Objective To analyze the stages of liver fibrosis in patients aged older than 40 with normal ALT.Methods 84 patients with chronic HBV infected were investigated in this study. Liver function, HBeAg, HBVDNA, serum liver fibrosis indexes were tested. And liver biopsy was taken in all the patients and the tissues were stained with HE and Masson.Results 73.4% patients were at fibrosis stage 2-4. The serum fibrosis indexes correlated with the fibrosis stage of liver histology. While the levels of HBeAg and HBVDNA didn't correlate with the severity of liver fibrosis.Conclusion Liver fibrosis of patients older than 40-year-old should be analyzed synthetically with many clinical indexes. These patients should be administered with antifibrosis therapy to prevent the progression of liver cirrhosis.

Colorectal cancer (CRC) generally occurs in older patients, however the proportion of young patients with CRC is increasing in recent years, which has drawn lots of scholar′s attention, but their research results were controversial. The current literature from several fields, including clinicopathological characteristic of young CRC patients, the optimal age cutoff between young and elder CRC patients, and the prognosis, early screening and diagnosis in young CRC patients will be reviewed.

Objective To explore the relative factors and prognosis of upper gastrointestinal bleeding in patients with hepatic cirrhosis. Methods The clinical data of upper gastrointestinal bleeding of 502 inpatients from January 1990 to September 2004 were statistically analyzed. Results Males and middle-aged patients with hepatic cirrhosis occurred upper gastrointestinal bleeding more frequently, and the most commom causes were vessel rupture of esophage or gastric varices, portal hypertensive gastropathy, and peptic ulcer. The most common complications of upper gastrointestinal bleeding were severe bleeding shock, hepatic encephaopathy, hepatorenal syndrome,etc. Drinking wine and NSAIDs were the most common inducements of upper gastrointestinal bleeding. The efficient rate of medical management was 89.84%,the death rate was 10.16%, and the most common death causes were shock of severe bleeding, hepatic encephalopathy, and hepatorenal syndrome. Conclusion Sex,age, and season,etc. were related to upper gastrointestinal bleeding in patients with hepatic cirrhosis. Bleeding causes, liver function, complications, and age, etc. were factors affecting prognosis.

By mean of the isolated perfused working heart model, the changes of myocardial contractile and relaxation functions, ventricular cell action potentials, myocardial oxygen and glucose consumptions etc. were observed at 1st,3rd, 8th and 24th h after burn injury in the guinea-pigs inflictedly III degree burn injury on 35% TBA. The results indicate that. 1 ) The contractile and relaxation functions go through a time course of 'normal-decrease-recover', i.e. the cardiac functions show a normal level within 1 h after burn injury. Then they are depressed gradually,and to the lowest at 8th h or so, after burn injury. The cardiac functions recover partly at 24th h after burn injury. It suggests that there is a repaired mechanism by itself in heart of the burn animal; 2 ) The depression of myocardial contractile and relaxation functions are related with depression of the oxygen consumption rather than reduce of intaking in nutrients; 3) the influencing factors of burn injury on the coronary flow and electrical activity of myocardial cells could be removed easily by the perfusate. It shows that these effects may be result from the extracardiac neurohumoral factors.

Objective:To summary the experience of the treatment of the patient in perioperative period with TAPVC.Methods:24 children(Male/Female 16/8)with TAPVC corrective operation were collected from March 2007 to June 2009,which age from 10 d to 182m(16.78?37.30)m and weight from 2.8～36 kg(7.00?6.83)kg.The care and treatment were applied to all cases after surgery,which included mechanical ventilation and continually low-does inotropic agents.Results:Two cases died postoperatively of pneumorrhagia and infection complicated with multiple organ dysfunction syndrome,respectively.The period of mechanical ventilation was 3～393(72.83? 80.63)h.The complication included low cardiac output syndrome(3 cases),pnmonia(11 cases),respiratory dysfunction(13 cases), arrhythmia(5 cases)and pneumorrhagia(1 case).Six cases were re-intubated children.Conclusion:TAPVC,especially with obstrction of pulmonary venous,should be surgically correced as earlier as possible to prevent pulmonary pertention and fibrosis of pulmonary venous.Pneumonia and respiratory dysfunction are the most important reason for prolonged ventilation time and ICU stay after cardiac surgery.Therefore,optimal respiratory management and prevention of low cardiac output will be beneficial for intensive care after TAPVC corrective operation.

Bacterial cellulose iunique and promising material aimplantand scaffoldin tissue engineering study.Iicomposed of pure cellulose nanofibemesh spun by bacteria.Aithigh watecontenand purity,iimore biocompatible fomultiple medical applications.In addition,iieasy to control itmechanical strength,chemical structure and morphology,therefore iimore suitable to be used abiomedical material in vivo.Bacterial cellulose habeen applied atissue engineering material in clinical medical aspects,foexample,wound dressingalternatives,artificial skin,artery eluting stent,bone tissue engineering scaffold,artificial blood vessel,artificial hearvalve prosthesis.The application of bacterial cellulose ialso extended to the construction of tissue engineering corneal stromand corneal contaclens.Thipapereviewthe progresin the applying spectrum of bacterial cellulose in corneal tissue engineering and othemedical field.

Objective To investigate the effective nursing measures of reducing the complications of intratra-cheal suction about mechanical ventilation patients to improve airway nursing quality. Methods 80 patients with ar-tificial air passage mechanical ventilation were divided into Control group (Group one, 40 cases) and Testing group (Group two, 40 cases) randomly. In the control group, suck at regular time after injecting normal saline solution in-to the in-airway (in order to diluted the sputum). There are improvement that nursing measures in testing group. For sample, suck sputums according to demands, choose appropriate sucking sputums tube, control the deepth of sucking sputum tube, adjust the negative pressure based on the deepth of sucking sputum tube, give pure oxygen two to three minutes before and after the suction, strengthen the airway humidfication, lubricate the sucking sputum tube with chlorotetracycline eye ointment, etc. Complications of intratracheal suction were compared in two groups. Results The comparison showed that the complications have a significant statistical difference in sputum obstruction, SpO2 de-scending to 80 percent and below during suction and airway mucous membrane traumatic hemorrhage. (P < 0.01). Conclusion The improved intratracheal suction will decrease the complications obviously like sputum obstruction, SpO2 reducing to 80 percent and below during suction and airway mucous membrane traumatic hemorrhage.

Objective We aimed to develop a safe, comfortable and effective perineal washer, which prevent perineum wound from infection and improve the healing of perineal wound. Methods The perineal washer was made from high polymer medical material, including two metal catheters, pressing gasbag, medical yoke and dicty blow head. We divided women patients after vagina delivery with perineum wound or after caesarean section into the observation group and the control group randomly with 120 cases in each group from Janurary to October 2007. The control group was given perineal washing by routine washing pot and cotton ball with forceps. The observation group received perineal washing by perineal washer with cleaning fluid and was scrubbed by sponge brash. The elimination of wood swelling, the healing of perineum healing, the urinary infection for patients with indwelling urinary catheterization and patients comfort degree were observed in the two groups. Results Statistical difference existed between the two groups in such aspects, elimination of wound swelling wound healing urinary tract infection and patients comfort degree, P<0.05 or P<0.01. Conclusions Adoption of self designed perineal washer accompanied with sponge brush could completely delete bacteria and inflammatory secretion deep in the vagina and prevent the incidence of infection. It not only could hasten the elimination of wound swelling, alleviate the pain and wound healing, but also was easily developed and portable to use. It provided a new and effective method for perineal washing and is worth clinical application.

It is of essential importance for college students to think creatively. Flexible teaching methods have been adopted during the teaching of medical writing in our university. We inspired, guided, stimulated students to develop their creative thought. The purpose of the article is to develop the creative thought of the students in medical universities.

The concepts of Western medicine in treating tumor have changed markedly in recent years, and begun to put more emphasis on the whole survival status of patients. With recent emergence of targeted drugs, it was found that curative effects of the same targeted drugs in treating patients with the same tumor type even the same tumor pathological subtype but different therapeutic targets may be different. On the contrary, the curative effects of different targeted drugs in treating patients with different tumor types but the same therapeutic targets may be similar. Accordingly, the viewpoint of personalized therapy is advocated in Western medicine. Under the guidance of syndrome differentiation treatment in traditional Chinese medicine (TCM), patients with the same tumor and different syndromes should be treated by different herbs, and patients with different tumor and the same syndrome should be treated by the same herbs. Both the theories of "the same treatment for the same syndrome" and "the same treatment for the same therapeutic target" indicate that personalized therapy in Western medicine is similar to TCM syndrome differentiation treatment. The article focuses on "different treatments for the same disease" as well as "the same treatment for different diseases" to describe the similar points between personalized therapy and TCM syndrome differentiation treatment and thereby proves that TCM syndrome differentiation treatment is a scientific and essential approach in treating tumor. At the same time, the article also points out the problems and solution methods of TCM syndrome differentiation treatment.