Micrometastasis is an independable prognostic factor for the cancer patients.Furthermore,free-disease survival and overall survival of the cancer patients are correlated with micrometastasis.In addition, detection of micrometastasis can be used to monitor the efficacy of adjuvant therapy,predict outcome and im.prove the stage of patients with carcinoma.Micrometastasis has great significance for clinical comprehensivetreatment.The limitations of this study include the lackness of retrospective analysis,the small number of pa-tients studied,and the short follow-up time for the cancer patients.

Objective To investigate the effects of sevoflurane on the systemic inflammatory response and cardiopulmonary function in septic shock rats. Methods Thirty-two SD rats, 8-10 months old, weighing 250-300 g, were randomly divided into 4 groups (n = 8 each): sham operation group (group S), cecal ligation and puncture (CLP) induced septic shock group (group CLP) , sevoflurane I group (group SEV, ) and sevoflurane II group (group SEV,). The abdomen was opened but CLP was not performed in group S. The septic shock was induced by CLP as described by Baker et al. Group SEV, and SEV, inhaled 2.4% sevoflurane for 30 min at 1 h and 3 h after the successful establishment of the model respectively. At 1, 3 and 5 h after septic shock, MAP and HR were recorded and arterial blood samples were taken for blood gas analysis and determination of plasma concentrations of TNF-α, IL-1, MDA and NO. The left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), left ventricular fractional shortening (LVFS) and cardiac output (CO) were also detected 5 h after septic shock. The animals were killed after the detection of cardiac function. The lungs were removed for determination of W/D lung weight ratio and Evans blue (EB) content. The tissues from the heart, lung, liver and kidney were taken for detection of NF-kB activity by electrophoretic mobility shift assay (EMSA) ResultsMAP was significantly lower, HR higher, LVEDD, LVESD, LVFS, CO, pH value, PaO2 and PaCO2 lower, and W/D lung weight ratio, EB content, plasma concentrations of TNF-α, IL-1, MDA and NO, and NF-kB activity in the heart, lung, liver and kidney tissues higher in group CLP, SEV, and SEV2 than in group S (P < 0.05). NF-kB activity in the heart, lung, liver and kidney tissues and plasma concentrations of TNF-α, IL-1, MDA and NO were significantly lower in group SEV, than in group CLP and SEV2 ( P < 0.05 ), but no significant differences were found in the other indices between group SEV, and CLP and between group SEV1 and SEV2 ( P > 0.05). Conclusion Inhalation of 2.4% sevoflurane for 30 min 1 h after septic shock can inhibit the systemic inflammatory response slightly, but can not improve the cardiopulmonary function in rats with CLP-induced septic shock.

The reoperation for biliary diseases is usually unplanned, and the major reasons leading to this situation include:(1) The initial operation was performed under emergency situation and radical procedure could not be carried out.(2) The surgical procedure was inadequate.( 3 ) The operator was unqualified for the operation. In order to avoid repeated operations,the following principles must be obeyed strictly.Firstly,once the initial operation was failed,the patients must be transferred to large medical center and the reoperation must be performed by hepatobiliary specialists.Secondly,the operator must realize that most of the patients were in poor condition because of the previous operation,and they needed careful evaluation of organ function and adequate supportive treatment before reoperation.Thirdly,various measures must be taken to avoid unplanned operation and ensure the successful implement of radical operation at a time:( 1 ) Operator must learn all the details of previous operation,which include operation procedure,findings during operation and postoperative complications.( 2 ) Cholangiogram of the whole biliary tree is important for surgical planning,ultrasonography,computed tomography (CT),endoscopic retrograde cholangiopancreatography,magnetic resonance cholangiopancreatography, percutaneous transhepatic cholangiography (PTC),or PTC-CT should be performed solely or comprehensively to determine the nature and location of lesions.For bile duct injury,additional examination including CT angiography,magnetic resonance angiography or digital subtraction angiography is necessary to ascertain the accompanied vessel injury.(3) Making individual surgical procedure according to patien's condition and distribution of lesions.

Medical consumables material is essential supplies to carry out medical work, which has a wide range of varieties and a large amount of usage. How to manage it feasibly and efficiently that has been a topic of concern to everyone. This article discussed about how to design a medical consumable material management information system that has a set of standardized processes, bring together medical supplies administrator, suppliers and clinical departments. Advanced management mode, enterprise resource planning (ERP) applied to the whole system design process.
Disposable Equipment ; Management Information Systems ; Materials Management, Hospital ; Software Design

Medical equipments are essential supplies to carry out medical work. How to ensure the safety and reliability of the medical equipments in diagnosis, and reduce procurement and maintenance costs is a topic of concern to everyone. In this paper, product lifecycle management (PLM) and enterprise resource planning (ERP) are cited to establish a lifecycle management information system. Through integrative and analysis of the various stages of the relevant data in life-cycle, it can ensure safety and reliability of medical equipments in the operation and provide the convincing data for meticulous management.
Equipment and Supplies ; Management Information Systems ; Reproducibility of Results

Present data achieving from collecting showed it should be pay attention to the intimate connection between rapid eye movement sleep behavior disorder( RBD) and neurodegenerative diseases such as Parkinson’ s disease( PD) ,there is a scholar who has announced that RBD is the mark of alpha-synucle-in,and the PD patients who also have the RBD may appear some certain clinical features.To integrate exist-ing data and analyze the research progress of Parkinson's disease with REM sleep behavior disorder,it’ s ex-tremely close between PD and RBD,however,their exact mechanism and the accurate relationship remains to be further defined so that we can correspond treatment such as nerve protection as soon as possible,to help delay occurrence or progress about disease.

Objective To evaluate the clinical value of bronchoscopy lung biopsy Combined with brush cytology .Methods Collected 113 cases of diffuse or clinical cases of peripheral pulmonary disease examined by bronchoscopy lung biopsy Combined with brush cytology with no X-ray guiding during January 2011 to December 2012 .And the inspection results and the corresponding clini-cal data were retrospectively analyzed.Results In 113 cases 73 cases made a definite diagnosis, diagnostic positive rate was 64.60% in total, include 96.02% of diffuse patchy shadows, 72.13% of diffuse millet or nodular, 54.12% of local infiltration fo-cal, 32.11% of diffuse grid or ground glass honeycomb lesion, 28.26% of local tumor nodules.Conclusion There is significantly clinical diagnosis value of bronchoscopy lung biopsy Combined with brush cytology to examine diffuse and peripheral pulmonary dis-ease.

OBJECTIVE:To observe therapeutic efficacy and safety of low molecular heparin calcium (fraxiparine) combined with vapour-pressure type blood circulation driver for the prevention and treatment of postoperative lower limb deep vein thrombo-sis(DVT)in elderly fracture patients. METHODS:80 elderly patients receiving fracture surgery were randomly divided into con-trol group and observation group,with 40 cases in each group. Control group only received preventive measures for lower limb DVT under the action of vapour-pressure type blood circulation driver,while observation group was additionally given Low molecu-lar heparin calcium injection on the basis of control group,Preoperative 2 h,postoperative 12 h and 24 h,0.4 ml was administrat-ed;Postoperative d2-d3,0.4 ml was subcutaneously injected;postoperative d4,0.6 ml was administrated and lasted for 10 d. The incidence of lower limb venous thrombosis,therapeutic efficacy,the changes of blood rheology indexes and the cross-section diam-eter difference of uninjured side limb were observed in 2 groups;the incidence of ADR was compared between 2 groups. RE-SULTS:The observation group;total effective rate (95.00%) was higher than control group (72.50%),with statistical signifi-cance (P<0.05). After treatment,the cross-section diameter difference of side and uninjured side limb in observation group de-creased to(1.10±0.87)cm,which was significantly lower than control group(2.59±1.55)cm,with statistical significance(P<0.05). The blood viscosity at both high and low shear rates,plasma viscosity and fibrinogen of observation group were all better than those of control group,with statistical significance(P<0.05). No obvious ADR was found in 2 groups. CONCLUSIONS:In the prevention of lower limb DVT in elderly fracture patients,Low molecular heparin calcium injection combined with vapour-pres-sure type blood circulation driver show high effective rate,significantly improve blood rheological index and lower the incidence of lower limb DVT with good safety.

The International Society on Thrombosis and Haemostasis has proposed to hold World Thrombosis Day on October 13 annually from 2014 to improve awareness and education of thrombosis. Thrombotic diseases are multidisciplinary disorders involving multiple systems.Thus, multidisciplinary team treatment for thrombotic diseases should be developed in China.A comprehensive study of genetic factors for thrombotic diseases is expected to achieve early diagnosis and risk prediction for this type of disease, and thus precision diagnosis and individualized treatment can be achieved.

Objective To study the effect of endoscopic treatment in acute severe pancreafitis. Methods EST(endoscopic sphincterepapiilotomy) and ENBD ( endoscopic naso-billary dralnage) or ENPD ( endoscopic naso-pancreatic drainage) were used to treat the acute severe pancreatitis(ASP). Results The recover time of blood dia-stase of the endoscopic therapy group and the contrast group was (3.2±1.5) days, (6.6±1.2) days, respectively (P<0.01) ; the incidence of needing to be operated was 0.7% (1/140), 6.5% (8/124), respectively (P<0.05) ;mortality rate was 0:7% (1/140) ,7. 3% (9/124) ,respectively(P <0. 01 ) ;the incidence of complication was 3.6% (5/140) ,41.9% (52/124), respecfivly(P<0.01). Conclusion EST + ENBD(or ENPD) in treating ASP has cer-tain effect and is the primary therapy to the ASP.