PurposeWith the extensive use of percutaneous radiofrequency ablation (RFA) for the treatment of hepatic carcinoma (HC), the study of MRI findings and its clinical signiifcance after RFA of HC have important value and can improve the complete ablation rate.Materials and MethodsA retrospective analysis of post-procedure MRI ifndings of 79 patients (114 lesions) with HC were performed, the size of the lesion, the signal changes and enhancement condition were observed at the ifrst, fourth and seventh month after RFA; the two different ifndings of high signal ring on MRI T1WI and local recurrence rate were analyzed.ResultsOne month after RFA, peripheral region of RFA lesion showed high signal on T1WI, and slightly lower signal on T2WI, the size of lesions was slightly larger than pre-procedure, enhancement scan showed the thin homogeneous ring enhanced around the non-enhanced lesions; 4 months later, the size of lesions were relative stable and the periphery enhancement was weaken; 7 months later, the size of lesions were reduced and showed no enhancement. For recurrence lesions, the high signal ring was incomplete on TIWI, the incomplete area showed nodular enhancement on the arterial phase, and most of nodule showed slightly lower signal on the delay phase demonstrated a feature of quick wash-in and wash-out; 7 months after RFA, recurrence rate was 6.12% in patients with complete high signal ring and 43.75% in patients with incomplete high signal ring, the difference was statistically significant (P<0.05). The total survival rate and accumulated survival rate of the patients with complete high signal ring on T1WI were higher than the patients with incomplete ring, the difference was statistically signiifcant (P<0.05).ConclusionThere are characteristic ifndings of MRI examination of liver cancer after percutaneous RFA, observation of the integrity of high signal ring on T1WI image and ifnding of dynamic enhancement scan can early evaluate efifcacy of RFA guide the selection of treatment plan.

OBJECTIVE:To discuss ward drug control to ensure safe.METHODS:We analyzed retrospectively the application of 5S theory in ward drug control.RESULTS & CONCLUSION:By this drug control mode,drugs were classified according to varieties,usage,frequency of use etc,drug control quality and work efficiency were enhanced,patients' needs could be satisfies and staff' s professional quality was enhanced.

Objective To explore the diagnostic value of MR diffusion weighted imaging (DWI) in the differential diagnosis between encephalitis and acute cerebral infarction.Methods The MR DWI appearances of 23 cases of encephalitis including 14 cases with viral encephalitis, 9 cases with demyelinative encephalitis and 30 cases with acute cerebral infarction were retrospectively analyzed.Results The 30 cases of acute cerebral infarction appeared bright signal in DWI with a ADC values of (0.46?0.13)?10 -3mm2/s. 7 cases with viral encephalitis and 9 cases with demyelinative encephalitis appeared slightly high or high signal intensity in DWI with a ADC values of (0. 98?0.18)?10 -3mm2/s and(0. 89?0.07)?10 -3mm2/s respectively. The ADC values of viral encephalitis and demyelinative encephalitis were higher comparing to acute cerebral infarction(?0.05). However, the ADC values showed higher or lower in different areas in 4 cases, and lower ADC values appearing in 3 cases with viral encephalitis comparing normal parenchyma.Conclusion MR DWI is useful in the differential diagnosis between encephalitis and acute cerebral infarction.

At present, many weak points still exist in teaching practices of medical English in medical colleges, such as lack of clear learning goals and prospects for medical English among medi-cal students, as well as the absence of systematic and practical teaching materials, as well as inappro-priate construction of teacher team for teaching practice. Therefore, corresponding modifications on teaching objectives, construction of teacher team and implementation methods for medical English are urgently needed so as to achieve effective teaching and subsequently meet the new international stan-dards for medical education.

Objective]To explore the aberrant expression of SOD1 gene in nasopharyngeal carcinoma tissues and adjacent tissues,as well as in NPC cell lines,then to observe the effect of SOD1 on NPC cells metastatic ability and investigate the intrinsic?mechanism.[Methods]Immunohistochemical technique was used to examine SOD1 expression in carcinoma tissues and adjacent tissues(n=10). Small interfering RNAs and inhibitor LCS-1 were used to knockdown of SOD1 expression and inhibit SOD1 activity, respectively. Then,wound healing test and migration assay were applied to detect cell metastatic ability in vitro. Real-time PCR and Western Blot were used to analyze the expression of EMT-related genes(E-cadherin,Vimentin,Twist).[Results]SOD1 was found to be significantly up-regulated in nasopharyngeal carcinoma tissues(n = 7 ,70%),compared to control. SOD1 was also highly expressed in highly metastatic potential NPC cell lines(CNE2,5-8F,S18)compared with low metastatic ability cell lines(6-10B). Knockdown SOD1 expression or inhibit SOD1 activity suppress cell motility in CNE2 and 5-8F cells. Finally,we demonstrate that SOD1 inhibition plays a role in induction of epithelial marker E-cadherin and has an opposite effect on mesenchymal marker vimen tin and transcriptional factor twist.[Conclusion]These results suggest that SOD1 contributes to EMT and might be important for tumor metastasis in NPC.

Objective To evaluate the clinical value of CT perfusion (CTP) imaging for providing quantitative information about angiogenesis in patients with lung carcinoma and investigate the correlation of CTP enhancement parameters and histological microvessel density (MVD) with lymphatic involvement in peripheral lung carcinoma. MethodsFifty-three patients with pathology-proved peripheral lung carcinoma underwent CT perfusion scan before operation. The enhancement parameters of CTP were calculated based on the time-density curves (TDC) of fist pass phase. All cases were classified into two groups according to pathologic results: tumor with and without lymph node involvement. Two-sample t test was used for the statistics. The ROC curve was used to assess the efficiency of the enhancement parameters of CT perfusion and MVD for predicting lymphatic involvement.Results Tumors with lymph node involvement had significantly higher value of MVD than those without lymph node involvement (64.69±16.34 and 42.67± 16.78, respectively,t=4.84,P<0.01). Tumors with lymph node involvement had significantly higher value of CTP enhancement parameters (PH, M/A, PV) than those without lymph node involvement [PH= (41.79±15.50) and (29.99±10.91) HU,M/A =0.24±0.09 and 0.15±0.06, PV=(2.14±1.09) and (1.27±0.53) ml·min~(-1)·ml~(-1), t=3.21,3.95, 3.66, P<0.01, respectively]. The CTP enhancement parameters (PH, M/A, PV) of lung cancer correlated positively with the MVD, the highest correlation coefficient was between the PV and MVD (r=0.716, P<0.01). MVD and PV had higher values for predicting lymph node involvement in ROC curve analysis.The sensitivity, specificity and accuracy for predicting lymph node involvement were 80.8%, 81.5% and 81.1% or 84.6% ,85.2% and 84.9% respectively if MVD>52/0.74 mm~2 or PV>1.52 ml·min~(-1)·ml~(-1). ConclusionThe CT perfusion PV and histological MVD have good correlation with lymph node involvement in peripheral lung carcinoma and are important predicting parameters before operation.

Objective To investigate the invasion situation of cardinal ligaments(CL) in stage Ⅰ A2 - ⅡA2 cervical cancer and to find the high risk clinicopathological factors affecting its invasion .Methods The retrospective analysis was performed on the clinicopathological data in 2 982 patients with cervical cancer treated by operation extracted in 5 hospitals from January 2004 to De‐cember 2014 .Results (1) Totally 855 cases according with the research condition were included .The CL invasion was found in 20 cases(2 .3% ) .No CL invasion occurred in the stage ⅠA2 ,the CL invasion rate in the stage ⅠB1 was 1 .7% ,in the stage ⅠB2 was 1 .2% ,in the stage ⅡA1 was 5 .7% and in the stage ⅡA2 was 2 .9% .With the increase of FIGO staging ,the CL invasion rate had no significant increase(P=0 .269) .(2) The infiltration rate of left CL and right CL had no statistical difference among the stageⅠA2- ⅡA2(P=1 .000) .And the invasion rate of the left CL with different FIGO stages had no statistical difference(P=0 .286) , while the right one had statistical difference(P=0 .005) ,in which the highest was in the stage ⅡA1 (4 .3% ) .(3)The univariate a‐nalysis found that lymph‐vascular invasion ,cervical stroma infiltration depth ,pelvic lymph node metastasis ,uterus body infiltration and vaginal fornix infiltration were the risk factors of CL invasion(P<0 .01);the further multivariate analysis determined that the invasion of uterine body(OR=11 .858) ,pelvic lymph node metastasis(OR=6 .359 ,) ,vaginal fornix infiltration(OR=6 .012 ,) were the risk factors for CL invasion(P<0 .05) .Conclusion The invasion rate of CL invasion in early stage cervcial cancer is low .The invasion of uterine body ,pelvic lymph node metastasis and vaginal fornix filtration are the risk factors for CL invasion in the stageⅠA2- ⅡA2 cervical cancer .

Objective To explore the significance of ADC value combined with MRI signs on identifying benign and malignant breast lump lesions with the type of TICⅡ.Methods 187 patients with breast lump lesions of TICⅡ,which were confirmed by surgical pathology,proceeded MRI.The ADC value,early-phase enhancement rate,length of lesions,lobulated appearance and spiculation, inverted nipple,thickening of the skin and the length of ipsilateral axillary lymph nodes were analyzed and recorded.T-tests was used to analyzed the measurement data,χ2test was used to analysis the attribute data.The ROC curves were used to evaluate the diagnostic efficiency of ADC value and MRI signs.Results The ADC value was (1.418±0.299)×10-3mm2/s and(0.860±0.142)× 10-3mm2/s (P<0.01)for breast benign and malignant lesions respectively,while the early-phase enhancement rate were (170.387± 74.580)% and (160.778±39.786)%(P=0.258)respectively.When ADC values were used for differential diagnosis of breast benign and malignant lesions with a threshold of 1.017×10-3mm2/s,the area under the sensitivity and specificity were 89.0% and 98.0% The sensitivity and specificity of lobulated appearance,spiculation,inverted nipple and thickening of the skin were 92.6% and 33.3%, 88.2% and 88.2%,20.5% and 94.1%,35.3% and 88.2%,respectively.When the 1.0 cm was used as the threshold of the length of ipsilateral axillary lymph,its sensitivity and specificity were 47.8% and 80.4%.The ROC curve of early-phase enhancement rate showed no diagnostic capability(P>0.05).Conclusion ADC value combined with MRI features are helpful to improve the sensitivity and specificity in breast lesions with the type of TICⅡ.

OBJECTIVE: To compare the mitigation role of nasopharyngeal and oropharyngeal airway in obstructive sleep apnea hypopnea syndrome (OSAHS) patients with upper airway obstruction after multiple plane operation. Observed parameters included life quality, the clinical value and reliability of nasopharyngeal and oropharyngeal airway. METHOD: The nasopharyngeal airway group, 56 patients with PSG in patients diagnosed with severe OSAHS, after setting nasopharyngeal airway. Oropharyngeal airway group, 45 cases of OSAHS by PSG confirmed severe patients home after oropharyngeal airway, the same as the other treatment groups. Line postoperative ECG, oxygen saturation and hemodynamic monitoring. Two groups were compared in 24 h breathing difficulties, low oxygen saturation, hemodynamics, pharyngeal pain and discomfort of the situation. RESULT: The multiplane after 24 h, the nasopharyngeal airway in patients hemodynamics HR (82.3 +/- 2.65) times/min, SBP(124.5 +/- 13.95) mmHg, DBP (76.2 +/- 8.1) mmHg, RPP(10282.0 +/- 1481.7), port pharyngeal airway in patients hemodynamics HR (93.4 +/- 2.89)times/min, SBP (135.1 +/- 16.5) mmHg, DBP (92.25 +/- 11.25) mmHg. There was significant difference between the two group (P < 0.05); pharyngeal pain nasopharyngeal airway group (1.71 +/- 0.45) points, oropharyngeal airway group (310) points, there was significant difference between the two (P < 0.05); nasopharyngeal airway breathing difficulties Group 0, 0 oropharyngeal airway group, no significant difference between the two (P > 0.05); the lowest oxygen saturation nasopharyngeal airway group (95.2 +/- 1.6)%, oropharyngeal airway group (95.41 +/- 1.34)%, no significant difference between the two (P > 0.05). 24 h before and after surgery between patients with the same group in the hemodynamic parameters (HR,SBP,DBP,RPP), pharyngeal pain, lowest oxygen saturation difference was statistically significant areas (P < 0.05). CONCLUSION Ventilation tube in the nasopharynx and oropharynx in patients with severe OSAHS the same period of postoperative respiratory management plane could well lift the upper airway obstruction. However, nasopharyngeal ventilation tube has a better hemodynamic stability and tolerance, it can reduce patient suffering and increased health and safety from, it is a more safe, minimally invasive and effective method.
Adult ; Airway Obstruction ; prevention & control ; Catheterization ; methods ; Humans ; Male ; Middle Aged ; Nasopharynx ; surgery ; Oropharynx ; surgery ; Sleep Apnea, Obstructive ; surgery

Objective:To explore the application value of real-time vascular quantification stiffness (R-VQS) technique in evaluating carotid artery elasticity and hemodynamic status in type 2 diabetic nephropathy (T2DN).Methods:The clinical data of 86 patients with T2DN treatment in the Fifth People′s Hospital of Zhuhai from March 2020 to March 2022 were collected retrospectively, according to the clinical stage, 44 patients were in the early stage group and 42 patients were in the clinical stage group. All of them underwent R-VQS technique to obtain carotid artery elasticity parameters stiffness index (HC), systolic diameter (Diam), diameter change value (Dist) and hemodynamic indexes pulse conduction velocity (PWV). Among the 86 patients, 21 had atherosclerosis (AS) and 65 did not. The differences of HC, Diam, Dist and PWV between the patients with and without AS were compared, and the value of HC, Diam, Dist and PWV in diagnosing T2DN complicated with AS was analyzed by receiver operating characteristic (ROC) curve.Results:The HC, Diam and PWV in the clinical phase group were higher than those in the early phase group, and Dist was lower than that in the early phase group: 4.76 ± 0.60 vs. 4.15 ± 0.52, (8.69 ± 1.13) mm vs. (7.21 ± 0.84) mm, (7.42 ± 0.63) m/s vs. (6.84 ± 0.57) m/s, (0.27 ± 0.07) mm vs. (0.35 ± 0.09) mm, there were statistical differences ( P<0.05). The HC, Diam and PWV in the patients with AS were higher than those in the patients without AS, and Dist was lower than that in the patients without AS: 4.82 ± 0.63 vs. 4.33 ± 0.51, (8.85 ± 1.18) mm vs. (7.63 ± 1.06) mm, (7.68 ± 0.75) m/s vs. (6.94 ± 0.59) m/s, (0.24 ± 0.05) mm vs. (0.33 ± 0.10) mm, there were statistical differences ( P<0.05). ROC curve analysis results showed that the area under the curve (AUC) of the combined diagnosis of T2DN complicated with AS by HC, Diam, Dist and PWV was 0.921, and the diagnostic sensitivity and specificity were 90.48% and 84.62%, respectively. Conclusions:R-VQS technology can detect abnormal changes in carotid elasticity and hemodynamics in patients with T2DN, and can diagnose T2DN complicated with AS. It can provide a reference basis for clinical prevention and treatment of cardiovascular and cerebrovascular complications in T2DN patients.