To summarize the imaging characteristic of parotid lymphoepithelial carcinoma (LEC) by retrospective analyses of computed tomography (CT) and magnetic resonance imaging (MRI) findings for 6 cases of parotid LEC confirmed by operation and pathology and review the relevant literatures.All lesions were located in unilateral parotid.There were single (n =5) and multi-module fusion (n =1).All were located in superficial lobe of parotid gland.And deep lobe (3/6) was involved.An infiltration of casting shape was found along superficial parotid (4/6).There was an irregular margin with small spines,uniform density and signal and above moderate enhancement.An infiltration of casting shape along superficial lobe,uniform density and signal and rich blood supply suggest a diagnosis of LEC.

Objective To study the application of multidector spiral CT(MSCT) in the diagnosis of pulmonary embolism(PE).Methods The clinical and MSCTPA data of 15 cases with suspected PE were analyzed retrospectively.Results Of 15 cases,14 cases(93.3%)were diagnosed as PE.849 branches(82%) of pulmonary arteries were showed in 1035 branches.PE was detected in 130 branches(15.3%) of 849 branches of pulmonary arteries.438 branches(73%) were showed in 600 branches of subsegmental pulmonary arteries,PE was showed in 43 branches(9.8%)of 438 branches.Direct signs of PE included central filling defect in 3 cases;eccentric filling defect(n=9);embolism attached to the wall of host artery(n=2) and total occlusion of the pulmonary arteries(n=3).Indirect signs includedmosaic sign in 1 case;subpleural infarction(n=3);pulmonary hypertension(n=5);Westermark sign(n=8) and pleural effusion(n=6).Conclusion MSCTPA is a fast,effective,security and non-invasive diagnostic method for PE,it may replace the pulmonaryangiography and will be the first choice for diagnosis of PE.

Thirty-five patients with ketosis-prone diabetes (KPD) and 38 patients with newly-diagonosed common type 2 diabetes mellitus (DM) were treated with insulin for 3 months.The results showed that the existing insulin resistance in patients with KPD was mild as compared with common type 2 DM, and the recovery of insulin sensitivity was less marked in patients with KPD after blood glucose was well controlled.

Objective To compare the diagnostic value of DSA with that of Gd-EOB-DTPA-enhanced MRI for postoperative recurrent tiny hepatocellular carcinoma (HCC) lesions.Methods The clinical data of a total of 38 patients,who were admitted to authors' hospital during the period from September 2011 to March 2016 as clinically they were suspected to have postoperative recurrent tiny HCC lesions,were retrospectively analyzed.DSA,DSA plus lipiodol CT scan and Gd-EOB-DTPA-enhanced MRI were performed in all patients.The positive and negative diagnosis rates were compared among different examination methods,the diagnostic sensitivity and specificity were calculated.The imaging diagnosis of each patient was made by two associationchief radiologists independently,both the pathological findings from surgery or puncture biopsy and the 6-month follow-up results were taken as the final diagnosis basis.Results A total of 47 lesions were detected in the 38 patients.The diameter of the lesions was 0.5-2.0 cm,with an average of (1.2+0.8) cm.Of the 47 lesions,41 were proved to be recurrent tiny HCC lesions.Among the 41 lesions,22 had pathological evidence,and the remaining 19 lesions were confirmed through clinical follow-up.Six lesions were non-HCC focus,which were proved by clinical follow-up.For all lesions,the diagnostic sensitivity and specificity were 72.2％ and 80.0％ respectively by conventional DSA,which were 90.2％ and 100％ respectively by DSA plus lipiodol CT scan,and were 95.1％ and 100％ respectively by Gd-EOB-DTPA-enhanced MRI.Statistical analysis indicated that significant differences in diagnostic sensitivity and specificity existed between conventional DSA and DSA plus lipiodol CT scan as well as between conventional DSA and Gd-EOB-DTPA-enhanced MRI (P＜0.05),while the differences in diagnostic sensitivity and specificity between DSA plus lipiodol CT scan and Gd-EOB-DTPA-enhanced MRI were not statistically significant (P＞0.05).Conclusion For the detection of postoperative recurrent tiny HCC lesions,DSA plus lipiodol CT scan has quite the same diagnostic value as Gd-EOB-DTPA-enhanced MRI does.For patients who are not suitable to receive MRI examination,the use of DSA plus lipiodol CT scan,as an alternative means of inspection,should be taken into consideration.

Objective To investigate the selection of treatment strategies and prognostic factors for patients with stage T3 and T4 laryngeal carcinoma. Methods A total of 132 patients with stage T3 and T4 laryngeal cancer admitted to our hospital from March 2010 to March 2019 were retrospectively selected as research objects. According to the different treatment strategies, the patients were divided into simple surgery group (group A, 57 cases), simple chemoradiotherapy group (group B, 32 cases), and surgery combined with chemoradiotherapy group (group C, 43 cases). The general data and clinicopathological features of the three groups were compared, and a survival curve was drawn by the Kaplan–Meier method. The 3-year survival rates of the three groups were compared. Then, the same 132 patients were divided into survival and death groups. The clinical data of the two groups were compared, and the prognostic factors were analyzed by multivariate logistic regression. A back propagation (BP) neural network model was constructed, and its differentiation and accuracy were evaluated. Results The proportions and 3 year survival rates of patients with poor differentiation, lymphatic vascular invasion, and involvement of lymph nodes outside the capsule in group C were significantly higher than those in groups A and B (P < 0.05). The 3 year survival rate of 132 patients was 68.94%(41/132). Poor differentiation, N2-N3 stage, lymphatic vascular invasion, and involvement of lymph nodes outside the capsule were risk factors for death (P < 0.05), whereas surgery combined with radiotherapy and chemotherapy were protective factors (P < 0.05). The BP neural network model exhibited good discrimination and high accuracy. Conclusion Surgery combined with radiotherapy and chemotherapy can significantly improve survival rate in patients with poor differentiation, lymphatic vascular invasion, and involvement of lymph nodes outside the capsule. Close attention should be paid to patients with stage N2-N3 in the formulation of reasonable treatment strategies.

Objective: To develop an oral live vaccine vector which stably carries exogenous genes.Methods:SL1344ΔsipBΔasd host-vector balanced lethal system was constructed by the method of recombinant suicide plasmid-mediated allelic exchange on the basis of attenuated Salmonella typhinurium SL1344ΔsipB.Then,the biological characteristics of SL1344ΔsipBΔasd was analyzed.Results:The results showed that the mutant was stabile with the Δasd gene in vitro;the serotype and growth rate of SL1344ΔsipBΔasd strain was almost same as the parent SL1344ΔsipB and SL1344 strain.And the mutant strains remain swim ming zones.Virulence test in mice showed that the virulence of SL1344ΔsipBΔasd which carried complementary plasmid pYA3493 by electro-transformation decreased by 1.4%compared with SL1344.Conclusion: These results showed that the SL1344ΔsipBΔasd mutant was successfully constructed.It is likely that this mutant should be used as a live vector to express foreign genes.

The latest epidemiological data suggests that the situation of adult diabetes in China is severe, and metabolic diseases have become significant chronic illnesses that have a serious impact on public health and social development. After more than six years of practice, the National Metabolic Management Center(MMC) has developed distinctive approaches to manage metabolic patients and has achieved a series of positive outcomes, continuously advancing the standardized diagnosis and treatment model. In order to further improve the efficiency, based on the first edition, the second edition guideline was composed by incorporating experience of the past six years in conjunction with the latest international and domestic guidelines.

Cardio-cerebrovascular disease (CCVD) is a major comorbidity of Coronavirus disease 2019 (COVID-19). However, the clinical characteristics and outcomes remain unclear. In this study, 102 cases of COVID-19 from January 22, 2020 to March 26, 2020 in Xixi Hospital of Hangzhou were included. Twenty cases had pre-existing CCVD. Results showed that compared with non-CCVD patients, those with CCVD are more likely to develop severe disease (15% versus 1%), and the proportion of pneumonia severity index grade IV was significantly higher (25% versus 3.6%). Computed tomography images demonstrated that the proportion of multiple lobe lesion involvement was significantly higher in the CCVD group than in the non-CCVD group (90% versus 63.4%). Compared with non-CCVD group, the levels of C-reactive protein, fibrinogen, D-dimer, and serum amyloid-A were higher, whereas the total protein and arterial partial PaO
COVID-19 ; Cerebrovascular Disorders/epidemiology* ; Comorbidity ; Humans ; SARS-CoV-2 ; Tomography, X-Ray Computed

In order to develop a recombinant attenuated Salmonella typhimurium as oral live vaccine vector, we constructed recombinant plasmid pYA-sopENt100 by replacing the trc promoter with the sopE promoter and secretion signal sequence sopENt100 of Salmonella typhimurium on the basis of plasmid pYA3493. Then, the complementary plasmid pYA-sopENt100 was transformed into ΔcrpΔasdSL1344 by electroporation to generate attenuated Salmonella typhimurium type III secretion system ΔcrpΔasdSL1344 (pYA-sopENt100). We further characterized ΔcrpΔasdSL1344 (pYA-sopENt100). We also constructed a recombinant strain ΔcrpΔasdSL1344 (pYA-sopENt100-egfp) that harbored the reporter gene-enhanced green fluorescent protein (egfp) gene. Vero cells were infected with ΔcrpΔasdSL1344 (pYA-sopENt100-egfp) and the ability of delivery foreign antigens was tested via Western blotting analysis. The results of PCR, enzyme digestion and sequencing showed that the ΔcrpΔasdSL1344 (pYA-sopENt100) type III secretion system was constructed successfully. The serotype of ΔcrpΔasdSL1344 (pYA-sopENt100) was identical to ΔcrpΔasdSL1344 and SL1344. Compared with wild strain SL1344, the biochemical characteristics of ΔcrpΔasdSL1344 (pYA-sopENt100) had obvious change, but it was basically the same with ΔcrpΔasdSL1344. The growth speed was much slower than that of the wild strain SL1344. The chicken virulence test (LD₅₀) showed that the virulence of ΔcrpΔasdSL1344 (pYA-sopENt100) was 7×10⁴ times lower than SL1344. In addition, we observed the 37 kDa SopENt100-egfp protein in the cultured supernatant of ΔcrpΔasdSL1344 (pYA-sopENt100-egfp) strain by Western blotting analysis. However, both the 37 kDa SopENt100-egfp protein and 27 kDa EGFP protein were detected in ΔcrpΔasdSL1344 (pYA-sopENt100-egfp)-infected Vero cells. These results demonstrated that the recombinant Salmonella typhimurium type III secretion system ΔcrpΔasdSL1344 (pYA-sopENt100) was successfully constructed, and it should be used as a live vaccine vector for expressing foreign genes.
Animals ; Bacterial Proteins ; genetics ; Cercopithecus aethiops ; Mice ; Plasmids ; Promoter Regions, Genetic ; Salmonella typhimurium ; genetics ; Type III Secretion Systems ; genetics ; Vaccines, Attenuated ; genetics ; Vero Cells ; Virulence

The dental operative microscope has been widely employed in the field of dentistry, particularly in endodontics and operative dentistry, resulting in significant advancements in the effectiveness of root canal therapy, endodontic surgery, and dental restoration. However, the improper use of this microscope continues to be common in clinical settings, primarily due to operators' insufficient understanding and proficiency in both the features and established operating procedures of this equipment. In October 2019, Professor Jingping Liang, Vice Chairman of the Society of Cariology and Endodontology, Chinese Stomatological Association, organized a consensus meeting with Chinese experts in endodontics and operative dentistry. The objective of this meeting was to establish a standard operation procedure for the dental operative microscope. Subsequently, a consensus was reached and officially issued. Over the span of about four years, the content of this consensus has been further developed and improved through practical experience.
Humans ; Dentistry, Operative ; Consensus ; Endodontics ; Root Canal Therapy ; Dental Care