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The construction and operation of the hospital-wide radiation protection management information system is of great significance for improving the efficiency and quality of radiation protection management. A hospital has built a hospital-wide radiation protection management system, which consisted of four modules: radiation staff management module, protection items management module, site and equipment management module, and self-inspection module. The system adopted B/S mode, carried the lightweight J2EE framework-SpringBoot framework, and used mybatis, which was flexible and practical, as the persistence layer of the system, to store the data completely in the SQLServer database.Java language was used as the system development language, and the front and back-end separation architecture was used. Each of the four modules implemented the management responsibility departments and responsible personnel to carry out the all-round management of radiation protection, and realized the integrated, information-based and standardized management of radiation protection management in the hospital.
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:To explore the value of quantitative perfusion histogram parameters of dynamic contrast-enhanced magnetic resonance imaging （DCE-MRI） in pathological classification of uterine leiomyoma and its correlation with Ki-67 protein expression. Thirty five patients with uterine leiomyoma confirmed by operation and pathology at Shaoxing People's Hospital from October 2015 to September 2017 were analyzed retrospectively，including 15 cases of ordinary type，8 cases of cellular type and 12 cases of degenerative type. All patients were examined by pelvic DCE-MRI before operation，and the histogram parameters （median，mean，skewness，kurtosis，energy，entropy） of various quantitative perfusion parameters，including volume transport constant （K），rate constant （K），extravascular extracellular space distribute volume per unit tissue volume （V），blood plasma volume per unit volume of tissue （V） were calculated，and the efficacy of different parameters in pathological classification of uterine leiomyoma was evaluated by ROC curve. The expression of Ki-67 protein in uterine leiomyoma was detected by immunohistochemical method，and the correlation between histogram parameters and Ki-67 protein expression was analyzed by Pearson and Spearman correlation analysis. The median and mean values of K，K，V and V in the cellular group were higher than those in the degenerative group and the ordinary group（<0.05 or <0.01），while the skewness of V，the skewness and kurtosis of K in the cellular group were lower than those in the ordinary group （all <0.05）. The entropy of K in the cellular group was higher than that in the degenerative group and the ordinary group （all < 0.05）. The entropy of V in the cellular group was higher than that in the ordinary group （<0.01）. The median，mean，skewness of K，median and mean of K，median and mean of V，median，mean，energy and entropy of V were correlated with Ki-67 expression（all <0.05）. The results of ROC curve analysis showed that the median threshold of K was 0.994/min，the sensitivity and specificity for the diagnosis of cellular uterine leiomyoma were 100.0% and 77.8% respectively，and the area under the ROC curve was 0.949. When the mean threshold of K was 1.170/min，the sensitivity and specificity for diagnosing cellular uterine leiomyoma were 100.0% and 77.8% respectively，and the area under the ROC curve was 0.958. The area under the ROC curve of K （entropy），K （median，mean），V （median，mean，entropy） in the diagnosis of cellular uterine leiomyoma were 0.755-0.907. :DCE-MRI quantitative perfusion histogram parameters have high diagnostic value in differentiating pathological types of uterine leiomyoma，especially for cellular uterine leiomyoma.
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Humans , Contrast Media , Leiomyoma/diagnostic imaging , Magnetic Resonance Imaging , Perfusion , Retrospective StudiesABSTRACT
Objective To investigate the correlation between quantitative perfusion histogram parameters of DCE-MRI and tumor tissue microvessel density(MVD) in patients with lung cancer.Methods 30 patients with lung cancer confirmed by pathology who underwent preoperative DCE-MRI were enrolled in this retrospective study .Quantitative perfusion histogram pa-rameters( including median, mean, skewness, kurtosis, energy, entropy) were measured for each patient using Exchange mo-dle.Using the Immunohistochemical method to detect the expression of CD34 in tumor tissue, and counting the number of mi-crovessels under microscope.SPSS 19.0 was used to carry out statistical analysis.The correlation between MVD and quantita-tive perfusion histogram parameters of DCE-MRI measured by exchange model was evaluated by Pearson linear correlation anal-ysis.Results There was no significant difference in MVD and each quantitative perfusion histogram parameters between the three different pathological groups of lung cancer(P >0.05).Ktrans perfusion histogram parameters(mean, 25％, 50％, 50％, 75％, 90％, 95％), Kep perfusion histogram parameters(entropy, 10％, 25％, 50％, 75％, 90％), Fp perfusion histogram parameters( mean, 25％, 50％, 75％, 90％, 95％) and Vp perfusion histograms parameters ( entropy, 75％, 90％, 95％ ) were positively correlated with MVD(P<0.05).Ktrans perfusion histogram parameters(energy) and Vp perfu-sion histogram parameters(skewness, kurtosis, energy) were negatively correlated with MVD(P<0.05).There was no signifi-cant correlation between Ve perfusion histogram parameters and MVD(P>0.05).Conclusion There was a certain correla-tion between the perfusion histogram parameters of DCE-MRI and MVD,suggesting that the quantitative perfusion histogram of DCE-MRI in lung cancer can reflect the MVD value of cancer tissue .
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OBJECTIVE@#To assess the predictive value of myocardial scar mass in malignant ventricular arrhythmia (MVA) after myocardial infarction.@*METHODS@#Thirty myocardial infarction patients with complete electrophysiology and cardiac MRI data admitted from January 2012 to August 2017 were enrolled in the study. According to the results of intracavitary electrophysiological study, MVA developed in 16 patients (MVA group) and not developed in 14 patients (non-MVA group). The qualitative and quantitative analysis of left ventricular ejection fraction (LVFE) and scar mass was performed with CV post-processing software and predictive value of myocardial scar and LVEF for MVA after myocardial infarction was analyzed using ROC curves.@*RESULTS@#LVEF in MVA group was significantly lower than that in non-MVA group, and scar mass in MVA group was significantly higher than that in non-MVA group (all <0.05). Regression analysis showed that LVEF (=1.580) and scar mass (=6.270) were risk factors for MVA after myocardial infarction. For predicting MVA, the area under ROC curve () of LVEF was 0.696 with a sensitivity of 0.786 and the specificity of 0.685; the of the scar mass was 0.839 with a sensitivity was 0.618 and the specificity of 0.929; the of LVEF combined with scar mass was 0.848 with a sensitivity of 0.688 and specificity of 0.857.@*CONCLUSIONS@#Myocardial scar assessed by late gadolinium enhancement MRI is more effective than LVEF in predicting MVA after myocardial infarction.
Subject(s)
Humans , Arrhythmias, Cardiac , Diagnosis , Cicatrix , Diagnostic Imaging , Contrast Media , Gadolinium , Myocardial Infarction , Diagnostic Imaging , Predictive Value of Tests , Ventricular Function, LeftABSTRACT
Objective: To compare the application value between medical adhesive and Hook-wire in pre-thoracoscopy localization of small pulmonary nodules (≤ 30 mm). Methods: Data of 107 patients with small pulmonary nodules who underwent thoracoscopic wedge resection, segmental or lobectomy were retrospectively analyzed. The patients were divided into medical adhesive group (88 cases with 90 nodules) and Hook-wire group (19 cases with 19 nodules) according to pre-thoracoscopy localization method. The location of lesion, nodule size, distance between nodule and pleura, nature of nodule(benign or malignant), surgery method and complications (including pneumothorax, pulmonary hemorrhage, pain and cough) were compared between the two groups. Binary Logistic regression analysis was performed to determine the complications' related risk factors. Results: There was no significant difference of the location of lesion, nodules size, distance between nodule and pleura, nature of nodule nor the method of thoracoscopic surgery between the two groups (all P>0.05). The pre-thoracoscopy localization success rate of both two groups were 100%. The overall complication rate and the incidence of pulmonary hemorrhage in medical adhesive group were significantly lower than those in Hook-wire group (both P<0.01). The localization method was an independent risk factor for complications after pre-thoracoscopy localization, pulmonary hemorrhage and chest pain, while the distance from the nodule to pleura was an independent risk factor for pulmonary hemorrhage. Conclusion: Medical adhesive can be used for pre-thoracoscopy localization of small pulmonary nodule with lower complication rate compared with Hook-wire.
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Objective To provide reference for bettering online health information supply and meeting residents' health needs by analyzing residents' access to and utilization rate of online health information. Methods 1 460 residents aged 18 years or above and having experienced medical visits themselves or accompanying others in one year were surveyed in June 2016. The survey covered their access to online health information and the utilization rate. χ2test, variance analysis, and important quadrant derivation model were used in the data analysis. Results 84.5% of the respondents used mobile phones as the most popular tool for accessing health information on the Internet, with more women than men. The importance quadrant analysis found that the residents have the highest utilization rate (72.6% ) of search engines, yet the reliability scoring of such engines was the lowest ( 62.8 ). Professional medical health websites scored the highest in reliability (81.8), yet the lowest utilization rate (2.1% ). Conclusions Search engines require stronger scrutiny to improve their information quality. Professional health and medical institutions'websites are encouraged to step up health information promotions, and health management Apps should be regulated in their development, to create convenient and reliable online health information platforms.
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Objective To provide reference for service optimization of information suppliers and doctors through analyzing the residents'value cognition and utilization of online health information.Methods Questionnaires were distributed in June 2016 to 1 460 residents aged 18 or above and having experienced medical visits themselves or accompanying others in one year. They were surveyed to learn their health information cognition and utilization behavior. The data so acquired were subject to constituent ratio and Chi square test analysis. Results In terms of their use of online health information, 58.5% of the respondents would consult relevant information before medical visits, 64.3% would verify the doctor's diagnosis online following such visits. In case of any inconsistences, 28.2% of them would seek second opinion at another hospital. Statistical differences were discovered in the cognitive difference of residents of different sexes on "internet health information inquiry can relieve tension" , and in the utilization difference of residents of different ages and educational on " whether to consult online health information before medical visits" ( P<0.05). Conclusions The residents'value cognition of online health information is rational in general, but there are also some cognitive behaviors worthy of notice. Information conflicts may incur doctor-patient conflicts and repetitive medical visits. Stakeholders should ensure the professionalism and quality of the information providers. The doctors should master the communication skills and pay attention to the potential impact of online health information.
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Objective To analyze the causes, characteristics and solutions of medical complaints against five tertiary general hospitals in Shandong province, and provide references for the hospitals to improve their quality of care and to build a harmonious relationship between doctors and patients. Methods A retrospective analysis method was used to analyze the causes, solutions and subjects of 1 049 medical complaints against five tertiary general hospitals in Shandong province from 2012 to 2015. Results Among the departments complained, orthopedics(165 cases, 15.7% ), and obstetrics and gynecology(136 cases, 13.0% )topped the rest. The causes of complaints mainly focued on the quality and effect of surgery(355 cases, 33.8% ), diagnosis and treatment(269 cases, 25.6% ), and service attitude(204 cases, 19.4% ). For outpatient/emergency departments, the patients mostly complained on " service attitude" (125 cases, 36.1% ), while the causes of complaints by inpatients were mainly " quality of surgery and effects" (332 cases, 44.8% ). In terms of the dispute solution pathways, consultation between doctors and patients became the most useful one(353 cases, 84.5%), and the third-party mediation approach(56 cases, 13.4% )also played an important role. Conclusions The hospitals should comprehensively strengthen their medical quality management, improve the quality of " service contact" and patient satisfaction. They are also recommended to establish a perfect complaint handling mechanism for higher patient satisfaction. The government should set up specialized courts for medical disputes and improve the efficiency of judicial solution of such disputes.
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Objective To study the effect of high copper on Wnt /β-catenin signaling pathway and oxidative stress. Methods BRL-3A cells were incubated with different concentrations of CuSO4.The cell growth and proliferation wre assessed using MRR method.The production of reactive oxygen species(ROS)and mitochondrial membrane potential (JC-1) were examined usingf flow cytometry. The content of malondialdehyde (MDA) and the activity of superoxide dismutase (SOD) were detected by microplate reader. The expression of protein was detected by Western Blot. Results①The results of MTT showed that CuSO4inhibited the growth and proliferation of BRL-3A cells in a time- and concentration-dependent manner(P<0.01).②Flow cytometry results showed that CuSO4induced a large amount of ROS and significantly decreased the fluorescence intensity of JC-1 in BRL-3A cells (P<0.01). ③ Microplate reader results showed that CuSO4increased the content of MDA and decreased the activity of SOD (P<0.05).④Western blotting assay showed that CuSO4significantly decreased the total expression levels of β-catenin and p-Ser 9-GSK-3β protein as well as nuclear levels of p-(S33+S37)-β-catenin and c-Myc (P<0.01) and increased expression levels of GSK-3β、DKK1、Dishevelled3 protein in BRL-3A cells. Conclusion High copper can induce oxidative stress and induce Wnt /β-catenin signaling pathway to deactivate liver cells,leading to hepatocellular injury.
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Acute promyelocytic leukemia (APL) is a distinctive subtype of acute myeloid leukemia with a distinct biology and clinical presentation. Its molecular biology characteristic is a aberrant chromosomal translocation of the promyelocytic leukemia (PML) gene on chromosome 15 and the retinoic acid receptor α(RARα) gene on chromosome 17. This translocation generates PML-RARα fusion protein, which plays an important role in the genesis, development, diagnosis and therapy of APL. The PML protein has a close relationship with PML-RARαfusion gene. This article mainly summarizes the character, the function of PML protein and the degradation pathway of PML-RARα.