Objective To investigate the clinical values of multiple ultrasound soft markers in screening for fetal chromosomal abnormality during first-trimester.Methods Two thousand seven hundred and eighty-nine nulliparas in Department of Obstetrics,the First Affiliated Hospital of Jinan University during early pregnancy (11-13+6 gestational weeks) were selected for this study.Fetalnuchal translucency (NT),facial angle (FA),ductus venosus (DV),fetal heart rate (FHR),tricuspid reverse (TR),nasal bone (NB) and fetal structures were scanned and measured.Risk calculation software (Astraia) was used to calculate the chromosomal abnormal risk (cut-off line:＞1/300) based on ultrasound records.The chorionic villi or amniotic fluid of high risk patients was collected with informed consent for karyotype analysis (prenatal diagnosis).All patients were followed up until six months after delivery.Chi-square test or Fisher exact test was used to compare the difference.Results One hundred and seven cases were high-risk of trisomy 21 among which 96 cases accepted invasive prenatal diagnosis.Sixteen chromosomal anomaly and six trisomy 21 cases were diagnosed out the 96 fetuses.Among 2789 cases,four were high-risk of trisomy 21 according to ultrasound screening.Six cases were diagnosed as trisomy 21.The false positive rate of ultrasound screening was 3.6％(101/2783).There were 196 cases whose NT ≥2.5 mm,in which 66 cases were high risk of chromosomal abnormality,and 16 fetal chromosomal abnormalities were diagnosed after chorionic villus sampling.The invasive procedure rate was 2.3％ (66/2789).Totally,186 pregnant women were older than 35 years,among which 32 cases were high risk.There was no significantly difference on the of rate fetal chromosomal abnormality between the groups of age≥ 35 pregnant women and the general population (P=0.055).But 29.9％ (32/107) high risk cases were detected in the group of age≥35.Five of thirteen fetal malformations cases were associated with abnormal karyotype.Conclusions Multiple ultrasound soft markers screening during early pregnancy could increase the diagnosis rate of chromosomal abnormality and decrease the false positive rate,false negative rate and invasive procedure rate.Early ultrasound screening might be effective in not only identifying chromosomal abnormality,but also diagnosing severe structure deformity of fetus.

Objective To analyze the thin-section CT features of fissure-attached nodules in asymptomatic patients.Methods The baseline and follow-up CT images of 120 asymptomatic patients with fissure-attached nodules were retrospectively analyzed.The thin-section CT findings include size,shape,density,interface,and the relationship with pulmonary fissure.Results There were 1 67 fissure-attached nodules of the 120 patients.The mean length of nodules was 5.46 mm±2.276 mm (2 - 1 5 mm).104(104/1 67,61.1%)nodules were less than 5 mm in length.1 63 (1 63/1 67,97.6%)nodules were typical and 4 (4/1 67,2.4%)nodules were atypical.All these nodules manifested as homogenous,solid,smooth interface,and widely adjacent to the fissure on CT ima-ges.Among those nodules,1 64(1 64/1 67,98.2%)nodules were triangular(88/1 67,52.7%)or oval(76/1 67,45.5%).126(126/1 67, 75.4%)nodules were abutting the major fissure.The angle between nodule and fissure was obtuse in 1 64(1 64/1 67,98.2%)fissure-attached nodules.During follow-up,4(4/1 67,2.4%)nodules increased in size and the corresponding volume doubling time (VDT) range was 863-4 228 days.However,no obvious malignant signs were found.Conclusion The thin-section CT images of fissure-attached nodules in asymptomatic patients showed the benign characteristics,most of which less than 5 mm and demonstrated trian-gle or oval,smooth interface and homogenous solid density.

OBJECTIVE To study the medical instruments,packs,and textile goods disinfected and sterilized in a hospital. METHODS Totally 432 of surgical instruments were randomly divided into 4 groups.They were washing by hands and machines and detected their blood residue. RESULTS Using the multi-enzyme detergent was more effective than unused.It was helpful for the contaminated medical instruments clean by multi-enzyme detergent for(2 min). CONCLUSIONS It is important for assure the quality of the disinfection and sterilization to proper cleaning and the care of the medical instruments.

OBJECTIVE To apply 3M standardized chemical indicator(CI) process challenge device(PCD) to the practice of batch monitoring to guarantee sterility assurance.METHODS The standardized CI PCD and biological indicator(BI) PCD to two different sterilizers were applied with the test parameters of 132 ℃,3.5min and 8min,and 134 ℃,3.5min and 8min,respectively.RESULTS A total of 310 trials of CI PCD were obtained as negative results,with the ink moved into the accept area of the moving-front style indicator,and 240 trials of BI PCD were obtained as negative results.CONCLUSIONS Standardized CI PCD can provide further sterility assurance with more accurate monitoring and batch release capabilities.

Objective To establish the biological reference interval of procalcitonin(PCT) applicable for children in Chongqing.Methods Serum PCT level were detected in 120 healthy children with age from 0 to 16 years, including 73 cases of male and 47cases of female children, by using by Maglumi2000 plus PCT analysis system.All data was evaluated according to EP28-A3c document to establish the biological reference interval.Results Data of PCT levels were with non-normal distribution, and without statistical difference between children of different ages and genders(P>0.05).The biological reference interval of PCT was less than or equal to 0.038 μg/L.Conclusion It might be important to establish a usefully biological reference interval in different laboratories with relative detection system, especially for children.

ObjectiveTo investigate the therapeutic effects of advanced lung adenocarcinoma treated with TCM treatment based on syndrome differentiation combined with Gefitinib.MethodsAll cases were recruited from adenocarcinoma of lung patients in Hunan Province Cancer Hospital from February 2008 to February 2010.These 56 adenocarcinoma of lung patients were randomly divided into a treatment group (30cases) and a control group (26 cases).The control group was treated with Gefitinib,250 mg/d,until the disease getting progress or the patient showing intolerable untoward reaction; while the treatment group was treated with TCM syndrome differentiation based on the control group.ResultsAfter the treatment,the total therapeutic effects was 90.00％ in the treatment group than 65.38％ in the control group (x2=5.40,P＜0.05); symptoms score in both group decreased after the treatment,comparing with the same group before the treatment,with the difference was statistical significance (tthe treatment group=9.2446,tthe control group=2.7778,both P＜0.01) ;non-progressive survival rate of half year,1year and 2year was 66.67％,50.00％ and 30.00％ respectively,and survival rate of lyear and 2yenr was 73.33％ and 46.67％ respectively,in the treatment group,while non-progressive survival rate of half year,lyear and 2year was 38.46％,23.08％ and 7.69％ respectively,and survival rate of 1year and 2year was 46.15％ and 19.23％ respectively,in the control group,showing statistical difference between the two groups (x2 value was 4.46、4.31、5.44、4.31、5.27,P value was 0.03、0.04、0.02、0.04、0.02,all P＜0.05 ) ; the effective power of KPS was 76.67％ and 46.15％ in the treatment and the control group respectively,showing statistical difference(x2=6.24,P＜0.05) ; both groups were absent of such side effects of hematology,heart,liver and kidney toxicity,and interstitial pneumonia,but the incidence rate of Ⅱ ～ Ⅲ degree rash and diarrhea was significantly decreased in the treatment group,comparing with the control group(x2=4.49、4.37,P＜0.05 ).ConclusionThe therapy of TCM treatment based on syndrome differentiation combined with Gefitinib can improve living quality,control aggravation of disease,prolong life span and enhance survival rate of the patients with advanced lung adenocarcinoma.

Diabetic retinopathy is a major cause of blindness all over the world, and it is one of the most serious and common microvascular complications of diabetes. Breakdown of the endothelial blood - retinal barrier ( BRB ) , as occurs in diabetic retinopathy, result in vasogenic edema and neural tissue damage, causing loss of vision. The inner BRB is created by complex tight juctions of retinal capillary endothelial cells, this barrier prevents the free diffusion of substances between the circulating blood and the neural retinal, the inner BRB efficiently supplies nutrients to the retinal and removes endobiotics and xenobiotics from the retina to maintain a constant milieu in the neural retina. The central mechanism of altered inner BRB function is a change in the permeability characteristics of retinal endothelial cells caused by elevated levels of cytokines, growth factors, advanced glycation end products, inflammation, hyperglycema and loss of pericytes. This article reviews the relationship between diabetes and the ultrastructure changes of BRB.

Purpose To investigate clinicopathological features, diagnosis and differential diagnosis of non-sebaceous lymphadenoma of the parotid gland. Methods The histopathological morphology, immunohistochemical profiles and clinicopathological features were an-alyzed in two cases of NSL, along with review the related literatures. Results Two patients were female adults. Microscopically, The tumor was a well-circumscribed mass surrounded by a fibrous capsule of variable thickness and comprised a mixture of proliferating epi-thelium accompanied by a prominent lymphoid component, reactive lymphoid follicles were found in lymphoid stroma. The epithelial component took the form of anastomosing trabeculae, glands, solid basaloid islands or cyst formation. The cysts and glands were lined with luminal cells and abluminal cells, filled with eosinophilic secretions with occasional histiocytes. The epithelial cell was no seba-ceous differentiation, significant cytological atypia and mitotic activity. A fibrous capsule with subcapsular sinus was seen around the mass in one case. Immunohistochemically, the abluminal cells were positive for p63, CK34βE12 and CK5/6, while the epithelial cells were positive for CK(AE1/AE3) and CK7. Conclusion NSL is a very rare benign of salivary gland, which occuring in the lymph node lesions are less reported, knowledge of the wide histological spectrum of this rare tumor is important in order to avoid misdiagno-sis, particularly as malignant tumor.

Acute Coronary Syndrome ; complications ; drug therapy ; Adrenergic beta-Antagonists ; therapeutic use ; Aged ; Heart Failure ; complications ; drug therapy ; Humans ; Male ; Middle Aged ; Treatment Outcome

Objective To evaluate the correlation between thin-section CT morphologic features and pathological vascular invasion in the clinical stage ⅠA peripheral lung adenocarcinoma.Methods The preoperative thin-section CT images,clinical and pathological characteristics of 102 nodules in 98 patients were retrospectively analyzed and divided into two groups according to pathological vascular invasion.Variables including the diameter of tumor(T) and consolidation part (C) in the mix ground glass nodule (mGGN),C/T ratio,morphology and pathological classification were analyzed by two-independent samples Mann-Whitney U test or t test and x2 test or Fisher exact probability test.Variables with significant difference in the univariate analyses were entered into multivariate analysis to explore predictors for vascular invasion.The correlation between these measurements and vascular invasion was evaluated by a ROC analysis.Results All of 102 nodules,36 had pathological vascular invasion and 66 without.The numbers of two groups with speculation,air bronchogram,abnormal vein,vascular convergence,pleural indentation were 30,30;26,26;35,3;35,39;32,39 and the mediandiameter of tumors were 2.1(1.0-3.0),1.2(0.5-3.0) cm respectively.By univariateanalysis,spiculation,air bronchogram,abnormal vein,vascular convergence,pleural indentation,and diameter of tumor were significantly associated with pathological vascularinvasion (P＜0.01).By multivariate logistic analysis,the statistically significant difference were found in speculation and abnormal vein (OR=33.867,8 161.063,P＜0.05).The ROC analysis showed the area under curve,cut-off value,sensitivity and specificity ofthe diameter of tumor and consolidation part of mGGN and C/T ratio were 0.784,2.05 cm,66.7％,78.8％;0.886,1.08 cm,82.4％,90.0％ and 0.861,0.65,79.4％,85.0％ respectively in differentiating tumors with pathological vascular invasion.Conclusion The spiculation sign and abnormal vein are independent predictors for vascular invasion in stage ⅠA peripheral lung adenocarcinoma.