Dual-energy computed tomography in the early evaluation of acute radiation pneumonia.

OBJECTIVE: To investigate the value of dual-energy dual-source computed tomography (DSCT) in evaluating pulmonary perfusion changes before and after radiotherapy for esophageal cancer, and its clinical use in the early diagnosis of acute radiation pneumonia (ARP). METHODS: We selected 45 patients with pathologically confirmed esophageal cancer who received radiotherapy (total irradiation dose of 60 Gy). Dual-energy DSCT scans were performed before and after radiotherapy and the normalized iodine concentrations (NIC) in the lung fields of the areas irradiated with doses of > 20 Gy, 10-20 Gy, 5-10 Gy, and < 5 Gy were measured. We also checked for the occurrence of ARP in the patients, and the differences in NIC values and NIC reduction rates before and after radiotherapy were calculated and statistically analyzed. RESULTS: A total of 16 of the 45 patients developed ARP. The NIC values in the lung fields of all patients decreased at different degrees after radiotherapy, and the NIC values in the area where ARP developed, decreased significantly. The rate of NIC reduction and incidence rate of ARP increased gradually with the increasing irradiation dose, and the inter-group difference in NIC reduction rate was statistically significant (P < 0.05). Based on the receiver operating characteristic (ROC) curve analysis, the areas under the curves of NIC reduction rate versus ARP occurrence in the V5-10 Gy, V10-20 Gy, and V> 20 Gy groups were 0.780, 0.808, and 0.772, respectively. Sensitivity of diagnosis was 81.3%, 75.0%, and 68.8% and the specificity was 65.5%, 82.8%, and 79.3%, when taking 12.50%, 16.50%, and 26.0% as the diagnostic thresholds, respectively. The difference in NIC values in the lung fields of V<5 Gy before and after radiotherapy was not statistically significant (P > 0.05). CONCLUSION: The dual-energy DSCT could effectively evaluate pulmonary perfusion changes after radiotherapy for esophageal cancer, and the NIC reduction rate was useful as a reference index to predict ARP and provide further reference for decisions in clinical practice.

Cross lagged analysis of body shame, abnormal eating behavior and eating disorder tendency among adolescents / 中国学校卫生

Objective@#To understand the longitudinal relationship between body shame, abnormal eating behavior and eating disorder tendency of adolescents, so as to provide reference for the intervention of eating problems among adolescents.@*Methods@#From September 2020, a total of 1 097 students from two high schools and two universities in Heilongjiang Province were investigated for three times (T1, T2 and T3) with an interval of 9 months. Adolescents completed the Chinese Body Shame Scale，the Chinese Version of Dutch Eating Behavior Questionnaire and the Sick, Control, One, Fat, Food(SCOFF) questionnaire. A cross lag analysis was used to explore the relationship between body shame, abnormal eating behavior and eating disorder tendency.@*Results@#The body shame, abnormal eating behavior and eating disorder tendency of adolescents showed an upward trend, but only the main effect of time on abnormal eating behavior was statistically significant ( F=3.78, P＜0.05, η 2=0.18), and the main effect of gender on three variables were statistically significant ( F=18.06, 30.48, 25.09, P ＜0.01). There were significant and positive correlations between body shame, abnormal eating behavior and eating disorder tendency at three wave survey (T1: r =0.34-0.58, T2: r =0.35-0.56, T3: r =0.33-0.53, P ＜0.01). Body shame could predict abnormal eating behavior across time ( β T1-T2 =0.13, β T2-T3 =0.08, P ＜ 0.05), and the predictive effect was stronger in female ( β T1-T2 =0.16, β T2-T3 =0.12, P ＜0.05), only the effect between T1 and T2 was significant in male ( β T1-T2 =0.09, P ＜0.05). Abnormal eating behavior ( β T1-T2 =0.14, β T2-T3 =0.15, P ＜0.01) and eating disorder tendency ( β T1-T2 =0.26, β T2-T3 =0.24, P ＜0.01) had cross time predictive effect. Abnormal eating behavior showed a mediating effect on the association between body shame and eating disorder tendency ( β ab =0.019, 95% CI=0.006-0.047, P ＜0.05), and the mediating effect was stronger in female ( β ab =0.029, 95% CI=0.008-0.053, P ＜0.05).@*Conclusion@#Adolescents body shame positively predicts abnormal eating behavior. Abnormal eating behavior and eating disorder tendency interact with each other, and body shame can indirectly affect eating disorder tendency through acting on abnormal eating behavior.