Index to Volume 23, Numbers 1 Through 4

Objective To investigate the effectiveness and safety of simultaneous lung volume reduction surgery in the treatment of lung volume mismatch after single lung transplantation. Methods Twenty-four single lung transplantations were performed on 20 male and 4 female patients, with a mean age of 54. 6 ± 12. 2 years (ranging from 28 to 75 years). Indications for transplantation included end-stage chronic obstructive lung disease (COPD) in 14 cases, COPD combined with upper lobe lung destruction in 1 case, COPD combined with pneumoconiosis in 1 case, end-stage interstitial pulmonary fibrosis in 6 cases, lymphangioleiomyomatosis (LAM) in 1 case, and post-transplantation bronchiolitis obliterans syndrom (BOS) in 1 case. Sixteen cases had right-side and 8 cases had left-side lung transplantation. Lung volume reduction surgeries were performed through open thoracotomy. Graft lung volume reduction was carried out through the same incision as transplantation, and native lung volume reduction through a small anterior lateral incision contralaterally. Patients were divided into lung volume reduction group (group Ⅰ) and control group (group Ⅱ). There were 8 cases in group Ⅰ,including 5 graft lung, 2 native lung, and 1 graft and native lung volume reduction surgeries. In group Ⅱ, there were 16 cases that had no further treatment for lung volume mismatch. Differences in various clinical parameters between the two groups were compared. Results Two out of 14 (14.3%) patients with COPD accepted lung volume reduction, which was significantly lower than that in patients with other diseases (6 out of 10, 60%, P＜0. 05). Post-transplantation chest X-ray showed that 50.0% and 25% of patients had an undeflected mediastinum in group Ⅰ and group Ⅱ, respectively (P＜0. 05).None of the other clinical parameters had significant difference between the two groups (P＞0.05).But a tendency of increase in mechanical ventilation, chest tube drainage time, air leak time, volume of chest drainage, and a tendency of decrease in times and volume of thoracentesis could be observed in group Ⅰ. Lung function test was not performed on 8 cases after transplantation. Sixteen cases (4 in group Ⅰ, 12 in group Ⅱ) had complete lung function data. There was no significant difference in FEV1 improvement after lung transplantation between the two groups (P＞0. 05). Conclusion Simultaneous graft or native lung volume reduction surgery is a safe and effective way of ameliorating lung volume mismatch after single lung transplantation, probably by improving ventilation-perfusion ratio. Key words: Lung transplantation; Lung volume reduction; Lung volume mismatch

Objective To explore the effect of phototherapy on urinating pattern in newborns with hyperbilirubinemia(HB). Methods A total of 26 newborns aged 3-14 days after birth diagnosed with mild to moderate HB were included in this study.Eight hours of free urinating pattern of the newborns was observed per day, including 4 hours(12:00-16:00) with phototherapy and 4 hours(08:00 -12:00) without phototherapy.The liquid was input into all newborns through vein uniformly and continuously by standard protocol in both periods.The urinating time, urinating volume and post-urinating residual(PVR) volume were recorded.The diaper weight difference before and after urinating was defined as urinating volume and the PVR volume was determined by ultrasound.The urinating frequency, total urinating volume, average urinating volume and average PVR volume in phototherapy period and non-phototherapy period were calculated.Data were analyzed by paired t-test. Results A total of 112 times of urinating were recorded, 45 times in phototherapy period and 67 times in non-phototherapy period.The urinating volume per time ranged from 2.1 to 103.3 mL[(19.73±13.16) mL] in both phototherapy period and non-phototherapy period.Most newborns could not void the bladder completely and the voiding was often accompanied by PVR volume.In phototherapy period, the PVR volume measured rate was 75.6%(34/45 cases) and the PVR volume was(11.73±10.81) mL.In addition, the PVR volume measured rate was 77.6%(52/67 cases) and the average PVR volume was(13.65±9.72) mL in non-phototherapy period.Compared with the non-phototherapy period, the urinating frequency, average urinating volume and total urinating volume in 4 hours were significantly lower than those in the phototherapy [(1.73±1.00) times vs (2.58±0.70) times, (16.26±9.34) mL vs (20.84±9.05) mL, and (30.83±24.45) mL vs (54.32±30.20) mL], respectively and there were significant differences, respectively(all P 0.05). Conclusion There was a significant change of urinating pattern in HB newborns with phototherapy. Key words: Phototherapy; Hyperbilirubinemia; Newborn; Urinating pattern

9 The degree of expansion of the early DWI lesion into the volume of the baseline PWI lesion is variable. In some patients partial recruitment of the DWI lesion volume occurs, while other patients develop a DWI lesion that equals or exceeds the size of the initial PWI volume. We investigated whether a quantitative analysis of the severity of the early perfusion deficit predicted the evolution of the PWI/DWI mismatch. Methods We studied patients with acute ischemic stroke in whom PWI and DWI MRI were performed within 7 hours after symptom onset and after 4–5 days. Maps of CBF, CBV and Mean Transit Time(MTT)were created after deconvolution of the arterial input function with the time-concentration curve. We compared the lesion volume on DWI at f/u with the baseline MTT volume. Patients in whom the lesion volume on DWI at f/u was smaller than the initial PWI deficit (group 1) were compared with patients in whom the DWI lesion at f/u (group 2) was ≥ than the initial PWI volume. Characteristics analysed included age, NIHSS, time to MRI, initial DWI volume, initial PWI volume, absolute mismatch volume, relative MTT(rMTT), CBF(rCBF) and CBV (rCBV) of the baseline PWI. Results Thirteen patients had an initial PWI>DWI mismatch of >20%. Seven of these patients (group 1) had DWI lesions at f/u that were smaller than the initial PWI lesion (mean 55% of PWI volume), while in 4 patients (group 2) the f/u DWI volume was larger than the PWI volume (mean 121% of initial PWI volume). Only the median rMTT (2.7 [group 1] versus 5.2 [group 2], p=0.006) and the median rCBV (1.4 [group 1] versus 2.7 [group 2], p=0.006) differed between the two groups. The initial rMTT and rCBV correlated significantly with the degree of expansion of the DWI lesion (ρ= 0.918 for rMTT and 0.864 for rCBV, p DWI, who do not have early reperfusion, the degree of expansion of the initial DWI lesion correlates with the severity of the initial perfusion deficit as measured by the rMTT and the rCBV.

Objective To observe the changes of spleen volume in patients with acute cerebral infarction, and to explore the relationship between the spleen volume and platelet reactivity, inflammatory factors′ lymphocyte subsets. Methods This is a case control study. Thirty patients with acute cerebral infarction from January 2017 to June 2017 in Department of Neurology, Weihai Municipal Hospital were included. The spleen volume, arachidonic acid-induced maximum platelet aggregation ratio (AA-MAR), interferon gamma (IFN-γ) and lymphocyte subsets of patients were monitored in 24 hours of stroke, at 48 hours of stroke, at four days of stroke and at seven days of stroke. Twenty patients without acute cerebral infarction with the same baseline data were selected as the control group, to determine the baseline of spleen volume, AA-MAR, IFN-γ and lymphocyte subsets. A t test was used to describe the changes of spleen volume, AA-MAR, IFN-γ and lymphocyte subsets at different time points, and Pearson′s correlation analysis was used to estimate the relationship between the spleen volume and these variables. Results Compared with the control group ((120.12±10.28) cm3), the patients with acute cerebral infarction in 24 hours of stroke ((117.48±7.93) cm3) and at 48 hours of stroke ((111.61±9.21) cm3) had smaller spleen volume (t=-2.142, P<0.05; t=-2.790, P<0.01), whereas at four days ((121.31±8.16) cm3) and seven days of stroke ((126.11±10.31) cm3) had bigger spleen volume (t=2.242, P<0.05; t=2.762, P<0.01), with the spleen volume decreased first and increased later. Compared with the control group, the patients with acute cerebral infarction had more AA-MAR (control group: 20.97%±8.21%; 24 h: 31.86%±9.54%, t=3.165, P<0.01; 48 h: 41.38%±8.55%, t=3.254, P<0.01; 4 d: 35.34%±8.15%, t=3.203, P<0.01; 7 d: 29.38%±10.46%, t=2.494, P<0.05) and IFN-γ(pg/L, control group: 15.21±5.21; 24 h: 29.75±4.57, t=3.262, P<0.01; 48 h: 43.37±12.15, t=3.304, P<0.01; 4 d: 40.44±9.86, t=3.291, P<0.01; 7 d: 20.93±5.51, t=2.417, P<0.05) at different time points, with the most AA-MAR at 48 hours of onset, and the most IFN-γ at four days of stroke. Compared with the control group, the patients with acute cerebral infarction had more T4, B lymphocytes and natural killer lymphocytes at the four time points, while the level of T8 lymphocytes did not show statistically significant difference even though also increased at the four time points. The correlation analysis results showed that in patients with acute cerebral infarction, the level of AA-MAR (r=-0.397, P<0.05; r=-0.515, P<0.01; r=-0.382, P<0.05) and IFN-γ (r=-0.408, P<0.05; r=-0.479, P<0.01; r=-0.378, P<0.05) was negatively corelated with the spleen volume in 24 hours of onset, at 48 hours of stroke and at four days of stroke; the level of T4, B and natural killer lymphocytes were negatively corelated with the spleen volume in 24 hours of stroke and at 48 hours of stroke. Conclusion After the acute cerebral infarction onset, the spleen volume tends to reduce and then increases, the levels of platelet reactivity, inflammatory factors and lymphocyte subsets are correlated with the spleen volume, and the spleen may aggravate the brain injury by releasing platelets inflammatory factors and lymphocyte subsets. Key words: Stroke; Spleen; Platelet aggregation; Interferon-gamma; Lymphocytes

Objective To assess the surgical outcome of fronto-orbital advancement (FOA)in the patients with craniosynostosis by quantitative analysis of the cranial volume using the three-dimensional digital technology. Methods From January 2010 to February 2016, 10 cases of craniosynostosis were included in the study. The average age of patients was 3.2 years (1 year old to 6.5 years old). All patients underwent modified FOA.Based on the uncompressed digital imaging and communications in medicine (DICOM) data of 3D cranial CT scan, the intracranial volume was measured by Proplan CMF 1.4.The average follow-up time was 23.6 months. We quantitatively analysed brain volume in ten patients with craniosynostosis, comparing with the normal data of age- and sex-matched healthy controls. Paired t tests were performed to compare mean value of the variables. Results The volume of intracranial cavity was(1 117.39 ± 105.83) ml before surgery and the preoperative volume of intracranial cavity in the control group was (1 251.37 ± 114.35) ml. The difference between the preoperative group and the preoperative control group was statistically significant(P=0.00030). The volume of intracranial cavity was (1 260.84 ± 122.08) ml after surgery. The volume was increased significantly after surgery(P=0.00002). There was no significant difference between the postoperative group and the preoperative control group(P=0.60000). The volume of intracranial cavity was (1 368.65 ± 94) ml at least one year follow-up and the cranial volume of the control group was (1 321.96 ± 80.21) ml. There was no statistically significant difference between the two groups(P=0.07000). There were statistically significant differences between the cranial volume at two weeks after operation and that of one year follow-up (P=0.00300). This result showed that the cranial vault and brain of patients grew and developed normally after FOA surgery. Conclusions Preoperative cerebral volume in the patients with craniosynostosis was lower than normal. The cranial volume has been effectively expanded and basically reached the normal level after fronto-orbital advancement. Especially, the intracranial volume maintained normal during follow-up. Key words: Craniosynostosis; Fronto-orbital advancement; Intracranial volume; Digitization

Magnetic resonance imaging was used to evaluate the influence of sex and brain size on compartmental brain volumes (grey matter, white matter, CSF) in a large and well-matched sample of neurologically normal women (n = 50) and men (n = 50). As expected, we found a significant sex difference for the absolute volumes of total brain, grey matter, white matter and CSF, with greater volumes for men. Relating these compartmental volume measures to brain volume resulting in proportional volume measures revealed a higher proportion of grey matter in women. No significant sex differences were found for white matter and CSF proportions. However, when the influence of sex was partialized out by regression analyses, brain volume explained 40-81% of the variance of the absolute grey matter, white matter and CSF volumes. Performing these regression analyses for the proportional volume measures revealed that brain volume explained approximately 16% of the variance in grey matter proportion. Sex or the interaction between sex and brain volume revealed no additional predicitve values. Interestingly, the correlation between brain volume and grey matter proportion was negative, with larger brains exhibiting relatively smaller proportions of grey matter. Thus, sex is not the main variable explaining the variability in grey matter volume. Rather, we suggest that brain size is the main variable determining the proportion of grey matter.

To analyze the correlation between olfactory bulb (OB) volume with depth of olfactory sulcus (OS) and olfactory function in patients with idiopathic Parkinson's disease (IPD). One hundred patients with IPD between January 2011 to December 2013 in Tianjin Huanhu Hospotal were compared with one hundred controls in terms of olfactory function T&T testing, OB volume and depth of OS assessed with Magnetic resonance imaging (MRI). One hundred IPD patients were investigated and estimated H-Y degrees, UPDRS, MMSE, MoCA. SPSS 13.0 software was used to analyze the data. T&T olfactory testing revealed that IPD patients (3.0 ± 0.3) had higher scores than controls (1.3 ± 0.2, t = 2.537, P < 0.01). Both men and women with IPD were affected by the same extent of olfactory loss (t = 0.893, P > 0.05). Both men and women as controls were affected by the same extent of olfactory loss(t = 1.184, P > 0.05). OB volume of left side in IPD patients was (34.25 ± 5.14) mm(3), right side was (35.79 ± 5.28)mm(3), average OB volume was (35.28 ± 5.21) mm(3); OB volume of left side in controls was (47.38 ± 6.47) mm(3), right side was (47.75 ± 6.51) mm(3), average OB volume was (47.53 ± 6.49) mm(3); OB volume were lower in IPD patients as compared to controls (t value were 2.876, 2.747, 2.798, all P < 0.01). OS depth study revealed no statistical difference between IPD patients and controls (t value were 0.914, 0.987, 0.951, all P > 0.05). Olfactory discriminate threshold was negatively correlated with average OB volume in IPD patients and controls (r value were -0.537,-0.526, both P < 0.05); was no correlated with average depth of OS (r value were -0.142, -0.157, both P > 0.05). There was relation between the average OB volume and UPDRS III, UPDRS, the degree of H-Y in IPD patients (r value were 0.312, -0.419, -0.358, all P < 0.05). However the average OB volume was not related to the course of disease (r = -0.089, P > 0.05). The OB volume is lower in IPD patients as compared to controls, the depth of OS have no significant changes in IPD patients; The OB volume is correlated with olfactory function, the depth of OS is not correlated with olfactory function; Olfactory function lower degree is accordance with serious degree in IPD patients, is not accordance with the course of disease.

Objective Evaluate myocardial strain of uremic patients after arteriovenous fistula (AVF) quantitatively by using 2-Dimensional Speckle Tracking Imaging (2D-STI), observe change of myocardial contractility of left ventricular after change of volume load. Methods Sixty-six uremic patients from the Nephrology Department of Shangxi Dayi Hospital from July 2012 to February 2015 were chosen as AVF group, and 30 age and gender matched healthy volunteers were chosen as healthy control group. Longitudinal stain (LS), circumferential stain (CS) and radial stain (RS) of each segment and global of systolic of left ventricular were obtained by using 2D-STI. Reference range of normal value is determined as 53-70 ml/m2 according to left ventricular end diastolic volume index (LVEDVI) of healthy control group. AVF group is divided into normal volume group (LVEDVI ≤70 ml/m2) and volume increase group (LVEDVI >70 ml/m2). Adopt ANOVA for myocardial stain of AVF group before operation and healthy control group, comparison in pairs shall adopt LSD-t test; comparison of AVF group before and after operation shall adopt paired t-test; correlation analysis of parameters of myocardial stain and volume load shall adopt curve fitting. Research of repeatability shall adopt Bland-Altman analysis chart and linear correlation; express with correlation coefficient (r) and D-value. Results (1) In healthy control group, left ventricular LS, CS increase gradually from basal segment to apical segment (F=14.19, 13.60, all P 0.05); (2) Each segment and global LS, CS, RS of left ventricular of AVF normal volume group and volume increase group before operation decrease compared with healthy control group; each segment and global LS, CS, RS of left ventricular of AVF volume increase group is higher than AVF normal volume group (apical-middle-basalt-global: LS: F=117.49, 61.66, 24.91, 80.70, CS: F=74.88, 43.91, 28.14, 57.08, RS: F=33.65, 96.09, 89.86, 85.85, all P<0.05); (3) Each segment and global LS of left ventricular decrease after AVF operation compared with pre-operation (t=24.05, 23.54, 16.64, 21.34, all P<0.05); (4) GLS and LVEDVI correlation of left ventricular: Y=-0.006X2+ 0.956X-25.719 (Y: GLS, X: LVEDVI, R2=0.703), X=80, Y value was maximum. Conclusions (1) Volume load has regular influence on myocardial contractility of left ventricular of uremic patients. When LVEDVI 80 ml/m2, myocardial contractility decreases gradually. (2) LS parameter of left ventricular is relatively sensitive to the change of volume load. The influence of volume load on myocardial mechanics of uremic patients can be evaluated by LS parameter of left ventricular. Key words: Echocardiography; Arteriovenous fistula; Volumetric overload; Speckle tracking; Strain

Objective To investigate the grey matter volume in patients with early adulthood episode (18-25 ages) schizophrenia and the correlations between regional volume and symptom severity. Methods Twenty-one schizophrenia patients with early adulthood episode and twenty-one normal controls matched with age, sex and education were recruited. The diagnosis of schizophrenia was made according to the Diagnostic and Statistical Manual of Mental Disorder the Fourth Edition (DSM-Ⅳ) criteria. Each participant received whole brain MRI scans, then the 3D brain structural MRI images were obtained. The grey matter volume difference between patients and controls was analyzed by using the optimized voxel-based morphometry method (VBM). Symptom severity were assessed using the Positive and Negative Syndrome Scale (PANSS), and the correlation with the grey matter volume were analyzed in the patients. Results Compared to the normal controls, the patients had multiple brain areas abnormal volume. It showed significant decreased grey matter volume in the left orbital gyrus（t=4.88，P<0.001）, left middle frontal gyrus（t=4.50，P<0.001）, left middle teporal gyrus（t=3.95，P<0.001）, right middle temporal gyrus ( t=3.92，P<0.001）, left superior parietal lobule（t=3.71，P<0.001）, left inferior parietal lobule（t=3.93，P<0.001） and right lingual gyrus/cuneus（t=3.65，P<0.001）. Within the patient group, total score of PANSS was positively correlated with grey matter volume of the right superior parietal lobule, but negatively correlated with the left pons/midbrain; and the positive symptom score was negatively related to grey matter volume of the right inferior parietal lobule; and the negative symptom score was positively correlated with grey matter volume of the right superior parietal lobule, bilateral precuneus, but negatively correlated with grey matter of the left pons/ midbrain; and the common score was negatively correlated with grey matter of the right inferior temporal gyrus, right inferior parietal lobule and left pons/midbrain. Conclusions These preliminary findings support that obvious multiple grey volume abnormality are in patients with early adulthood episode schizophrenia, and the gray matter volume of different brain regions are associated with symptoms severity. Key words: Schizophrenia; Magnetic resonance imaging; Grey matter; Voxel-based morphometry

Objective To explore the developmental characteristics of white matter volume in autism spectrum disorder (ASD) children longitudinal. Methods From May 2011 to September 2014, 37 ASD children (ASD group) and 27 developmental delays (DD) children (control group) were treated at the Child Mental Health Research Center, Nanjing Brian Hospital Affiliated of Nanjing Medical University, and the children whose age, gender and developmental quotient matched with the ASD children were scanned by structure magnetic resonance imaging (sMRI) at the age of 2-3 years old and 4-5 years old respectively.Region of interest(ROI) technology was adopted to investigate the change of the cerebrum white and the sub-lobes structure white matter volume with time.Then the correlation between clinical symptoms and brain white matter volume changes was analyzed. Results Among the 2-3 years old, compared with the control group, the white matter volume of the total brain[(383 521.84±6 427.57) mm3vs. (364 014.06±6 856.97) mm3], the left cerebral hemisphere [(191 609.35±3 206.60) mm3vs. (181 695.89±3 389.54) mm3], temporal lobe [(41 860.49±816.38) mm3vs. (39 444.18±834.85) mm3] and the right temporal lobe [(21 312.79±414.07) mm3vs. (20 084.22±412.13) mm3] were significantly larger in the ASD group, and the differences were statistically significant (all P 0.05). Among the 4-5 years old, compared with the control group, the white matter volumes of the total brain[(417 651.42±6 443.86) mm3vs. (394 317.27±6 404.86) mm3], left cerebral hemisphere [(208 714.16±3 214.61) mm3vs. (197 192.82±3 262.02) mm3], right cerebral hemisphere [(208 937.26±3 242.09) mm3vs. (7 124.45±3 193.13) mm3], frontal lobe [(107 107.46±1 681.99) mm3vs. (100 326.19±1 883.24) mm3], left frontal lobe [(54 569.63±846.85) mm3vs. (51 177.25±979.09) mm3], right frontal lobe [(52 537.83±841.99) mm3vs. (49 148.94±928.31) mm3], temporal lobe [(45 189.75±833.29) mm3vs.(42 487.73±786.27) mm3], left temporal lobe [(22 204.21±411.77) mm3vs. (20 922.90±418.46) mm3], and right temporal lobe [(22 985.54±426.93) mm3vs. (21 564.83±378.78) mm3] were significantly larger in the ASD group, and the differences were statistically significant (all P 0.05). For longitudinal analysis, there was a significant difference in the white matter volume between the whole brain, left cerebral hemisphere, right cerebral hemisphere, frontal lobe, left frontal lobe, right frontal lobe, temporal lobe, left temporal lobe, right temporal lobe and the differences were statistically significant(F=5.521, 5.533, 5.459, 5.830, 5.800, 5.723, 4.857, 4.418, 5.159, all P<0.05). There was a positive correlation between the changes of the volume of whole brain, the white matter volume in the whole brain, bilateral cerebral hemisphere, frontal lobe, parietal lobe, right parietal lobe and Childhood Autism Rating Scale(r=0.367, 0.343, 0.321, 0.349, 0.296, 0.308, 0.351, all P<0.05). Conclusions Among the 2-3 years old, the white matter volume of the brain regions have been increased significantly in ASD.Among the 4-5 years old, the increase of the white matter volume of the brain regions implicated more widely which mainly concentrated in the frontal and temporal lobe in ASD.The severity of the clinical symptoms of ASD may be associated with the white matter volume of the total brain, bilateral cerebral hemisphere, frontal lobe, parietal lobe and right parietal lobe. Key words: Autism spectrum disorder; White matter; Volume; Magnetic resonance imaging; Longitudinal study

Objective To verify the accuracy of the mathematical model of gastrointestinal decompression after esophagectomy of esophageal cancer and explore predictive value of the mathematical model in the postoperative complications. Methods The retrospective case-control study was conducted. The clinicopatholo-gical data of 192 patients with esophageal cancer who underwent esophagectomy in the Beijing Chaoyang Hospital of Capital Medical University between October 2013 and October 2016 were collected. Among 192 patients, 160 didn′t have postoperative complications and 32 had postoperative complications (7 with postoperative anastomotic leakage, 9 with pulmonary infection and 16 with dysfunction of gastralintestinal tract). Patients selected the appropriate surgical procedures according to individual conditions, and then volume of gastrointestinal decompression was recorded daily. According to the regression equation of influencing factors of volume of postoperative gastrointestinal decompression: average daily drainage volume within 5 days (mL)=262.287+ 132.873×tubular stomach-72.160×smoking history-27.904×pathological type of tumor-36.368×age, predictive value of postoperative gastrointestinal decompression was calculated and compared with real volume of gastrointestinal decompression. Observation indicators: (1) comparison between predictive value and real volume of postoperative gastrointestinal decompression in patients without complications; (2) comparison between predictive value and real volume of postoperative gastrointestinal decompression in patients with complications. Measurement data with normal distribution were represented as ±s and comparison was analyzed using the paired-samples t test. Measurement data with skewed distribution were described as M (range), and comparison was analyzed using the Wilcoxon signed rank tests. Results (1) Comparison between predictive value and real volume of postoperative gastrointestinal decompression in patients without complications: predictive value and real volume of postoperative gastrointestinal decompression in 160 patients without complications were respectively 187 mL (range, 58-392 mL) and 207 mL (range, 20-570 mL), with no statistically significant difference (Z=-1.106, P>0.05). (2) Comparison between predictive value and real volume of postoperative gastrointestinal decompression in patients with complications: 7 patients had postoperative anastomotic leakage, including 1 with cervical anastomotic leakage and 6 with chest anastomotic leakage. The predictive value and real volume of postoperative gastrointestinal decompression in 7 patients with anastomotic leakage were respectively (215±58)mL and (338±106)mL, with a statistically significant difference (t=-3.139, P 0.05). The predictive value and real volume of postoperative gastrointestinal decompression in 16 patients with dysfunction of gastralintestinal tract were respectively (236±60)mL and (357±107)mL, with a statistically significant difference (t=-4.716, P<0.05). Conclusions The mathematical model of gastrointestinal decompression after esophagectomy of esophageal cancer is correct and feasible. There is a predictive value for patients with postoperative anastomotic leakage and dysfunction of gastralintestinal tract. Key words: Esophageal neoplasms; Esophagectomy; Gastrointestinal decompression; Postoperative complications; Multivariable linear regression

Single molecule detection and fluorescence correlation spectroscopy on surfaces

Objective To probe into the application of left atrial volume tracking technique(LAVT)on the evaluation of right atrial function in patients with pulmonary hypertension.Methods Forty-one patients with pulmonary hypertension (pulmonary hypertension group) and 37 control subjects (control group) were involved.Right atrial maximal volume (RAVmax),right atrial presystolic volume(RAVpre),right atrial minimal volume (RAVmax),systolic right atrial filling rate (dv/dtS),early diastolic right atrial emptying rate(dv/dtE) and late diastolic right atrial emptying rate(dv/dtA) was derived by LAVT.Right atrial passive emptying volume (RAVp),right atrial passive emptying fraction (RAVpEF),right atrial active emptying volume (RAVa),right atrial active emptying fraction (RAVaEF),right atrial total emptying volume (RAVt)and right atrial total emptying fraction (RAVtEF) was calculated.All the right atrial volume parameter was corrected by body surface area to obtain right atrial volume index (RAVI).Results RAVImax,RAVImin,RAVIpre,RAVIt,RAVIa,dv/dtS and dv/dtA in pulmonary hypertension group was higher than that in control group [(78.39 ± 49.35) ml/m2 vs.(24.80 ± 11.91) ml/m2,(62.59 ± 46.56) ml/m2vs.(17.46 ± 8.40)ml/m2,(70.12 ± 48.03) ml/m2 vs.(20.02 ± 9.46) ml/m2,(18.77 ± 11.47) ml/m2 vs.(9.35 ± 6.74) ml/m2,(8.53 ± 9.81) ml/m2 vs.(3.25 ± 3.00) ml/m2,(145.85 ± 80.56) ml/s vs.(86.44 ± 48.46) ml/s,(155.63 ±126.47) ml/s vs.(67.74 ± 33.27) ml/s],and RAVIp in pulmonary hypertension group was lower than that in control group [(6.09 ± 5.16) ml/m2 vs.(10.23 ± 11.12) ml/m2],and there were significant differences (P ＜0.05).But there were no significant differences in RAVItEF,RAVIpEF,RAVIaEF and dv/dtE between two groups (P＞0.05).Conclusions In patients with pulmonary hypertension,right atrial booster pump function and reservoir function increases,while right atrial conduit function decreases.LAVT has a potential ability to evaluate right atrial function. Key words: Echocardiography, stress; Hypertension,pulmonary; Atrial function,right ; Left atrial volume tracking technique

Objective To investigate the correlations in target volumes based on positron emission tomography CT (PET/CT) and the end-expiration phase of four-dimensional CT (4D-CT) images for non-small cell lung cancer (NSCLC). Methods Seventeen patients with NSCLC sequentially underwent three-dimensional CT (3DCT), 4D-CT and 18F-FDG PET/CT thoracic simulation scans. The gross target volume (GTV) was contoured on the end-expiration phase (50%) of 4D-CT and defined as GTV50%. The internal gross target volumes (IGTV) based on PET/CT images (IGTVPET) were determined by the standardized uptake value (SUV) 2.0 (IGTVPET2.0) and 20% percentage of the maximal standardized uptake value (SUVmax) (IGTVPET20%). The following parameters were calculated to analyze the correlation between IGTVPET and GTV50% in volume ratio (VR) and conformity index (CI): maximum transverse diameter of GTV50%, volume of GTV50%, the displacement of GTV in the cranial-caudal direction and 3D Vector calculated from 4D-CT dataset as well as the SUVmax. Results There was no significant correlation between the VR of IGTVPET2.0 to GTV50% and the maximum transverse diameter of GTV50%, volume of GTV50%, the displacement of GTV in the cranial-caudal direction, 3D Vector and the SUVmax (P>0.05). The VR between IGTVPET20% and GTV50% inversely related to maximum transverse diameter of GTV50%, volume of GTV50% and SUVmax (r=-0.663, -0.669, -0.752, P<0.05). The CI between IGTVPET2.0 and GTV50% positively related to volume of GTV50% and maximum transverse diameter of GTV50% (r=0.613, 0.483, P<0.05). Conclusions 3D PET images provide a time-averaged image of the tumor during the numerous breathing cycle. They fail to include the full information of moving tumor. The target volumes based on 3D PET might not reflect the real IGTV of NSCLC. Key words: Non-small cell lung cancer; Fluorodeoxyglucose positron emission tomography; Four-dimensional computed tomography; Standardized uptake value; Internal gross target volume

The comparative ability to detect early abnormalities in smokers by commonly used lung function tests was studied. Sixty-five healthy male nonsmokers served as a reference group and provided standards for 1-sec forced expiratory volume, vital capacity, end-tidal spirometry, spirometric forced mid-and end-expiratory flows, single-breath diffusing capacity, static lung volumes (helium method), and single-breath N2 closing volume measurements, In the present series of 80 male smokers, the measurements of forced mid-expiratory flow and forced end-expiratory flow did not improve the ability of the more conventional indices, 1-sec forced expiratory volume and the ratio of 1-sec forced expiratory volume to vital capacity, to detect obstructive lung disease. In 71 smokers with normal 1-sec forced expiratory volume and ratio of 1-sec forced expiratory volume to vital capacity, the end-tidal spirometry, diffusing capacity, and residual volume indices revealed 14,20, and 21 per cent of abnormalities. respectively. The single-breath N2 closing volume test (Phase IV/vital capacity and slope of Phase III) detected the greatest number of subtle changes in lung function; this was abnormal in 32 per cent of smokers with normal conventional spirometry. In young or light smokers, Phase IV/vital capacity was more frequently increased than the slope of Phase III; an incerse trend was observed in older or heavier smokers. The single-breath N2 closing volume test also provided the greatest number of abnormal results when other indices were impaired in the same subjects.