ObjectiveTo comprehend the change of the characteristics of lifting force produced by a working space marker in process of its cavity-forming. Methods37 patients were successively operated with the surgical mode of minimally invasive video-assisted thyroidectomy (22/37 cases received a lobotomy and others un derwent a partial thyroidectomy) from January to August, 2010. Instead of hand-retraction, a mechanical armworking space marker type I ( WSM-I, MIEO Medinstr Co. Ltd, China) was applied to establish a working space. After pathway making, an interlayer-cavity above the lobe was created by the space maker and endoscopic view was properly built. Following all these steps, a simulated space making procedure was performed in a way of stepwise hook-lifting (5 mm rising per time). The lifting force ( LF)was measured during the process with a modflied force-measure device (FB-50, DESIK company, Germen). Then recorded data were assessed and analyzed statistically. Results①Ascending scope of LF in the process of entire space-forming was 0-27.5 Newton (N).②Along with hook rising, LF ascended correspondingly and 2 specific values emerged: One was 11. 2 ±3.5 N,as the lifting height approached 1.5 cm ( also a approximate position of essential space-forming ( Pe), at which themusculo-cutaneoustissuejustbecame tight) ; the other was 17.5 ± 4.3 N , as the lifting height approached 1.75 cm ( also a approximate position of maximal space-forming (Pmax), at which the musculo-cutaneous tissue appeared real tight, but not in a status of extreme tightness). ③Two types of LF ascending were found when the values transferred to a curve diagram : a palliative linearity increasing while lifting height varied from 0 to 1.5 cm (PO to Pe) and a rapid exponent-like increasing while lifting height varied from 1.5 to 1.75cm ( Pe to Pmax). ④ Dependability analyses yielded a diverse statistical outcome: negative significance of the comparison between incision length and LF value ( P ＞ 0. 05 ), and positive significance of the comparison between skin thickness and LF value ( P ＜ 0. 01 ). Conclusions①LF produced by WSM-I while establishing a working space is proper and relatively small, since the maximal value is merely 27.5N, far less than the stress produced by ordinary cosmetic skin expansion. ②The whole space-forming process can be divided into 2 stages according to the characteristic of LF ascending which correspond also separately to the “essential cavity-forming” and “the maximum cavity-forming” in the real establishing of a working space. ③Attention should be paid to the later stage since in which a rapid LF increasing occurs while the appearance of musculo-cutaneous tissue changes from “just become tight” to “real appear tight”. ④LF control, especially the fine readjustment at or about Pmax should be of necessity in individual space-forming, and then, ideal working space establishment can be archived at a pre cisely balanced LF point: maximum cavity volume acquired and minimal tissue expansion stress produced.

Objective To explore the correlation between homocysteine(Hcy),lipids amd type 2 diabetes mellitus (T2DM). Methods The laboratory test results of 533 cases of patients with T2DM(T2DM group)and 362 cases of healthy individuals (healthy control group)were retrospectively analyzed.Results The serum levels of Hcy and rates of abnormal serum cholesterol (TC),triacylglycerol(TG),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C)levels in the T2DM group were higher than those in the healthy control group,had statistically significant differences(P <0.05).Conclusion The high serum level of Hcy and abnormal lipid metabolism are correlated with T2DM,which might be risk factors of diabetes mel-litus and cardiovascular disease.

The paper quantizes symptom data through binary coding,divides 8 syndromes summed up by experts into excess and de-ficiency syndromes,values and quantizes them,and establishes the model for classification of excess and deficiency syndromes of colorec-tal cancer based on BP neural network and decision tree.The result shows that BP neural network classification model is more applicablefor the handling of the nonlinear mapping relation compared with decision tree classification model.

Background and purpose:Lung cancer is currently the greatest threat to human life and health of the malignant tumor, clinical examination revealed a solitary pulmonary nodules (SPN), including a signiifcant portion of early stage lung cancer. The research aimed to discuss the diagnosis value of CT guidance Hookwire positioning thoracoscopic surgery for solitary pulmonary nodule. Methods:From Jul. 2011 to Jun. 2013, 310 SPN patients in the Department of Thoracic Surgery of Fudan University Shanghai Cancer Center were collected. Hookwire positioning pins were retained guided by CT scan into the patients’ body. Video assisted thoracic surgery (VATS) pulmonary wedge resection was adopted. According to the result of intraoperative frozen pathology, further treatment method was decided. Positioning accuracy, complications, VATS lung wedge resection surgery successful rate, transfer rate in the chest and SPN pathological classiifcation and other indicators were calculated with statistical methods. Results:Hookwire positioning successful rate was 100%, meanwhile, 2 patients with hemoptysis received symptomatic treatment.Intraoperative Hookwire fell off in 12 patients (3.87%), VATS wedge resection surgery successful rate was 99%, transit thoracotomy was carried out in 3 patients. SPN postoperative histological pathology results:237 cases with primary lung cancer, 73 cases with benign lesions. Conclusion:The method of CT guided Hookwire thoracoscopic surgery after positioning in treatment of SPN has higher diagnostic accuracy rate, reliable curative effect, fewer complications and great value in clinical promotion.

Trying to provide ultrasonic image-aid measures for quantitative diagnosis and dynamic monitoring of liver fibrosis, we propose two scoring methods for liver fibrosis tissue in vivo , based on ultrasound radio frequency (RF) time series in this paper. Firstly, RF echo signals of human liver were recorded in this study. Then one of the recorded frame RF data was demodulated to be B model image. After that, a region of interest (ROI) in the B model image was selected. For each point in the ROI, its all frame data were acquired so that RF time series were formed. An SMR (size measure relationship) fractal dimension and six spectral features were extracted from RF time series in the ROI. With relative deviation and Fisher's discriminant ratio, seven features were weighted and summed so that the liver tissues' scores were obtained, Score-rd and Score-fisher, respectively. Area under ROC curve (AUC) and a support vector machine (SVM) were used to evaluate whether these scoring methods would be useful in distinguishing normal and cirrhosis tissues. Experimental results are shown as follows: Score-rd's AUC was 0.843, while Score-fisher was 0.816, SVM classification accuracies were both up to 87.5%. This proved that our proposed scoring methods were effective in distinguishing normal and cirrhosis tissues. Score-rd and Score-fisher have potential for clinical applications. They can also provide quantitative references for liver fibrosis diagnosis.
Area Under Curve ; Fractals ; Humans ; Liver Cirrhosis ; classification ; diagnostic imaging ; Radio Waves ; Support Vector Machine ; Ultrasonography

This guideline was published by the American Institute of Ultrasound in Medicine,which has been developed to assist physicians performing sonographic studies of the brain in neonates and infants.Neurosonography should be performed only when there is a valid medical reason,and gain the necessary diagnostic information.Although it is not possible to detect every abnormality,adherence to the following guideline will maximize the detection of most abnormalities of the brain in neonates and infants that can be imaged with ultrasound.

Objective To evaluate the diagnostic value of three nuclide imaging methods in patients with hyperparathyroidism. Methods Thirty five patients with hyperparathyroidism underwent 201 Tl/ 99m TcO-4 (8 cases), double phase 99m Tc MIBI imaging methods (27 cases) and 99m Tc MIBI/ 99m TcO-4 substraction imaging (20 cases). Abnormal increase of radioactivity in substraction imaging or delay imaging denoted positive result. All data of nuclide imaging were evaluated according to final clinical results and were compared with ultrasound or CT. Results 35 cases of hyperparathyroidism were proved, including 31 adenomas (ectopic 1), 3 hyperplasia and 1 carcinoma. The sensitivity of 201 Tl/ 99m TcO-4 , double phase 99m Tc MIBI imaging and 99m Tc MIBI/ 99m TcO-4 substraction imaging was 62.5%, 88.9%,90.0%, respectively. The specificity of 3 nuclide imaging methods was 100%. The sensitivity and specificity of ultrasound were 74.3%, 85.7%, respectively. The sensitivity of CT was 78.6%. The results showed that 99m Tc MIBI/ 99m TcO-4 was superior to other imaging. Conclusion An accurate diagnosis of hyperparathyroidism and preoperative anatomic localization can be determined by means of nuclide imaging.

The enzymatic synthesis of endomorphins were carried out by immobilized papain on sodium alginate-chitosan (IPSAC). The reaction has been carried out in two steps. First, Trp-Phe-NH2 was obtained by Boc-Trp-OH coupling with Phe-NH2 using IPSAC catalyst in microaqueous acetonitrile system with a 27.8 % yielding as determined by high performance liquid chromatography (HPLC). The catalytic properties of IPSAC were examined by studying the dependence of pH, ionic strength, solution content, reaction temperature,enzyme loading and reaction time over the yields. The results of orthogonal experiments indicated that pH was the most significant factor that influenced this synthesis. Second, Boc-Tyr-Pro-OMe and Trp-Phe-NH2 were suspended into the microaqueous acetonitrile to produce Tyr-Pro-Trp-Phe-NH2 (endomorphin-1) with a 35.2% yield.

To investigate the regulatory effect of acupuncture on insulin resistance in simple obesity patients and its clinical effect. Methods: By the method to benefit qi, strengthen the spleen, dissolve phlegm and remove turbidity, eight periumbilical acupoints, Tianshu (ST 25), Huaroumen (ST 24), Wailing (ST 26), Yinjiao (CV 7) and Shuifen (CV 9), and Guanyuan (CV 4) and Zusanli (ST 36) were used, in cooperation with ear-points-embedding method, and together with 30 healthy persons for comparison, in order to observe the changes in FBG, INS,ISI, TC, TG, LDLC and HDLC and to observe the changes in the waist circumference, hip circumference, waist-hip ratio, body weight and BMI in simple obesity patients before and after acupuncture treatments, and to observe the differences of the therapeutic effects between grade Ⅰ and grade Ⅱ obesity. Results: Hyperinsulinemia (HI) existed in the patients with simple obesity before the treatment, and ISI significantly decreased (P＜0.01) in comparison with the healthy group, and waist circumference, hip circumference, waist-hip ratio, body weight and BMI significantly decreased (P＜0.05, P＜0.01), and FBG, INS, TC, TG and LDLC also significantly decreased (P＜0.01, P＜0.05), and ISI and HDLC significantly increased (P＜0.05) after the treatment. Conclusion: Acupuncturecan not only effectively improve the body fat parameters but also regulate the abnormal fat metabolism and improve insulin resistance status in simple obesity patients.

Objective To explore the hospitalization status of patients with chronic obstructive pulmonary disease ( COPD ) . Method In total, 12,838 COPD patients hospitalized from January 2008 to December 2014 were involved in the study and their hospitalization status were analyzed. Results Among the 12,838 patients, 2,499 were hospitalized for critical conditions (19.47%), 5,455 for acute attack (42.49%), 4,884 for acute exacerbation (38.04%). The ratio of male/female was 5.32:1. Those in 71 to 80 years old were at the highest risk. They were hospitalized at least for 1 time, at most for over 38 times, averaged (3.52 ± 4.05) times. Conclusions The COPD patients were hospitalized due to acute attack and acute exacerbation. The patients'age ranged from 71 to 80 years. The male patients had a predominant incidence than the female ones. The times of hospitalization were related with possible complications of other chronic diseases. Therefore, nursing staff should draw up individual continuing nursing strategies based on the patients′ hospitalization reasons to reduce the hospitalization rate of acute attack and acute exacerbation. Meanwhile, we should formulate the pre-hospital rescue plan for the hospitalized patients at the peak age and implement prospective nursing.