The field medical station in military hospital plays an important role in the military logistic system. To better accomplish the duty of medical support mission, the problems of medical equipment and material store house management in the field medical station are discussed. Some targeted suggestions are introduced from daily management and the use of equipment respectively. It can be used as reference for other military hospitals to accomplish different medical support tasks.
Hospitals, Military ; organization & administration ; Military Medicine ; instrumentation

Objective To reconstruct anatomical structures and establish visible model of the hand and evaluate some key techniques of digitized virtual hand. Methods Three hands were scan and then perfused by self-curing denture acylic and cinnabar. With the datum from CT-scan of the specimen of perfused hand (cryopreserved 4-24 h), such anatomical structures as contour, bone, artery, extensor tendon, flexor tendon and nerve of hand were constructed by software of Mimics 10.01 and measured. Results The visible hand model based on anatomical structures was established and main anatomical structures were exactly showed. Each structure was displayed by the multiform solitude or combination. Vessel lumens was displayed hollow and fidelity. The hand nerve can the part demonstrate that can earnest reflect the normal human body nerve contour anatomy characteristic. Conclusion The visible hand model can provide 3D morphological data for clinical practice and research, as well as provide digitized model for virtual reality.

Objective To investigate the relationship between acute biliary pancreatitis and pancreaticobiliary maljunction and the role of magnetic resonance cholangiopancreatography(MRCP) in evaluation of pancreatico biliary maljunction.Methods To compare the liver function indicators of different groups of acute biliary pancreatitis patients(153 cases) associated with pancreatico biliary maljunction and without pancreatico biliary maljunction before and after the conservative treatment.Results The 32 acute biliary pancreatitis patients with pancreatico biliary maljunction detected by MRCP were compared with the 121 cases without pancreatico biliary maljunction.The ALT,AST,GGT after conservative treatment in both group of pancreatico biliary maljunction and Npancreatico biliary maljunction were significantly decreased (P ＜ 0.05).ALT,AST and GGT of pancreatico biliary maljunction group were higher than that of Npancreatico biliary maljunction group with statistical significance (P ＜ 0.05).Conclusions MRCP as a noninvasive cholangiopancreatography study of pancreatico biliary maljunction is a safe and reliable examination method,pancreatico biliary maljunction is one of the important causes of acute biliary pancreatitis.

Objective To evaluate the diagnostic value and safety of domestic electromagnetic navigation bronchoscopy (ENB) guided transbronchial lung biopsy (TBLB) for peripheral pulmonary lesions.Methods Sixty-four patients with peripheral pulmonary lesions shown by thoracic CT in Zhongshan Hospital,Fudan University between Jul.and Dec.,2014 were collected.The patients were randomly assigned to test group (underwent ENB in combination with X-ray guided TBLB) and control group (underwent X-ray guided TBLB).The final diagnosis was confirmed by pathologic examination of surgically removed lesions or by 24 months clinical follow-up.The operative time as well as the intraoperative and postoperative complications were also recorded.Results Sixty-four patients had 70 peripheral pulmonary lesions.There was no difference in age,sex,the lesion size or location between the two groups.Pathology results showed that the diagnostic yield of test group and control group were 88.6％ and 62.9％,respectively,with statistical significance (P =0.012).Subgroup analysis showed that if the lesion's diameter was ≤2 cm,the diagnosis yield of test group was higher than control group (66.7％ vs.20.0％,P =0.266);if the lesion was ＞2 and ≤3 cm,the diagnosis yield of test group and control group were 100 ％ and 81.8 ％,respectively (P =0.485).But if the lesion was＞3 cm,the diagnostic yield of the 2 group was significantly different (94.4 ％ in test group,63.1％ in control group,P =0.042).Mean operation duration of the 2 group was (966 ± 372)s and (1 040 ± 470) s,respectively,with no statistical difference (P =0.600).However,there was statistical difference between the 2 groups on the X-ray time needed to find the pulmonary lessions [(7.0 ± 4.8)s vs.(37.0 ± 37.5) s,P =0.008).There was no pneumothoraxes and excessive bleeding in patients undergoing ENB.Conclusions Compared with X-ray guide TBLB,ENB guided TBLB for peripheral pulmonary lesions has a certain degree of security,and has superiority in reducing the X-ray time required to find the lesion and improving diagnostic yield especially when the lesion's diameter was ＞3 cm.

Background and purpose:Epidermal growth factor receptor (EGFR) gene mutation is the most important predictive factor for determining the effectiveness of EGFR tyrosine kinase inhibitors (TKIs) for non-small cell lung cancer (NSCLC). This study aimed to determine the clinical application value of mutation-speciifc immu-nohistochemistry forEGFR mutation detection in NSCLC.Methods:Mutation-specific immunohistochemistry and ampliifcation refractory mutation system (ARMS) were used simultaneously to detectEGFR gene mutation status in 290 lung cancer specimens. The sensitivity, speciifcity, positive predictive value (PPV) and negative predictive value (NPV) of mutation-speciifc immunohistochemistry for detectingEGFR gene mutations were evaluated. The consistency was analyzed between mutation-speciifc immunohistochemistry results and ARMS results.Results:With ARMS testing as the gold standard, when a cutoff value of score 1+ was used as positive by immunohistochemistry, the sensitivity of mutation-speciifc immunohistochemistry forEGFR gene mutation was 72.92%, speciifcity 95.20%, positive predictive value 93.75% and negative predictive value 78.08%. The accuracy of immunohistochemistry was obviously different when variousEGFR gene mutations were detected. The sensitivity of immunohistochemistry for exon 19 deletion was only 55.55%, but speciifcity was above 99%. When immunohistochemistry score was 1+, the sensitivity for L858R mu-tation was 90.27%, whereas speciifcity was 95.86%. When immunohistochemistry score was 2+ or 3+, the speciifcity for L858R mutation was 98.63%-100%. The results of mutation-speciifc immunohistochemistry were ifnely correlated with mutation status determined by ARMS assay (P<0.001, Kappa value: 0.612-0.864). Mutation-speciifc immunohis-tochemistry can directly determineEGFR gene mutation abundance at the cellular level.Conclusion:Mutation-speciifc immunohistochemistry could be an effective supplemental method toEGFR molecular tests.

This study was purposed to comparatively analyse the value of PCR and FCM for dynamic monitoring minimal residual disease (MRD) of acute promyelocytic leukemia. The patients with acute promyelocytic leukemia hospitalized in our hospital from January 2011 to December 2012 were observed and all achieved complete remission after remission induction therapy. Before the chemotherapy, the bone marrow cell morphology examination, polymerase-chain reaction (PCR) and multi-parameter flow cytometry (FCM) were performed for each patient. Then the detection results were statistically analyzed. The 477 specimens were achieved from 159 detections for 48 patients. The results showed that 3 specimens were found to be relapsed by bone marrow cell examination, and other specimens were complete remission;PCR detection confirmed 7 positive, and the FCM confirmed 19 positive. There wasn't significant difference between PCR and FCM by kappa test (P > 0.05). It is concluded that FCM is as sensitive as PCR in evaluating the treatment effect of acute promyelocytic leukemia.
Adolescent ; Adult ; Aged ; Female ; Flow Cytometry ; methods ; Humans ; Leukemia, Promyelocytic, Acute ; therapy ; Male ; Middle Aged ; Neoplasm, Residual ; therapy ; Polymerase Chain Reaction ; methods ; Prospective Studies ; Young Adult

Objective This study aims to conduct an evidence-based analysis of the research progress and management status of the competence of clinical department heads and nurse managers in China,providing reliable references for further devel-oping their management research and improving the human resource management in Chinese hospitals.Methods The VIP,CNKI,WANFANG Chinese databases,online resources,and relevant official websites were searched to retrieve literature related to the competence of clinical department directors and nurse managers in China.Descriptive analysis was conducted using biblio-metrics and evidence-based principles and methods.Results A total of 82 articles were included,mainly focusing on the con-ceptual theories of clinical department directors and nurse managers,the construction of competence models,and application re-search.The research on the competence of clinical department directors and nurse managers in China started relatively late and showed a trend of initial growth followed by decline.The distribution of journals was relatively scattered,and the literature mainly came from higher education institutions and medical institutions.The research development has stagnated at the stage of empirical research and has not progressed to the stage of evaluative research.Conclusion The research on the competence of clinical de-partment directors and nurse managers in China is still in the stage of application and practice,lacking systematic research.It is mainly led by higher education institutions and medical institutions,and the attention from the national government in terms of competence of clinical department directors and nurse managers in hospitals needs to be strengthened.

The field medical station in military hospital plays an important role in the military logistic system. To better accomplish the duty of medical support mission, the problems of medical equipment and material storehouse management in the field medical station are discussed. Some targeted suggestions are introduced from daily management and the use of equipment respectively. It can be used as reference for other military hospitals to accomplish different medical support tasks.

Objective To study the cytomorphologic features of anaplastic lymphoma kinase ( ALK )-rearranged pulmonary adenocarcinoma.Methods The morphologic features in 153 pulmonary adenocarcinoma cytology specimens encountered during the period from September, 2011 to April, 2015 in Shanghai Cancer Hospital were retrospectively reviewed.Fluorescence in-situ hybridization ( FISH) and/or immunohistochemistry ( Ventana D5F3) for ALK gene rearrangement were carried out.The samples studied included 34 pleural effusion specimens, 40 endobronchial ultrasound-guided transbronchial needle aspirates ( EBUS-TBNA) and 79 fine needle aspirates of palpable masses on body surface.Results Thirty-nine cases (25.5%) of ALK-rearranged samples were identified by FISH and/or immunohistochemistry, including 3 cases diagnosed by FISH and 36 cases by both technologies.The median age of the ALK-positive group was 50 years, significantly younger than that of the ALK-negative group (60 years old,P=0.002) .Only 4 of the ALK-positive patients were smokers, which was significantly less than that of the ALK-negative group (P<0.01).In ALK-positive group, 3 cases showed cribriform pattern with prominent nucleoli, 3 cases showed cribriform pattern with mucin-rich cells and 8 cases showed extracellular mucus with mucin-rich cells.The above cytomorphologic patterns were significantly less common in ALK-negative tumors ( P <0.01 ) . Conclusions ALK-rearranged lung adenocarcinoma is associated with certain distinctive morphologic patterns, including cribriform architecture, presence of prominent nucleoli, mucin-rich cells and extracellular mucus, which can be observed in cytology specimens ( including conventional smears and cell block sections) .These findings, when combined with clinical features, may give clues to detection of ALK-positive cases.