Ten patients with 12 inflammatory pseudotumor of the liver (IPL) lesions were routinely examined by gray scale uhrasonography(B-US),color Doppler (CD)and pulscd Doppler(PD). All of them in B-US were hypoechoic pattern with inhomogeneity,and one of them displayed helo-like,margin, suggesting malignant tumor. However, the irregular shape with calabash-like was found in 10 IPL lesions by B-US, being different from liver cancer.The color blood flow and arterial spectrum were detected by CD and PD in the margin 3 of 9 IPL lesions,and the resistant index was less than 0.5 in 2 of 3 IPL with Doppler signals, 6 of them were suggested to lack of blood supply, the manifistations of Doppler were consistent with pathology of IPL. Therefore, 8 lesions were considered to be benign lesions by Doppler US and the accuracy for the diagnosis of IPL was 56%(5/9)by using Doppler combined with B-US.

Objective To study the feasibility and efficacy of minimally invasive repair for pectus excavatum in adult patients. Methods A total of 23 patients with pectus excavatum aged 18-38 years(mean 24.1?6.6) were treated in our hospital from June 2006 to June 2008.On admission,21 of patients had never been treated,and 2 patients were recurrent cases after Ravitch surgery;the Haller index of the cases ranged from 3.2 to 7.5(mean 4.38?1.16);type I pectus excavatum was diagnosed in 14 of the patients(60.9%) and type II in the other 9(39.1%).Under general anaesthesia with the patients at supine position,two 3-cm incisions were made along the bilateral mid-axillary line at the level of the most pronounced sternal depression.Then,a conductor was penetrated into the mediastinum from the right to the left at almost the same level.After establishing artificial pneumothorax by CO2 gas,a pectus bar(Lorenz) was placed through the mediastinum under the guidance of thoracoscopy.Afterwards,a stabilizer was used to fix the bar at the right side.Both the stabilizer and the bar were fixed to the muscle layer.Chest X-ray was performed to observe the stabilizer and the bar after the operation. Results Among the cases,the procedure was successfully completed in 22 patients.In the other patient,the pericardium and the right atrial appendage were injured,and we had to enlarge the incision for haemostasis.All of the patients were uneventful after the operation.No incisional infection or bar displacement occurred during the perioperative period.During a mean of 16-month follow-up(range 3-24 months),the symptom of chest distress was significant improved,and the cosmetic results were satisfying in 87% of the patients(20/23).Conclusions Minimally invasive repair is feasible and effective for adult patients with pectus excavatum.

Objective　To evaluate the value of the ultrasound and the helical CT in the diagnosis of hepatic focal nodular hyperplasia(FNH).Methods　Fifteen patients with 16 lesions were examined by B-mode ultrasound ,color Doppler ultrasound and helical CT. All of them were proved to be FNH by pathology.Results　In these patients, the hypoechoic pattern with homogeneous solid lesions was mostly displayed on B-mode ultrasound, and the central stellate scar was only found in 1 lesion. A color blood flow with arterial spectrum was detected within central area of FNH in 13 lesions, and spokewheel color flow was depicted in 3 lesions. These color flow patterns were specific for FNH. All lesions were hypervascular and homogeneous on arterial phase scans of CT. The central scars were detected in 7 lesions, and a dilated feeding artery was seen in 8 lesions on the arterial phase scans. The isodense changes were displayed in 11 lesions on the portal phase or delayed phase.Conclusions　The conventional ultrasound combined with color Doppler ultrasound and CT combined with dynamic scan can raise the accuracy for the diagnosis of FNH.

Objective To explore the analgesic effect of ropivacaine combined with sufentanil in epidural anesthesia on walk on painless labor.Methods 134 cases of maternal pregnancy were selected and randomly divided into two groups.61 cases were treated with conventional delivery,73 cases in the experiment group were treated with walk on painless labor.The visual analogue scale and improved Bromage classification score were compared at the first stage of labor,the second stage of labor,the third stage of labor.Results Compared with the control group,the rate of cesarean section was higher(P<0.05),The visual analogue scale was higher at the first stage of labor,the second stage of labor,the third stage of labor,the duration of labor were lower at the first stage of labor,the second stage of labor,the third stage of labor(P<0.05),and there was no significant difference between the two groups in the motor nerve block.Conclusion Ambulatory labor analgesia on maternal effect significantly,can significantly reduce the pain degree of maternal birth process and deliverry time,postpartum less complications.

Objective To explore the most effective formula to predict the catheterization length of the right internal jugular vein by an-terior approach. Methods Sixty-seven cases performed with right internal jugular vein catheterization from January 2013 to June 2013 were enrolled in this study and 4 formulas were selected to predict the catheterization lengths. Comparing their predicted lengths with the actual lengths defined as the lengths of the internal catheters which terminals were inserted to a accurate position,and analyse their predictive validi-ty. Results The predictive error percentages of the 4 formulas were all less than 15%. Comparing the predicted lengths and the actual lengths, there was no difference between the predicted length of the 1st formula and the actual one(P>0. 05),and the predicted lengths of the other three formulas were significantly less than the actual ones(P<0. 05). Comparing the mean absolute predictive errors of the 4 formu-las in the 3 height groups of 150~159 cm,160~169 cm and 170~179 cm,respectively,those of the 4th formula were all significantly higher than those of the 1st formula in all the 3 groups(P<0. 05);and no differences between those of the 2nd or the 3rd formula and those of the 1st formula were observed(P>0. 05). Conclusion The predictive error of all the 4 formulas is less than 15%, and the 1st formula is simple,practical and associated with a much smaller error,more suitable to estimate the length of the right internal jugular vein catheterization by anterior approach.

Objective To investigate the efficacy of endoscopic intranasal structure reconstruction surgery for rhinogenous headache. Methods 82 cases of rhinogenous headache were given endoscopic intranasal structure reconstruction. Compared VAS scores before and 6 months after treatment, counted the effective rate. Results Among the 82 patients, 69 patients(84. 1%) were cured, 8 cases (9. 8%) were of obvious effect, 5 cases (6. 1%) were invalid, and the total efficiency was 93. 9%. VAS scores of the mucosal contact headache group before treatment were greater than that of the sinus headache group (P<0. 05). Compared with VAS scores before treatment, both of the two groups had lower VAS scores after treatment (P<0. 05), but there was no significant difference between the two groups after treat-ment (P>0. 05). Conclusion Endoscopic surgical operation can remove the extrusion of the nasal cavity and paranasal sinuses and factors of nasal congestion, and then reconstruct normal anatomical structure of nasal cavity, thus restoring normal function of paranasal sinuses. It has good therapeutic effect on rhinogenic headache.

Objective To investigate the effect of the evaluation on teaching hospitals affiliat-ed to medical colleges in Guangdong province. Methods Questionnaire and on on-the-spot investi-gation was conducted among 18 teaching hospitals which owned the accreditation for 2-3 years based on Guangdong provincial teaching hospital accreditation indicator system 2008 modified version. Contents of investigation included general situation,teaching condition,management and implementa-tion of teaching activities as well as medical staffs' comments and suggestions for the teaching work. SPSS 13.0 software was used for frequency analysis. Results The general situation,teaching condi-tion,management and implementation of teaching activities were improved to varying degrees after the evaluation according to results of the questionnaire. 90.0%(54/90)people thought that the overall scale of the hospital was expanded and 5.0%(3/60)people thought that the overall scale of the hos-pital was obviously reduced or marinated the original level. 11.6%(7/60)and 88.3%(53/60)people thought that medical quality of the hospital was improved or obviously improved. 60.0%(36/60)people thought that educational occupancy of the hospital was improved while 5.0%(3/60)people thought that it was unsatisfactory. 83.3%(50/60)people thought that teaching mold and infrastructures were improved while 10.0%(6/60)people thought that it was unsatisfactory. 95.0%(57/60)people thought that teaching management was improved. Due to the lack of incentives and support in teaching work, management of teaching was loose. Conclusions The teaching work of t hospitals affiliated to medical colleges in Guangdong province do persevere basically and achieve desired purposes.

Objective To study the role of recombinant human epidermal growth factor (rhEGF) in the prognosis of multiple organ dysfunction syndrome (MODS) in mice. Methods One hundred and twenty clean male Kunming mice were randomly ( random number) divided into normal saline control group (n =15),MODS model control group (n =15) and MODS + rhEGF treatment group (n =90).The MODS models were made by using Caballero ME method with thioacetamide (TAA) 2000 mg/kg injected intraperitoneally to establish monophasic rapid onset pattern of MODS model in mice.MODS + rhEGF treatment group was further randomly divided into two subgroups,namely intraperitoneal injection group (n =45 ) and subcutaneous injection group (n =45 ).Each subgroup was divided again into three small subgroups (n =15) as per different doses of rhEGF used,namely 10 μg/kg,30 μg/kg and 50 μg/kg.Within 24 hours after modeling,the respiration,body weight,food eaten and general physical changes were observed.Mortality was calculated 24 hours after modeling.After the animals sacrificed,the tissues of viscus including liver,kidney,heart,brain,lung,spleen,pancreas,intestine and stomach were collected immediately.The histological changes of visceral tissues were studied by using hematoxylin -eosin staining under the light microscope.All the experimental data were presented in,and body weight changes were compared using t-test,and after different routes of administration with different doses of rhEGF used in MODS,the mice body weight changes were analysed by using the Dunnett method,and the mortalities of mice were compared by using Fisher exact test,and P ＜ 0.05 was considered statistically significant difference. Results There was no significant difference in mortality betweeu mice in rhEGF subcutaneous administration group and MODS model control group (P ＞ 0.05 ),but the total mortality of hrEGF MODS intraperitoneal administration group (6.7％ in dose of 50 μg/kg and 20％ in dose of 30 μg/kg) was significantly lower than that of MODS model control group (73.3％) ( P ＜ 0.05 ) and the mortality of mice treated with intraperitoneal 50μg/kg rhEGF (6.7％ ) was lower than that treated with 10μg/kg rhEGF (P=0.014).The mortality of mice in rhEGF MODS (50 μg/kg ) intraperitoneal administration group was significantly lower than that in subcutaneous administration group (40％) (P =0.031 ), The histopathological changes in rhEGF MODS treatment group were not as remarkable as seen in mice of control group.The histopathological changes were dose - dependent.The higher doses of rhEGF,the lesser hepatic congestion,liver cell apoptosis,hepatic cell cloudy swelling and cell vacuolization.Similarly,as RhEGF dosage increased,pulmonary interstitial congestion,inflammatory cells and apoptotic bodies reduced,and bronchial ciliated columnar epithelium less shed.Conclusions RhEGF plays a positive role in repairement of tissue damage in TAA - induced MODS murine model.The rhEGF given by intraperitoneal route of administration is more effective to reduce the 24 h mortality of MODS mice than that by subcutaneous route.

Objective To compare the efficacy of laryngeal tube suction Ⅱ (LTS Ⅱ ) and ProSeal laryngeal mask airway (PLMA) for airway management during general anesthesia. Methods One hundred and twenty adult ASA Ⅰ or Ⅱ female patients, aged 30-50, with body mass index ＜ 30 kg/m2, undergoing general anesthesia for elective surgery were randomly divided into 2 groups ( n = 60 each) : PLMA group and LTS Ⅱ group. Each group was further divided into 2 subgroups: PLMA controlled ventilation group (group PC), PLMA spontaneous breathing group (group PS), LTS Ⅱ controlled ventilation group (group LC) and LTS Ⅱ spontaneous breathing group (group LS) . The rate of successful insertion was recorded. PetCO2 , peak airway pressure, lung compliance and incidence of gas leakage during controlled ventilation were recorded before operation, 10 min after the start of operation and at the end of operation. The tidal volume and PetCO2 were recorded in patients breathing spontaneously when the breathing was stable. The bucking and body movement were observed during removal of LTS Ⅱ or PLMA. The side effects in 24 h after surgery were recorded.Results Insertion was successful in all the patients. During either spontaneous breathing or controlled ventilation, the peak airway pressure was significantly higher in the patients with LTS Ⅱ than in the patients with PLMA ( P ＜ 0.05), and there wag no significant difference in the other ventilatory parameters between the two devices. There was no significant difference in the incidences of postoperative complications among the groups ( P ＞ 0.05) . Conclusion The efficacy of PLMA for airway manage ment is better than that of LTSⅡ during general anesthesia.