Objective To evaluate the efficacy of superselective renal artery embolization in the treatment of iatrogenic renal hemorrhage. Methods The clinical data of 31 iatrogenic renal hemorrhage patients who had underwent superselective renal artery embolization were retrospectively analyzed. Results All patients were found to have bleeding site by contrast examination, including pseudoaneurysm in 21 cases, renal arteriovenous fistula in 3 cases, extravasation of contrast media in 4 cases, and pseudoaneurysm and renal arteriovenous fistula in 3 cases. Microcoil embolization was used in 20 patients, and microcoil embolization combined with gelatin sponge was used in 12 patients. Thirty patients got successful embolization once, and success rate was 96.8%(30/31). One patient got successful embolization in the second time. There were no serious complications and no recurrence of renal hemorrhage. Conclusions Superselective renal artery embolization in the treatment of iatrogenic renal hemorrhage has the advantages of exact hemostasis, less trauma and fewer complication, and can retain the normal renal tissue maximumly.

This is a retrospective study of 103 cases of early gastric cancer undergoing surgery during the years of 1974-1988 with a special discussion on surgical treatment.The lesions were localized to the mu-cosal layer in 54.3%,to submucosal layer in 45.7%,In 10% of patients there was lymphnode metastasis,all of them were in the first station.Operation consisted of radical subtotal gastrectomy in 94.2%.and total gastrectomy in 5.8%.The extent of lymphatic excision was:Ro in 12.6%,R1 in 61.2% and R2 in 26.2% Postoperative chemotherapy was given in 61.2%.However no statistical difference of 5 years survival rate was found in respect to the extent of lymphatic excision as well as postoperative chemotherapy.Since 60.2% of EGC lesions were of minute,multiple and plane type,preoperattve en-doscopy and intraoperative biopsy of gastric mucosa,if necessary,should be carefully done to ascertain that no lesion was overlooked in the remnant of the stomach.Follow-up rate was 96%,and the survival rates of 3 and 5 years were 97% and 93.7%.This makes the authors believe that a radical operation of R1 is justified and routine postoperative chemotherapy is unnecessary.

Objective To systematically assess the diagnostic performance of CTA for lower extremity peripheral arterial disease (PAD) using a Meta analysis method. Methods Studies were located through electronic searching of the PubMed, EBSCO, Springer, Ovid, CNKI, Cochrane library (from the date of establishment of the databases to October 2009 ). Bibliographies of the retrieved articles were also checked. All the studies concerning the diagnosis of PAD using CTA had been searched and reviewed, and the studies with the DSA as the gold standard were adopted as eligible. Subsequently, the characteristics of the included articles were appraised and extracted. Data on accuracy of included studies were extracted for further heterogeneity exploring, statistical pooling and SROC ( summary receiver operating characteristics)analyzing using the Meta Disc 1.4 software. Results Totally 24 studies met the inclusion criteria with a total of 1096 patients. The heterogeneity was found in these studies. The pooled accuracy indicators like sensitivity, specificity, and diagnostic odds ratio (DOR) were 0.95 ( 95% CI:0.94-0.95 ), 0.96 ( 95% CI:0.95-0.96), and 471.13 (95% CI:242. 92-913.71 ), respectively. The area under of SROC curve was 0.9888 and the Q index was 0.9555. Subgroup analysis demonstrated significant difference on diagnostic performance for various CT slices (P ＜ 0.05 ). Conclusion CTA can be regarded as an effective and feasible method for PAD diagnosis and screening, based on the results of this systematic review. However,more rigorous evaluations of CTA in patients with critical limb ischemia are needed.

Purpose To analyze the differences of CT manifestations, and to explore the disparity of drainage volume in early drainage between Klebsiella pneumoniae induced liver abscess and non-Klebsiella pneumoniae induced liver abscess. Materials and Methods 337 cases of patients whose blood culture or drainage fluid culture results were positive were divided into Klebsiella pneumoniae group (219 cases) and non-Klebsiella pneumoniae group (118 cases). CT characteristics of the two groups were analyzed, including lesion distribution, quantity, structure, texture, abscess wall thickness, enhancement character around the lesion, whether or not concurrent with thrombophlebitis or migratory infection and so on. Early drainage volume in interventional puncture drainage was observed in both groups. Results Chest CT showed that solitary, multi-room, solid, thin-walled abscesses with concurrent thrombophlebitis, migratory infection and no enhancement around tend to occur in Klebsiella pneumoniae group (χ2=4.065, 3.834, 4.682, 5.689, 5.215, 8.362, 8.407, P<0.01). Early drainage volume of Klebsiella pneumoniae group was significantly lower than that of non-Klebsiella pneumoniae group (χ2=5.863, P<0.01). Conclusion CT manifestations of Klebsiella pneumoniae induced liver abscess are solitary, multi-room, solid, thin-walled abscesses without enhancement around them, thrombophlebitis and migratory infection are common seen and drainage volume is less in early stage after interventional operation.

Objective To assess the value of MSCT in the follow-up of patients with small hepatocelluar carcinoma(sHCC) treated with RFA. Methods Twenty-eight patients with sHCC underwent MSCT scanning 1, 3 and 6 months after RFA. Results One month after RFA, 25 tumors were completely necrotized, among which 19 presented no enhancement on dual-phase contrast CT scans and 6 showed thin ring-shaped enhancement on artery-phase contrast. Three cases with residual tumor manifested as nodular enhancement in margin of lesion. Three and 6 months after RFA, all 25 tumors, which were completely necrotized, became small and presented no enhancement. New tumors were found in the liver in 2 cases six months after RFA. Conclusion RFA is an effective therapeutic method for sHCC, and MSCT dual-phase enhanced scanning is a good way for evaluating the curative effect and follow-up.

Objective To explore the clinical curative effect and complications of digital three-dimensional molding of titanium mesh for repairing skull defect. Methods The clinical data of 42 patients having underwent repairing skull defect with three-dimensional molding of titanium mesh were retrospectively analyzed. Results The average operation time was about 2 h, and 42 patients were operated successfully. The bilateral skull was symmetry and the appearance was good. In 42 patients, subcutaneous dropsy occurred in 1 case, epilepsy occurred in 3 cases, and intracranial bleeding again surgery occurred in 1 case. Patients were satisfied with the results of cranioplasty. Conclusions Repairing skull with digital three-dimensional molding of titanium mesh is simple, with shorter operation time, lower operation risk, and lower postoperative complication, and the clinical curative effect is satisfactory.

Purpose To investigate the relationship between maximum standardized uptake value (SUVmax) of 18F-FDG PET/CT and clinical features of tongue squamous cell carcinoma (TSCC),in order to provide better PET/CT results for clinical guide.Materials and Methods Fifty-two patients with pathologically confirmed TSCC who accepting PET/CT examination before surgery were retrospectively analyzed.Single-factor analysis and multiple regression analysis were conducted on possible factors influencing primary tumor SUVmax,including gender,age,smoking history,tumor location,tumor size,TNM stage,T stage and N stage.Results Single-analysis showed that SUVmax was correlated with gender,tumor location,tumor size,TNM stage,T stage and N stage (P＜0.05),and was not correlated with tumor differentiation,smoking history and age (P＞0.05).Multivariate linear regression analysis showed that gender,tumor location,tumor size,T stage and N stage were independent influencing factors of primary tumor SUVmax (P＜0.05).Primary tumor SUVmax had predictive value for lymph node metastasis.When the cutoff value was 6.57,the diagnostic efficiency was the highest,the sensitivity was 79.2％ and the specificity was 85.7％.Conclusion TSCC 18F-FDG PET/CT SUVmax is higher among male patients with tongue base tumor location,larger tumor size and lymph node metastasis.Primary tumor SUVmax is of important significance in predicting lymph node metastasis.

Purpose To investigate the application value of 18F-FDG PET/CT in the diagnosis and staging of tongue cancer,in order to improve the accuracy of preoperative staging.Materials and Methods The 18F-FDG PET/CT findings of 52 patients with pathologically confirmed tongue cancer were retrospectively analyzed.The tumor location,size,FDG metabolic characteristics and tumor staging were observed,and compared with postoperative pathology.Results PET/CT showed that most patients were at middle or late stage when initially diagnosed (28/52).The lesions were mostly located on middle or middle-back region of tongues,and the average SUVmax was 6.81 ± 3.81.The sensitivity of PET/CT diagnosing tongue cancer was 94.2％.There was no significant difference in SUVmax between high,medium-high and medium differentiated tongue cancer primary lesions (P＞0.05).The SUVmax of tongue cancer at stage Ⅲ and Ⅳ was obviously higher than that at stage Ⅰ and Ⅱ,and the difference was statistically significant (P＜0.008).The diagnose and staging of tongue cancer using preoperative PET/CT and postoperative pathology were in excellent consistence (Kappa=0.859,P＜0.01).The staging accuracy reached 90.4％ (47/52).Conclusion Higher SUVmax value indicates worse tongue cancer staging,but it is of little significance in predicting differentiation.PET/CT can provide an objective imaging basis for preoperative diagnosis and accurate staging of tongue cancer.

Objective:To explore the value of 70 keV virtual monoenergetic images(VMI) on dual-layer spectral detector CT in improving abdominal arterial phase images quality.Methods:The arterial phase images of patients who underwent abdominal enhanced scan on the Philips IQon dual-layer spectral detector CT in Shengjing Hospital of China Medical University from January to May 2019 were retrospectively analyzed. Fifty patients (12 males, 38 females) were included with age of 26-74 （53±12） years. Objective and subjective evaluation was performed in 120 kVp polychromatic conventional images (group CI) which derived from iterative reconstruction algorithm and group 70 keV VMI which derived from spectral reconstruction algorithm. The attenuation, noise, signal to noise ratio and contrast to noise ratio of abdominal aorta, celiac trunk, superior mesenteric artery, left kidney artery, right kidney artery, liver, spleen, pancreas, left and right kidney were compared between group 70 keV VMI and CI by using paired t test. Image quality of group 70 keV VMI and CI was evaluated by two radiologists independently with a 5-point scale and compared by Wilcoxon rank test. The inter-agreement of subjective scoring between the two radiologists was evaluated by Kappa test. Results:Except for pancreas, the attenuation of abdominal arteries and solid organs in group 70 keV VMI were higher than that of group CI and the difference was statistically significant ( Pall<0.05). The attenuation of pancreas was lower than that of group CI ( t=-3.097， P=0.003). The noise of abdominal arteries and solid organs in group 70 keV VMI showed lower values compared to group CI and the difference was statistically significant ( Pall<0.001). The signal to noise ratio as well as contrast to noise ratio of abdominal arteries and solid organs in group 70 keV VMI was higher than that of group CI and the difference was statistically significant ( Pall<0.001). Subjective image quality scores in group 70 keV VMI were higher than that of group CI and scores of group 70 keV VMI and CI were 5 (4,5) and 4 (4,5), respectively. The difference was statistically significant ( Z=-4.131, P<0.001). There was a good consistency of subjective image quality scores between two radiologists, which Kappa values of group 70 keV VMI and CI were 0.79 and 0.69, respectively. Conclusions:Compared to CI, 70 keV VMI derived from dual-layer spectral detector CT can optimize abdominal arterial phase image quality by decreasing the noise, improving the signal to noise ratio and contrast to noise ratio.

Objective:To explore the correlation between urine Alzheimer disease associated neuronal thread protein (AD7C-NTP) and cognitive dysfunction in patients with Parkinson disease (PD).Methods:The clinical data of 90 patients with PD in Weihai Central Hospital in Shandong Province from April 2016 to August 2019 were retrospectively analyzed. According to the Montreal cognitive assessment scale (MoCA) score, the patients were divided into non cognitive impairment group (46 cases) and mild cognitive impairment group (44 cases). Forty-five healthy persons matched in gender and age were selected as control group. The urine AD7C-NTP, and serum homocysteine (Hcy), uric acid, C-reactive protein (CRP) were detected. The MoCA score, PD Hoehn-Yahr classification (H-Y classification), levodopa equivalent dose and time of taking medicine were record. The correlation between AD7C-NTP and various clinical indicators was analyzed by Pearson method. Risk factors of cognitive dysfunction in patients with PD were analyzed by Logistic regression.Results:The AD7C-NTP and Hcy in mild cognitive impairment group were significantly higher than those in control group and non cognitive impairment group: (3.3 ± 2.3) μg/L vs. (1.9 ± 1.6) and (2.1 ± 2.0) μg/L, (13.5 ± 3.4) μmol/L vs. (9.1 ± 4.5) and (11.0 ± 3.1) μmol/L, the indexes in non cognitive impairment group were significantly higher than those in control group, and there were statistical differences ( P<0.05). The uric acid in mild cognitive impairment group was significantly lower than that in control group and non cognitive dysfunction group: (286.7 ± 62.9) μmol/L vs. (338.6 ± 70.4) and (322.9 ± 81.2) μmol/L, the index in non cognitive impairment group was significantly lower than that in control group, and there were statistical differences ( P<0.05). The MoCA score in mild cognitive impairment group was significantly lower than that in non cognitive impairment group: (22.9 ± 2.9) scores vs. (27.3 ± 2.4) scores, the H-Y classification, levodopa equivalent dose and time of taking medicine were significantly higher than those in non cognitive impairment group: (2.7 ± 0.7) stages vs. (2.4 ± 0.6) stages, (465.8 ± 132.1) mg/d vs. (405.8 ± 139.5) mg/d and (46.9 ± 22.1) months vs. (35.8 ± 24.4) months, and there were statistical differences ( P < 0.01 or<0.05). Pearson correlation analysis result showed that AD7C-NTP was negatively correlated with uric acid and MoCA scores ( r = -0.365 and -0.586, P < 0.01), and positively correlated with H-Y classification, levodopa equivalent, Hcy and time of taking medicine ( r = 0.568, 0.434, 0.362 and 0.324; P < 0.01). Multivariate Logistic regression analysis result showed that AD7C-NTP, Hcy and H-Y classification were independent risk factors of cognitive dysfunction in patients with PD ( P < 0.01 or<0.05), and uric acid was an independent protective factor ( P < 0.05). Conclusions:The expression of urine AD7C-NTP is increased in PD patients with cognitive impairment. The level of urine AD7C-NTP is correlated with cognitive impairment and disease severity, which may be an effective biomarker of cognitive impairment in PD patients.