Objective To investigate diagnose accordance rate of thyroid function tests .Methods Clinical data of 15 579 patients suspected with thyroid diseases ,treated during 2011 and 2013 ,were collected ,who were divided into hyperthyroidism group ,hypot‐hyroidism group ,normal group and other diseases group .Proportions of each type of patients were calculated .In each group ,100 pa‐tients were randomly selected to analyze the diagnose accordance rate of thyroid function tests .Results Among all of the 15 579 pa‐tients ,the proportion of hyperthyroidism(24 .73% ) ,hypothyroidism(9 .83% ) and other thyroid diseases(7 .56% ) were statistically different with the proportion of normal thyroid function (57 .89% ,P< 0 .05) .The diagnose accordance rates of thyroid function tests were 81 .00%‐99 .00% .Conclusion Thyroid function tests could be helpful for the diagnosis and differential diagnosis of thy‐roid diseases ,but still with probability of missed diagnosis .

Objective To study on the effect of health promotion on the prognosis of patients with acute myocardial infarction(AMI)combined with diabetes.Methods 104 patients of AMI complicated with diabetes were:randomly divided into the control and the experimental groups with 52 cases in each group.Two groups were conferred fixed medicine and other clinical interventions as well as programmed education during their hospitalization.After discharge.the experimental group continued to implement health promotion for six months'follow-up.After six months,the fasting blood glucose,postprandial blood glucose,triglyceride,cholesterol,clinic cost,level of knowledge and behavior were compared between the two groups after six months.Results after six months,there was significant difference between two groups in blood glucose,postprandial blood glucose,triglyceride,cholesterol clinic cost,level of knowledge and behavior(P＜0.05).Rate of readmission and mortality rate were not stanstically different(P＞0.05).Conclusions Health promotion can improve capital clinical index of the patients,decrease the cost and promote the life quality of patients.

Objective To investigate the curative effect of different time of irrigating after endolacrimal recanalisation surgery by Nd:YAG laser combining eye ointment stuffing. Methods Seventy-five cases (75 eyes) of lacrimal duct obstruction, which received endo-lacrimal recanalisation surgery by Nd:YAG laser combining eye ointment stuffing were divided into three groups by random digits table with 25 cases in each group. Group A received irrigating: the first day postoperative, consecutive 3 days,followed by once a week till a month. Group B received irrigating:the third day postoperative, consecutive 3 days,followed by once a week till a month. Group C received irrigating:the sixth day postoperative, consecutive 3 days, followed by once a week till a month. Followed-up survey for 12 months at the ophthalmologic outpatient clinic,the curative effect in each group was compared. Results In 6 months after surgery, the comparison of the curative effect was no statistical difference between group B and group C (P＞ 0.05), while the curative effects in group B and group C was superior to that in group A (P ＜ 0.05). In 12 months after surgery, the curative effect in group C was better than that in group A and B, the difference were statistically significant (P＜0.05). But there was no statistical significance compared with group A and group B (P＞0.05). Conclusions Properly delayed irrigating may improve the curative effect after endo-lacrimal recanalisation surgery by Nd:YAG laser combining eye ointment stuffing, while easier irrigating can increase the incidence of re-blockage of lacrimal duct and reduce the efficacy.

Objective To explore the effect and application value of percutaneous transhepatic various interventional technique for treatment of common bile duct stones.Methods 46 patients with common bile duct stones were treated.All patients were treated by percutaneous transhepatic cholangiopancreatography in order to confirm the number and location and size of the stones.Place me-chanical lithotripsy net according to the size of stones.Then percutaneous transhepatic balloon dilation.Postoperatively biliary tract was drained for 2 weeks.Results 45 operations were successful,The successful rate was 97.83%.Complete stone removal was obtained with one session in 41 patients and two sessions in 4 cases,respectively.There was no serious complications occurred during the operation. There was no perforation and bleeding,but hyperamylasemia occurred in 3 patients and acute pancreatitis occurred in 1 patient and bile perito-nitis occurred in 2 patients.Conclusion Percutaneous transhepatic various interventional technique can keep the function of papillary sphincter and is a valuable methed for patients suffering from common bile duct stones with a high successful rate and safety.

Objective To investigate the value of virtual touch tissue imaging (VTI) in the differential diagnosis of small solid thyroid nodules.Methods 35 patients with 41 small thyroid nodules were examined by conventional ultrasound and VTI examination.The stiffness of the nodules in VTI images was scored.Area ratios of VTI and gray scale images of nodules were calculated.The pathological diagnosis was used as the gold standard.The ROC curve was drawn to determine the cut off point of area ratio to predict thyroid cancer.Results 41 small thyroid nodules were confirmed by pathological diagnosis,including 23 benign and 18 malignant nodules.Compared with benign nodules,the ratio of VTI hardness score ≥4 was significantly higher in the malignant nodules (88.9％ vs 8.7％,P ＜0.01).Compared with benign nodules,the area ratios of malignant nodules were higher (1.67 ± 0.16 vs 1.23 ± 0.12,P ＜0.01).When 1.46 was set as the cut off point of areas ratio,the sensitivity and specificity of diagnosing thyroid cancer were 88.9％ and 95.7％,respectively.Conclusions VTI can provide information about thyroid nodules hardness.It has high value in the differential diagnosis of small solid thyroid nodules.

Objection To investigate the spectrum and survival status of HIV positive cancer in HuBei province, China. Methods HIV positive cancer patients were added up and followed up who had registered in Zhongnan Hospital between January 2004 and June 2009. The prognostic features were determined for HIV patients with cancer. Results The average age of HIV positive and HIV negative group who suffered with malignant neoplasm were 42.5±8.8 years and 55.1±13.7 years respectively (P ＜0.05), mean CD4 counts were (220.9±142.3)/μl and (554.4±174.3)/μl, respectively (P ＜0.05), the types of common cancer were NHL, cervical cancer, liver cancer and lung cancer, colon cancer, breast cancer, respectively. Anticancer and/or ART treatment were the important positive prognostic factors. Additional factors such as age and CD4 count were associated with survival of cancer patients with HIV infection. Conclusion Mean age of HIV positive cancer patients is about 42 years old. NHL, cervical cancer and liver cancer are HIV associated malignant tumor. ART and anticancer can effectively prolong the survival of HIV infected patients with cancer.

Diagnostic Errors ; Electrocardiography ; Humans ; Inferior Wall Myocardial Infarction ; Meningeal Neoplasms ; Meningioma ; Myocardial Infarction ; diagnosis

Brain ; pathology ; Cerebral Hemorrhage ; pathology ; Female ; Humans ; Infant, Newborn ; Infant, Premature ; Leukomalacia, Periventricular ; pathology ; Magnetic Resonance Imaging ; methods ; Male

Objective To explore the effect of doctor-nurse integrated ward round performed in the training of professional nurses′ core competence.Methods 18 nurses trained for core competencies in ICU and hemodialysis room were selected as research objects.All nurses were trained with doctor-nurse integrated ward round for one year.The professional knowledge, skills and clinical comprehensive ability of all nurses were tested before and after training.Results After doctor-nurse integrated ward round, the scores of professional knowledge, skills and clinical comprehensive ability of professional nurses were significantly higher than that of before training (P<0.05).Conclusion Doctor-nurse integrated ward round can improve the core competencies of professional nurses.

Objective To evaluate the analytical performance of lipid testing with six sigma(a) in order to promote the quality improvement.Methods Sixty-four Laboratories participated in trueness verification program and Internet-Based Interlaboratory Comparison of Internal Quality Control Data program lipid testing in 2012 were included in this study.The CVs and Bias of TC,TG,HDL-C,and LDL-C for each laboratory were evaluated from the reporting data.The sigma metrics based on the Tea from National Cholesterol Education Program according to the formula:σ =(TEa-Bias)/CV for each analyte.Quality goal index (QGI) was also calculated to investigate the reason for dissatisfied performance as follows:QGI =Bias/ (1.5CV).Results The rates for σ≥6 of TC,TG,HDL-C,and LDL-C were 21.9％,34.4％,9.38％,and 18.8％,respectively.The corresponding rates for 3 ≤ σ ＜ 6 were 31.3％,29.7％,29.7％,and 34.4％,while the rates for σ ＜ 3 were 46.9％,35.9％,60.9％,and 46.9％,severally.For analytes which σ were less than 3,91.3％-100％ of the laboratories should improve the trueness first,0.00％-8.75％ of the laboratories should improve the precision,and 0.00％-2.08％ should improve both.Conclusions Six sigma is an effective tool for quality control in clinical laboratory,which can help improve the quality level for laboratory testing.The analysis of performance of the lipid testing shows that further effort is acquired to enhance the supervision of the trueness verification.