Objective To assess the feasibility of computed tomography angiography (CTA) in renal artery using the iterative reconstruction technique (iDose4) in Brilliance iCT (Philips Ltd.).Methods 90 patients (body weight 60-70 kg) supposed to undergo renal artery CTA were selected and randomly divided into three groups:A(120 kV,120 mAs),B(120 kV,60 mAs) and C(100 kV,100 mAs).CTA images from Group A were obtained using filtered back projection and those from the rest groups were generated by iDose4.Then CT number of renal artery,noise (denoted as standard deviation SD),signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of images for each group were measured and recorded.Images were post-processed using volume reformation (VR) 3D imaging and image quality were assessed in five-level grade (1-5).Results The five parameters (CT number of renal artery,SD value,SNR,CNR and VR grade) of group A and group B were statistically insignificant (P ＞ 0.05).While SD values of group C were comparable to those of group A and B,the rest four parameters of group C were apparently larger,which was statistically significant (tCT value =-12.326,tSNR =-7.136,tCNR =-7.649,ZVR =-2.690,PVR ＜ 0.05).Conclusions Image quality could still fit the diagnosis requirements using iDose4 when mAs decreased lower than 50％.The image quality increases when radiation dose is halved at 100 kVp kV.

Akebia trifoliate has been reported to have many pharmacological activities and the roots, petioles and seeds are used to different symptoms. However, the structure and anatomy of its seeds was almost not reported until now. In the present study, we investigated the morphological characters of the fruit and seed, and the anatomical characters of the testa, micropyle, embryo and endosperm, which could provide evidences for the study on classification, identification and application of A. trifoliate. Our results showed that the testa of A. trifoliate consisted of an epidermic cell layer, the sclerenchyma cells layer, the parenchyma cells layer and an innermost pigment layer. At the micropylar region, the outermost epidermal cells were specialized the white caruncle-like structure and the testa included a lot of lignified tissues. Endosperm comprises two layer cells. Outermost yellowish-brown layer cells contains lots of fat droplets, and innermost white layer cells contains lots of aleurone grains and crystalloids.
Germination ; Magnoliopsida ; anatomy & histology ; growth & development ; Seeds ; anatomy & histology ; growth & development

Objective To study the method of using phantom test for daily quality assurance of on board image(OBI) system. Methods The routine procedures of radiotherapy, including CT simulation, planning,setup,cone beam CT(CBCT) scan and kilovolt X-ray orthogonal film were carried out on a head phantom. The procedures repeated once a day in the following 10 days. The geometric errors of the phantom were recorded. Results The geometric errors of the phantom by CBCT were [0.06±0.11] cm, [0.03±0.05] cm, [0.07±0.07] cm and [0.03±0.10] cm in longitudinal, vertical, lateral and rotation directions, respectively. The geometric errors of the phantom by kilovolt X-ray orthogonal film were [ 0.04±0.10] cm, [0.03±0.05] cm, [0.08±0.06] cm and [0.05±0.05] cm, respectively. The differences of geometric errors of the phantom by CBCT and kilovolt X-ray orthogonal film were not significant(t = 0.44,P=0.667 in longitudinal direction ; t=0.00, P=1.060 in vertical direction ; t=0.34, P=0.735 in lateral direction; t=0.58,P=0.568 in rotation direction). Conclusions The OBI system of our accelerator is reliable and at excellent performance status. The method by using phantom test for the daily quality assurance of OBI system is easy and reliable.

Objective To evaluate the application value of X-ray,echocardiogram,pulmonary perfusion scintigraphy,EBCT,Magnetic resonance Pulmonary angiography in diagnosis of PTE.Methods Twenty-five consecutive patients clinically diagnosed of having PTE were examined from july 2003 through March 2004. Patients underwent X-ray chest plain film, echoeardiogram, electronic beam computed tomographie (EBCT)angiography,ventilation-perfusion (V-P)seintigraphy,Magnetic resonance Pulmonary angiography (MRPA)and puhnonary angiography according to a strict diagnostic protocol.Two of the independent readers reviewed the pulmonary angiography and record all of the lobe and segmental involved in PTE and compared with other image method.Results Pulmonary angiography:all of the patients success underwent the technique,the pulmonary artery branch with PTE was in 556 of 775 branches (71.7%). Chest radiography had hints of diagnosis in 12 of 25 patients.Nine patients diagnosed with echocardiogram. Right heart enlargement was in 21,and pulmonary hypertension in 18.V-P scintigraphy revealed 247 segmental involved with PTE of 500 (52.0% ),and the sensitivity was 64.66% compare with the pulmonary angiography.There were 523 pulmonary branches involved PTE with EBCT pulmonary angiograpy of 775 branches,and the sensitivity was 94.06%.MRPA: 8 of 10 patients succeed in the technique, 155 branches of 248 were detected with PTE(62.5% ),the sensitivity was 81.29%.Conclusions EBCT is a high sensitivity method in diagnosis of PTE.Chest radiography and echocardiogram are the first-line modality of PTE.V-P scintigrapby is the valid compensation in diagnosis subsegmental pulmonary artery with PTE when EBCT miss diagnosis.Gd-CE-MRPA may be the second-line modality in diagnosis of PTE.

Objective Observe the response and adverse effects of impact dose recombination human erythropoietin(rhEPO)in the breast cancer patients with anemia induced by chemotherapy.Methods 43 breast cancer patients with anemia induced by chemotherapy were randomly divided into two groups,treatment group(23 patients)and the control(20 patients).The treatment group received rhEPO for 10 days and oral iron therapy,while the control group was oral iron therapy only.Results After 4 weeks,the hemoglobin level, hematocrit,reticulocyte and quality of life be revaluated,the treatment group was significantly better than the control.The adverse effects was tolerable.Conclusion The impact dose rhEPO is effective and tolerable in the breast cancer patients with anemia induced by chemotherapy.

AIM: To understand the relation between the penetrating keratoplasty rejection and the methods of cornea preservation.
METHODS: The 30 Wistar rats as donator and 60 SD rats as receptor were used to establish the animal models of penetrating keratoplasty rejection. And 60 SD rats were randomly divided into 3 groups. Donor cornea of Wistar rats preserved in different methods were used separately in 3 groups. The penetrating keratoplasty rejection index ( RI ) , means survival time ( MST ) of corneal grafts and pathological changes in post -operation were analyzed.
RESULTS: The MST was ( 10. 4±1. 70 ) d in moist-chamber- preserved group (Ⅰ), ( 12. 9 ± 1. 81 ) d in medium-term-preserved group (II) and (16. 1±2. 57) d in cryopreserved group ( Ⅲ) . The MST in the cryopreserved group was evidently prolonged, showing a significant correlation compared with other two groups (P<0. 01). The sections with HE staining revealed that the severity of inflammation in Ⅲ group was reduced compared with that of Ⅰ, II group after 10d of keratoplasty.
CONCLUSION: The postoperative rejection of penetrating keratoplasty in rats is decreased and rejection time is delayed in cryopreserved cornea.

Objective To explore the HEART risk score in predicting 30-day major adverse cardiovascu-lar events (MACE)for the patients presenting to Emergency Department (ED) with acute chest pain. Methods Patients presented in our ED with acute chest pain were enrolled from January,2016 to April,2016. All cause MACE of each patient were followed up at 30 days by Health insurance information management System and call . Results Total 209 patients were enrolled(mean age 65.28 ± 16.85 years;52.63%male). The age,hypertension, ratio of ACS,SpO2,in-patient number HEART score in MACE subject were significantly higher than that in non MACE patients(P<0.05). The blood pressure at admission of MACE patients was significantly decrease than that in non MACE patients(P<0.05). The MACE within 30 days was 5.74%. The respective areas under the curve (AUC)for 30-day MACE(95% CI)was 0.908(0.846 ~ 0.974). The percent of patients with 30-day MACE with HEART scores between 0% and 3,4 ~ 6,and 7 ~ 10 was 0%,2.5%,and 27%,respectively. Conclusion HEART score can be simple,rapid and accurate prediction of emergency department of patients with acute chest pain within 30 days of MACE,effective elimination of low-risk patients with MACE,it plays a very important role for disease assessment and diagnosis and treatment process in emergency department.

ObjectiveTo investigate the clinical characteristics of the inpatients suffering from dengue fever in order to provide references for better diagnosis and treatment.Methods The clinical data of 158 dengue fever patients admitted to the First Affiliated Hospital of Sun Yat-Sen University from July 23rd to October 31st, 2014 during the 2014 epidemic in Guangzhou area were retrospectively analyzed, including general clinical manifestations, conventional examinations, pathogenesis, and prognosis.Results The mean age of the 158 patients was (56±20) years, with half of them over 60 years old (79 cases). Among them, 94 (59.49%) were male.① The common manifestations included fever (100%), headache (70.89%), myalgia/bone soreness (62.03%), and skin rash (54.43%). Bleeding and plasma leakage were found in 25.95% and 14.56% of the patients respectively.② Laboratory examination:leucopenia (75.32%) and thrombocytopenia (77.85%) were found, and alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were elevated in 57.59% and 77.85% of the patients respectively. However, elevation of blood hematocrit was rare (1.27%).③ It was found that in the acute phase (0 - 5 days of the onset), serum dengue virus antibody IgM (DF-IgM) was positive in 63.54% of the patients (61/96), and 92.62% (113/122) of patients were dengue virus RNA (DENA-RNA) positive.④ The rate of comorbidity in this study was 55.06% (87/158), including hypertension (27.22%) and type 2 diabetes (15.82%), which were the two most common co-morbidities.⑤ All the patients were given supportive therapy to prevent complications. They were also isolated for more than 5 days after onset, and at least for 24 hours after subsidence of fever in addition.⑥ The criteria for the diagnosis of severe dengue were fulfilled in 18 patients (11.39%). One patient died of massive hemorrhage from gastro-intestinal tract, and 1 patient voluntarily left hospital with untreated multiple organ dysfunction syndrome (MODS). Another 2 patients of dengue fever died from primary cardio-cerebrovascular disease, and the remaining 154 patients (97.47%) fully recovered with supportive therapy and complication prevention measures.Conclusions The clinical manifestations of inpatients with dengue fever in this study were typical, and they manifested a higher incidence of severe illness. DENA-RNA could be a sensitive indicator for early pathogenic diagnosis. With symptomatic and supportive therapy, most patients had a good outcome. However, early diagnosis and clinical interventions of severe dengue still need further studies.

The effect of obesity on idiopathic central precocious puberty (ICPP) girls is still under discussion.The relationship between body mass index (BMI) and sexual hormone levels of gonadotropin-releasing hormone (GnRH) stimulation test in ICPP girls is controversial and the underlying mechanism is unclear.This study aims to further explore the independent effect of excess adiposity on peak luteinizing hormone (LH) level of stimulation test in ICPP girls and the role of other related factors.A retrospective cross-sectional study was performed on 618 girls diagnosed as having ICPP,including 355 cases of normal weight,99 cases of overweight and 164 cases of obese.The results showed that obese group had more progressed Tanner stage and no significant difference (P=0.28) in LH peak was found as basal LH value was used as a covariate.The obese group had higher total testosterone (TT),adrenocorticotrophic hormone (ACTH),17-α hydroxyprogesterone (17-αOHP) and androstendione (AN),with significantly increased fasting insulin (FIN) and homeostasis model of assessment for insulin resistance index (HOMA-IR).Stratified analysis showed inconsistency of the relationship between BMI-standard deviation score (BMI-SDS) and LH peak in different Tanner stages (P for interaction=0.017).Further smoothing plot showed linear and non-linear relationship between BMI-SDS and LH peak in three Tanner stages.Then linear regression model was used to analyze the relationship between BMI-SDS and LH peak in different Tanner stages,with and without different confounding factors being adjusted.In B2 stage,BMI-SDS was negatively associated with LH peak.In B3 stage,when BMI-SDS ＜1.5,as BMI-SDS increased,the level of LH peak decreased (model Ⅰ:β=-1.8,95％ CI=-4.7 to 1.1,P=0.214).When BMI-SDS ≥1.5,BMI-SDS was significantly positively associated with LH peak (model Ⅰ:β=4.5,95％ CI=1.7 to 7.4,P=0.002).In B4 stage,when BMI-SDS ＜1.5,BMI-SDS was negatively associated with LH peak (model Ⅰ:β=-11.6,95％ CI=-22.7 to-4.5,P=0.049).When BMI-SDS ≥1.5,BMI-SDS was positively associated with LH peak (model Ⅰ:β=-4.2,95％ CI=-3.3 to 11.7,P=0.28).It is concluded that there is an independent correlation between BMI-SDS and LH peak of stimulation test in ICPP girls,their relationships are different in different Tanner stages,and the effect of BMI-SDS can be affected by adrenal androgens,estradiol and glucose metabolism parameters.

OBJECTIVE: To analyze the rate of 235delC mutation in GJB2 gene in patients with idiopathic sudden hearing loss, and to explore its possible correlation with pathogenesis of idiopathic sudden hearing loss. METHOD: Two hundred and thirty-four patients with diagnosis of idiopathic sudden hearing loss in otolaryngology department were recruited as experimental group. Eighty people with normal hearing level were enrolled as control group. Their peripheral blood samples were obtained and genomic DNA was extracted. Using polymerase chain reaction, the coding region of GJB2 gene was amplified, and 235delC mutation is screened for in GJB2 gene by restriction endonuclease. At same time the clinical data of 234 patients was collected to analyze. RESULT: In 234 cases of idiopathic sudden hearing loss, 5 cases were found to have heterozygous 235delC mutation, none of them harbored homozygous 235delC mutation, the 235delC mutation rate was 2.1% (5/234). No 235delC mutation was found in control group. The rate of 235delC mutation in two group showed no statistically significant difference (P > 0.05). CONCLUSION This research shows that the rate of 235delC mutation in GJB2 is low in patients with idiopathic sudden hearing loss, and suggest that 235delC mutation possible has no correlation with idiopathic sudden hearing loss.
Adolescent ; Adult ; Aged ; Child ; Connexin 26 ; Connexins ; genetics ; DNA Mutational Analysis ; Female ; Hearing Loss, Sudden ; genetics ; Humans ; Male ; Middle Aged ; Mutation ; Young Adult