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.

Aged ; Coronary Disease ; Coronary Sinus ; pathology ; Female ; Heart Atria ; pathology ; Humans ; Middle Aged

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

Objective To observe the change of blood pressure variability (BPV)in elderly hypertension patients,and to analysis the correlation between BPV and stages of renal function damage.Methods 127 elderly primary hypertensive patients with chronic kidney disease(CKD) were divided into three groups:stage 2 CKD group (aged 60-90 years,n=50),stage 3 CKD group (aged 62-93 years,n=40) and stage 4 CKD group (aged 64-94 years,n=37),according to National Kidney Foundation's Kidney Disease Outcomes Quality Initiative (K/DOQI) guide.24 h ambulatory blood pressure monitoring (24 hABPM) was used to measure 24 h mean systolic blood pressure (24 hSBP),24 hSBP standard deviation (24 hSBPSD),and to calculate 24 hSBP coefficient of variation (24 hSBPCV).Differences in above indicators among groups were analyzed by ANOVA.The relationship between above indicators and estimated glomerular filtration rate (eGFR),urinary albumin excretion rates(UAER) were assessed by Spearman rank correlation coefficient.Logistic regression analysis was employed to assess the relationship between BPV and the degrees of impaired renal function.Results 24 h SBPSD and 24h SBPCV were lower in stage 2 CKD group than in stage 3 CKD and stage 4 CKD groups [(11.91±2.56) vs.(13.98±2.89),(14.25±3.16);(9.79±2.01)vs.(11.28± 1.70),(11.53±2.65) ;all P＜0.05].24 h SBPSD,24 h DBPCV and 24 h diastolic blood pressure (24 hdBP) CV were negatively correlated with eGFR (all P＜0.01) and were positively correlated with UAER (all P＜0.01).Logistic regression analysis showed that 24 h DBPSD and 24h SBPCV were related to impaired renal function (both P＜0.05).Conclusions Blood pressure variability is increasing along with impairing renal function in elderly hypertensive patients.Blood pressure variability is associated with renal function damage.

Digitalization is an important method for the objectification and quantification of quality control on Chi-nese herbal medicine. To solve the problem of texture online visualization of Chinese herbal medicine and the estab-lishment of automatic identification method based on the texture, 12 Chinese herbal medicines were selected to cap-ture the images of their transverse sections. A total of 11 features were extracted from images using Gray-level Co-occurrence Matrix (GLCM) method. Through analyzing the influence of distances and angles between pixels on identi-fication results, it was concluded that when the distance was d = 3 and the angle was ? = 0o, the features extracted were suitable for expressing the texture of the transverse sections. The results indicated the feasibility of establishing the automatic identification method on Chinese herbal medicine based on image of transverse section. It will provide new technologies for the objectification and quantification of identification on Chinese herbal medicine.

Objective To investigate the activities associated with nurses’occupational exposure to bloodborne pathogens and the source patients’infection status during blood collection process,so as to provide a basis for developing occupational exposure prevention strategies.Methods Data about occupational exposure to bloodborne pathogens during blood collection process in a hospital from August 2011 to September 2013 were monitored.Results A total of 89 times of bloodborne ex-posure occurred among HCWs,including 75 times of arterial blood collection and 14 venous blood collection.The top three procedures of occupational exposures were rebounding of needles after needles were pulled out (28.09%,n=25),concen-trated cleaning up of rubbish at the end of blood collection (20.22%,n=18),and touching blood and body fluids by skin and mucous membrane (14.61%,n=13).48.31% (n=43)source patients infected with at least hepatitis B virus,hepati-tis C virus ,hepatitis E virus,Treponema pallidum,and human immunodeficiency virus ,51.69%(n=46)source patients were not infected ,after proper handling,none of nurses were infected during blood collection .Conclusion Developing safe blood-withdraw needle,putting sharp instrument into sharp instrument container,wearing gloves,and intensifying training of standard and occupational precaution are important strategies for the reducing of the occurrence of bloodborne exposure of clinical nurses during blood collection process .

Objective To study clinical features, treatment and prognosis of nasal NK/T cell lymphoma associated Hemophagocytic Syndrome (HPS).Methods Retrospectively analysis method was used to analyze the clinical data of 3 patients with nasal NK/T cell lymphoma associated HPS. Results 3 patients with nasal NK/T cell lymphoma fulfilled the criteria of HPS. All patients had adverse prognostic factors of lymphoma.1 patient developed HPS as the main primary manifestations of underlying lymphoma,the other 2 patients developed HPS during lymphoma progression. In three cases, bone marrow was infiltrated with lymphoma cells.When HPS occurred,the disease progressed rapidly.The most obvious clinical features were fever,pancytopenia,hypofibrinogenemia,hyperferritinemia,and hemophagocytosis in bone marrow. After being treated according to the HLH-2004 combined with chemotherapy, all patients showed a clinical response,but with the progression of lymphoma,HPS quickly relapsed,and all patients died of severe hepatic dysfunction,coagulopathy,or DIC.Conclusion Nasal NK/T lymphoma associated HPS is an invariably fatal disease with poor prognosis,typically occurring at advanced stage or the terminal phase of the disease.HLH-2004 based protocol in combination with chemotherapy is helpful for nasal NK/T cell lymphoma associated HPS,which may delay disease progression and provid opportunities for the treatment of primary disease.

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 investigate the relationship between neurokinin B (NKB), endothelin-1 (ET-1) and the pathogenesis of hypertensive disorder complicating pregnancy (HDCP). Methods 22 HDCP, who received antenatal examination in the Department of Obstetrics and Gynecology of Union Hospital of Tongji Medical College in Huazhong University of Science and Technology from March to July in 2005, were selected for the study, including 12 gestational hypertension (gestational hypertension group) and 10 preeclampsia (preeclamptic group); 22 normal pregnant women in the same period were served as control. At different gestational weeks, maternal plasma levels of NKB and ET-1 in three groups were detected by enzyme-linked immunoassay technique, the expression and location of NKB in placenta were examined by immunohistochemical SP, and mRNA expressions of NKB and ET-1 in placenta were measured with RT-PCR method. Results (1) At 10 - 14, 20 - 24, and 30 - 34 gestational weeks, the plasma levels of NKB and ET-1 in preeclamptic group were ( 35. 6±5.2), ( 17. 9±4. 3), (39. 5±4. 3 ), (22. 7± 3.6), (47. 1±3. 3) and (27.5±3.5) μg/L, respectively; in the control group they were (22. 9±3. 3), (10.7±5.3), (30.2±3.4), (13.2±4.1), (34.6±4.3) and (16.6±4.8) μg/L, respectively. There was a significant difference between preeclamptic group and control group ( P < 0. 05), while there was no significant difference between gestational hypertension group and control group (P>0.05).(2) Immunohistochemical staining for NKB protein was observed in all groups and was located in the villous syncytintrophoblast and villous vascular endothelial cells as well as cytoplasm of stromal cells, mostly located in villous syncytiotrophoblast. The expressions of NKB in placenta of preeclamptic group (0.244±0.020) was significantly higher than that in control group (0. 160±0. 012), with a significant difference between the two groups (P<0.05 ). However, there was no significant difference between gestational hypertension group (0.162±0.019) and control group (P>0.05). (3) The transcription levels of the NKB mRNA (0. 97±0. 36) and ET-1 mRNA (0. 90±0. 36) in preeclamptic placentas were both significantly higher than those in control groups (0. 78±0. 54, 0. 65±0. 47, respectively ), with a significant difference between the two groups( P <0. 05 ). But there was no significant difference between gestational hypertension group (0. 80±0. 40, 0. 70±0. 32, respectively) and control group (P >0. 05). (4) There was an evident positive correlation between plasma NKB and ET-1 levels in preeclampsia ( r =0. 79, P < 0. 05 ). Conclusions The significantly increased maternal plasma levels of NKB and ET-1 of patients with preeclampsia occur at early pregnancy (10 -14 gestational weeks) before the onset of clinical symptoms. The change of maternal plasma levels of NKB and ET-1 is closely related to pathogenesis of HDCP.

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