objective To evaluate the relationship between the pulse pressure and the cardiac geometric structure in patients with essential hypertension. Methods Three hundred and ninety-five patients,age ranging from 20 to 77 years,were enrolled into the study. Their clinical systolic and diastolic blood pressure (SBP/DBP) were all above 140/90mmHg. All the patients either were initially diagnosed as having essential hypertension,or confirmed after taking a the placebo for 2 weeks after stopping anti-hypertensive drugs. The cardiac geometric structure was determined by the echocardiography at the same time when the patients untook the 24 hours ambulatory blood pressure monitoring. Results The clinical pulse pressure was significantly different among the groups as divided by the age ( P

Objective To explore the feasibility of gallbladder mucosal ablation by hysteroscopic rollerball electrocoagulation after cholecystostomy.Methods Under epidural or general anesthesia combined with local anesthesia,20 patients were examined and treated with hysteroscopy after cholecystostomy.After inserting a Storz endoscope,the epithelium of the proximal cystic duct and the mucosa of the gallbladder were ablated with the roller-ball and roller-barrel electrodes respectively.The electrocoagulation power was set at 60-70 W with the roller-barrel excursion rate between 10-15 mm/s,which makes the inner wall of the cyst homogenously brown-grey.Results The mean endoscopic operation time was 35 minutes(range: 25-55).Among the patients,the gallbladder lumen was completely obliterated within one month in 12 patients,and within 3 months in 5;3 patients developed retention cysts.Conclusion Endoscopic electrocoagulation of the cholecystic mucosa is feasible for obliteration of the gallbladder.

BACKGROUND:Titanium aloy and stainless steel are two common internal fixation materials, but there are some difference in their therapeutic effects and biocompatibility. OBJECTIVE:To explore the therapeutic effects and biocompatibility of titanium aloy and stainless steel internal fixation materials for the treatment of spinal tuberculosis. METHODS:Seventy-one spinal tuberculosis patients, 35 males and 36 females, aged 17-81 were enroled. Among them, 35 patients received titanium aloy internal fixation, and the 36 patients underwent stainless steel internal fixation. At the end of 12-month folow-up, Cobb angle changes, therapeutic effect and Frankel grade were analyzed in the two groups. RESULTS AND CONCLUSION:Before treatment, there was no difference in the spinal kyphosis angle and Frankel grade between the two groups. At the last folow-up, the Frankel grade and Cobb angle were both improved in the two groups (P < 0.05), but there was stil no difference between the two groups. The cure rate was 97% (n=34) in the titanium aloy group and 92% in the stainless steel group (n=33), and no significant difference was found between the two groups. These two kinds of internal fixation materials exhibited good biocompatibility, and no infection and other adverse reactions occurred. These findings indicate that both titanium aloy and stainless steel as internal fixation materials have good biocompatibility and therapeutic effects.

Objective To study the influence of prothrombin complex concentrates (PCC) containing different levels of antithrombin (AT) and heparin on its procoagulation and anticoagulation activities.Methods PCC containing traces of heparin and AT were prepared.The design of orthogonal experiment: set AT and heparin two variable factors, each factor respectively from three levels: 0, 0.4, 0.8 IU/mL; 0, 2.5, 5.0 IU/mL.Their influence on the procoagulation and anticoagulation activities of PCC were analysed.Results The R value of the influence of AT on thrombin inhibitory capacities was higher than that of heparin.With the increase of AT level, time to peak gradually extended.Lag time of 0.4 IU/mL and 0.8 IU/mL AT was the same.The peak height of 0.4 IU/mL AT was highest.The higher the level of AT, the greater the impact on thrombin inhibitory capacities.0.4 IU/mL and 0.8 IU/mL AT had similar impact on thrombin inhibitory capacities.The R values of the influence of heparin on thrombin generation were higher than that of AT.With the increase of heparin level, lag time and time to peak were longer while the peak height declined sharply.0 IU/mL and 2.5 IU/mL heparin had similar influence on thrombin generation.The higher the level of heparin, the greater influence on thrombin inhibitory capacities.2.5 IU/mL and 5.0 IU/mL heparin had similar influence on thrombin inhibitory capacities.Conclusion AT has greater influence on the anticoagulation activities of PCC than that of heparin, while heparin has greater influence on the procoagulation activities of PCC than that of AT.PCC containing medium levels of AT and heparin is relatively balanced between procoagulation and anticoagulation.

Objective To explore the application of low dose of radiation combined with low concentration of contrast medium in the energy spectrum CT of the coronary artery angiography.Methods 60 patients with suspected diagnosis of coronary heart disease were randomly divided into A,B two groups,30 cases in each group.Group A with 350 mg I/mL contrast agent,undergoing conventional CT scanning;Group B using 300 mg I/mL contrast agent,the gems energy spectrum CT scanning with low-dose.Two groups both adopted forward-looking heart switch control scanning mode.After scanning,group A reconstructed conventional images of 40% ASiR sequence,group B rebuilded axial surface images of single energy 65 keV and 40% ASiR sequence,all the reconstruction images were introduced to AW4.6 workstations used for analysis.Double-blind subjective rating was done by two experienced doctors to measure CT values and SD of aortic sinus (AS),left main (LMA),the left anterior descending branch proximal (LAD-p),left circumflex branch proximal (LCX-p), right coronary artery proximal (RCA-p)and pericardial fat,AS the noise (SD),to calculate the signal-to-noise ratio (SNR)and contrast to noise ratio (CNR),to calculate the effective doses of radiation(ED)by recording CTDI and DLP,and to record iodine intake.By using two independent samples t test to compare two groups of patients’the effective radiation doses,iodine intake,the average CT value,SD,SNR and CNR.Results The subjective image quality score differences and coronary measuring section CT values between the two groups had no statistical significance.In the aspects of effective radiation dose,group B reduced about 29% compared to group A,the difference was statistically significant.Iodine intake in group B decreased about 16% than in group A.Conclusion In coronary artery CT imaging, spectral scanning with low dose of radiation and reconstruction images with single energy can effectively reduce the radiation dose and iodine intake,at the same time it can obtain the approximate image quality like conventional scanning.

Objective To explore the value of the spectral CT iodine-based material decomposition technique in differential diagnosis of central pulmonary carcinoma from obstructive pneumonia and atelectasis.Methods 25 cases with central pulmonary carcinoma complicating with obstructive pneumonia and atelectasis underwent CT plain scan and spectral contrast scan including pulmonary-arterial-phase (PAP) and bronchial-arterial-phase(BAP).Conventional CT images and iodine base images were generated in each phase by GSI viewer.The 4 groups of images differences between the tumor and the obstructive pneumonia and atelectasis were analyzed.Results The margin of the tumor was ill-defined in plain scan.The cases that showed difference between the tumor and the obstructive pneumonia and atelectasis in 4 groups of images were respectively as follows,10 in conventional CT images of PAP,1 6 in conventional CT images of BAP,1 9 in iodine base images of PAP,and 23 in iodine base images of BAP.The difference of the 4 groups was significant (χ2 =16.54,P<0.05).There was the highest accuracy in iodine base images of BAP in defining the tumor margin (χ2 = 12.83,χ2 = 4.20,χ2 =1.34,P <0.05). The accuracy between conventional CT images of BAP and iodine base images of PAP had no significant differences (χ2 =0.86,P >0.05),but were better than that of the conventional CT images of PAP(χ2 =6.65,P <0.05).Conclusion Spectral CT iodine-based material decomposition technique is helpful to improve subjective diagnosis of central pulmonary carcinoma complicating with obstructive pneumonia and atelectasis,especially in iodine base images of BAP,it can provide accurate information for clinical stage and treatment.

Objective To evaluate the clinical value of spectral CT monochromatic imaging in improvement of imaging quality of bronchial arteries.Methods We retrospevtively analyzed the chest CT images in 38 patients who underwent the contrast-enhanced spectral CT.These images included a set of 140 kVp polychromatic images and default 70 keV monochromatic images.Using a standard Gemstone Spectral Imaging (GSI)viewer at an advanced workstation (AW4.6),an optimal energy level (in keV)for obtai-ning the best CNR of the bronchial artery could be automatically obtained.The SNR,CNR and objective imaging quality score for these 3 imaging sets (140 kVp,70 keV and optimal energy level)were obtained and compared with one-way ANOVA .Results The optimal energy levels for obtaining the best CNR were (62.58±2.74)keV.The SNR of the 140 kVp polychromatic images,70 keV monochromatic images,and the optimal keV monochromatic images were 1 6.44±5.85,20.96 ±8.32 and 24.91 ±9.91,the CNR were 13.30±5.45,1 7.25±6.97 and 20.67±8.62,and the subjective imaging quality scores were 1.97 ±0.82,3.24±0.75 and 4.47±0.60,respectively,exhibiting significant differences among groups (F =10.1 7,10.1 7 and 1 1 1.12,P <0.00).The optimal monochromatic group was superior to the 70 keV group and the 140 kVp mixed-energy group.Conclusion Monochromatic images at approximately 62 keV in dual-energy spectral CTA yields the best CNR and highest diagnostic confidence for imaging bronchial ar-teries,which may improve imaging quality for imaging bronchial arteries.

Objective To compare the virtual non-enhanced chest CT (VNCT)generated from spectral CT with conventional non-enhanced chest CT in patients with lung disease in terms of CT number accuracy and image quality.Methods A total of 30 patients with lung disease proved by pathology underwent the conventional non-enhanced thoracic CT and contrast enhanced CT with spectral imaging mode in arterial phase (AP)and venous phase (VP).The VNCT images were reconstructed based on the enhanced spectral CT imaging data.The mean CT number,signal to noise ratio (SNR)for the lesions and image quality score were obtained and compared between the true non-contrast CT (TNCT)and the VNCT (including AP and VP)with paired t test.Results The mean±standard deviation for CT number were (38.74±5.17)HU,(39.08±5.07)HU and (38.96± 5.18)HU for TNCT,VNCT at AP and VNCT at VP,respectively, with no statistical difference (P>0.05).All 3 sets of images demonstrated acceptable image quality,even though there were statistically significant differences in the SNR value and image quality score.The mean ± standard deviation values for SNR were 4.74±0.42 with TNCT, 3.79 ± 0.5 1 with VNCT at AP and 3.77 ± 0.39 with VNCT at VP (P <0.05),and the image quality scores were 5.00 ±0.00 with TNCT,4.17±0.65 with VNCT at AP and 4.17±0.53 with VNCT at VP (P<0.05).Conclusion In patients with lung disease,the vir-tual non-enhanced CT images generated from spectral CT provide accurate CT numbers for lesions and acceptable image quality com-pared with the true non-contrast CT.VNCT may be used to replace TNCT to improve work flow and reduce radiation dose.

PurposeTo explore the feasibility of personalized energy spectrum scanning in upper abdomen CT by comparing the image quality and radiation dose of optimizing choice spectrum scanning protocol with conventional 120 kVp scan.Material and Methods Sixty patients undergoing abdominal CT scan with and without contrast enhancement were prospectively collected and randomly assigned into two groups. Group A (30 patients) underwent conventional 120 kVp scan and spectral enhancement scanning; group B (30 patients) underwent spectrum scan and 120 kVp enhancement scanning. Spectral scanning protocol was based on individual choice with conventional 120 kVp NI10-5 mm average mAs scan for every patient. The CT dose index of volume (CTDIvol) and effective dose (ED) during non-contrast phase and portal venous phase were recorded. The CT value, standard deviation (SD), signal noise ratio (SNR) and contrast noise ratio (CNR) were measured in the liver parenchyma, spleen parenchyma and portal venous trunk.Results The CTDIvol and ED of spectrum scanning were less than 120 kVp scan but there was no statistical difference (P>0.05). The SD of group B GSI imaging was less than group A 120 kVp (P<0.05), while the SNR was greater than group A. The SD of group A GSI portal venous phase in the liver, spleen and portal vein was less than group B 120 kVp (P<0.05).ConclusionThe optimized energy spectrum scanning protocol can reduce radiation dose with quality of single energy image from the energy spectrum equal to or better than the conventional 120 kVp scanning protocol. Personalized energy spectrum scan protocol provides multi-parameter diagnosis and multi-application platform and can be used routinely in the upper abdomen scan.

Anti-Bacterial Agents ; pharmacology ; Child ; Humans ; Macrolides ; pharmacology ; Microbial Sensitivity Tests ; Mycoplasma pneumoniae ; drug effects