Objective: To investigate the quality control for purpose of radiologic protection in beside Photography. Methods: From a clinical application, based on the thress principle of radiological protection, combined with years of clinical experience, the need for comprehensive study bedside photography and protection security. Depending on the situation ,put forward corresponding countermeasures. Results: The different patient, especially in children photography and treatment of critically ill patients, with a reasonable operation mode, the method can reduce the radiation. Conclusion:The widespread popularity of medical radiological protection education, strengthen the quality control of bedside photography on bedside X-ray photography protection is very useful.

In order to investigate the mutation of HBV polymerase gene reverse transcription conserved region (P region) in chronic hepatitis B (CHB) patients, 212 CHB patients who took antiretroviral treatment with nucleotide analogues were chosen. The drug resistance mutations of HBV P region and HBV genotype were detected by Pyrosequencing. Sequence analysis showed that the drug resistance sites of HBV P region located at sites 173; 180; 181; 184; 204; 236 and 250. The main site of HBV P region drug resistance was 204 and 180, accounting for 35.8% and 23.5%, respectively. There were significant differences in the mutation rate of site 180 among different age groups. There were also significant differences in the mutation rate of site 204 among younger than 30 age group, 41 to 50 age group and 51 to 60 age group. (P < 0.05, P < 0.01). The mutation rate of site 180 combined with site 204 was 66.6%. The mutation rate of site 181 combined with site 236 was 23.3%. The age of C genotype infected patients was significantly older than B genotype infected patients (P < 0.01). M204V/I mutation mostly existed in the form of joint L180M mutation, the mutation rate was age-related. The detection of HBV genotypes and drug resistance sites of HBV P region have important clinical implications for the treatment and prognosis of patients with CHB.
Adult ; Aged ; Antiviral Agents ; pharmacology ; China ; Drug Resistance, Viral ; Female ; Gene Products, pol ; genetics ; Genotype ; Hepatitis B virus ; classification ; drug effects ; enzymology ; genetics ; Hepatitis B, Chronic ; drug therapy ; virology ; Humans ; Male ; Middle Aged ; Mutation, Missense ; Young Adult

Objective To investigate the causes of misdiagnosis of B-ultrasonography in thyroid nodule and the function of B-ultrasonography in diagnosis in thyroid nodule.Methods 307 patients with thyroid nodule were analysis between the diagnosis of B-ultrasonography and pathology.Results The diagnosis of B-ultrasonography was different from the diagnosis of pathology in thyroid nodule. If the thyroid nodule found by B-ultrasonography was multiple, it was nodular goiter; If the thyroid nodule found by B-ultrasonography was single, the ratio of nodular goiter and thyroid adenoma was 3∶2.Conclusions Clinical physician did not grant the diagnosis of B-ultrasonagraphy as clinical diagnosis. Most of multiple thyroid nodules were nodular goiter, single mass may be nodular goiter or thyroid adenoma. When the diagnosis of B-ultrasonagraphy was thyroid occupation, it may be malignant thyroid neoplasm.

AIM: To evaluate the relationships between maternal serum alpha-fetoprotein (MSAFP) levels and middle cerebral artery peak systolic velocity (MCA-PSV) in pregnancies with fetal anaemia and to compare the sensitivities of MSAFP and MCA-PSV for the predicting the risk of fetal anaemia. METHODS: Fifty-five measurements of MSAFP and MCA-PSV were carried out in 32 women at risk of fetal anaemia (4 cases of alloimmunisation, 11 cases of thalassemia, 10 cases of parvovirus infection and 7 cases of placental chorioangioma). The relationship between MSAFP and MCA-PSV was studied, and 19 fetal blood samples, in which MCA-PSV measurements were abnormal, were taken and the fetal heamoglobin were tested in order to evaluate the correlation of MSAFP and MCA-PSV. RESULTS: A correlation between MSAFP and MCA-PSV (n=55, r=0.57, P<0.01) was observed, in which 15 cases of fetal anaemia and 4 cases false positive (non-anaemia) were detected among the 19 fetal blood samples. The MSAFP levels of 4 false-positive cases were normal. The MSAFP levels in 15 fetal anaemia cases were higher than those in non-anaemia. The elevation of MSAFP level was 15-20 d earlier than that of MCA-PSV in the cases of alloimmunisation and thalassemia, and it was 10-12 d later in the cases of parvovirus infection and placental chorioangioma significantly (P<0.05). Both MSAFP (r=-0.87) and MCA-PSV (r=-0.67) were significantly correlated with fetal heamoglobin level. CONCLUSION: The MSAFP level is significantly correlated with both MCA-PSV measurements and fetal haemoglobin. The time and process of the elevations of MSAFP indicate that MSAFP is more sensitive than MCA-PSV to predict and monitor the pregnancies at the risk of fetal anaemia.

Objective To evaluate the clinical value of multi-slice spiral CT in diagnosing tracheobronchial foreign bodies in chil-dren.Methods 139 patients with airway foreign body confirmed by bronchoscopy were examined with 128-slice spiral CT,and then the CT data was reconstructed by using multiple-planar reconstruction(MPR),curved planar reconstruction (CPR),volume render-ing(VR),minimum intensity projection(MinIP)and virtual endoscopy (VE).The CT results were compared with bronchofibersco-py findings.Results Among the 139 cases,the foreign bodies located at trachea in 13 cases,right bronchia in 75 cases,left bronchia in 48 cases,and bilateral bronchia in 3 cases.137 cases (98.6%)were correctly diagnosed,and 2 cases (1.4%)were missed on CT.Although the difference of the results at trachea and right main stem bronchus was statistically significant (P <0.05),the over-all results was not significant difference between CT and bronchoscopy examination (P =0.340).Associated findings included em-physema in 74 cases,pneumonia in 48 cases,atelectasis in 22 cases,mediastinal displacement in 57 cases,lung interstitial emphyse-ma in 4 cases,pneumomediastinum and pneumoderma in 4 cases,bronchiectasis in 2 cases,and pleural effusion in 4 cases.Conclu-sion MSCT and its postprocessing techniques can accurately and intuitively display the tracheobronchial foreign body and complica-tions,which has important value for clinical application.

To assess early treatment for fracture of the maxillofacial bone complicated by cerebral injury, 120 patients were retrospectively reviewed. The change in GCS, the incidence of stress ulceration, nosocomial pneumonia and the injury of liver or kidney were determined 1 week after fixation of the fracture of the maxillofacial bone at different stages. There was no significant influence of the time of the operation on the severity of brain injury and the incidence of the complications. It is our assertion that the bone fracture could be fixed at an earlier stage, and RIMF is a kind of satisfactory fixation method.

Objective To observe the anatomical features of muscular branches of radial nerve in the forearm. Methods Forty seven adult embalmed cadaver arms were dissected under 4? loupe magnification. The radial nerve was identified in the interval between the brachioradialis and brachialis at the upper arm 10 cm proximal to the lateral humeral epicondyle (LHE). The nerve and branches were dissected and observed. The number of branches entering the muscles was counted and the following measurements were performed along the radial nerve and branches with a vernier caliper (accurate to 0.1 mm): distances from the origin point and muscle entry point of each branch to the LHE, the distance between the LHE and the styloid process of ulna (SPU). Data were pooled among all specimens (n=47) to calculate mean and standard deviation. Results In 35 of 47 (74.5%) specimens, the deep branch of the radial nerve coursed along the line between the LHE and the SPU. In all specimens, extensor indicis was the last muscle to be innervated. The average distance from the LHE to the origin point of extensor indicis branch was (160.6?12.1) mm, and that from the LHE to the SPU was (231.7?14.6) mm. The average proportionality between these two distances was 0.7?0.1. There was a large variation in branch number. The muscle with the highest branch number (4.6 averaged) was the extensor digitorum communis and that with the lowest number (1.1 averaged) were extensor policis longus and extensor indicis proprius. In 29 of 47 (61.7%), extensor carpi radialis brevis (ECRB) branch originated from the superficial branch of the radial nerve. In 15 of 47 (31.9%), the branch came from the deep branch of the radial nerve. In 3 of 47 (6.4%), the branch emanated from the radial nerve as 1 branch of a trifurcation (with the other branches being the deep branch and the superficial branch of the radial nerve). Conclusion With the forearm being pronated, the proximal 7/10 of the line between the LHE and the SPU can be considered as the projection on body surface of the deep branch of the radial nerve. The deep branch of the radial nerve may be damaged by operators improper dragging and detaching in surgery with the following reasons: branch lengths of extensor digitorum, extensor carpi ulnaris and extensor digiti minimi are short relatively, and origin points of these branches are more close than others to the point through which the deep branch of the radial nerve come out supinator. Differences in muscle architecture and function may be the reason that there is such variation in branch number. Discrepancies between studies about the ECRB branch origin may be related with the fault committed by researchers in dissecting.

Objective To explore the clinical features and CT characteristics of invasive pulmonary aspergillosis(IPA) in children with acute leukemia.Methods CT scanning of chest was performed in 13 cases with IPA proved clinically and sputum culture in children with acute leukemia.All cases followed up by CT 4 to 10 times.The clinical features and CT findings were analyzed retrospectively.Results The early CT findings included single nodule in 2 cases,multi-nodular shadow in 10 case and sub-pleural wedge-shaped consolidation in 5 cases,of these 5 cases,4 accompanied multi-nodules.Halo sign around the nodules in 9 cases.The follow-up CT showed air crescent sign or cavity in 11 cases,halo sign around the nodules in 7 cases and around cavity in 2 cases.Conclusion IPA has some characteristic manifestations on CT.CT is of important value in observing the evolution and evaluating the prognosis for the patients with IPA.

0.05) . Conclusions The effect of early-stage of breast cancer treatment by breast-conserving therapy plus other adjunct therapies is satisfactory . It can be as the first choice for the treatment of patients with early-stage of breast cancer.

Objective:To explore the efficacy and safety of 192Ir three-dimensional brachytherapy combined with intensity-modulated radiotherapy in patients with unresectable advanced obstructive extrahepatic cholangiocarcinoma. Methods:A retrospective analysis of the efficacy and safety of 18 patients with unresectable advanced malignant obstructive extrahepatic cholangiocarcinoma admitted to the Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine in Hebei province from January 2014 to January 2018.All patients were pathologically confirmed and received biliary stent implantation, followed by sequential intensity-modulated radiotherapy and 192Ir three-dimensional brachytherapy.The clinical data of all patients were collected, including gender, age, clinical stage, adverse reactions, brachytherapy dose-volume parameters, changes in bilirubin levels before and after treatment, evaluation of efficacy, local control rate and survival rate. Results:All patients successfully completed the treatment.Re-examination was conducted one month after the combined treatment, of the 18 patients, 16 had partial remission (PR) and 2 were stable(SD). Among them, 14 patients had tumor shrinkage after brachytherapy compared with intensity-modulated radiotherapy, and 4 patients showed no significant change.The 6-month local control rate (LC) was 94.4% (17/18). The 1-year survival rate was 55.6% (10/18), and the 2-year survival rate was 38.9% (7/18). Statistical analysis showed that after combined treatment, total bilirubin and direct bilirubin were significantly reduced, and jaundice symptoms were significantly relieved.The adverse reactions of the patient were nausea, vomiting, fever, biliary tract infection, etc.There were no adverse reactions of grade 3 or above.Conclusions:192Ir three-dimensional brachytherapy combined with intensity-modulated radiotherapy in patients with inoperable advanced extrahepatic cholangiocarcinoma has a good local control rate and tolerable adverse reactions, but the impact on long-term survival requires a large sample of controlled studies.