Objective To evaluate diagnostic accuracy of image interpretation using viewboxes at different luminance with ALVIM statistical phantom (TRG).Methods A digital film of TRG image was obtained by exposing the phantom of TRG with Kodak DR 3000 using proper parameter.Viewboxes with three different luminance were selected from those used in daily work.The film of TRG was evaluated with these viewboxes of three different luminance by three different radiologists with experience of five,eight and sixteen years respectively.A grade scale of 5 was used to evaluate each row of signal and noise.According to the results and formula,the probabilities of true-positive [P (S/s)],false-positive [P (S/n)] and true answer(Pdet) were obtained. Results The three kinds of luminance used in viewboxes were: (3489 ± 256),(2231 ± 220),(816 ± 168) cd/m2.When the average luminance of viewbox was 3489 cd/m2,Pdet of 0.6,0.7,0.8 mm in bone substitute was 0.558±0.009,0.788±0.008,0.813±0.006,Pdet of0.9,1.0,1.2 mm in muscle substitute was 0.663 ± 0.010,0.750 ± 0.008,0.933 ± 0.005 ; When the average luminance of viewbox was 2231 cd/m2 ,Pdet of 0.6,0.7,0.8 mm in bone substitute was 0.525 ± 0.013,0.713 ± 0.013,0.775 ± 0.016,Pdet of 0.9,1.0,1.2 mm in muscle substitute was 0.613 ± 0.019,0.650 ± 0.013,0.850±0.019 ;When the average luminance of viewbox was 816 cd/m2 ,Pdet of 0.6,0.7,0.8 mm in bone substitute was 0.475 ± 0.022,0.550 ± 0.018,0.688±0.020,Pdet of 0.9,1.0,1.2 mm in muscle substitute was 0.550 ± 0.025,0.575 ± 0.021,0.725 ± 0.016. Viewboxes of different luminance were compared to one another by paired t-test.The results of comparison all had significant statistical differences (t = 5.057 and 4.681 ,P <0.05).Conclusions The image displayed by viewboxes at different luminance had significant influence on image interpretation. The higher the luminace of viewbox,the richer the information displayed,and the higher the accuracy of diagnosis.

Objective To investigate radiation dose to the patients undergoing interventional radiology and make radiation risk assessment.Methods Data was collected on 198 instances of 10 interventional radiology procedures by using Philips Allura Xper FD20 DSA, which was equipped with the transparent ionization chamber system in compliance with IEC 60601-2.Patient peak skin dose and effective dose were estimated.Results Cumulative fluoroscopy time was 2.1 - 80.9 min, and number of images monitored for PSD were above 1 Gy and 79 cases monitored for E were above 20 mSv.Conclusions Substantial number of cases exceeded the dose threshold for erythema.Due attention should be paid to radiation protection of patients.

Objective To investigate the status of uncertainty in illness and social support among patients with post-traumatic brain syndrome (PTBS) and analyze their correlation.Methods One hundred and fourteen patients with PTBS were selected by convenience sampling and assessment.They were evaluated by Chinese disease Mishel Uncertainty in Illness Scale (MUIS) and Social Support Assessment Scale (SSAS) and the correlation of two scales was analyzed.Results MUIS total score was(135.23±19.29) scores with a median of 128.74 scores and SSAS total score was (43.14±5.54) scores with a median of 42.00 scores in patients with PTBS.Among 114 patients with PTBS,regarding ambiguity score was negatively correlated with objective support,subjective support,utilization degree of support and SSAS total score,r=-0.301,-0.374,-0.521,-0.509,complexity score was negatively correlated with objective support,sub-jective support,SSAS total score and utilization degree of support,r=-0.367,-0.326,-0.355,-0.533,both lack of information and regarding unpredictability score were negatively correlated with utilization degree of support,r=-0.376,-0.330,MUIS total score was negatively correlated with objective support,utilization degree of support and SSAS total score,r=-0.284,-0.424,-0.305.Conclusion There is high uncertainty of PTBS patients;increase of patients' social support will be good for decreasing the ambiguity and com-plexity among patients' uncertainty;promotion of patients' utilization degree of support will help to reduce patients' lack of information and unpredictability.

Objective To investigate the effect of continuous hemofiltration in patients with acute renal injury induced by rhabdomyolysis and summarize the nursing experience.Methods Ten patients with acute kidney injury induced by rhabdomyolysis were managed with continuous hemofiltration,corresponding nursing care performed.Results After treatment,the renal function of 7 patients resumed normal,the function of 2 were improved,and only 1 needed long-term hemodialysis.After treatment,the levels of serum creatine phosphokinase(CPK),myoglobin(Mb),blood urea nitrogen(BUN),creatinine(Scr),aspartate aminotransferase(AST) were gradually decreased,K+resumed normal and urine volume increased to normal level,with significant difference as compared to those before treatment(P<0.05).Conclusions Continuous hemofiltration together with pertinent nursing measures can ensure the curative effect.It is of great significance for improving the prognosis of rhabdomyolysis.

RBC, plasma and hair Mn levels have been measured in 38 children with Keshan disease from the Chuxiong district of Yunan province and were compared with that of 35 healthy children. After logarithmic, transformation, normal distribution of Mn levels of RBC, plasma and hair had been presented. The geometric means of the RBC, plasma and hair Mn content of the patients were 1.22?g/g(dry basis), 0.16?g/ml and 8.76?g/g respectively. In normal subjects, the means of RBC, plasma and hair Mn were found to be 0.59?g/g (dry basis), 0.13?g/ml and 2.57?g/g. The children with Keshan disease had higher Mn levels than controls. (P

Objective To investigate the value of MSCT in evaluating pulmonary functional changes in silicosis.Methods 56 cases of silicosis and 10 healthy people(as control group) underwent inspiratory and expiratory MSCT scans and pulmonary functional test one week later.The CT findings including silicotic nodules,large opacity,emphysema,reticular opacities,bronchiectasis and air trapping were recorded and graded subjectively on CT images.Air retention and emphysema were quantified using the software of Pulmo.CT scores were correlated with spirometric findings by using spearman rank correlative analysis in comparison with pulmonary functional index.Results The scores of CT features except for reticular shadows were of significant difference between silicotic group and control group,but not between simple silicotic group and complex silicotic group.The scores of air retention and emphysema on CT were significantly negative correlation.The reticular shadows were of positive correlation with FEF 75%,FEF 50% and FEV1,but on correlation with FEV1/FVC.There were no correlation between the scores of silicotic nodules,bronchiectasis,large shadows and pulmonary functional test.There was obvious correlation between air retention,the scores of emphysema on CT and the index of pulmonary function in obstruction of small airway.Conclusion MSCT is of important value in evaluating the damage of pulmonary function in silicosis.

Objective To explore clinical value of serum carcinoembryonic antigen (CEA) rate in early evaluation of imaging tumor efficacy and prognosis of disease control for advanced non-small cell lung cancer (NSCLC) before and after the second course of chemotherapy, and provide the basis for clinical adjustment chemotherapy regimens.Methods Patients in the Third Affiliated Hospital of Sun Yat-sen University were randomly collected in January 2007-September 2014 during the pathological diagnosis of 130 cases for advanced NSCLC, who had an elevated serum CEA level, including pre-chemotherapy and prochemotherapy, were collected.Receiver operating characteristic (ROC) was used to evaluate efficacy of CEA change in evaluation of early disease control (DC).SPSS 18.0 was used to analyze the relationship between CEA change and prognosis.Results After two chemotherapy cycles, the area under the ROC curve was 70.6％.When the cut-point of the change rates of CEA levels was 2.05％ , the Youden index reaches the maximum.Adenocarcinoma group and squamous cell carcinoma patients after 2 courses of CEA change rate evaluation, which area under the ROC curve was 72.0％ (95％ CI :61.4％ ～ 82.5％), and 70.1％ (95％ CI:45.8％ ～94.5％).Survival was analyzed with the Kaplan-Meier method, which showed the change rates of CEA levels were all the influencing factors of progression-free survival (PFS) in patients with advanced NSCLC(P ＜ 0.05).While the change rates of CEA levels were not predictive overall survival (OS) (P =0.715).Conclusions It prompts effective chemotherapy, and patients have the extended PFS, when CEA levels before and after chemotherapy dropped to a certain degree.

BACKGROUND: Vogt-Koyanagi-Harada (VKH) disease is characterized by bilateral granulomatous uveitis with neurologic, auditory, and dermatologic manifestations. However, acute myelitis complicating VKH disease has rarely been reported. CASE REPORT: A 50-year-old Chinese Han woman presented with difficulty walking, numbness on the left side of the body, and difficulty with urination. The patient was diagnosed with incomplete VKH disease and received corticosteroid treatment prior to the neurological presentation. Acute myelitis was diagnosed based on both clinical and spinal-cord MRI findings. CONCLUSIONS: Clinicians should consider acute myelitis as a rare possible neurological manifestation in VKH disease patients, and early systemic administration of corticosteroids will suppress the acute inflammatory process and prevent recurrences. This report raises the possibility that VKH disease and acute myelitis share common pathogenic pathways.
Adrenal Cortex Hormones ; Asian Continental Ancestry Group ; Female ; Humans ; Hypesthesia ; Mobility Limitation ; Myelitis ; Neurologic Manifestations ; Recurrence ; Urination ; Uveitis ; Uveomeningoencephalitic Syndrome

Objective To explore the effect of improving clinical practice ability of nursing undergraduates via double evaluation.Methods From September 2015 to May 2016, 61 nursing undergraduates enrolled in 2012 to Guangzhou University of Chinese Medicine were selected by convenience sampling method and divided randomly according to their student number into experimental group (30 cases) and control group (31 cases). According to the double evaluation method adopted in the experimental group, clinical teaching scheme was modified dynamically. In the control group, clinical teaching was conducted according to clinical teaching scheme made by the university, with OSCE and evaluation form of clinical practice ability as tools for observer and self evaluation.Results Within the experimental group, both scores of observer evaluation in OSCE and scores of self evaluation in clinical practice behavior showed a trend of going up in phases (P<0.05). In comparison of observer evaluation in OSCE at the 9th month, scores of the experimental group were all higher than those in the control group in all dimensions except writing of nursing documents (P<0.05). In comparison of self evaluation in clinical practice behavior at the 9th month, scores of the experimental group were all higher than those in the control group in all dimensions except communication ability, slightly lower (P<0.05).Conclusions With the double evaluation method adopted, dynamically modified clinical teaching scheme according to phases can obviously improve clinical practice ability of nursing students.

Objective:A dose verification system of two-dimensional semiconductor matrix(SRS MapCHECK)was used to verify the dose of the clinical treatment plan of patients who underwent CyberKnife(CK),which realized rapid verification for individualization of radiotherapy plans of patients through analyzed the γ-passing rates of them.Methods:A total of 253 patients with tumor who received CK clinical treatment in the First Medical Center of Chinese PLA General Hospital from March 2021 to May 2023 were selected.Among of them,121 cases received CK treatment on head,and 30 cases received that on lung,and 102 cases received CK treatment on abdomen and other metastatic tumor.In the MultiPlan treatment plan system,the plan of patient was mapped to the integrated model composed of StereoPHAN model and SRS MapCHECK matrix dose verification system by the means of the plan image center overlap.The dose verification was conducted on the plan of each patient on the basis of ensuring the consistency of the number of beam,direction of beam and the monitor unit.The different γ analysis standards(1%/1 mm,2%/1 mm,3%/1 mm,1%/2 mm,2%/2 mm,3%/2 mm,1%/3 mm,2%/3 mm and 3%/3 mm)were adopted to conduct global analysis of absolute dose for each verification plan,and the threshold(TH)of low dose was set as 10%.Results:The γ passing rates of phantom verification plans of 253 patients were respectively(88.64±5.91)%,(95.43±3.40)%,(97.90±2.06)%,(96.51±2.35)%,(98.15±1.68)%,(99.06±1.12)%,(98.30±1.39)%,(99.09±0.97)%and(99.52±0.63)%under different analysis standards.The γ passing rates of other standards of patients with tumor on different parts were larger than 95%except the analysis result of 1%1 mm standard.The overall analysis result of the deviation of central point dose was(-1.30±2.17)%,among of which the tumor of head,abdominal tumors and other metastatic tumor were about approximately-2%,while that of lung tumors were approximately-3%.The deviation of abdominal and other metastatic tumor was the minimum.The correlation analysis showed that the target volume and the size of the minimum collimator were respectively correlated to the dose deviation of the center.Conclusion:SRS MapCHECK dose verification system can conveniently and quickly realize the individualized verification for the plan of patients who receive CK treatment.