Objective To evaluate efficacy and safety of two methods for gas-filled and liquid-filled balloon of Swan-Ganz catheter to locate the bronchus of pulmonary air leakage. Methods All of 38 cases with pneumothorax were randomly divided into two groups. Group A : the bronchus of pulmonary air leakage were detected by injecting gas into balloon of Swan-Ganz catheter. Group B: the bronchus of pulmonary air leakage were detected by injecting physiological saline into balloon of Swan-Ganz catheter. Results The locating success rate in Group A was 89. 5% (17/19) and Group B was 94. 7% (18/19) ( P＞0. 05). The mean time of locating in Group A was (13. 3 ±4. 1) min and Group B was (9. 6 ±3. 2) min( P ＜0. 05).In Group A, the dislocation rate was 47.4% and adjacent bronchial compression rate was 68.4% , and was respectively higher than Group B 21. 1% and 26. 3% ( P ＜ 0. 05). Patients in both groups were well tolerated without any obvious adverse effects. Conclusion It is a more simple, quicker, the same safe and effective to locate the broken bronchus of pneumothorax by injecting physiological saline into balloon of Swan-Ganz catheter.

Objective To evaluate the value of p504S,CK34?E12 and p63 immunostaining for the diagnosis of benign and malignant lesions of the prostate. Methods Expression of p504S、CK34?E12 and p63 in benign and malignant lesions of the prostate was observed by microwave SP immunohistochemical method. Results Continuous positive expression of CK34?E12 and p63 was found in the acini and ducts of most benign prostatic hyperplasia, and few cases showed interrupted expression, but p504S staining presented negative reaction; Interrupted expression of CK34?E12 and p63 was found in high prostatic intraepithelial neoplasia cases, and was weekly positive or negative for p504S; CK34?E12 and p63 staining was positive in five atypical adenomatous hyperplasia cases, one case presented focally positive reaction by p504S; CK34?E12 and p63 staining was negative in forty prostatic carcinoma, but positive by p504S;The gleason histologic grading of prostate carcinoma was negatively related to expression of p504S. Conclusion Combined detection of p504S、CK34?E12 and p63 can be most helpful for diagnosis of prostate carcinoma, especially in needle biopsy specimen.

Objective To investigate the expression of NDRG1 and its relationship to differentiation level and metastasis in prostate cancer. Methods The expression NDRG1 was examined by immunohistochemistry LSAB method in 86 samples of prostate cancer and benigh prostate hyperplasia. Results The NDRG1 was shown to be highly expressed in 30(73.3%)of prostate cancer and 70.0%of benign prostate hyperplasia.There were no evident difference between prostate cancer and prestate hyperplasia(P＞0.05).The expression of NDRG1 was gradually reduction with the Gleason score from 2-4 to 5-7 to 8-10 in prostate cancer, which was statistical significance(P＜0.05).The expression of NDRG1 in lymph node or bone metastasis was significantly lower than that in no metastasis of prostate cancer. There was a negative correlation between the expression of NDRG1 and lymph node or bone metastasis. The age had no correlation with the expression of NDRG1(P＞0.05).Conclusion NDRG1 is involved in the genesis and development of prostate cancer, which may be related to the differentiation level of prostate cancer and serve as a useful marker for early diagnosis of cancer and metastasis.

Education of evidence-based medicine in clinical research is important in enhancing primary hospital clinical research capacity and quality.Dongyang People's Hospital of Zhejiang Province has carried out evidence-based medicine education and training,and greatly improved the performance of clinical research and development of scientific researchers.

Clinical thinking of Clinicians in Dongyang People's Hospital is gradually shifting from ‘empirical medicine’ to ‘evidence-based medicine’ after popularizing of evidence-based medicine, training core members and implementing multi-layered, multi-channeled, comprehensive and sustainable resident doctor training mode with clear steps and purposes within three years. This paper discussed on reasonable clinical practice of evidence-based medicine in primary hospital and provided realistic basis for the further development and improvement of training of evidence-based medicine in primary hospital.

60 years of age) groups(10.4%),and in summer season(8.3%),when existing antibiotic-resistant pathogenic germs(90%),respectively. CONCLUSIONS The surgical site infection after abdomen operations is closely related to factors such as incision site,incision type;malignant or benign diseases;age,sex,and antibiotics-resistant pathogenic germs,etc.Effective measures should be taken accordingly to reduce the infection.

Due to the insufficient education of medical ethics and tending to medical moral educa-tion, the residents lack the ability to make ethical decisions. Therefore, we applied Four Topics method in the clinical ethics training of residents. The clinical ethics training was divided into three stages, and each stage had different training content and objectives. Dongyang People's Hospital adopted the form of lectures and panel discussions. During the group discussion, the group leader was in charge of case preparation, which came from clinical practice, and then all members applied the Four Topics method to analyze and discuss the ethical conflicts, and make the ethical decision. Through this process, residents' ability to solve ethical problems in clinical practice was enhanced.

Objective To investigate the expressions of carbohydrate antigen 19-9(CA19-9), carbohydrate antigen 15-3(CA15-3) and carbohydrate antigen 125(CA125) and their clinical significance in papillary thyroid carcinoma (PTC). Methods The expressions of CA19-9, CA15-3 and CA125 were detected by immunohistochemical MaxVision method in 80 cases of PTC and 80 cases of benign thyroid lesions (BTL), including 34 cases of nodular goiter, 26 cases of Hashimoto's thyroiditis and 20 cases of follicular adenoma. The relationship between expressions of CA19-9, CA15-3 and CA125 and the clinical pathological characteristics were analyzed. Results The expression rates of CA19-9, CA15-3 and CA125 in 80 cases of PTC were 85%, 100%and 43.8%respectively, compared with BTL, the difference was statistically significant (P < 0.01). There was no significant correlation between expressions of CA19-9, CA15-3 and CA125 and age, gender, number and diameter of tumor nodules, lymph node metastasis, and TNM staging (P > 0.05). The sensitivity of CA19-9, CA15-3 and CA125 in the differential diagnosis of PTC and BTL were 85%, 100% and 43.8% respectively, and the specificity were 91.3%, 36.3%and 91.3%, respectively. Conclusion The expressions of CA19-9, CA153 and CA125 are helpful for the differential diagnosis of PTC and BTL.

Objective:To investigate the protective role and mechanism of hypoxia inducible factor(HIF)-1α in myocardial ischemia postconditioning.Methods:Forty healthy adult SD rats were randomly divided into four groups with 10 rats in each group.The control group(group A)was sham operation group, and the rats underwent the same surgical procedures except that the suture passed under the left anterior descending branch(LAD)of the coronary artery was not tightened for 225 minutes.In the ischemia-reperfusion group(group B), the LAD was blocked for 45 minutes, and then reperfusion for 3 hours.In the ischemic postconditioning group(group C), 45 minutes after blocking the LAD, reperfusion was performed for 10 seconds-ischemia for 10 seconds at the beginning of reperfusion, a total of 3 cycles of intervention, and reperfusion for 3 hours.Ischemic postconditioning + HIF-1α inhibitor group(group D): 45 minutes after blocking the LAD, HIF-1α inhibitor AG490 (3 μg/g) was injected intraperitoneally, and reperfusion was performed for 10 seconds-ischemia 10 seconds at the moment of reperfusion.A total of 3 cycles of intervention, reperfusion for 3 hours.Blood samples were harvested from femoral vein at three time points(before ligation of the LAD, 45 minutes after ischemia, 3 hours after reperfusion)to analyze the serum levels of creatine kinase and cardiac troponin respectively.After 3 hours of reperfusion, myocardial tissue was used to measure the infarction size through 2, 3, 5-triphenyltetrazolium chloride staining method; and Western blot method was used to detect the expression of HIF-1α in each group.Results:(1) There were no significant differences in the serum levels of creatine kinase and cardiac troponin among four groups before ligation( P>0.05); 45 minutes after ischemia, there were significant differences between group B, group C, and group D compared with group A ( P<0.01). After 3 hours of reperfusion, there were significant differences between group B, group C, and group D compared with group A (all P<0.01), and group B, group D were significantly higher than that in group C ( P<0.05). (2)Compared with group A[(2.46±1.13)%], the area of myocardial infarction in group B was (45.81±5.96)%, in group C was (37.17±4.99)%, and group D was (45.00±3.29) %, and the differences were statistically significant ( P<0.01). (3)The HIF-1α protein in myocardial tissue in group A was slightly expressed; the expression of HIF-1α protein in group B was higher than that in group A( P<0.05); and group C was significantly higher than that in group B ( P<0.05); HIF-1α protein was almost not expressed in group D. Conclusion:After ischemic postconditioning, HIF-1α increased in myocardium; the increased expression of HIF-1α may be involved in the protective process of myocardial ischemic postconditioning in rats.

Objective To study the calcium metabolism in tacrolimus(FK506)induced rats nephrotoxicity and the preventive effect of calcium channel blocker.Methods Twenty-four Spragueinduced or FK506-induced nephropathy model.Blood creatinine,blood electrolytes,renal tissue histopathology(HE stain)and the change of ultrastructural organization in renal cells by transmission electron microscope were observed.Results The blood creatinine levels of both CsA and FK506 groups [(36.00±2.61)and(34.17±4.54)μmol/L] were significantly higher than those of the FK506+Dilgroup and control group(all P＜0.05).The blood calcium levels of both CsA and FK506 groups (2.00±0.04 and 2.05±0.04 mmol/L) were significantly lower than those of the FK506+Dil group and control group(all P＜0.05).The blood creatinine and calcium levels of FK506+Dil group were not significantly different with those of control group(P＞O.05).Histopathology examination showed cloudy swelling and vacuolization of the renal tubular epithelial cells and intra-cellular mitochondria swelling and vacuolization in the CsA and FK506 groups.However,the pathological changes of the FK506+Dil group were remarkably milder in comparison with the CsA and FK506 groups.Concluum channel blocker,Dil,could prevent the FK506-induced nephrotoxicity.