In this paper, the importance of using advanced medical equipment to check treatment was ana-lyzed, and then pointed out that nowadays there were the following problems: the medical staff had excessive de-pendence on medical equipment; medical equipment inspection treatment of irrationality; medical equipment in-spection treatment with humanity was not enough; medical equipment management of dereliction of duty. Put for-ward to strengthen medical personnel professional moral education;to strengthen the medical students' ethical edu-cation;regular hospital manage concept;improve the cognitive level of medical staff of medical equipment.

ObjectiveTo observe the curative effect of alprostadil combined with cilostazol in treatment of patients with lower limb atherosclerosis.MethodsSixty-two patients with lower limb atherosclerosis were divided into cilostazol group (cilostazol 100 mg,2 times a day,oral) and therapeutic alliance group (cilostazol 100 mg,2 times a day,oral; alprostadil 10 μ g dissolved in 100 ml intravenous infusion of 0.9％ sodium chloride,once a day) by random number table with 31 cases each.The changes of ankle-brachial index (ABI),distance of 6-minute walk test(6-MWT) and the dorsal blood flow were compared before and after treatment.Results | After treatment,the distance of 6-MWT,ABI and the level of dorsal blood flow were significantly improved in two groups (P ＜ 0.05 or ＜ 0.01 ).Distance of 6-MWT and the level of dorsal blood flow in therapeutic alliance group was significantly higher than that in cilostazol group after treatment [(425.4±138.5) m vs.(379.5±124.6) m,(0.77±0.18) ml/ (s·cm2) vs.(0.66±0.14) ml/( s· cm2)] ( P＜0.05 ).The total effective rate in the treatment of cold feel in therapeutic alliance group was significantly higher than that in cilostazol group [ 87.5％(21/24) vs.61.9％( 13/21 ) ](P＜ 0.05).Conclusion Alprostadil combined with cilostazol is safe and effective in treating lower limb atherosclerosis.

Objective To evaluate the differences of clinical features,neuroimaging,angiography and laboratory findings between different stroke subtypes according to TOAST criteria in elderly patients.Methods 91 patients (aged ≥ 80 years) with acute ischemic stroke were retrospectively reviewed in Departement of Neurology from April 2009 to August 2010.Subtypes of ischemic stroke were analyzed according to the classification of TOAST.Risk factors,clinical manifestations,complications,prognosis,neuroimaging,cerebrovascular lesions,and laboratory findings of different TOAST subtypes were compared.Results Large-artery atherosclerosis (LAA) (34/91) was the most common cause of acute ischemic stroke in elderly patients,and most criminal lesions (25/34) located at the intracranial arteries.In the LAA group,patients with intracranial (25/34) or extracranial (12/34) occlusive diseases were more than those in other groups.Patients with cardioembolism (CE) had lower lipid levels.In the CE group,patients with poor shortterm prognosis (7/15) were more than in the LAA or small-artery occlusion (SAO) group,and patients with severe cerebral edema (4/15) were more than those in other groups.In patients of the SAO group,complications occurred infrequently (4/20),and none had poor short-term prognosis.Conclusions There were some differences among different TOAST subtypes in clinical features,neuroimaging,cerebrovascular diseases,and laboratory findings.The clinical significance of our findings needs to be explored further.

OBJECTIVE:To evaluate the cost and effectiveness of three pharmacotherapeutic schemes for hemorrhage of upper digestive tract caused by liver cirrhosis.METHODS:132 patients with hemorrhage of upper digestive tract were treated by different drugs:octreotide(49),somatostatin(42),pituitrin(41).Evaluation was carried out with pharmacoeconomic cost-ef_fectiveness analysis.RESULTS:The hemostatic rates of octreotide,somatostatin and pituitrin for rupture of esophageal varicosis were 88.89%,80% and 46.15%;for peptic ulcer bleeding associated with liver cirrhosis 88.89%,87.50% and 50.00% and for hemorrhage from acute gastric mucosa erosion combined with liver cirrhosis 100.00%,94.44% and 68.18%,respectively.The costs of octreotide,somatostatin and pituitrin schemes were RMB 2 242.8,3 294 and 996.2 yuans,respectively.CONCLU_SION:According to the evaluation with pharmacoeconomic cost-effectiveness analysis,the therapeutic scheme of pituitrin seems to be the best one for treating hemorrhage of upper digestive tract resulting from liver cirrhosis.

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The graphene prepared by chemical vapor deposition onto copper foils was transferred onto a poly(ethylene terephthalate) (PET) soft substrate by the aid of poly-methyl methacrylate (PMMA).The soft G/AuNPs/GOD composite electrode based on PET substrate was fabricated using a protocol in which the uniform distribution of Au nanoparticles (AuNPs) was firstly obtained by controlling the evaporation of gold sol on a graphene surface, then thioglycolic acid (TGA) was modified on the AuNPs through Au-S bond, and finally glucose oxidase (GOD) was immobilized on the surface of AuNPs through acylation reaction between TGA and the GOD.Glucose was detected in the linear range from 0.05 to 10.55 mmol/L with a linear correlation coefficient (r) of 0.9955.The detection was performed in phosphate buffer solution (pH 7) at 25℃ with a working potential of 0.6 V (vs.SCE electrode), and the detection limit was 1 μmol/L (3σ).The G/AuNPs/GOD flexible electrode based on PET substrate provided a new pathway to detect glucose in special environments using wearable equipment, which enlarged the applied field of glucose detection.

Objective To analyze the changes of benign and malignant thyroid nodules during followup and to increase the diagnostic accuracy.Methods The ultrasonographic changes of 161 thyroid nodules confirmed by pathology were retrospectively analyzed,including size,internal components,echogenicity,margin,microcalcification,anteroposterior to transverse dimension ratio(A/T) and the relationships with thyroid capsule,and the change of cervical lymph nodes.Results Ninety-three benign thyroid nodules and 68 malignant thyroid nodules were enrolled in this study,the changes in size,internal components,microcalcification,the relationships with glandular capsule,and cervical lymph nodes were significantly different (P ＜ 0.05),while the echogenicity,margin,and A/T were not significantly different,benign nodules changed more easily in size and internal components,while malignant nodules changed more easily in microcalcification.Both the nodules broken the thyroid capsule or cervical lymph nodes exhibited malignant signs suggest probable malignancy.Conclusions Analyzing the ultrasonographic changes during follow-up contributes to identify benign and malignant thyroid nodules.

Objective To investigate the sonographic features of follicular variant of papillary thyroid carcinoma (FV-PTC) and to decrease misdiagnosis rate. Methods Thirty-one patients with 35 FV-PTCs and 66 patients with 75 conventional PTCs (C-PTCs) were enrolled in this study. The sonographic features were reviewed retrospectively between the two groups with universally accepted standards. Results The sonographic features of 35 FV-PTCs included irregular shapes (6/35), anteroposterior to transverse diameter ratio A/T > 1 (7/35), spiculated margins (25/35), marked hypoechogenicity (0/35), hypoechogenicity (18/35), isoechogenicity (16/35), no calcification (15/35), microcalcifications (11/35), macrocalcification (9/35), color Doppler lfow patternⅠ(20/35), color Doppler lfow patternⅡ(10/35), color Doppler lfow patternⅢ(5/35). Irregular shapes, A/T>1, spiculated margins, marked hypoechogenicity, microcalciifcations, and color type Ⅱ were rarer in FV-PTCs than in C-PTCs, while isoechogenicity, no calciifcation, macrocalciifcation, and color type Ⅲwere more frequent in FV-PTCs than in C-PTCs. The differences of the above features were statistically significant [χ2=4.276, P=0.039; χ2=8.125, P=0.004; P=0.009 (Fisher′ s exact test); χ2=8.548, P=0.003;χ2=4.898, P=0.027,χ2=7.796, P=0.005;χ2=5.462, P=0.019;P=0.001 (Fisher′s exact test)] . During the preoperative ultrasonography, 20 of 35 FV-PTCs were diagnosed as malignancy, and others were misdiagnosed as benign nodules (misdiagnosis rate was 43%). The lymphatic metastasis rate of FV-PTCs was 29%(9/31), significantly lower than C-PTCs [62%(41/66),χ2=9.246, P=0.002]. In terms of the sonographic features of metastatic lymph nodes, there was no marked difference between FV-PTCs and C-PTCs. Conclusions Some FV-PTCs are lack of malignant features, and tend to be misdiagnosed frequently when coexisting with benign thyroid nodules. Observing the echogenicity, color lfow characteristics and other features of each thyroid nodule and cervical lymph node with multiple views may decrease the misdiagnosis rate.

Objective To investigate the impact factors of real-time shear wave elastography ( SWE) by using the ultrasound phantoms . Methods The noduled phantoms with different densities and viscosities and background phantoms with three textures ( soft ,medium ,and hard) were prepared by using gelatin as the main ingredient . Nodule phantoms were embedded in background phantom in different depths . The elasticity ( Emax ) was measured by SWE . Factorial designed was used to evaluate the effects of various factors ,including density ,viscosity and depth of nodule phantom and texture of background phantom on Emax of nodule phantom . Binary Logistic regression was used to analysis the effects of various factors , including density ,viscosity ,diameter ,depth of nodule phantom and texture of background phantom on the window phenomenon . Results The density ,viscosity and the Emax of nodule phantoms increased as the gelatin ratio increased . The Emax of nodule phantoms in shallow position ( depth < 3 .0 cm ) were higher than those in deep position ( depth ≥ 3 .0 cm) . In hard-background phantoms ,the Emax of nodule phantoms was maximal ,soft-background phantoms was minimal . Main effects of the density ,viscosity ,depth of nodule phantoms and texture of background phantoms on Emax of nodule phantoms were different ,and all of the factors had interactive effects ( P < 0 .05 ) . The density ,viscosity ,diameter and depth of nodule phantoms were independent risk factors of the windowphenomenon ( P < 0 .05 ) . According to OR ( 23 .846 ,0 .093 ,and 0 .003 ,respectively) ,reduced density and viscosity ,or increased diameter and depth of nodule phantoms ,could increase the incidence of the window phenomenon . Conclusions The density and viscosity of self-making ultrasound phantoms can be easily and flexibly controlled .Density ,viscosity , diameter ,depth of nodule and texture of background are the impact factors of shear wave elastography .

Objective To explore the value of high frequency ultrasound in differential diagnosis in dorsal thyroid (including gland dorsal or posterior) nodules.Methods Ultrasonographic features of 101 patients with ultrasonography suspected or misdiagnosed nodules in the dorsal area of the thyroid gland,which were then confirmed by pathology or hyaluronography/gastroscopy,were retrospectively analyzed.Ultrasonographic homogeneity (other nodules with similar ultrasonographic features were found in the ipsilateral gland),parenchyma homology (nodule parenchyma was continuous with glandular parenchyma) and blood homology (blood flow signals in nodules were continuous with those in glandular parenchyma) were applied as indicators for determinng thyroid nodules.Double-line sign or vascular arch sign at the edge of nodules served as an indicator for determining parathyroid nodules.Results Of the 101 cases,there were 46 thyroid nodules,35 parathyroid nodules,7 enlarged lymph nodes;6 esophageal diverticulum,6 esophageal cancer,1 cleft cyst.The determination of thyroid nodules by at least one of ultrasonographic homogeneity,parenchyma homology and blood homology showed sensitivity of 73.5 ％,specificity of 96.5 ％ and accuracy of 85.8％.In the determination of parathyroid nodules by double-line sign or vascular arch sign at the edge of nodules,sensitivity,specificity and accuracy was 54.1％,85.5 ％ and 74.5 ％,respectively.Conclusions Nodules in the dorsal area of the thyroid gland have different sources,and the understanding of corresponding characteristic ultrasonographic appearances is helpful for improving the differential diagnosis of these nodules.