Based on the analysis of the status quo of computer teaching,the present paper discusses the reform of teaching contents in the computer education in our college.

Objective To select a safe and feasible way by comparing the two main styles of splitting liver transplantation classical splitting and modified splitting.Methods In order to compare the distribution of artery, vein and bile duct of all segments of liver, 58 formaldehyde fixed livers and 8 fresh livers were divided into two groups. One group was subjected to classical splitting and the other group to modified splitting. Results Among 66 livers, 66.7?% of the segment VIII and 100?% of the segment V (all or some) drained to middle hepatic vein. In classical splitting group, the vein drainage of 5th and 8th segments of right graft was destroyed.Conclusion Modified splitting is safer and more reliable than classical splitting, so the former is the first choice when the size of donor liver is suitable.

Objective Applying diffusion weighted image (DWI) and apparent diffusion coefficient (ADC) to analyze brain injury caused by hypoxic-ischemic encephalopathy (HIE) in term neonates.Methods From June 1,2010 to January 5,2011,thirty-eight full term neonates with HIE were hospitalized in the Second Hospital of Tianjin Medical University.Those with nervous system diseases were excluded.The 38 cases were divided to mild HIE group (n=24) and moderate-to-severe HIE group (n=14).The control group included 10 normal full term neonates without history of asphyxia.All babies were scanned by magnetic resonance imaging (MRI).Spin echo-echo planar imaging sequence was used for DWI images.ADC values of nine regions (frontal lobe gray matter,frontal white matter,parietal gray matter,parietal white matter,corona radiata,caudate nucleus,putamen,posterior limb of the internal capsule and thalamus) were measured.MRI and DWI images were compared.ADC values were compared by analysis of variance and Student-Newman-Keuls test.Results ADC values of the nine indicated regions (frontal lobe gray matter,frontal white matter,parietal gray matter,parietal white matter,corona radiata,caudate nucleus,putamen,posterior limb of the internal capsule and thalamus) were (1.37±0.07),(1.81±0.12),(1.35±0.10),(1.84±0.09),(1.23±0.11),(1.28±0.09),(1.18±0.08),(1.05±0.07) and (1.15±0.08) ×10-3 mm2/s in control group,(1.28±0.11),(1.60±0.15),(1.27±0.09),(1.59±0.20),(1.19±0.15),(1.19±0.13),(1.11±0.09),(0.97±0.11) and (1.06±0.12) ×10-3 mm2/s in mild HIE group,and (1.18±0.14),(1.51±0.22),(1.19±0.09),(1.56±0.19),(1.03±0.16),(1.08±0.07),(1.02±0.07),(0.87±0.09) and (0.96±0.12) × 10-3 mm2/s in moderate-to-severe HIE group.ADC values among the three groups had statistical difference (F=3.89,3.21,4.05,3.30,3.28,3.27,4.12,4.75and 4.72,all P＜0.05).ADC values of frontal lobe gray matter,frontal white matter,parietal gray matter,parietal white matter,putamen,posterior limb of the internal capsule and thalamus in mild HIE group were lower than those in control group (all P＜0.05).All of the ADC values of nine regions in moderate-to-severe HIE group were lower than those in control group (all P＜0.05).ADC value of frontal lobe gray matter,parietal gray matter,corona radiata,caudate nucleus,putamen,posterior limb of the internal capsule and thalamus in moderate-to-severe HIE group were lower than those in mild HIE group (all P＜0.05).Conclusion DWI and ADC values could reflect brain injury caused by HIE,and ADC values can be used to quantitatively analyze the degree of hypoxic-ischemic injury.

OBJECTIVE:To investigate effectiveness and safety of rh-endostatin in the treatment of keloid.METHODS:Sixty-four keloid patients in Nanchong Central Hospital during Jan.2015-Jan:2016 were divided into observation group and control group by random number table,with 32 cases in each group.Both group received fractional CO2 laser treatment.After surgery,control group was given antioxidant drug and antibiotics routinely.Observation group was additionally given Rh-endostatin injection 0.1-0.2 mg/cm2 via keloid body,once a month,for twice,on the basis of control group.Clinical efficacy,symptom score after laser treatment and 2 months after laser treatment,wound healing time,wound pigmentation area and keloid area before and after treatment,the occurrence of ADR were compared between 2 groups.RESULTS:There was no statistical significance in total re sponse rate (93.75％ vs.87.50％) and the incidence of ADR (15.63％ vs.12.50％) between observation group and control group (P＞0.05).There was no statistical significance in symptom score of control group between after laser treatment and after 2 months of treatment (P＞0.05).The erythema,edema and pigmentation scores of observation group were significantly lower than before treatment and control group,with statistical significance (P＜0.05);there was no statistical significance in skin itching and burning sensation score between 2 groups (P＞0.05).The wound incrustation time,decrustation time and wound healing time of observation group were significantly shorter than those of control group,with statistical significance (P＜0.05).Pigmentation area and keloid area of 2 groups were significantly smaller than before,and the observation group was significantly smaller than the control group,with statistical significance (P＜0.05).CONCLUSIONS:Rh-endostatin can alleviate erythema,edema,pigmenta tion and other symptoms effectively,shorten healing time,and inhibit pigmentation and keloid regeneration effectively with good safety.

To intensify the medical students'clinical skills training is the main objective of medical imaging education. In the process of clinical teaching ,we have adopted many means including renewed multimedia courseware,teaching web page,film storage,and integration of various teaching methods. The film-reading skill of medical students has greatly increased.

In the educational reform of radiology,the importance of practical skills training has increasingly become the focus of teaching.As a symbol of medical imaging informationization,PACS provides solid material foundation for teaching reform,making it possible to establish a large capacity and stability of a picture library.By making full use of all intemet teaching resources and improveing teaching methods,teachers have more communication with students through PBL and CBL teaching.Therefore,students get deeper understanding and better ability to put the theory of knowledge into practice and the teaching effect is pretty good.

Objective: To compare the long term prognosis between revascularization (REV) and medical therapy (MP) in patients with three-vessel disease (3VD) with or without left main (LM) lesion.
Methods: A total of 4,875 consecutive patients with elective coronary angiography (CAG) diagnosed 3VD with or without LM lesion treated in our hospital from 2007-01 to 2008-12 were retrospectively studied. The patients were divided into 2 groups: MT group,n=705 (14.5%) and REV group,n=4170 (85.5%). The all cause mortality and the rate of revascularization during follow-up period were compared between 2 groups by inverse-probability-weighting approach with propensity score.
Results: There were 3962/4875 (81.3%) patients with simple 3VD (right, left anterior descending and left circumlfex coronary arteries) and 913 (18.7%) with 3VD+LM lesion. The in-hospital mortality was similar between 2 groups (OR=0.7, 95% CI 0.3-1.4,P=0.30). With the longest 2-year follow-up study, the adjusted all cause mortality and the rate of revascularization in MT group were both higher than those in REV group (HR=8.3, 95% CI 6.7-11.1,P<0.001) and (HR=1.4, 95% CI 1.1-1.6,P<0.001). No matter the patients with simple 3VD or 3VD+LM lesion, compared with REV group, MT group had the higher all cause mortality, for 3VD+LM lesion (HR=10.4, 95% CI 7.1-15.4,P<0.001) and for simple 3VD (HR=7.1, 95% CI 5.3-10.0,P<0.001).
Conclusion: In real world, the long term prognosis by revascularization treatment was superior to medical treatment in patients with either simple 3 vessel coronary disease or 3 vessel combining LM disease.

Discipline of medical imaging has developed very quickly,which play an increasingly important role in the diagnosis and treatment of clinical disease.According to the characteristics of medical imaging disciplines,we launched reform on teaching management,teaching methods,course content,teacher training and modes of teaching,examing and researching in an aim to improve medical imaging education standards.

Objective To assess the diagnostic value of CT spectral imaging using quantitative iodine-based material decomposition images in the evaluation of pulmonary embolism. Methods Fifty-three patients underwent CT angiography with spectral imaging mode on a GE Discovery CT750HD scanner. Iodine distribution in the lung parenchyma using the iodine-based material decomposition images was quantitatively measured by post-processing. Monochromatic CT angiographic images were reconstructed from the same data sets and thee images were reviewed for the identification and localization of pulmonary embolism as well as the degree ( partial or complete) of the embolic occlusion. The number and location of perfusion defects were recorded. The iodine content of perfusion defects and normal lung parenchyma on the iodine maps were measured by one reader using an ROI analysis. Comparative analyses were obtained using the Chi-square test for categorical data. Two independent samples rank test and 2 related samples signed-rank test were used to compare iodine densities between different groups. Results CT angiography showed no pulmonary embolism in 33 patients, and iodine distribution was homogeneous. A total of 93 clots with lobar ( n = 26), segmental (n = 54) and sub-segmental (n=13) distribution were detected in 19 patients; Fifty-one clots were occlusive and 42 clots were non-occlusive. The iodine-based material decomposition images of all occlusive clots showed lobar, segmental or sub-segmental iodine distribution defects; whereas eleven of 42 non-occlusive clots had evidence of iodine distribution defects. There was significant difference ( x2 = 39. 94,P＜0. 01 ) in the perfusion defects between occlusive and non-occlusive clots. There was a significant difference in iodine content between normal lung parenchyma [ (1.92 ±0. 54) g/L] and perfusion defects [ (0. 30 ± 0. 20)g/L] (Z= -5.63, P ＜ 0. 01 ). There was a significant difference in the iodine content of peffusion defects before [ (0. 26 ± 0. 23 )g/L] and after anticoagulation [ (0. 94 ± 0. 50 )g/L ] ( Z = -3.93,P ＜ 0. 01 ). Conclusion With the ability of iodine mapping, CT spectral imaging is areliable method in the evaluation of pulmonary embolism both qualitatively and quantitatively, and may be a useful tool in providing information regarding the severity of PE and monitoring therapeutic efficacy.

Objectives To investigate the clinical significance of dual energy spectral CT (DESCT) in quantitatively differentiating peripheral lung cancers from pulmonary inflammatory masses.Methods Sixty patients with 35 lung cancers and 25 inflammatory masses underwent DESCT to get arterial phase (AP) images and venous phase (VP) images.Iodine concentrations in the central and peripheral zone of the masses were measured and normalized to the aorta as normalised iodine concentration (NIC).The difference of NIC between central and peripheral zone of the masses (dNIC) was calculated.The spectral attenuation curve was obtained automatically and the slope of curve (λHU) was also calculated in the two groups.The quantitative parameters was presented as M (Q1,Q3),and Wilcoxon signed rank test was used to compare above two independent samples.Receiver operating characteristic (ROC) curves were generated to calculate the sensitivity and specificity.Results NICs in the central zone of peripheral lung cancers were significantly lower than that of inflammatory masses:mean NICs were 0.03 (0,0.05) versus 0.12 (0.07,0.20) in AP,and 0.14 (0.12,0.19) versus 0.30 (0.21,0.57) in VP (Z=-4.14,-3.70,respectively,P＜0.01).While the dNIC values of lung cancers were significantly higher than that of inflammatory masses:dNIC values were 0.08 (0.05,0.11) versus 0.04 (-0.02,0.08) in AP,and 0.23 (0.17,0.34)versus 0.07 (-0.04,0.08) in VP(Z=-2.56,-4.00,respectively,P＜0.05).Mean λHU values of lung cancers were also lower than inflammatory masses:1.03 (0.67,1.67)versus 2.75 (1.61,3.19) in AP,and 1.58 (1.30,2.17) versus 3.25 (2.37,4.54) in VP (Z=-3.90,-4.42 respectively,P＜0.01).According to ROC curves,cutoff value of λHU =2.11 in VP had the highest sensitivity (89％) and specificity (91％) in differentiating peripheral lung cancers from inflammatory masses.Conclusions Contrast-enhanced dual energy spectral CT imaging with some quantitative parameters such as normalised iodine concentration,dNIC,and the slope of spectral attenuation curves may be a promising new method for differentiating peripheral lung cancers from inflammatory masses.