Objective:To investigate the value of the 8-channel eye surface phased array coil in improving image quality and demonstrating ocular masses on 3.0 T MR scanner.Methods:From July 2018 to January 2020, the data of orbital MRI in 692 patients with ocular masses on 6 medical centers were prospectively collected. The patients were simple randomly assigned into 8-channel eye surface phased array coil group (413 patients) or 8-channel head phased array coil group (279 patients), with the same MRI sequences. The signal to noise ratio (SNR) and contrast to noise ratio (CNR) were calculated in orbital anatomy structures and masses (eyelid mass, intraocular mass, lacrimal mass and orbital mass). The image quality scores including motion artifact, mass margin, the relationship between the mass and adjacent structures, and overall image quality were recorded. The differences of image quality between the two groups were compared by two independent sample t-test or Wilcoxon rank test. Results:The SNR and CNR were higher in eye surface coil group than those in head coil group ( P<0.05). The scores of ocular movement artifacts were higher in head coil group than those in surface coil group ( P<0.05). The scores of intraocular mass margin, the relationship between the mass and adjacent structures, and overall image quality were higher in surface coil group than those in head coil group ( P<0.001). There were no significant differences in mass margin, the relationship between the mass and adjacent structures, and overall image quality scores of eyelid, lacrimal gland, and orbital mass between the two groups ( P>0.05). Conclusion:3.0 T MR scanner combined with the 8-channel eye surface phased array coil can improve the SNR and CNR of orbital MR images, the demonstration of the intraocular mass margin and the relationship between the mass and adjacent structures.

Objective:To investigate the value of periodically rotated overlapping parallel lines with enhanced reconstruction (PROPELLER) in improving ability of demonstrating ocular masses on 3.0 T MR scanner.Methods:This study was a multi-center prospective study involving 6 centers. From July 2018 to January 2020, totally 413 patients with ocular masses from 6 centers were prospectively enrolled, and all of them underwent T 1WI and T 2WI, PROPELLER T 1 FLAIR and T 2WI, and contrast-enhanced scans. The signal intensity of eyelid, vitreous body, lacrimal gland, intraorbital segment of optic nerve, and orbital masses of eyelid, intraocular, lacrimal gland and retrobulbar were measured by two radiologists, and the signal to noise ratio (SNR) and contrast noise ratio (CNR) were calculated. The 5-point scoring method was used to evaluate the motion artefacts, tumor edges and the relationship between the tumor and adjacent structures, and the overall score of image quality was calculated. Paired t-test or Wilcoxon signed rank test was used to compare the image quality between PROPELLER and non-PROPELLER images. Results:The SNR and CNR of PROPELLER T 2WI were higher than those of non-PROPELLER T 2WI (all P<0.001). The SNR and CNR of PROPELLER T 1 FLAIR were lower than those of non-PROPELLER T 1WI (all P<0.05). The scores of artefacts and overall image quality in PROPELLER images were higher than those in non-PROPELLER images (all P<0.001). The tumor edge and the relationship between the tumor and adjacent structures scores of eyelid, intraocular, and lacrimal gland masses in PROPELLER images were higher than those in non-PROPELLER images (all P<0.001),while compared to non-PROPELLER images, retro-global masses in PROPELLER images showed no significant differences (all P>0.05). Conclusion:PROPELLER can reduce ocular motion artefacts, effectively improve image quality and ability of demonstrating anterior (eyelid, intraocular, and lacrimal gland) masses.

Online and offline blended learning is the key link to change the teaching mode of higher education. As a new teaching mode, it faces problems such as too much emphasis on students' autonomous learning ability, inadequate supervision of students, and difficulty in building a holistic view of the medical system when applied to medical education. To better promote the reform of blended learning in medical colleges and universities, it is necessary to take the following actions: designing the course content carefully and scientifically arranging the length of online lectures; adopting various ways to follow up in all aspects and building a "whole course" supervision system; always maintaining a holistic view of medicine throughout the blended learning to cultivate comprehensive talents.

Objective To investigate the clinical application value of pancreatoduodenectomy combined with vascular resection and reconstruction for pancreatic head carcinoma.Methods The clinical data of a patient with pancreatic head carcinoma who underwent pancreatoduodenectomy combined with vascular resection and reconstruction at the Southwest Hospital in March 2014 were retrospectively analyzed.Preoperative imaging examination showed no gap between vascular wall of portal vein (PV) and pancreatic head space-occupying lesion,vascular compression and stenosis at intersection of PV,splenic vein (SV) and superior mesenteric vein (SMV),but not excluding adjacent main PV invasion.During the operation,it was difficult to separate pancreatic head carcinoma from PV,indicating vascular wall invasion at intersection of PV,SV and SMV.Therefore,the pancreatic head,bile ducts,duodenum,partial jejunum,invasive vein vessels,lymphatic and nerve tissues were radically resected,then PV,SMV and SV were reconstructed.The patient was followed up by outpatient examination and telephone interview after surgery till April 2015.Results The patient underwent pancreatoduodenectomy combined with vascular resection and reconstruction successfully without blood transfusion.The operation time was 285 minutes and volume of intraoperative blood loss was 300 mL.The patient had a smooth postoperative recovery,resuming diet at postoperative day 5.The abdominal drainage tube and stitches were removed at postoperative day 6 and day 12,and the patient was discharged from hospital at postoperative day 15.Computed tomography reexamination showed clear vascular anastomose.The patient was not complicated with pancreatic fistula,biliary fistula,intra-abdominal hemorrhage and vascular embolism.The postoperative pathological examination confirmed the diagnosis of pancreatic head moderately differentiated adenocarcinoma accompanied by PV invasion and lymph node metastasis,with a negative margin.The patient began a course of single drug common chemotherapy using gemcitabine at postoperative day 40.No cancer recurrence was detected during the one-year follow-up.Conclusion Pancreatoduodenectomy combined with vascular resection and reconstruction is safe and feasible for the treatment of pancreatic head carcinoma with good surgical effects.

Objective To investigate the expression of tripartite-motif protein 25 (TRIM25) and pyruvate kinase M2 (PKM2) protein in non-small cell lung cancer (NSCLC) and explore their role in the occurrence and progression of NSCLC. Methods The expressions of TRIM25 and PKM2 protein were detected in 60 NSCLC specimens and 20 adjacent normal lung tissue (>5 cm from the lesions) with immunofluorescence histochemical method and in 10 fresh specimens of NSCLC with Western blotting. The results were analyzed in relation with the clinicopathological features of the patients. Results The positivity rates of TRIM25 expression was 45%in the 60 lung carcinoma specimens, significantly higher than that in the 20 normal lung tissues (10%,Ρ=0.005). TRIM25 protein was expressed in 28.6%of lung adenocarcinoma tissues and in 59.4%of squamous carcinoma tissues (Ρ=0.017). TRIM25 protein expression was positively correlated with the TNM stages and lymph node metastasis of NSCLC (Ρ<0.05). The expressions of PKM2 protein in 60 cases of lung carcinoma was 73.3%,while in 20 cases of normal lung tissues the expressions was 30%(Ρ=0.001). The positivity rates of PKM2 expression differed significantly between lung adenocarcinoma and squamous carcinoma (57.1%vs 87.5%,Ρ=0.008). An inverse correlation was noted between TRIM25 and PKM2 expressions (Ρ=0.026). Conclusion TRIM25 and PKM2 protein may participate in the occurrence and progression of NSCLC, and their expressions are inversely correlated.

Objective To investigate the expression of tripartite-motif protein 25 (TRIM25) and pyruvate kinase M2 (PKM2) protein in non-small cell lung cancer (NSCLC) and explore their role in the occurrence and progression of NSCLC. Methods The expressions of TRIM25 and PKM2 protein were detected in 60 NSCLC specimens and 20 adjacent normal lung tissue (>5 cm from the lesions) with immunofluorescence histochemical method and in 10 fresh specimens of NSCLC with Western blotting. The results were analyzed in relation with the clinicopathological features of the patients. Results The positivity rates of TRIM25 expression was 45%in the 60 lung carcinoma specimens, significantly higher than that in the 20 normal lung tissues (10%,Ρ=0.005). TRIM25 protein was expressed in 28.6%of lung adenocarcinoma tissues and in 59.4%of squamous carcinoma tissues (Ρ=0.017). TRIM25 protein expression was positively correlated with the TNM stages and lymph node metastasis of NSCLC (Ρ<0.05). The expressions of PKM2 protein in 60 cases of lung carcinoma was 73.3%,while in 20 cases of normal lung tissues the expressions was 30%(Ρ=0.001). The positivity rates of PKM2 expression differed significantly between lung adenocarcinoma and squamous carcinoma (57.1%vs 87.5%,Ρ=0.008). An inverse correlation was noted between TRIM25 and PKM2 expressions (Ρ=0.026). Conclusion TRIM25 and PKM2 protein may participate in the occurrence and progression of NSCLC, and their expressions are inversely correlated.

Objective To investigate the correlation of spinal canal stricture and intramedullary increased signal intensity (ISI) in patients with ossification of the posterior longitudinal ligament (OPLL). Methods 92 patients with OPLL were divided into 3 groups, those with the sagittal diameter remained ≥66.7% were as group A, 33.3%~66.7% as group B, and <33.3% as group C. The incidence of intramedullary ISI was recorded, and their neurological condition was assessed with the Japanese Orthopedics Association Assessment (JOA). Results ISI were found in 6 cases in the group A (20.7%), 17 cases in the group B (47.2%) and 19 cases in the group C (70.4%) (P<0.05). The score of JOA was (7.1±2.1) in the group A, (6.0±1.8) in the group B and (5.6±2.0) in the group C (P<0.05). Conclusion The incidence of intramedullary ISI increased with the severity of spinal canal stricture, and with more severe nerve damage in OPLL patients.

The majority of the pancreatic cancer was diagnosed at advanced stage.The tumor may invade portal vein and/or superior mesenteric vein.Moore et al.firstly reported pancreaticoduodenectomy combined with portal vein and superior mesenteric vein resection and reconstruction in 1951.This procedure has improved the resection rate of pancreatic cancer.A 72-year-old man suffered from pancreatic cancer was admitted to the Southwest Hospital in September 2011.Because the tumor invaded the confluence of portal vein and superior mesenteric vein,thus the patient underwent a pancreaticoduodenectomy combined with portal vein and superior mesenteric vein resection and reconstruction.The patient recovered smoothly without any complication,and he had a normal liver function and CA19-9 value,and no local and remote metastasis was detected during the follow-up.

Objective To investigate the efficacy of pancreaticoduodenectomy (PD) combined with vascular resection and reconstruction.Methods The clinical data of 56 patients who received PD combined with vascular resection and reconstruction at the Southwest Hospital of Third Military Medical University from January 2007 to May 2011 were retrospectively analyzed.The incidence of perioperative complications,mortality and postoperative conditions were also analyzed.Results The mean operation time and intraoperative blood transfusion were 473 minutes (range,234-853 minutes) and 781 ml (range,0-900 ml),respectively.Seven patients did not receive blood transfusion.The median period of hospital stay was 25.9 days (range,17-100 days).A total of 43 patients underwent PD combined with vascular reconstruction.The incidence of perioperative complications and mortality rate were 34％ (19/56) and 7％ (4/56),respectively.There were 42 patients with pancreatic ductal adenocarcinoma,5 with ampullary carcinoma,3 with distal bile duct carcinoma,4 with papillary carcinoma of duodenum,1 with pancreatic neuroendocrine carcinoma and 1 with pancreatic serous cystadenoma.All patients were followed up till August 2011,and the 1-year survival rate was 57％ (32/56).The mean survival time was 13.5 months.The weight of 32 surviving patients increased and no abdominal pain occurred.Within 3 months after the operation,5 patients had slight diarrhea and were administered antidiarrheal; thrombosis in the artificial blood vessels and peritoneal effusion were found in 1 patient,while 6 months later,collateral circulation was formed and the peritoneal effusion was diminished.Conclusion PD combined with vascular resection and reconstruction can improve the quality of life for patients with pancreatic cancer and with blood vessels involvement.

Objective To investigate the effect of the teaching modes based on problem-based learning (PBL) and lecture-based learning (LBL) in clinical practice of hepatobiliary surgery.Methods 166 5-year program students were divided into 2 groups:PBL group (n=83)and LBL group (n=83).The performance in interrogation,physical examination,medical records and theoretical tests were analyzed.Results PBL group had better performance in all the above aspects compared to LBL group (P<0.05).Conclusions The teaching mode based on PBL is a good method,which Can inspire the students and improve their ability to solve problems in clinical practice of hepatobiliary surgery.