Liver cirrhosis is the advanced stage of various chronic liver diseases,and its complications include portal hypertension,esophageal and gastric varices,hepatocellular carcinoma,etc. Transient elastography( TE),a noninvasive method for liver stiffness measurement( LSM),has been used widely to detect liver fibrosis qualitatively and quantitatively. Recently,correlations were observed for LSM with liver cirrhosis and its complications. This article reviewed the studies focused on these correlations,as well as the clinical application of TE.

Objective To investigate the prevalence of lipids disorder in patients with diabetes and the relationship of lipids disorder with sex and hypertension.Methods Totally 2 545 diabetic patients were analyzed for their different lipids disorder based on the clinical data.Results In the group of diabetic patients,1 663 cases were found with lipids disorder (65.3%),and females and males with lipids disorder were 69.6% and 61.9% respectively (P

Objective To observe the phosphorylation level and nuclear translocation of signal transducer and activator of transcription factor-3 (STAT3) in hippocampal neurons induced by oxygen and glucose deprivation in vitro and discuss the dynamic changes of STAT3 signal pathway in an in vitro cell model of brain hypoxia and ischemia.Methods Hippocampal neurons from newly born SD rats (within 24 hours from birth) were cultured with DMEM/F12 for nine days,and then were transferred to oxygen and glucose deprivation environment for four hours to establish experimental cell models.The distribution of phosphorylated STAT3 (p-STAT3) in the hippocampal neurons in different groups was observed under laser scanning confocal microscope after immunofluorescence staining.Expression intensity of p-STAT3 at different time points after oxygen and glucose deprivation in the hippocampal neurons was detected by Western blotting.Results Expression of p-STAT3 was unobvious in the nucleus of the control group,but it was observed in the nucleus of the model group one hour after modeling,and peaked at three hour.Expression levels of p-STAT3 in the hippocampal neurons at each time point between the two groups showed significant difference (P ＜ 0.05).Conclusion Oxygen and glucose deprivation induces noticeable up-regulation of p-STAT3 in the hippocampal neuronal nucleus,which indicates the overactivation of signal transduction pathway of STAT3.

Objective To evaluate efficacy of routine cleaning and disinfection methods for incubators,and put forward a feasible improvement solution.Methods 30 incubators used in a neonatal intensive care unit of a hospital between Decem-ber 2013 and June 2014 were chosen and randomly divided into baseline,control,and trial groups(10 incubators in each group).Baseline group and control group were disinfected by routing disinfection method (wiping internal and external sur-faces of incubators with water and chlorine-containing disinfectant),trial group adopted intensified disinfection method (wi-ping internal surfaces of incubators with alcohol)on the basis of routine disinfection,disinfectant efficacy of three groups were compared.Results In baseline group,unqualified incubators were initially detected on the fourth day of monitoring, all incubators were contaminated in varying degrees on the seventh day of monitoring,the detection rate of unqualified spec-imens was 31.43% (88/280).The median time for the initial detection of unqualified incubators in control group and trial group were on the fifth day and seventh day respectively,there was significant difference between two groups(χ2 =12.38, P <0.05);The unqualified rate of trial group was significantly lower than control group (15.36%[43/280]vs 32.86%[92/280],χ2 =23.43,P <0.05 ).Conclusion Intensified disinfection with alcohol on the basis of routine disinfection method can effectively improve the disinfectant efficacy of the surface of incubators,it is convenient,inexpensive and safe, and worth to be popularized in primary hospitals.

Objective:To observe the clinical effect of tuina plus foot bath with Chinese medicine for patients with diabetic foot (DF) in early stage.Methods:A total of 70 patients with early-stage DF were randomly allocated by the random number table into two groups,with 35 cases in each group.Patients in the control group received conventional medication,while patients in the observation group received tuina plus foot bath with Chinese medicine on the basis of conventional medication.The clinical efficacy was compared after 2 courses of treatment.Results:After treatment,intra-group comparisons of ankle-brachial index (ABI) showed statistical significance in both groups (both P＜0.05).The curative rate was 83.3％ in the observation group,with the total effective rate of 96.7％,versus 29.4％ and 76.5％ in the control group,respectively,and the between-group comparisons showed statistical significance (both P＜0.05),indicating a better effect in the observation group.Conclusion:Tuina plus foot bath with Chinese medicine has a good therapeutic effect for DF patients in early stage.

To evaluate the clinical effect of laser in situ keratomileusis ( LASlK) with the corneal flap created by FEMTO LDV femtosecond laser for myopia.
●METHODS: The corneal flap was created by the FEMTO LDV femtosecond laser, and the thickness of the flap was 110μ m. A total of 143 myopic patients (283 eyes) were treated with the EC5000 - CXlll element laser. The optometry of the eye, best corrected visual acuity (BCVA) the thickness of the cornea, and ObscanⅡ were examined before the operation. The thickness of the flap was calculated by measuring the thickness of corneal bed during the operation in 35 eyes. The conditions of the corneal flap, complications, uncorrected visual acuity ( UCVA ), diopter, corneal topography were observed during and after the operation and were checked for 3mo follow-up.
●RESULTS: During the operation, it appeared small flap ( diameter < 5mm ) in 3 eyes, corneal margin incised incompletely in 5 eyes and incision bleeding in 8 eyes. Postoperative subconjunctival hemorrhage appeared in 6 eyes. The thickness of corneal flap in 35 eyes was 108. 75± 8. 52μ m (98-117μ m) and the error was 6. 49±8. 62μ m (3-12μ m). There was no significant difference between the actual flap thickness and the preset flap thickness ( P >0. 05) . The average equivalent spherical refractive was -0. 29± 0. 47 ( - 1. 50 to + 1. 00) DS after the operation for 3mo and the UCVA met or exceeded preoperative BCVA in 251 eyes (88. 7%).
●CONCLUSlON: The operation of myopia by LASlK flap created by FEMTO LDV femtosecond laser has fewer complications, and the effect is definite and safe.

Objective To analyze the impacts of early enteral nutrition (EN) and parenteral nutrition (PN) on the prognosis of acute pancreatitis.Method By searching relevant literature between January 1996 and August 2013 in Chinese and English databases including Wanfang,VIP,CNKI,PubMed,the Cochrane Library,CBM,and EMABSE,we compared the prognosis of acute pancreatitis after EN or PN in terms of casefatality rate,infections,multiple organ failure,and other complications.Result Compared with PN,early EN significantly reduced the case-fatality rate [OR =0.37,95％ CI (0.23,0.58),P ＜ 0.000 1],decreased the infection rate [OR =0.24,95％ CI (0.15,0.39),P ＜0.000 01],shortened hospital stay [MD =-9.87,95％ CI (-10.84,-8.89),P ＜ 0.000 01],and reduced complications [OR =0.26,95％ CI (0.12,0.58),P =0.001 0] in patients with acute pancreatitis,although the incident of multi-organ failure showed no significant difference [OR =0.35,95％ CI (0.10,1.19),P =0.09].Conclusions For patients with acute pancreatitis,early EN is superior than PN in terms of case-fatality rate,infection rate,hospital stay,and complications.Therefore,it should be applied in such patients whenever condition allows.

Objective To explore surgical methods of removing polyacrylamide hydrogel (PAHG) and the right time of repairing the deformity of breast after removing PAHG.Methods We operated with endoscopy to remove PAHG through the lower mammary areolar incision.According to injection influence,we made the dicision whether to put the silicon gel prosthesis (hereafter referred to as prosthesis) simultaneously,and to fix the porsthesis,and to rebuild the imframammary fold of breast using biological repair membrane (hereafter referred to as membrane).Results In all 46 patients,39 patients' injection and their envelope were removed entirely.7 patients left part of the envelope because of its thin and wide characters.14 of them accepted prosthesis augmentation mammaplasty simultaneously and 5 of these accepted membrane repair.4 patients received prosthesis augmentation in stage Ⅱ.All patients' incision were primary healing.The incision scars were not obvious.1 patient with breast cancer suffered breast excision; 1 patient who received prosthesis and membrane simultaneously appeared prosthesis displacement after 3 months and fixed again.1 patient who received membrane appeared hydrops in residual cavity,and the membrane was removed finally.Conclusions This method with endoscopy through mammary areolae is necessary for cleaning PAHG entirely.We can use prosthesis to repair the deformity of breast after removing PAHG,and if necessary use membrane to fix the implant and rebuild the inframammary fold of the breast.

Objective To investigate the incidence of needle stick injuries of nursing students in different stages of clinical practice and occupational protective education to provide evidence for developing education strategies. Methods One hundred and forty-one nursing students were surveyed retrospectively by a self-designed questionnaire. Results A total of 75.9%(107/141) nursing students had been injured in clinical practice. The incidence of needle stick injuries varied in different stages of clinical practice. Compared with the middle and late stage of clinical practice, the incidence of needle stick injuries was highest in the early stage of clinical practice:53.9%(76/141) vs. 38.3%(54/141),7.8%(11/141),and there was significant difference, χ2=216.14, P<0.05.About 64.2%(88/141)-78.0%(110/141) nursing students had not received protective education on the needle stick injuries. Only 48.9%(69/141)-55.3%(78/141) of nursing students were given protective training on needle stick injuries in their practice hospitals. Before clinical practice, 63.1%(89/141) nursing students had not been vaccinated to prevent infective diseases. Conclusions To reduce the incidence of needle stick injuries and related potential risks of infection caused by injuries, it is necessary to strengthen pre-practice education on occupational protection among nursing students. Perfect supervision system should also be established in practice hospitals and clinic wards.

Objective To investigate the application value of virtual touch tissue quantification (VTQ) technique in staging of chronic kidney disease (CKD). Methods VTQ examination was performed on a random sample of 96 CKD patients at different clinical stages and 45 healthy volunteers (control group). Shear wave velocity (SWV) of renal parenchyma was measured and compared. Correlation between SWV and clinical stage and glomeru-lar filtration rate (GFR) of CKD patients was analyzed. Results The SWV value of renal parenchyma decreased gradually, along with the progression of CKD disease and impairment of renal function. There was no significant difference(P>0.05)between the control group and the CKD1 group ( P=0.061), the CKD2 group and the CKD3 group (P = 0.238), and the CKD4 group and the CKD5 group (P = 0.624). The difference of SWV between the remaining groups was statistically significant(P < 0.05). SWV of renal parenchyma was negatively correlated with CKD stage (r =-0.65, P < 0.001), which means the higher the stage of CKD was associated with the lower the SWV. SWV was positively correlated with GFR (r = 0.73, P < 0.001), which means the lower the GFR was related to the lower the SWV. Conclusion VTQ technique can noninvasively reflect the changes of renal parenchyma elas-ticity and evaluate the impairment of renal function in CKD patients. It can provide a new quantitative evaluation index for the clinical staging of CKD.