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Objective:To investigate the predictive value of enhanced CT-based radiomics for brain metastasis (BM) and selective use of prophylactic cranial irradiation (PCI) in limited-stage small cell lung cancer (LS-SCLC).Methods:Clinical data of 97 patients diagnosed with LS-SCLC confirmed by pathological and imaging examination in Shanxi Provincial Cancer Hospital from January 2012 to December 2018 were retrospectively analyzed. The least absolute shrinkage and selection operator (LASSO) Cox and Spearman correlation tests were used to select the radiomics features significantly associated with the incidence of BM and calculate the radiomics score. The calibration curve, the area under the receiver operating characteristic (ROC) curve (AUC), 5-fold cross-validation, decision curve analysis (DCA), and integrated Brier score (IBS) were employed to evaluate the predictive power and clinical benefits of the radiomics score. Kaplan-Meier method and log-rank test were adopted to draw survival curves and assess differences between two groups.Results:A total of 1272 radiomics features were extracted from enhanced CT. After the LASSO Cox regression and Spearman correlation tests, 8 radiomics features associated with the incidence of BM were used to calculate the radiomics score. The AUCs of radiomics scores to predict 1-year and 2-year BM were 0.845 (95% CI=0.746-0.943) and 0.878 (95% CI=0.774-0.983), respectively. The 5-fold cross validation, calibration curve, DCA and IBS also demonstrated that the radiomics model yielded good predictive performance and net clinical benefit. Patients were divided into the high-risk and low-risk cohorts based on the radiomics score. For patients at high risk, the 1-year and 2-year cumulative incidence rates of BM were 0% and 18.2% in the PCI group, and 61.8% and 75.4% in the non-PCI group, respectively ( P<0.001). In the PCI group, the 1-year and 2-year overall survival rates were 92.9% and 78.6%, and 85.3% and 36.8% in the non-PCI group, respectively ( P=0.023). For patients at low risk, the 1-year and 2-year cumulative incidence rates of BM were 0% and 0% in the PCI group, and 10.0% and 20.2% in the non-PCI group, respectively ( P=0.062). In the PCI group, the 1-year and 2-year overall survival rates were 100% and 77.0%, and 96.7% and 79.3% in the non-PCI group, respectively ( P=0.670). Conclusion:The radiomics model based on enhanced CT images yields excellent performance for predicting BM and individualized PCI.
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Objective:To investigate the factors influencing the prognosis of anaplastic thyroid cancer (ATC) and to evaluate the application value of established random survival forest (RSF) model in the prognosis prediction of ATC.Methods:A total of 707 ATC patients diagnosed by histopathology in the Surveillance, Epidemiology and End Results (SEER) database of the National Cancer Institute from 2004 to 2015 were selected and randomly divided into the training set (495 cases) and the validation set (212 cases). Univariate Cox regression risk model was used to analyze the related factors affecting overall survival (OS) of patients in the training set. The multivariate Cox proportional risk model based on the minimum Akaike information criterion (AIC) was used to analyze the above variables and then the variables were screened out. The traditional Cox model for predicting OS was constructed based on the screened variables. The RSF algorithm was used to analyze the variables with P < 0.05 in the univariate Cox regression analysis, and 5 important features were selected. Multivariate Cox proportional risk model was selected based on the minimum AIC. Then the RSF-Cox model for predicting OS was constructed by using screened variables. The time-dependent receiver operating characteristic (tROC) curve and the area under the curve (AUC), calibration curve, decision curve and integrated Brier score (IBS) in the training set and the validation set were used to evaluate the prediction performance of the models. Results:Univariate Cox regression analysis showed that age, chemotherapy, lymph node metastasis, radiotherapy, surgical method, tumor infiltration degree, tumor number, tumor diameter and diagnosis time were factors affecting the prognosis of ATC (all P < 0.05). Multivariate Cox regression analysis based on minimal AIC (4 855.8) showed that younger age (61-70 years vs. > 80 years: HR = 0.732, 95% CI 0.56-0.957, P = 0.023; ≤ 50 years vs. > 80 years: HR = 0.561, 95% CI 0.362-0.87, P = 0.010), receiving chemotherapy (receiving or not: HR = 0.623, 95% CI 0.502-0.773, P < 0.001), receiving radiotherapy (receiving or not: HR = 0.695, 95% CI 0.559-0.866, P = 0.001), receiving surgery (lobectomy, no surgery or unknown: HR = 0.712, 95% CI 0.541-0.939, P = 0.016; total resection or subtotal resection vs. no surgery or unknown: HR = 0.535, 95% CI 0.436-0.701, P < 0.001), and tumor diameter (≤ 2 cm vs. > 6 cm: HR = 0.495, 95% CI 0.262-0.938, P = 0.031; > 2 cm and ≤ 4 cm vs. > 6 cm: HR = 0.714, 95% CI 0.520-0.980, P = 0.037; > 4 cm and ≤ 6 cm vs. > 6 cm: HR = 0.699, 95 % CI 0.545-0.897, P = 0.005) were independent protective factors for OS of ATC patients. Lymph node metastasis (N 1 unknown vs. N 0: HR = 1.664, 95% CI 1.158-2.390, P = 0.006; N 1b: HR = 1.312, 95% CI 1.029-1.673, P = 0.028), more aggressive tumor infiltration degree (group 3 vs. group 1: HR = 1.492, 95% CI 1.062-2.096, P = 0.021; group 4 vs. group 1: HR = 1.636, 95% CI 1.194 - 2.241, P = 0.002) were independent risk factors for OS of ATC patients. Although diagnosis time was not statistically significant (2010-2015 vs.2004-2009: HR = 1.166, 95% CI 0.962-1.413, P = 0.118), the inclusion of it could improve the efficacy of the traditional Cox model. RFS algorithm was used to select out 5 important variables: surgical method, tumor diameter, age group, chemotherapy, and tumor number. Multivariate Cox regression analysis based on minimum AIC (4 884.6) showed that chemotherapy (receiving or not: HR = 0.574, 95% CI 0.476-0.693, P < 0.001), surgical method (lobectomy, no surgery or unknown: HR = 0.730, 95% CI 0.567-0.940, P = 0.015; total resection or subtotal resection vs. no surgery or unknown: HR = 0.527, 95% CI 0.423-0.658, P < 0.001), tumor diameter (≤ 2 cm vs. > 6 cm: HR = 0.428, 95% CI 0.231-0.793, P = 0.007; > 2 cm and ≤ 4 cm vs. > 6 cm: HR = 0.701, 95% CI 0.513-0.958, P = 0.026; > 4 cm and ≤ 6 cm vs. > 6 cm: HR = 0.681, 95% CI 0.536-0.866, P = 0.002) were independent factors for OS of ATC patients. RSF-Cox model was constructed based on 3 variables. The tAUC curve analysis showed that RSF-Cox model for predicting the 6-month, 12-month, and 18-month OS rates were 93.56, 92.62, and 90.80, respectively in the training set, and 93.05, 92.47, and 90.20, respectively in the validation set; in the traditional Cox model, the corresponding OS rates were 89.00, 87.76, 85.24, respectively in the training set, and 86.22, 83.68, 82.86, respectively in the validation set. When predicting OS rate at 6-month, 12-month and 18-month, the calibration curve of RSF-Cox model was closer to 45° compared with that of traditional Cox model, and the clinical net benefit of decision curve in RSF-Cox model was higher than that in traditional Cox model. The IBS of RSF-Cox model (0.089) was lower than that of traditional Cox model (0.111). Conclusions:The RSF model based on chemotherapy, surgical method and tumor diameter can effectively predict the OS of ATC patients.
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Objective:To explore the prognostic value of pretreatment albumin in extranodal nasal type NK/T cell lymphoma (ENKTL).Methods:The clinical data of 184 ENKTL patients in Shanxi Province Cancer Hospital from January 2002 to December 2018 were retrospectively analyzed. The Contal-O'Quigley change point method was used to determine the optimal cut-off value of albumin for predicting the prognosis of patients. The propensity score matching (PSM) was used to minimize selection biases. The Kaplan-Meier method was used for survival analysis, and Cox proportional hazards model was used to determine the factors affecting survival. The time-dependent receiver operating characteristic curve, Akaike information criterion and integrated Brier score were used to evaluate the efficacy of international prognostic index (IPI), Korean prognostic index (KPI) and prognostic index of NK cell lymphoma (PINK) models incorporating albumin for predicting the prognosis of patients.Results:The optimal cut-off value of pretreatment albumin for predicting the prognosis of ENKTL patients was 37.5 g/L. The 3-year and 5-year overall survival (OS) rates in >37.5 g/L group (126 cases) were 66.2% and 60.3%, and the progression-free survival (PFS) rates were 58.8% and 49.6%; the 3-year and 5-year OS rates in ≤37.5 g/L group (58 cases) were 35.0% and 32.4%, and the PFS rates were 32.5% and 30.0%. The OS and PFS in > 37.5 g/L group were better than those in ≤37.5 g/L group (both P<0.001). After PSM, the OS and PFS in >37.5 g/L group were still better than those in ≤37.5 g/L group (both P = 0.002). Multivariate analysis showed that albumin was an independent influencing factor for OS ( RR = 0.419, 95% CI 0.266-0.660, P < 0.001) and PFS ( RR = 0.493, 95% CI 0.322-0.755, P < 0.001). After PSM, albumin was still an independent influencing factor for OS ( RR = 0.305, 95% CI 0.156-0.598, P = 0.001) and PFS ( RR = 0.341, 95% CI 0.185-0.627, P = 0.001). The prognostic prediction performance of the IPI, KPI and PINK models incorporating albumin were all improved. Conclusions:Pretreatment albumin is an important prognostic indicator for ENKTL.
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To compare the power of dyslipidemia diagnosis by different sets of cut points in the prediction of cardiovascular metabolic risk factors and identify the appropriate cut points for the diagnosis of dyslipidemia in children and adolescents in China. Data were obtained from the baseline survey of 'School-based Cardiovascular and Bone Health Promotion Program' in Beijing in 2017. Dyslipidemia was diagnosed by using two set of cut points. Receiver operating characteristic curve analysis was conducted to assess the power of dyslipidemia diagnosis by the two set of cut points to predict the prevalence of hypertension, obesity, high fat mass percentage and impaired fasting glucose. A total of 14 390 children and adolescents were in included in the study. The prevalence rates of high TC, high LDL-C, low HDL-C, and high TG in the participants were 2.7, 2.7, 14.4, and 3.7 according to 'Chinese Reference Standard', and 5.0, 3.7, 13.3, and 3.5 according to 'China Expert Consensus'. Low HDL-C and high TG defined by the 'Chinese Reference Standard' had better performance for the prediction of high fat mass percentage and obesity in boys, but worse performance in girls (<0.001). Using 'China Reference Standard' can increase the true positive rate in the prediction of obesity or high fat mass percentage in boys, and reduce the false positive rate in girls. The cut points for the diagnosis of dyslipidemia in Chinese children and adolescents need to be further validated by using national representative sample and in longitudinal study.
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Objective: To develop the EST-SSR molecular identification system of Lilium lancifolium, Lilium davidii var. willmottiae, Lilium regale, Lilium casa blanca and Lilium brownie var. viridulum, and analyze the development efficiency and identification ability of EST-SSR molecular marker technology for Lilium genus. Methods: The MISA.pl program was used to identify the SSR locus of the EST gene sequence published by NCBI. The EST-SSR primers were generated by Primer3 program module, and the primers were screened by PCR amplification and agarose gel electrophoresis. The primary screening primers were verified by polyacrylamide gel electrophoresis, and the characteristic bands of different germplasms were labeled and analyzed to construct an identification system. Results: A total of 199 pairs of SSR primers were designed. After screening 26 pairs of primers, two pairs of highly efficient primers were obtained. The molecular identification system constructed by primer JZ391 can effectively identify the mixed commercial materials, which had certain practical value. Conclusion: Based on the extreme genetic characteristics of the research materials, this identification marker development is very efficient. The results confirm that the genetic basis of the species is an important factor affecting the development efficiency of its EST-SSR molecular marker. At the same time, this case can be used as a reference for the development of EST-SSR markers for other Chinese medicinal herbs similar to Lilium genus.
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Objective@#To report an implementation method and results of an independent brachytherapy dose verification software (DVS).@*Methods@#The DVS was developed based on Visual C+ + and the modular structure design was adopted. The DICOM RT files exported from the treatment planning system (TPS) were automatically loaded into the DVS. The TG-43 formalism was employed for dose calculation. Six cervical cancer patients who underwent brachytherapy were retrospectively selected to test the DVS. Different applicators were utilized for each patient. Dosimetric parameters and γ analysis (0.1cm, 5%) were used to evaluate the dose difference between the DVS and the TPS.@*Results@#Compared with the TPS dose, the γ pass rates of the doses calculated by the DVS were higher than 98%. For CTV, the dosimetric differences were less than 0.29% and 0.53% for D100% and D90%. For bladder, rectum and sigmoid, the agreement of D0.1cm3, D1cm3 and D2cm3 within a 0.5% level.@*Conclusion@#With minimal human-computer interactions, the DVS can verify the accuracy of dose calculated by TPS for brachytherapy.
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Objective:To explore an implementation method and results of an inverse dose optimization algorithm (gradient-based planning optimization, GBPO) in three-dimensional brachytherapy.Methods:A standard quadratic objective function was used in the GBPO. The optimization code of GBPO was performed based on LBFGS (Limited memory Broyden Fletcher Goldberg Shanno). Seven cervical cancer patients using different applicators and 15 cervical cancer patients using the Fletcher applicator (Nucletron part#189.730) were retrospectively analyzed. The plan quality of GBPO was firstly assessed by isodose lines, then dose-volume histogram (DVH) parameters of CTV(D 100%, V 150%) and organs at risk(D 0.1cm 3, D 1.0cm 3, D 2.0cm 3) were used to evaluate the difference among the GBPO, IPSA and Graphic plans. Results:For the 7 patients using different applicators, GBPO could optimize the conformal dose distribution, and the DVH parameters of the target and organs at risk were basically the same among the GBPO, IPSA and Graphic plans. For 15 patients using the Fletcher applicator, the difference in DVH parameters between the GBPO and IPSA plans was not statistically significant. There was no remarkable difference in the DVH parameters between the GBPO and Graphic plans, but the D 100% of the GBPO plan was significantly higher ( P<0.01), and the V 150% was significantly lower ( P<0.01) than that of the Graphic plan. Conclusions:The quality of the GBPO plan is similar to that of the IPSA plan in terms of target coverage and organ protection. The inverse dose optimization algorithm GBPO can be integrated into a three-dimensional brachytherapy treatment planning system.
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Objective To report an implementation method and results of an independent brachytherapy dose verification software (DVS).Methods The DVS was developed based on Visual C++ and the modular structure design was adopted.The DICOM RT files exported from the treatment planning system (TPS) were automatically loaded into the DVS.The TG-43 formalism was employed for dose calculation.Six cervical cancer patients who underwent brachytherapy were retrospectively selected to test the DVS.Different applicators were utilized for each patient.Dosimetric parameters and γ analysis (0.1 cm,5％) were used to evaluate the dose difference between the DVS and the TPS.Results Compared with the TPS dose,the γ pass rates of the doses calculated by the DVS were higher than 98％.For CTV,the dosimetric differences were less than 0.29％ and 0.53％ for D100％ and D90％.For bladder,rectum and sigmoid,the agreement of D0.1cm3,D1cm3 and D2cm3 within a 0.5％ level.Conclusion With minimal human-computer interactions,the DVS can verify the accuracy of dose calculated by TPS for brachytherapy.
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OBJECTIVE@#To study the value of body fat mass measured by bioelectrical impedance analysis (BIA) in predicting abnormal blood pressure and abnormal glucose metabolism in children.@*METHODS@#Stratified cluster sampling was used to select the students aged 6-16 years, and a questionnaire survey and physical examination were performed. The BIA apparatus was used to measure body fat mass. Body mass index (BMI), body fat mass index (FMI), and fat mass percentage (FMP) were calculated. Fasting blood glucose level were measured.@*RESULTS@#A total of 14 293 children were enrolled, among whom boys accounted for 49.89%. In boys and girls, the percentile values (P, P, P, P, P, P, P, P) of FMI and FMP fitted by the LMS method were taken as the cut-off values. Based on the receiver operating characteristic curve analysis, the P values with a better value in predicting abnormal blood pressure and blood glucose metabolism were selected as the cut-off values for excessive body fat. When FMI or FMP was controlled below P, the incidence of abnormal blood pressure or abnormal glucose metabolism may be decreased in 8.25%-43.24% of the children.@*CONCLUSIONS@#The evaluation of obesity based on FMI and FMP has a certain value in screening for hypertension and hyperglycemia in children, which can be further verified in the future prevention and treatment of obesity and related chronic diseases in children.
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Adolescent , Child , Female , Humans , Male , Adipose Tissue , Blood Pressure , Body Composition , Body Mass Index , Electric Impedance , GlucoseABSTRACT
Genetic as well as genomic study has advanced the development of precision medicine. We are marching on the road for right patients who are receiving more and more right treatment at right time. In hypertension field, precision medicine is available, actionable and affordable. First and the most practical advancement is monogenic hypertension, the disease-genes have been found for at least 17 types of monogenic hypertension. These patients can be precisely treated according to their carried gene mutation. Secondly, pharmacogenetic and pharmacogenomic guided anti-hypertensive drug selection, very promising but lack of clinic outcome data to support widely clinical application. Majority of hypertension are due to multiple genetic and environmental factors. GWAS fund some genetic variants related to primary hypertension, but these variants can only be responsible for 1-10% of blood pressure variation. We have a long way to go in exploring the real cause of primary hypertension.
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Drug addiction is a chronic psychiatric disorder characterized by compulsive drug taking, and involves neuronal plasticity changes in multiple brain regions. The prelimbic cortex (PrL) is a key region of the dorsomedial prefrontal cortex and contains majority of pyramidal neurons. The excitatory projections from PrL play a very important role in the drug seeking behaviors. PrL also contains a small amount of GABAergic interneurons, which regulate the information integration and transmission of the pyramidal neurons. However, the roles of the GABAergic interneurons in PrL in drug-induced behavior changes are not clear. In the PrL, parvalbumin (PV) and somatostatin (SST) interneurons are two major GABAergic interneurons, which have been reported to regulate the activity of glutamatergic input, and form inhibitory synaptic transmission to regulate the output of downstream signals. Here, we used PV-Cre and SST-Cre mice combined with chemical genetics to explore the role of PV and SST interneurons in PrL in morphine-induced behavior changes. Our data showed that specific inhibiting SST interneurons in PrL significantly increased the anxiety level and decreased morphine-induced locomotor activity and the conditioned place preference (CPP) score. Instead, specific inhibiting PV interneurons in PrL had no effect on the anxiety level, morphine induced-locomotor activity and CPP. Our findings provide a new insight into the cellular and neuronal specific mechanism for drug addiction.
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Compared with intensity-modulated photon therapy, intensity-modulated proton therapy has significant dose advantages. However,the dose gradient of proton Bragg peak is relatively high,and the proton therapy is likely to be affected by range uncertainties,setup uncertainties and antonymic changes,etc. The difference between the planning dose and actual dose caused by respiratory motion hinders the widespread use of intensity-modulated proton therapy in thoracic cancers. In this paper,research progress on the effect of respiratory motion on intensity-modulated proton therapy and how to reduce the effect were summarized,aiming to provide reference for clinicians and researchers.
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Objective To evaluate the effect of different methods of deformable image registration on the dose evaluation in adaptive radiotherapy for lung cancer. Methods By using Raystation Ver4. 5 treatment planning system platform, two algorithms ( Hybrid-and Biomechanics-based deformable image registration) and two orders (CT images before and during radiotherapy as reference images) were adopted. Four deformable image registration methods were utilized to calculate the accumulative dose. Eleven patients of lung cancer received adaptive radiotherapy for 35. 0-61. 6 Gy were recruited. The mean doses of lung,heart and GTV and the D98 and D2 of GTV were statistically compared using four methods. Results With the four deformable image registration methods, the standard deviation of the mean lung dose of 11 lung cancer patients was ranged from 0. 07 to 0. 70 Gy,0. 01 to 0. 79 Gy for the mean heart dose,0. 01 to 2. 23 Gy for the mean GTV dose,0. 02 to 6. 51 Gy for the D98 of GTV and 0. 01 to 0. 97 Gy for the D2 of GTV,respectively. Conclusion The selection of deformable image registration method causes uncertainty to the calculation of accumulative dose during adaptive radiotherapy for lung cancer.
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Objective@#Rebiqing granules were prepared and the rolling drying granulation process parameters were optimized.@*Methods@#According to the previous knowledge and experience, the feed rate, pressure and speed of rolling were used as the factors for investigation, and the primary forming rate and the solubility of the Rebiqing granule were taken as the evaluation indexes, and the Box-Behnken response surface method was used to optimize the rolling drying granulation parameters.@*Results@#The optimum rolling drying granulation parameters were as follows: feed rate was 8.5 Hz, rolling pressure was 6.0 Mpa and rolling speed was 8.5 Hz. After continuous production of 3 batches of validation, the Rebiqing granules had high molding rate and good solubility.@*Conclusions@#The rolling drying granulation processes were optimized by the experimental design, which could improve the robustness of the processes and control the stability of the product quality.
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Based on Hospital Information System (HIS),mobile terminal devices are used to realize the application of medical Internet of Things (IoT) in clinical nursing in wards,including intelligent basic data collection and monitoring system of medical IoT,intelligent infusion management system and other aspects,to expand and extend nurse's work to sickbeds and enhance nursing efficiency.
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The drug-loaded ultrasound (US) contrast nanoparticles, which can effectively accumulate in the tumor to penetrate into its deep section, were prepared. After being heated or under the near infrared (NIR) light irradiation, the size of nanoparticles would transform from nanometer-scale to micrometer-scale in vitro, which can vastly enhance the effect of US imaging. We evaluated the size changes of the nanoparticles in vitro, investigating their effect in ultrasound imaging and distribution in vivo. Liposomes containing hydrophobic modified hollow gold nanospheres (HAuNS), doxorubicin (DOX) and perfluorohexane (PFH), which were referred to DOX and HAuNS loaded PFH liposome (DHPL), were prepared by thin film evaporation and ultrasonic technique. The morphology and size of DHPL were measured by transmission electron microscopy and particle size analyzer with dynamic light scattering (DLS) method. The agar gel pore model was used to investigate the enhanced effect of nanoparticles in vitro US imaging under the NIR light irradiation. The biodistribution of DHPL in 4T1 tumor-bearing mice after intravenous injection was measured by the in vivo imaging system. The DHPL were spherical at a particle size of 302 ±5 nm and polydispersity index of 0.195 ±0.018. The HAuNS loaded on phospholipid membrane was observed in transmission electron microscope (TEM) image. Under the NIR light irradiation (1 or 2 W·cm-2), the temperature of the solution containing the DHPL (0.2, 0.04, 0.02 g·L-1 in terms of HAuNS) rose rapidly. And a certain amount of micrometer-sized particles could be detected by the particle size analyzer when the temperature of the analyzer was raised to 52℃. The abundant microbubbles, which would enhance the effect of US imaging, were detected by ultrasonic diagnostic apparatus when the nanoparticles were irradiated by NIR light in the in vitro US imaging experiment. The in vivo distribution experiment showed that the DHPL could effectively accumulate in the tumor due to the enhanced permeability and retention effect (EPR effect) of the tumor. In this study, we successfully made a nanometer-micrometer reversible nanoparticles that can accumulate inside the tumor to provide a feasible scheme for US imaging in the tumor site and the combinational photothermal-chemotheraphy simultaneously.
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<p><b>OBJECTIVE</b>To evaluate the long-term clinical outcomes of intravascular ultrasound(IVUS) in guiding the treatment of non-left main intermediate coronary lesions for patients of acute coronary syndrome (ACS).</p><p><b>METHODS</b>A total of 25 patients with intermediate coronary lesions(stenosis of 40%-70%) confirmed by coronary angiography were performed with IVUS. When MLA≥4 mm, we deferred the PCI treatment and performed optimal medical treatment (OMT). The patient were followed up for 12 month. The primary outcome was target vessel revascularization (TVR) and secondary outcome was major adverse cardiac events (MACEs).</p><p><b>RESULTS</b>A total of 25 lesions of 25 patients were examined by IVUS. 19(76%) lesions were attenuated plaque, 4(16%)were echo-lucent plaque, 2(8%) were calcified plaque. Most of the plaque (18/25, 72%) were eccentric. Positive remodeling was found in 20(80%) lesions and negative remodeling in 5(20%) lesions with meanremodeling index of 1.17=0.15. Thrombus was found in 1 case, accounting for 4%. The diameter stenosis, area stenosis, minimal lumen area and the reference diameter mea-sured by IVUS were larger than those measured by quantitative coronary angiography (all P<0.05). One patient with non-ST segment elevated myocardiac infarction was performed revascularization because MI attacked again, and 2 patients with Unstable angina were treated with OMT but they were still rehospitalization because of angina occurred repeatedly. The incidence of TVR was 4.00%, so as 16.00% of MACE.</p><p><b>CONCLUSION</b>IVUS can be used to guide the treatment of non-left main intermediate coronary lesions for patients of acute coronary syndrome.</p>
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BACKGROUND: Open reduction and internal fixation is commonest surgical method for calcaneal fractures, but its postoperative complications are troublesome. Thereafter, choosing an appropriate treatment scheme is of great significance for reducing postoperative complications and promoting patients' functional recovery. OBJECTIVE: To compare the curative efficacy of the modified minimally invasive internal fixation with cannulated screws through tarsal sinus and traditional extended lateral "L-shape" incision with plate fixation for calcaneal fractures. METHODS: Sixty-eight cases of unilateral calcaneal fractures (Sanders II and III) were selected, followed by treated with modified minimally invasive internal fixation with cannulated screws through tarsal sinus (modified group, n=33) or traditional extended lateral "L-shape" incision with plate fixation (traditional group, n=35). The operation time, blood loss, and Visual Analogue Scale scores were compared between two groups; the preoperarive and postoperative American Orthopedic Foot and Ankle Society scores, Bohler angle, and Gissane angle as well as postoperative complications were detected and compared between both groups. Besides, the postoperative pain, range of motion, and ankle stability were evaluated. RESULTS AND CONCLUSION: (1) The American Orthopedic Foot and Ankle Society scores at 6 months postoperatively in both two groups were significantly higher than those at baseline, and the scores in the modified group were significantly higher than those in the traditional group (P < 0.05). (2) The Bohler angle, Gissane angle, and calcaneal width in the modified group were significantly improved compared with the traditional group at 1 week, 6 and 12 months postoperatively (P < 0.05). (3) Compared with the traditional group, the operation time, blood loss, and Visual Analogue Scale scores in the modified group were significantly improved (P < 0.05). (4) The incidence of complications in the modified group was significantly lower than that in the traditional group (P < 0.05). (5) These results manifest that compared with the traditional extended lateral "L-shape" incision with plate fixation for calcaneal fractures, the modified minimally invasive internal fixation with cannulated screws through tarsal sinus can significantly alleviate pain, and improve the range of motion and stability of the ankle joint.
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Along with the arrival of big data era, many countries have put forward different big data strategies according to their conditions, China promoted big data strategy to the national strategic level in 2015, training big data profes-sionals has thus become its top priority task. The new opportunity and challenge for medical information education were analyzed under the big data national strategy background and the orientation of medical information education strategy in our country was elaborated in this paper in order to provide experiences for training health and medical big data professionals in our country.
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Along with the arrival of big data era, many countries have put forward different big data strategies according to their conditions, China promoted big data strategy to the national strategic level in 2015, training big data profes-sionals has thus become its top priority task. The new opportunity and challenge for medical information education were analyzed under the big data national strategy background and the orientation of medical information education strategy in our country was elaborated in this paper in order to provide experiences for training health and medical big data professionals in our country.