Sclerosing cholangitis includes a spectrum of chronic, variably progressive cholestatic liver disease characterized by inflammation, fibrosis and stricture of the intrahepatic and extrahepatic bile ducts. Sclerosing cholangitis can be divided into primary sclerosing cholangitis of unidentified etiology and secondary sclerosing cholangitis caused by various identifiable etiologies, including immunoglobulin G4-related sclerosing cholangitis, recurrent pyogenic cholangitis, ischemic cholangitis, acquired immunodeficiency syndromerelated cholangitis and eosinophilic cholangitis. In this article, we describe the imaging findings of the various spectrums of sclerosing cholangitis with anemphasis on a systemic approach in differential diagnosis. It is very important for magnetic resonance cholangiography and endoscopic cholangiography in imaging diagnosis and differential diagnosis of sclerosing cholangitis. We also discuss the clinical significance and therapeutic options for treating sclerosing cholangitis.

The liver specific contrast agent gadolinium ethoxybenzyldiethylenetriaminepe ntaacetic acid (Gd-EOB-DTPA) is routinely used in clinical magnetic resonance imaging. It combines assessment of tissue perfusion during the vascular phase with hepatocyte specific imaging during the hepatobiliary phase. This combination of imaging properties has been shown to provide excellent results in the detection and differentiation of liver lesions. The enhancement characteristics of Gd-EOB-DTPA in hepatocellular carcinoma, regenerative nodules and degenerated nodules were summarized in this review. Liver cell specific contrast agent can further improve the diagnostic ability.

Objective Investigation of satisfaction of clinical nurses and analysis of the influence factors.Methods The ERG theory of Clayton Alderfer is used as the framework to design the questionnaires,for questionnaire investigation of 249 nurses in the hospital in a stratified sampling,Results The score of general satisfaction of nurses for their work is 3.40±0.58;the satisfaction of nurses for the management of their leaders and teamwork is high,as the satisfaction scores are 4.01±0.76 and 3.60±0.71 respectively;their satisfaction for salary,welfare and social identity is low,as the scores are 2.46±0.86 and 2.50±1.02 respectively.Work satisfaction varies with departments,academic levels,monthly income,work shifts,age,seniority,and objectives for their choice of nursing as profession.Conclusion Managers are prompted to enhance their work in view of the satisfaction scores on survival,mutual relations and growth,as well as factors affecting satisfaction,and take various incentives to improve overall satisfaction of nurses.

Objective To research the early effect and side effect on the radiotherapy of nasopharyngeal carcinoma patient using IMRT compared with conventional radiotherapy. Methods Seventy eight nasopharyngeal carcinoma patients were divided into IMRT group (38 patients) and conventional radiotherapy group (40 patients). After CT-sim, the radiation oncologist and physician delineated the outline of GTV, CTV, parotid gland, spinal cord and brain stem. The receiving volume of parotid, spinal cord and PTV was respectively calculated by using inversing plan. Face-neck, supracalvicular field, amte-aural field and postaural field were adopted to receive electrons during conventional radiotherapy. Seven to nine conformal fields including 80-100 sub-fields were adopted during IMRT. The reaction of skin, parotid (xerostomia) and oral mucosa were recorded during radiotherapy. Results The nasopharyngeal and para-nasopharyngeal lesions regressed completely after radiotherapy. The volume received by the parotid, spinal cord and PTV was 30%?4.8, 56%?6.7, 95%?8.6, 92%?8.1 respectively in IMRT group, and 98%?9.4, 56%?10.7, 100%?9.7, 99%?9.5 respectively in conventional radiotherapy group. The received volume of parotid in IMRT group was significantly lower than in conventional radiotherapy group. The reaction of skin was grade I in IMRT group and grade II, III in conventional radiotherapy group. The reaction of parotid (xerostomia) was grade I and II in IMRT group and grade II and III in conventional radiotherapy group. The reaction of oral mucosa was grade I to II in IMRT group and grade II and III in conventional radiotherapy group. The reactions of skin and parotid (xerostomia) were lighter in IMRT group compared with those in conventional radiotherapy group. The time of radiotherapy was 45?4.4 days in IMRT group and 51?5.3 days in conventional radiotherapy group respectively. Conclusion The radiotherapy using IMRT regime can decrease the reaction of parotid (xerostomia) and skin to complete the radiotherapy course of nasopharyngeal carcinoma patients. Moreover, it can increase the life quality in nasopharyngeal carcinoma patients after radiotherapy and also shorten the time of radiotherapy.

OBJECTIVE:To establish a method for the content determination of 1-phenyl-7-(3-methoxy-4-hydroxy) phe-nyl-5-ol-3-heptanone in active ingredients of Mongolian medicine compound shudage-4. METHODS:HPLC was performed on the column of Intersil ODS-3 with the mobile phase of acetonitrile-0.5%phosphoric acid at the flow rate of 1.0 ml/min,the detection wavelength was 210 nm,temperature was 30 ℃,and the volume was 20 μl. RESULTS:The linear range of 1-phenyl-7-(3-me-thoxy-4-hydroxy) phenyl-5-ol-3-heptanone was 0.102-1.02 μg(r=0.999 9);RSDs of precision,stability and reproducibility tests were no more than 1.52%;average recovery was 97.10%(RSD=1.80%,n=6). CONCLUSIONS:The method is accurate,sim-ple and reproducible,and can provide basis for the quality control of Mongolian medicine compound shudage-4.

Objective To explore a new method of nasal tip plasty and its clinical effect,which is much accorded with biomechanical properties of the human body.Methods From June 2010 to March 2016,a total of 33 cases of nasal tip surgery,6 males and 27 females,were performed.Ages ranged from 22 to 46 years in this group.Ear cartilage was trimmed into two strips and sutured them together in a M shape.When located to the original position of the nasal alar cartilage,theM shaped cartilage could be used in nasal tip;when fixing part of it on the nasal septum or lengthened nasal septal cartilage,the M shaped cartilage could be used in cosmetic surgery of nasal tip lengthening.Results The follow-up period was from one month to 60 months,with average 14 months.29 patients (87.9 ％) were satisfied with the efficacy and 2 patients were suffered from infection (6.1 ％).Conclusions When the M-shaped cartilage is fixed with lengthened nasal septum,it can lengthen the nasal tip much more and the contouring and texture of nasal tip are better than that of using a shield or a cap cartilage graft.

Kinematical alignment during total knee arthroplasty is an emerging process, and draws more and more attentions from scholars. Knee joint is close to normal joint after TKA through kinematical alighment, which has good clinical results and functional scores, and not increase failure probility. Thus, it may increase joint stress of patella-femur joint, lead to patellar maltracking and increase abrasion. The paper summarized defination and basical principle, operative method, clinical outcomes and deficiency of kinematical alignment during total knee arthroplasty, in order to choose a better way for kinematical alignment during total knee arthroplasty.
Arthroplasty, Replacement, Knee ; methods ; Biomechanical Phenomena ; Humans

The training system of rehabilitation talents and its problems were reviewed. The paper discussed a training system as to how to enhance students' clinical operating skills and innovation abilities to ensure the teaching quality and level in order to promote students'employment competitive, mainly from the aspects of teaching system, group of teachers and training base of training rehabilitation talents' clinical operating ability.

Background and purpose: Alveolar soft part sarcoma (ASPS) is a rare malignant neoplasm characterized by slow growth and indolent behavior, and most of the patients had metastases in diagnoses. This study was to define clinical features and assess prognostic factors of ASTS. Methods: Between January 2003 and December 2008, there were 15 patients with ASTS who received treatment and were followed up in the Department of Orthopedic Ontology of Peking University People's Hospital. We retrospectively analyzed the clinical factors of the disease related to prognosis: gender, age, tumor size, primary tumor site, metastatic sites, local recurrence, the roles of postoperative radiotherapy and postoperative chemotherapy. Resnlts: At a follow-up from 7 to 76 months, only 2 patients had local recurrences after excision, but there was a high incidence of pulmonary metastases. Only 6 patients achieved disease free survival, 5 patients died of metastases or other complications. The five-year overall survival rates was 41.7%, and the median survival time was 42.0 months. Univariate analysis and Cox regression analysis revealed that tumor size, tumor primary site and metastases at diagnoses were prognostic factors, but not gender and age, Conclusion: Alveolar soft part sarcoma is a high grade malignant soft tissue neoplasm with frequent metastases to lung, bone or brain. Tumor size, primary tumor site and metastases at diagnoses are some of the prognostic factors. Chemotherapy or radiotherapy after surgery have no benefit to the survival in our analysis. Further prospective studies are needed to clarify the best strategy for the treatment of ASPS.

Strong inhibition of Bacillus subtilis strain NJ-18 on mycelia growth of Alternaria solani was observed in the antagonistic tests by cylinder plate methods, and the inhibition width was 21.5 mm. Observation under microscope found that the supernatant of fermentation from NJ-18 could make the pathogen hyphae cells malformed and swelled, and consequently the growth of the pathogen was inhibited. Determining of the colonization in potato plants by the signed rifampicin-resistance in NJ-18 showed that it could colonize well in the plants, the colonization quantity of NJ-18 in the root and stem of the potato detected 30 days after fermentation irrigation was 103 CFU/g plant’s fresh weight. In pot experiment, we inoculated the tomato plants with the spore suspensions of Alternaria solani after spraying the fermentation of NJ-18, the results were investigated in 14 days and the efficacy in controlling the disease was 72.9%, which was significantly higher than 45.7%, the efficacy resulted from spray treatment of 2000 fold dilution of 50% iprodione wetable powder.