Objective:To investigate the role of thoracic echocardiography in diagnosis and differential diagnosis of the right ventricular outflow tract into the right aorta with right ventricular aneurysm rupture.Methods:A total of 19 patients with sinus rupture caused by ventricular septal defect in the right ventricular outflow road were reviewed.These patients were diagnosed as aortic right coronary sinus by preoperative transthoracic echocardiography from February 2010 to September 2016 in Xiangya Second Hospital and Xiangya Medical College Affiliated Haikou Hospital.The clinical symptoms,echocardiography and intraoperative lesions were compared and analyzed among the patients.Results:The intraoperative lesions were consistent with the preoperative echocardiographic diagnosis in 16 patients.Among them,11 cases could be heard the continuous sound of the machine with systolic murmur and no tremor in left sternal rib 2-3 auscultation.The color Doppler imaging of right ventricular systolic indicated the based continuous Doppler spectrum.The preoperative echocardiography and intraoperative lesions testified the ventricular septal defect size and the right ventricular outflow tract into the right aorta with right ventricular aneurysm rupture.Among them,3 cases were complicated with other heart diseases.Other 3 cases were not accorded with the preoperative diagnosis.There were auscultation smell and noise but no tremor.The preoperative echocardiography and lesions indicated the right ruptured aneurysm of the sinus of big and long mouth,1 case with aortic valve stenosis and regurgitation,congenital aortic valve two valve malformation,1 case with aortic valve-severe reflux,1 case with pulmonary infection,and 3 cases with no intraoperative lesions in the ventricular septal defect.Conclusion:Preoperative transthoracic echocardiography is the preferred preoperative,quick and noninvasive method for ruptured aneurysm.Each stage of observation procedure and method can observe the ruptured aneurysm of aortic sinus,the location,size and adjacent ofventricular septal defect.Meanwhile,the flow spectrum characteristics of the ventricular septal defect in the right outflow tract of the right sinus aneurysm can be found by Doppler ultrasound imaging.

Objective To investigate clinieopathologic characteristics and therapy of local advanced welldifferentiated thyroid carcinoma.Methods Data of 23 cases of advanced well-differentiated thyroid carcinoma treated from Jan.1996 to Dec.2005 were retrospectively reviewed.The data included age,pathologic type,local invasion,operative plan,postoperative complications and survival duration.Results Histology showed there were 15 cases of papillary carcinoma,6 ca8es of follicular carcinoma,and 2 cases of papiIlary follicular carcinoma.8 cases had local invasion into recurrent laryngeal nerve,12 cases had invasion into trachea,3 cases had trachea and esophagus invasion,and 8 cases had suprahyoid muscle invasion.All the 23 cases underwent resection procedure.According to surgical procedure,they were divided into radical resection group(n=6),tumor resection group(n=14)and tumor debulking group(n=3).2 cases received radiotherapy after thyroidectomy in tumor debulking group.All patients were followed up.Overall survival rate after 1 year,3 years and 5 years Was 91.3%(21/23),82.6%(19/23),and 60.8%(14/23)respectively.Prognosis of radical tumor removal group and tumor resection group was obviously better than that of tumor debulking group.Conclusions Prognosis is good for local advanced well-differentiated thyroid carcinoma patients receiving resection.Protection of local organ function Can enhance postoperative life quality.

Regional Medical Information System has been the objective of the construction of medical informatization. With HL7 and DICOM applied, this paper presents a tele-medical information-sharing platform based on PACS and HIS. Then the general scheme is put forward from such aspects as medical image storing center, copy import system for medical image data, tele-consultation center, disparate data source middle-ware transponder based on HL7 and clinical rounds system based on NC wireless network.

Objective To investigate the potential dosimetric advantages of half jaw volumetric modulated arc therapy ( H-VMAT) applied to the Oropharyngeal Cancer, comparing with full jaw VMAT (F-VMAT) and intensity modulated radiotherapy ( IMRT ). Methods Planning CT images of 10 oropharyngeal cancer patients were retrospectively chosen and transferred to Eclipse treatment planning system v. 11. 0 (Varian Medical Systems, Pala Alto, USA), based on which H-VMAT, W-VMAT, and IMRT plans were created. Two full arcs (360°) were adopted for VMAT planning, and the 7 beams were equally distributed for IMRT planning. The optimization constraints remained the same for the three kinds of plans. The dosimetric parameters such as D2 , D98 , D50 , HI, and CI were evaluated for PGTV, PCTV1, PCTV2, PGTVln, and PCTVln. In addition, the maximum dose (Dmax) and D1 cc(minimum dose received by 1cc) of the brainstem and spinal cord were analyzed respectively. The mean dose ( Dmean ) to the parotids, oral cave, larynx, and cervical normal tissues were also reviewed. The monitor units ( MU) for all treatment plans were recorded. Results Comparisons of the three planning techniques showed that H-VAMT improved the HI and CI of the targets (except PCTV2) significantly (HI: F =3. 959, 6. 764, 10. 581, 6. 770, 13. 040, P<0. 05;CI:F=6. 594, 4. 138, 0. 842, 4. 031, 5. 388, P<0. 05);reduced Dmax(F=4. 509, 20. 331, P<0. 05) and D1 cc for brainstem and spinal cord (F=27. 432, 26. 314, P<0. 05) significantly;reduced Dmean(F=4. 279, 29. 498, 19. 295, P<0. 05) to the normal tissues of the mouth, throat and neck significantly. The V50 of the mouth and throat were slightly lower in IMRT plans (F=8. 140, P<0. 05). IMRT was slightly better than W-VMAT in sparing oral cavity and larynx, but the dose distribution was the worst. The H-VMAT plans showed the best dose distribution in the cervical normal tissues, especially for the lower and posterior parts, where IMRT plans displayed high dose curves. Conclusions H-VMAT is dosimetrically superior than W-VMAT and IMRT for oropharyngeal cancer, which could be considered for clinical applications.

ObjectiveTo investigate the prevalence of nonalcoholic fatty liver disease (NAFLD) in Haikou, China and the association of NAFLD with metabolic syndrome (MS) and its components. MethodsA total of 18771 persons who underwent physical examination in Haikou People’s Hospital from September 2016 to August 2017 were enrolled. Body height, body weight, blood pressure, fasting plasma glucose, blood lipids, and liver function parameters were measured, and ultrasound examination was performed for the liver. The prevalence rate of NAFLD was calculated, and the association of NAFLD with MS and its components was analyzed. The t-test was used for comparison of continuous data between groups, and the chi-square test was used for comparison of categorical data between groups. ResultsOf all 18771 persons, 5715 had NAFLD, resulting in a prevalence rate of 30.45%; the prevalence rate of NAFLD was 41.74% in men and 1722% in women. Men aged 45-59 years had the highest prevalence rate of NAFLD, and women aged ≥45 years had the highest prevalence rate. Men had a significantly higher prevalence rate of moderate NAFLD than women (8.10% vs 1.19%, χ2=476.1, P＜0.001). Men with obesity and overweight had a higher prevalence rate of NAFLD, and women with obesity had a higher prevalence rate; in both men and women, there was a significant difference in the prevalence rate of NAFLD between groups with different levels of body mass index (BMI) (χ2=2111，1917，all P＜0.001). NAFLD patients had significantly higher BMI, blood pressure, fasting plasma glucose, triglyceride, alanine aminotransferase, aspartate aminotransferase, and gamma-glutamyl transpeptidase than non-NAFLD patients (t=41.276, 32.339, 31.487, 12.185, 9.716, 38.382, 26.350, 25.291, and 15.008, all P＜0.001). ConclusionThere is a high prevalence rate of NAFLD in people undergoing physical examination in Haikou, and men tend to have a higher prevalence rate than women. NAFLD is closely associated with MS and its components.

Objective:To discuss the method and strategy of selecting reviewers for nursing journals.Methods:Through the review practice of different review conclusions, this paper analyzed the reasons for the differences in review conclusions.Results:The methods and suggestions for selecting reviewers included more detailed research direction of reviewers and more comprehensive distribution of research direction; complementary "academic school" and "clinical school" in the same research direction; certain reserved candidates in hot research areas; full consideration of the energy and time of reviewers who hold concurrent administrative positions.Conclusion:The selection of reviewers of nursing journals should follow the characteristics of disciplines and fully consider the distribution of reviewers with different characteristics, so as to make the review process more professional and reliable.

Objective:To explore the methods to improve the ability of editors of nursing journals to recognize new clinical nursing techniques and methods.Methods:Aanalyzed the difficulties in the recognition of new nursing technology innovation points, and summarized the methods of improving the recognition ability of nursing journal editors.Results:It was difficult to identify the new technology of nursing that the presentation of innovation points was inappropriate, inaccurate and there were differences in the definition and application of new technology and new method in different levels of medical units. To improve the identification ability of new technology innovation, nursing editors must fully understand the new information and development trend of specialized field industry and specialized technology, and the application of clinical nursing technology in different levels of medical units.Conclusion:The editors of nursing journals should strive to overcome the difficulties in the identification of new nursing technology in the paper, improve the innovative appreciation ability of the paper, and assist the authors to enhance the innovative value of the paper.

The clinical data for a patient with sick sinus syndrome was retrospectively analyzed. The patient was treated because of his heart palpitations and the increased chest pain. The patient admitted to the hospital under consideration for the left atrial tumor dependent on the echocardiography findings. After the CT scan and the dynamic ECG examination, the patient successfully underwent the left atrial tumor resection, atrial septal repair and cardiac pacing lead installation. The postoperative pathological diagnosis showed that the infective endocarditis and left atrial thrombus in left atrium was cured. The patient was discharged after postoperative anti-inflammatory therapy. By analyzing the reasons for misdignosis before or during surgery, the possible mechanisms for left atrial subendocardial thrombus have been found. This study suggests that it is necessary to combine imaging diagnosis and clinical observations to distinguish tumor from excrescence.
Anti-Inflammatory Agents ; therapeutic use ; Arrhythmias, Cardiac ; etiology ; surgery ; Atrial Septum ; surgery ; Computed Tomography Angiography ; Diagnosis, Differential ; Diagnostic Errors ; Echocardiography ; Endocarditis ; diagnosis ; therapy ; Heart Atria ; diagnostic imaging ; surgery ; Heart Diseases ; etiology ; surgery ; Heart Neoplasms ; complications ; diagnostic imaging ; surgery ; Humans ; Male ; Pacemaker, Artificial ; Retrospective Studies ; Sick Sinus Syndrome ; etiology ; surgery ; Thrombosis ; etiology ; surgery

OBJECTIVE To comprehensively evaluate the quality of Yifei qinghua ointment by multi-component quantitative analysis combined with chemometrics and entropy weight-technique for order preference by similarity to ideal solution （TOPSIS） method. METHODS The contents of lobetyolin， syringin， calycosin 7-O-β-D-glucopyranoside， ononin， astraisoflavan-7-O-β-D- glucoside， isomucronulatol 7-O-glucoside， astragaloside Ⅳ ， deapi-platycoside E， platycoside E， platycodin D3， feretoside， asperulosidic acid， asperuloside， methylophiopogonanone A and methylophiopogonanone B in 14 batches of Yifei qinghua ointment （S1-S14） were determined by high-performance liquid chromatography method. Then， the quality of 14 batches of Yifei qinghua ointment was analyzed by chemometrics （principal component analysis and orthogonal partial least-squares discriminant analysis） and entropy weight TOPSIS method. RESULTS The results of chemometrics showed that 14 batches of Yifei qinghua ointment could be clustered into three categories， S1-S6 as the first category， S7-S10 as the second category， and S11-S14 as the third category. The values of variable importance for projection of calycosin 7-O-β-D-glucopyranoside， ononin， feretoside， astragaloside Ⅳ， astraisoflavan-7-O-β-D-glucoside， lobetyolin， methylophiopogonanone A and platycoside E were higher than 1. The results of the entropy weight TOPSIS method showed that the Euclidean closeness of the optimal solution of 14 batches of Yifei qinghua ointment were between 0.152 9 and 0.736 6， and that of sample S14 was the highest （0.736 6）. CONCLUSIONS Among 14 batches of Yifei qinghua ointment， sample S14 has the best quality， and 8 components such as calycosin 7-O-β-D-glucopyranoside and ononin may be differential markers affecting the quality of Yifei qinghua ointment.