Objective To evaluate therapeutic effects of endovascular therapy for in-stent restenosis of superficial femoral artery,and the risk factors of restenosis of re-intervention therapy.Methods We retrospectively summarized the clinical data of 35 patients(38limbs)who suffered from in-stent restenosis of superficial femoral artery(SFA)stent from 2010 to 2012.Results 35 patients (38 limbs)were enrolled in this study,there were 24 males and 11 females.Mean age was (68 ±8)years.The success rate of endovascular therapy was 89.5％ (34/38),including in-stent angioplasty in 14 limbs,in-stent and beyond-stent angioplasty in 5 limbs,in-stent angioplasty and beyond-stent re-stenting in 15 cases.The primary patency and sencondary patency rate for 6,12 and 24 months was 65.2％,46.5％,46.5％,and 87.5％,80.2％,55.8％ respectively.The independent risk factors for re-obliteration were age ＞ 70 years (P ＜ 0.05) and diabetes mellitus (P ＜ 0.05).Conclusions Endovascular therapy is effective and safe in treatment in-stent restenosis of superficial femoral artery.The long-term in-stent patency is not satisfactory,with age ＞ 70 years and diabetes mellitus as independent risk factors.

Objective:To understand the clinical diagnosis and treatment ability of Chinese and French medical students, so as to improve the education of clinical medicine in China, improve the diagnosis and treatment ability of medical students, and provide reference for improving training quality of medical personnel.Methods:Retrospective analysis was made on the clinical skills competition of Chinese and French medical students, and the percentages of three categories of students' scores were compared (1 team of general practice residents, 3 teams of Chinese undergraduates, and 3 teams of French undergraduates).Results:In clinical basic skills such as electrocardiogram and imaging interpretation site, the scores of general practice residents were higher than those of Chinese and French undergraduates, and there was no significant difference between Chinese and French undergraduates. In clinical virtual case sites, except for few items in surgery site, general practice residents and Chinese undergraduates were better than French undergraduates in many evaluation items. In the internal medicine site, 6 out of 8 scoring items of French undergraduates were higher than those of Chinese undergraduates. In the medical team comprehensive first-aid site, 8 out of 10 scoring items of Chinese undergraduates were higher than those of French undergraduates.Conclusion:Clinical thinking and decision-making of undergraduates in our university need to be improved compared with that of French students. The general practice residents in our school need to be strengthened in the aspects of clinical thinking, decision-making and the cooperation with emergency team.

The effect of triptolide on proliferation and apoptosis of human multiple myeloma RPMI-8226 cells in vitro, as well as the roles of nuclear factor-kappa B (NF-κB) and IκBα was investigated. The effect of tritptolide on the growth of RPMI-8226 cells was studied by MTT assay. Apoptosis was detected by Hoechest 33258 staining and Annexin V/PI double staining assay. The expression of NF-κB and IκBα was observed by Western blot and confocal microscopy. The results showed that triptolide inactivated NF-κB apoptotic pathway in human multiple myeloma RPMI-8226 cells. Triptolide at nM range induced proliferation inhibition in a dose- and time-dependent manner and apoptosis in a dose-dependent fashion in RPMI-8226 cells. Besides, we observed the inhibition of NF-κB /p65 in the nuclear fraction was correlated with the increase in the protein expression of IκBα in the cytosol. These results suggested that triptolide might exhibit its strong anti-tumor effects via inactivation of NF-κB/p65 and IκBα.

Objective To study the applicability of a new analytical specification defined in WS/T 403-2012 in the external quality assessment schemes and the external comparision of internal quality control .Methods It was a quality management method study.Total error allowable criterions listed in WS/T 403-2012 and GB/T 20470-2006 were selected to assess the results of 23 analytes in the 1st challenge of 2013 routine chemistry external quality assessment.The acceptable rate of 23 analytes were calculated with the two specifications.Criterions of imprecision derived from the two standards were applied to assess the coefficient of variation with internal quality control data.Results With the specification based on WS/T 403-2012, the ratio of laboratories that all five samples were passed in the 1st challenge for 23 analytes ranged from 55.5%to 94.7%.The ratio of laboratories with 80%or more samples passed in 2013 EQA ranged from 73.9%to 98.5%.While ratios of two kinds described above evaluated based on GB /T 20470-2006 ranged from 63.0%to 99.2%, and from 90.0% to 99.7%, respectively.The acceptable rate of CV according to the two criterions ranged from 55.5% to 94.7% and 63.0% to 99.2%, respectively.Conclusions As evaluation criterions of external quality assessment allowable total error and internal quality control imprecision in routine chemistry , the specification in WS/T 403-2012 can be used to assess the analytical performance of clinical laboratory more objectively and comprehensively.It can help laboratories to identify the latent problems for further quality improvement.

OBJECTIVE: To explore the application of polysomnography (PSG) and lateral cephalometric radiographs (LCR) in the diagnosis and treatment of sleep-disordered breathing (SDB) in children. METHOD: To select 157 cases of children suffering from SDB, 115 cases with primary snoring (PS) and 42 cases with obstructive sleep apnea hypopnea syndrome (OSAHS). After bilateral tonsillectomy and adenoidectomy, preoperative and postoperative LCR and PSG of measure were observed for statistical analysis. RESULT: Compared the group PS and group OSAHS; the thickness of adenoids was significantly different(P<0. 01). The preoperative oblique diameter of nasopharyngeal airway was significantly different (P<0. 05). There were significant differences on the preoperative and postoperative nasopharyngeal airway oblique diameter and oropharyngeal airway anteroposterior diameter in group PS and group OSAHS (all, P<0. 01). There were significant differences on the preoperative and postoperative AHI and LSaO2 in the group OSAHS (both, P<0. 01). The total effective rate of group PS was 97. 4% (112/115), and the total effective rate of group OSAHS was 97. 6% (41/42). CONCLUSION PSG and LCR have a very important role in the diagnosis and treatment of SDB in children. Bilateral tonsillectomy and adenoidectomy are the primary means of treatment in children with SDB.
Adenoidectomy ; Cephalometry ; Child ; Humans ; Polysomnography ; Sleep Apnea Syndromes ; diagnosis ; surgery ; Sleep Apnea, Obstructive ; diagnosis ; surgery ; Snoring ; Tonsillectomy

External quality assessments play important roles in quality improvement in clinical laboratories, but most laboratories focused on the unsatisfied data only.With appropriate quality controls, laboratories can detect not only the error sourses of unsatisfied data but the potential error sourse of satisfied data as well.

Objective To evaluate the commutability of certified reference material IRMM ERM-DA 471/IFCC for cystatin C measurement among 8 methods.Methods 46 individual samples used for the commutability study were residual serum samples collected from clinical laboratories.The individual samples interspersedwith pooled sera and the certified reference material IRMM ERM-DA 471/IFCC and the whole set of samples was divided into 2 subsets for measurements in 2 days.The measurements were performed by8 different methods o.The samples were measured in duplicate order.Calibration was performed every day. Passing-Bablok regression was performed to compare the slopes and intercepts of mean values of the serum samples derived from different methods. Pearson correlation cofficient was also calculated. Deming regeression and 95%confidence intervals were calculated to evaluate the statistics commutability of ERM-DA 471/IFCC.The minimal specification of bias derived from biological variations was calculated to evaluate the clinical commutability.Results The within-laboratory CVs of pool sera ranged from 0.5% to 4.0%.The Passing-Bablok slope ranged from 0.765 to 1.311 and intercepts ranged from -0.04 to 0.241.The determination coefficient of Pearson regression ranged from 0.988 to 0.999.Deming regeression and 95%confidence intervals demonstrated commutability of ERM-DA 471/IFCC in 4/28 (14.3%) methods pairs. The minimal specfication bias ( 5.12%) demonstrated commutability of ERM-DA 471/IFCC in15/28 (53.6%) methods pairs.Conclusions The ERM-DA 471/IFCC domonstrated poor commutability between some methods pairs. The commutability of ERM-DA 471/IFCC should be evaluated before used as calibrators.

Objective To describe and compare the roles of 3 external quality assessment programs in assessment of analytical quality of serum creatinine and urea.Methods Research in quality management methods.Sixty-five laboratories those enrolled in the Natonal Center for Clinical Laboratories′programs of routine chemistry external quality assessment ( EQA ) , trueness verification ( TV ) for small molecular metabolites and external comparison of internal quality control ( IQC) simultaneously in 2013 were selected , the performances of those laboratories of serum creatinine (crea) and urea in terms of total errors(TE), bias and CV were obtained by using the above 3 programs, and these performance were assessed against the criterion listed in the analytical quality specifications for routine analysis in clinical biochemistry ( WS/T 403-2012).The failure ratio of 65 laboratories on each performance was calculated , the sensitivity of 3 external quality assessment programs in detection of analytical quality deficiency among clinical laboratories were compared.Results Only 1 laboratory failed in the 1st routine chemistry EQA in terms of TE of creatinine , failure ratio is 1.5%(1/65).Three laboratories failed in the 2nd EQA and caused a failure ratio of 4.6%(3/65).For serum urea, 3 laboratories failed in the 1st routine chemistry EQA with a failure ratio of 4.6%(3/65).Two laboratories failed in the 2nd EQA with a failure ratio of 3.1%(2/65).The failure ratios of creatinine determination in two samples in TV were 41.5%(24/65) and 21.5%(14/65) respectively, and the failure ratio of urea determination were 53.8%( 36/65 ) and 32.3%( 21/65 ) respectively.In the program of external comparison of IQC , the CVs of creatinine and urea determination ranged from 0.7% to 6.2%and from 1.0%to 7.2%respectively, their respective failure ratio range were 15.4%(10/65) and 40.0%(26/65).The failure ratio in routine EQA were much less than those in the other two programs , the laboratories failed in routine EQA program were all failed in trueness verification or /and the comparison of IQC programs, but not vice versa.Conclusions By participating in the programs of routine EQA , TV and comparison of IQC laboratories could assess the performances of inaccuracy , bias and imprecision.Laboratories should participate in different external quality assurance programs to detect their quality issues and get improved.

AIM:To assess changes of tear film function in patients after pterygium excision combined with amniotic membrane transplantation.
METHODS:Totally 126 patients with pterygium excision with amniotic membrane transplantation from January 2011 to November 2013 were entered in the study. The tear breakup time ( BUT) , the Schirmer I test ( SⅠt) and tear ferning test ( TFT ) were elevated in the patients before and after pterygium excision combined with amniotic membrane transplantation. The examnation times were 1d before surgey, 1wk, 1, 2mo after surgery. Operation eyes were studied group, while opposite healthy eyes as control group.
RESULTS: Compared with the control group, BUT and TFT were significantly different in the eyes with pterygium (P<0. 05); However, no obvious difference was detected in the results of SⅠt (P>0. 05). The results of BUT and TFT at 1mo after surgery in study group were significantly better than 1wk (P<0. 05), while no significant difference compared with 2mo (P>0. 05); The tear film stability in the study group at 1wk after surgery was still inferior to the control group (P<0. 05) and there was no significant difference at 1, 2mo after surgery (P all>0. 05). SⅠt results did not differ between the different examination times(P>0. 05).
CONCLUSION:Tear film stability was broken in the eyes with pterygium. Pterygium excision combined with amniotic membrane transplantation can obviously restore the tear film function into normal state, and the tear film function could reach steady-state 1mo after surgery.

Objective To determine the activities of 131I for treating differentiated thyroid carcinoma with diffuse pulmonary metastases ( DTC-DPM ) from the perspective of internal radiation dosimetry.Methods According to Medical Internal Radiation Dosimetry (MIRD) schema, the activity constraint,from which the whole bdy retention at 48 h should not exceed 2.96 GBq (2.96 GBq rule), was converted to dose-rate constraint(DRC) to lungs at 48 h ( DRCLU ·48 h ) in 131I therapy for DTC-DPM. Based on the assumption of DRCLU·48 h at 48 h in lung, the fractions of whole body activities ( F48 ), the effective half times of 131I in lungs ( TLL ) and the remainder of body ( TRB ) were 0.6-0.9, 20- 120 h, and 10- 20 h, respectively. The maximum safe activities of 131I for different human phantoms from the Organ Level Internal Dose Assessment (OLINDA) software were calculated. Results According to MIRD schema and 2.96 GBq rule, DRCLU ·48 h should not exceed 46.4 mGy/h in 131I therapy for DTC-DPM. Depending on varying F48 h,TLL and TRB, the maximum safe activities of 131I were 6.77-81.36, 5.29-56.20, 5.08-55.19 and 3.87-40. 52 GBq for the male adult, female adult, 15-year-old, and 10-year-old patients with DTC-DPM, respec tively. Conclusion Dosimetry-guided 131I therapy for DTC-DPM considers adequately the differences of 131I kinetics in individual patients and can adjust administered activities of 131I on the precondition of avoiding radiological pneumonitis and pulmonary fibrosis.