Objective To explore the way to evaluate hemodynamics of posterior circulation distal ischemia with PWI. Methods Thirty-two patients with vertebral basilar artery severe stenosis were reviewed and compared with thirty normal persons. Information and data of PWI and MRA were collected and analyzed. Following parameters were observed, index of vascular stenosis, collateral vessels, cerebral blood flow (rCBF), cerebral blood volume (rCBV), and mean transit time (rMTT). Results All the patients had at least one vertebral basilar artery with more than 70% stenosis. There were 17 cases with severe vertebral artery stenosis , 20 cases with severe basal artery stenosis , 8 cases with severe superior cerebellar artery stenosis , 17 cases with posterior cerebral artery stenosis , 22 cases with after the traffic artery open , 11 cases with soft meningeal arteries show and 12 cases with small artery show. The ratio of ROI with frontal white matter was lower than the rCBF and rCBV in the country group. MTT value was extended and P value of the parameters in both groups was less than 0.05, reflecting the statistical difference. Conclusions PWI combined with MRA can effectively evaluate the posterior circulation distal ischemia area and tissue perfusion , as well as the hemodynamic status of ischemia area.

Objective To analysis the occurrence status of breast disease in married women in Tangshan area,and to provide basis for early prevention of breast cancer in this region.Methods 773 married women in Tangshan area were given mammography examination.The tissue biopsy or surgical treatment was recommended for patients with above grade 3 of breast imaging reporting and data system (BI-RADS) classification to obtain pathological diagnosis.Results In 773 women,482 cases (62.35 ％) were diagnosed as BI-RADS grade 2 or below,256 cases (33.12 ％) were BI-RADS grade 3,33 cases (4.27 ％) were BI-RADS grade 4,2 cases (0.26 ％) were BI-RADS grade 5.The distribution of each BI-RADS grade among different age group was statistically significant (x2 =17.90,P ＜ 0.001),35 cases got pathological diagnosis by biopsy or surgical treatment,including 30 cases of mammary gland hyperplasia,3 cases of breast fibroadenoma,and 2 cases of breast cancer.Conclusion Women's mammography screening is important for the prevention and early detection of mammary gland diseases.

Objective The aim of this study was to explore the clinical value of dual-source CT(DSCT)in the diagnosis of coronary artery fistula(CAF)before and after surgery. Methods A retrospective analysis was performed in 15 cases of patients with CAF,11 cases of which was treated by surgery during extracorporeal circulation. Results CAF arose from right coronary artery in 8 cases and left coronary artery in 7 cases,with the latter including 3 cases of ramus nodi sinuatrialis fistula,2 cases of anterior descending branch fistula,and 2 cases of left circumflex fistula. CAF entered into right atrium(6 cases),right ventricle(5 cases),left ventricle(4 cases)and left atrium(1 case). There were dilatation of coronary artery in 8 cases,localized aneurysm in 4 cases,normal coronary artery in 3 cases,single fistula orifice in 11 cases,and multiple fistula orifice in 4 cases. 11 patients underwent surgery under cardiopulmonary bypass(CPB).The postoperative imaging revealed fistula has been sutured in 10 patients with no residual fistula,including fistula vascular ligation in 3 cases,the proximal imaging and distal occlusion in right coronary artery angioplasty in 1 case,and pseudo diverticulum in 2 cases. Conclusion DSCT examination has significant value in preoperative diagnosis and postoperative follow-up for CAF.

Objective To study the changes of the peripheral blood regulatory B cells and related cytokines in children patients with chronic idiopathic thrombocytopenic purpura (CITP),and to analyze their correlations with effective Th cells,and to discuss their roles in the pathogenesis of CITP.Methods The peripheral blood mononuclear cells (PBMC)were separated in 30 cases of CITP,then percentages of Th1 ,Th17,Th22 and Breg cells were detected by the flow cytometry(FCM).IFN-γ,IL-17,IL-22 and IL-10 levels in culture supernatant were measured by the ELISA method.Results Compared with the control group,the proportions of the peripheral blood Th1 ,Th17,Th22 subsets in CITP children were increased[(18.4±4.7)% vs.(10.82±4.4)%;(2.42±1.02 )% vs.(1 .23±0.42)%;(0.79±0.24)% vs.(0.26±0.11)%],the proportion of Breg cells was reduced significantly,the differ-ences had statistical significance[(0.83±0.21)% vs.(1 .89±0.12)%,P <0.05].In CITP children,the IFN-γ,IL-17,IL-22 levels in culture supernatant were higher than those in the control group[(278.2±121.2)pg/mL vs.(181.8 ±82.2)pg/mL;(214.8 ± 100.5)pg/mL vs.(161 .4±67.8)pg/mL;(122.16±22.2)pg/mL vs.(90.8±31.1)pg/mL],but the IL-10 level was lower than that in the healthy control group[(27.4±12.6)pg/mL vs.(46.1±16.2)pg/mL),differences between them had statistical signifi-cance(P <0.05).Besides,there was a positive correlation between the proportion of Breg cells and cytokine IL-10 level(r=0.617, P <0.05 ),however,there was a negative correlation between the proportion of Breg cells with Th1 ,Th17 and Th22 cells (P <0.05),between IL-10 level with IFN-γ,IL-17 and IL-22 levels(P <0.05).Conclusion The downregulation of Breg cells proportion may participate in the immune disorder mechanism of effective Th cells in CITP children,which can provide a new idea for the im-munoregulation therapy in CITP children.

Objective To explore the manifestations and diagnostic significance of angiography in malformation of coronary artery.Methods 19cases of malformation of coronary artery underwent left and right coronary arteriography,the manifestations and causes of disease were analyzed retrospectively.Results 19 cases were taken coronary arteriography and it demonstrated the shape of malformation of coronary artery clearly.Of them,4 cases were coronary angioma and tumorlike dilatation,5case were malformation of coronary artery,10 case were coronary arteriovenous fistula.Conclusion Coronary arteriography is a very important method for correct diagnosing malformation of thecoronary artery.

Objective To investigate CT features on increased cerebral vascular density and its pathological mechanism in patients with cyanotic congenital heart disease(CCHD).MethodsPreoperative brain CT scan and clinical data in 82 patients suffering from CCHD were analyzed. According to the increased levels of vascular density,patients were divided into 4 groups:normal,mild,moderate and severe.Relationships between the increased levels of vascular density and Hb,RBC,HCT,as well as the degree of cyanosis,were studied.AVONA was carried out to test blood CT value of cerebral sinuses,Hb,RBC and HCT in different groups. Descriptive analysis and linear regression were adopted to study the correlation between blood CT value and Hb concentration.The relationship of increased vascular density todegrees of cyanosis was analysed by Spearman.Results Among 82 patients,12 patients ( 14.6％ ) werefound in the group of normal vascular density and 70 patients ( 85.4％ ) in the increased vascular density group.Among 70 patients with increased vascular density,22 patients (26.8％ ) with (55.4 ± 2.6) HU,(169 ±6)g/L of Hb,(5.8 ±0.3) × 1012/L of RBC and 0.51 ±0.03 of HCT,29 patients (35.4％) with (61.3 ± 2.9) HU,(209 ± 15 ) g/L,(7.1 ± 0.4) × 1012/L,0.66 ± 0.06 and 19 patients ( 23.2％ ) with ( 68.8 ± 4.2) HU,( 242 ± 23 ) g/L,( 8.3 ± 0.9 ) × 1012/L,0.78 ± 0.08 were observed in the mild,moderateand severe group,respectively.There were significant differences in distribution of blood CT value ( HU),Hb,RBC and HCT in different groups ( F =163.263,134.703,120.974,136.541 ;P ＜ 0.01 ).Blood CT value was positively correlated with Hb concentration ( r =0.98,P ＜ 0.01 ). Vascular density was also positively correlated with the degree of cyanosis ( r =0.86,P ＜ 0.01 ). Conclusions Cerebral vascular density of patients suffering from CCHD presented different levels of increases based on CT scan results due to rise of RBC stimulated by anoxia.The increased level of vascular density was positively correlated with blood Hb concentration,and also associated with RBC accunulation caused by abnormal blood circulation.Moreover,it was positively correlated with the degree of cyanosis.

Objective To explore the diagnostic value of tumor markers of CEA,CA153,TPS,Fer and CYFRA21-1 level in postoperative metastasis of breast cancer.Methods After 3-year follow-up for 578 patients with primary breast cancer from 2012 to 2014,we chose 42 patients with metastasis as metastasis group,and another 42 cases without as non-metastasis group.Level of CEA,CA153,TPS,Fer and CYFRA21-1 was detected using chemiluminescence and the difference of CEA,CA153,TPS,Fer and CYFRA21-1 level in 2 groups was compared.Pearson correlation test analysis and ROC curve test were performed for data analysis.Results Serum CEA,CA153,TPS,Fer and CYFRA21-1 levelq6.11 ± 1.87)ng/mL,(26.97 ± 9.52) U/mL,(155.95 ± 22.03)U/L,(173.08 ± 19.87)ng/mL and (18.98 ± 7.33)ng/mL respectively increased in metastasis group when compared with those in non-metastasis group (5.33 ± 1.85)ng/mL,(23.34 ± 8.30)U/mL、(133.22 ± 19.09)U/L,(142.29 ± 22.59) ng/mL and (6.76 ± 1.59)ng/mLrespectively and the change of TPS,Fer and CYFRA21-1 was more obvious and the difference was statistically significant (P ＜ 0.05).There was no significant correlation among serum TPS,Fer and CYFRA21-lin metastasis group.The area under ROC curve of CYFRA21-1 was 0.903,followed by Fer (0.849) and TPS (0.791) and in the diagnosis of metastasis of breast cancer,CYFRA21-1 has great diagnostic value.Conclusions The increase of serum TPS,Fer and CYFRA21-1 level is closely associated with postoperative metastasis of breast cancer and CYFRA21-1 has great diagnostic value for monitoring postoperative metastasis of breast cancer.