ObjectiveTo explore an individualized abdominal scan protocol with a 64-slice CT scanner.MethodsFrom Sep.2010 to Nov.2010,one hundred consecutive patients,who underwent twice non-contrast-enhanced abdominal CT scans within 3 months,were enrolled in this study.For each patient,the tube current of 274 eff.mAs and 207 eff.mAs were applied respectively in the first and second abdominal scan.The imaging qualities of the two scans were evaluated retrospectively by 3 reviewers.All the individual variants,including height,weight,body mass index (BMI),the maximum transverse diameter,the anteroposterior diameter and the average maximum diameter of abdomen were recorded.A five-point scale was used for grading the image noise of eight organs,including abdominal aorta,portal vein,liver,spleen,gallbladder,pancreas,renal cortex and renal medulla. Diagnostic acceptability of CT images at three anatomic levels,including porta bepatis,pancreas and the upper pole of renal,was also evaluated by using a five-point scale.The noise value of abdominal aorta was defined as the standard deviation (SD) of CT values of aorta at the level of porta hepatis.Scatter diagram and Pearson correlation analysis were used for evaluating the linear relationship between the individual variants and the noise value of abdominal aorta,and multivariate linear regression analysis was used for evaluating the relevance between the individual variants and the noise value of aorta.ResultsIn this patients group,the average height was ( 164.6 ± 7.5 ) cm,the average weight was (64.3 ± 11.0) kg,the BMI was (23.7 ±3.3) kg/m2,the maximum transverse diameter of abdomen was(29.8 ± 2.3 )cm,the anteroposterior diameter of abdomen was (23.1 ± 2.9) cm,and the average maximum diameter of abdomen was ( 26.5 ± 2.5 ) cm.Pearson correlation analysis showed significant positive linear correlation between the noise value of abdominal aorta( 1 1.7 ± 3.0)and patients' weight ( r =0.744,P ＜ 0.01 ),BMI ( r =0.689,P ＜ 0.01 ),the maximum transverse diameter ( r =0.813,P ＜ 0.01 ),the anteroposterior diameter ( r =0.781,P ＜ 0.01 ),the average maximum diameter of the abdomen ( r =0.789,P ＜ 0.01 ) ; however,there was no positive linear correlation between the noise value of abdominal aorta and patients' height ( r =0.292,P ＜ 0.01 ). The maximum transverse diameter of abdomen is greatly related to the noise value of abdominal aorta (Beta =0.487,P ＜0.01 ).For the patient with the maximum transverse diameter of abdomen ranging from 27 to 32 cm,diagnostic acceptability of CT images at the anatomic level of porta hepatis showed statistical significance compared with the patient with the maximal transverse diameter of the abdomen greater than 32 cm or less than 27 cm (P ＜ 0.05 ).Conclusion The tube current of 207 eft.mAs is reasonable for abdominal CT scan for patients with the maximal transverse diameter of the abdomen ranging from 27 to 32 cm.

Objective To summarize the experience in endovascular repair of De Bakey type Ⅲ aortic dissection in recent years and summarize the prevention and management of the related perioperative complications.Methods From January 2009 to January 2011,49 cases of endovascular repair for De Bakey type Ⅲ aortic dissection were performed under general anesthesia in our department.There were 45 male and 4 female.The follow-up was performed in the outpatient department or by telephone.Results There was no inhospital death and no paraplegia events.Severe complication included:coma,2 cases ( 4.1％ ) ; endoleak,2 cases (4.1％ ) ; upper limb ischemia,2 cases (4.1％ ).Recurrent proximal aortic dissection,1 case.Fever was occurred in most of those cases.Conclusion Endovascular repair of aortic dissection improves the outcome of aortic dissection patients.But more attention should be pay to prevent the severe complications,It will help to improve the prognosis and life quality by reducing the risk of retrograde dissection,acute brain ischemia and endoleak.

Objective To investigate the appropriate low tube current of abdominal CT on a 64-slice spiral CT. Methods (1) Phantom study:The phantom Catphan500R was scanned with a fixed 120 kVp,and 450,400,380,360,340,320,300,280 mA, respectively. 15, 9, 8, 7, 6 mm diameter low-contrast objects with 1% contrast were scanned for evaluating image quality. CT images were graded in terms of lowcontrast conspicuity by using a five-point scale. Statistical analyses were performed to determine the appropriate tube current and the interval leading to the qualitative change. (2) Clinical study: 3 groups of 45 patients who had 2 examinations of non-enhanced abdominal CT within 3 months were enrolled. All patients were scanned with 450 mA at first scanning. For the second scanning, group-1 was scanned with optimal tube current, group-2 was scanned with optimal tube current plus interval, group-3 was scanned with optimal tube current sinus interval. CT images were graded in terms of the diagnostic acceptability at three anatomic levels including porta hepatis, pancreas and the upper pole kidney, and the image noises of eight organs including abdominal aorta, portal vein, liver, spleen, gallbladder, pancreas, renal cortex, renal medulla were graded by using a five-point scale. The image quality was compared with non-parametric rank sum test,and the individual factors of the patients were compared with the A VONA. Results (1) The optimal tube current and interval leading to the qualitative change were 340 mA and 40 mA respectively. (2) There were no significant differences in image quality between 340 mA and 450 mA in group-1, between 380 mA and 450 mA in group-2 (P ＞ 0. 05). There was significant difference in image quality between 300 mA and 450 mA in group-3 (the mean scores for 300 mA were 2. 92 ± 0. 62,2.92 ± 0. 62,2.64 ± 0. 84,2. 72 ±0.82,2.63 ±0.71,2.51 ±0.84,3.04 ±0.72,3.04 ±0.72,2.63 ±0.71,2.52 ±0.73,2.93 ±0.81respectively; for 450 mA were 3.93 ± 0. 72,3.94 ± 0. 72,3.41 ± 0. 64,3.43 ± 0. 61,3.62 ± 0. 93,3.63 ±0.71,3.93 ±0.81,3.93 ±0.81,3.43 ±0.61,3.52 ±0.92,3.84 ±0.82 respectively) (Z = -2.449 to - 2. 236, P ＜ 0. 05). Conclusion Radiation dose can be effectively reduced by using an appropriate and lower current of 340 mA.

Objective To investigate the expression of indu ci ble initric oxide synthase(iNOS) in gastric carcinoma and its relationship with angiogenesis and the prognosis. Methods Immunohistochemical staining method was used to det ect the expression of iNOS, VEGF CD34 in gastric carcinoma. Results The positive expression of iNOS in gastric carcinom a was 58.70% and iNOS was not detected in normal gastric tissue. The rate of the positive expression of iNOS in stage Ⅳ was higher than that in stageⅠ～Ⅲ. Th e positive expression of iNOS in gastric carcinoma with lymph node metastasis wa s higher than those with no metastasis. The MVD was 59.88? 18.02/HP and 55.5 9+ 19.39/HP in gastric carcinoma positive for iNOS and VEGF, repectively, obviou sly higher than those with negative expression of iNOS and VEGF, repectively ( P

Objective To evaluate the relationship between the expression of cyclooxygenase-2(Cox-2) and inducible nitric oxide synthase (iNOS) and the angiogenesis in gastric carcinoma. Methods Immunohistochemical stain was used to detect the expression of Cox-2, iNOS and MVD in 45 resected specimens of gastric carcinoma. The monoclonal antibody against CD34 was used for displaying vascular endothelial cells, and MVD was detected by counting the CD34-positive vascular endothelia cells. Paracancerous tissues were examined as the control. Results The expression rates of Cox-2, iNOS and MVD in gastric cancer were significantly increased, compared with those in the paracancerous tissues (77.78% vs. 33.33%, 68.89% vs. 17.78%, 58.13?19.99 vs. 24.02?10.28, P

Objective: To study the expression of Survivin protein and its relationship with apoptosis in oromaxillofacial sarcoma(OMFS). Methods:The expression of Survivin protein and apoptosis were assessed by immunohistochemical staining and TUNEL method in 37 OMFS samples and 14 oral benign mesenchymal tumor(BMT) samples.Results:The Survivin positive rate in oromaxillofacial sarcomas was 81.08% and none in benign tumors(P

Objective To investigate if vascular endothelial growth factor-D(VEGF-D) and endostatin(ES) promote angiogenesis in colorectal cancer(CRC). Methods One hundred and five patients undergoing CRC surgery were enrolled in this study. CRC and normal tissue microarray were produced and measured for VEGF-D and ES by immunohistochemmical staining.Results VEGF-D and ES expression were stronger in CRC tissues than in control normal mucosa. MVD was higher in cancer tissues than in normal ones. ES down-regulated expression was associated with less invasiveness, positive lymph node metastasis, distant metastasis and in cases of early Dukes′ stage, while the expression of VEGF-D in corresponding tissues was on the opposite to ES. MVD increased along with tumor invasion, lymph involvement, distant metastasis and late Dukes′ stage. Conclusions VEGF-D in accord with ES promotes the angiogenesis and progression of CRC.

Objective To summarize our experience in endovascular repair of 83 cases with type B aortic dissection.Methods A retrospective analysis was performed in 83 cases of type B aortic dissections who were treated in our hospital.Results The surgical procedure was successful for all the patients.Two patients died peri-operatively.One case encountered a coma,but no post-operative paraplegia occurred.Conclusion Endovascular repair for type B aortic dissection is a micro-invasive,safe and effective technique.Long-term follow-up is required to give a comprehensive evaluation.

ObjectiveTo evaluate the effect on postoperative urinary and sexual function of radical resection with pelvic autonomic nerve preservation for female rectal cancer patients.MethodsPostoperative sex and urination disorders were compared between groups of pelvic autonomic nerve preservation and conventional procedure in 120 female cases of middle-lower rectal carcinoma undergoing radical resection. ResultsThe venery decline、sexual climax slip、vagina wetness degree slip and the coition pain rate were 12.5%、10.5%、8.33%、4.15% in autonomic nerve preservation group and 54.1%、45.9%、41.7%、37.5% in control group, respectively(all P0.05).ConclusionPelvic autonomic nerve preservation is effective to reduce postoperative sex and urination disorders in female rectal cancer cases undergoing radical resection though it does not seem to benift cases receiving posterior pelvic exenteration.