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Objective:To investigate the effects of total-body PET/CT imaging with short acquisition time on image quality and lesion detectability in lungs and parenchymal organs.Methods:Sixty patients (31 males, 29 females, age (61.1±11.8) years) with pulmonary nodules (PN) and 53 patients (29 males, 24 females, age (56.7±17.2) years) with parenchymal organ lesions (POL) who underwent total-body PET/CT imaging in the First Affiliated Hospital of Shandong First Medical University between October 2021 and April 2022 were retrospectively analyzed. The acquisition time with PET was 600 s, and the reconstructed images were divided into 6 groups based on different duration (30, 60, 120, 180, 300 and 600 s), namely G30, G60, G120, G180, G300 and G600 groups. The subjective analysis was carried out with the 5-point Likert scale in 3 aspects: the overall impression of image quality, noise, and lesion conspicuity. The objective analysis indicators included the SUV mean of the mediastinal blood pool (MBP); the SUV mean, standard deviation (SD) and signal-to-noise ratio (SNR) of the liver; SUV max and target-to-background ratio (TBR) of the lesions. Differences of the indicators among 6 groups were analyzed by Friedman test with Bonferroni correction. G600 served as the reference for the other 5 groups to test their lesion detectability. Results:The subjective image quality of different groups for PN and that of G120, G180, G300 groups for POL could meet the needs of clinical diagnosis in terms of the overall image quality, noise, and lesion conspicuity (all scores>3). There was no significant difference in the SUV mean of MBP among different time groups (median for PN: 1.52-1.56, median for POL: 1.35-1.47; χ2 values: 10.23, 11.02, both P>0.05). Difference was not found in SUV mean of the liver either (median for PN: 2.51-2.56, median for POL: 2.33-2.40; χ2 values: 8.35, 8.93, both P>0.05). The liver SD significantly increased along with the shortened acquisition time ( χ2 values: 400.99, 400.00, both P<0.001; z values: from -16.90 to -3.15, all P<0.003). The SNR significantly decreased along with the shortened acquisition time ( χ2 values: 397.32, 400.00, both P<0.001; z values: 2.98-16.90, all P<0.003). The SUV max (median for PN: 3.55-4.01, median for POL: 5.77-6.08; χ2 values: 8.58, 3.02, both P>0.05) and TBR (median for PN: 2.42-2.81, median for POL: 2.36-2.45; χ2 values: 9.83, 3.69, both P>0.05) of lesion were not significantly different among 6 groups. Taking G600 group as a reference, the lesion detection rates were 100% in G30 group and other 4 groups for PN (81/81) and in G120, G180, G300 groups for POL (80/80). Conclusion:Total-body PET/CT imaging with acquisition time of 30 s for lungs and that with acquisition time of 120 s for parenchymal organs are feasible for clinical use, with the PET image quality and lesion detectability maintained.
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Objective:To analyze the policy implementation of family doctors′ contracted services in different regions based on practices in typical regions.Methods:From April to October 2019, we conducted field investigations in 14 regions, collected data on policy formulation and implementation, organizational form and service content of contracting service, incentive mechanism and capacity development. By means of key persons′ interview, we tried to understand the background of district/county policy implementation, as well as policy delivery and existing difficulties. The measurement data were expressed by means, and the qualitative data were used to extract the key content through semantic analysis.Results:The policy of family doctors′ contracted services had been promoted from pilot exploration to normative development. 71.0% of responsible entities of the contracted services in research regions were family doctor teams. Contraction fee has begun to reflect the value of family doctors′ work, while the average contracted service fees in the eastern, central and western regions were 125, 31.25 and 42.5 yuan/person/year respectively. Comprehensive incentives and health insurance policies in some regions played a role in promoting contracted services.Conclusions:It is necessary to establish the family doctors′ " three roles" management concept, namely health gatekeeper, rights exchanger and resource coordinator; strengthen the professional training and capacity promoting of family doctors, implement the connotation of contracted service fees and economic incentives, in order to play the policy′s basic role in constructing a health-centered system.
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Objective:Based on the policy goals of family doctors′ contracted services, to build an indicator system as policy tools for policy outcomes assessment and policy delivery optimization.Methods:Through literature and policy review, an evaluation conceptual framework was built based on policy goals of family doctors′ contracted services, and an indicator system was established using Delphi method.Results:Upon consultation of 21 experts, an indicator system for policy effect assessment of the family doctors′ contracted services was established, covering both policy implementations and goal effects. This system consisted of 7 level-2 indicators and 23 level-3 indicators.Conclusions:The indicator system oriented to policy goals, ensures the pertinence of policy effect assessment to play a strong guidance on practical implementation of the family doctors′ contracted services.
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Objective To investigate and compare the predictive value of 2 prediction scoring systems for diagnosis of coronary heart disease (CHD) in patients with suspected symptom, and provide information for diagnosis and therapy. Methods By prospectively studying a database of 272 patients with suspected CHD,the total score was calculated by prediction scoring system including PROCAM (The Prospective Cardiovascular Munster Study) and SCP(Suspected CHD Prediction Scoring System) with the data of clinic parameters and risk factors. All patients received coronary angiography and they were categorized into the CHD group (n =94) and non CHD group ( =178) according to the angiography result. The relationship between total scores and the SYNTAX score was evaluated by Spearman analysis and the value of the prediction scoring system was evaluated by the ROC (receiver operating characteristic) system. Results The score of PROCAM was from 6. 00 -77. 00(41. 76 ± 19. 91), and the score was significantly correlated with the extent and severity of coronary artery atherosclerosis (rs = 0. 420,P = 0. 023). The score of SCP was from 1. 00 - 13. 00(8. 64 ± 3. 42), and it was significantly correlated with the SYNTAX score (rs = 0. 482,P = 0. 016). The areas under ROC was 0. 770 (P = 0. 007) in PROCAM and that was 0. 733 (P = 0. 012) in SCP. Conclusions The nature and extent of coronary artery atherosclerosis could be evaluated by the scoring system effectively,which had a good correlation with CAG result.
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OBJECTIVE:To compare the differences in the contents of water-soluble total protein,total phenolic acid and total polysaccharides among the water decoctions of crude Cibotium barometz and processed products and to illuminate the effect of pro-cessing on 3 kinds of components of C. barometz. METHODS:UV-visible spectrophotometry was adopted to determine the con-tents of water-soluble total protein,total phenolic acid and total polysaccharides in the water decoction of crude C. barometz and 4 processed products,namely sand-scorch C. barometz,yellow wine C. barometz,salt C. barometz and steamed C. barometz,at wavelengths of 590,760 and 489 nm respectively. RESULTS:The contents of water-soluble total protein in 5 samples were 4.03%,3.32%,3.13%,3.33% and 3.49%,those of total phenolic acid therein were 0.25%,1.34%,1.38%,2.34% and 1.41%,and those of total polysaccharides therein were 28.56%,36.06%,45.21%,49.60% and 49.01%,respectively. CONCLU-SIONS:All above processing methods have an effect to some degree on the contents of the 3 kinds of components of C. barometz, where the contents of water-soluble total protein are lower after processing,while those of total phenolic acid and total polysaccha-rides are higher thereafter.
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Objective To investigate the clinical manifestation of bacterial urinary tract infections among old patients with diabetes in recent seven years.Methods In this retrospective study,contrast analysis of clinical features was per- formed on urinary tract infections in old patients between 56 cases with diabetes and 56 cases without it diagnosed during 1998 to 2005.measuring fasting blood glucose,2 hour blood glucose,plasma albumin,24-hour microalbuminuria. Results Incidences of diabetic nephropathy,diabetic retinopathy,neuropathic bladder in observed group are signifi- cantly higher than control group.FBG、2hPBG、24-hour microalbuminuria are significantly higher than control group and plasma albumin is lower than control group.Conclusion The urinary tract infection in old patients with diabetes is associated with fasting blood glucose concentration,complication,gender,disease period and ages,etc.