Objective To observe the clinical efficacy of three types of drainage in the treatment of malignant obstructive jaundice.Methods 84 patients with malignant obstructive jaundice were selected,40 cases were treated with bridge drainage,24 cases were undergone percutaneous transhepatic cholangial drainage(PTCD) and 20 cases were treated with Roux-En-Y anastomosis.The changes of total bilirubin and direct bilirubin were detected 1,3,7 and 14 days after operation.Results The total bilirubin and direct bilirubin after 1,3,7 and 14 days had significantly decreased compared with pre-treatment(P ＜0.05),the decline rates in bridge drainage group were faster than the other two groups (P ＜ 0.05).Conclusion The three types of drainage for treating malignant obstructive jaundice have exact effect,and the bridge drainage can reduce the bilirubin to lower levels more quickly than the other two methods.

Objective:To design a software to read and display CT and RT structure and draw a new contour without treatment planning system (TPS).Methods: In order to display the contour information drawn by doctors, the first step was to match CT images and RT structure then the same screen rendering of CT and RT structures could be applied. In order to add contour in RT structure obtaining the coordinates interactively, connecting coordinate points were the essential steps. Then a unique identity was given in the area of that contour to ensure its unique results. Results: The software successfully read and displayed CT and RT structures and drew a new contour without TPS.Conclusion: In this study, the software establishes a basis to improve the precision of the radiotherapy dose.

Objective To discuss the clinical application of preoperative transcatheter arterial chemoembolization (TACE) in treating squamous cell carcinoma of tongue. Methods A total of 26 patients with pathologically proved squamous cell carcinoma of tongue were enrolled in this study. Using Seldinger technique, lingual artery angiography and TACE were carried out in all patients. Radical resection of tongue cancer was performed in 2-3 weeks after TACE. Results Super-selective catheterization and TACE was successfully accomplished in all patients. After TACE the tumor size was significantly decreased in all patients. During the operation, clear lesion's border was observed, and the amount of blood loss was less than usual. Conclusion For the treatment of squamous cell carcinoma of tongue, preoperative superselective TACE is safe and effective;it can increase the opportunity of surgical resection, reduce the surgical damage, and improve the quality of life as well as the survival rate.

Objective To determine the risk factors for postoperative acute kidney injury (AKI) in the patients undergoing cardiac transplantation.Methods Forty patients with end-stage heart failure (both sexes) , aged 13-66 yr, weighing 45-84 kg, of ASA physical status Ⅳ or Ⅴ (NYHA Ⅲ or Ⅳ), undergoing heart transplantation, with normal kidney function before operation, were selected.According to whether or not AKI occurred within 7 days after operation, the patients were divided into either AKI group or non-AKI group.Factors including age, gender, body weight, complications (including hypertension and diabetes mellitus), preoperative blood glucose, hemoglobin, serum creatinine, cardiac output, ejection fraction, pulmonary arterial systolic pressure, intraoperative cardiopulmonary bypass (CPB) time, transfusion of allogeneic red blood cells, and urine volume within 24 h after operation were recorded.The risk factors of which P values were less than 0.05 would enter the multivariate logistic regression analysis to stratify postoperative AKI-related risk factors for this type of patients.Results A total of 39 patients were enrolled in this study.Of the 39 patients, 14 patients suffered from AKI after operation, and the incidence was 36％.The results of logistic regression analysis showed that preoperative pulmonary hypertension and CPB time ＞ 180 min were the independent risk factors for AKI after cardiac transplantation.Conclusion Preoperative pulmonary hypertension and CPB time＞180 min are the independent risk factors for postoperative AKI in the patients undergoing cardiac transplantation.

At present,HbA1c is regarded as the gold standard in of the diagnosis of diabetes mellitus.Point-of-care HbA1c testing is popular used in China,however,the quality assurance of POCT HbA1c lags behind that of central laboratory HbA1c testing.The quality assurance strategy for POCT HbA1c must be taken into consideration.Strategies should include risk management,personnel evaluation,troubleshooting system,quality control,proficiency testing,method validation and calibration.

Liver transplantation is an effective treatment of the end stage HBV-related liver diseases,but the recurrences of hepatocellular carcinoma and hepatitis B are the important factors that affect the forward prognosis after liver transplantation.New prophylactic treatments have obviously reduced their recurrence rates.In this manuscript,we review the current research of the association between hepatocellular carcinoma recurrence and hepatitis B recurrence after liver transplantation,and suggest preliminary prospects.This article may be referenced for clinical treatment and research.

Objective To explore the effect of oleanic acid on key enzyme activity in insulin-resistant HepG2 cells. Methods The HepG2 cells were divided into normal control,model control,metformin,and oleanic acid groups.Glycogen content in insulin-resistant HepG2 cell model were detected by hepatic glycogen test kit upon treatment with oleanic acid.Activities of glucokinase ( GK) ,phosphoenolpyruvate carboxylase kinase (PEPCK),and glucose-6-phosphatase (G-6-Pase) were assayed by the glucose 6-phosphate dehydrogenase coupling colorimetric, lactate dehydrogenase coupling colorimetric and ammonium molybdate constant phosphorus methods. Results The oleanic acid enhanced glucose consumption,lowered the activity of G-6-Pase and PEPCK by 54.8% and 18.8%,respectively,and increased the activity of GK and glycogen content in also insulin-resistant HepG2 cells by 100.6% and 98.6%,respectively. Conclusion Aqueous extracts of shirako play a role in lowering PEPCK and G-6-Pase activities and inhibiting glucogenesis, resulting in the reduction of endogenous glucose in the cell. In addition,it can augment the activity of GK,accelerate the process of glucolysis,increase the glycogen content,and alleviate insulin resistance of HepG2.

Objective To investigate the changes of plasma vascular endothelial growth factor( VEGF) of patients of advanced primary liver cancer before and after interventional treatment and its clinical Significance. Methods Forty-six patients with advanced primary liver cancer were performed the hepatic arterial chemoembolization and served as observation group. Sixty healthy people were served as control group and measured their level of serum VEGF. The level of serum VEGF of patients in observation group before treatment and intervention 1 month were measured. Results Before interventional treatment,the serum VEGF level of observation group were(510. 0 ± 310. 0)ng/L,significantly higher than that of control group((27. 0 ± 23. 0) ng/L,P﹤0. 001). After interventional treatment,he serum VEGF level decreased to(316. 4 ± 240. 7)ng/L and the difference was statistically significant( P=0. 036 ). After one month interventional treatment,4 cases were complete remission(8. 70%),34 cases were partial remission(73. 91%),6 cases were in stable(13. 04%),and 2 cases were progress( 4. 35%),and the total effective rate were 82. 61%( 38/46 ). The 38 cases who were complete remission and partial remission were been served as effective group,the other 8 cases were served as invalid group. The serum VEGF level in effective group were( 260. 6 ± 70. 5 )ng/L,lower than that in invalid group(( 346. 7 ± 61. 3 )ng/L,P = 0. 046 ). Conclusion Hepatic arterial chemoembolization treatment on primary liver cancer curative effect is a better approach. VEGF involves in the development of primary liver cancer,and the high serum VEGF level with poor prognosis can be the reference of efficacy.

Objective To research the clinical curative effect of pegylated interferon α-2a (Peg-IFNα-2a) combined with ribavirin in treating chronic hepatitis C with positive autoantibodies.Methods The autoantibodies were screened in 93 cases of chronic hepatitis C patients and then the patients were divided into positive group and negative group.Both of the two groups were given therapy with Peg-IFN α-2a combined with ribavirin.The capacity of hepatitis C virus (HCV) RNA,virological response rate,and blood concentration of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were quantified before and in the process of treatment.Results Twenty-eight patients had autoantibodies,with 17 patients of antimitochondrial antibody,8 patients of anti smooth muscle antibody and 3 patients of anti-liver-kidney microsomal antibody-1.The quantity of HCV RNA and the virological response rate had no significant difference before and after treatment (P ＞ 0.05).The concentration of ALT and AST in positive group were higher than those in negative group before and in the process of treatment,while there were obvious differences only after 36 weeks of treatment (P ＜ 0.05).Conclusion Peg-IFN α-2a combined with ribavirin is effective for chronic hepatitis C for all the patients,but liver function of autoantibody negative patients have a better recovery.

Hypertension is a leading cause of mortality and morbidity around the world and,prevalence of hypertension is increasing with aging.Hypertension in the elderly is associated with increased occurrence rates of sodium sensitivity,isolated systolic hypertension,and 'white coat effect'.Arterial stiffness and endothelial dysfunction also increase with age.These factors should be considered in selecting antihypertensive therapy.The prime objective of this therapy is to prevent stroke.The fmdings of controlled trials show that there should be no cut-off age for treatment.A holistic program for controlling cardiovascular risks should be fully discussed with the patient,including evaluation to exclude underlying causes of secondary hypertension,and implementation of lifestyle measures.The choice of antihypertensive drug therapy is influenced by concomitant disease and previous medication history,but will typically include a thiazide diuretic as the first-line agent;to this will be added an angiotensin inhibitor and/or a calcium channel blocker.Beta blockers are not generally recommended,in part because they do not combat the effects of increased arterial stiffness.The hypertension-hypoten-sion syndrome requires case-specific management.Drug-resistant hypertension is important to differentiate from faulty compliance with medication.Patients resistant to the third-line drug therapy may benefit from treatment with extended-release isosorbide mononitrate.A trial of spironolactone may also be worthwhile.