Objective To study the relationship among depression associated type 2 deabetes mellitus (T2DM) and personality and quality of life.Methods A total of 246 cases of hospitalized T2DM patients were investigated by schedule tables:self-rating depression scale (SDS),Eysenck personality questionaire (EPQ) and adjusted diabetes-specific quality of life scale (A-DQOL).According to the results of SDS,patients were divided into depression group (171 cases) and non-depression group (75 cases).Correlation analysis and regression analysis were carried out for the collected data.Results There were differences in satisfaction,influence,anxiety Ⅰ,anxiety Ⅱ,neuroticism and extraversion between the two groups(P ＜ 0.05 or P ＜ 0.01).Depression extents was related to the quality of life,neuroticism,extraversion and course(r =-0.243-0.392,P ＜ 0.05 or P ＜ 0.01).Anxiety Ⅱ,satisfaction and course enter the regression equation of depression (β =-0.205-0.322,P ＜ 0.05 or P ＜ 0.01).Conclsion Anxiety Ⅱ,satisfaction and course are key factors inducing depression in T2DM.Neuroticism and extroversion may be the predisposing personality characteristics in T2DM patients with depression.In clinical work,it is helpful for treatment by changing personality and mood of patients.

Objective To study the relationship between the grading of schistosomiasis japonica hepatic lesions by B-ultrasonography and the portal vein and splenic vein haemodynamics. Methods The grades of 125 schistosomiasis patients’ hepatic lesions were determined by Doppler ultrasonography according to the method recommended by WHO/TDR. The portal vein and splenic vein inner diameters and blood flow velocity were examined and the portal vein and splenic vein volumes of blood flow were calculated in the patients above mentioned and 51 normal persons. Results The inner diameters, blood flow velocity and volumes of blood flow of portal vein and splenic vein in the patients were significantly different from those in the normal persons, and also there were significant differences among the patients with different degrees of fibrosis. Conclusions The changes of schistosomiasis patients’ portal vein haemodynamics is connect with the liver parenchyma characteristics. The step up of the ratio of blood flow volume of splenic vein with the portal vein is breakdown with the aggravate of the hepatic lesion.

The oral and gastrointestinal opportunistic pathogen contamination was compared between tooth mugs placed upward and down-ward(n=9)for 1 4 days.Selective cultivation of the pathogens was uesd to measure the extent of contamination.The colony forming units (CFU)of colibacillus in group up and group down were 4.25 ±0.71 and 2.84 ±1 .40(P=0.046),S.mutans 89 ±0.31 and 2.84 ±1 .40 (P<0.001 ),Candida 2.28 ±1 .36 and 2.53 ±1 .92(P=0.002),fungus 2.44 ±0.99 and 0,respecitvely.Thus,tooth mug placed open-ing down is superior for health.

Objective To compare volumetric size, conformity index (CI), degree of inclusion (DI) of internal gross target volumes (IGTV) delineated on 4D-CT-MIP and PET-CT images for primary thoracic esophageal cancer. Methods Fifteen patients with thoracic esophageal cancer sequentially underwent enhanced 3D-CT, 4D-CT and PET-CT simulation scans. IGTVMIP was obtained by contouring on 4D-CT maximum intensity projection ( MIP). The PET contours were determined with nine different threshold methods (SUV≥2?0, 2?5, 3?0, 3?5), the percentages of the SUVmax(≥20%, 25%, 30%, 35%, 40%) and manual contours. The differences in size, conformity index (CI), degree of inclusion ( DI) of different volumes were compared. Results The volume ratios ( VRs) of IGTVPET2. 5 to IGTVMIP , IGTVPET20% to IGTVMIP, IGTVPETMAN to IGTVMIP were 0?86, 0?88, 1?06, respectively, which approached closest to 1. The CIs of IGTVPET2?0,IGTVPET2.5,IGTVPET20%,IGTVPETMAN and IGTVMIP which were 0?55, 0?56, 0?56, 0?54,0?55, respectively, were significantly larger than other CIs of IGTVPET and IGTVMIP (Z= -3?408-2?215,P <0?05). There were no statistical significance in the DIs of IGTVMIP and IGTVPET2.5,IGTVMIP and IGTVPET20%, IGTVMIP and IGTVPETMAN(0?77,0?82,0?71,0?67, 0?68,0?82,P>0?05). Conclusions The targets delineated based on SUV threshold setting of≥2?5, 20% of the SUVmax and manual contours on PET images correspond better with the target delineated on maximum intensity projection of 4D-CT images than other SUV thresholding methods.

Objective To analyze the volume and position of the gross tumor volumes (GTV) in primary esophageal cancer based on contrast-enhanced three-dimensional (3D),four-dimensional (4D) and cone beam (CB) computed tomography (CT).Methods A total of thirty-four patients underwent 3D-CT and 4D-CT simulation scans for computer treatment plan and contrast-enhanced CBCT scans were conducted prior to the first treatment.GTV3D,GTV4D50,internal GTVMIP (IGTVMIP) and internal GTVCBCT (IGTVCBCT) were delineated on 3D-CT,4D-CT50 (the end expiratory phase),4D-CTMIP (the maximum intensity projection),and CBCT datasets,respectively.The IGTV10 was defined as 10 respiratory phases GTVs in 4D-CT.To evaluate the difference in position,volume and the volumes encompassed characteristic.Results The significant difference was observed in the volumes [IGTV10 ＞ (IGTVCBCT or IGTVMIP) ＞ (GTV3D or GTV4D50)] regardless of the tumor location.Regarding IGTV10 as the standard volume,the underestimations or overestimations between IGTV10 and IGTVCBCT were larger than that of between IGTV10 and JGTVMIP (t =-8.294--3.192,P ＜ 0.05).However,there was no significant difference between the areas of IGTV10 which excluded in IGTVCBCT and IGTV3D (P ＞ 0.05).The GTV4D50/ IGTVCBCT ratio for upper esophageal tumors was negatively correlated to motion vector (r =-0.756,P ＜ 0.05).The centroid coordinates of IGTVCBCT in AP direction were significantly different from the test volumes (GTV3D,GTV4D50,IGTVMIP and IGTV10) (t =-3.559--2.435,P ＜ 0.05).The IGTV10/IGTVCBCT ratio was positively correlated to motion vector (r =0.695,P ＜ 0.05) for middle esophageal tumors.The centroid coordinates of IGTVCBCT were significantly different IGTV10 (t =2.201,P ＜0.05) in AP direction.For distal esophageal tumors,the significant difference was observed in the centroid coordinate between IGTVcBcT and IGTVMIP (t =-2.365,P ＜ 0.05) in LR direction.The percentage of IGTV10 excluded the IGTVcBcT were significantly correlated to the motion vector (r =0.540,0.678,P ＜ 0.05) for both middle and distal esophageal tumors.The mean MI value of IGTVCBCT to the other four test volumes ranged from 0.65 to 0.72.Conclusions CBCT has much motion information than 3D-CT but less than IGTV10.CBCT was similar to MIP images based on respiration motion.However,the target motion information encompassed in CBCT and MIP images cannot be exchanged to each other.

Objective To compare the normal thickness of the esophageal wall measured by contrast?enhanced three?dimensional ( 3DCT ) , four?dimensional ( 4DCT ) , and cone beam computed tomography ( CBCT) ,and to provide a basis for target volume delineation in esophageal cancer. Methods From 2009 to 2016,thoracic contrast?enhanced 3DCT and 4DCT simulations were performed in 50 patients with lung cancer or metastatic lung cancer. Contrast?enhanced CBCT scans were acquired during the first three?dimensional conformal radiotherapy. The normal esophageal wall was contoured on 3DCT images, the end?exhalation phase of 4DCT images ( 4DCT50 ) , the maximum intensity projection of 4DCT images (4DCTMIP),and CBCT images. The wall thickness was measured on each segment and the average thickness of esophageal wall was obtained. Comparison of the thickness of a fixed segment of esophageal wall between different CT images was made by paired t test. Comparison of thickness on the same type of CT images between different segments of esophageal wall was made by one?way analysis of variance. Results For the thoracic and intra?abdominal segments,there was no significant difference in the thickness of esophageal wall between 3DCT and 4DCT50 images ( P= 0?056?0?550 );however, the thickness of esophageal wall was significantly smaller on 3DCT images than on 4DCTMIP or CBCT images (P=0?000?0?004).For the upper and middle thoracic segments,the thickness of esophageal wall was significantly larger on CBCT images than on 4DCTMIP images ( P= 0?008, P= 0?001 ) . On 3DCT, 4DCT50 , and 4DCTMIP images, the thickness of esophageal wall was significantly larger in the lower thoracic segment than in the upper or middle thoracic segments ( P=0.008~0?041);the intra?abdominal segment had a significantly larger thickness of esophageal wall than the thoracic segments ( all P=0?000 ) . There was no significant difference in wall thickness on CBCT images between three thoracic segments ( P=0.088~0?945) . Conclusions A uniform criterion can be adopted to judge the normal thickness of esophageal wall in gross tumor volume ( GTV ) delineation on 3DCT and 4DCT50 images for thoracic esophageal cancer. However,caution should be taken when 5 mm is used as a criterion for normal thickness of esophageal wall in GTV delineation on 4DCTMIP and CBCT images.

Objective To better understand the clinical management of tumor-induced osteomalacia (TIO) by analyzing the clinical features, diagnosis, treatment, postoperative biochemical changes, and clinical status in 12 cases of TIO. Methods Twelve cases of TIO hospitalized from 2004 to April 2010 were reviewed retrospectively. All cases were diagnosed based on their clinical manifestation, hypophosphatemia, and image study including technetium-99m octreotide scintigraphy (99mTc-Oct). Resuits There were 7 males and 5 females with mean age of (41.8±9.6) years (20 to 56 years). The course of disease was from 2 to 14 years ( median course 4.0 years). They all presented with bone pain, gait disturbance, muscle pain, and muscle weakness. Serum phosphate( Pi)levels were low in 12 cases with a range from 0.30 to 0.56 mmol/L. 99mTc-Oct was performed in 9 cases and it showed that the lesions were located in head of femur, fibula, retrocalcaneal area, foot, humerus,metacarpal, posterior chest wall or near nasal bone (apex partis petrosae ossis temporalis). Subcutaneous soft tissue mass was found in another 3 cases at loin, thigh, and foot by physical examination. The tumors were confirmed by CT, MRI or ultrasonography. Twelve patients underwent operation to remove the tumors and histopathology showed hemangioendothelioma or fibrous angioma (6 cases), giant cell tumor or fibroma of tendon sheath(4 cases), liposarcoma(1case), and phosphaturic mesenchymal tumor(1case). Serum Pi levels returned to normal in 10 patients after resection of tumor. During 2 to 64 months follow up, symptoms of bone pain and muscle weakness were improved obviously. Conclusions Patients with hypophosphatemic osteomalacia should be thoroughly investigated for TIO. 99mTc-Oct and other imaging examinations can effectively locate the tumors. Once the hidden tumor is found and excised, the patient will recover and enjoy normal life with normalized Pi concentrations and marked improvement of symptoms.

A 31-year-old male normotensive patient with aldosterone-producmg adenoma complained of thirst,polydipsia,polyuria,and periodical paraplegia.The diagnosis is raised by signs of hypokalemia.Despite the lack of hypertension,primary aldosteronism was confirmed by persistent hypokalemia,increased urinary potassium,increased urinary and plasma aldosterone levels and suppressed plasma rennin activity (PRA).The blood pressure profile was studied by ambulatory monitoring,and the mean blood pressure of 24h was normal and the circadian rhythm remained normal. Surgical removal of the histologically typical aldosterone-producing adenomas normalized the kalemia.The patient had a marked fall in blood pressure with mean values of 21/17 mm Hg ( diurnal and nocturnal blood pressure were 19/17 and 22/17 mm Hg respectively)and recovery of normal urinary and plasma aldosterone levels and PRA 6 weeks after surgery.This suggests that excess serum aldosterone induced relative hypertension in those patients whose blood pressure was spontaneously very low.Our observations call for primary hyperaldosteronism assay in patients with hypokalemia and renal potassium leakage.

Objective To study gender-related differences of clinical characteristics and vascular complications in patients with aldosterone-producing adenoma(APA).Method Consecutive 315 patients with APA confirmed by pathological diagnosis were included and the clinical features and vascular complications were compared based on gender.Results (1) Of the 315 patients with APA,female accounted for 52.7％ (166/315).Male patients with APA presented a higher BMI,compared with females [(25.4± 2.9) vs (24.1 ± 3.2) kg/m2,P＜0.01],and the history of smoking and drinking was more common in male patients.No significant difference was found in regard to the age,duration,hypokalemia,tumor size,and family history of hypertension between two groups (P＞0.05).(2) No significant difference was found in the prevalence of hypertension,duration of hypertension,blood pressure,and antihypertensive medieation between two groups.However,the patients with grade 3 hypertension tended to be more prevalent in males(P =0.08).(3) Serum aldosterone concentrations were similar in two groups,but 24 h urinary aldosterone showed an increased trend in male group (P =0.07).(4) The overall prevalences of cardiovascular (51.0％ vs 36.1％) and cerebrovascular (9.4％ vs 3.0％) complications were significantly higher in male group (P ＜ 0.05).Further analysis of cardiac events revealed significantly higher rates of left ventricular hypertrophy (23.5％ vs 13.9％) and arrhythmia (21.5％ vs 10.8％) in males (P＜0.05).However,no significant difference in the prevalence between two groups was found in regard to cerebral hemorrhage,infarction,and chronic renal insufficiency.(5) The fall of blood pressure and recovery from hypokalemia were comparable between males and females in two weeks after sugery.However,in the patients with persistent hypertension,the number of antihypertensive drugs used in males was greater than that in females and more male patients needed ≥ 2 types of antihypertensive drugs.Conclusion There were significant gender-related differences with regard to clinical features and vascular complications in patients with APA.

One case of suppurative acromioclavicular arthritis caused by Staphylococcus aureuswas reported. The patient was admitted to hospital due to swelling and pain in the right shoulder, limited mobility without no obvious cause.Through medical history, physical examination, imaging examination, and local tissue bacterial culture, it was confirmed that the infection was caused by Staphylococcus aureus. After surgery and anti infection treatment, satisfactory treatment results were achieved. Through literature review, 95 cases of suppurative acromioclavicular arthritis were retrieved and analyzed from 57 articles.Among them, 26 cases (27%) were infected with Staphylococcus aureus, including 3 cases of clearly identified methicillin-resistant Staphylococcus aureus, 2 cases of methicillin-sensitive Staphylococcus aureus, and 1 case of methicillin-resistant Staphylococcus epidermidis; 13 cases (14%) of Streptococcus; There were 6 cases (6%) of special pathogens, including 2 cases of Haemophilus parainfluenzae, 1 case of Candida, 1 case of Bacillus pallidum, 1 case of Mycobacterium avium, and 1 case of Pasteurella multocida; 50 cases (53%) of specific infections with pathogens were not clearly reported. Suppurative acromioclavicular arthritis has the characteristics of difficult early diagnosis, rapid disease progression, and strong destructiveness. MRI and ultrasound have high specificity and sensitivity in the diagnosis of this disease, and ultrasound can assist in obtaining joint fluid for examination. Early identification of the pathogen is the key to the treatment of this disease. Before identifying the pathogen, antibiotics should not be used arbitrarily. After diagnosis, timely anti infection treatment should be carried out, and if necessary, surgical debridement should be performed. The vast majority of patients can achieve satisfactory and accurate treatment results after active and standardized treatment.