Objective To evaluate the clinical effect of CYPHER TM (rapamycin) stent in treatment of left anterior descending (LAD) long lesion. Methods From October 2002 to April 2003, 65 patients with coronary heart disease (CAD) were treated with CYPHER TM (Cordis) stent and 65 stents were planted in 53 LAD lesions. Among the patients with LAD lesions, 42 cases were long lesions (≥20 mm). The length of lesion was from 20 mm to 50 mm (28.2?8.8 mm), the degree of stenosis before procedure was 88.9%?8.5%, and the vessel diameter before procedure was 3.0?0.9 mm. Three lesions were chronic total occlusion (CTO) lesion. Two lesions were in-stent restenosis. 12 lesions over 35 mm long were treated with two overlapped stents to cover the whole lesion. 30 lesions were treated with only one stent. We observed the procedure success and complication rates. The occurance of angina, myocardial infarction, sudden death, and the revascularization rate during the in-hospital and 6 months follow up. Results Immediate procedure success rate was 100% with residual stenosis of 5.0%?4.8%. All the lesions were covered fully by stents and the coronary flow reached TIMI grade three. No new dissection was observed in the optimal of stents. Only one patient was diagnosed as myocardial infarction after procedure and in-stent thrombolysis was proved by coronary artery angiography (CAG). During the 6 months follow-up, the symptom of angina was disappeared in 38 patients and alleviated in 4 patients. Eight patients received CAG in 3-6 months and no restenosis was observed. Conclusion Drug eluting stent (CYPHER TM) implantation is a safe and efficient therapy in treating patients with LAD long lesion, and short term follow-up results were better than the general coronary stents.

AlM:To investigate the myopia risk factors of different nationalities students in primary and secondary schools in Karamay City.
METHODS:This survey was a cross-sectional design, the sample was selected in the first, third and sixth grade primary school and middle school students by stratified random cluster method. The survey team comprised of ophthalmologists, technicians, optometrists and administrative staff. The staff was trained about the design, method and quality control, etc. According to the research needs, questionnaires were designed. ln person interview, pilot study, questionnaire, intraocular pressure, corneal curvature, refraction, axial length, corneal thickness, slit lamp microscopy and fundus examination were performed. A database was established using the Epi-data software by double entry method. All statistical analysis was completed by SPSS 17. 0 software.
RESULTS:The survey covers 1 922 students in total, which account for 91. 4% students of the whole four grades. The total prevalence of myopia was 39. 2%. Multivariate analyses revealed that ethnic origin, age, gender, parents of short-sightedness, daily after-school reading and writing time and bad reading and writing habits were closely related to myopia ( OR=0. 149, 95%CI:0. 103-0. 216, P=0. 000; OR=1. 372, 95%CI: 1. 296-1. 453, P=0. 000; OR=1. 517, 95%CI: 1. 200-1. 918, P=0. 000;OR=0. 695, 95%CI: 0. 602-0. 804, P=0. 000; OR=1. 310, 95%CI:1. 086-1. 581, P=0. 005;OR=0. 655, 95%CI:0. 486-0. 882, P=0. 005).
CONCLUSlON: Ethnic origin, age, gender, parents of short - sightedness, daily after - school reading and writing time and reading and writing habits were independent risk factors for myopia.

Adult ; Atropine ; therapeutic use ; Bronchodilator Agents ; therapeutic use ; Combined Modality Therapy ; Female ; Hemofiltration ; Humans ; Insecticides ; poisoning ; Male ; Middle Aged ; Organophosphorus Compounds ; Poisoning ; therapy ; Treatment Outcome

Objective To assess the application of echocardiography in mini-invasive surgical device closure of ventricular septal defect (VSD). Methods 73 VSD patients including 35 with aneurysm formation and among them 21 with multi-defects in the aneurysm were treated by mini-invasive device closure. A closure device was positioned to the defect through parastemal mini-incision in all patients. TEE was used to monitor the whole procedure, to guide the device positioning and to evaluate the curative effect instantly after operation. All patients were evaluated by TTE one year postoperatively. Results All patients were successfully positioned closure devices by TEE guiding. 9 cases were found with trace to small amount residual shunt instantly after operation. 7 cases still had small amount residual shunt at the time of 48 hours after the operation. In the one year follow-up, 4 cases had residual shunt, but the size and volume of left ventricle were significantly reduced than those before operation, and the pulmonary artery systolic pressure was also reduced. Conclusion Echocardiography possesses an important role in preoperative indication screening, intraoperation monitoring and evaluating the curative effect postoperatively.

Objective To study the sources and the relationship between the management and the outcome of hemorrhage after cephalic pancreatoduodenectomy.Methods The clinical data of 370 patients who underwent pancreatic resection at the Lihuili Hospital and the Second Affiliated Hospital of Zhejiang University were retrospectively analyzed.Results Postoperative bleeding occurred in 35 patients with 11 deaths.Among those intraabominal bleeding occurred in 14 cases and gastrointestinal hemorrhage occurred in 22,with one case suffering from both.Bleediug developing within 72 hours after operation in 12 cases (early-stage group),which was caused by improper intraoperative homeostasis.In other 23 cases,bleeding 72 hours after operation(later stage group)was caused by the erosion following pancreatic and/or bile leakage.Relaparotomy was performed in 13 cases and endoscopic homeostasis was performed in 3. Relaparotomy or endoscopic homeostasis was superior to that of conservative therapy in the early-stage group (P0.05).Pancreatic or bile leakage was identified as the significant risk factors for the postoperative bleeding.Conclusions In order to prevent the postoperative hemorrhage and to reduce the mortality of pancreatic resection,skillful techniques,expeditious homeostasis,proper management of stump pancreas and the prevention of pancreatic and bile leakage are essential.

Objective To analyze the classification,MR manifestations,and the pathological basis of solitary necrotic nodule of the liver(SNN)in order to evaluate MRI as a diagnosing tool Methods The MR appearances of 9 cases with pathologically proved SNN were analyzed and correlated with the classification and pathological appearances.Relevant literature was reviewed.Results(1)Simple coagulative necrosis type(5 cases):The signal of lesions was hypo-intense or iso-intense on both T_1-and T_2- weighted images.After Gd-DTPA administration,the internal part of the lesions showed no enhancement,while the thin capsule of the lesions demonstrated mild or moderate delayed enhancement. These lesions,proved by pathology,were composed of central coagulative necrotic core and a peripheral hyaline fibrosis capsule.(2)Coagulative necrosis aceompanied by liquefactive necrosis type(1 case):On T_1-weighted images,the signal of hypo-intensity was found within these lesions and even lower signal intensity was found in the central area of larger lesions.On T_2-weighted images,the lesions had a bright core and a peripheral hypointensive or isointensive area.After Gd-DTPA administration,the internal part of the lesions showed no enhancement,while the thin capsule of the lesions demonstrated mild or moderate delayed enhancement.These lesions had a central coagulative necrosis core interleaved by slit- like liquefactive necrosis foci,and peripherally a thin capsule of hyaline fibrosis proved by pathology.(3)Multi-nodular fusion type,(3cases):On T_1-weighted images,the lesions were of hypointensive or isointensive signal and had multiple septa of isointensive signal.On T_2-weighted images,the lesions were of hypointensive or isointensive signal and had multiple septa of hyperintensive or isointensive signal.After Gd-DTPA administration,No enhancement was found except mild or moderate delayed enhancement found in the thin capsule and septa.These lesions were composed of central coagulative necrosis area and a peripheral hyaline fibrosis capsule with multiple internal septa proved by pathology.Conclusion MRI apperances can reflect the classification and pathological features of solitary necrotic nodule of the liver.

PURPOSE: This study aims to gain in-depth understanding of nurses' perspectives of working in an overcrowded emergency. METHODS: Symbolic interactionism and Charmaz's construction of grounded theory were used. Purposive sampling at the start of the study and a further theoretical sampling by snowball technique were used to recruit 40 registered nurses (RN) to participate in in-depth, semi-structured interviews betweenMay and November, 2014. Data analysis included analytic techniques of initial, focused and theoretical coding. RESULTS: Study findings showed searching for work role is derived by the themes of Finding the role of positioning in Emergency Department (ED), Recognizing causes of ED overcrowding, and Confined working environment. Nurses' work experience which represents the RNs not gained control over their work, as care actions influenced by the problematic overcrowded circumstance of the ED environment. CONCLUSION: The findings fill a gap in knowledge about how RNs experience their work role in the context of an overcrowded Emergency Department in Taiwan. Arising from the study result include taking account of nurses' perspectives when planning staff/patient ratios, strategies to reduce waiting time and ensure that clients receive appropriate care.
Clinical Coding ; Crowding ; Emergencies* ; Emergency Service, Hospital* ; Grounded Theory ; Humans ; Nurses ; Statistics as Topic ; Taiwan*

Animals ; Bone Marrow Cells ; cytology ; Bone Marrow Transplantation ; Cell Differentiation ; Cell Proliferation ; Humans ; Liver Cirrhosis ; pathology ; surgery ; Liver Function Tests ; Mesenchymal Stem Cell Transplantation ; Rats ; Stem Cells ; cytology

OBJECTIVETo evaluate the clinical value of diffusion-weighted imaging (DWI) with 3.0 T magnetic resonance scanner for nasopharyngeal carcinoma (NPC) and to explore the appropriate b value during this procedure.

METHODSTotally 50 patients with histopathologically confirmed NPC and 20 volunteers underwent DWI using single-shot echo-planar imaging technique were enrolled in this study. Four groups of b value (600, 800, 1000 and 1200) were applied. The apparent diffusion coefficients (ADC) between the primary tumor of NPC and the metastatic lymph nodes were compared in each group. ADC between the metastatic lymph nodes and benign nodes were also compared.

RESULTSAlthough the mean ADC were not significantly different between NPC and those of metastatic cervical lymph nodes in each group, the mean ADC of the metastatic lymph nodes were significantly lower than those of benign nodes (P<0.05). When b value was 800, both satisfying images and accurate measurements were acquired.

CONCLUSIONDWI is helpful in the diagnosis of primary lesions and their lymph node metastases of NPC.

Adolescent ; Adult ; Aged ; Carcinoma ; Child ; Diffusion Magnetic Resonance Imaging ; methods ; Female ; Humans ; Male ; Middle Aged ; Nasopharyngeal Neoplasms ; diagnosis ; Young Adult

OBJECTIVETo investigate the usefulness of high-field MR diffusion-weighted imaging (DWI) in the diagnosis of endometrial carcinoma.

METHODSThirty-five female patients with pathologically proven endometrial carcinoma, 10 patients with pathologically proven endometrial dysplasia and 41 normal volunteers were enrolled into this study. MR images were obtained at a 3.0 T MR scanner (GE, SIGNA EXCITE HD 3.0T) and an 8-element phased-array torsopa coil was used to receive MR signal. The conventional pulse sequences included axial SE T1WI, FSE T2WI and fat saturated FSE T2WI, sagittal FSE T2WI, and coronal fat saturated FSE T2WI. Axial DWI was performed in all patients using a SE-EPI sequence with a 1000 s/mm(2) b value. The apparent diffusion coefficients (ADC) of carcinoma, dysplasia and normal mucosa were measured among the patients.

RESULTSCompared with myometrium, all the endometrial carcinoma, dysplasia and normal endometrium had a markedly high signal intensity on DWI. The ADC of endometrial carcinoma, dysplasia and normal endometrium was (1.08 +/- 0.23) x 10(-3)mm(2)/s, (1.29 +/- 0.21) x 10(-3) mm(2)/s and (1.41 +/- 0.21) x 10(-3) mm(2)/s, respectively. There were statistically significant differences between the carcinoma and normal endometrium (t = -6.416, P = 0.000), and between the carcinoma and dysplasia (t = -2.590, P = 0.013). However, no significant difference in ADC was found between highly-differentiated and moderately-differentiated adenocarcinomas.

CONCLUSIONHigh-field MR diffusion-weighted imaging (DWI) is highly sensitive in detecting endometrial lesions. It can be used to differentiate the endometrial carcinoma from either dysplasia or normal endometrium, but is difficult to differentiate highly-differentiated adenocarcinoma from moderately-differentiated one.

Adult ; Aged ; Aged, 80 and over ; Carcinoma, Endometrioid ; diagnosis ; surgery ; Cystadenocarcinoma, Serous ; diagnosis ; surgery ; Diagnosis, Differential ; Diffusion Magnetic Resonance Imaging ; methods ; Ectodermal Dysplasia ; diagnosis ; Endometrial Neoplasms ; diagnosis ; surgery ; Endometrium ; Female ; Humans ; Middle Aged ; Myometrium