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ObjectiveTo investigate the application value of liver/spleen CT value （CTL/S）， controlled attenuation parameter （CAP）， and magnetic resonance imaging-proton density fat fraction （MRI-PDFF） in chronic hepatitis B （CHB） patients with hepatic steatosis. MethodsA retrospective analysis was performed for the clinical data of 213 CHB patients who underwent liver CT， CAP， and MRI-PDFF examinations in Affiliated Hospital of Yan’an University from October 2018 to December 2022. According to MRI-PDFF， the 213 patients were divided into CHB group with 111 patients （MRI-PDFF<5%） and CHB+hepatic steatosis group with 102 patients （MRI-PDFF≥5%）， among whom there were 69 patients with mild hepatic steatosis and 33 patients with moderate to severe hepatic steatosis. The independent-samples t test was used for comparison of normally distributed continuous data between groups， and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between groups. The Bland-Altman plot was used to evaluate the consistency in MRI-PDFF measurement between two physicians. The Spearman’s correlation coefficient was used to analyze the correlation between CTL/S and MRI-PDFF and between CAP and MRI-PDFF. The receiver operating characteristic （ROC） curve was plotted and the area under the ROC curve （AUC） was calculated to investigate the value of CTL/S and CAP in the diagnosis of different degrees of hepatic steatosis， and the DeLong test was used to compare the AUCs of the two radiological examinations. ResultsMRI-PDFF had relatively high repeatability and stability in CHB patients. There is a significant negative correlation between CTL/S and MRI-PDFF （r=-0.800， P<0.001） and a significant positive correlation between CAP and MRI-PDFF （r=0.692， P<0.001）. Both CTL/S and CAP had a relatively high accuracy in the diagnosis of hepatic steatosis in CHB patients， with an AUC of 0.951 and 0.902， respectively， and CTL/S had a better accuracy than CAP （P<0.05）. In the diagnosis of mild and moderate-to-severe hepatic steatosis， CTL/S had an AUC of 0.921 and 0.895， respectively， and CAP had an AUC of 0.859 and 0.825， respectively， suggesting that CTL/S had a slightly higher diagnostic efficiency than CAP. ConclusionMRI-PDFF has high repeatability and stability in CHB patients， and CTL/S and CAP have a high diagnostic value for different degrees of hepatic steatosis in CHB patients.
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Objective:To investigate the risk factors of acute biliopancreatic complica-tions in patients of pregnancy combined with gallbladder stone and construction of prediction model.Methods:The retrospective case-control study was constructed. The clinical data of 98 patients of pregnancy combined with gallbladder stone who were admitted to the First Hospital of Lanzhou University from September 2011 to October 2022 and 53 patients of pregnancy combined with gallbladder stone who were admitted to Gansu Provincial Hospital May 2014 to October 2021 were collected. The age of 151 patients was 29(25,32)years. Observation indicators: (1) situations of patients of pregnancy combined with gallbladder stone; (2) risk factors of acute biliopancreatic com-plications in patients of pregnancy combined with gallbladder stone; (3) construction of prediction model for acute biliopancreatic complications in patients of pregnancy combined with gallbladder stone. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the independent t test. Measurement data with skewed distribution were represented as M( Q1, Q3), and comparison between groups was conducted using the Mann-Whitney U test. Count data were described as absolute numbers, and comparison between groups was conducted using the chi-square test. Comparison of ordinal data was conducted using the rank sum test. Univariate and multi-variate analyses were conducted using the Logistic regression model. Nomogram prediction model was conducted, and the receiver operating characteristic (ROC) curve was used to evaluate discri-mination of the nomogram predic-tion model. The calibration curve and clinical decision curve were used to evaluate calibration and net clinical benefit of the nomogram prediction model. Internal validation of the prediction model was performed by applying 10-fold cross-validation. Results:(1) Situations of patients of pregnancy combined with gallbladder stone. The total cholesterol, triglyceride, high density lipoprotein cholesterol, low density lipoprotein cholesterol, prepregnancy body mass index (<18.5 kg/m 2, 18.5?24.0 kg/m 2, >24.0 kg/m 2), gesta-tional period (early, mid, late), primipara (positive, negative), stone type (solitary, non solitary), diameter of stone (≤10 mm, >10 mm), gallbladder wall thickness (≥4 mm, <4 mm) were (4.9±1.4)mmol/L, 1.88(1.22,2.93)mmol/L, 1.48(1.22,1.83)mmol/L, (2.8±0.9)mmol/L, 13, 75, 58, 37, 45, 69, 86, 65, 37, 114, 89, 62, 38, 113 in the 151 patients of pregnancy combined with gallbladder stone. Of the 151 patients, the age, prepregnancy body mass index (<18.5 kg/m 2, 18.5?24.0 kg/m 2, >24.0 kg/m 2), primipara (positive, negative), stone type (solitary, non solitary), diameter of stone (≤10 mm, >10 mm), gallbladder wall thickness (≥4 mm, <4 mm) were 31(28,37)years, 3, 30, 36, 29, 40, 32, 37, 26, 43, 4, 65 in 69 cases without symptom, versus 27(24,31)years, 10, 45, 22, 57, 25, 5, 77, 63, 19, 34, 48 in 82 cases combined with acute biliopancreatic complications, showing significant differences in the above indicators between them ( Z=?3.636, ?2.385, χ2=11.544, 32.862, 23.729, 25.310, P<0.05). Five of the 82 patients of pregnancy combined with gallbladder stone missed data of prepregnancy body mass index. Of the 82 patients, there were 42 patients of simple acute cholecystitis, 40 patients of common bile duct stone and/or acute biliary pancreatitis including 18 cases of common bile duct stone, 13 cases of acute biliary pancreatitis and 9 cases of common bile duct stone combined with acute biliary pancreatitis. (2) Risk factors of acute biliopancreatic complications in patients of pregnancy combined with gallbladder stone. Results of multivariate analysis showed that primipara, non solitary stone, diameter of stone ≤10 mm, gallbladder wall thickness ≥4 mm were independent risk factors of acute biliopancreatic complications in patients of pregnancy combined with gallbladder stone ( odds ratio=3.102, 6.305, 3.674, 6.686, 95% confidence interval as 1.280?7.519, 1.886?21.080, 1.457?9.265, 1.984?22.528, P<0.05). Results of multivariate analysis in further analysis showed that primipara, non solitary stone, gallbladder wall thickness ≥4 mm were independent risk factors of simple acute cholecystitis in patients of pregnancy combined with gallbladder stone ( odds ratio=3.671, 8.905, 7.137, 95% confidence interval as 1.386?9.723, 2.332?34.006, 1.902?26.773, P<0.05), and age, non solitary stone, diameter of stone ≤10 mm, gallbladder wall thickness ≥4 mm were independent risk factors of common bile duct stone and/or acute biliary pancreatitis in patients of pregnancy combined with gallbladder stone ( odds ratio=0.883, 5.361, 5.472, 8.895, 95% confidence interval as 0.789?0.988, 1.062?27.071, 1.590?18.827, 2.064?38.325, P<0.05). (3) Construction of prediction model for acute biliopancreatic complications in patients of pregnancy combined with gallbladder stone. The nomogram prediction model for acute biliopancreatic complications in patients of pregnancy combined with gallbladder stone was constructed based on the clinical factors of age, primipara, stone type, diameter of stone and gallbladder wall thickness. The area under the curve (AUC) of ROC curve of prediction model was 0.869 (95% confidence interval as 0.813?0.923), indicating that the prediction model with good predictive ability. Results of Hosmer-Lemeshow test showed a good fit ( χ2=5.680, P>0.05), indicating that the prediction model with good calibration. Results of decision curve analysis showed the prediction model with high net clinical benefit. Results of internal validation of the prediction model based on 10-fold cross-validation showed the AUC of ROC curve for the cross-validation sample was 0.833, indicating that the prediction model with good stability. Conclusions:Primigravida, non solitary stone, diameter of stone ≤10 mm, gallbladder wall thickness ≥4 mm are independent risk factors of acute biliopancreatic complications in patients of pregnancy combined with gallbladder stone. The prediction model for acute biliopancreatic complications has good predictive ability.
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Objective To perform 3D dose reconstruction based on electronic portal imaging device ( EPID) of linear accelerator for the static intensity-modulated using Edose, a dose verification system, Aiming to assist the radiotherapy professionals to better understand the radiotherapy organs at risk and target dose changes. Methods CBCT image was acquired for patients with head and neck cancer and thoracic cancer once a week for a total of six times. Subsequently,CBCT images and planning CT images were subject to rigid registration and exported to the Edose software. According to the setup error, EPID-based three-dimensional dose reconstruction was performed by using Edose software. The gamma passing rate and dose of different organs at risk ( OARs ) were analyzed and statistically compared. Results For patients with nasopharyngeal carcinoma,the intra-fractional Dmax of the spinal cord was more significantly fluctuated and higher compared with the planning dose, whereas the intra-fractional Dmax of the brainstem did not significantly fluctuate. The V30 of the parotid gland significantly changed with a maximum increase of 28. 69％ per fraction. For patients with thoracic tumors,the Dmax of the spinal cord was slightly changed,and the actual doses in the lung and heart were higher than the planning doses. The average deviation of the pulmonary V5 was up to 16. 99％ between the actual and planning doses with statistical significance ( P<0. 05).According to the analysis of gamma passing rate,significant dose changes occurring in the OARs were detected in the 16th fraction for the head and neck cancer and the 24th fraction for the thoracic neoplasms. Conclusions The dose changes in the OARs can be obtained by reconstructing the EPID-based 3D dose distribution using the Edose software for each fraction, which can better protect the OAR, enhance the coverage of target dose and provide certain reference for dose-guided and self-adaptive radiotherapy.
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Objective To evaluate the clinical efficacy between stereotactic body radiotherapy (SBRT) and surgical treatment for stage Ⅰ-Ⅱ non-small cell lung cancer (NSCLC).Methods Clinical data of 120 patients with early-stage NSCLC who underwent SBRT or surgical treatment in Zhejiang Cancer Hospital from 2012 to 2015 were retrospectively analyzed.Propensity score matching was carried out between two groups.Sixty eligible patients were enrolled in each group.In the SBRT group,the 80％ isodose line covered 95％ of the planning target volume,and the 100％ isodose line covered 100％ of the internal gross tumor volume.The fractional dose was 5-15 Gy and the median biologically equivalent dose was 100 Gy (range:57.6-150.0 Gy).In the operation group,32 patients underwent video-assisted thoracoscopic lobectomy and 9 patients underwent wedge resection or segmentectomy.Results All patients successfully completed corresponding treatment and were followed up.The median follow-up was 32.3 months (range:8.6-68.4 months).In the operation group,3 patients died from infection within postoperative 90 d,whereas no case died in the SBRT group (P=0.079).In the SBRT group,3 patients died of other factors besides tumor (cerebral infarction,heart disease,etc.) during follow-up.Local-regional recurrence occurred in 12 patients including 5 cases in the operation group and 7 in the SBRT group (P=0.543).In the operation group,11 patients experienced distant metastases with a median disease-free survival (DFS) of 33.5 months.In the SBRT group,6 patients had distant metastases and the median DFS was 38.4 months (P=0.835,P=0.178).In the SBRT group,the 1-and 3-year overall survival rates were 93％ and 83％,and 95％ and 83％ in the operation group (P=0.993).Conclusions The 1-and 3-year overall survival rates and local control rate do not significantly differ between SBRT and operation for patients with early-stage NSCLC.
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Objective To evaluate the safety and clinical efficacy of stereotactic body radiation therapy (SBRT) for lung cancer.Methods A retrospective analysis was performed on 200 patients with primary non-small cell lung cancer (NSCLC)(118 patients) or solitary pulmonary metastasis (82 patients) who underwent SBRT in Zhejiang Cancer Hospital from January 2012 to September 2015.The 80% isodose line covered 95% of the planning target volume,and the 100% isodose line covered 100% of the internal gross tumor volume.The fractional dose was 4.0-18.0 Gy daily or every other day,and the biologically equivalent dose ranged from 40.0 to 151.2 Gy (median 100 Gy).Results All patients completed treatment.The follow-up rate was 96.0%.The complete response and partial response rates were 14.8%(17/115) and 65.2%(75/115) for the primary tumor group,versus 25%(19/77) and 38%(29/77) for the metastasis group.The incidence rates of grade Ⅱ and Ⅲ acute radiation pneumonitis were 4.7% and 3.1%,respectively.The median follow-up was 14.9 months.The 1-and 2-year local control rates were 95.7% and 84.3% for the primary tumor group,versus 92% and 73% for the metastasis group.The 1-and 2-year overall survival rates were 94.5% and 92.0% for the primary tumor group,versus 85% and 62% for the metastasis group.Conclusions SBRT is a safe and effective treatment for early primary NSCLC and solitary pulmonary metastasis,resulting in high 1-and 2-year local control and overall survival rates and low rate of complications.
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Gas chromatography with mass spectrum detector ( GC-MSD) coupled with purge-and-trap system was set up to analyze the concentration of isoprene in natural waters. The best experimental conditions were established, including purge gas flow rate ( 50 mL/min ) , purge time ( 15 min ) , the optimum capillary column ( Rt-Alumina BOND/KCl) and the appropriate condition of temperature programming. When analyzing isoprene in natural waters, the precision was <4% (n=6), the detection limit was 0. 5 pmol/L and the recovery was 91%-102%. The preservative experiment showed that there was no obvious variation in sample concentrations of isoprene within 60 days. The concentrations of isoprene measured with the method ranged from 60 . 8 to 278 . 7 pmol/L in the Jiaozhou Bay and its adjacent river estuaries and from 44 . 7 to 77 . 2 pmol/L in Yellow River estuary, which was in good accord with those results reported in literatures in other coastal waters. In conclusion, the analytical method could meet the requirements of the analysis of concentration of isoprene in natural waters.
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Objective To study the treatment of highly active antiretroviral therapy (HAART) in patients with HIV infection and AIDS and the patients′ survival time after HAART treatment. Methods Three thousand and one hundred cases of HIV infection and AIDS patients received HAART in 12 months by monthly flow cytometry instrument MultiSET absolute counting method detecting the CD4+T cell levels, bDNA method (detection range 1.60 log ~ 6.10 log RNA copies/mL) detecting serum HIV-1 viral load under rigorous clinical observation. Results Twelve months after treatment, the CD4+T cell count increased an average of 430 × 106/L (P < 0.01). Eight months after treatment, all viral loads reached their measurable levels (below 1.70 log copies/mL) by decreasing 45 log copies/mL on average. Conclusion HIV/AIDS patients showed treatment extremely significant possitive responses to highly active antiretroviral therapy. The patients′ survival rate after treatment has greatly improved compare to that in previous literature.
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BACKGROUND:The template method used in cementless total hip arthroplasty is influenced by many factors,so the accuracy is poor.Studies demonstrated that femoral isthmus plays an important role in total hip arthroplasty,which affect femoral prosthesis.OBJECTIVE:To discuss the effects of femoral isthmus on cementless total hip arthroplasty.METHODS:The images of 4 cadaver femoral isthmus were obtained by computer tomography.The relations between femoral component and cortical bone contact were observed on coronal slices by sawing manully.The longest and the smallest medullary canal dimensions and the cortical thickness of femoral isthmus were measured by CT films from 50 patients (55 hips) prepared forprimary total hip arthroplasty.The size of prosthesis was predicted based on the smallest medullary canal dimension of isthmus.And the conventional preoperative template was served as control.RESULTS AND CONCLUSION:There were a press fit and good contact between the femoral component and cortical bone of isthmus in 3 cadaver femoral bones.In 50 patients,the longest medullary canal dimensions of femoral isthmus were 8.2-22.4 mm(mean 14.2±3.1 ram).The smallest medullary canal dimensions of femoral isthmus were 6.1-17.9 mm[mean (10.2±2.9) mm],and the cortical thickness of femoral isthmus were 2.7-12.7 mm[mean (7.5±1.8) mm].The results of CT-isthmus measurement method predicted sizes were excellence in the 50.9% cases.There was statistically significant difference of predicted sizesbetween the excellence rate of CT-isthmus measurement method and the rate of control (P＜0.05).Particularly,the excellence rate of CT-isthmus measurement method was 63.9% in the group aged below or equal to 65 years.When the ratio of the longest medullary canal dimensions and the smallest medullary canal dimensions of femoral isthmus was large than or equal to 1.4,the excellence rate of CT-isthmus measurement method was 70%.The press fit and good contact between the femoral component and femoral isthmus plays a very important role in stabilizing of femoral prosthesis in total hip arthroplasty.The predicted sizes of femoral prosthesis depending on the medullary canal dimensions of femoral isthmus measured by CT film has better accuracy than the conventional preoperative template.
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To study the effect of exogenous oxygen, we added water solution of paraquat to 7 d cultures of Coriolus versicolor for the next 148 h. Enzyme exudation and biochemical process were investigated on the addition of paraquat. We found that compared with the control (without paraquat), the addition of 30 micromol/L paraquat stimulated the activity of manganese dependent peroxidase (MnP), lignin peroxidase (LiP), and laccases (Lac) 7, 2.5 and 1.3 times, respectively. Also, addition of paraquat enhanced activity of superoxide dismutase (SOD) and catalase (CAT) in the first 48 h. Impact of paraquat on ligninolytic enzymes was significant than that on antioxidant enzyme. Addition of paraquat enhanced phenolic compounds and formaldehyde of cultures too. And concentration of malondialdehyde was increased in the first 24 h. The results showed that addition of paraquat promoted oxidative stress, but the antioxidant systems of the fungal strain are sufficient to prevent mycelia from oxidative stress. As exogenous oxygen, paraquat might be a useful substrate in degradation of lignocellulose.
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Fungi , Lignin , Metabolism , Oxidative Stress , Paraquat , Pharmacology , Peroxidases , MetabolismABSTRACT
Objective To evaluate the MRI and CT representations and their valuation of intraeranial dermoid cyst. Methods 23 cases who suffered from intracranial dermoid cyst confirmed by pathology were included retrospectively. The MRI and CT representations, and the pathological and clinical characteristics were analyzed.All the cases were performed with MRI, and 20 cases were performed with CT at the same time. Results 22 cases showed inhomogeneous high signal intensity in T1WI and T2WI, 1 cases showed iso-high signal intensity in T1WI and low signal intensity in T2WI. 8 cases showed plaque-like inhomogeneous high signal intensity in DWI. 19 cases showed homogeneous low density in CT scans with standard window width and level ,amt showed inhomogeneous low density with large window width and low window level. One case showed high density in CT scans with standard window width and level. Fat drop in subrachnoid space and bilateral cerebral ventricle and interstitial brain edema were found in 8 cases with MRI and CT. Conclusion Intracranial dermoid cyst always have typical MRI and CT representations. Distinctive representations could be found when the rupture of dermoid cyst exist, and correct diagnosis could be made before operation. MRI is better than CT in the diagnosis of dermoid cyst.
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Objective To investigate the value of application of multi-slice helical CT(MSCT) indiagnosis of basicranial fracture. Methods Sixty-two patients with basicranial fracture were scanned withthin-section scanning mode after conventional CT scanning The images were transferred to the work-station for reconstruction including multiplanar reconstruction (MPR), volume rendering (VR). Comparison between thin-section scanning images and conventional CT scanning images were performed. Results Compared with the conventional CT scanning (67.9% and 45.0% respectively),the rates of fracture displayed of images acquired from thin-section scanning in diagnosis of fractures of anterior and middle cranial fossa (100.0% and 95.0% respectively) ,P＜0.01. The two scanning mode in diagnosis of fractures of posterior cranial fossa( 88.9% and 100.0% respectively )differed from each other unstatistically(P＞0.05 ). ConclusionThe thin-section scanning of MSCT can improve the diagnostic correctness of basicranial fracture.
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Objective To evaluate magnetic resonance angiography(MRA) and diffusion weighted imaging(DWI) features of transient ischemic attacks(TIA).Methods 40 patients with TIA were chosen as study subjects,and 34 healthy adults and 36 cases with brain infarction were randomly chosen as control subjects.MRA and DWI was performed with a superconductive GE 1.5T system.The relationship between TIA and the degree and distribution of stenosis of cranial and cervical arteries,the development of the vessels,DWI findings of the brain was analyzed.Results There were significant differences among the three groups in the number and the degree of stenosis of cranial and cervical arteries(P=0.006).The stenosis and occlusion of arteries were severe in the patients with TIA and brain infarctions than that in healthy adults(P=0.004,0.015),but there were no significant differences between TIA and brain infarctions(P=0.148).The incidence of dysplasia of unilateral vertebral arteries(VA) in TIA was higher than that in the normal subjects(P=0.039).The internal carotid artery(ICA)system supplying to the regions of brain tended to show more ischemic focus on DWI(4/8,50%) in the cases with TIA.Conclusion Severe stenosis or occlusion and irregular filling defects of cervical and cranial arteries in patients with TIA might be one of the risk factors for severe ischemia stroke.The hypoplastic VA was one of predisposing factor for TIA.
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Objective To probe imaging manifestations of bronchogenic cysts,as that to improve the knowledge of this disease.Methods Imaging features of congenital bronchial cyst in 32 cases confirmed by operation and pathology were analyzed.Results 4 cases of cyst localized in mediastinum ,all were liquid cyst.28 cases of cyst localized in lungs,aqmong them,22 cases were air-liquid cyst and 6 cases were air cyst,the diameter of lesions was 1~10 cm,there were 2 cases with pyothorax,4 cases with pulmonary maldevelopment,one case with brochio-pleural fistula.The cysts appeared as round or similar round,the walls of cyst was thin.The wall of cyst was obscure and there was infiltrating shadow around cysts when in company with infection.Conclusion X-ray and CT are very important in diagnosing congenital bronchial cysts,CT scan is of very help in diagnosing the compley cysts.