Objective To investigate the value of magnetic resonance (MR) imaging for diagnosing typeⅠ congenital choledochocele and its complications. Methods The MR imaging data of 13 cases with proved typeⅠ congenital choledochocele associated with complications were retrospectively reviewed and compared with operative findings. MR imaging sequences included axial T2W and T1W plain scan, true-FISP coronal images, 2D-MRCP, and Gd-enhanced T1W images. Results All patients had cystic dilatation of the common bile ducts to various degrees. In 6 patients complicated with stone and infection, the bile duct showed uniform wall thickening with marked enhancement, and calculus were depicted within the duct lumen with dilatation of the proximal biliary duct. In 7 cases complicated with carcinoma of biliary duct, a polypoid soft tissue mass or nodule was seen inside the ductal lumen in 3 cases, or the duct wall was irregularly thickened in 4 patients. Six cases received curative operation, but one patient with extensive local infiltration, vascular encasement and lymphadenopathy had only palliative treatment. MR imaging observations were verified by surgery findings in all 13 patients. Conclusion MR imaging is very valuable not only in diagnosing typeⅠ congenital choledochocele, but also in revealing its complications.

Objective To analyze and identify the chemical composition in water extracts from Hugu capsule and provide evidence for its pharmacological study and quality control. Methods A HPLC-DAD method was used. The separation was performed on Kromasil C18 column with acetonitrile and 1%glacial acetic acid as mobile phase by gradient elution at a flow rate of 0.8 mL/min. The chemical composition in water extracts from Hugu capsule were identified by comparison with the related chromatographic fingerprint. Results Thirteen characteristic peaks were found in the HPLC chromatographic fingerprint, and four peaks were identified. Conclusion The HPLC-DAD fingerprint expressed the general character of the chemical composition in water extracts from Hugu capsule. It can be used for qualitative analysis of water extracts from Hugu capsule, and improve the quality of Hugu capsule.

Objective To improve the diagnosis of cytomegalovirus pneumonia in patients who have undergone kidney transplantation. Methods The CT appearances of 10 cases were retrospectively analyzed. Results Ground glass opacity was seen in all cases, and disseminated several lobes were seen in 7 cases, diffuse distribution was seen in 3 cases. In addition,lung fibrosis happened in 3 cases,nodule in 2 cases,and consolidation in 3 cases.Conclusion Multi-slice CT could provide very valuable information for early diagnosis of cytomegalovirus pneumonia.

Objective To evaluate the value of 16-slice spiral computed tomography(SCT)in diagnosing acute aortic syndrome.Methods Thirty-four cases with acute aortic syndrome underwent 16-slice SCT,performed with unenhanced,contrast-enhanced scanning of bolus tracking and three-dimensional reconstruction.The CT findings of these cases were analysed.Results Twenty-three of them were confirmed Aortic Dessection(AD),the true and false lumen,intimal flap,extent involved and complications of which were all revealed.Six cases were confirmed intramural aortic hematoma(IMH),with features of ring or crescent-shaped non-enhanced thickening wall around the aorta.Five cases were confirmed penetrating atherosclerotic ulcer(PAU),with features of niche sign outstanding the lumen of the aorta.Conclusion Acute aortic syndrome can he diagnosed exactly and completely by 16-slice SCT,which can provide valuable information to select therapeutic methods.

Objective To evaluate 16-SCT in diagnosing aeute appendicitis.Methods The CT findings of 34 cases were retrospectively analyzed.These cases were all proved acute appendicitis by surgical-pathology.Results 30 cases were confirmed by CT,with accuracy 88% (30/34).The diameter of 28 appendix was more than 6mm;2 collapsed with thickening wall.Periappendiceal fat stranding could be seen in 25 cases.Perforated appendicitis happened in 4 cases.Abscess performed in 2 cases.3 cases were missed,1 misdiagnosed.Conclusion 16-SCT could confirm acute appendicitis and its complication timely and accurately.

Objective To investigate the value of panel fluorescence in situ hybridization (panel FISH)for detection of genomic aberrations in chronic lymphocytic leukemia(CLL). Methods Five types of fluorescein-labelled DNA probes including five sequence specific probes D13S25 for 13q14. 3, RB1, p53, ATM (11 q23)and centromeric probe for chromosome (CSP12) were used to perform fluorescence in situ hybridization assays in 17 patients with CLL. Its results were compared with that obtain by conventional cytogenetic (CC)examination. Results In 17 patients with CLL, CC examination showed that only one case (1/17) was found to have chromosomal abnormality that was simultaneous trisomies 3,8 and 18, whereas panel FISH assay showed that 10 cases (10/17) were found to have genomic aberrations including deletion of D13S25 in 4 cases,deletion of ATM in 2 cases,deletion of p53 in 1 case,deletion of D13S25 combined RB1 in 1 case and 1 case with a variety of abnormalities. Conclusions Panel FISH is a useful method for detection of genomic aberration in CLL If it is combined with CC,it can obviously enhance the detection rate of chromosomal abnormalities in CLL.

OBJECTIVE:To observe the efficacy and economy of omeprazole and esomeprazole in the treatment of brain trauma and cerebral hemorrhage complicated with upper gastrointestinal hemorrhage. METHODS:The data of 110 patients with trauma cere-bral hemorrhage complicated with upper gastrointestinal hemorrhage were retrospectively analyzed and divided into omeprazole group (56 cases)and esomeprazole group(54 cases). All patients were given conventional treatment. On this basis,omeprazole group was treated with Omeprazole for injection 40 mg by intravenous infusion;esomeprazole group was treated with Esomeprazole injection 40 mg by intravenous infusion,twice a day. The treatment course for 2 groups was 5 d. The efficacy and economy of patients were com-pared. RESULTS:The total effective rates in esomeprazole group were significantly higher than omeprazole group higher,the cost-ef-fectiveness in esomeprazde group(1 397.71)were significantly lower than omeprazole group(1 512.09)(P<0.05),andΔC/ΔE=91.52. CONCLUSIONS:Esomeprazole has good efficacy,safety and economy in the treatment of brain trauma cerebral hemorrhage compli-cated with upper gastrointestinal hemorrhage.

Objective:To explore the effectiveness and safety of tirofiban in patients with reocclusive ischemic stroke after intravenous thrombolysis with alteplase.Methods:Eighty-four patients with re-occlusive ischemic stroke after intravenous thrombolysis with alteplase, admitted to our hospital from January 2018 to May 2020, were prospectively chosen; these patients were divided into tirofiban group and routine (non-tirofiban) group ( n=42). In addition to thrombolysis, patients in the routine group received intensive lipid-lowering, collateral circulation improvement, blood glucose control, and early rehabilitation therapy; after thrombolysis for 24 h, patients without intracranial hemorrhage were given oral aspirin, 0.1 g/d, for 90 d. After thrombolysis and re-occlusion, patients in the tirofiban group were intravenously pumped with 0.4 μg/(kg·min), which was changed to 0.1 μg/(kg·min) after 30 min for 24 h; at 24 h after thrombolysis, brain CT was reexamined: tirofiban was discontinued for patients with intracranial hemorrhage, and intravenous pumping of tirofiban was continued for patients without intracranial hemorrhage for 24 h. Effectiveness was evaluated by comparing the general clinical data, National Institutes of Health Stroke Scale (NIHSS) scores 7 d after treatment, and modified Rankin Scale (mRS) scores 90 d after treatment between the two groups. Safety was assessed by comparing the intracranial hemorrhage, symptomatic intracranial hemorrhage, and mortality within 90 d of treatment between the two groups. Results:There were no significant differences in age, gender, underlying diseases, risk factors, baseline NIHSS scores, time from onset to start of treatment, infarction sites, and TOAST classification between the 2 groups ( P>0.05). NIHSS scores 7 d after treatment ([10.05±4.73] min vs. [7.93±4.68] min), mRS scores 90 d after treatment (3.48±1.48 vs.2.55±1.93), and good prognosis rate 90 d after treatment (21.4% vs. 42.9%) showed significant differences between the routine group and tirofiban group ( P<0.05). In terms of safety, there were no significant differences in intracranial hemorrhage rate (4.76% vs. 7.14%), symptomatic intracranial hemorrhage incidence (2.38% vs. 2.38%) and mortality (2.38% vs. 2.38%) between the 2 groups ( P>0.05). Conclusion:It is safe and effective for tirofiban in patients with re-occlusive ischemic stroke after intravenous thrombolysis with alteplase.

Objective:To control the pandemic of coronavirus disease 2019 (COVID-19) effectively, strict isolation measures have been taken in China. Suspected patients must be isolated, and the confirmed patients specifically are isolated in negative-pressure isolation rooms. During the isolation, patients face difficulty in adapting to their surrounding environment, worry about the prognosis of the disease, lack confidence in treatment, separate from their families, and have a sense of distance from medical staff. Isolated patients may possess the feelings of negativity, including loneliness, anxiety, depression, insomnia, and despair. Hence, to reduce the risk of adverse psychological outcomes,"family member-like"care strategies were developed and implemented to solve problems associated with the COVID-19 pandemic. This study aims to examine whether using"family member-like"care strategies can improve psychological resilience and reduce depression, anxiety, and stress symptoms among patients with COVID-19 in an isolation ward.Methods: A quasi-experimental design was used to evaluate the"family member-like"care strategies for adult patients with COVID-19 in an isolation ward. COVID-19 patients in the Xiangya ward of the West District of the Union Hospital of Tongji Medical College of Huazhong University of Science and Technology in Wuhan, Hubei province, were included in this study from February 9 to March 20, 2020. Healthcare providers who volunteered as family members were assigned to patients. They practiced one-to-one care and provided continuous and whole care for the patients who were from admission to discharge. Connor-Davidson Resilience Scale-10 (CD-RISC-10) and Depression Anxiety Stress Scale-21 (DASS-21) were used to evaluate the resilience and psychological status of COVID-19 inpatients upon hospital admission, 2 weeks after admission, and at their discharge from the hospital. Results: The questionnaire response rate of the"family member-like"strategies was 100％. Of the 60 patients, 39 (65.0％) were male, and 21 (35％) were female. The hospital stay was (27.5±3.5) days. All the 60 patients were cured and discharged without any death and serious complications. The total scores for CD-RISC were 8.83±6.86 at admission, 29.13±5.42 at 2 weeks after admission, and 33.87±6.14 at discharge, which were significantly improved at the 2 follow-ups (F=404.564, P<0.001). Multivariate analysis and repeated measurements also indicated that patients experienced significant improvements in tenacity (F=360.839, P<0.001), strength (F=368.217, P<0.001), and optimism (F=328.456, P<0.001) at the 2 follow-ups. The total scores of DASS-21 were 49.27±11.30 at admission, 30.77±16.71 at 2 weeks after admission, and 4.17±11.03 at discharge, and the scores were significantly decreased at the 2 follow-ups (F=270.536, P<0.001). Multivariate analysis and repeated measurements also indicated that patients experienced significant decreases in depression (F=211.938, P<0.001), anxiety (F=285.592, P<0.001), and stress (F=287.478, P<0.001) at the 2 follow-ups.Conclusion:"Family member-like"strategies had positive effects on improving psychological resilience and reducing the symptoms of anxiety and depression of COVID-19 patients. It might be an effective care method for COVID-19 patients. It should be incorporated into emergency care management to improve care quality during public health emergencies of infectious diseases.