Objective:To explore the value in differentiating Borrmann Ⅳ type gastric cancer (BT4-GC) from gastric diffuse large B-cell lymphoma (DLBCL) using a nomogram based on CT texture analysis (CTTA) and morphological characteristics.Methods:From June 2011 to December 2020, a total of 60 patients with BT4-GC and 24 patients with DLBCL were retrospectively collected in Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University. Morphological characteristics were evaluated, including major location, long axis range, circumferential range, mucosal line status, and perigastric enlarged lymph nodes. CTTA parameters were calculated using venous CT images with a manual region of interest. The morphological characteristics and CTTA parameters between BT4-GC and DLBCL were compared by χ 2 test, Fisher exact test or Mann-Whitney U test. The multivariate binary logistic regression analysis was used to filter factors into the diagnostic model and construct a nomogram. The receiver operating characteristic (ROC) curve was used to evaluate the diagnostic performance of CTTA parameters and the diagnostic model in differentiating BT4-GC from DLBCL. Results:For morphological characteristics, mucosal line status showed a significant difference between BT4-GC and DLBCL (χ 2=12.99, P<0.001). For CTTA parameters, 16 parameters showed significant differences between BT4-GC and DLBCL (all P<0.05). The area under the ROC curve (AUC) of 16 CTTA parameters in differentiating BT4-GC from DLBCL was 0.662-0.833. Percentile 90 showed the highest AUC of 0.833 (95%CI 0.736-0.906). The mucosal line status (OR 4.82, 95%CI 1.21-19.25, P=0.026) and percentile 90 (OR 1.09, 95%CI 1.04-1.15, P=0.001) were brought into the diagnostic model and constructed a nomogram. The AUC of the model in differentiating BT4-GC from DLBCL was 0.898 (95%CI 0.813-0.953), sensitivity was 0.833, and specificity was 0.817. Conclusions:The nomogram based on CTTA percentile 90 and morphological characteristics mucosal line status can effectively distinguish BT4-GC from DLBCL and shows high diagnostic efficacy.

OBJECTIVE:To standardize the ward rescue and essential drugs quality management in wards,and reduce the med-ication risk of patients. METHODS:Failure mode and effect analysis(FMEA)was used to analyze the inspection items and failure modes of quality management of ward rescue and essential drugs. According to scoring the possibility,severity and detectability de-gree of the failure modes and calculating the risk priority number(RPN),failure modes that should be given priority improvement were quantified and determined,improvement measures were developed and conducted,and management effects were evaluated af-ter 6 months. RESULTS:12 failure modes were determined,including the residue treatment of narcotic and the first-class psycho-tropic drugs was not recorded,drug storage temperature was not up to standard and drug expired,etc. Improving related systems, enhancing the inspection management,cold chain management,daily management and other measures were implemented and con-ducted. After 6 months,the top 3 items with the highest RPNs were dropped from 320,240,216 score to 16,16,27 scores,re-spectively,all in a relatively low risk area. Numbers of failure mode event were dropped from 1869 to 218,dropping by 88.3%. CONCLUSIONS:According to qualifying the failure modes in ward rescue and essential drugs quality management by using FMEA in our hospital,the management items with the highest risk has determined and improved,the medication risk of patients has significantly reduced.

Objective To evaluate the application value of glycerol blood chocolate soup in the bacteria preservation of Haemophilus influenzae.Methods Haemophilus influenzae strains ATCC10211,ATCC49247 and ATCC49766 were saved into glycerol blood chocolate soup,then it was stored in refrigerator at below -35℃.The preserved strains from the refrigerator at 1 month,3 months,6 months,1 year,2 years were taken out,and dissolved it at 35℃ for 5min,and then immediately transferred it to chocolate agar plate,placed it in the 35℃,CO2 environment overnight.Observed the survival of strains,colony morphology and whether the demand factor test had change.Saved the standard strains ATCC49247 and ATCC49766 2 years for the paper dispersion method drug sensitive test.Results After 2 years of observation,3 strains of Haemophilus influenzae strains grew well in the survival rate of 100%,the colony was colorless,transparent and flat moist,it could be observed gram small negative bacilli by Gram staining, blood agar satellite test was positive,no hemolysis,Columbia satellite test was negative.All traits were the characteristics of Haemophilus influenzae.The drug sensitivity characteristics of ATCC49247,ATCC49766 standard strains were still in line with the requirements of CLSI.Conclusion Glycerol blood chocolate soup is suit for Haemophilus influenzae bacteria preservation.

Objective To investigate the effect of Er-Chen-Er-Huang diet therapy on the visual acuity and the fundus of the patients with the wet age-related macular degeneration after the intravitreal injection of ranibizumab.Methods Fifty-eight patients (fifty-eight eyes) with the wet age-related macular degeneration (w-AMD) who were treated with the intravitreal injection of ranibizumab from June 2015 to August 2016 were included. They were divided into the control group (n=29) and the observation group (n=29) according to the random number table. The patients in the control group was fed with the normal diet. The patients in the observation group was supplemented with Er-Chen-Er-Huang diet. The ETDRS score, the CRT thickness, and the CNV lesion leakage control of the patients in two groups were observed after the three-month follow-up. Results One month after the treatment, the ETDRS score of the patients in the control group was (34.44±5.04), and the score of the patients in the observation group was (33.60±5.42). There was no significant difference between the two groups (t=1.054,P=0.297). Three months after the treatment, the ETDRS score of the patients in the control group was (39.60±4.41), which was significantly lower compared to the observation group (42.16±3.77)(t=2.207,P=0.032). One month after the treatment, the CRT thickness of the patients inthe control group was (346.36±48.87)μm. The CRT thickness of the patients in the observation group was (340.16±51.08)μm. There was no significant difference between the 2 groups (t=0.439,P=0.663).Three months after the treatment, the CRT thickness of the patients in the control group was (318.96±45.22)μm, which was significantly thicker compared to the observation group (286.28±44.62)μm(t=-2.572,P=0.013). The total effective rate of the CNV lesion leakage control of the patients in the observation group was 88.0%, which was significantly higher compared with 64.0% of the control group (P<0.05).Conclusions The intravitreal injection of ranibizumab combined with the diet therapy has a more obvious and longer effect on the improvement of the patients'visual acuity,the alleviation of the macular oedema and the occlusion of the CNV leakage than the only intravitreal injection of ranibizumab.

Objective To assess the health status of rodent laboratory animals by pathological diagnosis, our lab has being take apart in investigating the quality of laboratory animals in Beijing area for years and offer some advices for standardized breeding to ensure accurate results of scientific research.This paper focuses on the analysis of laboratory rodent samples that collected in October 2014.Methods We collected the heart, liver, spleen, lung, kidney, large intestine and small intestine, and put these organs into 10%Calcium formaldehyde solution for fixation, and then prepared into two different sections for optical microscopy observation including all paraffin specimens stained with H&E and the frozen sections stained with Oil Red-O and PAS.Results The vast majority of laboratory rodents were up to standard, but there still a problem in individual units.The main problem is liver and lung disease.The rate of Hepatocyte swellingis 6%(mouse), 2.5% (rat), 8.2% (guinea pig), moreover part of them were lipidosis, according to Oil Red-O stain.the mainly problem of lung is congestion ,edema and Interstitial pneumonia ,the detectable rate of pulmonarydiseases is 15.5%(guinea pig).Conclusions The vast majority of laboratory rodents were pathologically diagnosed as healthy animals.The liver disease may be caused by improper feeding.And disease of lung may led by haze, unqualified bedding and low temperature.

Objective To strengthen the training effect of the neuro-interventional surgeons using staged target teaching method. Methods A total of 39 neurosurgeons from all over the country were trained at the Department of Interventional Radiology,Xuanwu Hospital,Capital Medical University from March 2012 to March 2013. In the one-year training period,the training was divided into 4 stages (each stage for 3 months). All the learning contents were phased to focus on teaching and set the target at each stage,which had a clear purpose. Questionnaires were sent to the refresher doctors at 6 months and 12 months after they returned to their original work in order to obtain the conditions about their independent work after training. Results All the 39 neurosurgeons achieved their desired goal from theory to practical operation. They mastered the holistic treatment principles of ischemic cerebrovascular disease and were familiar with and mastered the whole brain DSA and stenting techniques. At the fourth stage,as an operator, everyone had finished at least 5 extracranial artery stentings. The recovered questionnaires after the end of training showed that 95. 8%(23/24)neurosurgeons were able to perform whole brain DSA independently and held≥5 surgeries monthly;87. 5%(21/24)neurosurgeons could complete stenting independently (1 patient/month). Conclusion The staged target teaching method is a practical and effective teaching means for special technical training of neurointervention.

Objective To summarize the experience in nursing children with pediatric advanced intraocular retinoblastoma treated with 23-gauge microinvasive vitrectomy. Methods Eleven infants (12 eyes) suffered from advanced intraocular (D or E) retinoblastoma and treated with 23-gauge microinvasive vitrectomy. Preoperative psychological nursing, postoperative complication nursing and follow-up nursing were performed. Results The retinal tumors was completely removed in all 12 eyes. After the follow-up of a half year, the conditions in 8 eyes were stable, and the tumors in 4 eyes recurred. Visual acuity in 4 eyes improved and that in 1 eye remained unchanged. Conclusions Microinvasive vitreous operation can effectively remove advanced intraocular retinoblastoma. Active efficient perioperative nursing plays an important role for the prevention of complications and promoting the recovery of affected eyes.

Objective To evaluate the quality and application value of improved sheep blood chocolate medium.Methods The ATCC 10211 of Haemophilus influenzae was inoculated into the modified medium and unmodified medium,the average growth index(GI)of Haemophilus influenzae in two kinds of culture medium was compared.Based on 352 selected qualified sputum specimens for detection of Haemophilus influenzae,the positive isolation rate of medium was compared between the two groups.Results GI value of the traditional blood chocolate culture medium was (3.69 ±0.58),which was significantly lower than (15.08 ±1.34)of the improved sheep blood chocolate culture medium,the difference was significant (t =25.31,P <0.01 ).352 sputum specimens in the improved sheep blood chocolate culture medium,Haemophilus influenzae detected in 41 cases,the positive rate was 11.65%.And 352 sputum specimens in traditional sheep blood chocolate culture,Haemophilus influenzae detected in 18 cases,the positive rate was 5.54%.There was significant differenceof Haemophilus influenzae in separation based on 2 kinds of chocolate culture medium (χ2 =21.04,P <0.05).Conclusion Haemophilus influenzae significantly improved sheep blood colony in chocolate culture medium,grows well,easily to be identified,which helps to detect sputum specimens of Haemophilus influenzae.

Objective To investigate the effects of diversified health education in screening of preemy retinopathy. Methods One hundred and eighty preterm newborns were collected and randomly divided into control group and observation group on average. The diversified health education was adopted in observation group and conventional health education was adopted in control group. The disease cognition and satisfaction questionnaire investigated in the parents of preemys, and compared after 6 months′ intervention. Results After diversified health education, the rate of mastering knowledge of disease from parents in the observation group was higher than that in control group (95. 6% vs 80. 0% ) while the degree of satisfaction from parents in observation group was higher than that of the control group (90. 0% vs 71. 1% ) ( χ2 = 8. 751, 14. 754;P < 0. 05). Conclusions The development of diversified health education can effectively improve the disease cognition and the degree of satisfaction from parents. It can also enhance the consciousness of ROP screening of the parents and play an active role in ROP prevention.

OBJECTIVETo assess efficacy of membrane peeling combined with intravitreal injection of bevacizumab in the treatment of macular epiretinal membrane.

METHODSFrom January, 2012 to June, 2013, 33 patients (33 eyes) with the diagnosis of macular epiretinal membrane underwent vitreous surgery and membrane peeling. The patients were randomly divided into intravitreal bevacizumab group (IVB group) and non-intravitreal bevacizumab group (non-IVB group). All the patients underwent standard three-port vitrectomy and peeling of epiretinal membrane, with intravitreal injection of 1.5 mg bevacizumab at the end of operation in IVB group. The best corrected visual acuity and optical coherence tomography (OCT) were examined before and after the treatment. The patients were followed up for 3-14 months (mean 6.5 months).

RESULTSMacular epiretinal membranes were successfully peeled during operation in all the patients without postoperative intraocular infection or bleeding. Fifteen eyes received vitrectomy combined with intravitreal injection of bevacizumab, and 18 underwent only vitreous operation and membrane peeling. At the end of the follow up, the visual acuity improved in 11 eyes (73.3%) in IVB group, as compared to 13 eyes (72.2%) in the non-IVB group (P=0.627). Central macular thickness decreased by 143∓62 µm in IVB group and by 96∓28 µm in non-IVB group, showing a significant difference between the two groups (t=5.564, P<0.01).

CONCLUSIONVitrectomy and membrane peeling combined with intravitreal injection of bevacizumab can promote the recovery of macular morphology but not visual function, and its clinical use still needs to be tested in a long-term and large-sample randomized controlled study.

Angiogenesis Inhibitors ; administration & dosage ; therapeutic use ; Antibodies, Monoclonal, Humanized ; administration & dosage ; therapeutic use ; Bevacizumab ; Epiretinal Membrane ; drug therapy ; pathology ; Humans ; Intravitreal Injections ; Postoperative Complications ; Tomography, Optical Coherence ; Treatment Outcome ; Visual Acuity ; Vitrectomy ; Vitreous Body ; surgery