Objective To evaluate the clinical value of the coronal plane of three-dimensional ultrasonography in the diagnosis of breast cancer. Methods Ninety-seven patients with 106 solid breast lesions were analyzed retrospectively. Two-dimensional images were evaluated with breast imaging reporting and data system for ultrasonography (BI-RADS-US) classification and were compared with pathological results. The value of two-dimensional ultrasound in the differentiation of benign and malignant lesions of breast lesions was evaluated. The ultrasonographic features on three-dimensional coronary plane of breast benign or malignant masses were analyzed by multiple stepwise binary logistic regression analysis. Receiver operating characteristic (ROC) curve was drawn and the areas under curves were calculated to evaluate the ability of regression model in diagnosis of benign and malignant breast lesions. Results The pathological results revealed that 106 lesions were consisted of 71 breast cancers and 35 benign neoplasms. The diagnostic accuracy, sensitivity and speciifcity were 85.8%, 84.5%and 88.6%respectively. Two ultrasonic features which were finally applied into the Logistic regression model were angulation or spiculation and′sun-like symptom′. The area under the ROC curve was 0.899, the standard error was 0.033, and the 95%conifdence interval was between 0.834 and 0.965. The logistic regression model could be useful for classiifcation of benign and malignant breast masses. The diagnostic accuracy was 88.7%(94/106), sensitivity was 90.1%(64/71), speciifcity was 85.7%(30/35), positive predictive value was 92.8%(64/69) and negative predictive value was 81.1%(30/37) respectively. Conclusions The coronal plane of breast three-dimensional, especially angulation or spiculation and′sun-like symptom′have an important value in the differential diagnosis of benign and malignant breast lesions. For complicated lesions, three-dimensional ultrasound coronal plane is helpful to improve the doctor′s diagnosis conifdence.

Displacement ventilation is described from the aspects of its primary principle, characteristics and differences from the traditional one. The factors that have to be taken account into when a displacement ventilation system designed are also discussed.

OBJECTIVE To study the homology of resistant Gram-negative bacteria isolating from the hospitalized patients,hospital environment and hands of medical staffs in intensive care unit(ICU).METHODS To collect and identify 58 clinical resistant Gram-negative bacteria isolates and environment isolates from intensive care units,the same type of Gram-negative bacilli were studied on the homology using plasmid profile,restriction endonuclease profile and enterobacter repetitive intergenic consensus PCR(ERIC-PCR).RESULTS The homology existed between the resistant bacteria of clinical isolates and environment specimens.CONCLUSIONS We found that the multidrug-resistant Gram-negative bacteria derive from a common origin and cause an outbreak in ICU.So medical staff must emphasize the concept of hand hygiene and reinforce the measure of cleaning and sterilization,in order to control nosocomial infection.

OBJECTIVE:To investigate the drug-induced renal injury of inpatients in our hospital and provide information for rational use of drugs.METHODS:A retrospective analysis was performed in 102 cases whose blood Cr level was abnormal in June,August,and October in 2007.RESULTS:Of the 102 cases,20 patients(19.6%)suffered from drug-induced renal injury induced by 22 suspected drugs including dehydrants,antibiotics and ACEI et al.CONCLUSION:To avoid drug-induced renal function injury,medication should be carried out by strictly following indications and the dosage and administration stated in the drug package insert.

Objective To report 2 cases of acute rejection following small intestin vivotransplantation and to disscuss the diagnostic significance of endoscopy and mucosal biopsy.Methods Endoscopic observation and mucosal biopsies of the graft through the terminal ileum enterostomy were carried out. Results Acute rejection was diagnosed in two patients with human small intestin vivotransplantation in good time.Endoscopic and the pathologic manifestations of the graft during acute rejection were discribed.Conclusion Endoscopy and the pathologic examination of endoscopically guided mucosal biopsy specimens are the most reliable method for diagnosing acute rejection following small intestin transplantation.

Objective To study the effect of cirrhosic liver on dynamic vascular curves analysis f(t)of hepatocellular carcinomas(HCCs) at contrast-enhanced ultrasound by exploring the difference between perfusion parameters of HCCs in cirrhotic liver and that in noncirrhotic liver. Methods One hundred and fifteen HCCs were analyzed off-line with dynamic vascular curve f(t) of Sonoliver. The HCCs were divided into 2 groups based on their background liver as cirrhotic liver group ( n = 86) and noncirrhotic liver group ( n =29). Such parameters as maximum of intensity(IMAX) ,rise time (RT,from 10% to 90% of IMAX),time to peak(TTP) ,mean trasit time(mTT) ,rise slope(RS) and washout time(WT) of the two groups were analyzed by statistics. Results There was no significant difference in the f(t) parameters of HCCs between cirrhotic liver group and noncirrhotic group(P >0. 05) [IMAX:(124. 25 ± 5. 56)% vs (113. 65 ± 5. 58)% ; RT: (12. 98 ± 0. 48)s vs (13. 68 ± 0. 92)s;TTP:(13. 70 ± 0. 52)s vs (14. 39 ± 0. 9)s;mTTi(138. 61 ± 9. 20)s vs (149. 49 ± 21. 70)s;RS:10. 11 ± 0. 60 vs 8. 89 ± 0. 77, WT: (34.17 ± 2. 91 )s vs (28. 36 ± 3. 25)s]. There was also no significant statistical difference in all above parameters in reference regions for the two group (P > 0. 05). Conclusions The f(t) parameters in HCCs can evaluate blood perfusion of the tumors, and cirrhotic liver does not affect the perfusion parameters of HCCs.

Objective To realize the incidence of healthcare-associated infection (HAI),the rate of invasive procedure and related infection rate,use of antimicrobial agents and distribution of pathogens in gereral intensive care units (GICUs) of hospitals in China.Methods HAI cross-sectional investigation data of GICUs reported to China HAI Surveillance Net-work were summarized and analyzed.Results Of 1 313 hospitals,621(47.30%)had GICUs;a total of 5 887 patients were surveyed,1 634 patients developed 1 962 times of infection,HAI prevalence rate and case rate was 27.76% and 33.33%respectively.The main infection sites were lower respiratory tract(70.39%),urinary tract (12.79%)and blood(2.86%). The application rate of urinary catheter,arteriovenous catheter and ventilator was 53.52%(n=3 151),37.05%(n=2 181) and 35.62%(n=2 097)respectively,and related prevalence of urinary tract infection,pneumonia and blood stream infection was 4.67%,20.41%,and 0.60%,respectively,which accounting for 58.57%,30.99%,and 23.21 % of urinary tract infection,pneumonia and blood stream infection respectively,the overall prevalence of above invasive procedure-re-lated infection accounted for 29.97%(588/1 962)of the overall HAI prevalence.A total of 1 795 isolated pathogens causing HAI were detected,the top three were Pseudomonas aeruginosa (20.78%),Acinetobacter baumannii(17.99%)and Klebsiella pneumoniae (11 .64%).The usage rate of antimicrobial agents was 71 .58%(n=4 214), rate of specimens delivered for detection was up to 75.27%(2 553/3 392).Conclusion Prevalence and antimicrobial use in patients in GICUs are all high,all kinds of invasive procedure are frequent,30% of HAI are related to inva-sive procedure;infection caused by non-fermentative bacteria is serious,pathogen detection is well performed.

Objective To investigate the impact of applying patient-centered care concept on easing the negative moods among the parents of the neonates hospitalized in NICU.Methods The parents of neonates (76 people) hospitalized in NICU from March to May in 2012 were selected as the control group,they conducted normal nursing.The parents of neonates hospitalized in NICU during June and August in 2012 were named as the observation group (81 people).In addition to the normal nursing,they were given nursing intervention according to patient-centered care concept.The anxiety and depression moods of the two groups was analyzed.Results Before the patient-centered care concept intervention,there was no statistical difference of SAS,SDS scores for both groups.For the observation group,the SAS,SDS scores after intervention were significantly lower than those before the intervention.While for the control group,there was no statistical difference of SAS,SDS scores.After intervention,the SAS、SDS scores of the observation group were significantly lower than those of the control group,and the difference was statistically significant.Conclusions The negative moods of the parents of hospitalized neonates can be eased significantly by applying patient-centered care concept intervention.

OBJECTIVE To study the relation between the occurrence of nosocomial infection(NI) and white blood cell(WBC) count in malignant tumor patients after chemotherapy.METHODS The occurrence of NI and leukopenia and application of granulocyte colony stimulating factor(G-CSF) in patients after chemotherapy from Jan 2003 to Jun 2004 was investigated and analyzed retrospectively.RESULTS Among 2 040 patients,8.87% developed NI,and case rate was 11.67%;among patients with WBC count

Objective To investigate the clinical characteristics,surgical indications and methods of children sylvian cistern arachnoid cysts complicated with subdural hematoma.Methods Fifty childhood cases of sylvian cistern arachnoid cyst complicated with subdural hematoma were retrospectively analyzed,who were all surgically treated in the First Affiliated Hospital of China Medical University from July 2005 to August 2015.Among them,20 childhood cases were subacute subdural hematoma,30 childhood cases were chronic subdural hematoma.All patients underwent microscopic cyst excision,cystocistern fenestration plus hematoma removal surgery.During the surgery,firstly we resected the cyst wall tissue as far as possible,and then we communicated the cyst with subarachnoid space and cisterns,which could make the cerebrospinal fluid flowed unobstructedly.Results The course of every operation was smooth,and there was no severe complication postoperatively.Original symptoms and imaging manifestation resolved or improved in all patients.During a mean follow-up period of 5.7 years,there were no recurrent cases.Conclusion Children sylvian cistern arachnoid cyst can induce subdural hematoma.In this situation,microscopic cyst excision,cystocistern fenestration plus hematoma removal surgery is safe and effective.