Objective To compare the difference between linear blending and non-linear blending function for dual-energy CT, and to evaluate the effect on CT image quality. Methods The model was made of a piece of fresh pork liver inserted with 5 syringes containing various concentrations of iodine solutions ( 16.3,26.4,48.7,74.6 and 112.3 HU). Linear blending images were automatically reformatted after the model was scanned in the dual-energy mode. Non-linear blending images were reformatted using the software of optimal contrast in Syngo workstation. Images were divided into 3 groups, including linear blending group, non-linear blending group and 120 kV group. Contrast noise ratio (CNR) were measured and calculated respectively in the 3 groups and the different figure of merit (FOM) values between the groups were compared using one-way ANOVA. Twenty patients scanned in the dual-energy mode were randomly selected and the SNR of their liver, renal cortex, spleen, pancreas and abdominal aorta were measured. The independent sample t test was used to compare the difference of signal to noise ratio (SNR) between linear blending group and non linear blending group. Two readers' agreement score and single-blind method were used to investigate the conspicuity difference between linear blending group and non linear blending group.Results With models of different CT values, the FOM values in non-linear blending group were 20. 65 ±8.18,11.40±4.25, 1.60±0.82,2.40±1.13, 45.49±17. 86. In 74. 6 HU and 112. 3 HU models, the differences of the FOM values observed among the three groups were statistically significant ( P＜0.05),which were 0.30±0. 06 and 14. 43 ±4. 59 for linear blending group, and 0. 22 ±0. 05 and 15.31±5.16 for 120 kV group. And non-linear blending group had a better FOM value. The SNR of renal cortex and abdominal aorta were 19.2±5.1 and 36. 5 ± 13.9 for non-linear blending group, while they were 12.4 ±3.8 and 22.6±7.0 for linear blending group. There were statistically significant differences between the two groups. The conspicuity scores of different organs in non linear blending group were far higher than those in the linear bending group. The Kappa value was 0. 64, showing good consistency. Conclusion Compared to the linear blending method, the non-linear blending method was a better option, especially in improving SNR and conspicuity.

Objective To observe the influence of intra-articular injection of lovastatin on cartilage degeneration and mRNA expres-sion of matrix metalloproteiase-1,-3 (MMP-1,-3) in cartilage and synovium of osteoarthritis (OA) model. Methods Thirty New Zeal-and rabbits underwent unilateral anterior cruciate ligament transection (ACLT) were random divided into two groups. The rabbits in experi-mental group received 0.1 mg/ml intra-articular lovastatin injection at 0.2 ml/kg of body weight immediately after surgery , once a week. Those in control group were treated with intra-articular injection of normal saline. At the 6th week after surgery, all rabbits were sacrificed. The articular cartilage degeneration of medial femoral condyle was evaluated under microscopy. Gene expression of MMP-1,-3 was detected by reverse transcription-polymerase chain reaction (RT-PCR). Results Cartilage degeneration in untreated group was significantly more severe than that in experimental group. In cartilage, no significant difference on the expression of MMP-1 and MMP-3 mRNA was found be-tween the experimental group and control group. In synovium, the expression of MMP-1 and MMP-3 mRNA was significantly suppressed in experimental group compared with control group. Conclusion During the development of experimental OA, intra-articular administration of lovastatin reduces the expression of matrix degrading enzyme, thus alleviate cartilage degradation.

Objective To investigate the relationships between fasting plasma glucose (FPG) level in early pregnancy and gestational diabetes mellitus (GDM).Methods Data of 11 477 pregnant women who accepted prenatal care in Beijing Obstetrics and Gynecology Hospital from October 2011 to September 2012 were collected.FPG was tested during 8 to 12 weeks of pregnancy in all women and those with FPG＜7.00 mmol/L were recruited.Women accepted 75 g oral glucose tolerance test (OGTT) during 24 to 28 weeks of pregnancy.The GDM diagnostic criteria was with reference to the criteria of International Association of Diabetes and Pregnancy Study Group.Mann-Whitney U test was used to analyze the difference of early pregnancy FPG between normal pregnant women and GDM women.Receiver operating characteristic (ROC) curve was used to analyze the validity and applicability of using early pregnancy FPG in GDM diagnosis.Chi-square test was used to analyze the relationship between the FPG levels and GDM diagnosis.Results There were 1 535 (13.4％) women diagnosed as GDM in 24 to 28 weeks of pregnancy (the rest 9 942 normal cases were taken as the controls).The median FPG level of the GDM group was 4.89 mmol/L (4.62-5.15 mmol/L),which was higher than that of the controls [4.75 mmol/L(4.53-4.98 mmol/L)] (Z=-13.994,P=0.000).The maximum area under curve (AUC),which was used to predict GDM with early pregnancy FPG,was 0.599 (95％ CI:0.582-0.617).Taking FPG 4.88 mmol/L as the cutoff value,the sensitivity was 0.523 and the specificity was 0.645.While taking FPG 5.10 and 5.60 mmol/L as the cutoff value,the sensitivity was 0.334 and 0.068,and the specificity was 0.811 and 0.983,respectively.When the FPG level ≤ 4.09,-4.60,-5.10,-5.60,-6.10 and ≥ 6.10 mmol/L,the GDM diagnostic rate gradually increased [8.5％(23/212),9.9％(335/3 379),12.3％(719/5 858),20.7％(359/1 734),40.2％ (78/194) and 52.5％ (21/40)] (x2=300.523,P=0.000).GDM diagnostic rate in FPG ≤ 4.09,-4.60,-5.10 and-5.60 mmol/L group were lower than that in FPG ≥ 5.60 but ＜6.10 mmol/L group and ≥ 6.10 mmol/L group (x2 were 67.242,164.680,128.125,37.860,55.843,76.856,58.589 and 23.484,all P=0.000) ; GDM diagnostic rate in FPG ≤ 4.09,-4.60,-5.10 mmol/L group were lower than that in FPG ≥ 5.10 but ＜5.60 mmol/L group (x2 were 22.877,113.717 and 78.040,all P=0.000); GDM diagnostic rate in FPG ≥ 4.09 but ＜4.60 mmol/L group was lower than that in FPG ≥ 4.60 but ＜5.10 mmol/L group (x2=11.803,P=0.001).When using abnormal fasting and postprandial OGTT level as GDM diagnostic criteria,the ratio of GDM in early pregnancy FPG level ≥ 5.60 but ＜6.10 mmol/L group and FPG ≥ 6.10 mmol/L group were higher than that of the FPG level ＜5.60 mmol/L group [50.0％ (39/78) and 71.4％ (15/21) vs24.1％ (346/1 436),x2 were 12.456 and 21.443,all P＜0.003].Conclusions Early pregnancy FPG level is not proper to be used as an early diagnostic tool of GDM.However,when early pregnancy FPG level is equal to or greater than 5.60 mmol/L,the incidence of GDM in late pregnancy will increase significantly.

Objective To investigate the effect of Shenmai injection combined with noninvasive ventilator on MDA , SOD and clinical efficacy in treatment of elderly patients with chronic respiratory failure.Methods 72 cases of elderly patients with chronic respiratory failure were randomly divided into control group and experimental group.Control group of 35 patients were treated with conventional therapy and the treatment of noninvasive ventilator, experimental group of 37 patients were treated combined with Shenmai injection for 1 weeks.The level of serum MDA, SOD and clinical efficacy were compared.Results The serum MDA level was decreased, SOD level increased in 2 groups after treatment (P<0.05), the level of MDA in experimental group was lower than control group, and the level of SOD was higher (P<0.05).The level of PaO2 was increased, PaCO2 level and QOL score decreased,the level of PaO2 in experimental group was higher than control group, the QOL score was lower than that of control group ( P<0.05),and there was no difference in PaCO2.After treatment, the total effective rate of experimental group was significantly higher than control group (P<0.05).Conclusion Shenmai injection combined noninvasive ventilator is effective on elderly patients with chronic respiratory failure, it can reduce serum MDA level, increase the serum SOD level.

Tg gene polymorphism, HLA and iodine interaction with Tg may be involved in the pathogenesis of autoimmune thyroid disease.Moreover, thyroglobulin antibody (TgAb), an important symbol of autoimmune thyroid disease, is also closely related to the development of autoimmune thyroid disease.In addition, the differences of TgAb IgG isoforms expression level also have broad application prospects in the classification and diagnosis of autoimmune thyroid disease.By researching on Tg, we review the pathogenesis of autoimmune thyroid disease and provided the evidence for its diagnosis and clinical treatment.

This paper analyzed the current status of clinical research at Peking University, which was compared with that of a number of international and domestic universities. Suggestions were put forward in accordance with the current domestic problems in clinical research.

Objective To analyze the changes of cesarean section rate (CSR) and indications of cesarean section (CS) after implementation of responsible system of attending physician (RSAP) and new partogram.Methods Totally,11 814 women,who delivered in the Department of Obstetrics,Beijing Obstetrics and Gynecology Hospital,Capital Medical University in the fourth quarter of 2012,2013 and 2014,were chosen.The mode of delivery,CSR,CS indications and matemal and fetal outcomes of these women were analyzed with Chi-square test.The RSAP was started in 2013,and both RSAP and the new partogram were applied in 2014 in our hospital.Results The CSRs in the fourth quarter of 2012,2013 and 2014 were 46.4％(1 502/3 235),40.4％(1 524/3 770) and 33.5％(1 612/4 809) (x2=138.312,P＜0.05),and the converting CSR in the delivery room were 10.9％(212/1 945),7.8％(189/2 435) and 6.1％(208/3 414),respectively (x2=39.765,P＜0.05).The proportion of assisted vaginal delivery in the fourth quarter of 2014 was higher than those of the former two years [4.9％(237/4 809) vs 3.4％ (108/3 235) and 3.5％(131/3 770),x2=17.041,P＜0.05].More and more CS deliveries emerged due to scarred uterus,multiple pregnancy,comorbidities and complications during pregnancy year by year,while those CS deliveries because of macrosomia,narrow pelvis,social factors,elderly primipara,umbilical cord entanglement,precious fetus and high myopia gradually decreased (all P＜0.05).In the fourth quarter of 2014,the proportions of CS with fetal distress,abnormal labor,cephalopelvic disproportion and intrauterine infection were lower than those in 2013 (all P＜0.05).No significant difference was shown in the proportion of postpartum hemorrhage and neonatal asphyxia among the three years (both P＞0.05).In 2014,smaller percentage of neonates were transferred to the Pediatrics Department after birth than in 2012 and 2013 [10.2％(491/4 809) vs 12.0％(388/3 235) and 13.7％(516/3 770),x2=24.681,P＜0.05].Conclusions The implementation of RSAP and the application of new partogram effectively reduce the CSR through strict control on indications of CS.

Objective To evaluate the therapeutic value of video-assisted thoracoscopy in treating posterior mediastinal benign neurogenic tumors.Methods From May 1994 to May 2006,40 patients received thoracoscopic resection of posterior mediastinal benign neurogenic tumor.Double lumen endotrocheal intubation was applied and 3 trocars were placed according to the location of the tumor.A mini-incision was used if the tumor was too large to be safely resected.Results The complete resections were successfully finished in 34 cases while the remaining 6 cases needed a 6 cm mini-incision to complete the surgery.Pathological examination showed 20 cases of neurilemoma,14 cases of neurofibroma,and 6 cases of paraganglioma.The average diameter of these tumors was 4.7 cm(range:2-12 cm).The average thoracic drainage time was 2.2 days(1-7 days).And the average postoperative hospital stay was 4.8 days(3-13 days).Only 2 cases experienced minor complications.There was no death in this study.The time of follow-up was 9 months to 12 years,in which 16 cases were followed for less than 3 years,12 cases for 3-5 years and 7 cases for over 5 years,5 cases lost contact.Only one patient received re-resection due to local recurrence.Conclusions Video-assisted thoracoscopic resection of posterior mediastinal benign neurogenic tumor is safe,reliable and minimally invasive,and can thus be regarded as the therapy of first choice.

Objective To explore the internal relations of HBV markers and its clinical significance.Methods HBV Pre S1-Ag、HBV-M(HBsAg、HBsAb、HBeAg、HBeAb、HBcAb)and HBV DNA of 106 patients were detected by ELISA and FQ-PCR respectively.Results The total positive rates of Pre-S1 antigen and HBV DNA in 106 cases were 81.1%and 84.9%respectively.In41 HBeAg-positive cases.Pre S1-Ag and HBV DNA detection rate was 95.1%.90.2%.And HBeAg-negative 2 groups Pre S1-Ag and HBV DNA detection rate was also higher.Conclusion HBV Per S1-Ag Was a very valuable serum marker in terms of direct HBV replication alone can not HBeAg-positive to determine whether the replication of the virus.

Dating of injury and the discrimination in trauma and disease is always an important hot topic in the field of forensic medicine. Lumbar disc herniation is a kind of physiological degeneration. To seek a method for deducing the occurrence time of traumatic LDH exactly, this article reviewed the correlation between humoral, celllur immunity and the occurrence time of LDH. It is suggested that some characteristic changes of the expression of IgG,IgM,macrophages may be a helpful method for the occurrence time deduction of traumatic LDH.