0.05).(2)In 67 cases with pre-and post-image selection and reconstruction in single-slice or twin-slice helical CT,the slice concordance rate in measurement was 20.98% and 97.01%,respectively(?2=80.22,P=0.00).The slice concordance was all accomplished with the same method in multi-slice helical CT in 5 cases.(3)Peak heights and SPN-to-aorta ratios of malignant [(38.48?14.32)HU,(19.64?9.52)% ] and inflammatory SPN [(42.48?11.55)HU,(21.14?7.77)%] were significantly higher than that of benign SPN [(9.52?3.78)HU,(3.41?1.86)%,P0.05).Slice optimization of dynamic contrast-enhanced CT scan improved the diagnostic accuracy of SPN from 78% to 80%.Conclusion No significant efficacy was found in the attenuation between primitive images and reconstructive images with the same slice thickness of homogenous material.Slice concordance of dynamic contrast enhanced spiral CT could reflect objectively the morphological appearance and CT value changes of solitary pulmonary nodules,and may improve the veracity of diagnosis.

Objective To evaluate MR relaxometry techniques and dual-energy X-ray absorptiometry (DXA) for the diagnosis of osteoporotic diseases in rats. Methods Thirty 3-month-old female rats were randomly divided (using completely randomized grouping method) into two groups (each contained 15 rats). Animals in group A without osteoporotic castration were included as normal controls, whereas osteoporotic castration was created in each animal in group B. Three parameters (BMC, BMD, Hbmdl)was measured for both groups by DXA at two time points, one immediately before the castration and another at the 12 th week after the castration. Then animals from the control group and the osteoporotic group went through the following three diagnostic procedures using a 1.5 T MR system: (1) A fast multi echo gradient echo (MEGRE) pulse train sequence with different inter-echo intervals (1000, 500, 400, 300, 200, 100) to obtain the T_2~* value. (2) A multi-echo fast spin echo sequence to obtain the T_2map. (3) A conventional spin-echo (CSE) sequence to obtain the T_1map. The statistical difference between group A and group B was tested by t-test to analyze parameters. And, the most significant parameter for diagnosis ofosteoporotic diseases was picked out from all parameters by Fisher Sequential diseriminant analysis. At the end of experiments, animals were killed and histopathological examination was performed on the femurs of animals from both control and osteoporotic groups. Results (1) Histopathological examination confirmed the presence of osteoperosis in all animals in group B. (2) BMD was picked out from 3 DXA parameters (BMC,BMD,Hbmdl) by fisher stepwise discriminant analysis, and its discriminant rates was 87.6%. (3) All 2-sample t-test results(t=6.20, 4.79, 5.18, 5.22, 5.59, 4.37, 6.14, 5.12, 5.09, 4.99, 5.57, 4.84, 4.07, 2.98, 6.75 individually) for MR relaxometry parameters(T_2~* 1000,R_2~* 1000,T_2~* 500,R-2~* 500,T_2~* 400,R_2~* 400,T_2~* 300,R_2~* 300,T_2~* 200, R_2~* 200, T_2~* 100, R_2~* 100, T_2map, R_2map, T_1map) showed statistically significant differences between groups A and B (P=0.01 for T_2~* map, P=0.00 for all other parameters) except the R_2map(P=0.07). (4) Using fisher stepwise discriminafion method in the analysis of 14 parameters of MR relaxometry techniques and 3 parameters of dual X-ray absorptiometry(T_2~* 1000,T_2~* 500,T_2~* 400,T_2~* 300,T_2~* 200,T_2~* 100,T_2map, R_2~* 1000, R_2~* 500, R_2~* 400, R_2~* 300, R_2~* 2OO, R_2~* 100,T_1map,BMC,BMD,Hbmdl), we found that the most significant difference was from the T_2map and T_1map. Conclusions The MR relaxometry parameter-T_2map in the present study is shown to be appropriate parameter for the diagnosis of osteoperotie diseases, and stability of magnetic field plays an important role in this process. It would be the optimal method to make a diagnosis of osteoporotic diseases with both MR relaxometry and DXA technological means.

Objective: To investigate the correlation between cord blood vitamin D level and recurrent respiratory tract infection in infants. Methods: From August 2014 to July 2015, 298 neonates in the Second Hospital of Jiaxing were selected in this study.The serum levels of 25-hydroxyvitamin D[25(OH)D] were measured by enzyme-linked immunosorbent assay(ELISA) in umbilical cord blood of neonates.The incidence of respiratory tract infection in infants was followed up. Results: There were 53.1%(158/298) newborns with vitamin D deficiency(deficiency group), 24.8%(74/298) neonates with inadequate vitamin D(inadequate group), 22.1%(66/298) infants with adequate vitamin D(adequate group). The incidence rates of recurrent respiratory infections in vitamin D deficiency group, inadequate group and adequate group were 29.7%(47/158), 17.6%(13/74), 10.6%(7/66), respectively.The incidence of recurrent respiratory tract infection among the three groups was statistically significantly different(χ²=11.114, P=0.01). Conclusion Vitamin D nutrition level of neonates has a significant correlation with infants with respiratory tract infection, especially lower respiratory tract infection.Therefore, it is necessary to pay attention to the supplement and detection of vitamin D during pregnancy, so as to reduce the incidence of infant respiratory diseases in the region.

PURPOSE: OnabotulinumtoxinA is used widely for the treatment of neurogenic detrusor overactivity. We conducted a systematic review and meta-analysis to assess its efficacy and safety for neurogenic detrusor overactivity treatment. METHODS: A systematic literature review was performed to identify all published randomized double-blind, placebo-controlled trials of onabotulinumtoxinA for neurogenic detrusor overactivity treatment. MEDLINE, Embase, and the CENTRAL were employed. Reference lists of retrieved studies were reviewed carefully. RESULTS: Six publications involving 871 patients, which compared onabotulinumtoxinA with a placebo were analyzed. Efficacy of onabotulinumtoxinA treatment was shown as a reduction of the mean number of urinary incontinence episodes per day (mean difference, -1.41; 95% confidence interval [CI], -1.70 to -1.12; P<0.00001), maximum cystometric capacity (135.48; 95% CI, 118.22–152.75; P<0.00001), and maximum detrusor pressure (-32.98; 95% CI, -37.33 to -28.62; P<0.00001). Assessment of adverse events revealed that complications due to onabotulinumtoxinA injection were localized primarily to the urinary tract. CONCLUSIONS: This meta-analysis suggests that onabotulinumtoxinA is an effective treatment for neurogenic detrusor overactivity with localized advent events.
Humans ; Urinary Incontinence ; Urinary Tract

To introduce the surgical procedure of orthopaedic robot-assisted vascularised fibular grafting for the treatment of ANFH and report the short-term result. Methods From September, 2016 to November, 2018, 17 patients (21 hips) with ANFH had undergone robot-assisted free fibular grafting. There were 14 males and 3 females, of which, 8 cases were associated with the right side, 5 cases the left side, and 4 cases with both sides. The average age was 35 (ranged from 17 to 55) years. There were 7 patients suffered from idiopathic ischemic necrosis of femoral head, 4 patients who had cannulated screws fixed after a femoral neck fracture, 4 patients who had a history of alcohol consumption, 1 patient who had taken corticosteroids for 6 months to treat nephritis, and 1 patient who had a history of alcohol consumption and had also taken corticosteroids. Seventeen hips were in Ficat stage II, and 4 hips were in Ficat stage III. The orthopaedic surgical robot workstation was used to plan the entry point and target of the guide pin during the operation, to place a cannula in the optimal position. Then a bone window was created and the fibula was placed into the bone tunnel.Using fluoroscopy to monitor each step of the procedure and verify the position of the fibula. Finally, the vessels were anastomosed. The patient remain in bed completely for a week with the use of vasodilator. The follow-up was accomplished with phone call and outpatient clinic, and Harris score was evaluated. Results All 21 surgical procedures were successful. The guide pins and fibula were accurately placed according to the robot’s plan, and the tips of the fibula were placed at the centre of the load-bearing region of the femoral heads, 4 to 6 mm from the articular surface. Conventional anticoagulant, anti-infective therapy was performed after the pro-cedure. Ten patients were followed-up postoperatively more than 1 year, with an average of 15 (from 12 to 24) months. The function of the hip joint recovered smoothly for 9 patients.Frontal and lateral X-ray and CT scans showed that the tips of the fibula were placed at the centre of the load-bearing region, 4 to 6 mm from the articular surface.One patient suffered from bilateral femoral head necrosis and the right side recovered smoothly after operation.However, joint move-ment was restricted for the left hip and the pain was significant.An arthroscopic examination was performed 1 month after the operation and did not identify any problems such as intraarticular incular infection or articular surface of the femoral head was protruded by the tip of the fibula.The symptoms were alleviated after removing the osteophytes at the rim of the acetabulum.The Harris score was 62.4±13.6 before operation, and 84.5±4.5 at the last time of followed-up after opera-tion.The difference in Harris scores was statisticly significant (P＜0.05). Conclusion With the assistance of an or-thopaedic robot system, the guide pin can be accurately positioned, thereby allowing the tip of the fibula to be inserted in-to the optimal anatomical position and maximising its mechanical efficacy.In theory, it is the best choice for performing fibular bone transplantation in ANFH.And the early effect of treatment is good.