BACKGROUND:To introduce the scanning technique and imageologieal signs of multi-slice spiral CT angiography in the diagnosis of venous thromboembolism,and concomitantly evaluate its apphcadon value and advantage in the early diagnosis of venous thromboembolism.METHODS:Using the terms"venous thromboembolism,pulmonary thromboembolism,CT angiography",the authors computer-retrieved Medline to identify studies published between January 1998 and October 2007 in the English language.At the same time,we searched the Wanfang database with the same terms in the Chinese language by hand and computer forstudies between January 2000 and October 2007.A total of 228 manuscripts Were obtained,and 24 of them corresponded to the inclusive criteria.RESULTS:Using collection technique and in conjunction with high-quality three-dimensional reconstructed images,multi-slice spiral CT can clearly reveal the distal branches of pulmonary artery,achieving subsegmental-level diagnosis of Duhnonary thromboembolism.There was no remarkable difference in the sensitivity for diagnosing pulmonary thromboembolism between thin-slice spiral CT and pulmonary artery angiography.The sensitivity and specificity of thin-slice spiral CT is higher compared to pulmonary ventilation-perfusion radioisotope scanning.When eliminating acute pulmonary thromboembolism,spiral CT is a promising first-ehoicemethod.CONCLUSION:Spiral CT is characterized by rapid scanning,clear image,and without omission of small foci.Spiral CT angiography is a safe,rapid,non-invasive,and effective method for the diagnosis of venous thromboembolism.

BACKGROUND: The MRJ studies of acute myocardial infarction (AMI)were more frequently focused on the changes of myocardial perfusion. OBJECTIVE: To investigate the characteristics of infarction and myocardial reperfusion in MRI, and make comparison of them with the results of their staining pathologic sections. DESIGN: Completely randomized grouping design and randomized controlled study. SETTING: Magnetic Resonance Department of Air-force General Hospital of Chinese PLA and Radiological Department of General Hospital of Chinese PLA. MATERIALS: The experiment was completed in the Medical Animal Experimental Center, General Hospital of Chinese PLA in December 2003.Fourteen miniature pigs were divided into 2 groups: infarction group and reperfusion group with 7 pigs in each group. One-month before and after the operation, MRI was performed in order to strengthen the scanning examination. One-month after operation, axial plane pathologic slices, which were corresponding to the MRI, were given TTC and SE staining. According to the TTC staining results, samples of the infarcted myocardium (corresponding to the anterior wall of the left ventricular) and normal myocardium (corresponding to the posterior wall of the left ventricular) were taken and given HE staining to observe the extent of infracted myocardium. MAIN OUTCOME MEASURES: The changes in cardiac shape and function and the changes of myocardial T1 and T2 relaxation time. RESULTS: Fourteen Chinese miniature pigs were used with 7 in each group. ①Relaxation time of T1 and T2 of infarcted myocardium in infarction group was obviously longer than that of thenormal myocardium [1 159.54±78.67, (60.15±6.31) ms, 1 056.15±70.95, (47.46±7.94) ms, t=2.63,5.38, P＜ 0.05, 0.01] and that of the infarcted myocardium in reperfusion group was also obviously longer than that of normal myocardium [1 171.14±139.98,(56.64±6.16) ms, 1 074.64±97.61, (44.57±4.25) ms, t=2.64, 6.24, P ＜ 0.05,0.01].②MRI in single infracted myocardium and reperfused infracted myocardium was both changed obviously,but without significant differences in relaxation time and stress.Dilatation of left ventricle in single infracted group was more obviously than that in the reperfusion infracted group.③Theresult of MRI was coincidence with that examinated with TTC staining CONCLUSION:①MRI is a useful imaging modality in the evaluation of AMI and the left ventricle remodeling after myocardial infarction.②It is significant for reperfusion to treat remodeling of left ventricle after acute myocardium infarction.③There is good correlation between MRI and pathological examination.

Objective To evaluate the MR manifestation to provide guidance for the clinical diagnosis of adenomyosis.Methods The MR images of 43 cases of adenomyosis which were proved by operation and pathology were reviewed.Results Among the 43 cases of adenomyosis,26 cases were of diffuse adenomyosis and 17 of focal adenomyosis.Leiomyoma(21 cases),intra-pelvic cavity chocolate cyst (17 cases)and ovarian cyst(15 cases)were concurrently found in this group of patients.The MRI of diffuse adenomyosis demonstrated an enlarged uterus and widened uterine junction zone with ill-defined margin between junction zone and myometrium.The adenomyosis lesions showed iso-signal intensity on T_1 weighted images and iso-signal or slight low signal intensity on T_2 weighted images with scattered hyper- intense foci.The uterine cavities were irregularly narrowed due to compression of thickening junction zone.The lesions showed mild con- trast enhancement on contrast-enhanced MR images.The MRI of focal adenomyosis displayed localized myometrial masses with ill-defined margin with widening of junction zone.The lesions were round or oval in shape with iso-signal intensity on T_1 weighted images and inho- mogeneous slightly low signal on T_2 weighted images.Multiple scattered hyperintense foci could be found in the mass on the T_2 weighted images.The lesions had mild contrast enhancement on contrast-enhanced MR images.The concurrent leiomyoma,intra-pelvic cavity choc- olate cyst and ovarian cyst were also displayed by MR imaging.Conclusion The widened junction zone is the characteristic change of ade- nomyosis.MRI can demonstrate the types,size and concurrent changes in adenomyosis,and is a useful noninvasive imaging method for the diagnosis of adenomyosis.

An intensive practice scheme,integrating clinical practicing education with continuing medieal education after graduation was introduced to Provide a new mode of teaching activities and management of clinical practice.

Objective To study the cellular immune response to a large-dose of HBsAg vaccine in transgenic (Tg) mice. Method After the Tg mice was immunized with HBsAg vaccine, the number of dentritic cells (DC), the level of proliferation of T-lymphocytes, and the production of IL-2 and IFN-?were determined. Results The percentage of cells positive for common stimulating factors CD80, CD86, and I-E k were significantly higher than that of the control group (P

Objective To investigate the correlation between the unilateral middle cerebral artery (MCA)stenosis ratio and cerebrovascular reserve(CVR) using computed tomography perfusion (CTP) and CO2 inhalation test in patients with unilateral middle cerebral artery stenosis.Methods CTP were performed in 31 patients who were diagnosed as unilateral middle cerebral stenosis before and after CO2 inhalation.The basal ganglia and radial dimension were selected as interested regions (thickness 8 mm).The value of cerebral blood flow (CBF) was measured and the mean CBF values of all interested regions in each MCA territory were harvested separately.Then the CVR of each MCA territory was calculated according to the following formula:CVR =(CBF after CO2 inhalation test-CBF before CO2 inhalation test)/ CBF before CO2 inhalation test × 100％.Patients were divided into two groups:the severe stenosis group and the moderate stenosis group.The association between the MCA stenosis ratio and the CVR values was investigated.Results In 31 patients,different changes of CBF were found in affected MCA territory after CO2 inhalation.CBF increased in 17 cases,unchanged in 2 cases and decreased in 12 cases.A decreased CVR was detected in 51.6％ of the patients(16/31) and more likely found in the severe stenosis group (13/19) than that in the moderate stenosis group(3/12,P =0.029).The degree of stenosis in MCA was also significantly correlated with the changes of CVR(r =0.423,P =0.018).Conclusions CVR is decreased in some patients with unilateral MCA stenosis and significantly correlates with the severity of stenosis in MCA.

Objective To explore the adeno-associated virus (AAV)gene transduction and cellular endocytosis mediated by ultrasound combined with microbubbles in two types of cells.Methods HeLa and NIH/3T3 cells were infected by rAAV2-EGFP at a concentration gradient to get the optimal concentrations for enhancement.At these concentrations,HeLa and NIH/3T3 cells were infected by rAAV2-EGFP mediated by ultrasound combined with microbubbles.The gene transduction efficiency were observed and measured by fluorescence microscopy and flow cytometry at 48 h after treatment.The cell viability was tested by CCK-8.The number and distribution of cellular clathrin-coated endocytic pits were observed by confocal fluorescence microscopy and transmission electron microscopy on 45 min after treatment.Results The optimal concentrations for HeLa and NIH/3T3 cells were 2000 v.g./cell and 10000 v.g./cell.Ultrasound combined with microbubbles significantly enhanced the transduction efficiency of rAAV2-EGFP (P <0.01) without significant cell viability decrease (P > 0.05 ).Confocal fluorescence microscopy and transmission electron microscopy demonstrated that clathrin-coated endocytic pits were more obviously increased in ultrasound combined with microbubbles mediated AAV transduction group than AAV transduction group. Conclusions Ultrasound combined with microbubbles can efficiently enhance the gene transduction of AAV,whose cellular transportation depends on cellular endocytosis,in two types of cells.Stimulating cellular endocytosis might be one of the mechanisms of enhanced cellular transportation of AAV mediated by ultrasound combined with microbubbles.

Objective To improve the selection of flying cadets of the Air Force of People′s Liberation Army of China ( PLAAF) by analyzing the differences of medical identification of lumbar spondylolysis between PLAAF and the US Air Force ( USAF) .Methods Flight crew who had been checked for lumbar spondylolysis during hospitalization at the Air Force General Hospital between 2013 and 2015 were chosen.The results of their medical identification were compaired according to PLAAF and USAF Medical Standards Directory, and their differences and possible reasons were analyzed accordingly.Results The qualified rate of PLAAF was about 85%, which was very close to the standards of USAF, but the difference was not of any statistical significance(P>0.05).Conclusion The standards of our medical identification of lumbar spondylolysis was similar to those of USAF, suggesting that the selection of flying cadets can be improved.

Objective To explore the better lock solutions of temporary catheter for patients with cont inuous renal replacement therapy (CRRT) in intensive care unit. Methods A total of 235 patients with insertion of temporary central venous catheters were divided into two groups randomly. 500 U/ml heparin saline was used in the observational group (123 cases) and 1 000 U/ml heparin saline was used in the control group (112 cases). Two groups adopted positive pressure seal tube method, and the situation of catheters and bleeding were observed. Results There were no statistical significance of two groups in the situation of catheters and bleeding (P>0.05). Logistic regression:8 observational factors (machine type, dilution method, catheter placement, blood flow velocity, the use of anticoagulants, whether to use immunity inhibitors, whether for high blood pressure, diabetes) in the Logistic regression, no factors was found to have association with the situation of catheters (P>0.05 ), 2 factors were found to have association with bleeding (P<0.05 ), one hazard effect:the maximum flow of blood, one positive effect:the position of catheter. Multiple linear regression: 6 observational factors [hemoglobin, acute physiology and chronic health evaluation (APACHE)Ⅱ, C-reactive protein, systolic pressure, diastolic pressure, activated partial thromboplastin time (APTT)] in the multiple linear regression, two factors were found to have association with the situation of catheters (P>0.05 ), all of them had positive effect: APACHEⅡ,APTT; two factors were found to have association with bleeding (P < 0.05), all of them had hazard effect: APACHEⅡ,APTT. Conclusions Compared with 1 000 U/ml, 500 U/ml heparin lock solutions doesn′t increase the thrombosis of temporary catheters, and also decrease the rate of bleeding,so 500 U/ml heparin lock solutions can use in CRRT patients who use anticoagulant.

Objective To investigate the expression and clinical significance of inhibitor of apoptosis protein XIAP in childhood acute leukemia(AL).Methotis The expression of XIAP protein was detected by immunohistochemical assay in 54 children with AL.including 26 newly diagnosed and untreated AL children.23 children in remission and 5 relapsed.The eontrol included 10 children with normal bone marrow.Results The level of XIAP proteins in the bone marrow of newly diagnosed AL children was higher than that in remission and normal controls(P＜0.05),compared with that in relapsed children,with no statistical difference(P＞0.05).The level of XIAP protein in remission was higher than that in normal controls(P＜0.05).The level of XIAP protein in ALL and ANLL in newly diagnosed AL children was compared. with no statistical difference(P＞0.05).Conclusion The higher expression of XIAP may contribute to the pathogenesis and the progress of the childhood AL.