Objective To investigate the influence of different scout image on the radiation dose of head and chest spiral scanning in CT using automatic tube current modulation(ATCM).Methods CT scanning was performed on the head-neck and chest phantom with ATCM.Five different scout images through the five various positions that include anteroposterior(AP),posteroanterior(PA),lateral,AP,lateral,PA and lateral.The phantom was scanned three times for each position.Then each scout image was scanned by spiral technique once more.ROI in orbital center and C5 upper edge level were selected for Head and neck phantom,ROI in the apical and tracheal bifurcation level were selected for chest phantom.The contrast to noise ratio (CNR) was measured and recorded.The organ dose of eye lens and mammary glands were measured by thermoluminescent dosimeters (TLD) in every scanning(the average of 3 measurements),The cumulative value of scout image and spiral scanning were calculated.The volume CT dose index (CTDIvol) of each scan was recorded,and the cumulative value of CTDIvol was calculated.Results In the five scout images of the head-neck phantom mode,the maximum value of accumulated radiation dose of eye lens and CTDIvol appear on PA scout image(18.354 and 26.43 mGy respectively),while the minimum value appear on the lateral scout image(11.847 and 18.20 mGy respectively).In the chest phantom mode,the maximum value of the accumulated radiation dose of the mammary gland and CTDIvol emerge from the AP scout image (6.873 and 9.42 mGy respectively),while the minimum value of the mammary accumulated radiation dose appear on lateral scout image(4.592 mGy),the minimum value of CTDIvol appear on AP plus lateral scout images(3.94 mGy).The accumulated radiation dose of eye lens and CTDIvol value in PA scout image mode were 54.9％(6.507/11.847) and 45.2％(8.23/18.20) higher than those of the lateral scout image mode.The accumulated radiation dose of mammary gland and CTDIvol value in AP scout image mode were 42.5％ (2.051/4.822) and 136.7％ (5.44/3.98) higher than that of PA plus lateral scout images mode.In the head-neck phantom mode,the CNR value of orbital center and C5 upper edge level were 102.55 to 115.89,161.01 to 204.52 respectively.In the chest phantom mode,the CNR value of the apical and tracheal bifurcation level were 82.74 to 164.00,83.12 to 121.49 respectively.Conclusion The choice of the scout image had significant effect on the radiation dose and the sensitive organ dose in CT.

Objective To explore the association of Lipoprotein-associated phospholipase A2(LP-PLA2) and Antithrombin Ⅲ(AT-Ⅲ)level with the severity of coronary artery lesion in patients with coronary disease. Methods 276 patients undergoing coronary angiography were recruited in the Affiliated Hospital of Xuzhou Medical University from March,2016 to March,2017. Patients were sent to one of the two following groups according to their CAG reports:the controlled group(n=111)and the CAD group(n=165). Gensini scores were calculated in CAD group,and divided CAD group into 4 groups by quartiles:group 1(n=41),group 2(n=39),group 3 (n=42)and group 4(n=43). LP-PLA2 and AT-Ⅲwere then compared in different groups and correlation was analyzed in deciding the severity of coronary artery disease. Results (1)LP-PLA2 level in CAD group was signifi-cantly higher than the controlled group(342.9 ± 91.9 vs. 131.8 ± 27.0,P<0.05),but AT-Ⅲlevel was lower than controlled group and(91.0 ± 12.9 vs. 97.8 ± 11.0,P<0.05).(2)Both LP-PLA2 and AT-Ⅲlevel were different in groups stratified by the quartiles of Gensini scores,and the difference is statistically significant.(3)LP-PLA2 was a risk factor while AT-Ⅲwas a protectional factor for coronary artery disease(OR=1.08,95%CI:1.05~1.11,P<0.01;OR=0.95,95%CI:0.93~0.98,P<0.01;respectively )analyzed by Logisitic regression model.(4)Correla-tion analysis showed a positive association of LP-PLA2 level with Gensini scores(r=0.48,P<0.01),and a nega-tive association of AT-Ⅲlevel with Gensini scores(r=-0.24,P<0.01). Conclusion LP-PLA2 level was higher in CAD patients compared to normal patients ,while the relationship of AT-Ⅲ level among the two groups was reversed. Elevated LP-PLA2 level was associated with the increased severity of coronary artery and can provide guidance for clinic.

Objective:To explore the effects of scout scanning parameters (projection angle and tube potential) on image quality and radiation dose in chest CT and to provide guidance for the selection of scanning parameters in clinical practice.Methods:Different parameter combinations were selected to acquire the scout view of the anthropomorphic adult chest phantom. Fifteen scout views were obtained under parameter combinations of the projection angle (0/90/180 degrees), tube potential (70/80/100/120/140 kV) and tube current (25 mA). And then, chest spiral scans were performed according to the scout views. The other parameters were Assist kV, smart mA (maximum range), 80 mm detector width, 0.992∶1 pitch, 0.5 s rotation time, 330 mm scanning length, 5 mm thickness, NI (noise index) 10. The radiation dose modulation index (ASiR-V) was 30%, and the iterative level was 50%. Volume CT dose index (CTDI vol) and tube current at 4 body levels (pulmonary apex, trachea bifurcation, mammary level and diaphragmatic dome) were recorded. The thermoluminescent dosimeters (TLDs) were used to measure the organ dose of the breast glandular. Regions of interest (ROIs)were selected at the trachea bifurcation and diaphragmatic dome to calculate the contrast noise ratio (CNR). Results:The tube potential of the spiral scanning was automatically selected as 80 kV when the projection angle was 0 degree. The changing of the tube potential for the scout had little influence on the tube current at the four body levels, and the variation range was 0-2% (5/230). The tube potential in the spiral scanning was automatically selected as 100 kV when the projection angles were 90 and 180 degrees. The changing of the tube potential for the scout had a great influence on the tube current at the slice of trachea bifurcation and the variation range was from 14%(29/210)to 44%(93/210). According to the angle projection, there were statistical differences in CTDI vol( P< 0.017), organ dose of the breast glandular, and CNR at the slices of trachea bifurcation and at diaphragmatic dome ( F=13.027, 24.727, 10.630, P< 0.05). According to the tube potential in the scout scanning, there were no significant differences in CTDI vol, organ dose of the breast glandular and CNR at both levels ( P> 0.05). Conclusions:In chest CT, the influence of the projection angle in scout scanning on the image quality and radiation dose was more significant than that of the tube potential.

Objective To study the relationship between reactive oxygen species (ROS) as well as total antioxidant capacity ( TAC ) within follicle fluid and body mass index ( BMI ) in patients with polycystic ovary syndrome (PCOS).Methods All patients enrolled in this study were infertile women receiving in vitro fertilization-embryo transfer (IVF-ET) treatment.55 PCOS patients were divided into over-weight group ( n =23 ) and non-over-weight group ( n =32 ).Another 55 age-matched non-PCOS women were also divided into control group ( n =30) and overweight group ( n =25 ).Plasma sex hormone,triglycerides,and total cholesterol were determined.On oocyte retrieval day after ovarian stimulation,ROS and TAC in follicular fluid were assayed.Results Subjects in over-weight and PCOS over-weight groups had higher triglycerides than those in control and PCOS non-over-weight groups [ ( 1.9 ±1.1,1.7 ± 0.9,1.0 ± 0.5,1.2 ± 0.7 ) mmol/L,respectively,all P＜0.05],so did total cholesterol [ ( 4.8 ± 1.2,5.2 ± 1.1,4.0 ± 0.6) mmol/L,respectively,all P＜0.05].In PCOS over-weight group,ROS and ROS/TAC within follicular fluid were ( 35.4 ± 6.7 ) RLU/S and 39.8 ± 22.0,both were higher than those in the other 3 groups ( all P＜0.05).TAC [ (0.8 ± 0.5 ) Mm] was lower in PCOS over-weight group than that among the other 3 groups( all P＜0.05 ).ROS/TAC was higher in PCOS non-over-weight group than that of control group ( 26.5 ± 14.5 vs 14.2 ± 12.5,P＜0.05 ).Univariate analysis showed that both ROS and ROS/TAC within follicular fluid in PCOS patients were positively correlated with BMI ( r =0.34 and r =0.32,both P＜0.05 ).Conclusion Abnormal oxidative stress exists in follicular fluid of PCOS patients,and the oxidative stress parameters show positive correlation with BMI.

Osteoporosis is a progressive metabolic disease. In traditional Chinese medicine (TCM), deficiency of the liver, spleen and kidney and blood stasis can induce osteoporosis. The main etiology was kidney deficiency which harmed the liver and spleen and causeqi-blood deficiency and blood stasis. The insufficiency of natural endowment and postnatal malnutrition caused poor nutrition of tendons and vessels, which induced debility of bone. This article discussed the etiology and pathogenesis of TCM understanding on osteoporosis in details. Opportunities and challenges of TCM in osteoporosis treatment were explored. The homology of Chinese medicine and food as well as the long-term of osteoporosis showed that TCM had incomparable superiority in osteoporosis treatment. While, the scientific research methods and reasonable evaluation of TCM safety were important to display its advantages in osteoporosis treatment.

Objective To explore the effect of nursing of Traditional Chinese Medicine on cognitive function among aged people with mild cognitive impairment in elderly care institution. Methods A total of 66 cases with mild cognitive impairment elderly that previously were screened out from two pension institutions in Taiyuan city as the research objects. According to the endowment institutions where the objects of study dwelled was divided into control group (34 cases) and intervention group (32 cases). The intervention group accepted nursing of Traditional Chinese Medicine plan for four months. The control group received the disease related knowledge health education. The cognitive function of the two groups were assessed using the Montreal Cognitive Scale (MoCA) before and after the intervention. Results Before the intervention, two groups had no statistical significance in each dimension score and total score of MoCA. After the intervention, four dimensions scores including ability of visual spatial and execute , attention , delayed recall , directional force and the total score of the intervention group respectively were (2.67±1.09) points, (4.07±1.08) points, (1.97±0.81) points, (4.83±0.99) points, (18.80±1.74) points while the control group were (2.15 ± 0.71) points, (3.30 ± 0.63) points, (1.39 ± 0.97) points, (4.24 ± 1.41) points, (15.06 ± 2.98) points, and the difference was statistically significant (t=1.91-6.06, P < 0.05 or 0.01) ;Before intervention the language score, delayed recall score and the total score of the intervention group were (1.43±0.77) points, (1.57±1.10) points, (17.27±1.99) points, respectively while after the intervention were (1.80 ± 0.66) points, (1.97 ± 0.81) points, (18.80 ± 1.74) points, there was statistically significant difference (t =-2.16,-2.11,- 4.34, P < 0.05 or 0.01). Conclusions Nursing of Traditional Chinese Medicine can delay the process of cognitive decline of mild cognitive impairment in the elderly, and have a certain effect on prevention and treatment of patients with mild cognitive impairment.

The abuse of opioids in the perioperative period has made the side effects of opioids increasingly prominent. So many anesthesiologists have proposed the concept of opioid-free anesthesia. Immunomodulation is an important field of modern medical research. With the introduction of the concept of enhanced recovery after surgery, the immunomodulatory effects of opioids have received increasing attention. Currently, the fentanyl family is commonly used opioid analgesics in clinical practice. This article reviews the research progress of the fentanyl family and immunomodulation, in order to provide guidance for clinicians to choose analgesic drugs.

Aim To investigate the behavioral changes of the pain related neuromodulation and neurotransmission in peripheral and central nervous systems in rats with trigeminal neuralgia (TN)and provide a disease relevant animal model for mecha-nism study of TN.Methods The male SD rats were randomly divided into sham operation group and TN surgical group.The latter group was further divided into model group and gabapentin group (100 mg · kg-1 ). TN was induced by intravenous erythrosine B injection and laser irradiation.The pain behavior of rats was evaluated using mechanical pain threshold measured with Von Frey hairs.Fluorescence quantitative PCR technique was deployed to study the change of Tac1 mRNA expressions in trigeminal ganglia.Utilizing microdialysis technique followed by high performance liquid chromatography fluorescence detection (HPLC-FLD),the extracellular striatum fluid was collected and glutamate(Glu)concentration was determined.Results In the model group,the average mechanical pain threshold in facial ar-ea innervated by the trigeminal nerve remained below 4g after 7 days post surgery.The mechanical threshold of the model group (1.63 ±1.27)g was significantly lower (P<0.01)than the control group (24.17 ±4.49)g on day10 post surgery.In gen-eral,the mechanical withdraw threshold was decreased from the preoperative value of 26g to the postoperative value of (1.60 ± 1.74)g (P<0.01),and maintained stable at (0.71 ±1.24) g during the whole dynamic monitoring period from day7 to day60.The successful rate of this model was 63%.After sur-gery,Tac1 mRNA expression in trigeminal ganglia and extracel-lular Glu levels in striatum were significantly up-regulated (P<0.05 ) in the model group. Animals receiving Gabapentin showed significant improvement in pain symptoms,as well as re-ductions of Tac1 mRNA expression in trigeminal ganglia and ex-tracellular Glu concentration in striatum (P<0.05 ).Conclu-sions The above described photochemically induced TN rat model can partially mimic the clinical TN symptoms and its pathophysiology.Considering its overall high stability,it is very likely that this model could be used in preclinical mechanism study or drug screening of TN.

Objective To investigate the influence of different scanning centers on the radiation dose of head-neck and chest spiral scanning in CT with automatic tube current modulation (ATCM) and automatic tube voltage modulation (CARE kV).Methods Combined with ATCM and CARE kV techniques,spiral CT scanning was performed on head-neck and chest phantoms.The head-neck phantom was scanned using 5 different scanning centers,with the levels of 4 cm above the eye,the eye,the midpoint of the eye and the outer ear hole,the external ear hole,5 cm below the outer ear hole,respectively,according to different heights of check bed.The chest phantom was scanned using 6 different scanning centers with the levels of 5 cm above breast,4 cm above breast,anterior axillary line,midaxillary line,posterior axillary line,respectively.At each scanning center they were scanned three times of scout and one spiral.ROIs were selected at the slices of orbital center and C5 upper edge level for head-neck phantom,and at the slices of the apical and tracheal bifurcation level for chest phantom.The values of contrast-to-noise ratios (CNRs) were measured and recorded.The organ dose of eye lens and mammary gland were measured with thermoluminescent dosimeters (TLD) for all of scans.The volume CT dose index (CTDIvol) of each scan was recorded.Results With 5 different scanning centers for the head-neck phantom,the maximum eye lens dose appeared at the level of midpoint of the eye and the outer ear hole (8.851 mGy),while the maximum CTDIvol and minimum eye lens dose at the level of 5 cm below the outer ear hole(15.850 mGy and 7.096 mGy).With 6 different scanning centers for the chest phantom,the maximum mammary gland dose emerged from the level of breast(6.467 mGy),while the maximum CTDIvol from the level of the anterior axillary line(4.120 mGy),the minimum gland dose and CTDIvol from the level of the posterior axillary line (4.794 mGy and 3.540 mGy).In the head-neck phantom images,the CNR values at the level of orbital center and C5 upper edge were 87.22 to 108.88,136.13 to 175.57 respectively.In the chest phantom images,the CNR values at the level of the apical and tracheal bifurcation were 75.19 to 116.92,42.85 to 86.78 respectively.Conclusions The selection of CT scanning center has great influence on the radiation dose of CT scanning,especially for radiation sensitive tissues and organs.

Objective To investigate the effect of the change of tube voltage on radiation dose and image quality in head-neck and chest scanning under automatic tube current modulation ( ATCM ) . Methods CT scanning was performed on the head-neck and chest phantom with ATCM and automatic tube voltage(CARE kV). The tube voltage was manually selected at 70, 80, 100, 120 and 140 kV separately, and a routine CT scanning of the head-neck and chest with ATCM was performed. The scout was scanned for 3 times and a spiral scanning was performed once at each of tube voltage. The regions of interest( ROIs) were selected in the slices of orbital center and C5 upper edge level for the head-neck phantom, in the slices of apical and tracheal bifurcation level for the chest phantom. The contrast to noise ratios ( CNRs) were measured and recorded. The organ dose of eye lens and mammary are measured with thermoluminescent dosimeters ( TLDs ) for every scanning ( the average of 3 measurements ) . The cumulative dose value of the scout and spiral scanning was calculated. The volume CT dose index ( CTDIvol ) of each scan was recorded, and the cumulative value of CTDIvol was calculated. Finally, the optimized tube voltage was obtained by calculating the FOM ( figure of merit) . Results With ATCM and CARE kV, 120 kV and 108 mAs were chose automatically by system for head-neck phantom, 80 kV and 167 mAs for chest phantom. With ATCM, the radiation dose of eye lens and CTDIvol were minimal with manually selected 70 kV ( 0.779 and 4.070 mGy respectively ) , and maximaum with manually selected 140 kV (2.571 and 25.670 mGy). The radiation dose of the mammary gland and CTDIvol were minimal with manually selected 70 kV ( 0.698 and 0.900 mGy ) , and maximal with manually selected 140 kV (3.452 and 7.400 mGy). The CNR values of orbital center and C5 upper edge level were 51.30-118.36 and 80.78 - 173.12 respectively. The CNR values of the apical and tracheal bifurcation level were 50.15-129.58 and 49.63-115.40, respectively. The optimal FOM was appeared at orbital center slice with 80 kV, at C5 upper edge level slice with 120 kV and at both the apical and tracheal bifurcation level with 70 kV. Optimum tube voltage for head-neck phantom: manual 100 kV at orbital level, CARE kV mode(120 kV) at neck level. Optimal tube voltage for chest phantom: manual 100 kV. Conclusions The selection of tube voltage is responsible for the radiation dose and image quality of CT scanning. For conventional CT scan, manual 100 kV is suitable for orbital scanning, automatic 120 kV is suitable for neck scanning, manual 100 kV is suitable for chest scanning.