Objective To study the effect application,method,time, and indwelling double J internal tube in the operation of upper urinary tract.Methods The double J of tubes were used as internal drainage and internal stent for 1～2 months in the operation of upper urinary tract in 104 patients with nephrolithiasis, ureteral calculi,PUJ obstruction,megaloureter syndrome and bladder tumor.Result No complications such as wound infection,leakage of urine occurrence after operation.Conclusions The double J tubes had the dual functions of internal sent and internal drainage. The double J tubes can be indwelled easily and safely.

Objective To compare the conventional non-enhanced and virtual non-enhanced images of dual-energy computed tomography (CT) in evaluating solitary pulmonary nodules (SPNs).Methods Forty-seven patients with SPNs proved by pathology underwent conventional and enhanced thoracic DECT.The virtual non-enhanced CT images and iodine images were reconstructed based on the enhanced imaging data.The mean CT number,noise,signal to noise (SNR),nodual diameter of SPNs were compared between the true non-contrast CT(TNCT) and the virtual non-contrast CT (VNCT),with paired t test.The image quality and detectability of calcification were also compared.The diagnostic accuracy for malignant nodulesbased on the increased CT values and iodine-enhanced image were compared.The independent t test was used to compare the increased CT number of SPNs and iodine images.The single-phase radioation dose of the single energy,was compared with dual energy scan.Results No significant difference in the mean CT Number(t =1.556,P ＞ 0.05),noise (t =-0.357,P ＞ 0.05),SNR (t =0.767,P ＞ 0.05) on TNCT and VNCT.The mean CT Number,the noise,and SNR were (29.90 ± 12.43)vs (27.52 ± 16.67) HU,(9.60 ±3.74) vs (9.88 ± 2.90),and (3.07 ± 1.93) vs (2.76 ± 2.36),respectively.The increased CT number ofSPNs with TNCT and VNCT from baseline were(18.63 ± 8.03) and(20.45 ± 9.13) HU.The CT number of iodine image was(23.82 ± 9.20)HU.A significant difference was observed between the TNCT and iodineed image (t =-2.371,P ＜ 0.05).The quality scores of VNCT image wasslightly worse than TNCT image.The detectability rate of calcification on VNCT was 92.3％ (72/78).The iodine image carried the highest diagnostic sensitivity rate and accuracy rate,82.3％ (28/34)and 74.5％ (35/47),respectively.The highest specificity rate was 76.9％ (10/13) from the increased CT number with VNCT.No significant difference in single-phase radiation dose was observed between TNCT and VNCT,(5.68 ± 1.31) vs.(4.89 ± 1.27)mSv.Conclusions VNCT could be obtained with similar image quality as TNCT.This methods might favor a reduction in radiation exposure.

Objective To observe the efficacy and side effects of Jianpi Qutan Decoction combined with Quetiapine in the treatment negative symptoms of schizophrenia.Methods 60 inpatients with schizophrenia were randomly divided into two groups,with one group treated with Jianpi Qutan Decoction combined Quetiapine and the other group treated with Quetiapine.Effects and side effects were assessed with the Positive and Negative Syndrome Scale (PANSS) and Treatment Emergent Symptoms Scale (TESS) respectively 1,4 and 8 weeks before and after the treatment.Results There was no significant difference in the overall efficacy between the two groups,but the improvement of the negative symptoms and illness provocation was significantly better in the treatment group than that in the control group respectively (P＜0.05).Moreover,the adverse reaction was milder in the treatment group.Conclusion It is suggested Jianpi Qutan Decoction in combination with typical antipsychotics is effective and safe in treating negative symptoms in schizophrenia patients.

Objective To explore clinical application of coronary artery imaging with 64-slice spiral CT.Methods 46 patients with coronary heart disease were undergone both coronary artery imaging with 64-slice spiral CT and coronary angiography,and the effects on coronary display respectively were compared Results Coronary display in coronary artery imaging with 64-slice spiral CT was better than that of the coronary angiography, which was a inspection pattern of noninvasive coronary display. Conclusion Coronary artery imaging with 64-slice spiral CT can accurately evaluate coronary artery stenosis, which was worth to application.

ObjectiveTo quantitatively characterize the inter-fractional anatomy variations and advantages of dosimetry for the adaptive radiotherapy in pancreatic cancer.MethodsA total of 226 daily CT images acquired from 10 patients with pancreatic cancer treated with image-guided radiotherapy were analyzed retrospectively.Targets and organs at risk (OARs) were delineated by the atlas-based automatic segmentation and modified by the skilled physician.Various parameters,including the center of mass (COM) distance,the maximal overlap ratio (MOR) and the Dice coefficient (DC),were used to quantify the inter-fractional organ displacement and deformation.The adaptive radiation therapy (ART) was applied to handle the daily GT images.The dose distributions parameters from the ART plan were compared with those from the repositioning plan.ResultsThe inter-fractional anatomy variations of pancreas head were obvious in the pancreatic cancer irradiation.The mean COM distance,MOR and DC of pancreas head after the bony or soft tissue alignment and registration was ( 7.8 ± 1.3 ) mm,( 87.2 ± 8.4 )％ and ( 77.2 ±7.9)％ respectively.Compared with the repositioning plan,the ART plan had better target coverage and OARs sparing.For example,the mean V100 of PTV was improved from (93.32 ± 2.89) ％ for repositioning plan to ( 96.03 ± 1.42) ％ for ART plan with t =2.79,P =0.008 and the mean V50.4 for duodenum was reduced from (43.4 ± 12.71 )％ for the repositioning plan to (15.6 ± 6.25)％ for the ART plan with t =3.52,P=0.000.ConclusionsThe ART can effectively account for the obvious inter-fractional anatomy variations in pancreatic cancer irradiation and be used to escalate the radiotherapy dose for the pancreatic cancer,which will lead to a promising higher local control rate.

Tumor cells can metabolize glucose through glycolysis to intermediates for biomacromolecule synthesis by inhibiting the activity of the pyruvate dehydrogenase complex (PDC) in mitochondria. In this process, pyruvate dehydrogenase kinases (PDKs) play a key role. The inhibition of the activity of PDKs can effectively block this metabolic pathway, activate mitochondrial oxidative metabolism, and induce tumor cell apoptosis. PDK inhibitors have become a research hotspot in medicinal chemistry, and novel structures targeting classical binding sites have been synthesized. In this paper, recent research progress on PDK inhibitors is reviewed to provide information on these latest entities and to explore their clinical applicability.

Objective To summarize the experience in surgical management of bile duct injury. Methods The clinical data of 683 patients with bile duct injury who were admitted to the Hunan People's Hospital from August 1990 to December 2008 were retrospectively analyzed. Of all the patients, seven received hepatectomy +T tube drainage, two received liver repair + T tube drainage, four received external biliary drainage + hepatectomy,27 received liver repair or hepatectomy + silicone support, 233 received temporary portal triad clamping + gelatin sponge hemostasis, 72 received biliary repair + T tube drainage, 248 received hepatobiliary basin Roux-en-Y anastomosis, 22 received external biliary drainage, 61 received long arm T tube drainage, two received pancreaticoduodenectomy and five received hepatectomy + T tube drainage. The surgical outcomes were evaluated by analyzing the results of the follow-up. Results The surgical outcomes were ranked excellent, good and poor according to the condition of patients and the results of imaging examination. Six hundred and twelve patients were followed up for 8 months to 19 years, and the surgical outcomes were excellent in 337 patients (55.1%), good in 214 patients (35.0%) and poor in 61 patients ( 10.0% ). Conclusion The surgical outcome of bile duct injury could be satisfactory if the approach of the surgery is properly selected.

Objective To investigate the antiviral efficacy of standard treatment with interferon (IFN)-α 2b and ribavirin (RBV) in patients with chronic hepatitis C (CHC) originating from a same blood donor.Methods The test group consisted of 65 CHC patients originating from a same blood donor,and was treated with IFN-α 2b 3-5 MU every other day in combination with RBV 0.6-1.0 g/d.Meantime,the control group consisted of 32 CHC patients who visited the Department of Infectious Diseases in Qiannan People's Hospital,and was treated with Peg-interferon (PEG-IFN)-α 2a 180 μg every week in combination with RBV 0.6-1.0 g/d.All the patients in the two groups were treated for 48 weeks and followed up for 96 weeks.Assessment indictors included sustained virological response (SVR),early virological response (EVR),end of treatment virological response (ETVR),biochemical response after withdrawal of treatment.Side effects during treatment were also evaluated.Measurement data were analyzed by x2 test.Results In test group,SVR rate was 83.1％ (54/65),EVR rate was 93.8％ (61/65),ETVR rate was 86.2％ (56/65) and biochemical response rate after withdrawal of treatment was 100.0％.In control group,SVR rate was 87.5％ (28/32),EVR rate was 96.9 ％ (31/32),ETVR rate was 90.6 ％ (29/32) and biochemical response rate after withdrawal of treatment was 100.0 ％.SVR rates of the two groups were not significantly different (x2 =0.072,P=0.086).Patients of the two groups were divided into two subgroups according to viral load:hepatitis C virus (HCV) RNA＜1.0 × 106 copy/mL and HCV RNA≥1.0 × 106 copy/mL.SVR rates of patients with low and high viral load in test group were 88.9％ and 54.5％,respectively (x2=7.67,P=0.008),those in control group were 96.0％ and 57.1％,respectively (x2 =4.41,P=0.038).SVR rates were higher in the subgroup of patients with low viral load.Leukopenia and thrombocytopenia were more common in control group than in test group (x2 =9.805,P =0.003 ; x2 =6.643,P=0.009).Conclusion IFN-α 2b and RBV combination therapy has similar antiviral efficacy to that of PEG-IFN-α 2a and RBV combination therapy,and has a lower rate of side effects as well.

Objective To analyze CT manifestation of Schistosoma haematobium cystitis.Methods Retrospective analysis 32 patients,who were tested for Schistosoma haematobium cystitis using the urine filtration method.CT scan was performed for each patient with contrast enhancement.Results The vast majority of urinary tract schistomiasis lesions were in the urinary bladder.Calcification of the bladder wall was observed in all patients and mild enhancement in non calcified zone was found after intravenous contrast.Except for 5 patients of bladder cancer,the rest were no abnormality in size of bladder when bladder was filling or emptying.Ureteral wall annular calcification could also be identified in 25 patients.Twenty two patients were companied with ureteric hydronephrosis.Seminal vesicle calcification was seen in 4 patients among 11 male patients,while both uterine and ovarian in female and prostate in men had non calcification.Serious illness can be combined with bladder cancer.In 5 patients of patients with bladder cancer,bladder showed irregular soft tissue mass which was enhanced moderately after post-contrast scan,with vesical calcification in mass medially.Conclusion Bladder calcification is the most prominent CT feature of Schistosoma haematobium cystitis,which is useful in diagnosis the disease.

Forty women with polycystic ovary syndrome( PCOS) were enrolled. Basal plasma and urine cortisol, pituitary hormones, homeostasis model assessment for insulin resistance, and plasma cortisol in 0. 25 mg dexamethasone inhibition test were determined. In over-weight or obese PCOS patients, cortisol levels before and after inhibition test were increased (P<0. 05 or P<0. 01 ). The results suggest that the feed-back regulation of glucocorticoids to hypothalamas-pituitary is impaired and the change in hypothalamic-pituitary-adrenal axis is associated with insulin resistance.