Objective? To explore the effects of need-based nursing practice in elderly patients with radical resection surgery for rectal cancer. Methods? From 1 February 2017 to 3 May 2018, we selected 80 elderly patients with radical resection for rectal cancer in colon-rectum-anus surgery at the First Affiliated Hospital of Zhengzhou University as subjects by convenience sampling. All of the patients were randomly divided into control group (n=40) and observation group (n=40) with the method of random number table. Control group carried out routine nursing care. Apart from the routine nursing, observation group provided need-based nursing care. We compared the post-operative recovery, scores of pain, anxiety, depression and quality of life as well as satisfaction after intervention among patients between the two groups. Results? The time for the first exhaust, ambulation and the removal of sutures as well as hospital stay in the observation group were shorter than those in the control group with statistical differences (P＜ 0.05). There were statistical differences in the scores of pain, anxiety and depression of patients after surgery between the two groups (P＜ 0.01). After intervention, the scores of pain, vitality, social functioning, emotional function, mental health and general health of quality of life in observation group were higher than those of control group with statistical differences (P＜0.05). After intervention, the patient satisfaction of observation group was higher than that of control group with statistical difference (P＜0.05). Conclusions? Need-based nursing approach can improve the postoperative recovery of elderly rectal cancer patients, alleviate pain, anxiety and depression, reduce the incidence of adverse events, improve the quality of life and satisfaction of patients, hence is worthy of being widely used in clinical practice.

Objective? To investigate the current status and influencing factors of anxiety and depression in rectal cancer patients with permanent intestinal orifice. Methods? By convenience sampling, we selected the rectal cancer patients with permanent intestinal orifice who were admitted to Department of Colorectal and Anal Surgery in the First Affiliated Hospital of Zhengzhou University from January 2016 to December 2018 as our participants in the study. They were investigated by Anxiety Self-Rating Scale and Depression Self-Rating Scale. Totally 165 questionnaires were distributed with 157 valid ones retrieved. Results? In the 157 patients, 74 patients (47.13%) suffered from anxiety: 32 of them had mild anxiety and 42 patients had moderate anxiety. In the 157 patients, 95 (60.51%)of them suffered from depression:54 patients had mild depression, 36 patients had moderate depression and 5 patients had severe depression. Patients who were females, working staff, have low income, impaired ability of self-care, have not received the preoperative education, or have postoperative complications tend to develop anxiety and depression(P＜0.05). Conclusions? There is a higher proportion of rectal cancer patients with permanent intestinal orifice who had anxiety and depression. The influencing factors are various and complex,and targeted intervention has positive significance in improving the patients＇ negative mood.

Objective To analyze the typical imaging features of various internal biliary fistulas by multislice spiral CT (MSCT),and the diagnostic value.Methods the data of 56 cases of internal biliary fistula in Wuxi No.2 Affiliated Hospital of Nanjing Medical University from January 2011 to March 2018 were analyzed retrospectively.All cases were examined by MSCT plain scan and enhanced examination.The imaging features of various biliary fistula were analyzed and studied.Results Among 56 cases of biliary fistula,39 cases were gallbladder duodenum fistula,and the diagnostic sensitivity was 87.2％ (34/39).The total coincidence rate was 85.7％ (48/56).21 cases were fistula formation,and 11 cases of narrow neck syndrome.Gallbladder bile duct fistula,liver-gallbladder fistula,bile duct and duodenal fistula of 6 cases were showed.In 4 cases of complex gallbladder fistulas,3 cases showed fistula clearly including 2 cases of fistula and a "clover" sign.In the indirect CT signs of 56 cases of internal biliary fistula,the common imaging features:atrophy of gallbladder or incarceration,stone incarceration of biliary tract,gallbladder or choledochal duct and cavity viscera.Conclusion MSCT scan can not only distinguish the type of biliary fistula and the structure of fistula,but also display the fistula,shape,atrophy of gallbladder,gallbladder and bile duct gas,stone and surrounding conditions,which have important guiding significance for the formulation of the operation scheme.

Objective To summarize the imaging characteristics and clinical diagnostic value of computed tomography (CT) examination in colon cancer combined with obstruction.Methods The clinical data of 33 patients with colon cancer combined with obstruction who were admitted to the Wuxi No.2 People's Hospital from June 2012 to March 2015 were retrospectively analyzed.All the patients received abdomianl plain scan and dualphase enhanced scan of CT,and the imaging data were summarized.Results Of 33 patients with colon cancer combined with obstruction,obstruction was located at the ascending colon in 9 patients,hepatic flexure of the colon in 2 patients,colon transverse in 7 patients,splenic flexure of the colon in 3 patients,descending colon in 3 patients,sigmoid colon in 7 patients and proctosigmoid in 2 patients.Thirty-three patients had irregular and thickened colonic wall at the obstructive segment and irregular constriction of colonic lumen,with a mean coloric wall thickness of 1.9 cm (range,0.6-3.2 cm).The length of constriction was 2.0-3.0 cm in 3 patients,3.1-4.0 cm in 3 patients,4.1-5.0 cm in 11 patients,5.1-8.0 cm in 12 patients and more than 8.0 cm in 4 patients.The mean length,diameter and mean diameter of the constriction of 33 patients were 5.8 cm,0-0.5 cm and 0.2 cm.The performance at the junction of the normal wall and the stenosis was scuff syndrome in 7 patients and shoulder symptoms in 5 patients.Colonic dilatation above the obstructive segment was detected in 26 patients with multiple gas-fluid levels and in 7 patients with mainly gas.Twenty-nine patients had colonic dilatation at the proximal end of obstruction with the diameter of right colonic dilatation of 6.0 cm,diameter of left colonic dilatation of 4.0 cm and colonic collapse at the distal end of obstruction.Thirty-three patients had different grades of cecal dilatation with a mean diameter of 6.9 cm.Three patients had ischemic colitis including 1 patient with colonic perforation and free underarm gas.The serosal invasion or organ involvement of colon cancer was detected in 25 patients with unclear boundary and cable-strip or nodular opacities.Fourteen patients had lymph node metastases,with surrounding tumor or retroperitoneal heterogeneous enhancement,sacvariable necrosis area,short-tempered edge of lymph node,bar-type exudation surrounding some of lymph node.There was 3 patients with hepatic metastases and 1 with pulmonary metastasis.Conclusion Irregular and thickened colonic wall,irregular constriction of colonic lumen,scuff syndrome and shoulder symptoms at the junction of the normal wall,colonic dilatation above the obstructive segment and multiple gas-fluid levels are mainly characterics of CT examination for colon cancer combined with obstruction.

Objective To summarize the characteristics and clinical value of multi-slice spiral computed tomography (MSCT) examination in the biliary gallbladder-duodenal fistula.Methods The imaging data of 28 patients with gallbladder-duodenal fistula who were admitted to the Wuxi No.2 Hospital of Nanjing Medical University between June 2012 and March 2015 were retrospectively analyzed.All the 28 patients received MSCT examinations,and the imaging changes were observed and analyzed,including the location of lesions,figures of fistulous tract,shrinking or enlarging gallbladder,pneumotosis and stones of gallbladder or bile duct.Results Of the 28 patients,fistula located at the duodenal bulb were detected in 14 patients,junction of the bulb and the descending part of the duodenum in 2 patients,ascending duodenum in 7 patients,horizontal part in 5 patients.Indirect signs of biliary gallbladder-duodenal fistula included that gallbladder volume in 28 patients was significantly reduced,cross sectional area of gallbladder was 2 cm × 1 cm-6 cm × 2 cm,and gallbladder wall was thickened with an average thickness of 5 mm (range,4-9 mm).Adhesion of gallbladder and duodenum,unclear boundary,structure disorder and visible effusion surrounding gallbladder were detected.Among 21 patients with biliary gas,19 patients had pneumotosis of gallbladder and 17 had biliary pneumatosis.Biliary stones were detected in 23 patients including cholecystolithiasis in 19 patients,gallbladder neck stones in 6 patients,common bile duct stones in 13 patients and intra-and extra-hepatic cholangiolithiasis in 1 patient.The diverticulum signs appeared in the duodenum of 11 patients.The direct signs of MSCT in the biliary gallbladder-duodenal fistula included that fistulous tract of 13 patients clearly showed and some were dumbbell-shaped.Two and 2 patients were complicated with gallstone ileus and multiple liver abscesses,respectively.The diagnostic results of MSCT in 28 patients were compared with the results of operative exploration,with an diagnostic concordance rate of 78.6％ (22/28),and the diagnostic concordance rate of gallbladder stones was 82.1％ (23/28).Conclusions The indirect signs of MSCT in patients with biliary gallbladder-duodenal fistula include pneumotosis of gallbladder or/ and biliary gas,gallbladder neck stones or common bile duct stones,gallbladder shrank,adhesion of gallbladder and duodenum,unclear boundary,diverticulum signs in the adhesions of duodenum and gallbladder,and clear orificium fistulae of gallbladder-duodenum is a direct sign of MSCT.

Objective: To assess the renal cortical perfusion parameters by the imaging of computed tomography (CT) in patients of essential hypertension (EH) with target organ damage.
Methods: A total of 90 subjects with the entire information including 59 EH patients were studied. The EH patients were divided into 2 groups: EH + target organ damage group,n=30 and EH without target organ damage group,n=29. In addition, there was a Control group,n=31 healthy volunteers. All subjects received 128-slice dual-source CT renal perfusion scanning, the quantitative perfusion of renal cortex blood lfow (BF), blood volume (BV), time to peak (TTP) and the mean transit time (MTT) were examined and compared among different groups.
Results: There were 90/97 (92.8%) participants eligible for perfusion analysis. Compared to Control group, EH without target organ damage group had the similar parameters of BF, BV, MTT and TTP,P>0.05. While EH + target organ damage group had decreased BF (214.6 ± 36.1) ml/(min?100 ml ) than Control group (262.1 ± 26.6) ml/(min?100 ml ),P<0.01, and BV, TTP, MTT were similar to Control group,P>0.05. Compared to EH without target organ damage group, the EH + target organ damage group presented decreased BF (214.6 ±3 6.1) ml/(min?100 ml ) vs (268.9 ± 33.1) ml/(min?100 ml ), P<0.01 and prolonged MTT, TTP,P< 0.05.
Conclusion: CT imaging may evaluate the renal cortical perfusion changes, and especially BF which can relfect the renal perfusion more sensitively than other parameters in EH + target organ damage patients.

Objective To study the radiologic features and the diagnostic value of multi-slice spiral CT (Multi-slice CT, MSCT) in cholecysto-duodenal fistula.Methods A retrospective analysis was conducted on 33 patients with cholecysto-duodenum fistula.Plain and IV enhanced MSCT were carried out on these patients.Results Of the 33 patients, the fistula was located at the duodenal bulb in 15 patients (45.5％) , the junction of the bulb and the descending part of the duodenum in 3 patients (9.1％) , the horizontal part in 5 patients (15.1％) and the ascending of the duodenum in 10 patients (30.3％).The CT signs of cholecysto-duodenum fistula included in 16 cases.The fistulae were clearly displayed including some fistulae being dumbbell-shaped.The indirect signs of cholecysto-duodenum fistula included in 2 cases the gallbladders were unclearly shown.In 1 case the gallbladder volume increased because of cancer and in another case because of acute cholecystitis.In 29 cases, the gallbladder volume was significantly reduced,with an average volume which ranged from 6 cm × 2 cm to 2 cm × 1 cm, and an average gallbladder wall thickening of 5 cm.There were extensive adhesions between the gallbladder and duodenum with visible effusion.In 26 cases, gas was present in the biliary system with 22 cases showing gallbladder gas, and 19 cases showing biliary pneumatosis.Biliary stones were present in 26 patients (gallbladder stones in 22 cases, gallbladder neck stones in 6 cases, common bile duct stones in 13 cases).At the site between the duodenum and the gallbladder there were radiological changes simulating a diverticulum.In 11 cases the changes were like a duodenal diverticula.The complications of cholecysto-duodenal fistula included 5 cases of gallstone ileus and 2 cases of multiple liver abscesses.Conclusions MSCT is important in depicting presence and location of cholecysto-duodenal fistula.The morphology and shape of the gallbladder, the presence of gas in the biliary system, the presence of stones and the surrounding adhesions could be fully demonstrated by MSCT.MSCT are important for diagnosing cholecysto-duodenal fistula and in the planning of surgery.

In order to investigate the clinical value of multi-slice computed tomography (MSCT) in the diagnosis of colonic neoplasms,the clinical data of 57 patients who were confirmed as with colonic neoplasms were admitted to the Wuxi No.2 People's Hospital from June 2013 to June 2014.Patients received plain and enhanced scan of MSCT,multiplannar reconstruction (MPR),sliding thin-slab maximum intensity projection (STS-MIP) and curved planar reformation (CPR),and the results of these examinations were compared with the postoperative TNM stage.Of the 57 patients,tumors located at the cecum in 1 patient,ascending colon in 23 patients,hepatic region of the colon in 9 patients,transverse colon in 11 patients,splenic region of the colon in 1 patient,descending colon in 3 patients and sigmoid colon in 9 patients.The results of the CT examination were in accordance with the results of exploratory laparotomy.The wall of the intestine was irregular ring-like thickened in 57 patients.The thickening of the intestine ranged between 0.6-3.2 cm,and patients had intestinal stricture in different degrees.Sixteen patients had gas-fluid level and dilatation of the intestine and were presented with intestinal obstruction signs.Forty-two patients had nodular or mass shadow in sofi tissues,and the nodules or mass protruded into the intestinal cavity or outside of the intestinal cavity,and resulting in intestinal stricture.The junction of the mass and the adjacent intestinal wall was blurred or clear,and the thickness of the intestinal walls was normal.Carcinomatous ulcer was observed in 20 patients.The shape of the ulcer was crateriform.The serosa and (or) adjacent organs were invaded by the tumors in 47 patients.Twenty-seven patients had lymph node metastasis,including 6 had distal metastasis,4 had hepatic metastasis and 2 had pulmonary metastasis.The sensitivity and accuracy of the preoperative CT examination for T stage were 100.0％ (57/57) and 77.2％ (44/57),respectively.The sensitivity,specificity and accuracy of the CT examination for N stage were 67.9％ (19/28),72.4％ (21/29) and 70.2％ (40/57),respectively.The sensitivity,specificity and accuracy of the CT examination for M stage were 100.0％ (6/6),100.0％ (51/51) and 100.0％ (57/57),respectively.The results of CT examination for TNM stage were well correlated with the pathological examination for TNM stage (κ =0.592,0.514,1.000,P ＜0.05).MSCT scanning and post-processing technique are of important clinical value in depicting tumor location,size and morphology,delineating tumor extension,revealing lymph nodes and metastases,and confirming preoperative tumor TNM stage in patients with colonic neoplasms.

Three hundred cerebrovascular disease (CVD) patients (disease onset <3 days) were evaluated for serum C-reactive protein (CRP) level at admission, and Scandinavian Stroke Scale (SSS) or Oxford Handicap Scale (OHS) at baseline and 3 months. Based on serum CRP levels, the participants were divided into group A [CRP(1.20 ±0.35)mg/L], group B[CRP(4.98 ± 1.08) mg/L] or group C[CRP (19.34±12.27)mg/L]. Our results showed that serum CRP level was positively correlated with SSS (r = 0.39 or0.43, both P<0.01) and OHS (r=0.40 or0.42, both P<0.01) at3 months. Thus, evaluating serum CRP level within 3 clays of disease onset might be helpful in predicting clinical outcomes of CVD patients.

BACKGROUND: The direct ratio is formed between the size of osseous defect around implant and the required time of complete repair. It is viewed that bone implantation is suggested if osseous defect is larger than 1 mm, which benefits the bone regeneration and early fixation of implant.OBJECTIVE: To compare the effects between coralline granules and hydroxyapatite (HA) during union after immediate implantation.DESIGN: Group observation and controlled experiment was designed.SETTING: Department of Stomatology Renmin Hospital of Wuhan University.MATERIALS: HA coated implant, HA granule, coralline granule and 3adult mongrel dogs.METHODS: The experiment was performed in Department of Stomatology, Renmin Hospital of Wuhan University from August 2002 to April 2003.Under anesthesia, 6 foramens were drilled on femurs of 3 dogs (3 foramens on each side) to result in osseous defect. Coralline granules were embedded in the osseous defect around the implant in all of proximal ends (coralline granule group, CG group), HA granules were embedded in the osseous defect around the implant in all of distal ends (HA group) and nothing was embedded in the defect around the implant in the center (the control). One dog was sacrificed under anesthesia on the 2nd, 3rd and 4th months after operation successively and the samples were collected from the implanted section in each group for X-ray examination and scanning electronic microscopic observation.MAIN OUTCOME MEASURES: X-ray examination on implanted sections and scanning electronic microscopic observation on samples in each the 4th month, it was observed that implants and osseous tissue were closely integrated in CG group and HA group and there was still partial osseous on samples in each group: on the 4th month, it was discovered that the regenerated osseous tissue was matured completely in CG group and few coralline granule residue was left. In HA group, the regenerated osseous tissue was matured completely, but there was still a large amount of HA granules left and the granules had not been absorbed obviously. In the control group, the space appeared partially in the implanted cervical region.CONCLUSION: The implantation of artificial bone is suggested if the osseous defect around immediate implant is larger than 1 mm. As the implanting materials, coralline granules and HA granules act on the most advantageous guide activity. Coralline granules can be degraded and substituted with osseous tissue,but HA granules cannot be absorbed, which affects osseous reconstruction.