Objective To explore the clinical and MDCT features of pediatric irreducible intussusception. Methods 66 patients were divided into irreducible intussusception group (19 cases) and reducible intussusception group (47 cases). Age clinical courses, length of intussusception body (L), neck max diameter (D1), head max diameter (D2) andthe ratio (D2/D1) and MDCT imaging data were compared and analyzed. Results (1) The course time, L and D2/D1 values of irreducible intussusception group were significantly higher than those of reducible group, the D1 was lower than that ofreducible group, and the difference is statistically significant (P<0.05). Clinical course,L and D2/D1 value AUC values were more than 0.7, the threshold values were 33.0 h, 7.5 cm and 1.33. (2) The occurrence rate of non-ileum-colon intussusception, Meckel's diverticulum, appendicitis and intestinal necrotic for irreducible intussusception were 36.8%, 21.1%, 21.1%, 15.8%and 10.5%respectively. Conclusion Whenthe time of course>33.0 mo, D2/D1>1.33 and L>7.5 cm, the irreducible intussusceptioncould be considered, and Meckel??s diverticulum, intestinal necrosis, appendicitis and intestinal obstruction should be judged further.

Objective To evaluate the therapeutic effect of antituberculosis therapy in elderly patients with smear-negative pulmonary tuberculosis by low-dose computed tomography (CT).Methods Forty-seven elderly patients diagnosed as smear-negative pulmonary tuberculosis were rechecked with low-dose chest CT scan (120 kV, 20 mAs) after 1-12 months of antituberculous therapy respectively. These images were compared with common CT before treatment (120 kV, 200-280 mAs). Results In the elderly patients with smear-negative pulmonary tuberculosis, the most common CT signs before treatment were acinus consolidation (100%) and lobar or segmental consolidation (77%), but the cavity was seen less. After effective antituberculous therapy, tree-inbud was improved after one to three months, the acinus consolidation and lobular or segmental consolidations were improved after four to nine months, and the cavitations were slowly improved after six months. Conclusions Low-dose CT can provide sufficient information for the therapeutic effects of antituberculous therapy of smear-negative pulmonary tuberculosis in the elderly and could be used for rechecking.

Objective To evaluate the effect and safety of pseudomonas aeruginosa injection (PA-MSHA) combined with ulinastatin (UTI) injection in the treatment of patients with malignant pleural effusion and/or ascites.Methods 52 patients were randomly divided into PA-MSHA group and PA-MSHA combined with UTI group,each group including 26 patients.All patients were given ultrasonic testing before treatment.The single drug group was given PA-MSHA 10 ml intrapleural and/or intraperitoneal injection.The two-drug combination group was given PA-MSHA 10ml and UTI 300 000 U,twice per week.Evaluation of the efficacy and adverse reaction was performed after 4 times.Results The effective rate of single PA-MSHA group was 34.6 ％ (CR 1 case,PR 8 cases),while the effective rate of PA-MSHA combined with UTI group was 61.5 ％ (CR 2 cases,PR 14 cases).The effective rate of PA-MSHA combined with UTI group was statistically higher than that of single PA-MSHA group (P ＜ 0.05).8 cases got fever in single PA-MSHA group,3 cases in PA-MSHA combined with UTI group got fever,side effect had no statistical significance (P ＞ 0.05).Conclusion PA-MSHA combined with UTI has better effect in the treatment of patients with malignant pleural effusion and/or ascites compared with single PA-MSHA,and both treatments have low side effects.

Objective:To detect the neutrophil extracellular traps (NETs) formation in the peripheral blood of the patients with recurrent respiratory tract infection,and to evaluate the effect of sulbactam sodium/cefoperazone sodium on the formation of NETs.Methods:A total of 36 patients with recurrent respiratory tract infection (case group) and 30 healthy volunteers (healthy control group) were selected.The NETs formation of subjects in two groups was detected by confocal microscope and scanning electron microscope (SEM).According to the appearance of neutrophils,the formation of NETs was classified as grade Ⅰ,Ⅱ and Ⅲ,the number of NETs formation cells of subjects in two groups was calculated.The formation of NETs of the patients in case group were detected before and after treated with sulbactam sodium/cefoperazone sodium.Results:The number of NETs formation cells of grade Ⅰ and Ⅱ of the patients in case group was more than that in healthy control group (P<0.05);while the number of NETs formation cells of grade Ⅲ of the patients in case group was less than that in healthy control group (P<0.05).The number of NETs formation cells of grade Ⅰ and Ⅱ of the patients in case group were significantly decreased (P<0.05),while the number of NETs formation cells of grade Ⅲ was significantly increased (P<0.05) after treated with sulbactam sodium/cefoperazone sodium.Conclusion:A lot of NETs with high antibacterial function can be formed in the patients with recurrent lower respiratory tract infection,and sulbactam sodium/cefoperazone sodium can inhibit the formation of NETs.

Objective:To explore the diagnostic values of Wells score and YEARS algorithm in the patients with pulmonary embolism and to compare the areas under receiver operating characteristic (ROC) curves (AUC) of Wells score and YEARS algorithm, and to find the more suitable score method for pulmonary embolism in clinic.Methods:A total of 139patients who were suspected with pulmonary embolism were collected, among them48patients were clinically as confirmed pulmonary embolism.The disease history, clinical manifestation and results of auxilliary examinations of the patients were collected.All the patients were assessed by Wells score and YEARS algorithm, respectively;the computed tomographic pulmonary angiography (CTPA) was considered as golden standard.The sensitivities, specificities, misdiagnosis rates and omission diagnostic rates, and the accuracies of Wells score and YEARS algorithm of the patients in two groups were analyzed with SPSS 22.0software;the conformities of results of Wells socre, YEARS algorithm, and CTPA were analyzed.Then ROC curves of Wells score and YEARS algorithm in diagnosis of pulmonary embolism were made, and the AUC was calculated and compared.Results:Compared with YEARS algorithm, the specificity and accuracy of Wells score in diagnosis of pulmonary embolism were markedly increased (P＜0.05) , the misdiagnosis rate was decreased (P=0.037) , however the sensitivity and the misdiagnosis rate had no significant differences (P＞0.05) .The Kappa value of Wells score and CTPA was 0.45, the conformity was moderate;the Kappa value of YEARS algorithm and CTPA was 0.22, the conformity was passable;the Kappa value of Wells score and YEARS algorithm was 0.11, the conformity was bad.The AUC of Wells score and YEARS algorithm were 0.753±0.044 (P＜0.01) and 0.585±0.049 (P=0.101) .Conclusion:The Wells score is superior to the YEARS algorithm in the diagnosis of pulmonary embolism.