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@#Objective To explore the predictive value of CT signs of mixed ground-glass nodules in the pathological subtype and differentiation of lung adenocarcinoma. Methods The clinical data of 66 patients with mixed ground-glass nodules pathologically diagnosed as invasive adenocarcinoma (IAC) in the Second Department of Thoracic Surgery, the First Affiliated Hospital of Xiamen University from May to December 2021 were retrospectively analyzed, including 20 males and 46 females, aged 35-75 years. The CT findings were analyzed before operation, and the lesion profile was cut after operation to distinguish the ground-glass and solid components, and the pathological results of different positions were obtained. According to the postoperative pathological results, the patients were divided into a low-risk group (containing adherent type and no components of micropapillary subtype and solid subtype, n=16), a medium-risk group (containing niple or acinar type and no components of micropapillary subtype and solid subtype, n=38), and a high-risk group (containing micropapillary or solid subtype, n=12). The relationships between CT features and the pathological subtype and degree of differentiation were analyzed and compared. Results In 66 patients with IAC, the infiltration degree of solid components was greater than that of ground-glass components. When the solid component ratio (CTR) was≥25% (sensitivity 90.2%, specificity 64.0%, P=0.005), and the average CT value was>−283.95 HU (sensitivity 82.9%, specificity 64.0%, P=0.000), the histological grade was more inclined to medium and low differentiation. The CTR, Ki-67, average CT value and histological grade of IAC in the medium- and high-risk groups were higher than those of nodules in the low-risk group. Conclusion The infiltration degree of solid components is higher than that of ground-glass components in IAC mixed ground-glass nodules. The pathological subtype, Ki-67 expression and histological grade of lung adenocarcinoma can be predicted according to its CT characteristics, which has important clinical significance for determining the timing of surgery.
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Autapses selectively form in specific cell types in many brain regions. Previous studies have also found putative autapses in principal spiny projection neurons (SPNs) in the striatum. However, it remains unclear whether these neurons indeed form physiologically functional autapses. We applied whole-cell recording in striatal slices and identified autaptic cells by the occurrence of prolonged asynchronous release (AR) of neurotransmitters after bursts of high-frequency action potentials (APs). Surprisingly, we found no autaptic AR in SPNs, even in the presence of Sr2+. However, robust autaptic AR was recorded in parvalbumin (PV)-expressing neurons. The autaptic responses were mediated by GABAA receptors and their strength was dependent on AP frequency and number. Further computer simulations suggest that autapses regulate spiking activity in PV cells by providing self-inhibition and thus shape network oscillations. Together, our results indicate that PV neurons, but not SPNs, form functional autapses, which may play important roles in striatal functions.
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Parvalbumins/metabolism , Corpus Striatum/metabolism , Interneurons/physiology , Neurons/metabolism , NeostriatumABSTRACT
@#MicroRNAs (miRNAs) are a class of short, highly conserved, non-coding RNA molecules that regulate gene expression by specific binding to the messenger RNAs (mRNAs). At present, the researches on miRNAs have caused immense global concern, and expression of miR-139-5p plays a significant role in tumorigenesis, metastasis and recurrence, through regulating proliferation, migration, and invasion of cancer cells in lung cancer, esophageal cancer, breast cancer, tongue squamous cell carcinoma, hepatocellular carcinoma, etc. MiR-139-5p has a positive impact on the prognosis of cancer, and it can combine with some chemotherapeutic drugs to reverse resistance and enhance the sensitivity of radiotherapy. It also works in the cells and tissues of other diseases, including nerve cells, and inflammation. This article reviewed the progress of miR-139-5p.
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@#Objective To investigate the clinical effect of three-port Da Vinci robot-assisted radical resection of lung cancer. Methods The clinical data of patients who underwent Da Vinci robot-assisted radical resection of lung cancer in the Second Department of Thoracic Surgery, the First Affiliated Hospital of Xiamen University from April 2021 to March 2022 were retrospectively analyzed. According to the number of surgical ports, they were divided into two groups: a three-port group (three-port Da Vinci robot-assisted radical resection of lung cancer), and a four-port group (traditional Da Vinci robot-assisted radical resection of lung cancer). The operation time, intraoperative bleeding, lymphadenectomy, total thoracic drainage, extubation time, postoperative complications and postoperative pain of the two groups were compared and analyzed. Results A total of 58 patients were included, including 19 males and 39 females, aged 31-79 years. There were 21 patients in the three-port group, and 37 patients in the four-port group. The visual analogue scores on the first and third day after the operation were 4.33±1.20 points and 2.24±0.77 points in the three-port group, and 5.11±1.22 points and 2.78±1.06 points in the four-port group, and there were statistical differences between the two groups (P<0.05). There was no significant difference between the two groups in terms of operation time, intraoperative bleeding, lymph node dissection, postoperative thoracic drainage, time of thoracic tube insertion or postoperative complications (P>0.05). Conclusion Three-port Da Vinci robot-assisted radical resection of lung cancer can reduce the postoperative pain without increasing the operation difficulty and complications, and can be widely used in the clinical practice.
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Objective:To observe the clinical effectiveness of manual therapy based on posture decoding for patients with lower crossed syndrome (LCS).Methods:Thirty-six LCS patients were randomly divided into an observation group and a control group, each of 18. The observation group received manual therapy based on posture decoding, while the control group was treated with proprioceptive neuromuscular facilitation (PNF), both in 20min sessions, once a week for 4 weeks. Before the experiment, after one, two and four weeks of treatment and followed-up 4 and 8 weeks later, both groups were evaluated using a visual analogue scale (VAS), the Oswestry Disability Index (ODI) and finger-floor distance (FFD). Anterior pelvic tilt angles (ASIS-PSISs), sacral slopes (SS), lumbar curve index (LCI) and surface EMG flexion-relaxation ratios (FRRs) were also recorded from both groups before and after the treatment.Results:After one and four weeks of the treatment, the average VAS, ODI, and FFD had decreased significantly in both groups, with all significantly lower in the observation group, on average. At the final follow-up, the average VAS and ODI scores of both groups were significantly lower than before the treatment, with those of the observation group significantly lower than the control group′s averages. After 4 weeks of treatment significant differences were observed also in the group′s average ASIS-PSISs, SSs and LCIs compared with before the treatment. And right after the treatment the left and right surface electromyography FRRs of the observation group were significantly higher than those of the control group.Conclusion:Manual therapy based on posture decoding can significantly improve the pelvis forward angle and lumbar motion of LCS patients, relieving back pain and relaxing back muscles.
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We report the diagnosis and treatment of a case of reversible cerebral vasoconstriction syndrome characterized by postpartum thunderclap headache. The patient experienced a thunderclap headache on the second day after delivery, which gradually worsened. On postpartum day 4, she presented with sudden convulsion and hypertension on admission on May 19, 2020, and was initially diagnosed with postpartum eclampsia. We confirmed the diagnosis of reversible cerebral vasoconstriction syndrome based on the results of cranial magnetic resonance angiography (MRA) and other examinations and the consultation with neurologists. After antihypertensive and spasmolytic treatment, the patient's blood pressure returned to normal, and she was discharged on postpartum day 8. Reexamination with cranial MRA at 50 + days after delivery indicated that the cerebral vasospasm was relieved. No severe headaches or convulsions were observed during follow-up till June 2021.
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Objective:To summarize the clinical experience of treating patients with severe acute organic fluorine poisoning using extracorporeal membrane oxygenation (ECMO).Methods:In January 2021, an acute mass organic fluorine gas poisoning incident occurred in Quzhou, Zhejiang Province. The clinical data of 4 severe patients with acute poisoning of organic fluorine treated by ECMO in our hospital were retrospectively analyzed, and the epidemiological characteristics, clinical symptoms, signs, the abnormal laboratory studies/examinations, and treatments of this kind poisoning patients, especially, the treatment pattern, support time, complications, and outcomes of ECMO were collected and analyzed.Results:All the 4 patients were male, with an average age of (52±9) years, and all of them came to the emergency department complaining chest tightness, cough and pharyngeal discomfort 6 h after exposure by inhalation. The patient’s condition progressed rapidly with severe acute respiratory failure and circulatory failure as the prominent manifestations. The mechanical ventilations were performed (13.0±4.8) h after poisoning, and ECMO treatment was performed (15.5±5.3) h after poisoning. Among them, 2 patients were treated using venoarterial (VA) ECMO, and 2 patients using venovenous (VV) ECMO, but 1 patient was converted to VA-ECMO 8 h later. The duration of ECMO support for the patients was (8.8±3.6) d. The duration of mechanical ventilation was (23.0±28.7) d and stay in intensive care unit was (42.0±55.4) d. Among them, one patient was transferred to a specialized rehabilitation hospital after the amputation surgery due to lower limb necrosis after VA-ECMO support, and the remaining 3 patients were discharged after recovery.Conclusions:ECMO support might have the irreplaceable value in the treatment of patients with severe acute organic fluorine poisoning, and should be considered as one of the reserves of regional health care system in dealing with public health emergencies.
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Objective:To explore the differential diagnosis and different treatment methods of chylothorax and pseudochylothorax after lung cancer surgery.Methods:Clinical data of 1 584 surgical patients with non-small cell lung cancer from January 2016 to December 2021 were analyzed, 21 cases of chylothorax and 8 cases of pseudochylothorax were identified and analyzed to compare the differences in pleural fluid chyle test, pleural effusion biochemical values, total cholesterol, triglycerides, total cholesterol/triglyceride ratio, leukocyte count, bacterial culture and treatment.Results:The incidence of chylothorax after lung cancer surgery was 1.3%, and the incidence of pseudochylothorax was 0.5%; 80.9%% of chylothorax on the right side was significantly higher than 19.1% of chylothorax on the left side, and the difference was statistically significant( P<0.05). Pseudochylothorax occurred on the right side(100%). The difference between chylothorax and pseudochylothorax in pleural fluid tests for cholesterol and triglyceride was statistically significant( P<0.05), the leukocyte count was significantly higher in pseudochylothorax than chylothorax, and the difference was statistically significant( P<0.05). The differences in drainage before treatment, postoperative drainage time and postoperative hospitalization time between the two groups were statistically significant( P<0.05). The success rate was 61.9% in 13 cases of chylothorax treated conservatively and 38.1% in 8 cases of thoracic duct clamping; all cases of pseudochylothorax were treated conservatively with a success rate of 100%. Conclusion:In naddition to pleural fluid chyle test and pleural effusion biochemical values, total cholesterol, triglyceride and total cholesterol to triglyceride ratio in pleural fluid should be tested to identify chylothorax and pseudochylothorax, high triglyceride in pleural fluid diagnosed as chylothorax; Pseudochylothorax is diagnosed with a cholesterol/triglyceride ratio >1 in the pleural fluid, pseudochylothorax is usually treated conservatively. Chylothorax is treated conservatively and surgically according to different conditions. If the drainage flow is greater than 800 ml/day for 3 consecutive days or if it causes serious electrolyte disorders, it is recommended to perform thoracoscopic-assisted thoracic duct clamping via right-sided approach.
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Objective: To observe the clinical efficacy of umbilical therapy with herbal cakes made of Ge Gen Qin Lian Tang prescription of different dosages in treating damp-heat diarrhea in young children. Methods: Seventy-two kids with diarrhea of damp-heat pattern were recruited and divided into a high-dosage group and a low-dosage group using the random number table method, with 36 cases in each group. They all received conventional antidiarrheal treatment and umbilical application with herbal cakes. However, the herbal cakes for the high-dosage group were made of the mixture of Ge Gen Qin Lian Tang powder and water, and those for the low-dosage group consisted of 10％ Ge Gen Qin Lian Tang powder and 90％ auxiliary materials (corn starch) plus water. The treatment duration was 3 d. The clinical efficacy, antidiarrheal rate, effective rate for symptoms and signs of traditional Chinese medicine (TCM), TCM symptoms score, and safety indicators were compared between the two groups. Results: After the treatment, the TCM symptoms scores dropped significantly in both groups (P<0.01) and were lower in the high-dosage group than in the low-dosage group (P<0.05). The clinical efficacy was more significant in the high-dosage group than in the low-dosage group after the treatment, and the between-group difference was statistically significant (P<0.05); the antidiarrheal rate was markedly higher in the high-dosage group than in the low-dosage group (P<0.05). Regarding the TCM symptoms and signs, the high-dosage group showed better results in improving the greasy and yellowish tongue coating, bowel movement frequency, watery excrement, short and dark urine, red tongue body, red anus, vomiting, bowel sounds, and abdominal bloating compared with the low-dosage group, and the between-group differences were statistically significant (P<0.01). Conclusion: Umbilical therapy with herbal cakes made of Ge Gen Qin Lian Tang is safe, reliable, and effective in treating damp-heat diarrhea in young children; the high-dosage herbal cakes produce more significant efficacy than the low-dosage ones and are worth further investigation.
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@#As an emerging technology, artificial intelligence (AI) uses human theory and technology for robots to study, develop, learn and identify human technologies. Thoracic surgeons should be aware of new opportunities that may affect their daily practice by the direct use of AI technology, or indirect use in the relevant medical fields (radiology, pathology, and respiratory medicine). The purpose of this paper is to review the application status and future development of AI associated with thoracic surgery, diagnosis of AI-related lung cancer, prognosis-assisted decision-making programs and robotic surgery. While AI technology has made rapid progress in many areas, the medical industry only accounts for a small part of AI use, and AI technology is gradually becoming widespread in the diagnosis, treatment, rehabilitation, and care of diseases. The future of AI is bright and full of innovative perspectives. The field of thoracic surgery has conducted valuable exploration and practice on AI, and will receive more and more influence and promotion from AI.
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Objective:To meet the demand of medical system for talents, the training of medical students' competency has become a new direction of medical education. This study aims to evaluate the effectiveness of training quality in medical graduates through the competency scale.Methods:Taking "attitude", "skill" and "knowledge" as the evaluation dimensions, the competency development was divided into four levels of "state", "explain", "apply" and "transfer", and we proposed the competence concept of "A.S.K.-SEAT" and formulated an evaluation scale. Questionnaires and behavior event interviews (BEI) were conducted in medical graduates of Shantou University in 2018. Reliability and validity of the questionnaire were evaluated and current situation of different competency items were analyzed.Results:A total of 155 questionnaires were collected with good reliability and validity, and 15 graduates participated in BEI. A total of 21 A.S.K. competency items (including five basic competency items and two discriminating competency items) and SEAT textual descriptions were finally established.Conclusion:A.S.K.-SEAT scale can provide valid references for the competency evaluation of medical graduates.
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Objective@#This epidemiology survey is intended to assess the periodontal health conditions of 12 to 15-year-old adolescents and the associated factors in Shenzhen.@*Methods@#The study utilized a multistage stratified cluster method and recruited 5 509 middle school students aged 12 to 15. Gingival bleeding and calculus were conducted and a self-reported questionnaire was administered. Additional periodontal pocket depth and attachment loss examination were performed in the 15-year-age group. Periodontal conditions and the associated factors were analyzed by t-test, Chi-square method and Logistic regression.@*Results@#The prevalence of gingival bleeding and calculus among adolescents was 43.95% and 44.25%, and the prevalence of periodontal pockets ≤3 mm was 0.57%. No periodontal pockets ≥6 mm or attachment loss ≥4 mm were detected. Gender, family income and frequency of teeth brushing were significantly associated with calculus detection (P＜0.05). The use of fluoride had an significant effect on gingival bleeding detection and calculus detection (χ 2=9.70，6.16，P＜0.05).@*Conclusion@#The periodontal health condition among 12-15 years old adolescents in Shenzhen is generally better than the national level. Adolescents living in high-economic districts and females had better periodontal health condition. The government can promote health education in schools and popularize the use of fluoride to improve the periodontal health condition among adolescents.
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Objective:To investigate the relationship between adenosine diphosphate (ADP) pathway-induced platelet dysfunction monitoring by thrombelastography with hospital mortality in patients with traumatic brain injury.Methods:The clinical data of 180 patients with traumatic brain injury in Zhejiang Quhua Hospital from January 2016 to December 2018 were retrospectively analyzed. The patients underwent thrombelastography examination. Among them, the ADP pathway-induced platelet inhibition rate (ADP inhibition rate) ≤ 60% was in 74 cases (non-ADP dysfunction group), and ADP inhibition rate > 60% was in 106 cases (ADP dysfunction group). Multiple Logistic regression analysis was used to analyze the independent influencing factors of patients′ hospital mortality. Logistic regression model was used to analyze the threshold of ADP inhibition rate to predict hospital mortality.Results:There were no statistical differences in the gender composition, age, prothrombin time, international standardized ratio, activated partial thromboplastin time, platelet count, systolic blood pressure, pulse, admission to thrombelastography examination time, Glasgow coma score, trauma severity score, simple trauma grading criteria and using of antiplatelet drugs before admission between 2 groups ( P>0.05). The intubation rate and in-hospital mortality in ADP dysfunction group were significantly higher than those in non-ADP dysfunction group: 69.8% (74/106) vs. 37.8% (28/74) and 32.1% (34/106) vs. 8.1% (6/74), and there were statistical differences ( P<0.01 or <0.05). The maximum amplitude and G value in ADP dysfunction group were significantly lower than those in non-ADP dysfunction group: (61 ± 9) mm vs. (65 ± 6) mm and (9 ± 4) kD/cm2 vs. (11 ± 3) kD/cm2, the ADP inhibition rate and arachidonic acid pathway-induced platelet inhibition rate were significantly higher than those in non-ADP dysfunction group: (76 ± 22)% vs. (45 ± 18)% and (75 ± 28)% vs. (35 ± 22)%, and there were statistical differences ( P<0.05). There were no statistical difference in the reaction time, blood clot formation time and angle between 2 groups ( P>0.05). Multiple Logistic regression analysis result showed that ADP inhibition rate >60% and trauma severity score were independent predictors of increased hospital mortality in patients with traumatic brain injury ( OR = 6.21 and 1.13, 95% CI 1.21 to 31.27 and 1.05 to 1.22, P<0.05). Logistic regression model analysis result showed that ADP inhibition rate >60% was the threshold for predicting the hospital mortality rate ( OR = 6.18, 95% CI 1.2 to 33.3). Conclusions:ADP inhibition rate of thrombelastography is related to the hospital mortality in patients with traumatic brain injury.
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Objective@#To improve the structure of current bronchoscopy specialized wagons, enhance the care efficiency and improve care experience.@*Methods@#Use the bronchoscopy specialized wagons in bronchoscope room from 3rd of January to 1st of June 2018 as control group. Use the bronchoscopy specialized wagons in bronchoscope room from 5 th June to 3rd November 2018 as the test group. Test group adopted the national patent, new bronchoscopy specialized wagons and control group with the general treatment wheel.@*Results@#The operation time of the test group was (14.25±0.45) seconds, lower than that of in the control group (47.99±1.84) seconds, the difference was significant (t=1.542, P<0.05). The operation trouble of the test group was 0, lower than that of in the control group (5.37±0.72) times, the difference was significant (t=4.917, P <0.05). Intake capacity of the test group was (107.70±15.18), higher than that of in the control group (48.17±6.93), the difference was significant (t=3.191, P <0.05).@*Conclusions@#The use of the new bronchoscopy specialized wagons can reduce operation time, greatly improve working efficiency. It is worthy to be applied in future.
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Objective@#To explore the nursing experience of a child with multiple organ dysfunction syndrome caused by physical abuse and severe soft tissue injury.@*Methods@#In this case, multiple soft tissue injuries and multiple organ dysfunction syndrome were caused by domestic violence abuse. Nursing included strengthening artificial airway nursing, continuous blood purification nursing, skin injury nursing, sedation and analgesia management, nutritional support nursing, psychological nursing and family education.@*Results@#After careful treatment and nursing, the child′s condition improved and was transferred to the general ward for further treatment and discharged.@*Conclusions@#The nursing of multiple soft tissue injuries and multiple organ dysfunction syndrome includes strengthening artificial airway nursing, continuous blood purification nursing, skin injury nursing, sedation and analgesia management, nutritional support nursing, psychological nursing and family education.
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Objective To improve the structure of current bronchoscopy specialized wagons, enhance the care efficiency and improve care experience. Methods Use the bronchoscopy specialized wagons in bronchoscope room from 3rd of January to 1st of June 2018 as control group. Use the bronchoscopy specialized wagons in bronchoscope room from 5 th June to 3rd November 2018 as the test group. Test group adopted the national patent, new bronchoscopy specialized wagons and control group with the general treatment wheel. Results The operation time of the test group was (14.25 ± 0.45) seconds, lower than that of in the control group (47.99±1.84) seconds, the difference was significant (t=1.542, P<0.05). The operation trouble of the test group was 0, lower than that of in the control group (5.37± 0.72) times, the difference was significant (t=4.917, P <0.05). Intake capacity of the test group was (107.70±15.18), higher than that of in the control group (48.17±6.93), the difference was significant (t=3.191,P <0.05). Conclusions The use of the new bronchoscopy specialized wagons can reduce operation time, greatly improve working efficiency. It is worthy to be applied in future.
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Objective@#By comparing the clinical characteristics of patulous Eustachian tube with habitual nasal extraction and those of non-Eustachian tube abnormalities, we aimed to investigate the relationship between patulous Eustachian tube and acquired cholesteatoma of middle ear.@*Methods@#A total of 218 patients in Affiliated Hospital of Qingdao University from November 2011 to November 2016 who underwent surgical treatment and with complete data of acquired cholesteatoma of middle ear were enrolled. The patients were divided into two groups: patulous Eustachian tube with habitual nasal extraction and non-Patulous Eustachian tube. Their ages of onset , sides, characteristics of acoustic immitance, clinical manifestations, prognosis and complications were compared. The statistical analysis was carried out with SPSS 19.0 software.@*Results@#Among the 218 cases of acquired cholesteatoma of the middle ear, 22 cases were diagnosed as patulous Eustachian tube with habitual nasal extraction [with average age of (35.7±7.5) years]; 196 cases were diagnosed as non-patulous Eustachian tube [with average age of (47.8±20.1) years]. The average age of the patulous Eustachian tube with habitual nasal extraction was significantly lower than that of the non-patulous Eustachian tube group (t=4.25, P<0.01). Ratio of bilateral middle ear cholesteatoma in patulous Eustachian tube [68.2%(15/22)] was significantly higher than that of the non-patulous Eustachian tube group [18.9%(37/196)] (χ2=26.47, P<0.01).@*Conclusions@#Some acquired cholesteatoma patients are associated with the patulous Eustachian tube with habitual nasal extraction. The patients have a lower age, and are susceptible for bilateral middle ear cholesteatoma.
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Objective@#To summarize and explore the clinical effect and application of L-shaped flap pedicled with peroneal artery perforator in the treatment of unhealed lateral L-shaped incision after calcaneal fractures.@*Methods@#From October 2013 to March 2015, 17 patients with unhealed L-shaped incision after calcaneal fractures were treated with one-stage thorough debridement, artificial bone filling with antibiotics-laden calcium sulphate and L-shaped flap pedicled with peroneal artery. Flap areas ranged from 8 cm × 2 cm to 11 cm × 3 cm. Donor sites are primarily sutured.@*Results@#All 17 patients were followed up for 6 to 18 months with an average of 11.5 months. All patients with infection were cured effectively, demonstrating well survived flaps with normal elasticity and pigmentation, no scar contracture, satisfactory appearance and normal ankle joint motility.@*Conclusions@#L-shaped flap pedicled with peroneal artery perforator was an effective method in the treatment of unhealed lateral L-shaped incision after calcaneal fractures. It was suitable for coverage of the unhealed wound and worthy of being popularized.
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Objective To access the effects of 70 kV tube voltage combined with low dose and low concentration of contrast medium in coronary CT angiography (CCTA)by evaluating the image quality,radiation dose and contrast medium dosage.Methods Ninety patients suspected with coronary artery disease with body mass index(BMI)of less than 25 kg/m2and heart rate (HR)of less than 75 beats per minute were enrolled.The patients were randomly divided into three groups (n=30 for each group):Group A,100 kV of tube voltage with 370 mg I/mL iopromide,1 mL/kg;Group B,80 kV with 270 mg I/mL iodixanol,1 mL/kg;Group C,70 kV with 270 mg I/mL iodixanol,0.8 mL/kg.All the patients underwent CCTA with a 256 row wide-coverage volumetric CT.Automatic tube current modulation technique was applied.The images were reconstructed by adaptive statistical iterative reconstruction V (ASIR-V).The subjective image quality scores were compared with rank-sum test.The signal-to-noise ratio (SNR),contrast-to-noise ratio(CNR),effective dose(ED)and the total iodine intake were calculated and compared with one-way ANOVA.Results No statistically differences in age,gender,heart rate and BMI were observed among the three groups (P>0.05).Subjective image quality scores had no difference among the three groups (P>0.05).The CT values of group C were higher than those of group A(P<0.05).The image noise of group C was higher than that of group A and group B (P<0.05).No significant differences in SNR and CNR were noticed among the three groups (P>0.05).The ED of group B (0.39±0.08)mSv and group C (0.19±0.01)mSv were lower than that of group A (0.81±0.19)mSv (each P<0.05).Compared with group A,the decrease rates of ED of group B and C were 51.8% and 76.5% respectively.Compared with group A and group B,the total iodine intake of group C was decreased by 25% and 21.4% (P<0.05).Conclusion 70 kV of tube voltage combined with low dose and low concentration of contrast medium in CCTA can reduce the radiation dose and iodine intake without compromising image quality.
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Objective To investigate the expression of HSPA9 in hepatocellular carcinoma(HCC) and its relationship with clinicopathological features and prognosis.Methods Forty-nine cases HCC treated by operative resection and follow up data in our hospital from January 2006 to January 2010 were retrospectively analyzed.Immunohistochemistry was performed to determine the expression of HSPA9 in HCC and paratumor tissues.The relationship between HSPA9 expression and clinicopathological features and prognosis was statistically analyzed.Results The HSPA9 protein expression in tumor tissue was higher that that in the paratumor tissue(t=6.601,P＜0.01),moreover the over expression of HSPA9 was significantly correlated with lymph node metastasis (P =0.005),TNM-stage(P =0.015),tumor differentiation (P =0.033),microvascular invasion (P =0.009) and recurrence (P =0.047).In the survival analysis results,the patients with over expression of HSPA9 had a much lower total survival rate(P=0.002)and much higher postoperative cumulative recurrence rate(P =0.003).There were significant differences in TNM-stage,microvascular invasion,lymph node metastasis,tumor differentiation and HSPA9 staining for overall survival and cumulative recurrence rate based on a univariate analysis(P＜0.05).Conclusion HSPA9 has over expression in HCC.The over expression of HS-PA9 is closely related to invasion and metastasis pathological features and can serve as an independent prognostic risk factor for predicting the prognosis of HCC.