Objective To study the value of CT and barium radiograpy in diagnosis of gastric schwannoma.Methods A retrospectiveanalysis was made on imaging of 8 patients with pathologically approved gastric schwannoma.Plain abdominal CT scan was performed in all patients, additional enhanced CT scan was carried out in 6 cases and barium radiography of upper digestive tract was carried out in 5 cases. Results The lesions localized in fundus ventriculi in 2 cases, curvatura ventriculi minor in 4 cases and pars pylorica in 2 cases. Three main types were seen: localized mass type (n=4), localized thickening of gastric paries type (n=2) and huge mass type (n=2).Conclusion In comparison with barium radiography of upper digestive tract, CT can accurately demonstrate the shape, the location and internal structure of lesions.Three main patterns of this lesion also can be showed clearly by CT scans and suggestive diagnosis can be made in some patients combined with barium radiography of upper digestive tract images.

Objective To study the MRI features and its ultrastructural pathology basis in different myocardial injury areas after acute infarction.Methods 10 rabbits were given ligation of left anterior descending branch 24 hours to make pathologic models.All animals underwent conventional MRI,contrast media dynamic enhancement MRI,cine-MRI and dobutamine stress test.Myocardial blood flow was measured with radioactive micropheres to define risk regions.Ischemic and infarcted regions were defined as Even's blue and 2,3,5triphenyltetrazolium chloride(TTC)negative regions respectively,and made electron microscopy specimens to observe the changes of mitochondria and myofibril.The myocardial ultrastructural injury was scored and graded.Results There were no significant change on T 1WI,but the signal intensity on T 2WI increased significantly after AMI.The diseased myocardium became thinning were seen in 40% cases,and the abnormal flowing high signal were seen in 60% cases.The dynamic enhancement time-signal intensity curves were different in normal,ischemic and infarcted regions.Cine-MRI showed the cardiac wall movement impairing and the wall thick thinning,but the wall movement reinforcing and the wall thick thickening after dobutamine stress.The water content of ischemic and infracted myocardium were marked higher than normal myocardium.The myocardial blood flow in diseased regions were decreased significantly than that in normal regions.The volume density and numerical density of mitochondria in different injury regions showed significant differences.Conclusion MRI appearances of AMI were associated with the injury degree of myocardial ultrastructure and the residual myocardial blood flow.

OBJECTIVE:To provide reference for promoting the inherirance and development of TCM powder decoction piec-es. METHODS:By retrieving literature,the inheritance,overview of modernization development,and key points in industrial de-velopment of TCM powder decoction pieces were analyzed,and development suggestion was put forward. RESULTS & CONCLU-SIONS:Aiming at inheritance of TCM powder decoction pieces,suggestions were put forward as explaining scientific connotation of TCM powder decoction pieces,mining the essence of preparation technology,and cultivating comprehensive decoction pieces talents with basic knowledge of powder science. According to the particle size of powder,TCM powder decoction pieces can be di-vided into TCM common powder,TCM ultrafine particle powder,and TCM nano powder. Aiming at the key points of TCM pow-der decoction pieces,such as application scope,particle size and its correlation with the performance of TCM,grinding technology and equipment and quality standards,the developing strategies were put forward as adjusting the suitable application scope,select-ing appropriate particle size,strengthening its performance research,standardizing and innovating the preparation,improving the packaging and sterilization technologies,establishing and implementing the quality standard with characteristics.

Objective:To explore the application effect of case-based learning (CBL) and lecture-based learning (LBL) in the teaching of image post-processing course in the standardized training system of medical imaging technology.Methods:A total of 34 trainees in the standardized training of imaging technology of Batch 2018 in West China Hospital of Sichuan University were divided into the experimental group and the control group according to their student numbers, with 17 students in each group. CBL teaching was carried out in the experimental group, and LBL teaching was carried out in the control group. According to the standardized training course design, after one year of image post-processing course teaching, the teaching effect was evaluated through closed-book examination, questionnaire survey and post-processing test. SPSS 20.0 was used for t-test and Mann-Whitney U test. Results:The scores of closed-book examinations (74.42±6.10) and post-processing test (73.47±6.03) in the experimental group were higher than those in the control group [(69.11±3.70) and (69.08±6.51)], and the difference was statistically significant ( P<0.05). The questionnaire survey showed that the students in the experimental group recognized CBL teaching in terms of learning interests stimulation, classroom atmosphere mobilization, clinical thinking cultivation, self-study ability training, and analysis of difficult and rare cases, etc. Conclusion:In the image post-processing course of standardized training of medical imaging technology, the rational application of CBL teaching mode is helpful to improve students' learning enthusiasm, self-learning ability, comprehensive analysis of clinical ability, practical ability, innovation consciousness and so on.

Objective:To access the efficacy of monoenergetic imaging from spectral CT combined with metal artifact reduction for orthopedic implants (O-MAR) on reducing contrast hardening artifacts in the vein on the injection side, and determining the optimal monoenergetic spectral range to improve the display of axillary lymph node.Methods:A total of 35 patients with breast cancer who underwent chest-enhanced CT scans were enrolled in this retrospective study. The original data were reconstructed to obtain a total of 35 sets of images, including one conventional image, 17 groups of monoenergetic images, and 17 groups of monoenergetic+O-MAR images. The areas of interest were delineated in the high and low-density artifact area on the injection side of the same layer contrast agent, and the contralateral ectopectoralis. The CT value and its standard deviation (SD) were recorded respectively, the artifact area was measured, and the number of axillary lymph nodes was recorded. The difference in CT values (ΔCT 1, ΔCT 2) and the artifact index (AI1 and AI 2) of the high and low-density artifact areas relative to the contralateral ectopectoralis in the same layer were calculated respectively. Friedman test and Wilcoxon signed-rank test were used to compare the differences of ΔCT, AI, artifact area, and number of lymph nodes among the three imaging modalities, and the Kappa test was used to compare the differences in subjective evaluation. Results:As the energy level increased, compared to the conventional image, monoenergetic image, ΔCT 1 absolute value, ΔCT 2 absolute value, AI 1, and AI 2 showed a trend of initially low and then high, artifact area decreased, and the number of detected lymph nodes increased ( P<0.01). Compared to other energy levels, when the monoenergetic image was 100 keV, ΔCT 1 value, 140 keV for ΔCT 2 value, 120 keV for AI 1 value, and 130 keV for AI 2 value were close to zero, and the number of detected lymph nodes was highest at 110-200 keV. In contrast, in the monoenergetic+O-MAR images, ΔCT 1 absolute value showed a trend of initially low and then high, but, ΔCT 2 absolute value, AI 1, AI 2, and artifact area all significantly decreased, whereas the number of detected lymph nodes significantly increased (χ 2 values were 916.23, 895.93, 387.08, 519.41, 890.10, and 1027.98, respectively. All P<0.01). Compared to other energy levels, when the monoenergetic+O-MAR image was at 100 keV, ΔCT 1 value was close to zero, while ΔCT 2 value became close to zero with increasing energy level, and the number of detected lymph nodes was highest at 110-200 keV. As the energy level increased, the ΔCT 1, AI 1, AI 2, and artifact area of monoenergetic+O-MAR images were significantly smaller than those of monoenergetic images at the same energy level, and the number of detected lymph nodes was significantly higher than that of monoenergetic images ( P<0.01). The subjective scores for 110-200 keV monoenergetic images and 100-200 keV monoenergetic+O-MAR images were both higher than 4, and the score for monoenergetic+O-MAR images was significantly higher than that of single-energy spectrum images. The agreement between the two radiologists in assessing subjective scores was good. Conclusion:At 100-120 keV level, spectral CT monoenergetic combined with O-MAR imaging technique has the best performance in removing hardening-induced artifacts of chest-enhanced CT contrast agent and detecting and displaying axillary lymph nodes.

Objective:To analyze the risk factors of three-vessel disease (TVD) in patients with stable coronary artery disease (SCAD).Methods:The clinical data of 447 patients with SCAD diagnosed in Zhongshan Hospital from May 2019 to April 2020 were retrospectively analyzed, including 108 cases with the single-vessel disease (SVD), 136 cases with the two-vessel disease, and 203 cases with three-vessel disease. The general data and hematological indexes were compared between patients with SVD and those with TVD; the related factors for TVD in SCAD patients were analyzed with univariate and multivariate logistic regression.Results:There were 244 males (78.5%) and 67 females (21.5%) with a median age of 57 years (64, 69). Univariate analysis showed that there were significant differences in diabetes history ( χ2=7.75, P=0.005), uric acid ( Z=-2.10, P=0.036), glycosylated hemoglobin ( Z=-2.77, P=0.006) and high density lipoprotein cholesterol (HDL-C) ( Z=-2.99, P=0.003) levels between SVD and TVD groups. Multivariate analysis showed that the high level of blood uric acid ( OR=1.01, 95% CI: 1.00-1.01, P<0.05) and the low level of HDL-C ( OR=3.29, 95% CI:1.23-8.85, P<0.05) were related risk factors of TVD. Conclusion:High blood uric acid level and low HDL-C level are related factors for TVD in patients with SCAD.

Objective:To investigate the effects of extracorporeal carbon dioxide removal (ECCO 2R) combined with continuous renal replacement therapy (CRRT) on respiratory efficiency and diaphragm function in patients with acute respiratory distress syndrome (ARDS) received mechanical ventilation. Methods:A prospective randomized controlled study was conducted. Sixty patients with mild to moderate ARDS admitted to the department of respiratory and critical care medicine of Henan Provincial People's Hospital from January 2019 to January 2021 were enrolled, and they were divided into observation group and control group according to the random number table method, with 30 cases in each group. All patients received antibiotics, anti-inflammatory, and mechanical ventilation therapy. On this basis, the observation group received ECCO 2R and CRRT, while the control group received bedside CRRT. Baseline data including gender, age, etiology, acute physiology and chronic health evaluationⅡ(APACHEⅡ), etc., were recorded. Arterial blood gas analysis [including arterial partial pressure of oxygen (PaO 2), arterial partial pressure of carbon dioxide (PaCO 2), and oxygenation index (PaO 2/FiO 2)] was performed at 12 hours and 24 hours during the treatment, and respiratory mechanics parameters [including tidal volume, respiratory rate, maximum expiratory pressure (MEP), and maximum inspiratory pressure (MIP)] were recorded, and rapid shallow breathing index (RSBI) was calculated. The levels of glutathione peroxidase (GSH-Px), malondialdehyde (MDA), and superoxide dismutase (SOD) in serum were detected by enzyme-linked immunosorbent assay (ELISA). Diaphragm thickness and diaphragm activity were measured by ultrasonography at 24 hours during the treatment. Results:There were no significantly differences in age, gender, etiology, and APACHEⅡ score between the two groups, indicating that the baseline data of the two groups were balanced and comparable. Compared with the 12 hours after treatment, the PaO 2 and PaO 2/FiO 2 in the observation group significantly increased, PaCO 2 significantly decreased, RSBI significantly decreased, MEP and MIP significantly increased, and serum GSH-Px and MDA significantly decreased, while SOD significantly increased at 24 hours during the treatment. In the control group, only PaCO 2 significantly decreased. Compared with the control group, the PaCO 2 significantly decreased in the observation group at 12 hours and 24 hours [mmHg (1 mmHg≈0.133 kPa): 55.05±7.57 vs. 59.49±6.95, 52.77±7.88 vs. 58.25±6.92, both P < 0.05], but no significantly differences in PaO 2 and PaO 2/FiO 2. Compared with the control group, the observation group showed significant decreases in RSBI at 12 hours and 24 hours (times·min -1·L -1: 85.92±8.83 vs. 90.38±3.78, 75.73±3.86 vs. 90.05±3.66, both P < 0.05), significant increases in MEP and MIP [MEP (mmH 2O, 1 mmH 2O≈0.01 kPa): 86.64±5.99 vs. 83.88±4.18, 93.70±5.59 vs. 85.04±3.73; MIP (mmH 2O): 44.19±6.66 vs. 41.17±3.13, 57.52±5.28 vs. 42.34±5.39, all P < 0.05], and significant decreases in serum GSH-Px and MDA [GSH-Px (mg/L): 78.52±8.72 vs. 82.10±3.37, 57.11±4.67 vs. 81.17±5.13; MDA (μmol/L): 7.84±1.97 vs. 8.71±0.83, 3.67±0.78 vs. 8.41±1.09, all P < 0.05], as well as a significant increase in SOD (U/L: 681.85±49.24 vs. 659.40±26.47, 782.32±40.56 vs. 676.65±51.97, both P < 0.05). Compared with the control group, the observation group showed significant increases in diaphragm thickness and diaphragm activity at 24 hours of treatment [diaphragm thickness (cm): 1.93±0.28 vs. 1.40±0.24, diaphragmatic thickening fraction: (0.22±0.04)% vs. (0.19±0.02)%, quiet breathing diaphragm displacement (cm): 1.42±0.13 vs. 1.36±0.06, deep breathing diaphragm displacement (cm): 5.11±0.75 vs. 2.64±0.59, all P < 0.05]. Conclusion:ECCO 2R combined with CRRT can reduce work of breathing and oxidative stress levels in ARDS patients receiving non-invasive ventilation, and protect diaphragm function.

Lipid Droplets/metabolism* ; Bacteria ; Lipid Metabolism