Objective To explore the clinical application of determination of troponin I(cTnI) by enzyme linked fluorescent(EL-FA) method .Methods The concentration of cTnI in serum was detected by chemiluminescence immunoassay(CLIA) method and ELFA method .The precision test ,linear test ,recovery test and interference test were done on ELFA method .The correlation analy-sis was done on the results of cTnI detected by ELFA method and CLIA method .Results Determination of the concentration of cTnI by ELFA method ,the intraassay coefficient of variation(CV) of high(30 .00 μg/L cTnI) and low (0 .12 μg/L cTnI) values were 2 .81% and 1 .62% ,the interassay CV were 5 .67% and 3 .52% .Reliable detection range detection of ELFA method was 0 .00-30 .00 μg/L .When the total bilirubin concentration less than 450μmol/L ,hemoglobin concentration less than 1 .5 g/L ,three glycerol concentration less than 7 .0 mmol/L ,the ELFA method for the determination of cTnI was without interference .Determina-tion of the concentration of cTnI had a good correlation between ELFA method and CLIA method(r=0 .971) .Conclusion The EL-FA method has good precision ,recovery and linear range ,and has a good correlation with the CLIA method ,and the ELFA method is rapid and convenient ,suitable for the emergency inspection ,can satisfy the clinical requirements .

Objective To assess the clinical application value of magnetic susceptibility-weighted imaging in cerebral vascular malformations. Methods Thirty-six patients with cerebral vascular malformations were enrolled in the study. All the patients received examination of T1WI, T2WI and SWI. SWI sequence was compared with T1WI, T2WI sequence in detecting and diagnosing cerebral vascular malformations. Results Cerebral vascular malformations were low signal in SWI sequence. Cavernous angioma, developmental venous anomalies and AVM had been found in 73,8,10 cases, respectively. The bounder of lesions was clearer, more multiple small lesions, more hair-thin pulp veins and draining veins were detected in SWI sequence. Conclusion SWI sequence has more sensitivity than T1WI and T2WI sequence in detecting the cerebral-vascular malformations. SWI sequence may become routine examination se- quence in diagnosis cerebral-vascular malformations.

AIM: To investigate the effects and safe of low molecular weight heparins (LMWH) in the treatment of patients with chronic pulmonary heart diseases (CPHD) at hypercoagulability state. METHODS: 65 patients were randomly assigned to treatment group (n=33) and control group (n=32). All patients were given routine treatments. The patients of treatment group were hypodermically injected with 4 100～6 150 U of LMWH per day for 7 days as a course. RESULTS: After 7 days of the treatments, the patients of treatment group showed better curative effect and significantly increase in PaO_2 and AT-III and decrease in PaCO_2 and FIB in comparison with the patients in control group (P

Objective We aimed to analyze the results of physical examinations in bank employees and understand the self-health care consciousness of them in order to establish health education method for the employees.Methods We collected data of physical examinations for 904 bank employees and analyzed the results statisticaUy.Results There were 510 employees who got abnormal results,accounting for 56.4%.The first four diseases were ordered as follows:hyperlipoidemia,hepar adiposum,high blood pressure and hyperuricacidemia.Moreover,the incidence increased with the increasing ages.Besides,the incidence of illness was closely correlated with the employees'living styles. Conclusions We should strengthen the health education and behavior intervention for bank employees in order to urge them to drop off bad living habits self-consciously and establish benign living styles.

Objective Following up with otoscopy after the middle ear surgery in order to understand the prognosis and recurrence of the surgical cavity. Methods Four hundred and eighty-three ears after middle ear surgery were followed up with otoscopy to understand the situation of its dry ear, surgical cavity lesions as well as whether there was recurrence. Among 483 ears with middle ear surgery, 172 ears were performed with tympanoplasty, 211 ears with tympanoplasty plus modified mastoidectomy, 26 ears with up wall mastoidectomy plus tympanoplasty, 15 ears with radical mastoidectomy, 59 ears with mastoid surgical cavity repair. Results By otoscopy 12 ears were found with secondary tympanic membrane perforation, 9 ears with tympanic membrane perforation without healing, 36 ears with granulation in tympanic membrane or mastoid, 23 ears with recurrent cholesteatoma, 11 ears with middle ear effusion, 5 ears with canal stenosis, 16 ears with fungus infections in surgical cavity, 2 ears with prolapse of artificial auditory ossicles, 3 ears with necrosis of mastoid cavity flap. The time of dry ear after the surgery in open mastoidectomy was (2.1 ± 0.4) months. Conclusion Following up regularly with otoscopy after middle ear surgery is benefit to the clearance of residual disease, preventing recurrence and promoting early dry ear.

Objective To investigate the value of diffusion kurtosis imaging (DKI)quantitative parameters in evaluating patholog-ical grade of cervical squamous cell carcinoma (CSCC).Methods The DKI images of 45 patients with CSCC were analyzed retrospec-tively.According to the results of pathology,22 cases were divided into poorly differentiated group and 23 cases well-moderately dif-ferentiated group.The DKI parameters of two groups were measured by two observers,which included mean kurtosis (MK),axial kurtosis (Ka),radial kurtosis (Kr),fractional anisotropy of kurtosis (FAk),mean diffusivity (MD),axial diffusivity (Da),radial diffusivity (Dr)and fractional anisotropy (FA).The intra-class correlation coefficients (ICC)was used to test the consistency of the parameters measured results on two observers.The two independent samples t test was used to compare the parameters of two groups,and the ROC curve was used to evaluate the effectiveness of each parameter in order to evaluate the poorly differentiated CSCC and find the boundary values.Results The data consistency of two observers were good (ICC>0.75).The MK,Ka and Kr values on poorly differentiated CSCC were greater than that on well-moderately differentiated (P<0.05),the MD,Da and Dr values were less than that on well-moderately differentiated (P<0.05),the FAk and FA values had no difference (P>0.05).Thearea un-der curve (AUC)of MK,Ka,Kr,MD,Da and Dr values to diagnose poorly differentiated CSCC were 0.914,0.831,0.865,0.850, 0.778 and 0.865,respectively.The boundary values of diagnosing poorly differentiated CSCC were MK≥0.973,Ka≥1.075,Kr≥0.823, MD≤0.974μm2/ms,Da≤1.185μm2/ms and Dr≤0.762μm2/ms,respectively.Conclusion DKI can effectively predict the patho-logical grading of CSCC,which has a good clinical application prospects.

Objective To assess the utility of single source-dual energy CT for distinguishing bladder cancer from hematoma. Methods We retrospectively identified 14 patients with postoperative or follow-up bladder hematoma who had undergone dual energy protocol (40-140 keV)scanning by single source-dual energy CT.The subjective scoring of tumor detection and image quality,the optimal monochrome images and iodine-water images were evaluated by two radiologists who didn’t know the results.The consistency of two observers was analyzed by Kappa test.Mann-Whitney U test was used to compare the difference between the two kinds of diseases and ROC curve was used to analyze the diagnostic efficiency.The statistical differences of image quality scoring among different images were obtained by using Mann-Whitney U test.Results The consistency of the two observers about scoring of lesion detection was good for all groups.There were statistical differences between two groups in non-enhanced phase and arterial phase of mixed-energy images,non-enhanced phase,arterial phase and delayed phase of optimal monochromatic images,and all phase of iodine-water images. The AUC of iodine-water images in the four phases (0.985,1.000,0.955,0.924,respectively)were all higher than that of polychrome unenhanced and arterial phase images (0.909,0.909).The diagnostic efficiency of arterial phase on iodine-water images was the highest.Sensitivity and specificity were both 100% when score was greater than 2.5.There was no statistical difference between two kinds of diseases on non-enhanced phase,delayed phases of mixed-energy or monochromatic images(P >0.05).There were no statistical differences in image quality scoring among the three groups with the same phases (P>0.05).Conclusion Optimal monochromatic images and iodine-water images of single source-dual energy CT are more effective than conventional CT in distinguishing bladder cancer from hematoma.

PurposeTo investigate the effects of the low concentration contrast medium combined with optimal single source spectral imaging on displaying feeding arteries of gastrointestinal tract malignant tumors.Materials and Methods Seventy-one patients of body mass index (BMI) >25 kg/m2 with gastrointestinal tract malignant tumors were prospectively studied. All the cases were randomly divided into two groups: high concentration group (33 cases with high concentration contrast medium of 350 mgI/ml in routine scan) and low concentration group (38 cases with low concentration contrast medium of 270 mgI/ml in optimal single source spectral imaging). The optimal single source images were generated automatically. The subjective image scores, CT value of the tumor feeding arteries, image noise, contrast-to-noise ratio (CNR) and CT dose index of volume (CTDIvol) of optimal single source spectral images in two groups were compared. Results The optimal single source of low concentration group were 51-60 keV. The subjective image score of low concentration group was higher than high concentration group (Z=-4.280,P<0.01). The consistency between the two investigators was good (Kappa=0.824 and 0.843,P<0.05). The consistency between the two investigators in evaluating CT value of the tumor feeding arteries, CT value at the right erector spinal muscle, image noise and CNR data was good (ICChigh concentration group=0.998, 0.968, 0.959 and 0.990; ICClow concentration group=0.988, 0.981, 0.969 and 0.937). The CT values of the tumor feeding arteries and CNR of the low concentration group were higher than that of the high concentration group, but the image noise was lower than that of high concentration group (t=-14.937, 4.263 and-17.264,P<0.01). There was no statistical difference of CTDIvol between the two groups (t=1.278,P>0.05).Conclusion The low concentration contrast medium with optimal single source spectral imaging in patients with large BMI may improve CTA image quality of feeding arteries of gastrointestinal tract malignant tumors without increasing radiation dose.

Objective To explore the application value of optimal energy imaging technique of monoenergetic dual-energy computed tomography (DECT) in feeding arteries examination of rectal cancer.Methods The clinical data of 33 patients with rectal cancer who were admitted to the First Affiliated Hospital of Dalian Medical University from July 2012 to July 2014 were analyzed retrospectively.The polychromatic and monochromatic images of feeding arteries of tumors were reconstructed and evaluated using a subjective image quality score of 5-point scale by 2 observers.The consistency and scores of evaluation were analyzed by the κ test and MannWhitney U test.The CT value of feeding arteries of tumors and hip muscle,image noise and contrast to noise ratio (CNR) were measured and calculated by 2 observers,and were compared by the independent sample t test.The consistency of data between the 2 observers were measured by the intra-class correlation coefficients (ICC).Results Inferior mesenteric arteries were contributor of blood supply of tumors in all the 33 patients,including 4 cases with right inferior rectal artery as contributor of blood supply of tumors,2 cases with bilateral inferior rectal artery.Among patients with abnormal blood vessels,there were 8 patients with left colic artery and sigmoid artery having common trunk,4 patients with left colic artery originated from Inferior mesenteric artery,1 patient with absence of left colic artery.The 0-,1-,2-,3-,4-score polychromatic image quality of feeding arteries of tumors were detected in 0,13,13,5,2 patients and 0,11,14,6,2 patients by 2 observers,respectively.The 0-,1-,2-,3-,4-score monochromatic image quality of feeding arteries of tumors were detected in 0,0,7,7,19 patients and 0,0,6,9,18 patients by 2 observers,respectively.Good interobserver agreement was found for the evaluation of subjective scores (κ =0.864,0.897).The subjective scores of image quality of feeding arteries in the polychromatic images and in the monochromatic images were 1.9 ± 0.9 and 3.4 ± 0.8,with significant difference (Z =-5.21,P ＜ 0.05).The latter was superior to the former.The ICC values of the CT values of feeding arteries of tumor,hip muscle,image noise and CNR were 0.953,0.907,0.839,0.964 and 0.966,0.933,0.952,0.962 from the 2 observers,with a good consistency.The CT values of feeding arteries of tumor,gluteal muscles,image noise and CNR in the polychromatic images and in the monochromatic images were (234 ± 52)HU and (412±83)HU,(57±9)HU and (71 ±15)HU,(21 ±3)HU and (31 ±6)HU,9 ±3 and 11 ±4,respectively,with significant differences (t =-18.65,-4.44,-14.14,-6.55,P ＜ 0.05).The levels of monochromatic images of 33 patients were 51-61 keV,with a median of 55 keV.Conclusion The optimal energy imaging technique of monoenergetic DECT can improve the angiographic quality of feeding arteries in patients with rectal cancer.

Objective To explore the value of diffusion tensor imaging (DTI) in differential diagnosis of intrahepatic cholangiocarcinoma (ICC) and hepatocellular carcinoma (HCC).Methods Fifty-two patients including 20 patients with ICC (ICC group) and 32 patients with HCC (HCC group) confirmed by histopathological examination were recruited in the study.All the patients were performed MR exams on a 1.5T scanner in a protocol containing the routine T1WI,T2WI,DWI and DTI.The values of ADC,fractional anisotropy (FA),diffusion coefficient (D) were blindly reviewed and analyzed by two experienced observers,and were compared between two groups.The ROC curve was used to evaluate the di agnostic efficiency.Results The border clear percentage of ICC group (9/20,45.00％) had no significant difference compared with that of HCC group (15/32,46.88％;x2 =0.02,P=0.90),the detection rate of bile duct expansion in ICC group (11/20,55.00％) was higher than that in HCC group (4/32,12.50％;x2=10.83,P=0.001).Theintraclasscor relation coefficient value of ADC,D and FA in the ICC group and HCC group were all more than 0.90.The mean FA of ICCgroup (0.45±0.16) were significantly higher than that of HCC group (0.30±0.13;P=0.001),while the mean ADC and D values in ICC and HCC groups had no significant difference (both P＞0.05).The area under the ROC curve of FA was 0.76.And when FA=0.31,there was a higher sensitivity (85.0％) in identifying ICC and HCC.Conclusion The FA of DTI shows a stronger capability than the ADC and D values in differentiating the ICC from HCC.