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 investigate the difference in influencing factors for diabetes between urban and rural residents in Hefei City, so as to provide the basis for control and research of diabetes. Methods: The residents aged 18 years and older were selected using the stratified multistage random sampling method from 5 districts (counties) in Hefei City from August to December 2021. Demographic information, smoking, self-rated health status and sleep duration were collected through questionnaire surveys. Height, body weight and fasting blood glucose were measured. The crude prevalence of diabetes was calculated and standardized by age using China Statistical Yearbook 2022. Factors affecting diabetes were identified using a multivariable logistic regression model. Results: Totally 10 443 residents were investigated, including 6 386 urban residents (61.15%) and 4 057 rural residents (38.85%). There were 4 690 males (44.91%) and 5 753 females (55.09%). Diabetes were detected in 1 492 cases, with a standardized prevalence of 9.57%. The standardized prevalence of diabetes among urban and rural residents were 9.21% and 12.58%, respectively, and the difference was statistically significant (P<0.05). Multivariable logistic regression analysis showed that region, age, educational level, occupation, body mass index and self-rated health status were influencing factors for diabetes. Further analysis stratified by urban and rural area showed that, in addition to the above factors, gender and smoking were influencing factors for diabetes among urban residents, while sleep duration was the influencing factor for diabetes among rural residents (all P<0.05). Conclusions There are urban-rural differences in the prevalence of diabetes among residents in Hefei City, and the prevalence of diabetes is associated with age, educational level, occupation, body mass index and self-rated health status.

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.

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.

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.

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.

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 evaluate the effect of modified Shengjiang Powder acupoint application on hypertension patients with phlegm-heat syndrome. Methods:A total of 61 patients in Shijiazhuang hospital of traditional chinese medicine (TCM) meeting the inclusion criteria from September 2018 to September 2019 were randomly divided into two groups, the treatment group was 30 cases, the control group was 31 cases. The control group was given Amlodipine Besylate Tablets orally, and the treatment group added modified Shengjiang Powder acupoint application, and both groups were treated for 4 weeks. TCM syndrome scores were performed before and after treatment, and 24 h ambulatory blood pressure were measured with an ambulatory blood pressure monitor, including daytime mean systolic blood pressure (dMSBP), daytime mean diastolic blood pressure (dMDBP), night time mean systolic blood pressure (nMSBP), and night time mean diastolic blood pressure (nMDBP), 24-hour mean systolic blood pressure (24 hMSBP), 24-hour mean diastolic blood pressure (24 hMDSBP) and blood pressure circadian rhythm detection. Results:After treatment, the nMSBP and 24 hMSBP in the treatment group were significantly lower than those control group ( t values were -2.331,-1.511, P values were 0.045, 0.033), the blood pressure circadian rhythm [(8.87 ± 8.33)% vs. (6.94 ± 6.12)%, t=1.034] of the treatment group was significantly higher than those of the control group ( P<0.05); mdizziness, headache, head wraps, vomiting, sputum salivation, upset, mouth pain, insomnia scores of the treatment group after treatment were significantly lower than those in the control group ( P<0.05). Conclusion:The modified Shengjiang Powder acupoint application can reduce the blood pressure level of hypertension patients with phlegm-heat syndrome, especially for the improvement of night blood pressure, and improve the clinical symptoms.