The effects of different statins in prevention of contrast induced nephropathy in perioprative period / 实用医学杂志

Objective To assess the effects of different statins in the prevention of contrast induced nephropathy (CIN)by comparing the changes of early renal injury biomarker serum levels in patients of with coronary artery angiography (CAG). Methods 183 patients who had normal renal function with CAG with normal renal function were randomly divided into the control group (n=61)、the atorvastatin group (n=60) and the rosuvastatin group (n=62). Renal injury biomarker levels (Scr,mALB, Cys C)and serum inflammatory factor (high sensitivity C reactive Protein,hs-CRP) of three groups were monitored and analyzed before and after CAG. Results The mALB(mg/L, 18.19 ± 8.25 vs. 12.07 ± 6.15,14.81 ± 6.23 vs. 12.32 ± 5.19,15.31 ± 7.53vs. 11.39 ± 5.38), Cys C(mg/L, 1.36 ± 0.32 vs. 0.90 ± 0.38,1.18 ± 0.25 vs. 0.91 ± 0.31,1.15 ± 0.21 vs. 0.93 ± 0.30), hs-CRP(mg/L,5.52 ± 2.09 vs. 1.96 ± 0.55, 3.86 ± 1.15 vs. 2.01 ± 0.34,3.93 ± 1.09 vs. 2.03 ± 0.23)levels in three groups raised up-regulated after angiography with statistical significance (P <0.05). Levels of mALB(mg/L,18.19 ± 8.25 vs. 14.81 ± 6.23, 18.19 ± 8.25 vs. 15.31 ± 7.53), Cys C(mg/L, 1.36 ± 0.32 vs. 1.18 ± 0.25,1.36 ± 0.32 vs. 1.15 ± 0.21), hs-CRP(mg/L, 5.52 ± 2.09 vs. 3.86 ± 1.15, 5.52 ± 2.09 vs. 3.93 ± 1.09)in the statin treatment groups was were lower than that in control group with statistical significance (P < 0.05). But Whereas there was were no significantly difference between the atorvastatin group and the rosuvastatin group [mALB (14.81 ± 6.23) mg/L vs. (15.31 ± 7.53) mg/L, CysC (1.18 ± 0.25) mg/L vs. (1.15 ± 0.21) mg/L,hs-CRP (3.86 ± 1.15) mg/L vs. (3.93 ± 1.09) mg/L,P﹥0.05). Conclusion Satains Statins may prevent this procedure by anti-inflammatory and anti-oxidative-stress mechanism. Different statins with conventional doses may have the same effect of in the prevention of CIN in patients with normal renal function.

Optimization research on preparation conditions of polymer-shelled microbubble contrast agents / 中国组织工程研究

BACKGROUND:In previous experiments, a polymer-shel ed microbubble contrast agent was successful y prepared using L-polylactic acid-polyethylene glycol methyl-covered liquid fluorocarbon perfluoropentane, which developed wel in vivo and in vitro under a second harmonic contrast-enhanced ultrasound with a low mechanical index OBJECTIVE:To optimize the conditions for preparing polymer-shel ed microbubble contrast agents with high yield and suitable size. METHODS:The polymer-shel ed microbubble contrast agent containing perfluoropentane was prepared by single emulsion method. Three preparation conditions, including polymer mass/perfluoropentane volume ratio (4/1, 2/1, 1/1, 1/2), hemogenate speed (18 000, 26 000, 35 000 r/min) and time (15, 30, 60, 120 seconds), were optimized, and the microbubble yield and size were set as judge standard. The contrast-enhanced ultrasonography of rabbit kidney was performed using the optimized microbubbles, and the arrival time, time to peak, half time of descending and peak intensity were analyzed by TCA software. RESULTS AND CONCLUSION:The preparation conditions were optimized as a polymer mass/perfluoropentane volume ratio of 2/1, homogenate speed of 26 000 r/min and homogenate time of 60 seconds, which presented a high microbubble yield of (1.8±0.4)×109/mL and mean size of (3.7±1.3)μm with uniform distribution. The arrival time, time to peak, half time of descending and peak intensity were detected as (3.1±0.6) seconds, (2.9±0.5) seconds, (4.0±0.7) seconds and (4.7±1.1)×10-5 AU, respectively. The polymeric microbubbles prepared by optimized conditions were of high yield, with suitable size and good contrast-enhanced effect in vivo.

Nefropatía por contraste en el síndrome coronario agudo / Contrast induced nephropathy in acute coronary syndrome

La nefropatía inducida por contraste (NIC) es una de las causas más frecuentes de insuficiencia renal en pacientes internados. En el síndrome coronario agudo (SCA), la presencia de NIC aumenta la morbimortalidad. Las medidas de profilaxis y los factores de riesgo intervinientes de NIC en SCA no han sido determinados con exactitud. El objetivo de este estudio fue evaluar la incidencia de NIC y los factores asociados a su desarrollo en pacientes ingresados en unidad coronaria con requerimiento de cinecoronariografía (CCG). Se realizó un estudio de cohorte retrospectivo. Se incluyeron pacientes consecutivos cursando SCA estudiados con CCG dentro de las 72 horas de su admisión. Se definió NIC al aumento del 25% del valor de creatinina a las 48 h sobre el nivel basal de ingreso. El período de inclusión fue entre el 1° de enero de 2004 hasta el 30 de junio de 2010. Se analizaron 125 casos. La incidencia de NIC fue del 10.4% (n = 13). En el análisis multivariado, los factores asociados independientemente a su desarrollo fueron la edad [OR 1.05 (IC 95% 1.004 - 1.11) p = 0.034], la angioplastia a múltiple vaso [OR 2.2 (IC 95% 1.07 - 4.8), p = 0.03] y el volumen de contraste utilizado [OR 1.007 (IC 95% 1.001 - 1.01), p = 0.014].

Contrast induced nephropathy (CIN) is one of the most frequent causes of acute renal failure in hospitalized patients. It is associated with an increase in morbidity and mortality in patients hospitalized for acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI). Risk factors and prevention strategies are not well defined. The aim of this study was to assess the incidence and clinical risk factors associated to the development of contrast induced nephropathy in patients hospitalized for ACS. In a retrospective cohort we analyzed consecutive patients hospitalized for ACS undergoing urgent PCI within 72 hours from the admission. CIN was defined as a 25% increase of creatinine levels from baseline at 48 hours from the PCI. The inclusion period was from January 1°, 2004 to June 30, 2010. A total of 125 patients were analyzed, and CIN occurred in 13 (10.4%) patients. An independent association was found between age (OR 1.05; 95% CI 1.004 to 1.11; p = 0.034), multiple vessel angioplasty (OR 2.2; 95% IC 1.07 to 4.8; p = 0.03) and the volume of contrast infused (OR 1.007; 95% CI 1.001 to 1.01; p = 0.014) with the development of CIN.

Comparison of visual quality between zero spherical aberration intraocular lens and spherical intraocular lens implanted eyes / 中华实验眼科杂志

Background Zero spherical aberration intraocular lenses(IOL)is designed to prevent the addition of positive spherical aberration after surgery.Research indicated that some positive spherical aberration can provide better depth distance of focus and pseudoaccommodation.Objective The present study was to compare the visual function and wavefront aberrations in pseudophakic eyes with zero spherical aberration IOL and spherical IOL.Methods A prespective case-controlled study was designed.Eighty eyes of 52 patients with age-related cataract were enrolled and divided into two matched groups based on random number table method.The regular phacoemulsification was performed on the eyes,and a zero spherical aberration IOL(Akreos AO)was implanted in the test group and a spherical IOL was used in the control group(Akreos Adapt IOL).The corrected distance visual acuity(CDVA),contrast sensitivity,depth of focus and wavefront aberrations were recorded and compared at 3 months after cataract surgery between these two groups.The trail was approved by the Ethic Committee of Eye Hospital of Wenzhou Medical College,and written informed consent was obtained from each patient prior to the program.Results The clinical demography from the two groups was matched(P ＞ 0.05).There were no significant difference in the CDVA (LogM AR)(-0.03 ±0.08 versus-0.02+0.10)(t =-0.50,P =0.61)and in depth of focus(3.48± 1.07 DS versus 3.20±0.77 DS)(t =1.15,P=0.25)between the zero spherical aberration IOL group and the spherical IOL group.The contrast sensitivities under the mesopic condition at 12.0 c/d and mesopic with glare at 3.0,6.0,18.0 c/d were 12.42 ± 13.16,42.58 ±24.96,30.19± 25.64 and 3.03 ± 5.49 in the zero spherical aberration IOL group,and those in the spherical IOL group were 5.59 ± 8.11,28.74 ± 18.69,17.07 ± 19.35 and 0.22 ± 1.15 without significant differences between these two groups(P＜0.05).Under the 5.0 mm pupil analyzing zone,the spherical aberration in zero spherical aberration IOL group was(0.13 ±0.07)μm,showing a significant reduction in comparison with spherical IOL group(0.21 + 0.07 μm)(P ＜ 0.05).No evidently differences were found in total high-order aberration,coma aberration and trefoil aberration(P＞0.05),but the sphere aberration was considerably lower in the zero spherical aberration IOL group compared with spherical IOL group(t=-4.19,P＝0.00).Conclusions The visual quality of the eyes implanted zero spherical aberration IOL is significantly better than ones implanted with spherical IOL.

Preparation and characteristics of BCUN- loaded lipid ultrasound contrast agent / 重庆医科大学学报

Objective:To preparate BCUN-loaded lipid ultrasound contrast agent and detect its physical properties and contrast-enhancing effects.Methods:Mechanical oscillation was used to prepare BCUN-loaded lipid contrast agent.Density was detected and analyzed with microscope.Malvern determined intensity,disposition and Zeta potential.RP-HPLC detected envelopment rate.Cryodesiccated-microb ubbles were sterilized by 60Co irradiation.Following injected it through rabbit ear vein,effects of ultrasounic enhanced imaging in rabbit liver was observed.Results:The density of microbubble was(2.6~3.1)?109/ ml.The mean intensity was(1.05?0.20)?m.The mean Zeta potential was(12.93?1.84)mV.The mean nvelopment rate was(42.6?0.11)%.After injecting this microbubble,good and sustained ultrasounic enhanced images in rabbit liver were seen.Conclusions:BCUN-loaded lipid contrast agents were successfully prepared,which hopefullyprovide a new option oftargetingtreatment for the tumor.

The study of two methods for high pressure injetion in CT enhancement to display the aortic dissecting aneurysm / 介入放射学杂志

Objective To discuss the consequences of two different methods of high pressure injection in CT contrast enhancement to display the aortic dissecting aneurysm.Methods 100 patients underwent Lightspeed 16 MS CT with contrast enhancement of Stellant D high pressure injector(Medrad),injecting speed of 4.0 ml/s and 80 ml dosage of contrast medium.All patients were divided into A and B groups with 50 in each.The single high pressure injection was applied to A group without isotonic Na chloride flush.B group underwent the same high pressure injection and followed by isotonic Na chloride flush.The method of evaluation was carried out by double blind observation.Results A group revealed radiologic artifact up to 40 cases with positive rate of 80%.B group demonstrated the same kind of radiologic artifact in 26 cases with positive rate of 52%.Conclusions Using normal saline(sodium chloride solution)flush after high pressure injection of contrast medium during MSCT angiography is obviously better to demonstrate the internal structures of treatvessels.

Enhancement of Image Contrast in Linacgram through Image Processing / 대한방사선종양학회지

PURPOSE: Conventional radiation therapy portal images gives low contrast images. The purpose of this study was to enhance image contrast of a linacgram by developing a low-cost image processing method. MATERIALS AND METHODS: Chest linacgram was obtained by irradiating humanoid phantom and scanned using Diagnostic-Pro scanner for image processing. Several types of scan method were used in scanning. These include optical density scan, histogram equalized scan, linear histogram based scan, linear histogram independent scan, linear optical density scan, logarithmic scan, and power square root scan. The histogram distribution of the scanned images were plotted and the ranges of the gray scale were compared among various scan types. The scanned images were then transformed to the gray window by pallette fitting method and the contrast of the reprocessed portal images were evaluated for image improvement. Portal images of patients were also taken at various anatomic sites and the images were processed by Gray Scale Expansion (GSE) method. The patient images were analyzed to examine the feasibility of using the GSE technique in clinic. RESULTS: The histogram distribution showed that minimum and maximum gray scale ranges of 3192 and 21940 were obtained when the image was scanned using logarithmic method and square root method, respectively. Out of 256 gray scale, only 7 to 30% of the steps were used. After expanding the gray scale to full range, contrast of the portal images were improved. Experiment performed with patient image showed that improved identification of organs were achieved by GSE in portal images of knee joint, head and neck, lung, and pelvis. CONCLUSION: Phantom study demonstrated that the GSE technique improved image contrast of a linacgram. This indicates that the decrease in image quality resulting from the dual exposure, could be improved by expanding the gray scale. As a result, the improved technique will make it possible to compare the digitally reconstructed radiographs (DRR) and simulation image for evaluating the patient positioning error.

Reduced Volume of Contrast Media: Effect on Vascular Opacification and Image Quality in Spiral CT of the Chest

PURPOSE: To evaluate the effect of reduced volume of contrast media on vascular opacification and image quality in spiral CT of the chest. MATERIALS AND METHODS: Sixty patients referred for chest CT were examined withspiral CT with 60ml(n=30) or 90ml(n=30) of 30% ionic contrast media(Rayvist 300 , Schering, Germany) alternately.Injection rate of each group was as follows : 2.0 ml/sec for 20 seconds followed by 1.0 ml/sec for 20 seconds in 60ml group and 2.0ml/sec for 45 seconds in 90ml group. Twenty-five seconds scanning delay was employed. For the objective comparison of vascular opacification, CT numbers were measured at superior vena cava, ascending and descending aorta, right and left pulmonary artery, left atrium, and inferior vena cava. For the subjective comparison three radiologists scored the grade of vascular opacification and image quality blindly and independently. All data were analyzed statistically. RESULTS: The mean values of measured CT numbers in 90ml group were higher than those in 60ml group(p <.05) at the same level. The overall mean score of vascular opacification in 90ml group was 2.86, and 2.31 in 60ml group(p <.0001). In the overall mean score of imagequality, there was no statistically significant difference between 90ml group(2.46) and 60ml group(2.40). CONCLUSION: Althought there is some degradation of vascular opacification in 60ml group, overall image quality is not degraded. Therefore, 60 ml of contrast media can be used in spiral CT of the chest without degradation ofoverall image quality except in spiral CT angiography.

Contrast Study of CT Image Quality in Two Different High-pressure Syringe Ways / 医疗卫生装备

Objective To discuss the consequences of CT image quality in two different contrast enhancement ways of high pressure syringe. Methods 100 cases by using high-pressure syringes of Lightspeed 16-raw spiral CT and Stellant D-type high-pressure syringe of Medrad, the dose of constrast medium was 4.0 ml/s and the total dose was 80 ml, which was divided into A and B group enhancement scanning. The canalis singularis high pressure syringe was used in 50 cases of A group that no isotonic Na chloride flush, in contrast to 50 samples of B group that were underwent the double isotonic Na chloride flush. The method of evaluation is double-blind observation. Results The number of positive is 40 samples which has radioactive constructed defect in A group. The masculine proportion is 80%. The number of the negative is 10 samples. The proportion is 20%. Correspondingly, the number of radioactive constructed defect in the B group is 24 samples(48%), and the negative number is 26 samples(52%, P