Chemotherapy and correlated treatments for primary bepatocarcinoma make great progress in recent years. Further studies for transarterial chemoembolization are investigating the new available embolization agents and drug eluting beads to improve the effect on tumor necrosis. Percotaneous ethanol injection for small hepatocellular carcinoma may be regarded as first line treatment. Hepatic arterial infusion and systemic chemo-therapy should also be considered further study.

The medical students are the future medical talent,so they need medical ethics education.This thesis lists medical students' cognitive bias on medical ethics study and enlightens some effective measures on it to achieve the educational purpose.

ObjectiveTo explore the expressions of EGFR and Ki-67 in vulvar dystrophy and their clinical significance MethodsTissue specimens were collected from 160 patients with vulvar dystrophy.Immunohistochemical method was used to detect the expressions of EGFR and Ki-67 in these specimens.The expression levels of EGFR and Ki-67 were compared among different pathological subtypes of vulvar dystrophy,and the relationship of these expressions with clinical pathological characteristics was assessed.ResultsNo significant differences were observed in the expressions of EGFR or Ki-67 between vulvar dystrophy of squamous cell hyperplasia type,lichen sclerosus type and mixed type(P ＞ 0.05).The expression level of EGFR was positively correlated with that of Ki-67 in vulvar dystrophy (r =0.66,P ＜ 0.05).There was a significant difference in the expression rate of EGFR and Ki-67 between patients with different courses of vulvar dystrophy(both P ＜0.05),but not between patients with different age at onset of vulvar dystrophy(both P ＞ 0.05).Conclusion The expressions of EGFR and Ki-67 are different among patients with different courses of vulvar dystrophy.

Objective To explore the influence of vacuum sealing drainage(VSD) technology in snake bite treatment.Methods 108 patients of snake bites need to incision decompression were randomly divided into two groups,VSD group (VSD) 58 cases,conventional group (wound change dressings ordinarily) 50 cases.The secondary suture of time,the number of change dressings,material consumption fees,antibiotics use cost,wound infection rate,in hospital,average length of hospital stay were compared between two groups.Results Compared the VSD group with the conventional group,the secondary suture of time (t =11.743,P ＜ 0.05),the number of change dressings (t =50.661,P ＜ 0.05),material consumption fees (t =9.054,P ＜ 0.05),antibiotics use cost (t =21.515,P ＜ 0.05),wound infection rate (x2 =9.155,P ＜ 0.05),in hospital,average length of hospital stay (t =10.350,P ＜ 0.05) had significant differences.Conclusion VSD technique can be a ideal way to treat snake bites patients and worth popularizing at this stage.

Objective To establish the quality standard of Huangqi-Changyu'an capsule. Method Thin layer chromatography was used to identify psoralen, evodia mtaecarpa, and nutmeg in Huangqi-changyu'an capsule. HPLC was used to determine the content of psoralen. A Hypeisil BDS C18 column(200 mm×4.6 mm,5 μm) was used with mobile phase consisted of acetonitrile-water (30:70) at the rate of 1 ml/min. The detection wavelength was set at 245nm with the column at room temperature. Results The liner range of psoralen was 3.572~53.58 μg/ml (r=0.999 9) with average recoveries of 99.04%, and the RSD was 0.8%. The liner range of isopsoralen was 3.796~56.94 μg/ml (r=0.999 9) with average recoveries of 99.20%, and the RSD was 0.6%. Conclusion This method is sentivive, accurate and rapid for the quality control of Huangqi-Changyu'an capsule.

The paper analyses the function of mutual communication in solving physician-patient conflict. Some feasible suggestions on the mutual communication between doctors and patients are also raised in order to solve the physician-patient conflict effectively.

OBJECTIVE To explore uticozation of nursing care in the operating room disinfection and isolation management. METHODS The nurses and doctors operating room were selected as the observers. Obsening in the operating room for 30-60 min, and recorded the results. After the guidance of the staff discussed to address the problem. RESULTS From June 2006 to June 2008, observed in disinfection and isolation problems of operating room management. The measures include 45 long-term plan, measures need to improve the implementation. To continue to reduce the existing problems, the increasing outstanding operation; Operating room working environment, surgical sterilization materials, sterile technique quality control inspection pass rate in 2006 from the third quarter of 94.2%, 97.1%, 95.1% to 2008 second quarter of 100.0%, 100.0%, 99.8%. CONCLUSIONS The meause can improve the initiative to participate in the management increase the communication between the department and surgery, disinfection and isolation technology improve the quality of management effectiveness. Disinfection and isolation of the operating room are needed to ensure the effectiveness of management to prevent nosocomial infection.

This paper introduces a new perspective of case choice in medical ethics teaching,which breaks through the limitations of the choice of teaching cases,chooses the hot-case analogy teaching methods out of medical field,and proves to have received good teaching results.

Objective To investigate the effects of intrathecal (IT) ketamine on the synapsis remodeling in the spinal dorsal horn during devolopment of morphine tolerance in a rat model of neuropathic pain (NP). Methods Male SD rats weighing 200-250 g were used in this study. IT catheter was placed in the subarachnoid space according to Yaksh. Forty-eight SD rats in which IT catheter was successfully placed were randomly divided into 6groups (n=8 each): group sham operation (group S); group NP; group normal saline 20 μl IT(group NS);group morphine 20 μg IT (group M); group ketamine 50 μg IT (group K) and group morphine 20 μ g + ketamine 50 μg IT (group MK). NP was induced by compression of right L4,5 dorsal root ganglions with steel wire inserted through L4,5 intervertebral foramen in NP,M,K and MK groups. Normal saline or morphine and/or ketamine were injected IT once a day for consecutive 14 days. Paw withdrawal threshold (PWT) to mechanical stimulation and paw withdrawal latency (PWL) to a thermal nociceptive stimulus were measured on 0, 1, 3, 5, 7, 9, 11, 14 days during the consecutive 14 days of administration. The animals were sacrificed after the final IT administration. The lumbar segment of the spinal cord was removed for determination of the number of synapsis in the spinal dorsal horn by immuno-histochemistry in 4 animals in each group and observation of synaptic structure remodeling using electron microscope in another 4 animals in each group. Results Compared with group S, PWT was significantly decreased and PWL was shortened in the other 5 groups, and the number of synapsis was significantly increased and the synaptic structure was thickened in NP, NS, M and K groups (P ＜ 0.05). Compared with group NP,PWT was significantly increased and PWL was prolonged in M, K and MK groups, and the number of synapsis was significantly decreased and the thickness of synaptic structure was significantly reduced in group MK ( P ＜ 0.05).Compared with group M, PWT was significantly increased, PWL was prolonged, the number of synapsis was significantly decreased and the thickness of synaptic structure was significantly reduced in group MK ( P ＜ 0.05). Conclusion IT ketamine can inhibit the synaptic remodeling in the spinal dorsal horn during development of morphine tolerance in a rat model of NP.

The atherogensis was involved in a complex pathological process. Injury to endothelial cells of blood vessels was confirmed to be the in itial stage of this process. Migration to subendothelial layer and accumulation and proliferation of smooth muscle cells were attributed to various cytokines an d adhesive molecules secreted by activated endothelial cells, subsequently resul ting in aggregation of lymphocytes,platelets, monocytes and macrophages in the i ntima of artery. These cellular components ultimatedly led to the formation of a mature atherosclerotic plaque. Its quite acknowledged that a better understan ding of the atherogenic events might promise us the development of new chemical entities of anti-atherosclerotic therapies. A large body of evidence has demons trated that sulfated polysaccharides played a critical role in the development o f atherosclerosis. The underlying mechanisms of the anti-atherosclerotic activi ty of sulfated polysaccharides were reported to contribute to protecting against endothelial cells injury,inhibiting migration and proliferation of vascular smo oth muscle cells, and reducing the adhesion of inflammatory cells, platelets and lymphocytes. And also, the prevention of complement activation by sulfated poly saccharides could not be excluded. On the other hand,the promoting effects of su lfated polysaccharides atherosclerosis was also reported. Its therefore conclu ded that the relationships between atheriosclerosis and sulfated polysaccharides remained to be further elucidated.