Problems and reflections on the construction of medical imaging technology specialty in affiliated hospitals of universities / 中华医学教育探索杂志

The medical imaging technology (MIT) specialty hasn't been set up for a long time in China, and the mode of educating students in other institutions vary greatly among different universities. There are several disadvantages in MIT specialty set up in the Affiliated hospitals of universities, such as unreasonable curriculum system, imperfections in teaching and research department, and inadequate guidance on students' innovation ability. Therefore, the solutions for alleviating the above problems that are unfavorable factors to education are proposed, so as to further improve the model of MIT specialty set up in the affiliated hospitals of universities and produce more competent graduates.

Status and factors analysis of scientific papers on medical basic research and clinical research in China, America and Japan / 中华医学科研管理杂志

Objective To analyze the changes of quantity and composition of scientific papers on medical basic research and clinical research in China,America and Japan,providing support for health China and healthcare reform.Methods The classification methods of publications in China,the United States and Japan included by PubMed database from 2006 to 2015 were established,based on the NIH clinical definition and mediated by subject headings and key words.Results The quantity of scientific research papers in China and Japan showed a positive increase,while the United States showed a negative increase.The proportion of clinical research and basic research papers in the three countries were different.The proportion of Chinese basic research papers was higher,while the proportion of clinical research papers was lower than United States and Japan.Conclusions There are abundant clinical resources in China,however with a relatively low proportion of clinical researches.Clinical researches are relatively insufficient,which are seriously inconsistent with research resources.

The correlation analysis between medical basic research and clinical research papers with domestic medical institutions rank / 中华医学科研管理杂志

Objective To discuss the correlation between Medical basic research and clinical research papers with domestic medical institutions rank.Methods 35 medical institutions,ranked as top 5 of the comprehensive strength among seven districts in the hospital ranking list published by Fudan University,were chosen to collect all the basic medical research and clinical research papers published during 2006-2015.The publication number and compositions of such papers were analyzed to study the correlation of hospital ranking data that published latest by Fudan University in 2015.Results The ranking of domestic medical institutions was positively correlated with the published papers (both basic research papers and clinical research papers),which was negatively correlated with the proportion of basic research papers and was positively correlated with the proportion of clinical research papers,and the quality of both basic research and clinical research papers have Positive correlation,while only with the IF＞ 5 basic research class weight was positively correlated with the clinical study of Q3 partition the proportion of the paper was negatively correlated.Conclusions The scientific research management departments of domestic medical institutions should encourage clinical-front-line researchers to make full use of clinical resources to carry out clinical research and improve the proportion of clinical research papers.At the same time to encourage the publication of high-quality research papers (including:basic medical research and clinical research papers),especially high-tech zoning research papers.

Correlation between standardized uptake value and intravoxel incoherent motion parameters of cervical squamous cell carcinoma with 18F-FDG PET/MR / 中华核医学与分子影像杂志

Objective To assess the correlation between standardized uptake value (SUV) and intravoxel incoherent motion (IVIM) parameters of primary cervical squamous cell carcinoma (CSCC) and pelvic metastatic lymph nodes in the use of hybrid PET/MR.Methods Forty-six CSCC patients in Shengjing Hospital from January 2015 to December 2015 were prospectively enrolled and divided into well-differentiated (G1) group,moderate-differentiated (G2) group and poorly-differentiated (G3) group.PET/MR examination with the multi-b-value diffusion-weighted imaging (DWI) sequence was performed before treatment.Maximum SUV (SUVmax) and mean SUV (SUVmean) were calculated.IVIM parameters,including the slow diffusion coefficient (D),fast diffusion coefficient (D*),perfusion fraction (f) were also measured.Pearson correlation analysis was used to evaluate the correlation between IVIM parameters and SUV(SUVmax,SUVmean).Results The D of G1,G2,G3 lesions and metastatic lymph nodes were (0.827± 0.232) × 10-3,(0.640±0.153) × 10-3,(0.563±0.090) × 10-3 and (0.772±0.246) × 10-3 mm2/s respectively.The f was 0.310±0.068,0.348±0.073,0.287±0.057 and 0.413±0.103 respectively.The D* was (9.241± 2.001) × 10-3,(9.408± 1.927) × 10-3,(9.715± 1.827) × 10-3 and (8.830± 1.632) × 10-3 mm2/s respectively.The SUVmax was 9.988±3.806,12.941±5.990,14.543±7.050 and 9.890±3.906 respectively.The SUVmean was 5.717±2.830,7.094±3.518,8.263±4.124 and 4.952±1.343 respectively.The D of G1 and G2 lesions had negative correlations with SUVmax and SUVmean(G1,r values:-0.816,-0.842;G2,r values:-0.528,-0.559;all P＜0.05);the f of G2 lesions had positive correlations with SUVmax and SUV (r values:0.554,0.550,both P＜0.05).Conclusions The SUVmax and SUV of the well-moderate differentiated CSCC are consistent with D and f,which reflect the cell density and the microvascular perfusion.PET/MRIVIM could provide important complementary information for treatment-monitoring and prognostic assessment of patients with cervical cancer.

MR elastography for evaluation of obstructive chronic pancreatitis / 中国医学影像技术

Objective To explore the value of 3.0T MR elastography (MRE) in diagnosis of obstructive chronic pancreatitis.Methods Totally 32 patients (lesion group) with suspected obstructive chronic pancreatitis who underwent pancreaticoduodenectomy and 32 volunteers (normal control group) were enrolled.MRE was performed,and pancreatic stiffness value was measured.The consistency between two observers and the repeatability of the same observer were evaluated.The difference of pancreatic stiffness value was compared between the two groups.The efficacy of pancreatic stiffness value in diagnosis of obstructive chronic pancreatitis was analyzed with ROC curve.Results The consistency between two observers and the repeatability of the same observer were excellent (all ICC＞0.9).The pancreatic stiffness value of normal control group and lesion group was (1.21±0.11)kPa and (1.51±0.24)kPa,respectively (t=-6.077,P ＜0.001).The area under ROC curve of pancreatic stiffness value in diagnosis of chronic pancreatitis,mild and moderate to severe,mild to moderate and severe was 0.900,0.941 and 0.960,respectively (all P＜0.001).Conclusion MRE can objectively measure pancreatic stiffness and noninvasively assess the severity of chronic pancreatitis.

Risk factors and PET/CT diagnosis of pelvic lymph node metastasis in early-stage cervical cancer / 中国医学影像技术

Objective To explore risk factors of pelvic lymph node (PLN) metastasis in cervical cancer,and to observe the value of PET/CT in diagnosis of PLN metastasis with qualitative and semi-quantitative evaluation.Methods Clinical data of 206 patients with cervical cancer who underwent PLN dissection were respectively analyzed.The age and BMI of patients,pathological type,depth of invasion and International Federation of Gynecology and Obstetrics (FIGO) stage of tumor,serum SCC level,lymph node status of PET/CT and tumor SUVmax were analyzed with univariate analysis.Multivariate analysis was performed for indicators with statistically significant variables.The accuracy,sensitivity and specificity of PET/CT in diagnosis of PLN metastasis of cervical cancer were calculated.Besides,the ratios of lymph node 'S SUVmax (SUVmaxLN) to SUVmax of primary tumor (SUVmaxL/T),to liver (SUVmaxL/H) and to arota (SUVmaxL/A) were recorded.ROC curves were plotted,whereas the areas under curve (AUC) were calculated to confirm the best diagnostic cutoff value.Results Univariate analysis showed that age,BMI,pathological type,depth of invasion,FIGO stage,serum SCC level,lymph node status of PET/CT and tumor SUVmax were important factors of PLN metastasis (all P＜0.05).Multivariate analysis revealed that serum SCC levels,depth of invasion,lymph node status of PET/CT and tumor SUVmax were independent predictors of PLN metastasis (P＜0.05).The sensitivity,specificity and accuracy of PET/CT in diagnosis of PLN metastasis was 54.90％ (28/51),91.61％ (142/155) and 82.52％ (170/206),respectively.The sensitivity of SUVmaxLN =4.19 was higher than SUVmax =2.5.No significant difference of SUVmaxLN with SUVmaxL/T,with SUVmaxL/H nor with SUVmaxL/A was found.Conclusion Serum SCC levels,depth of invasion,lymph node status of PET/ CT and tumor SUVmax are independent predictors of PLN metastasis.PET/CT has certain value in qualitative and semiquantitative analysis of cervical cancer PLN metastasis.

Establishment and assessment of chronic coronary stenosis model for fractional flow reserve derived from coronary CT angiography in Bama miniature pig / 中国医学影像技术

Objective To establish chronic coronary stenosis model for fractional flow reserve derived from coronary CT angiography (FFRcT) in Bama miniature pig,and to evaluate its reliability.Methods Sixteen Bama miniature pigs were used to establish chronic coronary stenosis models through placing Ameroid constrictor into proximal or middle segments of left anterior descending arteries (LAD).In the 2nd week after modeling,the degrees of stenosis were monitored with coronary CTA.Invasive coronary angiography was used to verify stenosis degrees and measure fractional flow reserve (FFR) within 2 days of last coronary CTA examination.Computational fluid dynamics model was constructed and FFRcT was calculated by the specialized laboratory based on coronary CTA data respectively.Simulated FFRcT and FFR values were compared to verify this model.Results Models were successfully established in 10 pigs with a total of 24 coronary CT examinations,of which image quality met the diagnostic requirements.All models were with LAD stenosis＜25 ％ in the 2nd week after operation.LAD stenosis ＞50％ was found in the 3rd week in 9 pigs,and the other one was found with LAD stenosis ＞50％ in the 4th week.The results of coronary CTA corresponded to those of coronary angiography.There was no significant difference between simulated FFRcT and FFR value (t =-1.13,P =0.29).Conclusion Through placing Ameroid constrictor into LAD of Bama miniature pig and monitoring the degree of stenosis with coronary CTA,model of chronic coronary stenosis could be successfully established,which are suitable for noninvasive simulating hemodynamics study based on coronary CTA.

Value of PET/CT and PET/MR in diagnosing primary cervical cancer and evaluating pelvic lymph node metastasis: Comparative study / 中国医学影像技术

Objective To compare the application value between PET/CT and PET/MR in diagnosing primary cervical cancer and pelvic lymph node metastasis.Methods Forty cases of cervical cancer were prospectively enrolled.PET/CT and PET/MR examinations were performed before treatment.All imaging data were evaluated by two experienced radiologists.The diagnostic consistency and difference of PET/CT and PET/MR were evaluated with Cohen's Kappa and paired Chi-square test.ROC curve was adopted to observe the value in diagnosing pelvic lymph node metastasis of cervical cancer.The lesions' visibility and diagnostic confidence of metastatic lymph nodes on PET/CT and PET/MR images were compared with Wilcoxon signed ranks test.Results Compared with the gold standard,the diagnostic consistency of PET/MR staging was much higher than that of PET/CT (x2 =10.286,P=0.002).The area under ROC curve of PET/CT and PET/MR on lymph node metastasis had no significant difference (Z=0.83,P＞0.05).No significant differences in lesion visibility between PET/CT and PET/MR images were detected in the evaluation of metastatic lymph nodes (P=0.157),while PET/MR revealed higher values regarding diagnostic confidence (P=0.014).Conclusion Both PET/CT and PET/MR provide high diagnostic value in detecting primary cervical cancer,but PET/MR has greater diagnostic superiority in the correct identification of cervical cancer stage and pelvic lymph node metastasis.PET/MR is expected to be a new technique for replacement of PET/CT in evaluation of cervical lesions.

Comparison of MR elastography and dynamic contrast-enhanced imaging in evaluation on gastroesophageal varices with liver cirrhosis / 中国医学影像技术

Objective To explore the value of MR elastography (MRE) and dynamic contrast-enhanced imaging (DCE-MRI) in diagnosis of gastroesophageal varices (GEV) in patients with liver cirrhosis.Methods Totally 59 patients with liver cirrhosis underwent MRE and DCE-MRI.Taking endoscopic examination as the standard,platelet (PLT) count,hepatic stiffness (HS),spleen stiffness (SS) and MR visual score (MR VS) were measured.Values of related parameters in diagnosis of liver cirrhosis GEV were compared with area under the curve (AUC).Results PLT,HS,SS and MR VS were significantly correlated with the grades of GEV with liver cirrhosis (rs =-0.317,0.436,0.682,0.703,all P＜0.05).In the diagnosis of with or without GEV,AUC of SS was higher than that of MR VS,HS,and PLT (AUC=0.880,0.795,0.744,0.635,respectively),and the AUC of SS and PLT had statistically difference (P=0.002).In diagnois of moderate or severe GEV,the AUC of MR VS was higher than that of SS,HS and PLT (AUC=0.893,0.816,0.713,0.665,respectively),and statistical differences of AUC were found between MR VS and HS,as well as between MR VS and PLT (P=0.018,0.002).Sensitivities of MR VS combined with SS in differential diagnosis of liver cirrhosis with or without GEV,liver cirrhosis with moderate or severe GEV were 94.16 ％ and 96.83 ％,respectively.Conclusion MRE is effective in the prediction of GEV with severity and diagnostic value equivalent to DCE-MR.

Imaging performance of hepatic inflammatory myofibroblastic tumor / 中国医学影像技术

Objective To assess the radiological imaging findings of hepatic inflammatory myofibroblastic tumor and to discuss the appropriate morphological classification.Methods A total of 22 patients with hepatic inflammatory myofibroblastic tumor confirmed by pathology were enrolled.Imaging performance of hepatic inflammatory myofibroblastic tumor were analyzed and the lesions were classified into appropriate type based on the imaging findings.Results Totally 23 lesions were found in 22 patients.The typical imaging features included great enhancement at later phase (13/20),moth eat en central necrosis (12/23) and peripheral shell (12/23).Seed in fruit was the most typical classification (8/23),followed by Seedless fruit (7/23).Conclusion Hepatic inflammatory myofibroblastic tumur typically shows as a single nodular lesion with moth eaten necrosis and peripheral shell like a Seed in fruit.The enhancement at later phase (especially the peripheral enhancement) can be regarded as a particular feature.

MR elastography of pancreatic masses:preliminary results / 中华放射学杂志

Objective To investigate the feasibility of spin-echo echo-planar imaging(SE-EPI) of magnetic resonance elastography (MRE) for the diagnosis of pancreatic mass and to evaluate the difference of stiffness value in different pancreatic mass. Methods In a retrospective study, MRE was performed in 20 healthy volunteer (control group) and 62 patients with surgery-proved pancreatic masses, including pancreatic cystadenoma in 5 cases and solid masses of pancreas in 57 cases (39 with malignant mass and 18 with benign mass) using 3.0 T MRE. The differences of stiffness between two groups were evaluated using non-parametric Mann-Whitney U test. ROC was used to assess the diagnostic ability of elastogram for the detection of pancreatic masses, and to evaluate MRE-determined stiffness for the differentiation of masses from healthy pancreas, and malignancy from benign solid masses. Results The total detection rate of elastogram was 91.9%(57/62),with false positive rate of 5.0%(1/20) and false negative rate of 8.1%(5/62). The median stiffness value in the control group vs patient group were 1.18 kPa (interquantile range:1.15 to 1.30) kPa and 2.43 kPa (interquantile range:1.94 to 3.64 kPa) respectively, with statistically significant differences (Z=-5.967,P<0.01). The sensitivity and specificity of stiffness (≥1.36 kPa) to differentiate pancreatic mass from healthy pancreas was 93.6%and 100.0%, respectively, and to differentiate benign and malignant solid masses (≥2.17 kPa) was 82.1%and 83.3%, respectively. Conclusion MRE is a promising method in detecting and distinguishing different pancreatic masses.

Research progresses of functional MRI in cervical cancer / 中国医学影像技术

Rapid development of MRI has gradually evolved from morphological imaging to functional imaging.Functional MRI can provide pathophysiological information more than morphological information,such as molecular and metabolic information.The application value of functional MRI in cervical cancer has become a hotspot in recent years.The research progresses of functional MRI in cervical cancer were reviewed in this article.

Research progresses of functional MRI in cervical cancer / 中国医学影像技术

Rapid development of MRI has gradually evolved from morphological imaging to functional imaging.Functional MRI can provide pathophysiological information more than morphological information,such as molecular and metabolic information.The application value of functional MRI in cervical cancer has become a hotspot in recent years.The research progresses of functional MRI in cervical cancer were reviewed in this article.

Value and Clinical Application of Orthopedic Metal Artifact Reduction Algorithm in CT Scans after Orthopedic Metal Implantation

OBJECTIVE: To evaluate orthopedic metal artifact reduction algorithm (O-MAR) in CT orthopedic metal artifact reduction at different tube voltages, identify an appropriate low tube voltage for clinical practice, and investigate its clinical application. MATERIALS AND METHODS: The institutional ethical committee approved all the animal procedures. A stainless-steel plate and four screws were implanted into the femurs of three Japanese white rabbits. Preoperative CT was performed at 120 kVp without O-MAR reconstruction, and postoperative CT was performed at 80–140 kVp with O-MAR. Muscular CT attenuation, artifact index (AI) and signal-to-noise ratio (SNR) were compared between preoperative and postoperative images (unpaired t test), between paired O-MAR and non-O-MAR images (paired Student t test) and among different kVp settings (repeated measures ANOVA). Artifacts' severity, muscular homogeneity, visibility of inter-muscular space and definition of bony structures were subjectively evaluated and compared (Wilcoxon rank-sum test). In the clinical study, 20 patients undertook CT scan at low kVp with O-MAR with informed consent. The diagnostic satisfaction of clinical images was subjectively assessed. RESULTS: Animal experiments showed that the use of O-MAR resulted in accurate CT attenuation, lower AI, better SNR, and higher subjective scores (p < 0.010) at all tube voltages. O-MAR images at 100 kVp had almost the same AI and SNR as non-O-MAR images at 140 kVp. All O-MAR images were scored ≥ 3. In addition, 95% of clinical CT images performed at 100 kVp were considered satisfactory. CONCLUSION: O-MAR can effectively reduce orthopedic metal artifacts at different tube voltages, and facilitates low-tube-voltage CT for patients with orthopedic metal implants.

Research on the progress of ASL functional magnetic resonance imaging of kidney / 中国医学装备

ASL-fMRI by measuring tissue blood flow, thus reflects the pathophysiology of organ blood flow dynamics and change, provides a new method for clinical and scientific research.With the improvement of MR image technology, technology as a MR perfusion imaging of arterial spin labeling method has been applied.It is non-invasive, repeatable high tissue contrast with a good advantage. Current clinical studies of renal ASL-fMRI is increasing. Includes renal transplantation, kidney tumors, acute kidney injury, patients with chronic renal dysfunction renal blood flow studies. Below reviews the progress of renal ASL-fMRI.

Research progress on TRAIL and its related apoptosis regulating mechanism in cholangiocarcinoma / 实用肿瘤学杂志

Cholangiocarcinoma (CCA) is a common cancer in hepatobiliary system .Because CCA is in sensitive to conventional chemotherapy and radiotherapy ,the current treatment is mainly depending on the surgical operation when diagnosed early .Tumor necrosis factor related apoptosis inducing ligand ( TRAIL) plays a key role in the process of controlling cell proliferation by binding with its receptor and therefore mediated cell apoptosis . Although the characteristic of selectively killing tumor cells by TRAIL makes it become the new direction of clini -cal treatment of cancer ,the condition that CCA cells are resistant to TRAIL mediated apoptosis restricts its scope of application.Nowadays many studies demonstrate that multiple signaling pathways can regulate the sensitive of CCA cells to TRAIL mediated apoptosis .In this review,we summarize the expression and effects of TRAIL and its receptor in CCA , and conclude the mechanism of multiple pathways restoring the sensitivity of CCA cells to TRAIL mediated apoptosis .

Biocompatibility in vitro between fascia fibroblasts and fibrin glue / 中国组织工程研究

BACKGROUND:Fibrin glue is a natural biodegradable scaffold, which can be used for tissue-engineered scaffolds, and is increasingly used as seed cel carrier for tissue engineering repair. OBJECTIVE:To investigate the biocompatibility in vitro of rabbit fascia fibroblasts and fibrin glue. METHODS:Tissue explants adherent method was used to culture fibroblasts from subcutaneous deep fascia tissue of New Zealand white rabbits. The fibroblasts could be passaged with trypsin digestion method. Suspension of passage four fibroblasts was co-cultured with fibrin glue. Morphology and proliferation of fibroblasts on the surface of fibrin glue were dynamical y observed under the inverted phase contrast microscope. At 5 days after co-culture, fibroblasts were identified by immunofluorescence staining under the laser scanning confocal microscope. The fibroblast growth and adhesion were observed under the scanning electron microscope. RESULTS AND CONCLUSION:There was no significant difference in fibroblast morphology between co-culture fibroblasts and pure culture fibroblasts with inverted phase contrast microscope. Scanning electron microscope demonstrated that fibroblasts ful y extended in fibrin glue surface, and showed a good adhesion between the“pseudopodium”and fibrin glue, and secreted matrix material. It is clear that the fibrin glue did not alter the morphologic features of fibroblasts. Laser scanning confocal microscope revealed that fibroblasts were positive for vimentin. These verified that properties of fibroblasts did not change after they were seeded in fibrin glue surface and did not be induced to differentiate. There is a very good biocompatibility between fascia fibroblasts and fibrin glue in vitro.

MRI features of the parotid gland in Sj?gren syndrome / 中华放射学杂志

Objective To investigate MR imaging features of parotid gland in Sj?gren′s syndrome ( SS).Methods Twenty-seven cases of xerostomia patients were collected and divided into SS group ( n=21) and non-SS group (n=6) according to the international classification (diagnosis) criteria for SS.Ten healthy volunteers were recruited as the control group.All the subjects underwent conventional MRI of parotid gland and MR sialography ( MRS).Standard deviation of T 1 WI and T2 WI signal intensity among 3 groups was observed, meanwhile, grading was made according to parotid glands , fat signal and parotid duct expansion degree respectively.With clinical diagnosis as the gold standard , diagnostic value of conventional MRI , MRS and their combination used in SS was compared.One-way ANOVA was used in comparison of standard deviation of parotid gland′s signal intensity among 3 groups , and Chi-square test was applied in comparison of conventional MRI and MRS diagnostic value.Moreover , Kappa value was calculated to assess the consistency of two grading results in SS.Results Signal intensity of parotid glands in control group and non-SS group was homogeneous.However , bilaterally diffused and heterogeneous high signal intensity on both T1WI and T2WI was found in SS patients, which was depressed on T2WI fat suppression sequences.Forty-two parotid glands were graded by fat signal:Grade 0 (n=2 glands), Grade 1 (n=10), Grade 2 (n=10), Grade 3 (n=6) and Grade 4 (n=14).Parotid peripheral ducts of control group and non-SS group were unexpanded , while bilaterally expanded parotid peripheral ducts were shown in SS patients.The grading of 42 parotid glands by expansion degree of parotid duct , Grade 0 was rated in 12, Grade 1 in 8, Grade 2 in 10, Grade 3 in 5, and Grade 4 in 7.Standard deviation of T1WI signal intensity of parotid glands among SS group , non-SS group and control group were 124.1 ±30.0, 81.8 ±27.6, and 86.3 ±35.0 respectively;and standard deviation of T 2 WI signal intensity were 115.1 ±35.2, 69.8 ±23.5, and 80.1 ±31.4 respectively; the standard deviation of T 1 WI and T2 WI signal intensity of SS group was higher than both non-SS group and control group′s ( F value =13.780 and 13.301, respectively, P 0.05).Among 42 parotid glands with SS, conventional MRI and MRS showed parotid gland lesions in 40 and 30 respectively , and the difference was statistically significant (χ2 =13.04, P=0.013).There was no false positive result.The combination of the two methods detected all 42 lesions.The consistency of detecting parotid abnormalities with SS between conventional MRI and MRS was poor (Kappa=0.12, P=0.092).Conclusions Diffuse fatty infiltration on conventional MRI and diffuse peripheral duct dilatation on MRS in the parotid gland are characteristic features of SS , and conventional MRI could be used as the preferred technique for the SS.combination with MRS may improve diagnostic accuracy.

The optimal dose reduction level in chest CT with CT volume scan mode using iterative reconstruction in piglet model / 中华放射学杂志

Objective To determine the feasibility and the optimal dose reduction of AIDR 3D on piglet chest CT which can provide image quality (IQ) comparable to filtered back projection (FBP).Methods Twenty-nine normal pigs with the weight of 3-12kg underwent 640-slice MDCT chest CT (Aquilion one,Toshiba) for 5 times with 80 kvp and various mAs.SureExposure3D technique were used and the index of noise were set to SD 10.0,12.5,15.0,17.5,20.0(Group A,B,C,D,E) to reduce dose successively.Group A were reconstructed with FBP,Group B,C,D,E were reconstructed using AIDR 3D (strong level).Quantitative image noise and signal to noise ratio(SNR) were measured in each group.Two radiologists graded subject image quality on both lung images (artifacts,central airway,lung tissue) and mediastinal images (mediastinal structure) and overall image quality using a 5-point scale in a blinded manner.Analysis of variance (ANOVA) and LSD test were used for comparisons of objective evaluation indices (CT value,noise,SNR)and radiation dose(CTDIvo1,DLP,ED) among the five groups.The Friedman test and Wilcoxon test were used for comparisons of demographic data and for detection of differences in subjective evaluation of IQ among groups.A receiver-operating characteristic (ROC) analysis was performed to establish a radiation reduction threshold up to which comparable IQ(score≥4) was maintained.Results Compared with Group A[noise(15.25 ± 3.14)HU,SNR 3.23 ± 1.07],Group B,C had significant lower noise and higher SNR [noise (12.11 ± 2.75),(13.18 ± 3.16)HU; SNR 4.13 ± 1.38,3.80 ± 1.20;F =7.38,3.11,P ＜0.05].Group D,E showed no significantly different noise and SNR with Group A[noise (15.14±4.51),(15.79 ±4.17)HU;SNR 3.40± 1.56,3.45 ± 1.70;P＞0.05].Group B,C had significant better subject image quality compared with Group A (P ＜0.01).Group D had no significantly different subject image quality compared with Group A (P ＞ 0.05).Group E had 5 pigs with overall image scores of ＜ 3.The ROC curve of IQ established SD 17.5 (Group D) as optimal cut-off point (AUC 0.75,95％ CI 0.58-0.92).Group D provided equivalent subjective image score and objective IQ measurements compared with FBP images in Group A.The ED of group D was 59％ lower than that of group A[CTDIvol (1.14±0.27) mGy vs (0.47 ±0.16)mGy,F=183.83,P＜0.01].Conclusion Using AIDR 3D technique,80 kvp with SureExposure3D (SD 17.5) can provide comparable IQ compared with routine dose with FBP reconstruction,and reduce 59％ dose in piglet model.

Damage to skeletal muscle cells leads to delayed muscle soreness:how to effectively improve muscle recovery both in recovery speed and quality / 中国组织工程研究

BACKGROUND:There is no simple and effective method to relieve delayed muscle soreness. OBJECTIVE:To conclude the injured mechanism and therapies of delayed muscle soreness by reviewing literature about damage and repair of the skeletal muscle. METHODWanfang and PubMed databases (from January 1991 to January 2014) were retrieved for articles related to morphological structure of the skeletal muscle, mechanism of delayed muscle soreness, and treatment and repair of the skeletal muscle using the keywords of“molecular mechanisms;delayed onset muscle soreness;pain;skeletal muscle;injury”in Chinese and English, respectively. Final y, 24 articles were included in result analysis. RESULTS AND CONCLUSION:Studies have shown that skeletal muscle injury is related to calcium imbalance, energy imbalance and high concentration of active oxygen. Skeletal muscle injury includes metabolic injury, mechanical injury and inflammatory injury. Insulin-like growth factor, peroxisome proliferator-activated receptorγ-coactivator-1αpromoter and tumor necrosis factorαplay important roles in skeletal muscle repair process. Animal experiments have demonstrated that edaravone may reduce secondary damage and inflammatory infiltration by means of directly preventing rapid peroxidation injury of free radicals in the skeletal muscle. Clinical studies have shown that Chinese medicine preparations, massage and acupuncture can delay the occurrence of exercise-induced muscle injury and fatigue, to improve the speed and quality of the recovery of damaged muscles. The treatment of delayed muscle soreness can achieve satisfactory results by combining physiotherapy with traditional Chinese medicine.