Objective: To discuss the possibility of using arc incision in the frontal neck for local-regional lymph excision in differentiated thyroid carcinoma of stage Ⅰand Ⅱ.Methods: A retrospective study was conducted on the results of the treatment of 56 cases of differentiated thyroid cancer in stage Ⅰand Ⅱ treated by thyroid lobectomy+isthmectomy+local-regional lymph nodes dissection.Results:Of all the 56 patients,only 2 developed postoperative complications,2 had cervical lymph nodes metastases after the operation,and none died.Conclusion: Arc incision in the frontal neck for lymphadenectomy of the central compartment could be applied as a routine treatment of differentiated thyroid carcinoma in stage Ⅰand Ⅱ.

Objective To study the prevention and treatment of bile duct injury during laparoscopic cholecystectomy(LC). Methods 22 cases of bile duct injury during LC were reviewed retrospectively. The features, diagnosis, treatment and efficacy of injury were summarized. Results All patients were successfully treated by Roux-en-Y cholangio-jejunostomy. Besides, 8 patients underwent plastic operation of bile duct of hepatic portal and 3 patients middle lobectomy of liver. 22 cases were followed up at the 1st and 3rd year after surgery, and no bile duct stricture, recurrence of jaundice and cholangitis occurred. Conclusions It's a key to prevent bile duct injury during LC. The management of bile duct injury should be chosen according to injured time, sites and types.

Objective To prepare the candidate reference materials for frozen mixed serum potassium, in order to calibrate and evaluate the conventional methods to achieve mutual recognition of the results.Methods Fresh sera without hemolysis,lipemia and choloplania were collected.Serum pools were packed in the freezing tube in the 1 000 (1 ml/per).Use the Single Factor Analysis of Variance(ANOVA) to evaluate the homogeneity.The short-and long-term stability [(2 -8℃,room temperature,37 ℃) and long-term (-80 ℃ ) ] were investigatedby linear regression analysis.The value was assigned by transfer from NIST SRM-956c using reference method by ICP-MS and uncertain was calculated.We observed the commutability of 25 fresh patient serum samples and 3 levels candidate RMs between reference method and three analyzed systems.The candidate RMs( refernce materials) were then distributed to 33 laboratories in Beijing to apply in routine assay by using different detection systems.Results By statistical analysis of the SPSS 17 statistical software, the F value of homogeneity test of each level candidate RMs was 0.247, 0.117, 0.162.All of them were less than F0.05 (9,20) =2.39;Stability can be last at least 12 months,30 days, 12 days and 4 days at -80 ℃, 2-8℃, room temperature and 37℃respectively.The definited values of three levels candidate RMs for potassium were (2.349 ±0.028) mol/L,(3.845 ±0.024) mol/Land (5.831 ±0.042)mol/L;Coordinate dots of 3 levels candidate RMs are all within 95% confidence interval range of 25 serums regression line.They have the same speciality as serum.In correctness verification survey of 33 clinical laboratory of conventional methods,97%bias in results The biases of 97%RMs were within the range of ±2.5%( ±1/2 CLIA′88Tea).Conclusion The homogeneity, stability and commutability of 3 levels candidate RMs all meet the requirement and the target values are assigned accurately.

Objective To explore the effect of radiofrequency ablation (RFA) combined with transcatherter arterial chemo-embolization (TACE) and percaulaneous ethanol injection (PEI) for unresectable hepatic malignancies. Methods The clinical data of 41 cases of unresectable liver cancer(URLC)treated by RFA,TACE and PEI were analysed retrospectively. Results There were 30 cases of primary hepatic cancer(PHT) and 11 cases of secondary hepatic cancer in this series.Ultrasound,CT and MRI showed the tumors shrinking or stable in 26 of the 41 patients postoperatively.AFP decreased to normal in 12 cases of 16 AFP positive PHT patients after operation. No severe complication was seen in the series. Conclusions RFA combined with TACE and PEI is a safe, well-tolerated and effective method for unresectable hepatic carcinoma, and may improve the treatment efficacy of URLC.

Objective To establish a method for the determination of serum potassium using isotope dilution inductively coupled plasma mass spectrometry.Methods Frozen human serum pools of different potassium concentrations were prepared from healthy donors of Chao-yang Hospital laboratory in 2010 Serum samples were diluted with 1％ HNO3 supplemented with 41K spike and isotope ratio was measured after selection and optimization of ICP-MS analysis conditions.Serum 39K concentrations were calculated by interpolation method.3 different serum samples were used to evaluate the precision of the method.Standard Reference Material 909b Ⅰ and Ⅱ of National Institute of Standards and Technology were used to evaluate the accuracy.The recovery was evaluated through 2 serum samples added standard material for potassium,uncertainty was calculated.Results The analytical precision of serum potassium measurement was 0.14％ to 0.11％.The results of SRM909b Ⅰ and Ⅱ gave the coefficients of variation (CVs) of 0.39％ to 0.32％.Data was consistent with the certified value and the CV was + 0.12％ and + 0.49％ respectively.The recovery was 99.68％ to 100.12％ for 2 different serum samples.Conclusions ID-ICP-MS method was successfully established to measure the serum potassium concerntration precisely and accurately,it is an ideal method for the accurate determination of inorganic elements.

Objective To explore Naukan therapy and health education combined with drug treatment clinical efficacy in the treatment of alcohol dependence.Methods The 66 cases of male alcohol dependent patients were randomly divided into study group (33 cases) and control group (33 cases),and both of patients were taking generic drugs.The study group was given Naukan treatment (including centralized within concept and dispersion Vipassana),and the control group received health education (including collective health education and individual health education).Duration of treatment was 4 weeks,the total number of hours were 55.5 h,56 h.Obsessive compulsive drinking scale(OCDS),social support rating scale (SSRS),Minnesota multiphasic personality inventory (MMPI) for the two groups before and after treatment; and follow-up the rate of recovery drink three months after hospital discharge.Results ① OCDS score after treatment in the study group was lower than that in the control group,the difference was statistically significant ((48.21 ± 2.05) vs.(54.15 ± 2.01),t =11.885,P＜0.01).②After treatment SSRS total score,objective support,subjective support,social utilization factor scores were higher than those in the control group,and differences were statistically significant ((49.05±5.63)vs.(40.15±6.50),t=5.946,P=0.000) ; ((14.32±3.51) vs.(8.72±6.22),t=4.504,P＜ 0.05) ; (27.02±4.26) vs.(19.45±4.92),t=6.682,P=0.000; (10.02±3.30) vs.(7.52±3.86),t=2.828,P=0.006).③MMPI with schizophrenia (Sc),paranoia (Pa),mental weakness (Pt),psychopathy (Pd) ie 8/6/7/4 model-based in two groups,and Sc,Pa,Pd,Pt dimensions of the original sub in study group were lower than those in the control group after treatment,in addition to outside Pt differences were statistically significant ((25.43 ± 6.76) vs.(29.01 ± 6.72),t =2.158,P=0.035; (14.12±6.01) vs.(18.32±6.42),t=2.744,P=0.008; (18.63±6.85) vs.(23.29±6.12),t=2.342,P=0.022).④Redrinking rate in study group was 39.39％ (11/33),and 72.73％ (24/33)in the control group,the difference was statistically significant(x2 =7.44,P＜0.05).Conclusion The Naukan therapy combined with general drug treatment can solve the problem of patients with alcohol dependenceof alcohol dependence in the psychological and physiological aspects,and its efficacy is superior to general health education combined drug therapy.

Objective:To assess the genetic relationship of clinical isolates of carbapenem-resistant A.baumannii (resistant to both imipenem and meropenem) from January 2007 to March 2008 in Peking University Third Hospital for measures to decrease the isolates; to investigate the characteristics of patients with carbapenem-resistant A. baumannii colonization or infection and to evaluate antibiotic treatment for health care-associated infections caused by carbapenem-resistant A. baumannii. Methods: The medical records of patients with carbapenem-resistant A. baumannii colonization or infection were reviewed. Antibiotic susceptibilities of the isolates were determined by the standardized disk-diffusion method and the clonal relationship of the isolates was analyzed by pulsed-field gel electrophoresis. Results: A total of 49 carbapenem-resistant A. baumannii strains were isolated from the 49 patients hospitalized during the study period and pulsed-field gel electrophoresis typing yielded 7 different patterns. A total of 45 (91.8%)genotyped strains showed clonal relationship. The most frequently identified predisposing factors were intensive care unit stay, invasive procedures, and hypoalbuminemia. Chronic obstructive pulmonary disease (12 cases) and cerebrovascular disease (10 cases) were the most common comorbid conditions.The mortality of patients with carbapenem-resistant A. baumannii infection was 38. 1% (8 of 21 patients), and the acute physiology and chronic health evaluation Ⅱ score, initial antibiotic therapy failure rate and the presence of hypoalbuminemia were significantly increased in the death group. Combination therapy regimens had higher success rates than monotherapy regimens (11/13, 84. 6% vs. 3/17,17.6%). Conclusion: There has been clonal spread of carbapenem-resistant A. baumannii strains among patients in our hospital since 2007. Intensive care unit stay, invasive procedures, hypoalbuminemia, chronic obstructive pulmonary disease and cerebrovascular disease were common in patients with carbapenem-resistant A. baumannii colonization or infection. Antibiotic combination therapy may be effective for carbapenem-resistant A. baumannii infection.

Objective To investigate the common reasons for intracranial hemorrhage after cranioplasty ,and to analysis the sig‐nificant perioperative factors of intracranial hemorrhage after cranioplsty .Methods Eight hundred and seventy two cases of cranio‐plasty were retrospectively analyzed ;the postoperative intracranial hemorrhage and perioperative risk factors were conducted with multiple linear regression analysis .Results Among the 872 cases ,46 cases suffered intracranial hemorrhage .We found three signifi‐cant perioperative factors of intracranial hemorrhage after cranioplasty :suspension for epidural ,not completely hemostasis and ex‐cessive drainage in ventriculoperitoneal shunt .Conclusion To avoid the three risk factors as far as possible could effectively reduce the incidence of intracranial hemorrhage after cranioplasty .

In recent years , with the development of error theory and the requirements of the international accreditation bodies , the quality indicators ( QIs) have become one of the important tools in the laboratory quality management .To explore the evolution and origin of QIs , the status and the future of QIs will be helpful for us to understand and to use the QIs .

Objective Through statistical analysis of specimen rejection reasons, aimed at finding the ways to reduce the failed specimen, making sure of continuous improvements in laboratory quality. Methods Department of Laboratory, Beijing ChaoYang Hospital, Capital Medical University had analyzed rejections specimen from October 2013 to September 2014 in CAP Q-TRACKS QT3 ( QT3: Laboratory Specimen Acceptability ) , and compared the laboratory rejection reasons with all laboratories of CAP. Results From October 2013 to September 2014, the total number of rejection specimen number was 2 367, in which 225 were incomplete labeled specimen/inadequate filled-out form, accounting for 9.5%.898 samples were rejected because of specimen clotted, accounting for 37.9%.The samples could not meet the requirement of specimen quantity of 254, accounting for 10.7%.Other reasons accounting for above 1%included wrong collection container, specimen hemolysis, lipemia or icteric specimen.After comparing the first five rejection reasons, Department of Laboratory, Beijing ChaoYang Hospital was found to be different with others laboratories of CAP.Conclusion The quality of the specimen is very important for the accuracy and reliability of the test results, and doing some positive statistical analysis and taking corrective measures can effectively reduce the unqualified specimen of the proportion.