Objective To compare the effect of inhibiting neointimal hyperplasia between domestic sirolimus eluting stent(Firebird TM stent)and the TaxusTM stent by IVUS.Methods From May 2003 to June 2007,168 patients with 236 native lesions underwent DES implantation,of which,108 patients(147 lesions)were implanted with the FirebirdTM stents and the other 60 patients(89 lesions)were implanted with the TaxusTM stent.Quantitative angiography(QCA)and intravascular ultrasound(IVUS)analysis were performed at one-year follow-up.Results The baseline clinical and angiographic characteristics between the two groups were similar.There were less in-stent late loss(0.17?0.29 mm vs 0.43?0.51 mm,P0.05).But the Absolute and relative measwements of intimal hyperplasia including manifested as intimal hyperplasia area(0.35?0.58 mm2 vs 1.29?1.26 mm2),percentage of intimal hyperplasia area(5.45%?9.26% vs 17.38%?13.75%),percentage of maximal intimal hyperplasia area(9.41%?14.15% vs 31.56%?20.99%),intimal hyperplasia volume(2.09?5.46 mm3 vs 13.43?18.59 mm3)and percentage of intimal hyperplasia volume(1.68%?5.84% vs 8.62%?9.90%)were lower in the Firebird stent group than those in the Taxus stent group(all P

UNLABELLEDWith different ratios, Omnipague mixed with cod liver oil and Meglumine Diatrizoate mixed with cod liver oil are compared with the stardard marker under the scanning of CT and MR in order to find the better ratio and materials for the marker. The experimental results show that the performances of both Omnipague mixed with cod liver oil and Meglumine Diatrizoate mixed with cod liver oil are better than the stardard marker.

CONCLUSIONOmnipague mixed with cod liver oil and Meglumine Diatrizoate mixed with cod liver oil can be used in making marker for neuronavigation system.

Biomarkers ; Cod Liver Oil ; Diatrizoate Meglumine ; Humans ; Iohexol ; Magnetic Resonance Imaging ; methods ; Neuronavigation ; instrumentation ; methods ; Reference Values ; Tomography, X-Ray Computed ; methods

OBJECTIVE: Medication errors (ME) more frequently affect pediatric patients than adults. Chemotherapeutic drug MEs seems more serious and less detected, among which, the most commonly involved chemotherapeutic agent was methotrexate (MTX). To engage multidisciplinary teams of childhood malignancy in a multisite study using proactive risk assessment methods to identify how MTX errors occur and propose risk reduction strategies. METHODS: We recruited doctors, nurses, pharmacists and parents from three children's hospitals in the northeast and southeast China to participate in failure mode and effects analyses (FMEA). An FMEA is a systematic team-based proactive risk assessment approach in understanding ways a process can fail and develop prevention strategies. Steps included diagram the process, collect failure modes /risks and prioritize failure modes, and propose risk reduction strategies. We focused on MTX-use process in and out of hospitals. RESULTS: A multidisciplinary medication safety team was formed of total 66 members. They developed a four-stage flow diagram with four main phases, based on which, 56 potential risks were recognized and 17 were classified as higher risks by the hazard-scoring matrix. The highest priority failure modes in hospital included wrong solvents, wrong frequency label and lake of monitoring; furthermore, errors involving excessive intake of oral MTX after discharge were worth extra attention. Meanwhile, remediation strategies were developed, consisting of constrained and recommended strategies. CONCLUSION: FMEA is a useful tool to identify the risk of MTX MEs and several years later, with the concerted efforts of all the healthcare staff and technicians, we wish to see a reduction in the potential for errors being made and an improvement of children safety.

In recent decades, the incidence and mortality rates of cancer have kept increasing in China, resulting in heavier health burden. Promoting reasonable and effective cancer screening services in community will meet the urgent needs of residents for cancer screening, decrease the incidence rate of advanced cancer, and reduce the burden of cancer. At present, the primary health setting in China has carried out screening practice for lung cancer, colorectal cancer, cervical cancer, breast cancer, liver cancer, stomach cancer and esophageal cancer, but there is still a lack of combined evaluation of various screening methods for different types of cancer in community. This article reviews the existing literature in order to summarize the organization of cancer screening services in community and the effectiveness and cost of screening common cancers, aiming to provide a more intuitive reference for cancer screening services in domestic primary health setting.

Objective : To construct an appropriate technology catalogue for general practice based on Delphi method,and to provide reference for promoting appropriate techniques and training general practitioners. Methods : The catalogue was briefly constructed based on literature reviews and the data of the top twenty diseases diagnosed in out-patient department of Sir Run Run Shaw Hospital and two community health service centers in Hangzhou. Two-round Delphi consultation was conducted by fourteen general practitioners coming from upper first-class hospitals and community hospitals. The final catalogue was established according to evaluation of the degree of involvement,authority coefficient and Kendall's W values of the fourteen specialists. consultations : Results Of the fourteen specialists,nine had bachelor's degrees and five had master's degrees or above;twelve were deputy chief physicians or chief physicians and two were physicians. They were engaged in general practice for 17.21 years in average. The positive coefficients of the two rounds of were both 100.00%. The authority coefficient of the specialists was 0.891. After the first round of consultation,the W values for importance and feasibility of 6 first-class indicators were 0.170 and 0.244,and the ones of 56 second-class indicators were 0.236 and 0.250（all P<0.05）. Six of second-class indicators were excluded because their coefficent of variation（CV）for importance and feasibility were more than 0.25. After the second round of consultation,the W values for importance and feasibility of 6 first-class indicators were 0.245 and 0.247,and the ones of 50 second-class indicators were 0.355 and 0.370（all P<0.05）. The CV for each indicator was less than 0.25. Finally,an instructional catalogue was defined,consisting of 6 first-class indicators（basic diagnosis and treatment skills,first aid skills,symptomatic diagnosis and treatment skills,chronic disease management skills,common disease diagnosis and treatment skills,and common manipulative skills）and 50 second-class indicators. Conclusion The degrees of involvement,authority and consistency of the specialists were relatively high. The catalogue of appropriate technology for general practitice had good reliability and feasibility,which was worthy of promotion and application.

The ancient discussion and modern clinical application regarding Yingxiang (LI 20) and Neiyingxiang (EX-HN 9) in acupuncture verses are explored. Acupuncture verses are the summary of clinical experiences of acupuncture scholars in the past dynasties, of which the records on application of Yingxiang (LI 20) and Neiyingxiang (EX-HN 9) mainly focused on nasal, facial and head-eye diseases, which is characterized with overall summarization, brilliant exposition, simple language, and distinctive characteristics. Nowadays, based on the ancient usage, the clinical application about these two acupoints is continuously developing. If the ancient acupuncture verses could be understood thoroughly, the clinical practice could be better guided and its effects could be improved.
Acupuncture Points ; Acupuncture Therapy ; history ; China ; History, Ancient ; Humans ; Medicine in Literature ; Rhinitis, Allergic ; therapy

Objective:To study the expression and significance of sodium channel Nav1.6 in oral leukoplakia and squamous cell carcinoma.Methods:Immunohistochemistry and Western blot were used to detect the expression of Nav1.6 in 21 case of normal oral mucosa,32 of oral leukoplakia and 63 of oral squamous cell carcinoma(OSCC).Results:Immunohistochemical results showed that the positive rate of Nay1.6 in normal group,oral leukoplakia group and OSCC group was 6.25％,40％ and 76.74％ respectively.The expression of Nav1.6 was related to the differentiation of oral squamous cell carcinoma.Western blot results revealed that the content of Nav1.6 in normal oral mucosa,oral leukoplakia and OSCC was 0.469 ±0.015,0.545 ±0.016 and 0.848 ±0.020(P ＜0.05) respectively.Conclusion:Nay1.6 may play a role in the development of OSCC.

OBJECTIVETo investigate the value of thyroglobulin measurement in ultrasound guided fine-needle aspiration(FNA-Tg)for detecting neck node metastasis in patients with papillary thyroid carcinoma(PTC)after thyroidectomy.

METHODSA total of 128 suspicious metastatic lymph nodes in 112 patients were retrospectively analyzed. Postoperative pathologic results were taken as the gold standard. The values of FNA and FNA-Tg combined FNA in the diagnosis of metastatic lymph nodes were compared with different ultrasonic features.

RESULTSThe sensitivity, specificity and accuracy of single FNA for the diagnosis of neck node metastasis were 67.5%, 98.0% and 79.7% respectively, and those of FNA-Tg combined FNA were 87.0%, 100.0% and 92.2% respectively. Compared with single FNA, the sensitivity and accuracy of FNA-Tg combined FNA were increased significantly(χ(2)=8.319, P=0.004; χ(2)=8.275, P=0.004). When the ultrasonographic characteristics met any one of five indicators for neck node metastasis, the sensitivity, specificity and accuracy of single FNA for the diagnosis of neck node metastasis were 38.1%, 95.7% and 68.2% respectively, and those of FNA-Tg combined FNA were 71.0%, 100.0% and 86.4% respectively. Compared with single FNA, the sensitivity and accuracy of FNA-Tg combined FNA were increased significantly(χ(2)=4.709, P=0.030; χ(2)=4.141, P=0.042). When the ultrasonographic characteristics met any two of five indicators for neck node metastasis, the sensitivity, specificity and accuracy of single FNA for the diagnosis of neck node metastasis were 55.0%, 100.0% and 73.5% respectively, and those of FNA-Tg combined FNA were 90.0%, 100.0% and 94.1% respectively. Compared with single FNA, the sensitivity and accuracy of FNA-Tg combined FNA were increased significantly(χ(2)=6.140, P=0.013; χ(2)=5.314, P=0.021). The ultrasonographic characteristics met any three, four or five of five indicators or did not meet any of the indicators, there was no significant difference in the value of the diagnosis of metastatic lymph nodes between single FNA and FNA-Tg combined FNA(P>0.05).

CONCLUSIONSThe combination of FNA with FNA-Tg could be helpful in diagnosis of lymph node metastasis. When the suspicious lymph nodes had one or two ultrasound characteristics for neck node metastasis, FNA-Tg could raise the sensitivity and accuracy of FNA, and FNA-Tg could not significantly improve in the diagnosis of FNA when presenting with no or with more than 2 ultrasonographic features.

Biopsy, Fine-Needle ; Carcinoma ; pathology ; Carcinoma, Papillary ; Humans ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; diagnosis ; Postoperative Period ; Retrospective Studies ; Sensitivity and Specificity ; Thyroglobulin ; analysis ; Thyroid Neoplasms ; pathology ; Thyroidectomy

Objective: To investigate the occurrence of occult carcinoma in contralateral lobes based on the ultrasonic features of unilateral papillary thyroid carcinoma. Methods: The study included 202 consecutives cases of unilateral papillary thyroid carcinoma with benign nodules in the contralateral lobe identified by preoperative ultrasound or fine-needle aspiration from June 2014 to December 2015. All patients received total thyroidectomies, and with postoperative pathological examination they were divided into two groups, one including 60 cases with positive occult cancer and another one consisting of 142 cases with negative occult cancer. Univariate and multivariate analyses were performed to analyze the sonographic features of unilateral papillary thyroid carcinoma relevant to the occurrence of occult carcinoma in the contralateral nodules. Results: Univariate analysis indicated occult carcinoma in the contralateral lobes was associated with Hashimoto's thyroiditis(χ²=3.955, P=0.047), unclear border (χ²=4.375, P=0.036)and multifocality in the ipsilateral(χ²=7.375, P=0.007), but not with tumors maximum size, location, A/T, shape, internal structure, internal echo, acoustic halo, calcification, capsular invasion and blood flow signal in the lobe with carcinoma on another side. Multivariate analysis showed unclear border (OR=2.727, P=0.010) and multifocality in the ipsilateral(OR=2.807, P=0.005)of carcinoma were independent predictive factor for contralateral occult PTC. Conclusions Unclear border and multifocality of PTC in the ipsilateral were closely relevant to the occurrence of occult carcinoma in the contralateral nodules.

Objective: To evaluate the diagnostic efficacies of BRAF^V600E testing and Bethesda system for reporting thyroid cytopathology (BSRTC) in thyroid nodules with thyroid imaging reporting and data system (TIRADS) category 4 and 5. Methods: A total of 187 thyroid nodules in 187 patients underwent the examinations of ultrasound-guided fine needle aspiration cytology (FNAC) and BRAF^V600E mutation were analyzed retrospectively. Receive operating characteristic (ROC) curve was used to investigate the diagnostic values of both methods and the clinical application of BRAF^V600E combined with BSRTC was evaluated. SPSS17.0 software was used to analyze the data. Results: Among 187 thyroid nodules, 123 were malignant nodules confirmed with histopathological examination and 64 benign nodules determined by FNAC, histopathological examination, or long-term follow-up. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of BRAF^V600E test were better than those of BSRTC [69.1%, 98.4%, 98.8%, 62.4%(χ²=77.3, P=0.000) vs 62.6%, 93.8%, 95.1%, 56.6%(χ²=54.4, P=0.000)]. While the sensitivity, specificity, PPV and NPV of the combined test of BRAF^V600E and BSRTC for diagnosis of malignant thyroid nodules were 87.8%, 92.2%, 95.6%, 79.7%(χ²=112.6, P=0.000), respectively. The area under the ROC curve for the combined test was higher than that for each of tests (0.900 vs 0.858 or 0.838). Conclusions The combined test of BRAF^V600E mutation and BSRTC has a higher diagnostic efficacy for malignant thyroid nodules compared with BRAF^V600E mutation or BSRTC alone.