Objective To detect the value of dynamic spiral CT on the prostatic cancer and benign prostate hyperplasia(BPH).Methods Plain and dynamic spiral CT scans were obtained in 88 male patients with various ages due to prostate or other pelvis diseases.Out of these detailed data in 5 cases of prostate cancer and 11 cases of BPH which were confirmed by operation and pathology were available.Contrast enhancement pattern and degree were correlated with the pathological and operational findings.Results Prostate was enlarged in all cases except one prostate cancer and 3 cases of BPH within normal limits in size.The contour of the prostate was irregular in all cancer cases and one BPH.On dynamic CT scans,prostatic malignant lesions appeared iso-hypodensity with the rest of the prostate gland at the arterial stage and low density at the veinous stage.Diffuse heterogeneous central enhancement was found in 10 cases of BPH at the arterial stage,especially in the lateral lobes and further enhancement was found in 10 cases of BPH at the arterial stage,especially in the lateral lobes and further enhancement was found at the middle stage.There was little enhancement in the peripheral part at the arterial and veinous stages in BPH.The ratio of the central and the peripheral decreased.One case of BPH within normal size had spotty enhancement in the central part.On delayed CT scans 8 cases of BPH showed homogeneous enhancement in the total prostate gland.Conclusion Prostate cancer and BPH have their own characteristic enhancement patterns and degress,therefore dynamic spiral CT scan could help make differentiation between the two disease.

Objective:This study aimed to observe the clinical efficacy of implanting radioactive 125I seeds to treat non-small cell lung cancer (NSCLC) on the basis of the recent changes in serum tumor markers (including CEA, CA125, SCC-Ag, and CYFRA21-1). Methods:We selected 72 patients who were pathologically confirmed with NSCLC and received CT-guided percutaneous implantation of radioactive 125I seeds from January 2009 to June 2012. The concentration of the serum tumor markers was detected 3 d before implan-tation and 1, 2, 3, and 6 months after implantation. Result:All of the operations were successfully completed. One month after implan-tation, a significant change was observed in the concentration of serum tumor markers (CEA, CA125, SCC-Ag, and CYFRA21-1) com-pared with their preoperative levels (P<0.01). No significant difference was observed between the different time points after implanta-tion. Conclusion:The treatment of NSCLC by implanting radioactive 125I seeds can effectively reduce the level of tumor markers. A sig-nificant difference was observed in the level of tumor markers between patients with different efficacy classifications.

Objective To assess the value of CTA and DSA in neurovascular diseases.Methods 20 cases with suspected neurovascular disorders who received CTA and DSA examination between March 1999 and August 2000 were retrospectively collected.The sensitivity,specifility and accurate rate of CTA were analysed compared with DSA as gold standard.Results In 20 cases,neurovascular disorders were found in 17 on CTA.18 lesions were detected,including 6 aneurysms,9 arteriovenous malformations(AVM),2 carotid cavernous fistulae(CCFs)and 1 arterial stenosis.By contrast,19 lesions in 17 cases were detected by DSA,including 7 aneurysms,8 AVMs,2 arterial stenoses and 2 CCFs.The sensitivity,specificity and accuracy of CTA in the detection of neurovascular disorders were 90.6%,95.2% and 90.6% respectively.Conclusion 3D-CTA is a new modality with high sensitivity and specificity in the detection of neurovascular disorders.As it can be obtained simply,conveniently and safely with mild injury to the patient,CTA can be used in the diagnosis of neurovascular diseases,especially in the AVMs.

AIM:To explore the effect of the pretreatment of hypertonic saline(HTS) in hepatic ischemia reperfusion(I/R) injury.METHODS:The rats were divided into sham group(sham group),ischemia reperfusion group(IR group) and pretreatment of hypertonic saline group(HTS group).Partial hepatic ischemia reperfusion model was used.The rats were sacrificed at the time of 1 h,3 h,6 h,12 h and 24 h after reperfusion in each group,respectively.Blood samples were obtained to examine ALT.The expression of the CD11b/CD18(Mac-1) on the neutrophils was analyzed by flow cytometry.RT-PCR and Western blotting were used to examine the expression of intercellular adhesion molecule-1(ICAM-1) in livers and chromatometry was performed to detect the activity of myeloperoxidase(MPO) in livers.The morphology of hepatocytes and the structure of sinusoid were observed by histological examinations.RESULTS:① HTS pretreatment decreased the level of ALT at the time points of 3 h,6 h and 12 h after reperfusion(P

Objective To synthesize a novel vector of chitosan-particles loaded with gadolinium (Gd-CPs) and observe the adhesion and absorption of the particles in the colon wall of mice with MR imaging in-vivo.Methods Chitosan particles (CPs) with and without gadolinium loaded were synthesized with the emulsion-droplet coalescence method.Sixteen mice were randomly classified into two groups.The suspension with Gd-CPs or with CPs was infused into the rectum of the 8 mice of each group,respectively.MR scans were performed before,during and 40 minutes after infusion for each mouse.Samples of the colon correlated to the enhanced area were obtained for electron microscopy examination.Signal intensity (SI) of ROIs in the wall of rectum or colon,muscles of the pelvis near the rectum and background were measured and corresponding relative SIs were calculated.Relative SI values between the two groups and pre- and post- infusion were compared with pared t test.Results Dimension of the Gd-CPs was about 500 nm,and content rate was about 30%. Values of relative SI of the rectum for pre- and post- infusion in the Gd-CPs group were 0.84±0.06 and 0.98±0.09(t=4.327,P＜0.01),respectively,while those in CPs group were 0.83±0.04 and 0.84±0.05(t=0.658.P＞0.05). The medial value of signal increase rate for CPs group was 19.0%.Gd-CPs particles were found inside the mucosal cells under the electron microscopy.Conclusion MR imaging in-vivo can reveal the phenomenon of adhesion and absorption of mucosa targeted chitosan particle carriers. Clinical MR imaging based on small animal coil is a good method to monitor colon mucosa targeted particle vectors in-vivo.

Objective To observe the pulmonary protective effect of large and small doses of mucosolvan in elderly patients with lung cancer undergoing radioactive seed implantation.Methods 93 patients with non-small cell lung cancer undergoing radioactive seed implantation guided by CT were selected and randomly divided into 3 groups:the high-dose group,the low-dose group and control group (n-31,each).All patients received the mucosolvan treatment with routine immunization and nutrition support after implantation.Patients was given mucosolvan 990 mg/d and 300 mg/d by continuous intravenous pumping in high-dose and small-dose groups respectively.Patients in the control group was given saline.The incidence of pneumothorax and plasma levels of C reactive protein (CRP),tumor necrosis factor alpha (TNF alpha),neutrophils (ANC) were compared between the three groups at 1 d,3 d and 5 d after implantation.Results There was no statistically significant difference in plasm levels of CRP,TNF alpha and ANC between the three groups at 1 d and 3 d after implantation (all P＞0.05).Plasma levels of CRP,TNF alpha and ANC were lower in highdose group than in low-dose group and control group at 5 d after implantation (F=3.596,3.555,3.406,respectively,all P＜0.05).The incidence of pneumothorax was lower in high dose group than in control group (x2 =4.31,P ＜ 0.05).Conclusions Perioperative application of high-dose mucosolvan can relieve lung inflammatory reaction rapidly and reduce the incidence of pneumothorax in elderly lung cancer patients undergoing radioactive seed implantation.

Objective To explore the cause,treatment and prognosis of delayed massive haemorrhage (DMH) after pancreatic resection.Method Clinical data of 1554 patients undergoing pancreatectomy in our hospital from Aug 2003 to Aug 2013 were retrospectively analyzed.Results 16 patients suffered from DMH,including 13 patients who had undergone pancreaticoduodenectomy,and 3 patients who had had resection of pancreatic body and tail.Gastrointestinal haemorrhage occurred in 6 patients,intra-abdominal haemorrhage occurred in 10 patients,respectively.Reoperations were performed in 11 patients,transcatheter arterial embolization (TAE) undertaken in 2 patients,and endoscopic treatment in 3 patients.10 patients recovered after treatment,6 patients (6/16) died.Conclusions The mortality of DMH after pancreatic surgery is high.Postoperative pancreatic leak and gastrointestinal stress ulcer are the most possible risk factors,intra-abdominal arterial haemorrhage is the main cause of death.

Objective To evaluate the effect of CT guided permanent 125I seeds implant brachytherapy on early non-small cell lung cancer (NSCLC) that is not suitable for operation.Methods 18 patients with early stage of NSCLC (stage Ⅰ and Ⅱ) were treated with CT guided permanent seeds 125I implantation from December 2002 to December 2006.The prescribed dose (PD)was 110 Gy,the median activity of 125I seed source was 0.7 mCi.The chest CT detection was performed at 1,2,6 months and 1 year after treatment.The tumor size and the clinical effect were compared before and after treatment.Results The minimum PD in target tumor was (107.7±5.3)Gy,D90 was (113±3.7) Gy,and D9o was more than mPD.The chest CT showed that complete relief (CR) was achieved in 7 patients (38.9％),partial relief (PR) was in 9 patients (50％),stable disease (SD) was in 2 patients (11.1％),no progress disease (PD) was found.The effective rate (CR rate + PR rate) was 92.9％ (16 cases),and local control rate was 88.9％ (16 cases) within one year.During the follow-up to December 2011,the 1,3 and 5 years cumulatively survival rate was 94.4 ％ (17 cases),72.2％ (13 cases),66.7％ (12 cases),56.8％ (10 cases) respectively.Median survival time was 58 months.Conclusions CT-guided permanent 125I seeds implant brachtherapy is effective in the treatment of early non-small cell lung cancer that is not suitable for operation.

Objective To evaluate the management of biliary complications (BC) following orthotopic liver transplantation (OLT). Methods From Feb 1999 to Feb 2004, 236 cases underwent OLT with end-to-end choledocho-choledochostomy. Biliary anastomosis was performed by intermittent suture with T tube placement in 96 cases, without T tube in 39 cases, by continuous suture in posterior wall and intermittent suture in anterior wall and without T tube in 101 cases. Results Thirty-two (13.3%) patients developed BC, with incidences in group 1, 2 and 3 of 17.7%, 15.4% and 7.9%, respectively. The incidence of hepatic hilar and/or intrahepatic bile duct strictures was 8.3%, 2.6% and 1.0%, respectively. BC incidence in group 3 significantly decreased. Twenty patients with biliary stricture underwent endoscopic and/or radiological interventions, and stricture resolution was achieved in 90% of patients with anastomotic strictures and 60% of patients with hepatic hilar and/or intrahepatic strictures. Conclusions Modified biliary tract reconstruction technique contributes to the decrease of BC. Endoscopic and/or radiological interventions should be used for non-ischemic anastomotic biliary strictures or simple hepatic hilar strictures.

Objective:To evaluate the curative effect of computed tomography (CT)-guided percutaneous implantation of 125I radioactive seeds on inoperable early-stage non-small cell lung cancer (NSCLC). Methods:From January 2003 to December 2012, we selected 48 patients who had pathologically confirmed early-stage NSCLC (stageⅠ, 18 cases;stageⅡ, 30 cases with N0). We treated the nidus by CT-guided percutaneous implantation of 125I radioactive seeds. Six months after implantation, the chest CT-scan was reviewed, and the effect of the treatment was evaluated according to the international standards. Final follow-up was performed in December 2013. Results:All operations were successfully completed. The target tumor matched peripheral doses (MPDs) were 215.8±14.3 Gy (D100), 106.8±11.6 Gy (D90), and 148.6± 17.3 Gy (D90>MPD). Six months after implantation, chest CT was reviewed, and treatment effects were evaluated. The percentages of stage I patients achieving complete relief (CR), partial relief (PR), stable disease (SD), and progressive disease (PD) were 27.8%(5 cases), 72.2%(13 cases), 0%, and 0%, respectively. Among stageⅡpatients, CR, PR, SD, and PD percentages were 0%(3 cases), 73.3%(22 cases), 13.3%(4 cases), and 3.3%(1 case), respectively. The effective rate was 89.6%. The 1-year local control rate was 85%. Until December 2013, the 1-, 2-, and 5-year cumulative survival rates up to the end of the interval were 95.8%(46/48), 81.3%(39/48), and 56.3%(27/48), respectively. Conclusion:CT-guided percutaneous implantation of 125I radioactive seeds is an effective micro-invasive method for treating inoperable early-stage NSCLC.