Objective To study the influence of environment oxygen supplement and passive smoking on the blood gas indexes in rabbits.Methods Eighty adult Newzealand white rabbits were randomly divided into 4 groups,20 in each.The oxygen supplement and passive smoking group was exposed to cigarette smoke produced by 25 burning cigarettes,four hours per time,consecutively for twenty-four hours,simultaneously exposed to oxygen produced by two oxygen generators(600-1 000 ml/min per generator).The oxygen supplement group was exposed to oxygen produced by two oxygen generators(600-1 000 ml/min per generator) consecutively for twenty-four hours.The passive smoking group was exposed to cigarette smoke produced by 25 burning cigarettes,four huors per time,consecutively for twenty-four hours.The control group was exposed to general feeding environment.The analysis of variance of factorial design(2?2) was conducted,five blood gas indexes were measured.Results Under the condition of surroundings oxygen increasing,the partial pressure of blood oxygen was improved significantly(P0.05).No evident interaction was found between surroundings oxygen increasing and passive smoking.Conclusion Oxygen metabolism can be improved by environment oxygen supplement in rabbits,and the effect of passive smoking on the investigated five blood gas indexes is not considered significant.

Objective To explore the value of echocardiography in the diagnosis of anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) in children.Methods The echocardiographic images of 14 patients with ALCAPA confirmed by operation and 18 patients with endocardial fibroelastosis (EFE) diagnosed by clinical were compared and analyzed.Results Both ALCAPA and EFE exhibited obvious dilated left ventricle,decreased left ventricular systolic function,thick endocardium and mitral regurgitation of different degree.The former additionally showed dilated right coronary artery(RCA) with normal origin,left coronary artery(LCA) emerging from the root or wall of the pulmonary artery(PA),the retrograde flow into PA in LCA and abundant collateral vessels in myocardium.However the later exhibited normal diameter of LCA and RCA and no collateral vessels.Conclusions Color Doppler echocardiography not only demonstrates left ventricular systolic function,endocardium,mitrial regurgitation and collateral vessels in myocardium,but also shows the origination and courses of LCA clearly,which provide exact informations to diagnose ALCAPA.The echocardiography can be used as a powerful tool of ALCAPA diagnosis and preoperative assessment.

Objective To further explore the blood supply and interventional therapy of adult cavernous hemangiomas of the liver (CHL).Methods Recently some authors reported that a satisfactory effect resulted from transcatheter portal venous embolization was obtained in few cases of CHL with blood supply of portal vein,and raised an objection to the standpoint that CHL was commonly supplied by hepatic artery completely.In order to get a scientific and reasonable explanation for it,this paper reviewed the vascular embryology and histology of the liver,the pathologic features of CHL as well as the relative literature,and combined with the investigation results of blood dynamic changes of CHL that had been performed in 2000～2002 by us.Results CHL was caused by the arrested development of hepatic sinusoids at the embryonic stage.Pathologically,CHL was consisted of a lot of enlarged abnormal sinusoids,which were variant in size and closely related with the hemodynamic changes of CHL (in inverse proportion).The CHL consisted of even and tiny abnormal sinusoids (diameter less than 50 ?m) pathologically usually presented a high flow.During the hepatic artery angiography or CTHA,it was rapidly filled by the arterial blood containing contrast media and frequently showed dense opacification or enhancement.Simultaneously this could result in increased pressure of abnormal sinusoids.When the sinusoidal pressure exceeded that of the connecting portal venules,the arterial blood containing contrast media filled in the abnormal sinusoids could lead to retrograde flow in the portal venules.That was arterial-portal venous shunts (APVS).These appearances described as above could also occur in some CHL with intermediate flow,in which many tiny abnormal sinusoids located in the peripheral area were identified pathologically.On the contrary,the CHL consisted of larger abnormal sinusoids (diameter more than 500 ?m) pathologically usually presented a low flow.During the hepatic artery angiography or CTHA,it was filled very slowly by the arterial blood containing contrast media and was difficult to opacify or enhance.Simultaneously this could result in a low pressure of abnormal sinusoids.When the sinusoidal pressure was lower than that of the connecting portal venules,the portal venous blood containing contrast media could easily flow into the abnormal sinusoids and make it enhanced during the direct or indirect portography (or CTAP).Conclusion CHL is really a congenital venous malformation.All the CHL with high flow and some CHL with intermediate flow are surely supplied by the hepatic artery and drained primarily by the peripheral branches of portal vein.However,in few CHL with marked lower flow,the portal vein should become a primary supply vessel,so a direct or indirect portography (or CTAP) must often be taken to identify the diagnosis.Thereby,the technique of transcatheter embolization of CHL including the aim,indication,approach,and the used sclerotic or embolic drugs,etc,should also be reconsidered in order to improve its therapeutic efficacy.

Objective To assess the patient effective dose during SPECT/CT imaging.Methods A total of 157 patients (85 males,72 females;mean age:(60.46±13.44) years,range:24-88 years) who underwent SPECT/CT from April 2013 to September 2014 were retrospectively analyzed.They were divided into 3 groups:99Tcm-MDP bone scan group (n=113),99Tcm-MIBI parathyroid imaging group (n=23) and 99Tcm-MAA pulmonary perfusion imaging group (n=21).The injection dose (MBq) was recorded and the effective dose (mSv) was estimated according to the International Commission on Radiological Protection (ICRP) guideline.The volume-weighted computed tomography dose index (CTDIvol) and dose length product (DLP) of CT were also recorded and the effective dose (mSv) due to CT was calculated.The effective doses among different groups were statistically compared by Kruskal-Wallis rank sum test and Wilcoxon rank sum test.Results The effective dose from radiopharmaceuticals were (4.02±0.35) mSv for 99Tcm-MDP bone scan,(6.13±0.53) mSv for 99Tcm-MIBI parathyroid imaging and (1.66±0.13) mSv for 99Tcm-MAA pulmonary perfusion imaging (x2=96.853;Z =7.533,7.262 and 5.676;all P＜ 0.05).The effective dose due to CT were (3.84±1.98),(1.04±0.19),(4.05±0.47) mSv respectively (x2 =41.225,P＜0.05),and there were significant differences between 99Tcm-MIBI parathyroid imaging group and 99Tcm-MDP bone scan group,99Tcm-MAA pulmonary perfusion imaging group(Z=6.046 and 5.672,both P＜0.05).The total effective dose during SPECT/CT imaging were (7.86± 1.98),(7.21±0.81) and (5.71±0.45) mSv (x2 =28.988,P＜ 0.05).There were significant differences between 99Tcm-MAA pulmonary perfusion imaging group and 99Tcm-MDP bone scan group,99Tcm-MIBI parathyroid imaging group(Z=4.967 and 4.994,both P＜0.05).Conclusions The increase in effective dose due to spiral CT during SPECT/CT examination should be concerned.Appropriate utilization and optimization of SPECT/CT is needed.

Objective To evaluate the value of echocardiography method for diagnosis of the downward displacement of the posterior leaflet of tricuspid valve with apical right heart two chamber view (AP-RH-2CV). Methods Rotating the probe clockwise from apical four chamber view(AP-4CV) to AP-RH-2CV at the septial and posterior leaflet of tricuspid valve, the shape, moving and position of the posterior leaflet of the tricuspid valve were observed by displaying the degree of downward displacement of the septial and posterior leaflet of tricuspid valve. The location of the orifice of tricuspid regurgitation was examined by color Doppler flow imaging(CDFI). Results In 15 patients with Ebstein's anomaly from the AP-RH-2CV, the downward displacement of posterior leaflet of tricuspid valve was clearly observed at the AP-RH-2CV. These results of echocardiography were confirmed by surgery except one ease missing out mild downward displacement of the anterior leaflet of tricuspid valve. Moreover, all 15 patients showed the obvious downward displacement of the location of the orifice of tricuspid regurgitation from AP-RH-2CV by CDFI. Conclusions The AP-RH-2CV is an ideal view in diagnosis of the downward displacement of the posterior leaflet of tricuspid valve by echocardiography. The downward displacement of the location of the orifice of tricuspid regurgitation is a critical character for diagnosis of the downward displacement of the posterior leaflet of tricuspid valve by CDFI.

Objective To investigate the effect of nutritional counseling combined with oral high-fat, high-protein nutritional supplement (Ensource) on nutritional status and clinical outcomes of esophageal cancer patients under radiotherapy treatment.Methods Totally 80 esophageal cancer patients under radiotherapy treat-ment who were able to take oral feeding and with Nutritional Risk Screening 2002 (NRS 2002) score≥3 were se-lected and divided into a study group (n=41, nutritional counseling combined with oral nutritional supplements) and a control group ( n=39, nutritional counseling) with a random number table.Energy intake, nutritional sta-tus, and incidences of radiotherapy complications of the two groups before and after radiotherapy were compared. Results Energy intakes in the study group increased significantly during radiotherapy compared with the control group [ (2 445 ±686) kJ vs.(1 747 ±456) kJ, P=0.003];and the level of prealbumin and transferrin were increased significantly compared with before radiotherapy [ (17.35 ±5.83) mg/L vs.(20.15 ±6.02) mg/L, P=0.008;(213.74 ±52.66) mg/L vs.(264.19 ±43.78) mg/L, P=0.002].Besides, compared with the control group, incidence of radiation esophagitis ( GradeⅢ) and radiation skin injury ( GradeⅢ) in the study group decreased significantly (24%vs.38%, P=0.000;27%vs.41%, P=0.000).Conclusion Nutritional counseling combined with oral nutritional supplements in esophageal cancer patients could help improve the patients'nutritional profile and decrease the incidence of complications related with radiotherapy.

Objective:To investigate whether the nutrition support team (NST) benefits esophageal carcinoma (EC) patients who are concurrently undergoing chemoradiotherapy. Methods: Between June 2012 and December 2013, 40 EC patients undergoing chemoradiotherapy were divided into the NST group and routine treatment (RT) group, with 20 patients in each group. At the end of chemoradiotherapy, the nutritional status, incidence of complications, and completion rates of radiotherapy were evaluated. The length of hospital stay (LOS) and cost were also compared between the two groups. Results:The nutrition and blood parameter values of the NST group were better (P<0.05) than those of the RT group. The incidence of complications was lower in the NST group (P<0.05) than that in the RT group. In addition, all patients in the NST group achieved the treatment plan, whereas five of the patients in the RT group interrupted or delayed the plan (P<0.05). The average LOS decreased by 3.8 d (P<0.05), and the hospitalization costs were reduced to 6300 RMB person-times (P>0.05) for the patients of the NST group. Conclusion: NST could maintain the nutritional status and improve the treatment compliance and tolerance of EC patients undergoing chemoradiotherapy, thereby shortening the LOS time and reducing the costs.

Objective To explore the value of CT quantitative analysis in differentiating lepidicGpredominant adenocarcinoma (LPA)from invasive nonGlepidicGpredominant adenocarcinoma (INV)manifested as subsolid nodules (SSN).Methods A total of patients with lung adenocarcinoma manifested as SSNs on CT images were divided into LPA group and INV group according to their pathological results.Total volume,solid volume,solid volume percentage,total mass,solid mass,solid mass percentage and threeGdimensional mean CT value of the nodules were calculated after segmenting pulmonary nodules by a 3DGCT segmentation software,meanwhile the oneGdimensional mean CT value and maximal diameter were manually measured.SPSS 22.0 software was used for statistical analysis. Results Solid volume (0.1 6 ±0.3 6 cm3 vs 1.2 6 ±2.1 7 cm3 ,P＜0.00 1),solid volume percentage (4.7 9 ±5.40% vs 2 6.3 3 ± 1 5.6 3%, P＜0.001),total mass (1 180.64±1 751.46 mg vs 2 386.59±3 224.54 mg,P＝0.010),solid mass (151.64±337.53 mg vs 1 257.34± 2 220.9 2 mg,P＜0.00 1 ),solid mass percentage (7.9 8 ± 8.5 8% vs 3 7.2 3 ± 1 8.83%,P＜0.00 1 ),threeGdimensional mean CT value (－492.26±71.21 HU vs －350.73±94.52 HU,P＜0.001 )and oneGdimensional mean CT value (－472.29 ± 1 12.46 HU vs －282.02 ± 1 5 9.13 HU,P＜0.001)in LPA group were found significantly lower than those in INV group.There were no significant differences in the maximal diameter and total volume between LPA group and INV group.Solid volume percentage and solid mass percentage were selected according to stepwise discriminant analysis.The accuracy of Bayes modes by using substitution method and cross validation method were 84.2% and 83.3%,respectively.Conclusion Solid volume percentage and solid mass percentage were important parameters for differentiating LPA from INV.Quantitative analysis of SSN was very helpful to preoperatively evaluate the subtypes and prognosis of lung adenocarcinoma by using 3DGCT segmentation technique.

Objective:To compare and analyze the differences of common dose indicators before and after operation of 3D-printing template assisted by CT-guided 125I seed implantation in the treatment of bone metastases to guide clinical application. Methods:A retrospective analysis of 12 lesions in the 10 patients (9 males and 1 female, median age 65 years), who underwent seed implantation surgery for bone metastases in the Tianjin Third Central Hospital from June 2019 to January 2021, was conducted. All the lesions were adopted for 3D-printing template to guide seed implantation and the prescribed dose was 120-140 Gy. The differences of common dose indicators between preoperative treatment plan and postoperative verification plan were compared, including D90 (dose received by 90% of the target volume), D100 (dose received by 100% of the target volume), V90 (the volume percent for tumor target volume receiving 90% of the prescribed dose), V100 (the volume percent for tumor target volume receiving 100% of the prescribed dose), V150 (the volume percent for tumor target volume receiving 150 % of the prescribed dose), as well as the quantity of seeds planned and actually used. The paired t-test was performed to compare and analyze those parameters. Results:There was no statistically significant difference in pre- and postoperative D90, D100, V90, V100, V150 ( P > 0.05). The actual quantity of seeds used after operation was more than that of the preoperative planned quantity and the difference was statistically significant ( t=-2.930, P < 0.05). Conclusions:The clinical use of 3D-printing template assisted by CT-guided 125I seed implantation for bone metastasis should be promoted since the dose is accurate and the requirements of preoperative plan can be achieved.