Objective To study the clinical diagnosis value of the combination application of CT perfusion(CTP) and CT angiography (CTA) in cerebrovascular diseases. Methods 20 patients suspected of cerebrovascular diseases（CVD） were examined with CTP and CTA. All the CTA data were send to 3D post processing card for MIP, SSD and VR reconstruction. Perfusion data were analyzed by CT perfusion package. The absolute TTP, MTT, CBV, CBF values and the relative value between normal and pathological sides were calculated.Results Low perfusion which indicated the prophase of ischemia infarction were detected in 15 cases, 12 cases were located in MCA area, and 10 of them the stenosis of responsible arteries were demonstrated. The degree of the vessel stenosis can be evaluated exactly by CTA source images. Other 5 cases were located in the area of PCA and no positive detection in CTA examination.Conclusion Combined application of CTP and CTA can finish two examinations at the same time in the fast and economic way. Both the hemodynamics changing and the morphology of the vessels were demonstrated which providing omnidirectional pathophysiological information for clinical diagnosis and therapy.

Objective To investigate the effect of ultrasound technology combined with Seldinger technique in the catheteration of peripherally inserted central catheter(PICC).Methods One thousand and eight malignant tumor patients undergoing PICC catheteration were divided into two groups:those with visible or palpable bouncy vein as the control group(n=540)and those with invisible or impalpable elbow vein as the experiment group(n=468).The control group were treated with PICC catheteration into the elbow vein as normal control group and in the experiment group the catheteration was done into the lower part of the upper arm of the basilic vein or brachial vein as the puncture point under the guidance of ultrasound with Seldinger technique.The two groups were compared in terms of success rate of one time puncturing, success rate of one time catheterization and postoperative phlebitis,venous thrombosis and catheter related infection rate.Result There were no significant difference in the success rate for one time puncturing,while the success rate of one time catheterization in the experiment group was significantly higher than that in the control group and the mechanical phlebitis,venous thrombosis,catheter related infection rate in the experiment group were significantly lower than those in the control group(P<0.001).Conclusion Ultrasound technology combined with Seldinger technique for PICC catheterization can obtain high success rate,lower postoperative complications and provide high security.

Objective To study the clinical effect and application value of micro-plasma beam joint radiofrequency treatment for the striae of pregnancy.Methods 21 female patients with the striae of pregnancy were included in this study,treated from the July 2012 to March 2014,aged 25-37 years;and time of the striae was from 3 months to 7 years.Micro-plasma radiofrequency technology was used to treat the striae,with interval of 30 days each time for total seven months.The total effective rate,satisfaction,and the adverse reaction were evaluated after the treatment.Results 21 patients included grade 4 in 6 cases,grade 6 in 10 cases,grade 2 in 4 cases and grade 1 in 1 case;the total effective rate was 95.2％ (20/21).Satisfactory degree was for the level C in 6 cases,B in 14 cases,and A in 1 case,with total satisfactory rate of 95.2％ (20/21).Adverse reactions included mild pigmentation in 2 patients after scab skin falling off,and disappeared at the end of the treatment course.Conclusions Micro-plasma beam combined with radio frequency in treating the striae of pregnancy has clear curative effect and good clinical application value.

Objective: To study magnetic resonance elastography (MRE) technique. Methods: An external force actuator was developed, the imaging pulse sequence of MRE was designed,and tissue simulating phantoms were constructed. The actuator controlled by the pulse sepuence produced shear waves at low frequency on the surface of the phantoms. A modified gradient echo sequence was developed with motion sensitizing gradient (MSG)imposed along X,Y or Z direction.Cyclic displacement within the medium induced by shear waves caused a measurable phase shift in the received MR signal.From the measured phase shift,the displacement at each voxel could be calculated,and the propatating shear waves within the medium were directly imaged. By adjusting the phase offsets,the dynamic propagation of shear waves in a wave cycle was obtained.The phase images were processed to aquire quantitative elasticity image using local frequency estimation(LFE)method. The experiments were implemented with 1.0% and 1.5% tissue simulating agarose gel. Shear waves at frequency of 150 Hz,200 Hz,250 Hz,and 300 Hz were applied. Results: The phase images of MRE directly imaged the propagating shear waves within the phantoms.The wavelength of shear waves varied with the change of exciting frequency and stiffness of the phantoms. The wavelength of shear waves was exactly proportional to the frequency and stiffness of the phantom. The contrast of elasticity in agarose gel with two concentrations was clearly demonstrated on elasticity images.Conclusion: The phase images of MRE can directly visualize the propagation of shear waves in the medium. The elasticity image of MRE can quantitatively image the elastic modulus of the medium

Objective To investigate the presences of regulatory T cells (Treg) and natural killer T cell (NKT)-like T cells in the peripheral blood of healthy subjects and patients with newly diagnosed cancer. Methods Patients were enrolled into four groups: healthy subjects (Group A), patients without cancer (Group B), patients with newly diagnosed stage Ⅰ~Ⅱ cancer (Group C), and patients with newly diagnosed stage Ⅲ~Ⅳ cancer (Group D). Flow cytometry was performed to detect the percentage of CD4+ CD25high CD127low cells in CD4+ T lymphocytes (Treg) and the percentage of CD3+ CD56+ cells in CD3+ T lymphocytes (NKT-like). Results The percentage of Treg cells in CD4+T lymphocytes was(6.72 ± 3.16)%, (6.49 ± 2.83)%,(6.80 ± 3.07)%and (7.63 3.47)% in Group A, B, C and D, respectively, with no significant differences among these groups (P>0.05). However, the percentage of CD3+CD56+T cells in CD3+T lymphocytes was (3.13 ± 1.66)%, (2.56 ± 1.27)%,(7.22 ± 2.70)% and (7.72 ± 3.10)% in Group A, B, C and D, respectively, with marked increases in Group C and D compared to those in Group A and B (P < 0.05). Conclusion Patients with newly diagnosed cancer demonstrated increasing trends in the percentage of peripheral NKT-like cells.

Objective    To evaluate the effects of low-dose epinephrine on cerebral oxygen saturation (rScO2) and awakening time during one-lung ventilation (OLV) for thoracic surgery. Methods    Thirty consecutive patients undergoing lobectomy from March to July 2016 in our hospital were randomly divided into an epinephrine group (n=15, 8 males and 7 females at an average age of 58.70±11.40 years) or a saline group (n=15, 7 males and 8 females at an average age of 57.00±11.40 years). They were continuously infused with 0.01 μg/(kg·min) epinephrine or saline after general induction. Hemodynamics was maintained ±20% of the baseline value. All patients were ventilated by a pressure control mode during OLV with tidal volume of 5-8 ml/kg and end-tidal carbon dioxide tension (EtCO2) of 35-45 mm Hg. Regional cerebral oxygen saturation (rScO2) was monitored using near-infrared spectroscopy (NIRS) continuously. Results    Compared with the saline group, the epinephrine group had a high rScO2 during OLV, with a statisitical significance at OLV 40 min and 50 min (67.76%±4.64% vs. 64.08%±3.07%, P=0.016; 67.25%±4.34% vs. 64.20%±3.37%, P=0.040). In addition, the awakening time of patients in the epinephrine group was shorter than that of the saline group (P=0.004), and the awakening time was associated with the duration of low-dose rScO2 (r=0.374). Conclusion    Continuous infusion of 0.01 μg/(kg·min) could improve the rScO2 during OLV and shorten awakening time in thoracic surgery.

Regional cerebral oxygen saturation cerebral oxygen saturation(rScO2) monitoring by using near-infrared spectroscopy(NIRS) is a simple, sensitive, continuous and noninvasive method, which can detect the change in oxygen supply and demand. It has already draw attentions and applications during perioperative in recent years. The technique was firstly used in cardiac surgery, thereafter some studies found thoracic surgery which mostly used one-lung ventilation also was necessary to monitor rScO2. A series of studies confirmed there were correlations among perioperative adverse events and rScO2. In this paper, we reviewed the basic principle of rScO2, summarized the applications of rScO2 in cardiac and thoracic surgery, discussed the existing problems.

Objective To evaluate the use of diffusion-weighted imaging(DWI)for early detection of tumor response to Angiostatin-Endostatin(Statin-AE)fusion gene therapy in a rat C6 glioma model.Methods Fifty male wistar rats with C6 tumor cells implanted into the striatum were examined by a 3.0T MR scanner,then the rats beating tmors were divided into two groups,treatment group and control group.Rats in the treatment group received 107 plaque forming unit(pfu)recombinant herps simplex viral (R-HSV)mediated Statin-AE fusion gene therapy on day 7,and then the tumors were conformed on MRI.Conventional MR and DWI examination were acquired on 1,2,3 weeks after implantation with a 5-inch surface coil.Two(1 w),eight(2 w)and all the residual rats(3 w)of each group were sacrificed to perform the histopathological examination after each MBI examination.Pretreatment and post treatment tumor volulnes and apparent diffusion coefficient(ADC)values were calculated.Rank sum test and t test were employed for statistical analysis.Results On MRI,43 rats demonstrated tumors on day 7 with a successful rate of 86%,On week 2,the tumor volumes of the controh and treatment group were 90.6 and 91.64 mm3,with no significant difference(Z=-0.14,P＞0.05).On week 3,the tumor volumes of the controls and treatment group were 156.64 and 29.64 mm3,and a significant difference was observed(Z=-3.45,P＜0.01).On week 2.the ADC values of the tumor centers of the treatment group and the control group were (1.20±0.25)×10-3 and(0.99±0.08)×10-3 mm2/s,and the values of the tumor peripheral parts of the two groups were(1.00±0.25)×10-3 and(0.83±0.12)×10-3mm2/s,the ADC values of both tumor centers and peripheral parts of the treatment group were significantly higher than those of the control group (t=-0.82 and-0.46,P＜0.05).On week 3,the ADC values of the tumor centers of the treatment group and the control group were(0.92±0.21)× 10-3 and(0.99±0.09)×10-3mm2/s,and the values of the tumor peripheral parts of the two groups were(0.81±0.19)×10-3 and(0.78±0.11)×10-3 mm2/a,there were no statisfical difference between the two groups(t=0.82,and-0.46,P＜0.05).HE stained slices showed more prominent tumor interstifial edenla.swelling and death of tumor cells in the treated rats than the controls.Conclusions Combination of conventional MRI and DWI can be powerful to monitor tumor progression and therapy effecL Conventional MRI showed that the therapy slow the tumor progression in size while DWI demonstrated the tumor response even earlier than size change.DWI has potential use forthe detection of early response to antiangiogenic gene therapy.

Objective To evaluate the value of DTI in mild articular cartilage injury in patellofemoral joint.Methods The DTI and arthroscopy data of 82 patients wih routine MRI diagnosed as mild articular cartilage injury were analyzed retrospectively.According to the results of arthroscopy,40 cases of mild articular cartilage injury with Outerbridge classification Ⅰ or Ⅱ were divided into experimental group,and 33 cases with normal patellofemoral articular cartilage were divided into control group.There were 8 articular cartilage injury patients with Outerbridge classification Ⅲ or Ⅳ in patello-femoral join were excluded.The DTI data were analyzed compared with arthroscopy.Results Arthroscopy detected 62 lesions of cartilage injury in experimental group.Totally 49 lesions (49/62,79.03 ％) were detected by ADC pseudocolor image and 51 lesions (51/62,82.25 ％) were detected by FA pseudocolor image.The DTI pseudocolor images of articular cartilage injury showed uneven levels.The red or pink levels can been observed.Compared with the control group,ADC value increased and FA value decreased significantly in experimental group (both P＜0.05).Conclusion DTI can clearly display and detect mild articular cartilage injury in patellofemoral joint,which provide valuable information for early cartilaginous injury.

Objective To investigate the relationship between serum uric acid level and renal function decline by retrospective cohort study.Methods Through the physical examination system of the First People's Hospital of Foshan,the physical examination data from 2015 to 2018 of a public institution in Foshan city were obtained.The gender,age,blood cell analysis,liver function,serum creatinine,uric acid,fasting blood glucose were obtained.The change of eGFR (△eGFR=eGFR2018-eGFR2015) was analyzed.Results A total of 2505 subjects were followed up for four years.The subjects were divided into △eGFR ≥0 group and △eGFR ＜ 0 group.There were 845 subjects in △eGFR ≥0 group,and 1660 subjects in △eGFR ＜ 0 group.Compared with that in △eGFR ＜ 0 group,the base-level of uric acid in △eGFR ≥ 0 group was higher [(349.48±87.62) μmol/L vs (325.72±82.58) μmol/L,t=6.669,P ＜ 0.001],but the rate of uric acid decline was greater [-15.00(-53.50,17.00) μmol/L vs 15.50(-18.00,49.00) μmol/L,Z=-13.470,P ＜ 0.001].According to the levels of uric acid in 2015 and 2018,then the subjects were divided into four groups,normal to normal group (N-N,1551 cases),normal change into high uric acid group (N-H,299 cases),high uric acid drop to normal group (H-N,238 cases),and high to high uric acid group (H-H,417 cases).The △eGFR was-1.58(-4.17,1.01) ml · min-1 · (1.73 m2) 1 in N-N group,and-3.60(-7.24,-0.98) ml · min-1 · (1.73 m2)-1 in N-H group,-0.20(-3.14,3.27) ml· min-1· (1.73 m2)-1 in H-N group,-0.96(-4.07,1.93) ml· min-1· (1.73 m2)-1 in H-H group,respectively.The △eGFR decreased most significantly in N-H group than the other three groups (x2=103.130,P ＜ 0.001).Multivariate logistic regression analysis showed that elevated uric acid was an independent risk factor for eGFR decline (OR=1.739,95％CI 1.587-1.906,P ＜ 0.001),while elevated indirect bilirubin (OR=0.968,95％CI 0.943-0.993,P=0.013),elevated red blood cells (OR=0.815,95％ CI 0.680-0.976,P=0.026) were independent protective factors for eGFR decline.Conclusion Elevated uric acid is an independent risk factor for the decline of renal function.Good control of hyperuricemia is beneficial to the protection of renal function.