Objective:To compare and study the improvement of different iterative reconstruction(IR)algorithms of the tomotherapy(TOMO)Radixact system on the image quality of megavoltage computed tomography(MVCT)imaging system,and the influence of that on the precision of automatic registration,and to explore the reconstruction algorithm that is suitable for clinical application.Methods:Using the MVCT imaging system to respectively scan the Tomo-Phantom HE phantom and the Catphan 604 phantom,and to analyze three groups of images were generated by three kinds of reconstruction algorithms,which included the Standard(STD)algorithm,IR General(IR-G)algorithm and IR Soft Tissue(IR-ST)algorithm,in MVCT image.The noise index(NI),uniformity index(UI)of image,modulation transfer function(MTF),low contrast visibility(LCV)index and contrast-to-noise ratio(CNR)of three groups of images were calculated respectively.The Lucy phantom was used to test the accuracy of automatic registration algorithm.The registration data of four dimensions,included left-right(X-axis),head-foot(Y-axis),vertical(Z-axis)and free rotation(Roll)around the Y-axis,were used to conduct verification analysis for the influences of them on the precision of automatic registration.Results:The NI values of IR-G and IR-ST reconstruction algorithms were respectively 39.58±0.10 and 14.62±0.26,which were better than 39.58±0.10 of STD algorithm,and the UI values of them were respectively 19.87±0.83 and 15.84±2.51,which were better than 24.51±1.81 of STD algorithm,and LCV values of them were respectively 2.50±0.03 and 1.74±0.11,which were better than 3.67±0.04 of STD algorithm.All of them appeared significant increase,but the resolution with high contrast of MTF were respectively 0.23 and 0.21,which were lower than 0.32 of STD.The overall image quality of the IR algorithms was superior to that of the STD algorithm.In the accuracy test of the automatic registration algorithm,the registration precisions of IR-G and IR-ST algorithms on Y-axis were respectively(0.360±0.142)mm and(0.245±0.050)mm,which were significantly higher than 0.145±0.136 of STD algorithm,and the differences of them were significant(Z=6.0,15.0,P<0.05).The differences of registration precisions of other directions were not significant(P>0.05).Conclusion:The IR algorithm has advantages in terms of noise,uniformity and resolution with low-contrast,however,it shows reduction on resolution with high-contrast.This reduction of resolution with high-contrast do not lead to the decrease of the precision of automatic registration.

ObjectiveTo evaluate the efficacy and safety of Linggui Zhugantang in the treatment of heart failure. MethodCNKI，Wanfang Data，VIP，CBM，PubMed，ClinicalKey，Cochrane Library ，Web of Science ，Medline and Embase were systematically searched to screen randomized controlled trials（RCT）of Linggui Zhugantang in the treatment of heart failure. Meta-analysis was performed on the included studies using RevMan 5.3 ResultTwenty-seven studies were included with a total sample size of 3 569 cases，including 1 816 in experimental group and 1 753 in control group. Meta-analysis showed that compared with conventional drugs alone，combination of Linggui Zhugantang and conventional drugs improved the marked effective rate [relative risk（RR）=1.41，95% confidence interval（CI）[1.29，1.54]，P<0.000 01] and the total effective rate（RR=1.21，95%CI[1.17，1.25]，P<0.000 01），decreased the levels of serum B-type brain natriuretic peptide （BNP）[mean difference（MD）=-390.08，95%CI[-538.84，-241.52]，P<0.000 01] and serum N-terminal pro-brain natriuretic peptide（NT-proBNP）（MD=-713.83，95%CI[-828.41, -599.25]，P<0.000 01）， left ventricular end-diastolic diameter（LVDD）（MD=-5.23，95%CI[-7.18, -3.29]，P<0.000 01）, left ventricular end-systolic diameter（LVSD）（MD=-4.54，95%CI[-6.75，-2.33]，P<0.000 01）, tumor necrosis factor-α（TNF-α）（MD=-37.53，95%CI [-50.72，-24.34]，P<0.000 01）and interleukin-6（IL-6）（MD=-23.64，95%CI [-47.40，0.11]，P=0.05）, increased left ventricular ejection fraction（LVEF）（MD=5.73，95%CI [3.33，8.14]，P<0.000 01），and cardiac output [stroke volume (SV) ]（MD=5.90，95%CI[4.56，7.25]，P<0.000 01）. In addition, the combination prolonged the 6 minute walking test distance（MD=51.08，95%CI [33.01，69.16]，P<0.000 01），reduced the traditional Chinese medicine (TCM) syndrome score（MD=-3.50，95%CI [-4.92，-2.07]，P<0.000 01），and improved quality of life（MD=-7.26，95%CI [-10.43，-4.09]，P<0.000 01），with higher safety（RR=0.36，95%CI [0.17，0.79]，P=0.01）. ConclusionLinggui Zhugantang combined with conventional drug therapy could improve cardiac function，reduce cardiac fibrosis，and improve prognosis, with high safety.