GPT-agents based on medical guidelines can improve the responsiveness and explainability of outcomes for traumatic brain injury rehabilitation.

This study explored the application of generative pre-trained transformer (GPT) agents based on medical guidelines using large language model (LLM) technology for traumatic brain injury (TBI) rehabilitation-related questions. To assess the effectiveness of multiple agents (GPT-agents) created using GPT-4, a comparison was conducted using direct GPT-4 as the control group (GPT-4). The GPT-agents comprised multiple agents with distinct functions, including "Medical Guideline Classification", "Question Retrieval", "Matching Evaluation", "Intelligent Question Answering (QA)", and "Results Evaluation and Source Citation". Brain rehabilitation questions were selected from the doctor-patient Q&A database for assessment. The primary endpoint was a better answer. The secondary endpoints were accuracy, completeness, explainability, and empathy. Thirty questions were answered; overall GPT-agents took substantially longer and more words to respond than GPT-4 (time: 54.05 vs. 9.66 s, words: 371 vs. 57). However, GPT-agents provided superior answers in more cases compared to GPT-4 (66.7 vs. 33.3%). GPT-Agents surpassed GPT-4 in accuracy evaluation (3.8 ± 1.02 vs. 3.2 ± 0.96, p = 0.0234). No difference in incomplete answers was found (2 ± 0.87 vs. 1.7 ± 0.79, p = 0.213). However, in terms of explainability (2.79 ± 0.45 vs. 07 ± 0.52, p < 0.001) and empathy (2.63 ± 0.57 vs. 1.08 ± 0.51, p < 0.001) evaluation, the GPT-agents performed notably better. Based on medical guidelines, GPT-agents enhanced the accuracy and empathy of responses to TBI rehabilitation questions. This study provides guideline references and demonstrates improved clinical explainability. However, further validation through multicenter trials in a clinical setting is necessary. This study offers practical insights and establishes groundwork for the potential theoretical integration of LLM-agents medicine.

A novel non-segmented inverted water outline rendering method can improve the tracking of responsible blood vessels for hemifacial spasm.

This study aimed to explore a novel, non-segmented based on inverted water outline, and rapid 3D rendering method for identifying the responsible blood vessels for hemifacial spasm. First, the software was developed using the free and open-source 3D Slicer to process magnetic resonance images. Outlines of the water region were extracted and rendered in a three-dimensional space. The traditional image re-slicing technique (IMRT) was used for the control group, while non-segmented inverted water outline rendering (NSIWR) was used to observe the relevant blood vessels in the root entry/exit zone (REZ) of patients with hemifacial spasm. The intraoperative exploration results were considered the gold standard for comparing the differences in identifying relevant blood vessels between the two methods. Twenty-five patients were included, and the reconstruction effect evaluation suggested that NSIWR could effectively reconstruct the responsible blood vessels of the cochlea, facial nerve, and REZ. Compared with IMRT, NSIWR effectively improved the diagnosis of the responsible blood vessels in the REZ, clarified their sources and directions, and was consistent with intraoperative results. This study introduced a novel rapid rendering method based on NSIWR, which was successfully applied for hemifacial spasm. The method enhances accuracy in identifying responsible blood vessels in the REZ without needing multi-modal techniques. It has the potential to improve surgical effectiveness and reduce exploration time in treating hemifacial spasm.

Magnetic resonance imaging in guiding choice of treatment pathway in patients with cholecystolithiasis and diffuse inflammatory thickening of gallbladder wall / 中华肝胆外科杂志

Objective@#To investigate the use of conventional MR imaging to guide treatment in patients with cholecystolithiasis and diffuse inflammatory thickening of gallbladder wall.@*Methods@#The clinical data of patients who were treated in the Ningbo Huamei Hospital, University of the Chinese Academy of Sciences between January 2017 and January 2018 were analyzed. These patients were divided into two groups: patients with acute cholecystitis (n=139) and patients with viral hepatitis combined with cholecystolithiasis (n=67). Differences in the imaging signs in standardized upper abdominal contrast enhanced MRI examinations were retrospectively analyzed.@*Results@#The imaging signs, including stone location, continuity of gallbladder mucosa, exudation in peri-gallbladder space, edema of intrahepatic portal area showed significant differences between the two groups (all P<0.05). On stratification analysis, the type of thickened gallbladder wall, background of liver parenchyma and extent of edema in intrahepatic catchment area also showed significant differences (all P<0.05). The imaging signs, including non-gallbladder neck ductal stones, concentric thickening of gallbladder wall, continuous mucous membrane in gallbladder and no peri-gallbladder space exudation but diffuse edema of intrahepatic catchment area supported the diagnosis of viral hepatitis combined with gallstones. The imaging signs, including discontinuity of gallbladder mucosa, exudation of peri-gallbladder space, diffuse edema of gallbladder wall without a cirrhotic background and edema in intrahepatic portal area supported the diagnosis of acute calculous cholecystitis of gallbladder.@*Conclusions@#Routine upper abdominal contrast enhanced MRI plays an important role in demonstrating the underlying cause of gallbladder wall diffuse edema thickening in patients with gallstones. It provides an important reference for the choice of clinical treatment pathway.

Magnetic resonance imaging in guiding choice of treatment pathway in patients with cholecystolithia-sis and diffuse inflammatory thickening of gallbladder wall / 中华肝胆外科杂志

0bjective To investigate the use of conventional MR imaging to guide treatment in patients with cholecystolithiasis and diffuse inflammatory thickening of gallbladder wall.Methods The clinical data of patients who were treated in the Ningbo Huamei Hospital.University of the Chinese Academy of Sciences between January 2017 and January 2018 were analyzed.These patients were divided into two groups:patients with acute cholecystitis(n=139)and patients with viral hepatitis combined with cholecys-tolithiasis(n=67).Differences in the imaging signs in standardized upper abdominal contrast enhanced MRI examinations were retrospectively analyzed.Results The imaging signs,including stone location,continuity of gallbladder mucosa,exudation in peri-gallbladder space,edema of intrahepatic portal area showed significant differences between the two groups(all P＜0.05).On stratification analysis,the type of thickened gallbladder wall.background of liver parenchyma and extent of edema in intrahepatic catchment area also showed significant differences(all P＜0.05).The imaging signs,including non-gallbladder neck ductal stones,concentric thickening of gallbladder wall,continuous mucous membrane in gallbladder and no peri-gallbladder space exudation but diffuse edema of intrahepatic catchment area supposed the diagnosis of viral hepatitis combined with gallstones.The imaging signs.including discontinuity of gallbladder mucosa.exudation of peri-gallbladder space,diffuse edema of gallbladder wall without a cirrhotic background and edema in intrahepatic portal area supposed the diagnosis of acute calculous cholecystitis of gallbladder.Conclusions Routine upper abdominal contrast enhanced MRI plays an important role in demonstrating the underlying cause of gallbladder wall diffuse edema thickening in patients with gallstones.It provides an important reference for the choice of clinical treatment pathway.

Multislice computed tomography performance in differential diagnosis of high-density thymic cyst and thymoma in lesions less than 3 cm.

BACKGROUND: This study was conducted to evaluate the performance of multislice computed tomography (MSCT) to diagnose high-density thymic cysts and thymomas in lesions measuring < 3 cm. METHODS: The records of 42 patients admitted to Ningbo No. 2 Hospital with an anterior mediastinal mass (diameter < 3 cm) suspected of carcinoma originating from the thymus were retrospectively analyzed. All patients underwent surgery and pathological examination. Twenty-eight were diagnosed with thymic cysts and 14 with thymoma. The features of thymic cysts and thymomas revealed on MSCT were compared. RESULTS: Mediastinal masses with a triangular or teardrop shape and a straight mediastina-lung border were more likely to be diagnosed as thymic cysts (P < 0.05), while those with a bulging nodule-lung border were more likely thymomas (P < 0.05). Using the CT value as a reference for differential diagnosis, the diagnostic sensitivity, specificity, and area under the receiver operating characteristic curve for CT values of non-contrast CT images, enhanced CT values, and ΔCT values were 0.65 (0.47-0.84), 0.95(0.86-1.00), and 0.96 (0.89-1.00), respectively. CONCLUSION: MSCT of high-density thymus gland nodules (maximum diameter ≤ 3 cm) can reveal specific features that could be helpful for differential diagnosis.

Effects of aloe- emodin on autophagy,apoptosis and migration of colorectal carcinoma LOVO cells / 中国医师进修杂志

Objective To investigate the effect of aloe-emodin on Akt/mTOR,apoptosis and migration of autophagy-related pathway in colorectal cancer LOVO cells. Methods The LOVO cells were divided into control group(normal culture),low dose group(LOVO cells+10 μmol/L aloe-emodin culture 30 min), medium dose group (LOVO cells + 30 μmol/L aloe-emodin culture 30 min) and high dose group (LOVO cells + 50 μmol/L aloe veratin culture 30 min). The cell proliferation rate was measured by CCk-8 method at 24,48 and 72 h respectively. The apoptotic rate of each group was detected by flow cytometry. The migration ability of each group was detected by Transwell chamber. Western blot was used to detect the expression of IC3-Ⅰ,IC3-Ⅱ,Beclin-1,mTOR,p-mTOR,Akt and p-Akt.Results Compared with that of the control group,the cell rate,migration ability and apoptosis rate of the low dose group was not significantly changed(P>0.05).The cell rate and migration ability of the medium and high dose groups was significantly decreased and the apoptosis rate was significantly increased:0.43 ± 0.03,0.59 ± 0.04 vs.0.16 ± 0.00;0.57 ± 0.07,1.06 ± 0.17 vs.0.34 ± 0.02;0.37 ± 0.02, 0.49 ± 0.01 vs.0.13 ± 0.00,P<0.05,there was dose dependent(P<0.05).Compared with those of the control group,the expressions of IC3-Ⅰ,IC3-Ⅱ,Beclin-1,mTOR,p-mTOR,Akt and p-Akt in the low dose group showed no significant change(P>0.05),those were decreased in middle and high dose groups which showed significant differences:0.85 ± 0.08,0.37 ± 0.02 vs.2.08 ± 0.07;1.42 ± 0.09,1.19 ± 0.02 vs.1.97 ± 0.11;0.97 ± 0.00,0.84 ± 0.06 vs.1.19 ± 0.02;0.43 ± 0.02,0.31 ± 0.01 vs.0.98 ± 0.08,P<0.05, there were dose dependent (P < 0.05). Conclusions Aloe-emodin can promote autophagy, apoptosis there inhibit the growth,migration of colorectal cancer LOVO cells by reducing the expression of Akt/mTOR signaling pathway and reducing its phosphorylation level.

CT and MRI features of splenic inflammatory myofibroblastoma / 中华普通外科杂志

Objective To analyze the CT and MRI features of splenic inflammatory myofibroblastoma (SIMF).Methods The CT and MRI images of 6 patients with SIMF were retrospectively analyzed.Results 5 cases underwent CT examination;2 cases did MRI.Six cases of SIMF were all single lesions;the average diameter was (3.9 ± 0.9) cm;the lesions were round or gourdshaped;most have clear boundaries with uneven scan density.On the MRI,the parenchymal part was slightly low signal on T1WI,inhomogeneous hypointensity on T2WI,or high signal on T2WI.After CT or MRI enhancement,lesions were progressively enhanced.Correct preoperative diagnosis was established in only 1 patient.Conclusion In this study,all SIMF cases present as single lesion.The circular appearance and clear boundaries are in common.Asymptotic intensification with map-unenhanced regions is the main enhancement feature.

Diffusion-Weighted MRI for the Initial Viability Evaluation of Parasites in Hepatic Alveolar Echinococcosis: Comparison with Positron Emission Tomography

OBJECTIVE: More than 70% of hepatic alveolar echinococcosis (HAE) are inoperable. Thus, long-term, or even life-long, pharmacological treatment with benzimidazoles is necessary. For effective treatment, it is of great importance to employ imaging techniques to detect and monitor the non-resectable parasitic viability. Therefore, this study aimed to evaluate diffusion-weighted imaging (DWI) in assessing the viability of HAE in comparison to 18-fluoro-deoxyglucose (18F-FDG) positron emission tomography, combined with computed tomography (PET/CT). MATERIALS AND METHODS: Positron emission tomography, computed tomography and DWI (b-values: 0, 800 s/mm2) were retrospectively analysed in eight patients with clinically-verified HAE to, generate the apparent diffusion coefficient (ADC) map. The activity of HAE lesions in both techniques were determined independently by two radiologists according to the following standard: (+), marked focally or perilesionally increased FDG uptake/high signal intensity; (−), a hepatic defect without FDG uptake/no high signal intensity. Every lesion's maximum standardized uptake value (SUV(max)) on the PET/CT images and mean ADC values on the parametric ADC maps were measured respectively. Results of PET/CT and DWI were compared on a per-lesion-basis. Pearson's correlation coefficient was assessed for statistical analysis. RESULTS: A total of 14 HAE lesions were detected. Eight lesions (diameter 3–15 cm) showed perilesional hyper-signal intensity on DWI. This was visualised on PET/CT as increased FDG uptake. They mainly existed in the lesion's border with normal liver parenchyma. Five lesions (diameter < 2 cm) were detected as nodular hyperintensity on DWI and a ‘hot spot’ on PET/CT in the same distribution. One patient, who had received oral drug therapy for three years showed significantly decreased perilesional hyperintensity on the DWI and a hepatic defect without any FDG uptake on PET/CT. Pearson's correlation coefficient indicated a significant inverse correlation of the ADC and the SUV(max) (r = −0.67, p < 0.001). CONCLUSION: Diffusion-weighted imaging is capable of offering information on visually detecting the HAE lesions' viability and may be useful for routine application in the initial diagnosis of HAE.

Nodular muscular sarcoidosis: MRI manifestation and pathological features / 中华内分泌外科杂志

Objective To analyze the MR imaging performances and pathological characteristics of nodular muscular sarcoidosis,and to improve the diagnostic accuracy.Methods Six cases with pathologically confirmed nodular muscular sarcoidosis were included,the MRI imaging findings and pathologic appearance were analyzed,and the literature was reviewed.Results Six patients underwent plain and enhanced MRI examination with 3 cases of unilateral gastrocnemius muscle single lesion,1 case of unilateral anterior medial thigh muscle lesions,and 2 cases of bilateral gastrocnemius muscle lesions.MRI plain scan showed a strip-shaped or fusiform with slightly short TI-long T2 signal along the muscle fibers,and the occupancy effect was not obvious."Dark star" sign showed in lesion center with axial T2WI and enhanced T1WI,and "three stripes" sign could be seen along the long axis view image lesions.The lesion obviously enhanced after enhancement,with mild enhancement center.Similar small nodular satellite lesions were seen around 5 large lesions,and 4 cases showed similar small nodule enhancement in distant muscle groups.Pathological manifestations:granulomatous inflammation of muscle fibers,intermuscular epithelial cells,and multinucleated tissue cells with or without lymphocytic infiltration;no cheese-like necrosis in the nodules,visible fusion of nodules.Conclusion On MRI,it is characterized by strips or fusiform lesions along the muscle fibers,visible "three-layer stripe sign" and "black star sign",and the characteristics of the enhanced muscle nodules in the surrounding muscle groups,which contributes to the diagnosis and differential diagnosis of muscular sarcoidosis.

The distribution of LAP+CD4+ T cells in gastric carcinoma microenvironment and its clinical significance / 中国医师进修杂志

Objective To investigate the distribution of LAP+CD4+T cells in gastric carcinoma microenvironment and the correlation of LAP + CD4 + T cells with the progression of gastric tumor. Methods Forty gastric tumor patients and 20 healthy donors were enrolled in this study. The percentage of LAP+CD4+T cells in the peripheral blood and tumor tissue was detected by flow cytometry. The correlation of LAP+CD4+T cells with the progression of gastric tumor was analyzed. Results The percentage of LAP+CD4+T cells in the peripheral blood of gastric tumor patients was higher than that of health donors:(10.9±3.3)%vs. (4.3 ± 1.2)%;the percentage of LAP+CD4+T cells from tumor tissue was higher than that from non-tumor tissue:(13.5 ± 5.3)%vs. (4.7 ± 1.4)%. The percentage of LAP+CD4+T cells in peripheral blood from metastasis patients was higher than that from non-metastasis patients and health donors: (10.1 ± 6.4)% vs. (4.5 ± 1.3)% and (4.3 ± 1.2)%. Conclusions LAP+ CD4+ T cells accumulates in gastric carcinoma microenvironment and the percentage of LAP+CD4+T cells increases along with the progression of gastric tumor.

The value of MSCT in differentiating low-or high-risk thymomas and thymic carcinomas with maximum diameter equal or less than 3 cm / 实用放射学杂志

Objective To evaluate the diagnostic value of MSCT in the differentiation of thymic epithelial tumours (TET)with the maximum diameter equal or less than 3 cm.Methods A retrospective analysis of pathological and imaging data of 56 patients with pathologically confirmed TET with the maximum diameter equal or less than 3 cm was performed.According to the 2004 WHO classification,56 TETs were classified as low-risk thymomas(types A/AB/B1),high-risk thymomas (types B2/B3)and thymic carcinomas (type C).The CT manifestations of TET in each group,including shape of tumor,tumor edge (smooth or spiculate protuberance), presence of small nodule around tumor,enhancement degree,pleura invasion and fat space around tumor,were analyzed retrospectively.The differences in the CT manifestations among three types were compared using chi-square test.If the sample number was too small, Fisher 's exact test was used.Results Compared with high-risk thymomas (23 cases)and thymic carcinomas (6 cases),regular round shape was more often observed in low-risk thymomas (27 cases)(χ2 =73,P <0.001;χ2 =116,P <0.001)and the mediastinum-lung interface was more likely to bulge (χ2 = 3.41,P =0.046;χ2 =7.39,P =0.01).Blurred edge,spiculate protuberance and pleural invasion and so on were significantly more common in high-risk thymomas and thymic carcinomas (P <0.001)and they were the most common in thymic carcinomas (χ2 =11.5,P =0.009).There was a significant difference between type B2 thymomas and thymic carcinomas (χ2 =31.52, P <0.001),however there was no significant difference between type B3 thymomas and thymic carcinomas (χ2 =6.96,P =0.07). Conclusion MSCT can accurately show the shape of tumor,tumor edge,presence of small nodule around tumor,enhancement degree,pleura invasion,which can predict the histologic type of thymomas and also can provide information for preoperative diagnosis and prognosis evaluation.

The distribution of LAP+CD4+ T cells in gastric carcinoma microenvironment and its clinical significance / 中国医师进修杂志

Objective To investigate the distribution of LAP+CD4+T cells in gastric carcinoma microenvironment and the correlation of LAP + CD4 + T cells with the progression of gastric tumor. Methods Forty gastric tumor patients and 20 healthy donors were enrolled in this study. The percentage of LAP+CD4+T cells in the peripheral blood and tumor tissue was detected by flow cytometry. The correlation of LAP+CD4+T cells with the progression of gastric tumor was analyzed. Results The percentage of LAP+CD4+T cells in the peripheral blood of gastric tumor patients was higher than that of health donors:(10.9±3.3)%vs. (4.3 ± 1.2)%;the percentage of LAP+CD4+T cells from tumor tissue was higher than that from non-tumor tissue:(13.5 ± 5.3)%vs. (4.7 ± 1.4)%. The percentage of LAP+CD4+T cells in peripheral blood from metastasis patients was higher than that from non-metastasis patients and health donors: (10.1 ± 6.4)% vs. (4.5 ± 1.3)% and (4.3 ± 1.2)%. Conclusions LAP+ CD4+ T cells accumulates in gastric carcinoma microenvironment and the percentage of LAP+CD4+T cells increases along with the progression of gastric tumor.

The value of MSCT in differentiating low-or high-risk thymomas and thymic carcinomas with maximum diameter equal or less than 3 cm / 实用放射学杂志

Objective To evaluate the diagnostic value of MSCT in the differentiation of thymic epithelial tumours (TET)with the maximum diameter equal or less than 3 cm.Methods A retrospective analysis of pathological and imaging data of 56 patients with pathologically confirmed TET with the maximum diameter equal or less than 3 cm was performed.According to the 2004 WHO classification,56 TETs were classified as low-risk thymomas(types A/AB/B1),high-risk thymomas (types B2/B3)and thymic carcinomas (type C).The CT manifestations of TET in each group,including shape of tumor,tumor edge (smooth or spiculate protuberance), presence of small nodule around tumor,enhancement degree,pleura invasion and fat space around tumor,were analyzed retrospectively.The differences in the CT manifestations among three types were compared using chi-square test.If the sample number was too small, Fisher 's exact test was used.Results Compared with high-risk thymomas (23 cases)and thymic carcinomas (6 cases),regular round shape was more often observed in low-risk thymomas (27 cases)(χ2 =73,P <0.001;χ2 =116,P <0.001)and the mediastinum-lung interface was more likely to bulge (χ2 = 3.41,P =0.046;χ2 =7.39,P =0.01).Blurred edge,spiculate protuberance and pleural invasion and so on were significantly more common in high-risk thymomas and thymic carcinomas (P <0.001)and they were the most common in thymic carcinomas (χ2 =11.5,P =0.009).There was a significant difference between type B2 thymomas and thymic carcinomas (χ2 =31.52, P <0.001),however there was no significant difference between type B3 thymomas and thymic carcinomas (χ2 =6.96,P =0.07). Conclusion MSCT can accurately show the shape of tumor,tumor edge,presence of small nodule around tumor,enhancement degree,pleura invasion,which can predict the histologic type of thymomas and also can provide information for preoperative diagnosis and prognosis evaluation.

A survey of mental health literacy of community medical staffs in district and town of Zhongshan / 中国基层医药

Objective To investigate mental health literacy (MHL) of community medical staffs in district and town of Zhongshan city,and to provide data to improve MHL of community medical staffs.Methods Totally 352 medical staffs who were not psychiatric physician and 81 psychiatric physician were selected.The Chinese Mental Health Knowledge Awareness Questionnaire (published by Ministry of Health) was used to investigate the awareness rate of mental health knowledge.Five vignettes of two schizophrenia,one bipolar disorder,one depression and one obsessive compulsive disorder,each with 8 related questions,were used to investigate the recognition and response ability.Results The average awareness rate of the two groups was more than 80.0% (87.6%,91.6%).For the item 2(75.6%,88.6%),6(74.1%,62.6%),19(36.5%,65.6%),and 20(74.1%,86.2%),the awareness rates were lower than 80.0%,and there were significant differences between the two groups (x2=8.45,4.92,27.48,6.99,all P<0.05).In vignettes survey,the correct rate was lower in the staffs who did not engaged in the mental health work than those in the other group,the difference was statistically significant(64.6% vs.75.9%,P<0.001).For both of the two groups the correct rate of depression was the lowest(x2=44.46,P<0.001).There was statistically significant difference between the total (x2=141.17,P<0.001).Conclusion The awareness rate of mental health knowledge has reached the national standards for community medical staffs,but they have to improve for some knowledge point.Their recognition and response ability for mental illness should be improved.

Association of parameters in dynamic contrast-enhanced MRI using reference region model with prognostic factors and molecular subtypes of breast cancer / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To investigate the association of parameters in dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) using reference region model with prognostic factors and molecular subtypes of breast cancer.</p><p><b>METHODS</b>MRI and pathological data of 50 patients with pathologically confirmed invasive ductal carcinoma of the breast were retrospectively analyzed. Reference region model was applied to analyze pharmacokinetic quantitative parameters including volume transfer constant (RR K), rate constant (K) and the ratio of Kto extracellular space volume (K/V). The associations of the above parameters with prognostic factors and molecular subtypes of breast cancer were analyzed.</p><p><b>RESULTS</b>RR Kand Kwere significantly higher in patients of histological grade 3 compared with those of histological grade 1 & 2 (all<0.05); and the patients with estrogen receptor (ER)-negative and/or progesterone receptor (PR)-negative also had higher RR Kand Kthan those with ER-positive or PR-positive (all<0.05). For immunohistochemistry, RR Kand Kwere significantly higher in triple negative breast cancer compared with luminal type breast cancer (all<0.05).</p><p><b>CONCLUSIONS</b>High RR Kand Kare associated with poor prognosis of breast cancer, and which can also be used to distinguish molecular subtypes of breast cancer.</p>

Application of low-tube-voltage combined with adaptive iterative reconstruction in lower extremity computed tomography angiography / 中华放射医学与防护杂志

Objective To investigate the feasibility of low-tube-voltage in combination with the three-dimensional adaptive iterative dose reduction (AIDR-3D) algorithm in performing lower extremity computed tomography angiography (CTA).Methods A total of 60 patients suspicious of lower extremity arterial occlusion were randomized into control group (120 kV,a =30) and experimental group (100 kV,n =30).The CTA was undertaken with a 320-row scanner (Toshiba Aquilion ONE),and the images was reconstructed with filtered back projection (FBP) algorithm in control group and FBP as well as the AIDR-3D algorithm in experimental group.The subjective image quality,vascular density (VD),noise,signal-to-noise ratio (SNR),contrast-to-noise ratio (CNR),and dose length product (DLP) were compared between two groups.Results The DLP was significantly lower in experimental group than that in control group [(503.5± 104.7) vs.(1 099.4 ± 151.7) mGy·cm,t =15.7,P ＜0.05].The images in experimental group with 100 kV and FBP protocol had significantly increased VD and noise (t =-3.13,-3.61,P ＜ 0.05) than that in the control.The images in experimental group with AIDR-3D had significantly lower noise and higher SNR and CNR than that with FBP (t =13.59,2.14,P ＜ 0.05),also significantly lower noise and significantly higher VD,SNR,and CNR than that in the control (t =-3.75,-4.19,-4.15,P ＜ 0.05).Conclusions Low-tube-voltage (100 kV) combined with AIDR-3D reconstruction could significantly improve the image quality and reduce radiation dose in lower extremity CTA with a 320-row CT scanner.Trial registration Chinese clinical trial registry,ChiCTR-DPD-16008054.

The diagnosis of insufficient blood supply in vertebral basilar artery by combined transcranial Doppler ultrasound and CT in elderly patients / 中华老年医学杂志

Objective To investigate the diagnostic value of the combined transeranial Doppler ultrasound and CT for vertebrobasilar insufficiency in elderly patients.Methods Fifty elderly patients with symptoms of vertebrobasilar insufficiency were enrolled and randomly assigned to 4 groups,including examinations of TCD,CTA,DSA,combination of TCD and CTA.The diagnostic accuracy was calculated and compared.Results Among 50 cases,the vertebrobasilar insufficiency was confirmed in 42 patients (84％) by TCD,45 (90％) by CTA,48 (96％) by DSA,49(98％) by combination of TCD and CTA.There was no significant difference in diagnostic rate between TCD combined with CTA and DSA (x2 =0.34,P＞0.05).Conclusions The diagnosis accuracy of the combined CTA and TCD is high,making it worth popularizing.

The epidemiology survey analysis of adult respiratory allergic disease / 中国基层医药

Objective To explore the epidemiological characteristics of adult allergic diseases,looking for risk factors of allergic airway disease in Shiqi District of Zhangshan,and to provide a scientific basis for the development of community health education.Methods The questionnaire which was designed by national respiratory allergic diseases research and epidemiological survey collaboration group was carried out,and the random cluster sampling method was used to extract a total of 2 000 adults from Shiqi District of Zhongshan City,and the questionnaires,physi calexamination,and laboratory tests were taken.Results In Shiqi District of Zhongshan,the incidence rate of adult respiratory allergic disease was 10.4％,including allergic rhinitis,allergic pharyngitis and allergic asthma,accounted for 54.33％,33.65％ and 12.02％.Most common cause is smoking and keeping pets.Among respiratory allergic disease population,smoking accounted for 28％ and keep pets accounted for 17.8％.Common allergens are mites,cockroaches,animal fur and flowers.Leather pilot assassination test positive rate of respiratory allergic disease population was 37.50％,including mites,cockroach accounted for 23.08％,7.21％ of animal fur,flowers accounted for 6.25％.Conclusion In Shiqi District of Zhongshan,adult respiratory allergic disease prevalence is same as the country,the majority is respiratory diseases.The most common cause is smoking and keeping pets.The most common allergens are mites,cockroaches,animal fur and flowers.The incidence maybe related to life behavior and the living environment.

Gemcitabine arterial infusion chemotherapy versus intravenous chemotherapy for patients with advanced pancreatic cancer: a comparative study / 中华胰腺病杂志

Objective To compare the clinical efficacy of gemcitabine arterial infusion chemotherapy with intravenous chemotherapy in the management of patients with advanced pancreatic cancer and to evaluate the efficacy and safety of gemcitabine arterial infusion chemotherapy. Methods 43 patients with advanced pancreatic cancer were included in this study, of whom 21 patients received arterial infusion chemotherapy (Group A) and the other 22 were treated by intravenous chemotherapy (Group B), gemcitabine combined with 5-FU chemotherapy was administrated in both groups. The main outcomes were clinical benefit response (CBR), tumor response rate and toxicity. Results Compared with Group B, there was a significant improvement of CBR in group A (81% vs 50%, P =0.033) ; there was also significant improvement of pain control in group A (76.2% vs 45.5%, P =0.039). There was no significant difference in the tumor response rate between two groups (33.3% vs 22.7%, P =0.498). No significant increase of side effects was observed in both groups. Conclusions In the management of advanced pancreatic cancer, the arterial infusion method may be more favorable than intravenous approach in improving clinical benefits with mild toxicity and well tolerability.

Prevalence and clinical features of pain in patients with pancreatic cancer / 中华胰腺病杂志

Objective To investigate the prevalence and the clinical features of pancreatic cancer pain in a Chinese patient population.Methods The study was carried out in 415 cages of pancreatic cancer which were admitted to the First Municipal people's Hospital of Guangzhou Medical college and the Second Affiliated Hospital of Sun Yat-sen University from 1999 to 2007.The prevalence,clinical features of pancreatic cancer pain and its correlations with the cancer site and the clinical staging were analyzed.Results Of the 415 patients.the prevalence of pain wag 65.1%and 60.5%of all the patients presented pain as the initial symptom;the incidence of pain in pancreatic body/tail cancer patients was 80.7%.while it was 71.4%in total pancreatic cancer patients.and the incidence was 58.2%in pancreatic head cancer patients;the incidence between pancreatic body/tail cancer and pancreatic head cancer patients was statistically different (P＜0.05).The incidence of pain in patients with stage Ⅰ,Ⅱ,Ⅲ,and Ⅳ was 28.6%,58.1%,66.2%and 78.6%.and the difference was statistically significant(P＜0.01).The incidence of moderate to severe degree of pain in patients with stage Ⅰ,Ⅱ,Ⅲ,and Ⅳ was 18.8%,44.4%,53.1%and 68.2%,and the differenee was statistically significant(P＜0.01).Conclusions Pain was very common in patients with advanced pancreatic cancer.The incidence and severity of pain increased with the progression of pancreatic cancer.