A new adaptively hybrid filtering algorithm is proposed to reduce the artifacts caused by metal in CT image. Firstly, the method is used to preprocess the projection data of metal region and is reconstruct by filtered back projection (FBP) method. Then the expectation maximization algorithm (EM) is performed on the iterative original metal project data. Finally, a compensating procedure is applied to the reconstructed metal region. The simulation result has demonstrated that the proposed algorithm can remove the metal artifacts and keep the structure information of metal object effectively. It ensures that the tissues around the metal will not be distorted. The method is also computational efficient and effective for the CT images which contains several metal objects.
Algorithms ; Artifacts ; Metals ; Tomography, X-Ray Computed ; methods

Objective: To investigate the effects of acupuncture on the number of associated phosphorylated proteins in brain tissues of middle cerebral artery occlusion (MCAO) rats, based on the protein microarray technique. Methods: The MCAO model was prepared according to the modified occlusion method using occlusion lines. Forty healthy Sprague-Dawley (SD) rats were randomly divided into 4 groups using the lottery method: a sham operation group, a model group, a control point group and an acupoint group, with 10 rats in each group. Rats in the sham operation group and the model group only received binding without acupuncture. Rats in the acupoint group received acupuncture at Dazhui (GV 14), Baihui (GV 20) and Shuigou (GV 25); rats in the control point group received acupuncture at non-acupoint control points. The needle was twisted once for 1 min after insertion and another time in the middle of the 30 min needle retaining. Acupuncture was conducted once every 12 h for 6 consecutive times. At the end of the experiment, the neurological impairment score was collected, and cells of the ischemic brain tissues were extracted. The protein phosphorylation of the related signaling was detected using the 720 phosphorylated antibody microarray technique, and the differentially expressed proteins between groups were screened. Results: The neurological impairment scores after 72 h of treatment: compared with the sham operation group, the scores of the model group, the control point group and the acupoint group were significantly increased (P<0.01); compared with the model group, the scores of the acupoint group and the control point group were significantly decreased (P<0.01,P<0.05); the score of the acupoint group was better than that of the control point group (P<0.05). The results of the protein microarray: compared with the sham operation group, 48 proteins showed up-regulated phosphorylation (≥1.5 times) in the model group and the down-regulated was 28; compared with the model group, 35 proteins showed up-regulated phosphorylation in the control point group, and the down-regulated was 24. There were 29 proteins showing up-regulated phosphorylation in the acupoint group and the down-regulated was 51. The numbers of proteins involved in the function and signal transduction pathways were also different. Conclusion: Acupuncture at Dazhui (GV 14), Baihui (GV 20) and Shuigou (GV 25) can effectively repair brain injury. The ischemic injury of brain tissue may be caused by imbalance of a variety of proteins, and acupuncture can promote brain tissue repair by multi-functional and multi-channel regulation of the protein disorders.

Objective To investigate the expression and im plication of cell-cycle related factors(Cyclin D1,CDK4,P16 MTS1 and PRb)in condyloma acuminatum(CA).Methods The expression and distribution of cyclin D1,CDK4,P16 MTS1 and PRb were detected by immunohisto chemical technique streptavidin peroxidase(SP)in 27cases of HPV6/11positive CA that were confirmed by PCR and 10cases of norm al skins(foreskins).Results①Cyclin D1was not expressed in both normal skin and lesions of CA.②The intensity of expression of CDK4was 2.19in the basal cells in the lesions of CA,which was significantly weaker than that in normal skin(4.8,P

This study was aimed to prepare the spraying agent of prescriptions of Miao nationality herb and investigate the effect of Miao nationality herbs spray for serum SOD, MDA, and expression of Fas and Caspase-3 mRNA in lung tissues of silica-treated rats. The healthy SD rats were divided into 5 groups. Silica dust suspension was used in the model establishment of 4 groups. After the model was successfully established, 3 groups were randomly selected and given glucocorticoids atomization inhalation, Miao nationality herbs spray, Miao nationality herbs spray combined with intragastric administration of herbal medicine, respectively. After 40-day treatment, water-solubletetrazolium salt (WST-1) was used in the detection of serum superoxide dismutase (SOD). Thiobarbituric acid (TBA) was used in the detection of malondialdehyde (MDA). The mRNA expression variance of the Fas and Caspase-3 were detected by RT-PCR. The results showed that compared with the silica dust suspension group, the SOD activity of serum in the Miao nationality herbs spray group was significantly increased (P< 0.05). MDA content and the mRNA of Fas and Caspase-3 were significantly lower in the Miao nationality herbs spray group (P< 0.05). It was concluded that Miao nationality herbs spray group was able to increase the SOD activity of serum, decrease MDA content, and obviously decrease the expression of Fas and Caspase-3 of lung tissues among silica dust suspension rats.

Objective:To evaluate the use of ulthera in carotid body tumor resectionMethods:From Jun 2004 to Jun 2019 at the First Hospital of China Medical University. Forty-three shamblin grade Ⅱ or Ⅲ patients were retrospectively assigned to ulthera assisted carotid body tumor resection (26 cases) and traditional carotid body tumor resection (17 cases).Results:In ulthera assisted group, the average tumor diameter was (4.0±0.6) cm, compared to (3.9±0.9) cm in traditional carotid body tumor surgery group, P=0.875. The operation time of the two group was respectively (117.6±39.8) min and (149.4±55.0) min ( P=0.005), blood loss (145.7±70.6) ml vs. (194.1±80.7) ml ( P=0.006), hospital stay was (16.8±7.5) d vs. (22.7±13.0) d ( P=0.017), and following-up period was between 6 and 180 months. One patient relapsed in ulthera assisted group. The postoperative complications occurred in 8 and 7 cases respectively. Conclusion:Ulthera assisted carotid body tumor resection helps shorten operation time, hospital stay and decrease intraoperative blood loss.

Based on the latest results of international researches, combining with the experiences of our team in the simulation of acute dyspnea, Xiangya Hospital Central South University has summarized 7 characteristics, procedures and methods of debriefing, including that immediate feedback happens after simulation; feedback is provided by a trained instructor with clinical experience; feedback time is at least longer than the simulation time; various international methods of feedback can be used; the content of feedback is the learning objective; oral feedback is preferred; video can be used to review the details. The study aims to provide a theoretical basis for debriefing in domestic scenario stimulation teaching, and finally improve the effectiveness of the scenario stimulation teaching.

Objective: To detect the changes of systolic function of left ventricle in patients with lymphoma receiving anthracycline by three dimensional speckle tracking imaging(3D-STI). Methods: Thirty patients with newly diagnosed diffused large B-cell lymphoma who had received R-CHOP chemotherapy were enrolled. Left ventricular global longitudinal strain (GLS), global circumferential strain(GCS) and longitudinal strain(LS) on different left ventricular segments were measured by 3D-STI at baseline, after the completion of 2 cycles and 4 cycles of the regimen respectively. Results: Compared with baseline, GLS reduced significantly after four cycles of anthracycline chemotherapy(P=0.002). Analysis of LS on different segments of the left ventricle shows: after 2 cycles of anthracycline chemotherapy, LS only on apical septum was significantly decreased(P=0.019). After 4 cycles of treatment, LS on mid anterior, mid anteroseptal, mid inferoseptal, mid anterolateral, apical anterior, apical septal walls and apex worsened (t=3.321, P=0.002; t=2.497, P=0.018; t=2.387, P=0.024; t=2.096, P=0.045; t=4.015, P=0.000; t=4.064, P=0.000; t=3.370, P=0.002, respectively). Conclusions LS deterioration emerges on some left ventricular walls in patients with lymphma underwent chemotheapy based on anthracycline in early stage of the remedy, especially on apex and mid segments. LS on apical septum manifests firstly. The segmental LS index maybe expected to be valuable for monitoring of early cardiotoxicity of antharcycline.

Objective: To observe the predictive value of serial platelet function testing (PFT) on outcome in patients undergoing complex percutaneous coronary intervention (PCI). Methods: Six hundred and two consecutive patients undergoing complex PCI in Anzhen hospital were enrolled during October 2011 to June 2012.Adenosine diphosphate(ADP)-induced platelet aggregation was measured by light transmission aggregometry on the first, sixth and twelfth month after PCI and the mean value was calculated.The cut-off value of high on-treatment platelet reactivity (HTPR) was defined as 40%.The primary endpoint was major adverse cardiovascular and cerebral event (MACCE). Clinical outcomes were analyzed by the Kaplan-Meier method and differences were compared using the log-rank test.Multivariate analyses by Cox proportion hazards regression were applied to identify variables independently associated with the adverse outcomes. Results: Five hundred and eighty-five patients (HTPR, n=285; non-HTPR, n=280) finished the follow-up ((28.47±7.45) months). A total of 33 cases of MACCE were observed during the follow-up, among which 29 cases(8.42%) were in HTPR group and 9 cases (3.21%) in the non-HTPR group.Kaplan-Meier analysis suggested that HTPR was associated with an increased incidence of MACCE (log-rank test, P=0.01). The Cox multivariate analysis indicated that HTPR was an independent risk factor of MACCE (HR=2.69, 95%CI 1.23-5.85, P=0.01) in patients undergoing complex PCI.Incidence of MACCE was similar between HTRP patients receiving standard dual antiplatelet therapy (DAPT) or prolonged DAPT (>12 months). Conclusion Serial PFT could predict the long-term prognosis of patients underwent complex PCI.

Objective:To explore the influence of virtual simulation experiment project on the experimental teaching effect of infectious diseases.Methods:Ten experimental contents were selected, including 3 703 students majoring in clinical five-year program, eight-year program, anesthesia, psychiatry and other majors of Medicine School of Central South University. The teaching effect and students' satisfaction were evaluated through examination and personal questionnaire survey. The measurement data was expressed by (mean ± standard deviation), the counting data was illustrated by percentage. The rate is compared by Chi-square test, and the difference is statistically significant when P<0.05. Results:All the students took part in the examination of 10 items. Except for item 8, the scores of students in all items had a large variance, with almost same number of high score students and low score students. Learning attitude is closely related to learning effect. Among the students who think it's necessary to learn, 20.5% and 53% have excellent learning effect and good learning effect, respectively. Compared with offline experiment teaching, virtual simulation teaching has both advantages and disadvantages, and needs to further improve the satisfaction of students.Conclusion:Virtual simulation teaching of infectious diseases is unable to completely replace offline teaching, and the combination of virtual and reality is more conducive to improving the quality of medical students.

Objective:To analyze the long-term prognosis of undergoing drug-eluting stent implantation (DES) or coronary artery bypass grafting (CABG) in patients with unprotected left main (ULM) coronary artery disease complicated with chronic renal failure (CRF).Methods:Patients with UML coronary artery disease complicated with CRF admitted to the department of cardiology intensive care unit (ICU) and cardiac surgery ICU of Beijing Anzhen Hospital Affiliated to Capital Medical University were enrolled. According to the estimated glomerular filtration rate (eGFR), the patients were divided into two layers, and the clinical characteristics of DES patients and CABG patients were analyzed. Log-Rank method and Cox regression were used to analyze the coronary artery disease and long-term clinical prognosis of patients with two surgical strategies.Results:A total of 353 patients were enrolled, including 150 patients with eGFR < 45 mL·min -1·1.73 m -2 (DES 67 cases, CABG 83 cases), eGFR 45-59 mL·min -1·1.73 m -2 in 203 cases (DES 80 cases, CABG 123 cases). In terms of demography and clinical history, compared with CABG group, DES group had lower proportion of complete revascularization and lower proportion of chronic totalocclusion (CTO) and multi vessel disease in each eGFR level. All patients were followed up for an average of (30.74±15.05) months. Log-Rank analysis showed that there was no significant difference in the incidence of major cardiovascular and cerebrovascular adverse events (MACCE), all-cause death, cardiogenic death and stroke between DES group and CABG group in each eGFR level. In eGFR 45-59 mL·min -1·1.73 m -2, the proportion of target vessel revascularization (TVR) in DES group was higher than that in CABG group (18.8% vs. 0.8%, P < 0.01); in eGFR < 45 mL·min -1·1.73 m -2, the incidence of myocardial infarction in DES group was higher than that in CABG group (10.4% vs. 1.2%, P < 0.05). Cox analysis showed that after adjusting for age, gender, history of hypertension, diabetes, left ventricular ejection fraction, smoking history, previous cerebrovascular disease, complete revascularization, multiple vessel disease and CTO, TVR proportion in DES group was still higher than that in CABG group in eGFR 45-59 mL·min -1·1.73 m -2 [hazard ratio ( HR) = 46.463, 95% confidence interval (95% CI) was 4.558-473.693, P = 0.001]; in eGFR < 45 mL·min -1·1.73 m -2, the incidence of myocardial infarction in DES group was still higher than that in CABG group ( HR = 14.098, 95% CI was 1.123-176.988, P = 0.040), there was no difference in TVR proportion between the two methods. Conclusions:eGFR < 45 mL·min -1·1.73 m -2 is an independent risk factor for DES in ULM patients. DES is safe and effective for ULM patients with CRF, but for patients with more severe CRF (eGFR < 45 mL·min -1·1.73 m -2), there was more myocardial infarction in DES group than that in CABG group, which should be carefully selected.