Sixty-four patients with solitary pulmonary nodules were included in this study. The diameter of pulmonary nodules was equal or less than 3.0 cm and no contact with the adjacent pleura. They were divided into study group( with acuductor locating method)and conventional group (with conventional method). The results showed that the one-time success rates were 97％ (31/32)in study group and 72％(23/32) in conventional group, the diagnostic accuracy were 94％ ( 30/32 ) and 88 ％ ( 28/32 ), respectively,while the successful puncture time were( 13. 5 ±4. 9)min and( 18. 7 ±5. 7) min, respectively. In study group,the complication rate was 9％ (3/32), while 28％ ( 9/32 ) in conventional group. There were statistical differences between the two groups. CT-guided aspriation biopsy for solitary pulmonary nodules with self-made acuductor can obviously improve one-time success rate and reduce the complication rate and operative time.

Purpose To investigate the clinicopathologic features of cervical adenoid basal cell carcinoma. Methods Clinical and pathological data were analyzed in 12 cases of cervical adenoid basal cell carcinoma and the relevant literatures were reviewed. Results The age of 12 cases of with cervical adenoid basal cell cancer patients ranged from 36~70 years ( mean:53. 3 years) , with a medi-an age of 51. 5 years. Amongst 12 patients who contained no gross definite lesion, 5 patients (41. 7%) had the symptoms of vaginal bleeding. 8 cases of patients underwent hysterectomy, while the other four received cervical conization. Cervical intraepithelial neopla-sia ( CIN) lesions were observed in all 12 cases. The tumor cells were small and uniform, with dark oval nuclei without conspicuous nucleoli and scanty cytoplasm. Tumor infiltrated into the stroma in nests and cords. Glandular differentiation within tumor nests were seen in 12 cases, including two cases of squamous cell differentiation accompanied by partial and minor interstitial edema. Peripheral palisading cells around tumor nests were also found. The infiltrating depth of tumor ranged from 0. 5~10 mm with the average 4. 12 mm. Cancer embolis were available in 2 cases with no lymph node metastasis. 10 cases followed up for 3~78 months with no recur-rence and metastasis, but 2 cases were lost. Conclusion Adenoid basal cell carcinoma is a rare uterine cervical tumor found in post-menopausal women, which are often accompanied with CIN. This tumor has a favorable prognosis and should be clearly separated from adenoid cystic carcinoma and other tumors which also have infiltrative growth pattern.

Objective To investigate the supplementary roles of MRI in the diagnosis of fetal abnormalities in twin fetuses.Methods MRI manifestations of 22 twins were retrospectively analyzed after abnormalities were found by prenatal ultrasonography (US) from Sep 2005 to Dec 2012.Two rapid scanning sequences were used in the study,fast-imaging employing steady-state acquisition (FIESTA) and fast inversion recovery motion insensitive (FIRM).MRI findings were compared with those of prenatal US,induced labour or postpartum diagnosis.Results A total of 22 twins were reported with 23 abnormal fetuses in 20 twins and 2 normal twins.MRI confirmed central nervous system abnormalities in 3 abnormal fetuses which were anencephalus,meningoencephalocele and enlargement of lateral ventricles respectively.The case of meningoencephalocele was showed brain tissue protruding from the occipital defect on MRI,which was misdiagnosed as a cystic lymphagioma by US.The MRI diagnosis of anencephalus and enlarged lateral ventricles were accordant with US.MRI made the definite diagnosis in 5 chest abnormalities,which were left congenital diaphragmatic hernia (CDH) in 5 abnormal fetuses.They were diagnosed as possible CDH by US.Abdominal abnormalities (n=7,8 abnormal fetuses) included two fetuses in one twin with expanded digestive tract,one fetus with expanded colon and rectus and five fetuses with omphalocele.MRI diagnosis was compatible with US diagnosis in the 7 cases.Twins micromelia were found in one case with 2 abnormal fetuses.Conjoined twins in chest and abdomen were found in another case,which manifested as two hearts,one shared liver and independent urinary tracts and gastrointestinal tracts on MRI.One fetus in twin was dead (n=1,1 abnormal fetus).MRI showed small size and skin edema of the dead fetus.One acephalus acardius of twins (n=2,2 abnormal fetuses) was proved.Normal MRI manifestations were indicated in 2 cases which were suspected by US for abnormal digestive tract and cryptorachischisis respectively.Conclusions MRI,an important supplementary method of prenatal US diagnosis,shows valuable advantages including multi-plane manifestations,more extensive visual field and good soft tissue contrast.It is especially helpful in the diagnosis and treatment of multiple pregnancy.

OBJECTIVE:To systematically investigate the management mode of non-medical prescribing in Britain and its enlightenment to the establishment and implementation of non-medical prescribing in China. METHODS:By retrieving domestic and foreign literatures,non-medical prescribing in Britain was introduced systematically in terms of development history,types, core elements,implementation status and effect;the suggestions were put forward for the development of non-medical prescribing in China. RESULTS & CONCLUSIONS:Britain implemented non-medical prescribing since 1994. After years of practice and a series of legislation and revision,independent prescribers (including nurses and pharmacists) have owned the statutory right to prescribe any medicine for patients by 2012. In Britain,non-medical prescribing is divided into independent prescribing which mainly exists in community pharmacies and is limited to specific diseases,supplementary prescribing which exists in hospitals or clinic and needs to be signed with doctors. The management institutions are mainly composed of one state administrative department (British Department of Health) and three professional associations (British Nursing and Midwifery Council,The Royal Pharmaceutical Society of Great Britain,The Pharmaceutical Society of Northern Ireland). There are detailed and strict stipulations on the qualification and corresponding responsibilities of the prescribing authority. The British government has provided legal protection for the development of the non-medical prescribing model,and the number of non-medical prescribers is increasing. The implementation of this model has increased the patients'access to medical services. Drawing lessons from the development of non-medical prescribing management in Britain,our country needs to improve legislation,provide legislative protection for the implementation of non-medical prescribing,expand the scope of practice of nurses and pharmacists,establish and improve the training program of non-medical prescribing professionals to promote the development of non-medical prescribing model in China.