Objective To assess quantitative and subjective image quality in computed tomography pulmonary angiography (CT-PA)with dual-energy subtraction methods,and to select the best dual-energy subtraction method.Methods 30 consecutive patients underwent CTPA using a single tube,fast voltage switching technique.One set of routine poly-chromatic images (RPI),two sets of monochromatic images with different optimal contrast-to-noise ratios (OCNR)and three sets of dual-energy subtraction images (DE-SI)were obtained by a dedicated workstation with dual-energy software (AW4.5 Advantage WS;GE Healthcare).For all the six sets of images,CNR and the score of global subjective image quality were calculated.Results DESI 3 got the highest CNR,and DESI 1 got the next high CNR.In global subjective image quality,DESI 1 got the highest score.However,when compared with DESI 2,no significant difference was found.Conclusion CTPA with dual-energy subtraction technique is feasible.DESI 1 affords the best bal-ance between quantitative analysis and subjective evaluation compared with other sets of images.

Objective To explore the accuracy of high definition computed tomography angiography (HDCTA)in the evaluation of coronary in-stent restenosis.Methods 93 patients with 159 implanted coronary stents who underwent both HDCTA and CAG were included in the study.The sensitivity,specificity,positive predictive value (PPV),negative predictive value (NPV)and diag-nostic accordance rate of HDCTA were calculated.The imaging quality was analyzed by visual estimation.Possible factors that in-fluenced the diagnostic accuracy of HDCTA were evaluated,which included stent location,stent diameter and heart rate in the pa-tients with left anterior descending branch stents.Results Restenosis was found in 21 stents by CAG and 19 stents by HDCTA.The false positive and false negative were 5 and 3,respectively.Sensitivity,specificity,PPV,NPV and diagnostic accordance rate were 90.5%,96.4%,79.2%,98.5% and 95.6% respectively.The image quality was 4 score in 75 stents (47.1%),3 score in 33 (20.8%),2 score in 27 (17%),≤1 score in 24 (15.1%).The image quality of proximal segments,large stents (≥3.0 mm)and slow heart rate (<66 beast per minute)was significantly better than that of distal segments,small stents (<3.0 mm)and fast heart rate (≥6 6 beast per minute).Conclusion HDCTA is a convenient,efficient and non-invasive method for follow-up after im-plantation of the coronary artery stents.

OBJECTIVE: To investigate the clinical features and operation treatment of the congenital middle ear cholesteatoma. METHOD: A retrospective review of clinical and surgical records of 10 patients with congenital middle ear cholesteatoma were performed. All patients were treated by surgeries,5 of 10 cases deal with one-stage tympanoplasty after drum exploration by external auditory meatus, 3 cases dealed with closed mastoidotympanectomy and tympanomastoidectomy, 2 cases dealed with open mastoidotympanectomy and tympanomastoidectomy. RESULT: The cholesteatomas were located at or around the posterior tympanum or mesotympanum in 5 patients, confined to the tympanic cavity and attic in 3 patients, advanced cholesteatoma that extended from the tympanic cavity into the mastoid antrum was seen in 2 patients. The mean postoperative PTA was 30 dB HL, the mean ABG was within 20 dB, after six months. No residual or recurrence of cholesteatoma was found. CONCLUSION The congenital cholesteatoma often originates from the posterior or anterior of the middle ear, with hiding lesion, thus result in severe conductive hearing loss. Imaging examination plays an important role in diagnosing and treating of congenital cholesteatoma. Early stage surgical treatment can obtain a good hearing reconstruction effect.
Adolescent ; Adult ; Child ; Child, Preschool ; Cholesteatoma ; congenital ; surgery ; Cholesteatoma, Middle Ear ; surgery ; Ear, Middle ; physiopathology ; Female ; Follow-Up Studies ; Humans ; Male ; Retrospective Studies ; Tympanoplasty ; methods ; Young Adult

Objective To investigate the development of auditory and speech skills and the safety and stability among the prelingually deaf children with Nurotron Venus cochlear implants.Methods A total of 78 cochlear implant subjects were recruited from the first of affiliated hospital of Zhengzhou university.They were divided into 5 groups according to the ages at the time of implantation: group A(between 13 and 24 months), group B(between 25 and 36 months),group C(between 37 and 48 months),group D(between 49 and 72 months),group E(between 73 and 96 months).Children were evaluated by IT-MAIS(group A and B) and MAIS(group C,D and E) before the surgery and 1 month,3 months,6 months, and 12 months after surgery.All children were evaluated by MUSS questionnaires 1 months, 3 months,6 months,and 12 months after surgery.Post-operative cochlear radiographs determine the position of the CIs.The complications and usage of The CIs were followed up.Results The auditory and speech ability of children with CIs improved constantly.The auditory and speech of different groups were statistically significant.All the surgeries of 78 cases Nurotron-Venus cochlear implants were successful.Post-operative cochlear radiographs showed electrodes in the normal position.2 cases had processor failures.The remaining CIs were implanted completely.Conclusion Within 1 year, the ability of auditory and speech improved gradually.The scores of auditory and speech about the small age groups are lower than older children in the early days.There is no influence on the audition in 12 months.Small children's scores of speech are lower than older children in 12 months.The better ability to integrate auditory information is , the better the ability to speak is.The Nurotron CIs work safety and effectively.

Objective To discuss the clinical characteristic of middle ear malformation with cholesteatoma.Methods From September,2011 to November,2016,23 cases of middle ear malformation with cholesteatoma were collected.Their symptoms,ENT examination,temporal bone high resolution computed tomography (HRCT) and intraoperative findings were analyzed.Results All 23 patients had hearing loss.90.0％ patients had ear discharge and tinnitus.86.96％ patients had perforation in pars flaccida of tympanic membrane.95.7％ patients had poor mastoid gasification.73.9％ patients had undeveloped or dysplastic tympanic antrum.100％ patients had destruction of the ossicular chain.56.5％ patients had malformation of the ossicular chain.52.2％ patients had exposed facial nerve.30.4％ patients had hyperplasia of the attic bone.Conclusion The symptoms and physical examinations of middle ear malformation with cholesteatoma are the same as middle ear cholesteatoma.Poor mastoid gasification can usually be detected on temporal bone HRCT.The most common malformation is dysplastic tympanic antrum,followed by malformation of the ossicular chain,exposed facial nerve and hyperplasia of the attic bone.Temporal bone HRCT can indicate the malformation and destruction quite well.

With thousands of sequenced 16 S rRNA genes available,and advancements in oligonucleotide microarray technology,the detection of microorganisms in microbial communities consisting of hundreds of species may be possible.The existing algorithms developed for sequence-specific probe design are not suitable for applications in large-scale bacteria detection due to the lack of coverage,flexibility and efficiency.Many other strategies developed for group-specific probe design focus on how to find a unique group-specific probe that can specifically detect all target sequences of a group.Unique group-specific probe for each group can not always be found.Hence,it is necessary to design non-unique probes.Each probe can specifically detect target sequences of a different subgroup.Combination of multiple probes can achieve higher coverage.However,it is a time-consuming task to evaluate all possible combinations.A feasible algorithm using relative entropy and genetic algorithm (GA) to design group-specific non-unique probes was presented.

The duck circovirus (DuCV) infection in sick ducks from Fujian Province was investigated. The liver samples of 43 sick Muscovy ducks with infectious serositis were collected from 12 duck farms in Fujian Province.Based on the published sequences of DuCV, two primers were designed for the detection of DuCV and four pairs of primers were designed to amplify four overlapping fragments that cover the complete genome of DuCV. The specific PCR products were amplified from positive samples. The fragments were then cloned into pMD18-T vector and sequenced, and the full length genomic sequence of the FJ0601 isolate of DuCV was obtained. PCR analysis showed that the proportion of ducks which were positive for circovirus was 79% and 10 out of the 12 farms were positive. Sequence analysis showed that the complete genome of DuCV-FJ0601 was 1988 bp and possessed features common to the family Circoviridae which included a stem-loop structure and the Rep protein motifs. Homology analysis showed that FJ0601 isolate of DuCV had 97.3%～97.5% nucleotide sequence identity to all the four Taiwan isolates (TC1/2002, TC2/2002, TC3/2002, TC4/2002), 82.9% identity to the America (33753-52) isolate and 82.3% identity to the Germany isolate. Phylogenetic analysis with Clustal W, however,showed that FJ0601 isolate of DuCV was on a common branch with Taiwan isolates, and Germany and America isolates belonged to the other branch.

Adult ; Branchio-Oto-Renal Syndrome ; diagnosis ; Child, Preschool ; Craniofacial Abnormalities ; diagnosis ; Diagnostic Errors ; Female ; Humans ; Male

Objective To investigate antibiotic resistance and molecular epidemiology profile of methicillin-resistant Staphylococcus aureus (MRSA) in Shanghai. Methods The antibiograms of 140 MRSA isolates from 5 hospitals for 13 drugs were analyzed by agar dilution and broth dilution. The PVL gene and SCCmec were detected by PCR; The clonal relatedness of 140 isolates were determined by PFGE and 39 strains were chosen to be characterized further by spa typing. Results All 140 MRSA are PVL negative and most of them were identified as SCCmec Ⅲ [45.7% (64/140)], followed by SCCmec Ⅲ a [25.0% (35/140)], SCCmecⅢb [14.3% (20/140)], SCCmecⅡ [10.7% (15/140)] and SCCmecⅣ [4.3% (6/140)]. All isolates were susceptible to vancomycin, teicoplanin and daptomycin. The resistance to gentamicin, sulphamethoxazole and clindamycin was 98. 6% (138/140), 98. 6% (137/140) and 97. 9% (137/140), respectively. Resistance to erythromycin, ciprofloxacin and tetracycline was above 80%, and resistance to rifampicin was 10. 7% (15/140). Sixteen different PFGE patterns(A-P) were found and most of MRSA belonged to group C[30. 7% (43/140)] ,B[13.6% (19/140)]and Ⅰ [10. 7% (15/140)]. Among 39 strains with prevalent PFGE patterns, 4 spa genotypes were identified: t002133. 33% (13/39)] ,t030 [12. 82% (5/39)] ,t037[51.28% (20/39)]and t459[2. 57% (1/39)]. Conclusions Sixteen different PFGE patterns and 4 spa genotypos were found from 5 hospitals in Shanghai. The most popular MRSA clone is PVL negative, SCCmec Ⅲ, with resistant profile of erythromycin, ciprofloxacin,clindamycin,etracycline, gentamicin,and sulphamethoxazole [E-C-L-T-G-M-]. This result suggests that hospital infection control and reasonable antibiotic usage are critical.

ObjectiveTo investigate the clinical value of serum cystatin C(CysC) and urinary microalbumin(MA) in the diagnosis of early renal function injury in patients with essential hypertension.MethodsOne hundred and twenty patients with essential hypertension(hypertension group) were divided into three groups by the results of blood pressure:grade 1 with 48 cases,grade 2 with 47 cases,grade 3 with 25 cases.Thirty healthy subjects were selected as control group.Serum CysC,urinary MA and serum creatinine (Cr) were detected in all subjects.ResultsThe serum CysC and urinary MA in grade 1,2 and 3 hypertension group [(1.57 ±0.48),(2.12 ±0.72),(2.91 ± 1.09) mg/L and(18.12 ±5.43),(29.01 ±8.07),(46.06 ± 13.21 ) mg/L] were obviously higher than those in control group [ (0.71 ± 0.23 ),(9.35 ±5.17)mg/L](P＜ 0.05).The serum Cr had no significant difference between grade 1,2,3 hypertension group and control group (P ＞ 0.05 ).Serum CysC was positively correlated with urinary MA in hypertension group (r =0.613,P ＜ 0.05),serum CysC and urinary MA were both negatively correlated with estimated glomenlar filtration rate (eGFR)(r=-0.635,-0.563,P＜0.05).ConclusionsSerum CysC and urinary MA are sensitive indexes of early renal function injury in patients with hypertension.The combined determination of serum CysC and urinary MA can improve the detection rate of early renal function injury.