Objective To study the application of the intelligent optimum tube voltage ( Care kV) combined with automatic tube current ( Care Dose 4D) technique in dual source CT scanning for the abdomen .Methods 180 adult patients underwent whole abdominal CT examination from February 2016 to March 2016 of were selected as the retrospective research objects .On the basis of reference mAs of the image quality the patients were divided into three groups using completely randomized grouping method with 60 patients in each group, such as 250 mAs group, 200 mAs group, and 150 mAs group.The other scanning parameters and image reconstruction parameters were the same .The liver parenchyma CT values and image noise( SD) at the second hepatic portal level were measured .The signal-to-noise ratios ( SNR) in the three groups were compared as well as contrast to noise ratio ( CNR ) , noise ( SD ) , the average volume CT dose index (CTDIvol), dose length product (DLP) and effective dose(E).Results The kV and mAs values in the plain scan , arterial phase scan and portal phase scan in the three groups of patients had statistically significant differences(F=35.25, P<0.05).With the reducing of the refference mAs, the frequency of choosing lower kV in three groups of patients increased gradually .The CTDIvol, DLP and E of plain scan, arterial and portal phase in three groups of patientshad significant difference (F=31.51, P<0.05).With the decline of the reference mAs, the radiation dose decreased gradually , with 150 mAs group lowest.The SNR, CNR and noise of three phases in 250 mAs group and 200 mAs group had no statistically significant difference (F=1.61, P>0.05).In 250 mAs group and 150 mAs group, the SNR and the noise of plain scan and arterial phase images had no statistically significant difference ( F=1.98, P>0.05) , and SNR of portal phase images and CNR of three phases had statistically significant difference (F=27.64, P<0.05);In group 200 mAs and group 150 mAs, the SNR, CNR and noise of plain scan and arterial phase images had no statistically significant difference (F=1.95, P>0.05), and the SNR and CNR of portal phase images had significant difference (F=19.63, P<0.05).Conclusions For the combined use of Care kV and Care dose 4D,it is feasible to select appropriate reference mAs in reducing radiation dose without sacrificing imaging quality .

AIM:To explore the changes and the mechanism of heart functions in the rats with spleen-qi defi-ciency syndrome.METHODS:The rats were randomly divided into blank control group and spleen-qi deficiency model group.The changes of cardiac functions in the rats were determined by ultrasonic imaging with a high-resolution in vivo im-aging system.HE staining was used to observe the pathological changes.The protein expression of brain natriuretic peptide ( BNP) in the myocardium was assessed by Western blotting.The contents of BNP and cAMP in the serum and myocardium were measured by ELISA.The mRNA expression of basic fibroblast growth factor ( bFGF) and protein kinase A ( PKA) was detected by real-time PCR.RESULTS:Compared with blank control group, the myocardial cells in the model group had different degrees of necrosis and degeneration.Stroke volume and ejection fraction were decreased.The contents of cAMP and BNP in the serum and myocardium were increased in model group.The protein expression of BNP and the mR-NA expression of bFGF and PKA were also increased.CONCLUSION:Spleen-qi deficiency syndrome causes heart func-tion decline in rats.The expression of BNP, cAMP, PKA and bFGF is all increased.

Objective To investigate expressions of microRNA-21 (miR-21),PTEN,NF-κB,and caspase-9 in colon carcinoma and their possible mechanisms in progression of tumor.Methods Expressions of above-mentioned indexes and percentage of apoptotic cells in colon carcinoma,colon adenoma,and normal tissue specimen were detected.Results Expressions of miR-21,PTEN,N F-κB,and caspase9 in normal tissue were 0.39 ±0.02,50％,25％,and 50％.Expressions of them in colon adenoma were 0.62 ±0.06,50％,35％,and 55％,and those in colon carcinoma were 0.88 ±0.04,30％,75％,and 20％.Percentage of apoptotic cells were (24.64 ± 7.66) ％,(15.86 ± 1.44) ％,and (6.20 ± 2.57) ％,respectively.The above P-values were all less than 0.05.Expression of miR-21 was positively correlated with TNM stage,depth of infiltration,differentiated level and expression of NF-κB while inversely correlated with PTEN and caspase-9 expressions and percentage of apoptotic cells.The r-values were 0.647,0.297,0.259,0.519,-0.299,-0.388,and-0.931,respectively.Conclusions Hyperexpression of miR-21 participated in progression of colon carcinoma probably through down-regulating expressions of PTEN and caspase-9 and up-regulating expression of NF-κB and then suppressing cell apoptosis.

Objective:To observe the anatomic characteristics of supratubal recess and the morphological change of it in the sick ear. To investigate the relation between the morphological changes of supratubal recess and otitis media.Method:Using high resolution CT to observe and measure the supratubal recess of the normal ears and the ailing ones.Result:For the normal adults, the anteroposterior diameter of the supratubal recess is(3.83±1.28)mm,the vertical diameter(3.67±1.14)mm,the height(3.76±0.36)mm;and the length of the cog is(2.84±0.38)mm.The size of the supratubal recess showed no significant difference between left and right(P＞0.05).There was no relationship between the size of the supratubal recess and pneumatization of mastoid cells (P＞0.05).There was significant differences in size of the supratubal recess between normal ears and the ears with cholesteatoma(P＜0.05),but there was no relationship between the size of the supratubal recess and pneumatization of mastoid cells(P＞0.05)in the ears with cholesteatoma.There was no significant differences in size of the supratubal recess between normal ears and the ears with chronic otitis media(P＞0.05).In the ears with cholesteatoma,40% had osseous destruction in supratubal recess.Conclusion:For the normal adults, the size of the supratubal recess showed no significant difference between left and right, and there was no relationship between the size of the supratubal recess and pneumatization of mastoid cells. Anterior tympanic isthmus , posterior tympanic isthmus and supratubal recess which is the supplement of the formers constitute the air way between attic and mesotympanum. The supratubal recess of the cholesteatoma is smaller than the normal, when the eustachian tube dysfunction occurs, the air way in the middle ear would herein be affected, and cholesteatoma forms eventually. There was no significant differences in size of the supratubal recess between normal ears and ears with chronic oti-tis media, as in the clinic.The effect of the supratubal recess should be taken into account when we consider the pathogeny and treatment of the middle ear cholesteatoma.

Objective To assess the interobserver reliability and intraobserver reproducibility of Neer classification system and its influencing factors.Methods The present study reviewed the series preoperative radiographs (including those of scapular anteroposterior view,scapular lateral view and modified Velpeau axillary view and an axial CT scan) of 40 patients who had been treated in our department from January 2010 to December 2010 for proximal humeral fractures.The radiographs were assessed by 12 individual observers on 2 separate occasions with an interval of 3 months at least Half of the observers (the professional group; n =6) had received a shoulder fellowship training and the other half (the control group; n =6) had not All the observers were asked to categorize the radiographs according to the Neer classification system of 16 types of fractures in a same process.The reliability and reproducibility of the system were assessed with the Kappa statistics.Comparisons of classification agreement were made between the professional group and the control group.We also evaluated the simplified Neer system of only 6 types of fractures with recombinant data.Results The interobserver reliability coefficients were 0.534 and 0.473 for the first and second assessments,with an intraobserver reproducibility coefficient of 0.669.The agreement level in the professional group was significantly higher than in the control group ( P ＜ 0.05).The interobserver reliability coefficients of the simplified Neer system were 0.581 and 0.502,with an intraobserver reproducibility coefficient of 0.680.Use of the modified Neer system did not elevate the agreement level beyond the moderate range.The classification was agreed on by all the observers in 17.5％ of the fractures during the first assessment and in 15.0％ during the second assessment.Conclusions Neer classification may have fair interobserver reliability and moderate intraobserver reproducibility.Experience of shoulder fellowship training is an important factor influencing the reliability of the Neer system.Simplification of the system may not help increase its reliability.

Objective To evaluate the clinical efficacy of integration of traditional Chinese and western medicine (ITWM) or pure western medicine on the patients with immune thrombocytopenia (ITP). Methods Randomized controlled trials (RCTs) on ITWM treatment of ITP were searched in PubMed, EMBASE, Wanfang database, CBMDisc, CNKI and VIP. Quality of the RCTs was evaluated strictly, and statistical analysis was performed with Cochrane Collaboration’s RevMan5.1.7 software. Results Twenty-two trials involving 1527 patients were included. The results of Meta-analysis showed that the ITWM treatment of ITP significantly improved the total effective rate [RR=1.23, 95%CI (1.17, 1.29), P<0.000 01] compared with that of pure western medicine treatment. Funnel plot showed that publication bias was small. Meanwhile, peripheral platelet count and the number of megakaryocyte which can generate platelet in bone marrow increased, obvious advantage was showed in long-term effect, and adverse reactions were reduced with ITWM treatment in ITP patients. Conclusion The existed limited evidences suggest that ITWM treatment of ITP can significantly improve clinical efficacy. The quantity and quality of research literature were limited, and well-designed randomized double-blind controlled trials with large sample and multi-centers are required for a more reliable conclusion.

Baby body plethysmography is a well-established technique of lung function determination,which is widely used to access the respiratory development and obstructive airway diseases by precisely measuring tidal breathing,functional residual capacity,and air way resistance.Babies who accept lung function measurements in the baby body plethysmography are under quiet state of spontaneous breathing without any subjective initiative,which results in multiplexed data acquisition,high precision and good repeatability.Clinical application of baby body plethysmography differs in different countries and areas,with the most intensive application in the German-speaking countries.In China,the clinical use of baby body plethysmography still remains in primary stage.Great progress has been achieved in its clinical use during the past 20 years,but there is still a lack of consensus on normal reference values or equations with which to interpret results,which has caused some trouble to diagnosis and identification of respiratory disease.In order to identify the nature and severity of airway disease,it is essential to understand the normal range of plethysmographic values that may occur in healthy infants of similar age,gender and body size.

Objective To investigate the effect of dopamine receptor in intestinal mucosal barrier function after brain injury in rats.Methods Twenty-four rats were allocated to control group,brain injury group,dopamine receptor group,and dopamine antagonist group according to the random number table,with 6 rats per group.Feeney' s weight-drop model was introduced to generate rat models of brain injury.Intestinal mucosal specimens were harvested at postoperative 7 days to evaluate intestinal mucosal morphology by HE staining,expressions of dopamine receptor D1 (DRD1) and dopamine receptor D2 (DRD2) by immunohistochemistry,and mRNA and protein expressions of DRD1 and DRD2 by real-time PCR and Western blot.Meantime,urinary samples were collected to measure lactulose to mannitol ratio (L/M) by high performance liquid chromatography (HPLC).Results Intestinal villus integrity was disrupted in brain injury group and dopamine receptor group when compared to control group,but it remained relatively intact in dopamine antagonist group.Ratio of L/M in brain injury group and dopamine receptor group was similar (0.192 ± 0.080 vs 0.183 ± 0.090,P ＞ 0.05),far higher than 0.037 ± 0.008 in control group (P ＜0.01),but it was reversed in dopamine antagonist group (0.071 ± 0.008,P ＜ 0.01).Real-time PCR showed DRD1 and DRD2 mRNAs expressed in brain injury group and dopamine receptor group were similar (0.764 ± 0.074 vs 0.718 ± 0.065,0.439 ± 0.051 vs 0.408 ± 0.090,P ＞ 0.05),far higher than 0.189 ± 0.008 and 0.076 ± 0.011 in control group (P ＜ 0.01),but both lowered in dopamine antagonist group (0.386 ± 0.071,0.270 ± 0.092,P ＜ 0.01).estern blot analysis showed DRD1 and DRD2 proteins in brain injury group and dopamine receptor group were similar,but both were far higher when compared to control group (P ＜ 0.01).Conclusion Impaired intestinal mucosal barrier may be relate to the up-regulated dopamine receptor in intestinal mucosa after brain injury in rats.

Objective To study helical CT manifestations of neck lymph node metastasis in thyroid carcinoma.Methods Forty-four patients of neck lymph node metastasis in thyroid carcinoma were performed helical CT scans and were analyzed retrospectively to compare with pathology and operation.CT manifestations mainly included:density,sector and calcification.Results On the one hand,CT manifestations had common character of neck lymph node metastasis;that was low-attenuant center and rim enhancement,on the other hand,CT manifestations showed:(1)thinness-sand and mottle calcification in the metastatic lymph node;(2)metastatic lymph node obvious enhancement.After enhance average density ranged from 28.00~50.54 HU to 62.85~145.78 HU,average density was near or more than 100 HU.Conclusion In metastatic lymph node of thyroid carcinoma,the findings of thinness-sand and mottle calcification suggest malignant tumor in thyroid focal,and metastatic lymph nodes were obviously enhanced;average density of lymph node after enhancement is near or more than 100 HU.

BACKGROUND: To review progressions in the pharmacological study of natural plant Ficus carica L. (fig), summarize its main pharmacological effects so as to manifest values in clinical practice.DATA SOURCES: .By computer retrieval system, the relevant papers on the researches on Ficus carica were retrieved on Medline from January 1950 to September 2004 and limited at the referred word "Ficus carica" in English. Simultaneously, the relevant papers were searched by the computer on China National Knowledge Infrastructure (CNKI) database from January 1999 to September 2004, focusing on the referred word "Fieus carica" in Chinese.STUDY SELECTION: Of all the relevant papers, ones focusing on the pharmacological study of Ficus carica were selected and the whole text were checked, meanwhile those had no relation with the pharmacological latex as well as various constituents and preparations. Exclusion criterion:repeated studies.DATA EXTRACTION: A total of 226 papers were checked on the study of Ficus carica, 30 papers were consistent with the standards. Among the 196 excluded papers, 189 were excluded because they were clinical experience report or repeated studies, 7 were reviews.DATA SYNTHESIS: Investigations of the fig, its leaves and latex as well as various constituents and preparations, have revealed many pharmacological effects such as: anti-tumor effects, the ability to mediate body metabolism, mediating hyperglycemia, hyperlipidemia and cholesterol levels, enhancing oxidation resistance, antibiotic effects, antivirus effects, the ability to mediate immunity, activating blood coagulation etc. It also may play an important role in supportive therapy in tumor treatment by reducing toxicity and side effects in actinotheraphy and chemotherapy. Several reports of anaphylaxis after fig intake have reported both in China and abroad.CONCLUSION: As an herb, fig has wide pharmacological effects and clinical practise values. The main pharmacological studies of it were focused on its anti-tumor effects and the ability to mediate body metabolism.Separation and purification of its active components and determining the interactions between them as well as the pharmacological and toxicological effects need further study. New pharmacological effect s will be found by studying various fig extracts.