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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 systematically search the related literature of dengue syndrome in recent years, so as to understand the traditional Chinese medicine (TCM) syndrome distribution of dengue fever.@*Methods@#China biomedical database, CNKI, VIP and Wanfang database were searched. The epidemiological studies on the TCM syndrome of dengue fever were enrolled. The first author of this study, sample size, diagnostic criteria and the syndrome differentiation were collected. SPSS 21.0 software was used to carry out frequency statistics, describe the distribution of common clinical syndromes of dengue fever, and count the number and percentage of patients corresponding to each syndrome type.@*Results@#A total of 12 articles were enrolled, including 2 639 patients. The number of male patients were much more than the females. Most of the patients came from Guangdong, mostly after the outbreak of dengue fever in Guangdong in 2014.The most common TCM syndrome types include both the defense and Qi phases (25.20%), damp heat repression (20.69%), blood stasis and toxin (16.37%), excess of Qi and heat (12.24%), vigorous heat at qi-blood phase (10.19%).@*Conclusions@#The main pathogenic factors of dengue fever are heat, humidity and toxicity. The most common syndromes are both the defense and Qi phases, damp heat repression and blood stasis and toxin.
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Objective To systematically search the related literature of dengue syndrome in recent years, so as to understand the traditional Chinese medicine (TCM) syndrome distribution of dengue fever. Methods China biomedical database, CNKI, VIP and Wanfang database were searched. The epidemiological studies on the TCM syndrome of dengue fever were enrolled. The first author of this study, sample size, diagnostic criteria and the syndrome differentiation were collected. SPSS 21.0 software was used to carry out frequency statistics, describe the distribution of common clinical syndromes of dengue fever, and count the number and percentage of patients corresponding to each syndrome type. Results A total of 12 articles were enrolled, including 2 639 patients. The number of male patients were much more than the females. Most of the patients came from Guangdong, mostly after the outbreak of dengue fever in Guangdong in 2014.The most common TCM syndrome types include both the defense and Qi phases (25.20%), damp heat repression (20.69%), blood stasis and toxin (16.37%), excess of Qi and heat (12.24%), vigorous heat at qi-blood phase (10.19%). Conclusions The main pathogenic factors of dengue fever are heat, humidity and toxicity. The most common syndromes are both the defense and Qi phases, damp heat repression and blood stasis and toxin.
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Objective To evaluate the diagnostic value of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI)for the differential diagnosis of the adenoid cystic carcinoma and pleomorphic adenoma of the head and neck.Methods Thirty-one pa-tients with histopathologically proved adenoid cystic carcinoma and pleomorphic adenoma were examined with DCE-MRI,in which 10 cases were benign and 21 cases were malignant.The data of the conventional 3.0T DCE-MRI were improved by the 3D fast spoiled gradient-echo sequence (FSPGR)method.Z-test was performed on the quantitative parameters for benign and malignant le-sions,including volume transfer constant (Ktrans ),rate constant (Kep )and extravascular extracellular space fraction (Ve ).The re-ceiver operating characteristic (ROC)curves were plotted to investigate the diagnosis.Results The mean Ktranss of the adenoid cystic carcinoma group and pleomorphic adenoma group were (0.266 ± 0.103 )min-1 and (0.1 55 ± 0.080)min-1 respectively,and the difference between them were statistically significant (Z =-2.699,P 0.05).The areas under the ROC curves of the Ktrans and kep were 0.813 and 0.763 respectively.Choosing the optimal diagnostic cut-off points corresponding to the maximum Youden indexes 0.173 min-1 and 0.818 min-1 ,the sensitivities of Ktrans and kep for identifying the adenoid cystic carcinoma and pleomorphic adenoma were 90.9% and 81.8%,and the specificities were 77.8% and 66.7%.Ktrans was of the highest sensitivity and specificity for the identification of the adenoid cystic carcinoma and pleomorphic adenoma.Conclu-sion The dynamic contrast-enhanced parameter Ktrans plays a certain role in the differential diagnosis of the adenoid cystic carcinoma and pleomorphic adenoma of the head and neck.
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Objective To evaluate the influence of lumbar disc herniation type on the curative effect of percutaneous lumbar discectomy (PLD). Methods 158 patients were classified into two groups including contained and discontained herniation according to clinical symptoms and diagnostic images. They were treated by meanes of the same technique in nonvascular intervention. Their curative effects were compared with each other in this study. Results The curative and total effective rates were 81.1% and 98.5% respectively in contained group, 7.7% and 38.5% in discontained group without serious complications. The duration of follow up ranged from 3 months to 73 months. Conclusions PLD is a effective procedure for lumbar disc herniation, which is relatively simple and safe with rapid recovery and without serious complications. It should be confirmed in simple contained herniation only.