Differential diagnosis of brucellar spondylitis and tuberculous spondylitis based on FS-T2WI sequence combined with machine learning / 中华地方病学杂志

Objective:To investigate the performance of a predictive model based on fat suppression (FS)-T2WI sequence combined with machine learning in the differential diagnosis of brucellar spondylitis (BS) and tuberculous spondylitis (TS).Methods:The clinical and imaging data of 74 patients with BS and 81 patients with TS diagnosed clinically or pathologically in the First Affiliated Hospital of Xinjiang Medical University from January 2017 to January 2022 were retrospectively analyzed, and all patients underwent spinal magnetic resonance imaging (MRI) examination before treatment. Patients were randomly divided into a training group ( n = 123) and a testing group ( n = 32) in an 8 ∶ 2 allocation ratio, and radiomics feature extraction and dimensionality reduction analysis were performed on FS-T2WI sequence images. Four machine learning algorithms, including K-nearest neighbor (KNN), support vector machine (SVM), random forest (RF) and logistic regression (LR), were used to construct a radiomics model, and receiver operating characteristic (ROC) curve was used to analyze the differential diagnostic performance of each model for BS and TS. Results:A total of 1 409 radiomics features were extracted, and 7 related features were screened and included for identification of BS and TS, among which the Maximum2DDiameterColumn feature value showed a strong correlation, and there was a statistically significant difference between BS and TS patients ( P < 0.001). In the testing group, the area under the ROC curve (AUC) value of the SVM model for identifying BS and TS was 0.886, with a sensitivity of 0.53, a specificity of 0.88, and a diagnostic accuracy of 0.81; in the training group, the AUC value of the SVM model for identifying BS and TS was 0.811, the sensitivity was 0.68, the specificity was 0.72, and the diagnostic accuracy of the model was 0.78. Conclusion:The prediction model based on FS-T2WI sequence combined with machine learning can be used to identify BS and TS, and the diagnostic performance of SVM model is prominent and stable.

Prompt value of MRI scanner-detected temporalis muscle thickness in patients with stroke / 中华老年医学杂志

Objective:To investigate the relationship of sarcopenia diagnosed by temporalis muscle thickness(TMT)with physical status and prognosis of stroke patients.Methods:Temporalis muscle thickness was detected by MRI scanner.The median value of TMT was used as the risk classification index of sarcopenia in 265 stroke patients.The relationships of TMT with several indicators of Essen Stroke Risk Score(ESRS), National Institutes of Health Stroke Scale(NIHSS), Barthel index, water swallow test, Venous thromboembolism(VTE)assessment of medical inpatients, as well as the modified Rankin Score(mRS)follow-up results at 3 and 6 months after discharge were retrospectively analyzed.Results:There were 166 men and 99 women in the study cohort, with an average age of(62±13.1)years.The TMT value of men was 0.58 mm, which was significantly higher than that of women( t=2.307, P<0.05).There were significant differences in age( χ2=33.443, P<0.001), albumin( t=-2.467, P<0.05), triglyceride( Z=-2.777, P<0.01)and hemoglobin( t=-3.264, P<0.001)between sarcopenia group and non-sarcopenia group.As compared with non-sarcopenia group, atherosclerosis( χ2=4.715, P<0.05), pulmonary infection( χ2=4.707, P<0.05)and hypertension( χ2=4.046, P<0.05)were easy to be accompanied in sarcopenia group.There was good agreement in TMT measurements among different investigators(ICC=0.980, P<0.001).After adjusting for confounding variables, Logistic regression analysis showed that sarcopenia was significantly correlated with ESRS( OR=1.92, P< 0.05)and Barthel index( OR=1.66, P< 0.05)at admission, and Barthel index after discharge( OR=1.84, P<0.05), mRS at 3 months after discharge( OR=3.09, P<0.001), mRS at 6 months after discharge( OR=3.36, P<0.001). Conclusions:TMT can be used as a comprehensive index to dynamically display the physical state and prognosis of stroke patients, but further research is needed to determine the causal relationship.

Research advances in the value of sarcopenia in the prognosis of patients after liver transplantation / 临床肝胆病杂志

Sarcopenia is often observed in patients with end-stage liver disease such as advanced liver cancer. This complication is associated with mortality rate in the perioperative period of liver transplantation, and limited liver resources require traditional evaluation systems to further improve the survival rate of the transplant cohort. Summarization and evaluation of skeletal muscular pathology and diagnosis and treatment strategies show that as a body composition parameter that can effectively predict the survival of patients, skeletal muscle can help to optimize the sequence of transplantation cohorts and surgical benefits in combination with liver function assessment scale. The specific mechanism of related death remains unclear, the diagnostic indicators are gradually streamlined, and there is no treatment strategy that can reverse the mortality rate. Based on the existing literature, sarcopenia is one of the important parameters for determining candidates for liver transplantation.

Investigation of AIDS cognition and testing willingness among freshmen in Fengtai District, Beijing / 中国学校卫生

Objective@#To examine college students awareness of AIDS (acquired immunodeficiency syndrome) and HIV (human immunodeficiency virus), as well as their willingness to undergo testing, and to provide guidance for further education targeted towards AIDS prevention.@*Methods@#The respondents were selected from two companies of military training camps in 4 universities in Fengtai District of Beijing using cluster sampling, and a questionnaire was used to obtain relevant information among 1 248 college freshmen. The content of the questionnaire included basic information about the students, awareness of AIDS, and willingness to undergo testing.@*Results@#A total of 87.18% students were familiar with AIDS related knowledge, and 62.98% students intended to have HIV tests in the future. Willingness to be tested for HIV was higher among not local students (67.39%) than among local students(55.65%)(χ 2=17.32, P<0.05). The willingness to get HIV testing was higher among students who had an understanding of AIDS (65.26%) than among those who lacked an awareness(47.50%)(χ 2=18.87, P<0.05). In terms of the willingness to be tested for HIV, the main concerns focused on personal privacy (23.24%) and the cost (18.59%). Multivariate regression analysis showed that improving students awareness of five of the items related to a basic knowledge of AIDS may increase their willingness to get HIV testing(P<0.05). Most students indicated a preference to get HIV testing at a hospital (68.51%) or at the Centers for Disease Control and Prevention(42.79%).@*Conclusion@#The willingness to get HIV testing can be increased by launching an AIDS health education program that targets weak knowledge points with respect to AIDS awareness.

Quantitative evaluation of magnetic resonance T2 mapping in Brucella spondylitis / 中华地方病学杂志

Objective:To analyze the characteristics and quantitative evaluation of Brucella spondylitis patients by magnetic resonance T2 mapping. Methods:A prospective clinical study was conducted to analyze the MRI data of 23 patients with brucellosis spondylitis diagnosed in the First Affiliated Hospital of Xinjiang Medical University from January 2016 to September 2018, and 25 healthy volunteers were selected as the control group. MRI was used to examine the vertebral bodies of the subjects, and T2 mapping map was automatically generated. Regions of interest (ROI) were selected on the T2 mapping map to generate T2 mapping values automatically. The T2 mapping values of diseased vertebrae, adjacent unaffected vertebrae, paravertebral abscess and healthy volunteers were analyzed.Results:Among 48 MRI examinees, 23 cases were Brucella spondylitis, including 17 males and 6 females, aged (38.5 ± 13.4) years; 25 healthy volunteers, including 15 males and 10 females, aged (35.1 ± 12.7) years. In 23 patients with Brucella spondylitis, 5 thoracic vertebrae, 40 lumbar vertebrae and 7 sacral vertebrae were involved, with a total of 52 vertebral bodies. Among them, 11 (21.2%) vertebral bodies showed bone marrow edema on MRI, 41 (78.8%) vertebral bodies showed bone marrow edema and vertebral bone destruction. T2 mapping values of the diseased vertebrae, adjacent unaffected vertebrae and paravertebral abscess in Brucella spondylitis patients and normal vertebrae in healthy volunteers were (115.62 ± 11.37), (75.21 ± 5.57), (240.26 ± 30.67) and (77.29 ± 4.19) ms, respectively. There were significant differences between the diseased vertebrae in Brucella spondylitis and adjacent unaffected vertebrae in Brucella spondylitis, and there were significant differences between the diseased vertebrae in Brucella spondylitis and normal vertebrae in healthy volunteers ( t = 26.78, 19.42, P < 0.05). Conclusion:Magnetic resonance T2 mapping can be used to evaluate the pathological tissues in Brucella spondylitis patients, and it has certain guiding significance for the quantitative description and qualitative diagnosis.

The value of MRI in differentiating Brucella spondylitis from tuberculosis spondylitis / 中华地方病学杂志

Objective:To evaluate the value of magnetic resonance imaging (MRI) in differentiating Brucella spondylitis from tuberculosis spondylitis. Methods:A retrospective analysis method was used to include Brucella spondylitis patients and tuberculous spondylitis patients who had undergone MRI examination at the First Affiliated Hospital of Xinjiang Medical University from January 2015 to December 2017. All patients data of MRI examination (all had T1WI, T2WI, STIR images) were collected and compared. The differences in lesion location, MRI signal, vertebral body destruction, vertebral wedge, kyphosis deformity, attachment destruction, dead bone, bone hyperplasia, intervertebral space change, abscess location, and abscess range were analyzed. Results:A total of 91 patients with brucella spondylitis were selected, including 36 women and 55 men, with an average age of 49.40 years old; 112 patients with tuberculous spondylitis selected in the same examination, including 48 women and 64 men, with an average age of 47.15 years old. There was no statistically significant difference in gender and age between the two groups (χ 2 = 0.225, t = 1.387, P > 0.05). Brucella spondylitis was more common in lumbar spine [72.53% (66/91)], and tuberculosis spondylitis was more common in thoracic spine [47.32% (53/112)]. Brucella spondylitis patients showed higher T2WI hyperintensity than tuberculosis spondylitis patients [51.65% (47/91) vs 24.11% (27/112), P <0.05]; and showed lower T2 hyperlipidemia than patients with tuberculosis spondylitis [59.34% (54/91) vs 72.32% (81/112), P < 0.05]; the incidence rates of mild destruction of vertebral body, bone hyperplasia, normal intervertebral space, paravertebral abscess, and abscess not exceeding the range of vertebral body were higher than those of patients with tuberculosis spondylitis [81.32% (74/91), 93.41% (85/91), 37.36% (34/91), 71.43% (65/91), 38.46% (35/91) vs 20.54% (23/112), 28.57% (32/112), 1.79% (2/112), 30.36% (34/112), 1.79% (2/112), P < 0.01]; the incidence rates of vertebral body severe destruction, vertebral wedge less than 1/2, kyphosis deformity, dead bone, inter vertebral space narrowing, inter vertebral space vanishing, psoas abscess, abscess beyond the range of vertebral body were lower than those of patients with tuberculous spondylitis [12.09% (11/91), 18.68% (17/91), 2.20% (2/91), 2.20% (2/91), 61.54% (56/91), 1.10% (1/91), 2.20% (2/91), 1.10% (1/91) vs 75.89% (85/112), 72.32% (81/112), 29.46% (33/112), 46.43% (52/112), 79.46% (89/112), 18.75% (21/112), 66.96% (75/112), 74.11% (83/112), P < 0.01]. Conclusions:MRI signs can be used to differentiate Brucella spondylitis from tuberculosis spondylitis through analysis of bone hyperplasia, vertebral body destruction, vertebral wedge, kyphosis deformity, dead bone, abnormal intervertebral space, and paravertebral abscess and psoas abscess.

Relationship between MRI features and clinical stages of hepatic alveolar echinococcosis / 实用放射学杂志

Objective To explore the relationship between conventional MRI characteristics and clinical stage of hepatic alveolar echinococcosis(HAE).Methods 54 patients diagnosed with HAE in our hospital were collected.The characteristics of HAE in conventional MRI were analyzed,and the correlationship among the Kodama classification,the maximum diameter of the lesion and the clinical stage of PNM were compared.Results According to the Kodama classification,the lesions were divided into 5 types:Kodama type 1 (2.63%,2/76), Kodama type 2 (18.42%,14/76),Kodama type 3 (51.32%,39/76),Kodama type 4 (26.32%,20/76)and Kodama type 5 (1.32%,1/76).In this study,22.37% (17/76)lesions were at P1 stage,7.89% (6/76)lesions were at P2 stage,60.53% (46/76)lesions were at P3 stage, 9.21% (7/76)lesions were at P4 stage.44.74% (34/76)lesions were at N1 stage.18.42% (14/76)lesions were at M1 stage.P stage and N stage were positively correlated with the maximum diameter of the lesions (P<0.000,r=0.516;P<0.000,r=0.754).Conclusion There is no correlation between the Kodama typing and the maximum diameter of the lesions.P and N staging is positively correlated with the maximum diameter of the lesions.There is no correlation between M staging and the maximum diameter of the lesions.

Calcification characteristics and biological activity of hepatic alveolar echinococcosis / 中华放射学杂志

Objective To investigate the calcification characteristics and biological activity of hepatic alveolar echinococcosis(HAE). Methods Retrospective analysis of 60 patients in the First Affiliated Hospital of Xinjiang Medical University from June 2016 to April 2017 with hydatid positive or surgical pathology confirmed HAE.All patients underwent abdominal CT scan and double-phase enhanced PET-CT examination were confirmed with single lesion.The CT and PET-CT features were analysed,and the maximum standard uptake value (SUVmax) of the focal lesion on the PET-CT was measured. According to the calcification,HAE patients were divided into A,B,C type.Kruskal-Wallis H test was used to compare the difference of SUVmax between lesions of different HAE types. Results Sixty patients with hepatic alveolar echinococcosis were evenly divided into A,B and C by different calcifications.The median SUVmax of A,B and C were 3.41(2.17 to 3.75),7.45(6.77 to 9.01)and 6.67(6.28 to 9.01),respectively.The median SUVmax within three types was statistically significant (χ2=4.429, P<0.05). Conclusion The biological activity of different HAE calcifications is different.

The effects of low contrast agent concentration combined with optimal monochromatic energy image on myocardial dual energy image quality / 中华放射学杂志

Objective To investigate the effects of low contrast agent concentration and optimal monoenergetic image on myocardial image quality in dual source, dual energy coronary CT angiography (CCTA).Methods Sixty patients,who were clinically suspected of coronary heart disease and referred to perform dual energy CCTA examination,were prospectively collected between January and June 2016 in the first affiliated hospital of Xinjiang Medical University and then randomly divided into two groups with thirty cases in each group.Dual-energy CCTA was performed in both groups with the same parameters expect the iodine contrast agent concentration.The iopamidol concentrations were 370 and 320 mg/ml for groups A and B, respectively. The raw images of the two groups were reconstructed to get conventional mixed energy images and 60,65,70,75,80,85,90 keV single energy images,respectively labeled as group A1 to A8 and group B1 to B8.The CT attenuation,noise,signal-to-noise ratio(SNR)and contrast to noise ratio(CNR)were measured in images from groups A1 to A8 and B1 to B8. And the optimal monoenergetic image set was selected.Rank sum test was used to compare the CT value,noise,SNR and CNR between groups A1 to A8 and B1 to B8.The differences of above-mentioned parameters between A1 and B5 group,A5 group and B5 group were compared by independent sample t test.Results The differences of CT value,noise,SNR and CNR between groups A1 and A8, B1 and B8 were statistically significant (P<0.05). The CNR and SNR of group A5 were significantly higher than that of group A1,and the image noise of group A5 was lower than that of group A1(all P<0.05),and the images of A5 group(75 keV)were the optimal monoenergetic image. The SNR and CNR of the left ventricular lateral wall in group B5 were significantly higher than those in group B1,and the noise was lower than that in group B1(all P<0.05),and the image of B5 group(75 keV) was the optimal monoenergetic image. The difference of image noise between groups A1 and B5 was statistically significant(P<0.05),while the differences of SNR and CNR between these two groups were not significant(all P>0.05).The differences of image noise,SNR and CNR between groups A5 and B5 were not significant(all P>0.05).Conclusions The myocardial CCTA image quality by using iodine contrast agent (320 mg/ml) and optimal monoenergetic imaging (75 keV) is equivalent to that of conventional iodine contrast agent(370 mg/ml)mixed energy image.The strategy can effectively reduce the amount of contrast agent when meeting the needs of the clinical diagnosis.

Effect of different enhancement scanning triggering threshold on dual energy coronary CT angiography image quality:an exploratory study / 中华放射学杂志

Objective To define the optimal enhancement scanning triggering threshold(ESTT)for both coronary and myocardial imaging of dual energy coronary computed tomography angiography (DE-CCTA).Methods One hundred of 135 patients who were going to receive DE-CCTA were enrolled in this study prospectively and equally assigned to five groups randomly of different ESTT as 100, 110, 120, 130 and 140 HU. Noise, signal-to-noise ratios (SNR), contrast-to-noise ratios (CNR), enhancement extent (EE) of coronary artery and myocardium, iodine concentration, beam hardening (BH) objective value and subjective rating of myocardium and EE of left ventricle (LV) were measured and compared between different group;and noise,SNR,CNR,EE of coronary artery and myocardium,iodine concentration and BH objective value of myocardium obey normal distribution and equal variance,so they were expressed as mean± standard deviation and compared with variance analysis of multiple independent samples, and pairwise comparison were done with SNK test.Myocardial BH subjective rating was ranked data,and was expressed as [median (P25, P75)], and compared with Kruskal-Wallis test, and pairwise comparison were done with Nemenyi test.Results Post contrast CT value of LAD,post contrast CT value and EE of LV chamber were different with different ESTT (F=3.471, 3.795, 3.132,and all P<0.05)Post contrast CT value of LAD was lower with 130 HU[(355.16±59.11)HU than ESTT of 100 HU[(404.9±49.0)HU].Myocardial BH value and subjective score were different with different ESTT(F=6.118,H=13.702,P all<0.05).Myocardial BH value was lower with ESTT of 130,140 HU[(8.8±12.4),(5.4±17.1)HU]than 100,110 HU[(24.2±17.7),(22.1± 11.6)HU].Myocardial BH subjective score was lower with ESTT of 130 HU[1.5(1.0,2.0)]than 110 HU[3.0 (2.0, 3.0)]. Post contrast CT value and EE of LV myocardium, noise, SNR and CNR of LAD and LV myocardium, EE of LAD were not different between group of different ESTT (P all>0.05). Conclusions ESTT could influence image quality of myocardium and coronary artery.One hundred and thirty HU is optimal ESTT of DE-CCTA for showing myocardium and coronary artery simultaneously during DE-CCTA on second generation dual-source CT with retrospective electrocardiogating technic and as monitoring position at aortic root.

Analysis of Influential Factors for Clinical Rational Use of Chinese Patent Medicine / 中国药房

OBJECTIVE:To provide reference for rational use of Chinese patent medicine. METHODS:The influencing fac-tors of rational use of Chinese patent medicine was investigated in respects of the selection of Chinese patent medicine,drug combi-nation,usage and dosage,clinical evaluation,pharmacoeconomic evaluation. RESULTS&CONCLUSIONS:Chinese patent medi-cine is a characteristic product of traditional Chinese medicine. It is a complex and important issue to use Chinese patent medicine rationally. It should be considered in many ways,not only pay attention to the principle of clinical use of Chinese patent medicine, but also need to carry out clinical evaluation of Chinese patent medicine;at the same time,the economics of Chinese patent medi-cine should be focused on.

Optimization of the extraction technology of ganglouyuchuang lotion by orthogonal test / 医学研究生学报

Objective Ganglouyuchuang lotion was used to dress the wound for Anal fistula in Crohn's disease, control inflammation and promote wound healing.This paper studied the extraction techonology of ganglouyuchuang lotion.Methods Four factors of ganglouyuchuang lotion, including volume of water, extraction time, extraction times and liquid ratio, were studied by the orthogonal test, and three levels were selected for each factor.The content of sodium danshensu, the active component contained in Chinese herbal medicine, was regarded as evaluating indicator, and the content of Danshensu Sodium was determined by HPLC.The water extraction and alcohol precipitation technology of ganglouyuchuang lotion was optimized according to the results of measurement.Results The optimum extraction technology of ganglouyuchuang lotion was as follows: four herbs, including Salvia miltiorrhiza, Radix Astragali, Radix sanguisorbae and Senecio were added with8 times amount of water overnight and decocted 3 times with 2 h, 1.5 h, and 1.5 h respectively, and then the extraction was concentrated to the ratio of herbs and concentrate of 1∶1.5.The results showed that the contents of Danshensu Sodium from the three examples were 0.520, 0.498, and 0.521 mg/mL, and the RSD were 0.34%, 0.41%, and 0.29%.Conclusion The optimum extraction technology is feasible and applicable for the preparation of ganglouyuchuang lotion.

CEUS in dynamicly assessing blood perfusion of hepatic alveolar echinococcosis in rats / 中国介入影像与治疗学

Objective To evaluate the value of CEUS in dynamicly assessing the blood perfusion of hepatic alveolar echinococcosis (HAE) in rats.Methods The experimentally induced secondary HAE in totally 70 rats were studied at different time periods (gth week,28th week,and 50th week) with CEUS,and compared to pathology results.Results At the 9th week,55 HAE lesions (55/70,78.57％) presented hyperechoic and the rest of 15 HAE lesions (15/70,21.43％)presented mixed echogenicity.The single or multiple vesicular structures were found as pathological feature.At later stages (28th week and 50th week),the size of lesions increased compared to 9th week with more solid structures and the calcifications found in HAE lesions.Microscopically,the fibrous tissues surrounding the lesions gradually thickened and the microvascular accumulation were visible around the lesions.The HAE lesions at the 9th week showed the ring enhancement and central septa enhancement in CEUS.The HAE lesions at the 28th week and 50th week showed combinations of no enhancement,ring enhancement,and central septa enhancement in CEUS.The ratio of edge enhancement to maximum diameter of lesions decreased with the progression (P=0.02).Conclusion The ultrasonographic features in HAE lesions become more complicated with increasing calcifications and enlarged necrosis areas with the progression.The CEUS can reveal the dynamics of blood perfusion of HAE lesions at different stages.

Value of imaging in the diagnosing echinococcosis of ribs / 中华放射学杂志

[Absract] Objective To investigate the imaging features of CT and MRI of echinococcosis, and improve the imaging knowledge of the disease. Methods Clinical and radiological findings of echinococcosis of ribs were retrospectively analyzed by reviewing the seventeen cases confirmed by clinical and pathological findings. All patients had CT scan, eight had X?ray plain film and five had MR examination, while 4 patients underwent additional contrast?enhanced CT examination. Results All lesions were unilateral. There were 33 ribs involved, and single involved rib was seen in 7 cases. On CT scans, 10 cases showed cystic, swelling and osteolytic bone destruction, and 7 cases showed moth?eaten osteolytic bone destruction. There were 13 cases of hydatid cyst, 3 cases of a single sac watery density shadow and 10 cases of polycystic separating wheels form. There were 4 cases of fractured ribs, 2 cases of the longitudinal fracture and 2 cases of the transverse fracture. On MRI, there was one case of rib medullary cavity expansion destruction. It was a single cyst with hypointensity on T1WI, hyperintensity on T2WI and hyperintensity on short time inversion recovery (STIR) images. There were one case of rib medullary cavity expansion destruction and 3 cases of hydatid erosion ribs cortex among 4 cases of polycystic type. Polycystic type echinococcosis appeared hypointensity on T1WI, hyperintensity on T2WI and hyperintensity on STIR images. Polycystic type had mother sac and ascus structure, and signal intensity of ascus was higher. STIR sequence showed more clearly polycystic structure. Conclusions CT and MRI can clearly show location of echinococcosis of ribs. There are the imaging features of cystic, swelling and osteolytic bone destruction or complicating cyst of polycystic type which can help the qualitative diagnosis of rib echinococcosis.

CT Pulmonary Angiography in Evaluating the Severity of Massive Pulmonary Embolism / 中国医学影像学杂志

Purpose To analyze the correlation of pulmonary artery obstruction index (PAOI) and the cardiovascular parameters in patients with massive pulmonary embolism (MPE), and to explore the CT pulmonary angiography (CTPA) significant in radiological massive pulmonary embolism. Materials and Methods Sixty-two patients with massive pulmonary embolism confirmed by CTPA were divided into two groups according to the severity with 17 cases in high-risk group and 45 cases in non-risk group. The correlation between pulmonary artery obstruction index and cardiovascular parameters of all subjects was analyzed. Parameters in the two groups were compared including PAOI, ratio of main pulmonary artery diameter (MPAd) to the ascending main artery diameter (AAd) named rPA, and ratio of right ventricular diameter (RVd) to the left ventricular diameter (LVd) named RVd/LVd. Results Pulmonary artery obstruction index had positive correlation with the cardiovascular parameters (r=0.504, 0.543, 0.629 and 0.657, P<0.05), but negative correlation with LVd (r=-0.500, P<0.05). PAOI, MPAd, rPA, RVd/LVd and RVd were higher in the high-risk group than those in the non-high-risk group (P<0.05). LVd was lower in the high-risk group than that in the non-high-risk group (P<0.05). Conclusion CTPA can not only effectively diagnose pulmonary embolism but also assess the severity of the radiologic massive pulmonary embolism, which contributes to the clinical prognosis and treatment options.

The predictive value of clinical and radiographic features in fungal pathogen identification in immunocompromised patients with pulmonary invasive fungal infection / 中华急诊医学杂志

Objective To investigate the predictive value of clinical and radiographic features in fungal pathogen identification in immunocompromised patients with pulmonary invasive fungal infection (IFI).Methods All consecutive immunocompromised adult patients with pulmonary IFI in respiratory intensive care unit (ICU)in the First Affiliated Hospital of Xinjiang Medical University were recruited during a 2 year period.All patients met the 2008 European Organization for Research and Treatment of Cancer and Mycoses Study Group (EORTC /MSG) criteria were studied for proved or probable IFI responding to antifungal agents.The data of demographic,clinical and radiographic features,as well as serological test results of the patients were collected.Differences in the clinical and radiographic features of pulmonary IFIs caused by yeasts and molds were compared by χ2 test.A logistic regression model was used to perform discriminant analysis,and the effect of discrimination was assessed for accuracy.Results The study included 143 patients with a probable diagnosis of IFI who had the following risk factors:diabetes mellitus (43.4%),chronic lung disease (32.2%),broad-spectrum antibiotics administration (≥14 days;35.7%),malignancy (23.1%),corticosteroid therapy (≥14 days;23.1%),chronic renal failure and renal replacement therapy (16.1%),and immunological disease (10.5%).Frequent broad-spectrum antibiotics administration was associated with yeast infection (P <0.05 ),while mold infection was associated with chronic lung disease (P <0.05 ) .Yeast was more often isolated from patients with concurrent bacterial infection and on mechanical ventilation (P <0.05 ) . Thoracic high-resolution computed tomography (HRCT)showed the following images:bronchial pneumonia/pulmonary consolidation (53.1%),massive shadowing (29.4%),small nodules (24.5%),large nodules (18.9%),pleural effusion (18.9%),halo sign (14%),and cavity (9.8%).Imaging showed that mold was more common than yeast in patients with pleural and pericardial effusions (P <0.05).Logistic regression modeling showed that broad-spectrum antibiotics administration,prolonged mechanical ventilation,and pleural and pericardial effusions were statistically significant in fungal identification (P <0.05 ),with a predictive accuracy of 77.6%.Conclusions For immunocompromised patients with pulmonary IFI,most of the risk factors ,the main clinical and chest HRCT features did not help to predict the type of fungal pathogen,and yeast but not cryptococcus may be accompanied or colonized.

Comparison of congenital coronary artery anomalies between Uyghur and Han: a multi-slice computed tomography study in Xinjiang, China / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The incidence of congenital coronary artery anomalies (CCAAs) is different between ethnic groups, but there is no report about Uyghur CCAAs because of the limitation of inspection methods. This study determined the prevalence of Uyghur CCAAs and analysis the difference of CCAAs between Uyghur and Han ethnic groups by the method of multi-slice computed tomography coronary angiography (MSCTCA).</p><p><b>METHODS</b>Seven thousand four hundred and sixty-nine MSCTCA were analyzed for the CCAAs retroactively, 1934 were Uyghur patients while 4746 were Han patients. All the coronary artery images dates obtained by MSCTCA were evaluated for the CCAAs by two doctors.</p><p><b>RESULTS</b>Nineteen kinds of CCAAs were found: (1) The overall incidence of CCAAs was 2.72% (203/7469) among all patients, 2.34% (111/4746) among Han patients whereas a significant higher 3.93% (76/1934) among Uyghur patients (χ2 = 12.780,P < 0.05); (2) the incidence of CCAAs among male patients was 2.48% (76/3069) in Han while 4.33% (56/1293) in Uyghur (χ2 = 10.663, P < 0.05); (3) the incidence of CCAAs on the left side was 1.07% (51/4746) among Han patients while 2.17% (42/934) among Uyghur patients (χ2 = 12.047, P < 0.05); (4) among these 19 kinds of CCAAs, there were significant differences of the incidence of the following kinds of CCAAs between Uyghur and Han: Left coronary artery (LCA) high location (χ2 = 8.320, P = 0.004), right coronary artery (RCA) originate from left coronary sinus (χ2 = 5.450, P = 0.020), and RCA originate from left Coronary sinus + LCA high location (P = 0.024).</p><p><b>CONCLUSIONS</b>There exists some difference in CCAAs between Uyghur and Han ethnic groups. The CCAAs incidence of Uyghur is higher than that of Han, especially in male patients and on the left side; among all kinds of CCAAs, the incidence of LCA high location, RCA originate from left coronary sinus, RCA originate from left coronary sinus + LCA high locations of Uyghur is higher than Han.</p>

Application of low-dose dual-source CT prospective electrocardiography gated scanning coronary imaging in evaluation of high body mass index patients / 中国医师进修杂志

Objective To evaluate the necessity and feasibility of low-dose dual-source CT coronary angiography imaging in the evaluation of high body mass index (BMI) patients. Methods Sixty patients with BMI≥28 kg/m2 and heart rate 65-90 beats/min were selected, and they were divided into prospective electrocardiography gated scanning group and retrospective electrocardiography gated scanning group by random digits table method with 30 cases each. The image quality, CT dose weighing index (CTDI) and dose length product (DLP) were compared between 2 groups. Results There was no statistical difference in the score of coronary image quality between retrospective electrocardiography gated scanning group and prospective electrocardiography gated scanning group:(3.47±0.61) scores vs. (3.18±0.94) scores, P>0.05. The CTDI and DLP in prospective electrocardiography gated scanning were significantly lower than those that in retrospective electrocardiography gated scanning: (32.44 ±10.18) mGy vs. (45.86 ±15.34) mGy and (458.00±95.27) mGy/cm vs. (532.15±154.43) mGy/cm, and there were statistical differences (P<0.05). Conclusion For high BMI patients, different low-dose dual-source CT scanning, especially prospective electrocardiography gated scanning, can guarantee image quality and reduce the radiation dose and the radiation damage at the same time.

Value of spectral CT imaging for improving beam-hardening artifact of myocardium / 中华放射学杂志

Objective To evaluate beam-hardening (BH) artifact reduction of myocardium in coronary computed tomography angiography(CCTA)with single-source dual-energy CT. Methods Thirty patients received CCTA on single-source dual-energy CT with findings of coronary artery stenosis reconstructed into monochromatic energy (60,70,80,90,100,110,120,130,140 keV) left vertical short-axis images via 40% ASIR and the polychromatic left vertical short-axis images were conventionally reconstructed. CT values were measured across multiple segments (basal anterior, basal lateral, basal inferior , basal septal, mid anterior, mid lateral, mid inferior , mid septal, apical anterior, apical lateral, apical inferior , apical septal and apex)of left ventricle wall at varying monochromatic energy levels and polychromatic images, and then the left ventricular myocardial average CT value and BH objective value were calculated retrospectively:BH1=CT value of mid inferior wall-CT value of basal inferior wall ,BH2=CT value of mid septal wall-CT value of mid inferior wall. BH subjective rating were evaluated by two radiologists independently. Single sample t test was used to compare the difference of myocardial CT values among 13 segments with the left ventricular myocardial average CT value on polychromatic images ;Kruskal-Wallis test was used to compare the difference of CT values among thirteen different segments of myocardium on fixed monochromatic energy images; Wilcoxon rank test was used to compare the difference of BH objective value and subjective rating between monochromatic images with polychromatic images. Results On polychromatic images, the mean myocardial CT value was(73 ± 25)HU, the CT value of basic inferior[(58±23)HU], basic septal[(85±21)HU], mid septal[(89±24)HU], apical anterior[(64±23)HU]and apex [(61 ± 24)HU ] were different from the mean myocardial CT value(t value were -3.76,2.89,3.50,-2.30, -2.86,P all0.05). The differences of CT value of different myocardial segments had statistical significance at 60 to 80 keV images(P all0.05), suggesting that the non-uniformity of CT value among different segments was improved. On polychromatic images,BH1 M(P25,P75)was 11(6,28),BH2 M(P25,P75)was 19(1,29) HU. BH1 was improved on 90 to 140 keV images while BH2 was improved on 70 to 140 keV images, the difference had statistical significance compared with the polychromatic images(P all<0.05). BH1,BH2 decreased with the increasing of monochromatic energy level on 60 to 100 keV images, then increased a little on 110,120 keV images, and hit bottom on 130 keV images with the value of 5.20,0.34 HU ,finally exist a slight increase on 140 keV images again. On polychromatic images,BH1,BH2 subjective rating M(P25,P75)both were 1(1,2), BH1 subjective rating was improved on 70 to 140 keV images while BH2 subjective rating was improved on 90 to 140 keV , the difference had statistical significance compared with the polychromatic images(P all<0.05). Conclusion Compared with the polychromatic images,monochromatic energy images of CCTA with dual-energy CT resulted in significant BH artifact reduction and improvements in the uniformity in the myocardium, and 130 keV is the optimal Monochromatic energy.

Determination of specnuezhenide in Yishen Pills by high-performance liquid chromatography / 医学研究生学报

Objective Former standards for Yishen Pills only identify angelica root , astragalus root and ligustrum lucidum by thin layer chromatography ( TLC) and there is no test for the content of effective components .The study was to improve the quality of Yishen Pills by perfecting the quality standards . Methods We determined the content of specnuezhenide in Yishen Pills by high-per-formance liquid chromatography(HPLC), with a mobile phase of MeOH-Water, a chromatography column of Agilent TC-C18(2) (4.6 × 250 mm, 5μm), a flow rate of 1.0 mL/min, a column temperature of 25℃, a detection wavelength of 224 nm, and a sample loop volume of 10μL. Results The linear relationship of specnuezhenide content was good in the range of 15.375μg/mL~246.000μg/mL.The relative standard deviation of precision experiment , stablity experiment and repeatablity experiment was 0.44%, 0.95%and 2.65%re-spectively.The average recovery was 99.60%.The qualified standard for specnuezhenide in Yishen Pills was ≥0.3 mg/g. Conclusion The method is simple , accurate and reliable , with good reproducibility , and it is applicable for the quality control of Yishen Pills .