Objective To evaluate the prevalence rate of pulmonary malignant disease in people at high risk of lung cancer through low-dose multi-slice spiral CT. Methods 1 200 symptom-free volunteers were under low-dose spiral CT scans in an on-going screening study. The people tested aged 40 or older regardless of their gender or smoking history. Low-dose CT scans were performed with Iightspeed Plus multi-slice scanner using spiral mode, 120 kV,30 mAs. Results Calcified nodules were detected in 32 participants and non-calcified nodules were detected in 18 participants by low-dose CT,in which 3 were vicious ones,including 1 non-solid lesion and 2 solid lesions. The detection rate of lung cancer was 0. 25%. Conclusion Low-dose multi-slice spiral CT was effective in detecting, classifying and defining lung nodules,and furthermore would make it possible to find lung cancer at earlier stage.

Objective:To explore the feasibility and efficacy of laparoscopic resection of abdominal and retroperitoneal cystic masses in children.Methods:A retrospective analysis of 11 cases of abdominal and retroperitoneal cystic masses in Department of Pediatric Surgery, Quanzhou First Hospital Affiliated to Fujian Medical University from June 2015 to January 2019 was performed, and all the patients underwent laparoscopic resection or laparoscopic-assisted resection, with 6 cases of boys and 5 cases of girls, aged 8 months to 10 years (with the average of 59 months). Meanwhile, 9 cases were from the abdominal cavity and 2 cases were from the retroperitoneum.Results:All patients underwent laparoscopic or laparoscopic-assisted resection without switching to laparotomy.The operation time was 60-210 minutes, with the average of 120 minutes.The intraoperative blood loss was 5-30 mL, with the average of 10 mL.There was no blood transfusion.All patients were discharged 3-8 days after surgery, with the average of 5 days.The postoperative pathological results included 5 cases of mature teratoma, 1 case of paraneoplastic cyst, 2 cases of intestinal duplication, 2 cases of lymphangioma, and 1 case of hepatic cyst.Totally, 11 cases were followed up for 7-51 months, with the average of 20.9 months.No recurrence occurred.Conclusions:Laparoscopic or laparoscopic-assisted resection of abdominal and retroperitoneal cystic masses has advantages of minimal invasion, rapid recovery in children, and it is safe and effective.

Objective To investigate the risk factors of electrical storm(ES) in patients with acute myocardial infarction (AMI) during perioperative period of direct percutaneous coronary intervention(PCI).Methods Forty-one AMI patients had been treated with direct PCI.The patients with perioperative ES were included in ES group and those without perioperative ES were included in conntrol group.ES was defined as the occurrence of spontaneous ventricular tachycardia or venicular fibrillation was twice or more within 24 h and unable to stop by itself and emergency treatment was needed.The difference of the clinical data between two groups were compared.Results There were 7 in 41 patients with direct PCI who had ES,the incidence was 17.07％,and 34 cases didn't have ES.Systolic pressure,diastolic pressure,white cell count,blood glucose,international normalized ratio and time duration from chest pain onset to direct PCI between two groups had no significant differences (P ＞0.05).Age,CK-MB,cardiac troponin I,the diameter of infarctrelated arleries(IRA ),incidence of reperfusion arrhythmia and mortality of ES group were all obviously higher than those of control group (P ＜ 0.05 or ＜ 0.01 ).The incidence of ES in patients whose IRA was left main artery or occlusion of middle section of two main coronary arteries,right coronary artery,left anterior descending branch and left circumflex artery was 66.67％(2/3),18.75％(3/16),11.76％(2/17) and O, respectively.Conclusions Perioperative ES during direct PCI most commonly occurrs in AMI patients with left main artery or occlusion of middle section of two main coronary artery.The diameter of IRA,TIMI flow classification after the patency of IRA and recanalization arrhythmia are the main risk factors of the occurrence of perioperative ES.

Objective:To explore the efficacy and experience of laparoscopic repair of hiatus hernia with absorbable biological mesh reinforcement in infants and children.Methods:The clinical data of patients with hiatal hernia undergoing laparoscopic surgery with biological mesh and Nissen fundoplication in the First Hospital of Quanzhou from January 2015 to December 2018 were retrospectively analyzed.All patients had undergone upper gastrointestinal contrast radiography and were diagnosed as hiatal hernia before operation.The clinical types were Ⅰ( n=9), Ⅱ( n=7), Ⅲ( n=1). Results:All patients underwent laparoscopic procedure without switching to laparotomy.The operation time was 100-180min, with an average of 120 min.The mean blood loss was 5-10mL.All patients were fed 1 to 2 days postoperatively and were discharged 5 to 10 days after surgery, with an average of 8 days.All patients were followed up for 6 to 53 months with an average of 30 months.They gained good development and growth.There was no recurrence.One case had dysphagia (esophageal stricture), and improved after esophageal dilation.Conclusion:Laparoscopic hiatal hernia repair with absorbable biological mesh reinforcement has low recurrence rate, fewer complications, and definite curative effect.

Objectives:To observe the anatomical location and mechanism of axis ring fractures (ARF) using 3-D CT scans, and propose a new classification for such fractures.Methods:By reviewing prospectively maintained database collecting ARF from 7 medical centers in China, 202 patients were included in this study. According to anatomical location, ARFs were classified into axis arthrosis fracture (AAF) and axis bony damage (ABD). The axis ring was divided into anterior, middle, and posterior rings, based on the border of the pars interarticularis (or pedicle) of axis. According to the features of ARF and previous study, a new classification was proposed based on the anatomical features of different fracture patterns, which was divided into three types and six subtypes (A1, A2, B1, B2, C1 and C2). The incidence of AAF and ABD and their distribution in different location of axis ring and the new classification, were observed.Results:In 202 patients with ARF, 501 anatomical structures were involved. 288 AAFs were found in 178 patients (288/501, 57%), while 213 ABDs were found in 149 patients (213/501, 43%). In anterior ring, 304 structures (304/501, 61%) were involved in injury, with 225 AAF and 79 ABD. In middle ring, 99 structures (99/501, 20%) were involved in injury, and all of them were ABD. In posterior ring, 98 structures (98/501, 19%) were involved in injury, with 63 AAF and 35 ABD. The anterior ring injuries (61%) were more common than middle (20%) or posterior ring (19%). In anterior ring, AAF (84%) were morecommon than ABD (16%); In middle ring, all the injuries were ABD; In posterior ring, AAFs (64%) were more common than ABD (36%). Type A fractures were featured with pedicle fractures and were identified in 30 patients (30/202, 15%). Type A1 fractures were bilateral pedicle fracture lines symmetrically or asymmetrically and identified in 12 (6%) patients; Type A2 fractures were pedicle fracture lineson one side and inferior articular facet injuries or lamina fractures on the otherside and identified in 18 (9%) patients. Type B fractures were featured with superior articular facet injuries or posterior wall of C2 body fractures on one side and identified in 136 patients (67%). Type B1 fractures were superior articular facet injuries or posterior wall of C2 body fractures on one side and pedicle fracture on the other side and identified in 57 (28%) patients; Type B2 fractures were superior articular facet injuries or posterior wall of C2 body fractures on one side and inferior articular facet injuries or lamina fractures on the otherside and identified in 79 (39%) patients. Type C fractures were featured with bilateral superior articular facet injuries or posterior wall of C2 body fractures and identified in 36 patients (18%). Type C1 fractures were bilateral superior articular facet injuries or posterior wall of C2 body fractures symmetrically and identified in 22 (11%) patients; Type C2 fractures were bilateral superior articular facet injuries or posterior wall of C2 body fractures asymmetrically and identified in 14 (7%) patients.Conclusion:ARF could occur in different anatomical locations, and most of these fractures were caused by hyperextension and axial load on superior articular facet on one or two sides. The new CT classification of ARF with three types and six subtypes might provide all fracture patterns, which could be useful for the choice of proper diagnosis and treatment for such fractures.

Objective To assess the diagnostic value of cardiac magnetic resonance (CMR) in patients with acute viral myocarditis.Methods Thirty patients with suspected acute viral myocarditis admitted in first people's hospital of Shunde from June 2011 to June 2013 were included in this prospective study.The diagnostic sensitivity,specificity,positive predictive value (PPV),negative predictive value (NPV) and accuracy of acute viral myocarditis were evaluated by clinical diagnosis.Diagnostic value among different scan methods and Lake Louise criteria were compared.Results Acute viral myocarditis was diagnosed in 63.33％ (19/30) patients.Values for sensitivity,specificity,PPV,NPV,and diagnostic accuracy within the overall cohort were 57.89％,72.73％,78.57％,50.00％,63.33％,respectively by edema imaging(ER).Values for sensitivity,specificity,PPV,NPV,and diagnostic accuracy within the overall cohort were 78.95％,63.64％,78.95％,63.64％,73.33％,respectively using global relative enhancement (gRE).Values for sensitivity,specificity,PPV,NPV,and diagnostic accuracy within the overall cohort were 78.95％,54.55％,75.00％,60.00％,70.00％,respectively using late gadolinium enhancement (LGE) criteria.Values for sensitivity,specificity,PPV,NPV,and diagnostic accuracy within the overall cohort were 84.21％,81.82％,88.89％,75.00％,83.33％ using Lake Louise criteria.The sensitivity,specificity,PPV,NPV,and diagnostic accuracy using Lake Louise criteria were significantly higher than using ER,gRE,LGE alone (all P ＜ 0.05).Specificity was higher using ER than using gRE and LGE(both P ＜ 0.05).The sensitivity,NPV,and diagnostic accuracy were significantly higher using gRE than using ER (all P ＜ 0.05) and was similar as using LGE (all P ＞ 0.05).Conclusion Cardiac magnetic resonance is an excellent imaging modality for the diagnosis of acute viral myocarditis.

In order to understand the prevalence of Akabane disease(AKAD)in Guizhou Province and the molecular characteristics of the isolates,the whole-genome sequence of a strain of Akabane virus(AKAV)from a bovine AKAD-positive sample was determined and analyzed.The genotype and genetic variation of the strain were also explored.Based on the conserved S sequence,a fluores-cence quantitative PCR(qPCR)detection method was established and applied for the investigation of AKAV infection status in four large-scale beef cattle farms of Guizhou.Results showed that the S,M and L fragments of the bovine strain were highly homologous to the Tianjin strain(TJ2016/China/2016)and the Australian strain(JaLAB39/Australia/1959),where they were in the same evolutionary branch and belonged to genotype Ⅱ.Sensitivity assay found that the lowest detection limit was 2.5 X 101 copies/μL.Specificity assay showed the established method detected only AKAV with no amplification on bovine bluetongue virus(BLUV),Pasteurella multocida(PM),bovine infectious rhinotracheitis virus(IBRV)and bovine Mycoplasma bovis.The variation coefficients of inter-and intra batches in the repeatability test were both lower than 2.26％.These findings illus-trated that the established qPCR method had high sensitivity,good specificity and repeatability.A total of 298 serum samples from 4 large-scale beef cattle farms in Qianxi City and Huangping County of Guizhou Province were collected and tested for AKAV by the method.Out of 298 sam-ples,25 positive samples(25/298)were detected as positive with a positive rate of 8.39％.In sum-mary,this work provided the reference data for a deep understanding of the molecular prevalence of AKAV in Guizhou Province and laid foundation for the prevention and control of AKAD.

We conducted a randomized, open-label, parallel-controlled, multicenter trial on the use of Shuanghuanglian (SHL), a traditional Chinese patent medicine, in treating cases of COVID-19. A total of 176 patients received SHL by three doses (56 in low dose, 61 in middle dose, and 59 in high dose) in addition to standard care. The control group was composed of 59 patients who received standard therapy alone. Treatment with SHL was not associated with a difference from standard care in the time to disease recovery. Patients with 14-day SHL treatment had significantly higher rate in negative conversion of SARS-CoV-2 in nucleic acid swab tests than the patients from the control group (93.4% vs. 73.9%, P = 0.006). Analysis of chest computed tomography images showed that treatment with high-dose SHL significantly promoted absorption of inflammatory focus of pneumonia, which was evaluated by density reduction of inflammatory focus from baseline, at day 7 (mean difference (95% CI), -46.39 (-86.83 to -5.94) HU; P = 0.025) and day 14 (mean difference (95% CI), -74.21 (-133.35 to -15.08) HU; P = 0.014). No serious adverse events occurred in the SHL groups. This study illustrated that SHL in combination with standard care was safe and partially effective for the treatment of COVID-19.
COVID-19 ; Humans ; Medicine, Chinese Traditional ; Research ; SARS-CoV-2 ; Treatment Outcome