ObjectiveTo develop and validate a diagnostic prediction model for differentiating pulmonary tuberculosis from community-acquired pneumonia based on routine blood parameters. MethodsA total of 642 patients with pulmonary tuberculosis and 503 patients with community-acquired pneumonia were retrospectively enrolled from the Seventh Hospital of Tangshan. They were randomly divided into a training set and an internal validation set at a 7∶3 ratio. Additionally， 218 patients from the 981st Hospital were independently included as an external validation set. The Boruta algorithm and recursive feature elimination were employed to select predictors from 82 blood parameters， sex， and age. A multivariate Logistic regression model was established and evaluated using receiver operating characteristic （ROC） curves， calibration curves， and decision curve analysis. ResultsThe final model incorporated eight predictors， namely uric acid， urea nitrogen， alkaline phosphatase， monoamine oxidase， alanine aminotransferase， glutathione， neutrophil percentage， and age. The model achieved areas under the curve （AUCs） of 0.800 （95%CI： 0.769-0.830）， 0.787 （95%CI： 0.738-0.836）， and 0.736 （95%CI： 0.667-0.835） in the training， internal validation， and external validation sets， respectively. The model demonstrated good calibration， and decision curve analysis showed clinical net benefit within the threshold probability range of 10%-80%. ConclusionThe developed model exhibits good discriminative ability and clinical utility， serving as an effective early screening tool for primary healthcare institutions.

Objective:To analyze the association between CRHR1 gene(rs1876828)polymorphism and the effect of inhaled corticosteroids(ICS)in children with bronchial asthma.Methods:A total of 60 children with moderate persistent asthma who were treated in the Department of Pediatrics of the First Affiliated Hospital of Harbin Medical University from January 2018 to June 2019 were included.The CRHR1 gene rs1876828 locus in children with asthma was detected by Sanger sequencing.The children were divided into TT genotype group(TT group) and CC genotype group(CC group)according to the different base sequences of gene loci.There were 22 cases in TT group(36.7%)and 38 cases in CC group(63.3%). Both groups were given aerosol inhalation of ICS and symptomatic treatment.Clinical symptoms and signs were observed and scored before and after treatment for 3d, 10d and 30d, and the days required for complete disappearance of symptoms and signs were recorded.Results:After 3d of treatment, clinical symptoms and signs of TT group and CC group were improved to a certain extent, but there was no statistical significant difference between two groups( P>0.05). At 10d and 30 d after treatment, the recovery of the two groups was better than that at 3d, and the improvement degree of the TT group was significantly better than that of the CC group, with statistical significance( P<0.05). The time of complete remission of symptoms and signs in TT group and CC group was(8.68±7.42)d and(16.21±7.82)d; the difference was statistically significant( P<0.01). Conclusion:There is a polymorphism of CRHR1 rs1876828 locus in children with bronchial asthma, which manifests as TT genotype and CC genotype, and CC genotype is the majority.The polymorphism of CRHR1 gene rs1876828 in asthmatic children is associated with the efficacy of ICS.The efficacy of ICS in children with TT genotype is better than that of CC genotype.

Objective To investigate the MRI features of intracranial solitary fibrous tumors/hemangiopericytomas (SFT/HPC),and to compare these findings with those of intracranial meningiomas.Methods The clinical features and MRI findings in 28 patients of intracranial SFT/HPC (SFT/HPC group)and 68 patients of meningiomas (meningiomas group) confirmed by operation and pathology were retrospectively analyzed.The indicators of two groups were compared.Results Shape of tumor,signal homogeneous,signal voids of vessel in tumor,hypointense signal nodules on T2WI and enhanded,cystic or necrosis in tumor,meningeal tail sign,changes of the nearby bone,sex,Ki-67％ level,blood lose in surgery had significant differences between SFT/HPC group and meningiomas group (all P＜0.05).Conclusion There are some differences between intracranial SFT/HPC and meningiomas.It is helpful in diagnosis and differential diagnosis through the comparative analysis of the imaging signs.

Objective To detect the change of interleukin-18 (IL-18) level in the serum of patients with acute leukemia (AL) in children, and explore the clinical significance of IL-18. Methods The level of IL-18 was measured by sandwich enzyme-linked immuno-sorbent assay (ELISA) in 45 patients with AL in children. Results The leverof IL-18 in pre-treatment AL group was 719.35±358.21pg/mL and significantly higher than that of normal-control group [(311.80±146.64)pg/mL P <0.01]. Mter treatment, the level of IL-18 was 401.14±180.78 pg/mL in post-treatment complete remission group, which was significantly lower than that of pre-treatment group(P <0.01). The level of IL-18 in non-remission group was higher than those of normal control and CR group (P<0.01);while pre-treatment group the difference was not significant (P >0.05). According to the clinical sub-group with risk factors in pre-treatment AL, the level of IL-18 in high risk(HR) and middle risk(MR) group was significantly higher than low risk(LR) group (P<0.05). The level of IL-18 in T-ALL group was significantly higher than that in B-ALL group (P<0.05). The levels of IL-18 in pre-treatment AL were markedly correlated to the count of blast cells in bone marrow (r=0.411, P=0.005). Conclusion The level of IL-18 in the patients of childhood AL was in a high expression, and related to the clinical treating effect and the count of blast cells in bone marrow, which would be taken as an index of treating effect. The level of IL-18 was closely related to the clinical risk factors in pre-treatment AL.