Objective To investigate the CT appearances of atypical renal angiomyolipoma to raise the CT diagnosing level and search for the differential points from renal angiomyolipoma. Methods Twenty-one patients with atypical renal angiomyolipoma and 24 patients with renal carcinoma underwent CT scan and enhanced scanning. Results CT results showed hyperintense in 12 of all 21 lesions of atypical renal angiomyolipoma,with iso-intensity in 6,hypointense in 3,and levering-cortex-up sign in 9 cases. The tumor body showed homogeneous enhancement on CT enhanced scanning and prolonged enhancement was noted in 7 cases. CT showed hyperintense in 3 of all 24 lesions of renal carcinoma,with mixed intensity in 5,hypointensity in 16,calcification in 2 cases. The majority of the tumor body showed heterogeneous enhancement on CT enhanced scanning with cortical hyperintensity and medullary low-intensity,and with contrast appeared fast wash-in and wash-out. Of all cases,8 presented with pseudo-capsule,7 with tumor embolus formation in the renal vein and inferior vena,10 with retroperitoneal lymphadenectasis,and 3 with intrahepatic metastasis. Conclusion CT scanning proves to play critical role in differentiating the atypical renal angiomyolipoma from renal carcinoma.

Objective To determine the CT features of the 16 - slice Spiral CT (MSCT) for aortic dissection (AD). Methods 16 - slice spiral CT were porformed in 25 patients of aortic dissection. All of patients were performed with unenhanced, contrast - enhanced scanning and three - dimensional reconstruction. Results 10 patients were normal on unenhanced and 15 patients were seen enlargred diameter of aorta. Intimal calcification and intimal displacement was seen in 8 cases and outer wall calcification was presented in 7 cases. After contrast - enhanced scanning, true and false lumen and intimal flap of AD could be shown in all of 25 cases (100%). The entry tears was revealed in 22 cases (88.9%). Beak sign was presented in all cases, but it was seen in the false lumen. The larger lumen was the false lumen in 88.5% of the cases. Intraluminal thrombus was presented in 12 cases. Conclusion Multislice spiral CT angiography is a safe,no - traumation,fast and accurate examination method. It can fully display theintimal flap,the true and false lumen and tear entrance, as well as the branches involved details and is therefore of important value for the diagnosis of aortic dissection.

Objective: To analyze delay in student pulmonary tuberculosis(PTB) case finding and associated factors in Suzhou, and to provide a reference for tuberculosis outbreak prevention and control in schools. Methods: A total of 1 148 students with PTB who registered and were treated in Suzhou from 2011 to 2020 were included. Kruskal Wallis H test, 2 test and Cochran Armitage trend test were used to analyze the time trend of case finding delay. Logistic regression was used to analyze the correlation between admission characteristics and case finding delay. Results: Among the students with PTB, a total of 569 cases were found to be delayed. The rate of delay was 49.6%, and the median delay time was 26(11-49) days. From 2011 to 2020, the difference in case finding interval of students with PTB was statistically significant( Hc=54.62, P <0.05), and the difference in case finding rate was also statistically significant( χ 2=53.69, P <0.05). The rate of delay fluctuated, with an overall upward trend over time( Z=-3.67, P < 0.05). Clinical consultation( OR=5.57, 95%CI =1.91-16.27), positive etiology ( OR=1.46, 95%CI =1.14-1.86) were positively correlated with case finding delay(all P <0.05). Conclusion There are significant delays in case finding among students with PTB in Suzhou. Clinical consultation and positive etiology are associated with case finding delay. In response to the growing problems in daily school tuberculosis prevention and control, multiple departments should cooperate to implement relevant measures and to reduce the occurrence of case finding delay.

Objective: To analyze the relationship between the risk of tuberculosis outbreaks in schools and the visit interval of index cases, so as to provide a scientific reference for predicting the risks of tuberculosis outbreak and making preventive measures. Methods: A total of 630 index cases from school tuberculosis outbreaks were studied during January, 2015 to December, 2022. Data on demographics, consultation history, etiological diagnosis, and methods of detection were collected. Restricted Cubic Splines (RCS), unconditional Logistic regression, and the receiver operating characteristic curve (ROC curve) were used for analysis. Results: The RCS fitted curve showed that the risk of a tuberculosis outbreak linearly increased when the consultation interval for etiologically negative patients exceeded 5.79 days, or for etiologically positive patients exceeded 8.37 days. After multi factor adjustment, for every additional day in the visit interval of the index case, the odds ratio ( OR ) value for a high risk outbreak was 1.10 (95% CI =1.07-1.13)( P <0.05). When analyzed by tertiles of visit intervals, compared to an interval of <14 days, the OR values (95% CI ) for high risk outbreaks in schools with intervals of 14-<28 days and ≥28 days were 10.32(3.04-35.10) and 82.58( 28.42 -239.95), respectively( P <0.01), indicating a trend of increasing outbreak risk with longer visit intervals. Based on the ROC curve analysis, the optimal threshold for predicting a high risk school tuberculosis outbreak was 23.5 days, with an area under the curve ( AUC ) of 0.93 (95% CI =0.89-0.98). Conclusion An extended visit interval of index cases is a good early warning indicator for high risk tuberculosis outbreaks in schools and could be considered a key factor in early intervention and risk control strategies.