0.05).The AI of tumor cells was(9.7?0.9)% in mice treated with endostatin compared to that (1.9?0.4)% in the group of control ( P

Objective To evaluate efficacy in detecting lung nodules at low-dose CT(LDCT) by nodule enhanced viewing(NEV).Methods One hundred and twenty seven patients who were referred to undergo low-dose CT (LDCT) for the evaluation of pulmonary metastasis or screening lung cancer were selected randomly.Two radiologists with at least 10 years experience read the images with normal clinical reading speed to find actionable nodules ≤ 2.0 cm in maximum diameter,and their consensus result was referred as Standard.NEV was adopted to detect the pulmonary nodules.Two residents with experience of less than three years read first detected suspicious nodules and recorded reading time,first consensus and mean time were recorded.Then,they made second decisions on the images with the help of NEV and the results and the reading time were recorded and analyzed by using wilcoxon test.The sensitivity and accuracy of NEV,residents and residents with NEV were analyzed.Results Standard,resident,NEV and resident with NEV detected 570,404,768 and 593 lung nodules ≤2.0 cm in maximum diameter,respectively.More than 60％ nodules were less than 0.5 cm in maximum diameter.The performance of NEV in detecting nodules ≤2.0 cm as well as nodules ＜ 0.5 cm in maximum diameter was significantly higher than that of the resident(Z =-6.887,P ＜0.01 and Z =-7.235,P ＜0.01),and the performance of resident with NEV indetecting nodules ≤2.0 cm as well as nodules ＜ 0.5 cm in maximum diameter was significantly higher than that of resident without NEV (Z =-6.606,P ＜ 0.01 and Z =-6.657,P ＜ 0.01).The resident,NEV and the resident with NEV detected nodules ＜ 20 mm in maximum diameter with sensitivities of 61.4％,86.3％ and 95.3％,and with accuracy of 56.1％,58.1％ and 87.6％,respectively.The resident achieved sensitivities of 51.4％,88.1％ and 94.8％,and accuracy of 47.0％,56.9％ and 87.5％ for nodules ＜5 mm in maximum diameter,respectively.The resident,NEV and resident with NEV spent 120-444 s,85-262 s and 131-1512 s per case to read the CT scans,respectively.The reading time of resident with NEV in was significantly higher than that of resident without NEV(Z =-9.781,P ＜ 0.01).The resident spent 23 s per NEV mark.Conclusion NEV considerable improves the resident's performance in lung nodule detection,especially in maximum diameter ＜ 0.5 cm nodule detection.

OBJECTIVE:To standardize periooperative prophylactic application of antibiotics. METHODS:According to the characteristics of orthopaedic and parenchyma surgery,classifying evaluation table of typeⅠincision infection risk was designed sci-entifically and rationally. The individual application of antibiotics in surgery patients had been achieved through infection risk evalua-tion. High risk typeⅠincision patients used antibiotics rationally and low risk patients seldom used or didn’t use at all. RESULTS:Through using infection risks classifying table,the rate of antibiotics prophylactic application in typeⅠincision drops from 74.10%to 28.68%,and and the per capita duration of antibiotics prophylactic application shortened from 4.23 d to 2.21 d. The postopera-tive infection rate remained the same. CONCLUSIONS:Through infection risk classifying evaluation,individual application of anti-biotics can be achieved in surgery patients,so as to promote rational use of antibiotics for prophylactic use,reduce antibiotics dos-age and antibiotics abuse under the condition of controllable surgery infection.

Objective In order to find the polymorphism site applicable to efficient genetic diagnosis on Haemophilia A in Han Chinese Population in Wenzhou.Methods With the method of polymerase chain reaction(PCR) and polyacrylamide gel electrophoresis(PAGE),288 of X chromosomes from 96 men and 96 women were detected on the polymorphism of BCL I in the intron 18 of FV Ⅲ gene.Results The gene frequency of the polymorphic site BCL I was 34.38% in Han Chinese population in Wenzhou.43.75% women were heterozygous and the polymorphism information content(PIC) was 0.4512.Conclusion For Han Chinese population in Wenzhou,the BCL I genetic site has enough information,being one of the genetic markers with high polymorphism,applicable to the screening for carrier and prenatal diagnosis of Haemophilia A in Wenzhou.

Objective To observe the inhibitory effect of endogenous angiogenesis inhibitor endostatin on the growth of bladder transitional cell carcinoma. Methods Recombinant mouse endostatin expressed by E. coli was purified with Ni NTA affinity chromatography and was administrated into mice bearing T739 bladder transitional cell carcinoma via subcutaneous injection at the dose of 20 mg?kg -1 ?d -1 . The tumor growth and angiogenesis were observed 10 days later. Results Tumors in mice treated with endostatin grew slowly and the inhibition rate reached 81 4%. Microvessel density(MVD) of tumor in treated group was significantly lower than that in the control group( P

Objective To evaluate the relationship between the lung volume (LV) in inspiration and expiration,pulmonary function tests(PFT),and other CT measurements of emphysema index (EI) and mean lung density (MLD) in patients with chronic obstructive pulmonary disease (COPD).Methods Seventy-six patients with COPD were included.Three-dimension analysis was performed to obtain the following CT parameters on the inspiratory and expiratory phases:EI,MLD,LV.The ratios and differencesof MLD and LV between the two phases were calculated(ΔMLD,ΔLV,MLDex/in,LVexin).Not only the linear correlations between the lung volume parameters and PFT but also the correlations of lung volume parameters with the other CT parameters were tested by the Spearman rank correlation test and multivariant step wise regression.Results LVex/in had negative correlations with forced expiratory volume in 1 second ％ predicted [FEV1 ％,(54.32 ± 7.11)] and the ratio of forced expiratory volume in 1 second to forced vital capacity [FEV1/FVC,(49.12 ±8.01)％] (r =-0.69,-0.56,P ＜0.01),but it had the positive correlation with the ratio of residual volume to total lung capacity [RV/TLC,(58.03 ± 8.55) ％,Spearman coefficients 0.66,P ＜ 0.01].LV/exin (0.67 ± 0.12) was positively correlated with MLDex/in (0.89 ± 0.04,r =0.88,P ＜0.01).The further multivariate step wise regression denonstrated that EI,LV and MLD could introduce a regression equation with R2 =0.77 and 0.73,respectively (P ＜ 0.01).Conclusions There is an association between LVex/in and the parameters of routine PFT,which can reflect the collapsibility of lung.Moreover,LVex/in can be considered to be equivalent to MLDex/in.Taking into account the impact of scanning parameters on MLDex/in,LVex/in may play a complementary role in the assessment of pulmonary function.

Objective To investigate the correlation between the paired inspiratory and expiratory quantitative CT and pulmonary function tests (PFTs) in patients with chronic obstructive pulmonary disease (COPD).Methods A total of 84 patients with COPD were enrolled.For each patient,CT scan was performed in deep inspiration and expiration.Using automatic post-processing software,a three-dimension quantitative measurement was employed to assess the CT parameters of emphysema and air trapping.The correlation between CT and PFT was evaluated by the Spearman rank correlation test and multivariate linear regression analysis.Results The percent 1 [Perc1,(-984.28 ± 17.93) HU] and percent 15 [Perc15,(-948.35 ± 22.26) HU] from the CT parameters of emphysema were positively correlated with the forced expiratory volume in 1 second predicted (FEV1％,48.69 ± 23,47),the ratio of forced expiratory volume in 1 second over forced vital capacity [FEV1/FVC,(45.89 ± 15.36)％,r =0.454.-0.67,P ＜0.01],was negatively correlated with the ratio of residual volume to total]ung capacity [RV/TLC,(61.32 ±14.48)％].The other CT parameters of emphysema index (EI) and the parameters of air trapping,the change in relative lung volume with attenuation values from-860 to-950 HU [RVC-860--950,(17.66 ±22.36)％],the expiration to inspiration ratio of mean lung density (MLDex/in,0.93 ± 0.06),the expiration to inspiration ratio of lung volume(LVex/in,0.71 ± 0.14) had negative correlations with logFEV1 ％,FEV1/FVC (r=-0.48--0.69,P＜0.01) and positive correlations with RV/TLC (r =0.41-0.66,P ＜0.01).The further univariate linear regressions showed that EI,Perc1,Pere15,RVC-860--950,MLDex/in,LVex/in were correlated with the parameters of PFTs (R square values of the regression equation,ranged from 0.27 to 0.66,P ＜ 0.01).After the pairwise combinations of the parameters of emphysema and air trapping,multivariate stepwise regressions showed better R square values from 0.66 to 0.85.Conclusions CT parameters of emphysema and air trapping can reflect pulmonary function in COPD patients.The combinations of the two types of CT parameters are more correlated with the PFTs parameters.

This article introduces a novel scavenger for waste anesthetic gas which makes use of negative pressure in operating room. This setting can scavenge the exhaust gas absolutely without affection the normal work of anaesthesia.
Anesthetics ; Gas Scavengers ; Operating Rooms

Recently , the country actively explores the pattern of an integrated healthcare which enables the as-sociation among hospitals of different levels , aimed to achieve maximum utilization of medical resources and lead a reasonable distribution of the patients .By reviewing the practices related to the integration of healthcare in Beijing , Shanghai , Zhenjiang and Wuhan city , this paper sums up in five typical mechanisms , i.e.organization and manage-ment mechanism , human resource management mechanism , interest distribution mechanism , service continuity and resources sharing mechanism .The effects of these practices were analyzed and the faced challenges were discussed . The following points were made clear during analysis and discussion:the sustainability of the collaboration mode and organization structure , human resource supports and incentive methods , health insurance guidance for hospitals and patients , two-way referral system and supporting measures , and building of information system .Then we put forward some suggestions , hoping to offer some references to the establishment of integrated healthcare in other regions .

Objective To study the targeting survivin small interfering RNA ( siRNA ) to inhibit proliferation and apoptosis survivin gene expression in rheumatoid arthritis synovial fibroblasts ( RASFs) .Methods RA patients were isolated and cultured in vitro synovial fibroblasts ( RASFs) , designed and synthesized siRNA targeting survivin and negative control, by liposome transfection RASFs cell; real-time quantitative polymerase chain reaction (PCR) and Western blot RASFs detect mRNA expression and protein levels of survivin.Tetrazolium blue (MTT) assay of cell proliferation;TUNEL assay apoptosis.Results The experimental group compared with the negative control siRNA group and control group, 48h after transfection of synovial fibroblasts survivin mRNA and protein expression levels were significantly decreased ( P<0.05 ) .The experimental group compared with the negative control siRNA group and control group, synovial fibroblast proliferation after transfection significantly decreased ( P<0.05 ) . After the experimental group transfected 24h, 48h, 72h growth inhibition rates were (11.5 ±2.6)%, (26.2 ±3.4)%, (47.6 ±4.1)%, at 72 hours after transfection most significant.The rate of apoptosis in experimental group (23.87 ±1.6)%, significantly higher than the negative control group (9.72 ± 1.15)% and the control group (8.70 ±1.09)% (all P<0.05).Conclusion siRNA targeting survivin expression levels through reducing survivin, inhibit synovial fibroblast proliferation and promotes apoptosis.