Objective To study the clinical features of patients with intracranial ependymal tumour, and explore the prognostic factors which have.a significant association with the outcome. Methods Eighty-three patients with histologically proven ependymal tumour were retrospectively reviewed. The tumour location, the patients' age, the histological features, imaging characteristics, surgical management and adjuvant therapy were studied. Results In 83 cases of intracranial ependymal tumour,41 cases were infratentorial and 42 cases were supratentorial ependymal tumour, 37 patients age ≤15 years, while 46patients age ＞ 15 years. Fifty-eight patients ( 69.9% ) and 25 patients (30.1% ) had low (WHO Ⅰ - Ⅱ ) and high-grade (WHOⅢ) tumors respectively. Sixty-reven (80.7%) patients had gross total resection and 16patients ( 19.3% ) had subtotal resection. The 5-year survival rate was 81.9%( 68/83 ). The factors that were found to have a statistical significance association with the outcome were the extent of the resection and the pathologic characteristics. Conclusions Gross total resection of these tumors results in a good long-term outcome. Reoperation should be considered, if feasible, to remove residual malignant tissue. Anaplastic ependymomas carries a much poorer prognosis. Radiotherapy may play an important role in their treatment.The role of chemotherapy appears limited but can be attempted, especially in the very young, in order to avoid the deleterious effect of radiotherapy.

The toxic effects of immunosuppressants are often dangerous factors which influence long-term survival of recipients.Individualized immunosuppressive therapy has been a hotspot and difficulty for comprehensive treatment of liver transplantation.Immunosuppressive therapy has been gradually developed to pursue long-term survival for receipients and graft,minimized side effects of immunosuppressants,optimized quality of life of patients,and reduce the economic burden of patients.Through consideration of patient's pathophysiological state,understanding the characteristics and side effects of various immunosuppressive,appropriate choose of the immune inhibitor,correct evaluation of immune state of recipients and graft,minimization of drug doses,individualized dosing regimen could be successfully carried out.

Objective　To evaluate the safety of biopsy of the prostate guided by transrectal ultrasound.Methods　Three hundred and seventeen patients suspected to have prostate cancer were examined and 208 patients were followed up.Results　One hundred and eighty-one patients followed up did not feel severe pain during the biopsy of the prostate. Clinical manifestations induded 12 cases of hematuria,4 dases of hematospermia,1 case of fever, 2 cases of pollakisuria and urodymia,2 cases of uroschesis,which disappeared after corresponding treatment.Conclusions　Biopsies of the prostate guided by transrectal ultrasound is advantageous in diagnosis of prostatic carcinoma.

Objective To investigate the significance of clinical nursing pathway in perioperative period of children with hypospadia.Methods 63 cases of hypospadia children patients were randomly divided into the control group (30 cases)and the experimental group (33 cases).The traditional nursing method was used in the control group,while the clinical nursing pathway was used in the experimental group.Results The hospital stay,hospital charges and complications of the experimental group were less than the control group.The satisfaction degree of the experimental group was higher than the control group.There was significant difference.Conclusions Clinical nursing pathway is a safe and effective nursing model.It can shorten hospital stay,reduce hospital charges,decrease complications,and improve patients' satisfaction degree.

Objective To review the blood gas analysis of H7N9 flu patients for better understanding the characteristics and prognosis of the emerging disease.Methods A retrospective review was conducted for the 15 H7N9 influenza patients,whose blood gas profile was tested with a Radiometer 80 Blood Gas Analyzerin our hospital.The profile of blood gas analysis was compared between the 12 surviving patients and the 3 deaths in terms of their outcomes.Results The 3 patients who died of H7N9 influenza averaged 83 years old.The partial pressure of oxygen was <8 kPa in 9 of the 12 surviving patients,which meet the diagnostic criteria of type I respiratory failure.Their partial pressure of oxygen all recovered to normal (11 .033 ± 2.335 kPa,reference range 10-14 kPa)on discharge.The pH value of peripheral arterial bloold averaged 7.335 (range 7.39-7.54)on adission for the 3 patients who died of H7N9 influenza.The worst average pH value was 7.233 (range 7.32-7.35), which was significantly different from the values of the surviving patients.Conclusions Elderly patients are susceptible to H7N9 influenza infection and subsequent respiratory failure.Old age was associated with higher mortality.The partial pressure of ox-ygen is not significantly associated with patient outcomes.Appropriate active treatment may recover the blood gas profile to normal regardless of the initial values.If decreasing peripheral arterial bloold pH value is highly suggestive of poor prognosis, comprehensive measures should be taken to keep acid-base balance,including assisted ventilation to correct hypoxemia.

lymphocyte,and especially the small lymphocytes were moreheavily labeled than the larger ones,and the Con A receptor of NK cell exhibitedpolarization along the cell surface.These results suggest that:1.the extent of ConA receptors was related to the functional activities of the ceils,the more active thecell is,the more the Con A receptors will be;2.the receptors of Con A wereprobably related to the cell recognition,for instance,on the NK cell Con A rece-ptors showed polar distribution;3.the number of receptors of Con A was dependenton the cell differentiation,the more mature the cell is,the more the Con Areceptors are.

Hypoxanthine,the pre_substance of uric acid,was used to create mouse model with hyperuricemia.The dose_effect relationship and time_effect relationship of hypoxanthine during the model establishment were observed.The effect of sex and xanthine oxidase inhibitor on the establishment of mouse model was studied.The results showed this method is effective for the establishment of a stable mouse model with hyperuricemia.

The pathogenesis of post- infectious irritable bowel syndrome(PI-IBS)involves abnormal intestinal immune barrier, which possibly includes the pathological aspects: Intestinal and systemic changes in T lymphocyte; the change of inflammatory cytokines; a increase in intestinal mast cells and enterochromaffin cells and so on. Treatment by western medicine based largely on symptomatic treatment. TCM thinks that the fundamental organ of the irritable bowel syndrome is the liver. Emotional factors inducing liver dysfunction lead to the symptoms of irritable bowel syndrome. The pathogenesis of IBS is, the disorder of movement of qi in liver and spleen. Stagnation of liver-QI with deficiency of the spleen or disharmony between liver and spleen is the key pathogenesis of post-infectious irritable bowel syndrome. On this basis, in various stages of the disease, there may be a different pathogenesis. As a special type of IBS, the balance of vital qi and evil factors determine the disease progression of PI-IBS, in the treatment course also should not forget dispelling pathogenic factors while strengthening body resistance, tonifying deficiency and removing dampness。

In February 2008 the Xiamen Municipal Government reorganized the health service in Xiamen City to create a"Xiamen Model"for community health service.The community health service centers were divided into two parts:the public health service was directly undertaken by the loal government,and the medical service was affiliated to one of the tertiary hospitals.Both were financed by govemment budget,but operated separately.A recent survey showed that the "Xiamen model" promoted the vertical integration of Xiamen medical resources.increased the service efficiency,reduced the medical and drug cost,and improved the satisfaction of local residents.Nevertheless,there were still some problems;the tertiary hospital should change its service pattern and enhance general practice in the community,the finance compensating mechanism need to be improved.

Objective To investigate the effects of somatostatin(SST)or vasoaetive intestinal peptide (VIP)on the expression of MAdCAM-1 in the intestinal muecosa of rats with multiple organ dysfunction syndrome (MODS)and its significance of prevention and treatment of MODS.Method Thirty six Wistar male rats were randomly divided into 6 groups(6 rats in each group),including control group,VIP group 1 and SST group1 (rats treated with VIP and SST respectively),MODS group(rats with MODS),VIP group 2 and SST group 2(NODS rats treated with VIP and SST respectively).The rat model of MODS(system inflammatory response syndrome,＞2 or-gans dysfunction)was established by occlusion of superior mesenteric arteries.0.2 ρmol·g-1 h -11 VIP or SST by intravenous injection combined with 0.25 ρmol/g VIP or SST by intraperitoneal injection were injected into rats.In each group,intestinal lymphocytes from rats labeled with 51 Cr were infused into rat veins and were quantified with γcounter in GALT.The expression of MAdCAM-1 in the intestinal mucosa was measured by western blot.Inflam-mation in the intestinal mucosa was evaluated with histological sections.Student's t test was used to assess differ-ence between the experiment group and the control group.Results In VIP group l and SST group 1,the peak values of MAdCAM-1 expression in diffusive lymphatic tissue of small intestinal were 157.67±2.52 and 154.33±3.22.and those in Peyer patches were 136.00±1.00 and 137.00±1.00.There were no significant difference when compared with control group(165.33±1.53,152.67±2.31,P＞0.05).The percentage of 51 Cr-lympho-cytes in diffusive lymphatic tissue of small intestine(1.04%±0.59%,1.01%±0.83%)showed no significant difference from control group(1.07%±0.61%,P＞0.05),and those in Peyer patches(1.83%±0.90%,1.56%±0.64%)were significantly less than control group(3.85%±2.02%,P＜0.05).In VIP group 2 and SST group 2,the peak values of MAdCAM-1 expression in diffusive lymphatic tissue of small intestinal(158.00±2.65,154.33±1.53)and Peyer patches(156.33±1.53.151.33±2.31)were significantly less than MODS group(175.33±2.52,173.00±2.65,P＜0.05).The percentage of 51 Cr-lymphocytes in diffusive lymphafic tissue of small intestine(1.58%±0.42%,1.45%±0.26%)and Peyer patches(2.14%±1.49%,0.81%±0.35%)were significantly less than MODS group(3.23%±1.69%,5.04%±1.23%,P＜0.05)and the se-vere histopathological danlage in intestine was relieved.Conclusions VIP or SST reduced intestinal lymphoeytes homing to GALT in rats with MODS through suppressing the expression of MAdCAM-1,and attenuated the inflam-matory injure in the intestinal mucosa.