Status of anemia and its association with feeding patterns in infants and toddlers aged 6 - 24 months in Linxia Hui Autonomous Prefecture / 中国儿童保健杂志

【Objective】 To investigate the anemia status of infants and toddlers aged 6 - 24 months in Linxia Hui Autonomous Prefecture, Gansu Province, and to comprehensively evaluate the differences in feeding behaviors between anaemic and normal children through the infant and child feeding index (ICFI) and feeding knowledge scores, so as to provide reference for the guidance of infants and young children feeding in ethnic minority areas and the promotion of children′s growth and development. 【Methods】 Taking infants and young children aged 6 - 24 months in Linxia Prefecture as the study subjects, a multi-stage random sampling method was used to select children who met the requirements from 5 townships and 5 villages in 7 counties in 2019 and 2020.Periphral blood samples were collected to test the level of hemoglobin, so as to determine the anemia status.Meanwhile, physical examination was performed and a questionnaire survey of guardians was conducted to analyze the association betweenanaemia and feeding patterns 【Results】 A total of 3 901 infants and children were included in this study, of whom 729 (18.70%) were anaemic, with a mean ICFI score of 12.56±2.70 and a mean feeding knowledge score of 1.97±1.01.There was no statistically significant association of low feeding knowledge score and low ICFI with anaemia after adjusting for confounders (P>0.05), Unqualified meat addition in ICFI was a risk factor for anaemia (OR=1.355, P=0.042), while non-bottle feeding in the past 24 hours (OR=0.762, P=0.021), and breastfeeding in the past 24 hours of infants and toddlers aged 12 - 24 months (OR=0.228, P=0.018) were protective factor for anemia in infants and toddlers aged 12 - 24 months. 【Conclusions】 The average prevalence of anemia in infants and toddlers aged 6 - 24 months in Linxia Hui Autonomous Prefecture of Gansu Province is high, but the level of infant feeding and the level of feeding knowledge of caregivers are low.Early adherence to breastfeeding, timely addition of supplementary food, and more comsumpution of meat for children are conducive to preventing anemia.

Correlation between serum N-terminal pro-B-type natriuretic peptide level and echocardiographic parameters in patients with chronic Keshan disease / 中华地方病学杂志

Objective:To study the correlation between serum N-terminal pro-B-type natriuretic peptide (NT-proBNP) level and echocardiographic parameters in patients with chronic Keshan disease, providing reference for diagnosis and prognosis evaluation of chronic Keshan disease.Methods:Ninety-nine patients with chronic Keshan disease who received standardized treatment at Jingchuan County People's Hospital in Pingliang City, Gansu Province from January to December 2020 were selected. Among them, 16 patients were classified as cardiac function grade Ⅱ according to New York Heart Association (NYHA), 69 as grade Ⅲ and 14 as grade Ⅳ. The patients underwent echocardiography and their serum NT-proBNP level was measured using fluorescence immunochromatography. The differences in serum NT-proBNP levels among patients with different cardiac function grades were compared, and the correlation between cardiac function grades, serum NT-proBNP level and echocardiographic parameters was analyzed.Results:The serum NT-proBNP levels in patients with cardiac function grades Ⅱ, Ⅲ, and Ⅳ were (1 107.26 ± 268.03), (2 125.98 ± 293.02), and (8 268.59 ± 2 659.50) pg/ml, respectively. The differences among the three groups were statistically significant ( F = 13.94, P < 0.001). The serum NT-proBNP level was positively correlated with cardiac function grades ( r = 0.44, P < 0.001), left ventricular end-diastolic diameter, left ventricular end-systolic diameter, and left atrial diameter ( r = 0.45, 0.52, 0.38, P < 0.001), and negatively correlated with fractional shortening and left ventricular ejection fraction ( r = - 0.39, - 0.46, P < 0.001). Conclusions:The serum NT-proBNP level in patients with chronic Keshan disease with different cardiac function grades is different, and is positively correlated with echocardiographic parameters reflecting the degree of cardiac structural and functional impairment. The NT-proBNP level may become an early diagnostic, grading, and prognostic indicator for chronic Keshan disease.

A semi-supervised network-based tissue-aware contrast enhancement method for CT images / 南方医科大学学报

OBJECTIVE@#To propose a tissue- aware contrast enhancement network (T- ACEnet) for CT image enhancement and validate its accuracy in CT image organ segmentation tasks.@*METHODS@#The original CT images were mapped to generate low dynamic grayscale images with lung and soft tissue window contrasts, and the supervised sub-network learned to recognize the optimal window width and level setting of the lung and abdominal soft tissues via the lung mask. The self-supervised sub-network then used the extreme value suppression loss function to preserve more organ edge structure information. The images generated by the T-ACEnet were fed into the segmentation network to segment multiple abdominal organs.@*RESULTS@#The images obtained by T-ACEnet were capable of providing more window setting information in a single image, which allowed the physicians to conduct preliminary screening of the lesions. Compared with the suboptimal methods, T-ACE images achieved improvements by 0.51, 0.26, 0.10, and 14.14 in SSIM, QABF, VIFF, and PSNR metrics, respectively, with a reduced MSE by an order of magnitude. When T-ACE images were used as input for segmentation networks, the organ segmentation accuracy could be effectively improved without changing the model as compared with the original CT images. All the 5 segmentation quantitative indices were improved, with the maximum improvement of 4.16%.@*CONCLUSION@#The T-ACEnet can perceptually improve the contrast of organ tissues and provide more comprehensive and continuous diagnostic information, and the T-ACE images generated using this method can significantly improve the performance of organ segmentation tasks.

Effect of needle-free jet injection of insulin glargine on glycaemic fluctuation in type 2 diabetic patients with uncontrolled glycemia / 中华内分泌代谢杂志

Objective:To investigate the effects of insulin glargine administration by jet injection versus conventional insulin pen on glucose profile using professional mode flash glucose monitoring(FGM) system in type 2 diabetic patients with poor glucose control.Methods:In this randomized, controlled, crossover study, 40 patients with T2DM who treated with insulin glargine were enrolled. The patients were randomly divided into group A(jet injector-conventional pen, n=20) and group B(conventional pen-jet injector, n=20). Each patient wore FreeStyle Libre sensor from day 4 to day 17. The specialist nurse instructed patients how to master the injection techniques. Professional FGM system was applied to assess glucose profile. Results:The fasting blood glucose(FBG) of the enrolled patients was(9.37±1.84) mmol/L. In contrast to conventional insulin pen, treatment with the jet injector significantly decreased the 24h MBG [(9.06±2.13 vs 9.98±2.67) mmol/L, P=0.001], MaxBG [(16.69±3.01 vs 17.95±3.48) mmol/L, P=0.001], AUC>10 mmol/L [95.93(21.12, 129.02) vs 142.66( 27.88, 198.46), P=0.002], TAR(31.10±21.89 vs 39.49±25.93, P=0.003), MAGE and SDBG. It was observed that patients using jet injector had significant increased TIR(65.94±20.47 vs 58.32±25.00, P=0.001). There were no difference in the risk of hypoglycaemia between two groups. Conclusion:Insulin jet injector was more effective than the insulin pen on glycaemic control and glucose fluctuation without increasing the risk of hypoglycemia in type 2 diabetic patients with uncontrolled glycemia.

A semi-supervised material quantitative intelligent imaging algorithm for spectral CT based on prior information perception learning / 南方医科大学学报

OBJECTIVE@#To propose a semi-supervised material quantitative intelligent imaging algorithm based on prior information perception learning (SLMD-Net) to improve the quality and precision of spectral CT imaging.@*METHODS@#The algorithm includes a supervised and a self- supervised submodule. In the supervised submodule, the mapping relationship between low and high signal-to-noise ratio (SNR) data was constructed through mean square error loss function learning based on a small labeled dataset. In the self- supervised sub-module, an image recovery model was utilized to construct the loss function incorporating the prior information from a large unlabeled low SNR basic material image dataset, and the total variation (TV) model was used to to characterize the prior information of the images. The two submodules were combined to form the SLMD-Net method, and pre-clinical simulation data were used to validate the feasibility and effectiveness of the algorithm.@*RESULTS@#Compared with the traditional model-driven quantitative imaging methods (FBP-DI, PWLS-PCG, and E3DTV), data-driven supervised-learning-based quantitative imaging methods (SUMD-Net and BFCNN), a material quantitative imaging method based on unsupervised learning (UNTV-Net) and semi-supervised learning-based cycle consistent generative adversarial network (Semi-CycleGAN), the proposed SLMD-Net method had better performance in both visual and quantitative assessments. For quantitative imaging of water and bone materials, the SLMD-Net method had the highest PSNR index (31.82 and 29.06), the highest FSIM index (0.95 and 0.90), and the lowest RMSE index (0.03 and 0.02), respectively) and achieved significantly higher image quality scores than the other 7 material decomposition methods (P < 0.05). The material quantitative imaging performance of SLMD-Net was close to that of the supervised network SUMD-Net trained with labeled data with a doubled size.@*CONCLUSIONS@#A small labeled dataset and a large unlabeled low SNR material image dataset can be fully used to suppress noise amplification and artifacts in basic material decomposition in spectral CT and reduce the dependence on labeled data-driven network, which considers more realistic scenario in clinics.

Study on the effect of ultrasound intermediate frequency acupoint drug guiding technology on the recovery of gastrointestinal function in patients undergoing lumbar spine surgery / 中国医师进修杂志

Objective:To observe the effects of ultrasound intermediate frequency acupoint targeted drug guiding technology on the recovery of gastrointestinal function and serum gastrin levels in elderly patients after lumbar spine surgery under general anesthesia.Methods:This study used prospective research methods.A total of 90 elderly patients undergoing lumbar spine surgery after general anesthesia in the orthopaedic ward of Beijing Geriatrics Hospital from June 2019 to June 2021 were randomly divided into blank control group, drug control group, and drug-guided treatment group, with 30 cases each group. After the operation, no intervention was given to the blank control group, the drug control group received oral mosapride citrate tablets, the drug-guided treatment group used the D patch to guide the medicine at the two acupoints of Zusanli and Zhongwan with ultrasound medium frequency guided medicine instrument for 1 week each. The serum gastrin levels of the patients in each group were detected 1 d before operation, 3 d after operation, and 1 week after operation, and the time of first exhaust and first defecation after operation were recorded.Results:The results showed that the level of serum gastrin preoperativein the three groups was not significantly different ( P>0.05). On the third day after operation, the levelof serum gastrin in the drug guide treatment group, drug control group and blank control group were lower than those at 1 d before operation: (66.51 ± 5.34) ng/L vs. (69.36 ± 6.50) ng/L, (58.34 ± 5.71) ng/L vs. (68.75 ± 5.13) ng/L, (55.76 ± 6.23) ng/L vs. (70.20 ± 6.71) ng/L, the differences were statistically significant ( P<0.05), and showed a decreasing trend in turn. Among them, the level of serum gastrin in the drug guide treatment group was higher than that in the drug control group and blank control group, the difference was statistically significant ( P<0.05). One week after operation, the level of serum gastrin in the three groups increased compared with the third day after operation ( P<0.05), and the drug guiding treatment group was higher than the drug control group and the blank control group: (72.38 ± 6.78) ng/L vs. (67.15 ± 6.27) ng/L, (63.52 ± 5.38) ng/L, the differences were statistically significant ( P<0.05). The time of first exhaust and defecation after the operation of the three groups of patients, the drug-guided treatment group was significantly shorter than the drug control group and the blank control group: (15.25 ± 3.10) h vs. (20.38 ± 4.21) h and (28.52 ± 3.69) h, (24.14 ± 3.53) h vs. (36.15 ± 3.54) h and (49.51 ± 4.37) h, the differences were statistically significant ( P<0.05). Conclusions:Ultrasound intermediate frequency acupoint drug guiding technology can increase the patient′s serum gastrin level and promote the recovery of gastrointestinal function in elderly patients with lumbar spine surgery after general anesthesia.

Metabolic syndrome and early renal function injury of chronic kidney disease in elderly: A retrospective cohort study in Yunnan Province / 中华内分泌代谢杂志

Objective:To investigate the association between metabolic syndrome and the risk of early renal function injury in chronic kidney disease(CKD) in the elderly.Methods:A retrospective cohort was established based on health check-up data of 4 495 elderly residents in Mengzi City, Yunnan Province from January 2016 to December 2018. The medial history, living habits, and related physical examination information were collected. Cox hazard regression model was used to explore the association between metabolic syndrome, along with its components, and the early renal function injury in CKD. Results:The median age of the elderly was 71.00(67.00, 75.00) years, with metabolic syndrome detection rate of 21.98%. Early renal function injury of CKD developed in 1 300(28.92%) subjects during the follow-up. Univariate Cox regression showed that the number of metabolic syndrome components was associated with the risk of early kidney development in CKD. The HRs were 1.23 (95% CI 1.03-1.47, P=0.022) with 1 component, 1.54 (95% CI 1.28-1.84, P<0.001) with 2, and 1.38 (95% CI 1.14-1.67, P<0.001) with 3 or more. Multivariate Cox regression showed that elevated fasting triglycerides( HR=1.20, 95% CI 1.07-1.36, P=0.003) and lower high density lipoprotein-cholesterol(HDL-C; HR=1.25, 95% CI 1.09-1.43, P=0.002) were risk factors for early kidney injury in CKD, while doing some physical activity( HR=0.57, 95% CI 0.33-0.98, P=0.042), or on daily basis( HR=0.57, 95% CI 0.49-0.66, P<0.001) was a protective factor for early kidney injury in CKD. Conclusion:The abnormality of one or more metabolic components can significantly increase the risk of early kidney injury in the elderly with CKD. Elevated triglyceride and decreased HDL-C may be the risk factors.

Effects of different doses of dexmedetomidine on heart rate variability in patients with non-ST-segment elevation myocardial infarction / 中国医师进修杂志

Objective:To investigate the effects of different doses of dexmedetomidine (Dex) on heart rate variability (HRV) in patients with non-ST-segment elevation myocardial infarction (NSTEMI).Methods:The clinical data of 144 patients with NSTEMI from January 2017 to October 2020 in the 942 Hospital of Chinese PLA were analyzed retrospectively. Among them, 36 cases were treated with Dex 0.05 to 0.15 μg/(kg·h) (Dex1 group), 36 cases with Dex 0.20 to 0.40 μg/(kg·h) (Dex2 group), 36 cases with Dex 0.50 to 0.70 μg/(kg·h) (Dex3 group), and 36 cases without Dex (control group). The changes of HRV time domain indexes, frequency domain indexes and prognosis index before and after treatment were compared among 4 groups, the time domain indexes include normal R-R interval standard deviation (SDNN), mean value of adjacent normal R-R interval standard deviation (SDANNindex), root mean square of adjacent normal R-R interval standard deviation (SDNNindex), square root of adjacent normal R-R interval difference (rMSSD) and percentage of adjacent normal R-R interval difference>50 ms to R-R interval number (PNN50); the frequency domain indexes include total power (TP), low frequency power (LF), high frequency power (HF), ultra-low frequency power (VLF) and LF/HF; the prognostic indexes include ICU stay time, vasoactive drug use time, 28-day mortality and incidence of complication.Results:There was no significant difference in HRV indexes among 4 groups before treatment ( P>0.05); after treatment, except for LF/HF in Dex2 group and Dex3 group was significantly lower than that in control group and Dex1 group, other HRV indexes were significantly higher than those in control group and Dex1 group, and there were statistical differences ( P<0.05). There was no significant difference in 28-day mortality among 4 groups; the ICU stay time and vasoactive drug use time in Dex2 group were significantly shorter than those in control group, Dex1 group and Dex3 group: (7.14 ± 1.25) d vs. (9.08 ± 1.68), (9.53 ± 1.98) and (9.81 ± 1.95) d, (122.67 ± 29.5) h vs. (176.15 ± 23.26), (181.72 ± 23.40) and (180.42 ± 22.90) h, the incidence of complication was significantly lower than that in control group, Dex1 group and Dex3 group: 16.67% (6/36) vs. 72.22% (26/36), 47.22% (17/36) and 61.67% (22/36), and there were statistical differences ( P<0.05); there were no statistical difference in ICU stay time, vasoactive drug use time and incidence of complication among control group, Dex1 group and Dex3 group ( P>0.05). Conclusions:Dex 0.20 to 0.40 μg/(kg·h) is well tolerated, and has less adverse reactions. It can effectively increase HRV, regulate the balance of sympathetic-vagal nerve tension, stabilize cardiovascular response and improve prognosis in patients with NSTEMI.

Impaired episodic memory network in subjects at high risk for Alzheimer's disease.

Episodic memory dysfunction is one of the hallmark symptoms of Alzheimer's disease (AD) and mild cognitive impairment (MCI). This cognitive impairment may be related to abnormal brain structure and activity. Functional connectivity mapping (FCM) analysis provides a powerful tool for exploring the topology of human brain function using magnetic resonance imaging (MRI). Thus, it would be advantageous to investigate the changes in functional connectivity within the episodic memory network in a longitudinal MCI dataset, as it may be helpful in identifying a potential marker of disease progress. Accordingly, FCM was performed in 23 normal control (NC) subjects, 26 patients with early MCI (EMCI) and 19 patients with late MCI (LMCI). Our results demonstrated that patients with MCI showed affected functional connectivity within the right fusiform gyrus (rFG) and between the rFG and right precuneus (rPreCU) compared to NCs. The results indicated that deficits in episodic memory would lead to impaired functional connectivity associated with visual information processing in early MCI. FCM may be helpful for exploring a sensitive marker of disease presence.

Effects of umbilical cord blood neural stem cells via stromal cell-derived factor-1/CXC chemokine receptor 4 signaling on neural recovery in rat models of intracerebral hemorrhage / 中华神经医学杂志

Objective To investigate the effects of umbilical cord blood neural stem cells (UCBNSCs) via stromal cell-derived factor-1 (SDF-1)/CXC chemokine receptor 4 (CXCR4) signaling on neural recovery in rat models ofintracerebral hemorrhage.Methods (1) In migration assay in vitro,UCBNSCs were distributed in the upper wells of Transwell plates,and SDF-1 at concentrations of 30,60 and 120 ng/mL was placed in the lower wells.(2) Sixty rat models of intracerebral hemorrhage were randomly divided into UCBNSCs-transplanted group and phosphate buffer (PBS)-transplanted group (n=30);two d after modeling,10 L UCBNSCs suspension and same amount of PBS were,respectively,transplanted into the two groups,and intraperitoneal injection of deoxyuridine (BrdU) labeled endogenous neural stem cells was performed;neurological functions were assessed with modified Neurological Severity Scale (mNSS) one d,and one and two weeks after cell transplantation;the expressions of SDF-1,vascular endothelial growth factor (VEGF),glial fibrillar acidic protein (GFAP),and doublecortin (DCX) were detected by immunofluorescence when the rats were sacrificed two weeks after cell transplantation;cell apoptosis was detected by TUNEL.Results (1) In the in vitro experiment,CXCR4 expression could be detected in UCBNSCs;60 ng/mL SDF-1 had the greatest migration effect on UCBNSCs,and this effect showed statistically significant difference as compared with that at other concentrations (P＜0.05).(2) In the in vivo experiment,two weeks after transplantation,the UCBNSCs-transplanted group had significantly increased number of BrdU-labeled cells in the subventricular zone,and significantly larger number of BrdU/DCX and BrdU/GFAP cells than the PBS-transplanted group (P＜0.05);the VEGF expression in the brain injury area of the UCBNSCs-transplanted group ([88.30±7.21]/field) was significantly higher than that of PBS-transplanted group ([53.20±4.45]/field,t=4.144,P=0.000);the number of apoptotic cells in the brain injury area of the UCBNSCs-transplanted group ([34.30 ±2.44] /field) was significantly smaller than that of PBS-transplanted group ([47.70±1.98] /field,t=4.266,P=0.001);two weeks after transplantation,the mNSS scores of UCBNSCs-transplanted group (6.40±0.163) were significantly lower than those of the PBS-transplanted group (7.50±0.17,t=4.714,P=0.002).Conclusion SDF-1/CXCR4 can reach the injured area of cerebral hemorrhage after chemotactic transplantation of UCBNSCs and promote the recovery of nerve function in rats,whose mechanism may be that it can promote neurogenesis and VEGF secretion and inhibit apoptosis.

Expressions of regulatory B cells in peripheral blood of patients with Guillain-Barre syndrome / 中华神经医学杂志

Objective To investigate the expressions of regulatory B cells and related cytokines in patients with Guillain-Barre syndrome (GBS).MethodsForty-four patients with GBS admitted to our hospital from October 2018 to June 2019 were enrolled as GBS group; 44 healthy subjects accepted physical examination in our hospital at the same period were selected as control group. Flow cytometry was used to determine the proportions of CD19+CD24hiCD38hi regulatory B cells and CD19+CD24hiCD27+ regulatory B cells in CD19+ lymphocytes in peripheral blood mononuclear cells of the two groups. ELISA was employed to detect the serum contents of interleukin (IL)-10, IL-35 and transforming growth factor (TGF)-β1 of the two groups.ResultsAs compared with those in the control group, the proportions of CD19+CD24hiCD38hi regulatory B cells and CD19+CD24hiCD27+ regulatory B cells in CD19+B lymphocytes of the GBS group were significantly decreased (P<0.05). As compared with the control group, the GBS group had significantly decreased IL-10 and IL-35 levels (P<0.05), and obviously increased TGF-β1 content without statistical difference (P>0.05).ConclusionRegulatory B cells play a role in the pathogenesis of GBS through IL-10 and IL-35 cytokine pathways.

A radiomic approach to differential diagnosis of renal cell carcinoma in patients with hydronephrosis and renal calculi / 南方医科大学学报

To explore the application of radiomic analysis in differential diagnosis of renal cell carcinoma in patients with hydronephrosis and renal calculi using supervised machine learning methods.The abdominal CT scan data were retrospectively analyzed for 66 patients with pathologically confirmed hydronephrosis and renal calculi, among whom 35 patients had renal cell carcinoma. In each case 18 non-texture features and 344 texture features were extracted from the region of interest (ROI). Infinite feature selection (InfFS)-based forward feature selection method coupled with support vector machine (SVM) classifier was used to select the optimal feature subset. SVM was trained and performed the prediction using the selected feature subset to classify whether hydronephrosis with renal calculi was associated with renal cell carcinoma.A total of 12 texture features were selected as the optimal features. The area under curve (AUC), accuracy, sensitivity, specificity, false positive rate and false negative rate of the SVM- InfFS model for predicting accompanying renal tumors in patients with hydronephrosis and calculi were 0.907, 81.0%, 70.0%, 90.9%, 9.1%, and 30.0%, respectively. The diagnostic accuracy, sensitivity, specificity, false positive and false negative rates by the clinicians provided with these classification results were 90.5%, 80.0%, 100%, 0.00%, and 20.0%, respectively.The computer-aided classification model based on supervised machine learning can effectively extract the diagnostic information and improve the diagnostic rate of renal cell carcinoma associated with hydronephrosis and renal calculi.

Establishment of a deep feature-based classification model for distinguishing benign and malignant breast tumors on full-filed digital mammography / 南方医科大学学报

OBJECTIVE@#To develop a deep features-based model to classify benign and malignant breast lesions on full- filed digital mammography.@*METHODS@#The data of full-filed digital mammography in both craniocaudal view and mediolateral oblique view from 106 patients with breast neoplasms were analyzed. Twenty-three handcrafted features (HCF) were extracted from the images of the breast tumors and a suitable feature set of HCF was selected using -test. The deep features (DF) were extracted from the 3 pre-trained deep learning models, namely AlexNet, VGG16 and GoogLeNet. With abundant breast tumor information from the craniocaudal view and mediolateral oblique view, we combined the two extracted features (DF and HCF) as the two-view features. A multi-classifier model was finally constructed based on the combined HCF and DF sets. The classification ability of different deep learning networks was evaluated.@*RESULTS@#Quantitative evaluation results showed that the proposed HCF+DF model outperformed HCF model, and AlexNet produced the best performances among the 3 deep learning models.@*CONCLUSIONS@#The proposed model that combines DF and HCF sets of breast tumors can effectively distinguish benign and malignant breast lesions on full-filed digital mammography.

Sparse-view helical CT reconstruction based on tensor total generalized variation minimization / 南方医科大学学报

OBJECTIVE@#We propose a sparse-view helical CT iterative reconstruction algorithm based on projection of convex set tensor total generalized variation minimization (TTGV-POCS) to reduce the X-ray dose of helical CT scanning.@*METHODS@#The three-dimensional volume data of helical CT reconstruction was viewed as the third-order tensor. The tensor generalized total variation (TTGV) was used to describe the structural sparsity of the three-dimensional image. The POCS iterative reconstruction framework was adopted to achieve a robust result of sparse-view helical CT reconstruction. The TTGV-POCS algorithm fully used the structural sparsity of first-order and second-order derivation and the correlation between the slices of helical CT image data to effectively suppress artifacts and noise in the image of sparse-view reconstruction and better preserve image edge information.@*RESULTS@#The experimental results of XCAT phantom and patient scan data showed that the TTGVPOCS algorithm had better performance in reducing noise, removing artifacts and maintaining edges than the existing reconstruction algorithms. Comparison of the sparse-view reconstruction results of XCAT phantom data with 144 exposure views showed that the TTGV-POCS algorithm proposed herein increased the PSNR quantitative index by 9.17%-15.24% compared with the experimental comparison algorithm; the FSIM quantitative index was increased by 1.27%-9.30%.@*CONCLUSIONS@#The TTGV-POCS algorithm can effectively improve the image quality of helical CT sparse-view reconstruction and reduce the radiation dose of helical CT examination to improve the clinical imaging diagnosis.

Effect of flash glucose monitoring on ambulatory glucose profile in patients with type 2 diabetes mellitus / 中国医师进修杂志

Objective To investigate the effect of flash glucose monitoring (FGM) on ambulatory glucose profile of only oral antidiabetic drugs treated patients with type 2 diabetes mellitus. Methods Twenty-eight type 2 diabetic mellitus patients with only oral antidiabetic drugs treatment from August 2017 to January 2018 were enrolled. All the patients were exposed to FGM for 14 d without changing the original treatment and encouraged to manage self-behavior by adjusting diet and activity based on the blood glucose data obtained from the real-time scanning. The changes in glucose profile during the FGM period were observed, including estimated glycated hemoglobin (HbA1c), standard deviation of blood glucose, variable coefficient of blood glucose, mean amplitude of glycemic excursions, time in range (blood glucose 3.9 to 10.0 mmol/L), area under the curve hyperglycemia (blood glucose> 10.0 mmol/L) and area under the curve hypoglycemia (blood glucose<3.9 mmol/L). The blood glucose levels on second day and thirteenth day were used as baseline and end point respectively. Results All of the 28 patients did not change their anti-diabetic drug therapy and there were no adverse events occurred. The estimated HbA1c was significantly lower than the baseline HbA1c: (6.90 ± 1.48)% vs. (7.57 ± 1.35)%, and there was statistical difference (P = 0.004). The standard deviation of blood glucose, variable coefficient of blood glucose, mean amplitude of glycemic excursions, area under the curve hyperglycemia and area under the curve hypoglycemia at end were significantly lower than those at baseline: (2.07 ± 0.86) mmol/L vs. (2.44 ± 0.86) mmol/L, 0.26 ± 0.11 vs. 0.30 ± 0.11, (5.32 ± 2.75) mmol/L vs. (6.76 ± 3.06) mmol/L, 265 (0, 1 310) vs. 351 (107, 2 177) and 0 (0, 0) vs. 0 (0, 19), the time in range at end was significantly higher than that at baseline: (1 069 ± 386) min vs. (921 ± 449) min, and there were statistical differences (P＜0.05 or＜0.01). The rate of scanning was (12.92 ± 4.87) times/d. Conclusions FGM could be applied by type 2 diabetic mellitus patients to make self-glycemic management without changing therapy, reduce the estimated HbA1c,and hypoglycemia, and improve the glucose fluctuations, which may result from real-time scanning to find abnormal glycemia and adjust daily behavior.

Key technologies in digital breast tomosynthesis system:theory, design, and optimization / 南方医科大学学报

OBJECTIVE@#To develop a digital breast tomosynthesis (DBT) imaging system with optimizes imaging chain.@*METHODS@#Based on 3D tomography and DBT imaging scanning, we analyzed the methods for projection data correction, geometric correction, projection enhancement, filter modulation, and image reconstruction, and established a hardware testing platform. In the experiment, the standard ACR phantom and high-resolution phantom were used to evaluate the system stability and noise level. The patient projection data of commercial equipment was used to test the effect of the imaging algorithm.@*RESULTS@#In the high-resolution phantom study, the line pairs were clear without confusing artifacts in the images reconstructed with the geometric correction parameters. In ACR phantom study, the calcified foci, cysts, and fibrous structures were more clearly defined in the reconstructed images after filtering and modulation. The patient data study showed a high contrast between tissues, and the lesions were more clearly displayed in the reconstructed image.@*CONCLUSIONS@#This DBT imaging system can be used for mammary tomography with an image quality comparable to that of commercial DBT systems to facilitate imaging diagnosis of breast diseases.

A survey on the present status of diagnosis and treatment of Graves' disease in Jiangsu province / 中华内分泌代谢杂志

Objective To investigate the management of Graves' disease in Jiangsu province. Methods According to the 2011 management of GD survey from American Thyroid Association and the 2013 survey from European Thyroid Association, a questionnaire was designed for this survey to acquire the diagnosis, treatment, and follow-up of Graves' disease among endocrinologists from 35 tertiary hospitals in Jiangsu province. Results A total of 476 valid questionnaires were collected. For patients with symptoms of hyperthyroidism, a large majority of respondents monitored serum FT3 , FT4 , TSH, thyroid peroxidase antibody, thyroglobulin antibody, TSH receptor antibody, and finding of thyroid ultrasound, accounted for 95. 6％, 95. 0％, 95. 4％, 95. 8％, 90. 3％, 90. 5％, and 93. 9％physicians, respectively. 91.2％ of physicians preferred anti-thyroid drugs as the first-line treatment, and 92. 6％ of them gave priority to the use of methimazole. For the duration of anti-thyroid drugs therapy, 41.2％of endocrinologists chose 24 months, while 20％ chose 18 months. When patients have moderate and active ophthalmopathy, most respondents with medium or senior professional titles preferred anti-thyroid drugs, while most resident physicians chose radioactive iodine plus corticosteroids. When pregnancy was confirmed in the patients of Graves' disease, 88％ of respondents preferred propylthiouracil during the first trimester of pregnancy, and 58. 4％ of them would continue propylthiouracil into the second trimester. Conclusions The mastering of basic perception of Graves' disease knowledge is satisfactory among the endocrinologists. But by comparing to the American and European survey results and related guidelines, there are still some differences in diagnosis and treatment. Therefore, physicians should notice those differences and make improvement on standardized treatment for patients to raise the response ratio while reducing the recurrent events.

The efficacy and dispersion analysis of high viscosity cement in the treatment of osteoporotic vertebral compression fractures with different degrees of osteoporosis / 中国基层医药

Objective To observe the efficacy and difference of dispersion of osteoporotic vertebral fractures with high-viscosity cement in the treatment of vertebral compression fractures with different degrees of osteoporosis.Methods From October 2013 to October 2016,a total of 65 patients with clinically diagnosed thoracolumbar osteoporotic fractures in Beijing Geriatrics Hospital were selected,and they were divided into three groups according to Genant semiquantitative method:24cases of] degree group (vertebral compression ≤ 25％),23cases of Ⅱ degree group(vertebral compression of ＞ 25％-40％),18 cases of Ⅲ degree group(vertebral compression ＞ 40％).All patients underwent vertebroplasty and received high viscosity bone cement.CT scan was performed after operation,then the volume of vertebral bone cement dispersion and diffusion coefficient were calculated,the differences among different groups were compared.The visual analogue scale(VAS) of all patients were recorded before operation,1 day after operation and 6 months after operation.The differences of preoperative and postoperative VAS scores were compared to evaluate the therapeutic effect of high viscosity cement on PVP.Results There were no statistically significant differences among the three groups in the time of single vertebral body operation and the amount of cement injected(all P ＞0.05).However,the volume and the diffusion coefficient of the cement in the Ⅲ degree group [(8.25 ± 1.38)mL and (2.15 ± 0.21)] were significantly different from those in the Ⅱ degree group[(9.32 ±1.85) mL and (2.42 ± 0.27)] (t =2.43,3.51,all P ＜ 0.05) and the Ⅰ degree group [(9.38 ± 1.92) mL and (2.44 ± 0.23)] (t =2.12,2.29,all P ＜ 0.05).There were no statistically significant differences in the volume and the dispersion coefficient of cement between the Ⅰ degree group and Ⅱ degree group(t =0.11,0.29,all P ＞0.05).The postoperative VAS score decreased significantly,and the differences were statistically significant among preoperation,postoperative 1 day and postoperative 6 months (t =28.21,27.01,all P ＜ 0.01).Conclusion The VAS score of patients with OVCF decreases significantly after PVP treatment with high viscosity cement.The pain symptoms of patients with OVCF are significantly relieved in both short-term and long-term,and PVP with high viscosity cement has a very low incidence rate of bone cement leakage.The different degree of preoperative vertebral compression doesn't affect the amount of bone cement injection and operation time,but partly impact the dispersion of high viscosity cement,shown as the dispersion volume and diffusion coefficient of bone cement can decline with the increase of the degree of vertebral compression,especially for heavily compressed vertebral fractures,the dispersion of bone cement is clearly diminished.

Analysis of genetic characteristics of four families with Huntington's disease / 中华神经医学杂志

Objective To investigate the features of molecular genetics of 4 Huntington's disease (HD) pedigrees in Xinjiang.Methods Collected for this study were the data of the HD patients who had been admitted by Department of Neurology,The First Affiliated Hospital to Xinjiang Medical University from August 2010 to June 2017 and the genetic data of their 4 HD pedigrees of altogether 15 members.Their mutations of HTT gene amplification of CAG trinucleotide were detected with the polymerase chain reaction and capillary electrophoresis.Their test results and genetic characteristics were analyzed respectively.Results The 4 pedigrees of HD included 3 Han families and one Hui family.The 4 HD patients confirrned were one male and 3 females;their onset age ranged from 21 to 47 years old;their CAG copy number ranged from 42 to 62 times.The 3 presymptomatic patients were 2 males and one female,aged from 27 to 31 years old;their CAG copy number ranged from 44 to 48 times.The CAG copy number ranged from 16 to 20 times in the normal family members of the 4 HD pedigrees.Conclusions The CAG copy number may be increased and anticipation may exist in the HD patients by paternal inheritance.

Effect of moderate exercise for 30 min at 30 min versus 60 min after dinner on glycemic control in patients with type 2 diabetes: a randomized, crossover, self-controlled study / 南方医科大学学报

<p><b>OBJECTIVE</b>To compare the effectiveness of moderate exercise for 30 min at 30 min and 60 min after dinner on glycemic control in patients with type 2 diabetes.</p><p><b>METHODS</b>This randomized, crossover, self-controlled pilot study was conducted in 15 inactive patients with type 2 diabetes without serious complications or use of exogenous insulin. The participants completed two randomly ordered exercise protocols (brisk walking for 30 min at 30 min or 60 min after dinner on the exercise day) spaced 1 week apart. All the exercise was performed while maintaining a heart rate reserve of 40%. The interstitial glucose level was monitored using a continuous glucose monitor (CGM) for all the participants, who maintained a standardized diet with routine medications. The 2-h postprandial mean glucose, peak glucose, and glucose area under the curve (AUC) were measured. The mean amplitude of glycemic excursions (MAGE) and other plasma glucose fluctuation parameters in 12 h after dinner, including the mean blood glucose (MBG) and the coefficient variation (CV) of glucose, were also calculated. The incidence of nocturnal hypoglycemia was recorded in all the participants.</p><p><b>RESULTS</b>The participants had a mean age of 46±11 years with a mean BMI of 25.8±3.1 kg/m and a mean HbA1c of 7.7%. No significant differences were found between postprandial 30 min exercise group and postprandial 60 min exercise group in terms of 2-h postprandial mean glucose, peak glucose, glucose AUC, or in MBG, CV and MAGE during the 12-h period after dinner. No nocturnal hypoglycemia occurred in the participants after exercise at 30 or 60 min after dinner. However, significant reductions in the 2-h postprandial glucose levels were detected after exercise at 60 min after dinner as compared to exercise at 30 min.</p><p><b>CONCLUSIONS</b>The timing (30 min 60 min after dinner) of moderate exercises for 30 min does not produce significant difference in the improvement of postprandial hyperglycemia in type 2 diabetic patients, and both exercise protocols are safe without a potential risk of hypoglycemia. Nevertheless, exercise at 60 min after dinner can be more effective to lower 2-h postprandial glucose, while exercise at 30 min after dinner might be safer for patients with a high risk of hypoglycemia.</p>