Prevalence of psoriatic arthritis in Chinese population with psoriasis: A multicenter study conducted by experienced rheumatologists / 中华医学杂志(英文版)

BACKGROUND@#Reports on the prevalence of psoriatic arthritis (PsA) among Chinese patients with psoriasis are very limited. This study, conducted by rheumatologists, estimated the prevalence of PsA in a large number of Chinese patients with psoriasis.@*METHODS@#Consecutive patients with a confirmed diagnosis of psoriasis attending nine dermatology clinics in five hospitals were recruited. All psoriasis patients were asked to complete a questionnaire comprising 16 questions to identify possible cases of PsA. All patients with one or more positive answers to the questionnaire were evaluated by two experienced rheumatologists.@*RESULTS@#A total of 2434 psoriasis patients, including 1561 males and 873 females, were enrolled. Both the questionnaire and rheumatologists' examinations were completed in the dermatology clinics. The results identified 252 patients with PsA, comprising 168 males and 84 females. The overall prevalence of PsA among psoriasis patients was 10.4% (95% confidence interval [95% CI], 9.1%-11.7%). By sex, the prevalence was 10.8% (95% CI, 9.2%-12.5%) for males and 9.6% (95% CI, 7.7%-11.9%) for females and there was no significant sex difference in the prevalence of PsA (P = 0.38). Of the 252 PsA patients, 125 (49.6%, 95% CI, 41.3%-59.1%) were newly diagnosed by rheumatologists. Consequently, the prevalence of undiagnosed PsA among psoriasis patients was 5.2% (95% CI, 4.4%-6.2%).@*CONCLUSION@#The prevalence of PsA in the Chinese population with psoriasis is about 10.4%, which is almost double that of previous reports in the Chinese population, but lower than that in Caucasians.

Feasibility study of predicting thyroid papillary carcinoma central lymph node metastasis based on wavelet texture analysis using venous phase CT images / 中华放射学杂志

Objective@#To investigate the value of CT wavelet texture analysis based on primary tumor of papillary thyroid carcinoma (PTC) in predicting central lymph node metastasis (CLNM).@*Methods@#A retrospective analysis was performed to 250 patients (307 nodules) who pathologically confirm with PTC in the First Affiliated Hospital of Kunming Medical University from December 2013 to August 2019. Thyroid dual phase scanning was performed in all patients within two weeks before surgery. All patients underwent central or total cervical lymph node dissection, among which 160 cases (189 nodules) were classified as training sets, while 90 cases (118 nodules) were in the verification sets. Besides, all patients were divided into CLNM group and no CLNM group according to pathology. The DeepWise software were used to manually delineate PTC primary nodules on venous phase CT images, and 576 wavelet texture features were extracted. The differences of texture feature parameters between the two groups were compared. The top 10 wavelet texture features of the area under curve (AUC) value were manually selected as the best parameters. Multivariable logistic regression analysis was used to establish and verify the model, the optimal cutoff value was found by using receiver operating characteristic curve analysis.@*Results@#Totally 124 features were statistical difference between the two groups. The top 10 characteristic parameters for manual diagnosis with AUC values ranged from 0.599 to 0.630 (P<0.05), multi-collinearity test and multi-logstic regression analysis showed that there was no collinear correlation between the above 10 features, and small-area low-gray emphasis was an independent predictor of risk factors. The AUC value, sensitivity, specificity, and accuracy of the predictive model for the diagnosis of CLNM in the training set were 0.693, 62.84%, 60.47%, 62.96% and validation set were 0.602, 64.95%, 33.33%, and 59.32%, respectively.@*Conclusion@#Wavelet texture analysis in CT venous phase may allow detection of CLNM of PTC.

Dual?energy CT iodine image for evaluation of cervical lymph node metastatic potential in papillary thyroid microcarcinoma / 中华放射学杂志

Objective To investigate the feasibility of morphology and quantitative parameters for evaluation of lymph node metastatic (LNM) potential in papillary thyroid microcarcinoma (PTMC) with dual?energy CT iodine image. Methods The ninety?five PTMC patients (59 patients with LNM, 36 patients without LNM in the neck) whom underwent dual?energy contrast scanning and confirmed by first postoperative pathology results were enrolled in this retrospective study from July 2014 to December 2016. Dual?energy iodine images were obtained by the dual?energy post?processing software. The iodine image morphology of each patient was analyzed, including size, number, aspect ratio, shape, uncompleted enhanced ring sign, nodule which breaks through the thyroid capsule, microcalcification, and enhanced?degree, and diagnostic efficiency of each imaging feature was calculated. The iodine concentration (IC) and CT value of PTMC solid parts were measured in arterial phase and venous phase images respectively, as well as the NICnod (normalized iodine concentration) and normalized CT value. The independent sample t test was performed to compare quantitative parameters between the LNM group and non?LNM group. ROC curves with quantitative parameters of two phases were used to analyze the diagnostic efficiencies of NIC and normalized CT value. Results Statistically, in the iodine image, the imaging features of LNM group, including multiple lesions, maximum diameter of nodules, aspect ratio, irregular shape, uncompleted enhanced ring sign, and nodule which breaks through the thyroid capsule, had significant differences compared with those of non?LNM group in the neck (χ2 were 14.965,8.724,11.494,8.097,6.324,23.272;P all<0.05), and there were positive correlations with LNM potential (r were 0.397,0.303,0.348,0.309,0.258, 0.495;P all<0.05), the diagnostic efficiency of nodule which breaks through the thyroid capsule was the highest among the imaging features for diagnosis of cervical LNM (sensitivity 77.9%, specificity 72.2%, accuracy 75.8%). During the artery phase, mean NICROI and normalized CT value of non?LNM group were respectively 0.29±0.10,0.33±0.11,and these of LNM group were respectively 0.45±0.15,0.44±0.13.NICROI and normalized CT value of non?LNM group were less than LNM group′s (t=-4.891,－3.462;P all<0.001). During the venous phase, NICROI and normalized CT value of LNM group were higher than non?LNM group′s (t=-3.381,－2.18;P all<0.05). Among all quantitative parameters, the NIC of arterial phase has the highest diagnostic efficacy for the diagnosis of cervical LNM. The area under the ROC curve (AUC) was the largest, 0.814, the sensitivity was 73.5%, the specificity was 79.2%, and the diagnostic threshold was 0.208. Conclusion Dual?energy CT iodine image morphology and quantitative parameters have important clinical value for evaluation of cervical lymph node metastatic potential in PTMC.

Laparoscopic and thoracoscopic Ivor Lewis esophagectomy without an abdominal small incision / 国际外科学杂志

Objective To investigate the feasibility and clinical effect of laparoscopic and thoracoscopic Ivor Lewis esophagectomy without an abdominal small incision.Methods Compared 80 cases underwent laparoscopic and thoracoscopic Ivor Lewis esophagectomy without an abdominal small incision with 68 patients receivesd laparoscopic and thoracoscopic Ivor Lewis esophagectomy with an abdominal small incision.The peri operative conditions and complications of the two groups were analyzed.Results There were no significant difference in the operation time [(263.3 ± 71.5) min vs (273.3 ± 73.7) min,t =-0.750,P =0.454],intraoperative blood loss [(246.9 ± 150.4) ml vs (252.9 ± 159.7) ml,t =-0.238,P =0.812],the number of lymph node dissection [(19.2 ±4.3) vs (19 ±4.5),t =0.272,P =0.786],gastrointestinal decompression time [(11 ± 3.4) d vs (11.9±3.3) d,t=-1.647,P=0.102],chest tube indwelling time [(6.6±2.7) d vs (6.3±2.6) d,t=0.544,P=0.587],postoperative hospitalization time [(13.2 ±3.4) d vs (14 ±3.4) d,t=-1.493,P=0.138] and rate of early gastric emptying dysfunction [6.25％ (5/80) vs 4.41％ (3/68),x2 =0.016,P =0.898].Comparing to patients in the small incision group,the visual analogue scale evaluation score of postoperative pain was lower in the groups without small incision (P ＜ 0.05).There were no anastomotic fistula,thoracic gastric fistula,upper gastrointestinal bleeding and death during perioperative periods.Conclusion It is safe and feasible to treat middle and lower esophageal carcinoma with laparoscopic and thoracoscopic Ivor Lewis esophagectomy without an abdominal small incision,which can further reduce abdominal trauma,relieve postoperative pain and make the abdominal incision more beautiful.

The value of dual-energy CT iodine image and NICnod in diagnosis of thyroid cancer / 实用放射学杂志

Objective To investigate the value of dual‐energy CT iodine image morphology and iodine concentration in thyroid cancer diagnosis .Methods The patients underwent dual‐energy contrast scanning and confirmed with pathology results were en‐rolled .90 cases (60 malignant nodules and 30 benign nodules) were chosen with the CT value of internal carotid :110-250 HU at ar‐terial phase and 70-110 HU at venous phase .The iodine concentration of normal thyroid and neoplasms were measured respective‐ly ,as well as the NICnod (normalized iodine concentration) .Then the data was compared among each groups .The iodine image mor‐phology was also analyzed of each neoplasms ,and sensitivity ,specificity and accuracy were calculated .Results ①In the iodine image the characteristics of thyroid cancer ,including irregular shape ,invading neighbor structure and uncompleted enhanced ring around the tumor ,have significant differences compared with normal CT image (P all0 .05) .②There were significant differences in the venous phase NICnod value from normal groups ,malignant groups and benign groups (P<0 .05) .When diagnosed as malignant tumor ,the critical NICnod was under 0 .76 ,the area under the ROC curve of AUC value were 0 .91 ,the sensitivity and specificity were 74 .61% and 75 .60% ,respectively .③The sensitivity ,specificity and accuracy of iodine image combined with the NICnod to diagnose thyroid cancer were 91 .67% ,86 .67% , 94 .44% ,respectively .Conclusion Dual‐energy CT iodine image morphology and iodine concentration have important value in thyroid cancer diagnosis .

Feasibility of Low Tube Current Combined with SAFIRE to Reduce Radiation Dose in Dual-energy Coronary Artery CT Angiography / 中国医学影像学杂志

Purpose Dual-energy coronary artery CT angiography (CTA) is a very promising one-stop examine, but the radiation dose is too high to hinder the development of the technology. The aim of this article is to explore the feasibility of low tube current combined with sonogram-affirmed iterative reconstruction (SAFIRE) technology in dual energy coronary artery CTA scan. Materials and Methods One hundred and twenty patients were randomly divided into four groups according to the tube current of A ball:conventional group (180 mAs) and low-dose groups (150 mAs, 120 mAs, 90 mAs). The SAFIRE 3 reconstruction method was used in the low-dose groups. The differences of mean CT values, image noise, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), image quality score and effective dose (ED) of the four groups were compared. Results The coronary artery segment display and the mean CT value of the four groups showed no statistic difference (P>0.05), while the image quality score, noise, SNR, and CNR showed statistic difference (P0.05). The ED was (5.50±1.47) mSv, (4.55±1.16) mSv, (3.41±0.77) mSv and (2.44±0.67) mSv, respectively for the four groups, and there was statistical difference (P<0.05). ED of 90 mAs group decreased 55.62% than that of 180 mAs group. Conclusion Coronary artery CTA using 90 mAs combined with SAFIRE can significantly reduce the radiation dose without losing image quality, thus it has a good prospect of clinical application.

Iodine Concentration on Dual-energy Contrast Enhanced CT in Differential Diagnosis of Thyroid Nodules / 中国医学影像学杂志

Purpose To investigate the clinical application of iodine concentration using dual-energy contrast enhanced CT in distinguishing malignant from benign thyroid nodules. Materials and Methods Patients with a total of 90 pathology proven thyroid nodules (60 malignant, 30 benign) underwent dual-energy contrast enhanced CT scanning. The iodine concentration and CT value were measured in arterial phase and venous phase, then the normalized iodine concentration (NICnod) and the normalized CT value were calculated. All results were compared in each groups, while morphology and capsule of these nodules on iodine image were analyzed. Results The morphology and capsule of nodules on iodine image were significantly different between benign and malignant nodules (Z=- 4.55, P<0.05). On iodine image, the sensitivity of partial capsule diagnosing malignant nodules was 78.33% with specificity of 66.67%. The NICnod and normalized CT value for normal group, benign group and malignant group showed significant differences in arterial phase and venous phase (F=36.87-69.89, P<0.05); the NICnod and normalized CT value between benign group and malignant group showed statistic difference in arterial phase (Z=- 3.48- -2.33, P<0.05), and those among normal group, benign group and malignant group also showed statistic differences (Z= -7.01- - 4.87, P<0.05). NICnod had significant correlation with normalized CT value in each phases (r=0.89, 0.74 and 0.75, P<0.05). When using NICnod and normalized CT value of 0.76 and 0.79 to differentiate malignant thyroid nodules, the area under ROC curve values were 0.91 and 0.92. NIC and normalized CT value showed a good consistency with iodine map in venous phase (Kappa=0.762 and 0.768), Combining morphology and capsule of nodules on iodine image, the sensitivity was 90.01% and the specificity was 93.60%. Conclusion Iodine concentration with dual-energy contrast enhanced CT scanning can differentiate malignant from benign thyroid nodules; combining morphology and capsule of nodules improves the accuracy of diagnosis.

The prognostic value of the number of negative lymph nodes in esophageal carcinoma without lymphatic metastasis after esophagectomy / 中华胸心血管外科杂志

Objective To investigate the correlation between the number of resected lymph nodes(LNs) and the prognosis of patients with node-negative esophageal carcinoma.Methods A retrospective review of 429 patients receiving esophagectomy with morden two-field lymphadenectomy for cancer between January 1998 and December 2008 was performed.All patients were proved without lymph node involvement histopathologically.The prognostic impact of the number of negative LNs and the clinicopathologic factors were analyzed.Results The overall median survival time was 63.0 months,and the 1-,3-,and 5-year overall survival rates were 78.5％,64.0％ and 51.2％,respectively.Survival analysis confirmed that the number of negative LNs and the depth of tumor invasion were showed to be independent prognostic factors.Patients with a high number of negative LNs had better overall survival than patients with a low number of negative LNs(P ＜ 0.05).The patients had better long-term survival outcomes with dissected LNs counts of more than 15 for cases with pT1 tumor(P ＜ 0.05),and more than 20 for cases with pT2-3 tumor(P ＜ 0.05).Conclusion The number of negative lymph nodes is an independent prognostic predicting factor for node-negative esophageal carcinoma.Sufficient dissection of LNs is recommended to improve the survival of patients with node-negative esophageal carcinoma.

Prognostic value of the number of negative lymph nodes in non-small cell lung cancer without lymphatic metastasis after pulmonary resection / 中国肿瘤临床

Objective:This study aims to investigate the correlation between the number of resected lymph nodes (LNs) and the prognosis of patients with node-negative non-small cell lung cancer (NSCLC). Methods:A retrospective review of 305 patients with NSCLC, who received curative resection between January 2004 and December 2009, was conducted. All patients were proved without lymph node involvement histopathologically. The prognostic impact of the number of negative LNs and the clinicopathologic factors were analyzed. Results:The overall median survival time and the 1-, 3-, and 5-year overall survival rates were 60.0 months, 76.1%, 59.3%, and 47.1%, respectively. Survival analysis confirmed that the number of negative LNs, T staging and the stations of the mediasti-nal lymph nodes dissected were showed to be independent prognostic factors. Patients with a high number of negative LNs had better overall survival than patients with a low number of negative LNs (P0.05). Conclusion:The number of negative lymph nodes is an independent prognostic predicting factor for node-negative NSCLC. Sufficient dissection of LNs is recommended to improve the survival of the patients with node-negative NSCLC.

CT Manifestations of Thyroid Carcinoma and Its Correlation with Lymph Node Metastasis / 中国医学影像学杂志

Purpose To explore CT manifestations of thyroid carcinoma and its correlation with neck lymph node metastasis. Materials and Methods CT findings of 165 patients with thyroid carcinoma confirmed by surgical pathology were studied, including number, shape, size, calcium, necrosis, surrounding invasion and enhancement of substantial part, and its correlation with neck lymph node metastasis was also analyzed. Results 107 out of 165 patients (64.85%) suffered from neck lymph node metastasis. Different tumor number, calcium and necrosis were not associated with the rate of neck lymph node metastasis (χ2=0.009, 2.606, 1.522;P>0.05);tumor shape, size, surrounding invasion and enhancement were significantly different from the rate (χ2=26.510, 75.995, 68.922, 20.819;Penh ancement>shape>size>age. However, patients gender, tumor number, calcium and necrosis showed on correlation (r=0.074, 0.126, 0.005, 0.121;P>0.05). Conclusion Lymph node metastasis is mainly associated with factors like age, tumor shape, size, enhancement and surrounding invasion. It is advisable that patients with high risk rate may consider selective cervical lymph node dissection.

Analysis of the differential binding protein in human breast cancer cell line(MCF-7) and paclitaxel resistant cell line(MCF-7/Taxol) / 中国药理学通报

Aim To identify paclitaxel differential binding protein in the cells of cell line MCF-7 and MCF-7/Taxol and to find new target for antitumor agents.Methods Synthesis and activity assay of biotinylated paclitaxel was used to gain paclitaxel binding protein by semiautomatic in vitro selection using the affinity magnetic beads method.LC MS/MS analysis and Western immunoblot analysis were used to identify the differential binding protein.Results The experimentation identified paclitaxel binding protein in the cells of MCF-7 and MCF-7/Taxol.An absent strap in MCF-7/Taxol was discovered by comparing the straps of two cell lines, which contained 25 kinds of proteins, among which 3 proteins were identified by western blot techniques: Heat shock protein HSP 90,Dermcidin Precursor,Actinin.Conclusions By comparing the straps of two cell lines, the differential protein in the cells of MCF-7 and MCF-7/Taxol are discovered, implying that they may be the novel mechanism of taxane resistance and may lead to find a new approach to finding a new target for oncotherapy drugs.

Clinical significance of serum level of transforming growth factor-beta 1 in patients with chronic idiopathic thrombocytopenic purpura / 中国综合临床

Objective To investigate clinical significance of transforming growth factor-beta 1 ( TGF-β1 ) in patients with chronic idiopathic thrombocytopenic purpura(CITP). Methods The serum level of TGF-β1 in 38 pa-tients with initial CITP were detected using enzyme-linked immunosorbent assay(ELISA). Results The serum level of TGF-β1 in initial patients with CITP was significantly higher than that of the controls [( 132.57±5.17) μg/L vs ( 76.81±4.42) μ/L] ( P <0.01 ). The serum level of TGF-β1 in those having good response after therapy was sig-nificantly lower than before treatment[(81.26±3.78)μg/L] (P <0.01 ). There was no difference in TGF-β1 be-tween nonremission [(123.49 ± 4.31 ) μg/L] and initial patients (P > 0.05 ). There was negative correlation between TGF-β1 and platelet count(r = -0. 342 ,P < 0.05 ) ,there was positive correlation between TGF-β1 and megakaryo-cyte count (r = 0.409, P < 0.01 ). Conclusions TGF-β1 partakes in the pathogenesis of CITP, the determination of which in patients with CITP is useful to judge the state of illness, which can be regarded as an assistant index of cur-ative effect.

Study on factors associated with long-term survival of acute leukemia / 白血病·淋巴瘤

Objective To analyze factors associated with long-term survival of acute leukemia(AL). Methods Clinical data is analyzed in 27 leukemia cases who had at least 5 years free survival (EFS). Combined intensive chemotherapy was administered under the principle of individualization to induce remission.Regular consolidation treatment after remission was strictly continued.Long-term follow up Was kept on,with the therapeutic regimen modified accordingly.Results Complete remission(CR) was achieved in 112 of 143(78.3%)AL patients and 27(18.9%)of them had survived more than 5 years.Conclusion The long-term survival of AL patients is related to the type of AL,leukemia cell burden,extramedullary leukemia, individual treatment,time required to achieve CR,continuous intensive chemotherapy and the regular postremission treatment.

Treatment of refractory and relapsed acute leukemia in 25 adult patients with MAAE regimen / 白血病·淋巴瘤

Objective To analyze on the efficacy and toxicity of MAAE (MIT ,Ara-C,AMSA,VP16)regimens on treating refractory and relapsed acute leukemia in adult patients. Methods MAAE (MIT, Ara-C,AMSA, VP16) regimen, which consisted of MIT 10mg/d (d1～3), intravenousdrop, Ara-C 200mg/d (d1～7),intravenousdrop, AMSA 75 mg/d (d1～3), intravenousdrop VP16 100 mg/d(d1～4), intravenousdrop were used to treat 25 cases of adults with refractory and relapsed acute leukemia (AL). G-CSF 5 μg/kg were used every day when WBC＜0.5×109/L. Results In the 25 cases with refractory and relapsed acute leukemia, 14 cases (56 %) reached complete remission, 5 patients(20 %) reached partial remission, the total effective rate was 76 %. Conclusion MAAE regimen was a very effective alternative treatment for CR induction in adult patients with refractory and relapsed AL and low toxicity.

Cloning, Expression and Polyclonal Antibody Preparation of the Asialoglycoprotein Receptor of Marmota Himalayan / 华中科技大学学报（医学）（英德文版）

The objective of this study is to express the carbohydrate recognition domain (CRD) of the asialoglycoprotein receptor (ASGPR) H1 and H2 subunits of Marmota himalayan in vitro, and develop polyclonal antibodies against the recombinant proteins. RT-PCR was used to amplify ASGPR CRDH1 and CRDH2 from the liver tissue of Marmota himalayan. The products of amplification were subcloned into prokaryotic expression vector pRSET-B, and expressed in E. coli BL21(DE3)plysS. The recombinant proteins were purified using Ni-NTA spin column. The purified proteins were inoculated into BALB/c mice to develop polyclonal antibodies. The sensitivity and specificity of antibodies were evaluated by enzyme-linked immunosorbent assay (ELISA), Western blotting and immunohistochemical staining (IHC). The polyclonal antibodies showed high sensitivity and specificity against both denaturated and native ASGPR proteins. We successfully amplified and expressed the ASGPR CRDs of Marmota himalayan. The nucleic sequences of ASGPR CRDH1 and CRDH2 of Marmota himalayan have been submitted to Genbank and the sequence ID are DQ 845465 and DQ845466, respectively. The proteins and antibodies prepared can be used for targeting gene therapy in a new animal model-Marmota himalayan-for the research of infectious diseases of hepatitis viruses and liver cancer treatment.

Study on the Negative Influences of Internet to Students' Morals Socialization / 中华医学教育探索杂志

While Internet brings convenience to teenagers,there are some negative and bad things too.In the network,various sorts of information is mixed,the good and bad are intermingled,and much harmful information has become the pollution source to students' inner world,which will have great impact on the moral socialization and virtue.

Discussion of the driving force and checking strategy for tfae unduly rapid increase of medical fees / 中华医院管理杂志

The increase of medical fees, which can be attributed to many factors, is inevitable. However, from the perspective of economics, medical services are characterized by monopolization, the dual nature of entrust-ment and agency and the inflexibility of demands. Driven by the pursuit of profits, suppliers are keen on the kind of medical programs they provide, leading in part to the excessively rapid increase of medical fees. One of the key mea-sures for checking this increase and deepening health reform is to replace payment by programs with payment by case groups. Payment by case groups can be implemented in many ways. A relatively scientific and rational way is payment by case mix.

Effect of autologous bone marrow mononuclear cell local transplantation on peripheral neovascularization / 中国病理生理杂志

AIM: To investigate the effect of autologous bone marrow mononuclear cells (BM-MNCs) local transplantation (BM-LT) on a rabbit model of hindlimb ischemia. METHODS: After unilateral femoral artery and its branches were surgically ligated and excised in rabbits (n=14) 1 hour or so, autologous BM-MNCs were injected into the ischemic skeletal muscles in 7 rabbits, and phosphate buffered saline for another 7 ones as control. Hemodynamics parameters were measured at day 0, day 7 and day 28, respectively. On day 28, the animals were sacrificed in groups for pathological analysis. RESULTS: Compared with control group, color Doppler flow image in BM-LT group was recovered significantly, and its' systolic peak velocity and end-diastolic velocity were also improved (P

Discussion of human resources management / 中华医院管理杂志

The paper first discusses the concepts and implications of human resources and human talents as well as the difference between the two. Then it expounds the difference between human resources management and personnel management with regard to historical conditions and functions. Finally the paper deals with the specific characteristics of personnel management and the urgency of transition to human resources management.

Significance and means of implementing clinical pathways / 中华医院管理杂志

The authors first describe the concept and connotation, origin and functions of clinical pathways and then give an account of the selection of disease groups or cases in clinical pathways and the formulation of means and procedures. They argue that in the implementation of clinical pathways, reform of the manner of hospital payment is the driving force, transformation of physicians idea of service is the key, and coordination and cooperation between various departments is the guarantee.