Objective To investigate the pathologic basis of intrahepatic biloma formed in the patients with hepatocellulr carcinoma (HCC) after interventional treatment and to assess its clinical significance. Methods Three hundreds and fifty cases of HCC were followed up with CT examination after TAE/PEI, 11 cases received percutaneous bilomography, 10 cases received percutaneous biopsy, and 1 case had surgical resection. All cases of biloma underwent external drainage of bile or ethanol ablation. Results 11 cases of biloma were found (11/350), and all of them displayed a cystic dilation (11/11), 4 cases showed a columnar dilation with indefinite border (4/11), and 3 cases accompanied with a “soft rattan sign” of intrahepatic bile ducts (3/11). The pathologic findings included necrosis on the wall of the biliary tract, extravasation of bile, and infiltration with inflammatory cells. After the external drainage or the ethanol ablation, jaundice had been decreased and symptoms relieved (9/11). Conclusions Biloma is one of the complications of the patients with HCC after TAE/PEI caused by the necrosis of the wall of biliary tract, the correct diagnosis depends on the imaging procedures and biopsy. It is helpful to the further treatment to distinguish biloma from residual nidus of carcinoma. External drainage, stent placement, and ethanol ablation may be the choice of management.

This study analyzes the reason and situation of the educational inspection for colleges and universities.The author suggests the five points to solve these problems and provide countermeasures for improving the educational inspection.

To investigate the protective effects and possible mechanism of Mycelium of Hirsutella hepiali Chen et Shen (MHCS) on metabolic syndromes, free fatty acid and MHCS-treated hepatocytes were used for detecting autophagy-related LC3, p62 and lipid accumulation. Moreover, high fat diet fed mice were used to establish metabolic syndromes model. 50-weeks age mice were randomly divided into: control group, model group and MHCS group. At 80-weeks age, 15 mice were randomly chosen from each group separately for examining oral glucose tolerance, serum insulin, insulin-like growth factor 1 (IGF-1), hepatic LC3, p62, p-NF-kappaB p65, NF-kappaB p65, IL-6 and CXCL-8. Moreover, insulin resistance index (IRI) was calculated. Hepatic pathological changes, including vacuoles, lipids accumulation and fibrosis were observed. Remaining mice were fed with diet separately to 110 weeks-age for statistics of mortality. MHCS promoted autophagy of free fatty acid treated hepatocytes. Mice fed with high fat plus MHCS diet exhibited improved oral glucose tolerance, insulin resistance, hepatic pathology, inflammation, mortality and activated autophagy. The protective effects of MHCS against metabolic syndroms might be through the activation of hepatic autophagy.

With the development of social concept and community service, the development of model of community rehabilitation serviceshas been changed profoundly to promote the mainstream development of the disabled. By means of eliminating poverty, supportingthe disabled and their families to benefit from health, education, livelihood development and social integration, etc., meeting the basic needsand raise quality of life, helping the disabled to integrate and participate in the community development process become mainstream thoughtin the community rehabilitation development. Referring to the community rehabilitation concept advocated by international organizationsuch as WHO, this article elaborates the accomplishments and experiences of community rehabilitation achieved by China Disabled PersonsFederation in the 8 poverty-stricken counties in midwestern China .

Objective: To observe the controlled hypotension effects of nicardipine in 2 different ways for spinal tumor operalion. Methods: Twenty-four adult patients, scheduled for selective spinal tumor operation, were randomly divided into 2 groups. In groupⅠ(n=12), the nicardipine was infused at a rate of 10 μg*kg-1*min-1 and the infusion continued until MAP was at the level of 7.33-8.66 kPa, and then the rate was decreased to 1 μg*kg-1*min-1. In Group Ⅱ(n=12), nicardipine was given 0.01-0.02 mg/kg as the load dose, then infused at 1-2 μg*kg-1*min-1. Results: During the period of controlled hypotension, cardiac index(CI) increased significantly, other hemodynamic variables were stable and no hypertension rebound occurred in both groups. Reaching time of target blood pressure in groupⅡ was shorter than that in groupⅠ（P＜0.05）. The dose required to obtain target blood pressure in group Ⅱwas less than that in group Ⅰ（P＜0.05）. BP recovery time from discontinuing nicardipine infusion to pre-hypotension level,bleeding volume and transfusion volume were similar between 2 groups（P＞0.05）.During mass bleeding,　serious arrhythmia and oliguria did not occur in any case. Conclusion: Controlled hypotension with nicardipine is rapid, stable and easily controlled without hypertension rebound. Nicardipine has considerable protective effects on heart and kidney during mass bleeding. The method of bolus injection followed with intravenous infusion is more suitable to clinical application.

OBJECTIVE: To study protection effect of trasylol on cerebral injury resulting from cerebral ischemia-reperfusion in the interference of immunological response.METHODS: 105 SD rats were randomly assigned into sham operation group,model group and trasylol group (n=35).Focal ischemia-reperfusion model were established by occluding middle cerebral artery.24 h before ischemia and at the 0 h,24 h,4 d,6 d,8 d,10 d,12 d and 14 d of reperfusion,trasylol group were given trasylol via tail vein and other two groups were given normal saline.The infiltration of CD4+ and CD8+ T lymphocytes was observed using immunohistochemistry at different stages of cerebral ischemia-reperfusion.RESULTS: As compared with sham operation group,CD4+and CD8+ T lymphocytes count in model group were increased significantly after cerebral ischemia-reperfusion injury and obtained maximum value at 10th day.CD4+ and CD8+ T lymphocytes count in trasylol group were lower than in model group after cerebral ischemia-reperfusion injury and obtained maximum value at 8th day (P

Objective To investigate the expression of CyelinD1 protein in nephroblastoma.Methods The tissue microarray were made in 28 cases of nephroblastoma and 19 cases of renal tissue adjacent to tumor.The expression of CyclinD1 and p53 proteins were detected by immunohistochemistry.Results The positive rate of the expression of CyclinD1 and p53 protein was significantly different between nephroblastoma and renal tissue adjacent to tumor (P < 0.05).The positive rate of the expression of CyclinD1 and p53 protein was significantly different in different degree of differentiation of nephroblastoma (P < 0.05).The expression of CyclinD1 and p53 protein was positively correlated (P < 0.05).Conclusions The CyclinD1 and p53 might be used as the marks for estimating the degree of differentiation of nephroblastoma.The over-expression of CyclinD1 and the mutation of p53 might play the vital role in nephroblastoma.

BACKGROUND: Total isoflavones of pueraria (TIP) possesses estradiol-like structures and has inhibition effect on bone loss or osteopenia in ovariectomized rats. However, studies have demonstrated that the prevention and treatment effect of TIP on osteoporosis in ovariectomized rats is poor, especially in single utilization. OBJECTIVE: To investigate the combination effect of TIP and vitamin D on the treatment of osteoporosis in ovariectomized rats. METHODS: Totally 81 female sprague-drawly (SD) rats of 3-month-old were randomly assigned into 9 groups. Exception those in the sham-surgery group, all rats were prepared for ovariectomized models. Vitamin D or low-, middle- and high-dose TIP or low-, middle- and high-dose TIP combined with vitamin D were intragastric administrated in the vitamin D, TIP or combination groups, respectively. There was no drug medication in the model and sham-surgery groups. The uterus coefficient was calculated at 3 months after medication. The serum alkaline phosphatase (ALP) activity, calcium, phosphonium, bone gla protein, estradiol levels, as well as bone mineral density of femur was determined. RESULTS AND CONCLUSION: Compared with the model group, the uterus coefficient and estradiol level was obviously increased in the middle- and high-dose TIP groups and all combination groups (P < 0.05); the ALP and bone gla protein levels significant decreased (P < 0.05); and the bone mineral density of central and distal femur were notably increased (P < 0.05); in particular, the result was more manifest in the high-dose combination group. TIP and vitamin D presented with synergism in uterus coefficient, estradiol, ALP, bone gla protein levels and bone mineral density of distal femur, but the effect was not significant in the calcium and phosphonium levels in the TIP and/or vitamin D groups. The findings demonstrated that Tip combined with vitamin D can induce synergism on prevention and cure of osteporosis in ovariectomized rat.

Objective To observe the vertebrobasilar artery and its branch courses,diameters and the included angles in the starting part,offering morphological basis for clinic intervention and vascular image.Methods Layer by layer dissecting head,neck and chest of nine adult specimens affused with red latex,and after affused carotid artery with red latex,the origin,course,branches,distribution,anastomosis,and accompanying of the vertebrobasilar artery were observed in three normal adult corroded specimens.Results The degree of the left included angle between subclavian artery and vertebral was (91.70 ± 0.90) ° and that of the right one was (115.80 ± 1.60) ° (P ＜ 0.05).A percentage (14.1％) of them contacted with vagus and glosssopharyngeal nerve.The degree of the left included angle between posterior cerebal lower artery and vertebral artery was (118.60 ± 3.70) ° and that of the right one (77.60 ± 7.90) °.A percentage (27.6 ％) of itself contacted or pressed by root of facial nerve.The degree of the included angle on the left side between anterior cerebellar lower artery and brobasilar artery was (91.60 ± 2.40) ° and that of the right one was (27.10 ±2.70)°(P ＜0.05).The degree of the left included angle between posterior cerebral artery and basilar artery was (93.90 ± 3.40) ° and that of its right one was (130.80 ± 3.20) ° (p ＜ 0.05).Conclusions Both vertebral artery in every part out of skull and the data of the each branch pipe diameter,the starting included angle of vertebrobasilar artery had statistical significance,which should select personalized catheter or operation method in endovascular intervention or craniocervical surgery.

Objective To discuss the clinical significance of vancomycin plasma concentration monitoring and its relationship with adverse reactions in treatment of elderly patients. Methods The clinical records of 32 patients aged over 70 years admitted in the Emergency Medical Department of Sichuan Provincial People's Hospital were collected. Based on the diagnosis and laboratory examinations on admission, the patients were treated with cefoperazone+sulbactam or moxifloxacin, while in patients with severe infections, intravenous drip of carbapenem antibacterial drugs were given. After treatment for 3-5 days, when no effective results were obtained, according to the pathogenic results achieved from cultures of blood, sputum, secretions, catheter, etc, the corresponding treatment was given. If the infection was caused by positive bacteria mainly methicillin-resistant Staphylococcus aureus (MRSA) sensitive to vancomycin, the original antibiotic was replaced by vancomycin or vancomycin combined with other antibiotic; intravenous drip of vancomycin 1 g in 250 mL normal saline was given, once in 12 hours, with a speed of 10 mg/min or not over 15 mg/min. The function of liver and kidney, and auditory impairment were observed, and the correlation between vancomycin plasma concentration and adverse reactions was analyzed. Results The total incidence of adverse reactions in elderly patients with different serum vancomycin trough concentrations was 37.50%(12/32) in which the highest incidence was kidney damage 18.75%(6/32) followed by the hearing loss 9.38%(3/32) and liver damage 9.38%(3/32). There were no statistical significant differences in the rates of adverse reactions among the different vancomycin trough concentrations (<10, 10-20,>20 mg/L) and [37.50%(6/16), 38.46%(5/13), 33.33%(1/3), all P>0.05], that meant along with the increase of vancomycin concentration, no tendency of increment of adverse reactions was seen. Of the 32 cases, there were 13 treated by vancomycin combined with other antibiotic, the combination rate being 40.63%. There were 2 cases of hepatic impairment (11.83%), 1 case of renal impairment (7.69%) and none hearing damage in patients treated with combination of antibiotic therapy. Therefore no correlation was concluded between the occurrence of adverse reactions and the combination therapy ( r=0.15, P>0.05). Conclusions In elderly patients over the age of 70 years, there is a higher incidence of kidney damage in the application of vancomycin. Thus, the monitoring of vancomycin plasma concentration in elderly patients has instructive significance in its clinical use.