Objective To discuss the CT diagnosis and differential diagnosis of lumbar posterior marginal intraosseous cartilaginous nodes(LPMN)and the possible pathogenesis.Methods CT manifestations of LPMN in 29 cases hospitalized in the last three years were analysed retrospectively.Results The mainly CT features of LPMN included:(1)Osseous defect with sclerotic margin in the posterior-superior or posterior-inferior margins of centrum;(2)Behind the defect area,bone fragments protrude into the spinal canal,totally dislocated or partially joined with centrum;(3)The dural sac and nerve root compressed accompanied by lumbar disc herniation and spinal canal stenosis.Conclusion LPMN can be definitively diagnosed by CT scan,which provides reliable basis for the treatment project.

This article explained that the evidence grading system occupied an important position in the evidence-based clinical practice guidelines. Through the comparative analysis on characteristics of clinical evidences between traditional Chinese medicine (TCM) and modern medicine, different possible establishment ideas of evidence grading system in TCM evidence-based clinical practice guidelines were proposed . The design for evidence grading standard of Chinese medical literature which reflected the academic characteristics of TCM was suggested.

Objective To investigate scanning and reconstruction techniques of multi-slice spiral CT (MSCT) in patients with complex congenital heart diseases (CCHD).Methods One hundred eighty-four patients suffering from CCHD underwent 16-detector MSCT scanning without ECG-gating.Multi-planar reconstruction (MPR),maximum intensity projection (MIP),curved-planar reconstruction (CPR) and volume rendering (VR) were used to reconstruct images.CT findings were compared with those of surgical operation or angiocardiography.Results A total of 616 cardiac deformities were found with MSCT and proved by angiocardiograms or surgical operation.The diagnostic accuracy of extracardiac malformation with MSCT was 100%,of atrial septal defect was 54.65%,and of ventricular septal defect was 78.62%.MSCT failed to display heart valve disease well.Conclusion MSCT can accurately detect extracardiac malformations of CCHD.

Objective To explore the effect of medicated serum of Sangleng and Eshu on the expression of vascular endothelial growth factor and vascular endothelial cell proliferation induced by VEGF in vitro. Methods Medicated serum of Sangleng and Eshu was used to culture human umbilical vein endothelial cell (HUVEC-1) induced by VEGF. The morphologic changes of HUVEC-1 were observed with phase contrast microscope, and cell proliferation was detected by MTT method, and the expression of vascular endothelial growth factor protein and mRNA in endothelial cells was detected by Western blotting and RT-PCR. Results The medicated serum of 5.0, 2.5 g?kg~ -1 ?d~ -1 Sangleng and Eshu could cause arrangement disorder in the normal umbilical vein endothelial cells. The medicated serum of 5.0 g?kg~ -1 ?d~ -1 Sangleng and Eshu (10%, 5%, 2.5%) and medicated serum of 2.5 g?kg~ -1 ?d~ -1 (10%) could inhibit vascular endothelial cell proliferation remarkably (P

Objective To investigate the value of multislice spiral CT(MSCT,)in interventional therapy of the hepatocellular carcinoma(HCC)emphasising on transcatheter hepanc arterial chemoembolization(TACE).Methods MSCT were performed in 60 cases of HCC before interventional procedure,CT findings of hepatic artery phase,portal venous phase and hepatic venous phase were observed respectively,among which CTA were done in 15 cases,and the anatomy of celiacartery and its branches were observed in 45 cases.The schemes of interventional therapy were worked out according to the findings of MSCT.Results MSCT showed 250 lesions,10 cases of tumor thrombosis in portal vein and 19 cases of hepatic arterioportal shunt.There was no significant difference between MSCT and digital subtraction angiography(DSA)in positive rate of in showing number of tumor or tumor thrombosis in portal vein(P＞0.05),but the 3D construction of celiac artery branches in CTA was better than that in DSA,while angles between celiac artery and abdominal aorta in MSCT were more convenient than that in DSA.MSCT showed 5 eases of hepatic artery original abnormality,according to that in DSA.Conclusion MSCT is of importance for guidance of interventional therapy of hepatocellular carcinoma.

Objective To study the influence factors of real-time shear wave elastography(SWE) on the elasticity of focal liver lesions (FLLs) measurement.Methods The mean Young's modulus of 160 FLLs were measured by SWE.The relation between elasticity with different aspects of FLLs were analyzed including postures (supine and left lateral position),respiratory phases (end of inspiratory and expiratory),the probe position (rib and intercostal space) and different operators.Results There were significant differences between different postures and respiratory phases in the elasticity measurement of FLLs by SWE (P ＜0.05).There was no significant difference between robe position and different operators in the elasticity measurement of FLLs by SWE(P ＞0.05).Conclusions The postures and respiratory phases can impact the elasticity measurement of FLLs by SWE.

Objective:To investigate the effect of right stellate ganglion block (RSGB)-serratus anterior plane block (SAPB) combined with general anesthesia in thoracoscopic radical resection of lung cancer.Methods:A total of 90 patients who planned to undergo thoracoscopic radical resection of lung cancer in Xiangya Changde Hospital from March 2020 to September 2021 were prospectively selected and divided into 3 groups by random number table method: general anesthesia group (G group), (SAPB)+ general anesthesia group (SG group), RSGB+ SAPB+ general anesthesia group (RSG group), 30 cases in each group. The SG group received SAPB on the operative side before general anesthesia, and the RSG group received RSGB+ SAPB on the operative side before general anesthesia. After the blocking effect was determined, all patients were given general anesthesia in the same scheme according to their weight, and patients were given patient-controlled intravenous analgesia (PCIA) after surgery. The mean arterial pressure (MAP) and heart rate (HR) were recorded before anesthesia (T 0), before intubation (T 1), 1 min after intubation (T 2), 5 min after intubation (T 3), at extubation (T 4) and 5 min after extubation (T 5). The intraoperative dosage of remifentanil, incidence of nausea and vomiting (PONV) within 24 hours after surgery, number of additional PCIA within 24 hours, the Visual Analogue Scale (VAS) of static and dynamic pain, the Bruggrmann Comfort Scale (BCS) and Richard Campbell Sleep Questionnaire (RSCQ) 24 hours after surgery were recorded. Results:Compared with T 0, the MAP and HR in 3 groups were increased 1 min after intubation (T 2) and at extubation (T 4), but the increases in RSG group were significantly less than those in G and SG groups (all P<0.05). The remifentanil dosage, PONV incidence and PCIA supplemental times in SG and RSG groups were less than those in G group, and the BCS score and RSCQ score were higher than those in G group (all P<0.05); the BCS score and RSCQ score in RSG group were higher than those in SG group (all P<0.05). Conclusions:RSGB+ SAPB combined with general anesthesia in thoracoscopic radical resection of lung cancer has little circulation fluctuation, good postoperative analgesia effect, less adverse reactions and high comfort level.

3D bioprinting has been widely used in the field of regenerative medicine since its introduction in 2004. Due to its advantages of personalized customization, it is broadly applied in plastic surgery. This paper introduces 3D bioprinting materials (bioink) and bioprinting method currently used in the field of otoplasty and rhinoplasty, analyzes the clinical application of bioink, presents the challenges in 3D bioprinting technology in this field, and prospects the future development of the technology.

3D bioprinting has been widely used in the field of regenerative medicine since its introduction in 2004. Due to its advantages of personalized customization, it is broadly applied in plastic surgery. This paper introduces 3D bioprinting materials (bioink) and bioprinting method currently used in the field of otoplasty and rhinoplasty, analyzes the clinical application of bioink, presents the challenges in 3D bioprinting technology in this field, and prospects the future development of the technology.

Objective To study the application value of pneumonia severity index high-risk score (PSI-HR) in high risk patients and neutrophil-to-lymphocyte ratio (NLR) in the condition evaluation of the pa-tients with respiratory tract infection in ICU.Methods The clinical data of the patients with lower respiratory tract infection hospitalized in the department of intensive care medicine of this hospital from January 2020 to July 2023 were retrospectively analyzed.According to the ICU outcomes,the patients were divided into the im-provement group (n=77) and the poor prognosis group (n=25),and the receiver operating characteristic (ROC) curve was drawn to analyze the evaluation value of PSI-HR score combined with NLR,NLR,PSI-HR score,PSI-HR grade and PSI grade in the prognosis of the patients with lower respiratory tract infection. Results The case fatality rates of the patients with different grades of PSI were 40.00％ (16/40) for the grade 5,18.75％ (6/32) for the grade 4,22.22％ (2/9) for the grade 3 and 4.76％ (1/21) for the grade 2,re-spectively.There was no significant correlation between different PSI grades and case fatality rate (r=0.911,P=0.089).The case fatality rates of different grades of PSI-HR were 75.00％ (3/4) for the grade 6,46.67％ (7/15) for the grade 5,28.57％ (6/21) for the grade 4,17.24％ (5/29) for the grade 3,and 12.12％ (4/33) for the grade 2,respectively,and the PSI-HR grade was positively correlated with the case fatality rate of the patients (r=0.955,P=0.011).The area under the ROC curve (AUC) of predicting the prognosis of the pa-tients with lower respiratory tract infection from great to small was 0.828(95％CI:0.717-0.938,P<0.05) for PSI-HR score combined with NLR,0.754 (95％CI:0.637-0.871,P<0.05) for NLR,0.744 (95％CI:0.636-0.852,P<0.05) for PSI-HR score,and 0.706 (95％CI:0.584-0.829,P<0.05) for PSI-HR grade and 0.695 (AUC=0.695,95％CI:0.582-0.807,P<0.05) for PSI grade.Conclusion The PSI-HR grade has good correlation with the case fatality rate of the patients with lower respiratory tract infection.The effi-ciency of PSI-HR grade combined with NLR for predicting the prognosis in the patients with lower respiratory tract infection in ICU is better than that of single index.