Objective To research the performance of micro infiltration type lung adenocarcinoma (MIA) in the low -dose CT (LDCT).Methods The clinical data of 34 patients with lung adenocarcinoma who found by LDCT screening and diagnosed as micro infiltration were retrospectively analyzed, LDCT performance of lesions was observed.Results In 34 patients,32 cases of single grinding glass tubers,2 cases of multiple ground glass nodules (2 and above),a total of 36 nodules.With pure glass grinding nodule in 11 (30.5%),mixed grinding glass nodules 25 (69.5%).Lesions was 0.7 -2.4cm in diameter,the diameter was about 1.0 -2.0cm,a total of 27(75.0%),an average of (1.7 ±0.3) cm.5(13.8%) of left upper lobe,left lung lobe 9(25.0%),6(16.6%) of the upper lobe, right lung middle in 8(22.2%),characterized by lower lobe in 8(22.2%).Radiographic signs included air -20 cases (55.6%),fine bronchiectasis sign clear edge in 22(61.1%),Ye Zheng a total of 29(80.6%),including deep lobe 9(25.0%),shallow lobes 20(55.6%),burr 17(47.2%),pleural indentation 20(55.6%).Bronchus truncation 6(16.7%),vascular cluster 9(25.0%).Conclusion Found in LDCT screening between 1.0 -2.0cm in diameter of grinding glass nodules,especially the grinding glass nodules,quantitative classification is higher at the same time, lesion boundaries clear,or points Ye Zheng,burr,air -with fine bronchiectasis and pleural indentation,micro infiltra-tion is characteristic and highly suggestive of lung adenocarcinoma.

Objective To investigate the value of preoperative total abdominal spiral CT scan in evaluating the staging of ovarian cancer.Methods Clinical data of 42 patients with ovarian cancer undergoing total abdominal spiral CT were collected.The CT images were retrospectively analyzed,and the CT staging and surgical pathologic staging were compared.Results Multi-slice spiral CT on ovarian cancer invasion and metastasis has high accuracy of diagnosis.The diagnostic accuracy of this group for direct tumor invasion,peritoneal metastasis,lymph node metastasis and ascites was 66％-100％.The correct preoperative staging were 34 cases:6 cases in stage I,6 cases in stage Ⅱ,17 cases in stage Ⅲ,5 cases in stage Ⅳ,and the staging accuracy of 80.9％.Conclusion Total abdominal multi-slice spiral CT examination is of great value in preoperative staging of ovarian cancer.

Objective: To investigate the trends in incidence of malignant tumors in Yuyao City, Zhejiang Province from 2011 to 2018, so as to provide insights into formulation of the malignant tumor control strategy. Methods: Data pertaining to the incidence of malignant tumor in Yuyao City from 2011 to 2018 were captured from the Chronic Disease Surveillance Module of Ningbo Municipal Digital Disease Control and Prevention Platform. The crude incidence, Chinese population-standardized incidence, global population-standardized incidence, cumulative incidence (0 to 74 years of age), and truncated age-standardized incidence (35 to 64 years of age) of malignant tumors were estimated, and the trends in incidence of malignant tumors were analyzed in Yuyao City from 2011 to 2018 using average annual percentage change (AAPC). Results: The crude incidence, Chinese population-standardized incidence, global population-standardized incidence, cumulative incidence (0 to 74 years of age), and truncated age-standardized incidence (35 to 64 years of age) of malignant tumors were 433.78/105, 289.37/105, 224.22/105, 25.83% and 83.34/105 in Yuyao City from 2011 to 2018, with AAPC of 5.90%, 3.31%, 3.31%, 2.84% and 4.24%, respectively (all P<0.05), and the incidence of malignant tumors appeared an overall tendency towards a rise. The incidence of malignant tumors increased with age in Yuyao City from 2011 to 2018, and the incidence of malignant tumors was significantly higher in women than in men at ages of 20 to 54 years, while higher incidence was seen in men than in women at ages of 55 years and older. The ten most common malignant tumors included lung cancer, gastric cancer, colorectal cancer, liver cancer, breast cancer, esophageal cancer, thyroid cancer, pancreatic cancer, prostate cancer and cervical cancer, accounting for 78.84% of all malignancies, and the the incidence of lung cancer, colorectal cancer, breast cancer, thyroid cancer, pancreatic cancer and prostate cancer appeared a tendency towards a rise year by year, with AAPC of 8.37%, 5.36%, 6.42%, 24.81%, 5.49% and 18.78%, respectively (all P<0.05). Conclusions The of malignant tumors appeared a tendency towards a rise in Yuyao City from 2011 to 2018, and lung cancer, thyroid cancer, specific female cancers, male gastrointestinal and prostate cancers should be given a high priority for cancer control in Yuyao City in the future. Early screening and early diagnosis of cancers should be facilitated among high-risk populations.

Objective:To investigate the efficacy and safety of plasma exchange (PE) combined with plasma perfusion (PP) in treatment of liver failure and the influence on inflammatory factors and liver function.Methods:98 patients with liver failure in our hospital from February 2014 to February 2016 were selected as the subjectswere,and they were randomly divided into experimental group and control group,and each group was 49 cases.The experimental group was treated with PE combined with PP,and the control group was received PE alone.The liver function before and after treatment was detected by automatic biochemical analyzer.The serum levels of C-reactive protein (CRP),tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) were determined by enzyme-linked immunosorbent assay (ELISA).The total effective rate,the incidence of side effects,the levels of liver function and inflammatory factors before and after treatment were compared between the two groups.Results:The clinical effective rate in the experimental group (91.84％) was significantly higher than that in the control group (73.47％),the difference was statistically significant (P＜0.05).The incidence of adverse reactions in the experimental group (10.20％) was significantly lower than that in the control group (38.78％),the difference was statistically significant (P＜0.05).The levels of serum alanine aminotransferase (ALT),total bilirubin (TBIL) and blood ammonia (NH3) were significantly decreased in both groups after treatment (all P＜0.05).Albumin (ALB) and thrombin activity (PTA) were significantly increased in both groups after treatment (both P＜0.05).After treatment,the serum levels of ALT,TBIL and NH3 in the experimental group were lower than those in the control group (all P＜0.05),the levels of ALB and PTA were higher than those of the control group,the difference was statistically significant (both P＜0.05).After treatment,the serum levels ofCRP,TNF-α and IL-6 were lower than those before treatment,and the serum levels of CRP,TNF-α and IL-6 in the experimental group were lower than those in the control group (all P＜0.05).Conclusion:The combination of plasma exchange and plasma perfusion has a good effect in the treatment of liver failure,and the incidence of adverse reactions is low.It can effectively remove inflammatory factors,improve liver function and improve the quality of life of patients.

Objective To evaluate the role of renal cell apoptosis in acute kidney injury (AKI) induced by sepsis in mice. Methods Forty-five male C57BL/6 mice were randomly assigned into 3 groups ( n = 15 each):sham operation group (group S), cecum ligation and puncture group (group CLP) and CLP + caspase-3 inhibitor Ac-DEVD-CHO group (group CI). Intra-abdominal infection was induced by CLP. Ac-DEVD-CHO 4 μg/g was infused subcutaneously 30 min before CLP in group CI. Five mice in each group were sacrificed after collection of blood samples at 6, 12 and 24 h after CLP. The levels of serum blood urea nitrogen (BUN) and creatinine (Cr)were detected. The apoptosis rate and expression of caspase-3 protein and caspase-3 mRNA were determined.Pathological changes in renal tissues were observed with light microscope. Results The serum BUN and Cr concentratiors, apoptosis rate and expression of caspase-3 mRNA and caspase-3 protein were significantly higher in group CLP than in group S, but lower in group CI than in group CLP ( P ＜ 0.05). Light microscopic examination showed that the pathologic changes induced by Ac-DEVD-CHO were less severe in group CI than in group CLP.Conclusion The renal cell apoptosis is one of the mechanism of AKI induced by sepsis.

Objective To determine the effects of trimetazidine (TMZ) on pathology and energy metabolism of myocardium in chronic renal failure(CRF) rats.Methods CRF models were built in Sprague-Dawley (SD) rats with 5/6 subtotal nephrectomy, and animals were randomyly divided into sham group, control group and three groups treated with different doses of TMZ (3 mg/kg,6 mg/kg or 9 mg/kg).TMZ was intragastrically administrated to CRF rats for 17 weeks, while physiologicalsalinewasusedascontrol. Transthoracicechocardiographywasperformedand myocardial morphosis was observed.Left ventricular weight/body weight(LVW/BW) and heart weight/body weight (HW/BW) were measured, and heart rate, and mean arterial pressure (MAP)were detected at the end of the study, while several parameters were detected, including urea nitrogen (BUN), creatinine(Scr), triphosaden(ATP), adenosine diphosphate(ADP), superoxide dismutase (SOD), malondialdehyde (MDA), interleukin 6 (IL-6) and tumor necrosis factor α (TNF-α).Results (l)Left ventricle end-systolic dimensions, anterior wall end-diastolic and end-systolic thicknesses, and posterior wall end-diastolic thickness were significantly lower in rats treated with either medium dose or high dose of TMZ, as compared with control group(P＜0.05).(2)LVW/BW and HW/BW in rats treated with either medium dose or high dose of TMZ were significantly lower than those in control group(P＜0.05). (3)Various pathological changes were observed in control group, such as irregular arrangement and hypertrophy of the cardiomyocytes, myocardial fibrosis,mitochondrial swelling, focal muscle fiber dissolution, etc.However, all these pathological changes were apparently ameliorated in TMZ-treated groups, while the beneficial effects of TMZ therapy were dose-dependent. (4)No difference was observed in heart rate among all the groups.Although no difference existed in all the CRF rats, concerning on the systolic/diastolic blood pressure and mean arterial pressure (P＞0.05), these parameters were elevated in CRF rats, as compared with sham-operated group(P＜0.01). (5)ATP and ADP in TMZ-treated rats were significantly higher as compared with control(P＜0.05), moreover, medium dose and high dose of TMZ were superior to low dose (P＜0.05).(6)SOD was significantly increased in TMZ-treated rats (P＜0.05), while IL-6,TNF-α and MDA were significantly decreased in medium dose and high dose of TMZ, as compared with control(P＜0.05).Conclusion TMZ may prevent myocardial fibrosis and left ventricular hypertrophy in chronic renal failure via ameliorating myocardial energy metabolism and alleviating inflammatory reaction and oxidative stress.

Objective To study on the different results of a minimally invasive method to reconstruct the ligaments of the lateral ankle using semitendinosus tendon autograft and tendon allograft.Methods Data of 68 patients with chronic ankle instability who had undergone lateral ligament reconstruction from September 2006 to June 2011 were retrospectively analyzed.In the group of semitendinosus autograft,there were 32 patients (19 males,13 females) with an average age of 32.4 years old.Semitendinosus was harvested through 2 small knee incisions.While in the group of tendon allograft,there were 36 patients (22 males,14 females) with an average age of 34.2 years old.For the ankle reconstruction,4 small incisions of 5 mm each were made at the medial and lateral side of the fibular tip,the talar neck,and the middle of the calcaneus.Anatomical reconstruction of the anterior talofibular ligament and calcaneofibular ligament was then performed through these small incisions.AOFAS questionnaires were used to measure clinical outcomes,donor site morbidity and patients' satisfaction.Preoperative and postoperative stress tests were performed and radiographic parameters were measured.Results The average operation time of the autograft group 85.5 ± 11.5 min was significantly longer than that in the allograft group 58.1±10.2 min,but the fever days in the latter 5.5±1.5 d was significantly longer than in the former 2.5±1.2 d.In autograft group,23 patients got followed up,and the mean period of follow-up was 33.5±6.7 months.The mean AOFAS score increased from 62.3±8.2 to 95.1 ±7.5.In allograft group,26 patients got followed up,and the mean period of follow-up was 28.5±6.7 months.The mean AOFAS score increased from 60.2±8.4 to 94.8±5.5.There were 5 patients (3 of autugraft group and 2 of allograft group) with residual instability on uneven ground.One case of the autologous group had instability in daily life.No patient presented weakness or disability in the donor site.The satisfaction level of the autograft group was excellent in 16,good in 5 and bad in 2.Significant improvement in stress radiographic parameters was noted for the talar tilt angle,with reduction from a mean of 14.0° to 3.8°; anterior talar displacement reduced from a mean of 12.3 to 4.6 mm.The satisfaction level of the allograft group was excellent in 17,good in 5 and bad in 4.The talar tilt angle reduced from 13.0° to 3.6°; anterior talar displacement reduced from 11.5 to 4.3 mm.Conclusion There is no differences in efficacy could we found in using these 2 kinds of materials.The process of healing and rehabilitation of tendon autograft is slightly faster than the tendon allograft,but the allograft tendon has many advantages such as limited injury,simple procedure andavoiding of donor site morbidity.

Objective: In order to describe the employment status of the first group of targeted admission medical graduates, evaluate the effects of targeted admission medical education program, find out the existing problems and provide relevant policy recommendations.Methods: This study conducted follow-up survey among 305 medical graduates and 315 clinical medical graduates in four medical colleges of the central and western regions.Data analyses of the contract fulfillment, their employment status, and their participation in the standardized residency training are carried out.Results: The contract fulfillment rate of rural-oriented medical graduates is 99.3%, while the percentages of rural-oriented medical graduates and clinical medical graduates are 90.7% and 2.8%, respectively.Their average monthly incomes are respectively 2,011 and 2,774 yuan, and their proportions of participating in standardized residency training are 77.8% and 43.3% respectively.From the findings it can be seen that the employment situation of the first group of targeted admission medical graduates in four medical colleges and universities is quite good, but the policy implementation process in terms of permanent post and income is less satisfactory.However, the way how medical graduates should participate in the standardized residency training is not yet clearly regulated.This paper recommends that medical colleges and universities should well coordinate with local health administrative departments and human resources and social security departments to systematically deploy medical graduates.At the same time, full consultations should be conducted to make appropriate arrangement for medical graduates to participate in standardized residency training.

The paper analyzed the status quo and dilemmas of the internal audit of an affiliated hospital of a university in Chongqing, proposing imperative reforms in the governance elements of the affiliated hospital system.These elements cover such aspects as strengthened system construction, value-added transformation, enhanced independent status, improved competency, and innovative methods and technologies.These efforts can help elevate the performance of affiliated hospitals.

OBJECTIVETo explore the value of MSCT in the preoperative TNM staging and the longest tumor diameter measurement (RESIST standard) of gastric cancer.

METHODSClinical data of 153 consecutive patients with biopsy-confirmed gastric carcinoma who were preoperatively evaluated with enhanced MSCT scanning in our hospital from January 2012 to March 2013 were retrospectively analyzed. Consistency comparison was performed between preoperative TNM staging and the longest tumor diameter measurement and histopathological findings.

RESULTST-staging consistency of Kappa value was 0.566, and accuracy was 71.2%. N-staging consistency of Kappa value was 0.284, and accuracy was 47.7%. The Kappa value of M-staging consistency was 0.893, and accuracy was 98.7%. The overall accuracy of TNM staging consistency was 66.7% (102/153) with a Kappa value of 0.573. Effective measurement of the longest cancer diameter was carried out in 53 patients. There was no significant difference between preoperative longest tumor diameter acquired by MSCT and postoperative tumor measurement [(68.8 ± 40.6) mm vs. (64.2 ± 36.2) mm, P=0.969].

CONCLUSIONMSCT is accurate in preoperative TNM staging and longest tumor diameter measurement of gastric cancer compared with postoperative pathological examination, and can provide reliable evidence for preoperative staging and neoadjuvant therapy evaluation of gastric cancer, but it is unfavorable to evaluate the lymph node metastasis.