Objective To study the difference of image quality which based on different reconstruction in head dual‐energy computed tomography angiography (DECTA) scanning ,and evaluate the radiation dose which using different tube voltage in DEC‐TA .Methods An anthropomorphic head phantom with simulated arteries was used for DECTA scanning by different scan parame‐ters (tube voltage 80/140 kV and tube voltage 100/140 kV) ,the data was reconstructed with filtered back projection (FBP) and Si‐nogram Affirmed Iterative Reconstruction (SAFIRE) .The CT values with SD were measured and calculate to SNR and CNR ,the dose length product (DLP) was recorded and invert to effective dose .The image quality and radiation dose were evaluated in differ‐ent imaging condition .Results The image noise of SAFIRE reconstruction was lower than FBP reconstruction in same san parame‐ters .The increase of tube current‐time product from 100 mAs to 300 mAs ,it shows the characteristics of linear tendency .When it was on 260 mAs ,the image quality become stable .The difference between the two groups(80/140 kV ,100/140 kV)of SD of CT value by SAFIRE was significant (P< 0 .05) ,the difference of SNR and CNR between the two groups was not significant (P>0 .05) .The effective doses of group A (80/140 kV) was significantly lower than group B(100/140 kV) .Conclusion Using tube voltage of 80/140 kV combine with SAFIRE algorithm in head DECTA can ensure the image quality ,which can significantly reduce radiation dose .

Objective To verify the safety of non-thoracoscopic Nuss procedure,and review our experience in correction of pectus excavatum by Nuss procedure with post-implantation thoracoscopic assistance.Methods 191 patients with pectus excavatum were surgically corrected by Nuss procedure with post-implantation thoracoscopic assistance.There were 146 boys and 45 girls,The age ranged from 2.8 to 20 years with mean age was ( 6.46 ± 3.36) years.Hailer' s index was 4.68 ± 1.84.The operation was performed under Non-thoracoscopic assistance first and then with thoracoscopic observation.Results The operation in all patients had been performed successfully.The time of the operation ranged from 27 to 50 minutes with mean time was ( 32.49 ± 2.79) minutes.The average bleeding volume during procedure was ( 2.19 ± 0.87 ) ml.The durstion of follow-up was 10 to 23 months.All patients have been satisfied with their surgical correction.The postoperative complication was 13 cases( 6.81％ ).The bar outsides the pleura in both sides was 18 cases( 9.42％ ).The bar outsides the right pleura was 23cases( 12.0％ ).The bar outsides the left pleura was 17 cases( 8.90％ ).Conclusion Nuss procedure with non-thoracoscopic assistance for correction of poctus excavatum is safety if the surgeon experienced and have certain methods.Post-implantation thoracoscopic Nuss procedure is safer,and can deal with the damage caused by non-thoracoscopic assistance.

Objective To summarize the experience of diagnosis and treatment of pectus excavatum associated with congenital pulmonary disease in children.Methods The data of 91 patients with pectus excavatum associated with congenital pulmonary disease was collected from July 2002 to August 2010 in Beijing Children's Hospital.There were 64 males and 27 females.30 patients with pectus excavatum associated with congenital pulmonary cyst,congenital cystic adenomatoid malformation,pulmonary sequestration,and some severe cases of congenital lobar emphysema received the Nuss surgery and lobectomy simultaneously.Results 30 cases with pectus excavatum asseeiated with congenital pulmonary disease received simultaneous Nuss procedure and lobectomy.All cases were confirmed by pathology and recovered uneventfully.Conclusion Chest CT scan is an effective way to evaluate pectus excavatum associated with pulmonary diseases.Whether surgery is needed for the pulmonary disease depend on the specific types of disease,age and other various factors.Simultaneous surgery for pectus excavatum and pulmonary disease can lower the risk of the multiple operations,and reduce the financial burden of famihes.

Objective To compare the safety and feasibility of thoracoscopic extrapleural Nuss procedure with traditional intrapleural Nuss procedure. Methods Total 252 patients with pectus excavatum received Nuss surgery from July 2008 to June 2009 in Beijing children' s hospital. Patients had following condition were excluded; (1) recurrent pectus excavatum; (2) complicated with other diseases, and need simultaneous surgery; (3) older than 13-year-old; (4) extensive depression, and need two Nuss bar; or (5) extreme severe or severe unsymmetric. 131 cases were selected in our study and they were randomly divided into two groups, thoracoscopic extrapleural Nuss procedure ( n = 62 ) and traditional intrapleural Nuss procedure ( n =69). Perioperative information, postoperative complications, effectiveness and the location of the Nuss bar were compared between two groups. Results All the 131 patients had completed the procedure successfully. There were no significant differences in age, Haller index; surgical effects, operation time, blood loss, and hospital stay, between two groups. Postoperative complications between the two groups are not significant. 131 patients were followed up from 14 to 26 months, and no recurrence and long-term complications occurred. About more than half cases of extrapleural Nuss procedure group were break the pleural into thoracic cavity. Conclusion Both extrapleural and intrapleural Nuss procedure are safe and effective for pectus excavatum, but extrapleural Nuss procedure have no advantage to the intrapleural Nuss procedure, also it' s hard to observe the other side of thoracic cavity during the surgery, and not easy to grasp and to promote.

0.05),but the HPPT was dose-dependently increased in 25 and 50 mg?kg -1 groups(P0.05); on the contrary ,strychnine 0.5,0.75,1.0 ?g(it) decreased the HPPT of propofol-treated mice as doses increased(P0.05). CONCLUSION Propofol can induce antinociception in hot-plate test and acetic acid-induced writhing test of mice. Spinal glycine receptors may play a role in propofol's antinociceptive properties in hot-plate test of mice.

Problem-based learning (PBL) teaching method combined with formative evalua-tion was used in the teaching practice of pediatrics education. This method was implemented by four phases: courses designing, group-preparing, problems-organizing and teaching practice. The method was evaluated by students' feedback and survey results of patients, teachers and teaching councilors. It was showed that the teaching effects of PBL combined with formative evaluation was better than tra-ditional teaching method in pediatrics teaching.

AlM:To investigate the effects of pirfenidone ( PFD) on the proliferation and transfomring growth factor-β1 ( TGF-β1 ) expression in vitro culture rat corneal stromal cells.METHODS: Corneal stromal cells from 8 to 10wk SD rats were isolated, cultured and treated with different concentrations of PFD 0mg/mL (control group), 0. 15mg/mL (experimental group▏), 0. 3mg/mL (experimental group‖), 1mg/mL (experimental group Ⅲ) for 48h. CCK-8 assay was performed to assess cell proliferation, while immunocytochemistry and Western Blot were used to detect the expression of ki-67 and TGF-β1 expression, respectively. RESULTS: Compared with control group, PFD significantly inhibited the proliferation in a dose -dependent manner ( all P < 0. 05 ), so was protein expression of ki-67. PFD significantly down-regulated the expression of TGF-β1 in a dose-dependent manner (P<0. 05).CONCLUSlON: Pirfenidone can significantly inhibit the proliferation of rat corneal stromal cell by down regulating TGF-β1 expression, therefore, it has potential prospect in lightening the corneal wound healing reaction.

Objective To evaluate the accuracy and efficiency of the Monte Carlo software in measuring the radiation dose to the patients who received the CCTA (Coronary Computed Tomography Angiography) examination.Methods A anthropomorphic chest phantom underwent CCTA using three scan parameters (tube voltage 80 kV,100 kV and 120 kV).Computer Software ImpactDose 2.0 was used to compute the chest organ dose on the basis of the three groups tube voltage CT scan characteristic,and the stimulation results of ImpactDose 2.0 software was verified by use of anthropomorphic phantom thermoluminescence dosimeter experiment method.Results For all the measured organs except for lung,the absorbed organ dose and effective dose of three groups of tube voltages of CCTA measured by the InpactDose 2.0 was lower than those as measured by anthropomorphic phantom study.The relative error of both methods was within ± 50％.Conclusions Monte Carlo software can be used to estimate the levels of radiation dose during CCTA examination with a tolerable error within the acceptable range.

Objective To evaluate the effect of moderate activities at moderate high altitude on acute mountain sickness (AMS) incidence .Methods Ninety-one healthy sea level residents traveled from sea level (345 m) to high altitude city (3200 m) ,by train within 48-hour .They walked 5 kilometers after 2-night stayed ,Lake Louis Score (LLS) Questionnaires ,blood pressure(BP) and oxygen saturation (SpO2 ) was administered before and after walking .Results Seven subjects were excluded because of incomplete data .The incidence of AMS before and after exercise was 20 .24% (n=17/84) and 11 .90% (n=10/84) respectively(P>0 .05) .Af-ter a 5 kilometer walking ,the heart rate increased from (73 .83 ± 9 .96)bpm to(84 .31 ± 12 .55)bpm (P<0 .05) ,Systolic BP and SpO2 level decreased from(128 .86 ± 13 .93)mm Hg to (124 .48 ± 13 .13)mm Hg ,(92 .80 ± 2 .25)% to (89 .94 ± 2 .45)% (P<0 .05) .Headache symptom improved after walking (P<0 .05) .Smoking was negative correlate with LLS score before and after ex-ercise(P<0 .05) .There is no relation between SpO2 and LLS scores .Conclusion Walking five kilometers at 3200 m improve head-ache symptom and tend to decrease AMS .

The treatment and signaling pathway regulation effects of kidney- tonifying traditional Chinese medicine on osteoporosis have been widely studied, but without a systematic summary currently. This review comprehensively collected and analyzed the traditional Chinese medicine on the treatment and signaling pathway regulation of osteoporosis in recent ten years, such as Epimedium, Drynariae Rhizoma, Cnidium, Eucommia, Psoralen and Dipsacus. Based on the existing findings, we concluded the following conclusions: (1) kidney-tonifying traditional Chinese medicine treats osteoporosis mainly through BMP-Smads, Wnt/β-catenin, MAPK, PI3K/AKT signaling pathway to promote osteoblast bone formation and through OPG/RANKL/RANK, estrogen, CTSK signaling pathway to inhibit osteo?clasts of bone resorption. ① Epimedium, Drynariae Rhizoma, Cnidium and Psoralen up-regulate the key proteins and genes of BMP-Smads and Wnt/β-catenin signaling pathways to promote bone formation.② Epimedium, Drynariae Rhizoma, Cnidium, Eucommia, Psoralen, Dipsacusinhibit the bone resorption by mediating the OPG/RANKL/RANK signaling pathway. (2) Kidney-tonifying traditional Chinese medicine prevent and treat osteoporosis through a variety of ways: Icariin, Naringin, Osthol, Psoralen can regulate BMP-Smads, Wnt/β-catenin signaling pathway to promote bone formation, but also activate OPG/RANKL/RANK, CTSK and other signaling pathway to inhibit bone resorption. (3) The crosstalk of the signaling pathways and the animal experiments of the traditional Chinese medicine on the prevention and treatment of osteoporosis as well as their multi-target mechanism and comprehensive regulation need further clarification.