“后扫描”模式在烟草工业企业码段管理系统中的应用研究

在生产过程中进行件烟打码时,存在一些比较突出的问题,如打印未打码、重码等异常现象,给正常的生产经营过程带来很大的困扰,同时也给日常的生产计划控制带来极大不便。基于此,在长期的实践摸索中提出了‘后扫描’模式,解决了打码异常所造成的问题。

Role of genetics in the diagnosis and prognosis of Crohn's disease

Considering the epidemiological, genetic and immunological data, we can conclude that the inflammatory bowel diseases are heterogeneous disorders of multifactorial etiology in which hereditability and environment interact to produce the disease. It is probable that patients have a genetic predisposition for the development of the disease coupled with disturbances in immunoregulation. Several genes have so far been related to the diagnosis of Crohn's disease. These genes are related to innate pattern recognition receptors, to epithelial barrier homeostasis and maintenance of epithelial barrier integrity, to autophagy and to lymphocyte differentiation. So far, the strongest and most replicated associations with Crohn's disease have been demonstrated with NOD2 , IL23R and ATG16L1 genes. Many genes have so far been implicated in the prognosis of Crohn's disease and many attempts have been made for classification of genetic profiles in Crohn's disease.CARD15 seems to be not only a susceptibility gene, but also a disease-modifier gene for Crohn's disease. Enriching our understanding of Crohn's disease genetics is of value, but when combining genetic data with functional data the outcome could be of major importance to clinicians.

Prognostic value of coronary artery calcium score in patients with stable an-gina pectoris after percutaneous coronary intervention

Objectives To evaluate the prognostic value of the coronary artery calcium （CAC） score in patients with stable angina pectoris （SAP） who underwent percutaneous coronary intervention （PCI）. Methods A total of 334 consecutive patients with SAP who underwent first PCI following multi-slice computer tomography （MSCT） were enrolled from our institution between January 2007 and June 2012. The CAC score was calculated according to the standard Agatston calcium scoring algorithm. Complex PCI was defined as use of high pressure bal-loon, kissing balloon and/or rotablator. Procedure-related complications included dissection, occlusion, perforation, no/slow flow and emer-gency coronary artery bypass grafting. Main adverse cardiac events （MACE） were defined as a combined end point of death, non-fatal myo-cardial infarction, target lesion revascularization and rehospitalization for cardiac ischemic events. Results Patients with a CAC score〉300 （n=145） had significantly higher PCI complexity （13.1%vs. 5.8%, P=0.017） and rate of procedure-related complications （17.2%vs. 7.4%, P=0.005） than patients with a CAC score≤300 （n=189）. After a median follow-up of 22.5 months （4-72 months）, patients with a CAC score≤300 differ greatly than those patients with CAC score＆gt;300 in cumulative non-events survival rates （88.9 vs. 79.0%, Log rank 4.577, P=0.032）. After adjusted for other factors, the risk of MACE was significantly higher [hazard ratio （HR）：4.3, 95%confidence inter-val （95%CI）：2.4-8.2, P=0.038] in patients with a CAC score〉300 compared to patients with a lower CAC score. Conclusions The CAC score is an independent predictor for MACE in SAP patients who underwent PCI and indicates complexity of PCI and proce-dure-related complications.

Spontaneous hemoperitoneum from hepatic metastatic trophoblastic tumor

Spontaneous hemoperitoneum(SP) is defined as the presence of blood within the peritoneal cavity that is unrelated to trauma.Although there is a vast array of etiologies for SP,primary hepatocellular carcinoma and hepatic adenoma are considered to be the most common causes.Hepatic metastatic tumor associated with spontaneous rupture is rare.SP from hepatic metastatic trophoblastic tumor may initially present with a sudden onset of abdominal pain.Abdominal computed tomography(CT) plays an important role in establishing the diagnosis of SP,indicating its origin and etiology,and determining subsequent management.Herein,we report an uncommon case of hemoperitoneum from spontaneous rupture of a hepatic metastatic trophoblastic tumor in a young female patient.Interestingly,the contrast-enhanced CT findings demonstrated hypervascular hepatic masses with persistent enhancement at all phases,which were completely different from the common appearances of hepatic metastases.For SP resulting from hepatic metastatic tumors,surgical intervention is still the predominant therapeutic method,but the prognosis is very poor.

Hepatic portal venous gas: Physiopathology, etiology, prognosis and treatment

Hepatic portal venous gas (HPVG), an ominous radiologic sign, is associated in some cases with a severe underlying abdominal disease requiring urgent operative intervention. HPVG has been reported with increasing frequency in medical literature and usually accompanies severe or lethal conditions. The diagnosis of HPVG is usually made by plain abdominal radiography, sonography, color Doppler flow imaging or computed tomography (CT) scan. Currently, the increased use of CT scan and ultrasound in the inpatient setting allows early and highly sensitive detection of such severe illnesses and also the recognition of an increasing number of benign and non-life threatening causes of HPVG. HPVG is not by itself a surgical indication and the treatment depends mainly on the underlying disease. The prognosis is related to the pathology itself and is not influenced by the presence of HPVG. Based on a review of the literature, we discuss in this paper the pathophysiology, risk factors, radiographic findings, management, and prognosis of pathologies associated with HPVG.

Prognostic value of 18-fluorodeoxyglucose positron emission tomography-computed tomography in resectable colorectal cancer

AIM:To assess the prognostic value of preoperative 18 fluorodeoxyglucose positron emission tomography(FDG-PET)/computed tomography(CT) in patients with resectable colorectal cancer.METHODS:One hundred sixty-three patients with resectable colorectal cancer who underwent FDG-PET/CT before surgery were included.Patient data including pathologic stage at presentation,histology,treatment,disease-free survival and the maximum standardized uptake value(SUVmax) of the primary tumor on FDG-PET/CT were retrospectively analyzed.Median follow up duration was 756(range,419-1355).The primary end point was disease-free survival.RESULTS:Twenty-five of 163 patients(15.3%) had recurrences.The median SUVmax values of the recurrence and no-recurrence groups were 8.9(range,5-24) and 8.2(range,0-23,P = 0.998).Receiver operating characteristic(ROC) curve analysis showed no significant association between SUVmax and recurrence(area under the curve = 0.5,P = 0.998,95% CI:0.389-0.611).Because a statistically significant value was not found,SUVmax was dichotomized at its median of 8.6.The disease-free survival curve was analyzed using the median SUVmax(8.6) as the cut off.Univariate and multivariate analysis did not provide evidence that disease-free survival rates for the subgroups defined by the median SUVmax were significantly different(P = 0.52,P = 0.25).CONCLUSION:Our study suggests that the high FDG uptake of primary mass in resectable colorectal cancer doesn't have a significant relationship with tumor recurrence and disease-free survival.

Tumour seeding after percutaneous cryoablation for hepatocellular carcinoma

AIM:To assess the rate and risk factors for tumour seeding in a large cohort of patients.METHODS:Over an 8-year period,1436 hepatocellular carcinoma(HCC) patients with 2423 tumour nodules underwent 3015 image-guided percutaneous cryoablation sessions [1215 guided by ultrasonography and 221 by spiral computed tomography(CT)].Follow-up CT or magnetic resonance imaging was performed every 3 mo.The detailed clinical data were recorded to analyse the risk factors for seeding.RESULTS:The median follow-up time was 18(range 1-90) mo.Seeding was detected in 11 patients(0.76%) at 1-24(median 6.0) mo after cryoablation.Seeding occurred along the needle tract in 10 patients and at a distant location in 1 patient.Seeded tumours usually showed similar imaging and histopathological features to the primary HCCs.Univariate analyses identified subcapsular tumour location and direct subcapsular needle insertion as risk factors for seeding.Multivariate analysis showed that only direct subcapsular needle insertion was an independent risk factor for seeding(P = 0.017;odds ratio 2.57;95%CI:1.47-3.65).Seeding after cryoablation occurred earlier in patients with poorly differentiated HCC than those with well or moderately differentiated HCC [1.33 ± 0.577 mo vs 11.12 ± 6.896 mo;P = 0.042;95%CI:(-19.115)-(-0.468)].CONCLUSION:The risk of seeding after cryoablation for HCC is small.Direct puncture of subcapsular tumours should be avoided to minimise seeding.

Carcinoma of the papilla of Vater following treatment of pancreaticobiliary maljunction

Pancreaticobiliary maljunction(PBM)is frequently associated with biliary cancer due to reflux of pancreatic enzymes into the choledochus,and even after surgery to correct the PBM such patients still have a risk of residual bile duct cancer.Here,we report the case of a 59-year-old female with carcinoma of the papilla of Vater which developed 2.5 years after choledochoduodenostomy for PBM.During the postoperative follow-up period,computed tomography obtained 2 years after the first operation demonstrated a tumor in the distal end of the choledochus,although she did not have jaundice and laboratory tests showed no abnormalities caused by the previous operation.As a result,carcinoma of the papilla of Vater was diagnosed at an early stage,followed by surgical cure.For early detection of periampullary cancer in patients undergoing surgery for PBM,careful long-term follow-up is needed.

Clinical Features and Treatment of Bronchogenic Cyst in Adults

Objective To investigate the clinical features and management of bronchogenic cyst in the adults. Methods We retrospectively reviewed 50 patients admitted to our hospital with histopathologically proved bronchogenic cyst from January 1983 to December 2007. Of all the patients, 28 were male and 22 were female, with an average age of 36.9 (range, 18 to 64) years. The symptoms, location of the cysts, imaging evaluation, surgical treatment manner, and outcome of these patients were analyzed. Results Symptoms were present in 33 of the 50 patients, and cough was the most common symptom. Thirteen patients presented with complications: hemoptysis, infected cyst, dysphagia, paralysis, and hoarseness. The locations of the cysts included the mediastinum (28 cases), pulmonary parenchyma (12 cases), hilar area (3 cases), visceral pleura (1 case), and some rare locations including the intestinal mesentery (1 case), retroperitoneum (1 case), adrenal gland (1 case), neck (2 cases), and dura matter of the cervical verte-brae (1 case). Chest X-ray was performed in 36 patients and computed tomography (CT) was performed in 41 patients. The bronchogenic cyst in CT was characterized as a round, well circumscribed, unilocular mass, with density ranging from that of water to high density (0-50 Hu). As for treatment, complete resection of the bronchogenic cyst was performed in 47 (94%) patients, subtotal resection was performed in 3 (6%) patients. Open surgery was performed in 45 (90%) patients, and thoracoscopy (video-assisted thoracic surgery) was performed in 5 (10%) paitients. Of the 12 patients with intrapulmonary cyst, 11 patients underwent lobectomy and 1 patient underwent wedge resection. Postoperative sequelae occurred in 2 patients, 1 with persistent air leakage and 1 with hoarseness. All patients were proved with bronchogenic cyst pathologically. The average follow-up period was 6.5 years (range, 4 months to 10 years), and no late sequelae or recurrence of the cyst occurred. Conclusions The clinical and imaging presentations of bronchogenic cyst in adults are variable. Surgical resection is the best way for diagnosis and treatment. Both open surgery and thoracoscopy are appropriate for the selected candidates.

A Defined Process to Digitally Reproduce in 3D a Wide Set of Archaeological Artifacts for Virtual Investigation and Display

This paper contributes to depict the current pattern of applications of digital 3D models for professional research and practice, and for broader dissemination of cultural heritage. Passing from a general review to the illustration of the background project, named MUSINT, the authors underline the objectives. The present case study primarily aims to share information about valuable archaeological collections which have little visibility. To enhance the project＇s contents, which include a whole set of different artifacts, the authors have reproduced high resolution, faithful and measurable digital models on one side, and on the other, lower resolution and geometrically simplified models are yet completed and very close to reality. The former are meant to implement a scholars＇ archive for further scientific activity. The latter to provide content for virtual exhibitions on the Web or on stand-alone interfaces situated in the actual physical museum spaces. The data acquisition and post-processing methods which have been tested and chosen are here briefly described. Hence, the authors then give an account of the most recurrent problematic issues of the established work-flow and how they should be solved. Touched instances are the delicate placing of the artifacts, which must be digitized, in relation to the triangulation-based laser scanner＇s functionality, the refining operations in order to build a coherent single polygon mesh, the most effective ways to deal with unavoidable missing parts or defected textures in the generated model and so on.

Role of computed tomographic colonoscopy of postoperative surveillance in patient with gastric cancer

AIM： TO examine the diagnostic yield of colorectal neoplasia at computed tomographic colonoscopy （CTC） as well as the feasibility of contrast enhanced CTC in patients with gastric cancer. METHODS： To examine the incidence of colon polyp we selected postoperative 188 gastric cancer patients, which we refer to as the ‘colon polyp survey group’. To examine the feasibility of CTC for early detection of colon cancer or advanced colon adenoma, we selected 47 gastric cancer patients （M：F 29：18, mean age 53.8 years）, which we call the ‘CT colonoscopy group’. All the 47 patients underwent successive CTC and colonoscopy on the same day. RESULTS： Totally 109 colon polyps were observed from 59 out of 188 gastric cancer patients, the inddence rate of colon polyps in gastric cancer patients being 31.4%. The sensitivity of CTC in detecting individuals with at least 1 lesion of any size was 57.1%, the specificity was 72.7%, the positive predictive value was 47.1%, and the negative predictive value was 71.9%. When the cutoff size was decreased to 6 mm, the sensitivity and specificity were 80.0% and 92.9%, respectively, with positive and negative predictive values of 57.1% and 97.5%, respectively. Only one patient was classified as false negative by virtual colonoscopy. CONCLUSION： The diagnostic yield of colorectal polyp was 31.4% in patients with gastric cancer, and contrast enhanced CTC is an acceptable tool for the detection of synchronous colorectal advanced adenoma and postoperative surveillance of gastric cancer patients.

Diagnostic accuracy of CT scan in abdominal blunt trauma

Objective： To evaluate the sensitivity and specificity of CT scan findings in patients with blunt abdominal trauma admitted to the university hospital. Methods： All the patients with blunt abdominal trauma admitted at a tertiary teaching trauma center in Iran between 2005 and 2007 were enrolled in this study. In the absence of any clinical manifestations, the patients underwent a diagnostic CT scan. Laparatomy was performed in those with positive CT results. Others were observed for 48 hours and discharged in case no problem was reported; otherwise they underwent laparatomy. Information on patients＇ demographic data, mechanism of trauma, indication for CT scan, CT scan findings, results of laparotomy were gathered. The sensitivity, specificity and accuracy of the CT-scan images in regard with the organ injured were calculated. The sensitivity, specificity and accuracy of the CT scan were calculated in each case. Results： CT scan had the highest sensitivity for detecting the injuries to liver （100%） and spleen （86.6%）. The specificity of the method for detecting retroperitoneal hematoma （100%） and injuries to kidney （93.5%） was higher than other organs. The accuracy of CT images to detect the injuries to spleen, liver, kidney and retroperitoneal hematoma was reported to be 96.1%, 94.4%, 91.6% and 91.6% respectively. Conclusion： The findings of the present study reveal that CT scan could be considered as a good choice, especially for patients with blunt abdominal trauma in teaching hospitals where the radiologic academic staff is not present in the hospital in the night shifts.

Cervical spine clearance in obtunded patients after severe polytrauma

Objective： To provide clinicians with data supporting three different clearance techniques in the obtunded patients after severe polytrauma. Methods： This study gave an overview of the available and pertinent literature regarding cervical spine clearance in obtunded patients after severe polytrauma. Results： Currently, there were three accepted techniques for clearance of the cervical spine in obtunded patients after severe polytrauma. Each of these methods has advantages and disadvantages to both of the patients and the clinicians, Conclusions： There are continuous improvements in both computed tomography （CT） and magnetic resonance imaging （MRI） techniques that increase their sensitivities. The continued use of plain radiographs is called into question with respect to cost and time requirements. An algorithmic approach to the evaluation of the cervical spine in the obtunded patients will lead to fewer missed injuries.