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Objective:To explore the predictive value of ultrasound-based radiomics for liver metastasis in pancreatic neuroendocrine tumors (pNEN).Methods:A retrospective analysis was conducted on clinical, pathological, and ultrasound data of 269 pNEN patients confirmed by pathology at Tianjin Medical University Cancer Institute and Hospital from January 2012 to June 2022, including 94 patients with liver metastasis and 175 without liver metastasis. The regions of interest (ROI) were delineated on the maximum diameter section of the tumor using ITKSNAP software, and radiomics features were extracted using Pyradiomics. Radiomics features with an intra-group correlation coefficient greater than 0.90 were retained, and the optimal features were selected using the maximum relevance minimum redundancy (MRMR) algorithm. The dataset was randomly divided into a training set and a validation set in a ratio of 7∶3, and the random forest algorithm (Rfs) was used to predict pNEN liver metastasis. Three models were constructed, including the clinical ultrasound model, the radiomics model, and the comprehensive model that combined clinical ultrasound and radiomics features. The predictive performance of different models for pNEN liver metastasis was analyzed using the ROC curve, and the predictive performance of different models was compared using the Delong test.Results:A total of 874 features were extracted from the ROI, and 12 highly robust radiomics features were retained for model construction based on inter- and intra-observer correlation grading and feature selection. The area under curve(AUC), sensitivity, specificity, and accuracy of the radiomics model, the clinical ultrasound model, and the comprehensive model for predicting liver metastasis in pNEN patients were 0.800, 0.574, 0.789, 0.714; 0.780, 0.596, 0.874, 0.777; and 0.890, 0.694, 0.874, 0.810, respectively. The Delong test showed that the comprehensive model had the best predictive performance, with an AUC superior to that of radiomics model ( Z=3.845, P=0.000 12) and clinical ultrasound model ( Z=3.506, P=0.000 45). Conclusions:The radiomics model based on ultrasound has good performance in predicting liver metastasis in pNEN, and the comprehensive model that combines clinical ultrasound and radiomics features can further improve the predictive performance of the model.
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Objective:To investigate the risk factors of acute biliopancreatic complica-tions in patients of pregnancy combined with gallbladder stone and construction of prediction model.Methods:The retrospective case-control study was constructed. The clinical data of 98 patients of pregnancy combined with gallbladder stone who were admitted to the First Hospital of Lanzhou University from September 2011 to October 2022 and 53 patients of pregnancy combined with gallbladder stone who were admitted to Gansu Provincial Hospital May 2014 to October 2021 were collected. The age of 151 patients was 29(25,32)years. Observation indicators: (1) situations of patients of pregnancy combined with gallbladder stone; (2) risk factors of acute biliopancreatic com-plications in patients of pregnancy combined with gallbladder stone; (3) construction of prediction model for acute biliopancreatic complications in patients of pregnancy combined with gallbladder stone. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the independent t test. Measurement data with skewed distribution were represented as M( Q1, Q3), and comparison between groups was conducted using the Mann-Whitney U test. Count data were described as absolute numbers, and comparison between groups was conducted using the chi-square test. Comparison of ordinal data was conducted using the rank sum test. Univariate and multi-variate analyses were conducted using the Logistic regression model. Nomogram prediction model was conducted, and the receiver operating characteristic (ROC) curve was used to evaluate discri-mination of the nomogram predic-tion model. The calibration curve and clinical decision curve were used to evaluate calibration and net clinical benefit of the nomogram prediction model. Internal validation of the prediction model was performed by applying 10-fold cross-validation. Results:(1) Situations of patients of pregnancy combined with gallbladder stone. The total cholesterol, triglyceride, high density lipoprotein cholesterol, low density lipoprotein cholesterol, prepregnancy body mass index (<18.5 kg/m 2, 18.5?24.0 kg/m 2, >24.0 kg/m 2), gesta-tional period (early, mid, late), primipara (positive, negative), stone type (solitary, non solitary), diameter of stone (≤10 mm, >10 mm), gallbladder wall thickness (≥4 mm, <4 mm) were (4.9±1.4)mmol/L, 1.88(1.22,2.93)mmol/L, 1.48(1.22,1.83)mmol/L, (2.8±0.9)mmol/L, 13, 75, 58, 37, 45, 69, 86, 65, 37, 114, 89, 62, 38, 113 in the 151 patients of pregnancy combined with gallbladder stone. Of the 151 patients, the age, prepregnancy body mass index (<18.5 kg/m 2, 18.5?24.0 kg/m 2, >24.0 kg/m 2), primipara (positive, negative), stone type (solitary, non solitary), diameter of stone (≤10 mm, >10 mm), gallbladder wall thickness (≥4 mm, <4 mm) were 31(28,37)years, 3, 30, 36, 29, 40, 32, 37, 26, 43, 4, 65 in 69 cases without symptom, versus 27(24,31)years, 10, 45, 22, 57, 25, 5, 77, 63, 19, 34, 48 in 82 cases combined with acute biliopancreatic complications, showing significant differences in the above indicators between them ( Z=?3.636, ?2.385, χ2=11.544, 32.862, 23.729, 25.310, P<0.05). Five of the 82 patients of pregnancy combined with gallbladder stone missed data of prepregnancy body mass index. Of the 82 patients, there were 42 patients of simple acute cholecystitis, 40 patients of common bile duct stone and/or acute biliary pancreatitis including 18 cases of common bile duct stone, 13 cases of acute biliary pancreatitis and 9 cases of common bile duct stone combined with acute biliary pancreatitis. (2) Risk factors of acute biliopancreatic complications in patients of pregnancy combined with gallbladder stone. Results of multivariate analysis showed that primipara, non solitary stone, diameter of stone ≤10 mm, gallbladder wall thickness ≥4 mm were independent risk factors of acute biliopancreatic complications in patients of pregnancy combined with gallbladder stone ( odds ratio=3.102, 6.305, 3.674, 6.686, 95% confidence interval as 1.280?7.519, 1.886?21.080, 1.457?9.265, 1.984?22.528, P<0.05). Results of multivariate analysis in further analysis showed that primipara, non solitary stone, gallbladder wall thickness ≥4 mm were independent risk factors of simple acute cholecystitis in patients of pregnancy combined with gallbladder stone ( odds ratio=3.671, 8.905, 7.137, 95% confidence interval as 1.386?9.723, 2.332?34.006, 1.902?26.773, P<0.05), and age, non solitary stone, diameter of stone ≤10 mm, gallbladder wall thickness ≥4 mm were independent risk factors of common bile duct stone and/or acute biliary pancreatitis in patients of pregnancy combined with gallbladder stone ( odds ratio=0.883, 5.361, 5.472, 8.895, 95% confidence interval as 0.789?0.988, 1.062?27.071, 1.590?18.827, 2.064?38.325, P<0.05). (3) Construction of prediction model for acute biliopancreatic complications in patients of pregnancy combined with gallbladder stone. The nomogram prediction model for acute biliopancreatic complications in patients of pregnancy combined with gallbladder stone was constructed based on the clinical factors of age, primipara, stone type, diameter of stone and gallbladder wall thickness. The area under the curve (AUC) of ROC curve of prediction model was 0.869 (95% confidence interval as 0.813?0.923), indicating that the prediction model with good predictive ability. Results of Hosmer-Lemeshow test showed a good fit ( χ2=5.680, P>0.05), indicating that the prediction model with good calibration. Results of decision curve analysis showed the prediction model with high net clinical benefit. Results of internal validation of the prediction model based on 10-fold cross-validation showed the AUC of ROC curve for the cross-validation sample was 0.833, indicating that the prediction model with good stability. Conclusions:Primigravida, non solitary stone, diameter of stone ≤10 mm, gallbladder wall thickness ≥4 mm are independent risk factors of acute biliopancreatic complications in patients of pregnancy combined with gallbladder stone. The prediction model for acute biliopancreatic complications has good predictive ability.
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Intraductal papillary mucinous neoplasm (IPMN) of the pancreas is a cystic tumor of the pancreas with some malignant potential. According to the degree of pancreatic duct expansion and the location of the tumor, it can be divided into main-duct type, branch-duct type, and mixed type. According to the degree of atypia, it can be classified as low-grade dysplasia, high-grade dysplasia, or invasive IPMN. According to histological morphology and immunohistochemistry, there are four subtypes: gastric type, intestinal type, pancreaticobiliary type, and eosinophilic type. Ultrasound is commonly used in screening and follow-up, while CT, MRI/MRCP, and EUS can identify IPMN with high-risk and anxiety characteristics, which are valuable in determining the timing of surgery and patient status. Imaging omics is highly accurate in assessing the degree of dysplasia and can be used to identify people at high risk of malignant transformation. In this article, the clinical manifestations, pathology, and imaging features of IPMN are reviewed in the light of the relevant guidelines and literature in recent years, in order to deepen our understanding of IPMN and thus improve the accuracy of imaging diagnosis.
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Objective To explore the relationship between social anxiety and acceptance of disability in breast cancer patients with mastectomy. Methods Totally 325 patients with breast cancer were investigated with general information questionnaire, Interaction Anxiety Scale and Acceptance of Disability Scale.Results The total score of Interaction Anxiety Scale was(40.01±9.38)points.The total score of Acceptance of Disability Scale was (78.02 ± 11.61) points. One-way ANOVA showed that age, education level, marital status, economic level, whether the spouse care about the appearance or not, therapy types affected social anxiety significantly(t/F=-4.696-35.694,all P<0.01).Significantly negative correlation was found between social anxiety and acceptance of disability (r =-0.469--0.371, P<0.01). Multiple regression analysis showed that acceptance of disability,age,whether the spouse care about the appearance or not, therapy types were influencing factors of social anxiety. Conclusions Nurses and doctors should explore effective psychological intervention mode to rebuild the patient′s self-confidence and return to normal social interaction in order to improve the acceptance of disability.
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Objective To investigate the effect of interventions based on Information-Motivation-Behavioral skills on the preoperative anxiety in patients with gynecological malignancies. Methods A total of 64 patients with malignant tumor were divided into two groups by random digits table method with 32 cases each. The patients in the two groups received routine nursing. In addition, interventions based on Information-Motivation-Behavioral skills were provided in the intervention group. All patients were investigated by the following indexes such as the Self-Rating Anxiety Scale (SAS), sleep quality scale, blood pressure and heart rate before and after the intervention. Results After the intervention, the SAS scores in the intervention group was (49.47 ± 3.81) points, sleep quality score was (3.66 ± 0.97) points, and systolic blood pressure and heart rate were (128.56±5.93) mmHg (1 mmHg=0.133 kPa), (75.09 ± 3.78) beats/min, which were lower than those in the control group (57.38 ± 3.75) points, (5.50 ± 1.50) points, (134.97 ± 7.19) mmHg, (81.34 ± 4.88) beats/min, the differences were statistically significant (t=-8.350--3.887, P<0.05). Conclusions The intervention focused on Information-Motivation-Behavioral Skills can help patients to relieve anxiety, reduce stress response, improve quality of sleep.
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Objective To compare the diagnostic efficiency of superb micro-vascular imaging ( SMI) and power Doppler imaging ( PDI) in differentiating different size breast tumors . Methods Retrospective analysis were performent in a total of 170 cases of breast tumors of 144 patients screened with SMI and PDI in our hospital from August 2016 to July 2017 ,and pathological results were finally obtained . These tumors were divided into two groups according to the maximum diameter 2 .0 cm . SMI and PDI diagnostic efficiency were compared by showing blood flow distribution ,vascular morphology and Alder grade . Results There were 68 benign tumors and 102 malignant tumors .When the maximum diameter was no more than 2 .0 cm ,there were no significant difference in the blood flow distribution ,vascular morphology and Alder grade between PDI and SMI of benign tumors( all P > 0 .05) ;However ,there were significant differences in the vascular morphology and Alder grade of malignant tumors( all P < 0 .05) ,but no difference in blood flow distribution( P = 0 .174) ;The area under the curve of ROC by PDI and SMI were 0 .724 and 0 .844 ,thus , the difference was statistically significant( P = 0 .024) . When the maximum diameter was more than 2 .0 cm ,the between PDI and SMI differences in blood flow distribution ,vascular morphology and Alder grade were not statistically significant ( all P > 0 .05) in benign tumors ,but there was statistical difference in vascular morphology ( P = 0 .001) in malignant tumors ,and there was no significant difference in blood flow distribution ,Alder grade in malignant tumors between PDI and SMI ( all P > 0 .05) . The area under the curve of ROC by PDI and SMI were 0 .768 and 0 .802 ,the difference was not statistically significant ( P = 0 .447) . Conclusions SMI can show the blood flow characteristics more clearly in breast tumors . When the maximum diameter is no more than 2 .0 cm ,SMI diagnostic efficiency is better than PDI .
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Objective@#To study the constitutional features of diseases spectrum of inpatients with liver disease in infectious diseases department of three comprehensive hospitals to provide resource allocation proposition for the construction of Department of Infectious Diseases.@*Methods@#Inpatients data were extracted from the department of infectious diseases of three comprehensive hospitals (Kunming General Hospital of the People's Liberation Army, Yuxi People's Hospital and Dali People's Hospital) between January 2010 to December 2015, and were retrospectively analyzed. The distribution of patients with viral hepatitis (A, B, C, E) and severe liver disease (Severe hepatitis, cirrhosis, liver cancer) was further analyzed in hospitalized patients. Data were analyzed by one-way analysis of variance. A chi-squared test was used for comparison between groups. The change trends of disease constituent ratio in different years were checked by 2 test.@*Results@#Liver disease, tuberculosis and AIDS were the three common diseases of three comprehensive hospitals in Yunnan, accounting for 58.61% of all admissions. However, an inpatients with liver diseases (17.25%, 3555/20606, 95% CI 16.73%-17.77%) were significantly lower than tuberculosis inpatients (33.98%, 7002/20606, 95% CI 33.34%-34.62%). An observations from different hospitals and at different time points showed that the proportion of patients with liver disease was lower than that of tuberculosis patients. The proportion of inpatients with HBV infection showed a downward trend (P < 0.001), whereas the proportions of inpatients with HCV and severe liver diseases showed an increased trend over time (P < 0.001).@*Conclusion@#The proportion of inpatients with liver diseases was lower than tuberculosis inpatients in the Department of Infectious Diseases of three comprehensive hospitals. Hence, the paucity of the disease spectrum should be considered for resource allocation in the construction of infectious disease department.
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Objective To compare the difference of colour Doppler flow imaging(CDFI)and superb-microvascular imaging(SMI)for detecting blood flow in cystic renal mass,and explore the consistency of conventional ultrasound combined with SMI and Contrast-enhanced ultrasonography(CEUS) in the diagnosis of renal cystic masses based on the Bosniak classification system,so as to evaluate the diagnosis value of SMI in renal cystic masses.Methods Fifty-five patients with renal cystic mass were enrolled in this study and underwent conventional ultrasound,CDFI and SMI.Patients with renal cystic mass at category Ⅱ for higher received contrast-enhanced ultrasonography additionally.The diagnostic performance of SMI and CEUS were evaluated based on final diagnosis obtained by follow-up or pathology diagnosis after surgery.Results In 55 cases,44 cases got the pathological diagnosis afer surgical resection including 38 cases of malignant masses,and 6 cases of benign masses.CDFI and SMI showed significant difference in tumor flow imaging(P <0.05).Kappa Value of SMI and CEUS was 0.866.The sensitivity,specificity, accuracy,positive predictive value and negative predictive value of SMI were 94.8%,75.0%,89.1%,90.2% and 85.7% respectively.Conclusions SMI is superior to CDFI in displaying micro-vascular of separated and solid structure in renal cystic masses.SMI has a better consistency with CEUS in Bosniak classification.SMI can improve the accuracy of non-invasive ultrasound in the diagnosis of renal cystic lesions.
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Objective To evaluate the effect of written expression on perceived stress,anxiety and depression in patients with gynecologic malignant tumor during chemotherapy. Methods From June 2016 to December 2016,90 chemotherapy patients with gynecologic malignant tumor were extracted from North China University of Science and Technology and divided into intervention group and control group by random digits table method,45 cases in each group.The control group received routine psychological intervention and while the intervention group received written expression lasting for 4 weeks in addition. Before and after the intervention,all patients were measured using the Chinese Version Perceived Stress Scale(CPSS), Self-Rating Anxiety Scale(SAS) and Self-Rating depression Scale(SDS). Results The intervention group showed a significant decrease in CPSS(32.12 ± 3.75) points, SAS(43.67 ± 5.23) points, SDS(46.18±4.37)points,compared with the control group(37.26±4.42),(50.88±3.15),(52.47±3.60)points, the difference was significant(t=-5.782,-7.667,-7.230,all P<0.05). Conclusions Written expression can effectively reduce perceived stress, anxiety and depression in patients with gynecologic malignant tumor undergoing chemotherapy.
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Objective To detect the mutation of epidermal growth factor receptor(EGFR) gene,fusion of echinoderms microtubule associated protein sample-4 and gradual change of lymphoma kinase(EML4-ALK) gene,as well as describe their relationship with the clinicopathological features in patients with non-small cell lung cancer(NSCLC) from Zhongshan city of Guangdong province.Methods Mutations of EGFR gene and EML4-ALK fusion gene in 753 NSCLC patients from Zhongshan People's hospital were detected by ARMS real-time PCR.To study the relationship between the mutation and clinical features and explore the significance of EGFR gene mutation and EML4-ALK fusion in NSCLC.Results The EGFR mutation rate of 753 NSCLC patients is 43.16％(325/753),with highest mutation rate in 19 and 21 exons,43.08％(140/325) and 47.38％ (154/325) respectively,and the main mutation in 21 exon is L858R mutation.EGFR mutation is more common in female/non-smoking patients,or patients with adenocarcinoma/adenosquqmous carcinoma/adenocarcinoma metastasis(P＜0.05),but not relates with the age of patients(P＞0.05).The EML4-ALK fusion gene of 110 patients whose EGFR mutation were checked were simultaneously detected,showing a 9.09 ％ (10/110) mutation rate,and the mutation rate in type 1(80％) is significantly higher than type 2(10％) and 3(10％).Patients with EML4-ALK gene mutation tend to be younger(P＜0.05),but the EML4-ALK gene mutation rates show no significant differences in groups classified by gender,smoking history or pathological classification(P＞0.05).EGFR gene mutation and EML4-ALK fusion were detected in one patient simultaneously.Conclusion The EGFR mutation rate of patients with NSCLC in Zhongshan city is consistent with results reported in domestic and foreign literatures.Detections of EGFR gene mutation and EML4-ALK fusion are necessary test items,providing important evidence in molecular targeting therapy in NSCLS.
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Objective To detect the mutation of epidermal growth factor receptor(EGFR) gene,fusion of echinoderms microtubule associated protein sample-4 and gradual change of lymphoma kinase(EML4-ALK) gene,as well as describe their relationship with the clinicopathological features in patients with non-small cell lung cancer(NSCLC) from Zhongshan city of Guangdong province.Methods Mutations of EGFR gene and EML4-ALK fusion gene in 753 NSCLC patients from Zhongshan People's hospital were detected by ARMS real-time PCR.To study the relationship between the mutation and clinical features and explore the significance of EGFR gene mutation and EML4-ALK fusion in NSCLC.Results The EGFR mutation rate of 753 NSCLC patients is 43.16％(325/753),with highest mutation rate in 19 and 21 exons,43.08％(140/325) and 47.38％ (154/325) respectively,and the main mutation in 21 exon is L858R mutation.EGFR mutation is more common in female/non-smoking patients,or patients with adenocarcinoma/adenosquqmous carcinoma/adenocarcinoma metastasis(P＜0.05),but not relates with the age of patients(P＞0.05).The EML4-ALK fusion gene of 110 patients whose EGFR mutation were checked were simultaneously detected,showing a 9.09 ％ (10/110) mutation rate,and the mutation rate in type 1(80％) is significantly higher than type 2(10％) and 3(10％).Patients with EML4-ALK gene mutation tend to be younger(P＜0.05),but the EML4-ALK gene mutation rates show no significant differences in groups classified by gender,smoking history or pathological classification(P＞0.05).EGFR gene mutation and EML4-ALK fusion were detected in one patient simultaneously.Conclusion The EGFR mutation rate of patients with NSCLC in Zhongshan city is consistent with results reported in domestic and foreign literatures.Detections of EGFR gene mutation and EML4-ALK fusion are necessary test items,providing important evidence in molecular targeting therapy in NSCLS.
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Objective To investigate the value of TI-RADS for sonographic diagnosis of papillary thyroid carcinoma (PTC) and follicular thyroid carcinoma (FTC) and to evaluate the sonographic findings of FTC compared to PTC.Methods The clinical and sonographic data of 363 cases of pathology confirmed thyroid nodules were retrospectively analyzed.The thyroid nodules were classified by TI-RADS grading criteria,the accuracy of TI-RADS and sonographic findings between FTC and PTC was analyzed.Results In 363 thyroid nodules,114 cases were confirmed as benign lesions;249 cases were confirmed as carcinomas,including 50 FTC cases and 199 PTC cases.The sensitivity,specificity,PPV,NPV,and accuracy of PTC were 97.0％ (193/199),85.1％ (97/114),91.9％ (193/210),85.8％ (97/113),95.7％ (290/303) respectively.The sensitivity,specificity,PPV,NPV,and accuracy of FTC were 97.0％(193/199),85.1％ (97/114),91.9％ (193/210),85.8％ (97/113),95.7％ (290/303) respectively.There were significant differences of nodule size,shape,margin,echogenecity,calcification,halo and flow between FTC group and PTC group (P ＜ 0.05).Conclusion TI-RADS has higher value in the sonographic diagnosis of PTC than that of FTC.FTC are greatly different from PTC in many sonographic findings making it less valuable for the diagnosis of FTC.
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Objective To investigate the effect of health education and behavioral intervention on the self-perceived burden of patients with gastrointestinal malignant tumor at end-stage.Methods From March 2012 to April 2013,70 patients with gastrointestinal malignant tumor whose lifetime was estimated to be within 6 months were extracted from five general hospitals in Tangshan.70 patients were randomly divided into the intervention group and the control group with 35 cases in each group.The two groups samely received routine nursing care,while the intervention group was given health education and behavioral intervention.Both groups were evaluated by SPBS-CP before and after intervention.Results The scores of the intervention group after intervention were lower than before intervention and the control group,which were reflected in 3 dimensions such as care burden,psychological and emotional burden and treatment burden.Conclusions Health education and behavioral intervention can effectively relieve self-perceived burden of patients with gastrointestinal malignant tumor at end-stage.