Objective To assess the influence of tube current and tube voltage on the CT attenuation,radiation dose,and image quality.Methods A total of 113 saline solutions with decreasing dilution of contrast medium (370 mg I/ml) was produced.MDCT scan was performed with 15 series of different settings of tube current and tube voltage.CT attenuations with 15 series of different settings were all measured,and influence of tube current and tube voltage on CT attenuations was analyzed.CT dose index (CTDIvol) was recorded.The CT attenuations with different tube voltage and current were compared with one-way ANOVA and Kruskal-Wallis rank sum test.The correlation of CT attenuation with different tube voltage and the influence of tube voltage and current on radiation dose and image quality were tested by correlation analysis.Results Tube current (250,200,150,100,and 50 mA) had no significant effect on CT attenuation (F =0.001,0.008,0.075,P ＞ 0.05),while tube voltage (120,100,and 80 kV) had significant effect (H =17.906,17.906,13.527,20.124,23.563,P ＜ 0.05).The correlation between CT attenuation and tube voltage was determined with equation:CT attenuatio N100 kV =1.561 × CT attenuatio N120kv + 4.0818,CT attenuatio N80kV =1.2131 × CT attenuatio N120kv + 0.9283.The influence of tube voltage on radiation dose and image quality was also analyzed,and equations were also obtained:N120 kV =-5.9771Ln(D120 kV) + 25.412,N100 kV =--10.544Ln (D100 kV) + 36.262,N80 kV =-25.326Ln(D80kv) +62.816.According to the results of relationship among CT attenuation,radiation dose,and image quality,lower tube voltage with higher tube current can reduce the radiation dose.Conclusions Lower tube voltage can reduce the radiation dose.However,CT attenuation was influenced,and correction should be done with the equations.

Objective To study the effect of intra arterial thrombolysis in combination with basic fibroblast growth factor (bFGF), and the protecting mechanism of the bFGF. Methods 50 male Wistar rats were subjected to middle cerebral artery occlusion (MACO) for 4 hours by a single fibrin rich clot. The rats were randomly assigned to the following two expremental groups: 1) treatment with urokinase alone; 2) treatment with urokinase and bFGF. The neurological deficits and the volume of lesions on MRI T2WI were observed at different periods after therapy. The expression of bax were analyzed by immunuohistochemical method at each time point. Results Bax expression increased at 3 hours after reperfusion, and reached the peak level at 12h reperfusion. At 6h after therapy, expression of bax ( P

OBJECTIVE:To reduce patient waiting time for drugs by improving work efficiency via the optimization of the in-telligent workflow of outpatient pharmacy. METHODS:The problems existing in each link in the workflow after the adoption of au-tomated drug dispensing machine in the outpatient pharmacy of our hospital were analyzed. Measures were developed and imple-mented,on the basis of the factors affecting each link including adding drugs,making up a prescription and dispensing drugs,to optimize the workflow. The effect after the optimization was evaluated,with the time it takes to make up a prescription and to dis-pense drugs and patient waiting time for drugs as the indexes. RESULTS:The averaged time it takes a pharmacist to make up a pre-scription and to dispense drugs and patient waiting time for drugs significantly reduced from 3.4 min,9.3 min and 12.7 min to 1.0 min,6.1 min and 7.1 min respectively,after taking measures such as adjusting the number of the drug types,tracks and positions in the machine,adding the contrasting pictures of the drugs which were similar on the system interface for adding drugs,standardiz-ing the process of adding drugs,improving and allocating information labels,adjusting the process of dispensing drugs and adding new small packages of drugs within 6 months. CONCLUSIONS:The optimized intelligent workflow in the pharmacy can reduce pa-tient waiting time for drugs,increase patient satisfaction and promote the development of intelligent pharmacy.

Objective To discuss the MRI characteristics of pituitary abscess,so that to improve the diagnosis of it.Methods MR imaging data in 8 cases with pituitary abscess proved by operation and pathology,and antibiosis therapy were retrospectively analyzed in combination with review of literatures.Of 8 cases,3 were male and 5 were female,the mean age was 53.3 years(ranged 36~62 years).Results MRI findings included hypophysis enlargement,isointensity in 6 cases and slight hyperintensity in 2 cases on T1WI;isointensity in 4,hyperintensity in 2 and mixed iso-and hyperintensity in 2 on T2WI;hyperintensity in one on DWI.On contrast-enhanced scan,all pituitary masses showed ring enchancement,6 cases showed thickened walls which were slightly lamellar;7 cases demonstrated pituitary stalk thickening and enchancement.Conclusion Pituitary abscesses are of certain typical MRI characteristics.

In order to find out appropriate model to best disseminate laparoscopy for colorectal cancer clinical advanced technologies,it is necessary to establish a whole set of training system,which included selecting training site,intensive training,operation observation,advanced study at home and abroad,technical support,etc..Evaluation was based on operation time,hemorrhage in surgery,other injuries in surgery,conversion to open surgery and the ratio of in situ relapse in one year post surgery.These five indexes were compared between the training group and the control group with the gradually stable trend of learning curve as standard.Without previous laparoscopic surgery experience,the training group required 13.8±0.75,14±0.89,10.2±0.74,16.4±0.49 and 20.4±0.49 cases,respectively,to achieve expected proficiency,and the control group required 28.6± 1.69,29.2±1.16,27.8 ± 0.74,22.8 ± 0.40 and 25.4± 1.03 cases,respectively.The learning time required 13.4± 1.02 months on average for the training group and 27.8±2.13 months for the control group.In conclusion,the training system achieved obvious superiority to the controls to achieve expected skills and proficiency in laparoscopy for colorectal cancer.

BACKGROUND:As a more common method in the orthopedic field, the method of intra-articular injection drugs has distinct curative effects, but there are some complications. In a certain extent, this method caters to the psychological fear of surgery, and can serve as a kind of conservative treatment. But some experts believed that because of the limit of sterile conditions, intra-articular injection of drugs wil increase the risk of intra-articular infection and they opposed this method.
OBJECTIVE:To review the efficacy and adverse reactions of intra-articular injection drugs in recent years, and explain clinical applications of intra-articular injection drugs in orthopedics.
METHODS:A computer-based search was conducted in PubMed and Wanfang database for articles related to the application of intra-articular injection drugs in orthopedics published between January 2007 and December 2013. The English and Chinese key words were“intra-articular, injection, orthopaedics, tranexamic acid, hyaluronic acid, corticosteroid, drugs”. Data were checked in the first trial, old articles and repetitive studies were excluded. The relevant 43 articles accorded with inclusion criteria were reviewed.
RESULTS AND CONCLUSION:In orthopedics, the method of intra-articular injection drugs is simple, economic and effective, but at the same time, there are some side effects. Tranexamic acid by intra-articular injection can significantly reduce blood loss after total joint replacement, is safety and economic. Intra-articular injection joint lubricant can reduce internal friction of joints and improve the adhesion of joint cavity, can be used as a good conservative treatment for osteoarthritis. Intra-articular injection hormone drugs can treat inflammatory arthritis, and short-term curative effect is obvious, but due to large long-term side effects, the method is not recommended now. Intra-articular injection of analgesic drugs and other drugs have both advantages complications. The efficacy of intra-articular injection drugs in orthopedics is obvious;meanwhile, this method has some complications. Orthopedic surgeons should select related drugs by indications. We stil need to further make reasonable regimen with intra-articular injection drugs in future large-scale study.

Objective To study the imaging features of the pleomorphic adenomas of the minor salivary glands in the palate and to improve its diagnostic validity. Methods CT and MRI manifestations of 6 patients with palatal pleomorphic adenomas confirmed pathologically were analyzed retrospectively. There were 2 males and 4 females, and their age ranged from 19 to 54 years, with the mean age of 36.3 years. Results Among 6 cases, 5 tumors located in hard palate, and 1 in soft palate. 4 lesions were round like, and 2 were lobulated. Most tumors showed soft tissue density on CT, slightly long T 1 and slightly long T 2 signal intensity on MRI. Cystic degeneration could occur in the central part in some lesions, which appeared as much lower density or obviously long T 1 and long T 2 signal intensity. On post contrast MR scans, the lesions usually showed slightly homogeneous enhancement. Conclusions Pleomorphic adenomas of the minor salivary glands were the most common benign tumors in the palate. Combined with the clinical history, typical CT and MRI appearances, a definitive diagnosis can be made.

BACKGROUND:Tranexamic acid has been more and more used in reducing bleeding after joint replacement, but its usage method and dosage remain controversial, and become a hot focus in recent years. OBJECTIVE:To investigate the efficacy of intra-articular injection of tranexamic acid on postoperative blood loss and limb circumference changes in patients who received unilateral total knee arthroplasty. METHODS:From March to October 2013, clinical data of 90 patients undergoing primary unilateral total knee arthroplasty were randomized to the tranexamic acid group and the control group, including 19 males and 71 females. The 30 patients in the tranexamic acid group received 50 mL of 3%tranexamic acid dilute solution inside knee joint after capsule closure, and 60 patients in the control group received the same volume of physiological saline. No significant difference in age, height, body mass index, anticoagulation, the type of prosthesis, tourniquet time and preoperative diagnosis was detected between the two groups (P>0.05). The amounts of intraoperative and postoperative blood loss and blood transfusion, postoperative drainage volume, the preoperative and postoperative limb circumference 10 cm above the operated knee were recorded. Routine blood test was reviewed after the surgery. RESULTS AND CONCLUSION:There were no significant differences in total blood loss, postoperative drainage volume and limb circumference changes between tranexamic acid and control groups (P>0.05). The amount of postoperative hidden blood loss was significantly less in the tranexamic acid group than in the control group (t=-2.683, P<0.05). These data suggested that the intra-articular injection of tranexamic acid intraoperatively in patients receiving total knee arthroplasty could significantly reduce the amounts of postoperative hidden blood loss, and did not affect the postoperative limb circumference changes.

Objective To evaluate the activation of premotor area (PMA) in verb generation task, and to discuss the possible function of PMA in language expression. Methods Block-designed fMRI with verb generation task was performed on 23 subjects with GE 1.5T MR Scanner. During the test, the subjects were asked to generate a verb based on a given noun word. The white + appeared on the center of the black screen was used as control. The fMRI data were processed with SPM 2. Group analysis was performed with single sample t-test. Average mapping was obtained and overlapped onto standard MNI template. Activation of the PMA was analyzed. Results The fMRI data of eleven subjects were selected for group analysis after head motion effect was ruled out. Average mapping showed activation in the Broca's area, posterior part of the right inferior frontal gyrus, bilateral PMA and supplemental areas (SMA), left posterior parietal cortex, right thalamus, left basal ganglions, right cerebellum, and posterior part of the right temporal lobe. The area with the greatest activated intensity in the brain was the left PMA. Conclusion PMC is important in verb generation and may be responsible for voice processing, motor imagery, word extracting as well as advanced regulation of information.

Objective To discuss the value of serum thymidine kinase 1 and DNA ploidy for the diagnosis of patients with acute myeloid lecukemia.Methods Determined TK1 and DI in 20 healthy people,6 patients with benign proliferate in hematological system and 66 patients with acute myeloid lecukemia by chemiluminescence detection technique and flow cytometry.Nonparametric comparisons among three group were done by rank sum test.ROC curve was used to determine the AUC and the diagnosis value serum thymidine kinase 1 and DNA.Results As showed by peripheral blood results,the TK1 (x2 =36.877,P＜0.001) and DI (x2=4.040,P＜0.05) had statistically difference among healthy people group,patients with benign proliferate in hematological system group and AML group.The normal control group compared with the AML group,TK1 (Z=-6.073,P＜0.001)and DI (Z=-2.012,P =0.044) had statistically difference;The normal control group compared with the benign proliferate patients,TK1 (Z=-1.234,P =0.169) and DI (Z=-1.084,P =0.278) had no statistically difference.The benign proliferate patients and that with AML patients,TK1 (Z=2.177,P=0.036) had statistically difference,but DI (Z=-1.801,P=0.061) had no statistically difference.The TK1 and DI area under the ROC curve were 0.950 (P＜0.001) and 0.638 (P=0.063),best cut-off were 1.73 pmol/L and 0.98,sensitivity were 0.95,0.78,and specifity were 0.88,0.39.Conclusion Serum TK1 and DI is a important diagnostic marker of early for AML patients,TK1 have a better diagnostic performance than DI significantly.