Japan has accumulated much mature experience in hospital management, which is worthy of being drawn upon by hospital managers in China. By means of an account of the model of ward rounds by doctors at three levels, the system of academic previews and the system of regular meetings for copying down and reading medical papers in foreign languages in Japanese hospitals and in light of the situation of domestic hospital management, the paper discusses measures for improving the system of ward rounds and scientific research management. The goal is to enhance the medical expertise levels, scientific research capabilities and foreign languages proficiency of medical workers in China so as to deliver better medical and healthcare services to the broad masses of the people.

Objective In order to improve diagnosis of pulmonary thromboembolism(PTE),the clinical features of pulmonary embolism between older and younger patients were compared.Methods Totally 105 patients(57 older and 48 younger)with diagnosed PTE were assessed retrospectively.Results There were more risk factors in the elderly as compared with younger group.Phlebitis was the major risk factor in both groups.Other risk factors,such as COPD,immobilization,malignancy and cardiac disease,were more frequent in the elderly;whereas in younger patients,intravenous drug injection and genetic factors were more frequent.Chest pain and hemoptysis were less frequent in older patients whereas syncope occurred more often in the older group."Triplicate symptoms" (including dyspnea,chest pain and hemoptysis)occurred more often in the younger group.Massive PTE occurred more often in the older patients.Severe complications were more frequent in cTnT-positive patients.Conclusion There are more risk factors in the elderly.The clinical presentation of PTE is often atypical in elderly patients,and prone to develop massive PTE.cTnT(Cardiac troponin T)is an independent predictor of prognostic implications in patients with confirmed PTE.

Objective To understand the clinical feature of the elderly patients with diabetes during coronary angiography,and analyze the risk factors of contrast-induced nephropathy (CIN).Methods The clinical data of 269 elderly patients who had undergone coronary angiography and percutaneous coronary intervention(PCI) from January 2007 to December 2009 in our hospital were analyzed retrospectively.The patients were divided into two groups:CIN group and non-CIN group.The possible risk factors for CIN,such as glycemic control,diabetic complication,renal function,volume of contrast medium,inflammatory state,therapy of perioperative period,past medical history were analyzed and compared between the two groups. Results In 269 elderly patients with diabetes,the incidence of CIN was 9.3 ％ (25/269).According to estimated glomerular filtration rate (e-GFR),the patients were divided into four subgroup:≥90 ml/min,89-60 ml/min,59-30 ml/min,＜29 ml/min.The incidences of CIN for the subgroups were 2.2％(1/45),4.4％(6/135),17.3％(14/81) and 50 ％ (4/8),respectively.Multivariate logistic gradual regressive analysis showed that loop diuretic use (OR＞ 6.07),preoperative e-GFR(＜60 ml/min) (OR＞3.27),volume of contrast medium (≥200ml) (OR＞3.26),chronic kidney disease(CKD) (OR＞2.80) (P=0.001,0.024,0.015,0.048) were indepen-dent risk factors for CIN (P＜0.05). Conclusions Loop diuretic use,preoperative GFR (＜60 ml/min),volume of contrast medium (≥200 ml) and CKD are independent risk factors of CIN.

Objective To investigate the imbalance between T helper 17 (Th17) cells and CD4+CD25+ regulatory T (Treg) cells in the peripheral blood of patients with psoriasis vulgaris and its significance. Methods Peripheral blood were collected from 48 patients with psoriasis vulgaris and 32 normal human controls. Pasoriasis area and severity index (PASI) was used to assess the disease severity in these patients. Flow cytometry was performed to determine the percentage of Th17 and Treg cells in peripheral blood, enzyme linked immunosorbent assay (ELISA) to measure the levels of serum interleukin (IL) -17 and IL-10. Results There was a significant increase in the percentage of Th17 cells [(2.70 ± 1.43)% vs. (0.86 ± 0.25)%, P< 0.01] and serum IL-17 level (90.65 ± 29.61 ng/L vs. 48.82 ± 5.49 ng/L, P < 0.01), but a decrease in the percentage of Treg cells [(3.63 ± 1.14)% vs. (7.87 ± 1.26)%, P< 0.01] and serum IL-10 level (17.78 ± 4.09 ng/L vs. 23.76 ± 3.82 ng/L, P <0.01) in patients with psoriasis vulgaris compared with the normal controls. The ratios of Thl7 to Treg cells and serum IL-17 to IL-10 level were significantly higher (0.95 ± 0.76 vs. 0.12 ± 0.06, 5.78 ± 3.19 vs. 2.16 ±0.68, both P < 0.01) in the patients than in the normal controls. The PASI score in patients was positively correlated with the percentage of Th17, serum level of IL-17, Th17/Treg ratio and IL-17/IL-10 ratio (r = 0.97,0.93, 0.99 and 0.97, all P < 0.01), but negatively correlated with the percentage of Treg cells and serum IL-10 level (r = -0.87, -0.90, both P < 0.01). Conclusion The imbalance between Th17 and Treg cells may play an important role in the pathogenesis of psoriasis vulgaris.

Air ; analysis ; Chlorpyrifos ; analysis ; Chromatography, Gas ; methods ; Workplace

Objective To investigate the expression of heparanase in non-melanoma skin cancer including cutaneous squamous cell carcinoma (CSCC) and basal cell carcinoma (BCC) and the relationship among heparanase expression and pathologic grading and lymph nodes metastasis of CSCC. Methods The expressions of heparanase were detected by RT-PCR assay and immunohistochemical staining in 38 cases of CSCC, 33 BCC and 19 normal human skin tissues. Then the relationship between heparanase expression and CSCC clinical pathological features was explored. Results The positive rate ( 68.4%, 60. 5% ) of heparanase mRNA and heparanase in CSCC (24. 2%, 18. 2% ) was significantly higher than those of BCC and normal skin tissue ( 10. 5% ,5.3% ) ( P <0. 01 ) . Heparanase expression rate in CSCC with lymph nodes metastasis (92. 3% ,84.6% ) and Ⅲ～Ⅳ(Broders) (92. 3% ,84. 6% ) was higher than those in tumor without lymph nodes metastasis (56. 0% ,48.0% ) and Ⅰ～Ⅱ (Broders) (56. 0% ,48. 0% ) ( P <0. 05). Conclusions Heparanase was over-expressed in CSCC compared with BCC and normal skin tissues. Expression of heparanase was correlated to pathologic grade and lymph nodes metastasis of CSCC.

Animals ; Asthma ; drug therapy ; metabolism ; Genistein ; pharmacology ; therapeutic use ; Guinea Pigs ; Interleukin-4 ; genetics ; metabolism ; Janus Kinase 1 ; genetics ; metabolism ; Lung ; metabolism ; Male ; Protein Kinase Inhibitors ; pharmacology ; therapeutic use

Objective To compare the value of (~99m) Tc-octreotide scintigraphy and planar X-ray mammography in the diagnosis of breast cancer. Methods A total of 32 patients with suspected breast cancer were enrolled into this study. All patients underwent (~99m) Tc-octreotide scintigraphy and planar X-ray mammography. The diagnostic efficiency of (~99m) Tc-octreotide scintigraphy and planar X-ray mammography were compared based on the post-surgery pathology. Results The sensitivity of (~99m) Tc-octreotide scintigraphy and planar X-ray mammography in the diagnosis of breast cancer was 91.67% and 66.67%, the specificity was 100% and 37.50%, the accuracy was 93.75% and 59.38%, respectively. Combining (~99m) Tc-octreotide scintigraphy with planar X-ray mammography, the sensitivity, specificity, accuracy, positive predicting values and negative predicting values for breast cancer was 95.83%, 100%, 96.88%, 82.14% and 47.06%, respectively. Conclusion The diagnostic efficiency of (~99m) Tc-octreotide scintigraphy for breast cancer is superior to planar X-ray mammography. (~99m) Tc-octreotide scintigraphy combined with planar X-ray mammography, the diagnostic efficiency for breast cancer will be further improved.

Objective To explore the clinical features and operative method of complicated spinal tuberculosis. Methods Totally 562 inpatients suffering from spinal tuberculosis during January 1997 to December 2006 were reviewed retrospectively. A new definition of complicated spinal tuberculosis was made. Complicated spinal tuberculosis was classified into different types. Every type had its special surgical operation approach. Results Among the 87 cases being followed up for 45 months, 75 patients were totally recovered, and 12 patients were obvious improved on the mend according to Dr. Fang Xian-zhi’s standard. The classification of function which above good was 97.1%. The fusion rate was 96.3% during 87 patients who received bone grafting treatment 9 months ago. Posterior convex angle was 24? to 57?, average 35.3?. Conclusion We consider that complicated spinal tuberculosis will not be surgical contraindication. Different types of complicated spinal tuberculosis by different operation approach, and careful preparation before operation will gain good curative outcome.

The interventional treatment of lung cancer is tightly related with hemodynamic situation of artery.To study hemodynamics of the interventional treatment of lung cancer can significantly improve curative effect and decrease complications.Through simulation experiment,the ratio of drug injection around the entrance of bronchial artery is obtained and the definition of natural perfusion region is given.The evidence for interventional treatment of lung cancer and the principle avoiding high-level paraplegia in clinical interventional treatment of lung cancer are also presented.