Objective To evaluate the influence of lesion size and depth on the diagnostic accuracy and the rate of pneumothorax in patients undergone CT-guided transthoracic aspiration biopsy for pulmonary lesions.Methods CT-guided percutaneous transthoracic biopsy was performed in 398 patients that had surgical resection or clinical follow-up.According to lesion size,lesions were divided into≤2 cm,2～4 cm and ≥4 cm.Lesion depth was measured from the pleura surface to the edge of the lesion.This depth was classified in three categories:≤1 cm,1～3 cm and ≥3 cm.Comparison of the diagnostic accuracy and the frequency of pneumothorax in different size and depth of lesion was performed.Results(1)The overall diagnostic accuracy of CT-guided percutaneous needle aspiration biopsy was 83.2%(331/398).Pneumothorax occurred in 58(14.6%)of 398 biopsy;(2)The diagnostic accurate rate in different size of lesion was 73.3%(44/60),81.5%(176/216)and 91.0%(111/122)respectively,?2=9.91,P0.05.The occurred rate of pneumothorax in different depth lesion was 2.8%(4/141),14.8%(21/142)and 28.7%(33/115),?2=34.03,P

Objective To explore the safety and efficacy of minimally invasive percutaneous nephrolithotomy (MPCNL) for pediatric upper urinary tract calculi. Methods We retrospectively reviewed the clinical data of 35 pediatric patients with upper urinary tract stones treated by MPCNL in our hospital. The series consists of 29 boys and 6 girls with a mean age of 8.5 years (4 to 13 years). Among the 35 cases,7 children had proximal ureteral stones and 28 showed renal stones; 2 of the patients were complicated with ureteropelvic junction obstruction (UPJ). Results Totally 31 (88.6%) of the 35 cases were cured by MPCNL. The one-session success rate was 87.1% (27/31),and two-session success rate was 75% (3/4). Four patients were converted to open surgery because of UPJ-caused ureteral stenosis under the level of the calculi or failure in percutaneous renal puncture. Conclusion MPCNL is safe and effective for renal calculi and proximal ureteral calculi in children.

OBJECTIVE:To investigate the situation of adverse drug reactions(ADR) in our hospital.METHODS:In this retrospective study,a total of 270 ADR cases reported between 2005 and 2007 in our hospital were analyzed statistically in respect of the age and sex of patients,drug categories and clinical manifestations etc.RESULTS:Of the 270 ADR cases,patients aged ≤18 years or ≥50 years took the highest proportion(51.1% for the two age groups).The ADR were chiefly manifested as lesion of skin and its accessories,followed by the reaction of digestive system.90.74% of the ADR cases were induced by injections,and 191 cases(70.74%) were induced by antibiotics.CONCLUSION:ADR worth the highest alert in the clinic.

Objective To investigate the factors influencing the diagnostic accuracy in CT-guided percutaneous transthoracic aspiration biopsy of lung lesions. Methods CT-guided percutaneous transthoracic biopsy was performed in 435 patients with surgical pathologic confirmation or clinical follow-up.Univariant statistical analysis and multivariant stepwise Logistic regression analysis were used to study the influence of lesion-related factors(benignancy or malignancy,size,location,depth,presence of cavity),procedure factors(laser-guidence,position of patient) and patient-related factors(sex,age,presence of emphysema);with the accuracy of the diagnosis. Results ① 289 lesions were diagnosed as malignant ones and 146 as benign ones.The accuracy of CT-guided biopsy was(83.4%)(363/435).Univariant analysis showed that the diagnostic accuracies for malignant and benign lesions were(88.9%)(257/289) and(72.6%)(106/146),respectively(?~2=(18.71),P=(0.00002)).Laser-group was superior to non-laser group((88.4%) versus(80.9%),respectively,?~2=(4.00),P=(0.0456)).Mean diameters of lesions in correct diagnostic group and non-correct diagnostic group were(3.78)?(1.64) cm and(3.02)?(1.26) cm,respectively((F=)(13.79),P=(0.0002)).②Multivariant stepwise Logistic regression analysis showed that among the various factors influencing the final benign or malignant diagnoses(Wald ?~2=(14.01),P=(0.0002)) and using laser-guidence(Wald ?~2=(3.92),P=(0.0477)) were significantly associated with the diagnostic accuracy. Conclusions Final correct diagnoses(benign,malignant) are closely related to the application of laser-guidence for determining the diagnostic accuracy in CT-guided transcutaneous thoracic needle aspiration biopsy.

Objective To prospectively assess the therapeutic procedure and outcome of MR-guided percutaneous sclerotherapy in patients with venous vascular malformations of the extremities. Methods Fifty-seven percutaneous sclerotherapy treatments were performed under MR guidance in 28 patients with venous vascular malformation. Assessment was conducted to analyze (1) individual success of therapy, (2) improvement of clinical symptoms, ( 3 ) occurrence of complications, (4) volume changes at follow-up examinations, (5) contrast-to -noise ration (CNR) changes. Paired-t test was used to compare the volume and CNR of pre- and postintervention. Results All MR-guided percutaneous sclerotherapy were performed successfully and without serious complications. Individual predominant symptoms were improved, especially about the pain and functional impairment. The mean lesion volumes of pre- and post-intervention were (56. 8 ± 11.7 ) cm3 and ( 27.0 ± 7.2 ) cm3 respectively, which showed significant difference ( t = 8. 90, P < 0. 01 ). The percentage of volume shrinkage ranged from 28. 5% to 74. 4% [ mean ( 54. 4 ± 5. 3 ) % ]. The CNR of the pre and post-interventional images were 21.9 ± 2. 0 and 8.4 ± 0. 9 respectively. There was significant difference(t = 21.76, P < 0.01 ) between them, and the percentages of CNR decrease were 40.0% to 78. 0% [ the mean(61.0 ± 3.6)%]. Conclusion MR-guided sclerotherapy of venous vascular malformations of the extremities is a safe and efficient technique.

Objective To investigate nontraumatic avascular necrotic of the femoral head with different etiology whether or not having similar MRI and pathologic findings.Methods MRI features of nontraumatic avascular necrosis of the femoral head caused by differant etiology in 98 patients(152 hips) were retrospectively analysed.The causes of osteonecrosis of the femoral head included steroid-induced in 49 patients(86 hips),alcoholic in 18 patients(25 hips) and idiopathic cause in 31 patients(41hips).Gross section and pathologic examinations were performed on 34 femoral heads obtained after total hip replacement from 25 patients.Results Osteonecrosis of the femoral head with different etiology occurred at the anterior superior part of femoral head.The necrotic zones both on pathological gross section and MRI were consisted of cartilage,necrotic focus,proliferative zone and normal bony zones along the lesions.The proliferative zone surrounded necrotic area was low signal intensity on both T1WI and T2WI.There was correlations between localized MRI signal behavior and specific histopathologic features of femoral head osteonecrosis.Conclusion Nontraumatic osteonecrosis of the femoral heads associated with different etiology have similar characteristics on both MRI and pathology

Objective To evaluate MR imaging of peripheral nerve tumors of the lower extremity. Methods MR imaging of peripheral nerve tumors of the lower extremity in five cases proved by surgery and pathology were retrospectively reviewed. In all patients, routine scanning was performed in axial, coronal, and sagittal planes, including T 1-weighted and T 2-weighted images. In two patients (schwannomas), T 1WI were obtained following intravenous injection of Gd-DTPA. Results There were four schwannomas (three benign and one malignant) and one malignant neurofibroma. Tumors arose at the following sites: leg ( n =2), popliteal region ( n =1), thigh ( n =1), and femoral region ( n =1). On T 1WI, tumors generally showed isointensity (two benign schwannomas) or lower-medium signal intensity to adjacent muscle with minimal inhomogeneity (one benign schwannoma, one malignant schwannoma, and one malignant neurofibroma). On T 2WI, tumors demonstrated inhomogeneous high signal intensity in all five patients. The target sign with peripheral hyperintense rim and central low intensity was see in two benign schwannomas on T 2WI. Conclusion MRI is useful in defining the location and extent of a lesion and in assisting the surgical planning. The target pattern appears to be a useful sign in the diagnosis of peripheral nerve tumors.

Objective To evaluate MR imaging of transient osteoporosis.Methods MR imaging of transient osteoporosis in eight patients was retrospectively reviewed.In all eight patients,routine scanning was performed in axial and coronal planes,including T_1-weighted and T_2-wighted images.Of the eight patients,five were male and three were female,with the age ranging from 12 to 70 years.Neither of the women was pregnant when they visited our hospital.Results The bilateral hips were affected in seven patients,the left shoulder in one.The MR images demonstrated low signal intensity in all eight patients on T_1WI,and normal signal intensity (2 cases),medium-high signal intensity (3 cases),or high signal intensity (3 cases) on T_2WI.The bone marrow edema (BME) pattern involved the acetabulum (one hip),both the femoral head in 5 hips,the femoral neck and the intertrochanteric region through the upper femur in 7 hips,and the upper humerus in one.A small joint effusion was observed in six hips on T_2WI.Conclusion MRI is useful in defining the location and extent of transient osteoporosis.

Objective To investigate the clinical effects of Compound Biejia Ruangan Tablet (CBRT) combined with entecavir in patients with chronic hepatitis B with hepatic fibrosis.Methods Totally 92 cases of patients with hepatic fibrosis of chronic hepatitis B in Ankang people's hospital from January 2013 to May 2016 were divided into observation group (n =45) and control group (n =47),patients in observation group were treated with CBRT combined with entecavir,and patients in the control group were treated with entecavir.Treatment was for 48 weeks.The liver function,liver fibrosis,serum inflammatory factors,and adverse reactions were compared between two groups.Results After treatment,the ALT,AST,TBIL,and ALB/GLB levels of two group were significantly lower than those before treatment (P ＜ 0.05),but there was no significant difference between two groups after treatment.After treatment,the PCⅢ,IV-C,HA,LN,IL-6,IL-4,IL-10,and TNF-α levels of two group were significantly lower than those before treatment (P ＜ 0.05),and the PCⅢ,IV-C,HA,LN,IL-6,IL-4,IL-10,and TNF-α levels of observation group were significantly lower than those of control group (P ＜ 0.05);there was no statistically significant difference in the incidence of adverse reactions between two groups (P ＜ 0.05).Conclusion CBRT combined with entecavir is safe and effective to treat liver fibrosis of chronic hepatitis b,and it could significantly improve liver function,improve the degree of liver fibrosis,and reduce the level of serum inflammatory factors.

Objective To evaluate the feasibility, safety, and efficacy of CT-guided permanent iodine-125 implantation for malignant tumors.Methods Thirteen lesions in 10 consecutive patients with malignant tumor were treated with CT-guided iodine-125 permanent implantation brachytherapy, of which four cases were primary unresectable carcinoma and six cases were metastases. There were 4 males and (6 females,) the mean age was 56.9 years (range 54 to 62 years). Based on the CT imaging within two weeks before the implantation of the seeds, a computer-based treatment planning system was used to determine the optimal seed distribution. Subsequent CT-guided needle placement and seed implantation were carried out. Post-implant CT scans were performed immediately and five to ten months after the implantation in all cases to assess seed distribution, complication, and curative effect. Results CT-guided iodine-125 permanent implantation was accomplished smoothly in all cases. This technique offered a better seed placement. The number of seeds implanted in one lesion was 1 to 44 (mean 18.6). No acute complications and late toxicity related to the implantation were observed. Pain relief was obtained in all four patients (100%) presenting with pain. Follow-up CT demonstrated that 3 of 13 lesions disappeared completely, eight lesions diminished, and the remaining 2 lesions had no significant change in size. Mean lesion size of pre-implant and post-implant were 3.15 cm and 2.06 cm, respectively (t=5.127, P