Objective To investigate the development of the digital wireless network billing system of oxygen flow in clinical application. Methods By random 220 cases of patients who need to absorb oxygen were divided into the observation group(108 cases)and the control group(112 cases), the observation group used the digital wireless network billing system of oxygen flow, and the control group adopted the traditional buoy type oxygen gauge instrument. The following items were compared between the two groups: dispute rates between nurses and patients for different amount of absorbed oxygen, the average time cost for nurses in measuring the duration of oxygen absorbing, total income per barrel for recycling oxygen. Results For the dispute rates between nurses and patients for different amount of absorbed oxygen were 0.93% in the observation group, and 75.89% in the control group. The average time cost for nurses in measuring the duration of oxygen absorbing was 2.03 minutes for the observation group, and 12.54 minutes for the control group; total income per barrel for recycling oxygen was 42.68 yuan per barrel of the observation group, and 28.23 yuan in the control group. The statistical analysis between the two groups was supported by 95% confidential level. Conclusions Using the digital wireless network billing system of oxygen flow in clinical can reduce the dispute rates between the nurses and patients, improve patients' satisfaction degree, reduce the total time cost for nurses in measuring the duration of oxygen absorbing, raise efficiency, build a clear scientific charge system of oxygen flow, and restore economic loss.

Objective To evaluate the value of CT and bronchoscopy in diagnosis of solitary pulmonary nodules.Methods The CT,FOB and histologic data of 60 patients with solitary pulmonary nodules were analysed retrospectively.Results 60 pulmonary lesions were all detected by CT scan,the detected rate was 100%.The detected rate by endoscopy was 67%(40/60).Conclusion CT can be used as the routine method in evaluating pulmonary nodules and guiding biopsy by fibroptic bronchoscopy.

Objective The widely use of ultrasound elastography has increased the detection rate of breast cancer.It has great advantage of differential diagnosis of breast tumor.Our study is to evaluate and compare the value of the quantitative ultrasound elastography parameters of AR ( area ratio) , ESR ( entire strain ratio) , LSR ( locolized strain ratio) , EFLR( entire fat to lesion ratio) and LFLR( locolized fat to lesion ratio) in the differential diagnosis of breast tumor. Methods 110 patients with 113 breast tumors were collected from Nanjing General Hospital of Nanjing Military Region between January 2015 and January 2016 who underwent breast exami-nation.The tumors were divided into two groups according to patholo-gy which acts as gold standard:benign group with 59 lesions and ma-lignant group with 54 lesions.Participants underwent quantitative ul-trasound elastography parameters examination.AR、ESR、LSR、EFLR、LFLR were compared between benign group and malignant group and ROC curve was drawn.Conventional ultrasound and ultrasound elastography parameter are combined to differentiate the benign or malignant lesion.Calculate the various parameters on the accuracy、susceptibility、specificity、positive likelihood ratio、negative likeli-hood ratio of the diagnosis of benign and malignant lesions, and determine the quantitative parameter with the highest accuracy. Results The mean value of AR、ESR、LSR、EFLR and LFLR of malignant lesions were all significantly greater than that of benign le-sions (P=0.000).Compared with the conventional ultrasound, AR、ESR、LSR、EFLR and LFLR have higher AUC in the differentia-tion of benign and malignant breast lesions;AUC of AR and ESR are higher than conventional ultrasound、LSR、EFLR and LFLR( P<0.000).Compared with conventional ultrasound(1.523) alone, conventional ultrasound combined separately with AR、ESR、EFLR and LFLR have higher positive likelihood ratio(11.581、8.272、3.482、2.458、2.100) in the differentiation of benign and malignant breast lesions, so as accuracy、susceptibility、specificity(P<0.000).The AUC of conventional ultrasound combined separately with AR and ESR[0.940(0.890~0.990)、0.941(0.891~0.990)] were higher than conventional ultrasound and conventional ultrasound com-bined separately with LSR、EFLR、LFLR[0.669(0.669~0.768)、0.837(0.759~0.915)、0.763(0.673~0.852)、0.787(0.701~0.874)],so as accuracy、susceptibility、specificity and positive likelihood ratio(P<0.000). Conclusion Quantitative ultrasound elastography may be helpful in differentiation of benign and malignant breast lesions, especially combining conventional ultrasound with AR and ESR, which were superior to combining with the other parameters and provide a more objective and credible basis to differenti-ate benign and malignant breast tumors with conventional ultrasound.

OBJECTIVE:To observe the compatibility of moxifloxacin hydrochloride and sodium chloride injection with four kinds of antihemorrhagic drugs(etamsylate injection,aminomethylbenzoic acid injection,vitamin K1 injection,and aminocaproic acid injection).METHODS:The concentration of moxifloxacin in the mixture of Moxifloxacin Hydrochloride and sodium chloride injection with four kinds of antihemorrhagic drugs at 25℃ and 37 ℃ were determined by UV-spectrophotometry and dual wavelength spectrophotometry within 8 h.The changes of the mixture in appearance and pH were also observed.RESULTS:The mixture of moxifloxacin hydrochloride and sodium chloride injection with four kinds of antihemorrhagic drugs experienced no obvious changes in both contents of moxifloxacin and pH and appearance.CONCLUSION:The mixture of moxifloxacin hydrochloride and sodium chloride injection with four kinds of antihemorrhagic drugs was stable in contents of moxifloxacin and property.However,further studies remain to be done to investigate whether there are changes in the contents of the other four injections.

0.05).Tn-C、CD44v6 were negative expression in group C.Conclusion Tn-C、CD44v6 protein are useful in early diagnosis of follicular thyroid carcinoma.

Objective To explore the timing of surgical intervention for severe acute pancreatitis (SAP). Meth-ods One hundred and fifty-seven cases with SAP treated in our hospital from March, 1998 to December, 2007 were analyzed retrospectively. Influence of surgical intervention and conservative treatment on curative rate were e-valuated in pancreatic necrotic area and with or without infected pancreatic necrosis. Results The overall curative rate of surgical treatment and conservative treatment was 80.4%, 87.1% respectively; the two methods had no sta-tistical difference. Conservative treatment was better than surgical treatment in patients with lesa than 30% necrotic area and surgical treatment was better than conservative treatment in patients with more than 50% necrotic area. But the two methods had no statistical difference in 30% ～ 50% necrotic area. Conservative management was better than surgical management in sterile pancreatic necrosis, but surgical management was better than conservative manage-ment in pancreatic necrosis with infection or suspection of infection. Conclusion Surgical intervention treatment plays an important role in SAP patients, we should combine pancreatic necrotic area and with or without infection to choose the timing of surgical intervention for severe acute pancreatitis.

Objective To explore the patterns of motor and linguistic activation in cortical and its correlations with abnormal gray matter in patients with malformations of cortical development(MCD)and epilepsy.Methods Seven MCD patients with epilepsy(2 patients with focal cortical dysplasia,2 heterotopia,2 schizencephaly,and 1 polymicrogyria)underwent blood-oxygen-level-dependent(BOLD)functional MRI(fMRI)in a 3 T MR scanner when practicing bilateral fingers tapping,toes twisting,verb generation,and picture naming.Functional images were post-processed by using SPM 5 software based on a general linear model(GLM)to generate activations above a uniform threshold with the cluster size (≥30 voxels,P ＜0.001 corrected).The activations were recognized and classified by two experienced neuroradiologists,and then compared with that in abnormal gray matter.Results The clusters and intensities of motor activations were mainly located in the sensormotor cortex(SMC)and premotor area (PMA).In linguistic tasks,activations produced by verb generation were found in language-associated cortical regions and PMA with higher activation in Wemicke area,picture naming significantly in the visual cortex,and language in Broca area.Combination of the two linguistic tasks produced significant clusters and intensities in language cortex.For MCD patients with abnormal cortical abnormalities,motor and language task could produce neuronal activities within normal as well as abnormal cortex regions.In 6 patients who underwent resective surgery,epileptic seizures decreased significantly,and the follow-up images demonstrated no new neurological dysfunctions and cognitive impairments.Conclusions fMRI can visualize neuronal activities in patients with MCD and epilepsy and demonstrate the motor and linguistic activations occurring in normal and abnormal gray matter.It should be cautious for surgery in patient with MCD and epilepsy.

Thirty-five patients with ketosis-prone diabetes (KPD) and 38 patients with newly-diagonosed common type 2 diabetes mellitus (DM) were treated with insulin for 3 months.The results showed that the existing insulin resistance in patients with KPD was mild as compared with common type 2 DM, and the recovery of insulin sensitivity was less marked in patients with KPD after blood glucose was well controlled.

Objective To compare enteral nutrition (EN) and total parenteral nutrition (TPN) in the treatment of severe acute pancreatitis(SAP) elucidate the advantage of EN. Methods Fifty-nine patients were assigned to TPN and EN groups. The nutritional index was detected, and the therapeutic efficacy was reviewed comparetively. Results After giving the nutritional support, the serum contents of albumin, pre-albumin, transferrin and beamoglobin were increased obviously (P < 0.05);and prealbumin, transferrin had statistical difference between the TPN and EN groups(P <0.05). APACHE Ⅱ score was lowered significant-ly in the EN group, comparing with the TPN group (P <0.05). In the EN group, complications, infection rate, food intake time, and hospitalization costs were significantly lower compared with the TPN group(P< 0.05), although mortality rate, hospital stay days had no statistical significance (P > 0.05). Conclusion EN is on ideal modality of nutrition support in SAP patients, which has many advantages in improving nu-tritional status, preserving gut mucosa barrier, decreasing bacterium and toxin shifting, regulating inflamma-tory and infective response, decreasing costs in the hospital.

In the comprehensive treatment of breast cancer, endocrine therapy has become one of the effective methods for hormone receptorpositive (HR+) breast cancer. However, the effectiveness of endocrine therapy has been limited by primary resistance and acquired resistance as its long-term application. The clinical trials associated with cyclin-dependent protein kinases (CDKs) inhibitors have proven that the CDK4/6 inhibitors have an effect in reversing the resistance of endocrine therapy for the patients with HR+ and human epidermal growth factor receptor 2-negative (HER2-) advanced breast cancer, and have significance advantage in progression free survival. CDK4/6 inhibitors can regulate cell cycle mainly by the CDK4/6-cyclin D-retinoblastoma (RB) pathway, which is also a key downstream target of estrogen receptor (ER) signal. Therefore, inhibiting the activity of CDK4/6 can restore cell cycle control and further block tumor cell proliferation. This review describes the efficacy, safety and pharmacokinetics of three CDK4/6 inhibitors (palbociclib, ribociclib and abemaciclib) in clinical trials of HR+ and HER2- advanced breast cancer. This article also reviews the latest research results about CDK4/6 inhibitors stimulating the immune response and blocking the distant metastasis of triplenegative breast cancer cell lines.