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Objective:To investigate the relationship between the expression levels of chemokines in serum of patients with differentiated thyroid carcinoma (DTC) and the progression of DTC.Methods:From January to April in 2017, blood samples of 76 patients (25 males, 51 females, median age: 39 years) with DTC after surgery in Nuclear Medicine Department of Tenth People′s Hospital Affiliated to Tongji University were collected retrospectively for detecting the expression levels of 40 chemokines. Patients were divided into different groups according to (1) with or without metastasis: the non-metastasis group ( n=13) and the metastasis group ( n=63); (2) degree of gradual dedifferentiation: without metastasis group ( n=13), lymph node metastasis group ( n=48), highly malignant group ( n=11) and radioactive iodine refractory (RAIR) with distant metastasis group ( n=4); (3) frequency of 131I treatment in follow-up for nearly 2 years: single treatment group ( n=51) and multiple treatment group ( n=25). Differences in chemokine levels among groups were compared. Receiver operating characteristic (ROC) curve analysis was used to evaluate the predictive value of differential chemokines′ levels on DTC metastasis and multiple 131I treatment. Independent-sample t test, Mann-Whitney U test and one-way analysis of variance were used to analyze the data. Results:Compared with the non-metastatic group, the expression levels of Eotaxin-3 ((25.94±6.05) vs (21.76±5.71) ng/L), interferon-γ (IFN-γ; (116.04±28.98) vs (98.71±26.18) ng/L), macrophage-derived chemokine (MDC; (1 468.08±401.74) vs (1 082.94±423.30) ng/L) and thymus expressd chemokine (TECK; (505.22(419.80, 563.36) vs 402.89(347.43, 442.97) ng/L) in metastatic group were decreased, and the differences were statistically significant ( t values: 2.376, 2.131, 3.007, U=215.000, all P<0.05). The area under the ROC curve of IFN-γ+ MDC+ TECK for predicting DTC metastasis was 0.844(95% CI: 0.755-0.932, P<0.001), and the sensitivity was 79.37%(50/63). Only the differences of MDC among without metastasis group, lymph node metastasis group, highly malignant group and RAIR with distant metastasis group were significant ((1 468.08±401.74), (1 121.59±454.20), (976.07±281.04), (922.68±342.41) ng/L; F=3.564, P<0.05), and the expression was gradually decreased with the degree of dedifferentiation. Only IL-8 was significantly increased in the multiple treatment group compared with the single treatment group (28.20(23.22, 32.51) vs 30.51(26.98, 35.57) ng/L; U=801.000, P<0.05). The area under the ROC curve of IL-8 for predicting multiple 131I treatment was 0.648(95% CI: 0.523-0.773, P<0.05), and the sensitivity was 100%(25/25). Conclusions:Decreased expression of IFN-γ, MDC and TECK may be potential markers for predicting metastasis in DTC. MDC is likely to be a potential molecular target for detecting the dedifferentiation degree of DTC, decreased expression of which may indicate the increased malignancy of tumor. IL-8 may be used to predict whether patients need multiple 131I treatments.
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Objective:To analyze the results of external quality control network of iodine deficiency disorders (IDD) laboratories in Jiangxi Province in 2018, to summarize the total detection level and capability at all levels, and to provide reliable quality assurance for monitoring and prevention of IDD.Methods:In 2018, IDD laboratories of provincial, municipal and county-level in Jiangxi Province were examined for the external quality control of salt iodine, urinary iodine and water iodine. Among them, there were 1 provincial, 11 municipal and 30 county-level laboratories participated in salt iodine assessment; there were 1 provincial, 11 municipal and 100 county-level laboratories participated in urinary iodine assessment; and there were 1 provincial and 11 municipal laboratories participated in water iodine assessment. Salt iodine was determined by direct titration method (GB/T 13025.7-2012); urinary iodine was determined by As 3+-Ce 4+ catalytic spectrophotometry method (WS/T 107.1-2016) or inductively coupled plasma mass spectrometry method (WS/T 107.2-2016); water iodine was determined by the method in the range of 0 - 100 μg/L in "Study on the Method Suitable for the Detection of Water Iodine in Areas with Iodine Deficiency and High Iodine" recommended by national IDD reference laboratory. Urinary iodine was determined with Z score method, when│Z│≤ 2, it was qualified; when 2 <│Z│ < 3, it was basically qualified; when│Z│≥ 3, it was not qualified. Water iodine and salt iodine were determined by the method of reference value ± uncertainty, and the average value of the test results within this range was judged to be qualified; otherwise, it was judged to be unqualified. Results:In 2018, the feedback rates and qualified rates of salt iodine, urinary iodine and water iodine in 1 provincial and 11 municipal laboratories in Jiangxi Province were all 100.00%. Thirty county-level laboratories participated in the salt iodine assessment, and 1 of them failed. One hundred county-level laboratories participated in the urinary iodine assessment, and 3 of them failed.Conclusion:Laboratory testing technology of IDD continues to maintain at a high level in Jiangxi Province in 2018, and the detection ability of some county-level laboratories needs to be further improved.
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Objective To develop a diagnostic model based on deep neural network for intelligent discrimination of thyroid function. Methods A total of 1616 patients ( 283 males, 1333 females, average age:52 years) who underwent thyroid imaging between May 2016 and June 2018 were selected. According to the clinical diagnosis, the 1616 cases included 299 normal thyroid cases, 876 hyperthyroidism cases and 441 hypothyroidism cases. Feature extraction and learning training were performed on 1000 training set sam-ples by two deep neural network models ( AlexNet;deep convolution generative adversarial networks ( DCGAN) ) using deep learning algorithm. Performance verifications were implemented on 616 test set samples. The con-sistency between the verification results of the two models and the clinical diagnosis was analyzed by Kappa test. Meanwhile, the time advantage of the intelligent diagnosis models was analyzed. Results The average diagnostic time of AlexNet model was 1 s/case, and the classification accuracy for normal thyroid, hyperthy-roidism, hypothyroidism were 82.29％(79/96), 94.62％(369/390), 100％(130/130), respectively. The Kappa value between results of AlexNet model and clinical diagnosis was 0.886 ( P<0.05) . The average di-agnostic time of DCGAN model was 1 s/case, and the classification accuracy for normal thyroid, hyperthy-roidism, hypothyroidism were 85.42％(82/96), 95.64％(373/390), 99.23％(129/130), respectively. The Kappa value between results of DCGAN model and clinical diagnosis was 0.904 ( P<0.05) . Conclusion The deep neural network intelligent diagnosis model can quickly determine the functional status of thyroid gland in thyroid imaging, and it has a high recognition accuracy, thus providing a new method for thyroid image review.
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Objective To study the qualitative and quantitative standard of Shengui anti-pruritic mixture. Mehtods Sophorae Flavescentis Radix, Cnidii Fructus, Polygoni Multiflori Radix, Astragali Radix, Paeoniae Radix Alba and Glycyrrhizae Radix Et Rhizoma were identified by TLC.The contents of matrine and ferulic acid were determined by HPLC. Results The TLC showed the obvious characteristics with the spots clear and well-separated with no interference by negative control. Matrine showed a good linear relationship at 0.062 5- 2.500 0 μg (r=0.999 9) with a good meeting of adding sample recovery test. Ferulic acid showed a good linear relationship at 0.021 0-0.840 0 μg (r=0.999 9) with a good meeting of adding sample recovery test. Conclusions The method is easy-operated and accurate which showed a good specificity for the quality control of Shengui anti-pruritic mixture.
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Objective To explore the effects of dexmedetomidine on analgesia of general anesthesia in elderly patients with lumbar vertebra surgery.Methods From August 2013 to for August 2014, 80 cases elderly patients with fracture of lumbar vertebra and prepared to have an surgery of pedicle screw internal fixation in Department of Anesthesiology in Beijing Jishuitan Hospital were admitted , and divided into control group and observation group.The control group were continuously-pumped with sufentanil and the observation group with dexmedetomidine for anesthesia.The anesthetic effect were compared between two groups.Results The rate of sedative satisfaction in observation group post-anesthesia was higher than that in control group (100.0%vs.75.0%;χ2 =11.429,P<0.05).The Ramesay score, awaking and extubation time perioperational period in observation group were lower than those in control group(P<0.05).The analgesic effect in observation group was higher than that in control group(100.0%vs. 90.0%;χ2 =4.211,P<0.05).Conclusion Dexmedetomidine has the obvious sedative and analgesic effect on elderly patients with lumbar vertebra surgery.
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BACKGROUND:To reduce the amount of bleeding and the amount of hemoglobin after total knee replacement has been a key project in the clinical research in the division of bone and joint. Currently, ice therapy has been widely used in the clinic for tissue sweling and pain due to various physical and chemical factors. OBJECTIVE:To investigate the risk factors of postoperative hemoglobin after total knee replacement and discuss the effects of ice intervention. METHODS: 240 patients with osteoarthritis based on the random draw principles were equaly divided into the treatment group and the control group. The general information, disease status, diagnosis and treatment and prognosis of the two groups were investigated. Al patients were actively subjected to artificial total knee replacement. On the basis of the treatment in the control group, the treatment group received ice intervention at 2 hours after replacement for 7 consecutive days. RESULTS AND CONCLUSION:The postoperative hemoglobin decrease occurred in 34 patients, with the incidence of 14.2% among 240 patients at 7 days after replacement. Multivariate logistic regression analysis results showed that age, no ice treatment, body mass index were the main risk factors for hemoglobin decrease after total knee replacement (P 0.05). Results verify that clinical application of total knee replacement facilitated the knee recovery in patients with osteoarthritis, but hemoglobin decrease and bleeding existed. Active ice intervention can reduce the risk and relieve postoperative pain.
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<p><b>OBJECTIVE</b>To explore a new approach to determining the location of S1 screw for percutaneous screw fixation of the sacroiliac joint using a targeting device.</p><p><b>METHODS</b>Virtual three-dimensional pelvic models were reconstructed using the computed tomography (CT) scan data obtained from 100 adult subjects without any bony abnormalities. Mimics software was used to determine the ideal operating plane for S1 sacroiliac screw fixation based on the osseous marks. The parameters for screw fixation on the plane were measured, including the entry point, the needle angle (γ) and the safety range, and the accuracy of these parameters was verified using the digital models.</p><p><b>RESULTS</b>The ideal operating plane could be determined by the osseous prominences of ASIS (A) and PSIS (B) and the midpoint of S1 vertebral spines. The point at the posterior 1/3 of the line connecting points A and B could be defined as the entry point on the plane. The range of the needle angle γ was 101.4-117.2° for male and 109.5-120.78° for female patients, showing a significant sexual difference. Simulation results based on these parameters resulted in a total success rate of 91.25% (92.5% in male and 90% in female).</p><p><b>CONCLUSION</b>These parameters of the S1 screw can ensure a high success rate for percutaneous screw fixation of the sacroiliac joint and provide anatomical evidence for the development of a targeting device for the procedure.</p>
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Adult , Female , Humans , Male , Bone Screws , Fracture Fixation, Internal , Sacroiliac Joint , SoftwareABSTRACT
BACKGROUND:During open reduction and plate fixation for acetabular anterior column fracture, screw penetrating the articular surface often occurred. To prevent this complication, quantitative anatomical measurement is very important for safe pedicle screw in acetabular area using anterior column plate technology. OBJECTIVE:To provide anatomical basis for screwing placement safely in acetabular anterior column plate. METHODS:Mimics Software was used to perform three-dimensional reconstruction of the 40 cases of male pelvic and 40 cases of female pelvic CT scan data. The cutting tool was used to make serial cross-sections of the acetabular anterior column and the measuring tool was used to determine the safe length and direction of screw entry on al entry points of each cross-section. Al data were uploaded into SPSS 13.0 software for statistics process. RESULTS AND CONCLUSION: The distance from anterior acetabular margin to posterior acetabular margin and iliopubic eminence was as folows: in males: (56.63±2.05) mm, (12.30±1.51) mm, and in females: (49.07±5.07) mm, (16.93±1.74) mm, respectively. The distance from posterior acetabular margin to iliopubic eminence was as folows: in males: (45.46±3.44) mm, and in females: (33.72±6.85) mm. The safe entry angle of screws to iliac plate in the sagittal plane was (72.17±0.93)° in males, and (81.05±0.92)° in females. On each section of B, C and D, the maximum of the safe entry angle of screws to iliac plate in the oblique coronal plane was (53.88±3.01)°, (43.22±1.86)°, (54.60±2.97)° in males; and (49.54±1.81)°, (39.10±1.22)°, (47.91±2.23)° in females, respectively. Results indicated that three-dimensional model can be used to measure anatomic characteristics of acetabular anterior column plate and has important instruction significance for avoiding screwing into joint in acetabular anterior column plate technique.
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Objective To explore the relationship between the endovascular aortic repair (EVAR)in patients with abdominal aortic aneurysm (AAA) and postoperative systemic inflammatory response syndrome (SIRS).Methods In this study,93 AAA patients undergoing EVAR were enrolled.Analysis was performed to evaluate the incidence of SIRS during peri-operation period.Logistic multiple regression analysis was performed to determine the parameters predicting SIRS.Results The incidence of SIRS was 58.1％.Aneurysm size,mural thrombus,iliac artery lesion,number of stent,operating time,volume of contrast agent,blood loss and length of stay were all significantly correlated with SIRS (P ＜ 0.05).In a logistic regression model,history of kidney disease or operation,aneurysm size,ruptured aneurysm and number of stents were strongly and independently associated with SIRS.Conclusions SIRS is common in AAA patients after EVAR.Optimizing treatment strategies avoiding risk factors for SIRS benefits AAA patients.