ObjectiveTo evaluate characteristic imaging findings of tumor attenuation in 4-phase CT between renal oncocytoma ( RO ) and clear-cell renal ceil carcinoma ( ccRCC ) of small tumor size (≤Scm).Methods Fifty-six patients with histologically confirmed renal masses (11ROs and 45 ccRCCs) were included in this study.Heterogeneous enhancement was found all tumors during the corticomedullary phase (CMP).The CT values of the normal renal cortex,the relatively high enhanced region and the relatively less-enhanced region of the tumor were measured in each phase.Statistical comparison was carried out by Chi-square test or Mann-Whitney test.ResultsIn CMP,the CT value of the relatively high enhanced region in RO [ 163.0 HU ( 141.0—178.0 HU) ] was significantly lower than that in ccRCC [ 194.0 HU ( 166.5—235.0 HU) ; Z = -2.847,P =0.004].Compared CMP with the excretory phase,the attenuation of the relatively highly enhanced region in RO [70.0 HU (41.0—86.0 HU)] were significantly lower than that in ccRCC [87.0 HU (65.0—126.5 HU) ] (Z= -2.032,P =0.042).In the excretory phase,9 of 11 ROs had a further enhancement with its relatively less-enhanced region which was significantly higher than that in ccRCC (21/45 ; x2 = 4.391,P = 0.036).ConclusionsIn CMP,the CT value of the relatively high enhanced region in RO was significantly lower than that in ccRCC.Compared with ccRCC,in the excretory phase,the RO had less attenuation of the relatively highly enhanced region with homogeneous density.

Objective To analyze the clinical effectiveness,safety and significance of treatment with external circular fixator,through the relationship of inducible nitric oxide synthase (iNOS) and bone regeneration to further explore the mechanism of the molecular biology of bone lengthening at the same time.Methods Collected bone defect after tibial shaft fractures secondary infection who were treated with external circular fixator as study group (28 cases),all the cases fixed by external circular fixator,20 healthy volunteers as control group.Study group in different time point measured the levels of serum iNOS content,were compared with the control group.Results All patients were scheduled to reach the extremity lengthening and the bone defect were repaired and healed in study group.The bacterial culture results showed that 18 cases (64.29％,18/28) of resistant Staphylococcus aureus,5 cases (17.86％,5/28) of Hemolytic streptocaccus,2 cases (7.14％,2/28) ofP.aeruginosa,one case (3.57％,1/28) of drug-resistant Enterobacter cloacae,one case(3.57％,1/28) of Staphylococcus epidermidis,one case(3.57％,1/28) of Onion-like aeromonas,the proportion of the former two was significantly higher than other bacteria (P ＜ 0.05).The levels of serum iNOS content 1 d after surgery in study group were increased,compared with control group,difference was no significant (P ＞ 0.05).The levels of serum iNOS content 14 d after surgery,stoped extend,1 d stoped extend,3 d stoped extend in study group were significantly higher than those in control group [(118.8 ± 6.6) U/L vs.(86.4 ± 5.4) U/L,(136.2 ± 8.4) U/L vs.(88.2 ± 3.6) U/L,(132.6 ± 9.0) U/L vs.(87.6 ± 4.8) U/L,(103.8 ± 5.4) U/L vs.(86.4 ± 4.2) U/L] (P ＜ 0.05),there was no significant difference between two groups in other times (P ＞ 0.05).Conclusions External circular fixator for the repair and reconstruction effects in patients with bone defect can achieve the desired therapeutic goal,the higher expression of iNOS may be one of the molecular biological mechanisms of bone lengthening.

Objective To study the effects of cyclooxygenase( COX)?2 selective inhibitors on post?endoscopic retrograde cholangiopancreatography ( ERCP ) pancreatitis ( PEP ) and hyperamylasemia for common bile duct stones. Methods A total of 128 patients with normal serum amylase underwent ERCP from June 2014 to February 2015 in our hospital and were given corresponding drugs to prevent PEP.The pa?tients were divided randomly into four groups:combination group( n=33) , celecoxib group( n=34) , nitro?glycerin group(n=32) and control group(n=29). The serum amylase(AMS), C?reactive protein(CRP) and direct bilirubin( Dbil) after ERCP were measured. Abdominal pain was observed, and the incidence of PEP and post?ERCP hyperamylasemia were recorded. Results The incidence of PEP in combination group, celecoxib group were lower than those in nitroglycerin group and the control group ( 3?03%, 2?94% VS 15?63%, 17?24%),but the difference was not statistically significant(P=0?078).The incidence of post?ERCP hyperamylasemia in combination group and celecoxib group were lower than that in the control group ( 3?03%,5?88% VS 31?03%) with statistically significant difference( P=0?003, P=0?010) . There was no significant difference between nitroglycerin group ( 25%) and control group. The abdominal pain grades of combination group and celecoxib group were lower than those in nitroglycerin group and control group with significant difference(P<0?05). Celecoxib may reduce CRP after ERCP(P=0?001) and nitroglycerin may reduce Dbil after ERCP(P=0?016). Conclusion Celecoxib may reduce the incidence of hyperamylasemia and can help to reduce the abdominal pain and inflammatory reactions after ERCP . Nitroglycerin can help to reduce the Dbil after ERCP .

Objective To evaluate the value of MRI in diagnosis of prostate diseases.Methods Clinical data and MRI findings of prostatic carcinoma(PC) in 43 cases and benign prostatic hyperplasia(BPH) in 33 cases confirmed pathologically were reviewed blindly by two radiologists and compared with that of pathology.The sensitivity,specificity,positive predictive value(PV+),negative predictive value(PV-) and accuracy of MR imaging were also calculated.Results The sensitivity,specificity,PV+,PV-and accuracy of MR imaging in diagnosing prostatic lesions were 90.7%,84.8%,88.6%,87.5% and 88.2% for PC,84.8%,90.7%,87.5%,88.6% and 88.2% for BPH,respectively.PC located in the peripheral zone were 67.4%(29/43 cases),in the central zone were 9.3%(4/43 cases),the prostates presented irregular enlargement with diffuse low signal intensity in 16.3%(7/43 cases),7.0%(3/43 cases) lesions did not found by MRI even after getting pathological results.The size of the mass ranged from 0.3~10.0 cm,mean 2.4 cm.All of 40 cases,the lesions showed low signal intensity without border and capsule.The affected structures around the lesions inculuded prostatic capsule(n=34),seminal vesicle(n=24),muscle(n=8),rectal(n=5),bladder(n=6) and ilium(n=1),lymph nodes metastasis(n=11),bone(n=13) and lung(n=2).The lesions of BPH located in the central zone were 87.9%(29/33 cases),showing enlargement of the central zone with inhomogeneous signal intensity,the other 4 cases in peripheral zone showed low signal intensity with border and 2 cases with capsule.Conclusion MRI has higher sensitivity,specificity,positive predictive value,negative predictive value,and accuracy in diagnosis of prostatic diseases.

ObjectiveTo study the best estimating method of measuring length of crutches.Methods99 healthy student acted as volunteers for the test and the height of crutches was estimated with error margin of linear regression.ResultsThe error value of subtracting 41cm from the height of the subject was 7.071, and the error value of tip of Olecranon to the 3rd fingertip was 9.165.Conclusion The value of subtracting 41cm from the height of subject is more reliable in estimating the ideal length of crutches. The value of tip of Olecranon to the 3rd fingertip is ideal for determining fitting of the handgrip.

Objective To explore the effective disinfection and management measures of standby aspirators. Methods Randomly sampled 17 standby aspirators in our hospital and examined whether their liquid storage bottles and covers were contaminated by pathogens.According to the situation,we developed appropriate measures to intervene.4 months after intervention,we sampled 17 standby aspirators which were tested again. Results 82.4% liquid storage bottles and 88.2% covers were contaminated. While the contamination rate after intervention was zero.The pathogens found were mainly Pseudomonas Aeruginosa, Klebsiella pneumoniae and other opportunistic pathogens.Conclusions To strengthen the disinfection management of standby aspirators can control the contamination of standby aspirators.

Objective To observe the effects of Panax notoginseng saponins and aspirin on platelet aggregation and analyzed resistance probability.Methods One hundred and twenty patients with cerebral infarction were di-vided randomly into Panax notoginseng saponins group and the aspirin group (each group 30 cases),respectively treated with adenosine diphosphatc (ADP),arachidonic acid (AA) to induced and detect the largest platelet aggre-gation (MAR).All patients received platelet aggregation test in hospital on the first and 14th day.Results In Pa-nax notoginseng saponins group and the aspirin group platelet aggregation induced by gents in the same role did not show statistical significance.There were resistances,semi-resistance phenomenon.Conclusions Panax notogin-seng saponins on platelet aggregation and the impact of aspirin was not significant; it may be used as anti-platelet aggregation drug,but there is also the resistance phenomenon.By combining Panax notoginseng saponins other an-ti-platelet drug anti-platelet aggregation of the long-term clinical.It might solve the resistance problem through large-scale clinical trials.

Objective To explore MRI appearances of malignant mixed mesodermal tumors (MMMT) of the uterus. Methods All 9 patients with MMMT were proved by pathology. MRI characteristics of MMMTs in 9 patients were analyzed retrospectively.Results Of 9 MMMTs,6 were uterus body-based and 3 were cervical-based.Body-based MMMTs tended to be expansive or infiltrative growth with expanded uterus cavity. Cervical-based.MMMTs tended to be exophytic growth without myometrial infiltration. The tumors presented iso- or low signal on T1WI. The body-based MMMTs presented heterogeneously hyper-intense on T2WI ( n =5 ),hemorrhage ( n =1 ),cystic degeneration and necrosis (n =5) were seen within the tumors. Cervical-based MMMTs presented relative hyper-intense signal on T2WI with band or tree-like hypo-intense signal,without hemorrhage and necrosis. Body-based MMMTs were enhanced more obviously than cervical-based MMMTs.Conclusions The growth pattern,MRI signal and enhancement characteristics of cervix and uterus body MMMTs are different. MRI is helpful for the diagnosis of MMMT.

Objective To evaluate contrast-enhanced MRI sequence for diagnosing cholangiocarcinoma.Methods Cholangiocarcinoma was confirmed by surgery and pathology in 17 cases,all underwent preoperative CT and MRI T1-VIBE scan with contrast-enhancement sequence.We retrospectively analyzed imaging signs in two scan methods,including lesion position,number,size,enhancement degree,expansion degree of bile duct,invasion of adjacent artery and portal vein,and portal vein tumor thrombosis.The differences on detecting lesions between two methods were compared.Results The contrast to noise ratio (CNR) between tumor and liver tissue in MRI T1-VIBE images was obviously superior to that in CT images.Peripheral lesion boundary in T1-VIBE enhanced images was clearer than CT.One hemorrhage lesion was shown in T1-VIBE images,and tumor thrombosis was visible in the left branch of portal vein in 1 case.Bile duct wall lesions in T1-VIBE enhanced images was more evident than CT in hilar cholangiocarcinoma and extrahepatic cholangiocarcinoma.The VIBE enhanced images find more lesions in 9 out of 11 multiple focus cases,compared with CT images.Conclusions Contrast-enhanced MRI T1-VIBE sequence can give more comprehensive and clear evaluation on cholangiocarcinoma,and has important clinical diagnostic values.

Objective To explore a simple and convenient surgical method for maxillary sinus cyst by endoscopic surgery. Methods Rudolf 4.5mm cannula paracentetic needle was used.The cyst was cut throuqh inferior nasal meatus and sampled. Results 30 cases were followed up for half a year to 3 years.No relapse was found either through X-ray or through CT scanning. Conclusions Exicision of maxillary sinus cyst by endoscopic surgery through inferior canal is one of minimally invasive operations,and the effect is positive.