Objective
To evaluate the feasibility of CT angiography of pediatric complex congenital heart disease by using radiation dose and isotonic contrast agent dose combined with iDose4 iterative reconstruction technique.
Methods
Prospectively, a total of 57 continuous patients with suspected congenital heart disease under or equal to 2 years old in our hospital between Mar 2016 and Jan 2017 were divided into 2 groups according to the reservation number. double low group included 32 patients using 80 kVp, 80 mAs, Iodixanol (270 mg I/ml) and iDose4 - 4iterative reconstruction algorithm; routine group included 25 patients using 100 kVp, 100 mAs, Iopromide (370 mg I/ml) and filtered back projection algorithm. Individualized injections were taken on the weight of children and the iodine intake was calculated. CT values of left atrium, left ventricle, right atrium, right ventricle, ascending and descending aorta at the level of tracheal bifurcation, midpoint of aortic arch, pulmonary trunk, left and right pulmonary artery, pectoralis major and erector spinae on both sides as well as background noise at the level of aortic arch were measured, and signal to noise ratios (SNR) and contrast to noise ratios (CNR) were calculated. The quality of all images was evaluated subjectively. Scan length (L), volume CT dose index (CTDIvol) and dose-length-product (DLP) were recorded, and the effective dose (E) and size-specific dose estimate (SSDE) were calculated. The diagnostic coincidence rates for CTA examinations of these two groups were calculated and compared with the surgery or cardiac catheterization examination called the gold standard .
Results
The iodine intake of double low group and routine group was (2.53±1.09) and (3.46±1.29)g, respectively, with statistically significant difference (t=2.976, P 0.05). The consistency of subjective evaluation for image quality of the two groups was good(Kappa=0.55, 0.76). Compared with routine group, CTDIvol, SSDE, DLP, E of double group descended by 57.19%, 56.71%, 56.74%, 53.33% respectively (t=54.107, 28.269, 15.338, 11.441, P 0.05).
Conclusions
Using 80 kVp, 80 mAs and Iodixanol (270 mg I/ml) combined with iDose4 iterative reconstruction technique for CT angiography of pediatric complex congenital heart disease, the image quality could meet the requirements for clinical diagnosis, and the radiation dose and the iodine dose of contrast agent could be lowered.
Trial registration
Chinese clinical trial registry, ChiCTR1800016576.
Key words:
Low dose; Congenital heart disease; Tomography, X-ray computed; Iterative reconstruction; Contrast agent
Objective:To observe the clinical application of Shenlingbaizhu powder in the rehabilitation therapy of patients after obstetric and gynecological abdominal surgery.Methods:100 patients undergoing obstetric and gynecological abdominal surgery were divided into observation group(50 cases) and control group(50 cases) randomly,all the cases received anti-infection and fluid replacement treatment.On the second day after surgery,the cases in observation group were administrated Shenlingbaizhu powder orally.The levels of C-reactive protein,IgA,IgG,IgM and symptomatic score of splenic asthenia were observed pre-operative and post-operative 24 hours and the fifth day after surgery.Results:Shenlingbaizhu powder improved the symptomatic score of splenic asthenia and the IgM level in peripheral blood,reduced the C-reactive protein level,but the levels of alexin3,alexin4,IgA and IgG changed indistinctively before and after the surgery.Conclusion:Shenlingbaizhu powder can improve the symptomatic score of splenic asthenia and immunity of patients,relieve the posttraumatic stress and immunosuppressive reaction.
Corridor" along the "One Belt One Road" In nowadays context of global economic integration, China has proposed the "One Belt One Road" Strategy in 2014, which fits into the new changes in global economy and finds us a new growth in economy development.This article has selected the panel data of 23 countries along the "new Eurasian Continental Bridge Economic Corridor" in 2002-2016 and analyzed the influences of one country's economic infrastructure and social infrastructure upon its national trades using the fixed effect model.The research result shows that the construction of energy infrastructure may produce less obvious negative effects on one country's national trade while the influences of the railway and aviation infrastructure will be varied because of the different natural endowments of the country.And one country's trade will increase as construction of communication infrastructure develops.For social infrastructure, the effects upon one country's trade are not obvious from education infrastructure construction, scientific research infrastructure construction, medical infrastructure construction and environmental infrastructure construction.
Purpose — To explore the differences in clinical characteristics of the first and second generation cases of COVID-19. Methods — 63 patients with COVID-19 and asymptomatic infections admitted to the Third People's Hospital of Wuhu City and the Fourth People's Hospital of Ma'anshan City from January 24, 2020 to March 3, 2020 were selected as the research objects. The patients were divided into the first and second generation case groups according to the history of epidemiology, and the differences of clinical data between the two groups were compared. Results — There was no significant difference between the two groups of patients in gender, age, and number of smokers (P>0.05). In the first generation group, the number of people with underlying diseases was lower than that in the second generation group (86.80%, 92.00%), and the number of patients of severe or critical type was higher than that in the second generation group (18.40%, 0.00%). The difference was statistically significant (P<0.05). The symptoms of the two groups were compared: fever (84.20%, 64.00%), cough (78.9%, 40.00%), chest tightness (44.70%, 12.00%), nausea (2.60%, 36.00%). The difference was statistically significant (P<0.05). The distribution of lesions in the two groups was compared: bilateral lung lesions (77.80%, 66.70%), unilateral lesions (17.80%, 5.50%), and no lesions (4.40%, 27.80%). The difference was statistically significant (P<0.05). There was no statistically significant difference between the two groups in laboratory tests (P>0.05). Conclusions — Compared with the first generation cases, the second generation cases have different degrees of relief in clinical classification, lower respiratory symptoms and the number of lung lesions; the differentiation of the transmission generation has a certain reference value for the evaluation of the disease condition.
Creativity has become prevalent in the routine work of knowledge employees in contemporary enterprises. From the perspective of ambidexterity, drawing upon expectancy theory and self-determination theory (SDT), the present study highlights the driver behind proactive and responsive creativity. Using two-stage longitudinal data collected from 373 knowledge employee-supervisor dyads in information and manufacturing companies in China, the results show that: (1) performance-contingent rewards have an inverted U-shaped influence on proactive creativity and a U-shaped influence on responsive creativity; (2) performance-contingent rewards have an inverted U-shaped influence on autonomous and controlled motivation; (3) autonomous motivation has a positive influence on proactive creativity, but controlled motivation has a negative influence on responsive creativity; (4) autonomous and controlled motivation play a partly mediating mechanism in the non-linear effects of performance-contingent rewards on proactive and responsive creativity, respectively. Managers should enhance the ambidextrous ability to deal with proactive and responsive creativity and establish an applied and dynamic policy of performance-contingent rewards intensity to drive ambidextrous creativity.
Objective
To explore the value of three-vessel and trachea(3VT) view plus aortic arch coronal section in ultrasonic diagnosis and classification of fetal right aortic arch(RAA).
Methods
Echocardiography data and follow-up results of 44 fetuses with RAA were retrospectively analyzed. Sonographic features on 3VT view and aortic arch coronal section were summarized.
Results
Among 44 fetuses with RAA, 27 cases(61.36%) were RAA with aberrant left subclavian artery(ALSA) and the left ductus arteriosus(LDA) connecting the ALSA and U-shaped vascular ring was formed; 17 cases(38.64%) were mirror right aortic arch(MRAA). Among 17 cases with MRAA, 3 cases were with LDA connecting the descending aorta(DAO) and U-shaped vascular ring was formed; 1 case was with LDA connecting the left innominate artery(LINA), 8 cases were with absent ductus arteriosus(ADA), 5 case were with right ductus arteriosus(RDA), no vascular ring was formed. Parts of MRAA were combined with other complex intracardiac abnormalities. RAA-ALSA-LDA were rarely combined with intracardiac abnormalities.
Conclusions
3VT view is simple and intuitive for diagnosing RAA. Aortic arch coronal section has great clinical value in determining the concrete type of RAA.
Key words:
Echocardiography; Fetus; Aortic disease; Three-vessel and trachea view; Aortic arch coronal section
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