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Objective:To investigate and compare the value of cross-sectional area measurement and width measurement by high frequency ultrasound in the diagnosis of congenital adrenal hyperplasia (CAH) in infants.Methods:The abdominal ultrasound images of 20 infants who were diagnosed as CAH in Tianjin Children′s Hospital and clinical diagnosised from November 2013 to August 2018 were analyzed retrospectively. The maximum cross-sectional area of adrenal gland and the maximum width of single limb were measured respectively to assess the size of adrenal gland. Fifty normal full-term infants were selected as control group at the same period. The differences of maximum cross-sectional area of adrenal gland, the maximum width of single limb between CAH group and control group were compared. ROC curve was plotted to compare the diagnostic values of cross-sectional area measurement and width measurement.Results:①There was significant difference in maximum cross-sectional area of adrenal gland between infants with CAH and normal infants[(129.47±37.39)mm 2 vs (54.42±20.85)mm 2; t=10.004, P<0.001]. There was significant difference in maximum width of adrenal gland between infants with CAH and normal infants [(4.56±1.20)mm vs (3.25±0.66)mm; t=5.445, P<0.001]. ②The area under ROC curve(AUC) of cross-sectional area measurement was 0.966, the best cutoff value was 87.5 mm 2, the sensitivity was 95.0%, and the specificity was 92.5%. AUC of width measurement was 0.817, the best cutoff value was 5.25 mm, the sensitivity was 90.0%, and the specificity was 62.5%. The difference of AUC between cross-sectional area measurement and width measurement was 0.149, which was statistically significant ( Z=2.309, P=0.021). Conclusions:Both cross-sectional area measurement and width measurement by high frequency ultrasound have diagnostic values for CAH in infants, with the former more valuable than the latter.
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BACKGROUND: Small-incision extreme lateral interbody fusion and minimally invasive transforamen interbody fusion are widely used to treat patients with lumbar degenerative diseases because of easy operation technology and less serious complications. However, for patients with lumbar degenerative diseases who meet the indications of both surgical methods, how to choose surgical methods needs further study. OBJECTIVE: To compare the clinical outcome between small-incision extreme lateral interbody fusion and minimally invasive transforamen interbody fusion in patients with lumbar degenerative diseases. METHODS: Seventy-six patients with single-segment lumbar degenerative diseases treated from June 2016 to December 2017 were retrospectively analyzed. The patients were divided into small-incision extreme lateral interbody fusion group and minimally invasive transforamen interbody fusion group. Operation time, intraoperative blood loss, postoperative visual analogue scale, Oswestry dysfunction index, Japanese Orthopedic Association score, complications, anterior convex angle of lumbar fusion segment, intervertebral height and intervertebral displacement were compared between the two groups. RESULTS AND CONCLUSION: (1) Operation time and intraoperative blood loss were better in the small-incision extreme lateral interbody fusion group than in the minimally invasive transforamen interbody fusion group (P 0.05). (4) At the last follow-up, the anterior convex angle of fusion segment was larger in the small-incision extreme lateral interbody fusion group than in the minimally invasive transforamen interbody fusion group. The intervertebral height of fusion segment was higher in the small-incision extreme lateral interbody fusion group than in the minimally invasive transforamen interbody fusion group (P 0.05). (5) Both small-incision extreme lateral interbody fusion and minimally invasive transforamen interbody fusion can treat lumbar degenerative diseases effectively. Small-incision extreme lateral interbody fusion is superior to minimally invasive transforamen interbody fusion in terms of operation time, intraoperative blood loss and maintaining the anterior convex angle and intervertebral height of lumbar fusion segment, but incidence of complications is higher.
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To disscuss the role of cross‐sectional area measurement under high frequency ultrasound in the diagnosis of congenital adrenal hyperplasia ( CA H ) in infants . Methods T he abdominal ultrasound images of 20 infants with CA H w hich were admitted to our hospital and clinical diagnosised from November 2013 to August 2018 were analyzed retrospectively . T he size of adrenal glands were evaluated by measuring the maximum cross‐sectional area .Fifty normal full‐term infants were selected as control group synchronism . T he size of adrenal glands between infants with CA H and normal infants were compared . T he area under the curve ( AUC ) and best cutoff value were obtained by drawing ROC curve .Sensitivity and specificity were also obtained . Results T here was significant difference in maximum cross‐sectional area of adrenal gland between CA H group and control group[ ( 129 .70 ± 37 .34) mm2 vs ( 54 .41 ± 20 .84) mm2 , t ＝10 .004 , P ＝0 .001] . T he AUC of cross‐sectional area measurement was 0 .966 ,and best cutoff value was 87 .5 mm2 . T he sensitivity and specificity were 95 .0% and 92 .5% . Conclusions High‐frequency ultrasound is convenient and accurate in measuring the maximum cross‐sectional area of adrenal gland in infants . Cross‐sectional area measurement has high sensitivity and specificity to the diagnosis of CA H . T he presence of CA H is highly suspected w hen the area of adrenal gland reached 87 .5 mm2 .
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Hepatocellular carcinoma (HCC) is highly heterogeneous in nature and has been one of the most common cancer types worldwide. To ensure repeatability of identified gene expression patterns and comprehensively annotate the transcriptomes of HCC, we carefully curated 15 public HCC expression datasets that cover around 4000 clinical samples and developed the database HCCDB to serve as a one-stop online resource for exploring HCC gene expression with user-friendly interfaces. The global differential gene expression landscape of HCC was established by analyzing the consistently differentially expressed genes across multiple datasets. Moreover, a 4D metric was proposed to fully characterize the expression pattern of each gene by integrating data from The Cancer Genome Atlas (TCGA) and Genotype-Tissue Expression (GTEx). To facilitate a comprehensive understanding of gene expression patterns in HCC, HCCDB also provides links to third-party databases on drug, proteomics, and literatures, and graphically displays the results from computational analyses, including differential expression analysis, tissue-specific and tumor-specific expression analysis, survival analysis, and co-expression analysis. HCCDB is freely accessible at http://lifeome.net/database/hccdb.
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Humans , Carcinoma, Hepatocellular , Genetics , Databases, Genetic , Gene Expression Profiling , Gene Expression Regulation, Neoplastic , Liver Neoplasms , GeneticsABSTRACT
BACKGROUND:Short-segment pedicle screw technology has been extensively used in the treatment and repair of thoracolumbar burst fractures. The technique of operative treatment through the paraspinal muscle approach has advantages such as less trauma and bleeding, and rapid recovery. However, it requires further investigations to verify the superiority of the paraspinal muscle approach of two lateral incisions near the posterior median line. OBJECTIVE:To evaluate the clinical efficacy and Cobb’s angle of short-segment pedicle screw fixation through paraspinal muscle approach of two lateral incisions near the posterior median line in the treatment of thoracic and lumbar fractures. METHODS:From September 2010 to June 2012, 56 patients with thoracic and lumbar fractures were included in the retrospective study, including 42 males and14 females, with an average of 45 years (range 18-59 years). According to the surgical approach, patients were divided into two groups, traditional approach (n=25) and paraspinal muscle approach (n=31). The operative time, intraoperative blood loss, postoperative drainage and postoperative ambulant time in the two groups were observed and compared. The visual analog scale scores at 7 days, 1 month and 6 months postoperatively were recorded. The Cobb’s angles of suffered vertebra were measured preoperatively and at 7 days and 6 months postoperatively. RESULTS AND CONCLUSION:Al patients were fol owed up after internal fixation. The paraspinal muscle approach was superior to traditional approach in the operation time, intraoperative blood loss, postoperative drainage and postoperative ambulant time, and visual analog scale scores at 7 days and 1 month postoperatively (P0.05). The short-segment pedicle screw fixation through paraspinal muscle approach of two lateral incisions near the posterior median line in the treatment of thoracic and lumbar fractures, is an effective and minimal y invasive treatment, with less trauma, less bleeding, rapid recovery, and simple operations. Similar to open surgery, this treatment can recover the anatomical morphology and reconstruct spinal stability, and had good biocompatibility to the host.
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Objective To evaluate the value of ultrasonography in the diagnosis of pediatric ovarian torsion (OT).Methods Ultrasonography was performed in 38 OT,and 52 non-OT children.Bilateral ovarian area was measured.The larger area was defined as S1,whereas,the smaller area was defined as S2.S1/S2 ratio was calculated.Follicles around ovaries,ovarian blood flow,and pelvic effusion were also observed during the ultrasonographic scanning.ROC curve was employed to evaluate the clinical value of ultrasonography in pediatric OT diagnosis.Results ①S1/S2 ratio,incidence of follicles around ovaries and of no ovarian blood flow were all higher in OT compared to non-OT children (P =0.000).While pelvic effusion showed no significant difference between the two groups (P =0.004).②Using S1/S2 ratio to diagnose OT,the area under the ROC curve was 0.925 (0.865-0.986),the best cutoff point was 1.6,sensitivity was 97％ and specificity was 88％.Patients were divided into two groups based on the cutoff point of 1.6,the area under the ROC curve of S1/S2 was 0.924(0.847-0.969),of follicles around ovarian was 0.896(0.781-0.931),and of no ovarian blood flow was 0.911 (0.831-0.961),indicating S1/S2 held the highest diagnostic value.Conclusions Ultrasonography is an accurate method in the early diagnosis of pediatric ovarian torsion,with S1/S2 ratio holding the highest diagnostic value in this application.
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Objective To compare the clinical effects in patients treated with anterograde reamed intramedullary nail (IMN) and dynamic compression plate (DCP) for diaphyseal fractures of the humerus.Methods Forty-seven patients with diaphyseal fractures of the humerus,were divided into two groups by random digits table:IMN group (23 cases) and DCP group (24 cases),IMN and DCP were performed fixation,respectively.After the surgery,perioperative,functional outcomes of shoulder and elbow,postoperative complications between two groups were compared.Results The average follow-up time was (22.3 ± 5.7)months,3 cases were lost in 12-month-follow-up,1 case in IMN group and 2 cases in DCP group.The operation time,intraoperative blood loss in IMN group were significantly shorter than those in DCP group [(67.7 ± 15.3) min vs.(87.0 ± 12.5) min,(106.3 ±57.6) ml vs.(226.7 ±60.2) ml,P＜0.05].The incidence rate of subacromial impingement in IMN group was significantly higher than that in DCP group [18.2％ (4/22) vs.0,P ＜ 0.05].The incidence rate of wound infection in IMN group was significantly better than that in DCP group [4.5％(1/22) vs.22.7％(5/22),P ＜ 0.05].There were no statistically significant differences between two groups in other indexes (P ＞ 0.05).Conclusions DCP has some advantage in perioperative period,but they are comparable in the functional outcomes of shoulder and elbow and complications.