Objective To systematically assess the diagnostic performance of CTA for lower extremity peripheral arterial disease (PAD) using a Meta analysis method. Methods Studies were located through electronic searching of the PubMed, EBSCO, Springer, Ovid, CNKI, Cochrane library (from the date of establishment of the databases to October 2009 ). Bibliographies of the retrieved articles were also checked. All the studies concerning the diagnosis of PAD using CTA had been searched and reviewed, and the studies with the DSA as the gold standard were adopted as eligible. Subsequently, the characteristics of the included articles were appraised and extracted. Data on accuracy of included studies were extracted for further heterogeneity exploring, statistical pooling and SROC ( summary receiver operating characteristics)analyzing using the Meta Disc 1.4 software. Results Totally 24 studies met the inclusion criteria with a total of 1096 patients. The heterogeneity was found in these studies. The pooled accuracy indicators like sensitivity, specificity, and diagnostic odds ratio (DOR) were 0.95 ( 95% CI:0.94-0.95 ), 0.96 ( 95% CI:0.95-0.96), and 471.13 (95% CI:242. 92-913.71 ), respectively. The area under of SROC curve was 0.9888 and the Q index was 0.9555. Subgroup analysis demonstrated significant difference on diagnostic performance for various CT slices (P ＜ 0.05 ). Conclusion CTA can be regarded as an effective and feasible method for PAD diagnosis and screening, based on the results of this systematic review. However,more rigorous evaluations of CTA in patients with critical limb ischemia are needed.

OBJECTIVE:To reduce the error rate of inventory in the automated pharmacy of our hospital. METHODS:Activi-ties were designed and implemented by the management method of quality control circles(QCC)-PDCA(Plan,Do,Check and Ac-tion)cycle. The reasons for the errors of inventory in the automated pharmacy were analyzed to investigate and implement counter-measures. Visible and invisible achievements were evaluated,and then standardized processes were made. RESULTS:The errors of inventory in the automated pharmacy mainly included those of drug dispensing,drug shelving,drug return sheet,automatic medi-cine dispensing machine and system. In view of the above reasons,relevant standards were formulated and performed,including the process of warehouse-out check and shelving of drugs,drug dispensing process for the automated pharmacy,the process of sec-ondary check,etc. After the implementation of the activities,the error rate of inventory in the automated pharmacy reduced from 9.17% to 3.77%,which was visible achievement;and the above-mentioned standardized processes could ensure continuous run-ning of PDCA cycle. The practice,sense of responsibility,communication and coordination of management members in PDCA cy-cle namely invisible achievements were improved to some extent. CONCLUSIONS:The management method of QCC-PDCA cycle is feasible in reduction of the error rate of inventory in the automated pharmacy,which can provide a reference for automated phar-macy management.

Objective To explore the characteristics of constitution according to traditional Chinese medicine and the anxiety susceptibility of the population, providing the theoretical basis for carrying out population intervention in anxiety and taking full advantage of the preventive treatment by investigating anxiety emotion of patients. Methods A cross-sectional study method was adopted. 317 anxiety patients were recruited into an observation group and another 251 anxiety patients were recruited into a control group. Based on the traditional Chinese medicine constitution scale we defined every participant’s constitution type and got the distribution of different constitution types among all the participants. Then we usedχ2 test and binary regression to analyze the impact of constitution on anxiety. Result The observation group constitution type distribution:Qi stagnation(19.24%), Qi deficiency(16.40%), blood stasis(15.46%), damp heat (11.04%), Yang deficiency(10.41%), Yin deficiency(8.83%), phlegm dampness(6.62%), mild quality(5.99%), special intrinsic quality(5.99%). The control group constitution type distribution:damp heat(17.53%), Yin deficiency (14.34%), phlegm dampness (13.94%), Yang deficiency(11.55%),mild quality (11.55%), Qi stagnation (8.76%), Qi deficiency (8.37%), blood stasis (7.97%), special intrinsic quality (5.98%). The result ofχ2 test showed that the distribution of constitution types among participants in the observation group were different from that in the control group and the difference was statistically significant(P<0.001). Three kinds of constitution types(Qi stagnation, Qi deficiency, Blood stasis)showed a different distribution percentage in the observation group(51.10%)and the control group(25.10%, P<0.01). In the observation group, the distribution ratio among Qi stagnation, Qi deficiency, blood stasis had no significant differences (P>0.05). The binary regression result showed that the three constitutions of Qi stagnation, Qi deficiency and blood stasis had significantly positive correlation with anxiety(P<0.05). Odds ratios showed Exp of Qi stagnation, Qi deficiency and blood stasis was 4.447, 3.942 and 3.929. while the other six constitutions are independent factors to anxiety. Conclusion Qi stagnation, Qi deficiency and blood stasis constitutions were possible risk factors for anxiety.

BACKGROUND:General assessment of viability of umbilical cord mesenchymal stem cel s during transport is not considered at home and abroad.
OBJECTIVE:To explore the effects of different transportation conditions such as albumin and transport time on survival rate of umbilical cord mesenchymal stem cel s.
METHODS:Umbilical cord mesenchymal stem cel s cultured in vitro were divided into experimental and control groups. Each of group contained 3.15×109/L cel s in 3 mL normal saline. The experimental group contained 1%albumin in dark environment. The control group included two subgroups:dark preservation group with the absence of albumin and light preservation group with the presence of albumin. Cel counting, trypan blue staining and cel survival rate were compared at 0, 2, 4, 8, and 24 hours.
RESULTS AND CONCLUSION:Compared with the control group, no cel loss was observed in experimental group (with the presence of albumin in the dark) and a 90%viability ratio was achieved at 8 hours. In the control group without albumin, loss rate reached 38.5%and survival rate reached 86%at 8 hours. Results revealed that 1%albumin predominantly improved cel survival rate in long-distance transport of umbilical cord mesenchymal stem cel s. When transport time was more than 8 hours, cel loss rate increased and cel survival rate downregulated. Our experimental data demonstrated that umbilical cord mesenchymal stem cel s preserved in normal saline consisting of 1%albumin placing in dark environment at 16 ℃ apply to clinical application criterion in 8 hours.

The technology of water-jet is an advanced technology of cold cutting which is widely used in industry, espe-cially in the cutting of metal, glass, ceramics and paper. Its character and classification are introduced, especially basic prineiple, development and application. The technology of water-jet will paly an important role in medicine.

Objective To explore the effect of elastic outside distraction on microvessel density and to illustrate the mechanism correcting inverted nipples. Methods Three female 3-month-old minipigs,with 12 nipples each,were employed.4 nipples of each minipig were remained without distraction were control group,and the other 8 nipples were continuously distracted with inverted nipple correction instruments.Corresponding nipples were excised at 2,4,8 and 12 weeks after traction.The excised nipple specimens were employed with immunohistochemical staining to detect the expression of vascular endothelial cells growth factor (VEGF) and CD34 in those tissues,and the percentageof positive cells and microvessel density (MVD) changes were counted.Results The expression of CD34 and VEGF in the experimental groups increased at 2 weeks after tracted,and reached at the peak at 4 weeks,then gradually decreased during 8 to 12 weeks after tracted.While those were weakly positive in control group.Compared with the control group,the integral optical density of VEGF-positive cells and MVD were significantly different (P＜0.01),and there was a significantly positive correlation between MVD and VEGF.Conclusions Continuous elastic outside distraction can promote the expression of VEGF and CD34 in female minipig nipple and enhance angiogenesis,which increases oxygen supply locally,and therefore those local tissue proliferation may be one of key mechanisms of correcting the inverted nipple by continuous elastic outside distraction.

Objective To evaluate the application of early 18F-FDG PET-CT imaging after radiofrequency ablation (RFA) of hepatic malignancies. Methods Fifteen patients with liver tumors (five hepatocellular carcinoma, ten colorectal cancer liver metastasis ) underwent RFA as part of clinical management. The lesions were all hypermetabolic on PET-CT performed within 2 weeks prior to RFA. All subjects underwent 18F-FDG PET-CT (early PET-CT) within 24 hours after RFA. Total photopenia, focal uptake, and rim-shaped uptake were regarded as complete ablation, residual tumor, and inflammation, respectively. Follow-up PET-CT scans were performed as the reference standard. Results Twelve patients showed total photopenia at the ablation site on the early PET-CT scan, and in all of these patients, total photopenia at the ablation sites was seen on the follow-up PET-CT scans. Two patients had focal uptake at the ablation sites on the early PET-CT scan, and both of these foci increased in size and intensity, which were compatible with residual tumors at the time of ablation. Only one patient had rim-shaped uptake on the early PET-CT scan. The rim-shaped uptake disappeared on PET-CT performed 3 months later, which indicated the nature of inflammation. Conclusions There is infrequent inflammatory uptake at the RFA site of liver tumors on 18F-FDG PET-CT if scanning is performed within 24 hours after ablation. Thus, early PET-CT has the potential to evaluate the efficacy of an RFA procedure by indicating tumor-free as total photopenia and residual tumors as focal uptake.

ObjectiveTo investigate the safety and efficacy of carbon dioxide ( CO2 ) insufflation during ERCP.MethodsBetween January and August 2011,a total of 102 consecutive patients who underwent ERCP were randomized to accept CO2 insufflation ( n =52 ) of air insufflation ( n =50 ) during the procedure.ERCP was carried out with the same instrument by an expert endoscopist who was blinded to the insufflation gas used and the procedure was controlled at 30 minutes to 1 hour.The heart rate,oxygen saturation of the patient was continuously monitored during the procedure.Before the procedure and 1 hour after the end of operation,abdominal X-ray was taken to evaluate the width of intestine,and the degree of intestinal expansion was defined as normal,mild,moderate and severe according to the width increased.A questionnaire with 100 mm visual analogue scale (VAS) was used to quantify the abdominal pain and distention experienced at 1 hour,2 hours,and 6 hours after the procedure.The patients' vital signs,bowel dilatation,the average operating time,abdominal pain score and distention score on VAS,and complications in 2 groups were analyzed.ResultsThe baseline characteristics of 2 groups were comparable.ERCP was successfully performed in all the patients and no complication was observed.In CO2 group,the average operating time,mean heart rate and oxygen saturation were (45.2 ± 10.6) min,( 102.2 ± 10.3 ) bpm and ( 99.5 ± 0.5)％,which were (48.5 ± 11.2) min,( 100.3 ± 11.4) bpm and (98.9 ±0.6)％,respectively,in air group.There were no significant differences on these items between the 2 groups ( P ＞ 0.05 ).Moderate to severe intestinal expansion 1 hour after ERCP was found in 14 patients (26.9％ ) in CO2 group and in 28 patients (56.0％ ) in air group,and the latter was significantly higher than the former (x2 =11.61,P =0.009).Both of the mean abdominal pain and abdominal distention scores at 1 hour post-ERCP in CO2 group were lower than those in air group,but without significant difference (P ＞0.05).However,the mean abdominal pain scores at 2 hours and 6 hours post-ERCP in CO2 group were significantly lower than those of patients in air group (7.4 ±2.2 vs.18.7 ±4.6 at 2 hours post-ERCP,9.6 ±3.7 vs.20.1 ±4.5 at 6 hours post-ERCP,all P ＜ 0.05 ).Similarly,the mean abdominal distention scores at 2 hours and 6 hours post-ERCP in CO2 group were significant lower than those of patients in air group (7.6 ±3.6 vs.18.3 ±4.1 at 2 hours post-ERCP,8.9 ±3.7 vs.19.4 ±4.2 at 6 hours post-ERCP,all P ＜0.05).ConclusionThe use of CO2 insufflation instead of air during ERCP appears to be safe.Insufflation of CO2 during ERCP palliates the intestinal expansion,post-ERCP abdominal pain and distention comparison to insufflation of air.However,because of the single-center clinical observation with limited number of cases,the safety and efficacy of CO2insufflation during ERCP requires to be further evaluated.

Objective To investigate the association between the genetic polymorphisms in GSTA1 and the clinical outcome of breast cancer patients treated with cyclophosphamide-based adjuvant chemotherapy. Methods A total of 137 breast cancer patients receiving cyclophosphamide-based adjuvant chemotherapy were recruited ( 124 cases with infiltrative ductal carcinoma, 5 cases with infiltrative lobular carcinoma and 8 cases with other histological types). PCR-LDR method was used to detect the genotypes of GSTA1. Survival curves were generated by the Kaplan-Meier method, and verified by the log-rank test. Cox proportional hazards regression analysis was used to estimate the prognostic factors in multivariate analysis. Results Of the 137 breast cancer patients, the genotypic frequencies of the GSTA1 * A/* A,* A/* B and * B/* B were 67.2% ( 92/137 ), 31.4% ( 43/137 ) and 1.5% ( 2/137 ), respectively. No significant differences were found between the genotypic frequencies and groups categorization according to age, stage, lymph node metastasis, ER or PR status (x2 = 0. 722,1. 967, 3. 303, 0. 226 and 0. 709, all P ＞0. 05 ) ;through Fisher exact test, also no significant differences were found between the genotypic frequencies and group categorization according to tumor size, histological types and grading ( all P ＞ 0. 05 ) . The recurrence rates in patients with GSTA1 * A/* A and * A/* B or * B/* B genotypes were 47. 8% (44/92) and 31.1% ( 14/45 ), respectively, and the mortality rates were 22. 8% ( 21/92 ) and 17. 8% ( 8/45 ),respectively. Patients with GSTA1 * A/* B and * B/* B genotypes were significantly associated with reduced hazard of relapse (x2 =18.723, P＜0. 01)and mortality (x2 =7.352, P＜0.01), compared to cases with the common * A/* A genotypes, according to Kaplan-Meier survival analysis and log-rank test. Moreover,Cox multivariate analysis showed that GSTA1 polymorphisms appeared to be an independent risk factor for recurrence-free survival ( OR =0. 222, 95% CI:0. 108-0. 458, P ＜0. 01 ) and overall survival ( OR =0. 362,95% CI:0. 145-0. 902, P ＜ 0. 05 ). Conclusion These data indicate that GSTA1 polymorphism may be a potential prognostic factor for recurrence-free survival and overall survival in breast cancer patients treated with cyclophosphamide-based adjuvant chemotherapy.

Objective To investigate the function of estrogen in the proliferative and involuting stages of infantile hemangioma. Meothods Expression of estrogen receptor(ER),VEGF and bFGF were detected with SP immunohistochemical method in 42 cases of hemangiomas and 17 cases of vascular malformations.Results The label index(LI) of ER,VEGF and bFGF in the hemangioma was significantly higher than those in the vascular malformation and normal skin(P