A preliminary study on the combination of high iodine flow rate and high noise index in reducing the radiation dose of CT angiography for head and neck / 中国医学装备

Objective:To carry out preliminarily study on the combination of high iodine flow rate (IDR) and high noise index (NI) in reducing radiation dose of CT angiography (CTA) for head and neck.Methods:A total of 120patients with lesions on head and neck who underwent head and neck CTA in the hospital were divided into high IDR combined with high NI group (high IDR+NI group, 50 cases) , middle IDR combined with middle NI group (middle IDR+NI group, 40 cases) and low IDR combined with low NI group (low IDR+NI group, 30 cases) according to the random number table method.The scanned images were reconstructed by the iterative reorganization algorithm (ASiR) 2.0.The CT values of head and neck, signal to noise ratio (SNR) , contrast noise ratio (CNR) of all images in three groups were analyzed objectively and scored subjectively.And the CT dose index (CTDI) , dose length product (DLP) , effective radiation dose (ED) of the iodine intake and radiation dose were recorded.Results:The differences of CT value of ascending aorta, upper common carotid artery or lower internal carotid artery among the three groups were no significant, respectively.The SNR and CNR in high IDR+NI group were significantly higher than those in middle IDR+NI group and low IDR+NI group (F=47.908, F=52.525, P<0.05) , respectively.And there was no significant difference in subjective scores among the three groups.The differences of CTDI, DLP and ED in high IDR+NI group were significantly lower than those in middle IDR+NI group and low IDR+NI group (F=224.861, F=199.610, F=412.443, P<0.05) , respectively.Conclusion:The combination of high IDR and high NI for patients who undergoes head and neck CT can reduce the radiation dose when ensure the image quality, and it is worthy in clinical application.

Changes in root and alveolar bone before and after treatment by retracting the upper incisors / 华西口腔医学杂志

OBJECTIVE@#Using cone beam computed tomography (CBCT) in image measurement on the patients with maxillary protrusion, the study aims to identify the changes in root and alveolar bone before and after treatment by upper incisor retraction.@*METHODS@#The study was conducted on 37 patients who have received orthodontic treatment from January 2014 to December 2015. The sample comprised 17 males and 20 females, with an average age of 14.5 years. The patients underwent extraction of bimaxillary premolars and given maximum anchorage to retract the upper incisors. The adducent angle, adducent amount, and the amount of elongation of the upper incisor teeth were measured by cephalograms. The patients were scanned by NewTom VGi to obtain CBCT data before and after treatment with upper incisor retraction. Using the NewTom NNT tool, we obtained the multiple planar reconstruction and then adjusted the coronal, axial, and sagittal axis. The sagittal section of the long axis of the maxillary central incisor through the incisal edge and root apex was selected to measure the changes in the root and alveolar bone before and after incisional treatment.@*RESULTS@#Before and after retracting the upper incisors, the adducent angle of central incisor measured 12.92°±6.43°. Adducent amount of the incisors reached (5.54±2.21) mm. Incisor extension amount totaled (0.60±0.95) mm. Root absorption length was (0.81±0.46) mm. Root absorption rate was 6.80%±3.60%. Statistical differences were observed in the changes in root length before and after incisor retraction (P<0.05). After upper incisor retraction, increasing distance from the labial side alveolar ridge to the cemento-enamel junction reached (0.20±0.22) mm. After treatment, we observed that the height of the labial-side alveolar bones decreased and showed statistical difference with the height of labialside alveolar bones before treatment (P<0.05). The results show the correlation between root absorption and horizontal displacement of maxillary center incisor and the distance from the upper incisor apex to labial cortical bone. A correlation also exists between the variable quantity of the labial-side alveolar bones and adducent angle of the upper incisor, with a correlation coefficient of 0.354. The results also show significant difference (P<0.05).@*CONCLUSIONS@#After compensatory treatment of patients with maxillary protrusion, the root length of upper incisor was absorbed remarkably. The height of the labial-side alveolar bones was reduced. A greater tooth movement or beyond the anatomical limitations and alteration limits of the alveolar bone can easily lead to root resorption. A negative correlation exists between the variable quantity of the labialside alveolar bones and adducent angle of the upper incisor.

Shuxuening injection combined with routine therapy in treating patients with active ulcerative colitis: an analysis of efficacy / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To observe the therapeutic effect and relevant mechanism of shuxuening Injection (SI) in treating patients with active ulcerative colitis (UC).</p><p><b>METHODS</b>Totally 91 patients with active UC were randomly assigned to 2 groups, 44 in the control group and 47 in the treatment group. Patients in the control group received routine treatment, while patients in the treatment group additionally received intravenous injection of SI (15 mL), twice daily for 14 days in total. Colonoscopy was performed before and after treatment. The therapeutic effect was assessed by Mayo scoring system and the grading of activities evaluated by Baron endoscope. Serum levels of IL-6 and TNF-α were detected by ELISA. The activity of SOD was detected by xanthine oxidase method. The content of MDA was detected by thiobarbituricacid (TBA). Besides, 20 healthy subjects were recruited as the healthy control group.</p><p><b>RESULTS</b>Totally 82 patients completed the study (40 in the control group and 42 in the treatment group). There was no statistical difference in serum levels of IL-6, TNF-α, SOD, MDA, the Mayo score and endoscope grading between the two groups before treatment (P >0. 05). Compared with the healthy control group, serum levels of IL-6, TNF-α, MDA significantly increased (P <0.01), and the serum SOD level decreased (P < 0. 05) in the treatment grup and the control group before treatment. Compared with before treatment in the same group, serum levels of IL-6, TNF-α, MDA, the Mayo score and endoscope grading all decreased in the treatment group and the control group after treatment (P <0. 01, P <0. 05). Compared with the control group after treatment, serum levels of IL-6, TNF-α, MDA, the Mayo score and endoscope grading all decreased (P <0.01, P <0.05), the serum SOD level increased (P <0.05) in the treatment group after treatment. The serum SOD level was obviously negative correlated with serum levels of IL-6, TNF-a, Mayo score, and endoscope score (r = -0. 621, -0.638, -0. 509, -0.787, P <0.01). The serum MDA level was obviously positive correlated with serum levels of IL-6, TNF-α, Mayo score, and endoscope score (r =0.711, 0. 882, 0. 525, 0. 639, P <0.01).</p><p><b>CONCLUSION</b>SI could improve inflammatory injury and clinical symptoms of patients with active UC, and its mechanism might be associated with antioxidant and scavenging oxygen free radicals.</p>

Effects of shuxuening injection on the levels of serum matrix metalloproteinase-9 and tissue inhibitor of metalloproteinase-1 in acute exacerbated chronic obstructive pulmonary disease patients / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To observe the effects of Shuxuening Injection (SI) on the levels of serum matrix metalloproteinase-9 (MMP-9) and tissue inhibitor of metalloproteinase (TIMP-1) in acute exacerbated chronic obstructive pulmonary disease (COPD) patients.</p><p><b>METHODS</b>Seventy-nine patients with acute exacerbated COPD were randomly assigned to the treatment group (39 cases) and the control group (40 cases). Routine therapies for COPD were given to patients in the control group, while 15 mL SI was given to those in the treatment group by intravenous dripping, twice daily for total 14 days. The forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) were detected by Spirometer. The FEV1/FVC (%) and the FEV1% were calculated. The levels of serum MMP-9 and TIMP-1 were detected using ELISA before and after treatment, and compared with 20 healthy subjects as the control.</p><p><b>RESULTS</b>The FEV1, FVC, FEV1/FVC (%), and FEV1% were significantly improved after treatment in the treatment group when compared with before treatment and with the control group (P < 0.05, P < 0.01). When compared with before treatment and with the control group, the levels of serum MMP-9, TIMP-1, and the ratio of MMP-9/TIMP-1 decreased more significantly in the treatment group after treatment (P < 0.01). Correlation analyses showed that obvious negative correlation existed between the levels of serum MMP-9 and TIMP-1 and FEV1/FVC (%) (r = -0.677, -0.629, P < 0.01). Obvious negative correlation existed between the levels of serum MMP-9 and TIMP-1 and FEV1% (r = -0.562, -0.661, P < 0.01). Furthermore, obvious negative correlation also existed between the ratio of MMP-9/ TIMP-1 and FEV1%, as well as FEV1/FVC (%) (r = -0.732, -0.891, P < 0.01).</p><p><b>CONCLUSIONS</b>SI could improve the pulmonary ventilation function of acute exacerbated COPD patients. One of its mechanisms might be correlated with lowering the serum levels of MMP-9 and TIMP-1, and correcting the imbalance of MMP-9/TIMP-1.</p>

Comparative study of anterolateral approach versus posterior approach for total hip replacement in the treatment of femoral neck fractures in elderly patients / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To compare the clinical outcome of anterolateral minimally invasive approach versus conventional posterior approach for total hip replacement against femoral neck fractures in elderly patients.</p><p><b>METHODS</b>The retrospective study was carried out on 42 patients who suffered from displaced femoral neck fractures (19 cases of Garden type III, 23 cases of Garden type IV) treated by total hip replacement via anterolateral minimally invasive approach or conventional posterior approach by the same experienced surgeon. The average age of the patients was 78.1 years (range: 65-89 years). They were divided into anterolateral mini-invasive group (22 cases) and posterior group (20 cases). The mean time of follow-up was 13 months (range: 6-36 months). The anterolateral approach described by Hardinge goes through between anterior 1/3 and posterior 2/3 of the gluteus medius muscle, reaching the femoral neck from anterior capsule. The traditional posterior approach described by Moore (Southern incision) goes through the insertions of short external rotation muscles, reaching the femoral neck from posterior capsule. The related variables under observation were length of incision, operation time, postoperative limp, length of hospital stay and bed stay and dislolcation rate.</p><p><b>RESULTS</b>The length of the skin incision varied between 7 cm and 12 cm with the anterolateral minimally invasive technique, compared to 15-22 cm in the conventional procedure. It took less time (average 15 minutes) to complete the anterolateral minimally invasive approach (72 min+/-15 min), compared with the conventional approach (87 min+/-10 min). The average Harris hip score was 91.23+/-10.20 in anterolateral approach, 90.03+/-11.05 in the posterior approach. The average length of hospital stay for patients with the anterolateral approach was (6.4+/-2.2) days (range: 4-9 days), while that in posterior approach was (9.2+/-3.1) days (range: 6-13 days). The average length of bed stay was (3.4+/-1.1) days (range: 2-5 days) in anterolateral group and (6.2+/-2.8) days (range: 3-10 days) in posterior group. No patients in anterolateral group experienced dislocation. One (5%) hip in posterior approach had dislocation.</p><p><b>CONCLUSIONS</b>Anterolateral mini-invasive approach can decrease trauma, operation time, length of hospital stay and bed stay and rehabilitation time. The stability and minimal muscular damage permit the acceleration of postoperative rehabilitation, which can subsequently reduce the perioperative risk in the treatment of femoral neck fractures in the elderly undergoing total hip replacement.</p>

Evaluation of POSSUM scoring system in the treatment of osteoporotic fracture of the hip in elder patients / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To evaluate the applicability of the modified physiological and operative severity score for enumeration of mortality and morbidity (POSSUM) scoring system in predicting mortality in the patients undergoing hip joint arthroplasty.</p><p><b>METHODS</b>A total of 295 patients with hip fractures were analyzed using the modified POSSUM surgical scoring system. The mean ages of the patients were 66.59 years in the complicative group, 62.28 years in noncomplicative group, 77.89 years in the death group and 63.25 years in the living group, respectively. The comparisons between the observed and predicted morbidity, between the observed and predicted mortality were made within 30 days after operation.</p><p><b>RESULTS</b>The average physiological scores and operative severity scores was 18.96+/-4.83 and 13.47+/-2.01 in complicative group, while 15.65+/-3.66 and 11.74+/-2.26 in noncomplicative group (P less than 0.05). The average physiological scores and operative severity scores was 25.56+/-3.78 and 14.22+/-0.67 in death group, while 16.46+/-4.09 and 12.25+/-2.33 in living group (P less than 0.05). Though POSSUM scoring system over-predicted the overall risk of death, its estimate was very close in the high risk groups (larger than 10% ). There was perfect consistence between the observed and the predicted morbidity as calculated by published predictor equation for morbidity, and consistence for mortality in the high risk band.</p><p><b>CONCLUSIONS</b>Modified POSSUM scoring system may be used to predict the morbidity in patients with hip fracture. Furthermore, POSSUM scoring system overpredicts the overall risk of death, but its estimate is close to the actual data in the high risk band (larger than 10%).</p>

Short-term effects of Sipulin combined with radiotherapy on local advanced non-small cell lung cancer and its influence on immune function / 肿瘤

Objective: To observed the short-term effects of Sipulin combined with radiotherapy on local advanced non small-cell lung cancer (NSCLC) and its influence on the immune function. Methods: Ninety patients with local advanced NSCLC were randomly divided into trial group (Sipulin plus radiotherapy) and the control group (only radiotherapy). The patients in trial group were given Sipulin (10 mL/d, 25 mg peptide) by Bolus infusion combined with radiotherapy for 4 weeks. The patients in control group received only radiotherapy at the same dosage. All the patients were followed up for 2 years. The follow up ratio was 100%. Results:(1) The response ratio was 66.7% and 33.3% in trial group and control group, respectively (P < 0.05). The one-year survival rate was 71.1% and 44.4% respectively (P <0.05). (2) The life quality of the patients in trial group was much better than that in control group (P<0.05). (3) The population of CD3+ cells, CD4+ cells and the ratio of CD4+/CD8+ were increased but the population of CD8+ cells were decreased after combined treatment. The population of CD3+ cells, CD4+ cells and the ratio of CD4+/CD8+ were decreased but the population of CD8+ cells were increased after single radiotherapy (P < 0.05). Compared with control group, combined treatment induced a marked rise in the population of CD3+ cells and CD4+ cells and the ratio of CD4+/CD8+ and a fall in the population of CD8+ cells (P < 0.01). Conclusion: The short-term effect of Sipulin combined with radiotherapy on local advanced NSCLC is better than that of single radiotherapy. Combined therapy could improve the life quality and enhance the immune function of the NSCLC patients.

Collection of peripheral blood stem cells from ABO incompatible allogeneic donors by using blood cell separator / 中国实验血液学杂志

To evaluate the yield of the blood cell separator for collection of peripheral blood stem cells (PBSC) from ABO major and (or) minor incompatible allogeneic donors and the feasibility of PBSC component infusion to the recipients without removal of erythrocytes or plasma, the Cobe Spectra (Version 6.1) blood cell separator was utilized to collect PBSC component from 9 allogeneic donors. Of all the donors, 4 were ABO major incompatible, 2 were minor incompatible and the other 3 were both major and minor incompatible to corresponding recipients. In each cycle, different amount of PBSC component was harvested, and the variable volume plasma chased the cells into the bag was adjusted according to the ABO incompatibility. The nucleated cell count, percentage of mononuclear cell, number of CD34(+) cell and percentage of viable cell (trypan blue excluding rate) in the component were detected. At the time of infusion, a series of protective measures to the renal function of recipients were taken. The results showed that apheresis was twice performed on these eight donors to collected enough PBSC for transplantation or cryopreservation, except one apheresis was enough for cell amount needed by transplantation, as the donor's body weight was much heavier than that of the recipient. Altogether 17 apheresises were performed, the mean yield of nucleated cells was 3.77 x 10(10), in which 97% to 99% were mononuclear cells (MNC). The harvested number of CD34(+) cell was 8.62 x 10(6)/kg. All the trypan blue exclusion rate was 100%. In ABO major incompatible or both major and minor incompatible component, there were 8 - 10 ml packed erythrocytes; in ABO minor incompatible component, there were 80 - 120 ml of plasma. These components were infused into the recipients without removal of erythrocytes or plasma and no haemolytic reaction was observed in any recipient, and their hematopoietic functions soon recovered. Results suggest that enough PBSC can be acquired by using blood cell separator Cobe Spectra (Version 6.1), with the modified separation factors, and the collected PBSC component can be safely infused into the ABO incompatible recipients without removal of erythrocytes or plasma.

Measuring the shelf life of CPDA and ACD whole blood stored at above 4 degrees C in vitro / 中国实验血液学杂志

In order to measure the shelf life of whole blood stored at above 4 degrees C and provide experimental data for blood preservation and transportation in battle fields, 200 ml whole blood was collected from each of the 10 donors and anticoagulated by CPDA or ACD, then 50 ml whole blood was separated from each one and marked as control group, the rest was marked as test group. The control group was stored at 4 degrees C and RBC ATP concentrations was measured at the end of its shelf life which signed as critical ATP. The test group was stored at above 4 degrees C condition, some items as ATP, FHb (free hemoglobin), serum K(+) and germiculture were tested daily and ensured all of them eligible. When RBC ATP decreased to the level of critical ATP, the time of preservation was considered as shelf life. The results showed that at temperatures from 10 to 33 degrees C, the shelf life of CPDA whole blood ranges from 2.5 days to 18 days, while shelf life of ACD whole blood ranges from 1 day to 13 days. It is concluded that CPDA whole blood stored at above 4 degrees C condition can be sent to the front hospital in effective shelf life so that the wounded can be cured in time.

A brief report on effect of rhG-CSF in treating leukopenia after radio-and chemo-therapy of patients with breast cancer / 中国实验血液学杂志

The study was to observe the effect of rhG-CSF (lishengsu) in treating leukopenia caused by radiotherapy and chemotherapy in patients with breast cancer. 100 cases of breast cancer received modified radical mastectomy were randomized into two groups with the same treatment of one cycle chemotherapy using the protocol of CAF at two weeks after the operations and then radiotherapy. The patients in treated group received rhG-CSF 75 micro g per day s.c. for 5 - 7 days constantly, and additional 3 - 5 days according to leukopenia during radiotherapy. The patients in control group did not receive rhG-CSF during the chemo- and radio-therapy. The results shows that nadir of WBC and neutrophil counts in the treated group was higher than that in control significantly. In conclusion, effect of lishengsu on leucopenia in process of chemotherapy and radiotherapy shows definite therapeutic effect, the side effects are not remarkable.