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.

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.

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.

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 explore the relationship between HPV infection ,the expression of PCNA ,Ki-67,p53 in cervical carcinoma and clinicopathologic data .Methods Seventy-six cases of cervical cancer tissues with complete clinical data were collected from the third affiliated hospital of harbin medical university from march 2012 to September 2012 .Tissue microarray technology ,immunohistochemical technique and statistic method were adopted to make comparative analysis among HPV ,PCNA,Ki-67,and p53 expression in patrents with cervical cancer.Results The expression rate of HPV in cervical carcinoma was 68.4%,which was related to the lym-phatic metastasis(P<0.05).Expression of PCNA in cervical cancer tissue was 90.1%and 100%in female pa-tionts women under the age of 35.The expression rate of Ki -67 and p53 were 48.9%and 38.2%respectively, both were correlated to lymphatic metastasis(P<0.05)and preoperative chemotherapy(P<0.01).Conclusion HPV infection with Ki -67,and p53 expression in cervicalcancer tissues are associated with the presence of lymph node metastasis .HPV promotes cervical epithelial cell proliferation ,inactivates tumor suppressor gene p 53 function ,and promotes the invasion and metastasis of cervical cancer .Preoperative chemotherapy of cervical canc-er can reduce the expression of p53,PCNA and Ki-67.

Objective To investigate the risk factors related to persistent unconsciousness in patients with severe traumatic brain injury (sTBI) by way of building a prognosis model.Methods The clinical data of 165 sTBI patients admitted from July 2011 to November 2013 were retrospectively analyzed.The eligible patients were randomly assigned to derivation cohort (n =115) and verification cohort (n =50) by treatment order.Inclusion criteria:(1) age ＞ 15 years; (2) definitive history of head injury; (3) traumatic brain injury confirmed by head computerized tomography or brain MRI; (4) initial Glasgow coma score (GCS) was less than 8; (5) patient's light come or consciousness impairment gradually deteriorating to profound coma on the day of admission.The exclusion criteria were as follows:(1) only a brief loss of consciousness or coma after trauma (coma time ＜ 6 hours) ; (2) post-injury hysteria or dementia causes appearance like coma ; (3) unconsciousness results of status epilepticus which was induced by emotion after injury.Univariate and muhivariable logistic regression were employed to determine the independent predictors of persistent unconsciousness in the derivation cohort,and then prognosis model was established.The Hosmer-Lemeshow goodness-of-fit test and the area under the receiver operating characteristic curve were used to assess the capacity of model for discrimination and calibration.Results Logistic regression analysis was used to identify GCS score,neurological complications,diffuse axonal injury (DAI),electrolytes disturbance as the most important predictors of persistent unconsciousness.The model was well calibrated in the derivation cohort (Hosmer-Lemeshow test,x2 =4.380,P =0.496).The model showed good discrimination (area under the receiver operating characteristic curve) in the derivation cohort (0.87; 95％ CI:0.798-0.942) and in the versification cohort (0.90; 95％ CI:0.803-0.997).Conclusions The prognosis model could accurately predict the persistent unconsciousness lasting in sTBI patients despite its certain limitations,and therefore,it has significantly clinical and societal value.

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.

Objective To explore the clinical features of very long chain acyl-CoA dehydrogenase deifciency (VLCADD). Methods The clinical manifestation and the biochemical data of one baby girl with VLCADD were summarized and related literatures were reviewed. Results Female patient, aged 7 months, presented with recurrent vomit, haematemesis, stare, nodal tachycardia, hypoglycemia, abnormal liver function and myocardial enzyme. She died after one month due to frequent relapse together with withdrawing treatment. Conclusion VLCADD as a rare disease that cause sudden unexpected death in infant, the early diagnosis and treatment are important to patients.

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.