Objective To analyze the CT findings of pulmonary cryptococcosis (PC)in patients without HIV infection.Methods CT data of 26 patients with PC proved by pathology were analyzed retrospectively.All cases underwent plain CT scan,8 of whom underwent contrast-enhanced CT scan.Results 26 patients (17 male and 9 female),single lesion on CT was found in 11 cases,multiple nodules or masses in 10 cases,and mixed-type lesions in 5 cases.The lesion was located in left lung in 1 1 cases,in right lung in 7 cases and bilateral lungs in 8 cases.The lesions with burr sign were found in 1 9 cases,with cavities or vacuoles in 10 cases,and with halo sign in 8 cases.Enhanced CT showed marked heterogeneity in 1 case,moderate heterogeneity in 2 cases,slight enhancement in 3 cases and nonenhancement in 2 cases.Conclusion Lesions of PC with various CT findings are easy to be misdiagnosed as lung carcinoma or other lesions.CT-guided percutaneous lung biopsy is an effective method for diagnosis.

Objective To analyze the feasibility of body surface electrodes instead of multipair esophageal electrodes for the evaluation of neural respiratory drive in patients with COPD. Methods Diaphragm electromyo-gram(EMG)from body surface electrodes and multipair esophageal electrodes,was recorded in 29 patients with stable COPD recruited from outpatient clinic. Changes of neural respiratory drive of two kinds of electrodes during resting and maximal isocapnic ventilation (MIV) were observed before and after inhalation of bronchodilators. Results Ventilation significantly improved ,RMS-sur and RMS-eso significantly decreased after the inhalation of bronchodilators during resting and MIV. RMS-sur and RMS-eso were significantly correlated(r=0.660,P<0.01). Conclusion EMG from the surface electrodes may be a useful and noninvasive technique to evaluate neural respi-ratory drive in patients with COPD.

Objective To observe and analyze the clinical curative effect of the platelet rich plasma (PRP) in treatment of chronic difficult to heal the wound.Methods We selected 60 patients with chronic difficult healing wounds and they were divide into two groups at random,30 patients of A group,B group of 30 patients.All patients were given routine debridement,drainage and decompression treatment,B group was given autologous PRP wound injection and follow-up on the basis of conventional treatment.After injection of PRP,platelet count,platelet recovery and application of PRP granulation tissue growth and wound healing were observed.Results The wound healing effect at the 7th,14th,21 st day between the two groups,and compared with the 1 st day,the differences were statistically significant (A group:10.28％,22.16％,43.25％,65.78％;B group:18.75％,37.58％,61.84％,80.26％;X2:7.895,8.934,10.231,9.076,all P ＜ 0.05).Two groups of patients had obvious difference in healing time,in B group the average healing time was (12.6 ± 5.2) d,which in was (17.3 ± 7.4) d,the difference was statistically significant (t =1.932,P ＜ 0.05).Conclusion The PRP can effectively promote the wound repair of soft tissue,to promote healing of chronic difficult wound healing,the curative effect is distinct,it is worthy of clinical popularization and application.

Objective To observe therapeutic effects of early scab-cutting combined with axis-like abdo-men skin flap implanting in patients with wrist deep electrical burns.Methods Retrospective study was employed to analyze 70 patients received axis -like abdomen skin flap implanting for wrist deep electrical burns.All the cases were separated with early scab-cutting group(35 cases)and delayed scab-cutting group(35 cases),according to types of skin flap implanting.The therapeutic effect for the two groups were evaluated with rate of infection,duration of healing,living rate of skin flap,grade of skin burning,and rate of amputate.Results In the early scab -cutting group,the rate of infection was 11%,the duration of healing was(24.0 ±6.0)days,the rate of amputate was 3%,the living rate of skin flap was 97.0%,the wound healing of class A was 94.3%.In the delayed scab-cutting group,the data were respectively 31%,(35.0 ±7.4)days,17.0%,31% and 28.6%.Compared with the data of the two groups,the difference had statistical significance(the chi-square value or T value were respectively 4.151,6.831,3. 968,31.895,3.968.All the P values was less than 0.05).Conclusion Early scab-cutting combined with varied sorts of skin flap implanting shown great benefits for treatment of wounded and facilitate rehabilitation in function of wrist,which suggest decrease rate of complications and minimized hospitalized duration.

Objective To characterize the MRI features of demyelinating pseudotumors(DPTs).Methods MR data of 10 cases clinically proved with DPTs were retrospectively analyzed .All cases were underwent MRI scan ,9 of 10 cases were performed with enhanced MRI,7 cases were underwent diffusion weight imaging(DWI),2 cases were performed with single voxel short echo 1 H-MRS.Results 8 cases showed lesions with mild to moderate edema,5 cases showed multiple lesions,3 cases were solitary nodular lesions,2 cases were solitary flaky lesions.On enhanced MRI,4 cases presented with open ring like enhancement,3 cases presented ring like enhancement,1 case with nodular enhancement,and 1 case showed patchy enhancement.All lesions showed high signal in DWI.In 1 H-MRS,2 cases demonstrated varying decrease in peaks heights of Nacetylaspartate(NAA),elevation of the choline(Cho),the lactate(Lac)and lipids(1ip).1 case demonstrated evident elevation in peaks height of glutamate/glutamine(Glx).Conclusion DPTs has some characteristics on MRI, especially as open ring like enhancement.It is helpful to identified DPTs from other lesions when together with DWI and 1 H-MRS.

Objective To observe the clinical effect of the anterolateral thigh flap in repairing defect caused by resection of malignant melanoma in the heel region.Methods 8 patients with heel malignant melanoma were trea-ted by surgery.The malignant melanoma was further diagnosed by histopathological examination.Their heel defects caused by large resection of malignant melanoma were treated by anterolateral thigh flap.Results All skin flaps sur-vived and all the patients could walk normally 1 month after operation.The recovery of the function and sense was well 6 months after operation.Compared with the another well heel,the flaps had normal texture,color and appearance of heel.8 patients had complete follow -up,ranged form 6 months to 3 years.All cases survived with neither local recur-rence nor distant metastasis.Conclusion The anterolateral thigh flap can achieve good clinical effect in treating heel defect caused by the resection of malignant melamoma.And especially apply in large skin and tissue defect of heel area.The flap can weight,wear -resisting and reduce overheating and over cold damage.The range of resection can not be restricted by local skin flap.The clinical effect is satisfied.

Objective To analyze CT features of extra-gastrointestinal stromal tumom(EGIST).Methods The CT data of 9 pa-tients with EGIST proved by operation and pathology were analysed retrospectively.Results Of 9 cases with EGIST,7 cases were malignant and 2 cases were benign.2 cases were origina-ted from liver.2 cases from mesocolon,2 cases from Small mesentericin,2 case showed widely diffuse nodules scattered in peritoneum,omentum,small intestine,mesangial and colon serosa.In those nodules, some nodules from pelvic cavity wereinosculated into larger mass.1 case came from right kidney week gap.The biggestdiameter of tumomrs of each case was ranged from 5.0 cm to 14.0 cm (mean 9.6 cm).5 cases showed lobulated shape,4 cases showed round or oval.All cases showed non-homogeneous density in plain CT,with cystic change and necrotic foci in 7cases,calcification in 2 cases.In arterial phase,all cases appeared significantly abnormal thickening or multiply tumor blood vessels in edge and center of those tumors.Conclusion EGIST has unique imaging performance.

Objective To investigate the clinical value of diffusion weighted imaging (DWI) in diagnosis of atypical cancerization nodules (CNs) of liver cirrhosis. Methods Totally 34 patients with atypical CNs of liver cirrhosis confirmed pathologically underwent routine MR, dynamic enhancement, and DWI (b=0, 500, 1000 s/mm~2). The detection rate of CNs of liver cirrhosis between routine MR and DWI was compared. Results Totally 21 patients with 28 cancerization nodules were diagnosed with routine and dynamic enhancement MR, while 27 patients with 37 cancerization nodules were detected with DWI. Significant difference was found in the detection rate between routine scan and DWI (P=0.025). Conclusion DWI shows more advantage than routine and dynamic enhancement MR for detection of liver cirrhosis with atypical CNs.

Objective To establish and identify transgenic mice model that specifically express delta drosophila homolog-like 1 (DLK1) in liver for the functional study of DLK1 on liver differentiation,hepatopathy,and hepatocellular carcinoma.Methods The coding sequence of DLK1 cDNA was inserted downstream of mouse albumin gene enhancer/promoter to construct a liver-specific DLK1 expression recombinant vector.The DNA fragment of transgene digested from the recombinant vector by Pine I was transfected to Hepl-6 cells to verify the expression of DLK1 in vitro.Then the transgene fragment was microinjeeted into fertilized eggs of C57×CBA F1 mice and 20 transgenic founder mice were generated.The F1 mice of DLK1 transgenie founder mice were used to identify the expression of the transgene in liver and other tissues.Results RT-PCR and cellular immunofluorescence showed DLK1 expression when the transgene fragment was transfeeted into Hep1-6.For transgenic mice,RT-PCR and immunohistochemistry showed that DLK1 was specifically expressed in adult F1 mice liver.Conclusion Successfully established the liver-specific DLK1 expression transgenic mice model.

Objective To explore the technique of double spiral CT cerebral angiography in order to improve the quality of CTA.Methods All 62 cases underwent cerebral CTA,including vascular lesions in 30,normal in 20 and others in 12.All were scanned with GE Hispeed NX/I CT,three-dimensional models were used in images reconstruction.Results The branches of 1~4 grades of cerebral arteriae could be displayed well in all cases,some cases could also be visible up to 5th grades.All cerebral vascular lesions could be showed by CTA and the same as DSA.Cerebral tumor could be demonstrated with tumor stain.The image quality would be better when the pitch was smaller with the same layer.Conclusion The factors that influence on the quality of CTA images are a lot of,but mostly are concerned with the pitch,contrast volume,injection rate and delayed time.