Objective To explore the diagnostic values of dual energy lung perfusion in the diagnosis of pulmonary embolism by using dual-source CT (DSCT). Methods Thirty patients with clinically suspected pulmonary embolism underwent dual-energy scanning with dual-source CT. The scanned data were integrated into three groups including 140, 80 kV and coefficient of 0.3. According to the CT pulmonary angiography (CTPA) of the fusion data, the patients were divided into pulmonary embolism group and normal group. The thin-slice reconstruction of data was analyzed using dual-energy perfusion imaging analysis software. The lung field was divided into upper, middle and lower part to make quantitative analysis of lung tissue perfusion. Paired t-tests were used in the normal patients to compare bilateral lungs, and independent samples t-tests were applied to compare the embolism group and normal group, while minimum intensity projection images (MinIP) were utilized in the assessment of lung ventilation. Results Dual energy CT showed symmetrical homogeneous perfusion in 16 normal cases, without significant perfusion defects. Quantitative analysis showed that left and right lung perfusion were (27 ± 7) and (28 ± 8 ) HU respectively, and no significant difference was found between the two sides ( t=-1.73, P ＞0.05 ).Perfusion of the left upper, middle and lower lung was ( 23 ± 6), (24 ± 6), and (28 ± 8) HU respectively, while the perfusion of right upper, middle and lower lung was (26 ±8), (27 ±8), and (28 ±9) HU respectively, showing no statistical significant difference between the two sides (t=-1.91, -1.96,-1.73 ,P＞0.05 ). Angiography of pulmonary embolism group(14 cases)showed filling defects in the pulmonary trunk, segments and sub-segments. Pulmonary perfusion imaging showed low perfusion or defectsin lung field that dominated by embolic vessels. Quantitative analysis showed that the perfusion of the whole lung and the middle and lower lung were (22 ±5), (22 ±8), and (21 ±8) HU in the embolism group,which were significantly different from the normal group (t=-2. 10, -2.32, -2.63, P＜0.05).Minimum intensity projection images showed a good consistency of abnormal ventilation zone area and perfusion abnormalities. Conclusions Pulmonary perfusion status, especially pulmonary embolism, can be analyzed by dual energy CT scanning. It helps to early discover and precisely locate the embolism.

Objective To evaluate the clinical efficacy of the covered stent placements in the treatment of malignant esophageal stenosis and to analyze the interrelated factors and countermeasures of complications.Methods 102 patients with malignant esophageal stenosis were undergone treatment with the covered stent placements through the mouths under X-ray fluoroscopy.The stents included China-made and imports,and the specifications were various.92 patients underwent radiotheraphy before or after process.All cases were followed up after operations.Results The successful rate of operation was 100%,110 covered stents were placed in total.The clinical symptoms of patients disappeared or abated obviously.Complications included:chest pain in 36 cases(35.3 %),restenosis in 7 cases(6.9%),stomach-esophageal countercurrent in 6 cases(5.9%),stent migration in 6 cases(5.9%),esophageal bleeding in 4 cases(3.9%),esophagus-mediastinum fistula in 1 case(1%),stent jam in 1 case(1%)and stent fell off accompanied with rupture partially in 1 case(1%).The mean survival time was 10.6 months.Conclusion The covered stent placement in the treatment of malignant esophageal stenosis is a high effective and easy method,but it is not very safe.

Objective To evaluate color process technioque and application of three-dimensional images coming from spiral CT and to improve the knowledge for color image.Methods The color process were differently applied in all 420 3-D images of spiral CT.Results All 420 images successfully were colored and printed.Conclusion 3-D color images can clearly display and differentiate tissue,organ and disease,it can supply more information for clinical diagnosis.

Objective To investigate the expression of complement regulatory proteins on placentas of pregnant C57BL/6 mice infected with Toxoplasma gondii in order to explore the molecular immunological mechanism for abnormal pregnancy induced by T. gondii infection. Methods Twenty-four pregnant C57BL/6 mice were randomly divided into two groups equally. The infection group was intraperitoneally injected with 200 of living T, gondii RH strain tachyzoites on the 8th day of gestation, and the normal group of mice was injected with physiological saline. All mice were killed on day 14 after gestation and placentas were collected. The expression levels of Crry, GPI-DAF and CD59a mRNA were analyzed by real-time quantitative PCR, and the positive rates of Crry and GPI-DAF were measured with flow cytometry. Results The died fetus rates of infected group and control were 80. 95% and 4. 41% , respectively. The infected group was significantly higher than of that the control group (P＜0.01). The expression levels of Crry, GPT-DAF and CD59a mRNA in the infected and control group were 0.786 ±0. 199, 0.594 ±0.096, 0.880 ±0. 179 and 0.550 ±0.077, 0.221 ±0.074, 0.591 ± 0.075 , respectively, and the difference of three kind of complement regulation proteins between two groups was all significant (P＜0.01). The positive percentages of Crry and GPI-DAF cells of infected and control group were (10. 03 ± 2. 11) % , (2.95 ±1.04)% and (3. 15 ± 1. 32) % , (0. 66 ±0. 26) % , respectively, and the difference of the two kind complement regulation proteins between two groups was also significant ( P ＜ 0. 01). Conclusion The expression level of mouse placental complement regulatory proteins was increased after infection with T. gondii, and then immunological microenvironment at the fetomaternal interface was destroyed. It may be one of important immunological mechanism for abnormal pregnancy induced by T. gondii infection.

acts was much lower than that in Tn-cell.Conclusion The expression of Tn,STn,T and ST antigen in gastric carcinoma tissues of different TNM stages is different.Tn antigen expression in tumor cells may be caused by the decrease of T-Synthase activity.

Objective To introduce the methods,complications and management of transiliaca external artery port catheter system (PCS) implantation,and to discuss its feasibility and superiority. Methods Transiliaca external artery PCS implantation were performed in 110 patients with medium or advanced malignant hepatic tumor.There were 86 male and 24 female, with average 50.8 years old, including 68 cases primary hepatic cancer, 42 cases metastatic cancer. Follow-up time was 2～53 months. Results The operation successful rate was 98.2% (108/110). Complications included: puncture local hematoma in 5 cases (4.5%), cut infection in 1 case (0.9%), slow bleeding in cut in 2 cases (1.8%), light swelling and paining of right testicle in 1 case (0.9%), target arteries occlusion or serious narrowness in 6 cases (5.5%), displacement of the tip of catheter in 3 cases (2.7%). Complications rate was 15.5% (17/110).Conclusion Transiliaca external artery PCS implantation is safe and feasible, the successful rate is higher and complications rate is lower, it can be introduced as a sort of routine method.

Objective To evaluate the value of electron beam computed tomography (EBCT) angiography and three-dimensional reconstruction in the diagnosis of aortic aneurysm.Methods 31 patients(24 male,7 female) with aortic aneurysm were performed scanning by EBCT . The scanning methods were contrast enhanced single slice volume scanning(SVS) and continuous volume scan(CVS); the 3D reconstruction methods were multiple planar reconstruction (MPR), maximum intensity projection(MIP), shaded surface display(SSD) and volume rendering(VR).Results Of 31 aortic disease, 7 cases were aortic aneurysm, 19 cases were aortic dissection and 5 cases pseudoaneurysm. 9 patients were performed operation and the diagnosis of EBCT coincided well with the operative findings in all cases. Conclusion EBCT angiography can obtain high quality images. EBCT angiographic findings and 3D imagings are in helpful accurate diagnosis and direct surgical operation. The 3D images can directly show the shape and range of aortic aneurysm and the tears of the dissection of pseudoaneurysm. It may substitute conventional aortic angiography in the diagnosis of aortic disease.

Objective To evaluate the clinical application of CT perfusion in predicting the status of axillary lymph nodes in patients with breast cancer.Methods Fony-five patients with infiltrating breast cancers and 46 clinically palpable axillary lymph nodes underwent dynamic mtdti-slice spiral CT(MSCT).Semi-automatic calculation of perfusion parameters including blood flow(BF),blood volume(BV),mean transit time(MTT)and permeability surface(PS)of "target" lymph nodes and muscles in the same scan level were respectively meagured and analyzed.Nonparametric Mann-Whitney U test was used for the statistics.Results Forty-six "target" lymph nodes examined by CTP were metastasis in 32 cases and reactive hyperplastic lymph node inflammation in 14 cases at pathology.22 of 32 metastatic "target" nodes (68%)were sentinel lymph nodes(SLN).BF of CIP for inflammation and metastatic "target" nodes were (76.18±31.53)and(161.60±40.94)ml·100 mg-1·min-1,BV were(5.81±2.50)and(9.15±3.02)ml／100 mg.MTT were(6.80±1.55)and(5.50±1.84)s,PS were(25.82±4.62)and (25.96±7.47)ml·100 mg-1·min-1.There were significant correlations between the BF value of inflammation and metastatic "target" nodes(r=0.14,P<0.05)and there were no significant correlations among the BV,MTT and PS values of inflammation and metastatic "target" nodes(r=-0.03,0.05,0.07.P>0.05).Conelusion CTP can provide useful informafion for evaluating lymph node status.

Objective:To investigate the demographic, epidemiological and clinical characteristics of measles in children, and to explore the risk factors for measles complicated with pneumonia in children.Methods:Children with measles aged≤18 years who were hospitalized in Jinan Infectious Disease Hospital from January 1, 2014 to December 31, 2018 were included. The demographic, epidemiological, clinical and laboratory data of inpatients were collected. The features of patients with pneumonia were analyzed. The risk factors of pneumonia were analyzed by chi-square test and multivariate logistic regression.Results:A total of 1 730 patients were recruited, including 423 patients (24.5%) in 2014, 437 patients (25.3%) in 2015, 856 patients (49.5%) in 2016, 10 patients (0.6%) in 2017 and four patients (0.2%) in 2018. The male to female ratio was 2∶1. The age ranged from four days to 18 years, and 1 572 patients (90.9%) were under three years old. There were 1 381 patients (79.8%) living in rural areas and 83 patients (4.8%) born with low birth weight. Two hundred and twenty-nine patients (13.2%) had a history of respiratory diseases within half a year before measles onset, and 1 489 patients (86.1%) had not been vaccinated before. According to the presence of pneumonia, 1 730 children with measles were divided into pneumonia group ( n=1 295) and non-pneumonia group ( n=435). There were more patients with bucking in pneumonia group than those in non-pneumonia group (56.8%(735/1 295) vs. 40.9%(178/435), χ2=32.770, P<0.01). Zero point seven percent (12/1 730) of children were critically ill, and 0.5%(8/1 730) of children died, all of whom were in pneumonia group. The white blood cell count, the percentage of white blood cell count>10×10 9/L, neutrophilic granulocyte count, the percentage of neutrophilic granulocyte count>7×10 9/L, C reactive protein level, the percentage of C reactive protein level>8.2 mg/L, procalcitonin level, the percentage of procalcitonin>0.5 ng/L, the percentage of hemoglobin level<110 g/L, and the percentage of albumin<35 g/L in pneumonia group were all significantly higher than those in non-pneumonia group ( t=7.153, χ2=47.239, t=8.297, χ2=41.176, Z=-6.769, χ2=40.131, Z=-4.119, χ2=19.284, χ2=7.465, χ2=18.356, respectively, all P<0.01). Multivariate logistic regression analysis showed that male (odds ratio ( OR)=1.316), living in rural areas ( OR=1.521), age7×10 9/L ( OR=3.666), and C reactive protein level >8.2 mg/L ( OR=1.871), procalcitonin>0.5 ng/L ( OR=1.711) were independent risk factors for pneumonia in children with measles. Conclusions:Measles vaccination in children should be farther strengthened. Male, children living in rural areas, low birth weight, history of respiratory diseases before measles and without measles vaccination are prone to be complicated with pneumonia, and special medical attention should be given.

Objective:To investigate the influence of endoplasmic reticulum stress (ERS) in the degeneration of cochlear hair cells in the type 2diabetic mice, and to clarify its mechanism.Methods:Twenty clean Kun Ming male mice aged one month were selected and randomly divided into control group and model group (n=10) .The mice in model group were injected with STZ (40 mg·kg-1) to establish the type 2diabetic models.The fasting blood glucose levels of the mice were measured through collecting the vena caudalis blood of the mice.Auditory brain stem response (ABR) was used to detect the ABR threshold of the mice.Otoacoustic emission (OAE) test was used to detect the OAE threshold of mice.The defect rate of mouse cochlear outer hair cells was calculated by the mouse cochlear spreading technique.The expression levels of GRP78, caspase-12, p-ERK and Nrf2proteins were detected by Western blotting method.Results:Compared with control group, the fasting blood glucose levels of the mice in model group at the 7th and the 14th days had no significant differences (P＞0.05) , but the levels were increased significantly at the 21th, 28th and 35th days and the level reached the highest value at the 35th day.The ABR thresholds of the mice in model group at 8, 12, and 24kHZ were increased significantly compared with control group (P＜0.05) .Under the stimulation of low frequency, there was no significant change in the OAE threshold of the mice in model grouop compared with control group.The OAE thresholds of the mice in model group were increased significantly under the medium frequency and high frequency stimulation compared with control group (P＜0.05) .The defects of the cochlear hair cells were mainly concentrated on the bottom of gyrus of the mice, and the defects in middle temporal gyrus and parietal gyrus were less.Compared with control group, the defect rate in the bottom of gyrus of the mice in model group was increased significantly (P＜0.05) ;the defect rates in the middle temporal gyrus and parietal gyrus were increased, but there was no significant difference (P＞0.05) .The expression levels of p-ERK and Nrf2in the cochlear hair cells of the mice in model group were lower than those in control group (P＜0.05) , and the expression levels of GRP78and caspase-12were higher than those in control group (P＜0.05) .Conclusion:ERS can result in the increase of defect rate of cochlear outer hair cells and ABR brainstem hearing threshold of the diabetic mice and decrease the expression levels of p-ERK and Nrf2proteins, suggesting that ERS can promote the degenerative lesions of cochlear hair cells in the type 2diabetic mice.