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Objective:To explore the value of ultrasound-based radiomics combined with clinical parameters in predicting lymph node metastasis of endometrial cancer.Methods:The clinical data and preoperative ultrasound images of 255 patients with endometrial cancer diagnosed after operation in the First Affiliated Hospital of Guangxi Medical University from January 2017 to February 2021 were analyzed retrospectively. The boundary of the tumor, that is, the region of interest(ROI), was determined manually by ITK-SNAP software, and the features were extracted from it. Through random sampling, the data were divided into training group used to build the model and verification group used to evaluate the reliability of the model at the proportion of 7∶3.In the training group, the spearman correlation coefficient was used as the threshold of 0.95 to remove the features with high correlation. The importance of the features were ranked by the decision tree model, the features of the top 6% importance were selected to establish a logical regression model, and then calculated the Radiomics score of each patient. On the basis of logical regression analysis, a comprehensive prediction model was established, the line diagram was drawn, and the prediction effect was evaluated by the analysis of the area under the subject working curve (AUC), calibration curve and the decision curve.Results:After dimensionality reduction and logical regression analysis, 20 features and 2 clinical parameters (CA125, CA153) were obtained to build the model. The AUC of training group and verification group in radiomics model and comprehensive prediction model were 0.81, 0.78 and 0.89, 0.85, respectively. The decision curve analysis showed that both of them had good clinical utility.Conclusions:The ultrasound-based radiomics model and the comprehensive model combined with relevant clinical parameters are effective in predicting lymph node metastasis of endometrial cancer.
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Objective@#To explore mechanism of lung injury of rats induced by inhalation of white smoke from burning smoke pot.@*Methods@#Forty-eight Sprague Dawley rats were divided into control group (n=12) and injury group (n=36) according to the random number table. Rats in injury group were placed in smoke-induced injury experimental equipment fulled with white smoke from burning smoke pot for 5 minutes to make lung injury, and rats in control group were placed in smoke-induced injury experimental equipment fulled with air for 5 minutes to make sham injury. Six rats in injury group at post injury hour (PIH) 6, 24, and 72 and six rats in control group at PIH 72 were collected to observe pathological changes of lung tissue and pathological score of rats in the two groups by hematoxylin-eosin staining, to detect expression of nuclear factor-κB (NF-κB) p65 mRNA in lung tissue of rats by reverse transcriptional polymerase chain reaction, and to detect content of tumor necrosis factor α (TNF-α), interleukin 1β (IL-1β), and IL-6 in lung tissue of rats by enzyme-linked immunosorbent assay. Data were processed with one-way analysis of variance and t test.@*Results@#At PIH 72, lung tissue structure of rats in control group was clear and complete, with no inflammatory cell infiltration. At PIH 6, there was edema, hemorrhage, and inflammatory cell infiltration in lung tissue of rats in injury group. At PIH 24, edema, hemorrhage, and inflammatory cell infiltration in lung tissue of rats in injury group aggravated. At PIH 72, area of edema in lung tissue of rats in injury group was enlarged, with obvious hemorrhage and inflammatory cell infiltration. At PIH 6, 24, and 72, pathological score of lung tissue of rats in injury group was (3.43±0.86), (5.39±0.93), and (9.99±0.84) points, respectively, obviously higher than that of rats in control group at PIH 72 [(2.11±0.20) points, t=3.659, 8.450, 22.355, P<0.05]. As time post injury prolonged, pathological scores of lung tissue of rats in injury group were significantly increased (F=121.244, P<0.01). At PIH 6, 24, and 72, expression of NF-κB p65 mRNA in lung tissue of rats in injury group was 15.5±4.3, 25.9±1.8, 30.9±3.5 respectively, significantly higher than that of rats in control group at PIH 72 (7.8±0.8, t=4.315, 20.445, 14.408, P<0.01). As time post injury prolonged, expression of NF-κB p65 mRNA in lung tissue of rats in injury group gradually increased (F=32.691, P<0.01). At PIH 6, 24, and 72, content of TNF-α, IL-1β, and IL-6 in lung tissue of rats in injury group was significantly higher than that of rats in control group at PIH 72, respectively (t=7.650, 8.968, 6.827, 6.726, 8.978, 3.460, 5.420, 13.289, 16.438, P<0.01). At PIH 24, content of TNF-α and IL-1β in lung tissue of rats in injury group was higher than that of rats in the same group at PIH 6 and 72, respectively (t=3.409, -2.549, 4.047, -4.100, P<0.05). At PIH 24 and 72, content of IL-6 in lung tissue of rats in injury group was respectively higher than that of rats in the same group at PIH 6 (t=8.273, 9.711, P<0.05).@*Conclusions@#After inhaling white smoke from burning smoke pot, rats are inflicted with lung injury by increasing expression of NF-κB p65 mRNA and content of TNF-α, IL-1β, and IL-6, and induce pathological changes of edema, hemorrhage, and inflammatory cell infiltration of lung tissue.
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Objective To study the correlation between laryngopharyngeal reflux (LPR) and secretory otitis media (SOM).Methods A total of 294 adult patients with reflux-related symptoms were recruited in this study.The patients were evaluated with reflux symptom index (RSI) and reflux finding score (RFS).Tympanometry was conducted to all the patients.The 54 patients with the otitis media effusion with type B tympanograms were tested by auripuncture.Results Among the 294 patients,168 cases showed RSI＜13,in which 128 cases,31 cases and 9 cases had type A,type C,and type B tympanograms,respectively.The other 126 patients showed RSI＞13 in which 52 cases,29 cases and 45 cases had type A,type C,and type B tympanograms,respectively.Among the 294 patiems,172 patients showed RFS＜7,in which 131,32 and 9 cases had type A,type C,and type B tympanograms,respectively.The left 122 patients showed RFS＞7,in which 49,28 and 45 cases had type A,type C,and type B tympanograms,respectively.The ratio of type B tympanograms in the patients with RSI＞13 and RFS＞7 were both significantly higher than those in the patients with RSI＜13 and RFS＜7 (P＜0.05).The RSI scores of patients with type A,C,and B tympanogram were 8.6± 3.8,15.9±7.5,and 23.9±8.6,respectively,and the RFS score were 5.6±2.6,9.6±4.7,and 15.3±6.6,respectively.Compared with type A and C,the patients with type B tympanogram had significantly higher RSI and RFS score (P＜ 0.05).Among the 54 patients of type B tympanograms,those with RSI＜13 were found to have serous fluid,grume fluid,glue fluid as in 6 cases,2 cases,and 1 case,while the patient of the RSI＞ 13 had serous fluid,grume fluid,glue fluid in 13 cases,23 cases,and 9 cases,respectively.The otitis media effusion of the patients with the RSI＜13 were mainly serous,while those with the RSI＞13 were mainly sticky.Conclusion The correlation between LPR and SOM was significant.LPRmay accelerate the progress of SOM.
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Objective To evaluate the clinical effect of dacryocystorhinostomy under nasal endoscope combined with lacrimal duct catheterization.Methods The retrospective comparative study was used to analyze 120 patients with chronic dacryocystitis in our hospital from June,2012 to May,2016,of whom 60 patients were treated with traditional dacryocystorhinostomy,and 60 patients were treated with dacryocystorhinostomy under nasal endoscope combined with lacrimal duct catheterization.Half year after the operation the patients were re-examined for the patency of their lacrimal passages and postoperative complication.The disappearance of tearing and the unobstructed patency of the lacrimal passages were set as the standard of a successful operation.The statistically analyzing was performed.Results Six months after operation,the success rate of dacryocystorhinostomy under nasal endoscope combined with lacrimal duct catheterization was 93.3％,the success rate of traditional dacryocystorhinostomy was 90.0％,without statistical difference between two types of operation (P ＞ 0.05).The skin scar formation rate in dacryocystorhinostomy under nasal endoscope combined with lacrimal duct catheterization was 0,while 100％ in traditional dacryocystorhinostomy,with statistical significant difference (P =0.00).The success rate of two-stage operation was 100％ after dacryocystorhinostomy under nasal endoscope combined with lacrimal duct catheterization for recurrence,while 16.7％ after traditional dacryocystorhinostomy,the difference is of statistical significance (P =0.048).Conclusions Dacryocystorhinostomy under nasal endoscope combined with lacrimal duct catheterization is not only reliable,effective method for treating chronic dacryocystitis,but also with less iatrogenic trauma,and no scar.
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Objective To observe the clinical effect of albendazole combined with cimetidine in the treatment of hepatic hydatid disease.Methods 60 cases with liver hydatid disease from 2010 to 2014 wrer selected,and they were randomly divided into two groups,30 cases in each group.The control group was treated with albendazole tablets,2 times daily,2 capsules/time.The treatment group was intravenously injected cimetidine based on the treatment of the control group.Before and after treatment,the ultrasound imaging changes and clinical effect were observed.Results In the control group,the total effective rate was 83.33%(25 /30).In the treatment group, the total effective rate was 96.67%(29 /30).The total effective rate between the two groups had statistically signifi-cant difference(χ2 =9.842,P <0.01).Conclusion Albendazole combined with cimetidine in treatment of hepatic hydatid disease has good curative effect,which can be viewed as first choice in the treatment of hydatid disease.
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Objective To evaluate the efficacy of intratympanic steroid therapy compared with systemic ster‐oid therapy on the treatment of idiopathic sudden sensorineural hearing loss (ISSNHL) patients with damaged glu‐cose tolerance .Methods Fifty first -diagnosed unilateral ISSNHL patients with damaged glucose tolerance were randomized devided equally to the intervention group (intratympanic steroid therapy) or the control group (systemic steroid therapy) ,all patients received conventional drug therapy simultaneously .Pure-tone hearing threshold tests were performed in all patients every 3 days after the first time ,and repeated measures anova was used to assess effects of hearing recovery accompanied with time .Results The mean hearing threshold in the control group de‐creased from 85 .4 ± 5 .6 dB to 48 .2 ± 4 .9 dB ,while in the intervention group it decreased from 84 .8 ± 5 .6 dB to 31 .7 ± 4 .6 dB .Total effective rate in the intervention group (84 .00% ,21/95) was higher than that in the control group (68 .00% ,17/25)(P<0 .05) .Conclusion The intratympanic steroid therapy is more effective than systemic steroid therapy in the treatment of ISSNHL patients with damaged glucose tolerance .
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<p><b>BACKGROUND</b>With the development of natural orifice trans-luminal endoscopic surgery, studies on transoral video-assisted thyroidectomy in preclinical experiments (e.g., human anatomy and animal trials) were progressing gradually. From 2009 to 2011, embalmed human cadavers were dissected to define the anatomical location, surgical planes, and related neural and vascular structures to create a safe transoral access to the front cervical spaces. Recently, experimental transoral endoscopic thyroidectomy was performed to verify the feasibility of this approach on 15 fresh specimens.</p><p><b>METHODS</b>Fifteen specimens were placed in the supine position with slight neck extension. Endoscopic incision was made on the midline between the Wharton's duct papillae and two other incisions were made on mandibular first premolar buccal mucosa. Sublingual combined bilateral vestibular tunnels were created from oral cavity to the cervical region. The neck subplatysmal working space was insufflated with CO2 at 6-8 mmHg. The bilateral thyroid lobes and central lymph nodes were dissected under craniocaudal view.</p><p><b>RESULTS</b>Three incisions were made in the oral cavity without any incisions on the body surfaces. The distance from the oral cavity to front neck region was the shortest. Bilateral thyroid lobes and central neck region were fully resected via transoral approach. This approach provided a craniocaudal view, in which retrosternal thyroid gland and lymph nodes were easily accessible. The recurrent laryngeal nerve could be identified safely on the inferior cornu of the thyroid cartilage. The only structure at risk was the mental nerve. Camera motion was somewhat limited by the maxillary dentition. The volume of harvested thyroid nodule through sublingual tunnel in the fifteen human cadavers was (40 ± 15) cm(3).</p><p><b>CONCLUSION</b>The transoral procedure is progressive and innovative which not only gives the best cosmetic result and minimal access trauma but also provides a craniocaudal view.</p>
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Femenino , Humanos , Masculino , Cadáver , Endoscopía , Métodos , Disección del Cuello , Métodos , Tiroidectomía , Cirugía Asistida por Video , MétodosRESUMEN
Objective To evaluate the curative effect,safety,advantages and disadvantages of helix hydro-jet and holmium laser lithotripsy in the treatment of intrahepatic bile duct stones.Methods 158 patients of intrahepatic bile duct stones were divided into helix hydro-jet group (n =82) and helix hydro-jet group (n =76).Time of lithotripsy,frequencies of lithotripsy,residual stone,intraoperative hemorrhage,postoperative hemorrhage,stone recurrence rate,postoperative fever,and therapeutic efficacy were compared between the two groups.Results There was no significant difference between the two groups on frequency of lithotripsy,residual stone rate and stone recurrence rate (P ＞ 0.05) ; whereas intraoperative washing normal saline (2 300 ± 275) ml vs (2 850 ± 331) ml,(P =0.002),the time of lithotripsy (54.2 ± 15.3) min vs (38.1 ± 12.7) min,P =0.041,intraoperative hemorrhage (19 cases vs 29 cases,P =0.041),Intraoperative analgesia (2 cases vs 9 cases,P =0.032),postoperative hemorrhage (11 cases vs 21 cases,P =0.037),and postoperative fever (30 cases vs 62 cases,P =0.027) had significant differences(P ＜ 0.05).Conclusions Both helix hydro-jet and the holmium laser lithotripsy is safe and effective for the treatment of intrahepatic bile duct stones.Holmium laser is more efficient than Helix Hydro-jet,while helix hydro-jet is safer than holmium laser in lithotripsy.
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Objective To discuss the value of ultrasonic examinion in laparoscope's thyroidectomy.Methods 41 cases who were performed in laparoscope's thyroidectomy were checked by color Doppler flow imaging and two dimensional sonography,the key of examination:(1)The length and depth of thyroid isthmitis.(2)Trachea curve degree and the depth in up-sternum.(3)The reference between thyroid,calvicle and sternum.(4)Thyroid tumefaction degree over sternomastoid.(5)Thyroid tumer's number,position and size.(6)Tumer's kind.(7)Bloodstream change.Results Only 1 case turned open.1 case recured in hyperthyroidism.Hoarseness occured in loose after operation and come-into being after 1 mouth.No trachea and parathyroid hurt appeared in any cases.The mean operation time was 125 minutes(range 86 to 193 minutes).The mean time stay in hospital was 9 days(range 6 to 15 days).Conclusion Ultrasonic examination before operation is very valuable.