Objective To explore the value of gemstone spectral imaging (GSI) in the detection and differential diagnosis of benign and malignant thyroid nodules.Methods The spectral CT images in 88 patients with thyroid nodules were analyzed retrospectively.All the patients underwent spectral CT scanning,including 33 patients undergoing biphase enhanced CT imaging.Nodules were divided into benign and malignant ones according to histopathologic results.The iodine concentration,slope of spectral curve,effective atomic number in non-enhanced and enhanced scanning were compared between benign and malignant group by the Wilcoxon rank sum test,respectively.The optimal iodine concentration threshold to predict malignancy was obtained by receiver operating characteristic curve (ROC),sensitivity and specificity were achieved.Results A total of 106 nodules were detected,including 76 benign and 30 malignant nodules.In non-contrast CT imaging,the average iodine concentration,slope of spectral curve,effective atomic number of were 2.35 × 100 μg/ml,0.29 and 7.71 for benign group:-0.51 × 100 μg/ml,-0.06 and 7.52 for malignant group (Z value were-3.072,-3.107 and-3.055,respectively ; P ＜ 0.05).In the arterial phase,the average iodine concentration,slope of spectral curve,effective atomic number of the two group were 27.22 × 100 μg/ml,3.23 and 9.10 for benign group; 18.81 × 100 μg/ml,2.24 and 8.69 for malignant group (Z value were-2.582,-2.582 and-2.564,respectively; P ＜ 0.05).In venous phase,no significant difference was found for each parameter between the two groups (P ＞ 0.05).The optimal iodine concentration to predict malignancy was-0.35 × 100 μg/ml in non-enhanced phase with 56.7％ sensitivity and 73.7％ specificity.The optimal iodine concentration was 22.91 × 100 μg/ml in arterial phase,with 76.2％ sensitivity and 75.0％ specificity.Using iodine concentration to predict malignancy in both noncontrast phase and arterial phase,the sensitivity and specificity were 81.2％ and 73.3％,while the accuracy was 81.6％.Conclusion Gemstone spectral CT imaging can quantitatively evaluate the iodine content of thyroid nodules,having a potential value in differential diagnosis of thyroid nodules.

Objective To analyze the CT findings of benign lymphoepithelial lesion (BLEL) of major salivary glands.Methods The CT findings of 11 cases with BLEL which were clinically and pathologically confirmed were analyzed.The relevant literatures were reviewed.All the patients received plain CT.Among them,5 patients had contrast CT as well.The location,number,shape,margin,density,and enhancement characteristics of the lesions were observed.Results Of 11 BLEL,8 lesions were located in the parotid gland,three in the submandibular gland.There were 7 cases with bilateral multiple lesions,and 4 cases with unilateral solitary lesion.BLEL of major salivary gland could be classified into three types according to the CT findings,including multinodular type,solitary mass type,and diffusely infiltrating type.Multinodular type was the most common type.The typical CT findings of the lesion included diffusely enlargement of bilateral parotids and (or) submandibular glands,heterogeneous increase of density of the parenchyma with multiple soft tissue density nodules,and multiple cystiform hypodense.On contrast-enhanced CT,the lesions mostly manifested as heterogeneous enhancement.The solid part of the nodules showed moderate or marked enhancement.However,the cystiform hypodense showed no enhancement.Conclusion Although the CT findings of BLEL of major salivary glands are variable,they still share some common characteristics,which are useful in the clinical diagnosis.

Objective To study the clinical value of 64-slice spiral computed tomography(64SCT) contrast-enhanced scan and three-dimensional reconstructed techniques in the diagnosis of complex congenital heart disease(CCHD). Methods 39 patients with CCHD underwent CT angiography and transthoracic echocardiograms (TTE). Of them, the electrocardiographic-gating technique was used in 8 cases. The accurate rates in diagnosing CCHD with CT, TTE and CT with or without electrocardiographic-gating were analysed compared with that of operation and χ~2 test using SPSS13.0 tool. Results A total of 102 cardiac deformities con-firmed by operations,those included 47 intracardiac deformities,the diagnostic accuracys with CT and TTE were 85.1% and 95.7%, respectively, and there was no obvious difference among them (χ~2=2.68, P>0.05). 55 extracardiac deformities, the definite diagnos-tic rates with CT and TTE were 98.2% and 78.2%, respectively. CT was superior to TTE in the indentification of extracardiac de-formities(χ~2= 14.64 ,P<0.01). There was no obvious difference between with and without electrocardiographic-gating technique during CT scanning in diagnosis of cardiac deformities(χ~2=1.84, P>0.05). Conclusion 64SCT has significant value in diagnosis of CCHD,and there was no obvious difference in diagnosis of cardiac deformities by 64SCT between with and without electrocardio-graphic-gating technic.

Gastrointestinal duplication cyst is a rare congenital disease which can occur in any part of the digestive tract between the root of tongue and the anus,and it is commonly seen in the ileum.About 45％ of the gastrointestinal duplication cyst occurs in the ileocecus and the epityphlon.Multiple gastric duplication cyst is a rare type of the gastrointestinal duplication cyst,which accounted for 3.8％-5.0％.Gastric duplication cyst mostly occurs in the greater curvature of the stomach,and it connects with the stomach wall.Multiple gastric duplication cysts in the mediastina is rarely seen.In this article,the imaging presentations of 1 patient with multiple gastric duplication cysts inside the mediastina were analyzed.

AIM: To investigate the mRNA changes of L-type Ca~(2+) channel ?_(1C) subunit (CaL-?_(1C)) and Na~+-Ca~(2+) exchanger (NCX) in the atria of renovascular hypertensive rats. METHODS: Two-kidney one-clip Goldblatt hypertensive Sprague-Dawley rats were divided into three groups 1 week after operation, HD group was treated with 250 mg/d diltiazem, LD group was treated with 50 mg/d diltiazem, control group (C group) was treated with vehicle. After 4 weeks treatment, semiquantitative RT-PCR was used to estimate the mRNA changes of CaL-?_(1C) and NCX, and GAPDH was used as internal control. RESULTS: Systolic blood pressure in LD group was comparable with C group, and that in HD group was decreased to normal level after diltiazem treatment. In C group, CaL-?_(1C) mRNA level were 2.5, 2.4 and 2.1 times of S, HD and LD group, and NCX mRNA level were 1.9, 1.6 and 2.1 times of S, HD and LD group. There were no significant difference in the mRNA level of CaL-?_(1C) and NCX among S, HD and LD group. CONCLUSION: The mRNA levels of CaL-?_(1C) and NCX are upregulated in the atria of hypertensive rats. Ca~(2+) antagonist inhibits their upregulation independent of blood pressure.

Objective To study the effect of basic fibroblast growth factor(bFGF) on neuron-like differentiation of superparamagnetic iron oxide nanoparticles (SPIONs)-labeled amniotic membrane-derived mesenchymal stem cell.Methods Cells were cultured from enzymatic-digested amniotic membrane tissue.After that,the following steps were taken:(1) Mesenchymal stem cells derived from amniotic membrane were identified by using cell morphology,MTT method and flow cytometry.(2)SPIONs were used to label amniotic membrane-derived mesenchymal stem.(3)bFGF was imported to induce the neuron-like differentiation of SPIONs-labeled amniotic membrane-derived mesenchymal stem cell.Results (1) Primary cultures of P3,amniotic membrane-derived mesenchymal stem cell were fibroblast-like and expression of surface molecules CD29,CD44,CD90 and CD105 was detected,while expression of CD31,CD34,CD45 and CD106 was negative.(2) SPIONs of no more than 14.0 μg/ml are safe to label amniotic membrane-derived mesenchymal stem cells.Cell activity is more than 80％ and expression of surface molecules CD29,CD44,CD90 and CD105 is positive.(3)RT-PCR and immunocytochemistry analysis showed that 10.0 ng/ml bFGF induced neuron-like differentiation of amniotic membrane-derived mesenchymal stem cell (14 μg/ml SPIONs-labeled).Conclusions Enzymatic digestion and cell adherent culture method can be used to isolate mesenchymal stem cells from amniotic membrane.SPIONs of no more than 14.0 μg/ml are safe to label amniotic membrance-derived mesenchymal stem cells and have no effect on the cell activity.Neuron-like differentiation of amniotic membrane-derived mesenchymal stem cell can be induced with 10.0 ng/ml bFGF.

Objective:To analyze the value of fine needle aspiration cytology and CT perfusion imaging in differential diagnosis of benign and malignant salivary gland tumors. Methods: Perfusion CT and fine needle aspiration cytology were performed in 36 patients of salivary gland tumors(26 cases in parotid gland, 8 cases in submandibular, 1 case in sublingual gland and 1 case in pars palatalis) and perfusion parameters, including: blood flow(BF), blood volume(BV), mean transit time(MTT), permeability surface(PS). Pathological diagnosis was performed on all salivary gland tumors. Results: 13 cases of 36 patients eventually were diagnosed as malignant salivary gland tumors. The sensitivity, specificity and accordance rate for malignancy of fine needle aspiration cytology were 84.6%(11/13), 95.7%(22/23) and 91.7%(33/36), respectively. The values of BF, BV and PS of the malignant tumors were higher than those of benign tumors significantly(P<0.05). However, the MTT values showed no significant difference between benign and malignant tumors(P>0.05).The sensitivity, specificity, and accordance rate for malignancy of CT perfusion were 92.3%(12/13), 86.9%(20/23) and 88.9%(32/36), respectively. The negative cases of fine needle aspiration cytology can be correctly identified as malignant by CT perfusion imaging. Conclusion: CT perfusion imaging can provide salivary gland tumors with information of microcirculation perfusion. It contributes to the identification of benign and malignant tumors. Paralled with fine needle aspiration cytology can greatly improve the accuracy of salivary gland tumors.

Objective We observed the effect of dexamethasone ointment on preventing phlebitis induced by vinorelbine. Methods Patients with malignant tumor who received chemotherapy of vinorelbine through peripheral superficial vein injection were divided into the observation group (70 cases) and the control group (72 cases) according to the date of hospitalization. All patients received vinorelbine four times averagely. Patients in the observation group was given dexamethasone ointment along punctured superficial vein. Patients in the control group received routine nursing measure. The incidence rate, time and degree of phlebitis was compared between these groups. Results The incidence rate and degree of phlebitis was lower than those of the control group (P< 0.01, P< 0.05). The incidence time of phlebitis in the observation group was also later than that of the control group (P<0.05). Conclusion Local application of dexamethasone ointment could effectively reduce the incidence of superficial phlebitis caused by vinorelbine chemotherapy.

Objective To study the influence of various doses and injection rates of contrast agent on CT perfusion in rabbits' liver with a deconvolution mathematical model. Methods Eight rabbits were enrolled in the experiment. Randomized block design was adopted. The treatment factor (contrast medium injection rate) was classified into 0.5, 1.0, 1.5 ml/s, while the subjects were divided into 3 blocks with contrast medium injection dose of 0.5, 1.0 and 1.5 ml/kg. The data obtained at CT perfusion imaging were then transferred to the workstation. Absolute values of 7 perfusion parameters (hepatic arterior fraction, blood flow, blood volume, permeability surface, mean transmit time, hepatic artery perfusion and portal vein perfusion) were measured with perfusion software (Perfusion 3). Results The dose of contrast medium had significant effect on peak enhancement of the aorta, the portal vein and liver tissue (P<0.05), whereas the injection rates had significant influence on the arrival time to peak enhancement of the aorta and the portal vein. However, the dose of contrast medium and injection rates had no significant effect on perfusion parameters (P>0.05). Conclusion CT perfusion imaging with a deconvolution mathematical model can quantify the hemodynamic functional status in liver with stable results. This technique does not need strict confinement to dose and injection rate of contrast medium, and has great potential value to be put into clinical use.

Objective:To provide scentific evidence for determining the harvest period of Cortex Abizziae by studying the dynamic variation of the content of lignan glycoside I in Cortex Abizziae.Methods:Chromatography was performed on a Boston Green ODS C18 (250 mm×4.6 mm,5 μm) column,the mobile phase was acetonitrile-0.04% phosphate (18∶82),the flow rate was 1.0 ml·min-1,the detection wavelength was 204 nm,and the column temperature was at 25℃.Results:There were differences in the contents of lignan glycoside I in Cortex Abizziae at different harvest periods.The content of lignan glycoside I reached the highest level in January,decreased quickly from January to March,and gradually increased from April to December.Conclusion:The content of lignan glycoside I in Cortex Abizziae at different harvest periods is different,and the optimum harvest time of Cortex Abizziae is determined from November to January of the following year.