheumatoid arthritis has important clinical significance, rheumatoid arthritis from Fuxie theory provides new ideas and methods for clinical treatment.

Chemotherapy is still the main treatment in advanced gastric cancer by now,but no standard approach has been adopted.Chemotherapy can prolong median overall survival and improve quality of life compared to the best supportive care alone.Recent years,with the appearance of various new agents,chemotherapy remains continuous improvement.As a result,response rate and overall survival of advanced gastric cancers were further improved.Meanwhile,with a greater understanding of the molecular biology of gastric cancer,molecular biological targeted therapies that target human epidermal growth factor receptor 2 (HER-2),endothelial growth factor receptor (EGFR) and vascular endothelial growth factor (VEGF) become the focus of the comprehensive treatment.Chemotherapy combined targeted therapy have shown great benefit and perspective in treatment of advanced gastric cancer,but their usage should be further modified and optimized in clinical trials and practices.

This report deals with 9 cases of brain paragonimiasis whose clinicalmenifestations are of several types, such as epulepsy, brain tumor menigitis.paralysis, vision disturbance and/or headache. Precipitation test and skintest are positive in 8 of the 9 patients, and electroencephalography is ab-normal to a certaln degree in 8 patients. All the cases received specifictherapy. After 4 month-2 and a half year follow-up, six cases returned to normal,one got recurrent episode and one got residual local damage in the brain. Bitin is a good choice in chemical therapy but should be used in combi-nation with dehydrants, cortisone, etc.

Objective To study the curative effect of Bairui capsule combined with azithromycin in treatment of children with mycoplasmal pneumonia and its effect on serum high sensitive C-reactive protein, eosinophil, soluble interleukin-2.Methods 86 patients with mycoplasma pneumonia were enrolled from August 2015 to July 2016 in our hospital.According to the order of admission, the patients were divided into observation group and control group.The control group was treated with azithromycin , and the observation group was treated with Bairui capsule and azithromycin.Clinical efficacy,symptoms and signs of disappearance of time, CRP, EC, SIL-2R and adverse reaction rate were compared between the two groups.Results The total effective rate in the observation group was significantly higher than the control group [90.70% (39/43) vs 67.44% (29/43)](P<0.05).The time of disappearance of lung rales, the disappearance time of cough, the time of fever and the recovery time of X -ray in the observation group were significantly shorter than the control group (P<0.05).The levels of serum hs-CRP, EC and SIL-2R in the observation group were lower than the control group (P<0.05) .There was no significant difference in adverse reaction rate between observation group and control group.Conclusion Bai Rui capsule combined with azithromycin in children with mycoplasma pneumonia can effectively reduce the serum hs-CRP, EC, SIL-2R levels, clinical efficacy is good, low adverse reaction rate.

Objective To explore the pathogenesis and diagnosis of chronic granulomatous disease. Methods Clinical features and laboratory examination results of a child with chronic granulomatous disease were retrospectively analyzed. Genome DNA was extracted from peripheral blood of the child and his parents. The high-throughput sequencing was performed by Illumina sequencing platform, using the Agilent SureSelect exome capture method. Results The child had recurrent infections along with liver enlargement and dysfunction. The anti-infection and symptomatic treatment were unsatisfactory. Gene sequencing analysis revealed a homozygous point mutation (c.7C?>?T, p.Gln3*) in CYBA gene. His mother had the same heterozygous mutation in this locus, and his father had a large fragment heterozygous deletions. No other candidate gene mutations were identiifed. Conclusions The diagnosis of chronic granulomatous disease is conifrmed in this child. It is caused by CYBA gene mutation.