Objective To assess the value of dual-source computed tomography angiography (DSCTA)in detecting intracranial aneurysms by comparing with conventional and three-dimensional DSA.Methods In this study,95 patients with subarachnoid hemorrhage(SAH)underwent both DSCTA and DSA examination.The detection rate,size,and ratio of the neck to the dome(N/D ratio)of the aneurysrns were evaluated.Statistical analysis was performed using a paired sample Student's t-test for the comparisons of the value of N/D and 2 Related Samples test for long axis.Results A total of 67 aneurysms in 63 patients at DSA and 64 aneurysms in 60 patients at DSCTA were detected,respectively;whereas no aneurysm was detected in 32 patients at DSA.Compared with DSA,the overall sensitivity.specificity,positive predictive value,and negative predictive value of DSCTA on a per-aneurysm basis were 94.2%,100.0%,100.0%,and 91.4%,respectively.For the aneurysms larger than 3 mm,the sensitivity and specificity of DSCTA in detecting intracranial aneurysms were equal to those of DSA:For aneurysms smaller than 3 mm,however,the sensitivity and specificity of DSCTA is 80.0% and 100.0%.The N/D ratio for DSA and DSC:TA was 0.46±0.14 and 0.51±0.18.respectively,and the median of long axis was 4.9 mm and 4.8 mm.respectively.There was no significant difierence in the N/D ratio(t=3.20;P＞0.05)and the long axis(Z=-1.309;P＞0.05)between DSA and DSCT.Condusions Compared with conventional and three-dimensional digital subtraction angiography,DSCTA has high sensitivity and specificity in the detection of intracranial aneurysms,especially for detection of snlall aneurysnm(＜3 mm).It can be used as a routine screening technique.

Objective We aimed to evaluatd the effect of oral nursing with oral washing on patients with peroral endotracheal intubation and discuss the appropriate oral nursing method for patients with patients with peroral endotracheal intubation. Methods We chose 150 patients with indwelling peroral endotracheal intubation after neurosurgery and divided them into the control group (73 cases) and the test group (77 cases). The test group received oral nursing with oral washing while the control group with routine oral nursing method. We compared the incidence of halitosis, the moist degree of oral cavity and the amount of the tooth fungus spot between the two groups. Results The incidence of halitosis and the amount of the tooth fungus spot in the test group were lower than those of the control group; The moist degree of oral cavity in the test group was higher than that of the control group, P<0.01. Conclusions Oral washing could effectively control halitosis, keep oral cavity moist and prevent the formation of tooth fungus spot.

Template direct dye-terminator incorporation with fluorescence-polarization (TDI-FP assay) is a technology for genotyping single nucleotide polymorphisms (SNPs). To apply this method in analyses of A647G variation in human papillomavirus (HPV) 16 E7 gene from HPV 16-positive cervical tissues, a total of 91 and 49 HPV 16-positive DNA samples obtained from women with cervical cancer and normal/inflamed cervices living in Shaanxi in northwest China were subjected to the partial E7 gene PCR with nucleotide (nt) 647 in the products. Then, the oligonucleotide probe designed to anneal immediately to nt 647 was hybridized to the template within the PCR amplicons, and extended specifically by TAMRA-ddTTP or R110-ddCTP directed by the base at nt 647. The increasing FP values were read and the base at nt 647 was identified. The prevalence of nt 647 A→G was 35.71% (50/140). The variation 647G detected in 42.86% (39/91) of women with cervical cancer was significantly higher than 22.45% (11/49) detected in those with normal/inflamed cervices (x2 = 5.778, P = 0.016). The odds ratio (OR) between these two groups was 2.59 (95% confidence interval=l.17～5.71). The results demonstrate that TDI-FP method can be potentially applied in analysis of interest point mutations in HPVs. The incidence and risk implication of HPV 16 A647G variant infection in Shaanxi, China, displays significant geographic difference from other areas. The HPV 16 with E7 gene A647G point mutation appears to have a higher risk for invasive cervical cancer in women living in Shaanxi.

Objective To evaluate monoenergetic imaging of dual energy CT in the visualization of metal fixation of factures. Methods In total, 29 patients with factures underwent 36 metal fixations,including 11 external fixations implanting in tibiofibula (n = 11 ) and 25 internal fixations (cervical spine,n=10; lumbar spine, n=4; tibiofibula, n=8; radial bone, n=3). They were recruited into this study.After dual energy CT scan, monoenergetic software was used to post-process with the following 6 photon energies: 40, 70, 100, 130, 160, 190 keV. Two radiologists evaluated and rated the reformatted images with 6 different photon energies and average weighted 120 kV images according to the following 4-score scale. Score 1: nonassessable, with marked artifact; score 2: assessable, moderate artifact; score 3: good,mild artifact, good visualization of bony structures; score 4: excellent, no artifact. Kruskal-Wallis was used to perform statistical analysis of image quality for total fixations, external and internal fixations with various selective kev settings and average weighted 120 kV. Results For total fixations, monoenergetic imaging of dual energy CT has 25 fixations with score 3 and 4, but 120 kV has only 4 fixations with score 3 and 4.Monoenergetic imaging of dual energy CT improved image quality of fractures with metal fixation compared to average weighted 120 kV images ( F = 116. 487, P ＜0. 01 ). Images of 130 kev had the best image quality for external metal fixation (9 fixations with score 3 and 4, F = 60. 902, P ＜ 0. 01), while 70 kev was best for internal metal fixation ( F = 122. 149, P ＜ 0. 01). Conclusions Monoenergetic imaging of dual energy CT improves image quality of fractures with metal fixation. Reformatted images at 70 keV and 130 keV havethe optimal image quality for internal and external metal fixation, respectively.

Objective To preliminarily investigate the effect of PBL applied in teaching of Obstetrics and Gynecology. Methods Ninety eight students were randomly divided into PBL pedagogy group and traditional pedagogy group in clinical practice teaching of dysfunctional uterine bleeding. Exam scores were assessed and opinion survey was summarized. Results The exam score was 80.7 ± 5.6 of PBL pedagogy group and 76.3 ± 4.9 of the other group respectively. There was significant difference between the scores of the two groups (P <0.05). Most students consider that PBL pedagogy was of benefit to students' ability. Conclusion PBL pedagogy has more advantages in training of clinical thinking than traditional teaching method.

ObjectiveTo evaluate the image quality of displaying the pulmonary artery and pulmonary emboli at different tube voltages and find the optimal tube voltage.MethodsSixty-six patients underwent contrast-enhanced dual energy CT pulmonary angiography (CTPA) from August 2007 to February 2010.Data obtained with 80 kVp,weighted average 120 kVp,and 140 kVp were divided into group Ⅰ,Ⅱ,and Ⅲ respectively.CT value of pulmonary artery ( grade 1—4),emboli,and muscles were measured.Corresponding signal to noise ratio (SNR) and contrast to noise ratio (CNR) were calculated.One-way ANOVA analysis and Friedman test were used to analyze statistical significance among these values.Image quality of CTPA from these three groups was assessed.The inter-reader agreement of image quality was performed by kappa test.ResultsCT value of branch 1 to 4 of ptlmonary artery was (446 ± 140) HU,(433±130) HU,(411 ±138) HU,and (392±127) HU in group Ⅰ,(303±91) HU,(290±85) HU,(276±86) HU,and (263 ±85) HU in group Ⅱ,and (244 ±70) HU,(230 ±63) HU,(216 ±72) HU,and (205 ±68) HU in group Ⅲ.There was significant difference for CT values (P ＜0.01) among three groups.CT value of pulmonary artery in 80 kVp images was higher than 140 kyp and 120 Kvp.On quantitative analysis of 37 patients,CNR value of pulmonary clots was 8.3 ± 3.3,8.0 ± 2.9,and 5.6 ± 2.2 in group Ⅰ,Ⅱ,and ⅢⅢ,respectively.CNR values of pulmonary clots in 80 kVp images and 120 kVp images were higher than that in 140 kVp (P ＜0.01 ).There was no statistical difference for image quality of CTPA among the three groups ( P ＞ 0.05 ).Agreement of image quality of CTPA derived from 80 kVp (kappa value =0.789,P ＜0.01 ) was superior to that of 120 kVp (kappa value =0.652,P ＜0.01 ) and 140 kVp ( kappa value = 0.509,P ＜ 0.01 ).Conclusions CT value of pulmonary artery in 80 kVp images was higher than that of weighted average 120 kVp and 140 kVp,and the image quality and CNR was comparable with that of weighted average 120 kVp images.This tube voltage ( 80 kVp) is optimal for CT pulmonary angiography in the evaluation of patients with suspected pulmonary embolism.

Objective To investigate the function of Bcl-2 and Bax in the pathogenesis,development and regression of human hemangiomas.Methods We examined the expression of Bcl-2 and Bax in proliferating versus involuting human hemangioma tissues and normal skin tissues using immunohistochemical technique.Results The expression of Bcl-2 in proliferating hemangiomas was significantly higher than that in involuting hemangiomas and normal skin tissues(P＜0.01).No significant difference was found between the expression of Bcl-2 in involuting hemangiomas and that in normal skin tissues(P＞0.05).The expression of Bax in involuting hemangiomas was significantly higher than that in proliferating hemangiomas and normal skin tissues(P＜0.01);the expression of Bax in proliferating hemangiomas was significantly higher than that in normal skin tissues(P＜0.05).Conclusion Bcl-2 and Bax participate in the development and involution of hemangioma,Bcl-2 plays a role in accelerating the proliferation of hemangioma by inhibiting the apoptosis of endothelial cells,and Bax promotes the switching from proliferation to involution in hemangiomas through inducing the apoptosis of endothelial cells.

clues for interpretation of myocardial ischemia.

Objective To evaluate the clinical values of dual energy lung perfusion using dual-source CT. Methods Fifty-four patients who underwent chest contrast-enhanced CT were included in this study from May to August in 2007. Dual energy CT scanning was performed in all patients. The patients were divided into four groups: normal group, exudation lesion group, mass lesion group, and pulmonary embolism group. Imaging appearances of dual energy CT perfusion in four groups were analyzed. Results Dual energy CT showed symmetrical homogeneous perfusion in healthy subjects (n = 14), exudation lesions (n =10) appeared as low perfusion, In mass lesions (n =27), peripheral masses presented as local perfusion defect, central masses appeared as segmental perfusion defect because of the involvement of hilar vessels,and pulmonary embolism (n = 3) appeared as perfusion defect in corresponding pulmonary segment.Conclusion Dual energy CT scanning can be used to show the pulmonary perfusion status and assess the pulmonary perfusion abnormalities in central lung cancer and pulmonary embolism.

OBJECTIVE:To evaluate the effects of PDCA cycle management on perioperative prophylactic application of antibiotics in typeⅠincision surgery of orthopedics department. METHODS:In retrospective analysis,512 discharge medical records, 861 ones and 1 070 ones were selected from our hospital before PDCA cycle management(Jan.-Dec. 2013,before intervention group), after first cycle of PDCA cycle management (Jan.-Dec. 2014,first intervention group) and after second cycle of PDCA cycle management(Jan.-Dec. 2015,second intervention group),respectively. The perioperative prophylactic application of antibiotics was analyzed comparatively before and after continuous intervention. RESULTS:After 2 cycles of PDCA cycle management intervention, the constituent ratio of internal fixation in orthopedics department increased significantly;utilization ratio of antibiotics,the rate of rational type,medication ratio 0.5-1 h before surgery,the rate of rational treatment course,the proportion of antibiotics use in accordance with indications increased from 50.20%,98.08%,93.77%,6.61%,82.10% to 58.41%,100%,99.04%,52.00%, 99.04%,respectively. The number of antibiotics type decreased from 4 to 2;the proportion of cephazolin increased significantly while that of clindamycin decreased significantly compared to before intervention. Postoperative prophylactic medication course decreased from(4.63 ± 2.42)d to(1.61 ± 0.75)d;the proportion of patients with medication course <24 h or ranged 24-48 h increased significantly, while those with medication course>72 h decreased significantly, with statistical significance (P<0.05). CONCLUSIONS:PDCA cycle management improves the rational rate of perioperative prophylactic application of antibiotics in typeⅠincision surgery of orthopedics department in our hospital. The prophylactic medication course of our hospital is not yet fully controlled within 24 h so it should be further intervened.