Objective To analyze the CT characteristics of atypical hepatic hemangiomas.Methods 20 patients with atypical hepatic hemangiomas confirmed by pathology were collected.All patients underwent plain and contrast-enhanced CT scan and the atypical CT findings were analyzed retrospectively.Results There were 24 lesions in 20 patients,among which 21 lesions were round in shape and 3 lesions were irregular.Scars and necrosis were found in 14 lesions,calcifications in 2 lesions and capsule contractions in 2 lesions.Contrast-enhanced CT showed significant peripheral enhancements with incomplete fill-in in delayed phase in 13 lesions, homogeneous enhancements in arterial phase and continuous enhancements in portal and /or delayed phase in 2 lesions,central patchy enhancements in the arterial phase and reverse enhancements from center to edge in portal and/or delayed phase in 4 lesions, mild to moderate peripheral enhancements in the arterial phase in 3 lesions,and no enhancements in the arterial phase and mild enhancement in portal and/or delayed phase in 2 lesions.In addition,2 cases had arteriovenous fistulas.Conclusion As for atypical hepatic hemangioma,it is necessary to comprehensively observe and analyze the delicate signs for correct diagnosis and differential diagnosis.

Objective To analyze the MSCT features of pulmonary sclerosing pneumocytoma (PSP)combined with pathologic findings,to improve understanding of imaging features of PSP.Methods The clinical features of 38 PSP patients confirmed by pathology between 2006 and 2015 were reviewed.All patients underwent MSCT plain and enhanced scan.The imaging findings were studied retrospectively combined with clinical pathology.Results 38 lesions were solitary roundlike nodules and masses.Among which 1 9 lesions were less than 3 cm, 9 lesions were more than 5 cm and 10 lesions were between 3 cm and 5 cm.6 lesions had cystic degeneration,13 lesions had calcification;8 lesions with heterogeneous density showed maplike distribution on unenhanced scans;1 9 lesions were homogeneous enhancement;1 9 lesions maplike heterogeneous enhancement,and 3 of 1 9 had significant peripheral enhancement;35 lesions were progressive enhancement. There were strip-shape vessels in 10 lesions in arterial phase,welt vessel sign in 26 lesions;halo sign in 8 lesions,air-meniscus sign in 3 lesions,pulmonary artery sign in 10 lesions,and tail sign in 9 lesions.There was halo sign with air-meniscus sign in 1 lesion.Conclusion PSP has the general characteristics of benign tumors,and there have certain characteristics in calcification,density distribution,enhancement form and adjoint features.A comprehensive analysis of all the MSCT features combined with clinical pathology can help to improve the accuracy of diagnoses in PSP.

Objective To investigate the toxicities of methotrexate in the treatment of the children with acute lymphoblastic leukemia Method 28 children with acute lymphoblastic leukemia were randomly divided into two groups(A and B), they were treated with methotrexate 3.0 g/m 2 (n=16) and 5.0 g/m 2(n=12). The toxicities of two doses of methotrexate were observed. Results The main toxicities of methotrexate were marrow suppression,gastrointestinal reaction and liver damage. They were mostly mild.No statistically significant difference was found between group A and group B .Conclusion The toxicities of methotrexate are common and can be tolerated.

Objective To evaluate the correlation between the dynamic enhanced CT signs of hepatocellual carcinoma(HCC),MVD and VEGF expressions in hepatocellular carcinoma.Methods The MVD and VEGF expression were examined by means of SP immunohistochemical technique in 45 cases of HCC proved by pathology.All patients were examined by plain and contrast-enhanced CT.Results(1)The relation of pathologic grade,MVD and VEGF:the MVD in HCC of grade Ⅰ,Ⅱ,Ⅲ,Ⅳ were 22.9 ± 12.6,36.7 ±16.2,51.1±17.3,67.8±21.4,VEGF positive rates in HCC of grade Ⅰ,Ⅱ,Ⅲ and Ⅳ were 28.6%(2/7),53.3%(8/15),90.9%(10/11)and 100.0%(12/12).The pathologic grading of HCC was positively correlated with MVD and VEGF expression,in grade Ⅰ and grade Ⅲ～Ⅳ,Ⅱ and grade Ⅳ(P＜0.05).There were no statistical correlation between Ⅰ and Ⅱ,Ⅱ and Ⅲ or between Ⅲ and Ⅳ(P＞0.05).(2)There were three blood supply types in HCC at contrast-enhanced CT,the MVD ad VEGF positive rates were 70.6±22.9 and 85.l%(23/27)in tumors with arterial blood,65.7±21.6 and 63.6%(7/11)in those with double blood supply,and 25.1±13.5 and 28.6%(2/7)in those with poor blood supply.There was statistical difference(P＞0.05)in VEGF expression between the tumors with arterial blood,arterial combining with double blood supply and poorly blood supply.In HCC with arterial and double blood supply,MVD expression level was higher than that with poor blood supplies(P＜0.01).Conclusion MVD and VEGF expression can reflect the tumor's cell differentiation of HCC in a certain degree.

@@

Objective:To investigate the vexation and relevant attribution in middle and high school students Methods:A total of 539 middle or high school students were sampled from Shanxi Province, they were investigated with a self-made inventory and some of them received interview Result:Most of the students had worries in life, mainly about self-image, control of their parents, pressure of studies, individuality and interpersonal relationships The worst things they worried were relationships between partners,their inefficiency in studies,being quipped by teachers The degree of worrying about appearance and individuality were markedly different between students in middle schools and in high schools Conclusion:It suggests that family, school and society should give enough concern for middle and high school students

Objective To summarize theskill practice as the coremethods and training effect in tumor specialist nurse training , and to explore the suitable effective methods and pattern of China′s national conditions of specialist nurse training in China, for providing a reference for conducting cancer specialist nurse training. Methods Reviewed and analyzed tumor specialist nurse training method to make clear the training effect from 2012 to 2013, 100 students was investigated by using questionnaires , which contain 15 aspects, before and after the training respectively. designskill practice as the coreof the training content (160 hours) and theoretical classes (80 hours), established training evaluation criteria and the organization management system. Results All 100 students had grasped maintenance technology, observation of the complications of treatment, infusion port of the maintenance, the use of chemotherapy drugs, health education for patients with PICC catheter, and the use of effective order, the grasp rate was 100%. Complications rate was decreased significantly after using PICC catheter, (the rate of catheter related blood stream infections and the rate of thrombosis was reduced from the top 35%and 12%before training to 4%and 1%after training respectively (P<0.05). Conclusions In order to train more practical clinical nurse specialists, reduce the complications, raise the overall level of nursing profession, and improve the quality of nursing after using PICC catheter. Skill practice as the core methods in tumor specialist nurse training should be advocated.

Objective To explore how to establish and safeguard the peripherally inserted central catheters(PICC) maintenance network for the management and practical activity of PICC,so as to provide continuous high-quality PICC maintenance for discharged patients with PICC. Methods 40 nurses each year from 10 cities and 100 country hospitals affiliated with Shanxi Quality Control Center to train in the 1st and 2nd affiliated hospital of Xi`an Jiaotong University were choosen as 214 PICC maintainers. These maintainers were taken into the inner-net of 1st affiliated hospital of Xi`an Jiaotong University management system complete the PICC maintenance net of Shanxi province. Results After the establishment of maintenance network, the number of patients with PICC increased (from 610 cases in 2008 to 1 434 cases in 2014);A large number of PICC management had been down by the qualified nurses in primary hospitals; Duration of PICC in patients days was prolonged; The PICC related complications including thrombophlebitis, catheter infection,occlusion or dislodgment and unplanned extubate were significantly decreased (P < 0.05 respectively). Conclusions Establishment of PICC maintenance network can provide patients with standardized and convenient PICC maintenance service,decrease the incidence of catheter which related complications and ensure patient safety. The application of PICC maintenance network should be used more and more.

Objective We determined the proportion of doctors in Haidian community participating in the training of secondary prevention of ischemic cerebrovascular diseases related knowledge and the knowledge level of doctors so as to make a new targeted training plan,and assessed the effect of the training.Methods We enrolled 80 doctors,who filled out the questionnaire on secondary prevention of ischemic cerebrovascular diseases related knowledge,from 22 Haidian community center from March to July in 2014 in Beijing.The primary outcome was the proportion of doctors with the training of secondary prevention of ischemic cerebrovascular diseases related knowledge and the improvement rate of new training.Results Seventy (87.5％) community doctors didn't accept ischemic stroke secondary prevention system training.The understanding of Chinese Ischemic Stroke Subclassification and three cornerstones of secondary prevention of ischemic stroke(anti-hypertention,anti-lipidemia,antithrombotic) after the training was significant improvement (20％ vs.82.5％,P ＜ 0.05;31.25％vs.90％,P ＜ 0.05),while according to different causes classification subtype the doctors could make corresponding strategies of secondary prevention of ischemic cerebrovascular diseases.The rates of all community risk factors identification,community health education,lifestyle intervention,antihypertension,aspirin use,statin use,hypoglycemic treatment were both above 60％ no matter before the training or after the trainig.Conclusion Our results suggest that the community doctors in Haidian District lack corresponding knowledge of ischemic stroke secondary prevention.Further training of ischemic stroke secondary prevention is needed.

Objective To discuss the imaging appearances and causes of hepatic pseudolesions around the falciform ligament.Methods 40 patients (23 cases of A-type,17 cases of B-type) of hepatic pseudolesion around the falciform ligament examined by CT were collected.Combined with pathology of 2 cases,follow-up of 6 cases,MRI findings in 5 cases,and with the relevant literature reviewes,the density change of CT plain and enhanced scan and the causes of hepatic pseudolesion around the falciform ligament were analyzed retrospectively.Results There were low density in 25 cases,isodensity in 13 cases,high density in 2 cases in arterial phase,density lower than that of liver in 40 cases in portal phase,low or slightly low density in 27 cases and isodensity in 13 case of A-type in delayed phase.Of 40 cases,there were isointense in 2 cases of A-type in any sequence,and no sigal changes on out-phase images;there were intensity decline on out-phase images comparing to in-phase images in 3 cases of B type.Of 6 CT follow-up cases,there were no changes in 2 cases of A-type and shrinked or disappear in 4 cases of B-type;and there were more shrinked in 1 B-type case of MRI follow-up again after one month.Conclusion Hepatic pseudolesion of A-type can be resulted from focal fatty infiltration,and that of B-type can be caused by special blood-supply.They have characteristics in locations,and characteristic imaging appearances on CT and MRI images,and they can be clearly diagnosed generally.