Objective To report the CT app earances in SARS (severe acute respiratory syndrome). Methods Nine chest CT scanning examinations were performed in 6 cases of SARS that were verified by the clinic. CT films were acquired with standard pulmonary window, mediastinal window, and wide window, respectively.CT imaging appearances were summarized. Results In 5 of the 6 cases, multi-lobar or multi-segmental consolidations of bilateral lungs were detected. There was no distribution tendency for any specific pulmonary lobes or segments. The big consolidation and small multiple consolidations existed simultaneously. The big range of consolidation manifested as the bilateral or unilateral pulmonary segment consolidation that distributing along the bronchi tree. There was the air bronchogram in the consolidation. Each consolidation expanded along the pulmonary segment and mixed together to form a pulmonary segment consolidation, or even a whole pulmonary lobe consolidation. The foci that crossed the interlobar fissure were not observed. The small foci manifested as the bilateral multiple oval foci, which distributed along the lung markings. The big consolidation could appear as homogeneous densification, ground-glass appearance, or honeycomb consolidation. The ground-glass appearance could appear in cases of first visiting and in cases of recovery period. The pleural thickened was common and hydrothorax was rare. The mediastinal lymph node enlargement was not observed. Conclusion The limited SARS cases show a tendency that the pathological changes disseminate along broncho-alveolar system when SARS is developing.

ObjectiveTo discuss treatment experiencing in femur periprothetic fracture after hip arthroplasty in pre-, intra- and post-surgery.Methods From March 2005 to May 2011, 27 patients (11 males, 16 females) aged ＞75 years with femur periprothetic fracture after hip replacement were studied. The mean time from primary hip replacement to femur perprosthetic fracture was 63 months(ranging from 7 to 83 months). According to vanconver classification, type A applying steel wire of character for 8 bind technique was 5 cases, type B applying prolonging stem technique locking compress plate (LCP)technique surrounding instrument technique was 19 cases and type C applying bone graft and plate fixation technique was 3 cases. All patients were followed up from 9 to 25 months (average, 16 months). The results of treatment were evaluated by Harris score and X rays. Results Bony heal was obtained in 22 patients and was not obtained in five cases among whom bony heal occurred in 3 cases and 2 patients could only keep prothetic and limb stable after receiving the bone graft once more. Walking was free in 14 cases,9 cases needed assistant walking instrument,and only 4 cases stayed in the bed freely. Harris score for last follow-up was 52 to 93 (mean 76).Conclusions Based on the patient general status, the fracture types and practical and stable principle, the effective methods can get good results in the treatment of femur periprosthetic fracture in aged patient.

Practical teaching is an important component of higher medical education. The article introduced a number of exploration and experience of Shaoyang Medical College in building a practical teaching quality guarantee system,such as revising personnel training programs, optimizing practice teaching environment,enhancing teaching quality construction projects, strengthening teachers troop construction reinforcing teaching practice management and the teaching quality monitoring,etc.

Objective To explore the role of MR imaging (MRI) in the differential diagnosis of pleural tumor. Methods Forty five cases of pleural tumor (8 benign and 37 malignant) were examined with both CT and MRI. The morphologic features of pleural lesions and MR signal intensity on T 1 weighted, T 2 weighted, and contrast enhanced T 1 weighted images were evaluated. Results On CT images, it was found that 30 cases were with diffuse pleural thickening (29 malignant and 1 benign), 28 with mediastinal pleural involvement (27 malignant and 1 benign), 23 with circumferential or irregular pleural thickening (22 malignant and 1 benign), and 9 with infiltration of the chest wall or diaphragm (only in malignant patients). On MR images, it was found that 32 cases were with diffuse pleural thickening (31 malignant and 1 benign), 29 with mediastinal pleural involvement (27 malignant and 2 benign), 24 with circumferential or irregular pleural thickening (23 malignant and 1 benign), and 11 with infiltration of the chest wall or diaphragm (only in malignant patients). According to the above mentioned morphologic features, CT had a sensitivity of 83.8% and a specificity of 62.5% in the detection of pleural malignancy, as compared to 86.5% and 62.5% by MRI, respectively. In combination with signal intensity and morphologic features, MRI had a sensitivity of 97.3% and aspecificity of 100% in the detection of pleural malignancy. Conclusion According to the morphological features only, MRI allowed a similar value in the detection and diagnosis of pleural tumor compare with CT. In combination with signal intensity and morphologic features, MRI is more useful and, therefore, superior to CT in differentiation of malignant from benign pleural tumor.

Objective To study retrospectively the outcome and failing factors of nasopharyngeal carcinoma(NPC) treated with late-course unconventional fractionation radiotherapy(LCUCFR). Methods From January 1996 to December 2000, 133 such patients were analyzed retrospectively. All had been confirmed by histopathology as poorly differentiated squamous cell carcinoma, including 101 males and 32 females. All were treated by LCUCFR. The nasopharyngeal lesion radiation schedule was as follows; 1.An initial conventional fractionation 34.5Gy/18f for face and neck port, with 1.92Gy per daily fractionation;2.The above regimen was followed by 1.25-1.50Gy per fraction twice daily in 6-8 days for pre-auricular port;3.The above regiment was then followed by conventional boosting dose 1.90Gy and 1.30Gy(morning 1.90Gy and afternoon 1.30Gy) twice daily(with interval of 6-8 hours) in 6-8 days. The whole course was 5 fractions per week with the median of 78Gy over a median of 47days. The positive and negative lymph node in the neck were treated by conventional radiotherapy with a median of 67Gy and a dose of 50-55Gy in median interval of 43 days. Results The 5-year nasopharyngeal lesion and neck metastasis lymph node control rate was 92.9% and 96.4%, respectively. T1,T2,T3 and T4 stage local control rate was 100%,96.6%,96.6% and 78.4%,respectively. The overall 5-year survival and disease-free survival rate was 73.3% and 70.8%,respectively. The 5-year distant-free metastasis rate was 80.2%. Fourteen varietes were used to analyze the prognosis. Both univariate and multivariate analyses revealed that the distant metastasis, lower neck and superclavicle area as well as both neck lymph node metastases and local recurrence were prognostic factors for 5-year survival rate(Logrank test all P

Objective To investigate the expression of IL-17 in the serum and T cells of the patients with breast cancer and its correlation with breast cancer functional indicators.Methods The flow cytometry analysis was adopted to detect the percentage of peripheral blood CD3 + CD4 + IL-17 + T cells in breast cancer patients;the ELISA method was used to detect serum IL-17 content;the chemiluminescence immunoassay was used to detect CA153 and CA125 levels.The correlation between IL-17 with various indi-cators was analyzed.Results The percentage of CD3 + CD4 + IL-17 + T cell in peripheral blood of the breast cancer patients had sta-tistically significant difference compared with the healthy control group(P <0.05);serum IL-17 level had statistically significant difference compared with the healthy control group(P <0.05);serum IL-17 level was positively correlated with the percentage of CD3 + CD4 + IL-17 + T cells and the CA153 level;IL-17 level had no significant correlation with serum CA125 level.Conclusion The IL-17 expression level is associated with breast cancer.

The paper quantizes symptom data through binary coding,divides 8 syndromes summed up by experts into excess and de-ficiency syndromes,values and quantizes them,and establishes the model for classification of excess and deficiency syndromes of colorec-tal cancer based on BP neural network and decision tree.The result shows that BP neural network classification model is more applicablefor the handling of the nonlinear mapping relation compared with decision tree classification model.

Objective To explore the feasibility and value of MRI examination in colorectal carcinoma. Methods Thirty-eight patients with clinically suspected colorectal carcinoma were included in this study and all of them underwent MRI examination. About 300- 1 000 ml water was administered transrectally before scanning. Axial plain scan, three-planar enhanced scan and hydrography were performed, respectively. Results In 38 patients, 31 cases were pathologically proved as colorectal carcinoma. The main MRI findings were: intraluminal soft tissue mass (n=5), irregular thickening of colorectal wall and partial or circumferential stenosis of colorectal lumen (n=26). The tumors were all demonstrated as medium signal intensity on T 1-weighted images. Thirty of 31 cases showed slightly hyperintensity and one was conspicuous high signal intensity on T 2-weighted images. Marked enhancement was demonstrated in all foci. Focal low signal structures were presented in the pericolorectal fat on precontrast T 1-weighted SE sequence in 5 cases. Smooth margins were revealed in 12 cases and irregular and/or nodular margins of peripheral wall in 19 cases. Colorectal hydrography showed that there were intraluminal irregular filling defects (n=14), and that "cuff sign" or "sawn-off sign" was demonstrated in the distal end of tumor and its proximal part couldn't be seen (n=10). Thirty of 31 patients with pathologically proved colorectal carcinoma and 4 of 7 patients with non-colorectal carcinoma were correctly identified by MRI. The sensitivity, specificity, and accuracy were 96.8%, 57.1%, and 89.5%, respectively. The accuracy of MRI in T staging was 83.9% (26/31). The accuracy in T1-2, T3, and T4 staging was 75.0% (9/12), 88.2% (15/17), and 100% (2/2), respectively. Conclusion MRI could clearly show the longitudinal and horizontal invasion of colorectal carcinoma as a whole. It could accurately determine the invasive depth of local lesions. Barium enema examination may be partially replaced by colorectal hydrography with MIP reconstruction. It is of directorial value in clinical treatment.

Objective To investigate the digital subtraction angiography (DSA) manifestations and clinical value of interventional embolization of renal artery with severe hemorrhage following percutaneous nephrolithotomy (PCNL).Methods 34 patients with severe hemorrhage following PCNL from Feb 2012 to Jun 2015 were subjected to perform renal arterial DSA, which was followed by super-selective renal arterial embolization (SRAE) with steel micro-coils and guglielmi detachable coils together with or without biological glue (GLUBRAN2). The patients were followed up for 6 ~ 12 months.Results Of the 34 patients, DSA examination showed that renal artery pseudoaneurysm (RAP) was found in 22 (64.7%), renal arteriovenous ifstula (RAVF) in 8 (23.5%) and RAP associated with RAVF in 4 (11.8%). Successful embolization with single session was achieved in all 34 patients. Both the technical success rate and the hemostasis rate were 100.0%. Meanwhile, the renal tissue and function were mainly reserved and no serious complication of embolization was observed. No hematuria recurrence or renal function failure appeared in all patients during the follow-up period. In 26 patients, different degree of embolism syndrome was observed after the treatment.Conclusions Renal artery pseudoaneurysm and renal arteriovenous ifstula are the main types of renal artery injury resulting in severe hemorrhage after percutaneous nephrolithotomy. Super-selective renal arterial embolization (SRAE) with steel micro-coils and guglielmi detachable coils together with or without biological glue (GLUBRAN2) is a minimally invasive method that can promptly stop the renal bleeding, and preserve the renal tissue and function to the greatest possible advantage. Therefore, this technique should be regarded as the ifrst choice in the treatment of the patients who suffered from severe hemorrhage occurred after PCNL.

Objective To evaluate effect of bone grafting combining with titanium mesh and/or reinforcement cup in reconstruction of acetabular bone defect in total hip arthroplasty (THA).Methods From January 2008 to November 2011,32 patients,including 23 males and 9 females,aged from 51 to 76 years (average,66 years),underwent THA with acetabular defect reconstruction by using bone grafting combining with titanium mesh and/or reinforcement cup.There were 6 cases of primary THA and 26 cases of revision THA.Twelve cases (Paprosky Ⅱ B) and 7 cases (Paprosky Ⅱ C) underwent impaction bone grafting with titanium mesh; 6 cases (Paprosky Ⅱ C) underwent impaction bone grafting with reinforcement cup; 6 cases (Paprosky Ⅲ A) underwent impaction bone grafting and structural bone grafting with winged reinforcement cup; 1 case (Paprosky Ⅲ A) underwent double-layer impaction bone grafting with titanium mesh and reinforcement cup.Harris score and Gill classification were used to evaluate clinical and radiological results,respectively.Results All cases (32 hips) were followed up for an average of 22 months (range,12 to 25months).One year postoperatively,Harris score improved from preoperative 44.00±11.71 to postoperative 78.41 ±9.32.Twenty-four cases were excellent,4 good,4 fair,and the excellent and good rate was 87.5％.Three cases occurred mild displacement of acetabular rotation center; one case occurred dislocation.There was no loosing,subsidence,and bone resorption in other 28 cases at final follow-up.ConcLusion Bone grafting with titanium mesh and/or reinforcement cup is effective in reconstruction of acetabular bone defect in THA,which can improve the stability of acetabular cup.