Objective To compare the sequential therapy and quadruple therapy for Helicobacter pylori ( H.pylori) eradicate rate and the effective rate for the treatment of H .pylori related peptic ulcer .Methods Prespec-tively,120 patients with H.pylori related peptic ulcer were randomly divided into the treatment group and the control group (n=60).The treatment group was received the ten days sequential therapy and the control group received the quadruple therapy .Results There were no significant differences in the effective rate for the treatment of H .pylori related peptic ulcer (86.7%% vs 91.7%,P>0.05) and the eradication rate of H.pylori infection (90.0% vs 85.0%,P>0.05) between the treatment group and the control group .Conclusion Ten days sequential therapy is an effective therapy for the treatment of H .pylori related peptic ulcer and H .pylori eradication ,which can be used as an initial treatment of patients with H .pylori infection .

Objective To investigate the outcome of the finger reconstruction using one toe transfer to repair the tissue defects of two fingers at the same time. Methods Two fingers joint tissue missing and finger defect of 8 fingers in 4 cases were reconstructed with dissociative transplants harvested from two parts of the same toe at the same time.Using the paratelum of the second toes reconstructed the indicis paratelum or finger tip,and using the proximal interphalangeal joint of the second toes repaired the proximal interphalangeal joint's tissue defects of the middle finger at the same time in 2 cases.Using the distal interphalangeal joint and the proximal interphalangeal joint of one second toe reconstructed the proximal interpha langeal joints of the index finger and the middle finger in 1 case.Using the proximal interphalangeal joint and the metatarsophalangeal joint of one second toe reconstructed the metacarpophalangeal joints of the index finger and the middle finger in 1 case. Results All the transplants survived.The patients were followed-up from 2 months to 46 months postoperatively.The function and shape of 2 resconstruction fingers were excellent as assessed with Criterion on Functional Evaluation on Finger Reconstruction issued by Chinese Society of Hand Surgery.Five resconstruction fingers were good.One resconstruction finger was fire. Conclusion For some appropriate cases with the tissue defects of 2 fingers such as the finger's paratelum,the interphalangeal joint or the metacarpophalangeal joint,this operated technique was a good method.

Objective To evaluate the application effect of modular management in technique and nursing of department of radiology. Methods 7 modules were divided: administrative management, quality management, equipment management, environment and emergency management, material cost management, education management and scientific research management. Each module was responsible for specially-assigned person reporting daily circumstance. Results After more than a year, 16 technical professionals, 8 educational professionals, 10 research professionals and 7 technicians were cultivated, 12 key performance indicators (KPI value) increased steadily were set up. Conclusions Modular management provided a novel concept for technique and medical care management of radiology department. Our practice suggests that modular management is alternative for development of technique and medical care in radiology department. Further research and application are needed.

Objective To study the value of D‐dimer for early diagnosing ischemic bowel disease(IBD) and to find more econom‐ic and more effective detection means for its diagnosis and control .Methods Ninety‐five patients with suspected acute IBD in our hospital from October 2014 to October 2015 were selected as the observation group ,and contemporaneous 74 individuals undergoing routine physical examination were selected as the control group .The differences in D‐dimer levels were compared between the con‐trol group and the patients with definitely diagnosed IBD in the observation group on 1 ,7 ,14 d after admission .At the same time the differences in initial WBC level and fecal occult blood were compared between the two groups .The sensitivity and specificity of plas‐ma D‐dimer level for early diagnosing IBD were calculated and their clinical application value was summarized .Results (1) Accord‐ing to plasma D‐dimer results ,the 74 cases of acute IBD were diagnosed and 21 cases were negative ,while 80 positive cases and 15 negative cases were diagnosed by adopting the CT inferior mesenteric arterial angiography and multislice spiral CT ,the sensitivity of plasma D‐dimer detection was 88 .75% and specificity was 80 .0% .(2) The D‐dimer level ,WBC count and fecal occult blood on 1 d after admission in the observation group were (5 480 .12 ± 876 .32)μg/L ,(17 .37 ± 2 .21) × 109/L and 81 .3% respectively ,which were far higher than those in the healthy control group ,the differences were statistically significant (P<0 .05) .(3)The D‐dimer levels on 1 ,7 ,14 d after admission in the observation group were significantly higher than those in the control group (P<0 .05) , while with the treatment duration extension ,the plasma D‐dimer level was gradually decreased .Conclusion The D‐dimer detection has a relatively higher sensitivity and specificity in the early diagnosis of acute IBD and has better clinical application value .

Objective To discuss the application value of contrast-enhanced uhrasound(CEUS)in diagnosis of hepatic artery thrombosis(HAT)after liver transplantation.Methods Four hundred and seventy-five liver transplantation patients were performed routine exam by color Doppler uhrasound,11patients suspected of HAT were examined by CEUS.Results All cases were confirmed bv DSA or CTA.Of them,6 cases were thrombotic by CEUS,and 3 cases out of the 6 cases HAT were founded infarction.The other 5 cases were nonthrombotic,but the diameter of hepatic artery showed narrow,3 Datients were accompanied by severe fatty liver. Conclusions CEUS is equally effective as DSA or CTA in diagnosing HAT after liver transplantation.

Objective In order to understand the children's blood lead load and presence status of blood lead levels,provide the first-hand information on further preventive intervention in high lead hyperlipidemia.Methods This study routinely collected 5 to 9-year-old children's blood,a total of 1963 cases.Peripheral blood lead levels was detected by atomic absorption spectrometry.Results Blood lead ≥ 100μg/L is 45 cases in 1963 cases of children, the rate is 2.3%, the highest is 439μg/L,only one.Other 44 persons' blood lead level is 100 ~ 200μg/L,average 149.2μg/L.Conclusion The children's blood lead levels in Beilun district of Ningbo city is in normal state in general,not high blood lead load.

OBJECTIVE To investigate the clinical feature,diagnosis and treatment of tuberculosis in post-solid organ transplantation patients.METHODS The clinical data of 11 patients with tuberculosis post-solid organ transplantation were analyzed retrospectively,in which eight cases were the patients with post-liver transplantation,two cases were the patients with post-kidney transplantation and one patient with post-liver and kidney transplantation.The diaghosis were based on the case history,pathogenic,image and the consequence of diagnostic therapy against tuberculosis were observed.RESULTS Infection rate of tuberculosis after liver transplantation,kidney transplantation and combined liver and kidney transplantation were 0.92%,1.10% and 7.14%,respectively.The three cases suffered from acute miliary tuberculosis.One case suffered from exudative pulmonary tuberculosis.One case suffered from tuberculosis pleuritis.One case suffered from lymph node tuberculosis.One case suffered from tuberculosis of lumber spine complicating exudative pulmonary tuberculosis.Four cases were not found lesion in their body.Each patient was adopted with individual treatment.The following up were 83 day to 1080 day.One case was died.Ten cases were cured.CONCLUSIONS Tuberculosis patients with post-solid organ transplantation had atypical clinical symptom under immunosuppressive agents.Part of the patients are lacked of evidences from image,bacteriology or immunology.Diagnostic errors are made sometimes.Diagnostic therapy against tuberculosis should be put into practice for the patients with suspicious tuberculosis.

BACKGROUND:The establishment of a standardized clinical liver transplantation specimen bank is the primary condition for scientific research in this field, which can help to provide a qualified sample resource platform for research. OBJECTIVE:To primarily establish biological specimen bank of hepatocelular carcinoma for liver transplantation, to explore the standardized procedures of specimen colection, processing and preservation of hepatocelular carcinoma for liver transplantation, and to establish the sound and comprehensive information management system of clinical information of colected specimens. METHODS: In accordance with standardized procedures to establish biological specimen banks, the operational processes and quality control system were formulated. Liver tissue and blood samples of hepatocelular carcinoma recipients undergoing liver transplantation were regularly colected, managed and stored. Simultaneously, liver tissue and blood samples of benign liver disease in liver transplant recipients and of healthy donor were colected as controls. A systematic management was conducted in colected specimens and corresponding clinical information. RESULTS AND CONCLUSION:From August 2009, tissue and blood samples of 501 cases of receipts and donors undergoing liver transplantation with complete clinical information were colected from the specimen bank, including 203 hepatocelular carcinoma specimens, 214 benign liver disease specimens and 84 healthy donor specimens. These specimens included tumor tissue, adjacent tissues and distal non-cancerous tissue specimens, totaly 1 773. A total of 45 specimens were randomly selected for quality monitoring. The colected specimens had a high quality. Specimen information data computer management system was developed. This study initialy established a standardized research-based clinical transplantation specimen bank, which is helpful to elevate sample quality and has a good manipuility.

Objective To assess the value of clinical applications of whole-body diffusion-weighted imaging (WB-DWI) in diagnosing patients with malignant tumors compared with positron emission tomography (PET). Methods A total of 22 patients with highly suspected malignant tumors underwent WB-DWI after PET. The differences between the two imaging methods were compared in displaying lesions, and the correlation between ADC and SUV value was analyzed. Results More lesions were showed with WB-DWI than PET. There was no significant difference between the two methods in detecting the lesions of lung, mediastinal septum or abdomen (P>0.05), but more lesions in skeleton were showed with WB-DWI (P<0.05). No significant correlation between ADC and SUV value was found. Conclusion Compared with PET, WB-DWI can detect more tumor lesions. The sensitivity of WB-DWI in detecting metastatic tumors of bone is higher than that of PET.

Objective:To analyze long-term outcomes of inoperable non-metastatic pancreatic cancer patients treated with definitive radiotherapy-based comprehensive treatment.Methods:Clinical data of 168 patients with medically unfit, refusal to surgery or inoperable non-metastatic pancreatic cancer treated with radiotherapy-based comprehensive treatment in PLA General Hospital between January 2016 and December 2020 were retrospectively analyzed. Survival outcomes,prognostic factors and patterns of treatment failure were analyzed in the radiotherapy ( n=95) and combined chemoradiotherapy ( n=73) groups. The survival analysis was conducted by Kaplan-Meier method. The survival curve was compared by log-rank test. Independent prognostic factors were identified by Cox proportional harzard model. Results:With a median follow-up of 20.2 months in the entire group, the median overall survival (OS) and median progression-free survival (PFS) were 18.0 and 12.3 months. The corresponding median OS and median PFS after receiving radiotherapy were 14.3 and 7.7 months. The 1-, 2-and 3-year OS rates were 72.1%, 36.6% and 21.5%, and the 1- and 2-year local control rates were 82.6% and 64.3%, respectively. The median OS for stage Ⅰ, stage Ⅱ and stage III were 27.1, 18.0 and 17.0 months, respectively. There was no significant difference in the median OS of patients with localized disease (stage Ⅰ-Ⅱ) between the radiotherapy and combined chemoradiotherapy groups (21.1 vs. 20.4 months, P=0.470). In patients with locally advanced disease (stage Ⅲ), combined chemoradiotherapy group showed better median OS compared with radiotherapy group (19.2 vs. 13.8 months, P=0.004). Clinical stage, CA19-9 before radiotherapy, comprehensive treatment and biological effective dose (BED 10) were identified as the independent prognostic factors for OS ( P=0.032, 0.011, 0.003 and 0.014). The cumulative 1- and 2-year actuarial rates of treatment failure, local-regional recurrence and distant metastasis were 48% and 74.4%, 15.0% and 27.4%, 23.6% and 33.1%, respectively. Liver metastasis (16.1%, 27/168) and local recurrence (11.9%, 20/168) were the primary patterns of treatment failure. Conclusions:Definitive radiotherapy-based comprehensive treatment effectively prolongs long-term survival in patients with inoperable non-metastatic pancreatic cancer. Definitive radiotherapy can be an alternative treatment option with curative intent for patients with localized pancreatic cancer who are medically unfit or refuse to undergo surgery. The combination of radiotherapy and chemotherapy remains an effective treatment choice for locally advanced unresectable pancreatic cancer.