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Objective:To investigate the detection rate of pulmonary nodules (PN) by CT scan at different doses and the application value of artificial intelligence(AI) system assistance.Methods:From October 2019 to October 2021, 210 patients with PN in Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, were retrospectively selected, and they were divided into the study group (106 cases) and the control group (104 cases) by CT scan at different doses. The control group used the conventional average dose (169 mAs) CT scan, the study group used an average low-dose (54 mAs) CT scan. The PN detection rate of different gender, age, body mass index (BMI) between the two groups were compared. The morphological characteristics, radiation dose, CT image quality between the two groups were compared. The diagnostic efficiency of radiologists and AI system was compared.Results:The detection rate of PN in the study group and the control group had no significant difference: 73.58% (78/106) vs. 80.77%(84/104), χ2 = 1.54, P>0.05. The detection rate of PN with different gender, age group and BMI in the two groups had no significant differences ( P>0.05). The diameter of nodules and the rates of calcification, cavitation, bronchial sign, lobar sign, burr sign and pleural adhesion sign in the two groups had no significant differences ( P>0.05). The mean effective tubular bulb dose, length product of radiation dose, total tubular bulb dose, radiation volume dose index in the study group were higher than those in the control group: (46.15 ± 7.38) mAs vs. (104.39 ± 10.53) mAs, (169.24 ± 19.77) mGy·cm vs. (427.17 ± 43.58) mGy·cm, (972.65 ± 58.34) mAs vs. (2 861.26 ± 181.37) mAs, (3.55 ± 1.16) mGy vs. (8.95 ± 2.07) mGy, there were statistical differences ( P<0.05). The excellent, good, acceptable, poor of 1.0 mm image quality in the study group were 26, 60, 18, 2, and in the control group were 32, 64, 8, 0, there was statistical difference ( u =1.71, P = 0.087). The excellent, good, acceptable, poor of maximum intensity projection (MIP) image quality in the study group were 58, 42, 6, 0 and in the control group were 70, 34, 0, 0, there was statistical difference ( u = 1.81, P = 0.070). The detection rate of PN by AI low-dose CT scan was higher than that of radiologists: 88.68%(94/106) vs. 73.58%(78/106), there was statistical difference ( χ2 = 7.89, P = 0.005). Conclusions:The low-dose CT chest scans for PN, the results of detection rate, morphological characteristics, CT image quality are basically the same as those of conventional-dose CT chest scans, and can greatly reduce the radiation dose, which is more suitable for PN screening, and combined with AI system can significantly improve the detection rate of PN.
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Objective To conduct a survey on the status of noise hazards in Tianjin in 2020, to analyze the main distribution characteristics of noise hazards, and to put forward corresponding preventive and control measures. Methods A unified questionnaire was used to investigate the city-wide enterprises with more than 5 employees, normal production and operation, and noise hazards. The χ2 test was used to analyze the survey results. Results There were 8 560 enterprises with noise hazards, which were concentrated in the five outer suburban districts, the four districts around the city and the Binhai New Area, mainly small and medium-sized enterprises. Totally, 223 800 people were exposed to noise. The rates of noise hazard detection and physical examination of workers were 25.88% and 17.66%, and the rate of over standard detection and the rate of abnormal physical examination were 13.09% and 1.62%, respectively. The differences in noise detection rate, over standard detection rate and physical examination rate were significant in different administrative regions, enterprise scales and industries. The detection rate and physical examination rate of enterprises in the five outer suburban districts, micro-scale enterprises, and paper products industries were the lowest, while the rate of exceeding standards was the highest in the railway, shipping, aerospace and other transportation equipment manufacturing industries. Conclusion Noise is a common occupational hazard in enterprises in Tianjin. There are a large number of people who are exposed to noise. The detection rate and physical examination rate of noise are at a low level. Individual industries have a high rate of exceeding the standard. The current situation of noise hazard prevention and control is not optimistic. It is recommended to pay attention to it and take effective intervention measures.
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Objective@#To investigate the trends in prevalence of depression symptoms among middle-aged and elderly residents at ages of 45 years and older in China from 2011 to 2018, so as to provide insights into depression prevention and control among middle-aged and elderly residents. @*Methods@#Demographic features and evaluation data of depressive symptoms were collected from middle-aged and elderly residents at ages of 45 years and older recorded during four follow-ups in the China Health and Retirement Longitudinal Study (CHARLS), and the depressive symptoms were screened using the Center for Epidemiological Studies Depression Scale (CES-D). Following sampling weights, non-response weights, and post-stratification weighting, the detection of depressive symptoms was analyzed among the middle-aged and elderly residents with different demographics, and the trends in prevalence of depressive symptoms were identified using annual percent change (APC). @*Results@#A total of 48 223 middle-aged and elderly residents were enrolled, including 12 624, 10 427, 12 144, and 13 028 residents in 2011, 2013, 2015 and 2018, with mean ages of (58.8±9.4), (58.9±9.2), (59.0±9.2), and (61.1±9.2) years, respectively. The prevalence of depressive symptoms was 34.5% (95%CI: 33.3%-35.8%), 29.6% (95%CI: 28.5%- 30.8%), 30.6% (95%CI: 29.4%-31.8%), and 35.0% (95%CI: 33.6%-36.4%) among middle-aged and elderly residents in 2011, 2013, 2015 and 2018, respectively, with no remarkable changing trends seen (APC=0.4%, t=0.188, P=0.868). Higher detection was seen among residents at advanced ages, among women than among men, among rural residents than among urban residents, among residents with lower educational levels, among widowed and unmarried residents than among married residents, among unemployed residents than among employees, and among residents that had lower per capita personal consumption expenditures than mean expenditures than among residents that had higher per capita personal consumption expenditures than mean expenditures (all P<0.05). @*Conclusions@#There were no obvious trends in prevalence of depressive symptoms among middle-aged and elderly residents in China from 2011 to 2018, and individuals with advanced ages, women, urban residents and those with low educational and economic levels should be given a high priority for depression control.
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【Objective】 To analyze the clinical data of prostate cancer patients with normal PSA level confirmed with transperineal prostate biopsy or transurethral prostate surgery, in order to improve the diagnostic level of this disease. 【Methods】 The clinical data of 6 patients were retrospectively analyzed. The age,clinical manifestations, body mass index (BMI),prostate specific antigen density (PSAD),blood triglycerides,blood cholesterol,color ultrasound imaging,magnetic resonance imaging (MRI),pathological types and Gleason scores were analyzed. The clinical characteristics and high-risk factors were summarized. 【Results】 Two cases were confirmed with prostate biopsy and four after prostate resection. Three patients had high blood triglycerides, three were negative for bone imaging, and the other three were not examined. PSAD was 0.017 to 1.215. Color ultrasound indicated that two cases had irregular morphology, two uneven echo, and one both irregular morphology and uneven echo; all six cases had calcification. In the three cases who received MRI, two had PIRADS4 nodules, one had PIRADS5 nodules, invasion of seminal vesicle, rectum, posterior wall of urinary bladder,bilateral thickening of NVB, and lymph nodes enlargement. Pathology suggested prostatic acinar adenocarcinoma in five cases, four of which had a Gleason score of 3+3=6 and one had 5+5=10; one case suggested a high-grade neuroendocrine carcinoma. 【Conclusion】 The clinical detection rate is low for prostate cancer with normal PSA. The biopsy indications should be determined by combining the characteristics and high-risk factors to improve the detection rate.
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【Objective】 To explore the rational management of contralateral patent processus vaginalis (CPPV) in laparoscopic high ligation of processus vaginalis. 【Methods】 A total of 300 children with unilateral oblique inguinal hernia/hydrocele who received laparoscopic high ligation of processus vaginalis in Baoding Children’s Hospital during Jun.2018 and Jun.2022 were selected and divided into two groups by random number table method, with 150 in either group. In the control group, 53 cases of CPPV were found intraoperatively, which were treated simultaneously. In the study group, 58 cases of CPPV were detected, among which 11 met the indications of high ligation and received simultaneous surgical treatment. The incidence of recurrence was compared between the two groups. 【Results】 After 1 year of follow-up, the recurrence rate was 8.62% in the study group and 1.88% in the control group (P>0.05). The detection rate of CPPV was 23.02% in children with unilateral inguinal hernia, significantly lower than that in children with unilateral hydrocele (49.07%, P<0.001). The detection rate of CPPV was 42.71% in children with left patent processus vaginalis and 32.95% in children with right patent processus vaginalis (P=0.19). The detection rate of CPPV was 62.93% in the age group of 1-2 years, significantly higher than that in other age groups (P<0.001). 【Conclusion】 The incidence of CPPV conversion into oblique inguinal hernia or hydrocele is low. Only children who meet the indications can be treated at the same time during surgery.
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Objective To analyze the positive rate of serum mycoplasma pneumoniae antibody IgM in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) in Liangjiang New Area of Chongqing and the related risk factors, so as to provide a theoretical basis for clinical diagnosis and treatment of AECOPD. Methods Retrospective analysis of 728 cases of AECOPD patients from January 2020 to December 2021 in Chongqing Liangjiang New Area Third Class Hospital. ELISA was used to determine Mycoplasma pneumoniae IgM antibodies. According to the detection of Mycoplasma pneumoniae IgM antibodies, the patients were divided into infection group and non-MP infection group. Clinical data such as gender, age, length of stay, place of residence, smoking status, home oxygen therapy, GOLD grade of COPD, number of acute exacerbations in the previous year, mechanical ventilation, and application of anti-infective drugs were collected. Univariate analysis and logistic regression were used to analyze the risk factors of MP infection in AECOPD patients. Results The positive rate of MP-IgM in 728 AECOPD patients was 15.38% (112/728), including 67 males and 45 females. There was no significant difference in the positive rate of MP-IgM in AECOPD patients between different seasons (χ2=2.840, P>0.05). Age ≥60 (OR=3.243), smoking (OR=2.559) and GOLD grade 3-4 (OR=3.760) were independent risk factors for MP infection in AECOPD patients. Conclusion The incidence of MP infection in AECOPD patients in Liangjiang New Area of Chongqing is relatively high, especially in AECOPD patients with age ≥ 60, smoking, GOLD grade 3-4, which should be warned of the possibility of mycoplasma pneumoniae infection , and targeted treatment measures can improve the cure rate.
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Objective:To investigate the prevalence of Mycoplasma pneumoniae ( Mp) in children undergoing physical examination. Methods:This study randomly enrolled 1 303 children at the age of 6-12 years who underwent physical examination in 2023. Their oral and pharyngeal swabs as well as venous blood samples were collected. The prevalence of Mp in these subjects was detected using isolation and culturing, nucleic acid detection and serological test. Chi-square test was used for statistical analysis. Results:Among the 1 303 children, the detection rate of Mp was 4.1% (53/1 303) by culturing, 7.3% (95/1 303) by nucleic acid detection and 13.6% (177/1 303) by serological test. Statistical analysis showed that there were significant differences in the the detection rates of Mp among children undergoing physical examination between the three methods ( P<0.05). Conclusions:The detection rate of Mp in children undergoing physical examination in 2023 was about 4.1%. Isolation and culturing was more accurate than nucleic acid detection and serological test in the detection of Mp in healthy population as the latter two methods would overestimate the rate.
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Objective:To learn about the current situation and growth and decline trend of Keshan disease in Gansu Province, so as to provide scientific basis for key prevention and control of Keshan disease.Methods:In 2019, the cross-sectional survey method was used to carry out case search in all diseased townships (towns) in 28 diseased counties (districts) of Gansu Province. The situation data of the disease areas were collected under the jurisdiction of counties (districts), and suspected cardiomyopathy cases were investigated by village doctors in the whole township (town) with the village as the unit. Suspected cases were diagnosed according to "Diagnosis of Keshan Disease" (WS/T 210-2011).Results:No Keshan disease cases were detected in the disease affected 8 counties (districts) of Gansu Province, and chronic and latent Keshan disease cases were detected in the remaining 20 counties (districts), and no cases of acute or subacute Keshan disease were found. There were 668 cases of Keshan disease, including 509 cases of chronic Keshan disease, 159 cases of latent Keshan disease; and 1 new case of chronic Keshan disease was found, the annual incidence rate was 0.10/10 000 (1/96 449). The specific ratios of male and female patients were 1.33 ∶ 1.00 (291 ∶ 218) and 1.01 ∶ 1.00 (80 ∶ 79) in chronic and latent Keshan disease; the age of chronic and latent Keshan disease was mainly > 50 - 60 years old, accounting for 36.94% (188/509) and 42.14% (67/159), respectively, followed by the > 60 - 70 years old, accounting for 36.15% (184/509) and 25.79% (41/159), respectively.Conclusion:Keshan disease is in a stable low incidence situation in Gansu Province, but there are still new cases, so the continuity of disease monitoring should be maintained.
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Objective:To dynamically monitor the prevalence and trend of dental fluorosis in children in Shandong Province, and to evaluate the prevention and control measures for drinking water-borne endemic fluorosis (referred to as drinking water-borne fluorosis), and to provide scientific basis for the next step.Methods:Totally 40 counties (cities, districts) were selected as project counties (cities, districts) from drinking water-borne fluorosis areas in Shandong Province in 2018, and all counties (cities, districts) were selected in 2019 and 2020, to investigate the situation of water improvement, detect water fluoride content, and investigate the prevalence of dental fluorosis in children aged 8 - 12 years.Results:From 2018 to 2020, the detection rates of dental fluorosis in children aged 8 - 12 years were 10.30% (503/4 884), 8.94% (25 895/289 539) and 8.66% (24 061/277 689), respectively, with statistically significant differences (χ 2 = 27.10, P < 0.001), and the dental fluorosis indexes were 0.21, 0.18 and 0.17, respectively. The total detection rates of dental fluorosis in children of different age groups in the 3 years were 7.26% (6 590/90 775), 7.97% (9 303/116 680), 9.29% (12 167/130 915), 9.29% (12 238/131 670) and 9.95% (10 161/102 072), the differences were statistically significant (χ 2 = 615.71, P < 0.001). In the 3 years, the total detection rate of dental fluorosis was 8.93% (28 101/314 737) in boys and 8.69% (22 358/257 375) in girls, the difference was statistically significant (χ 2 = 10.27, P = 0.001). In 2018 and 2019, the detection rates of dental fluorosis of children aged 8 - 12 years in water fluoride qualified villages [5.74% (235/4 095) and 7.98% (20 200/253 082)] were significantly lower than those in villages with excessive water fluoride [33.97% (268/789) and 15.62% (5 695/36 457), χ 2 = 570.61, 2 283.76, P < 0.001]. Conclusions:The prevalence of dental fluorosis among children aged 8 - 12 years has been effectively controlled, and remarkable results have been achieved in prevention and treatment of drinking water-borne fluorosis in Shandong Province. However, the detection rate of dental fluorosis among children in a few endemic villages is high, so it is necessary to continue to strengthen the monitoring of fluoride content in drinking water and the condition of dental fluorosis among children.
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Objective:To study the detection rates of using different MRI sequences and enhanced CT in colorectal cancer liver metastasis (CRLM).Methods:The imaging data of CRLM patients who were treated at Peking University Third Hospital from March 2018 to September 2021 were retrospectively analyzed. Sixty-six CRLM lesions with a maximum diameter ≤10 mm were selected. Different MRI sequences such as T 1 weighted imaging (T 1WI), T 2 weighted imaging (T 2WI), diffusion weighted imaging (DWI), dynamic enhanced phase of MRI (MR-Dyn), gadolinium-etoxybenzyl-diethylenetriaminepentaacetic acid (Gd-EOB-DTPA), enhanced hepatobiliary phase of MRI (HBP) and CT enhancement phase (CT-Dyn) were reviewed independently to determine whether the target lesions were detected. The pathological results were used as the gold standard. Paired chi-square test was used to compare the detection rate of CRLM in each group. Results:Among the 66 liver metastases, 15, 31, 55, 21, 56 and 20 were detected by T 1WI, T 2WI, DWI, MR-Dyn, HBP and CT-Dyn, respectively. Their detection rates were 22.7%, 47.0%, 83.3%, 31.8%, 84.8% and 30.3%, respectively. The detection rates of HBP and DWI were higher than those of T 2WI, MR-Dyn, CT-Dyn and T 1WI, respectively (all P<0.05). The detection rate of T 2WI was higher than that of MR-Dyn, CT-Dyn and T 1WI (all P<0.05). The detection efficiencies of non-contrast MRI and Gd-EOB-DTPA enhanced MRI for CRLM were highly consistent ( Kappa=0.745). Conclusions:The detection rates of HBP, DWI and T 2WI for CRLM were high. Non-contrast MRI could replace Gd-EOB-DTPA enhanced MRI for detection of large CRLM.
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Objective:To analyze the application of video nystagmography in the diagnosis and treatment of benign paroxysmal positional vertigo (BPPV) so as to provide evidence for clinical diagnosis.Methods:A total of 120 patients with suspected BPPV who received treatment in Yueqing People's Hospital from January to July 2020 were included in this study. There were anterior ( n = 24), posterior ( n = 80) and horizontal semicircular canal ( n = 16) BPPV according to the disease type. The detection rates of anterior, posterior and horizontal semicircular canal BPPV by video nystagmography and naked eyes were determined. Therapeutic effects of video nystagmography on three types of BPPV were compared. Results:The diagnostic rates of anterior, posterior and horizontal semicircular canal BPPV were 91.68%, 92.50% and 93.75%, respectively, and the difference was not statistically significant ( χ2 = 0.06, P > 0.05). The detection rates of anterior, posterior and horizontal semicircular canal BPPV by video nystagmography were 91.68%, 92.50% and 93.75% respectively, which were significantly higher than those by naked eyes (58.34%, 78.75%, 56.25%, χ2 = 7.11, 6.14, 3.86, all P < 0.05). After 1 week of treatment, total response rates of anterior, posterior and horizontal semicircular canal BPPV were 62.50%, 66.25%, 68.75%, respectively. After 3 months of treatment, total response rates of anterior, posterior and horizontal semicircular canal BPPV were 95.83%, 96.25% and 100.00%, respectively. There were no significant differences between anterior, posterior and horizontal semicircular canal BPPV after 1 week and 3 months of treatment ( χ2 = 0.18, 0.64, P > 0.05). At 3 months after surgery, the recurrence rates of anterior, posterior and horizontal semicircular canal BPPV were 4.16%, 5.00% and 6.25%, respectively, and the difference was not statistically significant ( χ2 = 0.08, P > 0.05). Conclusion:Video nystagmography is highly effective in the diagnosis and treatment of BPPV. It can accurately judge the occurrence of nystagmus in BPPV and increase the detection rate, which is worthy of clinical application.
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Objective:To design a replaceable corneal scaler and explore its effect on improving the positive detection rate of corneal bacteria and the cure rate of patients with infectious keratitis.Methods:Totally 100 patients with infectious keratitis treated in the Eye&Ent Hospital of Fudan University in Shanghai from June 2020 to October 2021 were conveniently selected as the application object, 50 patients from June 2020 to January 2021 were selected as the control group, and 50 patients from February 2021 to October 2021 were selected as the experimental group. The control group used the traditional corneal scalpel for corneal scraping, and the experimental group used the replaceable corneal scalpel for corneal scraping. The positive detection rate of bacteria, the cure rate of patients as of the date of data collection, the comfort status of patients and the operation difficulty score of medical staff were compared between the two groups.Results:The 28 cases (56%) were positive in the experimental group, and 30 cases (60%) were cured as of the date of data collection; 16 cases (32%) were positive in the control group and 18 cases (36%) were cured as of the date of data collection. The difference between the two groups was statistically significant ( χ2=-2.47, -2.20, all P<0.05). The score of comfort in the experimental group was (83.92 ± 6.40) and that in the control group was (54.04 ± 10.69). The difference between the two groups was statistically significant ( t=17.14, P<0.01). The operation difficulty score of medical staff in the experimental group was (1.46 ± 0.54) and that of medical staff in the control group was (3.24 ± 0.72). The difference between the two groups was statistically significant ( t=-13.50, P<0.01). Conclusions:The use of replaceable corneal scalpel can not only improve the positive detection rate of patients, improve the treatment effect of patients, improve the comfort and satisfaction of patients, but also improve the work efficiency of medical staff and reduce the operational risk of medical staff, so as to improve the real professional value of medical staff.
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【Objective】 To assess three severe acute respiratorysyndrome coronavirus 2 (SARS-CoV-2) enzyme linked immunosorbent assays (ELISA) and one pseudotype lentivirus-based neutralization test (ppNAT) in detecting the convalescent plasma antibody levles from COVID-19. 【Methods】 30 COVID-19 convalescent plasma samples were screened for antibodies against SARS-CoV-2 using three kinds of SARS-CoV-2 ELISA reagents and one ppNAT test in Shenzhen. The controls consisted of plasma samples from 32 healthy blood donors in February 2019. The diagnostic efficacy analysis of various SARS-CoV-2 ELISA reagents was performed using real-time fluorescent Polymerase Chain Reaction (RT-PCR). We also analyzed correlation between different immunological reagents and the age, gender, hospitalization, and severity of illness. 【Results】 The positive yielding rate of ppNAT and three kinds of IgG ELISA was higher than that of IgM ELISA. The positive yielding rates of three kinds of IgG ELISA were 100%(30/30), 93.33%(28/30), and 96.67%(29/30) respectively, while the yielding rates in control group were all 0. The positive yielding rate of three IgM ELISAs were 93.33%(28/30), 70%(21/30)and 46.67% (14/30). All the cases from negative control group were negative for IgG and IgM. Pearson correlation coefficient was calculated; there was a strong correlation between ELISA reagent 2 IgG and ELISA reagent 3 IgG (r=0.765, P0.05). 【Conclusion】 In the convalescent plasma with nucleic acid confirmed covid-19, the yielding rates of different IgM antibodies varied greatly. Antibody levels were influenced by age to some extent.
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ABSTRACT BACKGROUND: The gold standard test for colorectal cancer screening the colonoscopy. Although this is the test of choice, colonoscopy misses a significant number of lesions, mainly in the proximal colon. With the purpose of reducing the number of lesions missed, new techniques have been studied, amongst them, retroflexed view in the right side of the colon and the second direct forward view. OBJECTIVE: Assessing the safety of the retroview in the proximal colon (cecum and ascending colon), its impact on the detection of lesions in the proximal colon and its advantage over the double right forward view using adenoma detection rate and adenoma miss rate. METHODS: Three hundred and ninety-three patients who came to Hospital Mater Dei to undergo colonoscopy from March to July 2017, prospectively. Out of these, 372 were included in the study based on the following exclusion criteria: being under 18 years of age, inadequate bowel preparations (Boston scale <7), history of colectomy, inflammatory bowel disease or polypoid diseases. First, an endoscopist inserted the colonoscope into the cecum and examine the cecum and the ascending colon with a forward view twice. In the third insertion into the cecum, retroflexed view was performed, cecal mucosa was examined until the hepatic flexure in search of polyps missed on forward view. All lesions found were resected and sent for histological analysis. RESULTS: In 334 (89.8%) patients, retroflexed view was performed successfully, 65.8% of failures were attributed to the loops of the device which prevented the maneuver. The direct view identified 175 polyps in the proximal colon in 102 people. Retroflexed view detected 26 polyps missed by the direct view in 24 (6.5%) people, with a missing rate of 12.9% in the test with only the forward view. Out of the 26 polyps found in retroview, 21 (80.76%) were adenomas, one of them with a high-grade dysplasia. Eleven patients had polyps seen only in retroflexed view. Retroview has increased the polyp detection rate from 27.41% to 31.72% and the adenoma detection rate from 21.77% to 25%. The adenoma miss rate by the double direct view was 12.8%. Without the retroview, one polyp in every 13.91 colonoscopies would be missed (number needed to treat - NNT=13.91). There was no adverse event. CONCLUSION: The retroflexed view technique in the proximal colon was shown to be safe, fast and feasible in most cases. It increased the adenoma detection rate and was shown to be advantageous in this study wit benefit beyond the double direct view.
RESUMO CONTEXTO: O exame padrão ouro para rastreamento de câncer colorretal é a colonoscopia. Apesar de ser o exame de escolha, a colonoscopia perde um número não desprezível de lesões, principalmente no cólon proximal. Com a intenção de reduzir a perda de lesões, novas técnicas são estudadas, dentre elas, a retroflexão em cólon direito e a segunda visão frontal direta. OBJETIVO: Avaliar a segurança da retrovisão no cólon proximal (ceco e cólon ascendente), o seu impacto na detecção de lesões em cólon proximal e sua superioridade sobre a dupla visão frontal direta usando taxa de detecção de adenoma e taxa de adenoma perdido. MÉTODOS: Foram avaliados 393 pacientes de forma prospectiva que procuraram o Hospital Mater Dei para realizar colonoscopia entre março e julho de 2017. Desses, 372 foram incluídos baseados nos critérios de exclusão: menores de 18 anos, preparos intestinais inadequados (escala de Boston <7), com antecedente de colectomia, doença inflamatória intestinal ou síndromes polipoides. Primeiramente um endoscopista realizou a inserção do colonoscópio até o ceco e examinou o ceco e o cólon ascendente em visão frontal por duas vezes. Na terceira reinserção até o ceco era realizada a retroflexão e inspeção da mucosa do ceco até a flexura hepática em busca de pólipos perdidos à visão frontal. Todas lesões encontradas foram ressecadas e enviadas para análise histológica. RESULTADOS: Em 334 (89,8%) pacientes a retroflexão foi realizada com sucesso, 65,8% dos insucessos foram atribuídos a alças no aparelho que impediram a manobra. A visão direta identificou 175 pólipos no cólon proximal em 102 pessoas. A retroflexão detectou 26 pólipos perdidos pela visão direta em 24 (6,5%) pessoas, com uma taxa de perda de 12,9% no exame apenas em visão frontal. Dos 26 pólipos encontrados em retrovisão, 21 (80,76%) eram adenomas, um deles com displasia de alto grau. Onze pacientes tinham pólipos vistos apenas em retroflexão. A realização da retrovisão aumentou a taxa de detecção de pólipo de 27,41% para 31,72% e a taxa de detecção e adenomas de 21,77% para 25%. A taxa de adenoma perdido pela dupla visão direta foi de 12,8%. Se a retrovisão não fosse realizada, um pólipo a cada 13,91 colonoscopias seria perdido (NNT=13,91). Não houve nenhum evento adverso. CONCLUSÃO: A técnica de retroflexão em cólon proximal mostrou-se segura, rápida e factível na maioria dos casos. Ela aumentou a taxa de detecção de adenomas e mostrou-se soberana neste estudo com benfeitorias além da dupla visão direta.
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Humans , Adolescent , Colonic Polyps/diagnostic imaging , Colonic Neoplasms/diagnostic imaging , Colonoscopy , Tertiary Care CentersABSTRACT
BACKGROUND: Computed tomography (CT) accounts for 13% of all radiological examinations in the United States and 40-70% of the radiation that patients receive. Even with the advent of magnetic resonance imaging (MRI), CT continues to be the gold standard for diagnosing bone fractures. There is uncertainty as to whether CT with a low radiation dose has a fracture detection rate similar to that of standard-dose CT. OBJECTIVE: To determine the detection rate of low-dose radiation CT and standard-dose radiation CT for fractures, in patients with suspected fractures. DESIGN AND SETTING: Systematic review of comparative studies on diagnostic accuracy within the evidence-based health program at a federal university in São Paulo (SP), Brazil. METHODS: We searched the electronic databases Cochrane Library, MEDLINE, EMBASE and LILACS up to June 29, 2020, for studies evaluating the detection rates of low-dose CT and standard-dose CT for diagnosing bone fractures. The Research Triangle Institute (RTI) item bank tool was used for methodological quality evaluation. RESULTS: The fracture detection rate according to the number of bones evaluated, using CT with low-dose radiation was 20.3%, while with standard-dose radiation it was 19.2%, and the difference between the methods was not significant. The fracture detection rate according to the number of patients, using CT with low-dose radiation was 56.0%, while with standard-dose radiation it was 58.7%, and this difference between the methods was not significant, either. CONCLUSION: CT with low-dose radiation presented detection rates similar to those of CT with standard-dose radiation, regardless of the bones evaluated. REGISTRATION NUMBER: CRD42019148491 at the PROSPERO database.
Subject(s)
Humans , Tomography, X-Ray Computed , Fractures, Bone/diagnostic imaging , Brazil , Magnetic Resonance Spectroscopy , RadiographyABSTRACT
@#AIM: To compare the detection rate of axial length(AL)in cataract eyes by Tomey OA-2000 and IOL Master 500, and to evaluate the repeatability of OA-2000 in measuring ocular biometrics parameters. <p>METHODS: A cross-sectional study of 270 cataract eyes was implemented in the ophthalmic outpatient department from July to September 2018. Ocular biometric measurements including AL, keratometry readings(K), anterior chamber depth(ACD), lens thickness(LT), central corneal thickness(CCT), pupil diameter(PD)and white to white(WTW)were performed using OA-2000 and IOL Master 500. The detection rates of AL were calculated and compared between the two devices. <p>RESULTS: AL detection rates of 86.3%(233/270)and 97.0%(262/270)were found by IOL Master 500 and OA-2000 respectively. The mean difference in the measured AL by the two devices was(0.007±0.129)mm, and the 95% limits of agreement(95%<i>LoA</i>)of AL was 0.01(-0.24 to 0.26)mm. OA-2000 demonstrated good repeatability in measuring AL, ACD, K(2.5mm and 3mm pupil diameter), LT and CCT, but not in measuring PD and WTW. <p>CONCLUSION: Both OA-2000 and IOL Master 500 showed good agreement in AL measurement in cataract patients. However, compared with IOL Master 500, OA-2000 has a higher detection rate of AL. OA-2000 not only demonstrates excellent repeatability in ocular biometric measurements including AL, ACD, K, LT and CCT, but also more advantageous for the AL measurement of cataract with heavy lens opacity and subcapsular opacity.
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Objective:To explore whether the regular feedback system in opportunistic screening of colorectal cancer can improve the adenoma detection rate (ADR) of endoscopists.Methods:This study was an observational study, divided into three stages: the baseline stage before intervention (the pre-intervention period), the regular feedback stage (the intervention period) and the post-intervention stage (the post-intervention period). In the pre-intervention period, all patients who underwent opportunistic screening of colorectal cancer in Department of Gastroenterology in Beijing Shijitan Hospital Affiliated to Capital Medical University from June 2017 to May 2018 were reviewed, and the ADR of each endoscopist was calculated. In the intervention period from June 2018 to November 2018, colonoscopies were performed on patients for opportunistic screening of colorectal cancer by endoscopists who participated in the feedback. The ADR of each endoscopist during the previous month was calculated at the beginning of each month and feedback was provided in the form of a report. In the post-intervention period from December 2018 to January 2019, colonoscopies were performed on patients for opportunistic screening of colorectal cancer by endoscopists who participated in the feedback. The ADR of each endoscopist was calculated after the feedback stopped. ADR and polyp detection rate (PDR) of three stages were compared.Results:A total of 1 768, 1 308 and 344 patients were enrolled for opportunistic screening of colorectal cancer during the pre-intervention, the intervention and the post-intervention period respectively. Eight endoscopists participated in the whole process of this study. The total ADR increased from 23.70% (419/1 768) in the pre-intervention period to 33.72% (441/1 308) in the intervention period ( χ2=37.449, P<0.05). Two months after intervention, ADR decreased slightly to 33.14% (114/344), but was still higher compared with before ( χ2=13.602, P<0.05). The total PDR increased from 47.17% (834/1 768) in the pre-intervention period to 52.68% (689/1 308) in the intervention period ( χ2=9.111, P<0.05). Two months after the intervention, PDR increased slightly to 53.78% (185/344), and still higher compared with before ( χ2=5.035, P<0.05). Conclusion:Regular feedback to endoscopists can improve ADR in opportunistic screening of colorectal cancer.
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Objective:To analyze the relationship between the developmental eye movement (DEM) test results and the vocabulary size in Chinese children with developmental dyslexia.Methods:A cross-sectional study was conducted.A total of 1 243 fifth grade students from 10 primary schools were enrolled from September to December 2019 in Tianjin, among which there were 664 males and 579 females, with the average age of (10.68+ 0.53) years old.The Chinese vocabulary test and intelligence test were carried out.Eighty-five dyslexic children with subaverage vocabulary size were selected as the experimental group and 54 normal children were selected as the control group.The DEM test was conducted in the two groups, and the vertical time, the horizontal adjustment time, the ratio of horizontal to vertical time and the total number of errors were recorded and analyzed.The differences in positive rate of dyslexia, various DEM test indicators between different genders and different groups were analyzed.The correlations between vocabulary size and vertical time, horizontal adjustment time, the ratio of horizontal to vertical time and the total number of errors were analyzed.This study protocol adhered to the Declaration of Helsinki and was approved by an Ethics Committee of School of Optometry, Tianjin Vocational Institute (No.ysgxyll001). Written informed consent was obtained from the guardian of each subject.Results:The total positive rate of dyslexia was 6.83%(85/1 243), and the positive rate of 9.33%(62/664) in boys was higher than 3.97%(23/579) in girls, with a significant difference between them( χ2=13.974, P<0.001). There were no statistically significant differences in age, vocabulary size, vertical time, horizontal adjustment time, and the ratio of horizontal to vertical time between different genders in the control group (all at P>0.05). The vocabulary size of girls in the experimental group was larger than that of boys, showing a statistically significant difference ( t=-2.259, P=0.027). There was no significant difference in age, vertical time, horizontal adjustment time, and the ratio of horizontal to vertical time (all at P>0.05). The vertical time and horizontal adjustment time of the experimental group were longer than those of the control group, and the differences were statistically significant ( t=-4.848, -4.297; both at P<0.001). There was no statistically significant difference in the ratio of horizontal to vertical time between the two groups ( t=0.126, P=0.900). The total number of errors was 0(0, 1) in the experimental group, which was higher than the control group 0(0, 0), with a significant difference between them ( H=1.979, P=0.001). The vocabulary size of students in the two groups was negatively correlated with the vertical time, horizontal adjustment time and the total number of errors ( r=-0.397, P<0.001; r=-0.355, P<0.001; r s=-0.180, P=0.034), and was not obviously correlated with the ratio of horizontal to vertical time ( r=0.038, P=0.656). Conclusions:The DEM test scores of Chinese children with developmental dyslexia are higher than those of normal children, and there is no difference between different genders.The lower the scores of vocabulary size test, the higher the scores of DEM test.
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@#AIM: To evaluate the repeatability of a swept-source optical coherence tomography(SS-OCT)based biometer-IOL Master 700 in ocular biometrics in cataract eyes, and to investigate its agreement with a partially coherent optical interference based biometer-IOL Master 500. This study was also designed to compare the detection rate of the axial length(AL)measured by the two biometers. <p>METHODS:A total of 225 eyes of 133 cataract patients were included in this cross-sectional study from July to September 2018. Ocular biometric parameters including AL, keratometry(K), anterior chamber depth(ACD), lens thickness(LT), central corneal thickness(CCT)and white to white(WTW)were measured for each participant by both IOL Master 700 and IOL Master 500. <p>RESULTS: The IOL Master 700 measured <i>S<sub>w</sub></i> of AL, K<sub>m</sub>, K<sub>1</sub>, K<sub>2</sub>, ACD, LT, CCT, WTW in cataract patients were 0.027mm, 0.112D, 0.148D, 0.162D, 0.015mm, 0.010mm, 2.355μm and 0.134mm, <i>CoV</i> was 0.115%-1.162%, <i>ICC</i>≥0.923, the maximum <i>ICC</i> of AL is 1.000, and all measurements had high repeatability. The AL measured by IOL Master 700 and IOL Master 500 were(23.805±2.162)mm and(23.782±2.162)mm respectively, the difference was statistically significant(<i>t</i>=33.645, <i>P</i><0.001). However, the 95% <i>LoA</i> was 0.003mm-0.043mm, and the AL measured by the two biometers was significantly correlated(<i>r</i>=1.000, <i>P</i><0.001)with good agreement. The AL detection rates were 93.8%(211/225)for IOL Master 700 and 87.6%(197/225)for IOL Master 500, the difference was statistically significant(χ<sup>2</sup>=5.147, <i>P</i>=0.023).<p>CONCLUSION: IOL Master 700 demonstrates excellent repeatability in ocular biometric measurements including AL, K<sub>m</sub>, K<sub>1</sub>, K<sub>2</sub>, ACD, LT, CCT and WTW for cataract patients, especially in AL measurement. IOL Master 700 is in good agreement with IOL Master 500 in measuring AL, however the IOL Master 700 has a higher detection rate for AL in patients with severe opacity and subcapsular opacity in their lens.
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Objective:To determine the prevalence of renal function decline in the elderly population in a community and risk factors. Methods:Data in the physical examination of the elderly population aged over 60 years old in a community in 2018 were collected and analyzed. Estimated glomerular filtration rate was calculated by modified modification of diet in renal disease （MDRD） formula. Association between renal function decline and risk factors were determined. Results:Among the 9 626 elderly people， the prevalence of renal function decline was 10.71%， which increased with age. Multivariate logistic regression showed that men， age， anemia， abnormal uric acid， hypertension， hyperlipidemia， diabetes， glutamine transaminase， and the history of stroke were the independent risk factors associated with renal function decline. Conclusion:The prevalence of renal function decline in elderly people in a community in Shanghai is relatively high. It is necessary to pay attention to early screening and take effective preventive measures， such as health education， scientific exercise and reasonable diet， chronic disease management and other measures.