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Objective:To investigate the feasibility of using spectral CT chest enhancement venous phase images to obtain virtual non-contrast (VNC) images and virtual arterial phase images to achieve one phase scan instead of three phase scans.Methods:Imaging data of 100 patients who underwent spectral CT chest plain and dual-phase enhancement scans at the First Affiliated Hospital of Kunming Medical University from January to May 2022 were analyzed retrospectively. The venous phase images of all patients were post-processed to obtain virtual non contrast (VNC) and 40 keV virtual mono-energy images (VMI) for simulated arterial phase images (Vart). Image quality and lesion detection were compared between true non-contrast (TNC) and VNC images, and conventional arterial phase (CIart) and Vart images by paired t-test, Wilcoxon test and McNemar test. Objective evaluation indexes of image quality included thoracic aorta, all levels of pulmonary artery, T4 vertebral bone cancellous, chest wall fat CT value, background noise, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR); the subjective score of image quality was assessed by double-blind method on a 5-point scale; the assessment of lesion detection included the detection rate of calcified foci and pulmonary nodules size, density, volume, percentage of solid components and imaging characteristics. Results:Except for chest wall fat and T4 vertebral bone cancellous, the differences in CT values between VNC and TNC images were not statistically significant ( P>0.05); Except for right upper pulmonary artery and right lower pulmonary artery, the differences in background noise values and SNR between TNC images and VNC images were statistically significant ( P<0.05). Compared with CIart images, the CT values of chest wall fat were lower in Vart images ( P<0.05), and the CT values of the remaining sites were significantly higher ( P<0.05); the background noise values of all sites on Vart images were smaller than those on CIart images, and the SNR and CNR values were higher than those on CIart images ( P<0.05).The differences of subjective scores of images quality were not statistically significant between TNC and VNC images, between CIar and Vart images ( P>0.05). Taking TNC as the standard, the overall detection rate of VNC for calcification was 88.53% (301/340). Except for the short diameter of partially solid nodules, the differences of qualitative and quantitative assessment indexes of lung nodules between TNC and VNC images were not statistically significant ( P>0.05). Conclusions:Spectral CT chest venous phase 40 keV VMI can simulate arterial phase images in the diagnosis of vascular lesions, and venous phase VNC basically meets the standard of conventional plain scan, so it is feasible to replace plain scan, arterial phase and venous phase images in a certain range.
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Objective Integrate the evaluation indexes of clinical competence of master of nursing specialist. Methods Search the Cochrane Library, Joana Briggs Institute Library, Embase, Web of Science, PubMed, CNKI, VIP and Wanfang database, from the establishment of the database to December 10th,2018, and to collect researches about master of nursing specialist clinical competence evaluation index and then analyzed by content analysis method and thematic analysis. Results A total of 9 articles were included, 26 items and 9 categories including comprehensive practical ability, professional development ability, teaching guidance ability, clinical scientific research ability, organization and management ability, professional accomplishment, professional values, professional knowledge level, relevant knowledge level were selected. 3 dimensions including skill structure, attitude structure and knowledge structure. Conclusion Evaluating the clinical competence of master of nursing specialist we should not only consider their comprehensive practical ability, but pay attention to their professional development, teaching and scientific research, organization and management, professional accomplishment, knowledge and professional values assessment.
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Objective@#Integrate the evaluation indexes of clinical competence of master of nursing specialist.@*Methods@#Search the Cochrane Library, Joana Briggs Institute Library, Embase, Web of Science, PubMed, CNKI, VIP and Wanfang database, from the establishment of the database to December 10th,2018, and to collect researches about master of nursing specialist clinical competence evaluation index and then analyzed by content analysis method and thematic analysis.@*Results@#A total of 9 articles were included, 26 items and 9 categories including comprehensive practical ability, professional development ability, teaching guidance ability, clinical scientific research ability, organization and management ability, professional accomplishment, professional values, professional knowledge level, relevant knowledge level were selected. 3 dimensions including skill structure, attitude structure and knowledge structure.@*Conclusion@#Evaluating the clinical competence of master of nursing specialist we should not only consider their comprehensive practical ability, but pay attention to their professional development, teaching and scientific research, organization and management, professional accomplishment, knowledge and professional values assessment.
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OBJECTIVE@#To explore the phenotype and pathogenesis of a fetus with a rare chromosomal abnormality.@*METHODS@#The fetus was analyzed by clinical prenatal ultrasonography, G-banding karyotyping and next generation sequencing (NGS).@*RESULTS@#Prenatal ultrasonography of the fetus showed Dandy-Walker syndrome, growth restriction, and right-heart system dysplasia. The fetus had a chromosomal karyotype of 47,XY,t(11;22)(q23.3;q11.2),+der(22)t(11;22). Duplication of 11q23.3q25 and 22q11.1q21 were also detected by NGS. The chromosomal translocation carried by the fetus was derived from his father.@*CONCLUSION@#Duplications of chromosome 11q23.3q25 and 22q11.1q11.21 segments probably underlie the Dandy-Walker syndrome, growth restriction, and hypoplasia of the right heart system in the fetus.
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Feminino , Humanos , Gravidez , Transtornos Cromossômicos , Cromossomos Humanos , Feto , Cariotipagem , Diagnóstico Pré-Natal , Translocação Genética , TrissomiaRESUMO
Objective To reveal the present situation of geriatric nursing, summarize the important research topics, in order to determine the focus of the research and work of geriatric nursing in China. Methods To take geriatric nursing belonged to MeSH thesaurus as key words, related literatures from 2006 to 2016 in Web of Science core collection were searched, then clustering analysis were adopted to analyze highly cited papers. Results Totally 2148 pieces of literatures related to geriatric nursing, there were 80079 pieces of quotations. The contents involved inappropriate medication use and falls in geriatric nursing risk management, functional decline, delirium and chronic cognitive impairment of the elderly, distinguishing between the basic theory of geriatric diseases, tools and practice of geriatric nursing assessment. Conclusions The current research hotspots on geriatric nursing includes: the risk management of geriatric nursing, prevention and control of geriatric syndrome, systematic study on geriatric nursing assessment.
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Purpose To investigate the second generation dual source CT low tube voltage (100 kV) combined with sonogram-affirmed iterative reconstruction (SAFIRE) in assessing coronary artery stents. Materials and Methods One hundred and fifty-six patients underwent CT coronary angiography after implanted coronary artery stents. Among all the patients, 86 cases were performed with 100 kV combined with SAFIRE, and 70 cases with 120 kV combined with filtered back projection reconstruction (FBP). Mean CT values, image noise, SNR, SAIR, image quality scores, stents detecting and radiation dose of aortic root, inner-stent, and the coronary artery proximal to the stent were compared. Results The mean CT value of aortic root, inner-stent, and the coronary artery proximal to the stent of 100 kV group was higher than that of 120 kV group (t=2.75, 11.77 and 3.19, P0.05). There was no statistic difference of image quality score between the two groups (t= -0.203, P>0.05). Totally there were 243 stents detected, including 67 of right coronary artery, 123 of left anterior descending, 36 of left circumflex, and 17 of other branches. Stent length ranged 3.8 to 98.7 mm and averaged (27.5±16.4) mm. The CTDIvol, DLP and ED of 100 kV group were lower than those of 120 kV group (t= -11.03, -9.41 and -9.41, P<0.05). The effective dosage reduced about 51.5% in 100 kV group when compared with that of 120 kV group. Conclusion The second generation dual source CT low tube voltage (100 kV) combined with SAFIRE in assessing coronary artery stent could meet the diagnostic requirement and reduce the radiation dosage, without increasing image noise and beam hardening artifacts.
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Objective To explore the value of intelligent optimum tube voltage technology at dual-source CT coronary angiography.Methods One hundred and fifty patients with normal body mass index (＜25 kg/m2) with clinically suspected coronary heart disease requiring coronary artery CTA examination were collected.According to the different scanning method,patients were randomly divided into 5 groups,30 cases of each group were tested by coronary artery CTA examination.The intelligent optimum tube vohage scanning technology was set to Semi,the tube voltage of A,B,C group were 120,100 and 80 kV (Ref 120 kV,400 mAs),respectively.D and E group were set to on,the reference voltage of group D was 120 kV,and reference current was 400 mAs.The reference voltage of group E was 100 kV,reference current was 400 mAs.Using the 15 section improved segment method for evaluation of coronary artery (lumen diameter＞ 2 mm and no severe calcification).They were assessed by subjective evaluation (image quality score) and objective evaluation (including vascular CT value,signal-to-noise ratio and contrast to noise ratio).Analyses of the differences between groups were compared with image quality,objective evaluation index and radiation dose by single factor variance.Results The image quality scores in patients scanned with five groups were (3.42±0.63),(3.41±0.54),(3.49±0.33),(3.45±0.43) and (3.48±0.81),there was no statistical difference between the five groups (F=0.634,P=0.105).Each image quality was good,all could clearly show thewhole range of vessels.The CT values of the coronary artery with above groups respectively were (486±82),(554±71),(742±90),(506±81),(561±81) HU.The image noises were (25±12),(32±12),(46±14),(28± 11),(34±12) HU (F=3.430 and 4.332,P＜0.05).And the SNR and CNR was no statistic difference between the five groups (P＞0.05).The effective radiation dose of five groups are (9.3± 1.3),(6.3± 1.4),(2.8±1.5),(5.7 ± 1.2),(3.9 ± 1.3) mSv,which the difference was statistically significant (F=2.332,P＜0.05).Conclusions Intelligent optimum tube voltage technology (Ref.100 kV,400 mAs) at dual-source CT coronary angiography may be feasible in patients with normal BMI.To ensure the quality of the image at the same time,it can effectively reduce the radiation dose.
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Purpose To explore CT manifestations of thyroid carcinoma and its correlation with neck lymph node metastasis. Materials and Methods CT findings of 165 patients with thyroid carcinoma confirmed by surgical pathology were studied, including number, shape, size, calcium, necrosis, surrounding invasion and enhancement of substantial part, and its correlation with neck lymph node metastasis was also analyzed. Results 107 out of 165 patients (64.85%) suffered from neck lymph node metastasis. Different tumor number, calcium and necrosis were not associated with the rate of neck lymph node metastasis (χ2=0.009, 2.606, 1.522;P>0.05);tumor shape, size, surrounding invasion and enhancement were significantly different from the rate (χ2=26.510, 75.995, 68.922, 20.819;Penh ancement>shape>size>age. However, patients gender, tumor number, calcium and necrosis showed on correlation (r=0.074, 0.126, 0.005, 0.121;P>0.05). Conclusion Lymph node metastasis is mainly associated with factors like age, tumor shape, size, enhancement and surrounding invasion. It is advisable that patients with high risk rate may consider selective cervical lymph node dissection.
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Objective To explore the feasibility of DSCT dual-energy technique in pulmonary mass lesions.Methods A total of 100 patients with pulmonary masses underwent conventional plain CT scan and dual-energy enhanced CT scan.The virtual non-contrast (VNC) images were obtained at post-processing workstation.The mean CT value,enhancement value,signal to noise ratio (SNR),image quality and radiation dose of pulmonary masses were compared between the two scan techniques using F or t test and the detectability of lesions was compared using Wilcoxon test. Results There was no statistically significant difference among VNC ( A ) ( 32.89 ± 12.58 ) HU,VNC (S) ( 30.86 ± 9.60) HU and conventional plain images (35.89 ± 9.99 ) HU in mean CT value of mass ( F =2.08,P ＞ 0.05 ).There was statistically significant difference among VNC ( A ) ( 3.29 ± 1.45 ),VNC (S) ( 3.93 ± 1.49 ) and conventional plain image (4.61 ± 1.50) in SNR ( F =6.01,P ＜ 0.05 ),which of conventional plain scan was higher than that of VNC.The enhancement value of mass in conventional enhanced scan(60.74 ± 13.9)HU and distribution of iodine from VNC (A) ( 58.26 ± 31.99 ) HU was no statistically significant difference ( t =0.48,P ＞ 0.05 ),but there was a significant difference between conventional enhanced scan (56.51 ± 17.94 ) HU and distribution of iodine from VNC (S) (52.65 ± 16.78 ) HU (t =4.45,P ＜ 0.05 ).There was no statistically significant difference among conventional plain scan ( 4.69 ± 0.06 ) and VN C ( A ) ( 4.60 ± 0.09 ),VNC (S)(4.61 ±0.11 ) in image quality at mediastinal window ( F =3.014,P ＞ 0.05 ).The appearance,size,internal features of mass (such as necrosis,calcification and cavity) were showed the same in conventional plain scan,VNC (A) and VNC (S).Of 41 patients with hilar mass,18 patients were found to have lobular and segmental perfusion decrease or defect. Perfusion defect area was found in 59 patients with peripheral lung mass. The radiation dose of dual-energy enhanced scan was lower than that of conventional scan.Conclusion The virtual non-contrast,distribution of iodine and pulmonary virtual perfusion images can be obtained by DSCT dual-energy technique in one scan,which has a potential clinical value in the thorax.
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AIM:This study was performed to investigate the feasibility and efficiency of exogenous mesenchymal stem cells(MSCs) transplantation on post-infarction ventricular remodeling and heart function in rats and compare the effects between adult rat MSCs and neonate rat MSCs transplantation.METHODS:1-2 hours after left coronary artery ligation,MSCs cultured in ex vivo,marked with BrdU,were injected directly into the border of infarcts in exogenous rats.6 weeks after transplantation,rat' heart function,ventricular remodeling and pathological results were measured.RESULTS:MSCs transplantation decreased LV end-diastolic diameter and end-systolic diameter,limited LV chamber dilatation and reduced collagen content significantly.The numbers of blood vessels and cardiomyocytes were increased.BrdU-labelled MSCs with oval nucleus were widely distributed.There were no significant difference between adult rat MSCs and neonate rat MSCs transplanted groups.CONCLUSION:MSCs can survive and home in exogenous host infarct hearts without addition of any immunosuppressant.MSCs transplantation has benificial effects on remodeling processes and contributes to improvement of cardiac function,which may be related with the reduction of the amount of the collagen,promotion of myogenesis and angiogenesis.