Objective To evaluate the influence of integrated-CT artifacts on attenuation-corrected (AC) images of SPECT bone imaging. Methods Imaging documents of 78 patients who underwent SPECT/CT bone imaging were retrospectively analyzed, and the artifacts on CT images and CT attenuation maps were visually studied. Compared with the non-attenuation corrected (NC) images, the coefficient of variation (CV) and percentage difference (PD) of radioactive count of regional bone influenced by CT artifacts were calculated and statistically analyzed to estimate the influence of CT artifacts on AC images of SPECT bone imaging. Results The integrated-CT artifacts were found in 38 patients of 78, and appeared the same image findings as those on CT attenuation maps respectively, including truncation artifact, thoraco-abdominal gas artifact, photon starvation artifact, etc. On all the AC images with integrated-CT artifacts, regional bones were influenced not only on uniformity (CVAC 17.62%±4.13%, CVNC 11.19%±3.81%;t=2.13, P<0.05), but also by the distribution (PDAC 16.98%±3.31%, PDNC 9.84%±1.62%;t=2.46, P<0.05) of radioactive count. Conclusion Artifacts on integrated-CT images can induce false AC information on CT attenuation maps, therefore, a comparative analysis with NC images is recommended if necessary.

Objective To compare the safety and efficacy of intravenous thrombolysis for patients with acute cerebral infarction in a second-grand class-A hospital and a third-grand class-A hospital. Methods Twenty-one consecutive patients with cerebral infarction treated with alteplase for intravenous thrombolysis were enrolled in a second-grand class-A hospital (Fengtai Hospital,Beijing)prospectively from January 2012 to December 2013 as the study group,and 65 patients in a third-grand class-A teaching hospital (Xuanwu Hospital,Capital Medical University,Beijing)admitted at the same period for intravenous thrombolysis were used as a control group. The differences of efficacy and safety of intravenous thrombolysis in patients of both groups were compared. The primary outcome measures were Barthel Index (BI)at day14 after onset and the modified Rankin Scale (mRS)scores at discharge. The main safety indicator was the incidence of serious adverse events (SAEs)after thrombolysis (symptomatic intracranial hemorrhage and death). Results (1 )In the primary outcome measures,the proportions of mRS≤2 at discharge in the study group and the control group were 71. 4%(n=15)and 58. 5%(n=38)respectively. At day 14 after thrombolysis,the proportions of BI ≥60 were 61. 9%(n=13)and 64. 6%(n=42)respectively. There were no significant differences between the two groups (P>0. 05). (2)The incidences of the primary serious adverse events were 4. 8%(n=1)and 6. 2%(n=4). There was no significant difference (P>0. 05). Other secondary outcome measures,such as the early reperfusion rate,recanalization rate,and the proportion of neurological improvement at day 14 after thrombolysis and the overall incidence of cerebral hemorrhage had no significant differences. The case referral proportion (9. 5%,n=2)of the study group had a trend of lowering than the control group (27. 7%,n=18)P=0. 09. (3)The out-hospital time delay, in-hospital time delay,and overall time delay of the study group were less than those of the control group, and the mean time was 75 ± 33 vs. 102 ± 50 min,and 72 ± 41 vs. 111 ± 38 min,147 ± 41 vs. 212 ± 47 min. There were significant differences (P<0. 01). Conclusion The second-grand hospital selected by our study can relatively safely and effectively perform intravenous thrombolysis for acute cerebral infarction with alteplase. Moreover,the intravenous thrombolysis of the second-grand hospitals may reduce the case referral ratio and visiting time.

Objective To investigate the relationship of stress hyperglycemia,cystatin C and estimated glomerular filtration rate (eGFR) with short-term prognosis in elderly patients with acute myocardial infarction.Methods 242 consecutive patients with acute myocardial infarction were divided into two groups according to age:the elderly group (n=182),and the non elderly group (n=60).The clinical data including cystatin C (Cys C),eGFR and stress hyperglycemia levels were collected.The major adverse cardiovascular events (MACE) were observed during hospitalization and 30 days after discharge.Results The incidences of stress hyperglycemia,the levels of creatinine,Cys C and brain natriuretic peptide (BNP),as well as the total MACE were higher and eGFR was lower in elderly group than in non-elderly group (all P＜0.05).Cys C level was positively correlated with age,body mass index and levels of creatinine and BNP (all P＜0.05),and negatively correlated with fasting glucose and eGFR in elderly group (both P＜0.05).The eGFR was positively correlated with body mass index (P＜0.05),and negatively correlated with age,creatinine and BNP levels in elderly group (all P＜0.05).Logistic regression analysis indicated that stress hyperglycemia [OR=1.871,95％CI:1.071-3.269,P=0.03],Cys C [OR=7.093,95％CI:2.261-22.249,P=0.00] were the independent risk factors for MACE.Conclusions Cys C level and eGFR can predict the early renal dysfunction and its prognosis in elderly patients with acute myocardial infarction.The incidence of stress hyperglycemia is higher in the elderly,and stress hyperglycemia and Cys C level are the independent risk factors for MACE.

Objective To discuss the application of different types of bronchial arteriography catheter in performing bronchial artery embolization (BAE) for the treatment of hemoptysis.Methods The clinical data of a total of 97 patients with hemoptysis,who received BAE during the period from January 2013 to May 2016,were collected.According to angiographic findings in aspect of the opening and running direction of the arteries causing bleeding,the responsible arteries were divided into 4 types:upward opening,horizontal opening and running upwards,horizontal opening and running downwards,and downward opening.For each responsible artery,appropriate angiography catheter was selected from the following catheters:MIK catheter,left gastric artery catheter,Cobra catheter,Simmon-1 catheter and Simmon-2 catheter.With super-selective catheterization technique the selected suitable catheter was inserted into the responsible artery and angiography was subsequently performed.The effect of the selection of bronchial arteriography catheter in performing BAE for hemoptysis was analyzed.Results A total of 180 responsible arteries were detected in 97 patients.Of the 180 responsible arteries,artery with upward opening was seen in 42,artery with horizontal opening and running upwards was found in 54,artery with horizontal opening and running downwards was observed in 46,and artery with downward opening was detected in 38.The success rates of super-selective catheterization for MIK catheter,left gastric artery catheter,Cobra catheter and Simmon catheter were 83.3％ (35/42),92.6％ (50/54),87.0％ (40/46) and 89.5％ (34/38,including 30 Simmon-1 catheters and 4 Simmon-2 catheters) respectively.After BAE,the responsible arteries were occluded in all patients,and hemoptysis stopped immediately.The recurrence rate at 6 months after BAE was 7.2％ (7/97).Conclusion For the treatment of hemoptysis,BAE is safe and effective.The key point to ensure a successful BAE is that the selection of appropriate catheter should be based on the opening and running direction of the artery causing bleeding.

Objective To observe the degradation time and the intimal hyperplasia of biodegradable magnesium alloy stent (MPM) implanted in the abdominal aorta of experimental rabbits.Methods A total of 24 New Zealand white rabbits were randomly divided into four groups (30 d,60 d,90 d and 180 d) with 6 rabbits in each group.In cach rabbit one MPM stent was implanted in the abdominal aorta at the level of one cm below the left renal artery.Reexamination of abdominal aortography with DSA was separately performed at 30,60,90 and 180 d after stent implantation to check the stent condition.The rabbits of each group were sacrificed at the corresponding scheduled day,the stenting segment of aorta of each rabbit was removed and the specimen was sent for microscopic examination.The experimental results were analyzed with SPSS20.0 software.Results All the 24 experimental rabbits survived.During the follow-up period the stent showed gradual degradation changes,and basically complete degradation was not observed until to 180 days.Meanwhile,the intimal hyperplasia reached its peak at 90 days after implantation.The abdominal aorta remained unobstructed during the whole process of degradation.Conclusion The time of complete degradation for MPM stent is 182 days,which is long enough to meet the needs of vascular positive remodeling.

Chronic Disease ; Drugs, Chinese Herbal ; administration & dosage ; adverse effects ; therapeutic use ; Humans ; Male ; Prostatitis ; drug therapy ; Randomized Controlled Trials as Topic ; Suppositories

OBJECTIVETo compare the results of extended vertical partial laryngectomy (similar to modified supracricoid partial laryngectomy with cricohyoidoepiglottopexy) and cricohyoidoepiglottopexy in the treatment of laryngeal carcinoma.

METHODSRetrospectively analyzed on the results and prognosis in patients underwent extended vertical partial laryngectomy and cricohyoidoepiglottopexy between 1998 and 2005. The operation was similar to extended vertical partial laryngectomy. The healthy vocal cord and ventricular band as well as about 1/3 to 2/3 laminas of thyroid cartilage were removed. The healthy cricoarytenoid joint was reserved. The vocal cord, ventricular band, fixed or limitation of motion arytenoid cartilage and 2/3 laminas of thyroid cartilage in ill side were removed. The posteroinferior border of laminas of thyroid cartilage in both sides were reserved. The cricoid was lifted and fixed with hyoid epiglottis directly. Extended vertical partial laryngectomy group consisted of 37 patients with glottic carcinoma (stage T2 16 cases, stage T3 21 cases) and cricohyoidoepiglottopexy group consisted of 34 patients with glottic carcinoma (stage T2 12 cases, stage T3 21 cases, stage T4 1 case).

RESULTSKaplan-Meier analysis was performed to calculate the survival rates. The three-year cumulative survival rate was 91.7% in extended vertical partial laryngectomy group and 87.5% in cricohyoidoepiglottopexy group respectively. There was no significant difference between the two groups (P > 0.05). The five-year cumulative survival rate was 80.6% in extended vertical partial laryngectomy group and 81.3% in cricohyoidoepiglottopexy group respectively. There was also no significant difference between the two groups (P > 0.05). The decannulation rate was 100% (37/37) in extended vertical partial laryngectomy group and 94.1% (32/34) in cricohyoidoepiglottopexy group respectively. The decannulation time was (14.0 + or - 2.3) days in extended vertical partial laryngectomy group and (19.0 + or - 4.6) days in cricohyoidoepiglottopexy group respectively. The incidence of aspiration was 2.7% (1/37) in modified group and 23.5 (8/34) in cricohyoidoepiglottopexy group respectively evaluated at 8th weeks post-operatively. The evaluation of deglutition disorder was analyzed by Ridit analysis in both groups and the results showed that there was significant difference between the two groups (U = 7.341, P < 0.001). The symptom of aspiration in extended vertical partial laryngectomy group was significant less than in cricohyoidoepiglottopexy group.

CONCLUSIONSAlthough the survival rate was not different between the two groups. The preservation of laryngeal function in extended vertical partial laryngectomy group was significant better than in cricohyoidoepiglottopexy group and extended vertical partial laryngectomy.

Adult ; Aged ; Cricoid Cartilage ; surgery ; Female ; Humans ; Hyoid Bone ; surgery ; Laryngeal Neoplasms ; surgery ; Laryngectomy ; methods ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Survival Rate

In this study,the common critical medical cases were organically combined with SimMan simulation system,which enabled students to deeply understand the diagnosis,treatment of disease and clinical operation as consulting real patients.Also,it could improve their clinical thinking ability,clinical skills and operational level.

A set of system for in vitro testing and analyzing the 3D motion in the cervical spine specimen before and after the ACP's (anterior cervical plates) implantation is introduced in this paper. Six porcine specimens with C3 - C6 mounted by the custom clamp were used to mimic human physiological cervical motions. A non-contact real-time measurement system based on CCD was used to track segmental cervical motion signals during the motion. A Matlab program based on multibody dynamics was processed to give the angle changes between adjacent vertebras during the motion. The experimental results show that the methodology can appraise the clinical properties of the ACP effectively.
Animals ; Biomechanical Phenomena ; Cervical Vertebrae ; physiology ; surgery ; Range of Motion, Articular ; physiology ; Spinal Fusion ; methods ; Swine ; Treatment Outcome

Objective To analyze the characteristics and epidemic trend of malignant tumor in Yueqing City of Zhejiang Province from 2012 to 2015 so as to provide scientific bases for policy making regarding control and prevention of malignant tumor.Methods Descriptive epidemiological analyses were made on the data of malignant tumor in Yueqing City from 2012 to 2015.Results The average annual incidence rate of malignant tumor from 2012 to 2015 was 248.85/105, the incidence rates from 2012 to 2015 were 238.24/105, 242.95/105, 247.15/105, 266.85/105, respectively.The average male incidence rate was 265.82/105, the average female incidence rate was 230.38/105.The former was higher than the latter.The group of 40-year-old and above age accounted for 91.64% of the total number of malignant tumor cases.Leukemia was common among 20-year-old and below age group.Breast cancer, liver cancer and lung cancer were common among 20-to 39-year-old age group.Lung cancer, liver cancer and gastric cancer were common among the age group of 40-year-old and above.The top five incidence rates of malignant tumor were lung cancer, liver cancer, gastric cancer, colorectal cancer and breast cancer, accounting for 56.74% of total cases thereof.Conclusion From 2012 to 2015, the incidence trend of malignant tumor in Yueqing City remained basically stable;the incidence rate remained relatively high and showed a slow rising trend on a yearly basis with the incidence rate of lung cancer increasing most significantly.The male incidence rate of malignant tumor was obviously higher than the female incident rate thereof.For the age group over 40, the incidence rate of malignant tumor increased significantly.It is necessary to pertinently strengthen the relevant health education of malignant tumor and implement the relevant early monitoring, thereby reducing the incidence rate.