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Objective:To construct enhanced computed tomography (CT)-based nomograph model, to assist physicians in differentiating gastric schwannoma from gastric stromal tumor.Methods:From January 1, 2012 to January 1, 2022, at the Second Affiliated Hospital of Zhejiang University School of Medicine and Ningbo Hwamei Hospital, University of Chinese Academy of Sciences, 57 patients with gastric schwannoma and 275 patients with gastric stromal tumor confirmed by surgical pathology were retrospectively collected, among whom 39 patients with gastric schwannoma and 201 patients with gastric stromal tumor were enrolled in the training set, and the other 18 patients with gastric schwannoma and 74 patients with gastric stromal tumor were enrolled in the validation set. The contrast-enhanced CT imaging features (tumor size index, arterial phase CT value, venous phase CT value, necrosis, calcification, integrity of mucosal surface, and uniform enhancement, etc.) and clinical data (history of gastritis, carbohydrate antigen 19-9 (CA19-9), carcinoembryonic antigen, and monocyte to lymphocyte ratio (MLR), etc.) were collected. The least absolute shrinkage and selection operator (LASSO) regression analysis was used to screen the independent predictive factors of imaging features in the differential diagnosis of gastric schwannoma and gastric stromal tumor, and a nomograph model was constracted. Logistic regression analysis was used to analyze and screen the independent predictive factors of clinical indicators to distinguish gastric schwannoma from gastric stromal tumor, and a clinical control model was established. The receiver operating characteristic curve(ROC) was used to analyze the area under the curve (AUC) of the nomograph model in the training set and the verification set, and concordance index (CI) and decision curve analysis (DCA) were used to evaluate the predictive efficiency and clinical application value of the nomograph model. DeLong test was used for statistical analysis.Results:The results of LASSO regression analysis showed that tumor size index, arterial phase CT value, venous phase CT value, necrosis, calcification, integrity of mucosal surface, and uniform enhancement were independent predictive factors of imaging features in the differential diagnosis of gastric schwannoma and gastric stromal tumor(all P<0.05). The results of logistic regression analysis indicated that the history of gastritis ( OR=0.280, 95% confidence interval 0.138 to 0.566), CA19-9 ( OR=0.940, 95% confidence interval 0.890 to 0.993), carcinoembryonic antigen ( OR=0.794, 95% confidence interval 0.661 to 0.952), and MLR ( OR=0.087, 95% confidence interval 0.009 to 0.860) were independent predictive factors of clinical indicators in the differential diagnosis of gastric schwannoma and gastric stromal tumor ( P<0.001, =0.028, 0.013 and 0.037). The AUCs of the nomograph model in the training and validation set were 0.881 and 0.850, respectively, and the AUCs of the clinical control model in the training and validation set were 0.814 and 0.772, respectively, and the differences were statistically significant ( Z=2.57 and 1.96, P=0.005 and 0.030). The average CI of the nomograph model was 0.885. The results of DCA analysis showed that the overall benefit of the nomograph model was higher than that of the clinical control model. Conclusion:The enhanced CT-based nomograph model can effectively distinguish gastric schwannoma from gastric stromal tumor, and can help physicians to make precise clinical decisions.
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Objective:To analyze the clinical teachers′ cognitive evaluation of the residency training system and faculty competency through a survey , which in the standardized residency training bases of Zhejiang province, in the hope of providing a basis for exploring and reforming the training and the mechanism.Methods:A web-based questionnaire survey was made from December 2017 to December 2019 on clinical teachers at training bases in Zhejiang province. Data cleaning and statistical analysis were made under Anaconda1 9.7, multiple groups of numerical variables were analyzed by one-way ANOVA, and classified variables were subject to χ2 analysis, while the analysis was carried out after binarization in the statistical calculation of multi-choice items. Results:3 141 of valid questionnaires were received. The clinical teachers at large highly recognize the competency degree expected of the teachers, while those items of relatively lower recognition were " the ability to regularly publish research papers" " the ability to guide the trainees′ living style" , and " the ability to use multimedia teaching materials" (41.13%, 46.23%, and 47.02% respectively). 77.36% of the teachers reported that they need coordination and management ability training, while 83.38% need teaching ability training. The proportion of teachers in need of teaching ability training was influenced by both professional title( χ2=18.703, P < 0.001)and seniority( χ2=14.471, P=0.006). For the subjective criteria by the teachers on faculty competency assessment criteria, the scoring ranks from high to low were clinical ability, medical ethics, and teaching awareness(8.91±1.35, 8.86±1.52 and 8.64±1.47 respectively). For the operability criteria, the scoring ranks from high to low were professional title, education, and faculty training(8.47±1.80, 8.36±1.86 and 8.19±1.91 respectively), while the outcomes were influenced by the administrative title, professional title and seniority( P < 0.05). Only 39.03% and 33.37% of clinical teachers were satisfied or somewhat satisfied with the existing incentives for residency training. Conclusions:The teachers′ recognition of the criteria for faculty competency evaluating and the need for teacher training were influenced by their characteristics, and they were unsatisfied with the existing incentive policies. These suggest comprehensive factors in formulating the evaluation standards, and measures for progressive faculty training and for improved incentive policies.
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Objective@#To investigate the use of conventional MR imaging to guide treatment in patients with cholecystolithiasis and diffuse inflammatory thickening of gallbladder wall.@*Methods@#The clinical data of patients who were treated in the Ningbo Huamei Hospital, University of the Chinese Academy of Sciences between January 2017 and January 2018 were analyzed. These patients were divided into two groups: patients with acute cholecystitis (n=139) and patients with viral hepatitis combined with cholecystolithiasis (n=67). Differences in the imaging signs in standardized upper abdominal contrast enhanced MRI examinations were retrospectively analyzed.@*Results@#The imaging signs, including stone location, continuity of gallbladder mucosa, exudation in peri-gallbladder space, edema of intrahepatic portal area showed significant differences between the two groups (all P<0.05). On stratification analysis, the type of thickened gallbladder wall, background of liver parenchyma and extent of edema in intrahepatic catchment area also showed significant differences (all P<0.05). The imaging signs, including non-gallbladder neck ductal stones, concentric thickening of gallbladder wall, continuous mucous membrane in gallbladder and no peri-gallbladder space exudation but diffuse edema of intrahepatic catchment area supported the diagnosis of viral hepatitis combined with gallstones. The imaging signs, including discontinuity of gallbladder mucosa, exudation of peri-gallbladder space, diffuse edema of gallbladder wall without a cirrhotic background and edema in intrahepatic portal area supported the diagnosis of acute calculous cholecystitis of gallbladder.@*Conclusions@#Routine upper abdominal contrast enhanced MRI plays an important role in demonstrating the underlying cause of gallbladder wall diffuse edema thickening in patients with gallstones. It provides an important reference for the choice of clinical treatment pathway.
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0bjective To investigate the use of conventional MR imaging to guide treatment in patients with cholecystolithiasis and diffuse inflammatory thickening of gallbladder wall.Methods The clinical data of patients who were treated in the Ningbo Huamei Hospital.University of the Chinese Academy of Sciences between January 2017 and January 2018 were analyzed.These patients were divided into two groups:patients with acute cholecystitis(n=139)and patients with viral hepatitis combined with cholecys-tolithiasis(n=67).Differences in the imaging signs in standardized upper abdominal contrast enhanced MRI examinations were retrospectively analyzed.Results The imaging signs,including stone location,continuity of gallbladder mucosa,exudation in peri-gallbladder space,edema of intrahepatic portal area showed significant differences between the two groups(all P＜0.05).On stratification analysis,the type of thickened gallbladder wall.background of liver parenchyma and extent of edema in intrahepatic catchment area also showed significant differences(all P＜0.05).The imaging signs,including non-gallbladder neck ductal stones,concentric thickening of gallbladder wall,continuous mucous membrane in gallbladder and no peri-gallbladder space exudation but diffuse edema of intrahepatic catchment area supposed the diagnosis of viral hepatitis combined with gallstones.The imaging signs.including discontinuity of gallbladder mucosa.exudation of peri-gallbladder space,diffuse edema of gallbladder wall without a cirrhotic background and edema in intrahepatic portal area supposed the diagnosis of acute calculous cholecystitis of gallbladder.Conclusions Routine upper abdominal contrast enhanced MRI plays an important role in demonstrating the underlying cause of gallbladder wall diffuse edema thickening in patients with gallstones.It provides an important reference for the choice of clinical treatment pathway.
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Objective To investigate the application value of magnetic-controlled capsule endoscopy (MCE) for gastric diseases in physical examination of asymptomatic population.Methods Data of 211 asymptomatic individuals who received MCE examinations from July 2015 to December 2016 in Changhai Hospital were collected and rctrospectively analyzed.The tolerance and safety of MCE were studied by analyzing the detection rate for the focal lesions and the rate of endoscopy transfer.Results Among 211 patients,the detection rate of the gastric focal lesions was 9.5％ (20/211).The detection rate in male was higher than that in female (P＜0.05).All patients completed MCE examination successfully and no adverse event was reported.Conclusion MCE,a non-invasive endoscopic modality,is safe and better tolerated than conventional endoscopy,and can be used as a promising approach to screening the gastric diseases in asymptomatic population due to high detection rate of these diseases.
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To evaluate the efficacy and safety of drug-eluding beads transarterial chemoembolization (DEB-TACE) in treatment of unrecectable hepatocellular carcinoma (HCC).The clinical data of 42 consecutive HCC patients undergoing TACE were retrospectively analyzed, including 20 cases received conventional TACE (cTACE group) and 22 cases received TACE with epirubicine-loaded microspheres (CalliSpheres) (DEB-TACE group). MRI scans were performed 1 week before and 1, 3 and 6 months after initial therapy. The response to treatment, disease recurrence, complications and adverse effects were documented and compared between two groups.There were no significant differences in 1-month, 3-month and 6-month objective response rate (CR+PR) and disease control rate (CR+PR+SD), disease recurrence, complications and adverse effects of interventional therapy between cTACE group and DEB-TACE group. Additionally, there were no significant differences about locoregional biliary injuries, intrahepatic biloma, and newly detected intra- or extrahepatic HCC on MRI between cTACE group and DEB-TACE group.There were no statistically significant differences between cTACE group and DEB-TACE group with regard to the short-term response, disease recurrence, complications and side effects. Hepatic-locoregional complications may be more frequent in DEB-TACE group than those in cTACE group.
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Humans , Carcinoma, Hepatocellular , Diagnostic Imaging , Therapeutics , Chemoembolization, Therapeutic , Methods , Comparative Effectiveness Research , Drug Delivery Systems , Methods , Epirubicin , Therapeutic Uses , Liver Neoplasms , Magnetic Resonance Imaging , Microspheres , Neoplasm Recurrence, Local , Retrospective Studies , Treatment OutcomeABSTRACT
Objective To explore the social economic factors related to depressive in patients with long-term hemodialysis.Methods A total of 122 patients with hemodialysis for more than 3 months from December 1st 2008 to February 1st 2009 in Dongfang Hospital and Wangjin Hospital,were divided into a depression group (41 cases) and a non-depressed group (81 cases).Informations such as economic status,social interaction,education,hobbies,etc were collected by questionnaire and the relationship between these factors and depression was analyzed.Results There was significant difference between the two groups in the factors of economic status,social interaction,education,and hobbies (x2 values were 14.671 、6.256、6.744、6.390,P＜0.05).There was no significant difference in the factors of gender,drinking,relationship of family,profession,the condition of housing,social status,seasons of born,and careers,etc (x2 values were 3.651、0.765、2.034、3.093、0.772、5.956、2.687、5.138,P＞0.05).Conclusion Thepatientswithpooreconomic,lower education,less social communication,fewer hobbies,and no smoking habits are easy to be depressive.
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An experimental animal model of malignant soft-tissue tumor was established to investigate the applied value of multi-slice spiral CT perfusion imaging preliminarily. Ten New Zealand white rabbits which were implanted with VX2 tumor in either proximal thigh were subjected to CT plain scan and perfusion scan two weeks later respectively, then the original perfusion images were transmitted to AW4.0 Workstation. The functional maps and perfusion parameters including blood flow (BF), blood volume (BV), mean transit time (MTT) and permeability surface (PS) were computed and analyzed. All the values of BF, BV and PS in VX2 soft-tissue tumors were obviously higher while the MTT-values were lower than those in the normal muscular tissues significantly. It was suggested that multi-slice spiral CT perfusion imaging is an accurate, convenient and relatively safe functional imaging technique, and can give a quantitative assessment to angiogenesis and blood perfusion of soft-tissue tumors.
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An experimental animal model of malignant soft-tissue tumor was established to investigate the applied value of multi-slice spiral CT perfusion imaging preliminarily. Ten New Zealand white rabbits which were implanted with VX2 tumor in either proximal thigh were subjected to CT plain scan and perfusion scan two weeks later respectively, then the original perfusion images were transmitted to AW4.0 Workstation. The functional maps and perfusion parameters including blood flow (BF), blood volume (BV), mean transit time (MTT) and permeability surface (PS) were computed and analyzed. All the values of BF, BV and PS in VX2 soft-tissue tumors were obviously higher while the MTT-values were lower than those in the normal muscular tissues significantly. It was suggested that multi-slice spiral CT perfusion imaging is an accurate, convenient and relatively safe functional imaging technique, and can give a quantitative assessment to angiogenesis and blood perfusion of soft-tissue tumors.
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In order to explore the MRI volume of the amygdala and hippocampus in patients with major depression, quantitative MRI of the amygdala and hippocampus were studied in 22 patients with major depression and compared with 13 age-matched controls. The results showed that both groups exhibited similar significant hippocampal asymmetry (left smaller than right). The volume of the bilateral hippocampus was significantly smaller in the major depression group than that in control group. The patients had significant asymmetry of the amygdalar volumes (right smaller than left). No correlation was found between hippocampal volume abnormalities and ill duration. It was concluded that the hippocampus and amygdala within limbic-cortical networks may play a crucial role in the pathogenesis of major depression.
Subject(s)
Amygdala/pathology , Anthropometry , Depressive Disorder, Major/pathology , Hippocampus/pathology , Magnetic Resonance ImagingABSTRACT
In order to explore the MRI volume of the amygdala and hippocampus in patients with major depression, quantitative MRI of the amygdala and hippocampus were studied in 22 patients with major depression and compared with 13 age-matched controls. The results showed that both groups exhibited similar significant hippocampal asymmetry (left smaller than right). The volume of the bilateral hippocampus was significantly smaller in the major depression group than that in control group. The patients had significant asymmetry of the amygdalar volumes (right smaller than left). No correlation was found between hippocampal volume abnormalities and ill duration. It was concluded that the hippocampus and amygdala within limbic-cortical networks may play a crucial role in the pathogenesis of major depression.
Subject(s)
Adult , Female , Humans , Male , Amygdala , Pathology , Anthropometry , Depressive Disorder, Major , Pathology , Hippocampus , Pathology , Magnetic Resonance ImagingABSTRACT
A series of imaging features of extranodal, multi-systemic involvements in Non-Hodgkin's lymphoma (NHL) were investigated. The clinical data and imaging findings of 16 patients with pathologically proved NHL were retrospectively analyzed. The related literatures were reviewed. Of the 16 cases of NHL, skeletal involvement was found in 4, nasal cavity and nasal sinuses were involved in 4, too. Lesion in the thorax was seen in 3 patients, hepatic involvement occurred in one case, cerebral ventricle was affected in 3 cases, mesentery was involved in one case. Even though extranodal involvement of NHL exhibited extremely variable patterns, there were some relatively typical imaging findings. Emphasized in this report were the relatively specific imaging manifestations of different systems, which may mimic infectious or other neoplasms of different sites. The importance of imaging studies lies in the availability for diagnosis, staging and follow-up of NHL. Combined with the clinical and other related information, the diagnostic accuracy can be further improved, thus, providing reliable evidence in guiding clinical management.