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 The purpose of this study was to present the characteristic features on MSCT angiography of arterial sequestration.Methods The MSCT images of 5 patients with arterial sequestration were retrospectively reviewed All patients underwent MSCT contrast-enhanced angiography.3D rendering was made to evaluate the lung parenchyma,bronchial system,and vascular anatomy.Results All S cases demonstrated the anomalous systemic artery(ASA)as an isolated and tortuous artery arising from the descending thoracic aorta,taking a sigmoid course and running along with airway,entering the basal segments of the left lower lobe.The inferior pulmonary vein(IPV)was significantly engorged.The typical AS was diagnosed in 4 patients.Its ASA intercrossed with the IPV and two branches entering segments 7 and 8 over the IPV,and two branches entering segments 9 and 10 under the IPV.The volume of involved lung shrunk with the artery markedly engorged.A characteristic avascular section was found between the pulmonary artery supplying area and the ASA supplying area,and the bronchi did not accompany the arteries.One was diagnosed atypical AS because of coexistence with bronchial atresia.Conclusion The arterial sequestration had characteristic MSCT findings.The typical type can be definitely diagnosed,but the atypical type needs further three-dimensional analysis.

Objecfive To investigate multi-slice spiral CT(MSCT)appearances of pulmonary infections after liver transplantation(LT)and the diagnostic values of MSCT.Methods The clinical data and CT images of liver transplantation receptors were reviewed from 200 1 August to 2007 June,the types,onset time and CT appearances of pulmonary infections were analyzed retrospectively.Chi square test was used for the statistics.Results The incidence rate of pulmonary infections after LT was 32.9/(174/529),the mortality was 9.8/(1 7/174),The incidence of bacterial infection,fungus or associated fungus infection,and virus or associated virus infection were 17.2/(n=91),14.7/(n=78)and 2.3/(n=12)respectively,the pulmonary infections were seen in 64.7/,28.7/and 6.6/of patients 1 to 30 days,31-90 days and after 90 days following LT.Consolidations(n=32),ground-glass opacities(n=22),nodules(n=10),reticular or lineal opacities(n=4)were found in 45 patients who had CT examination,there were no statistic differences in incidence rate between bacterial infection and mycotic infection(P＞0.05).Conclusion Pulmonary bacterial and fungus infection are common after LT.and often present as the mixed infection,the high risk period for infection is within 30 days after LT,thoracic CT stall is very important for characterizing the pulmonary infections after LT.