Objective To evaluate the feasibility of dual-source computed tomography(DSCT)coronary angiography in a population with premature heart-beats.Methods Seventy patients with suspected coronary artery disease and premature heart-beats were routinely imaged on a DSCT scanner(Somatom Definition,Siemens AG,Germany).The images were reconstructed before and after ECG editing.Two readers independently assessed image quality of all coronary segments using a four-point grading scale from excellent(1)to non-assessable(4).The results ofthe two groups were compared with a paired t-test,and a P value of less than 0.05 Was considered significant.Results The mean heart rate during examination ranged from 49 to 111 bpm[mean(70.7±12.4)bpm].Twenty-eight of 70 patients with relatively small variability of the heart rate[(41.0±18.4)bpm]got diagnostic image quality without ECG editing.In other 42 patients with larger variability of the heart rate[(71.4±28.7)bpm],the meal image quality scores were 2.09±1.27 and 1.50±0.79 before and after ECG editing,there Was a significant difference(t=13.764,P＜0.01).The proportion of non-assessable segments Was reduced from 24.8%(154/620)to 3.4%(21/620)through ECG editing(X2=121.846,P＜0.01).Finally,the diagnostic image accounted 98.0%(1014/1035)in all segments of 70 patients.Conclusion DSCT can provide diagnostic images for patients with premature heart-beats.The image quality in patients with larger variability of the heart rate can be significantly improved through ECG editing.

Objective To evaluate the clinical effectiveness of early interfering of yellow-water on Deep Venous Thrombosis (DVT) in lower extremities of hip fracture patients after operation. Methods 60 patients with hip fracture were recruited into a control group and a treatment group randomly. The control group was treated with low molecular heparin,while the treatment group was treated additionally with yellow-water on that basis. The status of pain, swelling levels, vascular color doppler ultrasound and safety of medication were reviewed after two weeks. Results There was 23.3% cure rate and 60.0% significant improvement rate in the treatment group, and 13.3% cure rate and 40.0% significant improvement rate in the treatment group. The therapeutic effect in the treatment group was better than the control group, with significant difference (P＜0.05 ) . Conclusion Yellow-water was effective in early interfering in DVT in lower extremity due to its quickness in eliminating swelling and alleviating pains with no stimulus feeling.

Diffuse intrinsic pontine glioma( DIPG)is a highly invasive tumor located in the pons (middle)of the brain stem. They are usually diagnosed during childhood and account for 10% -15% of primary brain tumors in children. DIPG has a very poor prognosis. Fewer than 10% of DIPG patients survive more than 2 years after diagnosis. The imaging manifestations of DIPG are typical,and biopsy is only performed in atypi-cal cases. The tissue specimens of newly diagnosed DIPG are very few and limit its molecular biological research. Recent advances in surgical and molecular-analytic techniques have increased the safety of biopsy which has already been used in many clinical trials step by step. The research of DIPG′s molecular pathogenesis and treatment is sure to achieve new breakthroughs.

Objective To compare the clinical utility of alpha-fetoprotein (AFP) and des-gammacarboxyprothrombin (DCP) in diagnosing hepatocellular carcinoma (HCC) in patients with a hepatic mass.Methods From January 2015 to May 2015,141 patients were diagnosed to have a liver tumor after imaging examinations in the Hepatobiliary Surgical General Hospital of PLA,Beijing,China.Preoperative AFP and DCP were measured using commercial assay kits.The reference standard was either pathologic or clinical diagnosis of HCC.The performance of AFP and DCP in diagnosing HCC was determined using receiver operating characteristic curve analysis.Results Of 141 patients,98 were diagnosed to have HCC and 43 without.The levels of AFP were significantly higher in patients with HCC than those without [80.0(3.9-1 375.0) μg/L vs.2.1 (1.6-3.2) μg/L,Z =6.98,P ＜ 0.01].Similar results were observed in the levels of DCP [141.5 (24.0-978.0) AU/L vs.19.0 (14.0-25.5) AU/L,Z =5.18,P ＜ 0.01].Receiver operating curves (ROC) indicated the cut-off value with the best sensitivity and specificity was 3.6 μg/L for AFP and 35 AU/L for DCP.The difference in the area under ROC between AFP and DCP was not statistically significant (0.87 vs.0.78,Z =1.72,P =0.085).The sensitivity and specificity for detection of HCC in patients with a hepatic mass were 56.1％ and 95.4％ for AFP ＞ or =20 μg/L,69.4％ and 83.7％ for DCP ＞ or =40 AU/L,respectively.The level of AFP was associated with DCP in patients with HCC (x2 =9.12,P ＜ 0.01,r =0.292) and parallel testing of AFP and DCP gave an optimal sensitivity of 79.6％ with a specificity of 81.4％ in diagnosing HCC.Conclusions DCP is a useful biomarker and it gave an equal performance as AFP in diagnosing HCC in patients with a liver mass in this study.Parallel testing of AFP and DCP effectively increased the diagnostic sensitivity.Although the biomarkers only marginally improved the diagnostic results,it could be useful in diagnosing HCC in individuals who had atypical imaging results.

ObjectiveTo evaluate the impact of patient's heart rate(HR)on coronary CT angiography(CTA)image quality(IQ)and reconstruction timing in dual-source CT(DSCT).Methods Ninety-five patients with suspicion of coronary artery disease were examined with a DSCT scanner(Somatom Definition.Siemens)using 32×0.6 mm collimation.All patients were divided three groups according to the heart rate(HR):group 1,HR≤70 beats per minute(bpm),n=26;group 2,HR＞70 bpm to≤90 bpm, n=37;group 3,HR＞90 bpm,n=32. No beta-blockers were taken before CT scan.50-60 ml of nonionic contrast agent were injected with a rate of 5 ml/s. Images were reconstructed from 10%to 100% of the R-R interval using single-segment reconstruction. Two readers independently assessed IQ of all coronary segments using a 3-point scale from excellent(1)to non-assessable(3)for coronary segments and the relationshiD between IQ and the HR. ResuitsOverall mean IQ score was 1.31 ±0.55 for all patients with 1.08±0.27 for group 1,1.32±0.58 for group 2 and 1.47±0.61 for group 3. The IQ was better in the LAD than the RCA and LCX(P＜0.01).Only 1.4%(19/1386)of coronary artery segments were considered non-assessable due to the motion artifacts.Optimal image quality of all coronary segments in 74 patients(77.9%)can be achieved with one reconstruction data set.The best IQ was predominately in diastote(88.5%)in group 1,while the best IQ was in systole(84.4%)in group 3. ConclusionsDSCT can achieve the optimal IQ with a wide range of HR using single-segment reconstruction. With the increasing of HR,the timing of data reconstruction for the best IQ shifts from mid-diastole to systole.

Aim To investigate the possible mecha-nisms of the levels of NO decrease induced apoptosis in human placental trophoblast cells. Methods Human placental trophoblast cells ( HTR-8 ) were cultured in 5 ml DMEM-F12 culture medium with 37℃ 5% CO2 . Then, the old culture medium was discarded and re-placed with 10,100,500,1 000 μmol·L-1 L-NAME, and the group without L-NAME was set as the control group, cultured for 48h. The effects of L-NAME on the survival of cells were detected by methylthiazolyldiphe-nyl tetrazolium bromide ( MTT); the content of NO in cells was tested by nitrate reductive enzymatic;trans-mission electron microscopy, flow cytometry analysis and Annexin-V FITC dyeing were used to test the effects of L-NAME on apoptosis in HTR-8 cells;restore Fe3+ colorimetric assay was applied for detection of to-tal antioxidant capacity ( T-AOC ) , xanthine oxidase for detection of superoxide dismutase ( SOD) activity, and thiobarbituric acid colorimetry for determination of content of MDA. Results Compared with the control group, the survival rate of HTR-8 cells and the levels of NO in 100,500,1 000 μmol·L-1 L-NAME group were significantly reduced(P<0.05,P<0.01). Flow analysis and Annexin-V FITC staining showed that L-NAME could induce cell apoptosis in a dose-dependent manner. The number of cell apoptosis was negatively correlated with the content of NO ( r = -0.5210 ) in HTR-8 cells. Transmission electron microscopy results showed that compared with the control group, the ex-perimental group's cell nucleus shape was irregular, nuclear pyknosis in irregular shape, the chromatin ag-glutination or side the collection, mitochondrial swell-ing or enrichment, crest fracture or dissolved, even vanished, forming the vacuole, especially in 100 μmol ·L-1 L-NAME group, the apoptotic bodies obviously appeared. At the same time, T-AOC, SOD levels in HTR-8 cells decreased ( P <0.05 ) , and the MDA content increased ( P<0.05 ) . The number of cell ap-optosis was negatively correlated with the level of T-AOC ( r= -0.3212 ) , SOD ( r= -0.2779 ) in HTR-8 cells , while positively correlated with the content of MDA(r=0.2807). Conclusion Oxidative stress may play an important role in the levels of NO decrease in-duced apoptosis in human placental trophoblast cells.

Aim To explore the role of ERO1 αand its DNA methylation in homocysteine (Hcy)-induced in-hibition of hepatocytes proliferation.Methods The hepatocytes stimulated with 0 μmol·L -1 Hcy were set as the normal group (NC group)and the hepatocytes stimulated with 1 00 μmol·L -1 Hcy as the experimen-tal group (Hcy group).Methyl thiazolyl tetrazolium (MTT)reduction assay was used to reflect the prolifer-ation of the hepatocytes;qRT-PCR and Western blot were used to detect the mRNA and protein levels of ERO1 α;the expression of green fluorescence protein was observed in hepatocytes after the recombinant plas-mid of ERO1 α was constructed,which was used to confirm if the recombinant plasmid into hepatocytes was successful,then the mRNA and protein levels of ERO1 αwere assayed and the proliferation of the hepa-tocytes was also detected;ntMSP was used to detect the change of ERO1 αDNA methylation.Results The mRNA and protein levels of ERO1 αwere decreased in Hcy group compared with NC group,and the prolifera-tion activity of hepatocytes in Hcy group was de-creased.Sequencing result showed that the recombi-nant plasmid of ERO1 αwas constructed successfully. QRT-PCR and Western blot revealed that ERO1 αwas overexpressed. The result of MTT suggested that ERO1 αoverexpression restored hepatocyte proliferation inhibited by Hcy.Hcy caused ERO1 αDNA hyperm-ethylation.Conclusions Hcy inhibits hepatocyte pro-liferation by downregulating the expression of ERO1 α, and methylation of ERO1 αpromoter may play a role in this process.

Objective To summarize the clinical characteristics of papillary thyroid microcarcinoma with diameter ≤ 5 mm. Methods The clinical data of 259 papillary thyroid microcarcinoma patients who had underwent radical thyroidectomy from January 2015 to December 2017 were retrospectively analyzed. The patients were divided into 2 groups according to the preoperative tumor diameter: ＞5 mm group (88 cases) and ≤ 5 mm group (171 cases); then according to the lymph node metastasis, the 2 groups were divided into non-lymph node metastasis sub-group and lymph node metastasis sub-group. The reason of lymph node metastasis was analyzed. Results There were no statistical difference in gender composition, age and combined Hashimoto thyroiditis rate between ＞5 mm group and≤5 mm group (P＞0.05). The rates of T3-4 stage, N1a-1b stage and multifocal tumors in＞5 mm group were significantly higher than those in ≤ 5 mm group: 34.1% (30/88) vs. 18.7% (32/171), 45.5% (40/88) vs. 22.8% (39/171) and 39.8% (35/88) vs. 22.8% (39/171), and there were statistical differences (P＜0.05 or＜0.01). In＞5 mm group, lymph node metastasis sub-group had 40 cases, non-lymph node metastasis sub-group had 48 cases; the rate of T3-4 stage in lymph node metastasis sub-group was significantly higher than that in non-lymph node metastasis sub-group: 55.0% (22/40) vs. 16.7% (8/48), and there was statistical difference (P＜0.01). In≤5 mm group, lymph node metastasis sub-group had 39 cases, and non-lymph node metastasis sub-group had 132 cases; the rate of T3-4 stage in lymph node metastasis sub-group was significantly higher than that in non-lymph node metastasis sub-group:51.3% (20/39) vs. 9.1% (12/132), and there was statistical difference (P＜0.01). In＞5 mm group and≤5 mm group, there were no statistical difference in gender composition, age, combined Hashimoto thyroiditis rate and multifocal tumors rate between 2 sub-groups (P＞0.05). Conclusions The clinical behavior of papillary thyroid microcarcinoma with diameter ≤ 5 mm has a less aggressive nature compared to that＞5 mm. Tumor capsular invasion or extra thyroidal extension has a great influence on lymph node metastasis in thyroid papillary microcarcinoma of different diameter.

Objective:To investigate the ocular characteristics and treatment prognosis of ocular immune reconstruction inflammatory syndrome (IRIS) in patients with cytomegalovirus retinitis (CMVR) complicated with acquired immunodeficiency syndrome (AIDS).Methods:A serial case-observational study was conducted.Seventeen eyes from 15 male 21-to 43-year-old AIDS patients combined with CMVR, who were diagnosed with IRIS at Beijing You'an Hospital, Capital Medical University from February 2016 to December 2018 were included.The best corrected visual acuity (BCVA) of patients was recorded, and the intraocular pressure and anterior segment was measured with a non-contact tonometer and a slit-lamp microscope, respectively.The ocular fundus was observed by fundus photography and optical coherence tomography (OCT). Reverse transcription polymerase chain reaction was used to measure the cytomegalovirus deoxyribonucleic acid (CMV-DNA) content in the aqueous humor during the occurrence of IRIS.The flow cytometry was employed to determine the peripheral blood CD4 + T lymphocyte count before highly active antiretroviral therapy (HAART) and during the occurrence of IRIS.All patients were followed for 3 to 25 months, with an average of 15 months.The HAART time of patients was 17 to 104 days, with an average of (66.1±27.4) days.Patients with anterior segment inflammatory reactions were given the anti-inflammatory and mydriatic treatment.Patients with severe vitreous opacity were intravitreally injected with 4 mg of triamcinolone.Patients with macular edema were given 0.5 mg intravitreal injection of conbercept.The study adhered to the Declaration of Helsinki and was approved by an Ethics Committee of Beijing You'an Hospital, Capital Medical University (No.[2017]11). Written informed consent was obtained from each patient prior to any examination. Results:Anterior segment inflammation (Tyndall effect, KP, post-iris adhesion) was found in 9 eyes, vitreous opacities to varying degrees in 11 eyes, and macular edema in 2 eyes.The CMV-DNA content was negative (<500 copies/ml) in 15 eyes.The CD4 + T lymphocyte count in peripheral blood during IRIS was 67 (51, 99) cells/μl, which was significantly higher than 17(6, 20) cells/μl before HAART treatment ( Z=-4.48, P<0.01). Two of the 15 AIDS patients had tuberculosis.The BCVA of the patients was improved from 0.30 (0.10, 0.55) before treatment to 0.50 (0.35, 0.60) after treatment, and the difference was statistically significant ( Z=-2.34, P=0.019). Conclusions:The anterior and posterior segment may be involved in IRIS patients with AIDS and CMVR, and the corresponding ocular treatment is effective.

Objective:To explore the efficacies of bevacizumab monotherapy and combination therapy of bevacizumab with irinotecan, semustine and cisplatin in patients with recurrent high-grade glioma.Methods:Seventy patients with recurrent high-grade glioma admitted to our hospital from January 2011 to November 2019 were chosen in our study; 38 patients received bevacizumab monotherapy, 13 patients accepted bevacizumab and semustine combination therapy, 11 patients received bevacizumab and cisplatin combination therapy, and 8 patients accepted bevacizumab and irinotecan combination therapy. Survival statuses (progression-free survival [PFS] and overall survival [OS]) of these patients were retrospectively analyzed.Results:The median OS and median PFS of the enrolled patients were 12.83 months and 6.23 months, respectively. The median OS and median PFS of patients accepted bevacizumab monotherapy were 10.92 months and 5.03 months, respectively. The median OS and median PFS of patients accepted bevacizumab and semustine combination therapy were 16.30 months and 6.77 months, respectively. The median OS in patients accepted bevacizumab and irinotecan combination therapy and patients accepted bevacizumab and cisplatin combination therapy was 11.90 months and 14.40 months, respectively.Conclusion:Bevacizumab by different therapy methods enjoys good efficacy; bevacizumab monotherapy or combination therapy can be recommended for recurrent high-grade glioma.