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.

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 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 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.

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

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

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 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.

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.