PurposeTo evaluate the impact of filtered back-projection (FBP) and sinogram-affirmed iterative reconstruction (SAFIRE) technique on the image quality of routine dose temporal bone high resolution CT (HRCT) scan, and to provide reference for the realization of low dose scanning.Materials and Methods Sixty patients underwent routine dose temporal bone HRCT scan, 6 groups of images were reconstructed with FBP and SAFIRE (strength grade 1-5), average CT value, noise (SD), signal to noise ratio (SNR), contrast to noise ratio (CNR), subjective score and lesion detection were compared between different groups.Results There was no significant difference of average CT value among the 6 groups (P>0.05); compared with FBP, SD of SAFIRE (strength 1-5) reconstruction decreased gradually (F=1.78,P<0.01), which was 23.1%, 39.2%, 42.4%, 54.1% and 61.2% respectively; SNR and CNR increased gradually (F=1.42 and 3.15, P<0.05), SNR increased 26.6%, 40%, 71.1%, 117.7% and 153.3% respectively, while CNR increased 17.4%, 33.1%, 63.2%, 104.1% and 147.2% respectively. The differences among the 6 groups were statistically significant (P<0.05), subjective scores of SAFIRE 2-4 were higher than those of FBP, SAFIRE 1 and SAFIRE 5 group, while the difference among SAFIRE 2-4 group was statistically insignificant, reconstruction smoothness and edge sharpness of SAFIRE 3 group was better, with highest objective score.Conclusion Routine dose temporal bone HRCT scan combined with SAFIRE reconstruction can increase the image quality of temporal bone high resolution scan effectively, with the potential for radiation dose reduction.

Objective To establish a method for determining the dissolution oftorasemide sustained-release tablet in vitro and study the methodology of the determination.The consistency of the in vitro release behavior between self-prepared torasemide sustained-release tablet and original preparation were evaluated by constructed method.Methods HPLC method was applied to detect the cumulative release percentage of self-prepared torasemide sustained-release tablet and original preparation in five kinds of release media (water,0.1 mol/L hydrochloric acid solution,pH 4.5 acetate buffer,pH 6.8 phosphate buffer,and 0.1 mol/L hydrochloric acid solution turn to pH 6.8 phosphate buffer).Similarity factor (f2) was used to evaluate the similarity of release curves.Results There was a good linear relationship between the quality concentration of torasemide and peak area in the range of 1.0-12.0 μg/mL (r =0.9995).Results of precision and stability tests were good,and the RSDs for probational liquid were all lower than 2.0％.The average recovery of accuracy test was 100.04％,and RSD was 0.54％ (n =12).The homogeneity of within group of self-prepared preparation met the technical requirement,RSDs of each sampling points in six Dissolution Vessels were lower than 10.0％.The f2 factors of self-prepared torasemide sustained-release tablet and original preparation were 72,60,77,66,and 60 in five kinds of release media.Conclusion The method in the paper is suitable for the release test of torasemide,meanwhile,the self-prepared tablet shows consistent in vitro release behavior with that of the original preparation.

Objective To study the function of the toll-like receptor-4 (TLR-4) signaling pathway in the synthesis and secretion of pulmonary artery smooth muscle cells of rats with COPD. Methods The primary pulmonary artery smooth muscle cells (PASMCs) of rats with COPD were digested, separated and purified. Then they were randomly divided into control group, LPS group, TLR4 inhibitor group (TAK242) and LPS + TLR4 inhibitor group. RT-PCR, Western blot were used to detect the expression level of TLR-4 and NF-κB among groups. The levels of IFN-γ and PDGF-AB in supernatant with PASMCs in each group were detected by ELISA. Results LPS increased the expression of TLR-4、 NF-κB and the levels of IFN-γ and PDGF-AB. The expression of TLR4, NF-κB and the levels of IFN-γ and PDGF-AB were significantly reduced after inhibiting the expression of TLR4(P < 0.05). Conclusion TLR-4 signaling pathway involved in the inflammatory response and pulmonary vascular remodeling which increased the synthesis and secretion of IFN-γ and PDGF-AB in PASMCs. It provides a theoretical approach for the early intervention of clinical with COPD.

Objective To expore CT diagnostic values for hyaline-vascular type of giant lymph node hyperplasia(GLNH).Methods CT findings in 4 patients with hyaline-vascular type of GLNH confirmed by surgery and pathology were respectively analyzed and relevant literatures were reviewed.CT examination included plain and enhanced scan with contrast medium bolus injection.Results Lesions were located 2 at the posterior mediastinum,1 at the restroperitonum and 1 at the neck.The characteristic CT appearances were a large soft tissue mass round or oval in shape with homogenous density,well and regular margin.The masses were all markedly enhanced after contrast,their attenuation were similar to but slightly lower than the larger arteries in the same section.Conclusion GLNH is an uncommon disease and it′s clinical diagnosis is difficult.But CT scanning could showed some features.When CT found a mass with benign characters locating in lymph node regions,especially marked enhancement,Hyaline-vascular type of GLNH should be considered.

Objective:To compare the effects of dexmedetomidine and nicardipine in the induction of controlled hypotension in the pa-tients during orthognathic surgery.Methods:60 patients were randomly divided into 2 groups(n =30).The patients in group D were intravenously pumped with 1 μg/kg dexmedetomidine for 10 min followed by 0.2 ~0.7 μg/(kg·h).Those in group N were pumped with nicardipine for an initial dose of 0.75 μg/(kg·min)followed by 0.2 ~0.5 μg/(kg·min).HR,MAP were recorded before in-duction (T0 ),start of hypotension(T1 ),10 min(T2 ),20 min (T3 ),30 min(T4 )and 60 min(T5 )after hypotension,10 min(T6 ), 30 min(T7 )after stop of hypotension,and at the end of surgery(T8 ).The remifentanil dosage was recorded.Riker sedation-agitation score (RSAS)before extubation and Ramsay score 5 min after extubation were observed.Results:Comparing with T0 ,MAP at T2 -T7 in the 2 groups were significantly decreased(P <0.05).The intraoperative remifentanil consumption in group D was significantly lower than that in group N (P <0.05).The Ramsay score in group D was significantly higher than that in group N(P <0.05).The RSAS in group D was significantly lower than that in group N(P <0.05).Conclusion:Both dexmedetomidine and nicardipine are safe for con-trolled hypotension in providing ideal surgical field during orthognathic surgery.Dexmedetomidine can produce more stable hemdynamic indexes and offer more advantage in postoperative sedation.

Objective To analyze the clinical characteristics and therapy of levofloxacin-induced prolonged Q-T interval in patients with multi-drug resistant tuberculosis ( MDR-TB) . Methods Clinical materials of 6 patients with MDR-TB who developed prolonged Q-T/QTc interval caused by levofloxacin therapy were analyzed. Those cases were collected from the Tuberculosis Prevention and Control of Wuhan City form April 2010 to August 2014. Results The proportion of patients with levofloxacin-induced prolonged Q-T interval was approximately 3.0%.The condition occurred 2-8 months after the administration. The initial value of QTc interval ranged from 397 ms to 439 ms, while the average was (410.17±14.62) ms.The value of QTc interval was extended to 470-486 ms after treatment of levofloxacin, while the average was (476.33±6.16) ms.The increase of QTc interval was 47-85 ms, while the average was ( 66 ± 11. 48 ) ms. None of them developed Tdp. Conclusion The application of high dosage and long treatment course of levofloxacin in patients with MDR-TB could result in the extension of the Q-T/QTc interval, which should arouse our serious attention. In order to detect the abnormal Q-T/QTc interval in early stage, electrolyte level examination as well as ECG examination should be considered as routine tests before initiation of treatment and during the follow-up treatment.

Objective To evaluate the value of the SAFIRE reconstruction technique for the nasal traumatic lesions .Methods Six‐ty‐seven patients with nasal traumas were scanned by the orbital scan and were reconstructed with FBP and SAFIRE (strength grade 1 to 5) respectively .Then a comparative analysis for six kinds of reconstructed images were conducted on the average CT value ,noise ,signal to noise ratio (SNR) ,contrast to noise ratio (CNR) ,subjective scoring and lesion detection .Results Compared with reconstruction by FBP , SAFIRE (strength grade 1 to 5)reconstruction ,for the noise ,decreased to 20 .4% ,31 .4% ,39 .7% ,46 .5% and 57 .2% respectively ;For the SNR ,increased to 33 .3% ,54 .7% ,75 .4% ,87 .4% and 101 .4% respectively ;For the CNR ,it also increased to 23 .0% ,36 .4% ,57 .7% , 87 .4% and 106 .5% respectively ;The difference was statistically significant (P< 0 .05) .For the images of SAFIRE‐1 and SAFIRE‐5 ,the image subjective scoring was lower than that by FBP ;for the images of SAFIRE‐2 and SAFIRE‐4 ,the image subjective scoring was higher than that by FBP ;and SAFIRE‐3 had the highest score .But for the rate of lesion detection ,all the images were the same .Conclusion CT scan combined SAFIRE reconstruction technique can decrease effectively the noise and increase the image quality in the traumatic nasal scan , as well as has a potential effect to decrease the scan dose .

Purpose To explore the value of low tube voltage, original data iterative reconstruction (SAFIRE) and intelligent optimum tube voltage scanning (CARE kV) technology in reducing radiation dose of high resolution CT (HRCT) temporal bone scanning and its impact on image quality. Materials and Methods Ninety patients with ear problem underwent clinical HRCT scan. All the patients were randomly divided into group A (conventional scanning), group B (CARE kV) and group C (low tube voltage) according to chronological order, with 30 cases in each group. Image quality was double-blind scored by two qualified radiologists. CT value, noise, contrast to noise ratio (CNR), signal to noise ratio (SNR), CT dose index volume (CTDIvol), dose-length product (DLP) and effective dose (ED) were compared among three groups. Results Image quality and the average CT value had no statistical difference among three groups (F=3.70, 3.61;P>0.05);noise, CNR, SNR, CTDIvol, DLP and ED had statistical difference among three groups (F=1.23, 1.42, 2.05, 2.13, 1.79, 1.32; P<0.05). Compared with group B, noise reduced about 14.1%in group C, while CNR and SNR increased about 32.1%and 26.3%, respectively (q=3.64, 3.45, 4.36; P<0.05). CTDIvol, DLP and ED were significantly different between group B and group C (q=3.13, 4.24, 4.24; P<0.05). Conclusion Scanning with low tube voltage, SAFIRE and CARE kV technology not only effectively reduce radiation dose, but also obtain satisfactory image quality. It should be widely utilized.

Objective To study the maternal blood glucose management of gestational diabetes mellitus during the labor and relationship of maternal blood glucose in labor and neonatal blood sugar. Methods A prospective study on maternal blood glucose monitoring and control during labor was carried in 40 pregnant women with abnormal glucose metabolism. We adjusted maternal blood glucose by low-dosage constant insulin drop during labor. Results Maternal blood glucose in labor arranged between 3.8 ～ 11.2 mmol/L,and low-dosage constant insulin drop was used in 17 cases (42.5%). The neonatal blood glucose was (4.0?1.5)mmol/L following delivery and (3.9?1.0)mmol/L at 24-hour postpartum. There were 2 cases with neonatal hypoglycemia. The neonatal blood glucose of the rest 23 cases was (4.2?1.5)mmol/L,and (3.9?1.0)mmol/L at 24-hour postpartum,and 1 case with neonatal hypoglycemia. There was no the difference of the blood glucose level of newborns between mothers with abnormal glucose metabolism and the normal pregnant women. Conclusion It is necessary to monitor and control the blood glucose level by low dose constant insulin during labor in pregnant women with abnormal glucose metabolism.