OBJECTIVE To describe the sonographic features of carotid body tumor(CBT), and determine the utility of ultrasonography as a diagnostic study in the preoperative patients. METHODS Sonograms of 60 patients with 65 CBT were reviewed with gray scale and duplex Doppler sonography. The evaluated features included the location, size, margins, shape, internal echogenicity, the relationship between the tumor and the carotid artery,and blood flow velocity. RESULTS All carotid body tumors were located at the carotid artery bifurcation. Well-defined, solid, weakly hypoechoic masses were noted on gray scale sonography in the carotid bifurcation. Color Doppler sonography showed hypervascularity in 61 masses. Pulsed Doppler analysis of blood flow within the tumor mass was possible in 61 CBT, and low-resistance waveforms were obtained from multiple sites within the mass in all cases. CONCLUSION The ultrasound characteristics of the CBT possess specificity to some extent. Duplex Doppler ultrasound can provide the relationship between the tumor and the carotid artery,and provide important information of intratumor blood flow,which has important value in the diagnosis of CBT.

Objective To evaluate the accuracy and feasibility of 64-slice spiral CT (64SCT) in assessing coronary artery disease.Methods A total of 30 suspected patients (male 21 cases, female 9 cases, and mean age of 54.6 years) were undergone both 64SCT and selective coronary angiography (SCA). Volume redering (VR) ,multiplanar reconstruction (MPR), maximum intensity projection (MIP) and transverse section were reconstructed. The results of coronary reconstructions were compared with SCA to analyze the accuracy of the 64SCT in detecting coronary artery stenoses.Results In the 396 segments of coronary artery(diameter≥2 mm)of 30 patients, 385 were judged to be evaluable by 64SCT. The evaluable rate was 97.2%. The sensitivity, specificity, positive predictive value and negative predictive value of the 64SCT in detecting coronary artery stenoses(≥50% of stenosis) were 96.22%, 94.56%, 89.44% and 96.88%. The accuracy rate of 64SCT in detecting ≥50% stenosis of coronary artery was 95.90%.Conclusion 64SCT has high accuracy in detecting coronary artery stenoses, as a noninvasive method,it can be used for screening patients with known or coronary artery diseases.

Objective To explore the biomechanical characteristics of the pharynx in patients with aspiration after radiotherapy for nasopharyngeal carcinoma (NPC).Methods Clinical data on NPC patients with dysphagia admitted between July 2011 and June 2015 were retrospectively analyzed.Twenty-three patients were found who had received videofluoroscopic swallowing studies (VFSSs) and whose pharyngeal pressure and upper esophageal sphincter (UES) relaxing were tested using high-resolution solid-state manometry (HRM).The cases were divided into an aspiration group and a non-aspiration group according to the VFSS results.Differences in biomechanical parameters between the 2 groups when taking food of different viscosity were compared.Results Patients with aspiration had significantly higher UES residual pressure when taking thick liquids (20.1± 14.3 mmHg) and paste (18.0± 14.3 mmHg) than patients not aspirating (9.3±9.2 mmHg and 7.2±8.9 mmHg for thick liquid and paste respectively).But no significant difference in average pharyngeal pressure between the two groups was observed.Conclusion Aspiration after radiotherapy may be correlated with increased UES residual pressure.

Objective To preliminarily explore the feasibility of tree shrew as a new kind of animal model in research of amblyopia,to discuss the primary visual cortex plasticity mechanism of form deprivation in tree shrew,and to provide a theoretical basis for further understanding the mechanism of amblyopia formation and recovery.Methods Sixty 30-days old tree shrews were divided into five groups,12 in each group:the group A had the right eye sutured for 1 month;the group B had the right eye sutured for 2 months;the group C had the left eye sutured for 1 month and then opened and the righ eye was sutured for 1 month,in other words,the group C was performed by alternating suture;the tree shrews of control group 1(D1) were in the same age as the the group A,but fed in normal breedingenvironment;the tree shrews of control group 2(D2) were at the same age of groups B and C,but fed with a normal diet.Samples of the visual cortex were taken after the completion of modeling,and were processed to observe the histology and ultrastructure of the visual cortex,the neuron apoptosis,and the c-fos protein expression in the tree shrews of different groups.Results Damages to different degrees were found by histological and electron microscopic examination of the visual cortex in each experimental group,and they were more obvious in the group sutured for 2 months.TUNEL staining showed that there were no significant differences between the apoptosis in the experimental and control groups.The expression of c-fos mRNA and protein in the experimental groups was decreased,and it was the lowest in the group sutured for 2 months.There was a small increase in the c-fos expression after the alternate suture,and no significant difference of c-fos expression was found in the control groups.Conclusions Different degrees of deprivation amblyopia lead to different histopathological changes.There is a plasticity in the neurons affected by amblyopia.Tree shrew can be used as an ideal animal model for the studies of form deprivation amblyopia.

Objective To characterize the association between the mean CT value on a scout view and the dependent mA selection method, and to evaluate the clinical value of a mA selection method based on scout view mean CT value in obtaining individualized scan protocol and consistent image quality for patient population on 64-row MSCT CT coronary angiography (CTCA).Methods One hundred patients (group A) underwent CCTA consecutively using standard protocol with a fixed mA.The mean CT value of a fixed ROI (region of interest) from the scout AP view and the CTCA image noise (standard deviation on the root of ascending aorta) were measured.The correlation between CT values and noise was studied establish a formula and a list to determine the required mA for obtaining a consistent CTCA image noise based on the measured SV CT value.Another 100 patients (group B) were scanned using the same parameters as group A except the mA and the CT value was also measured.The mA was determined by the list established previously.The CTCA image quality (IQ) as well as the image noise (IN) and the effective dose (ED) from the two groups were statistically analyzed using t-test.The CT findings for the 32 patients in the group B were also compared with the selective coronary angiography (SCA) results.The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of CCTA for detection of significant stenosis were obtained.Results The formula between the required mA and the CT value was : XmA=FmA×[(K1×CTscout + C1)/INa]2.The CCTA images in B group had statistically higher IN (27.66±2.57,22.22±4.17,t=11.33, P=0.000), but no statistical difference between IQ scores for the two groups (3.29±0.66,3.37±0.67,t=0.009, P=0.990), and ED[(8.72±2.51) versus (12.53±0.90) mSv]was 30% lower for the B group (P<0.01).For the 32 patients in the B group who had SCA, the CCTA sensitivity, specificity, positive predictive value, negative predictive value, and stenosis detection accuracy were 94.92% (56/59), 92.13% (82/89) ,88.89% (56/63) ,96.47% (82/85) and 93.24% (138/148) wspectively for stenosis greater than 50%.Conclusion The mA selection method based on the SV CT value for CCTA in 64-row MSCT provides individualized protocol to obtain consistent image quality and to optimize dose delivery to patients.

Objective To investigate the clinical and molecular pathological features of limb-girdle muscular dystrophy 2A (LGMD2A) of Chinese patients. Methods Thirty cases of LGMD with excluding LGMD2B were included in this study. The muscle specimens were performed by a standard series methods of histochemistry, enzymohistochemistry, immunohistochemistry and Western blot. The clinical and molecular pathological features of LGMD2A were retrospective analyzed. Results Five cases with no or only trace expression of calpain-3 protein were diagnosed as calpainopathy (LGMD2A) by Western blot analysis. The age of onset of these 5 patients ranged from 10 to 45 years and the duration of the disease were about 2-10 years. Proximal muscles weakness and atrophy of lower limbs were predominantly involved. In all patients,symptoms progressed slowly. The ambulation could be retained for many years but running and jumping were impaired early. The serum creatine kinase level was elevated moderately to markedly. Electromyography showed myopathic patterns in all cases. Two siblings had similar symptoms indicating autosomai recessive inherited pattern. Pathologically, there was marked variation in fibre size and most small fibres were round. Some necrotic and regenerating fibers were seen. Fibres with centrally placed nuclei can be found frequently. No infiltrations of inflammatory cells were seen. Lobulated fibers were observed in 2 patients by NADH-TR stain. The expression of dystrophin, caveolin-3, α-, β-, γ- and δ-sarcoglycan protein were normally staining of 5 LGMD2A patients' specimens by immunohistochemistry. Two patients had reduced staining of dysferlin by immunohistochemistry study. Conclusions Clinical and pathological characteristics of our 5 LGMD2A patients are consistent with typical muscular dystrophy features reported in other countries. Identification of calpian-3 deletion by Western blot is essential for the diagnosis of calpainopathy.

BACKGROUND:Research on rough-surfaced implants has demonstrated similar survival rates for short and conventional-length implants. It is not clear whether ultrashort implant in limited alveolar bone of the posterior maxila can achieve good clinical results. OBJECTIVE:To evaluate the clinical effect of ultrashort implants in limited alveolar bone of the posterior maxila. METHODS:Eighteen patients with 21 ultrashort implants in limited alveolar bone of posterior maxila (the mean residual alveolar height=3.19 mm) were included in the study, including 10 males and 8 females, aged 25-68 years. At 12 months after restoration, the patients were detected with cone-beam CT to evaluate the osseointegration and marginal bone level around the implant. RESULTS AND CONCLUSION:Al the 18 patients completed the 12-month folow-up, and the 21 pieces of implants had good osseointegration. No soft tissue inflammation was found. At 12 months after restoration, the marginal bone height in the mesial and distal was (-0.21±0.78) mm and (-0.16±0.55) mm, respectively. Implant marginal bone changes in the mesial and distal had no statistical difference (P > 0.05). Ultrashort implants in limited alveolar bone of the posterior maxila can have good osseointegration, maintain the marginal bone mass around the implant, but stil need long-term clinical observation.

Objective To evaluate the multi-slice CT perfusion imaging in investigating whether edaravone can prevent and treat pulmonary thromboembolism ischemia-reperfusion injury(PTE-IRI).Methods Twenty mongrel canines were included.A Swan-Ganz catheter wag introduced into the right internal jugular vein using the Seldinger technique,and then was inserted into the pulmonary artery.Balloon occlusion of the right inferior lobe pulmonary artery for 4 h was followed by removing catheter and 4 h of reperfusion.Animals were divided into four groups of A(no edaravone during ischenmia and reperfusion),B(edaravone used only during ischemia),C(edaravone used during both ischemia and reperfusion)and D group(edaravone used only during reperfusion)(n=5 per group).Every group was divided into three time points including before ischemia,4 h after ischemia and 4 h after reperfusion.CT scan and CT perfusionwere performed at the three time points.The blood flow(BF),blood volume(BV)and mean transit time (MTT)of the bilateral inferior regional lung parenchyma were measured with the software of perfusion 3.Results CT examination showed pulmonary edema in the right inferior lung lobe at 4 h after reperfusion.(1)The BF and MTT of A,B,C and D group were[(259.4±15.7)ml·min-1·100 g-1,(293.7±7.9)ml·min-1·100 g-1,(379.4±14.5)ml·min-1·100 g-1,(382.5±16.6)ml·min-1·100 g-1]and[(3.1±0.2)s,(2.6±0.2)s,(2.2±0.1)s,(1.9±0.2)s]respectively at 4 h after reperfusion.The BF and MTT were statistically difierent(P＜0.01)between groups(A and B,A and C,A and D,B and C,B and D)except between group C and D(the P value＞0.05)at 4 h after reperfusion,but the BV was not statistically different between groups(P＞0.05).(2)The BF[(397.2±19.2)ml·min-1·100 g-1and(259.4±15.7)ml·min-1·100 g-1in group A,(393.2±16.1)ml·min-1·100 g-1and(293.7±7.9)ml·min-1·100 g-1 in group B]and MTT[(1.8±0.1)8 and (3.1±0.2)s in group A,(1.8±0.2)s and(2.6±0.2)s in group B]were statistically different(P＜0.01),but the BV[(12.0±0.9)ml/100 g and(12.2±1.0)ml/100 g in group A,(11.9±1.5)ml/100 g and(12.2±1.3)ml/100 g in group B]were not different(P＞0.05)between groups before ischemia and 4 h after ischemia.The BF.MTT and BV were not statistically significant between before ischemia and4 h after reperfusion in group C and D(P＞0.05).ConclusionsEdaravone can attenuate the degree of the PTE IRI.Multi-slice CT perfusion imaging can evaluate effect.

OBJECTIVETo summarize the sonographic features of primary non-Hodgkins lymphoma of the breast using the Breast Imaging Reporting and Data System-Ultrasound (BI-RADS-US) and explore the value of ultrasonography in the preoperative diagnosis.

METHODSThe clinical data of 11 patients with primary non-Hodgkins lymphoma of the breast were retrospectively reviewed. BI-RADS-US grading was performed for each lesion.

RESULTSTotally 13 lesions were detected in 11 patients. Single lesion at one side was detected in 9 patients (81.8%). Circumscribed (n=7, 53.8%) or microlobulated lesions (n=5, 38.5%), parallel orientation (n=10, 76.9%), and oval masses (n=8, 61.5%) were also observed on sonography. The echo pattern of the mass was hypoechoic in 10 lesions (76.9%), hyperechoic in 1 lesion, and complex echoic in 2 lesions. No mass had speculated margins or calcifications. Ipsilateral axillary lymph node involvements were noted in 6 patients.

CONCLUSIONSMost primary non-Hodgkins lymphomas of the breast present as single hypoechoic masses with circumscribed or microlobulated margins and parallel orientation on sonography. BI-RADS-US, combined with the analyses of multiple signs, is feasible for the pre-surgical diagnosis.

Adult ; Breast Neoplasms ; diagnostic imaging ; Female ; Humans ; Lymphoma, Non-Hodgkin ; diagnostic imaging ; Middle Aged ; Retrospective Studies ; Ultrasonography, Mammary ; methods ; Young Adult

OBJECTIVE:To demonstrate challenges of pharmacy automation reconstruction so as to set solutions. METHODS:Based on literature review,analysis of pharmacy automation setting and features,this paper gave the suggestions and solutions on construction cost,management model change,equipment maintenance and emergency response,etc. according to the practice of the hospital. RESULTS&CONCLUSIONS:Pharmacy automation construction should be stick to the requirements of new health re-form to lower the cost by using the out resources and interior optimal allocation,to improve efficiency by unified planning and proper design,and to ensure the system running efficiently by sufficient maintenance and contingency plan.