This paper introduces the forming of the metrology control network which attracts great attention of the hospital's leadership.The result indicates that the metrology knowledge training is strengthened,its level is raised,and the metrology control becomes more scientific,effective and standardized.Now a new atmosphere appears in our hospital that every staff values and participates in the metrology work.Both the examined rate and qualified rate of the measuring appliances reach 100%.Accurate,reliable,safe and effective measuring appliances are provided for the clinical work.

Objective To provide a series of surgical approaches for treatment of bone lesions in ankle and foot. Methods Based on the anatomic investigations,vascularized cuboid bone,medial cuneiform bone,navicular bone and lateral part of calcaneum bone grafting were designed for repaired bone lesions in the area of ankle and foot,and applied to 55 clinic cases. Results Forty-eight cases among them were followed up from 1 year to 10 years,4 years and 6 month in average,the results were satisfactory. Conclusion The designed four types of vascularized tarsal bone flaps are easy and reliable for dissection because of their superficial pedicle.

Objective To provide the anetomic base for the transposition of spine of scapular flap pedicled with thoracoacromial artery Methods The course, branches and distribution of thoracoacromial artery were observed on 40 adult cadaver specimens Results The main branch of thoracoacromial artery was the acromial branch Its length was (5 1?0 1) cm, the originated diameter was (1 2?0 2) mm The deltoid muscular branch went outward intermuscular ditch between deltoid muscle anspectoralis major muscle, and anastomosed with anterior humeral circumflex artery constantly besides distributing to deltoid muscle and pectoralis major muscle, its diameter was (1 9?0 2) mm, the length form the originated dot to the entrancing muscular dot of deltoid muscle or pectoralis major muscle was (4 8?0 5) cm or (3,2?0 4) cm respectively Conclusion The transposition of lateral segment spine of scapular flap pedicled with the acromial branch of thoracoacromial artery or deltoid muscular branch acromial branch may be designed for repairing proximal humerus

Sleep disorder is a common complication after is chemicstroke.If it is nottimely diagnosed and treated, it may affect the rehabilitation of stroke and recurrence. The manifestations of sleep disorders have various forms according to the different locations of infarction. For the treatment of sleep disorder after stroke, the method of the combination of drugs and physical therapy is used in clinical practice at present. In recent years, w ith the w idely use of the polysomnography, poststroke sleep disorders can be diagnosed clearly and carefuly. The treatment for sleep disorders after stroke may significantly improve the prognosis of patients.

Diabetes mellitus is an independent predictor of high platelet reactivity after antiplatelet therapy in patients with ischemic stroke,and the latter is closely related to the increased risk of recurrence of stroke.The mechanisms of high platelet reactivity in patients with diabetes or insulin resistance are associated with a variety of factors.Some circulating molecules can be used as markers for predicting the reactivity of platelets.Monitoring of platelet reactivity after treatment with new antiplatelet agents may provide basis for individualized antithrombotic therapy in ischemic stroke patients with diabetes or insulin resistance.

Clopidogrel can inhibit platelet aggregation and reduce the risk of recurrent stroke.However,it is a great difference in antiplatelet inhibition in different populations.This article reviews the mechanism of clopidogel resistance and its countermeasures in the prevention of ischemic stroke.

Objective To investigate the eye lens dose to the operators who tended to test the quality control of positron emission tomography (PET).Methods Before encapsulation and in preparation of point source,line source 1 and line source 2,the two operators were worn with lens thermoluminescence dosimeter each at the left of the left eye,the front of the left eye,between the right eye and the left eye,the left of the right eye,and the front of the right eye.Measurement and analysis were made of the radiation doses to eye lens received by the operators in order to calculate their maximum annual doses.Results The maximum lens dose was 2 439.80 μSv for the test of 5 PETs.There appears to be the same trend in the eye lens doses for the first and second operators.(x2 =15.629-16.155,P ＜ 0.05).The first operator have received higher eye lens dose higher than the second(Z =2.611,P ＜ 0.05).Conclusions The dose to the eye lens for a single PET test is relatively low.

Objective:To establish and validate a malignant risk prediction model of solitary pulmonary nodules (SPNs) with pulmonary fibrosis in long-term smokers based on 18F-flurodeoxyglucose (FDG) PET/CT. Methods:PET/CT images of 222 SPNs combined with pulmonary fibrosis which were shown in integrated CT scan in 169 patients (all males; age 68(63, 75) years) were analyzed retrospectively. All patients were examined in PET/CT Center of the Affiliated Hospital of Qingdao University from January 2011 to December 2019 and all had definite smoking history. The benign and malignant nodules were judged according to the pathological diagnosis or follow-up imaging data of lung lesions (follow-up≥2 years). The clinical characteristics (age, smoking index), morphological characteristics (longest diameter of lesion, density, location, distribution, relative position of fibrosis, spiculation, lobulation, calcification, vacuole, vascular convergence, pleural indentation, emphysema and severity of bilateral pulmonary fibrosis) and metabolic characteristics (maximum standardized uptake value (SUV max)) of the benign and malignant lesions were analyzed by χ2 test and Mann-Whitney U test. Then multivariate logistic regression analysis was applied to select independent risk factors of malignant nodules, and a risk prediction model was established and verified by the area under the receiver operating characteristic (ROC) curve and k-fold cross validation ( k=10) respectively. Results:Among 169 patients, 222 SPNs were detected (157 malignant nodules, 65 benign nodules). Univariate analysis showed that smoking index, speculation, lobulation, vascular convergence sign, calcification, emphysema, nodule size, relative position of nodule and fibrosis, SUV max and severity of bilateral pulmonary fibrosis were significantly different between the benign and malignant nodules ( z values: 2.514-9.858, χ2 values: 4.353-18.442, all P<0.05). Result of multivariate logistic regression analysis showed that calcification, vascular convergence and SUV max were the independent risk factors of malignant nodules combined with pulmonary fibrosis (odds ratio ( OR): 0.048-2.534, all P<0.05). The risk prediction model was as follow: P=1/(1+ e - x), x=-1.839-3.033×calcification+ 0.930×vascular convergence+ 0.754×SUV max(with calcification/vascular convergence=1, without calcification/vascular convergence=0). The area under ROC curve was 0.932(95% CI: 0.895-0.969), and the sensitivity and specificity of the model were 87.9% and 86.2%, respectively. Results of k-fold cross validation showed that the prediction accuracy of 10 test sets was 0.847±0.075, and was 0.862±0.010 in training sets. Conclusions:Calcification, vascular convergence and SUV max are independent risk factors of malignant SPNs combined with pulmonary fibrosis in long-term asymptomatic smokers. The model based on the above variables presents high diagnostic efficiency in diagnosing malignant SPNs.

Objective Toexplore the application value of diffusion tensor imaging (DTI) in evaluating evaluation offunctional changes of the in patients with primary trigeminal neuralgia caused (PTN) by neurovascular compression. Methods 40 unilateral PTN patients and 40 healthy volunteers were enrolled in ourstudy.They allAll patients underwent the general sequences and DTI ,and then to measured the ADC and FA values of the trigeminal nerves. Results (1) Compared with contralateral side (0.408 ± 0.054)and bilateral sides in control group(0.423 ± 0.057), FA value of the ipsilateral side in PTN group(0.330 ± 0.056) was significant lower (P< 0.05)compared with the contralateral side (0.408 ± 0.054) and bilateral sides in control group (0.423 ± 0.057).The ADC value of ipsilateralside (2.052 ± 0.473)× 10-3 mm2/s was significantly higher (P < 0.05) thancompared withthe contralateral side (1.541 ± 0.266) ×10-3 mm2/s and bilateral sides in control group(1.431 ± 0.308) ×10-3 mm2/s. (2) An There's a nnegative correlation was found (r = -0.613,P < 0.001) between the loss of FA and the increase of ADC (r = -0.613,P < 0.001). Conclusion DTI could be used to evaluate the changes of neuratrophy and demyelination ,so it canmight be used of in diagnosis and treatment of PTNin further way.

OBJECTIVE:To systematically review the related evidence-based guidelines of purulent meningitis in children,and to provide evidence-based reference for clinical treatment. METHODS:Retrieved from PubMed,EMBase,CBM,Wanfang Data-base,CJFD and VIP,NGC,GIN,TRIP and websites of domestic and international medical associations and industry bodies,the treatment guidelines about purulent meningitis in children were collected. Evidence-based evaluation was performed after data extrac-tion and quality evaluation. RESULTS:Finally 3 guidelines were enrolled in total,with development time ranging from 2004 to 2012,from USA,Britain and Australia,respectively. All of the recommendations were level B,scope and purpose and clarityshowed the higher scores in AGREEⅡ,more than 70%,and applicability showed generally low scores. Penicillin and cefotaxi-me were recommended in purulent meningitis of neonates,and vancomycin combined with cefotaxime or ceftriaxone were recom-mended for infants and children(it was combined with vancomycin when Streptococcus pneumoniae infection was suspected). The dose and duration of each guideline were certain different,and the period of treatment should be longer in neonates. In addition, the glucocorticoid was recommended in all guidelines. CONCLUSIONS:The recommendations of medicines for the treatment of pu-rulent meningitis are basically unanimous,with no regional difference,but there are some differences about dose and the course of treatment. In addition,the classification criteria of the levels of evidence and recommendation are still suboptimal,which needs fur-ther improvement. And guidelines on purulent meningitis should be improved inrigourandapplicabilityin future.