Child, Preschool ; Humans ; Influenza A Virus, H1N1 Subtype ; Influenza, Human ; virology ; Male

OBJECTIVETo compare the effectiveness of percutaneous microwave ablation ( MWA) versus hepatectomy for multifocal hepatocellular carcinoma.

METHODSFrom August 2002 to March 2012, one hundred and twenty-two patients with multifocal hepatocellular carcinoma (diameters 1 to 7 cm, 2 to 4 lesions) were treated by either complete MWA or radical hepatectomy, and their clinical data were collected and analyzed.The patients were divided into MWA group (n = 50) and resection group (n = 72), and the resection group was matched by MWA group based on clinical parameters. The survival and complications in the two groups were compared.

RESULTSThe overall 1-, 3- and 5-year survival rates were 100.0%, 73.0% and 62.0%, respectively, in the MWA group, and 80.0%, 56.0%, and 41.0%, respectively, in the resection group (P < 0.05). The corresponding recurrence-free survival rates were 88.0%, 63.0%, and 52.0% in the MWA group, and 68.0%, 45.0%, and 36.0%, respectively, in the resection group (P< 0.05). The multivariate Cox regression analysis indicated that albumin level, performance status, treatment modality, and tumor size were independent prognostic factors.

CONCLUSIONCompared with hepatectomy, percutaneous microwave ablation is a minimally invasive and reproducible procedure, and can improve the survival in patients with multifocal hepatocellular carcinoma.

Carcinoma, Hepatocellular ; mortality ; radiotherapy ; surgery ; Catheter Ablation ; Genetic Engineering ; Hepatectomy ; mortality ; Humans ; Liver Neoplasms ; mortality ; radiotherapy ; surgery ; Microwaves ; therapeutic use ; Regression Analysis ; Survival Rate ; Treatment Outcome

Objective To retrospectively analyze the MRI findings of epithelioid angiomyolipoma (EAML) of the liver.Methods The MR findings in a series of 8 patients with pathologically proven liver EAML were retrospectively analyzed. Distribution of lesions, signal intensity characteristics, tumor vascularity,feeding arteries and draining veins, fat, hemorrhage, cystic necrosis and pseudocapsule formation were evaluated and correlated with pathology.Results A single lesion was found in each of the 8 patients.All eight lesions showed long T1,long T2 inhomogeneous signal,and high DWI signal. There was only 1 lesion presented with fat,3 lesions presented with hemorrhage. On the dynamic contrastenhanced MRI scan,all 8 lesions manifested as hypervascular with tortuous vasculature in 7 patients.Dilated feeding arteries and draining veins were seen in 5 patients. Conclusion Liver EAML has unique MR imaging features,exhibiting hyperwascular lesions with dialated,tortuous feeding arteries,and draining veins on DCE MRI,which could be helpful in the differential diagnosis of liver EAML.

Objective:To explore influence of aerobic exercise training on serum copeptin level in aged patients with coronary heart disease (CHD) complicated chronic heart failure (CHF) .Methods :A total of 200 aged CHD + CHF patients were randomly and equally divided into routine treatment group (received cardiotonic ,diuretic etc .routine therapy) and aerobic exercise group (received aerobic exercise training based on routine therapy) .After six months , serum copeptin level was measured ,cardiac function and quality of life were assessed and compared between two groups .Results:Compared with before treatment after six months ,serum copeptin level significantly reduced in both groups ( P<0.05 all);compared with routine treatment group ,there was significant reduction in serum copep‐tin level [ (10.85 ± 2.66) pmol/ml vs .(9.24 ± 3.82) pmol/ml , P=0.036] in aerobic exercise group .Compared with routine treatment group ,there was significant improvement in cardiac function ,significant rise in 6min walk‐ing distance [ (185.3 ± 51.8) m vs .(386.5 ± 62.4) m] ,and significant reduction in score of Minnesota living with heart failure questionnaire [ (32.5 ± 5.5) scores vs .(21.8 ± 4.2) scores] in aerobic exercise group , P<0.05 both ;no patients suffered from adverse events such as aggravated heart failure and malignant arrhythmia etc .during aero‐bic exercise therapy .Conclusion:On the basis of drug treatment ,aerobic exercise training can reduce serum copeptin level ,improve cardiac function and quality of life in patients with chronic heart failure .

Objective To assess the value of combined detection of enterovirus nucleic acid and antibody in early etiological diagnosis for hand-foot-and-mouth disease ( HFMD).Methods A case-control study was conducted.A total of 1 066 cases of children clinically diagnosed with HFMD from Hangzhou Children′s Hospital were involved into the research group from January to June 2014, consisting of 401 common cases and 665 severe cases; Throat swabs and serum samples from these children underwent combined detection for EV71/CA16/EV of enterovirus nucleic acid by fluorescence quantitative RT-PCR and for EV71/CA16-IgM by ELISA.All data were analyzed with SPSS 16.0.Results The total positive rate of enterovirus nucleic acid EV71/CA16/EV by fluorescence quantitative RT-PCR in the 1 066 cases of children clinically diagnosed with HFMD was 75.52%( 805/1 066 ) ( 95%CI: 72.80%-78.05%).But the total positive rate of combined detection was 91.46%( 975/1 066 ) ( 95%CI:89%.58-93.04%).The total positive rate of combined detection is higher than that of RT-PCR test(χ2 =98.338,P=0.000).The positive rate of EV71 type of combined detection was 64.63%(689/1 066)(95%CI:61.67%-67.49%),which is 15.38%higher than that of RT-PCR test 49.25%(525/1 066)(95%CI:46.21%-52.29%)(χ2 =51.453, P=0.000).In 665 severe cases of HFMD, the total positive rate of combined detection was 96.69%(643/665)(95%CI:94.95%-97.87%), which is higher than that of RT-PCR test 79.25%(527/665)(95%CI:75.92%-82.22%)(χ2 =95.607, P =0.000).In the severe cases, the positive rate of EV71 type of combined detection was 87.52%( 582/665 ) ( 95%CI:84.71%-89.89%) , which is 18.95% higher than that of RT-PCR test 68.57%(456/665) (95%CI:64.87%-72.06%) (χ2 =69.665, P=0.000).In the fatal cases, the positive rate of EV71 type of combined detection was 95.92%(94/98) (95%CI:89.28%-98.68%).Conclusions The combined detection of enterovirus nucleic acid and specific IgM antibody can significantly increase the positive rate of HFMD, especially for severe cases.The combine detection increases both the total positive rate and EV71 positive rate.Thus it has a high potential for becoming a new guidelines for laboratory diagnosis of HFMD.

SUN Shu-chun,the chief researcher,is one of the famous expert of osteo-traumatology of TCM.He makes systematic sort and study on chirismus on basis of succeeding experience predecessors and his own years of clinic experience.He is good at treating cervical syndrome with TCM chirismus,especially combine it with drugs.In osteo-traumatology academic circles,he is called "the best doctor at home".Professor SUN advocates that the rule of applying various therapies according to different conditions,combination of rigid-flexible,light,skill,gentle,harmony should be obey when we use chirismus.His diagnostic and therapeutic methods and thoughts are original and ingenious.In this article,the author analyzes the academic experience of tendon trauma of professor SUN.

The paper introduces and summarizes the teaching purpose and content project,implementation and effect of the optional course in Excel and medical data analysis.

Objective To evaluate the applicable and clinical value of CT and radiography in the dignosis of acetabular fractures.Methods The data of CT,X-ray and clinical treatment in 18 cases with acetabular fractures were analyzed and comparatively.Results There were 4 cases of the anterior wall fracture,4 cases of the anterior column fracture,2 cases of the posterior wall fracture,2 cases of the posterior column fracture and ,6 cases of complex fracture,11 cases were in company with swelling of the soft tissue in pelvic cavity.Of them,4 cases misdiagnosed by radiography.27 pieces of bone fragment were detected by CT,including 17 pieces of them in joint cavity.12 pieces of bone fragment were detected by X-ray,only 4 pieces of them were in joint.3 cases with femoral head fracture were included in 7 cases of the hip joint dislocation,1 case of them was misdiagnosed by X-ray.Conclusion In detecting the bone fragments in articular space,the type of acetabular fractures and soft-tissue swelling,CT is super to radiography.

Researching on a large relevant literature of spinal tuberculosis, this paper discussed characteristics of spinal tuberculosis and its early diagnosis method. If spinal tuberculosis can be found and treated earlier, prognosis will be better. The early diagnosis of spinal tuberculosis has become hot spot at present. There are many different diagnostic methods including clinical manifestation, laboratory examination, imaging examination, etc. The newest standpoint showed that immunization has closely correlation with tuberculosis and it will become the focus and developmental direction of future research in spinal tuberculosis. In addition, we should know the differential diagnosis of spinal tuberculosis to avoid the misdiagnosis.
Diagnosis, Differential ; Early Diagnosis ; Humans ; Tuberculosis, Spinal ; diagnosis

Objective:To improve the quality standard for Qingyuantiaozhi capsules. Methods:The main components of the prep-aration, such as Chrysanthemum, Anthraquinones, Hawthorn and Radix Rehmanniae Preparata, were identified by TLC qualitatively. The content of chlorogenic acid in chrysanthemum was determined by HPLC. A DIKMA Spursil C18(250 ×4.6 mm,5 μm)column was used with methanol-0. 2% phosphoric acid solution(9 ∶91) as the mobile phase. The flow rate was 1. 0 ml·min-1, the detection wavelength was set at 327 mn and the sample size was 20 μl. Results:The spots in TLC were clear without any interference. The cali-bration curve was linear within the range of 4. 425 2-30. 976 4μg·ml-1(r=0. 999 9) for chlorogenic acid. The average recovery was 101. 18% (RSD=1. 88%, n=6). Conclusion:The improved quality standard is specific, accurate and reproducible, which can be used for the quality control of Qingyuantiaozhi capsules.