Objective To study the difference of image quality and radiation dose between different exposure modes with full-field digital mammography (FFDM).Methods The Fluke18-220mammographic phantom was exposed by FFDM system with different exposure modes at automatic exposure control ( AEC ) ,including contrast mode,standard mode and dose mode,and the exposure factors and radiation dose were recorded.The images on monitor with the best window width and window level were read by four independent radiologists.The images of specks groups,nylon fibers and masses was assessed by the four experienced readers at the criterion of American College of Radiology.Results The detection of specks groups,nylon fibers and masses were statistically different at the contrast mode and standard mode (F =41.321,P ＜ 0.05),further at the contrast mode and dose mode.The detection of specks groups、nylon fibers and masses were not statistically different( P ＞ 0.05 ) at standard mode and dose mode,but the radiation doses were different.The ESD at standard mode and dose mode was 4.5 and 3.15 mGy,respectively.The AGD of standard mode and dose mode was 1.18 mGy and 0.78 mGy,respectively.Conclusions The standard mode and dose mode of FFDM might be fit for most patients,especially at the dose mode.Contrast mode of FFDM should be strictly controled in use.

Objective To investigate the effect of different noise index (NI) combined with iterative recombination on the image quality and radiation dose of CT scan in patients with different body mass index (BMI). Method One hundred and sixty patients who had a liver CT enhanced scan were divided into group A (18 kg/m2≤BMI<24 kg/m2 ) and group B (24 kg/m2≤BMI<31 kg/m2) according to BMI, and each group had 80 patients. The two groups were randomly divided into 4 subgroups which NI value was 11, 13, 15 and 17 respectively. All images were restructured with 50% adaptive statistical iterative reconstruction. Subjective evaluation, objective evaluation [signal noise ratio (SNR) and contrast noise ratio (CNR)] and the effective dose of each group were recorded and calculated after the scan. ANOVA and Kruskal-Wallis test were used to evaluated the difference of imaging quality and radiation dose. Results In group A, the SNR, CNR and the subjective score of the later arterial phase images showed a statistical difference between NI=17 group and other subgroups (P<0.05), while there was no statistical differences among the other three subgroups during three CT enhanced phase. The average ED of NI=15, 17 group were decreased by 57.56%(2.17/3.77) and 61.54% (2.32/3.77) compared with NI=11 group, respectively. In group B, the SNR, CNR and the subjective image scores of the later arterial phase showed a significant difference between NI=15 and NI=11, 13 group (P<0.05). There was a statistically difference of image quality in group NI=17 compared with the other three subgroups in the later arterial phase, portal venous phase and equilibrium phase (P<0.05). The average ED of NI= 13, 15 group was decreased by 26.41% (1.69/6.40) and 45.31%(2.90/6.40) compared with NI=11 group, respectively. Conclusion Upon maintaining diagnostic imaging quality, setting different NI according to BMI and applying the iterative reconstruction algorithm can effectively reduce the radiation dose of liver CT enhanced scanning.

Child ; Female ; Head and Neck Neoplasms ; Humans ; Multiple Endocrine Neoplasia Type 2b ; Proto-Oncogene Proteins c-ret ; genetics

BACKGROUND: Percutaneous vertebroplasty is an effective method for osteoporotic thoracic vertebral compression fracture, but bone cement leakage is easy to occur in patients with intravertebral cleft. OBJECTIVE: To explore the therapeutic efficacy of bone-filling mesh containers in elderly patients with osteoporotic vertebral compression fractures combined with intravertebral cleft sign. METHODS: From October 2017 to July 2018, 62 patients aged from 60 to 80 years with osteoporotic vertebral compression fractures combined with intravertebral cleft sign were admitted at the Affiliated Hospital of Qinghai University. Among them, 31 cases were treated with unilateral percutaneous vertebroplasty (control group), and the other 31 cases were treated with bone-filling mesh containers (study group). The leakage of bone cement, the time of operation and the times of fluoroscopy were recorded in the two groups. The visual analogue scale score and Oswestry disability index score were compared between the two groups before and 7, 30, 60 days after treatment. The height changes of injured vertebrae were evaluated by X-ray before treatment and 7 days after treatment. The quality of life was evaluated by the MOS item short from health survey (SF-36) before and 60 days after treatment. RESULTS AND CONCLUSION: (1) The time of operation and the times of fluoroscopy in the study group were less than those in the control group (P < 0.05), and the leakage rate of bone cement in the study group was lower than that in the control group (6％ vs. 39％, P < 0.05). (2) The visual analogue scale score and Oswestry disability index score of the two groups were significantly improved at 7, 30 and 60 days after treatment. The visual analogue scale scores of the study group were lower than those of the control group at different time points after treatment (P < 0.05). There was no difference in Oswestry disability index scores between the two groups at different time points after treatment (P> 0.05). (3) The height of injured vertebrae 7 days after treatment in both groups was significantly higher than that before treatment (P < 0.05), and there was a significant difference between the two groups (P < 0.05). (4) The quality of life of the two groups was significantly improved at 60 days after treatment (P < 0.05), but there was no difference between the two groups (P> 0.05). These findings indicate that compared with unilateral vertebroplasty with bone cement injection, bone-filling mesh containers with bone cement injection could reduce the incidence of cement leakage, relieve pain and increase the height of injured vertebrae in elderly patients with osteoporotic vertebral compression fracture combined with intravertebral cleft sign.

AIM: To investigate the effects of serum 25-hydroxyvitamin D (25(OH)D) on the blood glucose and islet β-cells function in the elderly with type 2 diabetes (T2DM). METHODS: Fifty-eight elderly patients with type 2 diabetes were recruited from June 2019 to January 2020, and all the patients were divided into three groups according to levels of serum 25(OH)D. Age, body mass index (BMI) and the levels of fasting blood glucose (FBG), hemoglobin A1c (HbA1c) were analyzed. Steamed bread meal test was performed in all patients, and the levels of blood glucose and C-peptide were compared among the three groups at the time points of 0, 30, 60, 120 and 180 min to investigate the effect of serum 25(OH)D on the islet β-cells function.RESULTS: Compared with the elderly T2DM patients with sufficient 25(OH)D, the HbA1c increased significantly in the elderly T2DM patients with deficiency of 25(OH)D (P<0.05). The levels of blood glucose were increased at the time points of 120 min and 180 min, while the levels of C-peptide at the time point of 60 min and 120 min, C peptide index and AUCCP180 in elder T2DM patients decreased significantly (P<0.05). Pearson correlation analysis showed that serum was negatively correlated with HbA1c, and positively correlated with the C peptide and C peptide index and AUCCP180 (P<0.05). And stepwise multiple regression analysis indicated that C peptide was a factor influencing 25(OH)D levels. CONCLUSION: Elderly T2DM patients with deficiency of 25(OH)D are more likely to suffer with severe dysfunction of islet β-cells.

This study was aimed to explore the characteristics of urine metabolomics among HIV/AIDS patients with spleen-lung qi-deficiency. H-NMR technique was combined with principal component analysis and cluster analysis in the comparison of urine metabolic products among 24 HIV/AIDS cases with spleen-lung qi-deficiency and 20 healthy control cases. The results showed that urine metabolic products of HIV/AIDS patients with spleen-lung qi-deficiency and healthy people by H-NMR technique detection and PLS-DA analysis can classify the outline of urine metabolites. There were about 20 variables in the difference between two groups. The speculated substances contained glycyl-L-leucine, L-valine, α-aminobutyric acid, methyl succinic acid, glycine propionyl, and etc. It was concluded that H-NMR technique was able to classify the outline of urine metabolites between HIV/AIDS cases with spleen-lung qi-deficiency and healthy people. Part of the potential existed characteristic markers contributed to the clinical diagnosis of traditional Chinese medicine (TCM) syndrome differentiation of AIDS. It had certain effect in its quantitative analysis.

OBJECTIVETo study the metabolic changes of pancreatic extracts from insulin-resistant rats induced by fructose feeding using nuclear magnetic resonance ¹H spectroscopy (¹H NMR).

METHODSSixteen Wistar rats were divided equally into control group and model group and given water and 10% fructose water for 8 weeks, respectively. The pancreatic tissues were then obtained for H NMR spectra analysis and principal component analysis (PCA).

RESULTSCompared with the control rats, the rats in the model group showed significantly increased creatine, betaine/TMAO, taurine, glycine and myo-inositol and decreased levels of lipids, lactate, glutamate, choline and GPC/PC.

CONCLUSION¹H NMR and pattern recognition can define the metabolic characteristics of the pancreatic tissue extracts from insulin-resistant rats and provide reliable metabolic evidence for studying the mechanisms of insulin resistance at the molecular level.

Animals ; Fructose ; Insulin Resistance ; Metabolomics ; Pancreatic Extracts ; chemistry ; Principal Component Analysis ; Proton Magnetic Resonance Spectroscopy ; Rats ; Rats, Wistar

OBJECTIVETo analyze the clinical characteristics, prognosis and molecular biological changes of tonsillar squamous cell carcinoma (TSCC).

METHODSRetrospective analysis of 61 TSCC cases treated from January 1999 to December 2012. Demographic data and clinical charts, including histologic grade of tumor, treatment and outcome of the patients, were reviewed.Human papillomavirus (HPV)-DNA were detected using SPF10-DNA enzyme immunoassay and LiPA genotyping method. Expressions of p16 and p53 proteins were examinated by immunohistochemistry. Survival rate was calculated with SPSS 19.0 software using the Kaplan-Meier method.

RESULTSThere were 55 males and 6 females, with a median age of 57 years. Of the 61 TSCC, 21 were with well differentiation, 19 with moderate differentiation and 21 with poor differentiation, including 7 patients at stage II, 10 at stage III and 44 at stage IV. HPV-positive rate of TSCC was 29.5% (18/61) and high-risk HPV-16 subtype accounted for 72.2% (13/18). The percentage of famel patients in HPV-positive TSCC was higher than HPV-negative TSCC (22.2% vs 4.7%).HPV-positive TSCC was more common in non-smoking patients (50.0% vs 79.1%, χ(2) = 5, 155, P = 0.023) and non-drinking patients (27.8% vs 51.2%, χ(2) = 4.346, P = 0.037). HPV-positive TSCC mostly presented with high expression of p16 protein (88.9% vs 16.3%, χ(2) = 28.481, P = 0.000), and low expression of p53 protein (72.7% vs 46.5%, χ(2) = 5.028, P = 0.025). The prognosis of patients with HPV-associated TSCC was significantly better than non-HPV-associated TSCC, and The 3-year and 5-year overall survival rates of patients with HPV-positive TSCC were higher than those of patients with HPV-negative TSCC (87.7% vs 49.5% and 78.9% vs 33.0%, respectively).

CONCLUSIONHPV-associated TSCC had unique clinicopathological and molecular biological features, showing better prognosis compared to HPV-negative TSCC.

Carcinoma, Squamous Cell ; Female ; Genes, p16 ; Genotype ; Human papillomavirus 16 ; Humans ; Immunohistochemistry ; Male ; Papillomaviridae ; Papillomavirus Infections ; Prognosis ; Retrospective Studies ; Smoking ; Survival Rate ; Tonsillar Neoplasms ; metabolism ; virology ; Tumor Suppressor Protein p53 ; metabolism

Objective To systematically evaluate the efficacy and safety of Compound Danshen Dripping Pills combined with conventional western medicine in the treatment of coronary heart disease complicated with diabetes mellitus.Methods Wanfang database,CNKI,VIP,SinoMed,Cochrane Library,PubMed,Embase and Web of Science databases were searched to collect randomized controlled trials(RCTs)of Compound Danshen dripping pills combined with conventional western medicine in the treatment of coronary heart disease complicated with diabetes mellitus.The retrieval time is from the establishment of the database to May 2023.Two researchers independently completed literature screening,data collation and risk of bias evaluation.RevMan 5.4 software was used for Meta-analysis.Results Twenty-four RCTs with a total of 2 546 patients were included.Meta-analysis showed that the treatment of Compound Danshen Dripping Pills combined with conventional western medicine was better than that of conventional western medicine in improving the total effective rate of coronary heart disease complicated with diabetes mellitus[OR=4.93,95%CI(3.49,6.98),P＜0.000 01],plasma adiponectin[MD= 2.79,95%CI(2.30,3.27),P＜0.000 01],reducing fasting blood glucose[SMD=-1.06,95%CI(-1.24,-0.88),P＜0.000 01],postprandial two-hour blood glucose[MD=-1.53,95%CI(-1.71,-1.35),P＜0.000 01],glycosylated hemoglobin[MD=-1.56,95%CI(-2.01,-1.11),P＜0.000 01],homocysteine[MD=-8.47,95%CI(-8.89,-7.97),P＜0.000 01],low density lipoprotein[MD=-0.46,95%CI(-0.69,-0.24),P＜0.000 01],total cholesterol[MD=-0.45,95%CI(-1.11,-0.20),P=0.005],triglycerides[MD=-0.42,95%CI(-0.50,-0.34),P＜0.000 01],interleukin 6[SMD=-1.34,95%CI(-1.61,-1.07),P＜0.000 01],cardiovascular adverse events[OR=0.35,95%CI(0.19,0.64),P=0.000 6],incidence of adverse reactions[OR=0.45,95%CI(0.24,0.86),P=0.01].Conclusion Compound Danshen Dripping Pills combined with conventional western medicine in the treatment of coronary heart disease with diabetes mellitus is more effective than conventional western medicine treatment,and with better safety.However,due to the limit of the quality of the included studies and other factors,the above conclusions still need to be verified by more high-quality clinical trials.

Objective : To analyze the difference of urinary iodine level in Hashimoto thyroiditis ( HT) patients， and to explore the possible relationship between urinary iodine level and HT under different iodine nutritional sta- tus，so as to provide some references for reasonable iodine intake in HT patients． Methods : A total of 101 hospi- talized HT patients were selected as HT group and divided into 3 groups according to thyroid function : HT group with hyperthyroidism (41 cases) ．There were 25 cases in HT group with normal thyroid function．There were 35 cases in HT combined with hypothyroidism group．In addition，30 healthy subjects were selected as control group. Serum levels of thyroid stimulating hormone(TSH) ，triiodothyronine(T3 ) ，thyroxine (T4 ) ，thyroid peroxidase an- tibody (TPOAb) and thyroglobulin antibody (ATG) were detected by chemiluminescence assay．The size and mor- phological structure of thyroid organs were examined by ultrasonography．Urinary iodine was determined by catalytic spectrophotometry with arsenic and cerium．The nutritional status of iodine was classified into iodine deficiency ( < 100 μg/ L) ，iodine adequacy( 100 －199 μg/ L) ，iodine adequacy (200 －299 μg/ L) and iodine excess ( ≥ 300 μg/ L) ．Non-parametric test was used to compare urinary iodine level between HT group and control group，one- way ANOVA and t test were used to compare urinary iodine level between HT group and control group ，and Spearman correlation analysis was used to compare the correlation between urinary iodine level and T3 ，T4 ，TSH， ATG and TPOAb under different iodine nutrition status. Results : Compared with control group，ATG and TPOAb levels in HT group increased (P＜0. 001) ，and urinary iodine levels increased (P＜0. 05) ，with statistical signifi- cance．Compared with the control group in different thyroid function states，only the HT group with hypothyroidism increased the urinary iodine level (P＜0. 01) ，and the difference was statistically significant．Spearman correlation analysis showed that urine iodine level was positively correlated with ATG and TPOAb levels in iodine excess condi- tion (P＜0. 05) ，and urine iodine level was positively correlated with TSH level in iodine sufficient condition and iodine excess condition in HT patients (P＜0. 05) ． Conclusion The urinary iodine level of HT patients was high- er than that of normal people．When the urinary iodine level of residents is ≥ 300 μg/ L，iodine intake is prone to HT．When the urinary iodine level of HT patients is ≥ 200 μg/ L，iodine consumption is prone to hypothyroidism， and iodine intake should be limited.