Objective To investigate the clinical significance of plasma prothrombin activity (PTA) and serum alpha fetoprotein (AFP), prealbumin (PALB) in severe hepatitis patients treated with artificial liver plasma exchange. Methods The clinical data of 31 patients with severe hepatitis were retrospectively analyzed. The patients were treated with artificial liver plasma exchange based on the comprehensive treatment. The patients were divided into survival group (17 cases) and death group (14 cases) according to the clinical outcome. The plasma prothrombin time (PT) and serum AFP, PALB levels were detected before treatment, 3rd, 9th and 18th day after treatment and at the last time (prior to discharge/ in extrimis), and the PTA was counted. Results There was no statistical difference in PTA before treatment and 3rd day after treatment between 2 groups (P>0.05). The PTA levels 9th and 18th day after treatment and at the last time in death group were significantly lower than those in survival group:(30.17 ± 4.79)％vs. (39.74 ± 4.77)％, (25.47 ± 6.46)％vs. (42.79 ± 6.88)％and (21.40 ± 9.17)％vs. (47.17 ± 5.46)％,and there were statistical differences (P<0.05). There was no statistical difference in AFP before treatment between 2 groups (P>0.05);the AFP levels 3rd, 9th and 18th day after treatment and at the last time in death group were significantly lower than those in survival group:(121.9 ± 31.7)μg/L vs. (134.6 ± 31.8)μg/L, (88.7 ± 40.8)μg/L vs. (169.9 ± 41.7)μg/L, (56.9 ± 29.7)μg/L vs. (176.8 ± 48.1)μg/L and (29.8 ± 15.7) μg/L vs. (204.3 ± 41.2) μg/L, and there were statistical differences (P<0.05). There was no statistical difference in PALB before treatment between 2 groups (P>0.05); the PALB levels 3rd, 9th and 18th day after treatment and at the last time in death group were significantly lower than those in survival group: (107.2 ± 17.4) mg/L vs. (126.3 ± 33.2) mg/L, (91.2 ± 11.9) mg/L vs. (137.9 ± 35.7) mg/L, (54.7 ± 14.8) mg/L vs. (151.9 ± 27.9) mg/L and (43.3 ± 19.7) mg/L vs. (159.3 ± 41.2) mg/L, and there were statistical differences (P<0.05). Conclusions The plasma PTA and serum AFP, PALB levels are closely related with curative effect of artificial liver plasma exchange in severe hepatitis patients, and dynamic observation of its changes can help to determine the condition.

Objective To explore the MRI appearances of type Ⅴ bone contusion of knee, and explore the diagnostic value and clinical significance of MRI. Methods A retrospective review of 1672 consecutive MRI examinations of acutely injured knees was performed to screen patients with type Ⅴ bone contusion. The MRI findings of them were analyzed by two musculoskeletal radiologists. Results The type Ⅴ bone contusion of knee was found in 43 (2.6%)patients, involving both the inferomedial patella and the anterolateral femoral condyle. Bone contusion was defined as low signal on T_1WI, intermediate or slight hypointense signal on T_2WI,and high signal intensity on fat saturation PDWI, which could be easily detected on axial, sagittal or coronal MR images. Other concomitant specific MR findings included fracture in 9 patients, chondral injury in 29 patients, and lateral patellar subluxation or complete dislocation in 27 patients. Injury of the medial retinaculum was diagnosed and classified in 37 cases, which could be observed best on axial images. Conclusions MRI was accurate in detecting the type Ⅴ bone contusion and that is very helpful for diagnosis and treatment of transient lateral patellar dislocation,and should be used as a routine examination for knee trauma. Axial MR examination should be performed to evaluated the medial patellar retinaculum injury when type Ⅴ bone contusion was found.

Objective To assess the effects of caffeine use in apnea of prematurity (AOP) in the early stage (caffeine was used within 3 days after birth) versus late stage (caffeine was used 4 to 10 days after birth ) . Methods Medline, Science Direct, Elsevier, Embase, CBMdisc and Wanfang databases were retrieved to incorporate studies that met the inclusion criteria. The retrieval time limit was from the establishment of the databases to November, 2015. References that were in line with the inclusion criteria were selected and relevant conference data were collected by manual retrieval. Two researchers conducted meta-analysis using software RevMan 5. 2 after independent data selection, information extraction and quality evaluation according to the inclusion and exclusion criteria. Results One randomized controlled trial and four retrospective cohort studies were included. A total of 59 288 patients were involved. Meta-analysis suggested that, compared with caffeine use in the late stage, the early stage group showed significant lower incidence ( P < 0. 05 ) of mortality, bronchopulmonary dysplasia, intraventricular hemorrhage, periventricular leukomalacia, retinopathy of prematurity and surgical intervention of patent ductus arteriosus. No significant difference (OR = 0. 98, 95% CI 0. 72 - 1. 33, P = 0. 881) was observed between the 2 groups in terms of the incidence of necrotic enterocolitis. Conclusions Patients with AOP should start caffeine treatment as early as possible, which significantly decreases mortality rate and the occurrence of other complications with little adverse reactions and good clinical tolerance.

0.05).The lobular sign was markedly more in peripheral pulmonary squamous carcinoma than in other histopathological group(P0.05).Conclusion There are certain relation between spiral CT appearance and histopathology in peripheral pulmonary carcinoma.CT appearance may be one of the evidence in diagnosing the histopathological type in peripheral pulmonary carcinoma.

Objective To explore the effect of prenatal steroid (PNS) treatment on preventing early severe non-oliguric hyperkalemia in Extremely-Low-Birth-Weight (ELBW) infants.Methods Retrospective comparative analysis was performed on 31 ELBW infants who had been admitted to the hospital’s NICU between July 2001 and Jun 2005. Infants whose mothers received a full course of steroids before delivery (PNS group; n=18) were compared with those infants whose mothers did not receive steroids (NSG group; n=13). Infants were included in the PNS group if their mother was given one full course of dexamethasone ( 10 mg q12h4 doses) before delivery. The last dose must have been given at least 24 hours before delivery. The arterial blood gas , serum concentrations of potassium, sodium and creatinine were measured every 24 hours, and fluid intakes, urine outputs were monitored every day. Results Hyperkalemia was significantly lower in the PNS than in the NSG infants at the first 72 hours of age [5/18 cases ( 27.78%) vs 9/13 cases (69.23%)],P=0.023). However, the serum concentrations of sodium, creatinine, fluid intakes, urine outputs were not significantly difference in both groups. Conclusions Prenatal steroids treatment can reduce early severe non-oliguric hyperkalemia in EVBL infants.

Objective To investigate the occurrence of postoperative healthcare-associated infection(HAI)and its risk factors in neurosurgical patients undergoing removal of intracranial tumor,so as to provide theoretical basis for formulating intervention measures.Methods Prospective survey was adopted to monitor the occurrence of postoperative HAI in patients who admitted to the department of neurosurgery of a hospital and underwent selective removal of intracranial tumor between April 2013 and December 2014 ,risk factors for HAI were analyzed with univariate and multivariate logistic regression analysis.Results A total of 1 218 patients were surveyed,163 patents developed 193 times of postoperative HAI,inci-dence of postoperative HAI was 13.38%,case incidence of HAI was 15.85%.The main HAI site was intracranial site(n=125,64.77%),the next was lower respiratory tract (n=55,28.49%).Multivariate logistic regression analysis showed that operation grade and subtentorial operation were independent risk factors for postoperative HAI in neurosurgical patients undergoing removal of intracranial tumor,OR and 95%CI were 4.352(1.878-10.080)and 1.812(1.280-2.564)respec-tively.Conclusion Risk of postoperative HAI in neurosurgical patients undergoing high grade operation and subtentorial removal of intracranial tumor is high,effective prevention and control measures should be taken to prevent the occurrence of HAI.

To some problems on imaging teaching in traditional Chinese medical university,the countermeasures are as follows: the teacher team constructions and research work were perfected;the teaching contents were compiled by full time teachers;carefully preparing,supervising and guiding teachers could improve class teaching.The clinic should face to practice,society and future,the objective of which is to cultivate practical graduates with knowledge,skill and creativity who can adapt to clinic fast.The various examination forms were applied.By above means,imaging teaching quality has been improved perfectly.

Objective To evaluate the safety and efficiency of endovascular stenting on symptomatic stenosis of vertebral artery origin .Methods 62 patients with symptomatic stenosis of vertebral artery origin received vertebral stenting.Before and after operation ,vascular stenosis rate and clinical symptoms were observed ,and follow-up on all cases.Results The stents was successfully performed in 62 patients.The symptomatic stenosis and clinical symptoms were significantly improved.The stenosis rate decreased from (77.4 ±15.3)%to (12.2 ±6.5)%.The postoperative follow-up lasted for 6-42months.5 cases developed restenosis .Conclusion Endovascular stenting for symptomatic stenosis of vertebral artery origin is safe and effective ,but the long-term curative effect of this technique should be further observed .

Objective To investigate the timing of operation and the selection of surgical procedure for acute biliary pancreatitis.Methods The clinical data of 247 cases of acute biliary pancreatitis were retrospectively analysed.Results Among 10 non-operation patients,4 died;12 patients underwent emergency operation,5 had postoperative complications and 2 patients died after operation.169 patients underwent delayed operation after effective conservative therapy and 1 patient had postoperative complication;56 patients underwent(selective) operation without any postoperative complication or death.Conclusions Early emergency operation should be performed for relief of biliary obstruction in acute biliary obstructive pancreatitis.The patients with acute non-obstructive biliary pancreatitis should undergo conservative therapy at first and then,after(pancreatitis) has been controlled,delayed operation or selective operation to treat the biliary pathologic condition should be performed.

Objective To identify mutations in the OSMR gene in a pedigree with familial primary cutaneous amyloidosis (FPCA).Methods Clinical data were collected from a pedigree with FPCA.Peripheral blood samples were obtained from the proband,his 19 relatives,and 50 unrelated healthy human controls.Genomic DNA was extracted from these blood samples,and subjected to PCR for the amplification of 18 encoding exons and their flanking sequences of the OSMR gene followed by DNA sequencing.Results A heterozygous missense mutation c.2081C ＞ T,which leads to the substitution of proline by threonine at position 694,was detected in the OSMR gene of the proband and his affected relatives,but not in unaffected relatives or healthy controls.Conclusion The heterozygous mutation p.P694L in the OSMR gene may cause the clinical phenotype of FPCA in this family.