Objective To explore the CT manifestations of pediatric mesenechymal hamartoma of liver (MHL).Methods Clinical data of 15 cases with MHL confirmed by surgery and pathology were retrospectively analyzed.All children were performed with CT scans including plain and enhanced scans,and the imaging features were analyzed.Results All the lesions were solitary,and 9 masses located at the right lobe of liver,4 located at the left lobe,the others located at both right and left lobe.The maximum diameter of lesions was from 5 cm to 30 cm,with an average of (11.52±6.84) cm.Ten cases were cystic and solid mixed,5 cases were solid.After contrast administration,the solid component and the septa of the masses showed enhancement while no enhancement was observed in the cystic component.Two cases had the spot-like calcification.Conclusion MHL has some special characteristics in the CT scan before surgery,which should be differentiated from other cystic and solid tumors of live.Some MHLs can be diagnosed when combined with the clinical information and CT images.

Objective To study the effects of localized thermochemotherapy on cellular proliferation and the expression of PCNA and IGF-I protein of C6 gliomas in rat, and explore the possibility of developing new therapeutic method of gliomas. Methods C6 glioma cells were injectcd subcutaneously to rats. The rats were randomly assigned to 4 groups,and treatment were initiated on day 22 after tumor inoculation. Prior to treatment, the subcutaneous gliomas were examined to verify tumor size, which were ranged 1.5 to 2.0 cm. Then localized thermochemotherapy, hyperthermia and chemotherapy were given, respectively. The size and weight of subcutaneous tumors were measured. PCNA and IGF-I protein expression were detected by the technique of S-P immunohistochemistry. Glioma cells proliferation was detected by HE staining method and electron-microscopic observation. Results Compared with the control group, the tumor size of rats in the hyperthermia and chemotherapy as well as thermochemotherapy groups was decreased,the tumor weight was also decreased significantly (2.95g vs 1.95g vs 1.86g vs 1.09g, P

Tianjin Medical University set up the module of Early Clinical Practice in the 2012 year's new curriculum system which takes the teaching mode of combining the in-class curriculum and the extracurricular scientific research as well as the social practice.The in-class curriculum refers to the early contact clinical curriculum,namely making the early contact clinical practice training as a compulsory course,which focuses on the cultivation of students' medical professional ethics and the cultivation of doctor-patient communication ability,health promotion and preventive medicine consciousness,to strengthen students' clinical thinking,clinical research ability and basic skills training.The extracurricular part mainly takes the innovation credit project as the instruction,which will make the social practice,scientific and technological innovation activity project,clinical basic skills training comprehensive,and train students' ability of organization plan,communication and coordination,word expression and scientific research ability.

Objective To study the effects of localized thermochemotherapy on angiogenesis and the expression of VEGF protein of C6 gliomas in rats,and explore the mechanisms of angiogenesis inhibition by localized thermochemotherapy. Methods Following the establishment of animal models, 40 rats harboring the C6 gliomas were randomly allocated to 4 groups,the rats in the fore 3 groups were treated by localized thermochemotherapy, hyperthermia and chemotherapy, respectively, the remaining group served as control. The expression of VEGF and FⅧ RA protein were detected by S P immunohistochemistry. The vascular structure in rat's glioma was observed by immunohistochemistry and electron microscopy technique. Results As compared with the control group, the expression of VEGF protein was decreased in the hyperthermia and chemotherapy groups,as well as in the thermochemotherapy group.The expression of VEGF was positively correlated with the microvessel density in the tumor ( r =0.9798, P

Objective To evaluate the application of clinical cases related problem-based-learning (PBL) method in critical care medical standardized resident training program. Methods 84 residents were randomly divided into experimental group (n=42) and control group (n=42) by lottery way. The experimental group received PBL process during clinical case analysis while the control group learned completely through traditional teaching method . The residents' clinical competence were assessed by multiple scale mixed method including question bank examination (QBE), case-based discussion (CBD), direct observation of procedural skills (DOPS), simulation etc, and Likert-type scale questionnaire was used to evaluate the feedback of training residents. SPSS 17.0 was used to do line t test to the data of both groups. Results Finally 84 residents finished the study. There were no difference in the general conditions in two groups. The PBL group achieved higher examination score during QBE [(80.26 ±8.89) vs. (86.10 ±9.32)], CBD [(84.83±5.43) vs. (75.36±6.06)], DOPS [(88.81±6.68) vs. (82.70±6.98)], simulation [(79.86±10.09) vs.(72.71±9.30)]. Except two groups residents all gave high scores in enhancing cross connection in clinical knowledge [(4.786±0.470) vs. (4.571±0.859), P=0.16], and the questionnaire results showed that the resi-dents of PBL group gave higher points in exciting autonomous learning, improving clin-ical analysis ability, accelerating clinical thinking establish, developing independent thinking habits, improving the clinical communication skills and teamwork ability (P<0.05). Conclusion The clinical cases related PBL method can improve the training effects during critical care medical standardized resident training program. It can be used broadly after adapting modification in critical care medical education.

Objective To investigate the CT features of hepatic focal nodular hyperplasia (FNH) in children.Methods Thirteen patients with FNH,which was confirmed by postoperative pathology,were enrolled retrospectively.Plain and contrast CT were performed on all patients before operation.The CT imaging features of FNH including size,shape,density,style of contrast were analyzed retrospectively and compared with pathology.Results There were 13 patients with 16 lesions,8 lesions were found in the right lobe,5 lesions in the left lobe and 3 lesions involving both lobes.The tumor size ranged from 5.5 cm to 11.5 cm (media size 7.5 cm) in diameter.Histologically,2 cases were typical type,11 cases were atypical type.The lesions were regular morphology in 12 cases and 1 case with capsule.On plain CT,the lesions were isodensity (n=1) or slightly low-density (n=12).In 2 typical type lesions,there were slit-like,stellate-shaped low density central scars.Arterial phase demonstrated that 12 cases were significantly enhanced and 1 case showed mild enhancement.The central scar was not enhanced.In 12 cases,thickened and torturous arteries were seen.The enhancement was reduced at the portal venous phase in all the lesions,with 10 cases showing slightly higher density,2cases isodensity and 1 case low-density.Two cases showed mild enhancement of the central scar.The enhancement of the solid portion in all lesions decreased at the delay phase,with 12 cases showing isodensity and 1 case slightly low density.Two cases with central scar showed delayed enhancement with slightly higher density.Conclusion The CT features of FNH in children are diversified but distinctive which are related with postoperative pathological findings.Combining with clinical symptoms and CT features can be helpful for the early diagnosis of FNH in children.

AIM To study the effects of Rehmanniae Radix Preparata (A) and Poria (B) on decoction amounts of loganin,morroniside and 5-hydroxymethylfurfural in Corni Fructus (C).METHODS These three medicinal materials were combined one another and divided into seven groups (A,B,C,A + B,A + C,B + C and A + B + C).Then the contents of three constituents were determined by HPLC.RESULTS Compared with the single decoction of Corni Fructus,the decoction amounts of loganin and 5-hydroxymethylfurfural were decreased,and that of morroniside was increased at the time of mixed decoction of Rehmanniae Radix Preparata and Corni Fructus,or Rehmanniae Radix Preparata,Poria and Corni Fructus.This situation was just the contrary at the time of mixed decoction of Poria and Corni Fructus.CONCLUSION The mixed decoction of Corni Fructus,Rehmanniae Radix Preparata and Poria increases the decoction amount of morroniside,which may make mixed decoction liquid show better efficacy.

Objective To study how to decrease the hospital cost of liver transplants. Methods Fifty-four(patients) who underwent liver transplantation at our hospital within 2 years were analyzed retrospectively. The hospital costs of the patients with different liver function before operation, the costs of the(ICU-dependent), as well as the costs of the non-survival group with the survival group were analyzed and compared. Results The average hospital cost of all the patients was about 340 000 yuan. The cost of(pharmacy), anesthesia,(disposable)(materials), transfusion and laboratory tests accounted for 86.9 percent. The(average) cost of Child grade C(patients) was about 410 000 yuan, was 130 000 yuan higher than that of grade A or B patients. The cost of the ICU-dependent was 240 000 yuan greater than that of the(ICU-independent). The(non-survival) group incurred an average cost of 130 000 yuan higher than the(survival) group. Conclusions For decreasing the hospital cost of liver transplants significantly,it is best to encouraging the patients to receive(liver)(transplants) under good conditions.

Objective To investigate the effects of the astigmatism values of children on wavefront aberration.Methods The children aged from 7 years to 10 years were dilated the pupils for 3 days,and the optometry examination was performed.Fifty-nine children who met the inclusion criteria were divided into three groups according to the degree of astigmatism:1.00 D ≤ astigmatism ＜2.00 D,2.00 D ≤ astigmatism ＜ 3.00 D,3.00 D ≤ astigmatism ＜ 4.00 D.In the meantime,OPD-SCAN-Ⅲ aberrometer was used to measure corneal topography,point spread function (PSF),modulation transfer function(MTF) and other optical images.Total higher order aberrations,total coma aberration,total spherical aberration,total trefoil aberration corresponding to the root mean square (RMS) value and the area ratio (AR) value of MTF,the strehl ratio (SR) value of PSF with a 4 mm pupil diameter were assessed.Three groups of higher order aberrations corresponding to the RMS value and the AR value of MTF,the SR value of PSF were respectively compared by one-way ANOVA.Results The RMS of total high-er order aberrations,coma aberrations and trefoil aberrations with a 4 mm pupil diameter of three groups significantly increased with the degree of astigmatism increase,and there were significant differences among three groups (all P ＜ 0.05).The RMS of total spherical aberrations of three groups significantly increased with the degree of astigmatism increase,and there was no significant difference among three groups (P ＞ 0.05).The AR and SR values decreased with the degree of astigmatism increase,and there were significant differences among three groups (all P ＜ 0.05).Conclusion Astigmatism has a significant influence on the higher-order aberrations,MTF and PSF in the children with the rule astigmatism.The rule astigmatism mainly has an effect on the asymmetric components of higher order aberrations.

ObjectiveTo study the proper position for postoperative patients with retinal detachment by intraocular tamponade when using self-designed pillow. Methods Divided 70 postoperative patients with retinal detachment by intraocular tamponade into the experimental group and the control group randomly. The self-designed pillow was used in the experimental group, the routine nursing measures were used in the control group, and then compared the incidence rate of postoperative complication in the two groups, and evaluated the comfortable condition of the patients in the 2 groups. Results The postoperative condition in the experimental group were all better than those in the control group, P