Objective To evaluate the efficacy and safety of the pneumatic lithotripsy through ureteroscope for the treatment of ureteral calculi.Methods A total of 920 patients underwent ureteroscopic lithotripsy using pneu-matic lithotripsy 259 upper,375 middle,and 286 lower ureteral stone were treated.Results The overall successful fragmentation rate for all levels of ureteral stones in a single session achieved 94.0% (864 /920),failure rate 6.0%(56 /920).28 cases failed because of ureteral stricture.24 cases of stone moved up into the kidney.All worst -cases were in dewelled shock wave lithotripsy ESWL.Conclusion Ureteroscopic lithotripsy using pneumatic lithotripsy is a highly effective,minimally invasive and safe therapy for ureteral calculi.It is indicated as a first choice for treatment patients with ureteral stones,especially for the ones with the middle and lower uneteral stones.Develop particularly suitable for basic hospital.

Objective To investigate the clinical effect, influencing factors of 1 280 patients with ureteral calculi undergoing ESWL.Methods The data of 1 280 patients with ureteral calculi treated by ESWL for the first time in our hospital were retrospectively studied.There were 962 males and 318 females,age 23~78 years old,average 45.7 years old.Stones were located in the left ureter in 810 cases and right ureter in 470 cases.All patients were treated with ESWL for the first time.The lithotripsy rate, stone free rate, influencing factors and the incidence of complications after ESWL were compared over follow up period of there months.Results The overall successful fragmentation rate for all levels of stone in single session achieved 97.6%(1 249/1 280).The failure rate was 2.4%(31/1 280).Conclusion ESWL is indicated as a first choice in the treatment for patients with ureteral stones.The concrete impacted in ureteral mucosa is the key cause of failure to ESWl in ureteric stone.Once the fragments has not been cleared after ESWL, it suggests that other therapy modality should be selected.

Objective To study the calculational method for the radiotherapy facilities of the medical linear accelerator' s useful beam towars its maze.Methods The shielding calculation was made under the relevant national standards for a radiotherapy treatment room and compared with the test results.Results The dose rates at the maze entrance as calculated and measured were 89 and 86 μSv/h inside the maze door,as well as 5.7 and 6.2 μSv/h outside the maze door,respectively.The calculated results were consistent with measured results.Conclusions By comparison of calculated results with measured results,the accuracy of the theoretical calculation method could be verified.

Background and purpose:Papillary renal cell carcinomas (PRCC) is relatively infrequent, and there are few related researches in China. This study aimed to summarize the clinical and pathological features of PRCC, and evaluate prognostic factors for patients treated with surgery.Methods:A total of 64 patients who under-went surgery for PRCC were retrospectively assessed. PRCC tissue slides from each patient were reviewed for type (ⅠorⅡ), grade, TNM stage, coagulative tumor necrosis and microvascular invasion. We estimated overall survival using the Kaplan-Meier method. Multivariate analysis was done according to the Cox proportional hazards model of factors statistically signiifcant on univariate analysis. Results:The incidence rate of ENE was 6.04%in RCC, the median age was 55 (range 22 to 78) years. The comparison of the 22 (534.4%) typeⅠPRCCs and 42 (65.6%) typeⅡPRCCs revealed that typeⅡtumors were associated with a greater stage and grade more often. The median follow-up was 46 months (range 19 to 133). Of the 64 patients, 14 died, (4.5%) with typeⅠand 13 (31.0%) with typeⅡtumors (P=0.018). The overall survival rate was 85.7%in typeⅠtumors and 55.8%in typeⅡtumors, respectively. Univariate analysis identiifed symptoms at presentation, tumor type, TNM stage and grade as prognostic factors. On multivariate analysis only metastatic RCC remained associated with decreased overall survival (HR:14.78, P=0.004). Conclusion:The per-centage of PRCC is lower and typeⅡPRCC is relatively common compared with foreign data. Metastasis at diagnosis is an independent predictive parameter of overall survival in Chinese patients with PRCC.

OBJECTIVE: To observe the CT three-dimensional imaging features of the frontal recess region with advanced three-dimensional reconstruction, and develop the real image of the important anatomical structures around the region to conduct surgery. METHOD: Thirty patients were undergone spiral CT by 16 line high speed spiral CT, and multiplanar reconstruction images using standard three-dimensional reconstruction protocol on a computer workstation. The structure of the frontal recess, the agger nasi cell and adhere style of the uncinate process were observed. The parameter of the important anatomic structure of frontal recess was measured precisely. RESULT: After the reconstruction, we get the three-dimensional model very close to the true state of the nasal cavity-sinuses cell, in which parts of the frontal recess can clearly identify the agger nasi cell, frontal cell and other important structures. In these patients, the height, width and depth of the agger nasi and frontal sinus were (9.45 ± 3.60)mm, (8.08 ± 3.37)mm, (26.98 ± 6.82)mm and (26.86 ± 9.45)mm, respectively. CONCLUSION This study tried to develop the standardized techniques and measurements from three-dimensional reconstructed images of the frontal sinus and to ascertain the usefulness of the frontal sinus in identification of patients. The project results in better preoperative patient counselling and in predicting postoperative improvement in clinical status.
Ethmoid Sinus ; diagnostic imaging ; Frontal Sinus ; diagnostic imaging ; Humans ; Image Processing, Computer-Assisted ; methods ; Imaging, Three-Dimensional ; Nasal Cavity ; Paranasal Sinuses ; diagnostic imaging ; Tomography, Spiral Computed ; methods

OBJECTIVE: The purpose of the study was to observe the three-dimensional (3D) CT imaging features of the frontal recess region with 3D reconstruction, and obtain the real image of the important anatomical structures of the region to conduct surgery. METHOD: Five patients were undergone spiral CT by 16 line high speed spiral CT, and multiplanar reconstruction images using standard 3D reconstruction protocol on a computer workstation. The structure of the frontal recess, the agger nasi cell and adhere style of the uncinate process were observed. The parameter of the important anatomic structure of frontal recess was measured precisely. RESULT: After the reconstruction, we get the 3D model very close to the true state of the nasal cavity--sinuses cell, in which parts of the frontal recess can clearly identify the agger nasi cell, frontal cell and other important structures. In this patient, the height, width and depth of the agger nasi and frontal sinus were 12.3 mm, 12.1 mm, 38.5 mm, respectively. CONCLUSION This study tried to develop the standardized techniques and measurements from 3D reconstructed images of the frontal sinus and to ascertain the usefulness of the frontal sinus in identification of patients. The results in better preoperative patient counselling and in predicting postoperative improvement in clinical status.
Adolescent ; Adult ; Aged ; Female ; Frontal Sinus ; diagnostic imaging ; Humans ; Imaging, Three-Dimensional ; Male ; Middle Aged ; Tomography, Spiral Computed ; Young Adult

Objective: To assess dietary and urinary risk factors for urolithiasis by a case-control study. Methods: A retrospective analysis was made on the pathogenic factors of 1 151 patients with urolithiasis admitted to the People′s Hospital of Chenghai District from January 2016 to June 2018, and including external environmental factors and internal personal factors. Results: The proportion of male and female patients was 1.69∶1, and the peak age at onset of disease ranged from 21 to 60 years.Most of patients were diagnosed as upper urinary tract calculi.The following variables were found to have significant effects on the morbidity of urinay calculi: less intake of water, over intake of protein, fat and salt. Conclusion The diet and increase water intake and with low-protein, low-fat and low-salt diet are helpful to prevent urolithiasis.

Objective:To evaluate the value of a novel multiphase three-dimensional deep learning neural network of computer-aided diagnosis (CAD) used in LDCT lung cancer screening.Methods:Eight thousand eight hundred and fifty volunteers with 1 111 nodules were enrolled in the lung cancer screening from November of 2013 to December of 2017, and the baseline LDCT imaging data of volunteers accompanied with clinical information were retrospectively analyzed. All volunteers in this study were designed to receive LDCT test at least once. All the imaging of volunteers were read through the methods of visual detectioin (VD), CAD, and VD Combined CAD. The criteria of the true pulmonary nodule was determinated by the consistent opinion of two specialists in chest imaging（in case of disagreement, the decision should made by the third chief physician). In terms of the numbers, types or Lung-RADS categories of nodules, the detection rate, missed diagnosis rate and false positive rate of pulmonary nodules or lung cancer among three methods were compared, and the rates between groups were compared by χ 2test. Results:Compared with VD or CAD ,the detection rate of nodules in the CAD combined VD was significantly increased (95.7% , 94.2%, vs. 80.1% P<0.05 ), and the rate of missed diagnosis was significantly reduced (5.8%, 4.3% vs. 19.9% ，χ2=101.650, 128.500 ，P<0.05); Compared with VD, the methods of CAD or VD combined CAD significantly increased the the detection rates of Lung-RADS categories (χ2 =25.083,23.449, P=0.000, 0.000) or different types of nodules (χ2=6.955,6.821, P=0.031, 0.033), but there was no statistically significant difference between CAD and VD combined CAD for Lung-RADS categories and different types of nodules (all P>0.05); Compared with VD and VD combined CAD, the positive prediction rate of CAD for lung cancer was significantly reduced, and the rate of missed diagnosis and false positive rate were significantly increased, but there was no significant difference between VD and VD combined CAD in the prediction rate, missed diagnosis rate and false positive rate of lung cancer. Conclusion:The method of CAD combined VD can reduce the detection of false positive nodules and improve the detection rate of true pulmonary nodules,which is the preferred method using in LDCT lung cancer screening for city population.

Objective To investigate the predictive value of artificial intelligence(AI)-assisted high-resolution computed tomo-graphy(HRCT)in degree of invasion of early lung adenocarcinoma with subsolid nodules(SSN).Methods Ninety patients(a total of 90 SSN)with pulmonary SSN on AI-assisted HRCT scans were selected as the study subjects.According to the degree of invasion in pathology,the cases were divided into invasive adenocarcinoma(IAC)group(48 cases)and non-invasive adenocarcinoma(non-IAC)group(42 cases).The differences in general information,pulmonary SSN morphological characteristics,and related parameters were compared between the two groups.The influencing factors were analyzed using a multiple logistic regression model,and a nomo-gram prediction model was constructed.The diagnostic efficacy of the model was evaluated using receiver operating characteristic(ROC)curves,calibration curves,and clinical decision curves.Results Between the two groups,there were statistically significant differences in age,nodular nature,shape,tumor-lung interface,vacuole sign,burr sign,air-bronchial sign,vascular bunching sign and pleural indentation sign.Compared with the non-IAC group,the CT maximum value,energy,variance of CT value,CT average value,maximum surface area,mean long and short diameter,3D long diameter,surface area,volume,mass and entropy of the IAC group significantly increased,while the CT minimum value,compactness and sphericity of the IAC group significantly decreased.The results of multiple logistic regression model showed that burr sign,vascular bunching sign,tumor-lung interface,mass,pleural indentation sign,and CT average value were independent risk factors affecting the development of SSN into early IAC.Finally,a nomogram pre-diction model was constructed based on risk factors,and the results of ROC curves,calibration curves and clinical decision curves showed that the predictive model had good diagnostic efficacy.Conclusion HRCT imaging features assisted by AI have a high pre-dictive value for the degree of invasion in early lung adenocarcinoma with SSN,and focusing on the burr sign,vascular bunching sign,tumor-lung interface,mass,pleural indentation sign,and CT average value can improve clinical treatment and prognosis for patients.

Objective To explore the clinical and MRI features of central neurocytoma(CNC).Methods The clinical and MRI data of the pathologically confirmed CNC were retrospectively collected and compared,all the patients had undergone pre-surgery MRI plain and contrast enhanced scans.Patients were divided according to the location of the tumor as intra-lateral ventricle and ex-lateral ventricle group.Results Forty patients were finally enrolled,all tumors were solitary,39 of which were located in the ventricular system,including 2 7 cases located in lateral ventricle and 1 2 in the lateral ventricle,2 in third ventricle,5 in both lateral and third ventricle and 5 involving the whole ventricles;and 1 located in ex-ventricle(left temporal lobe).The tumors showed iso-intense on T1WI and T2WI with varying degrees of cystic degeneration.Hemorrhage was shown in 5 cases,calcification in 2 cases,markedly hyper-vascular enhancements were shown in 36 cases with 26 cases presented visible enhanced vessel sign.The comparison analysis between intra-and ex-lateral ventricle groups revealed that,the patients age,tumor size and Ki-67 expression were higher in ex-lateral ventricle group(P<0.05);hypervascular enhancement (P<0.05),gender ratio,cystic/cystic-solid appearance and vessel sigh(P>0.05)were lower than those in intra-lateral ventricle group.Conclusion CNC is typically located in lateral ventricle,with cystic and necrotic degeneration areas,hypervascular enhancement with visible vessels in solid portion on enhanced MR images;The ex-lateral ventricle CNC is rare,it commonly presents a larger tumor with high Ki-67 expression,and moderate enhancement with less visible vessels on enhanced MRI.