Female ; Fibromatosis, Abdominal ; diagnostic imaging ; pathology ; surgery ; Humans ; Middle Aged ; Radiography ; Rupture, Spontaneous ; surgery

Hierarchical diagnosis and treatment system has become one of the strategies for overcoming the diffi-culties in medical reform in our country. The important role of health information and its application in hierarchical diagnosis and treatment were thus elaborated in this paper in order to provide reference for the health information construction in establishing hierarchical diagnosis and treatment system at different levels in our country.

Two hundred and thirty-five patients of both sexes (123 male,112 female) aged 18-54 yr,weighing 35-62 kg underwent repair of tetralogy of Fallot from January 1996 to July 2009 in Fuwai hospital.Direct BP, ECG,CVP,SpO2,naso-pharyngeal temperature and TEE were continuously monitored during operation.Anesthesia was induced with midazolam and/or etomidate, fentanyl and pipecuronium and maintained with isoflurane/sevoflurane inhalation and intermittent iv boluses of fentanyl and pipecuronium. The total amount of fentanyl administered ranged from 30-50 μg/kg. Cardiac function was supported and hemodynamic stability was maintained with vasoactive and inotropic drugs. Measures were taken to strengthen blood conservation and respiratory function support.Seven patients(2.9%) needed urgent CPB during operation because of serious cyanotic spells. Perfusion-induced lung injury occurred in 18 patients (7.6%). Circulation was assisted by ECMO in 2 patients (0.9%). Three patients (1.3%) died of serious low cardiac output and perfusion-induced lung injury.

Objective To investigate the preventive effect of oral ulcer using two methods in radio-therapeutic patients after tongue squamous cell carcinoma operation. Methods Thirty-six radiotherapeutic patients after tongue squamous cell carcinoma operation were collected from May 2012 to May 2014 and divided into control group and treatment group according to the random number table method. Regular oral nursing was administered to control group, treatment group were received regular therapy plus orally vitamin B and cetylpyridinium chloride gargle for gargling, and then evaluated the efficacy according related standards. Results Less oral ulcer (1/18 vs.7/18,χ2=-2.372,P<0.05), better oral lustration (Z=-2.093,P<0.05) and overall oral nursing effect (Z=-2.166,P<0.05) were observed in treatment group compared to control group after 7 days of therapy, however, treatment group presented no significantly better comfort level at the same time (Z=-1.708,P>0.05). Conclusions Regular therapy plus orally vitamin B and cetylpyridinium chloride gargle for gargling are effective for the prevention of oral ulcer in radiotherapeutic patients after tongue squamous cell carcinoma operation.

The paper objectively analyzes the opportunities and challenges of Internet + medical,and puts forward relevant strategies and recommendations for deeply integratingInternet +into the traditional medical industry in several aspects,including strengthening the construction of Internet infrastructure in the medical industry,regulating the market access and improving the industry standards,as well as establishing and improving relevant supporting laws,regulations and policies.

It is one of the important tasks to promote the development of traditional Chinese medicine culture crea-tive industry in constructing the culture-rich Shandong Province. The major factors that influence the development of traditional Chinese medicine culture creative industry in Shandong Province and the ranks of their importance were thus analyzed by questionnaire survey and hierarchy analysis, respectively. Certain suggestions were put for-ward for the development of traditional Chinese medicine culture creative industry in Shandong Province.

Objective:To investigatethe transdermal delivery characteristics of methylphenidate hydrochloride (MPH) in vitro. Methods: Characteristics of MPH crossing nude rats skin were studied with Franz diffusion cells. A high performance liquid chromatographic (HPLC) method was established to determine the concentration of MPH crossed the skin. The permeability coefficient (P), steady state flux (J) and lag time(LT) for MPH through the skin of nude rats treated with various enhancers were compared with those of control. Results: The permeability coefficient increased with the increase of MPH concentration. The penetration of MPH through nude rats skin was obviously enhanced by 8%Azone and 5%propylene glycol (P

Objectives To evaluate the value of Treponema pallidum (TP) antibody analytical methods for syphilis screening.Methods A total of 4870 samples of Peking University First Hospital from May to October 2010 were detected of antibodies against TP by chemiluminescent microparticle immunoassay (CMIA),ELISA,rapid plasma reagin test (RPR),Treponema pallidum particle agglutination assay (TPPA) and dot-immunoblotting test (dot-IBT).The positive rates were compared by McNemar test for paired data;Using dot-IBT as gold standard,the sensitivity,specificity and total accordance rate of the other four methods were analyzed.Results In 4870 screening samples,the positive rate of dot-IBT was 2.5％(122/4870).The positive rate of CMIA and RPR was 3.1％(149/4870) and 1.2％(58/4870),respectively.According to McNemar test for paired data,there was significant difference when compared with dot-IBT (P ＜0.01).The positive rate of ELISA and TPPA was 2.4％ (119/4870) and 2.4％ (116/4870),respectively.There was no significant difference when compared with dot-IBT (P ＞ 0.05).When the dot-IBT results for the standard,CMIA has highest sensitivity,96.7％ (118/122),the specificity was 99.6％(4705/4724).The sensitivity and specificity of ELISA was 93.4％ (114/122) and 99.9％ (4720/4724),respectively,TPPA was 91.0％ (111/122) and 99.9％ (4721/4724),respectively,and RPR was 46.7％(57/122) and 100.0％ (4724/4724),respectively.The accordance rate of CMIA,ELISA,TPPA and RPR with the dot-IBT was 99.5％ (4823/4846),99.8％ (4834/4846),99.7％ (4832/4846) and 98.7％(4781/4846).When the TPPA results for the standard,sensitivity of CMIA was 96.6％ (112/116),the specificity was 99.2％ (4717/4754).The sensitivity and specificity of ELISA was 98.3 ％ (114/116) and 99.9％ (4749/4754),respectively,and RPR was 47.4％ (55/116) and 99.9％ (4751/4754),respectively.The accordance rate of CMIA,ELISA and RPR with the dot-IBT was 99.2％ (4829/4870),99.9％ (4863/4870) and 98.7％ (4806/4870).Conclusions Because of the low sensitivity of RPR,it is not fit for screening test.There are high sensitivity and specificity for detection of TP antibody using CMIA and ELISA,so they could be used as a screening test for TP.Due to the complexity of the operating steps,TPPA can be used to further confirm the test.

Objective To evaluate the value of supersonic shear wave elastrography(SWE) in the diagnosis of benign and malignant breast lesions.Methods SWE was performed on 134 breast lesions of 123 female patients and 74 normal breast glands to determine the values of overall elastic modulus and dispersion,and ROC curves were used to assess the diagnosis boundary value of two kinds of data respectively.Results According to the diagnostic gold standard-histopathology,the values of overall elastic modulus and dispersion were statistically significant when comparing benign lesions and malignant lesions with normal glands.ROC curve displayed that,when the Youden index reached to maximum,the diagnosis boundary value of overall elastic modulus was 41.01 kPa,the sensitivity and specificity of the value were 68.5％ and 83.8％ respectively; the diagnosis boundary value of dispersion was 12.25 kPa,the sensitivity and specificity of the value were 87.0％ and 88.7％ respectively.Conclusions The values of overall elastic modulus and dispersion for solid breast lesions can be used to reflect the elastic characteristics of lesions quantificationally,which is useful to diagnose benign and malignant breast lesions in clinical.

Objective To evaluate the diagnostic and prognostic value of BRAF V600E mutation screening of ultrasound-guided fine-needle aspiration (FNA)specimens in patients with thyroid nodule. Methods The BRAF V600E mutation status were assessed in FNA specimens of 104 patients with thyroid nodules before operations.The BRAF mutation status,clinical,and pathology records of the patients were reviewed and the associations between these characteristics and papillary thyroid cancer (PTC ) were analyzed.Results Seventy-one PTC and 14 benign thyroid nodules were included in this study.BRAF V600E mutations were found in 57/71 (80%)PTC.All benign thyroid nodules had no BRAF V600E mutation.The sensitivity,specificity,positive predictive value and negative predictive value of BRAF V600E mutations in differentiation between PTC and benign thyroid nodules were 80%,100%,100% and 50%(P < 0.001 ).In 44 patients with PTC who underwent surgery,the central compartment lymph node metastases and extrathyroidal invasion were not significantly different between BRAF-positive and BRAF-negative PTC (P = 0.283 and 0.307 ).Conclusions BRAF V600E mutation may be a potential tool to facilitate ultrasound in diagnosis of PTC.In patients with PTC,the presence of the BRAFV600E mutation was not significantly associated with prognostic factors.