The structures of DICOM image and BMP image are introduced through the analyses of them and DICOM standard.The method of translating DICOM image into BMP one is also presented.

Objective To compare radiation-induced lung injury (RILI) between concurrent and sequential combination of postoperative radiotherapy and endocrine therapy. Methods A total of 118 patients subjected by radical or modified radical operation of breast cancer were enrolled in this study and received radiotherapy and endocrine therapy between Jan 2003 and December 2007. All the patients were categorized into four groups: radiotherapy (RT) plus concurrent aromatase inhibitor(AI): RT+AI; RT plus sequential AI:RT-AI; RT plus tamoxifen (TAM): RT+TAM; RT plus sequential TAM: RT-TAM. Radiotherapy was delivered by using various energy of electron (6, 9, 12 Mev β-ray) or 6 M.V X-ray for different target with a dose of 50 Gy (2 Gy/Fx, 5 fractions per week). RILI grades were classified according to RTOG/EORTC and Aoki evaluation criteria from one month to at least one year after radiotherapy. Results 30/118(25.4 %) patients was observed with RILI, RT+AI 22.7 % vs. RT-AI 20.0 %(P =0.806), RT+TAM 35.7 % vs. RT-TAM 24.2 %(P =0.328). The incident rate of RILI was higher in elder patients(>60 yr) than in other patients (33.9 % vs.16.9 %, P =0.05). Patients with positive chemotherapy history had a higher risk of RILI than those with chemotherapy-negtive history (P =0.039). Conclusion These findings suggest that RILI are associated with age and chemotherapy history, but not correlated with the sequence of radiotherapy and endocrine therapy.

Objective To evaluate the role of autophagy in the development of inflammatory pain in the rats.Methods Twenty-four healthy adult male Sprague-Dawley rats,weighing 180-240 g,were randomly divided into 4 groups (n=6 each) by using a random number table:control group (group C),inflammatory pain group (group IP),dimethyl sulfoxide (DMSO) group (group D),and rapamycin (autophagy inducer) group (group R).Inflammatory pain was produced by injecting 50 μl bee venom into the plantar surface of the left hindpaw.In group C,0.9％ normal saline was injected into the plantar surface of the left hindpaw.In group D,2％ DMSO was injected through a gastric tube into the stomach 1 ml per day for 3 consecutive days,and the model was established at 1 h after injection on 3rd day.In group R,rapamycin l0 mg/kg (in 2％ DMSO) was injected through a gastric tube into stomach 1 ml per day for 3 consecutive days,and the model was established at 1 h after injection on 3rd day.The mechanical paw withdrawal threshold (MWT) and thermal paw withdrawal latency (TWL) were measured at 2 h after the model was established.After measurement of the pain threshold,the dorsal horn of the spinal cord was removed for determination of the expression of microtubule-associated protein 1 light chain 3 Ⅱ (LC3 Ⅱ),Beclin-1 and p62 by Western blot.Results Compared with group C,the MWT was significantly decreased,the TWL was significantly shortened in IP and D groups,and the expression of LC3 Ⅱ,Beclin-1 and p62 in the dorsal horn of the spinal cord was significantly up-regulated in IP,D and R groups (P＜0.05 or 0.01).Compared with group IP,the MWT was significantly increased,the TWL was significantly prolonged,the expression of LC3 Ⅱ and Beclin-1 in the dorsal horn of the spinal cord was significantly up-regulated,and the expression of p62 was significantly down-regulated in group R (P＜0.05),and no significant change was found in the parameters mentioned above in group D (P＞0.05).Conclusion Autophagy disorders are involved in the development of inflammatory pain in the rats.

Objective This paper was to study the absorption and metabolism differences of intestine and liver for multicomponent licorice.Methods The components were identified with the UPLC-MS/MS. In situ closed-loop method was used to carry out the comparative experiments of absorption and metabolism differences between intestine and liver.Results 13 components were identified by UPLC-MS/MS. The absorption and metabolism results indicated some components in licorice water extract could be absorbed into blood and metabolism happened during this process. 14 metabolites were detected in the plasma sample. The hepatic metabolism results indicated many components could experience complex metabolism and more metabolites could be generated.Conclusions Liver was the major metabolism organ for licorice water extract and some components could be metabolized along with the absorption process in intestine. The absorption and metabolism differences between intestine and liver were significant.

This study was aimed to determine the solubility an d oil-water partition coefficient of main active com-ponents in Ge-Gen Qin-Lian (GGQL) Tablets (puerarin, baicalin and berberine hydrochloride) in phosphate buffer solution of different pH values and under the background of many components. Solubility of puerarin, baicalin and berberine hydrochloride in different medium pH, and oil-water partition coefficient of the octanol-water and oc-tanol-buffer system were determined by HPLC method. The results showed that the solubility and oil-water partition coefficient of puerarin, baicalin and berberine hydrochloride were varied with the change of pH, and varied under the background of components. At pH 7.4, the solubility was the biggest;puerarin was 7.56 mg·mL-1;baicalin was 17.07 mg·mL-1; berberine hydrochloride was 3.57 mg·mL-1. Oil-water partition coefficient P of these components at pH 1.0 was bigger;puerarin was 0.420 (lgP=-0.38);baicalin was 10.783 (lgP=1.03);berberine hydrochloride was 0.267 (lgP=-0.57). It was concluded that lipid solubility of puerarin, baicalin and berberine hydrochloride at pH 1.0 was better. It was speculated that better absorption in the stomach, and low lipid solubility under other pH. It was speculated that lipid solubility may be one of the reasons affecting the intestinal absorption.

Objective To evaluate the efficacy and safety of ureteral stenting after transurethral resection ( TUR) of bladder tumors involving the ureteral orifice.Methods From March 2009 to November 2015,34 cases of non-muscle invasive bladder tumor including 28 male and 6 female aged from 26 to 79 years( mean 51 years) were treated by TUR.14 cases had single tumor and 20 had multiple tumors,and 29 were primary and 5 were recurrent.All the patients had tumors involving the ureteral orifice without preoperative hydronephrosis revealed by IVU or CTU examination.The tumors were resected into the deep muscle layer and the involved ureteral orifices were resected during the procedure,and after that a double-J ureteral stent was placed in 18 cases.All patients received one immediate intravesical instillation of 50mg epirubicin after TUR, and further scheme of adjuvant intravesical chemotherapy instillations were made according to the pathological diagnosis.Ureteral stents were removed 10-12 weeks after TUR,and cystoscopy and urinary tract ultrasound examinations were performed every 3 months for 1-2 years postoperatively. Results The operations were successful without complications.No serious adverse reaction occurred in immediate and further adjuvant intravesical chemotherapy.During the follow-up period of 3-71 months, no ureteral stricture, hydronephrosis or tumor recurrence in the upper urinary tract occurred in all the 18 patients with ureteral stent, and the resected ureteral orifices recovered well with normal appearance and ejecting urine.Hydronephrosis was observed in 3 of 16 patients without ureteral stent including 2 cases of nontumoral stenosis at the ureterovesical junction requiring ureteral reimplantation and 1 case of lower ureteral tumor on the involved side requiring nephroureterectomy and bladder cuff excision.No patient complained of symptoms secondary to vesicoureteral reflux or continuous unrelievable lower urinary tract symptoms.2 cases of bladder tumor recurred out of the resected area.Conclusions Ureteral stenting after TUR of bladder tumors involving the ureteral orifice can prevent stricture at the ureterovesical junction without increasing the risk of tumor cell seeding along the upper urinary tract.The existence of a double-J ureteral stent does not increase complications of adjuvant intravesical chemotherapy, and also won't cause intolerable lower urinary tract symptoms.

Objective:To investigate the methods and complications of ultrasound-guided percutaneous nephrostomy (PCN) for treat-ing cancer-related hydronephrosis. Methods:From June 2003 to December 2015, 289 patients (342 kidneys) with cancer-related hy-dronephrosis were treated by ultrasound-guided PCN in Fujian Provincial Hospital. Among the 97 cases of renal insufficiency, 4 pa-tients were treated with hemodialysis before PCN. Except for the anterior mid calyx of nine kidneys in nine patients, the posterior mid or lower pole calyx of all other kidneys was punctured with ultrasound guidance. With the one-step PCN technique, 8F pigtail nephros-tomy tubes were placed into six kidneys in six patients;with the Seldinger PCN technique, 14F balloon and Malecot catheters were placed into 25 kidneys in 25 patients and 311 kidneys in 258 patients, respectively. Results:No severe bleeding and injury in the intes-tine, liver, spleen, pleura, or lung occurred. Two pigtail tubes were blocked one week after PCN. Seven balloon catheters failed to drain well because of the tip and balloon of the catheters located in the proximal part of the dilated ureters. Four balloons slipped out of the collection system of the kidney because of the auto-deflation of three balloons and one case of meager renal parenchyma failing to hold the balloon after a severe hydronephrosis was emptied. All, except 1, Malecot catheter drained well, and 8/9 PCNs through anteri-or mid calyx were successful. Serum creatinine levels were significantly decreased in all the 97 patients with renal insufficiency, of which 81 cases returned to normal, and no one needed persistent hemodialysis. Conclusion:Ultrasound-guided PCN is safe and effec-tive for treating cancer-related hydronephrosis. For appropriately selected patients, puncturing the anterior mid calyx may be an op-tion without additional complications. One-step pigtail nephrostomy tubes are recommended for patients with poor systemic condi-tions. For patients with long life expectancy or suspected complicated urinary infection, large sized Malecot catheters should be consid-ered.

Objective To evaluate the efficacy of transforanminal endoscopic spine system (TESSYS) technique in treating lumbar disc herniation complicated with Ⅰ degree stability of lumbar spondylolisthesis.Methods Thirty-two patients with lumbar disc herniation,aged 51-82 yr,weighing 52-93 kg,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,were randomly divided into 2 groups (n=16 each) according to whether patients had lumbar spondylolisthesis:lumbar disc herniation group (Y group) and lumbar disc herniation combined with Ⅰ degree stability of lumbar spondylolisthesis group (Y+Z group).Extirpated protrusion,plasty ligamenum flavum and posterior longitudinal ligament and nerve root decompression were carried out using TESSYS technique in two groups,and in addition excision of osseous neoplasias and retro-positioned posterior margin of lumbar vertebral body was done in group Y+Z.Pain was assessed using Visual Analogue Scale (VAS) score at 1 day before surgery and 3 days and 1,3,6 and 12 months after surgery.Patient's function was assessed by using the Oswestry Disability Index (ODI) at 1 day before surgery and 12 months after surgery.The therapeutic effect was evaluated using modified Macnab criteria at 12 months after surgery.Results Compared with the baseline at 1 day before surgery,VAS scores were significantly decreased at each time point after surgery,and ODI was decreased at 12 months after surgery in two groups (P＜0.05).Compared with group Y,VAS scores were significantly decreased at 3 and 6 months after surgery (P＜0.05),and no significant change was found in ODI at each time point or VAS scores and Macnab outcome grade at 12 months after surgery in group Y+Z (P＞ 0.05).Conclusion TESSYS technique can be used to treat lumbar disc herniation complicated with Ⅰ degree stability of lumbar spondylolisthesis.

The curative efficacy of percutaneous transluminal angioplasty and stenting (PTAS) in the treatment of patients with ischemia cerebrovascular disease caused by artery stenosis was explored. The clinical data of 111 patients with ischemia cerebrovascular disease receiving PTAS in Guangdong Province General Hospital from Aug. 2007 to Nov. 2009 were retrospectively analyzed. In total 132 stents were implanted in the 111 patients. The mortality and rate of neural and non-neural complications were assessed perioperatively. Outcomes [including the frequency of transient ischemic attack (TIA), stroke, or death from vascular diseases) were assessed after operation. NIHSS rating was performed in all cases before and at first week, 6th month and 12th month after the operation. The PTAS success rate was 100%. The degree of stenosis was reduced after PTAS. The total complication rate during perioperative period was 15.3% (the rate of neural complications was 3.6%). Sixty-seven patients were followed up. Three patients (4.48%) developed cerebrovascular events within 1 month, containing one case of TIA, one case of ipsilateral mild stroke and one case of contralateral mild stroke. No severe stroke or death was observed. During a follow-up period of 12 months 7 patients had cerebrovascular events (10.44%), including 2 cases of ipsilateral TIA (2.99%), 2 cases of ipsilateral mild stroke and 2 cases of contralateral mild stroke (2.99%), one case of severe stroke (1.49%). In 13 patients receiving DSA re-examination one year after PTAS, 2 patients (15.38%) had in-stent restenosis. NIHSS scores were obviously decreased during a follow-up period as compared with those pre-operation (P<0.05). It was concluded that PTAS could significantly alleviate the neural function deficit of the patients with ischemia cerebrovascular disease. The success rate of PTAS was high, and the rate of complications was lower and the clinical outcomes were satisfactory. PTAS is a safe and effective therapeutic method, though the long-term outcomes need further study.

The curative efficacy of percutaneous transluminal angioplasty and stenting (PTAS) in the treatment of patients with ischemia cerebrovascular disease caused by artery stenosis was explored.The clinical data of 111 patients with ischemia cerebrovascular disease receiving PTAS in Guangdong Province General Hospital from Aug.2007 to Nov.2009 were retrospectively analyzed.In total 132 stents were implanted in the 111 patients.The mortality and rate of neural and non-neural complications were assessed perioperatively.Outcomes [including the frequency of transient ischemic attack (TIA),stroke,or death from vascular diseases) were assessed after operation.NIHSS rating was performed in all cases before and at first week,6th month and 12th month after the operation.The PTAS success rate was 100％.The degree of stenosis was reduced after PTAS.The total complication rate during perioperative period was 15.3％ (the rate of neural complications was 3.6％).Sixty-seven patients were followed up.Three patients (4.48％) developed cerebrovascular events within 1 month,containing one case of TIA,one case of ipsilateral mild stroke and one case of contralateral mild stroke.No severe stroke or death was observed.During a follow-up period of 12 months 7 patients had cerebrovascular events (10.44％),including 2 cases of ipsilateral TIA (2.99％),2 cases of ipsilateral mild stroke and 2 cases of contralateral mild stroke (2.99％),one case of severe stroke (1.49％).In 13 patients receiving DSA re-examination one year after PTAS,2 patients (15.38％) had in-stent restenosis.NIHSS scores were obviously decreased during a follow-up period as compared with those pre-operation (P＜0.05).It was concluded that PTAS could significantly alleviate the neural function deficit of the patients with ischemia cerebrovascular disease.The success rate of PTAS was high,and the rate of complications was lower and the clinical outcomes were satisfactory.PTAS is a safe and effective therapeutic method,though the long-term outcomes need further study.