Adenocarcinoma ; complications ; pathology ; surgery ; Aged ; Colectomy ; methods ; Colonic Neoplasms ; complications ; pathology ; Diagnosis, Differential ; Female ; Hepatectomy ; methods ; Humans ; Liver ; pathology ; surgery ; Liver Diseases ; complications ; pathology ; surgery ; Necrosis

Objective To discuss the value of CT prognosis on the Masaoka staging system of thymic epithelial tumors(TET) before surgical resection.Methods The CT images of 102 patients with TET proved by surgery and pathology were reviewed retrospectively.The TET were reclassified according to Masaoka stage system.The size,homogeneity,sharp,contour,infiltration of surrounding tissue,and metastasis on CT were analyzed with Logistic analysis.The diagnostic value was also evaluated with a ROC curve.Results Masaoka pathologic stages were stage Ⅰ for 36 (35.3 ％),stage Ⅱ for 27 (26.5 ％),stage Ⅲ for 30 (29.4 ％),and stage Ⅳ for 9 (8.8 ％).A multivariable Logistic regression model showed that TET with larger size of tumor (20/35,P =0.0371,OR =4.539),irregular or lobulated tumor contour (26/42,P =0.0230,OR =4.870),heterogeneous (21/33,P =0.0154,OR =6.020),infiltration of surrounding fat (25/32,P =0.0019,OR =14.005),and pleural seeding (11/11,P =0.0032,OR =36.153)were more likely to have stage Ⅲ or Ⅳ disease.The area under ROC curve was 0.940.Conclusions The tumor CT imaging features can differentiate between stage Ⅰ,Ⅱ and stage Ⅲ,Ⅳ disease.This helps identified patients more likely to benefit from neoadjuvant therapy.

An analysis of the present development of general practitioners in China,probed into the bottlenecks found.The paper proposed to set forth from the training,use and incentives of GPs to promote the systematic design of China's GP system.These measures center on the regulation of GPs development,while building a multi-channel and multi-level GP development system.Other recommendations include raising the professional standing and attractiveness of GPs as a discipline,and enhancing GPs capacity building to promote general practitioners development.

Objective To improve clinicians' understanding of tuberculosis as the adverse event of the tumor necrosis factor alpha (TNF-α) antagonists therapy. Methods Two rheumatoid arthritis (RA) patients were reported to develop lymphoid tuberculosis and pulmonary tuberculoma after TNF-α antagonists therapy. The relevant literature were reviewed. Results The first ease was a 62 year-old female RA patient. Her skin PPD reaction was negative and chest X-ray was normal before the therapy. Following 4 doses of infliximab injection (each dose of 3 mg/kg) which were completed within 3 months, the patient developed fight supraclavicular lymphoids tuberculosis in the 5th month after the last treatment. The patient completely recovered after lymphoids excision and antituberculosis therapy with 4 anti-tuberculosis medications combination. The second case was a 44 year-old female RA patient. She did not take the skin PPD test and chest X-ray before the therapy. The patient developed fever and chest distress after etanercept therapy (25 mg hypodermic twice per week ) for 1.5 months. The chest X-ray showed a shadow in the median lobe of the right lung, which had gradually developed to a pulmonary tuberculoma. The patient's physical condition improved after the tubereuloma resection. It has been reported in recent years that ① TNF-α antagonists therapy could increase the incidence of tuberculosis, ② the incidence at which infliximab associated tuberculosis was higher than etanercept, ③ the majority of the patient having tuberculosis were old people, and ④ the incidence of extrapulmonary tuberculosis and the disseminated tuberculosis were higher than regular tuberculosis. Conclusion TNF-α antagonists may decrease the host defense ability against mycobacterium tuberculosis and increase the incidence of tuberculosis. The pre-treatment tuberculosis screening, as well as tuberculosis monitoring during and after treatment is mandatory.

Objective To develop a suicide ideation scale for Chinese military.Methods Based on the analysis of literatures and the established ideation scale, the theory structure of suicide ideation scale was constructed and a scale was developed regarding to the results of specialists evaluation.Then 900 soldiers including navy, army and air force were picked out randomly as samples from a military region.The data Was submitted to factor analysis and to test the reliability and validity of the scale.Results The whole suicide ideation scale Was constitute of three factors, such as despair, depression and optimism.Correlation coefficient between each factor and the total score ranged from 0.679 to 0.913,Correlation coefficient between the scale and Suicidal Possibility Scale Was 0.620,the coefficient of stability was 0.904.the Cronbaeh α of each factor ranged from 0.750～0.894.Conclusion The scale proves to be applicable to Chinese military in evaluating their suicidal ideation.

Humans ; Male ; Middle Aged ; Polycythemia ; etiology ; Sleep Apnea, Obstructive ; complications

Cyclosporine ; pharmacokinetics ; therapeutic use ; Humans ; Treatment Outcome

Adult ; Aged ; Alveolar Ridge Augmentation ; methods ; Dental Implantation ; methods ; Female ; Humans ; Male ; Maxillary Sinus ; surgery ; Middle Aged

Objective To study the features of mammography,breast ultrasonography(US)and physical examination(PE)on 0-Ⅰstage(early stage)breast cancer,and to approach a diagnostic measure for early stage breast cancer(EBC).Methods Physical examination,ultrasonography and mammography were performed in 28 patients with pathologically proved breast cancer in 0-Ⅰ stage,and the data were analyzed.Results The accuracy of PE for 0-Ⅰstage of EBC was 57.1%(16/28),and the accuracy by US or mammography was 85.7%(24/28)and 89.3%(25/28),respectively.As the main clinical symptom of 0-Ⅰ stage EBC,breast lumps were found in 14 of 16 PE positive cases(87.5%).The main feature of EBC by mammography was the finding of a lump(14/25,56%).The low echo of a solid space occupying lesion was the main US feature of EBC(18/24,75%).The diagnostic accuracy of mammography for 0 stage EBC was 100.0%(8/8),while only 50%(4/8)by both US and PE.Malignant calcification was the main feature of o stage breast cancer in mammography.The diagnostic accuracy of US,mammography and PE for I stage EBC was 100.0%(20/20),and was 85.0%(17/20)and 40%(8/20),respectively.US was advantagious in detecting cancer in young patient with compact breast.Conclusion Early stage breast cancer often displayed atypical features in PE,US and mammography,which are important for the early-diagnosis of breast cancer,and false negative findings are inevitable in examination.Therefore,the diagnosis of early stage breast cancer should be made with.The findings of PE,US and mammography should be analyzed comprehensively,however,when one of examinations gives a positive finding,the diagnosis of breast cancer should be suspected,and further examination should be carried out to make an early diagnosis.

Objective To evaluate the significance of clinical physical examination, breast ultrasonography, and mammography in the diagnosis of breast cancer in Chinese, to compare their sensitivity, specificity and accuracy, and to elucidate the significance of combined application of the 3 methods. Methods A total of 112 patients suspected to have breast cancer as a result of mass screening (38 cases) and OPD examination (74 cases), were subjected to clinical physical examination, breast ultrasonography and mammography, and biopsy specimens were obtained from all the cases by puncture or surgery, then the final diagnosis was confirmed by pathological examination. The diagnosis made from clinical physical examination, breast ultrasonography or mammography was compared with pathological findings, and the sensitivity, specificity, accuracy, positive predictive value, and Kappa index of the 3 methods were then calculated. Results 61 cases of breast cancer and 51 cases of benign breast disease were identified. The diagnostic sensitivity of clinical physical examination, ultrasonography and mammography was respectively 68.85%, 88.52% and 72.13%, the specificity was respectively 88.23%, 21.57% and 56.86%, while the accuracy was respectively 77.68%, 58.04% and 65.18%. The combined use of ultrasonography and mammography yielded the highest sensitivity of 98.36% (P