Objective To investigate the diagnostic feasibility of acute tubular necrosis(ATN) in renal allograft using time intensity curves by intravenous contrast ultrasound.Methods The canine models of acute tubular necrosis in renal allograft were established,and examined subsequently with intravenous contrast ultrasound using auto control,and also the parameters of time intensity curves were analyzed,tracking the renal biopsies simultaniously.Results After ATN occured, the curve peak was ante displaced.And parameters of TIC (except peak intensity,PI),area under the curve(AUC),half time of descent(HT),mean transit time(MTT),the ratio of AUC were decreased dramatically.Conclusions Contrast ultrasound combined with TIC quantitative analysis could reflect the variation of blood perfusion objectively,and it is a potential new method for diagnosis of ATN in renal allograft.

Objective To evaluate the value of retrospective ECG-gated 256 slices spiral CT technique in the scanning of inferior phrenic artery (IPA).Methods 80 patients with underdone abdominal CTA were divided randomly into two groups (40 patients each)as regular abdominal CTA scanning group and retrospective ECG-gated technique group.And further analysis was done to evaluate the display of IPA branches and the image quality.Results 80 patients were all scanned successfully.40 cases LIPA and 40 cases RIPA were showed in the regular group.80 cases showed 1st level branches of IPA,73 cases with 2nd level,59 cases with 3rd and 43 ca-ses showing 4th level.40 cases LIPA and 40 cases RIPA were showed in ECG-gated group.And the numbers of IPA branches levels were 80,79,71,65,respectively.There is no significant difference in the ability of showing the1st level IPA or their image quality between those two groups (P >0.05);and there is a statistical significance in the ability of showing other levels of IPA and their im-age quality.Conclusion It is feasible that we use retrospective ECG-gated 256 slices spiral CT scanning technique to show the IPA. And it could improve the ability of showing the IPA branches as well as the image quality.

Objective To study the value of 256-slice spiral CT (MSCT) in internal thoracic artery. Methods The angiographic images of 107 patients who were suspected thoracic and abdominal aortic diseases were retrospectively ana-lyzed. The running rule and branches of internal thoracic artery on both sides were observed. Each side of the internal thorac-ic artery was divided into 3 sections according to the running rule. The lumen diameter, vessel length and its branches were measured in three segmental vascular of the internal thoracic artery. The lumen diameter of the diaphragmatic artery diame-ter,and the distance between internal thoracic artery and each border of the sternum were also measured. Results Both sides of the internal thoracic and diaphragmatic arteries were shown in 107 patients (100%). There were significant differenc-es in vascular lumen diameter of intrathoracic artery of both sides (P＜0.05). There were no significant differences between both sides of the corresponding segments (P>0.05). The left internal thoracic artery was significantly longer in the left side than that of right side (P＜0.05). There were no significant differences between the diameter of diaphragmatic arteries and the distance between the internal thoracic artery and the sternal edge of two sides (P>0.05). Conclusion The application of 256-slice spiral CT angiography can clearly show the running rule and anatomical features of internal thoracic artery ,and provide a relatively important clinical information.

Objective To summarize the experience of diagnosis and treatment of occult spontaneous pneumothorax in young adults.Methods To review and summarize the imaging data and treatment process of 22 cases of occult spontaneous pneumothorax.Results Surgical treatment was performed in 22 patients.Among them,VATS operation in 18 cases,VATMoperation in 4 cases.Operation difficulty was severe adhesion free existed in the apex of lung and pleural top.22 patients with the successful completion of the operation,no major bleeding during the operation,no open chest surgery.1 -3 years follow -up without recurrence.Conclusion Surgical treatment is the first choice for occult spontaneous pneumothorax in young adults.Often due to severe adhesion of the chest,surgery is difficult,the surgeon should be fully prepared before surgery.Patients with good prognosis,due to the difficulty of early diagnosis,clinicians should pay attention to.

Objective To evaluate the application value of 256 slice spiral CT angiography (CTA)in the bridge vessels lesions af-ter grafts operation in lower extremity arteriosclerosis obliterans patients.Methods Taken DSA as the gold standard,using 256 slices spiral CTA to analysis the post-processing image of 76 article Bridge vascular which can be assessed in 65 cases patients with lower extremity arteriosclerosis obliterans,and to evaluated the diagnosis accuracy,sensitivity,specificity,positive predictive rate and negative predictive rate of postoperative bridge intravascular lesions.Results Using 256 slices spiral CTA,the bridge vascular of grafts operation patients can be clearly displayed,stenosis or unobstructed,and the anastomosis of the bridge vascular.5 graft occlu-sion,22bridge intravascular plaque were diagnosed correctly,3 vascular lesions were undiscovered.The accuracy,sensitivity,speci-ficity,positive predictive rate and negative predictive rate were 98.15%,96.15%,97.90%,92.59% and 97.96% respectively. Conclusion Using 256 slices spiral CTA can clearly show the endovascular lesions of lower extremity arteriosclerosis obliterans after grafts operation,and has high accuracy and specificity.It can be safely used as one of noninvasive follow-up means after grafts oper-ation.

Objective To evaluation the anatomy relationship between thoracic artery and coronary artery by using 256 layer spiral CT angiography. Methods The angiographic images of thoracic aortic and coronary artery angiography were re?vealed in 200 patients with chest pain. Values of the major branch length, diameter, length of the aorta-coronary artery by?pass on both sides of the thoracic artery and coronary artery were measured. Results The diameter of thoracic artery was (2.52±0.38) mm, and the length of thoracic artery from the starting point to terminal was (190.12 ±1.90) mm. There were no significant differences in the thoracic artery lumen diameter and length between both sides. The inner diameters of left anteri?or descending coronary artery, left circumflex, diagonal branch, right coronary artery and the posterior interventricular branch were (2.82 ±0.25), (2.60±0.12), (2.22±0.25), (3.02±0.27) and (2.35±0.35) mm respectively. There were no significant differences in thoracic artery diameters except for the right coronary artery diameter, which was higher than that of the thorac?ic artery. About free transplantation the length from 2cm above in the ascending aorta starting to the halfway point of anterior descending coronary artery, to the atrioventricular node along the left circumflex way, to the atrioventricular node along the right coronary artery and from the atrioventricular node to halfway point of posterior interventricular branch was shorter than that of thoracic artery (P<0.05). About situ transplantation in addition to the length from the thoracic artery start department to the point of anterior descending compared with the thoracic artery length, there were no statistical significance ( P>0.05). The length from the thoracic artery start department to the left-hand atrioventricular node, to the right coronary artery atrio?ventricular node was higher than that of the thoracic artery length (P<0.05). Conclusion The branches of internal thoracic artery and coronary artery are similar. About situ transplantation is suitable for the wall blood vessels before the heart. With free thoracic artery transplantation, its length can meet any bridging from the ascending aorta to the coronary arteries.

Objective To evaluate the success rate, safety and efficacy of endoscopic retrograde cholangiopancreatography (ERCP) after Billroth Ⅱ gastrectomy. Methods Data of 75 patients with biliary disease after Billroth Ⅱ gastrectomy, who underwent ERCP from January 2007 to November 2009, were retrospectively analyzed. Results In 75 patients, afferent loop intubation was achieved in 69 (92%) and selective cannulation of bile duct were successful in 68 (68/69, 98. 5%). Diagnostic procedures were carried out in 3 patients, and therapeutic in 65 others, which included EST plus stone removal and ENBD in 16, ERBD in 19, EMBE in 18 and EBD plus stone removal and ENBD in 12. Afferent loop perforation occurred in 1 patient (1.3%) and was treated surgically, and 2 acute pancreatitis (2. 6%) were treated conservatively.There was no complication of bleeding. Conclusion ERCP after Billroth Ⅱ gastrectomy is safe and efficiency for biliary disease.

Objective To discuss the correlation between aortic elasticity and coronary artery calcification by CT.Methods Totally 111 patients who were diagnosed of coronary artery disease underwent coronary artery CTA.The images were qualified for aortic elasticity measurement.All patients were divided into calcification negative group (n=43) and calcification positive group (n =68).The calcification positive group was further divided into light,medium,and serious groups according to their calcification scores.The ascending aortic images were reconstructed every 5 ％ R-R intervals.The cross-sectional areas and diameters of aortic in each R-R interval were measured automatically,then diameter variation rate (％ A0),aortic distensibility (A0D),aortic compliance (A0C) and aortic stiffness (A0SI) were calculated to evaluate aortic elasticity.Correlation between aortic elasticity and coronary artery calcification were analyzed.Results ％ A0,A0 D,A0C were lower and A0SI was higher in calcification positive group than those in calcification negative group (all P＜0.05).There was no significant differences in the four reference indexes of aortic elasticity among light,medium,and serious groups in calcification positive group (all P＞0.05).Correlation analysis demonstrated negative correlations between ％ A0,A0 D,A0 C and calcification scores,and a positive correlation between A0SI and calcification scores.Conclusion Aortic elasticity is correlated with coronary artery calcification,and the combination of them will be beneficial for the early diagnosis of coronary heart disease.

OBJECTIVE:To investigate the effects of dexmedetomidine pretreatment on hepatic ischemia-reperfusion injury in patients with hepatocellular carcinoma radical surgery (HCRS).METHODS:A total of 40 patients underwent elective HCRS were randomly divided into control group (20 cases) and observation group (20 cases).Before operation,observation group was given Dexmedetomidine hydrochloride injection with loading dose of 0.7 μg/kg within 10 min,maintained at 0.4 μg/(kg.h) until the end of surgery.Control group was given constant volume of 0.9％ Sodium chloride injection as observation group and same anesthetic scheme.The levels ofALT,AST,IL-1,IL-6,CRP and TNF-α,the occurrence of ADR were observed in 2 groups before surgery,4 h,24 h,72 h after surgery.RESULTS:Before surgery,there was no statistical significance in the levels ofAST,ALT,IL-1,IL-6,CRP and TNF-α between 2 groups at different time points (P＞0.05).After surgery,the levels of AST and ALT in 2 groups were significantly higher than before surgery,and the observation group was significantly lower than the control group,with statisti-cal significance (P＜0.05).The levels of AST and ALT in 2 groups were decreasing gradually as time.4,24,72 h after surgery,the levels of IL-1 and IL-6 in 2 groups,TNF-α levels 4,24 h after surgery and CRP levels 24,72 h after surgery were significantly higher than before surgery,and the observation group was significantly lower than the control group;the levels of TNF-α in 2 groups 72 h after surgery were significantly lower than before surgery,with statistical significance (P＜0.05).The levels of IL-1,IL-6 and TNF-α were decreasing gradually as time.There was no statistical significance in the incidence of ADR between 2 groups (P＞0.05).CONCLUSIONS:Dexmedeptomidine pretreatment can relieve hepatic ischemia-reperfusion injury in HCRS patients,reduce the level of inflammatory cells without increasing the occurrence of ADR.

Background Climate change leads to frequent heavy rainfall events, and higher incidences of bacillary dysentery after heavy rainfall have been observed. The impacts of heavy rainfall and its antecedent rainfall conditions on the disease are worth paying attention to. Objective To quantitatively analyze how the relationship between heavy rainfall events and bacillary dysentery occurrence is modified by antecedent rainfall conditions in Anhui Province and explore the different moderation effects in urban and rural contexts. Methods CN05.1 meteorological data of Anhui Province and cases of bacillary dysentery of the same area were collected from January 1, 2006 to August 31, 2017. An exposure-response Poisson regression model of heavy rainfall events and the number of daily cases was constructed to explore the moderation effect of antecedent rainfall conditions on the incidence of bacillary dysentery, and further stratified by urban and rural areas. Results This study included 129 459 cases of bacillary dysentery, with a daily average of 30.39. Compared with dry antecedent conditions without heavy rainfall, dry antecedent conditions with heavy rainfall had no obvious different effect on the incidence of bacillary dysentery for the whole province (P>0.05). But wet antecedent conditions significantly increased the risk of bacillary dysentery for the whole province after heavy rainfall (wet antecedent conditions without heavy rainfall: RR=1.281, 95%CI: 1.264-1.298; wet antecedent conditions with heavy rainfall: RR=1.267, 95%CI: 1.167-1.376). After urban and rural stratification, antecedent rainfall conditions also showed a significant moderation effect on the incidence of bacillary dysentery following heavy rainfall events. Compared with dry antecedent conditions without heavy rainfall, dry antecedent conditions with heavy rainfall had no obvious effect on the incidence of bacillary dysentery for the urban and the rural populations (P > 0.05). However, wet antecedent conditions without heavy rainfall (urban: RR=1.391, 95%CI: 1.362-1.421; rural: RR=1.222, 95%CI: 1.201-1.243) and wet antecedent conditions with heavy rainfall (urban: RR=1.364, 95%CI: 1.193-1.559; rural: RR=1.218, 95%CI: 1.098-1.352) significantly increased the risk of bacillary dysentery in both rural and urban areas. Conclusion In the influence of heavy rainfall on the incidence of bacillary dysentery in Anhui Province, antecedent rainfall conditions have a certain moderation effect in the whole province and in both urban and rural areas, and the risk of bacillary dysentery is increased under wet antecedent conditions.