A logistic regression model for prediction of glioma grading based on radiomics / 中南大学学报(医学版)

OBJECTIVES@#Glioma is the most common intracranial primary tumor in central nervous system. Glioma grading possesses important guiding significance for the selection of clinical treatment and follow-up plan, and the assessment of prognosis. This study aims to explore the feasibility of logistic regression model based on radiomics to predict glioma grading.@*METHODS@#Retrospective analysis was performed on 146 glioma patients with confirmed pathological diagnosis from January, 2012 to December, 2018. A total of 41 radiomics features were extracted from contrast-enhanced T@*RESULTS@#A total of 5 imaging features selected by LASSO were used to establish a logistic regression model for predicting glioma grading. The model showed good discrimination with AUC value of 0.919. Hosmer-Lemeshow test showed no significant difference between the calibration curve and the ideal curve (@*CONCLUSIONS@#The logistic regression model using radiomics exhibits a relatively high accuracy for predicting glioma grading, which may serve as a complementary tool for preoperative prediction of giloma grading.

Epidemic features of coronavirus disease 2019 in Hunan Province / 中南大学学报(医学版)

OBJECTIVES@#To explore and analyze the epidemic features of coronavirus disease 2019 (COVID-19) in Hunan Province from January 21, 2020 to March 14, 2020, as well as to investigate the COVID-19 epidemics in each city of Hunan Province.@*METHODS@#The epidemic data was obtained from the official website of Hunan Province's Health Commission. The data of each city of Hunan Province was analyzed separately. Spatial distribution of cumulative confirmed COVID-19 patients and the cumulative occurrence rate was drawn by ArcGIS software for each city in Hunan Province. Some regional indexes were also compared with that in the whole country.@*RESULTS@#The first patient was diagnosed in January 21, sustained patient growth reached its plateau in around February 17. Up to March 14, the cumulative confirmed COVID-19 patients stopped at 1 018. The cumulative occurrence rate of COVID-19 patients was 0.48 per 0.1 million person. The number of cumulative severe patients was 150 and the number of cumulative dead patients was 4. The mortality rate (0.39%) and the cure rate (99.6%) in Hunan Province was significantly lower and higher respectively than the corresponding average rate in the whole country (0.90% and 96.2%, Hubei excluded). The first 3 cities in numbers of the confirmed patients were Changsha, Yueyang, and Shaoyang. While sorted by the cumulative occurrence rate, the first 3 cities in incidence were Changsha, Yueyang, and Zhuzhou.@*CONCLUSIONS@#The epidemic of COVID-19 spread out smoothly in Hunan Province. The cities in Hunan Province implement anti-disease strategies based on specific situations on their own and keep the epidemic in the range of controllable.

Application value of magnetic resonance 3D-SPACE full volume scanning sequence in direct imaging of lower extremity deep venous thrombosis / 中国医师杂志

Objective@#To evaluate the capability of magnetic resonance imaging 3D-sampling perfection with application optimize contrasts using different flip angle evolution (MRI 3D-SPACE) full-volume scanning sequence to detect lower extremity deep vein thrombosis (LEDVT), and to explore the characteristics of the images of LEDVT and surrounding soft tissue at different stages.@*Methods@#MRI 3D-SPACE full volume T1WI and T2WI scanning of lower limb were performed on 45 patients diagnosed of LEDVT via digital subtraction angiography (DSA) by Siemens Prisma 3T MRI scanner. 43 cases completed scanning. The location and quantity of vascular segment lesions were recorded, of which the diagnostic sensitivity, specificity and accuracy were calculated comparing to the gold standard of DSA results. The characteristics of magnetic resonance imaging signals of thrombus and thrombus surrounding soft tissue at different times were summarized.@*Results@#According to the location of thrombosis, there were 15 cases of central type, 17 cases of peripheral type and 11 cases of mixed type. In all imaging levels, 272 segments of embolic vessels were found in 3D-space T1WI and 261 segments in 3D-space T2WI. Compared with the DSA results, the sensitivity, specificity, and accuracy of the two groups in the diagnosis of deep venous thrombosis were: T1 WI: Common iliac vein 97.10%, 97.90%, 98.20%; External iliac vein 96.80%, 97.60%, 97.10%; Internal iliac vein 96.40%, 97.20%, 97.20%; Femoral vein 98.10%, 98.20%, 98.50%; Popliteal vein 94.40%, 93.50%, 93.70%; The anterior tibial vein is 94.30%, 88.50% and 90.40%. The posterior tibial vein is 93.40%, 85.20%, 85.30%. T2WI: Common iliac vein 97.10%, 97.90%, 97.10%; External iliac vein 96.50%, 96.20%, 96.00%; Internal iliac vein 96.20%, 96.60%, 96.20%; Femoral vein 98.10%, 98.20%, 98.50%; Popliteal vein 93.40%, 92.50%, 92.70%; The anterior tibial vein is 90.30%, 86.50% and 85.40%; Posterior tibial vein 89.40%, 84.20%, 83.30%. According to the onset time, 17 cases in the acute phase, the thrombus was equal or slightly higher and uneven signal in the two groups of sequences, the perivascular and muscle tissue gap signal increased; 21 cases in the subacute phase, the thrombus was high in both groups signal; 5 cases in the chronic phase, the thrombus showed equal or slightly lower signal in the two groups of sequences, the blood vessel wall was irregular, and the surrounding soft tissue was mild or no obvious edema.@*Conclusions@#MRI 3D-space sequence full volume scanning technology has high sensitivity, high specificity and high accuracy for the diagnosis of lower extremity deep vein thrombosis, and can reflect the characteristics of thrombus and soft tissue signal around thrombus in different periods. It has high application value for the early detection of thrombosis and the stage diagnosis of the course of disease.

Application value of magnetic resonance 3D-SPACE full volume scanning sequence in direct imaging of lower extremity deep venous thrombosis / 中国医师杂志

Objective To evaluate the capability of magnetic resonance imaging 3D-sampling perfection with application optimize contrasts using different flip angle evolution (MRI 3D-SPACE) full-volume scanning sequence to detect lower extremity deep vein thrombosis (LEDVT),and to explore the characteristics of the images of LEDVT and surrounding soft tissue at different stages.Methods MRI 3D-SPACE full volume T1WI and T2WI scanning of lower limb were performed on 45 patients diagnosed of LEDVT via digital subtraction angiography (DSA) by Siemens Prisma 3T MRI scanner.43 cases completed scanning.The location and quantity of vascular segment lesions were recorded,of which the diagnostic sensitivity,specificity and accuracy were calculated comparing to the gold standard of DSA results.The characteristics of magnetic resonance imaging signals of thrombus and thrombus surrounding soft tissue at different times were summarized.Results According to the location of thrombosis,there were 15 cases of central type,17 cases of peripheral type and 11 cases of mixed type.In all imaging levels,272 segments of embolic vessels were found in 3D-space T1WI and 261 segments in 3D-space T2WI.Compared with the DSA results,the sensitivity,specificity,and accuracy of the two groups in the diagnosis of deep venous thrombosis were:T1 WI:Common iliac vein 97.10％,97.90％,98.20％;External iliac vein 96.80％,97.60％,97.10％;Internal iliac vein 96.40％,97.20％,97.20％;Femoral vein 98.10％,98.20％,98.50％;Popliteal vein 94.40％,93.50％,93.70％;The anterior tibial vein is 94.30％,88.50％ and 90.40％.The posterior tibial vein is 93.40％,85.20％,85.30％.T2WI:Common iliac vein 97.10％,97.90％,97.10％;External iliac vein 96.50％,96.20％,96.00％;Internal iliac vein 96.20％,96.60％,96.20％;Femoral vein 98.10％,98.20％,98.50％;Popliteal vein 93.40％,92.50％,92.70％;The anterior tibial vein is 90.30％,86.50％ and 85.40％;Posterior tibial vein 89.40％,84.20％,83.30％.According to the onset time,17 cases in the acute phase,the thrombus was equal or slightly higher and uneven signal in the two groups of sequences,the perivascular and muscle tissue gap signal increased;21 cases in the subacute phase,the thrombus was high in both groups signal;5 cases in the chronic phase,the thrombus showed equal or slightly lower signal in the two groups of sequences,the blood vessel wall was irregular,and the surrounding soft tissue was mild or no obvious edema.Conclusions MRI 3D-space sequence full volume scanning technology has high sensitivity,high specificity and high accuracy for the diagnosis of lower extremity deep vein thrombosis,and can reflect the characteristics of thrombus and soft tissue signal around thrombus in different periods.It has high application value for the early detection of thrombosis and the stage diagnosis of the course of disease.

An artificial neural network model for glioma grading using image information / 中南大学学报(医学版)

To explore the feasibility and efficacy of artificial neural network for differentiating high-grade glioma and low-grade glioma using image information.
 Methods: A total of 130 glioma patients with confirmed pathological diagnosis were selected retrospectively from 2012 to 2017. Forty one imaging features were extracted from each subjects based on 2-dimension magnetic resonance T1 weighted imaging with contrast-enhancement. An artificial neural network model was created and optimized according to the performance of feature selection. The training dataset was randomly selected half of the whole dataset, and the other half dataset was used to verify the performance of the neural network for glioma grading. The training-verification process was repeated for 100 times and the performance was averaged.
 Results: A total of 5 imaging features were selected as the ultimate input features for the neural network. The mean accuracy of the neural network for glioma grading was 90.32%, with a mean sensitivity at 87.86% and a mean specificity at 92.49%. The area under the curve of receiver operating characteristic curve was 0.9486.
 Conclusion: As a technique of artificial intelligence, neural network can reach a relatively high accuracy for the grading of glioma and provide a non-invasive and promising computer-aided diagnostic process for the pre-operative grading of glioma.

Clinical findings of 16 cases of neonatal influenza / 临床儿科杂志

Objective To investigate the clinical features, laboratory diagnostics, treatments, and prognosis of neonates infected with influenza. Methods The clinical data of 16 neonates diagnosed as influenza admitted to the neonatal ward from January 2015 to May 2017 were retrospectively analyzed. Results Of the 16 neonates, 11 were male and 5 were female. Mean age was 18.5 days. 75% (12/16) of them were reported to be exposed to family members with common cold- like symptoms before hospitalization. Clinical manifestations included nasal obstruction (11/16), fever (10/16), cough (10/16), and rhinorrhea (8/16). Influenza antigen rapid detection (colloidal gold method) was positive in all cases. Influenza immunofluorescence assays were performed in 15 cases, only 6.67% (1/15) was positive. Sputum culture was performed in 13 cases, 8 of which were positive. Of them, 75% (12/16) neonates were diagnosed with pneumonia. Only 12.5% (2/16) neonates were treated with neuraminidase inhibitor. All cases recovered well and were discharged after antibiotic treatment. Conclusions Neonates contacted with family members displaying common cold-like symptoms should be examined for influenza in time. The common clinical manifestations include catarrhal symptoms, fever and cough. The sensitivity of the influenza immunofluorescence assay is lower as compared with the colloidal gold method. Pneumonia may often be developed in neonatal influenza. The prognosis of neonatal influenza is satisfactory if treated.

Clinical analysis of 8 cases of neonatal hand-foot-mouth disease / 临床儿科杂志

Objective To study the clinical features,treatment and prognosis of neonatal hand-foot-mouth disease.Methods Neonatal hand-foot-mouth disease patients admitted from July 2014 to May 2016 were retrospectively studied.EV71,CA16 and universal enterovirus were detected from newborn swabs by RT-PCR.Results A total of 8 neonatal patients with hand-foot-mouth diseases,6 boys and 2 girls were diagnosed at an age ranged from 7-26 days.Of them,7 patients had exposure history.Clinical manifestations including rash (8 cases),fever (6 cases),irritability (4 cases) and vomiting (1 case),nobody suffered convulsions.The results of RT-PCR showed pathogen enterovirus not-EV71 and not-CA16.There were 5 cases of pulmonary infection treated with antibiotic therapy.All of the 8 cases had a good prognosis.Conclusions Most of the handfoot-mouth diseases had exposure history without specific clinical manifestations.They had not-EV71 and not-CA16 intestinal virus infection,some patients had pulmonary infection.Therefore,neonatal hand-foot-mouth diseases need more clinical attention.

The distribution and resistance of bacteria isolated from infection department of children′s hospital / 国际检验医学杂志

Objective To investigate the distribution of pathogens isolated from clinical samples and the resistance to the com‐mon antimicrobial agents .Methods Of the 3 745 children ,Hand‐foot‐mouth disease was the most prevalent disease with 1 397 (37 .30% ) cases ,followed by the bronchopneumonia ,rotavirus enteritis and bacterial intestinal infection ;784 strains were isolated from the samples mainly including Haemophilus parainfluenzae (16 .20% ) ,Streptococcus pneumoniae (14 .92% ) ,Moraxella ca‐tarrhalis (12 .88% ) ,Staphylococcus aureus (10 .59% ) and Salmonella enterica(10 .8% ) ;The positive rate of Methicillin‐resistance Staphylococcus aureus(MRSA) was 27 .50% and the ESBLs producing Escherichia coli and Klebsiella pneumoniae were 46 .43%and 81 .40% ,and two or more pathogens could be isolated from sputum .Conclusion Haemophilu ,Streptococcus pneumonia and Moraxella catarrhalis are the main bacterial pathogens in the department of infectious .There is a certain resistance to the common antimicrobial agents .It is important for us to focus on the pathogens and we should pay more attention to the control the resistance of the bacteria .

1H-proton magnetic resonance spectroscopy in patients with multiple system atrophy and cognitive dysfunction / 中南大学学报(医学版)

OBJECTIVE@#To detect metabolic changes of bilateral frontal lobe in patients with multiple system atrophy (MSA) and cognitive dysfunction by 1H-proton magnetic resonance spectroscopy (1H-MRS).
@*METHODS@#N-acetylaspartate (NAA)/creatine(Cr), choline (Cho)/Cr, myoinositol (mI)/Cr in three sides of frontal lobe were detected by 1H-MRS in 48 healthy controls, 23 patients with MSA and cognitive dysfunction and 19 patients with MSA but without cognitive dysfunction.
@*RESULTS@#NAA/Cr of bilateral frontal lobes in patients with MSA and cognitive dysfunction was significantly decreased compared with MSA patients without cognitive dysfunction and healthy controls (P<0.05). mI/Cr of right frontal lobes was significantly increased in patients with MSA and cognitive dysfunction compared with healthy controls (P<0.05). There was a negative correlation between NAA/Cr of bilateral frontal lobes and duration while a positive correlation between NAA/Cr of bilateral frontal lobes and MoCA score in patients with MSA and cognitive dysfunction.
@*CONCLUSION@#There is a decrease in NAA/Cr and an increase in mI/Cr in frontal lobes in patients with MSA and cognitive dysfunction, which may be associated with cognitive dysfunction in MSA patients.

Effect of GPR56 on axonal development and myelination / 中华急诊医学杂志

Objective To determine the likelihood of G-protein coupled receptor 56 (GPR56 ) induces axonal development and myelination in the corpus callosum of mouse brain.Methods A total of 64 Gpr56 +/-and Gpr56 -/-mice were selected and randomly divided into two groups:Gpr56 +/-group (n=32)and Gpr56 -/-group (n=32).According to number of days after birth,each group was further divided into 4 subgroups including P7d,P14d,P21d and P28d subgroups.Levels of neurofilament-200 (NF -200)and proteolipid protein (PLP ) of myelin basic protein in corpus callosum were measured with immunohistochemistry staining and Western blot in P7d、P14d、P21d、P28d Gpr56 +/- and Gpr56 -/-mice.Gpr56 +/-and Gpr56 -/-neurons were cultured using P1 d Gpr56 +/-and Gpr56 -/-mouse brain.The lengths of Gpr56 +/- and Gpr56 -/-neuronal axon were measured and compared with Image J software. Axonal myelination in the corpus callosum of mouse brain in each group was observed under electronic microscopy and the axonal diameters between subgroups were compared.Results The levels of NF-200 and PLP in the corpus callosum in P7d、P14d、P21d、P28d Gpr56 -/-mice decreased significantly compared with Gpr56 +/- mice.The length of Gpr56 -/-neuronal axon was shortened compared with Gpr56 +/-neuronal axon.The number of myelinated axons was obviously reduced in the corpus callosum in P28d Gpr56 -/-mice.The diameter of axon in the corpus callosum of P28d Gpr56 +/-mouse is longer than that of P28d Gpr56 -/-mouse. Conclusions GPR56 may be involved in axonal development and myelination in the corpus callosum of mouse brain.

(1)H-magnetic resonance spectroscopy on bilateral thalamus of patients with secondarily generalized tonic-clonic seizures / 中南大学学报(医学版)

OBJECTIVE@#To examine the changes of metabolites in the bilateral thalamus of patients with secondarily generalized tonic-clonic seizure (SGTCS) and to explore the mechanism of SGTCS.@*METHODS@#Thirty patients with SGTCS (epilepsy group) and 30 matched healthy controls (control group) were examined by 1H-magnetic resonance spectroscopy (1H-MRS). The levels of N-acetyl aspartate (NAA), choline-containing compounds (Cho), creatine phosphocreatine (Cr-PCr), and myo-inositol (mI) of the bilateral thalamus were measured in both the epilepsy group and the control group. The ratios of NAA/Cr-PCr, NAA/(Cr-PCr+Cho), Cho/Cr-PCr and mI/Cr-PCr were compared and analyzed in the 2 groups.@*RESULTS@#The ratios of NAA/Cr-PCr, and NAA/(Cr-PCr+Cho)(1.7074 ± 0.2214; 0.9333 ± 0.2173) in the left thalamus in the epilepsy group were significantly lower than those in the control group(1.8834 ±0.2093; 1.1243 ±0.2447)(P0.05).@*CONCLUSION@#There is neuronal dysfunction in the bilateral thalamus in the epilepsy group. Abnormal changes of the bilateral thalamus are involved in the mechanism of SGTCS.

The value of apparent diffusion coefficient values of cerebellar and the middle cerebellar peduncles in differential diagnosis of multiple system atrophy and Parkinson disease / 中华放射学杂志

Objective To evaluate the apparant diffusion coefficient (ADC) values of cerebellar and the middle cerebellar peduncles in the differential diagnosis of multiple system atrophy (MSA) and Parkinson disease (PD). Methods Conventional MRI and DWI were performed in 18 clinically proved MSA patients with 7 cases of early cases (early-stage MSA group), 19 PD patients (PD group) and 18 agematched normal controls (the control group). DWI was performed using a single shot-spin echo-echo planar imaging sequences, and ADC values were measured in the ROIs (0. 16 cm2) of the bilateral cerebellum, the middle cerebellar peduncles and cerebral white matter. Then one way ANOVA test was used for statistical analysis. Results Of the 18 MSA patients, 11 had MR abnormalities, 8 had hot-cross bun sign in the pens on T2-weighted images, 11 patients had pontine, cerebellar and medulla oblongata atrophy, 10 patients had atrophy of the middle cerebellar peduncles, 2 patients had hyperintense rim of the putamen and putaminal atrophy on T2-weighted images. The ADC values in the middle cerebellar peduncles were significantly increased in the MSA group[ (0. 98 ±0. 07) × 103 mm2/s] and early-stnge MSA group [ (0. 95 ±0. 05) ×103 mm2/s] as compared to PD group [ (0. 77 ±0. 04) × 103 mm2/s] and control group[ (0. 78 ±0. 04) ×103 mm2/s]. There was statistical significant difference among them (F = 91.049,55. 301, P ＜ 0.01 ).There was no overlap in the distribution of ADC values of the middle cerebellar peduncles among the MSA group [ (0.86-1.13 ) × 103 mm2/s ], early-stage MSA group [ (0. 86-1.02 ) × 103 mm2/s ] and PD group [ (0. 68-0. 84) × 103 mm2/s] and the control group [ (0. 69-0. 82) × 103 mm2/s]. The ADC values in the cerebellum were significantly increased in the MSA group[ (0. 95 ±0. 09) × 103 mm2/s] and early-stage MSA group [ (0. 92 ±0. 07) × 103 mm2/s] as compared to PD group [ (0. 78 ±0. 05) × 103 mm2/s] and control group[ (0. 79 ± 0. 05 ) × 103 mm2/s ]. Statistically significant difference was found among them (F =39. 274,18. 623 ,P ＜0. 01 ). There was overlap in the distribution of ADC values of the cerebellum [ MSAgroup(0. 80-1.10) × 103 mm2/s,early stage MSA group (0. 80-0. 99) × 103 mm2/s,PD group(0. 72-0. 90) × 103 mm2/s,control group (0. 71-0. 87) × 103 mm2/s]. There was no significant difference among the ADC values of MSA group, MSA group(early stages) and PD group and the control group in the cerebral white matter( P ＞ 0. 05 ). Conclusions ADC values in the cerebellum and the middle cerebellar peduncles have very important significance in differential diagnosis between MSA and PD.

Expression of HSP70/HSP27 protein in residual lesion after NPC radiotherapy / 中南大学学报(医学版)

OBJECTIVE@#To analyze HSP70/HSP27 protein expression in the nasopharyngeal carcinoma (NPC) primary tissues and the residual lesion, and to explore its predictive value.@*METHODS@#Immunohistochemical experiment was performed to detect the expression of HSP70 and HSP27 in 58 NPC primary tissues: 28 were in the experimental group with the local residual lesion and 30 in the control group without recurring and metastasis within 5 years by conventional radiotherapy.@*RESULTS@#The positive expression of HSP70 and HSP27 in the experimental group was 92.9%(26/28) and 53.6%(15/28), while that in the control group was 53.3%(16/30) and 53.3%(16/30),respectively. There was significant difference in the 2 groups. The common positive expression of HSP70 and HSP27 between the 2 groups had significant difference, 50.0% (14/28) in the experimental group and 16.7% (5/30) in the control group, respectively. There was no significant difference in the negative ratio of HSP70 and HSP27 common expression between the 2 groups, 3.6% (1/28) in the experimental group and 10.0% (3/30) in the control group, respectively.@*CONCLUSION@#HSP70 may have an important role in the radioresistance of NPC, and may predict the residual lesion after radiotherapy.

Anticoagulantion of Ischemic Cerebrovascular Diseases / 国际脑血管病杂志

Anticoagulation, which has been used in clinical practice since 1940's, is one of the important measures in the prevention and treatment of cerebrovascular diseases. This article reviews the progress in anticoagulation for ischemic cerebrovascular diseases by introducing a series of large, important, international, randomized controlled clinical trials in the past 20 years (particularly in the recent 10 years).