Objective To evaluate three compartments of mediastinal anatomy in the diagnosis of space occupying lesions. Methods CT images of 78 mediastinal lesions confirmed by surgery or/and pathology were retrospectively studied. Results According to the occurrence ratio of occupying lesions, anterio superior mediastinal lesions were lymphadenovarix, thymoma, teratoblastoma, and intrathyroma, etc. In anterio inferior mediastinum, heart tumors, teratoblastoma, fatty tumor were found successively. Posterior mediastinal lesions were lymphadenovarix, neurogenic tumors, esophageal tumors, tracheo broncheal tumors, aneurysms, diaphrageal herniation and so on. Conclusion The results suggested that the mediastinal three compartments protocol was more terse and practical than others in the diagnosis of space occupying lesions before operation.

The clinical application of acupoints in Huangdi Neijing was analyze by evidence-based medicine. The results showed that 202 acupoints were recorded,the clinical usage rate was 81.28%,the first 10 acupoints with highest clinical usage rate were Yangming of foot,Taiyin of foot,Shaoyin of foot,Yangming of hand,ST36,Taiyin of hand,Taiyang of foot,shaoyang of foot,BL40,Taiyang of hand. But meridian acupoints with highest clinical usage rate were ST36,BL40,KI2,KI1,ST45,BL10,LR1,ST42,SP3 and PC9.

Objective To evaluate the findings of computerized tomography (CT) imaging in patients with primary pulmonary fungal infections.Methods CT findings and clinical data of 18 cases of primary pulmonary fungal infections from 2004 to 2012 were retrospectively analyzed.The diagnoses of all patients were confirmed by pathology or serology.Results The CT of primary pulmonary fungal infections showed soft tissue density nodules in 15 out of 18 cases,and masses in 3 out of 18.By pathology or serological examination,there were 12 cases of Aspergillus infections,3 cases of cryptococcal infections and 3 cases of coccidioidomycosis.The CT findings of all of the 12 cases of Aspergillus infection showed quasi-circular shaped lesions,with lobulation and spiculation (6/12),bronchial through syndrome (3/12),the air crescent sign (6/12),or mediastinal/hilar lymphadenopathies (3/12).Six cases presenting air crescent sign were all diagnosed with primary pulmonary aspergillosis.Among 12 aspergillosis cases,6 cases underwent CT enhancement scan,among which 3 showed no enhancement and 3 showed slight enhancements.The CT findings of all eases of Cryptococcus neoformans infections were cauliflower-like shape,with lobulation,spiculation,and no focal point calcification or mediastinal/hilar lymphadenopathies.After enhancement,all of the lesions were enhanced heterogeneously.The CT findings of all the coccidioidomycosis were irregular shaped lesions with halo sign and mediastinal/hilar lymphadenopathies.All 3 cases of halo signs were diagnosed with primary coccidioidal infections.Conclusions The CT findings of primary pulmonary fungal infections have certain characteristics.Diagnosis could be made based on CT imaging together with clinical manifestations before pathological results are available.

BACKGROUND: Bone marrow mesenchymal stem cells(MSCs) have been investigated initially. Because both fat tissue and bone marrow are tissues originated from mesoderm, so whether MSCs could be obtained from fat tissue as well, which also have multi-lineage differentiation potential?OBJECTIVE:To investigate the basic biological characteristics of adipose MSC and its differentiation into osteoblast under given culture condition for the exploration of its feasibility as seed cell in bone tissue engineering.DESIGN: A randomized and controlled study based on cells.SETTING: Department of Orthopaedics of an Affiliated Hospital of a university.MATERIALS: The study was conducted in the Department of Orthopaedics of the Third Hospital of Peking University. Adipose MSC extracted from the fat tissue of Lewis rats was used as subject.METHODS: Adipose MSCs were obtained from inguinal fat pads of Lewis rat after digestion, which were induced into adipocytes and osteoblasts with adipose and osteogenesis induced culture mediums. The differentiations were examined with cytochemical staining, immuncytochemical staining and Western blotting.MAIN OUTCOME MEASURES: Morphological and biological characteristic of adipose MSCs, and the specific mark of osteoblast after induction.RESULTS: Adipose MSCs were obtained from rat adipose tissue culture,which appeared fibroblast-likely in the culture in vitro, and could stably proliferate and passage in vitro. Primary adipose MSCs could differentiate into adipocytes spontaneously, and passaged cells could form fat drop under the reaction of insulin and dexamethasone, and then differentiate towards adipocytes after the expression of peroxidase proliferation activated receptor ?(PPAR-?) enhanced. There was significant difference between induction group and control group in alkaline phosphatase(ALP) activity detection under the induction of dexamethasone, ascorbic acid, and ?-sodium glycerophosphate(P ＜ 0.01) . Calcium node appeared in yon Kossa staining. Result of osteopontin (OPN) immunocytochemcial staining was positive,and OPN expression was detected by Western blotting after induction.CONCLUSION: MSCs with multi-lineage potential can be obtained from rat adipose tissue, and differentiate into adipocytes and osteoblasts after inductions. Therefore, adipose MSCs can possibly be served as one of optimal seed cells for bone tissue engineering.

nclude positive vascular remodeling,low plaque density,spotty calcification,and eccentric stenosis.

Objective To assess quantitative and subjective image quality in computed tomography pulmonary angiography (CT-PA)with dual-energy subtraction methods,and to select the best dual-energy subtraction method.Methods 30 consecutive patients underwent CTPA using a single tube,fast voltage switching technique.One set of routine poly-chromatic images (RPI),two sets of monochromatic images with different optimal contrast-to-noise ratios (OCNR)and three sets of dual-energy subtraction images (DE-SI)were obtained by a dedicated workstation with dual-energy software (AW4.5 Advantage WS;GE Healthcare).For all the six sets of images,CNR and the score of global subjective image quality were calculated.Results DESI 3 got the highest CNR,and DESI 1 got the next high CNR.In global subjective image quality,DESI 1 got the highest score.However,when compared with DESI 2,no significant difference was found.Conclusion CTPA with dual-energy subtraction technique is feasible.DESI 1 affords the best bal-ance between quantitative analysis and subjective evaluation compared with other sets of images.

Objective To explore the accuracy of high definition computed tomography angiography (HDCTA)in the evaluation of coronary in-stent restenosis.Methods 93 patients with 159 implanted coronary stents who underwent both HDCTA and CAG were included in the study.The sensitivity,specificity,positive predictive value (PPV),negative predictive value (NPV)and diag-nostic accordance rate of HDCTA were calculated.The imaging quality was analyzed by visual estimation.Possible factors that in-fluenced the diagnostic accuracy of HDCTA were evaluated,which included stent location,stent diameter and heart rate in the pa-tients with left anterior descending branch stents.Results Restenosis was found in 21 stents by CAG and 19 stents by HDCTA.The false positive and false negative were 5 and 3,respectively.Sensitivity,specificity,PPV,NPV and diagnostic accordance rate were 90.5%,96.4%,79.2%,98.5% and 95.6% respectively.The image quality was 4 score in 75 stents (47.1%),3 score in 33 (20.8%),2 score in 27 (17%),≤1 score in 24 (15.1%).The image quality of proximal segments,large stents (≥3.0 mm)and slow heart rate (<66 beast per minute)was significantly better than that of distal segments,small stents (<3.0 mm)and fast heart rate (≥6 6 beast per minute).Conclusion HDCTA is a convenient,efficient and non-invasive method for follow-up after im-plantation of the coronary artery stents.

2 cm).Immunohistochemistrical stain slice of operative specimen showed a lots of vascular endothelial cells and small vessels,which correlated with the tumor angioimaging area on CT images.The sensitivity,specificity,and positive predictive valve of tumor angioimaging in the lung cancers were 47.2%,91.3%,and 95.5%,respectively.Conclusion The “tumor angioimaging” sign can be regarded as another specific feature in peripheral lung cancer with contrast CT.

Purpose To investigate the diagnostic value of the arrhythmogenic right ventricular dysplasia (ARVD) using multi-slice spiral CT (MSCT). Materials and Methods Thirty-four patients who were suspected as ARVD received right ventricular radiography, including 16 ARVD patients and 15 non-ARVD patients regarded as control group. The structural and shaped change of heart on reconstructed images of long axis, short axis and four cavity surface and analyze were observed, and MSCT features of right ventricular radiography characteristics were analyzed for ARVD patients. Results Sixteen cases of ARVD were correctly diagnosed by MSCT, and 14 cases had fatty infiltration including 11 cases of apex of heart, 8 cases of inferior wall, 5 cases of anterior wall, 5 cases of anterior wall of funnel area, 3 cases of diagram, 4 cases of papillary muscle, 6 cases of muscular trabecula and moderator band and 1 case of whole right ventricular free wall. Five cases showed scallop sign, 16 cases excessive trabecular change, 11 cases thinned changes, and 16 cases enlarged changes of right ventricular wall. Conclusion MSCT features of right ventricular for ARVD have relative diagnostic characteristics, and the scallop sign and excessive trabecular change of right ventricular wall are its specific imaging characteristics.

OBJECTIVETo investigate clinical effects of calcaneal fracture with closed reduction and minimally invasive plate fixation assisted with bidirectional distractor distraction.

METHODSFrom September 2015 to October 2016, 11 male patients(13 feet) with calcaneal fractures treated with bidirectional distractor distraction assisted with minimally invasive plate fixation were retrospectively studied. They were aged from 24 to 57 years old with an average of 36.4 years old;8 feet were type IIand 5 feet were type III according to Sanders classification. Postoperative incision, fracture healing, Böhler angle, Gissane angle were observed and Maryland scoring system was used to evaluate clinical effects.

RESULTSAll fractures healed well without incision inflammation and incision disunion. All patients were followed up from 12 to 15 months with an average of 13.5 months. Böhler angle were improved from (9.6±7.3)° before operation to (20.2±4.6) ° at 1 year after operation, and had statistical meaning; Gissane angle increased from (92.7 ±8.5)° before operation to (121.7 ±7.6) ° at 1 year after operation. Maryland score at 1 year after operation was 88.79±8.25, and 11 feet got excellent results and 2 feet moderate.

CONCLUSIONSBidirectional distractor distraction assisted with minimally invasive plate fixation could effectively fix calcaneal fractures, reduce postoperative complications, and get satisfied results of postoperative images and functional recovery. It is one of effective methods for treating Sanders II and III calcaneal fractures.