Objective To discuss the X-ray and CT findings of pulmonary air leak in neonates and to improve the early diagnostic ability.Methods The supine anteroposterior chest films of 33 neonates with pulmonary air leak were retrospectively analyzed.A-mong them,spiral CT scanning was performed in 5 cases.Radiographic follow-up was made in 30 cases.Results Pulmonary intersti-tial emphysema was found in 2 cases,pneumomediastinum in 4 cases,simple pneumothorax in 14 cases.Pulmonary interstitial em-physema combined with pneumomediasfinum was detected in 2 cases,with pneumothorax in 4 cases.Pneumomediastinum combined with pneumothorax was displayed in 3 cases.Pulmonary interstitial emphysema combined with pneumomediastinum and pneumotho-rax was found in 4 cases.Among them,medial pneumothorax was shown in 26 side,lateral pneumothorax in 9 side.Conclusion X-ray radiography is the main method for the diagnosis of pulmonary air leak in neonates,and CT can further define the location,range and extent of the disease.

Objective To assess the value of low dose CT scanning applied in nasal sinus examination. Methods 100 cases were divided into two groups,including youth group and adult group,with 50 cases for each group.After scanned by standard dose(150mAs),all the patients were scanned with low dose. Those in youth group were scanned with 40mAs and 25mAs,and the others in adult group were scanned with 50mAs and 30mAs.CT images were evaluated by three doctors using blind method.The image quality was evaluated according to 3 grades:normal image,image with mild artifact,and image with serious artifact and the results were analyzed statistically. Results The CTDlw of low-dose CT scanning was obviously lower than that of standard dose(P

Objective To evaluate the specificity of CD105 labeled microvessel density (MVD)and its clinical significance.Methods Formalin fixed,paraffin wax embedded specimens from 63 patients with hepatocellular carcinoma (HCC) were stained with anti-CD105 monoclonal antibody.A correlation was analyzed between the expression and distribution of MVD-CD105 in HCC/adjacent non-tumorous tissues and clinicopathological features.Results CD105 immunoreactivity was seen in all the specimens of HCC and adjacent non-tumorous tissues.Immunoreactivity intensity was higher in adjacent non-tumorous tissues than in HCC (χ2=9.184,P＜0.01).The mean scores of M VD-CD105 were also higher in adjacent non-tumorous tissues than in HCC.The levels of expression and distribution of MVD-CD105 in HCC were associated with tumor metastasis and TNM staging (P＜0.01).The levels of expression and distribution of MVD-CD105 in adjacent non-tumorous tissues were associated with TNM staging and 2-year survival rate (P＜0.01).Conclusions CD105 showed no specificity in labeling MVD of HCC specimens.The higher level of expression and distribution of MVD-CD105 in HCC was associated with local tumor metastasis and progression.CD105 cannot be used as a target for anti-angiogenesis therapy for HCC.

Objective To investigate the correlation between CT grading and prognosis of hypoxic-ischemic encephalopathy(HIE),and with the diagnostic value of CT findings and followed-up.Methods 49 neonates from 1 month to 1 year with HIE whose CT findings and followed-up results and clinic were retrospectively analyzed.Results Among 49 cases,the clinical follow-up showed that the hypodense foci induced by HIE were absorbed and disappeared completely within 1～3 months after birth.10 neonates presented external hydro-cephalous at 1～3 months after birth and then that was absorbed after 6 months to 1year of age.In 3 months,the part poor moderate HIE in the neonates might cause the leukomalaria,while severe HIE might cause the cerebral malaria and atrophy within 1 month after birth.Conclusion The prognosis of HIE is closely related to the degree of abnormal manifestations on CT.Intracranial lesions were favorable in the mild HIE,good in the moderate ones and bad in the severe ones.If there were bleeding in ventricles,the prognosis would be more poor.

Objective To discuss the X-ray and CT manifestations of keratocystic odontogenic tumour(KCOT)in mandible,to im-prove the diagnostic accuracy of the disease.Methods The X-ray and CT features of KCOT(n=25)in mandible,which were proved by surgery and pathology,were retrospectively analyzed.Results The KCOT,including solitary tumor(n=23)and multiple tumor (n=2),mainly displayed unilocular or multilocular in shape with distinct sclerosing margin.Disruption of the adjacent cortex was de-tected in 7 cases,growth along the long axis of mandible in 18 cases,compression and displacement of the adjacent teeth in 21 cases, resorption of bevel of roots in 2 cases.Conclusion Most lesions of KCOT in mandible have characteristic manifestation in X-ray and CT findings,which is helpful for diagnosis and differential diagnosis.

Objective:To study the expression of tenascin in hepatocellular carcinoma(HCC)and to investigate the roles of tenascin expression in microvessel angiogenesis,invasion,metastasis and prognosis of HCC.Methods:Formalin fixed,paraffin wax embedded specimens from 63 HCC patients were stained with an anti-tenascin monoclonal antibody,and the measurements were also done for paracancerous specimens from the same patients and specimens from 15 patients with liver cirrhosis and 10 normal liver.The correlation was analyzed between expression of tenascin and clinicopathological features as well as microvessel angiogenesis.Results:Tenascin immunoreactivity was observed in 65.1% samples of HCC,69.8% of paracarcinoma,20.0% of liver cirrhosis and negative of normal liver samples.Positivity and intensity of tenascin expressions in samples of HCC and paracarcinoma were higher than those in samples of cirrhotic and normal liver.Tenascin expression was correlated with Edmondson-Steiner grades,tumour numbers,capsule invasion,tumour metastasis and microvessel angiogenesis.Conclusion:The up-regulation of tenascin expression may play an important role in invasion and metastasis of HCC.

Objective To explore the effect of doctor-nurse integrated ward round performed in the training of professional nurses′ core competence.Methods 18 nurses trained for core competencies in ICU and hemodialysis room were selected as research objects.All nurses were trained with doctor-nurse integrated ward round for one year.The professional knowledge, skills and clinical comprehensive ability of all nurses were tested before and after training.Results After doctor-nurse integrated ward round, the scores of professional knowledge, skills and clinical comprehensive ability of professional nurses were significantly higher than that of before training (P<0.05).Conclusion Doctor-nurse integrated ward round can improve the core competencies of professional nurses.

Objective To investigate the expression of CD133 mRNA in tissues of gastric cancer,and explore its relationship with clinicopathological features. Methods The tissues of gastric cancer and normal tissues adjacent to gastric cancer were obtained from 31 patients.The expression of CD133 mRNA was detected by semi-quantitative RT-PCR,and its relationship with clinicopathological features such as sex,age,tumor diameter,infiltration depth,TNM staging,tumor differentiation,lymph node metastasis and Ki-67 proliferation index was analysed. Results The relative gray scale values of CD133 mRNA in tissues of gastric cancer and normal tissues adjacent to gastric cancer were 0.378 3±0.141 1 and 0.038 1 ±0.091 9,respectively(P=0.000).The relative gray scale values of CD133 mRNA in tissues of gastric cancer with tumor diameter>5 cm were significantly higher than those with tumor diameter≤5 cm[(0.439 3±0.148 4)vs(0.334 3±0.121 2)](P=0.041),and those in tissues with lymph node metastasis were significantly higher than those without lymph node metastasis[(0.426 6±0.132 0)vs(0.239 5±0.030 9)](P=0.004).The rate of lymph node metastasis and the number of metastatic lymph nodes were positively related to relative gray scale values of CD133 mRNA(r=0.466,P=0.008;r=0.464,P=0.009).The relative gray scale values of CD133 mRNA in those with low expression of Ki-67 were significantly higher than those with high expression of Ki-67[(0.436 4±0.139 8)vs(0.316 4±0.117 4)](P=0.02),and expression of Ki-67 were negatively related to relative gray scale values of CD133 mRNA(r=-0.461,P=0.009).Conclusion The expression of CD133 mRNA in tissues of gastric cancer was associated with the rate of lymph node metastasis,number of metastatic lymph nodes and expression of Ki-67,which reflect the status of lymph node metastasis and proliferation of gastric cancer.

Objective To detect the expression of c-met (hepatocyte growth factor receptor), e2f-1 (transcription factor) and Ki-67 in tissues of gastric cancer, explore the relationship among them, and investigate their correlationship with clinicopathological characteristics and prognosis. Methods The tissue samples of gastric cancer from 86 patients with radical resection were subjected to immunohistochemical staining, and the expression of c-met, e2f-1 and Ki-67 was detected. The relationship between the clinicopathological characteristics and the expression of c-met, e2f-1 and Ki-67, and that among the expression of c-met, e2f-1 and Ki-67 were explored by univariate and multivariate data analysis. And the relationship between prognosis and expression of c-met, e2f-1 and Ki-67 was analysed by Log rank test. Results c-met, e2f-1 and Ki-67 were widely expressed in tissues of gastric cancer. The higher expression of c-met was associated with higher expression of Ki-67, shorter survival time, upper tumor location, higher lymph node metastasis rate, higher N stage and TNM stage (P<0.05), and the lower expression of e2f-1 was associated with larger tumor diameter, higher TNM stage, deeper invasion, higher lymph node metastasis rate and higher N stage (P<0.05). The multivariate analysis revealed that depth of invasion, N stage, TNM stage and expression of Ki-67 were independent factors for positive expression of c-met, and age and survival time were independent factors for positive expression of e2f-1. Log rank test demonstrated that the factors related to survival included expression of c-met, e2f-1 and Ki-67, N stage, tumor diameter, tumor location, lymph node metastasis rate, depth of invasion and TNM stage. Conclusion c-met is an indicator for malignant behavior and poorer prognosis of gastric cancer. There is a higher expression of e2f-1 in early gastric cancer, while advanced gastric cancer may be associated with a lower expression of e2f-1.

Objective To investigate the independent factors influencing the efficacy of pre-hospital CPR effect. Method The data base with 1376 cases was set up with EpiData software by means of questionnaires and the information was provided by the survivals from cardiopulmonary arrest( CA)saved with cardiopulmonary resuscitation(CPR), and the data were analyzed with SPSS 13.0 software to carry out binary logistic regression. Through single factor analysis, the factors with emerged statistical significance were chosen as variances. Results With regard to the restoration of spontaneous circulation(ROSC), the rescue did by the first witness was the protective factor(PF)( OR = 2.21, P = 0.001, 95.0% CI=1.356-3.602); the male was the risk factor(RF) contrasted with the female( OR = 0. 515, P =0. 006, 95.0%0 CI = 0.320 - 0. 26) ; ages between 20 and 29 years old had higher likelihood of ROSC than group ≥81 years old( OR = 3.241, P = 0.026, 95.0%CI = 1.146 -9.138); the length of CA time before CPR was RF(OR = 0.913, P = 0.000, 95.0%CI = 0.887-0.948);ventricular fibrillation(VF) was PF compared with asystole( OR = 5.092, P = 0.000, 95.0%CI=2.927 -8.861); electric shock was PF(OR = 3.384, P = 0.000, 95.0%CI = 2.033 - 5.635); epinephrine dosage 0 - 4 mg had higher likelihood of ROSC than > 5 nag dosage( OR = 3. 255, P = 0. 001, 95.0% CI = 1. 606 -6.597). In respect of probability about victims at the tittle reached hospital alive, ages of 2- 12 and 13 - 19 years old had higher rations than ≥81 years old( OR = 12.818, P = 0.029, 95.0% CI = 1.299 - 126.508)( OR = 10.505, P = 0.036, 95.0% CI = 1.161-95.058); the length of CA time before CPR was RF(OR =0.862, P = 0.000, 95.0%CI = 0.821-0.906); VF was PF compared with asystole(OR = 7.330, P =0.000, 95.0%CI = 3.962 - 13.560). Conclusions ECG change before CPR, rescue by the first witness,electric shock, the length of CA time before CPR, epinephrine dosage, gender and age were independent influencing factors of pre-hospital CPR for the emergency of ROSC. Age, the length of CA time before CPR and ECG before CPR were influencing factors of pre-hospital CPR for patients at the time transferred to hospital alive.