Objective To understand the evolution of health management research in China and 5-year development of Chinese Journal of Health Management.MethodsA total of 657 articles published in Chinese Journal of Health Management over the past 5 years were analyzed by using CiteSpace Ⅱ from the aspects of authors,organizations and fundings respectively.ResultsAbout1933authors and 625 organizations contributed to the publication of 657 articles.Every published article had 3 authors on average.Health management presentedin 24％articletitles.Fifty-four authorsshowed morethan 4 publications or a centrality of more than 0.HUANG Jian-shi,WU Liu-xin and ZENG Qiang showed higher productivity and centrality and cooperated well with BAI Shu-zhong,TIAN Jing-fa and HAN Jing.WANG Peiyu and DU Bing constituted their own collaboration team respectively.Authors with higher productivities were mainly from Institute of Aviation Medicine,Peking University Health Science Center,Beijing Physical Examination Center and Peking Union Medical College.Papers financially supported by national,provincial and other funding were increased over time.ConclusionOver half of publications presented in Chinese Journal of Health Management are directly related to health management,many of which are written by wellknown scholars.Taking Chinese Journal of Health Management as a platform,some research teams makeimportant contribution to promoting the development of health management.

Objective To investigate the feasibility to reduce radiation doses on pediatric mutidetector abdominal CT using the adaptive statistical iterative reconstruction technique (ASIR) associated with automated tube current modulation technique(ATCM).Methods Thirty patients underwent abdominal CT with ATCM and the follow-up scan with ATCM cooperated with 40％ ASIR.ATCM was used with agedependent noise index (NI) settings: NI =9 for 0-5 year old and NI =11 for ＞ 5 years old for simple ATCM group,NI =11 for 0-5 year old and NI =15 for ＞5 years old for ATCM cooperated with 40％ ASIR group(AISR group).Two radiologists independently evaluated images for diagnostic quality and image noise with subjectively image quality score and image noise score using a 5-point scale.Interobserver agreement was assessed by Kappa test.The volume CT dose indexes (CTDIvol) for the two groups were recorded.Statistical significance for the CTDIvol value was analyzed by pair-sample t test.Results The average CTDIvol for the ASIR group was (1.38 ± 0.64) mGy,about 60％ lower than (3.56 ± 1.23) mGy for the simple ATCM group,and the CTDIvol of two groups had statistically significant differences.(t =33.483,P ＜ 0.05).The subjective image quality scores for the simple ATCM group were 4.43 ± 0.57 and 4.37 ±0.61,Kappa =0.878,P ＜ 0.01 (ASIR group: 4.70 ± 0.47 and 4.60 ± 0.50,Kappa =0.783,P ＜ 0.01),by two observers.The image noise score for the simple ATCM group were 4.03 ±0.56 and 3.83 ±0.53,Kappa =0.572,P ＜ 0.01 (ASIR group: 4.20 ± 0.48 and 4.10 ± 0.48,Kappa =0.748,P ＜ 0.01),by two observers.All images had acceptable diagnostic image quality.Conclusion Lower radiation dose can be achieved by elevating NI with ASIR in pediatric CT abdominal studies,while maintaining diagnostically acceptable images.

Objective To prepare and evaluate the biocompatibility of polycarbonate coated with low molecular weight heparin (LMWH) and partial oxidation sodium alginate(OSA).Methods Coating material was prepared by means of chemical graft-modification and the feature of the material was determined with infrared spectrum and the stablity of the coating in fluid was examined.Biocompatibility was evaluated by contact angle and in-vitro tests including protein adhesion,platelet adhesion and caugulation.Results LMWH or OSA was tightly combined with polycarbonate.After being coated,the contact angle,albumin and fibrinogen adhering to materials were decrease (P＜0.05).The anticoagulant activity was notably promoted by coating.Compared with LMWH coated material,the contact angle,albumin and fibrinogen adhering were decreased significantly,but the improvement of anticaugulation was limited(P＜0.05).Conclusion Chemical graft-modification LMWH or OSA can be applied to polycarbonate.The biocompatibility of the coated materials was significantly promoted.

Objective To investigate the chest HRCT characteristics of pediatric perinuclear anti-neutrophil cytoplasmic antibody (p-ANCA) associated systemic vasculitis. Methods Retrospectively analysis of the clinical and HRCT data of 15 pediatric cases diagnosed as p-ANCA related pneumonia according to the classification and diagnostic criteria of Chapel Hill meeting of 1994 in our hospital were retrospectively analyzed. They were 13 girls and 2 boys. The age range was 1—17 years and the median was about 10 years old, In the 15 patients, 12 were diagnosed as primary MPA, 2 were secondary MPA, 1 was CSS. Two radiologists with 10 years of radiological experience read the CT imaging together. Results 1 of 12 primary MPA were found large opacities and ground glass shades in both sides of lung,especially the posterior parts on CT images with bilateral pleural effusion; 1 case had focal opacities in left lower lobe, around with thickened interlobular septa and pleural effusion; Another 1 case only had focal thickened interstitial in right middle lobe; The other 9 cases showed scattered or diffused ground glass opacity, with thickened pulmonary interstitial and (or) pleura. 1 of the 2 secondary MPA who had hemoptysis showed ground glass opacity on CT images with no thickened septal nodules or pleural effusion. The other one who had renal anomalies and no respiratory symptoms showed subpleural nodules with halo sign in right low lobe. The CSS showed diffused patchy ground glass opacity, consolidation of both lingular lobes, nodules of centri-and peri-lobular, thickened septa near the pleura, obviously thickened bronchial wall, slightly widened bronchial lumen and thickened pleura. Conclusion The classic imaging features of p-ANCA pneumonia on HRCT is the non-specific small pulmonary vessel hemorrhage.

10.3969/j.issn.2095-4344.2013.25.015

Objective To explore the application of adaptive statistical iterative reconstruction (ASIR)scanning technique in low dose pediatric cervical CT, especially in reducing the radiation dose for thyroid. Methods We retrospectivly analyzed 140 pediatric cervical CT. 70 cases of group A scaned with ASIR technology and preseting noise index 12 HU in Discovery CT 750 HD (GE Healthcare), and 70 cases of group B scaned with filtered back projection (FBP) technology and preseting noise index 14 HU in VCT 64 (64 Lightspeed VCT, GE Healthcare). The other scan parameters were same in 2 groups. The distribution characteristics of gender and age were completely consistent between groups. The minimum current, the maximum current, the current of thyroid on CT images and CT dose volume index (CTDIvol), scanning length and dose length product (DLP) on dose reports were all recorded for each child. The noise values of CT images were measured. 4 scores standard was used to evaluate the subjective image quality. The data were analyzed with SPSS 13, Kappa method for the test of consistency and t test for the differences of the measured data. Excel was used for mapping. Results The minimum current, the maximum current, the average current, the current for thyroid of the two groups were respectively (26.8 ± 4.2), (43.2 ± 15.4)mA;(35.8±9.6),(41.8±13.6)mA;(34.6±8.6), (41.0±13.2)mA;(36.8±12.3), (44.7±21.0)mA. The CTDIvol, DLP and the scanning length of the two groups were respectively(1.3 ± 0.3), (1.8 ± 0.6)mGy;(29.0 ± 8.3), (40.3 ± 15.6) mGy·cm and(157.5±20.2), (157.6±21.8)cm. The average current, the thyroid current, CTDI and DLP in group A were 15.8%, 17.9%, 27.3%and 28.4%lower than those in group B (t=-5.50—-0.02, P<0.01). The subjective image quality scores of the two doctors were respectively 3.4 ± 0.9, 3.3 ± 1.0, they were highly consistent (Kappa=0.834, P<0.01). The objective image noise of cancellous bone and neck muscles were respectively (32.5 ± 5.3),(32.9 ± 5.1)HU and (9.2 ± 2.3), (9.1 ± 2.0)HU, there were not statistically difference between the two groups (t=-0.47—0.24, P<0.05). Conclusion Compared with FBP, low dose pediatric cervical CT with 30%ASIR could provide dose reduction for thyroid and the whole neck while maintaining diagnostically acceptable images .

Objective To investigate the diagnostic value of MRI in reversible splenial lesion syndrome (RESLES) in children.Methods The clinical and MRI imaging data of 14 cases of RESLES in children were retrospectively reviewed.There were 4 males and 10 females,aging 11 to 35 months.Average age was (20±3) months.MRI studies were conducted in all the cases.Two experienced doctors analyzed independently the images and reached consensus.Results Fourteen cases showed the single abnormal signal in the splenial of corpus callosum on the initial cerebral MRI.Lesions in 10 of 14 cases appeared as isointensity on T1WI,hypo-intensity in 4 cases.Lesions in 14 cases were appeared as hyper-intensity on T2WI,hyper-/slightly hyper-intensity on FLAIR T2WI.The lesions were round,oval or irregular,with fuzzy boundary.DWI showed round or oval high signal with clear boundary.No edema around the lesion and no occupying effect were detected.After treatment,8 of 14 cases were reviewed after 7-14 d,and the abnormal signal in the corpus callosum disappeared in 5 cases,while the range was significantly reduced in 3 cases.MRI were reexamined after 1-2 months in 5 cases,and the lesions disappeared in the corpus callosum.One case didn't have MRI examination again after treatment and the clinical symptoms disappeared.Conclusions The clinical manifestations of RESLES in children are lack of specificity.And the cerebral MRI imaging is characterized by the reversible solitary lesion of the splenium,which can provide a reliable basis for clinical diagnosis and prognosis.

OBJECTIVEThe aim of this study was to determine the metameric color differences between natural teeth and three brands of commercially available resin teeth.

METHODSThe spectral reflectance and color coordinates of natural teeth and three brands of commercially available resin teeth of A2 shade were measured with a spectrophotometer (PR-650) according to the CIE L*, a*, b* and CIE XYZ color scale relative to illuminant D65, A, cool white fluorescent (CWF) and ultraviolet (UV), and the metameric indices were calculated to determine the metameric color differences between natural teeth and resin teeth.

RESULTSCIE L*, a*, b* values were influenced by the type of illuminants in both natural teeth and resin teeth. The pattern of spectral reflectance curves for natural teeth and resin teeth of A2 shade were different, while there were more than three crossing points among each curves, which meant the color of natural teeth and resin teeth of A2 shade might be the same under certain illuminant. The metameric indices between natural teeth and resin teeth of A2 shade were 3.48, 2.52 and 3.36 under illuminant A; 1.21, 1.90, and 2.79 under illuminant CWF; 1.59, 2.07, and 4.07 under illuminant UV. The metameric indices between resin teeth of different brand were 1.08, 0.10, and 1.01 under illuminant A; 1.46, 2.23, and 0.94 under illuminant CWF; and 2.55, 2.69, and 4.64 under UV.

CONCLUSIONChanges in optical properties of resin teeth of A2 shade relative to the different illuminants were different from those of natural teeth, the metameric effect between natural teeth and resin teeth of A2 shade were significant. Therefore, shade matching between natural teeth and resin teeth should be performed under more than one illuminant.

AIM:To investigate the value of 3D-optical coherence tomography (OCT) in the diagnosis of macular disease before phacoemulsification.METHODS:Clinical records of 423 cataract patients (512 eyes) who underwent phacoemulsification combined with intraocular lens implantation in our hospital from June to December in 2015 were retrospectively analyzed.In addition to preoperative routine examination of fundus, Topcon 3D-OCT 2000 was used to examine the macula, the detection rate of macular disease was compared, risk factors of cataract combined with macular disease were analyzed.RESULTS:The OCT image results of 305 cases (384 eyes, 72.1%) were successfully obtained, 133 cases showed macular disease (146 eyes), the detection rate was 28.5% (95%CI:27.64%-29.40%);the macular disease of 35 cases (37 eyes) were detected by routine examination of fundus before operation, the detection rate was 7.2% (95%CI:6.72%-7.74%);the detection rate of 3D-OCT was significantly higher than routine examination of fundus for macular disease (χ2=79.05, P<0.01).Female, over 65 years old, surgical history of diseased eye, and high myopia were risk factors of cataract combined with macular disease, the relative risk was 1.705 (95%CI:1.091,2.664), 1.893 (95%CI:1.219,2.939), 6.593 (95%CI:2.027,21.447) and 95%CI:5.130 (2.841,9.263) respectively, the risk of cataract combined with macular disease showed an increasing trend with rising age.CONCLUSION:In preoperative examination of cataract patients, 3D-OCT has higher sensitivity in the detection of macular disease, especially for women, over 65 years old, high myopia and surgical history of diseased eye, 3D-OCT can be used as a routine preoperative examination.

Objective:To explore the effect of continuous quality improvement for enhancing the ability of application and management of nurses of hepatobiliary surgery for physiological monitor.Methods: The data of clinical work were researched by using retrospective analysis, and they were divided into quality improvement group(n=40) and routine management group(n=40) according to different management method. The score of examination, satisficing of patient for physical monitor, false alarm situation and processing time between the two groups were researched and analyzed.Results: The score of examinations both of theory and operation of quality improvement group were significantly higher than those of routine management group (t=4.303,t=3.182,P<0.05), respectively. The reasonable storing rate, understanding rate of whereabouts and satisficing of maintenance about physical monitor of quality improvement group (92.5%, 100.0% and 87.5%) were significantly higher than those of routine management group(32.5%, 40.0% and 52.5%) (x2=5.02,x2=7.38,x2=9.35,P<0.05), respectively. The false alarm rate of quality improvement group (10.0%) was significantly lower than that of routine management group (35.0%) (x2=11.14,P<0.05). And the processing time of false alarm of quality improvement group was significantly shorter than that of routine management group (t=2.776,P<0.05).Conclusion: The method of continuous quality improvement can effectively enhance the ability of application and management level of the nurses of hepatobiliary surgery for physical monitor.