Objective To optimize the temporal bone scanning parameters, upgrade the picture quality, shorten the scanner time, and decrease the radiographic exposure during the scanning. Methods The scanning was performed on 20 volunteers using 16 spiral CT in the same position and range with optimizer parameters and general parameters respectively, and then the volume data were collected. Results Through comparision and analysis of the images of the 20 volunteers, 17 of them using the optimizer parameters were better than those using general ones, 2 of them showed no obvious difference, and 1 was not as good as the general one. Conclusions Through the experiment and the statistics of 1000 cases using optimizer parameters, the picture quality using optimizer parameters is better, the scanner time is 1/7 of the general scanning, and the radiographic exposure is decreased. Optimizer parameters are better than the general ones and worth popularizing.

Objective To explore the MSCT manifestations of chromophobe renal cell carcinoma (CRCC)and to improve its accu-racy of preoperative diagnose.Methods Clinical and MSCT finding were retrospectively reviewed in 14 patients with CRCC,which were confirmed by surgical pathology or biopsy.Results (1)On plain scanning,most of the CRCC lesions showed round or oval (86.7%,13/1 5)and isodensity (73.3%,1 1/1 5)mass;and the border of 66.7% (10/1 5)lesions were clear.53.3% (8/1 5)of the lesions were heterogeneous with lamellar cystic low density (8 lesions)and coarse ringed and/or foliated calcifications (4 lesions). (2)On contrast-enhanced sacanning,the CRCC lesions showed mild to moderate (86.7%,13/1 5)and heterogeneous (60%,9/1 5) enhancement,and 73.3% (1 1/1 5)of the lesions were persistent enhanced.(3)According to the pathology,80% (12/1 5)of the le-sions was the typical type,20% (3/1 5)was the eosinophilic type,and 0 was the hybrid type.Conclusion CRCC demonstrates cer-tain characteristics signs at MSCT examination.Lesion mostly shows well-circumscribed round or oval mass in the renal parenchy-ma,mild to moderate,heterogeneous and continuous enhancement on the contrast scanning.The diagnosis of CRCC should be con-sidered especially when the lesion has cystic change and coarse ringed and/or foliated calcifications.

Objective To design two-point two-line vein pricking for avoiding pain for patients and blood osmosis out of the vein caused by the high-pressure and fast-speed of the current high-pressure injector.Methods 19G butterfly-wing vein transfusion needle in the length of 19mm was used.The first point was needled with the needle tip under the skin and the first needling line was above and parallel the blood vessel in the length of 10-12mm.The second point was needled,with the second needle tip and needle line in the blood vessel,and the length of needling is 7-9mm.Results 100 persons were subjected.All the contrast medium and the physiologic saline were injected in vein in 98 persons,among which 2 had little hard tubercle in injecting area.Conclusion The two-point two-line vein pricking is safe for high pressure injector injecting in vein,and can prevent blood osmosis out of the vein.

Objective To probe the advantages and characteristics of imaging on dual-energy CT boneless and digital sub- traction brain angiography through comparative analysis. Methods Siemens 64-slice dual-source spiral CT and double high pressure syringe; The 200 patients were randomly divided into dual-energy group(n=100) and DSACT group(n=100); Every patient was injected 50 ml contrast medium and 50ml normal saline, injection rate was 4ml/s. Results The groups of cere- bra-vascular imaging without interference, and completely boneless; but experimental group has more boneless defects and vascular surface definition less. The cerebral arteries were interfered by the venous shadow in dual-energy group, and the dual-energy group received low-dose radiation. Conclusion The DSACT imaging quality is superior to dual-energy CT boneless imaging. The radiation dose of the dual -energy CT is lower than DSACT.

Objective To explore the protective effect of Sijunzi decoction and Danggui Buxue decoction on the immunological function in tumor-bearing mice treated by cyclophosphamide.Methods Transplantable carcinomas animal model were constructed by inoculating tumor cell to mice for 24 hours,and randomly divided into five groups.Tumor-bearing control group were reveived normal saline 0.2 mL per mice one day by intraperitoneal injection,and normal saline 0.4 mL per mice each day by intragastric administration.Cyclophosphamide group were reveived CTX 20 mg per kg weight each day,and normal saline 0.4 mL per mice each day.Sijunzi decoction and Danggui Buxue Decoction low dose group were reveived CTX 20 mg per kg weight each day and traditional Chinese medicine 0.1 g per mice each day.Sijunzi decoction and Danggui Buxue Decoction mediate dose group were reveived CTX 20 mg per kg weight each day and traditional Chinese medicine 0.2 g per mice each day.Sijunzi decoction and Danggui Buxue Decoction high dose group were reveived CTX 20 mg per kg weight each day and traditional Chinese medicine 0.4 g per mice each day.The weight indices of thymus gland and spleen,NK-cell activity and the proliferation of T-lymphocyte in five groups were measured after ten 10 days treatment.Results The weight indices of thymus gland and spleen,NK-cell activity and the proliferation of T- lymphocyte were increased in all three Sijunzi decoction and Danggui Buxue decoction groups,especially in Sijunzi decoction and Danggui Buxue decoction mediate and high dose group,the differences between them and CTX group were statistically significan(P<0.05,P<0.01).Conclusion Sijunzi decoction and Danggui Buxue decoction can antagonize the decrease of immunological function in tumor-bearing mice treated by chemotherapy.

As the medical college students are scattered to each practice hospital, the status of the secondary clinical medical colleges' education management to interns is weakened, and the problems and contradictions are becoming increasingly prominent. In the process of internship education management, through the establishment of the secondary medical colleges' interconnection management working mecha-nism, we can effectively solve the outstanding problems in the current internship edu-cation management, to achieve mutual trust between the secondary clinical medical college and the training hospital, and en-hance the effectiveness of the management of interns.

Objective To determine the effects of different anesthetic techniques on T-lymphocyte subsets in patients with esophageal carcinoma. Methods Forty patients were randomly assigned into general anesthesia group (group Ⅰ),or combined generae anesthesia with epidural anesthesia group(group Ⅱ). Peripheral blood CD3, CD4,CD8 were measured before induction ( T1 ), after anesthesia ( T2 ), end of operation ( T3 ), 1d ( T4 ), 3d ( T5 ) after surgery. Resolts CD3,CD4,CD8,CD4/CD8 decreased at T2 in the two groups. In group Ⅱ ,CD3,CD4,CD8,CD4/CD8 ratio almost returned to the baseline values at T4 ,while group Ⅰ did not. Conclusion Epidural anesthesia combined with general anesthesia can reduce depression of T-lymphocyte subsets induced by surgical trauma and anesthesia, and is the anesthetic tecnique of choice for cancer patients undergoing major operation.

Objective To evaluate the value of magnetic resonance cholangiopancreatography(MRCP) in the diagnosis of biliary obstruction diseases by comparison with endoscopic retrograde cholangiopancreatography (ER-CP). Methods A total of 36 patients with biliary obstruction diseases underwent both MRCP and ERCP. To review the images obtained from ERCP and MRCP ,the diagnosis were compared according to pathology. MRCP and ERCP in the diagnosis and treatment of biliary obstruction disease were analysed. Results 36 patients including 16 biliary tumors, 15 cholelithiases,and five other diseases were analysed. The diagnosis accuracy of MRCP and ERCP for bil-iary obstruction diseases were 86.1% and 91.7 %, there was no significant difference( P > 0.05). Conclusion MR-CP can accurately define the obstructively sites, identify the obstructive causes and is a noninvasive and reliable exam-ination for biliary obstruction diseases.

Objective To investigate the application value of interleukin-27 (IL-27) in the patients with acute coronary syndrome (ACS).Methods A total of 208 ACS patients were enrolled in the study,including 76 acute myocardial infarction (AMI) patients with ST elevation (STEMI),58 AMI patients with non-ST elevation (NSTEMI) and 74 unstable angina pectoris (UAP) patients.These patients were divided into single-vessel lesions,double-vessel lesions and three-vessel lesions groups,and 62 patients with chest pain syndrome (CPS) were selected as a control group.The plasma IL-27 levels of all patients were determined by enzyme linked immunosorbent assay (ELISA) and analyzed.Results The levels of plasma IL-27 (median[P25,P75]) in STEMI (308.64 [245.17,359.26] pg/mL),NSTEMI (256.88 [181.52,332.51] pg/mL) and UAP (218.12 [165.33,312.46] pg/mL) patients were significantly higher than that in CPS patients (100.66[68.98,228.86] pg/mL,P ＜ 0.01).The levels of plasma IL-27 in STEMI patients were significantly higher than that in NSTEMI and UAP patients (P ＜ 0.05).The positive rate of IL-27 in ACS patients with negative TnI was 54.24％ (32/59).The sensitivity and specificity of IL-27 in predicting ACS from chest pain patients were 80.29％and 58.06％,respectively.The levels of plasma IL-27 in the patients with three-vessel lesions were significantly higher than that with single-vessel lesions (P ＜ 0.05).Conclusion Plasma IL-27 levels in ACS patients increase obviously,which may be involved in the pathogenesis of ACS.IL-27 may be helpful for the diagnosis of ACS patients with negative TnI and the prediction of ACS state.

Objective To investigate the correlation between retinal deformation degree and retina thickness (RT) detected by optic coherent tomography (OTC) in patients with idiopathic macular epiretinal membrane (IMEM). Methods The 66 eyes (56 patients) with IMEM diagnosed by OCT were retrospectively analyzed in this study. After best corrected visual acuity (BCVA), ocular fundus and OCT examination, patients were divided into three groups (mild, medium and severe) according to retinal deformation degrees. The RT value was measured manually. Results There were significant differences in RT values between mild, moderate and severe groups:(311.95 ±51.78) μm, (447.13±41.95) μm and (560.00± 58.23) μm (P<0.05). The values of BCVA were 0.78±0.16, 0.38±0.12 and 0.27±0.14 for mild, moderate and severe groups, there were significant differences between them (P<0.05). There was no significant correlation between RT and BCVA in mild group (r=-0.352,P=0.128). There was negative correlation between RT and BCVA in medium group and serious group (r=-0.768 and-0.482,P<0.05). Conclusion The retinal deformation degree and RT are two objective indicators to assess visual performance in patients of IMEM. When RT is more than 400 μm, it can be used as objective criteria for surgical intervention.