10～7/mL specimens,17 were detected highly positive by PCR teststrip method,in 27 cases of 10～5～10～7 specimens 23 were intermediately positive,in 27 cases of 10～3～10～5 specimens 22 were weakly positive,showing statistical significance.All 28 cases

Objective　To study the diagnostic value of pleural fluid telomerase activity in distinguishing a malignant from a benign pleural effusion. Methods　Using a PCR-based assay, telomerase activity was examined in the pleural fluid cells obstained from 69 patients with pleural effusions (37 malignant, 32 benign). Results were compared with cytologic evaluation and carcinoembryonic antigen (CEA). Results　Of the 37 malignant specimens，26（70.27%）contained detectable telomerase activity. The positive rate in malignant pleural effusions was significantly higher than that in benign origin (2/32). Detection of telomerase in effusions was more sensitive than CEA level evaluation for the identification of pleural malignancy (telomerase assay: sensitivity=70.27%, specificity=93.75%; CEA: sensitivity=51.35%, specificity=96.87%). The consistant rate of telomerase with cytology was 54.05%. Conclusion　The detection of telomerase activity may be a useful adjunct to cytopathologic methods in the diagnosis of malignant pleural effusions. It may be useful in differential diagnosis of benign and malignant pleural effusions.

Liver metastasis is one of the critical prognostic factors for colorectal cancer.Complete surgical resection of liver metastases still remains the only potentially curative treatment for patients with liver metastases.There are still some controversies in how to choose the reasonable management for resectable colorectal cancer patients with simultaneous liver metastases,although neoadjuvant chemotherapy,tumor physical ablation technique and minimally invasive technology have made progress in recent years.One case of surgical treatment of synchronous rectal cancer liver metastasis at the Shengjing Hospital with laparoscopic microwave ablation + radical resection of colorectal cancer was disused in order to provide reference for individualized treatment for patients with the same disease.

Objective To assess the rationality of using CT for clinical staging in esophageal carcinoma.Methods 103 esophageal carcinoma patients with radical resection were selected,patients were examined by CT before surgery.To compare the clinical staging on the basis of CT findings with pathology.Results Lymph node enlargement were mentioned in 29 cases (28.2 ％) with CT findings before surgery,but 70 cases (68.0 ％) by pathology.The CT findings and pathology were inconsistent (x2 =11.719,P =0.001).Although the pathology staging in the cases which were positive with CT findings could be later (Z =-3.04,P =0.002),there was no correlation between the two methods (x2 =10.885,r =0.055,P =0.055).Conclusion The accuracy rate in esophageal carcinoma clinical staging by CT before surgery is low.Combining with PET-CT or endoscopic ultrasonography may improve the accuracy rate.

Humans ; Immunohistochemistry ; Lymphoma, Large B-Cell, Diffuse ; classification ; pathology

Pancreaticoduodenal anastomotic dehiscence complicated with peritoneal hemorrhage following pancreaticoduodenectomy is a serious complication which threatens patients'life.Prevention and mangement of pancreaticoduodenal anastomotic dehiscence and peritoneal hemorrhage is the focus in the surgical treatment.Operation is the most reliable treatment for bleeding.While reoperation is difficult for most surgeons and the risk of fistula and rebleeding after reoperation exist.Some procedures will affect the endocrine and exocrine function of pancreas.We applied pancreaticojejunal bridge drainage for most patients with hemorrhage after pancreaticoduodenectomy.This procedure is easy,safe,and can protect the pancreatic function.

ObjectiveTo observe the lesions of psoriasis vulgaris by confocal laser scanning microscopy(CLSM).MethodsThe typical lesions of 120 patients with psoriasis vulgaris were observed by CLSM,and scanning results were recorded.ResultsOf the 120 patients with psoriasis vulgaris,all (100％)had dilated and twisted capillaries in dermal papillae,113 (94.17％) acanthosis,106 (88.33％) parakeratosis,86 (71.67％) Munro microabscesses at the level of stratum corneum,71(59.17％) diminished or disappeared stratum granulosum.There were a few(1 to 2) dilated capillary lumens in papillary dermis,with no obvious reduction in the distance between dermal papillae.Some dermal papillary rings lost their integrity or brightness slightly in 24 of the 27 patients with psoriasis guttata.The height of stratum spinosum was 96.85 ± 17.88 μm (ranged:80-150 μm) in patients with psoriasis guttata,lower than that in those with plaque psoriasis (average:143.45 ± 23.19 μm,range:100-190 μm).In lesions of plaque psoriasis,the capillaries in dermal papillae were apparently dilated with hyperemia,showing a characteristic'S' shape or horseshoe appearance; the diameter of dermal papillae was increased and the distance between dermal papillae was reduced,giving a 'transverse section of lotus roots' appearance.Dermal papillary rings completely disappeared in 25 of the 29 patients with plaque psoriasis.ConclusionCLSM may serve as an aid in the diagnosis of psoriasis vulgaris.

This paper firstly analyses the sales and purchase contracts in the procurement of drugs in public hospitals, and then points out the market failure in the two contracts. After the implementation of administrative measures such as government pricing, administrative price reduction, price increase, centralized bidding and purcha-sing, various drug procurement stakeholders have adopted various game behaviors, and government procurement and price formation have appeared in government hospitals, not-neglecting the formation of the price ofGovernment fail-ure. The future price formation in public hospitals should be the market pricing under the limited government regu-lation, and increase the medical insurance institutions' price negotiation and the public hospitals' participation degree in the bidding process based on maintaining the centralized bidding and purchasing and zero administrative rate.

Objective To evaluate the performance of drainage through micropores in the treatment of axillary osmidrosis with subcutaneous trimming.Methods Forty-eight patients with axillary osmidrosis were enrolled in this study,and treated by subcutaneous trimming.After removal of apocrine sweat glands and hair follicles,a scalpel was used to cut several micropores (measuring 3 mm in length) along dermal ridges in skin flaps.Then,drainage was carried out through the micropores.Subsequently,the incisions were sewed up with 3-0 sutures followed by compression bandaging with elastic bandages.Dressings were changed and incisions were examined at 24 hours after operation,and bandages were taken off and skin flap viability was evaluated at 10 days.All the patients were followed for 3 months.Results After treatment,sweating was decreased and axillary odor disappeared in all the patients with a return to normal social activities.No obvious scar formed.Conclusion Drainage through micropores performs well in the treatment of axillary osmidrosis with subcutaneous trimming.

To expatiate upon the characteristics of systematization and refinement in medical English curriculum planning,to visualize the developing strategies of curriculum construction,and trying to probe into the formula in medical English teaching and learning.