Objective To explore the clinical application value of deep learning image reconstruction(DLIR)-based technique for radiation dose reduction with different noise index(NI)in CT-guided percutaneous transthoracic needle biopsy(PTNB).Methods Thirty-two patients undergoing PTNB were selected,and three sets of CT images with NI of 15,30,and 45 sequentially were obtained after adjusting the puncture needle using the scanning parameters of a small range(40 mm),tube voltage 100 kV,and automatic tube cur-rent modulation(ATCM).Group A was 50％weight of adaptive statistical iterative reconstruction-Veo(ASIR-V)scanned with NI 15,and group B and C were the DLIR-high reconstructed images with NI 30 and NI 45 respectively.The CT value and standard devia-tion(SD)value of paraspinal muscles,subcutaneous fat,and arterial vessels were measured at the puncture center point and its upper and lower 10 mm sclices,respectively,and the signal-to-noise ratio(SNR)and the contrast-to-noise ratio(CNR)were also calculated.Then the images were subjectively scored by two physicians,meanwhile the effective dose(ED)among the three groups was com-pared.Results According to the subjective evaluation,the image quality of group A,B,and C all met the clinical requirement for puncture.The SD and SNR of the images in group B were better than those in groups A and C.The SD and SNR of paraspinal mus-cles and sudcutaneous fat were significantly different between groups A and B,and between groups B and C(P＜0.05),however those of paraspinal muscles and subcutaneous fat between groups A and C were not significant.The differences in ED among the three groups were all statistically significant(P＜0.05).Compared with group A,the ED in groups B and C were reduced by 82.86％and 93.90％respectively,and the ED in group C was reduced by 64.44％compared with group B.Conclusion Increasing the NI combined with the DLIR technique can significantly reduce the radi-ation dose during CT-guided PTNB.

Objective:To analyze the clinical characteristics of lung abscess related to adenovirus (ADV).Methods:The data of 5 cases suffering from pulmonary abscess by ADV in Guangzhou Women and Children′s Medical Center from January to December 2019 were collected, including general information, clinical characteristics, examination and follow up visits.Results:The age of the patients ranged from 4 months to 12 months and the mean age was 8.6 months.All of them had fever and the degree was more than 39 ℃.What′s more, they had the history of cough and sputum.Somebody had dyspnea and pleural effusion.The imaging examinations of 5 cases strongly suggested that the interstitial and parenchymal lung disease subsequently appeared different sized cystic shadow, liquid flat cystic shadow, thickened wall empty tissue image, while some cases displayed the pleural effusion.The ADV-PCR or ADV-IgM were positive in the children, while the C-reactive protein, white blood cells and neutrophile were higher than the normal, but some were not.All the platelet count and lactate dehydrogenase were higher than the normal.Three children experienced the surgical treatment and their pathologic result revealed lung abscess.All the children were cured after the treatment, with good prognosis.Conclusions:Lung abscess related to ADV was rare in children and its system was not clear.If children who suffered from ADV were not cured after the treatment for a long time, the CT scan can differentiate whether it was combined with the complication of lung abscess or not.Early therapy for these patients could obtain satisfactory prognosis.

Objective:To optimize the preparation technic of Chuanxiong Rhizoma with vacuum steam method, and to investigate the anti-inflammatory and analgesic activity of Chuanxiong Rhizoma decoction pieces with Central Composite Design-Response Surface Method. Methods:Taking the content of ferulic acid as the evaluation index and the moistening temperature, moistening time and vacuum time as the observation indexes, the moistening technic of Chuanxiong Rhizoma was optimized by Response Surface Method, and selected the optimized plan. The anti-inflammatory and analgesic activities of Chuanxiong Rhizoma were investigated by auricle swelling induced by xylene and writhing induced by glacial acetic acid. Results:The optimum vacuum moistening technic was that the softening temperature was 80 ℃, the softening time was 50 min and the vacuum time was 45 min. The content of ferulic acid in Chuanxiong Rhizoma produced by this technic is highand could decreased the times of wrinkle reaction induced by acetic acid in mice, prolonged the latent period, and obviously or partially inhibitied the ear swelling degree induced byxylene in rats. Conclusions:The Response Surface Method technic of Chuanxiong Rhizoma is easy to operate with high accuracy. The vacuum steam treatment was more obvious than traditional technology group. It provides reference for the subsequent production of Chuanxiong Rhizoma decoction pieces and have the certain value for its promotion and application.

Objective: To carry out an assessment on the public health risk of imported infectious diseases in Jinhua, so as to provide evidence for prevention and control strategies. Methods : Twenty-nine imported infectious diseases were recruited. A risk assessment index system was established by Delphi method and analytic hierarchy process. The actual values of each index of twenty-nine imported infectious diseases were obtained through special investigation,literature review and consultation. The risk scores were calculated by the improved technique for sequencing by approximate ideal solution (TOPSIS) and classified according to median. Results : Among 41 experts recruited, 38 experts were engaged in infectious disease prevention and control, 31 had senior professional titles, and all had worked for more than 10 years. Through three rounds of consultation by Delphi method and analytic hierarchy process, the risk assessment index system (target level) included four items in criteria levels, which were response capacity, public health impact, the possibility of import and local transmission and population vulnerability in a descending order of weight; twenty-seven indicators, with international attention level, levels of medical institutions with confirmed cases, the emergency response capacity of Centers for Disease Control and Prevention (CDCs) , and effective vaccines with wide coverage weighed higher. There were eleven high-risk diseases, high response capacities lay in dengue, malaria, Zika virus disease and Chikungunya fever. The response capacities for sixteen of the eighteen low-risk diseases were insufficient, especially in emergency response capacity of CDCs, laboratory testing capacity and hospital infection control ability. Conclusion Jinhua has strong capacities to deal with the incidence of dengue fever, malaria, Zika virus disease and Chikungunya fever, compared with other imported infectious diseases.

OBJECTIVE: To report on the clinical pictures of 7 patients from a pedigree affected with X-linked adrenal hypoplasia congenita (XL-AHC) and hypogonadotropic hypogonadism (HH) and the underlying mutations. METHODS: Seven patients were identified from a four-generation pedigree affected with XL-AHC and HH. Their clinical features, endocrinological changes, treatment and drug response were recorded. The patients were subjected to next-generation sequencing, and the result was verified by Sanger sequencing. PolyPhen-2 was used for predicting the influence of the mutation on protein production. RESULTS: Three deceased patients had manifested adrenal insufficiency (AI) within one year after birth. Two died at 6 and one died at 12. The four survivors presented with salient clinical and endocrinological features of AHC and HH, adrenal and testicular atrophy, and renin-angiotensin compensation. Two adult patients had testicular micro-stone detected by ultrasound.One of them also had remarkable seminiferous tubule degeneration by biopsy. The patients were followed up for 0.5 to 10 years. All required hyper-physiological dose of hydrocortisone to stabilize their clinical condition. In three patients, gonadotropic or androgen replacement induced cardinal masculine development but with unsatisfactory testis growth and sperm production.Genetic analysis revealed a novel missense c.827A>C (p.Q276P) mutation in a hotspot region within a highly conserved domain. PolyPhen-2 predicted the mutation to be highly hazardous. CONCLUSION The novel p.Q276P mutation of the DAX1 gene probably underlies the XL-AHC and HH in this pedigree with variable clinical presentations in the patients.
Adrenal Insufficiency ; DAX-1 Orphan Nuclear Receptor ; genetics ; Humans ; Hypoadrenocorticism, Familial ; genetics ; Male ; Mutation ; Mutation, Missense ; Pedigree ; Repressor Proteins

Objective: To observe the effect of Prunellae Spica extracts (PS) on the lipid metabolism in Zuker Diabetes Fatty (ZDF) rats based on AMP-activated protein kinase/acetyl CoA carboxylase (AMPK/ACC) signaling pathway.Method: The 32 male ZDF (fa/fa) type 2 diabetic rats were randomly divided into model group,metformin group (180 mg·kg^-1·d^-1),and low and high-dose PS groups (12.25,24.5 mg·kg^-1·d^-1),with 8 in each group.8 male Zuker Lean (ZL) rats were selected as normal group.Body weight and fasting blood glucose were monitored at the 0^th,4^th and 8^th weeks after administration.After 8 weeks,abdominal aorta blood was collected,serum was frozen at-20℃ by centrifugation,liver tissue was frozen at-80℃,fixed with 4% paraformaldehyde and embedded in paraffin.Serum triglyceride (TG),cholesterol (CHO),low density lipoprotein cholesterol (LDL-C) and free fatty acid (FFA) levels were measured by radioimmunoassay.Fat droplets in hepatocytes were measured by oil red O staining.Gene expressions of AMP-activated protein kinase-alpha 2(AMPKα₂),Acetyl CoA carboxylase (ACC) in liver were detected by real-time polymerase chain reaction (Real-time PCR).Protein expressions of p-AMPKα were observed by immuno-histochemical (IHC) method.Result: Compared with the normal group,the T2DM model group showed significant increases in serum levels of TG,CHO,LDL-C,FFA and lipid droplets in hepatocytes.AMPKα₂ mRNA expression was decreased,while ACC1 and ACC2 mRNA expressions were increased significantly.p-AMPKα protein expression in liver was decreased significantly (P<0.05,P<0.01).Compared with the model group,low and high-dose Ps groups showed significant decreases in serum levels of TG,CHO,LDL-C,FFA and lipid droplets in hepatocytes in ZDF rats,up-regulation in mRNA expression of AMPKα₂,down-regulation in mRNA expressions of ACC1 and ACC2,and up-regulation in protein expression of p-AMPKα(P<0.05,P<0.01).Conclusion:PS can effectively improve liver lipid metabolism in ZDF rats.Its mechanism may be related to the regulation of AMPK/ACC signaling pathway in liver.

Objective To investigate the clinical characteristics and risk-factors of traumatic basal ganglia stroke (TBGS) in children.Methods A retrospective case study was conducted to analyze the clinical and imaging data of 16 children with TBGS in the First Hospital of Jilin University from January 2014 to June 2017.A total of 16 TBGS cases (11 males,5 females) were diagnosed and the age ranged from 0.5 to 13.0 years.The prognosis of children with TBGS at different ages (≥5 years and＜5 years) and with different traumatic stroke (infarction and hemorrhage) were compared.Fisher's test was used to compare the prognosis of different groups.Results All cases had clear history of head trauma and varying degrees of limb paralysis after injury,including 4 cases of facial paralysis,3 cases of consciousness disturbance and 1 case of seizures.Head CT scan of the 16 cases showed 11 cases of ischemic stroke and 5 cases of hemorrhagic stroke.Moreover,scattered calcification was observed in the bilateral basal ganglia point of 8 cases.Neurotrophic treatment,microcirculation improvement and nerve rehabilitations were given according to the clinical and imaging data.One patient was treated with craniotomy and hematoma clearance.Of the 16 cases,11 cases were restored to normal,while 3 cases developed limb paralysis and 2 cases died.The prognosis of 11 cases of traumatic basal ganglia infarction (10 cases recovered and 1 case remained hemiplegic) was relatively better than that of 5 cases of hemorrhage (1 case recovered,2 cases remained hemiplegic and 2 cases died) (x2=8.045,P=0.013).In addition,the children younger than 5-year-old (all 8 cases recovered) had a better prognosis than the children older than 5-year-old (8 cases,3 of whom recovered,3 cases remained hemiplegia,2 cases died)(x2=12.121,P＜0.01).Conclusions The anatomical characteristics of basal ganglia and calcification of the lenticulostriate artery are risk-factors for TBGS in children.The prognosis of infarcted children and younger children is relatively better.

Objective To investigate the relationship between the detection of serological antibodies of Helicobacter pylori(HP) infection and the pathological features of gastric ulcer.Methods 228 cases of patients with gastric ulcer diagnosed by endoscopic biopsy(180 cases of benign ulcer and 48 cases of malignant ulcer) were enrolled in this study from January 2015 to October 2016.All subjects were given 14C-urea breath test.The positive rates of cytotoxin associated gene A(CagA),urease A(UreA),urease B(UreB),vacuolating toxin A(VacA) and flagellin antibodies in serum were determined by immunoblotting.The relationship between serum antibody level of Hp infection and pathologic features of gastric ulcer patients were analyzed.Results HP positive rate and type Ⅰ HP positive rate in malignant gastric ulcer group were significantly higher than those in benign gastric ulcer group(P<0.05).The positive rates of CagA,UreA,UreB,VacA and flagellin antibodies were significantly higher in patients with malignant gastric ulcer than those in benign gastric ulcer group(P<0.05).The positive rates of UreA,UreB,VacA and flagellin antibodies in patients with gastric ulcer area>2.0 cm2,severe mucosal inflammatory reaction and severe inflammatory reaction activity were higher(P<0.05).Conclusion The occurrence of gastric ulcer and progression of the disease could be related to the interaction of HP virulence factors.HP serological antibodies detection could help to classify patients with HP-positive gastric ulcer and formulate targeted prevention and treatment plan.

Background and objective Radiotherapy combined with chemotherapy or molecular targeted therapy remains the standard of treatment for brain metastases from non-small cell lung cancer (NSCLC). hTe aim of this study is to determine if the deferral of brain radiotherapy impacts patient outcomes.Methods Between May 2003 and December 2015, a total of 198 patients with brain metastases from NSCLC who received both brain radiotherapy and systemic therapy (chemo-therapy or targeted therapy) were identiifed. hTe rate of grade 3-4 adverse reactions related to chemotherapy and radiotherapy had no signiifcant difference between two groups. 127 patients received concurrent brain radiotherapy and systemic therapy, and 71 patients received deferred brain radiotherapy after at least two cycles of chemotherapy or targeted therapy. Disease speciifc-graded prognostic assessment was similar in early radiotherapy group and deferred radiotherapy group.Results Me-dian overall survival (OS) was longer in early radiotherapy group compared to deferred radiotherapy group (17.9 monthsvs 12.6 months;P=0.038). Progression free survival (PFS) was also improved in patients receiving early radiotherapy compared to those receiving deferred radiotherapy (4.0 monthsvs 3.0 months;P<0.01). Receiving tyrosine kinase inhibitor (TKI) therapy atfer the diagnosis of brain metastases as any line therapy improved the OS (20.0 monthsvs 10.7 months;P<0.01), whereas receiving TKI as ifrst line therapy did not (17.9 monthsvs 15.2 months;P=0.289).Conclusion Our study suggests that the use of deferred brain radiotherapy may resulted in inferior OS in patients with NSCLC who develop brain metastases. A prospec-tive multi-central randomized study is imminently needed.