ABSTRACT
Objective To investigate the efficacy of combination of reattribution cognitive psychotherapy and low-dose antidepressants in the treatment of ulcerative colitis (UC) complicated with functional symptoms , and to explore the psychosomatic digestive disease pattern that incorporated psychosocial variables into clinical thinking and practice .Methods From March 2016 to April 2017 ,sixty patients with UC who met the admission criteria were randomly divided into control group and observation group with 30 patients in each group .Both groups were treated with oral mesalazine ,and the observation group was further treated with reattribution cognitive psychotherapy and antidepressants . Clinical symptoms ,self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were applied to assess the efficacy at the time of enrollment and four weeks after treatment in both groups .Chi square test or t test was performed for statistical analysis .Results Among the 60 patients ,47 (78 .3％ ) met four syndromes of diagnostic criteria for phychosomatic research , and there was no statistically significant difference in the case number of each syndrome between the two groups (P> 0 .05) .After four weeks treatment ,the total effective rates of observation group and control group was 93 .3％ (28/30 ) and 53 .3％ (16/30) ,respectively ,and the difference was statistically significant (χ2 = 22 .667 ,P< 0 .05) . Before and four weeks after treatment , the SAS scores of observation group were 54 .50 ± 6 .70 and 41 .07 ± 3 .72 ,respectively ,and the difference was statistically significant (t=9 .595 ,P= 0 .005) .The SAS scores of control group were 54 .30 ± 6 .06 and 51 .90 ± 7 .92 ,respectively ,and the difference was not statistically significant (P=0 .195) .Before and four weeks after treatment ,the SDS scores of observation group were 50 .63 ± 6 .29 and 34 .40 ± 4 .58 ,respectively ,and the difference was statistically significant (t=11 .426 ,P=0 .025) .The SDS scores of control group were 50 .03 ± 6 .02 and 43 .47 ± 6 .81 ,respectively , and the difference was not statistically significant ( P= 0 .307 ) . Conclusions Psychosomatic model can significantly improve the functional symptoms complicated with UC .It is meaningful to incorporate psychosocial variables into clinical thinking and practice in psychosomatic digestive disease pattern .
ABSTRACT
Objective To investigate the clinical value of multiple-slice spiral CT (MSCT) in identifying apical hypertrophic cardiomyopathy (AHCM) with giant negative T wave.Methods Sixteen patients with AHCM and giant negative T wave (AHCM group) underwent MSCT,electrocardiogram,echocardiography,coronary angiography and left ventriculography.Thirty patients without myocardial hypertrophy were enrolled as control group.Measurement results of two groups were compared.Results MSCT confirmed all patients with AHCM,but echocardiography missed 10 patients.In the end of diastole phase,left ventricular apical thickness (LVA) was (21.3 ± 3.6) mm and LVA/left ventricular posterior wall thickness (LVPW) was 2.2 ± 0.4 in AHCM group,which was (8.5 ± 1.6) mm and 0.9 ± 0.2 in control group.The level of LVA and LVA/LVPW in AHCM group were significantly higher than those in control group (P ＜0.01).Conclusion MSCT is a accurately diagnostic modality for AHCM with giant negative T wave,and the cardiac anatomy,function and coronary artery are also assessed simultaneously.
ABSTRACT
Objective To explore the feasibility of dual-source CT coronary angiography (CTCA) using 80 kV tube voltage setting in patients with low body mass index (BMI).Methods A total of 240 patients with suspected coronary artery disease (BMI range 18.6-21.5 kg/m2) underwent dual-source CTCA.They were randomly assigned to group A (120 kV tube voltage),B (100 kV tube voltage) and C (80 kV tube voltage) based on a random number table.The contrast media dose,volume CT dose index (CTDIvol),dose length product (DLP),and effective dose (ED) were evaluated for each patient.Image noise,CT value,contrast,signal-to-noise ratio (SNR),contrast-to-noise ratio (CNR) and figure of merit (FOM) of coronary artery were all evaluated.Tie image quality of coronary artery was assessed with a threepoint scale (3 points:excellent,2 points:general,1 point:poor).Scan length,CTDIvol,DLP,ED,and contrast media dose for patients,image noise,CT value,contrast,SNR,CNR,and FOM of coronary artery were all analyzed using one-way ANOV4 analysis for 3 groups.Time windows of ECG-pulsing protocol were analyzed using x2 test,and the image quality scores of coronary artery were analyzed using Kruskal-Wallis test.Results There were no differences in scan length and Time windows of ECG-pulsing protocol among 3 groups (scan length F =2.58,P ＞ 0.05,Time windows of ECG-pulsing protocol x2 =0.77,P ＞ 0.05).The average contrast media doses were (82.0 ± 6.4),(76.8 ± 6.1),and (59.1 ± 3.5) ml,the average CTDIvol were(27.5 ±6.2),(18.7 ±4.4),and(11.4 ±2.4)mGy,the average DLPs were (427.7 ±92.4),(295.4 ± 77.1),and (183.9 ± 41.3) mGy · cm,and the average EDs were (6.1 ± 1.3),(4.1 ± 1.1),and (2.6 ± 0.6) msy for group A,B and C,respectively.There were statistical differences in contrast media dose,CTDIvoI,DLP,and ED among 3 groups (the F values for contrast media dose,CTDIvol,DLP,and ED were 383.08,248.13,221.05,and 234.81,respectively,all P ＜0.01).Compared to group A and B,the contrast media dose in group C decreased 27.9％ and 23.0％,and the ED decreased 57.4％ and 36.6％,respectively.The average image noise was (22.6 ±2.2),(26.1 ±3.0),and(29.1 ±3.4)HU for group A,B and C,respectively,and there was statistical difference in image noise among 3 groups (F=101.32,P ＜0.01).The average CT value,contrast,SNR,CNR and FOM were (438.3 ± 66.3)HU,(517.3 ± 67.8)HU,19.5 ±2.8,23.0 ±3.0,and 92.9 ± 31.0 in proximal RCA and (440.2 ±59.9) HU,(509.5 ± 62.6) HU,19.6 ±2.6,22.7 ±2.9,and 90.1 ±29.7 in LMA for group A,(534.2 ± 68.8) HU,(628.9 ±70.0) HU,20.7 ± 3.2,24.3 ± 3.6,and 157.6 ± 59.8 in proximal RCA and (528.4 ± 61.2) HU,(607.9 ± 71.2) HU,20.4±3.0,23.5 ±3.4,and 147.6 ±57.6 in LMA for group B,and (602.1 ±78.8)HU,(696.8 ±83.3) HU,20.8 ± 2.9,24.1 ± 3.2,and 239.3 ± 74.8 in proximal RCA and (592.5 ± 72.3) HU,(671.8 ±82.5) HU,20.5 ± 2.5,23.2 ± 3.0,and 221.8 ± 65.7 in LMA for group C,respectively.The CT value,contrast,SNR,CNR and FOM of coronary artery for group C did not decrease (the F values for CT value,contrast,SNR,CNR and FOM were 106.06,119.90,4.69,3.70,and 127.50 in proximal RCA,and 111.79,101.57,2.68,1.39,and 123.00 in LMA,and the P values were ＜0.01,＜0.01,＜0.05,＜0.05,and ＜0.01,in proximal RCA,and ＜0.01,＜0.01,＞0.05,＞0.05,and ＜0.01,in LMA,respectively).Image quality was rated as excellent,general and bad for 631,330,and 37 segments in group A,640,323,and 41 segments in group B,and 615,348,and 45 segments in group C,respectively,there was no significant difference in image quality scores among 3 groups (x2 =1.90,P ＞ 0.05).Conclusion For the patient with BMI≤21.5 kg/m2,dual-source CTCA with 80 kV tube voltage setting can be used to diagnose coronary artery disease and the contrast media lose and radiation dosage can be reduced obviously.
ABSTRACT
ObjectiveTo investigate the feasibility of decreasing radiation dose and contrast media dose of abdominal CTA using low tube voltage setting combined with personalized contrast media application.MethodsOne hundred and twenty patients were randomly divided into 3 groups,and there were 40 patients in each group.120 kV tube voltage was used in group A,and 100 kV tube voltage was used in group B and C.Personalized injection flow rate of contrast media which determined according to patient's body mass (injection flow rate =λ × body mass) was used for all groups,and the λ values for group A,B and C were 0.07,0.07 and 0.06 ml · kg-1· s- 1 respectively. CT dose index volume ( CTDIvol ) effective dose(ED) and contrast media dose were evaluated,and these parameters were all analyzed using one-way ANOVA analysis.Image quality of abdominal aorta and branch arteries was rated using a three-point ordinal for all 3 groups,and image quality score was analyzed using Kruskal-Wallis test.ResultsCTDIvol were (8.2±0.8),(6.0 ±1.0) and (6.1 ±1.1)mGy for group A,B and C,ED were (5.2 ±0.8),(3.5 ± 0.7) and ( 3.6 ± 0.6) mSv,and contrast media dose were (72.3 ± 10.3 ),(73.5 ± 11.3 ) and (61.6 ±9.4) ml,respectively.There were significant differences in CTDlvol,ED and contrast media dose among 3 groups ( F =66.094,77.812,15.919 ; P =0.000).Compare with group A,the ED of group B was decreased 32.7％,and the ED and contrast media dose of group C were decreased 30.8％ and 14.8％,respectively.Image quality was rated as excellent,good,and general for 20,19 and 1 patients in group A,25,15 and 0 patients in group B,and 23,17 and 0 patients in group C,respectively.There was no significant difference in image quality score among 3 groups ( x2 =1.492,P =0.474 ).ConclusionsThe radiation dose and contrast media dose can be decreased in abdominal CTA using low tube voltage and personalized contrast media apolication while image quality can be preserved.
ABSTRACT
Objective To evaluate the value of reducing radiation dose with decreased size of ECG-pulsing windows and influence on image quality in dual-source CT coronary angiography. Methods 120 patients with stable heart rate(HR) were divided into four groups according to HR and the rang of ECG-pulsing windows in dual-source CT coronary angiography: HR ＜ 70 bpm and 61% ～ 77% R-R interval of ECG-pulsing windows, HR ＜ 70 bpm and 25% ～ 80% R-R interval of ECG-pulsing windows,HR ＞ 80 bpm and 31% ～47% R-R interval of ECG-pulsing windows, and HR ＞ 80 bpm and 25% ～ 80%R-R interval of ECG-pulsing windows was employed, respectively. The radiation dose parameters were recorded and image quality scores were performed. The image quality and radiation dose between two slow HR groups and between two fast HR groups were compared respectively. Result The effective doses were (7.06 ± 2. 13 ), ( 11.34 ± 3.65 ), ( 6. 67 ± 1.97 ) and ( 9. 92 ± 3. 15 ) mSy for four groups, respectively.The effective dose was decreased by 37.74% for slow HR and by 32. 76% for fast HR using narrow ECG-pulsing windows. There was no difference on image quality between two slow HR groups and two fast HR grouvs. Concluslons The proper application of narrow ECG-pulsing windows can reduce radiation exposure significantly to stable slow or fast HR patients in dual-source CT coronary angiography withont sacrificing the image quality.
ABSTRACT
Objective To investigate clinical effect of reattribution-cognitive-pharmacy model (RCPM) in the treatment for irritable bowel syndrome(IBS). Methods 125 subjects with diarrhea predominant irritable bowel syndrome (IBS-D) were divided into two groups randomly. 62 patients in group A were treated with 10 ～ 20 mg of paroxetine without any other medication or psychological interview and 63 patients in group B received RCPM with interviewing once a week for 6 sessions and took 10 ～ 20 mg of paroxetine in the same way as group A after a week. The effect was evaluated at the end of 4 weeks and 12 weeks by a questionnaire. Results At the end of 4 weeks,29 patients in group A reported a reduction in abdominal pain,and 28 reported a reduction in stool frequency ,and 12 patients stopped taking paroxetine because of worrying about those side effect . In group B 48 reported a reduction in abdominal pain ,and 42 reported a reduction in stool frequency ,and 3 patients stopped taking paroxetine. At the end of 12 weeks,36 patients in group A reported a reduction in abdominal pain ,and 30 reported a reduction in stool frequency,and 14 patients stopped taking paroxetine because of worry about those side effect. In group B,54 cases reported a reduction in abdominal pain,and 45 reported a reduction in stool frequency,and 5 patients stopped taking paroxetine because of no obvious improvement. Conclusion RCPM can alleviate the abdominal pain and bowl movement frequency of IBS-D,and it seems better than paroxetine treatment alone. RCPM can improve compliance of paroxetine in patients with IBS-D.