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Objective:To evaluate the effects of split-filter dual-energy CT (SF-DECT) in improving image quality at low doses in the process of abdominal examinations for children.Methods:A preliminary study was conducted using child phantoms. Furthermore, 20 children aged 4-6 years were recruited prospectively for clinical validation from June 2020 to December 2020. Conventional single-energy CT (SECT) and SF-DECT were employed to scan the abdominal areas of the phantoms and children. Then, the CT values, image noise, contrast to noise ratios (CNRs), and image subjective scores of SF-DECT and SECT were compared under various doses (1, 2, 3, and 4 mGy).Results:For the phantoms under doses of 3 and 4 mGy, SF-DECT decreased the image noise by 18.9% and 23.6%, respectively, and increased the liver and kidney CNRs (CNR liv and CNR kid) by 12.8% and 31.9% at most, respectively, compared to SECT ( Z = 3.00, 5.17, P < 0.001). For children, SF-DECT decreased image noise ( Z = 4.64, P < 0.001) and increased CNR liv and CNR kid ( Z = 3.78, 3.39, P < 0.001). For both the phantoms and the children, the subjective scores of images scanned using the SF-DECT were higher than those scanned using the SECT ( Z = 1.96-3.80, P < 0.05). Conclusions:Compared with SECT, SF-DECT can improve the quality of children′s abdominal images. This technique has a certain prospect of optimizing abdominal CT for children. However, it is necessary to conduct in-depth clinical research to verify the result.
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Objective@#To explore the efficacy of closed negative pressure irrigation and suction device (Patent number: Z200780013509.8) in the treatment of high perianal abscess.@*Methods@#From January 2015 to December 2016, ≥18-year-old patients with primary high perianal abscess who were treated at our department were prospectively enrolled. Exclusion criteria: (1) recurrent perianal abscess; (2) complicated with anal fistula formation; (3) preoperative, intraoperative or postoperative physical therapy, and curettage treatment, negative pressure irrigation; (4) Crohn′s disease-related perianal abscess; (5) with immunosuppressive status, such as transplant recipients; (6) co-existence of malignant tumors, such as leukemia; (7) with diabetes; (8) those who could not receive long-term follow-up and were not suitable to participate in this study. According to the random number table method, the patients were randomly divided into negative pressure irrigation and suction group and routine drainage group. All patients were clearly diagnosed and the location and size of the perianal abscess were marked before surgery. These two groups were treated as follows: (1) Negative pressure irrigation and suction group: the skin was incised at a diameter of 1-2 cm at the site where the abscess fluctuated most obviously. After the abscess was removed, a closed negative pressure irrigation and suction device was installed and the pressure of -200 to -100 mmHg (1 mmHg=0.133 kPa) was maintained to keep the abscess cavity collapsed. Generally, the irrigation was stopped 5 days later or when the drainage was clear. The closed vacuum suction was maintained for 2 additional days, before the wound was sutured. (2) Conventional drainage group: conventional incision and drainage was carried out. The skin was cut at a diameter of 8 to 10 cm at the site of abscess with most obvious fluctuation. After the abscess was removed, normal saline gauze was used for dressing. Dressing was changed regularly until the wound healed. The efficacy, operative time, intraoperative bleeding, incision length, frequency of dressing change, pain index (visual analogue score, VAS score), postoperative healing time, complications, recurrence rate of perianal abscess, anal fistula formation rate were observed. The t test and χ2 test were used for comparison between the 2 groups.@*Results@#There were both 40 patients in the negative pressure irrigation and suction group and the conventional drainage group. There were 28 males and 12 females in negative pressure irrigation and suction group with a mean age of (38.3±12.0) years and mean disease course of (6.6±2.1) days. The abscess in pelvic-rectal space accounted for 50.0% (20/40) and the mean diameter of abscess was (8.0±3.7) cm. There were 26 males and 14 females in the conventional drainage group with a mean age of (37.1±11.8) years and mean disease course of (6.4±2.5) days. The abscess in pelvic-rectal space accounted for 55.0% (22/40) and the diameter of abscess was (8.2±3.5) cm. The differences in baseline data between two groups were not statistically significant (all P>0.05). Both groups successfully completed the operation. There was no significant difference in operative time between two groups (P>0.05). As compared to conventional drainage group, intraoperative blood loss in negative pressure irrigation and suction group was less [(12.1±5.5) ml vs. (18.3±4.4) ml, t=5.606, P<0.001], incision length was shorter [(2.3±0.8) cm vs. (7.6±1.7) cm, t=17.741, P<0.001], postoperative VAS pain scores at 1-, 3-, 7-, and 14-day after operation were lower [3.7±1.4 vs. 7.6±1.8, t=10.816, P<0.001; 3.0±1.3 vs. 6.8±1.6, t=11.657, P<0.001; 2.7±0.9 vs. 5.1±1.1, t=10.679, P<0.001; 1.2±0.3 vs. 1.6±0.4, t=5.060, P=0.019], the dressing change within 7 days after operation was less (3.5±1.2 vs. 12.6±2.7, t=19.478, P<0.001), postoperative healing time was shorter [(10.4±3.0) d vs. (13.5±3.8) d, t=4.049, P<0.001] and postoperative complication rate was lower [17.5% (7/40) vs. 2.5% (1/40), χ2=5.000, P=0.025]. During follow-up of 12 to 36 (24±5) months, the recurrence rate of perianal abscess within 1 year after operation and anal fistula formation rate in negative pressure irrigation and suction group were lower than those in conventional drainage group [5.0% (2/40) vs. 20.0% (8/40), χ2=4.114, P=0.042 and 2.5% (1/40) vs. 17.5% (7/40), χ2=5.000, P=0.025, respectirely]. The one-time cure rate of negative pressure irrigation and suction group and conventional drainage group was 92.5% (37/40) and 62.5%(25/40), respectirely (χ2=10.323, P=0.001).@*Conclusions@#The application of the negative pressure irrigation and suction device in the treatment of high perianal abscess can improve the efficiency of one-time cure, reduce postoperative pain, accelerate healing time, decrease the morbidity of postoperative complication and the rates of abscess recurrence and anal fistula formation, indicating an improvement of the treatment.
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The purpose of this study is to reveal the protective effect of rib cage on scoliotic spine by comparing the different effect of rib cage on the stability of normal spine and Lenke1 scoliotic spine. Firstly, according to X-ray computed tomography (CT) image data, four spinal finite element models (SFEMs), including normal spine without rib cage (N1), normal spine with normal rib cage (N2), scoliotic spine without rib cage (S1) and scoliotic spine with deformed rib cage (S2), from the first thoracic vertebrae to the sacral vertebrae (T1～S) were established. Secondly, the natural vibration characteristics of the four SFEMs were obtained by modal analysis. Finally, the maximum vibration amplitudes of the four SFEMs under external excitation were obtained by steady-state analysis. As shown in results, compared with N1, the maximum deformation of N2 segment T4～T6 in the -axis (coronal axis), -axis (sagittal axis) and -axis (vertical axis) directions decreases by 38.44%, 53.80% and 33.72%, respectively. Compared with S1, the maximum deformation of S2 segment T4～T6 in the -axis direction, -axis direction and -axis directions decreases by 44.26%, increases by 32.80% and decreases by 49.23%, respectively. As it can be seen, for normal spine, the rib cage can improve the stability of the whole spine in three directions; for the Lenke1 scoliotic spine, the rib cage can reduce the vibration of the scoliotic spine in the -axis and -axis directions and improves the stability of the whole spine in the two directions, while in the -axis direction, for the serious severe anteversion of scoliotic spine, the deformed rib cage exacerbates the vibration of the scoliotic spine in this direction and destroys the stability of the scoliotic spine in the -axis direction. This study reveals the biomechanical characteristics of rib caged influence on the stability of the scoliotic spine and it has guiding significance for the study of daily protection methods and protective tools for scoliotic patients.
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Humans , Biomechanical Phenomena , Finite Element Analysis , Rib Cage , Scoliosis , Spine , Thoracic Vertebrae , Tomography, X-Ray Computed , VibrationABSTRACT
Objective To explore the effects of empowerment education model on glycemic control and self-management behavior of community patients with diabetes. Method A total of 120 diabetics from 2 different communities were set as the observation group and control group. The control group was treated by routine medications and health education and the observation group was intervened with empowerment education model. After intervention for 6 months, the patients′blood glucose index and the diabetes self-management behavior were assessed and compared by scale of the diabetes self-care activities (SDSCA) between the two groups. Result By the end of the study, the glycemic index and SDSCA score in the former group were both significantly decreased than those in the control group (P<0.05), indicating the patients in the experiment group had better glycemic control and self-management behaviors compared with those in the control group. Conclusions Empowerment education model can arouse the internal motivation of patients to change their behaviors from passive to active acceptance in the health education. Empowerment education model can enhance diabetes patients′self-management conduct and the glycemic level.
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Objective To compare the effects of venous port access ( VPA ) with peripherally inserted central catheters ( PICC) in patients with breast cancer .Methods 120 cases with breast cancer were divided into 2 groups from Jan.2009 to Dec.2010,among whom 60 cases were with VPA when receiving operation , and the other 60 cases were with PICC after the operation .The success rate of catheterization , duration of catheter in-dwelling and catheter-related complications of the 2 groups were compared .Results The one-time success rate of catheterization was 100%in VPA group and 66.7%in PICC group .The catheters were retained for more than 12 months in 59 cases in VPA group,while only 4 cases in PICC group retained catheter for more than 12 months. The complications occurred to 1 case in VPA group ( 1.7%) and 9 cases in PICC group ( 15%) .Conclusion VPA is an ideal pathway for chemotherapy of patients with breast cancer , which can reduce nursing work and is worth to be promoted in clinical practice .
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Objective To evaluate the efficacy and safety of mNGF to peripheral neuropathy induced by n-bexane. Methods 54 cases were treated with mNGF (18 μg i. m qd.) and the period of treatment is 56 days. 15 severe cases treated with two periods of treatment. Subjects received symptoms and signs of nerve system and activi-ties of daily living (ADL) scale were examined before and every 14 days after treated, The efficacy of mNGF was as-sessed by score increase of each index before and after treatment himself. To evaluate the safety, subjects received Is-boratory examinations before and every 28 days after treated, recorded adverse events everyday. Results During the trial, The indexes had improved remarkably in two weeks after the treatment , There were highly significant differ-ences in score increase after 4 ～ 8 weeks of treatment(P < 0. 01). It indicated that treatmented with mNGF was effec-tive. There were no severe adverse events (SAE) found among 54 trial subjects. There were no evident abnormalities in laboratory examinations before and after treatment. Pains of the injected sites are the main ADR, the incidence was 68.5% (37/54). Conclusion The results of the research indicated that mNGF clinical application could be consid-ered as safe and effective.
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Objective To construct the microbial limit test method for tetracycline ointment. Methods The medium dilution method and extracting binding membrane filtration method were used in the recovery rate and control bacterial test of tetracycline ointment. Results The counting of mould and yeast could be tested by the medium dilution. Extracting binding membrane filtration method could help to bacterial counting and detection of control bacterial. Conclusion The method can detect the microbial contamination of tetracycline ointment effectively,which supplies the scientific data for the better evaluation of the validity and quality control to tetracycline ointment.
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objective Microbial limit test(MLT)for Dahuang Zhechong pill was established and verified to supply scientific foundation for the establishment of MLT for antibacterial and anti-inflammatory Chinese patent medicine,and to supply principle guidance for the verification of the method issued in Chinese pharmacopoeia(2005 edition);meanwhile the antibiogram of Dahuang Zhechong pill was probed,which can provide evidence for its clinical administration.Methods With centrifugal sedimentation method and culture medium diluted method,the recovery test was done on each tested bacterial strain to validate the accuracy and feasibility of MLT.Results Dahuang Zhechong pill had a stronger inhibitory effect on staphylococcus aureus and bacillus subtilis,had a weak inhibitory effect on escherichia coli,and had no effect on candida albicans and aspergillus niger,indicating that the antimicrobial spectrum of Dahuang Zhechong pill is Gram-positive bacteria.Conclusion Centrifugal sedimentation method combined with culture medium diluted method can eliminate the anti-bacterial effect of Dahuang Zhechong pill during the experiment,thus the microorganisms in the polluted pill can be detected successfully.