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Objective:To investigate the predictive ability of Glypican-3 (GPC3) positive hepatocellular carcinoma based on the hepatobiliary specific contrast agent gadoxetate disodium enhancement of the liver imaging reporting and data system version 2018 (LI-RADS v2018) imaging features, and to assess the relevant clinical imaging features for postoperative recurrence in GPC3 positive HCC patients.Methods:This study was a cohort study. A total of 122 hepatocellular carcinoma patients who underwent gadoxetate disodium enhanced MRI examination with hepatic tumor resection in Henan Provincial People′s Hospital from January 2017 to December 2021 were retrospectively collected, including 96 GPC3 positive and 26 GPC3 negative patients. The imaging features defined by LI-RADS v2018 of HCC lesions were analyzed. Patients were followed up for 40 months to determine recurrence free survival (RFS). The logistic regression was used to analyze the risk factors of GPC3 positivity. An imaging model, and a clinical-imaging model which combined the patient′s alpha-fetoprotein levels were constructed. The efficacy of the model for predicting GPC3 positivity was assessed using receiver operating characteristic curves. Kaplan-Meier method was used to draw the survival curve, and the log-rank test was used to compare the RFS between GPC3 positive and negative patients. Risk factors affecting the recurrence of GPC3 positive HCC were assessed by Cox regression.Results:The results of logistic multivariate regression analysis confirmed that rim enhancement ( OR=5.685, 95% CI 1.229-26.287, P=0.026) and irregular tumor margin at hepatobiliary phase ( OR=4.431, 95% CI 1.684-11.663, P=0.003) were independent risk factors for GPC3 positive HCC. The area under the curve for predicting GPC3 positivity was 0.745 (95% CI 0.636-0.854) for the imaging model and 0.776 (95% CI 0.677-0.876) for the clinical-imaging model. The mean RFS in the GPC3 positive group was 22 months, and it was 32 months in the negative group. There was a statistically significant difference in RFS between the two groups ( χ2=5.15, P=0.023). The multivariate Cox regression analysis showed that the arterial rim enhancement ( HR=5.460, 95% CI 1.966-15.162, P=0.001), microvascular invasion ( HR=2.402, 95% CI 1.210-4.769, P=0.012), portal vein tumor thrombus ( HR=3.226, 95% CI 1.114-9.344, P=0.031) were independent risk factors for recurrence after hepatic tumor resection for GPC3-positive HCC. Conclusions:A model based on the LI-RADS v2018 imaging features of hepatobiliary specific contrast agent gadoxetate disodium enhancement can effectively predict GPC3 positive HCC. The arterial rim enhancement, microvascular invasion and portal vein tumor thrombus are independent risk factors for postoperative recurrence of GPC3 positive HCC.
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Objective:To explore the incremental value of subtraction technique in evaluating the major features of liver reporting and data system version 2018 (LI-RADS v2018) on gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA) enhanced MRI.Methods:The Gd-EOB-DTPA enhanced MRI of 117 pathologically verified hepatocellualr carcinoma(HCC) from 87 high-risk patients in Henan Provincial People′s Hospital from January 2019 to July 2020 was analyzed retrospectively. The major features of LI-RADS in arterial phase, portal venous phase, subtraction and combined images were evaluated including nonrim arterial phase hyperenhancement (Nonrim APHE), nonperipheral washout and enhancing capsule. The lesions were graded according to LI-RADS v2018. According to the lesion size (<20 mm, ≥20 mm) and T 1WI signal intensity (hypointensity, isointensity or hyperintensity), the patients were divided into different subgroups. Cochran′s Q test was used for the comparison of the detection rate of the major features of LI-RADS and the accurate diagnosis rate based on LR-5 as the diagnostic standard among multiple groups. McNemar test was used for the comparison between two groups. Results:For all HCC, hypointensity HCC and HCC ≥20 mm, the detection rate of Nonrim APHE (χ2=12.190, 12.500, 10.083, all P<0.001) and the accurate diagnosis rate of HCC (χ2=14.450, 12.500, 10.083, all P<0.001) of subtraction images from arterial phase were significantly higher than that of arterial images. For HCC<20 mm, the detection rate of Nonrim APHE combined with arterial phase images was significantly higher than that in arterial phase images (χ2=5.143, P=0.016). For all HCC and isointensity or hyperintensity HCC, the detection rate of nonperipheral washout combined with portal venous phase images was higher than that in portal venous phase images (χ2=7.111, 6.125, P=0.004, 0.008). The detection rate of enhancing capsule of subtraction images from portal venous phase was higher than that of portal venous phase images in all groups (all P<0.017). The accurate diagnosis rate of subtraction images from portal venous phase in all HCC and HCC≥20 mm was higher than that in portal venous phase images (χ2=6.722, 6.750, P=0.008, 0.006). The accurate diagnosis rate of LR-5 in all groups using subtraction images from arterial phase and portal venous phase was higher than that of MRI images (all P<0.013). Conclusion:For Gd-EOB-DTPA dynamic enhanced MRI, subtraction images from arterial phase and portal venous phase are better than arterial phase and portal venous phase images in displaying Nonrim APHE, nonperipheral washout and enhancing capsule, which can improve the LI-RADS classification of HCC.
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Objective:To explore the value of mammography-based radiomics for preoperative prediction of axillary lymph node metastasis in breast carcinoma.Methods:The clinical and X-ray data of female patients with pathologically confirmed breast cancer in Henan People′s Hospital from June 2013 to July 2017 were analyzed retrospectively. A total of 214 patients, aged 30-85 (53±11) years, were randomly divided into training set ( n=153) and verification set ( n=61) according to the ratio of 3∶1. According to pathological findings of the axillary lymph node metastasis, 99 cases were divided into positive group and 115 cases into negative group. The lesions were segmented and extracted in X-ray images of mediolateral oblique (MLO) and cranial caudal (CC). Three, nine and seven axillary lymph node metastasis related histologic features were selected from the high dimensional features of CC, MLO and CC combined MLO images by lasso regression model. According to the characteristics of imaging and clinical characteristics, the prediction model was constructed. The prediction ability of the model was verified by 10% cross validation. Results:The lymph node in positive group was larger than negative groups, the difference was statistically significant ( t=2.611, P<0.05). In the validation set, the area under curve (AUC) values of CC, MLO, CC combined with MLO images, clinical features and clinical features combined with CC and MLO images were 0.680, 0.723, 0.740, 0.558 and 0.714, respectively. Among them, CC combined with MLO images had the highest prediction efficiency, and AUC values were higher than CC alone, MLO images and CC combined with MLO images. Conclusions:Quantitative radiomics features of breast tumor extracted from digital mammograms are helpful for preoperatively predicting axillary lymph node metastasis. Future larger studies are needed to further evaluate these findings.
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In order to solve the pathological grading of hepatocellular carcinomas (HCC) which depends on biopsy or surgical pathology invasively, a quantitative analysis method based on radiomics signature was proposed for pathological grading of HCC in non-contrast magnetic resonance imaging (MRI) images. The MRI images were integrated to predict clinical outcomes using 328 radiomics features, quantifying tumour image intensity, shape and text, which are extracted from lesion by manual segmentation. Least absolute shrinkage and selection operator (LASSO) were used to select the most-predictive radiomics features for the pathological grading. A radiomics signature, a clinical model, and a combined model were built. The association between the radiomics signature and HCC grading was explored. This quantitative analysis method was validated in 170 consecutive patients (training dataset: = 125; validation dataset, = 45), and cross-validation with receiver operating characteristic (ROC) analysis was performed and the area under the ROC curve (AUC) was employed as the prediction metric. Through the proposed method, AUC was 0.909 in training dataset and 0.800 in validation dataset, respectively. Overall, the prediction performances by radiomics features showed statistically significant correlations with pathological grading. The results showed that radiomics signature was developed to be a significant predictor for HCC pathological grading, which may serve as a noninvasive complementary tool for clinical doctors in determining the prognosis and therapeutic strategy for HCC.
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Humains , Carcinome hépatocellulaire , Imagerie diagnostique , Tumeurs du foie , Imagerie diagnostique , Imagerie par résonance magnétique , Grading des tumeurs , Méthodes , Courbe ROCRÉSUMÉ
Objective To explore the value of mammogram texture analysis in prediction of metastasis of axillary lymph nodes for breast carcinoma.Methods Mammograms and clinical data of 171 patients with breast carcinoma confirmed by pathology were retrospectively analyzed,and all patients underwent axillary lymph node dissection (ALND).Then the patients were divided into axillary lymph node metastasis group and non-metastasis group according to the result of ALND.The texture features of these lesions were statistically analyzed,including gray-level histogram texture parameters (mean value,standard deviation,skewness,kurtosis and variance) and gray-level co-occurrence matrix texture parameters (energy,entropy,correlation,inertia,inverse difference moment and contrast).Results In all of 171 breast cancer patients,96patients had axillary lymph node metastasis,while 75 patients had no metastasis.Mammograms showed negative axillary lymph nodes in 119 patients and positive axillary lymph nodes in 52 patients,and the sensitivity and specificity of mammograms in the diagnosis of positive axillary lymph nodes was 48.96% (47/96) and 93.33% (70/75),respectively.Mammogram texture analysis showed the values of energy,entropy,inverse difference moment and correlation in axillary lymph node metastasis group were higher than those in non-metastasis group,while the values of inertia and contrast in the axillary lymph node metastasis group were lower than those in non-metastasis group (all P<0.05).The rest texture parameters had no significant differences between two groups (all P>0.05).Area under curve (AUC) for texture parameters of energy,entropy,inertia,inverse difference moment,correlation and contrast was 0.610,0.610,0.374,0.599,0.612 and 0.421 (all P<0.05),respectively.AUC of mammography,mammogram texture features,and the combination of mammography and texture features was 0.711,0.676 and 0.787 (all P<0.05),respectively.The sensitivity and specificity of mammogram texture features,the combination of mammography and texture features in diagnosis of axillary lymph nodes metastasis was 62.5% and 64.6%,66.7% and 82.7%,respectively.Conclusion Mammogram texture parameters are helpful for predicting axillary lymph node metastasis,and the combination of mammography and texture features can improve diagnostic efficiency of axillary lymph node metastasis.
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Objective To investigate the effect of special CT monochromatic images on improving imaging quality in Budd-Chiari Syndrome.Methods 40 patients with Budd-Chiari Syndrome underwent CT venography (CTV)with gemstone spectral imaging (GSI).Using the optimal contrast to noise ratio (CNR)curve of GSI software,the optimal CNR monochromatic images of the infe-rior vena cava and hepatic vein were chosen.The CT value of the intrahepatic segment of inferior vena cava,hepatic vein and the same level liver tissue were measured,and the CT value of the same region were measured on 140 kVp mixed energy images and 70 keV images.CNR on the optimal monochromatic images,the 140 kVp mixed energy images and 70 keV images were calculated respectively,and the image quality of the optimal monochromatic image,the 140 kVp mixed energy images and 70 keV images were subjective scoring.One-way ANOVA was used for statistical analysis using SPSS1 7.0 software.Results The optimal keVs from monochromatic images were distributed at 40 keV (50%)and (5 1 ± 1 )keV (50%)for IVC and 40keV (25%)and (53 ± 3)keV (75%)for HV.The CNR and CT value and subjective score of IVC/HV got from the optimal monochromatic images were signifi-cantly higher than those from 140 kVp mixed energy images and 70 keV images respectively(P <0.01 ).Conclusion The optimal monochromatic images provide higher image quality of IVC and HV in patientswithBudd-Chiari syndrome.
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Objective To investigate the short-term efficacy of CT-guided radiofrequency ablation (RFA) for the treatment of advanced non-small cell lung cancer. Methods During the period from June 2010 to June 2013, a total of 100 patients with advanced non-small cell lung cancer were admitted to authors’ hospital. The patients were equally and randomly divided into the study group (n=50) and the control group (n=50). The patients of the control group received concurrent radiotherapy and chemotherapy treatment, while the patients of the study group received CT-guided RFA. The clinical effect, changes in CT values after the treatment, the improvement of physical condition and postoperative complications were recorded, and the results were compared between the two groups. Results The remission rate of the disease in the study group was 86.0%, which was much higher than that in the control group (52.0%), and the difference between the two groups was statistically significant (P<0.05). After the treatment, the CT value of the study group was (14.1±3.9) HU, which was significantly lower than that of the control group (29.8±4.7 HU, P<0.05). The physical improvement rate of the study group (66.0%) was significantly higher than that of the control group (44.0%), the difference between the two groups was statistically significant (P<0.05). The occurrence of postoperative complications, such as pulmonary infection, chest pain, fever, thoracic effusion and gastrointestinal reaction, in the study group was strikingly lower than that in the control group (P<0.05). Conclusion For the treatment of advanced non-small cell lung cancer, CT-guided radiofrequency ablation is safe and less-invasive, it can improve the clinical short-term effect as well as the quality of life. Therefore, this technique should be recommended in clinical practice.
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Purpose To evaluate the diagnostic value of non-contrast-enhanced MR venography (NCE-MRV) for Budd-Chiari syndrome (BCS). Materials and Methods NCE-MRV and digital subtraction angiography (DSA) examination were performed in thirty-five patients with suspected BCS. The diagnostic agreement between them were compared. The sensitivity, specificity, accuracy, negative predictive value and positive predictive value were also calculated. Results In all 35 patients, 32 were diagnosed as BCS on DSA, and 33 on NCE-MRV. DSA showed inferior vena cava membrane stenosis in 8 patients compared to 10 on NCE-MRV;membrane obstruction in 7 compared to 6 on NCE-MRV, segmental stenosis in 3 compared to 4 on NCE-MRV;segmental obstruction in 10 compared to 10 on NCE-MRV, IVC thrombosis in 5 compared to 5 on NCE-MRV. The sensitivity, specificity, accuracy, negative predictive value and positive predictive value of NCE-MRV in diagnosing BCS were 100.0%, 67.8%, 97.1%, 100.0%and 96.9%, respectively. There was good intra-modality agreement (Kappa=0.89). NCE-MRV also demonstrated intra-hepatic collaterals in 30 patients, extra-hepatic collaterals in 27 cases, and accessory hepatic veins in 25 cases. Conclusion NCE-MRV has excellent diagnostic agreement with DSA in diagnosing inferior vena cava lesion in patients with BCS. It may be used in noninvasive diagnosis.
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Objective To assess the diagnostic value of capsule endoscopy (CE) and CT virtual endoscopy (CTVE) for small intestinal diseases.Methods The data of 31 patients with suspected small bowel diseases who were examined by both CTVE and CE were collected.The diagnostic rates of CE and CTVE was compared by paired data McNemar test,using the diagnosis confirmed by surgery or follow-up as the golden standard.Results The confirmed diagnosis of 31 patients were small intestinal tumor in 16,nontumorous lesion in 10 and no abnormal lesion in 5.CE identified positive findings in 24 patients,including 14 cases of tumorous lesion (with mis-location in 2 and failure in definite diagnosis in 7) and 10 cases of non-tumorous lesion.CTVE identified positive findings in 17 patients,including 14 cases of tumorous lesion (with mis-location in 1 and failure in definite diagnosis in 4) and 3 cases of non-tumorous lesion.The combination of CE and CTVE could identified positive findings in 26 patients,including 16 tumorous and 10 nontumorous lesions.The diagnostic rates of CE and CTVE for tumorous lesions were both 87.5% (14/16).The overall diagnostic rate of combined CE and CTVE was 83.9% (26/31),which was significantly higher than that of CTVE alone (54.8%,17/31) but similar to that of CE alone (77.4%,24/31).Conclusion Both CE and CTVE are effective in diagnosis of small intestinal lesions and the combined use of 2 methods can increase diagnosis yield.
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<p><b>OBJECTIVE</b>To describe the trend of multiple pregnancies and to compare the results with single pregnancy in Beijing from 1996 to 2010. Prevalence rates of pregnancy complications were compared between multiple and single pregnancies.</p><p><b>METHODS</b>In 1996, 1997, 1998, 1999, 2000, 2005, 2010, live births in two hospitals in Beijing were included to describe the trend of multiple and single pregnancy. Case-retrospective analyses were used. Information was collected, including maternal age, fetus number, delivery mode, with/without pregnancy induced diseases as hypertension, diabetes or anemia, gender of the baby, birth-weight and gestation etc. Linear regression analyses were applied to assess the trend of birth-weight and the rates of prevalence.</p><p><b>RESULTS</b>63 661 babies and 62 895 puerperal were involved in this study. From 1996 to 2010, prevalence of multiple pregnancies increased by 0.02%, prevalence of cesarean delivery among multiple pregnancy women increased by 2.25% and the proportion of women older than 30 years increased by 3.52% and 2.89% among multiple or single pregnancy women, annually. However, the birth-weight did not show obvious change in both multiple and single birth babies. No obvious change was observed in the prevalence of low birth weight. Prevalence rates of premature birth increased by 1.62% and 0.16% among multiple and single pregnancy women, annually. From 1996 to 2010, the mean values of birth-weight among single birth babies were larger than 3 250 grams and under 2 500 gram among multiple birth babies. Rates of prevalence on pregnancy induced hypertension and anemia were higher in multiple pregnancy women than in single pregnancy women. Differences of rates on prevalence rates of pregnancy diabetes between multiple and single pregnancy women were not statistically significant.</p><p><b>CONCLUSION</b>Prevalence of multiple pregnancies increased from 1995 to 2010 in Beijing. Mothers of multiples were more likely to get pregnancy complication than the single pregnancy women.</p>
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Adulte , Femelle , Humains , Nouveau-né , Grossesse , Chine , Épidémiologie , Complications de la grossesse , Épidémiologie , Issue de la grossesse , Grossesse multiple , Études rétrospectivesRÉSUMÉ
OBJECTIVE@#To observe the effect of Naoling decoction on the learning and memory behaviors and the expression of microglia and IL-6 in hippocampal CA3 region of rats with Alzheimer's disease (AD), and to elucidate the potential mechanism.@*METHODS@#Thirty SD rats were randomly divided into 5 groups: a normal group, a sham-operation group, an AD group, a Naoling decoction group and a Naofukang group. The spatial learning and memory behaviors of the rats were investigated by water maze and Y-maze. The Alzheimer's disease model was established by injecting Aβ1-42 into the hippocamal of the rats. Expression of OX-42 (one of the microglia specific markers) and IL-6 in the CA3 region of hippocamal was measured by immunohistochemical stain.@*RESULTS@#Morris water maze experiment showed that the escape latency of hidden platform in the AD group was significantly delayed (P<0.05) and the average times of passing was decreased (P<0.05). Y-maze test showed that the times needed to the learn how to evade the electrical stimulation in the AD group was most than in other groups (P<0.05). Compared with the AD group, the Morris water maze test and Y-maze test of the Naoling decoction group were significantly different (P<0.05). The expression of OX-42 and IL-6 in the CA3 region of hippocamal in the Naoling decoction group was decreased (P<0.05).@*CONCLUSION@#Naoling decoction can improve learning and memory, and weaken the expression of OX-42 and IL-6 in hippocampal CA3 of AD rats, which may partly be the therapeutic mechanism of Naoling decoction for AD.
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Animaux , Femelle , Mâle , Rats , Maladie d'Alzheimer , Traitement médicamenteux , Métabolisme , Région CA3 de l'hippocampe , Métabolisme , Anatomopathologie , Modèles animaux de maladie humaine , Médicaments issus de plantes chinoises , Utilisations thérapeutiques , Interleukine-6 , Génétique , Métabolisme , Apprentissage , Mémoire , Microglie , Anatomopathologie , Rat Sprague-DawleyRÉSUMÉ
Objective To investigate subtype of HPV infection among women at age of 25 to 54 years in Beijing. Methods From Sept. 2006 to Dec. 2008, 5552 reproductive women at age of 25 to 54 years classified into each 5-year as group were screened. Each participant completed a questionnaire and a sample of exfoliated cervical cells for liquid-based cytology and HPV subtype gene testing was performed.Results The overall prevalence of HPV was 6.68% (371/5552). High-risk HPV and Low-risk HPV prevalence were 5.76% (320/5552) and 2.00% (111/5552), respectively. The most common HPV types were HPV16 (2.61%, 145/5552), HPV58 (0. 97%, 54/5552), HPV33 (0.85%, 47/5552), HPV43 (0.74% ,41/5552) and HPV56(0.70% ,39/5552). There were two peaks of HPV prevalence: groups of 30 -34 years and 40 -44 years. Conclusion The most common HPV subtypes in Beijing were HPV 16,58, 33 and 43 and HPV prevalence showed a bi-medal age-specific curve.
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Objective To investigate high risk factors associated with cervical intraepithelial neoplasia (CIN) in married women aged 25 to 54 years in Beijing. Methods From Mar. 2007 to Sep.2008, 6339 married women at age of 25 to 54 years were selected randomly by cross sectional survey in a total of 137 communities of 12 districts or counties in Beijing. The interview was carried out with unified questionnaires, gynecological examination. The cervical smear cytology and high-risk human papillomavirus (HR-HPV) infection of cervical secretion were detected. Women with abnormal cervical cytology underwent colposcopy and cervical biopsy. Odd ratio (OR) and 95% confidence interval (CI) of related high risk factors with CIN were studied by logistic regression analysis. Results Among 6339 women, the prevalence rate of CIN including 4 squamous cell carcinoma (SCC) was 5. 90% (374/6339). By multinomial regression analysis, HR-HPV infection (95% CI: 9. 953 - 15.811 ), History of trichomonas vaginitis (95 % CI: 1. 046 -2. 104), oral contraceptives (95% CI: 1. 087 - 1. 806), age less than 45 years old ( 95% CI: 1. 069 -1. 828) were related with CIN. Conclusion Infection rate of HR-HPV is an independent risk factor of CIN, however, the history of trichomonas vaginitis, oral contraceptives and age less than 45 years old are related risk factors of CIN.
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Objective To investigate prevalence of cervical intraepithelial neoplasia (CIN) among the married women aged 25-54 years in Beijing.Methods With method of cross sectional survey,6339 married women at age of 25 to 54 years were selected randomly in 137 communities of 12 districts or counties in Beijing from March 2007 to September 2008.The cervical smear cytology and high-risk human papillomavirus (HPV) infection of cervical secretion were detected.Women with abnormal cervical cytology were underwent colposcopy and cervical biopsy.Results Among 6339 women,9.58% (607/6339) cases had abnormal cytological results,the colposcopy and cervical biopsy showed the rate of CIN was 5.84% (370/6339) in total selected women and 60.96% (370/607) in women with abnormal cervical cytology,including 4.65% (295/6339) in CIN Ⅰ,0.80% (51/6339) in CIN Ⅱ,0.38% (24/6339) in CIN Ⅲ; 0.06% (4/6339)in early invasive carcinoma (SCC).Based on geographical distribution,the rate of cervical lesions was 4.46% (42/942) in urban areas,6.27% (188/3000) in suburbs and 6.01% (144/ 2397) in outer suburbs (P > 0.05).Conclusion It was found that the incidence of CIN was 5.84% in married women aged 25-54 years in Beijing,which did not show significant prevalence in urban,suburb and outer suburbs region.
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Objective To investigate high risk human papillomavirus(HR-HPV)prevalence among married women in Beijing and to study the high risk flactors.nethods During March 2007 to September 2008.a total of 6185 married women sampled from 137 communities in 12 districts were screened bv HR-HPV DNA test and cytogical test.The interview was carried out with unified questionnaires.The databage was set up and twice entered in EpiDam 3.0.After checked up,the data were analyzed in SPSS 15.0.Results (1) The HR-HPV infection rate was 9.89%.The HR-HPV infection rate of the city zone,the suburb and the exurb were 9.34%,10.51% and 9.51% (P>0.05).The HR-HPV infection rate of the native and the oudander were 9.53%,11.30% (P<0.05).(2) The age distribution of HR-HPV infection was that the rate was around 10% among 25 to 44 age groups,which was the highest(11.21%) in 30 to 34 age group;then the rate was descended as the age raising,the rate of 50 to 54 age group was the lowest(7.78%).(3) Multiple logistic regression showed that the related risk factors of HR-HPV infection mainly included 1000 RMB and above of family income per person per month.possessing more than 1 sexual partner of her husband,outlander and hish levels of education.(4) The prevalence of cervical intraepithelial neoplasia(CIN)in HR-HPV positive group wag significantly higher than that in HR-HPV negative group(29.76% vs 3.32%,P<0.01).Conclusions(1)The HR-HPV infection rate among aged 25 to 54 years was 9.9% and there was no significant difference in area distribution.(2)The hish risk population which should strengthen screening was the married bearing-age women with high level of family income,outlander,high levels of education and her husband possessing more than 1 sexual partner.(3)HR-HPV infection is the main risk factor for CIN and cervical cancer.while does not provide a causal relationship with them.The high risk population should be checked regularly to understand the development of HR-HPV infection and CIN incidence.
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Objective To explore the diagnostic performance of 64-slice spiral CT combined with exercise treadmill test for coronary artery disease ( CAD). Methods Eighty-six patients suspected of CAD were divided into low risk group, intermediate risk group and high risk group according to estimated pretest probabilities of CAD. All patients underwent coronary angiography, 64-slice spiral CT and exercise treadmill test. With coronary artery stenosis rate >50% as positive findings, the sensitivity, specificity, positive predictive value ( PPV), negative predictive value ( NPV) and accuracy of 64-slice spiral CT and 64-slice spiral CT combined with exercise treadmill test in diagnosis of CAD were calculated. Results With coronary angiography as the "golden criteria", the sensitivity, specificity, PPV, NPV and accuracy of 64-slice spiral CT in diagnosis of CAD were 95.2% , 88.6% , 88.9% , 95.1% and 91.9% , respectively. The sensitivity of low risk group, intermediate risk group and high risk group was 100% , 100% and 92.6%, specificity was 94.4% , 94.1% and 66.7%, PPV was 80.0%, 91.7% and 89.3%, NPV was 100% , 100% and 75.0%, and accuracy was 95.5% , 96.4% and 86.1%, respectively. The sensitivity, specificity, PPV, NPV and accuracy of 64-slice spiral CT combined with exercise treadmill test in diagnosis of CAD were 97.6%, 97.7%, 97.6%, 97.7% and 97.7%, respectively. Conclusion 64-slice spiral CT combined with exercise treadmill test works well in screening CAD, especially for those with a low or intermediate estimated pretest probability.
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Objective To evaluate the clinical application value of multi-slice helical CT volumetric (VH) scanning in lumber spine. Methods One thousand of patients with back and leg pain who underwent CT examinations were selected as subjects. We simulated the traditional protocol of single-slice(SS) discrete scanning for L3/4, L4/5, and LS/S1 intervertebral discs. The VH scanning mode was performed with 120 kV, 210 mAs,pitch of 1.5 and coverage of 97. 5 mm. The simulated SS scanning mode was performed with 120 kV, 240 mAs and coverage of 45.0 mm. The diagnostic outcomes and the radiation doses were compared between the two scanning modes. Two groups doctors observed ten terms, including the osseous spinal stenosis,narrowed intervertebral space and so on in two scanning modes respectively. Then consistency analysis of the data was carried out. Results The VH scanning mode showed far more features than the SS mode. The detection rates of the VH mode in the osseous spinal stenosis, narrowed intervertebral space,herniated nucleus pulposus, narrowed lateral recess, vertebral lesion, hypertrophy of L5 transverse process,abnormal direction of facet, facet degeneration, lumbar spondyloschisis, and paraspinal soft tissue were 11.8% (n =118), 38. 5% (n =385), 9. 3% (n =93), 46. 8% (n =468), 31.4% (n =314), 5.7% (n =57), 25.4% (n = 254), 49. 7% (n = 497), 9.9% (n = 99), and 0. 6% (n = 6) respectively, while the detection rates of the SS mode in ten terms were 5.6% (n = 56), 0, 0. 6% (n = 6), 27. 9% (n = 279),22.4% (n =224), 1.2% (n = 12), 16.7% (n = 167), 37.2% (n =372), 0.5% (n =5), and 0.2%(n = 2) respectively. The difference between the two groups had statistically significance (average P <0.05), except the paraspinal soft tissue abnormal (P > 0.05). The detection rates of the VH mode were higher than the SS mode in the osseous spinal stenosis, narrowed intervertebral space, herniated nucleus pulposus, lumbar spondyloschisis, being 6.2% (n = 62) , 38. 5% (n = 385) , 8.7% (n = 87), and 9.4%(n =94), respectively. In addition, VH mode only partially showed the articular facets, narrowed lateral recess, hypertrophy of L.5 transverse process, and paraspinal soft tissue. We could not acquire the imaging slices paralleling to intervertebral discs in SS mode in 467 patients (46.7%) with lumbosacral angle greater than 35°. The radiation dose of VH mode (164.9 mGy/em) was slightly higher than SS mode (147.0 mGy/cm) Conclusion MSCT VH scanning mode can significantly improve the diagnostic rate of lumbar spine diseases compared with SS mode, and was not restricted by the lumbosacral angle with slightly increasing radiation dosage.
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Aim To develop a rapid and inexpensive method for purification of human albumin, a method of immunomagnetic microspheres (IMMS) based on enzyme-linked immunosorbent assay (ELISA)for the purification of human albumin from human serum. Methods Polystyrene magnetic microspheres with carboxyl groups as carriers were prepared, and then the carboxyl groups on the surface of the microspheres were activated by ethylcarbodiimide (EDC). Finally rabbit anti-human serum albumin (HSA) antibodies were covalently bound to it and the complex can specifically capture HSA. After the procedure of capturing HSA, through taking rabbit anti-human albumin protein antibodies as a capture antibody, and goat anti-human albumin protein antibodies as a detection antibody, an ELISA on IMMS was developed, which can determine the recovery yield of HSA from the human serum. Results The result of the experiment was that the recovery of human albumin with IMMS was (86 ± 4) % , and IMMS were reused for two other purifying cycles, the results of which were (69.0 ± 0.6) % and (40.8 ± 0.8) % , and the purity of the product was about 90%. Conclusion The results above prove that the immunomagnetic purifiying strategy was shown to be efficient and offers an new thought for a large scale production of highpurity HSA.
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Objective To explore the incidence features of neonatal congenital hypothy roidism in Lianyungang area.Methods The heel blood samples dried on filter paper was collected from newborns after 72 hours.Serum thyroid stimulating hormone(TSH)level was detected by Dissociation enhancement lanthanide fluoroimmuno assay(DELFIA).The cases diagnosed were analyszd for the clinicl characters and the incidence features.Result One hundred and fifty-eighet children with CH were diagnosed and the patients lived in 63 towns(streets)(66.3%).The distribution of CH was diffuse in Lianyungang.There was significant difference in incidence of CH between 2007 to June of 2008 and before 2006.Eighty-two patients were examined by thyroid gland color ultrasound,among which there were sixty-eight patients whoes thyroid glands were normal(82.9%)and fourteen patients were unusal(absent,replacement,hypogenesis)(17.1%).A couple of twins(male)and two embryoes from the same parents were screened for CH.Conclusion There are iodine lack(MUI300?g/L)individual among people.The iodine nutrition condition of pregnant women is one of important factor to influence the TSH level of newborns.Neonatal screeing is the only valid means to find patients with CH.
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To study the bioequivalence of a kind of progesterone sustained release suppository, a randomized cross-over study was conducted in 12 rabbits. A single rectal dose of 2.75 mg/kg progesterone sustained released suppository (tested formulation, T) and progesterone suppository(reference formulation, R) was administered; a multiple dose of 2.75 mg/kg was given up to seven times with an interval of 8 h. Concentrations in serum were determined by a competitive enzyme immunoassay. The main parameters of T were: for single and multiple doses, Cmax was 48.8±11.8ng/mL and 43.5±9.4 ng/mL, Tmax was 0.5±0.3 h and 0.4±0.3 h, AUC(0-24h) was 362.4±143 ng·h·mL-1 and 310.6±70.3ng ·h·mL-1,respectively.The relative bioavailability of T to R were ( 104.2 ±13.4) % and ( 111.4 ± 19. 1 ) %, respectively. Statistical analysis showed that the two formulations were bioequivalent and T had sustained released feature.