ObjectiveTo systematically evaluate the efficacy of mirror therapy for phantom limb sensation and phantom limb pain in amputee. MethodsDatabases include PubMed, EMbase, The Cochrane Library (Issue 9, 2015), CBM, CNKI, VIP and WanFang Data were searched to collect randomized controlled trials (RCTs) about mirror therapy for phantom limb sensation and phantom limb pain in amputee from inception to 1st Sept. 2015. Two reviewers independently screened literature, extracted data and assessed the methodological quality of included studies. Then metaanalysis was performed using RevMan 5.3 software. ResultsA total of 5 RCTs involving 129 patients were included. The results of meta-analysis showed that, there was no significant difference between the mirror therapy group and the control group in relieving the phantom limb sensation and phantom limb pain in amputee (MD=-7.29, 95%CI -27.73 to 13.16, P=0.48). ConclusionMirror therapy could improve the control of phantom limb, however, there is no sufficient evidence to support the effect of mirror therapy on pain management in amputee. The long-term effect of mirror therapy is still under exploration. Due to the limited quantity and quality of the included studies, larger-sample, high quality designed RCTs are needed to verify the above conclusion.
ObjectivesTo investigate the influence of scanning parameters (tube voltages and tube currents) on image quality and corresponding radiation doses with simulated lung nodules in chest CT.MethodsThe anthropomorphic chest phantoms with 12 simulated, randomly placed nodules of different diameters and densities in the chest were scanned by different scanning parameters. The detection rate, degree of nodular deformation, image quality (with both subjective and objective evaluation) and the corresponding radiation doses were recorded and evaluated, and the correlation between nodule detection rate, degree of nodular deformation, radiation dose and image quality using different scanning parameters was analyzed.ResultsThe image quality improved with the increase of tube voltage and tube current (P<0.05). When the tube current was constant, the CT values of the vertebral decreased gradually with the increase of tube voltages (P<0.05); however, significant difference was not detected in CT values of the lung field (P>0.05). When the tube current was 100 mAs, the lung nodules with CT values of +100 HU and −630 HU showed statistical difference when using different tube voltage (P<0.05); but there was no significant difference in nodules of −800 HU (P=0.57). When tube voltage was 100 kV and 120 kV each, it was possible to detect all lung nodules with a detection rate of 100%. The detection rate was 33% and 66% in 3 mm diameter when the tube current was 80 kV/15 mA and 80 kV/20 mA, respectively. The nodules deformation in nodules with a CT value of −630 HU and diameter less than 5 mm was the most prominent (P<0.05). After analyzing the relationship between image quality and radiation doses using different tube voltages, we established a system of correlation equations: 80 kV: Y=2.625X+0.038; 100 kV: Y=14.66X+0.158; 120 kV: Y=18.59X+0.093.ConclusionsThe image quality improves with the increase of tube current and tube voltage, as well as the corresponding radiation doses. By reducing the tube voltage and increasing the tube current appropriately, the radiation doses can be reduced. Follow-up CT examination of pulmonary ground glass nodules should apply the same tube voltage imaging parameters, so as to effectively reduce the measurement error of nodule density and evaluate the change of nodules more accurately.