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Objective: To quantitatively evaluate the changes of diffusional and perfusion of degenerative water molecules in lumbar inervertebral disc by multiple b-value voxel incoherent motion imaging. Methods: We selected 60 patients (34 males and 26 females) with low back pain or sciatica from The First Affiliated Hospital of Xi'an Jiaotong University. The subjects underwent lumbar MRI sagittal T2WI and median sagittal multiple b-value weighted imaging. We graded the L1-S1 disc according to the Pfirrmann grading standards, and measured the ADCslow, ADCfast, f values of the nucleus pulla, and the anterior and posterior edges of the annulus fibrosus. We compared the mean values of ADCslow, ADCfast, f at the anterior and posterior edges of nucleus pulposus and annulus fibrosus and analyzed the correlation analysis between them and the grade of degeneration. Single factor analysis of variance combined with SNK test was used in the statistics. Results: A total of 300 discs were measured and the statistical results showed that: ① The mean value of the ADC of the nucleus pulposus of each grade of the lumbar disc decreased with the increase of the grade. Although there was no significant difference between grade and grade Ⅱ, grade and grade , there were statistically significant differences between the other grades (P0.05). Conclusion: The quantitative measurement of nucleus pulposus ADCslow based on IVIM is a potential and more sensitive quantitative magnetic resonance method for evaluating early degeneration of lumbar disc.
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As one of the three pillars of Chinese medicine industry, traditional Chinese medicines prepared in ready-to-use forms are important raw materials for clinical medication and production of Chinese patent drugs. By considering the literature of Curcumae Radix, a multi-source Chinese herb and the situation of market investigation, the modern evaluation method based on traditional grading was introduced for comprehensive evaluation of the processed Curcumae Radix. The correlation between traditional grading method and modern evaluation index was explored to establish the grading standard of Curcumae Radix. According to the comprehensive evaluation, Curcumae Radix was divided into four grades: superior, first, second and third grades under the guidance of the theory of traditional Chinese medicine. This study provides a new idea for the grading of multi-source processed Chinese medicine, achieving high quality and good price, which is helpful to improve the clinical efficacy.
Subject(s)
Drugs, Chinese Herbal , Medicine, Chinese Traditional , Plant RootsABSTRACT
Objective To observe the accuracy of the five-level adult emergency triage system (FLAETS) in determining the severity of critically ill patients,and to analyze the factors that influenced the accuracy of the triage.Methods The triage information of patients admitted to Huashan North Hospital Affiliated to Fudan University between 1 year before and 1 year (started in July 2014) after the implementation of the FLAETS were retrospective analyzed.The patients who triaged by FLAETS (from September 2014 to August 2015) were served as observational group,and those manual triaged by modified early warning score (MEWS,from July 2013 to June 2014) were set as control group.The patients with triage of Ⅰ,Ⅱ,and Ⅲ levels were enrolled (fatal,critical,urgent),and the triage results of emergency physicians-in-chief on duty were set as gold standard.The gender,age,triage level,the proportion of over-triage,the proportion of under-triage,and mortality were compared between two groups.The reasons for the overtriage and under-triage were analyzed.The accuracy of FLAETS in determining severity of critically ill patients was calculated.Results 18449 patients were enrolled in observational group,and 720,1641 and 16088 patients were triaged as level Ⅰ,level ⅡⅡ,level Ⅲ respectively;17 378 patients were triaged as critically ill patients according to gold standard,and level Ⅰ,level Ⅱ,level Ⅲ were 637,1476 and 15 265 patients respectively.6 352 patients were enrolled in control group,and level Ⅰ,level Ⅱ,level Ⅲ were 204,771 and 5 377 patients respectively;6002 patients were triaged as critically ill patients according to gold standard,and level Ⅰ,level Ⅱ,level Ⅲ were 308,836 and 4 858 patients respectively.There were no statistically significant differences in gender and age between two groups (both P ＞ 0.05).Compared with the control group,the proportion of over-triage of level Ⅲ was significantly lowered [8.3％ (1 329/16088) vs.12.5％ (674/5 377),P ＜ 0.01],the proportion of under-triage of level Ⅱ and level Ⅲ was significantly lowered [level Ⅱ:0.6％ (9/1 641) vs.7.0％ (54/771),level Ⅲ:0.4％ (63/16088) vs.4.7％ (254/5 377),both P ＜ 0.01].The success rate of resuscitation in observation group was significantly higher than that of control group [80.70％ (619/767) vs.75.23％ (410/545),P =0.020],and the mortality was significantly lowered [1.11％ (193/17 378) vs.2.35％ (141/6002),P =0.037].Over-triages were mainly found in patients with chronic obstructive pulmonary disease (COPD),hypertension and the main complaint of chest tightness,shortness of breath,and under-triages were mainly found in patients with the multiple organ dysfunction in the elder,atypical heart disease and pneumothorax.The accuracy rates of level Ⅰ,level Ⅱ and level Ⅲ in observation group (99.37％,97.42％ and 89.58％) were significantly higher than those of the control group (97.51％,92.54％,and 80.16％,all P ＜ 0.01).Conclusion The FLAETS in determining severity of critically ill patients were objective and reliable,which enable the nurse to better handle the relationship of the emergency and the ordinary,the severe and the mild,the priority and the non-priority,which made the patients received timely and effective treatment.
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Objective: To establish the system of the quality evaluation technology for the seeds of Cynomorium songaricum and to draw up the quality grading standard for the seeds of C. songaricum. Methods: A stereomicroscope, electronic balance, and the method of in vitro embryo culture were used to measure the morphology, grain, and embryo rate and viability for the seeds of C. songaricum. The method of mathematical statistics were adopted to analyze the main index and reference index of dividing grades of seed; The method of standard deviation was applied in developing the seed quality grading standard. Results: Seeds were 1.03-1.63 mm long and 0.69-1.23 mm wide, kernel was about 0.61-1.05 mm long and 0.50-0.50 mm wide. There was a significant correlation among seed morphological indexes (P 0.05) and there was no correlation among the thousand-grain weight, viability, and embryo rate (P > 0.05), while there was a significant correlation between the viability and embryo rate (P < 0.01); the viability was the main index in the quality grading for the seeds of C. songaricum; while the clarity, grain, and water were the reference indicators of quality grading of the seeds. Conclusion: The seed quality of each grade should reach the following requirements. For the first grade seeds: seed viability is not less than 98%, purity is not less than 93%, housand-grain weight is not less than 0.8 g, water content is not higher than 8.0%; for the second grade seeds, the seed viability is not less than 95%-98%, the purity is not less than 86%, the thousand-grain weight is not less than 0.7 g, water content is not higher than 8.0%; for the third grade seeds, seed viability is not less than 90%-95%, purity is not less than 80%, thousand-grain weight is not less than 0.5 g, water content is not higher than 8.0%; seeds that do not reach the standard of the third level are unqualified ones.