For compiling the textbook of imagelogy on obstetrics and gynecology,this paper discussed the necessity and feasibility of it. Meanwhile,it also introduced the specific plans such as how to select compilers,to choose the textbook contents,to establish the compiling-style and how to administer whole process.

Objective To introduce a novel modified CT severity index based on the assessment of extrapancreatic inflammation and pancreatic necrosis on CT index (EPIPN) and to evaluate its effect in predicting the severity and prognosis of acute pancreatitis. Methods Seventy-seven consecutive patients diagnosed as acute pancreatitis (AP) from August 2006 to December 2007 were retrospectively analyzed. The clinical data included age, sex, cause, the C-reactive protein(CRP) level with in 72 hours of onset of symptom, Ranson signs, the APACHE I1 score, the disappearing time of the abdominal pain, the presence of organ failure, the length of hospital stay, etc. All patients underwent contrast-enhanced multisection CT scan after admission of 48-72 hours. The CT severity index (CTSI) and EPIPN scores were obtained. The severity of pancreatitis for each patient was then categorized as severe if CTSI≥7 or EPIPN>5. The diagnostic value of EPIPN in predicting the severe acute pancreatitis (SAP) was compared with that of CTSI using ROC curve. The correlation of EPIPN or CTSI with clinical coutcome was conducted. Results Of 77 patients, 34 were males and 43 were females with mean age of 51.79 years (age range 22-92 years). The causes of AP were gallstones (63 cases), hyperlipemia (6 cases), alcohol (1 case) and idiopathic (7 cases). Organ system failure was present in 14 (18.2%) of the 77 patients. The area under the ROC curve of CTSI in predicting the SAP was 0.72 (95% CI: 0.59-0.88) with sensitivity of 80.4% and specificity of 55% when CTSI≥7, and that in EPIPN was 0.82 (95% CI: 0.73-0.91) with sensitivity of 91.3% and specificity of 63% when EPIPN >5. EPIPN was well correlated with hospital stay, APACHE Ⅱ score and CRP levels. Conclusions The EPIPN allows accurate estimation of disease severity and prognosis in AP patients. The diagnostic effect of EPIPN for predicting SAP is superior to CTSI. The EPIPN index is-both convenient and practical, and has clinical value.

[Objective]Observe the clinical effect of leverage replacement manipulation on lumbar intervertebral disc herniation.[Method]299 hospitalized patients were divided into two groups.153 cases were in trial group and 146 patients were in controlled group.Trial group accepted constant traction and leverage replacement manipulation.While the controlled group accepted the same traction and muscular massage.[Result]In trial group,90 patients were cured,57 improved and 6 no improvement.The total effective rate was 96.08%;in controlled group,21 were cured,75 cases improved,and 50 no improvement.The total effective rate was 65.75%.The effect of trial group was better than the controlled group(P

Objective:To evaluate the utilization of Kanglaite injections in lung cancer patients in 11 hospitals of Zhejiang and analyze the prescription data. Methods: Totally 40-day prescription data of the patients with lung cancer in 11 hospitals of Zhejiang were withdrawn every year from 2009 to 2013. The data in respect of the consumption sum, DDDs, department distribution and medical insurance category of Kanglaite injections were analyzed. Results: The consumption sum of Kanglaite injections used in the patients with lung cancer in 11 hospitals of Zhejiang showed an upward trend year by year, the growth in 2011 and 2012 was the fastest, and the sum in 2012 was 1. 77-fold of that in 2009. The consumption sum proportion of Kanglaite injections in total amount of drug consumption rose after the first drop. The top 3 departments were oncology, radiotherapy and thoracic surgery in the five years. The dosage and DDDs of Kanglaite injections were also in an increase trend year by year, and the growth in 2011 and 2012 was the fastest. Conclusion:The utilization of Kanglaite injections in the patients with lung cancer in Zhejiang area shows a continuous rapid growth momentum, therefore, it is still essential to strengthen the reasonable application in clinics.

Objective To observe the anaesthetic effect of sulfentanil combined with bupivacaine for subarachnoid block on cesarean section patients and the influence on the patient and fetus.Methods Eighty patients who were scheduled for elective cesarean section under subarachnoid block,were distributed into two groups:bupivacaine with no sulfenlanil(group B)and bupivacaine with sulfentanil(group BS).Detected SBP,DBP,MAP,HR,SpO2 before and after anesthesia.The time of drug onset,motor recovery and pain recovery were recorded,the effect of muscle relaxation was evaluated,and the drag reaction,neonatal Apgar score and anesthesia complication were recorded.Results There was no significant difference in the time of drug onset and motor recovery,muscle relaxation,neonatal Apgar score between the two groups.MAP was lower after 3-10 min of anesthesia than before anesthesia,but there was no significant difference after 30-120 min of anesthesia in the two groups.The rate of drag reaction was 27.5% in group B,but no case in group BS.The time of pain recovery was longer in group BS than that in group B(P＜0.01).The rate of temporary itch of skin after operation was 17.5% in group BS.Conclusion The addition of sulfentanil to hyperbaric bupivacaine provides adequate anesthesia for cesarean section and good postoperative analgesia.

Objective To discuss and evaluate the value of multi slice spiral CT angiography in the diagno -sis of penetrating atherosclerotic ulcer materials .Methods 17 patients of PAU were collected and examined with MSCT,the location,radiological diagnosis and complications of PAU on axial ,CTA and 2D/3D images were analyzed. Results Ulcer-like aortic projections were observed of 17 patients,and connected with aortic cavity ,where narrow neck sign was showed .The indirect signs included localized or extensive IMH ,calcification of aortic wall and dilata-tion of aorta .Conclusion Multi slice spiral CT angiography is an effective method for the diagnosis of PAU by provi -ding valuable information for the diagnosis and treatment .

Objective To investigate the clinical value of multi-slice spiral CTA ( MSCTA ) and image-post processing techniques in diagnosis of acute aortic syndrome ( AAS) .Methods 71 patients with AAS were scanned by TOSHIBA Aquilion 64-slice spiral CT,the images on axial and 2D/3D were analyzed.Results 71 cases included 48 cases of aortic dissection ( AD) ,10 cases of intramural hematoma ( IMH) and 13 cases of penetrating atheroscle-rotic ulcer ( PAU) .MSCT depicted the imaging features of AAS:AD showed intimal flap and true and false lumens;IMH showed crescent or circular thickening of aortic wall .PAU showed a niche filling with contrast medium and pro-truding the aortic lumen ,where narrow neck signwas shown .The location ,radiological diagnosis and complications of AAS were observed in 71 patients.Intervention treatment or surgical treatment was conducted in 27 cases after defi-nite diagnosis .Conclusion MSCT is a fast and noninvasive examination technique , and it can provide important information for the diagnosis and treatment of AAS .

Objective To investigate the effects of dexmedetomidine on the end-tidal concentration of sevoflurane during recovery from breast cancer surgery under general anaesthesia. Methods A total of 120 patients undergoing unilateral breast cancer radical operation were randomly divided into four groups:group C (infusion of saline, n=30), group D0.5 [infusion of dexmedetomidine 0.5μg/(kg·h) during operation, n=30], group D0.6 [dexmedetomidine 0.6μg/(kg·h), n=30] and group D0.7 [dexmedetomidine 0.7 μg/(kg · h), n=30]. The end-tidal concentrations of sevoflurane during surgery and postoperation were observed. The end-tidal concentration of sevoflurane on palinesthesia was recorded. The time from stopping administration of anesthetic drug to palinesthesia and the operation time were recorded. The palinesthesia of patients from general anaesthesia and the degree of emergence agitation of the patient were measured using Riker ’s sedation-agitation scale. The operation time, anesthesia time, intraoperative remifentanil dosage, intraoperative auditory evoked potential index (AAI), sevoflurane inhalation concentration and the corresponding time were recorded. Results There were no significant differences in clinical data, remifentanil dosage, operation time and AAI between four groups. The anesthesia time was longer in group D0.7 than that in the other three groups (P<0.05). Compared to group C, the end-tidal concentration of sevoflurane during surgery, postoperation and palinesthesia were lower and the time of palinesthesia was delayed in groups D0.5, D0.6 and D0.7 (P<0.05). And the time of palinesthesia was delayed in group D0.7 than that of group D0.5 and group D0.6. Compared with group C, the ratio of Riker’s sedation-agitation scale>7 was lower in groups D0.5, D0.6 and D0.7 (P<0.05). The ratio of Riker’s sedation-agitation scale>4 was significantly higher in group D0.6 and group D0.7 than that in group C and group D0.5, but the ratio of score>6 was lower (P<0.05). The ratio of score>3 was higher in group D0.7 than that of other three groups (P<0.05). Intraoperative cardiac tachycardia was found in group D0.6 and group D0.7 (4 cases, 13%and 8cases, 7%). Conclusion Sevoflurane inhalation anesthesia and intravenous infusion of dexmedetomidine 0.6μg/(kg·h) can effectively reduce intraoperative sevoflurane dosage, the end-tidal concentration of sevoflurane during recovery, and the occurrence of agitation in patients undergoing general anesthesia.

Objective:To evaluate the efficacy and pharmacoeconomics of rhIL-11(Ⅰ) and rhTPO in the treatment of thrombocy-topenia caused by gemcitabine chemotherapy in lung cancer patients. Methods:A retrospective analysis was used. Totally 58 hospital-ized lung cancer patients who suffered thrombocytopenia caused by gemcitabine chemotherapy and treated with rhIL-11(Ⅰ) or rhTPO from June 2011 to June 2014 were involved in the study, and the efficacy and pharmacoeconomics of rhIL-11(Ⅰ) and rhTPO were e-valuated and compared. Results:The lowest platelet value after the chemotherapy in rhIL-11(Ⅰ) group was higher than that in rhTPO group (P<0. 01), and the platelet decrease time in rhIL-11(Ⅰ) group was shorter than that in rhTPO group (P<0. 01), while the platelet qualified rate of the two groups showed no statistically significant difference (P>0. 05). The results of cost-minimization anal-ysis showed that the average cost of rhIL-11(Ⅰ) group was lower than that of rhTPO group(P<0. 01), furthermore, the average cost of the patients with GP, GC or the other gemcitabine chemotherapy regimens in rhIL-11 (Ⅰ) group was lower than that in rhTPO group. Conclusion:The effect of rhIL-11 (Ⅰ) in the treatment of thrombocytopenia caused by gemcitabine based-chemotherapy in lung cancer patients is not inferior to that of rhTPO, and shows certain advantages in economic cost.

Objective To observe the minimum effective local anesthetic dose of intra-articular ropivacaine with dexmedetomidine for analgesia after knee arthroscopy in patients.Methods Seventy-two patients (35 males,37 females,aged 60-75 years,ASA grade Ⅰ or Ⅱ)undergoing knee arthro-scopy under total intravenous anesthesia were randomly divided into two groups (n =36 each):ropiv-acaine group (group R)and ropivacaine with dexmedetomidine group (group DR);Ropivacaine was injected intra-articularly in group C,and dexmedetomidine 1 μg/kg with ropivacaine was injected intra-articularly in group DR.ED50 of ropivacaine was determined by the sequence method.VAS score3 two hours after operation was rated as effective.The initial dose was 3 mg and according to the effective or ineffective results in previous patient,a dose of ropivacaine was decreased or increased 1.1 times to the previous patient.BP,HR,VAS Score,and OAA/S score were recorded five minutes preoperatively(T0 ),1 h (T1 ),2 h (T2 ),3 h (T3 ),6 h (T4 ),12 h (T5 ),24 h (T6 ),and 48 h (T7 ) after operation in two groups.Results There was no significant difference between the two groups with regard to the BP,HR,VAS Score,and OAA/S score.ED50 of ropivacaine for analgesia after knee arthroscopy was 0.31% (95%CI 0.30%-0.32%),and ED50 of ropivacaine with dexmedetomi-dine for analgesia after knee arthroscopy was 0.14% (95% CI 0.14%-0.1 5%). Conclusion Intra-articular administration of ropivacaine with dexmedetomidine could provide superior postoperative analgesia.The dose of ropivacaine for analgesia after knee arthroscopy should be reduced when combined with dexmedetomidine in patients.