Biograph Vision 600 PET performance testing and analysis / 中国辐射卫生

Objective To test and analyze the performance of Biograph Vision 600 PET/CT according to the NEMA NU2—2012 standard to achieve reliable, repeatable, and inter-system comparable performance measurement, and to provide a basis for future equipment stability testing and status detection. Methods The Biograph Vision PET equipment features a detector based on silicon photomultipliers, with 3.2 mm lutetium oxyorthosilicate crystals and full cover of the scintillation region. The spatial resolution, sensitivity, noise-equivalent count rate, scatter fraction, coincidence count rate, image quality, scatter correction, and time-of-flight resolution of Biograph Vision PET were tested by referring to the test model and method of the NEMA NU2—2012 standard. Results The Biograph Vision 600 PET equipment showed lateral and axial spatial resolutions of 3.69 mm and 3.81 mm at 1 cm off-center of the field of view, respectively and of 4.29 mm and 4.48 mm at 10 cm, respectively. The sensitivity was 17.5 kcps/MBq. The time-of-flight resolution changed from 210 ps to 215 ps as the count rate increased to the peak noise equivalent count rate. The NEMA peak noise-equivalent count rate was 247 kcps at 30.3 kBq/ml. The corresponding scatter fraction was 34.8%. With the NEMA module, the overall image quality contrast range was 73.6%-92.8%, and the background variability was 2.3%-6.5%; the mean lung residual error was 3.4%; and the time-of-flight resolution was 210 ps. Conclusion This performance test was performed according to the NEMA NU2—2012 standard, showing that all parameters were better than the ex-factory standard, which can provide a reference for other institutions selecting equipment and also provide a basis for future equipment stability testing and status detection.

Novel biopharmaceutical development investigations towards drug and formulation performance optimization

For a drug to excerpt pharmacological action after oral intake, it first needs to be released from the formulation, get into solution (dissolve), be absorbed, and reach the systemic circulation. Since only solubilized drugs can be absorbed, and thus have therapeutic effect, the understanding of the dissolution and drug release processes of a drug product is of primary importance. Such understanding allows a robust formulation development with an ideal in vivo performance. In order to meet set standards, the performance assessment of oral drug products, such as dissolution testing, often applies conditions that are not reflective of the in vivo environment. The use of non-physiologically relevant dissolution method during the drug product development phase can be misleading and give poor mechanistic understanding of the in vivo dissolution process. Hence, we hypothesized that applying physiologically relevant conditions to the dissolution test would result in more accurate in vivo predictability for a robust and precise development process. Since the buffering system in the intestinal lumen operates at low molarity values, phosphate buffer at low buffer capacity was used as a first approach to an in vivo relevant parameter. Furthermore, a biphasic system was used, that is, the low buffer capacity medium was paired with an organic layer (n-octanol) to mimic the concurrent drug absorption that happens with the in vivo dissolution. Both poorly and highly soluble drugs in immediate release formulations (ibuprofen and metronidazole, respectively) were tested in this set-up to assess the dissolution in the aqueous medium and the partitioning to the organic phase. Additionally, enteric coated formulations were tested in bicarbonate buffer at the in vivo reported molarities values to assess the impact of buffer species on drug dissolution. The evaluated parameters were the buffer system (bicarbonate buffer vs. phosphate buffer), buffer capacity and medium pH. In all approaches, dissolution was also carried out in compendial buffer for comparison purposes. Our results demonstrate that the USP-recommended dissolution method greatly lacked discriminatory power, whereas low buffer capacity media discriminated between manufacturing methods. The use of an absorptive phase in the biphasic dissolution test assisted in controlling the medium pH due to the drug removal from the aqueous medium. Hence, the applied noncompendial methods were more discriminative to drug formulation differences and manufacturing methods than conventional dissolution conditions. In this study, it was demonstrated how biphasic dissolution and a low buffer capacity can be used to assess drug product performance differences. This can be a valuable approach during the early stages of drug product development for investigating drug release with improved physiological relevance. Similarly, all the enteric coated formulations displayed a fast release in phosphate buffer and complied with the compendial performance specifications. On the other hand, they all had a much slower drug release in bicarbonate buffer and failed the USP acceptance criteria. Also, the nature of the drug (acid vs base) impacted the dissolution behavior in bicarbonate buffer. This study indicates that compendial dissolution test for enteric coated tablets lacks physiological relevance and it needs to be reevaluated. Thus, an in vivo relevant performance method for EC products is needed. Overall, the findings of this thesis comprehensively demonstrates that meaningful differences in performance and accordance to clinical reports were only obtained when physiological relevant conditions were applied. Hence, our results indicate that the central hypothesis was answered positively

Para que um medicamento exerça a ação farmacológica após a ingestão oral, ele primeiro precisa ser liberado da formulação, dissolver, ser absorvido e atingir a circulação sistêmica. Uma vez que apenas medicamentos solubilizados podem ser absorvidos e, assim, ter efeito terapêutico, a compreensão dos processos de dissolução e liberação de um medicamento é de extrema importância. Tal compreensão permite o desenvolvimento de uma formulação robusta com o desempenho in vivo ideal. Para atender aos padrões regulatórios previamente estabelecidos, a avaliação da performance de formulações orais, como por exemplo, o teste de dissolução, frequentemente aplica condições que não refletem o ambiente fisiológico. O uso de métodos de dissolução não fisiologicamente relevante durante a fase de desenvolvimento do medicamento pode gerar resultados equivocados sem uma compreensão mecanistica do processo de dissolução in vivo. Portanto, a hipótese desse trabalho é que a aplicação de condições fisiologicamente relevantes no teste de dissolução resultaria em uma predição mais precisa da dissolução in vivo para um processo de desenvolvimento robusto e preciso. Uma vez que o sistema tampão no lúmen intestinal possui baixa molaridade, o tampão fosfato com baixa capacidade tamponante foi usado como uma primeira abordagem como um meio de dissolução fisiologicamente relevante. Além disso, foi utilizado um sistema bifásico, ou seja, o meio de baixa capacidade tamponante combinado a uma fase orgânica (n-octanol) para imitar a absorção in vivo. Formulações de liberação imediata contendo fármacos de baixa e de alta solubilidade (ibuprofeno e metronidazol, respectivamente) foram testadas no sistema bifásico para avaliar a dissolução no meio aquoso e a partição para a fase orgânica. Ademais, formulações com revestimento entérico foram testadas em tampão bicarbonato nos valores de molaridades fisiológicos para avaliar o impacto da espécie tamponante na dissolução do fármaco. Os parâmetros avaliados foram o sistema tampão (tampão bicarbonato vs. tampão fosfato), capacidade tamponante e pH médio. Em todas as abordagens, a dissolução também foi realizada em tampão farmacopeico para fins de comparação. Nossos resultados demonstraram que o método de dissolução farmacopeico não foi discriminativo, enquanto o meio com menor capacidade tamponante diferenciou entre as formulações obtidas via granulação úmida ou compressão direta. Ademais, a utilização da fase orgânica no teste de dissolução bifásica auxiliou no controle do pH do meio aquoso. Portanto, os métodos não compendiais aplicados foram mais discriminativos do que as condições de dissolução convencionais. Neste estudo, foi demonstrado como a dissolução bifásica e uma baixa capacidade tamponante podem ser usadas para avaliar as diferenças na performance de formulações. Esta pode ser uma abordagem valiosa durante os estágios iniciais do desenvolvimento de medicamentos para investigar a liberação destes sob condições fisiologicamente relevantes. Da mesma forma, todas as formulações com revestimento entérico exibiram uma liberação rápida em tampão de fosfato e atenderam às especificações farmacopeicas. Entretanto, a liberação do fármaco foi muito mais lenta em tampão de bicarbonato e consequentemente não cumpriram com as especificações farmacopeicas. Além disso, a natureza do fármaco (ácido vs. base) impactou o comportamento de dissolução no tampão de bicarbonato. Este estudo indica que o teste de dissolução convencional para comprimidos de liberação retardada não possui relevância fisiológica e precisa ser reavaliado. Portanto, os resultados desta tese demonstram de forma abrangente que diferenças significativas na performance condizentes com relatórios clínicos foram obtidas apenas quando as condições fisiológicas relevantes foram aplicadas. Esses resultados indicam que a hipótese central foi respondida positivamente

Specific Learning Disability Assessment and Interpretation: NIMHANS SLD Battery and Beyond

To diagnose Specific Learning Disability (SLD) in India, only ‘NIMHANS Specific Learning Disability Battery (NSB)’ is accepted for assessment and certification of disability. Earlier editions of the NSB used ‘functioning at three standards below the current class of the child’ to arrive at a diagnosis of SLD, and was simple to administer and interpret. Given these, majority of psychologists used it in their routine assessments, and in most of the cases, it was relatively easy to diagnose SLD with this battery. A major limitation faced when using the NSB was that it had test items only till the 7th grade. In the updated NSB, there are test items till the 10th grade, which is definitely a big upgrade. However, as the battery is relatively concise and does not clearly describe the nuances of assessment and interpretation in marginal and complex scenarios, some young psychologists and research scholars might find it difficult to diagnose SLD. Some of these scenarios are, when the child shows problems in academics but does not exactly fulfil the NSB criteria; when the child is having problems with second language instead of the first language; when the child is from an international curriculum; when the child is studying in a class higher than grade 10; when comprehension appears to be impaired; and/or the issue of whether or not to have so many subtypes of SLD. This article highlights some of these issues, discusses and attempts to provide possible solutions with respect to assessment and interpretation.

Cognitive impairment in children with benign childhood epilepsy with centrotemporal spikes and attention deficit hyperactivity disorder: a prospective study / 中国当代儿科杂志

OBJECTIVES@#To study the difference in cognitive impairment between the children with benign childhood epilepsy with centrotemporal spikes (BECT) and attention deficit hyperactivity disorder (ADHD) and those with BECT or ADHD alone.@*METHODS@#A prospective study was performed on 80 children with BECT and ADHD, 91 children with BECT, and 70 children with ADHD , who were diagnosed with the diseases for the first time. Seventy children of the same age who underwent physical examination were enrolled as the healthy control group. Event-related potential P300, Wechsler Intelligence Scale for Children, and integrated visual and auditory continuous performance test were used to measure and compare each index between groups.@*RESULTS@#Compared with the healthy control group, the BECT+ADHD group, the BECT group, and the ADHD group had a significantly prolonged P300 latency, a significant reduction in the amplitude of P300, and significant reductions in the scores of verbal comprehension index (VCI), perceptual reasoning index (PRI), working memory index (WMI), processing speed index (PSI), full scale intelligence quotient (FSIQ), auditory response control quotient (ARCQ), visual response control quotient, full response control quotient (FRCQ), auditory attention quotient (AAQ), visual attention quotient, and full attention quotient (@*CONCLUSIONS@#Compared with the children with BECT or ADHD alone, the children with both BECT and ADHD have basically the same fields of cognitive impairment but a higher degree of cognitive impairment in some fields.

Comparison study of EEG biofeedback therapy on clinical efficacy of children with different subtypes of attention deficit hyperactivity disorder / 中华行为医学与脑科学杂志

Objective:To evaluate EEG biofeedback therapy on clinical efficacy of children with different subtypes of attention deficit hyperactivity disorder (ADHD) using the integrated visual and auditory integration continuous performance test (IVA-CPT).Methods:Children with ADHD who completed more than 60 times of EEG biofeedback training in Hangzhou Seventh People's Hospital from July 2018 to September 2020 were selected as the research subjects. According to the results of IAV-CPT before treatment, all the children were divided into three subtypes: attention deficit type ( n=21), impulse hyperactivity type ( n=11), and mixed type ( n=30). The differences of symptom improvement between the three subtypes before and after training were compared by SPSS 23.0 software. Results:(1) In terms of response control (a total of 9 items), there was no statistical significance in the attention deficit group before and after treatment (all P>0.05). In the hyperactivity group, the scores of visual and auditory response control, full scale response control, auditory prudence and auditory consistency, visual focus quotient and visual consistency before treatment were significantly lower than those after treatment(all P<0.05). In the mixed group, the scores of visual and auditory response control, full scale response control, auditory prudence, visual consistency, and visual prudence before treatment were significantly lower than those after treatment(all P<0.05). In terms of attention (a total of 9 items), the scores of auditory vigilance, auditory attention, visual attention, full scale attention, visual vigilance and visual speed in the attention deficit group before treatment were significantly lower than those after treatment(all P<0.05). The scores of visual attention, full scale attention, visual focus quotient (all P<0.01), auditory attention and visual speed (all P<0.05) in hyperactivity group before treatment were significantly lower than those after treatment. In the mixed group, the scores of the other 8 items before treatment were significantly lower than those after treatment (all P<0.01, auditory focus quotient were P<0.05), except that the auditory speed had no statistical significance before and after treatment.(2)After EEG biofeedback training, the changes of IVA-CPT scores of the three groups before and after treatment(visual response control (-2.76±24.39), (19.55±19.94), (12.93±25.30), F=3.932, P=0.025), (full scale response control (2.38±20.77), (21.27±15.86), (15.43±25.69), F=3.158, P=0.050), (full scale attention (18.43±27.44), (11.36±11.40), (26.23±18.41), F=4.692, P=0.016), (auditory vigilance (20.23±42.65), (6.55±10.20), (33.63±36.30), F=7.160, P=0.002), (visual vigilance (19.48±28.55), (5.27±10.62), (33.27±28.26), F=10.876, P<0.001), (visual focus quotient (-2.24±23.67), (14.45±13.79), (12.83±21.91), F=3.669, P=0.031) were statistically significant. After LSD comparison, the changes of visual control and total control scores in the attention deficit group before and after treatment were significantly lower than those in the impulse hyperactivity group (all P<0.05) and the mixed group (all P<0.05). In the three items of total attention score, auditory vigilance and visual vigilance, the changes of impulsivity hyperactivity group before and after treatment were significantly lower than those of mixed group ( P=0.050, P<0.05, P<0.01, respectively). The changes of visual attention quotient in the attention deficit group before and after treatment were significantly lower than those in the impulse hyperactivity group and the mixed group (all P<0.05). Conclusion:EEG biofeedback has clinical efficacy in the three groups of subtypes of ADHD, but the efficacy is different, and individualized EEG training programs should be developed for different subtypes of children on the basis of standard TBR therapy protocol.

Quality control measures of thermoluminescent dosimetry system used in environmental radiation monitoring / 中国辐射卫生

Objective To discuss the quality control measures of the thermoluminescent dosimetry system and to verify its propriety of when used in environmental radiation monitoring. Methods The quality control measures included the stability test, the dispersibility screening and the uncertainty evaluation of measurement results of the TLD reader and TLD detector, in addition, the environmental radiation accumulated dose monitoring results obtained by the high pressure ionization chamber were compared with those by the thermoluminescent dosimetry system. Results The variation range of TLD reader’s light source coefficient is within 0.070 ～ 0.073 during the preheating and measuring process, which meets the requirements of stability; The χ2 value of the TLD detector is 2.088, which obeys the normal distribution; The thermoluminescent dosimetry system’s nonlinear response, coefficient of variation and energy response meet the measurement requirements; There is a deviation of −6.58% the largest between the cumulative dose obtained by TLD and the high pressure ionization chamber. Conclusion The quality control measures discussed in this paper can be used as a reference for similar thermoluminescent dosimetry system. Our system has passed all the tests and can meet the environmental radiation cumulative dose monitoring requirements.

Study on event related potentials and behavioral characteristics in Go/Nogo task in children with sleep disordered breathing and normal children / 中华行为医学与脑科学杂志

Objective To compare and analyze the event related potential ( ERP ) and behavioral characteristics of sleep disordered breathing ( SDB ) and normal children by the persistent operating test ( CPT-AX) task,and to explore the characteristics and neural mechanism of the cognitive deficits in the left and right brain of school age SDB children. Methods SDB children( n=20) and normal children( n=20) aged 6-8 were selected. All subjects were tested by CPT-AX ( Go/Nogo task) . The ERP behavior of SDB and normal children was recorded,and the N2,P3 amplitude and latency of F3,Fz,F4 lead were compared. Re-sults ( 1) There was no significant difference between SDB group and normal group in behavioral correct number (36. 45±4. 69 vs 35. 00±3. 46),the reaction time ((516. 84±54. 14)ms vs (496. 94±78. 89)ms) and false alarm number( 1. 0 ( 0. 25,3. 75) vs 0. 5 ( 0. 00,3. 00) ) ( all P>0. 05) . ( 2) Comparison of F3,Fz and F4 lead:(1) SDB group:there was no significant difference in Go-N2 amplitude (-7. 75(-12. 03,-1. 09)μV vs (-8. 69±5. 72) μV vs ( -7. 12±4,68)μV) and Nogo-N2 amplitude((-10. 72±4. 49)μV vs (-12. 16±4. 60) μV vs (-11. 78±4. 44) μV) in the left,middle,and right of frontal regions. (2) Control group:there was no statistical difference between F3 and Fz ((-7. 26±3. 18)μV vs (-9. 09±3. 11)μV)(P>0. 05) in N2 amplitude and there was no statistical difference between F3 and F4((-7. 26±3. 18) μV vs (-6. 10±3. 36)μV) in N2 amplitude (P>0. 05). The N2 amplitude difference of Fz and F4 ((-9. 09± 3. 11) μV vs (-6. 10±3. 36)μV ) was statistically significant (P<0. 05). The Nogo-N2 amplitude differ-ence between F3 and Fz((-14. 05±3. 31) μV vs (-15. 50±3. 52) μV) was no statistically significant (P>0. 05) . The left frontal lobe Nogo-N2 amplitude was significantly higher than that of the right frontal lobe ((-14. 05±3. 31) μV vs-11. 75(-12. 68,-10. 43) μV) (P<0. 05),and the center of the frontal lobe No-go-N2 was significantly higher than that in the right frontal lobe((-15. 50±3. 52) μV vs -11. 75(-12. 68,-10. 43) ) ,and the difference was statistically significant (P<0. 05) . ( 3) There was no significant difference in N2 latency,P3 amplitude and latency between F3,Fz and F4 leads (P>0. 05). Conclusion Compared with normal children,SDB children showed no left dominant brain region while dealing with the same conflict monitoring tasks. It is suggested that left hemisphere activation is poor and function is incompatible. Left fron-tal lobe injury in SDB is more obvious than that in the right side.

Attention Deficit Hyperactivity Disorder in Neurofibromatosis Type 1: Evaluation with a Continuous Performance Test

BACKGROUND AND PURPOSE: The objective of this study was to determine if the MOXO visual- and vocal-distractors-based continuous performance test distinguishes patients with attention deficit hyperactivity disorder (ADHD) and neurofibromatosis type 1 (NF1) from those without NF1. METHODS: Thirty-five patients (16 males; mean age 9.91 years) attending a multidisciplinary NF1 clinic completed the MOXO test. The findings were compared to 532 healthy age-matched standardized control subjects (285 males) without ADHD. RESULTS: The overall performance in the MOXO text was significantly worse in the NF1 group than in controls (p < 0.01), but no group-specific pattern was identified. Impulsivity and hyperactivity were significantly more prominent in males than females (p < 0.01). Compared to controls, the NF1 group exhibited significantly more failures to respond to target stimuli in the presence of visual distractors. CONCLUSIONS: MOXO scores are abnormal in patients with NF1, but the test cannot differentiate between NF1 with ADHD characteristics and ADHD. The test highlights sex differences in ADHD characteristics in NF1. Overreactivity to visual distractors may form part of the attention deficit in NF1.

Uso del test de rendimiento continuo de conners para diferenciar niños normales y con TDAH en Chile / Using the conners continous performance test for differentiation of normal and ADHD Chilean children

El trastorno de déficit atencional con hiperactividad (TDAH) constituye uno de los cuadros de mayor prevalencia durante la niñez. El presente trabajo se focalizó en evaluar si el Test de Rendimiento Continuo de Conners era capaz de discriminar entre niños con y sin TDAH diagnosticados por el docente. Se conformó una muestra no probabilística de 30 niños escolares (15 clínicos y 15 normales) a través de la aplicación del cuestionario de atención. Todos los niños completaron la aplicación del test computarizado de Conners. Se observaron diferencias significativas entre la muestra normal y clínica. Todos los niños seleccionados como normales no encajaron el perfil clínico. Solo el 50% de los casos considerados con TDAH encajaron el perfil clínico. Se analizan las implicancias del sobre/diagnóstico del trastorno.

Attention-deficit hyperactivity disorder (ADHD) is one of the most prevalent disorder during childhood. The present study aimed to evaluate if the Conners Continous Performance Test was able to discriminate among ADHD and normal children completed the Conners computarized test. Significant differences between normal and clinical sample were found. All children selected as normal did not fit the clinical profile. Only 50% of the children considered as having ADHD fit the clinical profile. Implications for the issue of overdiagnosis of the disorder are discussed.

Protocolos para evaluación de desempeño en equipos médicos / Protocols for performance evaluation in medical equipment / Protocolos para avaliação de desempenho em equipamentos médicos

Resumen Las instituciones prestadoras de servicios de salud deben disponer de un control de calidad para los equipos médicos que garantice total confiabilidad en su funcionamiento y resultados, logrando el cumplimiento de los requisitos establecidos por las especificaciones técnicas y normas. En este contexto, las pruebas de desempeño en equipos biomédicos evalúan el desempeño, funcionamiento y cumplimiento de especificaciones de estos para brindar información confiable sobre su funcionamiento. En este trabajo se desarrolla un protocolo de evaluación de equipos médicos que permite cuantificar su desempeño, para esto se tiene en cuenta la información general del equipo, su estado y recomendaciones del fabricante entre otros; obteniendo un protocolo que pueda ser aplicado a diferentes tipos de equipos y que brinde información confiable y objetiva, en función de todos los aspectos que involucran su funcionamiento.

Abstract Healthcare service providers must count on the availability of quality control for their medical equipment which will assure total reliability in its operation, as well as results, thus complying with technical specifications and standards. Within this study, a medical equipment evaluation protocol is developed to quantify said equipment performance. In this context, performance tests in biomedical equipment assess the performance, operation, and compliance of biomedical equipment specifications to provide reliable information on its performance. This paper develops a protocol of evaluation for medical equipment that enables the quantification of its performance. To achieve this, it takes into account the general information of the equipment, its condition, as well as, manufacturer recommendations, among others, obtaining a protocol that can be applied to different types of equipment and that provides reliable and objective information, in terms of all the aspects that involve its operation.

Resumo As instituições prestadoras de serviços de saúde devem dispor de um controle de qualidade para as equipas médicas que garanta total fiabilidade em seu funcionamento e resultados, conseguindo o cumprimento dos requisitos estabelecidos pelas especificações técnicas e normas. Neste contexto, as provas de desempenho em equipas biomédicos avaliam o desempenho, funcionamento e cumprimento de especificações destes para brindar informação confiável sobre seu funcionamento. Neste trabalho desenvolve-se um protocolo de avaliação de equipamentos médicos que permite quantificar seu desempenho, para isto se tem em conta a informação geral do equipamento, seu estado e recomendações do fabricante entre outros; obtendo um protocolo que possa ser aplicado a diferentes tipos de equipamentos e que brinde informação confiável e objetiva, em função de todos os aspectos que envolvem seu funcionamento.

Quality control method and detection data analysis of electrosurgical unit / 中国医学装备

Objective:To establish the quality control method of electrosurgical unit(ESU) through the safety performance test and data analysis for electrotome.Methods: According to the testing standard of ESU, Fluke ESA612 electrical safety analyzer and QA-ES II electrosurgery unit analyzer were applied to test the properties of ESU were using during 2015 and 2016, and the testing results were analyzed.Results:In 2015 and 2016, the qualified rate of quality control results were 79% and 81%, respectively; the problems of unqualified ESU were resolved and their hidden risks in clinical applications were eliminated.Conclusion: By testing the properties of ESU, we can master the performance of the machine; find and deal with the risk of machine in time, and avoid the hidden danger and enhance the risk management for ESU, so that the machine can be safely and effectively applied in clinical surgery.

Study on relationship among pulsatility index, sustained attention function and collateral circulation in patients with severe stenosis or occlusion of internal carotid artery / 临床神经病学杂志

Objective To investigate the relationship among pulsatility index ( PI) , sustained attention function and collateral circulation in patients with severe stenosis or occlusion of internal carotid artery .Methods One hundred and thirty-five patients with severe stenosis or occlusion of internal carotid artery were examined by DSA and were divided into different groups according to the type of collateral circulation .Meanwhile, 30 healthy aged people were selected as a control group .The peak systolic velocity ( Vs) , and diastolic velocity ( Vd) , mean velocity ( Vm) and PI of bilateral middle cerebral artery were obtained by TCD .Sustained attention was evaluated by missed and mistaken scores as well as average reaction time of continuous performance test .The results were compared and analyzed.Results (1)According to the type of collateral circulation , 135 patients with severe stenosis or occlusion of internal carotid artery were divided into groups with patency of anterior communicating artery (AcoA)(31 cases),posterior communicating artery (PcoA)(20 cases), AcoA+PcoA (19 cases), primary collateral circulation (with AcoA, PcoA and AcoA +PcoA) (70 cases), secondary collateral circulation (including ophthalmic artery, leptomeningeal collateral vessel and new blood vessels ) ( 15 cases ) , primary+secondary collateral circulation ( 13 cases) and group without collateral circulation (37 cases).(2)Compared with control group, Vs,Vd,Vm and PI all decreased significantly in every other group ( all P<0.05 ) .Compared with group without collateral circulation , Vd of group with AcoA or primary collateral circulation , Vd and Vm of group with AcoA +PcoA all increased significantly;PI of groups with AcoA , AcoA+PcoA, primary collateral circulation and primary +secondary collateral circulation all decreased (all P<0.05).Compared with group with PcoA, PI of groups with AcoA and AcoA +PcoA both decresed significantly (all P<0.05).Compared with group with secondary collateral circulation , Vs,Vd and Vm of group with primary collateral circulation , Vd and Vm of group with primary +secondary collateral circulation all increased significantly; PI of groups with primary collateral circulation and primary +secondary collateral circulation both decreased (all P<0.05).(3) Compared with control group, the missed, mistaken scores and average reaction time of CPT in every other group increased significantly ( all P<0.05 ) .Compared with group without collateral circulation , the missed, mistaken scores and average reaction time in groups with AcoA , AcoA+PcoA and primary collateral circulation all decreased significantly; the missed and mistaken scores of group with primary+secondary collateral circulation decreased significanly ( all P<0.05) .Compared with group with PcoA , the missed and mistaken scores of group with AcoA decreased significantly while the missed , mistaken scores and average reaction time of group with AcoA +PcoA all decreased significantly ( all P<0.05 ) .Compared with group with AcoA+PcoA, the missed, mistaken scores and average reaction time in group with AcoA increased sinificantly ( all P<0.05).Compared with group with secondary collateral circulation , the missed, mistaken scores and average reaction time in group with primary collateral circulation all decreased significantly ;the missed and mistaken scores in primary+secondary collateral circulation both decreased significantly ( all P<0.05 ) .( 4 ) PI positively related to average reaction time in groups with AcoA , primary and secondary collateral circulation ( r=0.441, r=0.364, r=0.552; all P<0.05 ) .PI positively related to missed scores in group with PcoA and group without collateral circulation (r=0.668, r=0.397;all P<0.05).PI also positively related to mistaken scores in the above groups (r=0.509,r=0.480;all P<0.05).Conclusion High PI on the affected side of patients with severe stenosis or occlusion of internal carotid artery may reflect impairment of sustained attention function .

Study on relationship among pulsatility index, sustained attention function and collateral circulation in patients with severe stenosis or occlusion of internal carotid artery / 临床神经病学杂志

Objective To investigate the relationship among pulsatility index ( PI) , sustained attention function and collateral circulation in patients with severe stenosis or occlusion of internal carotid artery .Methods One hundred and thirty-five patients with severe stenosis or occlusion of internal carotid artery were examined by DSA and were divided into different groups according to the type of collateral circulation .Meanwhile, 30 healthy aged people were selected as a control group .The peak systolic velocity ( Vs) , and diastolic velocity ( Vd) , mean velocity ( Vm) and PI of bilateral middle cerebral artery were obtained by TCD .Sustained attention was evaluated by missed and mistaken scores as well as average reaction time of continuous performance test .The results were compared and analyzed.Results (1)According to the type of collateral circulation , 135 patients with severe stenosis or occlusion of internal carotid artery were divided into groups with patency of anterior communicating artery (AcoA)(31 cases),posterior communicating artery (PcoA)(20 cases), AcoA+PcoA (19 cases), primary collateral circulation (with AcoA, PcoA and AcoA +PcoA) (70 cases), secondary collateral circulation (including ophthalmic artery, leptomeningeal collateral vessel and new blood vessels ) ( 15 cases ) , primary+secondary collateral circulation ( 13 cases) and group without collateral circulation (37 cases).(2)Compared with control group, Vs,Vd,Vm and PI all decreased significantly in every other group ( all P<0.05 ) .Compared with group without collateral circulation , Vd of group with AcoA or primary collateral circulation , Vd and Vm of group with AcoA +PcoA all increased significantly;PI of groups with AcoA , AcoA+PcoA, primary collateral circulation and primary +secondary collateral circulation all decreased (all P<0.05).Compared with group with PcoA, PI of groups with AcoA and AcoA +PcoA both decresed significantly (all P<0.05).Compared with group with secondary collateral circulation , Vs,Vd and Vm of group with primary collateral circulation , Vd and Vm of group with primary +secondary collateral circulation all increased significantly; PI of groups with primary collateral circulation and primary +secondary collateral circulation both decreased (all P<0.05).(3) Compared with control group, the missed, mistaken scores and average reaction time of CPT in every other group increased significantly ( all P<0.05 ) .Compared with group without collateral circulation , the missed, mistaken scores and average reaction time in groups with AcoA , AcoA+PcoA and primary collateral circulation all decreased significantly; the missed and mistaken scores of group with primary+secondary collateral circulation decreased significanly ( all P<0.05) .Compared with group with PcoA , the missed and mistaken scores of group with AcoA decreased significantly while the missed , mistaken scores and average reaction time of group with AcoA +PcoA all decreased significantly ( all P<0.05 ) .Compared with group with AcoA+PcoA, the missed, mistaken scores and average reaction time in group with AcoA increased sinificantly ( all P<0.05).Compared with group with secondary collateral circulation , the missed, mistaken scores and average reaction time in group with primary collateral circulation all decreased significantly ;the missed and mistaken scores in primary+secondary collateral circulation both decreased significantly ( all P<0.05 ) .( 4 ) PI positively related to average reaction time in groups with AcoA , primary and secondary collateral circulation ( r=0.441, r=0.364, r=0.552; all P<0.05 ) .PI positively related to missed scores in group with PcoA and group without collateral circulation (r=0.668, r=0.397;all P<0.05).PI also positively related to mistaken scores in the above groups (r=0.509,r=0.480;all P<0.05).Conclusion High PI on the affected side of patients with severe stenosis or occlusion of internal carotid artery may reflect impairment of sustained attention function .

The applicability of NEMA NU1-2007 for the performance testing of SPECT based on CZT detector / 中国医学装备

Objective: To provide reference for the performance testing of single photon emission computed tomography (SPECT) based on CZT detector by correct applying NEMA NU1-2007 that established by NEMA. Methods: When the performance of SPECT based on CZT detector was tested, the CZT detector should be distinguished from single crystal detector. And the items of performance testing of CZT detector that was not suitable for NEMA NU1-2007 standard were discussed and explored. Result: The experiment items which was not suitable for NEMA NU1-2007 standard were grasped, and the research provided the relative analysis of reason and method of disposition. Conclusion: The performance testing of SPECT based on CZT detector could not completely be implemented according to the standard of NEMA NU1-2007. Besides, manufacturer need know which testing items were inapplicable and their reasons.

The Behavior Rating Inventory of Executive Function and Continuous Performance Test in Preschoolers with Attention Deficit Hyperactivity Disorder

OBJECTIVE: The aim of this study is to examine performance-based measures and behavioral ratings of executive functions (EF) as a component of preschool attention deficit hyperactivity disorder (ADHD). METHODS: Twenty-one 4-to-6-year-old children with ADHD and 52 children with no psychopathology, matched on age, gender, socioeconomic status, and parental education, were enrolled. Parents were interviewed with the use of The Schedule for Affective Disorders and Schizophrenia for School-Age Children Present and Lifetime version. The Conners' Kiddie Continuous Performance Test (K-CPT) was administered to the children, and the Behavior Rating Inventory of Executive Function-Preschool version (BRIEF-P) and the Conners' Parent Rating Scale-Revised/Short Form (CPRS-R/S) were filled out by the parents. RESULTS: All BRIEF-P and CPRS-R/S scores, the K-CPT measures of inattention and impulsivity were higher in the ADHD group. The CPRS-R/S ADHD index was strongly correlated with inhibition and related indexes in the BRIEF-P and was moderately correlated with inattention measures in the K-CPT. CONCLUSION: The current study is one of the few to investigate the features of preschool ADHD with the use of behavioral ratings of EF and a performance-based measure. Our results suggest that the BRIEF-P was able to identify behavioral difficulties in inhibition and working memory and that the K-CPT identified difficulties indicating inattention. The findings of this study support the use of a combination of methods for a complete evaluation of preschoolers with inattentive and hyperactive/impulsive behavior, the application of rating scales for screening ADHD symptoms, and the measurement of behavioral correlates of EF, along with performance-based measures.

The Relationship between the SNAP-25 Polymorphism and Omission Errors in Korean Children with Attention Deficit Hyperactivity Disorder

OBJECTIVE: This study aimed to investigate the association between the synaptosomal-associated protein 25 kDa (SNAP-25) genotype and performance on the continuous performance test (CPT) in Korean children with attention-deficit/hyperactivity disorder (ADHD). METHODS: Eighty-seven children with ADHD (mean age, 9.23±1.99 years) participated in this study. Omission errors, commission errors, reaction time, and reaction time variability on the CPT were analyzed. The single-nucleotide polymorphism (SNP) rs3746544 (1065 T>G) of SNAP-25 was genotyped to examine the association with CPT performance. RESULTS: We found significantly more omission errors on the CPT among children with the TT genotype of SNAP-25 (t=2.56, p=0.012) after correcting for multiple testing. CONCLUSION: Our results suggest the possible involvement of the SNAP-25 1065 T>G polymorphism in the inattention phenotype in children with ADHD. Further studies with more refined neuropsychological measures and much larger sample sizes are needed to confirm our findings.

Clinical application of the integrated visual and auditory continuous performance test on Tourette syndrome children with attention deficit hyperactivity disorder / 中华实用儿科临床杂志

Objective To explore the value of the integrated visual and audio continuous performance test (IVA-CPT) in the diagnosis of Tourette syndrome(TS) patients who have comorbid attention deficit hyperactivity disorder(ADHD).Methods IVA-CPT was performed in 519 TS patients with comorbid ADHD (observation group)and 857 patients with pure ADHD (control group).The gold standard for the diagnosis of ADHD was based on the Diagnostic and Statistical Manual of Mental Disorders (4th version,USA) (DSM-Ⅳ).Results (1) When DSM-Ⅳ was used as the gold standard,the sensitivity,specificity and coincidence rate of IVA-CPT were 62.4％,81.9％ and 75.7％,respectively.(2) IVA-CPT misdiagnosed 62 cases in TS + ADHD group,including 30.3％ (10/33 cases) inattentive subtype (ADHD-I),51.4％ (37/72 cases) hyperactive subtype (ADHD-H) and 25.0％ (15/60 cases) combined subtype (ADHD-C).Significant difference in misdiagnosis rate was found among ADHD-H and ADHD-I and ADHD-C (x2=10.646,P＜0.05).(3) There were 449 cases in which 2 diagnostic methods were both positive in both observation group and control group,including 103 cases in observation group and 346 cases in control group.The full scale response control quotient,visual reaction control,auditory reaction control in observation group and control group were 89.0±19.5/77.4±18.2,92.4±19.0/84.3±18.9,89.6±16.8/77.4±19.7,and there were significant differences between 2 groups (t=-5.024,-3.533,-5.255,all P＜0.05).The full scale response control quotient,visual response control quotient,full scale attention quotient and visual attention quotient between the 2 groups were statistically significant (t=2.510,-2.836,-1.402,-2.501,all P＜0.05).Conclusions (1) IVA-CPT can be used as an effective and objective tool for the diagnosis of TS children with comorbid ADHD.(2)Comparcd with TS childrcn with comorbid ADHD,pure ADHD children have a higher attention and control impairment.

Resultados de las pruebas de desempeño en la superación posgraduada para Enfermería en servicios clínico-quirúrgicos por competencias profesionales especializadas / Results of the performance tests of specialized professional competences in postgraduate education for nursing at the clinical-surgical services

Se realizó un estudio, donde se aplicó un pre-experimento desde las Ciencias Pedagógicas, que nos permitió comparar los resultados de dos pruebas de desempeño realizadas a una muestra de profesionales de la Enfermería, de los hospitales clínicos quirúrgicos y especializados del segundo y tercer nivel de atención de salud de La Habana. Este estudio tuvo como objetivo identificar la necesidad de una formación posgraduada para Enfermería en servicios clínico-quirúrgicos, para satisfacer las necesidades de aprendizaje de estos profesionales y elevar la calidad de la atención a los pacientes en hospitales. Se aplicó una prueba de desempeño antes de la intervención y otra después, en una muestra pareada no paramétrica. Estas pruebas se realizaron previa identificación de competencias profesionales especializadas para la Enfermería Clínico-Quirúrgica, las que dieron como resultados la necesidad de una formación posgraduada para estos profesionales y que con la intervención propuesta, se logró un mejoramiento en el desempeño profesional y la satisfacción de los pacientes con la atención de enfermería recibida.

A study was conducted where a pre-experiment was applied in pedagogic sciences which allowed us to compare the results of two performance tests carried out in a sample of nursing professionals and of clinical surgical hospital professionals and 2nd and 3rd degree specialists in La Habana province. This study was aimed to identify the need for postgraduate formation for clinical and surgical nursing in order to meet the learning requirements of these professionals and to increase the quality of care in hospitals. A performance test was made before and after the intervention using non-parametric paired sample. These tests were carried out after determining the specialized professional competencies for the clinical and surgical nursing and yielded as results the need for postgraduate formation. The suggested intervention managed to improve the professional performance and to make patients feel satisfied with the nursing care rendered.

The investigation on equipment (SPECT) performance in nuclear medicine / 中国医学装备

Objective:Through 51 SPECT and SPECT/CT systems for performance test results of the collation and analysis, to understand the status of the operation of the SPECT and SPECT/CT systems, and in-depth analysis of indicators and find out the weak links and puts forward suggestions for improvement. Methods:According to the NEMA standards and requirements of the manufacturer, the systems have been tested on intrinsic uniformity, intrinsic spatial linearity, intrinsic spatial resolution, maximum count rate, system sensitivity, system spatial resolution and tomographic spatial resolution. Results:The results show that the majority of SPECT or SPECT/CT systems can pass the test;the failure rate is 9.80%. And the failures mainly show intrinsic uniformity and intrinsic spatial linearity. Conclusion:It is effective to improve the equipment performance by doing well in the daily quality control, regular maintenance and calibration, reducing factors that influence the inherent uniformity and inherent linear.

A paper-and-pencil test for motion agility / 军事医学

Objective To develop a paper-and-pencil test for motion agility and to examine its psychometric properties. Methods For the purpose of measuring motion agility, the material of the paper-and-pencil test for motion agility included a special paper and 2 compasses.The radii of compasses were 1.5 and 2 cm, respectively.Subjects were asked to draw circles using the two compasses by turns on the special paper.Totally,712 subjects were subjected to the paper-and-pencil test for motion agility, among whom 45 were re-tested after 23 days, and 46 were subjected to screwing performance test. The training grades of 37 subjects were collected.Results The correlation between the paper-and-pencil test and screwing performance test scores was 0.48.The correlation between the paper-and-pencil test and the training grades was 0.40.The re-test reliability of the paper-and-pencil test for motion agility was 0.57.Conclusion The validity of the paper-and-pencil test for motion agility is acceptable.It can be operated easily as a group test for motion agility.