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Objective ToinvestigatethevalueoftheoptimalCNR monoenergeticimagesofportalveininpredictingesophagealGgastric varicealbleeding(EVB).Methods FortypatientswithlivercirrhosisandportalhypertensionunderwentcontrastGenhancedspectral CTscan.TheoptimalCNR monoenergeticimagesand70keV monoenergeticimagesoftheportalveinphasewereselectedtocompare theimagingquality.TheconsistencyoftheoptimalCNR monoenergeticimageswithendoscopyforesophagealGgastricvaricealwas analyzed by Kappa test.A ccording to the E V B history ,the patients w ere divided into bleeding group and nonGbleeding group.T he ROCcurveswerecalculatedtoassessthevaluesofthemainportalvein(MPV)anditstributariesdiameterstopredictingEVB.Results TheCNRandobjectivescoreoftheoptimalCNR monoenergeticimagesweresignificantlyhigherthanthoseofthe70keVimages(P＜0.05).TheoptimalCNR monoenergeticimageshadgoodconsistency withgastroscopeintheclassificationofesophagealGgastric variceal(k＝0.769).ThereweresignificantdifferencesofthediametersofMPV,intrahepaticleftbranchofportalvein(LPV),splenic vein(SV)andleftgastricvein (LGV)betweenthebleedinggroupandnonGbleedinggroup (P＜0.05).ROCcurveanalysisshowed thattheincidenceofEVBwashighestwithasensitivityof76.92%andaspecificityof85.71%,whentheLGVwasgreaterthan6.1mm. Conclusion TheoptimalCNR monoenergeticimagesofportalveincouldimprovetheimagingquality,andLGVdiametershouldbe ariskindicatorforpredictingEVBinlivercirrhosis.
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Objective To investigate the expression of proliferating cell nuclear antigen ( PCNA) and the level of 8-hydroxydeoxyguanosine (8-OhdG) in gastric carcinoma and their clinical significance. Methods PCNA protein expression of 63 tumor tissues , 36 paracancerous tissues and 9 chronic gastritis mucosa were ana-lyzed by immunohistochemistry and 8-O HdG of hydrolysates was determined by HPLC. Results The expression of PCNA and the level of 8-OHdG were upregulated in chronic gastrits mucosa adjacent tissues and gastric carci-noma raised gradually and these two metrics were associated with tumor differentiation and TNM stage. Conclu-sions Up-regulation of PCNA protein expression and 8-O HdG levels are observed in gastric carcinoma. Detec-tion of PCNA protein expression and 8-O HdG levels can be used to evaluate malignant biological behavior and prognosis of gastric cancer.
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Objective To investigate the effects of Skp2 overexpression on the sensitivity of troglitazone (TRG) in breast cancer cells and to devote to develop a novel drug for increasing the patient survival rate and eventually reaching the cure goal .Methods The transcription activities of PPARγ were analyzed on peroxisome proliferators response element(PPRE) luciferase reporter .The flow cytometry analysis and CCK‐8 assay were adopted to study that overexpression of Skp2 was associated with resistance to TRG‐mediated inhibition growth and apoptosis of breast cancer cells .Results Our study found that overexpression of Skp2 inhibi‐ted the transcriptional activity of the endogenous PPARγ and resisted to TRG‐mediated inhibition growth and apoptosis of breast cancer cells .Conclusion Overexpressed Skp2 breast cancer cells is able to be resistant to TRG‐induced sensitivity of breast cancer cells .Furthermore down‐regulating Skp2 will significantly enhance the growth inhibition of TRG on breast cancer cells .
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Objective To evaluate the clinical value of spectral CT mode in imaging liver by comparing the radiation dose and image quality between spectral CT and conventional multi-slice spiral CT (MSCT).Methods Thirty patients (group A) underwent three-phasic enhanced CT scans spectral CT mode in the portal phase (PP) and conventional helical mode in other phases (Discovery CT 750 HD,GE Healthcare).Another 30 patients in group B underwent conventional three-phasic enhanced CT on a 64-slice MSCT (VCT,GE Healthcare) with 120 kVp and automatic tube current modulation (ATCM) and noise index of 15.The images in PP from the two imaging modes were retrospectively compared.The contrast-noiseratio (CNR) for the veins was calculated using liver parenchyma as background.For the spectral CT mode,101 sets of monochromatic images were reconstructed from 40 to 140 keV,and the optimal energy level for obtaining the highest CNR was determined using the Gemstone Spectral Imaging (GSI)-viewer software.Image noise (at 70 keV),CNR (at the optimal keV level) for the vein and radiation dose to the patient were obtained for spectral images and statistically compared with those in group B with the conventional MSCT using t test.Results The CTDIw value in PP for spectral CT was 15.64 mGy,30％lower than the (22.44 ± 5.09) mGy for the conventional MSCT (t =29.56,P ＜ 0.01).Image noises on the liver parenchyma were 22.81 ±2.85 and 23.80 ±3.31 for the conventional MDCT and spectral CT images at 70 keV,respectively,with no significant difference (t =0.76,P ＞ 0.05).On the other hand,CNR for the vein at the optimal energy level in spectral CT was 7.17 ± 2.09,which was significantly higher than the 2.76 ± 1.34 for the conventional MSCT (t =7.21,P ＜ 0.01).Conclusion Compared with conventional standard-dose liver MSCT,spectral CT imaging provides improved CNR for vessels,comparable image noise for liver parenchyma with 30％ dose reduction.
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OBJECTIVE@#To discuss the role of image navigation in resection of the ossifying fibroma of paranasal sinuses and anterior skull base with nasal endoscope.@*METHOD@#Fourteen cases with ossifying fibroma involving paranasal sinuses and anterior skull base were underwent intranasal endoscopic surgery under the guidance of image navigation. Sequential nasal sinuses CT scans were obtained before and after operation. CT scans demonstrated that the nasal septum, orbital wall and anterior skull base were involved in every case. The anterior boundary of the frontal recess cells was involved in 10 cases. The lesions were adjacent to the orbital apex and optic canal in 5 cases. The sella turcica and clivus were invaded in 3 cases and the pterygopalatine fossa was invaded in 2 cases.@*RESULT@#The tumors were thoroughly removed in all cases. The average operative time was 280 minutes and the average registration time of navigation was 9 minutes. Postoperation CT scans demonstrated that the tumors were totally resected.@*CONCLUSION@#The image-guided endoscopic surgery of the ossifying fibroma of paranasal sinuses and anterior skull base provided accurate tumor resection, increased surgical effectiveness, decreased overall surgical complications.
Subject(s)
Adolescent , Adult , Child , Child, Preschool , Female , Humans , Male , Middle Aged , Young Adult , Endoscopy , Methods , Fibroma, Ossifying , General Surgery , Paranasal Sinus Neoplasms , General Surgery , Paranasal Sinuses , Skull Base , Surgery, Computer-AssistedABSTRACT
Objective To survey the non-intellectual factors, motivation of nurses on the impact of nursing health education. Methods 575 cases of nurses were investigated using a serf-designed questionnaire with reference to a lot of recent related articles. Results The mean motivation score of health education was 23.82. Most nurses were still not have a systematic understanding of nursing health education from the aspect of motivation. Conclusions In order to ensure effective implementation of nursing health education, various measures and methods should be adopted to improve nurses' systematic understanding of the content and the purpose of nursing health education.
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Objective To evaluate the robustness of body mass index (BMI) adapted tube current selection method for obtaining consistent image quality in MSCT coronary artery imaging Methods Initially one hundred patients in the control group ( C group) underwent cardiac scans using GE 64-row VCT with standard scan protocol (640 mA, 120 kV, 0.35 see, body bewtie, C2 filter). Noise measurement was obtained for each patient using the average of three consecutive slices in the ascending aorta with ROI of 10 mm×10 mm to establish the relationship between BMI, desired image noise (IN) and required mA. An excel table was established to predict the required mA to achieve a desired IN for each patient with different BMI. A second group of one hundred cardiac patients (L group) was scanned with BMI-aclapted mA from the table to evaluate the practicability of this method. BMI, IN, CT dose index(CTDI),effective dose (ED) were all recorded. Results For the control group of 100 patients, the mean values and standard deviations of image quality score (IQS), BMI, IN and ED were 3.71±0.54, 25.08±2.63, 24.56±5.03 and (17.63±1.68 ) mSv (with range of 15-22 msy). Regression analysis indicated linear relationship between BMI and image noise with fixed mA. Using the relationship between tube current and image noise and noise ratio between large bowtie and cardiac bowtie, the following equation for the required tube current Xma to achieve present image noise of Ins for patient with certain BMI value when using cardiac bowtie could be then obtained: Xma = Fma×( k1 x BMI + c1 )/Ina]2, where Fma = 640 mA, k1 = 1. 033, c1 = - 3.2, Ins = 27 in the study. (2) For the patients in L group, the mean values and standard deviations of IQS, BMI, and IN were 3.69±0.53, 25.07±2.91, and 26.61±3.44, respectively. The average tube current used was (469.95±113.45) mA, depending on patient's BMI values. The average effectively dose was(9.08±2.25) mSv. There was no statistically difference between the two groups in image quality( F= 0.068,P=0.794). Conclusions In 64-MSCT cardiac imaging, the use of BMI dependent tube current selection method, in conjunction with dose reduction techniques, can provide individualized scan protocol to obtain consistent image quality across patient population and to optimize dose delivery to patients.
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Objective To investigate patients'cognition of social status of physicians and nurses,and find out the influence factors of it. Methods 286 patients were asked to finish serf-designed scale of social status of physicians and nurses. Results Most patients thought social status of nurses was above the middle level in our country.The majority of patients considered doctors " social status was higher than nurses'(approval rate 75.5% ).The nurses'economic treatment was lower than doctors' (approval rate 62.2% );About 14 items among 15 items on the occupational reputation,doctors" occupation cognition rate was higher than the nurses,the nurses' occupation cognition rate was higher than the doctors' occupation only on the item of labor intensity.The influence factors of the social status differences between physicians and nurses were economic treatment,the important degree of occupation,the professional authority,the requirement of specialized skills for workers. Conclusions To study the influence factors of the social status difference of physicians and nurses is beneficial for us to study the strategy of improving the nurses' social status in order to fulfil the viewpoint of science development,keep nurse troops developing continuously and set up the harmonious physician-nurse relationship.
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OBJECTIVE Congenital aural atresia repair is difficult owing to unpredictable anatomy. Benefits may be gained from image-guided surgery(IGS) . its exact role and surgery indication were def ined. METHODS From 2001 to 2004,36 ears with bony type C(Schuknecht classification) congenital atresia were performed. In the IGS group(n=18) ,repair surgery was performed with IGS,while in the control group(Non-IGS,n=18) ,similar intervention was applied without IGS. IGS group:aged from 12-29 years,follow-up from 6 months to 1 year. Non-IGS group:aged from 10-27 years,follow-up from 6 months to 3 years. Intra-and post-operative clinical and audiometric findings were compared. RESULTS All of the patients had congenital bony aural atresia,ossicles malformation,tympanic cavity hypoplasia and facial nerve malformation. IGS revealed a malformed horizontal semicircular canal hidden in the bony atresia plate during the operation while computed tomography(CT) did not show preoperatively. IGS computed tomography images correlated well with intra-operative findings,gave the surgeon more securityand reduced operative time(2 hours and 24 minutes) by 25 minutes. The prepare time increased 20 minutes(15-30 minutes) ,but total time decreased 5 minutes in IGS group. The registration accuracy was 0.6-1.3 mm,average 0.84 mm,which was suitable for the otologic surgery. There were 1 case in IGS group and 3 cases in Non-IGS group happened local aural restenosis after operation. But there were no facial nerve paralysis and hearing injury happened in both groups,and all of the patients got the satisfactory hearing after the hearing reconstruction(the air-bone gap with an average of IGS is 31.8dB,Non-IGS is 30.5dB) . CONCLUSION In our estimation,IGS is valuable for type C congenital aural atresia repair. It serves as an educational tool and a guide both for the experienced and inexperienced surgeons in critical situations where anatomical landmarks are distorted and approach is limited. There is no statistically significant between two groups on hearing improvement after operation.
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This paper introduces a simple ultrasound studio suited to both field battle and peace time, which has many advantages including slight weight, stable structure, easy to take and simple operation. The studio can be applied to all kinds of medical organization and can improve the diagnostic level of ultrasound in field battle and peace time.