Objective To identify the types,frequency and risk factors of major complications using microwave ablation (MWA) to treat liver malignancies in a single center.Methods Using the electronic medical record system,patients with liver cancer who were treated with MWA from January 2010 to November 2015 were retrospectively studied,and the risk factors of severe complications were analyzed.Results Of the 7 403 patients who were treated with MWA (12 558 ablations).96 cases experienced severe complications (1.3％) and 5 patients died (0.07％).The complications included liver abscess (n ＝ 34,0.46％),pleural effusion (n ＝ 20,0.27％),bile duct injury (n ＝ 15,0.20％),hemorrhage (n ＝ 6,0.08％),liver failure (n ＝ 6,0.08％),extrahepa-tic organ injuries (n ＝ 5,0.07％),cancerous cells implantation of abdominal walls (n ＝ 2),cardiac arrest (n ＝ 1),vascular thrombosis (n ＝ 1),renal insufficiency (n ＝ 1),and patients with other associated diseases which developed after the MWA therapy (n ＝2).Metastatic liver cancer and earlier treatment of MWA sessions were associated with a higher major complication rate (P ＜ 0.05).Conclnsions MWA is a well-tolerated local treatment for liver cancer,with an acceptably low incidence of severe complications.Liver abscess was the most common postoperative severe complication.The surgeons＇ experience and tumor type were associated with the incidence of severe complications,however,not relavant with the frequency of preoperative ablations.Appropriate measures can be taken to effectively reduce the risk of serious complications.

Anaplasmosis ; complications ; Child, Preschool ; Female ; Humans ; Lyme Disease ; complications

Objective To observe blood pressure variability(BPV) and analyze the correlation between BPV and carotid artery-intima media thickness (CA-IMT) in elderly hypertension. Methods Totally 156 patients with primary hypertension were divided into 3 groups:patients aged 45-59years (48 cases) 60-79 years (52 eases),and 80-94 years (56 cases).24 h ambulatory blood pressure monitoring (24 h ABPM) was used to measure 24 h mean systolic blood pressure (24 hSBP),24 h SBP standard deviation (24 h SBPSD),and to calculate 24 h SBP coefficient of variation (24 hSBP CV).Meanwhile,SBP of daytime (DSBP) and nighttime (NSBP),DSBPSD and NSBPSD were measured,and DSBPCV and NSBPCV were calculated.CA-IMT was examined by ultrasound.Spearman rank correlation coefficient was employed to assess the relationship between above indicators and CA-IMT,age. Results No differences were found in 24 h SBP,DSBP and NSBP among the groups.24 hSBPSD( 14.3 ± 3.1),24 h SBPCV ( 11.5 ± 2.1 ),DSBPSD ( 13.8 ± 3.8),DSBPCV ( 10.7 ± 2.6),NSBPSD (13.4±3.3)of patients aged 80-90 years were higher than those of patients aged 60-79 years (12.2±2.5,10.1±2.0,11.6±2.6,9.5±2.3,11.9±2.8)and patients aged 40-59 years (11.7±2.8,9.4±1.9,10.9±3.1,8.4±1.8,11.6±3.0) (P＜0.05).NSBPCVof patients aged 80-90years was increased as compared with patients aged 40-59 years (10.9±2.7 vs.9.6±2.4,P＜0.05).24 h SBPSD,24 h SBPCV were associated with CA-IMT and age(r=0.26,0.39;0.28,0.42,all P＜0.01). Conclusions SBPSD and SBPCV of 24 h ABPM are higher in very older patient with hypertension and could be the useful markers for assessment of BPV.

ObjectiveTo understand the urban preference for outpatient pre-registration in large hospitals,and probe into the influencing factors,for recommendations to improve outpatient preregistration at the hospitals.Methods With Nanjing City as an example,the authors used tailoreddesigned questionnaire and qualitative interviews to investigate the preference of 1200 households of local residents regarding outpatient clinical pre-registration service at the tertiary hospitals.Results Age,education and economic factors are found to be the most important influential ones for urban preference in their outpatient pre-registration at large hospitals.Other factors include traditional approaches to outpatient clinic,inconvenience for outpatient pre-registration,and concerns for appointment breaking.Conclusion in order to increase their preference for outpatient pre-registration at large hospitals,hospitals should work to explore and improve approaches for outpatient pre-registration,and better their service quality,which will involve greater participation of both the hospital staff and residents.

Objective To report the clinical and magnetic resonance imaging(MRI)features of 5 eases with idiopathic orbital myositis.Methods Four females and one male,aged 27 to 57 years,presented department of neurology in the First Hospital of Peking University in October 2008 to September 2009.The duration of disease Was between 3 months and 4 years.Recurrent course appeared in 3 of them.0rbital MRI Was performed in all of them.After diagnosis they underwent long.term corticosteroid treatment.Results All patients presented ocular pain,asymmetrical and incomplete ophthalmoplegia and mild proptosis.EMG revealed no significant decline in repetitive stimulation.Muscle biopsies of limb muscle were unremarkable.Creatine kinase and thyroid function test were in normal limits.MRI revealed unilateral.focal or difluse enlargement and enhancement of extraocular muscles,involving 1 extraocular muscle in 2 cases,2extraocular muscles in 2 cases,more extraocular muscles in 1 case.No evidence indicated bone destruction or cavernous sinus abnormalities.Five Cases showed improvement and remission after long-term administration of steroids.Conclusion Persistent and asymmetrical ophthalmoplegia is connnon in orbital myositis.Extraocular muscle swelling characterized the MRI changes.

Objective To evaluate the predictive value of plasma levels of soluble vascular endothelial growth factor receptor 1(VEGFR-1,also known as sFlt-1) in second-trimester for preeclampsia.Methods One hundred and forty-six pregnant women with normal blood pressure previously were prospectively included in the study.Peripheral venous blood samples were obtained between 20 and 26 gestational weeks.Plasma levels of sFh-1 were measured by an enzyme-linked immunoassay.Results (1) Among 146 previously normotensive women,12 developed preeclampsia (preeclampsia group), 134 remained normal pregnant till the end (normal group).(2) The plasma levels of sFh-1 in preeclampsia group [(4135?699)ng/L] was significantly higher than that in normal group[(1490?1033)ng/L](P

Objective;To explore the relationship among parents' negative punishment,children's self-concept,and children's social behaviors.Methods;Data were collected from questionnaires given to a sample of 612 children from primary and secondary schools and their parents.Results;The structural equation modeling results showed parents' negative punishments could influence children's social behaviors directly and indirectly.In the indirect approach,through the mediating role of children's self-concept,parents' negative punishments could make a negative role on children's pro-social and aggressive behaviors,and a positive role on children's withdrawn behavior.In the direct approach,parents' negative punishments could make a positive effect on children's pro-social,aggressive and withdrawn behavior directly.Conclusion;Children's self-concept plays a mediating role between the relationship of parents' negative punishments and children's social behaviors.

Objective To investigate the efficiency and prognostic factors for the patients with hepatocel-lular carcinoma (HCC) at unresectable early stage when treated with percutaneous microwave ablation. Methods From January 2007 to January 2010 , 105 cases of at unresectable early stage were treated with percutaneous microwave ablation. Complete response rate, major complication rate, overall survival rates, disease-free survival rate were observed and prognostic risk factors were analyzed. Results The complete response rate was 95.7%. The major complication ratewas 3.8%. The 1-, 3-, and 5-year overall survival rates were 97.1%, 66.7%, 46.7%, and the corresponding disease-free survival rates were 82.9%, 48.6%, 31.4%, respectively. Age > 65 year and tumor size > 3 cm were independent risks for disease-free survival. Age > 65 year and recurrence were independent risks for overall survival. Conclusions Percutaneous microwave ablation is a safe and efficient ther-apy for HCC at unresectable early stage.

Objective To study the mechanics situation of proximal femoral locking plate internal fixation after dynamic hip fixation in-tertrochanteric fracture. Methods Totally 10 couple of elderly proximal femur specimens were collected and intertrochanteric fracture model were prepared. Fixation material was removed after dynamic hip screw fixation. The left sides were collected as control group and given anti-rotation intramedullary nail internal fixation, while the right side were collected as observation group and given proximal femoral locking plate internal fixation. Then vertical displacement, axial stiffness and rotational stiffness under different loads were compared. Results Under dif-ferent loads, femoral bone vertical displacement and femur tuberosity vertical displacement in the observation group were both significantly shorter than those in the control group (P<0. 05), and femoral bone and femur tuberosity axial stiffness and rotational stiffness in the observation group were significantly higher than those of the control group (P<0. 05). Conclusion Proximal femoral locking plate internal fixation can improve stress load and enhance axial stiffness and rotational stiffness, and it's an ideal material for refracture fixation model after dynamic hip fixation intertrochanteric fracture.

AIM: To study the effect of G-protein-coupled receptor kinase 5 (GRK5) on the activation of astrocytesin the brain cortex of newborn Wistar rats .METHODS: GRK5 gene was silenced in the model of rat brain cortexastrocytes in vitro for 24 h.N-acetylcysteine (NAC), which is a known inhibitor of NF-κB, was added into the culture mediumaccording to gene silencing for 24 h.The expression levels of GFAP and caspase-3 were detected by the method of immunofluorescence,and the mRNA levels of NF-κB, TNF-α, IL-1βand iNOS were determined by real-time PCR.Moreover,the activity of SOD and concentrations of TNF -αand NO were measured.RESULTS: GRK5 gene silencing increasedthe expression of NF-κB at mRNA and protein levels obviously (P <0.01), and the mRNA levels of IL-1βand iNOS increasedsynchronously (P <0.01).Furthermore, caspase-3-positive cells in GRK5 siRNA group were increased comparedwith control siRNA group (P <0.01).Treatment with NAC obviously reduced the activity of NF -κB and weakened theeffects induced by GRK5 siRNA (P <0.05).CONCLUSION: GRK5 siRNA increases NF-κB activity and induces the activationof astrocytes.