Objective: To assess the accuracy of multi-slice spiral CT (MSCT) with imaging reconstruction in judging bronchial involvement from central lung cancer. Methods: MSCT was done in 30 patients who were diagnosed as central lung cancer. Images of bronchi related to lobectomy or pneumonectomy were reconstructed by means of imaging processing techniques. Then the relation between tumor and bronchus was assessed prospectively with both axial CT and CT with imaging reconstruction in comparison with subsequent pathologic and surgical findings. Results: All 30 patients underwent thoracotomy, lobectomy or pneumonectomy. Total 66 bronchi were studied. Compared with axial CT images, CT with imaging reconstruction was better in judging the relation of bronchus and tumor in comparison with subsequent pathologic and surgical findings (0.01

Objective To assess the changes of left ventricule and analyze the influential factors in pulmonary hypertension (PH) by comparing the changes of left ventricular volume and function using single cardiac cycle real-time three dimensional echocardiography ( sRT-3DE ) and two-dimensional echocardiography (2DE).Methods In case group,there were 30 inpatients diagnosed as PH,systolic pulmonary artery pressure(PASP)≥40 mmHg estimated by echocardiography,excluding left heart disease or congenital systemic-pulmonary circulation shunt.There were 30 healthy people as control group.Conventional 2DE and sRT-3DE were performed in both groups and obtained 2D and 3D parameters.Results ①In case group,the 2D-LVEF were significantly larger than 3D-LVEF (P ＜ 0.01 ).There was less agreement of 2DE and 3DE in case group than in control.②Comparing with the control group,left ventricular EDV,ESV and SV in ease group decreased ( P ＜0.01 ),so as to 3D-LVEF ( P ＜0.05).The left ventricular spherical index(SIs,SId)and eccentric index (EId,EIs ) in case group were significantly larger than those in control group ( P ＜0.01 ).③LVEDV in case group was negatively correlated with PASP (r =- 0.47),and positively correlated with RVSV and RVEF ( r =0.84,0.66) ;3D-LVEF in case group was negatively correlated with PASP ( r =- 0.54),and positively correlated with RVSV and RVEF ( r =0.58,0.53); there was no significant correlation between LVEDV and RVEDV.LVEDV was negatively correlated with SIs and SId ( r =-0.65,-0.61),so as to EId and EIs ( r =-0.67,0.67).LVEF was negatively correlated with SIs and SId ( r =-0.64,-0.61),so as to EId and EIs ( r =-0.66,-0.68),and the corresponding P all above were less than 0.01.Conclusions PH can result in reductions of left ventricular volume and systolic function,and the variations of which have the correlations with the severity of PH and the increase in SI and EI.sRT-3DE can provide a method to get more accurate information of left ventricle.

Objective To study the imaging manifestations of spontaneous orbital hemorrhage and to evaluate the diagnostic values of different imaging techniques.Methods The manifestations of ultrasound,CT and MRI in 30 patients with spontaneous orbital hemorrhage confirmed by surgery or puncture were retrospectively analyzed.Then the imaging data were compared with pathological or clinical results.Results Eighteen of 30 patients were surgically confirmed, including 6 cases of simple blood cysts, 10 cases of venous angioma with hematocysts ( 7 cases in the intraconal space and 3 cases within the extraocular muscle),2 cases of varicosity with hernatocysts ( 1 case in the intraconat space and another case within the extraocular muscle).Twelve patients were proved by puncture.The sonngraphie features of the spontaneous orbital hemorrhage in all 30 cases were inhomogeneons and slightly compressible cysts without blood flow in them.The CT manifestation of the lesions was lack of specificity and showed isodensity or slight hyperdensity,however, the CT value of the lesions had the tendency of decrease over time.The CT values were 82.0 to 89.0 HU in 4 cases with the courses of 1-3 days.And when the hemorrhage courses were 4-20 days,21-60 days, the CT values were 69.0 to 82.0 HU (20 cases) and 30.0 to 37.0 HU (6 cases),respectively.On MRI, the lesions showed typical signal characteristics and evolution of hematomas.For 1-3 days (4 cases), the lesions showed isointensity on T1WI and hypointensity on T2WI; for 4-10 days (10 cases), the lesions appeared hyperintensity in the central zone on T1WI and still showed hypointensity on T2WI; for 11-20 days( 10 cases), the lesions was homogeneous or inhomogeneous hyperintensity on T1WI and homogeneous hyperintensity on T2WI; and for 21-60 days (6 eases), the lesions showed heterogeneous intensity on both T1 WI and T2WI.The coincidence rates with clinical diagnoses were 96.7% (29/30) for ultrasound, 26.7% (8/30)for CT and 100% (30/30) for MRI, but they all showed limited ability in distinguishing simple from secondary orbital hemorrhage.Conclusion MRI is superior to ultrasound and CT in diagnosing spontaneous orbital hemorrhage and evaluating the secondary changes.

Two regression models, based on panel data over the period of 2000-2011, are built and used to analyze what factors determine China's exports of primary and semi-finished products of traditional Chinese medicine to ASEAN. The results indicate that, China GDP, the ratio of ASEAN to China GDP per capita, average export price, the ratio of state-owned assets to total assets, have a significant positive influence on the export volumes of primary products of Chinese medicine. At the same time, RMB appreciation, the ratio of three kinds of foreign-invested assets to total assets, China-ASEAN Early Harvest Program, ASEAN-China Free Trade Area have a significant negative influence. In respect of the export volumes of semi-finished products of Chinese medicine, the significant influential factors are ASEAN GDP and the ratio of ASEAN to China GDP per capita. The former is positive and the latter is negative. In order to optimize the commodity composition of experts, it is needed to increase export volumes of both primary and semi-finished products of Chinese medicine. According to the analysis above, some proposals are put forward, such as, improving the performance of foreign capital, playing an exemplary and leading role in technological innovation by state-owned enterprises, taking advantage of bargaining power of suppliers, increasing outward foreign direct investment.
China ; Commerce ; Drugs, Chinese Herbal ; chemistry ; economics ; Europe, Eastern ; Medicine, Chinese Traditional ; economics ; standards ; Quality Control

OBJECTIVETo discuss the curative effect of traditional treatment and combination therapy for senile hip fracture.

METHODSUsing prospective methods to choose 300 cases of elderly patients with hip fractures from February 2011 to December 2012, which were randomly divided into comprehensive treatment group and conventional treatment group. After screening, 148 case were in comprehensive treatment group,including 62 males and 86 females with an average age of (78.76 +/- 7.32) years old ranging from 60 to 88; 45 cases were intertrochanteric fracture of femur, 103 cases were fracture of neck of femur; Singh index > or = IV in 74 cases, < IV in 74 cases;preoperative Harris score was 39.90 +/- 2.28. There were 146 cases in conventional treatment group,including 60 males and 86 females with an average age of (80.00 +/- 7.06) years old ranging from 66 to 96; 50 cases were intertrochanteric fracture of femur, 96 cases were fracture of neck of femur; Singh index > or = IV in 75 cases, < IV in 71 cases; preoperative Harris score was 40.10 +/- 2.81. Preoperative general situation,leaving bed time and hospital stay, the incidence of postoperative 12 weeks Singh index > or = IV and DPD/Cr value, Harris score at 12 months after operation and the incidence of fracture again of two groups were observed and compared.

RESULTSIn comprehensive treatment group 140 patients were followed up for 12 to 18 months with an anverage of 14.80 +/- 1.85. In conventional treatment group 132 patients were followed up for 12 to 14 months with an average of 12.75 +/- 0.79. There were no significant differences in age, gender, the classification of fracture, preoperative Harris hip score, preoperative Singh index > or = IV level and DPD/Cr value between the two groups (P > 0.05). Comprehensive treatment group had shorter leaving bed time and hospital stay, smaller postoperative 12 weeks DPD/Cr value and higher postoperative Harris score, higher incidence of postoperative 12 weeks Singh index > or = IV level, lower incidence of fracture again than conventional treatment group, there was statistically significant difference between two groups (P < 0.05).

CONCLUSIONFor the anti-osteoporosis effect, the comprehensive treatment group has more advantage than traditional treatment group in elderly hip fracture, which can further improve the elderly hip fracture treatment and provide the reference of evidence-based medicine cooperate with rehabilitation department.

Aged ; Aged, 80 and over ; Case-Control Studies ; Female ; Hip Fractures ; surgery ; Humans ; Incidence ; Length of Stay ; Male ; Postoperative Complications ; epidemiology ; Prospective Studies

Background The incidence of dry eye is growing.However,the early diagnosis of dry eye is still difficult up to now.Keratograph 5M analyzer,a novel noninvasive ocular surface analyzer for dry eye may offer important parameters.Objective This study was to evaluate the clinical value of Keratograph 5M analyzer for clinical diagnosis of dry eye.Methods An observational study was proceeded with 88 cases who accepted myopia diagnosis in Tianjin Medical University Eye Hospital from October to December 2013.A series of conventional dry eye-related examinations were performed on the patients,including tear film break-up time (TBUT),corneal fluorescein staining scoring,Schirmer Ⅰ test (S Ⅰ t),and then Keratograph 5M analyzer-related examinations were subsequently carried out,including noninvasive tear film break-up time (NITBUT) and conjunctival hyperemia scoring.The correlations between conventional dry eye-related examinations and Keratograph 5M analyzer-related examinations were assessed by using Spearman rank correlation analysis.Results A total of 88 patients were recruited with male 32 and female 56.No significant difference in age was found between different genders (P =O.34).In 88 patients,Keratograph 5M analyzer showed the non-dry eyes in 15 patients,suspicious 44 patients (50.0％) and dry eyes in 29 patients (33.0％).However,the non-dry eyes were checked out in 39 patients and dry eyes were in 49 (55.7％) based on China Dry Eye Clinical Diagnosis and Treatment Consensus.The first NITBUT (NITBUTf) was less than the average NITBUT (NITBUTav) (P =0.00),and a positive correlation was seen between them (rs =0.62,P =0.00).Dry eye grade was significantly correlated with NITBUTf or NITBUTav or conjunctival hyperemia scoring (rs =-0.60,P =0.00 ; r,=-0.89,P =0.00 ; rs =0.24,P =0.02).A negative correlation was found between the conjunctival hyperemia scoring and NITBUTav (rs =-0.24,P =0.02).However,no significant correlation was seen between conjunctival hyperemia scoring and NITBUTf,TBUT,S Ⅰ t or corneal fluorescein staining scoring (rs=-0.13,P=0.22;rs=0.16,P=0.14;rs =-0.16,P=0.13;rs=-0.08,P=0.44).No significant difference was found between TBUT and NITBUTf (P =0.71).And TBUT was correlated with NITBUTf (rs =0.23,P =0.03),but not NITBUTav (rs =0.18,P =0.09).In addition,no significant correlations were seen between S Ⅰ t and NITBUTf or NITBUTav (rs=0.20,P=0.07;rs=0.05,P=0.66).Conclusions NITBUTav has an important significance in assessing overall ocular surface conditions.The conjunctival hyperemia score is one of refrent indicators to judge ocular surface status.

OBJECTIVE:To provide reference for medical costs control in China. METHODS:Based on main characteristics of the United States health service system,information asymmetry,principal-agent theory and Freedman’s consumption theory were used to analyze the advantages of restrictive relationship among doctors,hospitals and health insurance institutions in control-ling medical costs and improving the quality of diagnosis and treatment. The growth rate of medical cost,the percentage of drug ex-penditure and other aspects were compared between China and the United States;the effect of restrictive relationship on medical cost control was demonstrated. RESULTS & CONCLUSIONS:In the United States,there are hierarchical medical system and two-way referral system;for-profit hospitals and non-profit hospitals are mutually complementary;different natures of health insur-ance system,different payment methods and strict“commercial bribe”monitoring system are carried out;doctors,hospitals and health insurance restrict each other. Not only there are many advantages in theory,but also in practice the growth rate of medical cost and the percentage of drug expenditure are superior to our country. Finally it controls the rapid growth of medical cost to a cer-tain extent. Combined with our national conditions,learning from the United States experience,restrictive relationship among doc-tors,hospitals and health insurance institutions is established to control the increase of medical cost in China through reducing infor-mation asymmetry and standardizing payment audit;establishing a scientific pattern of mixed payment;strengthening the indirect impact of the health insurance institutions on doctors and hospitals,etc.

Objective In order to investigate the roles of hIGF\|1 in treatment of diabetes mellitus and diabetic syndromes,the gene of human insulin like growth factor type Ⅰ(IGF\|1) was cloned and constructed into eukaryotic expression vector,then the expression and activity were determined. Methods Total cellular RNA of human fetal liver was abstracted and the RT\|PCR amplification of the cDNA fragment was performed.The fragment was cloned into pUCM\|T vector and sequenced.The eukaryiotic expression vector was recombined and transfected into fibroblast cell line,COS\|7.The expression of hIGF\|1 was examined by in situ hybridization and immunohistochemistry.The effect of hIGF\|1 on cultured islet cells was observed by glucose\|stimulated insulin release assay. Results The cDNA fragment of 710bp with additional Kozak sequence was amplified by RT\|PCR.Eukaryiotic expression vector pCI\|neo/hIGF\|1 was constructed and IGF\|1 gene expressed in COS\|7.The biological activity of hIGF\|1 was proved by increasing inslin secretion from islet cells.Conclusion\ The newly constructed vector,pCI\|neo/hIGF\|1 could be transfected into COS7 cells and its expressed product showed to have the biology activity of hIGF\|1.\;[

ObjectiveTo investigate the feasibility of using the ratio of (Cho + Cr)/Cit derived by MRS to predict the differentiation grades of prostatic cancer and Gleason grading.Methods Five postoperative prostate specimens were spitted and layered according to the region of interest of MRS inspections.The correlation between the CC/C values of each region of interest in each layer and the Gleason scores of the corresponding pathological sections was analyzed.The optimum diagnostic cutoff value was determined by conducting the hypothesis test of the area below the ROC curve of the well and moderately differentiated groups and poorly differentiated ones on the basis of CC/C values with a Spearman test.Results A total of 90 regions with valid pathologic diagnosis were obtained,70 cancer-affected and 20 cancer-free.In MRS,a CC/C value above 0.86 was used as a criterion for defining a cancer-affected region As a result,65 cancer-affected regions and 25 cancer-free regions were identified,among which pathologic diagnosis confirmed 59 and 14,respectively.Spearman′s rank correlation analysis revealed that the CC/C values of the prostatic carcinoma had significant positive correlation with Gleason scores ( r =0.746,P =0.000).For the well and moderately differentiated groups,the hypothesis test about the cutoff value,which was obtained by calculating the area below the ROC curve,was of no statistical significance.For the poorly differentiated groups,the optimum cutoff value was defined as 0.948,and the sensitivity and specificity were 81.4％ and 75.0％,respectively.It was also observed that the Gleason scores of the poorly differentiated endemic regions had positive correlation with the CC/C values ( r =0.605,P =0.000 ),suggesting that CC/C value was associated with the differentiation grade of the poorly differentiated prostatic cancer.When CC/C value was above 0.948,the poorly differentiated prostatic cancer was typically detected and Gleason score was often above 7.Conclusions CC/C values has positive correlation with Gleason scores.MRS may be used to predict the differentiation of prostate cancer.