The application study of scan technique of perspective ECG-gating of spiral CT with 64 slices in the CHD / 中国医学装备

Objective: To explore the setting of the scan mode of prospective electrocardiography (ECG)-gating of spiral CT with 64 slices for the adults with congenital heart disease (CHD) so as to obtain satisfying images and scanning parameters. Methods: 18 adults with CHD were scanned by using spiral CT with 64 slices. The flow rate of contrast agent was 4mL/s, and 20 mL normal saline (NS) was injected after 70 mL contrast agent was injected, and then 15mL contrast agent was injected following with NS, and 25mL NS was used for tracing injection. The prospective ECG-gating and intelligence tracing of contrast agent were adopted to scan. The descending aorta that has same height with crotch of weasand should be chosen as interesting position, and the threshold value was 130 HU, the scan mode of triggering threshold was adopted in the research. The post processing workstation (Philips EBW) was applied to adopt reestablishment of sagittal view, coronal view and axial view, and to carry out reconstruction of 3D multiplanar reformation (MPR), curved planar reformation (CPR), maximum intensity projection (MIP) and volume rendering (VR) so as to observe the situations of heart cavity and peripheral vessel of patients. Results: Each atrium and ventricle has clear construction, and the relationship with peripheral vessel was clearness, and the aortic valve and atrioventicular septum could be observed. And the diagnostic result by using reconstruction technique could be identical with image of Doppler echocardiography. Conclusion: The scan technique of perspective ECG-gating of spiral CT with 64 slices could obtain images, that conformed to requirement of diagnosis and had value, of each atrium, ventricle and peripheral vessel. In the scan, the accurate and suitable parameters, the appropriate dosage and usage of contrast agent, the scan speed, scan time and setting of triggering threshold were the key factors of obtaining image with high quality.

Clinicopathologic features and proliferative status of colorectal serrated lesions: a study of 104 cases / 中华病理学杂志

<p><b>OBJECTIVE</b>To study the clinicopathologic features and proliferative status of colorectal hyperplastic polyp (HP), sessile serrated adenoma (SSA) and traditional serrated adenoma (TSA).</p><p><b>METHODS</b>One hundred and four cases colorectal serrated lesions were collected from 2628 cases of colorectal polyps during the period from November, 2002 to December, 2007. The clinicopathologic features and expression of proliferation marker Ki-67 were studied.</p><p><b>RESULTS</b>On the basis of morphologic examination, 60 cases were classified as HP, 20 cases as TSA, 11 cases as SSA, 7 cases as mixed HP/SSA/TSA, and 6 cases as mixed serrated polyp/adenoma and tubular adenoma. Immunohistochemical study for Ki-67 showed that 40 cases (78%) of the 51 cases of HP were either mostly negative or rarely (<25% cells) positive. Most of the positive cells were located at crypt bases. Among the 15 cases of TSA, 11 of them revealed positive cryptal cells (25% to 50% or>50% positivity). Most of the positive cells were located in mid portion of crypts. The number and distribution of Ki-67 positive cells in SSA were similar to those in TSA but were significantly different from those in tubular adenoma and adenocarcinoma (chi2=34.601, P=0.000; chi2=63.077, P=0.000, respectively).</p><p><b>CONCLUSIONS</b>HP, SSA and TSA have their morphologic characteristics, with some overlapping features noted. The distinction between SSA and HP can be difficult. Diagnosis of SSA relies mostly on architectural rather than cytologic features. The distinction between TSA and SSA depends mainly on the presence of dysplasia. Ectopic crypt formation is almost exclusively seen in TSA. The distribution and percentage of Ki-67-positive cells are also helpful in subtyping of various colorectal serrated lesions. In general, the proliferative index is lower in serrated adenoma (TSA or SSA) than in tubular adenoma.</p>

Clinicopathological and immunohistochemical features of colorectal sessile serrated adenoma / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To investigate the clinicopathological characteristics and expression status of Ki67, p53, CEA, CDX, CK7 in colorectal sessile serrated adenoma (SSA).</p><p><b>METHODS</b>The clinicopathological data of 11 cases of SSA, 51 cases of hyperplastic polyp (HP) and one case with mixed HP/SSA were reviewed and analyzed retrospectively. The expression of Ki67, p53, CEA, CDX and CK7 were detected by immunohistochemistry.</p><p><b>RESULTS</b>The major histological features in SSA were architectural abnormality in crypts, dilatation of serrated crypt bases like an inverted "T" or "L" shape adjacent to muscularis mucosa. Atypical cells containing round to oval nuclei and nucleoli were also observed. The immunohistochemical staining showed that the expression of p53 increased gradually from HP to TA: 11.8% in HP, 20.0% in SSA, 41.2% in VTA and 75.0% in TA, with a significant difference among the groups (chi(2) = 17.996, P = 0.000). However, no significant difference in the expression of CDX and CK7 was observed between HP and SSA. Of the 10 SSA cases, positive expression of Ki67 was found in cells located in the base or middle part of crypt in 6 cases, positive cells index was 26% - 50% in 5 cases, and > 50% in 3. Compared with the expression of Ki67 in the HP, VTA and VA, SSA showed a significant difference in both the positive cell number and in the positive regions. (positive number: chi(2) = 34.601, P = 0.000; positive regions: chi(2) = 63.077, P = 0.000).</p><p><b>CONCLUSION</b>Morphological diagnosis of SSA was mainly based on crypt architectural and cellular abnormalities, and the crypt architectural abnormality may be more important than cellular features. Detection of p53 and Ki67 expression may be helpful in differential diagnosis and understanding the nature of SSA.</p>

Blood pressure change with age in salt-sensitive teenagers / 中国医学科学杂志(英文版)

<p><b>OBJECTIVE</b>To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.</p><p><b>METHODS</b>Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.</p><p><b>RESULTS</b>After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7 +/- 12.1 mmHg vs. 2.8 +/- 5.2 mmHg, P < 0.01; 12.2% +/- 12.0% vs. 2.5% +/- 4.4%, P < 0.001, respectively). There was a similar trend for diastolic blood pressure (8.4 +/- 6.4 mmHg vs. 3.7 +/- 6.4 mmHg, P = 0.052; 13.2% +/- 10.6% vs. 6.8% +/- 10.1%, P = 0.053, respectively).</p><p><b>CONCLUSIONS</b>Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.</p>

Long term observation in effects of potassium and calcium supplementation on arterial blood pressure and sodium metabolism in adolescents with higher blood pressure / 中华预防医学杂志

<p><b>OBJECTIVE</b>To investigate the effects of potassium and calcium supplementation in table salt on reduction of arterial blood pressure and sodium metabolism in adolescents with higher blood pressure.</p><p><b>METHODS</b>A single blind placebo-controlled trial was carried out for two years in 220 adolescents with higher blood pressure, aged 18 - 22 years, who were randomly divided into supplementary group (n = 110) and control group (n = 110). Each of the subjects in the supplementary group and their family members was given 10 mmol of potassium and 10 mmol of calcium mixed in their table salt daily for 24 months.</p><p><b>RESULTS</b>Night urinary sodium and potassium excretion increased (urinary Na(+), P < 0.05; urinary K(+), P < 0.01) and blood pressure lowered by 5.3 mm Hg/1.8 mm Hg in average from the baseline in the supplementary group two years after potassium and calcium supplementation, as compared with that in the control group increased by (1.3/1.7) mm Hg.</p><p><b>CONCLUSIONS</b>Adequate supplement of potassium and calcium in daily table salt intake was an effective way to prevent form hypertension and could promote their urinary sodium excretion and reduction of arterial blood pressure in adolescents with higher blood pressure.</p>