Development of a self-assessment questionnaire of abnormal menstruation and evaluation of its reliability and validity / 上海预防医学

ObjectiveTo develop a self-assessment questionnaire for menstrual abnormalities and test its reliability and validity. To provide an assessment tool for self-identification of abnormal menstruation in young women and to investigate the health seeking situation of abnormal menstruation in the population. MethodsFifteen physicians with clinical experience were invited to participate in the Delphi expert consultations. Medical indications for menstrual abnormalities were constructed and questionnaires were formed based on domestic and international literature， expert meetings and 2 rounds of Delphi expert consultations. A whole-group sampling was used to select 923 female college students from a medical school in Shanghai for the survey， and 306 of them were retested. The internal consistency， retest correlation， researcher-investigator evaluation correlation， and structural and response validity of the questionnaire were examined. ResultsThe questionnaire formed 6 dimensions with 17 indications. The positive coefficients for the two rounds of consulting experts were >90%. The mean authority coefficient was 0.857. The Kendall W coordination coefficient was 0.465 and 0.455， respectively （P<0.001）. The questionnaire Cronbach's alpha coefficient was 0.622. The retest correlation coefficient was 0.459. The correlation coefficient between the researcher's score and the respondents' self-assessment was 0.562. The five common factors extracted by factor analysis were consistent with the structure of the questionnaire， and the cumulative contribution of variance was 54.4%. Total questionnaire scores were moderately to highly correlated with each dimension score （0.409 to 0.699）. There was low correlation between the dimensions （-0.002 to 0.203）. Girls who had sought medical care had higher scores on the total questionnaire， category A， category B， cycle dimension， menstrual dimension， and dysmenorrhea/PMS dimension than girls who had not sought medical care （P<0.01）， and the difference between the two groups in menstrual volume dimension scores was not statistically significant. ConclusionThe self-assessment questionnaire for menstrual abnormalities developed in this study has acceptable reliability， good structure validity and response validity. It can provide a self-examination tool and medical consultation guidance for young women with abnormal menstruation.

Discussion on validity management of gynecological ward items / 中国实用护理杂志

Objective@#A more safe and efficient "classification" items validity management method is proposed through the comparative analysis of the merits and demerits of the common items validity management methods, combined with the exploration and practice of the gynaecological ward of a specialized hospital in Shanghai,@*Methods@#The "classification" item validity management method includes setting up a special task group and formulating a work flow. The critical point is to adopt different management methods according to the classification of items.@*Results@#According to the supplier of items, it is divided into Class I and Class II. Items of Class I adopt the management method of validity turnover rate and Class II items adopt the effective period safety area management method.@*Conclusion@#The validity management method of "classification" items ensures the quality of special task and improves the work efficiency.

Discussion on validity management of gynecological ward items / 中国实用护理杂志

Objective A more safe and efficient "classification" items validity management method is proposed through the comparative analysis of the merits and demerits of the common items validity management methods, combined with the exploration and practice of the gynaecological ward of a specialized hospital in Shanghai, Methods The "classification" item validity management method includes setting up a special task group and formulating a work flow. The critical point is to adopt different management methods according to the classification of items. Results According to the supplier of items, it is divided into Class I and Class II. Items of Class I adopt the management method of validity turnover rate and Class II items adopt the effective period safety area management method. Conclusion The validity management method of "classification" items ensures the quality of special task and improves the work efficiency.

CT manifestations of mucoepidermoid carcinoma of trachea and bronchus / 实用放射学杂志

Objective To discuss specific CT signs of primary trachea,bronchus mucoepidermoid carcinoma.Methods A retro-spective analysis was made on CT features,clinical manifestations and relevant pathology materials of 10 cases of trachea,bronchus mucoepidermoid carcinoma that had been proved by pathological examinations.Results (1)Sites:1 case was in the trachea,1 case in the bronchus,3 cases in lobar bronchus,5 cases in segmental bronchus and they were all central types.(2)Form and size:2 cases were lobular,7 cases were oval or round,1 case was irregular.The maximum diameters of the tumor were 10-39 mm (averagely 25 mm).(3)Edge:8 cases had smooth edge,2 cases had rough edge with infiltration of adjacent pulmonary parenchyma.(4)Densi-ty:6 cases with uneven density,3 cases with even density.The density of 4 cases were higher than that of chest wall muscle,4 cases were similar to chest wall muscle and 1 case lower than chest wall muscle.Calcification can be seen in 4 tumors.(5 )Enhancement features:9 cases underwent CT enhancement scanning,8 cases had mild enhancement and 1 case with light enhancement.(6)Pe-ripheral conditions:all cases showed trachea or bronchus stenosis and blocking,5 cases with obstructive pneumonia,2 cases with obstructive atelectasis,3 cases with far-end bronchus obstructive mucous embolism,1 case with obstructive emphysema,there was no evident swelling in mediastinum or hilar lymph nodes,1 case with multiple pulmonary bulla and pneumothorax in the left lung. Conclusion Primary mucoepidermoid carcinoma of trachea and bronchus is mostly central type,low potential malignancy.CT mani-festations are as follows,occurred in the trachea or bronchus,oval or lobulated masses with smooth edge,slight enhancement,gen-erally with calcification,but few showed invasive growth .

CT findings of abnormal bronchovascular bundle in peripheral small cell lung cancer / 实用放射学杂志

Objective To investigate CT findings of abnormal bronchovascular bundle in patients with peripheral small cell lung cancer (SCLC).Methods The CT findings of abnormal bronchovascular bundle in 78 peripheral SCLC patients confirmed by pathology were retrospectively reviewed.Abnormal bronchovascular bundle of peripheral SCLC was divided into three types:type Ⅰ (thickening of the bronchovascular bundle),type Ⅱ (string beads of bronchovascular bundle) and type Ⅲ (bronchial cast with bronchus cut-off).Results 41 of 78 patients had abnormal bronchovascular bundle,in which 26 cases were in type Ⅰ,10 in type Ⅱ,5 in type Ⅲ.Except for 1 case with no mediastinal lymph node metastasis among 41 cases with abnormal bronchovascular bundle,all other 40 cases had mediastinal lymph node metastasis.Conclusion The abnormal bronchovascular bundle could reflect the biologic character of SCLC.Abnormal bronchovascular bundle is associated with advanced patients.

CT signs of peripheral small cell lung cancer / 实用放射学杂志

Objective To investigate CT signs of peripheral small cell lung cancer (SCLC).Methods The CT signs of 78 patients with SCLC confirmed by pathology were retrospectively reviewed.According to the presence of mediastinal lymph node metastasis and its size, 78 cases of peripheral SCLC were divided into two types: typeⅠ(isolated lesion) and typeⅡ(lung lesion + lymph nodes).Type Ⅱwere divided into two subtypes:type Ⅱa (short diameter of lymph nodes of pulmonary hilar and mediastinum less than 10 mm) and type Ⅱ b (short diameter of lymph nodes of pulmonary hilar and mediastinum greater than or equal to 10 mm).Results Of the 78 SCLCs, typeⅠwas 7 cases, and typeⅡwas 71 cases,including 8 cases of typeⅡa and 63 cases of typeⅡb.All of the lesions were soild density.The shape were round or oval in 52 cases, vermicular or spindlein 9 cases, and other shapes in 17 cases.Among 71 cases performed CT enhancement, there were 9 cases with homogeneous enhancement, 58 cases with heterogeneous enhancement, 4 cases with non-enhancement large necrosis area.These cases showed the following CT signs: smooth edge in 65 cases, coarse edge in 12 cases, blurred edge in 1 case;air bronchogram in 3 cases, vacuole sign in 4 cases, calcification in 4 cases;lobulation sign in 46 cases, spiculated sign in 5 cases;thickening of the bronchovascular bundle in 41 cases, pleural indentation in 6 cases, marginal ground-glass opacity in 5 cases, vascular convergence sign in 1 case;emphysema in 42 cases;obstructive pneumonia in 4 cases;bronchus abruptly interruption on the edge of the nodules in 18 cases;enlargement of mediastinal lymph nodes in 63 cases, the diameter of mediastinal lymph nodes larger than the primary lesions in 42 cases;and a little pleural effusion in 9 cases.Conclusion Solid density, smooth margin with lobulation,and significantly enlarged mediastinal lymph nodes are common signs in peripheral SCLC.Thickening of the bronchovascular bundle indicates reletively advanced stage.

Window Settings in the Diagnosis of Invasiveness of Lung Adenocarcinoma with Ground Glass Opacities / 中国医学影像学杂志

Purpose To explore the value of window width adjustment in diagnosing the invasiveness of lung adenocarcinoma manifested as ground glass opacities on high-resolution CT, and to provide guidance for the diagnosis of lung adenocarcinoma in different types. Materials and Methods The preoperative CT data of 102 preinvasive lesions and 107 invasive lesions of lung adenocarcinoma were analyzed retrospectively. Among 102 cases of preinvasive lesions, 25 were atypical adenomatous hyperplasia (AAH), 77 were adenocarcinoma in situ (AIS). Among 107 cases of invasive lesions, 78 were minimally invasive adenocarcinoma (MIA), and 29 were invasive adenocarcinoma. The lesions were ground glass opacity (GGO) on lung window while were invisible on mediastinal window. The window width was adjusted constantly until the lesions were invisible with the fixed mediastinal window level (40 HU). When the lesions became invisible, the window width was compared and the best cut-off was found on ROC curve in the two groups. Results The window width of lesions between preinvasive lesions and invasive lesions was different (Z= - 6.203, P<0.05). Window width was a good indicator for the invasiveness of pulmonary adenocarcinoma (area under the ROC was 0.748, P<0.05), and the window width of 1303 HU was the best cut-off for preinvasive lesions and invasive lesions (sensitivity was 56.9%, specificity was 86.0%. Conclusion Window width may be useful for the diagnosis of the invasiveness of the GGO of lung adenocarcinoma on HRCT. The lesion disappearing when the window width is larger than 1303 HU is more likely to be preinvasive; while the lesion disappearing when the window width is smaller than 1303 HU is more likely to be an invasive one.

Interventional therapy and its effectiveness for acute massive pulmonary thromboembolism / 介入放射学杂志

Objective To evaluate the effectiveness and safety of interventional embolectomy in the treatment of acute massive pulmonary embolism. Methods Interventional managements, including fragmentation, aspiration and dissolving of the embolus, were performed in 12 patients with CTPA-or pulmonary angiography-proved acute massive pulmonary embolism. Clinical manifestations, blood gas tension, hemodynamic changes, the recanalization of the pulmonary artery as well as the occurrence of complications were observed. Results Eleven patients survived and nine patients showed significant clinical improvement. PaO2 was increased from (54.92 ? 6.17)mmHg before the procedure to (90.91 ? 1.62)mmHg after the procedure (P = 0.001), and SaO2 was also increased from (85.17 ? 8.39)mmHg before the procedure to (95.75 ? 1.96)mmHg after the procedure (P = 0.001). Miller score (21.75 ? 4.35 vs 13.83 ? 5.69, P = 0.001) and mPAP (25.59 ? 7.68 mmHg vs 30.04 ? 7.93 mmHg, P = 0.001)decreased significantly. One patient died of pulmonary embolism and one died of intracerebral bleeding three days after the procedure. Conclusion Interventional embolectomy is an effective and safe technique for the treatment of acute massive pulmonary embolism.