Objective To study the structure and the use of the information sharing platform for long-distance medical information network in integrating long -distance medical information network, HIS, PACS system and other resources, thereby enhancing the quality of long -distance medical consultation. Methods The study was conducted by integrating hospital internal data resources, structuring information platform and standardizing consultation process. Results The information sharing platform was achieved based on long-distance medical information network, thus achieving the greatest degree of information sharing and raising the level of long-distance medical consultation.

Objective To assess the effect of thoracoscopic surgery under laryngeal mask anesthesia and explore the nursing strategies. Methods Thirty-five patients from April to December in 2014 undergoing video-assisted thoracoscopic surgery (VATS) were given intubation anesthesia and another thirty-five ones undergoing the same surgery in 2015 received laryngeal mask anesthesia. The two groups were compared in terms of surgery conditions, surgery complication and ambulation time. Results No significant differences were found in surgery time or blood loss between two groups (P>0.05). The postoperative waking time in the mask anesthesia group was significantly shorter than that of the intubation anesthesia group (P<0.05), and ambulation time was significantly shortened (P<0.05). The rates of throat discomfort, hoarseness and gastrointestinal reactions were significantly lower. Conclusions Laryngeal mask anesthesia used in small thoracoscopic surgery for airway management is safe and feasible. Combined with training in respiration and limb function, better analgesia and nursing, it can keep away complications related to intubation anesthesia, shorten hospital stay and accelerate postoperative rehabilitation.

Objective To explore the anatomic character of brachial plexus nerve by ultrasonography,and provide a basis for ultrasound-guided brachial plexus block.Methods Twenty-four healthy volunteers were chosen for high-frequency sonography examination,the features of brachial plexus distributions were studied in the axilla location and the interscalene location.Results Brachial plexus of all the 24 cases were detected.At the axilla level,main braches of brachial plexus nerves were very close to the axillary artery.At the interscalene level,the brachial plexus was consistently found between the scalenus anterior and medius muscles in the interscalene groove.Conclusions Using high-frequency sonography,the main braches of brachial plexus can be observed clearly.

ObjectiveTo discuss the application value of high frequency ultrasound (HFUS) characteristics, acoustic radiation force impulse (ARFI) imaging technology and contrast-enhanced ultrasound (CEUS) in the diagnosis of soft tissue hemangioma.MethodsTo retrospectively analyze the clinical data of 44 cases of soft tissue hemangioma that were treated in Capital Medical University Affiliate Beijing Chaoyang Hospital from August, 2013 to May, 2014, and to analyze the difference between the characteristics of HFUS, ARFI and CEUS in soft tissue hemangioma and normal surrounding tissue.ResultsHFUS shows the features of morphological diversity of sinus shape expansion tube structure, unclear boundary, irregular configuration, compressibility and partial strong echo in the phlebolith. Color Doppler ultrasound (CDFI), detects abundant interphase red-blue bloodstream signal slowly and consistently. The blood signal is strengthened after partial compression. CDFI shows more vein spectrum in the lesion. The discrepancy of comparison between VTQ and SWV value of soft tissue hemangioma and surrounding muscular tissue possesses statistical significance [(1.082±0.183) m/svs (1.414±0.331) m/s,P<0.01]. Ultrasound contrast can show the relationship between diseased region and surrounding tissue clearly, which is beneficial to the selection of operation method and prognosis.ConclusionThrough conventional two-dimensional ultrasound and high frequency CDFI, and further combining the acoustic pulse radiation ARFI technology and CEUS technology, the soft tissue hemangioma can’t only be more accurately diagnosed, but also provides more reliable diagnostic basis for clinic.

Objective To explore the clinical characteristics and correlation of adult primary nephrotic syndrome (PNS) with thyroid dysfunction,and early identify high-risk adult PNS patients with abnormal thyroid function by clinical data.Methods The clinical data of 101 adult PNS patients in Heji Hospital Affiliated to Changzhi Medical College from March 2015 to December 2017 were retrospectively analyzed.According to the thyroid function,the patients were divided into 2 groups:normal thyroid function group (67 cases) and thyroid dysfunction group (34 cases),including 9 cases with low triiodothyronine (T3) syndrome and 25 cases with subclinical hypothyroidism.The clinical data were compared,and the correlation between thyroid-stimulating hormone (TSH) and 24 h urinary protein,blood albumin and systolic blood pressure were analyzed.Results The incidence of thyroid dysfunction in adult PNS patients was 33.66％ (34/101),including 21 cases of membranous nephropathy,8 cases of minimal change disease,4 cases of IgA nephropathy and 1 case of membranoproliferative nephritis.The 24 h urinary protein in thyroid dysfunction group was significantly higher than that in normal thyroid function group:(8.76 ± 3.62) g vs.(6.96 ± 3.43) g,the albumin was significantly lower than that in normal thyroid function group:(21.82 ± 4.89) g/L vs.(24.49 ± 4.14) g/L,and there were statistical differences (P＜0.05 or ＜0.01);there was no significant difference in gender composition,age,course of disease,systolic blood pressure,diastolic blood pressure,body mass index,hemoglobin,platelet,creatinine,cystatin C,fasting blood glucose,total cholesterol,triacylglycerol,low-density lipoprotein cholesterol (LDL-C),fibrinogen,complement C3,IgG,IgM,IgA,PNS types and comorbidities between 2 groups (P＞0.05).The results of subgroup analysis results showed that the systolic blood pressure in subclinical hypothyroidism patients of thyroid dysfunction group was significantly higher than that in normal thyroid function group and the low T3 syndrome patients of thyroid dysfunction group:(148.16 ± 18.09) mmHg (1 mmHg =0.133 kPa) vs.(139.55 ± 18.77) and (127.78 ± 16.81) mmHg,the 24 h urinary protein was significantly higher than that in normal thyroid function group:(9.00 ± 3.64) g vs.(6.96 ± 3.43) g,the albumin was significantly lower than that in normal thyroid function group:(21.71 ± 5.26) g/L vs.(24.49 ± 4.14) g/L,and there were statistical differences (P＜0.05).Pearson correlation analysis result showed that TSH had no correlation with 24 h urinary protein and systolic blood pressure (r =0.193 and 0.072,P =0.053 and 0.472);however TSH was negatively correlated with albumin (r =-0.340,P =0.001).Conelusions In adult PNS patients with thyroid dysfunction,membranous nephropathy is the most common,followed by minimal change disease.The systolic blood pressure in PNS patients with subclinical hypothyroidism is significantly higher than that in patients with normal thyroid function and low T3 syndrome.In adult PNS patients,the lower the blood albumin is,the more likely they have thyroid dysfunction.

Objective To find a new method for evaluating the left ventricular relaxation time constant Tau with aortic regurgitation by continuous wave Doppler.Methods Twelve Beagle dogs were included in the study.The dog aortic regurgitation model was produced under ultrasound guiding by carotid artery puncture.Aortic pressure was measured by pressure catheter and left ventricular pressure was measured by Millar catheter which was introduced into the left ventricular through cardiac apex.Then microspheres were injected into the left coronary artery under the guidance of ultrasound to induce acute ischemic left ventricular dysfunction,when left ventricular end-diastolic pressure increased more than 5 mmHg (1 mmHg=0.133 kPa).Dobutamine or esmolol was infused to alter left ventricular function.Aortic regurgitation velocity spectrum was recorded by the continuous-wave Doppler echocardiography in different hemodynamic status.At the same time,left ventricular pressure,dp/dt,aortic pressure and continuous ECG tracing were displayed on the multi-channel physiological recorder.Measurement was recorded of-dp/dtmax in the dp/dt tracings and the pressure at the time of-dp/dtmax in the left ventricular pressure tracings.Tau =-P/(dp/dtmax),Tau was the catheter-derived time constant (Taucatheter).Aortic regurgitation spectrum of original audio data was post-processed with MATLAB mathematical software.The spectral lines refresh time of about 300 μs was chosen to form a new Doppler spectrum.Three points:(t1,1 m/s),(t2,2 m/s) and (t3,3 m/s) were selected in aortic regurgitation velocity spectrum and tl,t2 and t3 was put into the corresponding Tau formula:Tau=(t2-t1)/ln[(ADP-C-4)/(ADP-C-16)],Tau=(t3-t1)/ln[(ADP-C-4)/(ADP-C-36)].Tau was the aortic regurgitant time constant (Tauultrasound).The difference between Taucatheter and Tauultrasound was compared by paired t test.The correlation between Taucatheter and Tauultrasound was analyzed by Pearson correlation analysis.Results Twelve dogs were successfully produced aortic regurgitation model.Two dogs died of ventricular fibrillation during the procedure of acute ischemic left ventricular diastolic dysfunction.The range of the Taucatheter was between 27.12 ms and 86.88 ms with an average of (48.973± 14.667) ms;the range of the Tauultrasound was between 28.13 ms and 90.18 ms with an average of (51.236± 15.146) ms.The difference was not statistically significant (t=1.841,P ＞ 0.05).Pearson correlation analysis showed that Taucatheter was positively correlated with Tatultrasound (r=0.89,P=0.000).Conclusion Choosing three points:(t1,1 m/s),(t2,2 m/s) and (t3,3 m/s) in aortic regurgitant velocity spectrum and putting into the corresponding formula,we can calculate Tau,which had a good correlation with the catheter-derived Tau.

China ; Esophageal Neoplasms ; Humans ; Length of Stay ; Malnutrition ; Mass Screening ; Postoperative Complications ; ROC Curve ; Sensitivity and Specificity

Dynamic multi-leaf collimator, which has the function of radiation beam shaping, is a key executive component of tumor precise radiotherapy, and plays a core role in improving the accuracy, efficiency and quality of radiotherapy. A new type of collimator leaf end structure with circular arc and plane combination was studied, and collimator penumbra performance analysis model combining analytical expression and graphic analysis was developed. The influence of leaf end structure on penumbra was analyzed quantitatively, and a set of three-dimensional structure design of dynamic multi-leaf collimator was completed. The feasibility of the structural design and analysis model was verified through experimental measurements.
Humans ; Radiotherapy Planning, Computer-Assisted/methods* ; Particle Accelerators ; Neoplasms ; Radiotherapy Dosage