Objective To compare the efficacy of open microwave ablation and repeat hepatectomy for recurrent small hepatocellular carcinoma.Methods The clinical data of 75 patients with recurrent small HCC who were admitted to our hospital from January 2007 to December 2010 were retrospectively analyzed.34 received microwave ablation (MWA group) and 41 received repeat hepatectomy (hepatectomy group).The perioperative condition,liver function recovery,the variation of AFP level,mobidities,hospitalization time and overall survival rate and disease-free survival rate were compared.Results The rate of complete elimination to tumor tissue was 100％ and the AFP levels returned to normal within 3 months in both groups.The mean average operation time in MWA group was shorter than that in hepatectomy group [(91 ±33) min vs (156 ±51) min,t =-6.399 5,P =0.000].The blood loss in MWA group was smaller than that in hepatectomy group [(87 ±62) ml vs (254 ± 134) ml,t =-6.691 5,P =0.000].Patients in PFRA group had a shorter hospital stay [(7.5 ± 2.2) d vs (11.3 ± 2.7) d,t =-6.588 8,P =0.000].The mobidities of the MWA group and hepateetomy group were 2.9％ (1/34) and 22.0％ (9/41),respectively (x2 =5.812 7,P =0.016).The overall survive rate of 1,3 and 5-year were 88.1％,68.8％ and 46.1％ in the MWA group,and 86.1％,71.5％ and 50.2％ in the hepatectomy group (x2 =0.16,P =0.692).The disease free survival rate of 1,3 and 5-year were 67.1％,38.2％ and 16.1％ in the MWA group,and 64.4％,45.5％ and 23.6％ in the hepatectomy group (x2 =0.03,P =0.870).Conclusions MWA can achieve survival benefits equivalent to hepatectomy for recurrent small HCC,and it is less traumatic.

Objective To investigate the mental health status of students with foreign nursing spe-cialty and analyze its relationship with stress, coping style and perceived social support. Method The cluster sampling was conducted between students with foreign nursing specialty. The Perceived Social Support Scale (PSSS), Symptom Check List-90 (SCL-90), and self-designed demographic questionnaires including demographic information questionnaire, College Students Stress Scale and Coping Style Questionnaire were employed. Results Students with foreign nursing specialty obtained significantly higher scores in all factors of SCL-90 when compared to the national youth norm,and obtained significantly higher scores in factors of somatization, obsession, anxiety, fear and psychotic diseases when compared to the norm of college students. The multifactor analysis of mental health status in students with foreign nursing specialty showed that soma-tization factors contained personal stress, seeking help, family supports and other supports;obsession factors contained personal stress, negative life events, academic stress and solving problem;interpersonal sensitivity factors contained personal stress, academic stress, solving problem, self-blame, fantasy and retreat; depres-sion factors contained personal stress, academic stress, solving problem, self-blame and other supports;anxiety factors contained personal stress, academic stress, fantasy, self-blame, family supports and other supports; hostility factors contained personal stress, seeking help, retreat, fantasy and other supports; fear factors contained personal stress, academic stress, seeking help, retreat and fantasy; crankiness factors con-tained personal stress, academic stress, solving problem, retreat, self-blame, family supports and friend sup-ports; factors of psychotic diseases contained personal stress, academic stress, solving problem, self-blame and friend supports;and factors of other symptoms contained personal stress, negative life events, academic stress, retreat, self-blame, family supports, friend supports and other supports. Conclusion The mental health status of students with foreign nursing specialty was inferior to the norms of national youths and col-lege students. It was negatively correlated with stress, active coping style, friend supports and other supports;while positively correlated with passive coping style (except escape) and family supports. Therefore, mental health education toward students with foreign nursing specialty should be strengthened in order to reduce their stress, improve their coping style, enhance their social supports, and finally promote their mental and physical development.

BACKGROUND:It is shown in past researches that total saponin of ginseng has the effect of promoting multiplication of bone marrow hematopoietic stem cells and progenitor cells in vitro, and promoting secretion of bone marrow hemotopoietic factors, however there has been little researches on the effect of multiplication of bone marrow stromal cells.OBJECTIVE: To investigate the effect of ginsenoside Rg1 on pig's bone marrow stromal cells multiplication in vitro.DESIGN: A controlled observation.SETTING:Department of Cardiology and Department of Dermotology,First Affiliated Hospital, Nanjing Medical University; Department of Pharmacology, Nanjing Medical University.MATERIALS: The experiment was conducted at the Cardiovascular Pharmaceutical Laboratory of Nanjing Medical University from January 2002 to February 2003. The experimental pigs ahd the powder of ginsenoside Rg1were chosen METHODS :The bone marrow stromal cells cultured in vitro were divided as control and experimental groups. For experimental group insenoside Rg1 in different concentrations (10-7,5×10-7,10-6,5×104 mol/L)were added for induction culture, and for control group the media of the same volume was added. The multiplication conditions of bone marrow stromal cells were respectively detected by fibroblast colony forming in vitro, tritiated thymidine {[3H]TdR} incorporation and MTT.MAIN OUTCOME MEASURES: ① The effect of ginsenoside Rgl on the fibroblast colony forming units of bone marrow stromal cells in vitro. ②The effect of ginsenoside Rg1 on [3H]TdR incorporation of bone marrow stromal cells. ③ The effect of ginsenoside Rg1 on bone marrow stromal cells multiplication detected by MTT.RESULTS:① The effect of ginsenoside Rg1 on the fibroblast colony forming units of bone marrow stromal cells in vitro: The numbers of units in experimental group were all higher than that in control group (P ＜ 0.05-P ＜ 0.01),especially obvious in (5-50)×10-7 mol/L experimental group, reaching peak in the concentration being 10-6 mol/L. ② The effect of ginseno side Rg1 on [3H]TdR incorporation of bone marrow stromalcells: As the concentration of ginsenoside Rg1 was 10-6 mol/L, the [3H]TdR incorporation efficiency of bone marrow stromal cells was obviously higher that that in control group (P ＜ 0.05-P ＜ 0.01), and the effect was enhanced as the dosage increased. ③ The effect of ginsenoside Rgl on bone marrow stromal cells multiplication detected by MTT: The value of absorbance in experimental group was obviously higher than that in control group (P ＜ 0.05-P ＜ 0.01), and it was dose-dependent. CONCLUSION: Ginsenoside Rg1 had an effect of multiplication on pig's bone marrow stromal cells in vitro, and it was dose-dependent.

Objective To explore the effect of emergency pre-hospital care intervention procedures on patients with acute cerebral hemorrhage treatment. Methods One hundred and eighty patients with acute cerebral hemorrhage rescued in the ambulance of our hospital from June 2011 to June 2014 were selected as the observation group , and another 120 patients of acute cerebral hemorrhage escorted by family members to our hospital during the same period were set as a control group. The patients in the observation group were given guidance nursing, on-site emergency care, emergency care and hospital transit emergency care, and the patients in the control group were given rescue in the hospital. The two groups were compared in terms of effective transit time. Results The effective transit time for the patients in the observation group was (0.87 ± 0.19)h, significantly shorter than the control group (1.26 ± 0.35) h (P<0.05). The complication rate in the observation group was 22.22%, significantly lower than that of the control group (54.17%) (P<0.05). Conclusion Pre-hospital emergency care intervention for patients with acute cerebral hemorrhage can effectively shorten transit time, reduce complications and improve outcome and improve survival, worthy of promotion.

Objective To explore the changes of elasticity in the large arteries and its clinical significance of sublingual administration of nitroglycerin in patients with elevated PWV,and mild and moderate essential hypertension.Methods Totally,779 patients with mild and moderate hypertension and PWV more than 1400 cm/s were selected and divided into four groups,one with simple hypertension,the second one with only one risk factor for it,the third one with two risk factors,and the fourth one with three risk factors or damage in their target organs.Sublingual administration of 0.5 mg nitroglycerin was administered and blood pressure and PWV were measured for all of them.and data were statistically compared and analyzed by groups and before and after nitroglycerin administration.Results Systolic blood pressure decreased to(135±20)mm Hg from(149±15)mm Hg,pulse pressure decreased to(50±11)mm Hg from(59±12)mm Hg,PwV decreased to(1329±288)cm/s from(1688±378)cm/s,respectively,after nitroglycerin treatment for hypertensive patients(t=3.036,2.473,3.885,all P＜0.05).Improvement of elasticity of the large arteries in them after nitroglycerin treatment inversely correlated with the number of risk factors for hypertension they had,with 89.1 percent,74.3 percent,72.6percent and 44.0 percent of improvement in PWV,respectively for those with simple hypertension,only one risk factor.two risk factors and three risk factors or with damage in target organs.Conclusions Systolic blood pressure and pulse pressure significantly correlated with elasticity of the large arteries in hypertensive patients,and their stifiness improved after sublingual administration of nitroglycerin due to decrease in systolic blood pressure and pulse pressure.The more risk factors the hypertensive patients had,the poorer elasticity of their large arteries and less sensitive to nitroglycerin treatment were.

Objective To investigate the dementia caregivers' awareness of dementia diagnosis for patients aged≥80 years in veterans community in Beijing.Methods Patients aged 80 years and over who were diagnosed as dementia were selected from Dec.2009 to Jul.2011 in the veterans community in Beijing.A face-to-face interview and questionnaire survey were conducted in dementia caregivers individually,including basic social demographic data (gender,age,educational background),awareness rate of dementia,treatment and drug use situation and their attitude to dementia patients.Results A total of 118 caregivers were investigated individually.The caregivers in this study were mainly the spouse of the patients,and most of them were elderly people.46.6％ (55/118) of caregivers were the spouse of the patients,and 52.5％ (62/118) of caregivers were 65 years old and over.The caregivers' awareness rate of dementia was 32.3％ (38/118) when patients were diagnosed as dementia.There was no correlations of gender,age and educational background with the awareness rate of dementia diagnosis (all P＞0.05).50％ of dementia patients received the dementia treatment,and only 17.8％ (21/118) of patients got the first line drug treatment for dementia (acetylcholinesterase inhibitors and / or memantine).98.3 ％ (116 / 118) of caregivers agreed that the dementia patients should be treated kindly.Conclusions The dementia caregivers are mainly patients' spouse in veterans community and most of them are the elderly.The awareness rate of dementia diagnosis is low among the caregivers.Most patients do not take the formal treatment.The social support for the dementia caregivers should be strengthened.

Objective To investigate the influence factors for immediate outcome after thymectomy for patients with myasthenia gravis (MG). Methods The clinical data of 108 patients with MG who received thymectomy in the Department of Thoracic Surgery, the Second Affiliated Hospital of Zhengzhou University from July 2009 to July 2012 were retrospectively investigated, including gender, age, duration of disease, clinical classification, pathological classification of thymus and anti-acetylcholine receptor antibodies (AChRab). The immediate outcome after thymectomy was also observed. Thirty-two cases of MG who had immediate outcome after thymectomy were enrolled into experimental group, while 76 cases who did not have immediate outcome after thymectomy were regarded as control group. Results The immediate outcome after thymectomy was associated with duration of disease (χ2=98.550, P<0.01), clinical classification (χ2=40.434, P<0.01), pathological classification of thymus (χ2=11.154, P=0.004) and AChRab (χ2=5.590, P=0.018). There were statistically significant differences between the two groups in the one-year (31.3% in the experimental group vs 14.5% in the control group, χ2=4.046, P=0.044), two-year (40.6% vs 21.1%, χ2=4.392, P=0.036) and three-year complete remission rates (46.9% vs 25.0%, χ2=4.995, P=0.025). Conclusion Duration of disease, clinical classification, pathological classification of thymus and AChRab could be influence factors for immediate outcome and complete remission for patients with MG after thymectomy.

BACKGROUND:The measure and prediction of the shape of optic nerve head are the key issues for early diagnosis and duration prediction of glaucoma. Therefore, it is significant to research the shape variation of optic nerve head under high intraocular pressure.
OBJECTIVE:To establish three-dimensional finite element model of optic nerve head and to analyze the deformation of optic nerve head and the change in retina thickness after acute high intraocular pressure.
METHODS:Animal model of acute ocular hypertension was established by methods of anterior chamber perfusion. The tomographic images of the optic nerve head of a cat were obtained at the normal intraocular pressure and 5 320 Pa, 7 980 Pa, 10 640 Pa, 13 300 Pa, 15 960 Pa intraocular pressures using optical coherence tomography. Then, we measured the variation of retinal thickness at typical location. Basing on the tomographic images of optic nerve head of a cat at normal intraocular pressure, we obtained three-dimensional structure of retina and choroid using software MIMICS. Then three-dimensional model of optic nerve head was established by assembling the retina and choroid. The deformation of optic nerve head and the change in retinal thickness under high intraocular pressure were observed using software ABAQUS. The effectiveness of the model was verified by the experimental result.
RESULTS AND CONCLUSION:With the increase of intraocular pressure, the retinal thickness is thinner, the optic nerve head depth, width and the ratio of the depth to width are gradual y increased. It suggests that the acute high intraocular pressure causes retinal thinning, optic nerve head widening and deepening. It is feasible to establish optic nerve head modeling in vivo by using optical coherence tomography, mechanical analysis can be applied to predict the shape variation of optic nerve head, which is significant to further deduce the pathological process of glaucoma.

Objective To explore the expressions and clinical significance of epidermal growth factor receptor (EGFR),COOH-terminus tensin-like molecule (CTEN)and epithelial cadherin (E-cad)in non-small cell lung cancer (NSCLC).Methods The expressions of EGFR,CTEN and E-cad in 36 cases of normal lung tissue and 82 cases of NSCLC tissues were observed with immunohistochemical SP method and their correlation with NSCLC invasion,metastasis and prognosis was analyzed.Results The positive rate of EGFR,CTEN and E-cad was 58.5% (48/82),69.5% (57/82)and 28.1% (23/82)in 82 cases of lung cancer,while 13.9% (5/36),0.0% (0/36)and 100% (36/36)in normal tissues;the differences were all significant (P<0.05).EGFR,CTEN and E-cad expressions in NSCLC tissues were significantly correlated with tumor differentiation,TNM stage and lymph node metastasis (P<0 .0 5 ).The expressions of EGFR and CTEN were correlated with each other in NSCLC (r=0 .5 3 0 , P<0.001),while the expressions of EGFR and CTEN were correlated with that of E-cad (r=0.499,P<0.001;r=0.333,P=0.001 ).Multivariate Cox regression analysis showed that CTEN expression in NSCLC was an independent prognostic factor (P<0.05 ).Conclusion EGFR,CTEN and E-cad may play a role in the development,invasion and metastasis of NSCLC and have some significance in predicting the prognosis of NSCLC.