Objective:To investigate the clinical efficacy and safety of entecavir combined with triple viable bifidobacterium capsules in the treatment of patients with cirrhosis induced by chronic hepatitis B.Methods:Totally 86 chronic hepatitis B patients with cirrhosis were randomly divided into the observation group and the control group with 43 ones in each.The control group was given entecavir treatment,and the observation group was treated with triple viable bifidobacterium capsules additionally.The treatment course was three months.The effect of treatment,changes of liver function(TBiL,AST,ALT,etc.),liver fibrosis level (HA,PCⅢ,LN,etc.)and adverse events were compared between the groups before and after the treatment.Results:The total effective rate of the observation group was higher than that of the control group (P<0.05);the levels of TBiL,AST and ALT decreased in both groups after the treatment (P<0.05),and those in the observation group were lower than those in the control group (P<0.05);the levels of HA,PC III and LN decreased in the two groups after the treatment (P<0.05),and those in the observation group were lower than those in the control group (P<0.05);there were no significant adverse drug reactions in both groups during the treatment course.Conclusion:Entecavir combined with triple viable bifidobacterium capsules in the treatment of patients with cirrhosis induced by chronic hepatitis B exhibits significant clinical efficacy,which can improve liver function and liver fibrosis with promising safety and without significant adverse reactions.

Adenoviridae ; immunology ; Antigens, Viral ; analysis ; Child ; Fluorescent Antibody Technique ; Humans ; Respiratory Syncytial Viruses ; immunology ; Respiratory Tract Infections ; immunology ; Respirovirus ; immunology ; Virus Diseases ; immunology

Objective To evaluate the feasibility of model-based iterative reconstruction (MBIR) in low-dose chest CT (80 kV) examination in children.Methods Forty-four children who had post-operation scoliosis and received low dose chest CT scans were included.The fix tube voltage was 80 kV,fix current was 50 mA.Images were reconstructed with MBIR (observation group).The pre-operation scan were used 120 kV and 50 mA for acquisition,and images were reconstructed with filtered back-projection (FBP) mehed (control group).The subjective quality of the images was independently evaluated by two radiologists.Objective noises in the muscle and lung field were measured,the SNR,CNR were calculated,and the CTDIvol was record.Results The subjective noise score in the observation group was significantly higher than that in the control group (P＜0.05).Objective noise reduced about 40.36％,SNR increased 72.37％,CNR increased 78.69％,CTDIvol decreased by 66.52％,all of which had statistical difference between both groups (all P＜0.001).Conclusion Low-dose chest CT (80 kV) examination in children can meet the requirements of diagnosis for children.

Objective To explore the value of snapshot freeze (SSF) technique in coronary CTA (CCTA) in pediatric patients with high heart rates. Methods Totally 50 children whose heart rate were ≥ 75 times per minute were selected and underwent CCTA. The raw data were reconstructed into 4 groups. The best phase in group A was manually selected without SSF technique, in group B was manually selected with SSF, in group C was automatically selected (Smart Phase) without SSF, while in group D was automatically selected with SSF. The image quality scores and diagnostic rates of coronary artery were compared among 4 groups. Results Totally 675 branches were assessed in 50 patients. There was no significant difference of left circumflex artery (LCX) image quality scores nor diagnostic rates among 4 groups (both P>0.05). There were significant differences of right coronary artery (RCA), left anterior descending (LAD), total coronary artery scores and diagnostic rates (all P<0.05). Significant differences of RCA and coronary artery scores were found (both P<0.01), while no significant difference of LAD scores was detected (P=0.08) between group A and B. There were significant differences of LAD and coronary artery diagnostic rates (both P<0.01), while no significant difference of RCA diagnostic rates was found (P=0.08) between group A and B. Significant differences of RCA, LAD and coronary artery scores and diagnostic rates were observed between group C and D (all P<0.05). Conclusion SSF technique can improve image quality of CCTA in children with high heart rate.

Objective:To understand the current situation of CT radiation dose in children all over our country, and to explore the diagnostic reference level (DRL) of CT in children.Methods:The radiation dose reports of pediatric CT examination were collected end to November 30, 2021 and divided into five age groups: 0-1 month,>1 month-4 years,>4-10 years,>10-14 years and >14-18 years. There were 9 scanning item such as head, nasal sinus, temporal bone, neck, chest, abdomen, head enhanced CT, chest enhanced CT and abdomen enhanced CT. In each item, volume CT dose index (CTDI vol) and dose length product (DLP) were selected as radiation dose parameters, the 75% percentile were selected for DRL. The DRL results of head, chest and abdomen were compared with the DRL published by Chinese Society of Radiology and European Commission. Results:From March 2019 to November 2021, a total of 33 hospitals in 23 provinces were collected, including 20 children′s specialized hospitals, 11 women′s and children′s hospitals and 2 general hospitals, including 19 135 children′s CT scans. The DRL of 45 subgroups according to 5 age groups and 9 scanning items were obtained. The DRL results showed that the CTDI vol in five age groups was 26.9-42.8 mGy, and the DLP was 347-694 mGy·cm for head; 3.5-8.0 mGy, 54-293 mGy·cm for chest; and 6.3-13.2 mGy, 155-564 mGy·cm for abdomen. The DRL of the age group >4-10 years group in this investigation was agreed to the DRL of Chinese Society of Radiology. Compared with the European guidelines, there was little difference in the radiation dose of head scan, while the radiation dose of chest and abdomen in the young age group increased significantly. Conclusion:This survey reveals the radiation dose level distribution of children CT in our country. The radiation dose level of some items was inconsistent with the DRL of relevant international organizations. So our own DRL is needed to be set up according to the actual clinical reality of our country as a guideline.

Objective:To demonstrate whether image quality and measurement accuracy of vessel wall thickening could be improved using a deep learning image reconstruction (DLIR) algorithm in children with Takayasu arteritis.Methods:From September 2019 to April 2020, 32 patients with Takayasu arteritis underwent low-dose contrast-enhanced CT with 100 kVp in Beijing Children′s Hospital were enrolled retrospectively. The raw data were reconstructed at 0.625 mm slice thickness using the filtered back projection (FBP), 50% adaptive statistical iterative reconstruction-V (ASIR-V) at 50% (50%ASIR-V), ASIR-V at 100% (100%ASIR-V) and DLIR. Subjective evaluation including the image quality of vessel wall identification, overall image noise and diagnostic confidence were evaluated using a 5 points scales by 2 observers. Objective evaluation including the thickness and standard deviation of vessel wall were measured, then the coefficient of variation (CV) was calculated. The CT value and noise of aorta were measured to calculate the contrast to noise ratio (CNR) of image. Friedman test was used to compare the differences of subjective scores among the four groups, and the analysis of variance of random blocks was used to compare the differences of objective measurement indices.Results:In terms of subjective score results, there was no significant difference between 100%ASIR-V and DLIR of overall image noise ( P>0.05), and the image scores of the two groups were higher than those of FBP and 50%ASIR-V (all P<0.05). The vessel wall identification and diagnostic confidence of DLIR were higher than those of other images (all P<0.05). The objective measurement results showed that the standard deviation and CV of vessel wall thickness in DLIR were significantly lower than those in other images (all P<0.05). There was no significant difference in vascular noise, muscle noise and CNR between 100%ASIR-V and DLIR (all P>0.05), which were lower than those in FBP and 50%ASIR-V (all P<0.05). Compared with 50%ASIR-V, the CV of DLIR was reduced by 22.9%, and the CNR was increased by 46.8%. Conclusion:DLIR can improve the overall image quality of CECT in children with Takayasu arteritis and the measurement accuracy of vascular wall, making it possible to further reduce the radiation dose.

Purpose To evaluate the image quality improvement of deep learning iterative reconstruction(DLIR)on pediatric head CT images of head injury and to evaluate the performance of DLIR and conventional adaptive statistical iterative reconstruction-veo(ASIR-V)of noise and image texture of CT image in children's head trauma.Materials and Methods A total of 80 cases in Beijing Children's Hospital,Capital Medical University from December 7th to 11th 2020 of children's head low-dose CT were retrospectively selected.Scan voltage was 120 kV.Scan current was 150-220 mA.The raw data were reconstructed into 5 mm thick slice and 0.625 mm thin slice brain window and bone window images.50%ASIR-V and high weight DLIR images(DL-H)were reconstructed,respectively.A 4-point system was used to subjectively evaluate the display of sulcus,brain matter and bone.The number of lesions in each group was counted.The CT value and image noise values of gray matter and white matter were measured,and the contrast to noise ratio was calculated,then measured the blur metric index was measured in the same slice.The differences between the two image reconstruction methods were compared.Results Compared to 50%ASIR-V images,DL-H significantly improved the display ability of the sulcus and ventricles,as well as the display ability of the brain parenchyma(W=5.5-22.2,all P<0.05)in both slice thickness.There was no statistically significant difference in the display ability of the sulcus and ventricles between 5 mm 50%ASIR-V and 0.625 mm DL-H images(W=0.9,2.0,P=0.32,0.05,respectively).In terms of bone display ability,all images could achieve a maximum score of 4.0.A total of 35 lesions were found in 80 patients via 5 mm 50%ASIR-V and DL-H images,including 12 hemorrhagic lesions,1 intracranial gas,9 fractures,and 13 soft tissue swelling.In terms of objective evaluation,the noise level of DL-H images was significantly lower than that of 50%ASIR-V images(t=21.4-35.7,all P<0.05),and there was no statistically significant difference in noise and contrast noise ratio between 5 mm 50%ASIR-V and 0.625 mm DL-H images(t=1.7-2.2,all P≥0.05).The blur metric index showed that DL-H was superior to 50%ASIR-V images(t=6.1,10.0,both P<0.05),and there was no statistically significant difference in blur metric index between 0.625 mm DL-H and 5 mm 50%ASIR-V images(t=2.6,P=0.28).Conclusion DLIR can improve the CT image quality and image texture of children's head trauma,0.625 mm DL-H image quality is close to 5 mm 50%ASIR-V image,which can meet the diagnostic requirements,and possible to further reduce the radiation dose.

Objective To explore the effect of cannabinoid receptor 2(CB2)on orthodontic tooth movement(OTM)rate and periodontal tissue reconstruction of pressure area in mice.Methods Thirty CB2-/-male mice and thirty littermate control WT male mice were individually accepted the orthodontic appliance at their age of 6 weeks.The mice were respectively scarified at 3 days,7 days,14 days and 21 days after the operation.Then the tooth movement distance was examined through the stereomicroscope.Hematoxylin-eosin staining was performed to explore the biological responses of periodontium at the distal mesial root pressure area.Anti-tartrate acid phospha-tase staining was performed to calculate the number and distribution of osteoclasts at the distal mesial root pressure area,and MMP-9 was evaluated by immunohistochemistry to examine the number of MMP-9(+)monocytes and multinucleated cells in the same district as the TRAP staining.Results Compared with those WT mice at 3,7,14 and 21 days,OTM distance showed a gradual increased tendency according with experimental time over 21 days.The widths of periodontal ligament on the pressure side were markedly greater in CB2-/-mice than WT mice at 7,14 and 21 days(P＜0.000 1).The numbers of TRAP positive osteoclasts were significantly greater in CB2-/-mice than those in WT mice at 14 days of OTM(P＜0.001).MMP-9 immunohistochemical staining showed that the number of MMP-9(+)monocytes and multinucleated cells was more in CB2-/-mice than that in WT mice at 14 days of OTM(P＜0.05).Conclusion The absence of CB2 accelerates orthodontic tooth movement under or-thodontic force.The absence of CB2 reinforces bone resorption in orthodontic tooth movement compressive area dur-ing orthodontic tooth movement.

Objective To assess the feasibility of low concentration contrast medium (270 mgI/ml) and low radiation dose (100 kV) for enhanced CT scanning in infants and young children abdominal CT examination.Methods Ninety children with abdomen tumors or abdominal injuries who underwent contrast-enhanced CT examination were selected.The patients were divided into 3 groups (each n＝ 30):Group A with tube voltage of 120 kV for non-contrast enhanced and parenchymal phase scanning and iodixanol contrast-medium (320 mgI/ml);group B with tube voltage of 100 kV for non-contrast enhanced and parenchyrnal phase scanning and iodixanol contrast-medium (270 mgI/rnl);group C with tube voltage of 100 kV for non-contrast enhanced and parenchymal phase scanning and iodixanol contrast-medium (270 mgI/ml).The 4-point scale was used to evaluate the quality of parenchymal phase imaging.The standard difference (SD) of CT value in subcutaneous fat,SNR and CNR of liver parenchyma,splenic parenchyma,renal cortical,renal vein,and abdominal aorta were measured at parenchymal phase,and CT dose index of volume (CTDI,ol),dose length product (DLP) and effective dose (ED) were recorded.The data were statistically analyzed among 3 groups.Results There was no significant difference of SNR,CNR nor objective scores of liver parenchyma,splenic parenchyma,renal cortical,renal vein and abdominal aorta among 3 groups (all P＞0.05).The differences of CTDIvol,DLP and ED among 3 groups were statistically significant (all P＜0.01).The CTDIvol had no statistical difference between group B and group C (P ＝ 0.001,0.002),DLP (P ＝ 0.013,0.004) and ED (P ＝ 0.03,＜0.001) of group A had statistical difference with those of group B and C.Conclusion CNR of the abdominal image can be guaranteed using low concentration contrast medium (270 mgI/ml) combined with 100 kV tube voltage for CT scanning of infants and young children,therefore satisfying clinical diagnostic requirements.

OBJECTIVE To provide reference for chronic disease management in grass-root institution . METHODS System structure design and audit class setting of the regional pretrial center in Changning district of Shanghai were introduced. The number of prescriptions/medical orders from the start of application to February 28，2022 were counted. The prescriptions/medical orders intercepted by the system ，prescriptions/medical orders intervened by physicians ，chronic disease types and drug use of regional multiple chronic diseases were counted and analyzed. RESULTS Compared with the data when the center was on line in September 2021，total qualified rate of prescriptions/medical orders （97.67％ vs. 86.42％）significantly increased ，the number of prescriptions/ medical orders intercepted by the system and intervened by physicians decreased by 55.39％ and 72.67％ in February 2022， respectively. The top five diseases were hypertension （26.52％），coronary heart disease （20.53％），sleep disorders （16.71％），diabetes（15.24％）and bone diseases （14.09％）. Among them ， there were many problematic prescriptions involving coronary heart disease ，sleep disorder and bone disease. CONCLUSIONS The incidence of chronic diseases among community residents remains high. In addition to common chronic diseases such as coronary heart disease ，hypertension and diabetes ，the incidence of sleep disorders and bone diseases is also increasing. With the help of the regional pretrial center ，the focus of chronic disease management can be adjusted timely ，drug supervision can be carried out in real time so as to improve the level of rational drug use in grass-root institution.