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.

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 .

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.

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 investigate the features of the mixed epithelial and stromal tumor of kidney (MESTK) and cystic nephroma (CN) on multi-detector CT (MDCT), in order to improve the accuracy of preoperative diagnosis and differential diagnosis. Methods Based on blind-retrospective review, CT features of 6 MESTK patients and 6 CN patients were reviewed retrospectively, and compared with pathological results postoperatively. Results All the lesions were single regular multi-cystic masses. Five patients with MESTK were diagnosed as Bosniak Ⅲ and 1 as Bosniak Ⅳ. In contrast, 6 of CN were all diagnosed as Bosniak Ⅱ. Six MESTK lesions were all consisted of irregular mixture of solid and cystic components, and the average thickness of septa was 0.93 cm. Six CN lesions were entirely cystic masses without solid components, and the average thickness of septa was 0.23 cm. After contrast enhancement, the solid components of MESTK and the cystic wall of CN presented mild-to-moderate delayed enhancement. Conclusion Some signs on multi-detector CT can help to differentiate MESTK and CN, especially the presence of solid components of the tumor.

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 evaluate characteristic clinical and imaging findings of pancreatic neuroendocrine tumors (NET) in dual-phase contrast enhancement MSCT.Methods The dual-phase contrast enhancement MSCT images of 23 lesions in 20 patients with histologically confirmed pancreatic NET were studied retrospectively.Their clinical presentations,imaging characters as well as the intensities of lesions and normal pancreas in each phase were measured,and the following indices were calculated.First,the absolute enhancement of lesions,including the increasing of CT value of the maximum enhancement area within a tumor in arterial phase,that was named A1 in short,and that of the minimum enhancement area was labeled as A2.The same ROI measured increasing CT values in portal venous phase was labeled as V1 and V2 respectively.Secondly,the relatively enhancement indices comparing with the normal pancreas in the same patient within the same phase were calculated.This included the differences between the maximum,as well as the minimum,enhancement areas of tumors and the normal pancreas in arterial phase,which was named as AP1 and AP2 respectively,and those differences in portal venous phase,which were labeled as VP1 and VP2 respectively.All of the tumors were graded as G1 to G3 according to the WHO classification in 2010.A Kruskal Wallis test were performed to compare differences of tumor diameters and the enhancement indices.The change trend of enhancement indices varying with pathology grading were described.Fisher exact test was used to find differences of clinical and imaging characters.Results Twenty-three lesions in 20 patients included 13 lesions in grade 1 (G1),8 in G2,and 2 in G3.Among the 10 patients with G1 NET,7 of them had no endocrine symptoms,while the other 3 had endocrine symptoms.Six of them had no abdominal pain,while 4 of them complained of it.All of the 10 patients with G1 NET had no hepatic metastasis.Among 8 patients with G2 NET,4 of them were with endocrine abnormality,and the other 4 were not.Five of them complained of abdominal pain while the other 3 did not.Six of them had no hepatic metastasis,and 2 of them had.Both of the 2 patients with NET in G3 did not have any endocrine abnormality,and one of them complained abdominal pain.Both of them were with hepatic metastasis.There was no difference between groups that whether or not endocrine syndrome and abdominal pain was presented (x2 =2.238,0.713,P =0.318,1.000),while hepatic metastasis was of significant differences (x2 =9.516,P =0.003).Tumor location,distinct outline,necrosis and/or calcification were not significantly different.Tumor enhancement showed a probable trend of decrease in group of higher grade.A1 decreased from (126.4 ± 45.7)HU to (38.7± 8.5)HU (x2 =7.254,P=0.027),A2 decreased from (94.1 ±31.1)HU to (22.8 ± 14.0) HU (x2 =7.323,P =0.026) and AP1 dropped from 80.6 HU(-21.8 — 169.7 HU) to -36.7 HU(-41.6—-31.7 HU) (x2 =6.778,P =0.034).All of the indices mentioned above were of significant difference and the other indices showed no significant difference (P ＞ 0.05).Conclusions Quantitative assessment of their enhancement patterns may provide useful information to preoperative grading of pancreatic NET,and tumors in a higher grade may show poorer enhancement.

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.