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.

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.

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 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 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 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.

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.

BACKGROUND:Internal fixation methods for traditional proximal clavicle fractures and sternoclavicular joint dislocation include Kirschner wire, Kirschner wire with tension band, clavicular hook plate and ordinary T-shaped plate fixation. However, al of these are easy to fal off, damage nerves and blood vessels and affect the fine motion of the sternoclavicular joint. OBJECTIVE:To investigate the therapeutic effects of internal fixation with T-shaped stainless steel locking plate on proximal clavicular fractures and sternoclavicular joint dislocation as wel as to observe the biocompatibility of materials with the host. METHODS: Twelve patients with proximal clavicular fractures and sternoclavicular joint dislocation were enroled at Shanxian Central Hospital from March 2011 to January 2014, including seven cases of proximal clavicular fractures and five cases of sternoclavicular joint dislocation. Al of patients were subject to open reduction and internal fixation with T-shaped locking plate. RESULTS AND CONCLUSION:Al the 12 patients were folowed up for 3-14 months, with an average of 9 months. Al incisions healed wel, with no local eminence. No major substernal blood vessels and organ damage occurred. X-ray films showed that fractures healed without further dislocation and steel plate fracture. At the last folow-up, Rockwood scoring system showed that the excelent rate of shoulder function was 100%. These findings indicate that the internal fixation with stainless steel T-shaped locking plate is reliable and effective in the treatment of proximal clavicle fractures and sternoclavicular joint dislocation, with low risks and satisfactory outcomes, by which, patients can maximize the recovery of shoulder function.