Objective To investigate the imaging findings of combined hepatocellular carcinoma and cholangiocarcinoma(cHCC-CC) with dynamic MRI and spiral CT.Methods Twenty-three patients of cHCC-CC were evaluated.All patients had surgery and diagnoses were confirmed by histopathology.Eighteen patients had pre- and post-contrast scans with spiral CT.Five patients had MR with dynamic multi-phase contrast scanning.Imaging findings in all patients were retrospectively reviewed.Results CT of eighteen patients showed low-density masses with ill-defined margin (n =15 ),lymphadenopathy( n =5 ),invasion of blood vessels ( n =7 ),satellite lesions ( n =5 ),enhancing pseudocapsule ( n =9 ),and dilatation of intrahepatic ducts (n =1 ).MRI of five patients showed lesions with low signal on T1 WI and high signal on T2WI,lymphadenopathy(n =1 ),invasion of blood vessels (n =1 ),enhancing pseudocapsule (n =4).Dynamic CT or MRI enhanced scanning showed areas of heterogeneous enhancement in the interior or periphery of the tumor on the arterial phase,areas of inhomogeneous high signal ( corresponding regions of low signal on the arterial phase) on the portal venous phase,areas of mixed signal intensity due to retention of contrast agents on the delayed phase.Conclusions Combined hepatocellular carcinoma and cholangiocarcinom demonstrate imaging features on conventional and dynamic MRI and spiral CT,which can be helpful to improve the diagnostic accuracy of this disease.

Two models, mouse hot plate and vocalization indused by electrical stimulation of rat's tail were used to demonstrate the antinocice-ptive action of the neurotoxin ( NT ) from cobra venom.The paw-lick latencies of mice of both NT groups in different dose (0.023 mg/kg, 0.03 mg/kg, im ) were significantly prolonged than that of the control group. In the rats, the vocalization threshold of NT group was significantly higher than that of the control group too. This action of NT showed in these models was in good dose-resp-onse relationship. The onset of antinociceptive action of NT was 2 h and reached highe level 3h after intramuscular injection. This effect could be maintained for more than 24 h 3 groups of mice were continuously given normal saline, NT and morphine respectively for 9 days, and no tolerance showed in NT group of mice, but the acute tolerance to morphine occured in morphine group of mice. These result suggested that the analgesic mechanism of NT may be quite different from that fo morphine.

OBJECTIVE:To establish a HPLC method for the simultaneous determination of quercitrin and isoquercetin in hypericum japonicum thunb.injection.METHODS:Merck Lichrospher RP 18 was used as chromatographic column and the mo-bile phase consisted of acetonitrile-(pH=3.0)buffer phosphate(18∶82)with flow rate at1ml/min,column temperature at25℃and detection wavelength at350nm.RESULTS:The linear range for quercitrin and isoquercetin were0.278?g～4.440?g(r=0.9991)and0.315?g～2.520?g(r=0.9991),respectively.The average recovery were98.60%(RSD=2.23%)and97.79%(RSD=1.74%),respectively.CONCLUSION:This method is accurate,reliable and applicable,and suitable for the quality control of hypericum japonicum thunb.injection.

Objective To assess the prevalence and related factors of postpartum depression in mothers of preterm infants in neonatal intensive care unit (NICU).Methods A total of 83 mothers who met the inclusion and exclusion criteria were investigated by using Edinburgh Postnatal Depression Scale (EPDS) and the comprehensive questionnaire for mothers of preterm infants in NICU,and the analysis was performed on SPSS 13.0 using the Spearman correlation analysis and Logistic regression analysis.Results Among the 83 mothers,38 got the EPDS score of 10 and above,which accounted for 45.78％ (38/83).The disease severity (OR =3.318,P ＜ 0.01),the worry about disease prognosis (OR =4.348,P ＜0.01),the worry about mental development of the newborn (OR =5.420,P ＜ 0.01) were the risk factors for postpartum depression in mothers of preterm infants in NICU.Conclusions It's different from the correlation to postpartum depression in mothers of full-term newborns,the correlation to postpartum depression in mothers of preterm infants in NICU are closely related to premature and admission in NICU.The mothers of preterm infants in NICU are the high-risk population for postpartum depression.Routine screening mechanism for mothers of preterm infants should be established for early detection and treatment of postpartum depression,and to promote maternal and infant health.

Objective To study the effectiveness of interventional chemotherapy in combination with embolization for bulky cervical carcinoma in stage Ⅱb.Methods Cases divided into preoperative interventional group(A)and preoperative radiotherapy group(B).Radical surgery for uterine and pelvic lymph node was performed in each group 2～ 4 weeks after treatment.Results The 3 year survival rates were 91.0% and 88.48%,and 5 year survival rates were 81.79% and 73.37% in A and B,respectively.The recurrence rates were 21.7% in A and 48.6% in B(P

OBJECTIVE To explore the infection control process in neonatal care unit by using evidence-based medicine(EBM).METHODS Under the guidance of EBM and process management theory,investigating and collecting relevant materials on hospital infection,searching the related literatures from the EBM websites(MEDLINE database,etc) and undertaking comprehensive evaluation,to establish the infection control process in neonatal care unit,in connection with practice,then using it in internal medicine and surgery wards.RESULTS After using infection control process,neonatal infection rate was reduced to 1.87%.Hygienic monitoring index of incubator,ventilator tube,pipe atomization,hand,air and handwashing compliance of medical staff were effectived changed(P

OBJECTIVE To explore how to establish the hospital infection control process by using evidence-based medicine.METHODS In order to establish the hospital infection control process for every department the data related to hospital infection were collected through searching related literature from MEDLINE,Chinese biomedicine literature database authorized by Institute of Medical Information.Chinese Academy of Medical Sciences and evidence-based medicine network then estimated thoroughly.RESULTS The incidence of hospital infection patients,environment sanitation inspection,medical staff hand-washing compliance,and occupational exposure all were up to scratch(P

OBJECTIVE To investigate the distribution of 2916 strains and analyze the antimicrobial susceptibility of major pathogens and to provide evidences for clinical therapy.METHODS The distribution,and the antimicrobial susceptibility of pathogens,which were collected and isolated from all of the clinical specimens from Jan 2007 to Oct 2008 in our hospital,were studied restrospectively.RESULTS Totally 2916 strains(except fungi) of pathogens were isolated from patients,among which 1857 strains were Gram-negative bacteria(63.7%) and 1056 strains were Gram-positive cocci(36.2%).The five common bacteria isolated from the specimens were Escherichia coli(14.3%),Klebsiella pneumoniae(11.8%),Pseudomonas aeruginosa(10.7%),Staphylococcus aureus(10.5%),and Acinetobacter baumanii(8.7%).The ESBLs producing E.coli and K.pneumoniae accounted for 31.4% and 33.7%,respectively;meticillin-resistant S.aureus(MRSA) accounted for 53.3% and meticillin-resistant coagulase-negative staphylococci(MRCNS) accounted for 49.6%;vancomycin-resistant S.aureus was not isolated Gram-negative bacilli had the lowest resistance to carbapenems,and then to piperacillin/tazobactam(TZP) and cefoperazone/sulbactam(CFS),showing multi-resistantce.Gram-positive cocci were more sensitive to vancomycin,rifampicin,nitrofurantoin than to other antibacterials.CONCLUSIONS The drug resistance of the isolated bacteria is common.It is very important to monitor the drug resistance of the bacteria regularly,for guiding the clinic use of antibiotics rationally,and infection control.

Objective To evaluate the treatment effect of later course accelerated hyperfractionated radiotherapy with chemotherapy for stage Ⅲ and ⅣA nasopharyngeal carcinoma. Methods 116 patients with stage Ⅲand Ⅳ s nasopharyngeat carcinoma were randomly divided into three groups: the conventional fractionation radiotherapy(CFR, 38 cases), the concurrent radiochemotherapy group(CCRT, 39 cases) and the later course accelerated hyperfractionated radiotherapy combined with chemotherapy group (LCAF+CT, 39cases). CFR group was treated with 60Co γ rays and X rays. When the patients had received the dose of 36～38 Gy through composite faciocervical fields, changed into preauricular fields, the total dose was 70 ～75 Gy.And the total dose of cervical metastasis lymph nodes were 70～80 Gy. CCRT group was treated with DDP and 5-Fu. LCAF+CT group was treated with accelerated hyperfractionated radiotherapy. When the dose of composite faciocervical fields had reached 36～38 Gy, changed the fields and treated with accelerated hyperfractionated radiotherapy, 1.3 Gy/fraction, twice daily. The total dose was 69.8～75 Gy. And the chemotherapy drugs was similar to CCRT group. Results The positive response rate among LCAF+CT, CCRT and CFR groups were 94.9 %, 89.7 %, 76.3 % respectively. The complete response rate in the nasopharyn of LCAF+CT group was higher than CFR group(P ＜0.05). The local control rates of one, two and three year of three groups were 100 %, 97.4 %, 89.5 %, 94.9 %, 84.6 %, 68.4 % and 89.7 %, 74.4 %, 57.9 %respectively; and the survival rates of one, two and three year of three groups were 100 %, 92.3 %, 84.2 %;89.7 %, 84.6 %, 71.0 % and 79.5%, 76.9 %, 57.9 % respectively. There were obvious difference between LCAF+CT and CCRT groups in local control rate and survival rate. But there were no difference between LCAF+CT group and CCRTgroup, and also between CCRT group and CFR group. Conclusion The later course accelerated hyperfraetionated radiotherapy combined with chemotherapy can promote disappearance of primary lesion and improve the local control rate and survival rate of patients with stage Ⅲand ⅣA nasopharyngeal carcinoma.