ABSTRACT
Objective:To investigate the efficacy of the nomogram model based on multiparametric MRI combined with clinical features for differential diagnosis of benign and malignant breast imaging reporting and data system (BI-RADS) 4 lesions.Methods:This study was a cross-sectional study. Clinical and imaging data of 56 patients (66 lesions) with pathologically confirmed BI-RADS 4 breast lesions from January 2020 to June 2022 at Second Affiliated Hospital of Shantou University Medical College were retrospectively analyzed. The patients were all females aged 42 (17, 71) years old. All patients underwent the breast MRI, including T 1WI, T 2WI, diffusion-weighted imaging, diffusion kurtosis imaging (DKI), and dynamic-enhanced MRI (DCE-MRI), and the patient clinical characteristics, imaging characteristics as well as relevant MRI quantitative parameters were recorded. Comparisons of the indicators of benign and malignant BI-RADS 4 lesions were performed by sample t-test , Mann-Whitney U, or χ 2 test. The least absolute shrinkage and selection operator regression was utilized to further select indicators with statistically significant differences in univariate analyses, and finally, nomogram models were constructed and reclassified all the lesions. Results:Of the 66 lesions in 56 patients, 24 lesions were found in 24 malignant patients and 42 lesions in 32 benign patients. The differences in age, body mass index, and menopausal status between benign and malignant patients were statistically significant (all P<0.05); the differences in tumor longest diameter, type of lesion enhancement, time-single intensity curve type, mean diffusivity and mean kurtosis (MK) between benign and malignant lesions were statistically significant (all P<0.05). After feature selection, MK ( OR=27.952, 95% CI 1.301-600.348, P=0.033), age ( OR=1.140, 95%CI 1.040-1.249, P=0.005), and the type of lesion enhancement ( OR=0.045, 95%CI 0.006-0.316, P=0.005) were the independent influences in predicting BI-RADS 4 malignant lesions. Using this to construct a nomogram model, its area under the curve for predicting BI-RADS 4 malignant lesions was 0.946, and the accuracy of reclassifying 66 BI-RADS 4 lesions as benign versus malignant was 86.36% (57/66). Conclusion:The nomogram model constructed with MK from DKI parameters, the type of lesion enhancement from DCE-MRI, and age is valuable in diagnosing the benign and malignant nature of BI-RADS 4 lesions.
ABSTRACT
Objective To investigate the correlation between serum neuregulin 4(Nrg4)level and metabolic associated fatty liver disease(MAFLD)in patients with type 2 diabetes mellitus(T2DM).Methods A total of 240 T2DM patients admitted to the Department of Endocrinology of Second People's Hospital of Yichang from June 2021 to August 2022 were collected and divided into simple T2DM group(n=120)and MAFLD group(MAFLD,n=120).120 healthy individuals were selected as the normal control(NC)group.Results The serum Nrg4 decreased gradually from NC group,T2DM group to MAFLD group(P＜0.05).Pearson correlation analysis showed that serum Nrg4 was negatively correlated with WC,HOMA-IR and hs-CRP(P＜0.05),and positively correlated with HDL-C(P＜0.05).Logistic regression analysis showed that Nrg4,WC,HOMA-IR and hs-CRP were the influencing factors of MAFLD.After adjusting for age,sex,smoking history,BMI,TC,TG,HDL-C,LDL-C,FPG,FIns,HbA1c and other factors,serum Nrg4 was still the influencing factor of MAFLD.Conclusion The decrease of serum Nrg4 is a risk factor for T2DM combined with MAFLD.
ABSTRACT
CT is an important imaging tool for the diagnosis of novel coronavirus pneumonia (COVID-19), therefore, it′s necessary to strictly control the disinfection of CT workplace and equipment and biosafety to avoid the place from becoming a potential infection source and to reduce the risk of infection of patients and radiological staff. It is also necessary to reduce the CT scan dose to minimize the radiation hazards on patients under the premise of ensuring the CT image quality and diagnostic efficiency. Based on the survey that novel coronavirus residues after disinfection at some CT workplace in domestic and overseas and the application of low-dose CT scan in diagnosis of COVID-19, as well as the current situation of radiological protection management in emergency hospital, this paper summarizes and proposes suggestions on infection control and radiological protection for CT workplace to strengthen the defense line of COVID-19 prevention and control.
ABSTRACT
OBJECTIVE To evaluate the genotoxicity of naproxen (NPX) impurities acetylnerolin (Ace). METHODS The genotoxicity of Ace was predicted by ADMET, Derek and Sarah with the quanti?tative structure-activity relationship (QSAR). The chromosomal aberration and bacterial reverse-muta?tion (Ames) tests were performed to verify the above results. In chromosomal aberration tests, CHL cells were incubated with Ace 10, 20 and 40 mg · L-1 for 4 h in the presence or absence of metabolic activation system solution (S9 mix). Methyl methane sulfonate (MMS) 20 mL · L-1 without S9 mix and cyclophosphamide (CP) 12 mg · L-1 with S9 mix served as positive control. The number of chromo?somes in each aberrant metaphase (including fissure, exchange, ring, break and polyploid) was counted and recorded, when the distortion rate less than 5％was considered negative and more than 10％was considered positive. In Ames test, the potential mutagenicity was evaluated using five strains of S. typhimurium ( TA97,TA98,TA100,TA102 and TA1535). They were treated with Ace 5, 25, 125 and 625μg per plate with or without S9 mix and incubated for 48-72 h. When without S9 mix, Dexon 50μg per plate served as positive control for TA97 and TA98, MMS 2.0μL per plate served as positive control for TA100 and TA102, and sodium azide 1.5μg per plate served as positive control for TA1535. When with S9 mix, 2-AF 100 μg per plate served as positive control for TA97, TA98 and TA100, 1, 8-dihydroxyanthraquinone (100μg per plate) served as positive control for TA102 and CP 50μg per plate served as positive control for TA1525. When the number of colonies was at least two-fold that of the negative control, the compound was considered mutagenic. RESULTS Although the Derek and Sarah software predicted that the NPX impurities were not genotoxic, ADMET data showed that Ace could induce chromosomal aberrations. The distortion rate of Ace 40 mg · L-1 was greater than 5％, but less than 10％. The distortion rate of Ace was less than 5％when<20 mg·L-1. Consistent with the results of ADMET, Ace might induce chromosomal aberrations. Ames test results showed that Ace did not signifi?cantly increase the number of bacteria (5-625μg per plate) compared with the negative control. Contrary to the ADMET results, Ace had no mutagenicity. CONCLUSION Ace has potential chromosomal muta?genicity. For life-long usage of NPX, the content of Ace should be reduced from 0.15％of conventional impurities to 0.015％.
ABSTRACT
Objective To evaluate the effect of fast-track surgery on perioperative nursing care for patients with abdominal surgery. Methods Using FTS and perioperative nursing as keywords, relevant literature was retrieved from the CNKI, Wanfang Med, Cochrane Library and PubMed databases. Articles including patients who underwent abdominal surgery as the research subjects were screened and analyzed with RevMan 5.3. Results Seven articles were included, covering 288 experimental cases and 290 control cases. Patients with FTS nursing had a higher satisfaction with nursing(P<0.05), shorter postoperative hospital stay(Z=6.71,P<0.05), shorter postoperative anal exhaust time(Z=9.08,P<0.05), and lower incidence of postoperative incision infection(Z=2.65,P=0.05),Hospitalization costs were also reduced(Z=11.75,P<0.05). The incidence of complications, including postoperative abdominal infection, anastomotic fistula, intestinal obstruction, and lower extremity deep vein thrombosis, did not increase. Conclusions FTS nursing can improve the satisfaction of patients with abdominal surgery and reduce their hospitalization expenses and recovery time these results indicate that FTS is a safe and feasible nursing measure.