Application of artificial intelligence reading label system in diabetic retinopathy grading training of junior ophthalmologists and medical students / 中国医师杂志

Objective:To evaluate the efficiency of using artificial intelligence reading label system in diabetic retinopathy (DR) grading training among junior ophthalmologists and medical students.Methods:520 diabetic fundus images were randomly divided into 8 groups with 65 images in each group. 13 junior ophthalmologists and medical students were selected as the research objects. Each of them read 8 groups of pictures and evaluated the DR grading of each fundus image. The sensitivity, specificity and diagnostic test consistency (Q-kappa value) of grading results were analyzed with the DR grading given by 3 senior ophthalmologists as the gold standard. The average Q-kappa values of 13 subjects were compared between the first four times and the last four times.Results:Through 8 round reading, the average Q-kappa was elevated from 0.67 to 0.81. Average Q-kappa of round 1 to 4 was 0.77, and average Q-kappa of round 5 to 8 was 0.81. The participants were divided into two groups. Participants in group 1 were junior ophthalmologists and participants in group 2 were medical students. Average Q-kappa of group 1 was elevated from 0.71 to 0.76. Average Q-kappa of group 2 was elevated from 0.63 to 0.84.Conclusions:The artificial intelligence reading label system was a useful tool in training junior ophthalmologists and medical students in doing diabetic retinopathy grading.

Electronic cleaning of intestinal contents tagging by diatrizoate meglumine for single-source dual-energy CT colonography with sequential acquisitions and volume scanning / 重庆医学

Objective To study the feasibility of applying electronic cleaning to intestinal contents tagging by diatrizoate meglumine for single-source dual-energy CT colonography with sequential acquisitions and volume scanning.Methods Twenty-four volunteers had fine effect of intestinal contents tagging by diatrizoate meglumine,good colorectal distension effect,fine image quality of dual-energy fusion colorectal images,and with informed consents were enrolled in this study.The single-source dual-energy CT colonography with sequential acquisitions and volume scanning was performed with an Acquilion ONE 320 row CT scanner,tube voltage 135 kVp/80 kVp.The intestinal contents conducted the dual-energy electronic cleaned based on decomposition of intestinal contents tagging by diatrizoate meglumine,soft tissue and air.The intestinal contents in one segment of intestinal lumen being 100％ electronically cleaned served as the basic standard,the electronic cleaning effects were divided into the 5 grades:excellent,good,moderate,fair and poor;and grade 1-3 were effective fecal electronic cleaning.Results The grade 1,2,3,4,5 of electronic cleaning effect for solid as the main intestinal contents were 22.2％,53.3％,17.8％,6.7％ and 0％ respectively;and which of electronic cleaning effect for liquid as the main intestinal contents were 47.5％,47.5％,5.0％,0％ and 0％ respectively.The together total effective electronic cleaning of intestinal contents was 97.9％ and the electronic cleaning effect was good.Conclusion Electronic cleaning could be used in the intestinal contents tagging by diatrizoate meglumine for single-source dual-energy CT colonography with sequential acquisitions and volume scanning.

Study on colorectal distension with partially automated and individualized insufflation of air for dual-energy CT colonography / 重庆医学

Objective To study the compliance of examinees,and effectiveness of colorectal distension with partially automated and individualized insufflation of air for dual-energy CT colonography.Methods Forty-six healthy adult volunteers without history of conditions affecting gastrointestinal motor function were enrolled in this study.One day before CT examination,volunteers were asked to orally administered 60 mL 4% diatrizoate meglumine five times for fecal tagging.Air was insufflated by using an inflator in a partially automated and individualized manner.The volunteers were initially asked to assume the right lateral decubitus position,then slowly turn to the supine position.Insufflation rate began at 1.5 L/min,and decreased to 0.5 L/min at later stage.The necessity and volume of air insufflation were decided according to effectiveness of colorectal distension on CT scout images,self-reported sensation of volunteers,and intestinal pressure.Dual-energy CT scanning was performed,and dual-energy blended images were acquired.Compliance of volunteers was statistically analyzed.The effectiveness of colorectal segments distension was statistically analyzed by using Kruskal-Wallis H test.Results No abdominal pain,bloating,nausea or vomiting were noted in the 46 volunteers.All volunteers easily accepted colorectal insufflation of air,with grade 1 compliance.The effectiveness of colorectal distension of grades 1,2,3 and 4 were 0%,2.1%,5.1% and 92.8%,respectively.The difference of effectiveness of colorectal segments distension had no statistical significance(χ2=6.19,P=0.288).The effectiveness of insufflation was poor in 6 colorectal segments,including 2 in sigmoid colon and 2 in rectum.Effectiveness of insufflation was suboptimal in 14 colorectal segments,including 4 in descending colon,4 in sigmoid colon,and 3 in rectum.Conclusion Compliance of examinees with partially automated and individualized insufflation of air for dual-energy CT colonography is excellent,with good effectiveness of colorectal distension.

Effect on colorectal cleansing of CT colonography with gulping down bisacodyl before or after oral taking polyethylene glycol / 重庆医学

Objective To comparative study the effect on colorectal cleansing of CT colonography with gulping down 10 mg bisacodyl before or 1 h after oral taking 2 liter polyethylene glycol .Methods Forty participants with informed consent were appor‐tioned to group A ,group B randomly ,20 cases in each group .On the day before CT colonography ,participants in group A oral took 20 mL of 40% W/V barium sulfate prior to 3 mealtime ,and 20 mL of 60% diatrizoate meglumine diluted in 250 mL of water after supper ,then gulped down 10 mg bisacodyl enteric‐coated tablets 1 hour before oral taking 2 liter polyethylene glycol electrolyte so‐lution .Participants in group B were the same as that in group A ,with the exception of gulping down 10 mg bisacodyl enteric‐coated tablets 1 hour after oral taking 2 liter polyethylene glycol electrolyte solution .Cleansing efficacy of stool and fluid ,and attenuation value of remainder fluid between the two groups were analyzed statistically .Results In group A ,score of cleansing efficacy of stool (1 .96 ± 0 .11) was lower than that in group B (2 .01 ± 0 .12) ,segments with good cleansing efficacy of stool (87/120 segments , 72 .50% ) was higher than that in group B (83/120 segments ,69 .17% ) ,the difference was not statistically significant (P>0 .05) .In group A ,score of cleansing efficacy of fluid (1 .50 ± 0 .06) was lower than that in group B (1 .53 ± 0 .06) ,segments with good cleansing efficacy of fluid(113/120 segments ,94 .17% ) was higher than that in group B (111/120 segments ,92 .50% ) ,the differ‐ence was not statistically significant (P>0 .05) .Attenuation value of remainder fluid [(729 ± 29)HU ] in group A was higher than that in group B[(653 ± 25)HU] ,the difference was statistically significant(P<0 .05) .Conclusion Gulping down 10 mg Bisacodyl before or after oral taking 2 liter polyethylene glycol has no effect on cleansing of stool and fluid ,with good cleansing efficacy .The former has better cleansing efficacy of fluid ,is beneficial to detecting polyps for CT colonography .

Evaluation on image quality and radiation dose of 640-slice CT coronary arteriography with AIDR3D reconstruction algorithm / 重庆医学

Objective To investigate the image quality and radiation dose of 640-slice CT coronary arteriography(CTCA) with adaptive iterative dose reduction three-dimensional (AIDR3D)reconstrucction algoritym.Methods 640-slice CTCA with auto-matic exposure was performed on 84 consecutive patients.The original image data were reconstructed with AIDR3D and the filtered back-projection (FBP)algorithms at the image postprocessing workstation.Two experienced radiologists without knowing clinical information and reconstruction algorithms independently measured and calculated the image noise,signal-to-noise ratio and contrast-to-noise ratio with AIDR3D and FBP reconstruction algorithms.The qualitative image quality was assessed by using the 4-point scale.The radiation dose was calculated based on dose-length product exported on CT scanner.The quantitative and qualitative im-age quality with two kinds of reconstruction algorithm was analyzed statistically.Results The CTCA image noise was (27.20± 4.40)HU with AIDR3D and (60.00±12.40)HU with FBP,which with AIDR3D was decreased by 46.10% than that with FBP;the signal-to-noise ratio was 21.10 ± 5.10 with AIDR3D and 11.40 ± 2.80 with FBP,which with AIDR3D was increased by 84.70% than that with FBP;the contrast-to-noise ratio was 24.70±5.10 with AIDR3D and 13.50±3.20 with FBP,which with AIDR3D was raised by 82.20% than that with FBP,the differences in 3 indexes between the two kinds of reconstruction algorithm were statistically significant(P < 0.05 ).The CTCA qualitative image quality scores of proximal,middle and distal parts with AIDR3D were (3.90±0.30),(3.70±0.50)and (3.60±0.60)respectively,which all were higher than (2.60±0.60),(2.30± 0.60)and (2.10±0.70)with FBP respectively,the differences in 3 items between 2 kinds of algorithm had statistical significance (P <0.05).The total segments which could be used to diagnose the CTCA images with AIDR3D and FBP algorithms were 1 216 segments (96.50%)and 504 segments (40.00%),respectively,the difference had statistical significance(P <0.05).The mean ef-fective radiation dose was (2.10±1.00)mSv.Conclusion 640-slice CTCA with AIDR3D reconstruction algorithm not only signifi-cantly reduces the image noise than the conventional FBP algorithm,improves the quantitative and qualitative image quality,but also decreases the effective radiation dose.

Comparison of real time PCR and PCRˉreverse dot blot hybridization for detection of Human papillomavirus / 国际检验医学杂志

Objective To compare real time PCR with PCR-reverse dot blot hybridization (PCR-RDB)for detecting human pap-illomavirus (HPV)infection in women.Methods A total of 109 genital specimens from women were collected in the study.All specimens were tested HPV by using real time PCR and PCR-RDB,discrepant samples were tested again by PCR-xMAP.Results The concordant rate was 83.5%(91/109)between real time PCR and PCR-RDB (kappa=0.671),the other 18 discrepant samples were retested by PCR-xMAP,7 of those were identical with real time PCR and 11 with PCR-RDB.No differences of PCR-RDB pos-itive rates were found between the high and low viral load groups (χ2 =1.476,P =0.224).Conclusion It demonstrated moderate consistency between real time PCR and PCR-RDB.The HPV positive rates of PCR-RDB were stable when the viral loads were 103-108 .

Analysis of women′s genital human papillomavirus infection and genotype distribution in Shenzhen / 国际检验医学杂志

Objective To investigate the female human papillomavirus(HPV)infection situation in Baoan district,the HPV pos-itive rates in different age groups and the subtypes distribution.Methods PCR followed with reverse dot blot was performed to ex-amine 23 kinds of HPV genotypes in 2 627 female patients in our hospital from the January 2011 to December 2012.Results In 2 627 samples,the positive rate of HPV was 23.94% (629 cases),in which the infection rate of single low-risk type was 15.1%(95 cases),the main HPV genotype was HPV43 (7.79%);the infection rate of high-risk type was 55.17% (347 cases),the 3 most prevalent HPV genotypes were HPV52 (12.56%),HPV16 (9.86%)and HPV58 (7.79%).The multiple HPV infection ac-counted for 29.73% (187 cases).The HPV infection rates in different age groups were 50.0% in age 15-20 years,24.7% in age 21-30 years,20.8% in age 31-40 years,25.8% in age 41 -50 years,42.1% in age >50 years respectively,the differences had statistical significance.Conclusion The HPV infection rate is 23.94% in Bao′an district.The most prevalent HPV genotypes are HPV 52,16,58,43.Women in age 15-20 years old have a higher infection rate.

CT virtual colonoscopy in patients with incomplete conventional colonoscopy / 中华医学杂志(英文版)

<p><b>OBJECTIVES</b>To study the usefulness of CT virtual colonoscopy (CTVC) in patients with incomplete conventional colonoscopy (CC) and assess the statistical differences between two methods of colorectal segment examination.</p><p><b>METHODS</b>Sixty patients with incomplete CC underwent volume scanning using spiral CT. CT VC images were obtained using a navigator software in workstation. All patients were confirmed by surgical or CC biopsy histology. Statistical analysis was done using t test comparing two sample percentages.</p><p><b>RESULTS</b>CTVC succeeded in 55/60 patients (91.7%) who had incomplete CC. Additional lesions were identified in the proximal colon in 15/55 patients (27.3%), including 1 primary carcinoma, 16 polyps in 13 patients and 1 ulcerative colonitis. The main cause of incomplete CC was occlusive mass; others were redundant, tortuous colon loops, and excessive colonic spasm. There was a statistically significant difference between the two methods in colorectal segment examination.</p><p><b>CONCLUSION</b>CTVC is a feasible and effective adjunctive method for evaluating the entire colorectal segment following an incomplete CC procedure. It offers a new approach for colorectal examination.</p>

Comparative study of colorectal carcinoma examination with four postprocessings of CT colonography / 中华放射学杂志

Objective To study the clinical value of colorectal carcinoma exa mination by comparison of different postprocessing techniques such as multiplana r reformation(MPR),CT virtual colonoscopy(CTVC), shaded surface display(SSD) a nd Raysum. Methods 64 patients with colorectal carcinoma s underwent volu me scanning using spiral CT. MPR, CTVC, SSD and Raysum images were obtained by u sing 4 different softwares in workstation. All cases were proved by surgical or CC bioptic histology. The results were compared and analyzed according to the circumferential extension, length and pathologic patterns of colorectal carcinoma with MPR, CTVC, SSD and Raysum. Results The correct ion rate of dete rmination the circumferential extension of colorectal carcinoma with MPR, CTVC, SSD and Raysum were 1000%, 828%, 797% and 797%, respectively There wa s signi ficant statistical difference between MPR and CTVC; The accuracy of judging the leng th of carcinoma were 891%, 766%, 953% and 1000%, respectively. There wa s stat istical difference between CTVC and SSD; The accuracy of showing carcinoma patho logi c patterns were 813%, 922%, 719% and 719%, respectively. There was stati stica l difference between CTVC and SSD, too. MPR could correctly determine the circum ferential extension of colorectal carcinoma. In determination the length of carc inoma, Raysum was more accurate than SSD. CTVC could be more helpful in showing carcinoma pathologic patterns. Conclusion There were advantag es and disadvant ages in colorectal carcinoma examination with MPR, CTVC, SSD and Raysum, and the combination could display colorectal carcinoma more completely and comprehensiv ely.

Strengthening scientific and technological management so as to enhance the core competitiveness of the hospital / 中华医院管理杂志

Future competition in the medical market will in essence be the contest of the core competitiveness of hospitals.It is therefore imperative for hospitals to do a good job in the following aspects in light of trends in medical development,the state of its resources and the needs of the market: enhancing their awareness of the importance of scientific and technological work,setting up a rationally distributed scientific research system,strengthening personnel and disciplinary development,improving the quality of scientific and technological management personnel,and establishing standardized systems for scientific and technological management.The goal is to enhance core competitiveness so as to gain competitive edges for sustainable development.