Objective To investigate the inaccurate causes of platelet(PLT)count and to propose the correcting measures.Meth-ods 180 specimens of abnormal PLT count were collected and divided into 4 groups:low PLT count group (PLT ≤20×109/L,72 cases),microcyte group(54 cases),large platelets group(33 cases)and platelet aggregation group(21 cases).The PLT count was simultaneously performed by using the three ways of the optical method (PLT-O),impedance method (PLT-I)and manual micros-copy method (PLT-M).The detection results were analyzed by the paired t test.Results The PLT count in the low PLT group, microcyte group and large platelets group had no statistical differences between PLT-O and PLT-M(P >0.05),and had statistical differences between the PLT-I and PLT-O(P <0.05).The PLT count of PLT-O in the platelet aggregation group was more close to actual value than that of PLT-I(P <0.05).Conclusion The PLT count by PLT-I has many influencing factors,which are mainly the microcytes interference leading to higher PLT count,missed detection of large PLT leading to lower PLT count,PLT aggrega-tion,etc.When the PLT count appears abnormal,the re-detection should be conducted according to the re-detection regulation, which can be corrected by adopting PLT-M or PLT-O,in necessity,the blood specimen could be re-collected for detection.

Objective To investigate current status of general practice service teams in urban Shanghai to provide practical evidence and lay theoretical basis for sustainable development of general practice service teams in the future. Methods A cross-sectional study was carried out for 40 staff members of eight general practice service teams in eight urban districts of Shanghai, as well as 110 local residents, by observation, interview and questionnaire methods during March to April 2008. Results Among 21 general practitioners, 86 percent of them ( 18/21 ) were graduated from medical colleges or universities with three-year curriculum or at levels above it and 52 percent ( 11/21 ) had intermediate professional titles or above.Among the eight general practice service teams, five had full coverage of supervision and management for tuberculosis therapy, six had full coverage of management for tumor patients, four had full coverage of management for cardiovascular and cerebrovascular diseases and four had full coverage of management for patients with mental disorders. In all staff members of eight general practice service teams, 38 percent of them (15/40) were satisfactory with their working environment, 40 percent (16/40) with their work activities, five percent (2/40) with their incomes, and 28 percent (11/40) with their professional future.In 110 local residents, 77 percent (85/110) were satisfactory with service environment, 85 percent (93/110) with quality of health-care service and 89 percent (98/110) with the attitude of service teams.Conclusions Implementation of management for chronic diseases and two-way referral, as well as satisfaction of staff members in general practice service teams should be improved further.

This paper summarized nursing experience of one patient with diffuse esophageal spasm(DES) undergoing peroral endoscopic myotomy (POEM).Key points of nursing included:preoperative training of use of medical bedpan;respiratory functional exercises;postoperative management of body position,nursing of gastrointestinal decompression,management of refined diet and prevention and nursing of complications.The patient recovered well and no complication occurred.The patient was discharged on the eighth day after surgery.

Objective 　To evaluate the CT manifestation of pancreatic cancer. Methods 　The CT signs of 18 cases of pancreatic cancer which include 13 cases of pancreas caput cancer,3 cases of pancreas corpus cancer and 2 cases of panceras cauda cancer were studied and compared with 7 cases of duct ampulla cancer,5 cases of duodenal papilla cancer,4 cases of inferior choledochus duct cancer and 3 cases of inflammatic mass in pancreatic caput.All of cases have pathologic results.The study were performed with plain and contrast scan with PQ－2000 CT set and then the 3～5mm thin slice dynamic study were performed in the ROI.The artery phase and venous phases were studied. Results　The characteristic signs of pancreatic cancer includes： no enhancement of pancreas mass;pancreas atrophy inferior mass;enlargement of venous arch of pancreas caput and superior mesenteric artery;obscure retropancreas space and distance increasing between inferior choledochus duct and proximal pancreatic duct. Conclusion　It is valuable to diagnosis of pancreatic cancer with HRCT.

Objective To identify nurses' practice of 5A's smoking cessation intervention in clinical settings of Beijing.Methods A cross-sectional survey was conducted among 248 nurses by convenient sampling.The questionnaire included the frequency of nurses' practice of 5A's intervention and its influencing factors,nurses' self evaluation of competency,and tobacco-related curricula in school of nursing.Results Most nurses implemented “advice” and “evaluated the patients' smoking history and current status” more frequently,but nurses' practice of other interventions was dissatisfactory.The belief that smokers could benefit from quitting was facilitating,however the barriers included no motivations to quit smoking,heavy work,and the belief that helping smokers to quit is not the priority in nursing routine.The nurses got insufficient knowledge about smoking cessation through school education and in-service training (12.8％).Conclusions There's a big gap between the implementation of nurses' smoking cessation intervention,accepted smoking cessation education,smoking cessation intervention competency and the urgent demands to help patients quit smoking.

OBJECTIVE To study the clinical and radiological characteristics of jugular foramen tumors.METHODS The clinical data of 32 patients with tumors of jugular foramen region treated from May 2006 to December 2009 were retrospectively reviewed.All patients were referred to systematic imaging examination of the temporal bone,such as CT(X-ray computed tomography) and MRI(magnetic resonance).Twenty two patients were further examined by angiography and embo1ized 24 hours before operation.Thirty one patients underwent different operations via different approaches, while one patient with glomus jugular tumor didn't receive operation because of fever caused by sigmoid sinus thrombophlebitis.According to pathologic examination, 21 cases were glomus jugular tumors, 10 cranial nerve neurilemmomas.RESULTS In the 32 cases, the major initial clinical symptoms of jugular foramen tumors were tinnitus,hearing loss and facial palsy.Bone erosion and the "salt and pepper" sign were the characteristic appearance of glomus jugular tumor.Neurilemmoma showed compressive bone change, cystic area and moderate enhancement on CT.CONCLUSION The combination of CT and MRI examination is benefit for both diagnosis and the choice of surgical plan.

There are some problems in the course of evaluating teaching quality in colleges and universities, such as theunclear aim of evaluation, few teachers taking part in evaluating, and problems existing in participants which affect thequality of evaluation. Some related measures are made here to solve the problems.[

Objective To explore the optimal situation of labeling bone mesenchymal stem cells (BMSCs) with superparamagnetic iron oxides (SPIO) mediated by poly-L-lysine (PLL), and determine the most optimal protocol of magnetic resonance imaging according to the patterns of MR in vitro. Methods BMSCs were isolated from white rat and purified, incubated with SPIO-PLL complexes at the range of concentrations (0, 4.2, 8.4, 21, 42, 84 ?g Fe per ml medium). The labeling ratio and distribution of SPIO particles in BMSCs, and the morphological evidence of abnormal visualization were evaluated by Prussian blue staining, fluorescent microscope and electron microscopy. MTT growth curves and magnetic resonance imagings were obtained at the range of concentrations. Trypan blue exclusion test was performed to elevate the viability of BMSCs labeled with PLL at the range of concentrations (0, 0.05, 0.25, 0.5, 1.0, 5.0 ?g PLL per ml medium). Results The cellular labeling ratio was strongly correlated to the concentrations of SPIO (P

BACKGROUND: As magnetic resonance (MR) contrast, a large number of clinical and experimental researches have been done on superparamagnetic iron oxide (SPIO), while the report on the labeled cell passaged cells is rare.OBJECTIVE: MR imaging was performed to the labeled bone mesenchymal stem cells (BMSCs) and its passaged cells in vitro, in order to establish the base of monitoring magnetic labeled BMSCs with magnetic resonance imaging (MRI) in vivo.DESIGN, TIME AND SETTING: The cytological in vitro experiment was performed at the Imaging Research Institute and Institute of Rheumatology and Immunology of North Sichuan Medical College Hospital from June 2006 to January 2007. MATERIALS: Two clean female albino rats (Animal Center, North Sichuan Medical College), SPIO (Schering AG,Germany) were used in this study.METHODES: Bilateral femur and tibia bone marrow was extracted from rats. BMSCs were harvested and purified using the adherent method, and then labeled with 600 μL ferric oxide-polylysine compound (42 mg/L iron concentration) in vitro. MAIN OUTCOME MEASURES: Cell maker-positive rate and the MR signal intensity were respectively measured to the labeled cells and its passaged cells under the inverted microscope and magnetic resonance imaging. RESULTS: Following Prussian blue staining, labeling rate of SPIO labeled cells at the first passage was 100%. With increased passage, the labeling rate was reduced from the first to fifth passages. Compared with non-labeled PBS control, there was no significant difference in signal intensity in the first and second passages cells, but the signal intensity percentage was gradually decreased with signal intensity of increased cell passage from the third passage. Cell labeling rate was negatively correlated with T2~*WI signal intensity (r=-0.986 6, P <0.005). CONCLUSION: The iron particles in the magnetic labeled cells can be passaged to the offspring cells, and can be monitored in a certain period of time with MRI in vitro. These results firstly introduced that SPIO-labeled cell iron particles can decrease with cell passage.

Objective To investigate the value of intraoperative neuromonitoring(IONM) for preventing recurrent laryngeal nerve(RLN) injury in thyroid surgery.Methods 1087 consecutive patients undergoing thyroid surgery at Wuhan Central Hospital from Oct 2010 to Dec 2012 were evaluated.277 cases(the study group) underwent thyroidectomy with RLN identification by naked eye plus IONM.810 cases(the control group)underwent thyroidectomy with RLN identification by naked eye only.Results In the control group,733 RLNs (90.49％,733/810)were successfully identified and 77 RLNs were failed to be identified.In the study group,all the 277 RLNs(100％,277/277)were successfully identified.28 cases had postoperative temporal RLN injury,among whom 26 cases were in the control group and 2 cases were in the study group.18 cases in the control group and 2 cases in the study group recovered in 2 weeks after surgery.The rest recovered in 2 months after surgery.RLN injury rate was significantly lower in the study group than in the control group.There was no significant difference in RLN injury for low-risk surgical patients between the 2 groups; however,the study group had advantages in RLN injury than the control group for high-risk patients.Conclusions IONM in thyroid surgery can improve the recognition rate of RLN during thyroidectomy.IONM can significantly reduce the incidence of RLN injury,especially in high-risk surgery.