A Thyroid Ultrasound Image-based Artificial Intelligence Model for Diagnosis of Central Compartment Lymph Node Metastasis in Papillary Thyroid Carcinoma / 中国医学科学院学报

Objective To establish an artificial intelligence model based on B-mode thyroid ultrasound images to predict central compartment lymph node metastasis(CLNM)in patients with papillary thyroid carcinoma(PTC). Methods We retrieved the clinical manifestations and ultrasound images of the tumors in 309 patients with surgical histologically confirmed PTC and treated in the First Medical Center of PLA General Hospital from January to December in 2018.The datasets were split into the training set and the test set.We established a deep learning-based computer-aided model for the diagnosis of CLNM in patients with PTC and then evaluated the diagnosis performance of this model with the test set. Result The accuracy,sensitivity,specificity,and area under receiver operating characteristic curve of our model for predicting CLNM were 80%,76%,83%,and 0.794,respectively. Conclusion Deep learning-based radiomics can be applied in predicting CLNM in patients with PTC and provide a basis for therapeutic regimen selection in clinical practice.

Prevalence and risk factors of Blastocystis infections among primary school students in Jiangjin District, Chongqing City / 中国血吸虫病防治杂志

Objective To investigate the prevalence and risk factors of Blastocystis infections among primary school students in Jiangjin District, Chongqing City. Methods A cross-sectional questionnaire survey was conducted among students sampled from a primary school in Jiangjin District, Chongqing City on April, 2018, and their stool samples were collected for microscopic examinations, in vitro culture and PCR assays to analyze the prevalence of Blastocystis infections and subtype of the parasite. In addition, the risk factors of Blastocystis infections among primary school students were identified using univariate analysis and multivariate logistic regression analysis. Results A total of 466 primary students were surveyed, and the subjects had a mean age of (9.81±1.66) years and included 236 males (50.64%) and 230 females (49.36%). The prevalence of Blastocystis infections was 15.24% (71/466) among the study students, and there was no significance difference in the prevalence between male and fe- male students (16.52% vs. 13.91%; χ2 = 0.616, P = 0.433). In addition, there was a significant difference in the prevalence of Blastocystis infections among grade 1 (6.35%, 4/63), grade 2 (5.17%, 3/58), grade 3 (21.74%, 15/69), grade 4 (25.30%, 21/83), grade 5 (10.19%, 11/108) and grade 6 students (20.00%, 17/85) (χ2 = 15.410, P = 0.009). There were four Blastocystis subtypes characterized (ST1, ST3, ST6 and ST7), in which ST6 was the most common subtype (45.07%, 32/71), followed by ST3 (25.35%, 18/71). Multivariate logistic regression analysis revealed that minority ethnicity [odds ratio (OR) = 4.259, 95% confidential inter- val (CI) : (1.161, 15.621)] and low maternal education level (primary school and below) [OR = 9.038, 95% CI: (1.125, 72.642)] were identified as risk factors of Blastocystis infection among primary school students in Jiangjin District, Chongqing City. Conclusions There is a high prevalence of Blastocystis infections detected among primary school students in Jiangjin District, Chongqing City, and ST6 and ST3 are predominant subtypes. Minority ethnicity and low maternal education level (primary school and below) are risk factors for Blastocystis infections in primary school students.

A new benzophenone isolated from fibrous roots of Anemarrhena asphodeloides / 中国中药杂志

Five compounds were isolated from the fibrous roots of Anemarrhena asphodeloides by silica gel, Sephadex LH-20 and semi-HPLC column chromatography. On the basis of physic-chemical properties and spectroscopic data analysis, these compounds were identified as methyl 2-[2,4-dihydroxy-3-(4-hydroxybenzoyl)-6-methoxyphenyl]acetate(1), 4-[formyl-5-(methoxymethyl)-1H-pyrrol-1-yl]butanoate(2), perlolyrine(3),syringaresinol-4'-O-β-D-glucoside(4) and 4',6-dihydroxy-4-methoxybenzophenone-2-O-(2″),3-C-(1″)-1″-desoxy-α-L-fructofuranoside(5). Among them, 1 was a new benzophenone. Compounds 2-5 were isolated from this plant for the first time. Compound 1 was tested for neuroprotective effects against H_2O_2-induced damage in SH-SY5 Y cells.

Variation of neck EMG and mechanical characteristics during the process of cervical traction / 医用生物力学

Objective To observe changes of surface electromyography (sEMG) in cervical traction under different loading weight and at different angles, and compare the muscle activity changes obtained by experiment with simulation results obtained by AnyBody cervical modeling, so as to verify the rationality of the simulation results. Methods Ten young volunteers with supine cervical traction were selected to test the sEMG signals of bilateral sternocleidomastoid (SCM) and upper trapezius (UT) muscles by using the JE-TB0810 surface EMG device. The average EMG (AEMG) and mean power frequency (MPF) were used to analyze the variation patterns of sEMG in cervical spine. Results The AEMG values of SCM and UT muscles increased as the loading weight and traction angles increasing, with a statistically significant difference (P0.05). The experimental results were consistent with muscle force activity characteristics of SCM and UT muscles by modeling and simulation of cervical traction. Conclusions The simulation results are reasonable. The traction weight should be loaded reasonably according to the excitation and fatigue of the cervical muscles in clinic. This can both reach the treatment effect and improve the patient’s comfort, which will provide an important reference for further development and improvement of the cervical traction device.

Academic features of tuina for children in western Hunan district / 中国针灸

Through the experiences in the clinical application of Liu Kai-yun's five-meridian theory of Tuina for children and consulting the relevant literatures, the following academic features of Tuina for children in western Hunan district are summarized in this paper: selecting the acupoints according to the pattern/syndrome differentiation and giving the treatment according to the meridian tropism theory; emphasizing the property of the body constitution and applying the reinforcing and reducing techniques; exquisitely combining the acupoints based on the five-meridian theory; coordinating the opening and closing techniques and regulating yin and yang. All of those provided the reference for the theoretic application of this Tuina school.

Deviation index of eye and mouth on peripheral facial paralysis / 中国针灸

Differences of some points, levels and angles of the healthy and affected sides of patients with peripheral facial paralysis were picked out according to photographs. Through analysis of the index between the healthy and affected side of the patients and the difference between healthy people and patients, it is approved that those special points, levels and angles, which are called as deviation index of eye and mouth, can evaluate peripheral facial paralysis objectively and judge the degree of deviation. Therefore, it provides references for the diagnosis of facial paralysis and its degree judgement.

A 3-year study of patients with Kawasaki's disease complicated with coronary artery lesion / 中华风湿病学杂志

Objective To investigate the prognosis of patients with Kawasaki's disease complicated with coronary artery lesion and to provide evidence for diagnosis and treatment of these patients. Methods This study was conducted during January 2002 to June 2007. All patients diagnosed as Kawasaki's disease complicated with coronary artery lesions were from the Affiliated Hospital of Guilin Medical College, the Second People's Hospital of Guangxi Province and Guilin Women and Childrens' Hospital. All cases were echocardiogram examined in month 3, 6, 12, 24 and 36 in the purpose of observing the morphology of coronary artery. The study subjects were re-categorized to the groups of mild, moderate dilatation of coronary artery and giant coronary aneurysm, based on the severity of coronary artery lesion. The results of these results of the three groups were compared. Results Eighty-four cases in the mild group, 27 cases in the moderate group and 8 cases in the giant coronary aneurysm. The recovery cases were 23 (27%), 3 (11%) and 0 in the 3 groups respectively at month 3. The above numbers were 44 (52%), 8 (30%) and 0 respectively at month 6.The numbers were 69(82%), 13 (48%) and 1 (13%) at month 12. The numbers were 78 (93%), 19 (70%), 3 (38%) at month 24. The numbers were 82(98%), 20(74%) and 4(50%) at month 36. Thirteen patients were treated with adenosine-triphosphate (ATP) stress echocardiography examiantion, 5 patients were evaluated by coronary angiography,and 4 patients were tested by 64-slice CT coronary reconstruction. Part of the patients were found to have coronary stenosis or occlusion. Conclusion Patients of Kawasaki's disease often have concurrent coronary artery lesions. Patients with mild dilatation of the coronary artery are the most commonly seen and have the best prognosis. On the contrast, patients with giant coronary aneurysm are the lest common situation and is the worst in prognosis. Part of them will develop coronary artery stenosis or occlusion in late stage which may lead to ischemic heart disease. We should stress on close follow-up of patients with Kawasaki's disease complicated with coronary artery lesion. Appropriate and timely treatment will increase their clinical outcomes.

The clinical value of using xMAP technology for detection of high-risk human papillomavirus / 肿瘤

Objective: To explore the clinical values of using flexible multi-analyte profiling (xMAP) technology for detection of high-risk human papillomavirus (HR-HPV). Methods: Six hundred and thirty eight cervical exfoliated cell samples were collected from women who lived in the region with high-incidence of cervical cancer in Shanxi province. The samples were tested with xMAP technology and Hybrid Capture 2 ® Assay (hc2). Pathological diagnosis was used as a hallmark to evaluate the detection results. HR-HPV infection rate and its genotyping distribution were analyzed and the coincidence of two methods above was assessed. Results: The sensitivity, specificity and accuracy of xMAP technology were 77.78%, 93.59% and 92.42%, respectively. The negative and positive predictive values were 98.13% and 49.30%, respectively. The prevalence rate of HR-HPV was 11.7%. HPV16 and 52 were the dominant types in non-neoplastic disease and cervical intraepithelial neoplasia (CIN) grade 1; HPV16 and 58 were the most common types in CIN2 samples; HPV16 was the most frequent type in CIN3 and cervical cancer. The lesion progress was positively related to the infection rate of HPV16, 52 or 58 (P<0.01). The Kappa value for agreement between xMAP technology and hc2 was 0.60. Conclusions: Compared with the hc2 test, the xMAP technology was highly specific, and the sensitivity is 77.78%. The agreement of these two methods is satisfactory. More improvements should be made to elevate the sensitivity of xMAP method and to increase the numbers of genotypes that can be detected.

Construction of recombinant bacillus Calmette-Guérin vaccine secreting human interferon-alpha 2b / 中华外科杂志

<p><b>OBJECTIVE</b>To construct a recombinant bacillus Calmette-Guérin vaccine (rBCG) secreting human interferon-alpha 2b (IFN alpha-2b).</p><p><b>METHODS</b>BCG Ag85B signal sequence and IFN alpha-2b gene were amplified from the genome of BCG and of human peripheral blood by polymerase chain reaction (PCR), respectively. IFN alpha-2b gene was cloned in E. coli-BCG shuttle-vector pMV261 to get pMV261-IFN alpha-2b. A new recombinant plasmid pMV261-IFN alpha-2b was constructed by inserting BCG Ag85B signal sequence into pMV261-Ag85B-IFN alpha-2b. Then, BCG was transformed with this recombinant plasmid by electroporation, and designated as rBCG-IFN alpha-2b. The DNA and protein expressions of IFN alpha-2b gene in rBCG were determined by PCR and Western blot respectively. Also the quantity of IFN alpha-2b protein secreted by rBCG in culture supernatants was determined by enzyme linked immunosorbent assay (ELISA).</p><p><b>RESULTS</b>By partial nucleotide sequencing, the DNA sequences of human IFN alpha-2b and BCG Ag85B were consistent with that in the Gene Bank, and were correctly inserted into the shuttle expression vector pMV261 to construct recombinant plasmid pMV261-Ag85B-IFN alpha-2b. BCG was successfully transformed with this recombinant plasmid by electroporation and the recombinant BCG (rBCG-IFN alpha-2b) was capable of synthesizing and secreting cytokine IFN alpha-2b. The concentration of IFN alpha-2b in culture supernatants was quantified by ELISA and calculated to be approximately 301.45 pg/ml.</p><p><b>CONCLUSIONS</b>Recombinant BCG secreting human IFN alpha-2b (rBCG-IFN alpha-2b) was constructed successfully and the specific IFN alpha-2b protein can be expressed highly and steadily by rBCG vaccine.</p>

Arbitrarily primed-PCR detection of Streptococcus mutans and Streptococcus sobrinus in dental plaque of children with high dmft and no caries / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To isolate and identify Streptococcus mutans (Sm) and Streptococcus sobrinus (Ss) in dental plaque of children with high dmft and no caries by selective medium, biochemical methods and arbitrarily primed-polymerase chain reaction (AP-PCR).</p><p><b>METHODS</b>A total of 401 3-4-year-old children from seven kindergartens were recruited using cluster sampling and their dental caries status were examined. From 30% of children with the highest dmft score (dmft >/= 5), 20 children were chosen randomly as test group and 20 age and gender-matched caries-free children were selected as control. Plaque samples were collected from buccal surfaces of the molars and plated onto TYCSB plate. Sm and Ss were primarily identified by colony morphology and biochemical characteristics. Then chromosomal DNA of the strains was isolated and Sm or Ss were confirmed by AP-PCR.</p><p><b>RESULTS</b>The proportion positive for Sm and Ss in children with high dmft was 100% and 40% respectively while that in caries-free children was 75% and 5% by AP-PCR analysis. The differences were statistically significant between the two groups.</p><p><b>CONCLUSIONS</b>The proportions positive for Sm and Ss detected by AP-PCR method were significantly higher in children with high dmft than in caries-free children and it is a risk factor for high dmft in deciduous teeth harboring Sm and Ss.</p>

Poor visualization of renal collecting system in intravenous urography as an indicator of invasive transitional cell carcinoma in the upper urinary tract / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Transitional cell carcinoma of the upper urinary tract (UUT-TCC) accounts for 5% to 10% of all renal tumours and 5% to 6% of all urothelial tumours all over the world. In China, the proportion of UUT-TCC to all urothelial tumours may be 26%, which is higher than that in the western world. The early diagnosis of UUT-TCC is difficult and the present study elucidates the diagnostic value of poor or nonvisualization (PNV) in intravenous urography in patients with UUT-TCC and its correlations with pathological findings and clinical characteristics.</p><p><b>METHODS</b>The data of 172 consecutive patients between January 1997 and January 2005 with UUT-TCC who underwent nephroureterectomy in our departments were selected and analyzed retrospectively.</p><p><b>RESULTS</b>Of our sample, 144 cases presented with gross haematuria (83.7%) and 12 with microscopic haematuria (7.0%). Forty-six cases (26.7%) were detectable by cytology. Filling defect identified 36 positive cases of 172 patients (20.9%), PNV was present in the images of 105 of 172 patients (61.0%). The detection rate by PNV (61.0%) was significantly different from that by cytology (26.7%) or by filling defect (20.9%) (P = 0.031, P = 0.001, respectively). Univariate logistic regression analysis for PNV showed that tumour stage, grade and size were significant predictors (P = 0.028; P = 0.031; P = 0.006, respectively). Tumour stage and size were identified as independent risk factors in the multivariate logistic regression model (P = 0.042; P = 0.014).</p><p><b>CONCLUSIONS</b>Except for suspected urolithiasis, urinary tuberculosis or congenital abnormalities, UUT-TCC should be considered if PNV exists in intravenous urography especially of old patients. The value of PNV is much more significant than filling defect in intravenous urography in the diagnosis of UUT-TCC. It is supposed that PNV carries more risk of higher stage and larger tumour size in UTT-TCC.</p>

Clinical evaluation of the xMAP technology in detection of high-risk human papillomavirus / 中国医学科学院学报

<p><b>OBJECTIVE</b>To evaluate the clinical application value of flexible multi-analyte profiling (xMAP) technology in detecting high-risk human papillomavirus (HR-HPV).</p><p><b>METHODS</b>Totally 1 061 women, aged 21-65 years, were randomly enrolled into the study. Cervical exfoliated cells were used in xMAP technology and hybrid capture II (hc2). Pathological diagnosis was used as golden standard. Consistency of these two methods was assessed.</p><p><b>RESULTS</b>The sensitivity and specificity of xMAP technology were 80.31% and 85.83%, respectively. The positive and negative predictive values were 44.5% and 96.9%, respectively. The Kappa value for consistency between xMAP technology and hc2 was 0.58.</p><p><b>CONCLUSIONS</b>The specificity of xMAP technology is similar to hc2 test, but the sensitivity is inferior to hc2. However, these two methods show good consistency in the detection of HR-HPV.</p>

Predictive factors for conversion of transurethral resection of the prostate to open prostatectomy / 中华男科学杂志

<p><b>OBJECTIVE</b>To evaluate the factors for the conversion of transurethral resection of the prostate (TURP) to open prostatectomy and to provide clinical evidence for surgical options.</p><p><b>METHODS</b>From January 1997 to March 2005, we performed 1 086 TURP and made retrospective analyses of 11 risk factors concerning the demographics, clinical history, laboratory data, ultrasound results, and intraoperative complications of the patients. In addition, multivariate logistic regression was used to determine those variables predicting the conversion of TURP.</p><p><b>RESULTS</b>Thirty-nine (3.59%) of the TURP cases required conversion, mostly because of uncontrollable hemorrhage (71.79%). Multivariate analyses showed that a prostate volume > 85.2 ml (OR = 2.568, P < 0.01), intraoperative slit of capsula prostatic (OR = 1.916, P < 0.01) and a second midstream bladder specimen (VB2) white blood cell count of the urine > 13.5/HP (OR = 1.486, P < 0.01) predicted the conversion to open prostatectomy.</p><p><b>CONCLUSION</b>Benign prostatic hyperplasia (BPH) patients with a huge prostate and those with intraoperative slit of capsula prostatic undergoing TURP are more likely to be converted. And uncontrollable hemorrhage, huge prostate and poor endoscopic vision are the major reasons for the conversion.</p>