Comparison of fat suppression effects between Dixon and SPAIR techniques in the neck MRI / 中华放射学杂志

Objective:To investigate the effect of water-fat separation (Dixon) and spectrally selective attenuated inversion recovery (SPAIR) on fat suppression in the neck.Methods:From June to December 2018, 35 patients, including 16 males and 19 females, aged 23-75 (46±13) years old underwent MRI examinations of cervical vertebrae in Sir Run Run Hospital Affiliated to Nanjing Medical University. The imaging data of Dixon and SPAIR fat suppression scanning were prospectively collected. The scanning sequences included Dixon VIBE-T 1WI, SPAIR VIBE-T 1WI, Dixon TSE-T 2WI and SPAIR TSE-T 2WI. According to the subjective evaluation, the quality of fat suppression was divided into 0-4 grades. The cases with clear depiction of the thyroid tissue on Dixon or SPAIR were counted. Fisher exact test and paired t test or rank sum test were used to compare the noise, SNR and CNR of mandible angle, glottis, thyroid and sternoclavicular joint. Results:There were 29 cases of grade 0, 4 cases of grade 1, 2 cases of grade 2 on Dixon VIBE-T 1WI, 4 cases of grade 3 and 31 cases of grade 4 on SPAIR VIBE-T 1WI group, and the difference was statistically significant ( P<0.05); 28 cases of grade 0, 5 cases of grade 1 and 2 cases of grade 2 on Dixon TSE-T 2WI, 33 cases of grade 3 and 4 on SPAIR TSE-T 2WI, and the difference was statistically significant ( P<0.05). There were 35 cases with clear depiction of the thyroid tissues on DIXON and 4 cases on SPAIR VIBE-T 1WI ( P<0.05); there were 35 cases on DIXON and 3 cases on SPAIR TSE-T 2WI ( P<0.05). At the level of mandible angle, for the SNR of sternocleidomastoid muscle, SNR and CNR of splenius capitis muscle on VIBE-T 1WI, Dixon images were better than those on SPAIR images, and the difference was statistically significant ( P<0.05); the noise, SNR of sternocleidomastoid and splenius capitis muscle on TSE-T 2WI images were more than those in SPAIR images, and the difference was statistically significant ( P<0.05). At the level of glottis, the SNR of sternocleidomastoid muscle and levator scapulae muscle in the sequence of VIBE-T 1WI and Dixon images were significantly higher than those on the images of SPAIR ( P<0.05); the noise and SNR of sternocleidomastoid muscle on Dixon TSE-T 2WI images were significantly higher than those on the images of SPAIR ( P<0.05). At the thyroid level, the noise of Dixon VIBE-T 1WI image was less than that of SPAIR image, the SNR of sternocleidomastoid muscle and levator scapulae muscle on Dixon images was greater than that of SPAIR image, and the difference was statistically significant ( P<0.05); For TSE-T 2WI sequence, the SNR of sternocleidomastoid muscle on Dixon image was greater than that on SPAIR image, and the difference was statistically significant ( P<0.05). At the level of sternoclavicular joint, there were no significant differences for noise, SNR and CNR between the two groups ( P>0.05). Conclusion:Dixon outperforms SPAIR in obtaining better image quality and suppression effect in terms of neck MRI scanning.

Efficacy of 308-nm excimer laser versus high-intensity ultraviolet radiation for the treatment of active localized vitiligo / 中华皮肤科杂志

Objective To investigate the efficacy and safety of 308-nm excimer laser compared to high-intensity ultraviolet radiation for the treatment of active localized vitiligo,and to observe changes in skin lesions before and after the treatment by confocal laser scanning microscopy.Methods Sixty patients with 203 skin lesions of active localized vitiligo and were enrolled into this study,and the vitiligo disease activity (VIDA) score of these patients ranged from 2 to 3.We selected more than 3 skin lesions from a same anatomical site of each patient,one of lesions served as a control and the other skin lesions (≥ 2) were randomly treated with 308-nm excimer laser (laser group) or high-intensity ultraviolet radiation (ultraviolet group).The treatment was conducted twice a week for 25 sessions,and a 3-month follow-up was performed.Results A total of 48 patients with 169 skin lesions completed the trial.The marked response rate was significantly higher in the laser group [66.15％ (43/65)] than in the ultraviolet group [44.64％ (25/56),x2 =8.28,P ＜ 0.01].The patients with a VIDA score of 2 showed a significantly higher marked response rate [67.69％(44/65)] compared with those with a VIDA score of 3 [44.64％(25/56),x2 =6.80,P ＜ 0.01].During the 3-month follow-up,no relapse was observed.Confocal laser scanning microscopy showed that the number of inflammatory cells increased at the dermal-epidermal junction of the intra-and extra-marginal lesional skin.After treatment,the number of inflammatory cells markedly decreased and returned to normal level in lesions.Conclusion Both 308-nm excimer laser and high-intensity ultraviolet radiation are effective in the treatment of active localized vitiligo,but the 308-nm excimer laser shows a more rapid onset of action and a better therapeutic effect.

The analysis of correlation between job burnout and sleep quality in psychiatric female medical staff of Wenzhou city / 中国基层医药

Objective To explore the relationship between job burnout feeling and sleep quality in psychiatric female medical staff.Methods 100 female medical staff were randomly selected from two mental hospitals in Wenzhou,and the Pittsburgh sleep quality index was used to evaluate and Maslach burnout inventory;and the relation-ship between sleep quality and job burnout was analyzed.Results Female psychiatric and medical personnel to the personality dimension score was (10.84 ±4.75)points,which was higher than Maslach norm (7.12 ±5.22)points;emotion exhaustion scores of (14.44 ±6.38)points,low achievement sense score of (15.07 ±6.89)points,below the Maslach often die emotion exhaustion scores of (22.19 ±9.53)points and low achievement sense scores (36.54 ± 7.34)points.The differences were statistically significant (t =-12.15,7.84,-31.15,all P <0.01).Job burnout and there were significant correlations between sleep quality and the emotional exhaustion and personification and PQSI seven dimensions and the total score was a positive correlation,low sense of achievement and PQSI total score and negatively correlated with seven dimensions.Conclusion Wenzhou psychiatric female medical staff burnout is significantly higher than the general population,there is a correlation between staff burnout and sleep quality,and the more serious burnout,poorer quality of sleep.Improving the quality of sleep of medical staff is one of the ways to relieve job burnout.

Research status for locoregional recurrence of breast cancer after mastectomy / 国际肿瘤学杂志

Although locoregional recurrence (LRR) after mastectomy is regarded as a signal of disease progression,but it is different from distant metastasis.Some patients could have better prognosis and benefit from salvage treatments,especially for patients with isolated LRR.Time to recurrence,site of recurrence and number of recurrent nodules have great influence on the prognosis of patients with LRR.For suited patients with LRR,surgical resection and endocrine therapy are valuable in suitable cases,but the role of chemotherapy still need further study.

Investigation and Study of Large-scale Medical Imaging Equipment in Zhenjiang Region / 医疗卫生装备

The current situation of large-scale medical imaging equipment in Zhenjiang region is briefly summarized.Investigation and study are made on DSA,CT and MR of 19 hospitals in Zhenjiang.Data are treated statistically.Suggestions on management and disposition of large scale medical imaging equipment are put forward at last.