Objective To research the value of CT perfusion imaging in diagnosing breast tumor .Methods 21 focuses in 17 cases withbreast tumorlike pathological changes diagnosed by molybdenum target examination were scanned by CT perfusion imaging . Cine model,0.5 s/circle ,5 mm in thickness?4,120 kV,60 mA,delayed time 10 s,scan time in all 50 s ,GE 4.2 workstation and perfusion 3 software were used ,the data of creating dynamic picture and the relative informations that image intention changes with time change were analyzed and every parameters related with perfusion were studied and analyzed statistically .Results Blood flow(BF),blood volume(BV),mean transit time(MTT) and permeability surface(PS) were (36.46?17.62)ml?min-1?100 g-1,( 13.76?8.59) ml/100 g,( 28.23?15.75) s and (16.45?12.36) ml?min-1?100 g-1.In cancer group,( 17.35?10.67)ml?min-1?100 g-1,( 4.63?3.47) ml/100 g,( 25.52?12.91) s and ( 3.57?3.36) ml?min-1?100 g-1 in benign lesion group,respectively,there was significant difference between two groups in BF,BV and PS(P

BACKGROUND: Enophthalmos deformity is the most common complication caused by orbital blow-out fractures, and others are diplopia and worsening of visual acuity. Since the therapeutic result of orbital blow-out is not satisfactory and many complications exist after operation, it is still a dispute to select implantation materials and therapeutic regimens.OBJECTIVE: To observe the therapeutic effect and assess the improvement of visual function by surgical reconstruction with porous high-density polyethylene (Medpor) for the correction of enophthalmos deformity caused by orbital blow-out fractures.DESIGN: A pre-and postoperative controlled study.SETTING: Beauty Center for Trauma Repair,Plastic Surgery Hospital,Peking Union Medical College, Chinese Academy of Medical Science .PARTICIPANTS: Totally 56 patients with orbital blow-out fractures who had enophthalmos deformity caused by fists or traffic accidents, treated at Beauty Center for Trauma Repair,Plastic Surgery Hospital, Peking Union Medical College, Chinese Academy of Medical Science, were selected in this study from December 1996 to March 2004. Final diagnosis were made with case history, X-ray film, two-demensional and three-dimensional CT before operation. 24 cases were accompanied with other areas fractures such as zygoma and nasal bone, 34 cases with diplopia, 35 cases with visual acuity worsening after injured.METHODS: ①Material implantation: Exposure of the orbital floor, inferior and medial walls could be performed through a 2 mm inferior subciliary incision of 3 cm long. To approach the orbital rim via a dissection plane anterior to the orbital septum, sub-periosteal dissection was then performed over the orbital rim, and along the orbital floor to the orbital apex. Mobilized the soft tissue from the bone throughout the entire area of fractures and re-position it to its proper position. Took Medpor (Type 6331) sheets as the implantation materials, trimmed Medpor sheets according to the radian and anatomic form, and 2 mm larger than the defect rim was needed.If other operations were needed during the operation, they could be done.Mannitol and dexamethasone should be used just postoperatively to decrease edema of the orbital contents and reduce inner orbital excessive pressure. ②Functional evaluation standard: Diplopia: completely disappear meant recovered, less diplopia residual meant improvement, no improvement meant inefficacy. Enophthalmos: marked improvement meant the degree of enophthalmos stabilizated at below 2 mm, less improvement meant stabilizated at above 2 mm.MAIN OUTCOME MEASURES: ①Improvement of enophthalmos; ②Improvement of diplopia ; ③Improvement of visual acuity.RESULTS: ①All 56 cases of enophthalmos deformities caused by orbital blow-out fractures improved greatly. ② Of all the 34 patients with diplopia, 27 recovered. ③ 9 patients' visual acuity of 35 improved with different degrees. No diplopia or visual acuity worsening occurred. With a follow-up ranging from 2 months to 5 years, the degree of enophthalmos stabilizated at below 2 mm, and no relapse and other complications occurred.CONCLUTION: Medpor has such advantages as better histocompatibility,fewer complications and better visual function improvement, so it is the preferred implantation material for correcting enophthalmos deformity caused by orbital blow-out fractures.

Objective To assess the relationship between type 2 diabetes and the risk of kidney cancer. Methods PubMed, Medline, CNKI and VIP were used to identify studies which regarded the relationship between type 2 diabetes and risk of kidney cancer up to July 2014. The relative risks (RRs) and the corresponding 95% confidence interals (CIs) were used to estimate the association between type 2 diabetes and the risk of kidney cancer through software STATA. Results 8 studies were included in this analysis. Compared to the popula-tion without type 2 diabetes, there was an increased risk of kidney cancer in the type 2 diabetes patients, the pooled RR (95%CI) was 1. 55 (1. 24,1. 92),P<0. 05. Conclusion Our meta-analysis suggestes that type 2 diabetes can increase the risk of kidney cancer.

AIM: To determine astragaloside Ⅳ in Qixiu Granule (Radix Astragali seu Hedysari, Radix Salviae Miltiorrhizae, Radix Paeoniae Rubra, etc.) by HPLC ELSD. METHODS: HPLC ELSD was used in the quantitative analysis by using Alltima C 18 chromatography column and acetonitril water (34∶66) as a mobile phase. The flow rate of mobile phase was 1mL?min -1 . The tube temperature of the detector was 100?C. The flow rate of pure air was 2.7L?min -1 . RESULTS: The regressione quation was Y=-4.40?105+2.07?105X, r=0.9992 (3.73～13.59?g). The average recovery of astragaloside Ⅳ was 100.73%, RSD was 3.97%. CONCLUSION: The method is simple, reliable, accurate and can be regard as the quantity control method of Qixiu Granule.

OBJECTIVE: To compare various models of diffusion-weighted imaging including monoexponential apparent diffusion coefficient (ADC), biexponential (fast diffusion coefficient [Df], slow diffusion coefficient [Ds], and fraction of fast diffusion), stretched-exponential (distributed diffusion coefficient and anomalous exponent term [α]), and kurtosis (mean diffusivity and mean kurtosis [MK]) models in the differentiation of renal solid masses. MATERIALS AND METHODS: A total of 81 patients (56 men and 25 women; mean age, 57 years; age range, 30–69 years) with 18 benign and 63 malignant lesions were imaged using 3T diffusion-weighted MRI. Diffusion model selection was investigated in each lesion using the Akaike information criteria. Mann-Whitney U test and receiver operating characteristic (ROC) analysis were used for statistical evaluations. RESULTS: Goodness-of-fit analysis showed that the stretched-exponential model had the highest voxel percentages in benign and malignant lesions (90.7% and 51.4%, respectively). ADC, Ds, and MK showed significant differences between benign and malignant lesions (p < 0.05) and between low- and high-grade clear cell renal cell carcinoma (ccRCC) (p < 0.05). α was significantly lower in the benign group than in the malignant group (p < 0.05). All diffusion measures showed significant differences between ccRCC and non-ccRCC (p < 0.05) except Df and α (p = 0.143 and 0.112, respectively). α showed the highest diagnostic accuracy in differentiating benign and malignant lesions with an area under the ROC curve of 0.923, but none of the parameters from these advanced models revealed significantly better performance over ADC in discriminating subtypes or grades of renal cell carcinoma (RCC) (p > 0.05). CONCLUSION: Compared with conventional diffusion parameters, α may provide additional information for differentiating benign and malignant renal masses, while ADC remains the most valuable parameter for differentiation of RCC subtypes and for ccRCC grading.
Carcinoma, Renal Cell ; Diffusion ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; ROC Curve

Respiratory syncytial virus(RSV)infection is a potential susceptibility factor for recurrent wheezing,which can affect the occurrence and development of asthma through immune damage,airway epithelial barrier damage,airway inflammatory infiltration,airway hyperresponsiveness,and high expression of induced susceptibility genes.Traditional Chinese medicine believes that asthma caused by RSV infection is mostly caused by the imbalance of the body's qi after infection and the retention of evil qi.By combing the mechanism of RSV infection in the occurrence and development of asthma and the research on traditional Chinese medicine intervention in recent years,it is hoped to provide ideas for the future application of combined Chinese and Western medicine to prevent and treat asthma.

Objective:To observe the application effect of caregiver coaching program in primary caregivers of patients with colorectal neoplasms.Methods:A total of 114 primary caregivers of patients with colorectal neoplasms who were hospitalized and treated in Beijing Friendship Hospital, Capital Medical University from January 2018 to January 2019 were selected as the research objects by the convenient sampling method. The routine intervention group was given routine discharge guidance before discharge. The coaching program group implemented the caregiver coaching program on the basis of routine intervention, that was, after training, the caregivers with nursing experience acted as caregiver coaches to mentor the caregivers and provided professional care knowledge and skills as well as psychological support. Interventions in two groups both lasted for 12 weeks. The Chinese version of Family Caregiver Task Inventory (FCTI) and Caregiver Burden Inventory (CBI) were used to assess and compare the care capacity and care burden of caregivers between two groups at discharge and after 12 weeks of intervention.Results:After 12 weeks of intervention, the five-dimensional scores of adapting to the caregiver's role ability, adapting and providing assistance for patients ability, adjusting self and patient's emotional ability, coordinating other care resources and adjusting the conflicts between self-life and care activities ability in the coaching program group were all lower than those at discharge and the routine intervention group, and the differences were statistically significant ( P<0.01) . After 12 weeks of intervention, there was no statistically significant difference in scores of the five dimensions of time dependence, developmental limitation, body, sociability and emotionality in the routine intervention group compared with those at discharge ( P>0.05) . However, scores of these five dimensions of the coaching program group were lower than those at discharge and they were all lower than those of the routine intervention group. The differences were statistically significant ( P<0.01) . Conclusions:The caregiver coaching program can improve the care ability of primary caregivers of patients with colorectal neoplasms and reduce their care burden. It is an intervention method with better application prospects.

Objective:To explore the effect of early pulmonary rehabilitation management model in elderly critically ill patients with mechanical ventilation.Methods:Using convenience sampling, 64 elderly critically ill patients with mechanical ventilation in the Intensive Care Unit (ICU) of the First People's Hospital of Hefei from June to December 2019 were selected as the control group, and 64 elderly critically ill patients with mechanical ventilation in the ICU of the First People's Hospital of Hefei from January to July 2020 were selected as the experimental group. The control group carried out routine nursing, and the experimental group implemented the early pulmonary rehabilitation management model on the basis of routine nursing. The pulmonary function indicators, invasive mechanical ventilation time, ICU stay and cost, delirium incidence, ventilator associated pneumonia (VAP) incidence, outcome and satisfaction of patients and their families were compared between the two groups.Results:The pulmonary function indicators of patients in the experimental group were better than those in the control group, and the difference was statistically significant ( P<0.01) . The invasive mechanical ventilation time and ICU stay of the experimental group were shorter than those of the control group, and the ICU cost was lower than that of the control group, and the differences were statistically significant ( P<0.01) . The incidence of delirium and VAP in the experimental group was lower than those in the control group, and the number of outcome cases was more than that in the control group, and the differences were statistically significant ( P<0.05) . The satisfaction of patients and their families in the experimental group was higher than that in the control group with a statistically significant difference ( P<0.05) . Conclusions:The implementation of the early pulmonary rehabilitation management model can effectively improve the pulmonary function of the elderly critically ill patients with mechanical ventilation, reduce the occurrence of complications and the patient's family financial burden, and increase the satisfaction of patients and their families, which is feasible and extendable.

Objective: To present a new method for correction of prominent malar complex via intraoral approach by double support technique osteotomy which can provide a stable support. Methods: According to the anatomical characteristics of malar complex and relevant masseter muscle, we designed a malar reduction technique including anterior and posterior support. The reduction procedure entailed an L-shaped osteotomy ofthemalarbody and oblique osteotomy of malar arch. On the basis of prominence degree, bone fragment was moved inward and upward to form double support, which could reduce malar and zygomatic arch effectively. Results: A total of 76 patients subjected to double support technique for malar reduction between January 2015 and January 2017 were retrospectively reviewed.The follow-up period ranged from 10 to 12 months. All patients were satisfied with aesthetic outcomes without major complications, such as facial nerve damage or bone ununion. Conclusions Double support technique is an effective method to correct malar prominence andreduce the zygomatic complex which can prevent saggy cheek and bony malunion.

Objective To discuss the correlation between initial malar reduction procedures and the method of revision procedures and the personalized treatment strategies for the second deformity of postoperative prominent malar complex.Methods From January 2003 to December 2017,27 patients underwent personalized revision surgery of malar reduction according to the different second deformity of malar complex.The surgical technique included the double support malar reduction technique,orthotopic malar osteotomy technique,malar bone grinding surgery,and autogenous bone transplantation.Results A total of 27 patients subjected to revision surgery for malar reduction between November 2006 and December 2017 were retrospectively reviewed.22 patients were satisfied with aesthetic outcomes after the first revision procedure,while 5 patients were satisfied after 2 or 3 procedures follow-up for 10 to 12 months.Conclusions The incidence of complications after malar reduction is related to the first surgical method.According to the unsatisfactory results,it can be repaired individually to obtain a better clinical repair effect.