Prognostic analysis of oral cancer based on deep learning / 口腔疾病防治

@#TNM（tumor node metastasis）classification is a common way to evaluate the prognosis of patients with oral cancer; however, many years of application have proven this method to be confined merely in clinical and pathological data and it cannot be adapted to the development of modern medicine. Deep learning (DL) has been widely used in various aspects of human life, has advantages for conducting efficient and intelligent searches and can explore and analyze substantial medical information well. Additionally, the application of DL to medical practice is quickly increasing. In the field of oral cancer prognosis, DL can efficiently process and analyze the pathological, radiographic and molecular data of oral cancer patients represented by lymphocytes, gray level cooccurrence matrix (GLCM) and gene maps and make accurate prognostic judgments accordingly. By assisting physicians in optimizing treatment plans, DL can effectively improve patients’ survival. Although DL lacks sufficient data and practical clinical application in prognostic studies, it has shown good clinical application prospects.

Imaging study on safety of deep needling at Dachangshu (BL 25) / 中国针灸

OBJECTIVE@#Based on magnetic resonance imaging technology, the dangerous depth of straight needling and the safety of deep needling at Dachangshu (BL 25) are discussed, and data support is provided for standardizing deep needling at Dachangshu (BL 25).@*METHODS@#The horizontal cross-sectional images of 148 healthy adult subjects under the spinous process of the 4th lumbar vertebra were collected by magnetic resonance instrument, the anatomical structure was analyzed, and the dangerous depth of straight needling at Dachangshu (BL 25) was measured.@*RESULTS@#The dangerous depth of straight needling at Dachangshu (BL 25) was (11.2±1.3) cm and (11.0±1.2) cm on the left and right sides of males, and (9.8±1.3) cm and (9.7±1.3) cm on the left and right sides of females. There was a positive correlation between the dangerous depth of straight needling at Dachangshu (BL 25) and body mass index (BMI). In the case of similar body size, the dangerous depth of straight needling at Dachangshu(BL 25) in males was greater than that in females (P<0.01).@*CONCLUSION@#At present, the deep needling at Dachangshu (BL 25) used in clinic is safe. In clinical application of the deep needling at Dachangshu (BL 25), the depth of needle insertion can be determined according to body size and gender.

Primary lung adenocarcinoma complicated with lung hamartoma: A case report and literature review / 中南大学学报(医学版)

The clinical data for a patient with primary lung adenocarcinoma complicated with pulmonary hamartoma, who admitted to Zunyi Medical University Hospital in September 2020, was retrospectively analyzed. The 62-years-old male visited outpatient service because of dysphagia in March 2015, and the pulmonary nodules were found. In September 2020, the computed tomography indicated the enlarged nodule in the lower lobe of left lung with lobulation, and there was ground glass nodule in the upper lobe of left lung. After thoracoscopic wedge surgery, the primary pulmonary adenocarcinoma in the upper lobe of left lung and pulmonary hamartoma in the lower lobe of left lung were confirmed by pathology. Whole exon sequencing revealed that kinesin family member 20B (KIF20B) gene was not expressed in lung adenocarcinoma, but was expressed in pulmonary hamartoma. The clinical manifestations of lung adenocarcinoma complicated with pulmonary hamartoma was not typical, which could locate in the same side and different sides of the lung. The imaging manifestations of the 2 kinds of tumors were diverse and can not be completely distinguished. The pathological examination after surgery is the gold standard, and the possibility of malignant transformation of pulmonary hamartoma should be warned.

Research progress of methods allowing quantitative analysis of aortic valve calcification / 中国胸心血管外科临床杂志

@#With the development of social economy and medicine, degenerative heart valve disease has become the major part in heart valve disease. Calcific aortic valve disease (CAVD) is one of the most representative manifestations of degenerative valvular disease. Aortic valve calcification (AVC) has been found to be a strong predictor of major cardiovascular events, which makes it necessary to identify an effective way to evaluate the degree of AVC. Numerous methods of quantitative assessment of AVC have been reported. Here, we discuss these methods from the aspects of pathology and imageology.

Application of next generation sequencing technology for genetic diagnosis of a case with globoid cell leukodystrophy / 临床儿科杂志

Objective To explore the clinical, radiological features and gene mutation of GALC gene in one child with globoid cell leukodystrophy (Krabbe disease). Methods The clinical and radiological data of a patient diagnosed with Krabbe disease through next-generation sequencing were retrospectively analyzed. Sanger sequencing was used to confirm the results. Results The patient was late infantile form with main manifestations of progressive psychomotor regression and convulsion. Brain MRI showed symmetric long T1 and long T2 signal changes in the white matter next to lateral ventricle angle, posterior limb of internal capsule, and the ministry of corpus callosum. The patient was found to have compound heterozygous mutations of c.1832T>C in exon 15 and c.979T>G in exon 9, which resulted in amino acid changes of p.L611S and p.F327V, respectively. Sanger sequencing results showed that the two heterozygous mutations were correspondingly inherited from his mother and father. Conclusions Next-generation sequencing technology is a useful tool for the detection of GALC gene mutation, which is valuable for definite diagnosis and differential diagnosis of Krabbe disease in clinical practice.

Study on relationship between imageology and pathology of 624 patients with T1 stage lung cancer / 中华胸心血管外科杂志

Objective To study the relativity between imageology and pathology during lung cancer,and estimate whether the lung cancer is preinvasive lesions,which can support evidences for the operation methods.Methods Clinical data of 624 patients who were diagnosed as lung adenocarcinoma and had solitary pulmonary nodule(diameter≤3 cm) were collected,all of them were scanned by thin layer CT scan(1 mm).The correlation between imageology and pathology data were analyzed.Results In 125 cases of GGO,the ratio of invasive lesions were 0 (0/72),6.1％ (3/49) and 100％ (4/4) in stage T1a,T1b and T1c respectively.In 285 cases of mGGO,if solid component was less than 0.5 cm,the ratio of invasive lesions were 1.7％ (1/58),6.9％ (2/29) and 50.0％ (2/4) in stage T~,T1b and Tic;but the ratio of invasive lesions were 81.3％ (13/16),94.1％ (96/102) and 97.4％ (74/76) respectively when the solid component was more than 0.5 cm.In 214 cases with solid nodules,the ratio of invasive lesions were 87.1％ (27/31),98.8％ (84/85) and 99.0％ (97/98) in stage T1 a,T1b and T1c.Conclusion The ratio of invasive lesions and solid component increased gradually along with the growing of tumor diameter in stage T1 lung cancer.CT imaging was highly correlated with the pathology diagnosis of preinvasive lesions and invasive lesions,which can be used as the guidance for operation methods.

Study on relationship between imageology and pathology of 624 patients with T1 stage lung cancer / 中华胸心血管外科杂志

Objective To study the relativity between imageology and pathology during lung cancer,and estimate whether the lung cancer is preinvasive lesions,which can support evidences for the operation methods.Methods Clinical data of 624 patients who were diagnosed as lung adenocarcinoma and had solitary pulmonary nodule(diameter≤3 cm) were collected,all of them were scanned by thin layer CT scan(1 mm).The correlation between imageology and pathology data were analyzed.Results In 125 cases of GGO,the ratio of invasive lesions were 0 (0/72),6.1％ (3/49) and 100％ (4/4) in stage T1a,T1b and T1c respectively.In 285 cases of mGGO,if solid component was less than 0.5 cm,the ratio of invasive lesions were 1.7％ (1/58),6.9％ (2/29) and 50.0％ (2/4) in stage T~,T1b and Tic;but the ratio of invasive lesions were 81.3％ (13/16),94.1％ (96/102) and 97.4％ (74/76) respectively when the solid component was more than 0.5 cm.In 214 cases with solid nodules,the ratio of invasive lesions were 87.1％ (27/31),98.8％ (84/85) and 99.0％ (97/98) in stage T1 a,T1b and T1c.Conclusion The ratio of invasive lesions and solid component increased gradually along with the growing of tumor diameter in stage T1 lung cancer.CT imaging was highly correlated with the pathology diagnosis of preinvasive lesions and invasive lesions,which can be used as the guidance for operation methods.

Patients Satisfaction with Diagnostic MRI Services in Teaching Tertiary Care Hospital in Telangana

Introduction: The health care industry is undergoing transformation to meet the demands of the patients. Hospitals are shifting from viewing patients as illiterates and with little health care choice, to that of educated consumer who has wider health care choices. Patient satisfaction is regarded as an important indicator of quality of care and survey is one of the tools for measuring consumer experiences in the hospital. Objective: To study “Patients‟ perceived satisfaction with diagnostic MRI services” in a Teaching hospital situated in Hyderabad. Materials and methods: A cross–sectional survey, conducted in 200 respondents attending hospital for MRI investigation. Pilot tested, pre-structured, self-completion questionnaire is used to collect data. The data isanalyzed using SPSS (statistical package for social sciences version 10.0.2). Results: The result showed that 79% (n=158) were males and 21% (n=42) females. Among two hundred respondents 54 (27%) were outpatients, 77 (38.5%) inpatients of same hospital, 50 (25%) subjects from private nursing homes, 9 (4.5%) patients from other hospitals and 10 persons not responded. Overall 74.5% of the patients satisfied with the waiting time, 80.5%, 77.5% and 86.5% of the patients satisfied with guidance to reach MRI facility, staff behaviour and staff communication respectively. 85.5% opined that utilization of waiting time by providing information regarding MRI is useful, and 62% of them requested to have trained personnel by their side during the procedure. Conclusion: Hospital administration shall take feedback from patients and their attendants and identify deficiencies and drawbacks in providing services and improve them to their satisfaction which in turn increases indirect publicity of the hospital.

The application of comparative imageology in oral and maxillofacial medical imaging diagnostics teaching / 中华医学教育探索杂志

The development of medical imaging diagnosis technology has brought forward higher requirements for the teaching of oral and maxillofacial medical imaging diagnostics, In this study, we intro-duce the methods and concepts of comparative imaging to guide students to analyze and compare oral and maxillofacial diseases from different perspectives, and to promote the students' understanding of the disease image and mastery of disease diagnosis, improve the students' ability to choose the appropriate imaging method in the future clinical work. Comparative imaging is one of the important teaching methods in the diagnosis of oral and maxillofacial medical imaging, and it is also the direction of its future development.

Clinical analysis of diagnosis and treatment of orbital cavernous hemangiomas / 中华实验眼科杂志

Background Orbital cavernous hemangiomas (OCH) is a common benign orbital tumor in adult,and accurate localization and diagnosis before operation supports the significant premise for surgical safety and success of tumor extraction.Objective This study was to research the clinical characteristics,preoperative diagnosis,the selection for different surgical approaches,therapeutic effectiveness and complication prevention of OCH.Methods The clinical data of 117 eyes of 117 patients with OCH who received surgery were retrospectively analyzed.The patients received surgery in Henan Eye Institute,Henan Eye Hospital from January 2011 to December 2014 and followed-up for 3 months to 5 years.The visual acuity,exophthalmos,ocular movement,orbital A/B ultrasound,color Doppler image,CT and MRI were examined before and after surgery.Results The primary clinical manifestations of OCH were gradual exophthalmos and impaired vision.The accordance rate of preoperative diagnosis and pathological diagnosis was 100％ in the group of patients.The surgical approachs included conjunctival approach in 52.14％ (61/117),lateral orbitectomy in 30.77％ (36/117),anterior approach in 16.24％ (19/117) and lateral combined with medial approach in 0.85％ (1/117).At the end of followed-up,visual acuity was significantly improved in 30.77％ (36/117),declined in 8.55％ (10/117) and unchanged in 60.68％ (71/117).Temporary complications after surgery were pupil dilatation in 14.53％ (17/117),emorrhoea in 1.71％ (2/117),ocular motility disorders in 16.24％ (19/117) and ptosis in 4.27％ (5/117).The permanent complications after operation were pupil dilatation in 2.56％ (3/117),visual loss in 0.85％ (1/117) and permanent abduction imitation in 0.85％ (1/117).Conclusions Accurate qualitative and site-specific diagnosis and correct choice of surgeries for OCH depend on clinical and iconographical examinations.Suitable surgical approach and operative skill are helpful to the therapeutic outcome and safety of OCH.

Image research on childhood mental disorder / 临床儿科杂志

Imaging tests have been paid widespread attention as a new method ofexploring psychopathologies, but the studies on childhood mental disorder are rare and still do not sufifce enough for conclusions. The study reviewed previous re-search results, views and our thoughts on values and limitations of imaging tests in childhood mental disorder. We summarized current problems and gaps in research.

Planning & design of teaching case database in T-PACS construction / 中华医学教育探索杂志

The application of PACS in the teaching is an hot focus in current medical imaging teaching reformation , and the establishing of independent medical imaging teaching case database based on PACS-HIS is the first and key of construction of teaching PACS(T-PACS). Several key steps of designing and constructing database will be discussed in this paper. ①To customize case classifi-cation and code according to the medical imageology textbook. ②To construct the independent case database meeting the teaching needs. ③To establish a set of mechanism of collection teaching cases based on real time in clinical PACS environment. ④development of experiment teaching application etc.

The composition of filament in filamentary keratitis eye / 中华实验眼科杂志

Background Eyes with filamentary keratitis present with serious clinical symptoms.This disease is easy to relapse and the treatment is tricky.At present,its pathogenesis is still unclear,and few works were done on filamentous composition.Objective This study was to analyze the composition of corneal filament by imageological and histopathological method,and discuss the formation mechanism of filamentary keratitis.Methods Eighty-eight eyes of 82 cases who suffered from filamentary keratitis were collected in Shandong Eye Hospital between January 2008 and January 2011.The etiologies of the patients were classified and the clinical data were recorded.Firstly,the corneal filiform strip was detected by laser scanning confocal microscopy (LSCM),and the corneal structure was examined by high-definition optical coherence tomography (HD-OCT).Then the composition of filamentary strip was analyzed by Giemsa and Masson trichrome staining of stretched preparation of filiform strip.Results Etiological study showed that filamentary keratitis occurred after penetrating keratoplasty in 40 eyes,after cataract surgery and photorefractive keratectomy (PRK) in 18 eyes,dry eye and neural dystrophic corneal disease in 14 eyes,acute conjunctivitis in 10 eyes.HD-OCT revealed that filament lesion developed to Bowman layer.Filament was composed of epithelial cells,inflammatory cells,mucus and the high reflective strip core with spiral arrangement under the LSCM,and epithelial cells,inflammatory cells and fibrous tissue were seen in the strip core.Giemsa staining exhibited that filament contained corneal epithelial cells,inflammatory cells,mucus and dark blued strip core with helical arrangement.Masson trichrome discovered that the strip core was red fibrous tissue surrounding by blue mucus.Conclusions Epithelial cells,inflammatory cells,mucus and the high reflective strip core with spiral arrangement are the main elements of filament in filamentary keratitis.The lesion can reach Bowman layer.The results contribute to reveal the formation mechanism of corneal filament and assist treatment.

Magnetic resonance imaging of congenital fibrosis of extraocular muscle associated with limb movement disorder in a family / 中华实验眼科杂志

Background Congenital fibrosis of extraocular muscles (CFEOM) affects patient' s appearance and quality of life,and no effective treatment for this disease is available.Imaging study is helpful for exploring the pathogenesis of CFEOM.Objective This study was to describe the characteristics of CFEOM associated with limb movement disorder using magnetic resonance imaging (MRI).Methods A family with CFEOM associated with limb movement disorder was investigated in Renmin Hospital of Wuhan University.Disease history was collected and the pedigree was investigated.Ophthalmologic examinations,including corrected visual acuity,refractive error,slitlamp examination,ophthalmoscopic examination,force of levator palpebrae superioris,ocular movement,eye position,forced duction test,and bell phenomenon examination,were performed.Ocular orbital and cranial MRI was performed in 4 CFEOM patients and 10 normal subjects to compare the structures of the extraocular muscles,motor nerve and cranium.Oral informed consent was obtained from each patient prior to any medical examination.Results A total of 1 1 members from 3 generations were investigated in this study,presenting with 4 cases of disease.The mode of inheritance of this family complied with the Mendelian autosomal dominant inheritance law.Clinical signs included disturbance of eye movement,deviation of eye position,ptosis,lack of Bell sign and positive reaction of passive pull test.In addition,unstable gait,improper body limb alignment,dysphasia and mental retardation were ohserved in 1 patient,which coincided with the diagnostic criteria of type 3 CFEOM.MRI results demonstrated that the levator palpebrae superioris,superior rectus and superior oblique muscle were clearly thinner,and the medial rectus,lateral rectus,inferior rectus muscle were thinning in the patients,showing significant differences in comparison with the normal controls(P＜O.05).The oculomotor and abducens nerves became thinner and even absent in the patients.Cranial MRI showed that Ⅲ-3 in the pedigree with callosum was shorter than that of the normal controls,suggesting that patient suffered from corpus callosum hypoplasia.Meanwhile,cranial MRI indicated the presence of cerebellar hypoplasia and the expansion of the fourth ventricle.Conclusions MRI demonstrates consistent abnormalities of the oculomotor nerves and abducens nerves in the affected individuals in this CFEOM 3 family,and some affected members exhibit two types of central nervous system abnormalities-corpus callosum and cerebellar hypoplasia.These findings suggest that CFEOM 3 is primarily a neuronal disease.

A case of pyeloureteritis glandularis and cystitis glandularis and review of the relevant literature / 中国综合临床

Objective To explore the clinical character,diagnosis and treatment principals of pyeloureteritis glandularis and cystitis glandularis.Methods The clinical manifestation,character of imageology and endoscopy images of the case for one year follow-up were analyzed and the relevant literatures were reviewed.Results During one year follow-up,there was no clinical symptoms and any progress on imageology.The patient is still in close following-up.Conclusions According to literatures,cystitis glandularis is not common in clinical,and it should be paid more attention by clinicians.There were a few reports about the ureteritis glandularis.Pelvis,ureter and bladder have the same epithelial tissue,pyelitis glandularis is very rare,up to now there is no efficient treatment ways.

A comparative imageology study of TOF-MRA and SWI in the diagnosis of intracranial vascularmalformations / 中国综合临床

Objective To study the imaging of arteriovenous malformation(AVM)and cerebral cavernous angiomas(CCA)by 3D-TOF MRA and SWI.Methods The clinical manifestations and MR imaging characteristics of 44 cases with intracranial vascular malformations were retrospectively analyzed.The MRA imaging and SWI imaging of 26 CCA cases and 18 AVM cases were compared.Results The location,size,input.artery and output vein of arteriovenous fistula were clearly showed by 3D-TOF MRA.3D-TOF-MRA did not show the artery of hemangioma.The imaging of SWI can clear display the number and increase of cavernous hemangioma,comparing with the conventional sequence.Moreover,SWI was effective to show the tortuous veins of arteriovenous malformation.However,it was not able to directly show the overview of abnormal blood vessels and big arteries such as input artery.Conclusion 3D-TOF MRA technologies is powerful to show the arteriovenous malformation with high flow velocity and low resistance(Such as AVM),while SWI has advantages in showing the cavernous hemangioma with low flow velocity and small diameters.Joining 3D-TOF-MRA and SWI techniques will improve the detection of cerebral vascular malformations and reduce the misdiagnosis and missed diagnosis.

Problems and corresponding solutions in clinic practice of medical imageology in pediatric resident training / 中华医学教育探索杂志

According to the characteristics of pediatric resident training, the situation in clinic practice of medical imageology are analyzed and the major problems are pointed out.This article empha sizes significance of standardized resident training of medical imageology, presents detailed requirement which the residents must meet and aims to improve the training effect by the solutions summarized after years of experience.

Uterine arterial embolization for the treatment of uterine leiomyomas: its dynamic imaging monitoring and therapeutic mechanism / 介入放射学杂志

Objective To study the dynamic imaging changes of the uterine leiomyomas before and after uterine arterial embolization (UAE) treatment and to discuss its therapeutic mechanism. Methods Color Doppler senography and both plain and enhanced MR[scanning were performed in 45 patients with uterine leiomyomas before and after UAE. Plain CT scan was performed in all patients after UAE. All the patients were followed up for 3-16 months (average 10±3.5 months). Results In 41 of the total 45 cases, the color Doppler senography showed rich blood flow signals in leiomyomas and myometrium before UAE and no or less blood flow signals in both leiomyomas and myometrium on the first day after UAE. On the seventh day, the blood flow signal was still absent in leiomyomas while it was restored in myometrium, and the same phenomena remained in the first, the third and the twelfth month after UAE. In the other four eases, color Doppler sonography demonstrated blood flow signals inside leiomyomas on the seventh day after UAE and it remained till twelve months after embolization. The embolic agent (Lipiodol) was found in both leiomyomas and myometrium on CT scan for 45 cases on the first day of UAE. CT scan also showed the deposit of the Lipiodol in myometrium, but Lipiodol gradually vanished in leiomyomas at one, three and the twelve months after UAE. The enhancement was apparent in leiomyomas and myometrium on MRI scan in all 45 cases before UAE. The enhancement was found in the myometrium, but not in leiomyomas, on MRI scan in 39 cases 3 months after UAE. The other six cases demonstrated different degrees of enhancement in leinmyomas after embolization. In two cases the detachment of the leiomyomas were observed after embolization and the desquamating materials were pathologicallyproved to be necrotic tissue. The difference in the measuring data about leiomyoma volume between MPI and color Doppler sonography was of no statistical significance (P > 0.05). Conclusion The therapeutic mechanism of UAE for uterine leiomyomas is selectively embolizing the vascular bed of uterus, leading to subsequent necrosis of leiomyomas. The color Doppler sonography should be the fast choice for the dynamic imaging follow-up after UAE.

Diagnosis and treatment of ischemic colitis in elderly patients / 中华老年医学杂志

Objective To explore the clinical features of ischemic colitis (IC) in elderly patients for improving diagnosis and treatment. Methods The clinical symptoms, physical signs,underlying diseases, colonoscopic features, pathology features, laboratory examination and medical imageology data and prognosis were analyzed retrospectively in 12 patients with IC. Results (91.7%) had underlying diseases. They all had different degrees of abdominal pain, and experienced bloody stools after abdominal pain. Majority of them showed symptoms of nausea, vomiting and diarrhea. Colonoscopy showed that the most common lesions were located in the left colon (91.7%).Endoscopic appearances were edema, congestion and erosion of mucous membrane in colon,submucosal bleeding as well, and the lesion was longitudinal and demarcated with normal areas. The detection of plasma D-dimer and the imageology in all patients were normal. Conclusions IC should be suspected in elderly patients who have related underlying diseases accompanied by acute abdominal pain, hematochezia and gastric emptying symptoms. The early endoscopy is the first choice in the diagnosis of IC. Abdominal CT scan as well as the detection of plasma D-dimer have an important negative predictive value for IC.

Occult thoracolumbar flexion-distraction fractures combined with compression of anterior and central columns / 中华创伤杂志

Objective To study a case series of thoracolumbar flexion-distraction fractures combined with compression of anterior and central columns to analyze the causes of its occult symptoms and explore the injury mechanism,imaging diagnosis and operative reduction of the fractures.Methods A retrospective study was carried out on data of 39 patients with thoracolumbar flexion-distraction fractures admitted into our hospital from May 2003 to December 2006.Of all,there were 17 patients with compression of anterior and central columns.The diagnostic value of imaging examinations such as X-ray,CT and MRI was evaluated.All patients were treated with posterior operation,in which simple distraction of the anterior and central columns was followed by compression and reduction of the posterior column from the rear axial direction.The clinical efficacy and safety of operation were assessed.Results The patients with compression of anterior and central columns accounted for 43.6% of all thoracolumbar flexion-distraction fractures.Before operation,six patients were misdiagnosed as simple compression fracture.Various kinds of imaging examinations detected the bone injury and/or ligaments complex injury of the posterior column at different degrees.The positive results on X-ray,CT,spiral CT multi-planar reconstruction (MPR)and MRI were in 8,7,11 and 17 patients respectively.After simple posterior distraction in 17 patients,there occurred over distraction in eight patients who were cured with posterior recompression plus reduction.Conclusions The posterior column injury of thoracolumbar flexion-distraction fractures combined with compression of anterior and central columns is relatively occult and easy to be misdiagnosed as simple compression fracture,when MPR CT and MRI are helpful for diagnosis.The operation with twostep reduction of axial distraction followed by compression can attain satisfactory and safe results.