Objective To research the significance of detection of cholyglycine(CG) and total bile acid (TBA ) in intrahepatic cholestasis of pregnancy(ICP) .Methods Totally 85 gestational patients of ICP and 85 normal pregnancy pregnant women(control group) were chosen .Indexes including CG ,TBA ,ALT ,AST and TBIL were detected ,and the results were compared .Results In ICP group ,the levels of serum CG ,TBA ,ALT ,AST and TBIL were significantly higher than those in the normal control group ,and the differences were statistically significant(P< 0 .05) ;The positive rates of serum CG and TBA in ICP were significant higher than those in control group(P< 0 .05) .Conclusion The level of CG and TBA in intrahepatie cholestasis of pregnancy are significantly increased and might be sensitive indicators of gestaional diabetes in intrahepatie cholestasis of pregnancy ,the joint detection is of great clinical significance for ICP early diagnosis and monitoring .

Objective To compare the effects of intramuscular or subcutaneous forearm parathyroid autotransplantation after total parathyroidectomy on patients with renal hyperparathyroidism.Methods From Jan.2012 to Dec.2013,total parathyroidectomy was carried out in 90 patients with renal hyperparathyroidism.According to the location of their parathyroid autograft,patients were divided into intramuscular group (n =39)and subcutaneous group(n =51).One patient in the intramuscular group and two in the subcutaneous group were excluded for the high levels of intact parathyroid hormone (iPTH) the day after operation.iPHT was analyzed 2 weeks,1 month,3 and 6 months after surgery.Results The time of autotransplantation was significantly shorter in subcutaneous group than in intramuscular group (11.46 (2.63) min vs 22.12 (3.78) min;t =0.632,P ＜ 0.05).iPTH levels were significantly lower in subcutaneous group than in intramuscular group 2 weeks after operation (P ＜ 0.05).There was no significant difference between the 2 groups regarding iPTH levels at 1 month,3 or 6 months after surgery.In the follow-up one patient in intramuscular group and one in subcutaneous group had graft-dependent hyperparathyroidism.Conclusion As compared to intramuscular parathyroid autotransplantation,subcutaneous parathyroid autotransplantation has advantages of simpler to operate,shorter autoimplantation time and easier to autograftectomy.

Objective To study the clinical effect of total parathyroidectomy with subcutaneous autotransplantation (TPTX + AT) in the treatment of secondary hyperparathyroidism(SHPT) in patients with chronic renal failure.Methods One hundred and thirty-four patients undergoing TPTX + AT in our hospital from January 2013 to October 2014 were includud in this study.The preoperative,postoperative and follow-up intact parathyroid hormone (iPTH),serum calcium,serum phosphorus and calcium-phosphorus product were statistically analyzed.The Kidney Disease Quality of Life Short Form (KDQOL-SFTM) scale was used to evaluate quality of life before and one year after parathyroidectomy.Postoperative complications and recurrence were observed.Results Postoperative iPTH,serum calcium,serum phosphorus and calciumphosphorus product decreased significantly compared with that before surgery.The difference had statistical significance (all P ＜ 0.05).One patient died in perioperative period.Temporary injury of recurrent laryngeal nerve was found in eight patients.Early postoperative hypocalcemia was frequently seen in 124 patients (92.5％) and in 7 cases (5.2％) occured intractable hypocalcemia.The quality of life was significantly improved one year after parathyroidectomy.Recurrence developed in 5 patients after operation.Conclusions TPTX + AT is safe and effective in the treatment of SHPT in patients with chronic renal failure and can significantly improve the patient's quality of life.

Purpose To investigate the clinicopathological characteristics and treatment of combined hepatocellular carcinoma-cholangio carcinoma (cHCC-CC).Methods 24 cases of cHCC-CC were collected.The clinical pathological characteristics,imaging,immunophenotyping and clinical features were retrospectively analyzed and reviewed the literature.Results There were 18 males and 6 females in 24 cases of cHCC-CC.The age ranged from 36 to 68 years (mean age was 54.38).Tumour location:right hepatic lobe in 15 cases,left hepatic lobe in 6 cases,both left lobe and right hepatic lobe in 1 case,hepatic caudate and left lateral lobe in 1 case,diffuse nodular liver tumors in 1 case.Grossly,the texture and color of tumor was related to the composition of tumor.Microscopically,classic cHCC-CC had two areas composed of hepatocellular carcinoma area and cholangiocar cinoma area of mixed distribution or migration distribution.3 cases were cHCC-CC with stem cell properties (cholangiolocellular carcinoma type,CLC type).Immunohistochemical staining revealed that HCC like area mainly expressed CD10,CK8,Hepatocyte and CD10,cHCC-CC area expressed CK7 and EMA.CLC type expressed the immunophenotypic features of intermediate type of HCC.Conclusion The clinical manifestations of cHCC-CC are not specific,the preoperative diagnosis is difficult,and it should be combined with pathological characteristics,imaging features and immunophenotype diagnosis.

Alzheimer's diseaseis is more and more popular in today's society. Currently the main way of treating AD is still the drugs,so this reviews introduce the AD drug-treatment from four areasthe improving intelligence drugs,con-ventional non-therapeuticdrug about AD,under development of the AD drugs and traditional Chinese medicine.

Objective:To investigate the effect of tumor deposit(TD) on the prognosis of patients with gastric cancer after radical surgery.Methods:A retrospective analysis was performed on gastric cancer patients who underwent radical surgery at the Department of Gastrointestinal Surgery, Peking University People's Hospital from Jan 2021 to Dec 2023. The relationship between the status of tumor deposit and clinicopathological features, as well as the impact on the overall postoperative survival of gastric cancer patients were evaluated.Results:Pathological examination revealed that among 212 patients with gastric cancer, 12 patients (5.1%) had tumor deposits (TD). The occurrence of TD was found to be associated with preoperative T stage, N stage, and extramural vascular invasion (EMVI) (all P<0.05). During the follow-up period, 31 patients experienced recurrence, metastasis, or death. The COX multivariate analysis indicated that N stage ( P=0.07), preoperative serum CEA level ( P<0.001), EMVI ( P=0.001), and TD ( P=0.011) were independent risk factors affecting the overall postoperative survival . Among patients who received neoadjuvant therapy and on pT4 stage, pN+ status, and EMVI status before surgery, the presence of TD was closely correlated with overall survival. Patients with TD had a worse prognosis and shorter overall survival( P<0.05). Conclusion:Tumor deposit is an important risk factor affecting the prognosis of patients after radical gastrectomy and may be a predictive biomarker of early peritoneal metastasis.

Objective To investigate visual impairment students' quality of life and its influencing factors in Braille learning class at Quanzhou Special School. Methods November, 2020, 52 students (aged seven to 26) with the best corrected distance visual acuity of the better eye above 0.02 were investigated with near visual acuity, contrast sensitivity and Chinese-version Low Vision Quality of Life Questionnaire (CLVQOL). The subjects were divided into second grade blindness group, first grade low vision group and second grade low vision group according to the best corrected distance visual acuity of the better eye. Results There were significant differences in distance visual acuity (Z = 45.671, P < 0.001), near visual acuity (Z = 24.972, P < 0.001), and contrast sensitivity (CS) ( Z = 13.285, P = 0.001) among three groups. There was a correlation between near visual acuity and distance visual acuity (r = 0.74, P < 0.001), CS to distance visual acuity (r = -0.58, P < 0.001) and near visual acuity (r = -0.57, P < 0.001), score of CLVQOL and CS (r = 0.44, P < 0.001). There were significant differences in the total score (Z = 10.145, P = 0.006), distance visual acuity subscale (Z = 13.586, P = 0.001), psychological adjustment subscale (Z = 7.824, P = 0.020), reading and fine work subscale (Z = 7.923, P = 0.019) of CLVQOL among the three groups. Conclusion Quality of life is different with the visual impairment for students in special school, especially the distance visual acuity, psychological adjustment and fine reading. CS correlates to the quality of life of visually impaired students, which needs to be a part of evaluation of visual function.