January 2020, Volume 23，No.3 Abstracts（B）
Author：尹鹏 Source：CGP Published： [01-16] views： 170
Analysis of Low-dose High Resolution CT Imaging Features of Pulmonary Alveolar Proteinosis with Volumetric Data YANG Fan1，XIAO Zhengyuan1，WEN Xiaoling2*
1.Department of Radiology，the Affiliated Hospital of Southwest Medical University，Luzhou 646000，China
2.West China School of Public Health/Department of Radiology，West China Fourth Hospital，Sichuan University，Chengdu 610000，China
*Correspondent author：WEN Xiaoling，Attending physician；E-mail：email@example.com
【Abstract】 Background At present，the diagnosis of pulmonary alveolar proteinosis（PAP） still needs bronchialveolar lavage and/or lung biopsy，which belongs to invasive examination.Chest CT plays an important role in the diagnosis of PAP，especially low-dose volume data high resolution CT（VHRCT），which can show more anatomical details and characteristics of lesions，thus providing help for clinical diagnosis.But there are few reports in this regard.Objective To observe the imaging findings of PAP before and after treatment with low-dose VHRCT，and to explore the clinical value of low-dose VHRCT in PAP diagnosis.Methods Clinical data，chest low-dose VHRCT data，diagnosis and treatment of 24 patients who were diagnosed as pulmonary alveolar proteinosis and treated in West China Fourth Hospital，Sichuan University from June 2015 to June 2018 were retrospectively analyzed.Results Before treatment，24 patients had multiple ground-glass opacities with clear borders and blurred margins in both lungs；12 had wide distribution of ground-glass opacities，showing a geographic appearance；seven had localized patchy consolidation in both lungs；six had thickened interlobular septum，presenting crazy paving pattern；three had large area shadows outward projection from both hilus pulmonis，distributing like butterfly wings，and two had pneumatic bronchus sign.In some cases，multiple micro-nodules and interstitial fibrosis were seen in both lungs.No enlarged lymph nodes in mediastinum and hilus pulmonis was found in 24 cases.In the same case，the above-mentioned imaging findings appeared simultaneously.In the course of follow-up and review after treatment，these ground glass opacities of 24 cases were reduced in scope，decreased in density and clear in edge；four cases of consolidation shadow were transformed ground-glass opacity，two cases of pneumatic bronchial sign.Sixteen cases were diagnosed by bronchoalveolar lavage，three cases by serum granulocyte macrophage- colony stimulating factor（GM-CSF） antibody detection，and five cases by lung biopsy.According to VHRCT characteristics of PAP，16 cases were correctly diagnosed，with the accuracy rate of 66.7%（16/24）．Five cases were misdiagnosed as bacterial pneumonia，two cases as pulmonary edema and one case as idiopathic pulmonary interstitial fibrosis.After treatment，the clinical symptoms such as dyspnea and cough were relieved.Total lung capacity/estimated value（TLC%），diffusing capacity of the lungs for carbon monoxide/ estimated value（DLCO%），vital capacity / estimated value（VC%），pH，and oxygen partial pressure（PaO2） were higher after treatment，while the partial pressure of carbon dioxide（PaCO2） after treatment was lower than that before treatment（P<0.05）．Conclusion The low-dose VHRCT of PAP showed ground glass opacity and/or consolidation with extensive or limited distribution.The “map pattern” and “crazy paving pattern” had certain characteristics，and some cases showed "butterfly wing pattern" and pneumatic bronchial sign.In addition，the disease generally had no enlargement of mediastinal and hilar lymph nodes.It is helpful for the diagnosis，severity evaluation and curative effect observation of pulmonary alveolar proteinosis，and can be used as a routine examination.
【Key words】 Pulmonary alveolar proteinosis；Volume data high resolution CT；Diagnosis
Ultrasonic Features of Invasive Ductal Carcinoma and Its Molecular Subtypes in Young Women LYU Qi1，WU Jungang2，JIA Chunmei1*，CHEN Fei1，WANG Jingjie1，HU Tian1
1.Department of Ultrasound，First Hospital of Shanxi Medical University，Taiyuan 030001，China
2.Department of Function Examination，Sixth Division Hospital of Xinjiang Production and Construction Corps，Wujiaqu 831300，China
*Corresponding author：JIA Chunmei，Associate chief physician；E-mail：firstname.lastname@example.org
【Abstract】 Background By comparatively analyzing breast cancer epidemics at home and abroad，we found that the average timing of breast cancer in China is 5-10 years earlier than that in western countries.And breast cancer in young women is more aggressive，resulting poorer prognosis.At present，there are few reports on imaging studies of breast cancer in young women.Objective To explore the ultrasonographic features of invasive ductal carcinoma and its molecular subtypes in young women.Methods Participants were 249 cases of invasive ductal carcinoma recruited from First Hospital of Shanxi Medical University from September 2014 to July 2018，all were female，aged 22 to 75 years old，undergoing preoperative breast ultrasonography，and receiving definite diagnosis by postoperative pathological examination.Ultrasonographic data were collected，including the maximum diameter，shape，aspect ratio，bounder，margin，internal echo，calcification，posterior echo，and blood flow，and were compared between the young group（91 cases，≤35 years old） and middle-aged and elderly group（158 cases，>35 years old）．According to the immunohistochemical determination results of estrogen receptor（ER），progesterone receptor（PR），human epidermal growth factor receptor 2（HER2） and Ki-67，invasive ductal carcinoma in the young group was divided into Luminal A，Luminal B，HER2-enriched，and basal-like molecular subtypes，and the ultrasonographic features of the subtypes were compared.Results There were significant differences in maximum diameter，internal echo，calcification and posterior echo of the carcinoma between young and middle-aged and elderly groups （P<0.05）．The numbers of Luminal A，Luminal B，HER2-enriched，and basal-like molecular subtypes of invasive ductal carcinoma in young group were 6，53，22，and 10，respectively.These four subtypes showed significant differences in the shape，boundary，internal echo and calcification（P<0.05）．Higher percentages of Luminal B and HER2-enriched subtypes were found with calcification compared with other two subtypes（P<0.05）．Conclusion Ultrasound images of invasive ductal carcinoma in young women were characterized by large maximal diameter，uneven internal echo，and often accompanied with calcification，and less posterior echo attenuation.And the ultrasound features were related to their molecular subtypes.
【Key words】 Carcinoma，ductal，breast；Ultrasonography，mammary；Pathology，molecular；Femininity
Research Progress on Preventive and Therapeutic Effects of Probiotics on Diarrhea Caused by Different Pathogens ZHANG Nan1，2，ZHU Huadong1，2*
1.Chinese Academy of Medical Sciences/Peking Union Medical College，Beijing 100730，China
2.Department of Emergency，Peking Union Medical College Hospital，Beijing 100730，China
*Corresponding author：ZHU Huadong，Chief physician，Professor，Doctoral supervisor；E-mail：email@example.com
【Abstract】 Probiotics are considered as a kind of living organisms that are beneficial to the host.In recent years，probiotics have gradually become a commonly used clinical prescription to treat gastrointestinal and non-gastrointestinal diseases.However，relevant clinical researches evaluating the efficacy of probiotics are often contradictory.At present，there are still a lot of clinical studies trying to explore the role of probiotics in the treatment of gastrointestinal diseases but without consensus on its effects on many diseases.This paper gives a review on the role of probiotics in diarrhea caused by different pathogens in recent years，including infectious diarrhea，antibiotic-related diarrhea，Clostridium difficile infectious diarrhea，and diarrhea-predominant irritable bowel syndrome.This paper points out the clinical application value of probiotics in the treatment of diarrhea caused by different diseases among varied people.Besides，the paper tells clearly about the potential risks in the use of probiotics thus offering a reference for further clinical researches and application in the field.
【Key words】 Diarrhea；Probiotics；Irritable bowel syndrome；Inflammatory bowel diseases；Infectious diarrhea；Antibiotic-associated diarrhea；Clostridium difficile associated diarrhea
Advances in Prophylaxis for Recurrent Urinary Tract Infections in Women ZHANG Yu，HUANG Wenxiang，JIA Bei*
Department of Infectious Diseases，the First Affiliated Hospital of Chongqing Medical University/Key Laboratory of Infectious and Parasitic Diseases in Chongqing，Chongqing 400016，China
*Corresponding author：JIA Bei，Professor，Master supervisor；E-mail：firstname.lastname@example.org
【Abstract】 Urinary tract infections（UTIs）are common bacterial infections that are recurrent easily in females.However，how to prevent and reduce the recurrence of UTIs in women remains a focus and challenge in clinical medicine.This article summarizes the existing preventive measures and advances in recurrent UTIs in women，and proposes the prevention strategies such as changing living habits，using estrogen locally after menopause，using probiotics，vaccinating，etc.，in addition to the preventive use of antibiotics，so as to provide effective references and suggestions for further preventive and treatment approaches for UTIs in women.
【Key words】 Urinary tract infections；Femininity；Prophylaxis；Recurrence；Review
Impact of Tobacco and Biomass Smoke Exposure on Phenotypes of Chronic Obstructive Pulmonary Disease SHEN Peichen，WANG Yizhe，HU Xuejun*
Department of Geriatric Respiratory and Infectious Diseases，the First Hospital of China Medical University，Shenyang 110001，China
*Corresponding author：HU Xuejun，Professor，Chief physician；E-mail：email@example.com
【Abstract】 Chronic obstructive pulmonary disease （COPD） is a common chronic respiratory disease.In contrast to the current diagnosis and treatment indications of COPD，COPD phenotype comprehensively measures patients' health state and disease severity to guide clinical individualized medication.Exposure to tobacco and biomass smoke is not only a main factor inducing COPD，but also affects its severity，drug sensitivity and comorbidities.In order to provide new ideas for the precise treatment of COPD，we reviewed recent advances in research on the role of tobacco and biomass smoke exposure in the diagnosis and treatment of COPD by clinical phenotypes，to provide new insights into the precise treatment of COPD associated with tobacco and biomass smoke exposure.
【Key words】 Chronic obstructive pulmonary disease；Phenotype；Tobacco smoke pollution；Biofuels