Objective To discuss the diagnostic value of monochromatic energy image spectral CT in active small bowel bleeding and to screen the optimal energy level that indicates active bleeding of the gastrointestinal tract.Methods The bleeding model was established using the small intestines of pigs in vitro.Seven blood flow rates were simulated:0.500,0.400,0.300,0.200,0.100,0.050,0.025 ml/min,respectively.For each rate,a GE Discovery HD750 CT scanner was used in GSI scan mode and 64 slice CT was performed,with a delay of 15 s and 40 s simulated the arterial phase and portal venous phase,respectively.Each out of the blood flow rate in the 2 modes was respectively scanned 5 times.The GSI reconstruction platform was employed to obtain 7 monochromatic energy images(40,50,60,70,80,90,100 keV).A set of polychromatic energy images was obtained from an ordinary scan.The detection rates of the contrast agent exudation regions using the two scanning methods were compared.The contrast to noise ratios(CNR) for the contrast agent exudation regions were measured.Randomized block analysis of Variance was performed to compare the differences in CNR between energy levels.The x2 test was used to compare the detection rates obtained from the 2 scanning methods.Results The detection rates for energy spectral CT and 64 slice CT in the arterial phase were 31/35 and 23/35,respectively; there was significant difference(x2=5.185,P=0.023).The total detection rates of portal venous phase were 35/35 and 32/35,respectively,there was no significant difference(x2=l.393,P=0.238).On the ordinary scan mode,the detection rates of arterial and portal venous phase difference was statistically significant(x2 =6.873,P =0.009);but on the GSI scan mode,there was no significant difference(x2=2.386,P=0.122). The CNR values at 8 group energy levels for arterial phase and portal venous phase were statistically different(respectively P＜ 0.05),the CNR value of the contrast agent exudation regions at 50 keV and 60 keV monochromatic energy images on the GSI scan mode higher than that of polychromatic energy images,the difference was statistically significant(respectively P＜0.05),the CNR in portal venous phase images were higher than that of arterial at all energy groups,differences were statistically significant(t=-3.996 to-2.380,respectively P＜ 0.05).Conclusions Monochromatic energy image spectral CT demonstrates superiority over polychromatic energy images in detecting active bleeding of the gastrointestinal tract.The optimal monochromatic energy value for detection was between 50 keV and 60 keV,and the detection was easier in the portal venous phase than in the arterial phase.

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.

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.

Objective To observe the effect of different energy levels of pulsed Nd∶YAG laser irradiation on the changes of NO and NOS levels in ulcer tissue of oral ulcer model.Methods Forty-eight Sprague-Dawley rats were inflicted with oral ulcer,and then randomly and equally assigned to 6 groups,that is,oral ulcer group,1% iodine glycerin group and the rest 4 groups receiving pulsed Nd∶YAG laser irradiation at 1.5 W 40 mJ,1.5 W 60 mJ,1.5 W 80 mJ or 1.5 W 100 mJ(once per day,for 3 consecutive days).The other 8 rats served as normal control.In 24 h after last treatment,4 rats from each group were sacrificed and their cheek pouches were taken out for NO and NOS levels in the mucosal tissue by spectrophotomentry.Ulcer healing were observed 24 h after the last treatment for 8 consecutive days.The efficiency of Nd∶YAG laser irradiation at different powers were evaluated.Results Irradiation groups had significantly shorter healing time compared with iodine glycerin group.Level of NO and NOS activity in 1.5 W 60 mJ and 1.5 W 80 mJ groups was evidently lower than the ulcer group(P

OBJECTIVE: To study the curative effect and prognosis of salvage surgery performed for recurrent laryngocarcinoma. METHOD: The clinical data of 43 patients with salvage surgery for recurrent laryngocarcinoma hospitalized in Nanfang Hospital between 2003 and 2011 were analyzed retrospectively. Survival analysis was performed by using Kaplan-Meier method and prognosis factors were analyzed by Log-rank test. RESULT: After salvage surgery, 10 (23.3%) patients developed postoperative complications. Pharyngocutaneous fistula and infection occurred in 8 (18.6%) patients. Kaplan-Meier analysis showed that patients survived for 3-year (n = 32) and 5-year 25) after salvage surgery were 56.3% and 32.0% respectively. Univariate analysis indicated that clinical stage in the first diagnosis was significantly correlated with 3 year overall survival (P < 10.05). Local recurrence of laryngeal cavity group and preservation of laryngeal function group had a good prognosis respectively, but no sig nificant difference between them. CONCLUSION Salvage surgery is a good choice for recurrent laryngeal carcinoma. Outcomes of these patients were correlated with clinical stages. Laryngeal function preserving surgery for local recurrent laryngeal carcinoma can achieve a expected curative effect and prognosis.
Adult ; Aged ; Aged, 80 and over ; Female ; Follow-Up Studies ; Humans ; Laryngeal Neoplasms ; surgery ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; surgery ; Prognosis ; Retrospective Studies ; Salvage Therapy ; Treatment Outcome

OBJECTIVETo investigate the application of intense pulsed light (IPL) depilation in the auricular reconstruction with totally expanded skin and its suitable parameter.

METHODSFrom February 2009 to September 2013, one tissue expander(100 or 150 milliliters) were implanted under the skin of mastoid in 126 patients who suffered from microtia. During the skin expanding, the hair on the expanded skin was depilated by JPL technique. The parameter, operation, interval, the depilation result and the complication were recorded. The autologous rib cartilage frameworks were implanted in the second phase of auricular reconstruction.

RESULTSThe energy of IPL was 20 - 35 J/cm2 (mean 25. 3 J/cm2), the width of pulse was 26 - 30 ms ( mean 27. 9 ms), the interval between two operations was 4 weeks. Ninety-six patients were cured(76. 2%, 96/126). The total depilation efficient is 96. 8% (122/126). A fine banding blisters was found in one patient whose depilation areas was marked by black pen. Skin erythema was found in five patients and skin pigmentation was found in 7 patients. There were no skin necrosis and expander exposure in all patients. During 6 - 12 months of follow-up period, ninety-two patients were cured (73.0%, 92/126) and the total depilation efficient is 92. 9% (117/126).

CONCLUSIONSIPL depilation during the skin expanding is feasible and safe with careful procedure. The hairless expanded skin is enough to cover the framework, as well as the post-auricular area. The appearance of reconstructed ear is better without hair.

Congenital Microtia ; surgery ; Costal Cartilage ; transplantation ; Ear, External ; Erythema ; etiology ; Hair Removal ; methods ; Humans ; Mastoid ; Phototherapy ; adverse effects ; methods ; Reconstructive Surgical Procedures ; Skin Pigmentation ; Surgical Flaps ; Tissue Expansion ; Tissue Expansion Devices

Objective To explore the effects of passive smoking on vascular endothelial function in office women.Methods Totally,94 healthy office women volunteers from urban(36 women)and townships or towns(58 women)were divided into three groups based on the extent of their daily exposure to passive smoking,group A exposed to one to eight cigarettes,group B exposed to nine to 15 cigarettes,and group C exposed to more than 15 cigarettes,respectively,with 20 healthy young women without exposure to passive smoking as controls.Internal diameter of the brachial artery Was measured by color Doppler ultrasound scanning for each of the participants and its changes were observed before and after congestive reaction of the brachial artery test and nitroglycerin test.Results Thirteen of 36 office women from urban and 38 of 58 from townships or towns exposed to passive smoking of more than eight cigarettes daily,with chi-square of 7.74,P=0.0054.The brachial artery in groups A,B and C dilated less than that in the controls did.The brachial artery in group C dilated less than that in the groups A and B did.Conclusion Passive smoking could damage vascular endothelial dilatation function in office women.

Objective:To explore the diagnostic value of serum cytokines and autoantibodies in children with central diabetes insipidus.Methods:A retrospective study was used.A total of 52 children diagnosed with central diabetes insipidus who were hospitalized in Qingdao municipal hospital affiliated to Qingdao Universityfrom January 2016 to January 2020 were selected as the study group, and 60 healthy children with similar gender and age were selected as the control group.The general data of the study group and the control group, 24 h urine volume, urine specific gravity and urine osmotic pressure before the start of water deprivation test, the results of pituitary magnetic resonance imaging (MRI), and the concentration of serum cytokines and autoimmune antibodies were compared to evaluate the value of serum cytokines and autoimmune antibodies in the prediction of central diabetes insipidus.Results:The 24 h urine volume in the study group (201.6 ± 9.9 mL/kg)was significantly higher than that in the control group(9.06±12.5 mL/kg). The urine specific gravity(1.006±0.002) and urine osmotic pressure((116.4±23.5) mOsm/L)were significantly lower than those in the control group((1.013±0.004) and (649.6±72.4) mOsm/L)( t=15.378, 13.298, 45.625, all P<0.001). MRI examination showed that the proportion of disappearance of high signal in posterior pituitary (46.1%(24/52)), the proportion of thickening of the pituitary stalk(32.7%(17/52))and abnormal signal in pituitary(7.7%(4/52)) in study group were significantly higher than the control group(0%(0/0)) (all P<0.05); the levels of serum IL-6, TNF-α, IFN-γ, IL-1β ((117.0±7.8), (234±21.4), (178.6±15.1), (87±6.5) ng/L)and autoimmune antibodies ((654.1±194.3) ng/L) in study group were significantly increased compared to the control((12.5±2.3), (32.5±9.7), (37.8±7.3), (22.6±4.7), (98.0±23.7) ng/L) ( t value were 17.031, 27.490, 15.670, 12.360 and 109.984, respectively; all P<0.05). Conclusion:The concentration of serum cytokines and autoimmune antibodies has a significant clinical value in the evaluation of central diabetes insipidus in children.Combined with head MRI examination, it has a certain value in the diagnosis, treatment and prognosis of central diabetes insipidus in children.

Objective To evaluate the value of multi-slice CT enterography(MSCTE),capsule endoscopy(CE) and contrast-enhanced ultrasound(CEUS) findings score in the assessment of Crohn disease activity,prospectively.Methods One hundred and eight patients were diagnosed with CD by endoscopy combined with clinical or pathological results,and all of the patients' Crohn disease activity index(CDAI) were greater than or equal to 150.MSCTE were performed in all the patients.At the same time,48 and 60 patients of them were voluntary to accept CEUS and CE examination,respectively.The imaging score of the three different techniques was calculated.Patients' CDAI were calculated combined with the C-reactive protein(CRP) content and clinical feature.To analyze the correlation among the imaging score patients' CDAI,and CRP content,respectively using the Pearson method.Results The mean score of MSCTE,CEUS and CE were(7.6±2.7),(11.5 ±4.3) and(12.8±8.2),respectively.The patients' mean CDAI and CRP content were(296.1±93.5) and(23.7±5.2) mg/L,respectively.It was high correlation between MSCTE score and CDAI (r=0.916,P＜0.01),but it was moderate between CEUS(r=0.752,P＜0.01),CE(r=0.707,P＜0.01) score and CDAI.There was no evident correlation between MSCTE(r=0.167,P＞0.05),CEUS(r=0.200,P＞0.05) score and CRP content excepting the CE result(r=0.467,P＜0.01).Conclusions There was a good correlation between the MSCTE score and CDAI.We could use MSCTE findings score to assess the activity of CD patients prospectively.

Objective To study the effect of infrasound on expression of calmodulin-dependent protein kinase II (CaMKII) and tau pro-tein in hippocampus of rats. Methods Fifty-six male Sprague-Dawley rats were randomized into control group (n=8), 1-day group (n=8), 7-day group (n=8) and 14-day group (n=32), and the 14-day group was subgrouped as 1-hour, 6-hour, 24-hour, 48-hour subgroups, naming after the time after infrasound exposure, 8 in each subgroup. All the test groups were put in an infrasound field with 8 Hz, 130 dB for 2 hours daily, while the control group was put in the infrasound instrument without infrasound exposure for 2 hours daily. The expression of pT286-CaMKII and tau protein in hippocampus was detected with immunohistochemisty, Western blotting and enzyme-linked immunoabsor-bent assay. Results The expression of pT286-CaMKII was the most in 14-day group (F>14.912, P<0.001), as well as the expression of tau pro-tein (F>36.229, P<0.001), and secondary in 7-day group (P<0.05). For 14-day group, the expression of tau protein was the most in 1-hour and 6-hour subgroups, and dropped down in 24-hour subgroup, although more than that in the control group (P<0.05). Conclusion Exposure of 8 Hz, 130 dB infrasound may induce phosphorylation of CaMKII and tau protein, and the expression of tau protein in hippocampal cells in rat, which may disturb their learning and memory function.