Objective To evaluate the value of high-energetic virtual monoenergetic imaging(MonoE),bone metal artifact reduction(O-MAR),and their combination based on dual-layer detector spectral computed tomography(DLCT)in removing the artifacts caused by lumbar metal implants.Methods Patients who undergone lumbar implant surgery and performed lumbar examination on DLCT after surgery were prospectively selected.MonoE from 100 to 200 keV with an interval of 20 keV were reconstructed.O-MAR and O-MAR combined with MonoE(O-MAR+MonoE)images were also reconstructed.The differences of objective and subjective image quality among the images were compared.Results There were 45 patients included in the study.With the increasing of keV of MonoE,the attenuation of the tissue with low-and high-density artifact on MonoE and O-MAR+MonoE was increased and decreased,respectively.140 keV MonoE was the best sequence for the artifact reduction and the display of soft tissue.200 keV MonoE and its combination with O-MAR showed the best performance in the display of the interface of metal and bone.However,O-MAR+200 keV MonoE had the lowest noise.Conclusion Compared to O-MAR and O-MAR combined with MonoE,high-energetic MonoE shows a good value in the reduction of metal artifacts caused by the lumbar metal implants.

Objective To study the detection of cytomegalovirus (CMV)-DNA in different kinds of blood and urine sample .Methods The CMV-DNA loads in 3 different kinds of blood sample from 52 patients and 3 different kinds of urine sample from 85 patients were detected by real-time fluorescence quantitative polymer-ase chain reaction(FQ-PCR) .The differences in CMV-DNA detection rate and virus loads were compared a-mong different kinds of blood and urine samples .Results The CMV-DNA detection rates in serum ,whole blood ,plasma and peripheral blood mononuclear cell (PBMC) from 52 patients were 48 .08％ ,71 .15％ ,57 .69％ and 69 .23％ respectively .The CMV-DNA detection rates of whole blood and PBMC were higher ,the difference was statistically significant (P<0 .05) .The quantitative results of PBMC was higher .The CMV-DNA detec-tion rates of mixed urine ,urine supernatant and urine sediment from 85 patients were 72 .94％ ,62 .35％ and 84 .71％ respectively ,the CMV-DNA detection rate of urine sediment was higher ,while the quantitative re-sults of mixed urine was higher .Conclusion The CMV-DNA detection results of blood and urine have large difference ,therefore using the same kind of sample for conducting detection has an important clinical signifi-cance in the clinical diagnosis ,treatment and monitoring of CM V infection .

Objective To establish the list of head nurses′ activities in China,in order to provide basis for work environment,propose the knowledge,skill and ability standard in head nurses.Methods A list of total 86 activities in 11 dimensions of head nurses′ was assembled by literature analysis and SMEs′ consultation. Convenient sampling method was used. Through a questionnaire to 395 head nurses,the frequency and importance of the activities were compared in 230 head nurses from level three hospitals,131 head nurses from level two hospitals,and 34 head nurses from special hospitals. Cronbach′s alpha coefficient was also calculated to test the reliability of the survey.Results The Cronbach′s alpha coefficient was beyond 0.9 and the result was reliable. The work in clinical practice involved multiple aspects in 395 head nurses and the top 5 frequencies of work included daily nursing work evaluation (4.60±0.67) score,patients encouragement and reassurance (4.31±0.84),regulations implementation of disinfection and isolation (4.27±0.83),to know patients′ condition (4.20±0.93),and ward environment (4.06±1.04). The top 5 important job for head nurses were regulations implementation of disinfection and isolation,critical patient′s management,medication management,rescue of critical patients,and daily nursing work evaluation.Conclusions Among all dimensions of head nurses′ activities,"nurse care quality and security management" is the most frequent activity of head nurses,which is also the most important activity.