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Objective:To investigate the diagnostic value of spiral CT head and neck angiography on carotid artery stenosis in patients with acute cerebral infarction.Methods:A total of 60 patients with acute cerebral infarction(ACI),who were treated in Affiliated Hospital of Yan'an University from January 2014 to January 2016,were selected as observation group,and 60 patients with non-acute cerebral infarction,as control group.The two groups of patients underwent spiral CT head and neck angiography.The degrees of carotid artery stenosis and the distribution of vascular plaques were compared between the two groups.The diagnostic value of spiral CT head and neck angiography in the diagnosis of carotid artery stenosis of the patients with ACI was evaluated.Results:The detection rates of mild and moderate stenosis in the observation group were significantly higher than those in the control group (P＜0.05),while the detection rates of severe stenosis and occlusion had no significant difference compared with the control group (P＞0.05).The total detection rate of stenosis in the observation group was higher than that in the control group (P＜0.05).There were plaques detected in the carotid bifurcation,common carotid artery,internal carotid artery and external carotid artery in the two groups.The total detection rate (69.4％) of the observation group was significantly higher than that (41.2％) of the control group (P＜0.05).Conclusion:Application of 128-slice spiral CT can effectively assess the head and neck angiography on carotid artery stenosis in patients with acute cerebral infarction.This method has a higher detection rate from mild to moderate stenosis and bilateral carotid artery plaques in the patients with ACI,and it has application value in the clinical diagnosis and prognosis.

Objective To analyze the diagnosis and prognosis value of abdominal CT scans in patients with acute pancreatitis complications.Methods 151 cases with acute pancreatitis were selected.The relationship between abdominal CT performances and the common complications and death in patients was analyzed.The prognosis of patients with different Balthazar CT severity index (CTSI) grade was compared.Results The complication rate of patients with CT signs of fatty liver, pleural effusion, liver gap effusion, adrenal gland involvement (AGI), penirenal space involvement (PSI) and gastric bare area involvement (GBAI) was significantly higher than that of patients with negative CT findings above (P<0.05).With CTSI grading increasing, the patient''s fasting time, heating time, hospital stay, recovery time of blood amylase were extended, and the incidence of pseudo cyst, transit surgery, organ failure and death was gradually increasing (P<0.05).Conclusion Severe fatty liver, AGI, GBAI, PSI and liver gap effusion are risk factors for acute complications and death in patients with pancreatitis.

One hundred patients with chronic renal failure(CRF) undergoing contrast diagnosis and/or interventional therapy were randomly divided into two groups: patients in hydration alone group( n = 49 )received intravenous infusion of 0.9% sodium chloride 12 h before injection of contrast media till 12 h after examination (hydration), patients in atorvastatin plus hydration group (n = 51 ) received atorvastatin 80mg/d 24 h before examintion for 3 d in addition to hydration.The serum creatinine concentrations were measured before and 48 h after injection of contrast media.In atorvastatin plus hydration group, the incidence rate of contrast-induced nephropathy (CIN) was 8% (4/51), which was significantly lower than that of hydration group (24%,12/49 )(P＜0.05).Short-term and large dose administration of atorvastatin plus hydration can decrease the incidence of CIN in patients with chronic renal failure undergoing contrast diagnosis and/or interventional thrapy.

Objective To explore the association of C20orf54 gene rs3746804 position single nucleotide polymorphism and susceptibility to esophageal squamous cell carcinoma (ESCC).Methods Purification of genomic DNA from whole blood was used the Maxwell(R) 16 System.rs3746804 in C20ort54 was detected by direct sequencing in 434 ESCC patients from Changzhi (Shanxi province) and Linzhou (Henan province) and 554 healthy controls from Changzhi,Linzhou and including immigrators from Linzhou to Changzhi.Results For rs3746804,the genotypic frequencies of CT(37.5％ vs 51.0％,37.5％ vs 52.0％),CC (44.2％ vs 34.8％,44.2％ vs 33.0％) in Changzhi ESCC patients showed significant differences with healthy Changzhi controls and the healthy immigrator controls (all P ＜ 0.05),and the frequencies of TT(18.3％ vs 4.1％) and CC (44.2％ vs 54.6％) in Changzhi ESCC patients showed significant differences with Linzhou ESCC patients (all P ＜0.05).The genotypic frequencies of TT (4.1％ vs 15.0％),CT (41.2％ vs 52.0％) and CC(54.6％ vs 33.0％) showed significant differences between Linzhou ESCC patients and the healthy immigrator controls (all P ＜ 0.05),and the frequencies of TT (4.1％ vs 14.1％) and CC (54.6％ vs 34.8％) showed significant differences between Linzhou ESCC patients and Changzhi healthy controls (all P ＜ 0.01).Meanwhile,there were significant differences between ESCC patients (including Changzhi and Linzhou ESCC patients) and healthy controls (including the healthy Changzhi,Linzhou and immigrator controls) in genotypic frequencies of CT(39.2％ vs 48.7％) and CC (48.8％ vs 38.2％) (all P ＜ 0.01).CT and CT + TT genotype could decrease the risk of ESCC compared with the CC genotype (OR =0.630,95％ CI0.481-0.826 ; OR =0.654,95％ CI 0.507-0.844).Conclusion There is a closed relationship between SNP rs3746804 in C20orf54 and susceptibility to ESCC.

ObjectiveTo study the relationship between plasma riboflavin levels and esophageal squamous cell carcinoma.Methods We detected and compared plasma concentrations of riboflavin in patients with esophageal squamous cell carcinoma (ESCC) and immigrants of Linzhou living in Changzhi.Plasma riboflavin levels were quantified in 445 ESCC patients,689 healthy control subjects and 347 immigrants of Linzhou living in Changzhi by using enzyme-linked immunosorbent assay.ResultsThe plasma riboflavin levels in patients with ESCC were significantly lower than those in the healthy controls and immigrants of Linzhou living in Changzhi [ (731.69 ± 330.67 ) μg/L vs ( 1090.43 ± 445.08 ) μg/L,(731.69 ± 330.67) μg/L vs ( 897.58 ± 177.78) μg/L,respectively,all P ＜ 0.05 ],and the plasma riboflavin levels of the healthy controls were higher than those in the immigrants of Linzhou living in Changzhi (P ＜ 0.05).ConclusionPatients with ESCC have decreased plasma riboflavin levels as compared with the healthy controls and immigrants of Linzhou living in Changzhi,there exists a lack of riboflavin in ESCC patients,but the specific mechanism needs further study.

Objective To investigate the risk factors for multiple organ dysfunction syndrome (MODS) in patients with type 2 diabetes mellitus (T2DM) complicated with infection.Methods The clinical data of 115 patients with T2DM complicated with infection in our hospital from Jan.2016 to Jan.2018 were retrospectively reviewed,including 60 patients with MODS(study group) and 55 patients without MODS(the control group).The related risk factors were analyzed by single factor and multi-factor logistic regression analysis.Results Single factor analysis showed that HbAlc[(5.47±0.86) vs (8.67±1.34)],hs-CRP[(8.31±2.18) vs (19.03±2.13)],PCT [(4.59±1.46) vs (13.42±2.67)],lac[(3.69±0.99) vs (6.58±1.18)],APACHE Ⅱ [(14.94±1.83) vs (24.98±3.19)],MBG[(9.81±0.62) vs (8.72±0.44)],SDBG[(3.43±0.20) vs (2.65±0.22)],MACE [(4.31±0.36) vs (2.93±0.19)],LAGE[(10.55±0.89) vs (6.49±0.19)],and MODD [(3.28±0.34) vs (2.05±0.25)] had statistical difference between the control group and the study group (P＜0.05).There was no significantly difference of blood glucose between the study group and the control group.Multi-factor logistic regression analysis showed that HbAlc,CRP,PCT,lac,APACHE Ⅱ],SDBG,LAGE,course of the disease were the main risk factors for MODS in patients with T2DM complicated with infection (P＜0.05).Conclusion HbAlc,CRP,PCT,lac,APACHE Ⅱ,SDBG,LAGE,and course of the disease were the main risk factors for MODS in patients with T2DM complicated with infection.

Objective:To explore the value of biphasic quantitative CT on small airway disease and emphysema injury in patients with smoking combined with chronic obstructive pulmonary disease (COPD).Methods:A total of 186 male physical examination subjects who underwent biphasic CT and pulmonary function (PFT) examinations in the Affiliated Hospital of Yan′an University from July 2018 to September 2020 were enrolled in this retrospective study. These subjects were divided into 121 smokers with COPD (COPD group), aged 34 to 84 (64±8) years old and 65 smokers without COPD (non-COPD group) aged 34 to 72 (61±5) years old. According to the guidelines of the COPD global initiative, patients in COPD group were divided into Global Initiative for Chronic Obstructive Pulmonary Disease (GOLD) Ⅰ-Ⅳ grades. The original DICOM data of CT were imported into the "Digital Lung" test and analysis platform. Quantitative parameters of functional small airway disease percentage (fSAD%) and emphysema area percentage (Emph%) of each lobe were calculated. The differences of CT quantitative parameters among non-COPD group and each grade in COPD group were analyzed by One-Way ANOVA or Kruskal-Wallis H test. The correlation between the smoking index and CT quantitative parameters was analyzed by Spearman correlation analysis. Results:There were significant differences in fSAD% and Emph% of each lobe among non-COPD group and COPD group GOLD Ⅰ-Ⅳ ( P<0.001). Except that the Emph% in right middle lobe of GOLD grade Ⅰ was higher than that of GOLD grade Ⅱ in COPD group, the fSAD% and Emph% in other lobes increased gradually with the increase of GOLD grade in COPD group. The fSAD% and Emph% were larger in the right middle lobe and both upper lobes of COPD group GOLD Ⅰ-Ⅳ. The comparison among each lobe showed that the differences were statistically significant ( P<0.01), except for the fSAD% and Emph% of GOLD Ⅳ ( P=0.395, 0.840). The smoking index was positively correlated with fSAD% and Emph% in each lung lobe. Among them, smoking index was highly correlated with fSAD% in the lower right lobe and Emph% in the lower left lobe ( r=0.474, 0.619, P<0.001). Conclusion:The biphasic quantitative CT can early and sensitively reflect the degree of small airway disease and emphysema injury in smoking combined with COPD, which is of great significance for the early diagnosis and evolution of COPD.

Objective To investigate the effect of real-time continuous monitoring system(RT-CGMS)on serum inflammatory factors and prognosis in patients with sepsis.Methods According to the prospective studies,patients were randomly divided into two groups Patients with sepsis were randomly divided into real-time continuous monitoring of blood glucose group and monitoring blood glucose meter group,of which the fasting serum tumor necrosis factor alpha(TNF-α) and interleukin-6(IL-6) and high sensitive C reactive protein (hs-CRP) were detected on the 1st,3rd,7th day.Meanwhile,insulin dosage,incidence of hypoglycemia and mortality rate of 28 days of patients in two groups were recorded,and the above indexes were analyzed.Results TNF-α,IL-6 and hs-CRP in the real-time continuous blood glucose monitoring group were (16.12±2.42)pg/ml、(112.37±17.39)pg/ml and(19.62±2.72)mg/L on the 7th day respectively,while TNF-α,IL-6 and hs-CRP in the blood glucose monitoring group were(23.46±3.12)pg/ml、(140.19±21.48)pg/ml and(25.42±2.54)mg/L on the 7th day,respectively.The decrease of TNF-α,IL-6 and hs-CRP in the continuous blood glucose monitoring group was more significant than that in the blood glucose monitoring group (P＜0.05).Insulin dosage in real-time continuous blood glucose monitoring group was (90.62±15.79)u,hypoglycemia rate was 5.4％,fatality rate was 10.81％ in 28 days of hospitalization,insulin dosage was (130.59±20.65)u,hypoglycemia rate was 22.85％,and fatality rate was 31.42％ in 28 days of hospitalization.There was significant difference between the two groups(P＜0.05).Conclusion For sepsis patients with stress hyperglycemia,a real-time continuous monitoring system combined with insulin therapy can improve the inflammatory response,and control blood glucose effectively as well as reduce mortality.

Objective To investigate the correlation between the infarction location and progressive motor deficits (PMD) occurrence.Methods The patients with middle cerebral artery(MCA) infarction within 24 h of onset without thrombolytic therapy were included.The National Institutes of Health Stroke Scale(NIHSS) motor item score increase ≥2 points of the base line within 7 d after stroke onset served as the PMD diagnostic criteria.The differences in clinical and laboratory data,and infarction location were compared between the PMD group and non-PMD group.The multivariate Logistic regression analysis predicted the risk factors of PMD occurrence.Results A total 121 patients with MCA acute cerebral infarction were included in the study and divided into the PMD group (45 cases) and non-PMD group (76 cases).The internal watershed infarction occurrencerate in the PMD group was higher than that in the non-PMD group (26.7 ％ vs.5.3％,p=0.001).The occurrence rate of penetrating arterial infarction (PAI) had no statistical difference between the PMD group and non-PMD group(42.2％ vs.35.5％,P=0.463).PAI was further divided into perforating branch atheromatous disease (BAD) and lipohyalinitic degeneration (LD).The occurrence rate of BAD in the PMD group was significantly higher than that in the non-PMD group (28.9％ vs.9.2％,P=0.005).The stepwise Logistic regression analysis indicated that watershed infarction [odds ratio (OR):9.750,95 ％ confidence interval(CI):2.828-33.612,P=0.000] and BAD lesion (OR:6.036,95 ％ CI:2.119-17.190,P =0.001) were the independent risk factors contributing to PMD.Conclusion Internal watershed infarction and BAD lesion may predict the PMD occurrence.The infarct location is conducive to find the high risk population of cerebral infarction progress.