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Objective:To explore the clinical application of the electronic portal imaging device (EPID) based on the linear accelerator produced by Shanghai United Imaging Healthcare Co., Ltd. (UIH) to in vivo dose verification. Methods:A total of 68 patients (32 cases with head and neck tumors, 16 cases with chest tumors, and 20 cases with abdomen and pelvis tumors) who were treated with volumetric modulated arc therapy (VMAT) in the Henan Provincial People′s Hospital were selected in this study. Each patient underwent the pre-treatment dose verification using an Arccheck device (Pre Arccheck), the pre-treatment dose verification using an EPID (Pre EPID), and the in vivo dose verification using an EPID (In vivo EPID). Moreover, the position verification based on fan beam computed tomography (FBCT) was also performed for each patient in the first three treatments and then once a week. The patients were treated when the setup error in any direction ( x: left-right, y: head-foot, z: vertical) was less than 3 mm; otherwise, position correction would be conducted. The three-dimensional setup deviation d was calculated according to setup errors x, y, and z. Results:The γ passing rates of dose verifications Pre EPID and In vivo EPID of 68 patients were (99.97±0.1)% and (94.15±3.84)%, respectively, significantly different from that (98.86±1.48)% of the Pre Arccheck dose verification ( t = -6.12, 9.43; P < 0.05). The γ passing rates of the chest, abdomen and pelvis, and head and neck in the In vivo EPID dose verification showed no significant differences ( P > 0.05). The difference in the γ passing rates (5.56±3.72)% between dose verifications Pre EPID and first In vivo EPID was unrelated to the three-dimensional setup deviation d (1.46±1.51 mm) ( P > 0.05). As the treatment proceeded, the γ passing rate of In vivo EPID gradually decreased from (94.15±3.84)% in the first week to (92.15±3.24)% in the fifth week. From the third week to the fifth week, the γ passing rates of In vivo EPID were significantly different from those in the first week ( t = 2.48, 2.75, 3.09, P < 0.05). Conclusions:The setup errors within 3 mm do not affect the γ passing rate of in vivo dose verification. The clinically acceptable threshold for the γ passing rate of in vivo EPID needs to be further determined. In addition, in vivo dose verification can support the clinical application of adaptive radiotherapy to a certain extent.
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Objective:To detect the abnormal changes of myocardial blood perfusion in patients with hypertrophic cardiomyopathy(HCM) by myocardial contrast echocardiography (MCE) combined with adenosine stress test.Methods:Fifteen adult patients with HCM who were treated in Fuwai Central China Cardiovascular Hospital from May 2021 to March 2022 were prospectively selected as the HCM group, and eighteen healthy volunteers matched by gender, age and body surface area during the same period were chosen as the control group. All subjects underwent routine echocardiography, rest and adenosine stress MCE. The MCE images were analyzed by QLab software to obtain the myocardial perfusion parameters: peak signal intensity (A value), rising slope of the curve (β value) and A×β value, and the differences of above parameters between the two groups were compared.According to whether the end-diastolic wall thickness ≥12 mm, the myocardial segments in the HCM group were divided into hypertrophic segments and non-hypertrophic segments. The differences in myocardial perfusion parameters were compared among control group segments, hypertrophic segments and non-hypertrophic segments of the HCM group. The correlations of stress myocardial blood flow with maximal left ventricular wall thickness (MLVWT), left ventricular mass index (LVMI) and left atrial volume index (LAVI) in the HCM group were analyzed.Results:Compared with the control group, the A value, β value and A×β value of whole myocardium, hypertrophic segments and non-hypertrophic segments in the HCM group were significantly decreased in the rest and adenosine stress state, and the differences were statistically significant (all P<0.05). In the stress state, the A value, β value and A×β value of the hypertrophic segments were significantly lower than those in the non-hypertrophic segments in the HCM group, and the detection rate of abnormal perfusion segments in the HCM group was significantly higher than that in the rest state(all P<0.05). Compared with the control group, the myocardial blood flow reserve of whole myocardium, hypertrophic segments and non-hypertrophic segments in the HCM group were significantly decreased, and the differences were statistically significant(all P<0.05). The stress myocardial blood flow in the HCM group was negatively correlated with MLVWT, LVMI and LAVI ( r=-0.815, -0.805, -0.742; all P<0.05). Conclusions:Myocardial blood perfusion abnormalities can occur in both hypertrophic and non-hypertrophic myocardial segments in patients with HCM, and adenosine stress MCE can significantly improve the sensitivity of detecting myocardial perfusion abnormalities. The stress myocardial blood flow in patients with HCM is negatively correlated with MLVWT, LVMI and LAVI.
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Objective:To detect the abnormal changes of myocardial blood perfusion in patients with hypertrophic cardiomyopathy (HCM) by myocardial contrast echocardiography(MCE) combined with exercise stress test.Methods:Twenty-seven patients with clinically diagnozed of asymmetric HCM in Fuwai Central China Cardiovascular Hospital from May 2020 to April 2021 were selected as the HCM group, and 29 healthy subjects during the same period were selected as the control group. All patients underwent routine echocardiography, resting and exercise stress MCE. The myocardial perfusion parameters of each segment of interventricular septum in the 2 groups were quantitatively analyzed: the peak plateau intensity (A value), ascending slope of the curve(β value) and value of A×β. According to the end-diastolic myocardial thickness, the interventricular septum of the HCM group was divided into hypertrophic and non-hypertrophic segments, and the myocardial contrast parameters of the interventricular septum of the study group were compared with those of the control group. The myocardial blood flow reserve value of the two groups were calculated, and the correlation of myocardial blood flow reserve value with left ventricular mass index (LVMI) and left ventricular remodeling index (LVRI) were analyzed.Results:No matter at rest or under stress, the A value, β value and A×β value of ventricular septal hypertrophic and non-hypertrophic segments in the hypertrophic cardiomyopathy group were lower than those in the control group, and the differences were statistically significant (all P<0.05). Under stress, the A value, β value and A×β value of interventricular septal hypertrophic segments were lower than those in non-hypertrophic segments in the HCM group, and the differences were statistically significant (all P<0.05). The myocardial blood flow reserve in the HCM group was negatively correlated with LVMI and LVRI( r=-0.899, -0.676; all P<0.001). Conclusions:In patients with HCM under resting and exercise stress, microcirculation disorders were found in both hypertrophic and non-hypertrophic segments of the ventricular wall, and the myocardial blood flow reserve was negatively correlated with LVMI and LVRI.
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Objective@#To explore the relationship between childhood abuse and cyberbullying among college students and to provide theoretical support for early intervention of cyberbullying among college students.@*Methods@#A total of 3 850 sophomores and juniors from 6 universities in Shanxi Province, randomly selected by stratified cluster sampling method, were investigated by using the Questionnaire on Cyberbullying and the Chinese Version of the Child Abuse Questionnaire.@*Results@#Male students reported higher rates of sexual abuse, emotional neglect and physical neglect than female students(χ2=5.22, 4.39, 7.53 P<0.05). The child abuse report rate of college students whose parents divorced was higher than that of those whose parents were not divorced(χ2=86.80, 134.06, 130.18, 175.64, 118.46，P<0.05). In addition to physical neglect, childhood abuse rate of only children was higher than that of non-only children, with statistically significant differences(χ2=9.44, 12.44, 21.18, 21.26, all P<0.05). The scores of all factors and total scores of cyberbullying implemented by male students were higher than those by female students(t=9.35, 5.59, 5.83, 7.57，P<0.05); the scores of all factors and total scores of cyberbullying implemented by only-child students were higher than those by non-only-child students(t=2.79, 3.74, 4.78, 4.40，P<0.05); the scores of all factors and total scores of cyberbullying implemented by students whose parents were divorced were higher than those by students whose parents were not divorced, with statistically significant differences(t=6.99,6.78, 8.04，11.33, P<0.05). Multiple linear regression model showed that there was a positive correlation between the childhood abuse of college students and the implementation of cyberbullying, and regression coefficient differences of all factors were statistically significant(β=0.10, 0.11, 0.05, 10.08,0.06, P<0.05).@*Conclusion@#Childhood abuse experiences increase the risk of college students practicing cyberbullying.
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Objective@#To investigate the relationship between daily outdoor activity time both on and off campus and respiratory symptoms of junior middle school students, then to provide evidence for the prevention of respiratory diseases in adolescents.@*Methods@#In 2016, two middle schools were selected in Wuhan，in which a total of 860 eighth grade students were surveyed, generalized linear analysis was conducted by SAS 9.4 software. @*Results@#Average outdoor activity time out of campus during weekdays in boys and was (1.84±2.30) hours, which was higher than in girls (1.51±1.99) hours (t=2.19, P<0.05). Average outdoor activity time in campus in boys was (1.74±1.50) hours, which was significantly higher than that of girls (1.49±1.20) hours (t=2.68, P<0.05). According to the results of generalized linear analysis, after controlled for gender, age and self-perceived physical condition, the longer the time adolescents spent outside the classroom during weekday, the less likely they were to have symptoms of throat and nasal cavity(estimated value=-0.06,-0.07, P<0.05).@*Conclusion@#Adolescents who spend more time outside the classroom during weekday can effectively prevent the occurrence of respiratory related diseases.
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Objective@#To explore the relationship between cyberbullying and depression in college students, and to provide a scientific basis for the prevention of cyberbullying.@*Methods@#A total of 3 914 college students from 6 universities in Shanxi Province were selected as research objects. The students’ cyberbullying behavior scale and depression self-rating scale were used to investigate the students.@*Results@#The overall reported rate of cyberbullying among college students was 17.4%. Boys who suffered from online verbal bullying and online fraud scored higher than girls. Students whose parents divorced scored higher than those whose parents did not divorce in all dimensions of cyber-bullying. There was a statistically significant difference in the overall scores of students with different degrees of education and time spent online( P <0.05). Depression was reported in 15.6% of participants. The depression scores of female students were higher than that of male students.College students whose parents were divorced had higher depression scores than those whose parents were not divorced.There were statistically significant differences in depression scores among college students with different fathers’ education levels and different time spent online every day( t / F =2.05, 6.64, 3.91 , 19.52, P <0.05). Pearson correlation analysis showed that online speech bullying, online fraud and identity concealment bullying were positively correlated with depression scores( r s =0.40, 0.36, 0.46, P <0.01). Multiple linear regression analysis showed that three forms of cyberbullying were risk factors for the increase of depression in college students( β =0.89, 0.38, 0.38, P <0.01).@*Conclusion@#Cyber-bullying is one of the risk factors for increasing the severity of depression among college students.Strengthening the management of Internet use, promotion college students’ interpersonal conununication and active cooperating between society, school and family are great significance to reduce the occurrence of cyberbullying.
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Objective@#To explore the relationship between childhood maltreatment and suicide ideation of college students,so as to provide basis for physical and mental health of college students.@*Methods@#Students from 6 universities in Shanxi Province(3 854 college students provided eligible questionniare for childhood abuse and 3 882 for suicidal ideation) were selected by multi-stage random cluster sampling from May to July 2018, the Chinese Version of the Childhood Trauma Questionnaire and the Self-rating Idea of Suicide Scale were used in the survey.@*Results@#Of all subjects,42.4% had at least one kind of abuse experience in childhood and 3.9% had suicidal ideation in the past week. By chi square test,the detection rate of suicidal ideation of college students who suffered physical abuse,emotional abuse,sexual abuse,physical neglect,emotional neglect in childhood was higher than that of college students without maltreatment (χ2=13.78，12.97，17.10，56.56，66.58，P<0.01)；Spearman correlation analysis showed that there was a positive correlation between each type of maltreatment in childhood and college students’ suicidal ideation(r=0.06，0.06，0.07，0.12，0.13，P<0.01)；Multivariate Logistic regression model found that after controlling other influencing factors,physical neglect and emotional neglect in childhood were independent risk factors for suicide ideation of college students (OR=2.18,2.07,P<0.05).@*Conclusion@#Physical neglect and emotional neglect in childhood can increase the risk of college students’ suicidal ideation. Paying enough attention and care to them in early childhood may help to prevent their suicidal ideation in adulthood.
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Objective:To explore the clinical value of adenosine stress myocardial contrast echocardiography in detecting myocardial blood perfusion abnormalities in patients with type 2 diabetes mellitus.Methods:Twenty-six patients with type 2 diabetes mellitus clinically diagnosed from May 2019 to January 2020 in the endocrinology department of Fuwai Central China Cardiovascular Hospital and 28 healthy examinees with gender and age matched during the same period were enrolled. Routine echocardiography, rest and adenosine stress myocardial contrast echocardiography were performed, the plateau signal intensity(A value), curve rising slope(K value) and A×K value of the myocardial perfusion time-intensity curve were obtained by offline analysis. And general data such as age, gender, disease course, body mass index and glycated hemoglobin were collected, and results of the two groups were compared statistically.Results:In the rest state, the A value of the myocardial perfusion parameter in the diabetic group was not significantly different from that of the control group, both in whole and in segments ( P>0.05), while the K value and A×K value of the myocardial perfusion parameters in the diabetic group were significantly lower than those in the control group ( P<0.05). In the stress state, the A value, K value and A×K value of myocardial perfusion parameters in the diabetic group were significantly lower than those in the control group, both in whole and in segments ( P<0.05). The detection rate of myocardial perfusion abnormality in the stress state was significantly higher than that in the rest state, and the difference was statistically significant ( P<0.05). The myocardial blood flow reserve in the diabetic group was negatively correlated with the course of disease and the level of glycated hemoglobin ( r=-0.580, P=0.020; r=-0.481, P=0.013). Conclusions:Adenosine stress myocardial contrast echocardiography can be used for detection of left ventricular myocardial perfusion abnormalities in patients with type 2 diabetes mellitus, which has great clinical application value.
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Objective:To prepare ultrasound-responsive nanodroplets with block polymer PEG-PCL as shell and perfluoropentane (PFP) as core, and study the effects of mechanical index (MI) on contrast-enhanced imaging properties of nanodroplet.Methods:PEG-PCL micelles were first prepared by dialysis, and then the micelles were mixed with PFP for emulsification to obtain nanodroplets. The particle size and zeta potential of nanodroplets were measured, and the morphology of nanodroplets were observed using transmission electron microscope (TEM). The stability of nanodroplets after storage at 25 ℃ and 37 ℃ was investigated. The phase transition and contrast-enhanced imaging of nanodroplets in vitro under a series of mechanical index (MI) were studied using an ultrasound diagnostic instrument.Results:The particle size of the nanodroplets was (356.6±5.6)nm, and the zeta potential was -(7.30±0.14)mV. The nanodroplets were close to spherical under TEM and had a clear core-shell structure. The particle size and dispersion of the nanodroplets increased after storage at 37 ℃ and 25 ℃. For imaging in vitro, no acoustic signal were observed at 25 ℃ when the MI varied from 0.08 to 1.0. At 37 ℃, acoustic signals were observed when MI≥0.4, and the intensity was stronger for higher MIs.Conclusions:The contrast-enhanced imaging of nanodroplets are closely related to the MI, and a higher MI could induce the phase transition of more nanodroplets and produce stronger contrast enhancement. This study could provide basis for the application of polymeric nanodroplets in ultrasound diagnosis and targeted therapy.
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Objective:To analyze the clinical data of primary hyperthyroidism patients complicated with thyroid microcarcinoma, and to guide clinical diagnosis and treatment.Methods:From January 2013 to March 2019, the clinical data of 42 cases of hyperthyroidism with thyroid microcarcinoma(study group) and 410 cases of thyroid microcarcinoma without hyperthyroidism(control group) who underwent surgical treatment in the People's Hospital Affiliated to Hubei University of Medicine were retrospectively analyzed.The epidemiological characteristics, clinical diagnosis and treatment, clinical stage, B-ultrasound characteristics, thyroid function and antibody, pathological data and prognosis of the two groups were compared.Results:In study group and control group, the proportion of microcalcification detected by B-ultrasonography was 61.9%(26/42) and 33.4%(137/410), respectively, the difference was statistically significant between the two groups(χ 2=13.411, P<0.05). In study group and control group, 47.62%(20/42) and 69.02%(283/410) of multifocal nodules were detected by B-ultrasound, the difference was statistically significant between the two groups(χ 2=7.899, P<0.05). The diagnostic rates of intraoperative frozen-section examination of the study group and the control group were 61.9%(26/42) and 66.1%(271/410), respectively, the difference was statistically significant between the two groups(χ 2=4.460, P<0.05). The lymph node metastasis rates of the study group and the control group were 9.5%(4/42) and 26.8%(110/410), respectively, the difference was statistically significant between the two groups(χ 2=6.049, P<0.05). The middle follow-up period was 37 months(1 month to 74 months). There was no recurrence of thyroid cancer in the study group, 2 cases with recurrence of hyperthyroidism after operation, and 3 cases with recurrence in the control group, with secondary surgical resection.There were no deaths in the two groups during follow-up. Conclusion:Thyroid cancer should be paid attention to when hyperthyroidism combined with nodules, but the prognosis of hyperthyroidism with microcarcinoma is better.The operation method tends to be bilateral lobectomy, which can prevent the recurrence of hyperthyroidism.In order to reduce the chance of parathyroid gland and recurrent laryngeal nerve injury, there may be no need of preventive lymph node dissection in area VI.
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OBJECTIVE@#To explore the relationship between food intolerance and adenoidal hypertrophy and accordingly to provide evidence for intolerance and adenoidal hypertrophy.@*METHOD@#Adenoidal hypertrophy in patients with a total of 111 cases as the experiment group, 30 cases of children with no history of allergies and allergy-related diseases and adenoidal hypertrophy symptoms as the control group, and compared the result of food intolerance between two groups.@*RESULT@#1) Food intolerance detected positive rate of adenoidal hypertrophy group was higher than the control group. 2) The distribution of the two groups of children in the extent of food intolerance is different. 3) Adenoid hypertrophy and how many types of the food, which is high, moderate intolerance, are unrelated. 4) The daily consumption of 14 kinds of food, the top three foods of adenoidal hypertrophy group and control group are eggs, milk, cod.@*CONCLUSION@#Food intolerance is the possible cause of adenoidal hypertrophy. The detection of specific IgG antibodies of food have positive significance in the prevention of adenoidal hypertrophy.