Objective To analyse CT appearances of malignant neurilemoma in the thorax and abdomen,in order to improve the diagnostic accuracy of this disorder. Methods There were 9 cases(5 cases in thorax and 4 cases in abdomen) with malignant neurilemoma proved by pathology (7 cases by surgery and 2 cases by CT guided percutaneous puncture biopsy). CT both plain and enhanced scans were performed in all cases. Results Tumors were located in the mediastinum in 5, in abdominal wall and retroperitoneum in 2 respectively .7 cases were isolated masses,2cases were disseminated masses,in company with pleuritic fluid was in 4 and with osteogenic metastasis of vertabral body in one case.The isolated masses appeared as round or ellipse with low density in the centre,the CT value was 5~20 HU,6 cases had complete capsule.The disseminated masses in 2 cases appeared as homogeneous density.On contrast-enhanced scan,the solid parts of masses were enhanced in different degree. Conclusion The isolated thoracic and abdominal malignant neurilemoma is of certain CT characteristics, but the disseminated one is not.

Objective To study the clinical application value of multi-slice spiral CT iliac venography.Methods The iliac venography with multi-slice spiral CT was performed in 50 cases.150 mgI/ml contrast medium at 2.5～3.0 ml/s was administered via the veins of dorsum of foot and the delayed time was 16～22 s,the images were reconstructed by several methods.The imaging quality and imaging characteristic of iliac vein disease were analyzed.Results Helical CT venography was performed successfully in all patients.Venography showed vein complete occlusion in 31 cases,vessel stenosis or filling defect in 9 cases,normally in 10 cases.The quality of images included:excellent 24%(12/50),good 60%(30/50),bad 16%(8/50),the collectivity was 84%(42/50).Conclusion The multi-slice spiral CT iliac venography is of certain clinical applied value.

Objective To evaluate the effects and safety of uterine artery embolization for uterine leiomyoma. Methods Total of 185 patients with uterine leiomyoma were treated by UAE. They were followed for one to 6 years to observe the changes of leiomyoma size and improvement in clinical symptoms. Ovarian function was evaluated in 44 cases. Results Bilateral embolization of uterine arteries was performed in 185 patients. Follow-up of 1 ～6 years for 292 leiomyoma indicated that one to 9 months after embolization, shrinkage of leiomyoma size was the most significant factor. One year after embolization, leiomyoma sizes decreased a little. Shrinkage of submucous leiomyoma was more significant than that of intratumoral one, and the latter was more significant than subserous one. Shrinkage of leiomyoma with large size ( volume ≥ 150cm~3) was less than that of small one. Menorrhagia, anemia and pressure symptoms were all resolved. There was no significant difference between pre- and post embolization ovarian hormone level. Conclusions The significant reduction in leiomyoma volume and resolution of clinical symptoms confirmed that the treatment validity of symptomatic leiomyomas by UAE. UAE is an effective therapeutic procedure which has no adverse effect on the ovarian function.

Objective To explore the application of LIS management group in hospital software and hardware management.Methods The objective,responsibilities and management procedure of hospital LIS management group were introduced,and its effects were studied in hospital software and hardware management.Results Hospital LIS management group optimized LIS management procedure,decreased fault rate and shortened the time for fault handling.Conclusion LIS management group promotes hospital digitalization and clinical laboratory department management.

Objective To compare the clinical values of impedance method,optical method and microscopy when used to detect platelet abnormal results.Methods Platelet re-examinations by optical method and microscopy were carried out in case of low confidence degree in platelet test with impedance method by XE-2100 automatic hematology analyzer,and then the results by the three methods were compared.Results Most of the low-confidence-degree results by impedance method could be corrected by re-examination by optical method,and the remained had to turn to microscopy due to unsatisfied requirements of the instrument.Conclusion Optical method has to be involved to correct the platelet abnormal results by XE2100 automatic hematology analyzer,and microscopy should be applied in case optical method doesn't work.The three methods gains advantages and disadvantages of themselves,and can be supplementaries for one another.

Objective To explore the efficacy of multiple interventional models combined through anterior tibial veins approach in treatment of acute deep venous thrombosis (DVT).Methods The clinical data and the imaging materials of 10 patients with acute DVT were analyzed retrospectively,and the interventional treatment strategies were discussed.Results The percutaneous mechanical thrombectomy (PMT) was performed after a temporary inferior vena cava filter implanted in all patients,and thrombus clearance rate of grade Ⅲ was obtained in 7 patients while 3 patients reached grade Ⅱ criteria.There were 7 patients underwent angioplasty,then the inferior vena cava filter was retrieved during the same procedure in 5 patients while 4 patients in the second stage and 1 patient rejected to retrieve the filter.All swelling limbs alleviated significantly after those procedures.There was no critical complications occured.The total hospital stay ranged from 4 to 7 days,with a mean time of (6.00±0.94) days.All patients were followed up with a mean time of (3.60± 1.84) months (ranged from 1 to 6 months).No thrombus recurrences of the previously affected vessels were reported.Conclusion The multiple interventional models combined via anterior tibial veins for acute DVT is simple,safe and effective,combined with mechanical thrombectomy device can reduce thrombus burden quickly,and combined with angioplasty can consolidate the therapeutic effect,all those methods combined can shorten the overall hospitalization time.

Objective To investigate the causes and factors of hemoglobinuria in patients with thrombosis after AngioJet mechanical thrombectomy.Methods The clinical data of 16 patients with thrombosis treated by AngioJet thrombectomy system were retrospectively analyzed.Nine patients with hemoglobinuria during the procedure were included in group A,while 7 patients without hemoglobinuria in group B.The type of surgical procedure,time of intraoperative aspiration and the thrombus volume were compared between both groups.Results Nine (9/16,56.23 ％) of 16 patients were found hemoglobinuria during and after AngioJet mechanical thrombectomy.There were no statistically significant differences in surgical approaches (x2 =1.667,P=0.197),the time of intraoperative aspiration ([320.11±108.80]s vs [265.29±31.46]s,t=0.741,P=0.457),the thrombus volume (x2=0.442,P=0.506) between both groups.No renal function failure were noted directly relating to the use of the AngioJet thrombectomy device.Condusion There are many factors influenced the occurrence of hemoglobinuria in the patients after AngioJet thrombectomy.It can be reduced by using reasonable type of intraoperative aspiration,controled time of aspiration and active perioperative symptomatic treatment.

Objective To screen the peripheral blood circRNA differently expressed in patients with rheumatoid arthritis (RA) and to explore the pathogenetic role of peripheral blood cicRNA in RA by analyzing the data with bioinformatics.Methods The study was performed in 3 RA cases and 3 healthy controls,using circRNA microarrays to screen the circRNA in peripheral blood of patients with RA.The data were normalized and analyzed by R soft package,screening by fold change and P value and searching the differently expressed circRNAs between the two samples by t test.Bioinformatics was performed to analyze the differently expressed circRNAs.Results The results from circRNA microarrays revealed that 36 circRNAs were significantly al-tered in RA patients (P ＜0.05) compared with the control group.Among them,22 were significantly up-regulated,and the other 14 were down-regulated.The GO analysis of the genes involved in the circRNA showed that these genes participated in the progress of biological regulation,cell differentiation,and metabolism.We predicted the target miRNA of all the differently expressed circRNAs,among the results there was a miRNA (hsa-miR-125a-3p) targeted by a circRNA(hsa_circ_0005397) experimentally confirmed by other studies.The relationships among circRNA-miRNA-Gene were predicted by Cytoscape software.Conclusion There are many differently expressed cireRNAs in peripheral blood of patients with RA,and the circRNAs maybe involved in the regulatory mechanisms of Rheumatoid Arthritis.

Objective Evaluate data of 1270 cases with free flap transplant,to find the problems in the process of operation,and then to analyse its causes and how to prevent and solve it,as well as providing reference for clinical colleagues. Methods To study 1270 cases of free flaps,musculocutaneous flap and perforator flap who was treated in our hospital from October 2000 to October 2010 retrospectively. A total of 722 cases of the group were followed-up 6 months to 5 years. To detective and search the problems and imperfection from designing,harvesting,tranfer,to the management and function of donor site after free flap transplantion.And also to analysis the couse of problems and operation failure,discuss the conclude of and to provide advisable measure. Results Total 1270 free flaps were transplanted successfully except 64 can-celled or failured for some reason, the success rate was 95.0％, the postopertive necrosis rate was 3.8％.Seventy-six cases were encountered vascular complications venous crisis in 42,arterial crisis in 38.Fifty-five cases were saved successfully without surgery,and 15 cases survived completely by vessel explorative operation. Five cases were partial necrosis and 7 cases necrosis. The rate of postoperative infection of emergency cases and chronic one were 4.7％ (682 cases)and 8.8％(588 cases) which show the infective incidence of latter was higher than former. In addition, there were many other problems were found such as distal flaps necrosis,contracture,deformation,impairment function of doner site,etc. Conclusion Preventing and management timely to vessle crisis is the key to flap suvive. The principle of dissecting flap should be followed strictly,and control the indications of modified processing during flap harvest,keep the proper flap tension were technical requirements in flap transplantion. Right way of donor site closed and management of insufficient timely were equally important to prevent and solve to complications and dysfunction.

Objective To explore the relationship between traditional Chinese medicine (TCM) syndromes of state of evil domination and clinical and laboratory indicators of IgA nephropathy. Methods A prospective study was used to collect data on clinical and laboratory examination of IgA nephropathy in multi clinical centers. Patients’ TCM syndrome types were determined according to the national diagnostic criteria at the same time. Totally 266 patients with IgA nephropathy were included in the study to establish a database for analyzing the relationship between TCM syndrome of state of evil domination and clinical and laboratory indicators. Results In the relationship between syndromes of state of evil domination distribution and clinical subtypes, patients of wind-heat syndrome had more macroscopic hematuria;patients of phlegm-damp syndrome had more nephrotic syndrome;patients of damp-heat syndrome had more chronic nephritis type Ⅰ;patients of blood stasis syndrome had more chronic nephritis type Ⅱ. In the relationship between syndrome of state of evil domination distribution and clinical manifestation, the incidence of hypertension was higher in patients of blood stasis syndrome than in other three types. It was more serious for hematuresis in the patients of wind-heat syndrome. For patients of phlegm-damp syndrome, the incidence of heave proteinuria was highest. In the relationship between syndrome of state of evil domination distribution and laboratory examination, 24-hour urinary protein quantification was higher than in patients of wind-heat and damp-heat syndrome, but the level of blood albumin was lowest. For patients of blood stasis syndrome, serum creatinine level was significantly higher than in other three types;the level of eGFR was just the opposite. The levels of blood cholesterol and triglyceride in patients of phlegm-damp syndrome were higher than in other three types. The activated partial thromboplastin time (APTT) levels in patients of blood stasis and phlegm-damp syndrome were lower than in other patients, but the FIB level was the exact opposite of APTT. In the relationship between syndrome of state of evil domination distribution and the stages of chronic kidney disease (CKD), patients of wind-heat syndrome were more in the first stage of CKD;patients of blood stasis syndrome were more in the third stage of CKD. Conclusion There is relative correlation between TCM syndromes of state of evil domination and clinical and laboratory indicators in IgA nephropathy, which would provide some reference to narrow the gap in the information of the four methods of TCM with clinical and laboratory indicators to enhance accurate diagnosis of TCM syndrome.