By using the procedures of the routinization of risk assessment - implementation - evaluation of result-modification to the risk management and carring out the feasibility exploretion on the application and effect of the ward nursing management, so that care defects, nursing errors and the number of cases of occurrence of accidents has significantly reduced, the patients satisfactory degree has rised from 92.5% to 98.5%, improved the quality of care and ensured the safety of patients, fully enhanced the quality of nursing services.

Objective To investigate the imaging manifestations and clinical features of hepatic and renal angiomyolipoma. Meth-ods The clinical data and imaging findings of hepatic and renal angiomyolipoma in a 51-year-old woman was retrospectively ana-lyzed with literature review. Results CT scan showed a large polymorphous hypodense mass in the right lobe of liver. After contrast -enhanced CT scan, the mass was enhanced gradually from periphery to ceritre. Bilateral kidneys obviously enlarged and appeared as alveolate appearance mixed density with spotty and stripped fat structures. At contrast-enhanced scan, the normal structures of cor-tex and medulla were disappeared, the alveolate walls were enhanced obviously. The arteries and veins of bilateral kidneys were com-pressed and displaced. Conclusion The imaging features of liver and kidney are of certain characteristic compared with other benign and malignant masses,but the final diagnosis of it is still depending on pathology mostly.

Objective To explore therapeutic effects of combinative artificial kidney treatment on renal osteopathy.Methods HD + HP Group composed by 30 urinaemia was treated with hemodialysis and hemoperfusion,and the HD Group was treated only with hemodialysis.Clinical symptoms and lab indicators including osteodynia,itch of skin,blood pressure,appetite,sleep,as well as BUN,SCr,Hb,BPC,Ca,P and iPTH,were compared between the two groups.Results Osteodynia decreased by 67.7% (21/31),and itch of skin by 71.0% (22/31)in HD group.Osteodynia decreased by 96.7% (29/30) ,and itch of skin by 96.7% (29/30) in HD + HP group (P ＜0.01 ).iPTH were (65.5 ± 34.4) pmol/L before treatment and (57.1 ± 21.4) pmol/L after treatment in HD group,and (73.5 ± 44.4)pmol/L and (19.1 ± 17.4)pmol/L in HD + HP group.HD Group eliminated less iPTH (P ＞0.05).HD + HP Group removed more serum poison molecules than HD Group ( P ＜ 0.05 ).Conclusions For patients in maintenance-dialysis stage but with higher iPTH,hemodialysis combined with hemoperfusion removes more poison molecules,consequently decreases incidence of renal osteopathy.

Objective To analyse the CT features of hepatic abscess in different stages of pathology so that to improve the accuracy of CT diagnosis.Methods The plain CT and triphase contrast-enhanced CT findings of hepatic abscesses in 50 cases proved by surgery or other clinical methods were retrospectively analysed and compared with CT findings of hepatic carcinoma,hepatic metastases and hepatic hemangiomas.Results CT features of hepatic abscesses were divided into three types according to different stages of pathology.Early pyogenic hepatic abscess(10 cases)had two types:small cavitation(9 cases)and mass(1 case).Typical pyogenic hepatic abscess(38 cases)and granulomatous hepatic abscess(2 cases).Conclusion CT findings of liver abscesses are different in different stage of pathologic changes,triphase contrast-enhanced CT is specific in diagnosing hepatic abscess.

Objective To explore CT and MR manifestations and its diagnostic value of liver cystic lesions.Methods The clinical and imaging data of 78 cases with liver cystic lesions were collected,including 21 cases of inflammatory cystic lesions,30 cases of tumor cystic degeneration and 27 cass of congenital growth cysts.Results The detected rate of liver cystic lesions with CT and MRI was all 100%.For inflammatory cystic lesions,tumor cystic degeneration and growth cyst,CT diagnostic accurate rate was 76%,90% and 93%,respectively,and MR was 83%,93% and 100% respectively.CT and MR manifestations:Of all inflammatory cystic lesions,hepatic abscess and liver echinococcosis cyst appeared as cystic occupying lesion,the cysts were of tension,low-density band on CT or water-like signal intensity on MR around the lesions in hepatic abscesses.Liver echinococcosis cysts were of big cyst with small cyst sign and enhanced moderately in cystic wall post contrast-enhanced scan.The metastasis cystic tumors showed single or multiple cystic lesions and mild or moderate circular enhancement.The primary liver tumor's cystc degenerative lesions showed cyst-solid lesions on CT and MR,and were of enhanced manifestations of the primary tumors.Growth cysts were single or multiple low-density or water-like signal intensity,generally there was not enhanced.Conclusion CT and MR have great diagnostic value for the location and nature of cystic lesions.

Objective This paper studies on feasibility of low dose CT scanning in lung cancer patients simulated localisation.Methods 62 patients cases of lung cancer are selected.Scan parameter:scan twice by 20/100 mA,the other parameter remain unchanged as voltage of 120 kV,thickness of 5 mm,pitch of 1:1 and scan time of 1 s.After scan,picture quality was evaluated according to excellent,good,bad under different condition.Volume of target was determined by treatment planning system.Data such as dose index value of single helical scan,z-axis scan range,dose length product value and etc.are recorded in order to evaluate radiation dose of patients.Picture quality and the difference of radiation dose were statistically analyzed using Fisher's and pair t-test.Results Picture quality of low dose scanning was a little bit lower than that of normal dose,however,picture quality difference of difference dose scanning was statistically meaningless (number of patients according to excellent,good,bad were 46,13,3 and 50,11,1,P =0.541).There is no obvious difference of target volume under different dose scanning in the same (36.78 cm3,40.35 cm3,t =2.57,P =0.189).Radiation dose of low dose scanning group is far less than that of high dose scanning group and the difference is obvious (133.05 mGy,941.25 mGy,t =-41.24,P =0.000).Conclusions Low dose scanning of 20 mA current during CT simulated localisation tremendously reduces harm that may happen to patients during CT scan,while tumor target delineation and scanned picture quality is guaranteed.

Objective To evaluate the effects of different concentrations of dexmedetomidine on large-con-ductance Ca2+-activated K+ (BKca) channels in the rat mesenteric arterial smooth muscle (MASM) cells.Methods Sprague-Dawley rats of both sexes,weighing 180-220 g,were used in this study.Single MASM cell was freshly isolated from mesenteric arteries in two steps.Ten cells were chosen and studied.When holding potential was 40 mV and the concentration of free calcium ions was 10-7 mol/L,inside-out patch-clamp technique was used to record the single BKCa channel current before and after application of different concentrations of dexmedetomidine (0,10-9,10-8,10-7,10-6,10-5 mol/L).Total open probability (NPo),amplitude (Am),mean open time (To) and mean close time (To) of single BKca channel were observed and recorded.Results Compared with the baseline value,dexmedetomidine 10-7,10-6 and 10-5 mol/L increased NPo in a concentration-dependent man-ner,and dexmedetomidine 10-9,10-8,10-7,10-6,10-5mol/L shortened Tc (P ＜0.05 or 0.01).Compared with the value obtained when the concentration of dexmedetomidine was 10-9 mol/L,Tc was significantly shortened when the concentration of dexmedetomidine was 10-8 mol/L (P ＜ 0.05),and no significant change was found in Am and To obtained when different concentrations of dexmedetomidine were applied (P ＞ 0.05).Conclusion Dexmedetomidine 10-7,10-6 and 10-5 mol/L activate BKca channels in rat MASM cells in a concentration-depen-dent manner,which is one of the mechanisms of decrease in blood pressure by dexmedetomidine.

Objective To evaluate the clinical diagnostic value of magnetic resonance cholangiopancreatography ( MRCP ).Methods MPCP data of 42 cases with pancreatic and bile duct lesion proved by operation and pathology were analyzed retrospectively.MRCP was performed using single-shot-radio SE sequence (SSH/RAD). Of all cases included bile duct lithiasis in 19 , inflammation in 3,congenital cyst in 6 , carcinoma in 12,jaundice caused by diverticulitis of duodenum in 1 and Mirizzi syndrome in 1 .Results MRCP was succeeded at one time in all cases . On MRCP , the visual rate of intrinsic and extrinsic hepatic bile duct was 100% and that of common pancreas duct was 80.58%.The localized and qualitative diagnosis of lesions were up to 100%,88.2% respectively.Conclusion SSH/MRCP/RAD plays an important role in diagnosis of the pancreatic and bile duct lesion in clinical practice.

Objective To improve recognition and diagnosis of primary non-obstructive megaureter.Methods The authors analyzed the X-ray findings of intravenous urography and B-ultrasonographic manifestations of 28 cases with primary non-obstructive megaureter proved by varied examinations and operations.Results The X-ray and B-ultrasonographic manifestations as follows:in the terminal ureter,there was a short segment,less than 3 cm in length,with normal caliber but adynamic to micturition and the ureter proximal to the adynamic segment was secondarily dilated remarkably.The terminal end of the dilated ureter appeared as drumstick shaped,spindle-shaped,snakehead shaped or rattail shaped.On right time fluoroscopy and B-ultrasonographic observation,a decrease of peristalsis frequency,increase of peristalsis range,interrupted downward convey of peristalsis wave could be noted.Conclusion The contrast urography is the main method,B-ultrasonography and cyctocopy are helpful for the diagnosis of primary non-obstructive megaureter.

Objective To study the clinical and X-ray manifestations of primary non-Hodgkin's lymphoma(PNHL)of bone so that to suppy the valuable informations for clinical diagnosis and treatment of this disease.Methods 14 cases with PNHL of bone confirmed by clinic and pathology were analyzed retrospectively.There were 9 male and 5 femal,age ranged from 20 to 60 years with average of 35 years,and average history of disease was 11 months in all cases.Results Of all cases single bone involved in 11 cases,multiple bone involved in 3 cases,most of them the flat bone and the distal end of long bone were involved.The appearances of the lesion on X-ray were bony destruction with slight sclerosis at the margin of destructive area,there were periosteal reaction,soft tissue masses and destruction of joint manifestations,PNHL of bone can be classified as four typers:osteolytic(n=8),sclerotic(n=2),mixed(n=3)and cystic(n=1)lesions by the form and feature of bone destruction.Conclusion PNHL of bone has characteristic X-ray manifestations comparatively.The correct diagnostic rate can be improved if we concern about clinical data.