After the advantages of PACS system in medical imaging examination were described, its rational appli-cation in medical imaging examination was elaborated .

Objective To measure the length and diameter of the main bronchus using three-dimensional reconstruction from spi-ral chest computerized tomography scans in Chinese patients,and to evaluate the relationship between the BMI of patients and the length and diameter of main bronchi in order to provide the basis for pre-operative tracheal intubation.Methods 100 males and 100 females,who were scheduled to undergo a chest CT scan for physical examination,the diameter at the carina of the left and right main bronchus were measured.The length of the main bronchi extending from the carina to the line that is vertical to the bronchial wall at the starting point from the branches of the upper lobe was measured at the workstation.Results the length of the men’s right and left main bronchus was (1 9.7±5.2)mm and (50.3 ±4.7)mm.the length of the women’s right and left main bronchus was (18.2±4.1)mm and (46.3±4.5)mm,The length of the left main bronchus(LMB)was about 3-4 times greater than right main bronchus(RMB).the cross-section of the men’s left and right main bronchus was (175.3±29.6)mm2 and (209.4±32.7)mm2 ,the cross-section of the women’s left and right main bronchus was (120.5±24.8)mm2 and (144.4±33.7)mm2 .There was no signifi-cant relationship between the length and diameter of main bronchi and the BMI of patients.Conclusion The results showed that there was no direct relationship between the diameter and the length of main bronchi and the BMI of patients.BMI is not the criteri-on for choosing double-lumen tube (DLT)size.We proposed that three-dimensional reconstruction be used to measure the size of the main bronchi and determine the optimal size of the DLT in a clinical setting.

Background Electroacupuncture pretreatment plays a protective role in myocardial ischemia/reperfusion (I/R) injury and microRNAs (miRNAs) could act on various facets of cardiac function. However, the role of miRNAs in the cardioprotection by electroacupuncture pre-treatment on myocardial I/R injury remains unknown. The purpose of the study was to examine whether miR-214 was involved in cardio-protection by electroacupuncture. Methods Using rat myocardial I/R model, we examined the role of electroacupuncture pretreatment in myocardial I/R injury and analyzed the changes in the expression of miR-214. In addition, I/R was simulated in vitro by performing oxy-gen-glucose deprivation (OGD) on H9c2 cell cultures, and the effect of electroacupuncture pretreatment on I/R injury as well as expressional level of miR-214 were examined in vitro. Furthermore, the miR-214 mimic was transfected into OGD-treated H9c2 cells, we analyzed the cell apoptosis, lactate dehydrogenase (LDH) and creatine kinase (CK) activities, intracellular free Ca2+concentration ([Ca2+]i) as well as the relative protein levels of sodium/calcium exchanger 1(NCX1), BCL2-like 11 (BIM), calmodulin-dependent protein kinase IIδ(CaMKIIδ) and Cyclophilin D (CypD). Results The in vivo results revealed that compared with the I/R group, the electroacupuncture pretreatment group showed significant decreased myocardial infarct size, as well as the increased indices of the cardiac function, including heart rate, mean arterial pressure, left ventricular systolic pressure and maximal rate for left ventricular pressure rising and declining (±dp/dt max). In addition, electroacupuncture pretreatment could inhibit the elevation of LDH and CK activities induced by I/R injury. The quantitative PCR (qPCR) results demonstrated electroacupuncture pretreatment could provide cardioprotection against myocardial I/R injury in rats with miR-214 up-regulation. In the meanwhile, in vitro, electroacupuncture pretreatment protected H9c2 cells from OGD-induced injury. Trans-fection of miR-214 mimic showed protective effects on OGD-induced injury to H9c2 cells by reducing apoptosis, decreasing LDH and CK activities, rescuing the OGD-induced Ca2+and down-regulating elevated protein levels of NCX1, BIM, CaMKIIδand CypD. Conclusions Our findings firstly demonstrated that electroacupuncture pretreatment promotes the expression of miR-214 in myocardial I/R injury and miR-214 contributes to the protective effect of electroacupuncture on myocardial I/R injury.

Objective To study the intra- tumor basis of pleural indentation (P I) and find the influential factors correlated with PI in peripheral lung cancer . Methods Eighty-six cases of peripheral lung cancer (includin g experimental gr oup of 34 cases with PI and control group of 52 cases without PI) were subjected to identify the constitution in tumoral interstitium. And 7 variables (includin g intra-tumor fibrosis, tumor-chest wall distance, histological type, diameter o f tumor, differentiated degree, lymphatic metastases, sex, etc.) were investigat ed about PI by single factor analysis and multiple factor analysis of Logistic r egression model. Results(1)Collagenous fibers were the mai n fiber in tumoral interstitium, and were higher in experimental group than that in control group ( t=3074, P005). Conclusion Collagen Ⅰfibers are the main type of interstiti al fibers, and myofibroblasts are the main type of interstitial cells in PI asso ciated peripheral lung cancer. Intra-tumor fibrosis, tumor-chest wall distance , and histological types are the main influential factors in PI formation, and int ra-tumor fibrosis is the basic and inside factor. The histological types affect PI formation. Tumor-chest wall distance plays an important outside role in PI f ormation.

The evaluation of outcomes of cancer therapy in clinic are largely based on volumetric and morphological evidences.These evidences,however,are very limited in assessing the early effects of therapy.Functional and molecular MR imaging allows co-registration of functional/molecular-based information with high-resolution anatomical detail within the same imaging modality,which makes it possible for assessing the early effects of tumor therapy.

Objective:To evaluate the efficacy of transcatheter arterial embolization with detachable balloon for pulmonary arteriovenous fistula(PAVF). Methods: A 48 year old female with PAVF suffered intermittent emoptysis, fatigability, exertional dyspnea, and palpitations. CT and MRI demonstrated 2 PAVF in the module lobe on right side. Pre embolization super selective pulmonary angiography revealed 2 fistulae communicating to the sac of the lesion.Three detachable balloons were used for embolization of the feeding arterial branch.The diameter of detachable balloons was twice as that of the feeding arterial branch. The study of blood gases showed the arterial oxygen pressure was 6.5 kPa before operation, hemoglobin at 158 g/L. Results: No complications were apparent in our case. Two PAVF were completely occuluded by the embolization of a feeding branch. One month later, the arterial oxygen pressure increased to normal values, hemoglobin at 125 g/L and clinical symptoms disappeared. On postcontrast CT, the fistulas treated by the embolization of a feeding arterial branch were not enhanced. No symptoms and signs were found in follow up for 16 months. Conclusion: The percutaneous transcatheter embolization with detachable balloon is effective for PAVF. [

Objective The sensitivity and specificity of 18 FDG PET/CT are poor in the diagnosis of gastric cancer .Gastric signet ring cell carcinoma and Mucinous gastric carcinoma is known to have low fluorodeoxyglucose (18FDG) uptake,but not known for poorly differentiated gastric adenocarcinoma .This study was to investigate the value of 18 FDG PET/CT in the diagnosis of poorly differ-entiated gastric adenocarcinoma . Methods We retrospectively analyzed the results of 18 FDG PET/CT of 34 cases of histologically confirmed poorly differentiated gastric adenocarcinoma .We recorded the volume , location , and gastric wall invasion depth , and maxi-mum standardized uptake value ( SUVmax) of the tumors and analyzed the relationship of 18 FDG uptake with the clinicopathologic pa-rameters. Results By 18 FDG-PET/CT, poorly differentiated gastric adenocarcinoma was diagnosed in only 67.6% of the patients (23/34).SUVmax was found to be significantly correlated with age , gastric wall invasion, and tumor size (P<0.05), but not with gender , tumor location , tumor pathologic subtype , lymph node metastasis , and distant metastasis ( P>0 .05 ) .Logistic regression a-nalysis showed the tumor size to be the sole factor influencing the 18 FDG uptake of poorly differentiated gastric adenocarcinoma ( OR=0.37, 95%CI 0.154-0.920, P=0.03). Conclusion The di-agnostic value of 18 FDG-PET/CT is but limited for poorly differentia-ted gastric adenocarcinoma , and attention should be paid to its false-negative results .

Objective To evaluate CT features of inpatients with pulmonary tuberculosis (TB) in general hospital.Methods 144 cases hospitalized with pulmonary tuberculosis from 2001~2006 in our hospital were included in this study.CT findings of pulmonary tuberculosis were retrospectively analyzed.Results 144 cases included:blood disseminated TB in 3,secondary tuberculosis in 102,tuberculous pleuritis in 39,pulmonary consolidation in 101,pulmonary nodus or masses in 18 and pleural effusion in 39.Conclusion CT examination has important value for diagnosing the patients with pulmonary tuberculosis in general hospital.

Objective To compare the pharmacodynamics of rocuronium intermittently administered according to body surface area and real body weight and individual differences. Method Forty-two patients undergoing elective surgery under general anesthesia were enrolled into the body surface area group (BSA group) and the real body weight group (RBW group), with 21 patients in each group. The patients in the two groups were induced with 2ED95 of rocuronium according to body surface area and real body weight (16.64 mg/m2 in BSA group; 0.6 mg/kg in RBW group). Whenever T1 recovered to 10%, a dosage of 0.5ED95 was administred repeatedly for 30 min before the end of the operation. The time of neuromuscular blockade and recovery of muscle relaxation were recorded, and the dosage of rocuronium was also recorded. Results No significant difference in each index of neuromuscular block time-effect was found between the two groups (P > 0.05). The single dosage and maintainance amount of muscle relaxation were less in the BSA group than that in RBW group (P < 0.05). Compared with the RBW group, the single dosage, dosing intervals, pharmacological duration and the time TOFr recovered to 0.7 between the different individuals were less in the BSA group (P < 0.05). Conclusion The intermittent administration of rocuronium can maintain the same clinical efficacy according to body surface area as that according to real body weight , with significantly less dosageand reducing the differences of individuals in blockade time-effect of muscle relaxation.

Objective To investigate the effect of gravity and lung volume on MR perfusion imaging of human lung using an arterial spin labeling sequence called flow sensitive alternating inversion recovery(FAIR).MethodsMagnetic resonance imaging of lung perfusion was performed in supine position in ten healthy volunteers on a 1.5 T whole body scanner(GE medical system).Five sequentially coronal slices with the gap of 3cm from dorsal to ventral(labeled as P3,P6,P9,P12,P15,respeectivly)were obtained on end respiration and the relative pulmonary blood flow(rPBF)was measured.Another coronal perfusion-weighted image of P3 slice was obtained on end inspiration.Tagging efficiency of pulmonary parenchyma with IR(⊿SI%),the rPBF and area of the P3 slice were analyzed.respectively.Paired Student's t test was used for statistical analysis.Results(1)In the direction of gravity,an increase in rPBF of the gravity-dependent lung was found.rPBF of right lung from dorsal to ventral were 100.57±18.22,79.57±12.36,61.65±11.15,48.92±9.96,41.20±9.88,respectively；and that of left lung were 106.61±26.99,78.89±11.98,64.00±13.64,51.27±8.95,43.04±12.18.No statistical differences between P12 and P15,there were significant statistic differences of any other two coronal planes.But along an isogravitational plane,no statistical difference was observed.Regression coefficients of right and left lung were -4.98 and -5.16,respectively.This means the rPBF of right lung falls by 4.98 for each centimeter above the dorsal and that of left lung falls by 5.16.(2)For(⊿)SI%,rPBF and area,there were significant statistic differences at different respiratory phases(P＜0.05).(⊿)SI%,rPBF,area at expiration phase vs.inspiration phase were 1.12±0.31 vs 0.71±0.18,90.78±17.35 vs 52.85±8.75,(12.59±3.23)×103mm2 vs (17.77±4.24)×103mm2 for right lung;and 1.01±0.24 vs 0.70±0.11,91.08±18.68 vs 54.58±10.70,(12.34±3.08)×103mm2 vs(17.34±4.98)×103mm2 for left lung.Greater (⊿)SI%and increased perfusion were observed on end expiration than on end inspiration.The area was larger on end inspiration than on end expiration.ConclusionsThe FAIR is sensitive to perfusion changes in the gravity-dependent lung.Pulmonary blood flow is less in a state of high lung inflation than in a low state(inspiration vs.expiration).Positioning the patient so that the area of interest is down-gravity and breath-hold on end expiration may improve visibility of perfusion defects.