Objective To evaluate the clinical effect of levocarnitine in the treatment of continuous blood purification and its effect on matrix metalloproteinase-2(MMP-2),interleukin-18(IL-18)and heart function.Methods 118 patients with continuous blood purification were randomly divided into the control group(n=59)and treatment group group(n=59).Two groups were treated with hemodialysis treatment.Control group was given folic acid,vitamin B and alpha keto acid,treatment group intravenous given levocarnitine injection 20mg/kg+0.9％NaCl 20mL on the basis of control group.A cycle of treatment was 28 days,and treated for 3 cycles.Serum levels of MMP-2 and IL-18,heart function,clinical effect and adverse drug reaction were compared between the two groups.Results After treatment,the total effective rate in control group was 84.74％,lower than 94.92％in treatment group(P<0.05).After treatment,serum MMP-2,IL-18,left atrial diameter(LAD),left ventricular end diastolic diameter(LVDd),left ventricular posterior wall thickness(LVPWT),ventricular septal thickness(IVST),left ventricular volume index(LVMI)in two groups were lower than pre-treatment(P<0.05),and the indexes in treatment group were more lower than control group(P<0.05).The E/A and left ventricular ejection fraction(LVEF)in two groups were all increased after treatment,and those in treatment group were higher than control group,the differences were significant(P<0.05).There was no significant in the incidence rate of adverse drug reactions between two groups.Conclusion Levocarnitine in the treatment of continuous blood purification was effective,and significantly reduce the serum MMP-2,IL-18 level and improve the heart function.

Objective To investigate the effect of surgical treatment for giant primary liver cancer.Methods One hundred and forty-six cases of giant primary liver cancer received surgical treatment in recent 11 years ware analyzed retrospectively. Of them, 99 cases underwent irregular hepatectomy ,28 hemihepatectomy and 4 right hepatic trisegmentectomy .Including 19 cases received secondary resection after preoperative TACE, meanwhile 6 cases were underwent portal venous cancer thrombus extraction, 15 cases received biopsies and DDS only, Interoprative DDS were performed in 105 cases. Result The postoperative complications was 10.3 %, the postoperative mortality was 1.4%.The 1-,3-,5- and 10year survival rates were 56.6 %, 30.2% ,14.4% and 2.1% respectively. Conclusions The main treatment of giant liver cancer is hepatcctomy.Combination with TACE,portal thrombus extraction and DDS can improve the long-term survival.

Objective:To explore the therapeutic effect of monoclonal anti EGFR antibody leading chemotherapy to human tumors.Methods:To prepare immunoconjugate of chemotherapy drugs with anti EGFR antibody and apply to clinic,and to observe it′s therapeutic effect and side effect. Results: This conjugated method could relief clinic symptoms and reduce side effect of tissues and organs significantly.Conclusion:Conjugates of monoclonal therapy of anti EGFR antibody and drug attached chemotherapy is a new and effective way for treatment of human tumors, and it can reduce side effect of the drugs meanwhile.

Objective To analyze the clinical and pathological characteristics of thyroid carcinoma in patients from Qilu Hospital of Shandong University in last 7 years,and to explore the changes in disease spectrum.Methods Records of 772 patients with thyroid carcinoma,who underwent thyroidectomy and pathological examination,were reviewed from January 2005 to December 2011.Results (1) Individuals suffering from thyroid carcinoma have increased rapidly during these 7 years.(2) The high incidence of the disease resided in the age group of 30-59 for both men and women,with a male-to-female ratio of 1 ∶ 2.73.(3) The proportion of papillary microcarcinoma showed a growing trend,the rising trends were also apparent in papillary thyroid cancer (PTC) coexisting with nodular goiter or Hashimoto's thyroiditis (HT).Papillary microcarcinoma accounted for27.27％ of all PTC in 2005 and reached 54.22％ in 2011.Coexistence of PTC and HT accounted for 12.38％ of the cases with a male-to-female ratio of 1 ∶ 6.Conclusion The occurrence of thyroid carcinoma,especially papillary microcarcinoma has been increasing in recent years.The coexistence of PTC with nodular goiter or HT showed a trend to increase.

OBJECTIVE To analyze the factors influencing endoscope disinfection,in order to take the effective measure,improve endoscope disinfection work and prevent nosocomial infection.METHODS According to Instructions for Technical Procedures of Endoscope Cleaning and Disinfection published by Ministry of Health,42 samples of disinfected endoscopes from 18 000 were randomly selected.RESULTS The work for rinse and disinfection of endoscope in our hospital came to be standardized procedure gradually.We already achieved qualified by 100 percent according to Instructions.CONCLUSIONS The standardized management for rinse and disinfection of endoscope is the assurance for preventing nosocomial infection.

[Objective]To explore the anatomical structures,depth and direction of needling at Chengqi (ST1).[Methods] Forty-eight adult orbital specimens were observed by dissection.[Results] When a needle was vertically inserted into Chengqi (ST1),the needle tip would pass through the skin,subcutaneous tissue,orbicularis muscle,orbital adipose body,inferior obliges and inferior rectus.[Conclusion] The acupuncture of the Chengqi (ST1) should select straight sting needling back-upwards.The depth should not exceed 25.0mm.

Objective To investigate the expression of long intergenic non-protein coding RNA-regulator of reprogramming (Linc-ROR) in high-grade ovarian serous cancer, and explore the relationship between Linc-ROR expression and biological function of high-grade ovarian serous cancer. Methods A total of 34 high-grade ovarian serous cancer tissue samples and 19 normal fallopian tube tissue samples were collected between June 2014 and February 2016. Real-time reverse transcription (RT)-PCR was used to detect the Linc-ROR mRNA expression in different samples. The relationship between Linc-ROR expression level and ovarian cancer International Federation of Gynecology and Obstetrics (FIGO) stage, lymph node metastasis was analyzed. Constructed Linc-ROR small interference RNA (siRNA) and pIRES2-EGFP-Linc-ROR plasmid, then Linc-ROR siRNA and pIRES2-EGFP-Linc-ROR plasmid were respectively transfected into SKOV3 cells. Cell proliferation, migration and invasion ability were assessed by cell counting kit-8 (CCK-8), wound healing assay and transwell invasion assay. Results (1) The expression level of Linc-ROR mRNA was significantly higher in high-grade ovarian serous cancer than normal fallopian tube tissues (4.31± 0.38 vs 1.03 ± 0.21; t=25.842, P<0.01). With the progression of FIGO stages, the expression of Linc-ROR was increased (F=95.702, P<0.01), and it was associated with lymph node metastasis (t=7.397, P<0.01). (2) The results of RT-PCR showed that the expression level of linc-ROR in Linc-ROR-i group was significantly lower than that in Linc-ROR-NC-i group (0.30 ± 0.11 vs 1.02 ± 0.10; t=15.269, P<0.01). The expression level in Linc-ROR-p group was significantly higher than that in Linc-ROR-NC-p group (8.90 ± 0.45 vs 1.03 ± 0.17;t=21.934, P<0.01). The CCK-8 assay showed that when the cells were cultured for 3, 4, 5 and 6 days, the A value in Linc-ROR-i group was significantly lower than that in Linc-ROR-NC-i group (P<0.05). And the A value in Linc-ROR-p group was significantly higher than that in Linc-ROR-NC-p group (P<0.05). Wound healing assay showed that, after 48 hours incubation, migration rate of cells in Linc-ROR-i group was significantly less than that in the Linc-ROR-NC-i group [(52±4)%vs(67±5)%;t=5.720,P<0.01]. The migration of cells in Linc-ROR-p group was significantly greater than that in the Linc-ROR-NC-p group [(84±4)%vs(66±4)%;t=7.330,P<0.01]. Cell transwell invasion assay showed that, after 48 hours of incubation, the number of invasive cells in Linc-ROR-i group was lower than that in Linc-ROR-NC-i group (74 ± 3 vs 104 ± 3; t=15.810,P<0.01). And the number of invasive cells in Linc-ROR-p group was higher than that in Linc-ROR-NC-p group (217 ± 4 vs 108 ± 5; t=38.060, P<0.01). Conclusion Highly expressed Linc-ROR could enhance the proliferation, migration and invasion ability of high-grade ovarian serous cancer cells, which may be one of the important molecules in the occurrence and development, invasion and metastasis of high-grade ovarian serous cancer.

Objective To evaluate the applicant effect of improved flushing suction method for SpyClass choledochoscope operation. Methods Seventy-three patients who underwent SpyGlass choledocho-scopy from February 2013 to January 2015 were enrolled. Negative pressure biopsy channel was used in group A(n= 34)during conducting SpyGlass choledochoscopy with the tube directly connected to the conveying pipe and combined with duodenoscope suction.In group B(n= 39),the biopsy channel of disposable syringe jacket was first connected to a delivery catheter,then the negative pressure pipe was put in the injector coat, combined with duodenoscope suction. Adverse reactions,theⅠ image acquisition time after the placement of SpyGlass delivery catheter to pancreaticobiliary duct,the total operation time,and the occurrence of compli-cations after operation were recorded. Results Sinus bradycardia,arrhythmia,agitation occurred in 7 cases (20. 6%),5 cases( 14. 7%),and 10 cases( 29. 4%) respectively in group A,those were 1 case (2. 6%),0 case(0/ 39),2 cases(5. 1%)respectively in group B with significant difference(P<0. 05). The time to acquire a clear image and the total operation time in group A were 6. 2 min and 24. 9 min,and 3. 3 min and 16. 8 minutes in B group with significant difference(P<0. 05),postoperative cholangitis oc-curred in 5 cases in group A(14. 7%),1 case(2. 6%)in group B with significant difference(P<0. 05). Conclusion New irrigation and suction method has obvious advantages in the SpyGlass system.

OBJECTIVE:To systematic review the relationship between CYP4F2 gene polymorphism and warfarin maintenance dose in Chinese population,and to provide evidence-based reference for clinical treatment. METHODS:Retrieved from Cochrane library,PubMed,EMBase,CJFD,VIP and Wanfang database,studies about the relationship between CYP4F2 gene polymorphism and warfarin maintenance dose in Chinese population were collected,and Meta-analysis was performed by using Rev Man 5.0 statis-tics software. RESULTS:A total of 13 studies were included,involving 2 958 patients. The type of gene was type TT,type CT and type CC. Results of Meta-analysis showed the relationship between 3 gene polymorphism and warfarin maintenance dose was type TT>type CT>type CC,and there were significant differences among groups. CONCLUSIONS:CYP4F2 gene polymorphism in Chinese population has significant correlation with warfarin maintenance dose. However,due to the limit of methodological quali-ty,large-scale and high quality studies are required for further validation of the conclusions.

ObjectiveTo observe the efficacy of acupuncture plus acupoint injection in improving the depression state and quality of life (QOL) in patients with depression after ischemic stroke (syndrome differentiated as blood stagnation obstructing collaterals).MethodAccording to the inclusion and exclusion criteria, the eligible subjects were enrolled and randomized into a treatment group and a control group. The treatment group was intervened by acupuncture plus acupoint injection, while the control group was by oral administration of Fluoxetine. They were evaluated by using the Hamilton Depression Scale (HAMD) and Barthel Index (BI) before treatment and after 2-month treatment.ResultAfter 2-month treatment, there was no significant difference in comparing the anti-depressionefficacy between the two groups (P>0.05). The BI score of the treatment group was significantly better than that of the control group after 2-month treatment (P<0.05).ConclusionAcupuncture plus acupoint injection is effective in improving the depression state in the patients with depression after ischemic stroke (syndrome differentiated as blood stagnation obstructing collaterals); after 2-month treatment, it can produce an equivalent therapeutic efficacy compared with oral administration of Fluoxetine.Acupuncture plus acupoint injection is superior to the control in improving the QOL of the patients.