Objective To study the CT manifestations and diagnostic value of stromal tumor.Methods CT documentation of 25 stromal tumor cases confirmed by surgery and pathology were analyzed retrospectively,all cases underwent 64 row or 256 row spiral CT plain scan and enhanced scan.Results Within 25 cases,1 7 cases were gastrointestinal,of which,10 cases were found in stom-ach,1 case in duodenum,3 cases in jejunum and 3 cases in ileum;and 8 cases were extra-gastrointestinal,of which,6 cases were found in enterocoelia,1 cases in inguinal region,1 case in abdominal wall;the ratio was 2.1 ︰ 1.In 25 cases,highly malignant dan-ger level were 1 1 cases,7 cases of moderate and 7 cases of low malignant danger;Transfer occurred in 7 cases and 3 cases of postop-erative recurrence.Conclusion The volume CT has great advantages in displaying information in lesion,and has high value in loca-ting the lesion and qualitative diagnosis of disease.

Aim To explore the effects of Nrf2-ARE signal path on levrtiracetam anti-epileptic and levrtiracetam on learning and memorizing ability.Methods Thirty-six SD rats were divided into normal saline group, levrtiracetam group, model group and treatment group.Each group recruited nine rats.Tests of Morries water maze were given to the rats to evaluate their learning and memorizing ability.The protein expression of nuclear factor (erythroid-derived2)-like2 (Nrf2), heme oxygenase 1(HO-1) and NAD(P)H quinone oxidoreductase(NQO1) were examined by Western blot.Results Compared with model group, levrtiracetam could shorten the plateau period in epileptic rats (P<0.05), and increase the expression of Nrf2 protein, HO-1 protein and NQO1 protein in hippocampus(P<0.05).Conclusions Levrtiracetam could improve the learning and memorizing ability in epileptic rats.Levrtiracetam may increase the expression of HO-1 protein and NQO1 protein through the Nrf2-ARE pathway and play a part in antiepileptic effects.

Objective:To study preoperative MRI imaging and its enhanced mode on tumor features in predicting microvascular invasion (MVI) in patients with hepatocellular carcinoma (HCC).Methods:The clinical data of patients with a solitary HCC who underwent MRI examination followed by surgical resection at the General Hospital of Ningxia Medical University from January 2017 to June 2019 were studied. The patients were divided into the MVI (+ ) and MVI (-) groups according to the findings on postoperative pathological diagnosis. The relationship between the rates of MVI and MRI tumor features including diffusion weighted imaging (DWI) signal, enhancement mode, enhancement type and other imaging characteristics were analysed.Results:Of 84 patients with HCC enrolled into this study, there were 65 males and 19 females. Their age (Mean±SD) was (54.94±11.51) years. MVI (+ ) was found in 46 patients and MVI (-) in 38 patients. The maximum tumor diameters (Mean±SD) of the two groups were (7.08±3.45) cm and (4.28±2.47) cm ( P<0.01). Single-factor analysis and comparison of imaging characteristics of the two groups of patients showed tumor DWI signal, tumor encapsulation, enhancement mode, tumor edge smoothness, abnormal enhancement around tumors, and intratumoral arteries were significantly different ( P<0.05); There were no significant differences in T 1WI signals, T 2WI signals, tumor periphery, and enhancement types between groups. After inputting MVI(+ ) as a risk factor into the logistic regression model, tumor maximum diameters >6.33 cm, type 3/4 enhancement mode, and unsmoothness of tumor edge were independent risk factors (all P<0.05). Through combined diagnosis using ROC curve analysis with a cut-off value of 0.53, the area under the curve was 0.881, the sensitivity 0.870, specificity 0.789, and the Youden index 0.659. Conclusion:The multivariate logistic regression model and combined diagnosis using ROC curve analysis improved the diagnostic efficacy of MVI in its prediction of HCC on imaging studies. The risk predictors were easy to use and to promote in clinical practice.

Objective:To evaluate the radiation doses from head and chest CT examinations of children in Ningxia, and provide basic data for the optimization of CT radiation doses to children of different ages.Methods:By using stratified cluster sampling method , the dose parameters on head and chest CT scanning, CTDI vol and DLP for the children under 15 years old were sampled within 1-2 weeks from hospitals at different levels in different regions of Ningxia for the calculation of effective doses. The 75th percentile (P75) of CTDI vol and DLP was compared with those recommended by other countries. All children included four age groups: up to 1 year old, 1 to 5 years, 6 to 10 years, 11 to 15 years. Results:There were 39 hospitals and 47 CT scanners in this survey, and 1 134 head scanning and 636 chest scanning were investigating. The 75th percentile (P75) of CTDI vol and DLP for head scanning were 44.2 mGy and 456.2 mGy·cm for those up to 1 year old; 57.2 mGy and 659.6 mGy·cm for 1 to 5 years old, 61.1 mGy and 668.7 mGy·cm for 6-10 years old, and 63.6 mGy and 849.3 mGy·cm for 11-15 years old, respectively. The 75th percentile (P75) of CTDI vol and DLP for chest scanning were 5.0 mGy and 89.2 mGy·cm for those up to 1 year old, 5.9 mGy and 124.8 mGy·cm for 1 to 5 years old, 6.0 mGy and 167.9 mGy·cm for 6 to 10 years, and 7.1 mGy and 235.0 mGy·cm for 11 to 15 years old, respectively. Conclusions:The chest CT radiation dose to children in Ningxia is close to the reported values, but the head CT radiation dose is relatively high in all age groups, especially in infants. The optimization and regulation of head CT radiation doses to children in Ningxia should be strengthened. It is high time to increase dose awareness for pediatricians and radiologists and raise awareness of radiation-related risks.

Objective:To analyze the hepatic hemodynamics changes after partial splenic embolization in patients with cirrhosis and hypersplenism.Methods:A total of 26 patients with cirrhosis and hypersplenism who underwent partial splenic embolization in the General Hospital of Ningxia Medical University from April 2018 to June 2019 were included in this study. The clinical data was retrospectively studied. The study objects consisted of 19 males and 7 females with an average of 55 years. Whole-liver perfusion enhanced CT imaging scan was performed for all patients. Changes in laboratory indexes and the blood perfusion of the liver sections including hepatic arterial perfusion, portal venous perfusion, total liver perfusion and hepatic arterial perfusion indexes before PSE and postoperative 1 month were compared.Results:The postoperative leukocyte and platelet counts increased, and the prothrombin time decreased in the 26 patient, and the differences were significant ( P<0.05). The hepatic arterial perfusion of the left lateral section, left medial section, right anterior section and right posterior section increased in postoperative 1 month, from 10.0 (7.0, 13.5) ml·min -1·(100 ml) -1, 9.3 (5.4, 12.8) ml·min -1·(100 ml) -1, 8.0 (6.0, 11.2) ml·min -1·(100 ml) -1, 10.7 (7.1, 13.8) ml·min -1·(100 ml) -1 to 7.7 (4.2, 11.0) ml·min -1·(100 ml) -1, 6.9 (2.6, 10.2) ml·min -1·(100 ml) -1, 7.1 (4.1, 8.7) ml·min -1·(100 ml) -1, 5.9 (4.4, 8.5) ml·min -1·(100 ml) -1, respectively. The differences were all significantly different ( P<0.05). There were no significant difference in portal venous perfusion and total liver perfusion before and after operation ( P>0.05). The hepatic arterial perfusion index of left lateral section, right anterior section and right posterior section increased after operation ( P<0.05). Conclusion:For patients with cirrhosis and hypersplenism who underwent partial splenic embolization, the state of hypersplenism was relieved, the hepatic arterial blood flow increased, and the liver function improved.

Objective:To explore the value of clinical data and MRI image features in predicting and analyzing the degree of differentiation of hepatocellular carcinoma (HCC).Methods:The clinical and imaging data of 180 patients with surgical outcomes of HCC from March 2015 to June 2019 in the General Hospital of Ningxia Medical University were retrospectively analyzed. Alpha-fetoprotein (AFP)、aspartate aminotransferase (AST)、D-dimer、clinical stage、tumor length、apparent diffusion coefficient(ADC)、enhancement types and so on the clinical and imaging data of the poorly differentiated and non-differentiated HCC were compared and analyzed. Multivariate logistic regression was used to predict independent risk factors for poorly differentiated HCC.Results:Of the 180 HCC patients, 121 were moderately and highly differentiated, and 59 were poorly differentiated. Univariate analysis showed that the patient’s age, gender, AFP, AST, D-dimer level, clinical stage, Child-Pugh score, tumor length, whether the capsule was complete, tumor apparent diffusion coefficient, the maximum level ADC value, enhancement type with HCC differentiation degree were correlated(all P<0.05). Multivariate logistic regression analysis showed that the patients' gender ( OR=4.524, P<0.05), clinical stage ( OR=5.598, P<0.05), D-dimer ( OR=8.576, P<0.05), HCC diameter ( OR=0.498, P<0.05), enhancement types ( OR=2.988, P<0.05), tumour ADC value ( OR=0.059, P<0.05) were independent of poorly differentiated HCC risk factor. Conclusion:MRI image features can be used as an effective indicator to predict the degree of HCC differentiation before surgery. It is more valuable to accurately predict the degree of HCC combined with D-dimer and AFP value.

Objective: To explore the optimization of CT urography imaging parameters and the control measures of radiation dose to patients with different body mass index. Methods: A total of 133 patients who were required to undergo CT urography were prospectively selected in terms of three different types of CT urography scan; firstly, conventional parameter scan (120 kV, CARE Dose4D); secondly, low kV scan (BMI ≤ 22.9∶80 kV, 22.9 < BMI < 30∶100 kV, BMI ≥ 30∶120 kV, CARE Dose4D) and thirdly, low mAs scan (120 kV, 40% reduction in mAs on CARE Dose4D). Noise, signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of all images were measured as objective evaluation indicators of image quality. The subjective evaluation of the images was performed by two radiologists who had been working for more than five years using a double-blind method and a 5-score system evaluation. The effective dose values (CTDI_vol, DLP, E) in each group were measured. Results: Patients′ effective dose was decreased by 77.7% in 80 kV group and 38.3% in 100 kV group, with a statistical difference between the two groups (Z=-3.330, -5.559, P<0.05). There was a statistically significant difference in renal cortex noise, SNR, CNR and ureteral noise between the 80 kV scan and the routine scan (Z=-3.705-2.392, P<0.05), but no significant difference in ureteral SNR, CNR and renal pelvis noise, SNR, CNR (P>0.05). There was a statistically significant difference in renal cortex noise and SNR between the 100 kV scan group and the routine scan group (Z=-5.096, -3.566, P<0.05), but no statistical difference in renal cortex CNR, renal pelvis and ureteral noise, SNR, CNR(Z=-5.086, -5.912, -2.842, P>0.05). The effective dose from low mAs scan in the three types of patients was decreased by 38.3%, 32.0%, and 34.7%, respectively, with a statistical difference between them (P <0.05). There was no significant difference in noise, SNR, and CNR between renal cortex, renal pelvis and ureter (P>0.05) besides ureteral CNR in the 22.9 < BMI < 30 group (Z=-2.587, P<0.05). The subjective evaluation scores of all images were greater than 3 points. Conclusions In this study, the scan method for low kV and low mAs used for patients with different body mass index can effectively reduce the radiation dose to patients and meet the requirements of clinical diagnosis.

Objective: To investigate the current status of CT radiation dose to adults in Ningxia, and provide basic data for developing the first diagnostic reference level of adults from CT scanning. Methods: Stratified cluster sampling method was used to investigate the in-service status of CT scanners with various brands and different models in different grades of hospital in Ningxia. Interval sampling method was used to obtain everyday′s scanning parameters and radiation dose values from different types of scanning examinations in surveyed hostipitals. Basic information was collected include hospitals, CT scanner, scanning types and patients. CT scanning parameters, CTDI_vol and DLP values were recorded, with effective dose values calculated. The data were statistically analyzed by examination types and comparation was made with the DRL values recommended by other countries. Results: Finally, there were 45 medical institutions in this study, including 10 public tertiary A hospitals, 5 public tertiary B hospitals, 23 public secondary A hospitals, 5 private hospitals and 2 physical examination centers. 58 CT scanners from 6 manufacturers and 4 952 adult patients were investigated. The 75th percentile (P₇₅) of CTDI_vol, DLP, and E values of common scanning examinations were listed as follows: 65.67 mGy, 860.74 mGy·cm, and 1.64 mSv in skull scanning; 29.32 mGy, 490.00 mGy·cm, and 2.83 mSv in neck scanning; 36.92 mGy, 954.42 mGy·cm, and 4.87 mSv in neck enhanced scanning; 11.50 mGy, 382.06 mGy·cm , and 5.68 mSv in chest scanning; 45.80 mGy, 1 713.22 mGy·cm, and 25.01 mSv in chest enhanced scanning; 20.10 mGy, 506.59 mGy·cm, and 7.75 mSv in upper abdominal scanning; 50.07 mGy, 1 434.19 mGy·cm, and 21.94 mSv in upper abdominal enhanced scanning; 14.33 mGy, 670.78 mGy·cm, and 10.26 mSv in abdominal-pelvic scanning; 48.00 mGy, 2 294.00 mGy·cm, and 35.10 mSv in abdominal-pelvic enhanced scanning; 16.10 mGy, 471.58 mGy·cm, and 6.08 mSv in pelvic scanning; 31.04 mGy, 1 138.78 mGy·cm, and 14.69 mSv in pelvic enhanced scanning. Conclusions The CT scanning radiation doses to skull, neck, chest and pelvis in Ningxia are slightly lower than, or similar to, in other countries, but the abdominal scanning dose is significantly higher than that in other countries. It is necessary to optimize the abdominal CT scanning protocol.