Purpose　To evaluate the clinical safety of ionic contrast media made in china and compare with nonionic contrast media being imported. Methods　Among contrast-enhanced CT 1096 cases, 76% meglumine diatrizoate were administed in 864 cases and ultravist in 232 cases , comparative studies on adverse drug reactions(ADRs) and image quality were performed. Results　In 76% meglumine diatrizoate group , the prevalence of overall and mild -middle ADRs was higher than in the ultravist group , the prevalence of severe and potentially life-threatening ADRs was approximate in the ultravist group , the image quality was well than in the ultravist group.Preventive inoculation alleviated ADRs at all levels. Conclusion　Ionic contrast media made in china was safe and effective in patients without hyperthyroidism after preventive inoculation.

Objective To analyze the CT findings of heterotopic pancreas and the correlation with pathologic changes.Methods CT findings in 1 9 patients with heterotopic pancreas proven by surgery were reviewed retrospectively,14 of whom were scanned with enhanced CT.The correlation of CT findings and pathologic results were also analyzed.Results All patients had a single lesion with sized range from 0.8 to 4.7 cm and mean diameter of (2.2±0.6)cm.All lesions with homogeneous density were showed on plain scans including 7 lesions in stomach,8 in duodenum,2 in jejunum,1 in ileum and 1 beside the cardiac lymph nodes.The border of the lesions in 5 was unclear with exudative changes,mimicking acute pancreatitis.A sign of central umbilical concave was found in 2.Pathological results confirmed 14 lesions in submucosa,3 in muscular layer,1 in serosal layer and 1 in abdominal cavity.Hetero-topic pancreas presented early obvious enhancement in 9,mimicking normal pancreas,which was composed chiefly of pancreatic aci-ni.The enhanced degree of 4 lesions was lower than normal pancreas,which were composed of pancreas ductal epithelium and few pancreatic acini.No significantly enhancement was seen in 1,mimicing liomyoma,which was composed chiefly of pancreas ductal epithelium and smooth muscle hyperplasia.Conclusion Heterotopic pancreas in most cases presents characteristic submucosal disea-ses-like pattern,and different enhanced patterns of heterotopic pancreas are related with the pathologic changes.

Objective To evaluate the diagnostic value of TNM staging of gastric carcinoma with triphase incremental helical CT.Methods Triphase incremental helical CT of the stomach with water-filling method were performed in 101 patients with gastric carcinoma.Results (1)The accuracy of T-staging,N-staging and TNM staging was 81.8%,72.9% and 80.2% respectively.(2)Demonstrating multilayered structure of the normal gastric wall in the arterial parenchymal-phase was advantageous to improve the accuracy of estimating the depth of tumor invasion (?

Objective To determine the risk factors for development of succinylcholine-induced postoperative myalgia.Methods One hundred and fifty-five patients,aged 18-64 yr,of ASA physical status Ⅰ or Ⅱ,with body mass index of 20-30 kg/m2,scheduled for elective craniofacial surgery,were included in the study.Total intravenous anesthesia with propofol or combined intravenous-inhalational anesthesia with sevoflurane was performed during surgery.The patients were divided into 2 groups according to whether or not myalgia occurred within 24.h after surgery:myalgia group and non-myalgia group.Factors including gender,age,body weight,duration of surgery,method of anesthesia,dose of succinylcholine,preinjection of lidocaine or nondepolarizing muscular relaxants during induction of anesthesia,use of hormone (dexamethasone or methylprednisolone) and nonsteroidal analgesics (parecoxib sodium) during surgery,and consumption of fentanyl were recorded.The risk factors of which P values were less than 0.05 would enter the multivariate logistic regression analysis to stratify the risk factors for development of succinylcholine-induced postoperative myalgia.Results Forty-one patients developed postoperative myalgia,and the incidence of myalgia was 27.2％.The results of logistic analysis indicated that succinylcholine ＜ 1.5 mg/kg and no preinjection of lidocaine were closely correlated with the development of postoperative myalgia induced by succinylcholine.Conclusion Succinylcholine＜1.5 mg/kg and no preinjection of lidocaine are the risk factors for development of succinylcholine-induced postoperative myalgia in the patients.

Adult ; Bone Diseases, Metabolic ; etiology ; Female ; Fractures, Spontaneous ; etiology ; Humans ; Liver Diseases, Alcoholic ; complications

Objective To investigate CT findings in gastric stromal tumors(GST).Methods Both plain and enhanced spiral CT findings in 46 cases with gastric stromal tumor were retrospectively analyzed.In all patients,diagnosis was confirmed with immunohistochemical markers.CT features were retrospectively studied and summarized.Statistical analysis of the shape,growth pattern,necrosis and enhancement patterns was performed with X2 test in 43 cases with single gastric stromal tumor.Results Of the 46 GST patients,43 patients had single GST and multiple GST was detected in 3 cases.In the 43 cases with single GST,tumors were found in the gastric body in 24 cases,gastric fundus in 16 cases,and in the gastric antrum in 3 cases.GST mostly grow along the vertical plane of gastric wall,with a large size but local attachment.The tumor size was less than 5era in diameter in 14 cases.Of them,ten cases had a regular shape,10 cases showed homogeneous enhancement,and 4 cases exhibited central necrosis,7 tumors showed intra-luminal growth and 5 tumors showed extra-luminal growth,while the other 2 cases involved both intra and extra lumina.Twenty-nine cases had tumors larger than 5cm in diameter.Of them,24 cases had irregular shape,27 cases showed inhomogeneous enhancement,24 cases had central necrosis,5 tumors showed intra-luminal growth and 9 tumors showed extra-luminal growth,while 15 cases involved both intra and extra lumina.The tumor size of GST closely was related to the shape,growth pattern,necrosis and the inhomogeneous enhancement patterns of the GST(P<0.05).The enhancement of the tumor was more intense in venous phase and delayed phase.Five cases showed septal enhancement,4 tumors exhibited marked enhancement in arterial phase with up to 60 HU.Conclusions CT can precisely display the location,shape and size of gastric stromal tumors.It is very helpful to provide useful information for early diagnosis and evaluation.

Objective To investigate the prognosis and related factors of community acquired pneumonia (CAP). Methods From August 2003 to March 2009, 689 CAP cases from 37 hospitals of 23 cities in China were enrolled. The onset information and clinical outcomes in one month of onset were recorded. Pearson Chi-square test and Logistic regression test were performed using the SPSS 12.0 software to identify prognosis-related factors. Results Among 689 patients there were 396 male and 293 female. The median age was (53 19) years old, 247 patients (35.8%) were≥65 years old. Forty four patients died with a fatality rate of 6.4%. Univariate analysis identified 19 risk factors, they were age≥65 years old, smoking, aspiration, use of antimicrobial agents in 3 months, use of immunodepressant in 2 months, heart failure, chronic renal failure, chronic liver disease, eerebrovascular disease, diabetes, emaciation, altered mental status, respiratory rate > 28/min, pulse > 100/min, lower diastolic blood pressure, neutrophil ratio > 0.9, ALT >40 U/L, elevated blood urea nitrogen level and PORT classification ≥Ⅳ. By multivariate analysis, use of antimicrobial agents in 3 months, respiratory rate > 28/min, pulse > 100/min and PORT classifications≥Ⅳ were identified as the independent risk factors for mortality. Conclusions The general fatality rate of CAP is low in China. Use of antimicrobial agents in 3 months, respiratory rate > 28/min, pulse > 100/min and PORT classifications≥Ⅳ are independent risk factors for mortality.

Objective To evaluate the value of MSCT in the diagnosis of extrahepatic cholangiocarcinoma.Methods The MSCT appearances of extrahepatic cholangiocarcinoma confirmed by pathology in 27 cases were analyzed retrospectively.Among them,20 patients underwent plain and four-phase dynamic contrast-enhanced CT scans including early arterial phase,late arterial phase,portal phase and delay phase,7 patients only underwent contrast-enhanced CT scans.Results 15 lesions were located in the hilar and 12 lesions were located in the common bile duct.CT features of cholangiocarcinomas in this group were varied with its position and growth pattern.Besides the direct sign such as delay enhancement,the indirect findings were also specific such as hepatic lobe atrophy,dilated bile duct,etc.Conclusion MSCT is of great value in diagnosis of extrahepatic cholangiocarcinoma.

Objective To observe the clinical efficacy of auricular point sticking with magnetic bead in treating insomnia in hepatocirrhosis patients. Method Ninety patients with hepatocirrhosis complicated with insomnia were randomized into a treatment group and a control group, 45 in each group. The treatment group was intervened by auricular point sticking with magnetic bead, while the control group was by auricular point sticking with medical adhesive tape. After successive 2-week treatments, the Insomnia Severity Index (ISI) and the Evaluation Criteria of Therapeutic Efficacy for Mental Disorders were observed for evaluating the treatment result. Result The ISI was significantly improved in the treatment group after intervention (P<0.05), and the improvement was significantly different from that in the control group (P<0.05). The total effective rate was 86.7% in the treatment group versus 60.0% in the control group, and the difference was statistically significant (P<0.01). Conclusion Auricular point sticking with magnetic bead is easy-to-operate and can produce a satisfactory efficacy in treating insomnia of hepatocirrhosis patients.

Objective To explore the effects of hyperbaric oxygen preconditioning on ischemia-reperfusion inflammatory reaction of rats after skin flap transplantation.Methods Fifty-six Sprague-Dawley rats were randomly divided into 3 groups:a sham ischemia-reperfusion (SH) group,an ischemia-reperfusion (IR) group and a hyperbaric oxygen reconditioning (HBO) group.Both IR group and HBO group were further divided into 3 subgroups,respectively,according to the time points of serum sampling for test post establishment of the IR model of the abdominal pedicle skin flap transplantation.The IR model of the abdominal pedicle skin flap transplantation was established in all the animals except those in the SH group,with those in the HBO group were preconditioned with HBO twice daily for 3 days before the operation.The blood was sampled at 1,3 and 5 day post-operation to test the level of IL-23 using enzyme-linked immunosorbeut assay (ELISA).The survival skin flaps were sampled from all the animals at 3 and 5 days after the operation for histological observation and evaluation.Results The average IL-23 level of HBO 3 d subgroup (17.80 ± 14.78) was significantly lower than that of the IR 3 d subgroup (38.91 ± 12.26).The average histological scores of the IR 3 d and 5 d subgroups,as well as HBO 3 d and 5 d subgroups were (2.66 ±0.44)and (3.2 ±0.53),(1.85 ±0.31) and (2.29 ±0.32),significantly higher than SH group (0.38 ±0.10).Moreover,the average histological score of the HBO 3 d and 5 d subgroups was significantly lower than IR 3 d and 5 d subgroups respectively.Conclusion Hyperbaric oxygen preconditioning can relieve the ischemia-reperfusion inflammatory reaction through reducing the serum level of IL-23 in rats after skin flap transplantation.