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AIM: To study the protective effect of fenofibrate on diabetic retinal neurodegeneration and observe its effect on miR-26a-5p and its target gene PTEN in the retinal of diabetic mice.METHODS: Diabetic mice models were established and they were gavaged by fenofibrate. H& E staining and transmission electron microscopy were used to observe the impairments of retinal neurons. Real-time PCR was used to examine the expression of miR-26a-5p, and Western blotting was employed to measure the expression of phosphatase and tensin homologue(PTEN)in the retina of diabetic mice. The expression level of nuclear factor-κB(NF-κB), interleukin-1β(IL-1β)and the morphology of neural tissues were observed.RESULTS: When compared with the diabetic mice, fenofibrate significantly attenuated the damage to retinal ganglion cells and the atrophy of retinal nerve fiber layer. While the level of miR-26a-5p was increased and the levels of PTEN and inflammatory mediators were significantly decreased in the retina of fenofibrate treated diabetic mice, with significant statistical significance(P<0.05).CONCLUSIONS: Fenofibrate protects against diabetic retinal neurodegeneration by upregulating miR-26a-5p and inhibiting PTEN, attenuating the inflammatory response and alleviating retinal cell injury.
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Objective:To investigate the effect of online acceptance and commitment therapy(ACT) group intervention on psychological flexibility of undergraduate students with facial negative physical self.Methods:From March to June 2022, thirty-two undergraduates with facial negative physical self-image were recruited, assessed and selected from a university in Zhejiang Province.The subjects were randomly divided into the training group( n=16) and the control group( n=16). The training group received 20 days of online ACT group intervention, while the control group kept waiting.The cognitive fusion questionnaire(CFQ), acceptance and action questionnaire version Ⅱ(AAQ-Ⅱ) and negative physical self scale-face(NPSS-F) were used to measure the two groups before and after intervention and 1 month after intervention.Repeated measurement analysis of variance(ANOVA) conducted was used to compare scale results with SPSS 26.0. Results:(1)The interaction effect between group and time of CFQ scores was statistically significant( F(1.625, 48.755)=4.316, P=0.025, ηp2=0.126). After intervention, the CFQ score of the training group was significantly lower than those of the control group(34.38±8.66, 40.94±8.82, P<0.05). The CFQ scores of the training group after intervention and 1 month after intervention(36.00±9.49) were both significantly lower than those before intervention(41.87±8.72, all P<0.05). (2)The interaction effect between group and time of AAQ-Ⅱ scores was marginally statistically significant( F(2, 29)=3.009, P=0.065, ηp2=0.172). After intervention, the AAQ-Ⅱ score of the training group was significantly lower than those of the control group(24.12±4.97, 28.69±6.78, P<0.05). The AAQ-Ⅱ score of the training group after intervention was significantly lower than those before intervention(28.75±6.11, P<0.05). (3)The interaction effect between group and time of NPSS-F scores was not statistically significant( F(2, 29)=1.509, P=0.238, ηp2=0.094), while the main effect of time was marginally statistically significant between the two groups( F(2, 29)=3.315, P=0.051, ηp2=0.186). The NPSS-F score of the training group after intervention was significantly lower than those before intervention(16.06±6.67, 18.81±7.85, P<0.05). Conclusion:Online ACT group intervention can effectively reduce the cognitive fusion and experiential avoidance of undergraduate students with facial negative physical self, then can improve their psychological flexibility.
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Stroke is the second leading cause of death worldwide,and oxidative stress plays a crucial role.Celastrol exhibits strong antioxidant properties in several diseases;however,whether it can affect oxidation in cerebral ischemic-reperfusion injury(CIRI)remains unclear.This study aimed to determine whether celastrol could reduce oxidative damage during CIRI and to elucidate the underlying mechanisms.Here,we found that celastrol attenuated oxidative injury in CIRI by upregulating nuclear factor E2-related factor 2(Nrf2).Using alkynyl-tagged celastrol and liquid chromatography-tandem mass spectrometry,we showed that celastrol directly bound to neuronally expressed developmentally downregulated 4(Nedd4)and then released Nrf2 from Nedd4 in astrocytes.Nedd4 promoted the degradation of Nrf2 through K48-linked ubiquitination and thus contributed to astrocytic reactive oxygen species production in CIRI,which was significantly blocked by celastrol.Furthermore,by inhibiting oxidative stress and astrocyte activation,celastrol effectively rescued neurons from axon damage and apoptosis.Our study uncovered Nedd4 as a direct target of celastrol,and that celastrol exerts an antioxidative effect on as-trocytes by inhibiting the interaction between Nedd4 and Nrf2 and reducing Nrf2 degradation in CIRI.
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The injury of vascular endothelial cells is not only the initial condition to promote the occurrence of early atherosclerosis （AS） plaques， but also an important link in the pathogenesis of AS. The microRNA （miRNA）， as an important medium of intercellular communication and gene regulatory factor， can affect vascular endothelial function and participate in the development of AS. The molecular mechanism of miRNA’s multi-target intervention in vascular endothelial cell injury has become a hot topic in the research of cardiovascular diseases. Monomers of traditional Chinese medicines such as ginsenoside Rb2 and paeonol， as well as traditional Chinese medicine for resolving phlegm and removing blood stasis could regulate miRNA to improve endothelial cell inflammation； astragaloside Ⅳ， dihydromyricetin and notoginsenoside could target miRNA and inhibit vascular endothelial oxidative stress； Danhong injection， Jianpi qutan and huayu prescription and paeonol could affect endothelial autophagy through miRNA； resveratrol， Bushen huoxue formula and Bushen tongmai formula could inhibit vascular endothelial aging by miRNA； dendrobine played an active role in regulating miRNA and improving endoplasmic reticulum stress. In the future， more in- depth research is needed on the effectiveness， mechanism of action， diagnosis and treatment plans， and safety of targeted regulation of miRNA for AS therapy by traditional Chinese medicine.
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Inflammatory injury of the intestine is often accompanied by symptoms such as damage to intestinal mucosa, increased intestinal permeability, and intestinal motility dysfunction. Inflammatory factors spread throughout the body via blood circulation, and can cause multi-organ failure. Pyroptosis is a newly discovered way of programmed cell death, which is mainly characterized by the formation of plasma membrane vesicles, cell swelling until the rupture of the cell membrane, and the release of cell contents, thereby activating a drastic inflammatory response and expanding the inflammatory response cascade. Pyroptosis is widely involved in the occurrence of diseases, and the underlying mechanisms for inflammation are still a hot spot of current research. The caspase-1 mediated canonical inflammasome pathway of pyroptosis and caspase-4/5/8/11-mediated non-canonical inflammasome pathway are closely related to the occurrence and development of intestinal inflammation. Therefore, investigation of the signaling pathways and molecular mechanisms of pyroptosis in intestinal injury in sepsis, inflammatory bowel diseases, infectious enteristic, and intestinal tumor is of great significance for the prevention and treatment of intestinal inflammatory injury.
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Humans , Pyroptosis , Inflammasomes/metabolism , Apoptosis , Caspase 1 , InflammationABSTRACT
BackgroundCompared with male adolescents， depression among female adolescents is of higher prevalence and greater severity. The level of generalized trust correlates with the severity of depression， and attachment correlates with the level of generalized trust. Therefore， based on the mediating role of generalized trust between attachment and depression， this study explores the pathogenesis of depression in female adolescents. ObjectiveTo explore the mediating role of generalized trust between paternal， maternal and peer attachment and depression in female adolescents， so as to provide references for improving the depression of female adolescents. MethodsThis study included 73 female adolescents who met the diagnostic criteria for depressive disorder in the International Classification of Diseases， tenth edition（ICD-10） as well as received outpatient and inpatient treatment in Hangzhou Seventh People's Hospital between March 2022 and October 2022. Investigation was conducted by use of Revised Inventory of Parent and Peer Attachment （IPPA-R）， the Inclusive General Trust Scale （IGTS） and Children's Depression Inventory （CDI）. Pearson correlation analysis was used to explore the correlation between each scale score. The Bootstrap method was used to test the mediating role of generalized trust between attachment and depression. Results① CDI score in female adolescents with depression was negatively correlated with scores of paternal， maternal and peer attachment in IPPA-R （r=-0.463， -0.459， -0.447， P<0.01）. Scores of paternal， maternal and peer attachment in IPPA-R were positively correlated with IGTS score （r=0.372， 0.318， 0.395， P<0.01）. IGTS score was negatively correlated with CDI score （r=-0.531， P<0.01 ）. ②The test of mediating role showed that the direct effect of paternal， maternal and peer attachment on depression level was significant in female adolescents with depression （effect size=-0.138， -0.136， -0.107， 95% CI： -0.236~-0.039， -0.242~-0.029， -0.203~-0.012）. ③The mediating role of generalized trust between paternal， maternal peer attachment and depression level was significant （effect size=-0.069， -0.066， -0.071， 95% CI： -0.127~-0.021， -0.137~-0.010， -0.145~-0.018）. ConclusionPaternal， maternal and peer attachment can influence the depression level of female adolescents both directly and indirectly through the generalized trust.
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Background@#and Purpose We performed a two-sample Mendelian randomization (MR) analysis to evaluate the causal effect of genetically proxied AMP-activated protein kinase (AMPK) activation, which is the target of metformin, on functional outcome following ischemic stroke onset. @*Methods@#A total of 44 AMPK-related variants associated with HbA1c (%) were used as instruments for AMPK activation. The primary outcome was the modified Rankin Scale (mRS) score at 3 months following the onset of ischemic stroke, evaluated as a dichotomous variable (3–6 vs. 0–2) and subsequently as an ordinal variable. Summary-level data for the 3-month mRS were obtained from the Genetics of Ischemic Stroke Functional Outcome network, including 6,165 patients with ischemic stroke. The inverse-variance weighted method was used to obtain causal estimates. The alternative MR methods were used for sensitivity analysis. @*Results@#Genetically predicted AMPK activation was significantly associated with lower odds of poor functional outcome (mRS 3–6 vs. 0–2, odds ratio [OR]: 0.06, 95% confidence interval [CI]: 0.01–0.49, P=0.009). This association was maintained when 3-month mRS was analyzed as an ordinal variable. Similar results were observed in the sensitivity analyses, and there was no evidence of pleiotropy. @*Conclusion@#This MR study provided evidence that AMPK activation by metformin may exert beneficial effects on functional outcome following ischemic stroke.
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Objective:To evaluate the performance of an artificial intelligent (AI)-based automated digital cell morphology analyzer (hereinafter referred as AI morphology analyzer) in detecting peripheral white blood cells (WBCs).Methods:A multi-center study. 1. A total of 3010 venous blood samples were collected from 11 tertiary hospitals nationwide, and 14 types of WBCs were analyzed with the AI morphology analyzers. The pre-classification results were compared with the post-classification results reviewed by senior morphological experts in evaluate the accuracy, sensitivity, specificity, and agreement of the AI morphology analyzers on the WBC pre-classification. 2. 400 blood samples (no less than 50% of the samples with abnormal WBCs after pre-classification and manual review) were selected from 3 010 samples, and the morphologists conducted manual microscopic examinations to differentiate different types of WBCs. The correlation between the post-classification and the manual microscopic examination results was analyzed. 3. Blood samples of patients diagnosed with lymphoma, acute lymphoblastic leukemia, acute myeloid leukemia, myelodysplastic syndrome, or myeloproliferative neoplasms were selected from the 3 010 blood samples. The performance of the AI morphology analyzers in these five hematological malignancies was evaluated by comparing the pre-classification and post-classification results. Cohen′s kappa test was used to analyze the consistency of WBC pre-classification and expert audit results, and Passing-Bablock regression analysis was used for comparison test, and accuracy, sensitivity, specificity, and agreement were calculated according to the formula.Results:1. AI morphology analyzers can pre-classify 14 types of WBCs and nucleated red blood cells. Compared with the post-classification results reviewed by senior morphological experts, the pre-classification accuracy of total WBCs reached 97.97%, of which the pre-classification accuracies of normal WBCs and abnormal WBCs were more than 96% and 87%, respectively. 2. The post-classification results reviewed by senior morphological experts correlated well with the manual differential results for all types of WBCs and nucleated red blood cells (neutrophils, lymphocytes, monocytes, eosinophils, basophils, immature granulocytes, blast cells, nucleated erythrocytes and malignant cells r>0.90 respectively, reactive lymphocytes r=0.85). With reference, the positive smear of abnormal cell types defined by The International Consensus Group for Hematology, the AI morphology analyzer has the similar screening ability for abnormal WBC samples as the manual microscopic examination. 3. For the blood samples with malignant hematologic diseases, the AI morphology analyzers showed accuracies higher than 84% on blast cells pre-classification, and the sensitivities were higher than 94%. In acute myeloid leukemia, the sensitivity of abnormal promyelocytes pre-classification exceeded 95%. Conclusion:The AI morphology analyzer showed high pre-classification accuracies and sensitivities on all types of leukocytes in peripheral blood when comparing with the post-classification results reviewed by experts. The post-classification results also showed a good correlation with the manual differential results. The AI morphology analyzer provides an efficient adjunctive white blood cell detection method for screening malignant hematological diseases.
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Objective:To investigate the impact of group-based rehabilitation exercise on motor and non-movement symptoms of Parkinson's disease(PD).Methods:A total of 88 patients from out-patient and in-patient services at our hospital were randomly assigned to an early exercise group(E-EG), a late exercise group(L-EG), and a control group(CG)using a randomized delayed-start design.Patients in the E-EG carried out a rigorous, formal group exercise program, one hour per session, twice per week, for 18 months(May 2018-November 2019). Patients in the L-EG took part in the exercise program in the final 6-12 months of the study.We assessed outcomes using the Unified Parkinson's Disease Rating Scale(UPDRS), Parkinson's disease questionnaire-39(PDQ-39 Q), trail-making test part A & B, nine-hole peg test(9-HPT), 30 second sit to stand test(30s SST), 10 m walk test(10 m W), mini-balance evaluation systems test(Mini-BEST), Fullerton Advanced Balance(FAB)Scale and time up and go(TUG)test.Results:Compared with pre-exercise levels, patients with PD in the E-EG had lower performance in UPDRS(17.5±8.3 vs.20.0±8.6, t=-2.2, P=0.02)and lower performance in PDQ-39(27.2±2.1 vs.29.0±9.8, t=-2.6, P=0.001)after exercise.Moreover, compared with pre-exercise levels, patients with PD in the E-EG showed decreased post-exercise performance in trail-making test part B(114.2±25.5 vs.129.8±28.4, t=-2.3, P=0.02)and in 9-HPT(33.7±7.3 vs.39.6±9.3, t=-2.6, P=0.001). Conclusions:The practice of group-based rehabilitation exercise can improve movement abilities and quality of life in PD patients, especially if implemented early.Targeted rehabilitation exercise should be taken as part of the treatment strategy for PD patients as early as possible to deliver the best benefits.
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Objective:To investigate the effect of different scanning modes, detector width and location in detector on high and low contrast resolution of wide-detector CT image.Methods:The Catphan600 phantom with high and low contrast resolution modules was scanned with GE Revolution CT at the same CTDI vol. The scans were performed with the detector widths of 40, 80 and 160 mm for sequential scanning mode and with the detector width/pitch combinations of 40 mm/0.516, 40 mm/0.984, 80 mm/0.508 and 80 mm/0.992 for spiral scanning mode. The resolution modules were placed at the adjacent region between two sequential scans, central and foot side edge in the longitudinal scanning range seperately. The subjective evaluation of the high and low contrast resolution was performed by two radiologists. Results:The high contrast resolution was 8 LP/cm at adjacent region between two sequential scans with the detector width of 80 mm or 160 mm in sequential scanning mode, and at the pitch of 0.5 in spiral scanning mode, while it was 7 LP/cm for the rest of detector combinations. The distinguishable diameter was 3 mm at 1% low contrast resolution at foot side edge with the detector widths of 80 mm or 160 mm in the sequential scanning mode, and it was 2 mm for all the other conditions. The distinguishable diameter was 2 mm at 1% low contrast resolution with the detector width of 40 mm and pitch 0.516 in the spiral scanning mode and it was worse with the wider detector and larger pitch.Conclusions:For the wide-detector CT, scanning mode, detector width, location in detector and pitches will affect the high and low contrast resolution to some degree. Appropriate selection should be done according to actual needs in clinical practice.
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Ferroptosis is a form of regulated cell death, characterized by excessive membrane lipid peroxidation in an iron- and ROS-dependent manner. Celastrol, a natural bioactive triterpenoid extracted from Tripterygium wilfordii, shows effective anti-fibrotic and anti-inflammatory activities in multiple hepatic diseases. However, the exact molecular mechanisms of action and the direct protein targets of celastrol in the treatment of liver fibrosis remain largely elusive. Here, we discover that celastrol exerts anti-fibrotic effects via promoting the production of reactive oxygen species (ROS) and inducing ferroptosis in activated hepatic stellate cells (HSCs). By using activity-based protein profiling (ABPP) in combination with bio-orthogonal click chemistry reaction and cellular thermal shift assay (CETSA), we show that celastrol directly binds to peroxiredoxins (PRDXs), including PRDX1, PRDX2, PRDX4 and PRDX6, through the active cysteine sites, and inhibits their anti-oxidant activities. Celastrol also targets to heme oxygenase 1 (HO-1) and upregulates its expression in activated-HSCs. Knockdown of PRDX1, PRDX2, PRDX4, PRDX6 or HO-1 in HSCs, to varying extent, elevated cellular ROS levels and induced ferroptosis. Taken together, our findings reveal the direct protein targets and molecular mechanisms via which celastrol ameliorates hepatic fibrosis, thus supporting the further development of celastrol as a promising therapeutic agent for liver fibrosis.
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Objective:To explore the effects of scout scanning parameters (projection angle and tube potential) on image quality and radiation dose in chest CT and to provide guidance for the selection of scanning parameters in clinical practice.Methods:Different parameter combinations were selected to acquire the scout view of the anthropomorphic adult chest phantom. Fifteen scout views were obtained under parameter combinations of the projection angle (0/90/180 degrees), tube potential (70/80/100/120/140 kV) and tube current (25 mA). And then, chest spiral scans were performed according to the scout views. The other parameters were Assist kV, smart mA (maximum range), 80 mm detector width, 0.992∶1 pitch, 0.5 s rotation time, 330 mm scanning length, 5 mm thickness, NI (noise index) 10. The radiation dose modulation index (ASiR-V) was 30%, and the iterative level was 50%. Volume CT dose index (CTDI vol) and tube current at 4 body levels (pulmonary apex, trachea bifurcation, mammary level and diaphragmatic dome) were recorded. The thermoluminescent dosimeters (TLDs) were used to measure the organ dose of the breast glandular. Regions of interest (ROIs)were selected at the trachea bifurcation and diaphragmatic dome to calculate the contrast noise ratio (CNR). Results:The tube potential of the spiral scanning was automatically selected as 80 kV when the projection angle was 0 degree. The changing of the tube potential for the scout had little influence on the tube current at the four body levels, and the variation range was 0-2% (5/230). The tube potential in the spiral scanning was automatically selected as 100 kV when the projection angles were 90 and 180 degrees. The changing of the tube potential for the scout had a great influence on the tube current at the slice of trachea bifurcation and the variation range was from 14%(29/210)to 44%(93/210). According to the angle projection, there were statistical differences in CTDI vol( P< 0.017), organ dose of the breast glandular, and CNR at the slices of trachea bifurcation and at diaphragmatic dome ( F=13.027, 24.727, 10.630, P< 0.05). According to the tube potential in the scout scanning, there were no significant differences in CTDI vol, organ dose of the breast glandular and CNR at both levels ( P> 0.05). Conclusions:In chest CT, the influence of the projection angle in scout scanning on the image quality and radiation dose was more significant than that of the tube potential.
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Abstract@#The outbreak of tuberculosis in campus shows a profound impact on academic learning and mental health of students, which might result in more serious social problems. The present editorial addresses weak links in the school tuberculosis prevention and control. Disease prevention and control institutions, medical institutions, education administrative departments and schools need to clarify work responsibilities, strictly implement the school tuberculosis prevention and control laws, regulations and management guidelines, and coordinate with multiple departments, with the aim to strengthen early warning capacity for campus tuberculosis, improve tuberculosis screening and risk assessment of relevant personnel, and implement the health checkup of schools and faculty, as well as the screening, diagnosis, registration, treatment and follow up of students cases. To further improve tuberculosis control across China, strengthening the awareness of tuberculosis prevention and control among institutions and the public, and improving adherence to tuberculosis treatment, as well as moving forward from passive to active tuberculosis monitoring and early prevention, reducing the occurrence of tuberculosis outbreak in school should be prioritized, so as to promote the smooth development of tuberculosis prevention and control work in China.
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A case with the diagnosis of the onset of inflammatory bowel disease (IBD) with chronic granulo-matous disease (CGD) in Children′s Hospital Affiliated to Zhengzhou University in June 2016 was chosen, and the patient′s clinical data and whole treatment process were analyzed.According to the relevant literature from Chinese and foreign databases, the clinical characteristics were analyzed and summarized, principles of diagnosis and treatment for children who had the onset of IBD with CGD.This patient was a child of 1 year and 9 months old, and the initial symptoms included repeated diarrhea and bloody stools.He was diagnosed as " ulcerative colitis" in the local hospital.After admission, the neutrophil respiratory burst test was positive.The genetic analysis result suggested that the CYBB gene was mutated, thus obtaining the diagnosis of CGD.Then, he was given prophylactic antibiotic therapy and symptomatic treatment.After the 3 months of follow-up after discharge, the patient still had intermittent diarrhea and bloody stools.CGD is a rare primary immunodeficiency disease, and current treatment methods of CGD include hematopoietic stem cell transplantation and anti-infection treatment.When IBD patients have complications other than gastrointestinal symptoms, the IBD treatment is not effective, or there are suspected parents who are married to close relatives, or with the family history of IBD, CGD should be considered.
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Objective:To investigate the uncertainty of the dose measurements of superficial organs and the image noise in CT scanning.Methods:GE Revolution CT was used to perform 20 repeated scans on the isolated skull specimen in sequential and helical mode. The chest phantom was scanned for 45 times with the pitch 1.0 and the collimation 80 mm for two scanners (GE Revolution CT, Philips Brilliance iCT) and 40 mm for the Siemens Somatom Definition Flash CT. The volume CT dose index (CTDI vol) was maintained during the above scannings. A dosimeter was used to measure the dose at the position of the right eye lens of the specimen and the center of right breast of the chest phantom. The position of dosimeter sensor remained unchanged. The standard deviation of CT values (image noise) in the air region of cross-sectional images at the center of the sensor reconstructed with lung/soft tissue algorithms were measured. The mean values ( Av), standard deviations ( SD), coefficients of variation ( CV) and relative ranges ( RR) of the dosimetric values and the standard deviations of CT values of 3, 5, 10, 20, 30 and 45 scans were calculated. Pearson and Spearman correlation analysis were used to evaluate the correlation between the dosimetric values and the standard deviations of CT values. Results:The measured dosimetric values of the skull specimen were almost unchanged in the sequential scannings. The relative range of dose in helical mode was 10.67%. The relative ranges of the measured values of the three CT scanners for 45 scans reached 43.83%, 25.31%, and 14.32%. The standard deviations of CT values of the lung/soft tissue images varied greatly and the differences were not completely related to the dosimetric values.Conclusions:The dosimetric values of superficial organs were stable in the sequential scanning mode. The dose measurements of superficial organs and the image noise changed greatly in helical scanning mode.
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Objective@#To investigate the relationship between current-exposure time products (mAs) and image quality in digital mammography.@*Methods@#The CDMAM phantom of 2 to 7 cm thickness were exposed by manual exposure modes using Mo-Rh anode-filer combinations. The exposure parameters were set as follows: (2 cm, 27 kVp, 10 to 90 mAs); (3 cm, 29 kVp, 20 to 120 mAs); (4 cm, 29 kVp, 20 to 200 mAs); (5 cm, 30 kVp, 40 to 220 mAs); (6 cm, 31 kVp, 40 to 260 mAs); (7 cm, 32 kVp, 80 to 280 mAs). The image quality figure (IQF), contrast to noise ratio (CNR), figure of merit (FOM) and the average glandular dose (AGD) were obtained from images. The optimum filtration and kVp for each breast thickness was found from the calculated FOMs. The optimum mAs for each breast thickness were found from the calculated FOMs and IQFs. And the Pearson correlation analysis was used to analyze the correlations among AGD, CNR and IQF.@*Results@#With the increase of mAs, the average glandular dose were linearly increased, and the FOM first increased and then decreased or changed slowly. The AGD, CNR and IQF were significantly correlated when the compression thickness was less than 7 cm (r all>0.87, P<0.05). The optimized exposure parameters were list as follows (2 cm,27 kVp,20 to 30 mAs);(3 cm,29 kVp,30 to 50 mAs); (4 cm,29 kVp,80 to 100 mAs); (5 cm, 30 kVp, 80 to 120 mAs); (6 cm, 31 kVp, 100 to 140 mAs); (7 cm, 32 kVp, 80 to 120 mAs).@*Conclusion@#The optimum range of mAs can be confirmed with different breast compression thickness and the setting of automatic exposure parameters should be chosen in clinical practice.
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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.
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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.
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Objective:To investigate the relationship between current-exposure time products (mAs) and image quality in digital mammography.Methods:The CDMAM phantom of 2 to 7 cm thickness were exposed by manual exposure modes using Mo-Rh anode-filer combinations. The exposure parameters were set as follows: (2 cm, 27 kVp, 10 to 90 mAs); (3 cm, 29 kVp, 20 to 120 mAs); (4 cm, 29 kVp, 20 to 200 mAs); (5 cm, 30 kVp, 40 to 220 mAs); (6 cm, 31 kVp, 40 to 260 mAs); (7 cm, 32 kVp, 80 to 280 mAs). The image quality figure (IQF), contrast to noise ratio (CNR), figure of merit (FOM) and the average glandular dose (AGD) were obtained from images. The optimum filtration and kVp for each breast thickness was found from the calculated FOMs. The optimum mAs for each breast thickness were found from the calculated FOMs and IQFs. And the Pearson correlation analysis was used to analyze the correlations among AGD, CNR and IQF.Results:With the increase of mAs, the average glandular dose were linearly increased, and the FOM first increased and then decreased or changed slowly. The AGD, CNR and IQF were significantly correlated when the compression thickness was less than 7 cm ( r all>0.87, P<0.05). The optimized exposure parameters were list as follows (2 cm,27 kVp,20 to 30 mAs);(3 cm,29 kVp,30 to 50 mAs); (4 cm,29 kVp,80 to 100 mAs); (5 cm, 30 kVp, 80 to 120 mAs); (6 cm, 31 kVp, 100 to 140 mAs); (7 cm, 32 kVp, 80 to 120 mAs). Conclusion:The optimum range of mAs can be confirmed with different breast compression thickness and the setting of automatic exposure parameters should be chosen in clinical practice.
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Objective:To determine whether these Streptococcus pneumoniae isolates identified by routine cli-nical methods that cannot be serotyped by the quellung reaction contain other species of viridans group streptococci and to determine the antibiotic susceptibility to provide reference for clinical medicine. Methods:A total of 105 isolates identified as Streptococcus pneumoniae by routine methods with negative quellung reaction results were enrolled in this study.Multilocus sequence analysis (MLSA) and matrix-assisted laser desorption/ionization time of flight mass spectrometry(MALDI-TOF-MS) were used to identify species of these isolates.Broth microdilution method was used to detect susceptibilities of 14 antibiotics. Results:Twenty-four of the 105 isolates were identified as Streptococcus pseudopneumoniae by MLSA, and the remaining 81 were Streptococcus pneumoniae.Six isolates of Streptococcus pseudopneumoniae were misidentified as Streptococcus pneumoniae, and 3 isolates as Streptococcus mitis/ oralis by MALDI-TOF-MS; and 6 isolates of Streptococcus pneumoniae were misidentified as Streptococcus pseudopneumoniae.All isolates were susceptible to Vancomycin, Levofloxacin and Moxifloxacin.The non-susceptibility rates between Streptococcus Pneumoniae and Streptococcus pseudopneumoniae against Ceftriaxone(28.4% vs.58.4%), Chloramphenicol(39.5% vs.4.2%), Erythromycin(77.8% vs.95.8%) and Azithromycin(75.3% vs.95.8%) were obviously different. Conclusions:Routine clinical methods may misidentify some Streptococcus pseudopneumoniae as Streptococcus pneumoniae, and so does the MALDI-TOF-MS.In addition, Streptococcus pneumoniae isolates with negative results of the quellung reaction showed differences in antimicrobial resistance.And misidentification may affect the evaluation of pathogenic bacteria and antibiotic resistance.