自适应性统计迭代重建在颈动脉CTA中的应用研究

目的探讨自适应统计迭代重建算法在颈动脉CTA的可行性,比较权重50%ASIR重建算法相对于常规滤波反投影重建算法对图像质量的影响。方法随机选取64例受检者在能谱CT上行颈动脉CTA检查。采用管电压120k Vp,管电流480m A,320mg I/m L碘佛醇5m L/s团注。将所得原始数据传输至GE AW4.5工作站,行影像重建分析。每组原始数据运用两类重建方法重建,分别获得对应两组数据,A组采用常规FBP重建算法对原始数据重建分析;B组运用权重50%ASIR重建算法对原始数据进行影像重建分析。分别记录两组影像颈部血管各分支CT值,噪声值及背景CT值,计算和比较图像对比噪声比(CNR),信噪比(SNR),行统计学分析。结果 B组血管噪声值(11.5±2.38)低于A组(16.70±2.98)(P<0.01);B组CNR(61.14±22.38)高于A组(38.19±11.57)(P<0.01);B组SNR(48.16±18.26)也高于A组(30.03±9.49)(P<0.01)。两组血管CT值和背景CT值均无统计学意义。结论颈动脉CTA结合权重50%ASIR重建算法不仅可以很好保证影像质量,还能有效降低影像噪声,提高影像信噪比和对比噪声比。     

双源CT"双低"冠脉成像应用的可行性研究

目的 探讨双源CT低管电压和低浓度造影剂冠脉成像在正常体质量患者中的应用可行性.方法 连续选择60例体质量指数(BMI)<24 kg·m-2、心率<80次/分的患者,将其分为两组,每组30例.A组使用370 mgI·mL-1造影剂和100 Kv管电压回顾性冠脉扫描,B组使用320 mgI·mL-1造影剂和80 Kv管电压前瞻性冠脉扫描.分别测量两组图像主动脉根部CT值、图像噪声、信号噪声比(SNR)和对比噪声比(CNR),使用双盲法对冠脉图像质量以4分法进行评分,对两组图像质量评分进行比较.结果 A组主动脉根部CT值、噪声低于B组,SNR和CNR高于B组,均差异有统计学意义(均P<0.05);主观评价两组图像质量差异无统计学意义;B组有效辐射剂量(1.60±0.41)mSev明显低于A组(4.15±0.52)mSev,差异有统计学意义(P<0.05),碘摄入量B组明显低于A组.结论 对于BMI<24 kg·m-2、心率<80次/分的患者,采取"双低"扫描方案,在保证图像质量的同时,患者接受有效辐射剂量和碘摄入量大大降低.     

低剂量对比剂在头颈部3D CE-MRA中的应用研究

目的探讨使用小剂量对比剂行头颈部动脉三维对比增强磁共振血管成像(3D CE-MRA0的可行性。方法 100例临床怀疑颅颈部血管病变的患者分成A、B两组,使用1.5T磁共振扫描仪行颅颈部动脉3D CE-MRA,A/B组使用剂量分别为0.15mmol/kg和0.30mmol/kg,比较两组患者图像最大密度投影(MIP)图像质量及原始增强图像颈总动脉、颈内动脉及大脑中动脉的信号强度(SI)、信噪比(SNR)和对比噪声比(CNR)。结果由两位医师在不知临床资料和对比剂用量的情况下共同评价MIP图像质量,发现A、B两组的MIP图像质量均符合诊断要求,差异无统计学意义(P>0.05),A组的静脉污染比B组略轻,但差异无统计学意义,A组显示分支血管的级数略低于B组,但差异亦无统计学意义;A、B两组颈总动脉的SI、SNR、CNR及颈内动脉的SI差异无统计学意义,A组颈内动脉SNR、CNR及大脑中动脉的SI、SNR、CNR均略低于B组,差异有统计学意义(P<0.05)。结论采用1.5T磁共振仪行头颈部3D CE-MRA,使用0.15mmol/kg的钆对比剂可以获得良好的图像质量并满足临床诊断。     

CT能谱成像技术在腹部扫描中的应用

目的 利用CT能谱扫描技术选择在腹部扫描中的最佳扫描参数、单能量图像、ASi R迭代算法。方法 对82例患者进行腹部螺旋平扫,能谱平扫,能谱增强,重建单能图像,重建10%~80%ASi R,分别测量肝脏、脾脏、肾脏、膀胱平均CT值、SD值、剂量CTDIvol和DLP,进行分析比较。结果 70 ke V单能量图像与120 k Vp 30%ASi R的图像质量相比,无统计学上的差异(P>0.05),表明二者图像质量相当,同时说明70 ke V单能量图像要优于120 k Vp的FBP图像质量(P<0.05),能谱成像的扫描剂量与常规120 k Vp螺旋扫描的剂量相当(P>0.05)。结论 能谱成像选择最佳参数,可以降低剂量,提高图像质量,为临床诊断提供准确而更多的信息。     

前置ASIR-V技术对腹部增强CT扫描图像质量及辐射剂量的影响

目的:探讨前置迭代重建算法-V(ASIR-V)技术对腹部增强CT扫描图像质量及辐射剂量的影响.方法:选取2018-05 ～2020-07于河南宏力医院行上腹部增强CT检查的160例患者,依据随机数表法将所有患者分为A、B、C、D组,各40例,A组患者采用常规增强CT扫描,B-D组分别采用20％前置ASIR-V、40％前置ASIR-V、60％前置ASIR-V进行增强CT扫描,其余CT参数均保持一致,比较四组图像质量及辐射剂量.结果:4组中,C组图像质量评分最高,其次为A组、D组,B组图像质量评分最低,差异有统计学意义(P＜0.05);4组中,D组剂量指数、剂量长度乘积最低,其次为C组、B组,A组剂量指数、剂量长度乘积最高,差异有统计学意义(P＜0.05).结论:40％前置ASIR-V技术可有效优化腹部增强CT扫描的图像质量,并有利于减少CT扫描期间对患者的辐射剂量.     

双源双能量螺旋CT肺动脉成像辐射剂量与图像质量的对比研究

目的对比第二代双源双能量螺旋CT肺动脉成像(CTPA)不同辐射剂量下CT图像质量的差异性。方法筛选我院收治的肺栓塞患者80例,作为研究对象。所有患者均自愿接受CTPA检查,每组40例,其中A组管电压80/Sn140KV检查,B组管电压100/Sn140KV检查,比较两组患者肺动脉主干、肺动脉段、背部脂肪CT值等指标,并对CT影像治疗进行主观评分,计算信噪比(SNR)、对比噪声比(CNR)、有效剂量(ED)等。结果 A组患者肺动脉平均CT值、平均CNR指标明显高于B组(P<0.05),主观CT影像质量评价结果显示A组与B组评分无显著差异,但A组ED水平明显低于B组(P<0.05)。结论双源双能量螺旋CT肺动脉成像选用80/Sn140 KV扫描在获得具有较高诊断价值的CT影像同时,可大幅度降低患者检查过程中所受辐射剂量,更易于被患者接受,具有临床应用及推广价值。     

第3代双源CT结合低浓度碘对比剂在头颈CT血管造影中的应用研究

目的 探讨第3代双源CT扫描结合低浓度碘对比剂在头颈CT血管造影(CTA)中的应用价值。方法 收集我院采用第3代双源CT行头颈CTA检查的160例患者资料,随机分为A、B两组,每组各80例。A组采用碘浓度为350 mgI/mL的对比剂,B组采用碘浓度为300 mgI/mL的对比剂;两组均采用管电压为80/sn150kV的双能量扫描模式。比较两组间客观图像评价指标,对比两组的图像质量和碘总量。结果 A组平均CT值高于B组,差异有统计学意义(P<0.05);但两组动脉的图像噪声(SD)、信噪比(SNR)和对比噪声比(CNR)差异均无统计学意义(P>0.05)。A组锁骨下静脉SNR和CNR均低于B组,差异有统计学意义(P<0.05)。结论 与350 mgI/mL的碘对比剂组相比,使用300 mgI/mL的碘对比剂可以降低碘总量,获得的头颈部CTA图像质量可以达到临床诊断要求。     

研究128层螺旋CT和轴扫技术降低腹部CT检查辐射量的作用

目的：研究128层螺旋CT和轴扫技术降低腹部CT检查辐射量的作用。方法27例腹部CT扫描患者作为观察对象,随机分为两组, A组14例,行128层螺旋CT扫描, B组13例,行轴位阶段扫描。两组患者分别接受平扫及增强扫描,观察两组扫描的图像质量、噪声水平以及辐射剂量。结果两组平扫和增强扫描的图像质量及噪声水平的差异无统计学意义（P〉0.05）, A组X线的辐射剂量明显比B组高,差异有统计学意义（P〈0.05）。结论患者使用128层螺旋CT和轴扫技术所获得的图像均有较高质量,但是轴扫技术的腹部CT的辐射剂量明显低于128层螺旋CT扫描,更值得在临床应用和推广。     

双源CT双能量上腹部虚拟平扫的临床应用研究

目的探讨双源CT双能量上腹部虚拟平扫的临床应用价值。方法选取2013年3月至2014年8月我院收治的拟诊上腹部病变患者共120例,所有患者行常规上腹部平扫后,再行双源双能量CT扫描,并应用后处理技术得出虚拟平扫图像,将常规扫描图像作为对照,比较两组图像在图像质量、辐射剂量、CT值、信噪比等方面的差异。结果两种CT扫描所得的图像均可清楚辨识,虚拟平扫图像的颗粒感较粗,其图像质量、平均CT值、图像性噪比与常规平扫图像无明显差异,组间差异无统计学意义,P>0.05;而VNC组的辐射剂量显著低于CNC组,组间比较结果有显著差异,P<0.05。结论应用双源CT双能量虚拟平扫进行上腹部疾病的诊断,不仅诊断准确率较高,还能显著降低辐射剂量,具有较高的临床应用价值。     

低辐射剂量在超重和肥胖人群冠状动脉 CTA 中的应用研究

目的：初步探讨通过降低kV降低超重和肥胖人群冠状动脉CTA辐射剂量的可行性。方法连续收集超重患者60例、肥胖患者72例,每组均分成低剂量组和常规剂量组,分别记作A1和A2、B1和B2组, A1组采用100 kV、A2和B1组120 kV、B2组采用140 kV,对比剂选用碘海醇（350 mg／ml）进行增扫描。对冠状动脉9个主要节段图像进行主观评分,对右冠状动脉近段（RCA-p）、左主干LM（LMA）、左前降支近段（LAD-p）、左回旋支近段（LCX-p）4个主要节段管腔增强后CT值及SD和同水平前胸壁肌肉组织的CT值及SD进行记录。对A1和A2、B1和B2以上增强水平、图像评分、图像噪声、信噪比（ SNR）、噪声比（ CNR）、有效辐射剂量（ ED）等进行分析比较。结果所有纳入病例均完成冠脉检查,图像质量满足诊断要求。9个冠脉节段图像评分、4个冠脉节段增强水平、图像噪声、SNR差异无明显统计学意义, CNR、ED差异具有统计学意义。 A1组和A2组ED 分别为（8ó．47±0．76） mSv和（12．22±2．41）mSv,B1和B2组ED分别为（13．69±1．142）mSv和（20．31±1．36） mSv。结论对于超重和肥胖人群进行冠脉检查,可通过降低kV减少检查个体的有效辐射剂量,降低冠脉图像CNR。     

超声波强化乙醇提取罗汉果甜苷

目的优选超声强化乙醇罗汉果甜苷的提取工艺。方法采用正交试验法考察乙醇溶液提取罗汉果甜苷的主要影响因素,以甜苷提取率为指标,评定优选工艺条件,在此基础上,进行扩展试验。结果在40 kHz、100 W超声波处理下,提取3次,最佳工艺条件为:第1次提取,以体积分数为40%的乙醇溶液,用量为25倍(溶剂体积与罗汉果质量之比),提取温度60℃,提取时间40 min;第2次提取,以体积分数为30%的乙醇溶液,用量为20倍,提取温度65℃,提取时间30 min;第3次提取,以体积分数为20%的乙醇溶液,用量为20倍,提取温度75℃,提取时间20 min。结论采用超声波可以有效地提高罗汉果的提取率。     

No effects of enhanced central norepinephrine on finger-sequence learning and attention

Rationale When paired with training, substances that increase monoaminergic transmission in the brain support motor and language learning in healthy subjects and in rehabilitation after brain lesions.Objectives To test the hypotheses that enhancement of central norepinephrine by the selective norepinephrine reuptake inhibitor reboxetine (1) improves skilled motor performance, (2) promotes skilled motor learning, and (3) does not exert these effects by modulation of attention.Methods In a double blind, placebo-controlled, crossover study in healthy, adult subjects (n=16), finger-sequence performance and learning was measured after the stimulation of the central noradrenergic system with a single dose (8 mg) of reboxetine and placebo. Effects on attention were assessed by the standardized continuous performance test “CPT-M”.Results No differential effects of reboxetine or placebo on finger-sequence performance, learning and parameters of attention were found.Conclusion Selective stimulation of the central noradrenergic system did not promote skilled motor learning or performance as assessed by finger-sequences. The plasticity-enhancing effect of reboxetine, documented in other studies, appears to be dependent on specific neurophysiological and neuropsychological characteristics of the task, and cannot be generalized to other behavioral paradigms.     

黄杨宁改进片增加动物冠脉流量和抗心律失常作用

目的：比较黄杨宁改进片和黄杨宁片对心血管系统的作用。方法：猫经心房直接插管,测量静脉窦的血流量以反映冠脉流量;利用垂体后叶素引起心肌急性缺血,观察黄杨宁改进片对心电图ST段改变的影响;观察黄杨宁改进片对乌头碱诱发的心律失常的作用。结果：①经胃直接给予黄杨宁改进片4mg/kg能显著提高猫冠脉流量,其峰值在给药后的min3,作用维持10min左右;2mg/kg黄杨宁改进片对冠脉流量的作用仅在给药后的min5-8时有显著意义。黄杨宁片4mg/kg也有作用,其效果虽小于同等剂量的黄杨宁改进片,但无统计学意义;②经胃直接给予黄杨宁片能减少由垂体后叶素引起的心电图ST段抬高。黄杨宁改进片5mg/kg组在15s时起效并维持3min,2.5mg/kg黄杨宁改进片组和5mg/kg黄杨宁片在30s时起效,分别维持2min和1min;③经胃直接给予黄杨宁改进片2.5,5mg/kg和黄杨宁片5mg/kg均能显著缩短由乌头碱诱发的心率失常持续时间,同等剂量下,黄杨宁改进片缩短心律失常时间与黄杨宁片有显著差异。结论：黄杨宁改进片能增加冠脉流量,对抗垂体后叶素引起的心电图ST段改变,有抗心律失常作用。与黄杨宁片相比,在同等剂量下,黄杨宁改进片的起效快,作用强。     

Beverage-induced enhanced bioavailability of carbamazepine and its consequent effect on antiepileptic activity and toxicity

The present study was undertaken to investigate the food–drug interaction of carbamazepine (CBZ). Common fruit juices [grapefruit juice (GFJ), lime juice (LJ)], known to inhibit the enzyme cytochrome P450 3A4 (CYP3A4), and some widely consumed beverages [milk (M), black tea (BT)] were involved in this study in the presence of CBZ, as might happen during clinical therapy. The effects of the beverages on the pharmacokinetics and drug-induced toxicity of CBZ was observed after concomitant administration for a period of 28 days. Accordingly, the influence of altered bioavailability of CBZ on its antiepileptic activity was investigated. A significant shift in the C_max as well as T_max of CBZ was observed in the presence of LJ and GFJ. This increase in bioavailability significantly enhanced hepatotoxicity and delayed the onset of tremor and piloerection against pentylene tetrazole (PTZ)-induced seizure in experimental animals. However, increased toxicity of CBZ was found to be absent with BT. Thus, from our observation, LJ or GFJ in the presence of CBZ significantly increased the bioavailability of CBZ, which might lead to increased toxicity and antiepileptic activity of the drug.     

Synergistic effect of propranolol and quipazine on desipramine enhanced shock-elicited fighting in rats

Changes in shock-elicited fighting (SEF) were measured following single or repeated injections (IP) of dl-propranolol (5 mg/kg, 20 mg/kg) or quipazine (1.25 mg/kg, 2.5 mg/kg) given either alone or in combination to saline or desipramine (DMI) (10 mg/kg) treated rats. DMI + propranolol (20 mg/kg) caused a greater increase in fighting than DMI + saline 18 hours after last dose. Propranolol (20 mg/kg) produced an equal inhibition in both of these groups at 15 min. Propranolol (5 mg/kg) had no effect. Quipazine (2.5 mg/kg) failed to alter DMI induced increase in SEF. The combination of propranolol (5 mg/kg) + quipazine (1.25 mg/kg) blocked the enhanced SEF significantly in DMI treated rats in comparison to DMI + saline treated group. This combination of propranolol + quipazine produced no significant change in SEF in saline treated group in comparison to the pretest level. These results suggested that propranolol + quipazine act synergistically at low doses to inhibit the increased SEF seen in DMI treated rats and might have therapeutic implications for the management of irritable aggression or mania.     

Structure-function studies of human interferons-alpha: enhanced activity on human and murine cells

To identify functionally important regions of the human interferon (IFN)-alpha molecule, mutagenesis in vitro of human IFN-a genes was used to create analogs with deletions or specific amino acid replacements. These analogs were expressed in vitro using SP6 RNA polymerase and a rabbit reticulocyte lysate protein synthesis system. Deletion of 7 highly conserved hydrophilic amino acids from the C-terminus of human IFN-alpha 4 reduced, but did not abolish, antiviral activity on human cells. However, analogs with deletions of 15 or 25 amino acids from the C-terminus, or 28 amino acids from the N-terminus, had no measurable antiviral activity. The antiviral activity of human IFN-alpha 4 was increased by substitution of cysteine for serine at position 86, and lysine for arginine at position 121. However, other amino acid substitutions at positions 121, 122 or 123 reduced antiviral activity. The size of the side chain of the amino acid residue at position 130 was shown to be important. Replacement of the absolutely conserved leucine residue at position 131 with glutamine had little effect on antiviral activity. However, the introduction of a proline residue at this position abolished antiviral activity, probably due to the formation of a beta turn in the polypeptide chain. The antiviral activity of human IFN-alpha 4 on murine cells was increased by substitutions at positions 86, 121 and 133. This study illustrates the utility of the in vitro mutagenesis and rabbit reticulocyte lysate systems for the investigation of structure-function relationships, and extends our knowledge of the biologically active regions and species specificity of the human IFN-alpha molecule.     

加速康复外科对剖宫产产妇术后康复和并发症的影响

目的 探讨加速康复外科(ERAS)对剖宫产产妇术后恢复和并发症的影响.方法 将安徽省立医院产科2019年3、5月份收治的154例选择性剖宫产的产妇根据时间段分组,3月收治的剖宫产产妇作为常规组(n=77例),5月份为ERAS组(n=77例),比较两组的术后恢复及并发症情况.结果 较于常规组,ERAS组在术后首次排尿时间[9.4(7.71,11.72)h比20.50(18.13,23.69)h]、首次下床活动时间[9.25(7.58,11.13)h比20(17.34,22.38)h]、肛门排气时间[38(20.88,51)h比44.62(33.28,53.40)h]均提前,术后3 d切口疼痛减轻[1(1,2)分比2(1,2)分]、术后24 h出血量[265(240,300)mL比285(250,345)mL]减少、术后住院天数缩短[4(3,4)d比4(4,5)d],均差异有统计学意义(P<0.05).结论 ERAS可加快剖宫产术患者术后快速康复,缩短住院时间,且未增加并发症的风险,建议在临床进一步推广.     

Financing and cost of standard and enhanced methadone treatment

Although some national surveys of drug-abuse treatment have examined cost and financing issues, our study is one of the first to rigorously analyze the costs and financing of methadone treatment at the program level. Our findings are similar to those found at the national level for treatment cost but deviate significantly from the National Drug and Alcoholism Treatment Unit Survey (NDATUS) findings on funding sources. In addition to examining financing and total cost, we grouped resources into particular categories and examined variations at the client, program, regimen, and setting levels. Our specific findings show that public funding sources overwhelmingly support the programs examined; the average annual cost per client for standard methadone treatment was between $3,750 and $4,400; the marginal cost of providing enhanced treatment was between 5% and 6% of the total annual cost of standard treatment; and the average annual cost at the freestanding community-based programs was significantly different from the average annual cost at the hospital-based treatment program. Our results provide a treatment cost methodology along with a financial profile of treatment operations at three clinics that can be compared across programs and settings.     

Effects of saikosaponin-d on enhanced CCl4-hepatotoxicity by phenobarbitone

The effects of saikosaponin-d extracted from the roots of Buplerum falcatum L. on increased toxicity of CCl4 and increased activities of microsomal enzymes induced by phenobarbitone have been examined. Saikosaponin-d showed protection against the CCl4-hepatotoxicity enhanced by phenobarbitone. It also inhibited increases in the content of cytochrome P450 and NADPH-cytochrome c reductase activity, which are induced by the phenobarbitone treatment, but the spectral characteristics of P450 were not altered. The rate of microsomal lipid peroxidation by NADPH and CCl4 was significantly lowered in-vitro in rats pretreated with phenobarbitone and saikosaponin-d compared with those pretreated with phenobarbitone alone.