ABSTRACT
Objective:To investigate the effect of different scanning centers on eye lens dose, image quality, and the dose reduction rate when using the organ dose modulation (ODM) technique in head CT.Methods:The porus acusticus externus of the head phantom was considered the scanning isocenter. The ODM was initiated and the spiral scans were performed at the scanning centers with the height of porus acusticus externus and its upper and lower 2, 4, and 6 cm, respectively. The scanning range was from the top of the head to the base of the head. Three thermoluminescent dosimeters (TLD) were placed on the surface of two eyes at each scan and the average measurement value was regarded as the radiation dose to the eye lens. The volume CT dose index (CTDI vol) and dose length product (DLP) were recorded. The scans were repeated with no ODM and the dose reduction rates at each scanning center were calculated. The regions of interest (ROI) in each group of images with ODM were drawn and the noise (SD), signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) were evaluated. Results:Compared with the isocenter, the maximum change rates of CTDI vol and DLP in each scanning center were 2.46% and 2.43%, respectively. The eye lens dose increased as the scanning centre moving upwars (i.e. the bed dropping) by 39.02% at the position of 6 cm above the isocenter and decreased by 35.91% at the position of 6 cm below the isocenter. With the seven groups of scanning centers, the reduction rates of CTDI vol and DLP caused by ODM were 7.95%-8.61%, 7.91%-8.61% respectively, and the difference in the reduction rate of each dose value was not statistically significant( P>0.05). The reduction rate for eye lens dose ranged from 18.09% to 26.14%, with the highest reduction rate at the position of 4 cm above the isocentre and the second rate at the isocentre (24.73%). The difference in the rate of reduction at each scanning center was statistically significant( t=0.13, P<0.05). As the scanning center moved up, the SD of the eye region decreased and the SNR increased, and the highest CNR at the isocentre was 239.79. The SD and SNR of the brain parenchyma region were 6.85-7.96 and 3.08-4.19 respectively, and the highest CNR at the isocentre was 244.79. Conclusions:When ODM technique is used in head CT, the scan centre has a significant effect on the eye lens dose and image quality. Meanwhile, the reduction rate of the eye lens dose caused by ODM is also affected. Therefore, porus acusticus externus is recommended as the scanning center in head CT.
ABSTRACT
Objective To investigate medication adherence and its influencing factors in community-based hypertensive patients in the Pearl River Delta of Guangdong Province, and lay the foundation for the development of targeted compliance interventions. Methods Between July 2015 and October 2016, a multi-stage cluster sampling method was used to conduct a community-based diagnostic survey in the Pearl River Delta region.A total of 1 829 community-based hypertension patients in this survey population were used to investigate medication adherence, the factors of which were derived through a multi-factor logistics regression analysis.Results The average medication-adherence score of hypertensive patients surveyed in this study was (4.6 ± 1.8), and patients with good medication adherence accounted for 62.82%(1 149/1 829).There were significant differences in medication adherence among patients according to their age, household registration types, marital status, level of education, employment status, medical payment methods,per capita monthly household income,drinking status,and family history of hypertension (P<0.05).Multivariate logistic regression analysis found that medication adherence was affected substantially by the type of household registration:local household types (OR= 0.537, 95% CI: 0.415-0.695); education level: college,bachelor and above (OR=2.139,95% CI:1.100-4.160); employment status: self-paying (OR=0.591, 95% CI: 0.376-0.930); and a family history of hypertension (OR= 1.279, 95% CI: 1.012-1.617).Conclusions It is necessary to pay more attention to medication adherence in patients with hypertension in communities.Given the influencing factors and characteristics illuminated by this study,it is suggested that various measures be taken to prevent and intervene in poor medication adherence, to improve the curative effect of hypertensive patients in communities.