Objective:To explore the perioperative treatment principle for arteriovenous fistulas of hemodialysis,the related factors to the success of operations and the intervention measures.Methods:1820 cases in the 2 periods from 1992to 2000 and from 2001 to 2008 were selected,and the relation of the change of primary diseases,the difference of their blood vessel condition before operation,different operation methods and different treatment after operation to the successful rate of operation and fistulas blood flow was analyzed and statistical analysis was made to the related data.Results:The ratio of secondary renal disease in the second period was much bigger and of significant difference with that in the first period(P

OBJECTIVE To survey the status quo of hospital infection management and countermeasures in township health center. METHODS To adopt a unified examination and assessment survey,the township hospital infection management,including organization,personnel training,monitoring,disinfection and isolation,occupational protection,sterile disposable medical supplies and medical waste management was investigated in 15 Lanxi Town ship Health Centers. RESULTS Only 2 centers had management organizations (13.33%),5 (33.33%) to participate in personnel/training,no one carry out the monitoring of hospital infection,with fuzzy concept about cleaning disinfection and sterilization and poor awareness of occupational protection. CONCLUSIONS Realizing a sound organization improving hospital infection management staff and intensive training,increaseing the investment and strengthening th supervision and inspection are in accordance with the law and guide management of patients in rural areas to be assured of a secure medical establishment.

Diffuse large B-cell lymphoma (DLBCL) is a heterogeneous group of non-Hodgkin's lymphoma.An uncommon subset with myc and either bcl-2 or bcl-6 rearrangement,also known as ‘double-hit’ lymphomas,is considered very aggressive clinical course and poor prognosis despite high-intensity chemotherapy.Recently,these lymphomas have received increased attention.This review explores the existing literatures for the involved genes with their functions,clinical features,diagnosis and treatment.

Objective:In order to improve operator’s cognitive level for standardized disinfection, this paper will focus on analyzing and interpreting the disinfection procedures for some common dialysis machines.Methods: This paper will interpret and compare the disinfection procedures for three brands of dialysis machines in the following aspects: the choice of the disinfectant, the disinfection method, the concentration of the disinfectant and the injected volume of the disinfectant, etc.Results: The procedures of hot disinfection with citric acid were used completely in those three brands of dialysis machine, and the procedure of sodium hypochlorite need been used periodically to remove the proteins and other organic matter.Conclusion:Although the dialysis machines provide almost complete and efficient disinfection procedures, but the operator should need to select the most suitable procedures according to their practical situation. If the operators cannot master the disinfection procedures and have not noticed the importance of it, the wrong operator will lead to incomplete disinfection, affect the normal operation of the dialysis machines and increase the risk of cross-infection.

Objective To investigate the expression of microRNA-451 (miR-451) in female invasive ductal carcinoma (IDC) and its roles in tumor cell invasion.Methods Forty five IDC tissues and matched tumor adjacent tissues were collected between January and December in 2014.The expressions of miR-451 in tissues were detected by quantitative real-time polymerase chain reaction (qRT-PCR).The relationship between long noncoding RNA taurine regulated genes 1 (lncRNA-TUG1) and clinical features was analyzed by student-t test.miR-451 mimics was transfected into MDA-MB-231 cells.Transwell assay was used to measure cell invasion ability.The expression of c-myc,a potential target of miR-451,and its downstream genes,matrix metalloproteinase (MMP)-2 and MMP-9 were detected by qRT-PCR and Western-blot.Resuts The expression of miR-451 was significantly lower in IDC tissues than in matched tumor adjacent tissues (P ＜ 0.05).Low expression of miR-451 was positively associated with lymphatic metastasis (P ＜ 0.05) and advanced tumor node metastasis (TNM) stage (P ＜ 0.05).Up-regulation of miR-451 in MDA-MB-231 cells could significantly suppress cell invasion ability (P ＜0.05).c-myc expression was down-regulatedwhen miR-451 was transfected (P ＜0.05).As downstream genes of c-myc,the expressions of MMP-2 and MMP-9 were suppressed.Conclusions miR-451 is down-regulated in IDC tissues and associated with cell invasion.miR-451 might inhibit IDC progression by inhibiting c-myc/MMP axis.

Neurosurgery is a superior difficulty and high risk surgical medicine.It will take a longer period time to finish the clinical residence training in neurosurgery.Standardized residency training is an inevitable way for the transition from medical students to the neurosurgical resident doctors,the central task of?residency training is to improve the clinical skills.In recent yea rs,smartphone-based mobile learning plays an increasingly important role in medical education.As a member of National bases of standardized residency training,we have analyzed the characters of training residency,and employed the Medical related Applications (Med-Apps) as modernized teaching technology to improve the clinical skills in areas of neuroanatomy,operation,management of patient and evaluation of trainees' competency.We help training residency finish the transition from smartphone-player to smartphone-learner,with the potential to improve overall clinical skills of training residency.

Objective To observe the predictive value of Alberta stroke program early CT score (ASPECTS) and hemorrhage after thrombolysis score (HAT score) for the hemorrhagic transformation (HT) of acute cerebral infarction (ACI) patients after thrombolysis with Alteplase.Methods One hundred and twenty-one patients with ACI admitted to the Department of Neurology of Tianjin Jinghai District Hospital from January 2015to March 2017 were enrolled, they were all treated by using Alteplase 0.6 mg/kg for thrombolysis, maximum dose being 90 mg, and 1/10 of the total dose was intravenously injected in 1 minute, and then the residual part dissolved in 100 mL normal saline was intravenously dripped continuously for 1 hour. The ASPECTS and HAT score were carried out before the start of thrombolysis, and then the HT incidence situations in patients with different ASPECTSs and HAT scores were compared, and logistic regression analysis was used to analyze the risk factors of HT after thrombolysis in patients with ACI; then the receiver operating characteristic (ROC) curve was drawn, and the clinical value of HAT score and ASPECTS in diagnosing HT occurrence was analyzed.Results In cases with ACI, it was discovered that the higher the ASPECTS, the lower the incidence of HT, indicating that the incidences of HT in patients with ASPECTSs 0-4, 5-7, 8-10 were 57.1% (4/7), 26.7% (8/30), 14.3% (12/84) respectively; Similarly, in such cases, the higher the HAT scores, the higher the incidence of HT, showing that the incidences of HT of patients with HAT scores 0, 1, 2, ≥ 3 were 7.1% (4/56), 21.0% (8/38), 33.3% (7/21), 83.3% (5/6) respectively. The single factor analysis showed that the risk factors influencing the HT incidence included the systolic blood pressure on admission, anti-platelet medicine taken in the past history, the sign of high density of middle cerebral artery shown in head CT film on admission, the time of interval between the onset of the disease and the beginning of thrombolysis, HAT store and ASPECTS [odds ratio (OR) values were 0.972, 0.279, 0.992, 0.311, 2.628, 2.625, respectively, 95% confidence intervals (95%CI) were 0.9352-1.012, 0.093-0.836, 0.983-1.000, 0.105-0.916, 1.362-5.071, 1.522-4.525,P values were 0.034, 0.023, 0.042, 0.034, 0.003, 0.045 respectively]; the multifactorial logistic regression analysis showed that the independent risk factors influencing HT incidence were as follows: the systolic blood pressure on admission, anti-platelet medicines taken in the past history, the sign of high density of the middle cerebral artery shown in the head CT film on admission, the time of interval between the onset of the disease and the beginning of thrombolysis, HAT score and ASPECTS (OR values were 1.766, 1.012, 1.574, 1.030, 2.155, 2.431, 95%CI were 1.233-2.103, 1.009-1.204, 1.186-2.091, 1.009-1.053, 1.237-4.907, 1.213-5.815,P values were 0.023, 0.004, 0.002, 0.005, 0.007, 0.047); HAT score and ASPECTS could predict the risk of HT incidence after venous thrombolytic therapy, sensitivity, specificity, area under ROC curve (AUC), 95%CI in ASPECTS were higher than thoes of HAT score (94.4% vs. 94.0%, 61.4 vs. 41.0%, 0.77 vs. 0.70, 0.710-0.830 vs. 0.650-0.800).Conclusions It is shown in this study that the higher the ASPECTS, the lower the incidence of HT, and the higher the HAT score, the higher the incidence of HT; both HAT score and ASPECTS can predict the risk of HT incidence after venous thrombolytic therapy, and the predictive value of ASPECTS system is higher than that of HAT score.

Objective To compare the difference between linear blending and non-linear blending function for dual-energy CT, and to evaluate the effect on CT image quality. Methods The model was made of a piece of fresh pork liver inserted with 5 syringes containing various concentrations of iodine solutions ( 16.3,26.4,48.7,74.6 and 112.3 HU). Linear blending images were automatically reformatted after the model was scanned in the dual-energy mode. Non-linear blending images were reformatted using the software of optimal contrast in Syngo workstation. Images were divided into 3 groups, including linear blending group, non-linear blending group and 120 kV group. Contrast noise ratio (CNR) were measured and calculated respectively in the 3 groups and the different figure of merit (FOM) values between the groups were compared using one-way ANOVA. Twenty patients scanned in the dual-energy mode were randomly selected and the SNR of their liver, renal cortex, spleen, pancreas and abdominal aorta were measured. The independent sample t test was used to compare the difference of signal to noise ratio (SNR) between linear blending group and non linear blending group. Two readers' agreement score and single-blind method were used to investigate the conspicuity difference between linear blending group and non linear blending group.Results With models of different CT values, the FOM values in non-linear blending group were 20. 65 ±8.18,11.40±4.25, 1.60±0.82,2.40±1.13, 45.49±17. 86. In 74. 6 HU and 112. 3 HU models, the differences of the FOM values observed among the three groups were statistically significant ( P＜0.05),which were 0.30±0. 06 and 14. 43 ±4. 59 for linear blending group, and 0. 22 ±0. 05 and 15.31±5.16 for 120 kV group. And non-linear blending group had a better FOM value. The SNR of renal cortex and abdominal aorta were 19.2±5.1 and 36. 5 ± 13.9 for non-linear blending group, while they were 12.4 ±3.8 and 22.6±7.0 for linear blending group. There were statistically significant differences between the two groups. The conspicuity scores of different organs in non linear blending group were far higher than those in the linear bending group. The Kappa value was 0. 64, showing good consistency. Conclusion Compared to the linear blending method, the non-linear blending method was a better option, especially in improving SNR and conspicuity.

Objective:To investigate the preparation, optimization and in vitro properties of riboflavin sodium phosphate floating microspheres. Methods: The floating microspheres composed of riboflavin sodium phosphate and calcium alginate were prepared using ion gelatin-oven drying method. Results: The properties of the microspheres were investigated, including the buoyancy, release, appearance and entrapment efficiency. The formulation was optimized by response surface methodology (RSM). Conclusion: The optimized microspheres were round. The entrapment efficiency was 57.49%. All the microspheres could float on the artificial gastric juice over 8 hours. The release of the drug from the microspheres complied with Fick' s diffusion.

Objective This paper is to explore the relationship between the placement of the bone oscillator and bone-conducted thresholds to ASSR stimuli in adults with normal hearing and to investigate the amplitude and the threshold differences to bone-conducted auditory steady-state responses (BC-ASSR) stimuli between single - and multiple-stimulus conditions. Methods Two groups of subjects were selected with 0. 5, 1, 2 and 4 kHz brief tones repeated at the rate of 77, 87, 93 and 101 Hz using a B-71 bone oscillator either in single- or multiple ted no significant differences between mastoid and behind-the-ear placements. The mean and standard deviations of bone-conducted behavioral thresholds to ASSR stimuli at 0.5, 1, 2 and 4 kHz were 62.6±4.8,47.1±4.8,46.8cant difference between the two conditions while the mean and standard deviations of BC-ASSR thresholds at 0.5, 1, 2 and 4 kHz were 96.7±9.7,70.3±11.6,60.6±7.4,52.8±7.2 dB re: 1μN (ppe), respectively. Conclusion The behavioral bone-conducted thresholds to ASSR stimuli with mastoid and behind-the-ear placemen yielded no significant differences. When the stimuli intensity was 50 dB nHL, the amplitudes in single-stimulus condition were significantly higher than those to multiple-stimulus condition. There were no significant differences for BC-ASSR thresholds between single- and multiple-stimulus condition.