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To analyze the lesion distribution situations and relationship of lesions detected by gastroscopy and colonoscopy in asymptomatic population in Beijing. Data of 1 663 patients who received gastroscopy and colonoscopy in the physical examination center of Peking Union Medical College Hospital and Beijing Hospital between January 2016 and December 2018 were analyzed retrospectively. Statistical analysis was conducted on the detection rate and relationship of different lesions based on the information of gender and ages. Gastroscopy data showed that chronic non-atrophic gastritis and chronic atrophic gastritis accounted for 1 240 (74.6%)and 423 (25.4%)cases respectively. Chronic atrophic gastritis was more common in population aged over 40. Other common diseases included erosions of gastric body and/or antrum, fundic gland polyps, reflux esophagitis, duodenitis, bile regurgitation and so on. Upper gastrointestinal tumors including esophagus cancer and gastric cancer were both early lesions. Colonoscopy results showed that colonic polyps were common lesions, among which there were 382 (23.0%)cases of colonic adenoma and 217 (13.0%)hyperplastic polyps. Incidence of colonic polyps increased with age. Colorectal cancer accounted for 0.7%. Colon diverticulum and melanosis coli were more common in population aged over 40. Colon adenoma was more common in male and melanosis coli was more common in female. The positive rate of HP was 32.2%. There was no positive relationship between HP infection and fundic gland polyps( P=0.329). There was no positive relationship between fundic gland polyps and colon adenomas as well as colorectal cancer( P=0.152, P=0.616). Gastroscopy and colonoscopy play important roles in different kinds of digestive diseases, especially in the early detection of tumors. More attention should be paid to the application of endoscopy in asymptomatic population.
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Background@#Thyroid diseases are highly prevalent worldwide, but their diagnosis remains a challenge. We established reference intervals (RIs) for thyroid-associated hormones and evaluated the prevalence of thyroid diseases in China. @*Methods@#After excluding outliers based on the results of ultrasound screening, thyroid antibody tests, and the Tukey method, the medical records of 20,303 euthyroid adults, who visited the Department of Health Care at Peking Union Medical College Hospital from January 2014 to December 2018, were analyzed. Thyroid-associated hormones were measured by the Siemens Advia Centaur XP analyzer. The RIs for thyroid-associated hormones were calculated according to the CLSI C28-A3 guidelines, and were compared with the RIs provided by Siemens. The prevalence of thyroid diseases over the five years was evaluated and compared using the chi-square test. @*Results@#The RIs for thyroid stimulating hormone (TSH), free thyroxine (FT4), free triiodothyronine (FT3), total thyroxine (TT4), and total triiodothyronine (TT3) were 0.71–4.92 mIU/L, 12.2–20.1 pmol/L, 3.9–6.0 pmol/L, 65.6–135.1 nmol/L, and 1.2–2.2 nmol/L, respectively. The RIs of all hormones except TT4 differed significantly between males and females. The RIs of TSH increased with increasing age. The prevalence of overt hypothyroidism, overt hyperthyroidism, subclinical hypothyroidism, and subclinical hyperthyroidism was 0.5% and 0.8%, 0.2% and 0.6%, 3.8% and 6.1%, and 3.3% and 4.7% in males and females, respectively, which differed from those provided by Siemens. @*Conclusions@#Sex-specific RIs were established for thyroid-associated hormones, and the prevalence of thyroid diseases was determined in the Chinese population.
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Objective To explore the image quality of coronary artery imaging with dual source computed tomography (DSCT) and analyze the coronary artery lesions. Methods Two hundred cases with clinically suspected coronary heart disease, who underwent plain and enhanced DSCT coronary artery imaging without oral Betaloc preparation were retrospectively analyzed. The patients were divided into two groups: the senile group of 126 cases with the average age of (71.3±7.7) years old and the control group of 74 cases with the average age of (50.4±6.2) years old. The clinical characteristics, the average heart rate and breath-holding time for plain and enhanced scan, the average calcium score, the image quality evaluation and the coronary stenosis were compared between the two groups. Results Compared with the control group, the incidences of chest pain or discomfort, hypertension, diabetes mellitus, hypercholesterolemia and old myocardial infarction were significantly higher in the senile group. The average calcium score and the numbers of <50% and ≥50% stenosis were also significantly higher in the senile group than those in the control group (364.9±442.6)points vs. (44.8±106.9)points, 159 vs. 45 branches, 212 vs. 32 branches, respectively, all P<0.01). The average heart rate and breath-holding time of plain and enhanced scan had no significant differences compared with the control group. The proportion of the coronary segments with grade 1 ,grade 2 and grade 3 image quality also had no significant difference compared with the control group (96.5%,2.3% and 1.2% vs. 97.1%, 2.0% and 0.9%, P>0.05). Conclusions DSCT coronary artery imaging in senile patients is noninvasive, safe and simple, and excellent coronary artery image can be obtained without oral Betaloc preparation. It can be used as a routine examination in the clinical diagnosis of coronary heart disease.
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ObjectiveTo evaluate the impact of patient's heart rate(HR)on coronary CT angiography(CTA)image quality(IQ)and reconstruction timing in dual-source CT(DSCT).Methods Ninety-five patients with suspicion of coronary artery disease were examined with a DSCT scanner(Somatom Definition.Siemens)using 32×0.6 mm collimation.All patients were divided three groups according to the heart rate(HR):group 1,HR≤70 beats per minute(bpm),n=26;group 2,HR＞70 bpm to≤90 bpm, n=37;group 3,HR＞90 bpm,n=32. No beta-blockers were taken before CT scan.50-60 ml of nonionic contrast agent were injected with a rate of 5 ml/s. Images were reconstructed from 10%to 100% of the R-R interval using single-segment reconstruction. Two readers independently assessed IQ of all coronary segments using a 3-point scale from excellent(1)to non-assessable(3)for coronary segments and the relationshiD between IQ and the HR. ResuitsOverall mean IQ score was 1.31 ±0.55 for all patients with 1.08±0.27 for group 1,1.32±0.58 for group 2 and 1.47±0.61 for group 3. The IQ was better in the LAD than the RCA and LCX(P＜0.01).Only 1.4%(19/1386)of coronary artery segments were considered non-assessable due to the motion artifacts.Optimal image quality of all coronary segments in 74 patients(77.9%)can be achieved with one reconstruction data set.The best IQ was predominately in diastote(88.5%)in group 1,while the best IQ was in systole(84.4%)in group 3. ConclusionsDSCT can achieve the optimal IQ with a wide range of HR using single-segment reconstruction. With the increasing of HR,the timing of data reconstruction for the best IQ shifts from mid-diastole to systole.
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Objective To explore the scanning technique and image quality of coronary artery imaging with dual-source CT without oral Betaloc preparation in the patients with high heart rate.Methods 412 cases were undergone coronary imaging with dual-source CT (including plain and enhanced scans) ,among them,there were 30 cases with heart rate more than 100 bpm.Multi-planar reconstruction(MPR),maximum intensity projection(MIP) and volume rendering (VR) were performed using contrast-enhanced images.The image quality was classified into 3 grades, and coronary segments named according to AHA standard were evaluated.Results The average heart rate during enhanced scan in the 30 cases was (115.6?11.8)(101～139)bpm,the average breath hold time was (5.7?1.2) s.The best reconstruction phase was in the systolic phase. Altogether 424 coronary segments were evaluated, among them 93.9%(398/424)belonged to the first grade,5.0%(21/424)belonged to the second grade,and 1.2%(5/424) belonged to the third grade. Conclusion Without oral administration of Betaloc preparation, good coronary artery images can be obtained in the patients with high heart rate by dual-source CT.