Metastatic lymph node ratio and prognosis of gastric cancer at different lymph node numbers examined / 中华普通外科杂志

Objective To investigate the role of metastatic lymph node ratio (MLR) in the evaluation of prognosis of patients with gastric cancer (GC) at different lymph node numbers examined.Methods Clinical data were reviewed retrospectively in a total 535 patients who underwent surgery for GC.Spearman correlation analysis between MLR or number of metastatic lymph nodes (N) and examined lymph node numbers,Kaplan-Meier method was used for comparison survival rates of N stage and MLR stage.A receiver operating characteristic (ROC) curve was used to evaluate the role of N stage and MLR stage in the prognosis of GC patients.Results Metastatic lymph node ratio and number of metastatic lymph nodes correlated with the examined lymph node numbers (r =0.146,r =0.378,P ＜ 0.01,P ＜ 0.001).The 5 year survival rate of MLR0,MLR1,MLR2 and MLR3 patients were 57.5％,69.9％,40.0％ and 21.7％ respectively when examined lymph node numbers ＜ 6 (P ＜ 0.01).The 5-YSR of MLR0,MLR1,MLR2 and MLR3 patients were 86.8％,59.2％,35.8％ and 39.2％ respectively when between 6-10 (P ＜0.001) and the 5-YSR of MLR0,MLR1,MLR2 and MLR3 patients were 88.7％,62.5％,0 and 17.7％ respectively when they ＞ 10(P ＜0.001).AUC of MLR staging was 0.68 ±0.05 when the numbers ＜ 6 (P ＜ 0.001).AUC of MLR staging was 0.72 ± 0.04 at numbers 6-10 (P ＜ 0.001).AUC of MLR staging was 0.79 ± 0.03 when numbers ＞ 10 (P ＜ 0.001).Conclusions MLR was less influenced by lymph node number examined than N.MLR stage has potential superiority to that the N stage in assessing prognosis of GC patients,especially for patients with more than 6 lymph nodes examined.

Study of Major Risk Factors Analysis and Prevention Measures of Infection in Endoscopic Cleaning and Disinfection / 现代生物医学进展

Objective:To summarize the major risk factors of infection in the process of cleaning and disinfection of endoscopy center in our hospital,and formulate the corresponding prevention measures to reduce the incidence of endoscopic infection so as to ensure medical safety of patients.Methods:The specialist check the cleaning disinfection process,statistics of each link in the risk factors of infection.600 endoscopes were taken at random after disinfection,endoscopic inner cavity and the outer surface samples are collected,the cleaning and disinfection of the test results for evaluating quality indicators.Results:Testing 600 samples of qualified 584,and the percent of pass is 97.3％,gastroscopy,colonoscopy,duodenum mirror,bronchoscope,endoscopic ultrasonography qualified rate was 98.6％,96.8％,95.6％,96.0％,97.2％,respectively.28 strains of pathogenic bacteria were detected in 16 cases of unqualified samples,including 13 strains of helicobacter pylori,7 strains of escherichia coli,4 strains of pseudomonas aeruginosa,2 strains of pseudomonas aeruginosa,1 strains of staphylococcus aureus,1 strains of Klebsiella pneumoniae;16 cases to detect unqualified reason analysis,scrub incomplete accounted for 37.5％,Not according to the instructions required to use multi-enzyme and disinfectant accounted for 18.75％,special infected patients did not do special treatment of endoscopy accounted for 12.5％,endoscopic insufficient drying and the staffhand hygiene is not up to standard accounted for 12.5％,respectively.Conclusion:Endoscopic cleaning and disinfection aspects of infection caused by many factors,infection control education should be strengthened for all personal in the endoscopy center,regular professional training of cleaning and sanitation personal,cleaning and disinfection process should be standardized management,establish traceability registration system,control the quality of the endoscope cleaning and disinfection from each link.It is the main measure to prevent digestive endoscopy center in infection.

MRI findings of spinal intramedullary tuberculoma and literature review / 实用放射学杂志

Objective To analyze the MRI findings of spinal intramedullary tuberculomas and the related literature was reviewed. Methods A retrospective study of 5 patients with intramedullary tuberculoma proved by clinical and radiological evidences was undertaken.Both T1-and T2-weighted images were obtained along with the postcontrast T1 WI.The locations,signal intensities,patterns of enhancement and morphology of the tuberculomas were observed.Results A tuberculoma in one patient was found in cervical spinal cord with slight hypointensity and nodular enhancement on T1 WI and hypointensity on T2 WI.Those in three patients were found in inferior thoracic spinal cord with typical “target sign”on T2 WI and rim-enhancement on postcontrast T1 WI,and the tuberculomas were ovoid along the long axis of spinal cord on sagittal images.A miliary tuberculoma in thoracic spinal cord in one of these three patients was found which could not be showed on plain MRI.The tuberculomas in last patient was located in conus terminalis with hypointensity and rim enhancement on T1 WI and hypointensity on T2 WI.Conclusion The MRI findings of spinal intramedullary tuberculoma are variable,and their characteristic manifestations include hypointensity or “target sign”on T2 WI,rim enhancement on postcontrast T1 WI along the long axis of spinal cord.

CT study of dependability in cerebral hemodynamic changes of carotid artery stenosis and the degree of carotid stenosis / 实用放射学杂志

Objective To investigate cerebral hemodynamic changes in patients with unilateral stenosis of carotid artery by using CTP and CTA,and to analyze the dependability of the degree of artery stenosis and cerebral hemodynamic changes.Methods Fifty patients with unilateral stenosis of carotid artery underwent toshiba aquilion one CTP and CTA.The patients were divided into mod-erate stenosis group,severe stenosis group and occlusion group according to the NASCET criteria.The rCBF,rCBV,rMTT and rTTP were measured ,and compared between stenosis and contralateral hemispheres ,and the dependability were analyzed between the de-gree of unilateral carotid artery stenosis and relative perfusion parameters by using ranking-test.Results (1)There were 20 cases of unilateral carotid artery occlusion,13 severe stenosis,1 7 moderate stenosis.(2 )No statistical significance on rCBF and rCBV was found among the three stenotic groups (P>0.05).There were statistical significances on rMTT and rTTP among the three stenotic groups(P<0.05).(3)There were statistically no correlations between the values of rCBV,rCBF and the degree of artery stenosis.There were statistically positive correlations between the values of rMTT,rTTP and the degree of artery stenosis with the pearson correlations 0.512 and 0.708. Conclusion rMTT and rTTP are more sensitive parameters for evaluation of cerebral hemodynamics and dependability of carotid ar-tery stenosis on the CTP and CTA.These have an important value to guide the clinical treatment.

Effects of intravenous infusion of lidocaine on colorectal resection / 中国医师进修杂志

Objective To investigate the effects of intravenous infusion of lidocaine on colorectal resection.Methods Sixty patients undergoing colorectsl resection were randomly divided into group L [receiving intravenous infusion of 1%lidocaine,bolus injection of 1.5 mg/kg lldocaine at induction of anesthesia,followed by a continuous infusion of 1.5 mg/(kg·h)intraoperatively and for 12 h postoperatively]and group C(an equal volume of saline).Postoperative pain scores(VAS score)and morphine consumption were measured.Times of flatus and first defecation were recorded.Results The end expiration sevotturane concentration maintaining hemedynamics stable in group L was lower than that in group C(P<0.05).The dose of sulfentsnyl was(17.5±3.8)μg in group L,(25.6±4.5)μg in group C,there was significant difference between two groups(P<0.05).The times of flatus first,defecation and morphine conaumption at 24 and 48 h after operation in group L were lower than those in group C[(23±6)h vs(28±7)h,(31±7)h vs(43±9)h,(32±6)mg vs(46±8)nag and(58±7)mg vs(71±10)mg,P<0.05].There was no significant difference at resting VAS score,but there was significant difference at movement and cough VAS score between twp groups(P<0.05).Conclusion Perioperative administration of low doses of intravenous infusion of lidocaine reduces intraoperative anesthetic requirements and has a clinically relevant beneficial effect on postoperative recovery after colorectal resection.

An exploration of the application of dataflow in picture archiving and communication systems / 中华放射学杂志

Objective To enhance the function of picture archiving and communication systems (PACS) and the efficiency of medical imaging by adjusting dataflow. Methods About 9500 examinations consecutive data in July of 2003 were analysed and and followed. The dataflow was adjusted by adding digital radiology servers and temporal servers. Results The network bottleneck was resolved and the system load balanced, then the function of the system was enhanced. The secure running of the system was ensured in condition of urgency or increasing of patients and image data. Conclusion Adjustment of dataflow in PACS makes full use of all resources, reduces unnecessary time-wasting , further improves the working efficiency in our department.