Objective To determine the effect of reducing mA on the diagnostic quality of images and the radiation dose to the lens in patients undergoing paranasal sinus CT. Methods Fifty patients undergoing paranasal sinus CT at 200 mA or 50 mA. The lens dose was measured using thermoluminescent dosemeters [LiF(Mg?Cu?P)]. Image quality was evaluated for six anatomical structures, including middle turbinate, uncinate process, maxillary ostium, ethmoid infundibulum, frontal recess, and cribriform plate. These anatomical structures were assessed as: not seen (0 points), demonstrated but not clearly visualized (1 points), or clearly demonstrated (2 points). Results Mean radiation dose to the lens was significantly reduced from 7.339 mGy (200 mA) to 1.108 mGy (50 mA). No significant difference of image quality between the two mA protocols was found in either rhinosinusitis group or non-rhinosinusitis group. And for rhinosinusitis the image quality showed no significant difference between high-resolution arithmetic and soft arithmetic. Conclusion CT scanning of the sinuses can be performed at greatly reduced mA without loss of diagnostic quality of the images. As far as the rhinosinusitis is concerned, high-resolution arithmetic can not improve the image quality and soft arithmetic is enough.

Mortality is a key index for assessing technical level and treatment quality of hospital. We filtered and analyzed the literatures about the influence of nurse factors on patient mortality out of China in recent years to guide the study within China. We found the nurse factors impacting mortality included workload, configuration of nursing staff, education status and working environment. Those findings point out the direction of the research on relationship between nurse factors and patient mortality in China, which has great significance.

Humans ; Laryngeal Neoplasms ; radiotherapy ; Radiation Tolerance ; Radiotherapy

OBJECTIVETo analyze the differences between the bacterial diversities in the saliva of caries-free and caries-susceptible adolescents through polymerase chain reaction (PCR)-denaturing gradient gel electrophoresis (DGGE).

METHODSTwenty adolescent subjects aged 12-18 years were recruited and subdivided into two groups: caries-free adolescents (n = 10) and caries-susceptible adolescents (n = 10). Saliva samples were collected. Total DNA was isolated directly from each sample. A portion of the 16S rRNA gene locus was PCR-amplified by using universal primers. Microbial diversity was analyzed through PCR-DGGE.

RESULTSAnalyzing the DGGE profile, we found that the composition of the saliva microbiome exhibited great intra-individual differences; the average band numbers of the caries-free adolescent group and the caries-susceptible adolescent group were 32.5 ± 3.7 and 27.3 ± 3.4, respectively. The differences between the groups were statistically significant (P = 0.008). Shannon-Wiener's indexes of the caries-susceptible adolescent group and the caries-free adolescent group were 2.5 ± 0.2 and 2.6 ± 0.2, respectively, but the differences between the groups were not significant (P = 0.405). Clustering analysis results suggested that most of the samples in the same group clustered together; this observation showed a high community structure similarity.

CONCLUSIONThe microbial diversity and complexity of bacteria in saliva are significantly higher in caries-free adolescents than in caries-susceptible adolescents. During caries development, bacterial diversity in the saliva likely decreases.

Adolescent ; Bacteria ; Child ; DNA, Bacterial ; analysis ; Denaturing Gradient Gel Electrophoresis ; Dental Caries ; microbiology ; Dental Caries Susceptibility ; Humans ; Microbiota ; Mouth ; microbiology ; Polymerase Chain Reaction ; RNA, Ribosomal, 16S ; Saliva ; microbiology

Objective To discuss the image characteristics of enlarged prostatic utricle in children.Methods 13 children with enlarged prostatic utricle were retrospectively analyzed,6 of whom checked by voiding cystic urethrography (VCUG),5 of whom by MRI,2 of whom by both VCUG and MRI.Results 8 cases with VCUG showed round-like or long circle utricle filled with contrast media located in the rear posterior urethra.Among them,3 cases showed the tubiform between utricle and posterior urethra.The other 5 cases displayed overlap between utricle and urethra,and there was no tubiform between utricle and posterior urethra.7 cases with MRI showed oblong cyst at the right rear middle of the bladder that showed low signal with T1 weighted image and high signal with T2 weighted image,crossing the center of prostate gland.Among them,5 cases showed the communication between oblong cyst and posterior urethra.Also,among them,5 cases were associated with the orchitis,epididymis phlogistic,scrotal phlogistic,and 1 case showed the right renal agenesis.Conclusion The VCUG and MRI are helpful to check enlarged prostatic utricle in children.They have different advantages in different aspect.

Objective To explore the diagnosis and management of functional pancreatic endocrine tumor.Methods Clinical data of 19 cases of functional pancreatic endocrine tumor were retrospectively analyzed.Results 15 cases of insulinoma,2 cases of gastrinoma and 2 cases of glucagonoma were qualitatively diagnosed.The positive rate of preoperative diagosis for type B ultrasonic inspection,CT,MRI,EUS,selective portovenous sampling and intraoperative type B ultrasonic inspection was 15.8％ (3/19),67.5％ (10/16),71.4％ (5/7),87.5％ (7/8),100％(2/2) and 85.7％(6/7) respectively.Of the total 19 cases,7 cases underwent open surgery,11 cases unde rwent laparoscopic surgery,and one case didn't undergo any surgery as liver metastasis had occurred when glucagonoma was diagnosed.The operation methods included tumor enucleation (n=13),distal pancreatic resection (n=3),distal pancreatic resection plus splenectomy (n=1),and pancreatic head resection with duodenum preserved (n=1).Conclusions The measurement of serum insulin,gastrin and glucagon is the main basis for qualitative diagonosis of pancreatic endocrine tumor.Two stage spinal CT thin scanning is the main method for tumor location.Intraoperative type B ultrasonic inspection is the supplement to preoperative location.Tumor enucleation is the main choice of treatment.

ObjectiveTo investigate the relationship between cytokine gene polymorphisms and long-term humoral response in children vaccinated against hepatitis B during infancy.MethodsA total of 293 children (6.08±0.59 years old) who received three doses of hepatitis B vaccine according to a 0-,1-,6-month schedule during infancy and were negative for HBsAg and/or anti-HBc,were enrolled.Of them,83children with anti-HBs ＜10 mIU/ml were considered as long-term poor responders ( group A),and 210 others with anti-HBs ≥ 10 mIU/ml were defined as long-term responders ( group B).A total of 11 single nucleotide polymorphisms (SNPs) of IL-1β,IL-2,IL-4,IL-10,IL-12B,and IL-13 were detected with PCR-restriction fragment length polymorphism.ResultsThe allele frequencies of -33T,-589T,and 2979T in IL-4 gene in group A were 86.1%,86.1% and 90.4%,respectively,higher than those in group B (76.0%,76.9%,and 83.3%,respectively,all P＜0.05).In IL-4 gene,frequencies of TT genotype at position -33 and -589 in group A were 74.7% and 75.9% respectively,higher than those in group B (57.1% and 59.0% respectively,both P＜0.01 ),while the frequencies of CT at position -33 and -589 in group A was 22.9% and 20.5% respectively,lower than those in group B (37.6% and 35.7% respectively,both P＜0.05).The genotype distributions of IL-4 2979 and the allele or genotype distributions of 8 other SNPs showed no significant differences between group A and group B.ConclusionPolymorphisms at position -33,-589,and 2979 in IL-4 gene are associated with the long-term humoral response in children vaccinated against hepatitis B during infancy.

Objective To analyze the histological underestimation of stereotactic core needle biopsy (SNCB).and tO attract clinicians' attention.Methods SNCB was performed in 146 patients with 179 lesions from September 2000 to June 2005.and 21 lesions were underestimated histologically.0f 21 nonpalpable breast lesions(NPBL).6 lesions were diagnosed as BI-RADS nl,12 8S BI-RADS Ⅳ,3 as BI-RADS V according to BI-RADS before biopsy.Mammography showed 16 lesions with calicification, 2 cases with masses,1 case with asymmetry density and 2 cases with stellate sign.Results Eleven lesions diagnosed as fibrocystic disease with atypical ductal hyperplasia by biopsy were proved to be ductal carcinoma in situ (DCIS)in 7 lesions and early infiltration in 4 lesions by pathology.3 lesions diagnosed as severe atypical hyperplasia by biopsy were finally proved to be 1 carcinoma in situ and early infiltration in 2 lesions by pathology.3 lesions diagnosed as DCIS by biopsy were invasive carcinoma.4 lesions diagnosed papillary lesions by biopsy and finally were 1 carcinoma in situ,1 early infiltration,1 infiltrating ductal carcinoma and l intraductal papillary adenocarcinoma.Conclusion The histological underestimation of SCNB Was related to the stereotactic location technology,lesion and doctor'S understanding,the radiologist should master the biopsy skills.

Objective To determine whether or not 810 nm low power Ga-Al-As laser treatment can stimulate the regeneration of damaged optic nerves by measuring the expression of growth associated protein 43 ( GAP-43 )and flash-visual evoked potential (F-VEP). Methods Eighty-eight Wistar rats weighing (180-220) g were randomly divided into a laser therapy group with 40 rats,an injury group with 32 rats,and a normal control group with 16 rats.Each group was subdivided into 1st,3rd,6th and 9th week subgroups.A standardized crushing of the optic nerve was applied to make the model.After this,the laser therapy group was treated for 3 minutes daily at 60 mW applied transcutaneously to a 5 mm diameter spot on the injured optic nerve.The injury and normal control groups received the same treatment with no laser output.The expression of GAP-43 was detected by immunohistochemistry and RT-PCR after 1,3,6 and 9 weeks of treatment.F-VEP was measured pre-injury,immediately after injury and 1,3,6 and 9 weeks post injury. Results After the optic nerve was injured,obvious changes in F-VEP were detected,including significantly prolonged latencies of N1,P1 and N2 waves.The latency increased immediately after the optic nerve injured,and then recovered,but after 1 and 3 weeks the latency was still prolonged.There was significant recovery from the 3rd to the 9th week.In the laser therapy group,the peak latencies of the N1,P1 and N2 waves were also prolonged,but the changes were less than those in the injury group.Expression of GAP-43 was hardly detectable in normal retinas and optic nerves.GAP-43 had its highest expression level at 1 week post-injury,and then decreased.At the 1st,3rd and 6th week post-injury,the expression of GAP-43 in the laser therapy group was significantly higher than in the injury group.GAP-43 mRNA content in the retina showed the same tendency as GAP-43 protein. Conclusion A 810 nm low power Ga-Al-As laser can promote neural repair and axonal regeneration after optic nerve injury.

Objective To explore tolerance-related factors of enteral nutrition(EN) by nasogastric (NG) tube in ICU patients, and to provide several nursing strategies for improving the patients' tolerance. Methods 83 patients using EN with NG tube in ICU were collected.Tolerance-related factors of EN were analyzed by multivariate Logistic regression analysis. Results Among the 83 patients, 36 patients (43.3%) could tolerate very well, 47 patients (56.6%) couldn't tolerate.After treatment 27 patients' tolerance was fair, the other was poor.Multivariate Logistic regression analysis showed that age, APACHE-Ⅱ score, the time of beginning EN, albumin level, drug administration by NG tube or not were the major factors affecting tolerance of NG tube feeding. Conclusions Patients' feeding with NG tube was well-tolerated in ICU.Besides the factors from patients as the severity of disease status and level of serum albumin,the time of beginning EN, drug administration by NG tube were significantly correlated with tolerance.