Objective To explore the current situation and the relationship of job satisfaction,job performance and career plateau in senior health technical personnel.Methods The career plateau questionnaire,job satisfaction scale,job performance scale were adopted to carry out the questionnaire survey among 410 senior health technical personnel in Wanzhou district of Chongqing.The results underwent statistical description,correlation analysis and regression analysis.Results Senior health technical personnel's career plateau score was 2～5 points,with an average of (3.26±0.58) points,job satisfaction score was 20～60 points,with an average of (44.81±11.46) points,job performance score was 20～75 points,with an average of (35.79 ± 9.55) points.The score of career plateau was significantly negatively correlated with job satisfaction,and was significantly negatively correlated with job performance.The content of plateau was a factor affecting job satisfaction,and the content and the level of plateau were influencing factors of job performance.Conclusions Career plateau in senior health technical personnel was in a moderate level,while job satisfaction and job performance were relatively low.Hospital managers should take in occupation development assistance strategy and reduce negative influence of career plateau to improve job satisfaction and job performance in senior health technical personnel.

Objective To review the CT appearance of various anomalous mediastinal veins left to aortic arch and provide guideline for differentiating between them. Methods All 41 patients (26 men, 15 women; mean age 50.6) underwent CT scan and no one associated with congenital heart disease. 36 of which had the injection of IV contrast material. Others had chest MRI or ultrasound examination. Three-dimension (3D) and MIP reconstruction of the major mediastinal vascular structures were performed in 6 patients. All the CT scans were reviewed in order to observe the CT findings in each anomaly. Results Of the all cases, 24 cases had persistent left superior vena cava, of them, 23 cases with duplication of SVC, and 1 case with absent right SVC. Eleven cases had anomalous left brachiocephalic vein, and 6 of 11 cases were associated with various anomalous aortic arches. Four patients had partial anomalous pulmonary venous drainage of the left upper lobe. Two cases had left brachiocephalic vein continuation of the azygos vein. There were different CT findings among various types of venous anomalies, especially their courses below the aortic arch. Conclusion Contrast enhancement CT scan was valuable in the diagnoses of these anomalous veins. Careful analysis of the CT scans allowed the radiologist to avoid making wrong diagnosis.

Objective To observe the mammographic appearance of accessory breast tissue in the axilla. Methods In the past 3 years, 7 562 women were underwent bilateral screen-film mammography. All of the mediolateral oblique(MLO) films were reviewed retrospectively to look for whether there was accessory breast tissue and what the mammographic features were like. Radiographically the accessory tissue resembled the main normal breast glandular tissue but was separated from it. Results Of the 7562 cases, accessory breast tissue in the axilla was detected in 161 cases. The prevalence was 2%. The age ranged from 17 to 70 years (mean, 39 years). 38% of them were found in the bilateral axilla, 42% only in the right, and 20% only in the left. The dimensions on the right ranged from 0.7 to 8.0 cm (mean, 3.5 cm), and that on the left ranged from 1.0 to 7.0 cm (mean, 3.3 cm). There were four types among the accessory breast tissue: patchy type was the most (35%), then the branched type(26%),mixed type(20%), and mass-like type(19%). 3 cases were proved by pathology. Conclusion It is important that the radiologist be familiar with the mammographic appearance of accessory breast tissue in the axilla in order that they could be distinguished from other pathological changes.

A kinetic method for the detemination of trace rhodium based on the catalytic effect of Rh on the oxidative color reaction of diantipyry1-(p-dimethylamino)-phenylmethane (DAMAM) with potassium periodate in the H3PO4 medium and ot wateer bath was estabished. The optimum condition and kinetic parameters of this reaction were studied in detail. The linear range of the determination was 0～80μg/L, and the detection limit was 6.20×10-7g/L. The apparent activation energy og catalytic reaction was found to be 89.03kJ/mol, rate constant was 2.51×10-4/s. The system wasstable at least 6h. The method has been applid to determine trace rhodium in some catalyst samples with the relative standard deviation of 2.7%～3.2%(n=6) and recovery of 98.2%～103.2% (n=5).

Objective To evaluate the role of CT or Chest radiograph in diagnosis of chest wall tuberculosis.Methods The study population included 21 patients with chest wall tuberculosis confirmed by operation or biopsy. Chest radiograph and plain CT were performed in all cases, while enhanced CT in 9 cases , and all images were reviewed by 2 radiologists.Results Single soft tissue mass of the chest wall was detected in all cases on CT, but not on chest radiograph(?2=42.000,P

Objective To describe the CT manifestations of thymic epithelial tumor and explore the correlation between CT findings and post-operative tumor-related survival time. Methods Ninety-one patients who underwent CT scan before operation were reviewed retrospectively. All cases had operation and were classified according to the WHO classification. The size, contour, shape, density and enhancement of the tumors on CT were assessed. Presence of mediastinal lymphadenopathy, great vessel invasion, metastasis to the lung or plural, myasthenia gravis (MG) were also analyzed. The survival rate was obtained using the Kaplan-Meier method. The Cox model was applied to determine the factors affecting the tumor-related survivals. Chi square test was used to analyze the relationship between CT findings and WHO classification. Results Two patients were excluded because of dying of myocardial infarction and colon cancer. The total 5-year survival rate was 84.3%(n=75). Eighty-nine patients had total 91 tumors. Tumors with diameter larger than 5 cm, lobular contour, heterogenous density, and presence of great vessel invasion, mediastinal lymphadenopathy, and metastasis were adverse factors which could significantly affect the survival time. Five-year survival rates of these factors were 72.7%, 77.3%, 76.7%, 73.8%, 30.0%, and 68.8%, respectively. Presence of MG was a favorable factor which also significantly affected the survival time (P＜0.05). While the shape and enhancement of the tumors and the age, gender of the patients did not significantly affect the survival time (P＞0.05). The result of the Cox multivariate analysis was consistent with that of the Log-rank test. For different WHO classification, there were significant different among the size or contour of the tumors, presence of great vessel invasion, mediastinal lymphadenopathy, and metastasis (x2 value were 6.598, 5.737, 18.307, 8.465, and 15.608, respectively P＜0.05). Conclusions CT findings may be served as predictors of clinical prognosis of the thymic epithelial tumors. Adverse factors for survival time are the size of the tumors and presence of mediastinal lymphadenopathy, while MG is a favorable factor for survival time.

ObjectiveTo investigate the CT findings of thymic epithelial tumors (TETs).Methods The CT images of 133 cases with TETs confirmed pathologically were reviewed retrospectively.The TETs were reclassified according to WHO 2004 Classification System.The CT features of different histopathological types of TETs were analyzed.The frequencies of demonstrating these CT features were compared between different types using Chi-square exact test.ResultsType A(9/10,90.0％),AB(15/17,88.2％),B1 (10/13,76.9％ ),and B2( 31/46,67.4％ ) tumors were more likely to have spherical or oval shapes and smooth contours on CT.TETs with irregular or lobular contours were mostly seen in type B3 (21/30,70.0％ )and thymic carcinoma (15/17,88.2％ ).TETs with cyst and necrosis formation were common in type A(6/10,60％ ),B3 ( 19/30,63.3％ ) and thymic carcinoma ( 15/17,88.2％ ).Calcification was more frequently seen in type B2 and B3 (32/76,42.1％ ) than any other type ofTETs (8/57,14.0％ ;x2 =12.20,P ＜ 0.01 ).Type A,AB,B3 and thymic carcinoma had higher prevalence of significant enhancement (39/74,52.7％) than type B1 and B2 (8/57,13.6％;x2=22.01,P＜0.01).ConclusionAccording to WHO 2004 histologic classification system,different types of TET have corresponding CT features.CT has showed the potentiality in differentiating histological subtypes of TETs.

ObjectiveTo investigate the value of uncinate process first for pancreaticoduodenectomy (PD).MethodsThe clinical data of 19 patients admitted from December 2010 to March 2011,who underwent uncinate process first for PD were studied.ResultsAmong the 19 patients,there were 5 cases of periampullary adenocarcinoma,11 cases of pancreatic cancer,1 case of duodenum aggressive fibromatosis,1 case of main pancreatic duct type IPMN,1 case of SPN.During operation,3 patients (21％) were found to have abnormal or aberrant right hepatic artery.Among the 11 patients with pancreatic cancer,there are Peripancreatic lymph node(3 ～7) metastasis,in 7 cases,and nerve invasion occurred in 8 cases.All the N16 lymph nodes,pancreatic stump,bile duct margin,duodenum and retroperitoneal margin were negative,and all the cases were subjected to R0 resection.The median time for the portal vein blocking was 16 minutes.The average operation time was 4h and there was no major bleeding occurred,and the mean blood loss was 600 ml.No intractable diarrhea occurred post-operatively. Conclusions Uncinate process first for PD offers a comfortable,safe,accurate and controllable method to resect pancreatic head.

Objective To describe a novel technical modification of the uncinate process first approach with a retrograde dissection of the pancreatic head.Methods The authors described the surgical technique,and reported their preliminary experience.The surgical data,postoperative outcomes and pathological results of patients who were submitted to PD/PP PD (20 patients) and TP (3 patients) for pancreatic neoplasm using “the uncinate process first” technique between December 2010and May 2011 were reviewed.Retrograde resection of the pancreatic head was performed starting with the uncinate process after division of the first jejunal loop.The transection of the pancreas was the last operative step of the resection.The technical aspects and possible advantages of this procedure were discussed.Results The authors used this technique successfully in 23 patients.In 3 patients with a replaced or accessory RHA,the arteries were all successfully preserved.In another patient with a replaced HCA,the artery was also successfully preserved.In 1 patient with adenocarcinoma which involved the SMV,en-bloc vascular resection was carried out.Additionally,the authors used this technique on 3 patients with IPMN-2 and SPPN-1 to carry out total pancreatectomy.The uncinate process first was performed on 23 patients without any intraoperative and postoperative complication and massive bleeding.No patient required blood transfusion.The surgical margins,including retroperitoneal marginswere negative.Conclusions The “uncinate process first” approach can be used as an alternative approach in modern pancreatic surgery.Further studies are required to evaluate this procedure regarding operative parameters and postoperative outcomes when compared with the standard resectional procedure.

Objective To summarize the experience in the diagnosis and treatment of solid pseudopapillary tumors of the pancreas. Methods Ten consecutive patients who underwent surgery with pathologically confirmed solid pseudopapillary tumors of the pancreas between October 2005 and December 2008 were retrospectively reviewed. Results All of the 10 patients were female and the median age at diagnosis was 24 years (range, 11 -39 years). Abdominal discomfort or pain were the most common presenting symptoms. 4 patients had palpable abdominal mass at physical examination. The tumors appeared on ultrasonography and/or CT, MRI as solid or cystic masses. The preoperative serum biochemical parameters and tumor markers level were within the normal range. All the patients underwent surgical treatment. The tumors were located in the head/neck (n = 6) or the distal part (n = 4) of the pancreas. The surgical procedures included enucleation (n=3) , distal pancreatectomy (n=3 , two with preservation of the spleen, one combined with splenectomy, distal gastrectomy and partial colectomy) , segmental pancreatectomy with pancreaticojejunostomy (n=3) and pancreaticoduodenectomy (n = 1). Pancreatic fistula (n = 2) was observed postoperatively and resolved with conservative treatment. The median resected tumor size was 5. 9 cm. All patients were alive and remained recurrence and metastasis free after a median followk-up of 19. 2 months (range, 8～42 months). Conclusions Solid pseudopapillary tumor of the pancreas was rare neoplasm occurred predominantly in young women with low malignant potential. Aggressive resection should be attempted and could result in excellent prognosis.