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??Comparative study of elastosonography and molybdenum X-ray photography in the diagnosis of breast diseases WANG Han-feng??HUAI Qi-liang??SHANG Yan-kun??et al??Department of Breast Surgery??Zouping Family Planning Maternal and Child Health Service of Binzhou??Binzhou 256200??China
Corresponding author??WANG Han-feng??E-mail??Hansinwang@163.com
Abstract Objective To investigate the value of elastosonography and molybdenum X-ray photography in the diagnosis of breast diseases. Methods From March 2009 to August 2010, 65 female patients with 72 lesions in breast were examined with elastosonography and molybdenum X-ray photography in Zouping Family Planning Maternal and Child Health Service of Binzhou City of Shandong Province.Pathology was used as the golden diagnosing criterion. The accuracy of elastosonography and molybdenum X-ray photography for diagnosing breast diseases was compared. Results Pathological examination showed 53 nodules were benign and 19 nodules were malignant.The sensitivity, specificity and Youden index of elastosonography were 84.2%,96.2% and 0.804 respectively.Those of molybdenum X-ray photography were 68.4%,92.4% and 0.608 respectively. Conclusion The accuracy of elastosonography is much higher than that of molybdenum X-ray photography.The combinative use of elastosonography and molybdenum X-ray photography can elevate the accuracy for differentiating the benign from malignant breast tumours.     

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??Prevention and accident injury in the process of combined liver and kidney graft rapid harvesting FU Bin-sheng, ZHANG Tong, LI Hua, et al. Liver Transplant Center, the Third Affiliated Hospital?? Sun Yat-sen University, Guangzhou 510630, China
Corresponding author: CHEN Gui-hua, E-mail: chgh1955@263.net
Abstract Objective To evaluate accident injury in the process of combined liver and kidney graft rapid harvesting and summarize clinical experiences. Methods From January 2008 to June 2009, a quick procedure for combined liver and kidney procurement was used in 232 cases. The clinical data of the cases, including accident injury of graft and anomalous hepatic arteries were analyzed retrospectively. The procedure included in situ perfusion through aorta and superior mesenteric vein plus drainage through inferior vena cava. Liver and kidney were separated after harvested en bloc. Results Varied degree laceration of liver capsule existed in 25 cases (10.8%), and knife wound in left lobe of liver in 1 case. Primary non-function was found after implanted the severe fatty liver graft in 1 case. Kidney injury existed in 2 cases including 1 case of cuts in renal parenchyma of the right kidney and 1 cases of renal vein laceration in renal sinus, which were discarded because they could not be repaired. The first hepatic portal was cut at the high level during separation in 1 case. Anomalous hepatic arteries were found in 46 grafts (19.8%) with 76 percents of anomalous arteries originating from the left gastric artery and the superior mesenteric artery. Accident injury of anomalous hepatic artery was found in 3 cases (6.5%), including the left hepatic artery originating from the left gastric artery (2 cases) and the right hepatic artery originating from the superior mesenteric artery (1 case). Conclusion Combined liver and kidney graft rapid harvesting is a simple and safe procedure, which can protect the quality of liver and kidney simultaneously. Adequate perfusion, skilled procurement techniques and the prevention of anomalous hepatic arteries injury are critical to assurance of graft quality.     

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??Value of percutaneous transluminal angioplasty in the treatment of infrapopliteal arterial occlusive diseasesXU Xin,ZHANG Wen??bo,YANG Jue,et al.Department of Vascular Surgery,Zhongshan Hospital,Fudan University,Shanghai 200032,China Corresponding author:FU Wei??guo??E??mail:fu.weiguo@zs??hospital.sh.cn AbstractObjectiveTo investigate the value of endovascular surgery in the treatment of infrapopliteal arterial occlusive diseases.MethodsThe clinical and follow??up data of 86 patients (90 limbs) with infrapopliteal arterial occlusive diseases admitted between February 2006 and May 2008 in the Department of Vascular Surgery of Zhongshan Hospital of Fudan University were analyzed retrospectively.ResultsEighty??six patients (90 limbs) were treated by percutaneous transluminal angioplasty (PTA).Angiographic success on the limb basis was achieved in 82 of 90 treated limbs (defined as the residual stenosis of the treated segment was less than 30%) and the initial technical success rate was 91??1%.Doppler ankle??brachial index (ABI) increased from 0??34±0??16 to 0??85±0??23 (pre vs. post).The 12??month accumulated primary patency rate,24??month accumulated primary patency rate,survival rate and limb salvage rate were 61??2%??49??5%,97??8% and 97??8% respectively.ConclusionPTA is feasible as a primary invasive treatment for infrapopliteal arterial occlusive lesions in patients with chronic critical limb ischemia, yielding acceptable primary clinical success with a low complication rate and resulting in??moderate long??term clinical patency and a high limb salvage rate??     

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当前,不少医院的质控工作仍局限于生物医学技术质控,在管理层次、内容和方法上,主要侧重于医院内部的微观质量管理。但随着社会的发展和人们生活水平的提高,生物医学模式向生物、心理、社会医学模式转变,新时期卫生工作奋斗目标对医院质量管理提出了新的更高的要求。我们抓住机遇,解放思想,更新观念,运用现代管理学的理论和方法,实施全员全程全面质量管理,开创优质高效低耗医疗新路。1 质量管理是医院工作的核心 在实施全面质量管理这一跨世纪质量工作中,我们强调:1.1 全员质量管理 是对医疗质量形成过程的全体人员工作质量的管理活动。注重提高全体职工参加质量管理的积极性,强调人的因素第一,合力同心,运用医学科学理论和专业技术,通过优质服