Objective To explore the feasibility of low-dose multi-slice computed tomography(MSCT) scan on pulmonary artery three-dimensional angiography, and the relationship between pulmonary VR image quality and the SD value of plain scan. Methods Pulmonary artery CT examination was performed in 87 patients. 63 volunteers were administered with low dose as a low-dose group, and the other 24 were scanned with conventional dose as a routine group. Both plain scans were use conventional dose of pulmonary scan with 150 mAs, and the low-dose pulmonary enhanced scans were used with 60 mAs. The images were post-processed with volume rendering(VR) and classified into three grades A, B and C, and VR image quality levels of both groups compared. The receiver operating characteristic curve( ROC) was used to analyze the relationship between VR image quality level and SD value of plain scan image SD value. Results The VR image level of A-class was 100% in the conventional dose group, and 85. 7% was in the low dose group . According to the correlation analysis between the standard deviation(SD) value of plain scan image and pulmonary artery VR image quality, the area under curve in receiver-operated characteristic analysis was 0. 906. Conclusions The low-dose scan of pulmonary artery three-dimensional angiography is feasible. Using 60 mAs low-dose in pulmonary artery enhanced scan could ensure better image quality. With the SD value of the plain scan decreased, the pulmonary artery VR image quality is improved.

Objective To explore the feasibility and reasonable of low-dose scan on abdominal angiography in 64-slice spiral helical CT. Methods Phantom test: at 120 KV and from 200 mAs to 30 mAs at an interval of 10 mAs in each image acquisition, it was measured standard deviation (SD) of CT number, high contrast resolution and low contrast resolution, and then analyzed the relationship between the three parameters and the mAs values. Three mAs values were chosen to undertake clinical analysis.Clinical analysis: 90 randomly selected objects with abdominal angiography were divided into three groups,scanning with above three mAs values.Measurement of the SD value at the plain scan images was performed and the enhanced low-dose scan images were used post-processing with three-dimensional volume reconstruction (VR). The VR images were classified into three grades (excellent, moderate, bad) with the blind evaluation of three CT radiologists. The quality-correlation analysis was used between the standard deviation (SD) values of plain scan image and abdominal angiography VR image. Results According to the quality-correlation analysis between the standard deviation (SD) value of plain scan image and abdominal angiography VR image, the area under curve in receiver-operated characteristic (ROC) analysis was 0.921, 0.906 and 0.893 in each three group, respectively. Conclusions The low-dose scan of abdominal angiography is feasible. 80mAs can ensure better image quality. The enhanced scan probably can use 60mAs when the SD value is less than 5.78 in the plain scan; but when the SD value of plain scan is greater than 11.8, the enhanced scan is used best 100 mAs or higher.

Objective To observe the effects of modified colonic irrigation using a disposable catheter in patients with neurogenic bowel dysfunction.Methods A total of 76 patients with cervicothoracic spinal cord injury admitted to the Third Hospital of Hebei Medical University from January 1st, 2017 to March 31st, 2018 were divided into groups according to the admission ward by convenience sampling method. The patients in ward Ⅱ were assigned as the observation group (n=38), and the patients in wardⅠ were assigned as the control group (n=38). After complaining of abdominal distension, the patients in the observation group were injected with glycerin by inserting 50 ml disposable urethral syringe, and deep enema by inserting about 30 cm. The patients in the control group were given direct enema with glycerin 7 cm to 10 cm deep. The changes of abdominal circumference, abdominal pressure, bowel sounds before enema and after exhaust, and complications of intubation were compared between the two groups.Results The improvement of abdominal distension symptoms such as abdominal circumference, abdominal pressure and bowel sounds after exhaust in the observation group was better than that in the control group, and the difference was statistically significant (P<0.05). There was no significant difference in the incidence of complications of intubation between the two groups (P>0.05).Conclusions Modified-depth colonic irrigation using a disposable catheter is more effective than traditional glycerin enema administration in the treatment of neurogenic bowel dysfunction.

Objective:To explore the effects of respiratory resistance training combined with active cycle of breathing techniques in nursing care for patients with lower cervical spinal cord injury.Methods:From April 2017 to March 2019, we selected 78 patients with lower cervical spinal cord injury in Trauma Emergency Center of the Third Affiliated Hospital of Hebei Medical University as subjects. All patients were divided into observation group and control group with the method of random number table, 39 cases in each group. Control group carried out the respiratory system nursing with the self-developed compound sequential technology on sputum exclusion. On the basis of that in control group, observation group implemented the resistance inspiratory training and expiratory training with the respiratory resistance training combined with active cycle of breathing techniques. We compared the volume of sputum excretion, pulmonary function[forced vital capacity (FVC) , forced expiratory volume in one second (FEV1) , peak expiratory flow (PEF) and maximal expiratory pressure (MEP) ] and incidences of pulmonary complications during hospitalization between two groups.Results:A total of four weeks after training, the volume of sputum excretion of observation group on the fifth day after surgery was lower than that of control group with a statistical difference ( P<0.05) . There were four pulmonary function indexes (FVC、FEV1、PEF、MEP) in observation group better than those in control group with statistical differences ( P<0.05) . The incidence of pulmonary complications of observation group was lower than that of control group with a statistical difference ( P<0.05) . Conclusions:Respiratory resistance training combined with active cycle of breathing techniques can promote the early excretion of sputum of patients with lower cervical spinal cord injury, improve the pulmonary function and reduce the incidence of pulmonary complications.

Objective: To summarize the clinical manifestations and treatment of retinal artery occlusion and cerebral infarction caused by facial injection of hyaluronic acid. Methods: Fifteen cases (15 eyes) with vision lose caused by facial cosmetic injection of hyaluronic acid visited Xi＇an No.4 Hospital from December 2010 to January 2017. The clinical data were collected such as general medical history and treatment methods, and follow-up for 1 year. Results: All patients were female, 22-41 years old, with average age of 33. All patients were injected with hyaluronic acid. For 8 patients the fillers were injected in the forehead, 3 patients were in the glabellar region, 3 patients were in the nasolabial fold, and 1 patient was in the temporal of left eye. All patients had vision lose after injection, the visiting time was 1 to 6 hours. 13 patients were central retinal artery occlusion (CRAO). 1 patient was retinal branch artery occlusion (BRAO), 1 patient was ischemic optic neuropathy (ION), 13 patients manifested as no light perception (NLP), 1 patient was 0.6, 1 patient was CF/30 cm, and 14 patients with cerebral infarction, manifested as headache, dizziness. All patients were given emergency treatment, and 9 patients had treated with interventional thrombolysis therapy. After treatment 11 patients, visual acuity had no significant improvement, but 4 patients improved. Headache, dizziness symptoms disappeared, but cerebral infarction lesions still existed on MRI. Conclusions Human face is a rich blood supply; vision loss and cerebral infarction could occur after injection of hyaluronic acid. After urgent treatment visual acuity is not improved obviously, eventually leading to irreversible visual impairment or even loss.

OBJECTIVE To optimize the water extraction process of Maxing kechuan granules. METHODS With the contents of ephedrine hydrochloride， bergenin， prim-O-glucosylcimifugin， 5-O-methylvisamin， naringin and hesperidin and the rate of extraction as the evaluation indexes， the weight was determined by the analytic hierarchy process（APH）-entropy weight method， and the comprehensive score was calculated as the response value. Based on the single-factor test， the Box-Behnken response surface method was used to investigate the factors， and the best water extraction process of Maxing kechuan granules was optimized； process validation was also carried out. RESULTS The best water extraction process of Maxing kechuan granules optimized was as follows： soaking for 40 minutes， adding 8 times water， and extracting for 180 minutes. After three validation tests， the comprehensive score was 94.82 （RSD＝0.96%， n＝3）， which had a small difference from the predicted value of 94.64. CONCLUSIONS The water extraction process of Maxing kechuan granules is stable and reliable， which can provide a reference for the development of the preparation.