RÉSUMÉ
Objective:To study the feasibility of magnetic resonance imaging(MRI)technique with amide proton transfer(APT)in predicting the prognosis of cerebral stroke.Methods:A total of 71 patients with acute cerebral stroke who admitted to the Nanjing First Hospital,Nanjing Medical University from September 2022 to May 2023 were selected.All of them underwent the test of National Institute of Health Stroke Scale(NIHSS),and received the MRI examination with chemical exchange saturation transfer(CEST).According to the modified Rankin scale(mRS)values of 1-month follow-up,they were divided into favorable recovery group(mRS<2,44 cases)and poor group(mRS≥2,27 cases).The asymmetric magnetization transfer ratio(MTRasym)image(APT)was obtained by analyzing data with special software.And then,the difference(△APTw)of APT values between ischemic zone and contralateral normal tissue was further calculated.The △APTw values of two groups were compared and analyzed,and the Pearson correlation analysis was adopted to analyze the correlation among △APTw,NIHSS and mRS.The receiver operating characteristics(ROC)curve was drawn,and the area under curve(AUC)of ROC curve was calculated.Results:There were significant positive correlations among △APTw,NIHSS and mRS scores(R2=0.659,0.522,P<0.001),and the differences of △APTW,NIHSS and mRS scores between the favorable recovery group and poor group were significant(t=5.73,6.36,13.92,P<0.05),respectively.The AUC value was 0.886,and the sensitivity and specificity of prediction were respectively 77.8%and 95.5%.The positive and negative predictive values were respectively 91.3%and 87.5%.Conclusion:APT imaging technique has feasibility in predicting the prognosis of acute cerebral ischemic stroke.
RÉSUMÉ
Objective To evaluate the value of magnetic resonance imaging (MRI) in screening for prostate cancer. Methods A total of 120 patients with a confirmed diagnosis of prostate cancer were enrolled in Nanjing Municipal First Hospital from March 2020 to March 2023, and 100 age-matched health volunteers during the study period served as controls. All patients and healthy individuals received prostate MRI scanning, and apparent diffusion coefficient (ADC) was estimated. Post-surgical pathology was used as a gold standard to evaluate the sensitivity and specificity of MRI in screening for prostate cancer. The correlation between pathological staging and ADC values in prostate cancer patients was investigated using Spearman correlation analysis. Results The mean ADC values were (1.01 ± 0.15) × 10−3, (0.88 ± 0.21) × 10−3, (0.72 ± 0.11) × 10−3, and (0.59 ± 0.09) × 10−3 mm2/s, respectively, for stage A, B, C, and D prostate cancer patients, and the differences were significant (F = 38.99, P < 0.01).Pearson correlation analysis showed a significant negative correlation between pathological staging and ADC value (r = −0.81, P < 0.05). In addition, the sensitivity and specificity of MRI in prostate cancer screening were 92.50% and 91.00%, respectively. Conclusion MRI shows a high value in screening for prostate cancer, and the ADC value is of great significance for staging prostate cancer.
RÉSUMÉ
The knowledge and technique of pre-hospital rescue are far from popularized in our country. Take for an example, patient with cardiac arrest can not get immediate and proper CPR on the scene. Furthermore, the staffs, skills and knowledge of emergency medicine of the staffs of the emergency departments, and the pre-hospital rescue teams are extremely inadequate to meet the need of the emergency medicine service for the whole society. Skill of emergency rescue and the admission system are not yet standardized to execute emergency medicine service. Because of the profession rank evaluation system for the emergency physicians lags far behind, and it is not applicable to the clinicians working in the emergency medicine service system (EMSS), including pre-hospital and in-hospital emergency systems, it is difficult to maintain a stable team of emergency physicians. The emergency medicine education has not yet been accommodated into the national medicine education program, and therefore its training course is not uniform and is self-generated. To improve the status of EMSS in our country, it is important to establish a perfect EMSS, to propagandize rescue knowledge with emphasis of CPR skill, and to enate laws for emergency rescue. The operation system of rescue and emergency should be in line with the international EMSS, and should establish “broad emergency system”. The emergency system in broad sense means that the emergency clinic should not be split into different specialties, and the emergency medicine should be looked upon as a specialty or discipline by itself, to include all the life-saving technology of all of the acute and urgent illnesses both outside and inside of the hospital, and the treatments should be integrated with that of all the related departments of the hospital.