AIM: To develop a rat model of insulin resistance and observe the effect of puerarin injection on expression of GSK-3 in insulin resistance rats.METHEDS: 30 Wistar rats were divided into three groups randomly: control group,model group and puerarin group.The model group and puerarin group were given high fat diet(20% surcose,10% ard,(2.5)% chlesterol,1% cholic acid) for 4 weeks.Then the puerarin group was given abdominal injection puerarin 100(mg?kg~(-1)?d~(-1)) for six weeks.At the end of this experiment,we detect GSK-3 protein by western-blot analysis.Then computer image pattern analysis system was used to analyze the expression of GSK-3 in the hepatacyte.RESULTS: Tthe model group showed a hyperglycemia,hyperinsulinism,the ISI decreased and HOMA-IR increased.GSK-3 expression enhanced in the model group,but the expression of GSK-3 in puerarin group decreased compared to the model group.CONCLUSION: Puerarin injection can significantly decreased the expression of GSK-3 and improve insulin resistance.

Objective To investigate the image quality differences of clinical conventional contrast injection solutions and personalized injection program in 64 -slice spiral coronary CT angiography (CTA),thus to obtain the CTA optimum contrast agent injection protocol.Methods 64 patients who needed to receive CTA angiography,were randomly divided into observation group and control group,32 cases in each group.The control group underwent rou-tine clinical angiography contrast agent injection protocol,the observation group received personalized contrast injec-tion solutions,the image difference of the two groups was compared.Results Compared with the control group,the right ventricular (RV)and pulmonary CT value of the observation group increased significantly[(272.4 ±72.3)HU, (372.1 ±78.2)HU],the differences were statistically significant (t =3.827,3.921,all P <0.05).CT values of left ventricular (LV),ascending /descending aorta had no significant differences between the two groups (P >0.05). Compared with the control group,the advantages of septal imaging of the observation group was significant (control group 3 points in 20 cases,29 cases of the observation group),the difference was statistically significant (χ2 =16.023,P <0.05).Conclusion In CTA angiography,personalized contrast injection speed can effectively improve the enhancement degree of right heart,so that the right ventricular septal has clearer image,provides a great conven-ience for clinical diagnosis and prognosis,it is worth further clinical application.

ObjectiveTo explore relationship between psychological resilience and life events of Tibetan nursing students receiving free vocational nursing education.Method The questionnaire of Symptom Checklist 90(SCL-90)and ASLEC were used in the survey among 120 nursing students to investigate the psychological resilience and life events and SPSS 17.0 was used to look into the correlations between them.Results The scores on psychological resilience of Tibetan nursing students was higher than the norm (P<0.05).There were negative correlations between life events and psychological resilience(P<0.05).Their psychological resilience was positively related to personal relations and health conditions(P<0.05)but negatively to learning pressure,punishment and losses (P<0.05).Conclusion The school and hospital should make teaching measures to psychologically support them in daily life to strengthen the abilities to handle failure and adjust to the society.

Objective To explore the high-risk factors of the abdominal wound undesirable healing in gynecologic operations and its prevention and treatment.Methods A retrospective clinical study reviewed 58 cases in gynecologic operations.To investigate and analyze its frequent clinical risk factors.Results The risk factors in these wound healing defect such as the fat liquefied:3 cases(48.3%),the anaemia and/or hypoproteinemia:13 cases(22.4%);combined with diabetes:3 cases(5.2%),hypertension:6 cases(10.3%),wound infection:2 cases(3.5%)and wound hematoma:1 case(1.7%);two high risk factors coexisted:22 cases(37.9%),three or more risk factors coexisted:11 cases(19.0%).The complication of such wound healing defect such as effusion:26 cases(44.8%),flare and induration:28 cases(48.3%),low-grade fever:5 cases(8.6%).Conclusion The fat liquefaction is the important reason of the wound dehiscence in gynecology operations;the effusion,flare or induration is the precipitation of the wound healing defect.If we can treat these high-risk groups positively,we will improve the clinical prognosis.

Objective To investigate the differential diagnostic values of CT bronchial sign for peripheral solitary pulmonary lesions(SPLs).Methods One hundred and eleven patients with peripheral SPLs were scanned using multi-slice helical CT(MSCT),and multiplanar reconstruction was performed to show the relationship between the lesion and bronchus,the diffefences between the benign and malignancy were compared by using chi-square test.Results Bronchial cutoff rate in malignant lesions(47/95,49.5%)was markedly hi er than that in benign lesions(10/42,23.8%.X12=7.896,P＜0.05),the frequency of type Ⅰ and type Ⅱ air bronchogram presented in malignant lesions(10/11.8/9)was higher than benign lesions(1/11,1/9.X2=6.975,4.818,P＜0.05),but type Ⅳ in benign lesions(12/17)was more common than that in malignant lesions(5/17.X2=7.390,P＜0.05).No significant difference was found in bronchus ran at the periphery of the lesion and bronchus dragged by the lesion between benign(9/24.1/4)and malignant lesions(15/24,3/4.X2=0.641,0.062,P＞0.05).The focal bronchial wall thickening in malignancy(21/22)was markedly higher than benign lesions(1/22.X2=4.185.P＜0.05),whereas the extensive thickening in benign lesiom(4/7)was more common(3/7.X2=8.650,P＜0.05).Conclusion CT bronchial sign is very important in the differentiation of benign and malignant pulmonary lesions.

Objective The purpose of this study was to present the characteristic features on MSCT angiography of arterial sequestration.Methods The MSCT images of 5 patients with arterial sequestration were retrospectively reviewed All patients underwent MSCT contrast-enhanced angiography.3D rendering was made to evaluate the lung parenchyma,bronchial system,and vascular anatomy.Results All S cases demonstrated the anomalous systemic artery(ASA)as an isolated and tortuous artery arising from the descending thoracic aorta,taking a sigmoid course and running along with airway,entering the basal segments of the left lower lobe.The inferior pulmonary vein(IPV)was significantly engorged.The typical AS was diagnosed in 4 patients.Its ASA intercrossed with the IPV and two branches entering segments 7 and 8 over the IPV,and two branches entering segments 9 and 10 under the IPV.The volume of involved lung shrunk with the artery markedly engorged.A characteristic avascular section was found between the pulmonary artery supplying area and the ASA supplying area,and the bronchi did not accompany the arteries.One was diagnosed atypical AS because of coexistence with bronchial atresia.Conclusion The arterial sequestration had characteristic MSCT findings.The typical type can be definitely diagnosed,but the atypical type needs further three-dimensional analysis.

Objective: To study the CT features and its diagnosis of spontaneous renal vein shunt (SPVA) in portal hypertension. Methods: Totally 220 cirrhosis patients with portal hypertension diagnosed clinically underwent multi-slice CT scanning. The parameters were 5 mm/6. 5 mm/2. 0 mm(collimation/effective thickness/interval) in 180 patients and 2. 5 mm/3. 2 mm/1. 6 mm in 40 patients. An arterial-phase (delaying 26-28 s) and a portal venous phase (55-60 s) were included. All images were showed by cine and CTA was displayed with volume rendering and thin-slab maximum projection when ah normal vessels were suspected. Results: The spontaneous renal shunt were found in 26 patients (11. 8%), including spleno left renal shunt(20 patients), gastro-left renal shunt (16 patients), and portal-right renal shunt(2 patients). The veins sur rounding renal hilum were rich and thick in 7 patients. Conclusion: The SPVA is not rare in portal hypertension, enhanced CT scan and angiography with multi-slice CT can effectively display the shunt vessels, contributing to the correct diagnosis and right therapy.

Objective To discuss the different contrast injection rate on the 64 -slice spiral CT scan liver arterial phase reinforced effect.Methods 60 patients who received abdominal CT scan were selected from January 2014 to April 2015.According to the different conditions,they were divided into control group (30 cases)and liver cirrhosis group (30 cases).Then each group based on packet injection rate into 2.5 mL/s (control group 1,cirrhosis group 1)and 3.5 mL/s (control group 2,cirrhosis group 2).Select Smartprep technology contrast agent tracking all patients,when the abdominal aorta CT value ≥150 HU start scanning.The departure time,CT value of each group were recorded,abdominal aortic artery,simultaneous analysis of each component of image quality comparison.Results When the contrast agent injection rate of 3.5 mL/s,excellent rate of the control group (95.5%)compared with the contrast injection rate of 2.5 mL/s (91.7%)had no significant difference (χ2 =0.021,P =0.638);The cirrhosis good rate (94.7%)compared with the contrast agent injection rate of 2.5ml/s (72.7%)had obvious advantages, the difference was statistically significant (χ2 =5.233,P =0.032).When the contrast agent injection rate of 2.5mL/s, cirrhosis abdominal aorta average peak enhancement [(187.25 ±21.00)HU]and the control group [(195.35 ± 19.00)HU]had no significant difference (t =0.826,P =0.436).The average trigger time of the control group (21.68 ±1.93)s was significantly less than the cirrhosis group (25.13 ±2.13)s,the difference was statistically significant (t =2.064,P =0.047).When the contrast agent injection rate of 3.5 mL/s,the control group,the mean abdominal aortic peak enhancement [(247.82 ±39.00)HU]was significantly greater than the cirrhosis group [(223.81 ±35.00)HU],the difference was statistically significant (t =2.652,P =0.037).The average trigger time of the control group (18.62 ±1.36)s was significantly less than the cirrhosis group (24.57 ±0.92)s,the difference was statistically significant (t =3.362,P =0.033).Conclusion The greater the contrast injection rate,arterial peak at the same time it increases the peak time come to shorten.When the contrast agent injection rate consistent with the control group,the average trigger time is short,high average peak enhancement.Cirrhosis needs higher contrast injec-tion rate.

Objective To explore the feasibility of low dose in MSCT thoracic angiography using Z-axis modulation. Methods The consecutive 60 patients were averagely divided into 3 groups and underwent thoracic angiography with a Toshiba Aquilion 16 scanner. The whole chest acquisition was commenced in automatic exposure control with Z-axis modulation 20-25 seconds after the contrast material was administered at the rate of 3.5-4. 0 ml/s. With the noise index (SD) as the variable, three study groups were classified as A (SD = 12) , B (SD = 15 ), and C (SD = 18 ). The mAs value per slice and the number of slices were recorded. The noises and artifacts of the axial images and the acceptability of CT angiogram were evaluated. The difference among the groups was compared by using ANOVA or nonparametric Kruskal-Wallis test. The threshold of the P value was 0. 05. Results The mean mAs value (46. 4 ± 15.6) mAs in group A was the highest but the SD value (21.6 ±7.7) was the lowest. The mean mAs value ( 37. 0 ± 13.5 ) and the SD value ( 24. 0 t 5.4 ) in group B were the mediate. The mean mAs value ( 20. 7 ±6.3) mAs in group C was the lowe(s)t but the SD value ( 30. 7 ± 6.9) was the highest ( H = 31. 390, P =0. 000). The middle slice images in all patients had the smallest mAs (40. 9,31.3,17. 1 for group A,B,C,respectively; F =9. 578, H =22. 230, F =21. 180,P =0. 000) and SD values( 16. 3, 20. 0,25.4 for group A,B,C, respectively; H = 28. 982, H = 20. 824, H = 24. 396, P = 0. 000). The acceptability of CT angiogram in all patients was excellent. The CT value of descending aorta in group A, B, and C was ( 335 ± 85 ) HU,(334 ±56)HU, and (427 ± 63 )HU, respectively. Conclusion Low dose in MSCT thoracic angiography using Z-axis modulation is feasible. We can use low dose (20 mAs, etc. ) for CT angiography when the contrast is significant.