Objective To analyze spectral curves and iodine levels in normal adult thyroid by using dual-source CT scanning technique and provide the basis for the differential diagnosis of thyroid space-occupying lesions.Methods A total of 70 subjects were selected for this study,including 38 females and 32 males.They were excluded from thyroid disease by ultrasound examination and had all taken the dual-source CT scan.The image data were transported to the CT workstation,the analysis of iodine levels and spectral curves were completed in theLiver VNCandMonoenergetic modes respectively.The gender differences in ratio iodine content were compared.Results The iodine ratio of thyroid was (1.35±0.19) mg/mlin plain scan,(1.35±0.23) and (1.35±0.21) mg/ml in left lobe and right lobe respectively.There was no statistically significant difference between left and right lobe (P ＞ 0.05),as well as between females and males (P ＞ 0.05).The slopes of the energy spectrum curve in the left and right lobe of the thyroid were 9.98 ± 2.43 and 9.74 ± 1.63,respectively,and 9.88 ± 1.74 and 9.74 ±0.09 for the male and female,respectively.There was no significant difference of slopes of the energy spectrum curve between the left and right lobe,as well as the male and female.The average dose length product of all patients was (208.29 ±21.80) mGy·cm,and the average effective dose was (1.23 ± 0.13) mSv.Conclusions Dual-source dual-energy CT scanning technique have definitive,diagnostic characteristic in the measurement of spectral curves and calculation of the ratio of iodine in normal adult thyroid tissue,and therefore has guidance value in the diagnosis of thyroid space-occupying lesions.

Objective To investigate the distribution pattern and antimicrobial resistance of the clinical isolates of pathogen.Methods The identification and dug susceptibility tests of the isolates from 2013 to 2015 were performed by using VITEK2-compact system.The susceptibilities of isolates to antimicrobial agents were analyzed with WHONET 5.6 software.Results A Total of 2 991(90.4%) gram-negative bacteria and 317(9.6%) gram-positive bacteria were isolated.Among all of the isolates,the top three pathogens were Klebsiella pneumonia,followed by Pseudomonas aeruginosa and Acinetobacter baumannii.The detection rates of extended-spectrum beta-lactamase(ESBLs)-producing Escherichia coli were 40.4%,48.2% and 38.3% respectively in the three consecutive years,while the detection rates of the ESBLs-producing Klebsiella pneumonia were 16.9%,8.4% and 11.6% respectively.No Escherichia coli resistant to impenem were detected.The resistant rate to impenem of Klebsiella pneumonia was 1.6%.The detection rates of methicillin resistant Staphylococcus aureus(MRSA) and methicillin resistant coagulase-negative staphylococci(MRCNS) in the three years were 53.8%,54.3%,42.9% and 84.5%,82.7%,85.9% respectively.No Staphylococci isolates resistant to linezolid and tigecycline were found.Enterococcus isolates were sensitive to gentamicine,linezolid,tigecycline and vancomycin.Conclusion Carbapenems could remain the best antimicrobials against Enterobacteriaccae.Lnezolid and tigecycline could be effective antimicrobials against Staphylococci isolates.The detection rates of Klebsiella pneumonia and Acinetobacter baumannii increased year by year.The monitoring of drug resistance should be strengthened to control the emergence and spread of multidrug resistant pathogen.

Objective To investigate the expressions of Pokemon and c-myc in colorectal cancer,colorectal adenomas and normal colorectal mucosa tissues,and demonstrate its relationship with clinicopathological features and prognosis in patients with colorectal cancer.Methods The specimens were taken from colorectal cancer tissue of 86 patients,colorectal adenomas tissue of 60 patients,and 40 normal colorectal mucosa tissue.The expressions of Pokemon and c-myc protein were detected by immunohistochemistry,and the expressions of Pokemon and c-myc gene were detected by reverse transcription polymerase chain reaction (RT-PCR).The correlation between the expressions of Pokemon and c-myc,and clinicopathological features was analyzed.Results The positive expression rates of Pokemon and c-myc protein in colorectal cancer tissue were significantly higher than those in colorectal adenomas tissue and normal colorectal mucosa tissue:69.8％ (60/86) vs.13.3％ (8/60) and 5.0％ (2/40),73.3％ (63/86) vs.15.0％ (9/60) and 2.5％(1/40),and the expression levels of Pokemon and c-myc gene in colorectal cancer tissue were significantly higher than those in colorectal adenomas tissue and normal colorectal mucosa tissue:0.915 ±0.247 vs.0.358 ±0.102 and 0.277 ±0.085,1.272 ±0.360 vs.0.398 ± 0.153 and 0.255 ±0.097,there were statistical differences (P ＜ 0.05).The expression levels of Pokemon and c-myc gene in colorectal cancer tissue had a close correlation with the degree of infiltration,histological differentiation,lymph node metastasis,distant metastasis and Dukes stage,there were statistical differences (P ＜ 0.05),but had no correlation with the sex,age,and tumor diameter (P ＞ 0.05).Conclusions The expression levels of Pokemon and c-myc are higher in colorectal cancer tissue,and the expressions are related to the clinicopathological features of colorectal cancer.The expression levels of Pokemon and c-myc may predict the prognosis in patients with colorectal cancer.

Objective To study the relationships between serum intedeukin-18(IL-18)and resistin for predicting intraamniotic infection.Method Serum levels of IL-18 and resistin were measured in 43 pregnant women with intraamniotic infection (infection group)and 40 normal pregnant women(control group).Results The level of IL-18 in infection group[(38.7±10.4)μg/L]was higher than that in control group [(23.5±5.6)μg/L],there was significant difference between two groups (P＜0.01).The level of resistin in infection group[(24.84±5.32)μg/L]was higher than that in control group[(17.3±5.15) μg/L],there was significant difference between two groups(P＜0.01).The levels of resistin and IL-18 were correlated in pregnant women with intraamniotic infection(r=0.61,P＜0.01).Conclusion Detecting the levels of IL-18 and resistin in pregnant women can identify intramnniotic infection.

Objective To analyze the clinical characteristics and therapy of Nocardia infection, and provide reference for clinical practice.Methods Patients with positive specimen culture of Nocardia from May 2014 to June 2016 were surveyed retrospectively, the body status, clinical features, therapeutic regimen, and prognosis were analyzed.Results A total of 10 cases of Nocardia infection were surveyed, there were 7 males and 3 females;average age was (49.90+13.75) years old.Nocardia infection occurred mostly in population with impaired immune status or underlying diseases, the main infection site was lung, compound sulfamethoxazole was the first choice drug for treatment of infection, amikacin, imipenem/cilastatin and so on were alternative choice according to disease condition, 8 patients all improved after therapy.Conclusion The diagnosis made on the basis of microbiological examination, imaging, and pathological examination, combined with comprehensive judgment according to risk factors of Nocardia infection, patient can be treated timely and rationally, and the prognosis is better.

Objective:To search the marker of micrometastatic hepatocellular carcinoma (HCC).Methods:Peripheral blood samples were obtained from 65 patients with hepatocellular carcinoma,21 non HCC malignant tumors,22 chronic hepatitis B or cirrhosis,and 21 normal healthy volunteers.To identify hepatocellular carcinoma cells in peripheral blood, liver specific alpha fetoprotein(AFP)mRNA was amplified from total RNA extracted from whole blood by nested reverse transcription polymerase chain reaction (Nested RT PCR).Results:AFP mRNA was not detected in the normal healthy volunteers and patients with non HCC malignant tumors.The presence of AFP mRNA in patients with HCC(44/65,67.7%)was higher than those with chronic hepatitis B or cirrhosis(2/22,9.1%, P

Objective:To evaluate the feasibility of making individualized scanning and contrast injection protocol based on body mass index (BMI) and body weight during dynamic myocardial computed perfusion (CTP) imaging in order to get high-quality images while drastically reducing radiation dose.Methods:A total of 128 patients with coronary heart disease diagnosed by coronary CTA (CCTA) performed CTP from June, 2019 to March, 2020 were prospectively enrolled. Patients were divided into six groups: group 1, BMI<24 kg/m 2, ≤60 kg, 70 kV; group 2,BMI<24 kg/m 2, 61≤kg≤70, 70 kV; group 3, BMI 24-28 kg/m 2, 61≤kg≤70, 80 kV; group 4, BMI 24-28 kg/m 2, 71≤kg≤80, 80 kV; group 5, BMI 24-28 kg/m 2,>80 kg, 80 kV;group 6, BMI>28 kg/m 2,>80 kg, 100 kV. 200 mA was fixed for all patients. Contrast agent with iodine containing 370 mg/ml was used in all patients. The iodine delivery rates (IDR) for each group was 0.8, 1.0, 1.2, 1.4, 1.6, 2.0 g/s, respectively. The attenuation and noise of left ventricle (LV) and septal myocardial were measured to calculate signal to noise ratio (SNR) and contrast to noise ratio (CNR) of the images in each group. The Shapiro-Wilk test was conducted to assess the normality of quantitative data. Quantitative variables were compared using one-way ANOVA if normally distributed. Results:The LV attenuation of the six groups were (506±85), (513±77), (510±81), (456±74), (477±111), (462±43) HU, respectively. There was no significant difference among them ( F=2.249, P=0.054). SNR values of LV were 23±8, 20±5, 21±5, 19±4, 19±7, 19±4, and CNR values were 19±7, 17±4, 17±4, 16±4, 15±6, 15±4, respectively. There were no significant differences among them ( F=1.674, 1.736, all P>0.05). Under a single CTP scan, the radiation dose of 70, 80 and 100 kV groups were 1.6, 2.3 and 4.3 mSv, respectively. The does of the 70 kV group and 80 kV group were significantly lower than that of the 100 kV group, and the dose of the 70 kV group was also significantly lower than that of the 80 kV group (all P<0.001). Conclusions:The application of individualized scanning and contrast agent injection protocol based on IDR is feasible in myocardial CTP with successful image quality, and the radiation dose decreases significantly.

Objective To analyze the clinical and imaging characteristics of congenital sensorineural hearing loss (CSNHL)children combined with white matter (WM)lesions in order to provide evidence for clinical practice. Methods With referral to the Department of Pediatrics,Peking University First Hospital from November 201 1 to De-cember 201 5,documents of 78 patients of CSNHL combined with WMlesions were collected and analyzed for the clini-cal and imaging characteristics.Results Bilateral severe -profound hearing loss existed in all 78 cases,48.1 %(25 /52 cases)of the patients exhibited gross motor development delay,98.1 %(51 /52 cases)of them had normal cognition development.One hundred percent (61 /61 cases)of patients had abnormal language development.Infection occurring during pregnancy existed in 21 .2%(1 1 /52 cases)of the patients,the premature and smaller for the gestational age in-fants accounted for 28.9% (1 5 /52 cases).The bilateral multiple WMlesions from the brain MRI were in dot to flake sizes with sharp boundary,the intensity of T1 -weighted imaging decreased,T2 -weighted imaging and fluid attenuated inversion recovery increased.Eighty -two point one percent (64 /78 cases)of the patients were found to have the periventricular and subcortical WM involvement.The most frequently affected periventricular region was the posterior horn (91 .9%,68 /74 cases),followed by the anterior horn and temporal horn,and the least with the body involvement. The former three had a combined lesion tendency (55.4% -68.9%).There was an extensive involvement in the sub-cortical WMof parietal,frontal,temporal and occipital lobes respectively(73.5% -88.2%).Subcortical WM involve-ment of multiple lobes was common (accounted for 67.6% -77.9%).The enlargement of bilateral ventricles existed in 37.2%(29 /78 cases)of the patients and cystic changes in the subcortical WM of anterior temporal lobe could be found in 9.0% (7 /78 cases)patients.Calcification in 2 CT cases was reported.Corpus callosum and basal ganglia of all cases were normal.For cases with MRI scans more than once,WMlesions of 96.0%(24 /25 cases)patients became silent or self -restored.Conclusions The clinical presentations of CSNHL combined with WM lesions are mild,not paralleled with their multiple foci.It is considered as demyelination or a delay of myelination.Due to its benign course, it is probably not the contraindication for the cochlear implantation.

Objective To explore serum levels of visfatin and high-sensitivity C-reactive protein (Hs-CRP) in patients with polycystic ovary syndrome (PCOS), as well as their clinical significance. Methods Ninety patients with PCOS and 30 ovulating healthy women with body mass index (BMI) less than 25 as controls were recruited. PCOS patients were divided to two groups, 48 in obese group with BMI≥ 25 and 42 in non-obese group with BMI<25. Serum level of visfatin was measured by enzyme-linked immunosorbent assay (ELISA) and that of Hs-CRP was assayed by immunoturbidimetry in all participants. Oral glucose tolerance test (OGTT) and insulin sensitivity were assessed in PCOS patients only. Results ①Obese and non-obese patients with PCOS beth presented markedly higher serum levels of visfatin and Hs-CRP than those in controls (t=11.35, 8.46, 10.43 and 8.25, respectively, P<0.05), and levels of visfatin and Hs-CRP were higher in obese group than those in non-obese group (t=7.74 and 6.38, respectively, P< 0.05 ). ②Univariate analysis revealed that serum levels of visfatin and Hs-CRP positively correlated with BMI and homeostasis model assessment insulin resistance, respectively (P<0.05) and serum level of visfatin positively correlated with that of Hs-CRP (P<0.05). Conclusions Chronic inflammation possibly exists in patients with PCOS, which may cause their serum visfatin and Hs-CRP levels increased.