Background and purpose: Since the detection of renal neoplasm is increasing, it's important to distinguish myomatous angiomyolipoma (mAML) from malignant tumors. This study aimed to investigate the imaging features of renal mAML on computer tomography (CT) and improve the accuracy of diagnosis and differential diagnosis. Methods: Ten patients were diagnosed with mAML. The cases were composed of 4 men and 6 women, with a mean age of 53.2 years (range 38-64). Among all of the cases, the percentage of spindle cell is more than 70%. Two radiologists reviewed all of the images to evaluate general characteristics, imaging features on unenhanced CT and enhanced CT. The mean attenuation on the unenhanced CT of mAML, normal renal parenchyma and skeletal muscle was compared by the paired-sample t test. Results: Among all of the tumors, nine lesions were solitary, and the other one was accompanied with typical AML. Six lesions were at the left kidney while four lesions were at the right side. Five lesions located intracapsularly. All the lesions were well-defined, nine of them were regular. The tumor sizes ranged from 15 to 80 mm with mean (43±19) cm. Intratumoral macroscopic fat, cystic degeneration and vessels were found in two lesions, two lesions and three lesions, respectively. Calcification or hemorrhage was not detected in any cases. On unenhanced CT, 70% cases were hyperattenuating. Eight cases were homogeneous or slightly heterogeneous. The mean attenuation of the tumor lesions on unenhanced CT was (48.60±5.50) HU, which was higher than that of normal renal parenchyma (39.70±6.67) HU (P<0.05), and similar to that of skeletal muscle (48.9±2.28) HU (P>0.05). After intravenous injection of contrast media, seven cases were categorized as the slightly heterogeneous or heterogeneous enhancement type. Four cases showed a weak enhancement whereas five cases were with a moderate enhancement. The gradual, prolonged and early washout enhancement patterns were observed in 40%, 40%, and 20% of the cases, respectively. Conclusion: The radiological appearance of mAML had a tendency to be hyperattenuating on unenhanced CT images without macroscopic fat; it could be homogeneous or slightly heterogeneous on unenhanced scans. After the injection of contrast agent, mAML tended to have a weak or moderate, lightly heterogeneous to heterogeneous enhancement, and it could demonstrate gradual and prolonged enhancement patterns.

Objective To explore and analyse the factors influencing the acceptability of"Internet medical alliance"among medical staff by UTAUT model,with a view to providing a basis for the sustainable development of"Internet medical alliance".Methods A questionnaire survey was conducted among medical staff participating in the"Internet medical alliance"in municipal hospitals,count-level hospitals,township health centers,village clinics and community health service centers.SPSS 20.0 and Amos 17.0 software were used to statistically describe the acceptance of"Internet medical alliance",and a structural equation model with behavioral intention and satisfaction as dependent variables was constructed.Results In the range of independent variables,the 841 follow-up subjects had the highest individual creativity score at(3.88±0.67),followed by social influence at(3.86±0.66)and the lowest perceived risk score at(3.52±0.78).Of the dependent variables,the behavioural intention score was(3.86±0.68)and the satisfaction score was(7.72±1.88).Conclusion Facilitation,individual creativity,self-efficacy,performance expectations,effort expectations,having heard of"Internet medical alliance"education level and perceived risk were key factors in the behavioral intention and satisfaction of medical staff to participate in"Internet medical alliance".

Objective:To study the influencing factors of liver regeneration and their prognostic impact after split liver transplantation.Methods:The clinical data of 44 patients who underwent split liver transplantation at the Organ Transplant Center of Affiliated Hospital of Qingdao University from January 2015 to July 2021 were analysed. There were 19 males and 25 females, aged (49±12) years old. Based on whether the liver regeneration rate (LRR) was greater than 100%, these patients were divided into the good regeneration group (LRR≥100%, n=24) and the poor regeneration group (LRR<100%, n=20). The differences in the perioperative data and postoperative survival rates between the two groups were compared. The patients were followed up by outpatient reexamination or telephone. Results:On days 15, 30, 90, and 180 after operation, the volume change rates in the transplanted liver were (117.04±7.00)%, (164.03±16.72)%, (180.98±26.30)%, (159.40±26.28)%, respectively. The body mass index, anhepatic period, intraoperative bleeding, intraoperative blood transfusion, hospitalization time, recovery time of liver function, fatty degeneration of donor liver and type of donor liver were the influencing factors of liver regenera-tion after split liver transplantation. The levels of aspartate aminotransferase and alanine aminotransferase on the days 1, 2, 3, 4, 5, 6 and 7 after operation in the group of patient with good regeneration were significantly lower than those in the group of patient with poor regeneration ( P<0.05). The levels of total bilirubin in the group of patient with good regeneration was significantly lower than those in the group of patient with poor regeneration on days 5, 6 and 7 after operation ( P<0.05). The portal vein flow per 100 g of liver mass in the good regeneration group was significantly better than the poor regeneration group on day 1 and 30 after operation. The 6-month cumulative survival rates of the good regeneration group and the poor regeneration group were 95.8% and 70.0% respectively, and the difference was significant ( P=0.017). Conclusions:Body mass index, anhepatic period, intraoperative blood loss, intraoperative blood transfusion, hospitalization time, recovery time of liver function, fatty degeneration of donor liver and type of donor liver were the influencing factors of liver regeneration after split liver transplantation. The prognosis of recipients with poor liver regeneration was significantly worse than recipients with good liver regeneration.