Objective:To explore the effectiveness of deep learning image reconstruction (DLIR) algorithm compared to adaptive statistical iterative reconstruction (ASIR-V) algorithm in improving the quality of low-dose brain CT images.Methods:Retrospective inclusion of patients who underwent brain CT examination in the People's Liberation Army General Hospital from November 2021 to August 2022. Four different algorithms were used to reconstruct low-dose CT scans of all patients to obtain 30% intensity ASIR-V (ASIR-V-30%) images, low intensity DLIR (DLIR-L) images, medium intensity DLIR (DLIR-M) images, and high intensity DLIR (DLIR-H) images. The regions of interest were selected from four sets of images, including superficial white matter, superficial gray matter, deep white matter, and deep gray matter, and their CT values and standard deviations were measured for calculating signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR).Subjective evaluation of image quality was conducted by three neuroimaging physicians based on the Likert 5-component scale. The objective and subjective scores of the 4 groups of images were analyzed using ANOVA or Kruskal Wallis. If there are overall differences, pairwise comparisons were conducted within the group.Results:A total of 109 patients were enrolled, including 104 males and 5 females, aged 65-110 years (89.16 ± 9.53) years. The radiation exposure of brain CT low-dose scanning was (0.93 ± 0.01)mSv, significantly lower than that of conventional scanning (2.92 ± 0.01) mSv ( t = 56.15, P < 0.05). The differences in objective image quality analysis of ASIR-V-30%, DLIR-L, DLIR-M, and DLIR-H images of low-dose CT in SNR deep gray matter, SNR deep white matter, SNR superficial gray matter, SNR superficial white matter, CNR deep gray white matter, and CNR superficial gray white matter were statistically significant( F =98.23, 72.95, 68.43, 58.24, 241.13, 289.91, P < 0.05). Among them, DLIR-H images had the lowest noise in deep gray matter, deep white matter, superficial gray matter, and superficial white matter, and had statistically significant differences compared to other image groups ( t = 167.43, 275.46, 182.32, 361.54, P < 0.05). The subjective score of DLIR-H image quality was superior to ASIR-V-30%, DLIR-L, and DLIR-M, with the statistically significant difference ( t = 7.25, 8.32, 9.63, P < 0.05). Conclusions:Compared with ASIR-V, DLIR algorithm can effectively reduce image noise and artifacts in low-dose brain CT, and improve SNR and CNR. The subjective and objective image quality evaluation of DLIR-H is the best.

Objective To explore the effect of L-ascorbic acid(AA) for reducing the fibroblast cells induced by cobalt(co)cytotoxicity.Methods The experiment was divided into the blank control group,Co2+ group,Co2++AA group,cobalt nanoparticles(CoNPs) group,CoNPs+AA group and AA group.The AA pretreated for 1 h was performed in advance.The CCK8 assay was used to detect the CoNPs and Co2+ induced and AA-treated cytotoxicity.The fluorescence staining was used to measure the production of ROS in mitochondria.The real-time polymerase chain reaction(PCR) and Western blot were used to measure the expression of related protein and related molecular mRNA respectively.Moreover the cytochrome-C level in cytoplasml was detected.Results After treating the cells by CoNPs and Co2+,the cells appeared apoptosis.CoNPs could significantly induce ROS generation;the proapoptotic factors(caspases-3,and Bax) were significantly increased,while the anti-apoptotic factor Bcl-2 expression was decreased;cytochrome C and AIF expressions were up-regulated and released from mitochondria into the cytoplasm,after AA pretreatment,these changes caused by CoNPs were decreased.Conclusion AA can reduce the CoNPs caused cytotoxicity by reducing ROS generation and release,but can not weaken the Co2+ toxic effect.

Objective To investigate the characteristics of pulmonary function and pathological changes in rats with acute lung injury (ALI) and provide experimental basis for further study on the mechanism of ALI.Methods Twenty five male SD rats were randomly divided into the control group (n =5) and acute lung injury (ALI) group (n =20).Lipopolysaccharide (LPS) (4.5 mg/kg) were injected into the ALI group rats to establish the ALI rat model.The rats in control group were given 150 μl isotonic saline.At 12,24,48,and 72 hours after injury,lung function of the rats were tested by Buxco small animal lung function test system,including the dynamic lung compliance (Cdyn),forced vital capacity (FVC),functional residual gas (FRC),quasi static compliance (Cchord),100th millisecond expiratory volume (FEV100),and airway resistance (RI).In addition,the bronchoalveolar lavage fluid (BALF) was collected for detection of protein level and tumor necrosis factor (TNF-alpha)concentration.At the same time,the changes of lung tissues were recorded,and the pathological changes were observed by HE staining.Results Compared with the control group,Cdyn,FVC,FRC,and FEV100 in ALI group were significantly decreased at each time point after injury (P ＜0.05 or ＜0.01),while the airway resistance (R1) in ALI group was significantly increased at 24 and 48 hours after injury (P ＜ 0.01).There was no significant difference in quasi static compliance (Cchord) between two groups (P ＞ 0.05).The protein level and TNF-alpha concentration of BALF in ALI group were increased significantly (P ＜0.05 or ＜0.01) 12-72 hours after injury (P ＜ 0.01).Compared with the control group,the whole lung was dark red in ALI group 12 hours after injury,and the most serious bleeding occurred in the pulmonary hilum area with single or multiple hemorrhagic foci of different sizes.Multiple punctate and focal bleeding of different sizes were seen on the lung surface,which were radially distributed around the pulmonary hilum.The color of lung tissue was gradually restored to normal at 72 hours after injury.Under the light microscope,pulmonary interstitial edema,inflammatory cell infiltration,pulmonary vascular congestion and focal pulmonary hemorrhage were observed 12 h after injury,showing typical ALl pathological changes.The pathological changes were the most significant at 24 hours and reduced obviously at 72 hours.Conclusions A single intratracheal injection of LPS can induce typical ALI pathological changes.There is a similar trend between the pulmonary function indexes,lung pathology characteristics,and the protein level of BALF and proinflammatory cytokine level,suggesting that the pulmonary function test parameters can provide reference for evaluation of ALI.

Objective To investigate the value of muhiple inflammatory cells and clinical score in early diagnosis and prognosis assessment of trauma sepsis risks.Methods This retrospective control study enrolled 209 severe trauma patients admitted from January 2010 and May 2016.White blood cell count,lymphocyte count and percentage,monocyte count and percentage,neutrophil count and percentage,ratio of neutrophil to lymphocyte count (N/L),acute physiology and chronic health evaluation (APACHE) Ⅱ score,sequential organ failure assessment (SOFA),improved early warning score (MEWS),Glasgow coma score (GCS),multiple organ dysfunction syndrome (MODS) score and lactic acid (LAC) were collected on the day of admission and 3,5,7 days after trauma.These data were applied to construct weighted and biological score models for early diagnosis and prognosis of traumatic sepsis.Receiver operating characteristic curve (ROC) was performed and area under the curve (AUC) was calculated to measure the value of the two models in early diagnosis and prognosis of sepsis.Results AUC of the weighted model combined by APACHE Ⅱ score,SOFA score and MEWS was 0.729 on the day of admission.AUC of the weighted model combined by inflammatory cells was 0.680 and AUC of the biological score model was 0.800 3 days after trauma (P ＜ 0.05).AUC of the weighted models combined by inflammatory cells was 0.798 and AUC of the biological score model was 0.812 5 days after trauma (P ＜ 0.05).AUC of the weighted models combined by inflammatory cells was 0.706 and AUC of the biological score model was 0.713 7 days after trauma (P ＞ 0.05).AUC of the biological score model had significant difference 3 days and 5 days after trauma (P ＜ 0.05).Of the weighted model combined by APACHE Ⅱ score,MODS score,GCS and LAC to evaluate the prognosis of sepsis,the AUC showed significant difference on the day of admission (0.838),3 days after trauma (0.878),5 days after trauma (0.947) and 7 days after trauma (0.936) (P ＜ 0.05).Conclusions Biological score possesses better effect on early diagnosis of sepsis 3 days after trauma.Weighted model combined by APACHE Ⅱ score,MODS score,GCS and LAC can effectively predict the prognosis of sepsis 5 days after trauma.

Objective To study the value of deferred stent implantation in patients with high thrombus burden of acute ST-segment elevation myocardial infarction (STEMI). Methods Select 106 cases with a high thrombus burden within 12 hours of onset in patients with STEMI ,the infarct-related artery thrombus aspiration after antegrade flow of TIMI 2-3 and≤2 points of the thrombus aspiration(TS)patients were randomly divided into immediate stenting group(n = 43)and deferred stenting group(n = 40). Two groups of patients were compared with the myocardial blush grade(MBG),the incidence of slow-/no-reflow ,the incidence of compound endpoints in 6 months and the cardiac function after PCI for 6 months. Results After stenting,the MBG of deferred group was significantly higher than that of immediate group ,the incidence of slow-/no-reflow and the compound endpoints events within 6 months in deferred group was significantly lower than that in the immediate group. After PCI for 6 months,the improvement of LVEF in the deferred group was significantly higher than that in the immediate group, the left ventricular end diastolic dimension(LVEDD)in deferred group was significantly lower than that in immedi-ate group,and the differences were statistically significant(P < 0.05). Conclusions The high thrombus burden in patients with acute STEMI after thrombus aspiration ,deferred stent implantation can significantly reduce the rate of slow-/no-reflow ,improve myocardial perfusion ,reduce the incidence of compound endpoints events ,im-prove cardiac function in patients.

This study is to explore the interventional effects of fluvastatin on anti-beta2GPI/beta2GPI-induced activation in THP-1 mononuclear cells. In vitro, human mononuclear cells THP-1 were treated with fluvastatin, LPS and anti-beta2GPI/beta2GPI, then the TF expression on THP-1 cells was detected by real-time quantitative PCR (RT-qPCR) or TF activity was detected by kit. TNF-alpha mRNA and its protein expression were investigated by RT-PCR and ELISA kit. The expression of phospho-NF-kappaB p65 and inhibitory protein of NF-kappaB (IkappaB-alpha) were measured by Western blotting. The results suggested that the expression of TF and TNF-alpha on THP-1 cells was significantly up-regulated with treatment of anti-beta2GPI/beta2GPI complex (100 mg x L(-1)), compared with that of untreated cells (P < 0.05). Fluvastatin (50 mg x L(-1)) could decrease TF (mRNA and activity) expression and the level of TNF-alpha (mRNA and protein) in THP-1 cells with anti-beta2GPI/beta2GPI complex. The expression of TF and TNF-alpha was shown in a concentration-dependent manner. Moreover, anti-beta2GPI/beta2GPI complex could downregulate IkappaB-alpha levels and increase the levels of phospho-NF-kappaB p65. And these effects of anti-beta2GPI/beta2GPI complex could be blocked by fluvastatin. In conclusion, fluvastatin may interfere the expression and regulation of NF-kappaB signal transduction pathway, thereby inhibit the effects of anti-beta2GPI/beta2GPI on activation of THP-1 cells, by decreasing the expression of TF and TNF-alpha.

Objective To discuss treatment effect of ritodrine and ambroxol on acceleration of fetal lung maturation,reduction of asphyxia of premature infants in premature women,and nursing. Methods 218 pregnant woman with premature delivery were divided into the treatment group (110 cases) and the control group ( 108 cases)stochastically.The treatment group adopted ritodrine and ambroxol,the control group adopted routine method.The curative effect was compared between two groups. Results The prolonged pregnancy time,rate of term labor,rate of newborn body weight ＞2500 g,incidence rate of puerperal infection,rate of neonatal pneumonia in the treatment group were better than those of the control group. Conclusions Appli cation of ritodrine in treating premature delivery proved to be safe and effective.For premature infants ＜ 34 weeks,prenatal use of ambroxol may promote the fetal lung maturity and reducecomplication rate of mothers and infants.

Objective To explore the effects of long-term Tai Ji exercise on risk factors of cardiovascular diseases and incidence of chronic diseases. Methods The elderly involved were divided into control group (n=62) and Tai Ji group (n=63). Both of them received 2-years health education. The Tai Ji group exercised with the frequency of 30~40 minutes each time, 3 times a week, while the control group didn't change their daily behavior. They were observed 2 and 6 years later. Results 2 years later, the blood pressure, weight and waistline decreased in Tai Ji group compared with the control group (P<0.05). After 6 years followed, 1 people died and 4 people occured cardiovascular diseases in Tai Ji group, while 2 people died and 12 people occured cardiovascular diseases in the control group. The incidence of chronic diseases was lower in Tai Ji group (9.52%) than in the control group (33.87%) (P<0.01). And the blood pressure, waistline, and hipline in Tai Ji group decreased significantly compared with the control group (P<0.001). Conclusion Long-term Tai Ji Exercise can ameliorate the risk factors of cardiovascular diseases and reduce the incidence of chronic diseases.

Objective To assess the capability of monochromatic energy images of Gemstone spectral imaging(GSI) in reducing artifacts caused by metallic implants. Methods Twelve subjects with metallic implants underwent GSI (Discovery CT750 HD, GE Healthcare, Milwaukee ). The metallic orthopedic implants included 3 patients of dentures, 2 patients of cervical spinal vertebraplasty, one clavicle fracture fixation, one lumbar spinal vertehraplasty, 3 patients of artificial femoral head, one iliac fracture fixation and one tibial fracture fixation. GSI was performed by using a single source ultra-fast dual energy X-ray switching (80 kVp and 140 kVp). Following GSI scanning, thin slice images were reconstructed into 1.25 mm slice thickness. The monochromatic energy images were set to the same window width and level (window width 1500 HU,window level 500 HU). The artifact indexes (AI) at different kiloelectronvolts (keV) images were measured and compared. 3D reconstruction was performed using images with minimal AI. Result The artifacts index on monochromatic energy images varied with the change of keV. Of the images from 12 subjects, the maximal AI ranged between 145-225 at 40 keV, and minimal AI ranged between 15-90 at the 95-140 keV. The artifacts are clearly visible on polychromatic energy images and the artifacts are reduced markedly on the monochromatic energy images with minimal AI. Conclusion The artifacts caused by metallic implants can be reduced significantly by GSI with high keV monochromatic energy images.

OBJECTIVE: To explore the pelvic injury mechanisms in road traffic fatalities (RTFs) according to Young-Burgess classification and its practical value in forensic medicine. METHODS: Retrospective study was performed on pelvic X-ray radiographs of adult RTFs outside the automobiles in 128 cases. Pelvic injury mechanisms were investigated according to Young-Burgess classification and then were analyzed statistically combined with the real circumstance. RESULTS: The accuracy of pelvic injury mechanism identification using APC subtype (94.1%) and LC subtype (92.9%) were significantly higher than that without using subtypes (63.6% and 70.7%) (P<0.05). LC subtype was helpful to discriminate the direction of force, for example the rear lateral force, anterior lateral force or continuous anterior lateral force. CONCLUSION Young-Burgess classification discriminated by various methods of medical imaging may be helpful to study the pelvic injury mechanisms and provide reliable reference for road traffic accidents reconstruction.
Accidents, Traffic ; Adolescent ; Adult ; Aged ; Female ; Forensic Medicine/methods* ; Fractures, Bone/diagnostic imaging* ; Humans ; Male ; Middle Aged ; Observer Variation ; Pelvic Bones/injuries* ; Retrospective Studies ; Tomography, X-Ray Computed/methods* ; Trauma Severity Indices ; Young Adult