Ojective To evaluate the value of computed tomographic angiography (CTA) in the diagnosis of intracranial aneurysml with acute subarachnoid hemorrhage and in making a surgical plan. Methods CTA was performed using Helical CT in sixty three cases of acute subarachnoid hemorrhage Results Twenty four patients with intracranial aneurysms were found by CTA, one case of aneurysm was found by DSA. Diagnostic results were confirmed by operation. Conclusion CTA is a rapid?safe and accurate method in the diagnosis of intracranial aneurysms, particularly for acute and severe patients.

Objective To evaluate the CT value in diagnosis and differential diagnosis of splenic tumors.Methods 52 cases of splenic tumors were examined by plain and contrast-enhanced CT scan.27 cases of splenic tumors were confirmed by operation and pathology,25 cases were definited by clinical history and having typical imaging signs.Results There were 18 benign and 34 malignant tumors.Most of benign splenic tumors appeared as single or multiple low dense nodus with different size,one hemangioma was isodense.Calcifications could be showed in splenic hemangioma and lymphangioma.Homogeneous and marked enhancement occurred in hemangiomas at delayed-phase,no or slightly enhanced in the septum of splenic lymphangiomas,and the cysts had no enhanced.The malignant tumors of spleen were bigger in size mostly with unhomogeneous density,and unhomogeneous enhancement could be seen at contrast-enhanced CT scan.Uneven enlargement of spleen was commonly seen in patients of splenic lymphoma and the lesions were multiple in a most of cases,and had not enhancement obviously.Conclusion Splenic tumors can be diagnosed correctly in most patients based on the features of plain and contrast-enhanced CT in combination with clinical history and the other examinations.

Objective To investigate the CT and MRI features of solid-cystic papillary tumors(SCPTs) of the pancreas.Methods Eight cases of SCPTs confirmed by operation and pathology underwent both plain and contrast-enhanced CT examination,and MR examination in three cases and contrast-enhanced MRI in two cases.Results In the eight patients,the mean tumor diameter was 7.6 cm and the lesions were found mainly in the body and tail of the pancreas,only one at the pancreatic head.On plain CT scan,the tumors appeared as huge solid-cystic mass with definite margin and an integritied capsul,the solid areas were papillary or irregular components,and the cystic areas in central were low attenuation.On contrast-enhanced CT,the cystic wall and solid part were slight enhancement in arterial phase,and moderate or obvious enhancement in parenchymal phase.Irregular ringed and punctate calcification could be seen in five cases,the acute hemorrhage occurred in one case,slight dilation of the pancreatic duct was noticed in one patient.MRI showed an ovoid solid-cystic mass of the pancreas with distinct border.On T1WI,heterogeneous iso-and hypo-intensity was observed.One case showing the high signal intensity in tumor was subacute hemorrhage.On T2WI,the tumors were mixed hypo-,iso-and hyperintensity.The papillary or flocculent solid portion and the cystic wall were enhanced after gadolinium was used.Conclusion SCPTs is of certain clinic,CT and MRI characteristic findings,which can aid in reaching a proper diagnosis.

Objective To study the molecular genetic background of Bel subtype at ABO blood group.Methods Three samples and fifteen samples were diagnosed as Bel subgroup and normal control samples by serological test,respectively.The extracted DNA was genotyped by sequence specific primer- polymerase chain reaction foilowed by sequencing for Exon6 and exon7 at ABO locus and clones were sequenced.Results A novel Bel variant allele(GenBank EF117687) was identified in a Bel individual.The Bel allele was different from the regular B101 allele by single 952G>A missense mutation in exon7.resulting in an amino acid subsfitution of Val for Met at 318 locus.No mutations were detected in the fifteen control samples and the other two Bel allele samples.Conclusions The mutation position was fimt found to lie on coding region of ABO gene behind nucleotide 930.The mutation of G952A in the al,3 galactosyhransferase gene may be one of the molecular genetic basis of Bel ohenotype.

ObjectiveTo investigate the misdiagnostic reason and treatment of the syndrom of splenic flexure of colon(SSFC). MethodsThe clonical data of 21 patients with SSFC admitted from May 1993 to May 2001 were retrospectively analysed. ResultsThese patients aged from 51 to 88 years old with a median age of 67.8years.Clinical manifestalion was repetitive stomach pain, abdominal distension, constipation, etc. Double contrast radiology of colon demonstrated that too high fixation site of colon of splenic flexure, volvulus of colon of splenic flexure, and displacement of colon usually occurred together with transverse or sigmoid colon redundant.All of them were cured by cololysis of colon of splenic flexure, redundant partial colectomy and managing other companying diseases.Postoperative pathological diagnoses were chronic colitis.Followed up was done for 6 months to 6 years, all of them released from primary symptoms. ConclusionsThe main misdiagnostic reason of SSFC is less understanding of SSFC and did not take double contrast radiology of colon. By way of cololysis of splenic flexure, redundant colon resection and managment other companying abdominal diseases, most patients with SSFC may expect satisfactory treatment effects.

Objective To investigate the clinical value of serum soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) in the treatment and therapeutic effect evaluation of patients with an exacerbation of chronic obstructive pulmonary disease.Methods The levels of serum sTREM-1,procalcitonin (PCT) and C-reactive protein (CRP) were determined by enzyme-linked immunosorbent assay (ELISA) in 49 exacerbation of chronic obstructive pulmonary disease (COPD) subjects [acute exacerbation of chronic obstructive pulmonary disease (AECOPD) group],49 stable COPD subjects(sCOPD group) after treatment and 49 healthy volunteers as healthy control group.The levels of sTREM-1,PCT and CRP in different groups were compared and the relationship between the level of sTREM-1 in AECOPD and sCOPD groups,and PCT,and CRP was analyzed,respectively.Results The content of sTREM-1,PCT and CRP between different groups had significant difference(P ＜0.05).The level of sTREM-1 in both AECOPD and sCOPD groups was significantly positive correlated with PCT (P ＜ 0.05) and negative correlated with CRP (P ＞ 0.05).Conclusions For guiding the treatment and curative effect evaluation of patients with AECOPD,sTREM-1 has important clinical reference value.

BACKGROUND: Microsatellite instability (MSI), an important gene change type, plays animportant role in the occurrence of tumor. Mismatch repair gene induces its occurrence. Although the effect of mismatch repair gene hMLH1 mutation in the hereditary nonpolyposis colorectal cancers (HNPCC) has been reported, its effect on the sporadic colorectal carcinoma lacks in-depth study.OBJECTIVE: To investigate the effect of mismatch repair gene hMLH1 mutation on colorectal carcinogenesis, and its correlation with MSI.DESIGN: Single-sample experiment.SETTING: Department of Gastroenterology, Southwest Hospital of Third Military Medical University of Chinese PLA.PARTICIPANTS: Seventy-six cases of sporadic colorectal carcinoma and corresponding normal tissues were obtained from surgically resected specimens of coloreetal carcinoma in Southwest Hospital between January 2001and December 2003. No patients had family history of tumor, or had received radiotherapy and chemotherapy. Patients were informed of the experiment.METHODS: Mutation of hMLH1 was detected by two-dimensional electrophoresis and DNA sequencing; MSI was analyzed by PCR-based methods.MAIN OUTCOME MEASURES: ① Detection rate of hMLH1 mutation of colorectal carcinoma and MSI. ② The relationship of MSI and hMLH1 mutation.RESULTS: Seventy-six cases of sporadic colorectal carcinoma were studied for hMLH1 mutation and MSI. hMLH1 mutation was detected in 8 (10.5%) cases of colorectal carcinomas while MSI was detected in 20 (26.3%) cases of colorectal carcinomas. Frequency of hMLH1 mutation and MSI was significantly higher in right colorectal cancer than in left colorec tal cancer (6/26 vs 2/50, x2=4.739, P=0.029; 11/26 vs 9/50,x2=5.212,P=0.022). No association was observed between hMLH1 mutation or MSI and tumor size, differentiation, histological type, depth of invasion, metastasis or clinical pathological stages. ② MSI was divided into high-frequency group (≥ 2 loci, n=10) and low-frequency group (1 locus, n-10), and MSI negative group (n=56). 8 hMLH1 mutations were all detected in high frequency MSI group, but no mutation was found in low frequency MSI or MSI negative groups.CONCLUSION: hMLH1 mutation and MSI occur in cancer of the right large intestine and hMLH1 mutation is involved in carcinogenesis of some sporadic colorectal cancer with high-frequency MSI.

We conducted the detection the Francisella spp.nucle acid from Hyalomma asiaticum asiaticum that main distribution is on railway line area from China-Kazakhstan border.The free-living ticks were collected and then identified by morphological and molecular methods.After species identification,they were detected by PCR targeting 16S rRNA and sdhA of Francisella spp.The amplified products were sequenced and the sequences was analyzed by using the Blast.A phylogenetic tree was constructed using MEGA 6 software.A total of 243 fleas were identified as H.asiaticum asiaticum.Only 35 samples were detected for Francisella spp.positive and the positive rate was 14.4％.Sequence analysis showed that two different sequences (seql and seq2) and all belong to Francisella-like endosymbionts (FLEs).Phylogenetic analyses showed that two FLEs were belong to the same cladd.This is first detection of FLEs nucleic acid from H.asiaticum Railway line area of China-Kazakhstan border.

Objective To investigate the sleep quality and the risk factors for sleep disorders in population at high-risk for stroke:.Methods A cross-sectional survey was conducted in population at highrisk for stroke:in Water Park and Wangdingdi Communities,Nankai District,Tianjin in March 2016.The residents were divided into either a good sleep group or a sleep disorder group according to the Pittsburgh Sleep Quality Index (PSQI).Multivariate logistic regression analysis was used to determine the risk factors affecting sleep quality.They also divided into a stroke history group and a non-stroke history group according to the high-risk population with or without previous history of stroke.The sleep quality was compared between the 2 groups,and the correlation between sleep disorders and stroke outcomes was analyzed.Results A total of 565 residents at high-risk for stroke were enrolled in the study,and 178 01.5％) had sleep disorders.The age in the sleep disorder group was significantly older than that in the good sleep group (66.70 ±8.97 years vs.62.87 ±9.46 years;t =4.540,P＜0.001).The proportions of female (68.0％ vs.49.1％;x2 =16.190,P ＜ 0.001),hypertension (69.7％ vs.57.9％;x2 =7.154,P =0.005),ischemic heart diseases (48.9％ vs.35.4％;x2 =9.253,P =0.002),history of previous stroke or transient ischemic attack (TIA) (30.9％ vs.18.9％;x2 =10.080,P =0.001),and carotid plaques (71.9 vs.53.7％;x2 =16.688,P ＜0.001) in the sleep disorder group were higher than those in the good sleep group.Multivariate logistic regression analysis showed that after adjusting for age and sex,the history of previous stroke or TIA (odds ratio [OR] 1.712,95％ confidence interval [CI] 1.105-2.653;P =0.016),and carotid plaques (OR 1.583,95％ CI 1.003-2.498;P =0.048) were the dependent risk factors for sleep disorders.The total score of PSQI in patients with previous stroke was significantly higher than that in patients without previous stroke (7.25 ±4.71 vs.6.13 ±4.20,t =-2.578,P =0.010).The sleep latency score (1.24 ± 1.06 vs.0.95 ± 1.02;t =-2.868,P =0.004) and sleep disorder score (1.23 ± 0.63 vs.1.07 ± 0.61;t =-2.622,P =0.009) in patients with previous stroke history were significantly higher than those without.According to the modified Rankin Scale scores,the patients with a history of stroke were divided into a good outcome group (0-2) and a poor outcome group (＞2),including 105 (82.0％) and 23 patients (18.0％),resectively.The proportion of patients with sleep disorders (78.3％ vs.35.2％;x2 =14.251,P＜0.001) and the PSQI score (median and four percentile interval:6 [3-8] vs.12 [8-18];Z =-4.392,P ＜0.001) in the poor outcome group were significantly higher than those in the good outcome group.Conclusions The incidence of sleep disorder is high in the high-risk population,the previous stroke or TIA history and carotid plaques are the independent risk factors for sleep disorder in the high-risk population,and sleep disorder is associated with the poor outcomes of strokes.Therefore,attention should be paid to the sleep quality of this stroke high-risk population and control the risk factors of causing sleep disorders,especially for those with a history of stroke.This will help reduce the risk of stroke.

Objective:To analyze the characteristics of adults (non-pregnant women) infected with Listeria monocytogenes and to provide evidence for diagnosis and treatment of this disease. Methods:Patients admitted in West China Hospital of Sichuan University between January 2008 and April 2020 with Listeriadisease were enrolled in this study. The clinical data of patients including age, symptoms, underlying diseases and prognosis, as well as the laboratory results of WBC, neutrophil ratio (N%), procalcitonin (PCT), interleukin-6 (IL-6) and C-reactive protein (CRP), were obtained for analyzing the clinical infection and prognosis characteristics of the patients. Results:A total of 57 patients were included, patients were 18-83 (52.8±15.9) years old, percent of over 60 years old patients accounted for 35.09% (20/57). The incidence rate in summer season was the highest (45.61%, 26/57). There were 48 cases with comorbidities, sepsis occurred in 31 cases and meningitis in 18 cases. The time of diagnosis of Listeriosis was (6.1±2.9) days. After diagnosis, the target therapy was applied: such as carbapenem (26.32%, 15/57) and penicillins (22.81%, 13/57). The levels of WBC (6.77 [2.99, 9.54]×10 9/L vs 10.23 [6.71, 16.55]×10 9/L), NLR (3.07 [1.66, 8.16] vs 11.26 [5.66, 20.08]) and CRP (40.7 [16.9, 91.9] g/L vs 92.8 [59.9, 142.7] g/L) were significantly lower after treatment than those before treatment in 47 hospitalized patients (all P<0.05). Thirty-eight patients were treated according to the guidelines, 33 cases improved, 2 cases had poor prognosis and 2 cases died. Conclusion:The main risk factors of Listeria monocytogenes infection in adults (non-pregnant women) are underlying diseases, especially autoimmune diseases and pulmonary infections. Penicillins can be used as the first choice for empirical therapy. Carbapenems and erythromycin serve as the combination medications during the full course of treatment.