Objective To explore the clinical effects of unilateral placement of plastic stents by ERCP for nonresectable Bismuth type IV hilar cholangiocarcinoma.Methods A prospective study was conducted in 42 patients with nonresectable Bismuth type IV hilar cholangiocarcinoma,who had unilateral insertion of plastic stents in the recent 4 years,All of the patients had successful insertion of single plastic stent by ERCP manipulation.Early results (less than 30 days) of procedure-related complications,mortality,long-term results (greater than 30 days) and survival were observed.Results All of the 42 patients had successful drainage.Mean total bilirubin value decreased from (332.3?163.4)?mol/L to (30.6?18.5)?mol/L,and complete resolution of jaundice was achieved in 61.9% (26/42)of the patients.Early comlications included papilla bleeding due to EST in 4 of 42 patients (9.5%) and acute cholangitis in 10 of 42 patients (23.8%).No procedure-related death occurred.All of the patients needed to have their stents replaced periodically,and the median duration up to the first stent replacement was 65 d,and without significant differences between the two groups in stent insertion to the left and right hepatic duct.Median duration of stent patency was 5.15 months,and median patient survival was 6.5 months,but also no significant differences were found between the two groups.Conclusions Unilateral plastic stent insertion is safe and feasible,can achieve adequate drainage for relatively long time,and can improve life quality and survival for patients with nonresectable hilar cholangiocarcinoma.

Objective To explore the variations of regeneration hormones after hepatectomy for liver cancer,and evaluate the relationship between the liver regeneration hormones and cancer recurrence.Methods The clinical data of 129 patients with primary hepatic carcinoma in our hospital from Dec 2004 to Dec 2005 were collected.The patients were divided into three groups according to their recurrent times,which were one-month recurrence group,6 months recurrence group and one-year recurrence group.And at the same time,40 cases of liver cancer that received TAE treatment were as contrast group.Serum HGF value was detected before operation and 1,3,7,10 and 14 days after operation.c-met,which is the receptor of HGF,was also detected as c-met mRNA and protein expression in cancer tissue and near-carcinoma liver tissue by semi-quantitative RT-PCR and Western Blot.The differences between the level of expression and the time of recurrence were compared,and the results were also compared with pathological indexes.Results Serum HGF value elevated after hepatectomy,the crest time appeared at about 10 days after the operation,and decreased after 14 days.The elevated values of HGF in large HCC tumors were markedly higher than those in small HCC tumors.The change of c-met mRNA and protein levels,revealed that the earlier the recurrence in both large and small HCC,the higher the c-met levels,and the higher the rate of vascular cancer emboli.Conclusions There is marked elevation of HGF level after hepatectomy in patients with liver carcinoma,and the over expression of c-met of the tumor may be related to its early postoperative recurrence.

Objective To investigate the difference of leucorrhea routine tests results among 3 periods of pregnancy in pregnant women.Methods Vaginal cleanliness,the presence of clue cells,trichomonas and fungi were tested for 3 103 obstetric outpatients who were pregnant and treated in the hospital.The test results were analyzed and compared.Results Among pregnant women in different periods of pregnancy,the difference in the proportion of vaginal cleanliness degree Ⅲ and fungal infection rates were statis-tically significant(P <0.05).Among pregnant women of different pregnant periods with vaginal cleanliness degree Ⅱ,difference of fungi infection rate was statistically significant(P <0.05).Among pregnant women of different pregnant periods with vaginal clean-liness degree Ⅳ,the difference of positive rates of fungi,trichomonas and clue cells were statistically significant(P <0.05).In addi-tion,there are a number of mixed infections.Conclusion Vaginitis during pregnancy should be early detected,diagnosed and trea-ted.

Objective To observe the effect of Bingdouting capsule(BC)on rabbit model of sick sinus syndrome.Methods Rabbit models of sick sinus syndrome were established by external application of 20 % methanal on the region of sinoatrial node.The effect of BC on heart rate and electrophysicological parameters of sinoatrial node was observed.Results BC markedly increased the heart rate,shortened the sinoatrial conduction time(SACT)and corrected sinoatrial node recovery time(CSNRT).Conclusion BC has an obvious effect for the treatment of sick sinus syndrome in rabbits.

Objective To investigate the feasibility in screening of normal ovarian tissues by evaluating the expressions of tumor-associated genes in tissues adjacent to human epithelial ovarian cancer of orthotopic implantation in nude mice.Methods Human epithelial ovarian cancer cell lines OVCAR3 were grown in subcutaneous tissues,and the tumor tissues were orthotopic implanted.The expressions of CK-7,CA125,P53,survivin,MMP-2,and TIMP-2 were detected by immunohistochemical staining in proximal tissues,middle tissues,distal tissues adjacent to tumor,tumor tissues,and normal ovarian tissues of nude mice.Results 35 samples ovarian tissues with normal biopsy were gained from 40 cases of human epithelial ovarian cancers of orthotopic implantation model in nude mice.The expression rate of CK-7,CA125,P53,survivin,MMP-2,and TIMP-2 were 95.0％ (38/40),95.0％ (38/40),75.0％ (30/40),85.0％ (34/40),77.5％ (31/40),and 77.5％ (31/40) in tumor tissues,respectively; 71.4％ (25/35),68.6％(24/35),57.1％ (20/35),62.9％ (22/35),60.0％ (21/35),and 57.1％ (20/35) in proximal tissues adjacent to tumor,respectively; 34.3％ (12/35),31.4％ (11/35),31.4％ (11/35),31.4％ (11/35),34.3％ (12/35),and 31.4％ (11/35) in middle tissues adjacent to tumor,respectively; and 25.7％ (9/35),22.9％ (8/35),25.7％ (9/35),25.7％ (9/35),28.6％(10/35),and 31.4％ (11/35) in distal tissues adjacent to tumor,re respectively.The expressions of CK-7,CA125,P53,survivin,MMP-2,and TIMP-2 were all negative in 23 samples normal ovarian tissues adjacent to tumor.The expressions of CK-7,CA125,P53,survivin,MMP-2 and TIMP-2 in proximal tissues adjacent to tumor were lower than those in tumor tissues(P＜0.05),and higher than those in middle tissues and in distal tissues adjacent to tumor(P＜0.01).There were no expression difference between in middle tissues and in distal tissues (P＞0.05).The strong positive expressions of CK-7,CA125,and survivin were higher than those of P53,MMP-2,and TIMP-2 (P＜0.01).No significant difference was found in those expressions in the normal ovarian tissues adjacent to tumor gained from orthotopic implantation model with different severity.The expressions of CK-7,CA125,P53,survivin,MMP-2,and TIMP-2 were all negative in 20 normal ovarian tissues of nude mice.Conclusions The expression of CK-7,CA125,P53,survivin,MMP-2,and TIMP-2 showed decreasing trend to non-cancer direction.Negative expressions of these tumor-associated genes can be used as standard in screening of normal ovarian tissues adjacent to tumor.Relative safe normal ovarian tissues can be obtained from the tissues adjacent to tumor.

Objective To explore the safety and short?term efficacy of irreversible electroporation (IRE)ablation which is a novel ablation technology in unresectable hepatic neoplasms. Methods Patients with pathologically diagnosed as liver cancer or liver metastases were prospectively enrolled. The patients were not suitable for surgery with PS score ≤ 2. Exclusion criteria included who was not tolerate general anesthesia, severe liver and kidney dysfunction, and with cardiac pacemaker. A total of 16 patients were included in this study. There was 12 males and 4 females, aged 40 to 86 years with mean age (60 ± 10)y. Ultrasound and CT guided percutaneous IRE ablation was performed. Perioperative hemodynamic changes were reviewed. Liver and kindey function before and 7 d after ablation was compare by t test. The adverse reactions within 30 d after ablation treatment were recorded. CT and MR scans within 1 month were performed and the 30 d curative effect was evaluated by the modified RECIST criteria. Results All patients received IRE treatment successfully, and some patients experienced adverse reactions within 30 days after ablation, including abdominal pain in 7 cases, peritoneal effusion in 5 cases, hydrothorax in 4 cases, fever in 3 cases, cough, nausea and vomiting in 2 cases, biliary tract infection and thrombocytopenia in 1 case. After symptomatic treatment, these symptoms were improved. Severe complications, such as massive haemorrhage and bile leakage didn't occur. At 30 days after ablation, the curative effects were evaluated. Complete response (CR) was achieved in 1 patient , partial response (PR) was achieved in 12 patients, stable disease (SD) was in 2 patients , and progressive disease(PD) was 1 patients . The tumor relief rate (complete response+partial response) was 81.3%. Conclusions IRE ablation in the treatment of unresectable hepatic malignant tumor could have many advantages, including high safety, mild adverse reactions, and short?term efficacy. However, its long?term effect still need further observation.

This article takes the setting of children's rehabilitation specialty in the rehabilitation therapy of Xiamen Medical College as an example, and expounds that in the process of cultivating talents in children's rehabilitation, theoretically, a training model of "2.5+0.5+1" has been built closely around the training goals of "solid foundation, wide caliber and strong skills", highlighting basic pediatric courses, core skills courses for children's rehabilitation therapy and special courses for children's rehabilitation. In practice, the training of "early clinical practice and early probation" for children's rehabilitation skills is stressed. The results show that students have greatly improved their professional knowledge and practical ability, and the effect of "early clinical practice and early probation" is obvious. Among the students who choose the direction of children's rehabilitation, 95% of the students want to engage in the career of children's rehabilitation and believe that the curriculum system will be of great help to their future employment.

Objective To observe the effect of different Nasointestinal feeding tube catheterization techniques on patients with ICU brain dysfunction.Methods Totally 51 patients were divided into the traditional blind intubation group(26 cases)and the ultrasound guided group(25 cases)according to the random number table.The efficacy of catheterization was evaluated using first catheterization success rate,final catheterization success rate,catheterization time,and complications.Results The ultrasound guided catheterization group has a higher success rate for the first catheterization compared to the traditional blind insertion group;There was no statistically significant difference in general information,final catheterization success rate,catheterization time,and incidence of complications between the two groups.Conclusion The two kinds of nasogastric tube placement techniques are safe and effective in patients with ICU brain dysfunction,ultrasound guided catheterization can improve the success rate of first catheterization and have better efficiency.

ObjectiveTo explore the correlation between phosphatase of regenerating liver-3 (PRL-3) and portal vein tumor thrombus in hepatocellular carcinoma (HCC).MethodsClinical data of 248 patients with HCC undergoing hepatectomy in the First People's Hospital of Foshan between December 2003 and December 2008 were retrospectively analyzed. The informed consents of all patients were obtained and the local ethical committee approval had been received. Among the 248 patients, 193 were males and 55 were females with the age ranging from 18 to 75 years old and the median of 48 years old. Forty-ifve cases were complicated with portal vein tumor thrombus. The expression of PRL-3 in HCC and portal vein tumor thrombus were observed by immunohistochemistry. The correlation between the expression of PRL-3 and the clinicopathological parameters of HCC patients and its signiifcance in portal vein tumor thrombus formation were analyzed. The analysis on the correlation between the expression of PRL-3 and the clinicopathological parameters of HCC was conducted usingχ2 test and the analysis on the risk factors associated with portal vein tumor thrombus formation was conducted using Logistic regression analysis.ResultsThe positive expression rate of PRL-3 in HCC and portal vein tumor thrombus was 70% (174/249) and 98% (44/45) respectively, and the positive expression rate in portal vein tumor thrombus was signiifcantly higher than that in HCC (χ2=15.253,P<0.05). The positive expression of PRL-3 was associated with the serum AFP, tumor diameter, histological differentiation of tumor, portal vein tumor thrombus formation, tumor TNM staging and early recurrence (χ2=4.836, 7.186, 4.226, 5.357, 13.862, 10.824;P<0.05). The positive expression of PRL-3 was the risk factor for portal vein tumor thrombus formation (OR=2.674,P<0.05).ConclusionsPRL-3 expression increases in HCC portal vein tumor thrombus and positive expression of PRL-3 may be closely associated with the invasion and metastasis of HCC.

Objective To investigate the relationship between cerebrovascular reactivity(CVR)and emotional disorders in the patients undergoing continuous hemodialysis for end-stage renal disease(ESRD).Methods The clinical data of the ESRD patients undergoing continuous hemodialysis were collected.Anxiety and depression of the patients were assessed by the Hamilton anxiety scale(HAMA)and Beck depression inven-tory,respectively.The cerebral hemodynamic changes during the breath holding test were monitored by transcrani-al Doppler sonography,and the breath-holding index(BHI)was calculated.The BHI≥0.69 and BHI＜0.69 indi-cate normal CVR and abnormal CVR,respectively.Binary Logistic regression was employed to analyze the factors affecting the depressive state of ESRD patients.Results The group with abnormal CVR exhibited higher total cholesterol level(P=0.010),low density lipoprotein level(P=0.006),and incidence of depression(P=0.012)than the group with normal CVR.Compared with the non-depression group,the depression group dis-played prolonged disease course(P=0.039),reduced body mass index(P=0.048),elevated HAMA score(P=0.001),increased incidence of anxiety(P＜0.001),decreased BHI(P=0.015),and increased incidence of abnormal CVR(P=0.012).Binary Logistic regression analysis indicated anxiety as a contributing factor(OR=22.915,95％CI=2.653-197.956,P=0.004)and abnormal CVR as a risk factor(OR=0.074,95％CI=0.008-0.730,P=0.026)for depression.Conclusion Impaired CVR could pose a risk for depression in the patients with ESRD.