Purpose To explore the value of 128-slice dual source CT (DSCT) three-dimensional post-processing techniques in the diagnosis of acute aortic dissection (AAD). Materials and Methods All image data of 116 patients with AAD who underwent conventional and enhanced DSCT scan by dual-energy scanning technology were retrospectively analyzed, and the multi-planar reconstruction (MPR), volume rendering (VR) and maximum intensity projection (MIP) were conducted in the workstation. Taking digital subtraction angiography (DSA) as the diagnostic gold standard, we analyzed the imaging manifestation of the original and 3D-reconstruction images and evaluated the specificity and the sensitivity of diagnostic accuracy and the image quality. Results The diagnostic accuracy of conventional scan was 37.1%(43/116). The display rates of MPR for initial break, intimal flap and true and false lumen were 93.1%, 100.0%and 100.0%, respectively. The display rates of VR and MIP for the initial break were 33.62%and 6.90%, respectively, which was both lower than that of MPR. The display rate of MIP for the true and false lumen was 23.28%. The overall display capability of MPR was significantly better than that of VR and MIP (P<0.01), and the display capability of VR was better than that of MIP (P<0.01). The sensitivity and specificity of enhanced DSCT in the diagnosis of AAD were both 100.0%. Conclusion DSCT has a fast and reliable diagnostic value on AAD. Conventional CT signs should be highly valued in the evaluation of chest or abdominal pain; and a thin layer of MPR and VR should be chosen in the three-dimensional reconstruction;whilst MIP reconstruction may be unnecessary for AAD.

Objective To access the efficacy of the arterial based complexity (ABC) scoring system in predicting complexity of LPN.Methods A total of 70 patients underwent laparoscopic partial nephrectomy from January 2013 to November 2015 were enrolled in the retrospective analysis.Among those patients,53 (75.7％) were males and 17 (24.3％) were females.Their mean age was 52 years,ranged from 44 to 61 years.The average BMI was 28 kg/m2,ranged from 25 to 32 kg/m2.Before operation,the average creatinine was 70.5 μmol/L,ranged from 60.5 to 81.0 μmol/L.43 patients accepted the procedure via retro-peritoneal approach and 27 patients accepted the procedure via peritoneal approach.38 tumor located in the left kidney and 32 tumor located in the right kidney.By using ABC scoring system,four readers independently scored contrast-enhanced computed tomography images of 70 patients who underwent laparoscopic partial nephrectomy.Interobserver variability was assessed with kappa values and percentage of exact matches between each pairwise combination of readers.Logistics regression was used to evaluate the association between reference scores and ischemia time,estimated blood loss,operation time.Results The operative duration ranged from 100 to 180 min,mean 147 min.The mean ischemic time ranged from 15 to 37 min,mean 24 min.The average blood loss was 210 ml (ranging 50-380 ml).The mean hospitalization was 16 days (ranging 11-21 days).The urine leakage was noticed in 2 patients after the operation.The size of tumor ranged from 1.8 to 3.0 cm,mean 2.5 cm.The pathological classification included renal cell carcinoma in 65 cases,renal cell carcinoma with cystic changing in 2 cases,renal chromophobe cell carcinoma in 2 cases,right renal solitary fibroma in 1 case.Based on the ABC scorirng system,15 cases were in 1 degree,29 cases were in 2 degree,17 cases were in 3S degree and 9 cases were in 3H degree.Pairwise comparisons of readers' score assignments were significantly correlated;average kappa =0.492,across all reader pairs.The average proportion of exact matches was 65％,the average proportion that differ between a level or less than a level was 98.6％.Logistics regression between the complexity score system and surgical outcomes showed significant associations between reference category assignments and warm ischemia time and estimated blood loss (P ＜ 0.05),but showed no significant associations with operation time (P ＞ 0.05).Conclusions The ABC scoring system for LPN demonstrated good correlation with perioperative morbidity.This system is a novel anatomy-reproducible tool developed to help patients and doctors understand the complexity of renal masses and predict the outcomes of kidney surgery.

Objective To investigate the expressions of epidermal growth factor receptor (EGFR), cyclooxygenase-2 (COX-2) and P63 protein in non-small cell lung cancer (NSCLC) and their relationship with TNM staging and lymph node metastasis of NSCLC. Methods Seventy-eight paraffin-embedded specimens of NSCLC from 1998-2005 were collected in this study. Inclusion criteria included no chemotherapy or radiotherapy before operation. Pathological diagnosis was made after operation: 43 squamous carcinoma and 35 adenocarcinoma, 45 with lymph node metastasis and 33 without, 13 in stage Ⅰ, 19 in stage Ⅱ, 28 in stage Ⅲ and 18 in stage Ⅳ. The expressions of EGFR, COX-2 and P63 were determined by immunohistochemical staining (S-P). Results The expression rates of EGFR, COX-2 and P63 were 65.4% (51/78), 61.5% (48/78) and 56.4% (44/78) respectively in 78 cases of NSCLC. Significant difference in the expressions of COX-2 and P63 was found between squamous carcinoma and adenocarcinoma (P0.05). The positive rate of EGFR and COX-2 protein expressions in NSCLC of stage Ⅲ-Ⅳ and NSCLC with lymph node metastasis was significantly higher than that in stage Ⅰ-Ⅱ and NSCLC without lymph node metastasis (P0.05). Conclusion Over-expressions of EGFR and COX-2 may play an important role in invasion and metastasis of NSCLC. COX-2 and P63 may be valuable markers in differentiating pulmonary squamous cell carcinoma from pulmonary adenocarcinoma.

OBJECTIVE:To provide reference for better improving the risk perception of Omeprazole sodium for injection in nurses in a third-grade class-A hospital,strengthening risk management of ward drugs and ensuring safety of patients. METHODS:Nurses in the clinical departments in a third-grade class-A hospital where usage frequency of Omeprazole sodium for injection was relatively more were adopted as study subjects and a self-designed questionnaire was used to investigate on related knowledge on medication risk in nurses in emergency department,gastroenterology department,ICU and CCU in 2012 and 2014. RESULTS:51 and 81 questionnaires were distributed in 2012 and 2014,and 51 and 81 were effectively received with effective recovery of 100%and 100%,respectively. In both surveys,100% surveyed nurses could correctly choose one solvent at least,1.96% and 3.70%nurses could correctly choose 2 solvents;correct answering rates of intravenous administration time were 94.12% and 96.30%,re-spectively;correct answering rates of stable duration after preparation were both lower than 9%;correct answering rates of adverse reaction of this drug were 3.92% and 1.23%,respectively;correct answering rates of interaction of this drug were 1.96% and 6.17%,respectively;correct answering rates of stable formulation of this drug were 17.65%and 22.22%,respectively;the propor-tion of nurses observing ADRs were 25.49% and 13.58%,respectively;the proportion of nurses finding inappropriate compatibility were 15.69% and 22.22%,respectively,Ornidazole and sodium chloride injection was the most used incompatible drug;45% or more nurses hoping to strengthen the continuing education of nursing personnel. CONCLUSIONS:Nurses in this third-grade class-A hospital lack certain knowledge on the medication risk of Omeprazole sodium for injection,the drug risk management is not sufficient,and awareness prevention of drug risk is relative weak. It is suggested that the hospital should strengthen drug risk management system,nurses should strengthen the learning about drug risk and play the role of clinical pharmacists in the drug risk management to reduce the related drug risk and incidence of adverse reactions.

Humans ; Melanoma ; diagnosis ; genetics ; Precision Medicine

BACKGROUND:Percutaneous vertebroplasty and percutaneous kyphoplasty in the treatment of osteoporotic vertebral compression fracture have obtained good outcomes, because the traditional method is invalid, but there are a variety of choices in operation time, anesthesia, surgical approach and method, and each method has its advantages and disadvantages. OBJECTIVE:To investigate the effect and preponderance of the manual reduction combined with unilateral percutaneous vertebroplasty under general anesthesia in the treatment of osteoporotic vertebral compression fractures. METHODS:A total of 53 patients with single vertebral osteoporotic vertebral compression fractures, who were treated with percutaneous vertebroplasty, were retrospectively analyzed from July 2012 to December 2014. The new method group (32 cases) received manual reduction, underwent unilateral pedicle puncture and bone cement injection during unilateral percutaneous vertebroplasty under general anesthesia. The conventional method group (21 cases) received conventional percutaneous vertebroplasty. RESULTS AND CONCLUSION: There was an average of 6-month folow-up (3-14 months). Significant differences in visual analogue scale scores, vertebral compression ratio and kyphosis Cobb’s angle were detected in the new method and the conventional method groups at 3 days post surgery and during final folow-up compared with before surgery (P < 0.01). No significant difference in visual analogue scale scores was found between the two groups (P > 0.05). Compared with the conventional method group, postoperative vertebral compression ratio, kyphosis Cobb’s angle and bone cement leakage rate were significantly lower in the new method group (P < 0.01). Results verified that the new method combined with the advantages of percutaneous vertebroplasty and percutaneous kyphoplasty, the advantages of unilateral and bilateral puncture approach. The new method can correct kyphosis deformity, effectively recover the vertebral height and physiological curvature and the puncture is safe. Simultaneously, the leakage rate of bone cement is reduced, and the distribution of bone cement is ideal.

Objective To investigate the effects of sufentanil on activation of spinal astrocytes in mice after unilateral sciatic nerve injury.Methods Eighty healthy male BALB/c mice,aged 6-8 weeks,weighing 18-22 g,were randomly divided into 4 groups (n=20 each): sufentanil high dose group (group H),middle dose group (group M),low dose group (group L) and model group (group MO).After model of sciatic nerve injury was established by unilateral sciatic nerve transection,group H,M and L,sufentanil 10 μg/kg,5 μg/kg,2.5 μg/kg was injected intraperitoneally once a day continuously for 3 days,while the equal volume of saline was injected in group MO.Five mice in each group were selected,and the sciatic nerve functional index were measured at 4,8,12 weeks.The 5 mice were sacrificed from each group and the damage on the same side L4-L6 segments of the spinal cord were removed at 2,4,8,12 weeks.The pathological changes were examined under light microscope at 8 week point.The expression of GFAP was determinatied at each time points by immuno-histochemistry.Results Compared with group L and MO,sciatic nerve functional index significantly was increased in groups H and M (P<0.05),and no significantly change was found in group L.Spinal cord neurons had a better morphology in groups H and M than in group L and MO.Compared with group MO,The expression of GFAP were significantly up-regulated in groups H,M and L (P<0.05).Compared with group L,the expression of GFAP were significantly up-regulated in groups H and M (P<0.05).Conclusion Sufentanil promotes spinal astrocyte activation after peripheral nerve injury in mice and improves repair after peripheral nerve injury.

Objective To investigate the effect of APE1 on differentiation of peripheral blood mononuclear cells into osteoclast-like cells(OCL) which induced by macrophage colony stimulating factor (RANKL) and macrophage colony stimulating factor (M-CSF) .Methods Human peripheral blood mononuclear cells (PBMCs) were collected by density gradient separation ;Constructed APE1 siRNA expression vector Ad5v-APE1 siRNA was used to transfect PBMCs .Tartrate-resistant acid phosphatase (TRAP) method was conducted to identify the cells ,the expression level of APE1 was detected by Western blot ,the mRNA expression levels of Cathepsin K(CK) and V-ATPase were detected by RT-PCR .Results PBMCs transfected with APE1 siRNA had significantly lower protein expression of APE1 than untransfected cells (P< 0 .05) ;PBMCs could differentiate into OCL under the stimulation of RANKL and M-CSF ,the mRNA expression levels of CK and V-ATPase increased ;After APE1 siRNA treatment ,the number of OCL was reduced and the levels of CK and V-ATPase mRNA decreased .Conclusion PBMCs can differentiate into a large number of OCL induced by RANKL and M-CSF ,APE1 siRNA significantly inhibited differentiation of PBMCs into osteoclast-like cells , APE1 may be involved in the regulation of osteoclast-like differentiation process .

Objectives:To determine the content of aminoacids in gastric cancer tissue and study the relationship between alterations of amino acids and cancer stages.　Methods:19 free amino acids of cancer tissue and paracancerous normal mucose were determined in 41 cases of gastric cancer.　Results:Most free amino acids were significantly increased in gastric cancer tissue as compared with those of paracancerous normal gastric tissue.The contents of proline,valine,methionine,isoleucine,leucine in advanced gastric cancer were significantly higher than those in early cases.　Conclusions:Gastric tumor tissue contains high amount of most free amino acids particularly in cases with advanced cancer..

Objective To observe the effect of superficial radial nerve transplanting to repair musculospiral nerve defection and using end-to-side neurorrhaphy to reconstruct the function of the donor site. Methods Thirtyfour cases underwent superficial radial nerve transplanting to repair musculospiral nerve defection and end-to-side neurorrhaphy was performed to reconstruct the function of the donor site. Results All cases were followed-up for 6 to 18 months,the functional recovery of the recipient of musculospiral nerve was excellent in 23 cases and good in 5 cases,with an excellent and good rate of 82. 53 %. Sensory recovery of donator nerve was excellent in 27 cases and good in 5 cases,with an excellent and good rate of 94. 12%. Conclusions Superficial radial nerve transplanting to repair musculospiral nerve defection and functional reconstruction of donor site is a better choice in treating neurologic defect.