Objective To evaluate the clinical value of MSCT in the diagnosis of unexplained aseites.Methods 113 patients with unexplained ascites were retrospectively reviewed by CT、clinical data and continous observation.Results Large ascites in 50 cases(44.3%),moderate amount aseites in 10 cases(8.8%),small ascites in 53 cases(46.9%);Parietal peritoneum changed in 51 cases(45.1%);Mesentery changed in 44 cases(38.9%);Grerter omentum changed in 20 eases(17.7%);Enlargement of lymph nodes in 67 cases(59.3%).Conclusion Malignant tumor was the most common cause of unexplained ascites.MSCT could help in identifying tumors and the tumor lesion,forecast malignant ascites,and had great value in etiology and diagnosis of ascites.

AIM:To develop the method for analyzing bulleyacinitine A in plasm from mice through the treatment of subcutaneous injection of bulleyacinitine A by liquid chromatography tandem mass spectrometry(LC-MS/MS).METHODS:50 ?L mouse plasma sample added zolpidem as internal standard and pH 9.2 buffer solution was extracted with ethylether,followed by liquid chromatography and mass spectrometric detection.The mobile phase was consisted of methanol-buffer solution(85∶15)(buffer solution consisted of 20 mmol/L ammonium acetate and 0.1% formic solution).The flow rate was 300 ?L per minute.The separation column was C_ 18 column.The electrospray ionization tandem mass spectrometry and the multiple reaction monitoring mode were applied to detecting the bulleyacinitine A in plasma.RESULTS:The assay was linear from 0.1 to 1 000 ng/mL.The recovery rate was more than 80%.CONCLUSION:The method could be used to detect bulleyacinitine A level in mouse plasma,which offers advantages of sensitiveness,specificity and simpleness.

AIM: To establish the quality standard for Qidan Granules(Radix et Rhizoma Salviae Miltiorrhizae,Radix Astragali,Myrrha,Rhizoma Curcumae;Faeces Togopteri). METHODS: Myrrh,Rhizoma Curcumae and Faeces Trogopteri in Qidan Granules were identified by TLC.The content of tanshinone Ⅱ_A was determined by HPLC.The astragaloside content was determined by HPLC-ELSD. RESULTS: Myrrh,Rhizoma Curcumae and Faeces Trogopteri could be identified by TLC.There was a good linear relationship between the peak area and quantity of tanshinone Ⅱ_A at the range of 2.98-953.6 ng,r=0.999 9,and the recovery was 100.6%,RSD was(0.5%.) Also,there was a good natural logarithm linear relationship between the peak area and quantity of astragaloside at the range of 2.05-40.92 ?g,r=0.999 8,and the recovery was 102.0%,RSD was 1.8%.(CONCLUSION:) The method can be used to set up the quality standard for Qidan Granules.

Objective To explore the function of the regional medical image network consultation system in propelling the quality control of regional medical image.Methods Based on the regional medical image network con-sultation system,the unified standard of quality control was implemented to reach the integrated management of the imaging quality control in region.The imaging specialists checked the quality of image and report in real time.In addi-tion,the specialists and inspectors monthly examined the quality of image and report.Subsequently,the unqualified causes were analyzed and the improvement measures were used.Finally,the quality of image and report were continu-ously improved.Results After the homogeneity management was applied for one year,the rates of remaking photos and returning the report were significantly decreased from 10% to 2%,and 12% to 4% respectively.Additionally,the rates of good image and report were significantly increased from 83% to 98%,and 89% to 100% respectively.The objective of good rate ≥90% was excellently achieved.Conclusion Based on the regional medical image network consultation system,the management in quality control of the networking hospitals has been uniform,and the technique of examination and the report format have been consistent.The standardability and accuracy of image examination have been realized.

Objective To evaluate the clinical value of 16 slice spiral CT 3D imaging in bone and joint trauma. Methods 30 patients with bone and joint trauma were collected.The patients received the 16 slice CT three-dimensional imaging and X -ray examination .The detection rate of bone and joint trauma , bone fracture , the collapse of the diagnosis were compared between the two methods .Results The detection rate of tibial fracture of 16 slice CT was 26.20％,which was higher than 3.33％of X-ray (χ2 =5.19,P=0.02).The detection rate of spinal fractures of 16 slice CT was 28.50％,which was higher than 6.67％of X-ray (χ2 =5.45,P=0.02).The detection rate of rib fracture of 16 slice CT was 30.00％,which was higher than 10.00％of X-ray (χ2 =4.81,P=0.02).The detection rate of pelvic fracture of 16 slice CT was 14.50％,which was higher than the X -ray (χ2 =4.29,P=0.04).The detection rate of tibial broken bone of 16 slice CT was 20.00％,which was higher than 3.33％ of X-ray (χ2 =4.04,P=0.04).The detection rate of pelvis broken bone of of 16 slice CT was 13.33％,which was higher than X-ray (χ2 =4.29,P=0.04).Conclusion 16 slice spiral CT three -dimensional reconstruction can accurately display the three-dimensional shape of lesions ,but also display the anatomical structure of spatial relations ,it is an ideal method for the diagnosis of fracture fragments of traumatic fracture .

Objective To investigate the application value of MR SWI and DWI in the diagnosis of liver lesions.Methods 1 300 patients underwent 1.5T MRI scan of liver,no pathology or follow-up examination results of patients with focal liver lesions were excluded,147 patients were included and underwent conventional magnetic resonance(MRI),DWI and SWI.By 2 senior radiologists with double blind method of conventional MRI and MRI combined with DWI and SWI image reading,the feature and enhancement pattern of signal intensity were evaluated.Kappa test was used to evaluate the consistency of the diagnosis of 2 physicians.The pathological examination and comprehensive follow-up results were used as the gold standard.The diagnostic accuracy of the two groups was compared.Results 2 doctors had good consistency in the image diagnosis of the two groups.The Kappa values of conventional MRI and conventional MRI combined with DWI and SWI images were 0.912 and 0.936,respectively.The conventional MRI diagnosed primary hepatocellular carcinoma(HCC) in 40 cases,bile duct cancer cells (ICC) in 13 cases,liver metastasis (HMs) in 14 cases,cavernous hemangioma of the liver (CHL) in 17 cases.The conventional MRI combined with DWI and SWI diagnosed HCC in 50 cases,ICC in 20 cases,HMs in 20 cases,CHL in 24 cases,the differences were statistically significant (x2 =5.660,5.250,5.560,6.640,all P ＜ 0.05).Conclusion Conventional MRI combined with DWI and SWI can provide additional valuable information and improve diagnostic performance for liver lesions.

Objective To discuss the radiation quality control in county based on regional medical imaging platform. Methods Based on regional medical imaging platform with the combination of PACS technology and telecommunication broadband network, we established the database, unified the radiological image quality standards and the regional medical imaging platform templates of the radiological examination report, built the evaluation standards, objectives, methods and processes of radiological quality, and observed the good rate of image quality and diagnostic report quality, in order to build a county-based radiation quality control system based on regional medical imaging platform. Results The good rate of the image quality and the diagnostic report quality increased and reached the target of examination(≥ 90％). Conclusion Through the regional medical imaging platform, changing the quality control mode of traditional radiation can improve the quality of radiation examination in the region and increase management efficiency and time efficiency.

Objective To investigate the application value of biological mesh in the pelvic floor reconstruction of extralevator abdominoperineal excision (ELAPE) for advanced low rectal cancer (RC).Methods The retrospective cohort study was conducted.The clinicopathological data of 228 patients with advanced low RC who underwent ELAPE in the Beijing Chaoyang Hospital of Capital Medical University between August 2008 and December 2016 were collected.Of 228 patients,174 using biological mesh closure and 54 using primary closure were respectively allocated into the biological mesh group and primary closure group.Observation indicators:(1)intra-and post-operative situations;(2) postoperative complications (including short-term and long-term complications);(3) follow-up and survival situations.Follow-up using outpatient examination and telephone interview was performed to detect postoperative long-term complications,tumor recurrence or metastasis and overall survival up to December,2017.Measurement data with normal distribution were represented as（ x） ±s,and comparison between groups was analyzed using the independent-sample t test.Measurement data with skewed distribution were described as M (range),and comparison between groups was analyzed using the nonparametric test.Comparisons of count data were evaluated by the chi-square test or Fisher exact probability.Results (1)Intra-and post-operative situations:all the patients underwent successful ELAPE.The perineal operation time,time of indwelling perineal drainage-tube and hospital expenses were respectively (60 ± 50)minutes,(11.6 ± 2.4) days,(57 781± 11 337) yuan in the biological mesh group and (50±21) minutes,(8.9± 1.7) days,(53 714± 13 395)yuan in the primary closure group,with statistically significant differences between groups (t =3.327,7.691,-2.203,P＜0.05).The total operation time and duration of postoperative hospital stay were respectively (242±53) minutes,(13.0±5.0) days in the biological mesh group and (228±51) minutes,(12.0±5.0) days in the primary closure group,with no statistically significant difference between groups (t =1.701,1.309,P＞0.05).(2) Postoperative complications:26 and 19 patients in the biological mesh group and primary closure group had respectively perineal wound complications (1 patient combined with multiple complications),showing a statistically significant difference between groups (x2 =10.660,P＜0.05).The perineal wound infection,perineal hernia and disruption of perineal wound were respectively detected in 20,6,1 patients in the biological mesh group and 12,7,3 patients in the primary closure group,showing statistically significant differences between groups (x2 =3.931,5.282,P＜0.05).(3) Follow-up and survival situations:174 patients in the biological mesh group were followed up for 64 months (range,13-112 months),and 54 patients in the primary closure group were followed up for 51 months (range,23-76 months).The local recurrence rate,distal metastasis rate and overall survival rate were respectively 5.17％ (9/174),20.11％ (35/174),77.59％ (135/174) in the biological mesh group and 7.41％(4/54),24.07％(13/54),79.63％(43/54) in the primary closure group,with no statistically significant difference between groups (x2 =0.080,0.389,0.101,P＞0.05).Conclusions The biological mesh in the pelvic floor reconstruction of ELAPE for advanced low RC is safe and feasible.Compared with primary closure,biological mesh closure will extend perineal operation time and time of indwelling perineal drainage-tube,and increase hospital expenses,but doesn't affect total operation time and duration of postoperative hospital stay,meanwhile,it can also reduce the overall perineal wound complications,especially in perineal wound infection,perineal hernia and disruption of perineal wound.

OBJECTIVELaparoscopic-assisted surgery for colorectal cancer has been widely spread worldwide. To avoid the invasiveness of abdominal wound and get better good-looking, incisionless laparoscopic low anterior resection with transanal natural orifice specimen extraction using prolapsing technique for rectal cancer has been developed in our center. The aim of this study was to evaluate the feasibility, safety and short-term outcomes of this technique.

METHODSFrom January 2013 to October 2013, twenty-seven patients with rectal carcinoma were treated by incisionless laparoscopic low anterior resection, and the data of these patients were collected and retrospectively analyzed to assess the value of this technique.

RESULTSAll operations were successfully accomplished without conversion to open surgery or laparoscopic-assisted surgery. The mean operation time was 135 minutes. The mean blood loss was 50 ml. The mean first bowel movement was 48 hours. The post-operative hospital stay was 9 days. All patients had clean distal margin and the mean number of dissected lymph nodes was 18. One patient had anastomotic leakage.

CONCLUSIONSIncisionless laparoscopic low anterior resection with transanal natural orifice specimen extraction using prolapsing technique for rectal cancer appears to be feasible, safe and oncologically acceptable with a satisfactory short-term outcome for selected cases.

Anastomotic Leak ; Colorectal Neoplasms ; Humans ; Laparoscopy ; Length of Stay ; Lymph Node Excision ; Operative Time ; Rectal Neoplasms ; surgery ; Retrospective Studies

Chemotherapy outcomes for the treatment of glioma remains unsatisfactory due to the inefficient drug transport across the blood-brain barrier (BBB) and insufficient drug accumulation in the tumor region. Although many approaches, including various nanosystems, have been developed to promote the distribution of chemotherapeutics in the brain tumor, the delivery efficiency and the possible damage to the normal brain function still greatly restrict the clinical application of the nanocarriers. Therefore, it is urgent and necessary to discover more safe and effective BBB penetration and glioma-targeting strategies. In the present study, menthol, one of the strongest BBB penetration enhancers screened from traditional Chinese medicine, was conjugated to casein, a natural food protein with brain targeting capability. Then the conjugate self-assembled into the nanoparticles to load anti-cancer drugs. The nanoparticles were characterized to have appropriate size, spheroid shape and high loading drug capacity. Tumor spheroid penetration experiments demonstrated that penetration ability of menthol-modified casein nanoparticles (M-CA-NP) into the tumor were much deeper than that of unmodified nanoparticles. imaging further verified that M-CA-NPs exhibited higher brain tumor distribution than unmodified nanoparticles. The median survival time of glioma-bearing mice treated with HCPT-M-CA-NPs was significantly prolonged than those treated with free HCPT or HCPT-CA-NPs. HE staining of the organs indicated the safety of the nanoparticles. Therefore, the study combined the advantages of traditional Chinese medicine strategy with modern delivery technology for brain targeting, and provide a safe and effective approach for glioma therapy.