Purpose To evaluate the correlation between acute pulmonary embolism (APE) and right ventricular parameters by multi-slice spiral computed tomography pulmonary angiogmphy (MSCTPA),and assess the severity and mortality of patients with APE.Materials and Methods The clinical and MSCTPA image data of APE patients from January 2012 to November 2015 was analyzed retrospectively.All the patients were divided into three groups according to the pulmonary embolism type and clinical prognosis:66 cases in mixed embolism group (25 cases of death,41 cases of survival);36 cases in peripheral embolism group,2 cases in centralembolism group.The CT post-processing software was used to measure thoracic aorta and main pulmonary artery inner diameter ratio (PA/AO),right ventricular diameter to left ventricular diameter ratio (RVD/LVD);right ventricular area to left ventricular area ratio (RVA/LVA) on axial four-chamber (4-CH) sections and the largest of maximum minor axis diameters on axial sections (RV/LV-LD).The difference of CT related right ventricular parameters among the mixed embolism groups,peripheral embolism and normal groups was compared.Results Statistical difference was found in right ventricular parameters (RVD/LVD,RV-LD/LV-LD,RVA/LVA) in mixed embolism death patients compared with the patients in other three groups (P＜0.05).There was significant difference of right ventricular parameters RVD/LVD,RVA/LVA in mixed pulmonary embolism survival patients compared with patients in peripheral pulmonary embolism and normal groups (P＜0.05),but there was no significant difference between peripheral APE patients and the control group in all RV and PA/AO parameters (P＞0.05).According to the result of ROC curve in mixed type embolism death patients,RVA/LVA was the best indicator of predicting early death (AUC=0.881),with 100.0％ sensitivity and 73.2％ specificity.Conclusion The right ventricular parameters by multislice CT pulmonary angiography can assess APE patient's condition and forecast their early mortality;and the clinical diagnosis accuracy of RVA/LVA is higher.

Physical performance is an ability with which the sufferers of lumbar disc herniation(LDH) achieve daily work and basic physical activity,including daily activities(such as the diverting movement from standing to sitting),functioning state of nerves and muscles,dailyworking ability and walking gait,etc.;abilities of body performance relative to pains,such as walking ten meters with loads,sit-stand test and Tread mill walk,etc.Most of current rehabilitation evaluation may be influenced by the subjective factors of the examinee or the examiner,but intelligent device for energy expenditure and activity(IDEEA) may be helpful to evaluate physical performance of the LDH patients in a complete,quantity-fixing,systematic and dynamic way.

The fetal neocortieal transplant(E15～17 days of gestation) of Wistar rats was grafted to the corresponding neocortical region of young rats of same strain.The immunohis-tochemical study and horseradish peroxidase(HRP) retrograde tracing were performed on the 7th,15th,30th, 60th,150th day after transplantation.The results showed that most grafted neurons survived,grew,differentiated and matured.The morphology of neurons was similar to the struc-ture of the neocortical neurons of host brain;integration of varying degree at the interface and reciprocal connection between graft and host brain tissue were established.

Cholecystocholedocholithiasis is a common disease. The traditional treatment is open surgery which has its inherent invasiveness and slow recovery. The advent of laparoscopic and endoscopic techniques change surgery in many ways. Laparoscopic cholecystectomy is now the gold standard for cholecystitis, while endoscopic procedure is a treatment of choice for choledocholithiasis. To combine them as a laparoendoscopic rendezvous procedure treats cholecystitis and choledocholithiasis in a single stage, and results in a safe, effective and minimal invasive procedure.

Objective To investigate the unusual CT features of pulmonary sclerosing hemangioma (SH). Methods Clinical and CT features of 25 patients of pulmonary SH proved with pathology were reviewed, among which 15 patients underwent plain and enhanced CT scan, 10 underwent only plain CT scan. Results Solitary nodules (20/25, 80.00%) and solitary mass (5/25, 20.00%) were found with CT. CT features included slight lobulation (6/25, 24.00%), calcification (6/25, 24.00%), ground glass opacity (2/25, 8.00%), emphysema (1/25, 4.00%), endobrochial variant (1/25, 4.00%), short speculation (1/25, 4.00%) and vascular bundle (2/25, 8.00%). Slight or remarkable enhancement was noticed in all 15 patients underwent contrast enhanced CT. Conclusion CT can reveal features and unusual manifestations of pulmonary SH, and is helpful to the diagnosis of pulmonary SH.

Objective To explore the imaging features of bone tumor of fibrous tissue origin.Methods 31 patients with bone tumor of fibrous tissue or igin confirmed by pathology were analyzed. All patients were examined by X-ray, of them, 6 by CT in the meantime.Results Non-ossifying fibroma(NOF n=14)occured commonly i n long bone,the imaging findings presented sacculated and expanded bone destruct ion which was encircled by sclerotic borders,bony septum could be observed iusid e the lesion.Ossifying fibroma(OF n=10)occured more in maxillofacial bone,there were circle or elliptical and expansive bone change,and most of them associated with local bone malformation.Depending on the ossified degree,the density of les ion,could be hyperdense,ground-glass opacity,cyst or mixed density,defined borde r,partly associated with sclerotic borders.Desmoplastic fibroma of bone(DF n=1) presented multiple patchy bony erosion at lateral of lower part of femur,and ext ending to articalar facies,ill-defined border,and soft tissue slightly swelling. Fibrosarcoma of bone(FS n=6) occured commonly in long bone,presened bitted-like or greater patchy osseous absorption with soft fissue mass,rarely periosteal rea ction and calcification.58.08% patients(18/31) were accurately diagnosed.The nat ure of 6 patients was undefined.Misdiagnosis was made in 7.Conclusion Most of NOF and OF are of specific imaging fin dings and can be accurately diagnosed before cperation.DF is of slight symptoms with invaded growth and is easily misdiagnosed.In the imaging features of FS are apparently different with various type and histological differentiation,it must be differentiated from other diseases.

ObjectiveTo explore the diagnosis and surgical treatment techniques for the patients with primary presacral tumor.Methods Data from 31 patients with primary presacral tumor admitted into our Department for Surgery from Jan. 1999 to Jar. 2009 were retrospectively analyzed.All patients underwent surgical treatment,among them,10 received per-sacroiliac or per-perineum approaches to remove the tumors,18 receivedper-abdomentumorectomy, and3receivedcombinedper-peritoneumandper-perineum tumorectomy.Results Patients visited the doctor while exhibiting the compression symptoms by the the tumors.Final diagnosis could be reached with the help of rectal touch,B-mode ultrasound,computerized tomography,or magnetic resonance imaging.Complete resection was performed in 28 patients.Partial resection was performed in 3 patients.Fractionated resection was successfully performed in 2 patients with chronic infection or sinus tract.ConclusionThe primary presacral tumor should be surgically resected once final diagnosised and without surgical contraindications.Pelvic plexus should be preserved and presacral hemorrhage should be prevented.The tumor should be resected as complete as possible.

Objective To investigate the effects and mechanisms of extracellular-signal regulated protein kinase-motogenactived protein kinase(ERK-MAPK)signaling pathway in gastrin-induced cell proliferation and apoptosis of colorectal cancer cells.Methods HT-29 cells were incubated in different media,and then were divided into the control group,gastrin group,proglumide group and gastrin + proglumide group.No reagent was added in the control group,and other groups were dealed with reagent in different concentrations.The changes of proliferation of the HT-29 cells were detected by MTT assay,and the optimal concentration of gastrin and proglumide were determined.The changes of proliferation index and apoptotic rates of HT-29 cells were detected by cell cytometry.The mRNA expressions of gastrin receptor/cholecystokinin-B receptor(CCK-BR),ERK1/2 and K-ras were detected by RT-PCR.The protein of ERK1/2,K-ras protein and phosphorylation levels were detected by Western blot.All data were analyzed by analysis of variance and SNK-q test.Results The proliferation of HT-29 was stimulated by gastrin when the concentration of the gastrin was 6.25-100.00 mg/L,and the optimal concentration of gastrin was 25.00 mg/L(F =31.36,P ＜ 0.05).Proglumide had no obvious effects on the proliferation of HT-29 cells,while it significantly inhibited the proliferation of HT-29 cells stimulated by gastrin when the concentration of proglumide was 8.00-128.00 mg/L,and the optimal concentration was 32.00 mg/L(F =24.31,P ＜ 0.05).The proliferation index of the gastrin(25.00 mg/L)group was 37.5 ％ ± 5.2％,which was significantly higher than 27.7％ ± 5.0％ of the control group and 27.3％ ± 5.8％ of the gastrin(25.00 mg/L)+ proglumide(32.00 mg/L)group(q =4.56,4.75,P ＜ 0.05).The apoptotic index of the gastrin(25.00 mg/L)group was 1.9％ ± 0.4％,which was significantly lower than 2.5％ ± 0.4％ of the control group and 2.4％ ± 0.3％ of the gastrin(25.00 mg/L)+ proglumide(32.00 mg/L)group(q =4.23,4.06,P＜0.05).The mRNA expression of CCK-BR was detected in the HT-29 cells.The levels of phosphorylated ERK1/2 protein and phosphorylated K-ras protein were 0.43％ ± 0.04％ and 0.45％ ± 0.06％,which were significantly higher than 0.32％ ± 0.02％ and 0.31％ ± 0.05 ％ of the control group(q =7.78,4.95,P ＜ 0.05),and they were also higher than 0.36％ ± 0.01％ and 0.35 ％ ± 0.04％ of the gastrin(25.00 mg/L)+ proglumide(32.00 mg/L)group(q =5.72,4.08,P ＜0.05).There were no significant differences in the mRNA and protein expressions of ERK1/2 and K-ras among the control group,gastrin(25.00 mg/L)group,proglumide(32.00 mg/L)group and gastrin (25.00 mg/L)+ proglumide(32.00 mg/L)group(F =0.52,0.72,0.78,0.28,P ＞0.05).Conclusion Gastrin could stimulate the proliferation of HT-29 cells and inhibit their apoptosis by upregulate the phosphorylation levels of ERK and K-ras through the Ras→Raf→ MEK1/2→ ERK1/2 pathway,while the effect can be restrained by gastrin receptor antagonist proglumide.

Objective To observe the microscopic anatomy structures of petroclival region via the retrosigmoid keyhole approach,then provide an anatomic basis for clinical application.Method Six adult cadaveric heads 6xed by 10% formaldehyde solution were used for simulating the retrosigmoid keyhole approach to observe major microscopic anatomy structures.Results By means of adjusting the microscope,structures such as the ipsilateral trigeminal nerves,cranial nerve,acoustic nerve,posterior nerves,anterior and lateral pons,lateral cerebellar hemisphere,anterior inferior cerebellar artery,vertebral artery,posterior inferior cerebellar artery were exposed via this keyhole approach.Conclusion This retrosigmoid keyhole approach is according with the minimally invasive principle,and represents a reasonable option for accessing the petroclival region.