Abstract:China has the third largest tuberculosis burden in the world, with a heavy anti-tuberculosis task. In recent years, ultrasound imaging technology has been widely used in the diagnosis of pulmonary and extrapulmonary tuberculosis. Because of its simplicity, convenience, and diagnostic function for multiple organs, ultrasound has gradually become an effective auxiliary diagnostic method for tuberculosis. In this paper, we reviewed the application status, problems and prospects of ultrasonic techniques in tuberculosis, hoping to provide new methods for the diagnosis of tuberculosis.

Abstract:Objective To compare and analyze the performances of contrast-enhanced ultrasonography in the diagnosis of pleural-based pulmonary tuberculosis and lung cancer lesions, so as to provide basis for imaging identification. Methods A total of 42 patients with pathologically confirmed pleural-based pulmonary tuberculosis and 42 patients with pleural-based lung cancer admitted to Shanghai Pulmonary Hospital from Jun. 2017 to Feb. 2018 were retrospectively enrolled, and the images of conventional ultrasound and contrast-enhanced ultrasound of the largest lesions in each patient were analyzed. The arrival time, enhancement pattern, enhancement intensity, uniformity, images of necrosis, clearance speed and other characteristics by contrast-enhanced ultrasound were analyzed in the two groups. Results The enhancement patterns of pulmonary tuberculosis and lung cancer were both mainly enhanced from the periphery to the center, but the number of lesions with regular dendritic vascular enhancement in the pulmonary tuberculosis group was significantly more than that in the lung cancer group (10 vs 1; χ²=8.473, P=0.004). Low enhancement was more common in pulmonary tuberculosis lesions (17 vs 6; χ²=7.244, P=0.007), and high enhancement was more common in lung cancer lesions (25 vs 6; χ²=18.456, P<0.001). Compared with the lung cancer group, the necrotic areas in the pulmonary tuberculosis group mostly showed a mesh-like appearance (13 vs 0; χ²=15.380, P<0.001) or regular large patchy necrosis (11 vs 2; χ²=7.372, P=0.007). The necrotic areas in the lung cancer group were more irregular compared with the pulmonary tuberculosis group (16 vs 2; χ²=13.859, P<0.001). The proportion of patients with arrival time<10 s in the pulmonary tuberculosis group was significantly higher than that in the lung cancer group (21 vs 9; χ²=7.467, P=0.006), and the proportion of patients with the arrival time difference<2.5 s compared with normal lung tissue in the pulmonary tuberculosis group was significantly higher than that in the lung cancer group (42 vs 3; χ²=65.227, P<0.001). Conclusion The arrival time difference, enhancement intensity and images of necrosis by contrast-enhanced ultrasound in the pulmonary tuberculosis and lung cancer are significantly different, which can provide evidence for the differential diagnosis of pulmonary tuberculosis and lung cancer.

Abstract:Objective To explore the clinical value of contrast-enhanced ultrasound-guided biopsy in the early diagnosis of pleural tuberculoma. Methods A total of 87 patients were recruited, who were admitted to Shanghai Pulmonary Hospital affiliated to Tongji University from Jan. 2017 to Jan. 2018 and were diagnosed to have pleural tuberculoma based on clinical indication and imaging. All patients underwent contrast-enhanced ultrasonography and ultrasound-guided biopsy, and then the samples were sent for pathological examination, acid-fast bacilli culture and polymerase chain reaction for Mycobacterium tuberculosis. The clinical data of the patients were collected and the results of contrast-enhanced ultrasound, final diagnostic positive rate and adverse reactions were statistically analyzed. Results The success rate of contrast-enhanced ultrasound-guided biopsy of 87 patients was 100%, among which 70 cases were diagnosed with tuberculosis, 7 with maligmant tumors, 4 with other infection diseases, and 6 cases obtained negative results (confirmed by diagnostic anti-tuberculosis and thoracoscopic biopsy, 5 with tuberculosis and 1 with pleural mesothelioma). Seventy-five of 87 cases were eventually diagnosed with tuberculosis, of which 70 (93.33%) were diagnosed by contrast-enhanced ultrasound-guided biopsy. The intensity of contrast-enhanced ultrasound was an important differential factor for pleural tuberculoma and malignant tumor; low enhancement mainly existed in the pleural tuberculoma (66/75), and high enhancement mainly existed in the malignant tumor (4/7). Hemorrhage and/or hemoptysis occurred in 5 cases during the puncture, pleural reaction occurred in 3 cases, and all of them was relieved after symptomatic treatment. Conclusion Contrast-enhanced ultrasound-guided biopsy has a high value for the early diagnosis of pleural tuberculoma, with high positive rate, small trauma and good reproducibility, and is worthy of clinical promotion.

Abstract:Objective To analyze and compare the ultrasound elastography (UE) features of various types of cervical tuberculous lymphadenopathy (CTL), and to investigate the value and limitation of UE in diagnosis of CTL. Methods A total of 70 CTL patients confirmed by pathology or diagnostic treatment who were admitted to Shanghai Pulmonary Hospital affiliated to Tongji University from Jul. 2017 to Mar. 2018 were enrolled, and the images of conventional ultrasound and UE of the largest lymph nodes in each patient were retrospectively analyzed. According to the conventional ultrasound classification criteria of tuberculous lymphadenopathy, the lesions were divided into acute inflammatory type (typeⅠ), caseous necrotic type (typeⅡ), cold abscess type (type Ⅲ) and healing calcification type (type Ⅳ). The elasticity score and strain ratio of various types of CTL lesions were summarized and compared. Results There were 24 (34.29%) typeⅠCTL lesions, 28 (40.00%) typeⅡ, 12 (17.14%) type Ⅲ, and 6 (8.57%) type Ⅳ. The hardness of CTL lesions of typeⅠand typeⅡ was high, with the elastic score being 3-4 (47/52, 90.38%) and the strain ratio being 3-5; the hardness of type Ⅲ was the lowest, with the elastic score being 1-2 (10/12, 83.33%) and the strain ratio<2; the hardness of type Ⅳwas the highest, with the elastic score being 4-5 (6/6, 100.00%) and the strain ratio>5. There were significant differences in elastic score and strain ratio among the four type CTL lesions (H=30.756, F=23.177; both P<0.001). Pairwise comparison showed that except for the differences between typeⅠand typeⅡ lesions, there were significant differences in elastic scores and strain ratios between the four type CTL lesions (P<0.05). Conclusion The value of UE in the diagnosis of CTL is limited. It may play some roles in determining whether there is an obvious granuloma formation in typeⅠlesions and the tension of type Ⅲ lesions.

Abstract:Objective To investigate the value of intrathoracic contrast-enhanced ultrasound in the treatment of pleural effusion. Methods Forty-four patients in our hospital were selected; they had stopped drainage during closed thoracic drainage and had residual pleural effusion determined by pathogenetic condition. The resistance in the catheter during normal saline flushing, whether the effusion could be drained and the effusion traits, and the enhancement of catheter, chest wall soft tissue and pleural cavity after contrast-enhanced ultrasound were all observed. Clinical and ultrasound examination was used to judge whether the catheters were out of the effusion cavity and the accuracies of the two examination methods were compared. Results When the catheter was located in the effusion cavity, contrast-enhanced ultrasound showed a linear enhancement in the catheter and a slow enhancement in the effusion cavity; when the catheter was removed, contrast-enhanced ultrasound showed a short linear enhancement in the catheter, a limited area of enhancement in the chest wall soft tissue and no enhancement in the effusion cavity. In clinical judgment, 8 catheters were located in the effusion cavity, and 36 cases were removed. In ultrasound judgment, 29 catheters were located in the effusion cavity, 14 cases were removed, and 1 case could not be judged. Taking whether there is still liquid extraction 24 h after saline flushing or drug injection as the standard of catheter removing, we found that the accuracy of contrast-enhanced ultrasound in determining catheter removing was significantly higher than that of the clinical judgment (97.73%[43/44] vs 50.00%[22/44], P<0.01). Conclusion Intrathoracic contrast-enhanced ultrasound can accurately judge the position of catheters and the internal condition of the effusion cavity. It provides a basis for further treatment of pleural effusion.

Abstract:In recent years, with the development of novel ultrasonic techniques, ultrasonography has been widely used as a non-invasive examination method in the diagnosis and treatment of pulmonary tuberculosis. Conventional ultrasound combined with contrast-enhanced ultrasound has great significance in the diagnosis and the long-term observation of treatment of tuberculosis, contrast-enhanced ultrasound combined with interventional ultrasound techniques can improve the success rate of percutaneous lung puncture, and endobronchial ultrasound has definite diagnostic value for pulmonary tuberculosis patients with negative results in sputum smear or sputum culture bacteriological examination. In this paper, we reviewed the progress of conventional ultrasound, contrast-enhanced ultrasound, ultrasound-guided percutaneous lung puncture and endobronchial ultrasound in the diagnosis of pulmonary tuberculosis.

Abstract:Objective To display the normal vascular structures of head and neck of Bama minipig by three-dimensional time-of-flight (3D TOF) and time-resolved imaging of contrast kinetics (TRICKS) magnetic resonance angiography (MRA), and to compare and analyze the imaging indicators of arteries, so as to provide references for large animal models of cerebrovascular disease. Methods 3D TOF and TRICKS MRA of head and neck vessels in 3 healthy Bama minipigs were performed using a 3.0 T magnetic resonance system. The artery definition scores of the two MRA methods were compared, and the contrast ratio (CR), signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of the main arteries were calculated for quantitative analysis. Results In terms of artery definition, 3D TOF MRA and TRICKS MRA both achieved high scores for the common carotid arteries and external carotid arterial system, but low scores for posterior circulation. 3D TOF MRA was significantly better than TRICKS MRA in displaying the intracranial artery system (1.60±0.50 vs 1.37±0.49, P=0.019 8). Quantitative analysis showed that TRICKS MRA improved CR of arteries to different extents; however, there were no significant differences in SNR or CNR between 3D TOF and TRICKS MRA (P>0.05). Conclusion Both 3D TOF and TRICKS MRA have good and comparable diagnostic performance for common carotid arteries and their main branch structures of Bama minipig, and each method has its advantages and limitations.

Abstract:Objective To explore the role and possible mechanism of grainyhead-like protein 2 (GRHL2) down-regulation in acquired drug resistance to tumor-targeted therapeutic drug gefitinib, an epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI). Methods Human colon cancer cell line DiFi and human lung adenocarcinoma cell line HCC4006 were cultured in a stepwise increasing concentration of gefitinib to obtain gefitinib-resistant cell lines. The differentially expressed genes between gefitinib-resistant cell lines and parent cells were selected by RNA sequencing and verified by real-time fluorescent quantitative PCR (qRT-PCR). The pcDNA3.1-GRHL2 plasmid was transfected into the gefitinib-resistant cell lines to overexpress GRHL2, and the sensitivity of the cells to gefitinib was detected by CCK-8 method. The expression of epithelial marker (E-cadherin) and mesenchymal marker (Vimentin) in the gefitinib-resistant cells was detected by Western blotting. The relationship between GRHL2 expression and expression of E-cadherin and Vimentin in 60 human tumor cell lines was analyzed by CellMiner^TM database. Results We successfully obtained two gefitinib-resistant cell lines. RNA sequencing and qRT-PCR confirmed that the expression of GRHL2 in the gefitinib-resistant cells was decreased, while the sensitivity of the cells to gefitinib was restored after overexpressing GRHL2 in the gefitinib-resistant cells. Western blotting analysis showed that the E-cadherin expression was decreased and the Vimentin expression was increased in the gefitinib-resistant cell line. CellMiner^TM database analysis showed that the expression of GRHL2 was highly consistent with the ratio of E-cadherin to Vimentin. Conclusion Down-regulation of GRHL2 mediates drug resistance of tumor cell to gefitinib by inducing epithelial-mesenchymal transition.

Abstract:Objective To explore the effect of herpes simplex virus type Ⅰ (HSV-1) infection on expression of β-amyloid (Aβ) in human neuroblastoma cell lines SH-SY5Y. Methods African green monkey kidney cell lines Vero cells were used to amplified HSV-1, and the virus titers were measured. SH-SY5Y cells were infected with HSV-1 3.2×10⁸ plaque forming unit (PFU)/mL at a multiplicity of infection (MOI) of 10 for 12 h or 24 h, and the morphological changes of the cells were observed under microscope. PCR was used to detect the expression of HSV-1 DNA. Double-color immunofluorescence assay was performed to show the expression of Aβ and apolipoprotein E (ApoE). Western blotting was used to detect the expression levels of amyloid precursor protein (APP), melanin metabolic enzyme (MME), ApoE, glycogen synthase kinase-3β (GSK-3β) and phosphorylated glycogen synthase kinase-3β (p-GSK-3β). Results After infection with HSV-1 for 12 h, the SH-SY5Y cells had synapse reduction and neurite retraction and few neurites. And after 24 h of infection, the cells began to aggregate, and were round and shed. Compared with phosphate buffer saline (PBS) control group, the expression of Aβ was significantly increased after infection with HSV-1 for 12 h (P<0.01), while the expression of ApoE protein was not significantly changed. After 24 h of infection, the expressions of Aβ and ApoE were significantly increased (P<0.05), but the expression of Aβ was significantly lower than that on 12 h of post-infection (P<0.01). Western blotting analysis showed that, compared with PBS control group, the expression of APP was significantly decreased on 12 h of post-infection (P<0.05), and the expressions of GSK-3β, p-GSK-3β and MME were significantly increased (P<0.05). However, the expression of MME was significantly decreased (P<0.05) and the expression of ApoE was significantly increased (P<0.05) 24 h post-infection. Conclusion HSV-1 infection induces the expression of Aβ in SH-SY5Y cells through promoting APP metabolism and Ser9 phosphorylation of GSK-3β on 12 h of post-infection, and inhibiting the degradation of Aβ on 24 h of post-infection.

Abstract:Objective To explore the effects of phytosterol ester (PSE) on the hepatic steatosis and amino acid profile of rats with non-alcoholic fatty liver disease (NAFLD) induced by high fat diet. Methods Thirty-one male SD rats were randomly divided into normal control group (NC group, n=7), high fat diet group (HF group, n=12) and PSE intervention group (PSE+HF group, n=12). The rats in the HF and PSE+HF groups were fed with high-fat diet to establish the NAFLD rat model, and the rats in the PSE+HF group were continuously intragastrically administered with PSE 0.5 g/kg for 12 weeks. The hepatic steatosis was evaluated with Oil Red O staining, and the serum amino acid profile was analyzed using automatic amino acid analyzer. Pearson correlation analysis was used to investigate the correlation between amino acids and degree of liver steatosis. Partial least squares-discriminant analysis (PLS-DA) was carried out using SIMCA-P 11.5 software. Results There was no significant difference in body mass of rats between the PSE+HF group and HF group (P>0.05). Moreover, there was no significant difference in food intake of rats between the NC, HF and PSE+HF groups (P>0.05). Compared with the HF group, the hepatic steatosis of rats was partly alleviated in the PSE+HF group. The serum levels of essential amino acids, including isoleucine and leucine, and the non-essential amino acids, including cysteine, aspartate, glutamate and alanine, in the PSE+HF group were increased by 17.25%, 12.42%, 41.47%, 15.61%, 17.87% and 16.07%, respectively, compared with the HF group, and the differences were statistically significant (all P<0.05). The levels of serum NH3 and histidine were significantly decreased in the PSE+HF group versus the HF group (both P<0.05). PLS-DA analysis results showed that HF group and PSE+HF group could be clustered respectively. Pearson correlation analysis results showed that the levels of histidine, proline and serum NH3 were positively correlated with the degree of hepatic steatosis (all P<0.01); and tryptophan, phenylalanine, isoleucine, cysteine, glutamate and the related metabolites, ornithine, were negatively correlated with the degree of hepatic steatosis (all P<0.05). Conclusion PSE can regulate the amino acid metabolic profile of rats with NAFLD induced by high fat diet.

Abstract:Objective To investigate the expression of mixed lineage kinase domain-like protein (MLKL) in uterus during early pregnancy and decidua in mice. Methods Different mouse models including early pregnancy model, artificially induced decidualization model and hormone and/or progesterone treatment of uterine model were constructed; human endometrial stromal cells were cultured in vitro and were induced for decidualization by treating with estradiol-17β, medroxyprogesterone acetate and dibutyryl cyclic adenosine monophosphate. The expression of MLKL mRNA and protein in the uterus of early pregnancy, decidual uterus, and hormone-treated uterus in mice were analyzed by real-time fluorescent quantitative PCR, in situ hybridization and Western blotting. The expression of MLKL mRNA in human decidual cells induced in vitro was detected by real-time fluorescent quantitative PCR. Results (1) In the uterus during early pregnancy in mice, the expression of MLKL mRNA and protein in uterine epithelium on the 1^st to 4^th day of pregnancy (day 1 was day of vaginal sperm) was low and irregular. It was expressed in the uterine epithelium and surrounding decidual cells on the 5^th day of pregnacy, and was mainly expressed in the decidua from the 6^th to 8^th day of pregnancy. After the implantation, the expression of MLKL mRNA and protein was day-by-day increased and reached the highest on the 7^th day of pregnancy, with a slight decrease on the 8^th day. (2) In the uterus of mice with artificially induced decidualization, MLKL mRNA was expressed in the entire decidual region with high level; while there was no significant expression in the uterus of the control mice. The expression of MLKL protein was consistent with the expression of MLKL mRNA. The expression of MLKL mRNA in human decidual cells induced in vitro was significantly higher than that in the control group (P<0.05). (3) The expression of MLKL mRNA and protein in progesterone-treated uterus was significantly increased compared with the control group (P<0.05). Conclusion MLKL regulated by steroid hormone progesterone is involved in embryo implantation and decidualization of mammals.

Abstract:Objective To investigate the short-term clinical efficacy of radioactive ¹²⁵I seed implantation in the treatment of patients with thymoma recurrence. Methods Clinical data of patients with thymoma, who underwent radioactive ¹²⁵I seed implantation in Huadong Hospital of Fudan University during Sep. 2016 and Jun. 2017, were retrospectively collected. Inclusion criteria:local pleural recurrence lesions; intolerable to systemic chemotherapy or failure in previous chemotherapy; previously received high-dose chest radiotherapy; and normal coagulation function. All the patients were examined by computed tomography (CT), ultrasound and positron emission tomography-computed tomography (PET-CT) before operation. According to the Radiotherapy Planning System (TPS), the patients were inserted with the particle needles at the puncture point under the guidance of CT or ultrasound, and the distance between the sources was generally 0.5 cm. The clinical efficacy and adverse reactions were observed at 2 months after treatment. The patients were followed up for 3-9 months. Results A total of 13 patients underwent radioactive ¹²⁵I seed implantation, aged from 30 to 78 years, with 7 males and 6 females. The median number of implanted particles was 30, ranging from 20 to 58; the median dose of the particles was 1.9×10⁷ Bq, and the range was (1.5-2.6)×10⁷ Bq. The objective response rate was 100% (7 cases in complete remission and 6 in partial remission) after 2 months of follow-up, and all the 4 patients with chest wall pain were relieved. Pneumothorax occurred in 1 patient during particle implantation. During 3 to 9 months of follow-up, no patient developed disease progression at the site of particle implantation. Conclusion Radioactive ¹²⁵I seed implantation is a safe and effective method in the treatment of pleural recurrence of patients with thymoma, and can be used as a salvage therapy after the failure of traditional radiotherapy and chemotherapy, but its long-term effect needs further observation.

Abstract:Objective To construct and identify rat myosin heavy chain 14 (MYH14) gene recombined lentiviral vector by RNA interference technique. Methods Based on the MYH14 mRNA sequence, a single-stranded primer was designed to form a double-stranded oligonucleotide sequence, which was ligated into the GV298 lentiviral vector linearized by AgeⅠ and BamHⅠ double enzymes restriction, and then the bacterial liquid was verified by PCR and sequencing, respectively. The plasmid was extracted in the bacterial liquid with correct sequence and transfected into rat Schwann cells RSC96. The transfection efficiency was observed by immunofluorescence, the shRNA plasmid could effectively knock down MYH14 was screened by Western blotting, and the cell viability of RSC96 cells after transfection was detected by CCK-8. Results Three pairs of MYH14-shRNA sequences were synthesized and cloned into GV298 vector to construct recombinant plasmids MYH14-shRNA1, 2, and 3, and the vector MYH14-shRNA1 and MYH14-shRNA2 were screened by PCR and sequencing. Immunofluorescence showed that the cell fluorescence was the strongest at 72 h after transfection. Western blotting analysis showed that compared with the negative control (scramble sequence) group, the expression level of MYH14 protein in RSC96 cells was significantly decreased after MYH14-shRNA2 transfection (0.57±0.15 vs 1.11±0.06, P<0.01), while there was no significant difference after MYH14-shRNA1 transfection (P>0.05). There was no significant difference in cell viability of RSC96 cells between the negative control and MYH14-shRNA2 groups 24 h after transfection (1.09±0.16 vs 1.00±0.15, P>0.05). Conclusion The rat MYH14 gene recombinant lentiviral vector has been successfully constructed, which can effectively down-regulate the expression of MYH14 in RSC96 cells.

Abstract:Choledocholithiasis is a common disease in biliary system and can cause obstructive suppurative cholangitis, acute pancreatitis and other severe complications. Thus it is very important to remove bile duct stones. Currently the first-line treatment for choledocholithiasis is endoscopic lithotomy. For the patients with failed endoscopic lithotomy, extracorporeal shock wave lithotripsy (ESWL) is a new alternative. Therapeutic effect of ESWL on choledocholithiasis is quite good, with the stone clearence rate being 73%-93% according to many studies. The efficacy of ESWL is related to many factors such as placement of nasal bile duct, shock wave frequence, and anesthesia method. ESWL is more effective when combined with other endoscopic techniques. Although ESWL is effective in the treatment of choledocholithiasis and the related application is mature, there are still complications, including postoperative biliary colic, pancreatitis and biliary obstruction. In this study, we reviewed the research advances of ESWL in the treatment of choledocholithiasis in recent years.

Abstract:Primary insomnia (PI), a prevalent sleep disorder, has been associated with cognitive deficits and emotional disorders. Several studies have shown that PI involves a wide range of brain abnormalities. In recent years, functional magnetic resonance imaging techniques combined with different analysis methods are widely applied in the study of PI. It can objectively and indirectly analyze the changes in brain functional activities, help to elucidate the neuropathological mechanisms of PI, and provide reliable objective basis for the early diagnosis of disease. In this paper, we reviewed the application of task state functional magnetic resonance imaging, resting-state functional magnetic resonance imaging and function connectivity in patients with PI.

Abstract:Bronchopulmonary dysplasia (BPD) is one of the most serious complications of preterm infants and seriously affects the quality of life of premature infants. With the continuous improvement of neonatal intensive care technology, more and more methods were used for the treatment of BPD, but the effect is still not satisfactory and has controversies. As a routine treatment, drug therapy plays an important role in the prevention and treatment of BPD. In this paper, we summarized the research progress of commonly used clinical drugs for BPD, and proposed possible effective ways for the prevention and treatment of BPD.

Abstract:Medical economic burden, also known as economic burden caused by disease, is defined as the actual or potential resources consumed for health needs. Research on the medical economic burden in China starts late and has a weak foundation compared with European and American countries, but it has developed rapidly in recent years. At present, there is no uniform standard on the academic definition, content and classification of medical economic burden. Moreover, most researchers in China mainly focus on the economic burden of single disease, with abundant contents but limited and traditional methods, and the researches on the factors influencing the medical economic burden and the medical economic burden caused by medical insurance and health investment are rare. In this paper, we proposed that the future research directions of medical economic burden may include the following aspects:(1) empirical and exploratory studies on the influencing factors of medical and health service costs; (2) to introduce catastrophic medical indexes, explore innovative measurement methods for medical economic burden, and compare the differences between different measurement methods; and (3) exploratory research on medical economic burden through interdisciplinary perspectives.

Abstract:Objective To explore the healthcare demands and utilization of soldiers in navy warship troops during maritime missions, so as to provide scientific basis for the relevant health agencies to make plan and allocate health resources. Methods Questionnaire were designed for naval soldiers to fill in, and the investigation included basic information of soldiers, disease occurrence, physical injury and medical treatment during the missions. The EpiData 3.1 was used for data input by double person and the SPSS 21.0 was used for statistical analysis. Results A total of 850 questionnaires were sent out and 755 valid questionnaires were returned (response rate 88.82%). During the maritime mission, the incidence of diseases of soldiers in navy warship troops was high, with various types of diseases. The diseases of high frequency were acute gastroenteritis (49.1%, 371/755) and heat stroke (36.4%, 275/755). The physical injuries of high incidence were seasickness (65.0%, 491/755), noise induced hearing loss (20.0%, 151/755), and cabin noxious gas poisoning (19.3%, 146/755). There were 242 persons (32.1%) who believed that the disease could not be solved during maritime missions. Conclusion During the maritime missions, the incidences of diseases and physical injuries of soldiers are high in navy warship troops, and the health services cannot well meet the demands of the soldiers.

Abstract:Objective To improve the detection rate of cytogenetic abnormalities of monoclonal plasma cells through quality control cycle (QCC) activities. Methods A QCC team was established to collect the bone marrow samples of patients suspected with multiple myeloma, who undergoing plasma cell-associated fluorescence in situ hybridization (FISH) in Department of Hematology, Changhai Hospital of Navy Medical University (Second Military Medical University) from Jun. 2014 to Dec. 2014. The detection rate of cytogenetic abnormalities of monoclonal plasma cells was analyzed and compared with literatures to find out the difference and related causes, and then the improvement measures were formulated and practiced to evaluate the improvement effect. Results We found that low tumor load in the initial specimen and the detection result could not be judged due to that value is very close to the critical value were the two key points to be improved in the QCC activity. Based on the brainstorming and the existing laboratory conditions, the QCC team chose to sort abnormal cells by flow cytometry to increase tumor cell density and reduce background value before genetic testing. Finally, the detection rate of cytogenetic abnormalities of monoclonal plasma cells increased from 61.3% (95/155) to 92.1% (174/189) in our hospital. Conclusion The FISH detection process of bone marrow of patients suspected with multiple myeloma is optimized through QCC activities, and the detection rate of cytogenetic abnormalities of monoclonal plasma cells is effectively improved.

Abstract:Objective To analyze the diagnostic value of computed tomography (CT) enhanced angiography of pancreatic artery with thin slice target scanning of field of view (FOV) for pancreatic cancer. Methods Clinical data of 36 patients with pancreatic cancer confirmed by postoperative pathology were collected. All patients received CT enhanced angiography of pancreatic artery with thin slice target scanning of FOV before operation, and the accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of the CT enhanced angiography of pancreatic artery with thin slice target scanning of FOV in evaluating tumor size, vascular invasion, arterial origin variation, and node metastasis were calculated with pathological results being the "gold standard". The Kappa test was used to evaluate the diagnostic value of CT enhanced angiography of pancreatic artery with thin slice target scanning of FOV for pancreatic cancer. Results The diagnostic accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of CT enhanced angiography of pancreatic artery with thin slice target scanning of FOV for tumor size were all 1.00; the diagnostic accuracy and sensitivity for vascular invasion and arterial origin variation were all 1.00, and the specificity was 0.97 or more; the diagnostic accuracy, sensitivity, specificity, positive predictive value, and negative predictive value for lymph node metastasis were 0.89, 0.75, 1.00, 1.00, and 0.83, respectively. The consistency of pathology and CT enhanced angiography of pancreatic artery with thin slice target scanning of FOV was good in evaluating pancreatic cancer (all Kappa>0.75). Conclusion CT enhanced angiography of pancreatic artery with thin slice target scanning of FOV is a comprehensive method in evaluating pancreatic tumors, tumor margin, relationship between tumor and peripheral vessels, and peripheral lymph node metastasis, and it can improve the accuracy of surgical resectability evaluation of pancreatic cancer.

Abstract:Objective To explore the relationship between blood pressure level and urinary micro-albumin, kidney damage and metabolic indicators, so as to provide scientific evidence for the prevention and treatment of hypertension. Methods Using stratified multi-stage random sampling method, we selected local residents (>15 years old) in Tongnan area of Chongqing for questionnaire survey, physical examination, and the detection of blood and urine samples to obtain blood glucose, blood lipids, urinary micro-albumin, and other clinical data. The data were statistically analyzed by SPSS 20.0 software. Results The proportions of patients with microalbuminuria (urinary micro-albumin level ≥ 20 mg/L) in the normal blood pressure group, the prehypertension group, and the hypertension group were 21.40% (61/285), 27.36% (110/402) and 48.06% (149/310), respectively, and there were significant differences between the three groups (P<0.05). The proportion of patients with microalbuminuria in the hypertension patients was significantly increased with the increase of blood pressure (P<0.05). Multiple linear regression analysis showed that systolic blood pressure was significantly increased with the increase of triglyceride and low-density lipoprotein cholesterol levels (P<0.05), and diastolic blood pressure was significantly increased with the increase of triglyceride level (P<0.05). Binary logistic regression analysis showed that urinary micro-albumin, high-density lipoprotein cholesterol, age and waist circumference were the influencing factors of hypertension (P<0.05). Conclusion Urinary micro-albumin level is closely related to blood pressure level, and can be used as an important indicator for the diagnosis of early renal damage diagnosis. Urinary micro-albumin, high-density lipoprotein cholesterol, age and waist circumference are independently associated with hypertension.

Abstract:Objective: Explore the safety and efficacy of irrigated radiofrequency ablation catheter applied in RDN, and compared with ordinary ablation catheter to provide a basis for the catheter used in RDN.

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