Objective To evaluate the role of spiral CT and its reconstruction techniques in orientation and determination of the nature of small bowel neoplasms.Methods CT manifestations,multiple planar reformation(MPR) and slip thin slice maximum intensity projection(STS-MIP) of 54 cases small bowel noplasms confirmed pathologically were analysed.Results 54 cases of small bowel neoplasm mainly included:adenocarcinoma in 15 cases,stromal tumor in 24 cases,lipoma in 4 cases,lymphoma in 4 cases and adenoma in one case.The accurate rate of orientation and determination of the nature of small bowel neoplasm by CT were all 96.3%(52/54).MPR and STS-MIP can demonstrated the blood supply arteries and drainage veins of tumors.Conclusion Spiral CT and its MPR,STS-MIP have an important clinical value in orientation and determination of the nature of intestinal obstruction by neoplasm.

Objective To investigate the development status of tumor radiotherapy in the Xinjiang Uygur Autonomous Region.Methods A questionnaire survey we used last time was conducted by letter,Email,telephone or fax to investigate all the medical institutions in the Xinjiang Uygur Autonomous Region for researching the current status of radiotherapy academic settings,human resources,allocation of radiotherapy facilities and standardization of medical practices.Results Up to the end of January 2015,there were 30 medical electron linear accelerators,21 simulated locators,10 breach-loading brachytherapy machines,31 treatment planning systems and 5γ or X knives in Xinjiang.Radiotherapy was carried out in 20 medical institutions,including 14 three-dimensional conformal radiotherapy and 9 intensity modulated radiation therapy,8 breach-loading brachytherapy,3 stereotactic radiotherapy,and 2 volumetric modulated arc therapy.There were 280 radiation personnel (except nurses),including 159 radiation oncologists,40 radiotherapy physicists and 81 radiotherapy technologists.There were 1167 hospital beds and 855 cancer patients received radiotherapy on average every day.Conclusions Although radiation personnel has increased,radiotherapy facilities have been improved,hospital beds and patients received radiotherapy also have become more,the improvements are needed for cause of imbalance in precise radiation therapy development.

Left ventricular assist device(LVAD) can improve the survival rate and quality of life of patients with end-stage heart failure, but the quality of life of patients after LVAD implantation is still lower than that of heart transplantation. The reasons for the influence of LVAD implantation on patients' quality of life include discomfort symptoms, surgical complications and high re-hospitalization rate, limitation of physical activity level and negative psychological emotions after device implantation. Cardiac rehabilitation training can improve the quality of life of LVAD patients by improving their psychological state, enhancing their exercise ability and reducing the risk of re-hospitalization. The exercise prescription of LVAD implant patients can include aerobic endurance training, walking training, light to moderate resistance training, gymnastics training, etc. The exercise training intensity should be controlled at the first ventilation threshold(anaerobic threshold), 50% peak oxygen consumption or 12-14 points of Borg scale. In addition, the safety of cardiac rehabilitation training for LVAD patients has been fully demonstrated.

Objective:To investigate the correlation between platelet distribution width(PDW)and cerebral microbleeds(CMB)in the middle-aged and elderly population.Methods:A total of 2 839 subjects who underwent cranial magnetic resonance imaging(MRI)examination at Lishui Hospital of Zhejiang University from May 2016 to December were enrolled in this cross-sectional study.According to MRI results, subjects were divided into the CMB group(n=525)and the non-CMB group(n=2 314). Clinical data and PDW levels were compared between the two groups.CMB-related factors were analyzed by using a logistic regression equation.A receiver operating characteristics(ROC)curve was drawn to analyze the value of PDW levels in predicting the incidence of CMB.Results:The percentage of males, the proportion of smokers, the number of subjects with diabetes and serum creatinine levels were higher in the CMB group than in the non-CMB group[(55.05%(289/525) vs.45.12%(1 044/2 314), 42.67%(224/525) vs.34.67%(802/2 314), 12.76%(67/525) vs.9.51%(220/2 314), (68.91±21.38)μmol/L vs.(66.45±15.40)μmol/L, all P<0.05]. PDW levels were higher in the CMB group than in the non-CMB group(15.52±2.49)% vs.(14.67±2.90)%, χ2=93.75, P<0.05). Multivariate logistic regression analysis showed that the PDW level was an independent risk factor for CMB in the middle-aged and elderly population( OR=1.13, P<0.05). The area under the ROC curve(AUC)of PDW in predicting the incidence of CMB was 0.582, and with 15.95% as the optimal threshold value, the sensitivity and specificity were 75.0% and 41.8%.Patients were divided into the high PDW sub-group(n=1 691)and the low PDW sub-group(n=1 083)based on the PDW cutoff at 15.95%.The number of CMB and the incidence of CMB were higher in the high PDW group than in the low PDW group(0.75 vs.0.48, 23.3% or 394/1 691 vs.12.1% or 131/1 083, χ2=30.37 and 51.28, P<0.05). Conclusions:PDW levels are high in middle-aged and elderly patients with CMB, and elevated PDW levels are an independent risk factor for CMB.

Small bowel capsule endoscopy and double-balloon enteroscopy have become new methods for clinical diagnosis of radiation enteritis (RE) , especially for abnormal intestinal tissue. Targeted biopsy or interventional therapy is expected to achieve precision treatment of RE. The screening of molecular markers in biological samples has also become a new direction for RE diagnosis. Fecal microbiota transplantation has become one of the promising treatments for RE. In addition, mechanism studies based on traditional Chinese medicine, targeted cell death, and omics analysis provide rich strategies for the diagnosis and treatment of RE.

Objective:To evaluate the role of long-chain non-coding RNA-lung cancer metastasis-related transcript 1/microRNA-145/Bcl-2 and adenovirus E1B19k Da interacting protein 3 (Lnc-MALAT1/miRNA-145/BNIP3) signaling pathway in sufentanil preconditioning-induced cardioprotection in rats.Methods:Rat H9C2 cells were inoculated in 6-well culture plates or flasks at a density of 1×10 6 cells/ml and divided into 5 groups ( n=30 each) using a random number table method: control group (group C), hypoxia-reoxygenation (H/R) group, sufentanil preconditioning group (S group), eukaryotic expression vector pcDNA3.0 group (pcDNA group) and pcDNA-MALAT1 group (MALAT1 group). Cells were incubated with 10 μmol/L sufentanil for 2 h, and then the H/R injury model was established in group S. In pcDNA group and MALAT1 group, cells were transfected with pcDNA3.0 and pcDNA-MALAT1, respectively, and then incubated with 10 μmol/L sufentanil for 2 h starting from 24 h after transfection, and then the H/R injury model was established.At 2 h after reoxygenation, the expression of Lnc-MALAT1, miRNA-145 and BNIP3 mRNA was detected by real-time polymerase chain reaction, the cell survival rate was detected by CCK-8, the apoptosis rate was detected by flow cytometry, the malondialdehyde (MDA) and superoxide dismutase (SOD) levels and amount of lactic dehydrogenase (LDH) released were detected, and the expression of Bcl-2, Bax and cleaved-caspase-3 was detected by Western blot. Results:Compared with group C, the survival rate was significantly decreased, apoptosis rate was increased, the MDA level and amount of LDH released were increased, SOD levels were decreased, the expression of LncRNA-MALAT1, BNIP3 mRNA, Bax, and cleaved-caspase-3 was up-regulated, and miRNA-145 and Bcl-2 expression was down-regulated in the other four groups ( P<0.05). Compared with group H/R, the cell survival rate was significantly increased, apoptosis rate was decreased, the MDA level and amount of LDH released were decreased, SOD levels were increased, the expression of LncRNA-MALAT1, BNIP3 mRNA, Bax, and cleaved-caspase-3 was down-regulated, and miRNA-145 and Bcl-2 expression was up-regulated in S and pcDNA groups ( P<0.05). Compared with group S, the survival rate was significantly decreased, apoptosis rate was increased, MDA level and amount of LDH released were increased, SOD levels were decreased, the expression of LncRNA-MALAT1, BNIP3 mRNA, Bax, and cleaved-caspase-3 was up-regulated, and miRNA-145 and Bcl-2 expression was down-regulated in group MALAT1 ( P<0.05). Conclusion:The mechanism of sufentanil preconditioning-induced cardioprotection is related to inhibiting Lnc-MALAT1/miRNA-145/BNIP3 signaling pathway in rats.

Objective:To investigate the correlation between the enhancement characteristics in arterial phase and the prognosis of patients with massive intrahepatic cholangiocarcinoma (IMCC).Methods:The imaging and clinical data of 92 patients with IMCC who were pathologically confirmed and underwent enhanced MRI or CT in Central Hospital of Lishui from June 2004 to February 2019 were retrospectively analyzed. According to the enhancement pattern of the primary lesion in the arterial phase, patients were divided into rich arterial blood supply group （17 cases） and deficient arterial blood supply group （75 cases）. The clinical data and imaging features of these patients were studied. Differences between measurement data and count data between the two groups were compared using t test and Fisher test. Kaplan-Meier analysis and log-rank test were used to analyze overall survival. The Cox regression multivariate analysis was used to study the relationship between the variables and the risk of death. Result:The enlargement of lymph nodes, long diameter of the primary lesion, CA19-9, treatment and HPD around the primary lesion in arterial phase were statistically different in the two groups ( P<0.05), others were no statistical difference. CA19-9>200 U/ml, lymph node enlargement, HPD around the primary lesion in arterial phase and deficient arterial blood supply were independent factors for the prediction of prognosis in IMCC patients with surgery ( P values were 0.008, 0.002, 0.049 and 0.005, respectively). Lymph node enlargement and deficient arterial blood supply were independent risk factors for the prediction of prognosis in IMCC patients with surgery ( P values are 0.049 and 0.045, respectively). Conclusion:The blood supply characteristics of arterial phase are independent factors for the prognosis of patients with IMCC.

Objective: To evaluate image quality and radiation dosage of CT cerebral perfusion (CTP) imaging of 70 kV with different tube current and scanning passes and its diagnostic value for hyperacute cerebral infarction. Methods: A total of 190 patients with suspected hyperacute cerebral infarction in Lishui Central Hospital of Zhejiang Province from December 2017 to February 2019 were selected prospectively, and all patients were divided into 4 groups according to random number table and received non-contrast CT examination and dual-source CT cerebral perfusion imaging with 70 kV protocol simultaneously within 6 hours after the onset of symptoms: group A, 120 mA, 21 scanning time points; group B, 100 mA, 21 scanning time points; group C, 100 mA, 17 scanning time points; group D, 80 mA, 21 scanning time points. The values of perfusion parameters such as cerebral blood flow (CBF), crerbral blood volume (CBV), mean transit time (MTT), time to peak (TTP) were acquired. Image quality was evaluated and effective dose (ED) was recorded. The quantitative variables of image quality and radiation dosage were compared between four groups using one-way analysis of variance test. Results: There was no differences between groups on the CBF, CBV, MTT, TTP maps for all CTP values (P>0.05), and all images could meet the diagnostic requirements. The subjective image quality score of vessel sharpness and overall image quality of both internal carotid artery and middle cerebral artery and the degree of noise of internal carotid in artery in group A was higher than that in group D (P<0.05). The score of vessel sharpness of internal carotid in artery ingroup A was higher than those in both groups B and C (P<0.05). The scores of vessel sharpness of both internal carotid artery and middle cerebral artery internal carotid in artery ingroups B and C were higher than that in group A (P<0.05). The mean EDs of non-contrast CT in group A, B, C, D were 1.10, 2.11, 1.76, 1.42, 1.40 mSv; compared to group A, ED was reduced approximately 16.6% (0.35/2.11), 32.7% (0.69/2.11) and 33.6% (0.71/2.11), respectively (P<0.05). The diagnostic accuracy of low dose dual source CTP for detecting hyperacute cerebral infarction was 93.5% (172/184), while that of non-contrast CT was 52.2% (96/184);for detecting hyperacutelacunar cerebral infarction, it was 72.1% (31/43) and 16.3% (7/43) respectively (P<0.05). Conclusion Appropriate reduction of tube current (100 mA) and scanning passes (17 scanning time points) can reduce the radiation dosage and acquire comparable image quality for 70 kV protocol CTP. Compared with non-contrast CT, low dose dual-source CTP is more sensitive to hyperacute cerebral infarction, especially hyperacute lacunar cerebral infarction.