Objective To evaluate the function imaging ability and dose for whole organ imaging of Aquilion ONE 320 Slice CT.Methods Aquilion ONE 320 Slice CT adpoted wide volume imaging mode to acquire 4D dynamic imaging results,then the expose dose was compared with that of 64 slice CT.Results 320 slice CT,with advantages in dynamic volume imaging and function imaging when compared with traditional spiral CT,restrained its organ time resolution to 0.35s,and thus the acquisition time and exposure dose was decreased.The motion artifact was reduced and image quality was enhanced.Conclusion 320 slice dynamic volume CT,with zero phase delay,can realize CT 4D function imaging.

0.05).Tongue base resection(P=0.0164)and different methods of reconstruction(P=0.0011)had significant effects on the swallowing function.CONCLUSION The main factors of influencing swallowing function after resection of oral and oropharyngeal cancers are presence or absence of tongue base resection and different methods of reconstruction.

Objective To explore the epidemic conditions of rheumatic fever (RF) with a simple method at some regions.Methods Antistreptococcal DNase B test microtiter method was adopted to detect human sera antibody in natural populations who are responsible to RF.All 216 schoolchildren aged 10～12 years old were chose by the random cluster sampling.The schoolchildren′s serum antibody against DNase B in each season from september 1988 to August 1989 was detected,and compared with antistreptolysin “O” (ASO);furthermore,5 different regional schoolchildren′s serum antibody to DNase B was tested, and 100 schoolchildren aged 10～13 years old were chose in every region.Meanwhile,the RF incidence of 5～18 year schoolchildren was investigated for 4 years,and approximately 364 915 person times were inquired.All the results of the anti DNase B and ASO were compared with the schoolchildren′s RF incidence.Results ① The levels of the anti DNase B were higher during fall,winter and spring seasons,and lower in summer,which were coincided with the RF incidence,and linear relation was very good ( r =0 913, P

Objective To investigate whether determination of CEA and CA19-9 levels in EUS-FNA pancreatic samples can be useful in detecting pancreatic adenocarcinoma and differentiating pancreatic adenocarcinoma from chronic pancreatitis.Methods Levels of CEA,CA19-9 were examined by chemiluminescence immunoassay analysis in EUS-FNA specimens obtained from 25 patients with chronic pancreatitis and 65 patients with pancreatic adenocarcinoma,and compared with those of their peripheral serum.Twelve patients with suspected pancreatic adenocarcinoma while with negative EUS-FNA pathological findings were followed up.Results First,the levels of CEA,CA19-9 in EUS-FNA specimens were higher than those in serum obtained from same patient with pancreatic adenoearcinoma(P＜0.01),but there was no difference in these variables of EUS-FNA specimens and serum obtained from patients with chronic pancreatitis.Second,in the EUS-FNA samples,the levels of CEA,CA19-9 in pancreatic adenocarcinoma were higher than those in chronic pancreatitis(P＜0.01).On the contrary,in serum samples,there was no significant difference in CEA level between pancreatic adenocarcinoma and chronic pancreatitis(P=0.079).CA19-9 level in serum of Dancreatic adenocarcinoma was higher than that of chronic pancreatitis(P＜0.01). Finally,during the follow-up,of all the 12 patients with suspected pancreatic adenocarcinoma,10 patients were diagnosed as having pancreatic adenocarcinoma and 2 patients as having chronic pancreatitis.Diagnostic accuracy of serum CEA and CA19-9were 30%and 70%respectively,while sensitivity of CEA and CA10-9 determined by EUS-FNA was both above 90%.Conclusion The method of measuring CEA and CA19-9 levels in samples obtained by EUS-FNAcan be useful in detection of pancreatic adenocarcinoma and differentiation of malignant pancreatic tissue from chronic pancreatitis.

Objective To summarize the clinical experience of reconstruction by using free flap after operation of head and neck tumor. Method A retrospective review was performed of 36 cases who were operated with free flap to reconstruct postoperative defects in head and neck tumor from March 2007 to March 2009, 28 cases repaired by free anterolateral thigh(ALT) flap, 8 cases repaired by free forearm flap. Results The operations of 26 cases repaired with free ALT flap were successful, 2 cases were necrosis. Vascular pedicle flap was 8-18 cm long, mean 12.5 cm, 25 cases were muscle skin perforator, 3 cases were muscle clearance wear. Eight cases of free forearm flap were successful. All of 36 cases recovered well. Conclusions The successful rate of free flap is perfect, and there is no serious complication in doner-site. The flap can be shaped into various forms. Free flap is an ideal measure to reconstruct hypopharynx and to preserve the laryngeal function.

Objective To investigate the effects of different energy,frequency and time of holmium laser on the ablated porcine pancreas in vitro,and to establish an ablation regression equation of holmium laser,in order to provide the experiment foundation for EUS-guided holmium laser ablation of pancreatic carcinoma.Methods According to pilot study,the range of energy,frequency and time of holmium laser was determined,and five values were chosen for the individual three parameters,therefore,a randomize table including 125 combinations (sample capacity) according to the various combinations of every parameter was constructed,then every combination of holmium laser was used for porcine pancreas ablation in vitro.EUS was applied to determine the ablation site and measure the ablation extent,and pathological evaluation was performed.Results Sonographic images showed hyperechoic cloudy area in the ablation site.It was observed that the ablation body was an approximately oval area,the middle part was carbonized area,and the out layer was grey-white necrosis area.Microscopic examination showed there was pool-like cavity in the middle of ablation site,and it was surrounded by coagulation necrosis of pancreatic tissue,and the out layer was inflammatory cells infiltration.Normal pancreatic tissue was found in the margin.The energy,frequency and time of hoimium laser were positively associated with the ablation extent,and the frequency was the main factor,followed by time and energy.The difference was statistically significant (P＜O.O1).The best combination was 25 s,25 Hz,1.8 J.An ablation regression equation was created,which was In (ablation volume) =β0 + β1 × time + β2 × frequency + β3 × energy.Conclusions The holmium laser can produce obvious tissue necrosis in porcine pancreas in vitro; the established holmium laser ablation regression equation can be the guidance for clinical practice.

Objective To evaluate the safety and efficacy of direct celiac ganglion irradiation with 125I seeds for pain relief secondary to advanced pancreatic carcinoma (PC).Methods This study enrolled 23 consecutive patients who had moderate to severe pain resulting from advanced PC.All patients underwent EUS-guided direct celiac ganglion irradiation with 125I seeds.Follow-up was conducted at least once weekly until death.Blood parameters,Visual Analog Scale (VAS) score,mean analgesic consumption,and complications were evaluated during follow-up.Results All patients successfully underwent implantation at one attempt.The mean number of seeds implanted in the celiac ganglion per patient was 4 (range 2-6).Immediately after the procedure,pain relief and analgesic consumption showed no significant changes compared with preoperative values.Six patients (26％) reported pain exacerbation.Two weeks later,the VAS score and mean analgesic consumption were significantly less than preoperative values.No procedure-related deaths or major complications occurred.Conclusion EUS-guided direct celiac ganglion irradiation with 125I seeds can reduce the VAS score and analgesic drug consumption in patients with unresectable PC.

Objective To investigate the feasibility,safety,and short term efficacy of endoscopicultrasound guided radiofrequency ablation (EUS-RFA).Methods Three patients with advanced,inoperable pancreatic carcinoma underwent EUS-RFA.Under the guidance of EUS,a 22 gauge fine needle was punctured into the pancreatic carcinoma,and 1 Fr radiofrequency (RF) catheter was placed into the cancer through this 22 gauge needle.RFA was applied at 10 watts for 2 minutes,and then 15 watts for another 2 minutes.The second needle's tract was selected and punctured about 1 ～ 1.5 cm apart from the first needle tract,and the ablation was repeated.Results The average age of these 3 patients was 63 years old.Two patients were diagnosed to have pancreatic tail cancer and one was pancreatic body cancer,and the mean diameter of the tumor was 3.6 cm.Pre-operative EUS-FNA confirmed the presence of malignant cells.EUS-RFA was performed three times at an interval of 2 weeks in the first patient and one time in the last two patients.The average session of EUS-RFA of each lesion was 3.67 times.After 2 weeks,EUS showed that the diameter of the lesions was reduced by 13.9％ on average.There were vacuolar degenerations of variable sizes in those lesions.The serum level of CA19-9 was averagely decreased by 46.5％.Abdominal pain was not obviously aggravated.There were no episodes of pancreatitis,perforation or bleeding within 48 hours after the procedure.The mean follow-up time was 49 days,and no complications occurred.Conclusions EUS-RFA can reduce the diameter of pancreatic carcinoma and decrease the serum level of CA19-9,and it is feasible and safe.

Objective To assess the safety of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA)of pancreatic lesions.Methods Patients who underwent EUS-FNA of a pancreatic lesion between January 2005 and June 2007were studied retrospectively.Possible risk factors were assessed by using logistic analysis.Results In 119 patients who underwent pancreatic EUS-FNA,mild acute pancreatitis were observed in 1(0.84%)patient after the operation.No complication occurred in 12 patients with regional portal vein hypertension.Nine patients(7.6%)showed hyperamylasemia 3 h after the procedure,rangeing from 197 to 835 U/L,with an average of(327±200)U/L.Blood amylase level kept increasing 24 h postoperatively in 6 cases of the 9.Logistic regression analysis showed past history of acute pancreatitis,gender,needle size,number of puncture,cystic foci,preoperative blood amylase level and location of foci would not possibly be the risk factors of hyperamylasemia.Conclusion Incidence of complications after EUS-FNA is 0.84%,and the occurrence rate of hyperamylasemia is 7.6%,indicating,EUS-FNA is a safe procedure.

Objective To investigate the relationship between alcohol and smoking and the development of pancreatic calcification in chronic pancreatitis (CP) in China. Methods The patients were divided into two groups according to the presence of pancreatic calcification at admission and the data were analyzed; furthermore, the discharged patients without pancreatic calcification were divided into two groups as newly diagnosed pancreatic calcification group and persistent non-pancreatic calcification group. Logistic regression and Cox proportional-hazards model was used for multivariate analysis of the risk factors for pancreatic calcification. Results From January1997 to July 2007, 449 patients with CP were enrolled and followed up successfully. 248 patients presented with pancreatic calcification at admission; among the 201 patients presented without pancreatic calcification, 13 patients developed pancreatic calcification after discharge. Patients with pancreatic calcification had a young age at onset, long CP history, higher incidence of diabetes mellitus and diarrhea. Age at onset ≤ 40, alcohol intake over 20 g/day, and diabetes mellitus and diarrhea were risk factors for pancreatic calcification. The only risk factor of development of pancreatic calcification after discharge was excessive alcohol intake (OR: 3.2). Conclusions Alcohol intake increased the risk of pancreatic calcifications, suggesting the patients abstain from alcohol intake. Further studies are necessary to clarify the role of smoking.