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Objective:To evaluate the performance of an artificial intelligent (AI)-based automated digital cell morphology analyzer (hereinafter referred as AI morphology analyzer) in detecting peripheral white blood cells (WBCs).Methods:A multi-center study. 1. A total of 3010 venous blood samples were collected from 11 tertiary hospitals nationwide, and 14 types of WBCs were analyzed with the AI morphology analyzers. The pre-classification results were compared with the post-classification results reviewed by senior morphological experts in evaluate the accuracy, sensitivity, specificity, and agreement of the AI morphology analyzers on the WBC pre-classification. 2. 400 blood samples (no less than 50% of the samples with abnormal WBCs after pre-classification and manual review) were selected from 3 010 samples, and the morphologists conducted manual microscopic examinations to differentiate different types of WBCs. The correlation between the post-classification and the manual microscopic examination results was analyzed. 3. Blood samples of patients diagnosed with lymphoma, acute lymphoblastic leukemia, acute myeloid leukemia, myelodysplastic syndrome, or myeloproliferative neoplasms were selected from the 3 010 blood samples. The performance of the AI morphology analyzers in these five hematological malignancies was evaluated by comparing the pre-classification and post-classification results. Cohen′s kappa test was used to analyze the consistency of WBC pre-classification and expert audit results, and Passing-Bablock regression analysis was used for comparison test, and accuracy, sensitivity, specificity, and agreement were calculated according to the formula.Results:1. AI morphology analyzers can pre-classify 14 types of WBCs and nucleated red blood cells. Compared with the post-classification results reviewed by senior morphological experts, the pre-classification accuracy of total WBCs reached 97.97%, of which the pre-classification accuracies of normal WBCs and abnormal WBCs were more than 96% and 87%, respectively. 2. The post-classification results reviewed by senior morphological experts correlated well with the manual differential results for all types of WBCs and nucleated red blood cells (neutrophils, lymphocytes, monocytes, eosinophils, basophils, immature granulocytes, blast cells, nucleated erythrocytes and malignant cells r>0.90 respectively, reactive lymphocytes r=0.85). With reference, the positive smear of abnormal cell types defined by The International Consensus Group for Hematology, the AI morphology analyzer has the similar screening ability for abnormal WBC samples as the manual microscopic examination. 3. For the blood samples with malignant hematologic diseases, the AI morphology analyzers showed accuracies higher than 84% on blast cells pre-classification, and the sensitivities were higher than 94%. In acute myeloid leukemia, the sensitivity of abnormal promyelocytes pre-classification exceeded 95%. Conclusion:The AI morphology analyzer showed high pre-classification accuracies and sensitivities on all types of leukocytes in peripheral blood when comparing with the post-classification results reviewed by experts. The post-classification results also showed a good correlation with the manual differential results. The AI morphology analyzer provides an efficient adjunctive white blood cell detection method for screening malignant hematological diseases.
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Anxiety is a major mood disorder, and the high morbidity, co-morbidity and disability of anxiety disorders seriously affect people's quality of life, so the importance and urgency of research on anxiety cannot be overstated. Animal models are the main carriers for studying the mechanism of disease occurrence and development, drug efficacy evaluation and drug development.Unconditioned anxiety model is a common anxiety model.Elevated plus maze test, open field test and light-dark box test are widely accepted paradigms for the detection of unconditioned anxiety.This kind of behavioral paradigm based on environmental exposure takes advantage of the conflict between curiosity and fear of the unfamiliar environment to simulate and detect the anxiety of animals.However, the validity of these behavioral paradigms for evaluating anxiety in animals is questionable.In this paper, we discuss the concept of anxiety, the definition of anxiety behavior in the behavioral test of unconditioned anxiety, and the factors to be considered in the test of unconditioned anxiety behavior.On this basis, new solutions were proposed to the contradictions and blind spots in order to improve the test paradigm of anxiety behavior and provide a more reliable animal model for the evaluation of anxiety.This paper presents a new approach to address the contradictions and blind spots of this paradigm.
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@#Objective - To optimize the extraction and quantification methods for the determination of S phenylmercapturic acid - Methods (SPMA) in urine with performance liquid chromatography mass spectrometry. The urine was hydrolyzed with 50.0% sulfuric acid. The hydrolysate was purified by solid phase extraction column. Purified samples were separated by C18 chromatographic column and detected by tandem mass spectrometry. The isotope labeled SPMA was used as the internal Results - standard. The internal standard curve was used for quantification. The linear range of SPMA was 0.50 50.00 μg/L with the correlation coefficient of 0.999 8. The detection limit and the lower limit of quantification were 0.05 and 0.17 μg/L, - - - - respectively. The recovery rate was 97.0% 102.0%. The within run and between run relative standard deviation were 0.6% 1.0% - and 1.7% 6.5%, respectively. The mass concentration of urinary SPMA in the occupational benzene exposure group was - vs P higher than the non occupational benzene exposure group by this method (median: 2.81 0.28 μg/g creatinine, <0.05). Conclusion Compared to the national standard method, this optimized method of solid phase extraction and internal standard for quantification eliminates the matrix effect. This method is accurate and precise, and is suitable for the determination of SPMA acid in urine.
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Objective:To investigate the distribution of HIV-1 genotypes and drug resistance in newly diagnosed HIV-1 patients in Baoding in 2020.Methods:A self-developed method was used to amplify the pol gene sequence of HIV-1, and the sequencing results were analyzed by phylogenetic analysis and compared with the Stanford drug resistance database to determine the HIV-1 subtypes and gene mutations. Results:A total of 96 patients with HIV-1 infection were recruited in this study, and 83 pol gene sequences were successfully obtained. In the study population, 88 (91.7%) were male with an average age of 39 years and 54 (56.3%) were married. Most of the patients were infected through sexual contact (95.8%, 92/96), and 75.0% (72/96) were through homosexual transmission. Phylogenetic analysis showed that various HIV-1 subtypes were detected and among them, CRF01_AE (51.8%, 43/83), CRF07_BC (24.1%, 20/83) and B subtype (10.8%, 9/83) were the most epidemic strains. Moreover, the subtypes of newly identified recombinant strains in recent years accounted for 13.3% (11/83). Drug resistance test results showed that the pre-treatment drug resistance rate in newly diagnosed HIV-1 patients was 8.4% (7/83), and the drug resistance rates to protease inhibitor (PIs), non-nucleoside reverse transcriptase inhibitors (NNRTIs) and integrase inhibitors (INIs) were 3.6% (3/83), 1.2% (1/83) and 3.6% (3/83), respectively. Conclusions:The HIV-1 subtypes in the newly diagnosed population in Baoding in 2020 were complex and diverse. There were many unique recombinant strains and drug-resistant strains. Therefore, it was necessary to strengthen drug resistance monitoring as well as the prevention and control of HIV-1 infection in this area.
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【Objective】 To evaluate the performance of electrochemiluminescence immunoassay (ECLIA) in detecting HIV antigen/antibody in blood screening. 【Methods】 A total of 128 donors, reactive to anti-HIV(ELISA)testing, from September 2016 to September 2020 were enrolled, and seven samples were reactive to double anti-HIV reagents, among which 6 were confirmed by WB, 1 confirmed by NAT as negative.Two group of donors, reactive to solo anti-HIV reagent but being confirmed negative by WB(n=121) vs.randomly selected donors non-reactive to ELISA + NAT(June to September 2020, n=1360), were subjected to HIV antigen/antibody testing using ECLIA to compare the testing results, including concordance rate, sensitivity and specificity. 【Results】 The ECLIA results remained non-reactive for 1360 samples initially non-reactive to both ELISA and NAT.The concordance rate of anti-HIV reactivity by ECLIA and ELISA+ WB were 100%(6/6). For 122 samples, reactive to ELISA anti-HIV testing but nonreactive to confirmatory testing, 4(3.28%)of them were reactive to HIV antigen/antibody testing and 118(96.72%) nonreactive, with the concordance rate of ECLIA and ELISA at 96.88%(124/128). The sensitivity, specificity and false positive rate of ECLIA and ELISA were 100% vs 100%, 99.73% vs 91.77%, and 0.27% vs 8.23%, respectively. 【Conclusion】 ECLIA for HIV antigen/antibody detection has good sensitivity and specificity, which can meet the requirements of blood screening, and the false positive rate is lower than that of ELISA, adopted commonly in blood bank at present.
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Objective: To observe the gadolinium imaging findings of inner ear in patients with sudden deafness and to analyze its clinical features. Methods: From November 2017 to July 2020, 21 patients with sudden deafness in the People's Hospital of Dongsheng District, Ordos City were selected as the research objects, including 14 males and 7 females, aged 36-76 years, with a median age of 50 years. The course of disease was 1-19 days, with an average of 5.5 days. The patients received audiology tests, laboratory examination, and intravenous gadolinium angiography, each of whom was scanned twice by 3D-FLAIR sequence: once before intravenous gadolinium injection, and once again 4.5-6.0 h after intravenous gadolinium injection. The following corresponding clinical treatment was given. The imaging manifestations and clinical features were observed. Results: Among 21 cases of sudden deafness in acute stage, the signal intensity of 11 cases was significantly higher than that of the contralateral ear, and 2 cases had vestibular labyrinthine hydrops. In laboratory examination, only 2 cases of total deafness had increased WBC count and faster erythrocyte sedimentation rate, and the rest had no abnormality. The hearing types of 21 patients with sudden deafness were: total deafness in 8 cases, flat decline in 10 cases, low frequency decline in 1 case, high frequency decline in 2 cases. The total effective rate was 57% (12/21). The hearing types of 11 patients with abnormal gadolinium angiography were total deafness in 5 cases, flat decline in 5 cases and high frequency decline in 1 case. The total effective rate was 64% (7/11). Conclusion: Gadolinium angiography is abnormal in some patients with sudden deafness, and the permeability of blood labyrinth barrier may be increased, which is worthy of further study.
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Female , Humans , Male , Middle Aged , Angiography , Deafness , Gadolinium , Hearing Loss, Sudden/diagnostic imaging , Magnetic Resonance Imaging , Vestibule, LabyrinthABSTRACT
Objective:To explore the correlation analysis between psychological status and blood pressure of residents in medium-risk areas during the coronavirus disease 2019 (COVID-19) epidemic, and provide references for early psychological intervention and hypertension management during the COVID-19 epidemic.Methods:From January 4 to 8, 2021, the convenience sampling method was used to conduct psychological questionnaire surveys on residents and employees of enterprises in the medium-risk area and surrounding areas of Jiuxianqiao, Chaoyang District, Beijing. General data (gender, age, height, weight, history of smoking and drinking, previous medical history), and home blood pressure monitoring were collected. Pearson′s χ 2 test was used to compare different factors (anxiety, depression, age, gender, body mass index, smoking, drinking, and history of chronic diseases) in normal blood pressure or not. A multivariate logistic regression analysis model was established to explore independent risk factors of abnormal blood pressure. Results:No anxiety accounted for 75% (684/912), and anxiety accounted for 25% (228/912). No depression accounted for 67% (611/912), depression accounted for 33% (301/912). Both anxiety and depression accounted for 23% (210/912). The substandard blood pressure accounted for 10.3% (94/912). The incidence of poor blood pressure control in participants with anxiety was 30.7% (70/228), which was significantly higher than that of participants without anxiety 3.5% (24/684) (χ 2=136.779, P<0.001). The incidence of poor blood pressure control in participants with depression 27.2% (82/301) was significantly higher than that of participants without depression 2.0% (12/611) (χ 2=139.388, P<0.001). Multivariate logistic regression analysis showed anxiety ( OR=3.261, P<0.001), depression ( OR=7.928, P<0.001), and complications of chronic diseases ( OR=3.207, P<0.001) were closely related to whether blood pressure was under control. Conclusions:During the COVID-19 epidemic, the psychological status of residents and employees in medium-risk areas should be screened and interventions implemented accordingly to prevent unstable blood pressure caused by anxiety or depression.
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Objective:To analyze the level and latent categories of the training needs of the nursing staff of the social volunteer teams in Jiangsu Province, and to provide basis for the targeted training.Methods:From March to July in 2018, 224 elderly care teachers from 13 social volunteer teams of 100 Red Cross societies in Jiangsu Province were surveyed for the knowledge of the care for the aged and the needs of training by the self-designed questionnaires. A total of 207 valid questionnaires were collected, with an effective recovery rate of 92.4%. SPSS 21.0 and Latent GOLD 5.1 software were used for description analysis, hierarchical clustering and latent category analysis.Results:The number of answer of "very need" to knowledge and skills among the aged care teachers for the elderly, such as psychological care, elderly volunteer services and recreational activities for the elderly, was 196, 196 and 193, with a proportion of 94.7%, 94.7% and 93.2%, respectively. Cluster analysis showed that training needs could be divided into four aspects: life care knowledge and skills, health care knowledge and skills, psychological care knowledge and skills, and spiritual comfort knowledge and skills. The results of latent category analysis showed that the aged care teachers could be divided into three groups based on their different training needs: high demand group for overall knowledge and skills, partial demand group for overall knowledge and skills, and high demand group for medical care and psychological care knowledge and skills. The corresponding latent probability of the three groups were 80.2%, 13.0%, 6.8%, respectively.Conclusion:The training for the aged care of social volunteer teams should pay attention to the teaching of spiritual comfort knowledge and skills for the elderly. The training program should be oriented to the multi-level and individualized needs of the teachers, so as to meet the needs of the aged care teachers for their own development.
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Purpose@#We compared the clinical outcomes of modified procedures for associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) based on a risk-reduced strategy with those of classic ALPPS procedures in treating large liver carcinoma. @*Materials and Methods@#Short-term outcomes, increases in future liver remnant (FLR) and functional FLR (FFLR), and overall survival (OS) were compared between 45 consecutive patients treated with modified ALPPS procedures and 34 patients treated with classic ALPPS procedures. @*Results@#Clinical outcomes after the 1st-stage operation markedly improved with the modified procedures. Although the proportions of liver cirrhosis and hepatocellular carcinoma were higher in the modified group, the mortality and incidence of severe complications did not increase. FLR and FFLR hypertrophy at 1 week after the 1st-stage operation were similar in both groups; however, kinetic growth rates in the modified group were lower. OS rates were similar. @*Conclusion@#Modified ALPPS procedures could be safely applied to provide long-term survival for patients with liver cirrhosis without sufficient FLR.
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Purpose@#We compared the clinical outcomes of modified procedures for associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) based on a risk-reduced strategy with those of classic ALPPS procedures in treating large liver carcinoma. @*Materials and Methods@#Short-term outcomes, increases in future liver remnant (FLR) and functional FLR (FFLR), and overall survival (OS) were compared between 45 consecutive patients treated with modified ALPPS procedures and 34 patients treated with classic ALPPS procedures. @*Results@#Clinical outcomes after the 1st-stage operation markedly improved with the modified procedures. Although the proportions of liver cirrhosis and hepatocellular carcinoma were higher in the modified group, the mortality and incidence of severe complications did not increase. FLR and FFLR hypertrophy at 1 week after the 1st-stage operation were similar in both groups; however, kinetic growth rates in the modified group were lower. OS rates were similar. @*Conclusion@#Modified ALPPS procedures could be safely applied to provide long-term survival for patients with liver cirrhosis without sufficient FLR.
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OBJECTIVES@#To study the effect of high-fat diet for maternal Sprague-Dawley rats at different stages on glucose and lipid metabolism in offspring and related mechanisms.@*METHODS@#According to the diet before pregnancy and during pregnancy and lactation, maternal rats were randomly divided into four groups (@*RESULTS@#Compared with the control diet groups (CC and CH groups), the groups with high-fat diet before pregnancy (HC and HH groups) had a significant increase in body weight (@*CONCLUSIONS@#High-fat diet for rats at different stages before and after pregnancy has different effects on glucose and lipid metabolism of offspring rats, and high-fat diet before pregnancy and during pregnancy and lactation has the greatest effect. The effect of high-fat diet on glucose and lipid metabolism of offspring rats is considered associated with the changes in the expression of genes involved in glucose and lipid metabolism.
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Animals , Female , Male , Pregnancy , Rats , Body Weight , Diet, High-Fat/adverse effects , Glucose/metabolism , Insulin , Insulin Resistance , Lipid Metabolism , Liver/metabolism , Rats, Sprague-DawleyABSTRACT
To systematically evaluate the efficacy and safety of Yangxue Qingnao Granules combined with conventional Western medicine in the treatment of essential hypertension and its accompanying symptoms. PubMed, EMbase, Cochrane Library, VIP, CNKI, Wanfang, and China biomedical database(CBD) were searched to screen out from the establishment of the database to April 2020 about the clinical randomized controlled trials of Yangxue Qingnao Granules combined with conventional Western medicine in the treatment of essential hypertension and accompanying symptoms. The articles were selected according to the inclusion and exclusion criteria. RevMan 5.3 software was used for Meta-analysis. TSA 0.9.5.10 Beta software was used for sequential analysis, and GRADE 3.6 was used for evidence quality evaluation. A total of 4 532 patients were included in 34 randomized controlled trials. Meta-analysis results showed that: Yangxue Qingnao Granules combined with conventional anti-hypertensive agents reduced systolic blood pressure(MD=-10.56, 95%CI[-13.63,-7.50], P<0.000 01) and diastolic blood pressure(MD=-8.21, 95%CI[-10.84,-5.59], P<0.000 01), improved total effective rate(RR=1.21, 95%CI[1.14, 1.29], P<0.000 01), improved patients dizziness(RR=1.29, 95%CI[1.21, 1.37], P<0.000 01), insomnia(RR=1.66, 95%CI[1.44, 1.91], P<0.000 01), headache(RR=1.32, 95%CI[1.21, 1.43], P<0.000 01), chest distress(RR=1.26, 95%CI[1.12, 1.42], P=0.000 1), memory loss(RR=1.24, 95%CI[1.10, 1.40], P=0.000 4), palpitation(RR=1.28, 95%CI[1.17, 1.41], P<0.000 01), and improved traditional Chinese medicine symptom scores(MD=-4.24, 95%CI[-5.25,-3.23], P<0.000 01) and headache symptom improvement scores(MD=-2.02, 95%CI[-2.51,-1.53], P<0.000 01) as compared with Western medicine group alone. Subgroup analysis results showed that Yang-xue Qingnao Granules combined with ACEI drug had more obvious effects in lowering systolic blood pressure and diastolic blood pressure. There was no statistically significant difference in the incidence of adverse reactions, and no abnormal liver and kidney function was observed in each study. Trial sequential analysis showed that the total effective rate was cumulative across the traditional and TSA thresholds, further confirming its clinical efficacy. The evidence level was mostly low or extremely low in GRADE evaluation. The clinical application of Yangxue Qingnao Granules combined with conventional Western medicine in the treatment of essential hypertension and its accompanying symptoms is clear and safe, so it is recommended for clinical application.
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Humans , Antihypertensive Agents/adverse effects , China , Drugs, Chinese Herbal/adverse effects , Essential Hypertension , Medicine, Chinese Traditional , Randomized Controlled Trials as TopicABSTRACT
To evaluate the efficacy and safety of Songling Xuemaikang Capsules combined with conventional Western medicine in the treatment of essential hypertension. PubMed, VIP, CNKI, Wanfang and other databases were retrieved from the establishment of the database to February 2020 for clinical randomized controlled trial(RCT) about Songling Xuemaikang Capsules combined with conventional Western medicine in the treatment of essential hypertension. The literatures were screened out according to the inclusion criteria, and RevMan 5.3 software was used for Meta-analysis. A total of 3 100 patients in 27 RCTs were enrolled. According to Meta-analysis, Songling Xuemaikang Capsules combined with conventional Western medicine could effectively reduce systolic blood pressure(MD=-7.88,95%CI[-9.68,-6.08],P<0.000 01) and diastolic blood pressure(MD=-7.85, 95%CI[-9.07,-6.62], P<0.000 01), triglyceride(MD=-0.46, 95%CI[-0.66,-0.26], P<0.000 01) and total cholesterol(MD=-0.92, 95%CI[-1.49,-0.35], P=0.001), but increase HDL cholesterol(MD=0.51, 95%CI[0.28, 0.73], P<0.000 01), with a better effect than the Western medicine group alone. The results of LDL-C analysis showed that there was no significant difference between the two groups(MD=-0.91, 95%CI[-1.82, 0.01], P=0.05). The subgroup analysis suggested that reduced systolic blood pressure may be related to the use of ARB. There was a close correlation between CCB drugs and the decrease of diastolic blood pressure. In addition, there was no significant difference in the compliance and the incidence of adverse reactions. Clinical application of Songling Xuemaikang Capsules combined with Western medicine in the treatment of patients with essential hypertension has clear efficacy and certain safety. More clinical randomized controlled trials are needed for verification in the future.
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Humans , Angiotensin Receptor Antagonists , Angiotensin-Converting Enzyme Inhibitors , Capsules , Drugs, Chinese Herbal , Essential Hypertension/drug therapyABSTRACT
BACKGROUND@#Shenyankangfu Tablet (SYKFT) is a Chinese patent medicine that has been used widely to decrease proteinuria and the progression of chronic kidney disease.@*OBJECTIVE@#This trial compared the efficacy and safety of SYKFT, for the control of proteinuria in primary glomerulonephritis patients, against the standard drug, losartan potassium.@*DESIGN, SETTING, PARTICIPANTS AND INTERVENTION@#This was a multicenter, double-blind, randomized, controlled clinical trial. Primary glomerulonephritis patients, aged 18-70 years, with blood pressure ≤ 140/90 mmHg, estimated glomerular filtration rate (eGFR) ≥ 45 mL/min per 1.73 m@*MAIN OUTCOME MEASURES@#The primary outcome was change in the 24-hour proteinuria level, after 48 weeks of treatment.@*RESULTS@#A total of 735 participants were enrolled. The percent decline of urine protein quantification in the SYKFT group after 48 weeks was 8.78% ± 2.56% (P = 0.006) more than that in the losartan 50 mg group, which was 0.51% ± 2.54% (P = 1.000) less than that in the losartan 100 mg group. Compared with the losartan potassium 50 mg group, the SYKFT plus losartan potassium 50 mg group had a 13.39% ± 2.49% (P < 0.001) greater reduction in urine protein level. Compared with the losartan potassium 100 mg group, the SYKFT plus losartan potassium 100 mg group had a 9.77% ± 2.52% (P = 0.001) greater reduction in urine protein. With a superiority threshold of 15%, neither was statistically significant. eGFR, serum creatinine and serum albumin from the baseline did not change statistically significant. The average change in TCM syndrome score between the patients who took SYKFT (-3.00 [-6.00, -2.00]) and who did not take SYKFT (-2.00 [-5.00, 0]) was statistically significant (P = 0.003). No obvious adverse reactions were observed in any group.@*CONCLUSION@#SYKFT decreased the proteinuria and improved the TCM syndrome scores of primary glomerulonephritis patients, with no change in the rate of decrease in the eGFR. SYKFT plus losartan potassium therapy decreased proteinuria more than losartan potassium therapy alone.@*TRIAL REGISTRATION NUMBER@#NCT02063100 on ClinicalTrials.gov.
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Objective:To identify the key factors affecting the time of proton and carbon ion radiotherapy by analyzing the timing characteristics of the accelerator system and to find out potential solutions to enhance treatment efficiency.Methods:The log files for 47 patients with different types of tumors treated with proton beams and carbon ion beams were analyzed. Lung cancer patients were treated with the gating technology. The timing characteristics of beam delivery were analyzed and potential solutions to enhance treatment efficiency were explored.Results:The mean spill time and mean cycle time per iso-energy slice (IES) for proton radiotherapy with beam gating technology were (2.98±1.98) s and (5.71±4.51) s, which were longer than the radiotherapy without using gating technology. The mean total cycle time for treatment without using gating technology was approximately 7 min for both proton and carbon ion beams. The mean total cycle time for lung cancer treatment using gating technology was approximately 15 min.Conclusion:Application of mini-ridge filter or ripple filter to reduce per IES numbers and use of passive breath hold technology to eliminate interruptions during beam delivery in each IES for gating radiotherapy are two feasible approaches to improve treatment efficiency for this specific machine.
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Objective:To investigate the dosimetric difference between glioma patients treated by particle (proton+ carbon ion) and photon radiotherapy.Methods:Twelve previously-treated glioma patients were selected, and given with the same total dose of 60.00 Gy [RBE]. Two types of planning target volumes (PTVs) including PTV-ion and PTV-photon were expended from clinical target volumes according to range uncertainty and patient setup errors. Based on PTV-ion, proton plans with sequential carbon ion boost (particle plan) were created. Following the same prescription, two types of photon intensity-modulated radiotherapy (IMRT) plans were established to achieve similar target coverage and compare the dose of organs at risk.Results:Target coverages of three types of plans had no statistical difference (all P>0.05). The median integral dose of normal brain of all patients receiving particle plan was merely 44.90% of the minimum number from photon plans ( P<0.001). Compared with the minimum number from photon plans, particle radiotherapy decreased the mean dose of brain stem[(6.83±6.22) Gy[RBE] vs. (15.10±10.11) Gy[RBE], P=0.001)], the maximum dose of chiasm[(47.76±20.80) Gy[RBE] vs. (49.59±20.52) Gy[RBE], P=0.009)] and the mean dose of contralateral hippocampus (0.26±9.08) Gy[RBE] vs. (16.28±11.14) Gy[RBE], P=0.002), respectively. Conclusions:Particle radiotherapy can achieve similar target coverage while maintaining lower normal tissue doses to the photon radiotherapy. Photon planion can increase the doses to adjuvant normal tissues.
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Objective:To investigate the efficacy and safety of endovascular recanalization treatment for acute vertebral basilar artery occlusion (AVBAO) underlying intracranial atherosclerotic disease (ICAD) using a balloon-mounted stent.Methods:A total of 16 cases of consecutive AVBAO patients who underwent endovascular treatment with the balloon-mounted stent within 24 h after onset were retrospectively enrolled in Henan Provincial People′s Hospital from February 2017 to August 2019. And the recanalization rate, operation-related complications, symptomatic intracranial hemorrhage, the improvement of 1 week National Institutes of Health Stroke Scale (NIHSS) score and 3 months modified Rankin Scale (mRS) after treatment were recorded.Results:In all of the 16 patients, 4 patients underwent direct stenting angioplasty, 12 patients received salvage stenting. Stent placement was successful in all 16 patients. Balloon-mounted stent were implanted in basilar artery of 4 cases, in intracranial segment of vertebral artery of 8 cases, and in origination segment of vertebral artery of 4 cases. Recanalization was successful (thrombolysis in cerebral infarction grade 2b and 3) in 15 patients. The time between arterial puncture and recanalization was 79.0 (72.3, 109.3) min. One patient experienced distal thrombosis during surgery. Two patients suffered symptomatic intracranial hemorrhage within 48 h after surgery. The scores of the NIHSS were improved more than 4 points at 1 week after operation in 8 patients. At 3 months follow-up, 9 patients had a good outcome (mRS 0-3 points) and 4 patients died.Conclusion:Selective stenting angioplasty treatment with a balloon-mounted stent seems to be feasible and safe for AVBAO patients underlying ICAD.
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Objective:To explore the relationship between cardiac radiation dose and prognosis of patients with non-small cell lung cancer (NSCLC).Methods:From August 2015 to September 2018, the clinical data and cardiac dose parameters of 180 patients with locally advanced NSCLC who received radiotherapy in Tangshan people′s Hospital of Hebei Province were analyzed retrospectively.The relationship between cardiac dose parameters and overall survival rate was analyzed by K-M analysis, and the prognostic factors of NSCLC patients were identified by multivariate Cox regression.Results:The median survival time of NSCLC patients was 33.4 months.Univariate analysis indicated prescription dose≥56Gy ( HR 1.54, 95% CI1.28-2.86, P=0.011), hypertension ( HR 1.42, 95% CI1.34-1.89, P=0.012), mean cardiac dose≥13.9Gy ( HR 1.12, 95% CI1.05-2.61, P=0.031), V5≥70% ( HR 1.08, 95% CI1.01-2.16, P=0.044), and V30≥40% ( HR 1.16, 95% CI1.04-3.01, P=0.041), V50≥20% ( HR 1.23, 95% CI1.11-2.81, P<0.001), and V60≥5% ( HR 1.03, 95% CI1.00-1.89, P=0.037) were the prognostic factors of NSCLC patients.After multi-factor adjustments, receiving chemotherapy was a favorable factor for the prognosis of NSCLC patients ( HR 0.711, 95% CI0.35-0.89, P=0.005); hypertension was a factor of poor prognosis ( HR 1.641, 95% CI1.56-1.86, P=0.034); V50≥20% in cardiac dose ( HR 1.161, 95% CI1.13-3.82, P=0.002) was a poor prognostic factor in NSCLC patients. Conclusion:The cardiac dose V50 is an independent predictor of prognosis in patients with advanced NSCLC.The increase of cardiac radiation dose may increase the potential risk of death.In clinical practice, the prognosis of patients may be improved by reducing the cardiac radiation dose.
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Objective:To compare the practical value of three statistical methods in establishing reference intervals by the indirect method.Methods:This is a methodological evaluation study. The data of coagulation parameters were obtained from laboratory information system, which were from pregnant women who had done prenatal examination in Peking University First Hospital from January 2017 to December 2019. The test results from 32 401 pregnant women were collected. Those healthy pregnant women were divided into three groups: early pregnancy group(n=11 151), middle pregnancy group(n=4 872) and late pregnancy group(n=16 378). Statistical analysis was performed for the result of PT, APTT, FIB, TT, D-D and FDP, and the necessity of stratification based on age in different periods of pregnancy was analyzed. Stratification based on age was necessary in three pregnancy groups for PT and APTT, in late pregnancy group for FIB and TT, and in early pregnancy group for D-D. The reference intervals of coagulation parameters were calculated by three statistical methods: non-parametric method, Hoffmann method and Q-Q plot method. Forty-two healthy pregnant women from October 2019 to January 2020 were enrolled as reference individuals for the validation of the reference intervals.The proportions of test results outside the reference intervals in the reference population calculated and compared.Results:The levels of the six coagulation assays vary significantly during the three periods of pregnancy, stratification based on age was necessary in three pregnancy groups for PT and APTT, in late pregnancy group for FIB and TT, and in early pregnancy group for D-D. If the number of test results was large, non-parametric and Hoffmann method provided more similar results, while the reference intervals calculated with Q-Q plot method was slightly wider than Hoffmann method. If the number of test results was small, reference intervals calculated with Hoffmann and Q-Q plot method were more reliable. For pregnant women during early pregnancy under the age of 35, the reference intervals of PT, APTT, FIB and TT calculated by this method were (10.44-13.11)s, (25.29-35.88)s, (2.61-4.64)g/L and (11.53-15.58)s.Conclusion:When establishing the reference interval, stratification according to pregnancy period and age was needed. Hoffmann method can be used as an alternative to the direct method.
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Objective: To explore the prevalence and risk factors of ischemic stroke in rural areas of Liaoning province. Methods: The study was a cross-sectional survey. From September 2017 to May 2018, a total of 10 926 rural residents aged ≥40 years were investigated in Chaoyang county, Lingyuan, Liaoyang county and Donggang city of Liaoning province. The investigation included questionnaire survey, physical examination and laboratory examination.Univariate and multivariate logistic regression models were used to analyze the risk factors of ischemic stroke. Results: The prevalence of ischemic stroke in the rural areas of Liaoning province was 5.51% (602/10 926), and the standardized prevalence rate was 4.04%. The standardized prevalence rate of male (5.05%) is higher than that of female (3.44%). The prevalence of ischemic stroke increased with age in both males (P<0.01) and females (P<0.01). Multivariate logistic regression analysis showed that age increase(compared with 40-49 years old group, 50-59 years old, OR=2.08, 95%CI 1.31-3.30, P=0.02; 60-69 years old, OR=3.90, 95%CI 2.51-6.05, P<0.01; 70-79 years old, OR=5.32, 95%CI 3.37-8.34, P<0.01; ≥80 years old, OR=3.64, 95%CI 2.00-6.62, P<0.01), male(OR=2.35, 95%CI 1.95-2.84, P<0.01),family history of stroke(OR=2.18, 95%CI 1.83-2.60, P<0.01),coronary heart disease (OR=2.01, 95%CI 1.52-2.66, P<0.01), hypertension (OR=2.82, 95%CI 2.21-3.60, P<0.01), diabetes mellitus (OR=1.36, 95%CI 1.11-1.67, P=0.03) and overweight/obese (OR=1.22, 95%CI 1.02-1.47, P=0.03) were the major risk factors of ischemic stroke. Conclusions: The prevalence of ischemic stroke in rural areas of Liaoning province is high. Age, male, family history of stroke, coronary heart disease, hypertension, diabetes mellitus, overweight/obesity are the risk factors of ischemic stroke in rural areas of Liaoning province.