Objective To compare the value of ultrasound International Ovarian of Tumor Analysis (IOTA) simple rules and gynecologic imaging reporting and data system (GI-RADS) ultrasonographie stratification in the diagnosis of adnexal masses.Methods A total of 463 patients with adnexal masses were classified according to IOTA simple rules by senior doctor.The benign and malignant masses were enrolled in the study.Then the masses were judged according to GI-RADS classification and IOTA simple rules by senior and junior doctors.And junior doctorn in diagnosis of adnexal masses with IOTA was group A1,senior doctor in diagnosis of adnexal masses with IOTA was group B1,junior doctor in diagnosis of adnexal masses with GI-RADS was A2,senior doctor in diagnosis of adnexal masses with GI-RADS was B2.The efficacy of the two methods were compared.Results Among the 463 cases,there were 411 cases (411/463,88.77％) of benign mass and malignant mass by IOTA and 52 cases (52/463,11.23 ％) of uncertain mass.The specificity,positive predictive value,diagnostic accuracy had statistical differences between groups A2 and B2,A1 and A2 (all P＜0.05),and sensitivity and negative predictive value had no statistical differences (all P＞0.05).Diagnostic efficacy index had no statistial signifi cance between group A1 and B1,B1 and B2 (all P＞0.05).Conclusion The diagnostic efficacy of IOTA simple rules and GI-RADS is high and similar in diagnosis of benign and malignant adnexal masse.IOTA simple rules do not depend on experience,but they are not suitable for the diagnosis of all adnexal masses.

Objective To investigate the expression of hypoxia - inducible factor -1 alpha and vascular endothelial growth factor in gastric carcinoma and its clinical significance. Methods The expression was detected by immunohistochemistry method in 100 cases of gastric carcinoma tissues of patients with carcinoma and HIF-1 alpha, VEGF, VEGF test results comparing the carcinoma tissue and adjacent normal tissues, HIF-1 alpha; different differentiation degree and infiltration depth of tumor tissue of HIF-1 alpha and VEGF detection results of recurrence or metastasis;group, no recurrence or metastasis detection results of HIF-1 alpha and VEGF tumor tissue cancer group. Results The positive rate of HIF-1 expression in gastric tumor tissue of patients with cancer (60.00％), the positive expression rate of VEGF (64.00％) were significantly higher than those in adjacent normal tissues (21.00％, 14.00％), the difference was statistically significant (P<0.05); high ang middle differentiation, invasive depth of tumor tissue before plasma membrane positive in patients with gastric cancer the rate of VEGF, HIF-1 alpha, was low, the data had significant differences (P<0.05); the positive rate of HIF-1 alpha and VEGF expression of gastric carcinoma tumor recurrence or metastasis was found in (70.97％), the positive expression rate of VEGF (77.42％) were significantly higher than those of HIF-1 alpha and VEGF expression in patients with gastric cancer recurrence or tumor tissue the transfer of (55.07％, 57.97％), the difference was statistically significant (P<0.05). Conclusion HIF-1 alpha and VEGF play an important role in the recurrence and metastasis of gastric cancer, is an important basis for the diagnosis and prognosis of gastric cancer patients, clinicians should understand the patients with gastric cancer HIF-1 alpha and VEGF expression, so as to reduce the recurrence and metastasis rate is of important value.

OBJECTIVE Based on hospital information system operation platform,the antibacterial drugs utilization and control information system was designed to share prescriptions for antibacterial drugs and results for bacteria culture and drug sensitivity,to analyze pathogen composition and drug resistance trend,and supervise physicians to utilize antibacterial drugs properly. METHODS Adopting C/S framework,the backstage supporter adopted the large-scale database of SQL SERVER 2000 enterprises edition,the front application program used PowerBuilder7 programming.Antibacterial drugs utilization software was integrated into resident physician's working stations.Antibacterial drugs utilization control software was installed into working stations for department of nosocomial infection. RESULTS The application of the information system strengthened control of antibacterial drugs utilization and could guide physicians to utilize antibacterial drugs properly. CONCLUSIONS Antibacterial drugs utilization and control information system could reinforce management of antibacterial drugs utilization,and facilitate to utilize antibacterial drugs properly and safely.

OBJECTIVE Based on hospital information system operating platform,the Nosocomial Infection Early Warning Information System is designed to study nosocomial infection concerning its risk factors,occurrence pattern,and control measures so that the epidemic of nosocomial infection could be early found and controlled effectively,the capability of nosocomial infection supervision could be steadily increased.METHODS Adopting C/S framework,the backstage supporter adopted the large-scale database of SQL SERVER 2000 enterprises edition,the front application program used PowerBuilder7 programming.To structure a reporting,early warning,and supervising network,nosocomial infection reporting card software was integrated into resident physician′s working stations,and early warning control software was installed into working stations for department of nosocomial infection.RESULTS The application of the information system could early warn and supervise occurring nosocomial infection cases,help to find the epidemic of nosocomial infection in time and take effectively control measures as soon as possible.CONCLUSIONS Nosocomial Infection Early Warning Information System could early warn and control nosocomial infection on-the-spot,increase efficiency of nosocomial infection management and improve quality of care.

Objective To compare the value of biphasicmulti-detector row helical computed tomogrpahy(MDCT),digital subtraction angiography(DSA)and lipiodol computed tomography(CT)in hypervascular hepatocellular carcinoma(HCC).Methods 80 cases with liver cancer were underwent MDCT、DSA、iodized oil CT scan,then compared detection rates of three methods.Results In detecting hepatic nodules(＞2cm),these three imaging techniques had the same sensitivity;for 1～2cm hepatic nodules,the detecting rate had no significant difference;The MDCT scan＜1cm detected 47 nodules(94.0%),iodized oil CT detected 27 nodules(54.0%),both statistically significant difference in detection rate(χ~2=3.11,P＜0.01),DSA is only detected 16 nodules(32.0%)compared with enhanced dual-phase MDCT scan and iodized oil CT detection rate the differences were statistically significant(χ~2=9.09,9.03,all P＜0.01).Conclusion MDCT is able to better show feeding arteries of hepatocellular carcinoma,The imaging examination of liver cancer before treatment can be used as a comprehensive evaluation.

Objective This paper provides an anatomical and theoretic basis for the reverse transposition of proximal ulnar or radial periosteal flap to repair non-union in distal humerus.Methods The origin,course,meanwhile,the outside diameter and length of relevent vessels were measured,on 30 upper limb cadaveric specimens.Results The recurrent interosseous,radial recurrentand the posterior branch of radial collateal arteries,their origin outside diameter and length from the origin to the humerus extermal epicondyle were (1 47?0 2)mm,(65 1?9 5)mm,(2 1?0 3)mm,(63 7?0 8)mm,(1 48?0 22)mm and (104 5?8 9)mm,respectively.Anastomoses pattern existed 3 types: in vicinity of the external epicondyle"Reverse Y"73 3%(22 cases)."Meeting in one point 13 3%(4 cases)"."Arteries networks"13 3%(4 cases).Conclusions It's possible that the reverse transposition of proximal ulnar or radial periostea flap pedicled with recurrent interosseous membrane or radial recurrent vessel for repairing non-union in distal humerus.

Objective To study retrospectively the results of minute tissue flap for repairing tissue defect of hand. Methods The transposition or transplantation of ten kinds of tissue flaps were applied to repair skin or bone or joint defect of hand in 102 cases. Results The period of follow-up was one to eighteen years. All skin flaps were live and appearance is excellent. The function of hand is good. The period of bone healing was three to four months and joint motion is satisfactory' Conclusions Microsurgical repair of skin defects of hand have shorter period and good results' Skin defect with naked bone and joint or tendon in hand should apply minute skin flap to repair in onestage. Various vascularized minute bone flaps may be choiced to repair non-union of scaphoideum or lunatum necrosis and metacarpal head defect.

Objective To explore the clinical value of application research in business process reengineering in transferring of inpatients for check-up. Methods We reorganized transferring of inpatients for check-up and service tache by introducing the Systematic Redesign method from the therory of Business Process Reengineering. The reengineered process was adopted and applied in the transferring processes. We randomly selected patients for check-up(126 cases for electrocardiogram,130 cases for Xrayand 128 cases for CT examination)and investigated the time cost for check-up and patients satisfaction rate. The above results were compared with those patients(112 cases for electrocardiogram,112 cases for Xrayand 120 cases for CT examination)before use of reengineered process. Results The time cost for the above mentioned check-up was shorter and patients satisfaction rate were alleviated compared with those before use of reengineered process(U=14.55,12.26,13.57;x2=17.37,14.65,10.75,P＜0.01).Conclusion Application of business process reengineering in the transferring process of inpatients for check-up proved pivotal important in that it could shorten time cost for transferring process and improve patients satisfaction rate.It possessed realistic significance for increasing benefit and competitions for hospitals.

von Willebrand factor (vWF) and factor Ⅷ (FⅧ) exist in a complex form in blood.After being activated,they mediated platelet adhesion and aggregation,and play an important role in the course of thrombosis.The levels in blood of both of them were affected by a variety of factors.vWF and FⅧ are closely associated with the risk,etiological type,severity and outcome of acute ischemic stroke.Studies on the corresponding antagonistic drugs have made a breakthrough,and these drugs may become more advantageous antithrombotic s.