Objective To explore the preventive effect of low molecular weight heparin(LMWH)combined with integrated medical-nursing enhanced recovery after surgery(ERAS)intervention on postoperative deep vein thrombosis(DVT)in colorectal cancer(CRC)patients.Methods A retrospective collection of postoperative CRC patients at Hangzhou Hospital of Traditional Chinese Medicine from January 2021 to October 2023 was conducted.Patients were divided in the combined intervention group(LMWH combined with ERAS)and the control group(LMWH)based on the intervention methods.The primary observation indicators of this study was the incidence of lower extremity DVT.Secondary observation indicators included changes in coagulation parameters[D-dimer(D-D),thrombin time(TT),prothrombin time(PT),activated partial thromboplastin time(APTT),and fibrinogen(Fib)]before and after intervention;blood flow velocity in the bilateral popliteal,external iliac,and femoral veins;time to first postoperative anal gas passage,time to resume eating,time to get out of bed and length of hospital stay;postoperative complication rate and adverse drug reaction rate.Results A total of 110 patients were included in the study,with 55 in the combined intervention group and 55 in the control group.There were no statistically significant differences between the two groups in terms of baseline characteristics,coagulation-related indicators before intervention,and lower limb venous blood flow velocity(P＞0.05).After 7 and 14 days of intervention,TT,PT,APTT,and Fib levels in both groups were higher compared to before the intervention,while D-D levels decreased(P＜0.05).There were no significant differences in TT,PT,and APTT between the two groups(P＞0.05),but the D-D level in the combined intervention group was lower than that in the control group(P＜0.05),and the Fib level was higher than that in the control group(P＜0.05).After 14 days of intervention,the blood flow velocities in the bilateral popliteal,external iliac,and femoral veins were higher in the combined intervention group than in the control group(P＜0.05),and the incidence of DVT was lower(1.82％vs.7.27％),but the difference was not statistically significant(P=0.363).The combined intervention group had shorter postoperative time to first anal gas passage,resumption of eating,getting out of bed,and length of hospital stay compared to the control group(P＜0.05).Finally,there were no statistically significant differences between the two groups in the incidence of postoperative complications and adverse reactions to LMWH(P＞0.05).Conclusion The combined intervention of LMWH and ERAS can effectively improve the hypercoagulable state in postoperative CRC patients,increase the venous blood flow velocity in the lower limbs,reduce the incidence of DVT,promote postoperative recovery,and has good safety.

Objective:To observe any effect of dry needling of myofascial trigger points on substance P and synaptophysin expression in the spinal dorsal horn.Methods:Sixty-four Sprague-Dawley rats were randomly divided into a control group ( n=16) and a model group ( n=48). Myofascial trigger points were induced in the model group by a blunt strike and eccentric running. That group was then randomly divided into a no-treatment group ( n=15), a massage group ( n=16), and a dry needling group (16 rats). The rats in the two treatment groups received 4 weeks of dry needling or Chinese massage. Pressure pain thresholds were recorded before the experiment and after the 4 weeks. The content of substance P and synaptophysin in the spinal dorsal horn were measured using immunoblotting and immunohistochemistry. Results:After the treatment 14 rats (93%) in the model group had trigger points, significantly higher than the 8 rats (50%) in the massage group and the 7 rats (44%) in the dry needling group. After treatment, the average pressure pain thresholds of the no-treatment and massage groups was significantly lower than the control group′s average, while the difference between the dry needling group and the control group was not significant. The average pressure pain threshold had improved significantly in the no-treatment group, the massage group and the dry needling group, and the averages of the massage group and the dry needling group were significantly higher than that of the no-treatment group. The level of substance P was significantly higher in the no-treatment group than in the other three groups and the ratio of substance P to Glyceraldehyde 3-phosphate dehydrogenase (GAPDH)was significantly higher. The substance P: GAPDH ratio of the massage group was significantly higher than that of the control group.Conclusions:Dry needling and massage are effective in relieving myofascial pain, at least in rats. Both can reduce the content of substance P in the spinal dorsal horn.

Objective:To investigate the value of the size-specific dose estimate (SSDE) on dose estimations of children's head CT scans.Methods:A retrospective study was conducted on plain head CT scans of 252 patients with the 64-row detector CT device of Discovery 750HD in the Union Hospital, Tongji Medical College, Huazhong University of Science and Technology from January to September in 2019. The volume CT dose index (CTDI vol)values were recorded. The head circumference (HC), area, and CT value were measured using a self-developed computer program, and the water equivalent diameter (WED), size-specific conversion factors ( f293 and f220), and absorbed dose (SSDE 293 and SSDE 220) were calculated according to the AAPM reports 293 and 220.The patients were divided into three groups by the quartering meth odaccording to their HC(<47.8 cm, 47.8-52.7 cm, >52.7 cm)and four groups based on their ages(0-2, 3-6, 7-10 and 11-14 years old). The difference between parameters ( f220 and f293, SSDE 220 and SSDE 293、SSDE 293 and CTDI vol) were compared for different groups, and the correlation of HC with f293 and SSDE 293 was analyzed. Results:There was an overestimation of f220 by 11.11% ( t=252.61, P<0.05) compared with f293. SSDE 220 was overestimated by 10.31% ( t=228.21, P<0.05) compared with SSDE 293, and SSDE 293 was underestimated by 9.60% ( t=-31.34, P<0.05)compared with CTDI vol. For the three HC groups, SSDE 220 was overestimated by 8.54%, 10.37%, and 11.57% ( t=73.73, 438.58, 275.52, P<0.05)compared with SSDE 293, and SSDE 293 was underestimated by 1.30%, 9.79%, and 14.61% ( t=-1.91, -60.95, -47.64, P<0.05)compared with CTDI vol. For the four age groups SSDE 220 was overestimated by 8.45%, 10.00%, 10.57%, and 11.36% ( t=63.58, 232.29, 247.84, 302.95, P< 0.05)compared with SSDE 293, and SSDE 293 was underestimated by 1.49%, 8.27%, 10.63%, and 13.78% ( t=-1.83, -28.27, -37.30, -49.80, P< 0.05)compared with CTDI vol. Furthermore, HC was highly correlated with f293 and SSDE 293 ( r2=0.88 and 0.76, respectively, P< 0.05). Conclusions:The radiation dose in children′s head CT scanning can be more accurately estimated according to the AAPM Report 293, while it can be overestimated by CTDI vol. Meanwhile, the CT radiation dose can be patently overestimated with the AAPM Report 220 compared with Report 293.HC is closely correlated with f293 and SSDE 293 and it can be used to estimatee more accurately for SSDE and the radiation dose received by children during head CT scanning.

Objective: To explore the effect of pre- and post-adaptive statistical iterative reconstruction-Veo (ASiR-V) on image quality and radiation dose in paranasal sinus CT, and to find the best combinations. Methods: One head specimen was scanned with the routine spiral CT scanning parameters [noise index (NI)=8] and different levels of pre-ASiR-V (0—100%, with an interval of 10%). The images were reconstructed with different post-ASiR-V (0—100%, with an interval of 10%) for the bone algorithm and standard algorithm. All of 242 thin-layer images of paranasal sinuses were obtained. The region of interest (ROI) was selected to measure the CT value to calculate the contrast to noise ratio (CNR) and figure of merit (FOM). The volume CT dose index (CTDI_vol) and Smart mA were recorded. The linear regression was conducted to analyze the relationship between CTDI_vol, SmartmA, CNR and FOM. And with the same pose-ASiR-V level, the CNR of images which reconstructed by bone and soft algorithms were compared with pair-wise t test. The image quality was subjectively evaluated by three independent experienced radiologists using a 4-point scale (4 was the best). Results: As the pre-ASiR-V levels (0—100%) increased, Smart mA and CTDI_vol were reduced with a linear negative correlation (r=-0.981, -0.976, both P<0.001). The Smart mA decreased by 72.05% and CTDI_vol by 71.22%. Keeping the same pre-ASiR-V level,the CNR increased with the increase of post-ASiR-V level (for the bone algorithm images:R²=0.976, 0.992, 0.982, 0.982, 0.975, 0.975, 0.979, 0.996, 0.952, 0.978, 0.965;for the standard algorithm images: R²=0.944, 0.990, 0.988, 0.993, 0.996, 0.987, 0.984, 0.996, 0.996, 0.990, 0.965).Under the same level of post-ASiR-V, the CNR and FOM fluctuated with the pre-ASiR-V level (for the bone algorithm images:R²=0.335, 0.341, 0.344, 0.364, 0.385, 0.405, 0.418, 0.429, 0.455, 0.474, 0.516; for the standard algorithm images: R²=0.223, 0.278, 0.327, 0.285, 0.309, 0.329, 0.325, 0.346, 0.360, 0.390, 0.380). All subjective image quality could meet the diagnostic requirements (the score≥3). Conclusion At NI=8, for the bone algorithm, the best combination is 80% pre-ASiR-V and 100% post-ASiR-V; for the standard algorithm, the best iteration combination is 100% and 100%. The appropriate choice of pre- and post-ASiR-V levels in paranasal sinus CT scan can effectively reduce the radiation dose under the premise of maintaining the image quality that meets the diagnostic needs.

Objective:To investigate the effect of organ dose modulation (ODM) technique on reducing the breast radiation dose in chest CT scanning.Methods:In the phantom test, the PBU-2 adult chest module was used. The clinical chest scan protocol was used and three sets of scans performed on the chest module： (1) ODM off group, ODM was not used; (2) ODM part group, ODM was applied only in the breast region； (3) ODM all group, ODM was applied in the whole scan scope. Other scan parameters were same for the three groups, with smart mA applied. The volume CT dose index (CTDI vol) was recorded for all three groups. A long rod ionization chamber was placed in a fixed position in front of the right breast area to measure the breast skin dose (D). The contrast noise ratio (CNR) and the figure of merit (FOM) were measured respectively. In clinical research, 72 female patients who underwent chest CT scanning in Beijing Tongren Hospital Capital Medical University from August to November 2018 were retrospectively recruited. According to the application of ODM, the patients were divided into ODM off group (without ODM, 36 cases) and ODM part group (ODM applied in the breast region, 36 cases). The CTDI vol and the dose length product (DLP) were recorded. CNR, noise of images were measured and calculated, respectively. The image quality was evaluated by subjective evaluation scores. The one way ANOVA analysis was used in comparing the difference of CNR among the 3 groups in module test. As for clinical cases, the independent samples t test was used to compare the difference in CTDI vol, DLP, CNR and the noise between two groups; and the rank-sum test was used for comparison in image quality subjective evaluation. Results:In module test, the radiation dose was highest in ODM off group, and lowest in ODM all group. The CTDI vol were (6.90±0.02), (6.26±0.02) and (5.99±0.02) mGy, and the D values were (9.17±1.01), (8.01±0.92) and (7.58±0.87) mGy for ODM off group, ODM part group and ODM all group respectively. The CNR values of images with soft tissue algorithm reconstruction were highest in ODM off group and lowest in ODM all group, while no statistically significant difference was displayed ( P>0.05). The CNR values of the images with lung algorithm reconstruction showed the same trend, with statistically significant difference among the three groups ( F=154.732, P=0.006). The FOM of the lung and soft tissue algorithm images was maximized when the ODM was partially applied. As for clinical cases, compared with ODM off group, the dose of ODM part group showed significantly decreased, with CTDI vol decreased by 16.12% ( t=2.604, P=0.011), and the DLP decreased by 16.85% ( t=3.293, P=0.002). No significant difference was found in CNR, noise and subjective score by two doctors between two groups ( P>0.05). Conclusion:The application of ODM in chest CT imaging can reduce the radiation dose of breast with simultaneously maintaining the image quality.

Objective:To explore the effects of tube voltage on the image quality and radiation dose of paranasal sinus CT on a 16 cm wide-detector CT.Methods:The sinus area of head specimen was scanned with sequential scanning mode and tube voltages of 70, 80, 100, 120 and 140 kV, respectively. The parameters were set as follows: NI=9, automatic tube current modulation, Smart mA with the maximum range at the corresponding tube voltage, 120 mm detector width. The images were reconstructed with bone and soft tissue algorithms separately.The slice thickness was 0.625 mm for all reconstructed images. The axial, coronal and sagittal images were reformatted as 2 mm thickness with clinical baseline. The CT value and standard deviation (SD) were measured in the region of interest(ROI) of central axial image and the contrast-to-noise ratio (CNR) was calculated. The volume CT dose index(CTDI vol) and dose length product (DLP) were recorded, and the figure of merit (FOM) of images was computed. The images obtained in the study were subjectively evaluated by two experienced radiologists and one technician using a five-point scoring system. Results:The subjective evaluation of images obtained in the study met the diagnostic requirements. With the reconstruction of bone algorithm, the CNR at the tube voltages of 100 and 80 kV were 66.98 and 64.75, respectively, which was significantly higher than those at the tube voltages of 70, 120 and 140 kV (51.61, 61.56 and 57.76, respectively). The maximum and minimum CTDI vol were 34.11 mGy at 140 kV and 17.45 mGy at 70 kV. The FOM value was 152.26 at 100 kV. With the reconstruction of soft tissue algorithm, the maximum CNR was 195.62 at 80 kV, which was markedly greater than those at 70, 100, 120 kV and 140 kV (139.46, 154.49, 148.06 and 155.58 respectively). The maximum FOM value was 1273.56 at 80 kV, which was significantly higher than those at the tube voltages of 70, 100, 120 kV and 140 kV (1114.56, 809.98, 735.63 and 709.62, respectively). Conclusions:For the sinus CT of head specimen, the scan protocols with 100 kV combined with bone reconstruction algorithm and 80 kV combined with soft tissue reconstruction algorithm can provide relatively lower radiation dose and good image quality.

Echinococcosis is an age-old disease that causes serious damage to the animal husbandry and the human health perennially. As a newly discovered species of Echinococus, E. shiquicus has the potential public health significance and could be a potential parasitic zoonosis. In this review, its etiology, life cycle, epidemiology, detection and diagnoses, public health etc. are discussed or summarized. Also, a series of comparisons among E. granulosus, E. multilocularis and E. shiquicus are made.

Objective To explore the effects of detector width and pitch on radiation dose and image quality when using organ dose modulation (ODM) technology in a wide?area detector CT scanning. Methods Based on the clinical chest scan protocol,3 sets of scans of the chest phantom were performed using any combination of two detector width (40 mm and 80 mm) and pitch (0.500,1.000 and 1.375) with the same parameters:1 Do not use ODM technology (ODM off),2 open ODM (ODM part) 240 mm from scan start layer to breast area,3 open ODM (ODM all) in full 320 mm scan range. A long rod ionization chamber was placed in the fixed position in front of the right breast area. The scanning parameters of each group were measured 7 times, and the volume computed tomography dose index (CTDIvol) and breast skin dose measurement values D were recorded and the mean was calculated and recorded as Dav. The coronal 5 mm thick images of lung and soft tissue algorithms were reformed. It was divided into three parts in the Z?axis direction, and the contrast?to?noise ratio (CNR) and figure of merit (FOM) were measured separately. Independent sample t test was used for CTDI and breast skin doses D and CNR at both detector widths. ANOVA was used for dose and CNR of three sets of pitch (0.500, 1.000, and 1.375) and the three ODM techniques. Result The FOM factor was the largest when using an 80 mm detector with a pitch of 0.992 and partially turning on the ODM. The radiation dose of the three ODM groups decreased in turn, and the effect of ODM on CTDIvol (P=0.019) and breast skin dose (P=0.002) was statistically significant. The width of the detector increased and the dose was increased. The width of the detector was statistically significant for CTDIvol (t=-2.723, P=0.015). There was no statistically significant effect on the breast skin dose (t=-0.908, P=0.377). The effects of the pitch were not statistically significant for CTDIvol (P=0.254) and breast dose (P=0.146). The CNR of the three ODM groups decreased in turn, and the effect of ODM on the soft tissue image CNR was not statistically significant (P=0.146). The CNR of lung algorithm image (P=0.030) had significant effects. The multiple comparisons:only ODM all was significantly different from ODM off (P=0.009). With the increase of detector width,the values of CNR increased,the values of CNR (t=-4.128,P=0.001) of lung images were significantly affected. The effects on the soft tissue images were not statistically significant (P=0.187). There was no statistically significant difference in the effect of pitch on the CNR (P=0.660) of the lung images. The effects of the pitch on the values of CNR of soft tissue images (F=11.756,P=0.001) were statistically significant. By multiple comparisons, the difference of CNR between 0.500 (P=0.000) and 1.375 (P=0.013) was statistically significant compared with that when the pitch was 1.000. There was no significant difference among the three ODM modes (P>0.05) on the values of CNR of upper and middle parts of lung and soft tissue arithmetic images. The differences of CNR between ODM all and the other two groups were statistically significant (P<0.05) on the bottom part of images. Conclusion The changes of detector width and pitch will affect the organs dose modulation technique, and then affect the radiation dose and image quality. When using 80 mm detector with the pitch of 0.992 and partially turning on ODM in chest CT scan,achieving the optimized benefits of quality and dose.

Objective To investigate the effects of different tube voltages on the dose of superficial radiation-sensitive organs and image quality when using organ dose modulation( ODM) in chest CT. Methods Based on clinical chest CT protocol with the sameother parameters, chest phantom was scanned using 140, 120, 100, and 80 kv ( 100 kV was the recommended by the CT system) without ODM ( ODM off ) or with ODM from the starting layer to the breast area ( ODM part ) . A long rod ionization chamber was placed iat a fixed position in front of the right breast area. The scans were repeated for 7 times with each group of scanning parameters and dose values were measured for each scanning, the CTDIvol and breast skin dose measurements( D) were recorded. Coronal images of 5 mm thickness for the lung and soft tissue algorithms were reformatted. The images were divided into 8 parts along the z axis direction, the contrast noise ratios( CNR) for every region were measured. For CTDIvol , D, CNR for different ODM and tube voltage scanning modes, two factor non-repeat test ANOVA was performed. LSD method was used for comparison among groups. Results The CTDIvol was lowest at 80 kV, and the breast skin dose measurement was lowest at 100 kV, CTDIvol decreased in turn from140 to 80 kV ( F=105. 5795, P<0. 05) . The breast skin dose measurement decreased in turn from140 to 100 kV, but increased instead at 80 kV. The difference was statistically significant(F=27. 736, P<0. 05). Compared with ODM off , the CTDIvol and D for ODM part both declined and the differences were statistically significant ( F=39. 732, 81. 961, P<0. 05). The CNRs of the lung and soft tissue images decreased at every tube voltage(F=12. 809, 11. 261, P<0. 05 ) . The CNRs decreased from140 to 100 kV, but there was no statistical difference( P>0. 05) , and the difference was significant at 80 kV( P<0. 05) . Compared with ODM off, the CNRs of lung and soft tissue algorithm images with ODM part decreased, withnot statistically significant differences ( P>0. 05 ) . Conclusions In clinical practice, with the tube voltage not less than the recommended(100 kV), the optimal reduction of breast radiation dose can be achieved by reducing kV and using ODM on the premise of resonable image quality.

Objective To study the pharmacokinetic features of ferulaic acid, senkyunolide A and ligustilide in Buyang Huanwu associated prescriptions (Buyang HuanwuDecoction andNaojianTablets).MethodsHPLC-DAD was applied for simultaneous determination plasma concentration of three ingredients with jugular venous cannula rats after intragastric administration ofBuyang Huanwu associated prescriptions. The pharmacolinetic parameters of each ingredient was calculated by DAS2.0, and then the total quantum statistical moment (TQSM) standard similarity was used to measure the overall pharmacokinetics behaviors.Results There were great differences in the three ingredients after the administration of two prescriptions, while the total quantum statistical parameters were very closely. The TQSM pharmacokinetic parameters of the three components inBuyang HuanwuDecoction andNaojian Tablets showed that AUC, MRT, VRT were 240.6 and 133.0, 3.192 min and 3.259 min, 21.59 min2and 19.75 min2, respectively.The similarity was up to 0.977 8.Conclusion The metabolic processes in vivo ofBuyang Huanwu Decoction andNaojianTablets have similarities. The efficacy of Chinese herbal compounds mostly depends on the multi-components overall contributions.