Objective To determine the effect of reducing mA on the diagnostic quality of images and the radiation dose to the lens in patients undergoing paranasal sinus CT. Methods Fifty patients undergoing paranasal sinus CT at 200 mA or 50 mA. The lens dose was measured using thermoluminescent dosemeters [LiF(Mg?Cu?P)]. Image quality was evaluated for six anatomical structures, including middle turbinate, uncinate process, maxillary ostium, ethmoid infundibulum, frontal recess, and cribriform plate. These anatomical structures were assessed as: not seen (0 points), demonstrated but not clearly visualized (1 points), or clearly demonstrated (2 points). Results Mean radiation dose to the lens was significantly reduced from 7.339 mGy (200 mA) to 1.108 mGy (50 mA). No significant difference of image quality between the two mA protocols was found in either rhinosinusitis group or non-rhinosinusitis group. And for rhinosinusitis the image quality showed no significant difference between high-resolution arithmetic and soft arithmetic. Conclusion CT scanning of the sinuses can be performed at greatly reduced mA without loss of diagnostic quality of the images. As far as the rhinosinusitis is concerned, high-resolution arithmetic can not improve the image quality and soft arithmetic is enough.

Objective To discuss the effect of Chinese medicine treatment on quality of life(QOL)of perimenopause syndrome(PMS)patients.Methods The evaluation with WHO QOL-BREF in Chinese version was applied to compare the QOL scores of normal perimenopause females with those of PMS patients.Results The scores of normal perimenopause group were higher than those of PMS group and the difference of scores of all aspects was significant(P

Background C57BL/6.NOD-Aec1Aec2 mouse is considered to be an idea model for the study of the pathogenesis of Sj(o)gren syndrome,but the cause of dry eye in these mice is unclear.Objective This study was to investigate the histopathological change of the ocular surfaces of C57BL/6.NOD-Aec1Aec2 mice,and to determine whether dry eye is developed spontaneously in these mice.Methods Forty-five clean C57BL/6.NOD-Aec1 Aec2 mice were used as the experiment group and forty-five C57BL/6J mice(both male and female)were used as the control group in this study.Detection of fasting blood-glucose,Schirmer' s test Ⅰ (S Ⅰ t),lissamine green staining and scoring of the corneal and conjunctival epithelium in the mice were performed at the age of 4,8,12,16 and 20weeks.Five mice from each group were sacrificed and their corneas were obtained to measure the central corneal epithelium thickness and to count the number of conjunctival goblet cells.In addition,lymphocyte infiltration in the lacrimal gland of the mice was examined with hematoxylin-eosin staining.The uhrastructure of the corneal epithelial cells and microvilli were assessed by scanning electron microscopy.The use and care of the mice were approved by the Experimental Animal Care Committee of the Third Military Medical University.Results No sign of dry eye was seen in both the 4-week-old C57BL/6.NOD-Aec1Aec2 mice and 4-week-old C57BL/6J mice.The S Ⅰ t values in 8-week-old,12-week-old,16-week-old and 20 week-old mice from the experiment group were (2.7 ±0.9) mm,(2.5 ±0.8) mm,(1.8±0.6) mm and (1.9± 0.1) mm,respectively,showing a significant reduction in comparison with those of the control mice of the same age(all P＜0.01).The amount of lissamine green staining in the C57BL/6.NOD-Aec1Aec2 mice gradually increased with age,showing elevated scores in 12-week-old,16-week-old and 20-week-old mice in the experiment group(all P＜0.01).The central corneal epithelium thicknesses were(20.18±3.75)μm,(17.01 ±5.25) μm,(14.19±5.72) μm and(12.00±3.25) μm in the 8-week-old,12-week-old,16-week-old and 20-week-old C57BL/6.NOD-Aec1Aec2 mice,respectively,which were significantly lower than those of the C57BL/6Jmice of the same age (all P＜0.01).The numbers of conjunctival goblet cells were (8.2±2.4),(6.2±2.1),(6.1 ±2.2) and (4.1 ± 2.0) in the 8-week-old,12-week-old,16-week-old and 20-week-old C57 BL/6.NOD-Aec 1Aec2 mice,respectively,showing a gradual decrease with age and a significant decline in comparison with those of the C57BL/6Jmice of the same age(all P＜0.01).Lymphocyte infiltration in the lacrimal gland and destruction of gland ducts were seen by hematoxylin-eosin staining,and acinar abnormality aggravated with aging.Reduction of corneal epithelial cells and the number of microvilli were distinguished with aging under the scanning electron microscope.The fasting bloodglucose levels of the two groups were both less than 6.0 mmol/L,and no significant difference was found between them at any age(P=0.637,0.610,0.163,0.086,0.938).Conclusions C57BL/6.NOD-Aec1Aec2 mice develop dry eye spontaneously with aging.The course of disease and characteristics of dry eye in C57BL/6.NOD-Aec1Aec2mice is similar to human dry eye.The C57BL/6NOD-Aec1 Aec2 mouse is the perfect model to study the pathogenesis of dry eye.

Objective: To investigate recombinant human insulin-like growth factor-1 (rhIGF-1) on the phosphorylated serine-threonine protein kinase (pAkt) and apoptotic cells in edematous perihematomal brain regions following experimental intracerebral hemorrhage in rats. Methods: A total of 78 healthy male rats were randomly assigned to a false operation group (n =6), a cerebral hemorrhage control group (control group for short, n=36) and a rhIGF-1 intervention group (intervention group for short, n=36). According to 6 time points after giving intervention measures, the rats of the control and intervention groups were randomly redivided into 6 subgroups: 6 h, 12 h, 1 d, 2 d, 4 d, and 7 d subgroups (n =6 in each subgroup). A rat model of acute cerebral hemorrhage was induced by stereotaxic injection of collagenase type IV. RhIGF-1 (50 μg/kg) was injected via tail veins in the intervention group, once a day, until the end of the experiment. An equivalent isotonic saline was injected via tail veins each day in the sham operation and control groups. Samples were taken from each group at a specified time. An immunohistochemical method was used to observe the expression of pAkt around hematomas ; deoxynucleotidyl transferase-mediated terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) technique was used to observe apoptotic cells. Results: Circled digit oneThe neurological deficit score of the rats in the control group and intervention group reached the highest at day 1 or day 2 after procedure, then decreased gradually. The only score in the intervention group at day 7 after procedure was lower than that in the control group. The difference was statistically significant (P <0. 05). Circled digit twoThere were only a few expressions of pAkt positive cells in rats of the false operation group. Except the 6-hour time point, the numbers of pAkt positive cells at the remaining time points in the intervention group were higher than those in the control group. The difference was statistically significant (P < 0. 05). Circled digit threeOnly a few TUNEL positive cells were observed in the false operation group. Except the 6-hour time point, the numbers of TUNEL positive cells at the remaining time points in the intervention group were significantly lower than those in the control group. The difference was statistically significant (P < 0. 05). Conclusion: RhIGF-1 may reduce apoptosis after cerebral hemorrhage and improve the neurological function. Its role may be associated with the activation of pAkt.

OBJECTIVE To explore the value of the continuous quality improvement(CQI) in the quality control of disinfection supply center.METHODS The CQI was applied to every aspect of disinfection supply center.We analyzed and identified the reason of the existence of quality problems,and took CQI measures and the implementaion of quality improvement.RESULTS After 5 years CQI,quality control of disinfection supply center had been remarkably improved.The harmony had increased among staff year by year.The professional knowledge rose from 60% to 100%,the rate of monitoring raised from 70% to 100%,the pass rate of sterilized package raised from 55% to 95%,the satisfaction rate of the relevant sections raised from 85% to 100%.The errors and accidents were eliminated or reduced owing to pay attention to quality control.CONCLUSIONS CQI plays an important role on medical service safety and can effectively improve the medical safety,medical quality and service quality.

Adult ; Cord Blood Stem Cell Transplantation ; adverse effects ; Cytomegalovirus ; Cytomegalovirus Infections ; complications ; Female ; Hemolysis ; Humans

In order to study the factors influencing quantitative measurement of CT lung densitometry, 54 healthy adults underwent lung spiral scans at 50 % vital capacity (VC). Among the 54 cases, 40 received HRCT scan at carina and 5 cm away from carina (± 5 cm) at 10 % VC and 90 % VC, 23 lung HRCT at those three sections at 50 % VC. Using automatic evaluation software-Pulmo, mean lung density (ME) and pixel index (PI) at each section were evaluated. It was found that the depth of respiration affected ME and PI markedly. The ME changed 125.91 Hu between 10 % VC to 90 % VC. The ME and PI were also influenced by collimation, age and sex. It was concluded that it was very important to control the depth of respiratory. The normal CT attenuation values for the lung should be established.

Objective To analyze the indications of clip deployment and influencing factors for clip dislocation immediately after stereotactic vacuum-assisted breast biopsy. Methods One hundred and fourteen microcalcifications in 108 women aged 35 to 85 years old (median 63 years) underwent 11-gauge stereotactic vacuum-assisted breast biopsy. Every lesion was marked on biopsy site with Gel Mark Ultra clips (n = 82) or MicroMark Ⅱ clips ( n = 32) after biopsy. All microcalcifications were classified 3 mono-focal groups: < 10 mm, 10--20 mm, > 20 mm and one muhi-focal group according to its diameter and distribution. The distances between clips and biopsy sites were directly measured on post-biopsy craniocaudal and mediolateral mammograms. The distance was recorded as < 10 mm, 10--20 mm and >20 mm. Results 88% (22/25) of mono-focal microcalcifications smaller than 10 mm and 70% (14/20) of mono-focal microcalcifications measured 10--20 mm were completely removed on mammograms, whereas none of mono-focal microcalcifications larger than 20 mm (n = 17) was completely removed. 65.8% (75/114) of the clips were accurately located. Thirty-nine clips were dislocated on at least one projection with 87.2% (34/39) of the clips dislocated only along the needle track, which is called "accordion effect". Hematoma was found in 4 patients, and the clip was accurately localized only in one case with hematoma, Conclusions Clips should be deployed as a standard procedure for mono-focal microcalcifications smaller than 20 mm and all multi-focal mierocalcifications. The major reasons for clip dislocation immediately after biopsy are the accordion effect and hematoma.

Objective To establish an effective technique in reservation and function reconstruction of a leg, in which all the muscles except gastrocnemius necrosed induced by the delayed necrosis of all the intermuscular vessels, the foot was linked only by skin, fascia and tibia. Methods The leg was linked with foot only by the skin, fascia, caput mediale of gastrocnemius and tibia when all the muscles, intermuscular vessels and fibula were removed. The direct island flap of tibialis posterior artery was cut from the healthy limb and used to cover the 4/5 length and 1/3 circumference of bone-fascia raw surface, then to anastomose the both arteries of the flap and the caput lateral gastrocnemius when dividing the pedicles. As soon as the raw surface healed, fuse the ankle in the functional situation and fix the flexor and extensor tendon in the proper situation. Results With sufficient blood supply from the skin and fascia of the flap, the raw surface healed soon, the severe ischemia pain relieved, and the circulation and sensation recovered gradually. The crutching and walking function of the leg reconstructed at last. Conclusion When all the necrotic intermuscular vessels and muscles except caput mediale of gastrocnemius were removed, the necrosis may be delayed by means of reticular collateral circulation among skin, deep and superficial fascia and tibia of the injured limb. However, the blood supply is very little, the severe ischemia wound and ischemia pain can't be healed. Through the tibialis posterior artery direct island skin flap of the healthy leg to cover the dystrophic wounds, the blood supply of the leg can be improved. As a result, the leg survives and its function is reconstructed, and an eternal axial-pattern artery for the wound leg through arteries anastomosis is rebuilt.

Objective To prove insulin resistance-induced by free fatty acid(FFA)with hyperinsulinemic-euglycemic clamp and assess the prevention from this resistance by N-acetylcysteine(NAC).Methods Twenty-four female Wistar rats were randomly divided into 4 groups,each of which received infusion of IH(20% intralipid +20 U/mL heparin),IH+NAC,NAC,and saline respectively for 7 h.Two-hour hyperinsulinemic-euglycemic clamp was made after 5h infusion.During the infusion and clamp the rats were awake.Blood samples were taken for measuring insulin,FFA and maleic dialdehyde(MDA)at 0 min,280 min,290 min,300 min,340 min,380 min,400 min,410 min and 420 min.The insulin sensitive index was calculated.Results Plasma FFA and MDA levels in IH group were significantly elevated compared with those in control,IH+NAC and NAC groups,P