Objective To study the diagnostic value of spectral CT in atypical tuberculosis ball and lung cancer.Methods 45 cases of pulmonary nodule or mass received unenhanced and two phase enhanced scan in gemstone spectral imaging mode,and all pulmonary nodule or mass were confirmed by pathology.Selecting unenhanced,arterial phase and venous phases of spectrum image,atypical tuberculosis ball group and lung cancer group were analyzed.Normalized iodine concentration (NIC), the spectral curve slope (λHU),CT value of unenhanced and two phase enhanced spectrum image were measured and calculated.Two independent samples t-test was used for the statistic analysis of each spectrum parameters between the two groups.The receiver operating characteristic (ROC) curve was obtained for comparing the sensitivity and specificity of each spectral parameter.Results Among the 45 patients,11 were atypical tuberculosis ball, and 34 were lung cancer.Comparison NIC,two phase enhanced λHU and the net enhanced CT values of 70 keV monoenergetic image of the two groups, lung cancer group was higher than atypical tuberculosis ball group,and the difference was statistically significant(P<0.05);However, the unenhanced CT value of 70 keV monoenergetic image of the two groups was not statistically significant (P>0.05).When the NIC diagnostic threshold was 0.105, the maximum Youden index (0.733), the area under the ROC curve was 0.89, and sensitivity and specificity was 82.4% and 90.9%, respectively.Conclusion The quantitative parameters of spectral CT is helpful in the diagnosis of atypical tuberculosis ball and lung cancer,especially the NIC with high value.

Objective: To preliminarily investigate the relationship between the baseline level of serum soluble ST2 (sST2) and 30-day MACE occurrence rate in patients with ST-elevation myocardial infarction (STEMI).
Methods: A total of 121 patients with confirmed diagnosis of STEMI in our hospital from 2015-05-01 to 2015-07-30 were consecutively enrolled. According to baseline sST2 level, the patients were divided into 2 groups:Low sST2 group, the patients with sST2≤56.68 ng/ml, n=61 and High sST2 group, the patients with sST2>56.68 ng/ml, n=60. Clinical condition and 30-day MACE (defined as death and new onset of congestive heart failure) occurrence rate were compared between 2 groups.
Results: ① The systolic blood pressure (SBP), Killip class≥II grade, blood levels of cTNI, NT-proBNP, hs-CRP and LVEF were different between 2 groups, all P<0.05. ② Baseline sST2 level was positively related to heart rate (r=0.271, P=0.003), Hs-CRP (r=0.359, P=0.000), cTNI (r=0.324, P=0.000) and NT-proBNP (r=0.425, P=0.000);negatively related to SBP (r=-0.226, P=0.013) and LVEF (r=-0.406, P=0.000).③30-day MACE occurrence rate was different between 2 groups (8.2%vs 30%, P=0.002). ④ Multivariate Cox regression analysis presented that sST2>56.68 ng/ml was the risk factor for 30-day MACE occurrence (HR=1.152, 95%CI 1.078-1.231, P=0.000).
Conclusion: Increased baseline level of sST2 implied the higher incidence of death and new onset of congestive heart failure in STEMI patients.

Objective To discuss the risk factors of free wall rupture (FWR) in acute ST-segment elevation myocardial infarction (STEMI) patients. Methods We retrospectively reviewed all patients (n=1247) with STEMI hospitalized in CCU from January 2005 to July 2010. Results FWR occurred in 29 patients(2.3%). Of these 1247 patients, 128 (10.2%) patients received thrombolytic therapy, 623 (50.0%) patients underwent primary PCI. Compared to No-FWR group, FWR group has signiifcant differences in age (62.4±6.4 y vs. 66.6±8.3 y, P<0.05), hypertenion (29.7%vs. 21.8%, P>0.05), diabetes mellitu (55.2%vs. 23.5%, P=0.022), presence of heart failure on admission (Killip≥Ⅱ) ( 16.4%vs. 34.0%, P<0.05), Peak value of hCRP[20.33 (15.02, 81.25) vs. 43.35 (16.56, 126.78)], no-history of pervious MI (10.3%vs. 18.4%, P=0.018). Multivariate logistic regression showed that age (≥70 years old), Killip≥Ⅱ, hCRP ( > 100 mg/L) and thrombolytic therapy were independent risk factors of FWR. Conclusions STEMI patients with advanced age, Killip≥Ⅱ, hCRP and thrombolytic therapy were more vulnerable of FWR.

Objective To evaluate the efficacy of siege scheme of TCM for acute cerebral infarction bowel and visceral strike (block pattern). Methods Totally 110 patients were randomly divided into TCM siege scheme group (55 cases) and control group (55 cases) by randomized parallel controlled study with foresight and multicenter. The control group was treated with the standardized treatment, and TCM siege scheme group was treated with TCM siege scheme, including mild hypothermia TCM pillow therapy, TCM rectal enema, and other multiple treatments based on the standardized treatment. The Glasgow Coma Scale (GCS), the time of pulling out urine tube and nasal feeding tube, and the number of tracheotomy caused by illness changes of the two groups were compared. Results The baseline data of two groups have good comparability (P>0.05). On 10, 15 d of treatment, the number of lucid people in the TCM siege scheme group was significantly more than that in the control group (P<0.05). Compared with the control group, treatment group had less number of tracheotomy, and shorter time of success pulling out urine tube and nasogastric feeding tube (P<0.05). Conclusion TCM siege scheme can improve the consciousness of ischemic stroke in patients with acute cerebral infarction bowel and visceral strike, reduce complications, shows shorter successful pull urine tube and nasogastric feeding, and provides guarantee conditions for further rehabilitation treatment.

Objective To evaluate the difference of the surrounding normal tissue and lesion apparent diffusion coefficient (appar-ent diffusion coefficient,ADC)value in identify malignant and benign breast lesions.Methods There were 65 suspicious malignant breast lesions received by DWI scan and dynamic contrast-enhanced MRI (DEC-MRI)in 64 patients.The ADC value of breast lesions and peripherial glands were respectively measured,and then the difference was calculated.Receiver operating characteristic curve (ROC)analysis was used to evaluate the difference’s performance in identification between benign and malignant breast lesions.Re-sults There were 35 malignant lesions and 30 benign lesions.For the malignant lesions,the optimal threshold values for ADC of breast lesions were 1.28×10-3 mm2/s.The area under the ROC was 92.2%,the sensitivity and specificity were 76.7% and 94.3%.While the optimal threshold values for ADC were 0.63×10 -3 mm2/s in the benign lesions.The area under the ROC was 94.9%,the sensitivity and specificity were 88.6% and 96.7%.Conclusion ADC difference can reduce the influences of individual physiological factors,different machine,scanning parameters,which play an important role in identification between benign and malignant breast lesions.

Objective To study the effect of levosimendan on cardiomyocyte apoptosis after coronary microembolization (CME) in swine,Methods Fifteen healthy swines were randomly divided into sham operation group,CME group and levosimendan treatment group (5 in each group).Their cardiac function was assessed by echocardiography,their cardiomyocyte apoptosis was assyed with TUNEL staining,and Caspase-3 expression was detected by Western blot at 12 h after operation.Results The LVEF was lower,the left ventricular minor axis was shorter and the cardiac output volume was smaller while the LVEDD was longer in CME group than sham operation group (P＜0.05).The cardiac function was significantly better in CME group than in sham operation group (P＜0.05).The cardiomyocyte apoptosis rate and Caspase-3 expression level were significantly higher in CME group than in sham operation group (P＜0.05).The cardiomyocyte apoptosis rate was significantly higher while the Caspase-3 expression level was significantly lower in levosimendan treatment group than in CME group (6.820％±-1.974 ％ vs 10.558％±2.425％,P＜0.05).Conclusion Pretreatment with levosimendan can effecively reduce the cardiomyocyte apoptosis and improve the cardiac function after CME by inhibiting the Caspase-3 expression in cardiomyocytes.

Objective To conduct bibliometric visualization analyses of the literature domestic and overseas on active surveillance of post-marketing safety of drugs,aiming to display the current status and trend of hotspots in this field and to provide references for future research and the improvement of the Chinese management system of active surveillance.Methods The English and Chinese literature on active surveillance of post-marketing safety of drugs were searched in Web of Science and CNKI respectively and imported into CiteSpace 6.3.R2 software for the analysis of the number of publications,authors,institutions,and national cooperative networks,and the analysis of keyword co-occurrence,clustering and emergence.Results 415 Chinese and 676 English literature were included,with an overall increasing trend in annual publication volume.The author collaboration network of Chinese literature was smaller than that of English literature,and the partnership network was sparse,with no strong centralized institution.Domestic drug regulatory agencies played an important role in the field,while drug companies'monitoring research on their own products was still relatively scarce.The research topic covered active surveillance systems,technical method research,and drug safety active surveillance practice research for specific drugs and diseases.Conclusion Countries worldwide have widely considered active surveillance of post-marketing drug safety.The heat of research activities in China has shown a significant growth trend.However,there is still a significant gap compared with the international frontiers.Further cooperation needs to be strengthened to promote the improvement of the active surveillance management system in China.