Hepatic failure following partial liver resection is a major complication and a cause of perioperative mortality for patients with primary liver cancer. Today, many different tests have been established for liver function evaluation. These tests contain conventional tests and quantitative tests.Furthermore, we should combine them to precisely evaluate hepatic functional reserve.

At present,hepatectomy are recognized as the firsttreatment option for hepatocellular carcinoma (HCC).However,the patients have high frequency of recurrence after operation.In China,Most of the patients with HCC are related to chronic hepatitis B infection.The hepatitis B virus(HBV) factors such as:genotype,status of hepatitis B e antigen,HBV DNA level in serum and HBV DNA level in liver tissue influence the recurrence of tumors.Antiviral therapy,especially interferon therapy may be the effective method to prevent recurrence.HBV status also can influence the recurrence rate after transplant.

Objective To investigate the condition of the professional identity and learning burnout in the college students majored in re-habilitation therapy, and discuss the correlation between them. Methods From October to November, 2014, students of grades 2 and 3 ma-jored in rehabilitation therapy were investigated with the professional identity questionnaire and the learning burnout questionnaire. Results A total of 127 questionnaires were sent out, and 119 returned. The score of professional identity was (3.36 ± 0.55), with the factors score of the cognition, emotion, behavior, appropriateness as (3.66±0.77), (3.25±0.60), (3.23±0.71), and (3.36±0.61), respectively. The score of learn-ing burnout was (2.90±0.46), the score of factors of low spirits, improper behavior and low achievement as (2.87±0.70), (3.10±0.60), (2.77± 0.52), respectively. There was negative correlation between score of professional identity and learning burnout (r=-0.271, P<0.01), as well as between some factors of the identity and the learning burnout (P<0.05). Conclusion The professional identity and learning burnout are in the middle level in students majored in rehabilitation therapy, which may interact each other.

ObjectiveTo investigate the clinical efficacy of acupuncture at specific points plus kidney-reinforcing Chinese herbal medicine in treating cervical spondylotic vertebral arteriopathy (liver-kidney deficiency type).MethodNinety patients with cervical spondylotic vertebral arteriopathy (liver-kidney deficiency type) were allocated, using a random number table, to a treatment group of 45 cases and a control group of 45 cases. One case dropped out in the control group. The treatment group received acupuncture at Baihui(GV20), Dazhui(GV14), Houxi(SI3), Sanyinjiao(SP6), Taixi(KI3) and Xuanzhong(GB39) plus oral administration of six ingredients with rehmanniaplus radix puerariae formula and the control group, oral administration of six ingredients with rehmannia plus radix puerariae formula alone. The clinical therapeutic effects were evaluated after eight consecutive weeks of treatment.ResultThe total efficacy rate and the cure rate were 91.1% and 62.2%, respectively, in the treatment group and 77.3% and 34.1%, respectively, in the control group; there were statistically significant differences between the two groups (P<0.05). The therapeutic effect was better in the treatment group than in the control group. After treatment, the difference values ofthe vertigo severity, frequency and duration, headache, neck and shoulder pain, and life and work scores on the scale werehigher in the treatment group than in the control group (P<0.05).ConclusionAcupuncture at specific points plus Chinese herbal medicine is more effective than Chinese herbal medicine alone in treating cervical spondylotic vertebral arteriopathy (liver-kidney deficiency type).

Objective To study curative efficacy of benazepril combined with atorvastatin in treatment of chronic heart failure and its effects on level of plasma N-terminal pro brain natriuretic peptide(NT-proBNP). Methods 90 patients of chronic heart failure who received therapy from January 2013 to January 2016 in the first people's Hospital of Xiangshan, Zhejiang. According to random number table, those patients were divided into the observation group and the control group with 45 cases in each group, on the basis of routine treatment, the control group was treated with benazepril, while the observation group was treated with atorvastatin on the basis of control group. After 2 months, the treatment effect was compared. Results After treatment, the left ventricular end diastolic diameter (LVIDd), left ventricular end systolic diameter (LVIDs) in the observation group were lower than the control group, left ventricular ejection fraction (LVEF) was higher than the control group, the difference was statistically significant (P<0.05), the level of NT-proBNP in the observation group was lower than the control group, the difference was statistically significant (P<0.05), 6 minute walking distance was better than the control group, the difference was statistically significant (P<0.05), the total effective rate in the observation group 91.11%(11/45) was higher than the control group 71.11%(32/45), the difference was statistically significant (P<0.05), during the follow-up of 6 months, the recurrence rate of heart failure in observation group 2.22%(1/45) was lower than the control group 20.00%(9/45), the difference was statistically significant (P<0.05). Conclusion Benazepril combined with atorvastatin is well for chronic heart failure, which can effectively reduce the level of plasma NT-proBNP and prognosis.

0.05);after IP,QTd of group B after AMI was significantly lower than that of group A (P

Objective To investigate optimum dose of anesthesia in pediatric axillary brachial plexus branch block under ultrasound-guided. Methods Forty-eight children from May 2012 to May 2013 in hand surgery of our hospital,whose age was from 6 to 12 years,were randomly divided into four groups, each group has 12 cases. The doses of Ropivacaine were different in different groups. Group A was 0. 25 mL/kg,group B was 0. 2 mL/kg,group C was 0. 15 mL/kg,group D was 0. 10 mL/kg. And Ketamine was added to the treatment ac-cording to the incidence of anesthesia intraoperative. Evaluating the effect of anesthesia according to the situation of nerve block,observing an-esthesia duration time,dosage of anesthesia and rates of complications. Results The blocking effect of group A,B and C in each nerve area was correspond after 30 min,and anesthesia efficiency was higher than group D,but additional rate was lower than group D,the differences were statistically significant (P<0. 05). The block time in group D was shorter than the other groups,and the dose of Ketamine was most, and the block onset,perfect time were longer than the other groups (P<0. 05). But the differences between group A,B,C were not signifi-cant. Two cases in group D converted to general anesthesia. Four groups did not occur complication related narcotic drug. Conclusion In pediatric brachial plexus block used Ropivacaine under ultrasound-guided would get complete branch block,the exact effect of anesthesia, smaller dosage of local anesthesia. When the dosage of Ropivacaine was 0. 15 mL/kg could achieve a better anesthesia effect.

Objective To explore the factors influencing pneumococcal vaccination uptake among the el-derly people in Guangzhou. Methods A survey by questionnaire was performed among 827 subjects aged 60 years or above and living in Guangzhou for five consecutive years. Chi-square test and multiple logistic regression analysis were applied to identify factors influencing pneumococcal vaccination uptake among the elderly. Results The positive factors for vaccination uptake among the elderly people included age of over 70 years (OR=1.677, 95%CI: 1.156 ~ 2.434), mental workers (OR = 1.837, 95%CI: 1.214 ~ 2.779), education background of over-three-year-course training (OR=1.769, 95%CI:1.039~3.012), and history of chronic diseases (OR=1.659, 95%CI:1.096~2.512) were positively associated with pneumococcal vaccination uptake. Monthly disposable income was not an influencing factor (OR=1.420, 95%CI: 0.895 ~ 2.251). Conclusion Strengthened publicity of pneumo-coccal vaccination among the elderly people and flexible measures tailored to the needs of different groups are rec-ommended in order to improve pneumococcal vaccination uptake among the elderly people.

Objective To investigate the risk factors of delirium in elderly patients with intertrochanteric fracture after internal fixation.Methods The data of 160 patients with intertrochanteric fractures who received internal fixation in our hospital from January 2012 to July 2014 were analyzed retrospectively.The risk factors such as age,sex,preoperative complications,preoperative cognitive function,fracture location,operation mode,operation time,anesthesia method,hospital-to-operation time and intraoperative blood loss were summarized.Results The incidence of postoperative delirium was 28.15％ in postoperative elderly patients with intertrochanteric fractures.Univariate analysis showed that delirium had correlated with preoperative cognitive impairment,preoperative preparation time,serum sodium,fentanyl,atrial fibrillation,anesthesia method,operation time and perioperative blood loss (P ＜ 0.05).The multivariate Logistic regression analysis showed that the independent risk factors of postoperative delirium were preoperative cognitive dysfunction,operative time more than 2 hours and preoperative preparation time more than 4 days.Conclusion The occurrence of postoperative delirium was associated with anesthesia method,cognitive deficits,preoperative preparation time and perioperative blood loss.The anesthesia method which had less effect on the whole body condition and less time of operation preparation can decrease the occurrence of postoperative delirium in a certain extent,which is conducive to improving the prognosis.

Objective To study peripheral blood lymphocytic ?-adrenoceptor(?-AR) densities and ?_1-adrenoceptor gene(?_1-AR mRNA) expression levels in patients with heart failure,to investigate the influences of different ?-adrenoceptor antagonists in ?-AR densities and ?_1-AR mRNA expression levels.Methods 104 cases of patients with heart failure were randomly divided into non-?-adrenoceptor antagonist group(35 cases),metoprolol group(34 cases) and carvedilol group(35 cases),we repeatly determined the ?-AR densities and ?_1-AR mRNA expression levels after two-month therapy.Results The ?-AR densities and ?_1-AR mRNA expression levels in heart failure group reduced significantly compared to these in normal persons(P0.05).After two-month therapy,?-AR densities and ?_1-AR mRNA expression levels in metoprolol group were significantly higher than those in carvendilol group and non-?-adrenoceptor antagonist group(P0.05).Conclusions The peripheral blood lymphocytic ?-AR densities and ?_1-AR mRNA expression level down-regulates in heart failure,which correlate with the severity of heart failure but etiological factors.Metoprolol can up-regulate the ?-AR densities and ?_1-AR mRNA expression level,whereas carvedilol has no such effects.