ObjectiveTo derive and evaluate the formula of exactly calculating the contrast dosage used during pulmonary CT angiography ( CTPA ). Methods Time density curves in 27 patients who underwent CTPA were collected and analyzed,the formula for calculating contrast dosage during CTPA was derived.68 patients suspected of pulmonary embolism ( PE ) clinically but no PE on CTPA were divided randomly into group A,with bolus tracing technique ( n =26 ),and group B,with small dose injection contrast test (SDCT) (n =42).The CT values of the right main pulmonary artery (RMPA),right upper pulmonary vein ( RUPV),right posterior basal PA,right lower PV (RLPV) and the aorta were calculated.The total contrast dosage and the hard beam artifact in the SVC were compared between the two groups.Student's t test,Chi-square test and Mann-Whitney U test were used.ResultsThe ratio of the time from starting injection to enhancement peak of caudal end of SVC and the time to enhancement peak of the main pulmonary trunk was 0.65 ±0.09 (about 2/3),the formula for contrast dosage calculation was derived as (DTs/3 + STs/2) FR ml/s.The CT values of RMPA and RLPA between the two groups[ (301 ±117),(329 ± 122) and (283 ±95),(277 ±98) HU respectively] were not significantly different (t =1.060,P =0.292 ;t =2.056,P =0.044),but the differences of CT values in the paired PA and PV between the two groups (median were 22.5,58.0 and 170.5,166.5 HU respectively ) were significant (U =292,P =0.001 and U =325,P =0.005),contrast artifact of the SVC (grade 1-3) in group B ( n =34,7,1 respectively) was significantly less than in group A (n =11,10,5 respectively,x2 =10.714,P =0.002),the contrast dosage injected in group A was ( 87.6 ± 7.3 ) ml,and in group B was ( 40.0 ±5.4) ml (P ＜0.01 ).ConclusionCTPA with SDCT technique is superior to that with conventional bolus tracing technique regarding contrast dosage and contrast artifact in the SVC.

Objective To explore operating efficiency of county-level public hospital by using data envelopment analysis ,provide reference ,and basis for health decision-making .Methods The health resources data of 16 county-level public hospitals were ran-domly selected from 2008 to 2011 ,its relative efficiency were studied by data envelopment analysis method of CCR-CRS and BCC-VRS model ,the change trend from 2008 to 2011 were analyzed through the Malmquist productivity index .Results The average ef-ficiency value was 0 .938 in 16 county-level hospitals in 2011 ,7 hospitals was DEA efficient and 9 hospitals was non-DEA efficient (8 hospitals with Scale efficiency decline gradually ,another one with increasing gradually ) .The total factor productivity increased 2 .5% from 2008 to 2011 average annual ,the productivity first decreased from 2008 to 2009 ,and then increased from 2009 to 2011 . Conclusion The overall efficiency 16 county-level hospitals is not high ,it is necessary to develope hospital scale reasonable , strength hospitals′management level and improve technical ability of doctors .

Objective To study the CT manifestations of delayed traumatic hematomas of the brain and evaluate their diagnostic significance in predicting the delayed traumatic brain hematoma. Methods The manifestations of initial CT studies and follow-up CT examinations of 31 delayed traumatic brain hematomas were analyzed. Another 50 CT studies of head trauma without delayed brain hematomas were included randomly as control. Results The abnormal findings of CT studies of the 31 delayed traumatic brain hematomas included: (1)Decreased density of the local brain parenchyma and disappeared difference between gray and white matter of the same area in 18 cases; (2)Local subarachnoid space hemorrhage in 24 cases; (3)Slight mass effect of local brain parenchyma in 16 cases. (4)Subdural hematoma in 9 cases. The locations of the abnormalities were roughly the same with the delayed hematoma except one local subarachnoid space hemorrhage, which was in the opposite of the delayed hematoma. The appearing rate of those abnormal findings in the control group was low and the difference was statistically significant. Conclusion The decrease of density of local brain parenchyma, the disappeared difference between the gray and white matter, local subarachnoid space hemorrhage, and local swollen of brain presented in the initial CT study of the patient with head trauma should be taken as indicators of delayed hemorrhage of the same area of brain, and it is necessary to do follow-up CT studies to exclude it.

Objective To investigate the effect of electroacupuncture on acupoint local extracellular ionized atom concentrations under physiological status and provide a basis for exploring the mechanism of action of electroacupuncture. Method Twenty male SD rats were selected. Rat point Zusanli (ST36) was given electroacupuncture (1 mA, 0.2 ms and 2 Hz) for 60 min. Meanwhile, local tissue fluid was collected at point Zusanli and non-acupoints using a microdialyzer. The collection by molecular probe membrane sampling lasted 4 hrs: 60 min physiological status before electroacupuncture, 60 min electroacupuncture, 60 min after electroacupuncture and 120 min after electroacupuncture. Real-time analysis of the sample was made by electrolyte analysis to observe local changes in concentrations of Ca﹢﹢, K﹢, Na﹢and Cl- at point Zusanli. Result Local Ca﹢﹢concentrations at point Zusanli increased significantly during electroacupuncture (P=0.003, vs before electroacupuncture), rose gradually afterwards and reached the peak at 60 min after electroacupuncture (P=0.75, vs during electroacupuncture). Ca﹢﹢concentrations decreased at 120 min after electroacupuncture; there was a statistically significant difference comparedwith during electroacupuncture (P=0.04). Acupoint local extracellular concentrations of Na ﹢ and Cl- also increased significantly during electroacupuncture (P<0.001, P=0.007, vs before electroacupuncture) but decreased gradually during 60 min after electroacupuncture and to (71.81±15.09) mmol/L and (57.42±14.30) mmol/L, respectively, at 60 min after electroacupuncture (P=0.09, P=0.07 vs during electroacupuncture). Acupoint extracellular K ﹢concentrations had a tendency similar to those of Na﹢and Cl- but there was no statistically significant difference. Non-point electroacupuncture slightly increased extracellular concentrations of Ca﹢﹢, K﹢, Na﹢and Cl- but there were no statistically significant differences compared with before electroacupuncture (P>0.05). Conclusion Rat point Zusanli electroacupuncture can induce significant increases in acupoint local extracellular concentrations of Ca﹢﹢, K﹢, Na﹢and Cl- . Ionized atom concentrations decrease in different degrees after electroacupuncture. These provide an experimental basis for studying the physiological mechanism of electroacupuncture treatment.

Objective To summarize the cl inical characteristics and imaging features of psittacosis. Methods The clinical features and imaging appearances of 3 cases with acute psittacosis were retrospectively analyzed. The related literature was reviewed . Results The clinical manifestation of psittacosis was high fever in the patients. Physical findings included pulse-temperature dis sociation, localized lung crackles, hepatomegaly, and splenomegaly. Laboratory findings showed elevation of ESR in all cases, and liver dysfunction was present in 2 cases. The counts of white blood cells were normal, but the percent of ne utrophils might be increased. The chest X-ray and CT scan showed air-space co nsolidation and ground-glass attenuation in the lung, and miliary, nodular, or consolidated shadows were found in pathological areas. Pleural effusions were a lso present in 2 cases. Psittacosis was diagnosed from the history of exposure to infected parrots and elevation of the IgG and IgM titer for Chlamydia psittac i. Erythromycin was effective in all 3 patients. Conclusion Although the appearance of psittacosis on clinical findings and chest X-r ay and CT scan is not characteristic, psittacosis can be diagnosed with the comb ination of the history of exposure to infected parrots and laboratory findings. CT scan can reveal the focus earlier and accurately, and catching the imaging f eatures of psittacosis is helpful in differential diagnosis.

Objective To analyze the equity of the allocation of the health human resources in Chongqing from 1997 to 2012 , and to provide the basic information for regional health planning .Methods The statistical description ,Gini Coefficient and Theil in-dex are used to analyze the previous allocation and trends of the health human resources and the equity in Chongqing during the 16 years based on the distribution of demography and geography .Results The number of the health human resources grew rapidly from 1997 to 2012 .The Gini coefficients of health professionals and medical practitioners (and assistants) are under 0 .3 based on the distribution of demography ,while registered nurses′are fluctuation in 0 .4 .However ,from the distribution of geography ,the Gi-ni coefficient of health professionals ,medical practitioners (and assistants) and registered nurses are above 0 .5 .The Gini coefficient of the one hour economic circle is higher than two wings areas .The trends about the totle Theil index are consistent with the Gini coefficient .Based on the distribution of demography ,the Theil index between regions is higher than the one within the region .On the contrary ,the Theil index between regions is below the one within the region by the geographic distribution .Conclusion Com-pared to the national ,less total health human resources are reserved in Chongqing .Distribution by demographics about health human resources are more equitably than the one by geographic distribution .The variances between the economic circles contribute more to the total Theil index than those within the economic circles .The government′s leading role should be strengthen ,and enhancing the regional health planning .

Objective:To observe the effects of different moxibustion times on proteins of transient receptor potential vanilloid 3 (TRPV3) ion channel protein and synovial cell apoptosis in rats with rheumatoid arthritis (RA), to provide a new basis for the anti-inflammatory mechanism of moxibustion. Methods:A total of 50 Sprague-Dawley (SD) rats were divided into a normal group, a model group, moxibustion groupⅠ, moxibustion groupⅡ and moxibustion groupⅢ by complete randomization, with 10 rats in each group. Rats in the normal group were bred routinely, and rats in the model group were also bred routinely after successful modeling. After successful modeling, rats in moxibustion groupⅠ,Ⅱ andⅢ accepted consecutive moxibustion at Zusanli (ST 36) and Shenshu (BL 23) for 15 d, once a day, respectively 5 min, 20 min and 30 min for each session. The degree of paw edema was observed and recorded. Immunohistochemical assay was used to detect the protein expression of TRPV3 ion channel in dorsal root ganglia and spinal cord dorsal horn. Terminal-deoxynucleoitidyl transferase-mediated nick end labeling (TUNEL) was used to detect apoptotic synovial cell number. Results: At the end of treatment, paw circumference of rats in moxibustion groupⅡ andⅢ were significantly reduced as compared with that in the model group (P<0.05). TRPV3 ion channel protein expression of dorsal root ganglia and spinal cord dorsal horn was higher in the model group than that in the normal group (P<0.05); the TRPV3 ion channel protein expressions of dorsal root ganglia and spinal cord dorsal horn in moxibustion groupⅡ andⅢ were higher than that in moxibustion groupⅠ (P<0.05); apoptotic synovial cell number in the model group was larger than that in the normal group (P<0.05), and apoptotic synovial cell numbers in moxibustion groupⅡ andⅢ were significantly higher than that in the model group (P<0.05). Conclusion:Moxibustion of appropriate time could induce TRPV3 expression, and promote synovial cell apoptosis.

Gastric cancer (GC) is the third leading cause of cancer-related deaths worldwide. GC stem-like cells (GCSCs), with unlimited self-renewal, differentiation, and tumor-regenerating capacities, contribute significantly to the refractory features of GC and have gained increasing attention for their role in GC drug resistance, relapse, and metastasis. Therapies targeting GCSCs seem to be one of the most promising methods to improve the outcomes of GC patients. Extensive investigations have attempted to outline the regulatory mechanisms in GCSCs and to develop GCSCs-targeting therapies with which to diminish GC drug resistance, metastasis and relapse. To the best of our knowledge, there is a lack of reviews summarizing these studies. In this review, we systematically recapitulated findings regarding the regulatory mechanisms of GCSCs, as well as therapies that target GCSCs, hoping to support the development of prognostic biomarkers and GCSCs-targeting anticancer therapies in GC.
Biomarkers ; Drug Resistance ; Hope ; Humans ; Neoplasm Metastasis ; Neoplastic Stem Cells ; Recurrence ; Stem Cells* ; Stomach Neoplasms*

Purpose: The influence of fasting blood glucose (FBG) and cholesterolemia primary liver cancer (PLC) in china was analyzed via a large prospective cohort study based on a community population, and the combined effects between them were investigated. Materials and Methods: Overall, 98,936 staff from the Kailuan Group who participated in and finished physical examinations between 2006 and 2007 were included in the cohort study. Their medical information was collected and they were followed up after examination. The correlations of serum FBG or TC with PLC were analyzed. Then, we categorized all staff into four groups: normal FBG/ non-hypocholesterolemia, normal FBG/hypocholesterolemia, elevated FBGon-hypocholesterolemia, elevated FBG/hypocholesterolemia and normal FBG/ non-hypocholesterolemia was used as a control group. The combined effects of elevated FBG and hypocholesterolemia with PLC were analyzed using the Age-scale Cox proportional hazard regression model. Results: During 1,134,843.68 person*years follow up, a total of 388 PLC cases occured. We found the elevated FBG and hypocholesterolemia increases the risk for PLC, respectively. Compared with the non-hypocholesterolemiaormal FBG group, the risk of PLC was significantly increased in the non-hypocholesterolemia/elevated FBG group (HR=1.19,95%CI 0.88–1.62) and hypocholesterolemiaormal FBG group (HR=1.53,95%CI 1.19–1.97), and in the hypocholesterolemia/elevated FBG group (HR=3.16 95%CI2.13-4.69). And, a significant interaction effect was found of FBG and TC on PLC. All results were independent from the influence of liver disease. Conclusion Elevated serum FBG and hypocholesterolemia are risk factors for PLC, especially when combined. Thus, for the prevention and treatment of PLC, serum FBG and TC levels should be investigated.

Objective To explore the application of the standard of Chinese lymph node dissection in minimally invasive esophagectomy.Methods Methods Between April 2014 to September 2015,63 patients with esophageal carcinoma received minimally invasive esophagectomy by the same group of surgeons.Wedescribed in detail the methods of thoracic esophagus mobilization and lymph node dissection in the peri-esophageal space.We analyzed the surgical effect,postoperative complications and follow-up results.Resnits The average operation time was(280.48 ± 44.28) mins,the median intraoperative blood loss was 100 ml,the mean number of lymph nodes was 22.25-± 11.18;the incidence of postoperative pulmonary infection in 28.57％,hoarseness was 17.46％,anastomotic leakage was 12.70％,postoperative 1 year survival rate was 84.1％,3 year survival rate of 61.1％.Conclusion Mobilization of thoracic esophagus based on peri-esophageal space and dissection lymph nodes guided by the Chinese standard of grouping lymph node would achieve good clinical effects.