Objective To evaluate the surgical treatment of bladder cancer near ureteral orifice. Methods 42 cases of bladder cancer requiring ureteral reimplantation were divided into two groups at random:20 cases in group A:tongue-shaped incision of bladder wall around ureteral orifice was performed to modify Huctch-Ⅱ ureter implantation and 22 cases in group B:severing the ureter just outside the bladder,the ureter was then implanted into the bladder after partial cystectomy.Duration of the procedure,blood loss,amount of post-operation drainage,early complication,bladder ureter reflux,ureter obstruction,and cancer recurrence rate were studied and compared. Results In group A,the surgery took 60.5?18.5 min,blood loss amounted to 50.6?12.8 ml and the post-operative drainage 50.6?17.8 ml.In group B,the operation needed 150.9?22.4 min,the blood loss amounted to 220.5?28.2ml and post-operative drainage 280.6?58.9 ml.All the above three indexes showed siginificant difference between the 2 groups (P0.05). Conclusions Tongue-shaped incision of bladder wall around the ureteral orifice better with less complication,technically easier and worth recommendation.

The paper gives an account of the building of the long-distance medical system, a project of Sino Japanese informationalized cooperation. It describes the configuration and structure of the long-range support system of clinical image diagnosis based on the Japanese technique of superhigh-defintion display, discusses the functions and characteristics of the long-distance medical system featured by superhigh-definition display and forecasts the prospects of the application of the system in China and the research and development of relevant projects.

Objective To devise an improved double J tube for ureteral stenting so as to simplify its postoperative removal. Methods One end of the double J tube was made blind and got through the urinary tract via the ureteral wall or via a weak point of the renal cortex.The blind end was then embeded in the subcutaneous tissue and the ureteral stent was left behind for 4～12 weeks.A small incision (0.5 cm) was made in order to withdraw the stent and cystoscopy could be avoided.The self devised tube has been clinically employed for 60 cases. Results The stent has been satisfactory in all the 60 cases and its postoperative removal has been easy with no need of cystoscopy. Conclusions The subcutaneous embedding of a blind end of double J tube is simple and effective and its postoperative withdrawal is easy with no need of cystoscopy.

Objective To study the occurrence of asymptomatic coronary artery endothelial lesions,and its relationship with coronary heart disease(CHD).Methods From June 2003 to September 2004,120 patients with old myocardial infarction(OMI)and stable angina pectoris(SAP)were enrolled in this study.The angioscopy of non-culprit vessels was successfully performed to detect the endothelial lesions including yellow plaque,plaque rupture and/or thrombosis.Meanwhile,the relationships between coronary artery endothelial lesions and hypertension,diabetes mellitus(DM)and low-density lipoprotein cholesterol(LDL-C)were examined.Results Detailed angioscopic findings were obtained in 80 of the 120 patients(66.67%)(in 155 non-culprit vessels).These lesions demonstrated a significantly higher occurrence in patients with hypertension,in patients with high level of LDL-C and in patients with DM than in patients without endothelial lesions(P

Objective To evaluate the changes of platelet activity before and after anti-platelet treatment in pa?tients with coronary heart disease, and their responsiveness to clopidogrel through detecting the phosphorylation levels of va?sodilator stimulated phosphoprotein (VASP). Methods Twenty-eight cases of healthy people were selected as control group . Patients with chronic stable angina pectoris (CSA, n=95) were randomly divided into A (48 cases) group and B (47 cases) group,and were given clopidogrel 75 mg/d or 150 mg/d respectively;Patients with non ST segment elevation acute coronary syndrome (NST-ACS, n=67) were all given 300 mg loading dose of clopidogrel at the first time, then randomly divid?ed into C (33 cases) group and D (34 cases) group, and given clopidogrel 75 mg/d and 150 mg/d respectively. Blood were tak?en to examine the phosphorylation levels of serum VASP by ELISA before taking clopidogrel, at time point of loading dose and the fifth day of clopidogrel administration . Results Before treatment, phosphorylation levels of serum VASP were low?er in A, B, C, D groups than those in the normal control group(P<0.05). After treatment of clopidogrel for 5 days: ① In group A and group B ,phosphorylation levels of serum VASP did not change compared to that before treatment (P>0.05).②In group C and group D, phosphorylation levels of serum VASP were significantly increased at loading dose and the fifth day of clopidogrel administration than those before treatment (P<0.05), but there were no significant differences in phosphory?lation level of VASP was lower group between group C and group D after serum treatment (P > 0.05). Conclusion The phosphorylation level of serum VASP was lower in patients with coronary heart disease than that in normal control group. Clopidogrel can improve the phosphorylation level of serum VASP in NST-ACS patients .

Objective To explore the fibrotic stroma characteristics of orthotopic liver cancer in rat and the relationship with MR delayed contrast enhancement.Methods 4 Wistar rats with orthotopic liver cancer underwent conventional triphasal and longer-de-layed contrast-enhancement MR scanning.12 HCC specimens obtained from the four Wistar rats were sliced and stained with HE, picric-sirius red,Verhoeff Van-Gieson elastic fiber,Gordon-Sweets reticular fiber and anti-α-SMA immunohistochemical staining.The relationshp between intratumoral fibrotic stroma and MR delayed phases of the 1 2 tumors were analyzed.Results Collagen fiber was expressed mainly in tumor fibrous septum.Elastic fiber distributed in tumor fibrous septum and the artery wall.Reticular fiber dis-tributed in fibrous septum of the regenerative nodules,portal area and tumor psuedocapsule.Integrated optical density (IOD)value of collagen fiber,elastic fiber and reticular fiber analyzed by Image-pro Plus6.0 were 0.102±0.020,0.063±0.018 and 0.109±0.032, respectively.As a result,the amount of collagen and elastic fibers were statistically different (P<0.01),and so were reticular fibers and elastic fibers (P<0.01).And there was a positive correlation between collagen fiber and MR delayed contrast enhancement (P<0.05).Conclusion MR delayed contrast enhancement of hepatic cancer in rat is closely associated with the collagen fiber,thus this fiber in liver cancer can be evaluated noninvasively by MRI.

This paper reviews the development of appropriate health technology policy from 1992 to 2012 in Zhejiang province.The evolvement of recent twenty years is classified into several stages and each is analysed and evaluated.This study provides reference for the establishment of appropriate health technology policy and the transformation of science and technology policy across the country.

Objective To investigate the prevalence of aminoglycoside resistance gene in multidrug-resistant Acinetobacter bau-mannii isolated in clinical at a certain time,and to provide the basis for the control of nosocomial infection.Methods 9 strains of multidrug-resistant Acinetobacter baumannii were isolated in First People′Hospital of Weifang from November 26,2013 to Decem-ber 12,2013.Identification of bacteria and susceptibility testing were conducted by VITEK2,and partial antimicrobial drug suscepti-bility tests were performed by the disk diffusion method.Aminoglycoside resistance genes were detected by PCR and the positive genes were partly sequenced.Results Among the 9 stains of multidrug-resistant Acinetobacter baumannii,2 strains carried aac(3)-Ⅰ gene,3 carried ant(3″)-Ⅰ gene,3 carried aac(6′)-Ⅰ gene.AndarmA gene was positive in 9 strains.All strains were resistant to aminoglycosides,such as amikacin,gentamicin and tobramycin.There were 5 specien issolated in ICU,while 3 specimens were isola-ted in neurosurgery ward.All specimens were separated from sputum.Conclusion Antimicrobial resistance to aminoglycosides of Acinetobacter baumannii isolated in the hospital during this time was related to aminoglycoside resistance gene.Nosocomial infec-tion caused by multidrug-resistant Acinetobacter baumanniiin,ICU and neurosurgery ward should be vigorously monitored.

OBJECTIVE: The purpose of this article is to discuss the clinical value of central neck lymph node dissection in papillary thyroid carcinoma, especially in thyroid papillary microcarcinoma (PTMC). Also this article wants to evaluate the diagnostic significance of preoperative ultrasonography of central neck metastasis lymph nodes and the clinical significance of preoperative ultrasonography in central neck lymph node dissection. METHOD: Collected and analyzed 121 cases from September 2012 to December 2013. All of them had done the central neck lymph node dissection with the same standard by the same surgeon in our department. Evaluate the value of preoperative ultrasound diagnostic in thyroid microcarcinoma and non-microcarcinoma. RESULT: In the 121 patients, The 62 patients were diagnosed with PTMC (primary lesion d≤1. 0 cm). Accuracy rate of ultrasound diagnostic was 74. 2% (46/62), the rate of missed diagnosis was 61. 9% (13/21), the rate of misdiagnosis was 7. 3 % (3/41), sensitivity was 38. 1% (8/21), specificity was 92.7% (38/41), positive predictive value was 72. 7% (8/11), negative predictive value was 74. 5% (38/51) and the value of Kappa was 0. 3485. The other 59 patients was diagnosed with thyroid papillary non-microcarcinoma (primary lesion d>1. 0 cm). The accuracy rate was 55. 9% (33/ 59), the rate of missed diagnosis was 58. 3% (21/36), the rate of misdiagnosis was 21. 7% (5/23), sensitivity was 41. 7% (15/36), specificity was 78. 3% (18/23), positive predictive value was 75. 0% (15/20), negative predictive value was 46. 2% (18/39) and the value of Kappa was 0. 1757. CONCLUSION Cervical central lymph node dissection was necessary when the ultrasound diagnosis of cervical central lymph node-positive was prompted suspiciously in the thyroid papillary microcarcinoma. However, when it prompted negative, we could recommend patients to do the prophylactic central lymph node dissection in conjunction with the risk factors. Whether the ultrasound diagnosis of central lymph node was prompted suspiciously or not in the thyroid papillary microcarcinoma and non-microcarcinoma, the central lymph nodes dissection is necessary.
Carcinoma ; diagnostic imaging ; Carcinoma, Papillary ; diagnostic imaging ; Diagnostic Errors ; Humans ; Lymph Node Excision ; Lymph Nodes ; diagnostic imaging ; Lymphatic Metastasis ; diagnostic imaging ; Neck ; Risk Factors ; Sensitivity and Specificity ; Thyroid Cancer, Papillary ; Thyroid Neoplasms ; diagnostic imaging ; Ultrasonography

Objective This study was designed to explore the influence about apoptosis of STI571 on NB4.Methods After NB4 cells were treated with STI571 in different concentration(0.5,1.0,5.0umol/L)at indicated time(24h,48h,72h)(1)morphological observation:To determine cell morphology by light microscope.(2)MTT assay:Inhibition of proliferation was measured with a colorimetric 3-(4,5-dimethylthiazol-2-yl)-2,5-dipheny tetrazolium bromide(MYa3 assay.(3)Flow cytometric analysis:The expression of survivin and smac were measured on NB4 by FCM.Results Morphological observation showed characteristic apoptosis changes.MTT assay showed that STI at (0.5,1.0,5.0 μmol/L) range for 24 h,48 h and 72 h can markedly inhibit the proliferation of NB4 cells in a dose-dependent manner as well as a time-dependent manner(P＜0.05).FCM showed the expression of survivin decrease and smac increase.Conclusion STI571 In Vitro inhibits proliferation of NB4.