Objective To evaluate the utility of three-dimensional digital subtraction angiography(3D-DSA) in the diagnosis of cerebral vascular diseases.Methods Seventy-one patients suspected and diagnosed with cerebral vascular diseases underwent conventional DSA and 3D-DSA. Three-dimensional (3-D) reconstructed images were obtained at a separate advantage 4.0 workstation after the rotational images were transferred. The available visualization techniques included maximum intensity projection (MIP), shaded surface display (SSD), and virtual angioscopy (VA). Results Sixty-four aneurysms were found in 44 cases. Nineteen cases were diagnosed as cerebral arteriovenous malformation (AVM) and 8 cases of cerebral ischemia were due to cerebral vascular stenosis (internal carotid artery in 6 cases and occlusion of anterior cerebral artery in 2 cases).Conclusions 3D-DSA is reliable, fast and safe for diagnosis of cerebral vascular diseases, especially involving intracanal areurysms AVM and vascular stenosis.

ObjectiveA HPLC-FLD method was developed to determine the levels of serum AAA in CRIpatients, and to studythe variationof serum AAAinCRI patientsanditsclinical significances. MethodsSerumsampleswerecollected from100healthcontrolsand 80CRI patients. According to 2002 National Kidney Foundation (NKF) staging diagnosis, CRI patients included 4 of stage 2, 12 of stage 3, 12 of stage 4, 52 of stage 5. According to pathogenesis, CRI patients were also divided into 3 groups :chronic nephritis group ( n = 32), DM group ( n = 36), hypertension group ( n = 12 ).Serums were deproteinized by equal volume of 5％ (v/v) PCA and supernate were analyzed direcdy. External standard method was used as quantitative method. The analytical column was Megres C18. 10％ acetonitrile in water was used as mobile phase. Flow rote was 1.0 ml/min. The wavelengths of fluorescence excitation and emission were changed with specific time. The levels of Tyr, Phe and Trp in CRI groups, different CKD stages and different pathogenesis were compared with healthy control groups to evaluated the sensitivity and specificity of serum AAA for CRI diagnosis. ResultsThe linear ranges of the method were 0. 550 -275.000, 3. 050 - 1220. 000 and 0. 049 -49. 000 pμmol/L for Tyr, Phe and Trp, respectively. The limit of detection (LOD) was 0.014 μmol/L for Tyr, 0.500μmol/L for Phe, and 0.005 μmol/L for Trp. The average recovery was 100. 9％, 101.3％ and 98. 5％ for Tyr, Phe and Trp, respectively. Intra-day CVwas 3. 18％ -4. 20％ ( mean was 3. 13％ )and inter-day CV was 3. 18％ -4. 20％ ( mean was 3. 58％ ). The concentration of serum AAA, Tyr and Trp and the ratio of Tyr/Phe in CRI patients were( 135.74 ±23.23 )μmol/L, (52.27 +8.25) μmol/L, (21.49 ±4.25) μmol/L and[0.87(0.68 - 1.05)]μmol/L. which were lower than that in healthy groups (t value was -14. 709, 4.452, 22. 100, U value was 266.000,respectively, P＜0. 05). The concentration of serum AAA, Tyr and Trp and the ratio of Tyr/Phe in healthy groups were ( 174. 47 ± 11.57 ) μmol/L, ( 63.53 ± 4. 68 ) μmol/L, (44. 22 ± 3. 67 ) μmol/L and[0. 97(0. 94 - 1.00)]μmoL/L. There were no statistically significant difference between the different stage of CRI. Compared with the concentration of Tyr, Phe and Trp among chronic nephritis group, DM group,hypertension group, the concentration of Tyr had no significant changes among these three kinds of diseases (P ＞ 0. 05 ). The concentration of Phe had significant changes between Chronic nephritis group and DM group, Chronic nephritis group and hypertension group ( U = 395.00, 114. 00, P ＜ 0. 05 ) ; the concentration of Trp haad significant changes between Chronic nephritis group and DM group ( U = 349.00, P ＜ 0. 05 ).The diagnostic sensitivity and specificity of serum AAA for CRI were 90％ (72/80) and 100. 0％ (100/100).ConclusionsThe method of high-performance liquid chromatography with fluorescence detection ( HPLC-FLD) is simple, rapid, sensitive and specific. Simultaneous determination of serum AAA was benefit to the diagnosis and evaluation of CRI patients.

Objective To evaluate the CT findings of multicentric Castleman disease(CD).Methods The CT findings of thorax and abdomen in a patient with multicentric CD biopsy-proved were retrospectively analyzed, and a literature review was conducted.Results The patient had systemic symptoms, polyclonal hypergammaglobulinemia, extensive lymph node enlargement and mild enhancement, and specific pulmonary infiltration. The lung lesions on thin-section CT were showed poorly-defined centrilobular nodules, ground-glass attenuation, thin-walled cysts, thickening of the bronchovascular bundles, and interlobular septal thickening. The above were highly coincident with that in the literatures.Conclusion Multicentric CD is characterized by the presence of systemic symptoms, extensive lymph node enlargement and mild enhancement, and specific pulmonary lesions when infiltrated. Typical manifestation might suggest multicentric CD.

Objective To evaluate carbon lymph tracer (CH40) in pancreatic cancer surgery.Method 61cases of pancreas head carcinoma undergoing whipple procedure from June 2011 to December 2013 were divided into intraoperative nano carbon group (group A,36 cases),in which resection range was adjusted according to lymph node staining including 13 standard resection cases (group A1),and 23 modified extended radical resection cases (group A2).Standard group (group B,n =17),and extended radical operation group (group C,n =8),respectively.Results The average lymph nodes harvested in group A1 were 25.08 ± 2.72,with positive lymph nodes of 7.92 ± 2.22,significantly more than group B (19.47±1.55,2.68 ±5.24),P＜0.05.In group A2,the average lymph node was 29.91 ±2.68,positive lymph node was 11.04 ± 2.38,significantly more than group C (25.13 ± 2.85,8.49 ± 3.32),P ＜0.05.The mean survival time and overall survival time of group A1 were 43.80 ±4.09 months,51.44 ±1.64 months,significantly more than group B (27.11 ±3.36,41.74 ±3.28 months),P ＜0.05.In group A2,the average tumor free survival time,and overall survival time was 31.58 ±2.99 months,45.02 ±2.54 months,not statistically different with group C (29.13±4.76 month,43.67 ±3.33 months),P ＞0.05.Conclusions Intraoperative lymphatic tracer technology significantly increases lymph node harvest,improving the survival time and tumor free prognosis.

Background Corneal contact lens have been widely used in vitrectomy.The corneal ring accompanying with the contact lens therefore is also much concerned.We designed a sutureless silicone corneal ring to renew a suturing?ring,but its detection of physicochemical properties and hiocompatihility is necessary for clinical application. Objective This study was to investigate the physicochemical properties and biocompatibility of the newly designed sutureless silicone corneal ring. Methods The Shore hardness,tensile stress-strain tests,tear strength,transmittance and the haze of the novel silicone ring were tested.The bioeompatibility of sutureless silicone corneal ring to corneal epithelial cells was evaluated by determining cytotoxieity.The ring was implanted into the counjunctival soc of 6 Japanese white rabbits for 4 hours to determine its stimulation response by measuring the area of corneal fluorescence staining,and then the ring was placed on the skin surface of 6 SD rats for 4 hours to assess the presence of allergic reaction by calculating the swelling area of skin. Results The new sutureless silicone corneal ring showed good physiological features with a Shore hardness of 63.4 degree,tensile strength more than 5.86 MPa,elongation＞100%and tear strength 34 kN/m.The transmittance of 3 legs in the ring was more than 93%;however,the haze was less than 0.1%.Cytotoxicity of the ring was 3.1 1×10-6%.No obvious corneal fluorescence staining was seen at any time point in all the rabbit eyes in the stimulating test.Furthermore,there was not any skin swelling in various time points in all the SD rats in the allergy test. Conclusion The physicochemical properties of the silastic used in our newly designed sutureless silicone cornea ring can meet the demands of the ring.The biological evaluation complies with the ISO i0993-1 international standards and meets the demands of the organism.Thus,it is all ideal material to use in constructing the corneal ring.

Objective To observe the influence of weight - lost therapy on obese children with impaired glucose tolerance( IGT), insulin resistance. Methods Fasting,post- prandail 2 hours blood glucose and insulin were measured in 14 obese children (age 8 - 15 years) with IGT before and after two - month weight - lost iherapy. Glucose were measured with enzymeoxidize assay, and insulin were measured with radio-immunity assay(RIA). Results Among 14 obese children with IGT, after two-month weight - lost the-rapy, there were 9 children becoming normal OGTT. There were significantly lower in the concentration of fasting insulin and post - prandail 2 hours blood insulin and glucose[(14.23?2.35) mIU/L,(47.20?10.26) mIU/L,(5.36?0.91) mmol/L] than before weight -lost therapy[ (32.54?7. 13) mIU/L,( 164.53?33.60) mIU/L, (8.75?1.09) mmol/L](P

BACKGROUND:Contraction of three-dimensional collagen gels has been used as a model for the contraction which characterizes both normal wound healing and the development of fibrosis in the tissue. Several factors and cytokines,such as tumor necrosis factor alpha (TNF-α), interleukin-1, prostaglandin E2 and insulin have been proved to play important roles in collagen remodeling in vitro as well as serum extravasation during the fibrotic progress.OBJECTIVE: To observe extracellular collagen matrix contraction and apoptosis of fetal lung fibroblasts in TNF-α,interleukin-1, insulin, prostaglandin E2, albumin and globum under three-dimensional culture, and investigate the effects of cytokines, insuin, serum and serum protein on the remodeling and fibrotic formation of lung tissue.DESIGN: A randomized controlled experiment.SETTING: Department of Respiratory Medicine, Lanzhou General Hospital of Lanzhou Military Area Command of Chinese PLA.MATERIALS: The experiment was carried out The experiments were carried out in the respiratory laboratory of Lanzhou General Hospital of Lanzhou Military Area Command of Chinese PLA from August 2005 to January 2006. Human fetal lung fibroblasts (American Type Culture Collection), Dulbecco's modified Eagle's medium (DMEM) and fetal bovine serum, insulin, transforming growth factor (TGF) (R&D), prostaglandin E2, type Ⅰ collagen was extracted from rat-tail tendons.METHODS: In order to investigate the effect of initial collagen concentration in the gels on the contractility of fibroblasts,the appropriate amount of collagen was mixed with distilled water, four fold-concentrated DMEM, and cells were suspended so that the mass concentration was 0.75-2.0 g/L, with a physiological ionic strength and the desired cell concentration. In order to investigate the effect of cell number in the gels on the contraction, the cellular concentration fibroblasts in the gels were prepared to 0.2×107-4×107 L-1. The areas of floating gels were measured daily and the contraction was calculated by contrasting the initial size (％ of initial area). Different serum concentrations (0.01％-0.5％)in the medium were prepared, the serum albumin (0.1％) or globulin (0.1％) were added to the serum-free culture medium to observe the gel contraction. TGF (10 mg/L), interleukin-1 (10 mg/L), insulin (1 mg/L) and prostaglandin E2 (0.1 μmol/L) were added to observe the effects of cytokines and insulin on fibroblasts-mediated collagen gel contraction.The DNA content and cellular survivability in gels in collagen were determined.MAIN OUTCOME MEASURES: Effect of lung fibroblasts on collagen contraction with or without the presence of cytokines in three-dimensional culture; Effect of collagen with different concentration on the proliferation and apoptosis.RESULTS: ① Collagen gel contraction showed a dependence on the number of fibroblasts. ② Collagen gel contraction was augmented by increasing serum concentration in culture medium, and albumin increased the contraction dramatically. ③TGF and insulin significantly increased the contraction, whereas prostaglandin E2 and interleukin-1 significantly inhibited the gel contraction. ④ The lower the initial collagen concentration was, the more gel contracted and smaller final size were observed, and cell apoptosis increased.CONCLUSION: During the fibrotic process, fibroblast population migrated into the injured lung tissue may play an important role in the development of pulmonary fibrosis and serum infiltrating into injury lung tissue may play an role in stimulating the fibrotic progress. Infiltrating fluids and edema result in the dilution of the collagen concentration in the pulmonary interstitial which may lead to stronger contraction and serious fibrosis. In the dense fibrosis area, cells were hard to survive. In consequence, the final structure of fibrotic lung could not been changed and lung fibrosis progressed.

Objective To determine the levels and significance of Krebs von den lungen-6(KL-6), pulmonary surfactant protein A (SP-A), SP-D and interleukin (IL)-6 in patients with connective tissue disease interstitial lung disease (CTD-ILD). Methods The serum KL-6, SP-A, SP-D and IL-6 in all subjects were detected and the imaging and pulmonary function were recorded t test, χ2 test, non-parametric test, ANOVA and correlation analysis were used for data analysis. Results ① The levels of serum KL-6, SP-A, SP-D, IL-6 in the CTD-ILD group [551.4 (428.2, 883.5) U/ml, 938.4(435.2, 2324.7) pg/ml, 90.7 (80.7, 100.3) ng/ml and 30.4 (22.9, 41.7) pg/ml; P all<0.05] was significantly higher than that in the CTD group [192.9 (139.2, 266.2) U/ml; 458.0 (372.6, 529.0) pg/ml; 80.0 (71.2, 98.3) ng/ml; 18.6 (4.9, 31.0) pg/ml, Z=-5.383, -3.76, -2.123,-3.903, P all <0.05]; and higher than healthy controls (n=30) [183.2(141.9, 216.6) U/ml; 229.0(162.0, 248.0) pg/ml;50.8(26.1, 96.4) ng/ml;7.1(3.7, 8.7) pg/ml, Z=-5.801,-8.13, 2.272, 3.266;P all<0.05].②The levels of KL-6 in pulmonary HRCT for active ILD group was significantly higher than the non-active ILD group [998.5 (640.3, 1293.3) U/ml vs 565.0(434.0, 799.5) U/ml, Z=2.182, P=0.023], there was no statistical difference in the levels of SP-A, SP-D, IL-6 between the 2 groups. ③ Spearman correlation analysis showed that KL-6 was negatively correlated with forced vital capacity (FVC%);SP-D, IL-6 and diffusing capacity of carbon monoxide (DLCO %). ④ Logistic multiple regression analysis showed that KL-6 [OR=1.017, P=0.002, 95%CI (1.006, 1.028)], SP-A [OR=1.023, P=0.009, 95%CI (1.006, 1.041)], SP-D [OR=1.175, P=0.009, 95%CI (1.075, 1.264)], IL-6[OR=1.213, P=0.001, 95%CI(1.088, 1.354)] were the risk factors for ILD. Conclusion Serum KL-6, SP-A, SP-D and IL-6 are significantly increased and correlate with CTD-ILD. KL-6 is related to the pulmonary inflammatory disease and vital capacity, while SP-D and IL-6 are related to diffusion function.

Objective To analyze the CT pulmonary angiography(CTPA) image quality and radiation dose of obesity patients with high and low tube voltage iterative reconstruction(IR) and the filtered back projection(FBP) reconstruct algorithm,and to explore the feasibility of low tube voltage IR algorithms in CTPA of obese patients.Methods Obese patients with suspected pulmonary embolism were randomly assigned into 80 kV or 120 kV group, and the images were treated with IR and FBP reconstructions.CT value of the basal segment of the right pulmonary artery, right upper lobe and main pulmonary artery were measured, and the average CT value of the pulmonary artery was further calculated, and the independent sample t test analysis was used.Results Comparing the CT value of the IR and FBP subgroup of two tube voltage groups, the differences were not significant (P>0.05), the differences of noise, signal noise ratio(SNR) and contrast noise ratio (CNR) were statistically significant (P<0.05), respectively.The CT value,noise,SNR and CNR of 80 kV group were significantly higher than those of the 120 kV group, and the differences were statistically significant (P<0.05), while the radiation dose were significantly lower than those of 120 kV group (P=0.000).Conclusion The CTPA image quality of 80 kV IR algorithm is significantly improved compared with the 120 kV FBP algorithm, and the radiation dose is significantly reduced, which could be used for CT pulmonary angiography in obese patients.

Practice abilityoriented professional quality training is an important part of thethree orientation talent training mode in Qiqihar Medical School, and it is the key link of the reform and inno-vation of talent training mode. This article mainly expounds the connotation of training mode in the three orientation under the guidance of medical personnel and medical research ability, and the training objec-tives cover innovative thinking ability and scientific research ability, including five aspects of training strat-egy such as reforming the teaching mode of the traditional theory course, setting up scientific research related courses, carrying out academic lecture, reforming the teaching mode of experiment course and con-structing the scientific research team of teachers and students by the scientific research project as well as seven aspects of the evaluation system, such as the literature review, the title of the report, academic report and research application writing, scientific research (comprehensive) experiment report, thesis writing and comprehensive performance, and deeply analyzes the close relationship between the practice ability and the medical research ability of medical students.