Objective To investigate the features of clinical pathology,phenotye and differential diagnosis of thyroid follicular carcinoma-like renal tumor.Methods A 25-year-old female patient was hospitalized in February 28,2011 because of hypertension for 20 months.Physical examination revealed a right renal space-occupying lesions without percussion pain.Blood pressure was 200/130 mm Hg (1 mm Hg =0.133 kPa).Thyroid,heart,lung,and abdominal examination showed no abnormalities.Blood,urine routine,biochemical examination,blood catecholamines,and thyroid function test results were normal.CT examination showed that a visible circular nodules with clear boundary was in the upper pole of the right kidney,and the maximum section about 2.2 cm × 3.0 cm withuneven density andrenal artery was pressed down.Clinical diagnosis was right renal tumor,and right renal tumor was removed under general anesthesia.Intraoperative tumor was located in the right renal hilumwithclear boundary,and the surrounding mild adhesions.Postoperative blood pressure wasnormal.Results General inspection of the specimen:a 2.5 cm diametermasswith intact capsule.The color of the section of the mass is gray red and gray.Multiple small cysts are seen in the section and the cysts contain jelly material.Microscope inspection:the tumor tissue is arranged like thyroid follicular and the follicular contains much acidophil colloid.Immunohistochemistry:the tumor cell is EMA (+),Vimtin (+),CK7 (+),CK20 (+),CD117 (-),TTF-1 (-),TG (-),CgA (-),Syn (-).Conclusions Thyroid follicular carcinoma-like renal tumors is a very rare kidney epithelial cell tumor,which is attributable to any known subtypes of renal cell carcinoma.To improve the understanding of it can avoid misdiagnosis and prevent inappropriate treatment.

Objective To investigate the efficacy and safety of long guidewire exchange technique in performing cerebral angiography via radial artery approach.Methods The clinical data of 257 patients,who received cerebral angiography during the period from June 2014 to May 2016 at Daxing Hospital of Capital Medical University,Beijing,China,were retrospectively analyzed.Among the 257 patients,186 had type Ⅱ or type Ⅲ aortic arch.According to the different looping technologies for Simmons-2 catheter used in the performance of cerebral angiography,these 186 patients were divided into the study group (n=90) and the routine group (n=96).The success rate of radial artery puncturing,the success rate of Simmons-2 catheter looping formation,the success rate of supra-arch arterial catheterization,the time spent for angiography,the radiation exposure time,complications,etc.were recorded.Results The success rate of radial artery puncturing was 100％ in both groups.The success rate of Simmons-2 catheter looping formation in the study group was 97.8％,which was significantly higher than 72.9％ in the routine group (P＜0.05).The success rates of catheterization for the left subclavian artery,left common carotid artery and right carotid artery in the study group were 97.8％,97.8％ and 97.8％ respectively,which were remarkably higher than 72.9％,72.9％ and 72.9％ respectively in the routine group (P＜0.05).No statistically significant difference in the success rates of catheterization for right subclavian artery and for right vertebral artery existed between the two groups (P＞ 0.05).The time spent for angiography in the study group and the routine group was (22.5±9.4) min and (28.3±8.3) min respectively.The radiation exposure time in the study group was (8.9±4.5) min,which was obviously lower than (12.6±6.5) min in the routine group (P=0.017 and P=0.035,respectively).The incidences of complications in the study group and the routine group were 4.4％ and 5.2％ respectively,the difference was not statistically significant (P＞0.05).No severe complications,such as intracranial arterial embolie events,puncture bleeding,arterial occlusion,etc.,occurred in all patients of both groups.Conclusion The use of long guidewire exchange technology can improve the success rate of Simmon-2 catheter looping formation and the success rate of supra-arch arterial catheterization,it can also shorten the time for angiography procedure and reduce the radiation exposure time.This technique is very effective with higher safety.Therefore,this long guidewire exchange technique should be used as a common method for cerebral angiopraphy via radial artery approach in patients with type Ⅱ or type Ⅲ aortic arch.

Objective: 1)To revise the Social Skills Scale (SSS) and examine its psychometric properties.2) To explore the relationship between SSS and mental health. Methods:1)A sample of 394 freshmen completed the Social Skills Scale, SCL-90, and Self Consistency and Congruence Scale. Exploratory factor analysis, item analysis, reliability and validity analysis were used to revise the Social Skills Scale. 2) The relations between the SSS , SCL-90 and Self Consistency and Congruence Scale were examined.Results:Using exploring factor analysis, 5 factors were extracted, i.e. social adaptation, social perception, social confidence, social expression, and impression management. The mean inter-item correlation coefficients ranged from 0.52 to 0.77. The correlation coefficients of item and corresponding subscale ranged from 0.52 to 0.77, and the item discrimination indexes ranged from 0.32 to 0.52. Social adaptation, social perception and impression management were positively correlated with mental health. Social confidence was negatively correlated with mental health. Social expression did not correlation with mental health. Conclusion:The revised Social Skills scale was an reliable and valid measurement.

Objective To study the application efficacy of ultrasound-guided catheter lavage in patients with severe pancreatitis surgery. Methods 60 patients with severe pancreatitis from January 2009 to March 2013 in our hospital were randomly and equally divided into the experimental group and the control group. Patients of the control group were merely treated with comprehensive treatment after severe acute pancreatitis operation,and Patients of the experimental group were given ultrasound-guided catheter lavage treatment additionally. Hospital stays,clinical examination indicators and clinical effects of the two groups were analyzed. Results Hospital stay of experimental group was significantly shorter than the control group (P<0. 05);the temperature and heart rate of experimental group was significantly lower than con-trol group (P<0. 05);leukocyte,serum amylase and urine amylase of the experimental group were significantly lower than the control group (P<0. 01). The total effective rate of experimental group (93. 3%) was significantly higher than the control group (66. 7%),which means a statistically difference (P<0. 01). Conclusion Ultrasound-guided catheter lavage has good results for patients with severe pancreatitis surgery,and it is worthy of clinical application.

Objective To study the effect of the combination of pathidine hydrochloride and anisodamine on the intraoperative effiacy of transhepatic biliary drainage and stent implantation done on the patient with advanced malignant obstructive jaundice.Methods 100 cases of percutaneous transhepatic catheterizde drainage (PTCD) and percutaneous transhepatic biliary stenting (PTBS) done for advanced malignant obstructive jaundice were divided into control group and experimental group,50 cases in each group.In experimental group,100 mg pethidine hydrochloride and 10 mg anisodamine were injected intramuscularly 30 min before operation,while in control group,no analgesic or antispasmodic were used before and during operation.The blood pressure and heart rate were observed,the incidence rate of biliary-cardiac reflex and operating time were recorded,while the scale of pain felt by patient was evaluated with visual analogue scale.Results Compared to the control group,the patients in experimental group have more stable vital signs,feel more comfortable,suffering shorter operative time,less incidence rate of biliary cardiac reflex and less pain by using pethidine hydrochloride and anisodamine.Conclusion Application of pathidine hydrochloride and anisodamine during the transhepatic biliary drainage and stent implantation done on the patient with advanced malignant obstructive jaundice may release pain,reduce operating time.It is safe,at lower cost and can be used as routine medicine before PTCD or PTBS.

Objective To observe the effect of elbow support on muscle activity and subjective feelings of comfort during typing.Methods Ten college students voluntarily participated in this experiment.They typed the same text using elbow supports of five different heights.The distance between their elbows and the desk was supported at 3 cm below,0 cm,and-3 cm and-6 cm above the desk.There was also an unsupported condition.Myoelectric readings were recorded from the right splenius,trapezius,biceps,extensor carpi radialis,flexor digitorum superficialis,flexor carpi radialis,and extensor digitorum muscles.Perceptions of comfort of the neck,shoulder,hand and forearm,and hand using the different supports were surveyed using a questionnaire.Results One way ANOVA shows that the height of the elbow significantly affects the activity of the trapezius,the extensor carpi radialis and the extensor digitorum muscles.Trapezius muscle activity was higher with 3 cm high elbow support than without support,and the value was smaller when using-6 cm elbow support.The activity of the carpi radialis longus extensor was least when using-6 cm and-3 cm elbow support,and greatest with 3 cm support.Extensor digitorum activity was least when using-3 cm high elbow support and again greatest with 3 cm support.The different elbow support heights had no significant relationship with comfort perceptions for any body part.Conclusion The height of elbow support can change the average myoelectric signals from muscles during typing,but there is no significant difference in the typist's perception of comfort.This could be due to a change of typing position and neuromuscular motion control mode in response to the height of elbow support.

Objective To explore the clinical feature and diagnosis of the X linked adrenal hypoplasia congenital (X-AHC). Methods The clinical data and gene detection results of one case of AHC were retrospectively analyzed. The related literatures were reviewed. Results Two-month-old male infant was suffered with slow weight gain, vomiting, and salt craving of adrenal insufifciency after birth. Gene detection found a new missense mutation on NROB 1 gene. The diagnosis of X-AHC was conifrmed. Conclusions X-AHC is a kind of rare disease and is diagnosed by clinical manifestation, laboratory testing, and NROB 1 gene detection.

Objective To explore the design and application of the multifunctional treatment beds on patients′ position compliance and comfort after intraocular retinal reattachment surgery. Methods Eighty-six patients needing special position nursing after intraocular retinal reattachment surgery were randomly divided into experiment and control groups. The former received the special multifunction treatment beds while normal ward beds were used for the control patients . The position compliance , comfort and the complications were observed one month after surgery. Result The position compliance and the degree of comfort in the experiment group were significantly better than those in the control group and the complication rate was significantly lower than that of the control group (all P<0.05). Conclusion The special multifunction treatment beds can be effective in increasing the patients compliance in positions and compliance as well as reducing postoperative complications and increasing the operation success rate.

Objective To investigate the values and characteristics of 75 g oral glucose tolerance test (OGTT) in pregnant women.Methods A total of 6 103 singleton pregnant women aged (30.4±3.8) years (18-49 years) who delivered in Peking University First Hospital between May 1,2011 and December 31,2012 underwent the 75 g OGTT at gestational age of 24-28 weeks.They were divided into five groups based on maternal age:＜25 years (n=222,3.6％),25-years (n=2 485,40.7％),30-years (n=2 573,42.2％),35-years (n=683,11.2％),and ≥ 40 years (n=140,2.3％).The normal values of the fasting,1 h and 2 h blood glucose were lower than 5.1,10.0 and 8.5 mmol/L.Gestational diabetes mellitus (GDM) was diagnosed when blood glucose of any point was higher than or equal to normal value.Comparison between groups was tested by analysis of variance and LSD test.Logistic regression was used to calculate the risk for GDM in different age groups.Results (1) The fasting,1 h and 2 h blood glucose levels were in Gaussian distribution.The （-x）+2s were 5.51,11.12 and 9.49 mmol/L.The 97.5 percentile were 5.63,11.32 and 9.95 mmol/L.Fasting plasma glucose of ＜ 25,25-,30-,35-,and ≥ 40 years were (4.53±0.40),(4.60±0.40),(4.67±0.43),(4.74±0.46) and (4.82±0.49) mmol/L.The 1 h blood glucose were (6.98± 1.70),(7.55± 1.60),(7.92± 1.63),(8.30± 1.71) and (8.76± 1.86) mmol/L.The 2 h blood glucose were (6.11±1.33),(6.53±1.27),(6.89±1.33),(7.23±1.50) and (7.57±1.60) mmol/L.Therewas statistical difference in the blood glucose levels at a same time-point test among different age groups (F=29.61,60.17 and 72.29,all P＜0.01).(3) The total prevalence rate of GDM was 21.1％ (1 290/6 103) ; and the prevalence rates were 9.9％ (22/222),16.7％ (414/2 485),22.7％ (583/2 573),32.1％ (219/683) and 37.1％ (52/140) among the five age groups,respectively,with significant differences (x2=120.68,P=0.00).Compared with the group aged ＜25 years,the OR (95％CI) of the prevalence among 25-,30-,35-,and ≥40 years group were 1.82 (1.16-2.86),2.66 (1.70-4.18),4.29 (2.69-6.86) and 5.37 (3.08-9.39),respectively.Conclusions Advanced age is a risk factor for GDM.The risk of GDM increases significantly after 35 years old and pregnancy in women aged ＜ 35 years can reduce the risk of GDM.

According to the operational principle of original switch K2 for the console of orthopantomography X-ray unit, the common switch K1 and some accessory circuits are used to improve K2.