Objective:To eveluate and study the anatomic basis of the posterior contour sign of lumbar intervertebral disc.Methods:The most protruding length of the soft tissue mass behind intervertebral spase on lumbar plain film were measured in 100 cases and compared with CT or MR findings.Results:41 posterior contour sign of the interlumbar disc were fined in 39 cases,of which there were 25 in L4/5(61.0%),15 in L3/4(15.6%)and 1 in L2/3(2.4%).The protruding was less than 0.2 cm in 26 and larger than 0.2 cm in 15,there were 10 lumbar disc protruding confirmed by CT or MR ,7 of which the pesterior contour ≥0.2 cm,and 3＞0.3 cm,none was ≤0.2 cm.Conclusion:The adipose tissue in the posterior border of lumbar body and disc was the anatomic basis of the sign,and it was an importent sign for diagnosing of lumbar disc hernia on plain film.

Objective To evaluate the applied value of bedside chest radiography in the intensive care unit ( ICU ) . Methods One hundred and ninety-three cases with 507 chest radiographs (CXRs) in the ICU were analysed retrospectively. The appearances of cardiopulmonary abnormalities were analysed.Results 97.4% of the CXRs were satisfied for diagnosis. 83.9% of the CXRs showed cardiopulmonary abnormalities, including atelectasis, pneumonia, pulmonary edema, ARDS, pneumothorax, mediastinal and subcataneous emphysema,pleural effusion,pericardial effusion and pulmonary thromboembolism, and 6.2% out of these positive cases was discovered accidentally. The chest radiograph has moderate accuracy (77.9%) in visualizing cardiopulmonary abnormalities at the initial CXR including atelectasis,pneumonia,pulmonary edema and pleural effusion. Misdiagnosis occurred mainly on the patients with a small quantity of pneumothorax and pulmonary thromboembolism. About one-third cases of cardiogenic edema and ARDS were indistinguishable.Conclusion Bedside chest radiographs are of significant value for the patients in the ICU.

Objective To assess the contribution of the portable chest computed radiography (CR) in evaluation of monitoring devices of the patients in the intensive care unit (ICU). Methods One hundred and sixty-two cases with 387 chest radiographs in the ICU were analysed retrospectively. The location of the catheters of monitoring devices and complications were observed.Results The malposition of the catheters was detected in 47 cases(16.9%),including the endotracheal (ET) tubes too deep at the position, the central venous catheters placed into the internal jugular veins,and the position of the thoracic drain tubes to be deep not enough causing the drain to fall.The complications after operation of monitoring devices were not common,including pneumothorax caused by ventilatory assistance,atelectasis and pneumonia caused by malposition of the ET tubes,totally in 11 cases.10 cases with cardiopulmonary abnormalities were discovered accidentally in all 162 cases(6.2%) when evaluation of monitoring devices.Conclusion Bedside chest CR not only can show the catheter position and the complications of the monitoring devices ,but also the cardiopulmonary abnormalities of patients in the ICU.

Objective To understand the therapeutic effect of clindamycin combined with compound sulfamethoxazole tablets on pneumocystis pneumonia(PCP)associated with acquired immunodeficiency syndrome (AIDS).Methods 97 AIDS patients with PCP in a hospital from January 2014 to March 2015 were randomly divided into control group (n=49,received compound sulfamethoxazole )and trial group(n=48,received clindamycin on the basis of com-pound sulfamethoxazole ),levels of partial pressure of oxygen in arterial blood (PaO2 ),arterial blood oxygen satu-ration(SaO2 ),serum albumin(ALB),and lactic dehydrogenase (LDH)in two groups of patients before and after treatment were recorded.Results Levels of PaO2 ,SaO2 ,ALB,and LDH between two groups of patients before treatment was not significantly different(all P >0.05).After treatment,PaO2 in control group and trial group were (73.01 ±4.62)mmHg and(84.92 ±5.34)mmHg respectively,SaO2 were (75.81 ±4.28)% and(90.86 ±5.94)%respectively,ALB were (32.62±4.41 )g/L and(43.95 ±5.03)g/L respectively,LDH were(416.53 ±30.77)U/L and(331 .58±20.86)U/L respectively,levels of PaO2 and SaO2 in trial group were both higher than control group , difference in ALB and LDH between two groups of patients after treatment were both statistically significant(both P <0.05).The total effective rate of trial group was 89.58% (n=43),which was higher than 69.39%(n=34)in control group (χ2 =6.04,P =0.014).Conclusion Clindamycin combined with compound sulfamethoxazole tablets has good therapeutic effect on AIDS and PCP,which is worthy of clinical popularization and application.

OBJECTIVE:To evaluate the bioequivalence of domestic secnidazole tablet,capsule and imported secnidazole tablet in healthy volunteers.METHODS:18healthy volunteers were randomly divided into3groups according to a triple-cross design,all the volunteers were given a single dose of1g secnidazole,the interval for washout period of3times adminis?tration was14days.The plasma drug concentration of secnidazole was determined by HPLC-UV.RESULTS:The main pharmacokinetic parameters of homemade tablet and homemade capsule and imported tablet were as follow,t max were(2.00?1.93),(2.67?2.14)and(1.54?1.53)h respectively,t 1/2 were(28.56?4.98)、(29.69?6.81)and(27.16?5.06)h,C max were(25.50?2.74),(24.27?3.76)and(25.64?4.10)?g/ml respectively.AUC 0～t were(736.03?73.20),(704.78?88.51)and(737.77?76.02)(?g?h)/ml respcetively.AUC 0～∞ were(886.36?114.50),(864.57?172.27)and(870.64?100.21)(?g?h)/ml respectively.The relative bioavailability of homemade tablet was(100.02?6.73)%,and that of homemade capsule was(95.91?10.66)%.CONCLUSION:3preparations of secnidazole are bioequivalent.

0.05). There was only 2/109 cases (5.8%) need a second course of antibiotics because of likely infection and 102/109 cases (93.5%)need not any moor antibiotics. The mean period of antibiotic treatment in group Ⅰ, group Ⅱa and group Ⅱb were (1.2?0.5) days,(4.8?0.8) days and (9.3?1.8) days,respectively.There were significant differences(all P

Objective To evaluate the effects of different doses of lidocaine on suppressing fentanyl-induced cough and determine a safe suppressing dose.Methods Two hundred patients undergoing general anesthesia were randomized to four groups evenly.The following medications were given within ten seconds:normal saline 10ml (groupⅠ,control group),lidocaine 1 mg/kg (groupⅡ),lidoeaine 1.5 mg/kg(groupⅢ),lidocaine 2mg/kg (groupⅣ).Toxic symptoms of lidocaine were recorded within lmin after the administration of lidocaine,then fentanyl 3?g/ kg was given intravenously within 5 seconds.Cough incidence and cough grade were recorded within 2rain after the administration of fentanyl.Systolic blood pressure (SBP),diastolic blood pressure (DBP),heart rates (HR),and satu- ration of pulse oximeter(SpO2) were recorded during different time points of induction,all recorded data were anal- ysed by the statistical software,P value

Objective To study the CT and MRI findings of hemorrhagic and necrotic nasal polyps. Methods The imaging data of 17 cases with hemorrhagic and necrotic nasal polyps confirmed by surgery and pathology were analyzed retrospectively. CT was performed in 14 cases, MRI in 16 cases, of which 15 also underwent contrast-enhanced MRI. Results All 17 lesions with well-circumscribed margin originated in the areas of maxillary sinus ostia and extended into adjacent nasal cavity and maxillary sinus. The lesions appeared as lobular shape in 16 cases and oval shape in 1 case. On non-enhanced CT, 14 lesions showed heterogenous soft tissue density masses, the hyperdense strip and nodule were detected on the periphery and in the center of 2 lesions respectively. All the involved bony walls were compressed and remodeled with focal defect,especially in the medial wall of maxillary sinus. On MRI, all 16 lesions revealed inhomogenous signal. The central region of the lesions appeared hypointense signal on T_1WI compared to gray matter and hyperintense signal on T_2WI with line-like hypointense signal septa in 14 cases, the irregular hypointense signal rims were also found on the periphery of 15 lesions on T_2WI, postcontrast MR imaging showed strongly inhomogenous enhancing masses with non-enhancing hypointense rim, the appearances of enhancement showed multiple nodules in 10 cases, patches in 4 cases and leaf-like in 1 case. The typical simple polyps were present in the ipsilateral nasal cavity of the lesions in 4 cases, extending into nasal vestibule anteriorly and choana posteriorly. On dynamic contrast-enhanced MRI in 11 cases, the timeintensity curves (TIC) showed increasing enhancement type in 7 cases and rapid enhancement and slow wash-out type in 4 cases. Conclusion The inhomogenous hyperintensity surrounded by the peripheral hypointense rim on MR T_2WI and marked nodular and patchy enhancement appearance are typical features of hemorrhagic and necrotic nasal polyps. CT is helpful to judge the nature of lesions, but difficultly confirms the diagnosis, while MRI should be the imaging modality of first choice for hemorrhagic and necrotic nasal polyps.

clues for interpretation of myocardial ischemia.

BACKGROUND: Intrapulmonary vascular abnormalities result in the right-to-left shunting and severe hypoxemia in liver transplantation candidates. Currently, a convenient, sensitive and effective method is absent to screen the intrapulmonary vascular dilatations.OBJECTIVE: To evaluate the role of contrast-enhanced echocardiography on clinical diagnosis of intrapulmonary shunting in liver transplantation candidates.DESIGN, TIME AND SETTING: The experiment, prospective controlled observation based on cases, was performed at the Hepatology Unit of the 458 Hospital of PLA (Guangzhou, Guangdong, China) from February 2004 to February 2006.PARTICIPANTS: Twenty-four consecutive liver transplantation candidates were recruited from the Hepatology Unit of the 458Hospital of PLA.METHODS: Routine examination was conducted under the condition without any regimen of vascular dilatation drugs.Contrast-enhanced echocardiography was applied to detect the prevalence of right-to-left shunting in the patients with end-stage liver disease. The microvesicle of the left ventricle in patients was qualitatively assessed by a score from 1+ to 3+. Accordingly, all patients were divided into two groups: intrapulmonary shunting and non-intrapulmonary shunting.MAIN OUTCOME MEASURES: The prevalence of right-to-left shunting and clinical characteristics of liver transplantation candidates were determined.RESULTS: Ten (41.7%) of 24 patients with positive contrast-enhanced echocardiography were proved to develop the intrapulmonary right-to-left shunting, including 6 for l+ and 4 for 2+ by left ventricle abnormality, which emerged after 6-10 cardiac cycles of right ventricle abnormality. There were no significant differences in age, gender, arterial blood gas analysis and liver function tests between the two groups (P > 0.05). Echocardiography results demonstrated that, the upper digestive tract hemorrhage,spleen thickness that indicated portal hypertension, pulmonary artery systolic pressure and Tei index were significandy higher in the patients of intrapulmonary shunting than in those of non-intrapulmonary shunting (P<0.05-0.01 ).CONCLUSION: Intrapulmonary vascular dilatation occurs frequently in liver transplantation candidates associated with intrapulmonary shunting but without hypoxemia. Contrast-enhanced echocardiography is a sensitive and non-invasive method for the early diagnosis of intrapulmonary vascular dilatation. The pathogenic cause is portal hypertension. Tel index can be used as an important parameter for evaluating right ventricular function in patients of intrapulmonary vascular dilatation.