Comparison of the clinical and CT features between COVID-19 and H1N1 influenza pneumonia patients in Zhejiang, China.

OBJECTIVE: To explore the different clinical and CT features distinguishing COVID-19 from H1N1 influenza pneumonia. PATIENTS AND METHODS: We compared two independent cohorts of COVID-19 pneumonia (n=405) and H1N1 influenza pneumonia (n=78), retrospectively. All patients were confirmed by RT-PCR. Four hundred and five cases of COVID-19 pneumonia were confirmed in nine hospitals of Zhejiang province, China from January 21 to February 20, 2020. Seventy-eight cases of H1N1 influenza pneumonia were confirmed in our hospital from January 1, 2017 to February 29, 2020. Their clinical manifestations, laboratory test results, and CT imaging characteristics were compared. RESULTS: COVID-19 pneumonia patients showed less proportions of underlying diseases, fever and respiratory symptoms than those of H1N1 pneumonia patients (p<0.01). White blood cell count, neutrophilic granulocyte percentage, C-reactive protein, procalcitonin, D-Dimer, and lactate dehydrogenase in H1N1 pneumonia patients were higher than those of COVID-19 pneumonia patients (p<0.05). H1N1 pneumonia was often symmetrically located in the dorsal part of inferior lung lobes, while COVID-19 pneumonia was unusually showed as a peripheral but non-specific lobe distribution. Ground glass opacity was more common in COVID-19 pneumonia and consolidation lesions were more common in H1N1 pneumonia (p<0.01). COVID-19 pneumonia lesions showed a relatively clear margin compared with H1N1 pneumonia. Crazy-paving pattern, thickening vessels, reversed halo sign and early fibrotic lesions were more common in COVID-19 pneumonia than H1N1 pneumonia (p<0.05). Pleural effusion in COVID-19 pneumonia was significantly less common than H1N1 pneumonia (p<0.01). CONCLUSIONS: Compared with H1N1 pneumonia in Zhejiang, China, the clinical manifestations of COVID-19 pneumonia were more concealed with less underlying diseases and slighter respiratory symptoms. The more common CT manifestations of COVID-19 pneumonia included ground-glass opacity with a relatively clear margin, crazy-paving pattern, thickening vessels, reversed halo sign, and early fibrotic lesions, while the less common CT manifestations of COVID-19 pneumonia included consolidation and pleural effusion.

[Relationship of distribution frequency of HLA antigen/antibody and PIRCHE score with DSA production and AMR occurrence].

Objective: To analyze the distribution frequency of HLA antigen gene and antibody, and explore the relationship of PIRCHE score with DSA production and AMR occurrence. Methods: Kidney transplantation cases of department Kidney transplantation, the First Hospital of Xi'an Jiaotong University from November 2013 to June 2017 were included in our study. HLA high resolution typing were detected with LAB Type (TM) SSO method. HLA classⅠ & Ⅱ antibody detection were tested by LAB screen Single Antigen beads with Luminex 200 technology. PIRCHE score were graded with PIRCHE score system. Results: HLA high resolution classification data of 798 recipients and 409 donors showed that HLA A2, A11, A24 were common in HLA A locus; HLA B46, B51 B60, B35, B62, B61 were common in HLA B locus; HLA DR9, DR4, DR15, DR12, DR7, DR11 were common in HLA DR locus; HLA DQ7, DQ6, DQ5, DQ9, DQ2 were common in HLA DQ locus. The positive cases of HLA class Ⅰ & Ⅱ antibody and DSA were 105, 40 and 32, respectively. The most common of HLA class Ⅰ antibody were A24 and B7 antibody; the most common of HLA class Ⅱ antibody was DQ antibody, including DQ2, DQ9, DQ4, DQ6, DQ7 and DQ8. PIRCHE scores of living donor transplantation recipients were significantly lower than DCD group (P<0.01). PIRCHE score of DSA(+) and DSA(+)AMR(+) group were markedly higher than that of DSA(-)and DSA(+)AMR(-)group, respectively(P<0.05); analysis of ROC curve on PIRCHE scores could predict DSA production and AMR occurrence. The AUC for prediction DSA production was 0.80, and the critical value was 115.5. For prediction of AMR, the AUC was 0.89 and the critical value was 133.5. Conclusions: The common HLA antigens have stronger immunogenicity, and easy to stimulate the body to produce HLA antibodies; matching of common antigen sites and HLA class Ⅱ antigen should be attached importance before kidney transplantation. PIRCHE score can predict the generation of DSA and the occurrence of AMR effectively. PIRCHE score for HLA match, is more sensitive than traditional methods, and contains more information.

CT and ultrasound features of basal cell adenoma of the parotid gland: a report of 22 cases with pathologic correlation.

BACKGROUND AND PURPOSE: Parotid gland BCA is a rare benign tumor. Only a few studies describing the imaging features of BCA have been published. This study investigated CT and sonography characteristics of BCA of the parotid gland. MATERIALS AND METHODS: Demographics of patients with BCA were evaluated, and lesion characteristics of CT (n = 22) and sonography (n = 20) were reviewed. These cases were grouped into 3 types: type 1 tumors, located at the superficial region of superficial lobe of the parotid gland; type 2 tumors, located at the deeper region of superficial lobe; and type 3 tumors, located in the deep lobe. Imaging findings were correlated with pathology. RESULTS: Sixteen patients (73%) were female and 6 (27%) were male. The mean age was 51.5 years (SD 10.2; range 32-73). The size of the tumors was less than 30 mm. The sizes of type 1, type 2, and type 3 tumors were 11.4 ± 3.29 mm, 19.3 ± 5.44 mm, and 26 ± 3.6 mm, respectively. The CT attenuation increase was 64.5 ± 19 HU on contrast CT. The type 1 tumors were solid (11/11), showed homogeneous or slightly heterogeneous enhancement on CT, and were homogeneously or slightly heterogeneously hypoechoic on sonography. Cystic changes tended to occur in type 2 (7/8) or type 3 (2/3) tumors, which showed obvious heterogeneous attenuation on CT and anechoic on sonography. CONCLUSIONS: The BCA tends to be small and shows early intense enhancement. The solid tumor is common in the superficial region of the parotid gland, and cystic lesions occur mostly in the deeper parts of the superficial lobe or in the deep lobe.