Objective To investigate the hepatitis B liver cirrhosis complicated with hepatic encephalopathy (HE),relevant risk factors in the development of strategies for the prevention and treatment of the disease,and make for the clinical experience accumulation.Methods A retrospective analysis of 64 cases of liver cirrhosis patients complicated with HE,for the observation group.In addition,53 patients of hepatitis B cirrhosis without HE patients were selected as control group.The two groups of patients with objective physiological indicators were recorded and compared.Results (1) Compared with the control group,blood ammonia,serum total bilirubin,blood urea nitrogen level and infection,incidence of digestive tract hemorrhage of the study group increased,blood sodium,alanine amin otrans ferase,decrease the serum albumin level,the differences were statistically significant (t =3.0 8 5,5.5 2 8,x2 =9.174,7.126,t =4.102,4.337,8.675,5.323,all P ＜0.05).(2) For the patients in the study group,age,more than 3 kinds of incentives and C grade of liver function were the high risk factors of death.(3) In the cause of deaths in the study group,the infection was the most common,the incidence rate was 75.9%,the second above digestive rare tract hemorrhage,the incidence rate was 65.5%.Conclusion The elderly,the number of risk factors and severity of liver function are the occurrence and development of related risk factors of hepatitis B related cirrhosis with hepatic encephalopathy,to remove the incentive is the key of HE with prevention and treatment of hepatitis B cirrhosis.

Objective To evaluate the efficacy and safety of modified technique of ureteral stent placement during transurethral resection of bladder tumor.Methods Seventeen patients with muscle invasive bladder cancer invading the ureteral orifice from March 2014 to June 2016 in Beijing Friendship Hospital were randomly divided into two groups.In the modified technique group (group A,n =10),tumor was resected until the ureteral orifice was exposed.Then,a guide wire was placed through the tunnel of Electrode loop and the ureteral stent was placed along the guide wire.In control group (group B,7 cases),after ureteral orifice exposed,the guide wire and ureteral stent was placed with cystoscopy.The demographic,oncological baseline and operative factors were evaluated between two groups.Results There was no difference in tumor grade and maximum diameter between two groups (P ＞ 0.05).The operation time in group A was significantly shorter than that in group B [(39.5 ± 14.8)min vs (59.3 ± 16.2) min,P =0.020],and the intraoperative vision clarity score was better in group A as well [(7.7 ± 1.3) vs (5.9± 1.2),P =0.010].There was no statistical difference between the two groups in the complication.Conclusions The modified technique can improve the efficiency of ureteral stent placement during transurethral resection of bladder tumor without any risk enhancement.

ObjectiveTo discuss the values of fiber bronchoscopy with three-way laryngeal mask airway continuous ventilation in 1-6 month old infants with oxygen-dependent respiratory diseases.MethodsFrom January 2010 to May 2011, 29 cases of 1-6 month old infants with oxygen-dependent respiratory diseases who underwent conventional ifber bronchoscope and 148 cases of 1-6 month old infants with oxygen-dependent respiratory diseases who underwent ifber bronchoscopy with three-way laryngeal mask airway continuous ventilation were enrolled in control and treatment groups respectively. The success rate of ifber bronchoscope and the incidence rate of complications were compared between two groups.ResultsIn the treatment group, the success rate of ifber bronchoscope was 89.2% which was signiifcantly higher than 58.6% in the control group and the rate of laryngeal edema was 9.1% which was signiifcantly lower than 35.3% in the control group. The rates of endotracheal intu-bation ventilation and postoperative hemorrhage were lower than those in the control group, but the difference was not statistical ly signiifcant.ConclusionFiber bronchoscopy with three-way laryngeal mask airway continuous ventilation is superior to the traditional ifber bronchoscope in 1-6 month old infants with oxygen dependent respiratory system diseases.

Objective To investigate the effects of ischemic preconditioning on the cholesterol content and the activity of Na+-K+-ATPase of hepatocytes following cold preservation in rats.Methods Twenty-five rats were randomly divided into five groups,including control group (C),cold preservation group (Ⅰ),ischemic preconditioning group (ⅠP),atorvastatin (30 μmol/L) treatment group (A30),and atorvastatin (100 μmol/L) treatment group (A100).The cholesterol content and the activity of Na+ -K+ -ATPase were assessed.Results The cholesterol contents on the rat liver tissue cell membrane in the C group,Ⅰ group,ⅠP group,A30 group and A100 group were (310.4 ± 27.5),(187.7±13.1),(394.3±25.9),(201.8±14.6) and (122.6±7.7) nmol/mg protein,and activity of the Na+ -K+ -ATP enzyme was (46.55 ± 3.20),(27.4 ± 2.81),(52.71 ± 3.02),(30.67 ±2.78) and (19.64 ± 2.11) μmol Pi/hr mg protein,respectively (P＜0.05).There was no significant difference in the plasma membrane phospholipid content among the five groups (P＞0.05).Conclusion Reduction of cholesterol content and Na+ K+ -ATPase activity on the liver cytoplasmic membrane is one of the factors causing donor liver cold preservation injury,but ischemic preconditioning can significantly improve cell membrane Na+ -K+ -ATPase activity and increase cytoplasmic membrane cholesterol content. Use of atorvastatin statins can reduce cytoplasmic membrane cholesterol synthesis,and significantly decrease Na+ -K+ -ATPase activity,thereby alleviating the donor liver cold preservation injury.

Objective To explore the efficacy and safety of Gemcitabine and Cisplatin combination chemotherapy in treatment of muscle-invasive urothelial cell carcinoma.Methods Analyse of 72 cases of patients with muscle-invasive urothelial cell carcinoma receiving chemotherapy from September 2010 to September 2012,including 47 male and 25 female,the avarage age was 65 (86-33).All patients were received GC chemotherapy (Gemcitabine 800-1 000 mg/m2,ivgtt,dl,d8,d15; Cisplatin 70 mg/m2,ivgtt,d2).Efficacy was reviewed after 1 cycle of chemotherapy.Results Fifty-one cases in all the patients completed two or more chemotherapy cycles and CR 10 cases,PR 27 cases,total effective rate was 51.39％ (37/72).The main toxic reactions included nausea,vomit,myelosuppression,and then damage of liver and renal function.Cconclusion GC regimen is a good choice for urothelial cell carcinoma.Close follow-up and the usage of adjuvant drugs can contribute to reduce the side effect of chemotherapy.

Objective The aim of the present study is to evaluate the reliability and validity of the Mandarin version of the PP (MPP) .Methods The first step in the establishment was to translate the original English version into mandarin version with the method of cross -culture translation .The reliability was performed with the internal consistency analysis and test -retest reliability .The validity was performed for the content validity and structure va-lidity .The samples were from 80 Chinese CI children ,and 43 parents answered this questionnaire again 1 month lat-er to evaluate the test -retest reliability .The average age at cochlear implantation were 26 ± 14 months ,ranging from 7 months to 68 months ,the average duration of CI use were 10 ± 7 months ,ranging from 0 month to 24 months .Results The reliability analysis indicates that the Cronbach'sαcoefficient was 0 .797 ,except for the well-being and happiness ,education ,whose coefficients are respectively 0 .303 ,and 0 .341 ,all of the other sundomainscoefficient were greater than 0 .5 ,indicating the internal consistency was good .Test -retest reliability of the scale Cronbach'sαwas satisfactory .All subdomains and total score of the scale coefficients were greater than 0 .70(P<0 .01) .The validity analysis indicated that the pearson correlation coefficients among the total scale and the 8 subdo-mains were 0 .395~0 .992 ,the correlation coefficients among each subdomains were 0 .09~0 .654 ,which confirmed with the psychological characteristics ,proving its good structure validity .Conclusion The Chinese version of the PP show s good reliability and validity and can be used to evaluation the quality of life in mandarin CI children.

Objective:To investigate the efficacy and safety of endovascular treatment (EVT) in patients with acute ischemic stroke due to acute primary medium vessel occlusion (MeVO).Methods:Patients with primary MeVO received EVT in the stroke center of Jining First People's Hospital from January 2019 to January 2022 were enrolled retrospectively. MeVO was defined as occlusion of M2/M3 segment of middle cerebral artery, A2/A3 segment of anterior cerebral artery and P2/P3 segment of posterior cerebral artery. The symptoms, vascular recanalization and surgical complications were documented. The National Institutes of Health Stroke Scale (NIHSS) score at discharge and the modified Rankin Scale (mRS) score at 90 d after onset were followed up.Results:A total of 17 patients with primary MeVO were included, among them 16 successfully achieved vascular recanalization, 1 had distal emboli escape, and 1 had asymptomatic intracranial hemorrhage. There was significant difference in NIHSS scores before and after thrombectomy ( P<0.01). Ten patients (62.5%) had good functional outcome (mRS score 0-2), and 1 died of secondary pulmonary infection at 20 d after procedure. Conclusion:After strict risk/benefit evaluation and screening, EVT of acute ischemic stroke due to primary MeVO was technically feasible, and had good efficacy and safety.

Homocysteine is closely associated with extracranial and intracranial atherosclerosis, and its main pathogenesis includes oxidative stress, lipid metabolism disorder and vascular endothelial dysfunction. As a protein modification related to homocysteine, homocysteinylation can promote the occurrence and development of cerebral atherosclerosis by promoting oxidation, changing lipid function and destroying vascular endothelial function. This article reviews the role of homocysteinylation in cerebral atherosclerosis, and discusses the possibility of preventing cerebral atherosclerosis by homocysteinylation.

Objective To evaluate the diagnostic efficacy of magnetic resonance(MR)-guided prostate biopsy based on abnormal diffusion weighted imaging for prostate cancer in elder men.Methods From July 2014 to Dec 2016,56 patients (age≥ 65 years) with diffusion weighted imaging (DWI)abnormalities undergoing MR-guided prostate biopsy were retrospectively evaluated.According to pathological diagnosis,patients were divided into prostate cancer and non-prostate cancer groups.The clinical data of two groups were analyzed.The correlation of Gleason score,prostate specific antigen(PSA),and the location and number of biopsy were compared.Results Among 56 cases,32 (57.1％)were diagnosed as prostate cancer,and 24 (42.9％)as chronic prostatitis and prostatic hyperplasia (non-prostate cancer).There were statistically significant differences between prostate cancer and non-prostate cancer in age[(73.0±5.7)vs.(70.1±4.3)year]and PSA[(9.3±6.0)μg/L vs.(6.0± 3.9)μg/L] (both P＜0.05),and no statistical differences in biopsy location and biopsy number(t =2.08,2.37,P＞ 0.05).Gleason score had no correlation with PSA level and biopsy location and biopsy number(r=0.189、-0.183、0.082,P＞0.05).Conclusions MR-guided prostate biopsy based on MR-DWI has some merits,such as accurate positioning,fewer numbers of biopsy,and lower false-negative rate.

Objective:To investigate the etiology of pleural effusion in hospitalized children in Beijing Children′s Hospital.Methods:Clinical information of children with pleural effusion admitted to Beijing Children′s Hospital Affiliated to Capital Medical University from January 2016 to December 2018 was retrospectively analyzed.According to the etiology, the children were divided into infection group (parapneumonic pleural effusion, tuberculous pleurisy and empyema) and non infection group.According to the age, the children were further divided into ≤ 3 years old, >3-7 years old and > 7 years old groups.Classification of statistics was performed, and the etiology of pleural effusion were retrospectively analyzed.Results:Among the 1 165 children with pleural effusion, 746 cases(64.0%) were infected with pleural effusion, 697 cases (697/746, 93.4%) of who were parapneumonic effusion.In patients with parapneumonic effusion, 457 cases (61.3%) had Mycoplasma pneumonia (MP) infection.Infectious pleural effusion was more common in children >7 years old(339/479 cases, 70.8%), while non-infectious pleural effusion was prevalent in children under 3 years old(188/324 cases, 58.0%). The difference was statistically significant ( χ2=96.33, P<0.05). Among the patients with non-infectious pleural effusion, 239 cases (239/419 cases, 57.0%) had multi-system diseases and 97 cases (97/419 cases, 23.2%) had malignant pleural effusion.All the 18 deaths were non-infectious pleural effusion. Conclusions:The leading reason for pleural effusion in children is infection.The most prevalent symptom is parapneumonic effusion, which is mainly caused by MP.