Objective To evaluate the use of endoscopy in assessment of invasion depth of colorectal flat lesions and in choice of treatment strategy. Methods The invasion depth of 222 colorectal flat lesions from 188 patients was endoscopically estimated by pit patterns, air-induced deformation testing and/or lifting sign. The lesion was endoscopically rosected if both tests were positive, otherwise, surgery was applied. The pathological evaluation of resected lesion was made according to WHO criteria and was used as a reference of tumor invasion depth. The sensitivity, specificity, positive and negative predictive value of airinduced deformation testing and lifting sign in prediction of invasion depth of tumors were calculated. Results The air-induced deformation testing and lifting sign were both positive in 212 cases, in which 192 were treated with endoscopic mucosal resection (EMR), 15 with endoscopic piecemeal mucosal resection (EPMR), 2 with additional surgery after EPMR and 3 with surgery only. Either air-induced deformation tesring or lifting sign was negative in 10, in which 4 cases underwent surgical resection. The sensitivity, specificity, positive and negative predictive value of air-induced deformation testing and lifting sign in prediction of invasion depth of tumors were 97.2%, 44. 4%, 97.6% and 40. 0%, respectively. Conclusion Endoscopic air-induced deformation testing and lifting sign can be used to predict invasion depth of colorectal flat tumors, which can guide instant therapeutic strategies and avoid excessive or insufficient treatments.

Objective To assess the role and its tecnhique superiority of 64-slice spiral CT angiography(CTA) in lower limb arterial diseases.Methods MSCT studies in 33 cases suspected diseases of lower limb arteries was performed,the helical scans covered the extent of renal artery to the artery of the lower extremity.3D reconstruction of vessel was done in Wizard workstation.The manifestations of MSCTA were compared with that of conventional angiography . Results Of the 693 segments of arteria , 683 were assessable on both DSA and CTA.Using the DSA images as the standard reference,the sensitivity,specificity and accuracy of CTA were 97.6%(95% CI,94.9%~100.7%),98.9%(95% CI,98.0%~99.8%),98.7%(95% CI,97.9%~99.5%)in detecting the segments occluded . With the regard the detection of segments that had more than moderate stenosis , the sensitivity , specificity and accuracy of MIP were 98.9% ( 95% CI , 97.4%~100.4%),99.4%( 95% CI, 98.7%~100.1%) and 99.3%(95% CI, 92.4%~99.9%).Conclusion In assessment of diseases of lower limb arteries with 64-slice spiral CT angiography is equal to DSA basically, it is a highly accurate and non-invasive angiography in diagnosing arterial diseases of the lower extremities.

Antineoplastic Agents ; adverse effects ; therapeutic use ; Diarrhea ; chemically induced ; Drug Delivery Systems ; methods ; Exanthema ; chemically induced ; Humans ; Leukopenia ; chemically induced ; Lung Diseases, Interstitial ; chemically induced ; Myocardial Infarction ; chemically induced ; Neoplasms ; drug therapy ; Tumor Lysis Syndrome ; etiology

Air ; analysis ; Air Pollutants, Occupational ; analysis ; Humans ; Occupational Exposure ; Phthalic Acids ; analysis ; Spectrophotometry ; methods ; Workplace

Functional magnetic resonance imaging (fMRI) is a technology combined with function, anatomy and images to evaluate the brain function in real-time, dynamic, non-invasive ways. fMRI has been applied in the rehabilitation after stroke for the assessment and prog-nosis of motor, speech, cognition and sense function, etc.

ObjectiveTo explore the clinical characteristics of pathological fracture in extremities caused by bone tumors or tumor-like lesions. MethodsFrom August 2002 to December 2010, 139 patients with pathological fractures were entered in the study, including 79 males and 60 females with an average age of 31.1 years. Fractures included tumor-like lesion in 55 cases, benign tumor in 13, giant cell tumor (GCT)in 7, primary malignant tumors in 28, and metastatic tumors in 36. Forces induced to fractures were classified into four grades: spontaneous fracture, functional activity, minor injury, severe injury. Age, fracture location, histological results, fractures forces, prodromes, and misdiagnosis were all observed. Chi-square test were use to compare forces and prodromes within different tumors. ResultsThe highest morbidity rate is 32.4％(45/139) which lies in 11-20 years old. The cites of fractures including femurs in 71 cases, humerus in 36, tibia in 15, fingers in 7, radiuses in 4, fibula in 3, ulnas in 2, and metatarsus in 1. Fracture forces include spontaneous fractures in 29 cases, functional activity in 42, minor injuries in 65, and traumatic injuries in 3. Sixty-seven patients(48.2％) had local prodromes. The prodromes of both malignant tumors and metastatic tumors were more than benign tumors. Twenty cases experienced misdiagnosis with average delay time of 12 weeks. ConclusionMinor injury forces and local prodromes are clinical key features of pathological fractures. Both of them are key points of avoiding misdiagnosis.

ObjectiveTo establish pediatric serum CysC reference intervals based on the children's hospital laboratory data in Zhejiang Province and analyse the effects of CysClevels on age and gender. MethodsCysC was one of tests of a routine biochemical screening panel employed for most outpatients and inpatients in the children's hospital, and 8 127 subjects (4 264 boys and 3 863 girls) were selected from 13 567 subjects from laboratory information system according to the exclusion criterion with seriously systemic diseases, cardiovascular diseases, kidney diseases, elevated values of creatinine, urea or ALT for which 1.5-fold upper limit, serum samples with hemolysis, icterus or lipid turbidity, same patients with non-first-time CysC results and living addresses which were not in Zhejiang. The serum CysC was determined by transmission turbidimetry on Roche DPP modular automatic biochemical analyzer. SPSS 17.0 software and EXCEL 2003 were employed for statistical analysis in this study. Results The serum CysC concentration was a Gaussian distribution after log transformation. The mean Log-transformated CysC lg (CysC) concentration of boys in five age groups ( ＜ 1 month, 1 to 3 months, 4 to 11 months, 1 to 2 years and 2 to 16 years) were 0. 224,0. 170,0. 112,0. 061, -0. 011 (mg/L,lg) respectively, and the mean Log-transformated CysC lg(CysC) concentration of girls in five age groups were 0. 222, 0. 164, 0. 089, 0. 057,-0. 010 ( mmg/L, lg) respectively, and no statistically significant differences between Ig( CysC ) and gender in five age groups were found ( t values were 0. 174, 0. 362, 0. 445,- 1. 464 and - 0. 093, respectively,and corresponding P values all were greater than 0. 05 ). The mean lg ( CysC ) concentrations in five age groups were 0. 222,0. 166,0. 100,0. 059, - 0. 010 ( mmg/L, lg), and significant differences between Lg ( CysC ) and ages by Analysis of Variance were observed ( F = 309. 785 and P = 0 in between-groups totally,P = 0 in any two groups). Serum CysC levels were highest in the age of ＜ 1 month, then declined to the age of 2 years and kept stable in the age of 2 to 16 years. The serum CysC reference intervals for children were as follows:0. 95 -2. 92 mg/L in the age of ＜ 1 month, 0. 81 -2.67 mg/L in the age of 1 to 3 months, 0. 65 -2.45 mg/L in the age of 4 tol2 months, 0. 56 -2. 35 mg/L in the age of 1 year and 0. 45 -2. 13 mg/L in the age of 2 to 16 years. ConclusionsThere is no significant effect on pediatric CysC levels with gender but close correlated with age below 2 years old. It is necessary to establish appropriate age-related reference intervals of serum CysC for efficiently evaluating renal function in local children.

involved,reexamination with colonoscopy is reconanended.

Objective To investigate the value of double-balloon endoscopy (DBE) and multi-slice CT enteroclysis (MSCTE) in diagnosis of Crohn's disease (CD) in small intestine. Methods DBE and MSCTE were performed in 71 patients with suspected Crohn's disease in small intestine. The two methods were compared in terms of diagnosis, extents of disease, existance of complications and activity of the disease according to the pathologic findings and the outcome of follow-up. Results The diagnostic yields of DBE and MSCTE were comparable with no significant difference (χ2=2.29, P> 0.05). The positive and negative likelihood ratios were 22.5 and 0. 022 in DBE respectively, and were 1.6 and 0. 240 in MSCTE respectively. The results of DBE was consistent with MSCTE in diagnosis of mild bowel stenosis, but was inconsistent with MSCTE in diagnosis of moderate-severe bowel stenosis (χ2=11.298, P=0.001). The concordance of two methods in diagnosis of disease activity was 95.8%. Conclusions The first choice in diagnosis of small bowel CD is DBE. The combination of two methods will be helpful in diagnosis and evaluation of CD severity.

Objective To investigate the causes of and prophylactic measure for complications of minilaparotomy cholecystectomy (MC).Methods The clinical data of 10 200 patients receiving MC from Apri1 1991 to March 2006 were analyzed.Results MC was successful in 9 835 cases(96.4%), and in 365 cases(3.6%) the incision was lengthened. Serious complications were 12 cases(0.12%)of bi1e duct injury, 4 cases(0.04%)of colon injury, 8 cases(0.08%)of massive haemorrhage, and 25 cases (0.25%)of bile leakage. Four 4 cases(0.04%) died. Conclusions The key to prevention of complications is a strict selection of MC indications,careful identification of the anatomical structures of Calot's triangle,use of suture ligation of the mesentery of gallbladder triangle and the technique of deep knot-tying and the timely use of extension of the incision.