Objective To observe the clinical efficacy of different kinds of insulin combined with Metformin in the treatment of T2DM.Methods 120 T2DM patients were selected and divided into three groups according to different therapies of reducing blood sugar with 40 cases in each group.Group A was treated with insulin glargine combined with Metformin;Group B with insulin detemir combined with Metformin and Group C with protamine zinc insulin combined with Metformin .The time for reaching the standards of blood sugar and the corresponding usage amount of insulin of three groups were observed;After 6 months, the three groups were com-pared in terms of FBG, PBG HbA1c, HOMA-IR, TC, TG and LDL-C.Meanwhile, the incidence rate of hypoglycemia after treat-ment was observed.Results Time for reaching the standards of blood sugar in Group A, Group B and Group C was (6.9 ±2.3)d, (4.1 ±3.0)d and (3.8 ±1.5)d, respectively;the corresponding dosages of insulin of the three groups was (19.0 ±7.8)U, (12.1 ±5.9)U and (11.9 ±5.3)U, respectively, with significant difference between Group A and Groups C, D (p<0.05) and insignifi-cant difference between Group B and Group C (p>0.05).After 6 months, FBG, PBG, HbA1c, HOMA-IR in Group B, Group C and Group A were significantly reduced (p<0.05);with insignificance between Group B and Group C (p>0.05).6 months follow-ing the treatment, TC, TG and LDL-C in Group B, Group C and Group A were significantly different (p<0.05), with insignificant difference between Group B and Group C (p<0.05).The incidence rate of hypoglycemia in Group A, Group B and Group C was 22.5%, 20.0% and 5.0%, respectively, with those in Group B and Group C significantly lower than Group A (p<0.05) and in-significant difference between Group B and Group C (p>0.05).Conclusion The insulin detemir and protamine zinc insulin com-bined with Metformin has a better clinical efficacy in the treatment of T2DM.It can promptly control the blood sugar level and lead to a lower incidence rate of hypoglycemia.Therefore it is worthy of promotion.

Objective To study the imageological findings and the evolution of pulmonary alveolar microlithiasis(PAM). Methods The clinical and imageological information of 3 siblings suffering from PAM were collected, and their imageological findings and changes in follow-up plain radiographs were analyzed retrospectively. Results On chest radiographs, the typical “sandstorm” pattern was shown in all 3 cases. The severity and extent of microliths and interstitial fibrosis were increased with age and clinical course by comparing with the radiographs 24 years ago. On conventional CT, bilateral diffuse micronodules in parenchyma were demonstrated with pulmonary window in 3 cases, concentrating in the subpleural zones of middle and lower lung fields and the areas around bronchovascular bundles. All were associated with various degrees of fibrosis. The nodules and calcifications were visible in both lungs with mediastinal window, forming so-called flame sign and white line sign in the concentrated areas. The extents and degrees of the microliths, small cysts and interstitial fibrosis were revealed more clearly and truly on HRCT. MRI showed diffusely increased signal intensity on T 1WI and lower signal intensity on T 2WI in both lung fields. Conclusion The chest radiograph was still an initial modality in detecting the disease. CT could comprehensively reveal the pathological status of the PAM and played a decisive role in the diagnosis and differential diagnosis. MRI had only limited value in evaluating the condition.

Objective To analyse CT signs of giant cell tumor of bone.Methods CT appearances of 42 cases of giant cell tumor of bone were reviewed.All patients were pathological proven.Results (1)Two kinds of bone destruction were seen in all ases:expansive cystic destruction and osteolytic destruction.The anterior was predominantly.(2)Most of our patients haven't bone septations in their tumors (95.2%).(3)Bone crests were usually seen in our study(63.2%).(4)Complete or incomplete sclerotic borders existed in 44.7% of all cases.(5)The inner bone soft tissues were heterogeneously in most of the patients.Fluid-fluid level can be seen in 5 cases (11.9%).(6)The outer-bone soft tissue masses were demonstrated in the majority cases with discontinuous bone shell.Conclusion CT may deepen our understanding and add imaging signs about giant cell tumor of bone;Which can enhance our diagnostic and differential diagnostic capability.

OBJECTIVE: To investigate the individual external dose level of medical radiation staffs in Guangzhou City.METHODS: The medical radiation staffs of Guangzhou City who conducted individual dose monitoring at Guangdong Province Hospital Center for Occupational Diseases Prevention and Treatment from 2008 to 2014 were selected as study subjects by convenient sampling method.Their individual dosage monitoring data were analyzed.RESULTS: A total of 17 754 person-times were monitored in 7 years.The annual collective effective dose was 10 621.1 person·mSv and the median per capita annual effective dose was 0.21 mSv/a.The per capita annual effective dose in 2008-2012 showed an increasing trend each year( P < 0.05),peaked in 2012,and then decreased in 2013 and 2014( P < 0.05).The per capita annual effective dose of radiology staffs in level Ⅱ medical institutions was higher than that of level Ⅲ medical institutions,level Ⅰ medical institutions and those below level Ⅰ( P < 0.01).The per capita annual effective dose of radiation staffs in level Ⅲ medical institutions was higher than level Ⅰ medical institutions and those below level Ⅰ( P <0.01).The effective monitoring rates of radiation staffs monitored for 4 cycles every year increased with time from 2008 to 2014( P < 0.01).The effective monitoring rate increased with the hospital level( P < 0.01).The per capita annual effective dose of the staffs in radiological diagnosis department was lower than that of clinical nuclear medicine,radiotherapy and interventional radiology( P < 0.01).CONCLUSION: The radiation dose of medical radiation staffs in Guangzhou City was within the national standard limit.Protection should be focused on the the staffs in secondary hospitals,clinical nuclear medicine,radiotherapy and interventional radiology.

Objective:To develope a deep-learning-based auto-segmentation model to segment organs at risk (OARs) in head and neck (H&N) region and compare with atlas-based auto-segmentation software (Smart segmentation).Methods:The auto-segmentation model consisted of classification model and segmentation model based on deep learning neural network. The classification model was utilized to classify CT slices into six categories in the cranio-caudal direction, and then the CT slices corresponding to the categories for different OARs were pushed to the segmentation model respectively. The CT image data of 150 patients were used for auto-segmentation model training and building atlas library in Smart segmentation software. Another 20 patients were used as testing dataset for both auto-segmentation model and Smart segmentation software. Dice similarity coefficient (DSC) and Hausdorff distance (HD) were used to evaluate the accuracy of two method, and auto-segmentation time cost was recorded. Paired Student′s t-test or non-parametric Wilcoxon signed-rank test was performed depending on result of normality test. Results:The DSC and HD of auto-segmentation model for brainstem, left eye, right eye, left optic nerve, right optic nerve, left temporal lobe, right temporal lobe, mandible, left parotid and right parotid were 0.88 and 4.41 mm, 0.89 and 2.00 mm, 0.89 and 2.12 mm, 0.70 and 3.00 mm, 0.80 and 2.24 mm, 0.81 and 7.98 mm, 0.84 and 8.82 mm, 0.89 and 5.57 mm, 0.70 and 11.92 mm, 0.77 and 11.27 mm respectively. The results of auto-segmentation model were better than those of Smart segmentation ( t=3.115-7.915, Z=-1.352 to -3.921, P<0.05) except left and right parotids. In addition, the speed of auto-segmentation model was 51.28% faster than that of Smart segmentation. Conclusions:In this study, the deep-learning-based auto-segmentation model demonstrated superior performance in accuracy and efficiency on segmenting OARs in H&N CT images, which was better than Smart segmentation software.

OBJECTIVE: To analyze the results of inter-laboratory comparison among occupational hygiene laboratories. METHODS: A convenient sampling method was used. The laboratories participating in the inter-laboratory comparison organized by the Guangdong Occupational Health Test Center from 2013 to 2017 were selected as study subjects. The data of detection of organic compounds, metal element, inorganic non-metal element in workplace air, detection of metal element in biological materials, and detection of free silica in dust were analyzed. The results were statistically analyzed by four-point robust statistical technique. RESULTS: A total of 615 laboratories(times) participated in the comparison, and 2 785 items of sample detection results were submitted from 2013 to 2017.Among them, a total of 2 484 items were tested qualified and the sample test qualified rate was 89.2%. The test qualified rates of organics in workplace air, metals in workplace air, inorganic nonmetals in workplace air, metals in biological materials and free silica in dust were 91.1%, 92.0%, 86.6%, 80.4% and 85.0%, respectively. The sample test qualified rates of the laboratories in different regions from high to low were: the laboratories Pearl River Delta region in Guangdong Province, the laboratories in non-pearl river delta region in Guangdong Province and the laboratories outside of Guangdong Province were 91.6%, 87.2% and 72.6%(P<0.01), respectively. The sample test qualified rate of the public laboratories was higher than that of the private laboratories(90.3% vs 87.0%, P<0.05). CONCLUSION: The accuracy of the occupational hazard factor test in the participating laboratories needs to be improved. It is necessary to further strengthen the investment, supervision and management to non-pearl river delta region laboratories and private laboratories in Guangdong Province.