Objective To study the interventional therapeutic methods in Budd Chiari syndrome (BCS) complicated with thrombosis. Methods Eighteen patients of BCS complicated with thrombosis, including 2 cases of hepatic vein (HV) occlusion and 16 cases of inferior vena cava (IVC) occlusion, were treated. Therapeutic methods were anti coagulation with Co Danshen and aspirin in 10 cases or the anti coagulation and thrombolysis with urokinase in 8 cases before operation, treatment with PTA and stent during operation,and thrombolysis with urokinase and the anti coagulation after operation. Results Technical success was achieved in all patients without serious complications. The mean blood pressure in IVC dropped from (31 82?0 52)cm H 2O(1 cm H 2O= 0 098 kPa) to (18 17?0 38)cm H 2O immediately after the procedure. The blood pressure in HV dropped from 42 cm H 2O and 41 cm H 2O to 15 cm H 2O and 16 cm H 2O, respectively. All 18 cases were followed up for an average of 38 months (range 6-72 months). The main symptoms and signs completely disappeared in 12 cases and partially alleviated in 6 cases. Conclusion The interventional treatment of BCS complicated with thrombosis was a safe and effective method.

Objective　To study the role of bcl-2 and bax in the pathogenesis of hepatitis D. Methods　Expression of HDAg， bcl-2 and bax in liver specimens of 79 patients with hepatitis D were studied by immunohistochemistry technique. Meanwhile， the relationship between expression of HDAg and that of bcl-2／bax in liver specimens of patients were studied by double labelling technique and serial sections.Results　bcl-2 was mainly expressed in the cytoplasm of hepatocytes， bax mainly in the cytoplasm of hepatocytes and partly in the nucleus of hepatocytes， and HDAg mainly in the nucleus of hepatocytes. Most of HDAg and bax positive cells were distributed among infiltrating lymphocytes at the periportal region especially at the advancing edges of areas of “piecemeal necrosis”. Most of hepatocytes of bax positive was found to locate near to positive cells of HDAg， and there were positive correlations between degrees of bax expression and HDAg expression（P＜0.05）. Conclusions　The distribution and the expression of bax and HDAg are significantly correlated with the activity of inflammation and the severity of the liver damage， and HDV infection may induce the expression of bax in the hepatocytes，and hepatocyte apoptosis mediated by bcl-2／bax may play an important role in the liver cell injury by HDV infection.

Objective To explore the influential factors of hospital management teaching and to apply new plans to improve quality of teaching. Methods Questionnaire survey was conducted among 94 students majored in health management in Xuzhou Medical College to investigate student' learning behavior as well as contents, applying value, procedures, and teaching effects of the course. Data was put in by Epidata 3.02, described and analyzed by SPSS 18.0. Continous variables were ana-lyzed by t test and classified variables were analyzed by X2 test. Results 25.6%(24/94) students were not interested in this course. 61.7%(58/94) students thought that the course was highly correlated with profession. 56.4%(53/94) students thought that the course was valuable. 35.1%(33/94) students thought that the course was not good in combining theory with practice in teaching. 19.1%(18/94) stu-dents thought that the course was deficient in interactive teaching and teaching methods. 62.8%(59/94) students were satisfied with the teaching effect. Conclusions Main influential factors of hospital man-agement teaching are learning interest, curriculum evaluation and teaching evaluation. To improve quality of hospital management teaching, it is necessary to communicate the importance of the course and to apply new teaching plans to arouse the interests of students.

A prospective study was performed to evaluate the diagnostic value of B- mode ultrasonography and inferior vena cavograme and the value of PTA in Budd-Chiari syndrome.One hundred sixty-eight cases including ninety-two men and seventy-six women, age ranged 11～63(mean,34.8 years).Among them 65 were treated with PTA or stent placement.The authors gave a minute and detail description of clinical feature,ultrasono- graphy,inferior vena cava or hepatic venogram,CT and other radiologic demonstration of Budd-Chiari syndrome retrospectively.Four types of Budd-Chiari syndrome were demon- strated based on anatomy,B-mode ultrasonography,inferior vena cavogram and hepa- tovenograme.(1)IVC membranous webs(76 subjects,45.2%),(2)IVC segmental stenosis or occlusion(65 subjects,38.7%),(3)hepatic vein occlusion(10 subjects,6. 1%),(4)mixed type(17 subjects,10%).The treatment of the Budd-Chiari syndrome with percutaneous transluminal balloon dilatation and stent placememnt of inferior vena cava or hepatic vein was safe and satisfied.Its long-term effectiveness(follow up 3-5 years)is al- so satisfactory.

Two patients of Budd-Chiari syndrome,suffering from the anemalons drainage of inferior vena cava into left atrium were reported including one male of 41 years old and female of 42. togectll with labial cyanosis,fingers and toes symptoms of portal hypertension and IVC hypertension. The obstruction of IVC wastreated with balloon catheter hypertension and IVC hypertension the disrotreaed also after PTA.The echo wasn't discovered with Dopple ultrasound after PTA.

Objective To investigate the expression level of serum Golgi protein-73 (GP73) in patients with primary hepatocellular carcinoma (HCC), or accompanied with Budd-Chiari syndrome (BCS), and to discuss its clinical value in making early diagnosis. Methods The peripheral serum samples were collected in 490 individuals, including patients with HCC (n = 65), cholangiocarcinoma (CC, n = 35), Budd-Chiari syndrome accompanied with HCC (n = 40), type B virus hepatitis (n = 60), cirrhosis after B hepatitis (n = 60), Budd-Chiari syndrome complicated by cirrhosis (n = 60), other malignant lesions (n =50), benign hepatic lesions (n = 60) and healthy volunteers (n = 60). The expression levels of serum GP73 and AFP were determined by using Elisa and electrochemiluminescence methods separately. Results The expression level of serum GP73 in the patients with HCC , CC or BCS plus HCC were significantly higher than that in the other individuals (P < 0.05). The area under the receiver operating characteristic curve (ROC), the sensitivity, the specificity and the diagnostic accuracy of GP73 and AFP for HCC were 0.868, 90.8%, 75.5%, 77.6% and 0.739, 60%, 83.2%, 80.2% respectively. The cut-off values of GP73 and AFP were 43.40 ng/ml and 20ng/ml respectively. The area under ROC and the sensitivity of GP73 for the diagnosis of HCC were strikingly higher than those of AFP (P < 0.05), while no significant differences in the specificity and diagnostic accuracy existed between GP73 and AFP (P > 0.05). The area under ROC, sensitivity, specificity and the accuracy of GP73 for the diagnosis of CC were 0.774 , 88.6%, 72.7% and 73.9%respectively, and the optimal cut-off value was 45.40 ng/ml. Conclusion In diagnosing HCC, the expression level of serum GP73 is superior to AFP. It is hopeful that serum GP73 may be proved to be an early serum tumor marker for HCC.

Based on the requirements of quality assurance during drug control process,a quality assurance system is developed for drug control in the institute of drug and equipment control.The results show that the method developed in this paper is much suitable tothe process of drug control and can be applied tocontrolling the quality from the drug receiving tothe drug releasing.The quality assurance system guarantees that the detected data are achieved scientifically and efficiently.

The stody explored the stalus and influential factors of Medical Marketing teaching and made some Droposition to teaching.The results showed that some students were dissatisfied with the teaching style,the curriculum,or the teaching effect,whose proportion was 42.6 percent,22.3 percent,14.3percent respectively.Main influential factors of Medical Marketing teaching were age,learning interest,evaluation to the curriculum and evaluation to the teaching.It was the findings through the study that the status of taaching was presented from two aspects,namely the students disliked the learning of curriculum and the teaching style was monotonous.Therefore it was urgent to develop the teaching reform and to arouse students'interest.

Objective To study the roles of apoptosis genes bcl 2, bax, and bak in the pathogenesis of hepatitis D. Methods Expressions of HDAg, bcl 2, bax, and bak in liver specimens of 77 patients with hepatitis D were studied by immunohistochemical method. Meanwhile, the relationship of HDAg expression with the expressions of bcl 2, bax, and bak was studied by double labelling. Results Bcl 2 was mainly expressed in the cytoplasm of hepatocytes, and bax and bak mainly in the cytoplasm of hepatocytes and partly in the nucleus of hepatocytes, and HDAg mainly in the nucleus of hepatocytes. Lots of HDAg and bax/bak positive cells were distributed in infiltrating lymphocytes at the periportal region especially at the advancing edges of areas of piecemeal necrosis. Apoptosis of many hepatocytes was found to locate near the HDAg positive cells. There was positive correlation between the expression of bax/bak and HDAg expression ( P

Objective To compare the correlation between ACCP, IgA-RF, IgG-RF, IgM-RF and disease activity, bone erosion of rheumatoid arthritis. Method The correlation analysis between ACCP, IgA-RF, IgG-RF, IgM-RF and disease activity score (DAS), Ritchie′s articular index (RAI) were made SPSS software. ACCP, IgA-RF, IgG-RF, IgM-RF were compared between patients with erosive disease and with non-erosive disease. Results IgM-RF was associated with RAI, but ACCP, IgA-RF and IgG-RF were not associated with RAI. The above parameters were not associated with DAS by Spearman correlation analysis. The association between above parameters and bone erosion was not detected, however. Conclusion IgM-RF is associated with disease activity. ACCP and IgA-RF, IgG-RF are not associated with disease activity. No association is found between above parameters and bone erosion.