To combine "the rule of military medical measurement" with the current situation of medical treatment quality control, the foundation, important component and necessary condition of medical treatment quality control was described. Some idiographic advices of intercoordination and communication in medical measurement institution, the direction and training of special technique, and how to develop compulsion coerciveness checking in base course were given. These are valuable for insuring medical treatment facility in hospital.

Objective To invesigate the value of contrast-enhanced spiral CT scan in diagnosing renal pelvic carcinoma.Methods All 35 cases with renal pelvic carcinoma confirmed by surgical pathology underwent plain and contrast-enhanced (including 4 phases) spiral CT scans before operation.CT data were reviewed retrospectively in comparison with surgical and patholgical results.Results CT findings of renal carcinoma could be classified into 3 types:type Ⅰ,the lesions limited within the renal pelvis in 25 cases;thype Ⅱ,the lesions were out of the renal pelvis and had indefinable margins with the renal parenchyma in 6 cases;type Ⅲ ,only showed the pelvic wall thickened with hydronephrosis in 4 cases.On contrast-enhanced CT scan,inhomogeneous enhancement of the lesions was presented in cortical phase,the intensity of enhancement was not obviously changed in 13 cases in parenchymal and excretion phases,but the lesions were still hypointense in comparison with renal parenchyma,14 cases demonstrated inhomogeneous enhancement of the lesions in delayed phase.Conclusion Contrast-enhanced spiral CT scanning is valuable in diagnosing renal pelvic carcinoma and renal delayed phase should be emphasized.

Objective To investigate the diagnosis of intracranial artery fenestration and its other vascular anomalies with CT angiography ( CTA ) . Methods The image data of 653 patients examined with head CTA and 39 patients diagnosed as intracranial artery fenestration in Zhongshan Hospital Affiliated to Sun Yat-sen University from January 2013 to January 2014 were analyzed retrospectively. The incidence, location,morphology of intracranial artery fenestration, and other vascular anomalies were analyzed. Results (1) In 653 patients,39 (5. 97%) with 41 artery fenestrations were detected. The detection rates of basilar artery fenestration was 3. 37% (n=22),vertebral artery fenestration was 0. 31% (n=2),anterior cerebral artery fenestration was 1. 22% (n =8),anterior communicating artery fenestration was 0. 61%(n=4),and middle cerebral artery fenestration was 0. 76% (n=5),respectively. The post-circulation fenestration was mainly convex lens type (66. 67%,n =17),the anterior-circulation fenestration was mainly fissure type (76. 47%,n=24),and there was significant difference (χ2=7. 411,P<0. 05). (2) In the 39 patients,22 complicated other vascular anomalies. Most of them were unilateral or bilateral fetal-type posterior cerebral arteries (n=10),and followed by aneurysms (n=5). The locations of 5 aneurysms were far from the fenestration,3 located in the communicating segment of internal carotid artery,1 in the top of basilar artery,and 1 in the M2 segment of bilateral middle cerebral arteries. Conclusion CTA can intuitively and clearly reveal the intracranial artery fenestration and other vascular anomalies. But there is no significant correlation between arterial fenestration and vascular anomalies.

Objective To understand the status of field feces in Jingzhou City, so as to provide the evidence for improving the control measures to interrupt the transmission routes of schistosomiasis. Methods The distribution of field feces was investigated in 27 schistosomiasis endemic villages in Gong’an,Jianli,Jiangling,Honghu and Shishou counties(cities)from 2010 to 2012. The schistosome positive status of the field feces was surveyed with the hatching method. Results There were 1 366 field feces and the average density was 0.089 2 feces per 100 square meters in this survey. The cattle feces,human feces,dog feces and elk feces respectively accounted for 99.71%,0.07%,0.15% and 0.07% in the survey. The infection rates of the field feces were 1.46%and 2.42%in the channels and bottomlands,respectively(P>0.05). The average rate of infected field feces was 3.21%in 2010,0.36%in 2011,and 1.60%in 2012,and the difference between 2010 and 2012 was not statistically significant(P>0.05). Conclusions The main field feces come from cattle,and the main distribution of infected field feces is in channels and bottom-lands. Therefore,the management of cattle and treatment of field feces should be strengthened.

Objective To assess the displaying of the cystic artery and the cystic duct in calculus cholecystitis patients using MSCT.Methods One hundred and three patients with calculus cholecystitis (the experimental group)and 71 patients with non-gallbladder disease (the control group)performed the cystic artery and the cystic duct imaging using MSCT.The data in two groups were recorded and statistical analyzed.Results (1)The display rate of the cystic duct were 93.2% (96/103)in the experimental group and 100% (71/71)in the control group with the significant difference between the two groups (P <0.05).7 cases whose cystic ducts could not displayed in the experimental group were all the acute cholecystitis,and the display rate of the cystic duct in the acute cholecystitis was 77.4%(24/31).The display rate of the cystic artery were 100% in both the experimental and control group.(2)The variation rate of the cystic duct running were 10.4% (10/96)in the experimental group and 18.3% (13/71 )in the control group with no significant difference between the groups (P >0.05).The variation rate of the cystic artery running were 13.5% (13/96)in the experimental group and 1 5.5% (1 1/71)in the control group.There was no significant difference between the groups (P >0.05).Conclusion The cystic duct and the cystic artery could be evaluted well in calculus cholecystitis using CT.The displaying of the cystic duct is relatively poor in acute cholecystitis.

ObjectiveTo discuss the effects of adsorption(AP) combined with continuous venovenous hemofiltration(CVVH) on the serum inflammatory mediators levels in systemic inflammatory response syndrome (SIRS) patients.Methods Sixty-three SIRS patients were divided into treatment group (31 cases,AP combined with CVVH ) and control group (32 cases,CVVH ) by random digits table method.The changes of the serum tumor necrosis factor-alpha (TNF-α ),C-reactive protein (CRP),interleukin (IL)-1,IL-6 and IL-10 before and after treatment were compared in two groups.ResultsThere was no significant difference in the serum TNF-α,CRP,IL-1,IL-6,IL-10 before treatment between two groups (P ＞ 0.05 ).The serum TNF- α,CRP,IL- 1,IL-6,IL- 10 decreased after 2,26 and 50 h treatment compared with those before treatment in treatment group[after 2 h treatment:(226.4 ± 27.6) ng/L,(70.4 ± 22.1 ) mg/L,(30.1 ±2.9) ng/L,(227.5 ± 13.2) ng/L,(40.0 ±5.2) ng/L; after 26 h treatment:(165.3 ±24.5) ng/L,(58.2 ±25.1) mg/L,(18.2 ±2.7) ng/L,(82.4 ±7.2) ng/L,(26.2 ±4.3) ng/L; after 50 h treatment:( 120.6 ± 19.2) ng/L,(46.2 ± 24.6) mg/L,( 12.4 ± 2.3 ) ng/L,(38.1 ± 4.4 ) ng/L,( 15.2 ± 2.1 ) ng/L; before treatment:(350.8 ± 40.2) ng/L,( 126.4 ± 34.6) mg/L,(38.2 ± 3.6) ng/L,(307.7 ± 15.1 ) ng/L,(60.2 ± 9.3)ng/L,P ＜0.05].The serum TNF-α,CRP,IL-1,IL-6,IL-10 decreased after 26 and 50 h treatment compared with those before treatment in control group [after 26 h treatment:(262.7 ± 29.4) ng/L,(86.4 ±23.7) mg/L,(29.6 ± 3.1) ng/L,( 175.0 ± 10.6) ng/L,(42.7 ± 5.4) ng/L; after 50 h treatment:(219.3 ±25.6 ) ng/L,(75.6 ± 24.0) mg/L,(23.5 ± 2.8 ) ng/L,(99.0 ± 8.2 ) ng/L,(29.3 ± 4.8 ) ng/L; before treatment:(352.5 ± 40.4) ng/L,( 123.2 ± 35.2) mg/L,(37.5 ± 3.8) ng/L,(308.2 ± 15.3) ng/L,(58.4 ± 8.8) ng/L,P ＜0.05].There were significant differences in the serum TNF- α,CRP,IL-1,IL-6,IL-10 after 2,26 and 50 h treatment between two groups (P ＜ 0.05).ConclusionAP combined with CVVH can effectively decrease the serum inflammatory mediators in SIRS patients and it's therapeutic effect is superior to mere CVVH.

Objective To understand the key risk factors of schistosomiasis transmission in Jingzhou City,so as to provide the evidence for improving the treatment of these risk factors. Methods Each village of six counties was investigated and 3 envi-ronments were surveyed each village for the distribution of Oncomelania snails and animal stools in the field. The results were ana-lyzed and the risk factors of schistosomiasis transmission were assessed. Results The density of living snails was 0.43 snails per 0.1 m2,the frequency of the frames with snails was 9.12%,and no schistosome infected snails were found. All of the animal stools collected from the field were from bovines. The schistosome positive rate of animal stools was 37.50%(3/8)among the environ-ments,and the schistosome infection rate of stools was 8.11%(3/37). The schistosome infection rate of animal stools was 0 near the residence living sites,and the positive rates were 12.50%and 8.33%in the ditches and slopes,respectively(χ2=0.07,P>0.05). Conclusions Bovine is still the main infectious source of schistosomiasis,i.e. the main risk factor of the disease transmis-sion. Therefore,the strategy of controlling bovine should be strengthened.

Objective To evaluate the detection rate and the efficiency of the modified crushing-cercariae escaping method.Methods The detection rates of the modified crushing-cercariae escaping method and the crushing methods were compared by using a double-blind control experiment with the latter as a gold standard.meanwhile the number of the cercariae was quantified.The efficiency of the two methods aforementioned and the cereariae escaping method were compared in field.Results The detection rate of the modified crushing-cercariae escaping method was 100%.the average number of cercariae in each infected snail was (4 778±1 157);and the number in certain volume of water sample was positively correlated with the number of infected snails.The efficiency of the modified menthed Was 18.2 times and 17.3 times as high as those of the crushing method and cereariae escaping method,respectively.Conclusions The modified crushing-cercariae escaping method Can detect the infected snails quicky and Can quantify the number of infected snails and cercariae,and is suitable for the detection of infected snails in large number.

OBJECTIVETo investigate the application of microsurgical technique in the replantation of amputated ear.

METHODS7 cases of amputated ears were analyzed from June 2009 to April 2015 in our department. We used microsurgical technique to anastomose about five vessels and nerves. The blood supply of auricle was restored within three to six hours. All subjects underwent treatments including anti-freezing, anti-spasm and anti-infection treatment after the emergency surgery.

RESULTS7 amputated ears were all survived after replantation. The patients were followed up for one month to six months ( average for 28 months). The appearances of survived ears body were fully recovered without any significant atrophy or pigmentation. The sensory function of ears recovered to normal after 1 year.

CONCLUSIONSThe application of microsurgical technique in the replantation of amputated ear can expect the high success rate of ear replantation. However, skilled and high-quality anastomosis technique of small vascular are required.

Amputation, Traumatic ; surgery ; Anastomosis, Surgical ; methods ; Ear Deformities, Acquired ; surgery ; Ear, External ; blood supply ; innervation ; Graft Survival ; Humans ; Microsurgery ; methods ; Replantation ; methods

A survey on schistosomiasis conducted in sampled 453 out of 1971 villages in Jingzhou City in the year of 2006. Miracidia hatching test demonstrated that the prevalence in human population was 3.9% (12 006/310 232), with sporadic cases of acute schistosomiasis, and the prevalence in cattle was 10.2%(270/2 651). The mean density of living snails was 0.67/0.11 m2(1 988/1 054 597) with a density of infected snails of 0.001 9/0.11 m2(1 988/713 486). In comparison to those of 2004, prevalence in humans decreased by 40.0%, prevalence in cattle increased by 22.3%; the snail-ridden area increased by 4.0%, but the mean density of living snails increased by 68.5% and the infected snail density increased by 18.8% with a decrease of 36.4% in snail infection rate. Consequently, there is an urgent need in controlling schistosome infection in cattle.