Tumor deposits(TD)is one of the independent risk factors for poor prognosis of colorectal cancer.The diagnosis of TD primarily relied on postoperative pathology,and precise preoperative assessment was difficult to achieve.With the development of medical imaging,many imaging techniques and analyzing methods had been applied to explore TD in colorectal cancer.The progresses in imaging research of TD in colorectal cancer were reviewed in this article.

Tumor deposits(TD)is one of the independent risk factors for poor prognosis of colorectal cancer.The diagnosis of TD primarily relied on postoperative pathology,and precise preoperative assessment was difficult to achieve.With the development of medical imaging,many imaging techniques and analyzing methods had been applied to explore TD in colorectal cancer.The progresses in imaging research of TD in colorectal cancer were reviewed in this article.

Objective To investigate the clinical and pathological features and risk factors of primary IgA nephrop-athy(IgAN)with foot process effacement(FPE).Methods The clinical and Oxford-type pathological data of 300 patients diagnosed with primary IgAN by renal biopsy were retrospectively analyzed,and the influential factors of IgAN foot process fusion were analyzed by multivariate logistic regression with significant clinical indicators.Results 300 cases of adult IgAN diagnosed by renal puncture biopsy were included,the extensive FPE group accounted for 15％.156 cases(52％)were female and 144 cases(48％)were male.The median age of onset was 36(30,50)years.The median duration of renal biopsy was 8(1,24)months.The proportion of nephrotic syndrome in the extensive fusion group was higher(55.6％vs 6.7％,P＜0.05).There was no significant difference in the propor-tion of IgAN with hypertension among different degrees of FPE(P=0.092),but the systolic and diastolic blood pressure in the extensive FPE group were higher than those in the mild FPE group(P＜0.05).The levels of total cholesterol(TC),triglyceride(TG),low-density lipoprotein cholesterol(LDL-c),and 24-hour urinary protein in the extensive FPE group were higher(P＜0.05),but the levels of albumin,estimated glomerular filtration rate(eGFR)and hyperuricemia were low(P＜0.05).There were no significant differences in hemoglobin,creatinine,and uric acid levels between the two groups(P＞0.05).There was a higher proportion of endothelial cell prolifera-tion(E1),segmental sclerosis or adhesion(S1),and cellular or cellular fibrous crescents(C1-2)in the extensive FPE group(P＜0.05),while there was no significant difference in tubular atrophy or interstitial fibrosis(T1-2)between the two groups(P＞0.05).Univariate logistic regression analysis showed that diastolic blood pressure,eGFR,TC,TG,and LDL-c were associated with extensive FPE in IgAN patients.Multivariate logistic regression a-nalysis showed that elevated TC(OR=2.135,95％CI 1.095-4.164,P=0.026)was an independent risk factor for extensive fusion of the foot process.Conclusion Compared with mild FPE,IgAN patients with extensive FPE had higher rates of blood pressure,blood lipid,nephrotic syndrome and hyperuricemia,slightly worse renal func-tion,and more severe pathological manifestations of the Oxford-type.Elevated TC is an independent risk factor for extensive FPE in IgAN patients.

Objective To determine the genotype and molecular typing of vancomycin-resistant Enterococcus (VRE).Methods Seventeen clinical isolates of VRE were collected in 2016.The strains were identified to species and confirmed by 16S rRNA sequencing.The minimum inhibitory concentration of antimicrobial agents was determined by microdilution method and agar dilution method.Multilocus sequence typing (MLST) was used for molecular typing.Results The VRE strains were confirmed as Enterococcusfaecium by 16S rRNA sequencing.All strains were resistant to vancomycin,but only 12 strains were resistant to teicoplanin.The vanA gene was identified in 13 of the 17 strains.The vanM gene was detected in 9 strains.Both vanA and vanM genes were identified in five of the 17 strains.Six MLST types were identified in the 17 strains,including ST78 (n=8),ST80 (n=4),ST555 (n=2),and one each for ST117,ST262 and ST341.Conclusions The van genotype was primarily vanA (76.5％) and vanM (52.9％) in clinical isolates of VRE.The VRE strains carrying both vanA and vanM were found for the first time.

[Abstract ] Objective To compare the accuracy between regular computed tomography colonography (CTC)and dual-energy CTC in lesion detection.Methods Twenty-eight patients with clinical suspicious space occupying lesions of the colon were selected.All patients were underwent dual-energy mode contrast-enhanced CT scan and the data were reconstructed with colonography and dual-energy iodine maps methods.The diameter,enhanced computed tomography (CT)value and iodine value were measured.The results of colonoscopy and pathology were taken as gold standard.The sensitivity, specificity,accuracy,positive predictive value and negative predictive value of regular CTC and dual-energy CTC were compared.Variance analysis was performed for measurement data comparison among groups and chi-square test was used for count data analysis.Results Among 28 patients,colorectal lesions were detected in 24 cases by regular CTC,of which four cases were false-positive and one case was false-negative confirmed by colonoscopy and pathology.Colorectal lesions were detected in 20 cases by dual-energy CTC,of which no false-positive and one case was false negative confirmed by colonoscopy and pathology.The contrast enhanced CT value of polyps,adenoma,adenocarcinoma and stool was (38.54± 6.82),(49.16±7.31 ),(52.61 ±5 .93 )and (34.00±1 .41 )Hu,respectively.The enhanced value of adenoma and adenocarcinoma was significantly higher than that of polyps and stool,the differences were statistically significant among groups (F = 10.760,P = 0.001 ).There was no significant difference between polyps and stool (t=1 .44,P =0.188).The sensitivity of regular CTC and dual-energy CTC in lesion detection was 95 .6% (95 %cofidence interval(CI ):77.9%-99.2%)and 95 .6% (95 %CI :77.9%-99.2%),respectively.The specificity was 42.8% (95 %CI :15 .4%-93.5 %)and 100.0% (95 %CI :47.9%-100.0%).Conclusion Compared with traditional CTC,dual-energy CTC would distinguish lesions from stool,help differentiate between benign and malignant tumors and further increase the accuracy of CTC diagnosis.

Objective To investigate outcome and cognitive changes of amnestic mild cognitive impairment (aMCI) in a follow-up study. Methods A cross-sectional and longitudinal parallel cohort study design was conducted among 109 aMCI patients and 104 matched normal controls. Multi-dimension neuropsychologic tests were used to extensively assess the cognitive function. Results The scores of neuropsychologic tests in aMCI patients were significantly lower than those in the normal controls( all P＜0.01 ) ,with the largest impairment on 20minutes delayed recall of the auditory verbal memory test ( AVMT), which reflects episodic memory ( aMCI pa-tients :2.50 ± 1.48, normal controls :7.85 ± 1.59, Z = - 12.697, P ＜ 0.01 ); AD was diagnosed in 15 of the 69aMCI patients with a prevalence rate of 22% ,but none was converted to AD in the normal controls. The cognitivechanges of performance in AVMT, CDT, MMSE of the patients in aMCI group (( 3.77 ± 60.83 )%, (6.89 ±28.24) %, (6.13 ± 16.89) % respectively) were significantly poorer than those of the controls group(( - 10.75 ±27.46) %, ( - 5.23 ± 14.05 ) %, ( - 1.11 ± 8.26 ) % respectively) ( all P ＜ 0.05 ). At baseline, demented aMCIperformed poorer in AVMT, CFT, TMT, SDMT, CDT, MMSE when compared to stable. During the follow-up, demented aMCI groups performed significantly poorer than did stable subjects in AVMT, CFT, DST, VFT, SDMT,MMSE ( all P ＜ 0.05 ). Conclusion aMCI is a prodromal period of AD and characterized by episodic memory impairment. The neuropsychologic test is a predictive factor for aMCI to develop AD.

Objective To explore the effect of brain-derived neurotrophic factor (BDNF) Val66Met polymorphism,environmental factor and their interactions on antidepressant treatment.Methods 340 patients of major depressive disorder (MDD) who met the diagnosis criteria of MDD ( DSM-Ⅳ Axis Ⅰ) were recruited.280 patients of them were finished 12 weeks antidepressant treatment.The severity of depression was measured with the Hamilton Depression Rating Scale (HDRS) before and after 12 weeks antidepressant treatment.Childhood Trauma Questionnaire,28-item Short Form (CTQ-SF) and Life Events Scale (LES) were used to evaluate childhood adverse and life stress before onset.Genotyping of BDNF Val66Met polymorphism was detected by Illumina GoldenGate assays.Results Male patients proportion were significantly higher in non-remitters than remitters (P =0.008 ).After adjusting by gender, the frequencies of genotype and allele for the BDNF Val66Met polymorphism were no significant difference between remitters (AA: AG: GG = 28: 79: 40, A:G = 135:159 ) and non-remitters (AA: AG: GG = 29:81:23 ,A: G = 139:127 ) (P ＞0.05 ).There was no significant difference of CTQ scores and LES scores between the two groups (P＞0.05 ).The regression analysis showed that social intercourse problem and age were the risk factor for the severity of depression.The gender, HDRS baseline scores and mental disorder family history were associated with the efficacy of 12 weeks antidepressant.However,there was no significantly relationship between the interaction of BDNF Val66Met polymorphism and environment with the antidepressant treatment.Conclusion The older men with the mental disorder family history, severe depression symptom would be less-response to antidepressant treatment.However, BDNF Val66Met polymorphism, childhood trauma, life events stress and the interaction of BDNF Val66Met polymorphism and environment have no significantly effect on the 12 weeks antidepressant treatment.

According to teaching outline and clinical training characteristic of psychophy-laxis speciality(including Psychiatry and Medicopsychology),we explored how to strengthen the clinical thinking ability and clinical skill training for clinical medicine students based on cultiva-tion of elementary knowledge and theory,and we also established a set of more appropriate item system of clinical skills assessment so as to improve the practice quality in psychiatry and medical psychology departments.