The application of transesophageal echocardiography (TEE) in perioperative monitoring was introduced,and its involvement in non-cardiac surgery was described.The advantages and disadvantages of TEE were analyzed when applied to cardiac and non-cardiac operations for congenital heart disease,coronary disease,vascular heart disease,aorta disease and etc.The abuse of vasoactive drug or fluid is avoided due to subjective evaluation on cardiac function and volume load.TEE facilitates the anesthetist in diagnosis and evaluation of the patient with heart diseases,and the surgeon in immediate assessment of the operation,which can be used for real-time monitoring of cardiac function and hemodynamics.

Objective:Comparing the expression of tumor necrosis factor receptor 1 (TNFR1) in decidua tissue and soluble tumor necrosis factor receptor 1(sTNFR1) in serum of normal pregnancy and spontaneous abortion mice to probe the relationship between TNFR1 and unexplained spontaneous abortion.Methods:The abortion-prone CBA?DBA/2 mating was established as the model of spontaneous abortion and nonabortion-prone CBA?BALB/c matings were used as the model of normal pregnancy.Immunohistochemistry method(SABC) was employed to detect the expression of TNFR1 in decidua tissue at the day 9 of gestation.The level of sTNFR1 in serum at the same time was determined by ABC-ELISA.Results:Compared with normal pregnancy model,the expression of TNFR1 in decidua tissue of spontaneous abortion was significantly increased (P

Objective To assess the value in detecting the tracheobronchial tree invasion by central lung cancer (CLC)using MSCT axial images and 4 kinds of images post-processed techniques.Methods 38 cases with CLC identified by fibrobrochoscopy or operation were scanned using MX8000 scanner with slice thickness of 3.2 mm, overlapping interval of 1.6 mm, pitch of 1.0. Multiplanar reformation(MPR), shaded surface display(SSD), volume rendering (VR) and virtual endoscopy(VE) were performed in all cases. Two radiologists assessed the invasion of tracheobronchial tree by CLC together.The imaging findings were compared with the data of surgery in 12 cases who were undergone operation.Results 38 cases of CLC, 0 grade to Ⅳ grade were assessed in 0,8,14,11 and 5 cases respectively by MSCT axial images, while in 0,10,11,12 and 5 cases by MSCT post-processing images. The concordance rate was 75% for MSCT axial images(n=9), and 100% for MSCT post-processing images(n=12) among 12 cases performed operation(? 2 test,? 2=6.0,P

Objective To improve the diagnosis and treatment of pulmonary lymphangiomyomatosis (PLAM). Methods The clinical data of 1 PLAM case in our hospital was analysed, along with a review of the related literatures.Results PLAM was a rare diffuse interstitial plumonary disease of unknown cause, which was oiraracterized by recurrent spontaneous pneumothorax shortness of breath (dyspnea) with physical activity, haemopthsis and chylothorax. Radiological appearances were extensive bilateral linear pattern, and honeycomb pattern in the end. High resolution CT scan (HRCT) showed multiple thin walled cysts distributed evenly throughout the bilateral lung fields with normal intervening lung parenchyma. Pathological characters were abnormal, pervasice multiplication of smooth muscle of cell in and around the small airway, lymphatic and small blood vessels. Immunohistochemical test showed HMB45(+).Conclusion It should be considered the probability of PLAM when women of childbearing ages have some clinical manifestations as follows, the increasing dyspnoea that can not be relieved similar to emphysema, high- resolution CT scan (HRCT) shows multiple thin walled cysts distributed evenly throughout the bilateral lung fields with normal intervening lung parenchyma, and recurrent pneumothorax or chylothorax. The optimal confirm diagnostic method is lung tissue biopsy.

A well Web-based teaching supplementary system is beneficial for saving teaching resources,arousing students’enthusiasm for study.but there is no the emotion exchange between teachers and students which exists in traditional class.Web-based supplementary teaching is an important supplementary method for medical morphology courses,but it can not replace the traditional teaching method.Combining them each other is needed for raising teaching quality.

Purpose To investigate the value of dual-source CT with dual-energy virtual non-contrast imaging in the diagnosis of cervical lymph node disease. Materials and Methods The dual-energy scan data of 126 lymph nodes from 50 patients confirmed pathologically were reviewed. The difference of average CT value, signal to noise ratio, contrast to noise ratio, image subjective assessment and lesion detectability between virtual non-contrast imaging and conventional non-contrast scan were analyzed. The radiation dose of virtual non-contrast imaging and real non-contrast imaging of cervical lymph node were also compared. Results ①The consistency of virtual plain scan combined with dual-energy contrast imaging in the diagnosis of six typical pathological types were all satisfactory (Kappa>0.7, P<0.01), and the detection rate of non-specific lymphadenitis, lymphomas and lymph node metastasis of thyroid carcinoma was higher among the six types (93.1%, 86.7% and 100.0%, respectively, Kappa=0.983, 0.893; P<0.01), and had the highest detection rate of lymph node metastasis of thyroid carcinoma (100.0%, Kappa=1.000, P<0.01). ②There was no significant difference among the average CT, signal to noise ratio and contrast to noise ratio of conventional scan and virtual non-contrast imaging during arterial phase and venous phase (H=3.125, 4.374, 4.037;P>0.05).③ Compared with conventional enhanced scan, dual-energy phases reduced radiation dose by about 19%. Conclusion Dual-energy virtual non-contrast imaging combined with contrast imaging can provide clear images in the diagnosis of enlarged cervical lymph nodes and reduce radiation dose of subjects, thus can be expected to replace real scan.

Objective To investigate the diagnostic value of dual energy CT for small central cervical metastatic lymph nodes in patients with papillary thyroid cancer.Methods The data of 43 patients with thyroid papillary carcinoma confirmed by pathology were retrospectively analyzed.All of the patients underwent dual energy CT scan before operation.The short diameter,iodine concentration and normalized iodine concentration (NIC) of enhanced arterial and venous phases and the slope of the energy spectrum curve were analyzed between metastatic central cervical lymph nodes and non-metastatic lymph nodes.ROC curve was used to analyze the diagnosis efficacy of iodine concentration and NIC for metastatic lymph nodes of thyroid carcinoma.Results Totally there were 119 lymph nodes in 43 patients included 55 thyroid papillary carcinoma metastasis lymph nodes (metastasis group) and 64 non-metastatic lymph nodes (non-metastasis group).There was significant differences of the mean short diameter of the lymph nodes between the two groupos (t=-2.20,P=0.03).In arterial phase,the average iodine concentration of metastasis group and non-metastasis group were (2.93±1.62)mg/ml and (2.17±1.09)mg/ml;the NIC were 0.33±0.21 and 0.19 ± 0.12;and the slope of the energy spectrum curve were 0.79±0.43 and 0.63±0.37 respectively.In venous phase,the average iodine concentration of metastasis group and non-metastasis group were (2.68± 1.54) mg/ml and (2.17 ± 1.01) mg/ml;the NIC were 0.51 ± 0.18 and 0.43 ± 0.15;the slope of the energy spectrum curve were 0.54 ± 0.42 and 0.62 ± 0.39 respectively.The iodine concentration and NIC in both phases and the slope of spectrum curve in arterial phase had statistical differences between the metastasis and non-metastasis groups (all P＜0.05).ROC curve showed that the area under the curve (AUC) of iodine concentration and NIC in the diagnosis of metastatic lymph nodes were 0.62 and 0.73 in arterial phase,respectively.And the AUC of iodine concentration and NIC were 0.61 and 0.63 in venous phase,respectively.Conclusion There are differences of iodine concentration,NIC in arterial and venous phases and curve slope in arterial phase of dual-energy between malignant and benign central cervical lymph nodes in thyroid papillary carcinoma.Dual energy CT technology is helpful in identifying of metastatic from non-metastatic small central cervical lymph nodes.

Test is an important way for getting feedback from students about teaching. The traditional examination is not suitable for the requirements of modernization teaching.Web-Based Course Examination of practice pathology simplifies the process of traditional examination greatly. It is one of the important means in modernization teaching.

Objective To discuss the clinical values of virtual endoscopy (VE) using multislice computed tomography (MSCT) in diagnosis of the aorta and iliac artery diseases.Methods MSCT angiography in 36 cases suspected of the aorta and iliac artery diseases and 40 cases underwent abdominal examination were performed, then all CT virtual endoscopy (CTVE) were obtained at the vessel with suspected lesions on work-station, and the relations between the quality of images and scanning parameters were observed.Results All internal and dual-cavity were seen in 10 cases of aortic dissection; enlarged cavity of aneurysm were showed in 16 aortic aneurysms. Calcification plaques were displayed in 48 cases. One endograft and one postoperative aorta were seen the morphology and the location of stenosis. One case of iliac artery obstruction was displayed obstructive cavity on the image of CT virtual endoscopy.Conclusion The quality of CT virtual endoscopy is related to the scanning technique,scanning parameters, motion aritiact. CT vitrtual endoscopy is the important complementary to maximum intensity projection, multiplannar reformation, surface shadow display, and axial images, and has high value in the diagnosis, treatment, and follow-up of the aortic diseases

Objective To explore the value of spectral imaging technique in dual-energy CT in differential diagnosis of the metastatic lymph nodes in thyroid carcinoma,squamous cell carcinoma metastatic lymph nodes and lymphoma in the neck.Methods In 30 patients with pathologically confirmed with a total of 79 cervical lymph nodes enlargement which were using dual energy scan .Then observed the change trend of the spectrum curve and comparison the three kinds of lymph node energy spectrum curve’s slope.Results In the 79 lymph nodes,the metastatic lymph nodes in thyroid carcinoma were twenty-three,squamous cell carcinoma metastatic lymph nodes were twenty-four and lymphoma were thirty-two.From 60 to 180 keV,with the increase of keV values,the three kinds of malignant lymph nodes of the corresponding CT value decreasing and the higher the keV value,the CT value decrease magnitude was small,and the spectrum curve was〞drop type〞.The slope spectrum curve of the metastatic lymph nodes of thyroid carcinoma in arterial phase and parenchymal phase were maximum,which were 1.23±0.41 and 0.85±0.33,respectively.The slope spectrum curve of lymphoma in arterial phase and parenchymal phase were least,whcih were 0.40±0.16 and 0.47 ±0.09.The slope spectrum curve of the squamous cell carcinoma metastatic lymph nodes in arterial phase and parenchymal phase were 0.88±0.10 and 0.62±0.28.The energy spectrum curve slope of the three kinds of malignant lymph nodes have statistical significance.Conclusion The energy spectrum curve slope of arterial phase and parenchymal phase has some significance lymph node metastasis of in thyroid carcinoma,the metastatic lymph nodes and lymphoma in the neck.