The notational DSA was first proposed for the application as a managing tool of neuronradiology in the early 70's of 20th centery.Later on,three dimensional image reconstruction(3D DSA) was aquired along with the progressing development of technique and equipment devices.As a rather practical instrument,it has been utilized successfully in the diagnosis and management of head and neck vascular disorders,and abdominal parenchymal diseases during recent years.We comprehensively intoduce the application of rotational DSA for the diagnosis and management in hepatic diseases.

Objective To detect the expression of p16 and discuss the significance in genesis and development of cervical cancer. Methods FQ-PCR method was used to detect the expression levels of p16 mRNA in cervical cancer(CC),cervical intraepithelial neoplasia(CIN),and normal tissues.And in situ hybridization was used to detect HR-HPV in these tissues.Results The expres-sion levels of p16 were 0.79±0.34,0.70±0.36,0.26±0.21 in CC,CIN and normal cervical tissues,respectively.The difference was significant (P <0.05).The expression level of p16 was significantly associated with FIGO stage (P <0.05),but it showed no significant relationship with age,tumor size,cell differential degree and lymphoid node metastasis (P >0.05).The expression level of p16 in HR-HPV positive cases was significantly higher than that in HR-HPV negative cases (P <0.05).Conclusion p16 shows high expression level in cervical cancer,which is closely related to the infection of HR-HPV infection.It suggests that the high ex-pression of p16 play an important role in genesis and development of cervical cancer.

Objective To analyze the complications and short-term effects of laparoscopic surgery for achalasia.Methods The clinical data of 41 patients with achalasia who were treated by laparoscopic surgery were analyzed retrospectively.Results The 41 patients were no deaths.All patients underwent Heller cardiomyotomy and fundoplication,39 patients with Dor anterior fundoplication,2 patients had the presence of hiatal hernia with Toupet fundoplication.The mean surgical time was 142 min.Intraoperative complications occurred in 7 cases,including 6 cases of mild complications.The mean follow-up was 21 months.The clinical efficacy excellent in 27 cases,good in 7 cases,generally in 5 cases,poor in 2 cases.Conclusions Heller cardiomyotomy should be the treatment of choice in achalasia patients,because of its short and medium term outcomes,and its low morbidity.

Editor's Notes: The basic theory of traditional Chinese medicine is the theoretical foundation of Chinese medicine , modernization of Chinese medicine needs of the modern theory of Chinese medicine urgently . However , it is always the important issues about how modern Chinese medicine theory should be created , and what kind of theory should have been established concerned and explored by domestic and foreign counterparts in tradi-tional Chinese medicine . To lead the development of modern Chinese medicine theory , Modern Basic Theory of Traditional Chinese Medicine series of symposiums are set up specially in the current Review column, and discussed thoroughly and systematically using three consecutive pats respectively. Among them, part I contains 3 articles about new concepts, new theories, new disciplines; part II contains 5 articles about new ideas, new norms, how to clear concept, how to verify hypotheses, why to evaluate theory; part III contains 12 articles about concept of wholism updating, treatment based on syndrome differentiation development, viscera-state doc-trine innovation, pathogeny, etiology, pathogenesis, prevention, principle of treatment, knowledge structure, cogni-tion structure , monographic study , 5-year outlook . Published article on this issue is the first one belong to new concept of part I. In this paper, we want to describe the denotation and connotation of the new concept of the modern basic theory of traditional Chinese medicine from three aspects of a concept: a label , a theoretical definition , and an operational definition learning from the international academic understanding of scientific concepts, demonstrate the necessity of theoretical premise to the research and establishment of the modern basic theory of traditional Chinese medicine and the need to build on , illustrate the inevitable trend toward modern science . The whole article contains profound meaning and a certain breakthrough and innovation. We are expected to cause concerns and discusses of experts and scholars through this article .

Objective To investigate the clinical efficacy and treatment method for no midline shift-severe craniocerebral trauma accompanied with post-traumatic acute diffuse brain swelling (PADBS).Methods 60 PADBS patients were randomly divided into conservative treatment group and operation group,30 patients in each group.The operation group was treated with intracranial pressure monitoring by implantation of the probe and decompressive craniectomy,while the conservative treatment group received conservative treatment.The postoperative recovery was observed.Results The GCS scores of operation group postoperative 7d and 15d were (11.21 ± 2.24) and (12.88 ±2.31),which were obviously higher than (7.47 ± 1.51) and (8.19 ± 1.28) of the conservative treatment group (t =2.215,2.321,all P ＜ 0.05).Postoperative long-term follow-up results indicated that,according to GOS score,63.3％ patients in the operation group recovered well,which was significantly higher than 26.7％ in the conservative treatment group.While the percent of patients with coma or dead was 6.7％ and 10.0％ in the operation group,which were significantly lower than the conservative treatment group (x2 =15.721,4.172,3.84,all P ＜ 0.05).Conclusion In general,PADBS could not be cured easliy,the operation methods of using intracranial pressure monitoring and decompressive craniectomy based on conservative treatment could help to evaluate the trauma objectivly,detect the changes of disease earlier,treat in time and assess the prognosis accurately,all which would reduce the mortality.

Objective To observe the clinical effect of procedure for prolapse and hemorrhoids (PPH) in treating hemorrhoids.Methods 78 patients with symptomatic Ⅱ,Ⅲ and Ⅳ degree hemorrhoids undergoing PPH were selected in this study.The diagnosis,medical history,operative time,blood loss and perioperative complications were recorded.The World Health Organization Quality of Life Scale(WHOQOL-BREF) was observed preoperation and 6 hours,24 hours,1 month postoperation.Results The postoperative pain score measured by visual analogue scale (VAS) at postoperative six hours was (7.6 ± 2.1),which reduced to (1.3 ± 1.1) at 24 hours.There was significant improvement in the overall perception of QOL,health,and in physical and psychological domains (t =1.901,1.805,1.714,P =0.041,0.038,0.029,all P ＜ 0.05).There was modest improvement in environmental domain,while no change was found in social domain (P ＞ 0.05).Conclusion PPH surgery achieves good clinical results,improved quality of life of patients,with a low incidence of complications,patients with hemorrhoids should be recommended for this preferred surgical approach.

ObjectiveTo investigate the optimal reconstruction windows for coronary angiography using 320-detector row dynamic volume CT (DVCT) and evaluate their effects on image quality,radiation dose and diagnostic accuracy.MethodsFrom 77 patients [mean heart rate (70 + 13) bpm,range:46-102 bmp] were scanned with retrospective ECG-gating 320-detector row DVCT.The relationship between heart rate and optimal reconstruction windows was analyzed.From 53 patients [mean heart rate ( 75 ±11 ) bpm,range:57-114 bpm] were scanned with prospective ECG-gating 320-detector row DVCT.The effects of prospective ECG-gating on image quality,radiation dose and diagnostic accuracy were evaluated.Friedman test was performed for image quality scores in random groups.Linear regression and Spearman correlation were performed to test bivariate data.ResultsThe proportion of systolic duration in the cardiac cycle increased significantly with higher heart rate (r =0.78,P ＜0.01 ).The image quality in systolic and diastolic phases were significantly influenced by heart rate ( r =0.38,0.82 ; P ＜ 0.01 ).According to the regression analysis of image quality score in different heart rate groups,the optimal reconstruction windows were determined as followed:when heart rate was ＜ 70 bpm,the optimal reconstruction windows should be preset at 65％-80％ ; 70 to 80 bpm,70％-85％ ; 81 to 90 bpm,70％-90％ ; ＞90 bpm,35％-50％.Compared with retrospective ECG-gating,prospective ECG-gating which preset reconstruction windows according to the phases mentioned above,could decrease radiation dose [(6.1 ± 3.8 )vs (12.4 ± 7.0) mSv],without deteriorating the image quality (t =6.5,P ＜ 0.01 ).However,in higher heart rate,the radiation dose of prospective ECG-gating DVCT was still higher ( r =0.64,P ＜ 0.01 ).ConclusionsDVCT can provide high image quality in a wide range of heart rate with prospective ECG gating.It is still recommended to control heart rate strictly since the radiation dose increases significantly in high heart rate.

Objective To assess the efficacy of combination of Jiehe pellet and the standardized anti-tuberculosis therapeutic regimen for pulmonary tuberculosis complicating cervical lymph node tuberculosis in the aged. Methods A total of 103 aged patients with pulmonary tuberculosis complicating cervical lymph node tuberculosis were enrolled and randomly allocated to either a standardized anti-tuberculosis therapeutic regimen group (control group with 51 patients) or a standardized anti-tuberculosis therapeutic regimen plus Jiehe pellet group (treatment group with 52 patients). The patients in the control group and the treatment group received the treatment with 2HRZE/4HR and 2HRZE/4HR plus Jiehe pellet for 6 months, respectively. The abscessed lymph nodes were treated by either total excision or incision and drainage after 4 weeks of medicine treatment in both groups. Sputum smear was examined for acid-fast bacilli. The CD8 cells expressing natural killer T cells receptors NKG2A, NKG2D in peripheral blood were detected by flow cytometry. The treatment outcome was measured at the end of treatment. Results The rates of lesion resolution (78.85%vs. 58.82%;χ2=4.439, P<0.05) and cavity closure (62.86% vs. 35.48%;χ2=3.893, P<0.05) in the treatment group were significantly higher than those in the control group. In the end of 2, 4 and 6 months of treatment, cumulative rates of sputum conversion from positive to negative in the treatment group were significantly higher than those in the control group (χ2 were 5.343, 5.067 and 4.118,all P<0.05). The CD8 cells expressing NKG2A after treatment in the treatment group were significantly lower than those before treatment in the treatment group (t=9.510, P<0.01) and after treatment in the control group (t=9.832, P<0.01);the CD8 cells expressing NKG2D after treatment in the treatment group were significantly higher than those before treatment in the treatment group (t=10.622, P<0.01) and after treatment in the control group (t=10.433, P<0.01). The serum levels of IL-6 and TNF-αafter treatment were significantly lower than those before treatment in both groups (t were 17.344 and 21.142 in the treatment group, 10.984 and 12.203 in the control group;all P<0.01 );the serum levels of IL-6 and TNF-α after treatment in the treatment group were significantly lower than those after treatment in the control group (t were 7.832 and 5.478,all P<0.01). The serum IL-10 levels after treatment were significantly higher than those before treatment in both groups (t were 12.454 in the treatment group, 7.934 in the control group; all P<0.01 ); and the serum IL-10 level after treatment in the treatment group was significantly higher than that after treatment in the control group (t=4.720, P<0.01). The effective rate for cervical lymph node tuberculosis in the treatment was significantly higher than that in the control group (88.5%vs. 64.7%;χ2=6.855, P<0.01). Conclusion Combination of Jiehe pellet and the standardized anti-tuberculosis therapeutic regimen may improve immune function, increase the rate of sputum conversion from positive to negative, and facilitate lesion resolution in aged patients with pulmonary tuberculosis complicating cervical lymph node tuberculosis.

t=2.331,P=0.022) T cell levels and CD4+/CD8+ ratio (1.1 ± 0.2vs. 0.9 ± 0.2;t=4.488,P<0.001) showed significant difference between post-treatment and pretreatment. CD3+, CD4+, CD8+ T cell levels and CD4+/CD8+ ratio after treatment showed significant different between the two groups (t values were 3.920, 11.966, 5.573, 10.700,P<0.01). After the treatment, the cure rate in treatment group was significantly higher than that in the control group (80%vs. 56%;χ2=5.561,P=0.018). The rates of sputum conversion from positive to negative (72.0%vs. 50.0%;χ2=5.086,P=0.024)and cavity closure (36.0%vs. 16.0%;χ2=5.198,P=0.023) 6 months after treatment in the treatment group were higher than those in the control group.ConclusionFeitai capsule combined with mycobacterium vaccae can significantly improve the immune function in elderly patients with pulmonary tuberculosis.

The clinical data of 42 patients with impacted upper-ureteral calculi undergoing retroperitoneal laparoscopicureterolithotomy(RPLU)from January 2008toDecember 2010 were retrospectively analyzed.RPLU was successfully performed in 40 cases,and simultaneous laparoscopic electrocoagulation ablation was also performed in 11 cases complicated with ureteral inflammatory polyps.No massive bleeding occurred during the operations.The stone-free rate 3 d after operation was 100％,and no stone left as reviewed by kidney ureter bladder X-ray (KUB) and B-ultrasonography.During the follow-up of 3 to 24 months (mean 11 months),40 cases showed no stone recurrence and no ureteral stricture in KUB and B-ultrasonography.The hydronephrosis of all RPLU patients relieved.Results indicate that RPLU is a safe and effective minimally invasive operation for treatment of impacted upper-ureteral calculi.