Objective To observe the MSCT features of invasive pulmonary tuberculosis,and to investigate its effect on the prognosis.Methods 60 patients with invasive pulmonary tuberculosis were selected as the study subjects.The gold standard was in sputum culture and histopathology.The clinical value of MSCT in the diagnosis of invasive pulmonary tuberculosis was evaluated.The distribution and morphological characteristics of the lesions in the invasive pulmonary tuberculosis were observed and analyzed.The patients were divided into the treatment group and the death group.The morphological changes of lung lesions were compared between the two groups.Results In 60 patients,a total of 45 patients with invasive pulmonary tuberculosis were diagnosed,MSCT of infiltrating pulmonary tuberculosis diagnostic sensitivity,specificity,positive predictive rate,negative predictive rate,correct rate,misdiagnosis rate,missed diagnosis rate,diagnostic accordance rate were 93.3%,80.0%,93.3%,80.0%,73.3%,20.0%, 6.7%,90.0%,respectively.On the lung multiple patchy shadow,real change shadow,multiple nodules,cavity shadow, on the unilateral lung syndrome,and branch sign and halo sign is the main sign of invasive pulmonary tuberculosis. Before treatment,MSCT signs of deterioration of chest between the treatment group and death group had no statistically significant difference(P>0.05).After 4 weeks of treatment,the proportion of effusion lesions in the treatment group was significantly decreased compared with before and during the same period of treatment(37.5%vs 76.9%;3.1%vs 92.3%),the differences were statistically significant(χ2 =5.750,16.541,all P<0.05).After 8 weeks of treat-ment,the proportions of effusion,nodules and cavity lesions in the treatment group were significantly lower than those in the deteriorated group(3.1% vs 92.3%;0.0% vs 15.4%;6.2% vs 38.5%),the differences were statistically significant (χ2 =16.541,5.152,7.302,all P<0.05).Conclusion Morphological changes of MSCT in invasive pulmonary tuberculosis have certain characteristics.In the diagnosis,differential diagnosis and therapeutic evaluation of invasive pulmonary tuberculosis,MSCT has high value.

Evidence-based medicine(EBM) is a new medical model,which is an inevitable tendency of modern clinical education.This article analyses the advantages and disadvantages of the evidence-based medical education(EBME) and emphasizes the great significance of EBM in paediatrics teaching.

Objective To explore the effect of Schisandrae Sphenantherae on proliferation and differentiation of rat osteoblast in vitro. Methods Using the method of serum pharmacology, osteoblast was isolated from calvaria of newborn SD rats by means of modified sequential collagenase digestion and incubated in RPMI 1640 medium. The cell morphology was observed under a phase contrast inverted microscope. MTT assay, ALP activity, mineral node count were detected to determine the status and activities of proliferation and differentiation. Results In 10%, 15% concentration groups after cultured 48 h and 5%, 10% after cultured 72 h, 75% ethanol extracts of Schisandrae Sphenantherae significantly stimulated the proliferation (P

Objective To isolate and purify polysaccharide from Angelica sinensis by ultrafiltration technology. Methods Extract of polysaccharide of Angelica sinensis was ultrafiltrated with different aperture membrane, the separation parameters on membrane separation efficiency of polysaccharide of Angelica sinensis were optimized by and orthogonal test. Results Polysaccharide of Angelica sinensis was separated with 200, 100, 50, 20 kD membrane. The contents of polysaccharide was 30.47% before ultrafiltration. The main component of Angelica sinensis polysaccharide was the fraction with 200 kD (65.42%). The optimum condition of ultrafiltration was obtained as follow:one times of extract volume, 35 ℃, 0.3 MPa. Conclusion The technology was simple and available, and the content of Angelica sinensis polysaccharide was higher.

Objective: The purpose of our experiment is to use new type esophageal prosthesis, which is pulmonary tissue with vascular pedicle, to repair the partial esophageal defect. Methods: Twelve adult mongrel dogs were used for the study. Middle lobar bronchus of right lung was ligated and incised, so the pulmonary tissue with vascular pedicle was made. A 4 cm long and 1/2～2/3 circled esophageal wall, and full-thickness defect was created. The defect was patched by pulmonary tissue with vascular pedicle. Results: Seven dogs were put to death at planned times after the reconstructive operation. One dog is still alive without any problems for more than 12 months. One dog survived 38 days and then died of chronic empyema. The other three dogs died of anastomotic leak at 5～7 days after operation. The living dogs could be fed orally at seventh day after operation. Epithelization was found in the luminal surface of the defect. Conclusion: It was feasible that the partial esophageal defect was replaced by pulmonary tissue with vascular pedicle.

Objective To study the distal intramural spread of rectal carcinoma, and provide evidence for modification of rectal carcinoma surgery. Methods Sixty patients with rectal carcinoma admitted to the first affiliated hospital of Chongqing university of medical science from November 2001 to October 2002 were included. The specimens were extended to its original size and shape by the fat clearing method. Mesenteric lymph nodes were dissected by using transillumination to examine metastases histologically, then a lymph nodes map was produced which including the site of the primary lesion, the vascular distribution, and the sites of dissected nodes. The specimen below the distal margin of the tumor was cut continuously with 0.5 cm interval then sectioned for histopathological examination. Results Tumor spread to the distal intramural was observed in 11 of 60 patients (18.3%) with the range within 1.5 cm, of which less than 0.5 cm in 5 case, 5 cm to 1.0 cm in 2 cases, 1.0 cm to 1.5 cm in 4 cases. The tumor invasion was correlated with gross type, histological type and infiltrative depth, but not with sex, age, location of the tumor, size of the tumor, lymph nodes metastases and Dukes stage. Conclusion The range of distal mural excision should exceed 1.5 cm to tumor margin in radical surgery for rectal carcinoma. This rule should be emphasized for patients with poor cell differentiation and deep infiltration.

An early and accurate response evaluation is essential for clinicians to decide whether to continue the treatment with current thera-peutic regimen or to make necessary changes.This article briefly introduces the development of response evaluation criteria for tumors,elab-orates on the application of radiological evaluation criteria in local interventional therapy or sorafenib treatment of hepatocellular carcinoma (HCC),compares the four radiological evaluation criteria,i.e.,World Health Organization (WHO)criteria,Response Evaluation Criteria in Solid Tumors (RECIST),European Association for the Study of Liver (EASL)criteria,and the modified RECIST (mRECIST),and thinks that EASL criteria and mRECIST are better than WHO criteria and RECIST and can predict the prognosis of HCC patients at earlier time points.

Objective To investigate the expression of RGC32 gene in pulmonary adenocarcinoma tissue and to explore the influence on proliferation and apoptosis of A549 cells.Methods Real-time PCR was applied to detect the expression of RGC32 gene in 36 cases of pulmonary adenocarcinoma and pericancerous tissues.RNA interference was used to inhibit the expression of RGC32 gene.After RNA interference,the expression of RGC32 gene was detected by real-time PCR,the apoptosis of the transfected cells was detected by flow cytometry and the inhibition ratio of cell proliferation was detected by methyl thiazolyl tetrazolium (MTT).Results The expression of RGC32 gene was upgraded in pulmonary adenocarcinomas tissues(1:2.2736,t=-29.185,P=0.01).After RNA interference,the expression of RGC32 gene transfected A549 cells was down-regulated significantly[(2.47±0.17)％ vs(4.65±0.26)％,t=-202.868,P=0.000].Comparing to the control cells,the apoptosis of experimental group cells increased significantly (2.9 ％ vs 45.4 ％,t=-37.915,P=0.01),and the inhibition ratio of cell proliferation increased significantly.Conclusion The expression of RGC32 gene shows an obvious upgraded in pulmonary adenocarcinoma.The low expression of RGC32 gene can induce apoptosis and inhibit proliferation of A549 cells.

Colorectal cancer is the third high incidence of tumor in the world,and liver is one of the most common sites of distant metastasis.Liver metastasis accounts for 50％-75％ in distant metastasis.Only about 10％ -15％ of patients are candidates for resection,and the recurrence is easy.Selective internal radiation therapy is a new type of radiotherapy.It is partial and liver-targeted.For unresectable colorectal liver metastasis,selective internal radiation therapy alone or in combination with other therapies can reduce cancer focus,prolong the survival,and maybe improve overall survival.

Objective:To examine the utilization and cost of outpatient care and their influencing fac-tors among middle and aged peasant-workers in China. Methods:The data of China Health and Retire-ment Longitudinal Study ( CHARLS) collected in 2011-2012 were used and the data on peasant-workers aged 45 years and older were analyzed with Two-part Model. Results: The four-week outpatient rate of middle and aged peasant-workers was 13. 7% (407/2 974). The determinants of the rate included gen-der, marital status, economic level, household size, the place of insurance enrollment, self-assessed health and having or having no chronic diseases. The average outpatient cost was (400. 3 ± 56. 7) yuan (RMB) and the median was 138. 0 yuan. Multivariate analyses showed that outpatient costs were higher for those males who lived in Eastern China and worked at the same place with insurance enrollment, with fair to bad self-assessed health and chronic diseases. Conclusion:Allowing higher flexibility for migrants to transfer the new rural cooperative medical system ( NCMS ) between rural and urban areas and thus making reimbursement for medical services provided by undesignated providers received immediately could increase the use of outpatient services.