Objective To evaluate the effect of different tube voltage and noise index (NI)on image quality and radiation dose during peripheral artery CTA with automatic tube current modulation(ATCM)technique.Methods Seventy-two patients were ran-domly divided into three groups with different scanning tube voltage and noise index as follows:group A with 100 kV and NI of 1 5, group B with 80 kV and NI of 1 5,group C with 100 kV and NI of 20.Image quality,segmental vascular enhancement,signal-to-noise ratio (SNR),contrast-to-noise (CNR)and effective dose (ED)were independently evaluated in 3 groups.The methods of sta-tistics analysis were ANOVA,and P <0.05 represented the significant difference.Results There was no significant difference of image quality of the peripheral artery among 3 groups.The CT value,SNR,CNR in group B (80 kV)was the highest,and there were statistical differences between A,B groups and B,C groups of arteries (P <0.05),and there was no satistiacal difference between A group and C group.Compared with group A and group B,the CTDlvol,DLP and ED of group C was reduced 50.45%,51.20%,51.21% and 35.03%,34.91%,34.92%,respectively,and the difference was statistical significance (P < 0.05 ),and there was no significant difference between group A and group B (P >0.05).Conclusion Using ATCM low-kV with high NI scanning can reduce radiation dose without interference on image quality for peripheral artery CTA.

Objective To study the clinical value of 64-slice spiral computed tomography(64SCT) contrast-enhanced scan and three-dimensional reconstructed techniques in the diagnosis of complex congenital heart disease(CCHD). Methods 39 patients with CCHD underwent CT angiography and transthoracic echocardiograms (TTE). Of them, the electrocardiographic-gating technique was used in 8 cases. The accurate rates in diagnosing CCHD with CT, TTE and CT with or without electrocardiographic-gating were analysed compared with that of operation and χ~2 test using SPSS13.0 tool. Results A total of 102 cardiac deformities con-firmed by operations,those included 47 intracardiac deformities,the diagnostic accuracys with CT and TTE were 85.1% and 95.7%, respectively, and there was no obvious difference among them (χ~2=2.68, P>0.05). 55 extracardiac deformities, the definite diagnos-tic rates with CT and TTE were 98.2% and 78.2%, respectively. CT was superior to TTE in the indentification of extracardiac de-formities(χ~2= 14.64 ,P<0.01). There was no obvious difference between with and without electrocardiographic-gating technique during CT scanning in diagnosis of cardiac deformities(χ~2=1.84, P>0.05). Conclusion 64SCT has significant value in diagnosis of CCHD,and there was no obvious difference in diagnosis of cardiac deformities by 64SCT between with and without electrocardio-graphic-gating technic.

Liver cirrhosis is a common chronic progressive liver disease,and at present the most effective treatment for advanced liver cirrhosis is liver transplantation.However,main reasons of limiting the wide application of liver cirrhosis are liver source deficiency,expensive cost,graft rejection reaction,the complications caused by long-term application of immunosuppressant and so on.Stem cell transplantation has become a new method for the treatment of liver diseases due to its beneficial to the damaged liver tissue repair,and it can compensate part of liver function.The basis and clinical research progress,the existing problems and prospects of the bone mesenchymal stem cell transplantation for the treatment of liver cirrhosis are summarized,aiming to provide theoretical basis for the further research.

Objective To explore the concentration of mannan-binding lectin(MBL ) of patients with chronic hepatitis B virus (HBV) .Methods Serum MBL concentrations of 250 patients(case group) with HBV and 150 healthy controls(control group) were measured .Results The serum MBL concentration in case group was higher than that in control group(t=7 .097 ,P<0 .01) . The serum MBL concentration in high HBV-DNA loading group was higher than that in control group(t=7 .179 ,P<0 .01) .The serum MBL concentration in low HBV-DNA loading group was higher than that in control group(t=4 .404 ,P<0 .01) .Conclusion Detection of serum MBL in patients with HBV will be clinically useful for understanding state of an illness and observing the cur-ative effect .

Objective To evaluate the techniques and application of 64-slice helical CT colonography in colonic lesions. Methods Thirty-eight patients (including 12 colonic carcinomas,10 polypi, 9 colon multiple scrobiculus, 2 multiple diverticula, 2 negative, 1 congenital bowel malrotaion,1 ulcerative colitis and tunica mucosa glandular organ hyperplasy,1 colocolic anastomosis of terminal ileum and sigmoid colon) underwent volume scanning using 64-slice helical CT after cleaning colon. Six types of reconstruction including CT virtual colonoscopy(CTVC), volume rendering(VR), multiple planar reconstruction(MPR), 360?sectional view, RaySum,and navigation were gained.CTVC appearances were compared with that of conventional colonoscopy(CC).Results In 12 colonic carcinomas and 10 polypi,the lesions’ morphology,number,size, were satisfactorily shown by CTVC. The lesions’ location,range,and 1 intestinal canal obviously stenosis were also exactly shown by RaySum.The relationship between tumor and environment, 3 liver or retroperitoneal lymph node metastasis were satisfactorily shown by MPR and 2D transection image. On 360?sectional view,the distance between tumor and anus was exactly measured and the result was in conformity to that of CC. Of the CTVC appearances,1 sigmoid carcinoma and 1 transverse colon polyp was in unconformity to that of CC;1 ulcerative colitis and descending colon carcinoma was diagnosed as ulcerative colitis and tunica mucosa glandular organ hyperplasy by pathology.Conclusion 64-slice helical CT is a valuable imaging technique for detecting colon diseases. CTVC can obtain more clinical information than CC combining MPR,RaySum and VR.

Objective To explore the CT features of renal epithelioid angiomyolipoma (EAML), and to improve the diagnosis of this disease.Methods The clinical materials and image findings of 15 cases (8 female, 7 male) with renal EAML proved by pathologies were retrospectively studied.Plain and enhancement CT scan were performed in all 15 patients.Nine of the 15 cases were correctly diagnosed and the other were misdiagnosed as renal cell carcinoma (RCC) (n=5), renal oncocytoma (n=1).Results There were some distinctive findings of EAML: (1) Little hypodense or iso-high-density, well defined, round lesion with diameter of 2 to 5 cm.(2) The tumor may involve the medulla of kidney or grow out without haematuria.(3) Most lesions showed obviously uniformity enhancement at artery phase, with a few of them showed inhomogeneous enhancement There were thickening and circuitous vessels in a few lesions.(4) Enhancement mode was quick-in and quick-out.Conclusions CT findings combined with clinical materials have important value in making a correct diagnosis of EAML preoperatively.

Objective To observe the physique and anatomy changes in patients with nasopharyngeal carcinoma (NPC) during intensity-modulated radiotherapy (IMRT), using repeated CT images and deformable registration technique, and analyze their impact on delivery dose distribution.Methods Ten NPC patients were randomly selected from those who had received IMRT treatment.Gross tumor volume of nasopharyn (GTVnx), GTV of metastastatic lymph node (GTVnd), clinical target volume (CTV) and normal tissue or organ (OAR) were re-contoured on the in-course repeated CT images using a kind of deformable registration and auto-segmentation software according to the original planning contouring.Changes in volume of treatment targets and organs at risk were evaluated and the trends were then analyzed.Dose distributions were recalculated with repeated CT images and compared to the original plans.Results The volume of GTVnx were decreased by 6.44%,10.23% and9.72%(F=1.34,P=0.278) in the 2-,4-and 6-week after IM RT comparing with before IM RT, with 6.59%, 30.98 % and 35.13 % (F = 9.22, P =0.000) in GTVnd, 0.73%, 1.86% and 1.41% (F=0.33,P=0.722) in CTV1, -1.78%, -6.47%and -9.34% (F =16.89 ,P =0.000) in CTV2, 13.96%, 32.97% and 37.77%(F=17.17,P=0.000)in the left parotid , and 3.56% , 29.57% and 35.63% (F = 13.49 , P = 0.000) in the right parotid.The mean dose change rate of GTVnx were -0.39%, 0.08% and 0.32% (F =0.15 ,P =0.860) in the 2-,4- and 6-week after IMRT comparing with planning faction dose, with 0.53%, 1.19% and 0.69% (F=0.81,P=0.455) in GTVnd, 1.95%, 2.70% and 3.78% (F=0.61,P=0.552) in the spinal cord,0.32%, 0.81% and 0.62% (F=0.03,P=0.975) in the brain stem, 4.50%, 4.66% and 7.20% (F=0.33,P=0.725) in the left parotid, 2.20%, 7.17% and 7.12% (F= 1.24,P=0.306) in the right parotid.Conclusions The GTVnd, CTV2 and parotids shrinks obviously along with the treatment times for NPC patients during IMRT.Although changes in fraction dose of GTV, CTV, spinal cord, stem and parotids are not significant, further study with larger samples is needed.

Objective To evaluate the value of serum kaliuretic peptide (KP) in predicting atrial fibrillation (AF) and its prognosis,by detecting serum KP levels in patients with severe sepsis.Methods Fifty-six patients with severe sepsis in Integrated Intensive Care Unit of Shajing Hospital of Shenzhen Affiliated to Guangzhou Medical University from January 2014 to August 2015 were collected as the case group.In addition 20 cases health checkup for the same period were collected as the control group.Serum KP were determined in all patients in the case group every day for 1 week after admission,meanwhile the APACHE-Ⅱ score was undertook,then according to heart guardianship and electrocardiogram whether occurrence of AF the case group were divided into AF group and non AF group.According to survival after 28 days again divided into survival group and death group,the relationship of serum KP with AF and the prognosis were analyzed.Serum KP was detected on the day of physical examination in the control group.Results (1) The incidence of AF was 32.1％(18/56) in 56 patients with severe sepsis.(2)Serum KP in admission to hospital in case group was significantly higher than that in the control group((234.2±73.5) pmol/L vs.(169.6±65.4) pmol/L;t =3.47,P =0.001).Serum KP in admission to hospital in AF group was significandy higher than that in the non AF group((306.0±35.6) pmol/L vs.(200.2±61.2) pmol/L;t =6.79,P =0.001).Serum KP in AF group before 1 day of the occurrence AF was significantly higher than of the admission to hospital ((339.2± 30.5) pmol/L vs.(306.0±35.6) pmol/L;P=0.007),serum KP on the day of occurrence AF was significantly higher than before 1 days of the occurrence AF((390.6±47.8) pmol/L vs.(339.2±30.5) pmol/L;P=0.006),there was no difference between the serum KP after 1 days of occurrence AF and on the day of occurrence AF(P=0.246),but began to gradually declining.Serum KP and APACHE-Ⅱ score in death group on admission to hospital were significantly higher than survival group((301.1±42.0) pmol/L vs.(199.8±61.5) pmol/L,(26.1±2.8) points vs.(19.9±4.3) points;t =6.44,5.67;P＜0.001).(3) Linear correlation analysis showed that serum KP on admission to hospital was positively correlated with the occurrence of AF(r=0.679,P=0.010).According to AF grouping,serum levels of KP on admission to hospital draw ROC curve,the serum KP of AUC was 0.908(95％ CI:0.831-0.984),when the KP value was 351.5 pmol/L,the sensitivity of the occurrence AF was 89.9％,specificity of 97.4％.(4)Linear correlation analysis showed that serum KP on admission to hospital was positively correlated with death(r=0.659,P =0.010),according to prognostic grouping,serum KP on admission to hospital and APACHE-Ⅱ score ROC curve was drew,the serum KP of AUC was 0.893 (95％ CI:0.811-0.974),when the KP value was 338.5 pmol/L,the sensitivity of death was 78.9％,specificity of 97.3％.Conclusion Early serum KP level can be used as an indicator to predict AF and prognosis in the patients with severe sepsis.

This study was aimed to establish the method of identifying bupleurum cultivated germplasm using simple sequence repeat (SSR) molecular markers and to initially establish dataset of characteristic SSR bands to the bred cultivars or strains. From the bupleurum SSR primer pairs which were designed in previous work, 50 primer pairs were selected. Two bred strains and 4 other bupleurum cultivated germplasms were used as test materials. Primers pairs were screened with effective PCR amplification and high polymorphism. Meanwhile, conditions for PCR amplification and electrophoresis were optimized. Then, obtained SSR bands were analyzed and a clustering tree on the basis of genetic distance was constructed. The results showed that 9 SSR primer pairs can be used for identification. The suitable assay conditions were established and characteristic SSR bands were obtained for tested materials. The tested samples can be divided into 4 categories in the genetic similarity coefficient of 0.73. TheB. scorzonerifolium cultivated inHeilongjiang andChuanhongchaiNo. 1 strains were clustered as one category. ChuanbeichaiNo. 1 strain andZhongchai No. 1 cultivar clustered as another category. Cultivated germplasms fromSichuan Fengshunand Rongxian clustered as a unique category. It was concluded that the primer pairs and assay method established in the present study can be used as reference in identification of bupleurum cultivars or cultivated germplasms.