Objective The purpose of this study was to evaluate the effect of patient’s body mass index on applications of auto-matic tube voltage selection (ATVS)for contrast-enhanced abdominal CT.Methods 1 60 patients underwent contrast-enhanced ab-dominal CT scan were assigned into the study group (ATVS technique)and the control group (120 kVp)with equal size (both n =80)according to the scanning mode.The two groups were both divided into four subgroups according to BMI (A:BMI <18.5 kg/m2 ;B:BMI 18.5~23.9 kg/m2 ;C:BMI 24~28.9 kg/m2 ;D:BMI ≥29 kg/m2 ).Image quality were assessed and compared with Rank-sum test.Analysis of variance was used to compare differences in mean contrast-to-noise ratio (CNR)and image noise a-mong the two groups.Two sample t tests were used to compare the radiation dose.Results In the study group,tube voltage of 100 kVp were selected highest(78.75%)and distributed from subgroups A to D,accounting for 60%,80%,90% and 60% respectively, with average BMI of (23.71±3.1 9)kg/m2 .Compared to control group,the effective dose of study group from subgroups A to C re-duced by 35.09%,27.61% and 1 9.08% respectively(t=3.829,4.389,2.238,P =0.005,<0.001,0.025).Despite the higher image noise in study group,the overall image quality was acceptable.Conclusion The contrast-enhanced abdominal CT with AVTS technique can reduce radiation dose in patients with BMI smaller than 28.9 kg/m2 .

Objective To investigate the impact of automatic tube voltage selection ( ATVS) and sinogram-affirmed iterative reconstruction ( SAFIRE) on image quality and radiation dose in the arterial phase (AP) and portal venous phase (PVP) abdominal dual-source CT imaging.Methods Abdomen contrast-enhanced computed tomography ( CECTs ) in 70 patients were scanned with dual-source CT.Patients were divided into study group and control group based on the scanning date.In the first 35 patients ( study group) , ATVS mode was applied; in the second 35 patients ( control group ) , the conventional fixed at 120 kVp mode was used.The imaging of the study group was reconstructed with FBP ( protocol A ) or SAFIRE ( protocol B ) respectively; the imaging of the control group was reconstructed with FBP ( protocol C).Image quality scores of the 3 protocols were assessed and compared with Rank-sum test.Analysis of variance was used to compare mean signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and image noise among the 3 protocols.Two sample t tests were used to compare the radiation dose difference.Results The effective radiation dose in the study group ( 3.9 ±0.4 ) mSv was much lower than that in the control group (4.9 ±0.4) mSv, dropped by 20.41% (t =2.315, P=0.021).The subjective rating scores in protocol A, B, C in arterial were (3.65 ±0.08), (4.41 ±0.10) and (3.79 ±0.10) point, while the subjective rating scores in venous phase were (3.57 ±0.08), (4.41 ±0.10) and (3.95 ±0.11) point.The differences were statistically significant (Z value were 27.587 and 27.436, P<0.01).The image noise of protocol A , B, C in dual-phase were ( 11.96 ±0.33 ) , ( 8.45 ±0.26 ) , ( 10.38 ±0.26 ) HU and (12.79 ±0.39),(9.14 ±0.36), (11.13 ±0.18) HU.The differences were statistically significant (F value were 39.235 and 29.846, P<0.01).Compared to protocol A and C, SNR and CNR in protocol B were much higher (P<0.01).No statistically significant differences were shown between protocol A and C in SNR and CNR ( P>0.05).Conclusion Use of ATVS and SAFIRE could reduce the radiation dose and provide better quality images compared with conventional abdominal CECT and FBP .

OBJECTIVETo detect the expression of the peripheral blood P2X5 receptor at various ambient temperatures, and to explore its relationship with deficiency-cold syndrome and deficiency-heat syndrome.

METHODSSubjects were selected by questionnaire and expert diagnosis, and assigned to the normal control group, the deficiency-cold syndrome group, and the deficiency-heat syndrome group, 20 in each group. 5 mL venous blood was collected at room temperature (25 °C) and cold temperature (-4-5 °C) respectively. Then the expression of P2X5 receptor was relatively quantified by real-time fluorescence quantitative PCR, and compared at room temperature and cold temperature respectively.

RESULTSThe expression of P2X5 receptor in deficiency-cold syndrome and deficiency-heat syndrome groups was lower than that in the normal control group at room temperature (P < 0.05). It decreased more at cold temperature in the deficiency-cold syndrome group than in the normal control group (P < 0.01) as well as in the deficiency-heat syndrome group (P < 0.05). The expression of P2X5 receptor showed no difference in all groups at two different temperatures (P > 0.05).

CONCLUSIONSThe expression of P2X5 receptor was different in different syndrome groups at various ambient temperatures. Ambient temperatures had insignificant effect on the expression of P2X5 receptor of the population with the same syndrome.

Cold Temperature ; Hot Temperature ; Humans ; Medicine, Chinese Traditional ; Receptors, Purinergic P2X5 ; metabolism ; Syndrome

Objective To explore the inhabitants' knowledge about Keshan disease(KD) in endemic area in Heilongjiang Province and analyze its influencing factors. Methods Yongjin Village, a national KD monitoring site in Fanrong Township of Fuyu County in Heilongjiang Province,was selected as an investigating spot. Specially designed questionnaire was applied in the investigation, which included three aspects, demographical information (gender, age, educational level, etc.), KD-related knowledge survey (KD prevention measures including a healthy diet supplementing selenium, preventing microbial infection, inducers such as climate change, fatigue, cold, mental shock, overeating) and KD controlling measures (take prescribed medicine, dietetic regulation and regular exercise, etc.) Results Seventy-senven point six percent(272/352) knew the disease by the name in the endemic area, while only 29.7% (81/272)and 30.8% (84/272)were aware the preventive measures and inducers , respectively. The awareness rates of KD preventive measures and inducers among the KD patients were 6/17 and 9/17 respectively. The influencing factors of the awareness rate of KD name were gender, vocation and the state of education (χ2 value were 9.838,9.878,12.462, all P < 0.05). However, factors influencing the awareness rates of preventive measures were gender and the state of education(χ2 value were 7.400,20.251, both P < 0.05). Conclusions The awareness rates of KD preventive measures and inducers axe low in the endemic area. The major factors influencing the awareness rate of KD are gender and the educational degree.

Objective To evaluate the demand for midwives in Yunnan province utilizing Birthrate Plus for planning and development of such workforce. Methods A convenient sample method was used to investigate 8435 maternal cases at 9 hospitals in Yunnan province in four months from 9 - 12 in 2017, and Birthrate Plus was used to calculate the demand for midwifery at each hospital. We also analyzed the two core elements of Birthrate Plus- maternal category allocation and midwife hours of each hospital. Results Maternal cases fall into five categories and maternal category allocation in hospitals is roughly the same;Maternal in higher category tended to need longer midwife hours; the average birthrate of 9 hospitals was (194. 22 ± 44. 84) case/ ( year·midwife). The number of midwives in two tertiary hospitals is obviously insufficient. Midwives at 7 secondary hospitals are more than predicted. Conclusions Midwives in Yunnan are generally faced with a large workload, especially at secondary hospitals, and midwives need to bear numerous non-midwifery workload beyond Birthrate Plus. Therefore, the Birthrate Plus can reflect the midwifery workload scientifically and reasonably in the current situation of midwifery work. But the predication for midwifery workforce requires a study of the ratio of midwifery work in the entire clinical work of the hospital.

OBJECTIVETo explore the surgical approaches, methods and techniques of repair of cerebrospinal fluid (CSF) rhinorrhea via frontal sinus under transnasal endoscopy.

METHODSCerebrospinal fluid rhinorrhea, located at the posterior wall of the frontal sinus (n = 9) and posterior lateral wall of the frontal recess (n = 4) had been repaired surgically. A transnasal endoscopic approach was chosen in 12 patients and combined approach was used in 1 patient during the first procedure. Three patients needed the second surgery. Among them, one patient needed to repair CSF rhinorrhea, 1 patient needed to treat intracranial abscess of frontal lobe via combined approach and another one was treated because of the complication of frontal cyst.

RESULTSTwelve patients were successfully repaired in the first surgery. Only 1 patient needed second surgery. Two patients occurred complications. One was intracranial infection after surgery, external drainage and packing in the frontal sinus was used. Another was obstructive cyst in frontal sinus, transnasal endoscopic frontal sinusotomy was performed.

CONCLUSIONSCSF rhinorrhea which located at the posterior wall of the frontal sinus can be successfully repaired via transnasal endoscopic approach if the leak was visible under endoscopy. The size of the frontal ostium and leak vantage should be considered to prevent the drainage of the frontal sinus which would result in obstructive cyst in frontal sinus, frontal sinusitis and intracranial infection. Combined approach was suggested to the patients that leakage could not be seen in frontal sinus or frontal ostium was difficult to enlarge.

Adolescent ; Adult ; Cerebrospinal Fluid Rhinorrhea ; surgery ; Child ; Endoscopy ; methods ; Female ; Frontal Sinus ; surgery ; Humans ; Male ; Middle Aged ; Young Adult

OBJECTIVETo compare the levels of STAT4 tyrosine phosphorylation in peripheral T-lymphocytes induced by IL-12 in rheumatoid arthritis (RA) and osteoarthritis (OA).

METHODSFrom May 2007 to August 2009, peripheral blood mononuclear cells (PBMCs) were isolated from RA patients [RA group, all the cases were female, the age was from 28 to 55 years with an average of (45.0 +/- 13.0) years] and OA patients [OA group, all the cases also were female; the age was from 55 to 75 years with an average of (67.0 +/- 9.6) years]. The purity of T-lymphocytes from PBMCs was accredited by flow cytometry. The IL-12 of 50 ng/ml added in T-lymphocytes, the levels of STAT4 tyrosine phosphorylation were detected by western blot after different time intervals (0, 10, 30, 60 min).

RESULTSThe purity of T-lymphocytes were above 91% through diremption and depuration for peripheral blood monouclear cells. The levels of STAT4 tyrosine phosphorylation in T-lymphocytes from RA induced by IL-12 were higher than that from OA in the different times (10, 30, 60 min); after 30 min, its levels from RA and OA achieved to crest value.

CONCLUSIONSTAT4 in peripheral T-lymphocytes of rheumatoid arthritis was more easily to be activated than osteoarthritis.

Adult ; Aged ; Arthritis, Rheumatoid ; immunology ; Female ; Humans ; Interleukin-12 ; pharmacology ; Middle Aged ; Osteoarthritis ; immunology ; Phosphorylation ; Polymorphism, Single Nucleotide ; STAT4 Transcription Factor ; genetics ; metabolism ; T-Lymphocytes ; drug effects ; metabolism ; Tyrosine ; metabolism

Objective To investigate the distribution patterns of traditional Chinese medicine(TCM)constitution in 959 patients with endometriosis(EMs).Methods From January 2019 to November 2019,959 EMs patients were selected from Guang'anmen Hospital of China Academy of Chinese Medical Sciences,Beijing Obstetrics and Gynecology Hospital Affiliated to Capital Medical University,Beijing Hospital,Dongfang Hospital of Beijing University of Chinese Medicine,Beijing Friendship Hospital Affiliated to Capital Medical University,and Fuxing Hospital Affiliated to Capital Medical University.The general clinical information of the patients was recorded and then the TCM constitution was identified.After that,the correlation of TCM constitution distribution with concurrent constitution and the relationship of TCM constitution distribution with age and the complication of dysmenorrhea were analyzed.Results(1)The constitution types of EMs patients listed in descending order of the proportion were yang deficiency constitution(65.1％,624/959),qi stagnation constitution(58.4％,560/959),qi deficiency constitution(52.8％,506/959),blood stasis constitution(44.2％,424/959),phlegm-damp constitution(42.5％,408/959),damp-heat constitution(41.9％,402/959),yin deficiency constitution(39.6％,380/959),balanced constitution(26.8％,257/959),and inherited special constitution(16.6％,159/959).Among the patients,there were fewer patients with single constitution,accounting for 20.2％(194/959),and most of them had concurrent constitution types,accounting for 79.8％(765/959).(2)The association rule mining based on Apriori algorithm obtained 33 related rules.The concurrent constitution types of qi deficiency-yang deficiency,blood stasis-yang deficiency,and blood stasis-qi stagnation were the association rules with high confidence.(3)Compared with patients aged 35 years and below,the patients over 35 years old were predominated by high proportion of blood stasis constitution(P＜0.05).Compared with patients without dysmenorrhea,the patients with dysmenorrhea had the increased proportion of biased constitutions and the decreased proportion of balanced constitution(P＜0.05 or P＜0.01).Conclusion Yang deficiency constitution,qi stagnation constitution,qi deficiency constitution and blood stasis constitution are the high-risk constitution types of EMs patients.The concurrent constitution types are commonly seen in EMs patients,which are more common than single biased constitution.Management of EMs patients with the methods of warming yang,relieving stagnation,benefiting qi and activating blood will be helpful for correcting the biased constitutions in time and preventing disease progression,which will achieve the preventive treatment efficacy through TCM constitution correction.

Objective To study the effects of selenium(Se) and protein on cardiac morphology and expression of cellular glutathione peroxidase(GPX1 ) and mitochondrial thioredoxin reductase(TR2) in rat myocardial tissue.MethodsSixty healthy weaning male Wistar rats were randomly divided into four groups by two factors two levels factorial design(n =15).Drinking water was divided into two levels of Se-deficient(0 mg/L) and Se-adequate (0.25 mg/L); diet was divided into two levels of protein-deficeient (10％ protein and 0.008 mg/kg Se) and protein-adequate(20％ protein and 0.015 - 0.026 mg/kg Se).The rats were killed after feeding for one year.Pathological changes in myocardial tissues were observed under light microscope.The expression of GPX1 and TR2 in rat myocardial tissue was detected by immunohistochemistry and Western blotting.Results Compared between groups,the difference of the rate of myocardial necrosis in rats was statistically significant(x2 =11.04,P ＜ 0.05),in which Se-deficient protein-deficient group [66.7％ (8/12) ] was significantly higher than Se-adequate proteinadequate group [ 7.1％ ( 1 / 14),x2 - 11.06,P ＜ 0.05 ].GPX 1 positive rates in Se-deficient protein-deficient group,Se-adequate protein-deficient group,Se-deficient protein-adequate group and Se-adequate protein-adequate group were 0(0/12),81.8％(9/11 ),10.0％(1/10) and 100.0％(14/14),respectively,in rat myocardial tissue determined by immunohistochemistry.Of which,Se-adequate protein-deficient group and Se-adequate protein-adequate group were significantly higher than Se-deficient protein-deficient group and Se-deficient protein-adequate group(x2 =12.88,8.14 and 35.89,32.60,all P ＜ 0.05).The positive expression rates of TR2 in rats myocardial tissue of the four groups were 0(0/12),81.8％(9/11),0(0/10) and 100.0％(14/14),respectively.Of which,Se-adequate proteindeficient group and Se-adequate protein-adequate group were significantly higher than Se-deficient protein-deficient group and Se-deficient protein-adequate group (x2 =28.67,18.25 and 35.89,32.60,all P ＜ 0.05).The four groups'results of the overall mean of the relatively value of protein expression of GPX1 in cardiac tissue by Western blotting were 0.87 ± 0.13,1.18 ± 0.13,0.95 ± 0.13 and 1.74 ± 0.23,respectively.Through analysis of variance of factorial design,the effects of Se and protein on protein expression of GPX1 in the heart were statistically significant(F=124.93,43.16,all P＜ 0.05).And there was interaction between them(F=24.10,P＜ 0.05).The four groups'results of the overall mean of the relatively value of protein expression of TR2 in cardiac tissue by Western blotting were 0.63 ± 0.19,0.97 ± 0.24,0.55 ± 0.08 and 1.03 ± 0.31,respectively.Through analysis of variance of factorial design,the effect of Se on expression of TR2 in the heart was statistically significant(F =36.97,P ＜ 0.05).Conclusions Adequate Se and protein diet can increase the levels of GPX1 and TR2 in the heart compared to deficient Se and protein diet,can enhance anti-oxidizing ability,protect the myocardial endothelial cells,reduce degree of myocardial injury,and the combined effects of both are better.

Objective To acquaint the situation of selenium nutrition level and coxsakievirus B(CVB) infection in Keshan disease(KD)patients in Heilongjiang province,and provide the evidence for taking the direction mell811rement$of KD contr01.Methods The subjeets were divided into three groups:disease area KD group, disease area control group,and non-disease area control group.We collected soil,food and blood,which were used to detect selenium content,and assay IgN antibody of CVB in plasma.The selenium content of blood was determined with hydride generation atomic fluorometry spectrometrie.The lgM antibody of CVB was measured with ELISA test Kit.Results Compared with those in non-disease areas,selenium content of soil,maize,wheat and bean(0.092 ±0.011,0.003±0.001,0.005±0.003,0.006±0.001)μg/L in disease area Welre significantly lower(t=17.007.8.551,15.842,12.109;all P<0.01).In disease area,the levels of blood selenium in disease area KD group(34.803.±13.302)μg/L was obviously decreased compared to disease area control group(41.235±13.571) μg/L (P<0.05).The rate of CVB infection among disease area KD group,control in disease area and control in non-disease area were 90.0%,68.3%and 45.8%.The odds ratio(OR) value of CVB infected exposure between disease area and non-disease areas was 3.957,and the 95% confidence interval(CI)Was 1.898～8.246.The OR value of CVB infected exposure between KD group and control group was 4.171,with the 95%CI of 1.298～13.404.Compared with CVB non-infection group,blood selenium of CVB infection group was,lower,but not significanfly(t=1.179, P>0.05).Conclusions Selenium deficiency and CVB infection still exist in KD area,Heilongjiang Province.