Objective Through the research on relationship between achievement motive and personality traits,to provide the basis theory of personality attributes for selecting outstanding medical professional scientifically and effectively,and give some advice for improving medical education mode.Method The 310 medical staffs in sample hospital were treated as the research object in October 2015,who were randomly investigated with the big five personality questionnaire and achievement motivation scale,among of which,valid questionnaires were 290 copies leading to 93.5％ effective rate.SPSS 17.0 software was used to make t test,Chi-square analysis and correlation analysis for the data of the recover valid questionnaires.Result ①Personality traits of friendliness and rigor of the medical staffs of different gender exist statistically significant difference (t=-7.39,P=0.00;t=-8.28,P=0.00) and there were significant differences in the openness and rigor of medical staffs of different gender (P＜0.05).②The achievement motivation level of male medical staffs was higher than that of female (P=0.00),and there was no significant difference in achievement motivation among medical staffs.③The personality trait of neuroticism was negatively correlated with the pursuit of success and achievement motivation (correlation coefficient was-1.24),while the achievement motivation was positively related to extraversion and openness and the pursuit of success (the correlation coefficients were 1.51 and 1.53).Conclusion There is a significant correlation between personality traits and achievement motivation.The more extroverted personality medical staffs have,the more easy-going they are,and the more the pursuit of success oriented achievement motivation they have;and the higher the neurotic tendency individuals have,the more they incline to avoid failure of achievement motivation.

Objective To investigate the optimal methods of detecting micrometastasis of sentinel lymph node(SLN) in papillary thyroid carcinoma(PTC).Methods Data of 51 consecutive PTC patients without clinical evidence of cervical lymph node metastasis were analyzed.They were conducted with SLN localization with blue dye,technetium-labeled sulfur colloid or the combination of them from Aug.2007 to Sep.2010.55 SLNs from 18 cases were selected.No metastasis was found to these 55 SLNs by routine pathological section.The 55 SLNs were serially sectioned at a 50 μm interval and stained by both HE and immunohistochemistry for detecting micrometastasis.Results SLN was successfully identified in all the 51 cases,with SLN identification rate of 100％.Among the 18 cases without metastasis to SLN by routine pathological section,5 cases were found micrometastasis by step sectioning plus immunohistochemically stains.The false negative rate was reduced from 15.4％ by routine pathological section to 2.6％ by step sectioning plus immunohistochemically stains.Conclusion Cytokeratin immunohistochemistry on series sections is a reliable method in detecting SLN micrometastasis in PTC.

ObjectiveTo evaluate combined radioisotope and methylene blue dye method for identifying sentinel lymph node (SLN) for modified radical neck dissection of papillary thyroid carcinoma (PTC). MethodFifty-one consecutive PTC patients without clinical evidence of locoregional lymph node involvement were enrolled in the study between August 2007 and September 2010.5 h ( rangel.5 - 8 h) before the surgery,one single intratumoral injection of 74 MBq in a volume of 0.4 ml 99mTc -Dextran was administered under ultrasound guidance and 1％ methylene blue dye was injected into the parenchyma surrounding the primary tumor intraoperatively.Preoperative lymphoscintigraphy,intra-operative hand-held gamma probe detecting and blue dyed lymph node were used to identify the SLN.All SLNs were sent for frozen-section and the specimens of routine selective neck dissection were stained with haematoxylin and eosin (H&E). ResultsSLNs were identified in 48 of 51 cases (94.1％ ) with combination method.SLN identification rate were 66.7％by methylene blue dye method and 90.2％by radioisotope method respectively.Final pathologic examination revealed that 30 cases ( 58.8％ ),including 3 cases who had negative SLNs,had lateral neck occult lymph node metastasis.The rate of occult lymph node metastasis in level Ⅱ,level Ⅲ,level Ⅳ and level Ⅴ were 17.6％,52.9％,29.4％ and 0％.Thus,the sensitivity,specificity,accuracy, and positive and negative predictive values of SLN biopsy were 90％, 100％,94.1％,100％ and 87.5％,respectively. ConclusionsSLNB is feasible and safe,the findings correlate with lateral lymph node status.Therefore,SLN biopsy is a good method for estimating the status of lateral lymph node in patients with clinical negative lymph node papillary thyroid carcinoma.

Objective To investigate the pattern of nodal recurrence after curative resection in adenocarcinoma of the gastroesophageal junction ( AGE ) , and to provide a basis for delineation of the radiation range in the high-risk lymphatic drainage area.Methods A retrospective analysis was performed in 78 patients with locally advanced AGE who were newly treated in our hospital from January 2009 to December 2013 and had complete clinical data.All patients received curative resection and were pathologically diagnosed with stage T3/T4 or N (+) AGE.Those patients were also diagnosed with SiewertⅡor Ⅲ AGE by endoscopy, upper gastroenterography, macroscopic examination during operation, and pathological specimens.None of the patients received preoperative or postoperative radiotherapy.All patients were diagnosed by imaging with postoperative nodal recurrence.The computed tomography images of those
patients were accessible and had all the recurrence sites clearly and fully displayed.Results The median time to recurrence was 10 months ( 1-48 months) , and 90%of the recurrence occurred within 2 years after surgery.The lymph nodes with the highest risk of recurrence were No.16b1( 39%) , No.16a2( 37%) , No.9 (30%), and No.11p (26%), respectively.There was no significant difference in the recurrence rate within each lymphatic drainage area between patients with SiewertⅡandⅢAGE ( P=0.090-1.000) .The lymph nodes with the most frequent recurrence were No.16b1, No.16a2, No.9, No.16b2, No.11p, and No.7 in patients with stage N3 AGE and No.11p, No.16b1, No.16a2, No.9, No.8, and No.7 in patients with stage non-N3 AGE.Patients with stage N3 AGE had a significantly higher recurrence rate in the para-aortic regions (No.16a2-b2) than those with stage non-N3 AGE (67%vs.33%, P=0.004, OR=4.00, 95% CI=1.54-10.37) .Conclusions The lymph nodes with the highest risk of recurrence are located in the celiac artery, proximal splenic artery, and retroperitoneal areas ( No.16a2 and No.16b1) in patients with SiewertⅡorⅢlocally advanced AEG.Moreover, patients with stage N3 AGE have a higher risk of retroperitoneal recurrence.The above areas should be involved in target volume delineation for postoperative radiotherapy.

BACKGROUNDThe incidence of thyroid cancer has been increasing. Our aim was to evaluate the efficacy of low-dose dual-phase helical computed tomography (CT) in the characterization of thyroid lesions, and to discuss the relationship between image characteristics and their pathology.

METHODSOne hundred and six patients with thyroid lesions underwent low-dose dual-phase helical CT after the injection of contrast material. CT scans were obtained at arterial and venous phase with delays of 25 and 65 seconds, and tube current of 60 and 120 mA, respectively. The attenuation change in the lesion between the arterial and venous phase was analyzed and categorized as "increased," "decreased," "mixed" or "no change."

RESULTSHistopathologic diagnosis was obtained by surgery in 106 patients (115 lesions). Of the 106 patients, 45 had nodular goiter, 5 thyroid adenoma, 6 thyroiditis, and 50 papillary thyroid carcinoma (PTC) (59 lesions). The attenuation value showed a significant difference (P < 0.05) between the arterial and venous phase for the high attenuation area. There was statistical significant difference in terms of attenuation value in high attenuation areas at both phases and in low attenuation areas on arterial phase between nodular goiter and PTC (P < 0.05). However, there was no significant difference in attenuation value between adenoma and PTC. Twenty-nine cases (76.3%) of goiter manifested mixed type, 3 cases (3/5) of adenoma showed decreased type, 6 cases (6/6) of thyroiditis showed increased type, and 55 cases (93.2%) of PTC showed decreased type attenuation. The sensitivity, specificity for thyroid carcinoma by dual-phase CT were 94.9% and 80.4% respectively. The overall diagnostic accuracy for thyroid lesions by dual-phase CT was 87.8%.

CONCLUSIONSThe performance of dual-phase helical CT is related to the pathological structure of the lesions. The analysis of enhancement patterns by using dual-phase helical CT will be helpful in the differential diagnosis of thyroid lesions.

Adolescent ; Adult ; Aged ; Carcinoma ; diagnostic imaging ; pathology ; Carcinoma, Papillary ; Female ; Goiter, Nodular ; diagnostic imaging ; pathology ; Humans ; Male ; Middle Aged ; Thyroid Gland ; diagnostic imaging ; pathology ; Thyroid Neoplasms ; diagnostic imaging ; pathology ; Thyroiditis ; diagnostic imaging ; pathology ; Tomography, X-Ray Computed ; Young Adult