Objective To analyze spectral curves and iodine levels in normal adult thyroid by using dual-source CT scanning technique and provide the basis for the differential diagnosis of thyroid space-occupying lesions.Methods A total of 70 subjects were selected for this study,including 38 females and 32 males.They were excluded from thyroid disease by ultrasound examination and had all taken the dual-source CT scan.The image data were transported to the CT workstation,the analysis of iodine levels and spectral curves were completed in theLiver VNCandMonoenergetic modes respectively.The gender differences in ratio iodine content were compared.Results The iodine ratio of thyroid was (1.35±0.19) mg/mlin plain scan,(1.35±0.23) and (1.35±0.21) mg/ml in left lobe and right lobe respectively.There was no statistically significant difference between left and right lobe (P ＞ 0.05),as well as between females and males (P ＞ 0.05).The slopes of the energy spectrum curve in the left and right lobe of the thyroid were 9.98 ± 2.43 and 9.74 ± 1.63,respectively,and 9.88 ± 1.74 and 9.74 ±0.09 for the male and female,respectively.There was no significant difference of slopes of the energy spectrum curve between the left and right lobe,as well as the male and female.The average dose length product of all patients was (208.29 ±21.80) mGy·cm,and the average effective dose was (1.23 ± 0.13) mSv.Conclusions Dual-source dual-energy CT scanning technique have definitive,diagnostic characteristic in the measurement of spectral curves and calculation of the ratio of iodine in normal adult thyroid tissue,and therefore has guidance value in the diagnosis of thyroid space-occupying lesions.

Based on summarizing the international experiences and reviewing the historical evolution and current situation of the physicians'compensation system of public hospitals in China,this paper clarified the existing problems of the current compensation system.Such problems namely included lack of security on the source of the physicians'compensation,low level of sunshine salary which caused thecompensatory mechanism,lack of scientific design of the salary structure and allocation,as well as other underlying causes.Drawing lessons from reform practices at home and abroad,the basic principles and reform directions were put forward,as well as 4 route selections,namely establishing an security investment system to guarantee a stable and higher level salary under the current compensation system, implementing a high level of flip-type annual compensation with locking the current salary into files, establishing an appropriate compensation system referring to an innovated evaluation system of physicians in public hospitals,and coordinating closely with public institution reforms to promote physicians' compensation system reform.

The paper presented the payment system theory of the primary health care service in China,the current status of the health service system,and analyzed main challenges for the time being.Based on such studies,the authors made the following policy proposals.The first is adjustment of the fiscal payment method of the government to such institutions in line with the classification guidance principle; the second is to shift the payment method of primary public health services to the post payment of fee-for-service; the third is reform of the performance-based salary system to link payment to medical workers directly with the amount and quality of their services; the fourth is a set of result-oriented performance appraisal indicators,with rising proportion of performance pay; the fifth is to integrate the outpatient clinic fund covered by medical insurance and the primary public health service fund,into a capitation payment.

To explore the influence of glucose level of 75 g oral glucose tolerance test ( OGTT ) druing pregnancy on delivery of large for gestational age infants. This research selected 790 cases of patients diagnosed as gestational diabetes mellitus( GDM) , 478 cases of pregnant women diagnosed as normal glucose tolerance( NGT) from Affiliated Hospital of Jining Medical University in 2014 and followed up until they delivered. Single live births were selected, risk factors which had influence on offsprings, birth weight were analysed. GDM group had significantly higher rate of delivering large for gestational age(LGA)infants than that of NGT group(47. 30% vs 31. 30%, P<0. 05). Adjusting for confounding factors, it suggested that 2 h plasma glucose level of 75 g OGTT was an independent risk factor for the delivery of LGA infants, and 1 mmol/L glucose increment in 75 g OGTT 2 h plasma glucose level, mayincreasetheriskofLGAby29%(OR=1.29,95%CI1.05-1.58,P=0.02). The2hplasmaglucoselevelof75 g OGTT is an independent risk factor for delivery of LGA infants.

Objective To investigate the relationship between anti-trophoblast membrane antigens(TA) antibodies and hypertensive disorders complicating pregnancy(HDCP).Methods Enzyme linked immunosorbent assay(ELISA) was used to detect anti-TA IgG and IgM in both maternal and umbilical serum samples of 40 normal pregnant women and 92 HDCP women(23 gestational hypertension or mild preeclampsia,41 severe preeclampsia and 28 eclampsia).Results The positive rates of anti-TA IgG and IgM in maternal serum samples with HDCP,eclampsia or severe preeclampsia were significantly higher than that in normal pregnant women,the positive rate of anti-TA IgM increased significantly with the aggravation of HDCP(P

Objective To explore whether or not the use of prophylactic antibiotics is required before inguinal hernia repair in metabolic syndrome (MS) patients.Methods According to the randomized double blind,prospective study,from 2010 July to 2012 December,186 MS patients underwent inguinal hernia repair operation were selected as the study objects.The control group(n =93) was given a one-time cefazolin 1.5g plus 0.9％ sodium chloride injection 20ml intravenous injection 30min before operation,the observation group(n =93) was given 0.9％ sodium chloride injection 20ml intravenous injection.Results The control group had 5 cases of infection,the observation group had 6 cases.There were no statistically significant differences in the normal body temperature of operation site infection,occurred between the two groups after operation (all P ＞ 0.05).But in the two groups,the probability of infection occurs of the patients with body mass index(WBI) more than 30 was higher that of the patients with 25 ≤WBI ≤ 30(17.24％ vs 1.56％,12.90％ vs 1.61％,x2 =4.69,4.87,all P ＜0.05),the probability of infection occurs of fasting blood glucose(FPG) more than 12.0mmol/L was higher than that of the patients with 6.1mmol/L≤FPG≤ 12.0mtol/L(15.30％ vs 1.64％,13.33％ vs 1.59％,x2 =4.81,5.13,all P＜0.05).Conclusion MS patients underwent tension-free repair of inguinal hernia don't need the use of antibiotics to prevent postoperative surgical site infection(SSI).But for the severe obesity,high blood sugar (FPG ＞ 12.0mmol/L) patients,the preoperation prophylactic antibiotics is necessary,and it can reduce the incidence of postoperative SSI.

Objective:To investigate the relationship between levels of plasma thrombopoietin(TPO) and thrombocytopenia.Methods:Sixty-eight thrombocytopenia with different causes were injected with rhIL-11 domestically made, by 25 ?g/(kg?d) for 10 days continuously. The plasma TPO levels were determined by quantitative sandwich enzyme immunoassay technique in thrombocytopenic patients between before and after treatment.Results:(1)The serum TPO controls of patients with thrombocytopenia after acute leukemia(AL) chemotherapy were lower than normal controls. The plasma TPO levels in aplastic anemia(AA) and myelodysplastic syndrome(MDS) patients were all elevated compared to those in normal controls.The serum TPO levels in patients with idiopathic thrombocytopenic purpura(ITP) and liver cirrhosis had no difference with the normals. Bone marrow megakaryocytes(MK) count in after chemotherapy AL and AA patients were lower than those with normal serum TPO levels controls. (2)In all above patients used interleukin-11(rhIL-11), their TPO levels were close to normal in efficiency patients. On the contrary, their TPO did not change dramatic. Those react to rhIL-11, their TPO levels were inversely correlated with platelet count.Conclusion:Testing serum TPO levels would be helpful for distinguish the thrombocytopenia with different causes, and provides theorical support to patients to use rhIL-11 reasonably.

OBJECTIVE:To understand the knowledge about rational drug use(RDU) in inpatients.METHODS:An cluster sampling investigation was carried out by questionnaire at separate times and in separate groups in 2 419 inpatients in the hospital where the authors work. RESULTS:The majority of the inpatients were concerned much with the drug use,but lacked the knowledge about RDU and had much misunderstanding about drug use.CONCLUSION:The relevant measures must be taken to guide the RDU in patients and to improve the understanding of RDU.

Objective To analyze the clinical and imaging characteristics of congenital sensorineural hearing loss (CSNHL)children combined with white matter (WM)lesions in order to provide evidence for clinical practice. Methods With referral to the Department of Pediatrics,Peking University First Hospital from November 201 1 to De-cember 201 5,documents of 78 patients of CSNHL combined with WMlesions were collected and analyzed for the clini-cal and imaging characteristics.Results Bilateral severe -profound hearing loss existed in all 78 cases,48.1 %(25 /52 cases)of the patients exhibited gross motor development delay,98.1 %(51 /52 cases)of them had normal cognition development.One hundred percent (61 /61 cases)of patients had abnormal language development.Infection occurring during pregnancy existed in 21 .2%(1 1 /52 cases)of the patients,the premature and smaller for the gestational age in-fants accounted for 28.9% (1 5 /52 cases).The bilateral multiple WMlesions from the brain MRI were in dot to flake sizes with sharp boundary,the intensity of T1 -weighted imaging decreased,T2 -weighted imaging and fluid attenuated inversion recovery increased.Eighty -two point one percent (64 /78 cases)of the patients were found to have the periventricular and subcortical WM involvement.The most frequently affected periventricular region was the posterior horn (91 .9%,68 /74 cases),followed by the anterior horn and temporal horn,and the least with the body involvement. The former three had a combined lesion tendency (55.4% -68.9%).There was an extensive involvement in the sub-cortical WMof parietal,frontal,temporal and occipital lobes respectively(73.5% -88.2%).Subcortical WM involve-ment of multiple lobes was common (accounted for 67.6% -77.9%).The enlargement of bilateral ventricles existed in 37.2%(29 /78 cases)of the patients and cystic changes in the subcortical WM of anterior temporal lobe could be found in 9.0% (7 /78 cases)patients.Calcification in 2 CT cases was reported.Corpus callosum and basal ganglia of all cases were normal.For cases with MRI scans more than once,WMlesions of 96.0%(24 /25 cases)patients became silent or self -restored.Conclusions The clinical presentations of CSNHL combined with WM lesions are mild,not paralleled with their multiple foci.It is considered as demyelination or a delay of myelination.Due to its benign course, it is probably not the contraindication for the cochlear implantation.

As a pilot program of teaching reform,some excellent undergraduates majoring in nursing were selected to take specialized courses in ICU in order to cultivate the intensive care specialized nurses.The teaching team of specialized courses in ICU was established to guarantee the teaching quality.The team was in charge of the ICU specialized curriculum building,textbooks selection and teaching content examination.The high leveled teaching team of specialized courses in ICU was organized by taking teaching and researching section as a unit to improve theoretical teaching level,using clinical department as training base to enhance practice skill and participating in special subject classes and in-service study to promote specialized quality.