Objective To study the effects of organ dose modulation (ODM) technique on dose reduction of the breasts and the related thoracic image quality in female chest CT.Methods One hundred and twelve female patients with chest CT were enrolled in this study and divided into two groups according to the order:control group (n =56,using conventional scan) and experimental group (n =56,using ODM technique).The tube currents in different directions (A/L/P/R) were analyzed in the two groups.The effects of ODM on the radiation dosage and image quality were assessed.Results The tubc currents in anterior and posterior direction were both (128 ± 43)mA in the control group.However,the tube current in the anterior was lower than that in the posterior in experimental group (t =-18.701,P ＜0.01).The tube currents in all direction in the experimental group were all lower than those in the control group (t =11.71-20.22,P ＜0.01).The CTDIvol and E in the experimental group were lower than those in the control group(t=3.58,3.55,P ＜0.05).There were no significant differences for the objective and the subjective scores between two groups (P ＞ 0.05).Conclusions ODM technique could protect the female breasts by reducing the radiation dose without image quality degrading during chest CT scan.

Objective To observe the effect of low concentration Aβ1-42 monomer/oligomers and CORM-2 in different concentration on livability of SN56 cells. Methods SN56 cells were cultured in the 96-well plate with uniform concentration, and were divided into control group, Aβ1-42 group, Aβ1-42 + CORM-2 50μM group, and Aβ1-42 + CORM-2 100 μM group. Three lines of cells in Aβ1-42 group were cultured in the surroundings of 10nM,100nM and 1 μM Aβ1-42monomer/oligomers, respectively. Aβ1-42 + CORM-2 50μM group and Aβ1-42 + CORM-2 100μM group had the same culture condition as group Aβ1-42 ,except contain 50μM, and 100μM CORM-2, respectively. Control group didnt have any effect factor. Three days later,the livability of different groups was compared with MTT method. Results The livability of group Aβ1-42 with the increasing concentration of Aβ1-42 was (79.73 ±0.94)% ,(67.99 ±0.79)% ,(60.42 ±0.62)% , respectively. The higher the concentration of Aβ1-42 was,the lower the livability of SN56 cell was. The livability of group Aβ1-42 + CORM-2 50μM/100μM was( 75.15±0.096)%,(63.20 ±0.17)%, (55.33 ±0.19)%; (73.20 ±0.27)%, (64.34 ±0.11 )%, (54.17 ±0.12)% , respectively. Both were lower than group Aβ1-42. And different CORM-2 concentration had discrepancy in the ability of decreasing the cell livability. Conclusion Low concentration of Aβ1-42 can reduce the livability of SN56 cells, and higher concentration has more significant effect; CORM-2 in different concentration both can decrease the livability of SN56 cells,and there is a discrepancy in the intensity.

Objective To investigate the expressions of protein kinase B (PKB/Akt) and glycogen synthase kinasc-3β in the hippocampus in mice with vascular dementia (VaD) induced by repetitive bilateral common carotid artery occlusion.Methods Forty-eight healthy adult male C57B1/6 mice were randomly allocated into 3 group:normal group,sham operation group,and model group (n =16 in each group).A mouse VaD model was induced by intermittent blocking the bilateral common carotid artery for 3 times in the model group.The sham group only separated the bilateral common carotid artery,but did not block it.The normal group did not receive any treatment.The behavioral changes of the mice were observed using the water maze and step-down tests at 4 weeks after procedure.HE staining was used to observe the histopathological changes of hippocampal tissue.The Western blotting was used to detect the expressions of Akt,p-Akt (Ser473),GSK3β and p-GSK3β (Ser9) proteins.Results In the water maze test,the time of swimming the entire distance was prolonged at the learning stage and memory stage (learning stage:F =19.389,P ＜0.05; memory stage:F =27.929,P ＜ 0.05),the number of errors increased (learning stage:F =7.228,P ＜ 0.05; memory stage:F =21.189,P＜0.05) in the model group.In the step-down test,the response time was prolonged (F=19.162,P ＜0.05) at learning stage and the number of errors increased (F =6.562,P ＜ 0.05),the latency time was shortened (F=10.634,P＜0.05) and the number of errors increased (F=12.890,P＜0.05) in the model group.At the same time,HE staining showed the reduction of neurons and the proliferation of glial cells in the hippocampal CA1 region in the model group; p-Akt (Ser473) (F=37.849,P＜0.05) and p-GSK3β (Ser9)(F =67.725,P ＜0.05) protein expressions were up-regulated significantly (F =37.849,P ＜0.05; F =67.725,P＜0.05) at 4 weeks after procedure compared to those in the sham operation group,while there were no significant differences in Akt (F =1.004,P ＞0.05) and GSK3β(F =0.329,P ＞0.05) total protein expressions among all groups.Conclusions The repetitive bilateral common carotid artery occlusion may result in learning and memory impairment and severe damage in the hippocampus in mice.The Akt and GSK3β expressions may be involved in the mechanism of VaD.

Objective To investigate the value of partial hepatectomy and vascular resection in the treatment of hilar cholangiocarcinoma. Methods Seventy four patients with hilar cholangiocarcinoma who underwent hepatectomy of Chinese People' s Liberation Army from January 2008 through December 2011 were analyzed retrospectively.Results Of the 74 patients,33 underwent radical resection and 19 palliative resection,22 received internal or external drainage.In the radical resection group,the median survival time was 27 months,and the overall survival rate at 1,2 and 3 years were 79％,64％ and 49％.In the palliative resection group,the median survival time was 14 months and the overall survival rate at 1,2 and 3 years were 56％,25％,and 19％.In the drainage group,the median survival time was 9 months and the overall survival rate at 1,2 and 3 years were 23％,15％,0.Conclusions Hepatectomy combined with hilar vascular resection helps increase survival rate of patients in radical excision of hilar cholangiocarcinoma and Surgical resection is the most elective method for treatment of hepatic hilar cholangiocarcinoma,and the radical resection might improve the prognosis of the patients with hilar cholangiocarcinoma.

Objective To investigate the expression pattern of transcription factor Olig 2 in cuprizone-induced mouse model of acute demyelination .Methods C57BL/6 mice were fed with 0.2%cuprizone to induce acute demyelina-tion.Immunofluorescence and qRT-PCR were used, and Olig2, MBP and GFAP were detected in the brain tissues of con-trol group and cuprizone-treated groups for 6 weeks and recovery for 2 weeks.Results Severe demyelination occurred in the corpus callosum following 6-weeks exposure to cuprizone , while remyelination was detected in the white matter after the mice were given diet without cuprizone .In the normal mice , Olig2 was expressed in a low level , while the experessions of Olig2 and GFAP were significantly increased , and Olig2 +/GFAP+cells were detected after demyelination .But the expres-sion of MBP was below the normal level with demyelination .After recovery for 2 weeks, the experession of Olig2 was lower, but the experessions of MBP and GFAP were increased .Conclusions Olig2 may play an important role in the glial differ-entiation from neural progenitor cells into active astrocytes , and in the glial scar formation .

Objective To determine the effects of different doses of cisatracurium on motor e-voked potential of neurosurgery operation.Methods Sixty patients,36 males and 24 females,aged 18 to 65 years,ASA physical status Ⅰ or Ⅱ,scheduled for spinal surgery with motor evoked potential monitoring,were included and randomly assigned to three groups.A single dose of cisatra-curium besilate for injection was given by intravenous injection in 5 s after the induction of general an-esthesia,respectively 0.1 mg/kg (group A),0.1 5 mg/kg (group B)and 0.2 mg/kg (group C).Cas-cade Elite 32 channel monitor was used to monitor MEPs,the electrode was stimulated for once two minutes after given the muscle relaxant,and the leading time of the wave of MEPs was recorded. Cooper’s score was used to evaluate the intubation conditions.Results The appearance time of the wave of motor evoked potentials was significantly longer in group C [(39.60±1.79)min]than that in groups A [(20.10 ± 1.89 )min]and B [(20.50 ± 1.93 )min](P < 0.05 ).The intubation conditions was significantly better in group B (100%)and C (100%)than that in group A (65%)(P<0.05).Conclusion The shortest time to elicit waveform of MEPs using the dose of cisatracurium is 0.1 5 mg/kg at induction of general anesthesia,which is better for tracheal intubation.The dose 0.1 5 mg/kg of cisatracurim is recommended as the initial dose on neurosurgery operation with motor e-voked potential monitoring.

Objective:To analyze the effect of permissive hypercapnia(PHC) in premature infants with respiratory distress syndrome(RDS).Methods:Seventy preterm infants diagnosed with RDS from July 2019 to September 2020 were enrolled.The preterm infants were divided into PHC group[noninvasive high-frequency ventilation(NHFV)+ PHC, n=34] and non PHC group(NHFV, n=36)after injection of pulmonary surfactant by LISA method.Ventilator parameters, time of ventilation, oxygen therapy, enteral feedingand hospitalization days were compared between the two groups.The incidences of patent ductus arteriosus, intracranial hemorrhage, pneumothorax and ventilator-induced lung injury were recorded. Results:The time of mechanical ventilation, oxygen therapy, age of enteral feeding and hospitalization time in PHC group were less than those in non PHC group( P<0.05). PaO 2 and PaCO 2 of the two groups had no difference before mechanical ventilation treatment( P>0.05), and PaO 2 of the two groups had no difference after 24 hours of treatment( P>0.05). After treatment, PaCO 2 in non PHC group was significantly lower, and there was no significant difference in PHC group( P<0.05). There was no significant difference regarding ventilator parameters MAP and FiO 2 after 24 hours of treatment between the two groups( P>0.05), and the ΔP of PHC group was significantly lower than that of non-PHC group ( P<0.05). The incidence of ventilator-induced lung injury in PHC group was lower than that in non-PHC group( P<0.05). Conclusion:Compared with conventional ventilation therapy, PHC has similar therapeutic effect, but it can shorten the mechanical ventilation time, oxygen therapy time, age of enteral feeding and hospitalization days, and reduce the incidence of ventilator-induced lung injury.

Objective:To explore the influence of deep learning reconstruction algorithm combined with low-dose CT on image quality and bone mineral density measurement and the application value in opportunistic osteoporosis screening.Methods:A total of 119 patients (aged ≥40 years) who underwent a combined chest and upper abdominal low-dose scan were prospectively included. All the images were reconstructed using filtered back projection(FBP) alogrithm, hybrid model-based adaptive statistical iterative reconstruction (ASIR-V) 50% and three levels of deep learning reconstruction algorithm respectively. Bone mineral density (BMD) values for different reconstruction conditions were measured and compared using asynchronous quantitative CT software. The signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of descending aorta, liver and spleen were calculated, and the image noise was the standard deviation of anterior abdominal wall fat and the image quality was objectively evaluated by using the five-point subjective evaluation method. The objective and subjective image quality of different body parts with different reconstruction method was compared.Results:There was no statistical difference in BMD with different reconstruction method ( P > 0.05). Compared with ASIR-V 50%, the SNRs of high level deep learning image reconstruction (DLIR-H)in descending aorta, latissimus dorsi, liver and spleen were increased by 103.88%, 125.09% and 136.13% respectively, and the image noise was decreased by 55.98%. Both the CNR and subjective scores (except the ability to display lung lesions) of DLIR-H were better than those of DLIR-L and ASIR-V 50% ( χ2 =158.31-275.35, P<0.001). Conclusions:The deep learning algorithm does not affect the accuracy of bone mineral density measurement, and the image quality is better than that of ASIR-V 5%. Deep learning algorithm combined with low-dose CT can be used for opportunistic osteoporosis screening.

Objective This study was conducted to analyze the clinical characteristics and pituitary function of patients with primary empty sella (PES).Methods The clinical data from 123 hospitalized adult patients with PES from January 2010 to May 2016 were retrospectively studied.Results (1) The average age of the 123 (male 43,female 80) PES patients was (59.2 ± 13.6) years (ranging 24-92 years),among whom 61％ patients were in the age group between 50-69 years.(2) The symptoms of the patients included fatigue (56.1％),headache (34.1％),nausea and vomiting (17.9％),gonadal dysfunction (17.1％),visual disturbance (5.7％) and hypopituitarism crisis (3.3％).(3) Hypopituitarism was found in 66 of the 123 patients.Among them,36.6％,31.7％ and 17.1％ were central hypoadrenalism,hypogonadism,and hypothyroidism,respectively.The percentage of hypopituitarism in complete PES was significantly higher than that in partial PES (P ＜ 0.05).(4) Sixteen patients were concomitant with other autoimmune diseases including 11 patients with Graves' disease and 2 with Cushing's syndrome due to adrenal adenoma.Conclusions The incidence of hypopituitarism in PES was 53.7％,in which the pituitary-adrenal axis hypofunction was more common.An overall evaluation of the pituitary function was essential for the patients who had headache and fatigue,or with suspected PES.The patients with hypopituitarism should be given hormone replacement therapy in time and followed up afterword.

Objective To investigate the correlation between mammographic findings and different molecular subtypes of breast cancer.Methods Totally 84 patients with breast cancer proved pathologically who underwent digital mammography examination before operation were enrolled.All cases were examined by immunohistochemical staining,the expression levels of estrogen receptor(ER),progesterone receptor (PR)and human epidermal growth factor receptor-2(HER-2)in tumor cells were analyzed.They were classified into four molecular subtypes:Luminal A,Luminal B,HER-2 + and Basal-like tumors according to their expression levels.The correlation between mammographic findings and different molecular subtypes of breast cancer were analyzed.Results Among the 84 cases of breast cancer,there were significant differences between mass shadow and mass shape in the four subtypes of tumors(P<0.05).Luminal A,Luminal B breast cancer showed more irregular edge of the tumor;HER-2 + breast cancer with more malignant calcifications,of which simple calcifications of breast cancer were more;Basal-like breast cancer with regular shape,clear border shadow,rarely accompanied by malignant calcifications.Conclusion Mammographic features of breast cancer can predict its molecular subtypes to some extent,which can provide objective basis for the selection of clinical preoperative treatment protocols.