Objective To evaluate the peripheral dose (PD) from megavoltage cone-beam CT (MVCBCT) imaging for head-and-neck region image-guided radiation therapy,to determine the correlation of PD with monitor unit (MU),and to investigate the impact of imaging field size on the PD.Methods Measurements of PD from MVCBCT were made with a 0.65 cm3 ionization chamber placed in a specially designed phantom at various depths and distances from the field edges.The PD at reference point inside the phantom was measured with the same ionization chamber to investigate the linearity between MU used for MVCBCT and the PD.The homogeneity of PD in the axial plane of the phantom were measured.Results PD from MVCBCT increased with increasing number of MU used for imaging and with increasing the field size.The measured PD in the phantom decreased exponentially as distance from the field edges increased.PD also decreased as the depth from the phantom surface increased.There was a strong linear relationship between PD and MUs used for MVCBCT.The PD was heterogeneous,with higher dose at the anterior than the posterior.Conclusions The PD from MVCBCT depend much on the MVCBCT delivery MU and the scan field size.In clinic,using the smallest number of MU allowable and reducing MVCBCT scanning field size without compromising acquired image quality is an effective method of reducing the PD.

Objective: To observe the effect of Yi Jin Jing (Sinew-transforming Qigong Exercises) plus tuina on the neck for stiff neck. Methods: A total of 60 patients with stiff neck who met the screening criteria were selected and randomly divided into two groups, with 30 cases in each group. Patients in the control group received tuina on the neck, 30 min every time, once a day, while patients in the observation group practiced Yi Jin Jing (Sinew-transforming Qigong Exercises) plus the same tuina therapy as the control group, and Yi Jin Jing (Sinew-transforming Qigong Exercises) was conducted for more than 30 min every time, once a day. Visual analog scale (VAS) scores were observed before treatment, and after 1 time, 3 times and 5 times of treatment to evaluate the degree of neck pain. Results: During the treatment, each group had 2 dropouts. After treatment, the total effective rate was 92.9％ in the observation group versus 82.1％ in the control group, showing a statistical significance (P<0.05). The VAS scores in the observation group at the three time points were significantly lower than those in the control group (all P<0.05). Conclusion: Yi Jin Jing (Sinew-transforming Qigong Exercises) plus tuina on the neck can effectively relieve neck pain and improve cervical range of motion in patients with stiff neck, and can achieve a better effect than tuina alone.

Chronic kidney disease (CKD) is a serious chronic disease with high incidence, poor prognosis, and a variety of complications. Indoxyl-sulfate (IS) and p-cresol sulfate (PCS) are two typical gut-derived uremic toxins, which are produced by the co-metabolism of intestinal microbes and the host. With the progression of CKD, gut-derived uremic toxins such as IS and PCS accumulate in patients with CKD and thereafter accelerate the progression of CKD. Gut microbiota is closely related with CKD, and targeting gut microbiota to regulate gut-derived uremic toxins synthesis and metabolic pathways may be a promising strategy to delay the progression of CKD. In this paper, the relationship between gut microbiota, gut-derived uremic toxins, and CKD was analyzed, and the strategy to delay the progression of CKD by targeting gut microbiota and uremic toxins metabolism pathway was proposed.

Hepatic encephalopathy is a common metabolic neuropsychiatric syndrome in the development of end-stage liver disease. Since the concept of intestinal-liver-brain axis was proposed, the relationship between the pathogenesis of hepatic encephalopathy and the gut microbiota has been a hot research topic. In recent years, studies have confirmed that gut microbiota is involved in and affects various pathological processes of hepatic encephalopathy. This article combines the latest research progress at home and abroad to elaborate on the research status of regulating gut microbiota and thus interfering with the pathological process of hepatic encephalopathy, hoping to provide new ideas and methods for the intervention of hepatic encephalopathy based on the regulation of gut microbiota.

Objective To explore the effects of the Chinese medicine, modified Erchen decoction, on the serum lipid spectrum of ApoE-/-mice, and to explore its possible anti-atherosclerotic mechanism.Methods Forty-four male 7-8-week old ApoE-/-mice were used in this experiment.ApoE-/-mouse models of atherosclerosis were generated by high-cholesterol diet for 4 weeks.And then, they were given simvastatin or modified Erchen decoction by gavage.The body weight of mice was recorded every week, The mice were sacrificed after treated with the drugs for 8 weeks continuously, and the plasma lipid was determined by enzymatic method.The aortic valves and arches were stained with oil red O to depict atherosclerotic plaques and liver structural changes of the mice were examined by pathology.Results Modified Erchen decoction lowered plasma lipid ( including TCHOL and LDL-C ) significantly ( P<0.01 ) .The body weight was increased in the mice of all groups, but it was more pronounced in the mice of model group than in the blank and modified Erchen decoction groups.The serum CHOL and LDL-C levels were significantly lowered in the modified Erchen decoction group (P<0.01).The area of atherosclerotic plaques in the aortic wall was significantly reduced in the mice of modified Erchen decoction group as shown by oil red O staining.The pathological changes of hepatocytes were less severe and the structure of hepatic lobules was better preserved in the mice of modified Erchen decoction group.Conclusions The Chinese medicin modified Erchen decoction can effectively reduce serum lipids, regulate lipid metabolism, and ameliorate the process of atherosclerosis in ApoE-/-mice.

Objective To observe the effects of platelet-rich plasma (PRP) gel in the treatment of [Ⅳ stage pressure ulcers.Methods A total of 12 patients with stage Ⅳ pressure ulcers were treated with PRP gel from December 2012 to December 2013 in our department.The PRP gel was formed by autologous PRP mixed with thrombin and calcium chloride.The PRP gel was applied to the wound after dressing.Time intervals between dressing were 4 days.Overall pressure ulcer improvement was assessed every week until complete wound healing.Results All stage Ⅳ pressure ulcer wound infection was controlled and fresh granulation tissue was found after 2 times of PRP gel covering.The time of ulcer wound healing were 6-10 weeks (mean 8 weeks).The times of changing the PRP gel were 16.No patients experienced adverse reactions during treatment.Conclusions PRP gel can effectively control the pressure ulcer infection and promote ulcer wound healing.

Objective To investigate the clinical significance.of thrombocytopenia in systemic lupus erythematosus (SLE).Methods One hundred and two SLE patients with thrombocytopenia who were admitted to Peking University People's Hospital were involved in the study.SLE patients without thrombocytopenia were controls.Clinical and laboratory characteristics were analyzed.T-test and Chi-square test were used for inter-group comparison.Results Patients with thrombocytopenia had more organ damage than those without,although the disease activities (SLEDAI) were not different between these two groups.Bone marrow characteristics were analyzed and 16 patients were amegakaryocytic.However,there were no differences observed between patients with amegakaryocytosis and normal megakaryocytes in organ damage,disease activity and response to therapy.Conclusion Lupus patients with thrombocytopenia usually have more organ damage.About 32％ of those patients are amegakaryocytosis.

Objective To assess the diagnostic value of CT spectral imaging using quantitative iodine-based material decomposition images in the evaluation of pulmonary embolism. Methods Fifty-three patients underwent CT angiography with spectral imaging mode on a GE Discovery CT750HD scanner. Iodine distribution in the lung parenchyma using the iodine-based material decomposition images was quantitatively measured by post-processing. Monochromatic CT angiographic images were reconstructed from the same data sets and thee images were reviewed for the identification and localization of pulmonary embolism as well as the degree ( partial or complete) of the embolic occlusion. The number and location of perfusion defects were recorded. The iodine content of perfusion defects and normal lung parenchyma on the iodine maps were measured by one reader using an ROI analysis. Comparative analyses were obtained using the Chi-square test for categorical data. Two independent samples rank test and 2 related samples signed-rank test were used to compare iodine densities between different groups. Results CT angiography showed no pulmonary embolism in 33 patients, and iodine distribution was homogeneous. A total of 93 clots with lobar ( n = 26), segmental (n = 54) and sub-segmental (n=13) distribution were detected in 19 patients; Fifty-one clots were occlusive and 42 clots were non-occlusive. The iodine-based material decomposition images of all occlusive clots showed lobar, segmental or sub-segmental iodine distribution defects; whereas eleven of 42 non-occlusive clots had evidence of iodine distribution defects. There was significant difference ( x2 = 39. 94,P＜0. 01 ) in the perfusion defects between occlusive and non-occlusive clots. There was a significant difference in iodine content between normal lung parenchyma [ (1.92 ±0. 54) g/L] and perfusion defects [ (0. 30 ± 0. 20)g/L] (Z= -5.63, P ＜ 0. 01 ). There was a significant difference in the iodine content of peffusion defects before [ (0. 26 ± 0. 23 )g/L] and after anticoagulation [ (0. 94 ± 0. 50 )g/L ] ( Z = -3.93,P ＜ 0. 01 ). Conclusion With the ability of iodine mapping, CT spectral imaging is areliable method in the evaluation of pulmonary embolism both qualitatively and quantitatively, and may be a useful tool in providing information regarding the severity of PE and monitoring therapeutic efficacy.

Retrospective analysis was performed for the clinical data of 15 chronic insertion achilles tendinitis patients undergoing platelet-rich plasma (PRP) trigger point injection.The scores of Validated Victorian Institute of Sports Assessment-Achilles (VAS-A) and foot function index (FFI) improved greatly versus pre-treatment (all P ＜ 0.05).Tendon insertion structure inflammation decreased significantly on magnetic resonance imaging.At the last follow-up,all patients recovered normal gait and daily activity.The trigger point injection of PRP is efficacious for chronic insertion achilles tendinopathy.

Objective To investigate the influence of electrocardiogram(ECG)-controlled dose modulation on exposure dosage and image quality of cardiac CT imaging in a cardiac phantom with simulated fluctuant heart rate.Methods The basal heart rate of the cardiac pulsating phantom was set as 60 bpm.the experimental situations were divided as 6 groups according to different heart rates.The cardiac imaging was performed on the cardiac phantom when the ECG-controlled dose modulation was firstly turned off.The exposure dosage of each scan sequence was documented.The standard deviation of the CT values of the phantom was measured on the central slice after coronal reformation of the raw data.The quality of 2D and 3D images were scored.Thell cardiac imaging was performed when ECG modulation was on and set as four groups according to different modulation parameters.All the data were documented as before.The results from the five groups with and without ECG modulation current were analyzed bv F test and comparative rank sum test using the statistical software SPSS 10.0.Results Statistical analysis showed no significant difference(P＞0.05)between the SNR of images(SD value was 27.78 and 26.30)from the groups that full mA output at wide reconstruction phase(69%～99%)when the heart rate was fluctuant(≥7.5 bpm).There was also no significant difference(P＞0.05)between the quality of the 2D and 3D images.But there was a significant difference(P＜0.01)between the SNR of images(SD value was 26.78 and 29.90)that full mA was only used at 85%reconstruction phase when the heart rate Was fluctuant(≥7.5 bpm).The exposure dosage was remarkably reduced when the ECG modulated current was on than when it Was off under fluctuant heart rate.Furthermore.there were significant difierence(P＜0.01)among the difierent ECG modulated current parameter groups.The exposure dosage can be reduced by 44.7%under the situation that the heart rate was fluctuant.Whell the fluctuation of the heart rate was≤12.5 bpm,there wag no obvious relationship between the fluctuation of the heart rate and the exposure dosage (the variation was from 0.1 to 1.1 mSv),but if the heart rate fluctuation was＞12.5 bpm,the exposure dosage would increase obviously (from 0.6 to 1.7 mSv).Conclusion For cardiac imaging with 16-slice row CT,the application of ECG modulated current can effectively reduce the exposure dosage without compromising the image quality even if heart rate was fluctuant.