Objective To study the imaging findings of atypical thymoma.Methods 16 patients with atypical thymomas confirmed by pathology were involved in this study.Results In 16 cases,the all tumors appeared as soft tissue masses in anterior mediastinum,other imaging findings included lobulated sign in 12,calcification with in the tumors in 9,directly invasion to adjacent fatty tissue in 13 and mediastinum pleural and anterior chest wall in 7.The ipsilateral mediastinum pleural planting in 8,vascular involvement in 7 and pleural effusion in 6,pericardium effusion in 3 were showed.The tumors with smooth margins and clear surrounding fatty tissue were seen in 3,that were really simulating the benign thymoma.Conclusion Atypical thymoma are of certain imaging characteristics.

As the development of clinical medicine has depended on modern medical equipment increasingly,clinical medical engineers have become the bridges between modern clinical medicine and engineering.They keep the normal running of hospitals and promote the hospital modernization.The equipment service & maintenance isn't the only responsibility of medical engineers.In fact,engineers should be responsible for all medical activities relevant to engineering equipment.The main tasks of engineers should shift from the equipment service & maintenance to the application safety and quality control in the whole process of the equipment usage,which include equipment application safety and risk control,failure service and preventive maintenance,quality control and management,measurement and monitor of adverse event,etc.

With wide range applications of the ultra-large-scale integrated circuits, multilayer circuit board and components surface welding technology, clinical medical engineers have been confronted with challenges in the service and maintenance of largescale medical equipments and the traditional model has faced the great challenges too. The clinical medical engineers should be actively get involved in operation, maintenance and service of large-scale medical equipment, in the same time; it's necessary for buying suitable service supply, protecting the smooth function of large- scale equipment and meets the clinical needs.

Objective To assess the quality of coronal multi-planar reconstructed versus direct coronal scan images and to confirm whether the multiplanar reconstructed image can replace coronal scan.Methods One hundred and sixteen patients with orbital and paranasalsinuses disease were examined with GE Lightspeed plus 4 slices helical CT.All patients had transvers scan,and the coronal multiplannarreconstructed images were reformatted basis on transverse scan.All reformatted and scanned images were evaluated by the senior radiologists.Results In 116 cases,simultaneously multiplanar reconstructed images were performed in 60 cases,the quality of reformatted coronal imageswas similar to direct coronal scan in revealing normal anatomy and lesions of orbit and paranasal sinuses,all images were excellent andimaging quality was grade Ⅰ.54 cases couldn't be undergone direct coronal scan but reformatted coronal images also acquired the effect of diagnosis(32 cases were grade Ⅰ and 3 cases were grade Ⅱ on quality).Conclusion Direct coronal scan can be substitued by multiplanar reconstruction of multi-slice helical CT scan for orbit and paranasal sinuses.

Objective The aim of this randomized,double-blind,placebo-controlled trial was to evaluate the efficacy of the Saccharomyces boulardii (S.boulardii) power in preventing antibiotic-associated diarrhea (AAD) in hospitalized children with pneumonia.Methods Two hundred and forty-five hospitalized children with pneumonia were randomly divided into two groups,group 1 treated with antibiotics and S.boulardii power (n =104),and group 2 with antibiotics and placebo,along with S.boulardii power and zinc when suffered from diarrhea (n =141).All children received montmorillonite powder and fluid replacement therapy for diarrhea.The stool frequency and consistency were observed.Diarrhea incidence,diarrhea and pneumonia duration of treatment,and therapeutic effect were recorded.Results AAD is more prevalent in group 2 than in group 1 (P ＜0.05).A 55.7％ relative risk reduction in AAD was seen in group 1 compared with group 2 (RR =0.443,95％CI 0.233 ～ 0.845,P =0.012).Patients with preventive treatment of S.boulardii power in broup 1 had lower AAD incidence compared with those in group 2 (P ＜ 0.05).Both the diarrhea and pneumonia duration of treatment in group 1 were shorter than that in group 2(P =0.001 for diarrhea duration,P =0.030 for pneumonia duration,respectively).No drug related adverse reactions were found during the observation period.Conclusion Preventive use of S.boulardii power may effectively reduce the risk of AAD,improve therapeutic effect,and shorten hospital stays for hospitalized children with pneumonia.

Objective To investigate the relationship between coagulation function and pediatric critical illness scores (PCIS) in children with severe pneumonia.Methods The PCIS were collected in 152 children with severe pneumonia (pneumonia group) admitted in our pediatric intensive care unit from Jan 2010 to Jul 2011,and 20 healthy children in the same period were selected as the healthy control group.The coagulation indicators of children in both groups were detected and the relationship between coagulation markers and severity of pneumonia was analyzed.Results There were significant differences in platelet count,fibrinogen,D-Dimer,soluble P-selectin between pneumonia group and healthy control goup [(185.74 ±116.26) × 109/L vs (287.10 ±90.01) × 109/L,(3.51 ±0.50) g/L vs (3.15 ±0.15) g/L,(1.39 ±2.18) μg/ml vs (0.36 ± 0.07) μ g/ml,(110.07 ± 83.47) ng/ml vs (33.74 ± 9.47) ng/ml,P ＜ 0.05].There were positive correlation between soluble P-selectin,D-Dimer and severity of disease and negative correlation between platelet count and severity of disease in children with severe pneumonia.Regression equation:y =1.154 +0.003 × soluble P-selectin + 0.089 × D-Dimer-0.001 × platelet count (P ＜ 0.05).As the children's critical condition getting worse,soluble P-selectin and D-Dimer levels increased (P ＜ 0.05).Hatelet count showed no significant difference between critical group and extremely critical group,which was significantly lower than that in non-critical group (P ＜ 0.05).Conclusion Soluble P-selectin,D-Dimer,and platelet count are associated with the severity of pneumonia.The children with severe pneumonia are easy to have coagulation disturbance.

The activity of matrix metalloproteinases (MMPs) in the uterine flushing and endometrial tissue of normal adult women wearing FCu-IUD (fixed Cu-IUD) or FICu-IUD (indomethacin-releasing FCu-IUD) was observed by using zymography on SDS-PAGE containing gelatin. The results showed that the activity and kinds of MMPs in FCu-IUD group were increased significantly as compared with themselves before being inserted FCu-IUD. However, compared with the FCu-IUD group, the activity of some kinds of MMPs in the FICu-IUD group was decreased significantly. These data suggest that IUD can enhance the activity of MMPs in human endometrium, intermediated by prostaglandins, and MMPs may have relation to IUD-induced menorrhagia and indomethacin reduces IUD-induced menorrhagia by partly inhibiting MMPs synthesis.
Endometrium/*enzymology ; Indomethacin ; Intrauterine Devices, Copper/*adverse effects ; Intrauterine Devices, Medicated/*adverse effects ; Matrix Metalloproteinases/*metabolism ; Uterine Hemorrhage/etiology ; Uterine Hemorrhage/prevention & control

Objective To study the diagnostic value of endoscopic ultrasonography (EUS)for benign and malignant bile duct stricture.Methods Data of 51 patients who underwent EUS from January 2007 to March 2015 due to distal biliary stricture were retrospectively studied.And their diagnosis with EUS,IDUS,bile duct cytological brushing and final diagnosis were compared.Results Malignant bile duct stenosis were finally confirmed in 19 cases and benign stenosis were confirmed in 32 cases.The sensitivity (73.7％ VS 57.1％) and positive predictive value (73.7％ VS 57.1％) of EUS for the benign and malignant diagnosis of biliary tract stenosis were significantly higher than that of IDUS (P＜0.05),while their specificity(84.4％ VS 84.2％)and accuracy(80.4％ VS 76.9％)were similar.The sensitivity of EUS was significantly higher than that of bile duct cytological brushing (73.7％ VS 50.0％),while their specificity (84.4％ VS 100.0％)and accuracy(80.4％ VS 81.6％)were similar.EUS findings of hypoechoic mass features had higher diagnostic accuracy for detecting malignant distal bile duct stricture than irregular thickening of the lumen in the distal bile duct (100.0％ VS 64.3％,P＜0.05).Conclusion For patients with lesions of the distal bile duct that CT/MRI could not diagnose,EUS has an important value for the further diagnosis of benign and malignant bile duct stricture.

Objective To evaluate the risk factors,treatment and follow-up of capsule retentions after capsule endoscopy examination.Methods A total of 1 100 capsule enteroscopic examinations,performed at our hospital from October 2006 to March 2013,were retrospectively studied.The positive findings of lesions, clinical indications of capsule endoscopy,treatment and follow-ups were recorded.Results The incidence of capsule retentions was 1.18%(n =13).The rates of capsule retentions in OGIB,suspected Crohn′s disease (CD),known CD,suspected tumors and chronic abdominal pain were 0.95%,4.0%,10.5%,7.1% and 0.3%,respectively.In 11 patients,the capsule was removed by means of double-balloon enteroscopy,the cap-sule was removed surgically in one patient,and spontaneous expulsion occurred in another patient after 1 year of treatment.Risk factors for capsule retention were known or suspected CD and suspected tumor(OR =11.44, P =0.02;OR =5.59,P =0.02),and suspected tumor was also a risk factor(OR =7.42,P =0.04).Conclu-sion Capsule endoscopy is a safe procedure with low risk of capsule retentions.Advantages and disadvantages of capsule endoscopy examinations should be considered carefully when high-risk patients are involved.

Objective To evaluate the effectiveness and safety of double balloon enteroscopy( DBE) in retrieval of retained capsule and identify the factors associated with successful retrieval. Methods A total of 23 consecutive retention cases who received retrieval of retained capsules by DBE from January 2010 to December 2013 were reviewed. They were assigned to success group and failure group. The differences in insertion route, insertion depth, lesion location between the two groups were analyzed. Results Fifteen cases of all 23 retention cases were successfully retrieved and the success rate was 65?2%. There was no significant difference in the mean entrapped period of CE between the two groups [20?0(15?0,57?0)d VS 21?0(16?0,240?0) d,P=0?525]. DBE via oral route exhibited remarkable higher success rate than anal route [ 71?4%( 15/21) VS 0/5, P=0?007] . Compared with ileum, it was easier to take out CE located at jejunum( 8/8 VS 7/13, P=0?046 ) and the insertion depth was significantly less in the success group [(167?3±33?8)cm VS (258?3±23?9) cm, P=0?041]. Whether the capsule was in pelvic cavity shown by x?ray film before the surgery was irrelevant to the successful rate(9/14 VS 5/6,P=0?613) and insertion depth of the DBE on access to the capsule[(132?0±68?6) cm VS (200?0±40?3) cm, P=0?376],or to the actual location of the capsule. Conclusion Peroral DBE is an effective method for removal of retained CE and the success rate isn′t relevant to the entrapped period. Retained CE locates in ileum and jejunum is more difficult to be taken out than in duodenum.