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Objective:To evaluate the effect of height (HT), total body weight (TBW), body mass index (BMI), lean body weight (LBW), body surface area (BSA) and blood volume (BV) on aortic and liver contrast enhancement during upper abdominal contrast-enhanced CT scans.Methods:One hundred and thirteen enrolled patients underwent upper abdominal multiphase contrast-enhanced CT scans. The enhancement (ΔHU) of aorta in hepatic arterial phase and liver parenchyma in portal venous phase were measured and calculated. The ΔHU values difference of aorta and liver parenchyma in subgroups between males and females, TBW<60 kg and TBW≥60 kg, BMI<25 kg/m 2 and BMI≥25 kg/m 2 were compared. To evaluate the effect of the patient′s body parameters on aortic and hepatic enhancement, we performed simple linear regression analyses between the change in CT numbers per gram of iodine (ΔHU/gI) at aorta and liver and each of the following: HT, TBW, BMI, LBW, BSA, and BV. Pearson and t test were used. Results:The mean ΔHU values of aorta and liver were significantly lower at males than that of at females ( P<0.05). They were higher at TBW<60 kg patients than at TBW≥60 kg patients( P<0.05), and the mean ΔHU values of the liver at BMI<25 kg/m 2 patients were significantly higher than at BMI≥25 kg/m 2 patients( P<0.05). The proportion of the ΔHU values at liver less than 50 HU was higher at males (18.3%, 11/60) than at females (7.5%, 4/53). The most obvious negative correlation coefficients were found between the ΔHU/gI of aorta and LBW at hepatic arterial phase ( r=-0.559, P<0.01), and between the ΔHU/gI of liver and BSA at portal venous phase ( r=-0.680, P<0.01). Conclusion:LBW or BSA could be the alternative body index to TBW for the calculation of personalized iodine dose protocol at aortic and liver enhanced CT scans.
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Objective@#To evaluate the effect of height (HT), total body weight (TBW), body mass index (BMI), lean body weight (LBW), body surface area (BSA) and blood volume (BV) on aortic and liver contrast enhancement during upper abdominal contrast-enhanced CT scans.@*Methods@#One hundred and thirteen enrolled patients underwent upper abdominal multiphase contrast-enhanced CT scans. The enhancement (ΔHU) of aorta in hepatic arterial phase and liver parenchyma in portal venous phase were measured and calculated. The ΔHU values difference of aorta and liver parenchyma in subgroups between males and females, TBW<60 kg and TBW≥60 kg, BMI<25 kg/m2 and BMI≥25 kg/m2 were compared. To evaluate the effect of the patient′s body parameters on aortic and hepatic enhancement, we performed simple linear regression analyses between the change in CT numbers per gram of iodine (ΔHU/gI) at aorta and liver and each of the following: HT, TBW, BMI, LBW, BSA, and BV. Pearson and t test were used.@*Results@#The mean ΔHU values of aorta and liver were significantly lower at males than that of at females (P<0.05). They were higher at TBW<60 kg patients than at TBW≥60 kg patients(P<0.05), and the mean ΔHU values of the liver at BMI<25 kg/m2 patients were significantly higher than at BMI≥25 kg/m2 patients(P<0.05). The proportion of the ΔHU values at liver less than 50 HU was higher at males (18.3%, 11/60) than at females (7.5%, 4/53). The most obvious negative correlation coefficients were found between the ΔHU/gI of aorta and LBW at hepatic arterial phase (r=-0.559, P<0.01), and between the ΔHU/gI of liver and BSA at portal venous phase (r=-0.680, P<0.01).@*Conclusion@#LBW or BSA could be the alternative body index to TBW for the calculation of personalized iodine dose protocol at aortic and liver enhanced CT scans.
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Objective To explore the optimal body size index for the calculation of iodine contrast agent dose required for multiphase liver enhanced CT scans based on the total body weight (TBW),lean body weight (LBW)and body surface area (BSA).Methods Two hundred and twenty enrolled patients were randomly divided into three groups,TBW-group (n＝75),LBW-group (n＝72)and BSA-group (n＝73),and administrated iodine doses were 600 mg I/TBW(kg),780 mg I/LBW(kg)and 22 g I/BSA(m2 ),respectively.All patients had taken upper abdominal plain scans and triple-phase enhanced CT scans.The enhanced values (ΔHU)of the aorta at hepatic arterial phase (HAP),the portal vein and liver parenchyma at portal venous phase (PVP)were compared.The correlation coefficients of adjusted maximal hepatic enhancement(aMHE)with TBW,LBW and BSA in three groups were evaluated,respectively.Results There were no statistical differences in the ΔHU values of the aorta at HAP and the portal vein and liver parenchyma at PVP in the three groups respectively.The smallest variances of the aorta at HAP,the portal vein and liver parenchyma at PVP were found in the LBW group. The aMHE showed mildly positive correlation with TBW (r＝0.230)with a P value of 0.047,but it was consistent with LBW (r＝0.158)and BSA (r＝－0.1 54)with corresponding P values of 0.1 85 and 0.1 9 2 ,respectively.Conclusion Compared with TBW and BSA,iodine contrast agent dose calculated based on the patient’s LBW can improve the patient-to-patient uniformities on aorta,portal vein and liver enhancement during the liver multiphase enhanced CT scans.The LBW is the best body index for the calculation of iodine dose on liver enhanced CT scans.
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Objective To assess the efficacy and safety of ipragliflozin ,a sodium glucose cotransporter 2 (SGLT2)inhibitor,for the treatment of type 2 diabetes. Methods Pubmed,the Cochrane Library,EMbase,CBM and CNKI databases was searched to identify randomized controlled trials(RCTs)pertinent to of ipragliflozin. The risk of bias of the included RCTs was assessed according to the Cochrane Handbook for Systematic Reviews of Inter-ventions Version 5.1.The RevMan 5.3 software was used for Meta-analysis. Results Ten RCTs with 2,390 partici-pants were included,Meta analysis showed that ipragliflozin was more effective than placebo in improving HbA1c level,and could concurrently reduce body weight,blood pressure,and the fasting plasma glucose(FPG)but not increase the risk of hypoglycemia. There were no statistically significant differences in the occurrence of urinary tract infection and genital infection as well as serious adverse events. Conclusion As a safe method ,ipragliflozin can effectively improve the HbA1c level in type 2 diabetes,help patients lose weight and reduce blood pressure.
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Objective To assess the efficacy and safety of ipragliflozin ,a sodium glucose cotransporter 2 (SGLT2)inhibitor,for the treatment of type 2 diabetes. Methods Pubmed,the Cochrane Library,EMbase,CBM and CNKI databases was searched to identify randomized controlled trials(RCTs)pertinent to of ipragliflozin. The risk of bias of the included RCTs was assessed according to the Cochrane Handbook for Systematic Reviews of Inter-ventions Version 5.1.The RevMan 5.3 software was used for Meta-analysis. Results Ten RCTs with 2,390 partici-pants were included,Meta analysis showed that ipragliflozin was more effective than placebo in improving HbA1c level,and could concurrently reduce body weight,blood pressure,and the fasting plasma glucose(FPG)but not increase the risk of hypoglycemia. There were no statistically significant differences in the occurrence of urinary tract infection and genital infection as well as serious adverse events. Conclusion As a safe method ,ipragliflozin can effectively improve the HbA1c level in type 2 diabetes,help patients lose weight and reduce blood pressure.
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Objective To investigate the effect of tube voltage and iodine concentration of contrast medium (CM) on abdominal dynamic enhanced CT image quality.Methods Six miniature pigs underwent repeated upper abdomen dynamic contrast-enhanced CT scans in 4 scanning protocols with different concentration of CM and tube voltage,namely,protocol 1,CM with iodine concentration of 270 milligrams iodine per milliliter (mg/ml) and 80 kV tube voltage;protocol 2,270 mg/ml and 120 kV;protocol 3,370 mg/ml and 80 kV and protocol 4,370 mg/ml and 120 kV.The same iodine dose (600 mg/ml) and iodine delivery rate (IDR) (920 mg/s) were used in all protocols.The CM with iodine concentration of 270 mg/ml were injected at a flow rate of 3.4 ml/s,and 370 mg/ml CM injected at 2.5 ml/s.Image reconstruction was performed with iterative reconstruction (iDose4) in protocol 1 and 3,filtered back projection (FBP) was used in protocol 2 and 4.A subjective scoring system for image quality,image noise and sharpness was conducted by 2 radiologists independently.The measured values (peak of enhanced CT values,image noise of aorta,inferior vena cava,portal vein,hepatic vein and liver parenchyma) as well as the calculated values [their time-to-peak,signal-to-noise (SNR) and contrast-to-noise (CNR) ratios] were compared between among 4 protocols.The CT volume dose index (CDTIvol) and dose length product (DLP) were recorded from the CT console after each scanning.Factorial designed ANOVA was used for comparison of enhanced CT values of vessels and liver parenchyma,noise,SNR and CNR.The Kruskal-Wallis test was used for comparison of values among the 4 protocols,including the time-to-peak enhancement of vessels and liver parenchyma,the subjective scores of image quality indices.Result There was no significant differences in subjective scores of the image quality,image noise and image sharpness (P＞0.05).The scored were more than 3,and the images with 4 scanning protocols were all acceptable for diagnosis.There was no significant differences between protocol 1 and 3,protocol 2 and 4 in the peak enhancement CT values of aorta [(729±46) HU vs.(707±59)HU,(515±84)HU vs.(513±53)HU],inferior vena cava [(366±95)HU vs.(368±92)HU,(282±39)HU vs.(262 ± 67)HU],portal vein [(213± 18)HU vs.(201 ±29)HU,(180±21)HU vs.(176±27)HU],hepatic vein [(207±18)HU vs.(193±10)HU,(179±24)HU vs.(170±14)HU] and liver parenchyma [(128±7) HU vs.(127±4) HU,(135±5)HU vs.(135±6)HU] (P＞0.05).But the CT values of vessels (aorta,inferior vena cava,portal vein and hepatic vein) in protocol 1 and 3 were significantly higher than those in protocol 2 and 4 (P＜0.05),the CT values of liver parenchyma in protocol 1 and 3 were significantly lower than values in protocol 2 and 4 (P＜0.05).The image noises of vessels were higher in protocol 1 and 3 than noises in other protocols (P＜0.05),but there was no significant difference in liver parenchyma noise among protocols (P＞0.05).No significant differences were observed on the peak times,SNR and CNR in aorta,inferior vena cava,portal vein,hepatic vein and liver parenchyma among 4 protocols (P＞0.05).The CDTIvol and DLP were 199.67 mGy,1 597.4 mGy· cm respectively in protocol 1 and 3,585.12 mGy and 4 680.9 mGy· cm in protocol 2 and 4 (scanning with 120 kV).Conclusions CM with different iodinated concentration could achieve the same enhancement in the abdominal vessels and liver parenchyma by using the proper scan protocols,which have the same IDR and iodine dose per kilogram body weight.Higher vessel enhanced peak values were achieved when using the protocols with 80 kV tube voltage than 120 kV.By using a low dose protocol of 80 kV tube voltage with the iterative reconstruction algorithm,the quality of image can be warranted.
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Objective To study the characteristics of susceptibility weighted imaging (SWI) and it's role in glioma classfication. Methods 45 glioma patients with pathologically confirmion, underwent preopera-tive plain MRI, enhanced MRI and SWI examination. By using double blind method, the score of T1 WI, T2WI, enhanced T1 WI, SWI and enhanced SWI were acquired to display enhancing tumor, peritumoral edema, tumor hemorrhage and tumor vein. The tumor volume of low signal areas was measured by using measurement software to acquire the bleeding of tumor. Results In 26 cases of high grade gliomas,18 patients with intratu-moral, multiple patchy low signal cords in varying degrees, which were proved by pathology as tumor hemorrhage and tumor blood vessels; in 19 case of low grade gliomas, 10 cases occured a few spots, linear low signal in tumor, which were proved by pathology as tumor hemorrhage; the bleeding of high grade gliomas was higher than that of the low level group ( P < 0.05 ). SWI was superior to T, WI, T2 WI on displaying tumor hemorrhage and tumor vein(P<0. 05). Conclusion Different grades of glioma show obvious different display on SWI, and SWI probably be helpful for evaluation of glioma grading preoperatively.
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Objective To evaluate the usefulness of diffusion-weighted magnetic resonance imaging (DWI) and apparent diffusion coefficients (ADC) in differentiating tumor, edema, and normal brain tissue, and in classification of cerebral gliomas. Methods Using Philips Achieva 1.5T super conduct MR scanner, 46 patients with gliomas underwent conventional MR imaging and DWI. The ADC of regions of interest ( ROI ) were measured with two different b values, 0s/mm2 and 1000s/mm2. ROIs were manually placed over areas of tumor,edema, and normal brain tissue. Results The signals of DWI and ADC map in tumor tissue were respectively higher and lower than those in normal brain tissue. The ADC values in tumor were 1.68 ± 0.18,1.65 ± 0.20,1.29 ±0.16,1.21 ±0.21 for grade Ⅰ、Ⅱ、Ⅲ、Ⅳ gliomas, respectively; the corresponding figures in edema were 1.74 ±0.22,1.72 ±0.19,1.35 ±0.20,1.28 ±0.19, respective. The ADC values in tumor were not significantly different from the values in edema (P ＞0.05); however, both values were significantly different from those in normal brain ( P ＜0.05 ). The ADC value of low grade ( grade1-2 ) gliomas was significantly higher than that of high grade (grade3-4) glioma (P＜0.05). Conclusion ADC values can aid in distinguishing tumors from normal tissues, but can not distinguish tumors from adjacent edema. Individually, ADC values overlapped considerahly. ADC value is associated with cellularity of gliomas. DWI can help characterizing the malignancy of gliomas.
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Objective To evaluate the efficacy and safety of biphasic insulin aspart 30 (BIAsp30)plus metformin in type 2 diabetes subjects switching from basal insulin plus oral antidiabetic drugs (OAD)Methods During 16 weeks, multiple-center, open-label, and single-arm study including 2 weeks of screening period,4 weeks of run-in period,and 16 weeks of treatment period were carried out. Subjects with type 2 diabetes mellitus inadequately controlled on basal insulin therapy with or without oral antidiabetic drugs were switched to twice-daily BIAsp30 plus metformin with dose titration to achieve fasting plasma glucose target. Results Of the 293 Chinese subjects exposed to trial drugs [age: ( 54.0±9.6 ) years, diabetes duration: ( 8.54±5.49 ) years, body mass index: (24.89±3.28)kg/m2, baseline HbA1c: 8.16% ±0.89%], 122 were previously treated with basal insulin analogues and 169 with human basal insulin. At end of the trial ,the mean reduction of HbA1 c was 1.30% ±0.96% (P＜0. 01 ). The proportion of patients achieved HbA1c＜7.0% and HbA1c ≤6.5% was 60.4% and 38.9% respectively. 8-point plasma glucose measurements showed significant improvements at all the time points examined ( all P＜0. 01 ) ,and the average value of all 8 points measured decreased from ( 10.53±2.58 ) mmol/L atbaseline to (7.79± 1.58 ) mmol/L at the end of treatment ( P＜0. 01 ), reduced by 2.76 mmol/L. Postprandial glucose increments were significantly reduced after breakfast ( -1.73 mmol/L,P＜0.01 )and dinner ( -1.28 mmol/L,P＜0.01 ), while no significant reduction was observed after lunch ( -0.09 mmol/L, P = 0. 734 5 ). No severe adverse effect and no major hypoglycemia were reported. The overall hypoglycaemia rate was 2.68 events/subject year. The average weight gain was (0. 76 ±0. 14 )kg (P＜0. 0l ). Conclusion Twice-daily BIAsp30 plus metformin is effective and safe to type 2 diabetic subjects inadequately controlled on basal insulin treatment.BIAsp30 treatment should be considered for type 2 diabetic subjects who have unsatisfactory response to previous basal insulin treatment.
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This is a work aimed to investigate the efficacy and safety of the combination of metformin with glargine or with neutral protamine Hagedorn in treatment of type 2 diabetes mellitus. Sixty such patients with poor glycemic control by oral antidiabetic drugs were included and divided into group A and group B. Thirty patients in group A were treated with glargine and metformin, and the other 30 patients in group B were treated with neutral protamine Hagedorn and metformin for 12 weeks. Fasting plasma glucose (FPG), postprandial glucose(PPG) and HbA1c were measured before and after the treatment. Hypoglycemia was also noted. At the end of the study, the levels of FPG, PPG and HbAlc were significantly lower than the baseline levels in the two groups (P < 0.05). At the 12th week, the percentage of HbAlc < 7% in group A was 53.3% and that in group B was 40.0%; statistically, there was no significant difference (P > 0.05). After the end of the treatment, there was no significant difference in that the percentage of HbA1c < 7% was 70.6% in group A and 62.5% in group B; the two groups' HbA1c levels were > or = 7%-9% at the baseline (P > 0.05). No sigificant difference in respect to the incidence rate of hypoglycemia in the two groups was noted (P > 0.05). In the cases of type 2 diabetes mellitus with poor glycaemic control by oral antidiabetic drug, glucose and HbA1c can be lowered further by the combination of metformin with glargine or with neutral protamine Hagedorn, the incidence rate of hypoglycemia is low. Metformin plus glargine or plus neutral protamine Hagedorn is a safe and effective therapeutic choice for type 2 diabetes mellitus cases with poor glycaemic control; moreover, metformin plus neutral protamine is a cheaper and effective choice.
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Aged , Female , Humans , Male , Middle Aged , Diabetes Mellitus, Type 2 , Drug Therapy , Drug Therapy, Combination , Hypoglycemic Agents , Insulin Glargine , Insulin, Isophane , Insulin, Long-Acting , MetforminABSTRACT
Objective To assess influence factors of imaging quality with 64-slice spiral CT angiography (CTA) of renal artery. Methods A total of 305 hypertension patients underwent CTA of renal artery, and 108 of them were examined with DSA. The imaging quality was classified as Ⅰ, Ⅱ, Ⅲ, Ⅳ, Ⅴ, and the degree of stenosis wass classified as <50%, 50%-74%, 75%-99% and occlusion. The sensitivity and specificity of CTA of renal artery was analyzed taking DSA as the standard. Results The influence factors of CTA of renal artery included the delayed time set, rotation time, the units dose of contrast medium and the speed of injection, breath-holding, the patients age and vascular calcification. The sensitivity and specificity of CTA of arterial stenosis <50%, 50%-74%, 75%-99%, occlusion was 76.30% and 76.80%, 89.70% and 90.40%, 96.30% and 97.10%, 100% and 100%, respectively. Conclusion The influence factors of CTA of renal artery are the delayed time set, rotation time, the units dose of contrast medium and the speed of injection, breath-holding, the patients age and vascular calcification. CTA of renal artery can meet the clinical requirements in assessing the renal arterial stenosis.
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Objective To observe CT features of struma ovarii (SO) in comparison of pathologic findings. Methods CT features of 9 patients with pathologically confirmed SO were analyzed retrospectively and compared with pathological findings. Results All tumors were unilateral and had smooth margins, 3 were cystic and 6 were cystic-solid lesions, 5 were high attenuation lesions in the cyst portion of the mass on contrast CT. The cyst wall moderately (n=3) or markedly (n=5) enhanced after administration of contrast medium. Scattered, stripe-like or ring-like calcifications were found in 6 patients. On pathology, most of cystic portions were filled with high proteinaceous gelatinous fluid of eosinophiclic colloid, and the solid portion of tumors consisted of the thyroid tissue and stoma containing abundant blood vessels and fibrous tissue. Conclusion SO appears as a smooth marginated multicystic mass with calcification, high attenuation lesionin plain CT, and marked solid part enhancement on contrast CT.
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This study was aimed to compare the effect of insulin plus rosiglitazone with that of insulin plus metformin on the level of serum N-terminal pro-brain natriuretic peptide (NT-BNP) in patients with type 2 diabetes mellitus, and to find out whether serum NT-BNP can be used as an index for predicting heart failure induced by rosiglitazone in the cases of type 2 diabetes mellitus. Sixty type 2 diabetic patients were recruited and were randomly divided into two groups: group A (n = 30) received insulin plus rosiglitazone (4 mg/d) and group B (n = 30) received insulin plus metformin. The observations covered an 8-weeks' course of treatment. Serum NT-BNP was measured at the beginning and at the end of 8 weeks. The Before-After study revealed that the level of serum NT-BNP did not change apparently in the two groups (P >0.05). There was no remarkable difference in the level of serum NT-BNP between the two groups (P>0.05). There were 3 cases with edema in the group of insulin plus rosiglitazone, but none with heart failure; in these three cases, the mean serum NT-BNP level at the end of the treatment exhibited an increase of 108.99 fmol/ml when compared with that at the beginning. Neither insulin plus rosiglitazone nor insulin plus metformin had apparent effect on the level of serum NT-BNP in the patients with type 2 diabetes mellitus. The question of whether serum NT-BNP is a predictive index of heart failure awaits answers given by more observation on type 2 diabetes mellitus patients using rosiglitazone.
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Aged , Female , Humans , Male , Middle Aged , Diabetes Mellitus, Type 2 , Blood , Drug Therapy , Drug Therapy, Combination , Hypoglycemic Agents , Therapeutic Uses , Insulin , Therapeutic Uses , Metformin , Therapeutic Uses , Natriuretic Peptide, Brain , Blood , Peptide Fragments , Blood , Thiazolidinediones , Therapeutic UsesABSTRACT
On the basis of our previous work, the electric frequency property of human blood in different components, in physiological state and in pathological state (diabetes) are tested and analyzed in the range of 1Hz-20MHz progressively. Among the different components of blood; the lowest electrical impedance is serum; the plasma and the whole blood gradually become larger, the blood corpuscle is the largest one. Otherwise, the negative phase of serum is the largest, the plasma and the whole blood are lower, and the blood corpuscle is the lowest. Here, the question is why the effect of the electric capacity of serum and plasma is the biggest in the condition of no cell and cell membrane; diabetes mellitus is an endocrine disorder in which blood changes obviously, the electric frequency property of the blood of diabetic patients changes markedly; the electrical impedance of blood decreases (more obviously with low frequency), the negative phase increases (more obviously with high frequency). These indicate that the increase of electric conductivity in diabetic patients' blood is due to electric capacitance conductivity that is related to the changes of cell membrane, deformation abilities and aggregation of RBC. Related experiments demonstrate again that with the progressing of research in the electric frequency property of blood, we may use the theory and method of electricity to examine some important characters of blood in a different way, and so to corroborate other tests and analyses.
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Adult , Female , Humans , Male , Middle Aged , Blood Physiological Phenomena , Diabetes Mellitus , Blood , Electric Impedance , Electricity , Electrophysiology , Plasma , PhysiologyABSTRACT
In order to understand the electricity frequency specialties of blood, we have developed a wide frequency electricity characteristic testing system and used it to test the amplitude frequency property and phase frequency property of the blood in different states and constituents at 1 Hz to 20 MHz. Further analysis on the results of tests helped us know some important properties of blood at even more microcosmic levels from a new angle. Meanwhile, some problems and considerations on the improvement of the electricity model of biotic tissue and blood were pointed out. (1) From 1 Hz to 5 KHz, the impedance of blood descended 99%. (2) Simple equivalent circuit of resistance and capacitance must be used in series equivalent but not in usual parallel connection equivalent. (3) Experiment indicated, equivalent circuits of blood need more analysis, because simple equivalent circuit of resistance and capacitance is liable to gross error. (4) When the three element model is used for measuring the resistance of inside liquid, capacitance of cell membrane and the resistance of outside liquid of blood, the three testing frequencies must be very similar.