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Objective ToinvestigatethefeasibilityofspectralvirtualnonGcontrast(VNC)takingtheplaceoftruenonGcontrast (TNC)inthyroiddiseases.Methods CTimagesof30patientswiththyroiddiseasewerecollected,includingTNC,spectraldualGphase contrastandconventionaldelayedcontrastimaging.36lesionswithcorrespondingsurgeryandpathologicalconditionswereselected forretrospectiveanalysis.Theradiationdose,imagequality,meanCTvalues,SNRanddiagnosticefficacybetweenTNCand VNC werecompared.Results Theeffectivedose(ED)andtotaldoseGlengthproduct(DLP)ofthespectraldualGphasecontrastscanswere bothsignificantlylowerthanthoseofTNCincombinationwithconventionaldualGphasecontrast(P＜0.05).Thesubjectivequality scoreofVNCwasslightlylowerthanthatofTNC (P＜0.05),howeveritwasacceptableforradiologistwithascoreabove3.The SNRofVNCimageswassignificantlylowerthanthatofTNC (P＜0.05).The meanCTvaluesofVNCimageswerelowerthan thoseofTNCimagesbutwithoutasignificantdifference(P＞0.05).TheabilityofVNCtodelineatenecrosis,calcification,andlymph nodemetastasisinthelesionwasconsistentwithTNC (k＞0.75).Conclusion TheimagequalityofVNCissatisfiedinthediagnosis ofthyroiddiseases.VNChassimilardiagnosticefficacytoTNCwitheffectivelyreducdingradiationdose,whichisapromisingclinical application.
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Objective To explore the value of dynamic contrast-enhanced MRI (DCE-MRI) based radiomics model in predicting the pathological complete response (pCR) to neoadjuvant chemotherapy (NAC) of breast cancer. Methods In this retrospective study, 91 patients who had received NAC and had pathological response results were collected in Meizhou people′s hospital from January 2016 to August 2018. A primary cohort consisted of 63 patients and an independent validation cohort consisted of 28 patients. The patients were divided into pCR group of 23 cases and non-pathological complete response (Non-pCR) group of 68 cases. All the patients underwent dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) before NAC. A list of radiomics features were extracted using the A. K software and the corresponding radiomics signature was constructed. Logistic regression was used to develop the prediction model. The predictive ability of the model was tested by using the area under the curve (AUC) of ROC analysis. Results The discrimination performance of radiomics signature yielded a AUC of 0.750 in the primary dataset and a AUC of 0.789 in the validation dataset. The model that incorporated estrogen receptor (ER), progesterone receptor (PR) and radiomics features was developed, and had an AUC of 0.859 in the primary dataset and an AUC of 0.905 in the validation dataset. Conclusion The radiomics predictive model, which integrated with the DCE-MRI based radiomics signature, ER and PR, can be used as a promising and applicable adjunct approach for predicting the pCR to NAC of breast cancer.
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Objective ToinvestigatethecorrelationandthediagnosticefficiencyofquantitativeDCE-MRIparametersandADC valueinhistopathologicalgradeinpatients withinvasiveductalbreastcancer.Methods The DCE-MRIquantitativeparameters (Ktrans,KepandVe),semiquantitativeparameters(W-in,W-outandTTP)andtheADCvaluewereanalyzedandcomparedaccording bydifferenthistopathologicalgradein90invasiveductalbreastcancerpatients.Results ThemeanvalueofKtrans washigheringradeⅢgroupthanthatingradeⅡgroup,andthemeanvalueofADCwasloweringradeⅢgroupthanthatingradeⅡgroup.Thedifferenceswere statisticallysignificant(P<0.05),butthecorrelationswereweak(|r|<0.30).TherewerenostatisticallysignificantdifferencesamongKep, Ve,W-in,W-out,TTPingradeⅡandgradeⅢ (P>0.05).TheAUCofKtrans,ADCandKtranscombinedwithADCwere0.647,0.685 and0.749,respectively.Conclusion TheDCE-MRIquantitativeparametersKtransandADCvaluehavecorrelationswithhistopathologicalgradeof invasiveductalbreastcancer.HigherKtransandlowerADCvalueindicatehigherhistologicalgrade,andKtranscombinedwithADCcould improvethediagnosticefficiency.
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Objective@#To explore the value of dynamic contrast-enhanced MRI (DCE-MRI) based radiomics model in predicting the pathological complete response (pCR) to neoadjuvant chemotherapy (NAC) of breast cancer.@*Methods@#In this retrospective study, 91 patients who had received NAC and had pathological response results were collected in Meizhou people′s hospital from January 2016 to August 2018. A primary cohort consisted of 63 patients and an independent validation cohort consisted of 28 patients. The patients were divided into pCR group of 23 cases and non-pathological complete response (Non-pCR) group of 68 cases. All the patients underwent dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) before NAC. A list of radiomics features were extracted using the A.K software and the corresponding radiomics signature was constructed. Logistic regression was used to develop the prediction model. The predictive ability of the model was tested by using the area under the curve (AUC) of ROC analysis.@*Results@#The discrimination performance of radiomics signature yielded a AUC of 0.750 in the primary dataset and a AUC of 0.789 in the validation dataset. The model that incorporated estrogen receptor (ER), progesterone receptor (PR) and radiomics features was developed, and had an AUC of 0.859 in the primary dataset and an AUC of 0.905 in the validation dataset.@*Conclusion@#The radiomics predictive model, which integrated with the DCE-MRI based radiomics signature, ER and PR, can be used as a promising and applicable adjunct approach for predicting the pCR to NAC of breast cancer.
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Objective To study the characteristics,operative timing,repair methods for iatrogenic bile duct injury caused by laparoscopic cholecystectomy.Methods Clinical data of 30 cases of iatrogenic bile duct injury found during or after laparoscopic cholecystectomy were studied retrospectively.Results There were type Ⅱ 1 bile duct injury in 9 patients,type Ⅱ 2 in 4 patients,type Ⅱ 3 in 2 patients,and type Ⅱ 4 in 15 patient.17 cases underwent immediate repair,13 cases did early repair.All cases followed up from 5 months to 10 years,the follow-up rate was 83.3％.1 case with end-to-end anastomosis and biliary stent underwent Roux-en-Y choledochojejunostomy for biliary stenosis 13 months postoperatively,4 cases underwent secondary Roux-en-Y choledochojejunostomy because of obstructive jaundice and the cicatricial anastomotic orifice stenosis one to one and half years after primary repairs.The remaining cases were doing well up to the end of the follow-up.Conclusion Most iatrogenic bile duct injury after laparoscopic cholecystectomy were high in position,while Roux-en-Y choledochojejunostomy is the mainstay of repair.
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Objective To evaluate the significance of laparoscopy in the diagnosis and treatment of unexplained acute right lower abdominal pain in women. Methods Clinical data of 52 women with unexplained acute right lower abdominal pain from April 1999 to April 2004 were retrospectively analyzed. Results Diagnosis was clarified under laparoscope in all the 52 patients, including 28 cases of acute appendicitis, 18 cases of acute pelvic inflammatory disease, 3 cases of ovarian cyst pediculotorsion, 2 cases of right tubal pregnancy, and 1 case of Crohn’s disease with iliac perforation. With exception of a conversion to open surgery in 3 patients, laparoscopic treatment was successfully completed in the remaining 49 patients. No surgical complications occurred. The patients were discharged from the hospital 2~6 days postoperatively. Conclusions Laparoscopy is a timely, safe and effective alternative for the diagnosis and treatment of unexplained acute lower right abdominal pain in women.
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<p><b>OBJECTIVE</b>To study the immunogenicity and safety of recombinant yeast-derived hepatitis B vaccine (YDV) in adults.</p><p><b>METHODS</b>One hundred and twenty-four healthy teachers aged 22 approximately 58 years with serum negative HBsAg, anti-HBs, anti-HBc and with normal temperature were randomly selected from Beipiao city, Liaoning province. All the subjects were immunized with 5 microg/0.5 ml of YDV made by Beijing Institute of Biologic Products, for three doses at an interval of one and six months, respectively.</p><p><b>RESULTS</b>The positivity of serum anti-HBs was 35.0%, 83.3%, 65.5% and 32.7% with a geometric mean titre (GMT) of 12.6 mIU/ml, 402.0 mIU/ml, 70.3 mIU/ml and 20.3 mIU/ml, respectively, three, seven, 12 and 24 months after immunization. The positivity and GMT of serum anti-HBs appeared the highest seven months after immunization, then began to decrease sharply. The positivity and GMT of serum anti-HBs in women was higher than that in men either three, or seven, or 12, or 24 months after immunization. The positivity of serum anti-HBs in those of 35 years or over was lower than that less than 35 years, seven months after immunization, but no age difference could be found 12 months after immunization. No local or systematic adverse reactions were found in all the subjects within three days after immunization.</p><p><b>CONCLUSION</b>The recombinant yeast-derived hepatitis B vaccine (YDV) is immunogenic and safe for adults, but the persistency of serum anti-HBs in after immunization should be followed-up further.</p>