Objective To investigate the value of spiral CT in diagnosis and its differiential diagnosis of adrenal hyperplasia char-acterized with solitary nodule.Methods 20 cases of adrenal hyperplasia characterized with solitary nodule and 28 adrenal adenomas confirmed by pathology underwent routine CT plain scan and multiphase enhanced CT scan.The density of nodule,capsule and de-gree of enhancement in each period were respectively analyzed and compared with the normal adrenal.The difference of CT value be-fore and after enhancement(△CT value)of the both was compared using pairing t test.Results 20 cases of adrenal hyperplasia nod-ules had no clear boundary with normal adrenal.Of which 1 5 cases showed isodensity,and their degree of enhancement was synchro-nized with normal adrenal;4 cases showed lower density,of which 2 had no enhancement,the other 2 obviously enhanced,but lower than normal adrenal;1 case showed mixed density mass,mainly composed of soft tissue,fat and punctuate calcification could be seen in it.Enhanced △CT values of 20 cases of adrenal hyperplasia nodule and normal adrenal were compared respectively,and there was no significant difference(P >0.05).28 cases of adrenal adenomas presented lower density than that of normal adrenal and had obvi-ous boundary between them.Enhanced △CT values in arterial phase of the lesion and normal adrenal showed significant statistically difference (P <0.05).Conclusion CT performance of adrenal hyperplasia with solitary nodule has specific characteristics,the densi-ty,capsule and enhanced mode will be helpful in differentiating from adrenal cortical adenoma.

Objective To investigate association between serum uric acid (SUA),albuminuria and glomerular filtration rates (eGFR) in type 2 diabetic patients.Methods A total of 220 patients were enrolled in this cross-sectional study.According to urinary albumin excretion rates,patients were divided into 3 groups:normoalbuminuria (NAU) group,microalbuminuria (MAU) group,and macroalbumnuria group (MAAU).The first two groups were subdivided at SUA ＞ 420 μmol/L (＞ 357 μmol/L,female) into normouricemia group and hyperuricemia group,at eGFR ＞ 90 ml/min into high and low renal function groups.General information,blood biochemical results were collected to analyze the association between serum uric acid,eGFR,UAER and urine albumin quantification among different groups.Results The difference of SBP,duration of diabetes (DD),Scr,SUA and eGFR between every two groups were significant (P ＜ 0.05).SBP,DD,Scr and SUA were highest in subjects with macroalbumnuria,second in microalbuminuria group,and lowest in normoalbuminuria group,while eGFR was lowest in macroalbumnuria group and highest in normoalbuminuria group.Prevalence of hyperuricemia in macroalbumnuria group (56.9％) and microalbuminuria group (51.2％) were also significantly higher than that in normoalbuminuria group (17.5％) (all P ＜ 0.01).The difference of UAER in the subgroups of normouricemia and hyperuricemia was more significant in microalbuminuria group than in normoalbuminuria group.eGFR was significantly lower in hyperuricemia subgroups (P ＜0.01).Age and SUA were significantlg higher in subjects with low renal function compared with high eGFR (P ＜ 0.05).Linear regression analysis indicated SUA was negatively correlated with eGFR after adjusted age,DD and UAER (β =-0.430,P ＜ 0.01).Binary logistic regression analysis found that increased age,DD and SUA were risk factors of microalbuminuria β =1.092,95％ CI(1.025,1.163),P ＜ 0.01;β =1.005,95％CI(1.001,1.009),P ＜ 0.05;β =1.407,95％ CI(1.052,1.881),P ＜ 0.05)] and SUA,age were risk factors of early renal function decline [β =1.015,95 ％ CI(1.00,1.023),P ＜ 0.01;β =1.098,95％ CI(1.006,1.199),P ＜ 0.05].Conclusion SUA is independently associated with albumnuria and renal function decline in type 2 DM patients.

PurposeTo evaluate 64-slice spiral CT in grading of colorectal adenoma and in the diagnosis of adenocarcinoma.Materials and Methods Sixty-eight cases of pathology confirmed colorectal adenoma were retrospectively reviewed to analyze CT performance including the location, size, shape and their relationship with adjacent structures and degree of enhancement in arterial, venous and delayed phase. The difference of CT attenuation value before and after enhancement (△CT value) in arterial, venous and delay phase of different pathological types and different levels of adenomas were compared.Results Among 68 lesions, 16 were villous adenomas, 42 were tubulovillous adenomas and 10 were tubular adenomas. Villous adenomas and tubulovillous adenomas were characterized by wide base, villous-like with gyral or frond pattern enhancement in arterial phase. There was a layer of low density mucus covering the surface. Tubular adenomas were featured as narrow base, nodular in shape with homogeneous enhancement.△CT values in each phase between villous adenomas and tubular adenomas showed statistically significant difference (arterial phaset=2.56,P<0.05; venous phaset=3.22,P<0.05; delayed phaset=2.48,P<0.05), however no significant difference was shown between villous and tubule villous adenomas or between tubulovillous and tubular adenomas. Adenocarcinomas showed creeping-type growth along the intestinal wall with a cluster of vessels adjacent to the tumor or enlarged lymph nodes.△CT values in each phase between non-dysplasia group and carcinoma group showed statistically significant difference (arterial phaset=2.49,P<0.05; venous phase t=2.69,P<0.05; delayed phaset=2.75,P<0.05), however no significant difference was shown between non-dysplasia group and dysplasia group or between dysplasia group and carcinoma group. Using 50 HU of△CT value in artery phase as standard, the sensitivity and specificity for diagnosis of adenocarcinomas were 76.92% and 70.91%, respectively.Conclusion CT findings of different pathological types of colorectal adenomas and adenocarcinomas are characteristic and useful in preoperative diagnosis and treatment planning.

Over-expression of APP and Swedish mutation could cause some familial early onset AD. In this study, a primary screening was conducted of effective small interference RNAs (siRNAs) targeted wild type APP (APPwt) and Swedish mutant APP (APPswe). One siRNA targeting APPwt and the other siRNA targeting APPswe were designed. All these siRNAs were endogenously expressed by siRNAs expressing plasmids. COS-7 cells were transiently co-transfected with APP-GFP recombinant plasmids and siRNA expression vector. The silencing effect of each siRNA was quantitatively assessed by the level of expression of green fluorescent protein (GFP). It was found that the siRNAs silenced APPwt and APPswe to different degrees. siRNA directed against APPswe was more effective in suppressing the expression of fusion gene of APPswe than that of APPwt. The silencing effect of siRNA directed against APPswe indicating allele-specific silencing property of the siRNAs. Therefore, siRNAs directed against APP play an important role both in the therapeutic study of Alzheimer disease and functional exploration ofAPP gene.

Objective To investigate the clinical characteristics of systemic lupus erythematosus (SLE) and the situation of diagnosis after onset. Methods Three hundred outpatients diagnosed with SLE were investigated in the People's Hospital, the Third Hospital of Peking University, Xinjiang People's Hospital and the Affiliated Hospital from May to July 2008, including gender, age of onset, clinical manifestations and the site of first hospitalization. Results ① In the cross-sectional study, 300 SLE patients were investigated. The male-to-female ratio was 1:13. ② The most common manifestations at onset were arthritis (46.3%), rash (34.%) and fever (32.7%). Lupus nephritis was found to occur in a significantly higher frequency in male patients than female as the initial manifestation. 60.9% patients had lupus nephritis in the first year after onset. ③ 99.1% of the patients were correctly diagnosed after visiting rheumatologists. 23.7% of the SLE patients were not correctly diagnosed for more than one year after disease onset. Conclusion Arthritis, rash and fever are the most common initial clinical manifestations of SLE. Lupus nephritis is more commonly seen in male SLE patients than female at the disease onset. The diagnosis of lupus is delayed in certain proportion of patients.

Objective To investigate the effects and mechanism of huoxuexiaoying tablet on experimental goiter of rats. Methods The rats were randomly divided into six groups: the control, the model control group, huoxuexiaoying tablet at different doses,and the sodium levothyroxine group ( Euthyrox group) . Except for the rats in the control,the rats in other groups were given with propylthiouracil (20 mg·kg-1 ·d-1 ) by intragastric ( i. g. ) administration every day for 60 days. Meanwhile, some rats were treated with huoxuexiaoying tablet at low (4. 4 g·kg-1·d-1),middle (8. 8 g·kg-1·d-1) and high dose (17. 6 g·kg-1 ·d-1 ) orally,and those in the Euthyrox group were given with 7. 8μg·kg-1 ·d-1 Euthyrox by i. g. administration. The rats in the control group were administrated with the same volume of saline (N. S). After 60 days of treatment,the rats were sacrificed,the organ indexes of thyroid and pituitary and the levels of free triiodothyronine ( FT3 )、free thyroxin ( FT4 ) and thyroid stimulating hormone(TSH) in serum,were tested. The expression of basic fibroblast growth factor(bFGF),transforming growth factor-β( TGF-β) and B-cell lymphoma 2 gene ( Bcl-2 ) were examined by immunofluorescence. Results Compared with the model,organ indexes of thyroid were significantly reduced by huoxuexiaoying tablet at three doses (P<0. 05),but not for the pituitary (P>0. 05). The levels of FT3 and FT4 were in a elevating trend,but TSH decreased with no significance (P>0. 05). The morphological structure of thyroid was greatly improved by huoxuexiaoying tablet in comparison with the model. In which the gland dilated,thyroid follicular restored to moderate size,epithelia were cubic or flattened and follicular cavity filled with abundant glial. The expression of bFGF and Bcl-2 decreased significantly (P<0. 01) while TGF-β expression increased notably (P<0. 01). Conclusion Huoxuexiaoying tablet has a great anti-goiter effect,the mechanism of which may be related to promoting thyroid cells apoptosis and inhibiting thyroid cells proliferation.

Objective:To observe the clinical effect of four-point fixation in patients with posterior chamber intraocular lens dislocation.Methods:A retrospective case series study was adopted.Sixteen patients (16 eyes) with posterior chamber intraocular lens dislocation who underwent suture suspension techniques with four-point fixation in Changzhou No.2 people's Hospital from January 2015 to January 2018 were enrolled.Postoperative effects were observed during follow-up, ranging from 6 to 13 months.The preoperative and 6-month postoperative uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), corneal endothelium cell count and astigmatism were measured and the differences were compared, and the relationships between total astigmatism and corneal astigmatism or intraocular lens induced astigmatism were analyzed, and the postoperative position of intraocular lens and complications were observed.This study adhered to the Declaration of Helsinki.The study protocol was approved by an Ethics Committee of Changzhou No.2 People's Hospital (No.2015-C-012-01).Written informed consent was obtained from each patient before surgery.Results:The mean preoperative UCVA (LogMAR) and BCVA (LogMAR) were 1.09±0.24 and 0.48±0.20, respectively, which were significantly improved to 0.30±0.12 and 0.26±0.13 at 6 months after operation, respectively.And the differences were statistically significant ( t=11.782, 3.795; both at P<0.01).The preoperative and 6-month postoperative corneal endothelium cell count were (2 270±360)/mm 2 and (2 032±327)/mm 2, respectively, and the difference was not significant ( t=1.921, P=0.074).The 6-month postoperative mean total astigmatism, corneal astigmatism and intraocular lens induced astigmatism were (-1.47±0.82)D, (-1.34±0.61)D and (-0.22±0.35)D, respectively.There was a highly positive correlation between total astigmatism and corneal astigmatism ( r=0.885, P<0.05), but there was no significant correlation between total astigmatism and intraocular lens induced astigmatism ( r=-0.432, P=0.095).No dislocation, deviation or torsion of intraocular lens were observed during the follow-up.Varying degree of symptoms of iridocyclitis were observed during early stage after operation, which disappeared after treatment.There were two cases of high intraocular pressure, which were normal after treatment.No retinal detachment, choroidal detachment, expulsive suprachoroidal hemorrhage, endophthalmitis, corneal endothelial decompensation or other complications occurred during and after operation. Conclusions:There is a stable position of intraocular lens, good visual acuity and few complications after four-point fixation with suture and suspension, which is a feasible method to treat dislocated intraocular lens.

Objective To discuss the operative procedures and clinical result of posteromedial and posterolateral approaches in treatment of posterior condylar tibial plateau fractures. Methods From January 2006 to June 2008, 21 patients of posterior condylar tibial plateau fractures were treated by posteromedial and posterolateral knee approaches. There were 12 males and 9 females. The age ranged from 28 to 68 years, with a mean of 39.5 years. Of the patients, 13 had resulted from a traffic accident and 8 had caused by a fall. As for the state of posterior condylar tibial plateau fractures, 7 patients had a medial condylar.fracture, 8 patients had a lateral condylar fracture and 6 patients had a bilateral condylar fracture. Results A follow-up lasted 12-24 months (mean 16.2 months ) in 21 patients. There was no infection, no varus or valgus of the knee, no nerve injuries and loosening or breakage of the screw. All cases had attained bone union. According to the Rasmussen functional scoring, the results were excellent in 12, good in 7 and fair in 2. The excellent and good rate of clinical results was 90.5%. Radiologic results were graded with the Rasmussen score to evaluate the reduction of fracture. There were excellent in 13, good in 7 and fair in 1. The excellent and good rate of clinical results was 95.2%. Conclusion Posteromedial and posterolateral approaches can facilitate the reduction and fixation for posterior condylar tibial plateau fractures. It has many advantages such as good exposure, less invasion and the excellent clinical results.

Hepatic alveolar echinococcosis is a kind of zoonosis with poor prognosis.At present,the diagnosis and treatment are mainly based on ultrasound,CT diagnosis,MRI and other classical imaging by detecting the terminal effects of the changes on the cell molecules of the disease itself,the organ anatomy changes.However,it is found that the above imaging techniques have limitations in the diagnosis and treatment.For example,the infiltration zone of the lesion is not clear and the degree of biological activity can not be determined.This leads to a higher recurrence rate in the late stage of clinical treatment.In recent years,the molecular imaging shows the abnormal cell and molecular level in the disease process has been developed rapidly.This has led to several diagnosis and treatment problems related to liver vesicular disease.This paper mainly reviews the research results of the disease in the field of molecular imaging and the development direction of this field in the future,to provide guidance for future clinical and scientific research.

Objective: To investigate the characteristics of neuropsychological factors in patients with persistent postural-perceptual dizziness(PPPD) and provide the basis for the psychosomatic comprehensive treatment. Methods: Cartel Personality Test (16PF), Symptom Checklist 90 (SCL-90), HAMA, HDMD, SAS and SDS were used to evaluate personality and mental state in patients with PPPD(PPPD group, n=65) and control group(n=63). Dizziness handicap inventory(DHI) was used to evaluate the degree of vertigo.The correlation analysis was carried out between the DHI scores and 16-PF, SCL-90 factor scores. Results: (1)16PF factor scores: the factor scores of assertiveness(8.50±1.84), excitability (6.59±1.73), boldness (7.46±1.78), sensitivity (7.25±1.79), doubtfulness (6.55±1.74), fantasy(6.20±1.60), anxiety(7.67±1.61) and tension(6.81±1.67)in PPPD group were higher than those in the control group, and the differences were statistically significant (all P<0.05). The gregariousness (4.38±1.65), intelligence (4.51±1.67), stability (3.51±1.75), independence (4.39±1.56) and self-discipline (4.70±1.82) factor scores in PPPD group were lower than those in the control group, and the differences were statistically significant (all P<0.05). (2)SCL-90 factor scores: the factor scores of somatization(1.62±0.40), anxiety (1.64±0.56), interpersonal sensitivity (1.79±0.42), terrifying(1.71±0.53), total points(150.77±21.60), total average score (1.62±0.51) in PPPD group were higher than those in control group (all P<0.05). There were no differences in obsessive-compulsive (1.50±0.55), depression (1.45±0.44), hostility (1.69±0.60), paranoia (1.76±0.53), somatization (1.42±0.49) and psychotic (1.29±0.35) between PPPD group and the control group (all P>0.05). (3)The factor scores of HAMA(9.08±1.77) and SAS(37.88±2.96)in patients with PPPD were higher than that in the control group, and the differences were statistically significant (all P<0.05). There was no significant difference in HAMD (6.19±2.82) and SDS (36.36±4.71) scores between PPPD group and control group (all P>0.05). (4)The DHI scores were positively correlated with assertiveness, sensitivity, tension and doubtfulness factors of 16PF.The DHI scores were positively correlated with somatization, interpersonal sensitivity, anxiety and terrifying factors of SCL-90. Conclusion Patients with persistent postural-perceptual dizziness suffer from personality changes, mental disorders and anxiety disorder.