Objective To evaluate the scan technique and clinical value of multi-slice spiral CT angiography(MSCTA) of coronary artery.Methods MSCTA was performed in 86 patients,and 25 of them were also investigated with selective coronary angiography(SCA).The imaging quality of MSCTA in different scanning condition were analyzed.The patency of coronary artery and other branches were examined.The distribution and extent of coronary arterial stenoses were assessed.The findings demonstrated on MSCTA were compared with those seen on SCA.Results(1)The imaging quality on MSCTA of coronary artery was significant better in patients with a heart rate below 60 beats per minute,contrast flowing rate 3.0~3.5 ml/s,volume 120~150 ml and delayed time 22~25 s;(2)in 25 cases,of 71 coronary artery and branches without stenoses examined with MSCTA,68 had identical appearance on both MSCTA and SCA.The distribution and extent of 19 coronary arterial stenoses revealed by MSCTA were correlated exactly with SCA in 29 coronary arterial stenoses.The negative and positive predicted value were 95.8% and 65.5% respectively.Sensitivity,specificity and accuracy were 86.4%,87.2% and 87.0% respectively.Conclusion MSCTA as a noninvasive examination is a valuable method in detecting diseases or variations of coronary artery.

Objective To evaluate the diagnostic and differential value of triphasic, especially the arterial phase, contrast enhanced CT scans for the hepatocellular adenoma, and to improve CT diagnostic accuracy. Methods Spiral CT scanning of pre and post contrast arterial phase, portal venous phase and delayed phase was performed in 5 patients with hepatocellular adenomas proved surgically and pathologically. The enhancement was administrated with venous injection of 3 ml/sec, totally 100 ml angiografin. Arterial phase of contrast enhanced scanning started 20～30 sec, portal venous phase 60～70 sec and delay scanning 3 min after the injection of contrast medium. The degrees of the enhancement of adnoma and normal tissues of liver in the three contrast enhanced phases were calculated and compared statistically. Results In plain CT, the lesions were iso density in 4 cases and slight hypodensity in 1 case, which was hardly distinguished from the normal tissue. In all 5 cases, the lesions showed marked enhancement in the arterial phase compared with normal tissue of liver (38 HU high), and there were markedly statistical difference ( t =18 94, P 0.05). The mean CT value of hepatocellular adenoma in the arterial phase was much higher than that in portal venous and delay phase, there were statistical differences between them ( F =18.39, P

Objective To assess the role and its tecnhique superiority of 64-slice spiral CT angiography(CTA) in lower limb arterial diseases.Methods MSCT studies in 33 cases suspected diseases of lower limb arteries was performed,the helical scans covered the extent of renal artery to the artery of the lower extremity.3D reconstruction of vessel was done in Wizard workstation.The manifestations of MSCTA were compared with that of conventional angiography . Results Of the 693 segments of arteria , 683 were assessable on both DSA and CTA.Using the DSA images as the standard reference,the sensitivity,specificity and accuracy of CTA were 97.6%(95% CI,94.9%~100.7%),98.9%(95% CI,98.0%~99.8%),98.7%(95% CI,97.9%~99.5%)in detecting the segments occluded . With the regard the detection of segments that had more than moderate stenosis , the sensitivity , specificity and accuracy of MIP were 98.9% ( 95% CI , 97.4%~100.4%),99.4%( 95% CI, 98.7%~100.1%) and 99.3%(95% CI, 92.4%~99.9%).Conclusion In assessment of diseases of lower limb arteries with 64-slice spiral CT angiography is equal to DSA basically, it is a highly accurate and non-invasive angiography in diagnosing arterial diseases of the lower extremities.

Objective To investigate the distribution and antibiotic resistance profile of clinical isolates in the First Hospital of Qiqihar during 2015.Methods Antimicrobial susceptibility test was carried out according to a unified protocol using automated system from January 1,2015 to December 31,2015.The results were analyzed with WHONET 5.6 software according to the 2014 breakpoints of Clinical and Laboratory Standards Institute.Results A total of 5 162 clinical isolates were collected,of which 28.1％ (1 450/5 162) were gram-positive cocci and 71.9％ (3 712/5 162) were gram-negative bacilli.About 36.5％ (255/698) ofS.aureus isolates and 81.4％ (180/221) of coagulase negative Staphylococcus isolates were resistant to methicillin.No S.aureus and coagulase negative Staphylococcus isolate were found resistant to vancomycin or linezolid.Enterococcus isolates showed low resistance to vancomycin and linezolid.One strain of E.faecium was found resistant to vancomycin.ESBLs were produced in 39.9％ (298/747) ofE.coli,26.1％ (294/1 127) ofKlebsiella spp.,and 15.6％ (12/77) ofP mirabilis strains.The Enterobacteriaceae strains were less resistant to imipenem,beta-lactam/beta-lactamase inhibitor combination and amikacin.About 36.6％ (163 / 445) of A.baumannii isolates and 1.8％ (13/715) of P.aeruginosa isolates were extensively drug-resistant strains.Conclusions Antibiotic resistance poses a serious threat to clinical practice,to which more attention should be paid.Clinical microbiology lab should make more efforts to provide better support to clinical therapy.

Objective:To assess the clinical value of Gore C-TAG stent-graft segmented release mode combined with 'periscope’ technique in dealing with distal reentry tear of aortic dissection after thoracic endovascular aortic repair (TEVAR).Methods:The clinical data of 5 patients of distal false lumen enlargement after thoracic endovascular aortic repair for Stanford type B aortic dissection (TBAD) from 2019 to 2020 was retrospectively analyzed.Results:All five patients were male. Combining Gore C-TAG stent-graft segmented release mode with 'periscope’ technique was used. All five patients successfully underwent secondary endovascular repair, no intraoperative thoracotomy or major postoperative complications during hospitalization occurred . Compared to aortic CTA imaging in pre- and post-secondary endovascular repair, the curative efficacy of this method in the treatment of distal reentry tear of aortic dissection was evaluated. It showed that distal reentry tears were covered completely without reperfusion of aortic false lumen, as well as branch stents with well-perfusion based on aortic CTA imaging during the first year following-up.Conclusions:Gore C-TAG stent-graft segmented release mode combined with 'periscope’ technique in dealing with distal reentry tear of aortic dissection is technically applicable and highly successful with satisfactory short-term results.

Objective To investigate the influence of the hematoma involving the aortic arch in endovascular aortic repair of complicated type B intramural aortic hematoma. Methods A total of 69 patients[58men; mean age(58.1±8.9)years; range 38-77]underwent endovascular repair between February 2011 and June 2015 were retrospectively reviewed. Patients with hematoma involving about the left subclavian artery level were categorized as group A(n=28) and patients without hematoma involvement to the aortic arch were categorized as group B (n=41). Results All the patients were treated with coverd aortic stents. The success rate was 97.1％ with complete isolation of lesion in 67 patients. The average follow-up period was(19.6±14.1)months. During perioperative period, no procedure related deaths was recorded. Perioperative complications include paraplegia in 1case(1.4％) in group B and stent graft-induced new entry in 2 cases(2.9％) in group A. During the follow-up period 1 case in group A within 1 month and another 1 case in group B within 1 year developed new entries at proximal end of stents. 1 case (1.4％) in group B had asymptomatic type Ⅰ endoleak 2 years after TEVAR. Conclusions Type B aortic intramural hematoma with arch involvement is not a risk factor of stent-induced new entry in perioperative period after endovascular treatment and further studies are needed. Strict control of blood pressure is essential for the prevention of stent-related complications.

0.05).But significant enhancement was found after LAD ligation for 4 hours (82.1?15.2) HU.MSCT coronary angiography could show the blockage of LAD in nine dogs.Conclusion MSCT myocardial perfusion combined with coronary angiography could estimate myocardial ischemia and infarction,and show the blockage of the coronary artery.

Coronary Artery Disease ; therapy ; Fistula ; therapy ; Humans ; Percutaneous Coronary Intervention

Objective To assess the diagnostic value of determining infarct core and penumbra using CT perfusion source images (CTP-SI) mismatch model in hemispheric stroke less than 9 hours.Methods "one-stop shop" CT examination including non-contrast enhanced CT (NCCT), CTP, CT angiography (CTA) were performed in 24 patients with symptoms of stroke less than 9 hours.The Alberta Stroke Program Early CT Score (ASPECTS) were analyzed on arterial phase CTP-SI and venous phase CTP SI using Wilcoxon rank-sum test, then compared with the follow up imaging ASPECTS using multiple linear regression.Results The median (min-max) scores of ASPECTS on arterial phase CTP-SI, venous phase CTP-SI and follow-up imaging were 9.0 ( 2.0-10.0 ), 9.3 ( 6.5-10.0 ) and 9.0 ( 7.0-10.0 ),respectively. ASPECTS measured on arterial phase CTP-SI significantly differed from the ASPECTS on venous phase CTP-SI ( Z =-2.812, P = 0.005 ).Moreover, the linear regression analysis showed significant correlation between the ASPECTS on venous phase CTP-SI and follow up imaging ASPECTS ( Beta =0.715,P = 0.003 ).Conclusion CTP-SI mismatch model provides a method of choice in predicting penumbra and infarct core in hemispheric stroke.

The rat model of multi-infarct was adopted in this study to elucidate the protective mechanism of Sailuotong capsule (Sailuotong) in recovery period of multiple cerebral infarction. The effects of Sailuotong on levels of Glu, GABA and the expression of NMDA receptor subtypes including NR1, NR2A and NR2B, were detected. The multi-infarct model rats were established by injecting embolizing microsphere via internal carotid artery, and were given Sailuotong treatment (16.5 and 33.0 mg x kg(-1)) for 60 days. The pathological changes in brain ultrastructure were observed by transmission electron microscope. The levels of Glu and GABA in brain tissue were measured with high performance liquid chromatography. The expression of NMDA receptors including NR1, NR2A and NR2B in neurons was evaluated by immunohistochemical staining. Compared with the sham rats, abnormal changes were observed in ultrastructures of neurons, neuroglia cells and synapses of model rat brains. Moreover, significant decrease of Glu and GABA, as well as the elevated expression of NR1, NR2A and NR2B were detected in brain tissues. Sailuotong (16.5 and 33.0 mg x kg(-1)) could improve ultrastructure of cerebral tissue, facilitate synthesis of Glu and GABA, and down-regulate expression of NR1, NR2A and NR2B in neurons. The results demonstrated that Sailuotong could exert neuroprotective effects to some extent in the recovery phase of multiple cerebral infarction by promoting expression of NMDA receptors and synthesis of Glu and GABA.