Objective To study the effect of recombinant human endostatin hormone combined with transcatheter arterial chemoembolization (TACE) for the treatment of primary hepatocellular carcinoma (HCC).Methods Fifty-two primary HCC patients were divided into combined group (26 patients) and control group (26 patients) by random digits table method.The patients in combined group received TACE and recombinant human endostatin hormone added in embolism emulsion.The recent curative effect,level of serum vascular endothelial growth factor (VEGF),adverse reactions,recurrence rate and survival rate were compared between two groups.Results The response rate(RR) and clinical benefit rate(DCR) in combined group were 57.69％(15/26),84.62％(22/26),in control group were 34.62％(9/26),73.08％(19/26),there were significant differences (x2 =5.237,P ＜ 0.05 ; x2 =4.284,P ＜ 0.05).The 7th,14th,28th day after TACE,the level of VEGF in two groups was first increased and then a downward trend,the difference were statistically significant (P ＜ 0.05).The level of VEGF in combined group was significantly lower than that in control group (P＜ 0.05).The follow up rate was 94.23％(49/52),the 1-year and 2-year recurrence rate in combined group was significantly lower than that in control group (P＜ 0.05).The 2-year and 3-year survival rate in combined group was significantly higher than that in control group (P ＜ 0.05).Conclusion With TACE plus recombinant human endostatin hormone can effectively inhibit the increase of serum VEGF level,improve curative effect and disease control rate,reduce tumor recurrence and improve survival rate.

Objective To assess the clinical siginificance of the cardiopulmonary resuscitator in respiratory and cardiac arrest patients by comparing the curative effect of cardiopulmonary resuscitator and bare-handed cardiopulmonary resuscitation. Methods 102 patients on the verge of the death were randomiy divided into two groups and begin to CPR in four seconds after confirmation of respiratory and cardiac arrest. Patients in group 1 were given bare-handed CPR. Patients in group 2 were given cardiopulmonary resuscitation by cardiopulmonary resuscitator. Patients in both group 1 and group 2 received lasting CPR according to the 2010 GUIDE of CPR, then we observed their self-heart-beating, self-breathing, caroid puise, expression, puplillas, ECG. Results In the group 1,the effective case was 1,the non-effcctive cases were 63,the effective rate was 1.56%. In the group 2, the effective cases were 6, the non-effective cases were 31, the effective rate was 16.21%, there was a statistically significant difference between two groups ( <0.01) . Conclusion Cardiopulmonary resuscitator has good effect in cardiopulmomary resuscitation for respiratory and cardiac arrest patients, and the effective rate is significantly higher than bare-handed CPR,so it deserves clinical promotion.

Liver fibrosis is the excessive accumulation of extracellular matrix (ECM) proteins that occurs in most types of chronic liver diseases. Hepatic stellate cells (HSCs) are major sources of the excess ECM deposited in fibrotic liver. Transforming growth factor ? (TGF-?) is considered to play a generic role in the development of tissue fibrosis, as it stimulates the synthesis and deposition of ECM components. Smad pathways are central mediators of signals from the receptors for transfor- ming TGF-? to the nucleus. However, growing biochemical and developmental evidence supports the notion that non-Smad pathways also participate in TGF-? signalling. TGF-? signalling pathways play an important role in regulating tissue homeostasis and have been implicated implicated in diverse pathological conditions. It is oow our challenge to design ways of blocking the fibrosis-specific actions of TGF-? through downstream signalling pathways and mediators without compromising the other activities of this multifunctional cytokine, which is essential for health.

Dignity is the idea that a being has the innate right to be valued, respected, and treated ethically. It reflects the value of life.Dignity therapymainly discusses thedignity during the period of death and dying.It involves symptom control, body integrity, au-tonomy, privacy boundaries, respect, and proper handling of personal affairs and death in peace. Dignity therapy is a unique, individu-alized, and brief psychotherapy that was developed for the purpose of relieving distress, enhancing end-of-life experience, reducing psychological and mental burden, and improving the quality of life for dying patients.

Megaureter was put forward firstly by Caulk in 1923.The common causes of children obstructive megeureter have been divided into congenital(congenital ureteral stricture,congenital lower segment ureteral valve,no performance of ureteral distal and ectopic ureter openings),and secondary (urethral valve disease,ureter cyst and polyp,neurogenic bladder and iatrogenic traumatic).Now commonly used surgical treatments has approved by bladder ureter bladder reimplantation,the bladder ureter bladder reimplantation,bladder disc ureteral reimplantation,etc.This paper summarizes the research progress of obstructive megaureter.

Objective To explore the incidence of nosocomial pulmonary infection in elderly patients with cerebral infarction and its prognosis.Methods Six hundred and sixty-nine patients with cerebral infarction were divided into elderly group (384 cases,≥75 years) and control group (285 cases,40-74 years).Logistic regression analysis was used to research the risk factors for pulmonary infection.According to in-hospital heart disease,neurological damage and hospital death,the prognosis of patients in elderly group was analyzed.Results The proportion of female patients,and patients with hypertension,atrial fibrillation and congetive heart disease in elderly group was significantly higher than that in control group,the incidence of patients with nosocomial pulmonary infection was significantly higher than that in control group,the proportion of patients with smoking and diabetes was lower than that in control group,there were significant differences (P ＜ 0.05 or ＜ 0.01).The proportion of patients with high cholesterol,ischemic heart disease,peripheral arterial disease between 2 groups had no significant difference (P ＞ 0.05).Logistic regression analysis showed that diabetes and smoking were independent risk factors for nosocomial pulmonary infection (P ＜ 0.05).The proportion of patients with the United States National Institutes of Health Stroke Scale(NIHSS) score 11-15 scores in elderly group was higher than that in control group[33.59％(129/384) vs.25.96％(74/285)],there was significant difference (P ＜ 0.05),but the proportion of patients with other NIHSS score had no significant difference (P ＞ 0.05).The proportion of patients with cardioembolism in elderly group was higher than that in control group (x2 =4.38,P ＜ 0.05),the proportion of patients with large artery atherosclerosis was lower than that in control group (x2 =4.57,P ＜ 0.05).The complication rate of in-hospital heart disease,the proportion of patients with severe nerve dysfunction (modified Rankin score ≥ 2 scores) and hospital mortality in elderly group was significantly higher than that in control group,there was significant difference (P ＜ 0.01).Conclusions Nosocomial pulmonary infection is more common in elderly patients with cerebral infarction,and prognosis may be even worse.Prevention and control of pulmonary infection is very important for elderly patients with cerebral infarction.

Nowadays more and more evidences suggest that glycemic management of the patients in intensive care units needs to be individualized.We should pay more attention to the diabetes history in these patients besides the primary diseases.A brief literature review and a commentary about this topic were presented in this article.

Medicine, Chinese Traditional ; Translations

High salt intake over four months caused high blood viscosity as well as hypertension in rats, reflected by the obvious increases of blood viscosity, plasma viscosity and hematocrit, and the decrease of erythrocyte sedimentation rate. With some vicious circle resulted from certain blood viscous factors in circulatory (especially in microcirculatory) system the high blood viscosity might relate to chronic sodium chloride toxicity and easily induce hypertension.

Objective To evaluate the CT features of solitary inflammatory nodules of the lung. Methods CT features in twenty-three cases of solitary inflammatory nodules of the lung confirmed by operation or clinical were analyzed retrospectively. Spiral CT including plainscans and contrast enhanced scans was done in all patients. Thin-slice target scan and multiple plane reconstruction were used on the area of nodule. Different width and level of window were used to show the characteristic sign of the nodule.Results No calcification,satellite lesion,concentrated vessels and enlarged lymph nodes were found in or around all of the nodules. The size of these nodules were 10 mm?15 mm～30 mm?40 mm with round or irregular margin. Superficial lobular or spiculated margin was seen in only three nodules. Hyperemia and clouding appearance were found in 19 nodules and reflecting thickening pleura in 18 nodules. Unsteady edge enhancement were found in 18 nodules and no enhancement in 5 nodules. Effused change around the nodules could be seen perfectly when the level was about -400. MPR was the most accurate technique to show the relationship of nodule and pleura. Conclusion Solitary inflammatory nodules of the lung have obvious CT characterizes. By analyzing various CT manifestations comprehensively most nodules can be diagnosed correctly. Suitable width and level of window as well as MPR are helpful in showing the characterizes of the nodules.