Objective To compare the iodine contrast agent dosage,radiation dose and image quality in CT pulmonary angiogra-phy (CTPA)with low tube voltage and high tube current in 64-slice spiral CT.Methods 60 patients with suspected pulmonary em-bolism in our hospital were randomly chosen and divided into three groups:Group Ⅰ:20 patients,using 120 kV,180 mA,contrast dose of 70 mL.Group Ⅱ:20 patients,using 100 kV,280 mA,contrast dose of 50 mL.Group Ⅲ:20 patients,using 80 kV,automat-ic tube current modulation techniques (300-500 mA),comparative dose of 30 mL.CT values and image noise of three pulmonary central areas and a segment branch were measured in each group.Objective indicators,subjective image quality assessment,CT dose index volume (CTDIvol),dose-length product (DLP)and effective absorbed dose (ED)were compared in three groups to evaluate the value of low kV,high mA with low-contrast dose in CTPA.Analysis of variance and t-test was used for data analysis.Results Compared with those of the standard method of CTPA,all pulmonary dry in two groups of low dose were well displayed.There was no statistical significance between each two groups in image quality score (P > 0.05),but was statistical significance in CT values, noise,SNR and CNR (P < 0.01).The CT radiation dose,CTDIvol and DLP of Group Ⅱ and Group Ⅲ were significantly lower than those of Group Ⅰ (P < 0.01).Conclusion Compared with traditional methods,low dose contrast agent injections under 80 kV could reduce the dose of contrast agent and the effect of hardening artifacts due to contrast agent in superior vena cava on right pul-monary artery.It is helpful to reduce the risk of contrast induced nephropathy and reduce patients’exposure to X-ray radiation.

Professor CHAO En-xiang thinks that several rules should be obeyed when we treat gangrenous appendicitis complication with paralytic ileus and ARDS.Firstly,we should adhere to the TCM characteristics of the holistic concept and treatment based on syndrome of differentiation.Secondly,we should formulate therapeutic method according to major pathogenesis.Thirdly,we should use drugs flexibly according to the patient's specific situation.Professor CHAO En-xiang considered it was the syndrome of dysfunctional activity of qi,fu qi being obstructed,dysfunction of middle-jiao in transportation.The therapeutical principle was regulating qi activity,dredging intestines and relieving distention.Nasal feeding with Dachengqi decoction adding Agastache rugosa,Tatarian Aster,paste umbilicus with mud of shallot stalk,fresh ginger,fennel and enema with Radix Aucklandiae.

AIM: To research how to separate the active component in Ligusticum chuanxiong Hort by high speed counter current chromatography. METHODS: Senkyunolide A and Z-ligustilide,the main components of volatile oil in Ligusticum chuanxiong Hort were one step separated by high speed counter current chromatography. n-hexane-ethyl acetate-ethanol-water,1 ∶ 1 ∶ 1 ∶ 1(v/v),was used as the solvent system for HSCCC. Top phase and bottom phase were respectively used as static phase and mobile phase. Optimum speed and flow rate were 900 r/min and 1. 2 mL/min respectively. RESULTS: Collected fractions were analyzed by HPLC and identified by EI-MS and 1HNMR. Purity could reach more than 95% . CONCLUSION: Lactone is fit to be separated and prepared by high speed counter current chromatography with good resolution and high purity. We find a fast and efficient way to separate these.

Objective To investigate the relation between VEGF and prognosis of lung carcinoma.Methods ESISA was used to investigate the level of VEGF in lung carcinoma group,pulmonary disease group and normal group,and evaluate the diagnostic efficiency of lung carcinoma transfer or dead.Results The levels of VEGF in lung carcinoma group and pulmonary disease group were significantly higher than those in normal cases(P0.05).The level of VEGF in pulmonary disease group had a degression after treatment.The negative rate of lung carcinoma was 76%.The transfer rate in the increases group of lung carcinoma was 65% in the six month.The dead rate was 10%(P

Objective To examine the effect of oral external suction on environmental pollution of microorganism in dental clinic.Methods Aerobe was counted na observation index of air contamination and air sample of the area leveal 1m and 2.5 m,hight 1m,which using oral cavity collectors of aspirator or not was collected by the method of sedimentation.Results The datum of the group with oral cavity collectors of aspirator was much lower than the group without it.Conclusion Environmental pollution from tooth treatment in dental clinic can be reduced by using oral extemal suction.

Objective To investigate the effect of spectral CT monochromatic images for improving imaging quality in hepatic venography.Methods Thirty patients underwent spectral CT examination on a GE Discovery CT 750 HD scanner.During portal phase,1.25 mm slice thickness polychromatic images and optimal monochromatic images were obtained,and volume rendering and maximum intensity projection were created to show the hepatic veins respectively.The overall imaging quality was evaluated on a five-point scale by two radiologists.Inter-observer agreement in subjective image quality grading was assessed by Kappa statistics.Paired-sample t test were used to compare hepatic vein attenuation,hepatic parenchyma attenuation,CT value difference between the hepatic vein and the liver parenchyma,image noise,vein-to-liver contrast-to-noise ratio (CNR),the image quality score of hepatic venography between the two image data sets.Results The monochromatic images at 50 keV were found to demonstrate the best CNR for hepatic vein.The hepatic vein attenuation[(329 ± 47) HU],hepatic parenchyma attenuation [(178 ± 33) HU],CT value difference between the hepatic vein and the liver parenchyma [(151 ± 33) HU],image noise (17.33 ±4.18),CNR(9.13 ±2.65),the image quality score(4.2 ±0.6) of optimal monochromatic images were significantly higher than those of polychromatic images[(149 ± 18) HU],[(107 ± 14) HU],[(43 ±11) HU],12.55 ± 3.02,3.53 ± 1.03,3.1 ± 0.8 (t values were 24.79,13.95,18.85,9.07,13.25 and 12.04,respectively,P ＜ 0.01).In the comparison of image quality,Kappa value was 0.81 with optimal monochromatic images and 0.69 with polychromatic images.Conclusion Monochromatic images of spectral CT could improve CNR for displaying hepatic vein and improve the image quality compared to the conventional polychromatic images.

On the basis of analysis of the current status and future tendency of development of the health services industry in Shanghai,the authors identified key problems and bottlenecks.Thus they made clear the target positioning and principles of the industry,and proposed the basic ideas and pattern of the industry in the 13 th five-year plan period,focusing on such fields as private and high-end healthcare services,traditional Chinese medicine services,public health services,commercial health insurance,and other related industries.In the end,corresponding supporting polices were proposed.

Objective To investigate the clinical effect of facial dermabrasion by microcrystal combined with red blue light in the treatment of acne pitting scar.Methods Selected from June 2013 to April 2016 hospital dermatology outpatients,98 cases of facial acne pitting scar were retrospectively analyzed,in which 50 cases of patients with facial acne dermabrasion were treated with red and blue light treatment (combined group),48 patients only choose facial acne dermabrasion treatment (control group),then treatment effect was compared between the two groups.Results At 3 months after operation,the ECCA score and mean sag depth of the two groups were significantly lower than those of the preoperative (t=23.208 and 18.586,P＜0.001).The ECCA score of the combined group was significantly lower than that of the control group (t=7.039,P＜0.05);The healing rate was 80％,which was significantly higher than those in the control group (56.25％) (x2 =6.387,P＜0.05);after 1 months and 3 months;the subjective satisfaction scores of the patients in the combined group were significantly higher than those in the control group (t=3.318 and 3.776,P＜0.05);Patients in the combined group were significantly earlier than the control group (t =4.419,P＜0.05);the incidence of edema and erythema was significantly lower in the combined group than in the control group (x2 =5.096,P＜0.05).Conclusions Facial acne dermabrasion by microcrystal combined with red and blue light treatment is superior to the single use of dermabrasion.

Objective To investigate the clinical pathological characteristics and prognosis of primitive neuroectodermal tumor (PNET) of breast.Methods Patients with breast PNET were retrieved from CNKI,Pubmed,Europe PMC and other databases from Jan.1980 to Dec.2016.The clinical data of one patient with breast PNET in our hospital were analyzed retrospectively.Results 18 cases had painless,rapid growth mass as the main clinical features.The pathological morphology showed small round cell tumors,PAS staining positive.Immunohistochemistry CD99 and Fli-1 characteristic expression were the main indexes for the diagnosis of breast PNET.The positive expression of Vimentin,NSE,Syn and negative expression of CK,EMA,Desmin,CgA,LCA,S-100 also played an important role in the diagnosis of breast PNET.The positive expression of genetic marker EWSRI was the golden standard for diagnosis of breast PNET.The size of the tumor,surgical treatment,lymph node metastasis,distant metastasis and chemotherapy were the important factors that affect the prognosis of the PNET.The survival rates of 1 and 3 years were 71.4％ and 33.3％ respectively.Conclusions Breast PNET is a rare tumor with poor prognosis,and its diagnosis is highly dependent on pathology.Surgery can significantly improve the prognosis of the patients.Surgery should be the main treatment,combined with radiotherapy and chemotherapy.The current study does not show evidence of effectiveness in terms of endocrine or targeted drug therapy for breast PNET patients.

OBJECTIVE：To investigate th e stabilities of antitumor candid ate Gedatolisib in plasma in vitro and simulated gastric/intestinal fluids ，and to analyze the possible catabolites in plasma. METHODS ：HPLC method was adopted. Using indometacin as internal standard ，the contents of Gedatolisib incubated in plasma of SD rats （male）for 0，0.5，1.0，1.5，2.0，3.0 h and blank simulated gastric fluid （pH 1.3，no enzyme ），blank simulated intestinal fluid （pH 6.8，no enzyme ），simulated gastric fluid（pH 1.3，containing pepsin ）and simulated intestinal fluid （pH 6.8，containing trypsin ）for 0，0.5，1.0，2.0，3.0，4.0，6.0 h were determined. The remaining percentage of Gedatolisib was calculated. UPLC-Q-TOF/MS was used to analyze the TIC of blank plasma and incubated samples. The differential peaks were compared， and catabolites were inferred by MS 1Z073）.gzwjkj2019-1- chromatograms. RESULTS ： The remaining percentage in plasma of rats for 2.0 h was about 63％，and there was nosignificant change after continued incubation. The remaining percentage of Gedatolisib incubated in blank simulated intestinal fluid for different time ranged （99.18 ± 2.15）％ -（103.20 ± 3.41）％ . The remaining percentage in simulated com intestinal fluids for 2.0 h ranged （88.76 ± 1.53）％ . The remaining percentage in blank simulated gastric fluids for 2.0 h was ranged （85.63±1.55）％，and there was no significant change after continued incubation. The remaining percentage in simulated gastric fluid was from （94.94±3.52）％（0 h）to（16.19±1.17）％ （6.0 h）. TIC of UPLC-Q-TOF/MS showed that the differential peaks of incubated samples and blank plasma was 6.42 min under positive mode scanning ，molecular ion peak of m/z 616.335 1，simulated 632.327 7，630.317 0，602.278 6 [M+H]+ could be found in scanning channel. It was speculated that Gedatolisib could generate 1-（4-（3-（4，6-dimorpholino-1，3，5-triazin-2-yl）phenyl）urea） benzoyl）-N，N-dimethylpiperidin-4-amine oxide ，1-（4-（4-（dimethylamino）piperidine-1-carbonyl）phenyl）-3-（4-（4-morpholino-6- （3-oxomorpholino）-1，3，5-triazin-2-yl）phenyl）urea and 1-（4-（3-（4-（4，6-dimorpholino-1，3，5-triazin-2-yl）phenyl）urea） benzoyl）-N-methylpiperidine. CONCLUSIONS ：Gedatolisib is not stable in rat plasma ，and it may undergo terminal N oxidation， morpholine ring oxidation and terminal N demethylation. Gedatolisib is stable in artificial intestinal fluid and blank artificial gastric/ intestinal fluid ，and degrades obviously in the presence of pepsin.