BACKGROUND:The morbidity and mortality of lung infection after solid organ transplantation remains high, especial y the opportunistic aspergil osis infection. The early diagnosis of invasive pulmonary aspergil osis is difficult. OBJECTIVE:To summarize the CT manifestations of invasive pulmonary aspergil osis after solid organ transplantation. METHODS:The VIP database, CNKI database, Medline database, Highwire database and Foreign Journals Integration System were retrieved with the key words of“solid organ transplantation/renal transplantation/liver transplantation/lung transplantation/heart transplantation, aspergil osis, fungus, mold, pulmonary invasive, tomography computerized”in Chinese and English for the articles published from January 2001 to October 2012. The clinical reports related with the CT manifestations of invasive pulmonary aspergil osis among the reports of pulmonary aspergil osis infections and the fungus or mold lung infections were selected. Secondary manual retrieval of solid organ transplantation was performed, and the literatures on the CT manifestations of invasive pulmonary aspergil osis after solid organ transplantation were included. Reproductive research and atypical report were excluded. RESULTS AND CONCLUSlON:The typical chest CT manifestations of invasive pulmonary aspergil osis after solid organ transplantation included nodules, masses, consolidations and ground-glass opacities. With infection time prolonged, the halo sign, reversed halo sign, cavitis and air crescent sign appeared successively. Different incidences of these signs may be associated with the time interval between onset to a CT examination, fungus preventive treatment time and early antifungal treatment. Meaningful results are the relationship between invasive pulmonary aspergil osis signs and the prognosis of patients. No consolidations or masses and presence of smal cavitis may be related with a better prognosis. Greater nodules, multi-infarct consolidation, renal replacement therapy and persistent positive serum galactomannan is a 90-day independent predictor for mortality. Halo sign on behalf of bleeding has nothing to do with the 90-day mortality. Although the report is less, the CT pulmonary angiography is a promising diagnostic tool for the diagnosis of invasive fungal pneumonia, which can early detect the vascular occlusion used to reflect the invasive vascular involvement, and its sensitivity and specificity are better than the halo sign, and approximate to serum galactomannan test.

Objectiye To explore the diagnostic and therapeutic methods of anastomotic leakage after low anterior resection of rectal cancer. Methods The clinical data of 16 cases with anastomotic leakage after sphincter saving operation which was performed through anterior resection for patients with lower rectal cancer were retrospectively analyzed. Results Among the 186 cases of low anterior resection of rectal cancer,16 cases occurred anastomotic leakage,incidence rate was 8.6% ;14 cases healed through local douche and drainage; 1 case healed by emergency operation and upper colostomy after bacterial peritonitis;only one elderly patient died for infectious shock. Conclusion Anastomotic leakage was the severe complication of low anterior resection,and timely correct treatment and doing well safety precautionary measures before operation could reduce the incidence rate of anastomotic leakage.

Objective To put forward suggestions for improving the writing standards of package inserts of Chinese patent drug in China. Methods Totally 84 package inserts of Chinese patent drug were chosen randomly. The labeled items in them would be investigated and analyzed according to legal documents in China. Results The rate of complete labeled items was 0%. Meanwhile, many problems existed in the items which affected medication safety seriously. In addition, there were defects in expression of the content, revision of package inserts of Chinese patent drug and so on. Conclusion It is urgent to improve the writing standards and the completeness of the labeled items as well as the scientificalness on the expressions of package inserts of Chinese patent drug.

Objective Investigation of satisfaction of clinical nurses and analysis of the influence factors.Methods The ERG theory of Clayton Alderfer is used as the framework to design the questionnaires,for questionnaire investigation of 249 nurses in the hospital in a stratified sampling,Results The score of general satisfaction of nurses for their work is 3.40±0.58;the satisfaction of nurses for the management of their leaders and teamwork is high,as the satisfaction scores are 4.01±0.76 and 3.60±0.71 respectively;their satisfaction for salary,welfare and social identity is low,as the scores are 2.46±0.86 and 2.50±1.02 respectively.Work satisfaction varies with departments,academic levels,monthly income,work shifts,age,seniority,and objectives for their choice of nursing as profession.Conclusion Managers are prompted to enhance their work in view of the satisfaction scores on survival,mutual relations and growth,as well as factors affecting satisfaction,and take various incentives to improve overall satisfaction of nurses.

OBJECTIVE Through biomonitoring the effect of ethylene oxide sterilization process,to discuss the precision usage and management of the technology in operating room,and instruct the sterile job in operating room in the future.METHODS The process of ethylene oxide sterilization was monitored by biological indicators to realize the whole controlling of sterilization effects.RESULTS In the whole 210 sterile articles,202 were qualified,and 8 were disqualified.CONCLUSIONS With correct procedures of sterilization and assurance the qualification of the biomonitoring indicators,the optimal quality of sterilization would be achieved.

Sclerosing cholangitis includes a spectrum of chronic, variably progressive cholestatic liver disease characterized by inflammation, fibrosis and stricture of the intrahepatic and extrahepatic bile ducts. Sclerosing cholangitis can be divided into primary sclerosing cholangitis of unidentified etiology and secondary sclerosing cholangitis caused by various identifiable etiologies, including immunoglobulin G4-related sclerosing cholangitis, recurrent pyogenic cholangitis, ischemic cholangitis, acquired immunodeficiency syndromerelated cholangitis and eosinophilic cholangitis. In this article, we describe the imaging findings of the various spectrums of sclerosing cholangitis with anemphasis on a systemic approach in differential diagnosis. It is very important for magnetic resonance cholangiography and endoscopic cholangiography in imaging diagnosis and differential diagnosis of sclerosing cholangitis. We also discuss the clinical significance and therapeutic options for treating sclerosing cholangitis.

The liver specific contrast agent gadolinium ethoxybenzyldiethylenetriaminepe ntaacetic acid (Gd-EOB-DTPA) is routinely used in clinical magnetic resonance imaging. It combines assessment of tissue perfusion during the vascular phase with hepatocyte specific imaging during the hepatobiliary phase. This combination of imaging properties has been shown to provide excellent results in the detection and differentiation of liver lesions. The enhancement characteristics of Gd-EOB-DTPA in hepatocellular carcinoma, regenerative nodules and degenerated nodules were summarized in this review. Liver cell specific contrast agent can further improve the diagnostic ability.

The mechanism and pathophysiological progress of ischemia/reperfusion are complicated,and all the factors influence each other.This article summarized recent development on the related factors of inflammatory reaction mechanism.

At present,conventional whole brain radiotherapy is the standard treatment for brain metastases and prophylactic cranial irradiation,and it can improve patients' clinical symptoms and survival.However,whole brain radiotherapy may induce cognitive function impairment and affect patients' long-term quality of life.The newest radiotherapy technology can protect the hippocampal gyrus during whole brain radiotherapy and then protect cognitive function and improve quality of life.This article reviews the methods and clinical value of hippocampal gyrus protection in whole brain radiotherapy,as well as related advances.

Objective To investigate the effect of tunor necrosis factor alpha (TNF-α) antagonist treatment and traditional disease-modifying antirheumatic drugs treatment on the quality of life of male patients with ankylosing spondylitis (AS).Methods In 42 patients with AS open-label study,patients were grouped after consent,and divided into the TNF-α antagonist treatment group and the non-TNF-α antagonist treatment group.All patients were treated for 4 months.The clinical and laboratory indexes and quality of life changes were analyzed before and after the treatment.T test,Pearson's correlation analysis were used for statistical analysis with software version 13.0.Results There were no significant differences in age,disease course,disease activity and the quality of life between the two groups before treatment.Disease activity and the quality of life of the two groups after treatment were improved compared with that of before treatment.After treatment,the Bath ankylosing spondylitis disease activity index (BASDAI) score [(1.9±1.6) scores,(3.0±1.3) scores,t=-2.429,P=0.020],erythrocyte sedimentation rate (ESR) [(9±6) mm/1 h,(18±17) mm/1 h,t=-2.286,P=0.031] and C reactive protein(CRP) levels [(18±21) mg/L,(62±85) mg/L,t=-2.258,P=0.035] of the TNF-α antagonists treatment group decreased significantly than those non-TNF-α antagonist treatment group,while the hemoglobin (Hb) levels [(143±15) g/L,(138±18) g/L,t=2.545,P=0.015] were significantly increased in TNF-α antagonist treatment group.The improvement extent of quality of life was more evident in TNF-α antagonists treatment group,such as,the average score [(72± 15) scores,(55±19) scores,t =3.254,P=0.002].The average degree of improvement in quality of life and BASDAI score,Bath ankylosing spondylitis functional index (BASFI) score were negatively related to the improvement in the TNF-α treatment group (r=-0.497,P=0.018; r=-0.558,P=0.007).Conclusion TNF-α antagonist treatment can not only improve the AS disease activity,but can also improve the quality of sexual life of male patients,which may direct affect on male reproductive system.