Objective To investigate the image quality difference of the virtual monochromatic spectral(VMS) images synthesized from fast kilovoltage switching and dual-source dual-energy CT for a given radiation dose. Methods A plurality of disposable syringes containing 15 mg/ml iodine contrast agent and saline were placed on the surface of the male anthropomorphic phantom consisting ofhead neck and torso, GE HD750 gemstone spectral imaging and Siemens Somatom Definition Flash dual energy CT protocols were performed on the phantom for a same dose(volume CT dose index 6.52 mGy), and VMS images (40, 60, 70, 80, 100, 120, 140 keV) were reconstructed and obtained(VMSkV switching and VMSdual-source image), respectively. The objective image noise, iodine signal noise ratio(SNR), iodine contrast noise ratio (CNR) and CT values were measured. The results were analyzed using the paired t test and ANOVA. Results All VMS iodine CT values were gradually decreased with the increasing of keV , and iodine CT values on VMSdual-source images were greater than on VMSkV switching images(P<0.05), VMSkV switching iodine CT values in descending order from the head , chest, abdomen at less than 100 keV,while most VMSdual-source iodine CT values were highest on chest(P<0.05). VMSdual-source and VMSkV switching image noise were highest at 40 keV and successively raised from the head, chest , abdomen. VMSkV switching image noise gradually decreased with the increase of keV in the range of 40 to 70 keV , gradually increased up to the trough after 70 keV from 80 keV gradually decreased, while VMSdual-source image noise was lowest at 70 keV or 80 keV , and then with the keV increased gradually increased. Image noise on VMSkV switching images in the range of 40 to 100 keV were higher than that on VMSdual-source images and lower in the range of 100 to 140 keV at most part(P<0.05). VMSdual-source and VMSkV switching iodine SNR were highest at 40 keV or 60 keV,SNR on VMSdual-source images are greater than on VMSkV switching images except 40 keV images on head and abdomen(P<0.05) . VMSdual-source and VMSkV switching iodine CNR were highest at 60 keV,CNR on VMSdual-source images are greater than on VMSkV switching images except 40 keV images on head 100 keV and 120 keV on abdomen(P<0.05).SNR and CNR decreased from the head, chest, abdomen (P<0.05). Conclusion VMS images synthesized from fast kilovoltage switching and dual-source dual-energy CT have different image quality performance at most keV and body parts, but VMS imaging at approximately 70 keV yielded lower image noise, and at approximately 60 keV yielded highest SNR and CNR.

This study aims to evaluate the ability of C-arm cone-beam CT to detect intracranial hematomas in canine models. Twenty one healthy canines were divided into seven groups and each group had three animals. Autologous blood and contrast agent (3 mL) were slowly injected into the left/right frontal lobes of each animal. Canines in the first group, the control group, were only injected with autologous blood without contrast agent. Each animal in all the 7 groups was scanned with C-arm cone-beam CT and multislice computed tomography (MSCT) after 5 minutes. The attenuation values and their standard deviations of the hematoma and uniformed brain tissues were measured to calculate the image noise, signal to noise ratio (SNR) and contrast to noise ratio (CNR). A scale with scores 1-3 was used to rate the quality of the reconstructed image of different hematoma as a subjective evaluation, and all the experimental data were processed with statistical treatment. The results revealed that when the density of hematoma was less than 65 HU, hematomata were not very clear on C-arm CT images, and when the density of hematoma was more than 65 HU, hematomata showed clearly on both C-arm CT and MSCT images and the scores of them were close. The coherence between the two physicians was very reliable. The same results were obtained with C-arm cone-beam CT and MSCT grades in measuring SD value, SNR, and CNR. The reasonable choice of density detection range of intracranial hematoma with C-arm cone-beam CT could be effectively applied to monitoring the intracranial hemorrhage during interventional diagnosis and treatment.
Animals ; Cone-Beam Computed Tomography ; Disease Models, Animal ; Dogs ; Hematoma ; diagnosis ; Image Processing, Computer-Assisted ; Intracranial Hemorrhages ; diagnosis ; Multidetector Computed Tomography ; Signal-To-Noise Ratio

Objective To investigate the effects of kidney-deficiency on auditory cortex metabolism in the elderly by using the proton magnetic resonance spectroscopy(1H-MRS).Methods 50 volunteers,including 20 young subjects and 30 older subjects matched for gender,were measured by pure tone audiometry、“kidney-deficiency”-related test and were executed 3.0 T multi-voxel 1H-MRS tests,The ratios of N-acetylaspartate (NAA),choline (Cho) and lactate (Lac) to creatine (Cr) were measured and were compared between the two groups.The t-test analysis were used for statistic process.The relationship between auditory cortex metabolism and the symptom of kidney-deficiency was also analyzed.Resnlts The result of kidney-deficiency-related test and pure tone audiometry revealed that there was significant difference between the two groups and the older subjects had the more severity kidney-deficiency and high-frequency hearing loss (t=6.335、19.558,P＜0.05).The NAA/Cho ratio in the auditory cortex in the older group was significantly lower than that in the younger group (t=2.90,P＜0.05).There were no significant differences between two groups for the ratios of NAA/Cr and Cho/Cr (t=1.415、0.927,P＞0.05).Decrease of the ratio of NAA/Cho in the older group is significantly related with kidneT-deficiency(r=- 0.773,P=0.025).Conclusion kidney-deficiency play a very important role in the hearing loss and reduction of the number of neurons in auditory cortex of older healthy subjects.It suggests one possible underlying mechanism for the speech perception difficulties exhibited by aging adults.

This review aims to interpret the interventions to improve physical function for children and young people with cerebral palsy, thus providing relevant suggestions.Relevant literatures published before November 2018 were systematically searched in Cochrane library, CINAHL, and Embase MEDLINE using the Grading of Recommendations Assessment, Development and Evaluation method.Consult with international experts and patients to assess evidence and recommend it.Based on 3 systematic reviews, 30 randomized clinical trials, and 5 pre-and post-treatment studies, a total of 13 recommendations were given.The guidelines recommend that, in order to achieve functional stan-dards, intervention measures should include, patient-selected goals, full-task practice in real-life settings, support for family empowerment, and a team approach.The age, ability, and child/family preferences were all needed to be considered.In order to improve walking ability, ground walking and treadmill training can be carried out.Various methods can promote the realization of hand use goals hand use, including the two-hand exercise training, constraint-induced moverment therapy, goal-oriented training and cognitive therapy.In terms of patient self-care, the guideline proposed that, the combination of full-task practice and auxiliary equipment can improve the independence of self-care and reduce the burden of care givers.Leisure goals could be achieved by the combination of the practice of the entire task with strategies to address environmental, personal, and social barriers.The intervention of children and adolescents with cerebral palsy should take into consideration of patient selection and the goal of full-task practice.The child/family preference, age and ability should be considered when clinical workers selecting specific interventions.

ObjectiveTo investigate the value of the serum levels of Clusterin and sphingosine 1-phosphate （S1P） in assessing the prognosis of sepsis patients with acute liver injury. MethodsA total of 127 sepsis patients with acute liver injury who were admitted to Lianyungang Hospital， Xuzhou Medical University， from March 2019 to May 2022 were enrolled， and according to their prognosis after 28 days of treatment， they were divided into death group with 35 patients and survival group with 92 patients. The independent-samples t test was used for comparison of continuous data between two groups， and the chi-square test was used for comparison of categorical data between groups. A pearson correlation analysis was used to investigate the correlation. The prognostic value of serum Clusterin and S1P was analyzed by receiver operating characteristic curve. ResultsThere were significant differences between the two groups in the degree of liver injury， Acute Physiology and Chronic Health Evaluation Ⅱ （APACHEⅡ） score， Sequential Organ Failure Assessment （SOFA） score， the presence or absence of acute kidney injury， prothrombin time （PT）， international normalized ratio （INR）， Child-Pugh class， and C-reactive protein （all P<0.05）. The death group had significantly lower serum levels of Clusterin and S1P than the survival group （t=11.094 and 10.390， both P<0.05）. The patients with severe liver injury had significantly lower serum levels of Clusterin and S1P than those with mild or moderate liver injury （t=9.825 and 11.418， both P<0.05）. The multivariate regression analysis showed that the degree of liver injury （odds ratio ［OR］=1.260， 95% confidence interval ［CI］： 1.081 — 1.468， P<0.05）， APACHEII score （OR=1.031， 95%CI： 1.019 — 1.044， P<0.05）， SOFA score （OR=1.066， 95%CI： 1.039 — 1.094， P<0.05）， Clusterin （OR=0.899， 95%CI： 0.859 — 0.940， P<0.05）， and S1P （OR=0.824， 95%CI： 0.749 — 0.908， P<0.05） were independent risk factors for the prognosis of patients with sepsis. The ROC curve analysis showed that serum Clusterin and S1P used alone or in combination had an area under the ROC curve of 0.864， 0.861， and 0.949， respectively. Serum Clusterin and S1P were significantly negatively correlated with alanine aminotransferase， total bilirubin， PT， and INR in sepsis patients with acute liver injury （all P<0.05）. ConclusionThe sepsis patients with acute liver injury who died had significant reductions in serum Clusterin and S1P compared with those who survived， and the levels of Clusterin and S1P are closely associated with the degree of liver injury. The combination of Clusterin and S1P has a good value in predicting the prognosis of sepsis patients with acute liver injury and is expected to become a potential marker for predicting the prognosis of sepsis patients with acute liver injury.