ABSTRACT
Both feature representation and classifier performance are important factors that determine the performance of computer-aided diagnosis (CAD) systems. In order to improve the performance of ultrasound-based CAD for breast cancers, a novel multiple empirical kernel mapping (MEKM) exclusivity regularized machine (ERM) ensemble classifier algorithm based on self-paced learning (SPL) is proposed, which simultaneously promotes the performance of both feature representation and the classifier. The proposed algorithm first generates multiple groups of features by MEKM to enhance the ability of feature representation, which also work as the kernel transform in multiple support vector machines embedded in ERM. The SPL strategy is then adopted to adaptively select samples from easy to hard so as to gradually train the ERM classifier model with improved performance. This algorithm is verified on a B-mode ultrasound dataset and an elastography ultrasound dataset, respectively. The results show that the classification accuracy, sensitivity and specificity on B-mode ultrasound are (86.36±6.45)%, (88.15±7.12)%, and (84.52±9.38)%, respectively, and the classification accuracy, sensitivity and specificity on elastography ultrasound are (85.97±3.75)%, (85.93±6.09)%, and (86.03±5.88)%, respectively. It indicates that the proposed algorithm can effectively improve the performance of ultrasound-based CAD for breast cancers with the potential for application.
Subject(s)
Humans , Algorithms , Breast Neoplasms/diagnostic imaging , Computers , Diagnosis, Computer-Assisted , Support Vector Machine , UltrasonographyABSTRACT
Objective@#To explore the recovery time and risk factors of coagulopathy caused by rodenticide poisoning through analyzing and following up the confirmed cases, and to provide more useful guidance information for the clinic practice.@*Methods@#A total of 96 cases with coagulation dysfunction caused by anticoagulant rodenticide poiso-ning in Children′s Hospital, Chongqing Medical University from January 2014 to December 2016, were analyzed retrospectively.The recovery time of coagulation function and the relationship between recovery time and drug involved way, dysfunction organs and poison concentration were studied respectively.@*Results@#(1) A total of 96 patients were hospitalized because of severe coagulopathy caused by the poisoning of second generation anticoagulant rodenticide.Brodifacoum was detected from 33 blood samples and the median concentration was 364 μg/L (55-4 654 μg/L). Bromadiolone was detected from 7 blood samples and the median concentration was 130 μg/L (18-652 μg/L). Brodifacoum and Bromadiolone were both detected from 8 cases and the median concentration was 741 μg/L (63-6 000 μg/L) and 11 μg/L (3-3 694 μg/L), respectively.(2) A total of 57 cases of the patients were successfully followed up.A total of 18 cases were confirmed with oral poisoning, 16 cases with dermal poisoning, while 23 cases denied any involved ways of poisoning, and 7 cases had organs dysfunction.The follow-up time was 12-54 months.All the hospitalized patients were given specific antidote Vitamin K treatment and recovered successfully without any sequelae.(3) The median recovery time of coagulopathy caused by rodenticide poisoning was 2.5 months.(4) The recovery time of coagulation function was positively correlated with the plasma concentration of Brodifacoum(r=0.619, P<0.01). (5) There was no significant correlation between recovery time and organ dysfunction or drug involved ways of poisoning involvement (all P>0.05).@*Conclusions@#The recovery time of coagulation dysfunction caused by anticoagulant rodenticide in children is much longer.The higher the concentration of Brodifacoum poison is, the longer the recovery time.Enough supplementation course of Vitamin K should be given according to the follow-up of coagulation function.
ABSTRACT
Objective To investigate the CT findings of primary orbital lipid prolapse. Methods The CT data of 13 patients with primary orbital lipid prolapse in Jiaxing Traditional Chinese Medicine Hospital Affiliated to Zhejiang Chinese Medical University from January 2012 to June 2018 were retrospectively analyzed. Results In all of the 13 cases of primary orbital lipid prolapse, there were 12 cases of bilateral orbital lipid prolapse and 1 case of unilateral orbital lipid prolapse. The CT images showed that the fat density masses in the posterior orbital septum were herniated from the outer quadrant of the orbit. The tumor was crescent shaped and connected with the orbital adipose tissue. The mass and the orbital adipose tissue were natural and homogeneous. Conclusions CT has distinctive imaging findings in the diagnosis of primary orbital lipid prolapse, and it is helpful for the diagnosis and differential diagnosis of this disease.
ABSTRACT
Objective To assess the predictive effect of myocardial injury biomarkers (proBNP, CK-MB, and cTnI) on the severity of acute pancreatitis (AP). Methods The records of 246 patients diagnosed with acute pancreatitis who were treated at Ruijin Hospital Emergency Department from January 2015 to December 2016 were retrospectively analyzed. According to the revised 2012 Atlanta guidelines, these patients were divided into the mild acute pancreatitis (MAP, n=47), moderately severe acute pancreatitis (MSAP, n=151) and severe acute pancreatitis (SAP, n=48) groups. The highest plasma levels of troponin I (cTnI), creatine kinase (CK)-MB, N-terminal B-type brain natriuretic peptide (NT-proBNP), C-reactive protein (CRP), and procalcitonin (PCT) were recorded for comparison within 72 h after admission. The acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ ) score, sequential organ failure assessment (SOFA), bedside index for severity in acute pancreatitis (BISAP) and Balthazar computed tomography severity index (CTSI) were calculated at admission within 72 h. Whether there is an occurrence of organ dysfunction, and the organ types and persist time of organ dysfunction were recorded. The analysis of variance, SNK-q test and paired samples t test were used for the statistical analysis. Results The levels of proBNP, CK-MB, and cTnI were significantly higher in the SAP group than in the non-SAP group. The receiver operating characteristic (ROC) curve demonstrated cTnI had the maximum predictive power (AUC=0.872), while proBNP had the least predictive ability (AUC=0.763). The established model, which is to explore whether the myocardial injury markers had the predictive value, showed that the combination of myocardial injury indicators (CK-MB, cTnI) and traditional indicators had higher predictive value for SAP than traditional indicators alone (AUC=0.966 vs. AUC=0.945, P=0.04). Conclusions The elevated markers of myocardial injury had certain predictive value for severe acute pancreatitis.
ABSTRACT
Objective To investigate the characteristics of multislice spiral CT in solitary pulmonary mucinous adenocarcinoma and its relationship with pathology. Methods The clinical data, CT characteristics and pathological features of 16 patients with solitary pulmonary mucinous adenocarcinoma confirmed by pathology from March 2010 to May 2018 were analyzed, and the number, distribution, size, shape, boundary, density, adjacent structure changes and intensifying performance were observed and compared with pathological results. Results The single lesion was distributed in the lung lobe in 16 cases, in the lower lobe in 13 cases, in the middle lobe in 1 case, and in the upper lobe in 2 cases, of which 12 cases were located under the pleura. There were 2 cases of central type and 14 cases of peripheral type. The longest diameter of tumor was 1.2- 3.0 cm, with an average of (2.1 ± 0.9) cm. Eleven lesions were round or approximately round, 5 lesions were irregular, 8 lesions had clear boundary, 6 lesions had irregular boundary and burr sign, 12 lesions had shallow or deep lobulation, 2 lesions had small vacuoles and 2 lesions had vascular aggregation. Multislice spiral CT plain scan showed that the density of lesions was lower than that of the same level muscle density. Enhanced scanning showed mild to moderate homogeneous or heterogeneous enhancement. Microscopic examination revealed that the cytoplasm of tumor cells contained large amounts of mucus and mucus was fluid. Most of the tumor cells were attached to the cell wall. Some of the tumor cells were floating in mucus and flowing with mucus. Conclusions If the tumor distribution and morphology is associated with the gravity factor, the enhanced scan is stripe like, and there is no invasion of the pleural, no pleural effusion and no metastasis when the tumor is large, and the solitary pulmonary mucinous adenocarcinoma should be highly suspected.
ABSTRACT
Objective To evaluate the value of virtual touch tissue imaging quantification (VTIQ),which was combined with ultrasound Breast Imaging Reporting and Data System (BI-RADS),for differentiating benign from malignant breast lesions.Methods Totally 190 patients with 214 breast lesions were enrolled in this study.All lesions were classified according to the BI-RADS for sonography.The maximum,minimum and mean shear wave velocity (SWV) values on VTIQ in the lesions were obtained.The SWV between benign and malignant lesions were analyzed.Receiver operating characteristic(ROC) curves were plotted to determine the cut off value of VTIQ for differential diagnosis of breast lesions. Results Pathology confirmed 166 benign lesions and 48 malignant lesions.The SWVmax,SWVmin,SWVmean of malignant lesions were significantly higher than those of benign lesions (all P<0.001).The SWVmean 3.67 m/s as the best value in the diagnosis of benign and malignant lesions.The sensitivity,specificity,positive predictive value and negative predictive value of the combination of the SWVmean and BI-RADS classification standard in the diagnosis of benign and malignant breast lesions were 77.6%,97.5%,92.7%,91.3%,respectively.Conclusions The combination of VTIQ and ultrasonic BI-RADS can improve the ability of differential diagnosis of benign and malignant breast lesions.
ABSTRACT
OBJECTIVE:To provide reference for drug registration declaration. METHODS:The disapproval comments of Chi-na Food and Drug Administration on the declared drugs in Guangdong Province in 2015 were collected,existing problems in cur-rent drug registration declaration in clinical trials stage and registered production stage were analyzed. And suggestions were put for-ward based on relevant policies and regulations. RESULTS & CONCLUSIONS:Reasons for the rejection of declaring chemical drugs in clinical trials stage mainly focused on that there had been imported drugs applied for registration or new drugs entering monitoring period. While pharmacy research quality defects,especially insufficient research in impurities and relevant materials, are the main problems of declaring clinical trials and production. In terms of clinical trail declaration,applicant should respond to new drug registration classification reform,strengthen original innovation development;the development of biological products should establish comprehensive and effective evaluation system to form superior technology and products. In terms of drug registra-tion production declaration,related departments or drug manufacturers should enhance the evaluation for drug form and specifica-tions design,and generic drugs should pay attention to the consistency evaluation with the original research drugs. Besides,the above problems can be solved by conducting scientific and feasible research methods for impurities and related material,and pay at-tention to enlarging research of forward-looking production technology.
ABSTRACT
Objective To investigate virtual touch tissue imaging quantification shear wave elastography in the differential diagnosis between benign and malignant breast lesions and the value of heterogeneity. Methods A total of 149 patients with 155 breast lesions by ultrasonography were selected from October 2016 to March 2017 in Drum Tower Hospital Affiliated to Nanjing University Medical School. All patients were confirmed by surgical pathology. The breast lesions were first examined by conventional ultrasound and the conventional ultrasonography features were recorded. The lesions were classified by breast imaging reporting and data system (BI-RADS). Then the shear wave velocity (SWV) values were measured under the virtual touch tissue imaging quantification (VTIQ) speed mode. The SWV maximum, average were obtained and coefficient of variation was calculated. According to pathological results, the receiver operating characteristic (ROC) curves of SWV maximum, average and coefficient of variation in differentiating benign or malignant breast lesions were drawn. Results The surgical pathology confirmed that there were 48 malignant lesions and 107 benign lesions in 155 breast lesions. The SWV maximum, average and coefficient of variation in malignant lesions were all higher than those of benign lesions [(6.85±2.26) cm/s vs (3.95±1.54) cm/s, (4.74±1.36) cm/s vs (3.10±0.94) cm, (0.30±0.15) vs (0.17±0.10)], and the difference was all statistically significant (t=8.085, 7.583, 5.366, all P < 0.001). According to ROC curve, the areas under the curves of SWV maximum, average and coefficient of variation in differentiating benign or malignant breast lesions were 0.842, 0.826 and 0.759 and the cutoff values were 5.51 cm/s, 4.28 cm/s and 0.25 respectively. The diagnostic sensitivity, specificity and accuracy of SWV maximum, average and coefficient of variation were 72.92%, 85.98% and 81.93%, 64.58%, 87.85% and 80.65%, 64.58%, 84.11% and 78.06%, respectively. And the combined diagnostic sensitivity of coefficient of variation with SWV maximum and SWV average were 81.25%. Conclusion VTIQ technology plays an important role in the differential diagnosis between benign and malignant breast lesions and the value of heterogeneity.
ABSTRACT
Objective To investigate the effect of adrenomedullin on epithelial barrier function of Caco-2 cells under hypoxia/reoxygen-ation injury and the molecular mechanism.Methods Build hypoxia/reoxygenation injury model,Caco-2 cells were randomly divided into three groups:normal control group( N) ,hypoxia/reoxygenation group( H/R) and hypoxia/reoxygenation plus 1 μmol/L adrenomedullin group(H/R+AM).Transepithelial electrical resistance(TEER) was determined,and the laser confocal microscope was used to detect the construction of tight junction.The protein expressions of tight junction proteins (Occludin and ZO-1) and nuclear factor kappa B(NF-κBp65) were examined by using western blotting.Results Pretreatment of AM significantly attenuated the disruption of morphological structure of tight junction caused by H/R.The TEER of N group,H/R group and H/R+AM group were(157.68 ±5.54),(96.06 ±3.42),(134.56 ± 4.72) Ohm/cm2 respectively.After AM pretreatment, the TEER were significantly raised compared with that in H/R group by 40.00%(P<0.05).The relative protein expressions of Occludin and ZO-1 in N group,H/R group and H/R+AM group were [(0.43 ±0.03), (0.27 ±0.04)],[(0.20 ±0.03),(0.15 ±0.07)],[(0.32 ±0.15),(0.21 ±0.03)]respectively.After AM pretreatment,the protein ex-pression of Occludin and ZO-1 were significantly raised compared with that in H/R group(by 60.00% and 40.00%).Simultaneously,the relative protein expressions of NF-κBp65 in N group,H/R group and H/R+AM group were (0.53 ±0.30),(2.89 ±0.16),(1.75 ±0.25) respectively.And H/R induced NF-κBp65 activation was significantly inhibited by AM treatment (decreased as compared with H/R group by 40.00%).Conclusion AM can attenuate intestinal epithelial barrier dysfunction by regulating the expression of intestinal tight junction pro-teins.The inhibition of NF-κB activation may be involved in this mechanism.
ABSTRACT
Objective To analyze the related factors of foot blisters caused by long-distance weight-bearing march and to explore the pathogenesis of foot blisters to provide a useful way for the prevention and treatment.Methods After the 300 km march,counted the number who had accomplished the march,and then recorded the number of foot blisters,location of blisters,and abrasion of sole.Collected the data of gender,age,body mass index (BMI),hand dominance,and whether had bliters before the march through questionnaire.And the data were coded for analysis with SPSS 13.0 statistical package.Results The 7 cases who complete the whole march and 17 cases who already had foot blisters before the march were ruled out of the final statistics.Among the remaining 590 cases,there were 554 cases (93.9%)suffered from foot blisters.And there were 1 282 blisters in total,among which the plantar blisters occupied 98% (1 257 cases).The analysis showed that the incidence of foot blisters had no significant correlation with gender,left/right foot,hand dominance,BMI and age.The predilection sites of blisters were the second and third metatarsals (28.2%),the hallux (21.3%),the fifth metatarsal (18.1%),and the calcaneus (15.8%)of the left foot.The predilection sites of blisters were the second and third metatarsals (33.3%),the hallux (22.4%),the fifth metatarsal (18.6%),and the calcaneus (14.5%)of the right foot.In terms of the abrasion of sole,the lateral heel was worn out the most (34.6% on the left and 34.2% on the right).Conclusion The study confirmed that the incidence of foot blisters had no significant correla-tion with gender,left/right foot,hand dominance,BMI and age,which may be affected by the particularity of this march.Most of the foot blisters occurred in the planta,and the predilection sites of blisters were in accord with sites of of the abrasion of sole and the distribution of plantar shear force,which demonstrated the shear force is the most critical factor on the pathogenesis of foot blisters.
ABSTRACT
<p><b>OBJECTIVE</b>To discuss the therapeutic effect of free anterolateral thigh flap for the treatment of burn scar carcinoma.</p><p><b>METHODS</b>From Jun. 2005 to Feb. 2013, 10 cases with burn scar carcinoma at craniofacial area and extremities underwent radical excision and transposition of free anterolateral thigh flaps for the leaving wounds.</p><p><b>RESULTS</b>The flaps in 10 cases survived completely and primarily without any complications. The operation time was 7 hours in average. The patients were followed up for 5 months to 2 years (1 year, in average) without no recurrence and no functional morbidity in donor sites. The cosmetic results were satisfactory in all the cases, even with hair growth in 6 cases.</p><p><b>CONCLUSION</b>The free anterolateral thigh flap is suitable for the treatment of burn scar carcinoma.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Burns , Cicatrix , General Surgery , Follow-Up Studies , Surgical FlapsABSTRACT
Objective To investigate the correlation between the severity of subcortical ischemic lesions and vascular cognitive impairment in encephalorrhagia patients. Methods One hundred and twenty-four encephalorrhagia patients were enrolled into two groups, the normal cognition group (60 cases, without cognitive impairment) and the cognitive impairment group (64 cases, with vascular cognitive impairment). Parameters of the lesion diameters, various lesion locations, white matter lesions severity and NIHSS scale score, modified Bathel index score were compared between these two groups. The correlations between the above indexes and the vascular cognitive impairment degree were analyzed by Logistic regression proceduress. Results Compared to the normal cognition group, the indexes of lesion number of frontal area and basal ganglia, lesion diameters, white-matter severity and NIHSS scale score of cognitive impairment group were higher (P0.05, respectively) in the cognitive impairment group. Result of Logistic regression analysis showed a positive correlation between the severity of white-matter and the degree of vascular cognitive impairment (OR =4.705, P=0.009). Conclusion The severity of white-matter can effectively assess the degree of vascular cognitive impairment of encephalorrhagia patients.
ABSTRACT
Objective To evaluate the characteristic appearance and diagnosis value of central neurocytoma on magnetic resonance imaging (MRI).Methods MRI data of 9 patients with central neurocytoma confirmed surgically and pathologically were retrospectively reviewed.Results All the lesions located in the lateral ventricle septum pellucidum,adjacent to Monro hole,in the anterior 1/3 to 2/3 of the lateral ventricle.Most of them were irregularity,sublobe and sharpness of border.They presented as inhomogeneous intense signal on MRI,with slight to equal enhancement on enhancement.DWI could be high or slightly high signal.Conclusion Central neurocytoma has the characteristic appearances on MRI,being helpful to the diagnosis.
ABSTRACT
objective To detect the serum macrophage migration inhibitory factor(MIF)and interlbukin (IL)-17,IL-23 levels in rheumatoid arthritis patients with atherosclerosis and to analyze the association between them and their role in the pathogenesis of atherosclerosis in rheumatoid arthritis patients.Methods Total of 69 patients with RA were divided into atherosclerosis group(AS group)and those without atherosclerosis group(NAS group)according to neck vascular ultrasonography.Sixty-four healthy controls(the control group)were also enrolled into this study.MIF and IL-17,IL-23 levels were determined bv ELISA assay.The t test of two independent-samples and One-way ANOVA were used to compare the levels of MIF.IL-17 and IL-23 in different groups of patients and healthy individuals.The correlation between diffrent paramenters was assesed by Pearson's coefficient of correlation and Logistic regression.Results The serum MIF level in the AS group was significantly higher than that in the NAS group and healthy controls(15.2±1.7,13.8±2.2,8.0±2.9,P<0.05),and there were significant correlations between the serum MIF concentration,carotid intima-media thickness(IMT)(r=0.271,P=0.036).the size of atherosclerotic plaques(r=0.291,P=0.024),the serum level of IL-17(r=0.328,P=0.007)and IL-23(r=0.316,p=0.010).The serum IL-17 and IL-23 level in the AS group was higher than healthy controls(2.8±2.0 vs 2.0±0.8,449±174 vs 341±113),while there were no significant differences between AS group and NAS group.The serum MIF level in RA patients was positively correlated with atherosclerosis according to Logistic regression analysis.Conclusion The serum MIF level in RA patients with AS is significantly higher than that in NAS group and healthy controls,and it may be related with the serum level of IL-17 and IL-23.The elevated serum MIF level may be a predictor for atherosclerosis in patients with rheumatoid arthritis.
ABSTRACT
Objective To analyze the epidemiologieal characteristics of the pre-hospital care cases in Shanghai in the year 2007. Method Based the demographic records in the year 2007, the cases which from the database of Shanghai pre-hospital care center with full items were analyzed. Chi-square test and exact probabilities were used to compete the consfituent ratio; and the method of circular distribution was used to calculate the peak time, date and month. Results There were 86 815 patients with pre-hospital care well documented from the ur-ban districts of Shanghai. The ratio of male to female was 3.89: 1. The senile patients accounted for 84.95% of all the pre-hospital care ones. The major causes of disease in patients with pre-hospital care were trauma, eere-brovascular disease,cardiac diseases, coma, high fever, tumor emergency, acute abodomen emergency,OB/GYN emergency and upper G1 tract bleeding in turn. During the daytime, the occurrence of those emergency patients with pre-hospital care usually peaked at 2:15 o' clock with the high frequency in the period of 5:45 to 17:45 o' clock.The top nine diseases had their own peak time and high frequency period, respectively. Within a year, no peak date occurrence of patients with prehospital care, in tolal, was found. Howerer, the occurrence of patients with high fever, acute abdomen and upper GI bleeding had specific peak dates within a year, respectively. Conclusioes The pre-hospital care eases in the urban of Shanghai have own epidemiologieal characteristics. Perfect the construc-tion of pre-hospital emergency care system, improving the professional training, and thereby meeting the require-ments are factors in the fundamental guarantee of improving the rescue full success rate of severe patients.