Objective To observe the value of 80 kVp combined with artificial intelligence iterative reconstruction(AIIR)in lower extremity CT angiography(CTA)of diabetic foot.Methods Sixty patients with diabetic foot were prospectively enrolled and divided into experimental group and control group(each n=30).Lower extremity CTA was performed using 80 kVp combined with AIIR in experimental group,while using 120 kVp combined with hybrid iterative reconstruction(HIR)in control group.The subjective and objective evaluation results of imaging quality,as well as the radiation dose of scanning were compared between groups.Results Compared with control group,images in experimental group showed higher subjective scores(5[5,5]vs.4[4,4]),displayed more branches of lower limb arteries(both P＜0.05),while the radiation dose decreased by 59.76％ ([8.29±0.53]mSv vs.[20.60±2.42]mSv).CT values,signal-to-noise ratio(SNR)and contrast-to-noise ratio(CNR)of each lower extremity artery segments were higher,while the noise of each lower extremity artery segments in experimental group were lower than those in control group(all P＜0.05).Conclusion 80 kVp combined with AIIR could reduce radiation dose and improve imaging quality of lower extremity CTA of diabetic foot,hence being helpful to displaying small arteries of lower extremity,such as dorsalis pedis arteries and common plantar metatarsal arteries.

OBJECTIVE: To explore the relationship between the effect of acupuncture and layered localization of computed tomography (CT) in treatment of lumbar disc herniation. METHODS: Based on the CT layered localization, the herniated lumbar discs were positioned in 5 layers, A, B, C, D and E among 300 patients with lumbar disc herniation. Combined with the horizontal and the frontal planes, the three-dimensional location was formed. Acupuncture was delivered at acupoints including bilateral Shenshu (BL23), Dachangshu (BL25), and Huantiao (GB30), Weizhong (BL40) on the affected side. One intervention of acupuncture was 30 min, once daily; 1 course of treatment was composed of 10 interventions and 2 courses were required. Before and after treatment, Japanese orthopaedic association (JOA) score was recorded, and the effect was evaluated. The curative effect was classified and compared with the CT layered localization. RESULTS: Of 300 patients, 226 cases were effective and the effective rate was 75.33%. The JOA scores of all patients, and in the effective group and the non-effective group were higher compared with the scores before treatment (P<0.05). With the layered localization considered, acupuncture was more effective on the cases positioned in C layer. Regarding the horizontal plane, the effect was better on the cases with zone 1 and zone 1-2 involved. In terms of the grade of frontal plane, acupuncture was more effective on the cases graded Ⅰ and Ⅱ. CONCLUSION The clinical effect of acupuncture on lumbar disc herniation is related with the layer and the horizontal zone of herniated disc positioned, as well as to the grade of the frontal plane.
Humans ; Acupuncture Therapy ; Intervertebral Disc Displacement/diagnostic imaging* ; Male ; Female ; Middle Aged ; Adult ; Tomography, X-Ray Computed ; Lumbar Vertebrae/diagnostic imaging* ; Acupuncture Points ; Aged ; Young Adult ; Treatment Outcome

Objective To observe the value of 80 kVp combined with artificial intelligence iterative reconstruction(AIIR)in lower extremity CT angiography(CTA)of diabetic foot.Methods Sixty patients with diabetic foot were prospectively enrolled and divided into experimental group and control group(each n=30).Lower extremity CTA was performed using 80 kVp combined with AIIR in experimental group,while using 120 kVp combined with hybrid iterative reconstruction(HIR)in control group.The subjective and objective evaluation results of imaging quality,as well as the radiation dose of scanning were compared between groups.Results Compared with control group,images in experimental group showed higher subjective scores(5[5,5]vs.4[4,4]),displayed more branches of lower limb arteries(both P＜0.05),while the radiation dose decreased by 59.76％ ([8.29±0.53]mSv vs.[20.60±2.42]mSv).CT values,signal-to-noise ratio(SNR)and contrast-to-noise ratio(CNR)of each lower extremity artery segments were higher,while the noise of each lower extremity artery segments in experimental group were lower than those in control group(all P＜0.05).Conclusion 80 kVp combined with AIIR could reduce radiation dose and improve imaging quality of lower extremity CTA of diabetic foot,hence being helpful to displaying small arteries of lower extremity,such as dorsalis pedis arteries and common plantar metatarsal arteries.

Objective To investigate the value of calculi CT value,infection possibility score(IPS),and Toll-like receptor(TLR)mRNA level of peripheral blood mononuclear cells in predicting urinary sepsis after percutaneous nephrolithotomy(PCNL).Methods Forty-three patients with urinary sepsis after PCNL were selected as sepsis group,while 105 patients without sepsis after PCNL were selected as control group according to propensity score.The postoperative calculi CT value,IPS and TLR mRNA level of peripheral blood mononuclear cells were compared between two groups,and receiver operating characteristic(ROC)curve was drawn to analyze the value of each index in predicting urinary sepsis after PCNL.Results The calculi CT value,IPS,TLR2 mRNA and TLR4 mRNA levels in sepsis group were significantly higher than those in control group(P<0.05).Compared with control group,sepsis group had higher proportion of stone diameter≥2.0 cm,proportion of staghorn stone,postoperative ratio of neutrophil to lymphocyte and postoperative procalcitonin,but lower postoperative albumin,with statistical differences(P<0.05).The area under ROC curve of calculi CT value,IPS,TLR2 mRNA,TLR4 mRNA and the combination of the 4 indexes to predict urinary sepsis after PCNL were 0.669,0.794,0.710,0.584 and 0.907,respectively.Conclusion The increases of calculi CT value,IPS,TLR2 mRNA and TLR4 mRNA after PCNL are associated with urinary sepsis.A comprehensive consideration of these 4 indicators is of high value for predicting urinary sepsis in clinic.

Objective: To explore the neural processing differences in inhibitory control and cognitive flexibility associated with motor development levels in preschool children, so as to provide a basis for motor learning and cognitive development in preschool children. Methods: From March 20 to 31 in 2023, a total of 84 preschool children aged 4-6 were recruited from two kindergartens in Xi an City. The MOBAK-KG Motor Development Assessment Scale was used to assess the children s motor development levels. The Go/no go task paradigm was employed to test inhibitory control ability, and the Dimensional Change Card Sort (DCCS) task paradigm was utilized to evaluate cognitive flexibility. Functional near infrared spectroscopy (fNIRS) was used to monitor the preschool children s prefrontal cortex oxygenation dynamics during inhibitory control and cognitive flexibility tasks. Malab software and Homer 2 plugins were used to calculate prefrontal oxygenated hemoglobin concentration of preschool children during the tasks. Results: The high motor skills group exhibited significantly higher task accuracy during inhibitory control and cognitive flexibility tasks [0.95(0.92, 0.97),(0.54±0.12)] compared to the low motor skill group[0.93(0.85, 0.97),(0.45±0.13)] ( Z/t =-2.09, 3.14 , P <0.05). During the inhibitory control task, the high motor skill group [0.24(0.10,0.41), 0.34(0.16,0.62), 0.30(0.07, 0.52 ), 0.26(0.09, 0.53), 0.15(0.01, 0.43), 0.34(0.10, 0.67)mol/L] showed significantly higher oxygenated hemoglobin concentrations in the left and right dorsolateral prefrontal cortices (L-DLPFC, R-DLPFC), left and right pars triangular Broca s areas ( L- PTBA, R-PTBA), and left and right frontopolar areas (L-FPA, R-FPA) compared to the low motor skill group [0.04( -0.13 , 0.15), 0.00(-0.12, 0.11), -0.01(-0.17, 0.14), 0.04(-0.14, 0.16), -0.01(-0.16, 0.12), -0.03(-0.21, 0.15) mol/L ] ( Z=-4.83, -5.57, -4.77, -4.10, -3.45, -5.74, P ＜0.01). During the cognitive flexibility task, the high motor skill group[0.21(0.03, 0.36), 0.28(0.15, 0.45), 0.15(0.05, 0.30), 0.20(0.05, 0.37), 0.04(-0.17, 0.26), 0.14(-0.08, 0.40) mol/L ] exhibited significantly higher oxygenated hemoglobin concentrations in the L-DLPFC, R-DLPFC, L-PTBA, R-PTBA, L- FPA, R-FPA brain regions compared to the low motor skill group [0.02(-0.20, 0.23), 0.02(-0.12, 0.21), 0.00(-0.22, 0.16 ), 0.00(-0.16, 0.15), -0.05(-0.25, 0.06), 0.01(-0.23, 0.20)mol/L] ( Z=-3.63, -4.45, -3.58, -3.75, -2.18, -1.98 , P ＜0.05). Conclusions The motor development level in preschool children is closely related to inhibitory control and cognitive flexibility. It is crucial to emphasize motor learning in early childhood to further promote holistic development of both mind and body.

Objective To investigate the value of calculi CT value,infection possibility score(IPS),and Toll-like receptor(TLR)mRNA level of peripheral blood mononuclear cells in predicting urinary sepsis after percutaneous nephrolithotomy(PCNL).Methods Forty-three patients with urinary sepsis after PCNL were selected as sepsis group,while 105 patients without sepsis after PCNL were selected as control group according to propensity score.The postoperative calculi CT value,IPS and TLR mRNA level of peripheral blood mononuclear cells were compared between two groups,and receiver operating characteristic(ROC)curve was drawn to analyze the value of each index in predicting urinary sepsis after PCNL.Results The calculi CT value,IPS,TLR2 mRNA and TLR4 mRNA levels in sepsis group were significantly higher than those in control group(P<0.05).Compared with control group,sepsis group had higher proportion of stone diameter≥2.0 cm,proportion of staghorn stone,postoperative ratio of neutrophil to lymphocyte and postoperative procalcitonin,but lower postoperative albumin,with statistical differences(P<0.05).The area under ROC curve of calculi CT value,IPS,TLR2 mRNA,TLR4 mRNA and the combination of the 4 indexes to predict urinary sepsis after PCNL were 0.669,0.794,0.710,0.584 and 0.907,respectively.Conclusion The increases of calculi CT value,IPS,TLR2 mRNA and TLR4 mRNA after PCNL are associated with urinary sepsis.A comprehensive consideration of these 4 indicators is of high value for predicting urinary sepsis in clinic.

Objective:To identify the risk factors of cognitive dysfunction in patients with atrial fibrillation and to establish a risk prediction model.Methods:The convenience sampling method was used to evaluate 260 patients with atrial fibrillation who were hospitalized in the Department of Cardiology of the Affiliated Hospital of Jining Medical College from January to December 2020. The cognitive function of the patients was evaluated with the Montreal Cognitive Function Assessment Scale (MoCA). Univariate analysis was used to screen the independent variables that had influence on the occurrence of cognitive dysfunction, and the statistically significant variables were included in the multivariate Logistic regression model. According to the regression coefficients of statistically significant variables, a line map was drawn to construct the risk prediction model of cognitive dysfunction in patients with atrial fibrillation.Results:There were 209 cases with cognitive impairment and 51 cases without cognitive impairment. Univariate analysis showed that sex, age, smoking history, drinking history, education level, free thyroxine, hemoglobin, D-dimer and BMI ( χ2 values were 4.08-18.83, t values were -6.04-2.94, Z=-2.76) were significantly different between the patients with or without cognitive dysfunction. The results of multivariate Logistic regression analysis showed that age ( OR values were 1.13), education level ( OR=0.01-0.05), quit smoking history ( OR=0.36), drinking history ( OR=0.35) and free thyroxine( OR=1.14) had significantly statistical significance ( P<0.05). The area under ROC curve (AUC) = 0.878 and AUC>0.8, this model had good clinical prediction ability. Conclusions:The construction of cognitive dysfunction risk prediction model for patients with atrial fibrillation can prevent or intervene high risk factors in advance, facilitate clinical use, and provide data support for the improvement of cognitive function in patients with atrial fibrillation.

Objective:To investigate the predictive value of total cholesterol / high density lipoprotein cholesterol ratio (TC/HDL) for ischemic stroke in patients with coronary heart disease (CHD) .Methods:A total of 1 983 inpatients with CHD in the Affiliated Hospital of Jining Medical University from January 1, 2017 to December 31, 2017 were selected as subjects by cluster sampling method. The clinical data were collected and followed up prospectively for 2 years.Results:During the 2-year follow-up period, 36 cases of ischemic stroke occurred in patients with CHD, and the incidence rate was 1.82% (36/1 983) . There was a curvilinear relationship between TC/HDL and ischemic stroke in male patients with CHD, and the tipping point was 3.84.When TC / HDL was less than 3.84, TC / HDL was negatively correlated with the incidence of ischemic stroke. The incidence of ischemic stroke decreased by 72% for each additional unit of TC/HDL ( P=0.049) . When TC/HDL was over 3.84, there was no correlation between TC / HDL and the incidence of ischemic stroke ( P=0.267) . There was a curvilinear relationship between TC/HDL and ischemic stroke in female patients with CHD, and the tipping point was 2.81. When TC / HDL was less than 2.81, TC / HDL was negatively correlated with the incidence of ischemic stroke. The incidence of ischemic stroke decreased by 99% for each additional unit of TC/HDL ( P=0.019) . When TC/HDL was over 2.81, there was no correlation between TC / HDL and the incidence of ischemic stroke ( P=0.110) . Conclusions:TC/HDL has different thresholds in predicting ischemic stroke in CHD patients with different genders, which has a certain clinical significance in predicting the prognosis of patients with coronary heart disease.

Objective:To understand the current status of exercise self-efficacy of patients after percutaneous coronary artery stent implantation (CASI) and analyze its influencing factors.Methods:Using the convenient sampling method, CASI postoperative patients who revisited in Department of Cardiology of a Class Ⅲ Grade A hospital in Shandong Province from May to August 2020 were selected as the research objects. The general information questionnaire, Exercise Self-Efficacy Scale, Exercise Behavior Stage Scale, The Tampa Scale for Kinesiophobia Heart (TSK-SV Heart) and Exercise Social Support Scale (ESSS) were used to investigate them.Results:After CASI, the score of Exercise Self-Efficacy Scale of patients was (8.32±3.42) , which was at a low level. The results of multiple linear regression analysis showed that the frequency of outpatient follow-up, fear of exercise and social support of exercise were the influencing factors of exercise self-efficacy in patients after CASI ( P<0.05) , which accounted for 50.9% of the total variation. Conclusions:The exercise self-efficacy of patients after CASI is at a low level, which is affected by many factors. It is recommended that clinical medical staff strengthen targeted exercise guidance to improve exercise self-efficacy of patients and promote exercise behaviors of patients.

To explore the way of prenatal echocardiography in the diagnosis of fetal double aortic arch . Methods T he data of fetuses diagnosed as double aortic arch in 6 prenatal centers in Hunan in echocardiograms performed at 20－36 weeks of gestation from 2013 to 2018 were reviewed . T he characteristics of echocardiographic with double aortic arch , and the associated malformations were observed ,the clinical outcome were analyzed . Results T he main echocardiographic features of the double aortic arch were three‐vessel‐tracheal view s ,which showed a bifurcation of the ascending aorta and a ring consisted of aortic right and left arch . From this retrospective analysis , 29 double aortic arches were identified ,which 8 cases ( 28% ) combined with cardiac defect and extracardiac abnormalities , 1 case with 22q11 deletion . Among them ,5 cases were confirmed by autopsy ,24 cases were diagnosed by computed tomography angiography ( 8 cases were confirmed by operation ) . Conclusions Systematic prenatal echocardiography in the diagnosis of fetal double aortic arch has significant clinical value in the cliagnose of double aortic arch ,w hether it is associated with other malformations and is important for assessing fetal prognosis .