Objective To investigate the clinical manifestation and management of acute cholangitis severe type (ACST) with different typos of obstruction. Methods From January 1997 to December 2006, 164 consecutive patients with ACST had been admitted to Chengdu First People's Hospital. All patients were divided into extrahepatic type group (n=122), intrahepatic type group (n=18) and mixed type group (n=24) accord-ing to the types of obstruction. Clinical manifestation and therapeutic outcome of the 3 groups were analyzed using chi-square test, continuity correction test or Fisher exact test. Results There was no significant difference in clinical manifestation between patients with extrahepatic type and those with mixed type (P>0.05). The incidence of jaundice and abdominal pain in patients with intrahepatic type is significantly lower than those with extrahepatic type (P<0.05). The incidences of distention in consciousness and response to initial medical treat-ment were higher than those with extrahepatic type (P<0.05). The total mortality rate was 9.8% (16/164). Of all patients, 123 received open surgery. There was no significant difference in morbidity and mortality in patients with intrahepatic type and mixed type (χ~2=0.172,0.789; 1.769, 1.948, P>0.05). In emergency operation, the incidence of biliary high pressure and postoperative vital sign improvement rates were significant higher in patients with extrahepatic type than the other 2 types (P<0.05). The morbidity and mortality of patients who received emergency operation were higher than non-emergency operation (P<0.05). Conclusions The clinical manifestation of ACST is different between intrahepatic obstructive type and the other 2 types. There is no signi-ficant difference in morbidity and mortality among the 3 types of obstruction. The morbidity and mortality are high in patients who received emergency operation. Proper management of surgical timing is helpful in decreasing the morbidity and motality of ACST.

Objective:To study the practical value and imaging expression of target reconstruction technique of HRCT in the diagnosis of pneumoconiosis.Methods:Fifty-seven cases with different level type of pneumoconiosis were first examined by routine CT scan,followed by HRCT examination at top of aortic arch,carina of trachea,3 cm below bifurcation of bronchi,and 2 cm above thd right diaphragm.Target reconstruction have been finished using the raw data stored.Results:Target reconstruction photoimages were cleared to display the morphology of delicate lesions of pneumoconiosis:(1)Nodular shape(100%).(2)Interlobular septal thickening(98.24%).(3)Lobular structure abnormality(98.24%).(4)Subpleural nodes (84.21%).(5)Centrilobular emphysema(63.15%).(6)Subpleural line(64.91%).(7)Bronchiectasis(63.15%).(8)Ground-glass opacity(35.08%).(9)Honeycombing(15.78%),and to display earlier period change details.Conclusion:HRCT target reconstruction technique may make lesion dispaly more detail than comventional and high-resblution CT.It is reliable to display the delicate lesions of pneumoconiosis and provide more diagnostic information.

OBJECTIVETo study the value of CT quantitativeness in the diagnosis of coal miner's pneumoconiosis.

METHODS104 cases were examined by HRCT scan at top of aortic arc, carina of trachea, 3 cm below the bifurcation of bronchi, among them there were 87 patients with different stages of coal miner's pneumoconiosis, 17 cases of normal males as the control group. All images were determined by CT density histogram at specific region (- 1,024-0 HU). Calculated the percentage of each pixel included a varying number of CT value, and the ratio of density values in the specific region.

RESULTSThe ratio of density values in the region of -983 (-) -778 HU was 87.31% in normal control group, and 80.51%, 75.27% and 72.99% respectively in the I, II, III stages of coal miner's pneumoconiosis. There were statistically significant differences among the groups (P < 0.01).

CONCLUSIONCT quantitative histogram information was able to observe the fibrosis and its degree of coal miner's pneumoconiosis. It has a good diagnostic value for its reliability and objectiveness.

Coal Mining ; Humans ; Pneumoconiosis ; diagnostic imaging ; Pulmonary Fibrosis ; diagnostic imaging ; Tomography, X-Ray Computed ; methods