Objective To discuss the value of color Doppler ultrasonography in the diagnosis and differential diagnosis of urinary tract urothelial carcinoma (UTUC).Methods Color Doppler ultrasonography exam was practiced in 84 UTUC patients preoperatively.According to ultrasound characteristics,lesions was classified into nodular type,wall thickening type and solid mass type,which were confirmed by pathology in all cases postoperatively.Results In the total of 84 cases (76 transitional-cell carcinoma,5 adenocarcinoma and 3 epidermoid carcinoma),lesions infiltrated laminae propria and surrounding tissue in 65 cases.In the nodular type of UTUC,there were nodules raising into lumen.Wall thickening type of UTUC was characterized by irregularly wall thickening,lumen narrowing,truncating and breaking.Similarly,obstruction broke off the ureteral lumen suddenly in solid mass type of UTUC.A clear demarcation could be found between the pipe wall and surrounding tissue in nodular type.However,such clear demarcation could not be found in wall thickening type and solid mass type.The accordance rate of ultrasonographic located diagnosis were 92.9 ％ (78/84),with 6 missed diagnosis cases.The accordance rate of qualitative diagnosis were 89.7％ (70/78).Conclusions As result of color Doppler ultrasonography,there were different relationship between lesion and the peripheral tissue in different types of UTUC.In types of wall thickening and solid mass,the demarcation was unclear and it is easier to violate the surrounding tissue.Color Doppler ultrasonography can provide more effective information for diagnosis and therapy UTUC.

OBJECTIVE:To explore the construction effect of rational drug use monitoring system on the improvement of clini-cal drug use in the hospital. METHODS:The data about the construction of rational drug use monitoring system were collected from our hospital,including pharmacist workstation prescription check(check before prescription/medical order charging to realize warning in advance),clinical pharmacy management system prescription comment(realize prescription/medical order comment after-wards)and adverse drug reaction/adverse drug event(ADR)reporting information platform(realize online ADR reporting)during 2014-2015. The data was analyzed to evaluate the effectiveness of system construction. RESULTS & CONCLUSIONS:There were a total of 3 417 329 prescriptions audited by the pharmacist workstation within 2 years through improving system functions,includ-ing 7 315 prescriptions were returned to doctors to be modified,the percentage of which declined from 0.39% to 0.08%. The pass rate of prescription comment pre-judgment increased from 81.2% to 90.4% in 2015 by clinical pharmacy management system. The valid case number of ADR monitoring and reporting increased from 186 cases to 267 cases,involving all department of our hospi-tal. The construction of rational drug use monitoring system in our hospital can improve the standardization of prescription/medical orders,the level of rational drug use and the case number of ADR,which has achieved the expected results.

ObjectiveTo assess the clinical value of ultrasound-guided percutaneous ethanol injection (PEI) in the treatment of hepatocellular carcinoma (HCC) combined with portal vein tumor thrombosis (PVTT).MethodsNinety HCC patients with different type PVTT underwent ultrasound-guided PEI once or twice a week.The follow-up lasted 12 to 60 months,and the 1-,2-,3-,4- and 5-year survival rates were calculated.ResultsThe median survival time of HCC combined with PVTT patients treated with PEI was 12 months,and the 1-,2-,3-,4- and 5-year survival rates was 52.22％,23.33％,15.56％,12.22％ and 10.00％,respectively.The survival rate correlated significantly to the type of PVTT.The lower the type of PVTT was,the longer the patients lived.ConclusionUltrasound-guided PEI is a safe and effective method for the treatment of HCC combined with PVTT,and can prolong the survival time of HCC patients with low type PVTT.

Objective To find out the exposure level and distributional characteristics of risk factors for stroke in health checkup population. Methods Target population was selected from two health management centers including Qianfoshan Hospital Affiliated to Shandong University and Shandong Provincial Hospital Affiliated to Shandong University in Shandong province. Data were investigated with a questionnaire which included general information, physical examination, laboratory examination and electrocardiography. Exposure rate of risk factors and its distributional characteristics were described. Results A total of 95 909 individuals were enrolled into data analysis, including 59 686 males (age:44.48± 14.43), 36 223 females (age: 44.80 ± 13.90). The major risk factors were lack of exercises (68.02%), overweight (60.54%)and dyslipidemia (58.27%). There were significant differences in age groups and sex. Conclusion Exposure rate of risk factor for stroke was high and there were substantial differences between sex and age in health checkup population. Screening and health management for stroke risks might be a necessary strategy for the preventive intervention.

Objective To assess the reliability and validity of the Chinese version of Multidimensional fatigue symptom inventory-short form(MFSI-SF).Methods The reliability and validity of the Chinese version MFSI-SF were assessed in a sample of 203 cancer patients.Statistical software was used to perform the analysis.Results The results showed moderate correlation between items and the total scale,the content validity index was 0.82,and exploratory factor analysis indicated five dimensions of the scale,the cumulative variance contribution was 56.65％.Confirmatory factor analysis showed moderate model fitting:x2/df=l.73,GFI=0.83,AGFI=0.79,NNFI=0.94,RMSEA=0.06,criterion validity was 0.585,and the Cronbach α of the total scale was 0.896.Conclusions The results demonstrated good convergent validity,it is suitable to evaluate fatigue status in Chinese cancer patients.

Objective To develop a PCR-mverse dot blot hybridization(RDB)assay to rapidly detect pathogenic mycoplasmas in genitourinary tract.Methods Universal primers were designed and applied to amplify the 16S rRNA gone of ureaplasma parvum(Up),ureaplasma urealyticum(Uu),Mycoplasma genitalium(Mg),Mycoplasma hominis(Mh)by using nestcd PCR.Specific nucleotide probes of Up,Uu,Mg and Mh Were constructed and immobilized onto nylon membranes.PCR products were denatured and hybridized、with specific oligonucleofide probes on nylon membrane.The sensitivity and specificity of the PCR-RDB assay were evaluated based.on the hybddizafion results.Also,PCR-RDB Was utilized to detect pathogenic mycoplasmas from 60 clinical samples.Results The four probes selectively hybridized with the PCR product of corresponding mycoplasmas,and no cross hybridization was observed.The detection limit of PCR-RDB Was one colony forming unit(CFU)of mycoplasma.Out of the 60 clinical samples、19were positive for mycoplasm,Mixed infections were found in three samples,including two coinfected with Up and Uu and one with Uu and Mg.Conclusion PCR-RDB is a rapid,specific and sensitive approach to the identification of pathogenic mycoplasmas in urogenital tract.

ObjectiveTo investigate the mechanism and the protective effect of heat shock protein 27 (HSP27) on rat cardiomyocytes when ischemic preconditioning performed.MethodsCultured rat cardiomyocytes were divided into four groups: control group, ischemic group,ischemic preconditioning group and cyclohexamide group. Cell viabilities were analyzed by MTT. The apoptosis was evaluated with DNA ladder and flow cytometry Annexin V Flous staining. Western Blot was used to determine the expression of HSP27 and caspase-3 in cardiomyocytes.ResultsIschemic preconditioning could improve cell viability. The apoptosis ratio in ischemic preconditioning group was significantly less than that in ischemic group. These were accompanied by an increase in the expression of HSP27 and a decrease in caspase-3. The expression of the increased HSP27 and the protective effect induced by ischemic preconditioning were completely abolished by the presence of cycloheximide, a translation inhibitor.ConclusionThe expression of HSP27 induced by ischemic preconditioning plays an important role in protecting cardiomyocytes, and the mechanism is possibly related to the inhibition of cell apoptosis.

Objective To evaluate the effects of flapless versus flap implant surgery on the tissues surrounding the implants in the esthetic zone.Methods A controlled study was conducted in 20 patients with a single implant in the anterior esthetic zone,as compared with the flapless and traditional flap implant placement.6 and 12 months after the implant ation,the vertical reduction of labial and lingual bone were assessed by cone beam computed tomography (CBCT);6 and 12 months after the crowns restoration,the peri-implant soft tissues were examined by probing depth (PD),modification sulcus bleeding index (mSBI),papillary index (PPI) and evaluated by pink esthetic score (PES) standard.Results The vertical reduction of the flapless labial and lingual bone was lower than that of the flap,in which the change of labial bone was statistical differences at 6 months after implant surgery between groups (P ＜ 0.05).The differences of PES between two groups were not statistically significant,although PES increased over time in both groups,which the flapless group had a significantly change in PES from crown placement to 12 months (P＜0.05).Conclusions A flapless implant surgery in sufficient bone support may provide a better short-term esthetic result,whereas the longterm effects need further studies.

Objective To investigate the value of color Doppler ultrasonography in metaplastic breast carcinoma(MBC).Methods The ultrasonic characteristics of 23 MBC and 1 1 8 invasive ductal carcinoma (IDC) confirmed by pathology were analyzed retrospectively.And the ultrasound characteristics of different types of MBC was analyzed according to pathology.Results Mean maximum diameter of(3.73±1 .74)cm in MBC was larger than that in IDC[(2.57 ± 1 .19)cm,P = 0.005].Most MBC lesions showed larger diameter(>3 cm),clear border(56.5%),irregular shape(65.2%),lack of hyperechoic halos(65.2%), posterior enhancement(60.9%),no calcification(60.9%) and grade 2 - 3 of blood flow (56.5%).The detection rate of unclear border,unsmooth edge and hyperechoic halos of MBC was lower than those of IDC (P <0.05).But MBC had a higher detection rate in the masses with larger than 3 cm in diameter and posterior enhancement than IDC.Five (45.5%) lesions of 1 1 squamous cell carcinoma showed cystic constituent.The mean maximum diameter of 5 MBC with mecenchymal tissue lesions was larger than spindle cell carcinoma,but smaller than squamous cell carcinoma.And 4 lesions of the 5 MBC with mecenchymal tissue showed calcification,which occupied the highest proportion among different pathological types of MBC. The ultrasonic coincidence rate for MBC was 86.96%.Conclusions The ultrasonic appearances of MBC have a certain characteristics,and different pathological types of MBC also have corresponding characteristics.It shows important value of ultrasonography in preoperative diagnosis for MBC.

Objective The study was aimed to explore the effect of care bundles on the management of nasal intestine for the cerebral apoplexy patients with dyspinic dysfunction. Methods A total of 102 cerebral apoplexy patients with dyspinic dysfunction, who were administrated with nasal intestine, were recruited in Qianfoshan Hospital of Shandong Province from August, 2016 to June, 2017. Random number table was applied to analyze the separate two groups, experimental group and control group, in which, the patients were administrated with care bundles and usual care. Various parameters, like one-time catheterization, complications of nasal intestine administration, hospital stay, cost and the patients' satisfaction degree, were compared between two groups. Results The success rate of once placed tube in the test group was 78.4％ (40/51), which was significantly higher than that in the control group [54.9％(28/51)], and the difference was statistically significant (χ2=6.353, P<0.05). The incidence of complications of indwelling nasoenteric tube, including unplanned extubation, reflux aspiration, tube-feeding associated diarrhea, were 9.8％(5/51), 17.6％(9/51), 11.8％(6/51), respectively. All of them were significantly lower than those of the control group, which were 37.3％(19/51), 41.2％(21/51), 31.4％(16/51), respectively, indicating that there was a statistical difference (χ2= 10.679, 6.800, 5.795). The days and costs of hospitalization were (11.0 ± 2.5) d, (9645.35 ± 193.30) yuan, respectively, which were significantly lower than those of the control group [(17.0 ± 4.2) d, (12523.79 ± 190.28) yuan], indicating that there was a statistical difference (t=8.767, 10.612, P<0.01). Patients' satisfaction was 90.2％(46/51), which was significantly higher than that of the control group [68.6％ (35/51)]. The difference was statistically significant (χ2=7.256, P<0.01). Conclusions The administration of care bundles for the cerebral apoplexy patients with dyspinic dysfunction can effectively increase the success rate of one-time catheterization, alleviate the complications, and therefore reduce the risk of aspiration pneumonia development. In addition, care bundles can remarkably alleviate the medical burden on the patients, shorten the hospital stays and improve the survival quality of the patients.