Objective To evaluate the diagnosis value of CT through analyzing 11 cases with the rare disease-lung carcinosarcoma.Methods 11 cases of lung carcinosarcoma proved by operation and pathology from 1994-2000 were analyzed.Results Lung carcinosarcoma had the characteristics of both lung cancer and sarcoma. The border of the carcinosarcoma was irregular, it had lobulation or spiculation, just like primary lung cancer. When IV contrast medium was used, it had some sarcoma’s characteristics such as lower density in center of mass. Conclusion CT is a good method to show the characteristics of lung carcinosarcoma. It is important to recognize the CT appearances of lung carcinosarcoma in order to improve diagnostic ability.

Objective To analyze the image noise and artifact of low-dose chest CT scanning and the distribution pattern. Methods A chest phantom equivalent to human tissue was scanned by 64 slices spiral scanner at standard dose (250 mAs) and low-dose (50, 30,and 21 mAs) respectively, HU in sites of the phantom and SD of which was recorded. 200 patients with pulmonary nodules were scanned at 30 or 21 mAs for minimal length. The relationship between severity of noise and artifact in chest low-dose CT scanning and gender or body mass index (BMI) of the patients, as well as the distribution of noise and artifact was evaluated. Results There was no statistical difference between the HU in sites of the phantom: lung (-777.3-- -758.2 HU, F=0.992, P<0.01), chest wall (107.9--111.3 HU, F=2.044, P>0.05), vertebra (835.6--875.3 HU, F=1.453, P>0.05), while the SD of which was of statistical signification: lung (9.5--29.0 HU, F=108.7, P<0.01), chest wall (10.1--32.4 HU, F=84.3, P<0.01), vertebra (19.2--57.1 HU, F=30.6, P<0.01),tbe SD increased with the decrease of the tube current. There was no statistical difference between male (in which 74 cases no or mild, 17 cases severe)and female (81 cases no or mild, and 28 cases severe)in image noise and artifact in low-dose images (X~2=2.294, P>0.05), and significant difference between groups of different BMI(in BMI<18.5 group, 29 cases no or mild,2 cases severe, in group of 18.5≤BMI<24.0, 120 cases no or mild, 13 cases severe, and in group of BMI≥24.0, 6 cases no or mild, 30 cases severe, X~2=128.274, P<0.01). The noise andartifact was greater in the upper (80 cases no or mild, 38 cases severe, X~2=18.918, P<0.01) and dorsal field (89 cases no or mild, 33 cases severe, X~2=6.760, P<0.05). Conclusions The image noise and artifact was significant in low-dose CT, especially in the dorsal and upper field of the lung, which might be attributed to the distribution of skeleton in the chest. It was recommended that scanning protocol (mAs value) be individualized adjusted in according to the patients BMI.

Objective To evaluate the sensitivity and optimized scanning parameter of 64-slice spiral CT in detection of pulmonary nodules with different size and density. Methods Three groups of prosthesis nodules with diameter of 2.5～13 mm and different density (soft-tissue, low density, and ground glass opacity,GGO)were taken into the chest phantom equivalent to human tissue,then scanned with Philips Brilliance 64 scanner in standard dose(tube voltage:120 kV, tube current: 250 mAs)and low-dose(tube voltage:120 kV, tube current: 50, 30,and 21mAs) respectively. The radiation dose(CTDIw and DLP) of the scans, Hounsfield unit(HU) and standard deviation(SD) of CT values in different regions of the phantom, and visibility of the nodules was assessed and recorded.Results The radiation dose of 64-slices spiral CT scanning in low-dose(tube current 21～51 mAs) decreased to 8%～20% of which scanning in standard-dose(250 mAs). There was no statistical difference between the CT values in different regions of the phantom (P>0.05), while the SD of CT values was of statistical significantce (P<0.001) and SD increased with the increment of the density under different scanning parameters. None of the nodules besides of GGO nodules with 2.5 mm and 4 mm in size scanned at 21 mAs was invisible. Conclusion GGO nodules of 2.5 mm in diameter can be detected with 64-slice spiral CT using 30 mAs at experimental study, which might be the optimized dose for detecting pulmonary nodules.

Objective To evaluate the clinical significance of video-assisted thoracic surgery ( VATS) in localization of pulmonary ground-glass opacities( GGOs) by intraoperative ultrasound ( IU ) . Methods An intraoperative ultrasonographic procedure was prospectively performed on 14 patients harboring GGOs of no more than 3 cm in diameter to localize these lesions and achieve adequate margins . Patients were excluded with both asthma and chronic obstructive pulmonary disease from this study inasmuch as the intraoperative ultrasonographic procedure was more difficult to interpret when residual air is present in the lung . The sonographic characteristics of nodules were compared with those from CT and pathology . Results A total of 18 GGOs were successfully identified by intraoperative ultrasonography without any complications .In all instances 13 GGOs were localized in the lung of complet collapse ,and high-quality echo images were obtained . Additionally ,the IU showed that the nodule sizes were similar to those of CT and postoperative pathological specimens( P < 0 .05) . There was significant difference in lung collapse degree , the maximum diameter of CT and the distance from the lesion to the pleura between echo types ( P <0 .05) . The mean operation time was ( 4 .2 ± 2 .7) min . Conclusions Intraoperative ultrasonography can both safely and effectively localize pulmonary GGO in a completely deflated lung . Hence ,ultrasonography may assist surgeons to perform minimally invasive lung resections with clear surgical margins during the treatment of lung GGO .

Objective To explore the relationship between plasma adiponectin, visfatin, leptin, and resistin levels, and the onset of colonic polyps in prediabetes subjects. Methods A total of 468 prediabetes subjects, who received colonoscopy examination, were enrolled in this study, including 248 cases of colon polyps (polyps group with prediabetes) and 220 cases without colonic mucosal lesions ( polyps-free group with prediabetes). According to the clinical characteristics of colonic polyps, colonic polyps patients with prediabetes were subdivided into single polyp group, multiple polyps group, low-risk polyps group, and high-risk polyps group, respectively. In addition, 108 subjects with normal glucose tolerance, who were matched with prediabetes subjects on gender and age, were selected as control group, and 46 cases of them were refered to polyps group with normal glucose tolerance and 62 cases were refered to polyps-free group with normal glucose. Plasma adiponectin, visfatin, leptin, and resistin levels were measured in all subjects, and related risk factors of colonic polyps in prediabetes patients were analyzed. Results Not only in normal glucose tolerance subjects, but also in prediabetes subjects, plasma visfatin levels in polyps group were significantly higher than those in polyps-free group (P＜0.05), and plasma adiponectin levels were significantly lower than those in polyps-free group [normal glucose tolerance (9.8±4.8 vs 13.3±3.9)mg/L, P＜0.05; prediabetes (5.6 ± 3.7 vs 9.2 ± 4.4)mg/L, P＜0.01], respectively. However, no significant difference in the plasma leptin and resistin levels were observed between polyps-free group and polyps group ( both P＞0. 05), respectively. In addition, in prediabetes subjects, plasma visfatin levels increased (P＜0.05) and adiponectin levels decreased significantly [(4.3 ± 2.6 vs 6.7 ± 3.9) mg/L, P＜0.05] in multiple polyps group than in single polyp group. Nevertheless, there were no significant differences in plasma leptin and resistin levels between two groups (both P＞0.05). Moreover, plasma adiponectin levels decreased significantly in high-risk polyps group with prediabetes than in low-risk polyps group with prediabetes[(3.7±2.9vs7.4±3.5)mg/L,P＜0.05].Meanwhile,noneofplasmavisfatin,leptin,andresistinlevels had shown significant difference between two groups (all P＞0.05). The multivariate logistic regression analysis found that adiponectin was an independent protective factor for colon polyps, multiple colon polyps and high-risk colon polyps. Conclusion The changes of plasma adiponectin levels might be associated with onset of colonic polyps in prediabetes.

Objective To analyze the changes and correlation of serum Hcy level in patients with type 2 diabetes mellitus (T2DM) complicated with acute cerebral infarction (AIS). Methods A total of 427 T2DM patients admitted to our hospital from June 2019 to June 2021 were selected and divided into the control group (T2DM, n=129) and experimental group (T2DM combined with AIS, n=298) according to whether the patients were complicated with AIS. According to NIHSS score, the patients in the experimental group subsequently were divided into the mild group (NIHSS score <7 points, n=51), moderate group (7≤NIHSS score 7-15 points, n=43) and severe group (NIHSS score >15 points, n=35). According to infarct size, the patients in the experimental group were divided into the lacunar cerebral infarction group (n=57), small area cerebral infarction group (n=45) and large area cerebral infarction group (n=27). The basic data of all patients, including age, gender, history of hypertension, stroke and smoking, were collected by self-made scale. The levels of FBG, TG, LDL-C, SBP and serum Hcy were compared between the groups. Logistic regression analysis was used to screen the independent risk factors for development of AIS in T2DM patients. Spearman was applied to analyze the correlation between serum Hcy level and the degree of neurological impairment as well as infarct area in T2DM patients with AIS. Results There were statistically significant differences in age, history of hypertension, stroke, smoking, and the levels of TG, LDL-C, FBG, SBP, Hcy between the control and experiment groups (P<0.05). Logistic regression analysis showed that age and the levels of TG, FBG, SBP, Hcy were independent risk factors for development of AIS in T2DM patients (P<0.05). The serum Hcy level in severe group was significantly higher than that in mild and moderate groups, and it in moderate group was significantly higher than that in mild group (t=16.995, t=8.850, t=12.163, P<0.05). The serum Hcy level in large area cerebral infarction group was significantly higher than that in lacunar and small area cerebral infarction groups, and it in small cerebral infarction group was significantly higher than that in lacunar cerebral infarction group (t=8.677, t=2.858, t=7.028, P<0.05). Spearman correlation analysis showed that serum Hcy level was positively correlated with the degree of neurological impairment and infarct area in T2DM patients with AIS (r₁=0.459, r₂=0.513, P<0.05). Conclusions T2DM patients with old age, poor control of smoking, blood glucose, blood pressure and blood lipids are at greater risk of AIS development. The serum Hcy level of T2DM patients with AIS is significantly increased, which can be monitored to determine the degree of neurological impairment and infarct area of T2DM patients with AIS..