Objective To analyze the evaluation value of ABCD2 combined with carotid ultrasound on the prediction of cerebral infarction after transient ischemic attack. Methods The clinical data of 133 patients with TIA admitted from July 2014 to December 2015 were analyzed. We score patients according to the standard of ABCD2 score and carotid ultrasound. The incidence of cerebral infarction within 7 days was observed. Results In the 133 TIA patients 35(26.3%) progressed to cerebral infarction. The 7-day incidence of cerebral infarction was 7.1% in patients with an ABCD2 score of low risk (0-3), 25% with a score of moderate risk(4-5), and 40% with a score of high risk(6-7). The difference of the incidence of cerebral infarction was significant between the low and moderate risk stratification (P < 0.05). The 7-day incidence of cerebral infarction was 39.5% in patients with carotid plaque and 75.0% in patients with carotid stenosis , both higher than the control group (P < 0.05). In the ABCD2 score ≥4 group, the incidence of cerebral infarction in the patients with abnormal carotid ultrasound was 38.4% ,significantly higher than the patients with normal carotid ultrasound (P < 0.05). Conclusions The ABCD2 score is effective to predict short-term risk of cerebral infarction in the patients with TIA. Combination with carotid ultrasound can improve the predictive accuracy of 7- day risk of cerebral infarction after TIA.

Objective To investigate the clinical application of CT perfusion imaging in assessing the hemodynamic changes in patients with small hepatocellular carcinoma (<5 cm) before and after transcatheter arterial chemoembolization (TACE). Methods Twelve patients with small hepatocellular carcinoma were enrolled in this study. CT perfusion imaging of the liver was performed 1 - 2 days before and 3 - 4 weeks after TACE. By using the perfusion parameters the hemodynamics of the preoperative and postoperative tumor tissue, the hemodynamics of the preoperative tumor tissue and the normal tissue, and the hemodynamics of the postoperative active tumor tissue and the normal tissue were determined , and the results were compared between each other. Results Before TACE, the blood flow (BF), hepatic arterial fraction (HAF), hepatic arterial perfusion (HAP) and permeability of surface (PS) in the tumor tissue were significantly higher than those in the normal tissue (P < 0.01), while after TACE all the perfusion parameters except blood volume (BV) were significantly decreased in the tumor tissue (P < 0.01). After TACE, BF, PS, HAF and HAP in the activity tumor tissue were increased more than those in the normal tissue (P < 0.05). Conclusion CT perfusion imaging is of great clinical value in diagnosing < 5 cm hepatocellular carcinoma , in evaluating the hemodynamic changes after TACE and in demonstrating the activity of the residual tumor tissue.

Objective To investigate the effect of heat treatment on the proliferation of, melanin synthesis and tyrosinase activity in cultured normal human melanocytes. Methods Normal human foreskin tissue was obtained by sterile circumcision and melanocytes were harvested by using methods for epidermal cell culture. Basic fibroblast growth factor (bFGF) was utilized as the primary mitogen to establish the culture system of normal human epidermal melanocytes. Masson-Fontana staining was proformed to identify melanocytes.Third-passage melanocytes were treated with hyperthermia at various temperatures (39 ℃, 41 ℃, 42 ℃, 43 ℃ and 45℃) for 1 hour a day for consecutive 3 days followed by the measurement of cell viability with MTT assay. The hyperthermia at optimized temperature was used to treat fourth-passage melanocytes for 1 hour a day for consecutive 3 days; subsequently, the tyrosinase activity were detected with L-Dopa as the substrate, and melanin content was determined in heat-treated and untreated (control) melanocytes. Results The hyperthermia at 42 ℃ exhibited the strongest promotive effect on the proliferation of melanocytes among these 5 hyperthermia conditions. After treatment with hyperthermia at 42 ℃ for 1 hour a day for consecutive 3 days, melanocytes showed an increment in tyrosinase activity by 36.4% and melanin synthesis by 78% compared with the untreated melanocytes (both P＜0.05). Conclusions Heat treatment can enhance the proliferation of cultured human melanocytes, promote their melanin synthesis and tyrosinase activity.

Objective To evaluate the significance of coronary calcification and stenosis in elderly hypertensive patients by 16-row multi-sliced computed tomography (MSCT) and its association with peripheral arterial atherosclerosis and other target organ damages. Methods Sixty-four patients with hypertension (n=50) 76.1?6.5 years and normotensions (n=14) 73.4?6.8 years were enrolled. All patients underwent coronary calcification scan by MSCT and the coronary calcification score(CCS) was calculated as AJ130 and Volume. Fourty-four patients in the hypertensive group were subjected to MSCT enhanced scan for evaluation of coronary stenosis. Intima media thickness (IMT), atherosclerotic and calcified plaques in carotid and femoral arteries and ankle-brachial index (ABI) carotid and femoral arteries were measured by echosonography and echocardiography; Fasting plasma blood glucose, blood lipid series, insulin, HOMA-IR, hsCRP and morning urine albumin were determined. Results (1) Both AJ130 and Volume of left anterior descending artery(LAD), left circumflex artery(LCX) and the total calcification score were higher in the hypertensive group than those in the control group (P

To intensify the medical students'clinical skills training is the main objective of medical imaging education. In the process of clinical teaching ,we have adopted many means including renewed multimedia courseware,teaching web page,film storage,and integration of various teaching methods. The film-reading skill of medical students has greatly increased.

Background and purpose: The position of thymidine kinase 1 (TK1) expression during cell division is in the cytoplasm. It is a catalytic enzyme to convert deoxythymidine into thymidylate. It is the key enzyme of pyrimidine salvage pathway. The aim of this study was to analyze the serum expression level of TK1 in patients with breast cancer, and explore the application of serum TK1 test in clinical assessments of diagnosis, treatment and prognosis for breast cancer. Methods: Patient data were collected from the patients admitted in Comprehensive Breast Health Center at Rui Jin Hospital. Chemiluminesence dot blot assay was used to detect serum TK1 levels in 145 breast cancer patients and 55 patients with breast ifbroadenoma. The correlations of serum TK1 levels with breast tumor biological behavior was further studied. Results:Serum TK1 expression levels was signiifcantly increased in breast cancer patients [(2.749±0.122)pmol/L] when compared to breast fibroadenoma patients[(1.319±0.126)pmol/L, P<0.000 1]. Serum TK1 levels were statistically increased in patients with lymph node metastasis (P=0.049), distal metastasis (P=0.003 1), and late TNM stages (P=0.01). No serum TK1 level differences were found in patients with different ages (P>0.05), different tumor grades (P=0.453) and different tumor size (P=0.908). Preoperative imaging results including breast ultrasound, breast mammography and breast magnetic resonance were analyzed by assessments of BI-RADS category, and serum TK1 levels in patients with different BI-RADS categories were studied. Serum TK1 levels in patients with breast ultrasound BI-RADS categories 4C-6 were signiifcantly higher than those with category 0-4B (P<0.001). Consistently, the serum TK1 levels in patients with MR BI-RADS categories 4C-6 were higher than categories 0-4B (P=0.005). The serum TK1 levels in patients with mammography BI-RADS categories 4C-6 were higher than categories 0-4B (P=0.032). The serum TK1 levels were signiifcantly increased in patients with ER high expression in breast tumor tissues than those with low expression (P=0.034). Serum TK1 levels had no differences in patients with different expression levels of PR, HER-2 and MIB-1 (P>0.05). Most patients were followed up in our outpatient department for about 2 years. No progression-free survival differences were found in 2years. Conclusion:Serum TK1 test might be a potential tool for screening, prognosis determination and effect evaluations of targeted therapy in breast carcinoma.

ObjectiveTo investigate the effect of heat treatment combined with narrow band ultraviolet B(NB-UVB) on cultured normal human melanocytes in vitro.MethodsMelanocytes were isolated from the foreskin of normal human,cullured in vitro,and irradiated with NB-UVB of different doses(20,30,50,70,90,120 and 180 mJ/cm2).Then,MTT assay was performed to evaluate the proliferation and activity of melanocytes to determine the optimal dose of UVB for the next experiment.Melanocytes were classified into 3 groups to be treated with heat at 42 ℃ for 1 hour (heat group),irradiated with UVB at 50 mJ/cm2 (UVB group),or irradiated with UVB at 50 mJ/cm2 followed by heat treatment at 42 ℃ for 1 hour (combination group),daily for 3 successive days; those receiving no treatment served as the control.After 24-hour culture following the last treatment,tyrosinase activity was evaluated with L-dopa as the substrate,melanin content was detected by NaOH assay,and cell cycle stages were determined by flow cytometry.ResultsNB-UVB irradiation decreased the viability of melanocytes in a dose-dependent manner,and the optimum dose of UVB was 50 mJ/cm2.The tyrosinase activity of melanocytes was 0.244 ± 0.018 and 0.310 ± 0.015 respectively in the UVB group and combination group,and increased by 3.8％ (P ＜ 0.05) and 31.9％ (P ＜ 0.05) respectively compared with the control group (0.235 ± 0.018); the melanin content was 0.201 ± 0.016 and 0.286 ± 0.019,respectively in the UVB group and combination group,and increased by 17.5％ (P ＜ 0.05 ) and 67.3％ (P ＜ 0.05) compared with the control group (0.171 ± 0.016).In comparison with the control group,the percentage of melanocytes in G1 phase was decreased by 23.94％ in the UVB group(P＜ 0.05) and 33.51％ in the combination group(P ＜ 0.05),while that in S phase and G2 phase increased by 15.35％ (P ＜ 0.05 ) and 11.93％ (P ＜ 0.05),respectively in the UVB group,and 17.76％ (P ＞ 0.05) and 16.08％ (P ＞ 0.05),respectively in the heat group.ConclusionHeat treatment and NB-UVB can synergistically enhance the tyrosinase activity and accelerate melanogenesis,proliferation and differentiation,of melanocytes.

Objective To evaluate maximum intensity projection(MIP) images and apparent diffusion coefficient(ADC) values of MR diffusion weighted imaging with background body signal suppression (DWIBS) on pulmonary diseases.Methods Sixty-one patients with pulmonary diseases underwent DWIBS.The findings in three dimensional(3D) MIP image were observed and the ADC values of diseased region were measured.The diagnostic value of DWIBS on pulmonary diseases was evaluated.Results Lung cancer and inflammatory disease were all demonstrated as dense intensity area on DWIBS.The mean ADC value of central lung cancer was (1.05±0.23)×10-3 mm2/s.The mean ADC value of peripheral lung cancer was(1.10±0.17)×10-3 mm2/s.The mean ADC value of the inflammatory disease was(1.69±0.29)×10-3 mm2/s.The mean ADC value had significant difierence between peripheral lung cancer and the inflammatory disease (P＜0.05). The MR sensitivity,specificity and accuracy in diagnosing the pulmonary diseases with DWIBS(86.84%,82.60%,85.24%,respectively) was higher than conventional MRI(78.94%,78.26%,and 78.68%,respectively).Conclusion DWIBS can demonstrate clearly the lesion's shape with 3D display.The quantitative measurement of ADC values iS feasible.DWIBS may be a potential diagnostic method for differentiation on pulmonary diseases.

Objectives To investigate the clinical significance of dual energy spectral CT (DESCT) in quantitatively differentiating peripheral lung cancers from pulmonary inflammatory masses.Methods Sixty patients with 35 lung cancers and 25 inflammatory masses underwent DESCT to get arterial phase (AP) images and venous phase (VP) images.Iodine concentrations in the central and peripheral zone of the masses were measured and normalized to the aorta as normalised iodine concentration (NIC).The difference of NIC between central and peripheral zone of the masses (dNIC) was calculated.The spectral attenuation curve was obtained automatically and the slope of curve (λHU) was also calculated in the two groups.The quantitative parameters was presented as M (Q1,Q3),and Wilcoxon signed rank test was used to compare above two independent samples.Receiver operating characteristic (ROC) curves were generated to calculate the sensitivity and specificity.Results NICs in the central zone of peripheral lung cancers were significantly lower than that of inflammatory masses:mean NICs were 0.03 (0,0.05) versus 0.12 (0.07,0.20) in AP,and 0.14 (0.12,0.19) versus 0.30 (0.21,0.57) in VP (Z=-4.14,-3.70,respectively,P＜0.01).While the dNIC values of lung cancers were significantly higher than that of inflammatory masses:dNIC values were 0.08 (0.05,0.11) versus 0.04 (-0.02,0.08) in AP,and 0.23 (0.17,0.34)versus 0.07 (-0.04,0.08) in VP(Z=-2.56,-4.00,respectively,P＜0.05).Mean λHU values of lung cancers were also lower than inflammatory masses:1.03 (0.67,1.67)versus 2.75 (1.61,3.19) in AP,and 1.58 (1.30,2.17) versus 3.25 (2.37,4.54) in VP (Z=-3.90,-4.42 respectively,P＜0.01).According to ROC curves,cutoff value of λHU =2.11 in VP had the highest sensitivity (89％) and specificity (91％) in differentiating peripheral lung cancers from inflammatory masses.Conclusions Contrast-enhanced dual energy spectral CT imaging with some quantitative parameters such as normalised iodine concentration,dNIC,and the slope of spectral attenuation curves may be a promising new method for differentiating peripheral lung cancers from inflammatory masses.

Objective To investigate the impact of a single sub-anesthetic dose of ketamine on postoperative emotional reactions of anxiety and depression during colorectal tumors surgery. Methods A total of 42 patients undergoing selective colorectal surgery,aged 18 to 65 years,were randomly divided into ketamine group (group K)and control group (group C).After induction of an-esthesia,a single intravenous injection of 0.3 mg/kg ketamine and saline were used in Group K and group C 5 minutes before the operation respectively.The intravenous analgesia program was identical between the two groups.The patients??emotional reactions (anxiety,depression)were assessed using the Hospital Anxiety and Depression Scale (HAD),the quality of recovery was assessed using the QoR-40 questionnaire on the day before operation and within postoperative 48 hours respectively.Pain was estimated by the visual analog scale (VAS)and sedation was assessed with Ramsay score 30 mi-nutes after extubation.The time of anesthetic end and extubation were recorded.The complications during anesthesia and recovery such as cough, agitation 30 minutes extubation were recorded. Results The HAD-A and HAD-D scores of group K were lower than group C (P <0.05)48 h post-operatively.There was no difference on the QoR-40 score postoperative 48 h between the two groups. The patients??emotional state QoR-40 score of group K were higher than group C (P <0.05 ).The VAS scores 30 minutes after extubation of group K were lower than group C (P <0.05).There was no significant difference on sedation score 30 minutes postoperatively between the two groups.There was no significant difference in extubation time,cough,agitation and delirium between the two groups.There was no dizziness, nausea, vomiting or diplopia 30 minutes after extubation. Conclusion A single subanesthetic dose of ketamine can significantly reduce the scores of postopera-tive anxiety and depression,improve the quality of recovery,and no postoperative adverse reactions increased.