Objective: To observe the effects of neuromuscular blockade after combining atracurium (ATC) with veeuronium (VEC). Method: Fifty-four patients undergoing elective abdominal surgery(ASA grade Ⅰ-Ⅱ) were allocated randomly into 3 groups. After induction with intravenous midazolam-etomidate-fentanyl, neuromuscular blockade was measured with the train of four (TOF) to the ulnar nerve by monitoring the contraction of musculus adductor pollicis. The onset time and the peak effect were observed. According to the dose-effect relationships of the combination of ATC and VEC and that of either ATC or VEC given alone,the ED_(50) and ED_(95) were caeulated. The isogram and algebraic methods were used to analyse interaction between them. Result: The fraction ED_(50) values of ATC and VEC in combination were 52.26 and 11.71?g/kg respectively, The algebraic subtotal of combinations was 0.75

Objective To establish the determination method of Tubeimoside Ⅰ in Jiazhongxiao preparation and serum of rat. Methods RP-HPLC/UV method was used as follows:Diamonsil C18 column (250 mm?4.6 mm, 5 ?m) and Easyguard column, methanol-water (65∶35) as mobile phase with flow rate of 1.0 mL/min, UV detection at 214 nm. Results The mean recovery rates of Tubeimoside Ⅰ in preparation and serum of rat were (103.49?3.49)% and (104.70?4.69)% respectively. The linearity of Tubeimoside Ⅰ was shown in the range of 1.18～88.5 ?g/mL. Tubeimoside Ⅰ in preparation and serum of rat were 995.3 ?g/g and 3.19 ?g/mL. Conclusion The method was simple, reliable and rapid. It’s quite suitable to be used in the analysis of Tubeimoside Ⅰ in Jiazhongxiao preparation and serum of rat.

Objective To investigate the effectiveness and feasibility of cardiovascular computed tomography angiography(CTA) in 128-slice DSCT with low tube voltage and low dosage contrast media in children with tetralogy of Fallot (TOF). Methods Forty patients with TOF were randomly divided into group A and group B by random number table method, patients in group A received a conventional scan with 80 kVp and contrast media of 1.2 ml/kg, patients in group B, 70 kVp and contrast media of 1.0 ml/kg were used. The injection time of the two groups were both fixed for 12 s. CT attenuation, image noise and signal-to-noise ratio (SNR) of ascending aorta, the main pulmonary artery, left ventricle and right ventricle were quantified. Radiation dose and volume of the contrast medium were recorded. Subjective image quality was assessed by two radiologists in consensus. The Student's t test was performed to analyse the differences between the two groups regarding CT attenuation, image noise, SNR, radiation dose and volume of the contrast medium. The image quality scores between the two groups were compared by using the Mann-Whitney U test. Results No significant difference was found in the attenuation, noise, SNR between the two groups in the same evaluated anatomic regions and no significant difference was found in the image quality. Effective dose (ED) was(0.17±0.05),(0.13±0.04)mSv respectively, there was significant reduction in group B than that in group A (t=2.48, P=0.019). The consumed iodine amount was(10.00±1.84),(8.29± 1.45) ml respectively, there was significant reduction between the two groups (t=2.89, P=0.007). Conclusions In children with TOF, the cardiovascular CTA with diagnostic quality can be adequately acquired with low tube voltage (70 kVp) and low concentration contrast media (1.0 ml/kg), there is significant reduction in radiation dose and contrast medium amount.

Objective To evaluate the contrast-enhanced 64-slice spiral CT(64-SCT) features and pathologic findings of coloniccancer comparatively.Methods 56 cases of colonic cancer underwent 64-SCT dynamic enhancement scans.All cases were classifiedaccording to 64-SCT features of arterial phase and then analysed pre-operatively with pathological comparation.Results There werecharacteristic manifestations on arterial phase of contrast-enhanced CT scan in all cases,the tumors with well differentiation appeared as slight-medial homongeneous enhancement in 23 cases,while undifferentiation tumors appeared as obviously inhomogeneous enhancement or layer-like enhancement in 33 cases.The tumors were classified according to their features on contrast-enhanced CT,the accuracy rate was 91.07%,the accuracy rate evaluated pre-operation was 92.86%.Conclusion 64-SCT dynamic scan has distinctive superiority in diagnosis and treatment of the colonic tumor.

Objective To improve the applied value of Multi-slice CT (MSCT) in the diagnosis and treatment of the colonic tumours.Methods MSCT axial images reconstruction 4-D,MIP and CT virtual colonoscopy (CTVC) in 30 patients with colonic tumours proved histologically were analysed and compared these results with that of barium enema and colon endoscopy.Results The diagnostic correctly rate in this group was 100% by MSCT,while the diagnostic rate by CTVE and colon endoscopy was basicly identical.Conclusion MSCT is recommended for the diagnosis and treatment of the colonic tumour.

Objective To study the clin ic al application of 64-slices spiral CT in coronary artery. Methods Twenty-six patients were performed 64-slices spiral CT in coronary artery, 15 of the 26 patients underwent selective coronary artery angiography. Results The main branches and part of the sub-branches o f the coronary artery were clearly displayed. 38 coronary artery branches of 16 patients were found stenosis. In 15 cases with conventional angiography, all mai n branches and parts of sub-branches of coronary artery were displayed clearly. All patients demonstrated coronary artery stenosis. The diagnostic accuracy of 64-slices spiral CT was 94.12%. Conclusion As a minimall y invasive examination, 64-slices spiral CT is a valuable method to detect and diagnose the diseases of coronary artery.

Objective To explore the clinical application of dual-soure CT(DSCT) in coronary artery.Methods 51 patients suspected with coronary artery disease underwent both DSCT coronary arteriography and selective coronary angiography(CAG), the DSCTA results were compared with that of CAG.Results DSCT coronary arteriography in 51 patients at any heart rate was successful.Coronary artery branches and part sub-branches were clearly displayed by DSCT angiography.Stenosis or obstruction of 166 coronary artery branchs in 51 patients were showed ,of them,150 branches were confirmed by CAG. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of DSCTA were 100%, 90%, 90.4%, 100% and 94.8% respectively.Conclusion DSCT is a valuable method in detecting the diseases of coronary artery with lower dose. The accuracy of the DSCT is approximate to the CAG.

Objective To explore the optimal reconstruction windows in patients with heart rate (HR) over 91 (beats per minute) bpm, and to explore the feasibility of prospective ECG-gated DSCT coronary angiography.Methods Two hundred and thirty-two patients[body mass index (BMI):23-25 kg/m2, with stable HR, and average HR ≥91 bpm]with suspected or known coronary artery disease underwent retrospective ECG-gated DSCT coronary angiography.They were divided into 3 groups (A-C) according to the average HR of scanning.Images were reconstructed from 29% to 80% of the R-R interval in 3% increments.Two independent readers assessed the overall image quality by a five-point scale and determined the optimal reconstruction windows of each coronary segment and the ranges.Coronary arteries were segmented according to the guideline of the American Heart Association (AHA).The degree of interobserver agreement was determined by Kappa statistics.Results Three thousand three hundred and fortythree segments were considered to have diagnostic image quality in 232 patients.The ranges of optimal reconstruction windows of images were concentrated on 81%-61% and 51%-31%.In group A(91-95 bpm), there were 1183 segments in 83 patients, and the according proportions were 5.49%, 94.51%,respectively; In group B(96-100 bpm), there were 986 segments in 68 patients, and the according proportions were 0.20%, 99.80%, respectively; In group C(≥ 101 bpm), there were 1174 segments in 81 patients, and the according proportions were 0.17%, 99.83%, respectively.The optimal construction windows in 3274 segments out of 3343 segments in 232 patients were concentrated in 41%, ranged from 51%-31%.The image quality assessment in 3343 segments in 232 patients have a high inter-observe agreement (Kappa=0.883,P <0.05).Conclusion The optimal reconstruction windows of patients with stable HR(≥91 bpm) was concentrated in 41%, ranged from 51%-31%.When nothing except the window of data acquisition is considered, the prospective ECC,-gated DSCT coronary angingraphy can be used in patients with stable HR(≥91 bpm).

Objective To investigate the value of prospectively electrocardiogram (ECG)-triggered high-pitch coronary computed tomography angiography at 70 kV and 30 mL contrast medium with Stellar detector dual-source CT.Methods 60 patients with the BMI<24.9 kg/m2 were randomized into two groups:Group A (30 cases)with the tube voltage of 70 kV and 30 mL contrast medi-um.Group B (30 cases)with the tube voltage of 100 kV and 50 mL contrast medium.All the patients were performed with a Stellar detector dual-source CT using a prospectively ECG triggered high-pitch spiral technique.The images of Group A were reconstructed with SAFIRE technique,while Group B were with FBP technique.The objective image quality includes CT attenuation,SNR, CNR.And radiation dose was also calculated.The subjective was evaluated by 4-scale point.Independent sample t test was used.Re-sults There was no difference for subjective image quality between the groups,A:(3.38±0.942),B:(3.50±0.682),(t=-0.562, P >0.05).The CT attenuation of the 70 kV group were higher than that of the 100 kV group for all the segments(P <0.01).The SNR and the CNR have no statistically significant difference between the groups (P >0.05).Compared with the 100 kV group,the radiation dose of the 70 kV group was reduced by 76.5% (A:0.19±0.023 mSv,B:0.81±0.101 mSv,P <0.01).Conclusion Using 70 kV with 30 mL contrast medium in Stellar detector dual-source CT coronary angiography for the patients with a normal BMI could obtain qualified diagnostic image with low radiation dose and contrast medium.

Objective To compare the accuracy, image quality and radiation dose between prospective ECG?gated sequential and high?pitch acquisition on 128?slice dual?source CT (DSCT) angiography in infants and children with congenital heart disease (CHD). Methods Ninety?two children with CHD from October 2011 to February 2013 were prospectively enrolled and assigned into two groups according to random number table. Forty?six patients underwent DSCT angiography with sequential mode, and the other 46 patients were examined with high?pitch mode. With surgical and/or DSA results as the standard, the diagnostic accuracy and sensitivity of the two groups for the intracardiac structures, extracadiac and coronary artery anomalies were evaluated, and the comparison was analyzed by Fisher exact test. A 5?grade scoring system was used to interpret the image quality of intracardiac structures, great vessels and the proximal and middle segments of coronary arteries. Interobserver agreement on grades of image quality was assessed by Kappa statistics. The image quality scores were compared using the Mann?Whitney U test. The Student t test or the Mann?Whitney U test was used to analyze the differences between the two groups regarding to patients' age, weight , heat rate, CT attenuation, image noise and SNR in the ascending aorta and the pulmonary trunk as well as radiation dose. Results All 92 patients successfully underwent DSCT angiography. The diagnostic accuracies of intracardiac anomalies by high?pitch group and sequential group were 95.65%(88/92) and 99.28%(274/276), showed significant difference between the two groups (P<0.05), but no significant difference in the sensitivity of intracardiac anomalies (P>0.05) .There was no significant difference in the diagnostic accuracy and sensitivity of extracadiac anomalies between the two groups (P>0.05). The diagnostic accuracies of coronary artery anomalies by high?pitch group and sequential group were 93.48%(43/46) and 100.00%(46/46), showed no significant difference between the two groups (P>0.05), but there was significant difference in the sensitivity of coronary artery anomalies (50.00%(3/6) , 100.00% (11/11)) (P<0.05). There was excellent agreement for image quality scoring of the intracardiac structures, great vessels and the proximal and middle coronary arteries between the two observers (Kappa=0.81, 0.85, 0.85, P<0.05). The median image quality scores of extracardiac great vessels were both 5.00 in high?pitch group and sequential group, and there was no significant difference between the two groups (U=981.000, P>0.05). The median image quality scores of intracardiac structures and proximal and middle segments of coronary arteries respectively by high?pitch group were 4.00 and 3.00, and 5.00 and 4.00 respectively by sequential group. The image quality of intracardiac structures (U=594.500, P<0.05) and proximal and middle segments of coronary arteries (U=397.500, P<0.05) was significantly better in the sequential group than that in the high?pitch group. There was no significant difference between the two groups in CT attenuation, noise and SNR of the ascending aorta and pulmonary trunk. The mean effective doses of the high?pitch group and the sequential group were(0.27±0.11)and(0.39±0.17)mSv, and showed significant difference between the two groups (t=4.316, P<0.05). Conclusions Both sequential and high?pitch mode of 128?slice DSCT angiography provide high accuracy for the assessment of CHD in infants and children, while the high?pitch mode, though with some image quality declined, shows further significantly lower radiation dose.