Objective:To analyze the differences in gut microbiota between patients with hyperuricemia (HUA) and healthy population for better understanding the correlation between gut microflora and high uric acid.Methods:This study recruited 63 adult volunteers, including 25 HUA patients (HUA group) and 38 healthy people (control group), who underwent physical examination in the PLA Strategic Support Force Characteristic Medical Center in 2021. Their fecal samples were collected and analyzed by 16S rRNA high-throughput full-length gene sequencing to analyze the composition of gut microbiota.Results:The overall composition of gut microbiota was different between HUA group and control group. The α diversity index decreased significantly in HUA group and β diversity analysis showed that there were significant differences between the two groups. HUA group showed increased Bacteroidetes and decreased Firmicutes. LEfSe analysis indicated a unique microbiota structure in HUA group, characterized by significantly decreased short-chain fatty acid (SCFA)-producing bacteria represented by Faecalibacterium prausnitzii and significantly increased Streptococcus salivarius, Bacteroides fragilis, Fusobacterium hwasookii, Flavonifractor plautii, Mycobacterium mucogenicum B and Blautia sp003287895. In addition, functional prediction through PICRUSt2 showed that the metabolism related to gut microbiota SCFA pathway in HUA group was decreased, which was consistent to the unique microbiota structure. Conclusions:Compared with healthy population, patients with hyperuricemia had different composition of gut microbiota and metabolic feature.

Objective:To investigate the correlation between gut microbiota and serum diamine oxidase (DAO) level and to analyze the differences in gut microbiota between high DAO (DAO-H) and normal DAO populations.Methods:This study recruited 62 adult volunteers (31 in DAO-H group and 31 in normal control group) taking health examination in the Strategic Support Forces Special Medical Center in 2021. Their stool samples were collected to analyze the composition of gut microbiota in the two populations by full-length 16S rRNA gene sequencing.Results:No significant difference in the alpha diversity of gut microbiota was found between the DAO-H group and the normal control group, but the structure and function of gut microbiota varied. In the DAO-H group, commensal bacteria decreased, such as Phocaeicola and Bacteroidetes, while potential pathogenic bacteria increased, such as Klebsiella pneumoniae. There were changes in the metabolism of gut microbiota in the DAO-H group, including inhibited sphingolipid metabolism and enhanced biosynthesis of vancomycin group antibiotics, one carbon pool by folate pathway, terpenoid backbone biosynthesis, cell cycle-Caulobacter, protein export, base excision repair and nitrogen metabolism.Conclusions:Compared with the people with normal DAO, the population with high DAO had unique characteristics in gut microbiota composition and metabolism.

OBJECTIVES: To explore the method and significance of prenatal counseling in cardiac surgery for fetal congenital heart disease (CHD). METHODS: The prenatal counseling should be provided by experienced CHD experts. The preliminary clinical diagnosis based on relevant data was carried out, the prognosis risk for fetal CHD was graded, and the pathophysiological process and potential hazards of the disease were analyzed. The current condition of CHD in the treatment plan, the long-term quality of life, and the special requirements of parturition in place, period and mode were described. A reliable follow-up system of the fetuses was established, the diagnosis after delivery was verified, and surgical treatment was carried out timely. RESULTS: From January 2016 to December 2018, 225 parents with fetal CHD received prenatal counseling, including 60 fetuses (26.7%) with simple CHD and 165 (73.3%) with complex CHD, among which 59 cases (98.3%) and 93 cases (56.4%) decided to continue the pregnancy, respectively. During the follow-up, 118 fetuses were born, of which 66 infants received surgical treatment within 6 months after birth, 63 infants (95.5%) recovered and 3 infants (4.5%) died. The rest 52 infants continued to be followed up. CONCLUSIONS The prenatal counseling for fetal CHD can provide the parents a comprehensive medical information about CHD, which is beneficial to making appropriate pregnancy decisions, and can turn the fetuses from unreasonable birth and passive treatment to selective birth and active treatment in CHD.
Cardiac Surgical Procedures ; Counseling ; Female ; Fetus ; Heart Defects, Congenital ; surgery ; Humans ; Pregnancy ; Prenatal Diagnosis ; Quality of Life ; Ultrasonography, Prenatal

Objective To evaluate the application of exponential apparent diffusion coefficient (eADC)value in differentiating benign from malignant thyroid nodules.Methods Routine MR sequences and axial diffusion weighted imaging (DWI)sequences with different b-values(0, 300,500,800 s/mm2)were performed in 46 patients with 51 histopathologically confirmed thyroid nodules,including 35 malignant nodules and 1 6 benign nodules.The eADC values of each thyroid nodules’solid component with different b-values were measured and assessed by independent samples t test.Receiver operating characteristic (ROC)curves were drawn and used to determine the diagnostic threshold and assess the screen test.Results The eADC values of the malignant nodules were higher than that of benign nodules (P<0.05)in all of the three different b-values.The eADC values of the malignant nodules and the benign nodules were 0.618±0.080 and 0.492±0.071 (b=300 s/mm2),0.520±0.104 and 0.371±0.077 (b=500 s/mm2)and 0.407±0.114 and 0.286±0.097 (b=800 s/mm2)respectively. According to the ROC curve,the area under the curve(AUC)was 0.883,0.890 and 0.824 when the b-value was set as 300,500 and 800 s/mm2respectively.When the b-value was set as 500 s/mm2and the diagnostic threshold was 0.454,the sensitivity,specificity, positive predictive value,negative predictive value and Youden index were 74.3%,93.8%,96.3%,60.9% and 0.68,respectively.Conclusion The eADC value is helpful in differentiating benign from malignant thyroid nodules,and the best result can be obtained by using DWI with b-value of 500 s/mm2.

Objective To evaluate the diagnostic value of preoperative ultrasonography(US)and magnetic resonance imaging (MRI) for the extrathyroidal extension (ETE) in patients with papillary thyroid carcinoma(PTC).Methods The clinical data of 90 patients with PTC from January 2013 to June 2016 were analyzed retrospectively,and all patients were examined by US and MRI before operation.The diagnostic sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of minimal ETE, extensive ETE and ETE (minimal ETE + extensive ETS) were compared between UC and MRI.Results The diagnostic minimal ETE sensitivity of UC was significantly higher than that of MRI (81.9% vs.60.0%), and there was statistical difference (P<0.05).The diagnostic extensive ETE specificity of MRI was significantly higher than that of UC(80.9% vs.63.5%),and there was statistical difference (P<0.01).The diagnostic ETE sensitivity and NPV of UC were significantly higher than those of MRI(97.4% vs.88.3% and 80.0% vs.50.0%),and there were statistical differences (P<0.05 or <0.01).Conclusions US has a higher sensitivity, compared with MRI for diagnostic minimal ETE.MRI has a higher specificity for diagnostic extensive ETE,compared with US.And US has a higher sensitivity and NPV for diagnostic ETE,compared with MRI.

Objective To compare the image features of magnetic resonance imaging (MRI) and ultrasound (US) for papillary thyroid carcinoma(PTC).Methods From January 2015 to April 2016,86 consecutive patients underwent surgery and pathologically confirmed PTCs in the People 's Hospital Affiliated to Jiangsu University were selected.All patients received neck US and MRI examination before thyroid surgery .For each case,the US and MRI features emphasized included the echogenic /signal,margin,shape,anteroposterior to transverse diameter ratio (A/T), microcalcifications and lymph node metastasis .Statistical analysis was performed using the χ2 test.Results In the comparison of US and MRI features,A/T≥1(41.9％in US and 62.8％in MRI) and lymph node metastasis(88.0％in MRI;56.0％in US) demonstrated statistically significant differences (χ2 =7.551,P=0.009;χ2 =6.349,P=0.025),and no significant differences were observed in the margin ,shape(P=0.724,P=0.316).Conclusion The MRI features of PTCs included A/T and lymph node metastasis was superior to US .

Objective To evaluate the diagnostic performance of preoperative multi b values of DWI and ADC for the prediction of extrathyroidal extension (ETE) of papillary thyroid carcinoma (PTC).Methods Between January 2013 and February 2017,MR images including dynamic contrast-enhanced MR imaging (DCE-MRI) and DWI images of 81 patients diagnosed as papillary thyroid carcinoma in the Affiliated Renmin Hospital of Jiangsu University were retrospectively analyzed.ADC values were measured on solid regions of tumors.The differences of ADC were compared between tumors with total ETE(minimal ETE,extensive ETE) and without ETE by independent-samples t test.Results When b=500 s/mm2,ADC values of PTCs with ETE[(1.27±0.17)× 10-3mm2/s]were significantly lower than those from PTCs without ETE [(2.12±0.72)× 10-3mm2/s,(t=9.126,P=0.000)].ADC values of PTCs with extensive ETE[(1.23±0.17)× 10-3mm2/s] were significantly lower than those from PTCs with minimal ETE[(1.29±0.16)× 10-3mm2/s,(t=1.467,P=0.147)].When b=500 s/mm2,the cutoff value of ADC to discriminate PTCs with and without ETE was 1.530×10-3 mm2/s with a sensitivity of 69.0％,specificity of 93.7％,positive predictive value of 77.6％,negative predictive of 77.5％ and ROC curve area of 0.887.Conclusion ADC values of the solid tumor tissue of PTC with ETE are significantly lower than those of PTC without ETE.DWI may be helpful in the determination of thyroid papillary carcinoma ETE.

Objective The study the multislice spiral computed tomography (MSCT) characteristics of gastric glomus tumor. Methods The clinical data of 8 patients with gastric glomus tumor were retrospectively analyzed, and the MSCT characteristics were observed. Results Among 8 patients, 3 cases were male and 5 cases were female, and the age was 25-67 years. The diameter of lesions were 1.3-3.5 cm, and lesions situated in the antrum of the stomach. Gastric glomus tumor showed strong enhancement in the arterial phase, and prolonged enhancement during multiphasic scans. Conclusions Gastric glomus tumor has some characteristics in MSCT. The prolonged enhancement during multiphasic scans of the subepithelial lesion should be suspected of the gastric glomus tumor.

Objective To discuss the application of spectral CT imaging in evaluating the early therapeutic response of 125I seed interstitial brachytherapy for pancreatic carcinoma in experimental nude mice.Methods BxPC-3 human pancreatic cancer cell xenografts were subcutaneously inoculated at the dorsal part of the limbs in 16 BABL/c nude mice. When the tumor developed to the size of 1-1.5 cm, the tumor-bearing mice were randomly divided into the study group (n=8,receiving implantation of 125I seeds of 1.0 mCi) and the control group (n=8,receiving implantation of ghost shell particles of 0 mCi). Two weeks after the procedure, plain spectral CT scan as well as enhanced multiphase (10 s, 25 s and 60 s) spectral CT scan were performed to obtain multi-phasic image series. The contrast-to-noise ratio (CNR) and iodine concentration (IC) inside the lesions were determined, and the normalized iodine concentrations (nIC) of tumor were thus obtained. Immunohistochemical staining of tumor was used to measure microvessel density (MVD) within the tumor;the correlation between nIC and MVD was analyzed. Results The lesion's nICs measured on each of three phases (10 s,25 s and 60 s) in the study group were lower than those in the control group, the differences were statistically significant (P<0.05). MVD count in the study group was lower than that in the control group, the difference was statistically significant (t=5.957,P<0.01). A parallel linear correlation existed between nIC obtained from each phase of three phases and MVD count (r=0.63,P<0.000 1;r=0.51,P=0.002;and r=0.48,P=0.001 7 for 10 s, 25 s and 60 s phases respectively). Conclusion Spectral CT imaging is an effective method for evaluating the therapeutic effect of 125I seed interstitial brachytherapy for pancreatic carcinoma of experimental mice.

Objective To retrospectively analyze imaging features of multi-slica computed tomography (MSCT) and clinical characteristics of male patients with pancreas solid pseudopapillary tumor (SPT) and compare with that of female patients.Methods From November 2000 to October 2012,clinical data of 18 male patients and 94 female patients underwent MSCT examination and pathological diagnosed as SPT were retrospectively analyzed.Clinical characteristics and imaging features of MSCT of male and female patients with SPT were analyzed,which included lesion location,size,shape,encapsulation,calcification,internal composition,density and enhancement pattern of tumors.Rank sum test or x2 test was performed for statistical analysis.Results The median age of male patients with SPT was significantly older than that of female patients (39.0 (15.0,67.0) years vs 27.5 (11.0,63.0) years; U=2.865,P =0.005).There were no significant differences in clinical manifestation,lesion location and composition ratio of benign and malignant tumors between male and female patients with SPT (all P＞0.05).Imaging of MSCT indicated that the median maximum tumor diameter of male patients with SPT was significantly shorter than that of female patients (5.1 (1.0,11.6) cm vs 7.9 (2.5,18.7) cm; U=3.161,P=0.002).Solid tumors were more common in male patients compared with female patients (9/18 vs 5.3％ (5/94) ; x2 =30.606,P＜0.01).Conclusions The imaging features of male patients with SPT are different with those of females.For pancreas lesion in males,if imaging of MSCT shows more solid composition,small lesion and with typical enhancement patterns of SPT,the possibility of SPT should be considered.