Deep learning method for magnetic resonance imaging fluid-attenuated inversion recovery image synthesis / 生物医学工程学杂志

Magnetic resonance imaging(MRI) can obtain multi-modal images with different contrast, which provides rich information for clinical diagnosis. However, some contrast images are not scanned or the quality of the acquired images cannot meet the diagnostic requirements due to the difficulty of patient's cooperation or the limitation of scanning conditions. Image synthesis techniques have become a method to compensate for such image deficiencies. In recent years, deep learning has been widely used in the field of MRI synthesis. In this paper, a synthesis network based on multi-modal fusion is proposed, which firstly uses a feature encoder to encode the features of multiple unimodal images separately, and then fuses the features of different modal images through a feature fusion module, and finally generates the target modal image. The similarity measure between the target image and the predicted image in the network is improved by introducing a dynamic weighted combined loss function based on the spatial domain and K-space domain. After experimental validation and quantitative comparison, the multi-modal fusion deep learning network proposed in this paper can effectively synthesize high-quality MRI fluid-attenuated inversion recovery (FLAIR) images. In summary, the method proposed in this paper can reduce MRI scanning time of the patient, as well as solve the clinical problem of missing FLAIR images or image quality that is difficult to meet diagnostic requirements.

Results analysis of laboratory external quality assessment of iodine deficiency disorders in Inner Mongolia in 2018 / 中华地方病学杂志

Objective:To analyze the results of external quality assessment (EQA) of different levels laboratories of iodine deficiency disorders (IDD) in Inner Mongolia in 2018, and to understand the detection ability of these laboratories.Methods:In 2018, the Inner Mongolia region level laboratories and all 12 league and municipal level laboratories were assessed for salt iodine, urinary iodine and water iodine (74 banner, county and district level laboratories participated in the urinary iodine assessment, and 100 banner, county and district level laboratories participated in the salt iodine assessment). As 3+-Ce 4+ catalytic spectrophotometry (WS/T 107.1-2006) was used to measure the iodine in urine, direct titrimetric method (GB/T 13025.7.1-2012) was used to measure the salt iodine, and water iodine was determined based on "Determination of Iodine in Drinking Water by As 3+-Ce 4+ Catalytic Spectrophotometry" in the range of 0 - 100 μg/L. The examination results of EQA of different levels of IDD laboratories in Inner Mongolia were statistically analyzed. Results:Regional level leboratory passed all the 3 assessments, qualified rates of salt iodine, urinary iodine and water iodine were 83.3% (10/12), 91.7% (11/12), and 100.0% (12/12), respectively, at league and municipal level; qualified rates of salt iodine and urinary iodine were 95.0% (95/100), and 90.5% (67/74), respectively, at banner, county and district level in 2018.Conclusions:The detection ability of IDD laboratories at all levels in the whole region has been stabilized, but there are still fluctuations in some laboratories. It is suggested that the technical and responsibility training, instrument verification, experimental environment control and quality control of laboratories at all levels should be continued.

Prevalence and risk factors of thyroid diseases in the physical examination population of Hohhot / 中华地方病学杂志

Objective:To explore the prevalence and risk factors of thyroid diseases in the physical examination population of Hohhot.Methods:From July 2017 to July 2018, 3 100 health examinees from Inner Mongolia National Examination Medical Center were selected as subjects for questionnaire survey, thyroid function test and thyroid ultrasound examination; a multinomial logistic regression model was used to analyze the relationship between relevant investigation factors and different types of thyroid diseases (simple thyroid nodules, simple thyroid dysfunction, and thyroid dysfunction with nodules).Results:Among the 3 100 healthy examinees, there were 2 885 effective responders, including 743 males and 2 142 females, aged (46.23 ± 12.32) years; the simple thyroid nodules, simple thyroid dysfunction, and thyroid dysfunction with nodules were 909, 648, and 619 cases, respectively, and the detection rates were 31.51%, 22.46%, and 21.46%, respectively. Logistic regression analysis results showed that age [35 - 54 years old: odds ratio ( OR) = 1.30, 95% confidence interval ( CI): 1.01 - 1.68; ≥55 years old: OR = 2.30, 95% CI: 1.68 - 3.14, P < 0.05], gender ( OR = 1.65, 95% CI: 1.32 - 2.07, P < 0.05), obesity ( OR = 1.35, 95% CI: 1.08 - 1.70, P < 0.05), and mental stress [significant: OR = 1.64, 95% CI: 1.09 - 2.48; some: OR = 1.54, 95% CI: 1.02 - 2.32, P < 0.05] were the risk factors affecting the occurrence of simple thyroid nodules. The age (35 ~ 54, ≥55 years old), gender, bad mood (a little), and mental stress (significant) were risk factors that affected the occurrence of simple thyroid dysfunction; eating high iodine food was its protective factor. The age (35 ~ 54, ≥55 years old), gender, obesity, and thyroid family genetic history were risk factors for thyroid dysfunction with nodules; the consumption of iodized salt was its protective factor. Conclusions:Older women are high-risk groups for thyroid diseases. Obesity, bad mood, mental stress will increase the risk of the disease. Daily consumption of iodized salt and moderate consumption of high iodine food can reduce the risk of the disease.

Analysis of current status of iodine nutrition in pregnant women in Inner Mongolia in 2018 / 中华地方病学杂志

Objective To understand the current iodine nutritional status of pregnant women in Inner Mongolia, and provide scientific basis for iodine supplementation during pregnancy. Methods In 103 banners (counties, cities and districts) of Inner Mongolia Autonomous Region, 5 townships were randomly selected according to their sub-area positions of east, west, south, north and center in each banner (county, city and district) in 2018. Twenty pregnant women in each township were sampled to collect edible salt and a random urine samples. The iodine in salt was determined by direct titration. Urinary iodine was detected by As3+-Ce4+catalytic spectrophotometry. According to different pregnancy, maternal age and regional type, the iodine nutrition level of pregnant women was analyzed. Results Totally 9809 pregnant women were investigated, the median of salt iodine was 23.4 mg/kg, iodized salt coverage rate was 98.03％(9616/9809), qualified iodized salt consumption rate was 93.32％(9154/9809), and the median of urinary iodine was 167.20 μg/L. Between different pregnancy and different age groups, there were no significant differences in qualified iodized salt consumption rate (P > 0.05). But the difference between different regions was statistically significant(P<0.05). Between different age groups, there was no significant difference in the median of urinary iodine(P > 0.05). In both different pregnancy and different regions, there were statistically significant differences between groups (P < 0.05). Conclusions The current iodine nutrition level of pregnant women in Inner Mongolia is suitable to meet the physiological needs of themselves, and the fetus. But pregnant women in different regions have different levels of iodine nutrition.

Analysis of thyroid function under different iodine nutritional status / 中华地方病学杂志

Objective To understand the iodine nutritional status of medical examination people and the thyroid dysfuction rates under different urinary iodine.Methods A total of 2 650 medical examination people from Inner Mongolia National Examination Medical Center from March to December of 2018 were selected.The average age was (46.2 ± 12.5) years old,including 697 males and 1 953 females.Blood samples were collected for determination of thyroid function [thyroid stimulating hormone (TSH),thyroid peroxidase antibody (TPOAb),thyroglobulin antibody (TgAb),free thyroxine (FT4),and free triiodothyronine (FT3)],and according to the results of the examination,people were divided into normal thyroid function,subclinical hypothyroidism,subclinical hyperthyroidism,hypothyroidism,hyperthyroidism,autoimmune antibody abnormalities,and other abnormal groups.Urine samples were collected to detect urinary iodine levels,to analyze the thyroid dysfuction rates of each group people and different urinary iodine.The thyroid function was detected by automatic electrochemiluminescence immunoassay analyzer,the urinary iodine was determined by arsenic cerium catalytic spectrophotometry.Results Among the 2 650 medical examination people,there were 1 270 patients with abnormal thyroid function,and the total abnormal rate was 47.92％.The abnormal rates of males and females were 28.84％ (201/697) and 54.74％ (1 069/1 953),respectively,and the abnormal rate of females was higher than that of males (x2 =376.19,P ＜ 0.05).The urinary iodine medians of each group were 145.38,152.60,103.21,176.31,134.17,138.92,and 127.00 μg/L,all in the appropriate range of iodine (100-199 μg/L).Thyroid abnormal rates [55.56％ (125/225),50.86％ (445/875)] of urinary iodine ≥ 300 μg/L (iodine excess) group and ＜ 100 μg/L (iodine deficiency) group were higher than that of 100-199 μg/L group [44.70％ (460/1 029),x2 =12.65,12.61,P ＜ 0.05].Among thyroid abnormal people,autoimmune antibody abnormalities people was the most,accounting for 69.61％ (884/1 270).Urinary iodine was positively correlated with FT4 and FT3 (r =0.04,0.05,P ＜ 0.05);FT4 was negatively correlated with TSH and TgAb (r =-0.20,-0.73,P ＜ 0.05),and it was positively correlated with FT3 (r =0.52,P ＜ 0.05);TPOAb was positively correlated with TgAb (r =0.64,P ＜ 0.05).Conclusions Urinary iodine of medical examination people is in the appropriate range of iodine,indicating that the overall iodine nutritional status is good.However,some people still have iodine excess and iodine deficiency,both of which lead to an increase in thyroid abnormal rate.

Discussion and improvement methods of quantitative susceptibility mapping reconstruction / 生物医学工程学杂志

To assess the background field removal method usually used in quantitative susceptibility mapping (QSM), and to analyze the cause of serious artifacts generated in the truncated -space division (TKD) method, this paper discusses a variety of background field removal methods and proposes an improved method to suppress the artifacts of susceptibility inversion. Firstly, we scanned phase images with the gradient echo sequence and then compared the quality and the speed of reconstructed images of sophisticated harmonic artifact reduction for phase data (SHARP), regularization enable of SHARP (RESHARP) and laplacian boundary value (LBV) methods. Secondly, we analyzed the reasons for reconstruction artifacts caused by the multiple truncations and discontinuity of the TKD method, and an improved TKD method was proposed by increasing threshold truncation range and improving data continuity. Finally, the result of susceptibility inversion from the improved and original TKD method was compared. The results show that the reconstruction of SHARP and RESHARP are very fast, but SHARP reconstruction artifacts are serious and the reconstruction precision is not high and implementation of RESHARP is complicated. The reconstruction speed of LBV method is slow, but the detail of the reconstructed image is prominent and the precision is high. In the QSM inversion methods, the reconstruction artifact of the original TKD method is serious, while the improved method obtains good artifact suppression image and good inversion result of artifact regions.

Relationship between rationed X receptor α mRNA expression in blood and skin lesion of residents exposed to arsenic via drinking water / 中华地方病学杂志

Objective To detect retinoid X receptor α (RXRα) mRNA expression in blood of subjects exposed to different concentrations of arsenic via drinking water, to analyze the relationship between RXRα mRNA expression and skin lesion caused by arsenic,and further to explore the skin lesion mechanism of arsenic. Methods Study sites were selected by molecular epidemiology method from high arsenic drinking water area of Bayannur City. Two hundred and thirty-five subjects who had been lived in high arsenic area for more than 10 years were selected;blood samples and water samples were collected from the subjects; according to arsenic concentration in drinking water,they were divided into four groups,<10 μg/L(control group),10-<100 μg/L(low dose group),100- <200 μg/L (middle dose group), and ≥200 μg/L (high dose group). Skin hyperkeratosis and pigment abnormity examination were conducted. The RXRα mRNA expression level in blood samples was detected by real-time quantitative PCR, and then the relationship between expression of RXRα mRNA and different levels of arsenic exposure,and skin lesion induced by arsenic were analyzed. Results ①The results showed that there was a dose-effect relationship between the prevalence of hyperkeratosis, pigment abnormity and arsenic exposure (χ2= 14.597, 12.825, P < 0.05); ②With increasing of arsenic exposure, RXRα mRNA expression in blood decreased firstly and then increased (F = 8.312, P < 0.05), which were significantly different statistically from those of control [(1.20 ±0.53)×10-3]and low dose groups[(0.92 ± 0.49)×10-3,P<0.05];RXRα expression was significantly higher in high dose group[(1.40 ± 0.45)×10-3]than those of middle and low dose groups [(1.12 ± 0.58,0.92 ± 0.49)×10-3,P<0.05]; ③The RXRα mRNA expression in people with different level of skin damage (hyper keratosis and pigment abnormity)were statistically significant(F=4.206,4.389, P< 0.05); degree Ⅲ[(1.98 ± 0.38) × 10-3] hyperkeratosis patients compared with degree Ⅰ [(1.11 ± 0.52) × 10-3] and degree Ⅱ [(1.13 ± 0.42) × 10-3], RXRα mRNA expression was significantly different (P < 0.05), degree Ⅱ and higher degrees [(1.61 ± 0.54) × 10 -3] pigment abnormity patients compared with control [(1.15 ± 0.52)×10-3],RXRα mRNA expression was significantly different (P < 0.05). Conclusions Chronic arsenic exposure has an effect on RXRα mRNA expression in blood. There is a relationship between abnormal expression of RXRα mRNA and skin lesion induced by arsenic.

Study on the scale of the comprehensive quality evaluation of medical postgraduates and application in the awards / 中华医学教育探索杂志

Objective Under the guidance of graduate education evaluation theory,to establish the comprehensive quality evaluation standard of medical graduate students and apply it in the research of the scholarship evaluation.Methods Byusing literature study,brainstorming,expert advice and other research methods,we established comprehensive quality assessment scale.In the work of graduate scholarship,the scale was used to carry out the evaluation work,and the application of the scale,the use value and the effect of moral evaluation were studied.Results A comprehensive quality assessment scale for medical graduate students,which included 4 dimensions of moral education,training process,scientific research and social activities was established so that the students' daily performance was quantified and evaluated,which,to a certain extent,eliminated the influence of the subjective judgment to the evaluation work,and had good guidance and practicality.Conclusion Establishing comprehensive quality quantitative evaluation mechanism of the graduate students and conducting the dynamic evaluation to graduates' moral education,their academic and social activities are conducive to stimulating the development of postgraduates' comprehensive quality and improving the quality of training.

Comparison of Anticoagulant Efficacy and Safety of Dabigatran Etexilate and Warfarin in the Treatment of Non-valvular Atrial Fibrillation / 中国药房

OBJECTIVE:To compare anticoagulant efficacy and safety of dabigatran etexilate and warfarin in the treatment of non-valvular atrial fibrillation(NVAF). METHODS:In retrospective analysis,360 NVAF patients were divided into control group (180 cases)and observation group(180 cases)according to therapy plan. Control group was given Warfarin sodium tablet with ini-tial dose of 2.5 mg orally,once a day,adjusted dosage according to INR. Observation group was given Dabigatran etexilate cap-sule 150 mg with warm water,twice a day,during or after meal. The levels of ALT,AST and INR,the occurrence of ADR were observed in 2 groups before treatment and 1,3 month after treatment. RESULTS:There was no statistical significance in the levels of ALT or AST between 2 groups before and after treatment (P>0.05). Before treatment,there was no statistical significance in INR between 2 groups (P>0.05),1,3 months after treatment,INR in control group was significantly higher than before treat-ment,with statistical significance(P<0.05);there was no statistical significance in the INR of observation group before and after treatment(P>0.05);but INR of 2 groups ranged were in normal range. There was no statistical significance in the incidence of ADR between 2 groups(P>0.05). CONCLUSIONS:Anticoagnlant efficacy of dabigatran etexilate is significantly better than war-farin for NVAF. Both have similar safety.

Iodine nutritional status of vulnerable people in Inner Mongolia after adjustment of iodized salt standard / 中华地方病学杂志

Objective To investigate the iodine nutrition level of vulnerable people in Inner Mongolia after adjustment of iodized salt standard and to provide theoretical bases for scientific iodine supplementation. Methods In 2013, 3 cities were selected from eastern, central and western parts of Inner Mongolia in accordance with the random number table, 3 or 4 counties were selected from each target city, 5 units according to their sub-area position of east, south, west, north and center were selected from each county, and then 1 township was selected from each unit, 5 groups of target population including school children aged 8- 10, women of childbearing age, pregnant and lactating women and infants each at least 10 people were investigated in each township. Edible salt samples from their homes and urine samples were collected. The direct titration method among the generic methods of iodide testing for salt production industry (GB/T 13025.7-2012) was used to determine the salt iodine level, and As3+-Ce4+catalytic spectrophotometry using ammonium per sulfate digestion (WS/T 107-2009) was used to test the urinary iodine level. Results Totally 3 300 samples of edible salt from local residents had been examined and median iodine was 26.20 mg/kg. The median of urinary iodine was 190.6μg/L of 1 289 school-age children;was 183.6μg/L of 621 women of childbearing age; was 178.2 μg/L o f 876 pregnant women; was 178.6 μg/L of 664 lactating women and was 167.7μg/L of 599 infants. Conclusion After adjustment of iodized salt standard, iodine nutrition level is suitable in all vulnerable people.

Effects of chronic arsenic exposure on mRNA expression of estrogen receptor-binding fragment-associated gene 9 and estrogen-responsive finger protein in female rat's uterus and ovary tissue / 中华地方病学杂志

Objective To observe the effects of chronic arsenic exposure on mRNA expression of estrogen receptor-binding fragment-associated gene 9 (Ebag9) and estrogen-responsive finger protein (efp) in uterus and ovary of female rats.Methods Fifty female Wistar rats were randomly divided into five groups according to arsenic (As2O3) concentrations given through drinking-water:0.00 (control),0.05,0.10,0.20,0.40 mg/L arsenic exposure groups and real-time RCR (RT-PCR) was used to detect the mRNA expression of Ebag9 and efp in uterus and ovary tissue at the 31 weeks of experiment.Results The mRNA expression levels of Ebag9 and efp of the 0.00,0.05,0.10,0.20,0.40 mg/L arsenic exposure groups were respectively as follows:0.761 ± 0.178,0.521 ± 0.130,0.544 ± 0.035,0.525 ± 0.198,0.498 ± 0.240 and 0.795 ± 0.171,0.874 ± 0.077,0.797 ± 0.066,0.796 ± 0.040,0.832 ± 0.096.Compared with control group,a decreased tendency was observed in Ebag9 mRNA level(with P value 0.055 in 0.40 mg/L arsenic exposure group) and increased tendency in efp mRNA level in experimental groups (all P ＞ 0.05).The mRNA expression levels of Ebag9 and efp in ovary of the five groups were by turns:0.702 ± 0.484,0.719 ± 0.336,0.693 ± 0.095,0.706 ± 0.055,0.728 ± 0.073 and 0.924 ± 0.061,1.009 ± 0.034,0.930 ± 0.085,0.929 ± 0.068,1.012 ± 0.101.Compared with control group,the expression level of Ebag9 mRNA showed a increased tendency in 0.05,0.20,0.40 mg/L arsenic exposure groups(all P ＞ 0.05).The efp mRNA level increased in experimental groups,with significant difference in 0.05,0.40 mg/L groups (all P ＜ 0.05).Conclusions The expression of efp mRNA has changed in ovary of female rats exposed to chronic arsenic.Arsenic may act as an environmental endocrine disruptor to exert its effect.

Application of tracer methodology in the training of intern medical record writing / 中华医学教育探索杂志

Objective To discuss the effectiveness of tracer methodology in the training of intern medical record writing. Methods Fifty interns who received medical record writing training in July 2012 were set as control group and were trained by traditional methods. Meanwhile, 58 interns who received medical record writing training in July 2013 were set as investigation group and were trained by tracer methodology. Pre-training questionnaire survey was conducted for interns in investigation group and targeted training was provided. After the training, interns in two groups were surveyed by questionnaire of basic norms of medical record writing. Excel software was used to do data entry and SPSS 21.0 statistical software was used to statistical analysis. P<0.05 signifies statistical differences. Results Final record writing exam after the training demonstrated that there were significant differ-ences in basic requirement of record writing, basic principle of record writing, history taking, record time limit, contents of record writing and correct rate of patients' answer to the document between in-vestigation group and control group with statistical differences(P<0.05). Conclusion Tracer method-ology has obvious effects in intern medical record writing training and is worth popularization and ap-plication in clinical teaching.

Regularized inhomogeneity correction method for phased array image in magnetic resonance imaging / 生物医学工程学杂志

Phased array coils (multiple receiver coil systems) have been extensively used for acquisition of MR images owing to their ability of increasing SNR, extending field-of-view (FOV), and reducing acquisition time. But the SOS algorithm,which is main method for phased array image reconstruction,will cause inhomogeneity in reconstructed image. A regularized least square method for phased array image combination is proposed in this paper. In the method, an additional reference scan is performed in advance. By using the reference scan, coil sensitivity map can be acquired, and image reconstructed from reference scan can be used as reference data in the regulation term. Experiments showed that the image uniformity was greatly improved by this method with scanning phantom and volunteer.

Auto-segmentation method for lung parenchyma of CT images / 中国医学影像技术

Objective To establish a new automatic lung segmentation method in order to deal with the omission of pleural nodules and pulmonary vessels. Methods Lung parenchyma were extracted from chest CT images with the inversed operation of 2D region growing and connected area classification, then the contours and locating the contour points were traced with scan line searching. Finally, the parameters of lung contour points were analyzed to locate the contours distorted by nodules, and curve spline was used to correct distorted contours. Results The experimental results of many sets of CT images verified that the technique proposed was effective. The comparison with other contour correction algorithm verified that line searching contour correction was superior. Conclusion The proposed algorithm includes tumors in the segment results, and confirms the integrality, veracity, real-time quality of this auto-segmentation method.