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Objective:To explore the value of nomogram based on dual-energy CT (DECT) enhanced imaging in predicting postoperative recurrence-free survival (RFS) of early-stage glottic carcinoma (EGC).Methods:The clinicopathological and DECT data of patients with EGC confirmed by pathology in the Tianjin First Central Hospital from January 2015 to July 2018 were analyzed retrospectively. A total of 178 patients were enrolled, including 162 males and 16 females, with the age from 44 to 86 (62±9) years old. According to the follow-up data, the patients were divided into recurrent group ( n=32) and non-recurrent group ( n=146). The differences of clinicopathological data and DECT iodine maps parameters between the two groups were analyzed using χ 2 test, independent-sample t test and Mann-Whitney U test. The survival related cut-off values of the quantitative data between the two groups were selected by X-tile software. The survival curve was drawn using Kaplan-Meier method, and the difference of survival rate was tested with log-rank analysis. The variables with statistical differences were included in the Cox proportional hazard model for multivariate analysis to select the independent predictors of postoperative RFS. Based on the multivariate Cox analysis, the nomogram was drawn to predict the RFS at 1, 2 and 5 years. The prediction efficiency and clinical benefit of the nomogram were evaluated by C-index, calibration curve and decision curve analysis. Results:The median follow-up time was 24.3 months, ranging from 2 to 63 months. There was a significant difference in T-stage between recurrent and non-recurrent groups (χ2=9.21, P=0.002). The prognostic cutoff values obtained by X-tile software were arterial phase standardized iodine concentration (SIC AP)=0.28 and venous phase standardized iodine concentration (SIC VP)=0.87. The results of log-rank test showed that there were significant differences in RFS among patients with different T-stage, SIC AP and SIC VP (χ2=10.74, 15.50, 17.97, P=0.001,<0.001,<0.001). T-stage, SIC AP and SIC VP were identified as independent predictors of postoperative RFS (hazard ratio=2.271, 3.552, 3.266, P=0.026,<0.001, 0.003). The C-index of the nomogram combined with DECT parameter and T-stage was 0.785, which was higher than that of T-stage alone (0.622). The calibration curve showed that there was good consistency between the actual and predicted probability of the sample. The decision curve analysis showed that the clinical benefit of the nomogram was higher than that of the T-stage alone. Conclusion:The nomogram based on preoperative clinical factors (T-stage) and DECT iodine map factors (SIC AP and SIC vp) can predict the postoperative RFS of patients with EGC.
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Objective@#To analyze and summarize the clinical characteristics of tubercular lymphadenitis, and to improve the ability of diagnosis. @*Methods@#Clinical records of 129 patients first confirmed with tubercular lymphadenitis were collected retrospectively from Nanfang Hospital of Southern Medical University between January 2012 and December 2016. The categorical variables were described with the percentage (%) and compared with the chi-squaue test. Non-normal distribution data were described with M(P25, P75) and compared with rank sum test.@*Results@#The disease courses were different in all cases, mostly of 1-3 months (45.7%). Among the cases, 83 cases (73.6%) complained of lymph node enlargement. The predominant involved lymph node site was cervical (56.6%) with main presentation of single lymph node (61.2%). Only a few cases presented with fever (34.1%). The positive rate of histological examinations was 94.3%, while the positive rate of T cell spot test of tuberculosis infection (T-SPOT.TB) test was 93.3% and purified protein derivative (PPD) test was 69.6%. In the diagnosis of tubercular lymphadenitis, 100 cases (77.5%) were confirmed by histological examinations, 27 cases (20.9%) were given diagnostic treatment, and only 2 case (1.6%) was confirmed by culture. The average period of diagnosis was (10.4±6.5) days. The median age of patients with fever was 50.5 years old with a median disease course of 2.5 months, while the median age of patients fever was 35(24, 49) years old with a median disease course of 1.2(0.5, 6.0) months. The differences between two groups were statistically significant (Z=-3.118 and -2.982, respectively, both P<0.05). Patients with fever had higher proportion of swollen deep lymph nodes (54.5% vs 11.8%), elevated white blood cell counts (34.1% vs 7.1%) and neutrophils (31.8% vs 1.8%), elevated erythrocyte sedimentation rate (97.1% vs 56.1%), elevated C-reactive protein (95.0% vs 40.0%) and received diagnostic treatment (47.7% vs 7.1%) than patients with no fever (χ2=27.337, 15.545, 13.567, 19.347, 25.410 and 28.974, respectively, all P<0.05). @*Conclusions@#Most patients of tubercular lymphadenitis do not present with typical symptoms which might lead to misdiagnose in early stage. The histological examinations and T-SPOT.TB test are especially essential, and histological examinations is the most important diagnostic method. Patients without symptoms of tuberculous poisoning are more common in young people, and the confirmation of diagnosis are mainly based on histological examinations. Patients with symptoms of tuberculous poisoning are more common in middle-aged, with longer duration and deep lymph node involved, which is more serious and nearly half of which are confirmed with diagnostic treatment.
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OBJECTIVE To investigate the immunogenicities of Poria cocos polysaccharides, PCP-Ⅰand PCP-Ⅱ, as a vaccine adjuvant. METHODS ①Keyhole limpet hemocyanin (KLH) was linked to PCP-Ⅰor PCP-Ⅱrespectively to prepare immuno-antigen KLH-PCP-Ⅰor KLH-PCP-Ⅱ. Bovine serum albumin (BSA) was also linked to PCP-Ⅰor PCP-Ⅱrespectively to prepare screening-antigen. Rabbits were immunized with KLH-PCP-Ⅰor KLH-PCP-Ⅱplus Freund adjuvant by intradermal injection twice, and serum specific antibody titers were determined by ELISA. ②BALB/c mice were immunized with PCP-Ⅰ or PCP-Ⅱ alone intramuscularly twice, and serum polysaccharide antibody titers were determined by ELISA.③BALB/c mice were co-immunized intramuscularly or subcutaneously with PCP-Ⅰor PCP-Ⅱplus hepatitis B surface antigen (HBsAg) or porcine reproductive and respiratory syndrome virus inactivated vaccine (PRRSV) twice, and serum polysaccharide-antibody titers were determined by ELISA. RESULTS ①Serum anti-KLH and anti-polysaccharides (PCP-Ⅰor PCP-Ⅱ) antibodies were pro?duced after rabbits were immunized with KLH-PCP-Ⅰor KLH-PCP-Ⅱplus Freund adjuvant twice.②Serum anti-PCP-Ⅰor anti-PCP-Ⅱantibodies were not found after mice were immunized with PCP-Ⅰand PCP-Ⅱalone twice.③After mice were immunized with HBsAg or PRRSV plus PCP-Ⅰor PCP-Ⅱtwice, serum anti-PCP-Ⅰor anti-PCP-Ⅱantibodies were not found. CONCLUSION PCP-Ⅰand PCP-Ⅱshow weak immunogenicity, which may be quite safe as a vaccine adjuvant.
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Objective To evaluate the effects of problem-based learning (PBL) teaching model in medical imaging education in China. Methods Such databases as PubMed, Medline, CNKI, WanFang, VIP Data were electronically searched for literature on PBL versus lecture-based learning (LBL) applied in medical imaging education in China up to April, 2015. According to the strict quality evaluation of the in-cluded studies, meta-analysis was performed using RevMan 5.2 software. Results Fourteen studies were included totally. Studies included 1 233 students, of whom the PBL group had 608 cases, while LBL group had 625 cases. Compared with LBL, PBL was superior in medical imaging theoretical scores [WMD=5.22, 95%CI(3.06, 7.37), P=0.000], and the case analysis scores [WMD=6.45, 95%CI(4.77, 8.12), P=0.000]. PBL was also superior in the autonomous learning ability [RR=1.78, 95%CI (1.47, 2.16), P=0.000], the unity cooperation ability [RR=1.42,95%CI (1.25, 1.61), P=0.000] and analysis ability [RR=1.73,95%CI (1.42, 2.11), P=0.000]. There were significant differences between PBL group and LBL group. Conclusion PBL can improve teaching results in medical imaging education.
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Objective To investigate the status and associated factors of demand satisfaction (DS) of services for older adults with visual disability (OAVD).Methods Based on the 2nd National Sample Survey on Disability in 2006,a total number of 24 017 OAVD cases were included.Associated relationships among demographic,health-related,social,economic factors and services of DS,including health demand (Type Ⅰ),basic livelihood demand (Type Ⅱ),and environmental support demand (Type Ⅲ) were analyzed.Results The proportions of DS of Type Ⅰ,Ⅱ,Ⅲservices for OAVD were 35.1％,9.3％ and 4.3％ respectively.Eight factors as:having pension insurance (OR =1.64),living in urban areas (OR =1.54),per capita household income at ≥ 5 000 or over Yuan (OR=1.46) were favorable ones on OAVD DS while at age ≥ 80 or above (OR =0.90),being male (OR=0.93) were adverse factors of Type Ⅰ.Four factors as:being male (OR=1.43),living in urban areas (OR=1.15),subjects defined as grade Ⅱ (OR=1.36) and grade Ⅰ (OR=1.70)etc.,were favorable factors on OAVD DS.Five factors as:range of age groups at 15-59(OR=0.57)or at ≥60 (OR=0.45),per capita household income at 1 000-1 999 Yuan(OR=0.77),2 000-4 999 Yuan (OR =0.58) and ≥ 5 000 Yuan (OR =0.39) were adverse factors of Type Ⅱ.Factors as:living in urban areas (OR =1.23),defined as grade Ⅱ (OR =1.38) and grade Ⅰ (OR =1.34),having pension insurance (OR=1.62) and per capita household income at ≥5 000 Yuan (OR=1.42) etc.,were favorable factors of Type Ⅲ.Conclusion The DS degree of older adults with visual disability was generally very low while factors as:per capita household income,situation on social insurance,age,degree of disability,age when disability was identified,areas of residence,gender,grade of disability,marriage status,levels of education etc.,were significantly associated with the service on DS.
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ObjectiveTo investigate the event-based prospective memory (EBPM)and time-based prospective memory( TBPM )in stable patients with schizophrenia and to explore the relationships between prospective memory and social functioning.Methods40 schizophrenic patients and 40 normal controls matched in age,gender and education were assessed with a neuropsychological battery of tests including EBPM and TBPM tasks.The patients were also assessed with social disability screening schedule(SDSS).ResultsA statistically significant in EBPM was observed between patients with schizophrenia and normal controls (4.18 ± 1.04 vs 5.33 ±0.86,t=- 5.408,P ＜ 0.01) and the same result in TBPM ( 3.45 ± 1.48 vs 5.20 ± 0.82,t =- 6.522,P ＜ 0.01).In patients with schizophrenia TBPM was impaired more significantly than EBPM ( z=-3.238,P＜0.01 ).After controlling the total score of PANSS,the negatively correlate was showed between the total scores of SDSS and EBPM ( r =- 0.346,P ＜ 0.05 ),TBPM ( r =- 0.374,P ＜ 0.05 ) in the patients.ConclusionThe results suggest schizophrenic patients impairs both EBPM and TBPM,and TBPM is impaired more significantly than EBPM.PM shows positively correlated with social functioning moderately in the patient.
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ObjectiveTo explore the relationship among the aggressive behavior,hostile attribution bias and childhood trauma in schizophrenic patients.Methods 135 schizophrenic patients were tested with Modified Overt Aggression Scale (MOAS),the Chinese-version of the Ambiguous Intentions Hostility Questionnaire (AIHQ-C) and Childhood Trauma Questionnaire (CTQ).According to the score of the MOAS,the patients were divided into the aggressive group ( n =58 ) and the non-aggressive group ( n =77 ).The hostile attribution bias and the childhood trauma were compared between the two groups,and correlation and hierarchical regression analysis were used to investigate the relationships of the variables.ResultsCompared with the non-aggressive patients,the aggressive patients had significantly higher AIHQ-C total hostility bias score (6.27 ± 1.20 vs 5.90 ± 0.97,P ＜0.05 ),total blame bias score (8.04 ± 1.97 vs 6.91 ± 2.10,P ＜ 0.01 ) and total aggression bias score ( 6.17 ±1.02 vs 5.59 ± 1.04,P ＜ 0.01 ).Correlation analysis showed that the MOAS score,AIHQ scores and the total score of CTQ were significantly positively correlated with each other ( r =0.171 ～ 0.350,P ＜ 0.05 ～0.01 ).Regression analysis indicated the hostile attribution bias directly predicted the aggressive behavior( β =0.342,P ＜0.05) and completely mediated the relationship between the childhood trauma and the aggressive behavior.ConclusionThe aggressive behavior in schizophrenic patients is associated with the experience of childhood trauma and the attribution style.The childhood trauma indirectly influences the aggressive behavior by the mediating of the hostile attribution bias.
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Objective To compare eye expression recognition in stable outpatients with schizophrenia with that in normal controls and to explore the relationships between eye expression recognition and social functioning.Methods 107 schizophrenic outpatients and 66 normal controls matched in age,sex and years of education were assessed with Eye Basic Emotion Discrimination Task(EBEDT) and Eye Complex Emotion Discrimination Task(ECEDT).The patients were also assessed with Social Disability Screening Schedule (SDSS).Results The correct numbers were significantly lower for patients to identify basic emotions of eye expressions(13.2±3.8 vs16.0±2.6,P<0.01) and complex emotions of eye expressions(17.9±4.3 vs 20.6±3.5,P<0.01)than those for controls respectively;the correct numbers to identify anger(3.1±1.0 vs.2.1±1.2,P<0.01),fear(1.8±1.0 vs 1.3±1.0,P<0.01) and disgust(1.8±1.1 vs 1.4±1.2,P<0.05)for controls were higher than those for patients significantly.The correct numbers to identify total basic emotions(r=-0.335,P<0.05)and total complex emotions (r=-0.374,P<0.05)in eye expressions showed negatively correlated with the total scores of SDSS in the patients after controlling age and total score of PANSS.Conclusions The ability to recognize basic and complicated emotions in eye expressions in the outpatients with schizophrenia is lower than that in the controls. It shows positively correlated with social functioning moderately in the patients.
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[Objective]To evaluate the prognostic value of skull-base invasion of nasopharyngeal carcinoma(NPC)based on magnetic resonance imaging(MRI).[Methods]A total of 924 patients who were diagnosed with NPC between 2003 and 2004,had undergone MRI scan and received mdiothempy as their primary treatment,and had no distant metastasis were included in this study.MRI images and medical records were analyzed retrospectively.All the 924 eases.patients who developed skull-base invasions based on MRI,315 patients with T3 disease and 227 patients with T2 disease were selected for analysis.The staging was according to the sixth edition of the American Joint Commission on Cancer(AJCC)staging system.[Results]Incidence of skullbase invasion according to MRI was 55.4%.Of 924 cases.skull-base invasion on MRI was not an independent prognostic factor for overall survival(OS)and distant metastasis-free survival(DMFS),but was a marginally significant independent prognostic factor for local relapse-free survival(LRFS),P=0.068.Grading of MRI-detected skull-base erosion according to the site of invasion was an independent prognostic factor for OS(P=0.002 and P=0.005)and DMFS(P=0.001 for both)in the 512 patients with skull-base invasions and 315 patients with T3 disease.Severe-grade of skull-base invasion on MRI was an independent prognostic factor for OS and DMFS in the 924 patients(P ＜ 0.001 for both).No significant differences were observed on OS,LRFS,and DMFS between T2a patients and T3 patients with low-grade of MRI-deteeted skull-base involvement.[Conclusions]Skull-base invasion based on MRI is not an independent prognostic factor for NPC.However,severe-grade of invasion according to the site of involvement has positive prognostic value.