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Objective:To explore the risk factors for cognitive impairment 3 months after an ischemic stroke and their predictive value.Methods:A retrospective case-control study considered the records of 856 elderly patients who had survived an ischemic stroke. All had been evaluated using the Montreal Cognitive Assessment scale (MoCA). They were divided according to their MoCA scores into a group without cognitive impairment (the PSNCI group) and an impaired (PSCI) group. The subjects′ demographic and clinical laboratory data were compiled. All had been assessed using the National Institutes of Health stroke scale (NIHSS), the Barthel Index (BI), and the Hamilton depression scale (HAMD). Univariate and multivariate logistic regressions were evaluated and a receiver operator characteristics (ROC) curve was computed.Results:There were significant differences between the two groups in terms of gender distribution, age, hypertension and heart disease history, family history of dementia and education level. Moreover, significant differences were observed in the groups′ average total cholesterol (TC), triglyceride (TG), high density lipoprotein (HDL), urinary neurofilament protein (AD7c-NTP), NIHSS scores, BIs and ADL scores. Logistic regression showed that a history of heart disease, urinary AD7C-NTP level and HAMD score were significant independent predictors of cognitive impairment 3 months after a stroke. A high BI was an independent protective factor. The area under the ROC curve for urinary AD7C-NTP was the largest (0.875) and had significant predictive value with a cut-off value of 2.43, sensitivity of 0.94 and specificity of 0.75.Conclusion:Age, sex, education, smoking, drinking, body mass index, a history of heart disease or stroke, a family history of dementia and elevated AD7C-NTP, TC or TG are risk factors for cognitive impairment after a stroke. A high BI suggests a better prognosis. Urinary AD7c-NTP is a useful predictor of PSCI 3 months after a stroke.
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Objective:To investigate the effect and safety of calcitriol on high turnover osteodystrophy in the treatment of patients with maintenance hemodialysis renal failure.Methods:Eighty patients with maintenance hemodialysis renal failure from April 2018 to June 2020 were selected as study objects and divided into the control group (40 cases) and the observation group (40 cases) by the random number table method. The control group was treated with oral calcium carbonate and other oral calcium preparations. The observation group was additively treated with calcitriol on the basis of the control group for 3 months. The therapeutic efficacy and the incidence of adverse reactions during the treatment were compared between the two groups; the levels of bone metabolism related index, kidney function index, hematocrit (Hct) and hemoglobin (Hb) and other index were compared between the two groups before and after treatment.Results:The total effective rate of the observation group was higher than that of the control group: 95.0%(38/40) vs. 80.0%(32/40), the difference was statistically significant ( χ2 = 4.11, P<0.05). After treatment, the levels of immune reactivity parathyroid hormone (iPTH), serum phosphorus, bone alkaline phosphatase (BALP) in the observation group were lower than those in the control group: (391.74 ± 28.69) ng/L vs. (468.50 ± 30.52), (1.02 ± 0.16) mmol/L vs. (1.63 ± 0.21) mmol/L, (70.59 ± 4.15) U/L vs.(73.64 ± 4.09) U/L, and the level of serum calcium was higher than that in the control group: [(2.05 ± 0.13) mmol/L vs. (1.93 ± 0.11) mmol/L, the differences were statistically significant ( P<0.05). After the treatment, the levels of serum creatinine (SCr), blood urea nitrogen (BUN), serum albumin (ALB) and the incidence of adverse reactions between the two groups had no significant differences ( P>0.05). Conclusions:The administration of calcitriol in the treatment of patients with maintenance hemodialysis renal failure can improve the status of high turnover osteodystrophy and anemia, and has a high safety.
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The clinical data of a child with ABCB1 rs1045642 T/T genotype and skin photosensitivity induced by Voriconazole were analyzed retrospectively in Beijing Children′s Hospital, Capital Medical University in September 2020.Literature was reviewed to discuss the relationship between ABCB1 genetic polymorphism and Voriconazole pharmacokinetics.The patient was a 6.8-year-old boy, who was diagnosed with primary immunodeficiency disease.Long-term oral Voriconazole was administered for prevention and treatment of fungal infections.Skin photodistributed erythema and pigmentation occurred about 3-4 weeks after treatment.The skin lesions were significantly alleviated about 1 month after the withdrawal of Voriconazole.Gene test showed ABCB1 rs1045642 T/T in the patient.Some studies reported that ABCB1 rs1045642 T/T genotype reduced the clearance rate of Voriconazole.Monitoring such adverse reaction of Voriconazole in clinical practice is important. ABCB1 gene polymorphism is possible to correlate with the pharmacokinetics and adverse reactions of Voriconazole.However, further large-scale clinical studies are warranted to verify it.
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Objective:To analyze the ultrasonographic features of adenoma of the nonpigmented ciliary epithelium (ANPCE).Methods:A retrospective series of case studies. From January 2014 to October 2021, 31 patients (31 eyes) with ANPCE (ANPCE group) were diagnosed in the eye center of Beijing Tongren Eye Center of Beijing Tongren Hospital, Capital Medical University, and 17 patients (17 eyes) with ciliary body melanoma (control group) diagnosed at the same time were selected as the control group. There was no significant difference in age ( t=-0.564) and sex composition ratio ( χ 2=0.182) between the two groups ( P=0.576, 0.670). All patients underwent ultrasound biomicroscopy to obtain the measurement parameters: tumor height, maximum basal diameter, maximum diameter, ratio of maximum diameter to basal diameter and ratio of maximum diameter to height; tumor location, shape, internal echogenicity intensity, echogenicity uniformity, degree of sound attenuation, invasion of iris, anterior displacement of the iris, lens subluxation were observed. The measurement parameters and observation indexes of the two groups were compared by independent sample t-test and χ 2 test. Receiver operating characteristic (ROC) curve was drawn, area under the ROC curve (AUC) was determined, and parameter indicators with differential diagnosis value were screened. Results:The maximum diameter, height, maximum basal diameter, ratio of the maximum diameter to the maximum basal diameter, and the ratio of the maximum diameter to the height of the tumors in the ANPCE group and the control group were 5.64±0.98 mm, 4.24±0.59 mm, 3.66±0.71 mm, 1.58±0.34, 1.34±0.19 and 7.82±2.03 mm, 4.47±2.44 mm, 7.02±1.96 mm, 1.13±0.16, 2.09±1.06. The maximum diameter, the maximum basal diameter, and the ratio of the maximum diameter to the height of the tumor in the ANPCE group were all smaller than those of the control group, and the ratio of the maximum diameter to the maximum basal diameter was greater than that of the control group, and the differences were statistically significant ( t=-4.159,-6.808, -2.924, 6.257; P<0.05). The tumors in the ANPCE group were mainly spherical (87.1%, 27/31), with no significant acoustic attenuation (77.4%, 24/31), less invading the root iris (77.4%, 24/31), and the tumors were mostly located in the ciliary body coronal (74.2%, 23/31); tumors in the control group were mainly hemispherical (47.1%, 8/17) or spherical (47.1%, 8/17), with significant sound attenuation (76.5%, 13/17), most of the tumors invaded the iris (70.6%, 12/17), and the tumors were mostly located from the pars plana to the coronal (76.5%, 13/17). There were statistically significant differences in the position, shape, sound attenuation degree, and whether it invaded the iris between the two groups of eyes ( χ 2=15.132, 19.767, 13.118, 10.581; P<0.05). The results of ROC curve analysis showed that the ratio of the largest diameter to the largest base diameter, the degree of sound attenuation and the AUC of whether the iris was violated were higher, which were 0.881, 0.769, and 0.740, respectively. Conclusions:Ultrasound biomicroscopy is helpful in the diagnosis and differential diagnosis of ANPCE and ciliary body melanoma. The ratio of maximum diameter to maximum basal diameter, the degree of sound attenuation and whether it invades the root iris are important parameters to distinguish the two tumors.
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Early-onset scoliosis (EOS) is defined as the scoliosis occurs before 10 years old. Such patients with severe scoliosis often require early surgical intervention, but spinal fusion may also affect their thoracic development and lung function. Based on etiology, EOS can be classified as congenital, neuromuscular, syndrome-related and idiopathic scoliosis. The clinical goal is to control the progression of the curve while allowing the spine and chest to grow as much as possible to promote the development of alveolar. Clinical treatments include physiotherapy, plaster and brace correction as well as surgery. Patients of EOS were usually at the critical stage of thoracic and lung development due to their young age. In addition, the combination of severe thoracic deformity may also lead to life-threatening cardiopulmonary disorder and related complications considering the clinical inconsistency and complexity of EOS. Thoracic anatomical changes brought by scoliosis itself can limit chest wall movement and reduce lung compliance, resulting in changes in thorax diameter and compression of thoracic volume, leading to restrictive ventilation dysfunction. And spinal fusion can effectively correct curve and control progression, which still remains as the primary surgical option for severe EOS patients nowadays. However, early spinal fusion can also lead to deformation of lung tissue, collapse and malformation of alveolar while limiting the height and growth rate of thoracic cavity, hindering the circulatory system and leading to respiratory dysfunctionof children. Spinal growth restriction, crankshaft phenomenon and restricted alveolar proliferation may play a role in thisprocess. The present review retrospectively summarized the effects and possible mechanisms of early spinal fusion on lung function and thoracic development in patients with EOS, aiming to further provide guidance for clinical decisions.
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Objective:To investigate the curative effect of Haikunshenxi capsule combined with losartan potassium tablets on chronic kidney disease (CKD) and its effect on renal function and inflammatory factors.Methods:One hundred patients with chronic kidney disease in Shaoxing Central Hospital from January 2018 to December 2019 were selected and randomly divided into observation group (50 cases) and control group (50 cases). The control group was treated with losartan potassium tablets based on conventional therapy, and the observation group was treated with Haikunshenxi capsulebase on control group. The treatment course of the two groups was 12 weeks. The curative effect, renal function, inflammatory factors, 24h urinary protein (24 h Upro) and glomerular filtration rate (GFR) were compared between the two groups before and after treatment.Results:The total effective rate in the observation group was higher than that in the control group: 90.0%(45/50) vs. 72.0%(36/50), χ2 = 5.26, P<0.05. After treatment, the levels of serum creatinine (Scr) and blood urea nitrogen (BUN) in the two groups were decreased and the levels of Scr and BUN in the observation group were lower than those in the control group: (63.27 ± 2.89) μmol/L vs. (67.89 ± 2.35) μmol/L, (5.23 ± 0.19) mmol/L vs. (5.56 ± 0.16) mmol/L, the differences were statistically significant ( P<0.05). After treatment, the levels of serum C-reactive protein (CRP) , interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) in the two groups were decreased and the levels of CRP, IL-6 and TNF-α in the observation group were lower than those in the control group: (2.97 ± 0.34) mg/L vs. (3.58 ± 0.42) mg/L, (3.64 ± 0.68) ng/L vs. (4.97 ± 0.96) ng/L, (14.32 ± 2.17) ng/L vs. (17.86 ± 2.06) ng/L, the differences were statistically significant ( P<0.05). After treatment, the level of 24 h Upro in two groups was decreased, while the level of GFR was increased, and the level of 24 h Upro in the observation group was lower than that in the control group: (0.87 ± 0.09) g vs. (1.15 ± 0.13) g , but the level of GFR in the observation group was higher than that in the control group: (101.73 ± 3.12) ml/(min·m 2) vs. (96.75 ± 2.35) ml/(min·m 2), the differences were statistically significant ( P<0.05). Conclusions:Haikunshenxi capsule combined with losartan potassium tablets has obvious curative effect on patients with chronic kidney disease, and can improve renal function and micro inflammation.
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To compare the performance of generalized additive model (GAM) and long short-term memory recurrent neural network (LSTM-RNN) on the prediction of daily admissions of respiratory diseases with comorbid diabetes. Daily data on air pollutants, meteorological factors and hospital admissions for respiratory diseases from Jan 1st, 2014 to Dec 31st, 2019 in Beijing were collected. LSTM-RNN was used to predict the daily admissions of respiratory diseases with comorbid diabetes, and the results were compared with those of GAM. The evaluation indexes were calculated by five-fold cross validation. Compared with the GAM, the prediction errors of LSTM-RNN were significantly lower [root mean squared error (RMSE): 21.21±3.30 vs. 46.13±7.60, <0.01; mean absolute error (MAE): 14.64±1.99 vs. 36.08±6.20, <0.01], and the value was significantly higher (0.79±0.06 vs. 0.57±0.12, <0.01). In gender stratification, RMSE, MAE and values of LSTM-RNN were better than those of GAM in predicting female admission (all <0.05), but there were no significant difference in predicting male admission between two models (all >0.05). In seasonal stratification, RMSE and MAE of LSTM-RNN were lower than those of GAM in predicting warm season admission (all <0.05), but there was no significant difference in value (>0.05). There were no significant difference in RMSE, MAE and between the two models in predicting cold season admission (all >0.05). In the stratification of functional areas, the RMSE, MAE and values of LSTM-RNN were better than those of GAM in predicting core area admission (all <0.05). has lower prediction errors and better fitting than the GAM, which can provide scientific basis for precise allocation of medical resources in polluted weather in advance.
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Female , Humans , Male , Beijing/epidemiology , Diabetes Mellitus/epidemiology , Hospitalization , Memory, Short-Term , Neural Networks, ComputerABSTRACT
Objective:To explore the clinical treatment of retinoblastoma (RB) after being treated with vitrectomy (PPV) due to misdiagnosis.Methods:A retrospective case study. From July 2015 to July 2018, 5 cases and 5 eyes of RB children diagnosed by pathological examination at the Eye Center of Beijing Tongren Hospital were included in the study. Among them, there were 3 males with 3 eyes and 2 females with 2 eyes; all of them had monocular disease. The average age was 4.8±1.7 years old. At the first visit, the diagnosis was endophthalmitis in 2 eyes (40%, 2/5); vitreous hemorrhage in 3 eyes (60%, 3/5). All were treated with PPV. All children underwent slit lamp microscopy, orbital MRI and CT, and eye color Doppler ultrasound blood flow imaging. If there was no clear extraocular spread, the eyeball removal combined with artificial orbital implantation was performed; if there was clear extraocular spread, the modified orbital content enucleation operation was performed with part of the eyelid preserved. The average follow-up time after surgery was 34.6±7.9 months.Results:Among the 5 eyes, 2 eyes (40%, 2/5) underwent eyeball enucleation combined with stage I artificial orbital implantation, and 3 eyes (60%, 3/5) with modified orbital content enucleation. There were 2 eyes of endogenous type (40%, 2/5), 1 eye of diffuse infiltration type (20%, 1/5), and 2 eyes of mixed type (40%, 2/5). The orbit spread in 3 eyes, the tumor invaded the optic nerve in 1 eye, and regional lymph node metastasis in 2 eyes. All children received systemic chemical therapy (chemotherapy). During the follow-up period, there were no new metastatic diseases and no deaths.Conclusions:After RB misdiagnosis and PPV, surgical treatment should be performed as soon as possible. If there is no clear extraocular spread, eyeball removal or combined stage I orbital implantation should be performed. If there is clear extraocular spread, the orbital contents should be enucleated; Chemotherapy should be combined after surgery.
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Objective:To explore the application of computer simulation teaching based on GasMan @ software in anesthesiology standardized nursing training. Methods:Thirty-six anesthesia nurses undergoing standardized training were selected as research objects. They were randomly divided into the traditional teaching group (group C) and the computer simulation teaching based on GasMan @ software group (group G), with 18 nurses in each group. All the nurses received the theory test before and after the training, and the practical operation assessment and the teaching satisfaction survey were conducted after the training. SPSS 17.0 was used for independent-samples t test and chi-square test. Results:There was no significant difference in the theoretical test scores of the anesthesia nurses before class between the two groups ( P > 0.05); the theoretical test, practical performance and satisfaction survey of group G were significantly better than those of group C, with statistical significance ( P < 0.05). Conclusion:Computer simulation teaching based on GasMan @ software is in favor of the anesthesia nurse to learn and master the relevant theory of inhalation general anesthesia, especially to improve practical skills.
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:To predict the epidemiological trend of coronavirus disease 2019 (COVID-19) by mathematical modeling based on the population mobility and the epidemic prevention and control measures. : As of February 8，2020，the information of 151 confirmed cases in Yueqing，Zhejiang province were obtained，including patients' infection process，population mobility between Yueqing and Wuhan，etc. To simulate and predict the development trend of COVID-19 in Yueqing, the study established two-stage mathematical models，integrating the population mobility data with the date of symptom appearance of confirmed cases and the transmission dynamics of imported and local cases. : It was found that in the early stage of the pandemic，the number of daily imported cases from Wuhan (using the date of symptom appearance) was positively associated with the number of population travelling from Wuhan to Yueqing on the same day and 6 and 9 days before that. The study predicted that the final outbreak size in Yueqing would be 170 according to the number of imported cases estimated by consulting the population number travelling from Wuhan to Yueqing and the susceptible-exposed-infectious-recovered (SEIR) model; while the number would be 165 if using the reported daily number of imported cases. These estimates were close to the 170，the actual monitoring number of cases in Yueqing as of April 27，2020. : The two-stage modeling approach used in this study can accurately predict COVID-19 epidemiological trend.
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Humans , COVID-19 , China/epidemiology , Disease Outbreaks , Models, Theoretical , Pandemics , SARS-CoV-2ABSTRACT
:To evaluate the impact of socioeconomic status，population mobility，prevention and control measures on the early-stage coronavirus disease 2019 (COVID-19) development in major cities of China. : The rate of daily new confirmed COVID-19 cases in the 51 cities with the largest number of cumulative confirmed cases as of February 19，2020 (except those in Hubei province) were collected and analyzed using the time series cluster analysis. It was then assessed according to three aspects，that is, socioeconomic status，population mobility，and control measures for the pandemic. : According to the analysis on the 51 cities，4 development patterns of COVID-19 were obtained，including a high-incidence pattern (in Xinyu)，a late high-incidence pattern (in Ganzi)，a moderate incidence pattern (in Wenzhou and other 12 cities)，and a low and stable incidence pattern (in Hangzhou and other 35 cities). Cities with different types and within the same type both had different scores on the three aspects. : There were relatively large difference on the COVID-19 development among different cities in China，possibly affected by socioeconomic status，population mobility and prevention and control measures that were taken. Therefore，a timely public health emergency response and travel restriction measures inside the city can interfere the development of the pandemic. Population flow from high risk area can largely affect the number of cumulative confirmed cases.
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Humans , COVID-19 , China/epidemiology , Cities , SARS-CoV-2 , Social ClassABSTRACT
This study aimed to quantitatively assess the effectiveness of the Wuhan lockdown measure on controlling the spread of coronavirus diesase 2019 (COVID-19). : Firstly，estimate the daily new infection rate in Wuhan before January 23，2020 when the city went into lockdown by consulting the data of Wuhan population mobility and the number of cases imported from Wuhan in 217 cities of Mainland China. Then estimate what the daily new infection rate would have been in Wuhan from January 24 to January 30th if the lockdown measure had been delayed for 7 days，assuming that the daily new infection in Wuhan after January 23 increased in a high，moderate and low trend respectively (using exponential, linear and logarithm growth models). Based on that，calculate the number of infection cases imported from Wuhan during this period. Finally，predict the possible impact of 7-day delayed lockdown in Wuhan on the epidemic situation in China using the susceptible-exposed-infectious-removed (SEIR) model. : The daily new infection rate in Wuhan was estimated to be 0.021%，0.026%，0.029%，0.033% and 0.070% respectively from January 19 to January 23. And there were at least 20 066 infection cases in Wuhan by January 23，2020. If Wuhan lockdown measure had been delayed for 7 days，the daily new infection rate on January 30 would have been 0.335% in the exponential growth model，0.129% in the linear growth model，and 0.070% in the logarithm growth model. Correspondingly，there would have been 32 075，24 819 and 20 334 infection cases travelling from Wuhan to other areas of Mainland China，and the number of cumulative confirmed cases as of March 19 in Mainland China would have been 3.3-3.9 times of the officially reported number. Conclusions: Timely taking city-level lockdown measure in Wuhan in the early stage of COVID-19 outbreak is essential in containing the spread of the disease in China.
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Humans , COVID-19 , China/epidemiology , Cities , Communicable Disease Control , SARS-CoV-2ABSTRACT
Objective:To compare MRI findings of uveal melanomas and other intraocular masses in adults and to evaluate the optimal MRI features for the differential diagnosis.Methods:The MRI data of 254 patients with intraocular masses confirmed by histopathologic or clinical follow-up results from March 2005 to December 2015 in Beijing Tongren Hospital, Capital Medical University was analyzed retrospectively. A total of 128 patients with uveal melanoma and 126 patients with other intraocular masses were enrolled. MRI findings of the masses including the location, shape, margin, signal intensity on T 1WI and T 2WI compared to the gray matter and vitreous body, homogeneity and degree of enhancement of the mass, secondary retinal detachment, height, and ratio of basal diameter to height were compared between uveal melanoma and other intraocular masses by χ 2 test or independent t test. The logistic regression analysis was performed to identify the most discriminating MRI features. The diagnostic performance of different predictive models was analyzed by receiver operating characteristic (ROC) curve. The model of multiple parameters was established by logistic analysis, and the diagnostic efficacy was evaluated. Results:The location, shape, margin, signal intensity on T 1WI and T 2WI compared to the gray matter and vitreous body, homogeneity and degree of enhancement of the mass, secondary retinal detachment, height and ratio of basal diameter to height were significantly different between the uveal melanoma and other intraocular masses (all P<0.05). The results of logistic regression analysis showed that the signal intensity on T 1WI and T 2WI compared to the gray matter, height, shape, location, degree of enhancement of the mass, and secondary retinal detachment were associated with higher likelihood of uveal melanoma. The mass with hypointense on T 2WI (compared with gray matter) was the best MRI feature in the differential diagnosis of uveal melanoma and other intraocular masses (odds ratio 12.237), with the accuracy of 86.2%. The diagnostic accuracy of low signal on T 2WI and high signal on T 1WI (compared with gray matter) was significantly higher than those of vitreous (Delong test, P<0.001). The sensitivity, specificity and accuracy of the combination of height, degree of enhancement, T 1WI and T 2WI signal compared to the gray matter were 90.6%, 92.1% and 96.1%, respectively. The diagnostic performance of combination features was higher than that of each single sign ( P<0.001). Conclusion:MRI features including the signal intensity on T 1WI and T 2WI compared to the gray matter, height, shape, degree of enhancement of the mass, and secondary retinal detachment are helpful in the differential diagnosis between uveal melanoma and other intraocular masses. In addition, the gray matter as the reference is superior to the vitreous body in the evaluation of the signal intensity of intraocular masses.
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Objective:To investigate the transthyretin ( TTR) mutations and clinical characteristics of patients with vitreous amyloidosis. Methods:Ten cases of suspected vitreous amyloidosis were recruited in Beijing Tongren Hospital from January 2011 to December 2018.The patients and their relatives underwent detailed ophthalmologic examination.Genomic DNA was extracted from 4 ml peripheral blood samples of patients and their available family members.The four exons of TTR were amplified by PCR, followed by Sanger sequencing.The pathogenicity of gene variants were predicted by Polyphen2, MutationTaster, SIFT, and PMut.The allele frequency of gene variants was searched in the 1000 Genome, EVS, and ExAC database.Co-segregation analysis was performed in available family members.The vitreous specimen of 5 patients obtained during vitrectomy was stained with hematoxylin and eosin and Congo red.Written informed consent was obtained from each subject prior to entering the study cohort.The study protocol was approved by the Ethics Committee of Beijing Tongren Hospital(No.TRECKY2017-08). Results:Six reported missense mutations of the TTR gene, p. V30A, p.K35N, p.L55R, p.Y69H, p.G83R, and p. Y114C, were identified in 8 patients.The mutations were located in the beta-strand and beta-hairpin domain of TTR.The average onset age of 8 patients was (41.9±8.9) years.All patients showed dense grayish white cord or agglomerate opacity in the vitreous.Hematoxylin and eosin staining of vitreous specimens in 5 patients showed no structural substance.Congo red staining was positive in one patient.Six of 8 patients showed combined hearing system, autonomic nervous system or peripheral nervous system abnormalities. Conclusions:The β-strand C is the protein region where common TTR mutations are located.The p. G83R mutation of TTR gene is a mutation hotspot in Chinese patients with vitreous amyloidosis.Mutation screening of the TTR gene can be used to distinguish vitreous amyloidosis from other causes of vitreous opacity.
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Objective:To analyze the clinical pathological features of mushroom shaped uveal melanoma.Methods:Retrospective clinical study. From June 2001 to Aprilh 2013, pathological sections from 102 eyes of 102 patients with uveal melanoma diagnosed in Beijing Tongren Eye Center were included in the study. The sections were divided into group A (mushroom shaped uveal melanoma, 30 eyes) and group B (flat, hemisperical and spherical uveal melanoma, 72 eyes). The height-to-base ratio was calculated. The tumors size was divided into small, medium and large according to the standards of American Multicentre Study of Ocular Melanoma. The tumor cell type was divided into spindle, epithelioid, mixed and others by Improved Callender taxonomy. Motic Med 6.0 software was used to collect and measure the images. The retinal thinning rate of group A and B was compared by χ2 test. Results:In group A, large size in 19 eyes (63.3%), medium size in 11 eyes (36.7%). In group B, large size in 49 eyes (68.1%), medium size in 16 eyes (22.%), small size in 7 eyes(9.7%). In group A and B, the average tumor base diameter were 14.2±5.1 mm and 18.7±6.4 mm, respectively; the average tumor height were 10.0±2.1 mm and 7.6±3.9, respectively; the height-to-base ratio were 0.77±0.29 and 0.44±0.28, respectively. In group A, spindle type in 24 eyes (80.0%), epithelioid type in 1 eye (3.3%), mixed type in 5 eyes (16.7%). In group B, spindle type in 52 eyes (72.2%), epithelioid type in 5 eyes (6.9%), mixed type in 11 eyes (15.3%), and others in 4 eyes (5.6%). The proportion of retinal thinning were 73.3% (22 eyes) and 29.2% (21 eyes) in group A and B, respectively. The difference in the proportion of retinal thinning between group A and B was significant ( χ2=16.94, P=0.000). Conclusion:The height of the tumor increased rapidly and the retinal thinning rate is high in mushroom shaped uveal melanoma.
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Objective:To investigate the metal artifact reduction effect of orthopedic metal artifact reduction (O-MAR) techonology and its improvement effect on the image quality in CT examination in the patients with arthroplasty, and to elaborate the significance of the technology in clinical diagnosis and treatment of arthroplasty.Methods:The CT data of 20patients with hip or knee prostheses was collected.There were two tube voltages in each group of CT data:120and 140Kev.There were also two groups of CT data in each tube voltage group:nonO-MAR group and O-MAR group;there were four subgroups of CT data of each case:120 Kev/-O-MAR, 120Kev/+O-MAR, 140Kev/-O-MAR, 140Kev/+O-MAR.After data collection, Mimics software was applied to conduct three-dimensional (3D) reconstruction for purpose of the qualitative and quantitative analysis of CT data.Qualitative analysis mainly included the grade of severity of metal artifact and quality of data.Quantitative analysis included the volume of metal artifact, the average CT value and standard deviation (SD) in region of interest (ROI) .ROI 1and ROI 2were chosen at the location of beam hardening artifact (radial high-density metal artifact) and photon starvation artifact (band low-density metal artifact) , respectively.Results:According to the result of3D measurement, the volumes of artifact had no significant difference between 120 Kev/-O-MAR group and140Kev/-O-MAR group (P=0.062) , but there were siginificant differences in the volumes of artifact between other groups (P＜0.05) ;O-MAR technology decreased the volume of beam-hardening artifact obviously (P＜0.05) .According to the results of two-dimensional (2D) measurement, there was no significant difference in the average CT values in ROI 2between 120Kev/-O-MAR group and 140Kev/-O-MAR group (P=0.069) , but there were significant differences in the average CT values between other groups (P＜0.05) ;O-MAR technology decreased the high-density beam-hardening metal artifact and the low-density photon-starvation metal artifact in 2D measurement.Conclusion:O-MAR technology could significantly reduce the CT metal artifact of hip and knee prostheses and increase the clinical value of CT data.
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Objective@#To investigate the clinicopathologic and genetic features, pathologic diagnosis and differential diagnosis of angiofibroma of soft tissue(AFST).@*Methods@#The clinicopathologic characteristics of 24 cases diagnosed at Fudan University Shanghai Cancer Center from 2011 to 2017 were analyzed; immunohistochemical staining and interphase fluorescence in situ hybridization (FISH) were performed, and the literatures were also reviewed.@*Results@#There were 15 male and 9 female (male∶female=1.7∶1.0) patients with age of onset ranging from 8 to 68 years (mean, 45 years). Fourteen cases occurred in extremities, including upper limbs (n=3) and lower limbs (n=11); seven cases were in the trunk, and 1 case each was in the temporal region, retroperitoneum and liver, respectively. Clinically, the tumors usually presented as a slowly growing painless mass. Tumor sizes ranged from 0.8 to 14 cm (mean 4.6 cm). Microscopically, most lesions were well-circumscribed, with fibrous capsules. Few cases infiltrated the surrounding fibrofatty tissue focally. The tumors were mainly composed of sparse short spindle cells and numerous small, branching, thin-walled blood vessels distributed in amyxoid, fibromyxoid or collagenous matrix, often accompanied by medium-sized, round or irregular and ecstatic vessels at the tumor periphery.By immunohistochemistry, all tested cases expressed vimentin (5/5), and showed variable positivity for EMA (2/4), ER (1/2), PR (2/3), α-SMA (1/18)and desmin (1/10). Ki-67 proliferation index were all less than 5%. CD34, CD31 and ERG staining clearly outlined the contours of blood vessels in the stroma. Four cases were tested for NCOA2 gene rearrangement by FISH, of which three were positive. Follow-up data was available in 17 patients (range, 3 to 69 months; mean, 30 months) were all free of disease.@*Conclusions@#Soft tissue angiofibroma is a benign fibroblastic neoplasm characterized by a prominent and complex vasculature set in a myxoid-to-collagenous stroma, and cytogenetically a distinctive NCOA2 gene rearrangement. Caution should be exercised for the possibility of potentially misinterpretation of AFST as vascular tumors and other myxoid soft tissue tumors.
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Objective:To discuss the accuracy of stereolithography (SLA)-3D printing model in orthopedics and maxillofacial surgery,and to clarify the reliability of its clinical application.Methods:A total of 33 cases of SLA-3D printing models were randomly included (10 long bones,13 irregular bones and 10 prostheses),and the CT scanning and three-dimensional reconstruction were performed.According to the clinical application characteristics of the models,the max height (MH),max length (ML),max width (MW),width of the trochlear (WT),length of the trochlear (LT),length of the glenoid cavity (LGC),width of the glenoid cavity (WGC),distance of pubic tubercle-anterior superior iliac spine (DPI),diameter of the acetabulum (DA),diameter of the marrow cavity (DMC),anterior height of right ramus (AHRR) and posterior height of right ramus (PHRR) were selected to measure the original data and model data,respectively.The absolute / relative errors were calculated.Intraclass correlation coefficient (ICC) was used to evaluate the consistency of the data.The three-dimensional error analysis of the prosthesis model was carried out.Results:There were no significant differences in the anatomical parameters except MW of irregular bone (P＞0.05) in 33 cases of SLA-3D printing model.The values of ICC were all greater than 0.950;the maximum values of absolute / relative errors were-0.58 mm and-1.37％,respectively;the maximum 3D error of prosthesis model was 0.237 mm,and the average value was 0.132 mm.Conclusion:The CT data of SLA-3D model is highly consistent with the original data,and it is accurate and reliable in the diagnosis and treatment of the diseases in orthopedics and maxillofacial surgery.
ABSTRACT
Objective:To discuss the accuracy of stereolithography (SLA)-3D printing model in orthopedics and maxillofacial surgery,and to clarify the reliability of its clinical application.Methods:A total of 33 cases of SLA-3D printing models were randomly included (10 long bones,13 irregular bones and 10 prostheses),and the CT scanning and three-dimensional reconstruction were performed.According to the clinical application characteristics of the models,the max height (MH),max length (ML),max width (MW),width of the trochlear (WT),length of the trochlear (LT),length of the glenoid cavity (LGC),width of the glenoid cavity (WGC),distance of pubic tubercle-anterior superior iliac spine (DPI),diameter of the acetabulum (DA),diameter of the marrow cavity (DMC),anterior height of right ramus (AHRR) and posterior height of right ramus (PHRR) were selected to measure the original data and model data,respectively.The absolute / relative errors were calculated.Intraclass correlation coefficient (ICC) was used to evaluate the consistency of the data.The three-dimensional error analysis of the prosthesis model was carried out.Results:There were no significant differences in the anatomical parameters except MW of irregular bone (P＞0.05) in 33 cases of SLA-3D printing model.The values of ICC were all greater than 0.950;the maximum values of absolute / relative errors were-0.58 mm and-1.37％,respectively;the maximum 3D error of prosthesis model was 0.237 mm,and the average value was 0.132 mm.Conclusion:The CT data of SLA-3D model is highly consistent with the original data,and it is accurate and reliable in the diagnosis and treatment of the diseases in orthopedics and maxillofacial surgery.
ABSTRACT
Objective:To evaluate the clinical effects of topical administration of phenytoin ( PHT) on wound healing. Methods:The clinical trials on PHT topically used for wound healing were collected from Cocharne Library and PubMed ( from database establish-ment to May, 2016. Meta-analysis was performed using RevMan 5. 0 software and Stata 12. 0 software. Results:A total of 15 stud-ies involving 1 048 patients were included. Topical PHT treatment was significantly associated with complete healing rate (OR=3. 28, 95%CI:1. 23-8. 75, P=0. 02), production rate of health granulation tissue (OR=2. 18,95%CI:1. 33-3. 59, P=0. 002) and aver-age percentage reduction of wound surface size (SMD=1. 77, 95%CI:0. 53-3. 02, P<0. 000 01). However, heterogeneity existed in complete healing rate and average percentage reduction of wound surface size among the studies. Meta-regression analysis showed that wound types (P=0. 02) and treatment periods(P=0. 08) were associated with the heterogeneity of complete healing rate outcomes, and mean age was associated with the heterogeneity of average percentage reduction of wound surface size(P=0. 07). Conclusion:Meta-analysis suggests that topical PHT treatment has significant positive clinical effect on wound healing. There is heterogeneity among the studies, so topical PHT treatment still should be applied in clinical practice prudently.