Objective To assess the value of CT in diagnosis of recurrent rectal carcinoma.Methods Forty seven patients who had undergone locally curative surgery were examined by CT.All patients received intravenous contrast medium and two oral doses and a intrarectal doses of 500 ml 3% Ultravist were given.The characters of benign and malignant lesions were analysed in order to evaluate the value of the classification on CT in the differentiation of benign masses from malignant ones.Results 26 local recurrences occurred in 47 cases,including 13 cases with an round preasacral mass,8 cases with an irregular rectal wall thickening,2 cases with a flat preasacral mass,3 cases with a preasacral mass with low attenuation.The degree of enhancement of local recurrent masses was higher than that of benign masses.Conclusion The features of recurrence of rectal carcinoma on CT is an round or irregular asymmetrical preasacral mass or an irregular rectal wall thickening.It is useful way in diagnosis of recurrence of rectal carcinoma.

Objective To report the preliminary clinical results of treatment of severely comminuted radial head fractures by replacement with floating cup radial head prosthesis. Methods In the period from August 2002 to June 2005, replacement with floating cup radial head prosthesis was performed to treat 10 cases of Mason Ⅲ , Ⅳ radial head fractures, of whom 9 were acute fractures and 1 old. Results All the patients were followed up for 6 to 40 months (mean 14.9 months). The mean flexion/extension of the elbow was 133.5? /9.0? , while the mean pronation/supination of the forearm was 78.5? /84.0? . There were 3 cases of mild pain, 1 case of mild valgus instability in the elbow and 3 cases of mild weakness. The Broberg and Morrey elbow scores averaged 93. The result was excellent in 6 cases, good in 3 and fair in 1, the excellent and good rates were 90% . Conclusion The replacement with floating cup prosthesis shows satisfying preliminary clinical outcome in the treatment of radial head fractures unable to be reduced, while its long- term result needs further follow- up

Objective To investigate CT features of XGC in order to improve pre-operative diagnosis of the disease.Methods The CT features of 6 cases with XGC confirmed by histopathology were analyzed retrospectively.Results The gallbladder walls thick-ened in all 6 cases,diffusely thickened in 4 cases and focally thickened in 2 cases.Hypodensity nodules or bands in thickened walls were seen in all 6 cases.The continuous mucosal lines were observed in 4 cases.After contrast administration,the hypodensity band sign was seen in most cases in artery phase.Stones were found in all 6 gallbladders and in 4 common bile ducts,dilatation of biliary tract was seen in 3 cases.There were hepatic involvement in 5 cases,duodenal,hepatic flexure of the colon and antrum of the stom-ach adhesion with gallbladder was seen in 1 case respectively.Conclusion Hypodensity nodules or bands in thickened gallbladder walls and continuous mucosal line are characteristics of XGC,which are helpful in diagnosis and differential diagnosis.

Objective To analyze the radiologic characteristics of focal organizing pneumonia (FOP) and discuss its values in diagnosis of FOP.Methods 57 lesions of FOP proved by histological examination were studied retrospectively.All of the lesions could be classified into types of nodule(diameter≤30 mm, n=40) and mass(diameter>30 mm, n=17),which were analyzed to explore the imaging characteristics such as location, margin, internal state, and enhancement features.Results 39 lesions were located in the right lung and 18 lesions in the left lung, and 51 lesions in the peripheral and 6 lesions in the inner or middle of the lung.The differences between the location of lobe and lung field were statistically significant.The radiographic common features included air bronchogram were seen in 28 cases, while loose composition sign in 18 cases and vessel convergence in 21 cases.49 lesions occurred in subpleural region, including 34 lesions broad contract with pleura.In 54 lesions with contrast-enhanced CT scan, the difference between arterial phase and plain scan in CT value was 35 HU and difference of venous phase and plain scan was 45 HU, presenting gradual enhancement.14 lesions were inhomogeneous enhancement in mass type and 25 lesions were homogeneous enhancement in nodule type.There were statistic differences in margin, shape, round-glass opacity, necrosis, cave and the relationship with pleura between the nodule type and mass type.Conclusion FOP has specific radiographic features.Enhanced CT scan combining multi planar reformation images is helpful in differential diagnosis.

Objective To investigate the expression and clinical significance of serum ferritin in patients with lung cancer. Methods The relationship between preoperative serum ferritin level and corre-sponding clinicopathological data in 174 patients with lung cancer and 85 patients with benign pulmonary diseases was reviewed and analyzed. Results The level of serum ferritin in patients with lung cancer was significantly higher than that in patients with benign pulmonary diseases. For non-small cell lung cancer, patients with large-sized,poorly differentiated squamous carcinoma in advanced stage had higher serum ferritin levels than those with small-sized,highly or moderately differentiated adenocarcinoma in early stage. Conclusion Serum ferritin may play a promoting role in the development and malignant progres-sion of lung cancer.

Objective To investigate the value of spiral CT in diagnosis and its differiential diagnosis of adrenal hyperplasia char-acterized with solitary nodule.Methods 20 cases of adrenal hyperplasia characterized with solitary nodule and 28 adrenal adenomas confirmed by pathology underwent routine CT plain scan and multiphase enhanced CT scan.The density of nodule,capsule and de-gree of enhancement in each period were respectively analyzed and compared with the normal adrenal.The difference of CT value be-fore and after enhancement(△CT value)of the both was compared using pairing t test.Results 20 cases of adrenal hyperplasia nod-ules had no clear boundary with normal adrenal.Of which 1 5 cases showed isodensity,and their degree of enhancement was synchro-nized with normal adrenal;4 cases showed lower density,of which 2 had no enhancement,the other 2 obviously enhanced,but lower than normal adrenal;1 case showed mixed density mass,mainly composed of soft tissue,fat and punctuate calcification could be seen in it.Enhanced △CT values of 20 cases of adrenal hyperplasia nodule and normal adrenal were compared respectively,and there was no significant difference(P >0.05).28 cases of adrenal adenomas presented lower density than that of normal adrenal and had obvi-ous boundary between them.Enhanced △CT values in arterial phase of the lesion and normal adrenal showed significant statistically difference (P <0.05).Conclusion CT performance of adrenal hyperplasia with solitary nodule has specific characteristics,the densi-ty,capsule and enhanced mode will be helpful in differentiating from adrenal cortical adenoma.

PurposeTo evaluate 64-slice spiral CT in grading of colorectal adenoma and in the diagnosis of adenocarcinoma.Materials and Methods Sixty-eight cases of pathology confirmed colorectal adenoma were retrospectively reviewed to analyze CT performance including the location, size, shape and their relationship with adjacent structures and degree of enhancement in arterial, venous and delayed phase. The difference of CT attenuation value before and after enhancement (△CT value) in arterial, venous and delay phase of different pathological types and different levels of adenomas were compared.Results Among 68 lesions, 16 were villous adenomas, 42 were tubulovillous adenomas and 10 were tubular adenomas. Villous adenomas and tubulovillous adenomas were characterized by wide base, villous-like with gyral or frond pattern enhancement in arterial phase. There was a layer of low density mucus covering the surface. Tubular adenomas were featured as narrow base, nodular in shape with homogeneous enhancement.△CT values in each phase between villous adenomas and tubular adenomas showed statistically significant difference (arterial phaset=2.56,P<0.05; venous phaset=3.22,P<0.05; delayed phaset=2.48,P<0.05), however no significant difference was shown between villous and tubule villous adenomas or between tubulovillous and tubular adenomas. Adenocarcinomas showed creeping-type growth along the intestinal wall with a cluster of vessels adjacent to the tumor or enlarged lymph nodes.△CT values in each phase between non-dysplasia group and carcinoma group showed statistically significant difference (arterial phaset=2.49,P<0.05; venous phase t=2.69,P<0.05; delayed phaset=2.75,P<0.05), however no significant difference was shown between non-dysplasia group and dysplasia group or between dysplasia group and carcinoma group. Using 50 HU of△CT value in artery phase as standard, the sensitivity and specificity for diagnosis of adenocarcinomas were 76.92% and 70.91%, respectively.Conclusion CT findings of different pathological types of colorectal adenomas and adenocarcinomas are characteristic and useful in preoperative diagnosis and treatment planning.

Objective To explore the curative effect of triple lumen feeding tube on upper gastroin-testinal tract perforation after endoscopic operation.Methods A total of 1 12 patients with upper gastrointes-tinal perforation after endoscopic operation were involved in this prospective control test.The remission rate of abdominal pain and abdominal distension,gastric pH,lesion healing time,length of stay and the success rate of conservative treatment were compared between the control group (indwelling traditional gastric tube and intravenous use of omeprazole injection)and the experimental group (intestinal administration of PPI through triple lumen feeding tube).Results The remission rate of abdominal pain of the experimental group was 61. 3% at 6 hours,and 83. 2% at 12 h,which were significantly higher than those of the control group (P<0. 05 ).The lesion healing time(of cases where lesions were not clipped)and length of hospitalization of the experimental group were significantly shorter than those of the control group(P<0. 05 ).The gastric pH and success rate of conservative treatment of the two groups had no significant difference(P>0. 05 ).Con-clusion The curative effect of triple lumen feeding tube on upper gastrointestinal tract perforation after endo-scopic operation is ideal.

Objective To compare the myocardial protective effect between off pump coronary artery bypass(OPCAB) and on pump coronary artery bypass in the aged. Methods Four five patients were randomly divided into 3 groups:off pump coronary artery bypass (n=15),tepid blood cardioplegia group(n=15) and cold blood cardioplegia group (n=15).There was no statistical difference in heart function,sex,age and lesion of coronary artery .Venous blood samples were taken for determineing the serum concentration of creatine kinase MB isoenzyme(CK MB),troponin I perioperatively and the clinical situations were observed postoperatively. Results CK MB,troponin I release in beating group during and after bypass was lower than that in on pump groups( P

AIM: To observe the neuroprotective effect of combined treatment with taurine and diazepam against focal cerebral ischemia-reperfusion in rats. METHODS: Sixty male Sprague-Dawley rats were randomly divided into five groups: sham-operation group, vehicle group, taurine group (200 mg/kg, ip), diazepam group (10 mg/kg, ip) and combined treatment group (taurine 100 mg/kg+diazepam 5 mg/kg). Focal cerebral ischemia was induced by the method of middle cerebral artery occlusion (MCAO) in rats, and reperfusion was emerged by removing the thread 2 h later. The drugs were administered respectively at the time of reperfusion, and subsequently repeated once 12 h later. The animals in vehicle group were intraperitoneally injected with isodose normal saline. The neurological deficit score, the brain water content and cerebral infarction were measured 48 h after MCAO. Other 5 group animals of focal cerebral ischemia-reperfusion (n=16 in each group) were set up as mentioned above and accepted treatments 10 h after reperfusion, likewise repeated once 12 h later. Twelve animals in each group were adopted the same management as the previous 5 groups at 48 h after MCAO. The remained 4 animals in each group were sacrificed until two weeks after MCAO to observe the histopathological changes by nissl staining. RESULTS: Compared to vehicle group, the animals in combined treatment group at 2 h or 12 h after MCAO both decreased the neurological deficit score, reduced the brain water content and infarct volume (P<0.01 or P<0.05). The combined treatment significantly alleviated the neurological necrosis as well. The neuroprotective effect of the combined treatment was superior to that of using taurine or diazepam alone. CONCLUSION: These results suggest that combination of taurine and diazepam treatment has a coordinate neuroprotective effect on both the acute and chronic brain damage of focal cerebral ischemia-reperfusion.