Objective To evaluate the value of reducing radiation dose with decreased size of ECG-pulsing windows and influence on image quality in dual-source CT coronary angiography. Methods 120 patients with stable heart rate(HR) were divided into four groups according to HR and the rang of ECG-pulsing windows in dual-source CT coronary angiography: HR ＜ 70 bpm and 61% ～ 77% R-R interval of ECG-pulsing windows, HR ＜ 70 bpm and 25% ～ 80% R-R interval of ECG-pulsing windows,HR ＞ 80 bpm and 31% ～47% R-R interval of ECG-pulsing windows, and HR ＞ 80 bpm and 25% ～ 80%R-R interval of ECG-pulsing windows was employed, respectively. The radiation dose parameters were recorded and image quality scores were performed. The image quality and radiation dose between two slow HR groups and between two fast HR groups were compared respectively. Result The effective doses were (7.06 ± 2. 13 ), ( 11.34 ± 3.65 ), ( 6. 67 ± 1.97 ) and ( 9. 92 ± 3. 15 ) mSy for four groups, respectively.The effective dose was decreased by 37.74% for slow HR and by 32. 76% for fast HR using narrow ECG-pulsing windows. There was no difference on image quality between two slow HR groups and two fast HR grouvs. Concluslons The proper application of narrow ECG-pulsing windows can reduce radiation exposure significantly to stable slow or fast HR patients in dual-source CT coronary angiography withont sacrificing the image quality.

Objective To observe the affection of smoking on atherosclerosis. Methods The research objects were divided into two groups,smoking group and control group in 60 cases. intima-media thickness and the numbers of plaques were measured in both sides of common carotid arteries by gray-scale imaging.Results There was significant difference between smoking group and control group(P

AIM: In this context, the high performance liquid chromatography (HPLC) of Tongbiding Injection was used as fingerprint examples of traditional Chinese medicine to compare the different methods for evaluating the similarity. METHODS: Computing methods for similarity assessments were first compared on the basis of theoretical analysis, and then comprehensive evaluations for performances of each method of similarity assessment were investigated via data simulation and statistics. RESULTS: The results manifested that each approach had its individual properties and limitations. Distance coefficient has better general properties as compared with other methods of assessing similarity. CONCLUSION: In practie, to estimate the similarity between the fingerprints of traditional Chinese medicines, the appropriate methods would be selected for the different problems, and therefore quality of traditional Chinese medicines would be better controlled.

Objective To investigate the effect of trabeculectomy combined with segmental iridectomy, mitomycin C (MMC) and viscoelastic agents usage on the treatment of glaucoma secondary in uveitis. Methods According to the age, degree of inflammation and the condition of Tenon capsule of patients, differ-ent concentration of MMC (0.25-0.33 mg/ml) was used during the operation, with separation of the anterior and posterior synechia, resection of pupillary organization membrane using viscoelastic agents. Segmental iridec-tomy and releasable sutures were also performed on the patients. The visual acuity of preoperation and postoper-ation, intraocular pressure, inflammation and the complication were record. Results Forty-two eyes of 38 cases with glaucoma secondary in uveitis were studied, the mean follow-up time was (12.01±3.56) months. The postoperative visual acuity improved in 14 eyes, didn't change in 28 eyes. The postoperative inflammation of anterior chamber disappeared in 35 eyes, relieved in 7 eyes. And the average postoperative intraocular pres-sure (15.20± 4.64) mmHg was significantly lower than the preoperative intraocular pressure (38.37±12.93) mmHg (t = 8.255, P = 0.000). The total success rate was 92.9%. There were no severe complication. Conclusion Trabeculeetomy combined with MMC, viscoelastic agents usage, separation of anterior and poste-rior syneehia, segmental iridectomy and releasable suture could increase the success rate of operation on pa tients with glaucoma secondary in uveitis, decrease the complication and inflammation reaction of operation, and the recurrence of uveitis.

Objective:The paper is designed to reveal differences in stroke patients'hospitalization costs crea-ted by different socioeconomic factors , health insurance and occupational background , and analyze those differences on health outcome .Methods:18879 cases of hospitalized patients with stroke in five tertiary hospitals from four prov-inces from 2011 to 2014 were included in the database .Descriptive statistics was used to describe patients'hospitali-zation costs and health outcome .Multiple linear regression model and logistic regression were used to evaluate the im-pact of insurance and occupation .Results:After controlling for patients'social characteristics , health risks , premise during hospitalization process and clinical characteristics of patients with free healthcare costs , the socialized medi-cine was charged 19.7% higher than the private ones ( P <0.001 ), the retired people and civil servants were charged 4.2%(P<0.001) and 2.9%(P=0.049) more than farmers.The socialized medicine was also associated with health outcome.The risk of death in patients with free medical care is (OR=4.901) compared with private pa-tients (95%CI 1.652~14.537), and the retired people had increased risk of death compared with farmers (OR=2 .145 , 95%CI 1 .287 ~3 .573 ) .Conclusions: Due to the impact of social background factors , some groups are found to have a higher level of expenses than their counterparts during hospitalization , but the more hospitalization costs are not spent the better the health outcome of stroke was achieved .

Objective To investigate the change of extracellular histone level as well as the mecha-nism of the cytotoxicity of extracellular histones on vascular endothelial cell in sepsis. Methods Septic chil-dren admitted to PICU in Shanghai Children′s Medical Center between January 2010 and December 2014 were included in the present study. According to the diagnostic criteria of sepsis,the patients were divided into the sepsis group(51 cases) and the severe sepsis group(79 cases),with healthy children as the control group (108 cases). Patients in the severe sepsis group were further divided into the survival group(45 cases) and the non-survival group ( 34 cases ) based on 28-day mortality. The plasma concentration of extracellular histones in these children was determined and its correlation with the severity of sepsis was analyzed. Human umbilical vein endothelial cells(HUVECs) were incubated with calf thymus histone(CTH) at various con-centrations(0,50,100,200 and 300μg/ml) or different time periods(200μg/ml,0,5,15,30,45 and 60 mi-nutes) . The treated cells were subject to flow cytometer to measure the cell survival rate and scanning/trans-mission electron microscopy to observe their morphological changes. Western blot was used to detect the ex-pression of IκB and phosphor-p38/p38 in nuclear factor ( NF )-κB and mitogen-activated protein kinase ( MAPK) signaling pathways,while ELISA was used to determine the levels of tumor necrosis factor-α and interleukin-6. Results The levels of circulating histones in the septic children(2. 29 ± 1. 00) and severe sep-tic children ( 19. 17 ± 10. 20 ) were significantly higher than that of healthy controls ( 0. 23 ± 0. 26 ) ( P <0. 001),and the histone levels in the severe septic children were even higher(P<0. 001). Among the chil-dren diagnosed as severe sepsis,the level of circulating histones in the non-survivors was significantly higher than that in the survivors(29. 47 ± 5. 99 vs. 10. 94 ± 2. 68,P<0. 001). The survival rate of HUVEC gradually decreased along with the increase of CTH concentration or the treatment period in vitro. Data from electron microscopy showed that CTH treatment could directly disrupt the plasma membrane of HUVEC. Histones could also activate NF-κB and MAPK pathways,leading to the release of large amount of tumor necrosis fac-tor-α and interleukin-6. Conclusion The levels of extracellular histones in the septic children are correlated with the severity of sepsis. CTH can induce HUVEC death in a dose-and time-dependent manner. Extracellu-lar histone-induced endothelial dysfunction may mediate the progression of sepsis and such cytotoxicity might be due to the destruction of endothelial cell membranes and activation of the NF-κB and MAPK signaling pathways.

Objective To observe the effect of acupuncture on the infracted area and apoptosis of rats with brain contusion.Methods Feeney's method was used to establish brain contusion model.The 40 rats were randomized into sham-operation,model,acupuncture and naloxone (NX) group with 10 in each.Acupuncture was performed for the rats of acupuncture group and NX was injected intraperitoneally for the rats of NX group.The treatment was done once everyday,7 days altogether.Then the brain histotomy was prepared after all the treatment finished.Computer image analysis system was used to detect the infracted area.TUNEL method was adopted to detect the apoptosis.Results The brain contusion in the model group was severe,there were lots of apoptotic cells and the infracted areas were bigger than the injured areas (P0.05).Conclusion Acupuncture can decrease the infracted areas and apoptosis of the rats with brain contusion,being effective in anti-secondary brain injuries.

Objective To investigate the effects of quiet respiratory intrathoracic pressure changes on ventricular dimensions and left ventricular systolic function,and to further verify our newly proposed hypothesis of the mechanism of respiratory effects on hemodynamics.Methods Twenty healthy volunteers aged 18 to 40 years average(24?7) years were included.The respiratory curve and electrocardiogram were simultaneously recorded.The interventricular septum movement,ventricular dimensions and ventricular systolic excursions were recorded by two-dimensional and M-mode echocardiography during quiet respiration.The respiratory variations of the above parameters were derived,and the parameters for assessing ventricular systolic function were calculated.Results With quiet respiration,the interventricular septum moved towards the left ventricle on inspiration,and then towards the right ventricle on expiration.The right ventricular diastolic dimension increased significantly on inspiration compared with those on expiration.The opposite changes occurred with left ventricular diastolic dimensions.The left ventricular posterior wall systolic excursion and the left ventricular stroke volume significantly increased during expiration compared with those during inspiration.No significant differences were found in left ventricular ejection fraction and fractional shortening between inspiration and expiration.Conclusions The respiratory intrathoracic pressure change is one of the factors influencing the reciprocal changes of the left and right ventricular parameters related to ventricular dimensions and systolic function.

ObjectiveTo investigate the feasibility of decreasing radiation dose and contrast media dose of abdominal CTA using low tube voltage setting combined with personalized contrast media application.MethodsOne hundred and twenty patients were randomly divided into 3 groups,and there were 40 patients in each group.120 kV tube voltage was used in group A,and 100 kV tube voltage was used in group B and C.Personalized injection flow rate of contrast media which determined according to patient's body mass (injection flow rate =λ × body mass) was used for all groups,and the λ values for group A,B and C were 0.07,0.07 and 0.06 ml · kg-1· s- 1 respectively. CT dose index volume ( CTDIvol ) effective dose(ED) and contrast media dose were evaluated,and these parameters were all analyzed using one-way ANOVA analysis.Image quality of abdominal aorta and branch arteries was rated using a three-point ordinal for all 3 groups,and image quality score was analyzed using Kruskal-Wallis test.ResultsCTDIvol were (8.2±0.8),(6.0 ±1.0) and (6.1 ±1.1)mGy for group A,B and C,ED were (5.2 ±0.8),(3.5 ± 0.7) and ( 3.6 ± 0.6) mSv,and contrast media dose were (72.3 ± 10.3 ),(73.5 ± 11.3 ) and (61.6 ±9.4) ml,respectively.There were significant differences in CTDlvol,ED and contrast media dose among 3 groups ( F =66.094,77.812,15.919 ; P =0.000).Compare with group A,the ED of group B was decreased 32.7％,and the ED and contrast media dose of group C were decreased 30.8％ and 14.8％,respectively.Image quality was rated as excellent,good,and general for 20,19 and 1 patients in group A,25,15 and 0 patients in group B,and 23,17 and 0 patients in group C,respectively.There was no significant difference in image quality score among 3 groups ( x2 =1.492,P =0.474 ).ConclusionsThe radiation dose and contrast media dose can be decreased in abdominal CTA using low tube voltage and personalized contrast media apolication while image quality can be preserved.

Objective To explore the changes of corticotropin releasing factor (CRF) levels secreted by hypothalamus neuron in children with acute brain injury. Methods Fifty-one intracranial-infection children with brain injury and 11 intracranial-noninfection children with brain injury were chosen from pediatric intensive care unit of our hospital. Severities of their brain damage were evaluated by Glasgow score,and CRF level in cerebrospinal fluid (CSF) and serum TNF-α and IL-6 levels were measured by radioimmunoassay. Results There was no significant difference of Glasgow scores between the intracranial infection group and intracranial-noninfection group ( P = 0. 302 6 ), CSF CRF level of intracranial infection group was significantly lower than that of intracranial-noninfection group ( P ＜ 0. 01 ), serum TNF-α and IL-6 levels of intracranial infection group were significantly higher than those of intracranial-noninfection group ( P ＜ 0. 01,P ＜0. 001 ). As comparing to the children with Glasgow score of 6 ～ 7, the levels of CSF CRF and serum TNF-α and IL-6 in children with Glasgow score of 4 ～ 5 were significantly increased ( P ＜ 0. 05, P ＜ 0. 001 ).Conclusion CSF CRF level of the children with acute brain injury is changing, which may be concerned with the secretion of hypothalamus CRF neuron stimulated by TNF-α, IL-6 and hypoxia stress in children with brain injury.