Regarding the prevention and treatment of hepatocellular carcinoma (HCC) recurrence after curative resection,surgeons do not have a clear consensus to evaluate the risk factors of recurrence and effectiveness of surgical resection.Therefore,postoperative HCC recurrence patterns were reviewed in this article,including differentiating intrahepatic metastasis (IM) and multicentric occurrence (MO),which play a key role in manifesting recurrence and patient prognosis.Additionally,the definitions of small HCC and curative resection,and the prophylactic and therapeutic values of anatomic resection and repeated hepatectomy in patients with recurrent HCC were reviewed.Fully understanding these issues might allow for a more objective,precise,and consistent clinical assessment of HCC.

ObjectiveTo observe the therapeutic effects of calcium dobesilate combined with irbesartan in treating early diabetic nephropathy ( DN ).Methods65 patients with early DN were randomly divided into two groups,experiment group( irbesartan plus calcium dobesilate,n =34) and control group( irbesartan,n =31 ).After 24 week treatment,the urinary albumin excretion rate(UAER),fasting blood glucose ( FBG ),postprandial blood glucose (PBG) and glycosylated hemoglobin(HbA1c) were detected and compared between two groups before and after treat ment.ResultsUAER after treatment was significantly reduced in both 2 groups(t =8.074,12.89,all P＜0.01),and the decrement in the experiment group was more obvious than that in the control group with statistical significance ( t =3.965,P ＜ 0.05).ConclusionCalcium dobesilate combined with irbesartan has good effects in the treatment of early DN.

Objective To compare the reliability and effectiveness of anterolateral thigh flap with double vein anastomosis or one vein anastomosis for reconstruction of head and neck defects.Methods Two hundred and sixty four cases of anterolateral thigh flap transfers for head and neck reconstruction from January,2013 to September,2013 in the Second Xiangya Hospital of Central South University were reviewed.260 patients were randomly divided into 2 groups.In the experimental group,there were 138 patients 140 cases of anterolateral thigh flap with one vein one artery anastomosis.In the control group,there were 122 patients 124 cases of anterolateral thigh flap with double vein one artery anastomosis.Results Among 264 anterolateral thigh flaps,the overall success rate of free flap was 98.1％ (259/264),5 free flaps were lost.In the experimental group,there were 6 free flaps occurred venous thrombosis,two of them were lost.In the control group,there were 5 cases occurred venous thrombosis,three of them were lost.No arterial thrombosis occurred in both groups.The time of micromanipulation was 18 to 101 min,with the average of 47 min in the experimental group.In the control group,the time was 45 to 133 min,with the average of 71 min.(P =0.0003).Conclusion Anterolateral thigh flap with one vein one artery anastomosis for head and neck reconstruction did not affect the survival rate but it can absolutely reduce the operation time.

OBJECTIVE: To analyze the characteristics of medical malpractice from different grades of hospitals and to explore forensic investigation strategies in assessing medical dispute. METHODS: A total of 206 cases of medical dispute from 2009 to 2010 investigated by the Department of Forensic Medicine in Nanjing Medical University were selected and analyzed according to fault incidence, fault-prone part, and degree of causality in the treatment. RESULTS: Among the 206 cases analyzed, tertiary hospitals, secondary hospitals and primary hospitals showed medium, high and low error rate, respectively. A majority of medical malpractice cases were distributed in the departments of surgery, medicine and gynecology. CONCLUSION The frequency and severity of medical malpractice in primary hospitals were high, which were gradually reduced in tertiary and secondary hospitals.
Dissent and Disputes ; Expert Testimony ; Forensic Medicine ; Gynecology/statistics & numerical data* ; Hospital Departments/statistics & numerical data* ; Humans ; Incidence ; Malpractice/statistics & numerical data* ; Medical Errors/statistics & numerical data* ; Retrospective Studies ; Time Factors

Humans ; Genetic Markers ; Family ; DNA Fingerprinting ; Microsatellite Repeats/genetics*

OBJECTIVETo explore the feasibility to evaluate objectively auditory temporal resolution using the iso-modulation depth temporal modulation transfer function (TMTF) derived from the amplitude of evoked response to sinusoidally modulated signals.

METHODSChronic electrodes were implanted in inferior colliculus and auditory cortex of guinea pigs. We recorded the evoked response to sinusoidally modulated tones with modulation frequency being varied from 20 to 400 Hz and modulation depth fixed at 100%. The response amplitude in uV was converted into relative amplitude using the fast Fourier transform (FFT) function provided by Biosig software, and then the iso-modulation depth TMTF was plotted with the relative amplitude changed with modulation frequency. Then we recorded the evoked response to the sinusoidally modulated tones with modulation depth being varied from 100% to 10% and derived the iso-amplitude TMTF comparable to conventional modulation depth threshold TMTF. The derived iso-amplitude TMTF was compared to iso-modulation depth TMTF to determine the validity of iso-modulation depth TMTF.

RESULTSThe iso-modulation-depth TMTF and iso-amplitude TMTF in inferior colliculus and auditory cortex of guinea pigs represented respectively bandpass and lowpass characteristic. The cut-off frequency calculated from the two TMTF methods didn't differ significantly and the cut-off frequency derived from auditory cortex iso-modulation depth TMTF was consistent with behavioral results.

CONCLUSIONSThe TMTF plotted with the response amplitude to sinusoidally modulated tones with the modulation depth fixed at 100% and the modulation frequency was a valid method to evaluate objectively auditory temporal resolution.

Animals ; Auditory Cortex ; physiology ; Electrodes ; Evoked Potentials, Auditory ; physiology ; Fourier Analysis ; Guinea Pigs ; Inferior Colliculi ; physiology ; Reaction Time

Objective To investigate the effect of vascular endothelial growth factor C (VEGF-C) on apoptosis of pancreatic cancer cell. Methods Human pancreatic cancer cell line PANC-1 orthotopic implantation tumor model was established in nude mice. Primary pancreatic cancer cells and that derived from lymphatic metastasis were primarily cultured. Expression of VEGF-C was inhibited through antisense oligodeoxynucleotide in vitro transfection. Reverse transcription polynlerase chain reaction (RT-PCR) and flow cytometer were used to detect the effect of VEGF-C on apoptosis of pancreatic cancer cells and bcl-2. Results After in vitro transfection, mRNA expression level of VEGF-C in PANC-1 pancreatic cancer cells significantly decreased (P ＜0. 01 ). Apoptosis rate of pancreatic cancer cells derived from spontaneous lymphatic metastasis was (2. 83 ± 1.01 ) %, ( 4. 98 ± 2. 05 ) %,and ( 13.22 ±2. 17) % respectively for control group, SODN group and ASODN group after in vitro transfection among which apoptosis rate in ASODN group increased significantly (P ＜0. 01 ). However, apoptosis rate for pancreatic cancer cells derived from primary tumor had no obvious change (P ＞0.05), with (3.51 ±1.38)%, (4.76 ±2. 16 ) %, and (5. 33 ± 2. 18 ) % respectively in control group, SODN group and ASODN group. The expression level of bcl-2 in pancreatic cancer cells derived from spontaneous lymphatic metastasis decreased significantly (P ＜0. 05) while it had no obvious change in primary pancreatic cancer cells (P ＞ 0. 05). Conclusion To inhibit expression of VEGF-C in pancreatic cancer cell can promote apoptosis of pancreatic cancer cell, which is relevant to downregulation of bcl-2;however, it has no obvious effect on primary pancreatic cancer.

Objective To observe the expression of hypoxia inducible faetor-1α (HIF-1α) in the retina of rabbits with acute high intraocular pressure and to investigate the mechanism of systemic domestic recombinant human erythropoietin (rhEPO) protecting the retina from ischemia-reperfusion injury. Methods First, control group and model group were established in rabbit eyes. The acute high intraocular pressure model was established by saline perfusion into anterior chamber, and then hypodermic injection of domestic rhEPO was made. HIF-1α protein in the retina was observed by immunohistochemical staining method on days 1, 3, 7 and 14 after retinal ischemla-reperfusion, respectively. Results No cells with HIF-la positive expression were observed in the retina of the control group. Ceils with HIF-1α positive expression in the model group outnumbered those in the control group (P < 0. 01). The resemblance pattern occurred in EPO group but its degree was slightly greater than that in the model group from day 3 after ischemia-reperfusion (P<0.05). Conclusion Domestic rhEPO can down-regulate the expression of HIF-1α in the retina with acute high intraocular pressure, which may be one of the mechanisms that rhEPO protects the retina from ischemia-reperfusion injury.

Abstract: Objective　This article summarizes the clinical characteristics and diagnosis and treatment experience of an elderly patient infected with Omicron variant BA.5.1.3 of COVID-19 in Hainan Province. Methods　The clinical data and treatment of an elderly patient infected with Omicron variant BA.5.1.3 of COVID-19 admitted to Haikou designated hospital on August 15, 2022 were retrospectively analyzed. Results　A 107-year-old female patient was admitted to the hospital with "fever and cough for 1 day". Two of her family members have infected with COVID-19. The patient initially developed fever, accompanied by cough, expectoration, a little white sticky sputum, accompanied by sore throat, muscle pain, fatigue. Nucleic acid test was positive in throat swab, indicating Omicron variant BA.5.1.3 infection. The patient was diagnosed as mild COVID-19 and treated with antiviral therapy, Chinese medicine conditioning, anticoagulation, electrolyte disorder regulation and symptomatic treatment for 9 days. The patient's clinical symptoms were relieved, and she was cured and discharged after two negative nucleic acid tests. One week later, the patient recovered well. Conclusions　Omicron variant BA.5.1.3 is highly infectious, and comprehensive treatment such as antiviral treatment and traditional Chinese medicine treatment has achieved good efficacy. For elderly patients, attention should be paid to maintaining the stability of organ function and internal environment, which is helpful to improve the prognosis of patients.