Objective To observe the changes of red blood cell distribution width, mean platelet volume and cardiac troponin I in patients with Acute Coronary Syndromes, and to evaluate the value for early diagnosis by using ROC curve. Methods 191 patients with ACS and 206 patients with the chest pain syndromes non-ACS were selected in this study. Electrocardiogram,blood routine,creatinine, LDL-C and cardiac troponin I were determined within six hours after hospitalized,meanwhile the feature of ROC curves was observed. Results There was no significant difference between ACS group and non-ACS group about red blood cell, hemoglobin, platelet,creatinine and LDL-C［(3.82±0.57)×1012/L,(101.3±3.3)g/L,195（98.6-334.8）×109/L,69（45-120）μmol/L,(2.95±0.85)mg/dl vs (3.89±0.50）×1012/L,(103.5±3.7)g/L,201（135.2-346.9）×109/L,71（49-100）μmol/L,(2.82±0.75)mg/dL］ (P＞ 0. 05). Red blood cell distribution width, mean platelet volume and the cardiac troponin I in ACS group［13.70(12.00-15.20)%,9.4（7.42-12.31）fL,(5.63±1.39)μg/L］ were significantly higher than that of non-ACS group［12.60（11.20-13.83）%,8.2（6.24-10.97）fL,(0.04.±0.01)μg/L］ (P＜0.01) .The area under ROC curves of red blood cell distribution width,mean platelet volume and cardiac troponin I were 73.5%, 78.8%, 98.1% respectively, while the best cut-off value was 13.15%, 12.45 fL, 0.06 μg/L respectively. Conclusions The combination using of red blood cell distribution width andmean platelet volume and cardiac troponin I and other conventional cardiac markers might be served as early diagnosis marker for the ACS patients admitted to emergency departments.

Objective To study the effect of CT scanning condition on the target position coordinate with WIMRT radiotherapy planning system using the" Z" form localizing frame. Methods The whole Head Phantom containing three metal targets was scanned under the following conditions: localizing frame transver-sally tilting, CT gantry tilting and localizing frame axially tilting. Then the three target coordinates were com-puted respectively and compared with those under the standard condition. Results The height and width of coordinate under the localizing frame transversally tilting condition deviated from those under the standard scanning condition,which was in an angle dependent manner. On the other hand ,a tendency was shown that the greater the absolute height value of the targets coordinate, the greater the width value deviation. And so was the relation between the absolute width value of the coordinate and height value deviation. If CT gantry angle was not zero degree or localizing frame axis is not in the same line with the CT bed moving direction, the calculated longititude value of the targets coordinate was mainly affected. Conclusions CT scanning must be performed strictly under the standard localizing scanning condition by a proficient physicist.

Objective To study the safety and availability of extended resection,gland reconstruction and mammary gland lavage in treatment of mammary duct expansion.Methods 41 patients with duct expansion admitted from Mar.2012 to Jan.2015 were studied and they were randomly divided into two groups.15 patients in the control group received normal surgical treatment,and 26 patients in the observation group received extended resection,gland reconstruction and mammary gland lavage treatment.Results The operation time,intraoperatve blood loss,length of hospital stay and degree of satisfaction of the observation group were superior to those of the control group while the recurrence rate was lower than that of control group.The gland expanded resection reduced the recurrence rate,the shape of the breast was improved,and the continuous irrigation was the guarantee for the immediate formation of the gland.The three kinds of surgical procedures were organically combined and complement each other.Conclusion The surgical methord of extended resection,gland reconstruction and mammary gland lavage is worth of further exploring due to its advantages of easy to operate,good cosmetic effect and low recurrence rate.

The clinical data,endoscopic and CT findings of 39 patients with Crohn's disease(CD) and 24 patients with intestinal tuberculosis (ITB) were retrospectively reviewed.Diarrhea,hematochezia,perianal disease,intestinal obstruction,occurred more frequently in CD than in ITB (P ＜0.05 or ＜0.01).Night sweating,febrility,pulmonary tuberculosis and ascites were more common in ITB than in CD (P ＜0.01).The endoscopic findings showed that longitudinal ulcer,cobblestone sign,intestinal stricture were detected more often in CD than in ITB (P ＜ 0.05 or ＜ 0.01),but transverse ulcer and rodent ulcer were more frequently found in ITB than in CD (P ＜0.05 or ＜0.01).On the CT imaging mural gas,fat,enteric cavity stenosis and layering thickening were more common in CD than in ITB (P ＜ 0.05 or ＜ 0.01),but mural single layer thickening and hollow lymph nodes were discovered more frequently in ITB than in CD (P ＜ 0.01).The degree of intestinal wall thickening,enhancement and lymph nodes enlargement of ITB were more severe than that of CD (P ＜ 0.01).The clinical manifestations combined with endoscopic and CT finding may improve the differential diagnosis between Crohn's disease and intestinal tuberculosis.

Objective To evaluate the clinical presentations,pathologic characteristics,and the diagnosis and treatment of eosinophilic cystitis.Methods Two cases of eosinophilic cystitis were analyzed,and the relevant literature was reviewed.Case 1,a 63-year-old man,complained of voiding urgency and frequency,dysuria,intermittent hematuria,and lower abdominal pain.Cystoscopic examination showed that an about 5cm?3cm abnormal focus was 0.2-0.4 cm above bladder mucosa at the fundus of the bladder.Case 2,a 42-year-old woman,complained of voiding urgency and frequency,dysuria,and suprapubic pain with intermittent hematuria.Cystoscopic examination showed that about 4 cm?3 cm?2 cm abnormal foci of cauliflower-like were 0.3-0.4 cm above bladder mucosa at the fundus and neck of the bladder.Imaging examinations(Bultrasound,CT and IVU) showed diffuse thickening of bladder wall and tumor-like lesions.They both underwent transurethral resection of the lesions and were treated with oral steroids and antibiotics.Results Postoperative pathology confirmed eosinophilic cystitis in both cases.The follow-up was 6 months.The voiding symptoms disappeared,and imaging examinations showed no space-occupying lesions of the bladder in them.Up to now,there has no evidence of relapse.Conclusions Eosinophilic cystitis is a very rare tumor-like inflammatory disease.It is easily misdiagnosed as bladder neoplasm.Cystoscopy and biopsy are gold standard for the diagnosis.Current treatment modalities include transurethral resection of the bladder lesion along with nonspecific medical therapy.

In March 2017, a severely burned male patient aged 36 years with hypovolemic shock was admitted to our hospital. The patient received large quantities of antibiotics and blood products and repeated skin graft after admission, and then he suffered wound errhysis and throat congestion. The patient was healthy before without family history of bleeding or thrombosis disease. Laboratory tests showed that prothrombin time and activated partial coagulation time were remarkably prolonged, blood coagulation factor Ⅴ activity was extremely low, and the result of qualitative test of coagulation factor inhibitor was positive. Acquired blood coagulation factor Ⅴ deficiency was diagnosed. After application of dexamethasone (5 mg, twice per day) and infusion of fresh frozen plasma, blood coagulation indicators of patients recovered in 4 days, the result of qualitative test of coagulation factor inhibitor was negative, and bleeding symptoms were improved.