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Objective@#To evaluate the feasibility of CT angiography of pediatric complex congenital heart disease by using low radiation dose and low isotonic contrast agent dose combined with iDose4 iterative reconstruction technique.@*Methods@#Prospectively, a total of 57 continuous patients with suspected congenital heart disease under or equal to 2 years old in our hospital between Mar 2016 and Jan 2017 were divided into 2 groups according to the reservation number. " double low" group included 32 patients using 80 kVp, 80 mAs, Iodixanol (270 mg I/ml) and iDose4 - 4iterative reconstruction algorithm; routine group included 25 patients using 100 kVp, 100 mAs, Iopromide (370 mg I/ml) and filtered back projection algorithm. Individualized injections were taken on the weight of children and the iodine intake was calculated. CT values of left atrium, left ventricle, right atrium, right ventricle, ascending and descending aorta at the level of tracheal bifurcation, midpoint of aortic arch, pulmonary trunk, left and right pulmonary artery, pectoralis major and erector spinae on both sides as well as background noise at the level of aortic arch were measured, and signal to noise ratios (SNR) and contrast to noise ratios (CNR) were calculated. The quality of all images was evaluated subjectively. Scan length (L), volume CT dose index (CTDIvol) and dose-length-product (DLP) were recorded, and the effective dose (E) and size-specific dose estimate (SSDE) were calculated. The diagnostic coincidence rates for CTA examinations of these two groups were calculated and compared with the surgery or cardiac catheterization examination called the " gold standard" .@*Results@#The iodine intake of " double low" group and routine group was (2.53±1.09) and (3.46±1.29)g, respectively, with statistically significant difference (t=2.976, P<0.05). No statistically significant difference existed in CT value of heart cavities, large blood vessels or CT value of muscles, background noise, SNR, CNR at the level of aortic arch or subjective evaluation for image quality between the two groups (P>0.05). The consistency of subjective evaluation for image quality of the two groups was good(Kappa=0.55, 0.76). Compared with routine group, CTDIvol, SSDE, DLP, E of double low group descended by 57.19%, 56.71%, 56.74%, 53.33% respectively (t=54.107, 28.269, 15.338, 11.441, P<0.05). The diagnostic coincidence rates of the two groups were 96.6% and 97.1% respectively (P>0.05).@*Conclusions@#Using 80 kVp, 80 mAs and Iodixanol (270 mg I/ml) combined with iDose4 iterative reconstruction technique for CT angiography of pediatric complex congenital heart disease, the image quality could meet the requirements for clinical diagnosis, and the radiation dose and the iodine dose of contrast agent could be lowered.@*Trial registration@#Chinese clinical trial registry, ChiCTR1800016576.
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Objective To investigate the value of MR 3D CUBE T2WI sequence in displaying anatomical structure of knee joint.Methods Sixty cases of knee joints (30 cases in lesion group and 30 cases in control group) were scanned with conventional 2D and 3D CUBE T2WI sequence by HDXt 3.0T superconducting magnetic resonance of GE Signa imaging system and hased-array coil.The meniscus,articular cartilage,anterior and posterior cruciate ligaments demonstrated by two sequences were evaluated as excellent,good and poor grade,the results were comparatively analyzed by statistics.Results 3D CUBE T2WI was superior to conventional 2D sequence in displaying of articular cartilage,anterior and posterior cruciate ligaments,and inferior to conventional 2D sequence in displaying of meniscus(all P =0.000).When we put excellent and good levels of image quality as according with diagnostic requirement.The satisfaction rate demonstrating anterior and posterior cruciate ligaments by 3D CUBE T2WI sequence in lesion and control group were 100％,articular cartilage was 93.33％ in control group and 90.00％ in lesion group,while the meniscus was 30.00％ in control group and 33.33％ in lesion group.Conclusion MR 3D CUBE T2WI sequence is a sensitive technique in demonstrating ligaments and articular cartilage of knee joint,but it was inferior to conventional 2D sequence in displaying of meniscus.We should adopt it according to clinical diagnosis.
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Objective To investigate the type A behavior, brain-derived neurotrophic factor (BDNF) and hypersensitive C-reactive protein (hs-CRP) levels in serum in patients with post stroke depression (PSD) ,and explore the correlation between them.Methods The HAMD-17 was used to assess the severity of depressive symptoms in patients with stroke (n=116).TABP,Social Support Scale, MMSE, NIHSS,mRS and BI were measured in PSD group(n=36) and non PSD group(NPSD group, n=80);fast blooding samples were analyzed with BDNF and hs-CRP in patients with PSD group, NPSD group and healthy controls (NC group).Results (1) The incidence of acute PSD was 31.03％.(2)The constituent ratio of type A behavior(83.33％ vs 57.50％), CH scores, TH +CH scores were significantly higher in PSD group than NPSD group(P＜0.01).Social Support Scale scores,MMSE scores were significantly lower in PSD group than NPSD group(P＜0.01, P＜0.05).NIHSS scores,mRS scores were significantly higher in PSD group than NPSD group, BI scores were significantly lower(P＜0.01).(3) The levels of serum BDNF,hs-CRP in the PSD group,the NPSD group and the normal control group were respectively (BDNF (617.24(274.98,976.22)) pg/ml, (938.19(615.88,1 714.76)) pg/ml, (4 149.46(1 658.83,7 583.34)) pg/ml);(hs-CRP(6.47(2.66,11.21)) mg/L, 1.77(0.74,6.51) mg/L, (0.86(0.47,1.59)) mg/L).The BDNF levels of PSD group were significantly lower and hs-CRP levels were significantly higher than NPSD group (P＜0.01).(4) The severity of depression was positively correlated with CH,TH+CH scores(r=0.38, P＜0.05;r=0.43, P＜0.01).CH scores were negatively correlated with social support(r=-0.38, P＜0.05),and were positively correlated with hs-CRP levels(r=0.34, P＜0.05).Conclusion In patients with post stroke depression,the BDNF levels decrease and hs-CRP levels increase,but severity of depression and cognitive function are not correlated with BDNF levels.Hostility and competition(CH) are correlated with the increasing hs-CRP levels.Patients with type A behavior, especially high CH scores, have immune system dysfunction and lower social support.Hostility and excessive competition are psychosocial risk factors occurring PSD.
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Objective To investigate the influence of psychological intervention in emotional disorder on blood pressure,lipids and glucose in hypertensive patients in community.Methods 599 hypertensive in community were divided to intervention group (n =302) and control group (n =297) by randomization.The control group received routine medication.Additionally the intervention group got another psychological intervention which lasted 6 months.An SCL-90 scale was adopted to evaluate patients'psychological change of mental health,blood sugar,low density lipoprotein cholesterol,total cholesterol,systolic pressure and diastolic blood pressure before and after treatment.Results Somatization,compulsion,interpersonal relationship,depression,anxiety,hostility and terror in intervention group((1.44±0.29),(1.78 ±0.39),(1.66±0.38),(1.63 ±0.48),(1.43 ±0.35),(1.37 ± 0.52) and (1.28 ± 0.41) respectively) had a lower score than control group ((2.01 ± 0.59),(2.04±0.68),(1.88 ±0.38),(1.84±0.59),(1.92±0.54),(1.61 ±0.53)and(1.60±0.50)).The differences were significant(P＜ 0.01).After intervention,blood glueose,low density lipoprotein,total cholesterol,systolic pressure,and diastolic pressure were ((4.65 ± 0.811) mmol/L,(2.97 ± 0.702) mmol/L,(4.86 ± 0.884)mmol/L,(134.11 ± 13.39)mm Hg(1 mm Hg =0.133 kPa) and (93.73 ±7.61)mm Hg respectively) and before intervention((5.09 ± 0.710) mmol/L,(3.23 ± 0.584) mmol/L,(5.36 ± 1.138) mmol/L,(150.13 ± 12.23) mm Hg and (89.64 ± 8.35) mm Hg respectively).The differences were significant (P＜ 0.05).Conclusion Cognitive behavioral therapy can improve community hypertension patients' physiology and psychology,which is good for blood pressure,lipids,glucose control.
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ObjectiveTo investigate the hypersensitive C-reactive protein(hs-CRP),level in serum and the heart rate variability(HRV) in patients with dysthymic disorder,and explore the possible psychological and physiological mechanisms.MethodsPHI and short-term HRV were measured in 42 patients with dysthymic disorder( DD group),33 patients with major depressive disorder ( MD group)and 30 heathy controls( NC group),fasting blood samples were also analyzed with high-sensitivity C-reactive protein (hs-CRP).Results ( 1 ) DD group gained higher score in the somatization,anxiety,psychopathic deviate and hypomania than the MD group(P＜0.05 or P ＜ 0.01 ).(2)The standard deviation of differences between the consecutive RR intervals (SDNN),the percentage value of consecutive RR intervals that differ more than 50 ms(PNN50) and the high frequency band(HF) of DD group were lower significantly than MD and NC groups,the low frequency band(LF),and the ratio of LF to HF power(LF/HF) and hs-CRP level were higher than other two groups (P ＜ 0.05 or P＜0.01 ).(3)The somatization and anxiety were correlated with SDNN,the very low frequency band(VLF),LF and hs-CRP level ( r=-0.27,-0.29,r=0.38,0.33,r=0.41,0.31,r=0.34,0.23,P＜0.05 or P＜0.01).(4)The hs-CRP level in serum were correlated with SDNN,the root mean square of successive RR intervals (RMSSD),the standard deviation of differences between the consecutive RR intervals ( SDSD),VLF,LF,HF and LF/HF ( r =- 0.47,- 0.45,- 0.45,0.26,0.46,-0.51,0.10,P ＜ 0.05 or P ＜ 0.01 ).ConclusionThe patients with dysthymic disorder have significant somatization and anxiety,the personality character was mainly resulting in reducing HRV,which is related with the increasing serum hs-CRP level.
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Objective To investigate the value of CARE Dose 4D technique in decreasing radiation dose and improving image quality of multi-slice spiral CT in adult chest scanning.Methods 100patients of chest CT scanning were equally divided into study group and control group randomly.CARE Dose 4D Technique was used in study group.Effective mAs value,volume CT dose index (CTDIvol) and dose length product (DLP) were displayed automatically in machine while chest scanning; those values and actual mAs value of every image were recorded respectively.The image quality at apex of lung,lower edge of aorta arch,middle area of left atrium and base of lung on every image of 400 images was judged and classified as three level (excellent,good,poor) by two deputy chief physicians with double blind method,the image noise at corresponding parts was measured.Results While setting 80 mAs for quality reference mAs,the effective mAs value in study group most decreased 44 mAs than control group with an average decrease of 9.60( 12.0% ) ,CTDIvol with 4.75 mGy with an average decrease of 0.95 mC y( 11.0% ) ,DLP 99.50% in study group,with 98.0% in control group.But it was higher at apex of lung and base of lung,lower at middle area of left atrium,and similar at lower edge of aorta arch in study group than contrast group.The image noise were lower at apex of lung and base of lung in study group than control group (t =6.299 and 2.332,all P ＜ 0.05 ) ,higher at middle area of left atrium in study group than control group (t=3.078,P ＜0.05) and similar at lower edge of aorta arch in study group than control group (t =1.191,P ＞0.05).Conclusions CARE Dose 4D technique provides a function regulated mAs real-time on line,it not only raises utilization rate of radiation and decreases radiation dose,but also promises and increases image quality in chest CT scanning,and has some clinical significance.
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Objective To investigate the characteristics of attention in children with comorbid attention deficit hyperactivity disorder (ADHD) and tic disorder (TD) (CAT). Methods 60 children with comorbid ADHD and TD (CAT), 79 children with ADHD, 60 children with TD and 71 normal control children (NG) were collected. All of those cases were evaluated with the integrated visual and auditory continuous performance test (IVA-CPT). Results It was slightly higher for visual response control quotient (VRCQ) in CAT group(85.15 ±21.10) than those in ADHD group(78.52 ± 21.85) (P ＜ 0.05), there was no significant different in the other five scores between CAT group and ADHD group (P＞0.05). It was significantly lower for the full response control quotient (FRCQ), auditory response control quotient (ARCQ) ,visual response control quotient (VRCQ), full attention quotient (FAQ), auditory attention quotient (AAQ) and visual attention Quotient (VAQ) in CAT group (83.43 ± 20.98,86.12 ± 19.88,85.15 ± 21. 10,64.88 ± 16.88,67.92 ± 17. 11 ,67.97 ± 20.04) than those in TD group(96.47 ± 17.83,97.50 ± 17.62,95.72 ± 18.87,85.37 ± 18.54,86.47 ± 17.32,87.43 ± 19.89) and those in normal control group(98.42 ± 12.67,101.50 ± 15.39,95.92 ± 11.79,99.33 ± 12.98,98.50 ± 12.09,100.00 ± 16.12) (P＜0.01). Conclusion There have serious reduced control ability and attention deficit in children with CAT. The attention deficit is attributed to the existence of ADHD.
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Objective:To study the effect of repeated transient ischemic attacks(TIAs)on cumulative injury of cognitive function.Methods:The cognitive condition of 42 patients with repeated TIAs were assessed after each TIA using the event related potential,modified version of Wisconsin card sorting test,trail making test,digit span task,and verbal fluency test.The cognitive condition was compared and analyzed after different attack times.Results:There were significant differences among the cognitive condition after different attack times,latency and amplitude of P300,and detection rate of mild cognitive impairment.With the increase of the attack times,cognitive impairment aggravated gradually,and the detection rate of mild cognitive impairment increased gradually.Conclusions:Repeated TIAs have cumulative injury on cognitive function.The prevention and treatment of cerebral ischemia may become an important approach in decreasing cognitive impairment.
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Objective To explore the changes on autonomic nervous function of the patients with different Traditional Chinese medicine syndrome types.Methods The cases of anxiety or depressive diseases were divided into different types according to traditional Chinese medicine syndrome types,and then heart rate variability(HRV) were tested and compared with normal controls.Results Indicators of time or frequency of heart rate variability(HRV) in anxiety or depressive disease patients with Gan-Yu-Tan-Zu Zheng or Xin-Pi-Liang-Xu Zheng or Gan-Yu-Qi-Zhi Zheng were lower than those of controls group,especially in parasympathetic nervous.The abever disorders of the patients with Gan-Yu-Tan-Zu Zheng or Gan-Yu-Qi-Zhi Zheng was more significant than those in patients with Xin-Pi-Liang-Xu Zheng.Conclusions The autonomic nervous function of anxiety or depressive diseases with Gan-Yu-Tan-Zu Zheng or Xin-Pi-Liang-Xu Zheng or Gan-Yu-Qi-Zhi Zheng is disordered and their HRV of was lower than that of control(P
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Objective To investigate the cerebral CT appearances of toxic encephalopathy of tetramine and improve the recognition on this disease. Methods Four cases of toxic encephalopathy of tetramine were collected and their cerebral CT appearances were retrospectively analyzed. Results Cerebral CT appearances in acute phase (within 8 days): (1) cerebral edema in different degree. CT abnormalities consisted of cortical hypodensities and complete loss of gray-white matter differentiation. The CT value were in 11-13 HU, and to be watery density in serious case,(2)subarachnoid hemorrhage. It demonstrated the signs of poisoning hypoxic ischemic encephalopathy in chronic phase. Conclusion The cerebral CT appearances of toxic encephalopathy of tetramine had some character in acute phase and it can predict the serious degree of intoxication, but there was no characteristic findings in chronic phase.
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Objective:To explore psychosocial factors of depressed elderly patients. Methods:33 elderly people with the first episode of depression diagnosed according to CCMD-3, and elderly healthy people were investigated with EPQ, SSRS (social support rating scale), LES (life event scale) and MMSE (mini mental state examination). Results:The rates of psychiatric family history, somatic diseases, risk factors for vascular disease and long-term difficulties were significantly higher in the depressive group than in control group. The score of MMSE was significantly lower in depressive group than in control group. The scores of negative life events and problems in social intercourse were significantly higher in depressive group than in control group. There were lower score of social support and its utility in the depressive group than in control group. The score of neuroticism was significantly higher in the depressive group. Most depressive elderly patients had the personality of neuroticism.Conclusion:Chronic stress, high neuroticism and severe cognitive impairment are important risk factors for depression in late life.[
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Objective: To study psychosocial factors and immunity of patients with generalized anxiety disorder Method: 30 patients with generalized anxiety disorder (GAD), 25 patients with neurotic depression and 32 normal controls were collected and assessed with LES (life event scale), SCSQ (simplified coping style questionnaire) and EPQ (Eysenck personality questionnaire) The blood level of IL-2, and rates of NK cell and CD3+ cell of them were also measured Result: The number of negative life events and LEU of negative life events of GAD group were higher that of normal controls, but lower than that of neurotic depression group Their total life events were also more than that of normal controls They had less positive coping than normal controls, more negative coping than both normal controls and patients with neurotic depression Their N score of EPQ was higher than that of normal control and had no significant different to that of patients with neurotic depression They also had higher levels of IL-2 than that of the other two groups There was no significant difference in rates of NK cell and CD3+ cell among all three groups The level of IL-2 was negatively correlated to the number of total life events and L score of EPQ, positively correlated to the rate of NK cell Conclusion: Patients with GAD have psychosocial stress in their life, they incline to negative coping, having unstable mood and impaired immune function Psychosocial stress has influence on immunity
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Objective: To study the relationship between immune function and psychosocial factors of patients with malignant tumors Method:37 inpatients with malignant tumors were collected They had no chemotherapy or radiotherapy in the past month and without history of immune disease or medication influencing immune system 37 inpatients of internal department without tumor were collected as control All subjects completed EPQ, SCL-90, SAS, SDS, LES, SSRS and DSQ Researchers assessed their mood with HAMA and HAMD, and their immune function by measuring serum IgG, IgA, IgM, C 3, C 4, CH50 and sub-groups of lymphocyte Results:Study group had lower IgM and less CD 16 + than control The level of IgM was associated with course of disease, educational level, gender, personality, defense style, negative life events and social support The level of CD 3 + was associated with depression in addition to other factors mentioned above Conclusion: Patients with malignant tumors have immune dysfunction, which associated with psychosocial factors such as negative life events, social support and depression