Objective To study the clinical value of HRCT in staging of lung interstitial disease(LID) in connective tissue disease(CTD).Methods 222 patients with CTD confirmed clinically underwent HRCT scan.The staging of LID according to the HRCT features of LID were done and the therapeutic effect was compared between each stage.Results In 222 cases ,64 cases were negative on HRCT as stage 0,158 cases had disseminated LID in different degree,including stage Ⅰ in 107,stage Ⅱ in 36 and stage Ⅲ in 15.There were significant statistically between the therapeutic effect and staging of LID.Conclusion The staging of CTD with LID by HRCT is helpful for judging the extent of LID and clinical treatment.

Objective To evaluate the display ability and the clinical application of multislice spiral CT virtual endoscopy (CTVE) in the diagnosis of vascular diseases. Methods Fifty-six patients were examined by CT virtual endoscopy.32 patients also had DSA for comparison.18 patients were confirmed by operation (3 patients also had DSA).9 patients with pulmonary embolism were confirmed by other examinations and treatments.Results 56 patients showed successful CT virtual endoscopy images.CT virtual endoscopy images could clearly show the inner wall and inner structures of the vessels,mural thrombus,calcification form,stenosis of the vessels,the true and false lumina of aortic dissections,the lesion of false aneurysm,and the anatomic relationship between the lesion and surrounding structures of the normal vessels.Out of the 32 patients with vessel abnormalities on DSA,24 patients (75%) showed the lesions on CTVE.17 out of 18 patients with operation showed the lesions on CTVE.All 9 patients with pulmonary embolism showed the abnormalities on CTVE.Chi-square test:? 2=5.2809,P=0.071 patients showed the vascular diseases on CTVE in 56 patients (84%).Conclusion MSCT virtual endoscopy could provide more information of the vessel by displaying the inner wall and allowing users to map the vessels in a display.It is helpful in correct diagnosis and guiding surgery.

Objective To evaluate the effectiveness of multiple spiral CT angiography in diagnosis of pulmonary embolism.Methods 16 patients clinically suspected of pulmonary embolism underwent multiple spiral CT angiography.Emboli were found in the 8 patients of all on multiple spiral CT angiography.5 of the patients were reexamined with this method 20 to 30 days after thrombolysis. Results In 8 patients with pulmonary embolism,43 vessels were involved with pulmonary embolism.The presence of pulmonary embolism on CT was seen as a total occlusion,partial filling defect,mural filling defect et al;dilated of pulmonary artery trunk;all signs with deceleration of pulmonary blood or “mosaic sign”. 5 patients were reexamined with this method.The emboli dissoved partly or entirely.Conclusion Multiple spiral CT angiography is a noninvasive and effective method for examining pulmonary embolism.

Objective To investigate the clinic characteristics of hepatosplenic γδT cell lymphoma (γδ HSTCL) and analyze the important role of morphology,immunology,cytogenetics and molecular(MICM) in the early diagnosis of γδHSTCL.Methods The clinical features of MICM of a rare case of childhood γδHSTCL had been analyzed,and the related literatures were reviewed.Results Bone marrow aspiration showed approximately 0.365 abnormal cells infiltrated.The immune phenotype analysis displayed 0.245 of the nuclear cells were abnormal ones,which possessed CD2/CD3/CD7/CD19/CD3s/cCD3 and TCRγδ expression.The immunohistochemical staining of spleen tissues showed clusters of differentiation (CD) 3/CD45 RO/CD8/Cytotoxic-granule associated protein (TIA-1)/leukocyte common antigen (LCA)/Granzyme B positive,CD4/CD20/T cell receptor (TCR) β/CD79 α/CD30/terminal deoxynucleotidy transferase (TdT) /CD10/ myeloperoxidase (MPO)/anaplasticlymphoma kinase (ALK) negative and 80.00％ of tumor cells displayed Ki-67 positive.The detection of spleen tissues by flow cytometry displayed that 72.26％ of the karyocytes were lymphocytes,with 88.90％ T lymphocytes.And 92.09％ of the T lymphocytes showed Ki-67/CD7dim,TCRγδ/CD2/CD8/CD34 positive,and TCRαβ/CD5/CD4/CD56 negative.And about 59.16％ of these karyocytes were abnormally matured T lymphocytes.The cytogenetic karyotype of bone marrow showed 46,XY.The detection of T cell receptor gene rearrangement showed TCRβ,TCRγ and TCRδ positive.The patient had been given prednisone of 60 mg/m2 when the diagnosis of γδHSTCL affirmed.But his parents discontinued chemotherapy for him and died.Conclusions MICM has shown a significant value in the diagnosis of γδHSTCL,a rare lymphoma in childhood.

Objective To develop and evaluate an aptamer based biosensor (aptasensor) for rapid colorimetric detection of enteropathogenic Escherichia coli (EPEC). Method The aptasensor was fabricated by modifying the truncated LPS-binding aptamer on the surface of nanoscale polydiacetylene vesicles using peptide bonding between the carboxyl group of the vesicle and the amine group of the aptamer. Molecular recognition between EPEC and aptamer at the interface of the vesicle led to blue-red transition of polydiacetylene which was readily visible to the naked eyes and could be quantified by colorimetric responses (CR). Transmission electron microscopy (TEM) was used to confirm the specific interactions between EPEC and polydiacetylene vesicles. Result Truncated aptamer showed the similar LPS-binding activity. The aptasensor could detect the target bacteria in a range of 105-108 colony-forming units (CFU)/ml within less than 30 minutes and its specificity was 100% for detection of EPEC O111. The sensor reproducibiliry obtained at 106 CFU/ml was 6. 08% R. S. D. The results of TEM confirmed that the specific interactions between EPEC and polydiacetylene vesicles. Conclusion A new aptasensor was developed successfully for rapid colorimetric detection of EPEC.

Objective To compare the safety and efficacy of flexible ureteroscopic lithotripsy (F-URS) and mini-percutaneous nephrolithotomy(MPCNL) for treating upper ureteral calculi by the randomized controlled clinical trial .Methods 120 cases of up-per ureteral calculi treated in this hospital from May to September 2013 were randomized into the F-URS group and the MPCNL group with 60 cases in each group .The postoperative clinical curative effects were compared between the two groups .Results The initial stone clearance rates of the F-URS group and the MPCNL group were 68 .33% and 95 .00% respectively ,and the difference was statistically significant (P< 0 .05) .The clearance rate of the two groups after postoperative 3 months were 96 .67% and 98 .33% respectively ,and the difference between the two groups had no statistical significance (P>0 .05) .The operating time of the F-URS group and the MPCNL group was (35 .33 ± 11 .57)min and (53 .75 ± 17 .31)min respectively ,the average hospital stay after operation was(3 .05 ± 0 .62)d and (5 .43 ± 1 .84)d respectively ,and the average visual analogue scale(VAS) score on first postoper-ative day was 1 .70 ± 1 .37 and 3 .68 ± 1 .57 respectively .These indicators had statistically significant differences between the two groups(P<0 .05) .The average dropped amount of hemoglobin and the occurrence rate of complications after operation had no sta-tistically significant differences between the F-URS group and the MPCNL group(P>0 .05) .Conclusion For upper ureteral calculi with surgical indication ,the effect of F-URS is equivalence to MPCNL in the aspect of the stone clearance rate ,but F-URS has high-er security and shorter postoperative hospital stay .In the department with the condition to conduct F-URS ,F-URS should be ranked as the preferred treatment method for upper ureteral calculi .

Objective To evaluate the effectiveness of rapid hepatitis B vaccination with different vaccine dosages and types in adults.Methods Adults who were aged ≥20 years,negative in the detections of 5 HBV serum markers or only anti-HBc positive were selected from Chaoyang district of Beijing.They were divided into 4 community-based specific groups and given three doses of 10 μ g HepB-SCY vaccine,20 μ g HepB-SCY vaccine,20 μ g HepB-CHO vaccine and 10 μ g HepB-HPY vaccine respectively at month 0,1,and 2.Their blood samples were collected within 1-2 months after completing the three dose vaccination to test anti-HBs level by using chemiluminesent microparticle immunoassay.A face to face questionnaire survey was conducted,and x2 test,Mantel-Haensel x2 test,Kruskal-Wallis rank test and multiple logistic regression analysis were performed.Results A total of 1 772 participants completed vaccination and observation.Their average age was 48.5 years,and 62.75％ of them were females.The anti-HBs positive rates in the groups of 10 μg HepB-SCY,20 μg HepB-SCY,20 μg HepB-CHO and 10 μg HepB-HPY vaccines were 79.49％,84.34％,82.50％ and 74.15％,respectively (P=0.005),and the geometric mean titers (GMT) were 39.53 mIU/ml,62.37 mIU/ml,48.18 mIU/ml and 33.64 mIU/ml respectively (P=0.025).The overall anti-HBs positive rate and GMT were 79.01％ and 41.18 mIU/ml.The anti-HBs GMT of 4 groups declined with age.The differences in anti-HBs GMT among 4 groups minimized with age.The result of logistic modeling indicated that vaccine type and dosage,age and smoking were associated with anti-HBs statistically after controlling the variables of "only anti-HBc positive or not" and "history of hepatitis B vaccination".Conclusion Hepatitis B vaccination at dosage of 20 tg based on 0-1-2 month rapid schedule could achieved anti-HBs positive rates ＞80％ in middle aged and old people,which can be used as supplement of 0-1-6 month routine schedule.

ObjectiveTo evaluate the clinical effect of Jiechang Buxu pills on chronic relapsing ulcerative colitis （syndrome of spleen-kidney Yang deficiency） and the repair effect on mucosal barrier injury. MethodA total of 108 patients were randomly assigned into observation （54 cases） and control （54 cases） groups. Both groups were treated with mesalazine enteric-coated tablets， 0.5 g/time， 3 times/d. In addition， the observation group received Jiechang Buxu pills， 10 g/time， 3 times/d， and the control group received simulant of Jiechang Buxu pills， 10 g/time， 3 times/d. Both groups were treated for 3 consecutive months. During monthly follow-up， clinical response， clinical remission rate， C-reactive protein （CRP） compliance rate， fecal calprotectin （FC） compliance rate， and endoscopic mucosal healing rate were compared. The early recurrence rate was recorded after 3 months of follow-up. The modified Mayo score， mucosal histological score， colonoscopic mucosal score， inflammatory bowel disease questionnaire （IBDQ） score， and syndrome score of spleen-kidney Yang deficiency were compared before and after treatment. The levels of hypoxia-inducible factor-1α （HIF-1α）， diamine oxidase （DAO）， D-lactic acid （D-LA）， interleukin（IL）-1β， IL-6， IL-17A， IL-22， tumor necrosis factor-α （TNF-α）， T helper 17 （Th17）， and regulatory T cells （Treg）， and Th17/Treg ratio were measured and calculated before and after treatment. ResultThe clinical response rate， clinical remission rate， and CRP compliance rate in the observation group were higher than those in the control group （P<0.05， P<0.01） 1， 2 and 3 months after treatment. The FC compliance rate in the observation group was higher than that in the control group （P<0.05） 2 and 3 months after treatment. After treatment， the observation group had higher endoscopic mucosal healing rate （P<0.01） and lower early recurrence rate （P<0.05） than the control group. In addition， the observation group had lower Mayo score， mucosal histological score， colonoscopic mucosal score， and syndrome score of spleen-kidney Yang deficiency （P<0.01）， higher IBDQ score （P<0.01）， lower levels of HIF-1α， DAO， D-LA， IL-1β， IL-6， IL-17A， TNF-α， Th17， and Th17/Treg and higher levels of IL-22 and Treg （P<0.01） than the control group. ConclusionJiechang Buxu pills combined with mesalazine enteric-coated tablets can improve the clinical response rate， clinical remission rate， CRP compliance rate， FC compliance rate， and endoscopic mucosal healing rate， reduce the early recurrence rate and disease activity， promote histological remission， and improve the quality of life in the patients with chronic relapsing ulcerative colitis （syndrome of spleen-kidney Yang deficiency）. The therapy may exert the therapeutic effect by inhibiting inflammation， inducing intestinal mucosal immune tolerance， and protecting the function of intestinal mucosal barrier.

A 38-year-old female presented with irregular menstruation and hirsutism that started at age of 16 and diagnosed with polycystic ovary syndrome at age of 29 with elevated testosterone. When treated with ethinestradiol cyproterone tablets, her menstruation returned to normal and androgen levels was not changed. At age of 38 she was referred to the hospital with infertility, a diagnosis of nonclassical 21-hydroxylase deficiency was confirmed using 17-hydroxyprogesterone, dehydroepiandrosterone-sulfate, a cosyntropin-stimulation test and genetic test. This case suggested that nonclassical congenital adrenal hyperplasia should be considered when a patient is presented with oligomenorrhea, hirsutism with hyperandrogenemia and infertility.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.