Objective To investigate psychosocial factors for post-stroke depression (PSD). Methods 405 in-pa-tients with stroke were first screened for depression using Comprehensive International Diagnostic Interview-3.0. 22 pa-tients with depression were recruited as the depression group. From 383 patients without depression, 44 patients were se-lected and served as the non depression controlled group according to the sex and age paired with 1:2. Both groups were measured by using questionnaires including Life Event Scale, Simplified Coping Style Questionnaire, Social Support Rat-ing Scale, Activities of Daily Living Scale and Quality of Life Enjoyment and Satisfaction Questionnaire, Short Form. Re-sults The score of passive coping was significantly higher in depression group than in non depression group [(1.2 ± 0.5) vs. (0.8±0.7), P<0.05]. The score of subjective support was significantly lower in depression group than in non depression group [(17.5±4.0) vs. (20.7±4.6), P<0.05]. Logistic regression analysis showed, minority nationality (OR=2.564, 95%CI:1.039~6.327) and passive coping style (OR=2.223, 95%CI:1.052~5.192) were risk factors for PSD, while subjective sup-port was protective factor for PSD (OR=0.884, 95%CI:0.793~0.986). Conclusions Passive coping style and low subjec-tive support may be the important psychosocial factors of PSD.

Objective To explore the clinical value of the dual-low-dose with low tube voltage for head and neck CTA. Methods One hundred and sixty patients who were clinically suspected head and neck vascular disease underwent CTA procedure were propective selected, and whose body mass index (BMI) was also lower than 25 kg/m2. Forty cases were randomly selected as conventional group(120 kV,150 mAs, iodine 320 mg/ml), the other 120 cases were as the low dose group. The low dose group divided into three subgroups according to the random number table method, which were low iodine group (37 cases;120 kV,150 mAs, iodine 270 mg/ml), low tube voltage group (42 cases;100 kV,150 mAs, iodine 320 mg/ml) and low iodine and tube voltage group (41 cases;100 kV,150 mAs, iodine 270 mg/ml). The carotid bifurcated CT value, standard deviation (SD), signal-to-noise ratio (SNR), iodine intake and effective radiation dose (ED) of the four groups were recorded,all data undertook statistical analysis useing one-way ANOVA. Meanwhile, the subjective image quality score was applied to evaluate the image quality, and the differences among groups were compared by Wilcoxon signed ranks test. Results The image quality score were (2.85±0.19),(2.33 ± 0.34),(2.26 ± 0.32),(2.87 ± 0.22) in the four groups, and there was no statistical difference between groups(P>0.05).The carotid bifurcated CT value were respectively (380±30),(314±27),(514±52) and (425±28) HU in conventional, low iodine, low tube voltage and dual-low-dose groups, and the iodine intake were (18.85±2.10), (15.75±1.78), (18.53±1.98), (15.62±1.92) g, the ED of the four groups were (1.74±0.14), (1.73± 0.11), (1.32 ± 0.08) and (1.35 ± 0.09) mSv, the difference were all statistically significant (P<0.01). Furthermore, the iodine intake and the effective radiation dose in dual-low-dose group were significantly lower than the conventational group. Conclusions Head-and-neck CTA with dual-low-dose scan can provide same quality images as using 100 kV and high dose iodine contrast agent, and which also significantly reduced the ED and iodine intake greatly. Thus, this scanning program has great clinical value.

Objective:To evaluate the application of one-stop dynamic volume perfusion CT (dVPCT) in upper abdomen, and its feasibility of replacing conventional enhanced CT, perfusion, and angiography.Methods:A total of 94 patients with upper abdominal perfusion examinations were retrospectively enrolled in Deyang People's Hospital of Sichuan Province from April 2017 to June 2019. The data of another 64 patients underwent routine upper abdominal enhancement with 64-slice CT (28 patients) and dual-source CT (26 patients) were analyzed in the same period. The radiation dose and image quality were compared. According to different contrast agent concentration and dosage, 4 perfusion groups and 2 conventional enhanccement groups were divided, including 60 ml iohexol group (350 mg/ml) and 60 ml ultravist group (370 mg/ml), 60 ml and 80 ml iomeprol group (400 mg/ml), 64-slice routine group and dual-source CT routine group. Signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of the liver, pancreas and abdominal aorta images in the arterial and portal vein phases were measured by two radiologists in a blinded way. Subjective image quality was evaluated by two radiologists using a 5-point Likert Scale in a blinded method. Statistical analysis was performed using analysis of variance and kappa test. Imaging findings and typical cases of perfusion were retrospectively analyzed.Results:Radiation dose: the effective dose of each perfusion group was lower than that of the 64-slice spiral CT scan, but higher than that of the dual-source CT routine scan. The SNR and CNR of the 80 ml iomeprol dVPCT group were better than that of 64-slice spiral CT and dual-source CT routine scan ( P<0.05), and were better than that of 60 ml iohexol, ultravist and iomeprol dVPCT groups ( P<0.05). However, the subjective index was lower than that of the dual-source CT routine scan group ( P<0.05). The comprehensive information of multi-phase images, vascular images and perfusion quantitative parameters of volume perfusion data reconstruction in this group is superior to conventional enhanced CT in the detection of lesions, visualization of normal tissues and blood vessels. Conclusion:One-stop dVPCT imaging of the upper abdomen has lower radiation dose with good image quality and more diagnostic information. dVPCT with 80 ml Iomeprol (400 mg/ml) can obtain much better images.

Objective:To investigate the effects of different local complications of acute pancreatitis (AP) on the microcirculation of multiple organs in the upper abdomen.Methods:A dynamic volume perfusion computed tomography (DVPCT) scan in the upper abdomen was prospectively conducted in 101 patients with AP and 24 patients with neither AP nor other obvious upper abnominal lesions diagnosed in People′s Hospital of Deyang City from April 1 to October 31, 2019, 86 patients with AP (AP group) and 21 controls (control group) were enrolled in the study. AP patients were divided into no local complications group (21 cases), acute peripancreatic fluid collection (APFC) group (19 cases), acute necrotic collection (ANC) group (27 cases), walled-off necrosis (WON) group (11 cases) and walled-off necrosis with infection (WONI) group (8 cases). The blood flow (BF) of pancreas, liver, spleen, two kidneys and adrenal glands was measured by deconvolution. The hepatic arterial perfusion (HAP), hepatic portal perfusion (HPP) and hepatic perfusion index (HPI) of each group were calculated by maximum slope. T test was used for statistical analysis. Results:The BF of pancreas, spleen and left adrenal gland of ANC group was (139.89±34.28), (141.42±47.85) and (107.87±26.41) mL·min -1·(100 g) -1, respectively, the BF of pancreas, spleen and left adrenal gland of WON group was (130.00±44.83), (106.12±38.16) and (98.38±41.39) mL·min -1·(100 g) -1 respectively, and the BF of pancreas, spleen and left adrenal gland of WONI group was (127.91±35.86), (102.09±23.73) and (105.66±27.01) mL·min -1·(100 g) -1, respectively, which were all lower than those of control group ((161.22±31.60), (174.00±62.73) and (134.53±36.36) mL·min -1·(100 g) -1), and the differences were statistically significant ( t=2.440, 2.043, 2.943; 2.296, 3.796, 2.548; 2.448, 4.479, 2.154; all P<0.05). The BF of left kidney cortex of WONI group was lower than that of control group ((247.44±39.32) mL·min -1·(100 g) -1 vs. (294.80±39.13) mL·min -1·(100 g) -1), and the difference were statistically significant ( t=2.910, P<0.05). The HAP of ANC group, WON group and WONI group was (18.63±9.54), (19.10±7.47) and (19.51±6.26) mL·min -1·(100 g) -1, respectively, and the HPI was (25.01±15.51)%, (45.98±31.42)% and (35.92±24.95)%, respectively, which were all higher than those of control group ((12.18±5.14) mL·min -1·(100 g) -1 and (13.44±6.49)%), and the differences were statistically significant ( t=2.997, 3.088, 3.235; 3.503, 3.397, 2.517; all P<0.05) . The HPP of ANC group, WON group and WONI group was (72.37±21.76), (48.83±35.10) and (57.55±29.45) mL·min -1·(100 g) -1, respectively, which were all lower than that of control group ((86.43±17.98) mL·min -1·(100 g) -1), and the differences were statistically significant ( t=2.391, 3.331 and 3.226, all P<0.05). The HAP and HPI of APFC group were both higher than those of control group ((18.67±10.24) mL·min -1·(100 g) -1 vs. 12.18±5.14) mL·min -1·(100 g) -1 and (23.75±20.41)% vs. (13.44±6.49)%), and the differences were statistically significant ( t=2.572 and 2.108, both P<0.05) . Conclusions:AP complicated with ANC, WON and WONI can reduce the BF of pancreas, spleen and left adrenal gland, and WONI can induce the decrease of BF of left kindney cortex. AP complicated with ANC, WON and WONI can increase HAP and HPI, but decrease HPP. Furthermore, AP complicated with APFC can increase HAP.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.