甄别疑似新冠肺炎的CT表现分析

自2019年底武汉市发现至波及全国的新型冠状病毒肺炎传染性强、波及范围广。但恰至冬末春初,多数的细菌及病毒性肺炎也恰是高发病率时期,早期CT表现存在相似性。故如何尽早提高临床诊断速度及准确度,并指导尽快筛查接触者有无感染及高度疑似、确诊者的快速隔离已成当务之急。本文将在新型冠状病毒感染肺炎早期诊断作出分析,旨在提高新型冠状病毒感染的肺炎的认识,为早期诊断、及时隔离与治疗提供参考依据。

Differential study of DCE-MRI parameters in spinal metastatic tumors, brucellar spondylitis and spinal tuberculosis

Objective： In the present study, spinal metastatic tumors, brucellar spondylitis and spinal tuberculosis werequantitatively analyzed using dynamic contrast-enhanced magnetic resonance imaging （DCE-MRI） to assess thevalue of DCE-MRI in the differential diagnosis of these diseases.Methods： Patients with brucellar spondylitis, spinal tuberculosis or a spinal metastatic tumor （30 cases of each）received conventional MRI and DCE-MRI examination. The volume transfer constant （Ktrans）, rate constant （Kep）,extravascular extracellular volume fraction （Ve） and plasma volume fraction （Vp） of the diseased vertebral bodieswere measured on the perfusion parameter map, and the differences in these parameters between the patients werecompared.Results： For pathological vertebrae in cases of spinal metastatic tumor, brucellar spondylitis and spinaltuberculosis, respectively, the Ktrans values （median ＋ quartile pitch） were 0.989±0.014, 0.720±0.011 and0.317±0.005 min-1; the Kep values were 2.898±0.055, 1.327±0.017 and 0.748±0.006 min-1; the Ve values were0.339±0.008, 0.542±0.013 and 0.428±0.018; the Vp values were 0.048±0.008, 0.035±0.004 and 0.028±0.009; thecorresponding H values were 50.25 （for Ktrans）, 52.47 （for Kep）, 48.33 （for Ve） and 46.56 （for Vp）, and all differenceswere statistically significant （two-sided P〈0.05）.Conclusions： The quantitative analysis of DCE-MRI has a certain value in the differential diagnosis of spinalmetastatic tumor, brucellar spondylitis and spinal tuberculosis.

Association between essential hypertension and polymorphisms of beta 1 adrenergic receptor gene G1165C (Gly389Arg) in Chinese Mongolian population

BACKGROUND： The prevalences of hypertension, cerebrovascular diseases, etc. are higher in Mongolian population because of the influence of various factors including genetics, geography, diet, etc. Therefore, it is helpful to develop researches on the genetics of various diseases including hypertension in Mongolian population. OBJECTIVE： To analyze the association between the polymorphism of beta1 adrenergic receptor （β1-AR） gene G1165C （Arg389Gly）, an important candidate gene for various diseases of cardiovascular system, and essential hypertension in Mongolian population. DESIGN ： A cross-sectional study SETTINGS： Department of Neurology, the First Affiliated Hospital of Inner Mongolia Medical College; Wulate Houqi Red Cross Society. PARTICIPANTS： The survey was carried out from February 2003 to March 2005. Totally 239 Mongolian residents, whose blood relations of 3 generations were all Mongolians, were selected from Wulate Houqi, Inner Mongolia, and they were all informed with the survey and detected items. Based on the diagnostic standard of hypertension set by WHO in 1999, the subjects were divided into two groups according to the level blood pressure： ① Normal blood pressure group （n=117）： systolic blood pressure （SBP） 〈 140 mm Hg （1 mm Hg =0.133 kPa）, diastolic blood pressure （DBP） 〈 90 mm Hg, and those having histories of cerebrovascular disease, heart disease, diseases of liver, kidney and tiroides, and diabetes mellitus were excluded. ② Essential hypertension group （n=122）： including 51 patients with simple high SBP. All the enrolled subjects had no blood relationship with each other, and had no history of miscegenation. METHODS ： The body height, body mass, waist circumference and blood lipids were measured routinely, and their habits of smoking and drinking were also investigated. Penpheral venous blood （5 mL） was drawn, the genome DNA was extracted, and the polymorphisms of the β1-AR Gl165C （Gly389Arg） genotype were detected with the Sequenom system. Polymerase chain reaction （PCR） experiment and SNP detection were performed in Huada Gene Laboratory of Bejing, then the univariate analysis of variance was applied in the sample comparison among groups, and the chi-square test was used to compare the genotypes and allele frequencies. The odd ratio （OR） and 95% confidence interval （CO were calculated. MAIN OUTCOME MEASURES： The distributions of β1-AR Gl165C （Gly389Arg） genotypes and alleles were observed. RESULTS： A11 the 239 subjects were involved in the analysis of results, and no one missed, ①Comparison of β1-AR G1165C （Gly389Arg） genotypes and allele distnbutions： In Mongolian population, the frequencies of CC and GG＋GC genotypes at β1-AR G1165C （Gly389Arg） site in the essential hypertension group （72%, 28%） were not significantly different from those in the normal blood pressure group （67%, 33%） （xz=0.841, P=-0.359; OR 0.773, 95%Cl： 0.445-1.342）; The frequencies of C and G alleles also had no significant differences between the essential hypertension group （85%, 15%） and the normal blood pressure group （82%, 18%） （x^2=1.136, P=-0.287; OR： 0.769, 95%Cl： 0.747-1.248）. ②The frequencies of CC and GG＋GC genotypes at β1-AR G1165C （Gly389Arg） site had no significant differences between the patients with simple high SBP （71%, 29%） and the normal blood pressure group （x^2=0.250, P=-0.617; OR： 0.833, 95%C/： 0.408-1.703）; The frequencies of C and G alleles were not significantly different between the patients with simple high SBP （86%, 14%） and the normal blood pressure group （x^2=0.670, P=-0.413; OR 0.766, 95%Cl： 0.404-1.453）. CONCLUSION： In Mongolian population, the distributions of the genotypes and alleles of β1-AR Gl165C （Gly389Arg） have no obvious differences between the subjects with normal blood pressure and the patients with essential hypertension （including simple SBP increase）, which suggests that G1165C （Glu389Asp） site of β1-AR gene may be not a genetic mark of essential hypertension and simple high SBP in Mongolian population.

Genetic predisposition to essential hypertension in a Mongolian population Detecting the C825T polymorphism of the G-protein beta 3 subunit gene

BACKGROUND： The prevalences of hypertension, cerebrovascular diseases, etc. are higher in Mongolian population because of the influence of various factors including genetics, geography, diet, etc. Therefore, it is helpful for prevention to develop researches on the genetics of various diseases including hypertension in Mongolian population. OBJECTIVE： To analyze the association between C825T polymorphisms of G-protein beta 3 subunit gene （GNB3）, the important candidate gene of various disease of cardiovascular system, and Mongolian patients with essential hypertension. DESIGN： A comparative observation. SETTINGS： Department of Neurology, the First Affiliated Hospital of Inner Mongolia Medical College; Wulate Houqi Red Cross Society. PARTICIPANTS： Totally 267 Mongolian residents, whose blood relations of 3 generations were all Mongolians, were selected from Wulate Houqi, Inner Mongolia. The patients were screened based on the diagnostic standard of hypertension set by WHO in 1999, and the enrolled subjects were divided into two groups according to the level of blood pressure： ① Normal blood pressure group （n =124）： 64 males and 60 females, systolic blood pressure （SBP） 〈 140 mm Hg （1 mm Hg=0.133 kPa）, diastolic blood pressure （DBP） 〈 90 mm Hg;②Essential hypertension group （n =143）： 71 males and 72 females, including 60 patients with simple high SBP （SBP ranged 145 to 195 mm Hg, whereas DBP 〈 90 mm Hg）. METHODS： Peripheral venous blood （5 mL） was drawn from all the subjects, the genome DNA was extracted, and the polymorphisms of the GNB3 C825T genotype were detected with the Sequenom system. Polyrnerase chain reaction （PCR） experiment and SNP detection were performed in Beijing Huada gene laboratory. Then the univariate analysis of variance was applied in the sample comparison among groups, and the chi-square test was used to compare the genotypes and allele frequencies. The odd ratio （OR） and 95% confidence interval （CI） were calculated. MAIN OUTCOME MEASURES： The distributions of GNB3 C825T genotypes and alleles were observed. RESULTS： All the 267 Mongolian subjects were involved in the analysis of results.① GNB3 C825T genotypes： In Mongolian population, the frequencies of CC, CT and TT genotypes at GNB3 C825T site in the essential hypertension group （48%, 41%, 11%） were not obvious different from those in the normal blood pressure group （43%, 47%, 10%, x^2 =0.162, P =0.688; OR：1.176, 95%CI： 0.533- 2.592）, whereas there were also no obvious differences between the simple high SBP group （57%, 35%, 8%） and the normal blood pressure group （x^2 =0.733, P =0.392; OR：1.957, 95%CI： 0.623- 6.143）. ②GNB3 C825T alleles： In Mongolian population, The frequencies of C and T alleles in the essential hypertension group （69%, 31%） were not obviously different from those in the normal blood pressure group （67%, 33%, x^2 =0.094, P = 0.759; OR：0.945, 95%CI：0.657 - 1.358）, whereas there were also no obvious differences between the simple high SBP group （74%, 26%） and the normal blood pressure group （ x^2 =2.133, P =0.144; OR：0.697, 95%CI： 0.428- 1.133）. CONCLUSION： GNB3 C825T site may be not a genetic marker of essential hypertension and simple high SBP in Mongolian population.

Smoking and Alzheimer's disease among Mongolian and Han Chinese aged 55 years and over living in the Inner Mongolia farming area of China

Residents aged 55 years or older from 27 communities and two settlements in Xilingol League of Inner Mongolia were selected for participation in an Alzheimer＇s disease epidemiological investigation from June 2008 to June 2009, including 3 259 Mongolians and 5 887 Han Chinese. The Mongolian subjects in the Alzheimer＇s disease group were at age of 55 years or older （on average）, and more of them were male, illiterate and/or had a history of coronary artery disease and/or diabetes compared with the Mongolian subjects in the non-Alzheimer＇s disease group. The Han Chinese subjects in the AIzheimer＇s disease group were at age of 55 years or older （on average） and more of them were women, illiterate and/or had a history of coronary artery disease, and less of them had a history of alcohol consumption compared with the non-Alzheimefs disease group. Non-conditional multivariate stepwise logistic regression identified that male gender, increasing age and having a history of diabetes and/or coronary heart disease were associated with higher odds of Alzheimer＇s disease among Mongolians while having an educational background was associated with lower odds （OR = 0.259, 95%C/0.174-0.386）. Among the Han Chinese subjects, male gender, increasing age and having a history of coronary heart disease and/or hypertension was associated with higher odds of Alzheimer＇s disease, while having an educational background was associated lower odds （OR = 0.271, 95%C/0.192-0.381）. The results also indicated that extremely heavy smoking may be a risk factor for Alzheimer＇s disease in Mongolian males aged over 55 years. There was no significant difference in smoking habits between the Mongolian and Han Chinese subjects with Alzheimer＇s disease.

Breaking Mirror Circularly Polarized Luminescence of Chiral Metal-Organic Frameworks by High-Pressure Stimulation

Understanding high-pressure-stimulated circularly polarized luminescence(CPL)of enantiomers remains a challenging but significant task in fundamental research and optical applications.Here,we combined in situ high-pressure photoluminescence with circularly polarized light to study how high pressure stimulated the CPL of crystalline enantiomers.Chiral lanthanide(Ln)-tartrate(Tar)metal-organic frameworks(MOFs;Ln=Eu,Tb)were synthesized to study their CPL from atmospheric pressure to 10 GPa.Under atmospheric pressure,D-and L-Eu(Tar)showed strong andmirror CPL.CPL intensity changes,emission wavelength shifts,and signal inversions were induced by increasing pressure.Note that the D-Eu(Tar)enantiomer showed strong CPL with a maximal dissymmetric factor(g_(lum))of 0.69 under 3 GPa,which is much higher than that under atmospheric pressure and of other reported MOF-based CPL materials.More interestingly,D-and L-Ln(Tar)enantiomers display obvious asymmetric CPL signals with increasing pressure,demonstrating that high pressure can break the mirror CPL of the MOF enantiomers.Our findings provide a critical understanding on in situ high-pressure CPL of chiral materials and establish a new optical phenomenon where high pressure can break the mirror CPL of enantiomers.