ABSTRACT
Acute lung injury/acute respiratory distress syndrome (ALI/ARDS) is a common complication after liver transplantation, which could prolong the length of postoperative intensive care unit stay, affect clinical efficacy of liver transplantation and even lead to the death of recipients. ALI/ARDS has attracted extensive attention from liver transplant surgeons in clinical practice. ALI/ARDS after liver transplantation may be directly caused by pulmonary factors (such as mechanical ventilation-related lung injury, lung infection and aspiration, etc.) or indirectly induced by non-pulmonary factors (such as severe infection outside the lungs, blood transfusion and ischemia-reperfusion injury, etc.). In this article, the diagnostic criteria, incidence, mechanism, risk factors, laboratory and clinical diagnostic approaches and treatment of ALI/ARDS after liver transplantation were reviewed, aiming to deepen the understanding and cognition of ALI/ARDS during the perioperative period of liver transplantation and provide reference for the diagnosis and treatment of ALI/ARDS following liver transplantation.
ABSTRACT
Long non-coding RNA (lncRNA) and circular RNA (circRNA) are two important types of non-coding RNA that can regulate gene expression by directly interacting with DNA, RNA or protein. A large number of studies have shown that lncRNA and circRNA can not only predict the prognosis of patients with esophageal squamous cell carcinoma (ESCC) after radiotherapy and chemotherapy, but also affect the sensitivity of ESCC to radiotherapy and chemotherapy through competing endogenous RNA mechanisms, regulating PI3K/Akt/mTOR and Wnt/β-catenin signaling pathways, participating in DNA and protein modification, regulating the cell cycle and other pathways. In-depth research on the mechanism of lncRNA and circRNA regulating the sensitivity of ESCC to radiotherapy and chemotherapy will improve the effect of radiotherapy and chemotherapy in ESCC patients.
ABSTRACT
The clinical manifestations of patients with schizophrenia and patients with depression not only have a certain similarity, but also change with the patient's mood, and thus lead to misdiagnosis in clinical diagnosis. Electroencephalogram (EEG) analysis provides an important reference and objective basis for accurate differentiation and diagnosis between patients with schizophrenia and patients with depression. In order to solve the problem of misdiagnosis between patients with schizophrenia and patients with depression, and to improve the accuracy of the classification and diagnosis of these two diseases, in this study we extracted the resting-state EEG features from 100 patients with depression and 100 patients with schizophrenia, including information entropy, sample entropy and approximate entropy, statistical properties feature and relative power spectral density (rPSD) of each EEG rhythm (δ, θ, α, β). Then feature vectors were formed to classify these two types of patients using the support vector machine (SVM) and the naive Bayes (NB) classifier. Experimental results indicate that: ① The rPSD feature vector performs the best in classification, achieving an average accuracy of 84.2% and a highest accuracy of 86.3%; ② The accuracy of SVM is obviously better than that of NB; ③ For the rPSD of each rhythm, the β rhythm performs the best with the highest accuracy of 76%; ④ Electrodes with large feature weight are mainly concentrated in the frontal lobe and parietal lobe. The results of this study indicate that the rPSD feature vector in conjunction with SVM can effectively distinguish depression and schizophrenia, and can also play an auxiliary role in the relevant clinical diagnosis.
Subject(s)
Humans , Bayes Theorem , Depression , Electroencephalography , Schizophrenia , Signal Processing, Computer-Assisted , Support Vector MachineABSTRACT
Objective To explore the practical value of Stroop task of symptomatic words and identity-related words for screening executive dysfunction in schizophrenia.Methods Sixty-five patients with schizophrenia in clinical remission and sixty-two healthy controls were recruited in this trial.Patients and controls completed the Stroop task of symptomatic words and identity-related words.Analyze and compare the difference of reaction time between the two groups on the two stroop paradigms and further analyze the degree of discrimination of the two stroop paradigme.Results The reaction time of schizophrenic patients was longer than that of healthy controls in both symptom-word Stroop task ((1 206.65 ± 476.39)ms vs (916.01 ± 395.85) ms,t =6.46,P＜ 0.001),and identity-word Stroop task ((1 256.22 ± 630.18) ms vs (927.85 ± 419.98) ms,t=6.01,P＜0.01).The sensitivity and specificity were obtained by Receiver Operating Characteristic curves in symptom-word Stroop task (89％ and 57％,respectively) and identity-word Stroop task (81％ and 66％,respectively).Conclusion Symptom-word Stroop task and identity-word Stroop task showed moderate diagnostic value for the identification executive dysfunction in patients with schizophrenia.
ABSTRACT
Objective To discuss the correlation between histological evaluation of primary lesions and prognosis of gastric cancer patients treated with neoadjuvant chemotherapy.Methods A total of 117 patients with stage Ⅱ-Ⅲ gastric cancer who received neoadjuvant chemotherapy in our hospital from January 2006 to December 2012 were enrolled.All patients received 2 courses of neoadjuvant chemotherapy and underwent CT,gastrointestinal radiography or endoscopic examination to evaluate the response to neoadjuvant chemotherapy,and the histochemical staining results of the surgical specimens were also used for chemotherapy responsive validation.Kappa (κ) coefficient was used to analyzed the consistency of different evaluation methods for chemotherapy reactivity.The 5-year survival rate was used for compared the effective assessments in three different approaches.Results There were 38 cases (32.5％),78 cases (66.7％) and 43 cases (36.8％) were considered to be CT,gastrointestinal radiography or endoscopic examination and histologic responders,respectively.Histological evaluation of primary lesions was less correlated with CT,gastrointestinal radiography or endoscopic evaluation (κ values were 0.10 and 0.19 respectively).Based on CT evaluation,the median survival time of patients with chemotherapy response was longer than 60 months,and the median survival time of patients without response was 43 months,and the difference was not statistically significant (x2 =2.978,P =0.076).Based on gastrointestinal radiography or endoscopy evaluation,the median survival time of patients with chemotherapy response was longer than 60 months,and the median survival time of patients without response was 29 months,and the difference was not statistically significant (x2 =1.230,P =0.239).Based on histological evaluation,the median survival time of patients with chemotherapy response was longer than 60 months,and the median survival time of patients without response was 18.5 months,and the difference was statistically significant (x2 =29.020,P ＜ 0.001).Multivariate Cox regression analysis showed that nonrespond of adjuvant chemotherapy under histologic evaluation (HR =4.021,95％ CI:1.548-8.767,P =0.002) and non-respond of gastrointestinal radiography or endoscopic examination (HR =8.210,95％ CI:4.333-17.980,P ＜ 0.001) were independent risk factors for poor prognosis in patients with gastric cancer,and intestinal gastric cancer (HR =0.241,95％ CI:0.080-0.871,P =0.019) was an independent predictor of survival improvement in patients with gastric cancer.Conclusion The degree of neoadjuvant chemotherapy response assessed by histological evaluation of primary lesions can effectively predict the long-term survival outcomes for gastric cancer patients.
ABSTRACT
Purpose To evaluate the diagnostic value of contrast-enhanced ultrasound (CEUS) in papillary thyroid carcinomas (PTC) by exploring the relationship between quantitative parameters of time-intensity curve (TIC) of CEUS for PTC and tumor size and metastasis of cervical lymph nodes.Materials and Methods 124 patients with PTC confirmed by surgery and pathology in the Affiliated Hospital of Qingdao University were retrospectively analyzed.According to maximum diameter of lesions (D),the lesions were divided into three groups with D＜1.0 cm,1.0 cm ≤ D ≤ 2.0 cm and D＞2.0 cm.The lesions were also divided into LN(+) group with lymph node metastasis and LN(-) group without lymph node metastasis based on pathology of cervical lymph nodes.The features of CEUS and quantitative parameters of TIC of the above groups were analyzed.Results ① The CEUS showed that the PTC nodules were mainly concentric and heterogeneous enhancement.Thyroid carcinoma with D＜1.0 cm and 1.0 cm≤D≤2.0 cm showed low enhancement (45/57,31/42),while thyroid carcinomas with D＞2.0 cm exhibited high enhancement (14/25),and the difference was significant (P＜0.05).① With the increase of the diameter of PTC,the peak intensity [(12.75 ± 3.77)％,(15.53 ± 3.62)％,(18.11 ± 4.28)％],the area under the curve [(820.52±289.19)％.s,(873.84± 156.19)％· s,(1118.8± 152.48)％ ·s] and the ratio of the perfusion defects (24.56％,52.38％,72.00％) were increased,and the differences were statistically significant (P＜0.05).③ The cervical lymph node metastasis rate of PTCs with isoenhancement or hyperenhancement patterns showed by CEUS was significantly higher than that with hypoenhancement (P＜0.05).The peak intensity and the area under the curve of LN (+) group were higher than that of LN (-) group,and the differences were statistically significant (P＜0.05).Conclusion There were significant differences in imaging features of CEUS between the PTC nodules with different size and lymph node metastasis,which can provide valuable information for clinical diagnosis.
ABSTRACT
OBJECTIVE: To discuss the development direction for hospital pharmacists in the medical reform and to promote rational use of drugs.METHODS: The status quo for the medical reform was analyzed based on the practicality of hospital and the author's perspectives on how to improve pharmaceutical care level was presented.RESULTS & CONCLUSIONS: Hospital pharmacists should change pharmaceutical care model to face up to the challenges in the medical reform by establishing clinical pharmacists' team and setting up pharmaceutical care center to improve pharmaceutical care level and adapt to the development of medical reform.