Abdominal Pain ; Cough ; Humans

Distortion product otoacoustic emission (DPOAE) signal can be used for diagnosis of hearing loss so that it has an important clinical value. Continuously using sweeping primaries to measure DPOAE provides an efficient tool to record DPOAE data rapidly when DPOAE is measured in a large frequency range. In this paper, locally weighted least squares estimation (LWLSE) of 2f1-f2 DPOAE is presented based on least-squares-fit (LSF) algorithm, in which DPOAE is evoked by continuously sweeping tones. In our study, we used a weighted error function as the loss function and the weighting matrixes in the local sense to obtain a smaller estimated variance. Firstly, ordinary least squares estimation of the DPOAE parameters was obtained. Then the error vectors were grouped and the different local weighting matrixes were calculated in each group. And finally, the parameters of the DPOAE signal were estimated based on least squares estimation principle using the local weighting matrixes. The simulation results showed that the estimate variance and fluctuation errors were reduced, so the method estimates DPOAE and stimuli more accurately and stably, which facilitates extraction of clearer DPOAE fine structure.
Algorithms ; Hearing Loss ; diagnosis ; Humans ; Least-Squares Analysis ; Otoacoustic Emissions, Spontaneous ; Regression Analysis

Objective To evaluate the raliability and validity of walking impairment questionnaire applied to assess the walking ability of patients with type 2 diabetes. Methods One hundred and twenty-six patients with type 2 diabetes were selected. WIQ, SF-36 and 6-minute walk test were used to collect da-ta that was conducted for reliability analysis, correlation analysis and independent-samples t test to evaluate the reliability and validity. Results The internal consistency determined by Cronhach's α was 0.867 for the total WIQ score. Significnat correlations were found between WIQ and 6MWD, also between WIQ and physical domains of SF-36. compared with patients over seventy-one years old, the score of WIQ including the distance, speed, stair climbing and total score is significantly higher than that in patients aged seventy-one or less than seventy-one years old. Conclusions The Chinese version of WIQ is a simple, valid and reliable, clinically relevant tool to assess the walking ability of patients with type 2 diabetes.

Objective To evaluate the application of microvascular coupler device (MVCD) in the free-tissue flap transfer for head-and-neck defects reconstruction.Methods Its a retrospective study of the clinical data of 743 patients who received 763 free-tissue flap transfer for head and neck defects reconstruction in Hunan Cancer Hospital from January,2014 to January,2016.For microvascular anastomoses,413 were done manually (the manual group) and 350 done with MVCD (the MVCD group),of which the latter included end-to-end venous anastomosis in 159,endto-side venous anastomosis in 190 and end-to-end arterial anastomosis in 1.The time for anastomosis,rate of blood leakage from the anastomosis and venous thrombosis,and the survival rate of flaps were compared between the manual group and the MVCD group.The impacts of types of anastomosis of end-to-end vs end-to-side (both with MVCD),on the formation of venous thrombosis and survival of flaps were also recorded.The analysis was performed under t-test and chi-square test using SPSS software 19.0 with P ＜ 0.05 for differences with a statistical significance.Results Time for anastomosis was significantly shorter in the MVCD group (4.43±0.51min) than in the manual group (14.75± 2.43min,P＜0.05).The rates of anastomosis leakage were 0 in the MVCD group and 9.7％ in the manual group(P＜0.01),flap necrosis were 0.57％ and 1.69％ (P=0.15),the rate of venous thrombosis were 1.15％ and 3.63％(P=0.02),respectively.There was no significant difference in the time for anastomosis,the rate of venous thrombosis and the survival rate of flaps with end-to-end anastomosis and end-to-side anastomosis with MVCD.Conclusion The application of microvascular coupler device is valuable in the reconstruction of head-and-neck defects with free-tissue flaps because it can significantly shorten the time for anastomosis,decrease the ocurrence of anastomosis leakage and venous thrombosis,reduce the risk of flap failure.

Objective Currently,pediatric 18F-FDG dose and acquisition durations are generally based on coarse extrapolation from adult guidelines.This study sought to determine whether shorter acquisition durations or a lower 18F-FDG injected activity could be used during pediatric 18F-FDG PET/CT examinations while maintaining diagnostic utility.Methods Thirty-six whole-body 18F-FDG PET/CT examinations were performed on 36 patients (weight,13-89 kg,(46.51±5.63) kg; age range,3-14 years old,(9.22±3.16) years old) with a weight-based injected activity (5.3 MBq/kg (0.144 mCi/kg)),fixed acquisition durations 180 S/FOV,VIP record acquisition mode using Discovery STE.For each examination,the Vip-mode data was truncated to form multiple datasets with shorter acquisition durations down to a minimum of 60 s/FOV (i.e.,60,80,100,120,140,160 s/FOV data were formed from single 180 s/FOV acquisition).168 image volumes were generated,randomized,and reviewed in a masked manner with corresponding CT image volumes by 6 radiologists.Overall,subjective adequacy and objective lesion detection accuracy by body region were evaluated.Results All examinations with maximum acquisition duration were graded as adequate and were used as the reference standard for detection accuracy.For patients more than 30 kg,when acquisition duration was more than 120 s/FOV,all PET/CT examinations were graded as adequate for clinical tasks,whereas,when acquisition duration was reduced to less than 120 s/FOV,lesion detection became less accurate.For patients less than 30 kg,lesion detection accuracy was perfect for acquisition times between 140 s/FOV and 180 s/FOV for all regions of the body.However,lesion detection became less accurate when imaging acquisition time was reduced less than 140 s/FOV.Conclusions When GE Discovery STE PET/CT was applied during pediatric PET/CT examination,using decreased acquisition times as a surrogate for 18F-FDG dose,18F-FDG dose can be reduced by approximately 33.33％ when patients weigh over 30 kg were scanned for 180 s/FOV.For patients less than 30 kg,18F-FDG dose can be reduced by approximately 22.22％ without losing diagnostic quality.Reduction of overall scan time potentially reduces motion artifacts,improves patient comfort,and decreases length of sedation.Alternatively,decreased 18F-FDG dose minimizes radiation risk.

Objective:To investigate the normal sonographic anatomic characteristics of the pectoralis major and the clinical value of ultrasound in diagnosing the extent and location of the pectoralis major tears.Methods:High frequency transducer was used in scanning the pectoralis major.The ultrasono-graphic images of 40 normal pectoralis major were obtained from 20 healthy volunteers with both sides. Longitudinal and transversal views were performed and stored.The distal tendon was identified in the transverse plane coursing superficially to the long head of the biceps brachii tendon inferior to the level of the subscapularis tendon.Eighteen cases of pectoralis major tears were analyzed retrospectively,with MRI,surgical and ultrasound follow-up results correlation respectively.Results:High-frequency ultra-sound could clearly show the anatomic orientation of the normal pectoralis major.The fibers converge was like a fan into three laminae that twisted upon each other at 90°before coalescing into a single tendon of insertion.In the study,1 8 patients of pectoralis major muscle tears [average age:(37.2 ±1 5.6)years] sustained injuries during weightlifting,basketball and impact.Three of the eighteen patients had MRI re-sults;nine had surgical correlation;six were followed by ultrasound.Eleven were injured on the left side,and 7 on the right side.Seven were involved in the distal tendon (1 in sternal head,2 in clavicular head,4 in both sternal and clavicular head),five were involved the musculotendinous junction,6 were involved muscle belly.Twelve cases were partial-thickness petoralis major tears(4 in the distal tendon, four in the muscle tendon junction,4 in the muscle belly),with the partial fiber intact,echogenicity de-creased and the internal structure disordered;6 cases (3 in the distal tendon,1 in the muscle tendon junction,2 in pectoralis major muscle belly)were completely disrupted,with fiber fracture and retrac-tion,accompanied with or without hematoma formation.Conclusion:High-frequency ultrasound can clearly show the anatomic structure of the pectoralis major.Ultrasonography can diagnose the pectoralis major tears with the extent and location of injuries,and can be used to help the clinical treatment.

OBJECTIVE: To observe the effect and explore the mechanism of Huannao Yicong capsule in treating senile patients with mild cognitive impairment (MCI). METHODS: The investigational drugs were packed by blind method. A randomized, double-blind and controlled trial was conducted on ninety senile patients with MCI. Other forty-five senile healthy persons were recruited to the healthy control group. The ninety senile patients were randomly divided into the Huannao Yicong capsule-treated group (45 patients administered with three Huannao Yicong capsules and two aniracetam capsule analogues) and aniracetam-treated group (45 patients treated with two aniracetam capsules and three Huannao Yicong capsule analogues). Patients in the two groups were treated three times daily for 16 weeks. Memory, traditional Chinese medicine syndrome, cerebral blood flow, free radicals and inflammatory mediators, such as superoxide dismutase (SOD), malondialdehyde (MDA), acetylcholinesterase (AchE), interleukin-1alpha (IL-1alpha) and interleukin-6 (IL-6) were determined before and after the treatment. Blood lipids, including triglyceride (TG), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), apolipoprotein A-1 (ApoA-1) and apolipoprotein B-100 (ApoB-100), were detected before and after the treatment. The safety indexes, such as routine tests of blood and urine, hepatic and renal function tests and electrocardiogram (ECG) were taken before and after the treatment. RESULTS: Index score of clinical memory scale in senile healthy people was significantly higher than that in MCI patients before treatment (P<0.01), and the content of AchE, IL-1alpha and IL-6 was obviously lower (P<0.01, P<0.05), the activity of SOD was higher (P<0.05). No significant difference was found in direction memory of clinical memory scale between the two treatment groups. Other index scores of clinical memory scale and traditional Chinese medicine syndrome in patients of Huannao Yicong capsule-treated group were significantly improved as compared with those of the aniracetam-treated group (P<0.05, P<0.01). The blood flow parameters of anterior cerebral artery, posterior cerebral artery and resistant index in patients of Huannao Yicong capsule-treated group were increased significantly (P<0.01, P<0.05). Huannao Yicong capsule could significantly increase the activity of serum SOD and decrease the content of AchE, IL-1alpha and IL-6 (P<0.01, P<0.05), better than aniracetam. Furthermore, Huannao Yicong capsule could significantly improve the blood lipid, such as the level of TG, LDL-C, HDL-C, ApoA-1 and ApoB-100 (P<0.01, P<0.05), and better than aniracetam (P<0.01, P<0.05). No significant changes were found after treatment in safety indexes, such as routine tests of blood and urine, hepatic and renal function tests and ECG. CONCLUSION: Huannao Yicong capsule has better therapeutic effect than aniracetam capsule in treating senile mild cognitive impairment.

Objective To discuss the effect of “practice teaching methods ” in musculoskeletal ultrasound diagnosis training process .Methods Thirty refresher doctors for a month with the method training .The effect training is evaluated by objective exam and questionnaire survey .Results Thirty refresher doctors received tests before and after the training .Test results showed that the accuracy after the training was significantly higher than that of before ( P<0.05 ) .Refresher doctors survey about satisfaction of the training method showed that whole satisfaction is 100%, in which 70%were very satisfied , 30%were satisfied .The self-assessment results for the improvement of the level of diagnosis musculoskeletal ultrasound showed that 45%doctors are very satisfied ,40%doctors are satis-fied, and 15%is not satisfied .Conclusions With the implementation of “teaching by practice” method, refresher doctors could master the knowledge of musculoskeletal anatomy as soon as possible , and have the ability to diagnose common musculoskeletal diseases independently .

Objective To evaluate the value of 18F-FDG PET/CT in early in vivo monitoring of tumor response to cisplatin,and analyze the relationship between 18F-FDG uptake in tumor and the corresponding pathological changes.Methods Thirty VX2 rabbits were divided into 5 groups by random number table with 6 in each group,including 4 treatment groups and 1 control group.18F-FDG PET/CT were performed before and after (6,12,24 and 36 h post-injection respectively) intravenous administration of cisplatin (7 mg/kg) in the treatment groups,respectively.The control group was injected with physiological saline followed by 18F-FDG PET/CT.The ROI was drawn and the SUVmax and T/NT ratio were calculated.The tumor necrosis rate and apoptosis index were observed by histopathologic examination.Paired t test,GamesHowell test and arcuation correlation analysis were used to analyze the data.Results Significant differences were found in SUVmax and T/NT of the control group before and after injection of physiological saline (6.58±1.67 vs 9.77±2.45,52.93±3.90 vs 29.34±3.31;t=-5.480,17.593,both P＜0.05).18F-FDG uptake decreased after 6 h post-injection of cisplatin,with the mean SUVmax decrease rate of (11.83±8.89) ％ and the mean T/NT decrease rate of (59.00±8.22)％.In the 24 h treatment group,18F-FDG uptake decreased most,and the mean SUVmax decrease rate was (42.33±33.80)％,the mean T/NT decrease rate was (83.50± 7.69) ％.The SUVmax and T/NT of those 2 groups were significantly different from those of the control group,and no difference was found between the 2 treatment groups(all P＜0.05).The changes of SUVmax and T/NT were positively correlated with apoptosis index and tumor necrosis rate (r=0.750,0.794,0.804,0.874,all P＜0.05).Conclusion 18F-FDG PET/CT is a sensitive method for monitoring early response to tumor chemotherapy in VX2 tumor-bearing rabbits at 24 h after treatment.

Objective To assess the value of 18F-FDG PET-CT in monitoring early chemotherapy response in patients with diffuse large B-cell lymphoma (DLBCL).Methods 56 patients with DLBCL received 18F-FDG PET-CT before and after 2 cycles of chemotherapy (CHOP or R-CHOP protocol).The patients were divided into 3 groups,including complete response group (30 cases),partial response group (18 cases) and no response group (8 cases).The x2 test was performed on comparison of complete remission rate and the t test on SUVmax.Results Complete remission rate of complete response group,partial response group and no response group were 93.33 ％ (28/30),66.67 ％ (12/18),and 12.50 ％ (1/8),respectively (x2 =21.62,P ＜ 0.005).Complete remission rate of complete response group was higher than that of partial response group (x 2 =4.00,P ＜ 0.05).Complete remission rates of complete response group and partial response group were higher than that of no response group (x2 =18.58,P ＜ 0.005; x2 =4.51,P ＜ 0.05).A significant difference was observed in SUVmax of partial response group before and after chemotherapy (17.18±4.68 vs 5.20±3.35,t =14.32,P ＜ 0.001) and no obvious difference was showed in SUVmax of no response group between before and after chemotherapy (16.63±6.49 vs 13.81±5.95,t =2.073 2,P ＞ 0.05).Conclusion 18F-FDG PET-CT is very useful and helpful for predicting early chemotherapy response in DLBCL.