Abdominal imaging is one of the important clinical applications of magnetic resonance imagining, but image degradation due to respiratory motion remains a major problem. Retrospective respiratory navigator gating technique is an effective approach to alleviate such degradation but is subject to long scan time and low signal-to-noise ratio (SNR) efficiency. In this study, a modified retrospective navigator gating technique with variable over-sampling ratio acquisition and weighted average reconstruction algorithm is presented. Experiments in phantom and the imaging results of seven volunteers demonstrated that the proposed method provided an enhanced SNR and reduced ghost-to-image ratio compared to the conventional method. The proposed method can also be used to reduce imaging time while maintaining comparable image quality.
Algorithms ; Artifacts ; Humans ; Imaging, Three-Dimensional ; Magnetic Resonance Imaging ; Motion ; Phantoms, Imaging ; Respiration ; Signal-To-Noise Ratio

Conventional magnetic resonance (MR) pulse sequences typically have an echo time (TE) of 1 ms or longer, providing an excellent contrast between different soft tissues. However, some short T2 tissues appear dark in conventional MR images because the signal from these tissues has decayed to nearly zero before the center of k-space is acquired. Because of the ability of directly imaging short T2 tissues, ultrashort echo time technique has been widely studied in recent years. An overwhelming majority of the studies were carried out at high fields, while many low- field scanner systems are still used in developing countries. To investigate the effects of the delay between analog-to-digital converter sampling and the readout gradient, the TE of the second echo used to calculate the R2 * map, and the undersampling ratio on the results of three-dimensional (3D) ultrashort echo time imaging at a low field, we implemented a 3D ultrashort echo time sequence on a 0. 35T scanner. Different parameters were used and the reconstructed images and R2 * maps were compared. Images reconstructed with slightly varying delays appeared quite different. Different contrast between short and long T2 tissues were found in R2 * maps calculated with different echoes. The result of undersampling study indicated that excessive undersampling could cause unwanted blurring, making it difficult to better visualize the short T2 tissues in the R2 * map. The results suggested that cautions should be taken in the choice of these parameters in 3D ultrashort echo time imaging. Short T2 tissues can be visualized with appropriate imaging parameters at this low field.
Humans ; Image Processing, Computer-Assisted ; Imaging, Three-Dimensional ; Magnetic Resonance Imaging ; methods

Objectives:To evaluate the nursing diagnostic items in perioperative patients, its indication and clinical directive effect. To explore the conception and goal of perioperative nursing diagnosis and the method of making diagnosis from theories, identifying and using them from theories and practice, and to discuss the training method and positive outcomes from quality management. Methods: One thousand and fifty items of nursing diagnosis were collected from 10 surgical units and 20 items were screened from them. Continuous practice and improvement was done by a cycling model: training nurses use items examine nurses analyze outcome find out problems and causes plan and apply interventions. The consistency of the diagnosis and the outcomes of the patients were also compared. Results: The nursing quality of 10 surgical units was improved markedly from 2001 to 2002. Conclusions:The screened 20 items are commonly used in perioperative patients. If used correctly, they could play a strong pragmatic and directive role in nursing practice. Theoretical training and practice are the key to the correct diagnosis and nursing care.

OBJECTIVE:To evaluate the effect of L-carnitine on serum total level of homocysteine (tHcy) in patients undergoing maintenance hemodialysis. METHODS: 60 patients undergoing maintenance hemodialysis were randomly divided into two groups (treatment group and control group): the patients in the treatment group were injected i.v. with 1.0 g of L-carnitine for 12 weeks,and those in the control group were injected i.v. with 5 mL normal saline for 12 weeks. Meanwhile,the healthy people were involved as normal control group(n=20). tHcy was detected by ELISA method;the fasting insulin was detected by radio-immunity method. Fasting blood glucose,total cholesterol,triglyeride,HDL and LDL were detected by routine method. The reciprocal of the multiplication product between fasting blood glucose and insulin concentration were computed as insulin sensitivity index(ISI). RESULTS: After treatment for 12 weeks,the treatment group showed increased ISI but significantly reduced tHcy(P

Objective To explore the roles of B lymphocyte and plasma cell in liver allograft re-jection to find the evidences of humoral factor participating in the rejection. Methods Immunohisto-chemical inspection of C4d, CD20+ B lymphocytes and CD138+ plasma cells were performed in 34 liver biopsy specimens from 25 patients with hepatic injury and their preoperative specimens. Then we ob-served the variances of the above parameters in the liver biopsy specimens and the differences of them with different hepatic injuries. We further observed the relation of the presence of CD20+ B lympho-cytes and CD138+ plasma cells to C4d positivity. Meanwhile, we compared the difficulties of clinical therapy with different presences of CD20+ B lymphocytes and CD138+ plasma cells in the liver biopsy specimens. Results The positive ratios of CD20+B lymphocytes and CD138+ plasma cells were signif-icantly higher in the acute rejection group than in the non-rejection group(P<0. 05 and P<0. 01).The positive ratios of CD20+ B lymphocytes were markedly higher in the chronic rejection group than in the non-rejection group(P<0. 05). There was no difference in CD138+ plasma cells between the 2 groups. The degrees of hepatic injury could not influence the positive ratioes of CD138+ plasma, but the positive ratioes of CD20+ B lymphocytes in the heavy hepatic injury groups was higher than in the slight hepatic injury groups(P<0. 05). CD20+ B lymphocytes and CD138+ plasma cells presented fol-lowing C4d(P<0. 01 and P<0. 05). The effective power of steroid in the all-positive group was obvi-ously lower than in the all-negative group(P<0. 05). Conclusion Humoral immune may participate in some liver allograft rejection. It would be more favorable for observing and prewarning the humoral re-jection by finding CD20, CD138 and C4d by immunohistochemical staining in liver biopsy specimens with hepatic injury after liver transplantation. It would be helpful for choosing the therapeutic regi-mens of liver allograft rejection.

Aim To investigate the effect of sphingo-sine kinase 1 (SphK1 )on unilateral ureteral obstruc-tion(UUO)-induced tubulointerstitial fibrosis and ex-plore the possible mechanism.Methods The CD-1 mice were randomly divided into four groups:sham-op-eration group(Sham),PF-543 treatment control group (Sham +PF-543),model group(UUO)and PF-543 treatment group(UUO +PF-543).On 1 ,3,7 and 1 4 d after operation,eight mice were selected randomly from each group and sacrificed.The protein expressions of SphK1 ,mature TGF-β1 ,FN,ColⅠ,LC3,Beclin1 ,Atg5 and Atg1 2 were observed by Western blot.The histo-logical changes were examined by Masson′s trichrome stain.Immunhistochemistry was performed to measure the levels of expression of SphK1 ,FN and Col Ⅰ. Transmission electron microscope was used to observe the autophagic body.Results SphK1 expression and autophagy were both upregulated in a mouse model of kidney fibrosis induced by UUO. Meanwhile, in-creased mature TGF-β1 and deposition of extracellular matrix(ECM)were observed in tubulointerstitial areas compared with sham-operated mice.After intraperito-neal injection with the SphK1 specific inhibitor PF-543 in UUO mice,enhanced expression of SphK1 and acti-vated autophagy were significantly abrogated.Howev-er,aggravation of renal fibrosis was detected when SphK1 inhibitor PF-543 was applied to suppress SphK1 expression in UUO mice.Conclusion SphK1 activa-tion is renoprotective through the induction of autoph-agy in the pathogenesis of kidney fibrosis.

BACKGROUND:Previous research indicated that iron-fluorouracil-phenanthroline complex has good antitumor activity in vitro, which can inhibit the proliferation of human cancer cels. OBJECTIVE:To detect the antitumor activity and toxicity of iron-fluouracil-phenanthroline complex, [Fe(5-Fu)2(Phen)SO4],in vivo. METHODS:A total of 40 Kunming mice were randomly divided into four groups, which were intraperitoneally injected with 72, 102.9, 147, 210 mg/kg [Fe(5-Fu)2(Phen)SO4] and the half lethal dose of the complex was detected. One day after the establishment of mouse S180 sarcoma models, the model mice were randomly divided into eight groups, and administered with the intraperitoneal injection of 15 mg/kg (low dose group), 30 mg/kg (middle dose group), 60 mg/kg (high dose group) [Fe(5-Fu)2(Phen)SO4], normal saline (negative control group), cisplatin (positive control group), 5-fluorouracil, iron-salt and phenanthroline, respectively. The injection was done once a day, lasting for 7 days. The weight of sarcomas, body weight, the main organ coefficient and histopathological changes of the main organs were detected. RESULTS AND CONCLUSION: The half lethal dose of [Fe(5-Fu)2(Phen)SO4] was 103.9 mg/kg. Compared with the negative control group, high dose group, positive control group and 5-fluorouracil could significantly inhibit the growth of the tumor (P< 0.05 orP< 0.01), and the effect of high dose group was the most obvious (P < 0.01). Compared with cisplatin, 60mg/kg [Fe(5-Fu)2(Phen)SO4] had a weaker inhibitory effect on the kidney, but higher inhibitory effect on the liver, spleen and thymus, indicating the complex has a lower nephrotoxicity, but stronger immunotoxicity and hepatotoxicity than cisplatin.

Objective To evaluate the effects of isokinetic quadriceps training with different ranges of motion for improving mal-patellar tracking after total knee replacement (TKR). Methods Isokinetic quadriceps training was administered to 52 TKR cases, involving 66 knee joints with poor patellar tracking. The subjects were randomly allocated into 3 groups for isokinetic training with ranges of 0-30°, 30-60° or 60-90°, with 22 knee joints in each group. The angular velocity was set at 30°/second. X-rays with loading and with 45° knee flexion were taken before and after the training. The lateral patello-femoral angle,the patella index and the patello-femoral index were recorded along with the maximum torque ( MT), the total work ( TW ), and the average work(AW) in the three different ranges of motion. Hospital for Special Surgery (HSS) scores were also recorded. Results After 3 months of training, the average lateral patello-femoral angle, patella index, and patello-femoral index in the 0-30° training group were all significantly better than before the training. However, there was no significant difference in these measures for the 30-60° and 60-90° groups. After training average MT, TW and AW increased significantly in all groups, but the improvements were significantly correlated with the differences in lateral patello-femoral angles, patella indices and patello-femoral indices only for the 0-30°group. When compared with the baseline values, a statistically significant difference in HSS score after training was observed only in the 0-30° training group. Conclusions Isokinetic quadriceps training with a 0-30° range of motion can best realign patellar tracking after TKR, and best improve knee function.

Objective To evaluate the effectiveness and safety of open tension-free hernioplasty and two kind of laparoscopic hernia repair for the treatment of primary unilateral inguinal hernia. Methods Patients suffering from primary unilateral inguinal hernia were randomly divided into 3 groups to undergoopen operation with mesh-plug and patch or transabdominal preperitoneal hernioplasty (TAPP) or totally extraperitoneal hernioplasty (ZEP). Results From February 2006 to February 2009, a total of 164patients were divided into 3 groups, with 62 undergoing open tension-free mesh-plug hernia repair, 50receiving TAPP and 52 receiving TEP. Postoperative patients were then followed up for a period of(16±8)months. The average operating time for the patients in the open mesh repair group was significantly shorter compared to the other two groups (P＜0.01 ). The cost in the open mesh repair group was also significantly lower than the other two groups (P＜0.01). The pain scores in open mesh group were significantly higher than those in the other two groups (P＜0.01). The hospital stay and the recovery time were both significantly longer in the open mesh repair group (P＜0.01) compared to the other two groups. No major complications and recurrence was found in neither groups. Conclusions Open tension-free mesh-plug hernia repair, TAPP and TEP are all safe and effective for the treatment for patients with primary unilateral inguinal hernia. TAPP and TEP are superior to open tension-free mesh-plug hernia repair as these two procedures involve less postoperative pain and fast recovery.

Taking Suxi Healthcare Center in Yiwu City, Zhejiang province as an example, the paper analyzed the present mission and organizational characteristics of township healthcare centers in China, especially their dual functionality of community public health and primary medicare. Based on such analysis, it designed a matrix-based model for organizational structure and job performance management for such heslthcare centers. The features are as follows. 1) The two dimensions of the matrix structure refer to the departments for medical treatment and the multi-village doctors team in the community, respectively and jointly offering primary medicare and public health services; 2) Jobs are designed based on the organizational structure and functionality. Every job carries out dual Junctions as described and managed by the job description and target responsibility certificate; 3) The job responsibility certificate is a breakdown of the balanced scorecard of the healthcare center, as divided between the departments for medical treatment and the multi-village doctors team; 4) The balanced scorecard of the township healthcare center is designed based on its strategic mission and developing plan. The entire organizational design and management of the center are built on the strategic orientation and logical programmed research.