Objective To design a vehicle-mounted X-ray diagnosis simulation training system based on the field X-ray diagnostic vehicle to solve the problems during its training and utilization.Methods The field X-ray diagnostic vehicle had its internal and external structure analyzed,and was divided into several functional modules.The technologies of computer programming and database were used for the simulation of the modules.An example was given to simulate the operating process of the vehicle by establishing traumatic condition model,war injury image library and etc.esults The system developed realized the simulation training of the vehicle,and the trainee gained feedback after simulation as references.Conclusion The system implements informatized training of the field X-ray diagnostic vehicle,shortens the training period,decreases the training cost and increases the training efficacy.

Lymph node dissection was the key procedure of pancreatic surgery.The majority of guidelines indicated that extended lymph node dissection was helpless for improving survival rate.However,there were still quite a few researches which demonstrated that the extended dissection was a valuable procedure.It was still a controversial topic considering lymph node dissection.To review the shortcomings of previous randomized controlled trials (RCT),this article combined the experience of new techniques in pancreatic surgery,which are developing rapidly in recent years,and our theory and practice of radical resection of retroperitoneal lipo-lymphatic layer (RRRLLL).Therefore,the controversy and update of extended lymph node dissection for pancreatic head carcinoma were discussed,which could provide references for standardizing the treatment of extended lymph node dissection in clinical practice.

Objective To investigate the streptomycin(SM)-resistance of Mycobacterium tuberculosis (MTB) in urine and to examine their relationships with the mutation of rspL gene. Methods 47 strains of MTB were isolated from the urine of patients with renal tuberculosis.The mutation of rspL gene were analyzed by PCR-SSCP with silver-staining,and the strains were tested for the sensitivity to streptomycin. Results All the 47 strains had positive expression of rspL gene of MTB,with 28 SM-resistant and 19 SM-sensitive.Among the 28 SM-resistence strains 19(68%) had rspL gene mutation by SSCP testing.The 19 strains of SM-sensitive had no mutation. Conclusions Detecting mutation of MTB rspL gene in urine by PCR-SSCP can rapidly and exactly identify the MTB's sensitivity to streptomycin,which is significantly important in clinical treatment of anti-tuberculosis.

The aticle briefly introduced the working principle and clinical applicability of Coblation. The application of Coblation promoted the improvement of traditional surgery and the generation of new operation, it is the most important to hold the indication of the operation strictly. This review summarized that and discussed the advantages and the notes of Coblation in operations of the pharynx and larynx.
Humans ; Larynx ; surgery ; Laser Therapy ; Pharynx ; surgery

Central pancreatectomy is an ideal surgical procedure for the treatment of benign or low-grade malignant tumors in the pancreatic neck or the proximal body of the pancreas,and it can preserve more normal pancreatic tissue in order to reduce the incidence of endocrine and exocrine insufficiency after surgery.Although some clinical studies have demonstrated the feasibility and safety of this procedure,laparoscopic central pancreatectomy was technically challenging with a few number of cases.This article reviews the current status of laparoscopic central pancreatectomy and introduces our clinical experience of laparoscopic central pancreatectomy and pancreaticojejunostomy.

Objective To analyze blood-CSF barrier and cerebrospinal intrathecal IgG synthesis in patients of multiple sclerosis, and explore the Protis software, IgG index and IgG synthesis rate in the and evaluation for cerebrospinal intrathecal IgG synthesis and blood-CSF barrier dysfunction. Methods 134 patients with neurological diseases were divided into threes groups, including multiple sclerosis group (34 cases), disease control group(80 cases) and control group(20 cases). IgG and ALB concentration of CSF and blood was detected by BN-Ⅱ. The oligoclonal IgG was detected by immunofixation electrophoresis. The relationship between Protis software results and IgG index or IgG synthesis rate was calculated and analyzed. Results The function of blood-brain barrier was almost normal in multiple sclerosis group,QALB was 4.5×10-3[(3.1-7.6)×10-3], there was no significance compared with control group (D=5.25, P>0.05). there were 31 patients with oligaclonal bands in cerebrospinal fluids in multiple sclerosis group (34 patients) with the positive rate of 91.2%. In multiple sclerosis group the intrethecal IgGIF, IgG index and IgG synthesis rate of 24 hours were 31.25% (11.65%-71.45 %), 0.93% (0.80%-1.04%), 24.25 mg/24 h(15.25-46.15 mg/24 h) ,the results were all higher than that in control group (D=175.5, 112.5,103.4,P<0.05). And in multiple sclerosis group there was no significant difference among the intrethecal IgGIF, IgG index and IgG synthesis rate of 24 hours, the positive rate of oligaclonal bands (P>0.05). In disease control group(80 patients) QALB Was 35.2×10-3[(18.5-55.5)×10-3] ,the result was significantly higher than control group (D=102.7, P<0.05), the oligaclonal bands were all negative, IgG index and IgG synthesis rate of 24 hours were 0.75(0.69-0.82) ,44.29 mg/24 h(20.35-65.98 mg/24 h) were both higher than control group(D=85.6,98.5,P<0.05). In disease control group the positive rate of intrathecal IgGIF, IgG index and IgG synthesis rate of 24 hours were 0 (0/80), 40.0% (32/80), 72.5% (58/80) respectively, IgG index and its positive rate both increased alone with the lesion degree of blood-brain barrier increasing (P<0.05). And there was similar trend in the IgG synthesis rate of 24 hours. There were significant correlations among intrathecal IgGIF, IgG index and IgG synthesis rate of 24 hours in multiple sclerosis group (r=0.788, 0.695 ,P<0.05). However there was no correlation among intrathecal IgGIF, IgG index and IgG synthesis rate of 24 hours in disease control group (r=0.000,P>0.05). Conclusions The Protis software can be used to analyze the intrathecal IgGIF and reflect the actual status of intrathecal IgG synthesis more accurately. Protis software has great application value for clinical diagnosis for nervous system disease.

BACKGROUND: With the development of neural interventional therapy, the application of covered stents in neural intervention is becoming a topic of general interest.OBJECTIVE: To introduce the structure of stent-graft, and to summary the application of covered stents in clinical treatment of the neural interventional therapy and the shortage of covered stents.RETRIEVAL STRATEGY:The relevant articled were searched for in Pubmed database by researcher of this article with the key words of "stent graft, covered stents, cerebrovascular disease" in English, and with the key words of "covered stent, cerebrovascular disease" in Chinese in VIP database. 223 English and 196 Chinese articles were selected and reviewed primarily. Inclusive criteria: Articles having a close relation with the application of covered stents in neural intervention, especially in cerebrovascular disease, and the latest articles or articles published in authority journals in the same field were chosen. Exclusive criteria: articles with repetitive studies were excluded.LITERATURE EVALUATION: 223 English and 196 Chinese articles were primarily checked by reading titles and abstracts. Among the 31 collected articles, 4 are reviews, 3 are experimental studies and others are clinical studies.DATA SYNTHESIS: Covered stents show special advantages in neural interventional therapy and become a hot spot in present study. There are individual case reports or small group case reports on the application of covered stents in hemorrhagic cerebrovascular disease. It is reported that the covered stent effectively occludes aneurysm, dissecting aneurysm and arteriovenous fistula, keeps patency of the parent artery. The covered stent isolates ulcerated plaque via physical barriers, avoids the abscission of embolus, which can further reduce the development of embolism in percutaneous carotid artery stenting. After releasing covered stents, polytetrafluoroethylene makes the disepiment smooth. Its good biocompatibility reduces thrombosis, and then decreases the incidence of restenosis. Covered stents in vessel for cerebrovascular disease have achieved good effects, but there are some problems in clinic as follows. ①The main shortage of covered stents is to occlude small branch vessels. ②Thrombosis and restenosis occur after covered stenting. ③Covered stents increase the volume of the stent, reduce the compliance and flexibility of the stents, and increase the pushing difficulty and vascular injury. ④Covered stents cannot be used in vessels of less than 4 mm.CONCLUSION: Covered stents for intracranial ischemic and hemorrhagic diseases shows significant outcomes, but there are disadvantages. With the clarification of the related theories and the improvement of new material technology, there will be a brighter future of the application of covered stents for treatment of cerebrovascular diseases.

ObjectiveTo explore the cytogenetic characteristics of multiple myeloma (MM) patients,to evaluate the effect of a long-term culture stimulated by cytokines on cytogenetic study of MM,and to investigate the clinical detection value of RB1 and P53 deletion in interphase plasma cells by using fluorescence in situ hybridization (FISH).MethodsKaryotype analysis was performed in 81 MM patients by using the short-term culture of bone marrow cell and G-banding technique.Among the 81 MM patients,28 patients used two culture methods:one was the short-term culture and the other was to culture cells for 6 days with recombinant granulocyte-macrophage colony-stimulating factor (GM-CSF) (40 μg/L) and IL-6 (10 μg/L).RB1 and P53 deletion were detected on interphase plasma cells by using FISH in 31 patients.ResultsAmong the 81 patients,75 had enough metaphases for analysis.Among the 75 patients,31 (41.3％)had clonal karyotypic abnormalities including 4 numeric abnormalities,11structural abnormalities and 16 both abnormalities.Among the 28 patients using two culture methods,the clonal karyotypic abnormalities were detected in 6 patients(25.0％ ) in the group of cultured for 24 hours,and 14 patients (51.9％) in 6-day culture group with a significant difference (P =0.026).RB1 deletion and P53 deletion were detected in 10 patients (32.3％ ) and 11 patients(35.5％ ),respectively,with both RB1 and P53 deletions be detected in 5 patients ( 16.1％ ).ConclusionsMore than half of the tested MM patients have both numeric and structural chromosome abnormalities.The karyotype analysis using banding technique is basic cytogenetic study.Extended culture in the presence of IL-6 and GM-CSF could improve the efficiency of cytogenetic analysis to MM.Interphase FISH is a sensitive method of clinical application significance to detect the gene deletion of MM.

Objectives The aim of the study was to detect the frequency of B regulatory cells (Breg)and the correlation between Breg and T regulatory cells (Treg) in pancreatic cancer patients,and to investigate its role in pathogenesis of pancreatic cancer.Methods 50 pancreatic cancer patients and 21 healthy controls were enrolled.CD19+CD24hiCD38hi Breg and CD4+CD25high Treg was also determined via flow cytometry.The correlation between Breg and Treg was analyzed by Spearman correlation test.Results Upregulation of CD19+CD24hiCD381hi Breg was associated with pancreatic cancer progression.Furthermore,this B cell subset was positively correlated with the frequency of CD4 + CD25high Treg cells.Conclusions Together,CD19 + CD24hiCD38hi Breg cells are significantly elevated in pancreatic cancer patients,indicating this B cell subset might play an vital role in clinical progression of pancreatic cancer.The significant positive correlation between Breg and Treg may suggest CD 1TCD24hiCD38hi Breg are affecting tumor progression through Treg cells.

Objectives To investigate current status in asthma education in the remote suburban districts and counties of Beijing and to provide basis to draw up and modify the work plan for asthma education. Methods Ten district or county hospitals in the remote suburban areas of Beijing were investigated, and 81 professionals in respiratory disease subspecialty of internal medicine were selected to answer the questionnaire and their practical performance was observed, including 35 residents, 27 attending physicians and 19 chief or deputy chief physicians. Results Only 8.6% (7/81) of them could correctly answer the question "What is the GINA?" And, 55.6% (45/81) of them could correctly answer the question "Is the Guidelines for Prevention and Treatment of Asthma in China formulated by Chinese Society of Respiratory Disease, Chinese Medical Association? " About one fifths of the interviewee (22.2% , 18/81) could correctly master the six steps in manipulation of metered-dose inhaler. Nearly two thirds of the interviewee (31.7% , 50/81) could correctly answer that "Inhalation of glucocosteroids is the most important treatment to control persistent episodes and chronic symptoms in asthma patients and to prevent asthma attack. About two thirds of physicians (61.7% ,50/81) did not attend any lectures or workshops on asthma during the recent year, and only 22 of them attended lectures or workshops on asthma sponsored by the medical association, reflecting its influence in asthma education. Only 15 of 81 physicians (18.5%) could instruct a few patients to use the peak airflow meter to monitor their conditions, and other 81.5% of the physicians "never heard about peak airflow meter" or "having ever heard about it but never instructed the patients to use it". Conclusions Asthma education by the respiratory disease specialists in the hospitals at remote suburban districts and counties hasn't improved obviously. It is worthy to have a try in changing and modifying asthma education model and going round the remote suburban districts and counties to provide asthma education.