Current Issue

2020 Vol.5 No.3 Published:20 March 2020

The implement effects and innovative strategies for tuberculosis controlling among migrants Tan Weiguo, Guan Hongyun, Wu Qingfang, Lu Puxuan, Hong Chuangyue, Lai Peixuan, Li Mingzhen, Chen Rong, Yu Weiye 2020, 5 (3):  145-149.  DOI: 10.19871/j.cnki.xfcrbzz.2020.03.001 Abstract ( 288)    PDF (993KB) ( 612 )    Managing tuberculosis (TB) among migrants is one of the most important and challenging tasks of TB control in China. Controlling TB epidemic among migrants can prompt the progress towards the ultimate goal to "End TB by 2035". Shenzhen remains one of the cities with the largest number of internal migrants in China and even the world, resulting in a more grave situation for TB control. Through establishing a specialized comprehensive TB management system for the internal migrating population, Shenzhen took the lead in covering migrants for district-level TB control, implementing a population-wide TB control strategy, and sustaining exclusive funds for migrants. As a result, the prevalence of smear-positive TB among migrants has dropped by 54.2% for the last 20 years with treatment success rate increased to 90.3%, and coverage rate of DOTS reaching 100%, having achieved the goals proposed by WHO at least 10 years ahead of schedule. The research work "Integrated Research and Application of Tuberculosis Control" won the second prize of the 2017 China National Tuberculosis Association Science and Technology Award; Another work "The Research and Effect Evaluation on Shenzhen Tuberculosis Control Strategy" won the 2004 Shenzhen Science and Technology Progress Award; The first monograph on TB prevention and control among internal migrants Tuberculosis Control in Migrating Population was published in English by the editor-in-chief of Springer, which has unprecedented downloads. During the implementation of the World Bank-financed TB control project, the evaluation of health economics showed that TB controlling strategy among migrants produced 134.98 Chinese Yuan of social and economic benefits with each Yuan invested, and the direct or indirect economic benefits reached to 20.245 billion Chinese Yuan. Meanwhile, the exploration and practice of innovative strategies for TB controlling among migrants have provided the "Shenzhen Model" for the development of a series of TB prevention and controlling strategies techniques and policies for related national and international institutions or organizations.

Design and regular application of major infectious disease indices in Shenzhen Lu Jianhua, He Jianfan, Xu Shule, Wang Xin, Lin Liangqiang, Lu Yan, Jiang Min, Zou Xuan 2020, 5 (3):  150-153.  DOI: 10.19871/j.cnki.xfcrbzz.2020.03.002 Abstract ( 256)    PDF (951KB) ( 532 )    Since 2015, as an important measure for deepening the reform of medical and health system, and strengthening the construction of public health system, Shenzhen Center for Disease Control and Prevention have designed and released the ‘Four health indices’with flu index as representative for the first time by conducting a systematic analysis of surveillance data of key infectious diseases forthe past 10 years. With establishment of this index system, complicated surveillance data can be transferred to simple and plain risk stratification system. In this way, not only has health knowledge been effectively propagandized, but also the public health behavior of citizens has been promoted. Up to 31 July 2020, the cumulative released times of flu index, dengue fever index, susceptibility indices of infectious diarrhea and hand-foot-and-mouth disease were 281, 57, 50 and 92, respectively. The risk levels of the ‘four health indices’ were mainly level Ⅲ and Ⅳ, accounting for 82.1% (394/480). The ‘four health indices' were basically consistent with the prevalence of target infectious diseases with high forecast consistency rate of up to 70%. It has performed well for early precaution and forecasting. Based on next month report for vaccination in Guangdong province, after the release of flu index in March 2015, number of vaccination was increased from 259 039 times in 2014 to 806 240 times in 2019 with an increase of 211.2% and a save-up of 200 million yuan in medical cost, which has shown considerable social and economic benefits. The construction of key infectious diseases effectively paved the way for serving people’s health, and promoting the building of “healthy China”, which has won the first prize in the “party building cup” creativity contest and nomination for the ten reform creative cases proposed by health institutions in Shenzhen city, consecutively.

Let the "well-being of the whole people" support the "comprehensive well-off": "Longhua model" Luo Anfei, Chen Zhaodi, Deng Xuelin, Quan Youren, Mo Chunqi, Wu Chuan'an 2020, 5 (3):  154-158.  DOI: 10.19871/j.cnki.xfcrbzz.2020.03.003 Abstract ( 238)    PDF (923KB) ( 764 )    In September, 2017, Longhua District, as the only experimental national health promotion zone in Shenzhen, China, stood out from 64 districts with an evaluation score of 91.15 and ranked second nationwide, and was entitled as "Excellent Health Promotion District". Since the establishment of the health promotion zone, the Longhua Government has adhered to the people-centered development concept, firmly established the notion of "high hygiene, big health", and closely focused on "mechanism, cooperation cross departments, health environment, health literacy, health services, health promoting paths" to improve people's life, taking the construction of health promotion district as an important tool for filling medical shortcomings, building a healthy China, and improving society and people's livelihood, putting the "well-being integrated into all policies" idea into action. After two years of development, Longhua District has over-completed the establishment of six types of health promotion places, including health promotion hospitals, health promotion schools; the development and implementation of health policy has basically run through the whole process of cooperation between government departments; the proportion of residents' health literacy and regular physical exercisers have increased from 7.60% and 41.90% to 21.11% and 47.33%, respectively. Adults smoking rate has been reduced from 19.40% to 18.62%. The concept of "everyone is for health and everyone enjoys health" has been praised by various government departments and the general public with unprecedented social impact. The model for the well-being of whole people that "leadership by party committee, government guidance, cooperation across different departments and all people involved" almost built. As the construction of Longhua Health Promotion Zone proceeded into the stage of regularization, we summarized the successful experience of "Longhua Health Model" for reference for other places in current study.

Studies on the relationship between the changes in serum myocardial injury indicators and the risk of severe COVID-19 Lin Lyu, Liu Xia, Wu Nianning, Zou Jun, Lan Jian, Huang Jinping, Chen Xinyu, Huang Meiqing 2020, 5 (3):  159-164.  DOI: 10.19871/j.cnki.xfcrbzz.2020.03.004 Abstract ( 353)    PDF (918KB) ( 652 )    Objective To investigate the relationship between the severity of COVID-19 and the changes of lactate dehydrogenase (LDH-L), creatine kinase (CK), creatine kinase MB isoenzyme (CK-MB), α-hydroxybutyrate dehydrogenase (α-HBDH) in vitro. Methods Retrospective analysis of serum LDH-L, CK, CK-MB, α-HBDB and clinical characteristics of 58 patients with confirmed COVID-19 admitted to the Fourth People's Hospital of Nanning, Guangxi from January 18th to March 2nd in 2020. According to COVID-19 diagnosis and treatment program (trial 7th edition), the patients were classified into two groups: common type (including mild type) group, severe type and critical type group. with following information obtained, including heart rate, LDH-L, CK, CK-MB, α-HBDH biochemical indexes, basic information, and clinical characteristics. A logistic regression model was built to analyze the independent risk factors for COVID-19. Results There were 51 cases of mild and common type, 7 cases of heavy and critical type (4 cases of heavy type and 3 cases of critical type). A single-factor analysis showed that the gender ratio of control group was similar between the common type (including mild type) and the heavy and critical type (86.21% vs 89.66%,13.79% vs 10.34%, χ2=0.162, P=0.687), The common type and mild type are mainly young adults, while the heavy and critical types are elders [(41.48±17.49)years old vs (68.86±17.49)years old, t=-9.936, P<0.001]; Fewer complications of cardiovascular and cerebrovascular diseases and diabetes were present in common and mild cases than that in heavy and critical types with significant difference by Fisher precision test (23.53 vs 85.71%, P<0.001).However, no significant difference was found in heart rate (t=-0.180, P=0.858), CK-MB (t=1.531, P=0.131), and CK (t=-1.449, P=0.197), but not for LDH [(200.67±49.44)U/L vs (385.02±86.33)U/L, t=-5.527, P=0.001], and α-HBDH [(149.43±34.85)U/L vs (289.15±56.70)U/L, t=-6.357, P<0.001]. The suspicious risk factors with significance selected by single factor analysis and clinical important discriminators were analyzed by collinearity analysis and spearman correlation analysis to select the suspicious risk factors for multivariate logistic regression analysis, which showed that LDH-L was an independent risk factor for the occurrence of COVID-19 with odds ratio of 1.037 (95% CI=1.010-1.065, P=0.006)and accuracy in prediction of 93.1%. Conclusion LDH-L is an independent risk factor for assessing the severity of the COVID-19, which can guide early effective treatment in the clinical scenarios.

Clinical and CT findings of AIDS-related abdominal lymphoma Qin Chunle, Li Yu, Pan Shirong, Lu Yibo 2020, 5 (3):  165-168.  DOI: 10.19871/j.cnki.xfcrbzz.2020.03.005 Abstract ( 527)    PDF (2040KB) ( 584 )    Objective To explore the clinical characteristics and CT findings of AIDS-related abdominal lymphoma, enhance the understanding of AIDS-related abdominal lymphoma, and provide evidence for clinical diagnosis and treatment. Methods The clinical characteristics and CT findings of 39 patients with AIDS-related abdominal lymphoma confirmed by pathology were retrospectively analyzed. Results 1 of 39 cases of HIV/AIDS with abdominal lymphoma was associated with Hodgkin's lymphoma, and the other 38 cases were non-hodgkin's lymphoma cases.The main finding is the presence of multiple enlarged lymph nodes with high rate of extra-lymph node involvement (27/39, 69.23%). All the extra-lymph node involvements include liver (n=11), pancreas and stomach (both n=8), spleen, intestines, and adrenal gland (n=4), kidney（n=3）, bladder, uterus and testes (all n=2), and prostate gland (n=1). The lesions were mostly manifested as soft tissue masses with reduced density, often piled or fused into masses, with central liquefaction and necrosis. Conclusion AIDS-related abdominal lymphoma is mainly non-Hodgkin's lymphoma, which is highly invasive, extensively involving abdominal lymph nodes and organs other than lymph nodes, and has a high incidence of extra-lymph node involvement. CT findings were characteristic to some extent, and if combined with clinical manifestations, could improve the diagnostic match rate.

Clinical study of heat-clearing and detoxifying drugs on fatty metabolic syndrome after anti- viral treatment of AIDS Ou Jian, Li Weixin, Ma Yuting, Tang Hongli, Wu Qiuyun, Wen Lemin 2020, 5 (3):  169-172.  DOI: 10.19871/j.cnki.xfcrbzz.2020.03.006 Abstract ( 268)    PDF (965KB) ( 563 )    Objective To investigate the clinical efficacy and safety of Qingre Jiedu prescription on patients with fatty metabolic syndrome after anti-viral treatment of AIDS. Methods 105 AIDS patients with dyslipidemia syndrome after antiviral treatment were randomly divided into treatment group A (Qingre Jiedu recipe), treatment group B (Jianpi Huashi formula) and control group C (placebo). After 12 weeks of treatment, the changes of serum TC, TG, LDL, HDL, B-ultrasound imaging appearance and the improvement of traditional Chinese medicine (TCM) related symptoms were obtained. Results After 12 weeks of treatment, the improvement of TCM related clinical symptoms, serum TC, TG, LDL-C and HDL-C, abdominal B-ultrasound imaging findings of treatment group A and B were significantly better than those of the control group, while the differences of serum TC and B-ultrasound imaging findings between treatment group A and group B were statistically significant. Conclusion To a certain extent, the short-term clinical efficacy of Qingre Jiedu prescription on patients with fatty metabolic syndrome after anti-viral treatment of AIDS is better than that of conventional Jianpi Huashi prescription.

Clinical characteristics of 77 cases of tsutsugamushi disease in Guangxi Li Sha, Lu Yibo, Xie Zhouhua 2020, 5 (3):  173-177.  DOI: 10.19871/j.cnki.xfcrbzz.2020.03.007 Abstract ( 325)    PDF (910KB) ( 634 )    Objective To analyze the clinical characteristics of patients with tsutsugamushi disease, and provide the basis for scientific prevention and control of tsutsugamushi disease. Methods The clinical data of 77 cases of tsutsugamushi disease in Nanning infectious disease hospital from 2012 to 2020 were retrospectively collected. The epidemiological characteristics, clinical characteristics, laboratory examination, imaging examination, treatment and prognosis of the patients were analyzed. Results Among the patients with tsutsugamushi disease, the presence of fever and eschar/ ulcer accounted for 100%, with liver injury of 57.1%, kidney injury of 41.6%, central nervous system compromise of 5.2%, multiple organ function failure of 15.6%. There were 39 cases (50%) with eosinophilia, 65 cases (84.4%) with anemia, 67 cases (87%) with elevated C-reactive protein, 73 cases (94.8%) with elevated ferritin, 67 cases (87%) with increased ESR, 58 cases (75.3%) with decreased albumin, 60 cases (77.9%) with increased α-hydroxybutyrate dehydrogenase, and 64 cases (83%) with elevated lactate dehydrogenase. There were 61 cases (79.2%) with abnormal findings on chest imaging. The administration of Doxycycline, levofloxacin and azithromycin was effective treatment. Conclusion The clinical manifestations of tsutsugamushi disease varies, and could involve multiple organs. Fever, eschar or ulcer are the specific signs with the most diagnostic value. The course of disease is related to the incidence of organ injury. With timely and effective anti-bacterial treatment, this disease has a good prognosis.

Liver fibrosis score assessed by GD-EOB-DTPA enhanced MRI T1-mapping Zhou Zhongyang, Xiang Yanhan, Liao Jinyuan 2020, 5 (3):  178-182.  DOI: 10.19871/j.cnki.xfcrbzz.2020.03.008 Abstract ( 434)    PDF (970KB) ( 506 )    Objective To investigate the diagnostic value of Gd-EOB-DTPA enhanced MRI T1-mapping in grading the severity of liver fibrosis. Methods A total 149 patients who have underwent Gd-EOB-DTPA enhanced MRI T1-mapping scans and then hepatectomy were enrolled. T1 relaxation time before and 5, 10, and 15 minutes after bolus of contrast agent and ishak fibrosis score of Liver tissue surrounding the lesion were obtained. The differences in T1 relaxation time between cases with different fibrosis scores and the diagnostic ability to use T1 relaxation time to grade the severity of liver fibrosis were statistically analyzed. Results The differences in T1 relaxation time among patients with different fibrosis scores were statistically significant in each phase of the scan. Among them, the difference in T1 relaxation time was the largest at 15 min after enhancement. After pairwise comparison, there were statistically significant differences between groups 0 and 5 (P=0.007), group 0 and 6 (P<0.001), group 1 and 6 (P=0.001), group 2 and 6 (P=0.002), and group 3 and 6 (P=0.008). Using ROC curve analysis, T1 relaxation time obtained from T1-mapping acquired 15-minute after enhancement outperformed others with largest area under the curve, specifically in which the area under the ROC curve for patients with fibrosis score >0, >1, >2, >3, >4 and >5 were 0.727, 0.736, 0.697, 0.708, 0.703, and 0.720, respectively. Conclusion T1 relaxation time can be used to evaluate the severity of fibrosis in patients, and particularly, the T1 relaxation time of 15 minutes after enhancement has the best diagnostic efficacy.

Comparative analysis of CT images acquired before and after coronavirus disease 2019 turning from positive to negative by nucleic acid testing Zhu Yunxian, Liu Jing, Ren Yan, Wu Minyu, Ren Rong, Zhu Yi, Yao Wenyan, Li Min 2020, 5 (3):  183-187.  DOI: 10.19871/j.cnki.xfcrbzz.2020.03.009 Abstract ( 1624)    PDF (1379KB) ( 1594 )    Objective To compare and analyze the CT images of patients with coronavirus disease 2019（COVID-19）before and after their nucleic acid detection results turning from positive to negative, and to evaluate the value of CT in clinical diagnosis and treatment. Methods In this retrospective analysis, 32 cases of COVID-19 from the Affiliated Infectious Diseases Hospital of Soochow University were enrolled. Chest CT images were acquired before the last positive nucleic acid test and after the first negative test. The imaging findings of the two timepoints were compared and observed, and a semi-quantitative scoring system was used to quantitatively estimate the extent of lesion in each lung lobe, using rank sum test. According to the "Guidelines for Imaging Diagnosis of New Coronavirus Pneumonia (First Edition 2020)", whether the CT images of 32 cases entered the absorption stage after the first negative nucleic acid test were determined. Results The CT images of 32 cases of COVID-19 during the transition from positive to negative in nucleic acid detection results all showed signs of viral pneumonia. The lesions were mainly bilateral, asymmetric, and subpleural distribution. After the nucleic acid test result turned negative for the first time, the lesion was decreased in extent in 24 cases (75.00%), increased in 7 cases (21.87%), and showed no overt change in 1 case (3.13%); The lesion density was decreased in 13 cases (40.63%), increased in 12 cases (37.50%) and showed no overt change in 7 cases (21.88%). The occurrence of intralobular septal thickening, air bronchogram sign, and enlarged vasculature sign before the last positive nucleic acid test and after the first negative test were 87.50% vs 84.38%, 96.88% vs 87.50%, 46.88% vs 34.38%. Compared with the lesion extent before the last positive nucleic acid test, the overall lesion extent after the negative test were significantly decreased in the semi-quantitative scores of lesion extent (P<0.05). Based on CT images diagnosis after the nucleic acid test turned negative for the first time, and 27 cases (84.38%) entered the absorption stage. Conclusion sThere is certain difference in CT image findings during the transition from positive to negative in nucleic acid test in patients with COVID-19, and the CT image findings after the first negative nucleic acid test are mostly indicating the absorption stage, which can assist the clinical evaluation of therapeutic efficacy.

The manifestations of MRI-DWI and ultrasound in prostate tuberculosis Wang Xiangdong, Wang Yali, Gao Yueli 2020, 5 (3):  188-190.  DOI: 10.19871/j.cnki.xfcrbzz.2020.03.010 Abstract ( 567)    PDF (1656KB) ( 1139 )    Objective To investigate the manifestations of MRI-DWI and ultrasound in prostate tuberculosis. Methods 3 patients with clinically diagnosed prostate tuberculosis from January 2014 to December 2018 were collected, including 1 patient with bilateral seminal vesicle tuberculosis. The imaging manifestations of ultrasound and MRI were retrospectively analyzed to explore the characteristic manifestations of ultrasound, MRI and DWI in the diagnosis of prostate tuberculosis. Results The diagnosis was confirmed by the pathology of prostate biopsy in 1 of the 3 patients, while prostatic fluid tuberculous bacilli culture was positive in the remaining 2 cases. Ultrasound examination revealed that the prostate lesions of 3 patients were located in the external gland area and the internal gland area, mainly with hypo-echogenicity, occasionally with mixed echogenicity.Abundant color blood flow around the lesions was also detected on color doppler. MRI findings included heterogeneous signal intensity in prostate signal and tuberculosis nodules with T1 isointense signal, T2 slightly high signal and obviously restricted diffusion on DWI. In addition, tuberculosis granuloma was shown as nodular T2 low signal, T1 iso-intenseor slightly lower signal, low signal on DWI, and the ADC value of (1.08-1.10)×10-3mm2/s. Conclusion Ultrasound, MRI and DWI could show certain characteristics for tuberculous granuloma of prostate tuberculosis, which provides evidence for clinical diagnosis tuberculosis granuloma.

Investigation and analysis on tuberculosis report of medical institutions in Shenzhen in 2018 Zhuo Zhipeng, Wu Qingfang, Lai Peixuan, Lu Chunrong, Yu Weiye, Tan Weiguo 2020, 5 (3):  191-194.  DOI: 10.19871/j.cnki.xfcrbzz.2020.03.011 Abstract ( 711)    PDF (981KB) ( 524 )    Objective To assess the under-reporting situation of tuberculosis in medical institutions in 2018, in order to provide evidence for enhancing the registration of tuberculosis patients in Shenzhen. Methods Investigation was performed in all 160 medical institutions, which were qualified for conducting chest X-ray examinations in Shenzhen. The reports of tuberculosis patients in medical institutions, wards and laboratory departments during the survey between September to October 2018 were checked and matched with the report cards of all confirmed and suspected tuberculosis patients reported in Shenzhen in the national tuberculosis management information system, in order to analyze the missing report and registration of tuberculosis in Shenzhen. Results The under-reporting rate of suspected tuberculosis in medical institutions in Shenzhen was 4.51%, while the under-reporting rate of confirmed diagnosis in medical institutions for tuberculosis prevention and treatment in Shenzhen was 1.29%. The under-reporting rate of multidrug-resistant and rifampicin-resistant tuberculosis patients is 0%. Conclusion sThe under-reporting of tuberculosis in Shenzhen has meet the basic requirements of the national Thirteenth Five-Year health and wellness plan, and in the next step, we should use information technology to realize the real-time collection and exchange of data related to the tuberculosis report card, and constantly improve the tuberculosis reporting system in medical institutions to enhance the quality of tuberculosis reporting.

Dolutegravir for rapid viral suppression in acute HIV infection Meng Zhihao, Qin Shanfang, Liu Aimei, Shen Yinzhong 2020, 5 (3):  195-197.  DOI: 10.19871/j.cnki.xfcrbzz.2020.03.012 Abstract ( 258)    PDF (901KB) ( 644 )    Objective To explore the early diagnosis and treatment for acute HIV infection. Methods A patient with acute HIV infection were analyzed in the aspect of clinical manifestations, treatment course and prognosis. Results One week after high-risk behavior, the patient developed fever, fatigue, headache, etc. 15 days later, this patient's HIV antibody screening test was positive, but confirmation test was uncertain. This patient's HIV-1 RNA was 8 847 000 copies/ml with CD4+T cell count of 173/mm3, indicating the diagnosis of acute HIV infection. TDF+3TC+DTG regimen was given as initial antiviral treatment. After 4 weeks, HIV-1 RNA was 3303 copies/ml and was dropped to 150copies/million cells after 3 months. After 6 months of antiviral treatment, CD4+T cell count was increased to 530/mm3 with viral load decreased to 75copies/ml. Conclusion RNA testing is helpful for the diagnosis of acute HIV-1 infection. Early initiation of antiviral therapy with Integrase Inhibitor during acute HIV infection stage can rapidly reduce the viral load, enhance CD4+T cells recovery and reduce the HIV-1 DNA load to an extremely low level.

Prevention and control of COVID-19 epidemic and long-term mechanism building of occupational health in infectious disease hospital Wu Fengyao, Meng Xingxing, Wei Caiyun, Liu Dongmei 2020, 5 (3):  198-202.  DOI: 10.19871/j.cnki.xfcrbzz.2020.03.013 Abstract ( 374)    PDF (1060KB) ( 669 )    Since the outbreak of coronavirus disease 2019, medical workers who fought in the forefront of the epidemic have been directly exposed to the patients and become susceptible people, facing the risk of occupation exposure. This may affect the physical and mental health of medical staff, and put forward higher requirements for prevention and control work. This review summarizes the epidemic prevention and control measures of Nanning Fourth People's Hospital. Specifically, we summarize the experience of infectious disease hospital in the construction of long-term mechanism of occupational health, perfecting various systems, optimizing work flow and strengthening personnel training, so as to improve the awareness of occupational safety protection of medical personnel, standardize the use of protective equipment, strengthen hospital supervision, and avoid insufficient or over protection, maintain Law-based scientific prevention and control. Ultimately, we hope this experience could assist minimizing the incidence of occupational exposure and avoiding cross infection in the hospital, coming up with a scientific solution to the epidemic situation of infectious diseases and playing a guiding role for the future unpredictable epidemic prevention and control.

The latest research progress of co-infection with HIV/AIDS and neurosyphilis Tang Xike, Peng Zhipeng, Liang Lianshao, Zheng Yanqing, Xie Zhouhua 2020, 5 (3):  203-206.  DOI: 10.19871/j.cnki.xfcrbzz.2020.03.014 Abstract ( 419)    PDF (902KB) ( 1067 )    Acquired immunodeficiency syndrome (AIDS) caused by human immunodeficiency virus (HIV) infection and syphilis share the same route of transmission and similar high-risk population. Co-infection with AIDS and syphilis poses a more grave challenge for national public health and safety. The clinical manifestations of AIDS complicated with syphilis are complex, lacking specificity, which often makes it difficult to diagnose and leads to treatment delay. The objective of this study is to summarize the latest research progress in the incidence, clinical characteristics, diagnosis and treatments of co-infection with AIDS and syphilis, so as to deepen the clinicians’understanding of this disease.

Application of ultrasound elastography in the diagnosis of liver fibrosis Li Qinyuan, Dong Changfeng, Jiang wei 2020, 5 (3):  207-211.  DOI: 10.19871/j.cnki.xfcrbzz.2020.03.015 Abstract ( 603)    PDF (910KB) ( 873 )    Liver fibrosis is a ultimate pathological manifestation of various chronic liver diseases, and also an inevitable stage for liver cirrhosis. However, how to accurately diagnose liver fibrosis has always been a challenge and research hotspot in the clinical setting. Although liver biopsy remains the gold standard for the diagnosis of liver fibrosis, its application is limited by its invasiveness, relatively high risk potential complications such as bleeding, infection, and rupture of organs, high cost, low patient's acceptance and it is not suitable for repeatable test, which limited the surveillance for liver fibrosis in the follow-up. In recent years, how to noninvasively and accurately stage liver fibrosis has become a new research hotspot. And ultrasound elastography, as a diagnosis technique combining a new type of medical imaging and biomechanics is characterize for its non-invasiveness and simpleness, advantage of real-time visualization and its quantitative nature, which can be used to quantitatively evaluate liver stiffness. As a result, it was extensively used to stage fibrosis of chronic liver disease and to evaluate the liver stiffness after liver transplantation. Also, it could be integrated into the guidance for clinical treatment prognosis assessment, and dynamic surveillance for the patients. This article briefly introduces the technique principles, latest developments, application status, and challenges of ultrasonic elastography.

The clinical application value of high filed MRI in the examination and diagnosis of pulmonary tuberculosis Qi Wanling, Wu Yingying, Zhu Xuechao, Wan Tianyi, Tang Xin, He Yulin 2020, 5 (3):  212-214.  DOI: 10.19871/j.cnki.xfcrbzz.2020.03.016 Abstract ( 630)    PDF (3990KB) ( 605 )    Pulmonary tuberculosis is one of the leading causes of death from infectious diseases, and China is an annual incidence of about 1.3 million and a death toll of about 150 000. Therefore, early detection, diagnosis and effective treatment of patients have become the key to tuberculosis control. Routine examination modalities for tuberculosis includes DR, B-US, CT, MRI and PET-CT, in which DR and CT are most commonly used. However, due to radiation, especially for pregnant women, children, adolescents, and patients requiring short-term and repeated follow-up observations, there are potential safety risks. MRI has non-ionizing radiation and high soft tissue resolution. MRI showed excellent agreement with CT in detecting the imaging features of pulmonary tuberculosis (except for calcification). Moreover, MRI had advantages in the detection of liquefactive necrosis, caseous necrosis, mild pleural pleura thickening and slight hydrothorax compared with CT, which is helpful to differentiate active or inactive pulmonary tuberculosis, so it is worth more extensive application in clinical setting.