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Objective To investigate the clinical efficacy of neoadjuvant chemotherapy (oxaliplatin +capecitabine,XELOX) for the resectable locally advanced adenocarcinoma of esophageal-gastric junction (AEG).Methods The prospective study was conducted.The clinicopathological data of 106 locally advanced AEG patients who were admitted to the Cancer Hospital of Shantou University Medical College from January 2011 to December 2014 were collected.All the patients were divided into the treatment group and control group by single blind,randomized,controlled random number table.Patients underwent preoperative neoadjuvant chemotherapy (XELOX) + surgery + postoperative adjuvant chemotherapy (XELOX) in the treatment group and surgery + postoperative adjuvant chemotherapy (XELOX) in the control group.Total gastrectomy + Roux-en-Y esophagojejunostomy + D2 lymphadenectomy were applied to patients by the same team of doctors.Observation indicators:(1) treatment situations;(2) results of postoperative pathological examination;(3) follow-up and survival situations.Follow-up using outpatient examination was performed to detect the postoperative tumor recurrence or metastasis and patients' survival up to February 2017.Measurement data with normal distribution were represented as (-x)±s,and comparisons between groups were evaluated with the t test.Measurement data with skewed distribution were described as M (range) and analyzed by the nonparametric test.Comparisons of count data were analyzed using the chi-square test.The ordinal data were compared using the nonparametric test.Survival rate and curve were respectively calculated and drawn by the Kaplan-Meier method and survivals were compared using the Long-rank method.Results One hundred and six patients were screened for eligibility,including 54 in the treatment group and 52 in the control group.(1) Treatment situations:① preoperative neoadjuvant chemotherapy:54 in the treatment group received 2-4 cycle neoadjuvant chemotherapy.During the chemotherapy,gastrointestinal reaction,grade 1-2 granulocytopenia,elevated alanine transaminase (ALT) and grade 3 granulocytopenia were detected in 21,17,8,1 patients,and 7 patients had no adverse reaction.The complete response(CR),partial response (PR),stable disease (SD) and progressive disease (PD) of neoadjuvant chemotherapy in the treatment group were detected in 4,27,20 and 3 patients,respectively.Of 54 patients in the treatment group,4,13,25 and 12 were in grade 0,1,2 and 3 of response to preoperative chemotherapy,respectively.② Surgical situations:preoperative carcinoembryonic antigen (CEA) in the treatment and control groups were respectively 4.71 μg/L (range,0.20-36.19 μg/L) and 14.09 μg/L (range,0.71-178.20 μg/L),with a statistically significant difference between groups (Z =-1.92,P＜ 0.05).All patients underwent total gastrectomy + Roux-en-Y esophagojejunostomy + D2 lymphadenectomy.Operation time in the treatment and control groups were respectively (210± 31) minutes and (195 ±26) minutes,with a statistically significant difference between groups (t =-2.45,P ＜ 0.05).Volume of intraoperative blood loss,cases with intraoperative blood transfusion,time to postoperative anal exsufflation,time to defecation,time for initial diet intake,cases with postoperative complications and duration of hospital stay were respectively (216± 172) mL,6,(4.3± 1.0) days,(4.5±0.8)days,(3.1±0.5)days,11,(15.0±5.0)days in the treatment group and (174±108)mL,4,(4.2± 1.0) days,(4.4± 0.8) days,(3.1 ± 0.5) days,15,(15.0± 5.0) days,with no statistically significant difference between groups (t=-1.01,x2 =0.36,t=-0.31,-0.88,-0.36,x2 =1.03,t=-0.38,P＞0.05).③Postoperative adjuvant chemotherapy:all the patients completed the postoperative adjuvant chemotherapy.The granulocytopenia,elevated ALT and gastrointestinal reaction occurred in 25,5,28 patients in the treatment group and 21,7,30 patients in the control group,respectively,with no statistically significant difference between groups (x2 =0.38,0.47,0.36,P＞0.05).Some of the patients were merged with multiple adverse reactions.(2) Results of postoperative pathological examination:maximum tumor dimension,cases with lymphovascular invasion,perineural invasion,T0,T2,T3,T4 (T stage),stage 0,Ⅰ,Ⅱ and Ⅲ1 (TNM stage) were respectively (3.6±1.4)cm,5,10,4,10,20,20,4,7,15,28 in the treatment group and (4.5±1.7)cm,24,30,0,2,13,37,0,1,12,39 in the control group,with statistically significant differences between groups (t=-2.88,x2 =18.14,17.30,Z=14.74,8.13,P＜0.05).(3) Follow-up and survival situations:of 54 patients in the treatment group,52 were followed up for 4-72 months,with a median time of 32 months;of 52 patients in the control group,49 were followed up for 5-71 months,with a median time of 36 months.The postoperative diseasefree survival time,1-,3-and 5-year tumor-free survival rates,postoperative overall survival time and 1-,3-and 5-year overall survival rates were respectively 26 months (range,3-72 months),79.5％,64.7％,61.3％,27 months (range,5-72 months),88.3％,69.2％ and 62.1％ in the treatment group.Seventeen patients had tumor recurrence,including 2 with intraperitoneal local recurrence and 15 with distant metastasis.The postoperative disease-free survival time,1-,3-and 5-year tumor-free survival rates,postoperative overall survival time and 1-,3-and 5-year overall survival rates were respectively 33 months (range,2-71 months),89.7％,55.4％,55.4％,33 months (range,5-71 months),91.8％,72.1％ and 59.7％ in the control group.Nineteen patients had tumor recurrence,including 8 with intraperitoneal local recurrence and 11 with distant metastasis.There was no statistically significant difference in disease-free survival and overall survival between groups (x2 =0.018,0.596,P＞0.05).There was a statistically significant difference in cases with local recurrence between groups (x2=4.41,P＜ 0.05) The tumor-free survival time and overall survival time in the treatment group were respectively 29 months (range,8-72 months),38 months (range,10-72 months) in 31 patients with CR and PR and 11 months (range,3-68 months),18 months (range,4-68 months) in 23 patients with SD and PD,showing statistically significant differences in tumor-free and overall survival times (x2=5.27,7.72,P＜0.05).Concluslon Neoadjuvant chemotherapy with oxaliplatin and capecitabine is safe and effective for patients with the resectable locally advanced AEG,it can also decrease tumor stage and reduce local recurrence,but fail to demonstrate a survival benefit.
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Objective To explore the influential factors of esthetic evaluation of mandibular prominence by orthodontic patients from two dimensions (ideal value and tolerance range).Methods 226 orthodontic patients were investigated by an electronic questionnaire of esthetic evaluation of mandibular prominence.Binary logistic regression was adopted to analyze the influential factors.Results The tolerable boundary value for female mandibular retrognathism was affected by age (OR1.360) and orthodontic history (OR2.849).The tolerable boundary value for female mandibular prognathism and male mandibular retrognathism were found to be affected by orthodontic history (OR2.557 and 2.845,respectively).The tolerable boundary value for male mandibular prognathism was affected by age (OR1.347) and orthodontic history (OR2.310).The ideal value of male mandibular prominence was affected by age (OR1.420).Conclusions Orthodontic patients' esthetic evaluation of mandibular prominence is influenced by age and treatment condition,but not by sex,education level,marital status and personal profile.
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Objective To investigate the factors influencing positive and negative affects ot orthodontic patients.Methods 145 orthodontic patients were selected and finished questionnaire survey.The questionnaires included demographic data,psychosocial impact of dental aesthetic questionnaire (PIDAQ),aesthetic content of index of orthodontic treatment need (IOTN-AC),perception of occlusion scale (POS),and positive affect and negative affect scale (PANAS).Mann-Whitney U-test,Kruskal-Walis H-test,and Spearman correlation analysis were used to analyze the relation between impact of dental aesthetics and positive and negative affects in orthodontic patients.Results The scores of adolescent patients were higher than adult patients in negative affect (U =1886.500,P＜0.05).The patients under orthodontic treatment scored higher than those before treatment (U=2228.000,P＜0.05).The subdomains of PIDAQ,such as social impact (x2=ll.794,P＜0.05),aesthetic attitude (x2 =45.853,P＜0.05),and dental confidence (x2 =33.551,P＜0.05) were related with negative affect.The scores of IOTN-AC,PIDAQ,POS demonstrated positive correlation with negative affect (P＜0.05).The scores of social impact showed negative correlation with positive affect (P＜0.05).Conclusions Adult orthodontic patients suffer more negative affect than adolescent patients.Orthodontic treatment could promote patients' positive affect.However,the negative psychosocial impact in dental aesthetics would strengthen the negative affect.
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Clinical engineering is at a strategic developing point. Technical, economical, and cultural dynamics are at work shaping the future of clinical engineering. As the nature of clinical engineering transformed by these forces, delay or failure to adopt effective methods will result in a diminished role for clinical engineering in healthcare. This article will demonstrates in detail the challenges which the clinical engineering encounters presently and its direction of development in the future.
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The gating mechanical kinetical of ion channels has been modeled as a Markov process. In these models it is assumed that the channel protein has a small number of discrete conformational states and kinetic rate constants connecting these states are constant, the transition rate constants among the states is independent both of time and of the previous channel activity. It is assumed in Liebovitch's fractal model that the channel exists in an infinite number of energy states, consequently, transitions from one conductance state to another would be governed by a continuum of rate constants. In this paper, a statistical comparison is presented of Markov and fractal models of ion channel gating, the analysis is based on single-channel data from ion channel voltage-dependence K+ single channel of neuron cell and simulation data from three-states Markov model.
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Animals , Female , Male , Rats , Cells, Cultured , Computer Simulation , Electrophysiology , Fractals , Ion Channel Gating , Physiology , Markov Chains , Models, Biological , Neurons , Physiology , Patch-Clamp Techniques , Potassium Channels , Physiology , Rats, Sprague-DawleyABSTRACT
When a conventional phase-encoding magnetic resonance spectrascopic imaging(MRSI) method is in use, the data acquisition is very time consuming and thus it is not well accepted in clinical settings. Echo planar spectroscopic imaging (EPSI) technology has been applied for rapid acquisition of MRSI data. It significantly reduces scan time by simultaneously encoding the spectral dimension and the spatial dimension. Reconstruction of EPSI data is sophisticated. For the t-dimension, data are non-uniformly sampled. Fast Fourier transform (FFT) is applied in odd echoes and even echoes respectively and then shift method is used to combine them together. For the kx dimension, the data are unevenly sampled and have to be interpolated onto a Cartesian grid before FFT is applied. For the phase-encoding dimension (ky), the Fourier transform can be readily done with FFT since the data are evenly spaced.
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Algorithms , Echo-Planar Imaging , Methods , Image Processing, Computer-Assisted , Methods , Magnetic Resonance Spectroscopy , Methods , Signal Processing, Computer-AssistedABSTRACT
Support Vector Machine (SVM) is an efficient novel method originated from the statistical learning theory. It is powerful in machine learning to solve problems with finite samples. Due to the deficiency of cancer cells, character of patient and noise in the raw data, it is very difficult to diagnose early cancer accurately. In this paper, SVM is employed in detecting early cancer and the results are encouraged compared with conventional methods. The accuracy of Non-linear SVM classifier is especially high in all kinds of classifiers, which indicates the potential application of SVM in early cancer detection.
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Humans , Algorithms , Artificial Intelligence , Data Interpretation, Statistical , Early Diagnosis , Models, Statistical , Neoplasms , Diagnosis , Neural Networks, Computer , Pattern Recognition, AutomatedABSTRACT
The required time of conventional magnetic resonance spectroscopic imaging technique is too long to be applied to clinic. It is necessary to develop the fast methods for magnetic resonance spectroscopic imaging. Nowadays there are 7 kinds of methods presented, which come from MRI techniques. In this contribution the conventional spectroscopic imaging and 7 sorts of fast spectroscopic imaging are elaborated. It is envisaged that more rapid imaging techniques will be designed, if these arbitrary trajectory reconstruction methods in MRI are applied to spectroscopic imaging.
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Magnetic Resonance Imaging , Methods , Magnetic Resonance Spectroscopy , MethodsABSTRACT
In this paper, the R-PS integration technique of the digital radiology is discussed. By the integration of the RIS and PACS, all data and information of each system and each medical image equipment in R-PS can be exchanged according to DICOM3.0, and seamless linkage can be realized by module interfaces. R-PS has many advantages such as share, safety, compatibility, practicability and feasibility. Standardization of communication interface, modularization of application and resource share of medical information can be realized by this technique.
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Humans , Computer Communication Networks , Hospital Information Systems , Radiographic Image Interpretation, Computer-Assisted , Radiology , Radiology Information Systems , Software , Systems Integration , TeleradiologyABSTRACT
Image registration methods based on mutual information, including mutual information and normalized mutual information, have been accepted as the most accurate and efficient methods. But there are many fluctuations in the registration functions that hinder the optimization procedure and lead to registration failure in intra-modal registration. We found that besides the interpolation artifacts, the uncertainty of the changing of entropy with the changing of overlap also contributes to the fluctuations. The effect of interpolation artifacts can be eliminated, but it is difficult to eliminate the effect of uncertainty of entropy. Luckily, this effect is not significant in normalized mutual information. Normalized mutual information is more stable and robust than standard mutual information and its better performance and wider application can be expected.
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Humans , Algorithms , Diagnostic Imaging , Image Processing, Computer-Assisted , Methods , Magnetic Resonance Imaging , Methods , Medical Informatics , Methods , RegistriesABSTRACT
This paper introduces an adaptive filter method for enhancing ventricular late potentials. The adaptive filter has only one signal electrode and does not need the reference electrode. The experiment results show that this adaptive filter method can effectively improve signal-to-noise ratio of ventricular late potentials.
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Humans , Action Potentials , Algorithms , Computer Simulation , Electrocardiography , Signal Processing, Computer-Assisted , Ventricular FunctionABSTRACT
A PC-based software was developed and programmed with VC++6 for reconstructing MR images from the data acquired on an irregular k-space trajectory. It can read clinical MRI raw data and image data, create numerical phantoms, design k-space trajectories, generate k-space data from numerical phantom, calculate weighting functions, reconstruct images, and carry out error analysis for the reconstructed images. It is helpful to the investigations of new k-space trajectories and new reconstruction algorithms.
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Humans , Algorithms , Bayes Theorem , Brain , Fourier Analysis , Image Processing, Computer-Assisted , Methods , Magnetic Resonance Imaging , Methods , Programming Languages , Software , Software DesignABSTRACT
In order to overcome the effects of the anti-aliasing filter and the colored background noise, an adaptive algorithm is proposed to estimate the parameters of ion channel kinetics and the background noise, and whereafter the ion channel signal could be restored from the strong noisy patch-clamp recordings. The algorithm cross-couples the recursive expectation-maximization algorithm, which estimates optimally the parameters of hidden Markov model, and the recursive extended least square algorithm, which estimates optimally the characteristics of the background noise. Simulation suggests that this cross-coupling algorithm convergences consistently, and is very robust to the inexact conformation number.
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Algorithms , Ion Channels , Physiology , Least-Squares Analysis , Likelihood Functions , Models, Theoretical , Noise , Patch-Clamp Techniques , Methods , Signal Processing, Computer-AssistedABSTRACT
Based on the Bloch equation, we can describe the working principle of the magnetic resonance imaging system with mathematic model, the inputs are the three templates of appropriate rho, T1 and T2. In this paper, the simulation process is illustrated by spin echo examples of the signal exciting, phase coding, reading-out and image reconstruction. The satisfactory results show that this method can be widely used in simulation researches.
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Algorithms , Computer Simulation , Magnetic Resonance ImagingABSTRACT
The history and current situation of cell membrane ion-channel gating mechanism study were reviewed, with an emphasis on the application and the latest developments of kinetic model in gating mechanism study; the problems in present study and ion-channel gating mechanism kinetics model for future investigations were finally discussed.