Objective The existing standards of skeletal development for Chinese were revised in this study due to the accelerated growth and development of Chinese children in the past 20 years.Methods Seventeen thousand and four hundred and one (17,401) healthy children of Han nationality (8,685 boys, 8,716 girls), aged 0～20 years, from cities of Shanghai, Guangzhou, Wenzhou, Dalian and Shijiazhuang were served as the sample for standardization. The radiographs were evaluated by a single observer using TW3 method. Furthermore, the new skeletal maturity events were chosen in 4, 5, 6, 7 stages of first metacarpal, proximal and middle phalanges, as well as in 5, 7 stages of radius and 5 stage of ulna in accordance to TW3-RUS. As a result, each stage was divided into two new stages. The fusion stages of radius and ulna were divided to 4 phases. The skeletal maturity scoring was computed by “scaling of categorized attributes” to minimize the overall disagreement between the different bones totaled over the standardizing sample. The new method is called RUS-CHN. The means and standard deviations of maturity score transformed by logarithm in each age group were calculated, and were fitted by quadratic and linear functions of age, respectively.Results The percentile standards of TW_3-C RUS, TW_3-C Carpal, RUS-CHN skeletal maturity scores were established. The revised standards are designated as “The Standards of Skeletal Maturity of Hand and Wrist for Chinese of Han Nationality-China 05”. Ages of the complete maturity of TW_3-C RUS, TW_3-C Carpal and RUS-CHN standards are 16, 13.5 and 18 years in boys and 15, 11.5 and 17 years in girls, respectively. In the verified sample of 2,438 children (1,301 boys, 1,137 girls), aged 1～19 years, the differences between skeletal age and chronological age of all age groups were mostly 0.0～0.3 year in TW_3-C RUS, TW_3-C Carpal and RUS-CHN skeletal maturity standards.Conclusion “The Standards of Skeletal Maturity of Hand and Wrist for Chinese of Han Nationality-China 05” are applicable to contemporary Chinese children.

Objective Due to the accelerated growth of Chinese children, the secular trend of accelerated skeletal development was observed in this study in order to provide the evidence for using the standards of skeletal maturity in reason.Methods The subjects were the children from two skeletal development surveys in 1980s and 2000s. The appearance age and fusion age of ossification centers in hand and wrist were calculated using the probit regression analysis, and the skeletal ages of children from the survey in 2000s were estimated by CHN method. The CHN skeletal ages were compared with calendar ages. Results Compared with the children in 1960s, the appearance ages and fusion ages of the ossification centers were all advanced in children in 1980s. Compared with the children in 1980s, the metacarpals and phalanges of children in 2000s were advanced by 0.5-1.0 year at age of appearance of ossification centers and 1.0 year in boys and 1.0-1.5 years in girls at the ages of fusion ossification centers. The ages of complete ossification of radius and ulna in children in 2000s were advanced by 0.4 year in boys and 0.3 year in girls. The differences between CHN skeletal age and chronological age of all age groups in 2000s were 0.3-1.1 year in boys and 0.2-1.0 year in girls. Conclusions In the last 40 years, the secular trend of accelerated skeletal development was presented in Chinese children. It should be cautious to estimate the contemporary Chinese children when using the skeletal norms of 1960s or 1980s.

Diagnosis, Differential ; Head and Neck Neoplasms ; diagnosis ; Humans ; Lung Neoplasms ; diagnosis

Objective Investigate the different changes of host cellular immunity in patients with different infection by compa-ring peripheral blood lymphocyte subsets.Methods Flow cytometry was used to detect the peripheral blood lymphocyte subset a-mong 96 patients including 31 bacterial infection cases,13 fungal infection cases and 62 virus infection cases.Results Compared with control group the ratio of CD3 + T cell was increased in virus group,and the ratio of CD4 + T was decreased in fungi and virus group and the fungus is lower than the virus group,while the ratio of CD8 + T cell was increased in the two groups,and fungi group is higher than the virus,CD4 +/CD8 + ratio in the two groups were reduced.Three groups of NK cells (of CD16 + CD56 + )ratio was reduced to some extent,and bacteria group was lower than that of other two groups.The ratio of B cell was increased in Bacteria group and it was more obvious in the G+ bacteria.NK cells in G+ bacteria and G- bacteria group were relatively lower than control group,but the difference between the two groups was not significance.In virus infection cases,the ratio of CD3 + T in HBV group was higher than that of dengue fever group.And the ratio of CD3 + and NK cells were increased in the two groups.The ratio of CD4 + was decreased in dengue fever group.Conclusion Detection of lymphocyte subset can objectively reflect and help to under-stand the state of the immune function of patients with infectious diseases,providing laboratory basis for the diagnosis and preven-tion in order to reduce the infectious risk and side effect.

Objective To investigate the expression level of human telomerase RNA component (hTERC) and C-myc in cervical lesions.Methods Fluorescence in situ hybridization (FISH) was applied to detect hTERC and C-myc expression in 62 cases of cervical tissue including 35 cases of cervical intraepithelial neoplasia,8 cases of invasive cervical cancer,19 cases of inflammation as controls.Results The positive rates of hTERC on chromosome 3 in chronic cervicitis organizations,CIN Ⅰ,CIN Ⅱ-Ⅲ and cervical cancer were 5.3 ％ (1/19),16.7 ％(2/12),87.0 ％ (20/23),87.5 ％ (7/8) (x2 =36.299,x2 =40.237,P ＜0.01).The positive rates of C-myc in chronic cervical inflammation organization,CIN Ⅰ,CIN Ⅱ-Ⅲ and cervical cancer were 5.3 ％ (1/19),8.3 ％ (1/12),78.3 ％ (18/23),62.5 ％ (5/8) (x2 =30.200,x2 =34.224,P ＜0.01 ).The differences among groups were statistically significant.hTERC had a positively correlation with C-myc expression (r =0.514,P ＜ 0.01).Conclusion The expression of hTERC and C-myc on chromosome 3 is closely related to cervical cancer progression.

OBJECTIVE Epithelial-myoepithelial carcinoma (EMC) is a rare malignant neoplasm of the salivary glands. The aim of the study was to investigate the diagnosis, treatment and prognosis of EMC of the parotid gland.METHODSThe clinical data of 23 cases of EMC of the parotid gland from 1999 to 2013 were analyzed retrospectively. Of all the patients, 13 cases received radical surgery only, 9 cases received postoperative radiotherapy, and one case received postoperative chemotherapy. Kaplan-Meier survival curve was used to analyze the clinical data. RESULTSThe overall survival rate at 5-year was 81.0% and the overall no recurrence survival rate at 5-year was 67.3%. The recurrence rate was 39.1% (9/23). The 5-year no recurrence survival rate of radical surgery group was 55.6%, compared with 80.0% in the combined modality therapy group, there was no significant deference (χ2=2.232, P=0.135).CONCLUSIONThe postoperative recurrence rate of EMC is high. Radical surgery could be the main treatment of EMC, when the surgical margin couldn't be achieved, adjuvant radiotherapy or chemotherapy might be helpful.

Objective To study the expression of nitricoxide(NO) and intercellular adhesion molecule-1(ICAM-1) in the animals with hypercholesterolemia and atherosclerosis(AS) in order to investigate the relationship of hypercholesterolemia with AS and vascular endothelium function and ICAM-1. Methods Fed rabbits with high-cholesterol diet to establish the models of hypercholesterolemia and AS,and the control group was fed with normal diet;Blood was collected from vein in 0,8 and 16 weeks in two groups,and the concentrations of TC,LDL,NO and ICAM-1 were measured;The correlation among TC,LDL and NO,ICAM-1 was observed;After 16 weeks,the rabbits were put to death,and immunohistochemistry analysis and RT-PCR were performed to measure the expression of ICAM-1 in the aortas.Results TC and LDL in 8 weeks were higher in the high-cholestrol diet group,but NO and ICAM-1 had no change;NO decreased and ICAM-1 increased in 16 weeks(P

Objective To determine the half-effective target effect-site concentration (Ce) (EC50) of sufentanil required to inhibit the body movement during insertion of ureteroscopes when combined with propofol in patients undergoing transureteroscopic holmium laser lithotripsy. Methods Fifty ASA Ⅰ or Ⅱ patients of both sexes, aged 20-60 yr, BMI ＜ 30 kg/m2 , undergoing transureteroscopic holmium laser lithotripsy were randomly divided into 5 groups according to the different C es of sufentanil ( n = 10 each): group S1 (Ce 0.21 ng/ml), group S2(Ce 0.14 ng/ml), group S3(Ce 0.09 ng/ml), group S4(Ce 0.06 ng/ml), group S5(Ce 0.04 ng/ml). TCI of propofol with target plasma concentration set at 2.5-3.0 μg/ml was given. Sufentanil with the corresponding Ce was infused in each group. The ureteroscopes were inserted as soon as the patients lost consciousness and the effect-site concentration of sunfentanil was achieved. The response was defined as positive when body movement occurred within 1 min after insertion of ureteroscopes. The EC50 of sufentanil required to inhibit the body movement during insertion of ureteroscopes when combined with propofol and 95% confidence interval (CI) were calculated. Results The EC50 of sufentanil required to inhibit the body movement during insertion of ureteroscopes when combined with propofol was 0.084 ng/ml and 95% CI was 0.066-0.107 ng/ml. Conclusion The EC50 of sufentanil required to inhibit the body movement during insertion of ureteroscopes was 0.084 ng/ml when combined with propofol.

Objective To evaluate the relationship between neoadjuvant chemotherapy (combination of taxanes and anthracyclines ) induced-neutropenia and the efficacy of neoadjuvant chemotherapy and long-term survival in operable breast cancer patients. Methods Two hundred and eleven patients received 4 cycles of neoadjuvant chemotherapy (combination of taxanes and anthracyclines).Clinicopathological characteristics were compared between patients with neoadjuvant chemotherapy-induced neutropenia and patients without neutropenia. The efficacy of neoadjuvant chemotheray and long-term survival rate were analyzed. Results Among 211 patients there were 51 (24. 2% ) cases suffering from neutropenia and 160 (75.8%) cases were of no-neutropenia. The response to chemotherapy in patients with neutropenia were more effective than in no- neutropenia ones ( P ＜ 0. 05 ). The 5-year disease-free survival (DFS) in patients with neutropenia was 82. 4%, while the 5-year disease-free survival ( DFS) with nonneutropenia was 60% ( P ＜ 0. 01 ). Additionally, the 5-year overall survival ( OS ) in patients with neutropenia was 90. 2% and in patients with non-neutropenia patients was 67. 5% ( P ＜ 0. 01 ).Conclusions Chemotherapy-induced neutropenia during neoadjuvant chemotherapy combination of taxanes and anthracyclines in patients with operable breast cancer has a better prognosis. The sensitivity of tumors given to chemotherapeutic drugs could be evaluated by chemotherapy-induced neutropenia.

Taking Suxi Healthcare Center in Yiwu City, Zhejiang province as an example, the paper analyzed the present mission and organizational characteristics of township healthcare centers in China, especially their dual functionality of community public health and primary medicare. Based on such analysis, it designed a matrix-based model for organizational structure and job performance management for such heslthcare centers. The features are as follows. 1) The two dimensions of the matrix structure refer to the departments for medical treatment and the multi-village doctors team in the community, respectively and jointly offering primary medicare and public health services; 2) Jobs are designed based on the organizational structure and functionality. Every job carries out dual Junctions as described and managed by the job description and target responsibility certificate; 3) The job responsibility certificate is a breakdown of the balanced scorecard of the healthcare center, as divided between the departments for medical treatment and the multi-village doctors team; 4) The balanced scorecard of the township healthcare center is designed based on its strategic mission and developing plan. The entire organizational design and management of the center are built on the strategic orientation and logical programmed research.