Objective To determine the accuracy of endorectal ultrasonography (ERUS) in preoperative staging of rectal cancer and investigate the limitations and pitfalls of ERUS. Methods Ninety-four patients with rectal cancer were examined preoperatively by ERUS between September 2008 and November 2009 in this hospital. The size, shape, echo pattern, infiltration depth, and extra-rectal invasion of lesions were observed. The results of ERUS staging were compared with histopathology findings of the resected specimens. Results The overall accuracy of ERUS in T staging was 63.8% (60/94). The accuracies of ERUS for pT1, pT2, pT3, and pT4 tumor were 87.2% (82/94), 76.6% (72/94), 76.6% (72/94), and 97.9% (92/94), respectively. The sensitivity, specificity, and accuracy of ERUS for advanced rectal cancer (pT3+pT4) were 70.8% (34/48), 78.3% (36/46), and 74.5% (70/94), respectively. The sensitivity, specificity, and accuracy of ERUS in lymph node metastasis were 75.0% (42/56), 42.1% (16/38), and 61.7% (58/94), respectively. There was no significant difference of accuracy among various tumor locations above anocutaneous line (P＝0.495). The accuracy of ERUS for T staging improved with experience, the T staging accuracy improved from 40.0% after assessment of 30 cases to 81.3% after 94 cases were examined (P＝0.026). Conclusions The ERUS provides a good accuracy rate for assessment of the depth of tumor invasion and lymph node metastasis of rectal cancer, and has become an important imaging tool for preoperative staging rectal cancer. The operator experience, peritumoral inflammation mainly influences the accuracy of ERUS.
Objective To analyze and compare the urban-rural difference of health resource allocation of maternal and child health institutions in Sichuan province. MethodsGini coefficient and agglomeration degree was used to analyze the equity of health resource allocation of maternal and child health institutions in Sichuan province. ResultsThe number of maternal and child health institutions per 10 000 population in rural areas was higher than that in urban areas, while the hospital beds and health workers per 10 000 population was lower. In terms of population-based Gini coefficient, the value of three type of health resources of maternal and child health institutions in Sichuan Province were lower than 0.4, indicating a good equity, however, the value of institutions and health workers in urban areas were lower than those in rural areas, the value of hospital beds were higher than those in rural areas. In terms of the difference between HRAD and PAD, there were great differences in the population-based accessibility of health resources of maternal and child health institutions in Sichuan province, relative excess and relative deficiency coexisted in different city (state). Moreover, there were differences in population-based accessibility to health resources of maternal and child health institutions between urban and rural areas in each city (state). ConclusionThere are obvious urban-rural and regional differences in health resources allocation of maternal and child health institutions in Sichuan province. Social factors such as population, geographical area and service radius should be comprehensively considered according to the real needs in the planning of rational health resources allocation of maternal and child health institutions.