Objective　To examine the intraindividual reproducibility of the octanoic acid breath test in normal subjects and diabetics and to investigate whether cardiovascular autonomic neuropathy and delayed gastric emptying influence the intraindividual reproducibility.Methods　Nine normal subjects (six men, three women,mean age 38 years) and 15 diabetics with insulin treatment ［nine men, six women; mean age 47 years; six had cardiovascular autonomic diabetic neuropathy (CADN) and/or delayed gastric emptying time］ were, after a nocturnal fasting period, given a standard test meal (labeled with 13C-octanoic acid, 1 046 kJ). Breath samples were taken at ten minute intervals over first one hour and at fifteen minute intervals over the following three hours and examined for 13CO2 by isotope ratio infrared spectrometry. Using a regression method gastric emptying half times (t1/2) and lag phase (tlag) were determined.Results　There was not a significant difference of t1/2 and tlag between two measurements in normal subjects and diabetics. The coefficients of variation of day-to-day reproducibility were 11.7% for t1/2, 19.4% for tlag in normal subjects and 17.8% for t1/2, 28.2% for tlag in diabetics, but there was not significant difference between normal subjects and diabetics. There was not significant difference of intraindividual coefficient of variation of t1/2 and tlag between diabetics with/without CADN and between diabetics with normal gastric emptying time and diabetics with delayed gastric emptying time.Conclusions　 The 13C-octanoic acid breath test has a high intraindividual reproducibility which is not affected by the cardiovascular autonomic neuropathy and delayed gastric emptying. It can be recommended as a non-invasive test for assessing gastric emptying time after a solid test meal in diabetics.

Objective To explore the relationship between subclinical hypothyroidism(SCH)and microvascular complications(diabetic nephrop-athy and diabetic retinopathy)in type 2 diabetic patients. Methods According to the condition of complicating with SCH,157 patients with type 2 diabetes were divided into SCH group(40 cases)and the euthyroid group(117 cases). The age,sex,duration of diabetes,smoking status,blood pressure,body mass index(BMI),glycosylated hemoglobin(HbA1c),blood lipid,renal function,thyroid function,urine albumin/urine creatinine, and fundus examination were analyzed and compared between the two groups. The relationship between SCH and microvascular complications in type 2 diabetic patients was explored. Results There was no significant difference of age,sex,duration of diabetes,smoking,blood pressure,BMI, HbA1c,blood lipid,or serum creatinine between the two groups. The incidence of diabetic retinopathy in SCH group was significantly higher than those in euthyriod group(32.5%vs 14.5%,P=0.044);however there was no difference in the incidence of diabetic nephropathy. After adjustment for potential confounding factors(age,sex,duration,blood pressure,BMI,HbA1c,diabetic nephropathy)by multivariate logistic regression analy-sis,SCH was still the risk factor of diabetic retinopathy(OR=2.210,95%CI 1.512-4.117,P=0.032)in type 2 diabetic patients. Conclusion SCH could be a risk factor of diabetic retinopathy in type 2 diabetic patients,and there was no significant effect on diabetic nephropathy.

Abstract: Objective　To investigate the frequency of peripheral blood T cells among patients positive for both hepatitis B virus surface antigen (HBsAg) and surface antibody (HBsAb). Methods　 Thirty six patients with co-existence of HBsAg and HBsAb diagnosed were enrolled as the experimental group, who were admitted by Shanghai tenth people's hospital and Wuxi 9th people's hospital from 2014 to 2020. while 40 patients tested positive for HBsAg and negative for HBsAb served as controls, who were admitted by Wuxi 9th people's hospital. Flow cytometry was used to detect and compare the proportions of peripheral blood CD3+, CD4+ and CD8+ T cells between the experimental and control groups. In addition, the associations of serum HBsAb level with peripheral blood T cell proportions, serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels were examined among chronic hepatitis B patients with co-existence of HBsAg and HBsAb using Pearson correlation analysis. Results　The median age, gender distribution, mean ALT and AST concentrations, proportion of HBV DNA viral load>103 copies/mL, seroprevalence of HBV E antigen (HBeAg), seroprevalence of HBV E antibody (HBeAb), seroprevalence of HBV core antibody (HBcAb) were comparable between the experimental and control groups, and there were no significant difference in them (P>0.05). There were no significant difference between the experimental and control groups in terms of CD3+ T cell proportion [(71.83±1.50)% vs (72.75±1.47)%; t=0.66, P>0.05], CD4+ T cell proportion [(36.81±1.53)% vs (39.88±1.57)%; t=1.43, P>0.05] and CD8+ T cell proportion [(33.17±2.04)% vs (32.40±1.75)%; t=0.77, P>0.05]. Pearson correlation analysis revealed that the serum HBsAb level did not significantly correlate with peripheral blood CD3+ (r=0.026, P=0.65), CD4+ (r=‒0.08, P=0.16) and CD8+ T cell proportions (r=0.09, P=0.24), CD4+/CD8+ T proportion (r=‒0.005, P=0.35), serum ALT (r=0.04, P=0.56) and AST levels (r=0.002, P=0.69) among chronic hepatitis B patients with co-existence of HBsAg and HBsAb. Conclusions　There are no significant differences between HBsAg+/HBsAb+ and HBsAg+/HBsAb- CHB patients in terms of peripheral blood CD3+, CD4+ and CD8+ T cell proportions.

Objective To study CT manifestations of the malignant pleural mesothelioma(MPM) in rat.Methods 100 Wistar rats in the test group were injected with asbestos fibrous mixed fluid into closed right chest cavity 20 mg/ml one per month,the overall volume of asbestos was 40 mg,19 rats in the control group were injected with sterilized saline water of 1 ml per time,totally 2 ml as the same way.Dying or died rats were undergone CT scanning and pathologic examination,the experiment lasted for 2 years.Results In experimental group,there were 66 rats of MPM,14 cases of pleural hyperplasia and 12 cases without pleural change.There were 4 cases of pleural hyperplasia,10 cases without pleural change and no one of MPM in the control group.According to pathologic changes,they were divide into 66 cases of MPM,26 cases of non-MPM in the experimental rats and 14 cases of non-MPM in the control group.The occurrence rate,morphology and thickness of pleural thickening were significant among MPM group,non-MPM group and the control group.The specificity of nodular pleural thickening was 100%.The mean CT number of pleural thickening had no significance.The occurrence rate of masses of MPM in the chest cavity was 94.5%.The masses included tumors,abcesses or encapsulated effusion,the masses of MPM accounted for 62.5%.The mediastinal changes included irregular widening mediastinum,mediastinal pleural changes and masses and so on.But irregular widening mediastinum and adjacent invasion were more common and specified signs.Enlarge lymph nodes were not seen.Conclusion There were some specific CT signs in induced MPM.

Objective To explore CT features and clues to diagnosis of rhabdmyosarcoma(RMS) in head and neck .Methods 14 cases of rhabdmyosarcoma scanned by CT were co llected retrospectively during 1992～2001 and comparatively studied by the age o f patients and the pathologic types. Results Children and adolecence were mainly involved in R MS in head and neck which pathologic types were embryonal type and adeno-vesicle type ,and the former was the main type .CT features of rhabdomyosarcoma include d round and oval masses which had a homogeneous high density and close relation to muscles ,obvious enhancement after injection of contrast media ,often complic ated with the wide destruction of bone and other adjacent tissues,the collecting lymph node enlargment.Conclusion CT findings of rhabdomyosarcoma in head and ne ck had some features and combined with the age of patients can be made the diagn osis of RMS.

OBJECTIVE:To provide reference for the hospitals about emergency drug supply and pharmaceutical support in case of emergent events.METHODS:The pertinent literature both at home and abroad was retrieved and summarized analytically.RESULTS:The definition and the classification of emergent events were introduced,and the emergency drug supply and pharmaceutical support both at home and abroad in case of emergent event were introduced.CONCLUSIONS:Drugs are essential thing in medical aid in case of emergent events,and medical institutions should establish a scientific and practical drug supply system,and the pharmacists should bring their professional talents into full play by participating in medical aid in case of emergent event to ensure safe,effective and economic drug use.

Objective:Elaborated the system cloud platform based on wireless coverage of automatic temperature measuring system, complete the body temperature measurement, collection, transmission and processing, discusses the intelligent temperature monitoring in the medical role in the process of practical application.Methods: through the establishment of information system cloud and accurate and the design of the portable detector, by constantly monitor the temperature; put forward the study of the importance of the temperature in the clinical diagnosis and treatment. Results: based on the information platform, the real temperature of the intelligent detection, which changes the traditional temperature measurement model.Conclusion: the clinical information and make full use of the equipment and software resources of integration, further perfecting the existing function of hospital information system, reduce the work intensity of medical staff, improve the utilization of medical resources.

A total of 1140 medical workers from 8 public hospitals of secondary and tertiary levels in Anhui were surveyed with questionnaire. Their knowledge of the reform, acknowledgement of key points of the reform, desire of participating in the reform and other factors that may influence the reform were investigated as categorized by their hospital, position, title and age. This study comes up with such recommendations as reinforcing communications on public hospital reform, reforming the compensation mechanism to clarify government responsibilities, probing into a better model for multi-institution practice of certified physicians, and encouraging private capital to participate in medical service while ensuring its non-profit nature, and improving the performance appraisal mechanism to ensure incentives of medical workers. These recommendations aim to enable the health administrators in their decision making.

Objective To investigate effect of low molecular weight heparin (LMWH)on oxidative stress and renal function in elderly patients undergoing gastrectomy of stomach neoplasms. Methods 90 elderly patients undergoing radical surgery were randomly divided into LMWH group (Ⅰ group,n=45)and control group (Ⅱ group,n=45). Patients inⅠ group received a subcutaneous injection of LMWH(100 u/kg,1/d)from the time before anesthesia induction to postoperative 5 days,and patients in Ⅱ group were given equal volume of saline. Venous blood samples were collected to determine level of malondialdehyde(MDA),aldose reductase(AR)activity level,superoxide dismutase(SOD)activity level,catalase (CAT)activity level,creatinine(Cr)and blood urea nitrogen(BUN)before anesthesia induction(T0 ),at the end of the surgery(T1 ),on postoperative 1 day(T2),3 days(T3)and 5 days(T4)respectively;urine specimen were also collected to measured albumin(Alb)and N-acetyl-beta-D-amino glycosidase enzymes(NAG)at the same time points. Results There were obvious statistical differences in MDA,AR,SOD and CAT at different time points by intra-group comparison (P<0.05 ). MDA and AR rose first and then fell in two groups,and both reached the peak at T2 ,whereas SOD and CAT had the opposite trends. There were obvious statistical differences in MDA,AR,SOD and CAT at T1 ~T3 (P<0.05 ). MDA and AR inⅠgroup at T1 ,T2 and T3 was lower than those in groupⅡ(P<0.05 ),whereas SOD and CAT inⅠgroup at T1 ,T2 and T3 were significantly higher than those in group Ⅱ(P<0.05). Cr and BUN of both groups were found no significant statistical difference within the group and between groups(P>0.05).Alb/Cr of both groups at T1 and T2 were significantly higher than those at T0 (P<0.05 ),while Alb/Cr in Ⅰ group at T1 was obviously lower than Ⅱgroup(P<0.05 ).NAG/Cr in both groups at T1 ,T2 and T3 were significantly higher than those at T0 (P<0.05 ),while NAG/Cr inⅡ group at T4 was still higher than that at T0 (P<0.05 ),and NAG/Cr inⅠgroup at T1 ~T4 was obviously lower thanⅡgroup (P<0.05 ). MDA and AR in both groups at T1 ,T2 were positively correlated with Alb/Cr and NAG/Cr respectively(P<0.05 ),whereas SOD and CAT in both groups at T1 ,T2 were negatively correlated with Alb/Cr and NAG/Cr respectively(P<0.05 ). Conclusion Oxidative stress reaction resulted from radical surgery of elderly patients is associated with perioperative renal damage. LMWH could reduce oxidative stress in elderly patients,and alleviate the kidney damage,as well as protect the renal function.

Objective To explore the feasibility of DSCT dual-energy technique in pulmonary mass lesions.Methods A total of 100 patients with pulmonary masses underwent conventional plain CT scan and dual-energy enhanced CT scan.The virtual non-contrast (VNC) images were obtained at post-processing workstation.The mean CT value,enhancement value,signal to noise ratio (SNR),image quality and radiation dose of pulmonary masses were compared between the two scan techniques using F or t test and the detectability of lesions was compared using Wilcoxon test. Results There was no statistically significant difference among VNC ( A ) ( 32.89 ± 12.58 ) HU,VNC (S) ( 30.86 ± 9.60) HU and conventional plain images (35.89 ± 9.99 ) HU in mean CT value of mass ( F =2.08,P ＞ 0.05 ).There was statistically significant difference among VNC ( A ) ( 3.29 ± 1.45 ),VNC (S) ( 3.93 ± 1.49 ) and conventional plain image (4.61 ± 1.50) in SNR ( F =6.01,P ＜ 0.05 ),which of conventional plain scan was higher than that of VNC.The enhancement value of mass in conventional enhanced scan(60.74 ± 13.9)HU and distribution of iodine from VNC (A) ( 58.26 ± 31.99 ) HU was no statistically significant difference ( t =0.48,P ＞ 0.05 ),but there was a significant difference between conventional enhanced scan (56.51 ± 17.94 ) HU and distribution of iodine from VNC (S) (52.65 ± 16.78 ) HU (t =4.45,P ＜ 0.05 ).There was no statistically significant difference among conventional plain scan ( 4.69 ± 0.06 ) and VN C ( A ) ( 4.60 ± 0.09 ),VNC (S)(4.61 ±0.11 ) in image quality at mediastinal window ( F =3.014,P ＞ 0.05 ).The appearance,size,internal features of mass (such as necrosis,calcification and cavity) were showed the same in conventional plain scan,VNC (A) and VNC (S).Of 41 patients with hilar mass,18 patients were found to have lobular and segmental perfusion decrease or defect. Perfusion defect area was found in 59 patients with peripheral lung mass. The radiation dose of dual-energy enhanced scan was lower than that of conventional scan.Conclusion The virtual non-contrast,distribution of iodine and pulmonary virtual perfusion images can be obtained by DSCT dual-energy technique in one scan,which has a potential clinical value in the thorax.