23 cases of advanced malignant tumors of the aged and MOFare analysed It has been found that the sequences of MOF are lung, kidney, heart, liver, brain, gastro-intestine ard Dic, amounting to the average of 3.4 organs with a death rate of 100%. The results indicate that old people with advanced malignant tumors have very low immunity. The attack of organs by the primary and secondary tumors is the basic factor of MOF, and various infections are its precipitating factor. The incidence characteristics, prevention and treatment of the MOF are discussed.

Chronic atrophic gastritis( CAG)is a commonly seen digestive tract disease with the histopathological findings of mucosa inflammation,gland atrophy,intestinal metaplasia and dysplasia. Intestinal metaplasia is considered as a typical sign of CAG. In recent years,with the rapid progress of endoscopic technique,new technology has been applied for the diagnosis of CAG. This article reviewed the advances in studies on ordinary endoscopy,narrow-band imaging technique,magnifying endoscopy,narrow-band imaging-magnifying endoscopy and confocal laser endomicroscopy for the diagnosis of CAG.

Objective To investigate the MRI appearances of postpartum posterior reversible encephalopathy syndrome (PRES). Methods The clinical and radiological data of 8 patients with postpartum PRES were analyzed retrospectively, 5 cases were 1 week after postpartum,2 cases were 2 weeks afterpostpartum, 1 case was 4 weeks after postpartum. All cases underwent MRI examination, checking sequence included T,WI,T2WI,FLAIR,DWI,SWI, and 4 of them underwent MR venography (MRV). Results MRI showed basal bilaterally symmetrical distributions of lesions, mainly located in subcortex and cortex of cerebral hemisphere and predominantly in the occipital lobe,the lesions appeared as hyperintensity on FLAIR and T2WI,isointensity or mildly hypointensity on T1WI,hyperintensity on DWI. MRI in 8 patients demonstrated multiple lesions located in bilateral parietal lobe (8 cases),bilateral occipital lobe (8 cases), bilateral frontal lobe ( 4 cases ), bilateral temporal lobe (6 cases ), bilateral tempura-occipital lobe ( 8 cases),splenium of corpus callosum(l case), bilateral basal ganglia (l case), bilateral oval center( 1 case), bilateral cerebellar hemisphere (1 case), left frontal lobe hemorrhage (l case). Five patients' follow-up scan showed decreased or disappeared abnormal signals. Conclusion MRI examination scan identify the location, quality and degree, meanwhile, analyze the pathological foundation of postpartum PRES, which conduces to guiding treatment and preventing complication.

Objective To investigate the clinical effect of psychological intervention combined with milrinone on the treatment of the children with congenital heart disease complicated with severe pneumonia and heart failure. Methods In the First People's Hospital in Jining City from February 2015 to December 2016, 100 children with congenital heart disease complicated with severe pneumonia and heart failure as the research object, randomly divided into the control group and the experimental group, 50 cases in each group. The control group were received routine treatment, including ECG monitoring, anti infection and oxygen therapy,and the treatment of rice farmers. The experimental group was treated with milrinone treatment, psychological intervention, pay attention to the mental health of patients. The therapeutic effects of the experimental group and the control group were compared and analyzed. Results after the corresponding treatment, the patients in the experimental group and the control group were mild and no serious adverse reactions occurred. There was no significant difference in the incidence of adverse reactions between the two groups, and there was no statistical significance. The experimental group of patients with respiratory stabilization time is (1.76±0.32) days, to eliminate irritability (7.12±1.12) hours, heart rate recovery time (1.82±0.74) days, pulmonary rales disappeared time was (8.12±1.41) days. The clinical symptoms of the patients in the control group were significantly longer than those in the experimental group, with statistical difference (P<0.05). Conclusion The effective rate about psychological intervention combined with milrinone on the treatment of the children with congenital heart disease complicated with severe pneumonia and heart failure is high, which is worthy of clinical application.

Objective To explore the time-effectiveness of acupuncture in treating hypertensive intracerebral hemorrhage (HICH), and to find the best intervention time of acupuncture. Method The eligible HICH patients were randomized into a 2 d acupuncture group, a 7 d acupuncture group, and a 14 d acupuncture group. The National Institute of Health Stroke Scale (NIHSS) and Barthel Index (BI) were adopted for evaluation, and the clinical efficacies of acupuncture intervened at different time points for HICH were observed. Result The treatment efficacy of the 2 d acupuncture was better than that of the 7 d acupuncture group(P<0.05), and the treatment efficacy of the 7 d acupuncture group was better than that of the 14 d acupuncture group(P<0.05). There were no significant between-group differences in comparing the security indexes. Conclusion Acupuncture is safe and effective in treating HICH, and its efficacy is related to the intervention time, the earlier the better.

The paper describes the drawbacks of hospitals neglecting personnel centered management and sets forth ways of conducting such management. They include strengthening cultural construction, implementing impartial management, and setting good examples by leading officials.

Objective To investigate the effect of synchronous chemotherapy combined with spleen polypeptide on immune function in patients with esophageal cancer and cardiac cancer after operation. Methods Sixty postoperative patients of esophageal and esophagogastric junction carcinoma were collected in the Fourth Hospital of Hebei Medical Universitythe from March 2013 to January 2014,and were randomly divided into two groups,including 30 cases were treated with simple chemotherapy as control group,and the other 30 cases were treated with chemotherapy combined with lineal polypeptides as experimental group. Results There were no significant differences in terms of CD3,CD4 and CD4/CD8 between the two groups before operation( P>0. 05) . After two cycles of chemotherapy,the CD3,CD4,CD4/CD8 of experimental group were all significantly higher than the control group((76. 08±8. 04)% vs. (38. 58±6. 40)%,(42. 91±7. 73)% vs. (42. 91±7. 73)%,1. 31 ±0. 21 vs. 1. 16±0. 22),and the differences were significant(P=0. 037,0. 022,0. 008). The survival quality of the experimental group was better than that of the control group ( P=0. 038 ) . The proportion of patients with WBC in the normal range of the experimental group was significantly higher than that in the control group (80. 0% vs. 53. 3%,P=0. 028). The adverse reactions of the digestive system in the experimental group were lower than those in the control group, the difference was statistically significant between the two groups ( acid reflux and heartburn:26. 7% vs. 63. 3%,P=0. 004;nausea and vomiting:33. 3% vs. 73. 3%,P=0. 002;loss of appetite:46. 7% vs. 80. 0%,P=0. 007) . Conclusion The treatment of the patients with esophageal cancer and cardiac cancer after chemotherapy with spleen peptides can improve immunity,and improve the quality of life of patients after chemotherapy and chemotherapy.

Objective To investigate the clinicopathological significance of transforming growth factor-β1 (TGF-β1), transforming growth factor-β1 receptor Ⅱ (TGF-βRⅡ ), Smad4 and Smad7 protein expressions in gastric carcinomas. Methods 109 cases of gastric carcinomas,28 of high grade dysplasia,20 of low grade dysplasia,30 of chronic atrophic gastritis,29 of intestinal metaplasia, and 21 of normal gastric mucosa were selected for the detection of the expression level of TGF-β1,TGF-βRⅡ , Smad4 and Smad7 proteins by immunohistochemistry. Results The expression of TGF-β1,TGF-βRⅡ and Smad7 proteins in gastric carcinomas and dysplasia (high and low grade) were significantly higher than those in chronic atrophic gastritis, intestinal metaplasia and normal gastric mucosa (all P <0. 001 ) ,whereas the expression of Smad4 was significantly increased in high and low grade dysplasia (cytoplas-mic IS :4.89±2.38,5.80±1.54, respectively; nuclear IS: 3.89± 1.52,3.80±1.33, respectively), and decreased in gastric carcinomas (cytoplasmic IS:2.41±2.27,nuclear IS:2.02±2. 14) (P <0.001 ,P <0.001 ,respective-ly). Meanwhile,the expressions of TGF-β1,TGF-βRⅡ and Smad7 were higher in advanced gastric cancer (4.36± 2.66,3.05±1.93,4.84±3.06, respectively) than those in early gastric cancer ( 2.93±1.85,2. 17±1.87, 4. 14±2.46, respectively) ( P < 0.01, P < 0.05, P < 0. 05, respectively ) ; however the expression of Smad4 protein was much higher in early gastric cancer (P < 0. 001 ). The expression of Smad4 protein was significantly correlated with tumor size( P < 0.05 ), lymph node metastasis ( P < 0. 001 ), T stage ( P < 0. 001 ) and chnical stage ( P < 0.001) ,and the expressions of TGF-βRⅡ and Smad4 proteins were correlated with patients' 5-year survival rate (P<0.05 ,P < 0.01 ). TGF-β1 showed the positive correlation with TGF-βRⅡ and Smad7 (r1= 0.45 ,P <0. 05; r2 = 0.49, P <0. 05), but negative correlation with Smad4 ( r = - 0.21,P < 0.05 ). Conclusion TGF-β1, TGF-βR Ⅱ, Smad4 and Smad7 protein may play an important role in the carcinogenesis of gastric carcinoma,and smad4 is the key in TGF-β pathway. Also, the detection of these proteins expression can be a useful marker for predicting the gas-tile cancer invasion,metastasis and patients' prognosis.

Objective The double-cavity balloon oppressor surgery for rhegmatogenous retinal detachment (RRD) has been utilized in past decades. But we have not yet a domestic device available. Present study was to investigate the effectiveness of double-cavity balloon oppressor using a domestic device in primary RRD surgery. Methods This clinical trial was a prospective study. Total 74 cases of patients with rhegmatogenous retinal detachment(RRD) (74 eyes) were enrolled. Double-cavity balloon oppressor surgery was performed in 40 eyes of 40 patients, and conventional segmental scleral buckling surgery was used in 34 eyes of 34 patients. The mean operative time, retinal attachment rate, vision and astigmatism change after operation between two different operative fashions were compared. The intra- and post-operative complication was discussed. The mean follow-up period was 4. 5 months. Written informed consent was obtained from all the patients before clinical trial. Results The retinal anatomic attachment rate was 92. 5% (37/40) in balloon oppressor surgery group and 91. 1% (31/34) in conventional surgery group, and there were no significant difference in retinal attachment rate among PVR grade A, B and C1 (P ＞0. 05) . The postoperative best corrected visual acuity (operative 3 months) was improved in 29 eyes(72. 5%) after balloon oppressor surgery and 25 eyes(73. 5%) after conventional surgery, showing insignificant difference between them (P ＞ 0. 05) . The mean surgical time was about (27. 00 ±8. 60) minutes in balloon oppressor surgery group and (47. 00 ± 14. 30) minutes in conventional surgery group(t =7. 41, P ＜0. 01) . Cylinder diopter change after surgery was insignificantly different between before and after operation in balloon oppressor surgery group (0. 52 ± 0. 30 D vs 0. 81 ± 0. 41 D, P ＞ 0. 05), however, there was a significant difference in cylinder diopter change between preoperation and postoperation (0. 65 ± 0. 32 D vs 1. 83 ± 0. 69 D, P ＜ 0. 05) . Conclusion Double-cavity balloon oppressor surgery for RRD is accurate and reliable. This operation procedure offer an economic, efficient and convenient choice for treatment of RRD.

Objective To explore the use of lamivudine alone induced the poor response,especially the related factors of the occurrence of YMDD.Methods Retrospective analysis of 160 cases of the poor answering cases after lamivudine treatment,the baseline parameter values,the time appearing to the poor answering and the HBVDNA load in treatment were analyzed,to study their relationship with poor response.Results The lamivudine prolonged,the poor response to the probability gradually increase.The mutation rate in the 12nd month was 19.67％ and in the 36th month was 49.18％ ( P ＜ 0.05 ).Response to the many reasons,the YMDD mutation is the more common one.The relationship among HBVDNA load,ALT level on baseline and the rate of poor response emergence,the YMDD mutation rate was clear.By comparison in groups,the difference was significant (P＜0.05).Conclusion The lower baselins of ALT level,the higher of HBVDNA load,the greater probability of the poor response and the YMDD mutation.