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Objective:To evaluate the feasibility of brain injury after cardiopulmonary resuscitation (CPR) in rats based on T2WI image texture analysis.Methods:Eighteen SD rats were randomly divided into the sham group ( n=8) and model group ( n=10). The rats in the model group underwent MRI scanning at 6 h after return of spontaneous circulation (ROSC), and the rats in the sham group received MRI scanning at 6 h after the operation. The differences in the texture features of T2WI images and the expressions of AQP4 and NSE between the two groups were analyzed. The receiver operating characteristic curve (ROC) was used to evaluate the diagnostic efficacy of statistically different texture features between the two groups for brain injury. The associations between texture features and AQP4 and NSE expressions in the sham group and model group were analyzed using Spearman correlation coefficients. Results:The minimum intensity, standard deviation, and inverse difference moment of the whole brain T2WI texture features of the model group were significantly lower than those of the sham group ( P<0.05), while the difference entropy and characteristics of high gray in homogeneity were significantly higher than those of the sham group ( P<0.05). The difference entropy was the best with an area under curve (AUC) of 0.922, a sensitivity of 100% and a specificity of 75%. The AQP4 and NSE expressions in the model group were significantly higher than those in the sham group ( P<0.05). The minimum intensity value was positively correlated with AQP4 and NSE expressions ( r=0.501, 0.568, P=0.048, 0.022). The standard deviation was positively correlated with AQP4 and NSE expressions ( r=0.620, 0.530, P=0.010, 0.035). The difference entropy was negatively correlated with AQP4 expression ( r=-0.535, P=0.033). Conclusions:Texture analysis on T2WI images can evaluate the degree of brain edema and neuronal damage. The minimum intensity, standard deviation, and difference entropy are sensitive indicators to evaluate brain injury after CPR, and difference entropy has the highest sensitivity and specificity.
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Objective: To investigate the impact of intravertebral cleft on adjacent vertebral fracture (AVF) after percutaneous vertebral augmentation. Methods: Data of 172 patients with osteoporotic vertebral compression fracture (OVCF) who underwent percutaneous vertebral augmentation were retrospectively analyzed. The patients were divided into intravertebral cleft group (n=37) and control group (n=135) according to the presence or absence of intravertebral cleft before operation. The operative information and postoperative imaging characteristics were compared between 2 groups, and the impact of intravertebral cleft on AVF was analyzed. Results: The incidence of AVF after vertebral augmentation in intravertebral cleft group (54.55%, 24/44) was significantly higher than that in control group (23.21%, 39/168, χ2=16.39,P50% (75.00%) was significantly higher than in those ≤50% (42.86%, χ2=4.24, P=0.04), but there was no statistical difference of the incidence of AVF among different fracture locations nor components (χ2=2.13, 0.27, both P>0.05). Conclusion: OVCF patients with intravertebral cleft are at increased risk of recurrence AVF after percutaneous vertebral augmentation, especially those with higher anterior wall height decreased ratio, postoperative bone cement mass distribution and bone cement-bone surface fluid signs and being required close follow-up observation.
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Objective To assess the value of preoperative MRI in predicting the incidence of cement leakage into adjacent discs during percutaneous vertebral augmentation (PVA) for osteoporotic vertebral compression fracture (OVCF).Methods Clinical and radiological characteristics of 127 patients who were treated with PVA for OVCF were analyzed retrospec tively.The following clinical data of these patients were analyzed,including gender,age,location of treated vertebral body and surgical approach.The image features of endplate injury,fracture line extended to the endplate,adjacent intervertebral dick injury and intravertebral cleft were evaluated on the preoperative MRI.The incidence of cement leakage into the adjacent disc were compared for the above factors with statistical methods.Results Totally 127 patients were enrolled in our study,including 179 treated vertebral bodies,358 endplates and 341 adjacent intervertebral discs.The incidence of intradiscal cement leakage was 57.73％ (56/97) in endplate injury sign,60.98％ (25/41) in fracture line extended to endplate sign,35.91％(51/142) in adjacent discs injury sign and 55.56％(20/36) inintravertebral cleft sign.The differences were statistically significant on preoperative MRI in patients with the above signs compared to those who had not (P＜0.05).The incidence of intradiscal cement leakage in percutaneous kyphoplasty (PKP) and percutaneous vertebroplasty (PVP) were 26.67％(16/60) and 42.86％(51/119),respectively,which was significant different (P=0.035).For bone cement volume ≤ 5 ml vertebral bodies,the incidence of intradiscal cement leakage was 31.19 ％ (34/109),lower than bone cement volume ＞ 5 ml vertebral bodies (47.14％ [33/70],P=0.031).There was no statistically significant association between intradiscal cement leakage and age,gender and location of treated vertebral body (P＞0.05).Conclusion Preoperative MRI can predict the leakage of bone cement into adjacent discs effectively during PVA.The PKP and the lower volume of bone cement injection can reduce the risk of intradiscal cement leakage.
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Peace Ark Hospital Ship of China and Mercy Hospital Ship of U.S.had their current statuses introduced,and then were compared from the aspects of technical parameter,personnel allocation,running mode and etc.The advantages of Mercy Hospital Ship were described in safety,details and rationality.It's pointed out the hospital ship in China minimize cost of medical resources,optimize medical treatment and nursing as well as maximize medical efficacy.
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This article introduced the peritoneal dialysis nursing model of Home Dialysis Unit in the affiliated hospital of Colorado University,including:overall status,setting and distribution,responsibilities of staff,work model of PD (pre-dialysis education,catheter insertion,CAPD/CCPD training,clinic visit model,home visit model,etc),and explored the enlightenment of this model on PD nursing in our country.This model provided references for dialysis center distribution,staff arrangement,pre-dialysis education,home visit,increase of social support and so on.