Objective: To investigate the situation of quality control of 3.0T magnetic resonance imaging (MRI) system. Methods: A series of indicators, including signal noise ratio(SNR), image uniformity, resolution of long-scale contrast, resolution of space, linearity and quality control of slice thickness, of 3.0T MRI system were measured by using Magphan SMR170 phantom (made by the phantom laboratory in American) on the Discovery MR 750 w system which made by GE company of American. And a series of formula, including SNR=(Sinside-Soutside)÷SDinside, U∑=(1-Smax-Smin/Smax+Smin ×100%, linearity=LR-LM/LR×100%、thickness=half of height and width ×0.25, were used to calculate SNR, image uniformity, linearity and quality control of slice thickness, and all of these results were used to evaluate the situation of quality control of 3.0T MRI system. Results:The results revealed that SNR of 3.0T MRI was 105, the imaging uniformity achieved to 99.13%, the resolution of long-scale contrast was 5mm/0.5mm, the resolution of space was 6 LP/cm, linearity achieved to 0.89% and the deviation of slice thickness was 0.6mm. All of these indicators has achieved the standards of detection. Conclusion: Through detecting the SNR, imaging uniformity, resolution, linearity and the deviation of slice thickness of 3.0T MRI system, the performance of the MRI can be accurately obtained, and these contribute to ensure the equipment operating in ideal situation.

Critical patients in the intensive care unit (ICU) are often accompanied with acute pain,which may lead to a series of physiological responses that affect the prognosis of patients.With the continuous advancement of modem medicine,the pain management strategies and analgesics have also greatly developed,and the concept has been continuously updated.In the individualized diagnosis and treatment mode,the pain management is an indispensable component of ICU comprehensive treatment.Multimodal analgesia (MMA) strategies have also shown to be effective in optimizing analgesia in critical patients.However,there are still many shortcomings and differences in pain evaluation and its management.The characteristics and methodologies of related analgesics need to be further summarized and discussed.The current literature about the evaluation of pain,pharmacology and non-pharmacological techniques were reviewed to provide references for the scientific and reasonable implementation of analgesia treatment in ICU.

Objective To investigate the clinical efficacy of methylene blue in the treatment of refractory hypotension caused by vascular paralysis during the course of vasodilatory shock. Methods The related articles were searched by retrieving the terms using methylene blue, vascular paralysis, hemodynamics, hypotension, vasodilatory shock in CNKI, China Biomedical Literature database, Wanfang database, PubMed, Springer Link, and BIOSIS Previews database. The retrieval time was from January 1994 to June 2017. The randomized clinical trials (RCTs) which using methylene blue as the experimental group, normal saline or catecholamine as the control in the treatment of refractory hypotension caused by vascular paralysis during the course of vasodilatory shock were collected. The primary end points were mean arterial pressure (MAP) immediately or 1 hour after the methylene blue administration, and the mortality at the longest follow-up available; the secondary end point was serum lactic acid (Lac) 1 hour after the methylene blue administration. Literature screening, data extraction and quality evaluation were carried out by two researchers. Meta analysis was performed using RevMan 5.3 software. The sensitivity analysis was performed in two trials with low risk of bias. The funnel plot for MAP was performed in five relative trials to analyze the research and publication bias. Results Totally 269 relative articles were collected, according to the inclusion and exclusion criteria, finally 6 RCTs with 214 patients were enrolled, 108 in methylene blue group, and 106 in control group. Four of the studies were considered to have mild to moderate risk of bias, two studies of high risk of bias. The Meta-analysis demonstrated that compared with the control group, methylene blue could significantly improve MAP [mean difference (MD) = 4.87, 95% confidence interval (95%CI) = 2.61 to 7.13, P < 0.000 1], reduce the serum Lac levels (MD = -1.06, 95%CI = -1.98 to -0.14, P = 0.02), and the mortality was decreased without statistical difference [odds ratio (OR) = 0.58, 95%CI = 0.25 to 1.31, P = 0.19]. Sensitivity analysis was performed in two trials with low risk of bias, which demonstrated methylene blue could exactly increase MAP (MD = 8.93, 95%CI = 1.55 to 16.32, P = 0.02). Funnel plot for MAP was performed in five relative trials which found no obvious publication bias. Conclusions Methylene blue could significantly increase MAP in the patients with refractory hypotension caused by vascular paralysis during the course of vasodilatory shock, decrease the Lac levels, and does not increase the risk of death. Therefore, methylene blue should be a potential and safe vasoconstrictor.

Objective:To investigate the effect of terlipressin on prognosis of adult septic shock patients.Methods:All randomized controlled clinical trials (RCT) of terlipressin in the treatment of adult septic shock patients from January 1980 to December 2019 were retrieved from CNKI, Wanfang, SinoMed, PubMed, Embase, Springer Link, Cochrane Library, Google Scholar, and etc. Patients in the treatment group received terlipressin while patients in the control group received norepinephrine or other vasopressors. Main outcome indicator was mortality. Secondary outcome indicators included the incidence of severe adverse events, limb peripheral ischemic events and renal complications. Literature screening, data extraction and quality evaluation were conducted by two researchers respectively. Meta-analysis was performed with RevMan 5.3 software. Funnel plot was used to analyze the publication bias.Results:A total of 507 related literatures were retrieved. According to the inclusion and exclusion criteria, 8 RCT studies were finally included, with a total of 811 patients. One study was considered to have a lower risk of bias, 6 studies had uncertain risk of bias, and 1 study had a higher risk of bias. The Meta-analysis showed that terlipressin did not significantly improve the mortality of septic shock patients compared with the control group [odds ratio ( OR) = 0.89, 95% confidence interval (95% CI) was 0.67-1.19, P = 0.45]; increased the incidence of severe adverse events ( OR = 2.98, 95% CI was 1.99-4.45, P < 0.000 01); there was a tendency to increase the incidence of limb peripheral ischemic events, but without statistical difference ( OR = 10.81, 95% CI was 0.88-133.19, P = 0.06); and reduced the incidence of renal complications ( OR = 0.30, 95% CI was 0.09-0.96, P = 0.04). Funnel plot analysis indicated that there might be publication bias in a study on case fatality and incidence of serious adverse events in the included literature. No significant publication bias was found in studies on the incidence of limb peripheral ischemic events and the incidence of kidney-related complications. Conclusions:The available evidence suggests that terlipressin could not significantly improve mortality in adult's septic shock patients, but it may reduce the incidence of renal complications. A tendency to increase the incidence of limb peripheral ischemic events in the terlipressin-treated group needs to be emphasized.