Application of CT pulmonary function imaging in convalescent COVID-19 patients / 中华放射学杂志

Objective:To explore the application value of CT pulmonary function imaging in patients with Coronavirus Disease 2019 (COVID-19) in the convalescent phase.Methods:The COVID-19 patients who were clinically cured and discharged from Union Hospital, Tongji Medical College, Huazhong University of Science and Technology were prospectively collected from January to April 2020. Clinical pulmonary function tests (PFTs) and CT pulmonary function imaging were performed 3 months after discharge. The Philips IntelliSpace Portal image post-processing workstation was used to obtain the paired inspiratory-expiratory CT quantitative indexes of the whole lung, left lung, right lung and five lobes. The patients were divided into two groups according to whether residual lesions remain in inspiratory CT images: non-residual lesion group and residual lesion group. The chi-square test was used to compare the differences in the PFT results between groups; the Mann-Whitney U test was used to compare the differences in PFT indexes [forced expiratory volume in the first second as percentage of predicted value (FEV 1%), FEV 1/forced vital capacity (FEV 1/FVC), total lung capacity as percentage of predicted value (TLC%), FVC%] and the differences in quantitative CT indexes [lung volume (LV), mean lung density (MLD), volume change in inspiratory phase and expiratory phase (?LV)] between groups. Multiple linear regression was used to analyze the relationship between CT pulmonary function imaging and PFT indexes of convalescent COVID-19 patients. Results:Of the 90 patients with COVID-19, 35 were males and 55 were females; 45 were included in the non-residual lesion group and 45 were included in the residual lesion group. Fifty-three patients had clinical pulmonary dysfunction 3 months after discharge, including 22 patients in the non-residual lesion group and 31 patients in the residual lesion group. In patients with residual disease, left lower lobe and right lower lobe LV, left lower lobe and right lower lobe ?LV in the inspiratory and expiratory phase were smaller than those without residual disease; whole lung, left lung, right lung, left upper lobe, left lower lobe and right lower lobe MLD in the inspiratory phase and left lower lobe and right lower lobe MLD in the expiratory phase were greater than those without residual disease ( P<0.05). Since there was no significant difference in FEV 1/FVC and FVC% between residual and non-residual lesion groups ( P>0.05), FEV 1/FVC and FVC% of two groups were combined. Multiple linear regression analysis showed FEV 1/FVC=91.765-0.016×LV in-right middle lobe+0.014×MLD ex-left lower lobe ( R2=0.200, P<0.001), FVC%=-184.122-0.358×MLD in-right lung-0.024×?LV left upper lobe ( R2=0.261, P<0.001). There was significant difference in TLC% between residual and non-residual lesion groups ( P<0.05), so multiple linear regression analysis was performed both in the two groups. In the non-residual lesion group, TLC%=80.645+0.031×LV ex-right lower lobe ( R2=0.132, P<0.001); In the residual lesion group, TLC%=-110.237-0.163×MLD in-right upper lobe-0.098×MLD ex-left upper lobe -0.025×LV ex-right lower lobe ( R2=0.473, P<0.001). Conclusion:CT pulmonary function imaging can quantitatively analyze the whole lung, unilateral lung and lobulated lung, thus reflecting the regional pulmonary function, providing more valuable diagnostic information for the assessment of pulmonary function in convalescent patients with COVID-19.

Influencing Factors of Renal Blunt Impact Injury: A Finite Element Method Study / 医用生物力学

Objective To study influencing factors of renal blunt impact injury by using finite element (FE) method. Methods Based on CT images of the kidney, the kidney FE models for different age groups were constructed. The renal blunt impact test was reconstructed, and the influence of kidney material constitutive parameters, kidney tissue structure, kidney size, impact position and impact velocity on injury severity were analyzed. Results Under the same impact condition, the stress of renal cortex decreased with the kidney mass increasing, and increased with the impact velocity of the hammer increasing. The renal capsule had a certain energy absorption effect, so as to reduce the kidney stress. When the kidney was impacted, the stress of renal cortex under side impact was significantly higher than that under frontal impact. Conclusions Compared with viscoelastic constitutive model, Mooney Rivlin material constitutive model is more suitable for FE evaluation on renal injury severity. The renal injury decreases with the kidney mass increasing. The increase of impact velocity will intensify the renal injury severity. Renal capsule will reduce renal injury to a certain extent, so the existence of renal capsule structure must be considered in FE modeling of the kidney. Compared with frontal and rear impact, the renal injury severity is greater when the kidney is impacted from the lateral side.

Effect of triple therapy with omeprazole in the treatment of children with peptic ulcer / 中国基层医药

Objective:To observe the clinical effect of omeprazole based triple therapy in the treatment of children with peptic ulcer.Methods:From September 2016 to September 2018, 86 children with peptic ulcer in the People's Hospital of Qingyuan County were selected in this study.By using the random number table method, they were divided into two groups, with 43 cases in each group.The control group received ranitidine based triple therapy treatment, the observation group was given omeprazole based triple therapy treatment.The treatment course of the two groups was 30 d. The eradication rate, clinical effect, gastrointestinal hormone level and adverse reactions of helicobacter pylori were compared between the two groups.Results:The eradication rate and total effective rate of helicobacter pylori in the observation group were 97.67%(42/43) and 95.35%(41/43), respectively, which were higher than those in the control group[81.40%(34/43) and 79.07%(34/43)], the differences were statistically significant (χ 2=6.081, 5.108, all P<0.05). After treatment, the levels of gastrin and motilin in the observation group were (75.29±8.31)μmol/L, (164.88±15.05)ng/L, respectively, which were lower than those in the control group [(81.07±8.96)μmol/L, (204.15±17.67)ng/L], the differences were statistically significant( t=3.102, 11.095, all P<0.05). The somatostatin level of the observation group was (22.67±3.95)ng/L, which was higher than that of the control group [(18.31±3.31)ng/L], and the difference was statistically significant( t=5.548, P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups(χ 2=0.938, P>0.05). Conclusion:Omeprazole based triple therapy is safe and effective in the treatment of children with peptic ulcer, which is helpful to eradicate helicobacter pylori, reduce gastrin, motilin levels and improve the level of somatostatin.

Study of the upper airway in obstructive sleep apnea hypopnea syndrome by 128-slice CT 3D reconstruction / 实用放射学杂志

Objective To evaluate the value of 128-slice CT on locating the obstruction site of the upper airway in obstructive sleep apnea hypopnea syndrome (OSAHS)patients by three-dimensional reconstruction technology.Methods There were 52 patients with OSAHS diagnosed by the PSG and 32 cases of healthy volunteers in our hospital.All objects were performed 128-slice CT scan of the upper airway during awake state,and those patients’upper airways were scaned on Muller test.The airway volume of the ret-ropalatal region,retroglottal region and epiglottal region,and the total length of upper airway were measured,and statistical analysis of the each index was obtained.Results During awake state,compared with the control group,the length of upper airway in OSAHS patients increased significantly(P <0.001).Compared with the awake state,OSAHS patients’airway volume of the retropalatal region, retroglottal region and the total airway volume on the Muller test were reduced significantly(P <0.001).OSAHS patients’upper air-way length was correlated negatively to the average MSaO 2 (r=-0.33,P <0.05).Conclusion The three-dimensional reconstruc-tion of upper airway on 128-slice CT can evaluate the position and degree of the obstruction site in OSAHS patients’upper airway better,which has important significance to guide clinical treatment.

The clinical significance of the changed positions of hyoid bone in the upper airway of OSAHS patients by 128-slice computed tomography / 实用医学杂志

Objective To discuss the clinical diagnostic and guiding treatment value of changed positions of hyoid bonein the upper airway of patients with obstructive sleep apnea hypopnea syndrome. Methods 128-slice computed tomography was performed for 52 patients with severe OSAHS and 32normal healthy people to measure thehyoid bone in the upper airway in sober state and Muller maneuver. The correlationsbetweenthese indexes were analyzed under linear relation. Results (1)In comparison of the Muller maneuver with sober state , chinnodules and palatal plane to the hyoid in the OSAHS group were statistically higher than the healthy controlgroup (P < 0.001). (2)The distance of hyoid to chinnodules in the OSAHS group was significantlylonger and greater than that of the healthy control group (P < 0.001).(3)The distance of palatal plane to the hyoid was positively correlated with AHI , while thedistances of palatal plane andchinnodules to the hyoidwere both negatively correlated with MSaO2. Conclusion The changes ofhyoid positionare indicative for the clinical diagnosis and is helpful for the guidance of clinical treatment of OSAHS.

The evaluation of 128 slice spiral CT for soft palate, hard palate and mandible in patients with obstructive sleep apnea hypopnea syndrom / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To discuss the soft palate, hard palate and mandibule for the pathogenesis and clinical treatment of patients who have obstructive sleep apnea hypopnea syndrome.@*METHOD@#There were 52 patients with OSAHS diagnosed by the PSG and 32 cases of normal healthy volunteers in our hospital. All objects were given 128 slice spiral CT scan of the upper airway. We measured the related indexes of the soft palate, hard palate and mandible, then analysed statistical differences between them and did Pearson correlation analysis with apnea hypoventilation index (AHI), average blood oxygen saturation (MSaO2) in PSG.@*RESULT@#Compared with the control group, the soft palate length [(37.93 ± 5.20)mm VS (33.52 ± 4.25)mm] and the distance between mandible with cervical vertebra [(75.00 ± 7.10)mm VS (69.93 ± 5.58)mm] increased significantly, but the distance of trailing edge of hard palate to inferior margin of slope significantly reduced [(42.57 ± 4.52)mm VS (45.80 ± 2.94)mm, P 0.05).@*CONCLUSION@#The soft palate, hard palate and mandibular are some of the important risk factors of OSAHS, and they also have reference value for the choice of clinical treatment operation. Preoperative CT examination can offer help in the treatment of OSAHS.