Clinical and Histopathological Review of 229 Cases of Ranula

The purpose of this paper was to evaluate the relationship between the thrombosis and secretory duct dilation, lesion size, clinical types, nature （primary or recurrent） and duration of illness in the development of ranula. A total of 229 cases of sublingual gland cysts were treated with surgical resection from Jan. 1990 to Feb. 2010. The patients＇ data were investigated on histopathological findings, size of ranula, the clinical types, nature of ranula （primary or recurrent） and duration of illness. Sections from the paraffinembeded blocks were HE-stained. CK expression was immunohis-tochemically detected. Among 229 cases the incidence of venous thrombosis was 58.52%. The incidence of venous thrombosis with or without duct dilation was 73.25% and 26.39% respectively, with a significant difference between the two groups （P〈0.005）. The incidence of venous thrombosis of ranulas with diameter larger or less than 3 cm was 72.22% and 46.28% （P〈0.005）. The incidence of venous thrombosis of oral ranula, plunging ranula and mixed ranula was 49.37%, 77.19% and 85.71% respectively, with a significant difference found between oral and plunging or mixed ranula （P〈0.01）. The incidence of venous thrombosis in ranula patients with duration of illness longer or less than 3 months was 69.77% and 51.75% （P〈0.01）. The incidence of venous thrombosis with recurrent and primary ranulas was 51.85% and 64.85%, without a significant difference noted between them （P〉0.05）. It is concluded that the formation of venous thrombosis was related to the dilation of secretory duct, lesion size, clinical types, duration of lesion but formation of venous thrombosis was not related to the nature （primary or recurrent） of ranulas.

Evidence-Based Chinese Medicine Clinical Practice Guideline for Stomach Pain in Hong Kong

Stomach pain in Chinese medicine（CM） is a very common disorder in clinical practice and it has been listed as one of the pilot three conditions in Hong Kong to develop evidence-based CM clinical practice guidelines（CM CPGs）. The aim of this stomach Pain CPG is to summarize the treatment methods of stomach pain with CM and evaluate reasonably, then to guide local licensed CM practitioners and provide beneficial reference for social medical decision makers and patients. In this manuscript, we defined stomach pain in CM and the category of chronic gastritis in Western medicine. The clinical manifestation, CM pattern classification, and CM intervention including herbal medicine treatment based on pattern differentiation, symptomatic treatment, acupuncture treatment, regulation and nursing were illustrated.

Use of prostate-specific antigen testing in Medicare beneficiaries:Association with previous evaluation

Objective:Determine uptake of prostate-specific antigen(PSA)testing in Medicare benefi-ciaries according to previous receipt of PSA testing.Methods:A 5%random sample of men aged 67 years or older without a previous diagnosis of prostate cancer was identified through 2009-2012 Medicare claims.We measured the annualized frequency of PSA screening among men due for PSA testing,stratified by PSA testing use in the previous 2 years,and clustered by ordering provider.Results:Throughout the study period,PSA testing use was consistently higher for men with previous screening than for men without previous screening.For men without previous screening,there was a decline in testing that was most pronounced in 2012.Compared with 2009,the cor-responding odds ratios were 0.98[95%confidence interval(CI)(0.96-1.00)]in 2010,0.94[95%CI(0.92-0.95)]in 2011,and 0.66[95%CI(0.65-0.68)]in 2012.In contrast,for men with previous screening,PSA testing frequency was stable from 2009 to 2011,and declined to a lesser extent in 2012[odds ratio 0.80,95%CI(0.79-0.81)].Conclusion:Receipt of PSA testing is highly dependent on whether an individual was tested in the recent past.In previously unscreened men,the largest decrease occurred in 2012,which may reflect in part the publication of US Preventive Services Task Force guidelines,but there was much less impact among men already being screened.