Health education plays an important role in clinical nursing. In practice, nurses perform effective health education policies according to the basic principles of health education based on the professional ethics and morals. Health care administrations should perfect and strengthen further the supervision and check mechanisms, and integrate the plan, operation, and evaluation systems of health education. Educational institutions should enhance the nursing students' humanistic stuff and the ability of health education. Continuing improvement in nurses' consciousness and capabilities of health education is an important step to carry out health education effectively.

Objective To evaluate the value of MRI in the diagnosis of complex congenital heart disease.Methods Twenty-one patients with complex congenital heart disease,who had undergone MRI examination were enrolled in this research.The MRI data of every patient was analyzed and abnormalities of anatomy was counted by two experienced cardiovascular radiologist.Surgical diagnosis (17 cases) or consistent diagnosis (4 cases) of ultrasonic,cardiac catheter and cardiac CT was regarded as reference standards.Accuracy and misdiagnosis rate were obtained.Results Twenty-one patients had 63 main abnormalities,61 malformations was found by MRI examination,the diagnostic accuracy was 96.8％,and the misdiagnosis rate was 4.8％ (1 atrial septal defect (ASD) and 1 major aorta pulmonary collateral arteries (MAPCAS) were missed,1 arterialduct stump was misdiagnosed as patent ductus arteriosus (PDA).Conclusion MRI has excellent diagnosticaccuracy on complex congenital heart disease,it is another good noninvasive cardiac examination method beside ultrasonic.

Objective To explore the value of 64-slice CT coronary artery angiography in detecting anomalous origin of left coronary artery from the pulmonary artery (ALCAPA) in infants. Methods Ten children aged from 5 months to 2 years and weighed from 5.5 to 10.0 kilograms with surgical confirmed ALCAPA were underwent contrast-enhanced retrospective ECG-gated 64-slice CT, and the data were retrospectively analyezd. Scanning were performed with 80 kV tube voltage, 150 mA tube current, 0.35 s rotation time, 0.625 mm slice thickness and 0.2 pitch. Results The heart rate ranged from 110 to 150 beats per minute. All images were good enough for diagnosis. The radiation dose was 1.11-1.62 mSv. The left coronary arteries were found to originate from the posterior-right sinuse in 4 patients, from posterior-left sinuse in 4 parients, from posterior-right wall and inferior wall above the pulmonary sinuses in 1 patient, respectively. Conclusion The 64-slice CT coronary artery angiography can reveal the location of the ectopic ostium and the course of left coronary artery in ALCAPA infants with low radiation dose.

Objective To construct a shuttle plasmid for inducible gene expression in Borrelia burgdorferi (B.burgdorferi) with an advantage of flexible genetic manipulation.Methods The IPTG-inducible lac repressor/operator system from Escherichia coli (E.coli) was adopted and modified in the current study.The plasmid shuttle vector was developed by inserting multiple cloning sites,FLAG and HA tags into the shuttle vector by molecular cloning approaches.The target gene was inserted at the site under the control of the promoter (Tn5 derivate) in plasmid pQE30.This promoter contained two lac operators and a codonoptimized lacI gene driven by flaB promoter.Results A plasmid shuttle vector,pJJ275,was successfully constructed with the ability to express target genes in B.burgdorferi in the presence of IPTG.By using this system,a HA-tagged rpoS gene was introduced into the typical infectious strain B.burgdorferi B31.The target gene expression induced by IPTG was confirmed at transcriptional and translational levels.The RpoS dependent virulence factor of Borrelia,OspC,was also detected,indicating that the expressed protein was functional.Conclusion The constructed plasmid shuttle vector can express exogenous genes in B.burgdorferi with an inducible feature and an advantage of flexible genetic manipulation.It can be applied for genetic manipulation of B.burgdorferi involved in gene regulation and complementation.

Objective To investigate the CT features of nodular or mass-like type pulmonary cryptococcosis(PC). Methods A total of 52 cases with nodular or mass-like type PC confirmed by pathological examinations at Fuzhou Pulmonary Hospital of Fujian from January 2008 to December 2012 were studied. Each patient underwent a breath-hold MSCT scan and contrast enhanced CT was performed in 19 patients. The data including lesion size, number, distribution, density, performance of enhanced CT scan and accompanying signs were analyzed. Each CT accompanying sign was compared between nodular lesions and mass-like lesions using χ2 test,continuous correction χ2 test or Fisher exact test. Results Of all the 52 patients, pulmonary cryptococcosis was consisted single nodules/masses (21 cases) and multiple of nodules/masses (31 cases). There were total 206 lesions with 172 nodules and 34 masses. The lesions were mainly found in lower lobe(73.3%, 151/206)and outer zone or subpleura(87.4%, 180/206)of lung. Plain CT scan showed the densities of most lesions were solid and uniform(74.7%, 154/206). A total of 95 lesions were detected in the 19 patients with contrast enhanced CT, in which 61 lesions (64.2%) showed homogeneous enhancement and 86 lesions (90.5%) showed moderate enhancement. Nodular or mass-like lesions accompanied by many CT signs including halo sign (59.2%, 122/206), air bronchogram (32.0%, 66/206), pulmonary cavity or vocule sign (15.0%, 31/206), lobulation sign (25.2%, 52/206), spicule sign (13.1%, 27/206), pleural indentation(7.8%, 16/206) and vascular cluster (1.9%, 4/206). Compared with mass-like lesions, lobulation sign was more frequently observed in nodular lesions(χ2=13.750, P=0.001), whereas air bronchogram and pulmonary cavity orvocule sign were less frequently observed(χ2=19.957, P=0.001; χ2=5.295, P=0.021, respectively). No significant statistically differences were detected in other CT signs between them (P>0.05). Conclusions PC lesions usually occur in right lung, lower lobe and close to the pleura. Halo sign and air bronchogram are the characteristic findings of CT manifestations in nodular or mass-like type PC.

Objective To measure the dose to the primary operator and assistant operators by employing eight beam projections commonly used in coronary angiography with and without radiation protection shields in order to supply helpful guidance on radiation protection in cardiac intervention.Methods From 20 to 180 cm above the ground at the primary and assistant operators' locations,a DoseAware personal dose meter was placed in terms of an increment of 20 cm to measure radiation dose.Eight commonly used beam projections were performed,including LAO (left anterior oblique) 45°,RAO (right anterior oblique) 30°,CRAN (cranial)25°,cranial LAO (LAO45°/25°),caudal LAO(LAO45°/ 25°),CAUD (caudal) 25°,cranial RAO (RAO30°/25°),caudal RAO (caudal RAO30°/25°).Under the two different conditions,with or without radiation protection shields,the doses to the operators in the selected beam projections were respectively recorded at nine measuring positions and the shielding factor were calculated.Results The primary operator was effectively protected with radiation protection shields.In the standing area of the primary operator,except for the position at the height of 120 cm (radiation dose rate:0.35-4.78 mSv/h;shielding factor:27.67％-89.33％),the shielding factor for each measuring position was above 91％.Higher radiation doses were found at caudal LAO,LAO,and cranial LAO.The shielding factor for the assisting operator was lower than for the primary operator.In the standing area of the assisting operator (radiation dose rate:0.27-1.86 mSv/h;shielding factor:30.34％-92.13％),the peak levels were found at the height of 80,100,140 cm.And caudal RAO,caudal LAO,CRAN,LAO were found to have received higher radiation doses.Conclusions Emphasis should be attached to the use of radiation shields in coronary angiography.With radiation protection shields,higher dose is still recorded in caudal LAO,LAO,cranial LAO,caudal RAO.Furthermore,it should be paid more attention to radiation protection at 80-140 cm height,and less prolonged exposure should be employed in those beam projections mentioned above.

Objective To evaluate the radiation protective efficacy of different types and the positions of ceiling-suspended lead shield to the principal and assistant interventional operators in order to provide a scientific basis for the selection of optimal scheme in using ceiling-suspended lead shield.Methods At the principal and assistant interventional operators’ standing places the personal dose-measuring instruments were set up, which were placed at the height of 20 cm to 180 cm above the ground with an interval distance of 20 cm between each other.The postero-anterior (PA) projection and left lateral projection were used.The ceiling-suspended protection lead shields included lead glass (glass type) and lead glass with connected lead flexible stripe below (mixed type).The placed sites of the protection lead-shields were close to the principal operator, away from the principal operator, on the left side of the principal operator and close to the X-ray tube respectively.The radiation doses of PA projection and left lateral projection were determined.The real-time radiation dose rate and dose shielding rate at the nine measuring positions for the principal operator and assistant operator were separately calculated.The results were analyzed.Results The radiation protection of the glass type was slightly superior to that of the mixed type, but the difference was not significant.The principal operator was best protected when the shield was positioned close to him in the PA projection, and for left lateral projection the principal operator was best protected when the shield was positioned on his left side.For the assistant operator, the optimal protection was obtained when the shield was positioned close to him in both PA and left lateral projection.In the optimal position of ceiling-suspended lead shield, the highest radiation dose rate (0.71 mSv/h in glass group and 1.07 mSv/h in mixed group) was recorded on the principal operator at the height of 120 cm at PA projection, and higher radiation dose rate (≥0.47 mSv/h) was recorded on every point of both operators at the left lateral projection.Meanwhile, the overall received radiation doses of the two groups were very close.At the principal operator standing area, except for the position of 120 cm height (attenuation ratio 60.11% in glass group and 39.89% in mixed group), the attenuation ratio of each measuring point was above 93%.And the assistant operator standing area the attenuation ratio was 57%-97%.The lateral shielding ratio was generally slightly higher than PA shielding ratio.Conclusion The radiation protection effect of the two type shields is quite similar, both shields can obtain excellent protection efficacy.But the radiation dose at the height of 120 cm above the ground at PA projection is higher for the principal operator, while at lateral projection the radiation dose at all height levels is still relatively higher for both operators.Therefore, the radiation protection at the level of 120 cm height needs to be strengthened and the lateral projection exposure should be used as less as possible.

Objective To observe the imaging features of primary lymphoma of bone (PLB) on MRI and PET, and to assess the value of MRI combined with PET for PLB. Methods Sixteen patients with pathologically confirmed PLB were collected, and the MRI and PET appearances were analyzed retrospectively. Results Single bone infiltration was detected in 15 patients (5 in femurs, 3 in vertebro, 3 in right iliums, 2 in tibias, 1 in radius and 1 in maxillae), while multiple bones infiltration were noticed in 1 patient (lesion located in manubrium sterni and the 7th right rib). MRI demonstrated heterogeneous focal-lamellar or diffuse signal intensity within marrow, isointense or hypointense on T1WI and slightly hyperintense on T2WI with homogeneous or heterogeneous enhancement. Severe soft tissue mass was seen in all 16 patients, the range of soft tissue mass was larger than osseous lesion in 15 patients and equal to osseous lesion in 1. Most PLB were homogeneous isointense or slightly hypointense on T1WI and homogeneous or heterogeneous slight-hyperintense on T2WI with slightly or moderately homogeneous or heterogeneous enhancement, while in 3 patients showed single vertebral compression fracture with local epidural- and/or paravertebral-soft tissue, and the range of soft tissue larger than the pathologic vertebrae. PET was performed before operation in 13 patients, showing local increasement of glycometabolism and uptake of radioactive nuclide without abnormality for other sites. For three patients of primary lymphoma of vertebrae underwent PET after operation, and recurrence was detected in 1 patient after 2 months. Conclusion Large soft mass with small osseous destruction and relatively hypointensity on T2WI is somehow characteristic for PLB. PET features of PLB are not specific, but has some advantages in determining the nature of lesion, differentiating lesions and follow-up after operation. MRI combined with PET is an appropriate imaging method for PLB.

Objective To evaluate the value of iterative modal reconstruction (IMR) for reducing radiation dose and controlling image quality in cardiac CT. Methods Ten pigs were included. All pigs were scanned on a 256?slice prospectively ECG?gated cardiac CT utilizing routine dose (group A) and tube current reduced by 30%(group B), 50%(group C) and 70%(group D), respectively. Filtered back projection (FBP), hybrid iterative reconstruction (iDose4) and IMR were used for all data, respectively. Image noise and contrast?to?noise ratio (CNR) of ascending aortic root were measured, while overall image quality and coronary artery image quality was rated (five point scale). All results reconstructed by FBP, iDose 4 and IMR were compared. Objective measurements were compared with one?way analysis of variance, and subjective assessments were compared with Kruskal?Wallis H test andχ2 test. Results Compared with that of FBP and iDose4, image noise of IMR was(15.1 ± 6.1),(18.8 ± 5.5),(22.1 ± 4.8)and(33.0 ± 4.0)HU, respectively in group A, B, C and D with significant reduction (F=82.77, 90.71, 96.59, 95.51 respectively, all P<0.01). Using IMR, groups A, B, C, D had higher CNR (42.0±11.1, 37.2±10.4, 31.4±8.7, 23.7±7.0;F=50.65, 53.55, 76.60, 57.36, all P<0.01) and overall image quality (5.0 ± 0.0, 4.8 ± 0.4, 4.6 ± 0.5, 4.5 ± 0.5;H=20.96, 15.63, 18.66, 23.56, all P<0.01) than FBP and iDose4. Using IMR, group A (100%, 40/40) and group B (100%, 40/40) had no significant difference (P>0.05) in the diagnosis rates of proximal coronary arteries compared with that using FBP and iDose4, while group C (100%, 40/40) and group D(92%, 37/40) had significantly increased diagnosis rates (χ2=20.05, 45.72, both P<0.01). The diagnosis rates of distal coronary arteries of IMR reconstruction which were 100%(50/50), 98%(49/50), 90%(45/50), 78%(39/50), respectively in groups A, B, C, D had significant increase compared with that of FBP and iDose4 reconstruction (χ2=7.39, 16.75, 34.62, 81.33, all P<0.05). Conclusions IMR can significantly reduce image noise, improve CNR and image quality compared with iDose4. Application of IMR can reduce radiation dose but without compromising image quality.

Objective To investigate the difference of morphology and blood flow of cavopulmonary anastomosis by MRI and that by ultrasonic cardiography (UCG) in patients with bidirectional Glenn shunt (BGS).Methods Phase-contrast MRI (PC-MRI) and contrast enhanced MRI (CE-MRI) were performed for superior vena cava ( SVC ) and inferior vena cava (IVC) in 22 patients with BGS on 3.0 T MR scanner.PC-MRI was used for measuring blood flow and CE-MRI for illustrating morphology.The width,peak flow velocity and gradient pressure of cavopulmonary anastomosis were calculated by using Report Card software.The similar data of UCG was collected.The parameters by MRI and that by UCG were compared statistically by t test and Pearson correlation.Results Based on the MRI data,the blood flow of SVC [ ( 1.002 ±0.208) L/min ] was significantly lower than that of IVC [ ( 1.794 ± 0.392 ) L/min ] ( t =- 15.148,P ＜0.01 ),while the regurgitation fraction of SVC [ (26.54 ± 12.82)％ ] was significantly higher than that ofIVC [ ( 17.44 ± 10.17)％ ] (t =11.060,P ＜0.01 ).The morphology displayed with MRI angiography couldnot be detected with UCG.The width of cavopulmonary anastomosis measured by MRI [ (12.46 ±3.43 ) mm ] was significantly higher than that of UCG[ ( 11.04 ± 2.63 ) mm] ( t =4.048,P ＜ 0.01 ),while the peak flow velocity of cavopulmonary anastomosis measured by MRI [ (47.77 ± 10.44) cm/s] was significantly lower than that of UCG [ (52.19 + 9.63) cm/s] ( t =- 2.237,P ＜ 0.05 ).No significant difference was found in gradient pressure of cavopulmonary anastomosis between the values by MRI [(0.95+0.42) mm Hg(1 mm Hg =0.133 kPa)] and that by UCG [(1.12+0.38)mm Hg] (t=2.010,P ＞ 0.05).The width,peak flow velocity and gradient pressure of cavopulmonary anastomosis by MRI were closely correlated with those by UCG (r =0.858,0.489,0.427,all P＜ 0.05 ).Conclusions A good correlation is found in the width,peak flow velocity,and gradient pressure of the cavopulmonary anastomosis obtained by 3.0 T MRI and UCG.MRI is more useful tool to display the width and abnormal morphology of cavopulmonary anastomosis than UCG.