Child ; Child, Preschool ; Diagnostic Errors ; Female ; Humans ; Male ; Otitis Media with Effusion ; diagnosis ; Retrospective Studies

Objective To explore the independent design of database for radiologic report.Methods Using the Access2000 to establish the corresponding objects in the database; Using software EasySetup to make the installing software.Results The established software (CT Diagnosis Center, CT-DDC) included menu user-defined, interface of reporting input, interactive interface of query and printing, data sheet editing and backup, it could be carried by floppy disk easily, the installing and running were stable. Conclusion The database for radiolgic report can be exploited independently,using for radio-diagnosis by the clinical doctor,it is economic and available for popularizing use in the basic medical units.

Objective To observe the clinical effect of DC-CIK cells combined with S-1 in the treatment of non-small-cell lung cancer.Methods 76 patients with non-small-cell lung cancer were randomly divided into the observation group and the control group on average.The control group was treated with S-1,and the observation group was treated with DC-CIK cells combined with S-1.For the observation group,the peripheral venous blood was collected before the treatment for DC cells and CIK cells cultivation.The expression of CD4+/CD8+,CD4+ and NK cells in the peripheral blood of the two groups was detected by flow cytometry before the treatment and after one week of the treatments.Besides,the number of white blood cells and platelet count were also measured and the symptoms of non-small-cell lung cancer were observed.Results The percentage of CD4+/CD8+,CD4+ and NK cells in the peripheral blood of the observation group after the treatment was (1.65±1.03),(34.56±8.90) and (18.68±7.98),respectively,which was significantly higher than (1.32±0.70),(29.07±7.15) and (15.28±8.23) in the control group (all P＜0.05).There was no significant difference in the percentage of CD8+ cells between the observation group (25.56± 8.90) and the control group (26.64±6.77) (P＞0.05).The vomiting,leukopenia and thrombocytopenia in the observation group were less than those in the control group (all P＜0.05).The one-year survival rate was 52.63％ in the observation group which was significant higher than 42.11％ in the control group (P＜0.05).Conclusions DC-CIK cells combined with S-1 is a safe and effective treatment for non-small-cell lung cancer,which can effectively improve the clinical efficacy and prolong the survival time of patients.

Objective To analyze the atypical CT and MRI findings of renal cell carcinoma (RCC) and to discuss how to improve the diagnostic accuracy of RCC using CT and MRI. Methods The data of 100 cases of RCC (71 males and 29 females;age range from 29 to 75 years with a mean of 55 years) were reviewed.The surgical and pathological findings showed clear cell carcinoma in 82 cases,mixed cell carcinoma in 8,granular cell carcinoma in 5,papillary RCC in 4 and sarcomatoid RCC in 1.A total of 101 masses were found.The masses were 0.8 to 9.0 cm (mean,4.3 cm) in greatest dimension. According to the CT and MRI findings of most cases in this group and the relevant information in literature,the typical CT and MRI findings of RCC were summarized. The atypical CT and MRI findings of RCC were analyzed,and correlated with surgical and pathological findings. Results There were 17 cases presenting with atypical CT and MRI findings.The atypical CT and MRI findings of RCC were divided into 4 types:① hypovascular RCC (12 cases,including 3 of clear cell carcinoma, 1 of mixed cell carcinoma, 5 of granular cell carcinoma and 3 of papillary RCC);②cystic RCC (3 cases of clear cell carcinoma);③RCC with volumes of hemorrhage (1 case of papillary RCC);④tumor's diameter less than 1㎝ (1 case of clear cell carcinoma). Conclusions Correct evaluation of the CT/MRI findings of hypovascular and cystic RCC,application of adequate scanning methods and careful interpretation of the imaging films are helpful for improving diagnostic accuracy of RCC.

Objective To explore the classification , age , ratio of gender , to provide clinical basis for prevention and treatment of pediatric eye diseases. Methods Clinical data of 0-14 year old patients with eye diseases from January 1993 to December 2014 were collected and analysized. Results The total rate of boy and girl is 2.14:1. Boys with ocular trauma were much more than girls , and the ratio of boy and girl is 3.7:1. The peak occurrence age of ocular trauma was 8 to 11 year old , 0-7 year old children with eye diseases mainly contained congenital diseases such as congenital cataract and congenital ptosis. Children between 7 to 14 year old were more liability to intermittent exotropia and accommodative esotropia. Retinopathy of prematurity was the most common eyeground disease. The most popular tumor were major in corneal dermoid and retinal glioblastoma, potential age was 1-6 year old. Conclusion Pediatric eye diseases should be paid more attention. Ocular examination were needed to be done periodically , primary diseases should be treated early , occurrence should be prevented depending on different ages , to protect the ocular function of children.

Objective To investigate the preoperative preparation for pheochromocytoma. Methods The data of 286 cases of pheochromocytoma, who were treated in our hospital from 1980 to 2002,were collected and reviewed on the preoperative preparation.Phenoxybenzamine was given to 207 cases and urapidil to 78 during preoperative period, lasting for 2～9 weeks with a mean of 6 weeks.The remaining 1 underwent emergent surgery without use of ?-adrenergic blockers.In 28% of the cases,?-adrenergic blocker was given for control of heart rate. Results In 254 cases,blood pressure remained stable at the level of 120/80 mm Hg (1 mm Hg=0.133 kPa) or so.No paroxysmal hypertension,palpitation and sweating occurred after use of ?-blockade.The heart rate remained 80～85 times/min.No arrhythmia occurred.Peri-microcirculation was obviously improved.The tumor size (range,3～12 cm in diameter;mean,5.2 cm) was not related to the function and length of preoperative use of the medications.Hypertensive crisis occurred in 32 cases 2 weeks before operation. In most cases (96%), blood pressure fluctuated (reaching up to 280/180 mm Hg) when they experienced anesthesia induction and tumor crush during operation.However,it was easy to control.Postoperative blood pressure remained stable. Conclusions The full preoperative preparation for patients with pheochromocytoma is essential for the safety and success of anesthesia and operation.

Objective To evaluate the value of the corticomedullary phase ( CMP ) of CT and MRI scan for the differentiation of the subtypes of renal cell carcinoma ( RCC ) .Methods Ninety six cases of RCC proved by surgery and pathology were performed CMP scan with multislice helical CT and/or 1.5T MRI . The enhancement patterns of CT/MRI were correlated with the subtypes of RCC.Results There were 1 case of sarcomatoid RCC , 78 cases of clear cell RCC , 5 cases of granular cell RCC , 8 cases of mixed cell RCC and 4 case of papillary RCC . The masses were 2 cm to 9 cm in diameter . Sarcomatoid RCC, mixed cell RCC , 97.4% ( 76/78 ) of clear cell RCC and 75.0%(3/4) of papillary RCC showed inhomogenous enhancdment, and granular cell RCC showed homogenous enhancdment. Comparing with renal cortex, 51.3%(40/78) of clear cell RCC and 37.5%(3/8) mixed cell RCC showed hyperdensity or hypertension, sarcomatoid RCC, 44.9%(35/78) of clear cell RCC and 50.0%(4/8) mixed cell RCC showed isodensity or isotension, and all the granular cell RCC and papillary RCC showed hypodensity or hypotension.Conclusion The enhancement pattern in CMP of CT and MRI scan is different among the subtypes of RCC, and could be used for differentiation.

Objective To evaluate the clinical application of immediate breast reconstruction with the pedicle transverse rectus abdominus myocutaneons(TRAM)flap.Methods Ten breast cancer patients underwent immediate breast reconstruction with the pedicle TRAM flap after mastectomy,among which 4 cases used single pediele TRAM and 6 cases used bipedical TRAM.Polypropypene mesh were applied on all cases of patients to repair the abdominal defect. Results All the breast reconstructions were successful.Complications included grafting flap infection in one case and skin necrosis on partial abdominal skin flap in one case.The reconstructed breasts had a very good shape in 8 cases,and good in 2 cases.No local recurrence and distant metastasis occurred in the patients during the follow-up time ranging from 3 to 15 months. Conclutions Immediate breast reconstruction with the pedicle TRAM flap is an ideal breast reconstruction method for those patients undergoing mastectomy not only because it reconstructs the defective breast but for its cosmetic effect on the abdominal wall.

Objective To analyze the factors contributing to local recurrence following body gamma knife radiotherapy in patients with non-small cell lung cancer(NSCLC),and to explore a standard therapeutic scheme under the circumstance.Methods 332 patients with NSCLC received body gamma knife therapy and subsequent regular follow-up.Dose per fraction and total dosage used were dependent on disease condition,tumor location,tumor features and tumor size,etc.On the basis of patients' conditions and adverse effects,biological effective dose(BED) was 56-90Gy calculated with LQ model.Univariate analyses were performed including sex,age,Karnofsky performance score,clinical stage,pathological type,tumor differentiation degree,tumor size,tumor location,target volume delineation,dose per fraction,BED and chemotherapy scheme,etc.with X2 or t test.By selecting significant clinical factors in univariate analysis,multivariate analyses were performed with COX regression model.Results Of the 332 patients,local recurrence occurred in 22 cases during regular follow-up period,with average recurrence time of 10 months,and the local recurrence rate was 6.63%.The results of multivariate analysis showed that low BED,low Karnofsky score,old age,too small delineation for target volume range and central type of lung cancer were the factors related to local recurrence.Conclusions Low BED in body gamma knife radiotherapy is the significant factor of local recurrence for patients with NSCLC.BED in body gamma knife radiotherapy should be more than 80Gy for NSCLC patients who receive the radical treatment.

In artificial immune optimization algorithm, the mutation of immune cells has been considered as the key operator that determines the algorithm performance. Traditional immune optimization algorithms have used a single mutation operator, typically a Gaussian. Using a variety of mutation operators that can be combined during evolution to generate different probability density function could hold the potential for producing better solutions with less computational effort. In view of this, a linear combination mutation operator of Gaussian and Cauchy mutation is presented in this paper, and a novel clonal selection optimization method based on clonal selection principle is proposed also. The simulation results show the combining mutation strategy can obtain the same performance as the best of pure strategies or even better in some cases.