Effect analysis of thoracic paravertebral nerve block combined with propofol intravenous anesthesia in radical treatment of lung cancer / 中国医师杂志

Objective:To investigate the effects of thoracic paravertebral nerve block combined with propofol intravenous anesthesia (PPA) on hemodynamic parameters, inflammatory stress indexes, postoperative analgesia and immune indexes in patients with lung cancer undergoing radical surgery.Methods:116 patients with lung cancer admitted to the Southern Theater General Hospital from January 2020 to December 2021 were randomly divided into observation group and control group, with 58 patients in each group. The observation group received PPA combined with general anesthesia, and the control group received sevoflurane inhalation combined with general anesthesia; the hemodynamic parameters, the amount of anesthetic and analgesic drugs used during and after the operation, the pain score of the patients after the operation, the serum interleukin-6 (IL-6), interleukin-10 (IL-10), cortisol (Cor), norepinephrine (NE), vascular cell growth factor-C (VEGF-C), transforming growth factor-β 1(TGF-β1) and T lymphocytes before and after the operation, adverse reactions of the two groups were monitored and compared.Results:The intraoperative dosage of remifentanil and postoperative dosage of sufentanil in the observation group were lower than those in the control group (all P<0.05). There was no statistically significant difference in cardiac output (CO), systemic vascular resistance index (SVRI) and extravascular lung water index (EVLWI) between the observation group and the control group at T 0 to T 3 (all P>0.05); The mean arterial pressure (MAP) at T 1 to T 2 in the observation group was higher than that in the control group, and the MAP at T 3 was lower than that in the control group (all P<0.05). There was no significant difference between observation group and control group in Visual Analogue Scale (VAS) scores at resting state and coughing state 2 h after surgery(all P>0.05). The VAS scores in the observation group at resting state were lower than those in the control group at 4 h and 12 h after surgery (all P<0.05), and the VAS scores in the observation group at coughing state were lower than those in the control group at 4 h, 12 h and 24 h after surgery (all P<0.05). Before surgery, there was no significant difference in serum levels of IL-6, IL-10, Cor, NE, VEGF-C and TGF-β1 between observation group and control group (all P>0.05). The serum levels of IL-6, NE and VEGF-C in observation group were lower than those in control group 24 h after surgery (all P<0.05). Before surgery, there was no significant difference in CD3 +, CD4 + and CD8 + between observation group and control group (all P>0.05). 24 h after operation, the CD3 + in observation group was higher than that in control group ( P<0.05). The incidence of adverse reactions in observation group (10.34%) was lower than that in control group (24.14%, P<0.05). Conclusions:PPA anesthesia for patients undergoing radical resection of lung cancer is conducive to maintaining the stability of hemodynamic parameters, reducing the inflammatory stress response of patients, the impact of surgery on patients′ immune function, and the amount of anesthetic drugs and postoperative analgesics during surgery.

Preventing Infection Measures of COVID-19 Patients during Mechanical Ventilation / 中国医疗器械杂志

OBJECTIVE@#To explore the preventing infection measures of new coronavirus disease 2019(COVID-19) patients during mechanical ventilation, and to provide reference for the safe application of mechanical ventilation.@*METHODS@#Retrieved from PubMed, Ovid and other databases, and combined with the application experience of mechanical ventilation were collected to explore the preventing infection measures of COVID-19 patients during mechanical ventilation.@*RESULTS@#This paper put forward the preventing infection measures of external circuit, internal circuit, outer surface, filter and special parts in ventilator. The preventing infection measures of sputum suction and nebulization were summarized.@*CONCLUSIONS@#The preventing infection measures of COVID-19 patients during mechanical ventilation are successfully completed, which can provide suggestions for the application and maintenance of mechanical ventilation.

Protective effect of TFB on serum induced injury of HUVECs in henoch-schonlein purpura children patients / 中国医师杂志

Objective:To investigate the protective effect and mechanism of total flavonoids of bidens bipinnata L (TFB) on vascular endothelial cell injury in children with henoch-schonlein purpura (HSP).Methods:Human umbilical vein endothelial cells (HUVECs) were cultured in vitro and intervened with normal and HSP children's serum. Then the HUVECs were divided into blank group, normal group, HSP group and TFB group. Levels of interleukin-8 (IL-8) and tumor necrosis factor α (TNF-α) in the supernatant were detected by enzyme-linked immunosorbent assay ( ELISA). The mRNA and protein expression of nuclear factor kappa B (NF-κB) and Fractalkine were detected by reverse polymerase chain reaction (RT-PCR) and Western blot in HUVECs. Results:ELISA results showed that the expression of IL-8 and TNF-α in HSP group were significantly higher than that in normal control group and blank group ( P<0.05), and the level of IL-8 and TNF-α in the TFB group was significantly lower than that in the HSP group ( P<0.05); the results of RT-PCR and Western blot showed that the expression levels of NF-κB, Fractalkine mRNA and protein in HSP group were significantly higher than those in normal group and blank group ( P<0.05). The expression levels of NF-κB, Fractalkine mRNA and protein in the TFB group were significantly lower than those in the HSP group ( P<0.05). Conclusions:TFB can inhibit the expression of NF-κB in children with Henoch-Schonlein purpura, reduce the secretion of IL-8 and TNF-α in HUVECs, and then relieve the occurrence of vascular injury.

Comparison of hidden blood loss between minimally invasive percutaneous locking plate fixation and intramedullary nail fixation in the treatment of tibial shaft fracture / 中国骨伤

OBJECTIVE@#To analyze and compare the hidden blood loss of minimally invasive percutaneous plate osteosynthesis(MIPPO) combined with locking plate fixation and intramedullary nail fixation in the treatment of tibial shaft fracture.@*METHODS@#One hundred and ninety-one cases of tibial shaft fracture treated from January 2017 to January 2019 were analyzed retrospectively. The patients were all treated with closed reduction and divided into two groups:group A (110 cases) and group B (81 cases). In group A, 78 males and 32 females were treated with MIPPO combined with locking plate. The age ranged from 19 to 74 (45.32±11.79) years old. According to AO classification, 42cases were type 42-A, 45 were type 42-B and 23 were type 42-C fractures. Group B was treated with intramedullary nail, including 65 males and 16 females, aged 19 to 84 (45.44± 14.32) years old. According to AO classification, there were 39 cases of type 42-A, 29 cases of type 42-B and 13 cases of type 42-C. The operation time, intraoperative blood loss and hidden blood loss were observed and compared between the two groups.@*RESULTS@#On the first day, the hidden blood loss was (155.27±47.89) ml in group A and (160.43±131.42) ml in group B, the difference was statistically significant (0.05).@*CONCLUSION@#In the treatment of tibial shaft fracture with intramedullary nail, there is obvious hidden blood loss, which is much higher than expected.

Clinical observation of 6 severe COVID-19 patients treated with plasma exchange or tocilizumab / 浙江大学学报·医学版

OBJECTIVE@#To observe the clinical effect of plasma exchange and tocilizumab in treatment of patients with severe coronavirus disease 2019 (COVID-19).@*METHODS@#Six patients with severe COVID-19 admitted in First Affiliated Hospital of Bengbu Medical College from January 25 to February 25, 2020. Three patients were treated with plasma exchange and three patients were treated with tocilizumab. The effect on excessive inflammatory reaction of plasma exchange and tocilizumab was observed.@*RESULTS@#The C-reactive protein (CRP) and IL-6 levels were significantly decreased and the lymphocyte and prothrombin time were improved in 3 patients after treatment with plasma exchange; while inflammation level was not significantly decreased, and lymphocyte and prothrombin time did not improve in 3 patients treated with tocilizumab.@*CONCLUSIONS@#For severe COVID-19 patients with strong inflammatory reaction, plasma exchange may be preferred.

Acupuncture in the treatment of chronic fatigue syndrome based on "interaction of brain and kidney" in TCM: a randomized controlled trial / 中国针灸

OBJECTIVE@#To observe the effects of acupuncture on the fatigue symptoms of chronic fatigue syndrome, the potential symptoms and cytokines on the base of the theory as "interaction of brain and kidney" and explore its clinical therapeutic effects and the potential mechanism.@*METHODS@#A total of 68 patients were randomized into an observation group and a control group, 34 cases in each one. In the control group, oryzanol and vitamin B1 were prescribed for oral administration and the patients were required to have a proper rest and physical exercise. In the observation group, on the base of the theory as "interaction of brain and kidney", acupuncture was added to Baihui (BL 20), Fengchi (GB 20), Pishu (BL 20), Shenshu (BL 23), Sanyinjiao (SP 6) and Taixi (KI 3). The treatment was given once a day, 5 treatments a week, with 2 days break. The consecutive treatment for 4 weeks was required. Before and after treatment, the score of the fatigue scale-14 (FS-14), the score of the somatic and psychological health report (SPHERE) and the score of the Pittsburgh sleep quality index (PSQI) were observed in the patients of the two groups separately. The enzyme-linked immunosorbent assay (ELISA) was adopted to determine the levels of serum interleukin-6 (IL-6) and interferon-γ (INF-γ) before and after treatment.@*RESULTS@#After treatment, FS-14 scores, SPHERE scores and PSQI scores were all reduced as compared with the scores before treatment in the two groups (<0.05, <0.01). After treatment, the levels of IL-6 and INF-γ in the serum in the observation group were reduced as compared with the levels before treatment (both <0.01). After treatment, the scores of FS-14, SPHERE and PSQI as well as the levels of serum IL-6 and INF-γ in the observation group were all lower than the results in the control group (<0.05, <0.01).@*CONCLUSION@#On the base of the theory as "interaction of brain and kidney", acupuncture therapy relieves the fatigue symptoms and the potential symptoms and improves the sleep quality in the patients of chronic fatigue syndrome. The effect mechanism is probably related to the decrease of the levels of IL-6 and INF-γ in serum.

Imaging features of cerebral small vessel disease in systemic lupus erythematosus patients with impaired renal function and its associated risk factors / 中华放射学杂志

Objective@#To investigate the imaging features of cerebral small vessel disease(SVD) in systemic lupus erythematosus(SLE) patients with impaired renal function and their related risk factors.@*Methods@#Seventy-six SLE patients and forty age- and sex-matched healthy controls were recruited, and SLE patients were divided into the impaired renal function group [estimated glomerular filtration rate (eGFR) <90 ml/(min·1.73 m2)] (n=38) and the normal renal function group [eGFR≥90 ml/(min·1.73 m2)] (n=38) according to their eGFR. All subjects underwent brain MRI, cognitive and psychiatric testing. The SVD scores were measured, total white matter hyperintensity (WMH) and SVD scores were calculated, and the risk factors of SVD scores were analyzed by using ordinal logistic regression.@*Results@#SLE patients in the impaired renal function group showed higher basal ganglia PVS, centrum semiovale perivascular space (PVS), periventricular WMH, deep WMH and total SVD scores compared with normal controls or patients with normal renal function (H=44.568, 31.380, 31.172, 43.419, 24.317, P<0.001) . The ordinal logistic regression analysis showed that C-reactive protein was a risk factor for SVD in patients with SLE(OR=1.323, P<0.01).@*Conclusion@#SLE patients with impaired renal function had a higher SVD burden on MR imaging, particularly PVS in the basal ganglia and deep WMH, which was affected by the C-reactive protein level.

Clinical efficacy on anxiety , depression and sleep disorders in middle-aged and elderly patients with chronic subjective tinnitus / 中华老年医学杂志

Objective To evaluate the efficacy of tinnitus retraining therapy (TRT) on anxiety , depression , and symptoms of sleep disorders in patients with chronic subjective tinnitus. Methods Eighty patients with chronic subjective tinnitus visiting The Affiliated Hospital of Hangzhou Normal University from January 2016 to December 2017 were recruited ,and were divided into an observation group and a control group through computer generated random numbers. Patients in the control group were given drug treatment only ,while those in the observation group received TRT in addition to drug treatment. Clinical efficacy was evaluated using Tinnitus Handicap Inventory (THI) , Pittsburgh Sleep Quality Index (PSQI) ,Hamilton Depression Scale (SDS) ,and Hamilton Anxiety Scale (SAS ) for both groups. Results Patients in the observation group were associated with significantly lower scores of THI ,PSQI ,SAS and SDS ,compared with those in the control group 3 months after treatment (each P＜0.05). Furthermore ,the effectiveness rate was markedly higher (82.5% or 33 cases vs. 55.0% or 22 cases ,χ2＝7.040 ,P＜0.01) in the observation group than in the control group 6 months after treatment. Conclusion Tinnitus retraining therapy combined with conventional therapy can help to reduce the severity of tinnitus handicap ,ameliorate negative emotions such as anxiety and depression ,and improve sleep quality in patients with chronic subjective tinnitus.

Diagnostic accuracy of dual-energy CT angiography in patients with intracranial aneurysm: Meta-analysis / 中国医学影像技术

Objective To explore the diagnostic value of dual-energy CTA in detection of intracrania[aneurysms by using Meta-analysis.Methods Taking "Dual energy"," intracranial aneurysms" or "subarachnoid hemorrhage" as key words,related literatures of diagnostic accuracy of intracrania[aneurysms by using dual-energy CTA compared with DSA were extracted from Wanfang database,CNKI,Chinese biomedical database and PubMed from January 2006 to January 2017.The quality of included literatures was assessed.MetaDISC1.4 was used for Meta-analysis to examine the heterogeneity among the studies and to analyze the diagnostic accuracy index.The forest map was drawn.The summary operating characteristic curve was analyzed.Results Fifteen studies without heterogeneity were considered for analysis.The pooled sensitivity,specificity,positive likelihood ratio and negative likelihood ratio was 0.97 (95 ％CI [0.96,0.99]),0.99 (95 ％ CI [0.97,1.00]),21.71 (95％CI [12.10,38.96]) and 0.04 (95％CI [0.03,0.07]),respectively.The value of OR was 703.4 (95％CI [303.96,1 627.74]).The area under the curve of summary ROC was 0.990 8.The maximum value (Q value) of sensitivity and specificity was 0.992 5.Conclusion Dual-energy CTA has high sensitivity and specificity in diagnosis of intracranial aneurysms,therefore can be taken as the first choice for patients with suspected intracranial aneurysms.

Simultaneous Determination of 5 Constituents in Xiao'er Magan Granule by HPLC-QAMS / 中国药师

Objective:To develop a method of quantitative analysis of multi-components by single marker(QAMS)for the determi-nation of five constituents(ephedrine hydrochloride,amygdalin,liquiritin, baicalin and ammonium glycyrrhizinate)in Xiao'er Magan granule. Methods:Amygdalin was used as the internal reference substance, and the relative correlation factors(RCF) of ephedrine hydrochloride,liquiritin,baicalin and ammonium glycyrrhizinate to amygdalin were calculated and evaluated. The contents of the five constituents were determined by the external standard method(ESM) and QAMS,respectively. The content results determined by the two methods were compared and the feasibility of QAMS method was verified. Results:The RCF between amygdalin and the other con-tents was 1.237,1.318,1.327 and 0.884,respectively. There were no significant differences in the results between QAMS and ESM with the relative errors less than 0.3%. Conclusion:The QAMS method is accurate and feasible for the simultaneous determination of Xiao'er Magan granule.

Effects of auditory integration training on brainstem auditory evoked potential and symptoms in children with autism spectrum disorders / 中华行为医学与脑科学杂志

Objective To investigate the curative effect of auditory integration training (AIT) on autism spectrum disorders (ASD) in children with abnormal brainstem auditory evoked potential (BAEP).Methods 56 cases of ASD patients with abnormal BAEP were treated with AIT (aged 2-6 years).BAEP will be reviewed after each course of treatments until the test results were back to normal or had no obvious changes.Children' s core symptoms were evaluated by using autism behavior checklist (ABC) and the childhood autism rating scale (CARS) before and after treatments.Results 56 children accepted (1.95±0.92) courses of AIT.Compared with the data before AIT,CARS scores ((36.32± 3.54),(34.11 ± 3.12)),scores of the sensory factor((5.65±4.61),(4.28±4.11)) and the stereotypes factor of ABC were decreased significantly(P＜0.05).After treatments,BAEP of 29 cases (51.79％) went back to normal levels.The bilateral wave incubation periods on left side (Ⅰ:(1.81 ± 0.17) ms,(1.71 ± 0.12) ms,Ⅲ:(4.14 ± 0.18) ms,(4.07 ±0.17)ms,V:(6.09±0.23)ms,(5.97±0.22) ms)and right side (Ⅰ:(1.79±0.17) ms,(1.74±0.13) ms,Ⅲ:(4.15±0.16) ms,(4.07±0.16) ms,V:(6.06±0.23) ms,(5.99±0.26) ms) were significantly shortened (P＜ 0.05).Conclusion AIT can improve the functional handicap of auditory pathway in brainstem of ASD children,and the core symptoms of ASD.

Propensity score-matching method for evaluating the effect of anatomic liver resection and non-anatomic liver resection on prognosis of hepatocellular carcinoma patients / 第二军医大学学报

Objective To compare the prognoses of hepatocellular carcinoma (HCC) patientswho underwent anatomic liver resection (AR) or non-anatomic liver resection (NAR) using propensity score-matching methods. Methods We retrospectively analyzed the clinical data of 124 HCC patients who were treated in the First Affiliated Hospital of Nanchang University between Jan. 2010 and Dec. 2015. The patients included 64 undergoing AR (AR group), and 60 undergoing NAR (NAR group). Propensity score-matching methods were used to assess the overall survival (OS) of the patients in AR and NAR groups whle controlling the potential confounders, and the risk factors of prognosis of HCC patients were analyzed by Cox proportional hazardmodel. Results In the propensity score-matching cohort, the OS of the patients in AR group (n=29) was significantly longer than that in the NAR group (n=45) after propensity score-matching (52 [44. 83-59. 17] months vs 38 [31. 45-44. 55] months, P = 0. 005). The Cox proportional hazards model revealed that AR was associatedwith a superior OS (HR=0. 54, 95%CI 0. 30-0. 96, P =0. 04). Conclusion Propensity score-matching method has shown that AR can better improve the OS in HCC patients after liver resection compared withNAR.

Effect of age on prognosis of hepatocellular carcinoma patients with diabetes mellitus: A propensity-score matching analysis / 第二军医大学学报

Objective To explore the effect of age on prognosis of patients with hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) complicated with diabetes mellitus (DM) after radical resection. Methods The clinical data of 250 patients with HBV-related HCC complicated with DM who received radical resection were collected from the First Affiliated Hospital of Nanchang University and the Eastern Hepatobiliary Surgery Hospital and were retrospectively analyzed. The patients aged 30-80 years old and were divided into the elder group (≥60 years n=58) and the non-elder group (<60 years, n=192). Propensity score matching (PSM) method was used for covariate balance and the overall survival (OS) rates were compared between the two groups. Cox regression was used to analyze the risk factors influencing the prognosis of HCC. Results In the PSM cohort (n=53 in elder group, n=85 in non-elder group), the 1-, 3-, 5-year OS rates were not significantly different between the two groups (P =0. 15). The results of Cox multivariate regression analysis revealed that age was not significantly associated with OS of patients with HBV-related HCC complicated with DM. Conclusion Elder age seems not to decrease the OS of patients with HBV-related HCC complicated with DM after radical resection; elder patients can obtain similar survival as the non-elder ones.

Arterial spin labeling analysis of the cerebral blood flow in systemic lupus erythematosus patients / 医学研究生学报

Objective Neuropsychiatric systemic lupus erythematosus ( SLE) is a common complication of SLE, whose path-ogenesis is not yet clear but associated with the alteration of cerebral blood flow ( CBF) in some studies.This study was to investigate the CBF alteration in SLE patients without overt neuropsychiatric symptoms by arterial spin labeling ( ASL) MRI. Methods Twenty-eight SLE patients without overt neuropsychiatric symptoms and 30 age-and sex-matched healthy controls underwent conventional MRI and ASL examinations, and all received such neuropsychologic tests as number connecting test-A ( NCT-A ) , digit symbol test ( DST ) , self-rating anxiety scale ( SAS ) , and self-rating depression scale ( SDS) .Independent sample-t test was used to detect the mean CBF in the whole brain, gray matter, and white matter of the SLE patients and healthy controls.The voxel-wise CBF maps of the two groups of subjects were further analyzed with the SPM8 software to compare the regional CBF between the two groups, followed by evaluation of the correlation between the regional CBF values and clinical markers. Results In comparison with the healthy controls, the SLE pa-tients showed significantly reduced CBF in the gray matter (40.5 ±3.7 vs 37.3 ±6.5, P=0.028) and the whole brain (38.0 ±3.5 vs 35.1 ±6.1, P=0.032), especially in the supplementary motor area and the adjacent middle cingulate, anterior cingulate, left medial frontal gyrus, left inferior frontal gyrus, and left insula (P<0.05, FWE corrected).The NCT-A score was negatively correlated with the CBF values of the left medial frontal gyrus (r=-0.402, P=0.032) and left inferior frontal gyrus (r=-0.382, P=0.045) of the SLE patients. Conclusion ASL and MRI showed significantly reduced cerebral blood flow in the SLE patient without overt neu-ropsychiatric manifestations, which was correlated with the change of the patient's cognitive function.

The value of MRI in diagnosing and classifying of plasma cell mastitis / 实用放射学杂志

Objective To evaluate the value of the magnetic resonance imaging (MRI)in the diagnosis and classification of plas-ma-cell mastitis (PCM).Methods The breast MRIs of eighteen pathologically confirmed PCM patients were retrospectively ob-served and analyzed.The manifestations of lesions,including shape,size,margin,and characteristic enhancement on T1 WI,T2 WI with fat suppression and contrast enhanced T1 WI were observed and documented respectively.Results PCM were divided into three types according to MRIs:the inflammation type 4 cases,the abscess type 9 cases,and the mixed type 5 cases.In the inflammation type,3 cases of lesions were wide extending while the other 1 limited in nipple and areola.All 4 cases of lesions were hypointensity on T1 WI and hyperintensity on T2 WI with fat suppression.And in the contrast enhanced scanning,2 cases showed patchy hyperin-tensity and 2 cases showed branch-like enhancement.In abscess type,6 cases of lesions were wide and 3 cases limited in one quad-rant.Of all 9 cases,there were 3 cases with single abscess and 6 with multiple abscess;and all cases showed hypointensity on T1 WI and hyperintensity on T2 WI with fat suppression.In the enhanced scanning,there were 4 cases with honeycomb-like hyperintensity and 5 cases with annular and patchy enhancement.In mixed type,inflammation was accompanied with abscess and fistula.All cases were hypointensity on T1 WI and hyperintensity on T2 WI with fat suppression.In the enhanced scanning,3 cases showed honeycomb-like enhancement,1 case showed multiple annular enhancement and 1 case showed annular and patchy enhancement.Regions of in-terest were selected and time-signal intensity curves were obtianed in every enhancement cases,all of which were influent.Of all ca-ses,5 showed high-protein deposition in the expansion ducts,exhibiting hyperintensity on T1 WI and hypointensity on T2 WI with fat suppression.Conclusion The abscess type is the most common in PCM and the second is the mixed type.Annular and honeycomb-like enhancement are characteristic appearance of these two types,which are helpful in the diagnosis and classification of PCM.

A randomized controlled trials on treatment of cervicogenic sudden hearing loss with chiropractic / 中国骨伤

<p><b>OBJECTIVE</b>To investigate the clinical effect and safety of chiropractic in treating cervicogenic sudden hearing loss.</p><p><b>METHODS</b>From January 2011 to October 2013, 90 patients with cervicogenic sudden hearing loss were randomly divided into treatment group and control group according to the random number table produced by SPSS 19.0 software. In the treatment group, there were 17 males and 28 females, aged from 31 to 62 years old with an average of (47.57±9.43) years; course of disease was from 1 to 3 days with an average of (1.43±0.68) days; pure-tone audiometry score was from 46.5 to 77.8 dB with the mean of (61.20±9.83) dB; Northwick Park Neck Pain Questionnaire (NPQ) score was from 17 to 31 scores with an average of (23.46±7.18) scores. In the control group, there were 15 males and 30 females, aged from 28 to 64 years old with an average of (45.77±6.99) years; course of disease was from 1 to 3 days with an average of (1.50±0.73) days; pure-tone audiometry score was from 48.1 to 75.0 dB with the mean of (63.91±8.05) dB; Northwick Park Neck Pain Questionnaire (NPQ) score was from 20 to 29 scores with an average of (25.61±10.43) scores. The patients of control group were treated with dexamethasone intravenous drip of 10 mg, 3 days later, decreased to 5 mg, 3 days again. And with the methycobal intravenous drip of 500 μg, treatment continued for 10 days. The patients of treatment group were treated with chiropractic additionally except for the therapeutic methods of control group. Chiropractic included local muscle loosening, attacking point, bilateral pulling atlanto-axial joint, and continuous treatment for 10 days. The pure-tone audiometry score and NPQ score were compared between two groups after treatment.</p><p><b>RESULTS</b>After the treatment, pure-tone audiometry score and NPQ score in treatment group improved to (40.23± 8.14) dB and (12.70±8.29) scores respectively, which were obviously better than that of control group's (37.70±10.61) dB and (21.24±11.13) scores (P<0.05).</p><p><b>CONCLUSION</b>Compared with routine method for cervicogenic sudden hearing loss, additional chiropractic can improve hearing and relieve neck pain effectively.</p>

Evaluation of susceptibility weighted imaging in defining penumbra during acute stage of cerebral infarction and comparison with perfusion weighted imaging / 中华神经科杂志

Objective To evaluate whether susceptibility weighted imaging (SWI) can be used in definition of penumbra during acute stage of cerebral infarction,compared with perfusion weighted imaging (PWI).Methods Ischemic stroke patients within 3 days after onset were included.They adopted multimodal magnetic resonance imaging examination,including regular magnetic resonance imaging sequence (T1 WI,T2 WI and T2-weight fast fluid-attenuated inversion-recovery),diffusion weighted imaging (DWI),PWI and SWI.Alberta Stroke Programme Early CT Score was done on DWI,SWI and PWI.The mismatch of SWI-DWI (minimal indensity projection (mIP)-DWI) was compared with that of PWI-DWI (mean transit time (MTT)-DWI) and analyzed statistically.The application of prominent vein (PV) on SWI as a sort of alternation of cerebral blood volume (CBV) and direct observation of thrombosis in arteries on SWI were done.Results The SWI-DWI (2.39 ± 1.42) and the MTT-DWI (2.72 ± 1.49) mismatch showed no statistically significant difference (r =0.726,P ＞ 0.05).The grade of PV was positively related with the CBV of the ipsilateral brain tissue on admission (r =0.564,P ＜ 0.05).SWI showed the similar ability with magnetic resonance angiography to judge responsible blood vessels with susceptibility vessel sign.Conclusion SWI-DWI can evaluate the ischemic penumbra.PV may reflect the increased blood volume of the lesion side of the brain tissue.SWI can reveal the thrombosis of the responsible vessels.

Altered whole brain functional connectivity in patients with minimal hepatic encephalopathy: a resting-state functional MRI study / 中华放射学杂志

Objective To investigate the alteration of the whole brain functional connectivity in patients with minimal hepatic encephalopathy(MHE) by using resting-state functional MRI,and to explore its role in distinguishing the MHE from cirrhotic patients without MHE by using the receiver operator characteristic(ROC) curve.Methods Thirty cirrhotic patients with MHE,32 cirrhotic patients without MHE (non-MHE),and 49 healthy controls underwent standard resting-state functional MRI scan.Whole brain functional connectivities were compared with analysis of variance test to observe the difference among three groups,and then compared with Post-hoc test to investigate the changes between MHE and non-MHE groups.Results There were widespreadly different functional connectivities among three groups.All 115 functional conenctivities showed significant difference among three groups(all P＜0.05).Compared with non-MHE patients,MHE patients showed 6 decreased functional connectivity in the following brain regions (P＜0.05):between left supper temporal gyrus-right orbitofrontal cortex,left Heschl's gyrus-left Rolandic operculum,left Heschl's gyrus-right olfactory cortex,left hippocampus-right amygdala,left putamen-right putamen,and left temporal pole of supper temporal gyrus-right temporal pole of middle temporal gyrus (t=-4.41-3.82,P＜0.01).ROC analysis demonstrated that the left hippocampus-right amygdala had the highest value for differentiating MHE from non-MHE group(AUC=0.78,95％CI 0.66-0.90) with a cutoff value=0.56,sensitivity=73％ and specificity=81％).Conclusion Functional connectivity analysis can be used to observe the functional changes in MHE patient,and has a potential for the early diagnosis of MHE.

Preliminary clinical study of primary liver cancer using 3 Tesla dynamic enhanced MR imaging / 医学研究生学报

Objective Dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) is a novel functional imaging tech-nique for assessing the property of the tissue vessel .This study was to investigate whether DCE-MRI can manifest the angiogenesis of pri-mary liver cancer in the aspect of vascular permeability so as to provide more objective diagnostic information for the evaluation of primary liver cancer . Methods Twenty-one patients with primary liver cancer underwent DCE-MRI.The region of interest ( ROI) was placed in the whole tumor, the hot spot of the tumor and the adjacent liver parenchyma .Tissue 4D software package was used for the post-pro-cessing of the DCE-MRI images, the quantitative parameters including transfer constant (Ktrans), rate constant (Kep) and tumor extravas-cular extracellular space volume (Ve), and such semi-quantitative parameter as the initial area under the contrast concentration versus time curve (iAUC). Results The mean Ktrans, Kep, Ve and iAUC values were (0.124 ±0.057)/min, (0.632 ±0.158)/min, (0.205 ±0.098) and (10.009 ±6.201) in the adjacent liver parenchyma , (0.196 ±0.109)/min, (0.546 ±0.214)/min, (0.424 ± 0.160) and (13.675 ±6.113) in the whole tumor, and (0.422 ±0.170)/min, (0.780 ±0.308)/min, (0.589 ±0.116) and (35.663 ±19.086) in the hot spot of the tumor .All the parameters were significantly higher in the hot spot of the tumor than in the whole tumor (P<0.05), and so were Ktrans and Ve in the whole tumor than in the adjacent liver parenchyma (P<0.05), but Ktrans, Ve, and iAUC were markedly lower in the adjacent liver parenchyma than in the hot spot of the tumor (P<0.05). Conclusion Analysis of the vascular permeability of the tissue using DCE-MRI parameters can indirectly reflect the angiogenesis of the tumor and contribute to the evaluation of primary liver cancer , while monitoring the DCE-MRI pa-rameters of the hot spots of the tumor may allow more accurate evalua-tion of primary liver cancer .

The value of dual-energy CT in diagnosing pulmonary embolism in children / 中华放射学杂志

Objective To evaluate the value of dual energy CT with Lung Vessels application in diagnosing pulmonary embolism (PE) of children.Methods Forty-seven patients with nephrotic syndrome and aged ≤ 18 years old (32 male,15 female,mean age 15 years) underwent dual-energy CT pulmonary angiography (CTPA).Two radiologists recorded the presence or absence of emboli and counted the clots on a per-patient and per-lobe basis with Lung Vessels,respectively.With conventional CTPA as reference standard,sensitivity,specificity,positive predictive value (PPV),negative predictive value (NPV) of Lung Vessels application to detect PE were computed for two readers.Inter-reader agreement was also calculated.Results Conventional CTPA detected 51 clots in 35 lung lobes in 13 patients,giving PE incidence was 27.6％ (13/47) for this cohort.On a per-patient basis,readers 1 and 2 detected 25 and 21 patients with PE with Lung Vessels,corresponding to sensitivities,specificities,PPVs,and NPVs of 100.0％ (13/13),58.6％ (17/29),43.3％ (13/30),100.0％ (17/17) and 100.0％ (13/13),76.5％ (21/29),50.0％ (13/26),100.0％ (21/21),respectively.On a per-lung lobe basis,readers 1 and 2 detected 74 and 63 clots with Lung Vessels,respectively,corresponding to sensitivities,specificities,PPVs,and NPVs of 94.3％ (33/35),79.5％ (159/200),44.6％ (33/74),98.7％ (159/161) and 97.1％ (34/36),85.5％ (171/200),54.0％ (34/63),98.8％ (171/173),respectively.On a per-clot basis,134 and 105 clots were detected with Lung Vessels application,corresponding to sensitivities,specificities,PPVs,and NPVs for DECT of 96.1％ (49/51),64.9％ (159/245),36.3％ (49/135),98.7％ (159/161) and94.1％ (48/51),75.0％ (171/228),45.7％ (48/105),98.3％ (171/174)for readers 1 and 2,respectively.Excellent or good inter-reader agreement was observed on a per-patient,per-lobe and per-clot basis (Kappa =0.828,0.859,0.695 ; all P ＜ 0.01).Conclusions Dual-energyCT with Lung Vessels application has a high sensitivity and negative predictive value for PE detection in children.More clots are detected with Lung Vessels application than conventional CTPA,which deserve further investigation.