Objective To investigate the feasibility of double low scanning technique using the gem spectrum CT coronary artery angiography among the patients at low heart rate≤ 65 beats per minute.Methods This prospective study was approved by the institutional re-view board with patient informed consent.Ninty patients (heart rate≤65 beats per minute)were randomly devided into 3 groups.Group A un-derwent spectral CCTA with iodixanol (Visipaque,270mg/mL)and low scanning technique,Group B conventional CCTA with iohexol (Omnipaque,370 mg/mL)and Group C conventional CCTA with iodixanol (Visipaque,270 mg/mL),Routine scan mode was used in Group B and Group C.Prospective ECG gating mode was used in all groups.120kVp polychromatic images with FBP algorithm (Group B and Group C)were reconstructed for conventional CCTA,60 keV monochromatic images with FBP algorithm (Group A) or with a fixed blending level (40%)of ASiR (Group A1 )were reconstructed for spectral CCTA.Compared the image quality of four groups and ED in three groups.Results The difference was ststistically significant between four groups with the CT value,im-age noise,SNR and CNR of coronary (each P<0.001.Group A1 has the highest SNR and CNR.Group C has the lowest image noise.There were no significant difference of coronary score between group A1 and group B(χ2=0.01,P=1.000)).There was significant difference of coronary score between group A and group B (χ2=22.428,P<0.001),group B and group C (χ2=39.005,P<0.001), group A1 and group A (χ2=21.854,P<0.001).Effective radiation dose in the group A(ED2.60±0.26 mSv)was lower than that of group B (ED3.02±0.36 mSv)(t=3.738,P=0.001)and group C (ED3.11±0.23)(t=3.725,P=0.001).Conclusion Double low scan-ning technique using the gem spectrum CT coronary artery angiography with 40% blending level of ASiR is able to provide better im-age quality than using conventional CCTA and to reduce the effective radiation dose and contrast dose.

This study was aimed to analyze medication experiences of Professor Sun Zixue in the treatment of asthenospermia. A total of 286 asthenospermia cases treated by Prof. Sun Zixue were collected. Frequency and index clustering analysis method were used in the processing of patient data. The results showed that the using frequency of 37 types of drugs is more than 10%. And the clustering analysis classified drugs into seven cat-egories , which were the kidney essence tonification , kidney-yang tonification , qi tonification , blood nourish-ment , heat-toxin reducing , heat-dampness reducing , blood-activation and collateral-regulation. It was conclud-ed that based on Prof. Sunˊs syndrome differentiation , the treatment of asthenospermia can be from the combi-nation of kidney tonification , qi tonification and blood nourishment , or the combination of heat-dampness re-ducing and blood-activation and stasis-removing , or the combination of kidney tonification and collateral-regu-lation. The commonly used drugs are 38 types from seven categories .

Biomechanical Phenomena ; Humans ; Lumbosacral Region ; physiology ; Male ; Occupational Health ; Wood ; Workplace

Adolescent ; Astragalus membranaceus ; Case-Control Studies ; Cells, Cultured ; Child ; Child, Preschool ; Dendritic Cells ; drug effects ; metabolism ; Female ; Humans ; Interleukin-10 ; blood ; Interleukin-12 ; blood ; Interleukin-18 ; blood ; Male ; Purpura, Schoenlein-Henoch ; blood

Objective:To explore the relationship between level of urinary iodine excretion (UIE) before 131I treatment and excellent response (ER) in low-to-intermediate risk differentiated thyroid carcinoma (DTC) patients. Methods:A retrospective analysis was performed with 432 DTC patients (124 males, 308 females, age: (42.1±11.0) years) who were treated with 131I for the first time after total thyroidectomy from June 2017 to October 2018 in Department of Nuclear Medicine, the Second Hospital of Shandong University. All patients were divided into 4 groups: G1, group 1, UIE<50 μg/L; G2, group 2, 50 μg/L≤UIE<100 μg/L; G3, group 3, 100 μg/L≤UIE<200 μg/L; G4, group 4, UIE≥200 μg/L. Patients were given 131I with a fixed dose (3 700 MBq). Response was evaluated 6 to 8 months after 131I treatment: ER, indeterminate response (IDR), biochemical incomplete response (BIR), and structural incomplete response (SIR). χ2 test and Kruskal-Wallis rank sum test were used to analyze the data. The adjusted standardized residual (residual) and Cramer′s V between G1-G4 and different treatment reactions were calculated to judge the difference among groups. IDR, BIR and SIR were classified into non-ER (NER) group, and binary logistic regression analysis and receiver operating characteristic (ROC) curve analysis were performed to find the influencing factors of treatment reactions. Results:There were 51.9%(41/79), 64.9%(98/151), 53.8%(63/117), 30.6%(26/85) patients achieved ER in G1-G4, and the proportion of G4 was significantly lower than that of G1-G3 ( χ2 values: 7.695-25.697, all P<0.05), and there was no significant difference among G1-G3 ( χ2 values: 0.072-3.667, all P>0.05). The UIE level of patients in ER, IDR, BIR, SIR group was 87.5(57.0, 129.0), 97.0(55.7, 211.5), 141.0(74.0, 231.0), 148.0(68.5, 221.0) μg/L( H=15.977, P=0.001), and there was significant difference between those of patients in ER and SIR groups ( χ2=8.729, P=0.019). There was a certain correlation between UIE levels and different treatment reactions (Cramer′s V=0.151, P=0.001). UIE (≥200 μg/L), gender and preablative stimulated thyroglobulin could be used as independent factors affecting ER ( Wald values: 4.029, 7.185, 56.301, all P<0.05). Conclusion:Among DTC patients with low-to-intermediate risk, 131I treatment does not affect ER when the UIE level is less than 200 μg/L, while 131I treatment should be performed carefully when the UIE level is more than 200 μg/L.

Objective To compare the diagnostic value of the Standardized Bedside Swallowing Assessment (SSA)and the Scottish Intercollegiate Guidelines(SIC)for bedside dysphagia screening of patients after acute cerebral infarction(ACI). Methods Eighty-six ACI patients within 24 h of stroke onset were enrolled in the study.Within 48 h after hospitalization,swallowing function assessments and dysphagia screenings were carried out with the SSA and SIG,as well as video fluroseopic swallowing studies(VFSSs).The SSA and SIG assessments generated sensitivities,specificities,positive predict values(PPVs),negative predict values(NPVs),positive likelihood ratios (PLRs)and negative likelihood ratios(NLRs).These were compared with the VFSS results. Results The SSA showed a sensitivity of 89.1%,specificity of 75%,PPV of 0.804,NPV of 0.833,PLR of 3.56,NLR of 0.15,and Kappa of 0.648 compared to the VFSS results.The SIG showed a sensitivity of 60.9%,specificity of 82.5%,PPV of 0.800,NPV of 0.647,PLR of 3.44,NLR of 0.47 and Kappa of 0.425 compared to the VFSS.The sensitivity of of the SIG.Both assessments correlated well with the VFSS results. Conclusions Both the SSA and the SIG are elfective in dysphagia screening.The SSA is more sensitive than the SIG and is more suitable for early screening.The SIG is helpful in guiding dysphagia management and evaluating curative effects.

Objective To label rat bone marrow mesenchymal stem cells (BMSCs) with superparamagnetic iron oxide in vitro, and to monitor the survivorship and location of the labeled BMSCs in rat models of traumatic brain injury (TBI) with high field MR. Methods BMSCs were cultivated in vitro, and were labeled with SPIO. TBI models were built in the left hemisphere of the rats with Feeney's method. Then SPIO-labeled BMSCs were grafted stereotactically into the region nearby the contusion site 24 h later. The rats underwent MR examination 1 day, 3 days, 1 week and 3 weeks after implantation. Results Brown iron particles could be demonstrated in the SPIO-labeled BMSCs under inverted phase contrast microscope. Numerous intracytoplastic iron particles were stained with Prussian blue, and diffused distribution of iron particles could be seen in the intracytoplasm under electron microscope. At implanted sites low signal intensity could be observed on every sequence of MR examination, among which T2~*WI and SWI were better than other sequences, and SWI was the best. Conclusion MR is sensitive of tracking the survivorship and location of the labeled BMSCs, and SWI is the most sensitive sequence to detect the labeled cells.

Acute Disease ; Adolescent ; Adult ; Electromyography ; Female ; Humans ; Male ; Middle Aged ; Nervous System Diseases ; chemically induced ; diagnosis ; Organophosphate Poisoning ; Pesticides ; poisoning

Objective To investigate the clinical value of multi-slice spiral CT (MSCT)in the diagnosis of focal pulmonary ground-glass opacity nodules(fGGO)of 1 cm or less.Methods The MSCT examination data of 95 patients with subcentimeter fGGO was analyzed and compared with pathology results.The different pathological types of fGGP lesion size,internal solid component size,mixed type ground glass nodules (mGGO)proportion and pleural sag,lesion shape,grave leaves,burr,cavitation and the boundary conditions were compared. According to the relationship of the lesions and the surrounding blood vessels,3 types were classified,and the relationship of fGGO and blood vessel were analyzed.Results The minimal lesion was 0.41 cm of 95 cases and the maximum was 0.99 cm.There was statistically signifi-cant difference in the lesion size,solid component sizes,mGGO and lobulation occupied the percentage of the group before infiltrating and the adenocarcinoma group (P <0.05),and there was no statistically significant difference in pleural indentation,lesion shape,burr,vacuoles and boundary conditions (P >0.05).The difference was statistically significant in the leaflet occupied the percentage of the benign group com-pared with the adenocarcinoma group,and the differences of the remaining features were not statistically significant compared with the adeno-carcinoma group(P >0.05).According to the relstionship between fGGO and the vessels,patients in the benign group were type Ⅰ or typeⅡ,type Ⅲ was found in 10 cases of the group before infiltrating (25.6%),and type Ⅲ in 17 cases of the adenocarcinoma group (39.5%), the proportion of type Ⅲ of the group before infiltrating and the adenocarcinoma group was higher than that of the benign group (P <0.05). Conclusion The qualitative diagnosis of pulmonary fGGO is difficult,and the relationship between the morphology of the lesions under the MSCT and the surrounding vessels have some value for the diagnosis of the lesions.

Objective To investigate early reduction of the dose of immunosuppressive drug after allogeneic peripheral blood stem cell transplantation(allo-PBSCT)for patients with refractory or relapsed leukemia.Methods Between Janaury 2004 and December 2006,15 patients with relapsed or refractory leukemia in Department of Hematology,the First Affiliated Hospital,Sun Yat-Sen University and Institute of Hematology & Blood Diseases Hospital,CAMS & PUMC,received allo-PBSCT from their relatives,12 from HLA-identical siblings.The preparative regimens included BuCy and TBICy with or without cytarabine.Cyclosporine A(CsA)or tacrolimus was used for graft-versus-host disease(GVHD)prophylaxis,with rapid decreasing starting on day 30 of post transplant if no GVHD appeared in receipts of matched sibling tranplantation.Results(1)Faster engraftment was achieved in all patients.Grade Ⅰ~Ⅱ acute GVHD appeared in 5 patients.Chronic GVHD occured in 7 of 11 evaluable patients.(2)Of 9 patients with an lower CsA or tacrolimus dosage,only 1 developed grade Ⅰ acute GVHD,4 chronic GVHD,2 extramedullary relapse.(3)After a median follow-up of 328 days,8 patients has leukemia-free-survival(LFS),4 relapsed,and only 1 had transplantation-related mortality(TRM)in the first 3 months post-transplant.The estimated LFS at 1 year and 2 years was 51% and 25%,respectively.Conclusion Patients with advanced leukemia might benefit from allo-PBSCT with significant lower treatment failure incidence.Dose reductions of CsA and tacrolimus in early transplant might enhance graft-versus-leukemia effect,and improve long-term LFS.