RESUMEN
Objective:To explore the value of deep learning technology based on mammography in differentiating for breast imaging reporting and data system (BI-RADS) category 3 and 4 lesions.Methods:The clinical and imaging data of 305 patients with 314 lesions assessed as BI-RADS category 3 and 4 by mammography were analyzed retrospectively in Shenzhen People′s Hospital and Shenzhen Luohu People′s Hospital from January to December 2020. All 305 patients were female, aged 21 to 83 (47±12) years. Two general radiologists (general radiologist A and general radiologist B) with 5 and 6 years of work experience and two professional breast imaging diagnostic radiologists (professional radiologist A and professional radiologist B) with 21 years of work experience and specialized breast imaging training were randomly assigned to read the imaging independently at a 1∶1 ratio, and then to read the imaging again in combination with the deep learning system. Finally, breast lesions were reclassified into BI-RADS category 3 or 4. The receiver operating characteristic curve and area under the curve (AUC) were used to evaluate the diagnostic performance, and the differences of AUCs were compared by DeLong method.Results:The AUC of general radiologist A combined with deep learning system to reclassify BI-RADS category 3 and 4 breast lesions was significantly higher than that of general radiologist A alone (AUC=0.79, 0.63, Z=2.82, P=0.005, respectively). The AUC of general radiologist B combined with deep learning system to reclassify BI-RADS category 3 and 4 breast lesions was significantly higher than that of general radiologist B (AUC=0.83, 0.64, Z=3.32, P=0.001, respectively). There was no significant difference in the AUCs between professional radiologist A combined with deep learning system and professional radiologist A, and professional radiologist B combined with deep learning system and professional radiologist B in reclassifying BI-RADS category 3 and 4 breast lesions ( P>0.05). Conclusion:The deep learning system based on mammography is more effective in assisting general radiologists to differentiate between BI-RADS category 3 and 4 lesions.
RESUMEN
Objective:To establish the predictive models for the prognosis of ductal carcinoma in situ (DCIS) at different pathological stages, and to evaluate the predictive performance of the models.Methods:Complete data of 273 patients with confirmed DCIS at different pathological stages who underwent mammography examination in Shenzhen People′s Hospital, Peking University Shenzhen Hospital and Shenzhen Luohu People′s Hospital from November 2014 to December 2020 were retrospectively collected, including 110 cases in the DCIS+ductal carcinoma in situ with microinvasion (DCIS-MI) group and 163 cases in the invasive ductal carcinoma (IDC)-DCIS group. The clinical, imaging and pathological features were analyzed. Mammary Mammo AI fusion model and deep learning-based natural language processing (NLP) structured diagnostic report model were used for image feature extraction. Patients in each group were randomly divided into training set and validation set with a ratio of 6∶4, and the predictors were screened by univariate and multivariate logistic regression analysis. The lowest Akaike information criterion value of each group was selected to construct the final predictive model. The receiver operating characteristic (ROC) curve was drawn to evaluate the performance of each model.Results:Taking estrogen receptor (-) or human epidermal growth factor receptor 2 (3+) as the poor prognostic reference, there were 62 cases considered with poor prognosis and 48 cases with good prognosis in DCIS+DCIS-MI group; while in the IDC-DCIS group, taking the Nottingham prognostic index as the reference, 33 cases were considered with poor prognosis, 73 cases with moderate prognosis, and 57 cases with good prognosis. Four predictive factors were screened to construct the DCIS+DCIS-MI-group predictive model, including DCIS nuclear grade, calcification with suspicious morphology in mammography, DCIS pathologic subtype and DCIS with microinvasion. Five predictive factors were screened to construct the IDC-DCIS-group predictive model, including neural or vascular invasion, Ki67 level, DCIS subtype, DCIS component proportion and associated features in mammography. The area under curve (AUC) for predicting poor prognosis of DCIS+DCIS-MI was 0.92 (95%CI 0.84-1.00) in the training set and 0.90 (95%CI 0.82-0.99) in the validation set; while the AUC for predicting poor prognosis of IDC-DCIS was 0.84 (95%CI 0.76-0.93) in the training set and 0.78 (95%CI 0.64-0.91) in the validation set.Conclusion:The developed models based on deep learning combined with NLP can effectively predict the prognosis of DCIS at different pathological stages, which are beneficial to the risk stratification of patients with DCIS, providing a reference for clinical decision.
RESUMEN
Objective To detect the expression levels of miR-7-5p and POLE4 in non-small cell lung cancer cells and their effect on cells proliferation, migration and invasion. Methods qRT-PCR was used to detect the relative expression levels of miR-7-5p and POLE4 mRNA in NSCLC tissues, adjacent tissues, tumor cells and human normal bronchial epithelial cells. Luciferase reporter gene was used for analyzing of the targeting relation between POLE4 and miR-7-5p in NSCLC cells. si-NC and si-POLE4 were transfected into SPC-A-1 cells as the si-NC group and si-POLE4 group, and the control group was set at the same time. MTT method, scratch test and Transwell test were used to detect cell proliferation, migration and invasion. Results The expression levels of miR-7-5p in NSCLC tissues and cells were reduced, and the expression levels of POLE4 were increased. miR-7-5p could target to combine with POLE4. After 72 hours of culture, the OD value in si-POLE4 group was significantly lower than those in the control group and si-NC group (P < 0.05). The migration rate and the number of transmembrane cells in the si-POLE4 group cultured for 48 hours were lower than those in the control group and the si-NC group (P < 0.05). Conclusion miR-7-5p may inhibit the proliferation, migration and invasion of non-small cell lung cancer cells by targeting POLE4.
RESUMEN
Objective To investigate the expressions of AGGF1 in esophageal squamous cell carcinoma (ESCC) and their relationships with clinical features and prognosis of ESCC. Methods The expressions of AGGF1 in 70 cases of ESCC and 30 cases of normal esophageal tissue were examined using SP immunohistochemical staining and were analyzed according to the clinical features and follow-up data. Results The expressions of AGGF1 in 70 cases of ESCC was significantly higher than those in 30 cases of normal esophageal tissue [54.29%(38/70) vs. 23.33%(7/30)](P=0.004). The expressions of AGGF1 in ESCC were significantly related to the TNM stage, clinical stage and prognosis (P all<0.05). The OS was shorter in the positive teams of AGGF1 than that in the negative teams [(19.7 ± 3.5) months vs. (33.2 ± 4.0) months] (P=0.015). Cox- proportional multivariate analysis showed that positive expressions of AGGF1 and VEGF (P=0.043, 0.024) and clinical stage (P=0.035) were significant prognostic factors in overall survival. Conclusions AGGF1 has high expressions in ESCC, and it is closely related to the clinical features and prognosis of ESCC.
RESUMEN
Objective To analyze the reasons of cesarean section in primiparae without operation indications ,in order to provide foundation for reducing the rate of cesarean section .Methods 640 cases of primipara were randomly divided into cesarean section with no operation indications(observation group) and spontaneous labor group(control group) ,320 cases in each each .The general data was investigated and analyzed ,the scale of cesarean section causes ,scale of cesarean section and pregnancy knowledge were compared between the two groups .Results The average age of the observation group was significant higher than that of the control group ,the percentage of monthly income of over 2 000 yuan and the proportion of level of education for college or above was signifi-cant higher than that of the observation group(P<0 .05) .In terms of pain tolerance ,no confidence in the natural delivery ,timing production ,family members will ,elderly parturient women ,the observation group were significant higher than the control group (P<0 .05) .The pregnancy knowledge level of observation group was significant lower than the control group (P<0 .05) .Multi-fac-tor analysis showed that ,high education level ,no tolerence of pain ,no confidence in the natural delivery ,timing production ,elderly parturient women ,and low degree of knowledge during pregnancy were major cause of of cesarean section rate .Conclusion The ap-propriate analgesia and encourage should be adopted for pregnant women who can′t stand the pain ,without confidence in the natural delivery .Education should be strengthen for pregnant women who timing production ,elderly parturient women ,low degree of knowledge .
RESUMEN
Objective To study the risk factors,methods of etiologic diagnosis and treatment of disunion of fracture due to delayed infection after the internal fixation. Methods The clinical data including bacterial tests, clinical manifestation and the administration of antibiotics , of 24 cases of disunion of fracture due to delayed infec-tion after the internal fixation were retrospectively analyzed. Results 22 strains of pathogenic bacteria were distin-guished with a detection rate of 91.67% in the 24 cases. 16 strains of these bacteria were gram-positive,and 6 gram-negative. The gram-positive ones were all sensitive to vancomycin and teicoplanin. The gram-negative ones were all sensitive to imipenem and meropenem. It was common for patients to take antibiotic after operation. Conclusion More infection is caused by gram-positive bacteria than by gram-negative ones. Antibiotic therapy based on the bacte-rial test is reasonable and necessary besides surgeries.
RESUMEN
Objective To observe the results of treatment by open reduction and humeral head replacement for proximal humeral fracture-dislocation. Methods According to Neers classification, the cases included two-part proximal humeral fracture-dislocation 15 cases, three-part proximal humeral fracture-dislocation 29 cases, and four-part proximal humeral fracture-dislocation 21 cases. Fifty-four patients received T shaped steel plate and 11 patients received humeral head replacement. Early rehabilitation was started postoperatively. Results Fifty-four patients who received T shaped steel plate were followed up from 1 to 5 years (in average of 2.5 years), final results of all the patients were evaluated according to the HUANG Gong-yi′s criterion. The rate of excellent or good in patients of two-part fracture-dislocation were 100%, three-part fracture-dislocation was 79%, humeral head necrosis was 25%, four-part fracture-dislocation was 60%, and humeral head necrosis was 53%. Eleven patients who received humeral head replacement were followed up from 6 months to 5 years (in average of 1.5 years). According to SSMH of UCLA, the average score was 25.6. Score was above 27 in 1 case, 24~27 in 8 cases, 18~ 23 in 2 cases, less than 18 in 0. These cases were with an excellence rate of 82%. Average score was 9.0 in pain, 8.2 in function and 7.5 in muscle power. Conclusions T shaped steel plate to treat the two-part proximal humeral fracture-dislocation is effective in the functional recovery of the shoulder joint, but the rate of satisfaction as well as the necrosis in the three-part and four-part is poor. Satisfactory results can be obtained in humeral head replacement for the treatment of proximal humeral fractures especially for the treatment of three and four-part fracture-dislocation.
RESUMEN
Objective To analyze the pregnancy outcomes and measures to prevention and cure for pregnancy women with pulmonary hypertension.Methods Clinical data of 40 women with pulmonary hypertension were analyzed and they were divided into three groups on the basis of Doppler transthoracic echocardiography detections.Results(1)The proportions of rheumatic heart disease and congenital heart disease were 22.64% and 45.38%;8 cases appeared with the perinatal heart disease and 5 cases' hearts structure were normal.(2)49 cases applied cesarean section and 2 delivery naturally.2 women were induction of labour in second trimester.In midrange and severity groups,prematurity and small gestational age were significently higher than those of gentle group.(3)3 women died of congestive heart failure and pulmonary embolism.6 women were treated by SICU and physician because of serious illness.Conclusion Women with midrange and severely pulmonary hypertension should avoid pregnancy.Pregnant women with pulmonary hypertension needed monitor closely and being treated with pulmonary vasodilator added decoagulant would improve outcomes of mather and infant.
RESUMEN
[Objective]To explore a new therapy for postoperative non-union distal humeral frature.[Method]From January 2000 to January 2005,27 cases of non-union after internal fixation operations of distal humeral fractures were treated with retrograde intramedullary nailing combined with bone graft.[Result]All cases were followed up form 6 months to 32 months,with an average of 16 months.All the non-union were healed and joint function resumed to normal.No infection,no nail and locking bolts broken and no humeral distal fracture were found.[Conclusion]Retrograde intramedullary nailing combined with bone graft is an effective therapy for postoperative non-union of distal humeral fracture.
RESUMEN
OBJECTIVE: To probe into the function of early exercises on healing of grafts after anterior cruciate ligament (ACL) reconstruction and on motor function recovery of knee joint by summarizing biology and biomechanical properties of ACL reconstruction.DATA SOURCES: The relevant literatures on ACL reconstruction of knee joint and its biomechanical properties were looked up in period of MEDLINE1970-01/2004-01 on computer. Retrieval words: "anterior cruciate ligament, knee joint, biomechanics" only in English.STUDY SELECTION: In initial examination, the complete contents of literatures on ACL reconstruction of knee joint and its biomechanical properties were selected. The controlled papers were randomized, for those written by the same writer, the papers with the most cases were included.Comprehensive and Mete analyzed papers were excluded. Quality evaluation was mainly based on the reality of observed data and rigor of investigation and application.DATA EXTRACTION: Fourty-six papers on ACL reconstruction of knee joint and its biomechanical properties were looked up totally, of which, 29papers were tallied with inclusive criteria, 17 papers were excluded, 9 papers were the analysis on small samples and 8 papers referred to comprehensive and Meta analysis.DATA SYNTHESIS: By understanding biomechanical properties of normal ACL it is to implement reconstruction measures and plan for rehabilitation. Animal experiment after ACL reconstruction suggests that the motor function recovery of knee joint is not satisfactory, but the results of human experiment are superior to animal one. It is indicated in randomized control experiment that immediate weightbearing right after ACL reconstruction will not aggravate knee joint laxity; on the contrary, it is advantageous to alleviate patellar pain.CONCLUSION: Reconstruction of injured ACL fixes knee joints, limits peripheral muscle contraction and results in limited motor function of ligaments, joints and peripheral muscles. Early rehabilitation exercises may alleviate pain, improve articular cartilage metabolism, prevent capsule contracture and benefit recovery of motor function after ACL reconstruction of knee joint.In randomized comparisons of Bear[27], Fischer[28] and Beynnon[29],there is no difference between rehabilitation at home and in hospital after ACL reconstruction with bone-patellar-bone graft.
RESUMEN
Objective To probe the effects of interlocking intramedullary nail fixation in treatment of long bone fractures, evaluate the application of intramedullary nail fixation treatment of long bone fractures, and explore the complications and their management. Methods Retrospective study of 2126 cases with long bone fracture treated with interlocking intramedullary nail from January 1996 to January 2004 was carried out. Of them, 1089 cases were followed up, and the average follow-up duration was 4 years (1 to 8 years). The locations of fracture were tibial and fibular in 603 cases, which were left in 237 cases and right in 331 cases and bilateral in 35 cases, close fracture in 511 cases of type C 240 cases, type A of 134 cases and type B 137 cases, open fracture 92 cases of Gustilo Ⅰ type 63 cases and Gustilo Ⅱ type 29 cases; femoral fractures in 360 cases, which were left 136 cases, right 205 cases and bilateral 19 cases, close fracture 319 cases of type C 191 cases, type A 103 cases, type B 25 cases; Open fracture 41 cases; Humeral fractures in 126 cases, which were left 49 cases, right 71 cases and bilateral 6 cases, close fracture 113 cases of type C 24 cases, type A 64 cases and type B 25 cases; Open fracture 13 cases. Results Fracture healing rate was 93% in interlocking intramedullary nail fixation treatment of long bone fracture. Complication included fracture nonunion rate 7%, infection rate 3%, fat embolism syndrome 2%, nail and locking bolts broke 2%, iatrogenic fracture 1.3%, knee pain in patients with tibia shaft fracture after interlocking intramedullary nail treatment 35%. Conclusion Interlocking intramedullary nail is more suitable for long bone fracture because it can result in more reliable fixation, less operative trauma. It can be used as the first alternative to treat long bone fractures.