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Objective:To investigate the clinical value of gadolinium ethoxybenzyl diethy-lanetriaminepentaacetic acid (Gd-EOB-DTPA) enhanced magnetic resonance imaging (MRI) in the preoperative diagnosis of macrotrabecular-massive hepatocellular carcinoma (MTM-HCC).Methods:The diagnostic test was conducted. The clinicopathological data of 150 HCC patients who were admitted to the First Affiliated Hospital of Army Medical University from January 2019 to December 2020 were collected. There were 116 males and 34 females, aged (53±10)years. There were 38 MTM-HCC patients and 112 non-macrotrabecular-massive hepatocellular carcinoma (nMTM-HCC) patients. All patients received Gd-EOB-DTPA enhanced MRI examination. Observation indicators: (1) clinicopathological features of MTM-HCC and nMTM-HCC; (2) imaging features of MTM-HCC and nMTM-HCC; (3) imaging features for diagnosis of MTM-HCC. The normality test of continuous data was analyzed by the Kolmogorov-Smirnov test. Measurement data with normal distribution and homoscedasticity were represented as Mean± SD, and comparison between groups was analyzed using the independent sample t test. Measurement data with skewed distribution were represented as M( P25, P75), and comparison between groups was analyzed using Mann-Whitney U test. Count data were described as absolute numbers, and comparison between groups was analyzed using the chi-square test. Multivariate analysis was conducted using the Logistic regression model. The receiver operating characteristic (ROC) curve was used to evaluate diagnostic value of indicators, and Delong test was used for comparison. Results:(1) Clinicopathological features of MTM-HCC and nMTM-HCC: the alpha-fetoprotein and cases with microvascular invasion were 329 μg/L(20 μg/L,1 034 μg/L) and 24 for MTM-HCC patients, versus 25 μg/L(8 μg/L,200 μg/L) and 31 for nMTM-HCC patients, showing significant differences between the two groups ( Z=-3.306, χ2=15.380, P<0.05). (2) Imaging features of MTM-HCC and nMTM-HCC: cases with regular morphology of tumor, intra-tumoral fat, arterial phase peritumoral enhancement, complete capsule, intratumoral necrosis or ischemia, peritumoral hypointense at hepatobiliary phase (HBP) were 6, 4, 20, 5, 28, 17 for MTM-HCC patients, versus 44, 40, 21, 43, 26, 11 for nMTM-HCC patients, showing significant differences between the two groups ( χ2=7.049, 8.684, 16.399, 8.303, 31.368, 22.783, P<0.05). (3) Imaging features for diagnosis of MTM-HCC. ① Results of multivariate analysis showed that intratumoral fat, intratumoral necrosis or ischemia were independent predictors for MTM-HCC ( hazard ratio=4.033,0.215, 95% confidence interval as 1.196-13.603, 0.079-0.588, P<0.05). ② Diagnostic efficacy: the arear under ROC curve, sensitivity and specificity of intratumoral fat combined with intratumoral necrosis or ischemia for diagnosis of MTM-HCC were 0.799(95% confidence interval as 0.718-0.880, P<0.05), 73.7%, 76.8%. The above indicators of intratumoral fat for diagnosis of MTM-HCC were 0.626(95% confidence interval as 0.530-0.721, P<0.05), 89.5%, 35.7%. The above indicators of intratumoral necrosis or ischemia for diagnosis of MTM-HCC were 0.752(95% confidence interval as 0.659-0.845, P<0.05), 73.7%, 76.8%. There were significant differences in the diagnostic efficacy between the intratumoral fat combined with intratumoral necrosis or ischemia and single intratumoral fat, between the intratumoral fat combined with intratumoral necrosis or ischemia and single intratumoral necrosis or ischemia, respectively ( P<0.05). Conclusions:Intratumoral fat, intratumoral necrosis or ischemia on Gd-EOB-DTPA MRI are independent predictors for MTM-HCC. The two combined features has higher diagnostic efficacy. Gd-EOB-DTPA MRI can be used for pre-operative diagnosis of MTM-HCC.
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Objective:To explore the effect of sequel reperfusion percutaneous coronary intervention (PCI) therapy on heart rate variability (HRV) during myocardial reperfusion in patients with acute ST segment elevation myocardial infarction(STEMI).Methods:With a randomly case controlled study method, 180 patients with STEMI in Yidu Central Hospital Affiliated to Weifang Medical College were selected as study objects, and they were randomly divided into two groups: sequel recanalization PCI(sPCI) group(observation group) and conventional primary PCI(pPCI) group(control group), with 90 cases in each grouop.The rate of SDNN<70 mm of the two groups and other indicators of HRV were observed at 14 d after successful PCI.Results:There was statistically significant difference between the two groups in MBG3(77.78% vs.63.33%, χ 2=4.51, P=0.03). There was statistically significant difference between the two groups in the incidence of SDNN<70 mm at 14 d after PCI(10.00% vs.23.33%, χ 2=5.69, P=0.02). If sequel recanalization PCI was served as a variable for predicting SDNN<70 mm, the results of Logistic regression analysis showed that odds ratio ( OR) value was 0.36, 95% confidence interval ( CI) was 0.16-0.85, P=0.02.The other factors that affected the incidence rate of SDNN<70 mm were the level of MBG3( OR=0.45, 95% CI: 0.16~0.95, P=0.03), time-to-reperfusion( OR=2.65, 95% CI: 1.06~5.98, P=0.04), blood sugar level of admission ( OR=1.96, 95% CI: 1.04~7.71, P=0.04), TnI value( OR=2.06, 95% CI: 1.03~5.68, P=0.04), heart function( OR=2.18, 95% CI: 1.08~6.89, P=0.04). Conclusion:The sequel recanalization PCI may be better than conventional PCI for the patients with STEMI in obtaining myocardial blush grades.Meanwhile, it can increase the indicators of HRV and decrease the incidence rate of SDNN<70 mm.
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Objective To investigate the application of evidence - based perioperative nursing in transradial interventional treatment by using sheathless guiding-catheter for coronary artery lesions. Methods The evidence-based nursing team researched for the relevant literature and evidences. According to the theory of critical evidence - based nursing, evidence - based perioperative nursing measures were carried out for 30 patients with coronary artery diseases who were receiving transradial interventional treatment by using sheathless guiding-catheter. Results The success rate of puncturing was 100％. After the procedure only two patients developed radial artery complications, and after promptly treatment no severe consequences occurred. The treatment achieved the desired clinical results. Conclusion Evidence-based nursing measures can regulate nursing behavior, and presciently make the nursing work in a standardized and sequenced way, thus, the nursing work is changed from the passive mode to an active mode. Therefore, evidence - based perioperative nursing is worth of clinical application(J Intervent Radiol, 2018, 27:281 -284)
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Objective To explore the application value in distinguishing the postoperative intracranial abscess from the spontaneous intracranial abscess using diffusion-weighted imaging(DWI).Methods Total of 73 patients with intracranial abscess,including 30 patients with spontaneous intracranial abscess and 43 patients with postoperative intracranial abscess underwent DWI scan.The clinical data and apparent diffusion coefficients (ADC)values were analysed using Mann-Whitney and χ2tests between the two groups,and χ2automatic interaction detection analysis was used to classify the ADC values into categories in each group.Results The ADC value of the postoperative intracranial abscess(median,1.34 ×10 -3mm2/s;interquartile range,1.00-1.62×10 -3mm2/s)was significant higher than that of the spontaneous intracranial abscesses (median,0.68×10-3mm2/s;interquartile range,0.58-0.79 ×10-3mm2/s;P<0.001).Theχ2 automatic interation detection analysis showed that 24 patients (80%)were found to be spontaneous abscess with ADC values less than 0.79×10-3mm2/s,the other 6 patients (20%)were found to be spontaneous abscess with ADC values between 0.79 and 1.33× 10-3mm2/s,and no patietns were found bo be spontaneous abscess with ADC values greater than 1.33×10-3mm2/s(P<0.001). Conclusion DWI has certain application value in distinguishing the postoperative intracranial abscess from the spontaneous intracranial abscess.
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Objective To analyze the CT findings of invasive mucinous adenocarcinoma of the lung.Methods The CT findings of 7 patients with invasive mucinous adenocarcinoma of the lung were retrospectively analyzed. Results Six cases manifested isolated pulmonary nodules or masses, among which circular/round shape was in 6 cases,clear tumor-lung parenchyma interface was in 6 cases,lobular sign was in 5 cases,specular sign was in 6 cases,calcifications was in 3 cases,angiogram sign of contrast enhancement was in 4 cases, and the CT value was close to the liquid density in 6 cases. One case showed consolidation of lung with multiple nodules or mass, and the lesions had angiographic signs calcification, unenhanced area with water density as well. The CT findings of angiography signs, calcification and consolidation of regional focal liquid opacity had significance for the diagnosis.One case was misdiagnosed as tuberculosis and 1 case as hamartomas. Factors which caused misdiagnosis were irregularly shaped calcifications and angiographic signs in lesion, and the enhanced CT value was less than 20 HU. Conclusions The invasive mucinous adenocarcinoma of the lung has characteristic CT findings. In addition to the malignant tumor features. When plain CT scan finds the watery density, calcifications and angiographic signs in the lesion, the invasive mucinous adenocarcinoma of the lung should be considered.The enhanced CT scan shows no enhancement or enhanced value less than 20 HU is also the characteristic of invasive mucinous adenocarcinoma of the lung. MRI check will help us to improve the diagnostic accuracy.
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Objective To evaluate the clinical value of whole-brain diffusion tensor imaging(DTI) in diagnosing patients with social anxiety disorder(SAD) using an automated method based on support vector machine(SVM) classification.Methods Whole brain DTI data were collected from 19 patients with SAD and 19 age-,gender-and education-matched healthy control(HC) subjects.Fractional anisotropy(FA) of whole brain was obtained by input all tensor images into Diffusion Toolkit software.Based upon the characteristics of brain FA,the pattern recognition of brain image data(PROBID) toolbox on the grounds of SVM algorithm was employed to classify the subjects,evaluate the diagnostic value of whole-brain FA data based SVM in diagnosing SAD patients and verify the robustness of the diagnostic results using permutation test with the threshold at P≤0.001.The weight vector score of each voxel was calculated according to the ratio between this voxel and whole brain in FA differences of the two groups.The white matter regions identified by setting the threshold to the top 30％ of the weight vector scores with at least 10 contiguous voxels were demonstrated by MRIcro software.Results Diagnostic accuracy of whole-brain FA based SVM in diagnosing SAD was 92.11％ (35/38) in which the specificity was 94.44％ (17/18),the sensitivity was 90.00％(18/20),the positive likelihood ratio was 17.01,the negative likelihood ratio was 0.11 and the diagnostic index was 184.22％.Permutation test suggested that the diagnostic results were significantly reliable.White matter regions showing major contributions favoring SAD over HC were located in the genu and splenium of the corpus callosum,the left uncinate fasciculus,the left inferior longitudinal fasciculus,the left inferior fronto-occipital fasciculus,bilateral frontal gyri and the left occipital lobe.Whereas,white matter in bilateral anterior cingula,the left middle cerebellar peduncle and the left inferior parietal lobule showed more contributions to diagnose HC than to diagnose SAD.Conclusions As whole brain FA data based on SVM showing a high accuracy in diagnosing SAD,brain DTI characteristics have the potential to be the specific indicators in the diagnosis of SAD.SVM might be used as a tool to verify the reliability of white matter abnormalities and provide regions of interest in DTI study of neurological and psychiatric diseases.
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Objective To investigate influence of preservation of remnant ligament on vascularization of grafts in anterior cruciate ligament (ACL) reconstruction.Methods Seventy-eight New Zealand rabbits were involved and both knees of the rabbits received one-stage ACL reconstruction simultaneously.One knee was reconstructed with preservation of residual fibers (remnant preservation group),and the contralateral one was treated with conventional debridement of residual fibers (remnant removal group).Blood flow of grafts was evaluated in vivo by laser doppler flow meter,expression of CD34 in vessels of grafts was measured by immunofluorescence method,growth of vessels surrounding grafts was observed with ink perfusion under stereomicroscope at 6,12,18,and 24 weeks after reconstruction.Results Laser doppler flow meter showed blood flow of grafts was significantly larger in remnant preservation group than in remnant removal group (P ＜ 0.01).Immunofluorescence testing revealed positive expression of CD34 of grafts was notably higher in remnant preservation group than in remnant removal group (P ＜ 0.05).Ink perfusion showed that the number of vessels surrounding grafts was much more in remnant preservation group than that in remnant removal group (P ＜ 0.05).Conclusion Remnant preservation benefits the vascularization of grafts in early stage after ACL reconstruction.
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BACKGROUND: Although we have gained much information about leadinduced organ damage, the effect of blood lead level on T cell subgroup is yet to be determined.OBJECTIVE: To assess the effect of blood lead level on T cell subgroup of children, and the association of T cell subgroup with threshold limit value of blood lead level.DESIGN: Comparative observation.SETTING: The Institute of Molecular Microorganism, Maternity and Child Care Hospital, Shanxi Provincial Children Hospital.PARTICIPANTS: Sixty children, (32 boys and 28 girls), aged 3-6 years with a mean of (4.5±1.5) years old, were selected from the suburbs of Taiyuan city between May 2003 and October 2003. Informed consents were obtained from all their guardians. The enrolled children according to their blood lead levels were assigned into three groups, 13 in Group Ⅰ with blood lead level ≥ 0.48 μmol/L, 20 in Group 2 with lead level ≥ 0.24 μmol/L but ＜ 0.48 μmoL/L and 27 in Group 3 with lead level ＜ 0.24 μmol/L.METHODS: Blood lead level and expression of T cell subgroup were measured with graphite furnace atomic absorption spectroscopy and immunofluorescence methods respectively. Student t test was used in data analysis, and linear correlation analysis was used to assess the correlation between blood lead level and expression of T cell subgroup.level and expression of T cell subgroup.pression of CD3 and ratio of CD4 to CD8 were lower in Group 1 (lead level ≥0.48 μmol/L) than Group 3 (lead level ＜ 0.24 μmol/L) (t=3.27,blood lead level showed had significant inverse correlation with CD3 expression and the ratio of CD4 to CD8(r=-0.689,-0.674,P ＜ 0.01).CONCLUSION: A blood lead level ≥ 0.48 μmol/L, is shown to significantly decrease the expression of CD3 and ratio of CD4 to CD8 in peripheral blood, which may impair the children's immunological function.
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BACKGROUND: Although we have gained much information about leadinduced organ damage, the effect of blood lead level on T cell subgroup is yet to be determined.OBJECTIVE: To assess the effect of blood lead level on T cell subgroup of children, and the association of T cell subgroup with threshold limit value of blood lead level.DESIGN: Comparative observation.SETTING: The Institute of Molecular Microorganism, Maternity and Child Care Hospital, Shanxi Provincial Children Hospital.PARTICIPANTS: Sixty children, (32 boys and 28 girls), aged 3-6 years with a mean of (4.5±1.5) years old, were selected from the suburbs of Taiyuan city between May 2003 and October 2003. Informed consents were obtained from all their guardians. The enrolled children according to their blood lead levels were assigned into three groups, 13 in Group Ⅰ with blood lead level ≥ 0.48 μmol/L, 20 in Group 2 with lead level ≥ 0.24 μmol/L but ＜ 0.48 μmoL/L and 27 in Group 3 with lead level ＜ 0.24 μmol/L.METHODS: Blood lead level and expression of T cell subgroup were measured with graphite furnace atomic absorption spectroscopy and immunofluorescence methods respectively. Student t test was used in data analysis, and linear correlation analysis was used to assess the correlation between blood lead level and expression of T cell subgroup.level and expression of T cell subgroup.pression of CD3 and ratio of CD4 to CD8 were lower in Group 1 (lead level ≥0.48 μmol/L) than Group 3 (lead level ＜ 0.24 μmol/L) (t=3.27,blood lead level showed had significant inverse correlation with CD3 expression and the ratio of CD4 to CD8(r=-0.689,-0.674,P ＜ 0.01).CONCLUSION: A blood lead level ≥ 0.48 μmol/L, is shown to significantly decrease the expression of CD3 and ratio of CD4 to CD8 in peripheral blood, which may impair the children's immunological function.