Objective To investigate the value of qualitative and quantitative characteristics of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid(Gd-EOB-DTPA)enhanced MRI in preoperative prediction of vessels encapsulating tumor clusters(VETC)pattern in hepatocellular carcinoma(HCC).Methods A total of 234 patients diagnosed with HCC by pathology were analyzed retrospectively.A total of 101 VETC-positive HCC patients and 133 VETC-negative HCC patients were included.All patients were divided into training group and validation group according to 7︰3.The training group data were used to construct a prediction model for VETC-positive HCC.Receiver operating characteristic(ROC)curve was drawn and the area under the curve(AUC)was calculated to verify the diagnostic efficiency of the model.Calibration curve was drawn to verify the calibration of the model.Results Multivariate logistic regression analysis predicted the independent risk factors for VETC-positive HCC:portal phase peripheral washout[odds ratio(OR)6.493],necrosis or severe ischemia(OR 4.756),targetoid transitional phase or hepatobiliary phase(OR 0.307),and lesion to liver signal intensity ratio(LLR)on arterial phase(OR 0.074).The AUC of the training group in predicting VETC-positive HCC was 0.790[95%confidence interval(CI)0.720-0.859].The AUC of the validation group in predicting VETC-positive HCC was 0.779(95%CI 0.668-0.889).The calibration curve diagram showed that the calibration curve(the slope was 0.91)almost coincides with the ideal curve,indicating that the prediction model had better calibration.Conclusion The qualitative and quantitative characteristics of Gd-EOB-DTPA enhanced MRI can be used to predict VETC-positive HCC preoperatively,the independent risk factors of VETC include portal phase peripheral washout,necrosis or severe ischemia,targetoid transitional phase or hepatobiliary phase,and LLR on arterial phase.

Objective To investigate the value of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA) enhanced MRI in assessing liver reserve function in patients with normal liver function and abnormal liver function.Methods Totally 99 hepatitis B cirrhosis patients with abnormal liver function were classified into the following three groups,i.e.Child-Pugh A group (n=48),Child Pugh B group (n=40),Child Pugh C group (n=11),while 21 patients without chronic liver disease were taken as normal liver function group.All patients underwent Gd-EOB-DTPA enhanced MRI.At 3 min,10 min and 20 min after intravenous administration of Gd-EOB-DTPA,the relative enhancement (RE) of whole liver and liver segments (S1-S8) was calculated,and the differences of liver RE were compared among different liver function groups and liver segments.Results At 3 min,10 min and 20 min after intravenous administration of Gd EOB-DTPA,the differences of whole liver RE and segmental liver RE among the Child Pugh A group,Child-Pugh B group,Child Pugh C group and normal liver function group were statistically different (all P＜0.05).At 3 min,10 min and 20 min after injection,RE of normal liver function group and Child Pugh A group was significantly different among different liver segments (S1-S8).At 10 min and 20 min after injection,RE of Child-Pugh B group was significantly different among different liver segments,while at 20 min after injection,RE of Child-Pugh C group was significantly different among different liver segments.Conclusion Gd-EOB-DTPA enhanced MRI can accurately assess whole liver and segmental liver function.

Objective To evaluate the ability of Gd-EOB-DTPA enhanced MRI in the evaluation of liver reserve function in patients with hepatitis B cirrhosis.Methods Patients with hepatitis B cirrhosis and controls with normal liver function and free of chronic liver disease were collected prospectively.Signal intensity(SI)of each hepatic segments(S1-S8)were measured of all cases before injection and after bolus administration of Gd-EOB-DTPA,and the whole liver signal intensity was assessed as the average signal intensity.The whole liver relative enhancement degree(relative enhancement RE)was calculated.The one way A NOVA was used to compare SI and RE among four groups at different time and the Friedman test was used to compare SI and RE within each group at different time.The Spearman rank correlation analysis was used to do correlation analysis.ROC curve was used to analyze the efficacy of Gd-EOB-DTPA enhanced MRI in the diagnosis of liver dysfunction and was used to compare the diagnostic performance of SI and RE in discriminating normal liver function group-Child A from Child B-C.Results Patients enrolled with normal liver function,Child-Pugh A,B and C was 21, 40,48 and 11.SI and RE between different groups were statistically significant at each time(P<0.05);and was statistically significant at different time within the same group.Correlation analysis of SI and RE with liver function classification at different time points showed:in addition to SI20 s(r= -0.190,P= 0.038),RE20 s(r=0.081,P=0.382),SI and RE at each time point were highly negatively related with liver function classification(P<0.01).SI10 minand RE10 minwere higher significantly negatively related with liver function classification.T he area under the ROC curve was 0.839,0.707,0.779 and 0.547,respectively.Conclusion Gd-EOB-DTPA enhanced MRI can assess liver reserve function in patients with hepatitis B cirrhosis,SI and RE can reflect the degree of liver function reserve in a certain extent.It has some value in predicting the normal or mild injury of liver function with moderate or severe injury of liver function.

Objective The sirolimus-eluting stent (SES) has dramatically reduced the rate ofrestenosis in comparison to that with the bare-metal stent (BMS).This study aimed to evaluate the short-term efficacy and safety of Firebird stent implantation for patients with coronary heart disease (CHD). Methods From Apri12006 through July 2007, 155 patients (mean age 58.93～10.27 years) with CHD were implanted with Firebird stent or Cypher select stent at Daxing Hospital. Patients were followed up for one year. All-cause mortality, major adverse cardiac events (MACE, including cardiac death, myocardial infarction, recurrence of angina pectoris, heart failure, revascularization, and adverse arrhythmia) and stent thrombosis were compared between the 2 groups. Results Of the 155 consecutive patients, 147 patients were revascularized completely. Of these patients, 48 (with 59 lesions) were treated with Firebird stent, 59 patients (with 75 lesions) with Cypher select stent. The demographic characteristics were similar in the 2 groups. All the angiographic and procedural results were not significantly different between the 2 groups. All-cause mortality, myocardial infarction, recurrence of angina pectoris, MACE and stent thrombosis were almost identical between the 2 groups before discharge, at 6 months and at one year .Conclusion The short-term efficacy and safety of Firebird stent are similar to that of the cypher select stent for the treatment of patients with CHD.

Objective To study the different therapeutic proportion of the patient populations undergone coronary angiography (CAG) in the era of development in multislice spiral computed tomography(MSCT).Methods Two hundred and fifty four consecutive patients(mean age 59.24±10.65),who underwent CAG at Daxing Hospital from February 2007 through October 2007,were enrolled,160 patients were male and 94 were female.By evaluating from the coronary angiogram,the patients were not diagnosed to have coronary heart disease(CHD) with less than 50% diameter stenosis of coronary artery;the patients to have CHD with more than or equal to 50% stenosis of coronary artery;the patients were performed the procedure of percutaneous coronary intervention(PCI) with more than or equal to 70% stenosis;the patients were proposed to have coronary aortic bypass graft(CABG) surgery with left main coronary artery lesions or diffuse triple coronary artery lesions.Results In the 254 consecutive patients,59 patients(23.2%) had not been diagnosed to have CHD;195(76.8%)to have CHD,of these patients with CHD,49 patients(19.3%)were not indicated for PCI (including the patients receiving follow-up coronary angiography after stenting),81(31.9%)had been performed the procedure of stent implantation,57(22.4%)proposed to have CABG,8(3.1%)the procedure of PCI had not been successful,or had not been performed because of patients opposing to this therapy.Conclusion Multislice spiral computed tomography can be applied as a non-invasive screening tool to exclude the presence of CHD,to increase the positive proportion of the populations with CHD in all patients receiving coronary angiograhpy,to avoid the use of CAG in a subset of patients.

Objective To evaluate the clinical effect of ambulatory labor analgesia used in latent phase of the first stage of labor, which include labor progress, Apgar score after ambulatory labor analgesia begun to use when the cervix was different size dilatated. Methods Seventy-five parturient primiparas who had no complication were randomly divided into three groups: group Ⅰ: ambulatory labor analgesia was begun to use when the cervix was 1.0 cm dilated, group Ⅱ: ambulatory labor analgesia was begun to use when the cervix was 2-3 cm dilated, group Ⅲ: control group without use of ambulatory labor analgesia. Analgesic effects were observed, changes of uterine contraction were recorded by fetal monitor. Meanwhile, total stage of labor ,outcome of delivery and Apgar score were recorded. Results Duration of total stage of labor had no significant difference between group Ⅰ and group Ⅲ.The duration of the first labor stage was significantly longer in group Ⅰ than that in group Ⅱ(P