Objective To investigate the correlation between CT parameters of erector spinae muscle(ESM)and pulmonary function in elderly patients with chronic obstructive pulmonary disease(COPD),and to analyze its predictive value for the prognosis of patients.Methods A total of 120 COPD patients were included as the case group(including 60 cases in stable stage and 60 cases in acute exacerbation stage),and 60 smokers were selected as the control group.The differences of ESM CT parameters and pulmonary function parameters in each group were compared.According to the prognosis of COPD,patients were divided into good prognosis group(n=106)and poor prognosis group(n=14),and the predictive efficacy of ESM CT parameters on the prognosis of COPD patients was analyzed.Results The pulmonary function parameters,ESM cross sectional area(CSA)(ESMCSA)and ESM local volume in the case group were significantly lower than those in the control group(P<0.05).ESMCSA and ESM local volume were positively correlated with inspiratory capacity(IC),vital capacity(VC),forced vital capacity(FVC)and forced expiratory volume in one second(FEV1)(P<0.001).The average muscle density of ESM was positively correlated with IC,VC and FVC(P<0.05),but not with FEV1.The area under the curve(AUC)of ESMCSA and ESM local volume in predicting poor prognosis of COPD patients was 0.769[95%confidence interval(CI)0.661-0.876]and 0.827(95%CI 0.734-0.919),respectively.Conclusion There is a certain correlation between the CT parameters of ESM and the pulmonary function parameters of COPD patients,among which the ESMCSA and the ESM local volume have high predictive efficacy for the prognosis of COPD patients.

OBJECTIVE: To investigate the surgical technique and effectiveness of titanium elastic nail (TEN) assisted retrograde channel screw implantation of superior pubic branch. METHODS: The clinical data of 31 patients with pelvic or acetabular fractures treated with retrograde channel screw implantation in superior pubic branch between January 2021 and April 2022 were retrospectively analyzed. Among them, 16 cases were implanted with assistance of TEN (study group) and 15 cases were implanted under the guidance of C-arm X-ray machine (control group). There was no significant difference in gender, age, cause of injury, Tile classification of pelvic fracture, Judet-Letournal classification of acetabular fracture, and time from injury to operation between the two groups ( P>0.05). The operation time, fluoroscopy times, and intraoperative blood loss of each superior pubic branch retrograde channel screw were recorded during operation. X-ray films and three-dimensional CT were reexamined after operation, the quality of fracture reduction was evaluated by Matta score standard, and the position of channel screw was evaluated by screw position classification standard. The fracture healing time was recorded during the follow-up, and the postoperative functional recovery was evaluated by Merle D'Aubigne Postel score system at last follow-up. RESULTS: Nineteen and 20 retrograde channel screws of superior pubic branch were implanted in the study group and the control group, respectively. The operation time, fluoroscopy times, and intraoperative blood loss of each screw in the study group were significantly less than those in the control group ( P<0.05). According to the postoperative X-ray films and three-dimensional CT, none of the 19 screws in the study group penetrated out of the cortical bone or into the joint, and the excellent and good rate was 100% (19/19); in the control group, there were 4 screws of cortical bone penetration, and the excellent and good rate was 80% (16/20); the difference between the two groups was significant ( P<0.05). Matta score standard was used to evaluate the quality of fracture reduction, there was no patient in the two groups with poor reduction results, and the difference was not significant between the two groups ( P>0.05). The incisions of the two groups healed by first intention, and there was no complication such as incision infection, skin margin necrosis, and deep infection. All patients were followed up 8-22 months, with an average of 14.7 months. There was no significant difference in healing time between the two groups ( P>0.05). At last follow-up, the difference in functional recovery evaluated by the Merle D'Aubigne Postel scoring system between the two groups was not significant ( P>0.05). CONCLUSION TEN assisted implantation technique can significantly shorten the operation time of retrograde channel screw implantation of superior pubic branch, reduce the times of fluoroscopy, and have less intraoperative blood loss and accurate screw implantation, which provides a new safe and reliable method for minimally invasive treatment of pelvic and acetabular fractures.
Humans ; Titanium ; Fracture Fixation, Internal/methods* ; Blood Loss, Surgical ; Retrospective Studies ; Bone Screws ; Treatment Outcome ; Fractures, Bone/surgery* ; Spinal Fractures ; Hip Fractures

Objective:To evaluate the diagnostic accuracy and application value of high-frequency ultrasonography in proximal radial nerve injuries associated with humeral shaft fractures.Methods:A retrospective case series study was performed for 19 patients with proximal radial nerve injuries associated with humeral shaft fractures treated in Huashan Hospital Affiliated to Fudan University from August 2014 to September 2020. The were 17 males and 2 were females，with the age range of 16-55 years ［（38.1±12.7）years］. Of all，11 patients were injured at the left side and 8 at the right side. All the patients had histories of traumatic humeral shaft fracture and were treated in other hospitals，including internal fixation in 17 patients，external fixation in 1 and internal fixation combined with external fixation in 1. All patients underwent radial nerve exploration surgeries，among which 8 had high-level radial nerve release and 11 had high-level radial nerve suture or graft transplantation. All patients underwent high-frequency ultrasound examination before surgery. The ultrasonographic characteristics of the radial nerve were recorded，including the continuity of the epineurium，honey-comb structure on the transversal section，neuromas on the longitudinal section and external scar or callus or metal fixation compressing the nerve. The injury type and neural continuity of each radial nerve were evaluated. The radial nerves of type Ⅰ，type Ⅱ，type Ⅲa ，type Ⅲa ，type Ⅲb and type Ⅳ appeared as normal，swelling，short-segment compressed，neuroma-like and ruptured，respectively. Taking the intraoperative findings as the gold standard，the diagnostic coincidence rate，sensitivity，specificity，positive predictive value and negative predictive of high-frequency ultrasound were analyzed in diagnosis of proximal radial nerve injuries associated with humeral shaft fractures.Results:According to ultrasonographic characteristics，proximal radial nerve injuries were classified into 4 types in 5 subtypes. It was confirmed by surgeries that there were 1 patient with type Ⅱ，4 with type Ⅲa，1 with type Ⅲb and 13 with type Ⅳ，with no type Ⅰ. The diagnostic coincidence rate of high-frequency ultrasound was 89%. The diagnostic coincidence rate of type Ⅱ，type Ⅲa，type Ⅲa，type Ⅲb and type Ⅳ was 100%，100%，100% and 85%，respectively. The sensitivity of high-frequency ultrasound for evaluating the neural continuity was 75%，the specificity was 100%，the positive predictive value was 100%，the negative predictive value was 85%.Conclusions:The high-frequency ultrasound has a relatively high sensitivity and specificity in diagnosis of proximal radial nerve injuries associated with humeral shaft fractures，which can provide relatively accurate morphological information for clinical diagnosis and treatment.

At the end of December 2019, acute respiratory infectious diseases caused by a new type of coronavirus were prevalent in Wuhan and other cities of China. Different from radiology examinations, the protocols of nuclear medical imaging examinations are complicated, in which more workplaces and staff are needed, resulting more complex management of patients and higher protection requirements. Combined with the characteristics of SPECT and PET imaging procedures, this paper puts forward some suggestions on the protective process of imaging examinations for patients with confirmed or suspected novel coronavirus infection. The main purpose is to protect medical staff from virus infection, effectively reduce the risk of virus transmission during the examination process, and ensure the medical quality and safety.

At the end of December 2019, acute respiratory infectious diseases caused by a new type of coronavirus were prevalent in Wuhan and other cities of China. Different from radiology examinations, the protocols of nuclear medical imaging examinations are complicated, in which more workplaces and staff are needed, resulting more complex management of patients and higher protection requirements. Combined with the characteristics of SPECT and PET imaging procedures, this paper puts forward some suggestions on the protective process of imaging examinations for patients with confirmed or suspected noval coronavirus infec- tion. The main purpose is to protect medical staff from virus infection, effectively reduce the risk of virus transmission during the examination process, and ensure the medical quality and safety.

Objective To understand the distribution of water iodine in the external environment of Shanxi Province, and to provide a basis for redefining and implementation of scientific iodine supplementation in iodine deficiency, iodine adequate or iodine high areas. Methods In 2012 - 2016, administrative villages (neighborhood committees)in 119 counties(cities,districts)in 11 cities of Shanxi Province were selected as the investigation units, and 1 to 5 drinking water samples were collected. Water iodine content was detected using arsenic-cerium catalytic spectrophotometry. Areas standard was designated: water iodine content < 10 μg/L as iodine deficiency areas, > 100 μg/L as iodine high areas. Results A total of 26 213 administrative villages (neighborhood committees) of 1 362 townships (towns) of 119 counties (cities, districts) were surveyed, covering 2 850.94 ten thousand people. A total of 32 766 water samples were collected and the median iodine was 5.2 μg/L. There were 18 199 villages with water iodine < 10 μg/L, accounting for 69.4% (covering 1 812.17 ten thousand people, accounting for 63.6%), 6 471 villages with water iodine 10-<50 μg/L,accounting for 24.7%(covering 787.44 ten thousand people,accounting for 27.6 %),1 166 villages with water iodine 50 - < 100 μg/L,accounting for 4.4% (covering 181.46 ten thousand people, accounting for 6.4%), 377 villages with water iodine ≥100 μg/L, accounting for 1.4%(covering 69.87 ten thousand people, accounting for 2.5%).In 1 362 townships (towns), 71.1% (969)water iodine median was<10 μg/L,24.2%(330)water iodine median was in 10-<50 μg/L,3.4%(46)water iodine median was in 50-<100 μg/L,and 1.2%(17) water iodine median was ≥100 μg/L. In 119 counties(cities,districts),there were 90 counties(accounting for 75.6%) with the water median < 10 μg/L, there were 26 counties (accounting for 21.8%) with the water median 10 - < 50 μg/L. Conclusions Most parts of Shanxi Province(or the resident population) are iodine deficiency areas, the external environment water iodine contents in the rest of the regions are different, we should adopt different iodine supplement or iodine reduction measures in regions with different water iodine levels.

Objective To study the nutritional status of pregnant women in Shanxi Province before and after the implementation of the new standards of iodized salt content,provide the basis for scientific supplementation of iodine for pregnant women.Methods According to the method of population proportion sampling,30 county-level monitoring sites were selected,a primary school was selected from each county (city,district) by the method of simple random sampling and 40 students in 2011 or 50 students in 2014 aged 8-10 years were selected in each school,direct titration was used to detect salt iodine;at the same time,20 pregnant women were selected from each town where the primary school was located and urinary iodine was determined using arsenic cerium catalytic spectrophotometry (WS/T 107-2006).Results A total of 1 182 and 1 437 salt samples was detected in Shanxi Province in 2011 and 2014,the median of salt iodine was 30.5 and 24.1 mg/kg,respectively,and the difference was statistically significant (H =567.45,P ＜ 0.01);it was 95.41％,80.31％,76.62％ of the coverage rate of iodized salt,qualified rate of iodized salt,qualified iodized salt consumption rate in 2014,respectively;which were compared with those in 2011 (97.63％,97.49％,95.18％),the differences were statistically significant (x2 =9.27,232.40,166.25,P ＜ 0.01).A total of 440 and 630 urinary samples of pregnant women were tested in 2011 and 2014,the median of urinary iodine was 279.6 and 177.1 μg/L,respectively,iodine nutrition of pregnant women was more than adequate in 2011,and iodine nutrition was suitable in 2014.The difference was statistically significant (H =153.89,P ＜ 0.01).The proportion of pregnant women's median of urinary iodine less than 150 μg/L in 2014 [41.11％ (259/ 630)] was significantly higher than that in 2011 [8.18％ (36/440),x2 =140.68,P ＜ 0.01].The constituent ratio of 250 to 500 μg/L was significantly decreased [23.65％ (149/630) vs 54.77％ (241/440),x2 =108.33,P ＜ 0.01).Conclusion It is at a reasonable level of iodine nutrition level of pregnant women in Shanxi after the adjustment of iodized salt content,but the ratio of ＜ 150 μg/L is increasing,which needs to be paid attention to.

Objective To evaluate the influences of FBP and OSEM (with different iteration numbers or subset numbers) on cardiac function parameters with MPI,and to identify a suitable clinical method.Methods The MPI of 66 patients (33 males,33 females,age range: 18-77 years) from January 2012 to December 2014 were retrospectively analyzed.The imaging data was reconstructed with FBP and 5 different OSEM (4-16 subsets and 2-4 iterations) in order to evaluate if there was any difference of cardiac function parameters calculated by QGS between the different image processing methods.In addition,the results were compared with those of cardiac ultrasonography.One-way analysis of variance was used for data analysis.Results The statistical differences of LVEF,EDV,and ESV(F values: 10.73,4.89 and 5.97,all P<0.05) were found among 6 reconstructed methods.The values of LVEF were (66.14±11.12)％,(75.05±12.10)％,(70.09±11.27)％,(66.88±10.38)％,(64.97±10.25)％,and (62.58±9.84)％.Those of EDV were (77.32±27.58),(67.97±27.56),(75.10±27.89),(81.03±28.11),(84.94±29.07),and (89.98±29.71) ml,and the ESV values were (28.71±10.04),(19.71±16.51),(25.13±17.66),(29.01±18.47),(32.10±19.63),and (35.83±20.41) ml respectively.The cardiac function parameters measured by OSEM (with 2 iterations,12 subsets) were much similar to that measured by cardiac ultrasonography.Conclusion Compared with other 5 processing methods of MPI,the OSEM (with 2 iterations,12 subsets) method may be more suitable for practical clinical application.

Objective To establish a arsenic cerium catalytic rate method for determination of urinary iodine,and increase the linear range of urinary iodine determination.Methods Standard series and urine samples after digestion treatment,were tested using dynamics function of spectrophotometer to record the curve of absorbance value (A) change with time (t) during arsenic cerium catalytic reaction for each measurement system,choice (A1,t1) and (A 2,t2) on this curve and calculating the reaction rate (v),v =(lgA1-lgA2)/(t2-t1).Through the determination of the standard series it could calculate regression equation of iodine concentration (C) with X:C =a ± bX,X =1 000 (v-v0),and the v0 is the reaction rate of reagent blank.Results (① C and X were positively correlated.The standard series linear range was 0-1 200 pμg/L and correlation coefficient r was higher than 0.999 1.The minimum detection limit was 3.9 μg/L (0.25 ml urine).②)Precision:5 urine samples (A,B,C,D,E) were selected within the range of 0-1 200 μg/L and the measured value were (72.3 ± 2.7),(148.2 ± 5.2),(210.5 ± 4.4),(562.7 ± 6.8),and (899.3 ± 8.0) μg/L.The relative standard deviation (RSD) was between 0.9％-3.8％.(③)Accuracy:4 samples (A,B,C,D) were measured for standard addition recovery test,recovery was between 94.2％-107.2％;urinary iodine standard material [the given values were (67.9 ± 9.0),(142.0 ± 10.0),(195.0 ± 10.0),(558.0 ± 17.0),(885.0 ± 28.0) μg/L] were determined and the results were in the range of uncertainty of the standard material.④Method contrast:with the national health standard method (method for determination of iodine in urine by arsenic cerium catalytic spectrophotometry) to determinate 120 urine samples,the results showed that there were 60 urine samples within 0-300 μg/L,60 urine samples were more than 300 μg/L.Then rate method was used to test the 120 urine samples.For the 60 samples within the scope of 0-300 μg/L,the determination results of the two methods were positively correlated (r =0.994,P ＜ 0.01);the results of the rate method were lower than those of the standard method and the difference was statistically significant (t =2.047,P ＜ 0.05).But the average deviation was only 2.1 μg/L,for the determination of urine iodine there was no practical significance;for the 60 samples higher than 300 μg/L,the determination results of the two methods were positively correlated (r =0.993,P ＜ 0.01) and the difference was not statistically significant (t =-1.092,P ＞ 0.05).Conclusions Arsenic cerium catalytic rate method has increased the linear range of urinary iodine determination.Using this method,the vast majority samples can be tested directly without dilution,thereby reducing the workload for determination of urine iodine.

Background:Pancreatitis is the main complication of ERCP,and a variety of risk factors will increase its risk. Studies showed that temporary pancreatic duct stent can reduce the incidence of post-ERCP pancreatitis (PEP). Aims:To study the efficacy and safety of prophylactic pancreatic duct stenting on preventing PEP in patients with risk factors. Methods:Patients undergone ERCP and accompanied with one or more PEP-associated risk factors from November 2013 to November 2016 at Huaibei People's Hospital were enrolled,and were divided randomly into pancreatic duct stenting group (observation group)and non-stenting group (control group). Serum levels of amylase at 4,24 and 48 hours after the procedure and incidence of PEP were compared between the two groups. Results:A total of 297 patients were enrolled, and 147 patients were in observation group,and 150 patients in control group. No significant differences in gender,age and ERCP disease spectrum were found between the two groups (P > 0. 05). Incidence of PEP was significantly decreased in observation group than in control group (6. 1％ vs. 16. 0％,P < 0. 05). Serum levels of amylase at 4,24 and 48 hours after the procedure were significantly decreased in observation group than in corresponding control group (P < 0. 05), however,no significant difference in incidence of hyperamylasemia was found between the two groups (59. 2％ vs. 54. 7％, P > 0. 05). Conclusions:Prophylactic pancreatic duct stenting may decrease the incidence of PEP in patients accompanied with PEP-associated risk factors, especially could decrease the severity of PEP. However, the incidence of hyperamylasemia is not decreased.