Digital X-ray photography has been applied to clinical medicine in recent 3years.This paper introduces the development situation of the flat detectors for digital X-ray photography.The technical indexes and structure differences of the detectors are presented in this paper.

Objective To compare the clinical outcomes of urethral resectoscopy and retroperitoneal laparoscopic nephroureterectomy with open surgical nephroureterectomy. Methods A total of 44 patients with renal pelvic and ureteral neoplasms were included.Urethral resectoscopy and retroperitoneal laparoscopic nephroureterectomy were performed in 15 cases (Group A) and open surgical nephroureterectomy in 29 cases (Group B).The therapeutic effectiveness,postoperative recovery,relevant cost and complications were compared between Group A and Group B. Results The analysis showed that the intra-operative bleeding volum [(75.1?29.5)ml],the postoperative intesinal function recovery [(24.1?12.6)h],time to ambulation [(24.3?10.5)h],use of antalgesic [(3.0?0.8)d],intravenous antibiotic [(7.2?3.1)d],hospital stay [(6.3?1.2)d],convalescene of normal activities [(28.0?7.8)d] and incidence of complications with Group A were significantly superior to those with Group B(P

Objective To explore the factors imfluencing the prognosis of patients with renal cell carcinoma after laparoscopic partial nephrectomy.Methods Clinical data from 593 renal cell carcinoma patients underwent laparoscopic partial nephrectomy in our institution from December 2010 to December 2015 were retrospectively collected..Tbere were 396 males and 197 females,aged 35 to 72 years old(mean 55.4 years).There were 181 cases of smoking history,206 cases of hypertension and 105 cases of diabetes.Before operation,98 cases of liver function were damaged and 122 cases were anemia.There were 521 cases with PLT ＜ 450 × 109/L,72 cases PLT≥ 450 × 109/L.Thc tumor of 292 cases on the left and 301 cases on the right.The Kaplan-Meier method log-rank test was used for survival analysis.Univariate analysis and factors which were significantly associated with survival in the univariate analysis were conducted into the multivariate analysis with Cox proportional hazards model.Results The operative time was 88.0-120.6 min,mean 104.3 min,the blood loss during operation was 47.2-157.8 ml,mean 102.5 ml. Pathological tumor stage revealed that 398 cases were T1 and 195 cases were T2 . Fuhrman classification revealed that 29 cases were grade Ⅰ,411 cases were grade Ⅱ,150 cases grade Ⅲ,3 cases grade Ⅳ . The median follow-up time was 36 months(ranged 6 to 99 months) . Five cases (1.3％) in the T1 patients relapsed,recurrencefree survival (RFS) rate was 98.7％;In the T2 patients,7 cases (3.6％) relapsed,1 of them had local recurrence and died of lung metastasis,and the RFS rate was 96.4％.Univariate analysis revealed that T stage,Fuhrman grade,tunor necrosis,tumor pseudocapsule,lymphovascular invasion,collection system violation,anemia,and high platelet were significantly associated with RFS of patients.Multivariate analysis found that T stage (HR =1.524,95 ％ CI 1.326-1.926,P =0.001),Fuhrman grade (HR =1.600,95 ％ CI 1.035-2.364,P =0.022),tumor necrosis (HR =2.315,95％ CI 1.523-3.624,P =0.001) were independent risk factors for the RFS of patients with renal cell carcinoma after retroperitoneal laparoscopic partial nephrectomy.Conclusion High T stage,high Fuhrman grade and tumor necrosis were independent risk factors for the RFS of patients with renal cell carcinoma after retroperitoneal laparoscopic partial nephrectomy.

Bioeleotrical activities of human cerebral cortex which control and regalate movements get to increase during voluntary movements, the metabolic level of the cells of motor areas change at the same time,and consequently regiond cerebrd blood flow (rCBF)changes. Different changes of rCBF indicate the range of motor areas with which the relavant movemats are involved.And studies of this take great significance in finding out the basic active regalarity and features of human brain. In this artide motheds of the determination of rCBF an introduced briefly, and changes and distribution of rCBF of rCBF of each cortical moter area during different types of volantary movements are discribed. Keywords：regional cerebral blood flow; voluntary movements; cerebral corrical motor areas

Objective To study the effect of rehabilitation in stroke patients with dysphagia. Methods 31 cases with dysphagia were randomly divided into rehabilitation group (17 cases) and control group (14 cases). Two groups were given same basic therapy on the whole, while the early rehabilitation was performed on the patients in rehabilitation group three times a day for 3 weeks. We compared assessment score of dysphagia by VFSS (videofluoroscopic swallowing study), and observed serum potassium, sodium, albumin levels and the incidence of inhalation-pneumonia in two groups before and after treatment. Results VFSS score (7.2?2.1) of rehabilitation group was markedly higher than before treatment (4.0?1.9) and control group (4.7?2.1)(all P0.05).Conclusions Rehabilitation has a remarkable effect on stroke patients with dysphagia.

Influenced by the intensity, volume of exercise, the basic metabolic features of skeletal muscle are changed to such structural and functional adaptations as there are increases in the amount of contractile components, muscle glycogen and myoglobin, in the volume and quantity of mitochondria and in the density of capillary in skeletal muscle, which result in enhanced aerobic metabolism, contraction efficiency and prolonged time defore failure. It is also pointed out that the structural changes and decrease of function of sarcoplasmic reticula during acute exercise are important reasons for skeletal muscle fatigue , whereas, high- intensity training can improve sarcoplasmic reticulum function and its Ca2＋ -intake rate, so that to improve the physiological efficacy of excitation- contraltion coupling. So it is put forward that anti- resistance training, as a means of exercise therapy, can efficiently increase muscle strength and prevent muscle atrophy. Keywords：exercise;muscle metabolism;contractile protein;sarcoplasmic reticulum;mitochondria;oxygen restore;exercise therapy

Objective To investigate the feasibility of dose verification of helical tomotherapy (HT) using the PTW Seven29 2D-ARRAY with Octavius phantom.Methods The 12 patients HT plan were verified with the PTW Seven29 2D-ARRAY combining Octavius phantom.The detector array was guided and registered by MVCT imaging,and measured dose distributions on the corresponding planes were compared with those calculated by the treatment planning system (TPS).Based on several different Gamma criteria,the Gamma analysis method was utilized to evaluate the dose verification.Results According to the different acceptance criteria combination of dose difference/distance to agreement at different threshold level including 3％/2 mm,3％/3 mm,3％/4 mm,3％/5 mm at TH5,TH10,TH20,TH30,the mean passing rates with γparameter ≤ 1 were all above 91.7％ and 93.9％ when PTW Seven29 2D-ARRAY was horizontal and vertical.The dose distribution measured by the 2D-ARRAY combining Octavius phantom was well consistent with that calculated by the TPS.Conclusions 2D-ARRAY with Octavius phantom can get satisfying results when used in HT plan dose verification and is a viable tool to replace traditional film dosimetry system in clinical quality assurance work.

Objective:To compare the safety of adrenal central vein treated at different times in laparoscopic adrenal pheochromocytoma resection through abdominal approach.Methods:A study was conducted on 43 patients with adrenal pheochromocytoma admitted to Xijing Hospital, Air Force Military Medical University from June 2012 to June 2019. The included patients were divided into two groups according to the surgical method: observation group ( n=22) and control group ( n=21). The patients of observation group were ligated the central advenal vein before the tumor was completely isolated, and the patients of control group were ligated the central advenal vein after the tumor was isolated. The changes of blood catecholamine levels before anesthesia, before central adrenal vein ligation, and after tumor resection were compared between the two groups, as well as the differences in operative time, intraoperative blood loss, hospital stay, number of cases with intraoperative blood pressure fluctuations and frequency. Measurement data were expressed as mean±standard deviation ( Mean± SD), comparison between groups was by t-test; comparison of count data between groups was by Chi-square. Results:There was no significant difference in the mean operation time, the mean hospital stay, intraoperative blood loss, number of cases with dramatic blood pressure fluctuations between two groups ( P>0.05). The frequency of severe fluctuation of intraoperative blood pressure in observation group and control group was 19 times and 47 times, respectively, the difference was statistically significant ( P<0.05). There was no significant difference in the blood epinephrine and norepinephrine levels between the two groups before anesthesia and after tumor resection ( P>0.05). However, before ligation of the central vein, the epinephrine concentrations in the observation group and the control group were (572.1±282.1) pg/mL and (935.6±417.5) pg/mL, respectively, the noradrenaline concentrations were (8 347.9±4 103.6) pg/mL and (13 695.7 ±3 205.3) pg/mL, respectively, the difference was statistically significant ( P<0.05). Conclusion:Early ligation of the adrenal central vein can improve the safety of the laparoscopic approach to adrenal pheochromocytoma.

Objective To investigate inhibitory effects of matrine (Ma) combined with vincristine (VCR), cytosine arabinoside (Ara-c), harringtonine (HRT), adriamycin (ADM), and daunorubicin (DNR) on proliferation of K562 cells. Methods MTT colorimetric assay was used to detect the inhibition rate of Ma combined with antineoplastic on K562 cells. Results The proliferation of K562 cells was inhibited by Ma at the concentration of 160 ?g/ml to 400 ?g/ml. The inhibitory rates of Ma combined respectively with VCR, Ara-c, HRT, ADM, and DNR were significantly higher than those of VCR, Ara-c, or HRT alone (P0.05). Conclusion Ma can inhibit the proliferation of K562 cells in a dose-dependent manner. The anti-proliferation effect of VCR, Ara-c, and HRT on K562 cells could be enhanced by Ma.

Objective To investigate whether echocardiography left ventricular ejection fraction (LVEF) and NT-proBNP could be an early detective marker for patients with untypical NSTE-ACS. Methods A total of 248 ACS cases admitted to the emergency department of our hospital from January 1,2015 to June 31,2016 were retrospectively reviewed. The data included age,gender,past medical history,D-dimer,MB isoenzyme of creatine kinase(CK-MB),cardiac troponin I(cTnI),the precursor of the N-terminal pro-brain natriuretic peptide(NT-proBNP),electrocardiogram(ECG)before treatment,and the CK-MB,cTnI and LVEF,the treatment of percuta-neous coronary intervention(PCI)or thrombolytic by drugs. Survival condition and time from onset to death were recorded. According to the results of multivariate logistic regression analysis ,receiver operating characteristic curve(ROC curve)and fitting curve were drawn. The association between the LVEF and NT-proBNP before the treatment and prognosis of ACS was analyzed. Results NSTE-ACS patients with chief complaint of chest pain were less than those of STE-ACS(33.6% vs. 70.1%,P=0.003). Pre-hospital time was longer than that of STE-ACS group(67.92 ± 116.89 vs. 30.65 ± 55.59,P = 0.006). CTNI(4.37 ± 12.53 vs. 9.62 ± 18.00,P=0.011)and LVEF(53.51 ± 14.51 vs. 56.26 ± 12.30,P=0.019)were less than that of the STE-ACS group. NT-proBNP was higher than that of the STE-ACS group(2288.37 ± 4612.10 vs. 1506.84 ± 1722.51,P=0.038). mortality rates was higher than the STE-ACS group((15.3%vs. 6.8%,P=0.036). Multivariate logistic regression analysis showed that LVEF values was correlated to 28-day death(B =-0.097 ,P=0.022). The ROC curves showed that LVEF values was negative correlated with the 28-day death. However,combination of LVEF and NT-proBNP was better than single LVEF values. LVEF values was negative correlated with the NT-proBNP(r =-0.263,P=0.001), LVEF values had greater and longer survival time(B=0.401,P=0.045)but NT-proBNP was not related to surviv-al time.(B=0.00,P=0.931). Conclusion LVEF and NT-proBNP are correlated with the early risk assessment of patients with ACS,but was not correlated with the time from onset to death. The decrease in LVEF values at the early stage of NSTE-ACS may be helpful to indicate the critical condition of the ACS patients.