Objective:To discuss what impact prone position ventilation (PPV) plays in treatment of acute respiratory distress syndrom (ARDS)originating from pulmonary disease(ARDSp) and extra-pulmonary disease(ARDSexp).Methods: Retrospective case-control cohorts study. Sixty patients with ARDS were included, were classified two groups which were originated from pulmonary disease(n=30) and extra-pulmonary disease(n=30), they were ventilated in PPV. And oxygenation of 0,2,4, and 6 hours in PPV, static compliance(Cst), airway resistance(Raw) of were evaluated. The Ultrasonic Cardiac Output Monitor was applied to monitor the cardiac function.Results:At 2 hours after ventilation in ARDSexp group, PaO2/FiO2 have been improved significantly. The longer duration of PPV seemed to be associated with continuous improvement and peaks at 4 hours. In ARDSexp group PaO2/FiO2 after ventilation at 3 hours exceeds the other groups. At 4 hours after ventilation, PaO2/FiO2 of both ARDSp and ARDSexp groups of PPV have been improved than that of supine position. After ventilation for 4 hours, the RAW of ARDSp decreases dramatically and considerably below the other groups.Conclusion: PPV was a safe and effective maneuver for improving oxygenation in patients with ARDSp and ARDSexp. Both ARDSp and ARDSexp clearly appear to benefit from PPV, particularly in ARDSexp group. PPV aslo influenced haemodynamics in patients rarely.

Objective To compare the virtual non-enhanced chest CT (VNCT)generated from spectral CT with conventional non-enhanced chest CT in patients with lung disease in terms of CT number accuracy and image quality.Methods A total of 30 patients with lung disease proved by pathology underwent the conventional non-enhanced thoracic CT and contrast enhanced CT with spectral imaging mode in arterial phase (AP)and venous phase (VP).The VNCT images were reconstructed based on the enhanced spectral CT imaging data.The mean CT number,signal to noise ratio (SNR)for the lesions and image quality score were obtained and compared between the true non-contrast CT (TNCT)and the VNCT (including AP and VP)with paired t test.Results The mean±standard deviation for CT number were (38.74±5.17)HU,(39.08±5.07)HU and (38.96± 5.18)HU for TNCT,VNCT at AP and VNCT at VP,respectively, with no statistical difference (P>0.05).All 3 sets of images demonstrated acceptable image quality,even though there were statistically significant differences in the SNR value and image quality score.The mean ± standard deviation values for SNR were 4.74±0.42 with TNCT, 3.79 ± 0.5 1 with VNCT at AP and 3.77 ± 0.39 with VNCT at VP (P <0.05),and the image quality scores were 5.00 ±0.00 with TNCT,4.17±0.65 with VNCT at AP and 4.17±0.53 with VNCT at VP (P<0.05).Conclusion In patients with lung disease,the vir-tual non-enhanced CT images generated from spectral CT provide accurate CT numbers for lesions and acceptable image quality com-pared with the true non-contrast CT.VNCT may be used to replace TNCT to improve work flow and reduce radiation dose.

Objective To explore the value of the spectral CT iodine-based material decomposition technique in differential diagnosis of central pulmonary carcinoma from obstructive pneumonia and atelectasis.Methods 25 cases with central pulmonary carcinoma complicating with obstructive pneumonia and atelectasis underwent CT plain scan and spectral contrast scan including pulmonary-arterial-phase (PAP) and bronchial-arterial-phase(BAP).Conventional CT images and iodine base images were generated in each phase by GSI viewer.The 4 groups of images differences between the tumor and the obstructive pneumonia and atelectasis were analyzed.Results The margin of the tumor was ill-defined in plain scan.The cases that showed difference between the tumor and the obstructive pneumonia and atelectasis in 4 groups of images were respectively as follows,10 in conventional CT images of PAP,1 6 in conventional CT images of BAP,1 9 in iodine base images of PAP,and 23 in iodine base images of BAP.The difference of the 4 groups was significant (χ2 =16.54,P<0.05).There was the highest accuracy in iodine base images of BAP in defining the tumor margin (χ2 = 12.83,χ2 = 4.20,χ2 =1.34,P <0.05). The accuracy between conventional CT images of BAP and iodine base images of PAP had no significant differences (χ2 =0.86,P >0.05),but were better than that of the conventional CT images of PAP(χ2 =6.65,P <0.05).Conclusion Spectral CT iodine-based material decomposition technique is helpful to improve subjective diagnosis of central pulmonary carcinoma complicating with obstructive pneumonia and atelectasis,especially in iodine base images of BAP,it can provide accurate information for clinical stage and treatment.

Coronary Sinus ; abnormalities ; Humans ; Male ; Middle Aged ; Subclavian Vein ; Vena Cava, Superior

Objective To evaluate the effect of health education on endemic diseases in Henan province in 2010.Methods According to the requirements of The Education Program for Endemic Diseases Control in 2009 Henan Province,50 counties (districts) of 18 cities with endemic diseases were selected.Referring to the health education questionnaire in the program,knowledge of endemic diseases were asked of pupils and housewives.Intervention effects were evaluated two months after teaching pupils and housewives in counties,towns,villages and schools with the knowledge of endemic diseases and the questionnaire was used.Results Among 50 counties investigated,5523 pupils and 3206 housewives were surveyed in the baseline according to the requirement,and 5417 pupils and 2891 housewives were surveyed for outcome evaluation.The results showed that after this education,pupils' knowledge about endemic diseases increased from 66.31％(10 987/16 569) in the baseline survey to 93.84％(15 250/16 251),the difference have statistical significant(x2 =3877.78,P ＜ 0.01) ; housewives from 67.56％(6133/9078)to 92.67％(8037/8673),the difference have statistical significant(x2 =1736.33,P ＜ 0.01).After the education,the pupils' knowledge about the iodine deficiency disorders,drinking-water-borne fluorosis and arsenic poisning,coal-burning-borne fluorosis increased from 70.15％ (6263/8928),62.29％(4423/7101),42.96％ (185/270),68.52％ (116/270) to 94.19％ (8344/8859),93.05％ (6376/6852),99.63％ (261/270),96.67％ (269/270),the difference have statistical significant (x2 =1749.85,1939.26,211.83,74.43,all P ＜ 0.01),housewives' knowledge about the iodine shortage diseases,drinking-water-borne fluorosis,the endemic fluorine,the arsenic poisoning increased from 73.27％ (3330/4545),62.79％ (2677/4263,30.37％ (85/135),62.96％(41/135) to 93.96％(4228/4500),91.08％(3555/3903),97.04％(123/135),91.11％(131/135),the difference have statistical significant (x2 =751.03,924.65,129.75,30.23,all P ＜ 0.01).Conclusions Health education intervention has a marked effect in increasing the peoples' knowledge of endemic diseases.Therefore health education should be enhanced in the future.

Objective To assess the role of health education in outcomes of diabetes mellitus among high-risk populations.Methods The community physicians who participated this investigation received standardized training,and 307 community residents at high risk of developing diabetes obtained three-month intense health education and nine-month follow-up study.Paired t-test,and Analysis of Variance were used for data analysis.Results After systematic health education,professional level of community physicians was improved.Cognitive level of health knowledge was also significantly improved (5.5 vs 12.6,t=-28.511,P＜0.05).In addition,health knowledge of variant age (F=4.036,P＜0.05),education level (F=15.27,P＜0.05) and occupation (F=9.80,P＜0.05) subgroups was significantly increased.In comparison with baselines,the scores of each age subgroups (F=0.204,P＞0.05) showed no significant differences,although scores of different education level (F=4.71,P＜0.05) and occupation (F=4.87,P＜0.05) subgroups were significantly different.The risk factors of diabetes were effectively controlled.Conclusions Health education should be the key to health management of diabetes,which plays important roles in improving cognitive level of health knowledge among populations at high risk of developing diabetes and reducing the incidence of this condition.

Objective To identify the potential neoplastic risk in gonadal development abnormality with Y chromosome.Methods Inquiries about the illness history were made.Lymphocyte chromosoreal karyotype of peripheral blood Was analyzed.Sex determining region Y gene and relative steroids and enzymes were detected.Gonadal site was examined through medical imaging.Conadal excision Was performed by laparotomy or laparoscopy.Pathological examinations were done on all of the specimens.Results Among 41 cases of androgen insensitive syndrome,spermatogenie cell neoplasm occurred in 1 patient,sertoli cell tumor in 2,and interstitial cell hyperplasia in 5.Among 14 cases of 17a.hydroxylase deficiency(XY)syndrome,one was sertoli eell tumor,and one Was sertoli cell hyperplasia.In 4 cases of XY pure gonadal dysgenesis.one was gonadoblastoma with dysgerminomm One of 16 cases of X0/XY gonadal dysgenesis Was spermatogenic cell neoplasm with agenda cell tumor.Four cases of testes degeneration were all with dysgenetic testes.All of the gonadoblastoma and germ-cell tumor were located in the pelvis.Tumors occurred mostly during 15 years of age to 32 years.Conclusions The gonads of XY pure gonadal dysgenesis has high risks of gonadoblastoma and germ-cell tumor.The older the onset age after puberty. the higher the malignancy risk is.Once diagnosed,bilateral gonads should be excised as soon as possible.

Objectives To investigate the expression and diagnostic value of 14-3-3 protein in brains of patients with sporadic Creutzfeldt-Jakob disease(sCJD).Methods 14-3-3 protein was immunohistochemically analyzed in tissue from the frontal lobe of 5 patients with sCJD and 4 non-CJD eases Using 14-3-3 ?and ?antibodies with reference to the results of KB,GFAP and PrP detection.Results The expressions of 14-3-3 protein in five brains of sCJD were more obviously,mostly in gray matters and astrocytes in three cases.The concentration was related to PrP deposition type,but not related to prion protein genotype.Except few expression of 14-3-3 protein in neurous of two cases of acute contusion,there were no expression in the other two cases in control group.Conclusions The expression of 14-3-3 protein in brain is useful to pathological diagnosis of CJD.

The high molecular weight genomic DNA of yeast was extracted using three methods.Products were separated on agarose gel electrophoresis,quantified by spectrophotometer ND-1000 and restricted by EcoRⅠand MesⅠ.The result was shown that the genomic DNA extracted by modified benzyl chloride method was the best.The products of wild isolates supported it,too.This method was suitable for restriction of genomic DNA from yeast.

Objective To investigate the eftect of radiation dose of dual-source computed tomography (CT) dual energy single-phase enhanced scan in patients with esophageal cancer.Methods The prospective study was conducted.The clinicopathological data of 56 patients with esophageal cancer who were admitted to the Lishui Hospital of Zhejiang University between January 2015 and December 2016 were collected.All the patients were divided into the experimental group (undergoing dual-source CT dual energy single-phase enhanced scan) and control group (undergoing dual-phase CT enhanced scan) bv randomised block method.TNM classification of esophageal cancer (Seventh Edition) published by American Joint Committee on Cancer (AJCC) was used as a standard TNM staging.Two observers independently read films.All the patients underwent radical resection of esophageal cancer or palliative surgery,and then received adjuvant radiochemotherapy.Follow-up using outpatient examination and telephone interview was performed to detect postoperative survival of patients up to March 2017.Observation indicators:(1) consistencies of T staging,N staging and M staging;(2) accuracies of T staging,N staging and M staging (pathological results as a gold standard);(3) radiation dose of CT scan;(4) treatment and follow-up situations.The Kappa test was used for evaluating the consistency,κ≥0.75 as a good consistency,0.40≤κ＜0.75 as a normal consistency and κ＜0.40 as a poor consistency.Comparisons of count data and ratio were done by the chi-square test.Comparisons of measurement data were analyzed by the t test.Results A total of 50 patients were enrolled in the study,including 25 in the experimental group and 25 in the control group.(1) Consistencies of T staging,N staging and M staging:all the 50 patients finished successfully CT scans.Two observers considered that consistencies of T staging,N staging and M staging in the 2 groups were normal (κ =0.452,0.618,0.729,P＜0.05).Consistencies of N staging and M staging were superior to T staging.(2) The pathological results were used as a gold standard.Accuracies of T staging,N staging and M staging in the experimental and control groups were 72％,76％ and 88％,84％ and 92％,88％,respectively,with no statistically significant difference between the 2 groups (x2 =0.10,0.37,0.50,P＞0.05).(3) Radiation dose of CT scan:volume CT dose index (CTDIvol),dose length production (DLP) and effective radiation dose (E) were (10.35±2.01) mGy,(400.63± 34.13) mGy · cm,(5.61 ± 0.47) mSv in the experimental group and (3.55 ± 0.60)mGy,(140.66± 10.89) mGy · cm,(1.98±0.17) mSv in the control group,respectively.There were statistically significant differences in CTDIvol and E between the 2 groups (t =16.23,36.30,P＜0.05).(4) Treatment and follow-up situations:of 50 patients,43 patients received treatments,including 32 undergoing radical resection (11 receiving postoperative adjuvant chemotherapy),6 undergoing palliative surgery,3 receiving single radiotherapy and 2 receiving single chemotherapy.Thirty-six of 43 patients were followed up for 3-18 months,with a median time of 6 months.During follow-up,1-year survival rate was 61.1％.Conclusion Dual-source CT dual energy single-phase enhanced scan in patients with esophageal cancer cannot reduce accuracy of TNM staging,but decreased effectively radiation dose.