Objective To evaluate the diagnostic role of the color Doppler flow image(CDFI) in malfunction of lower extremity perforator vein. Methods Using color Doppler flow image method,60 lower extremities were ex-amined,and compared with the results of the lower extremity vein angiography,then assessed the accuracy of CDFI method. Results 212 lower extremity perforator veins of malfunction were found,and compared with results of the lower extremity vein angiography, the sensitivity of CDFI method is 91.1%, the specificity of CDFI method is 85.8 % ,the accuracy of CDFI method is 91.9 %. Conclusion CDFI is useful for the diagnosis of malfunction of lower extremity perforator vein and can offer reliable bases to clinical operation.

Objective To develop a new kind of tracheal catheter for large or medium -sized surgical anesthesia as a medical equipment of respiratory management,and to rescue the patients with anhelation of respiratory arrest,which is essential to first-aid treatment and will be widely used clinically.Methods The disposable non-toxic transparent plastic was adopted,which was reinforced by the spiral stainless steel wire with regular separations.The diameter of the tracheal catheter varied with the different models.The tracheal catheter was composed of the items put into the trachea when applied for anesthesia such as the inflatable bladder and liquid mouth,the ones connected with the anesthesia machine such as the ring lines regulating direction of the front end of the catheter,and the syringe adapters for the liquid and gas.Results The flexible,air-proof tracheal catheter,with its direction adjustable,injected the medicine through its front end.Conclusion The tracheal catheter can be used for intratracheal medication,and will be popularized clinically.

ObjectiveTo explore the clinical diagnostic value of ambulatory EEG (AEEG) in epilepsy and atypical epilepsy.MethodsThe monitoring of 24-hour AEEG were performed in 67 epileptic and 53 atypical epileptic.Results65.7% of epileptic cases presented abnormality, and 34.0% of atypical epilepsy. The 85.5% of epileptic form discharges were found in the stage of sleep, especially in the Ⅰor Ⅱstage of NREM. The main epileptic form discharges was sharp waves.ConclusionThe monitoring of 24-hour AEEG may play important role in the diagnosis of epilepsy or atypical epilepsy, but can do little in the classification and detecting the focus of epilepsy.

ObjectiveTo explore the relationships among atrial natriuretic peptide (ANP) and cerebral vasospasm (CVS) following subarachnoid hemorrhage (SAH) and hyponatremia.MethodsPlasma ANP levels and serum natrium and blood flow rate of intracal major arterial were assessed at different times (1 to 3 days, 7 days and 14 days after SAH) in 42 patients with SAH. Correlation analysis was carried out among plasma ANP, blood sodium level and blood flow rate of intracal major arterial.Results28 patients had CVS. Plasma ANP levels in CVS patients significantly elevated compared with non-CVS and control subjects (P<0.05). Hyponatremia in CVS patients also significantly elevated compared with non-CVS subjects (P<0.05). Plasma ANP level had significant negative relationship with serum natrium level at the 7th day and 14th day (r2=-0.778,r3=-0.653;P<0.01,P<0.05) in SAH patients. Plasma ANP level had significant positive correlation with middle cerebral artery mean flow velocity on the 7th day (r3=0.702,P<0.05) in SAH patients. Middle cerebral artery mean flow velocity had significant negative relationship with serum natrium level on the 7th day and 14th day (r2=-0.693,r3=-0.653 , both P<0.05) in SAH patients.ConclusionANP might cause hyponatremia following SAH and play an important role in pathogenesis of earlier period CVS.

Objective To research the feasibility of using three-dimensional CT (3DCT) associated with active breathing control (ABC) in determination of the individual internal tumor volume (ITV) for hepatocellular carcinoma (HCC) comparing the four-dimensional CT (4DCT).Methods After 4DCT scans of 15 HCC patients who had accepted TACE,completed the 3DCT scans associated with ABC in three ways of breathing:free breathing ( FB),end inspiration hold ( EIH),end expiration hold (EEH).4DCT images were sorted into 10 phases and the maximum intensity projection (MIP) images were constructed.The GTVs were manually contoured on 4DCT and 3DCT images (labeled as GTV0,GTV10.….GTV90,GTVMIP,,GTVFB,GTVEIH and GTVEEH).GTV0…GTV90,GTV0 and GTV50,GTV0,GTV20 and GTV50,GTVEIH and GTVEEH were respectively merged into IGTV1,IGTV2,IGTV3,IGTV4.The volume and geometry displacement of GTVs and IGTVs were compared.Results All patients were compatible with the ABC technique and completed the CT scans in two ways.The motion of diaphragm measured between 4DCT and 3DCT images was not significantly different ( 1.39 cm and 1.39 cm,t =-0.02,P =0.983 ),it was similar to the volume difference among GTV0,GTV20,GTV50,GTVEIH,GTVEEH and GTVFB (56.4,54.6,55.5,55.6,55.2,59.7 cm3,F =0.01,P =1.000 ).The comparison result of volume difference among IGTV1,IGTV2,IGTV3,IGTV4 and GTVMIP (77.9,71.4,73.4,72.3 and 66.3 cm3,F =0.02,P =1.000)were similar to the differences of geometry displacement in x,y and z axial among them (F =0.48,0.04,0.02,P =0.750,0.997,0.999,respectively).Conclusion The application of 3DCT associated with ABC in determination of the individual IGTV for HCC is feasible and safe comparing to 4DCT.

ObjectiveTo investigate the dosimetric difference in the application of RapidArc using 6 and 15 MV X-rays for radiotherapy of multiple hepatic malignancy.MethodsA total of 12 cases with multiple hepatic tumors ( primary 5 cases and secondary 7 cases) were selected.All patients underwent the three dimensional CT simulation in free breathing.For each patient,RapidArc plans with single or two 358° arcs using 6 or 15 MV X-rays were designed respectively,the prescription dose was 2Gy per fraction × 25 fractions.The dosimetric differences were compared among RapidArc plans.ResultsAll of RapidArc plans could meet the clinicalrequirement.There were no significant differences in the conformity index ( CI ),homogeneity index ( HI),the maximum dose and the minimum dose of PTV among RapidArc plans ( P ＞ 0.05).All the CI could get to 0.91 and HI could get to 0.88.In the RapidArc plans with two 358° arcs,the Vs,V10,V15 of normal liver were higher than with single arc,while V20,V25,V30,V35,V40 were lower than with single arc.There were no significant differences in the different radiation dose of normal liver,stomach,duodenum and spinal cord among different plans ( P ＞0.05 ).The monitor units of RapidArc plans using 6 MV X-rays increased 12％ compared to 15 MV averagely.CondusionThe 6 MV X-ray would be selected chiefly in the radiotherapy of multiple haptic tumor using RapidArc with whole arc(s).

Objective To investigate the molecular characteristics and epidemiological signification of patients with low-level HBsAg. Methods PCR and gene sequencing were used to detect HBV DNA and Tyr-Met-Asp-Asp(YMDD) mutant in 136 serum samples with low-level HBsAg and 44 sernm samples with high-level HBsAg. Genotyping was performed in 47 cases with HBV DNA 10~5 copies/L by concentration method and 37 cases with high-level HBsAg. S gene sequences and serotypes were analyzed in 14 cases with HBV DNA 105 copies/L and 29 cases with high-level HBsAg. S gene sequences were compared with the consensus sequence of Chinese strain by BioEdit software. Results The HBV DNA-positive rate, YMDD mutation rate and HBV DNA load (logarithm) in low-level and high-level HBsAg group were 34.6% (47/136), 0% (0/136), 6.5±1.4 and 84.1% (37/44), 9.1% (4/44), 8.9±1.8, respectively. There was statistically significant differences between two groups (for concentration method,χ~2 = 30.8, P < 0.05; for direct method, χ~2 = 53.5, P < 0.05; for YMDD mutation ratio, P = 0.003, For HBV DNA (log), t = 6.5, P < 0.05). The genotypes in low-level HBsAg group included type B (16/47), type C (5/47) and non-classified ones(26/47). There were significant differences between two groups (χ~2=21.8, P <0.01). The serotypss included adw (7/14), ayw (4/14), adr (2/14) and ayr (1/14). There were significant differences in genotypes (χ~2 = 13.5, P < 0.05) but not in serotypes between two groups (χ~2 = 4.7, P >0.05). S gene sequencing results showed no S gnne variation was detected, but there were 6 single nucleotide polymorphisms in 16 cases, which would not result in the alternation of amino acid. Conclusions Low-replication phenomenon of HBV DNA was present in patients with low-level HBsAg. The major genotyps and serotype was type B and adw/ayw, respectively. Polymorphic variants have been found in the S gene. The existence of low-level HBsAg might be related with its own molecular characteristics resulting in low expression of HBsAg or immune tolerance induced by low-level HBsAg after HBV infection.

Abstrct Objective To develop a new type of paste for external trauma or surgical incision.Methods The paste is consisted of 6 parts,which are outer package;stickiness-proof soft membrane;aeration absorption layer;sticking fixation surface;neodymium,iron,boron and lanthanon magnet;cuticle.Different sizes of paste are made to observed the clinical effect.Results The product can accelerate wound healing,lower wound infection rate,and release pain,reduce the formation and soften scar.Conclusion The new type paste is a relatively reliable wound dressing,which can be applied in relative department.

Objective To investigate the distribution and severity of cerebral artery stenosis and the prognosis in elderly patients with acute cerebral infarction using digital subtraction angiography (DSA). Methods The 432 elderly patients with acute cerebral ischemia infarction underwent DSA,and they were divided into two groups: elderly group (n= 320) and non-elderly group (n= 112). The characteristics of distribution and severity of cerebral artery stenosis, the relationship between artery stenosis and relative risk factors, and the prognosis of acute cerebral infarction were analyzed.Results In elderly group, 270 cases (84.3%) had intra- and extra- cranial artery stenosis, of which 98 patients (30.6%) with pure extracranial arterial stenosis, 132 patients (41.3%) with combined extra- and intra-cranial artery stenosis. They were both significantly higher than the corresponding data in non-elderly group [23 cases (20.5%) and 28 cases (25%), P＜0.05 and 0.01]. The prevalences of moderate and severe cerebral artery stenosises were higher in elderly group than in nonelderly group [224 locations (52.1%) vs. 51 locations (40.8%), P＜0. 05]. The number of patients with previous history of cerebrovascular disease was much more and the prognosis was much worse in elderly group than in non-elderly group (both P＜0.05), Conclusions The elderly patients with cerebral infarction have severer cerebral artery stenosis, increased proportion of multivessel disease and poor prognosis. So it is very important to take aggressive treatment as soon as possible, and to make secondary prevention and effective rehabilitation so as to improve their prognosis.

Objective To study the feasibility of defining the internal gross tumor volume (IGTV) of hepatocellular carcinoma applying the enhanced four-dimensional computed tomography (4DCT) images with deformable registration technology.Methods Ten HCC patients who accepted radiation therapy were selected in this study.The 4DCT in free breathing,non-enhanced 3DCT and arterial phase enhanced 3DCT in end inspiration breath holding associated with active breathing coordinator were acquired sequentially.4DCT were sorted into ten series CT images according to breath phase,and named CT00,CT10..…CT90.Gross tumor volume (GTV) were contoured on different CT series and the IGTV1 was merged by ten phases GTVs of 4DCT.The GTV of enhanced 3DCT was registered to different CT series of 4DCT and the IGTVDR was obtained by merging the GTVs after deformable registration.The target volumes differences were compared by paired t-test.Results The edge of tumor was difficult to define on 4DCT and non-enhanced 3DCT images.The enhanced 3DCT image showed clearer tumor edge,and the GTV increased by mean 37.99％ compared to GTV on 4DCT different series images and non-enhanced 3DCT image (P =0.002).The GTV after deformable registration on 4DCT different phase images increased by mean 36.34％ (P =0.011),which were similar to GTV on enhanced 3DCT image (P =0.632).The IGTVDR increased by 19.91％ (P =0.017),compared to IGTV1.Conclusions The contrast-enhanced 4DCT image which was obtained by combining enhanced 3DCT and 4DCT images with deformable registration technology could raise the position precision of the HCC IGTV effectively.