Diagnostic value of CEM and MRI in differentiating benign and malignant breast lesions based on the 2013 BI-RADS lexicon and the supplement on CEM / 中华放射学杂志

Objective:To explore the diagnostic value of contrast-enhanced mammography (CEM) and MRI in differentiating benign and malignant breast lesions based on the 2013 breast imaging reporting and data system (BI-RADS) lexicon and the supplement on CEM.Methods:The clinical and imaging data of 83 patients with breast lesions from March 2019 to April 2022 in the Third Affiliated Hospital of Soochow University were retrospectively analyzed. Totally 100 breast lesions from 83 female patients aged 28 to 78 (49±14) years, were divided into benign lesions (50 lesions) and malignant lesions (50 lesions) according to the pathological results. The t-test, χ 2 test and Fisher′s exact test were used to compare the differences of clinical and imaging features between benign and malignant lesions, and these imaging features which had statistical differences were established CEM and MRI models by multivariate logistic regression analysis respectively. The receiver operating characteristic curves and the area under the curve (AUC) were used to assess the diagnostic efficacy of two models in differentiating benign and malignant breast lesions. Using the DeLong test compared the AUC. Results:Multivariate logistic regression analysis showed that associated features (OR=9.075,95%CI 1.430-57.570, P=0.019), lesion conspicuity (OR=6.180,95%CI 2.608-14.646, P<0.001), mass margin (OR=2.193,95%CI 1.405-3.422, P=0.001) and calcification distribution (OR=2.147,95%CI 1.157-3.986, P=0.015) were independent predictors of differentiating benign and malignant breast lesions in CEM, and then the predictive model of CEM was constructed. Time-signal intensity curve (OR=9.230, 95%CI 3.178-26.805, P<0.001), associated features (OR=5.289,95%CI 1.343-20.831, P=0.017) and mass margin (OR=2.192,95%CI 1.336-3.597, P=0.002) were independent predictors of differentiating benign and malignant breast lesions in MRI, and the predictive model of MRI was constructed. The AUC of CEM and MRI models for differentiating benign and malignant breast lesions were 0.947 and 0.930 respectively, and two models were no significant difference ( Z=0.68, P=0.494). Conclusion:The diagnostic efficacy of CEM and MRI in differentiating benign and malignant breast lesions is comparable based on the 2013 BI-RADS lexicon and the supplement on CEM.

Analysis of HIV-1 genetic subtype and pretreatment drug resistance among men who have sex with men infected with HIV-1 from 19 cities of 6 provinces in China / 中华流行病学杂志

Objective: To investigate the distribution of HIV-1 genetic subtypes and pretreatment drug resistance (PDR) among men who have sex with men (MSM) from 19 cities of 6 provinces in China. Methods: From April to November 2019, 574 plasma samples of ART-naive HIV-1 infected MSM were collected from 19 cities in Hebei, Shandong, Jiangsu, Zhejiang, Fujian, and Guangdong provinces, total ribonucleic acid (RNA) was extracted and amplified the HIV-1 pol gene region by nested polymerase chain reaction (PCR) after reverse transcription. Then sequences were used to construct a phylogenetic tree to determine genetic subtypes and submitted to the Stanford drug resistance database for drug resistance analysis. Results: A total of 479 samples were successfully amplified by PCR. The HIV-1 genetic subtypes included CRF01_AE, CRF07_BC, B, CRF55_01B, CRF59_01B, CRF65_cpx, CRF103_01B, CRF67_01B, CRF68_01B and unrecognized subtype, which accounted for 43.4%, 36.3%, 6.3%, 5.9%, 0.8%, 0.8%, 0.4%, 0.4%, 0.2% and 5.5%, respectively. The distribution of genetic subtypes among provinces is statistically different (χ2=44.141, P<0.001). The overall PDR rate was 4.6% (22/479), the drug resistance rate of non-nucleoside reverse transcriptase inhibitors, nucleoside reverse transcriptase inhibitors, and protease inhibitors were 3.5% (17/479), 0.8% (4/479) and 0.2% (1/479), respectively. The PDR rate of recent infections was significantly higher than that of long-term infections (χ2=4.634, P=0.031). Conclusions: The HIV-1 genetic subtypes among MSM infected with HIV-1 from 19 cities of 6 provinces in China are diverse, and the distribution of subtypes is different among provinces. The overall PDR rate is low, while the PDR rate of recent infections was significantly higher than that of long-term infections, suggesting the surveillance of PDR in recent infections should be strengthened.

Multimodal MRI radiomics for preoperative predicting Fuhrman nuclear grade of clear cell renal cell carcinoma / 中华放射学杂志

Objective:To investigate the value of multimodal MRI radiomics in the preoperative prediction of Fuhrman nuclear grade of clear cell renal cell carcinoma (ccRCC).Methods:A total of 129 patients with ccRCC confirmed by pathology from April 2011 to April 2021 in Third Affiliated Hospital of Soochow University were collected, and the imaging and clinicopathological data were retrospectively analyzed. All patients were divided into training set ( n=90) and validation set ( n=39) at the ratio of 7∶3 using random indicator method. According to the postoperative pathological results, Fuhrman grades Ⅰ and Ⅱ were included in the low grade group (96 cases, 65 cases in the training set and 31 cases in the validation set), and Fuhrman grades Ⅲ and Ⅳ were included in the high grade group (33 cases, 25 cases in the training set and 8 cases in the validation set). Two radiologists manually delineated regions of interest (ROI) on T 1WI, T 2WI, Dixon-water, Dixon-fat, susceptibility weighted imaging (SWI), blood oxygen level dependent (BOLD) images, and 396 texture features were extracted from each ROI. In the training set, intra-class correlation coefficient, Mann-Whitney U test, minimum redundancy maximum relevance and least absolute shrinkage and selection operator method were used to reduce the dimension of features to obtain the best texture features. The logistic regression was used to develop the multimodal radiomics model, and the receiver operating characteristic (ROC) curve was used to evaluate the effectiveness of the model in identifying high and low-grade ccRCC in training set and validation set. Results:Four SWI, one T 2WI and one BOLD texture features were selected for modeling. The areas under the ROC curve (95%CI) of the multimodal radiomics model for identifying high and low grade ccRCC in the training and validation sets were 0.859 (0.770-0.923) and 0.883 (0.740-0.964), with the specificity at 95.4% and 87.1%, the sensitivity at 68.0% and 87.5%, the accuracy at 87.8% and 87.2%, respectively. Conclusion:The multimodal MRI radiomics model based on T 2WI, SWI and BOLD images has high effectiveness in preoperative predicting Fuhrman nuclear grade of ccRCC.

Prospect and hybridization of three-channel multi-mirror robot for early lung cancer diagnosis and treatment / 中国胸心血管外科临床杂志

@#Nowadays, the development of the medical instrument industry makes rapid changes in clinical practice. Hybridization of latest technology is playing an increasingly important role in the diagnosis and treatment of disease. Especially, the trend of the integration of three-channel hybrid technology in diagnosis and treatment of early lung cancer has become increasingly obvious. This paper will focus on the technical advance of the three-channel multi- mirror robot and its application in the diagnosis and treatment of early lung cancer.

An experimental study of MR elastography and Gd-EOB-DTPA dynamic contrast-enhanced MRI in quantitative evaluation of liver fibrosis / 中华放射学杂志

Objective:To compare the diagnostic efficacy of MR elastography (MRE), Gd-EOB-DTPA dynamic contrast-enhanced MRI (DCE-MRI) in early quantitative evaluation of liver fibrosis (LF) staging of experimental rabbits.Methods:From April to December 2019, 200 healthy rabbits were randomly divided into LF group ( n=160) and control group ( n=40). LF group were injected subcutaneously with 50% CCl 4 oil solution, while control group were injected with normal saline solution. The LF group ( n=40) and control group ( n=10) were randomly selected at the end of the 4th, 8th, 12th and 16th weeks respectively to undergo axial MRI scan including MRE and Gd-EOB-DTPA DCE-MRI. The quantitative parameter values were obtained, including liver stiffness (LS), volume transfer constant (K trans), reflux rate constant (K ep), volume fraction of extravascular extracellular space (V e) and volume fraction of plasma (V p). Histopathological LF staging was based on Scheuer staging. One-way ANOVA analysis was used to evaluate the differences of LS, K trans, K ep, V e and V p among different LF stages. The Spearman correlation analysis was used to evaluate the correlations between pathological LF staging and quantitative parameter values. The ROC curve was used to compare the diagnositic performance of all quantitative parameter values. Results:Among the final qualified 150 rabbits, there were 32 in F0, 32 in F1, 35 in F2, 30 in F3, 21 in F4. Significant differences of LS, K trans, K ep, V e and V p were found among different LF stages. There was correlation between LS, K trans, K ep and LF stages ( r=0.832, 0.730, -0.617, all P<0.001), respectively. However, no statistically correlation was found between V e, V p and LF stages ( r=-0.074, P=0.367; r=-0.078, P=0.342). The area under the ROC curve (AUCs) of LS were the greatest (0.920 for F0 vs F1-F4, 0.900 for F0 vs F1-F2, 0.945 for F0 vs F3-F4, 0.926 for F1-F2 vs F3-F4), while the AUCs of K trans were 0.897, 0.863, 0.942, 0.809, respectively. Conclusion:The early quantitative diagnostic efficacy for LF staging by MRE was superior to Gd-EOB-DTPA DCE-MRI in rabbits.

Therapeutic efficacy observation of warm needling moxibustion plus spine subtle adjusting manipulation for cervical radiculopathy / 针灸推拿医学（英文版）

Objective: To observe the clinical efficacy of warm needling moxibustion plus spine subtle adjusting manipulation for cervical radiculopathy. Methods: A total of 70 patients with cervical radiculopathy were randomized into an observation group and a control group, with 35 cases in each group. The observation group was treated with warm needling moxibustion plus spine subtle adjusting manipulation, while the control group was treated with warm needling moxibustion alone. The treatments were performed three times a week, and for four weeks in total. The visual analog scale (VAS) was scored before and after treatment. And the clinical efficacy of the two groups was compared after treatment. Results: The total effective rate was 97.1％ in the observation group, versus 88.6％ in the control group. The difference between the two groups was statistically significant (P<0.05). After treatment, the VAS scores in both groups significantly decreased (P<0.01), and the score in the observation group was significantly lower than that in the control group (P<0.05). Conclusion: Warm needling moxibustion plus spine subtle adjusting manipulation has a better effect in the treatment of cervical radiculopathy than warm needling moxibustion alone.

The application of autoantibodies detection in the early diagnosis and screening of lung cancer / 中华胸心血管外科杂志

Lung cancer is the malignant tumor with the highest morbidity and mortality worldwide, most lung cancer patients were diagnosed at an advanced stage. Using low-dose computed tomography(CT) for lung cancer screening in high-risk patients were proved to decrease lung cancer mortality and find out more early-stage patients. However, CT is of high false-positive rate which requires long-term follow-up or invasive examination to confirm the diagnosis. Serum tumor markers have become the focus of early diagnosis of lung cancer due to their characteristics of minimally invasive and good stability. Lung cancer-related antigens can be captured by the immune system to produce autoantibodies. These autoantibodies can appear in the early stage of lung cancer development with high concentration and stably exist. Therefore, the detection of serum autoantibodies can be effective in the early screening and early diagnosis of lung cancer. Here, we provide a systematic review of the production and detection methods of tumor autoantibodies and their application in the diagnosis and screening of malignant tumors, especially lung cancer.

Species Identification of Sarcosaprophagous Flies Based on Vein Digital Image Analysis / 法医学杂志

Objective To identify species of common sarcosaprophagous flies based on digital image analysis of veins, in order to provide new idea for fast and accurate species identification of sarcosaprophagous flies in forensic entomology. Methods Random trapping of 226 male and female sarcosaprophagous flies that comprised of 7 common species, including Sarcophaga peregrina, Parasarcophaga ruficornis, Sarcophaga dux, Seniorwhitea reciproca, Bercaea cruentata, Aldrichina grahami, and Synthesiomysia nudiseta with carrion in the field was conducted. The 17 landmarks on the right wing of each fly were digitally processed and the images were analyzed. The effects of allometry were evaluated using a permutation test. Wing shape variations among 7 sarcosaprophagous fly species and female species was analyzed using canonical variate analysis （CVA）. Additionally, cross-validation test was used to evaluate the reliability of classification. Results Among 7 sarcosaprophagous fly species and female species, the effect of allometry had statistical significance （P<0.05）. The CVA results showed that among 7 sarcosaprophagous fly species and female species, differences in the wing shape were significant, and the first two canonical variates accounted for 82.9% and 84.1% of the total variation of vein shape. Vein digital image analysis can be used to separate the 7 common sarcosaprophagous flies, with an overall species identification accuracy of 81.2%-100.0%, and with a species identification accuracy of 75.0%-100.0% to distinguish the female flies of the 7 sarcosaprophagous flies species. Conclusion Vein digital image analysis is a relatively convenient and reliable method for identification of insect species, which can be used for species identification of common sarcosaprophagous flies.

Implication of enhanced recovery after surgery in the surgical management of hypopharyngeal squamous cell carcinoma / 中华耳鼻咽喉头颈外科杂志

Objective: To investigate the safety and efficacy of enhanced recovery after surgery (ERAS) in the clinical management of hypopharyngeal squamous cell carcinoma (HSCC). Methods: In this retrospective study, a total of 168 patients with pyriform sinus carcinoma in Qilu Hospital of Shandong University from January 2015 to January 2019 were divided into two groups, based on the different perioperative interventions that patients received, i.e. the ERAS group (n=64) and the conventional group (n=104), including 164 males and 4 females, whose ages ranged from 42 to 84 years old. The difference between two groups in the operative time, postoperative nutritional status, incidences of postoperative complications and postoperative hospitalization time were compared using the student's t test, Chi-squared test or Fisher's exact test. Results: Compared with the conventional group, patients in the ERAS group had significantly shorter operative time [(166.8±58.2) min vs. (183.3±39.9) min,t=-2.72, P=0.031], higher levels of postoperative serum albumin [(38.3±4.2) μmol/L vs. (36.6±3.3) μmol/L, t=2.73, P=0.007] and more body weight [(65.4±9.4) kg vs. (62.1±9.4) kg, t=2.22, P=0.028], lower incidences of postoperative subcutaneous infection [7.8% (5/64) vs. 20.2% (21/104), χ²=4.64, P=0.03] and severe pneumonia [4.7% (3/64) vs. 15.4% (16/104), χ²=4.52, P=0.03], and shorter postoperative hospitalization time [(16.5±3.9) d vs. (18.2±4.3) d, t=-2.65, P<0.05]. Conclusion: ERAS is effective and safe in the surgical management of HSCC, with benefits in reducing the operative stress via saving operation time, shortening the hospitalization time, ameliorating nutritional status and decreasing the incidences of complications.

Study on the Application of A New Type of Anhydrous Thoracic Negative Pressure Drainage Device in Patients after Thoracic Surgery / 中国肺癌杂志

BACKGROUND@#After general thoracic surgery, a chest tube is usually placed for closed drainage to expel gas accumulation in the thoracic cavity and fluid accumulation to promote lung re-expansion. It can also be observed whether there is active bleeding after the operation and whether there is a pulmonary leak. The conventional drainage of the chest cavity is connected with a water-sealed drainage bottle, and the patient condition is judged by observing the drainage situation and the fluctuation of the water column, which is a very classic method. However, the water-sealed bottle has the disadvantages of being easy to overturn and inconvenient to carry, which is not conducive to the early activities of patients. Under the concept of accelerated rehabilitation, our center applied a new type of anhydrous thorax negative pressure drainage device and achieved good results. The purpose of this study was to observe the effect of a new type of anhydrous thoracic negative pressure drainage device in patients after thoracic surgery.@*METHODS@#Retrospective analysis of patients who underwent lung surgery in the First Affiliated Hospital of Zhejiang University Medical College from January 2018 to December 2019, patients were divided into two groups. One group of patients used a traditional closed-chest drainage water-sealed bottle as a control group, and the other group used a new type of anhydrous negative-pressure drainage bottle as an experimental group. Patients' gender, age, hypertension, diabetes, smoking history, surgical incisions and surgical methods, and the length of hospital stay and postoperative hospital stay were calculated.@*RESULTS@#There were no statistical differences in age, gender, comorbidities (hypertension, diabetes, smoking history), scope of surgery, and duration of surgery between the two groups of patients, but there were statistical differences in surgical incisions between the two groups of patients (P=0.01). We found that patients using the new waterless negative pressure drainage device were shorter than patients with water negative pressure drainage device in terms of postoperative hospital stay and total hospitalization time, and the difference was statistically significant (P=0.02, P=0.04).@*CONCLUSIONS@#The new type of anhydrous thoracic negative pressure drainage device has a good effect on the rapid recovery and advancement after thoracic surgery.

A comparative study of MRI texture analysis and histopathology for early renal ischemia-reperfusion injury / 中华放射学杂志

Objective:To explore the relationship between MRI texture features with the histopathology in early renal ischemia-reperfusion injury (IRI).Methods:Forty-eight healthy New Zealand rabbits were randomly divided into the IRI group ( n=40) and the sham group ( n=8). As for the IRI group, rabbits underwent the left kidney surgery by clamping the left renal artery for 60 mins and then releasing the clamp to establish renal IRI model. The rabbits in the sham group underwent the same operation, but without clamping the left renal artery. MR examination were performed before and at 1 h, 12 h, 24 h, and 48 h after the operations. As for the IR group, eight rabbits were randomly sacrificed at each time point immediately after MR exam. The eight rabbits in the sham group were sacrificed after MR exam at 48 h after the operation. The left kidney was harvested for histopathological examination. The single item score of the histopathological features, the microvessel density (MVD), and the pathological total score were calculated. Differences in the single item score of the histopathological features, MVD, and the pathological total score among IRI group with different time points and sham group were determined using the Kruskal-Wallis test. MRI texture features of the left kidney were extracted. Multiple dimensionality reduction for MRI texture features were performed, and the features associated with the pathological total score were selected. The relationship between MRI texture features with the single item score of the histopathological features and MVD was assessed by Pearson correlation coefficients. Results:There were significant differences in renal tubular brush border destruction, renal tubular epithelial edema, necrosis, cast, interstitial inflammatory cell infiltration, MVD, and the pathological total score in IRI group among the different time points (all P<0.05). T 2WI_S (3, -3) InvDfMom had the highest correlation with renal tubular brush border destruction, renal tubular epithelial edema, necrosis, and cast ( r=0.56, -0.58, 0.62, 0.69, all P<0.01). BOLD_S (4, -4) Correlat had the highest correlation with interstitial inflammatory cell infiltration ( r=0.63, P<0.01). SWI_S (4, 4) DifEntrp had the highest correlation with MVD ( r=0.61, P<0.01). Conclusion:MRI texture analysis can provide valuable information for evaluating early renal IRI.

Safety and efficacy of regional transport combined with PCI model in patients with STEMI after thrombolysis in northwest China / 中华心血管病杂志

Objective: To investigate the safety and efficacy of regional transport to percutaneous coronary intervention(PCI) hospitals from non-PCI hospitals after thrombolysis in patients with acute ST-segment elevation myocardial infarction(STEMI) in northwest China. Methods: In this retrospective study, 1 062 STEMI patients who were transferred from non-PCI hospitals within 24 hours from symptom onset, during January 2015 and January 2019 in the First Hospital of Lanzhou University, were included. According to the treatment strategy, they were divided into two groups, namely intravenous thrombolysis combined with PCI group(n=240), and primary PCI group(n=822). Observation endpoint were in-hospital adverse cardiovascular and cerebrovascular events and bleeding events, Including all-cause death, ischemic stroke, malignant arrhythmia, intracranial hemorrhage and hemorrhage with hemoglobin decrease≥50 g/L. Results: A total of 1 062 STEMI patients were included(age was (61±12) years old), with 905 males (85.2%). The proportion of grade 0 TIMI blood flow in the primary PCI group before operation was significantly higher than that in the thrombolysis combined with PCI group(63.0%(518/822) vs. 36.3%(87/240)， P<0.001). Compared with primary PCI group, the time from symptom onset to first medical contact(2.11(1.00, 4.00)hours vs.3.00(1.13, 7.07)hours, P<0.001) and reperfusion in thrombolysis combined with PCI group(3.07(1.83, 4.87)hours vs. 6.92(4.07, 11.15) hours, P<0.001) were significantly shorter. The proportion of all-cause death was significantly higher in the primary PCI group than that in the thrombolysis combined with PCI group (1.8%(15/822) vs. 0, P=0.03). There was no significant difference in hemorrhage, ischemic stroke and malignant arrhythmia between the two groups(all P>0.05). Conclusions: For STEMI patients initially hospitalized in non-PCI hospitals, regional transport combined with PCI is feasible and effective. It does not significantly increase the risk of bleeding and cardiovascular and cerebrovascular events, with shorter time from symptom onset to myocardial reperfusion.

Outcomes of patients treated with drug-coated balloons for de novo large coronary vessels / 中华心血管病杂志

Objective@#To evaluate the efficacy and safety of drug-coated balloons (DCB) for de novo large coronary vessels.@*Methods@#One hundred and two patients were retrospectively enrolled in this study, there were 104 lesions with the reference lumen diameter of target vessel more than 2.8 mm and patients were treated with DCB in de novo lesions during May 2015 and July 2017 in our center. Coronary artery angiography and quantitative coronary angiography were performed in 82 (80.4%) patients at follow up period ((8.1±1.7) months post procedure). The endpoints were late lumen loss (LLL) at follow up,and major adverse cardiac events (MACE) including cardiac death, myocardial infarction (MI), target lesion revascularization (TLR) and stent or target lesion thrombosis at 12 months post procedure.@*Results@#Ninety-eight lesions were treated with DCB only, 6 (5.9%) bailout drug-eluting stent (DES) were used because of severe coronary dissection, 2 patients (2.0%) received revascularization driven by acute ischemic events during hospitalization. Cutting balloons and NSE balloons were used in 65.4% (68/104) and 26.0% (27/104) lesions. The lesion length was (12.57±3.58) mm and the DCB length was (19.87±4.55) mm. The late lumen loss was (0.01±0.52) mm during angiographic follow up. The TLR rate and overall MACE rate was 3.9% (4/102) and 3.9% (4/102) and there was no death,MI and target lesion thrombosis at 12 months follow up.@*Conclusion@#DCB treatment for de novo large coronary vessels is effective and safe.

Relationship Between Plasma Level of Neutrophil Gelatinase-associated lipocalin and Coronary Lesion Severity in Patients With Acute ST-elevation Myocardial Infarction / 中国循环杂志

Objective: To study the relationship between plasma levels of Neutrophil gelatinase- associated lipocalin (NGAL), matrix metalloproteinase (MMP-9), hs-CRP, IL-1β and the severity of coronary stenosis in acute ST-elevation myocardial infarction (STEMI) patients without kidney disease; to explore the ability for NGAL discriminating severe coronary stenosis. Methods: Our research included in 2 groups: STEMI group, n=124 patients admitted in our hospital from 2014-01 to 2017-03 and Control group, n=124 subjects without obvious coronary stenosis. According to SYNTAX score, the patients were divided into another set of 2 groups: High score group, patients with SYNTAX score ≥ 33, n=26 and Low score group, patients with SYNTAX score < 33, n = 98. Relationship between plasma levels of NGAL, MMP-9, hs-CRP, IL-1β and the severity of coronary stenosis were studied by Spearman correlation analysis; the ability for NGAL discriminating severe coronary stenosis was examined by ORC curve; the influencing factors for SYNTAX score were determined by Logistic regression analysis. Results: Compared with Control group, STEMI group had increased plasma levels of NGAL, MMP-9, hs-CRP, all P < 0.01,while IL-1β was similar between 2 groups, P=0.272. NGAL was positively related to MMP-9 (r=0.757, P<0.01), SYNTAX score (r=0.616, P<0.01) and IL-1β (r=0.185, P<0.05). Compared with Low score group, High score group showed the higher plasma levels of NGAL, MMP-9, both P<0.01, while the lower LVEF, P<0.01. The area under ROC curve for NGAL discriminating severe coronary stenosis was 0.881 (95% Cl 0.813-0.949, P<0.01) which was greater than MMP-9 [0.799 (95% Cl 0.709-0.890, P<0.01)] and hs-CRP [0.446 (95% Cl 0.306-0.587, P=0.400)]. Multivariate regression analysis presented that plasma NGAL level was independently related to high SYNTAX score [OR=1.115, 95% Cl (1.107-1.123), P<0.01]. Conclusion: STEMI patients had increased plasma levels of NGAL, MMP-9 and hs-CRP; NGAL had better ability for discriminating severe coronary stenosis than MMP-9 and hs-CRP. NGAL as a new biomarker should be helpful for risk stratification in STEMI patients.

Perioperative sustained renal replacement therapy for percutaneous coronary intervention i patients with severe acute myocardial infarction / 中国介入心脏病学杂志

Objective To evaluate the safety and efficacy of continuous renal replacement therapy (CRRT) during percutaneous coronary intervention (PCI) in patients with severe acute myocardial infarction (AMI). Methods A total of 945 patients with AMI who were hospitalized in the CCU of the First Hospital of Lanzhou University from January 2016 to December 2017 were retrospectively analyzed and 21 patients had undergone perioperative CRRT during percutaneous coronary intervention. Baseline clinical characteristics of the AMI patients were evaluated before and after CRRT treatment. The changes in heart function, renal function, liver function and other parameters were evaluated. Results The heart rate of patients receiving CRRT was significantly lower at 24h and 48h after CRRT than that of before treatment (P=0.038). Decrease in mean systolic blood pressure and diastolic blood pressure was observed af ter CRRT treatment without statistical significance (P>0.05). Proportion of patients with Killip class I ~ II heart function increased significantly after CRRT[23.8%(5/21)vs. 57.1%(12/21),P=0.001]. Amelioration in urea nitrogen, creatinine, aspartate aminotransferase, glutamic pyruvic transaminase and total bilirubin were found at 24h and 48h after CRRT treatment compared to pre-CRRT levels (P<0.05). Conclusions Perioperative CRRT is safe and effective for patients with severe AMI.

Effect of Different Collateral Bleeding Methods on TNF-α in Peripheral Blood of Cervical Spondylosis of Nerve Root Type / 上海针灸杂志

Objective To study the difference between scattered prick with three-edge needle and tapping prick with plum-blossom needle (seven-star needle) in treating cervical spondylosis of nerve root type by observing the content of serum tumor necrosis factor-α (TNF-α) in patients' peripheral blood. Method Sixty patients with cervical spondylosis of nerve root type were randomized into a three-edge needle group and a plum-blossom needle group. The three-edge needle group was intervened by scattered prick with three-edge needle, while the plum-blossom needle group was intervened by plum-blossom needle. The two groups were treated once a week, for 4 weeks in total. The level of TNF-αin serum of the two groups was measured before and after the treatment, and the clinical efficacies were compared. Result The level of serum TNF-α changed significantly after the treatment in both groups (P<0.05), but there was no significant between-group difference in comparing the level of serum TNF-α after the intervention (P>0.05). The between-group difference in the clinical efficacy was statistically insignificant (P>0.05). Conclusion Both three-edge needle and plum-blossom needle can significantly down-regulate the content of serum TNF-α in peripheral blood, and there is no noticeable difference between the two methods.

Effects of exercise on activity tolerance and life quality after heart failure for patients with a preserved ejection fraction / 中华物理医学与康复杂志

Objective To ohserve the effect of individualized exercise programs on the activity tolerance and life quality of heart failure patients with a preserved ejection fraction.Methods Heart failure patients with a preserved left ventricular ejection fraction (LVEF) were randomized to an exercise training group (n=55) or a control group (n =53).Both groups were given optimized heart failure drug therapy,while the exercise training group was additionally provided with individualized exercise training.The LVEFs,6-minute walking distances (6MWDs),Minnesota living with heart failure questionnaire (MLHFQ) scores and adverse events were noted before the experiment and after 12 months of the intervention.Results After one year,no significant differences were found in the groups' average LVEFs or in the ineidence of adverse events,while the average 6MWD and the average MLHFQ score of the exercise training group were significantly better than those of the control group.The average MLHFQ seore decrease (7.8 points) was statistically and practically significant.Conclusion Individualized exercise training can significantly improve the activity tolerance and quality of life of patients with a preserved ejection fraction.It is safe,but the impacts on the ejection fraction are small.

Value of histogram analysis of susceptible signal intensity in differentiating papillary from chromophobe renal cell carcinoma / 中华放射学杂志

Objective To evaluate the feasibility of histogram analysis of susceptible signal intensity in differentiating papillary (pRCC) from chromophobe renal cell carcinoma(ChRCC). Methods Thirteen cases with pRCC and 9 cases with ChRCC, who underwent susceptible-weighted imaging(SWI), MR common scanning and enhancement, were assessed retrospectively. The histogram parameters of susceptible signal intensity were measured, including maximum, minimum, mean, median, skewness and kurtosis. The independent samples t test(normal distribution) and Mann-Whitney rank sum test(skewed distribution) were used to compare the differences in SWI parameters between pRCCs and ChRCCs. Receiver operating characteristic curve was used to evaluate the efficiency of the whole-tumor SWI parameters in differentiating pRCCs from ChRCCs. Results The significant differences of the minimum, mean, median and skewness between pRCCs and ChRCCs were present(P0.05). In all the histogram parameters, the area of ROC curve of mean value was largest(0.80). The sensitivity of minimum value (84.62％) was the highest and and the specificity of skewness(100.00％) was the highest. Conclusion Histogram analysis of susceptible signal intensity can help differentiate pRCCs from ChRCCs.

Anatomic data and clinical significance analysis of 150 cases of type A aortic dissection / 临床外科杂志

Objective To analyse of 150 cases of type A aortic dissection anatomic parameter and the relationship between anatomic parameter and clinic date and prognosis.Methods We identified 150 cases of type A aortic dissection who were diagnosed clearly.All patients were divided into groups by gender and surgical approaches.General clinic data and radiological data were recorded.Survival rate was evaluated by follow up 3 months after surgery.Results The aortic root diameter of group aortic root replacement was(53.25±13.17)mm,group aortic root sparing was (49.08±6.94)mm,there was significant difference between the two group(P0.05).There were gender differences between type A dissection parameters of descending aorta,the start diameter of male and female's descending aorta were (41.09±8.86)mm and(37.44±5.60)mm,respectively.The descending aorta in parallel to the pulmonary artery diameter were(34.31±0.59)mm and(31.11±0.88)mm,respectively.Descending aorta diameter of the diaphragm were(31.45±6.50)mm and(28.46±5.20)mm,respectively(all P>0.05).Conclusion In patients who suffer from type A aortic dissection,Parameter of aortic root is one of factors which determine surgical approach to aortic root.When treating descending aorta,surgeon should consider the influence of gender.Our study provided data references for selection and design of endovascular stent-graft.

Clinical comparative study of patients with PI-IBS and NPI-IBS / 重庆医学

Objective To observe the clinical characteristics in the patients with post infectious irritable bowel syndrome(PI-IBS) and patients with non-PI-IBS(NPI-IBS).Methods Ninety-three patients with irritable bowel syndrome(IBS) treated in our hospital from March 2014 to June 2015 were selected,including 38 cases of PI-IBS and 55 cases of NPI-IBS.The differences of serum inflammatory cytokines levels,gastrointestinal score and gastrointestinal function were compared between the two groups.Resuits The levels of CRP,IL-18 and IL-6 in the PI-IBS group were significantly higher than those in the NPI-IBS group,and the difference was statistically significant (P＜0.05);the level of GAS,VIP and MOT in the PI-IBS group were significantly lower than those in the NPI-IBS group,the difference was statistically significant(P＜0.05);the bowel sounds score,abdominal distension and pain score and gastrointestinal reaction score in the PI-IBS group were obviously higher than those in the NPI-IBS group,the difference was statistical significance (P＜0.05);the various dimensional scores of quality of life in the PI-IBS group were lower than those in the NPI-IBS group,and the difference was statistically significant (P＜0.05).Conclusion The levels of serum inflammatory cytokines in PI-IBS patients are higher,moreover the gastrointestinal function is poorer than that in NPI-IBS patients,which can be the indicators of clinical differentiation.