The digital radiography system(DR) is one of the foundational equipments of modern digital hospital. The hardware components, main function and parameter of DR are analyzed, and it is helpful to choose the hardware and software of the DR system scientifically and reasonably.

Objective To study the reliability of the formaldehyde diffusion tube as a standard gas generating source. Methods Three diffusion tubes with different diffusion ratios were selected and the diffusion ratios were determined using the reference method,viz. AHMT colorimetry, and the results were compared with those obtained by gravimetric analysis. The accuracy of standard gases generated by the formaldehyde diffusion tube was analyzed. Results The thermal decomposition efficiency of trioxane turning into monomolecular formaldehyde was more than 99%, and the relative standard deviation was 0.40%. The uncertainty of AHMT colorimetry was less than 5% with a confidence limit of 95%. Conclusion The formaldehyde diffusion tube was precise and reliable as a standard gas generating source.

Objective To explore the etiological factors of primary pathological duodenogastric reflux (DGR) through investigating the relationship between severity of bile refulx,the changes of surface gastric electric rhythm and gastric emptying movement in primary pathological DGR patients.Methods From January 2007 to April 2008 in Qingdao Municipal Hospital,58 cases of outpatients diagnosed as primary pathological DGR and 21 healthy individuals (control group) were collected and underwent 24-hour gastric bilirubin monitoring,gastric endoscopy,gastric electric rhythm,and gastric emptying test.The relationship between gastric electric parameters and gastric emptying,bilirubin reflux,Hp infection was analyzed.Results 1.The main frequency in fasting and postprandial of primary pathological DGR patients [(1.94±0.04) cpm vs (2.93±0.07) cpm; (2.12±0.03) cpm vs (3.35 ±0.05) cpm],the percentage of normal gastric slow wave in fasting and postprandial (74.46± 0.56 vs 85.55 ± 1.06 ; 63.97 ± 0.64 vs 86.13 ± 1.49),and fasting/postprandial power ratio (PR) (1.68±0.02 vs 2.75±0.09) were all lower than those of control group (P＜0.05).The percentage of bradygastria in fasting and postprandial of DGR patients (18.04±0.36 vs 7.76±0.78;23.73±0.91 vs 8.47±0.55),the percentage of tachygastria in fasting and postprandial (8.93±0.26 vs 5.75±0.66;13.02±0.40 vs 7.66±0.27) were higher than that of control group (P＜0.05).2.The main frequency of severe reflux patients in fasting and postprandial [( 1.68 ± 0.07) cpm vs (2.13 ± 0.07)cpm; (2.18±0.09) cpm vs (2.76±0.06) cpm],the percentage of normal gastric slow wave in fasting and postprandial (69.71±0.43 vs 80.35±0.68; 56.36 ±0.85 vs 72.34±0.80),fasting /postprandial PR (1.47±0.04 vs 2.02±0.04) were lower than those of mild-reflux group (P＜0.05).The percentage of bradygastria in fasting and postprandial of severe reflux patients (22.94 ± 0.68 vs 13.47 ± 0.61; 29.61 ± 1.14 vs 17.55 ± 0.51) and the percentage of tachygastria in fasting and postprandial (9.94 ± 0.54 vs 7.02 ± 0.42 ; 17.04 ± 0.70 vs 10.71 ± 0.20) were higher than that of mild-reflux group (P＜0.05).3.There was no significant difference of gastric electrical parameters in fasting and postprandial between Hp-positive and Hp-negative groups (P＞0.05).4.The ratio of gastric emptying in DGR group was significantly lower than that of control group (37.9％ vs 90.5 ％,P＜0.05).The gastric emptying delay in DGR group significantly increased compared with control group (60.3％ vs 9.5％,P＜0.05).There was no significant difference in gastric emptying delay between severe-reflux group and light-reflux group (69.0％ vs 51.7％,P ＞ 0.05).Conclusions There is dysfuntion of gastric myoelectrical activity and gastric motility in primary pathological DGR patients,which may be an important mechanism in pathological DGR.

Carotid atherosclerosis is an important pathogenesis of ischemic stroke.Inflammation plays a crucial role in the artery atherosclerotic genesis and development as well as its caused complications.Human CXC chemokine ligand 16 (CXCL16),as a novel chemokine,involves in the formation and development of atherosclerotic plaques.It may be associated with atherosclerotic stroke.

Objective To compare the curative effect of laparoscopic and laparotomic operation for elderly Chinese women with cervical cancer. Methods The randomized controlled trials (RCT) and case controlled trials (CCT) were collected by searches of WanFang database, CNKI, VIP, China Biology Medicine (CBM) , PubMed. Data were extracted from these trials and data analysis was performed by RevMan 5.2.9. Results There were no RCTs, however, a total of 10 CCTs met the inclusion criteria and had data extracted for this review. The baseline characteristics of the laparoscopic group were similar to those of the laparotomic group. Comparing to laparotomic group, the laparoscopic group have longer operation time (MD =32.60, 95%CI: 5.65~59.55, P = 0.020), less amount of bleeding (MD = -94.01, 95%CI: -130.65 ~ -57.37, P = 0.000), smaller number of lymph node dissection(MD = 1.69, 95%CI: 0.67 ~ 2.72, P = 0.001), earlier anus exhaustion (MD=-17.09, 95%CI: -21.19 ~ -12.98, P = 0.000) and shorter hospital stays (MD = -4.30, 95%CI: -5.57 ~ -3.02, P = 0.000). There was significant difference between the two groups. But there was no statistical significance in postoperative indwelling catheter time (MD = -0.67, 95%CI: -1.92 ~ 0.58, P = 0.290) and surgical complications incidence (OR=0.62, 95%CI: 0.27 ~ 1.42, P = 0.260) between the two groups. Conclusion Laparoscopic management has the advantages of less traumatic and recovered quickly, and did not increase the incidence of complications. Laparoscopic operation is an ideal procedure for elderly Chinese women with cervical carcinoma.

Objective To study the effect of combination of Hydrochlorothiaside (HCTZ) with Captopril or spironolactone on serum high-sensitivity C-reactive protein (hsCRP) in hypertension patients. Methods A multi-centre, random and parallel control study was applied in this study. Slight and moderate hypertension patiens were se-lected. The patients were treated with placebo for two weeks and HCTZ 12.5 mga day for 6 weeks,wbo were then randomly divided into HCTZ group(12.5 mg once a day), spironolactone group(HCTZ 12.5 mg once a day + Spi-ronolactone 20 rag once a day) and captopril group(HCTZ 12.5 mg once a day + Captopril 25 rag twice a day) . By the end of one-year follow up, HCTZ group was randomly added to Spironolactone group and Captopril group because combination therapy was superior to single medication,which was recognized. During the treatment, the patients were followed up once a month ,for monitoring blood pressure, and serum hsCRP level was measured every year. Follow-up last for 4 years. By the end of 4 years, the patients were divided into treatment group and control group in order to compare the changes of serum hsCRP levels. Results At the end of 4 years, the blood pressure and serum hsCRP level were significantly decreased as compared with baseline, and were statistically different from that of control group (P <0.05 or 0.01). Multi-factor analysis showed that pre-treatment systolic blood pressue and serum hsCRP level, post-treatment decrease value of systolic blood pressue and age were the major influencing factors for the de-crease of serum hsCRP level(P < 0.05 for each). Conclusion The long-term combinaion of HCTZ with Spironolactone or Captopril not only effectivley decreases blood pressure but also decreases serum hsCRP level. The decrease value of systolic blood pressure is the major factor for influencing serum hsCRP level.

Objective To investigate the correlation between microembolic signal (MES) and immune inflammation in patients with acute ischemic stroke. Methods The consecutive patients with acute ischemic stroke were enroled. According to the results of MES, they were divided into either a positive group or a negative group. The Immune inflammatory indexes, demographics, and baseline clinical data in both groups were compared. Multivariate logistic regression analysis was used to analyze the independent influencing factors of MES in acute ischemic stroke. Results A total of 237 patients were enroled, including 52 in the MES positive group and 185 in the MES negative group. There were significant differences in the levels of triglyceride (2. 130 ± 0. 933 mmol/L vs. 1. 811 ± 0. 962 mmol/L; t = 2. 126, P = 0. 035), plasma fibrinogen (2. 946 ± 0. 255 g/L vs. 2. 833 ± 0. 322 g/L; t = 2. 332, P = 0. 021 ), Lp-PLA2 level ( 288. 265 ± 27. 855 μg/L vs. 261. 652 ± 29. 961 μg/L; t = 2. 897, P = 0. 004 ), as wel as the proportions of CD4 + CD25high Treg (8. 695% ± 1. 461% vs. 9. 445% ± 1. 397% ; t = 3. 386, P = 0. 001), artery stenosis ≥70% (21. 15% vs. 5. 41% ; χ2 = 10. 592, P = 0. 001 ) and smal arterial occlusive stroke (9. 62% vs. 23. 24% ; χ2 = 4.667, P = 0. 031) between the MES positive group and the MES negative group. Multivariate logistic regression analysis showed that the increased plasma fibrinogen level (odds ratio [OR] 3. 257, 95%confidence interval [CI] 1. 124 - 9. 438; P = 0. 030), artery stenosis ≥ 70% (OR 3. 585, 95% CI 1. 394 -9. 219; P = 0. 008), and the decreased ratio of Treg (OR 3. 801, 95% CI 1. 190 - 12. 148; P = 0. 024) were the independent risk factors for positive MES, and smal arterial occlusive stroke was its independent protective factor (OR 0. 244, 95% CI 0. 072 - 0. 829; P = 0. 024). Conclusions MES may be associated with immune inflammation. The relationship between stroke and immune inflammation should be taken seriously.

Objective To analyze the clinicopathologic characteristics of atypical polypoid adenomyoma (APA) of endometrium,and investigate the special characteristics of cancerous transformation from APA.Methods Fourteen cases of APA were collected in General Hospital of People' s Liberation Army from January 2007 to March 2013.The clinical data,morphologic features,immunohistochemistry and the related literature were reviewed.Results The median age of the 14 patients was 38 years (ranged from 23 to 72 years),only 1 patient was postmenopausal.The most common symptom was irregular vaginal bleeding (4/14),and 4 patients were identified during routine physical examination for infertility.Among 14 cases,4 cases were diagnosed as well differentiated endometrioid adenocarcinoma originating from APA,and their median age was 35 years (ranged from 28 to 41 years); color Doppler flow imaging (CDFI) of ultrasound showed rich blood flow signal.The tumors with cancerous components were obviously larger than the usual APA (mean diameter:4.7 versus 1.8 cm).Histologically,irregular and branched glands were embedded in fibromuscular stroma and the glandular epithelium were atypical hyperplasia in varying degrees.While carcinoma developed in the APA,the sieve,solid and papillary structures were noticeable,and necrosis were common.Conclusions APA is a rare lesion of the uterus.Although the clinical behavior is benign in most cases,there may be possible for some cases developing carcinomas.If the APA mass is more than 4 cm in diameter,and microscopically demonstrates prominent sieve,solid,papillary structures and necrosis,the diagnosis of carcinoma developed from APA can be made.Thorough analysis should be done before the most proper therapeutic regimen is drawn up.

Problem-based Learning(PBL)in medical education is the method of instruction using problems of clinical medicine to stimulate students' driving force of learning and guide them to grasp the learning contents.Compared with the traditional teaching method,it has the fundamental difference in the designing idea,implementing mode,evaluation system and actual effect.The management of PBL teaching process and the active creation of teaching environment and conditions are the key factors to ensure the successful implementation of PBL.

Objective To investigate the correlation of short-term systolic blood pressure variability (SBPV) with esti?mated glomeruar filtration rate (eGFR) in the elderly. Methods In physical examination for the third time of kailuan group, the method of cluster sampling was used to collect randomly retired employees, age≥60 in kailuan group. The 24-hour am?bulatory blood pressure monitoring was given to these objects. Finally, 1 405 participants with integral data were recruited in?to the survey. SBPV indices were standard deviation of systolic blood pressure (SD), variability independent of the mean (VIM), maximum-minimum difference (MMD), and average real variability (ARV). Multivariate stepwise linear regression models were used to analyze the influence of short-term SBPV on eGFR. Results (1) Among 1 405 participants (67.16 ± 5.82) years, 933 individuals (66.4%) were male and 472 (33.6%) were female. (2) Study population were divided into four groups based on the 24-hour mean SBP, daytime mean SBP, night time mean SBP (group 1:mean SBP<120 mmHg, group 2:120≤mean SBP<140 mmHg, group 3:140≤mean SBP<160 mmHg, group 4:mean SBP≥160 mmHg), respectively. Values of SD, MMD and ARV, but not VIM were increased with increased mean SBP. (3) The participants were grouped according to the median SBPV with between-group comparison of the eGFR. The average eGFR levels were lower in the high 24-hour SB?PV group (SD, VIM, MMD and ARV), day-time SBPV group (SD, VIM, MMD and ARV) and night-time SBPV group (SD, MMD and ARV) than those in the low SBPV groups (P<0.05). (4) Multivariate stepwise linear regression showed that eGFR increased with 3 indices of 24-hour SBPV (SD, MMD and ARV) and 2 indices of day-time SBPV (MMD and ARV) but not for night-time SBPV (β=-0.07,-0.11,-0.07,-0.12 and-0.07, respectively). Conclusion There is a certain degree of asso?ciation between short-term SBPV indices and eGFR.