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Cost data caliber governance is key to fine cost management. To tackle the troubles in cost data management at multiple campuses of one hospital, the authors built a multi-campus cost data caliber governance mode. By means of enhanced top-level design, the mode carried out data governance by such measures as the establishment of data dictionary mapping library, standardizing department names and caliber, classification of charging items of medical services, precisely matching between fixed assets and charging items, interconnecting the management system of charging library and the procurement library of consumables, as well as precisely matching surgical disease types and charging items. These measures accomplished the consistency and comparability of cost data across campuses, building an automated, streamlined, standardized and integrated data governance mode for reference of hospitals with multiple campuses in need of cost management.
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Objective:To confirm the efficacy and safety of cinepazide maleate injection in acute ischemic stroke patients with obvious motor function deficit.Methods:This study is a subgroup analysis of multi-center, randomized, double-blind, placebo-controlled phase Ⅳ clinical trial. A total 812 patients of acute ischemic stroke with obvious limb motor deficit [motor function of limbs score in National Institutes of Health Stroke Scale (NIHSS) ≥4] were enrolled in this subgroup analysis. Patients received either cinepazide maleate injection or placebo. The treatment period was 14 days and follow-up was 90 days. The efficacy endpoints included the proportions of patients with a modified Rankin Scale (mRS) score ≤2, mRS score ≤1 and Barthel Index <95 on day 90. Safety was evaluated by recording all adverse events, monitoring vital signs, laboratory parameters and electrocardiogram.Results:A total of 732 patients were involved in the final efficacy analysis (361 in cinepazide maleate group and 371 in control group). The baseline limb motor function score of NIHSS was 5.23±1.43 in the cinepazide maleate group whereas 5.20±1.36 in the control group. Logistic regression analysis showed that following treatment for 90 days, the proportion of patients with a mRS score ≤2 was significantly higher in the cinepazide maleate group than in the control group [56.0% (202/361) vs 44.2% (164/371), OR=0.60, 95% CI 0.44-0.82, P=0.002]. The proportion of patients with a mRS score ≤1 was higher in the cinepazide maleate group than in the control group [43.3% (139/361) vs 35.2% (118/371), OR=0.69, 95% CI 0.50-0.97, P=0.031]. The proportion of patients with a Barthel Index <95 on day 90 was significantly lower in the cinepazide maleate group than in the control group [45.2% (145/361) vs 55.2% (185/371), OR=0.64, 95% CI 0.46-0.88, P=0.007]. During the treatment and follow-up period, the incidence of the most common adverse events in the cinepazide maleate group was 50.4% (199/395). Constipation and abnormal liver function were more common, but there were no statistically significant differences between the two groups. Conclusion:Cinepazide maleate injection is superior to placebo in improving neurological function and activities of daily living, reducing disability, and promoting functional recovery and safe in patients with acute ischemic stroke with obvious limb motor deficit.
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Objective:To evaluate the diagnostic value of cardiac magnetic resonance (CMR) in myocardial contusion.Methods:A case-control study was performed on 42 patients with blunt chest injury treated in Affiliated Hospital of Hangzhou Normal University from September 2018 to January 2021. There were 24 males and 18 females, with the age range of 23-66 years [(44.2±10.9)years]. The patients were divided into myocardial contusion group ( n=20) and non-myocardial contusion group ( n=22) according to the clinical diagnostic criteria of myocardial contusion (cardiac troponin I>0.06 ng/ml). All the patients underwent CMR examination within 7 days after hospitalization, and eletrocardiography (ECG) as well as transthoracic echocardiography (TTE) examinations with 24 hours. Abnormal findings on CMR, ECG and TTE were compared between the two groups. The receiver operating characteristic (ROC) curve was used for the comparison of the diagnostic efficacy of CMR, ECG and TTE for myocardial contusion. The area under the curve (AUC), sensitivity, specificity, positive predictive value and Youden index of CMR, ECG and TTE were calculated, respectively. Results:There were 15 patients (75%) presenting CMR abnormalities in myocardial contusion group compared to 2 patients (9%) in non-myocardial contusion group ( P<0.01). CMR abnormalities mainly included myocardial oedema, ischemia or hemorrhage, which were located in the left ventricle of 12 patients (71%), right ventricle of 3 (18%) and ventricular septal of 3 (12%). There were 12 patients (60%) showing ECG abnormalities in myocardial contusion group compared to 7 patients (32%) in non-myocardial contusion group ( P>0.05). Abnormal ECG changes included 8 patients (42%) with sinus tachycardia or bradycardia, 5 (26%) with ST-T changes, 3 (16%) with atrial premature beat, 2 (11%) with bundle branch block and 1 (5%) with frequent premature ventricular contractions. There were 10 patients (50%) showing TTE abnormalities in myocardial contusion group compared to 9 patients (41%) in non-myocardial contusion group ( P>0.05). TTE abnormalities manifested as left ventricular diastolic dysfunction in 12 patients (63%) and wall motion abnormalities in 7 (37%). The AUC of CMR, ECG and TTE for diagnosing myocardial contusion was 0.83 (95% CI 0.70-0.96), 0.64 (95% CI 0.47-0.81) and 0.55 (95% CI 0.70-0.72), respectively. For CMR, ECG and TTE, the diagnostic sensitivity was 75.0%, 60.0% and 50.0%, with the specificity of 91.0%, 68.2% and 59.1%, the positive predictive value was 88.2%, 63.2% and 52.6%, and the Youden index of 66.0, 28.2 and 9.1, respectively. Conclusion:CMR can accurately detect myocardial contusion, with better diagnostic performance than ECG and TTE as well as relatively higher sensitivity and specificity, indicating that CMR has great value for clinical diagnosis of myocardial contusion.
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Objective:To investigate the blood pressure change in patients with acute ischemic stroke (AIS) and hypertension treated with cinepazide maleate injection.Methods:This was a subgroup analysis of post-marketing clinical confirmation study of cinepazide maleate injection for acute ischemic stroke: a randomized, double-blinded, multicenter, placebo-parallel controlled trial, which conducted in China from August 2016 to February 2019. Eligible patients fulfilled the inclusive criteria of acute anterior circulation ischemic stroke with National Institutes of Health Stroke Scale (NIHSS) scores of 7-25. The primary endpoints were mean blood pressure of AIS patients treated with cinepazide maleate or control, which were assessed during the treatment period (14 days), and the proportion of the patients with normal blood pressure was analyzed after the treatment period. Furthermore, a subgroup analysis was performed to investigate a possible effect of the history of hypertension on outcomes.Results:This analysis included 809 patients with hypertension. There was no significant difference in patients blood pressure and the proportion of patients with normal blood pressure (60.5% vs. 59.0%, P>0.05) between cinepazide maleate group and control group. Conclusion:Administration of cinepazide maleate injection does not affect the management of clinical blood pressure in patients with AIS.
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Background/Aims@#Depressive symptom is one of the most common symptoms in patients with irritable bowel syndrome (IBS), but its pathogenetic mechanisms remain unclear. As a voxel-level graph theory analysis method, degree centrality (DC) can provide a new perspective for exploring the abnormalities of whole-brain functional network of IBS with depressive symptoms (DEP-IBS). @*Methods@#DC, voxel-wise image and clinical symptoms correlation and seed-based functional connectivity (FC) analyses were performed in 28 DEP-IBS patients, 21 IBS without depressive symptoms (nDEP-IBS) patients and 36 matched healthy controls (HC) to reveal the abnormalities of whole brain FC in DEP-IBS. @*Results@#Compared to nDEP-IBS patients and HC, DEP-IBS patients showed significant decrease of DC in the left insula and increase of DC in the left precentral gyrus. The DC’s z-scores of the left insula negatively correlated with depression severity in DEP-IBS patients.Compared to nDEP-IBS patients, DEP-IBS patients showed increased left insula-related FC in the left inferior parietal lobule and right inferior occipital gyrus, and decreased left insula-related FC in the left precentral gyrus, right supplementary motor area (SMA), and postcentral gyrus. In DEP-IBS patients, abstracted clusters’ mean FC in the right SMA negatively correlated with depressive symptoms. @*Conclusions@#DEP-IBS patients have abnormal FC in brain regions associated with the fronto-limbic and sensorimotor networks, especially insula and SMA, which explains the vicious circle between negative emotion and gastrointestinal symptoms in IBS. Identification of such alterations may facilitate earlier and more accurate diagnosis of depression in IBS, and development of effective treatment strategies.
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Background/Aims@#Depressive symptom is one of the most common symptoms in patients with irritable bowel syndrome (IBS), but its pathogenetic mechanisms remain unclear. As a voxel-level graph theory analysis method, degree centrality (DC) can provide a new perspective for exploring the abnormalities of whole-brain functional network of IBS with depressive symptoms (DEP-IBS). @*Methods@#DC, voxel-wise image and clinical symptoms correlation and seed-based functional connectivity (FC) analyses were performed in 28 DEP-IBS patients, 21 IBS without depressive symptoms (nDEP-IBS) patients and 36 matched healthy controls (HC) to reveal the abnormalities of whole brain FC in DEP-IBS. @*Results@#Compared to nDEP-IBS patients and HC, DEP-IBS patients showed significant decrease of DC in the left insula and increase of DC in the left precentral gyrus. The DC’s z-scores of the left insula negatively correlated with depression severity in DEP-IBS patients.Compared to nDEP-IBS patients, DEP-IBS patients showed increased left insula-related FC in the left inferior parietal lobule and right inferior occipital gyrus, and decreased left insula-related FC in the left precentral gyrus, right supplementary motor area (SMA), and postcentral gyrus. In DEP-IBS patients, abstracted clusters’ mean FC in the right SMA negatively correlated with depressive symptoms. @*Conclusions@#DEP-IBS patients have abnormal FC in brain regions associated with the fronto-limbic and sensorimotor networks, especially insula and SMA, which explains the vicious circle between negative emotion and gastrointestinal symptoms in IBS. Identification of such alterations may facilitate earlier and more accurate diagnosis of depression in IBS, and development of effective treatment strategies.
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Objective:To assess the efficacy and safety of cinepazide maleate injection in the treatment of patients with acute ischemic stroke.Methods:A multicenter, randomized, double-blind, placebo-controlled phase Ⅳ clinical trial, led by Peking Union Medical College Hospital, was conducted in 65 Hospitals in China. The efficacy of cinepazide maleate injection in patients with acute anterior circulation cerebral infarction with onset time of ≤48 hours, 7≤National Institute of Health stroke scale (NIHSS) score ≤25 was assessed from August 2016 to February 2019, using the proportion of modified Rankin scale (mRS) score≤1 and Barthel index (BI) score≤95 on day 14 as efficacy endpoint. The patients were divided into treatment group who were treated with cinepazide maleate injection and control group who were treated with placebo.Results:A total 937 patients were involved in the final efficacy analysis (466 in treatment group and 471 in control group). The proportion of subjects with mRS score≤1 on day 14 after treatment were higher in the treatment group than that in the control group (102/466(21.89%) vs76/471(16.14%)). Logistic regression analysis showed that patients treated with cinepazide maleate were significantly more likely to have a favorable outcome (mRS score≤1) than patients treated with placebo on day 14 ( OR=0.677, 95% CI 0.484-0.948 , P=0.023), and patients treated with cinepazide maleate were more likely to reach independence in activities of daily living (Barthel Index ≥95) than those treated with placebo on day 14 (125/466(26.82%) vs 91/471(19.32%); OR=0.632, 95% CI0.459-0.869, P=0.005). The rate of adverse events was similar between the treatment and control groups. Conclusion:The 14-day treatment with cinepazide maleate injection could reduce the degree of disability whereas did not increase the risk of adverse events.
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Objective@#To test the differences in diffusion properties-namely fractional anisotropy (FA) and apparent diffusion coefficient(ADC)-between amateur marathon runners and healthy volunteers′ thigh muscles using diffusion tensor imaging (DTI) at rest.@*Methods@#Thirty amateur marathon runners(Group A) and 20 healthy volunteers (Group B) were recruited. All were males and their age was between 28 to 53 years. All subjects underwent both thigh DTI examination. DTI parameters FA and ADC were evaluated in thigh muscles(rectus femoris, vastus lateralis, vastus intermedius, vastus medialis, adductor longus, adductor magnus, biceps femoris long head, semitendinosus and semimembranosus)in all subjects. We tested the differences in diffusion properties between GroupA and B using independent sample t test.@*Results@#The average FA value of the thigh muscles measured in Group A was (0.24±0.03), which was significantly lower than that in Group B=(0.27±0.03)(t=5.164,P<0.01). The average ADC value of the thigh muscles measured in Group A was (1.74±0.10)×10-3mm2/s, which was significantly higher than that in Group B=(1.70±0.09)×10-3mm2/s (t=2.060,P<0.05). The FA value of Group A was lower than that of Group B in the rectus femoris, vastus lateralis, vastus medialis, biceps femoris long head, semitendinosus and semimembranosus (P<0.05). The ADC value of Group A was higher than that of Group B in the vastus intermedius, vastus medialis and biceps femoris long head (P<0.05).@*Conclusions@#In the absence of positive findings from conventional MRI, DTI technique can non-invasively assess the subtle changes in the bilateral thigh muscles of amateur marathon runners at rest in the early stage of microscopic molecular level, providing important imaging evidence for early changes in skeletal muscle caused by marathon.
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Objective@#To study the effects of half marathon loading on the T2* mapping assessment of knee joint cartilage.@*Methods@#Twenty male amateur marathon runners with more than three years of running age were enrolled. The T1WI, PDWI, 3D-DESS, and T2* mapping were performed on right knee joint before and after the half marathon within 3h and after a period of approximately 1 week. Cartilage was divided into 6 regions: medial and lateral femoral cartilage, medial and lateral tibial cartilage and patella and trochlea cartilage. Femoral cartilage was partitioned into central weight-bearing regions, posterior cartilage nonweight-bearing regions with the posterior boundary of the meniscus as the dividing mark. All cartilage was further divided into deep and superficial layers according to the thickness 1/2, and the ROI was delineated to obtain the T2* value of the corresponding area. One-way repeated measures analysis was performed to test the difference of T2* values pre- and post-marathon. LSD tests were used to estimate the different influences of physiological activities on each articular cartilage area.@*Results@#All cartilage areas of the knee joint did not show cartilage injury during the examination. The differences in the global T2* values of the superficial layers of the knee cartilage before and after the half-marathon marathon were statistically significant (t=5.145, P<0.05), but the global T2* value of the deep region were not (t=1.864, P>0.05). After a week, the T2* values of all cartilage areas were not statistically different from those before running (t=1.062, 0.309; P>0.05).@*Conclusion@#After a single half marathon, the changes of knee cartilage composition in male amateur marathon runners are reversible. In the absence of positive findings in conventional MRI, T2* mapping can indirectly reflect changes in biochemical composition of the articular cartilage during exercise.
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Objective To test the differences in diffusion properties?namely fractional anisotropy (FA) and apparent diffusion coefficient(ADC)?between amateur marathon runners and healthy volunteers′thigh muscles using diffusion tensor imaging (DTI) at rest. Methods Thirty amateur marathon runners(Group A) and 20 healthy volunteers (Group B) were recruited. All were males and their age was between 28 to 53 years. All subjects underwent both thigh DTI examination. DTI parameters FA and ADC were evaluated in thigh muscles(rectus femoris, vastus lateralis, vastus intermedius, vastus medialis, adductor longus, adductor magnus, biceps femoris long head, semitendinosus and semimembranosus)in all subjects. We tested the differences in diffusion properties between GroupA and B using independent sample t test. Results The average FA value of the thigh muscles measured in Group A was (0.24 ± 0.03), which was significantly lower than that in Group B=(0.27±0.03)(t=5.164,P<0.01). The average ADC value of the thigh muscles measured in Group A was (1.74±0.10)×10?3mm2/s, which was significantly higher than that in Group B=(1.70±0.09)×10?3mm2/s (t=2.060,P<0.05). The FA value of Group A was lower than that of Group B in the rectus femoris, vastus lateralis, vastus medialis, biceps femoris long head, semitendinosus and semimembranosus (P<0.05). The ADC value of Group A was higher than that of Group B in the vastus intermedius, vastus medialis and biceps femoris long head(P<0.05). Conclusions In the absence of positive findings from conventional MRI, DTI technique can non?invasively assess the subtle changes in the bilateral thigh muscles of amateur marathon runners at rest in the early stage of microscopic molecular level, providing important imaging evidence for early changes in skeletal muscle caused by marathon.
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Objective To study the effects of half marathon loading on the T2* mapping assessment of knee joint cartilage. Methods Twenty male amateur marathon runners with more than three years of running age were enrolled. The T1WI, PDWI, 3D?DESS, and T2*mapping were performed on right knee joint before and after the half marathon within 3h and after a period of approximately 1 week. Cartilage was divided into 6 regions: medial and lateral femoral cartilage, medial and lateral tibial cartilage and patella and trochlea cartilage. Femoral cartilage was partitioned into central weight?bearing regions, posterior cartilage nonweight?bearing regions with the posterior boundary of the meniscus as the dividing mark. All cartilage was further divided into deep and superficial layers according to the thickness 1/2, and the ROI was delineated to obtain the T2* value of the corresponding area. One?way repeated measures analysis was performed to test the difference of T2*values pre?and post?marathon. LSD tests were used to estimate the different influences of physiological activities on each articular cartilage area. Results All cartilage areas of the knee joint did not show cartilage injury during the examination. The differences in the global T2*values of the superficial layers of the knee cartilage before and after the half?marathon marathon were statistically significant (t=5.145, P<0.05), but the global T2*value of the deep region were not (t=1.864, P>0.05). After a week, the T2* values of all cartilage areas were not statistically different from those before running (t=1.062, 0.309; P>0.05). Conclusion After a single half marathon, the changes of knee cartilage composition in male amateur marathon runners are reversible. In the absence of positive findings in conventional MRI, T2* mapping can indirectly reflect changes in biochemical composition of the articular cartilage during exercise.
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Objective To investigate the value of hydrogen proton MR spectroscopy (1H-MRS) and Dixon sequence for the quantitative diagnosis and classification of steatosis in patients with non-alcoholic fatty liver disease (NAFLD). Methods Sixty seven patients with NAFLD confirmed by liver biopsy were prospectively collected from October 2015 to May 2017 in Hangzhou Normal University Hospital. All patients underwent 1H-MRS and Dixon sequence scan within 7 days after liver biopsy, 1H-MRS-based hydrogen proton density fraction (MRS-PDFF) and Dixon-based hydrogen proton density fraction (MRI-PDFF) were obtained. Fat grading based on the fat percentage obtained from liver biopsy. Pearson correlation analysis was performed to analyze the correlation among pathological steatosis and MRS-PDFF, MRI-PDFF. One-way ANOVA analysis was performed to compare the difference of PDFF between patients with different degrees of severity of fatty liver. And the ROC curve analysis was performed to generate the thresholds of MRS-PDFF and MRI-PDFF for determining the presence of fatty liver. Results The steatosis grade of pathological biopsy showed grade S1 in 36 cases, grade S2 in 16 cases, grade S3 in 15 cases, the MRS-PDFF values of S1, S2 and S3 patients were (8.25 ± 4.32)％, (15.67 ± 4.54)％, (23.46 ± 5.82)％and the MRI-PDFF values were (6.31 ± 2.94)％, (15.42 ± 5.07)％, (24.47 ± 6.31)％. Statistically significant differences were observed among them (P<0.01). Both MRS-PDFF and MRI-PDFF were positively correlated with histological fat percentage (r values were 0.840 and 0.892,all P<0.01), there was also a correlation between MRS-PDFF and MRI-PDFF (r=0.930, P<0.01). Area under ROC curve of MRS-PDFF and MRI-PDFF for differential diagnosis of grade S1 steatosis were 0.955 and 0.976, and area under ROC curve for differential diagnosis of grade S3 steatosis were 0.972 and 0.978. Conclusion 1H-MRS and Dixon sequces have high value in liver fat content detection and classification of patients with NAFLD, and both have similar diagnostic efficacy.
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Mild traumatic brain injury (mTBI) is a common clinical disease,and some of these patients still have postconcussion syndrome (PCS) for months or years after injury.Currently,the assessment of mTBI,prognosis monitoring and early identification of patients with high risk of PCS after injury have become one of the key problems in contemporary medicine.With the improvement of MR performance and the popularization of equipments,new technologies,such as diffusion kurtosis imaging (DKI),arterial spin labeling (ASL),susceptibility weighted imaging (SWI) and resting state function MRI(rs-fMRI),can be used to analyze microstructure and functional changes of brain,therefore improve the understanding of mTBI to a higher and more comprehensive level.The progresses of MRI in PCS were reviewed in this article.
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Objective To systematically evaluate the relationship between stroke location and post-stroke depression (PSD) in first-ever stroke patients.Methods The studies on the relationship between stroke location and PSD published from January 1980 to March 2016 were retrieved from databases,including Chinese science and technology journal full-text database (VIP),China journal full-text database (CNKI),Wanfan database,PubMed,ISI Web of Science,Ovid database and Elsevier Science Direct.RevMan5.3 software was adopted for data consolidation and analysis.Results A total of 14 studies,including 1 952 cases of patients were included.The meta analysis indicated that no direct relationship was found between stroke location and PSD in first-ever stroke patients [random effects model,95 ％CI(0.89,1.43),P＜0.01].The results of subgroup analysis indicated that the PSD was associated with the right hemisphere lesion when the Hamilton Depression Scale (HAMD) was adopted for assessment [fixed effects model,95 ％ CI(1.21,1.76),P＜0.01],while the relationships were not found in the subgroup analysis of time course after stroke and the aphasia occurrence.Conclusion Stroke location may be not directly associated with PSD,further studies are needed to ascertain the relationship between stroke location and PSD.
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Objective@#To investigate the value of 1H-magnetic resonance spectroscopy (1H-MRS) in determining the content of liver triglyceride in patients with fatty liver disease (FLD), as well as its influencing factors.@*Methods@#A total of 124 patients with nonalcoholic fatty liver disease (NAFLD), chronic hepatitis B (CHB), or hepatitis B complicated by FLD who underwent liver biopsy in the Affiliated Hospital of Hangzhou Normal University were enrolled, and the clinical data, serological markers, FibroScan results, and 1H-MRS results were collected. A correlation analysis was performed with the results of liver biopsy as the gold standard, and the influence of factors including hepatitic B virus (HBV) infection and obesity on accuracy was analyzed. A one-way analysis of variance was used for comparison of means between the three groups, and the LSD or SNK test (for homogeneity of variance) or the Tamhane’s or Dunnett’s test (heterogeneity of variance) was used for comparison between any two groups. The t-test was used for comparison of continuous data between groups, and the chi-square test was used for comparison of categorical data. The MRS-PDFF receiver operating characteristic (ROC) curve was plotted, the area under the ROC curve (AUC) was calculated, the optimal cut-off points for the diagnosis of NAFLD were estimated, and sensitivity and specificity were calculated.@*Results@#The NAFLD group (42 patients) and the CHB + NAFLD group (40 patients) had a significantly higher proton density fat fraction (PDFF, the content of triglyceride in the liver) than the CHB group (42 patients) (16.84±9.76/9.39 ± 5.50 vs 3.45 ± 1.63, P < 0.001). The results were significantly correlated with the degree of steatosis confirmed by liver biopsy (P < 0.001), but it was not significantly correlated with inflammation or fibrosis grade. The correlation analysis showed that the MRS-PDFF value measured by 1H-MRS was significantly correlated with body mass index (BMI), blood lipids, alkaline phosphatase, and blood glucose, while it was not significantly correlated with age, sex, or the presence or absence of hepatitis B. The ROC curve analysis showed that the AUCs of PDFF measured by 1H-MRS were 0.93, 0.974, and 0.976, respectively, for the diagnosis of steatosis S1(≥5%), S2(≥34%), and S3(≥66%), and the corresponding optimal thresholds were 5.14%, 11.16%, and 16.7%, respectively.@*Conclusion@#1H-MRS has a high diagnostic value in quantitative evaluation of the degree of liver steatosis in patients with FLD and is not affected by the factors such as HBV infection, age, and sex, while it is correlated with BMI and lipid metabolism.
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Objective@#To explore the diagnostic performance of susceptibility weighted imaging (SWI)in distinguishing benign or malignant soft tissue tumor, and to study pathological observation.@*Methods@#Sixty-eight patients with soft tissue tumor, who received no previous treatment or invasive examination, received routine preoperative MRI examination and SWI scanning. The graduation and distribution of intratumoral susceptibility signal intensity(ITSS) and proportion of tumor volume were observed.The pathological results were also included for comparative analysis.@*Results@#Fourty of 68 patients were benign and 28 were malignant. 72.5% (29/40) patients with benign soft tissue tumors were ITSS grade 1 and ITSS grade 3 (hemangioma). 89.3%(25/28) patients with malignant soft tissue tumors were ITSS grade 2 and ITSS grade 3. The difference was statistically significant (P<0.01). The distribution of ITSS in patients with benign soft tissue tumors was dominated by peripheral distribution and diffuse distribution (hemangioma), accounting for 90.0% (36/40). The distribution of ITSS in patients with malignant soft tissue tumors mainly distributed in the central region, accounting for 78.6% (22 /28). The difference was statistically significant (P<0.01). The proportion of tumor volume occupied by ITSS in benign soft tissue tumors was <1/3 and> 2/3 (hemangioma), accounting for 90.0% (36/40). The volume of malignant soft tissue tumors were predominantly <1/3 , accounting for 82.1% (23/28). The difference was statistically significant (P<0.01).@*Conclusion@#SWI is sensitive in displaying the vein and blood metabolites in soft tissue lesions, which is helpful for the differential diagnosis of benign and malignant tumors in soft tissue.
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Objective To investigate the status and influencing factors of cooperation of doctors and nurses in the nutritional support of critically ill patients, and provide the basis for future improve the physician-nurse collaboration in the nutritional support. Methods Doctors and nurses who from ICU in Soochow were investigated by the Nurse-Physician Collaboration Scale (NPCS). Results The doctors′score of physician-nurse collaboration in the nutritional support of critically ill patients was 87.42 ±15.73, which was significantly higher than 80.97 ± 13.80 the nurses′(t=3.279, P= 0.001).In addition, under the item 1, 3, 5 in the dimension one as well as the total items in the dimensions two and three, the doctors′score was similarly higher than the nurses, and the differences are also statistically significant (Z=-3.894--1.964, all P<0.01 or 0.05). Technical titles, educational level and age was significantly related to the cooperative level between doctors and nurses respectively (χ2=11.037, P=0.012;F=3.488, P=0.037; F=3.499, P=0.016). Conclusions Doctors have higher levels of perceived collaboration than nurses in the nutritional support of critically ill patients, while both require further improvement. We should highlight the physician-nurse collaboration in feeding critically ill patients, and should improve the nutrition quality through standardized process management and active team cooperation.
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Objective To observe the incidence and the influencing factors of kidney insufficiency in acute cerebral infarction patients with non-valvular atrial fibrillation. Methods From January 2013 to January 2015,266 consecutive acute cerebral infarction patients with non-valvular atrial fibrillation admitted to the Department of Neurology,Xuanwu Hospital,Capital Medical University were enrolled retrospectively. Renal function was assessed by the estimated glomerular filtration rate (eGFR),eGFR 0. 05). (2)Multiple Logistic regression analysis showed that the age (≥65 years)was an independent risk factor for the occurrence of renal insufficiency in acute cerebral infarction patients with atrial fibrillation (OR,1. 147,95% CI 1. 087 -1. 209;P < 0. 01),and the histories of hypertension (OR,0. 870,95% CI 0. 362-2. 089;P = 0. 755),diabetes mellitus (OR,1. 078,95% CI 0. 403 -2. 883;P = 0. 882 ), and hyperlipidemia (OR,1. 666,95% CI 0. 645 - 4. 302;P = 0. 292 )were not associated with renal insufficiency in cerebral infarction patients with atrial fibrillation. Conclusions The incidence of renal insufficiency in cerebral infarction patients with atrial fibrillation is higher. Age (≥65 years)is an independent risk factor for renal insufficiency in this type of patients.
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Objective To study the role of monochromatic energy images from spectral CT in diagnosing X-ray negative biliary stones.Methods 32 patients who were diagnosed to have X-ray negative biliary stones were retrospectively studied.They were examined by spectral CT scanning and the spectral CT data were loaded into a spectrum analysis software.The optimal contrast-to-noise ratio (CNR) of the monochromatic energy images were exposed and the contrast ratio between the X-ray negative stones and bile on the optimal monochromatic and hybrid energy CT images were compared,respectively.The monochromatic and hybrid energy CT images for diagnosing X-ray negative biliary stones were validated by two senior radiologists based on postoperative histology.Results The corresponding KeV of optimal CNR for X-ray negative stones were not quite consistent.They were 140KeV in 19 patients,40KeV in 8 patients,53KeV,57KeV,62KeV,64KeV and 73KeV in one patient each.The contrast between the negative stones and the adjacent bile were (6.4 ±5.6) HU on hybrid energy CT images and (50.4 ±24.4) HU on optimal monochromatic energy CT images.The Eff-Z of negative stones and bile were 6.6 ± 0.6 and 7.9 ± 0.2,respectively.In our study,the diagnostic accuracy of hybrid energy CT images was 34.38％ and that of optimal monochromatic energy CT images was 78.13％.Conclusion The optimal monochromatic energy CT images were more valuable in diagnosing X-ray negative bile duct stones,which were obviously better than the hybrid energy images from traditional CT.
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Objective To revise the Symptom Distress Scale for postoperative patients with pituitary tumor and to test its reliability and validity. Methods On the base of previous qualitative interview and literature review, Delphi consultation was performed to identify items of the Symptom Distress Scale for postoperative patients with pituitary tumor. By convenience sampling method, totally 191 patients from four first-class ternary hospitals in Jiangsu province were investigated effectively by this scale. Results A scale of 4 factors and 16 items was identified by expert interviews, item analysis, exploratory factor analysis and the four factors could explain 69.812%of the variance. The Cronbachαcoefficient of the scale was 0.920, the content validity index was 0.915, and the interrater reliability was 0.860. Conclusions Symptom Distress Scale for postoperative patients with pituitary tumor has good reliability and validity to assess the symptom distress of pituitary tumor patients after operation.