Objective:To observe therapeutic efficacy of intense pulsed light on acne. Methods:Acne was treated individually by ENERGIST ULTRA intense pulsed light system and suitable wave length,pulses width,energy density,delay time of pulse, pulse mode. One course of treatment contained thrice with the interval of 21days. Therapeutic efficacy was evaluated based on contrast picture of before and after treatment and clinical manifestations. Results:Average derma-lesion decreased by 80% and imflammatory erythema decreased by 84% , curing rate reached 77% ,total effective rate 96% and recurrence rate 3% . Conclusion:The therapeutic efficacy of intense pulsed light on acne is conspicuous,especially erythema acne.

2 years;appearedrigh quadrent abdominal signs,thickness of gallbladder wall≥3 mm;and hydrops of gallbladder.Conclusions The risk factors for conversion of LC to OC were attacks of acute cholecystitis,the length of disease,tenderness of upper abdomen,thickening of gallbladder wall and hydrops of gallbladder.A detailed history,clinical examination with suitable imaging test,proper selection of patients and improving the skill of operators,may decrease the occurrence of the LC conversion rate and the complicationafter operation.OC should be selected for the patients with the above risk factors.

Objective To study the combination treatment of lfexible/lfexible sheath and rigid ureteroscopic lithotripsy (F-ul) for upper and middle ureteral stones. Methods The clinical data of patients diagnosed of upper and middle ureteral stones were collected. The treated group (110 cases):ifrstly treated with rigid ureteroscopic lithotripsy to broke and removed stones through lfexible sheath, then the lfexible ureteroscopic lithotripsy was used to broke and removed stones through lfexible sheath;The control group (110 cases):traditional operation for ureter calculi. The clinical data was compared between the two groups. Results The effective ratio of treatment group is 90.0%, which was better than that of control group (87.3%) (P>0.05). The operation time, stone processing time of treatment group were signiifcantly shorter than those of control group (P<0.05), and F-ul using time was signiifcantly much more (P<0.05). The hospitalization time and complication rate were no signiifcantly difference between the two groups (P> 0.05). Conclusion The method of combining flexible/flexible sheath and rigid ureteroscopic lithotripsy for upper and middle ureteral stones was better than that of traditional operation, which worth to be popularize in clincal treatment.

Objective To apply electrical impedance tnmography that is a new evaluation ap-proach to monitor the development of retroperitoneal injury. We used retroperitoneal inject blood model in pigs to study the feasibility on monitoring retroperitoneal bleeding and to provide premise in theory and practice for clinical application. Methods Five pigs were used on the experiment. We insert a vessel into the retroperitoneal and inject blood to simulate retroperitoneal bleeding. Sixteen electrodes were atta-ched on the abdominal region circumference of pigs and used for electrical current injection and surface voltage measurement. Then the monitoring images were performed by electrical impedance tomography. Results The images of electrical impedance tomography retroperitoneal inject blood model of five pigs were clear, the minimal impedance scale was decreasing significantly as the bleeding volume increasing and the images were changed significantly too. The computerized tomography and the dissecting results confirmed the blood was limited in retroperitoneal. Conclusions The establishments of pigs retroper-itoneal inject blood model was successful. The images of electrical impedance tomography retroperitoneal inject blood model were clear with significant contrast. It's feasible to use electrical impedance tomography system to monitor the retroperitoneal bleeding. This technique may become a useful tool for monitoring ret-roperitoneal injury in intensive care patients.

Objective To analyze the clinical value of combined detection of tuberculous T cell enzyme-linked immuno spot assay (T-SPOT.TB) and adenosine deaminase (ADA) in tuberculous pleurisy patients of different ages.Methods From February 2014 to February 2018,three hundred and thirty-six patients with pleural effusion were admitted to Hebei Thoracic Hospital.Among them,two hundred and fifty five cases were diagnosed as tuberculous pleurisy and 81 cases were diagnosed as non-tuberculous pleurisy.The patients were divided into two groups according to their age.The younger group (214 cases) was 16-59 years old and the older group (122 cases) was over 60 years old.The sensitivity and specificity of T-SPOT.TB combined with ADA in the diagnosis of tuberculous pleurisy were compared between the two groups.Results The sensitivity and specificity of T-SPOT.TB were 85.5％ (153/179) and 71.4％ (25/35) in the young and middle-aged group,73.7％ (56/76) and 58.7％ (27/46) in the old group,respectively.The sensitivity of the young and middle-aged group was significantly higher than that of the old group (x2 =4.990,P =0.045).The sensitivity and specificity of T-SPOT.TB combined with ADA were 98.9％ (177/179) and 94.3％ (33/35) in the young and middle-aged group,96.1％ (73/76) and 89.1％ (41/46) in the elderly group,respectively.There was no significant difference in sensitivity and specificity between the two groups (x2 =0.256,P=0.393、x2=0.655,P=0.218).Conclusion The diagnostic efficacy of T-SPOT.TB combined with ADA in patients with tuberculous pleurisy at different ages has been improved,especially for those who can not tolerate pleural biopsy and elderly patients.

Objective: To explore the application and effect of superficial temporal fascia flap combined with avulsion auricular tissue in emergency auricular restoration. Methods: From June 2015 to December 2015, 6 patients with auricular large area complete avulsion were underwent treatment in Department of Plastic Surgery of General Hospital of Shenyang Military. After thorough debridement, the auricular cartilage scaffold of the avlusion ear and skin was completely stripped. The auricular cartilage was repositioned on its anatomical site and subsequently covered by superficial temporal fascia flap. The free skin was stripped as full-thickness graft to cover the surface of reconstructed ear. Results: All 6 patients with auricle large area complete avulsion achieved immediate repair under emergency condition. The operations were successfully completed and the ears were healed primarily. The patients were followed-up for one year. Five patients with partial auricular avulsion achieved obvious reconstructed auricle profile. The color of reconstructed ear was close to the surrounding skin and the cranioauricular angle was nearly normal. Patients and their families were very satisfied. One patient of total auricular reconstruction had auricular contracture. The auricle profile was not obvious with small size, morphological changes and external auditory canal stenosis. Conclusions Avulsion auricle and temporal superficial fascia flap can be used to repair partial auricle defects as a first-stage repair with ideal results. It is the best choice for large auricle defects in emergency cases.

Objective:The extensive development of anatomical pulnonary segmentectomy requires thoracic surgeons to be familiar with the anatomical variations of the lung segment. The purpose of this study is to analyze the anatomical patterns of the right upper lobe lung segment using three-dimensional reconstruction, and to count rare variant types.Methods:From October 2017 to March 2020, 101 patients with small pulmonary nodules who were undergo segmental resection in our center were subjected to preoperative three-dimensional reconstruction of the lung structure, and the reconstruction data was retained for the statistics and analysis of the anatomical structure in the right upper lung lobe.Results:The right upper lobe bronchus is the most common with three branches(77/101), followed by two branches(16/101) and four branches(7/101). The two branches(70/101) of the right upper lobe pulmonary artery are the most common, followed by single branch(19/101) and three branches(11/101). In rare cases, four branches(1/101 cases) can be seen. The two branches(63/101) of the right upper pulmonary vein were the most common, followed by three branches(32/101) and single branch(6/101). In addition, a total of 12 rare mutations were counted. There were 2 variants in the bronchus, totaling 2 cases; 4 rare variants in the pulmonary artery, 13 cases total; 6 rare variants in the pulmonary vein, 10 cases total.Conclusion:The lung anatomy is complex and has many variations. The surgeon should fully grasp the anatomical structure of the lung segment of the patient's operating area before surgery, the data in this article will be a valuable reference for thoracic surgeons to carry out the upper right lobe segmentectomy.

Objective To evaluate the clinical value of CT urography (CTU) in quantitative analysis of single?kidney renal glomerular filtration rate (GFR) in patients with renal tumor and hydronephrosis.Methods A total of 49 patients with renal tumor or hydronephrosis from January 2018 to September 2018 in the Second Hospital of Tianjin Medical University were prospectively collected. In all cases, the CT urography and 99mTc?DTPA renal dynamic imaging data and related clinical data were collected. All patients were divided into two groups: the experimental group (39 patients with a total of 78 kidneys) and the validation group (10 patients with a total of 20 kidneys). According to the presence or absence of renal diseases, the kidneys of the experimental group and the validation group were further divided into four groups, namely, the single kidney group, the tumor group, the stagnant water group and the healthy group. The CT urography protocol consisted of noncontrast, arterial phase, nephrographic, and excretory phase imaging. The total renal GFR was determined by CT measurement of renal clearance of contrast media (CM), and the total CT?GFR was then split into single?kidney CT?GFR by a left and right kidney proportionality factor. Differences between CT?GFR and SPECT?GFR measurements in each group of the experimental group was compared by paired?sample t test. Correlations between CT?GFR and SPECT?GFR in the experimental group and their correlations with RPV was analyzed by Pearson method. The Bland?Altman mapping method was used to evaluate the consistency between CT?GFR and SPECT?GFR in the experimental group. Results Paired difference between single?kidney CT?GFR (48.76 ± 18.50) ml·min-1·1.73 m-2 and single?kidney SPECT?GFR (45.68±17.95) ml·min-1·1.73 m-2 in the experimental group, P<0.05, demonstrating 6.8% systemic overestimation. A good correlation(r=0.80, P<0.01) and consistency (± 22.50 ml·min-1·1.73 m-2, ± 49.2% measurement deviations) was revealed between both measurements. There were positive correlations between CT?GFR and SPECT?GFR in the renal tumor group, hydronephrosis group, and healthy kidney group (r=0.67, 0.92, 0.80; P<0.01) respectively, and with good agreement (95% CI measurement deviation<30 ml·min-1·1.73 m-2). In all validation groups, there was no statistical difference between the estimated and true values of the Gates?GFR (all P>0.05). Pearson Correlation analysis showed that the correlations between CT?GFR and RPV in all experimental groups were better than the correlation between Gates?GFR and RPV (P<0.05). Conclusions This study demonstrated the feasibility of using CT urography to measure single?kidney GFR, verifying its application value in diseases such as kidney tumors and obstructive hydronephrosis, and proved that the proposed single?kidney CT?GFR correlates better than the SPECT?GFR with RPV.

Objective To provide theoretic rationales and clinical experience for post-transplant lymphoproliferative disorder (PTLD ) by comparing the characteristics of PTLD in kidney and hematopoietic stem cell transplant recipients and reviewing the relevant literature reports .Methods Twenty-seven adult PTLD patients from 2000 to 2017 were retrospectively reviewed .There were 11 kidney transplant recipients (KT group) and 16 hematopoietic stem cell transplant recipients (HSCT group) .Clinical characteristics and outcomes were analyzed between two groups .Cox's proportional hazard model was utilized for evaluating the prognostic factors .Results The incidence of PTLD for KT and HSCT groups were 0 .5 ％ and 1 .1 ％ respectively .PTLD patients of KT group had a later onset than that of HSCT group (105 .1 vs 3 .1 months , P<0 .01) .Also Epstein-Barr virus was less frequently detected in KT group (36 .4 ％ vs 81 .3 ％ , P< 0 .05) .The 5-year overall survival was (46 .8％ ± 10 .5％ ) .According to Cox analysis ,application of antithymocyte globulin (ATG) and high ECOG scores were risk factors for a poor prognosis of PTLD .Conclusions Most cases of KT-PTLD have a late onset . In contrast , HSCT-PTLD has an earlier onset and a higher incidence of EBV infectious .And application of ATG and high ECOG scores are poor prognosis factors of PTLD .

Objective To investgate the application value of low-dose CT scanning in right adrenal vein imaging.Methods A total of 124 patients were enrolled in the study who were suspected as primary aldosteronism and requiring a contrast enhanced CT examination on adrenal glands.Four patients were excluded according to the exclusion criteria,so that the rest 120 patients were divided equally into three groups.Group A was a control group with conventional radiation dose using tube voltage of 120 kV and automatic mA.It was divided into A1,A2 and A3 groups according to arterial phase,portal venous phase and parenchymal phase.Group B was a experimental group with conventional tube voltage of 120 kV and automatic mA,which was divided into B1,B2 and n3 groups according to arterial phase,late arterial phase and portal venous phase.Group C was a low-dose experimental group with a tube voltage of 100 kV and a tube current of 150 mA only in the second phase,the remaining scanning parameters and method were the same as that of group B.The subjective scores of the images of groups A,B and C were statistically analyzed,and the CT values of the right adrenal vein(RAV),the right adrenal gland(RAG),and the fat of anterior abdominal wall at different scan phases were measured.The dose length products (DLP) were recorded and the signal-to-noise ratios (SNR),contrast-to-noise ratios (CNR),effective doses (E) of the three groups were calculated and compared.Results The subjective scores of the two observers were consistent (Kappa value =0.63);the subjective scores of the B2 images were statistically significant (H =7.18,P＜0.05).Difference of subjective scores between B2 and A2was statistically significant (t=-18.03,P＜0.05).The CT values of RAV,SNR,and CNR of the B2 group were higher than those of the A2 group (t=36.99,6.92,9.02,P＜0.05).The radiation dose comparison showed that the effective dose (E) was 45.52％ lower in the low-dose group than the conventional dose group with the statistically significant difference(t =12.19,P＜0.05).Conclusions Using MDCT scanning technique with lower tube voltage and lower tube current of 100 kV-150 mA,the detection rate of right adrenal vein can reach 95％ in the late arterial phase,and the effective dose can be reduced about 45.52％ on the basis of ensuring image quality.