Objective To study CT findings of duodenal malignant tumor.Methods Plain and contrast-enhanced CT date of 20 patients with duodenal malignant tumor proved by pathology were retrospectively analysed.Results There were three adenocarcinomas, two lymphomas, three malignant gastrointestinal stromal tumors, three ampulla carcinomas, eight carcinomas of head of pancreas, one pancreatic nonfunction neuroendocrine cell carcinoma. Duodenal adenocarcinoma manifested as local irregular constriction of cavity accompanied with soft tissue mass. After enhancement, the mass manifested as moderate enhancement. Lymphoma manifested as extensive duodenal wall thickening or extracavity mass,after enhancement,the mass was manifested as mild enhancement. Malignant gastrointestinal stromal tumor manifested as massive mass with heterogeneous marked enhancement,ileus was not obvious. Ampulla carcinoma manifested as local soft tissues mass with mild and moderate enhancement in the media of duodenal descent part, intrahepatic and extrahepatic biliary duct dialated. Carcinoma of head of pancreas involving duodenum manifested as duodenal medial wall roug,mass in the head of pancreas with no enhancement, intrahepatic and extrahepatic biliary duct dilated. Pancreatic nonfunction neuroendocrine cell carcinoma involving duodenum manifested as massive mass with marked enhancement in the head of pancreas,there was indistinction between mass and duodenum, intrahepatic and extrahepatic biliary duct were non-dilation.Conclusion CT scan plays an important role in the diagnosis of duodenal malignant tumor.

Evoked potentials which can monitor spinal cord function in operation continuously and timely has been widely used in spinal orthopedics. However, intraoperative evoked potentials are affected by the technique in a variety of factors, how to improve the accuracy of intraoperative monitoring is still a problem to explore. In this paper, intraoperative nerve monitoring application and intraoperative potential reasons for the changes in the spine surgery orthopedic surgery were reviewed.

Objective To investigate the carrying rate and genotype of thalassemia in the household population of Yantian dis-trict in Shenzhen city so as to provide the scientific basis for Thalassemia genetic counseling,prenatal diagnosis and prevention plan. Methods 3 mL of anticoagulation blood by EDTA-K2 was extract for conducting the whole blood cells analysis.With the mean cor-puscular volume(MCV)<80 fL as the preliminary screening test,then the suspected cases were performed the DNA extraction for conducting the gene test.In theα-thalassemia detection,4 pairs of PCR primer were used to amplify in the same reaction system and the results were analyzed according to the band after the agarose gel electrophoresis.In theβ-thalassemia detection,the PCR product sequencing was adopted.Results After the preliminary screening,4 657 suspected cases all were performed the gene detection.510 carriers with thalassemia gene were detected out with the thalassemia gene carrying rate of 10.95%,including 389 cases carryingα-thalassemia gene with the carrying rate of 8.35%,which was dominated by α-3.7,α-4.2 and α-SEA,and 121 cases carrying βthalassemia gene with the carrying rate of 2.59%,which was dominated by CD41.42,LVS-Ⅱ-654,CD17 and CD71.Conclusion The carrying rate of thalassemia gene in the household population of Yantian district was 10.95%,which is closed to that in other districts within Guangdong province,all of the 8 detected genotypes of thalassemia are the common types.

Objective To evaluate the application value of denaturing high-performance liquid chromatography (DHPLC) as a rapid gene typing tool for β thalassemia. Methods 226 suspicious samples were screened with MCV, RDW, erythrocytcte agility and hemoglobin electrophoresis. The final diagnosis ofβ thalassemia genotype was made by DHPLC and PCR-reverse dot blot (PCR-RDB). Results Sixty-nine samples (30. 5% ) were eventually diagnosed as βthalassemia by PCR-RDB. The genotyping results for βthalassemia identified by DHPLC were complete agreement with genotyping results by PCR-RDB. We found 37 cases of CD41/CD42 ( - TCTT) frame shift mutation(54% ) ; 12 cases of IVS - Ⅱ - 654 (C→T) insertion mutation( 17% ) ;10 cases of TATA - 28 (A→G) transcription mutation ( 15% ) ;5 cases of CD17 (A→T)nonsense mutation ( 7% ) ; 5 cases of CD71/CD72 ( + A) frame shift mutation (7%). Conclusion The DHPLC is a rapid, sensitive , efficient and highly accurate assay in the diagnosis of β-thalassemia.

The study aims to screen the ability of the bacteria to metabolize ononin and assess the effect of ononin on the intestinal bacteria. Fresh human fecal sample was obtained from a healthy volunteer, diluted serially in sterile water and sixty-nine different bacterial colonies were picked out ultimately. UPLC-Q-TOF/MS with automated data analysis software (MetaboLynx) was applied to fast analysis of ononin metabolites. Furthermore, an E(max) precision microplate reader was employed to determine the growth situation of Enterococcous sp., Enterobacter sp., Lactobacilli sp., and Bifidobacteria sp. Results indicated that hydrogenation, demethylation, hydroxylation and deglycosylation were the major metabolic pathways of ononin by human intestinal bacteria in vitro. Ononin can inhibit the growth of pathogen such as Enterococcus sp., Enterobacter sp. and can promote the growth of probiotics such as Bifidobacteria sp. and Lactobacilli sp. This study suggested that intestinal bacteria have the metabolic effects of ononin and the biotransformation was completed by different bacteria. And ononin can affect the balance of intestinal flora and the degree of influence varies depending on the bacterial species and the concentration of ononin.

Naringin has been reported to possess a wild range of biological activities. However, the route and metabolites of naringin produced by intestinal bacteria are not well understood. In this paper, different bacteria were isolated from human feces and their abilities to convert naringin to different metabolites were studied. Ultra performance liquid chromatography-quadrupole time-of-flight mass spectrometry (UPLC-Q-TOF/MS) with automated data analysis software (MetaboLynx) was applied to fast analysis of naringin metabolites. Using MSE and mass defect filter techniques, three metabolites were detected and tentatively identified. The results indicated that acetylation, hydrolyzation and hydrolyzation with hydrogenation were the major metabolic pathways of naringin in vitro. Then, we studied the gene sequence of the 16S rRNA of the bacteria by extraction of genomic DNA of the strain, PCR amplification and clone of the 16S rRNA. The consequence proved that Enterococcus sp.30, Bacillus sp.46, Escherichia sp.54 and Escherichia sp.63 have the peculiar metabolism characteristic of naringin.

As the state vigorously promotes the high-quality development of hospitals and improves people's medical ex-perience,the patient-centered hospital should make full use of technological resources such as the Internet,5 G and artificial in-telligence,vigorously develop mobile medical services and artificial intelligence services,transform and optimize the diagnosis and treatment process,and streamline all links before,during and after diagnosis so as to provide better data services to the pa-tient to ensure that they can get things done with greater ease.The patients'medical experience and hospital management effi-ciency can be greatly improved.In this study,specific measures to create a new diagnosis and treatment model through the con-struction of smart hospital platform were expounded in order to provide references for related research and policy formulation of other Chinese medical institutions.

Purpose To explore the value of iodine concentration(IC)and effective atomic number(Zeff)derived from dual-layer spectral detector CT in diagnosing the regional lymph nodes of gastric cancer.Materials and Methods From May 2021 to September 2022,108 patients pathologically confirmed with gastric cancer(92 non-metastatic lymph nodes and 116 metastatic lymph nodes),who underwent dual-phase enhanced dual-layer spectral detector CT scanning preoperatively in the Second Affiliated Hospital of Guangzhou University of Chinese Medicine,were included in the study.The imaging and clinical data of all cases were collected,retrospectively.According to preoperative CT images,the short diameter,margin and enhancement homogeneity of the lymph nodes were evaluated.The IC and Zeff were obtained from the delineated region of interest of the solid portion of the maximum layer of the target lymph nodes,and the normalization IC(nIC)and normalization Zeff(nZeff)were calculated.The difference of parameters between two groups were compared.The efficiency of differential diagnosis and combined diagnosis of each parameter was analyzed.The area under the receiver characteristic curve(AUC)for each parameter were compared.Results There were statistical differences in short diameter,margin and enhancement homogeneity between the two groups(t/x2=-7.575,30.971,20.913,all P＜0.001).In the benign lymph nodes group,all spectral parameters in the arterial phase(AP)were lower than those in malignant lymph nodes,while the parameters in the venous phase(VP)were higher(t=-10.723-12.610,all P＜0.001).Among the three conventional features,the AUC of short diameter was the highest(0.749).Compared with the AUC values of ICAP and ZeffVP,the AUC values of short diameter and quantitative parameters had no statistical difference(P＞0.05),but were lower than those of other spectral parameters.Among the spectral parameters,the AUC value of nICVP was the highest(0.925).The sensitivity and specificity of the spectral parameters were higher than those of conventional features.The diagnostic efficacy of the multi-parameter combined model was superior to that of the univariate model.The AUC value of the combined model with conventional features was 0.815.Among the combined model based on CT spectral parameters,the diagnostic efficacy of model combined with the parameters of arteriovenous phase was the highest(AUC=0.993).Conclusion The quantitative parameters of dual-phase enhancement derived from dual-layer spectral detector CT can effectively evaluate the characteristics of gastric cancer regional lymph nodes,and the diagnostic efficiency is higher than the conventional characteristics of lymph nodes.The multi-parameter combined model can improve the diagnostic efficiency.

Purpose To explore the value of dual-layer spectral detector CT(DLSCT)in evaluating preoperative tumor staging in rectal adenocarcinoma(RA).Materials and Methods A total of 78 patients with pathologically confirmed RA in Guangdong Provincial Hospital of Chinese Medicine from May 2021 to March 2022 were involved in this retrospective study.All the patients underwent plain and dual-phase contrast-enhanced scans by DLSCT within one week before surgery.Taking pathological results as the golden standard,the accuracy rates of tumor staging were calculated and compared between the multiple-parameter maps derived from DLSCT and 120 kVp polyenergetic image.The effective atomic number(Z-eff)from plain scan,iodine concentration(IC)from arterial phase(AP)and venous phase(VP)were measured.The normalized iodine concentration(NIC)in AP and VP were calculated.The differences of Z-eff,NICAP and NICVP were compared among the pT1-2,pT3 and pT4 groups.The correlation between the pT stages and above values was assessed and the diagnostic efficiencies were analyzed.Results The overall accuracy rate(88.46%vs.67.95%;χ2=9.628,P=0.002),the pT1-2 staging accuracy rate(80.00%vs.40.00%;χ2=6.667,P=0.01),and the pT3 staging accuracy rate(88.10%vs.69.05%;χ2=4.525,P=0.033)of multiple-parameter maps derived from DLSCT were significantly higher than those of 120 kVp polyenergetic image,respectively.The Z-eff,NICAP and NICVP were significantly different among pT stage groups(F=6.456,11.029,12.698,all P<0.05)and exhibited a positive correlation with pT stages(r=0.371,0.367,0.363,all P<0.01).The areas under the curve of Z-eff,NICAP and NICVP to assess pT3-4 staging RA were 0.77,0.71 and 0.74,respectively.Conclusion The multiple-parameter maps derived from DLSCT can significantly improve the diagnostic accuracy of preoperative tumor staging of RA.Z-eff from plain scan and NIC from dual-phase helps differentiate pT1-2 from pT3-4 staging RA.

Objective:To explore the value of dual-layer detector spectral CT quantitative parameters in evaluating the treatment response of neoadjuvant chemoradiotherapy (nCRT) in patients with locally advanced rectal cancer (LARC).Methods:The study was a cross-sectional study. From May 2021 to March 2023, a total of 52 patients with LARC who received complete nCRT and were pathologically confirmed rectal adenocarcinoma at the Guangdong Province Hospital of Traditional Chinese Medicine were retrospectively enrolled. Each patient underwent spectral CT examination before and after nCRT, including plain scan, arterial phase (AP), and venous phase (VP) scans. According to the tumor regression grade, the patients were divided into the good response ( n=20) and the poor response group ( n=32). Measurements of the primary tumor′s spectral CT parameters, including effective atomic number (Z eff) at plain scan, iodine concentration (IC), CT values of 40 keV and 100 keV virtual monochromatic image (VMI) at dual-enhanced phases, were taken before and after nCRT. Additionally, the normalized iodine concentration (NIC), spectral curve slope (λHU), and the change rate of the above parameters before and after nCRT were calculated. The independent sample t-test or Mann-Whitney U test was used to compare the differences between the two groups. The receiver operating characteristic (ROC) curve was used to assess the efficacy of various metrics in evaluating the tumor treatment response of nCRT. A binary logistic regression analysis of combined parameter results was performed for the parameters with the areas under curve (AUC)>0.75, and the AUC of the combined parameter was evaluated. Results:There were significant differences in NIC AP and λHU VP before nCRT, NIC VP and λHU VP after nCRT, and the change rates of Z eff, NIC AP, NIC VP and λHU AP between the good response group and the poor response group ( P<0.05). The remaining parameters showed no statistically significant difference ( P>0.05). The ROC curve results showed that the AUCs of the above 8 parameters for evaluating tumor treatment response of nCRT were 0.702, 0.655, 0.695, 0.769, 0.738, 0.807, 0.791, and 0.677, respectively. The AUC of the combined model of the three parameters with AUC>0.75 (λHU VP after nCRT, the change rate of NIC AP and NIC VP) was 0.869, with 80.0% sensitivity and 84.4% specificity. Conclusion:The quantitative parameters derived from spectral CT may provide new markers for evaluating the response to nCRT treatment in patients with LARC. The multi-parameter combined model can improve diagnostic efficacy.