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Due to the limitations professional status and training channels, the training of pediatric imaging talents in China is seriously insufficient. Pediatric imaging doctors are concentrated in children's hospitals. Pediatric imaging knowledge and talents in primary medical institutions are scarce, which is not conducive to the construction of hierarchical diagnosis and treatment system. Large-scale telemedicine and online medical treatment based on mobile Internet have become the mainstream platforms for medical consultation and teaching, providing a good opportunity for remote teaching of pediatric imaging, and are expected to become a powerful tool for training pediatric imaging talents. The analysis of literature, mobile phone application market software and cost-effectiveness shows that the current large-scale telemedicine construction cycle is long, the construction and maintenance costs are high, and it is vulnerable to geographical and environmental constraints. It is still a long way to go for remote teaching in hospitals below the county level. The use of mobile terminals and mobile Internet is very convenient. It is an excellent choice to realize the remote teaching of pediatric imaging. It is expected to solve the problem of pediatric imaging talent training and skill dissemination.
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Objective:To investigate clinicopathological and magnetic resonance imaging (MRI) characteristics of pediatric cardiac tumors.Methods:The clinical, pathological and MRI data of 7 patients with pediatric cardiac tumors confirmed by pathological examination in Children's Hospital of Chongqing Medical University from February 2012 to December 2016 were retrospectively analyzed.Results:There were 3 males and 4 females with first diagnosis age ranging from 1 month to 3 years. As for clinical presentation, most cases were featured with cardiac murmur and enlarged cardiac boundary; only 1 case had acute cerebral infarction, and 1 case did not show any abnormal performance. Pathological findings showed that 6 cases of benign tumors (including 2 cases of fibroma, 1 case of rhabdomyoma, 1 case of myxoma, 1 case of lipoma and 1 case of hemangioma), 1 case of malignant tumor (primitive neuroectodermal tumor of pericardium). MRI results showed that the signal intensity of malignant tumor was higher than that of normal myocardium in each sequence; significant differences were found in benign tumors; first-pass perfusion, cardiac cine image and late gadolinium enhancement were the most obvious.Conclusions:The clinical presentations of pediatric cardiac neoplasms are atypical. Each tumor type has pathognomonic pathological features. MRI has great advantages in the diagnosis and differential diagnosis of cardiac tumors especially for benign tumors.
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Objective To explore the effect of 4R crisis management theory on reducing urinary tract infections in Department of Urology severe craniocerebral injury. Methods A randomized controlled clinical trial was conducted. From January 2018 to January 2019, 92 patients with indwelling urinary catheter were selected as the study subjects in the Department of Urology, Jiangsu People's Hospital. The control group was given routine nursing of indwelling catheter, while the observation group was given nursing of indwelling catheter with 4R crisis management theory on the basis of the control group. The incidence of catheter-associated urinary tract infections (CAUTI), the occurrence time of CAUTI, the days of indwelling catheter, the days of hospitalization and the urine culture bacteria were observed. Results The incidence of CAUTI, occurrence time and days of indwelling catheter in the observation group were 8.70% (4/46), (12.417 ± 3.542) d, 5 (3,12), while those in the control group were 30.43% (14/46), (9.762 ± 2.874) d, 9 (4,21). There were significant differences in CAUTI incidence, occurrence time and days of indwelling catheter between the two groups ( χ2=7.168,t=5.838,Z=5.192,P<0.01 or 0.05); there was no significant difference in hospitalization days between the two groups ( P >0.05). Seven pathogenic bacteria were detected in urine culture of control group and three pathogenic bacteria were detected in observation group. The number of pathogenic bacteria in observation group was less than that in control group. Conlousion 4R crisis management theory can effectively reduce the incidence of CAUTI, delay the occurrence of CAUTI, shorten the days of indwelling catheter, and reduce the pathogenic bacteria in urine culture, which is worthy of clinical application.
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Objective@#To explore the effect of 4R crisis management theory on reducing urinary tract infections in Department of Urology severe craniocerebral injury.@*Methods@#A randomized controlled clinical trial was conducted. From January 2018 to January 2019, 92 patients with indwelling urinary catheter were selected as the study subjects in the Department of Urology, Jiangsu People's Hospital. The control group was given routine nursing of indwelling catheter, while the observation group was given nursing of indwelling catheter with 4R crisis management theory on the basis of the control group. The incidence of catheter-associated urinary tract infections (CAUTI), the occurrence time of CAUTI, the days of indwelling catheter, the days of hospitalization and the urine culture bacteria were observed.@*Results@#The incidence of CAUTI, occurrence time and days of indwelling catheter in the observation group were 8.70% (4/46), (12.417 ± 3.542) d, 5 (3, 12), while those in the control group were 30.43% (14/46), (9.762 ± 2.874) d, 9 (4, 21). There were significant differences in CAUTI incidence, occurrence time and days of indwelling catheter between the two groups (χ2=7.168, t=5.838, Z=5.192, P < 0.01 or 0.05); there was no significant difference in hospitalization days between the two groups (P > 0.05). Seven pathogenic bacteria were detected in urine culture of control group and three pathogenic bacteria were detected in observation group. The number of pathogenic bacteria in observation group was less than that in control group.@*Conlousion@#4R crisis management theory can effectively reduce the incidence of CAUTI, delay the occurrence of CAUTI, shorten the days of indwelling catheter, and reduce the pathogenic bacteria in urine culture, which is worthy of clinical application.
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Objective To detect molecular subtypes of medulloblastoma, and its correlation with prognosis. Methods Surgically treated 32 cases of primary medulloblastoma from 2010-2013 were collected, the molecular subtypes were determined by immunohistochemical detection of GAB1 and YAP1 protein in the sample. Clinical characteristics, imaging features and survival condition of different molecular subtypes were analyzed. Results Molecular typing of the 32 cases (21 males and 11 females) shows 4 (12.5%) cases of SHH, 7 (21.9%) cases of WNT and 21 (65.6%) cases of non-SHH. There was no significant correlation of molecular subtypes with age, gender and pathological classification. Three-year progression free survival rate in SHH, WNT and non-SHH/WNT subtypes were 75%, 57.1% and 38.1%, respectively. Three-year progression free survival rate was significantly higher in patients under 3 years old group than that in patients over 3 years old group in non SHH/WNT (P=0.047). Conclusions The prognosis of SHH was better than WNT, WNT was better than non-SHH/WNT type, prognosis in patients under 3 years old group of non-SHH/WNT was better than that in patients over 3 years old group.
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Objective To explore the value of magnetic resonance imaging(MRI)in staging diagnosis of posterior fossa tumor in children. Methods The MRI features of low and high grade tumor for posterior fossa brain tumors confirmed by pathology in 19 children treated in Children's Hospital of Chongqing Medical University from January 2012 to December 2013 were retrospectively reviewed. The measurement of gross tumor volume, the ratio of solid component, the rate of brain edema and the tumor cystic degeneration rate were studied with statistical analysis, all datum were classified according to the World Health Organization (WHO) central nervous system tumor classification criteria. Results There were 5 cases in cerebellum and 4 cases in four ventricle in the low grade tumor group;there were 6 cases in four ventricle and 4 cases in cauda cerebelli in the high grade tumor group. Combined obstructive hydrocephalus: the low grade tumor group had 8 cases(8/9), the high grade tumor group had 10 cases (10/10). The gross tumor volume: (51.2±3.2) mm3for the low grade tumor group, (31.9±1.8) mm3for the high tumor group, there was significantly statistical difference (t= 2.591, P = 0.019). The ratio of solid components: 41.7 % for the low grade tumor group, 66.1 % for the high tumor group, there was also significantly statistical difference (χ 2= 6.52, P < 0.05). Combined the edema around brain parenchyma: the low grade tumor group had 4 cases(4/9), the high grade tumor group had 4 cases (4/10), there was no statistical difference (χ2= 2.591, P = 0.274). The tumor cystic degeneration: the low grade tumor group had 9 cases (9/9), the high grade tumor group had 4 cases (4/10), there was no statistical difference (χ2= 0.052, P = 0.819). Conclusions MRI has high clinical application values in staging diagnosis of posterior fossa brain tumor in children. It can provide the basis for clinical operation plan.
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Objective To compare the value of fractional anisotropy(FA)of MR diffusion tensor imaging(DTI) and Glasgow coma scale(GCS) at admission for judging the injury severity and prognosis of diffuse axonal injury (DAI). Methods Thirty-four patients with DAI adopted the GCS score to evaluate the conscious disturbance levels at admission and conducted the DTI examination within 2 weeks. Twenty-three individuals undergoing healthy physical examination conducted the DTI examination. The FA values of visuality lesion area in various sites,healthy side symmetric site and cerebral midline site were measured. The reduction degree of mean FA value at midline site and visuality lesions were measured. The correlation between GCS score,mean FA value reduction degree in visuality lesions and mean FA value at cerebral midline site with consciousness disorder time and recovery degree in half a year after injury was analyzed. Results The reduction degree of mean FA value at cerebral midline site was significantly correlated with consciousness disorder time and recovery degree in half a year after injury(r= 0. 519,P=0. 002; r= 0. 669, P=0. 000) ;the mean FA value reduction degree in visuality lesions and GCS score had low or weak correlation with consciousness dis order time and recovery degree in half a year after injury(r=0. 285,P=0. 103;r=0. 487,P=0. 003;r= -0. 241,P=0. 169;r=-0. 229,P=0. 192). The correlation between mean FA reduction degree in cerebral midline site and mean FA value reduction degree in visuality lesions with the recovery degree in a half years after injury was higher than that in GCS score. Conclusion DTI is a sensitive sequence for diagnosing DAI and has much more value for judging the injury degree and prognosis than the GCS score generally adopted by clinic.
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Objective To study the assisted diagnostic value and significance in precise surgery of MSCT angiography in torsion of ovar-ian tumors in children. Methods The dual-phase enhanced MSCT images data of 15 children patients with ovarian tumor torsion which were confirmed by surgery were retrospectively analyzed. Showed the vascular changes around the ovaries and judged the ovarian tumors arise and torsion side with the vascular reconstruction methods of multi-planar reconstruction (MPR),maximum intensity projection (MIP),volume rendering ( VR) ,then compared with the operation situation. Results Among the 15 cases aged from 2 months to 11 years old who were de-tected with MSCT scanning and angiography, there were 11 cases of benign tumor (9 cases of ovarian teratoma and 2 cases of serous cystade-noma) and 4 cases of malignant tumor (3 cases of yolk sac tumor and 1 case of malignant mixed germ cell tumor). MSCTA displayed that o-varian vessels changes were abnormal thickening and twisting of distal feeding artery and tumor vascular network formation;and there were thickening, tortuosity, increased density and a few visible‘whirl sign’ in draining veins. Preoperative MSCTA displayed ovarian tumor blood supply arteries were found 5 cases of downlink of ovarian artery and 10 cases of asscending branches of uterine artery. There were 4 cases of ovarian tumor originated from the left ovary combined with reverse and 11 cases originated from the right ovary combined with reverse, which were consistent with intraoperative findings. Intraoperative MSCTA provide information which helped accurate chose of the surgical incision, precise abruption of tumor blood vessels and resection of the tumor and ovarian lesions, thus saved the operation time and reduced the blood loss. Conclusion MSCT angiography can not only provide diagnosis information of torsion of ovarian tumors in children,but also more impor-tantly,it has an important assisted significance in precision surgery.
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According to the characteristics of postgraduates of clinical medicine and features of radiology and based on traditional teaching, picture archiving and communicating system (PACS), tutorial system, lecture and modernized tests with the help of problem-based learning (PBL) were ap-plied so that the effect of students' rotation internship was improved.
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Objective To perform the bibliometric research on the literatures of the endoscopic retrograde cholangio pancreatog-raphy(ERCP) in the last ten years to provide reference for accurately grasping the international research situation and selecting the cutting-edge technological topics .Methods The literatures of ERCP in the database Web of Science from 2001 to 2011 were collect-ed .The CiteSpace software was adopted to analyze the distribution characteristics ,key point literature ,hotspots fields and research frontier of articles of ERCP .Results 2 921 citations of the research articles were retrieved .The analysis showed that America was strongest in the ERCP research field ;10 key point articles were detected .The high frequency keywords were complications ,manage-ment ,sphincterotomy ,etc .,the concentricity ranged 0 .06-0 .24 .The high frequency burst words were gold standard ,procedure-re-lated-complications ,biliary-stents ,but the concentricity was 0 .Conclusion The research hotspots of ERCP field are the occurrence rate of ERCP postoperative complications ,diagnosis and treatment ,but no obvious research cutting-edge is formed .
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ObjectiveTo determine the role of low-field magnetic resonance angiography(MRA) in diagnosis of intracranial artery steno-occlusive disease in patients with cerebral infarction.Methods67 cases with cerebral infarction were given low-field MRA and DSA examination.Results62 cases of cerebral infarction MRA diagnosis and DSA agree,diagnostic accuracy was 92.5％.ConclusionLow-field MRA has a good reliability in diagnosis of intracranial artery steno-occlusive disease with the advantages of safe,reliable and convenient,can provide effective instruction for treatment of cerebral infarction.
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According to the characteristics of pediatric resident training, the situation in clinic practice of medical imageology are analyzed and the major problems are pointed out.This article empha sizes significance of standardized resident training of medical imageology, presents detailed requirement which the residents must meet and aims to improve the training effect by the solutions summarized after years of experience.
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Objective To determine the proportion and the clinical value of the thymus extending superiorly into the lower neck in children.Methods The MR images of 400 normal children were retrospectively reviewed.According to the childhood staging criteria.all children were divided into four groups:the infancy and toddlerhood group(0-3 yo,42),the pre-school age group(>3-6 yo,87),the school age group(>6-12 yo,168),and the adolescence group(>12-18 yo,103).The presence or absence of the superior extension of the thymus above the manubrium Was determined on sagittal T2-weighted images.If so,the distance between manubrium and thymic apex was measured.The associations between frequency of ccrvicaI extension and age and sex were evaluated using correlation analysis.Results Superior extension of the thymus was detected in 288(288/400,72.0%)children,with 39(39/42,92.9%)in the infancy and toddlerhood group,72(72/87,82.8%)in the pre-school age group,118(118/168,70.0%)in the school age group,and 59(59/103)in the adolescence group(57.3%).There Was a statistically significant relationship between age group and frequency of cervical extension of the thymus (X2=4.9684,P0.05).Conclusions Cervical extension of the thymus occurs in the majority of children,and should be considered as a normal finding.Through recognizing this finding,doctors can avoid misdiagnosing it as a pathologic mass.
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Objective To study the characters of using the high pressure injector in the contrast CT scanning for children. Methods Summarized the nursing measures of 407 children who had accepted the contrast CT scanning. Results There were 369 children have obtained perfect effects of CT scanning, 35 children have obtained general effects and there were 2 children failure. Conclusion The method of using high pressure injector in the contrast CT scanning for children is convenient, safety and effective.
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To study the mode of practice teaching in medical imageology,140 students from pediatric department and medical imageology department were surveyed.The results showed that the problem of out-of-date teaching mode existed in both departments,and the differences between pediatric and medical imageology department were that the latter have a more intensive need for more disease entity and such advanced contents as CT and MRI.In this paper,the causes of the problems mentioned above were analyzed and related strategies were put forward.
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With the progress of the medical imaging technology,imaging medicine plays an essential role in medical treatment practice,primarily including the imaging equipment and personnel cultivation。This paper presents some opinions on how to combine imaging technology with personnel and bring modern imaging medicine into full play. Imaging medicine progress is also changing our thought on the diagnosis and treatment,and we should accept new technology and adopt new idea,so as to bring many patients new hope.
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According to the characteristics of pediatric specialty,the teaching content of medical imageology was adjusted and optimized by blending with pediatric imaging.The purpose of the present study was to elevate the teaching efficiency and to cultivate medical talents with characteristics of pediatric specialty.
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<p><b>OBJECTIVE</b>To study the expression of vascular endothelial growth factor (VEGF) and transcription factor E26 transformation-specific-1 (ETS-1) in breast carcinoma and its effect on angiogenesis, tumor invasion and metastasis.</p><p><b>METHODS</b>In situ hybridization and immunohistochemistry (streptomycin avidin-biotin-peroxidase complex, SP) were used to detect the mRNA and protein expression of VEGF and ETS-1 in breast carcinoma.</p><p><b>RESULTS</b>VEGF mRNA and its protein were highly expressed in tumor cells of breast carcinoma. The positive rate was 75% (36/48) and 70.8% (34/48) respectively. There was almost no expression of VEGF in vascular endothelial cells. Over expression of ETS-1 was seen in both breast carcinoma and endothelial cells. The positive rate of ETS-1 mRNA and protein in carcinoma cells was 85.4% (41/48) and 79.2% (38/48) respectively. The microvessel density was significantly higher in VEGF and ETS-1 highly expressed groups than that in the low expressed groups (P < 0.01). Both VEGF and ETS-1 expressions were well correlated with the histological grade and lymph node metastasis.</p><p><b>CONCLUSIONS</b>VEGF and ETS-1 can promote angiogenesis in breast carcinoma and correlate with tumor invasion and lymph node metastasis. The expression of VEGF and ETS-1 might be considered to be a reference indicator for determining the angiogenesis and invasion of breast carcinoma.</p>
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Humanos , Neoplasias de la Mama , Hibridación in Situ , Metástasis Linfática , Neovascularización Patológica , Metabolismo , Factor A de Crecimiento Endotelial Vascular , MetabolismoRESUMEN
Objective:To sum up the x- ray signs of intestinal malrotation and to evaluate the means of examination. Methods:40 cases of intestinal malrotation in children aged from 1 hour to 16 years were reviewed. The diagnostic evaluations included 40 plain abdomen films,40 upper gastrointestinal barium series and 20 barium enemas. Results: Upper gastrointestinal obstruction was found on the plain film in 34 cases among which 4 showed abnormal position of jejunum. Duodenal obstruction was detected in 37 cases with gastrointestinal barium study among which 21 showed malposition of duodenojejunal junction and 16 showed "whorl" sing. Fifteen of twenty were found abnamal cecal position with barium enema examination. Conclusion :The malposition of duodenojejunal junction, "whorl" sign and abnormal cecal position are special signs of intestinal malrotation;The combination of the three x- ray examinations may be helpful in the diagnosis of intestinal malrotation.
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Objective:To explore the relationship between the bone age and adolescent growth spurt(AGS),in order to establish a quantitative standard for determination of AGS of the children in Chongqing.Methods:Five hundred healthy children in Chongqing,aged from 7 to 16 years,were enrolled in this study.The bone ages were measured with CHN method in all children.Three phases of adolescent growth spurt were determined by Grave method in normal developing group.The range and median of the bone ages in every phase were analysed statistically by gender.Results:In Chongqing children,the accelerative phase of AGS started at 11.7 years for boys,and 9.5 for girls.The peak phase started at 14.2 years and 12.3 years for boys and girls respectively.The decelerative phase of AGS started at 15.9 years for boys and 14.8 years for girls.Conclusion:The assessment of bone ages provides a quantitative standard for determination of AGS,which is of help for orthopedists to determine the time of operation.