Objective To explore the clinical significance of serum HGF level changes in gastric cancer pa-tients. Methods 60 cases of patients who operatied and clinicopathological confirmed gastric cancer, were detected serum HGF level by enzyme linked immunosorbent assay(ELISA) .40 cases were administered radical gastrectomy,20 cases of patients who had distant metastasis and loss operative chance were detected 7 days and 3 months preopera-tive,postoperative serum HGF level respectively. At the same time 40 cases of chronic gastritis patients and 40 cases of healthy examination people were selected as control group. Results Serum HGF level in patients with gastric canc-er was significantly higher than that of chronic gastritis and normal controls(P <0. 01). The serum HGF level of pa-tients with tumor vascular invasion significantly increased(P <0. 05). The patients with lymph node metastasis,serum HGF level was significantly higher than that patients with no lymph node metastasis(P <0. 05). The serum HGF level of patients with liver metastasis was significantly higher than that patients with no liver metastasis(P <0. 05). The se-rum HGF level of gastric cancer patients whose maximum diameter of the tumor ≥3cm were significantly higher than that maximum diameter of the tumor <3cm(P<0. 05). According to TNM staging of gastric cancer,the serum HGF level of Ⅰ phase and Ⅱ phase patients were significantly lower than that Ⅲ phase and Ⅳ phase patients(P <0.05).The serum HGF level of gastric cancer patients had no significant correlation with sex ,age and histological type(P <0.05). The serum HGF level of 40 cases of patients who were 1 week after surgery were significantly decreased,the patients who were 3 months after surgery were more obvious(P <0. 05 and P <0. 001). Conclusion HGF may play an important role in gastric cancer occurrence and development. The detection of serum HGF level can become an im-portant index for monitoring the degree of gastric cancer and prognosis of patients.

Objective: To evaluate the clinical effect of acupuncture in managing thalamic pain syndrome. Methods: Eighty patients with thalamic pain syndrome were randomly allocated into two groups, with 40 cases in the treatment group receiving combined scalp and body acupuncture treatment and 40 cases in the control group receiving single body acupuncture treatment. The intervention was given for 28 d in total, and the effects were evaluated after 14-day and 28-day treatments. Results: The inner-group comparison of McGill Pain Questionnaire (MPQ) showed significant differences after the treatment d 14 in both of the two groups (P<0.05), and after the treatment d 28, the differences were even more significant (P<0.01). After 28-day treatment, compared with pre-treatment, the Transcranial Doppler (TCD) test detected significant changes in the two groups (P<0.05). The total effective rate was 72.5% in the treatment group versus 47.5% in the control group, and the difference was statistically significant (P<0.05). The 3-month follow-up study found the relapse rate was 0 in the treatment group and 15.8% in the control group, and the difference was significant (P<0.05). Conclusion: Acupuncture is effective in treating thalamic pain syndrome and combined scalp and body acupuncture can achieve even better results.

ObjectiveTo evaluate surgical management of femoral pseudoaneurysm caused by injection of addictive drugs.MethedsData of 18 cases were reviewed and analysed retrospectively.13 patients underwent primary expanded polytetrafluoroethylene(ePTFE) external iliofemoral bypass (end to side) grafting. Postoperative anastomotic burst and bleeding in one of the 3 patients undergoing saphenous vein autotransplant in situ was successfully treated by ePTFE grafting. Results All of the grafts were patent as demonstrated by postoperative color Dopler ultrasonography. Although 2 patients had their femoral arteries ligated, limbs of all the 18 patients were salvaged.ConclusionsWhen a suitable saphenous vein is not available for autotransplantation, an artificial vessel grafting is still an effective procedure for managing femoral artery false aneurysm.During operation thorough debridement and avoidance of artificial vessel contamination are the most important factors for preventing infective complications of the graft.

Accidents, Traffic ; Forensic Medicine ; Hoarseness ; Humans

onclusions Both three-dimensional CT and MR images integrated into an CARTO system can be successfully used to perform catheter ablation for AF and there was no difference in registration accuracy between the two groups.

Objective To study the effects of propofol used alone and in combined with opioids in gastroscopy,in order to select the more suitable anesthesia protocol.Methods A total of 285 pa-tients undergoing gastroscopy were selected in April ,201 5 in our hospital,including 105 males,180 females,ranging from 18 to 65 years old,weighing 40-90 kg,falling the category of ASA Ⅰ or Ⅱ. According to random number table,subjects were divided into four groups:dezocine group(group D, n =76),fentanyl group (group F,n =87),oxycodone group (group O,n = 71 )and control group (group C,n =5 1).Each group was implemented the corresponding anesthesia.SBP,DBP,HR,SpO 2 in baseline(T0 ),1(T1 ),3(T2 ),5(T3 )min after entering gastroscope were recorded.Choking cough, body movement,extra propofol,awakening time and inspecting time were observed.Results Among four groups,there was no statistical significance in age,gender,weight,blood pressure,heart rate and oxygen saturation and other general information.There were more cases given extra propofol in group C than in the other three groups (P <0.01 ).While for the experimental groups,there were more cases needing extra propofol in group O than in group D and group F (P < 0.01 ).The incidences of body movement and choking cough in group C were higher than those in the other three groups (P <0.01 ).Compared with the group C,dosage of propofol ,awakening time in the three groups,especially in group D,were much lower (P < 0.01 ).Conclusion Propofol in combination with opioids for sedation during painless gastroscopy can alleviate adverse reaction caused by propofol used alone.The more suitable anesthesia protocol is propofol with dezocine.

Complex clinical situation requires healthcare providers to be able to perceive, un-derstand and predict the situation changes correctly, namely they need situation awareness. Good clin-ical situational awareness can help clinical decision-making and cooperation, which is critical to im-proving the quality of healthcare. Therefore this review aims to summarize the meaning, applications, status and influence factors, measurements and training of clinical situation awareness, to provide evidence for training and improving clinical situation awareness.

ObjectiveTo observe the potential effects of microcystin-LR (MC-LR) to open field behaviors and cognitive functions of rats after low-dose and 60 days exposure.Methods20 SD male rats (4 weeks old) were grouped into control ( double distilled water),0.2,1.0 and 5.0 μg/kg groups by random number table.Rats were exposed to microcystin-LR intragastrically every two days for 60 d.Open fields and Morris water maze were employed to observe the spontaneous behavior and spatial learning and memory capacity of rats.ResultsFor each group,the duration in the central area of open field were ( 8.86 ± 3.38 ) s,( 3.09 ± 1.22 ) s,( 1.68 ± 0.24) s,(1.22 ±0.93) s,frequencies in central area were (4.80 ± 1.16) times,(4.40 ± 1.91 )times,( 1.40 ±0.23)times,(3.80 ± 1.02 ) times,movement duration were ( 137.30 ± 5.25 ) s,( 122.97 ± 9.50) s,( 108.86 ± 6.38 ) s,( 129.35 ± 9.40) s,the escape latency were ( 23.17 ± 4.28 ) s,(77.00 ± 8.31 ) s,(59.00 ± 11.89) s,( 63.80 ±16.09) s,respectively.Compared to control,the duration in the central area of open field decreased and escape latency increased significantly (P ＜ 0.05 ) in all the MC-LR treated groups; and frequencies in central area and movement duration of 1.0 μg/kg treated rats decreased significantly.No significant differences were observed between expsoured group and control group in spacial probe tests(P＞0.05).ConclusionMC-LR exerts effects on the spontaneous behavior and spatial cognitive ability of rats.The further study on neurobehavior effects of MC-LR is necessary.

Objective To investigate the value in distinguishing benign and malignant vertebral fractures with MR diffusion-weighted imaging(DWI).Methods 31 patients with 58 vertebral fractures were underwent routine MRI scanning and echo-planar DWI(EPI/DWI).The materials were divided into benign group(n=32,20 cases),malignant group(n=18,8cases),tuberculosis group(n=8,3cases) and normal vertebral body group(n=31). Signal intensities on DWI were compared and apparent diffusion coeffient(ADC) values of normal and abnormal vertebral bodies were calculated. ADC values among the benign,malignant,tuberculosis vertebral bodies and normal ones were quantitatively analyzed and compared.Results The ADC values of benign,malingnant,tuberculosis and normal vertebral bodies were (1.44?0.41)?10 -3 mm2/s,(0.94?0.17)?10 -3 mm2/s,(0.98?0.13)?10 -3 mm2/s and(0.42?0.16)?10 -3 mm2/s ,respectively. The ADC values of the three abnormal groups were higher than normal group ( all P0.05). The sensitivity and specificity of ADC for the diagnosis of malignant lesion were 72.2% and 90.6% if the upper bound of 95% confidence interval was set as a differential level.Conclusion DWI provides an important supplement to the routine MRI in the differentiation of benign with malignant vertebral fractures.

Objective Intrahepatic biliary papillomatosis(IBP)is a rare disease that is characterized by multiple numerous papillary adenomas in the intrahepatic biliary duct(IBD).The clinical features and outcome,however,are not well known.The clinicopathologic features,treatments and follow-up results were retrospectively analyzed in order to improve the efficiency of diagnosis and treatment for the disease.Methods Between August 2006 and October 2008,9 patients were diagnosed with IBP by histological findings at a tertiary referral center,Ningbo Medical Center(University of Ningbo,College of Medicine,Ningbo,China).The authors retrospectively reviewed the medical records to obtain clinical,radiological and pathologic data.The therapeutic results and follow-up data were also reviewed.Results The ratio of male to female was 2:7 and the middle age was 59 years.Repeated episodes of fever and right upper quadrant abdominal pain with or without jaundice were the common clinical manifestations.There were intrahepatic choledocholithiasis and/or history of previous biliary operation in 8 cases.The level of CA19-9 and CEA were almost normal.Imaging workup demonstrated cyst-like dilatation of intrahepatic biliary tree with or without liver atrophy,which were more obvious in the mucin-hypersecreting IBP.All of the 9 cases underwent curative resection with an adequate resection margin.Macroscopic findings demonstrated that the tumors of 9 cases were all located in the left lobe with mucin-hypersecreting type in 7 cases.The diameter of numerous papillary granular was usually less than 10 mm(from 2 to 5 mm.frequently)and friable,that filled the dilated IHD dispersive.Fine fibrovascular cores lined by dysplastic epithelial cells were frequently found under microscope.Few foci of stromalinvasion were noticed in the two cases with malignant transformation.All of the 9 cases survived and there was no recurrence.Conclusion IBP occurs more often in middle and old women who have history of biliary disease. Repeated episodes of cholangitis are the common clinical manifestations. Extra- and intrahepatic biliary tract dilatation is the common imaging finding.MRCP/ERCP is more valuable than others in diagnosis. Clinical and histological finding shows that IBP is a premalignant disease with high malignant potential. Curative resection should be done as earlyas possible for the long-term survival rate. The use of cholangioscopy in operation and rapid biopsy of resection margin will benefit the curative resection.