Objective To study the relationship between the renal cortical thickness and age,and to establish the range of the normal renal cortex thickness by using CT measurement in different age groups so as to obtain a best age-related and practicable method for clinical measurement. Methods (1) the accuracy of measuring renal cortical thickness by CT was evaluated; 18 kidneys resected due to renal neoplasm were studied and the cortical thickness of the normal part of these specimens was assessed. The difference between the renal cortical thickness of specimens and preoperative measurements of renal cortex of the same patient by contrast enhanced CT was analyzed statistically. (2) 120 patients without history of renal disease or long term usage of potentially renal toxic drugs or history of hypertention were examined by CT with indication(s) other than renal disease. All the patients were divided into 20-40, 41-60, and 61-80 year-old groups. The renal cortical and parenchymal thickness and renal size were measured in three CT sections. The difference of the measurements among the three groups and their relationship to age was analyzed statistically. Results There was no significant difference between the renal cortical thickness measured by enhanced spiral CT and measured in renal specimens(t =0. 80,P =0. 43). The renal cortical thickness in three groups was 0. 73 cm, 0. 65 cm, and 0. 53 cm, respectively, and the differences among the three groups were significant ( F = 93.430, P 0. 05). Conclusion The measurement of the renal cortical thickness with enhanced spiral CT was reliable and was a sensitive method in investigating the morphologic changes of the kidney. The renal cortical thickness of normal kidney diminishes with age, but the change of the ratio of thickness of renal cortex to renal parenchyma with age was not significant.

0.5). Conclusion To some extent, the cup sign and split sign on CT reflect the biologic character of AMLs, and the signs are helpful in making the specific diagnosis of AML combined with other imaging manifestations.

Objective:To explore the application of group sandbox game intervention on emotional state and coping style in patients with gastric cancer.Methods:A total of 92 patients with gastric cancer treated with chemotherapy in the First People′s Hospital of Lianyungang from March 2018 to March 2019 were selected by convenient sampling method, they were divided into two groups according to admission time, 46 patients in the control group received conventional care after chemotherapy, and 46 patients in the observation group received group sandplay therapy for three months which was performed after chemotherapy. The Distress Thermometer(DT), Hamilton Depression Scale (HAMD), Hamilton Anxiety Scale (HAMA), Medical Copingmodes Questionnaire (MCMQ) were used to assess the emotional status and coping style of the patients before and after intervention.Results:After intervention, the DT, HAMA and HAMD scores of the observation group were 2.26±2.09, 13.52±2.50 and 16.47±3.61 respectively, and the DT, HAMA and HAMD scores of the control group were 3.36±2.23 and 20.85±4.53, 23.63±4.82, respectively. The DT, HAMA, HAMD scores in observation group were significantly lower than those in the control group, the difference between the two groups was statistically significant ( t value was 2.441, 9.608, 8.064, P<0.05). The dimensional score of the MCMQ measurement surface of the observation group after intervention was 18.35±3.19, and 14.25±3.04 in the control group. MCMQ scale escape and yield dimension scores in the observation group were 15.26±3.14, 10.24±2.56, and 17.81±2.59 and 12.84±2.64 in the control group. After the intervention, the observation group′s MCMQ surface score was higher than the control group, and the escape and yield dimension score was lower than that of the control group ( t value was 6.311, 4.249, 4.795, P<0.05). Conclusions:Group sandplay therapy can relieve negative emotion in patients with gastric cancer undergoing chemotherapy, and improve their coping style.

Objective　To compare the predictive value of Glasgow coma scale (GCS), revised trauma score (RTS) and acute phsiology and chronic health evaluation (APACHEⅡ) system on head injury prognosis, and selectscoring systems apt to predicting prognosis of the head injury. 　Methods　The data of 116 case of head injury were reviewed. The correlation between the score of GCS, RTS, or APACHEⅡ and the patients' prognosis was determined by Spearman rank relation test on admission. Then, the logistic regression analysis was administered, in which GOS I～Ⅲ in half year were regarded as risk event. The independent predictive varieties were determined from following varieties: GCS, systolic pressure, respiratory rate, age, and chronic health condition. 　Results　GCS, RTS and APACHEⅡ were significantly related with the prognosis (r=0.660,0.676 and -0.578, respectively). GCS and age were independent predictive indexes. 　Conclusions　RTS system doesn't show the superiority to GCS system. The predictive accuracy may improve if GCS system is appropriately combined with APACHEⅡ system.

Objective To investigate the treatment effect of gamma knife radiosurgery for hypothalamic hamartomas. Methods Gamma knife radiosurgery was performed in 9 patients with gelastic seizures. Collimator helmets (4 and 8 mm) were used and a radiosurgery plan was designed to cover 90% of the hamartoma at the 40%~55% isodose curve with the center dose of 28~40 Gy and the margin dose of 12~18 Gy. The clinical outcome was evaluated with the Tan’s scale. Results No complications due to gamma knife radiosurgery occurred. A follow-up from 24 to 54 months showed effectiveness in 7 patients, disappearance of seizure in 1 patient, rare occurrence in 3 patients, significantly reduced occurrence in 2 patients, improvement in seizure control in 1 patient, but ineffectiveness in 2 patients. Conclusion As an approach to the treatment of hypothalamic hamartomas, gamma knife is a safe and cost-effective therapy with rare side effects for hypothalamic harmatomas.

Objective To explore operating efficiency of county-level public hospital by using data envelopment analysis ,provide reference ,and basis for health decision-making .Methods The health resources data of 16 county-level public hospitals were ran-domly selected from 2008 to 2011 ,its relative efficiency were studied by data envelopment analysis method of CCR-CRS and BCC-VRS model ,the change trend from 2008 to 2011 were analyzed through the Malmquist productivity index .Results The average ef-ficiency value was 0 .938 in 16 county-level hospitals in 2011 ,7 hospitals was DEA efficient and 9 hospitals was non-DEA efficient (8 hospitals with Scale efficiency decline gradually ,another one with increasing gradually ) .The total factor productivity increased 2 .5% from 2008 to 2011 average annual ,the productivity first decreased from 2008 to 2009 ,and then increased from 2009 to 2011 . Conclusion The overall efficiency 16 county-level hospitals is not high ,it is necessary to develope hospital scale reasonable , strength hospitals′management level and improve technical ability of doctors .

Objective To investigate the clinical effect of using uninterrupted vacuum sealing drainage combined with routine debridement and pedicled periosteal flap sealing frontal sinusitis in treating frontal sinusitis after craniotomy.Methods The clinical data in 31 cases of frontal sinusitis after craniotomy in our hospital from January 2006 to December 2014 were retrospectively analyzed.Seventeen cases adopted simple debridement and drainage treatment and 14 cases were treated with continuous vacuum sealing drainage combined with routine debridement treatment.Postoperative follow up lasted over 1 year.Results In simple debridement and drainage,12 cases were cured,the other 5 cases recurred after operation,and the cure rate was 70.6 ％.But in the continuous vacuum sealing drainage combined with routine debridement treatment,14 cases were cured,no case recurred after operation,and the cure rate was 100％.Therefore,the cure rate of continuous vacuum sealing drainage treatment combined with routine debridement was higher than that of simple debridement and drainage treatment(P＜0.05).Conclusion Adopting vacuum sealing drainage combined with routine debridement and pedicled periosteal flap sealing frontal sinusitis can promote the infection focus clearance and wound healing,and increases the cure rate.

Objective To study the CT manifestations of delayed traumatic hematomas of the brain and evaluate their diagnostic significance in predicting the delayed traumatic brain hematoma. Methods The manifestations of initial CT studies and follow-up CT examinations of 31 delayed traumatic brain hematomas were analyzed. Another 50 CT studies of head trauma without delayed brain hematomas were included randomly as control. Results The abnormal findings of CT studies of the 31 delayed traumatic brain hematomas included: (1)Decreased density of the local brain parenchyma and disappeared difference between gray and white matter of the same area in 18 cases; (2)Local subarachnoid space hemorrhage in 24 cases; (3)Slight mass effect of local brain parenchyma in 16 cases. (4)Subdural hematoma in 9 cases. The locations of the abnormalities were roughly the same with the delayed hematoma except one local subarachnoid space hemorrhage, which was in the opposite of the delayed hematoma. The appearing rate of those abnormal findings in the control group was low and the difference was statistically significant. Conclusion The decrease of density of local brain parenchyma, the disappeared difference between the gray and white matter, local subarachnoid space hemorrhage, and local swollen of brain presented in the initial CT study of the patient with head trauma should be taken as indicators of delayed hemorrhage of the same area of brain, and it is necessary to do follow-up CT studies to exclude it.

Objective To analyse the therapeutic outcome of cavernous sinus meningiomas by gamma knife radiosurgery. Methods Retrospective analysis was conducted of 37 patients with cavernous sinus meningiomas. The median maximum diameter was 2.6 cm (1.4～3.2 cm) with the median dose to the tumor margin of 15.7Gy(8～22 Gy), the isodose curve to the tumor margin of 40%～60% and the target numbers of 1～9. The radiosurgical dose to the optic nerve and brain stem was not more than 10 Gy and 15 Gy, respectively. Results After an average follow up of 22.6 months(ranging 4～43 months), unchanged symptoms were found in 22 cases(59.5%), alleviated in 12 cases(32.4%) and complications of optic and trigeminal nerve in 3 cases(8.1%). By MR image analysis, unchanged size was found in 18 cases(48.6%), smaller size in 15 cases(40.5%) and larger size in 4 cases(10 8%). One factor analysis of variance revealed that tumor recurrence was associated with marginal dosage(

Objective To assess the characterization and usefulness of contrast enhanced ultrasound (CEUS)to diagnose solid focal lesions of pancreas(s-FLPs)in comparison to contrast enhanced computed tomography(CECT).Methods Forty-nine s-FLPs with final diagnosis were studied with low mechanical index CEUS and CECT.The enhanced patterns and diagnostic capability of CEUS were analyzed,and these results were compared with those from CECT.Results ①In CEUS,the perfusion of capillary could be detected in vascular phase.②The concordance of dual-phases enhanced patterns between CEUS and CECT was 73.5%(36/49).The concordance of enhanced level between early parenchymatous perfusion phase in CEUS and pancreatic phase in CECT could achieve 87.8%(43/49).Hypo/hypo enhancement was the most common enhanced pattern of pancreatic carcinoma in CEUS and CECT.③There was no statistical significance between CEUS and CECT in the differential diagnostic.Conclusions The concordance of enhanted patterns between CEUS and CECT is satisfactory.CEUS is similar to CECT in the differential diagnosis of s-FLPs.CEUS would become an important non-invasive diagnostic method for s-FLPs.