ABSTRACT
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 investigate influence on the quality of life of psychological intervention combined with hydrochlorothiazide on the treatment of the patients undergoing heart valve replacement. Methods The control group after heart valve replacement surgery were accepted the routine drug combined with hydrochlorothiazide, at this basis, the study group were received targeted nursing interventions. The changes of quality of life (SF-36) before and after cardiac valve replacement in the two groups were recorded. The effect in the two groups were compared. Results There was no statistically significant in SF-36 in the two groups before heart valve replacement; After treatment, the SF-36 scale scores in the 2 groups were significantly higher than that before treatment, and the SF-36 scale score in the study group was significantly higher than that in the control group (P<0.05). Conclusion The combination of hydrochlorothiazide and psychological intervention in the patients undergoing cardiac valve replacement can significantly improve the quality of life and improve the prognosis.
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Objective To investigate the effect of psychological intervention on patients with non-small cell lung cancer treated with cisplatin or gemcitabine or Changchun vinorelbine. Methods 64 cases of patients with non-small cell lung cancer after surgery, nursing for patients in the group given basic treatment, routine care control group, the observation group based on routine nursing and psychological nursing effects were compared between the two groups. Results No significant difference of anxiety and depression in the patients of the two groups before nursing, after grouping nursing, the observation group improved significantly; compared two groups of patients with quality of life score, visible two group before the intervention had no significant difference after intervention group was clearly observed after the patients in the observation group were higher than that of the control group, comparison between groups were indicates that the difference is obvious (P<0.05). Conclusion Chemotherapy in non-small cell lung cancer after surgery for patients with psychological intervention, compared to conventional nursing, can improve the psychological status of patients with better, improve the quality of life of patients, so it is worthy of reference in clinical use.
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Objective To investigate the effect of combined inhalation of ambroxol hydrochloride, intermittent tapping and sputum drainage and psychological intervention on postoperative lung cancer. Methods 68 cases of lung cancer patients treated in our hospital from January 2015 to March 2017 were selected, the control group received oxygen aerosol inhalation of ambroxol hydrochloride and intermittent beating back sputum at the early stage of the operation. The study group was treated with psychological intervention on the basis of the treatment of the control group. The postoperative pulmonary complications in two groups of patients with lung cancer were recorded. The data were input into SPSS statistical software and analyzed. Results The incidence rate of atelectasis and pulmonary infection in the study group (5.88％, 8.82％) were higher than those in the control group (The incidence of atelectasis was 32.35％, and the incidence of pulmonary infection was 38.24％) was significantly reduced, the difference was statistically significant (P<0.05). Conclusion On the basis of providing oxygen aerosol inhalation of ambroxol hydrochloride and intermittent beating back sputum for early postoperative lung cancer patients, the clinical prognosis can be significantly improved if psychological intervention is used.