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【Objective】 To investigate the value of deep learning image reconstruction (DLIR) in improving image quality and reducing beam-hardening artifacts of low-dose abdominal CT. 【Methods】 For this study we prospectively enrolled 26 patients (14 males and 12 females, mean age of 60.35±10.89 years old) who underwent CT urography between October 2019 and June 2020. All the patients underwent conventional-dose unenhanced CT and contrast-enhanced CT in the portal venous phase (noise index of 10; volume computed tomographic dose index: 9.61 mGy) and low-dose CT in the excretory phase(noise index of 23; volume computed tomographic dose index: 2.95 mGy). CT images in the excretory phase were reconstructed using four algorithms: ASiR-V 50%, DLIR-L, DLIR-M, and DLIR-H. Repeated measures ANOVA and Kruskal-Wallis H test were used to compare the quantitative (skewness, noise, SNR, CNR) and qualitative (image quality, noise, beam-hardening artifacts) values among the four image groups. Post hoc comparisons were performed using Bonferroni test. 【Results】 In either quantitative or qualitative evaluation, the SNR, CNR, overall image quality score, and noise of DLIR images were similar or better than ASiR-V 50%. In addition, the SNR, CNR, and overall image quality scores increased as the DLIR weight increased, while the noise decreased. There was no statistically significant difference in the distortion artifacts (P=0.776) and contrast-induced beam-hardening artifacts (P=0.881) scores among these groups. 【Conclusion】 Compared with the ASiR-V 50% algorithm, DLIR algorithm, especially DLIR-M and DLIR-H, can significantly improve the image quality of low-dose abdominal CT, but has limitations in reducing contrast-induced beam-hardening artifacts.
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【Objective】 To evaluate the effect of one-beat acquisition with wide detector CT on the image quality and diagnostic efficiency of coronary CT angiography (CCTA) in patients with atrial fibrillation. 【Methods】 A total of 52 consecutive patients with atrial fibrillation, including 31 males, (67.32±11.45) years old, who underwent CCTA from July 2022 to February 2023, were analyzed retrospectively. All patients underwent one-beat acquisition CCTA. The subjective and objective image quality of the coronary arteries was evaluated, and using invasive coronary catheter angiography as the gold standard, the diagnostic efficacy of stenosis degrees above moderate and severe degrees was calculated, respectively. 【Results】 Subjective evaluation results: 92.31% (384/416) of the vascular segments were rated as excellent or good, and the diagnosable rate reached 98.08% (408/416, subjective score ≥3 points). Objective evaluation results: The CT value of the right coronary artery, anterior descending branch, and circumflex branch was (433.41±95.17)HU, (422.69±92.81)HU and (420.27±95.43)HU, respectively; the contrast-to-noise ratio was 38.46±7.54, 32.46±13.78 and 37.74±8.89, respectively. The total diagnostic accuracy, sensitivity, and specificity was 94.71%, 87.9% and 96.62%, respectively, for moderate stenosis and 96.15%, 83.64% and 98.06% for severe stenosis. 【Conclusion】 One-beat acquisition with wide detector CT can obtain high-quality coronary artery images and high diagnostic accuracy for patients with atrial fibrillation without radiation dose increase to patients. It has good clinical application value for patients with atrial fibrillation.
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Objective:To investigate the mid-term clinical outcomes of selective column arthrodesis based on the three-column theory in the treatment of malunion of Lisfranc injury.Methods:The 28 patients with malunion of Lisfranc injury were analyzed retrospectively who had been treated by selective column arthrodesis at Department of Orthopedic Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine from January 2011 to January 2020.They were 18 males and 10 females, with an average age of 37.2 years(from 18 to 65 years). Twelve left and 16 right sides were affected. According to Myerson's three-column classification, one case was medial column injury (type A), 4 ones middle column injury (type B), 7 ones medial plus middle columns injury and 16 ones three-column injury. Medial column arthrodesis was conducted in 7, middle column arthrodesis in 4 and medial plus middle columns arthrodesis in 17. The American Orthopaedic Foot and Ankle Society (AOFAS) midfoot score and visual analogue scale (VAS) were compared between preoperation and the last follow-up to evaluate the improvements in foot function and pain. The operation-related complications were recorded.Results:All patients were followed up for an average of 35.6 months (from 18 to 60 months). The AOFAS midfoot score increased from 43.1±4.1 at pre-operation to 84.1± 7.4 at the last follow-up and the VAS score decreased from 5.7±1.3 at pre-operation to 2.0±0.9 at the last follow-up (both P<0.001). The wounds healed in 28 patients, 3 of whom had postoperative wound exudation but responded to dressing change. There were no such complications as injury to the deep peroneal nerve or deep venous thrombosis. The internal fixation was removed in 5 patients at about one year after arthrodesis. Conclusion:Selective column arthrodesis based on the three-column theory can result in satisfactory med-term clinical outcomes in the treatment of malunion of Lisfranc injury.
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With the emergence of ultrafast MR sequences,fetus MRI has been greatly improved.Because of its excellent detailed visualization and large view on soft tissue,MRI has more advantages in diagnosing fetal congenital brain malformation than ultrasound.Therefore,MRI has become an important examination method for prenatal screening and has a broad application prospect.This article reviews the safety,indications,scanning sequence, clinical application and precautions of fetal craniocerebral magnetic resonance.
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Objective: To investigate the influence of autophagy on sensitivity to the chemotherapy drug cisplatin (DDP) and the role of PI3K in autophagy. Methods: MTT methods and flow cytometer, with rapamycin up-regulating the autophagy and 3-MA down-regulating the autophagy, were employed to measure the proliferation inhibition rate on DDP-treated osteosarcoma cells and the change in cell cycle. The expression of intracellular protein was detected by Western blot. The autophagy of MG63 cell was observed using fluorescence microscope and transmission electron microscope. Results: Western blot showed that basic autophagy level of MG63 cell was significantly lower than that of hFOB cell. MTT test revealed that the cell proliferation inhibition rate in the group treated with rapamycin and DDP, group treated with 3-MA and DDP, and group only treated with DDP was significantly different. It was demonstrated by the flow cytometry that in group treated with DDP, inhibition on autophagy can increase the cell numbers in G
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Objective To explore the changes of gut microbiota in response to abdominal and pelvic radiotherapy and its potential relationship with intestinal infection.Methods Irradiation was delivered to the abdominal region of BALB/c mice,following the regular human pelvic-radiotherapy protocol,2.0 Gy/d,continuous 5 d/week.Samples of ileum tissue and the intestinal content were collected at different time points of irradiation procedure,including after 3 and 5 weeks,and at 1 week after 6 weeks of irradiation.Quantitative RT-PCR was used to measure the mRNA level of antimicrobial peptides and pro-inflammtory factors.Bacterial translocation was determined by PCR.The gut microbiota was characterized by the denaturing gradient electrophoresis assay.Results The expressions of cryptdin-1 and cryptdin-4 were decreased after 3 weeks of irradiation and at 1 week after 6 weeks of irradiation(t =-7.43,-3.54,-4.72,-4.27,P ＜ 0.05),while they were significantly increased at the 5 weeks of radiation (t =6.15,5.75,P ＜ 0.05).The diversity index and richness of gut microbiota after 3 or 5 weeks irradiation were significantly decreased (t =-3.49,-4.19,-3.44,-4.97,P ＜ 0.05).The gut microbiota dysbiosis of the irradiated mice was characterized with the decrease of probiotics of Lactobacillus and the increasing of opportunistic pathogen of Escherichia coli,Shigella flexneri,et al.Bacterial translocation episodes were more frequently in the irradiated mice than that of control animal.The mRNA levels of IL-1β、IL-6 and TNF-α were significantly increased after 3 or 5 weeks of irradiation (t =4.85,6.16,7.71,4.60,4.86,5.97,P ＜ 0.05).Compared with the control,the expression levels of IL-1β and TNF-α at the 1 week after 6 weeks of irradiation ending was also obviously enhanced (t =3.67,5.88,P ＜0.05).Conclusions Pelvic radiotherapy can induce abnormality of enteric antimicrobial peptides and may result in gut microbiota dysbiosis.The disturbed gut microbial flora may further trigger an incurrence of bacterial translocation and enteritis.Therefore,the gut microbiota may be a potential interfering target to alleviate radiotherapy adverse effect.
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Objective To analyze the adverse reactions of hysterosalpingography and prevention measures. Methods Totally 6 352 patients who underwent hysterosalpingography in our hospital between January 2006 and December 2013 were analyzed. Results Totally 836 cases had adverse reactions of different degrees including 312 cases of drug reactions and 626 cases of non?drug reactions. The adverse drug reactions were mainly hy?pogastralgia,laryngopharyngeal malaise,irritating cough,nausea,vomiting,shortness of breath,flush of the face,and pruritus. The non?drug reac?tions were mainly hypogastralgia,nausea,vomiting,pallor,speeding up of heart?beat,decreased blood pressure,dizziness,and blur version. Con?clusion Among patients who were negative for iodine anaphylactic test,there were still some who had adverse reactions of different degrees during HSG. Targeting at different conditions of reactions,corresponding prevention measures should be adopted to ensure the smooth progress of hysterosal?pingography.
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OBJECTIVE@#To investigate the influence of autophagy on sensitivity to the chemotherapy drug cisplatin (DDP) and the role of PI3K in autophagy.@*METHODS@#MTT methods and flow cytometer, with rapamycin up-regulating the autophagy and 3-MA down-regulating the autophagy, were employed to measure the proliferation inhibition rate on DDP-treated osteosarcoma cells and the change in cell cycle. The expression of intracellular protein was detected by Western blot. The autophagy of MG63 cell was observed using fluorescence microscope and transmission electron microscope.@*RESULTS@#Western blot showed that basic autophagy level of MG63 cell was significantly lower than that of hFOB cell. MTT test revealed that the cell proliferation inhibition rate in the group treated with rapamycin and DDP, group treated with 3-MA and DDP, and group only treated with DDP was significantly different. It was demonstrated by the flow cytometry that in group treated with DDP, inhibition on autophagy can increase the cell numbers in G1 phase and reduce the cell numbers in S phase of cell cycle. Increase of autophagosome in MG63 cytoplasm was observed under fluorescence microscope.@*CONCLUSIONS@#Up-regulating the autophagy significantly reduced the sensitivity of MG63 cell to chemotherapy with DDP. DDP induced autophagy of MG63 cell and blocked the cell cycle at G1 phase.
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To evaluate the efficacy of treatment with acupuncture for knee osteoarthritis. We searched PUBMED, EMBASE, and the Cochrane Central Register of Controlled Trials databases from July to October 2011 for randomized controlled trials that compared needle acupuncture with sham acupuncture, standard care, or waiting list control groups in patients with knee osteoarthritis. Of the 490 potentially relevant articles, 14 RCTs involving 3,835 patients were included in the metaanalysis. Two authors independently extracted outcome data on short-term and long-term pain and functional measures. Standardized mean differences and 95% confidence intervals were calculated using the mean differences in improvements from baseline and the associated standard deviations in patients assigned to acupuncture and those assigned to control groups according to measurement time points. Compared with sham acupuncture control treatment, acupuncture was significantly better at relieving pain [p=0.002] and restoring function [p=0.01] in the short-term period, and relieving pain [p=0.06] and restoring function [p=0.06] in the long-term. Compared with the standard care and waiting list control treatments, acupuncture was significantly better at relieving pain and restoring function. Acupuncture provided significantly better relief from knee osteoarthritis pain and a larger improvement in function than sham acupuncture, standard care treatment, or waiting for further treatment.
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To evaluate gait patterns in patients with metal-on-metal resurfacing hip arthroplasty [RHA] compared with big-femoral-head total hip arthroplasty [BHA] at one year postoperatively. In this retrospective comparative observational study, 2 groups of 30 resurfacing hip arthroplasty [RHA] and big-femoral-head total hip arthroplasty [BHA] patients participated between June 2006 and March 2009 in the Sixth Affiliated People's Hospital, Shanghai Jiaotong University, Shanghai, China. Gait parameters and range of motion [ROM] in gait cycles were measured by Vicon gait analysis system and were used to calculate operated/contralateral ratios. No significant difference was found between gait parameter ratios, Hospital for Special Surgery Score [HSS], and University of California at Los Angeles Score [UCLA] of the 2 groups. However, there was significant difference between ROM ratios in gait cycles. Range of motions of operated hip joint were more similar to that of contra-lateral side in RHA group [hip flexion/extension p=0.007, hip abduction/adductionp=0.005, hip rotation p=0.006, knee flexion/extension p=0.037]. Gait parameters of patients who underwent RHA and BHA are approaching to normal values at one year postoperatively. At the time point, ROMs of RHA patients are larger than that of BHA patients during walking
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Humans , Arthroplasty, Replacement, Hip/methods , Hip Joint/physiopathology , Arthroplasty, Replacement, Hip/instrumentation , Postoperative Period , Hip Joint/surgeryABSTRACT
<p><b>BACKGROUND</b>Total knee arthroplasty (TKA) is an important therapy for the treatment of various late-stage knee diseases. However, it has been observed that patients have lower hemoglobin (HB) counts postoperatively, which are significantly inconsistent with the measured blood loss. Although the concept of hidden blood loss has been presented in 2000, very little clinical attention has been paid since then. In this study, we investigated the characteristics and influential factor of hidden blood loss after TKA in treating knee osteoarthritis.</p><p><b>METHODS</b>One hundred and eight patients, with 42 males and 66 females, were retrospectively analyzed. The perioperative blood loss and the hidden blood loss following TKA were calculated by Gross formula. Potential factors affecting perioperative and hidden blood loss included gender, surgical time, tourniquet time, hemostasis (during operation with deflating tourniquet), and reinfusion of salvaged blood.</p><p><b>RESULTS</b>The average perioperative blood loss was found to be (1553 ± 356) ml and the average hidden blood loss was (793 ± 223) ml. The hidden blood loss of the male was significantly higher than that of the female, and was reduced by hemostasis during the operation with a deflating tourniquet. Hidden blood loss was not affected by postoperative blood salvage and reinfusion, surgical time, or tourniquet time.</p><p><b>CONCLUSIONS</b>When calculating the value of hidden blood loss by Gross formula, the lowest value of hematocrit should be chosen as the parameter so that hidden blood loss would not be underestimated. No significant differences could be found in hidden blood loss for males compared to females. Hidden blood loss can be reduced by hemostasis during operation with a deflating tourniquet. Although reinfusion of salvaged blood could not reduce the perioperative blood loss or hidden blood loss, it was still an effective method to reduce transfusion rate.</p>
Subject(s)
Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Arthroplasty, Replacement, Knee , Blood Loss, Surgical , Osteoarthritis, Knee , General Surgery , Perioperative Period , Retrospective Studies , Sex FactorsABSTRACT
Objective To compare gait patterns in patients with metal-on-metal resurfacing hip arthroplasty(RHA)and big-femoral-head total hip arthroplasty(BHA)at one year postoperatively.Methods From June 2006 to March 2009,two groups of 30 RHA and BHA patients participated in the study.Gait parameters,knee and hip joint range of motions(ROMs)in gait cycles were measured at one year postoperatively by Vicon gait analysis system,and the values were used to calculate affected/unaffected ratios of patients themselves.Results No significant difference were found in affected/unaffected ratios of cadence,single limb support time,foot off,peak value of vertical ground reaction force,the hospital for special surgery score and the university of California at Los Angeles activity assessment between the two groups.However,several ROM affected/unaffected ratios in RHA group(hip range of flexion/extension,abduction/adduction,and rotation were 1.0323,0.9747,and 1.0558,respectively.The knee range of flexion/extension for affected/unaffected ratios was 1.0027)were significantly higher than those in BHA group(the corresponding values were 0.8615,0.7824,0.8162,0.9472,respectively).The P values were 0.007,0.005,0.006,and 0.037,respectively.Conclusion(1)Gait parameters of patients who underwent RHA and BHA were close to normal values at one year postoperatively.(2)At the follow up time point,joint ROMs of RHA patients are larger than those of BHA patients during gait cycle.(3)RHA can retain enough bone stock for future revision option,moreover,it can achieve maximum recovery of joint function.
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A model of intestinal helminth control program for primary school children was conducted during two years in Thai Nguyen province, where a high prevalence of intestinal worm had been found before the intervention. Results of the base line surveys showed a cumulative infection rate of intestinal worm of 86.23%, of which Ascaris: 83.6%, Trichuris: 20.6%, and hookworm: 3.9%. The cure rate was 97% (+/-2.52%) after intervention, but the reinfection rate was 53.11 % (+/-1.43%) by 4 months after the first treatment, and 35.88% (+/-1.85%) after the second treatment. Thus, periodical mass treatment every 6 months is needed for intestinal worm infection control. KAP surveys were performed to evaluate knowledge, attitude and practice of the children and their parents before and after intervention. The knowledge on the ways of transmission of worm infection and the role of environment among children and their parents was found to have been significantly improved immediately after the campaign of health education (P<0.05). Their attitude on the prevention of infection relating to the ways of infection, environment contamination and personal hygiene was enhanced significantly (P<0.05). Accordingly, their practice in term of intestinal worm infection control was also significantly enhanced (P<0.05), especially after the second round of health education and the school supervision. All families agreed to contribute budget to annual deworming program. The model was much supported by children, their parents and teachers for its high cost-effectiveness, easy application and safety, and therefore, it should be expanded to other places.