Objective To explore the solution of local water-fat separation swap artifacts(WFS-SA)on nasopharyngeal T1WI-itera-tive decomposition of water and fat with echo asymmetry and least-squares estimation(T1WI-IDEAL)enhanced examination images.Methods Thirty-seven patients with obvious WFS-SA on nasopharyngeal enhanced examination using the A group T1WI-IDEAL param-eters were collected.Scans with modified parameters B,C,and D groups were subsequently performed based on the A group parame-ters.Subjective ratings of image quality were conducted on the four image groups,and the image signal-to-noise ratio(SNR)of the posterior wall of the nasopharynx and medulla oblongata was quantified.The total number of artifact slices(TAS),total artifact area(TAA),and maximum single-slice artifact area(SSAAmax)of the WFS-SA in the four image groups were recorded.The consistency of image quality ratings between the two technologists was analyzed via the intraclass correlation coefficient(ICC),and one-way analysis of variance or rank-sum test was used to compare the SNR,TAS,TAA,and SSAAmax among the four image groups.Results The subjective rating for modified B,C,and D groups of T1WI-IDEAL images by two technologists was deemed satisfactory(ICC=0.721-0.928,P<0.001).Significant variations in image quality ratings were observed among the three groups(H=45.131,P<0.001),with ratings for C and D groups surpass-ing those for B group(P<0.001).The TAS,TAA,and SSAAmax exhibited a decreasing pattern on T1WI-IDEAL images across A,B,C,and D groups,with statistically significant variances observed among all groups(P<0.001).Moreover,the SNR of the medulla oblongata layer in D group displayed a notably higher value compared to A,B groups,with statistically significant distinctions(P<0.001).Conclusion By combining the reduction of the echo train length(ETL)to 2 with the implementation of a double shimming,the occurrence of WFS-SA on nasopharyngeal T1WI-IDEAL enhanced examination images can be minimized and the overall image quality can be enhanced.

Objective To compare and analyze the application value of brain black blood technology three-dimensional BrainVIEW(3D-BrainVIEW)and conventional three-dimensional turbo field echo T1 weighted imaging(3D-TFE T1WI)in brain metastases of lung cancer.Methods A total of 60 patients with pathologically confirmed lung cancer were selected.All patients underwent brain enhanced MRI using 3D-BrainVIEW and 3D-TFE T1WI.The signal-to-noise ratio(SNR)and contrast-to-noise ratio(CNR)of the two groups were compared and analyzed,respectively.The diagnostic efficacy(including number,size,and location)of the two groups of images in detecting brain metastases was evaluated by two experienced radiologists via double-blind method.Results The diagnostic consistency between the two radiologists was excellent[intraclass correlation coefficient(ICC)=0.998,P<0.001].There were significant differences in SNR,CNR,and the number and location of brain metastases between 3D-BrainVIEW sequence and 3D-TFE T1WI sequence(P<0.05),and 3D-BrainVIEW sequence was significantly superior to 3D-TFE T1WI sequence.In addition,the number of brain metastases detected by 3D-Brain VIEW sequence was significantly higher than that detected by 3D-TFE T1WI sequence in lesions with minimum diameter(Dmin)<5 mm(P<0.001).There was no difference in the number of lesions detected by the two sequences in lesions with Dmin>5 mm(P>0.05).Conclusion The SNR and CNR of 3D-Brain VIEW enhanced scan images are significantly higher than those of 3D-TFE T1WI,which has higher detection efficiency for lung cancer brain metastases,and can effectively reduce misdiagnosis caused by microvascular enhance-ment,which has high clinical application value.

Objective We aimed to evaluate the efficacy and safety of Shengxuebao Mixture in the treatment of cancer-related anemia(CRA)presenting with syndrome of deficiency of liver and kidney combined with syndrome of deficiency of both qi and blood.Methods A randomized,double-blind,placebo-controlled,multicenter clinical trial was conducted.Eligible patients with malignant tumors meeting the inclusion and exclusion criteria were enrolled from 26 hospitals,including Dongzhimen Hospital,Beijing University of Chinese Medicine,Xiaogan Central Hospital,and Yangzhou Hospital of Traditional Chinese Medicine,from June 1,2022,to September 30,2024.Patients were allocated 1:1 to either the experimental group receiving Shengxuebao Mixture or the control group receiving its simulator(placebo)using a block randomization method under double-blind conditions.Both groups received 15 mL orally three times daily for 28 consecutive days.The primary efficacy indicators included the hemoglobin(Hb)improvement rate(RHb)and the traditional Chinese medicine(TCM)syndrome improvement rate(RTCM)at week 4 of treatment.The secondary efficacy indicators encompassed Hb and red blood cell(RBC)count,Karnofsky Performance Status(KPS)score,TCM syndrome score,individual TCM symptom scores,and changes in each of these indicators compared to the baseline period at weeks 2,4,and 6 of treatment.Safety evaluations were conducted at week 4 of treatment.Results A total of 239 patients were enrolled,with 225 cases included in the Full Analysis Set(FAS)(109 in the experimental group vs.116 control group),163 in the Per Protocol Set(PPS)(77 vs.86),and 225 in the Safety Set(SS)(109 vs.116).Baseline characteristics between groups showed no significant differences.Significant differences were observed between the experimental and control groups in RHb at week 4(FAS:49.51%vs.35.24%,P<0.05;PPS:53.25%vs.36.05%,P<0.05)and RTCM at week 4(FAS:61.54%vs.39.62%,P<0.01;PPS:64.94%vs.40.70%,P<0.01).At weeks 2,4,and 6,the experimental group showed greater improvements in Hb and RBC counts than the control group.Additionally,the TCM syndrome scores were lower in the experimental group than in the control group at these time points.Except for week 2 in PPS,the KPS improvement was better in the experimental group than in the control group(P<0.05).The experimental group also demonstrated a greater reduction in scores for individual TCM symptoms such as spiritlessness and weakness,poor appetite and reduced food intake at weeks 4 and 6 compared to the control group(P<0.05,P<0.01).Furthermore,the reduction in vertigo score was more pronounced in the experimental group at week 6(P<0.01).For the score of pale and lusterless complexion,only in the PPS was the reduction from baseline more significant in the experimental group than in the control group at weeks 4 and 6(P<0.05).No significant differences were observed between the experimental and control groups in the incidence of all adverse events or drug-related adverse reactions.Conclusion Shengxuebao Mixture demonstrates significant efficacy in patients with CRA presenting syndrome of deficiency of liver and kidney combined with syndrome of deficiency of both qi and blood,effectively increasing Hb levels,ameliorating TCM syndromes,alleviating clinical symptoms,and enhancing functional status,with no significant difference in adverse drug reactions compared to the placebo.

Objective To explore the solution of local water-fat separation swap artifacts(WFS-SA)on nasopharyngeal T1WI-itera-tive decomposition of water and fat with echo asymmetry and least-squares estimation(T1WI-IDEAL)enhanced examination images.Methods Thirty-seven patients with obvious WFS-SA on nasopharyngeal enhanced examination using the A group T1WI-IDEAL param-eters were collected.Scans with modified parameters B,C,and D groups were subsequently performed based on the A group parame-ters.Subjective ratings of image quality were conducted on the four image groups,and the image signal-to-noise ratio(SNR)of the posterior wall of the nasopharynx and medulla oblongata was quantified.The total number of artifact slices(TAS),total artifact area(TAA),and maximum single-slice artifact area(SSAAmax)of the WFS-SA in the four image groups were recorded.The consistency of image quality ratings between the two technologists was analyzed via the intraclass correlation coefficient(ICC),and one-way analysis of variance or rank-sum test was used to compare the SNR,TAS,TAA,and SSAAmax among the four image groups.Results The subjective rating for modified B,C,and D groups of T1WI-IDEAL images by two technologists was deemed satisfactory(ICC=0.721-0.928,P<0.001).Significant variations in image quality ratings were observed among the three groups(H=45.131,P<0.001),with ratings for C and D groups surpass-ing those for B group(P<0.001).The TAS,TAA,and SSAAmax exhibited a decreasing pattern on T1WI-IDEAL images across A,B,C,and D groups,with statistically significant variances observed among all groups(P<0.001).Moreover,the SNR of the medulla oblongata layer in D group displayed a notably higher value compared to A,B groups,with statistically significant distinctions(P<0.001).Conclusion By combining the reduction of the echo train length(ETL)to 2 with the implementation of a double shimming,the occurrence of WFS-SA on nasopharyngeal T1WI-IDEAL enhanced examination images can be minimized and the overall image quality can be enhanced.

Objective We aimed to evaluate the efficacy and safety of Shengxuebao Mixture in the treatment of cancer-related anemia(CRA)presenting with syndrome of deficiency of liver and kidney combined with syndrome of deficiency of both qi and blood.Methods A randomized,double-blind,placebo-controlled,multicenter clinical trial was conducted.Eligible patients with malignant tumors meeting the inclusion and exclusion criteria were enrolled from 26 hospitals,including Dongzhimen Hospital,Beijing University of Chinese Medicine,Xiaogan Central Hospital,and Yangzhou Hospital of Traditional Chinese Medicine,from June 1,2022,to September 30,2024.Patients were allocated 1:1 to either the experimental group receiving Shengxuebao Mixture or the control group receiving its simulator(placebo)using a block randomization method under double-blind conditions.Both groups received 15 mL orally three times daily for 28 consecutive days.The primary efficacy indicators included the hemoglobin(Hb)improvement rate(RHb)and the traditional Chinese medicine(TCM)syndrome improvement rate(RTCM)at week 4 of treatment.The secondary efficacy indicators encompassed Hb and red blood cell(RBC)count,Karnofsky Performance Status(KPS)score,TCM syndrome score,individual TCM symptom scores,and changes in each of these indicators compared to the baseline period at weeks 2,4,and 6 of treatment.Safety evaluations were conducted at week 4 of treatment.Results A total of 239 patients were enrolled,with 225 cases included in the Full Analysis Set(FAS)(109 in the experimental group vs.116 control group),163 in the Per Protocol Set(PPS)(77 vs.86),and 225 in the Safety Set(SS)(109 vs.116).Baseline characteristics between groups showed no significant differences.Significant differences were observed between the experimental and control groups in RHb at week 4(FAS:49.51%vs.35.24%,P<0.05;PPS:53.25%vs.36.05%,P<0.05)and RTCM at week 4(FAS:61.54%vs.39.62%,P<0.01;PPS:64.94%vs.40.70%,P<0.01).At weeks 2,4,and 6,the experimental group showed greater improvements in Hb and RBC counts than the control group.Additionally,the TCM syndrome scores were lower in the experimental group than in the control group at these time points.Except for week 2 in PPS,the KPS improvement was better in the experimental group than in the control group(P<0.05).The experimental group also demonstrated a greater reduction in scores for individual TCM symptoms such as spiritlessness and weakness,poor appetite and reduced food intake at weeks 4 and 6 compared to the control group(P<0.05,P<0.01).Furthermore,the reduction in vertigo score was more pronounced in the experimental group at week 6(P<0.01).For the score of pale and lusterless complexion,only in the PPS was the reduction from baseline more significant in the experimental group than in the control group at weeks 4 and 6(P<0.05).No significant differences were observed between the experimental and control groups in the incidence of all adverse events or drug-related adverse reactions.Conclusion Shengxuebao Mixture demonstrates significant efficacy in patients with CRA presenting syndrome of deficiency of liver and kidney combined with syndrome of deficiency of both qi and blood,effectively increasing Hb levels,ameliorating TCM syndromes,alleviating clinical symptoms,and enhancing functional status,with no significant difference in adverse drug reactions compared to the placebo.

Objective To compare and analyze the application value of brain black blood technology three-dimensional BrainVIEW(3D-BrainVIEW)and conventional three-dimensional turbo field echo T1 weighted imaging(3D-TFE T1WI)in brain metastases of lung cancer.Methods A total of 60 patients with pathologically confirmed lung cancer were selected.All patients underwent brain enhanced MRI using 3D-BrainVIEW and 3D-TFE T1WI.The signal-to-noise ratio(SNR)and contrast-to-noise ratio(CNR)of the two groups were compared and analyzed,respectively.The diagnostic efficacy(including number,size,and location)of the two groups of images in detecting brain metastases was evaluated by two experienced radiologists via double-blind method.Results The diagnostic consistency between the two radiologists was excellent[intraclass correlation coefficient(ICC)=0.998,P<0.001].There were significant differences in SNR,CNR,and the number and location of brain metastases between 3D-BrainVIEW sequence and 3D-TFE T1WI sequence(P<0.05),and 3D-BrainVIEW sequence was significantly superior to 3D-TFE T1WI sequence.In addition,the number of brain metastases detected by 3D-Brain VIEW sequence was significantly higher than that detected by 3D-TFE T1WI sequence in lesions with minimum diameter(Dmin)<5 mm(P<0.001).There was no difference in the number of lesions detected by the two sequences in lesions with Dmin>5 mm(P>0.05).Conclusion The SNR and CNR of 3D-Brain VIEW enhanced scan images are significantly higher than those of 3D-TFE T1WI,which has higher detection efficiency for lung cancer brain metastases,and can effectively reduce misdiagnosis caused by microvascular enhance-ment,which has high clinical application value.

Objective:To analyze the safety and effectiveness of application of modified double-lumen microcatheter in the measurement of fractional flow reserve(FFR) in coronary bifurcation lesions.Methods:Total of 28 patients with coronary bifurcation lesions in two centers were divided into two groups:conventional technique group(CON) and novel technique group(NOV). The fluoroscopy time, contrast dye usage and FFR-related complications of the two groups were analyzed retrospectively.Results:There were 16 cases in CON group and 12 cases in NOV group. The median time required fluoroscopy in NOV group was significantly less than that in CON group; additionally, lesser amounts of contrast dye were used in NOV group (both P<0.05). The NOV group procedures were successfully accomplished in all cases without complications, such as damage of the pressure sensor, SB spasm or dissection. However, The CON group failed in three patients, including two who experienced coronary artery spasms( P>0.05). Conclusions:Limited experience suggests that the application of modified double-lumen microcatheter in the jailed SB FFR measurement after MV stenting is a safe and technically feasible approach.

Objective To investigate the changes of postprandial serum insulin and C-peptide concentration of type 2diabetes mellitus (T2DM) patients with different fasting blood glucose concentrations, and to study the islet function of them.Methods There were 492T2DM patients from January 2016to June 2017in our hospital were selected and divided into three groups according to different fasting plasma glucose (FPG) levels:group A, 7.0mmol/L≤FPG＜11.1mmol/L;group B, 11.1mmol/L≤FPG＜14.0mmol/L;group C, FPG≥14.0mmol/L.Meanwhile, 50healthy examinees were collected as the control group.A standard 75g OGTT were performed in 492T2DM patients and 50healthy controls, and 2mL of venous blood of them were collected at 0.5, 1.0, 2.0and 3.0h.The concentration of insulin and C-peptide at each point was measured by chemiluminescence method, and then compared with the control group.Results The concentration of insulin and C-peptide in T2DM patients were slightly higher than those in the control group, but there was no statistical significance (P＞0.05).The serum insulin and C-peptide post-meal in the A, B and C groups and control group increased, but the 1.0hpostprandial blood glucose of control group increased to a peak, and gradually returned to normal at 3.0h;the 2.0hpostprandial blood glucose of A, B and C groups increased to a peak, and decreased at 3.0h, but did not return to normal level.The concentrations of insulin and C-peptide in the A, B and C groups at 0.5, 1.0, and 2.0hpost-meal were significantly lower than those in the control group (P＜0.05).Conclusion The function of isletβcells in T2DM patients decreases with the increase of blood glucose.The determination of insulin and C-peptide can provide a scientific evidence for judging the severity of disease and guiding treatment.

OBJECTIVE: To analyze the current status of diagnosis and management of acute appendicitis (AA) in China. METHODS: Questionnaire survey was used to retrospectively collect data of hospitalized patients with AA from 43 medical centers nationwide in 2017 (Sort by number of cases provided: Jinling Hospital of Medical School of Nanjing University, The First Affiliated Hospital of Xinjiang Medical University, Lu'an People's Hospital, Tengzhou Central People's Hospital, Dalian Central Hospital, The Affiliated Hospital of Xuzhou Medical University, Dongying People's Hospital, Jinjiang Hospital of Traditional Chinese Medicine, Huangshan Shoukang Hospital, Xuyi People's Hospital, Nanjing Jiangbei People's Hospital, Lanzhou 940th Hospital of PLA, Heze Municipal Hospital, The First College of Clinical Medical Science of China Three Gorges University, Affiliated Jiujiang Hospital of Nanchang University, The Second People's Hospital of Hefei, Affiliated Central Hospital of Shandong Zaozhuang Mining Group, The Third People's Hospital of Kunshan City, Xuzhou First People's Hospital, The 81st Group Army Hospital of PLA, Linyi Central Hospital, The General Hospital of Huainan Eastern Hospital Group, The 908th Hospital of PLA, Liyang People's Hospital, The 901th Hospital of Joint Logistic Support Force, The Third Affiliated Hospital of Chongqing Medical University, The Fourth Hospital of Jilin University, Harbin Acheng District People's Hospital, The First Affiliated Hospital of Zhengzhou University, Nanjing Luhe People's Hospital, Taixing Municipal People's Hospital, Baotou Central Hospital, The Affiliated Hospital of Nantong University, Linyi People's Hospital, The 72st Group Army Hospital of PLA, Zaozhuang Municipal Hospital, People's Hospital of Dayu County, Taixing City Hospital of Traditional Chinese Medicine, Suzhou Municipal Hospital, Beijing Guang'anmen Hospital, Langxi County Hospital of Traditional Chinese Medicine, Nanyang Central Hospital, The Affiliated People's Hospital of Inner Mongolia Medical University).The diagnosis and management of AA were analyzed through unified summary. Different centers collected and summarized their data in 2017 and sent back the questionnaires for summary. RESULTS: A total of 8 766 AA patients were enrolled from 43 medical centers, including 4 711 males (53.7%) with median age of 39 years and 958 (10.9%) patients over 65 years old. Of 8 776 patients, 5 677 cases (64.6%) received one or more imaging examinations, and the other 3 099 (35.4%) did not receive any imaging examination. A total of 1 858 (21.2%) cases received medical treatment, mainly a combination of nitroimidazoles (1 107 cases, 59.8%) doublet regimen, followed by a single-agent regimen of non-nitroimidazoles (451 cases, 24.4%), a nitroimidazole-free doublet regimen (134 cases, 7.2%), a triple regimen of combined nitroimidazoles (116 cases, 6.3%), nitroimidazole alone (39 cases, 2.1%) and nitroimidazole-free triple regimen (3 cases, 0.2%). Of the 6 908 patients (78.8%) who underwent surgery, 4 319 (62.5%) underwent laparoscopic appendectomy and 2589 (37.5%) underwent open surgery. Ratio of laparotomy was higher in those patients under 16 years old (392 cases) or over 65 years old (258 cases) [15.1%(392/2 589) and 10.0%(258/2 589), respectively, compared with 8.5%(367/4 316) and 8.0%(347/4 316) in the same age group for laparoscopic surgery, χ²=91.415, P<0.001; χ²=15.915,P<0.001]. Patients with complicated appendicitis had higher ratio of undergoing open surgery as compared to those undergoing laparoscopic surgery [26.7%(692/2 589) vs. 15.6%(672/4 316), χ²=125.726, P<0.001].The cure rates of laparoscopic and open surgery were 100.0% and 99.8%(2 585/2 589) respectively without significant difference (P=0.206). Postoperative complication rates were 4.5%(121/2 589) and 4.7%(196/4 316) respectively, and the difference was not statistically significant (χ²=0.065, P=0.799). The incidence of surgical site infection was lower (0.6% vs. 1.7%, χ²=17.315, P<0.001), and hospital stay was shorter [6(4-7) days vs. 6(5-8) days, U=4 384 348.0, P<0.001] in the laparoscopic surgery group, while hospitalization cost was higher (median 12 527 yuan vs. 9 342 yuan, U=2 586 809.0, P<0.001). CONCLUSIONS The diagnosis of acute appendicitis is still clinically based, supplemented by imaging examination. Appendectomy is still the most effective treatment at present. Laparoscopic appendectomy has become the main treatment strategy, but anti-infective drugs are also very effective.
Acute Disease ; Adolescent ; Adult ; Aged ; Anti-Bacterial Agents ; therapeutic use ; Appendectomy ; Appendicitis ; diagnosis ; therapy ; China ; Female ; Health Care Surveys ; Humans ; Laparoscopy ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome ; Young Adult

Objective:To explore diagnostic value of dynamic electrocardiogram (DCG) combined esophageal electro‐physiological examination (EEE) for sick sinus syndrome (SSS) .Methods :A total of 74 cases suspecting SSS ,who presented 24h mean heart rate <55 beats/min in DCG ,were selected .After DCG examination ,all subjects received EEE . Diagnostic value of single and combined examinations wereexplored .Results:Compared withthe SSS positive rate of single DCG and single EEE(87.8% ,86.5% ) ,theSSS positive rate ofDCG combined EEE(97.3% ) was sig‐nificantly rose ,P<0.05 both .Conclusion:Dynamic electrocardiogram combined esophageal electrophysiological ex‐amination can evaluate sinus node function from different angles ,which can significantlyincrease SSS diagnose rat .