Objective To explore the possibility of non-discarding blood after cisplatin hyperther-mic antiblastic perfusion(HAP)in treating the patients with malignant bone tumor of lower extremity.Methods Forty patients consisted of 31osteosarcomas and9malignant fibrous histiocytomas of bone.The clinical stages were wholly classified intoⅡB stage according to Ennekings surgical staging system for muscu-loskeletal tumors.The patients were divided into three groups:group1:discarding blood group(10cases),in whom200ml of the400ml blood remaining in heart-lung machine was discarded after HAP;group2:Non-discarding blood group(25cases),the blood remaining in heart-lung machine was not discarded after HAP and re-infused into systemic circulation;group3:systemic chemotherapy group(5cases),cisplatin was infused intravenously.The regional and the systemic blood cisplatin concentrations were determined at3,30and60minutes during HAP,and the systemic blood cisplatin concentrations were determined at0,0.5,1,2,4,8,12,24,48and72hours after HAP in the group1and group2.While1h after cisplatin infusion in-tra venously in the group3,the blood cisplatin concentration were also measured.Results The regional blood cis platin concen tra tions were high er than that in systemic blood at the time during HAP.The systemic blood cisplatin concen trations after HAP,ex cept at0minute in the group2were higher than that in the group1,there were sig nificant statistic differences between the two groups.The systemic blood cisplatin con-cen trations after HAP in the group2were simi lar to that after systemic chemotherapy.No severe adverse ef-fects in the group1were found.The Ennek ings surgical stagings for the tumors were turned fromⅡB intoⅡA in all the patients.Conclusion The method of non-discarding blood after HAP is available,it is not only local treatment ,but also systemic chemotherapy in the patients with malignant bone tumor of lower ex-tremi ty for limb-salvage surgery.

Objective To evaluate efficacy in detecting lung nodules at low-dose CT(LDCT) by nodule enhanced viewing(NEV).Methods One hundred and twenty seven patients who were referred to undergo low-dose CT (LDCT) for the evaluation of pulmonary metastasis or screening lung cancer were selected randomly.Two radiologists with at least 10 years experience read the images with normal clinical reading speed to find actionable nodules ≤ 2.0 cm in maximum diameter,and their consensus result was referred as Standard.NEV was adopted to detect the pulmonary nodules.Two residents with experience of less than three years read first detected suspicious nodules and recorded reading time,first consensus and mean time were recorded.Then,they made second decisions on the images with the help of NEV and the results and the reading time were recorded and analyzed by using wilcoxon test.The sensitivity and accuracy of NEV,residents and residents with NEV were analyzed.Results Standard,resident,NEV and resident with NEV detected 570,404,768 and 593 lung nodules ≤2.0 cm in maximum diameter,respectively.More than 60％ nodules were less than 0.5 cm in maximum diameter.The performance of NEV in detecting nodules ≤2.0 cm as well as nodules ＜ 0.5 cm in maximum diameter was significantly higher than that of the resident(Z =-6.887,P ＜0.01 and Z =-7.235,P ＜0.01),and the performance of resident with NEV indetecting nodules ≤2.0 cm as well as nodules ＜ 0.5 cm in maximum diameter was significantly higher than that of resident without NEV (Z =-6.606,P ＜ 0.01 and Z =-6.657,P ＜ 0.01).The resident,NEV and the resident with NEV detected nodules ＜ 20 mm in maximum diameter with sensitivities of 61.4％,86.3％ and 95.3％,and with accuracy of 56.1％,58.1％ and 87.6％,respectively.The resident achieved sensitivities of 51.4％,88.1％ and 94.8％,and accuracy of 47.0％,56.9％ and 87.5％ for nodules ＜5 mm in maximum diameter,respectively.The resident,NEV and resident with NEV spent 120-444 s,85-262 s and 131-1512 s per case to read the CT scans,respectively.The reading time of resident with NEV in was significantly higher than that of resident without NEV(Z =-9.781,P ＜ 0.01).The resident spent 23 s per NEV mark.Conclusion NEV considerable improves the resident's performance in lung nodule detection,especially in maximum diameter ＜ 0.5 cm nodule detection.

After a description of medical literature retrieval teaching in our library, the contents in the designed medical literature retrieval practice course teaching and the ideas for its reform, the competitive practice method was proposed according to the characteristics of subjects in which the undergraduates were majored and the experi-ence with several teaching models such as PBL, the effect of its implementation was analyzed with its related prob-lems and measures for their solution pointed out.

Objective To demonstrate the frequency changes in immune cells on secreting interleukin-10 (IL-10),interferon-? (IFN-?),tumor necrosis factor-? (TNF-?) and interleukin-4 (IL-4) under the stimulation of a mimic 7-amino acid peptide of HCV HVR1 (7P),and to explore the mechanism of such changes. Methods The peripheral blood mononuclear cells (PBMCs) were isolated from healthy people and co-cultured with 7P. Intracellular cytokine staining was performed using antibodies against IL-10,IFN-?,TNF-? and IL-4. The related cells were harvested on a FACSCalibur flow cytometer,and then analyzed with FACSCalibur software. Results Compared to the controls,the frequency of immune cells secreting IFN-? was significantly increased in both CD4+CD8-,CD4-CD8+ T cells and NK,NKT cells (P

Purpose: To investigate the influence of cataract surgery on detection of a foveal avascular zone (FAZ) and retinal capillary density (RCD) by optical coherence tomography angiography (OCTA). Methods: In this study, 64 eyes of 64 patients with cataracts who underwent surgery were included and studied retrospectively. All patients underwent cataract surgery of the included eye and a FAZ was detected on OCTA preoperatively and postoperatively using one of two kinds of OCTA devices. The FAZ and RCD were compared before and after cataract surgery using paired t-test. Results: Using the Cirrus Angioplex OCTA device, there was no significant pre- or post-operative difference in the FAZ area (p = 0.060), perimeter (p = 0.052) and circularity (p = 0.190). It also revealed no significant difference between the central (p = 0.310), inner (p = 0.310), and outer (p = 0.310) zones and full RCD (p = 0.228) before and after cataract surgery The Spectralis OCTA device also showed no significant difference in the FAZ area (p = 0.239) before and after cataract surgery. Conclusions Cataract surgery does not affect detection of the FAZ and RCD on OCTA. Although patients who have a FAZ-related retinal disorder such as diabetic retinopathy and undergo cataract surgery are followed up regularly, it seems that the results gained by OCTA are reliable and comparable to the preoperative result.

The purity of 4,4′-dimethoxy-5,6,5′,6′-bis (methylenedioxy)-2′-morpholine methylenebiphenyl-2-methyl formate methanesulfonate (IMH), a new drug for fatty liver treatment, was determined through differential scanning calorimetry (DSC). Analysis of two-factor non repeatability method was performed in the investigation the effects of two factors (heating rate and sample weight) on purity determination. The DSC experimental parameters were optimized as follows: heating rate was 10 ℃·min^-1, temperature range was 150-300 ℃, sample weight was 2.0-4.1 mg, and N₂ flow rate was 80 mL·min^-1. The linear correlation coefficient (r) of this DSC method was 0.999 8. The RSD value (n = 6) of precision was 0.03%. The standard value and uncertainty of the purity results of the multiple batches of IMH drugs were (99.74 ± 0.29)%, (99.91 ± 0.28)%, (99.90 ± 0.28)%, and (99.81 ± 0.28)% with inclusion factor (K) of 2 and confidence probability (P) of 0.95. The results were basically consistent with the results of the mass balance method. The DSC mehod is a simple, rapid and accurate method, and provides a new reference method for determining the purity of IMH drugs, improves the accuracy and reliability of purity determination.

OBJECTIVE To investigate the hospital infection rate and sites of patients in emergency intensive care(unit)(EICU),and provide basis for prevention and treatment of hospital infection.METHODS Patients who were hospitalized in EICU were investigated by retrospective study.RESULTS Among the hospital infection sites,(respiratory) tract was the most frequent one(65.63%),the next was urinary tract(28.13%),and the deep vein was the third(6.25%).The most common hospital infection bacteria were Staphylococcus aureus,Pseudomonas aeruginosa and Acinetobacter baumannii.CONCLUSIONS The analysis of the subjective and objective factors of hospital infection,and the acknowledge of relationship between nursing and hospital infection sites are(important) basis for hospital infection prevention and treatment.

PURPOSE: In the present study, two cases of intraoperative acute opacification of hydrophilic intraocular lens were reported. CASE SUMMARY: (Case 1) A sixty-seven year-old female presented with chronic visual impairment. Slit lamp examination revealed nuclear cataract of the left eye. Cataract surgery for her left eye was performed. A hydrophilic intraocular lens was checked before implantation and no defect was noted. Immediately after the implantation of the intraocular lens, acute whitish opacification of the intraocular lens occurred. However, the intraocular lens was not explanted, and the opacification cleared after one day. (Case 2) A 65 year-old male presented with chronic visual impairment of the left eye. Nuclear cataract of his left eye was noted, and he went through cataract surgery of the left eye. After the implantation of intraocular lens, acute whitish opacification of the intraocular lens was noted but it disappeared a day after. CONCLUSIONS: Intraoperative acute opacification of intraocular lens seems to occur due to radical temperature change. There is no need to remove or exchange the intraocular lens as opacification tends to clear within a day. No structural or mechanical change of intraocular lens was noted after opacification. Careful management of temperature for intraocular lens storage is necessary for prevention of intraoperative intraocular lens clouding.
Cataract ; Female ; Humans ; Lenses, Intraocular ; Male ; Slit Lamp ; Vision Disorders

PURPOSE: We report a case of unilateral, focal, pigmented paravenous retinochoroidal atrophy (PPRCA). CASE SUMMARY: A 46-year-old female visited our clinic in complaint of a vague problem with her right eye identified during a general medical examination. The visual acuity (without correction) of both eyes was 1.0. Slit-lamp examination of both eyes revealed no specific signs. Fundus examination of the right eye revealed focal, bony-spicule-shaped retinochoroidal atrophy with pigmentation along the course of the superior retinal vein. A fundus autofluorescence examination revealed principally hypofluorescence with some hyperfluorescence at the margin of the atrophic retinochoroidal lesion. Optical coherence tomography revealed mixed clumping and atrophy of the retinal pigment epithelium (RPE) layer and thinning of the choriocapillaris layer. Fluorescence angiography revealed a window defect and blockage at the site of the lesion (the fluorescent material did not enter the lesion). The site of the window defect was in correlation with the atrophic RPE region. The site of the blockage at lesion also matched with the site of the regional pigment clumping. No definite leakage was observed. CONCLUSIONS: To the best of our knowledge, this is the first case of unilateral focal PPRCA reported from Korea.
Atrophy ; Female ; Fluorescein Angiography ; Humans ; Korea ; Middle Aged ; Pigmentation ; Retinal Pigment Epithelium ; Retinal Vein ; Tomography, Optical Coherence ; Visual Acuity

PURPOSE: A case of a transient visual field defect and a change in spectral-domain optical coherence tomography (SD-OCT) after an overdose of sildenafil citrate is described. CASE SUMMARY: A 67-year-old male with no previous medical history presented with a bluish tinge and visual field defect in both eyes. He had consumed eight tablets of sildenafil citrate (800 mg) 3 days before the visit. His best-corrected visual acuity was 14/20 in the right eye and 20/20 in the left eye. No specific finding was noted on slit-lamp examination. Fundus examination and fundus photography revealed focal foveal hypopigmentation in both eyes. He underwent SD-OCT imaging with the Cirrus HD-OCT (Carl Zeiss Meditec, Oberkochen, Germany), and thickening of the ellipsoid zone and choroid was revealed by SD-OCT scans. He was advised not to take any more sildenafil citrate and was followed for 1 week after the first visit. Central scotomas of both eyes were revealed by a visual field test, and thickening of the ellipsoid zone and choroid remained. His eyes were re-evaluated 1 and 3 months after the first visit, and although the symptoms nearly disappeared, abnormalities in the visual field test and on SD-OCT remained, albeit with some degree of improvement. He revisited us 4 months after the first visit, at which time the visual field test and SD-OCT scans showed results within normal ranges. CONCLUSIONS: Sildenafil citrate overdose can result in a color anomaly (bluish tinge), visual field defects, and thickening of the ellipsoid zone and choroid on SD-OCT scans.
Aged ; Choroid ; Humans ; Hypopigmentation ; Male ; Photography ; Reference Values ; Scotoma ; Sildenafil Citrate ; Tablets ; Tolnaftate ; Tomography, Optical Coherence ; Visual Acuity ; Visual Field Tests ; Visual Fields