Objective:To investigate the risk factors of dysplasia in patients with ulcerative colitis (UC) in China.Methods:From March 1st, 2012 to December 30th, 2013, a total of 154 UC patients were prospectively enrolled from the following 11 hospitals, Xijing Hospital of Digestive Diseases, Ruijin Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Peking Union Medical College Hospital, Renji Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Nanfang Hospital affiliated to Southern Medical University, China-Japan Friendship Hospital, The Second Hospital of Hebei Medical University, West China Hospital affiliated to Sichuan University, The Seventh Medical Center of PLA General Hospital, Zhongshan Hospital affiliated to Xiamen University, and the First Affiliated Hospital of Anhui Medical University. The patients were followed up till December 1st, 2017. All the UC patients underwent colon endoscopy and histopathological evaluation. T test and Chi-square test were used for statistical analysis. Cox proportional risk model was used for identifying the risk factors of dysplasia in UC patients. Results:Finally, 133 UC patients were enrolled, the age was (50.0±11.9) years, the diagnosis age was (35.5±11.6) years, the course of disease was (14.5±6.7) years, and the number of endoscopic examinations was (3.4±1.6) times. A total of 21 patients were detected with dysplasia. No patients were detected with colorectal cancer. The results of univariate analysis revealed that the diagnosis age (hazard ratio ( HR)=1.05, 95% confidence interval ( CI) 1.01 to 1.10, P=0.009) and extensive colitis ( HR=2.92, 95% CI 0.97 to 8.79, P=0.057) were factors with statistically significant difference. The results of multivariate analysis revealed that the old age at diagnosis ( HR=1.06, 95% CI 1.02 to 1.11, P=0.003) and extensive colitis ( HR=3.68, 95% CI 1.21 to 11.19, P=0.022) were independent risk factors of dysplasia in UC patients. The cumulative incidence of dysplasia of UC patients with extensive colitis was higher than that of patients with left-sided colitis (24.3%, 17/70 vs. 6.3%, 4/63), and the difference was statistically significant ( χ2=8.023, P=0.005). Conclusions:Extensive colitis and older age at diagnosis are two independent risk factors of dysplasia in UC patients of our country. The cancer monitoring should be strengthened in UC patients with long course of disease and extensive colitis.

Objective ToinvestigatetheMRIandCTimagingcharacteristicsofcerebralpleomorphicxanthoastrocytoma(PXA). Methods CTandMRImanifestationsof5cerebralPXAcasesconfirmedbypathologywereanalyzedandcomparedwiththosecases reportedindocumentation.Results The meanageof5caseswas (27±18)years,andallthecasesrespectivelyhadsinglelesion whichwaslocatedinthecortexorsubcortex.In5cases,3leionsoccurredinthetemporallobe,while1lesioninthefrontallobeand1 lesioninthecerebellarvermis.Solid-cystictumorsin3casesandsolidtumorsin2cases(including1casewithpartialpiamaterinfiltrated) wereidentifiedbyCTandMRI.ThecysticpartoflesionwasshownaslowdensitywhilethesolidpartasmixeddensityonplainCT scan,including1casewithscatteredpoint-stripecalcification.Thesolid-cysticcapsuleandthesolidpartoflesionweredemonstrated asuniform markedenhancementonenhancedCTscan.ThesolidareaoftumorwasshownasslightlyhypointenseonT1WI,slightly hyperintenseonT2WI,markedenhancement,andequisignalorhyperintenseonDWIimage.Thesolid-cysticcapsulewallwasenhanced in3cases,whilethecysticpartwasnotenhanced.ThemildtomoderateedemaaroundthetumorwasdetectedinalltumorsbyCT and MRI.Conclusion PXAoccursmostfrequentlyinthetemporallobeofadolescents.TypicalcharacteristicsofCTandMRIaresolid-cystic massandmarked-enhancementofwallnodule,withdifferentdegreeofedemaaroundthetumor.

Objective To investigate the predictive value of CT signs in the pathological Fuhrman grading of clear cell renal carcinoma (ccRCC).Methods The clinicopathological features and CT findings of 72 patients with ccRCC which confirmed by operation and pathology were analyzed retrospectively.According to the WHO Fuhrman grading,all patients were divided into low-grade(Fuhrman gradeⅠorⅡ)or high-grade (Fuhrman gradeⅢorⅣ).ChiG square test and t-test were used to compare the clinical data and CT findings between the two groups,including morphological features (site,whether the renal medulla invasion,morphology,growth pattern,border,pseudo-envelope,lobulation sign,interface,perirenal fascia and the same lateral adrenal invasion,renal sinus and perirenal fat invasion,venous invasion,lymphadenopathy, maximum diameter),density (bleeding,necrosis ratio,calcification,fat)and enhancement characteristics (the degree of enhancement, strengthening method).And the pathological Fuhrman grading was the gold standard.The ROC was used to analyze the diagnostic efficacy of CT signs on Fuhrman grading.The Delong test was used to compare the AUC of different CT signs.Results There were significant differences in tumor maximum diameter,the renal medulla invasion,and lobulation sign between the Fuhrman low-grade and high-grade group(χ2/t＝－4.31 7,9.794,7.325,P＜0.05).There were no differences in gender,age,location sign,morphology,growth pattern, border,pseudo-envelope,interface,perirenal fascia and ipsilateral adrenal invasion,renal sinus and perirenal fat invasion,necrosis ratio,degree of enhancement,strengthening method between two groups (P＞0.05). The largest diameter of the tumor,the renal medulla invasion and the lobulation sign were useful for Fuhrman diagnosis.The AUC was 0.778,0.647 and 0.644,respectively.And there were significant differences between the maximum diameter and the renal medulla invasion or lobulation sign (P＜0.05).Conclusion The maximum diameter,medulla and lobular sign can predict the Fuhrman grading of ccRCC,and the maximum diameter prediction is the most accurate.

Objective To evaluate the efficacy and safety of endoscopic submucosal dissection for the treatment of colorectal large laterally spreading tumor. Methods ESD was applied to treat 150 cases of colorectal LST with diameter larger than 4 cm. The morphological features of LST, distribution, the clinicopathological data and the en-bloc resection rate, complete resection rate, complications were retrospectively evaluated. Results There were 87 patients with LST-granular lesions and 63 patients with LST-nongranular lesions. Colorectal LST mainly distributed in the rectum for 109 cases (72.7%), sigmoid colon for 13 cases (8.7%), descending colon for 5 cases (3.3%), transverse colon for 8 cases (5.3%), ascending colon for 13 cases (8.7%), cecum for 2 cases (1.3%). There were 23 patients with low-grade neoplasia, 104 patients with high-grade intraepithelial neoplasia, 7 with intramucosal carcinoma and 16 with submucosal carcinoma. The en-bloc resection rate and complete resection rate were 92.7% (139/150) and 89.3%(134/150). Adverse events were intra-operative bleeding in 12 patients (8.0%), postoperative bleeding in 2 patients (1.3%), perforation in 3 patients (2.0%), postoperative stenosis in 3 patients (2.0%). Conclusion Colorectal large LST-NG has higher potential for malignancy. ESD is a safe and effective method to provide en-bloc and complete resection of colorectal large LST.

Objective To investigate effect of Murphy's law on the nursing safety management of the hemodialysis patients. Methods 4598 hemodialysis cases in a blood purification center of a first class grade A hospital from April to July in 2011 was assigned as pre-implementation group.Then Murphy's law was used in the nursing practice.In the following,another 5683 hemodialysis cases from November in 2011 to January in 2012 were assigned as post-implementation group.The incidence of nursing risks and hemodialysis equipment failures were compared between the two groups.Result The incidences of nursing risks and hemodialysis equipment failures in the post-implementation group were significantly lower than those of the pre-implementation group(P<0.05).Conclusions Murphy’s law is effective for the declines of nursing manipulative defects and hemodialysis equipment failures.Besides,the law can be good for the strengthened awareness of safety and enhanced consciousness of all staff participating in the safety management so as to ensure the safety and quality of hemodialysis.

Objective To investigate the expression of urokinase-type plasminogen activator(uPA)and β-catenin proteins and their relationship with tumor angiogenesis,and explore their correlation with invasion and metastasis of thyroid carcinoma.Methods SP immunohistochemistry was performed to detect the expression of uPA,β-catenin and CD105 in 90 cases of thyroid carcinoma tissues.MVD counting was performed and analyzed in conjunction with the clinicopathological features of human thyroid carcinomas.Results The positive rate of uPA expression and abnormal expression rate of β-catenin and the MVD value was positively correlated with histological typing of thymid carcinoma.There was significant difference in thyroid carcinoma with lymph node metastasis,which was significantly higher than those cases without lymph node metastasis(P＜0.05),as well as between clinical stage Ⅲ～Ⅳ and Ⅰ～Ⅱ.The MVD value was significantly correlated with the positive expression of uPA and abnormal expression of β-catenin in thyroid.There was statistically significant correlation between the expression of uPA and β-catenin.Conclusion The expression of uPA protein in thyroid carcinoma was higher than those in normal.A reduced membranous expression rate and abnormal nuclear/cytoplasmic expression of β-catenin was observed in thyroid carcinoma cells,which was positively correlated with histological typing and clinical staging,invasion and metastasis in thyroid carcinoma.uPA and β-catenin were cooperated in angiogenesis of thyroid carcinoma.MVD was positively correlated with invasion and metastasis in thyroid carcinoma.They were hopeful to be an important prognostic indicator of thyroid carcinoma.

Objective To discuss the applied value of diffusion weighted imaging(DWI) in evaluating emboliza-tion effect of transcatheterhepatic arterial chemoembolization(TACE) for Hepatic Metastases. Methods DWI was performed in 17 Hepatic Metastases patients at the next day after TACE. Embolization effect was analyzed andcompared with DSA results. Results 17 lesions were revealed in DSA anA with complete iodinated oil accumulation,9with incomplete accumulation. 47 lesions were revealed in DWI and 33 with complete iodi, a oilaccumulation,9 with in-complete accumulation,5 without iodinated oil accumulation.The area of iodinated oll accumulation and necrosis appeared aslow signal on DWI,and residual tumor tissues appeared as high signal. Conclusion DWI may detect Hepatic Metastases lesions sensitivelyand can be used to evaluate the embolization effect of TACE.

Objective To discuss the applied value of MSCT in the interventional treatment of hepatic metastases (HMs). Methods 23 cases HMs were treated by interventional treatment before it MSCT plain scan was performed first,and then dual-phase dynamic contrast-enhanced scanning and reconstruct angiography. Results 78 lesions were found by plain scan,and 102 lesions in the arterial phase and 105 lesions in the portal venous phase were found by contrast-enhanced scan,dynamic contrast-enhanced CT scanning was superior to detecting lesion of diameter <1cm (P<0.05). CT scanning showed that plain scan showed low-density foci; and according to the number of enhanced lesions,enhancede scanning showed enhancement for the edge of the ring,diffuse enhancement,heterogeneous enhancement,and no enhancement respecfly. Vascular remodeling showed that all eases could show the hepatic artery three grade below through MSCTA,eompletely conformed to the DSA,the indication rate was 100%;14 cases could show the hepatic artery four grade above,with 60.9% indication rate. Portal vein showed that all cases could show the branches of intrahepatic portal vein four grade below through MSCTA; DSA hepatic arteriography could show the portal vein indirectly,but most of the intrahepatic branches three grade below couldn't show clearly. Conclusion MSCT dynamic contrast-enhanced scan could improve the detection rate of HMs,and dynamic contrast-enhanced scanning was superior to the detection rate then plain scan,high-qulity imagy of hepatic artery and portal vein could be reconsructed by fast dynamic contrast-enhanced scanning,and compared with DSA,it had the advantage of operat more easily and non-invasive,so as be a guide in the interventional treatment of HMs.

The study is designed to investigate the progress in cardiac auscultation proficiency of residents after training program.Thirty eight residents were selected to test their ability of cardiac auscultation.There were 13 cardiac events(or murmurs)in 15 patients,and the auscultation proficiency was expressed as the percentage of recognizing cardiac events accurately.The results showed that the highest auscultation proficiency was whole systolic and diastolic murmurs(up to 79 percent and 61 percent respectively)before training.The percentage of recognizing continuous murmurs,click,mitral stenosis and regurgitation,aortic stenosis increased significantly after training program(P＜0.05).

OBJECTIVE To evaluate the clinical significance of quantitative analysis of EBV DNA in plasma,CYFRA21-1 and VCA-IgA in serum of nasopharyngeal carcinoma patients.METHODS EBV DNA in plasma,CRFRA21-1 and VCA-IgA in serum of 62 patients were analyzed using RealTime PCR technique,electrochemiluminescence immunoassay(ECI),and immunoenzyme assay respectively.And these were compared among clinical remission,recurrent or metastasis groups.RESULTS The positive rate of preoperative radiotherapy group was significantly higher than clinical remission group(P