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

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

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 investigate the damaging traits of cognitive function in first episode depression patients with the assessment of neuropsychological status ( RBANS) and Stroop Color-word Test. Methods Two hundred and thirty first-episode depression patients as experimental group and one hundred and seventy-eight health person as control were evaluated separately by repeatable battery for the RBANS and Stroop Color-word Test. Results In Stroop Color-word Test,the time required for completing the words,color,double-word,two-color in depression patients ( (14.37 ±6.65)s,(21. 58 ±8. 70) s,( 16. 56 ±8. 23)s, (37. 88 ± 13. 67) s) were longer than the control group ((12.38 ±3.34)s, (18.01 ±5.51) s, (14. 17 ±4. 37) s, (32. 87 ± 10.28) s). The difference between the two groups was found in cognitive function in first episode depression patients (P ＜ 0.05). The scores of color interference and meaning interference were no difference between the two groups (P＞0.05) . The patients'scores of the RBANS test in all items( (72.19 ± 17.22), (80.89 ± 15.29), (82.00 ± 16.37) , (98.74 ± 17.01) ,(82.09 ± 14.62) )were significantly poorer than those in healthy controls. Compared with control group, scores of the scales were significant difference between two groups. Pearson correlation analysis showed that RBANS total score and five factors had no correlation with HAMD total score and factors. It positively correlated with education level (P＜0.05) ,but not with sex (P＞0.05). Immediate memory,verbal function,delayed memory in five factors and RBANS total score negatively correlated with age and course of disease respectively, but breadth of vision,attention were not did(P＜0.05). Conclusion First-episode depression patients suffer from more serious and comprehensive damage of cognitive function such as memory,attention,executive function.

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.

Objective To investigate the clinical curative effects and side effects of concurrent radiotherapy combined with interventional artery infusion chemotherapy in advanced cervical carcinoma.Methods 48 patients with advanced cervical carcinoma were randomly divided into two groups including concurrent radiotherapy combied with interventional artery.infusion ehemotherapy group (25 patients) and radiotherapy group (23 patients).Each patient in the concurrent radiotherapy combined with interventional artery infusion chemotherapy group was given THP,DDP and 5-Fu,repeatedly every 28 days,total 3-4 cycles.Radiotherapy was given at the same time.Results The effective rates of the concurrent radiotherapy combined with interventional artery infusion chemotherapy group and radiotherapy group were 92.0 ％ (23/25)and 69.6 ％ (16/23),respectively.The overall 3 year survival rates for the patients in concurrent radiotherapy eombined with interventional artery infusion chemotherapy group and radiotherapy group were 80.0 ％ (20/25)and 52.2 ％ (12/23),respectively,and there was statistically significant between the 2 groups (all P ＜ 0.05).No more side effects were found in the concurrent radiotherapy combined interventional artery infusion chemotherapy group (P ＞ 0.05).Conclusion Concurrent radiotherapy combined with interventional artery infusion chemotherapy in advanced cervical carcinoma can increase short term therapeutic effect and improve the survival rate of the patients without more side effects.

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.

Objective To investigate the short-term outcome of laparoscopic adjustable gastric banding (LAGB) for morbid obesity complicated with type 2 diabetes. Methods Eight morbidly obese patients with type 2 diabetes underwent LAGB from October 2006 to August 2007. The weight parameters, fasting (FBG) and 2-hour blood glucose (2hBG), medication for diabetes were assessed 1,3, 6 and 9 months after surgery. Results All of the patients lost weight, with a mean body mass index decreased from (38.7±7.5) kg/m2 before LAGB to (30.5±4.3) kg/m2 9 months after LAGB. The FBG and 2hBG were decreased significantly at month 6 and 9 after LAGB, with normal FBG and 2hBG in 4 patients. At month 9 after LAGB, 3 of 5 patients with insulin treatment before LAGB were changed to oral hypoglycemics, 1 was continuously administered with a reduced dose of insulin, and 4 patients stopped any medication. Conclusion LAGB is an effective procedure in the treatment of morbid obesity complicated with type 2 diabetes with a favorable short-term outcome.