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 evaluate the value of vascular intervention in the diagnosis and management of hemobilia. Methods With Seldinger's technique ,digital subtraction angiography of superior mesenteric artery and hepatic arteriography were performed on 3 patients with hemobilia, two of whom manifested hemobilia after the operation of liver trauma and one of whom did after the operation of command bile duct stones . Arteriography showed the bleeding vascular branch, the false aneurysm and the arteriovenous fistula. And then a small catheter was put into the bleeding focus. The bleeding branch arteries were selectively embolized with embolus of n-butyl cyanoacrylate (NBCA),PVA granule,spring wire loop and gelatin sponge. Results Two cases showed diffuse bleeding focus and another showed a local bleeding focus. Two cases had expression of false aneurysm and one showed expression of ateriovenous fistula. The artery branches of the bleeding focus were successfully embolizated and the hemobilia stopped immediately. Conclusions Vascular intervention is an effective method for the diagnosis and management of hemobilia.

Objective To analyze the demographic characteristics,composition characteristics as well as influencing factors of the cost of hospitalization of patients with lung cancer in Gansu Province in order to help reduce their expenses. Methods The basics,healthcare records and expenses of patients diagnosed with lung cancer in a third-level grade-A hospital in Lanzhou were extracted between 2010 and 2014 through the hospital information system(HIS)database.The Wilcoxon rank-sum test was used to analyze the difference of expense composition over the past five years and the difference between subgroups.The forward,backward and stepwise selection method was used to select variables and the multi-linear regression analysis was adopted to explore the influencing factors of the cost of hospitalization.Results A total of 2778 eligible lung cancer patients were collected.The statistical analysis showed that western medicine cost (36.39%)and treatment cost (22.46%)accounted for the most of the total expense.The length of hospital stay was the No.1 influencing factor of the cost of hospitalization,followed by the acceptance of surgery,the year of admission and charge type. Conclusion Regulating drug use,enhancing treatment regimens,giving psychological guidance,strengthening hospital management and improving medical resources allocation may be effective measures to reduce the cost of hospitalization and lighten the economic burden for lung cancer patients in Gansu Province.

Objective:To explore the expression of IL-5 and its role in the formation and development ofnasal polyp. Method: 31 patients with nasal polyp, 11 patients with chronic sinusitis (CS) and 6 control cases werechosen . Their IL-5 concentration in tissue homogenate were measured by ELISA. All patients with chronic si-nusitis,control cases and 15 patients with nasal polyp were chosen to be counted eosinophils in their HE slice.Result :①The values of IL-5(pg/ml) in nasal polyp,CS and control group separately were .. 23.44± 6.68,16.41±3.09,12.86±4.17. IL-5 concentration in nasal polyp group was higher than that in the other two groups( P ＜0. 001). ②The numbers of eosinophils in nasal polyp ,CS and control group were 7.42±2.33,1.30± 0. 59,1.07±0.70 separately,the numbers of eosinophils in nasal polyp group were higher than that in CR or control group(P ＜ 0.05). Conclusion: Nasal polyp is a disease characterized by eosinophilia, and IL-5 which activateseosinophil plays part role in the formation of nasal polyp.

An analysis of the medical risks exposure for resident doctors in their standardized training,and insights into the risk management measures proposed for this stage.These measures include:1) Pre-control of risks;2) Full-length supervisor of such training stage;3) Systematic education for medical risk exposure;4) Timely guidance on risk identification and response;5) Development of the evidence awareness.

Objective To investigate a method to detect the sentinel lymph nodes(SN) of thyroid papillary carcinoma and its predictive value for cervical metastasis of carcinoma. Methods Intraoperative methylene blue dye mapping was performed in 24 cases of thyroid papillary carcinoma. The coincidence rate of frozen section pathology and routine section pathology of SN was observed,and the predictive value of SN for (metastasis) of the cervical lymph nodes was noted. Results SN was successfully detected in 21(87.5%) of 24 cases. The average number of SN was 3 nodes. There was one false negative case, the false negative rate was 4.8%(1/24), and no false positive cases were found. The predictive value of sentinel lymph nodes to (cervical) lymph node metastasis was 83.3%.Conclusions Methylene blue staining to identify sentinel lymph nodes could accurately predict the status of cervical lymph node metastasis of thyroid papillary carcinoma.

Objective To investigate the imaging methods of multi-slice CT(MSCT) in costicartilage and the diagnostic value in the costicartilage injuries. Methods There were 100 cases in normal group and 36 cases in group of chest injuries. All cases were performed in volume scan according to conventional chest scan by SIEMENS Sensation 4 MSCT, then performed in thin slice low and high contrast image reconstructions. After that, all the source images were input into CT 3D workstations,costicartilage were imaged by postprocessing software such as multiplanar reconstructions(MPR), maximum intensity projection(MIP), surface shade display(SSD) and volume rendering technique(VRT). All the pictures were observed and analyzed by two radiologists. Results All postprocessed images that obtained from the MSCT could show the costicartilage clearly. Normal costicartilage displayed uniform density,regular shape and smooth surface;there were 6 injuries in 10 cases with costicartilage injuries,which displayed no uniformity density or cranny in costicartilage and showed cranny in 2 cases. No significant difference of image quality was found among the three imaging modes of MIP、SSD、VRT(?2=1.356, P=0.716). [JP2]Significant differences were found between MPR and other three imaging modes(U_ MIP:MPR=[JP]12.981,U_ SSD:MPR=12.652, U_ VRT:MPR=12.937, P=0.000). Conclusion So far, the MSCT is the best noninvasive imaging method to show the shape of costicartilage, it may be considered as a clinical “gold standard” in the diagnosis of costicartilage injury.

0.05).(2)In 67 cases with pre-and post-image selection and reconstruction in single-slice or twin-slice helical CT,the slice concordance rate in measurement was 20.98% and 97.01%,respectively(?2=80.22,P=0.00).The slice concordance was all accomplished with the same method in multi-slice helical CT in 5 cases.(3)Peak heights and SPN-to-aorta ratios of malignant [(38.48?14.32)HU,(19.64?9.52)% ] and inflammatory SPN [(42.48?11.55)HU,(21.14?7.77)%] were significantly higher than that of benign SPN [(9.52?3.78)HU,(3.41?1.86)%,P0.05).Slice optimization of dynamic contrast-enhanced CT scan improved the diagnostic accuracy of SPN from 78% to 80%.Conclusion No significant efficacy was found in the attenuation between primitive images and reconstructive images with the same slice thickness of homogenous material.Slice concordance of dynamic contrast enhanced spiral CT could reflect objectively the morphological appearance and CT value changes of solitary pulmonary nodules,and may improve the veracity of diagnosis.

Objective To observe the relationship between CT signs, prognosis and the expression of CD44v3 and CD44v6 in peripheral non-small-cell lung cancer (NSCLC). Methods The expression of CD44v3 and CD44v6 was detected with immunohistochemistry (SP method) in 46 patients with peripheral NSCLC confirmed by surgery and pathology. The expression, CT signs and prognosis of NSCLC were analyzed respectively. Results The expression of CD44v3 and CD44v6 correlated with deep lobulation, spinous protuberant sign, short spiculation and lymph node enlargement of hila or mediastinum (P<0.05), but not with the tumor size, vacuole sign, vessel convergence sign and pleural indentation in CT images of peripheral NSCLC (P＞0.05). The expression of CD44v3 and CD44v6 correlated with the three-year survival rate in peripheral NSCLC patients (P<0.05). Conclusion Deep lobulation, spinous protuberant sign, short spiculation and lymph node enlargement of hila or mediastinum may indicate strong potential invasion and metastasis in peripheral NSCLC. The positive expression of CD44v3 and CD44v6 may suggest shorter survival time and poorer prognosis in peripheral NSCLC patients.

Objective: To explore the IL\|5 values in the tissue and secretion of nasal polyp. Methods: The concentrations of IL\|5, either in tissue homogenate or in nasal secretion, were measured by ELISA. The values of total protein in tissue homogenate were measured by Bradford colorimetry. In this study, 31 cases with nasal polyp, 8 patients with perennial allergic rhinitis (PAR), 11 cases with chronic sinusitis (CS) and 6 control cases were chosen. Results: ① In tissue homogenate, the IL\|5 concentrations of nasal polyp were higher than that in CS or control group (P＜0.001). ② In nasal secretion, IL\|5 values of both nasal polyp and PAR group were significantly higher than that in CS or control group (P＜0.05). ③ When all cases or only patients with nasal polyp were taken as the subjects, the Pearson correlation coefficient were 0.70, 0.66 respectively. Conclusions: IL\|5 values, both in tissue homogenate and nasal secretion, are significantly higher, which suggested that there were a close relationship between IL\|5 and nasal polyp, and IL\|5 play a key role in the formation of nasal polyp.