Objective To explore the diagnostic value of multiplanar reconstruction(MPR)of spiral CT in the disorders of lumbar intervertebral discs.Methods Fourty-one cases with the disorders of lumbar intervertebral discs were examined with conventional CT scans and MPR of spiral CT.CT findings of intervertebral discs at L 3/4 ,L 4/5 and L 5/S 1 were compared and observed.Results The conventional scans showed bulging and /or herniation of intervertebral discs in 35 cases,and normal in 6 cases which compression of nerveroots by intervertebral discs or osseous narrow of intervertebral discs were showed on MPR.The MPR showed compression of nerve roots,compression of dural sac or osseous narrow of intervertebral foramens in 36 cases.Conclusion MPR possesses important value in diagnosing the disorders of lumbar intervertebral discs,showing the causes of lumbar vertebral diseases and distinguishing the various diseases of lumbar vertebrae.

Objective To evaluate the changes of growth hormone(GH), brain natriuretic peptide(BNP) and adrenomedullin(ADM) in congestive heart failure patients. Methods The blood samples were obtained from 60 pa-tients with congestive heart failure(CHF) and 30 patients without CHF,and their serum/plasma levels of GH,BNP and ADM were measured by enzyme-labeled immunosorbentassay(ELISA) and radioimmunoassay. At the same time all the patients received colorful Doppler ultrasonocardio-gram to determine left ventricular end-dilation diameter (LVED) and left ventrieular ejection fraction(LVEF). Results The levels of BNP and GH in heart failure group were[(0.83±1.06) μg/L,(115.31±191.16) ng/L] higher than eontrol group[(0.15±0.42) μg/L, (33.51±49.85) ng/L] (t = 2.689, t = 2.765, P < 0.01); The efficiency and total efficiency in heart failure group was (39.7% ,76.5%) higher than control group (32.3%, 61.3%) (t = 1.894, P > 0.05, t = 2.265, P < 0.05); The sensitivities and specificities of BNP were 89.3% and 63.0%; The sensitivities and specificities of GH were 85.7% and 59.3%; The BNP combined with GH were 75.0% and 74.0%. Condusion The combination of GH and BNP is better than application alone in the diagnosis of CHF.

Objective To evaluate the value of MR-guided neurolytic celiac plexus block(NCPB)for treatment of upper abdominal cancer pain.Methods 13 neurolytic celiac plexus blocks were carried out in 12 patients with severe upper abdominal pain caused by malignant tumors.The pain-relieving effect of the block was both evaluated using visual analogue scale(VAS) and analyzed statistically in all cases.Results The placement of the needle MR-guided was easy and accurate,the successful rate of the puncture was 92%.There were no severe complications.The pain before and after the procedure had obvious difference and the pain relief could last for a long time.Conclusion MR-guided NCPB is a simple and effective technique for treatment of upper abdominal cancer pain.

Objective To explore the characteristics and the clinical application of MR perfusion weighted imaging(PWI)in the normal kidneys and the renal diseases.Methods Thirty-one subjects including 9 cases without urinary diseases,14 cases with renal carcinoma,6 cases with renal cyst and 2 cases witll renal tuberculosis who had been examined with T1WI,T2WI and PWI were analyzed retrospectively.All the data were processed by a workstation to obtain time-signal intensity curves,color perfusion maps and relative perfusion value.The relative renal blood volume(RBV),relative renal blood flow(RBF),mean transition time(MTT)and the time to peak(TTP)in the normal renal cortex and medulla and the renal lesions were calculated.Comparisons between the right and the left normal kidneys,and between the cortex and the medulla of the normal kidneys were performed using t test,and comparisons between the normal and the abnormal kidneys were performed using q test.Results Relative RBV and relative RBF of the cortex were 1.33±0.08 and 1.44±0.09 respectively,and for medulla were 0.58±0.05 and 0.78±0.13 respectively(t=9.2241 and 5.0336,P＜0.01);MTT(1.11±0.08)and TTP (1.04±0.06)of the cortex has no difference with that of the medulla(0.97±0.04 and 0.94±0.03)in the normal kidneys(t=2.2551 and 2.2613.P＞0.05).The values of relative RBF of the renal carcinoma (1.35±0.34)were significantly higher than that of the normal tissues(1.02±0.06)(q=3.0882,P＜0.01).Conclusion PWI is able to demonstrate the hemodynamic change of the normal renal tissues and the renal lesions,and it maybe an ideal method for showing the functional changes of the kidney and for differentiating the renal diseases.

Objective To retrospectively assess the diagnostic value of nuchal translucency (NT) thickness and facial profile ultrasonic markers [including frontomaxillary facial (FMF) angle,and the ratio of prenasal thickness to nasal bone length (PT/NBL)] for trisomy 21 syndrome in first-trimester fetuses.Methods Ultrasonograhic images of 35 fetuses with trisomy 21 syndrome and 70 gestational age matched normal fetuses were analyzed in first-trimester.NT,FMF angle and the PT/NBL ratio were measured retrospectively in stored images from digital database between January 2012 and December 2015.The diagnostic value of NT,FMF angle and PT/NBL ratio were compared with different combinations.Results (1) The mean NT was significantly higher in the trisomy 21 group than that in controls (t =7.401,P =0.00).The NT above 2.5mm was observed in 20 trisomy 21 fetuses (57.1％) and in 3 normal fetuses (4.3％).(2) The mean FMF angle was significantly higher in the trisomy 21 group than that in controls (t =-5.283,P =0.00).The FMF angle above the 95th percentile (93.6°) was observed in 13 trisomy 21 fetuses (37.1％) and in 1 normal fetus (1.4％).(3) The mean PT/NBL ratio was significantly higher in the trisomy 21 group than that in controls (t =-7.826,P =0.00).The PT/NBL ratio above the 95th percentile (0.93) was observed in 19 trisomy 21 fetuses (54.3％) and in 4 normal fetuses (5.7％).(4) The sensitivity and Youden index for trisomy 21 increased gradually,which were 57.1 ％ and 0.528 by using NT,and 74.3％ and 0.686 by using NT and FMF angle,and 91.4％ and 0.828 by using NT,FMF angle and PT/NBL ratio.There were significant differences in the detection rates of trisomy 21 among the three strategies,while the diagnostic specificity of the three strategies were more than 90％.Conclusions The three parameters are significantly increased in trisomy 21 fetus in first-trimester.First,increased NT was most commonly detected,followed by increased PT/NBL ratio,and increased FMF angle again.Detection rates for trisomy 21 fetuses in first-trimester by ultrasound screening can be significantly improved if combination of all three parameters rather than just one parameter are performed.

BACKGROUND: Ambulatory blood pressure monitoring can sensitively and objectively reflect blood pressure level, which is closely related to target organ damage and disease prognosis. In hypertension, vascular endothelial damage is the most common lesion to target organs. There is little known about how ambulatory pulse pressure correlates to large artery elasticity and vascular endothelial function. OBJECTIVE: To investigate changes of large artery elasticity and of vascular endothelial function in patients with primary hypertension using an automatic pulse wave velocity determinator and ultrasound techniques, and to analyze the correlation of ambulatory pulse pressure to large artery elasticity and vascular endothelial function.DESIGN: A non-randomized concurrent control clinical observation. SETTING: Diagnosis and Treatment Center for Coronary Heart Disease, the 305 Hospital of Chinese PLA. PARTICIPANTS: A total of 156 inpatients and/or outpatients, who were recently confirmed with primary hypertension, were recruited for this study between June 2005 and April 2007. Patients consisted of 114 males and 42 females. All patients averaged 56 ± 4 years of age (range: 40-75). Inclusive criteria: Corresponding to diagnostic standards for preventing and treating hypertension instituted in 2004 by Chinese scholars. Confirmed as primary hypertension within 1 month. Not receiving any blood pressure lowering, hypolipidemic or nitrate-like drug treatments. Written informed consents for laboratory measurements were obtained from all subjects. The study was approved by the hospital's Ethics Committee. METHODS: According to the mean pulse pressure over 24 hours, all patients were assigned into 3 groups: Group A (mean pulse pressure ＜ 40 mm Hg, n=92), group B (40 mm Hg ≤ mean pulse pressure ＜ 60 mm Hg, n=39) and group C (mean pulse pressure ＞ 60 mm Hg, n=25). In each group, daytime pulse pressure and night-time pulse pressure, as well as 24-hour mean pulse pressure were measured using a non-invasive portable ambulatory blood pressure monitor (ABPM-04, Meditech Inc, USA). Carotid-femoral and carotid-radial arterial pulse wave velocities were measured using an automatic pulse wave velocity determinator to evaluate large artery dilation. Blood flow mediated and nitroglycerin-dependent dilatation of the brachial artery was determined using a high-resolution ultrasound technique to evaluate vascular endothelial function. MAIN OUTCOME MEASURES: Correlations of ambulatory pulse pressure to large artery dilation and arterial endothelial function. RESULTS: All 156 patients were included in the final analysis. Correlation of ambulatory pulse pressure to large artery dilation: Carotid-femoral arterial pulse wave velocity was significantly positively correlated to daytime pulse pressure, night-time pulse pressure and 24-hour mean pulse pressure, with coefficient of partial correlation being 0.310, 0.281 and 0.303, respectively, P ＜ 0.01). There were no significant correlations of carotid-radial arterial pulse wave velocity to daytime pulse pressure, night-time pulse pressure or 24-hour pulse pressure (P ＞ 0.05). Correlation of ambulatory pulse pressure to arterial endothelial function: There was a linear relationship between ambulatory pulse pressure and blood flow-mediated blood vessel dilatation values. Linear correlation analysis was performed, taking ambulatory pulse pressure as an independent variable, and endothelial-dependent dilatation as a dependent variable. Results demonstrated that blood flow-mediated blood vessel dilatation was significantly negatively correlated to daytime pulse pressure, night-time pulse pressure and 24- hour mean pulse pressure (r = -0.684, -0.597, -0.668, P ＜ 0.01). There was no correlation of ambulatory pulse pressure to non-endothelial-dependent blood vessel dilatation. CONCLUSION: Ambulatory pulse pressure increase is closely related to large artery elasticity decrease and injury to endothelial function in patients with primary hypertension.

Objective To study MR imaging manifestations of the mesorectum and mesorectal fascia. Methods 100 cases were divided into five groups according to the age. All MR images were retrospectively observed and analyzed by two radiologists.The observing contents included: ①exhibition of the mesorectal fascia, ②the signal intensity of the mesorectum and the pelvic fat and ③the thickness ratio of the mesorectum and the subcutaneous fat in different ages. All data were dealed with SPSS 10.0 software. Results The showing rate of the anterior, posterior, left and right mesorectal fascia respectively were 77, 100, 91 and 93 by MR imaging. The signal intensity of the mesorectum(550.8843) was significantly higher than that(469.8693) of pelvic fat in all five groups(P﹤0.05) and the signal difference between the mesorectum and the pelvic fat could be detected by naked eye. The thickness of the mesorectum and the subcutaneous fat had no association with ages.Conclusion MRI can display the mesorectum and mesorectal fascia clearly. The signal intensity of the mesorectum is significantly higher than that of pelvic fat in five groups. The thickness of the mesorectum and the subcutaneous fat have no association with ages.

Objective To assess the role of dynamic contrast-enhanced MRI for diagnosis and differential diagnosis of prostatic cancer. Methods Six volunteers, 32 patients with benign prostatic hyperplasia and 13 patients with biopsy-proven prostatic cancer underwent MR imaging. Dynamic MR with Gd-DTPA (gadolinium-diethylene triamine pentaacetic acid) bolus enhancement was performed followed by post-contrast T 1-weighed imaging. The signal intensive value in dynamic MRI was measured and calculated to draw the time-signal intensity curve of normal peripheral zone, prostatic cancer and benign hyperplasia. Results In dynamic MRI, the normal peripheral zone were enhanced mildly and slowly. The lesion enhancement of benign prostatic hyperplasia in 32 patients were obvious in early phase (60 s) and strengthened gradually, and then went to decrease in late phase (240 s) after peak value. The lesions in 9 of 13 cases with prostate cancer were enhanced obviously in early phase (60 s) and washed out rapidly in late phase, and the peak value was located on early phase. Conclusions In dynamic MRI, the enhancement of normal peripheral zone, prostate cancer and benign hyperplasia were different significantly. Dynamic MRI was very useful in the diagnosis and differentiation of prostate cance.

Objective To determine the lower limit of detection (LLOD) and cut off values of K-ras mutation detection by peptide nucleic acid (PNA) clamping-PCR.Methods The genomic DNA of pancreatic cancer cell lines (PANC1 and SW1990) with codonl2,13 mutation and the genomic DNA of placenta with K-ras wild type were mixed and diluted serially into samples with different mutation rate (0,0.1％,0.2％,0.4％,0.8％,1.6％,3.1％,6.25％,12.5％,25％,50％),PANC1 cells with 1％ mutation rate and SW1990 cells with 30％ mutation rate and 4 samples with the quantity of DNA was 50,20,5,1 ng and 50,10,5,1 ng was prepared.Codon 12,13 mutation of K-ras was determined by PNA-PCR,and the mutation Ct values,overall Ct values were collected,and the △Ct values (mutation Ct values-overall Ct values) were calculated,and the tests were repeated for 10 times.ROC curve was used to analyze the △Ct values and determine the best cut off values for K-ras mutation,and the positive diagnostic rate,LLOD was evaluated.Results The mutation Ct,△Ct values of codon 12 mutation of PANC1 and codon 13 mutation of SW1990 of all the different mutation rates were statistically significantly different (P ＜ 0.05) when compared with negative control group,but the overall Ct values were not statistically significantly different from that of negative control group.For detection of K-ras codon 12 mutation by ROC curve,the relevant area of ROC curve (AUC) was 0.926,the optimum cut off value of △CT was 11,the sensitivity and specificity were 84％ and 100％,respectively,and the LLOD was 0.4 ng.For detection of K-ras codon 13 mutation by ROC curve,the relevant AUC was 0.906,the optimum cut off value of △CT was 9.5,the sensitivity and specificity were 71％ and 100％,respectively,and the LLOD was 1.5 ng.The mutation detection results of fixed rate further confirmed the LLOD.Conclusions This study successfully defines LLOD and cut off value of PNA clamping-PCR/K-ras method in detection of K-ras 12 and 13 codon mutations.This method meets the requirement of clinical application.