ObjectiveTo observe the clinical effect of sodium aescinate in the treatment of patients with stage Ⅰ - Ⅱ internal hemorrhoids.Methods177 patients with stage Ⅰ - Ⅱ internal hemorrhoids were randomly divided into two groups,the treated group( n =87 ) and the control group( n =90).Patients in the control group were treated with external hemorrhoids suppositories ( 1 per time,bid),while patients in the treated group took sodium aescinate orally(2 per time,Bid).After the 7-day course of treatment,the efficacy of sodium aescinate was determined.ResultsThere was significant difference between the two groups in the total obvious effective rate and the total effective rate(P ＜0.01 ).Compared with the control group,the symptoms of hematochezia and anal pain were more improved in the treated group( P ＜ 0.01 ).There was significant difference between the two groups in the hemorrhoidal mucosa,prolapse,the size of hemorrhoids and total score difference ( P ＜ 0.05 ).The total obvious effective rate and the total effective rate of the treated group were 87.4％ and 95.4％.ConclusionSodium aescinate had better clinical effect in the treatment of patients with stage Ⅰ - Ⅱ internal hemorrhoids.

Objective To investigate the best weighting of adaptive statistical iterative reconstruction (ASIR) algorithm and optimized low-dose scanning parameters in thoracic aorta CT angiography(CTA).Methods Totally 120 patients with the body mass index (BMI) of 19-24 were randomly divided into 6 groups.All patients underwent thoracic aorta CTA with a GE Discovery CT 750 HD scanner (ranging from 290-330 mm).The default parameters (100 kV,240 mAs) were applied in Group 1.Reconstructions were performed with different weightings of ASIR (10％-100％ with 10％),and the signal to noise ratio (S/N) and contrast to noise ratio (C/N) of images were calculated.The images of series were evaluated by 2 independent radiologists with 5-point-scale and lastly the best weighting were revealed.Then the mAs in Group 2-6 were defined as 210,180,150,120 and 90 with the kilovoltage 100.The CTDIvoland DLP in every scan series were recorded and the effective dose (E) was calculated.The S/N and C/N were calculated and the image quality was assessed by two radiologists.Results The best weighing of ASIR was 60％ at the 100 kV,240 mAs.Under 60％ of ASIR and 100 kV,the scores of image quality from 240 mAs to 90 mAs were(4.78 ±0.30)-(3.15 ±0.23).The CTDIvol and DLP were 12.64-4.41 mGy and 331.81-128.27 mGy,and the E was 4.98-1.92 mSv.The image qualities among Group 1-5 were nor significantly different (F =5.365,P ＞ 0.05),but the CTDIvol and DLP of Group 5 were reduced by 37.0％ and 36.9％,respectively compared with Group 1.Conclusions In thoracic aorta CT Angiography,the best weighting of ASIR is 60％,and 120 mAs is the best mAs with 100 kV in patients with BMI 19-24.

Objective To investigate the effect of different noise index (NI) combined with iterative recombination on the image quality and radiation dose of CT scan in patients with different body mass index (BMI). Method One hundred and sixty patients who had a liver CT enhanced scan were divided into group A (18 kg/m2≤BMI<24 kg/m2 ) and group B (24 kg/m2≤BMI<31 kg/m2) according to BMI, and each group had 80 patients. The two groups were randomly divided into 4 subgroups which NI value was 11, 13, 15 and 17 respectively. All images were restructured with 50% adaptive statistical iterative reconstruction. Subjective evaluation, objective evaluation [signal noise ratio (SNR) and contrast noise ratio (CNR)] and the effective dose of each group were recorded and calculated after the scan. ANOVA and Kruskal-Wallis test were used to evaluated the difference of imaging quality and radiation dose. Results In group A, the SNR, CNR and the subjective score of the later arterial phase images showed a statistical difference between NI=17 group and other subgroups (P<0.05), while there was no statistical differences among the other three subgroups during three CT enhanced phase. The average ED of NI=15, 17 group were decreased by 57.56%(2.17/3.77) and 61.54% (2.32/3.77) compared with NI=11 group, respectively. In group B, the SNR, CNR and the subjective image scores of the later arterial phase showed a significant difference between NI=15 and NI=11, 13 group (P<0.05). There was a statistically difference of image quality in group NI=17 compared with the other three subgroups in the later arterial phase, portal venous phase and equilibrium phase (P<0.05). The average ED of NI= 13, 15 group was decreased by 26.41% (1.69/6.40) and 45.31%(2.90/6.40) compared with NI=11 group, respectively. Conclusion Upon maintaining diagnostic imaging quality, setting different NI according to BMI and applying the iterative reconstruction algorithm can effectively reduce the radiation dose of liver CT enhanced scanning.

Objective To investigate the image quality,radiation dose and iodine intake of CT pulmonary angiography (CTPA) in patients using low tube voltage (100 kVp) combination of different noise indexes (NI) and low concentration contrast agent.Methods A total of 80 patients with suspected pulmonary embolism (PE) and other pulmonary diseases who had undergone CTPA were divided into four groups (A,B,C and D),with 20 patients in each group.Group A underwent 120 kVp CT scan protocol in combination with NI=25 and 370 mg iodine/ml contrast agent,while groups B,C and D underwent 100 kVp CT scan protocol in combination with NI=30,35,40,and 320 mg iodine/ml contrast agent,respectively.All images were restructured using 60％ adaptive statistical iterative algorithm 2.0.Objective image quality evaluation included CT values of pulmonary artery,noise values of pulmonary artery,signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR).Subjective image evaluation used a 5-point scoring method and was conducted by two independent radiologists.The CT dose index of volume (CTDIvol),dose-length product (DLP) and iodine intake was recorded,and the mean value was calculated.The DLP was converted to the effective dose (ED).Analysis of Variance or Kruskal-Wallis test was used to evaluate the differences among the four groups in terms of image quality,radiation dose and iodine intake.Results There was a significant difference in CT values of pulmonary artery among the groups A,B,C and D (P＜0.05),and the CT values of pulmonary artery of group A was the lowest.There was no significant differences in noises of pulmonary artery,SNR,CNR and subjective indexes scores among the groups A,B,C and D (P＞0.05).There was a significant difference in iodine intake among the groups A,B,C and D,iodine intake of the group A was the highest,iodine intake of the group D was the lowest.The iodine intake of groups B,C and D decreased by 12.4％ (42/340),13.2％ (45/340) and 15.0％ (51/340) relative to group A,respectively.There was a significant difference in radiation dose among the groups A,B,C and D,The CTDIvol,DLP and ED of group D decreased by 45.3％ (3.9/8.6),48.6％ (120/247) and 48.3％ (2.02/4.18) relative to group A,respectively (P＜0.01).Conclusion Low tube voltage combination with high NI value and low concentration contrast agent can more effectively reduce the radiation dose and iodine intake for CTPA while maintaining diagnostic image quality.

BACKGROUND:Bone cement used in the vertebroplasty treatment of osteoporotic vertebral compression fractures is nonabsorbable and has stronger intensity than normal bone tissue, which can cause further fractures of adjacent segments. OBJECTIVE:To investigate the short-term effect of vertebroplasty with artificial bone in the treatment of osteoporotic thoracolumbar fractures. METHODS:A total of 21 patients with osteoporotic vertebral compression fractures were enrol ed, including 7 males and 14 females, aged 61-89 years old. Al the patients were subjected to vertebroplasty with calcium sulfate injection. Visual analog scale and Oswestry Disability Index assessment were used before and at 0, 24, 48 weeks after treatment;meanwhile, X-ray and CT were used to observe the fil ing and leakage of artificial bone. RESULTS AND CONCLUSION:After treatment, al the patients showed improvements in the scores of visual analog scale and Oswestry Disability Index (P<0.01). X-rays and CT scans showed that there were three cases of leakage but without spinal cord and nerve compressions. After 3 months, most of the artificial bone was absorbed. These findings indicate that vertebroplasty with artificial bone can ease pain and improve living conditions of patients with osteoporotic vertebral compression fractures.

Objective:To analyze the curative effect of arthroscopic debridement combined with extracorporeal shock wave therapy in the treatment of knee osteoarthritis. Methods:All cases were divided into 2 groups:the control group were treated with arthroscopic debridement,the treatment group were treated with arthroscopic debridement combined with extracorporeal shock wave therapy. The Lysholm score and VAS score was used to determine the changes in patients. Results:After 1 months and 3 months, Lysholm score in the two groups of patients was higher than that before operation (P<0.05) . Lysholm score in the treatment group were higher than that in the control group, VAS score was lower than that in control group (P<0.05) . After 6 months, Lysholm score and VAS score showed no significant difference in 2 groups (P>0.05) . Conclusion:Arthroscopic debridement combined with extracorporeal shock wave therapy in early stage can achieve the functional recovery and pain-relief effect, can better improve the patient's joint function and quality of life.

BACKGROUND:Cuscuta chinensis is a mature seed of Cuscutachinensis Lam., can warm kidney. Previous studies demonstrated that kidney compound composed of Cuscuta chinensis could apparently inhibit bone loss and improve bone density.
OBJECTIVE:To explore the influence of flavonoids from Cuscuta chinensis on bone mineral density of femur, 1,25(OH)2D3 levels of serum and kidney, the expression of smal intestine CaBp-D9K mRNA in model rats with ovariectomized osteoporosis.
METHODS:A total of 72 Sprague-Dawley female rats were equal y and randomly divided into six groups (n=12):sham surgery group, model group, vitamin D3 group and low-, moderate-and high-dose flavonoids groups. The sham surgery group only received sham operation and the other five groups were ovariectomized respectively. One week after ovariectomy, the rats were given flavonoids from low-, moderate-and high-dose Cuscuta chinensis and vitamin D3 (2 mg/kg) by intragastric administration for 3 consecutive months. Blood was obtained from the abdominal aorta. Serum was isolated. The kidney was obtained. Enzyme linked immunosorbent assay was used to determine 1,25(OH)2D3 contents of renal and serum. Rats were sacrificed at the end of experiment. The thighbone was taken out to determine bone mineral density. The second lumbar vertebra was taken out to measure the expression of lumbar vertebra and renal vitamin D receptor mRNA using real-time fluorescent reverse transcription-polymerase chain reaction. The smal intestine was taken out to measure the expression of smal intestine CaBp-D9K mRNA using real-time fluorescent reverse transcription-polymerase chain reaction.
RESULTS AND CONCLUSION:Compared with the sham operation group, bone mineral density of femur, and 1,25(OH)2D3 levels of serum and kidney and the expression of lumbar vertebra vitamin D receptor mRNA significantly decreased in model group, and the expression of smal intestine CaBp-D9K mRNA significantly decreased in model group. Compared with the model group, bone mineral density of femur, and 1,25(OH)2D3 levels of serum and kidney, and the expression of the second lumbar vertebra vitamin D receptor mRNA, and the expression of smal intestine CaBp-D9K mRNA were increased in moderate-and high-dose flavonoids groups and vitamin D3 group. Results indicated that flavonoids from Cuscuta chinensis could significantly raise bone mineral density of femur, and 1,25(OH)2D3 levels of serum and kidney and the expression of lumbar vertebra vitamin D receptor mRNA and the expression of smal intestine CaBp-D9K mRNA, accelerate intestinal calcium absorption and osteoblast activity, and reinforce quality of the bone.

Objective To compare the image quality and radiation dose of CTA of the kidney in patients using routine CT and the spectral imaging combination of different scanning protocols with the adaptive statistical iterative reconstruction 2.0 algorithm (ASIR 2.0). Methods A total of 90 patients who had undergone a CTA of the kidney were divided into three groups (A, B and C), with 30 patients in each group. Group A underwent a routine CT examination, and the scan parameters are:120 kVp, 30 to 650 mA, rotation time 0.5 s/r, scan FOV 50 cm × 50 cm;while groups B and C underwent spectral imaging protocol 1 and 2, the scan parameters of spectral imaging protocol 1 and 2 are:rapid dual kVp (80-140 kVp) switching in 0.25 ms, 375 mA and 360 mA, rotation time 0.7 s/r and 0.6 s/r, scan FOV 36 cm × 36 cm and 32 cm × 32 cm, respectively. All images were reconstructured using ASIR 2.0. The signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of all images were calculated when the kidney CTA was completed. Each subjective image evaluation used a 5-point scoring method and was conducted by two independent radiologists. The CT dose index (CTDIvol) and dose-length product (DLP) were recorded, and the mean value was calculated. The DLP was converted to the effective dose (ED). All data were compared with Kruskal-Wallis test and one-way ANOVA. Results The energy level of 49 to 56 keV was found to provide the best CNR for displaying CTA of the kidney. There were significant differences in CT values, noise, SNR, CNR and subjective score between groups B, C and A (P<0.05), and there was no significant differences in CT values, noise, SNR, CNR and subjective score between groups B and C (P>0.05). There were significant differences in ED among groups A, B and C (P<0.05), and the ED of groups A, B and C were (8.2±1.2), (5.2± 0.9) and (4.4 ± 0.7) mSv, respectively. Conclusion Spectral imaging with different scanning protocols can more effectively reduce the radiation dose than the routine CT scan mode for a kidney CTA while still maintaining diagnostic image quality, and protocol 2 of spectral imaging in our study is recommended.

Objective:To explore the rules of prescription and medication of Traditional Chinese Medicine (TCM) syndrome differentiation treatment for insomnia.Methods:We screened the medical records related to insomnia from the ancient medical cases, modern medical cases, famous medical cases and shared medical record database, and then we put data into the Ancient and Modern Medical Case Cloud Platform (V 1.5.7). The platform software Data mining was applied and performed by frequency analysis, correlation analysis, and drug pair analysis. Results:This study collected 664 cases related to insomnia, like difficulty in falling sleep, early waking up, easy to wake up, dreaminess. The top 5 syndromes included internal phlegm-heat, imbalance between heart-yang and kidney-yin, liver stagnation transforming into fire, heart and spleen deficiency, restless mind. There were 664 prescriptions, 414 TCM medications, where the top 5 medications included Glycyrrhizae Radix et Rhizoma, Poria, Rehmanniae Radix, Ziziphi Spinosae Semen, Angelicae Sinensis Radix. The effect of high-frequency medications were nourishing the heart and calming the mind, clearing heat and dissipating phlegm, soothing the liver and relieving depression, and nourishing yin and yang. The top five drug-combinations included Ostreae Concha- Longgu, Poria- Glycyrrhizae Radix et Rhizoma, Citri Reticulatae Pericarpium- Poria, Angelicae Sinensis Radix- Rehmanniae Radix, Bupleuri Radix- Glycyrrhizae Radix et Rhizoma. Conclusions:TCM syndrome differentiation for insomnia focus on the heart. The medications are mainly to nourish the heart and calm the mind, supplemented by clearing heat, replenishing heart and spleen, soothing the liver and relieving stagnation, nourishing yin and blood for the symptoms relief, with treatment priciple of seeking both temporary and permanent solutions.

Objective To analyze research literature about integration of the body and the spirit; To understand the research status of this classical theory.Methods Relevant articles about integration of the body and the spirit in CNKI, Wanfang Data, VIP-Chinese Scientific and Technological Journal Data were searched, and bibliometric analysis with NoteExpress3.0, Bicomb2.0 and SPSS19.0 software was used to analyzed the data.ResultsA total of 156 efficient articles were retrieved. The number of published articles increased, but the core author group had not yet been formed. The number of cited articles was low. The study hot spots mainly focused on TCM constitution, the subject of health preservation, TCM basic theories, and psychosomatic medicine.Conclusion Domestic studies on integration of the body and the spirit are still in the initial stage. Research number should be increased, meanwhile, innovation and quality should be emphasized.