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Objective:To investigate the feasibility of reducing the radiation dose on coronary artery calcium score (CS) of virtual non-contrast (VNC) scanning in dual-layer spectral coronary CT angiography(CCTA).Methods:One hundred and twenty-two patients were examined on a dual-layer spectral detector CT scanner from March 2019 to August 2020. Volume CT dose index (CTDI vol), dose length product (DLP), effective dose ( E) were all evaluated for each patient. CS was calculated from both true non-contrast (TNC) and VNC images for left anterior descending (LAD), left circumflex (LCx), right coronary artery (RCA), and the total coronary artery (Total) by two radiologists independently. Pearson′s correlation coefficient was calculated for measuring the association between variables. The correction coefficients of each branch (λ LAD, λ LCx, and λ RCA) and the average correction coefficient (λ AVG) of the total coronary artery were obtained. The calibrated calcium score (CCS_VNC) was equal to λ multiplied by CS_VNC. The CS_TNC and CCS_VNC were compared using repeated oneway analysis of variance test. Correlation analyses for CS_TNC and CCS_VNC and agreement evaluation with Bland-Altman-Plots were performed. Results:The average effective doses in TNC, CCTA and total group were 0.69, 6.47 and 7.16 mSv, respectively. The effective dose was reduced by 10.6% and the scan time was reduced by 39% while using VNC images. There were significant differences among the CS_TNC and CS_VNC of LAD, LCx, RCA and Total ( t=6.75, 5.33, 4.99, 6.60, P< 0.05). Excellent correlations were observed between CS_VNC and CS_TNC ( R2 values were 0.929, 0.896, 0.958, and 0.918; λ values were 2.18, 1.18, 2.15, and 2.07, respectively). There were no significant statistically difference among the CS_TNC, CCS_VNC AVG, and CCS_VNC LAD/RCA of the LAD and RCA (all P> 0.05). The difference was statistically significant among the CS_TNC, CCS_VNC AVG, and CCS_VNC LCx of the LCx ( F=10.94, P<0.05). The paired comparison were performed in groups and the differences were statistically significant between the CS_TNC versus CCS_VNC AVGand CCS_VNC AVG versus CCS_VNC LCx ( t=3.31, 3.43, all P<0.05). There was no significant statistically difference between the CCS_VNC LCx and CCS_VNC AVG( P>0.05). Conclusions:It was feasible to accurately evaluate the CS_VNC from spectral data in comparison to TNC imaging, and to reduce the patient radiation dose and acquisition time.
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Objective@#To investigate the clinical prognostic value of peripheral blood albumin and fibrinogen levels in advanced non-small cell lung cancer (NSCLC).@*Methods@#A total of 158 patients with advanced NSCLC who were admitted to Chest Hospital District of the Affiliated Brain Hospital of Nanjing Medical University from May 2010 to September 2015 were retrospectively analyzed. All patients received systemic chemotherapy plus or not local radiotherapy. The clinicopathological characteristics of patients and the results of peripheral serum protein and fibrinogen were collected, and the correlation between peripheral serum protein and fibrinogen levels and prognosis was analyzed.@*Results@#The median level of serum albumin and plasma fibrinogen was 40.8 g/L (27.6-46.9 g/L) and 3.4 g (2.4-5.2 g/L), respectively, and the median serum albumin and fibrinogen ratio (AFR) was 12.1 (6.2-17.0). The median overall survival (OS) time in the increased serum albumin group (≥40 g/L) and the decreased serum albumin group (<40 g/L) was 17.0 and 9.0 months, respectively, and the median OS time in the increased plasma fibrinogen group (≥40 g/L) and the decreased plasma fibrinogen group (<40 g/L) was 9.0 and 17.0 months, respectively. The median OS time in the increased AFR group (≥10) and decreased AFR group (<10) was 17.0 and 8.0 months, respectively, and there were significant differences between two groups (all P < 0.01). Multivariate analysis showed that serum albumin level (HR = 1.58, 95% CI 1.20-2.06, P = 0.003), plasma fibrinogen level (HR = 1.43, 95% CI 1.01-2.03, P = 0.046) and AFR (HR = 1.81, 95% CI 1.22-2.62, P = 0.001) were independent prognostic factors of OS.@*Conclusions@#In patients with advanced NSCLC, higher albumin level and/or lower fibrinogen level are associated with better clinical prognosis. Peripheral serum albumin, fibrinogen level and AFR are independent prognostic factors for advanced NSCLC.
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Objective To investigate a new technique for small wound repairs on the faces.Methods 71 skin lesions of 42 patients were selected in the study and removed with ring-cutting drills.The new formed small wounds were treated with nature repair technique under the help of bFGF and hyaluronic acid (HA).The bFGF and HA were applied on the wounds 3 times a day until the wounds were healed completely.The early and long-term healing effects were estimated.Results The wounds were all cured with very small scars.The wounds were healed within 15 days for the size of 7 mm × 7 mmand25 days for the size of 15 mm × 15 mm.63 lesion spots from 35 patients were followed up 12 months later.Compared with original skin lesion,the small scar contracted about 50％in size with flat appearance and similar skin color.Conclusions The tissue regeneration and nature repair technique is an ideal surgical procedure for small wounds on the faces with good appearance in quality and aesthetics.
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Drug eluting stents (DESs) have revolutionized the interventional cardiology over the past decade since the first DES became commercially available in Europe in 2002. Compared to bare metal stents that are deployed to keep the vessel open by mechanical force, DESs have an additional function of reducing restenosis by the action of the drug on the target site. Coatings on the stent surface which ensure the maximum delivery of therapeutic agents to the target site with minimal systematic toxicity, also play an important role in adjusting the drug release profile. Coating material and technology not only affect the surface biocompatibility and the integrity maintenance during the implanting process, but also decide the way of drug delivering and transmitting from the coating. This paper reviews the basic principles of DES coating design, the categories of DES coatings, the commonly used clinical DES coatings and their efficiency in reducing restenosis, and finally provides the future perspectives for DES coatings.
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<p><b>BACKGROUND</b>To analysis and evaluate the efficacy of I-131 labeled chimeric TNT antibody ( ¹³¹I-chTNT MAb) targeting therapy in advanced lung cancer, and then choose the best way of administration.</p><p><b>METHODS</b>Forty-three patients with advanced lung cancer were treated by 3 different protocols using ¹³¹I-chTNT MAb. Their diagnosis was confirmed by histology and there were 30 cases in stage IIIB and 13 cases in stage IV, 32 cases were newly diagnosed and 11 cases were retreated. All patients were divided into three groups and treated with different methods: (1)iv infusion (n=22); (2) intratumoral injection (n=16); and (3) combination iv (25% of total dosage) and intratumoral (75%) infusion (n=5). All patients received radiolabeled MAb at a total dosage of 2.96×10⁷ Bq/kg on days 1 and 14.</p><p><b>RESULTS</b>There were 2 complete response (4.7%), and 11 partial response (25.6%), the total response rate was 30.2% (13/43) in all patients. For those patients receiving iv injection alone, the response rate was 9.1%. For those patients receiving intratumoral injection alone, the response rate was 56.3%. There was significant difference between them (P < 0.01 ). The main toxicity was reversible bone marrow suppression, 2 cases (4.7%) with grade III leukopenia and 3 cases (7.0%) grade III thrombocytopenia.</p><p><b>CONCLUSIONS</b>¹³¹I-chTNT has significant therapeutic effects on advanced lung cancer and the intratumoral injection is the best way of administration.</p>