Objective To assess the virtual non-contrast liver CT from dual-energy CT for the clinical application. Methods In total, 51 patients were included in the study, and all patients underwent multi-phase liver CT on a dual-source CT. The True non-contrast liver CT (TNCT) was performed in a single-energy acquisition mode, but the arterial and portovenous liver CT (VNCT) were performed in a dual-energy mode of 110 kV and 140 kV respectively. The virtual non-contrast CT images were derived from the arterial data using liver virtual non-contrast software. Between the true non-contrast CT and the virtual non-contrast CT, the image quality, mean CT HU values in the liver and muscle, signal to noise (SNR), the radiation dose of volume CT dose index (CTDIvol) and dose length product (DLP) in a single phase and total examination were compared with t test. Results There was no significant difference in the detection of liver lesions between TNCT and VNCT. The CT Hu values of muscle on both TNCT and VNCT images were almost equal. The CT HU values of liver on VNCT images were higher than that on TNCT images and the difference was significant [61.32 ±6. 04 vs. (56. 85 ±4. 80) HU, t = -3. 927,P＜0.01]. There was also significant differenc of SNR between TNCT (11.28±2. 78) and VNCT (8.65 ± 1.56) images( t =-5.590,P＜0.01). The CTDIvol and DLP of single phase were (7.07 ±0.85) mGy and (155.11 ±respectively, but in TNCT the total CTDIvol and DLP reached (21.43 ± 2. 46 ) mGy and (469. 02 ±significance, but the total CTDIvol and DLP were significantly different (t = 16. 168 and 13. 132, P ＜0. 01). Conclusion With the consequent reduction in radiation dose, the VNCT can replace TNCT as an imaging protocol in multi-phase abdominal CT examination in clinic.

Objective To study the effect of thrombin on proliferation and invasion of esophageal cancer cell line Eca109, and to explore its possible mechanism. Methods The proliferation and invasion of Eca 109 cells treated with thrombin were detected by MTT and Transwell assay, respectively. The activity of matrix metalloproteinase 2 (MMP-2) and MMP-9 in the supernatant of Eca109 cells was detected by gelatin zymography. Reverse transcription polymerase chain reaction (PCR) and immunocytochemistry were used to study the mRNA expression of protease-activated receptor 1 (PAR-1), the important receptor of thrombin, and subcellular localization of PAR-1 protein in Eca109 cells, respectively. Results Thrombin could promote Eca109 cells proliferation in a dose-dependent manner. Cell proliferative rates of 0.5 U/ml and 1.0 U/ml thrombin were 34.38 % and 57.19 %, respectively (P< 0.05). Compared to that of control group, the number of Eca109 cells incubated with 1.0 U/ml thrombin invading through the basement membrane of Transwell was increased (303.33 ±6.66 vs. 116.33 ±11.51, P< 0.05). When treated with various concentrations of thrombin for 24 h, the activities of MMP-2 and MMP-9, especially MMP-9, in the supernatant of Eca109 cells were increased in a dose-dependent manner. Eca109 cells expressed PAR-1 mRNA, and PAR-1 protein was mainly located on the cellular membrane. Conclusion Thrombin increases proliferation and invasion of esophageal cancer Eca109 cells and enhances the activities of MMP-2 and MMP-9 in cells supernatant, which might be induced by activation of PAR-1 located on cellular membrane.

Objective To investigate the gene carrying rate,gene type and composition ratio of thalassemia among pre-pregnant population in Chongqing area.Methods A total of 1054 people were enrolled in the hospital from April 2014 to March 2016 for thalassemia screening.The content of screening included mean corpuscular volume (MCV),mean corpuscular hemoglobin (MCH) and hemoglobin electrophoresis.Thalassemia gene was examined in people with any abnormal term of screening result.Results In 10854 cases,1117 cases showed positive in thalassemia primary screening,and the positive rate was 10.29％.458 cases were tested positive of thalassemia gene,the carrying rate of thalassemia was 4.21％.In which,253 cases of pure a-thalassemia were tested.The carrying rate of α-thalassemia was 2.33％.The most common kind in α-thalassemia was--SEA whose constituent ratio were 52.17 ％.197 cases of pure β-thalassemia were tested,the carrying rate of β-thalassemia was 1.81％.The most common kind in β-thalassemia was CD17 (A→T),whose constituent ratio were 31.47 ％.11 cases were diagnosed with αβ-thalassemia.Conclusion Chongqing is high-prevalence area of thalassemia.It is important to conduct thalassemia genetic screen before pregnancy which plays a vital role in improving population quality and achieving prepotency.

Objective To compare a prospective ECG-gated high-pitch spiral technique (Flash) and conventional retrospective ECG-gated spiral technique for the image quality of coronary artery stent and radiation dose with a dual source CT.Methods One hundred and fifty five coronary stents in one hundred and twenty patients (mean age 64.9 ± 10.6 years,heart rates≤65 bpm) were examined using a dual source CT.All patients were divided in two groups,receiving either Flash or conventional coronary artery CT angiography separately.After images of coronary artery were reconstructed using both the smooth (B26) and sharp (B46) kernel,the coronary stent image quality and stent lumen were scored by two observers individually using four point scale (1 = excellent,4 = unvaluable) .The effective radiation dose of volume CT dose index (CTDIvol,mGy) and dose length product (DLP,mGy x cm) were also calculated for each patient.x2-test analysis of image quality and t-test analysis of radiation dose were used respectively for statistical difference between two groups.Results Interobserver agreement for stent image quality was good (Kappa =0.764,P＜0.001).The mean scores were 1.61 ±0.77 and 1.65 ±0.82 in Flash group and conventional group respectively.There was no significant difference in image quality between the two groups (x2 = 0.865,P = 0.834).The effective radiation dose in Flash group was significantly lower than that in conventional group.The mean values of CTDIvol were 3.24 ± 1.21 in Flash group and 31.26 ± 10.79 in conventional group (t = 19.83,P < 0.001) ,and the mean values of DLP in Flash group and conventional group were 54.61 ±19.88 and 468.30 ± 174.88,respectively (t = 18.06,P < 0.001).Conclusions Compared with the conventiaonal coronary artery CT angiography,the Flash coronary artery CT angiography technique has a similar coronary stent image quality,but at a lower radiation dose in patients with heart rates lower than 65 beats per minute.

ObjectiveTo determine the feasibility of using left ventricular volume-time curve in the evaluation of left ventricular diastolic function,and to analyze characteristics of left ventricular volume-time curve changcs in hypertrophic cardiomyopathy (HCM).MethodsSeventeen cases of HCM and 12 healthy volunteers received cardiac MRI (CMRI) examination,and left ventricular (LV) 2-chamber long and short axis cine imaging were performed,LV volume-time curves were reconstructed and platform time,different diastolic volume recovery (DVR) time and their corresponding filling velocity were calculated from LV volume-time curve off-line.The DVR time and their corresponding filling velocity were analyzed by using multiple linear regression analysis. Results Compared with the group of healthy volunteers,ventricular septal HCM group had delayed left ventricular 50％,70％ DVR time[ (8.9 ± 1.3) versus (7.7 ± 0.8 ) phase,F=6.787,P=0.016;(11.3 ±1.6) versus(9.7±1.8) phase,F=4.927,P=0.036] and shortened plateau time [ ( 1.8 ± 1.7) versus ( 4.1 ± 1.4 ) phase,t =6.787,P ＜ 0.01 ].Ventricular septal HCM group had reduced 30％,50％ DVR filling rates [ (0.22 ± 0.11 ) versus (0.40 ± 0.15 ) ml/ms,F =12.916,P ＜ 0.01 ; (0.20 ± 0.09 ) versus (0.30 ± 0.10) ml/ms,F =7.121,P =0.014 ] compared with those in the group of healthy volunteers.But 70％,80％,90％ DVR filling rates showed no statistically significant different in the two groups.In HCM patients,myocardial fibrosis caused 50％,70％,80％ DVR time delay [ (9.6 ± 1.0) versus ( 7.9 ± 1.5 ) phase,F =5.000,P =0.045 ; ( 12.3 ± 1.4 ) versus ( 9.6 ± 1.8)phase,F=8.039,P=0.015;(13.1 ±1.4 ) versus(10.9±1.9)phase,F=5.060,P=0.044],but no significant difference of DVR filling rate was found between the two groups. Conclusions Left ventricular volume curve analysis techniques can be used for detailed evaluation of left ventricular diastolic function.The left ventricular diastolic dysfunction of hypertrophic cardiomyopathy occurs mainly in early diastolic period,and accompanied by the shortening of the plateau time. Myocardial fibrosis can aggravate early left ventricular diastolic dysfunction of hypertrophic cardiomyopathy.

Objective To evaluate the clinical performance of an automated image analysis systems named CellaVision DM96 in classifying White Blood Cells.Methods A total of 2267 peripheral blood samples (male 1 235, female 1 034, average age 46) were obtained from outpatient and inpatient in Peking Union Medical College Hospital ( PUMCH ) . These samples were selected to evaluate the precision, sensitivity, specificity and the analytical error of the system.We first evaluated the coincidence rate of reclassification and manual microscopy.On the base of favourable coincidence rate, we then evaluated the correlations between the pre-classification and reclassification of segmented neutrophil, band neutrophil, lymphocyte, monocyte, eosinophile, basophile, blast cell, promyelocyte, myelocyte, metamyelocyte, plasma cell and reactive lymphocyte.Results The sensitivity and specificity of pre-classification of White Blood Cell were 46% -100% and 24%-92%, respectively.When studied on the cell level, the total coincidence rate of pre-classification was 88%.And the coincidence rates of pre-classification and reclassification of White Blood Cell were 6%-95% and 25%-100%, respectively.When assessed on the sample level, the coincidence rates of pre-classification and reclassification of leukocytes were 64%-98%and 84%-100%, respectively.The correlations of pre-classification and reclassification of leukocytes in order from high to low were: lymphocyte, segmented neutrophil, eosinophile, band neutrophil, monocyte, basophile, when r were 0.943 9, 0.915 2, 0.785 4, 0.775 6, 0.676 2 and 0.289 1, respectively.The correlations between reclassification and manual microscopy of White Blood Cell were higher than those between pre-classification and manual microscopy.Order from high to low was: eosinophile, segmented neutrophil, lymphocyte, monocyte, band neutrophil, basophile.And r were 0.972 1, 0.968 5, 0.957 0, 0.831 9, 0.800 6 and 0.648 7, respectively.The ability of this automated image analysis systems at pre-classification in distinguishing between band cell and segment cell, atypical lymphocyte and normal lymphocyte was not good. Conclusion The performance of reclassification was better than pre-classification.The reclassification can be substitute for the microscopy inspection, and be used in the Clinical practice.

Objective To explore the distribution of pathogenic micro-organisms in the diabetic patients with foot infection,and to investigate the characteristics of the pathogen distribution and its relationship with the severity of diabetic foot ulcer( DFU ).Methods Ninety diabetic foot patients with positive culture of micro-organisms were classified into Wagner 1-5 grades according to the severity of DFU,which was ranked as mild,moderate,and severe infection based on the gradient of infection.The family,genus,and strain of micro-organisms were analyzed,and associated factors were discussed in regard to the kinds and severity of DFU and infection.Results With rising Wagner's grades and aggravating infection,the bacterial floras were transformed from gram-positive cocci( 61.1％ in Wagner 1 ) to gram-negative rods( 80.0％ in Wagner 5),at the same time,composite( 10.0％ to 28.6％ ) and opportunist ( 83.3％ to 100％ ) infections were increased.Wagner's grade,severity of infection,previous treatment,patients' age,control of blood glucose,course of DFU,etc,were all related to types of infection and opportunist infection ( P＜0.05 ).Conclusions Proportion of gram-negative bacilli with opportunist composite infection seems to increase in patients with severe DFU and severe infection requiring appropriate application of antibiotics.

Objective Most common infected bacteria were found to analyze their effects on clinical characteristics and 3-year outcome of patients with diabetic foot ulcer ( DFU ) . Methods Materials of cases with positive bacterial culture were selected from DFU patients. 203 cases were infected with the most common 6 strains of mono-bacteria, and 62 cases were infected with multi-bacteria. Data were grouped according to the most common 6 infected bacteria. The outcomes of healing, recurrence, amputation, cardiac events, cerebrovascular events and death were calculated of 3 years after hospitalization. Clinical characteristics of mono-and multi-infected groups and these 6 mono-bacterial infection groups, and risk factors to outcome were analyzed. Results No significant difference was found in baseline clinical characteristics, cardiac and cerebrovascular events, and death during follow-up between mono-and multi-infected groups. The most common 6 infected bacteria were staphylococcus aureus, pseudomonas aeruginosa, proteus, enterococcus faecalis, escherichia coli and klebsiella pneumoniae. Among these groups, there were no significant differences of baseline clinical characteristics and recurrence, cardiac and cerebrovascular events, and death except for the foot ulcer and foot ulcer related prognosis. In staphylococcus aureus infected group, severe lower extremity arterial disease (8.5％), Wagner grade 3-5 (48.9％), moderate and severe infection rate (34.0％) were significantly lower than other groups, and the healing rate ( 93. 6％) was higher than other groups ( all P<0.05). Severe lower extremity arterial disease, cardiac function grading over 3(NYHA), eGFR<60 ml·min-1· (1.73 m2)-1, duration of DFU over 30 days were the main risk factors for ulcers′healing. Wagner grade over 3 was main risk factor for minor amputation. Severe lower extremity arterial disease, Hb<90g/L were the main risk factors for major amputation. Cardiac function grading over 3 ( NYHA ) was main risk factor for cardiac events, and also for death. ALB<30 g/L was main risk factor for death (all P<0.05). Conclusion DFU patients infected with different strains of bacteria were significantly different in foot ulcer and healing rate, while not in cardiac and cerebrovascular events and death.

Background:Rectal cancer is a common malignant tumor of alimentary tract.It has been demonstrated that oxaliplatin-based neoadjuvant chemotherapy is effective for rectal cancer,however,its mechanism is not fully clarified.Aims:To explore the effect of neoadjuvant chemnotherapy with FOLFOX4 (folinic acid,fluorouracil,and oxaliplatin) on expressions of Ki-67,a proliferating cell-associated nuclear antigen,matrix metalloproteinase-2 (MMP-2),and Fas,a death receptor in cancerous tissue of patients with rectal cancer.Methods:A total of 104 cases of patients with histologically proven rectal cancer from Aug.2014 to Feb.2016 at Central Hospital of China National Petroleum Corporation were enrolled prospectively and randomly allocated into treatment group (n =58) and control group (n =46).Patients in treatment group finished 6 cycles of neoadjuvant chemotherapy with FOLFOX4 before surgery,and those in control group underwent surgery directly.Expressions of Ki-67,MMP-2 and Fas protein in cancerous tissue of surgical specimens were determined immunohistochemically.Results:Immunoreactivity of Ki-67 mainly located in the nucleus of rectal cancer cells,and those of MMP-2 and Fas mainly located in the cytoplasm.Expression rates of Ki-67 and MMP-2 were significantly lower in treatment group than in control group (41.4％ vs.80.4％,P ＜ 0.05;36.2％ vs.73.9％,P ＜ 0.05),while those of Fas was significantly higher in treatment group than in control group (62.1％ vs.32.6％,P ＜ 0.05).Conclusions:The therapeutic effect of neoadjuvant chemotherapy with FOLFOX4 on rectal cancer might be associated with the inhibition of proliferative,invasive and metastatic capacities and induction of apoptosis in cancer cells.

Objective To investigate the clinicopathologic features of Chinese patients with early gastric cancer (EGC) according to the World Health Organization(WHO) diagnostic criteria,and to explore the risk factors of lymph node metastasis (LNM) in EGC.Methods From 2002 to 2017,at the Second Affiliated Hospital of Nantong University,and from 2014 to 2017,at the People's Hospital of Qidong City,the People's Hospital of Haimen City and the People's Hospital of Rugao City,315 EGC patients with complete clinicopathological data were enrolled.The clinicopathologic features were analyzed including gender,age,tumor location,tumor size,macroscopic type,histological type (WHO),differentiation degree,depth of tumor invasion,Lauren subtype,infiltration pattern,ulceration,lymphoid follicles,lymphovascular invasion and perineural invasion.Chi-square test and Fisher's exact test were performed for univariate analysis and the logistic regression was used for multivariate analysis.Results The ratio of EGC was 10.0％ (315/3 140) of patients with gastric cancer and received surgery during the same period.Among the 315 EGC,the ratio of well-differentiated tubular adenocarcinoma was 11.7％ (37/315),which was lower than 24.8％(2 752/11 104) in Japan and 19.9％(41/206) in South Korea,and the differences were statistically significant (x2 =28.208,P＜0.01;x2 =6.51 0,P =0.011),however there was no statistically significant difference when compared with Western countries (11.9 ％,8/67;x2 =0.002,P=0.964).Among the 276 patients who underwent radical gastrectomy,49 (17.8 ％) patients had with LNM.The results of univariate analysis showed that tumor size,macroscopic type,differentiation degree,depth of invasion,infiltration pattern,ulceration and lymphovascular invasion were related with LNM(x2=9.327,6.038,6.381,34.983,19.309,52.297 and 5.058;all P＜0.05).The results of multivariate analysis revealed that lymphovascular invasion and ulceration were the independent risk factors of LNM (odd ratio (OR)=7.028 and 2.566,both P＜0.05).Conclusions There is obvious difference in pathological diagnostic standard of well-differentiated tubular adenocarcinoma between China,Japan and South Korea,which may influence the therapeutic strategy of EGC.Lymphovascular invasion and ulceration are independent risk factors of LNM in EGC.