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.

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 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.

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 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 investigate the effect of the teaching modes based on problem-based learning (PBL) and lecture-based learning (LBL) in clinical practice of hepatobiliary surgery.Methods 166 5-year program students were divided into 2 groups:PBL group (n=83)and LBL group (n=83).The performance in interrogation,physical examination,medical records and theoretical tests were analyzed.Results PBL group had better performance in all the above aspects compared to LBL group (P<0.05).Conclusions The teaching mode based on PBL is a good method,which Can inspire the students and improve their ability to solve problems in clinical practice of hepatobiliary surgery.

ObjectiveTo measure fetal lung volumes in different gestational age (GA) by using 3D ultrasound,and further to obtain the regression formula between fetal lung volume and GA.MethodsTotal 228 fetal lung data had been collected.By using the 3D reconstruction function in Philips Qlab,fetal lung volumes were obtained by subtracting the non lung volumes from the whole thoracic volumes.For each slice of 3D data,thoracic area and non-lung area were manually outlined.The contour stacking technique in Qlab was then used to transform 2D slices into 3D volumes.ResultsThe measurement results of total 228 cases indicate that the fetal lung volumes increase with the GA.The average lung volume at GA of 20 weeks was 8.85 cm3,and 70.5 cm3 at 36 weeks.The fetal lung volume increases about 3- 4 cm3 in each week,and the increasing trend turns to a little lower after 24 weeks.During 33 to 34 week there was a great increasing in fetal volumes.Second-order regression,exponential regression and logarithmic regression were respectively used to characterize the relationship between fetal lung volume and GA.The second-order regression formula was:Volume =39.52 - 4.48 × GA + 0.149 × GA2.The exponential regression formula was:Ln (Volume) =- 8.233 + 1.747 × Ln(GA2 ).The logarithmic regression formula was:Ln(Volume) =- 2.413 + 0.29× GA- 0.003 × GA2.The correlation coefficients of three formulas are equal,with r =0.99,P ＜ 0.001.Conclusions 3D ultrasound fetal lung volume measurement is useful for fetal lung maturity assessment and thus can provide important referential information for prenatal diagnosis.

Objective To evaluate the left ventricle geometry shape and left heart regional function in mitral insufficiency (MI) by quantitative tissue velocity imaging (QTVI) and the left ventricle systolic and diastolic geometry spbericity index. Methods Thirty normal subjects and 62 MI patients underwent QTVI and color Doppler imaging (CDFI) were enrolled in this study in order to measure the left ven-tricular geometry shape and left ventrieular regional function along LV apical long-axis view. Off-line LV regional velocity images along LV apical long-axis view were synchronously obtained. Peak tissue velocities of LV regional muscular tissue during systole(Vs),systolic acceler-ation(a), early diastole(Ve), LA contraction(Va)were synchronously measured as the index of left ventricular regional systolic and dias-tolic function. The left ventricle geometry shape index were reflected from the systolic and diastolic geometry sphericity index (SIs and Sid) and the left ventrieular ejection fraction (LVEF) and the peak D and peak a (PVd/PVa) of pulmonary veins flowing spectrum reflected the global left ventricular function index. The Vs, Ve, Va, a, PVd/PVd ratio, LVEF, SIs, SId were recorded and their correlation between normal subjects and patients with MI were compared. Result Vs, Ve,Va,a,PVd/ PVa ratio,SIs,SId in patients with MI were significantly re-duced. There was positive relation between Sis and a(r=0.602)and Ve/Va and SId(r=0.635). Conclusion There was negative rela-tion between regional cardiac function and LV spberieity, the higher cardiac function was accompanied with the lower SI.