ABSTRACT
Objective: To investigate the mechanism of moxibustion in the treatment of diarrhea-predominant irritable bowel syndrome (IBS-D), by observing the effects of moxibustion at Tianshu (ST25) and Shangjuxu (ST37) on microRNA-133b (miRNA-133b), pituitary homeobox family factor 3 (Pitx3)/tyrosine hydroxylase (TH), and neurotransmitters in the brain tissue of IBS-D rats. Methods: Healthy Sprague-Dawley rats were randomly divided into a normal group, a model group, a moxibustion group, and a Western medicine group, with 12 rats in each group. Except for the normal group, the IBS-D rat model was established by mother-offspring separation and acetic acid enema combined with restraint stress stimulation in all the other groups. No intervention was performed in the normal and model groups. Mild moxibustion was applied to both Tianshu (ST25) and Shangjuxu (ST37) in the moxibustion group. Rifaximin was given by gavage in the Western medicine group. The physical status of rats in each group was observed at different periods. After the intervention, hematoxylin- eosin staining was performed to observe the histopathological morphology of rat colon; enzyme-linked immunosorbent assay was used to measure the levels of dopamine (DA), noradrenaline (NE), and 5-hydroxytryptamine (5-HT) in plasma, colon, and midbrain tissue of rats; the relative expression levels of miRNA-133b, Pitx3 mRNA, and TH mRNA in the midbrain tissue were measured by real-time fluorescence quantitative polymerase chain reaction, and the relative expression levels of Pitx3 and TH proteins in the midbrain tissue were measured by Western blotting and immunofluorescence. Results: The body weights of rats among groups and at different time points were statistically different (P<0.01). The body weight of the normal group was higher than that of the other groups over time (P<0.01). After modeling, the minimum volume threshold of abdominal withdrawal reflex (AWR) was significantly lower (P<0.01) and the loose stool rate was significantly higher (P<0.01) in the model, moxibustion, and Western medicine groups compared with the normal group; the miRNA-133b expression in the midbrain tissue was significantly lower (P<0.01), the expression levels of Pitx3 and TH in the midbrain tissue were significantly higher (P<0.01), and the levels of DA, NE, and 5-HT in plasma, colon and midbrain tissue were significantly higher (P<0.01). After the intervention, the minimum volume threshold of AWR was significantly higher (P<0.01), the loose stool rate was significantly lower (P<0.01), the miRNA-133b expression was significantly increased (P<0.01 or P<0.05) and the expression levels of Pitx3 and TH were significantly decreased (P<0.01) in the midbrain tissue, the levels of DA, NE, and 5-HT in plasma, colon, and midbrain tissue were significantly reduced (P<0.01) in the moxibustion and Western medicine groups compared with the model group; the levels of 5-HT in the colon and midbrain tissue of the moxibustion group were significantly lower than those in the Western medicine group (P<0.05), and there was no statistical difference compared with the remaining groups (P>0.05). Linear correlation analysis showed that miRNA-133b was negatively correlated with Pitx3 (r<0, P<0.01); Pitx3 with TH, TH with DA, and NE with 5-HT were positively correlated (r>0, P<0.01).Conclusion: Moxibustion at Tianshu (ST25) and Shangjuxu (ST37) improves diarrhea symptoms and visceral hypersensitivity in IBS-D rats. The mechanism may be related to up-regulating miRNA-133b, inhibiting Pitx3/TH, and reducing neurotransmitter expression levels in the midbrain tissue.
ABSTRACT
Objective:To explore the basic characteristics of various types of intensive care unit (ICU) patients and the predictive value of six common disease severity scores in critically ill patients on the first day on the 28-day death risk.Methods:The general information, disease severity scores [acute physiology score Ⅲ (APSⅢ), Oxford acute disease severity (OASIS) score, Logistic organ dysfunction score (LODS), simplified acute physiology score Ⅱ (SAPSⅡ), systemic inflammatory response syndrome (SIRS) score and sequential organ failure assessment (SOFA) score], prognosis and other indicators of critically ill patients admitted from 2008 to 2019 were extracted from Medical Information Mart for Intensive Care-Ⅳ 2.0 (MIMIC-Ⅳ 2.0). The receiver operator characteristic curve (ROC curve) of six critical illness scores for 28-day death risk of patients in various ICU, and the area under the ROC curve (AUC) was calculated, the optimal Youden index was used to determine the cut-off value, and the AUC of various ICU was verified by Delong method.Results:A total of 53 150 critically ill patients were enrolled, with medical ICU (MICU) accounted for the most (19.25%, n = 10 233), followed by cardiac vascular ICU (CVICU) with 17.78% ( n = 9 450), and neurological ICU (NICU) accounted for the least (6.25%, n = 3 320). The patients in coronary care unit (CCU) were the oldest [years old: 71.79 (60.27, 82.33)]. The length of ICU stay in NICU was the longest [days: 2.84 (1.51, 5.49)] and accounted for the highest proportion of total length of hospital stay [63.51% (34.61%, 97.07%)]. The patients in comprehensive ICU had the shortest length of ICU stay [days: 1.75 (0.99, 3.05)]. The patients in CVICU had the lowest proportion of length of ICU stay to total length of hospital stay [27.69% (18.68%, 45.18%)]. The six scores within the first day of ICU admission in NICU patients were lower than those in the other ICU, while APSⅢ, LODS, OASIS, and SOFA scores in MICU patients were higher than those in the other ICU. SAPⅡ and SIRS scores were both the highest in CVICU, respectively. In terms of prognosis, MICU patients had the highest 28-day mortality (14.14%, 1 447/10 233), while CVICU patients had the lowest (2.88%, 272/9 450). ROC curve analysis of the predictive value of each score on the 28-day death risk of various ICU patients showed that, the predictive value of APSⅢ, LODS, and SAPSⅡ in comprehensive ICU were higher [AUC and 95% confidence interval (95% CI) were 0.84 (0.83-0.85), 0.82 (0.81-0.84), and 0.83 (0.82-0.84), respectively]. The predictive value of OASIS, LODS, and SAPSⅡ in surgical ICU (SICU) were higher [AUC and 95% CI were 0.80 (0.79-0.82), 0.79 (0.78-0.81), and 0.79 (0.77-0.80), respectively]. The predictive value of APSⅢ and SAPSⅡ in MICU were higher [AUC and 95% CI were 0.84 (0.82-0.85) and 0.82 (0.81-0.83), respectively]. The predictive value of APSⅢ and SAPSⅡ in CCU were higher [AUC and 95% CI were 0.86 (0.85-0.88) and 0.85 (0.83-0.86), respectively]. The predictive value of LODS and SAPSⅡ in trauma ICU (TICU) were higher [AUC and 95% CI were 0.83 (0.82-0.83) and 0.83 (0.82-0.84), respectively]. The predictive value of OASIS and SAPSⅡ in NICU were higher [AUC and 95% CI were 0.83 (0.80-0.85) and 0.81 (0.78-0.83), respectively]. The predictive value of APSⅢ, LODS, and SAPSⅡ in CVICU were higher [AUC and 95% CI were 0.84 (0.83-0.85), 0.81 (0.80-0.82), and 0.78 (0.77-0.78), respectively]. Conclusions:For the patients in comprehensive ICU, MICU, CCU, and CVICU, APSⅢ or SAPSⅡ can be applied for predicting 28-day death risk. For the patients in SICU and NICU, OASIS or SAPSⅡ can be applied to predict 28-day death risk. For the patients in TICU, SAPSⅡ or LODS can be applied for predicting 28-day death risk. For CVICU patients, APSⅢ or LODS can be applied to predict 28-day death risk.
ABSTRACT
Purpose@#This study aimed to evaluate nursing students’ understanding of the prevention of COVID-19, as well as their anxiety towards the disease and their perception of their professional identity in the wake of the pandemic, in Zhengzhou, China. @*Methods@#A cross-sectional study was designed to investigate 474 nursing students by cluster sampling using a stratified questionnaire from February 15 to March 31, 2020. Multiple linear regression was used to identify the factors affecting professional identity. Binary and multiple logistic regression were used to identify the factors affecting anxiety. @*Results@#Responders with a high level of understanding of COVID-19 and frequent use of behavioral strategies for its prevention comprised 93.2% and 30.0% of the cohort, respectively. Professional identity was significantly associated with gender and anxiety (p < .050). The prevalence of anxiety among nursing students was 12.4%. Male (odds ratio [OR] = 2.39; 95% confidence interval [CI] = 1.26~4.52), sophomores (OR = 5.30; 95% CI = 1.61~7.45), and infrequent use of prevention measures (OR = 3.49; 95% CI = 1.16~5.19) had a significant effect on anxiety. @*Conclusion@#Anxiety during the COVID-19 epidemic gives an adverse effect on the professional identity of nursing in students. Nursing education institutions need to provide psychological counseling services for nursing students, in addition to improving their teaching of COVID-19 prevention strategies.
ABSTRACT
Objective@#To explore the effects of ambient fine particulate matter（PM2.5）exposure on semen quality in healthy adult men .@*Methods@#The semen quality data were collected from the pre-pregnancy check outpatient of Taizhou Central Hospital from August 2014 to December 2017,excluding the patients with any disease of reproductive system. The data of daily pollutant concentration of this area during the same period were also collected to estimate the exposures of PM2.5,PM10,SO2,NO2,O3 and CO during 90 days before each semen examination. Logistic regression model was applied to estimate the association between PM2.5 exposure and semen quality .@*Results@#A total of 3 456 healthy adult men were included in this study. The median （interquartile range）of the total sperm count of the 3 456 subjects was 161.00（122.00）×106,and 94.40% of the subjects could reach the lower reference limit for sperm count. The median（interquartile range）of the sperm concentration was 22.20（18.80）×106/mL,and 69.50% of the subjects were qualified. The median（interquartile range）of the sperm vitality was 55.30%（23.37%）,and 44.10% of the subjects were qualified. The median（interquartile range）of daily average concentration of PM2.5 at 0-90 days before semen examination was 37.82（12.33）μg/m3. The results of multivariate logistic regression model showed that,with each 12.33 μg/m3 increase of PM2.5 exposures at 0-90 days before semen examination,the odds ratios of unqualified sperm concentration,sperm motility and sperm vitality were 1.236（95%CI：1.041-1.466）,1.493（95%CI：1.260-1.770）and 1.462（95%CI：1.246-1.715）,respectively .@*Conclusion@#The results suggested that high concentration of ambient PM2.5 exposure during the sperm development period negatively affects sperm concentration,sperm motility and sperm vitality.
ABSTRACT
Objective To observe the clinical effect of lansoprazole enteric -coated tablets combined with flupentixol and melitracen in the treatment of erosive gastritis with anxiety .Methods Eighty patients with erosive gastritis complicated with anxiety were selected , and they were randomly divided into control group ( n =40 ) and observation group( n=40) according to the digital table .The control group was treated with lansoprazole enteric -coa-ted tablets.The observation group received lansoprazole enteric -coated tablets combined with flupentixol and melitra-cen.Hamming anxiety scale ( HAMA ) and Hamilton depression scale ( HAMD ) were used to evaluate in the two groups before and after treatment .The changes of HAMA and HAMD scores were compared between the two groups .Results Before treatment,the scores of abdominal pain ,bloating,pantothenic acid and belching had no statistically significant differences between the two groups (all P>0.05).After treatment for 4 weeks,the scores of abdominal pain,bloating, pantothenic acid and belching in the observation group were ( 0.63 ±0.12 ) points, ( 0.43 ± 0.11)points,(0.30 ±0.11)points and (0.31 ±0.14)points,respectively,which were lower than those in the control group [(1.42 ±0.18)points,(1.08 ±0.15)points,(0.79 ±0.16)points,(0.98 ±0.25)points] (t=15.396, 13.285,16.758,17.492,all P<0.05).The scores of HAMA and HAMD in the observation group were (12.15 ± 2.51)points and (14.32 ±2.51) points,respectively,which were lower than those in the control group [(19.84 ± 2.65)points,(19.84 ±3.17)points](t=20.151,21.841,all P<0.05).There was no statistically significant differ-ence in the incidence rate of adverse reactions between the two groups after treatment for 4 weeks (P >0.05) .Conclusion Lansoprazole enteric -coated tablets combined with flupentixol and melitracen in the treatment of erosive gastritis with anxiety can relieve anxiety and depression ,improve clinical symptoms and treatment effect .
ABSTRACT
Objective To study the influence of frailty on quality of life among nursing homes elders,to improve the elders′quality of life and provide references for health ageing. Methods Totally 369 nursing homes elders in Jinan were investigated by using the general information and health status questionnaires, Mini-mental State Examination (MMSE), FRAIL scale, European Quality of Life 5-Dimensions(EQ-5D). Results Of the samples,52.8%(195/369)were pre-frail and 23.0%(85/369)were frail.After controlling the confounding factors,pre-frail and frail elders had lower quality of life than the other elders(OR=0.097,0.016,P<0.01).Resistance and ambulationclosely associated with quality of life in FRAIL scale(OR=0.030,0.364,P<0.05). Conclusion Measures for improving the quality of life and physical and mental well-being of nursing homes elders can be designed based on frailty.
ABSTRACT
Objective To systematically assess the clearance rates of periodontal instrumentation in combination with triple therapy and triple therapy alone for patients with gastric Helicobacter pylori(HP) infection.Methods PubMed,EMbase,Medline,CNKI,SinoMed and Wan Fang databases were searched to collect controlled clinical trials,conducted between March 1997 and March 2017,on periodontal therapy combined with triple therapy or triple therapy alone for patients with gastric HP infection.Two reviewers independently screened the literature,extracted data,and assessed the risk of bias of included studies.Then meta-analysis was performed using RevMan 5.3 software.Results Eight studies involving 777 patients were included.The results of the metaanalysis showed that clearance rates of HP were 52.1％ for triple therapy alone and 81.1％ for periodontal therapy combined with triple therapy.The difference was statisticatly significant (OR =4.08,95％CI:2.94～ 5.67,P＜0.001).Conclusions Currently available evidence suggests that,compared with triple therapy alone,periodontal therapy in combination with triple therapy produces higher rates of gastric HP eradication.
ABSTRACT
Objective To systematically assess the clearance rates of periodontal instrumentation in combination with triple therapy and triple therapy alone for patients with gastric Helicobacter pylori(HP) infection.Methods PubMed,EMbase,Medline,CNKI,SinoMed and Wan Fang databases were searched to collect controlled clinical trials,conducted between March 1997 and March 2017,on periodontal therapy combined with triple therapy or triple therapy alone for patients with gastric HP infection.Two reviewers independently screened the literature,extracted data,and assessed the risk of bias of included studies.Then meta-analysis was performed using RevMan 5.3 software.Results Eight studies involving 777 patients were included.The results of the metaanalysis showed that clearance rates of HP were 52.1％ for triple therapy alone and 81.1％ for periodontal therapy combined with triple therapy.The difference was statisticatly significant (OR =4.08,95％CI:2.94～ 5.67,P＜0.001).Conclusions Currently available evidence suggests that,compared with triple therapy alone,periodontal therapy in combination with triple therapy produces higher rates of gastric HP eradication.
ABSTRACT
Objective To summarize and analyze the shielding,retention and reentry works of blood donors,and to investigate the feasibility of retention and reentry strategy.Methods The samples of ELISA single reagent reactive/NAT non-reactive and ELISA non-reactive/ NAT reactive were negative by confirmatory tests.Then the blood was weeded out and the donation qualification was reserved.The donors of shielding more than 6 months could propose the reentry application at any blood station in the province,and were allowed to return to the ranks after qualified by routine detection and re-detection by Jiangsu Provincial Blood Center.The unqualified rates were compared between the donors of again blood donation after retention and reentry with the common donors by χ2 test.Results From October 2014 to June 2016,1 615 cases were ELISA single reagent reactive/NAT non-reactive,among which 67 cases were confirmed as positive,42 cases were undetermined and 1 506 cases were negative;831 cases were ELISA non-reactive/ NAT reactive,in which 809 cases were positive by confirmation and 22 cases were negative.A total of 1 528 donors were confirmed as negative and their donation qualifications were reserved,89 donors conducted blood donation again and 79 were qualified in blood detection.The unqualified rate was 11.24%,compared with that of common donors,the difference was statistically significant(P<0.001).Meanwhile,596 donors applied for reentry,among them 218 persons were weeded out by the reentry blood station.In remaining 378 samples sent to Jiangsu Provincial Blood Center,359 samples were qualified and confirmed to the reentry condition.Among them,332 donors conducted blood donation and all were qualified by blood detection.Conclusion The reentry strategy in Jiangsu Province is reasonable and feasible,but the donors retention strategy needs to be further optimized and perfected.
ABSTRACT
Salmonella is an important zoonosis.China is the largest pork consumer.Contaminated pork is the main source of Salmonella disease at home and abroad.There are many swine Salmonella vaccine in use in Europe.Now the current swine Salmonella vaccine is a live attenuated vaccine,Salmonella can reduce colonization in pigs,and can induce immune response efficiently after the two immunizations.The control effect is poor,at this stage of swine vaccine cross protection research,type of Salmonella and vaccine antigen are not the same.This paper reviews the research progress of swine Salmonella vaccine.
ABSTRACT
Objective To construct the care needs assessment index for institutional elderly. Methods A total of 30 experts were consulted by the Delphi method. The indexes were selected and identified according to the inquiry results. Results The response rates of three expert consultation rounds were 93.33％(28/30), 85.71％(24/28), and 79.17％(19/24) respectively. The authority coefficients of the three rounds were all above 0.80. The assessment index includes 4 first level indicators, 13 secondary level indicators, and 48 third level indicators. Weighting results indicated that in terms of the elderly in institutional care, the most important domain of care needs was physical function, followed by ability of activity. At the same time, psychological function and social function in the elderly cannot be ignored. Conclusions The study obtained key elements that should be included in a comprehensive care needs assessment index of the institutional elderly, which laid a solid foundation for further investigation on the formation of specific assessment tools for care needs of the elderly in institutional care.
ABSTRACT
Objective To explore the effect of a new prone position for general anesthesia.Methods 50 patients in the group were made a retrospective study:All the 50 patients needed prone position surgeries under general anesthesia.After awake flexible fiberoptic intubation,with the anesthesia of thyrocricoid puncturing the intra-trachea surface,has been taken,patients lied in the prone position according to their own comfort with the guide of medical staff,which was followed by anesthesia induction and the operation.The SBP,DBP,HR and RPP were recor-ded at different point of time after patients entered the operation room.Results 33 cases of 50 patients completed the whole process successfully and the indexes at the time of the intubation had no significant difference with those at basic state(all P >0.05).17 operations suffered discomfort.The SBP,DBP,HR and RPP in these patients were (159.2 ±25.9)mmHg,(97.2 ±11.6)mmHg,(98.2 ±9)beats per minute and (16 028 ±6 725)respectively, which were higher than those at basic state(t =2.698,2.802,5.720,8.905,all P 0.05).Conclusion It is technically simple and easy to operate,the way that patients waiting for prone position surgeries lie in the prone position by themselves with awake flexible fiberoptic intubation lightens the workload of medical staff and reduces complications of the intubation,which is optional in clinical situations.
ABSTRACT
Objective To perform a meta-analysis on the association of of genotype B/C and HBV DNA conversion of negative or HBeAg clearance to lamivudine therapy.Methods Several databases (PubMed, Web of Science, Science Direct, and CNKI Database) were searched from 1966 to 2012 for all publications on the association between genotype B/C and response to LAM therapy.The articles were selected according to the protocol previously designed.Meta analysis using Revman 5 software.Results Finally, 19 RCTs were retrieved involving 3148 patients for the subsequent meta-analysis. Among them, 10 articles (n=1860) look at HBV DNA and 9 (n=1288) at HbeAg clearance.For HBV DNA conversion of negative, the overall RR (95% CI) associated with genotype B/C was 1.07(0.98-1.17). Of the nine analyzed trials, HBeAg clearance was observed in genotype B group as compared with that genotype C group, the overall RR (95% CI) was 1.27 (0.94-1.71).Conclusion Meta-analysis indicates that genotype B/C is not associated with response to LAM therapy.Further mechanism researches are required to clarify.Large-scale population studies in multicountries are also necessary to evaluate the influence of HBV genotypes in hepatitis B progression and antiviral treatment.
ABSTRACT
Objective To explore the feasibility of the ultrasonic atomization surface anesthesia with lido-caine for awake fiberoptic endotracheal intubation in patientsˊautonomous position -display before general anesthesia and to evaluate its advantages.Methods 68 adult patients who needed prone position for elective surgery under general anesthesia were selected and randomly divided into two groups,the control group and the treatment group,each group in 34 cases.In control group patients were received surface anesthesia of cricothyroid membrane puncture.In treatment group,nebulized 2% lidocaine with ultrasonic nebulizer was used for topical anesthesia.Patients lied in the prone position according to their own comfort with the guide of the medical staff in the waking state after an awake fiberoptic endotracheal intubation.The statistics of mean arterial pressure (MAP)and heart rate (HR)were recorded respectively in the basal state(T0),in the time instantly after intubations(T1 ),in the 3 minute after intubations(T2 ) and in the time instantly after the body turning(T3 ).Choking cough response were recorded during endotracheal intubation.Patients were asked the efficacy of surface anesthesia and the tolerance for awake intubation after operation.Results Patients in both two groups completed the whole process smoothly.MAP and HR had no signifi-cant differences between the two groups in the same time point (all P >0.05).There were no statistical significance between the two groups in choking cough response,the time of surface anesthesia and intubation,neither (all P >0.05).Conclusion The surface anesthesia with lidocaine by continuous ultrasonic atomizing inhalation is a good and simple method deserving generalization with plenty merits and is practicable for patients to display position autonomously. This method have the advantages of small operation,it will and can replace cricothyroid membrane puncture.
ABSTRACT
Objective To investigate the image quality and radiation dose of 640-slice CT coronary arteriography(CTCA) with adaptive iterative dose reduction three-dimensional (AIDR3D)reconstrucction algoritym.Methods 640-slice CTCA with auto-matic exposure was performed on 84 consecutive patients.The original image data were reconstructed with AIDR3D and the filtered back-projection (FBP)algorithms at the image postprocessing workstation.Two experienced radiologists without knowing clinical information and reconstruction algorithms independently measured and calculated the image noise,signal-to-noise ratio and contrast-to-noise ratio with AIDR3D and FBP reconstruction algorithms.The qualitative image quality was assessed by using the 4-point scale.The radiation dose was calculated based on dose-length product exported on CT scanner.The quantitative and qualitative im-age quality with two kinds of reconstruction algorithm was analyzed statistically.Results The CTCA image noise was (27.20± 4.40)HU with AIDR3D and (60.00±12.40)HU with FBP,which with AIDR3D was decreased by 46.10% than that with FBP;the signal-to-noise ratio was 21.10 ± 5.10 with AIDR3D and 11.40 ± 2.80 with FBP,which with AIDR3D was increased by 84.70% than that with FBP;the contrast-to-noise ratio was 24.70±5.10 with AIDR3D and 13.50±3.20 with FBP,which with AIDR3D was raised by 82.20% than that with FBP,the differences in 3 indexes between the two kinds of reconstruction algorithm were statistically significant(P < 0.05 ).The CTCA qualitative image quality scores of proximal,middle and distal parts with AIDR3D were (3.90±0.30),(3.70±0.50)and (3.60±0.60)respectively,which all were higher than (2.60±0.60),(2.30± 0.60)and (2.10±0.70)with FBP respectively,the differences in 3 items between 2 kinds of algorithm had statistical significance (P <0.05).The total segments which could be used to diagnose the CTCA images with AIDR3D and FBP algorithms were 1 216 segments (96.50%)and 504 segments (40.00%),respectively,the difference had statistical significance(P <0.05).The mean ef-fective radiation dose was (2.10±1.00)mSv.Conclusion 640-slice CTCA with AIDR3D reconstruction algorithm not only signifi-cantly reduces the image noise than the conventional FBP algorithm,improves the quantitative and qualitative image quality,but also decreases the effective radiation dose.
ABSTRACT
<p><b>OBJECTIVE</b>To evaluate the application of low-dose CT enterography with adaptive iterative dose reduction(AIDR) technique in diagnosing Crohn's disease.</p><p><b>METHODS</b>Retrospective analysis was performed on 26 patients diagnosed as Crohn's disease by the multidisciplinary team in our hospital. Low-dose CT enterography with 640-slice MDCT was performed on these 26 patients using adaptive iterative dose reduction(AIDR) technique. Characteristics of Crohn's disease in CT enterography images were independently analyzed by two radiologists who were experienced in Crohn's disease with calculating the total radiation dosage.</p><p><b>RESULTS</b>The radiation dosage of 26 patients ranged from 5.58 to 12.90 [mean (9.00±2.00)] mSv, which was lower than conventional scan (around 15 mSv) known from the literatures. According to the images of CT enterography of 26 cases, bowel wall thickening with abnormal enhancement and lymphadenectasis were found in 25 cases with total 109 segmental bowel wall thickening. Among 25 thickening cases, enterostenosis was found in 16 cases, stratification enhancement in 12 cases and comb sign in 14 cases. Besides, it was found that 8 cases with hyperdense fat on the mesenteric side, 7 cases with intestinal fistula, 6 cases with abdominal cavity abscess, and 3 cases with anal fistula.</p><p><b>CONCLUSION</b>CT enterography of Crohn's disease with adaptive iterative dose reduction technique is an effective method to evaluate Crohn's disease without compromising image quality with reduced radiation dosage.</p>
Subject(s)
Humans , Crohn Disease , Diagnostic Imaging , Intestinal Fistula , Radiation Dosage , Rectal Fistula , Retrospective Studies , Tomography, X-Ray Computed , MethodsABSTRACT
Objective To analyze retrospectively the impact of different heart rates on image quality and radiation dose of coronary angiography using 640-slice dynamic volume CT.Methods A total of 461 patients with suspected coronary artery disease or referred to health check underwent coronary angiography with 640-slice dynamic volume CT.Two groups were created according to their heart rates:Group A had heart rate < 65 beats per minute (n=337)and Group B had heart rate between 65 to 122 beats per minute (n=124).Image quality was assessed by analyzing the 1 5 segments of the main coronary branches using 3-grade scale (grade I-good,grade Ⅱ-acceptable,grade Ⅲ-poor).Effective radiation dose was also evaluated.Results Patients in both A group and B group performed successful CT coronary angiography with a total of 6 91 5 coronary segments.Among them,coronary segments that could be evaluated reliably accounted for 94.5% (6 535/6 91 5)while 5.5% (380/6 91 5)were too small (≤1.5 mm)to be assessed. For the image quality,Group A and Group B had grade I in 90.5% (305/337)vs 74.2% (92 /124),grade Ⅱ in 9.5% (32/337)vs 21.0% (26 / 124)and grade Ⅲ in 0 % (0 / 337 )vs 4.8% (6 / 124),respectively.Image quality was significantly different be-tween Group A and Group B (P <0.001).In addition,32 patients (9.5%)in Group A had slight cardiac motion artifacts but with-out affecting image quality,whereas 26 patients (21.0%)in Group B had higher degree of cardiac motion artifacts thus graded as grade Ⅱ.Stair-step artifacts were not found in all patients.The effective radiation dose was higher in Group B than in Group A by 32.05%(7.91±0.34 mSv vs 5.99±0.17 mSv).Conclusion Coronary angiography using 640-slice dynamic volume CT can guarantee excellent image quality when heart rate < 65 beats per minute.Although the image quality would decrease in some extent it is still diagnostic when heart rate is between 65 to 122(include 65 and 122)beats per minute.
ABSTRACT
Objective To evaluate the role of spinal sigma-1 receptors in the maintenance of bone cancer pain (BCP) in rats and the relationship with extracellular signal-regulated kinase (ERK).Methods Part Ⅰ Twenty-four female Sprague-Dawley rats,weighing 180-220 g,were randomized into 2 groups using a random number table:sham operation group (S group,n =4) and BCP group (n =20).BCP was induced by inoculating Walker 256 mammary gland carcinoma cells into the medullary cavity of the right tibia.Four rats were sacrificed on day 10 after inoculation in S group or on day 3,5,7,10 and 14 after inoculation in BCP group,and the L4-6 segments of the spinal cord were removed to measure the expression of sigma-1 receptors by Western blot.Part Ⅱ Forty female Sprague-Dawley rats,weighing 180-220 g,were randomized into 4 groups (n =10 each) using a random number table:sham operation group (S group),sigma-1 receptor inhibitor BD1047 group (BD group),BCP group,and BCP + BD1047 group (BCP + BD group).On day 10 to 14 after inoculation,normal saline 20 μl was injected intrathecally once a day in S and BCP groups,or BD1047 120 nmol/20μl was injected intrathecally once a day in BD and BCP + BD groups.Mechanical paw withdrawal threshold (MWT) to yon Frey filament stimulation was measured one day before inoculation,on day 3,5 and 7 after inoculation,and on day 10,12 and 14 after administration.After measurement of MWT on day 14 after inoculation,the rats were sacrificed and the L4-6 segments of the spinal cord were removed to determine the expression of phosphorylated ERK (p-ERK) by Western blot.Results Part Ⅰ Compared with group S,the expression of sigma-1 was significantly up-regulated and peaked on day 10 after operation in group BCP.Part Ⅱ Compared with S group,no significant changes were found in MWT and p-ERK expression at each time point in BD group,and MWT was decreased and p-ERK expression was up-regulated in BCP and BCP + BD groups.Compared with group BCP,after intrathecal injection of BD1047,MWT was significantly increased and the expression of p-ERK was down-regulated in BCP + BD group.Conclusion Spinal sigma-1 receptors are involved in the maintenance of BCP in rats possibly through promoting phosphorylation of ERK.
ABSTRACT
Objective To investigate the clinicopathologic features and prognosis of secretory carcinoma of the breast (SCB).Methods We enrolled 43 cases of secretory carcinoma of the breast out of invasive breast cancer patients according to the 2012 WHO Classification of Tumors of the Breast.Results The incidence of breast SCB was low,accounting for about 0.17％ of all breast cancer patients.The median age of onset was 49 years old.The diameter of tumor was 1.0-10.0 cm(mean size 3.2 cm).Pathology revealed large number of eosinophilic secretory material inside or outside the cancer cells positive for periodic acid-Schiff stains (PAS) and Alcian blue (AB).The positive rate of estrogen receptor (ER) was 34.9％ (15/43),progesterone receptor (PR) was 23.3％ (10/43),human epithelial growth factor receptor 2 (HER-2) was 25.6％ (11/43),S-100 was 97.7％ (42/43),and special PAS and AB diastase were tested and positive in 8 cases.The postoperative average follow-up time was 78 months,7 cases were found with distant metastasis.2 cases dying of distant metastasis.Conclusions SCB has a good prognosis despite of occasionally axillary lymph node metastasis,local recurrence or distant metastasis.
ABSTRACT
Objective To investigate the clinical performance of fiber post restorations in elderly patients with residual root and crown and to analyze the factors affecting the clinical success rate.Methods A total of 66 elderly patients requiring post restoration were selected.They were randomly divided into two groups:the observation group (n=33,restored with fiber post-resin cores) and the control group (n=33,restored with cast metal post-cores).All patients were rechecked 1 year and 2years after the restoration.The clinical efficacy and the failure types were recorded.The differences in clinical performance between the 2 groups were compared by using Fisher's exact test.Results The differences in the gingival index and periodontal index in the 2 groups between the experimental teeth and the control teeth were zero.There were no significant differences in dental morphology,root canal treatment failure,tooth color matching and marginal coloration between the 2 groups (all P＞0.05).1 case with post debonding and 1 case with fiber post fracture were found in the observation group and 1 case with marginal coloration was found in control group.There was no significant difference in clinical success rate between the 2 groups (93.94％ vs.96.97％,P＞0.05).Conclusions The clinical success rate in fiber post-resin core restoration is the same as in cast metal post-cores restoration in elderly patients.