Objective To evaluate the curative effect and indications of medical ozone for the treatment of lumbar disc herniation.Methods 10~20 ml(35~45 ug/ml) medical ozone was injected into the lumbar disc percutaneously each case. The patients were followed up for 6~12 months. Results 60 cases (66 lumbar discs) with lumbar disc herniation were treated with the injection of medical ozone. The total effective rate was 96.67% , excellent and good rate was 76%.The efficacy in herniation to be 30% of vertebral canal diameter and lumbardisc bulging group. Conclusion The treatment of lumbar disc herniation with medical ozone is simple,effective and no complications.

Objective To observe the curative effect and safety of interventional therapy of uterine fibroids using Embosphere and Pingyangmycin lipiodol emulsion.Methods The clinical data of 120 cases with uterine fibroids treated in our hospital were reviewed,and the patients were according to the different treatments given,divided into two groups (each with 60 cases).Patients in control group were treated with interventional therapy of Pingyangmycin lipiodol emulsion,while patients in the study group were given interventional therapy of Embosphere.The clinical efficacy and safety in the two groups were compared.Results The total efficiency in the study group was 93.33%,which was significantly higher than that in the control group (75.00%),and the difference was statistically significant (P<0.05).The comprehensive indexes after the treatment were improved in both groups compared with those before the treatment,and the improvement in the study group was significantly better than the control group (P<0.05,P<0.01).Besides,the total incidence of adverse effects in the study group was 11.67%,which was significantly lower than that in the control group (26.67%)(P<0.05). Conclusion The interventional therapy using Embosphere has better effect on uterine fibroid compared with the therapy using Pingyangmycin lipiodol emulsion,which is worthwhile to be brought into clinical application.

Objective To analyze the value of MRI combined with single photon emission computed tomography?CT (SPECT?CT) for the diagnosis of nasopharyngeal carcinoma with early skull base bone invasion and the effect on clinical decision. Methods This retrospective study included 195 pathologically proven nasopharyngeal carcinoma patients with complete clinical and follow?up data, which did not find the signs of skull base bone invasion by CT and be subsequently performed MRI and SPECT?CT. The MRI and SPECT?CT images were respectively analyzed and the positive or negative judgment was made on whether there was skull base bone invasion. Clinical doctors made the routine clinical decision according to MR results, and then made the combined clinical decision based on the results of MR combined with SPECT?CT. The changes between 2 clinical decisions were analyzed. To assess the value of MR, SPECT-CT and combined examination in the diagnosis of skull base bone invasion on the basis of comprehensive clinical results (including symptoms, imaging and follow up, etc) as qualitative criteria. The diagnostic power of MRI, SPECT?CT and combined examination was analyzed by ROC. Results Compared with the routine clinical decisions, combined clinical decisions (44.6%, 87/195) were changed in 87 cases, including 21 cases with new diagnosis of skull base bone invasion, 46 cases with skull base invasion range increased and 87 cases with treatment plan changes. In 195 cases, 114 cases were confirmed to have the skull base bone invasion by comprehensive clinical results. When MRI was positive and SPECT?CT positive, MRI negative and SPECT?CT negative, MRI positive and SPECT?CT negative, MRI negative and SPECT?CT positive, the presence of skull base bone invasion respectively were 100.0%(74/74), 0 (58/58), 66.7%(16/24), 61.5%(24/39). MRI and (or) SPECT?CT positive was regarded as positive, it was used as the criterion of combined examination. For skull base bone invasion, MRI, SPECT?CT and combined examination had the sensitivities of 78.95%(90/114), 85.96%(98/114), and 100.00%(114/114), the specificities of 90.12%(73/81), 81.48% (66/81), 71.60% (58/81) , the area under the ROC curve of 0.845, 0.837, 0.858; and the misdiagnosis rate of 16.41%, (32/195), 15.90% (31/195), 11.79% (23/195). Conclusion MRI combined with SPECT?CT can improve the accuracy of diagnosing skull base bone invasion and effectively affect the clinical decision of nasopharyngeal carcinoma.

Objective To analyze the voluntary blood donors of Shaoguan city in recent 10 years HIV infection status and distri‐bution characteristics ,and to take effective prevention and control measures ,in order to reduce the risk of HIV infection through blood transfusion .Methods HIV screening test in the early by the reagent of two different manufacturers ,from 2005 to 2014 vol‐untary blood donors specimens of 265 771 doses of blood donation in Shaoguan ,and early screening positive specimens confirmed by Center for Disease Control of Shaoguan .Results The voluntary blood donors of Shaoguan in the 10 years that initial screening test anti‐HIV positive were 310 cases ,and 35 cases confirmed positive;The confirmed positive rate was 1 .317/10 000;The HIV infec‐tion rate in 2012 was highest (2 .867/10 000) and there were 9 cases ,which was significant difference (P<0 .05) .The district of the maximum rate was New Fengxian ,which was 5 .369/10 000 ,and different districts had significant difference (P<0 .05) .The epidemiology survey about HIV infections found that male were 30 cases(85 .71% ) ,which was significantly more than women;By age distribution ,most HIV infections were 18 to 35 years old young adults ,which accounted 26 cases(74 .29% ) .Married and un‐married people infected respectively accounted 28 .57% and 71 .43% .The occupations of HIV infections were scattered with farm‐ers ,staffers ,the service industry ,cadres in the majority .The HIV infection rate with low education was relative higher ,which had some relationship to educational level .The residents and the non‐residents infected respectively accouted 71 .43% and 28 .57% ;Blood donors for the first time of HIV infections were 24 cases (68 .57% ) .Blood donors for the second time of HIV infections were 11 cases (31 .43% );Other virus co‐infection respectively were 2 HBV infections ,1 HCV infection and 3 syphilis infections .The route of transmission was mainly through sexual transmission that was mainly heterosexual transmission ,which was 33 cases (94 .58% ) .Conclusion The voluntary blood donors of Shaoguan with HIV is on the rise ,and give priority to with male youths spread through heterosexual sex .It should be pay high attention to by the government ,society and blood stations ,and strengthen the propaganda work of AIDS prevention and control checks ,and minimize the risk of HIV transmission by blood transfusion in or‐der to guarantee the safety of clinical blood transfusion .

Objective:To investigate the clinical value of virtual monoenergetic images (VMI) and electron density map (EDM) derived from the dual-layer spectral detector CT (DLCT) in the differential diagnosis of benign and malignant pulmonary ground glass nodules (GGN).Methods:From July 2019 to August 2020, a total of 65 patients with lung GGN (27 benign GGNs and 38 malignant GGNs) confirmed by pathology were retrospectively enrolled in Gulou Clinical Medical College of Nanjing Medical University. All the patients underwent DLCT plain scanning within two weeks before the surgery. The conventional 120 kVp polyenergetic image (PI), EDM and 40-80 keV VMI were reconstructed. The differences of CT and electron density (ED) values between benign and malignant lesions on different images were compared by Mann-Whitney U test. Independent t-test was used to compare the lesion size and χ 2 test was used to analyze the CT features (including lesion location, shape, edge, internal structure, adjacent structure, nodule type) between benign and malignant lesions. Receiver operating characteristic (ROC) curve was used to analyze the efficacy of different energy spectrum quantitative parameters in the differential diagnosis of benign and malignant GGN. The statistically significant CT signs and energy spectrum quantitative parameters were analyzed by logistic regression analysis to find out the independent risk factors of malignant GGN, and then ROC curve analysis was performed for each independent risk factor alone or in combination. Results:There were significant differences in lesion shape, spiculation, lobulation, location and size between benign and malignant groups ( P<0.05). The CT value of pulmonary GGN in PI, 40-80 keV VMI and the ED value in EDM were statistically different between benign and malignant lesions ( P<0.05). The area under ROC curve (AUC) were 0.680, 0.682, 0.683, 0.686, 0.694, 0.676 and 0.722, respectively, among which the ED value had the highest AUC. Binary logistic regression analysis was carried out with GGN shape, spiculation, lobulation, location, size, ED value and CT value in PI, 40-80 keV VMI as independent variables, and malignant GGN as dependent variables. The results showed that ED value (OR=1.045, 95%CI 1.001-1.090, P=0.044), lesion size (OR=1.582, 95%CI 1.159-2.158, P=0.004), spiculation sign (OR=11.352, 95%CI 2.379-54.172, P=0.002) were independent risk factors for malignant GGN. ROC curve analysis showed the AUC of ED value, lesion size, spiculation sign and combination of the three for differential diagnosis of benign and malignant GGN were 0.722, 0.772, 0.698 and 0.885. The AUC for the combined parameters was the largest, with sensitivity of 92.1% and specificity of 74.1%. Conclusion:The diagnostic efficacy of EDM is higher than that of other VMI in the differential diagnosis of pulmonary GGN by DLCT images; The efficacy is further improved when EDM is combined with lesion size and spiculation sign for comprehensive diagnosis.

INTRODUCTION: Acute respiratory distress syndrome (ARDS) in COVID-19 is associated with a high mortality rate, though outcomes of the different lung compliance phenotypes are unclear. We aimed to measure lung compliance and examine other factors associated with mortality in COVID-19 patients with ARDS. METHODS: Adult patients with COVID-19 ARDS who required invasive mechanical ventilation at 8 hospitals in Singapore were prospectively enrolled. Factors associated with both mortality and differences between high (<40mL/cm H RESULTS: A total of 102 patients with COVID-19 who required invasive mechanical ventilation were analysed; 15 (14.7%) did not survive. Non-survivors were older (median 70 years, interquartile range [IQR] 67-75 versus median 61 years, IQR 52-66; CONCLUSION COVID-19 ARDS patients with higher compliance on the day of intubation and a longitudinal decrease over time had a higher risk of death.
COVID-19 ; Humans ; Lung Compliance ; Phenotype ; Respiratory Distress Syndrome/therapy* ; SARS-CoV-2