Objective:To evaluate the diagnostic efficiency of contrast-enhanced magnetic resonance angiography (CE-MRA), T 1WI and three-dimensional thin-layer T 1WI sequences (3D-T 1WI) in evaluating the blood supply of brain tumors, so as to improve the enhanced magnetic resonance imaging (MRI) scanning scheme of brain tumors. Methods:After the contrast agent was injected, 29 patients with brain tumors were scanned with CE-MRA, T 1WI and 3D-T 1WI. The imaging manifestations of " observing the enhancement of tumor substance" , " observing the small vessels in the tumor body" and " observing the small vessels around the tumor" were qualitatively classified, and the diagnostic differences of the three sequences were analyzed by McNemar test. Results:⑴ In the aspect of " observing the contrast medium in the tumor body" , CE-MRA, T 1WI and 3D-T 1WI sequences diagnosed as grade A1 were 0 cases, 8 cases (27.59%) and 19 cases (65.52%) respectively. The diagnostic efficiency of 3D-T 1WI sequences was better than that of T 1WI sequence ( P<0.05), and T 1WI sequence was better than that of CE-MRA sequence ( P<0.05). ⑵ In the aspect of " observing the small vessels in the tumor" , CE-MRA, T 1WI and 3D-T 1WI sequences diagnosed as grade B1 were 8 cases (27.59%), 5 cases (17.24%) and 16 cases (55.17%), respectively. The diagnostic efficiency of 3D-T 1WI was better than that of T 1WI and CE-MRA ( P<0.05). ⑶ In the aspect of " observing the small vessels around the tumor" , CE-MRA, T 1WI and 3D-T 1WI sequences diagnosed as grade C1 were 18 cases(62.07%), 5 cases (17.24%) and 14 cases (48.28%) respectively. The diagnostic efficiency of CE-MRA and 3D-T 1WI wre better than that of T 1WI ( P<0.05). Conclusions:The combination of 3D-T 1WI and CE-MRA sequence can comprehensively evaluate the blood supply of the tumor, which is of great significance for the localization, characterization and treatment of brain tumors.

Objective To evaluate the absolute quantification of brain metabolites concentrations using external standard MRS in acute hypoxia ischemia encephalopathy (HIE) piglet model. Method Eight 7-day-old healthy piglets were subjected to insult of hypoxia ischemia (HI). The animals and an external standard phantom containing detectable metabolites of known concentrations were studied on a 1.5 T GE Signa scanner. The single-voxel proton magnetic resonance spectroscopy (1H-MRS) data were processed using LCModel software, and the quantification of N-acetylaspartate ( NAA), creatine (Cr) and lactate (Lac) were accomplished. Multivariate analysis of variance was performed to compare the NAA, Cr, Lac concentration differences in the brains of piglets pre- and post-HI (0h). In addition, the dynamic changes of brain metabolites concentrations of 2 HIE piglets were observed at the time points of 0 h and 2 h. Results One piglet was excluded because it was over anesthetized to death. Seven piglets' data were analyzed. The concentrations of NAA pre- and post-HI were ( 6. 86 ± 0. 49 ) mmol/kg and ( 5.73 ± 0. 88 ) mmol/kg respectively, they were ( 4. 65 ± 0. 73 ) mmol/kg and ( 4. 40 ± 0. 80 ) mmol/kg for Cr; and were 0. 00 mmol/kg and (0. 43 ± 0. 39) mmol/kg for Lac. After HI, decreased NAA concentration immediately was observed, and it was of statistical significance ( F = 8. 608, P = 0. 013 ). The concentration of Cr was insignificantly decreased ( F = 0. 379, P = 0. 550). The concentration of Lac was increased, and the difference was of statistical significance ( F = 8. 600 ,P = 0. 013 ). Dynamic observation showed a Lac peak immediately after HI and it decreased after 2 h post-HI. Conclusions External standard MRS using LCModel has great value in the quantitative analysis of brain metabolites. The changes of NAA and Lac concentrations are sensitive to reflect the early metabolic change of acute HIE.

Objective:To investigate the stability of Liuwei Qiangu cataplasms. Methods:The active ingredient( naringin) in the samples was determined by HPLC. Meanwhile, the other indices including character, identification, ointment content, adhesion, mi-crobial limit and so on were detected as well. Results:The results of the accelerated test and long term test showed that Liuwei Qiangu cataplasms were stable. No significant change in each index was found before and after the tests. Conclusion: Liuwei Qiangu cata-plasms are stable at room temperature. The designs of preparation process and package are rational to keep the stability of the prepara-tion.

Objective To assess the dignosis value of CT three-dimensional reconstruction with Fisher discriminant model in small solitary pulmonary nodules before operation.Methods CT data of 40 cases with SPN were retrospectively analyzed and divided into into malignant pulmonary nodules (25 cases),squamous cell carcinoma (4 cases),adenocarcinoma (13 cases),lung cancer (4 ca-ses),small cell lung cancer (2 cases),large cell carcinoma (1 case),metastases tumor (1 case),benign nodules (1 5 cases,6 cases of tuberculosis,2 cases of hamartoma,and 7 cases of non-specific inflammatory nodules)by pathology and follow-up results.The CT features of pulmonary nodules were evaluated through multi-planar reformation (MPR),curved-planar reformation (CPR),volume rendering (VR),maximum intensity proj ection (MIP)and other three-dimensional reconstruction.The three-dimensional data were divided into benign and malignant groups.In each of the two groups,the significant signs of morphological signs of discrimination indicators were adminstrated Fisher discriminant,and the probalitiy of false positives were estimated using cross-validation method. Results The positive features of pulmonary nodules in there-dismensional images were much more than in two-dimensional images. Fisher discriminant formula of solitary pulmonary nodules in three-dimensional images was Z=1.143X1 + 0.454X2+1.606X3-0.262X4+0.04X5+0.483X6+1.611X7-2.164.Discriminant boundary value Zc was-0.516.When Zcgreater than -0.516,nodules were proneed to considere as malignant nodules.In 25 cases of malignant nodules,4 cases mistook for benign.When Zc less than -0.516,nodules were proneed to considere as benign nod-ules.In 1 5 benign nodules,2 cases mistook for malignant.The total misdiagnosis and accuracy rate were 15 % and 85% respec-tively.Conclusion CT three-dimensional reconstruction combined with Fisher discriminant model have a high clinical value in dif-fereiating diagonsis of pulmonary nodules were proneed to considere as malignant nodules.In 25 cases of malignant nodules,4 cases mistook for benign.When Zc less than -0.516,nodules were proneed to considere as benign nodules. In 15 benign nodules,2 cases mistook for malignant.The total misdiagnosis and accuracy rate were 15 % and 85% respec-tively.Conclusion CT three-dimensional reconstruction combined with Fisher discriminant model have a high clinical value in differeiating diagonsis of pulmonary nodules.

Objective To discuss the clinical efficacy of improved TIPS of percutaneous portal vein puncture in treatment of acute upper gastrointestinal bleeding induced by portal hypertension.Methods 28 patients with acute upper gastrointestinal bleeding underwent improved TIPS therapy in our hospital were enrolled.The clinical data,laboratory parameters and hemodynamic changes were collected and analyzed before and after operation.Results The success rate for the first time and hemostatic rate of postoperative 24 hours in all patients was 100%.2(7.14%)patients underwent mild hepatic encephalopathy.After TIPS operation,the concentration of serum albumin increased,whereas,concentration of total bilirubin and alanine aminotransferase decreased(P<0.01).Portal vein pressure (PVP)of pre-and post-operation was(41.48 ± 3.72)mmHg and(28.91 ± 2.59)mmHg,and the hepatic venous pressure gradient (HVPG)was(20.30 ± 2.76)mmHg and(8.81 ± 2.04)mmHg.PVP and HVPG were both decreased significantly after operation(P<0.01).Conclusion Improved TIPS therapy can obtain good clinical efficacy and safety for esophageal and gastric varicose bleeding in acute cirrhosis.

Objective To investigate the psychological and behavioral change of student nurses after contacting with syphilis patients and to seek the measures to improve the awareness of related knowledge , in order to help them overcome the psychological fear and to strengthen their protection awareness .Methods A self-designed questionnaire on syphilis-related knowledge was used to randomly survey 100 student nurses who were in clinical practice at our hospital .Results In the 100 questionnaires , most of student nurses had poor-mastering knowledge on syphilis .84% student nurses were afraid of being infected with syphilis , and 92%student nurses would wash hands and disinfection after caring of syphilis patients .Conclusions The student nurses have relatively poor knowledge on syphilis , so the education on syphilis should be paid much more attention, as well as the education of professional ethics .Thus, the student nurses can improve the awareness of self-protection , and provide syphilis patients with better meticulous nursing care .

Objective To select the most accurate classification in white light imaging(WLI)and narrow band imaging(NBI)for diagnosing the pathological result of vocal cord leukoplakia(VCL)and the proposed cut-off point,which can improve the accuracy of non-invasive prediction of the pathological result of VCL and can provide basis for whether the VCL patients need surgery and the timing of surgical intervention.Methods Ninty six VCL patients were included in the study.Before surgery,images were collected in WLI and NBI respectively.According to Chen classification in WLI and Ni classification in NBI,lesions were evaluated.By comparing Youden's index,the proposed cut-off point for classification more than two degrees can be assessed.By comparing the area under curve(AUC),accuracy,sensitivity,specificity,positive predictive value(PPV)and negative predictive value(NPV)of four clinical classifications per the purposed cut-off point,the diagnostic performance of different clinical classifications on the pathological results of VCL was assessed,the most accurate classification and the purposed cut-off point were obtained.Results There was a correlation between Chen classification WLI light mode and Ni classification in NBI mode with pathological grade(rs=0.513,0.653,P＜0.001).In WLI,the purposed cut-off point of Chen classification is 3(flat and smooth type is bengin,elecated and smooth type and rough type are maligant);in NBI,the purposed cut-off point of Ni classification is 5(Ⅰ-Ⅳ type were bengin,Ⅴ and Ⅵ type were maligant).The AUC of two clinical classifications'model were 0.815,0.875.The accuracy,sensitivity,specificity,PPV and NPV of the Chen classifications(purposed cut-off point)were 79.51％,84.62％,75.71％,72.13％,86.89％,Those of Ni classification were 85.25％,76.92％,91.42％,86.96％,84.21％.Conclusions:Ni classification in NBI and Chen classification in WLI both perform well.The diagnostic performance of Ni classification in NBI is better than Chen classification in WLI.