Objective To explore the diagnostic value of transbronchial lung biopsy(TBLB), CT-guided percutaneous lung biopsy and sputum cytology for unknown lung mass. Methods The clinical data of 101 inpatients with unknown lung mass were retrospectively analyzed. Results Among the 101 cases, 73 cases underwent fibrous bronchoscopic examination, 18 cases underwent CT-guided percutaneous lung biopsy, and 10 cases underwent both of them.The diagnostic coincident rate of the two methods was 70%. 54 cases were diagnosed lung carcinoma by pathology. The sensitivity and specificity of TBLB for diagnosing central type of tumor were 88% and 100%, respectiely, and those for diagnosing peripheral type of tumor were 43% and 100%, respectively. The sensitivity of CT-guided percutaneous lung biopsy was 80%,while the specificity was 100%. Complication frequency in the CT-guided percutaneous lung biopsy was 22%, and much higher than that (12%) in the TBLB. Only 30% cases underwent sputum cytology examination, and the positive rat was 6%. Conclusion Sputum cytologic examination is a convenient and cheap method, but its diagnostic rate is relatively low. TBLB was the first choice for examining central type of lung mass. For the peripheral type of lung mass, examination method was selected based on the location and size of the mass.

ObjectiveTo develop a new formula to estimate macrosomia weight and compared with published 25 formulas.Methods1153 fetuses including 239 macrosomia within one week of delivery were considered.Two-dimensional ultrasound measurements of the fetal biparietal diameter (BPD),head circumference (HC),abdominal circumference (AC) and femur length (FL) were performed and recorded by experienced sonographers.The birth weight were measured after the babies born.The formula finding group,1034 fetuses including 914 fetuses weighting less than 4000g and 120 macrosomia,were utilized to generate an overall regression formula by stepwise linear regression.120 macrosomia were used to established the formula for estimating macrosomic weight.As the training group,other 119 macrosomia were used to test the new formula and compared with other 25 existing formulas.ResultsThe new formula for whole weight was:lgBW =0.180 (HC) + 0.00628 (AC) - 0.00318 (HC)2 + 0.00173 (AC) (FL) +0.0000430(BPD)(HC)2.The new formula for macromia was:lgBW =0.730(BPD) -0.0375 (BPD)2 +0.000264(AC) (FL).The new method gave ( - 87.89 ± 230.95)g of estimation error and (4.4 ± 3.9) ％ of absolute percentage error,while the best existing formula provided (115.61± 345.09)g and (6.8 ± 5.4)％.With the new method,89.1％ of estimates fell within ± 10％ of the actual birth weight,while the best existing formula gave 75.6％.ConclusionsThe new formula was based on typical Chinese Han women,the error was lower and more suitable than those developed formulas for Chinese populations,especially for macrosomia fetuses.

Objective To test the key indexes of full-field digital mammography to keep it in good condition.Methods The testing was carried out based on clinical experiences and GBZ 186—2007 Mammography Quality Control Testing Specification.Results The testing items and indexes were proposed to facilitate the staff to check and operate the machine.Conclusion Clinical safety of full-field digital mammography and image quality are both enhanced greatly.

Objective To explore the Csx/Nkx 2.5 gene expression in the heart during the embryonic period and its mutation in subjects with congenital heart disease(CHD). Methods Immunohistochemistry was used to reveal the Csx/Nkx 2.5 gene expression, and PCR-SSCP-silver staining and DNA sequencing for mutation. Sixty-three embryos or fetus, 126 children with congenital heart diseases and 30 normal controls were included in the study. Results Elevated expression of Csx/Nkx 2.5 gene was found in atrium and trabecular of ventricle. After 16 weeks of gestation, the expression in atrium was stable, while slightly reduced in the trabecular. The expression in the ventricle was lower than that in the atrium in early embryonic stage followed by continuous increase which was most remarkable in 13~16 weeks and kept stable after 16 weeks. No expression of Csx/Nkx 2.5 was detected in epicardium. Three different kinds of gene polymorphisms in the third base of the 21st amino acid codon were found in all subjects:A,G,A/G. Conclusions Gene Csx/Nkx 2.5 plays an important role during the fetal heart development and its expression varies in different parts of the heart during different period in fetal development. Neither the sporadic nor the CHD cases showed any mutations in this study.

ObjectiveTo evaluate the probability of the fetal heart scanning in first trimester(11 -14+6 week) by transabdominal ultrasonography.MethodsBy using advanced ultrasound machine with high resolution transabdominal probe,249 fetal hearts were scanned.Four chamber view,left and right outflow view,three vessels view were obtained.The successful observation rates of these views under different gestational age were recorded.For 18 pregnant women with suboptimal transabdominal scanning condition,transvaginal scan were supplemented.ResultsAmong 249 singleton fetuses with low risk of congenital heart disease,four chamber view was successfully visualized in 227 (91.2％),left outflow view in 125(50.2％),right outflow view in 102(40.9％),three vessels view in 98(39.4％).The successful observation rate of these four views increased with gestational ages.The successful observation rate of each view in successive gestational age showed remarkable difference (P ＜ 0.05).The four chamber view had the highest successful observation rate with 95％ after 12 weeks.After 13 weeks,left and right outflow views visualizing rate was above 85％.Transvaginal scanning can increase the four chamber view successful observation rate.For observation of other views,transvaginal scanning,however,showed no superior than transabdomial scanning.ConclusionsHigh resolution transabdominal probe can be used to perform the fetal hearts scanning in early trimester.It will benefit to find the fetal heart malformation.

Objective To investigate quitting motivation of smoking patients with mild and moder-ate chronic obstructive pulmonary disease ( COPD) and evaluate the effects of smoking cessation methods based on cognitive intervention.Methods A total of 102 smoking patients with mild and moderate COPD from the outpatient department was divided into 4 blocks according to their intention of quitting smoking.Pa-tients in each block were randomly divided into intervention and control groups.Results ⑴All the re-spondents were at an average age of (61.3 ±12.3) years old.The sex ratio of men to women was 99∶3. The average smoking index (bag/year) in all the respondents was (39.81 ±11.53).The average daily smoking was (14.22 ±2.30) packs.The respondents with a lower degrees accounted for 55.9%and the respondents with high nicotine dependence 49.0%.A total of 39 people (38.2%) hoped to give up smok-ing, 20 people (19.6%) strongly hoped to give up smoking.⑵The main reasons for smoking included en-joyment (7.02), dependence (6.88), and calm (6.55).⑶There were statistically significant difference in the half-year continuous abstinence rates (χ2 =4.993, P =0.025) and in June quit rates (χ2 =6.668, P =0.010) between the intervention (58.82%) and control (33.33%) groups.The weight gain had sig-nificant difference between the intervention and control groups at the 3rd month ( t =2.65, P <0.01) or 6th month ( t =2.07, P <0.05) after quitting smoking.Conclusions The quitting motivation of smoking patients with mild and moderate COPD is not strong, while the smoking cessation methods based on cogni-tive intervention are effective for those patients.

Objective To study the relationships between hepatocellular carcinoma (HCC) and the polymorphisms,promoter methylation,and expression of glutathione S-transferases P1 gene (GST) P1 gene.Methods Using methylation-special PCR (MSP),the methylated status of CpG islands of GSTP1 gene in tumor tissues of 53 HCC and its adjacent nontumor tissues were studied.The enzyme activities of GSTP1 were evaluated by ultraviolet colormetry.And using PCR-RFLP,the genetic polymorphisms of the GSTP1 genes of 74 healthy controls and 53 HCC patients were studied.Results The diffe-rences of the frequency of GSTP1 Ile/Ile,Ile/Val and Val/Val genotypes between HCC patients and the normal controls did not reach statistical significance (X~2=0.84,v=2,P=0.656).The frequency of methyla- tion of CpG islands of GSTP1 gene was significantly higher among the HCC tumor tissues when com- pared to the corresponding nontumor tissues (X~2=19.08,P＜0.001),and significantly higher in stageⅢ-Ⅳcases when compared to the stageⅠ-Ⅱcases (X~2=4.84,P=0.028).GSTP1 enzyme activities of cytoplasm in tumor cells were lower significantly than that in the adjacent nontumor tissues (t=2.49, P=0.014),and significantly higher in stageⅠ-Ⅱcases when compared to the stageⅢ-Ⅳcases (t= 2.31,P=0.025).On the other hand,the GSTP1 enzyme activities of cytoplasm in tumor cells with methylated status of GSTP1 gene were significantly lower than that in tumor cells with unmethylation (t=3.50,P=0.001).Conclusion GSTP1 inactivation via CpG island hypermethylation may contrib- ute to the pathogenesis of HCC.

Objective To learn the current culture of the hospital and identify its future development pathway. Methods The current culture types of the hospital are evenly distributed among the four quadrants. Results These types are found to be identically distributed among the tribe type, temporary system type, hierarchy type and market-oriented type of culture. Among these four type, the hierarchy type and market-oriented type score higher (27 scores both) and take the lead. Conclusions Hospitals are expected to enhance its exchange and communication with the employees, and head to its desired direction of a hospital culture type.

Objective:To investigate the effect of standardized nutritional therapy for gastric cancer during perioperation.Methods:Seventy-six patients with gastric cancer who underwent nutritional therapy were randomly divided into observation group (38 patients) and control group (38 patients),between May 2015 and May 2016.In the observation group,the nutritional therapy was made by medical workers who had received the training of Total Nutritional Therapy (TNT) and Goal Nutrition Therapy (GNT) for Cancer Patient.In the control group,the nutritional therapy was given by doctors according to their conventional experience.Nutritional conditions,gastrointestinal function recovery conditions,complications and hospital stays were compared between the two groups.Results:First,the weight,triceps skinfold thickness and arm muscle circumference of preoperative 1 day and postoperative 7 day in the observation patients were significantly higher than those in the control patients (P ＜ 0.05).Second,the level of serum prealbumin of preoperative 1 day,postoperative 1 and 7 day in the observation patients was significantly higher than that in the control patients (P ＜ 0.05).Third,the time of anus exhaust and defecate in observation group was significantly shorter than that in the control group (P ＜ 0.01).Fourth,each group had one patient who suffered bleeding after operation,and 2 patients in control group had anastomotic leakage.Fifth,the time of hospital stays in the observation group was significantly shorter than that in the control group (P ＜ 0.01).Conclusion:The standardized nutritional therapy for gastric cancer can improve the patient's nutrition status,promote the recovery of gastrointestinal function,and then decrease the time of hospital stays during perioperation.

Objective To summarize the imaging features of ultrasound, computed tomography (CT) and gadolinium-ethoxybenzyl-diethylenetriamine pentoacetic acid (Gd-EOB-DTPA) enhanced magnetic resonance imaging (MRI) of solitary extramedullary plasmacytoma (SEP) of liver, and investigate the key points of identification and diagnosis.Methods The clinical data of 1 patient with SEP of the liver who was admitted to the Southwest Hospital of the Third Military Medical University at 7 May, 2015 were retrospectively analyzed.The patient received contrast-enhanced ultrasound (CEUS) , plain and enhanced scan of CT and Gd-EOB-DTPA enhanced MRI.The patient underwent treatment after preoperative examinations.Pathological examination and immunohistochemical staining were done after operation.The patient was followed up by outpatient examination of color Doppler ultrasonography till 12 November, 2015.The location, size, shape, echo, density or signal, enhancement pattern, secondary performance were recorded by imageological examinations.Surgical treatment, results of pathological examination, immunohistochemical staining, postoperative recovery and recurrence of tumor were recorded.Results CEUS examination demonstrated a hypoechoic hepatic lesion at S7 segment of the right liver measuring 24 mm × 19 mm with clear boundary and dotted blood flow signal in the mass.In the arterial phase, the lesion was enhanced rapidly.Abdominal CT scan showed that the mass at the right liver lobe had slightly low density with clear boundary, the CT value of 34-64 HU, and liver capsule having no significant outer convex.On enhanced CT, the lesion presented a homogeneous enhancement and shape of posterior upper tributaries of right hepatic artery in the arterial phase, the lesion presented continuous enhancement which was slightly lower than that of liver parenchyma in the portal venous phase with the CT value of 77-102 HU, the lesion presented decreased enhancement with the CT value of 41-98 HU in the equilibrium phase.The maximum density projected image showed that the shape of an enlarged vascular image was found inside the lesion in the arterial phase and the lesion was adjacent to inferior vena cava and right hepatic vein which was compressed and displaced in the portal venous phase.On Gd-EOB-DTPA enhanced MRI, the right liver lobe showed a homogeneous T1-weighted and T2-weighted signal with clear boundary and without lipid component, hemorrhage or calcification.The lesion presented obvious enhancement in the arterial phase, homogeneous continuous enhancement which was slightly lower than that of liver parenchyma in the portal venous phase, decreased enhancement in the equilibrium phase.The lesion showed mild signal, adjacent to inferior vena cava and right hepatic vein which was compressed and displaced in the hepatobiliary phase.There was no obvious cirrhotic nodule in the liver.The patient received laparoscopic space-occupying lesion resection at the right liver lobe after finishing inspection.The grayish white lesion in hardness was seen, with clear boundary and capsule, adjacent to anterior wall of inferior vena cava and right hepatic vein in the operation.The results of pathological examination showed that the small tumor cells were scattered in bundle, nuclear were round or oval shape and eccentric with mitosis seen.The results of immunohistochemical staining showed that endothelium cell marker CD34, human multiple myeloma gene MUM1, vimentin, plasmacyte markers 38 and 138, expression of λ light chain protein were positive, the positive cell rate of proliferation activity marker Ki-67 was 10％.The results of blood routine test and blood biochemistry showed that the patient had no anemia, hypercalcemia, abnormal renal function or monoclonal immunoglobulin in the serum or urine.The results of postoperative bone marrow aspiration, immunoglobulin determination and whole body bone scan showed normal.Postoperative examinations confirmed the SEP of right liver.The patient recovered well and was discharged at postoperative day 9.Postoperative change at right liver lobe was detected by color Doppler ultrasonography at 1 month after operation.The patient was followed up for 6 months without tumor recurrence.Conclusion SEP of liver mainly locates at the right lobe of liver, and the imaging features include clear boundary, homogeneous echo, density or signal, adjacent capsule showing no significantly outer convex, surrounding vein demonstrating no violation and shifted by compression, enhancement pattern as fast-in and fast-out.