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1.
Chinese Journal of Orthopaedics ; (12): 985-991, 2021.
Article in Chinese | WPRIM | ID: wpr-910681

ABSTRACT

Objective:To explore the correlation between fibular head height and varus knee osteoarthritis occurrence and severity.Methods:A retrospective analysis was performed on 618 participants (618 knees, 184 males and 434 females, mean age 61.12±10.98 years) who underwent standard weight-bearing full-leg radiographs and were diagnosed as non-knee osteoarthritis or varus knee osteoarthritis from January 2019 to June 2019. Knee osteoarthritis was diagnosed according to Kellgren-Lawrence grading: 0-I grades were diagnosed as non-osteoarthritis, II-IV grades were diagnosed as osteoarthritis. Joint line convergence angle (JLCA), medial proximal tibial angle (MPTA) and hip-knee-ankle angle were measured on X-rays to reflect varus deformity. The fibular head height was defined as the vertical distance from upper edge of fibular head to lateral tibial plateau. Patients were divided into 5 groups according to Kellgren-Lawrence grading. Differences of age, gender, height, weight, body mass index, varus deformity (JLCA, MPTA and hip-knee-ankle angle) between Kellgren-Lawrence 0-IV grades were compared. Ordinal logistic regression was performed to analyze the correlation between fibular head height and Kellgren-Lawrence grades. Pearson's correlation analysis was used for the correlation among fibular head height, JLCA, MPTA and hip-knee-ankle angle, and the main factor of JLCA, MPTA and hip-knee-ankle angle was extracted by factor analysis. Multiple linear regressions were used to analyze the correlation between fibular head height and varus deformity score.Results:There were 68, 66, 97, 98, 289 participants in Kellgren-Lawrence grades 0-IV respectively that was 134 participants were diagnosed as non-osteoarthritis and 484 participants were diagnosed as osteoarthritis. Fibular head height and MPTA showed a decreasing trend ( F=129.076, 24.875; P<0.001) while JLCA and hip-knee-ankle angle showed an increasing trend ( F=414.346, 105.996; P<0.001) with the increase in Kellgren-Lawrence grading. Age, body mass index and fibular head height are influencing factors of Kellgren-Lawrence grading with OR(95%CI) were 1.116(1.093, 1.141), 1.363(1.060, 1.754), 0.617(0.575, 0.662) . Fibular head height was negatively correlated with JLCA and hip-knee-ankle angle ( r=-0.641, -0.478; P<0.001) , respectively, and positively correlated with MPTA ( r=0.320, P<0.001). There were significant correlations between age, fibular head height and the varus deformity score ( β=0.274, -0.457; P<0.001). Conclusion:Fibular head height of patients with varus knee osteoarthritis is lower than that of non-osteoarthritis. In addition to age and body mass index, fibular head height is a risk factor for varus knee osteoarthritis occurrence. The smaller the fibular head height is, the more serious the osteoarthritis severity and varus deformity are.

2.
Chinese Journal of Radiology ; (12): 1259-1263, 2021.
Article in Chinese | WPRIM | ID: wpr-910289

ABSTRACT

Objective:To evaluate the diagnostic value of spectral CT calcium suppression (CaSupp) technique in acute and chronic thoracolumbar compression fractures.Methods:A total of 31 patients with thoracolumbar compression fractures were given spectral CT and MR scans from March to October 2020 in the Second Hospital of Shanxi Medical University. Acute and chronic vertebral fractures were diagnosed by doctor A and B based on CaSupp diagram, and the consistency between the two doctors was evaluated by Kappa test. CT values of fractured vertebra and adjacent normal vertebra were measured on conventional CT and CaSupp graphs respectively, and the CT value difference between fractured vertebra and adjacent vertebra was calculated. Independent sample t-test was used to compare the conventional CT value and CT value difference, CaSupp CT value and CT value difference between acute and chronic fractured vertebra. Using MRI as the gold standard, the ROC curves were drawn to evaluate the subjective diagnostic efficacy of physicians and the diagnostic efficacy of each quantitative parameter. DeLong test was used to compare the area under the curve (AUC) of each quantitative parameter in pairs. Results:The number of vertebral bodies in acute and chronic compression fractures diagnosed by MRI was 48 and 11 respectively. The Kappa value of subjective diagnosis of acute and chronic vertebral fractures by doctors A and B was 0.782, and the AUC, sensitivity, specificity were 0.882 and 0.857, 85.4% and 89.6%, 90.9% and 81.8%, respectively. The differences of conventional CT value, CaSupp CT value and CaSupp CT value difference between acute and chronic compression fractures were statistically significant (all P<0.05), and the AUC values of conventional CT value, CaSupp CT value, conventional CT value difference and CaSupp CT value difference were 0.824, 0.930, 0.706 and 0.934, respectively. Pair comparison showed that the AUC of the CaSupp CT value and CaSupp CT value difference was greater than that of conventional CT value difference, with statistically significant differences ( Z=2.014, P=0.044, Z=2.028, P=0.043), while there were no statistically significant differences between other AUC values (all P>0.05). Conclusion:The dual-layer detector spectral CT CaSupp technique has high value in differentiating acute and chronic thoracolumbar compression fractures, and the CaSupp CT value and CaSupp CT value difference are recommended for diagnosis.

3.
Article in Chinese | WPRIM | ID: wpr-910094

ABSTRACT

Objective:To investigate the role of contrast-enhanced ultrasound (CEUS) features in preoperative screening of patients with uterine fibroids treated by magnetic resonance imaging guided focused ultrasound (MRgFUS).Methods:The preoperative CEUS features of 28 patients (32 lesions) with uterine fibroids treated by MRgFUS in Xijing Hospital of Air Force Military Medical University from January 2018 to March 2021 were analyzed. The relationships between the imaging features of lesions and the necrosis range were evaluated, which included echo intensity in gray-scale ultrasound, the patterns of the perfusion intensity, perfusion distribution, the contrast agent into the model, lesions with entangled branch vessels, ring-like enhancement, and perfusion regression.Results:The gray-scale ultrasound showed that 68.75%(22/32) lesions were hypoechoic. The CEUS showed that 81.25%(26/32) lesions were iso/hypo-enhancement, 65.63%(21/32) lesions were heterogeneous enhancement, 68.75%(22/32) lesions with entangled branch vessels, 71.88%(23/32) lesions with ring-like enhancement, and 75%(24/32) lesions with fast-out enhancement. The 6 indicators above-mentioned had effects on the non-perfusion volume ratio≥50%, the differences were statistically significant (all P<0.05). Conclusions:CEUS can evaluate the blood flow characteristics in uterine fibroids, providing important information for preoperative screening of uterine fibroids for MRgFUS ablation.

4.
Article in Chinese | WPRIM | ID: wpr-906504

ABSTRACT

Momordica charantia has been a traditional Chinese medicine (TCM) and food since ancient times. The discussions on its nature, taste and efficacy in ancient books of TCM are almost the same. With a high nutritional value, M. charantia is rich in a variety of vitamins and minerals, and has been widely used in the production of a wide range of dietary supplements and functional foods. At the same time, M. charantia is one of the most deeply studied natural medicines in traditional alternative medicine, with a wide range of pharmacological effects, especially in the treatment of metabolic diseases. Clinical trials have confirmed that M. charantia has a hypoglycemic effect, and could reduce blood lipids and weight loss, so as to improve metabolism in a comprehensive manner. According to the study on the mechanism of M. charantia in the treatment of diabetes, M. charantia could reduce blood sugar by improving islet β-cell function, improving insulin resistance, inhibiting intestinal glucose absorption and resisting inflammation and oxidative stress. However, at present, there is a lack of unified standards for the hypoglycemic effects and various mechanisms of action of M. charantia, and the safety has not been fully confirmed. Further studies shall be conducted to investigate the hypoglycemic effect and mechanisms of M. charantia, explore active components of M. charantia, define the pharmacodynamics material basis, extract monomer compounds with a clear structure and confirm its effectiveness and safety, which is helpful to develop and utilize the homologous value of medicine and food of M. charantia and further apply it in clinic. The application of the hypoglycemic effect of M. charantia in clinic has important economic benefits and a social significance.

5.
Article in Chinese | WPRIM | ID: wpr-906349

ABSTRACT

Traditional Chinese medicine (TCM) and western medicine have their respective advantages and limitations in the diagnosis and treatment of common otorhinolaryngology head and neck diseases. Although the integrated TCM and western medicine exhibits definite curative effects, there is no consensus on the otorhinolaryngology head and neck diseases responding specifically to TCM or integrated TCM and western medicine, as well as the diagnosis and treatment schemes. The China Association of Chinese Medicine (CACM) thus organized the otorhinolaryngology head and neck specialists of both TCM and western medicine to discuss the etiology, pathogenesis, and clinical diagnosis and treatment methods of common otorhinolaryngology head and neck diseases with the results of multiple clinical trials taken into account. The acute pharyngitis, chronic pharyngolaryngitis, paraesthesia pharyngis, hysterical aphasia, allergic rhinitis, subjective tinnitus, and otogenic vertigo were confirmed to respond specifically to TCM or integrated TCM and western medicine. Then a mutually agreed diagnosis and treatment scheme and recommendation with integrated TCM and western medicine was formulated as a reference for clinical practice, thus benefiting more patients.

6.
Mycobiology ; : 297-307, 2021.
Article in English | WPRIM | ID: wpr-902749

ABSTRACT

A cordycipitoid fungus infecting Hepialidae sp. in Nepal was supposed to be identical to Cordyceps liangshanensis, originally described from southwestern China, and thus, transferred to the genus Metacordyceps or Papiliomyces in previous studies. However, our multi-gene (nrSSU-nrLSU-tef-1α-rpb1-rpb2) phylogenetic and morphological studies based on the type specimen and additional collections of C. liangshanensis revealed that the fungus belongs to the genus Ophiocordyceps (Ophiocordycipitaceae). Therefore, a new combination O. liangshanensis was made, and a detailed description of this species was provided.

7.
Mycobiology ; : 297-307, 2021.
Article in English | WPRIM | ID: wpr-895045

ABSTRACT

A cordycipitoid fungus infecting Hepialidae sp. in Nepal was supposed to be identical to Cordyceps liangshanensis, originally described from southwestern China, and thus, transferred to the genus Metacordyceps or Papiliomyces in previous studies. However, our multi-gene (nrSSU-nrLSU-tef-1α-rpb1-rpb2) phylogenetic and morphological studies based on the type specimen and additional collections of C. liangshanensis revealed that the fungus belongs to the genus Ophiocordyceps (Ophiocordycipitaceae). Therefore, a new combination O. liangshanensis was made, and a detailed description of this species was provided.

8.
Article in Chinese | WPRIM | ID: wpr-885978

ABSTRACT

Objective: To observe the clinical efficacy of ginger-partitioned moxibustion plus pediatric massage (tuina) in treating infantile diarrhea due to spleen deficiency. Methods: Ninety infants were randomly divided into a massage plus moxibustion group, a massage group and a drug group by the random number table method, with 30 cases in each group. The intervention was conducted for two consecutive courses. The infants in the massage plus moxibustion group were treated with pediatric massage and ginger-partitioned moxibustion at Shenque (CV 8). The infants in the massage group were treated with pediatric massage alone, while those in the drug group were treated with smecta. The primary and secondary symptom scales were assessed before and after treatment and at the follow-ups, and the total effective rate was evaluated after treatment. Results: The total effective rate in the massage plus moxibustion group was significantly different from that in the massage group and drug group (both P<0.05). After treatment, the scores of primary and secondary symptoms decreased in all three groups, with statistically significant intra-group differences (all P<0.05); the scores of primary symptoms were significantly different between the massage plus moxibustion group and the drug group (P<0.05); the scores of secondary symptoms in the massage plus moxibustion group and the massage group were significantly different from that in the drug group (both P<0.05). The differences in the time to recover normal bowel movement frequency among the three groups were not statistically significant (P>0.05). Conclusion: Ginger-partitioned moxibustion plus pediatric massage compared with pediatric massage or smecta monotherapy shows superior clinical efficacy in treating infantile diarrhea due to spleen deficiency, and has the advantages of appetite improvement, physique strengthening and short course.

9.
Article in Chinese | WPRIM | ID: wpr-793282

ABSTRACT

Objective To investigate the expression pattern of linc00346 and E2F2, and its prognostic value on liver cancer. Methods Gene expression profile data of patients with liver cancer was downloaded from the cancer genome atlas (TCGA) database. Paired t test was used to evaluate the differential expression of linc00346 and E2F2 from tissues and matched adjacent normal tissues. Co-expression analysis of linc00346 and E2F2 was performed using Pearson correlation. Log-Rank test and Cox proportional hazards regression were used to estimate prognostic value of linc00346 and E2F2. Results linc00346 and E2F2 expression were upregulated in liver cancer tissue specimens (all P<0.05), and fold change was 2.24 and 3.72, respectively. Pearson coefficient was 0.20 (P<0.001). Patient with linc00346 and E2F2 high expression had a 1.77 (95 % CI: 1.23-2.55) and 2.19 (95 % CI: 1.51-3.17) times higher hazard of death than those with linc00346 and E2F2 low expression, respectively. However, only E2F2 was significantly associated with the prognosis of liver cancer in multiple Cox regression. Conclusions linc00346 and E2F2 expressions are upregulated in liver cancer tissues, and patients with linc00346 and E2F2 high expressions has poor prognosis. It is of great significance to discover linc00346 and E2F2 as a novel therapeutic target for liver cancer.

10.
Article in Chinese | WPRIM | ID: wpr-843216

ABSTRACT

Objective : To verify the feasibility of replacing the expensive commercial reagent SMART-Seq v4 Ultra Low Input RNA Kit (hereinafter referred to as TaKaRa reagent) with a reagent (hereinafter referred to as DIY reagent) which was made by ourselves based on the SMART (switching mechanism at 5' end of RNA template) technology. Methods ¡¤ Four 8-week-old C57BL/6 female mice were randomly di-vided into two groups. One group did not receive any treatment as a control, and the other group was intraperitoneally injected with 1 mL of 4% thioglycollate broth to induce peritoneal macrophages. After 72 hours, RNA was extracted from the peritoneal macrophages. cDNA library con-struction was performed with DIY reagent and TaKaRa reagent respectively. Finally, bioinformatics analysis was performed to compare the RNA sequencing results after use of different library construction reagents from different aspects, such as data quality, gene differential expression analysis, and KEGG (Kyoto encyclopedia of genes and genomes) pathway analysis. Results ¡¤ The results of bioinformatics analysis showed that the sample processed by the DIY reagent and TaKaRa reagent were both of good data quality, and the two reagents had comparative capabil-ity in transcripts capture. Gene coverage of the sequences both showed consistent uniformity. On top of these, the results of differential gene ex-pression analysis and gene pathway analysis were consistent. Conclusion ¡¤ Considering relatively great reduction in experimental cost for li-brary construction, the DIY reagent can replace expensive commercial reagent for library construction experiments with a small amount of cell input.

11.
Article | WPRIM | ID: wpr-833560

ABSTRACT

Objective@#The presence of coagulative necrosis (CN) in clear cell renal cell carcinoma (ccRCC) indicates a poor prognosis, while the absence of CN indicates a good prognosis. The purpose of this study was to build and validate a radiomics signature based on preoperative CT imaging data to estimate CN status in ccRCC. @*Materials and Methods@#Altogether, 105 patients with pathologically confirmed ccRCC were retrospectively enrolled in this study and then divided into training (n = 72) and validation (n = 33) sets. Thereafter, 385 radiomics features were extracted from the three-dimensional volumes of interest of each tumor, and 10 traditional features were assessed by two experienced radiologists using triple-phase CT-enhanced images. A multivariate logistic regression algorithm was used to build the radiomics score and traditional predictors in the training set, and their performance was assessed and then tested in the validation set. The radiomics signature to distinguish CN status was then developed by incorporating the radiomics score and the selected traditional predictors. The receiver operating characteristic (ROC) curve was plotted to evaluate the predictive performance. @*Results@#The area under the ROC curve (AUC) of the radiomics score, which consisted of 7 radiomics features, was 0.855 in the training set and 0.885 in the validation set. The AUC of the traditional predictor, which consisted of 2 traditional features, was 0.843 in the training set and 0.858 in the validation set. The radiomics signature showed the best performance with an AUC of 0.942 in the training set, which was then confirmed with an AUC of 0.969 in the validation set. @*Conclusion@#The CT-based radiomics signature that incorporated radiomics and traditional features has the potential to be used as a non-invasive tool for preoperative prediction of CN in ccRCC.

12.
Article in Chinese | WPRIM | ID: wpr-876215

ABSTRACT

Objective To report an epidemiological investigation on identification of the first case of coronavirus disease 2019(COVID-19) in Jinghu District of Wuhu City. Methods A field epidemiologic survey was conducted on the case.Throat swab sample was tested using real-time reverse transcription polymerase chain reaction (RT-PCR) assay to detect the nucleic acid of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).The close contacts of the case were tracked and appropriate prevention and control measures were implemented. Results The case had lived in Xi′an usually and arrived in Wuhu from Xi′an on January 22 of 2020.On January 23, the patient developed respiratory symptoms but the diagnosis of COVID-19 was excluded after two negative SARS-CoV-2 nucleic acid tests.On January 26, the patient was admitted to hospital again due to fever, chest tightness and other symptoms.On January 27, the patient tested positive for SARS-CoV-2 nucleic acid and was confirmed with COVID-19 after a review by the Anhui Provincial Center for Disease Control and Prevention.The case had no history of travel or residence in Wuhan, and no history of contact with wildlife or markets, however, had close contact with a confirmed COVID-19 patient before returning to Wuhu. Conclusion Based on the epidemiological history, clinical symptoms and the results of the SARS-CoV-2 nucleic acid test, the patient is determined as the first reported case of COVID-19 in Jinghu District of Wuhu City.

13.
Article in Chinese | WPRIM | ID: wpr-873006

ABSTRACT

Tibetan medicine Edgeworthia gardneri is the flower bud of Edgeworthia gardneri, mainly distributed in the eastern Tibet as well as the northwest and west parts of Yunnan. It is called one of the " Eighteen treasures of Qinghai-Tibet" and has been used in many Tibetan secret recipes for a long time. Nowadays, the local people often drink E. gardneri Meisn tea for blood glucose regulation and health care. In this study, the related papers were searched in CNKI, Wanfang, Weipu, PubMed and other databases by using the keywords " Lv luo hua" and " flower of E. gardneri Meisn" . Then the status quo of the flower of E. gardneri was summarized from three aspects: provenance, chemical compositions and extraction method, as well as efficacy and function. It is found that E. gardneri mainly contains coumarins, flavonoids, polysaccharides and polyphenols. The extraction methods of E. gardneri include ultrasonic extraction, microwave extraction, supercritical CO2 extraction, and bio-enzyme-assisted extraction method, et al. The extraction of flavonoids and polyphenols is more common. In terms of medicinal efficacy, it has many medicinal effects such as regulating blood sugar, lowering blood fat, anti-oxidation, enhancing immunity and anti-tumor. The flower of E. gardneri has broad pharmacological effect, attracting more and more scholars to research it. However, studies on its medicinal effectiveness both at home and abroad are mainly focusing on it' s crude extractions or extracts, with no in-depth studies on action mechanism. This review aims to summarize the provenance, main chemical compositions and extraction methods, efficacy and effect of the flower of E. gardneri, especially focusing on the research on the medicinal efficacy and mechanism of the flower of E. gardneri, and provide a reference for the further research of the flower of E. gardneri.

14.
Clinical Medicine of China ; (12): 189-192, 2020.
Article in Chinese | WPRIM | ID: wpr-867494

ABSTRACT

Talus fracture is a relatively rare injury. The indication of surgical treatment of talus fracture is the obvious displacement of talus neck or talus body fracture, the purpose of which is to achieve anatomical reduction of the fracture site. The anatomical structure of talus is special, most of its surface is covered by the articular surface, so the injury often involves the articular surface, so the treatment is difficult and the incidence of complications after fracture operation is high, which is prone to ischemic necrosis and traumatic arthritis. Based on the anatomical structure of talus, we reviewed the latest treatment methods of talus fracture and its complications, the advantages and disadvantages of different treatment methods and the existing problems.

15.
Neuroscience Bulletin ; (6): 34-46, 2019.
Article in English | WPRIM | ID: wpr-775468

ABSTRACT

Intermedin/adrenomedullin-2 (IMD/AM2), a member of the calcitonin gene-related peptide/AM family, plays an important role in protecting the cardiovascular system. However, its role in the enhanced sympathoexcitation in obesity-related hypertension is unknown. In this study, we investigated the effects of IMD in the paraventricular nucleus (PVN) of the hypothalamus on sympathetic nerve activity (SNA), and lipopolysaccharide (LPS)-induced sympathetic activation in obesity-related hypertensive (OH) rats induced by a high-fat diet for 12 weeks. Acute experiments were performed under anesthesia. The dynamic alterations of sympathetic outflow were evaluated as changes in renal SNA and mean arterial pressure (MAP) in response to specific drugs. Male rats were fed a control diet (12% kcal as fat) or a high-fat diet (42% kcal as fat) for 12 weeks to induce OH. The results showed that IMD protein in the PVN was downregulated, but Toll-like receptor 4 (TLR4) and plasma norepinephrine (NE, indicating sympathetic hyperactivity) levels, and systolic blood pressure were increased in OH rats. LPS (0.5 µg/50 nL)-induced enhancement of renal SNA and MAP was greater in OH rats than in obese or control rats. Bilateral PVN microinjection of IMD (50 pmol) caused greater decreases in renal SNA and MAP in OH rats than in control rats, and inhibited LPS-induced sympathetic activation, and these were effectively prevented in OH rats by pretreatment with the AM receptor antagonist AM22-52. The mitogen-activated protein kinase/extracellular signal-regulated kinase (ERK) inhibitor U0126 in the PVN partially reversed the LPS-induced enhancement of SNA. However, IMD in the PVN decreased the LPS-induced ERK activation, which was also effectively prevented by AM22-52. Chronic IMD administration resulted in significant reductions in the plasma NE level and blood pressure in OH rats. Moreover, IMD lowered the TLR4 protein expression and ERK activation in the PVN, and decreased the LPS-induced sympathetic overactivity. These results indicate that IMD in the PVN attenuates SNA and hypertension, and decreases the ERK activation implicated in the LPS-induced enhancement of SNA in OH rats, and this is mediated by AM receptors.


Subject(s)
Adrenomedullin , Metabolism , Animals , Blood Pressure , Physiology , Hypertension , Lipopolysaccharides , Pharmacology , Male , Neuropeptides , Metabolism , Obesity , Rats, Sprague-Dawley , Receptors, Adrenomedullin , Metabolism , Sympathetic Nervous System , Metabolism , Toll-Like Receptor 4 , Metabolism
16.
Chinese Medical Journal ; (24): 379-387, 2019.
Article in English | WPRIM | ID: wpr-774821

ABSTRACT

BACKGROUND@#An artificial intelligence system of Faster Region-based Convolutional Neural Network (Faster R-CNN) is newly developed for the diagnosis of metastatic lymph node (LN) in rectal cancer patients. The primary objective of this study was to comprehensively verify its accuracy in clinical use.@*METHODS@#Four hundred fourteen patients with rectal cancer discharged between January 2013 and March 2015 were collected from 6 clinical centers, and the magnetic resonance imaging data for pelvic metastatic LNs of each patient was identified by Faster R-CNN. Faster R-CNN based diagnoses were compared with radiologist based diagnoses and pathologist based diagnoses for methodological verification, using correlation analyses and consistency check. For clinical verification, the patients were retrospectively followed up by telephone for 36 months, with post-operative recurrence of rectal cancer as a clinical outcome; recurrence-free survivals of the patients were compared among different diagnostic groups, by methods of Kaplan-Meier and Cox hazards regression model.@*RESULTS@#Significant correlations were observed between any 2 factors among the numbers of metastatic LNs separately diagnosed by radiologists, Faster R-CNN and pathologists, as evidenced by rradiologist-Faster R-CNN of 0.912, rPathologist-radiologist of 0.134, and rPathologist-Faster R-CNN of 0.448 respectively. The value of kappa coefficient in N staging between Faster R-CNN and pathologists was 0.573, and this value between radiologists and pathologists was 0.473. The 3 groups of Faster R-CNN, radiologists and pathologists showed no significant differences in the recurrence-free survival time for stage N0 and N1 patients, but significant differences were found for stage N2 patients.@*CONCLUSION@#Faster R-CNN surpasses radiologists in the evaluation of pelvic metastatic LNs of rectal cancer, but is not on par with pathologists.@*TRIAL REGISTRATION@#www.chictr.org.cn (No. ChiCTR-DDD-17013842).


Subject(s)
Adult , Aged , Aged, 80 and over , Artificial Intelligence , Female , Humans , Lymphatic Metastasis , Male , Middle Aged , Neoplasm Recurrence, Local , Neoplasm Staging , Neural Networks, Computer , Pathologists , Radiologists , Rectal Neoplasms , Diagnostic Imaging , Mortality , Pathology
17.
Chinese Medical Journal ; (24): 2804-2811, 2019.
Article in English | WPRIM | ID: wpr-781740

ABSTRACT

BACKGROUND@#Artificial intelligence-assisted image recognition technology is currently able to detect the target area of an image and fetch information to make classifications according to target features. This study aimed to use deep neural networks for computed tomography (CT) diagnosis of perigastric metastatic lymph nodes (PGMLNs) to simulate the recognition of lymph nodes by radiologists, and to acquire more accurate identification results.@*METHODS@#A total of 1371 images of suspected lymph node metastasis from enhanced abdominal CT scans were identified and labeled by radiologists and were used with 18,780 original images for faster region-based convolutional neural networks (FR-CNN) deep learning. The identification results of 6000 random CT images from 100 gastric cancer patients by the FR-CNN were compared with results obtained from radiologists in terms of their identification accuracy. Similarly, 1004 CT images with metastatic lymph nodes that had been post-operatively confirmed by pathological examination and 11,340 original images were used in the identification and learning processes described above. The same 6000 gastric cancer CT images were used for the verification, according to which the diagnosis results were analyzed.@*RESULTS@#In the initial group, precision-recall curves were generated based on the precision rates, the recall rates of nodule classes of the training set and the validation set; the mean average precision (mAP) value was 0.5019. To verify the results of the initial learning group, the receiver operating characteristic curves was generated, and the corresponding area under the curve (AUC) value was calculated as 0.8995. After the second phase of precise learning, all the indicators were improved, and the mAP and AUC values were 0.7801 and 0.9541, respectively.@*CONCLUSION@#Through deep learning, FR-CNN achieved high judgment effectiveness and recognition accuracy for CT diagnosis of PGMLNs.@*TRIAL REGISTRATION@#Chinese Clinical Trial Registry, No. ChiCTR1800016787; http://www.chictr.org.cn/showproj.aspx?proj=28515.

18.
Chinese Journal of Surgery ; (12): 108-113, 2019.
Article in Chinese | WPRIM | ID: wpr-810432

ABSTRACT

Objective@#To investigate the clinical significance of high definition (HD) MRI rectal lymph node aided diagnostic system based on deep neural network.@*Methods@#The research selected 301 patients with rectal cancer who underwent pelvic HD MRI and reported pelvic lymph node metastasis from July 2016 to December 2017 in Affiliated Hospital of Qingdao University. According to the chronological order, the first 201 cases were used as learning group. The remaining 100 cases were used as verification group. There were 149 males (74.1%) and 52 females in the study group, with an average age of 58.8 years. There were 76 males (76.0%) and 24 females in the validation group, with an average age of 60.2 years. Firstly, Using deep learning technique, researchers trained the 12 060 HD MRI lymph nodes images data of learning group with convolution neural network to simulate the judgment process of radiologists, and established an artificial intelligence automatic recognition system for metastatic lymph nodes of rectal cancer. Then, 6 030 images of the validation group were clinically validated. Artificial intelligence and radiologists simultaneously diagnosed all cases of HD MRI images and made the diagnosis results of metastatic lymph node. Receiver operating characteristic (ROC) curve and area under curve (AUC) were used to compare the diagnostic level of them.@*Results@#After continuous iteration training of the learning group data, the loss function value of artificial intelligence decreased continuously, and the diagnostic error decreased continuously. Among the 6 030 images of verification group, 912 images were considered to exist metastatic lymph nodes in radiologists′ diagnosis and 987 in artificial intelligence diagnosis. There were 772 images having identical diagnostic results of lymph node location and number of metastases with the two methods. Compared with manual diagnosis, the AUC of the intelligent platform was 0.886 2, the diagnostic time of a single case was 10 s, but the average diagnostic time of doctors was 600 s.@*Conclusion@#The HD MRI lymph node automatic recognition system based on deep neural network has high accuracy and high efficiency, and has the clinical significance of auxiliary diagnosis.

19.
Article in Chinese | WPRIM | ID: wpr-734205

ABSTRACT

Objective To design and evaluate a new type of acromion & clavicle anatomic plate with combinatorial hinge more suitable for acromioclavicular joint dislocation and distal clavicular fracture.Methods The new type of acromion & clavicle anatomic plate with combinatorial hinge we had designed was used in 21 patients (21 shoulders) who were treated for acromioclavicular joint dislocation or distal clavicular fracture from October 2016 to April 2017 at Department Ⅰ of Orthopaedics,The 2nd People's Hospital of Lu'an.They were 15 men and 6 women,aged from 24 to 63 years(average,41.5 ±4.2 years).Of the 14 cases of acromioclavicular joint dislocation,7 were type Ⅲ,5 type Ⅳ and 2 type Ⅴ,according to the Rockwood classification;all the 7 distal clavicular fractures were Neer type Ⅱ.They were all treated by open reduction and internal fixation with our self-designed acromion & clavicle plate with combinatorial hinge.They were followed up at the outpatients department at 3 weeks,3,6,12 and 15 months postoperatively for evaluation of their shoulder functions by Constant-Murley score,changes in coracoclavicular clearance before and after operation and loss of coracoclavicular clearance after removal of internal fixation by X-ray.Results All the 21 patients were effectively followed up for 15 to 20 months (average,18 months).As for their Constant-Murley scores,preoperation (49.7±4.9) <3 weekspostoperation (57.6±5.9) <3 monthspostoperation (83.2±5.7) <6 months postoperation (90.4 ±4.0) < 12 months postoperation (94.3 ±4.2) < 15 months postoperation (98.1 ±4.2),with significant differences between different time points (P < 0.05).The postoperative coracoclavicular clearances at different time points were all significantly decreased than the preoperative value (P < 0.05).With the aid of our new type of acromion & clavicle anatomic plate,the shoulder functions of the patients were gradually improved,the postoperative acromioclavicular joint and reduction of the distal clavicular fracture were stable,and no re-dislocation occurred after removal of internal fixation.Conclusion Our new handy type of acromion & clavicle anatomic plate with combinatorial hinge can provide more effective internal fixation for acromioclavicular joint dislocation and clavicular distal fracture,facilitating functional recovery of the shoulder.

20.
Article in Chinese | WPRIM | ID: wpr-756725

ABSTRACT

Objective: To compare the therapeutic efficacy between warm needling moxibustion and electroacupuncture (EA) in the treatment of simple obesity due to yang deficiency of the spleen and kidney. Methods: Seventy patients with simple obesity due to yang deficiency of the spleen and kidney were randomly divided into a warm needling moxibustion group and an EA group, with 35 subjects in each group. Same major acupoints were selected for the two groups, including Shuifen (CV 9), Guanyuan (CV 4), Daheng (SP 15), Shuidao (ST 28), Shousanli (LI 10), Zusanli (ST 36), Sanyinjiao (SP 6) and Taixi (KI 3). The warm needling moxibustion group received warm needling moxibustion, while the EA group received EA treatment. The interventions were performed once every other day, with 15 treatments as one course. The therapeutic efficacy, body weight and body mass index (BMI) were then observed and compared. Results: The total effective rate in the warm needling moxibustion group was 85.7% versus 77.1% in the EA group, and the between-group difference was statistically significant (P<0.05). The warm needling moxibustion was remarkably superior to the EA in weight loss and lowering BMI, both with statistical significance (P<0.05, P<0.01). At the three-month follow-up, the body weight and BMI further decreased in the warm needling moxibustion group (both P<0.05), and the levels were lower than those in the EA group (P<0.05, P<0.01). Conclusion: Warm needling moxibustion can produce reliable and consistent efficacy in the treatment of simple obesity due to yang deficiency of the spleen and kidney. Compared with EA, warm needling moxibustion shows advantage in both short-term and long-term efficacies, and thus is worth promotion in clinical practice.

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