Objective To investigate the diagnostic and therapeutic methods for liver injury.Methods The clinical data of 80 patients with liver injury were retrospectively analyzed.Results The liver injury was srede Ⅰ in 12 patients.grade Ⅱ in 25 patients,grade Ⅲ in 20 patients,srede Ⅳ in 14 patients,and grade V in 9 cases.16 patients were not treated with operation,24 patients were treated with hepatic artery ligation,and 3 patients were treated with plugging.75 patients were cured,and 5 patients died.Conclusion Liver injury should be clearly diagnosed as early as possible,correct therapeutic methods should be selected according to the state of the injury,and operative manner should be reasonably selected according to intraoperative conditions.The treatment of complications and postoperative protection to the function of important organs should be paid attention to.

Objective To develop a sensitive and stable substrate for enzyme‐linked immunosorbent assay(ELISA)and carry out methodology evaluation tests on it .Methods A kind of substrate with tetramethyl benzidine and urea peroxide as its main compo‐nents were made up ,its sensitivity ,precision and storage stability were evaluated and compared with other three kinds of substrate . Results This substrate was more sensitive than two of the three commercial substrates .The variable coefficient of precision test was 3 .5% .The optical densities(OD) of the new substrate after stored one day ,seven days ,one month ,six months ,twelve months in 4 ℃ environment were 2 .268 、2 .403 、2 .358 、2 .278 、2 .330 respectively ,the standard deviation was 0 .056 185 ,the variable coeffi‐cient was 2 .4% .Conclusion The substrate proposed in this paper displays good sensitivity ,precision and stability .The preparation method is simple ,reproducible .This substrate not only satisfies the requirements of laboratory research ,but also meets with the de‐mands for commercial kit development due to its function as an important component of test kits .It is an economical and effective choice for both laboratories and research transformation .

Objective To compare the bronchial blocker and double-lumen tube for one-lung ventilation in the elderly patients undergoing minimally invasive direct coronary artery bypass (MIDCAB).Methods Thirty six patients of both sexes,aged 65-78 yr,with the left ventricular ejection fraction ≥ 45％,with body mass index ＜ 30 kg/m2,of ASA physical status Ⅱ or Ⅲ (NYHA Ⅰ-Ⅲ),scheduled for elective MIDCAB in the left thorax,were randomly divided into 2 groups (n =18 each):double-lumen endotracheal tube group (group D) and bronchial blocker group (group B).Anesthesia was induced with midazolam 0.05 mg/kg,etomidate 0.3 mg/kg,fentanyl 10μg/kg and cisatracurium 0.15-0.20 mg/kg.The patients were intubated with a left-sided double-lumen endotracheal tube 5 min later in group D.The patients were intubated with a single-lumen endotracheal tube 5 min later,and then Coopdech bronchial blocker was inserted into the primary bronchus in group B.The patients were mechanically ventilated.Before induction of anesthesia,at 2 min before intubation,immediately before and after intubation,and at 1 and 2 min after intubation,mean arterial pressure (MAP),heart rate (HR),and mean pulmonary arterial pressure (mPAP) were recorded and rate-pressure product (RPP) was calculated.The requirement for vasoactive drugs was recorded during induction of anesthesia.Lung collapse developed after the pleura was opened was also recorded.Surgical exposure was scored at the end of operation.Results Compared with group D,MAP,HR RPP and mPAP were significantly decreased after intubation,the requirement for nicardipine and esmolol was decreased,and no significant change was found in the requirement for atropine and metaraminol,rate of lung collapse and score of surgical exposure in group B.Conclusion Compared with doublelumen tube,bronchial blocker can provide sufficient exposure of the surgical filed,and intubation-induced fluctuation of hemodynamics is small in the elderly patients undergoing MIDCAB.

There are different degrees of cardiac allograft vasculopathy in patients with long term cardiac transplantation. Coronary angiography shows partial or diffuse coronary artery stenosis, which is one of the main causes of death. There are few typical symptoms of angina pectoris because of no autonomic innervation in transplanted heart. The first symptom to the end of the disease is severe congestive heart failure or arrhythmia. So the principles of diagnosis and treatment in long-term survivors should be in accordance with the coronary heart disease treatment. In this paper, we reported a case of anesthesia of a patient underwent stent implantation for abdominal aortic aneurysm after 8 years of cardiac transplantation. The preoperative preparation and perioperative management were performed according to the principle of coronary heart disease. The patient passed through the perioperative period safely.

Objective To determine the significance and expression of S100A9 and NMP238 in cervical carcinoma with different concurrent chemoradiotherapy sensitivities. Methods Fresh carcinoma tissues were collected from untreated cervical carcinoma patients and preserved at -80 ℃. The tissues were classified into 2 groups:a high sensitivity group (HS) and a low sensitivity group(LS) according to their response to concurrent chemoradiotherapy. Protein was separated by 2-dimensional gel electrophoresis (2-DE). Peptide mass fingerprintings (PMF) were acquired by matrix assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF-MS) and the proteins were identified by data searching in the Mascot-database. Differential expressed proteins were assayed by Western blot and immunohistochemistry.Results Most of the gels were clear and were successfully and reproductively analyzed. Intensity and rate of S100A9 expression were higher in the HS group than in the LS group,and those of NMP238 expression were higher in the LS group than in the HS group. Conclusion S100A9 and NMP238 expression is associated with concurrent chemoradiotherapy sensitivity in cervical carcinoma.

Objective: To study the features of spontaneous isolated superior mesenteric artery dissection (SISMAD) by unexpected detection of renal artery dual-source CT (DSCT) imaging in hypertension patients. Methods: A total of 4107 patients with suspected secondary hypertension received renal artery DSCT examination in our hospital from 2010-03 to 2015-04 were studied and SISMAD was unexpectedly found in 12 patients. There were 3 patients with mild abdominal pain and the rest without obvious abdominal symptoms. The position and length, true and false lumens, detached tunica intimal flap and branch involvement of dissection, intestinal wall edema and ileus were recorded. Results: SISMAD in all 12 (0.3%) patients were found unexpectedly. Axial CT with post-processing technique clearly displayed the ruptured tunica intimal orifice, true and false lumens, detached intimal flap; the branches were all originated from true lumen. According to Sakamoto classification, all 12 patients were belong to Type I as the true and false lumens were with an entry and re-entry respectively, no filling defect in false lumen. The distance from orifice of dissection to root of abdominal aorta was (26.7 ± 11.3) mm and the length of dissection was (35.1 ± 11.7) mm.There were 10 patients with aneurysmal expansion with the diameter of (11.9 ± 2.5) mm. Conclusion: Unexpected detection of SISMAD by renal artery CT imaging was about 0.3%, radiologist should pay special attention to find superior mesenteric artery dissection in hypertension patients.

Objective To investigate the underlying neural mechanism of left hemiparalexia and left hemialexia in reading Chinese characters. Methods A patient with reading disorders caused by brain infarctions at the left ventralis medialis occipitotemporal lobe and the splenium of the corpus callosum was studied. A series of neuropsychological tests, such as reading Chinese characters presented in the central foveal field or in the left and right half of the foveal field, were conducted with the patient, and neuroimaging techniques including high spatial resolution 3D-MRI and diffusion tensor tractography (DTT) were used to examine whether or not there were lesions of the neural pathway. Results The patient showed left hemiparalexia, which was characterized by making substitution or omission mistakes, mostly in the left parts of Chinese characters, and also left hemialexia(alexia for characters presented in left visual field). 3D-MRI demonstrated infarctions in the left ventral mesial occipitotemporal area and in the left side of the splenium of the corpus callosum. The left lateral mid-fusiform cortex, which has been identified as the visual word form area(VWFA), was almost intact. DTT indicated the major forceps fibers running through the splenium were all disconnected due to the infarction of the left splenium. Conclusion As a result of disruption of the splemium-major forceps pathway, visual character information in the left visual field which is initially projected to the right occipital cortex cannot be transferred from the right visual cortex to the left VWFA. This mechanism of left hemiparalexia and left hemialexia in reading Chinese characters is similar to that in reading English words.

Objective To evaluate the efficacy of multimodal-antiemetic therapy on postoperative dizziness,headache,nausea and vomiting (PONV) in patients undergoing thyroidectomy.Methods One hundred patients (39 males and 61 females,ASA physical status Ⅰ or Ⅱ) scheduled for thyroidectomy were randomly divided into two groups according to random number table: control group (group C) and multimodal-antiemetic therapy group (group M).Two groups received total intravenous anesthesia (TIVA) with propofol and remifentanil.Prophylactic dexamethasone 10 mg were given after anesthesia induction and palonosetron hydrochloride 0.25 mg was used 30 min before the end of surgery in both groups.Mannitol 2 ml/kg in group M and the same amount of normal saline in group C were given 30 min before the end of surgery.The incidence of dizziness,headache and PONV were observed for 24 h in two groups.Results The incidence of headache was 5 cases (10%)and PONV was 5 cases (10%) in group M,which were respectively significantly lower than that of group C of 15 cases (30%) and 12 cases (24%) in 24 h after surgery (P<0.05).The additional antiemetic therapy for 24 h after surgery in group M of 2 cases (4%) was significantly lower than that of group C of 9 cases (18%) (P<0.05).Conclusion The multimodal-antiemetic therapy: prophylactic dexamethasone,palonosetron hydrochloride and mannitol were used 30 min before the end of surgery could significantly reduce the incidence of dizziness,headache and PONV after thyroidectomy.

Objective To evaluate protein kinase Cθ(PKCθ)for the differential diagnosis of gastrointestinal stromal tumors(GIST).Methods The expression pattern of PKC θ was detected by immunohistochemistry in 121 GISTs,paired 51 distant normal tissues and 70 non-GIST sarcomas.Results Immunoreactivity for PKC θ was detected in 111 of 121 GIST cases,all eight CDll7-negative GISTs were PKC θ positive.PKC θ was negative in all distant normal tissue samples and 26 smooth muscle tumors.The positive expression rate of gastrointestinal mesenchemal tumors other than GIST was 18.2％.The expression rate of PKC θ did not vary with of tumor location,cell morphology and risk grades.Conclusions PKC θ could be a potential diagnotic marker in GIST patients,especially in those with negative CD117.

Objective:To investigate the current status of social support and mental health among residents in Weifang and analyze the impact of social support on mental health,thus to provide reference for improving the mental health status of residents.Methods:A sample of 6174 residents in Weifang was investigated using Social Support Rate Scale (SSRS) and Kessler Psychological Distress Scale (K10).The data was analyzed statistically with Chi-square test,Kruskal-Wallis test and Multiple Logistic regression analysis.Results:About 0.3％ residents in Weifang reported low social support and 93 ％ residents showed good mental health.Gender,age,social support level and 3 dimensions of social support were associated with mental health respectively in the correlation analysis.In the multiple analyses,social support,subjective support,availability of support and mental health were positively correlated in the model of Good mental health and General mental health.Conclusion:The mental health status of residents in Weifang is not optimistic.The social support level has beneficial effect on mental health starus.Subjective support,objective support and the utilization of these supports imposes different degrees of inflnence on mental health status.