Objective Based on the technique of computer network communication,to design and construct a mini medical picture archiving and communication systems (mini-PACS) in radiological department.Methods Radiologic information networks were composed of Anke SCT scanner, GMS and SHIMADZU digital radioscopy, SGI picture workstation, laser film printer, Dell server and report terminal computers with DICOM 3.0. Mini-PACS was constructed with radiological networks mentioned above and local area networks (LAN) existing in our hospital. Network parameters were set and network communication software FTP2000 was used to transport data. Radiological diagnosis and report program was edited with Visual Basic 6.0 (VB6.0).Results Five functions such as image acquirement, data transport and share, data archiving, report and print, register and statistics could be realized by mini-PACS. The system was stable for about 2600 cases during 420 days and no obstacle could be found after simple maintenance.Conclusion The mini-PACS can realize the five functions. Mini-PACS is practical, stable, safe and easy to maintain. It playes an important role in economic management and scientific research.

Objective To evaluate the imaging features of ulcer-like projections (ULP)and penetrating atherosclerotic ulcers (PAU)of intramural hematoma(IMH)using dual-source CT (DSCT).Methods Retrospectively analysis of DSCT imaging data of 1 12 patients in our hospital was performed.The shape of hematoma and location of ULP and PAU were evaluated Stanford A and B IMH depicting on DSCT images.The maximum diameter of aorta,maximum thickness of hematoma,deepness of ulcer were com-pared between in patients of IMH with or without ULP and PAU.Results IMH manifested as circular or crescent high density on plain scan and without contrast enhancement on DSCT images in 1 12 cases.Among of them,68 cases(68/1 12,61%)of IMH had ULP or PAU,in which there were 21 cases(21/1 12,1 9%)with ULP and 47 cases(47/1 12,42%)with PAU,the mean maximum depth was (0.48±0.1 5)cm in ULP and (1.08±0.56)cm in PAU.There were 4 cases with ULP and 9 cases with PAU in 29 cases of Stanford type A,while 1 7 cases with ULP and 38 cases with PAU in 83 cases of Stanford type B.There were 14 cases with single ULP and 7 cases with multiple ULP in 21 patients with ULP,while there were 27 cases with single PAU and 20 cases with multiple PAU in 47 patients with PAU.There were 1 9 cases with both PAU and ULP.There was statistical significance that PAU occurred more likely in the descending aorta and distal aorta than that in ULP (P =0.028).Conclusion IMH patients are susceptible to ULP and PAU,DSCT can objectively evaluate CT features of ULP and PAU of IMH.

Objective:To explore the obliteration of the old mastoid cavity and reconstruction of the posterior canal wall after radical mastoidectomy. Method:Posterior canal wall reconstruction and mastoid obliteration of 11 ears of 10 patients with old mastoid cavity for 1 to 6 years after radical mastoidectomy were done using the pedicle postauricular composite skin flap (PPCSF),and their tympanoplasty were performed at the same time. Follow-up was performed at 3 to 30 months. Result:All PPCSFs survived. The old mastoid cavity of 11 ears vanished and reconstructed posterior canal wall remained in normal position without retraction. The drying ear time took 2 to 3 weeks postoperatively,and the symptoms of the radical cavity disease after radical mastoidectomy were cleared up nearly,and the average hearing threshold decreased 13.6 dB HL. The otorrhea and perforation of tympanic membrane resulted from infection happened to 1 of 11 ears three month after the operation. Conclusion: The PPCSF is an effective method in the obliteration of old mastoid cavity and reconstruction of the posterior canal wall. It can reduce drying ear time postoperatively, treat the radical cavity disease after radical mastoidectomy and is beneficial to the tympanoplasty at the posterior external at the same time.

Objective·To evaluate the clinical value of two-dimensional ultrasound combined with four-dimensional color Doppler ultrasound in the diagnosis of uterine space-occupying lesion.Methods·A total of 75 patients with uterine space-occupying lesion were enrolled in this study from March 2015 to February 2016 at Hospital of Southwest Medical University.Patients received both two-dimensional ultrasound and four-dimensional color Doppler ultrasound to determine the location,number and nature of the lesions,as well as the clinical staging of malignant lesions,then the diagnostic accuracy was evaluated.Results·Among 75 patients,there were 26 cases with endometrial carcinoma,21 cases with hysteromyoma,16 cases with metropolypus,and 12 cases with uterine adenomyosis.The diagnostic accuracy of two-dimensional ultrasound combined with four-dimensional color Doppler ultrasound for the uterine space-occupying lesion was 88.0％,which was significantly higher than that of two-dimensional ultrasound (64.0％) (P＜0.05).What's more,the diagnostic accuracy of two-dimensional ultrasound combined with four-dimensional color Doppler ultrasound for the clinical staging of endometrial carcinoma was 88.5％,which was significantly higher than that of two-dimensional ultrasound (61.5％) (P＜0.05).Conclusion·Two-dimensional ultrasound combined with four-dimensional color Doppler ultrasound is more effective to improve the diagnostic accuracy of uterine space occupying lesion and clinical staging of endometrial carcinoma in comparison with two-dimensional ultrasound,which will favor the clinical strategy for the treatment of uterine space-occupying lesion.

Objective To study CT and MRI findings of esthesioneuroblastoma.Methods Nine cases of esthesioneuroblastoma proved pathologically were presented.There were four male and five female,with mean age of 34.6 years.CT scan in four cases and MRI in seven cases were done and 2 cases had enhanced MRI.Results The location of lesions were in nasal cavity in 2 cases and in nasoethmoid region in 7 cases.Among nine cases,six cases were seen in the right side,and three cases in the left side.On CT and MRI,the lesion demonstrated a destructive solid mass,CT value ranged 29～36 HU.The lesions appeared as hamogeneous signal intensity which was higher than tongue muscle on T_1WI,and higher than grey matter on MRI T_2WI . Turbinal and ethmoid bony destruction were showed on all nine cases. The lesions invaded into opposite nose and ethmoid sinus in four cases,intruded into intracrainial cavity in eight cases, frontal sinus in six cases, orbit in eight cases in which two cases had eye protrusion, maxillary sinas in five cases and sphenoid sinus in five cases.Conclusion A esthesioneuroblastoma can be considered if a destructive solid mass occurs in nasal cavity and ethmoid sinus,with a middle signal intensity on T_2WI.

Objective To explore the causes of negtive results on emergency CT and prevent method in craniocerebral trauma.Methods 51 cases of craniocerebral trauma with negtive results on emergency CT were analyzed respectively during 2002 to 2004.Results The causes of negtive results on emergency CT in craniocerebral trauma were:the insufficient experience for technicians and doctors (12.8%);the atypical signs in early phase(48.6%);the delayed lesions after injury(16.2%) and the limitation of CT (24.2%).Conclusion CT technicians and doctors should be well trained primarily. Furthermore, CT images, clinical manifestations and other examinations should be combined with to obtain precise diagnosis. Finally, uncertaint cases should be examined again with CT or MRI.

Objective: To explore the necessity for application of bone wax stanching bleeding at sternal edge in cardiac surgery by median sternotomy. Methods: A total of 445 patients who receive cardiac surgery by the same surgeon performing median sternotomy in our hospital from 2011-01 to 2014-12 were studied. According to application of bone wax stanching bleeding, the patients were divided into 2 groups: Bone wax group,n=210 and Non-bone wax group,n=235. Re-thoracotomy for hemostasis, 12 h, 24 h and total draining volume after the operation and time of closing incision were compared between 2 groups. Results: There were 2 patients and 1 patient received re-thoracotomy for hemostasis in Bone wax group and Non-bone wax group respectively, which was not related to bone marrow cavity bleeding. In Bone wax group and Non-bone wax group, the draining volume at 12 h post-operation were (451 ± 240) ml vs (483 ± 238) ml, at 24 h post-operation were (615 ± 304) ml vs (639 ± 285) ml and the total volume were (842 ± 467) ml vs (842 ± 364) ml, allP>0.05; the time of closing incision were (68.0 ± 23.0 ) min vs (66.0 ± 19.0 ) min,P>0.05; the total transfusion rates were 21% vs 19%,P>0.05. Conclusion: Application of bone wax at sternum edge could neither affecting the drainage nor the speed of closing incision in cardiac surgery and therefore, it might be given up.

Objective:To investigate the efficacy and safety of ticagrelor and clopidogrel in patients with coronary atherosclerotic heart disease (CHD) and hyperhomocysteinemia (Hhcy).Methods:A total of 101 patients with CHD complicated with HHcy who had successfully undergone percutaneous coronary intervention (PCI) were enrolled. They were divided into ticagrelor group ( n=49) and clopidogrel group ( n=52) according to the different antiplatelet drugs used. The clinical data of the two groups were collected, and the incidence of major cardiovascular and cerebrovascular adverse events (MACCE) and bleeding events in one year were compared between the two groups. Results:There was no statistical difference in baseline datas and PCI datas between the clopidogrel and ticagrelor groups ( P>0.05). Compared with clopidogrel group, ticagrelor can reduce the total MACCE (8.16% vs 32.69%, P<0.05) and the incidence of unstable angina pectoris events (0 vs 13.46%, P<0.05) in patients with hyperhomocysteinemia PCI 1 year after operation. The incidences of ischemic stroke, unstable angina pectoris, recurrent myocardial infarction, and cardiogenic death were compared separately between the two groups, and the difference was not statistically significant ( P>0.05). The incidence of major bleeding events, minor bleeding events, and minimal bleeding events were similar between the two groups, and the difference was not statistically significant (4.08% vs 0; 4.08% vs 1.92%; 20.41% vs 9.62%; P>0.05). Conclusions:In patients with CHD and Hhcy, ticagrelor can play a better antithrombotic effect, reduce the incidence of ischemic events, and has good security, which is more worthy of clinical recommendation.

Objective To investigate the relationship between cathepsin L and apoptosis cell in rats after cerebral ischemia reperfusion.Methods Sixty healthy male Sprague-Dawley Rats (10-12 weeks old,260-300 g) were chosen.Based on the random number table method,the rats were randomly divided into sham-operated control group (Sham group,n =10),ischemia-reperfusion group (model group,n =25),and Z-FY-DMK intervention group (CLI group,n =25).Rats were randomly divided into 6 h,12 h,24 h,and 48 h four subgroups in model group and CLI group,respectively.Modified transient middle cerebral artery occlusion was made as Longa described,the intervention groups were injected intracerebroventricularly Z-FY-DMK (20 μg / 1μ1 ×5 μl) preoperative 30 min prior to surgery,Sham group and schemia reperfusion injury (IRI) group were injected intracerebroventricularly dimethyl sulfoxide (DMSO) 5 μ1 (10ml/L) at the same time.Cell apoptosis was detected by terminal dexynucleotidyl transferase (TdT)-mediated dUTP nick end labeling (TUNEL) straining.Western blotting was used to detect the expression of cathepsin L and caspase-3.Results In the cortical area of ischemic brain,apoptosis cells of sham operation group were rare,while apoptosis of nerve cells of model group with 6 hours reperfusion were visible,and were gradually increased in the order of 12 hours,24 hours and 48 hours.At the same time point,the apoptosis cells of CL intervention group (6 h,12 h,24 h,48 h) were obviously less than model group (P ＜0.05).Western blotting found little visible cathepsin L protein expression in ischemic cerebral cortex preoptic in the sham group.For model group,the cathepsin L expression initially increased in sub groups with 6 hours reperfusion,reached to a peak in sub groups with 12 hours and 24 hours,and remained a high level in sub groups with 48 hours reperfusion.Compared to model group,the cathepsin L expressions of CL intervention group were obviously decreased at all time points (P ＜ O.05).Conclusions Cathepsin L may be involved in neuronal apoptosis by means of caspases 3 pathway.

Objective To investigate and compare the killing effect of photodynamic therapy (PDT)induced by hematoporphyrin derivative (HpD),hematoporphyrin monomethyl ether (HMME) and photocarcinorin (PsD007) on human leukemia cells K562 in vitro.Methods Human leukemia cells were cultured with serial concentrations of photosensitizers followed by irradiation of different dosage of laser light,then MTT colorimetric assay was applied to measure the relative survival rate of PDT for the cells.Results Significant difference in the inhibitory between the PDT group and control group was observed (P＜0.05).The survival rate of PDT for the cells elevated along with the increase in the concentration of sensitizer and dose of laser light.When the photosensitizer concentration was bigger (25 μg/ml) or the energy density was bigger (7.2 J/cm2),the effect of PsD007 was better than HMME,and they were significantly better than HpD (P＜0.05).Conclusion PDT has significant killing effect on human leukemia cells K562,and its relative inhibitory rate appears to be correlated with the dose of sensitizer and laser light irritation.The effect of PDT is related to the photosensitizers.The effect of HpD-PDT is not as effective as PsD007 and HMME.On the conditions of higher energy density and larger photosensitizer concentration,the effect of PsD007-PDT is better than HMME-PDT.