Objective To analyze the misdiagnosis in extraovarian peritoneal carcinoma(EOPC). Methods The clinical manifestation, blood tumor marker, imaging examination, laparotomy, pathology, treatment and prognosis of 19 EOPC patients were retrospectively analyzed. Results The clinical symptoms were abdominal distention, abdominal pain and swelling. 17 cases were tested for blood CA-125 with 15 at abnormaly high level, and in 4 cases ascites was CA-125 positive ( ＞ 10 KU/L). Tumor cells were detected in the ascites in 12 cases. Three cases were misdiagnosed as of uterine origin, 13 cases misdiagnosed as adnexal tumor, 1 case was misdiagnosed as bladder and intestinal tumor. Only 2 cases were correctly diagnosed before the operation. All of the cases were pathologically proved as peritoneal carcinoma. The five-year survival rate was only 20 percent. Conclusions Abdominal distention and pain with unknown causes were the primary manifestations of EOPC, elaborate physical examination sometimes may provide with important information. The significant elevation of serum CA-125 and the ascites cytology may be helpul for the differential diagnosis of PPC. CT scan is valuable for the diagnosis of EOPC.

Mobile reading has greatly impacted the use of printed Chinese books in academic libraries.It is the most important task to introduce the users-needed books in order to improve their utilization.Acquisition of Chinese books should be arranged closely around the need of users by studying the reading features of users under mobile reading environment and establishing the open channels for book recommendation and feedback information in order to improve its quality .

ObjectiveTo study the effect of platelet aggregation rate (PAR) level on the prognosis of percutaneous transluminal coronary angioplasty (PCI).MethodsFour hundred and one patients who performed PCI were divided into 4 groups:group 1 (PAR≤30％,103 cases),group 2 (PAR 31％ - 40％,102 cases),group 3 (PAR 41％ - 49％,103 cases ) and group 4 (PAR ＞ 49％,93 cases ).All the patients were followed up.The survival analysis was performed in 4 groups.ResultsThe data of survival table were tested by 3 methods among 4 groups:statistic was 0.612,degree of freedom was 3,P =0.894 in Log-rank (Mantel-Cox) test,statistic was 0.567,degree 9f freedom was 3,P =0.904 in Wilcoxon test and statistic was 0.586,P =0.900 in Tarone-Ware test.There was no significant difference among them.The mean follow-up duration was 2.2 years,and there was no significant difference in survival function among 4 groups (P ＞0.05).ConclusionPreoperative and postoperative measurement of PAR levels may not improve the prognosis.

Objective To evaluate the effect of different regimens of antiplatelet drugs on the major adverse cardiac events (MACEs) in elderly patients undergoing selected percutaneous coronary intervention (PCI) in direction of the adenosine diphosphate (ADP) -induced platelet aggregation index. Methods The 1230 cases aged 60-80 years, mean (67. 2±10. 2) years undergoing selected PCI with the drug eluting stent were enrolled. The 615 cases of the ADP guided group according to the ADP-induced platelet aggregation index. After the first loading dose of clopidogrel (300 mg) , once the decrease of ADP-induced platelet aggregation index was more than 50% as compared with the basic level, the dose of 75 mg each day would be maintained for one year. If the decrease of the index was less than 50%. the another 300 mg of clopidogrel would be given again, until up to 900 mg on the 3th day. If the decrease of the index was still not enough, the combination of clopidogrel 75 mg, cilostazol 100 mg and aspirin 100 mg each day would be suggested. The rest 615 patients in the routine dosage group took the routine dose of clopidogrel (the first loading dosage 300 mg was taken, then 75 mg each day for one year ) . The MACEs, including cardiac death, myocardium infarction, revascularization and stent thrombosis, were observed for 12 months. Results After the first 300 mg of clopidogrel, only 45% of patients reached the standards. Until reaching 900 mg, 67.5% of patients in the ADP guided group were eligible. The tailored clopidogrel loading dose in the ADP guided group yielded a better effect on the inhibition of platelet aggregation (the routine dose vs. the tailored loading dose: 45% vs. 67. 5% , P=0. 028). After one year follow up, the MACEs were less in ADP guided group than in routine dosage group (2. 8% vs. 4. 9% , P = 0. 035). All of patients had no major bleeding, and the minor bleeding and other drug adverse events in two groups had no significant differences. Conclusions The patients undergoing selected PCI should receive ADP -induced platelet aggregation test in order to assess the inhibition effect of clopidogrel on the platelet aggregation. It is safe and effective to modify the antiplatelet drugs regimen during the peri-PCI procedure in direction of ADP-induced platelet aggregation.

OBJECTIVESTo investigate the power density and other relevant data of clinical curing-light units used in Changchun, and to provide practice recommendations to clinical dentists about maintaining of cuing-light units.

METHODSStomatology hospitals, departments of stomatology in general hospitals, and private dental offices in Changchun were randomly selected to participate in the Survey. The investigation analyzed 270 curing-light units. The following data of curing-light units were gathered: brand, type, operation ages, numbers and types of light guide, resin build-ups on light guides, damages of light guides, use frequency, monitor and maintenance of curing lights, and unit numbers/chair numbers.

RESULTSThere were 174 QTH and 96 LED units. The distribution of power density was from 0 to 1702 mW/cm(2). The mean power density was 413.2 mW/cm(2). The power densities of 73 lights were less than 200 mW/cm(2) and could not polymerize resin composites adequately. The mean number of operation age of the light units was 4.74 years. Most of clinical dentists didn't monitor the light-curing units and the situation of build-up from composite resin or damages on light guides was very severe.

CONCLUSIONSMost of the light-curing units used in Changchun were QTH. Some QTH units degenerate severely and need to be replaced with the new ones. Most of the clinical doctors lack the knowledge of how to properly monitor and maintain the light-curing units.

China ; Composite Resins ; chemistry ; Curing Lights, Dental ; classification ; statistics & numerical data ; Halogens ; Quartz ; Semiconductors ; Tungsten

Adenocarcinoma ; pathology ; Adenocarcinoma, Papillary ; pathology ; Aged, 80 and over ; Carcinoma, Renal Cell ; pathology ; Duodenal Neoplasms ; pathology ; Humans ; Kidney Neoplasms ; pathology ; Lung Neoplasms ; pathology ; Male ; Neoplasms, Multiple Primary ; pathology ; Sarcoma ; pathology ; Stomach Neoplasms ; pathology

Objective:To investigate the clinical efficacy and patient and partner's satisfaction with penile prosthesis implantation(PPI) for treating Chinese patients with severe erectile dysfunction(SED).Methods:One hundred and sixty-eight SED patients were successfully treated by PPI from July 2000 to June 2010.Of the 146(86.9%) patients who had been followed up over 6 months post-operation,36(24.7%) had been implanted with one piece malleable prosthesis(AMS650) and 110(75.3%) with three piece inflatable prosthesis(AMS700CXM).All the patients had been followed up by using international index of erectile dysfunction(IIEF5),Quality of Life Score(QOL) for evaluating clinical efficacy and using Visual Analogue Scale(VAS) for evaluating patient and partner's satisfaction and the duration of the follow-up was 6 to 119 months.Results:The mean age of patients was 35.9?12.1 years(20 to 75 years),All the operations were successful and sexual intercourse with PPI was performed post 4 to 6 weeks without severe complications like infection and erosion.The prosthesis survive rate and frequent sexual intercourse rate were 98.6% and 87.7% respectively.IIEF5 scores pre and post PPI were 6.3?1.7 and 21.3?1.6 respectively,the QOL scores pre and post PPI were 5.1?0.9 and 1.5?0.5 respectively,and both of them showed significant improvement(P

Objective:To observe influence of up‐regulated expression of myocardial heat shock protein (HSP) 70 in‐duced by heat stress on myocardial calcium‐activated potassium channel (KCa ) 3.1 expression in rabbits with atrial fibrillation (AF) caused by rapid atrial pacing (RAP) .Methods :A total of 24 New Zealand white rabbits were ran‐domly divided into sham operation group (n=8 ,only implant electrode without pacing ) ,pacing group (n=8 ,right atrium (RA) received RAP at 600 times/min for 6h) and heat stress pacing group (heat stress group ,n=8 ,received heat stress preconditioning ,then the same RAP as pacing group ) .Results:Compared with sham operation group and pacing group ,there were significant up‐regulation of HSP70 mRNA and protein expression in different sites of heart [HSP70 protein ,left atrium (LA):(39.00 ± 3.21) vs .(39.75 ± 2.82) vs .(69.75 ± 3.45) ,RA: (38.38 ± 2.92) vs .(39.50 ± 3.89) vs .(69.00 ± 2.93) ,left atrial appendage (LAA):(37.75 ± 3.28) vs .(39.00 ± 3.89) vs . (68.63 ± 3.23) ,right atrial appendage (RAA): (37.00 ± 3.85) vs .(38.38 ± 3.74) vs .(68.75 ± 2.82)] in heat stress group , P<0. 01 all ,but there were no significant difference between pacing group and sham operation group , P>0.05 ;compared with pacing group with down‐regulation of KCa3.1 mRNA and protein expressions ,there were significant up‐regulation of KCa3.1 mRNA and protein expressions in different sites of heart [KCa3.1 protein ,LA:(21.25 ± 1.67) vs .(24.00 ± 2.62) ,RA :(21.13 ± 1.96) vs .(23.75 ± 1.83) ,LAA :(21.00 ± 2.07) vs .(23.75 ± 1.67) ,RAA:(20.88 ± 2.03) vs .(23.50 ± 2.45)] in heat stress group ,P<0.05 all ,and there were no significant difference between heat stress group and sham operation group , P>0. 05. Conclusion:Heat stress may induce up‐regulated expression of myocardial HSP 70 of myocardium ,and HSP 70 may inhibit down‐regulation of KCa 3. 1 mR‐NA and protein expressions in rabbits with atrial fibrillation.

Objective To compare dose-volume parameters for local failure in esophageal cancers treated by there-dimensional conformal radiotherapy (3 D-CRT) or intensity modulated radiotherapy (IMRT) with different target regions.Methods A total of 244 patients with esophageal cancer (including 127 patients with local recurrence and 117 without recurrence) underwent radical 3D-CRT and IMRT were enrolled in this study.Data including dose-volume parameters and clinical features were analyzed retrospectively.Results No statistically significant differences were found in the dose-volume parameters of different planning target regions between groups with local tumor recurrence and without recurrence (P ＞ 0.05).In the elective nodal irradiation(ENI) group, neither the recurrence and the non-recurrence groups showed statistical differences in the dose-volume parameters (P ＞ 0.05).While for the involved-field iradiation(IFI) group, the GTV-V60, CTV-V60, PTV-V60 of local recurrent group were significantly lower than those in the non-recurrent group (t =-2.08,-2.19,-2.08, P ＜ 0.05).In the ENI group, radiated doses of GTV, CTV and PTV as well as dose-volume of PTV were significantly higher than the IFI group (t =1.97-3.12, P ＜ 0.05).For patients with a esophageal GTV less than 30 cm3 but without concurrent chemotherapy, radiated dose of CTV-D98％ , CTV-D95％ in the recurrent group were significantly lower than in non-recurrent group (t =-2.24--2.07, P ＜ 0.05).Conclusions Elective nodal prophylactic radiation of esophageal carcinoma could provide greater volume and doses of GTV, CTV and PTV to prescribed target regions, which may decrease local recurrence.Greater efficiency can be obtained when the primary lesion of the esophageal cancer is smaller or at an early stage, and concurrent chemotherapy is not given.

Objective Using Mental Practice as a training method to train students grasping skills of minimally invasive surgery(MIS),and analyze the change of mental practice in training grasping skills of MIS.Methods 36 students were randomly divided into mental practice training group (MPTG) ( n =12 ),conventional training group (CTG) ( n=12),control group (CG) ( n=11 ).Under the uniform appraisal standards and conditions,using different training methods to teach the grasping skills of MIS,and analyze the results statistically.Results MPTG' s pre-training test results ( 16.18 ± 5.73 ) and post-training test results (79.47 ± 22.05 ) were significantly different(P ＜ 0.001 ),post-training and two weeks later test results ( 89.32 ± 31.56) displayed no significant difference(P=0.283) ; CTG' s pre-training test results ( 17.47 ±8.33) and post-training test results (57.18± 21.83 ) were significantly different (P ＜ 0.001 ),post-training and two weeks later test results (42.27 ± 24.64)had significant difference(P=0.048) ; CG's pre-training test results ( 18.19 ± 4.74) and post-training test results (38.04 ± 19.13 ) were significantly different(P =0.003 ),post-training and two weeks later test results (23.71 ±15.71 ) had significant difference (P=0.034).Compared with MPTG in pre-training test,CTG (P=0.632) and CG (P =0.464) neither had significant difference,but in the post-training test,CTG (P =0.014) and CG (P ＜0.001 ) both had significant difference compared with MPTG.In the two weeks later test,CTG and CG both (P＜0.001 ) had significant difference compared with MPTG.Conclusion Mental practice training method can improve the pedormance of gasping skills of MIS significantly and better durability,improve the learning curve,easy to implement in teaching,easy to master students,it will be a new method of MIS skills training in the future.