Clinical effect of total hip arthroplasty through Watson-Jone approach on hip osteoarthritis caused by advanced Kaschin-Beck disease / 中华地方病学杂志

Objective:To explore the clinical effect of total hip arthroplasty (THA) through Watson-Jone approach on hip osteoarthritis caused by advanced Kaschin-Beck disease (KBD).Methods:Using a prospective design, patients with hip osteoarthritis caused by advanced KBD admitted to Second Department of Orthopaedics, Hulun Buir People's Hospital from May 2014 to October 2017 were selected as research objects. THA through Watson-Jone approach was used to treat, all patients were treated with non-bone cement biological prosthesis. Visual analogue scale (VAS) score and Harris hip score were used to evaluate the pain, function, and hip flexion of patients before and after operation. At the same time, patients were evaluated by postoperative X-ray to observe the occurrence of complications.Results:A total of 14 patients (17 hips) were included in the study, including 6 males (7 hips) and 8 females (10 hips), the average age was 62.3 years old, and the duration of the disease was 7 - 20 years. The VAS scores [(2.15 ± 1.20), (1.07 ± 0.58) points] at 2 and 24 months after operation were significantly lower than that before operation [(8.22 ± 0.47) points, P < 0.05], and Harris scores [(87.93 ± 4.98), (91.07 ± 3.99) points] were significantly higher than that before operation [(35.72 ± 6.40) points, P < 0.05]. X-ray evaluation showed no complications such as loosening, dislocation, and fracture around the prosthesis, joint infection, and gluteus medius gait. Conclusions:THA through Watson-Jone approach is effective in the treatment of patients with hip osteoarthritis caused by advanced KBD. It has significantly reduced hip pain and improved hip range of motion, with a lower incidence of complications.

Dynamic changes of chest CT imaging in patients with corona virus disease-19 (COVID-19) / 浙江大学学报·医学版

OBJECTIVE@#To analyze the dynamic changes of chest CT images of patients with corona virus disease-19 (COVID-19).@*METHODS@#Fifty-two cases of COVID-19 were admitted in the First Affiliated Hospital of Zhejiang University School of Medicine. The consecutive chest CT scans were followed up for all patients with an average of 4 scans performed per patient during the hospitalization. The shortest interval between each scan was 2 days and the longest was 7 days. The shape, number and distribution of lung shadows, as well as the characteristics of the lesions on the CT images were reviewed.@*RESULTS@#The obvious shadows infiltrating the lungs were shown on CT images in 50 cases, for other 2 cases there was no abnormal changes in the lungs during the first CT examination. Ground-glass opacities (GGO) were found in 48 cases (92.3%), and 19 cases (36.5%) had patchy consolidation and sub-consolidation, which were accompanied with air bronchi sign in 17 cases (32.7%). Forty one cases (78.8%) showed a thickened leaflet interval, 4 cases (7.6%) had a small number of fibrous stripes. During hospitalization, GGO lesions in COVID-19 patients gradually became rare, the fibrous strip shadows increased and it became the most common imaging manifestation. The lesions rapidly progressed in 39 cases (75.0%) within 6-9 days after admission. On days 10-14 of admission, the lesions distinctly resolved in 40 cases (76.9%).@*CONCLUSIONS@#The chest CT images of patients with COVID-19 have certain characteristics with dynamic changes, which are of value for monitoring disease progress and clinical treatment.

Dynamic changes of chest CT imaging in patients with COVID-19 / 浙江大学学报·医学版

OBJECTIVE@#To analyze the dynamic changes of chest CT images of patients with coronavirus disease 2019 (COVID-19).@*METHODS@#Fifty-two cases of COVID-19 were admitted in the First Affiliated Hospital of Zhejiang University School of Medicine. The consecutive chest CT scans were followed up for all patients with an average of 4 scans performed per patient during the hospitalization. The shortest interval between each scan was 2 days and the longest was 7 days. The shape, number and distribution of lung shadows, as well as the characteristics of the lesions on the CT images were reviewed.@*RESULTS@#The obvious shadows infiltrating the lungs were shown on CT images in 50 cases, for other 2 cases there was no abnormal changes in the lungs during the first CT examination. Ground-glass opacities (GGO) were found in 48 cases (92.3%), and 19 cases (36.5%) had patchy consolidation and sub-consolidation, which were accompanied with air bronchi sign in 17 cases (32.7%). Forty one cases (78.8%) showed a thickened leaflet interval, 4 cases (7.6%) had a small number of fibrous stripes. During hospitalization, GGO lesions in COVID-19 patients gradually became rare,the fibrous strip shadows increased and it became the most common imaging manifestation. The lesions rapidly progressed in 39 cases (75.0%) within 6-9 days after admission. On days 10-14 of admission, the lesions distinctly resolved in 40 cases (76.9%).@*CONCLUSIONS@#The chest CT images of patients with COVID-19 have certain characteristics with dynamic changes, which are of value for monitoring disease progress and clinical treatment.

The value of many non-gaussian distribution models diffusion weighted imaging in evaluating the model of hepatic ischemia reperfusion injury model in rats / 中华放射学杂志

Objective To explore the value of multiple non-gaussian distribution models DWI in evaluating hepatic ischemia reperfusion injury (HIRI) model in rats.Methods Forty-two SD rats were divided into 7 groups by random numeric table method.Each group had 6 rats.The 7 groups were 6 h,12 h,1 d,3 d,7 d,14 d group after HIRI and control group,respectively.The experimental groups underwent right hepatic portal vein and hepatic artery ligation,and received reperfusion 3 h after operation.MRI scanning (T1WI,T2WI,single b-values DWI and 15 b-values DWI) was performed at 6 h,12 h,1 d,3 d,7 d and 14 d after reperfusion.The control group underwent sham operation and MRI scanning.According to monoexponential model,biexponential model,threxponential model,stretched-exponential model DWI and diffusion kurtosis imaging,many parametres were obtained and their dynamic changes at each time point were observed.The parameters included standard apparent diffusion coefficient (ADCs),pure diffusion coefficients (D),pseudodiffusion coefficients (D*),perfusion fraction (f),ultra-high apparent diffusion coefficient (ADCu),distributed diffusion coefficient (DDC),water diffusion heterogeneity index (or),mean diffusion coefficient (MD) and mean diffusion kurtosis (MK).One way ANOVA was used to compare the differences of parameters among different groups.Results MRI examination and pathological examination were successfully completed in all rats.The right hepatic lobe in the experimental groups appeared hypointense on T1WI and hyperintense on T2WI relative to control group from 6 h after operation.The infarcted liver lobe in the experimental groups became significantly smaller at 1 week after HIRI and almost disappeared at 2 weeks after HIRI.The findings of DWI at different b-values were consistent with those at T2WI.There were significant differences in parameters among 6 h,12 h,1 d,3 d,7 d,14 d groups after HIRI and control group (P＜0.05).There were significant differences among 12 h after HIRI,1 d after HIRI,3 d after HIRI and 6 h after HIRI,7 d after HIRI,14 d after HIRI,control group concerning ADCs values respectively (P＜0.05).There were significant differences among 6 h after HIRI,12 h after HIRI,1 d after HIRI,3 d after HIRI,7 d after HIRI and 14 d after HIRI,control group concerning D,D*,f,ADCu,α,DDC,MK values respectively (P＜0.05).In addition,there were significant differences among 1 d after HIRI,3 d after HIRI and 6 h after HIRI,12 h after HIRI,7 d after HIRI and 14 d after HIRI,control group concerning D values respectively (P＜0.05).There were significant differences among 6 h after HIRI,12 h after HIRI,1 d after HIRI,3 d after HIRI and 7 d after HIRI,14 d after HIRI,control group concerning f values respectively (P＜0.05).There were significant differences among 12 h after HIRI and 14 d after HIRI,control group concerning MD values respectively (P＜0.05).There were significant differences between 1 d after HIRI and 14 d after HIRI concerning MD values (P＜0.05).Conclusion Multiple non-gaussian distribution models DWI is superior to conventional DWI in evaluating HIRI model in rats.

Combined application of low kV,low mAs, and iterative model reconstruction (IMR) in carotid CT angiography / 中华放射医学与防护杂志

Objective To evaluate the application value of combination of low kV,low mAs,and iterative model reconstruction (IMR) in carotid CT angiography.Methods Forty patients (BMI 20-25 kg/m2) were enrolled and randomly divided into routine dose group(20) and low dose group(20),The parameters in routine dose group were 120 kV,automatic mAs,and filter back projection(FBP);and that in low dose group were 80 kV,automatic mAs but upper limit 150 mAs,and FBP or IMR.All patients received the injection of 32 ml of iopamidol(370 mg I/100 ml) at a flow rate of 4 ml/s,followed by 50 ml normal saline at the same rate.The CT value and image noise(SD)of the aortic arch,left carotid artery bifurcation,and right carotid artery of rock bone were measured with region of interest(ROI) method,and then signal to noise ratios (SNR) and contrast to noise ratio (CNR)of image were calculated.The image quality was evaluated by two radiologists using a subjective four points scale on multiplanar reformated (MPR),maximum density projected (MIP) and volume rendered (VR) images.Volume CT dose index (CTDIvol),dose length product (DLP),and the effective dose (E) of each patient were recorded.Results CT values of carotid artery[(479.87 ± 70.28),(514.78 ± 82.69),(436.50 ± 89.87) HU] in low dose group were significantly higher than those in routine dose group [(295.63 ± 34.75),(325.09 ± 37.81),(286.93±36.46)HU](t =-6.47,-5.76,-3.66,P＜0.05).The SNR and CNR of IMR reconstructed image in low dose group were significantly higher than those of FBP reconstructed image in routine dose group (t =-7.54,-3.55,-5.31,-7.13,-5.28,-8.35,P＜0.05).The image quality of FBP reconstructed images in routine dose group and IMR reconstructed images in low dose group were all enough for diagnosis.The image quality of FBP reconstructed images in low dose group was significantly poorer than that in routine dose group and IMR reconstructed images in low dose group (Z =-2.87,-3.69,P ＜0.05).The effective dose in low dose group (0.57 ±0.13) mSv was 73％ less than that in routine dose group (2.22 ± 0.36) mSv.Conclusions Using low kV,low mAs,and IMR would help to obtain good carotid CT angiographic images and low radiation dose.

BOLD MRI in evaluation of renal oxygenation in primary nephrotic syndrome / 中国医学影像技术

Objective To evaluate the renal oxygenation in patients with primary nephrotic syndrome (PNS) using BOLD MRI.Methods Twenty patients with untreated first-onset PNS and 18 healthy control subjects underwent BOLD MRI.The R2* of renal cortex and medulla were measured.Blood and urine samples were obtained on the day of MRI,and the patients underwent renal biopsy after MRI.The renal tubulointerstitial damage scores (TIDS) were determined using Katafuchi criteria.All patients received corticosteroids within 7 days after MRI and were followed up for 12 months.The difference of R2* levels between the PNS patients and controls were compared,and the correlations between R2* values and TIDS,laboratory parameters (eGFR,etc.) were tested.Results R2* values of renal medulla in PNS patients significantly decreased compared that of the controls (t =-9.270,P＜0.001).R2* values of renal medulla in PNS patients were negatively correlated with eGFR (r=-0.462,P=0.040) and positively correlated with TIDS (r=0.809,P＜0.001).There was a slight tendency for higher R2* values of renal medulla in individuals with poor prognosis.Conclusion BOLD MRI is a noninvasive method for the detection of renal oxygenation changes,which can evaluate the renal function and tubulointerstitial impairment,as well as prediction of the prognosis for PNS patients.

Informatization Construction of Disease Prevention and Control in the United States and Its Enlightenment to the People's Armed Police Forces / 医学信息学杂志

The paper sorts out the achievements in informatization construction of disease prevention and control in the United States,summarizes the construction features,and puts forward the objective,requirements,functions and contents of Informatization construction of disease prevention and control of People's Armed Police forces in China based on its current situations.

Imaging findings and morphology classification of intraductal papillary mucinous neoplasm of the bile duct / 中华放射学杂志

Objective To investigate the CT and MRI features and morphology classification of intraductal papillary mucinous neoplasm of the bile duct (IPMN-B).Methods A total of 18 patients with IPMN-B proved by pathology were retrospectively analyzed.Out of 18 patients,16 patients underwent enhanced and non-enhanced CT,13 underwent contrast enhanced MR,and 11 out of 13 underwent both CT and MRI.IPMN-B was classified into 4 types:typical IPMN-B,cystic-forming IPMN-B,non-tumor IPMN-B and invasive IPMN-B,according to imaging findings and gross pathological findings.Results Typical IPMN-B (9 cases):tumors were distributed along the bile ducts,both upstream and downstream bile ducts were obviously dilated.Cystic-forming IPMN-B (5 cases):single or multiple tumors were found in aneurysmal dilatation of bile ducts.Non-tumor 1PMN-B (2 cases):no mass was found in the widely dilated bile ducts with smooth bile duct wall.Invasive IPMN-B (2 cases):tumors protruded into the dilated bile ducts causing jagged wall of bile duct,with accompanied abnormal density or signal intensity outside the bile ducts.Bile duct dilatations were shown in all 18 cases,and tumors were shown in 16 cases.In 2 cases no mass was displayed in widely dilated bile ducts.CT density of the tumor was lower than that of liver parenchyma,and higher than that of the bile and intraductal mucin.Signal intensity of the tumor was higher than that of stones,and lower than that of bile and intraductal mucin at MR T2WI.All tumors showed high intensity on DWI.Tumors showed mild to moderate enhancement after injection of contrast agent,CT density or signal intensity of the tumors were lower than that of the liver parenchyma during all three phases of contrast-enhanced CT or MRI.Conclusion IPMN-B has some specific CT and MR imaging features,which are helpful for the diagnosis and classification of IPMN-B.

Initial investigation of magnetic resonance perfusion-weighted imaging in leukoaraiosis / 中华老年医学杂志

Objective To investigate whether perfusion-weighted imaging (PWI) can be used to evaluate blood perfusion of patients with leukoaraiosis (LA), its relationship to clinical features, and the therapy effect of LA. Methods The 44 patients with LA were recruited in the study. All the subjects were examined with both conventional and dynamic susceptibility contrast-enhanced perfusion MR imaging, 13 of them repeated the examinations after the treatment. The shapes and sizes of the biggest lesions in each patient were confirmed by conventional MR imaging, then the values of relative cerebral blood volume (rCBV), relative cerebral blood flow (rCBF) and relative mean transit time (rMTT) in each lesion were calculated respectively. Furtherly, a Pearson's correlation analysis was performed to show whether these values were correlated with mini-mental state examination (MMSE)scores or activities of daily living (ADL) scores. Results The 44 lesions of all the subjects showed significant decreases in rCBV (0. 797 ± 0. 160) and rCBF (0. 779± 0. 164) but increase in rMTT (1. 029±0. 073). There were positive correlations between rCBV and MMSE (r = 0. 524, P =0. 000), between rCBV and ADL (r=0. 621, P=0. 000), between rCBF and MMSE (r=0. 555, P=0. 000), and between rCBF and ADL (r= 0. 690, P= 0. 000), and negative correlations between rMTTand MMSE (r=-0.307, P=0.043), and between rMTT and ADL (r=-0.434, P=0. 003). The blood perfusion was enhanced in 10 out of 13 patients who received the repeated examinations after the treatment, most of whom showed the improvement of clinical symptoms.Conclusions Perfusion MR imaging can assess hemodynamic alterations in LA, which could reflect the clinical symptoms. Moreover, the changes of blood perfusions can be used to evaluate and monitor the therapy effect of LA.

Age-related deposition of brain iron in normal adults:an in vivo susceptibility weighted imaging study / 中华放射学杂志

Objeetive The purpose of this study was to investigate the effect of age on the iron concentration of the human brain.Methotis The brain iron level wag evaluated in vivo in 78 healthy adult volunteers using a noninvasive magnetic resonance method termed susceptibility weighted jmaging.The subjects were divided into three groups due to different ages:young(22-35 years old,n=27),middleaged(36-55 years old,n=35),and aged(56-78 years old.n=16).The phase values were measured on the corrected phase images in the giohus pallidus,putamen,caudate,substantia nigra,red nucleus,thalamus and frontal white matter.The phase values of those regions measured from the subjects over than 30 years old were correlated with published valnes of brain iion concentration in normal adults to check the validity of the data.Then,the phase values of the three groups were tested for significant age-related differences using one-way ANOVA,foUowed by post hoc testing using least significant difference(LSD)procedure.Regression analysis wflg used to further examine age.related effects revealed by group compagisons,and to estimate the rates of age-related changes.Results A strong negative correlation was found between the phase values and the published values ofthe brain iron concentration(r=-0.796.P=0.032),which indicated that the hisher the imn deposition level.the greater the negative phase values.In the putamen(F=20.115,P＜0.01)and frontal white matter(F=3.536,P=0.034),significant differences were detected in the phase value$ofthe three age groups.Linear regression analysis showed that phase values of the putamen,frontal white matter,and red nucleus decreased with age(The regression coefficients were-0.001,-0.001,and＜-0.001 respectively,and the P value were all＜0.05),which indicated that the iron concentration of those brain structures increased with age.No significant agerelated changes of the iron concentration were found in the globus pallidus,caudate,substantia nigra,and thalamus.Conclusions These findings extended our knowledge of the patterns of the brain iron accumulation in normal aging.Such information is necessary to understand disease-related changes that involve the brain iron deposition.

Diagnosis and prediction of early acute renal transplant rejection with blood oxygen level dependent magnetic resonance imaging / 中华肾脏病杂志

Objective To assess the value of blood oxygen level-dependent magnetic resonance imaging (BOLD-MRI)in diagnosis and prediction of early acute renal transplant rejection.Methods BOLD-MRI was performed in a cohort of 103 patients undergoing cadaver renal transplantation between Dec 2005 and March 2007.Among them,82 recipients had nomlal renal function,21 had biopsy-proved acute rejection.R2* (1/s)measurements were obtained in the medulla and cortex of grafted kidneys. Results R2* values of the medulla were significantly lower in the acute rejection group[R2*=(14.02±2.68)/s]than that in the normally functioning transplants group [R2*=(16.66+2.82)/s],the difference between these two groups was significant (P＜0.01);ROC curve analyses suggested that medullary MR2* values could accurately identify acute rejection in the early post-transplantation period.In the normal functioning transplant group,those with lower medullary R2* values (MR2*＜14.9/s,n=23) had higher acute rejection rates than those with higher medullary R2* values (MR2*＞14.9/s,n=59) in the first 6 months following transplantation,but the difference between these two groups was not significant (17.39% vs 8.47%,P=0.259). Conclusions Mean R2* values in the medullary regions of grafted kidneys with BOLD-MPd may be a non-invasive diadynamic criteria with good sensitivity and specificity,and may be a valuable predictor of early acute renal transplant rejection.

Solitary pulmonary nodules:quantitative investigation with dynamic MRI / 中华放射学杂志

Objective To evaluate the diagnostic efficacy of contrast enhanced dynamic MRI in differentiating benign from malignant solitary pulmonary nodules (SPNs) Methods A prospective study was undertaken in forty four patients with SPNs using contrast enhanced dynamic MRI Patterns of Time Signal Intensity Curve (T SI Curve) were assessed Steepest Slope (SS), Peak Height (PH) and the change rates in signal intensity at the first (E 1), second (E 2), and fourth (E 4) minute of T SI curve were calculated Results Malignant nodules and inflammatory nodules showed higher SS [(4 44?1 40) %/s,(3 99?0 71)%/s, (0 86? 0 37)%/s, P