Objective: To propose a reasonable and feasible system of performance audit indicators for New Rural Cooperative Medical System(NCMS). Methods:Using the balanced score card as amended to perform the evaluation. Results:From 5 dimensions, 37 indicators were used to perform comprehensive evaluation for the NCMS. Conclusion: The indicator system is suit for the current situation, as well as audit evidence through questionnaires to obtain the required data of the system;it provides a better evaluation of the NCMS performance.

Objective To investigate the CT presenting rate and features of gastric bare area (GBA, including the area posterior to GBA and the adipose tissue in the gastrophrenic ligament) without pathologic changes.Methods Thirty cases with superior peritoneal ascites, but without pathological involvement of GBA were included into the study to show the normal condition of GBA, including the presenting rate and CT features. We selected some cases with GBA invasion by inflammation or neoplasm to observe their CT features. Results All cases with superior peritoneal ascites showed the GBA against the contrast of ascites with the presenting rate of 100%. The GBA appeared at the level of gastric esophageal conjunction and completely disappeared at the level of hepato duodenal ligament and Winslow’s foramen. The maximum scope of GBA presented at the level of the sagital part of the left portal vein with mean right to left distance of (4.39? 0.08 )cm (3.8～5.7 cm) (distance between the left and right layer of the gastrophrenic ligament). In acute pancreatitis, the width of GBA increased, in which local hypo density area could be seen. In gastric leiomyosarcoma invading GBA, the mass could not separate from the crus of the diaphragm. In lymphoma and metastasis invading GBA, the thickness of GBA increased and the density was heterogeneous, in which lymph nodes presenting as small nodes or fused mass. Conclusion The results of this study show that it is helpful to use contrast enhanced spiral CT scanning to observe the change of GBA and to diagnose retroperitoneal abnormalities that involving GBA comprehensively and accurately.

Objective To explore the diagnosis value of narrow-band imaging magnifying endoscopy (NBI-ME) in the early esophageal cancer and precancerous lesions while estimating the quality,depth and treatment strategy.Methods One hundred and eleven cases of patients with suspected early esophageal cancer and precancerous lesions,who underwent ESD treatment,were selected as the study subjects.To estimate the diagnosis value of NBI-ME in the quality,depth and treatment strategy with pathological histology as gold standard.Results While estimating quality,there was no low grade intraepithelial neoplasia(LGIN) cases with NBI-ME.A total of 33 cases were diagnosed as high grade intraepithelial neoplasia(HGIN),including 30 cases of HGIN and 3 cases of LGIN after ESD treatment,and the other 78 cases were diagnosed as early esophageal cancer,including 5 cases of LGIN,22 cases of HGIN,and 51 cases of early esophageal cancer.Compared with the pathology results,the quality consistency of NBI-ME is general:K=0.498.While estimating depth,there was no LGIN cases with NBI-ME.A total of 33 cases were diagnosed as HGIN,including 30 cases of HGIN and 3 cases of LGIN after ESD treatment,67 cases were diagnosed as intramucosal carcinoma,including 5 cases of LGIN,22 cases of HGIN,30 cases of intramucosal carcinoma,and 10 cases of submucosal carcinoma after ESD treatment,and 11 cases were diagnosed as submucosal carcinoma.Compared with the pathology results,the depth consistency of NBI-ME is general:K=0.469.Most of the patients shoud be treated by ESD except 8 cases of LGIN.Conclusion The study shows general diagnosis value of NBI-ME in estimating quality,depth and treatment strategy of early esophageal cancer and precancerous lesions.

Objective To investigate the change in the proportion of NK or NKT cells in the peripheral blood of patients with HBV associated acute-on-chronic liver failure(HBV-ACLF) .Methods the frequency of NK or NKT cells in the blood of 25 healthy controls(HC) ,40 patients with chronic hepatitis B(CHB) and 26 HBV-ACLF patients was detected by flow cytometry .The differ-ences in the proportion of NK and NKT cells among the three groups were analyzed by SPSS software and the correlation was ana-lyzed between the frequence of NK or NKT cells and HBV markers and the level of liver function .Results the proportion of NK cells in HC ,CHB ,or HBV-ACLF group was (15 .0 ± 6 .0)% ,(11 .4 ± 6 .8)% ,(8 .9 ± 6 .7)% respectively ,and the difference be-tween the HBV-ACLF group and HC or CHB group was statistically significant (P<0 .05) .And for the NKT cells ,its frequence in the HC ,CHB ,or HBV-ACLF group was (1 .9 ± 1 .3)% ,(4 .3 ± 3 .7)% ,(5 .4 ± 8 .6)% respectively ,and there was significant difference between the HBV-ACLF group and HC group(P<0 .05) .Conclusion The proportion of NK cells in HBV-ACLF has a significant decline ,while NKT cells has a significant increases .it indicate that NK or NKT cells might be play a certain role in the HBV-ACLF development process .

Objective To characterize the natural history of psoriasis vulgaris.Methods A retrospective study was carried out.Totally,245 patients admitted to hospitals within three months after the first episode of psoriasis vulgaris were selected from 1136 patients with psoriasis vulgaris who had been followed up for more than 20 years.Changes in disease severity during the long-term follow-up were traced,and information on the shape and distribution of skin lesions,family history,use of anticancer drugs,vitamins and traditional Chinese medicines was collected and analyzed.SPSS13.0 software package was utilized to assess factors associated with the evolution of psoriasis vulgaris.Results The natural course of psoriasis vulgaris could be classified into six types:immediate healing,slow healing,intermittent relapse,frequent mild relapse,frequent moderate relapse,and frequent severe relapse.The immediate healing type and slow healing type amounted to 30％ of these patients,and the frequent severe relapse type to less than 10％.Statistical analysis revealed that the clinical severity of psoriasis was associated with the age of onset and family history,and was negatively correlated with the use of anticancer drugs.Conclusions The long-term follow-up study reveals the natural course of psoriasis vulgaris,which may be helpful in guiding the prediction of prognosis,prevention of recurrence and selection of treatment.

Malignant tumors are highly heterogeneous in terms of molecular phenotypes such that personalized therapy will be-come the standard for tumor therapy. Molecular classifications of cancer based on differences in biological behavior are important for selecting treatment strategies and prognostication. The unique optical and chemical properties of quantum dots have been widely used in biomedical applications such as tumor diagnosis, monitoring, pathogenesis, treatment, molecular pathology, and heterogeneity based on biological markers. In this study, we discuss the application of quantum dot-based nanotechnology and the molecular classification of cancer in personalized oncology.

Humans ; Pulmonary Embolism ; Pyrazoles ; Pyridones ; Venous Thrombosis

Objective To investigate the application of hypocaloric parenteral nutrition in postoperarive elderly patients with gastric cancer. Methods 59 elderly patients aged 60- 79 years with gastric cancer after operation were randomly assigned to receive 84 kJ · kg -1.d -1 hypocaloric parenteral nutrition (29 cases) and 126 kJ · kg-1 · d -1 standard-calorie parenteral nutrition (30cases),totally 6 d from postoperative 2 d. Complications, serum proteins, immune function,inflammation,blood glucose, liver function and recovery time of gastrointestinal function were observed during nutritional support. Results The postoperative complication rate were 37.9％(11/29) in hypocalorie group and 43.3 ％ (13/30) in standard calorie group ( P＞0.05),mainly pulmonary infection.There were no ditferences in levels of serum albumin,total protein and prealbumin between two groups at postoperative 3 d and 6 d (P＞0.05).Peripheral blood lymphocytes and T lymphocyte subsets CD3+,CD4+,CD4+/CD8- ratio were decreased after sugery,but CD8 1 values increased in two groups (P＞0.05).C reactive protein was increased significantly at postoperative 3 d compared with preoperation,and decreased at 6d than 3 d (P＞0.05).Blood glucose was decreased gradually at 3 and 6 d (P＞0.05).Postoperative liver function paraneters were elevated,no difference was found at 3 d (P＞0.05),and continued to rise at 6 d in standard calorie group than in hypocalorie group (P＜0.05). There was no difference in times of aerofluxus and cacation after operation between hypocalorie and standard calorie groups (P＞0.05). Conclusions Hypocaloric parenteral nutrition is a safe and effective method for nutrition support in postoperative elderly patients with gastric cancer.

Objective To synthesize 99Tcm labeled VEGF fragment (VEGF125-136) and evaluate its biodistribution and imaging in the nude mice bearing human osteosarcoma,in order to find a probe to improve the early diagnosis and targeted therapy of osteosarcoma.Methods VEGF125-136 was synthesized by conventional solid phase synthesis method,and directly coupled with MAG3 to form MAG3-VEGF125-136,then MAG3-VEGF125-136 was labeled with 99Tcm.The osteosarcoma bearing nude mice were randomly divided into four groups by random number table and studied for 99Tcm-MAG3-VEGF125-136 distribution at 0.5,1,2,4 h,respectively.The other 10 osteosarcoma bearing nude mices were divided into the experimental group and competitive inhibition group,and underwent radionuclide imaging.The T/NT ratio was calculated.Data were analyzed using two-sample t test.Results The radioactive labeling rate was greater than 95％,radiochemical purity was still greater than 85％ after 12 h in room temperature.The 99Tcm-MAG3-VEGF125-136 was cleared fast in blood and mainly excreted through the kidneys and liver.Tumor uptake of 99Tcm-MAG3-VEGF125-136 was highest at 1 h with (0.28±0.02) ％ID/g.The T/NT ratios of experimental group at 0.5,1,2,4 h were 1.07±0.10,3.10±0.19,2.63±0.14,1.90±0.09,respectively.In competitive inhibition group,no obvious radioactivity concentration was observed in tumors.The T/NT ratios were 0.99± 0.05,1.06± 0.06,0.98±0.03,0.97±0.03 at 0.5,1,2,4 h respectively.The T/NT ratios were significantly different between the two groups at 1,2,4 h (t=22.52,26.36 and 22.31,all P＜0.05),but no significant difference was observed at 0.5 h (t =1.44,P＞0.05).Conclusion 99Tcm-MAG3-VEGF125-136 has high labeling efficacy,good stability and high specificity to osteosarcoma.It can be used as an agent for early diagnosis and therapy monitoring in osteosarcoma.

Objective In order to know the operative key points of combined endoscopic nephroureterectomy. Methods Retrospective analyzed 16 patients with combined endoscopic nephroureterec-tomy, and then summarized perioperative nursing points. Results All the patients had successful operation without any complications. Conclusions Careful perioperative nursing are the guarantee for successful oper-ation, which can effective promote the rehabilitation for patients.