Radiofrequency ablation (RFA) is one of the most important methods for the treatment of liver cancer and has the advantages of small trauma,simple operation,and repeatability.However,for tumors in high-risk locations within 5 mm of the first and second branches of the hepatic portal vein,near the hepatic vein,the inferior vena cava,or the gallbladder,within 5 mm of the intestinal tract,under the Glisson's capsule,and in the diaphragm,RFA has the issues of a low complete ablation rate,a high local recurrence rate,and serious complications.This article introduces the complications of RFA for liver cancer in high-risk locations and their prevention and points out that with the promotion of individualized and standardized RFA,liver cancer in these high-risk locations is no longer a contradiction for RFA.

Objective To explore the application of plastic pancreatic stents and/or nasal biliary drainage for choledocholithiasis patients having DSBC during Endoscopic Retrograde Cholangiopancreatography (ERCP).Methods Retrospective analysis on clinical data of 57 ERCP cases aiming at choledocholithiasis patients having DSBC from January 2010 to December 2015 has been carried out. According to the guide wire cannulation in an operation, patients are divided into three groups, i.e. plastic pancreatic stents group, nasal biliary drainage group, and plastic pancreatic stents + nasal biliary drainage group, so as to observe the success rate of operation and the occurrence rate of postoperative complications, such as pancreatitis or hyperamylasemia, as well as to compare the differences between the three groups.Results Out of the 57 patients receiving ERCP, 13 patients are in the plastic pancreatic stents group, with two successful operations (15.4%), one case of hyperamylasemia (7.7%), two cases of postoperative pancreatitis (15.4%), one case of fever (7.7%) and one case of hemorrhage (7.7%); 20 patients are in the nasal biliary drainage group, with 20 successful operations (100.0%), no occurrence of hyperamylasemia or postoperative pancreatitis or other complications including hemorrhage and fever; 24 patients are in the plastic pancreatic stents + nasal biliary drainage group, with 19 ERCP operations succeeded at the first attempt (79.2%) and 5 ERCP operations succeeded at the second try (20.8%), as well as 4 cases of hyperamylasemia (16.7%), 2 cases of hemorrhage (8.3%) , no occurrence of fever cases and postoperative pancreatitis. In comparison between the three groups, the occurrence of postoperative pancreatitis and successful rate of operation show a significant difference.Conclusion By adopting plastic pancreatic stents and/or nasal biliary drainage for patients having a dififcult selective biliary cannulation during ERCP, the success rate of operation can be improved, and the occurrence of pancreatitis can also be reduced.

Aberrant promoter methylation in special genes such as tumor suppressor genes is early eventin carcinogenesis of lung cancer. Aberrant methylation, resulting in corresponding mRNA silence or overexpression , closely relates to carcinogenesis, development, treatment response and prognosis of lung cancer and it may become a potential biomarker. Methylation of special genes may provide evidences for individual treatment of lung cancers.

Adolescent ; Atrial Appendage ; Diagnostic Errors ; Female ; Humans ; Tachycardia, Ectopic Atrial ; diagnosis ; Tachycardia, Sinus ; diagnosis

Adenocarcinoma, Clear Cell ; pathology ; Aged ; Female ; Humans ; Kidney Neoplasms ; pathology ; Paranasal Sinus Neoplasms ; secondary

Objective To sum up the measures for nursing the patients with laparoscopic gastrectomy-induced anastomotic leakage treated by open center vacuum aspiration. Method We retrospectively reviewed the histories of 22 patients with laparoscopic gastrectomy-induced anastomotic leakage to look into the nursing measures to look into the management of open vacuum aspiration , observation of the drainage, leakage care, mental care. Results The time for open center vacuum aspiration was between 10 to 17 days, averaged (15.63 ± 3.22)d. The hospital stay was between 13 to 23 days, averaged (17.21 ± 5.47)d. No complications were observed. Conclusions The nursing measures for managing the anastomotic leakage can be effective in improving the effect of peritoneal irrigation. The mental care can be effective for the reduction of patients′pains so as to promote the heal of the leakages.

Objective To understand the present situation of safety organizing and quality of nurse work life in pediatric intensive care unit(PICU),and to discuss the relationship between safety organizing and quality of nurse work life.Methods A total of 279 PICU nurses in eight hospitals in Zhejiang were selected by the safety organizing scale (SOS)and quality of nursing work life(QNWL).Results The score of SOS was (45.23 ±10.88)points,and the score of QNWL was (159.46 ±33.60)points.There was a positive correlation between safety organizing and quality of nurse work life(r =0.256,P <0.05).Conclusion The nurse managers should improve the level of quality of nurse work life by safety organizing.

Objective To solve the problem of hospital Bureau class cost accounting system to manage the Branch class cost. Methods The system was optimized by extracting the raw data of localization, collecting income and expenditure account of flexible specialization, and setting subclass accounting ratio ways of rationalization. Results The optimization subsystem has been a fundamental change in cost accounting management and creates more effective. Conclusion According to the special requirement of sanatorium financial process, information system and cost accounting ways, the new system can be optimized in design and implementation method and achieve better effects during the implementation and operation.

Objective To investigate the accuracy of serum neuron-specific enolase (NSE)predicting malignant middle cerebral artery infarction(mMCAI).Methods A total of 40 patients with acute massive cerebral infarction within 24 hours after symptom onset were recruited.Blood samples were collected at 24,36 and 48 hours after symptom onset.Serum NSE concentration was determined by automatic electrochemiluminescence analyzer.mMCAI was defined as hernia signs in clinical practice,and CT/ MRI showed mass effect.The receiver operating characteristic curve was used to analyze the accuracy of serum NSE concentration in predicting mMCAI at 3 time points.Results Sixteen patients(40%)developed mMCAI.The serum NSE concentration for predicting the accuracy of mMCAI was poor at 24 hours after symptom onset;the serum NSE concentration for predicting the specificity of mMCAI was high (96%)at 36 hours after symptom onset,but the sensitivity was lower(69%);the serum NSE concentration for predicting the specificity(92%)and sensitivity(88%)of mMCAI were high at 48 hours.Conclusions The serum NSE conoentration and its dynamic changes may predict the occurrence of mMCAI,and the predicting time points are appropriate from 36-48 hours after symptom onset.

Objective To explore the relationship between left atrial diameters (LAD) and prothrombotic state in senile patients with hypertension (HT) and atrial fibrillation (AF). Mcthods Totally 105 patients with cssential hypertension were divided into 65 patients with atrial fibrillation and 40 cases without atrial fibrillation,and then patients with atrial fibrillation were subgrouped into paroxysmal and persistent atrial fibrillation groups.30 healthy people without hypertension and atrial fibrillation were used as control group.LAD was determined by M type ultrasound cardiogram.Fibrinogen (Fg),D-Dimer(D-Dimer),von willebrand (vwF) and haematocrit (HCT) were also measured as prothrombotic state and compared among the groups. Results In groups of HT with AF versus HT without AF versus control,LAD[(43.56 ± 6.72) mm vs.(36.28 ± 5.83) mm vs.(31.63±4.32)mm],Fg[(4.24±0.59)g/L vs.(3.09 ±0.49)g/L vs.(2.80± 0.46)g/L],D-Dimer [(0.43±0.13)mg/L vs.(0.28±0.]0)mg/L vs.(0.18±0.08)mg/L],vwF[(290.44±29.02)％ vs.(101.32±21.36)％ vs.(84.15±20.26) ％],HCT[(0.46±±0.07)vs.(0.37±0.05)vs.(0.34±0.03)]were significantly higher in HT patients with atrial fibrillation than those without atrial fibrillation and control ( all P＜ 0.05),and there were differences in LAD and D-Dimet (P＜＜0.05),but not in Fg,vwF and HCT (all P＞0.05) between patients without atrial fibrillation and control.LAD[(46.75±7.32)mm vs.(40.82±6.21)mm],Fg [(4.68±0.65)g/L vs.(3.85±0.53)g/L],D-Dimer [(0.48±0.16)mg/L vs.(0.40±0.12)mg/L],vwF [(384.96±29.75)％ vs.(209.43±28.63)％] and HCT [(0.49±0.08)vs.(0.43±0.06)] in persistent atrial fibrillation group were increased than those in paroxysmal atrial fibrillation group ( P ＜ 0.05 ).Fg ( r =0.683 ),D-Dimer ( r =0.735 ),vwF ( r=0.763) and HCT(r=0.759)were corrclated with LAD (all P＜0.01). Conclusions Increased LADmight he one of the elevated risks of atrial fibrillation and a higher prothrombotic state is increasing with larger LAD in senile hypertension.