Objective To investigate the correlation of traditional Chinese medicine (TCM) syndrome types of chronic gastritis with Helicobacter pylori (Hp) eradication rate after anti-Hp treatment. Methods A total of 180 chronic gastritis patients with Hp infection were differentiated into spleen-stomach insufficiency syndrome, spleen-stomach dampness-heat syndrome, and liver depression and qi stagnation syndrome, and each syndrome group had 60 cases. Patients in each group were evenly divided into two subtypes, and were treated with triple therapy or quadruple therapy for 10 days respectively. After treatment, the Hp eradication rate in each group was compared. Results (1) The overall Hp eradication rate was 78.3%. No matter after triple therapy or quadruple therapy, patients with spleen-stomach insufficiency syndrome had the lowest Hp eradication rate (61.7%), which was lower than that of the patients with spleen-stomach damp-heat syndrome (88.3%) and the patients with liver depression and qi stagnation syndrome (85.0%), the difference being statistical significance (P < 0.05 or P < 0.01). However, the difference of Hp eradication rate between spleen-stomach damp-heat group and liver depression and qi stagnation group was not statistically significant (P>0.05). (2) A total of 10 cases had adverse reaction such as nausea and vomiting, stomachache, and gastric distention, 8 cases from spleen-stomach insufficiency group, one from spleen-stomach dampness-heat group, and one from liver depression and qi stagnation group. Spleen-stomach insufficiency group had higher incidence of adverse reaction than the other two groups (P < 0.05). Conclusion The Hp eradication rate after anti-Hp treatment varied in chronic gastritis patients with different TCM syndrome types, and the rate in patients with spleen-stomach insufficiency syndrome was lower than that of the patients with spleen-stomach damp-heat syndrome and the patients with liver depression and qi stagnation syndrome no matter after triple therapy or quadruple therapy.

Objective To investigate the effect of imaging parameters and postprocessing methods on the quality of MR imaging of short T2 components with 3D ultrashort TE (UTE) double echo pulse sequence. Methods 3D UTE double echo pulse sequence was performed on dry human femoral specimen and the tibial diaphyses, knee joints, and tendons of ankles of a group of healthy volunteers. To investigate the effect of different trajectory delays of the imaging system(-6, -3, -2, - 1,0, 1,2, 3 s), different flip angles(4°, 8°, 12°, 16°, 20°, 24°), different TEs (0. 08, 0. 16, 0. 24, 0. 35 ms)and different postprocessing methods(difference imaging of subtracted volume and non-volume UTE)on the 3D UTE MR imaging quality, the SNR and CNR were calculated and compared, and the artifacts of the images were analysed. Results The cortical bone, periosteum, tendon and meniscus showed high signal intensity on the images of UTE pulse sequence. The best SNR was acquired with 2 s trajectory delay. The best flip angle was 8° to 12° for the human UTE imaging in vivo. The highest CNR was obtained from the TE of 0. 08 ms. The longer the TE was, the more artifacts appeared. The SNR of difference imagewas improved when image subtraction was performed afer multiplanar reconstruction (MPR) of the primary double echo images.Conclusions The short T2 components show high signal intensity on the MRI of 3D UTE double echo pulse sequence. The imaging quality can be improved by shortening TE, using appropriate flip angle and performing subtraction for difference image after MPR of the primary double echo images.

Objective To investigate the association between vascular risk factors and the location of intracranial artery stenosis (anterior versus posterior).Methods Magnetic resonance angiography(MRA) were examined in 374 acute stroke patients.It was divided into two groups (anterior and posterior intracranial artery stenosis group).Analyzed possible risk factors.Results Univariate analysis showed there were differences between anterior and posterior intracranial artery stenosis in systolic blood pressure,history of smoking,drinking and stroke status,and national institutes of health stroke scale (NIHSS) score at discharge,short-term prognosis,serum creatinine,triglyceride,low density lipoprotein cholesterol (LDL-C) (P ＜ 0.05).In multivariate logistic regression analysis,high blood sugar (OR =1.135,95％ CI:1.003-1.284),history of stroke(OR =1.133,95％ CI:1.007-1.276),good short-term prognosis (OR =5.987,95％ CI:1.441-24.873) were preferentially related to anterior intracranial artery stenosis,whereas history of smoking (OR =0.003,95 ％ CI:0.000-0.376),high serum creatinine values (OR =0.509,95 ％ CI:0.328-0.790),high triglyceride values (OR =0.054,95％ CI:0.004-0.645) and high LDL-C values (OR =0.096,95％ CI:0.015-0.608) were preferentially related to posterior intracranial artery stenosis.Conclusion Vascular risk factors appeared to exert different effects of risk for anterior and posterior intracranial artery stenosis.

Objective To explore the effect and application of the clinical teaching method of stage-separated to targeted management in the comprehensive ICU. Methods ICU rotation learning plans were developed for 113 probationers and rotating physicians,who were given the training of stage-separated to targeted teaching. The program was divided into three stages based on corresponding teaching objective and comprehensive examination and assessment with combination the dynamic and static evaluation were carried out to three parts. Results The probationers and rotating physicians had significant improvement in the familiarity and mastery of ICU specialist knowledge and skills through the systematic training. Conclusion Such training program can effectively improve the ICU specialized quality and comprehensive ability of the probationers and rotating physicians and bring about better clinical teaching effect.

Objective To investigate the application of 3D ultrashort TE double echo pulse sequence in the bone and joint MR imaging. Methods Eight volunteers and a porcine fibula in vitro with intact muscle were involved in this study. Among the volunteers, one was suspected with meniscus tear, the others were asypmtomatic. MR imaging of 3D ultrashort TE double echo pulse sequence were performed on the tibial diaphysis, knee joint, ankle and wrist of each volunteer and the porcine fibula in vitro. Using the first echo images subtract with the second echo images, we observed the subtracted images from the primary double echo images and MPR images respectively. We then compared the difference of SNR. Four different echo times of the first echo (TE1) in the images were set as 0. 08 ms, 0. 16 ms, 0. 24 ms, 0. 35 ms. The quality of the subtracted images from the primary double echo images of the four different TE1 was compared.The MIP images from the primary double echo images with TE1 of 0. 08ms were performed to display the 3D structure of the ankle tendons. The data were analysed with One-Way ANOVA and Paired-Samples t test statistically. Results The 3D images of the tendons were displayed through MIP of the subtracted images from the primary double echo images. The cortical bones, periosteums, tendons and menisci of the 8 volunteers appeared as high signal intensity in UTE pulse sequence. The SNR of the subtracted images from MPR images (SNR, 3.76 ± 0. 88) was significantly higher than those from the primary double echo images(SNR,2. 82±0. 75) (t = - 4. 851, P < 0. 01). There were significant differences among the subtracted images from each of the four different TE1. The highest quality were obtained from the TE1 of 0.08ms. The CNR were as follows: CNR<,0.08ms>1.74±0. 54, CNR<,0.16ms> 1.35 + 0. 60, CNR0.24ms>1.20±0. 48,CNR<0.35ms> 0.89±0. 24 (F = 3. 681, P < 0. 05). The artifacts appeared markedly with prolonging of the TE1.Conclusion The MRI of ultrashort TE double pulse sequence may display the short T2 components that appeared as low signal with conventional clinical MR imaging, which made it pessible to quantify the tissues containing a majority of short T2 components.

Objective To investigate the imaging characteristics of USPIO-enhanced and Gd-enhanced MRI in atherosclerosis and to compare the detection rate of atherosclerotic plaque between them. Methods Thirty-five healthy male rabbits were assigned to experimental group (n=30) to establish a model of atherosclerosis by damaging aortic tunica intima with Foley′s tube in combination with a high fat diet and 5 to control group without any intervention. At week 12, USPIO-enhanced and Gd-enhanced MRI scanning were conducted to compare the signal changes of atherosclerotic plaque before and after enhancement with the 2 contrast media. Ninety seven pictures were randomly selected respectively from the pictures enhanced by the 2 contrast media to compare the detection rate plaque between them. Pthology examination was used for detection standard. For the control group , pictures were randomly selected. Results In the experimental group, 7 rabbits died of Foley′s tube damaging, 2 died of raising and 1 died of anesthesia. All 5 rabbits in control group survived. A total of 172 pathological sections were made with 134 plaques and 72 vulnerable plaques pathologically confirmed. In pictures enhanced by USPIO , 84 plaques were confirmed by HE staining with a detection rate of 86.6%. In pictures enhanced by Gd, 72 plaques were confirmed by HE staining with a detection rate of 74.2%. Detection rate of USPIO-enhanced MRI in atherosclerosis plaque was significantly higher than that of Gd-enhanced MRI (X2=3.96, P=0.046). Conclusion USPIO shows its superiority as a new contrast medium in detection of atherosclerosis plaque.

Objective To evaluate the value of DTI in mild articular cartilage injury in patellofemoral joint.Methods The DTI and arthroscopy data of 82 patients wih routine MRI diagnosed as mild articular cartilage injury were analyzed retrospectively.According to the results of arthroscopy,40 cases of mild articular cartilage injury with Outerbridge classification Ⅰ or Ⅱ were divided into experimental group,and 33 cases with normal patellofemoral articular cartilage were divided into control group.There were 8 articular cartilage injury patients with Outerbridge classification Ⅲ or Ⅳ in patello-femoral join were excluded.The DTI data were analyzed compared with arthroscopy.Results Arthroscopy detected 62 lesions of cartilage injury in experimental group.Totally 49 lesions (49/62,79.03 ％) were detected by ADC pseudocolor image and 51 lesions (51/62,82.25 ％) were detected by FA pseudocolor image.The DTI pseudocolor images of articular cartilage injury showed uneven levels.The red or pink levels can been observed.Compared with the control group,ADC value increased and FA value decreased significantly in experimental group (both P＜0.05).Conclusion DTI can clearly display and detect mild articular cartilage injury in patellofemoral joint,which provide valuable information for early cartilaginous injury.

The patient, a 50-year-old male, was admitted to the hospital on April 1, 2020 with the chief complaint of "confusion with vomiting for 1 hour due to falling from height ", and the emergency craniotomy was performed. Intermittent fever with a maximum temperature of 38 ℃ occurred 3 days after the surgery, and the inflammation indexes were all higher than the upper limit of the reference values. Recurrent fever remained despite after empirical anti-infection treatment. On April 12, the patient was treated with vancomycin combined with meropenem after cerebrospinal fluid specimens routine and biochemical tests suggested intracranial infection. After 48 hours of cultivating the cerebrospinal fluid and blood specimens, some small, clear, needle-like colonies were found and they were identified as Mycoplasma humanum by using 16S rRNA gene. Eventually, the patient died due to the severity of the disease and complications.

Student standardized patient refers to that students are trained to become standardized patients, and then they are applied to clinical teaching or examinations. The training of student standardized patients in China started late, but the development is relatively balanced and rapidly in recent years. Although an outline-style standardized teaching model has not yet been formed, the basic training framework of "basic training-case-specific training-training assessment" tends to be consistent, and different universities have certain specific innovations. The review combs the literature on the current training mode of student standardized patients in China, summarizes the innovations in four aspects: training population, training mode, training purpose and application method, then makes the conclusion about the objective problems and subjective difficulties faced by the current training, and proposes corresponding countermeasures and prospects.

Objective:To further understand the etiological distribution of fever of unknown origin (FUO) in patients underwent 18F-fluorodeoxyglucose (FDG) PET/CT imaging, and to explore the significance of 18F-FDG PET/CT in the diagnosis of different types of diseases in FUO patients. Methods:From January 2013 to August 2019, the clinical and PET/CT image data of 466 FUO patients (194 males, 272 females, age: 3-91(52.7±20.9) years) in Peking University People′s Hospital were retrospectively analyzed. The etiological distribution of FUO patients was analyzed according to the final clinical diagnosis. PET/CT imaging manifestations were analyzed for different types of diseases in FUO patients. The role of 18F-FDG PET/CT in differential diagnosis for FUO was evaluated through clinical questionnaire. Data were analyzed by using χ2 test. Results:The common disease types in FUO patients were rheumatic and immune disease (48.7%, 227/466), infection (28.5%, 133/466) and malignant tumor (11.2%, 52/466). For PET/CT imaging, 95.5% (445/466) of the patients were positive, of which 313 (70.3%, 313/445) were found to have focal lesions, and the other 132 (29.7%, 132/445) showed only nonspecific abnormal uptake. Lesions in different types of diseases were varied in the location, morphological changes as well as FDG uptake. The results of the questionnaire showed that PET/CT imaging could benefit 95.9% (447/466) of the patients in the FUO diagnosis and treatment. PET/CT reached direct etiological diagnosis of malignant tumors more frequently than other types of diseases ( χ2 values: 14.408-25.466, all P<0.001). PET/CT helped or directly reached the etiological diagnosis of rheumatologic diseases more frequently than infection and unknown cause group( χ2 values: 7.922, 9.647, both P<0.05). Conclusion:18F-FDG PET/CT imaging has high clinical value in the diagnosis of FUO etiology and can provide multilevel diagnostic information.