Objective To describe the distribution and spatial clustering of active pulmonary tuberculosis patients in Funing county of Jiangsu Province,China,and to determine the rules of recent transmission in TB patients and help establish the strategy of TB control with the results of genetic typing of Mycobacterium tuberculosis (M.TB).Methods Newly reported and retreated tuberculosis patients registered in Funing county,Jiangsu Province between Jun 1,2009 and Nov 30,2010 were recruited as research subjects.Geographic information system was applied to analysis the spatial clustering of tuberculosis patients.The M.TB isolates were genotyped by mycobacterial interspersed repetitive units (MIRU).Cluster was defined as two or more patients' M.TB isolates harboring identical MIRU genotype.Results During the study period,there were a total of 681 active pulmonary tuberculosis patients reported.Global Moran's I value and local Moran's I value indicated a random and sporadical manner instead of global spatial clustering of tuberculosis patients in Funing county.Spatial scan statistics (SaTScan) showed that the patients in Guoshu town was statistically significant in spatial clustering (RR=1.85,P=0.036).Among 169 strains of M.TB,27 strains distributed in 12 clusters,which indicated recent transmission among patients within the cluster.Conclusions In rural areas with high tuberculosis incidence,it is less likely to have massive tuberculosis outbreak.Sporadic transmission of tuberculosis may have played an important role in the transmission of tuberculosis in high prevalence area.

Objective To evaluate the value of high-energetic virtual monoenergetic imaging(MonoE),bone metal artifact reduction(O-MAR),and their combination based on dual-layer detector spectral computed tomography(DLCT)in removing the artifacts caused by lumbar metal implants.Methods Patients who undergone lumbar implant surgery and performed lumbar examination on DLCT after surgery were prospectively selected.MonoE from 100 to 200 keV with an interval of 20 keV were reconstructed.O-MAR and O-MAR combined with MonoE(O-MAR+MonoE)images were also reconstructed.The differences of objective and subjective image quality among the images were compared.Results There were 45 patients included in the study.With the increasing of keV of MonoE,the attenuation of the tissue with low-and high-density artifact on MonoE and O-MAR+MonoE was increased and decreased,respectively.140 keV MonoE was the best sequence for the artifact reduction and the display of soft tissue.200 keV MonoE and its combination with O-MAR showed the best performance in the display of the interface of metal and bone.However,O-MAR+200 keV MonoE had the lowest noise.Conclusion Compared to O-MAR and O-MAR combined with MonoE,high-energetic MonoE shows a good value in the reduction of metal artifacts caused by the lumbar metal implants.