Objective To compare the immunogenicity of pneumococcal surface adhesion A (PsaA) and pneumococcal surface protein A (PspA). Methods The variability of the genes and the expressed pneumococcal proteins PsaA and PspA was investigated by electrophoresis. Cross-reactivity of proteins with the antibodies induced by the corresponding proteins of Streptococcus pneumoniae serotype 5, 6B,1, 19F and 23F was researched by Western blot. The enzyme-linked immunosorbent assay (ELISA) was adopted to detect the antibody subclasses and the accessibility of antibodies induced by PsaA and PspA to the surface of the above intact strains. Cross-protection against challenging with Streptococcus pneumoniae strains was indagated in mice. Results Both proteins showed to induce the similar level of antibody subclasses.This study demonstrated that cross-reactivity of pneumococcal PspA was restricted in the same clade, which showed less extensive than pneumococcal protein PsaA. But antibody induced by pneumococcal protein PspA could be bound to the surface of the intact strains, which conduced the stronger cross-protection against inva sive strains. Conclusion The mice immunized with PspA protein cross-protected well against the invasive strains in which PspA belonged to the same clade 1 of family 1. It showed that pneumococcal protein PspA was more effective than PsaA in protection as composition of vaccine.

Objective To explore the relationship between ileocolonic lesions and perianal fistulas of Crohn's disease as sessed by CT enterography (CTE).Methods Totally 28 patients with initial diagnosis of active ileocolonic lesions of Crohn 's disease were collected,16 with perianal fistula and 11 without perianal fistulas.All patients underwent CTE and pelvic MRI.Total number of lesions,minimum length between every two lesions in colon wall and maximum length of colonic le sions were calculated.The rank sum test was performed respectively.Results Lesions of 14 patients (14/16,87.50％) in perianal fistulas group located in left colon or rectum,while lesions of 6 patients (6/12,50.00 ％) in non-perianal fistulas group located in left colon or rectum,the difference was statistically significant (Z=-2.135,P＜0.05).The mean number of lesions in patients with perianal fistulas was 3.06,while in patients without perianal fistulas was 2.91,there was no statistical difference (P＞0.05).The maximum length of colonic lesions in patients with perianal fistulas was (12.79± 8.30)cm,while in patients without perianal fistulas was (7.04± 3.09)cm,and there was no statistical difference(P＞ 0.05).The minimum length hetween every two lesions in patients with perianal fistulas was (5.23±2.98)cm,while in pa tients without perianal fistulas was (8.44 ± 2.87) cm,the difference was statistically significant (Z =-2.095,P＜ 0.05).Conclusion Crohn's disease complicated with perianal fistulas has relationship with lesion location and smaller length intervals between two lesions in colon wall,and has no relationship with total number of lesions and maximum length of colon lesions.

Objective To analyze retrospectively the impact of different heart rates on image quality and radiation dose of coronary angiography using 640-slice dynamic volume CT.Methods A total of 461 patients with suspected coronary artery disease or referred to health check underwent coronary angiography with 640-slice dynamic volume CT.Two groups were created according to their heart rates:Group A had heart rate < 65 beats per minute (n=337)and Group B had heart rate between 65 to 122 beats per minute (n=124).Image quality was assessed by analyzing the 1 5 segments of the main coronary branches using 3-grade scale (grade I-good,grade Ⅱ-acceptable,grade Ⅲ-poor).Effective radiation dose was also evaluated.Results Patients in both A group and B group performed successful CT coronary angiography with a total of 6 91 5 coronary segments.Among them,coronary segments that could be evaluated reliably accounted for 94.5% (6 535/6 91 5)while 5.5% (380/6 91 5)were too small (≤1.5 mm)to be assessed. For the image quality,Group A and Group B had grade I in 90.5% (305/337)vs 74.2% (92 /124),grade Ⅱ in 9.5% (32/337)vs 21.0% (26 / 124)and grade Ⅲ in 0 % (0 / 337 )vs 4.8% (6 / 124),respectively.Image quality was significantly different be-tween Group A and Group B (P <0.001).In addition,32 patients (9.5%)in Group A had slight cardiac motion artifacts but with-out affecting image quality,whereas 26 patients (21.0%)in Group B had higher degree of cardiac motion artifacts thus graded as grade Ⅱ.Stair-step artifacts were not found in all patients.The effective radiation dose was higher in Group B than in Group A by 32.05%(7.91±0.34 mSv vs 5.99±0.17 mSv).Conclusion Coronary angiography using 640-slice dynamic volume CT can guarantee excellent image quality when heart rate < 65 beats per minute.Although the image quality would decrease in some extent it is still diagnostic when heart rate is between 65 to 122(include 65 and 122)beats per minute.

OBJECTIVETo evaluate the application of low-dose CT enterography with adaptive iterative dose reduction(AIDR) technique in diagnosing Crohn's disease.

METHODSRetrospective analysis was performed on 26 patients diagnosed as Crohn's disease by the multidisciplinary team in our hospital. Low-dose CT enterography with 640-slice MDCT was performed on these 26 patients using adaptive iterative dose reduction(AIDR) technique. Characteristics of Crohn's disease in CT enterography images were independently analyzed by two radiologists who were experienced in Crohn's disease with calculating the total radiation dosage.

RESULTSThe radiation dosage of 26 patients ranged from 5.58 to 12.90 [mean (9.00±2.00)] mSv, which was lower than conventional scan (around 15 mSv) known from the literatures. According to the images of CT enterography of 26 cases, bowel wall thickening with abnormal enhancement and lymphadenectasis were found in 25 cases with total 109 segmental bowel wall thickening. Among 25 thickening cases, enterostenosis was found in 16 cases, stratification enhancement in 12 cases and comb sign in 14 cases. Besides, it was found that 8 cases with hyperdense fat on the mesenteric side, 7 cases with intestinal fistula, 6 cases with abdominal cavity abscess, and 3 cases with anal fistula.

CONCLUSIONCT enterography of Crohn's disease with adaptive iterative dose reduction technique is an effective method to evaluate Crohn's disease without compromising image quality with reduced radiation dosage.

Crohn Disease ; diagnostic imaging ; Humans ; Intestinal Fistula ; Radiation Dosage ; Rectal Fistula ; Retrospective Studies ; Tomography, X-Ray Computed ; methods

OBJECTIVETo evaluate the influences of inferior mesenteric artery (IMA) types and Riolan artery arcade absence on the incidence of anastomotic leakage(AL) after laparoscopic resection of rectal cancer.

METHODSClinical data of 116 local advanced rectal cancer patients who underwent laparoscopic resection in The Sixth Affiliated Hospital of Sun Yat-sen University from January 2012 to December 2014 were analyzed retrospectively. IMA and Riolan artery arcade were examined by preoperative computed tomography angiography (CTA) reconstruction. The influences of IMA type, Riolan artery arcade absence and ligation site (high or low) on AL were analyzed by Logistic regression.

RESULTSThe proportion of IMA types(I(-IIII() was 57.8%(67/116), 10.3%(12/116), 31.0%(36/116) and 0.9%(1/116), respectively. Riolan artery arcade absence was found in 60.3%(70/116). Eight (6.9%) patients suffered from AL. IMA type III( had significantly higher AL incidence as compared to other IMA types [19.4%(7/36) vs. 1.2%(1/80), P=0.001]. Meanwhile, patients with Riolan artery arcade absence also had significantly higher AL incidence[11.4%(8/70) vs. 0.0%(0/46), P=0.030]. However, the difference in AL incidence between high and Low IMA ligation was not statistically significant [8.0%(7/87) vs. 3.4%(1/29), P=0.531]. Seven of these 8 AL patients were found in IMA type III( with Riolan artery arcade absence and high ligation. Multivariate analysis showed that IMA type III( (P=0.001) and Riolan artery arcade absence (P=0.002) were independent risk factors of AL.

CONCLUSIONSIMA type III( with Riolan artery arcade absence increases AL incidence significantly in laparoscopic resection of rectal cancer. IMA type and Riolan aretry arcade absence or not contribute to the selection of IMA ligation site in the operation. For the colorectal cancer patients with IMA type III( and Riolan artery arcade absence, selective low IMA ligation with root lymph node dissection should be recommended.

Adult ; Anastomotic Leak ; Arteries ; Colorectal Neoplasms ; surgery ; Female ; Humans ; Incidence ; Laparoscopy ; Ligation ; Lymph Node Excision ; Lymphatic Metastasis ; Male ; Mesenteric Artery, Inferior ; Middle Aged ; Rectal Neoplasms ; surgery ; Retrospective Studies