Objective: To compare the effect of urapidil at different doses on blood pressure and prognosis of patients with acute ischemic stroke (AIS) so as to provide data evidence for its clinical use.Methods: Totally 62 patients with AIS were divided into 3 groups in a prospective study: 20 cases in high dosage group, 21 cases in middle dosage group and 21 cases in low dosage group.All the patients were treated with urapidil and urokinase, and the initial dose of urapidil was 25 mg, 15 mg and 5 mg, respectively.Systolic blood pressure (SBP) and diastolic blood pressure (DBP) of the patients before and after the treatment were observed, and the US national institutes of health stroke scale (NIHSS), modified Rankin scale (mRS) and activity of daily living scale (ADL) were also evaluated in the follow-ups.Results: The time of blood pressure up to standard in the middle dosage group and low dosage group was longer than that in the high dosage group.At the same time, the time of blood pressure up to standard in the low dosage group was longer than that in the middle dosage group, and the difference had statistical significance (P＜0.05).After the treatment, SBP and DBP at T1 in all the groups were notable lower than those at T0,and those at T2 and T3 were lower than those at T1, and the differences had statistical significance (P＜0.05).After the treatment, the SBP and DBP levels in the high dosage group were lower than those in the middle dosage group and low dosage group, and those in the middle dosage group were lower than those in the low dosage group, and the differences had statistical significance (P＜0.05).The NIHSS, mRS and ADL scores of the middle dosage group were lower than those of the low dosage and the high dosage group (P＜0.05), and there was no significant difference between the latter two groups (P＞0.05).Conclusion: With the initial dose of 15 mg, urapidil can ensure good prognosis on the premise of effective decompression.

Objective To investigate the clinical features and CT findings of cystitis glandularis.Methods The cystoscopic findings,clinical data and CT findings in 12 cases of cystitis glandularis patiens confirmed by cystoscopy and pathology were analyzed retrospectively with literatures review. Results The clinical symptoms included hematuria (8 cases),symptoms of urinary tract infection(3 cases) and dysuria(1 case).The lesions predominataly located at the trigone, neck of the bladder and around the entrances of the ureter.CT showed normality in 3 cases,bladder wall locally thickening in 7 cases( the ranges were 1.6～ 5.5 cm),extensive bladder wall thickening in 1 case. The lesions were isodensity on plain CT images and slightly enhanced after administration of contrast medium, the CT value increased 13.1 HU averagely.Conclusion Cystitis glandularis is of certain CT characteristics,however,no abnormalities are found by CT that can not be ruled out cystitis glandularis.

Objective To study CT value in diagnosis and differential diagnosis of submandibular tumor.Methods The CT features of submandibular tumors proved by pathology in 20 cases were analyzed retrospectively and compared with pathologic findings. Double-blind was used to evaluate the value of CT in differentiating both malignant and benign submandibular tumors. Results Of 20 patients,8 were benign tumors, 6 appeared as homogeneous density and well-defined, 2 appeared as inhomogeneous density and partial ill-defined.12 case were malignant of them, 10 were irregular in shape, 8 were heterogeneous indensity, 7 were ill-defined, 5 were well-defined in shape, 4 were homogeneous indensity. Double-blind indicated that 75% submandibular tumors could be qualified by CT, but could not determine the histological type of tumors. Conclusion CT can differentiate most of malignant submandibular tumors from benign tumors, but can not be used to categorize the histological type of tumors.

Objective To analyze CT features and CT diagnostic value in lymph node reactive hyperplasia.Methods CT findings of lymph node reactive hyperplasia in 13 cases proved surgically and pathologically were retrospectively analyzed.Results Of 13 cases,7 cases were only involved cervical lateral lymph nodes,2 cases were simultaneously involved cervical lateral,facial and submental lymph nodes,1case was involved axillary and inguinal lymph nodes,1 case demonstrated simultaneously enlarged in cervical,axillary,mediastinal,retroperitoneal and inguinal lymph nodes.Enlarged lymph nodes ranged from 0.6 to 2.6 cm in minimal diameter.with mean of 1.6 cm.Lymph nodes enlaged showed isolated existence in 12 cases,merely 1 case mixed existence and the density was unhomogeneous,12cases showed homogeneous density and obvious enhancement on postcontrast CT,and CT value increased by 19.1~113.2 HU,with mean of 59.1 HU.Conclusion Lmyph node reactive hyperplasia is of characteristic CT appearances,CT examinations is of important value for its qualitative and differential diagnosis.

Objective to observe the efficacy and application value of PFNA and Gamma in the treatment of intertrochanteric fractures in elderly. Methods 100 patients with intertrochanteric fractures were divided into PFNA group and Gamma group, who received PFNA treatment and Gamma treatment respectively. And the operation status of patients at different ages,postoperative recovery,and complications were observed. Results The operation time,intraoperatve blood soss of PFNA group were lower than those of Gamma group(P<0. 05). There was no significant difference in fracture healing time. The Harris score of the over 75s in PFNA group was higher than that in Gamma group(P<0. 05),and the complications were less than Gamma group(P<0. 05). Conclusion PFNA was suitable for the patients at differ-ent ages with the advantages of more rigid fixation,good anti-rotation,fewer trauma and fewer complications.

Objective To investigate the MRI findings of the breast fibroadenoma which has a washout type of time signal intensity curve (TIC)for the purpose of improving imaging diagnosis.Methods The MRI findings of 20 cases of the breast fibroadenoma with a washout TIC and 20 cases of breast carcinoma verified by histopathology were analyzed retrospectively.Morphological features,internal signal, ADC value and dynamic enhancement performance of the two groups were compared with each other.Results The shapes of the breast fibroadenomas were more commonly ovoid or round (18/20),and the margins were circumscribed(16/20),Most of the fibroadenomas were high intensity in T2 WI with the non-contrast enhanced separations (9/20).The average minimum ADC value was (1.412±0.332)×10-3 mm2/s,and higher than that of breast cancer (0.888 ±0.1 60)×10 -3 mm2/s with the significant difference (P <0.05).Enhancement scanning showed relatively homogeneous enhancement (16/20).The early enhancement ratio of the breast fibroadenoma was (1.694±0.628)×100% on average,and lower than that of breast cancer (1.849 ±0.430)× 100%.The difference was no statistical significance(P >0.05 ). Conclusion The breast fibroadenoma with washout TIC has a similar performance with the breast cancer in TIC and the early enhancement rate, however,the clear edge,higher T2 WI signal intensity,the non-contrast enhanced internal separations and higher ADC values are helpful to the diagnosis of breast fibroadenoma with washout TIC.

Objective To discuss the MSCT performances of appendix mucinous cystadenoma in order to improve the preoperative diagnosis.Methods MSCT plain and enhanced findings of mucinous appendix mucinous cystadenoma proved by pathology in 6 pa-tients were analyzed retrospectively.Results CT showed cystic dilatation of the appendix in 2 patients with heterogeneous density, and cystic mass in the right iliac fossa in 4.As for the cystic wall,uniform thin wall was seen in 4,curvilinear mural calcification in 3 and septation in 2.Dynamic enhanced CT showed the ring mural enhancement in 4.In addition,the blurred surrounding fatty tis-sues were seen in 2.Conclusion MSCT findings of mucinous appendiceal cystadenoma appeared as cystic dilatation or cystic mass in the right iliac fossa,curvilinear mural calcification and enhanced wall.

Objective To expore CT diagnostic values for hyaline-vascular type of giant lymph node hyperplasia(GLNH).Methods CT findings in 4 patients with hyaline-vascular type of GLNH confirmed by surgery and pathology were respectively analyzed and relevant literatures were reviewed.CT examination included plain and enhanced scan with contrast medium bolus injection.Results Lesions were located 2 at the posterior mediastinum,1 at the restroperitonum and 1 at the neck.The characteristic CT appearances were a large soft tissue mass round or oval in shape with homogenous density,well and regular margin.The masses were all markedly enhanced after contrast,their attenuation were similar to but slightly lower than the larger arteries in the same section.Conclusion GLNH is an uncommon disease and it′s clinical diagnosis is difficult.But CT scanning could showed some features.When CT found a mass with benign characters locating in lymph node regions,especially marked enhancement,Hyaline-vascular type of GLNH should be considered.

Objective To study CT value of diagnosis and identified diagnosis in osteolytic metastases of the vertebral column through describing their CT manifestation.Methods In 46 patients, 72 vertebrae osteolytic metastases were analyzed and compared with X-ray findings of 28 cases.Results In 72 vertebrae osteolytic metastases, there were destruction of 74 corpus vertebrae in 45 patients, of pediculus arcus vertebraes in 22 cases, of processus transverses in 15 cases, of processus spinosus in 11 cases and lamina vertebrae in 11 cases. Micrometastases were concentrated in corpus vertebrae(45/49). CT found the rate of bone-destruction, affection of vertebrae canal and soft tissue around vertebrae were 100%, 67.8% and 71.4%, but the corresponding rates were only 53.6%, 14.3% and 32.1% by X-ray. Conclusion Vertebral column metastases destructed corpus vertebrae at first, vertebral metastases are the origin or base of destruction of the pediculus arcus vertebrae, lamina vertebrae, processus transverses and processus spinous. CT scanning is more sensitive in finding and evaluating the lesions than X-ray plain film.

Objective To determine whether tChoI and ADC and their changes could be applied to predict pathologic response be-fore,during and after NAC of locally advanced breast.To assess the diagnostic performance of each parameter.Methods The tChoI and ADC and their changes in 22 women who underwent MRI before,during and after the NAC were analyzed prospectively.All pa-tients were divided into major histological response group and non-major histological response group by methods of Miller and Payne system according to the final pathologic response.Pre-and post-treatment measurements and changes in tChoI and ADC values in MHR versus NMHR were analyzed using Mann-Whitney U test.ROC curve analysis was performed to assess the diagnostic per-formance of each parameter and also to identify which parameter could be used to predict the pathologic response to NAC and find the optimal cut off value for MHR prediction.Results After NAC,14 patients showed MHR and 8 showed NMHR.After NAC,all the parameters and their changes were significantly different between the MHR and NMHR groups,the change rate of all parameters af-ter NAC can actively diagnosis the MHR according ROC(AUC>0.5).Using 0.913 ×10 -3 mm2/s of ADCmin after NAC as the cut off value,prediction of MHR with sensitivity and specificity was 85.7% and 100%,respectively.Using 81.25% of the change rate of tCho I after NAC as the cut off value,prediction of MHR with sensitivity and specificity was 71.4% and 100%,respectively(AUC=0.881,P =0.008).The △ADCmin 2% and △tChoI2% are better than △ADCmean 2%.Conclusion Application of 3D 1 H-MRS and DWI can predict pathologic response and may provide more detailed and accurate evidence for subsequent treatment.