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Objective:To explore the feasibility and value of individualized scheme of dose of iodine contrast medium in enhanced abdominal CT imaging based on liver volume (LV) measurement.Methods:The examination data and technical parameters of 64 patients, who underwent multi-phase dynamic enhanced abdominal CT imaging from February to September 2019 at First People's Hospital of Yunnan Province were retrospectively analyzed. The density of liver on CT pre-contrast images and post-contrast images, LV and average iodine content in the liver (AII) of all subjects were measured. The difference of liver density (ΔHU), total iodine dose of contrast agent injected (IM) and total intrahepatic iodine (TII) were calculated. Pearson correlation analysis was performed to evaluate the association between AII and ΔHU, as well as IM and TII. The difference between the injection volume of contrast agent predicted by the formula and the actual injection volume of contrast agent was tested by paired t test. Results:The ΔHU and AII showed highly positive correlation ( r=0.926, P<0.05). The regression equation was Y AII=0.034X ΔHU+0.296. The TII showed significantly positive correlation with the IM ( r=0.759, P<0.05), and the regression equation was Y IM=3.649X TII+16 486.754. With the liver enhancement ΔHU=50 HU as a reference, the individually dose of contrast medium injection could be deducted based on LV, with Y IM=7.225X LV+ 16 486.754. This formula was introduced into all the subjects to calculate the predicted value of contrast agent application, and the calculated injection volume of contrast agent was (64.27± 4.92) ml. Paired t test was conducted to compare the predicted injection volume of contrast agent with the actual injection volume of contrast agent, and the difference was statistically significant ( t= 6.009, P<0.05). Conclusion:The feasibility of calculating individualized scheme of contrast agent based on LV in enhanced abdominal imaging is verified. This method can be used to predict the enhancement level of liver and to reduce the dosage of iodine contrast agent.
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Objective To establish chronic coronary stenosis model for fractional flow reserve derived from coronary CT angiography (FFRcT) in Bama miniature pig,and to evaluate its reliability.Methods Sixteen Bama miniature pigs were used to establish chronic coronary stenosis models through placing Ameroid constrictor into proximal or middle segments of left anterior descending arteries (LAD).In the 2nd week after modeling,the degrees of stenosis were monitored with coronary CTA.Invasive coronary angiography was used to verify stenosis degrees and measure fractional flow reserve (FFR) within 2 days of last coronary CTA examination.Computational fluid dynamics model was constructed and FFRcT was calculated by the specialized laboratory based on coronary CTA data respectively.Simulated FFRcT and FFR values were compared to verify this model.Results Models were successfully established in 10 pigs with a total of 24 coronary CT examinations,of which image quality met the diagnostic requirements.All models were with LAD stenosis＜25 ％ in the 2nd week after operation.LAD stenosis ＞50％ was found in the 3rd week in 9 pigs,and the other one was found with LAD stenosis ＞50％ in the 4th week.The results of coronary CTA corresponded to those of coronary angiography.There was no significant difference between simulated FFRcT and FFR value (t =-1.13,P =0.29).Conclusion Through placing Ameroid constrictor into LAD of Bama miniature pig and monitoring the degree of stenosis with coronary CTA,model of chronic coronary stenosis could be successfully established,which are suitable for noninvasive simulating hemodynamics study based on coronary CTA.
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Objective To investigate post-traumatic stress disorder (PTSD) and life quality (QOL) of children and adolescents with cancer,and analyze the correlation between PTSD and QOL and study whether PTSD would influence QOL.Methods We investigated PTSD by using the PTSD-SS,and investigated QOL by using the EORTC QLQ-C30 V3,and the data was performed by SPSS 17.0.Results The PTSD-SS total score and the scores of EORTC QLQ-C30 of function field and of whole life quality field were negatively correlated,and the PTSD-SS total score and the scores in symptom field and six single measurement of EORTC QLQ-C30 were positively correlated.Conclusions PTSD of children and adolescents with cancer was closely related with the poor functional status and the high level of symptoms problem.PTSD has affected QOL.The higher level the PTSD is,the lower level of QOL will be.
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ObjectiveTo evaluate bacteria contamination during collection,processing and storage of cord blood to gain insight into contamination mechanism and direct prevention.MethodsFresh cord blood was separated by hydroxyethyl starch (HES) to harvest nucleated cells.The bacteria contamination was tested by culturing 10 ml plasma-red cells with BacT/ALERT 3D-480 automatic blood culture system.Total 87 positive samples were further identified for bacteria species.Ninety six cord blood nucleated cells concentrate with bacteria positive stored in liquid nitrogen(LN2) for 6-7 years were thawed at 37 C and re-cultured for bacteria analysis.ResultsWe collected 19 062 umbilical cord blood.Among them,336 was bacteria positive ( contamination rate 1.8 ％ ).Eighty-seven positive samples were further investigated with facultative bacteria 58 (66.7 ％ ),aerobic 38(43.7％ ) and anaerobic 17( 19.5％ ),Gram- negative accounted for 68％ while positive 32％.The most frequent bacteria were Escherichia coli ( 25.3％ ),Streptacoccus intermediate ( 14.9％ ) and Chromobacteria violaceum(9.2％ ).Ninety-six nucleated cells concentrate with bacteria positive were cryopreserved at liquid nitrogen for researching.Of them,83 samples( 86％ ) showed positive of bacteria culture after deep-low temperature storage for 6-7 years.ConclusionsBacteria contamination rate of the cord blood collection,processing and storage in 2000 ～ 2007 was 1.8％.Stored in liquid nitrogen for 6-7 years,the viability of bacteria was 86％.The aseptic procedures of cord blood collection in delivery room should be intensified.The bacteria re-culture following thawing of cord blood cells is necessary before clinical transfusion.
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Objective To assess ventilation administration during fiberoptic bronchoscopy (FB) in neonates. Methods Twenty-three neonates divided into two group (A group 12 neonates, B group 11 neonates) received FB. All were given pressure support ventilation (PSV)by a Y-like facility which connected to fiberoptic bronchoscope suction hole. In A group,after the tip of fiberoptic bronchoscope arrived at the carina, PSV was administrated. In B group, PSV was administrated in the entire process during FB, SpO2 and electrocardio were monitoring. Artery blood samples for blood gas analysis were obtained at four stages of just before FB,with the tip of the bronchoscope at the supralarynx,just before withdrawing bronchoscope out off trachea and within 20-30 minutes after FB. The arterial blood oxygen tension (PaO2), arterial blood carbon dioxide tension (PaCO2) and SpO2 just before FB served as baseline. The same indexes of other three stages were compared with the baseline. Results All 23 neonates were studied completely. When the tip of fiberoptic bronchoscope advanced from nostril to the supralarynx, SpO2, PaO2 and PaCO2 in two groups were similar to the baseline. In A group, when the tip below the glottis, cyanosis occurred, and SpO2 decreased significantly ( P＜0. 01 ) in 11 cases (92%) by 25% ; When tip at the carina, after PSV, cyanosis disappeared, and SpO2 returned to the baseline level, PaO2 keep on the baseline just before withdrawing the bronchoscope out of the trachea. SpO2 ,PaO2 in all B group neonates keep on the baseline during FB. After the tip below the glottis,PaCO2 in all neonates of the two groups increased significantly ( P＜0. 01 ), but returned to baseline within 20-30 minutes after FB. Conclusion FB can cause significant hypoxemia and hypercapnia in neonates. PSV through fiberoptic bronchoscope can be considered a safe and beneficial ventilation technique for maintaining oxygenation during FB.
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Objective To investigate the reliability of using inhibitors including Phenylboronic acid (PBA)and Fqucloxacillin(FCC)in detecting derepressed hyperproduction and plasmid-mediated AmpC B-lactamases.Methods PBA and FCC were chosen as inhibitors and double-disk potentiation method and double-disk synergy method were used to detect positive and negative control strains of AmpC β-lactamases and 107 clinical isolates for AmpC β-lactamases production.The positive control strains included E.cloacae (029M),plasmid-mediated ACT-1 type of E.coli DH5a2919,MOX-1 type of k pheumoniae,LAT-2 type of E.coil.The negative control strains included E.cloacae 029(wild-type),E.coli SHV-1,E.coli SHV-2, E.coil SHV-5,E.coli TEM-1,E.coli TEM-3,k peumoniae SHV-18 and E.coli ATCC25922.We compared the results above with the three dimensional test(3-DT)to observe the accuracy in detecting AmpC-BLA.Results 3-DT together with PBA and FCC based inhibition tests showed the 4 positive control strains and the 9 negative control strains were determined as expected.AmpC-BILA was detected in 107 clinical isolates ofEnterobacteriaceaes.The positive rate of3-DTmethod is24.3%.The positive rates ofPBA.FCC double-disk potentiation method and double-disk synergy method are 30.8%(33/107),26.2%(28/107) and 23.4%(25/107),respectively.The conjugate results in two strains of P mirabilis and one strain of K.peumoniae were positive.They were all plasmid-mediated AmpC-Bi.A.There Was a higher false positive when using PBA and FCC-based double-disk potentiation method to detect the induction type of AmpC-BLA, but the accuracy of double-disk synergy method was high.Compared with the 3-DT,the coincidence rate using PBA and FCC-based double-disk synergy method is 99.1%.Conclusions Using PBA and FCC as inhibitors in the double-disk synergy test is a accurate and reliable method to detect AmpC-BLA regardless of derepressed hyperproduction type or plasmid-mediated type.
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Objective To study mortality of acute myocardial infarction caused by acute left main coronary artery occlusion.The objectives of this analysis were to determine the effect of primary PCI and the impact of cardiogenic shock on acute myocardial infarction caused by acute left main coronary artery occlusion.Methods From 1999 to 2005,of 752 consecutive patients with acute myocardial infarction,16 patients had acute left main coronary artery occlusion with TIMI flow≤2.All patients were given primary PCI.Results Of these 16 patients,9(56.25%)died in hospital,and 7(43.75%)discharged.In the survival group reperfusion was successful in 100% of patients,as opposed to 44.44% in the mortality group(P=0.019).Cardiogenic shock was overt in 12(75.00%)patients,42.86% of the survival group and 100% of the mortality group(P=0.020).Shock patients had higher in-hospital mortality than stable patients(75 % vs 0%,odds=4.0,95%CI 1.50~10.66,P=0.019).Conclusion Patients presenting with AMI caused by acute left main coronary artery occlusion and cardiogenic shock have poor survival regardless of primary PCI.Nevertheless,primary PCI is a feasible and effective procedure,and it may save lives in this clinical setting.