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ObjectiveTo investigate the cost-effectiveness ratio of Gd-EOB-DTPA contrast-enhanced magnetic resonance imaging (EMRI) versus ultrasound in liver cancer screening for the high-risk population. MethodsThe TreeAge Pro 2011 software was used to establish a decision-tree model. A mathematical model was used to simulate the costs and benefits of EMRI or ultrasound screening every 6 months in patients with liver cirrhosis, and the cost-effectiveness ratios under different screening models were calculated. ResultsThe EMRI group had a mean cost of liver cancer screening of 2050.2 RMB each person each time and mean benefits of 0.11 YLG, while the ultrasound group had a mean cost of 262.6 RMB and mean benefits of 0.02 YLG. When the incidence rate of liver cancer was 17.8%, the EMRI group had a similar cost-effectiveness ratio as the ultrasound group, and the cost of 1 YLG was 11445 RMB; EMRI tended to have a lower cost and a better effect in screening with the increase in the incidence rate of liver cancer. The cost-effectiveness ratio of EMRI gradually decreased with the reduction in its price, and its effect in screening gradually increased with the reduction in price. ConclusionThe cost-effectiveness of liver cancer screening is closely related to the incidence rate of liver cancer and the price of screening. EMRI has a good cost-effectiveness ratio in screening when the risk of liver cancer is higher than 17.8%.
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Objective To evaluate the correlation between the expression level of Nanog gene and clinical outcomes of GP regimen in the advanced non-small cell lung cancer (NSCLC).Methods 62 patients of NSCLC were treated by GP method,and the outcomes were investiged between Nanog positive and nagetive patients.The expression level of Nanong was evaluated by RT-PCR and immunohistology.Results 30 out of 62 patients (48.4 ％) were Nanog positive,9 patients (28.1％) were Nanog positive,and 23 out of 32 patients were Nanog negative (71.9 ％) who have the positive effect (CR+PR).However,among 32 treatment nagetive cases,there were 21 cases (70.0 ％) who were Nanog positive and 9 cases (30.0 ％) were Nanog negatve.Survival analysis showed that 5-years lifetime of Nanog positive patients was shorter than Nanong nagetive patients.Conclusion Nanog overexpression decreases the sensitivity of GP regimen and lifetime of NSCLC patient.Nanog expression level may provide a useful factor for clinical treatment and prognosis of NSCLC patient.
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Objective To investigate the CT characteristics of anaplastic thyroid carcinoma and evaluate the diagnostic value of CT in this disease.Methods The CT findings of 10 patients with pathologically proved anaplastic thyroid carcinoma were retrospectively reviewed.The patients included 7 females and 3 males.Their age ranged from 25.0 to 78 years with median of 61 years.Multi-slices plain and post contrast CT scans were performed in all patients.Results Unilateral thyroid was involved in 6 patients.Unilateral thyroid and thyroid isthmus were both involved in 2 patients due to big size.Bilateral thyroid were involved in 2 patients.The maximum diameter of anaplastic thyroid carcinoma ranged from 2.9-12.8 cm with mean of (4.5 ± 1.4) cm.All lesions demonstrated unclear margins and envelope invasion.The densities of all lesions were heterogeneous and obvious necrosis areas were noted on precontrast images.Seven lesions showed varied calcifications,and coarse granular calcifications were found in 5 lesions among them.All lesions showed remarkable heterogenous enhancement on post-contrast CT.The CT value of solid portion of the tumor increased 40 HU after contrast media administration.The ratios of CT value which comparing of the tumor with contralateral sternocleidomastoid muscle were 0.69-0.82 (0.76 ± 0.18)and 1.25-1.41 (1.33 ± 0.28)on pre and post CT,respectively.Enlarged cervical lymph nodes were found in 6 cases (60.0％).It showed obvious homogeneous enhancement or irregular ring-like enhancement on post-contrast images and dot calcifications were seen in 1 case.Conclusions Relative larger single thyroid masses with coarse granular calcifications,necrosis,envelope invasion,remarkable heterogeneous enhancing and enlarged lymph nodes on CT are suggestive of anaplastic thyroid carcinoma.
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N-terminal pro-brain natriuretic peptide(NT-proBNP) with no biological activity is the best cardiac marker in the diagnosis,risk stratification,prognosis and therapeutic monitoring of the patients with cardiac dysfunction,and is one of the natriuretic peptides.In this review,we aim to the latest progress of NT-proBNP study on its change during peri-cardiopulmonary bypass,and its applications in the diagnosis of preoperative cardiac function and in the guidance of heart failure therapy.