An attention-guided network for bilateral ventricular segmentation in pediatric echocardiography / 生物医学工程学杂志

Accurate segmentation of pediatric echocardiograms is a challenging task, because significant heart-size changes with age and faster heart rate lead to more blurred boundaries on cardiac ultrasound images compared with adults. To address these problems, a dual decoder network model combining channel attention and scale attention is proposed in this paper. Firstly, an attention-guided decoder with deep supervision strategy is used to obtain attention maps for the ventricular regions. Then, the generated ventricular attention is fed back to multiple layers of the network through skip connections to adjust the feature weights generated by the encoder and highlight the left and right ventricular areas. Finally, a scale attention module and a channel attention module are utilized to enhance the edge features of the left and right ventricles. The experimental results demonstrate that the proposed method in this paper achieves an average Dice coefficient of 90.63% in acquired bilateral ventricular segmentation dataset, which is better than some conventional and state-of-the-art methods in the field of medical image segmentation. More importantly, the method has a more accurate effect in segmenting the edge of the ventricle. The results of this paper can provide a new solution for pediatric echocardiographic bilateral ventricular segmentation and subsequent auxiliary diagnosis of congenital heart disease.

Hemodynamic Effects of Banding Width on Pulmonary Artery / 医用生物力学

Objective To investigate the effects of banding width on hemodynamic characteristics of pulmonary artery (PA) by constructing pulmonary artery banding (PAB) models with different widths. Methods Based on clinical practice, with the same banding position and degree, computer-aided design (CAD) was utilized to reconstruct three-dimensional PAB models with different banding widths (2, 3, 4, 5 mm). Hemodynamic characteristics of the models with different banding widths, including pressure, streamlines, energy loss, energy efficiency and blood flow distribution ratio, were compared and analyzed through computational fluid dynamics (CFD). Results The pressure of PA decreased significantly, while the change of banding width had no significant effects on the pressure drop level at banding position. With the increase of banding width, the energy loss decreased, and the energy efficiency showed an upward trend. The blood flow of the left PA raised, and the ratio of blood flow distribution between the left PA and right PA increased, with the maximum reaching up to 2.28 : 1. Conclusions The increase of banding width can reduce the energy loss of PA and improve the energy efficiency of blood flow, but it will lead to the imbalance of blood flow distributions between the left and right lungs. Both the balance of blood flow distribution and the energy loss should be considered in choice for banding width of PAB. The virtual design of PAB surgery based on CAD and CFD will assist individualized banding width selection in future.

Management analysis of neurosurgery residency training bases in different types of hospitals of Guangdong Province / 中华医学教育探索杂志

Objective:To comprehensively understand the operational status and existing problems of the neurosurgery professional training bases for standardized residency training in Guangdong Province.Methods:According to the scoring rules of "Standardized Residency Training Evaluation Indicators—Surgery (Neurosurgery) Professional Base" formulated by the Post-Graduation Medical Education Neurosurgery Professional Committee of the Chinese Medical Doctor Association, 28 training bases were supervised and evaluated. The scoring results of the supervision of 28 neurosurgery training bases were collected, and the training bases were divided into two categories according to the traditional teaching history, 6 affiliated hospitals of traditional medical schools and 22 non-traditional affiliated/teaching hospitals. GraphPad 5.0 software was used for statistical analysis of the 14 core indicators, and t-test, variance analysis and Chi-square test were used for analysis. Results:The results showed that there was a statistically significant difference in the compliance rate of 14 core indicators between traditional teaching hospitals and non-traditional teaching hospitals ( P = 0.003), skill operation and type and number of surgeries ( P = 0.041) and student rotation plan ( P = 0.012). The differences were also statistically significant. Conclusion:This study reveals that the comprehensive management ability of training bases in traditional teaching hospitals is significantly better than that in non-traditional teaching hospitals. Additionally, it's suggested to strengthen the construction of professional bases, enhance the institutionalized management of bases, and thus realize the homogenization training of neurosurgery residents.

Application progress of emerging techniques in patient-specific Nuss procedure for pectus excavatum / 中华胸心血管外科杂志

Pectus excavatum is a common congenital chest wall deformities in children, presented with abnormal collapse of anterior chest wall. Thoracoscopic Nuss procedure is the present widely utilized clinical approach. Due to implanting a steel bar into the substernal area, operative organ injuries, postoperative pain, bar malposition, incomplete correction as well as risks of bar removal may occur. With the advancement of digital precision medicine and the interdisciplinary research of various disciplines and fields, there are more and more clinical applications and translations of these emerging applications represented by computational biomechanical simulations, three-dimensional printing and the latest absorbable biomaterial. They bring new opportunities and prospects for solving problems in the clinical treatment of PE as well as the improvement and development of patient-specific Nuss procedure planning.

Hemodynamic Study on Non-Newtonian Properties of Fontan Procedure / 医用生物力学

Objective To investigate the effects of non-Newtonian properties on hemodynamic characteristics of Fontan procedure in computational simulation. Methods A Fontan vascular model was reconstructed based on patient-specific medical images. The boundary conditions were set according to velocity profiles measured by real-time echocardiography. The Newtonian model and two non-Newtonian (Casson and Carreau) models were applied to analyze the hemodynamic parameters, including flow ratio (FR), energy loss (EL), wall shear stress (WSS) as well as non-Newtonian importance factor, so as to compare flow differences between the Newtonian model and non-Newtonian models. Results The rheological models had small effects on the FR. The EL of non-Newtonian models was higher than that of the Newtonian model, and the EL of Casson model was the highest. Flow recirculation and flow disturbance accompanied with low WSS were observed in inferior vena cava (IVC). At low inflow velocity, flow disturbance in IVC of Newtonian model was more obvious. The calculations of non-Newtonian importance factor suggested significant non-Newtonian viscosity in IVC. Conclusions Non-Newtonian viscosity is significant in IVC where low velocity and flow recirculation are observed. Non-Newtonian properties of the blood should be considered in patient-specific hemodynamic simulation of Fontan procedure.

Comparison of the curative effect of open and laparoscopic Glisson pedicled transected anatomical segmentectomy of liver in the treatment of hepatocellular carcinoma / 国际外科学杂志

Objective:To compare the efficacy of laparotomy and laparoscopic Glisson pedicle transecting segmental hepatectomy in the treatment of hepatocellular carcinoma.Methods:The clinical data of 138 patients with hepatocellular carcinoma who underwent Glisson pedicle transection hepatectomy in the Affiliated Hospital of Chengde Medical College from March 2012 to November 2015 were collected retrospectively. 45 patients underwent laparoscopic surgery (laparoscopic group) and 93 patients underwent laparotomy. 45 patients were selected as open group according to the most clinical ratio of propensity score. The baseline data, operation, stress index, liver function index and postoperative survival rate were compared between the two groups. COX proportional hazard regression model was used to analyze the influencing factors of 5-year prognosis. Normally distributed measurement data were expressed as mean±standard deviation ( Mean± SD), and independent sample t test was used for comparison between groups. The chi-square test was used to compare the enumeration data between groups. Results:The operation time, intraoperative blood loss, blood transfusion cases, complications, postoperative eating time, drainage tube removal time, and hospital stay in the laparoscopic group were (219.48±53.61) min, (208.53±39.74) mL, 2, 3, (3.62±0.51) d, (4.73±0.85) d, (10.59±1.37) d, the open group were (185.37±46.92) min, (267.49±35.83) mL, 8, 10, (4.56±0.73) d, (5.29±0.94) d, (13.87±1.68) d, the differences between the two groups were statistically significant ( P<0.05). Cortisol, norepinephrine, C-reactive protein, aspartate aminotransferase, alanine aminotransferase, total bilirubin in the postoperative laparoscopic group) And albumin levels were (258.39±30.76) ng/mL, (66.78±7.31) ng/mL, (28.39±3.45) μg/mL, (66.51±7.14) U/L, (73.39±7.85) U/L, (20.67±2.74) μmol/L, (37.52±6.48) g/L, the open group were (316.92±37.51) ng/mL, (75.63±8.39) ng/mL, (38.47±4.56) μg/mL, (82.39±9.06) U/L, (94.05±9.74) U/L, (22.93±3.18) μmol/L, (34.65±5.87) g/L, the differences between the two groups were statistically significant ( P<0.05). There were no statistically significant difference in overall survival rate and tumor-free survival rate between the laparotomy group and the laparoscopic group at 1, 3, and 5 years after surgery ( P>0.05). The COX proportional hazards regression model showed that HBsAg positive, Child-Pugh grade, alpha-fetoprotein, and tumor diameter were risk factors affecting the 5-year prognosis of patients ( HR=6.627, 7.518, 5.143, 4.881, 95% CI: 1.516-9.738, 2.382-12.495, 3.078-6.249, 1.925-7.723, P<0.05). Conclusion:The long-term effects of laparotomy and laparoscopic Glisson pedicle transection hepatectomy are the same in selective hepatocellular carcinoma cases, but laparoscopic surgery can reduce intraoperative blood loss, blood transfusion cases and complications, facilitate early removal of drainage tube and food intake, shorten hospital stay, reduce stress reaction, and promote the recovery of liver function, so the short-term effect is better.

The hemodynamic effects of ductus arteriosus on modified Blalock-Taussig shunt / 中华胸心血管外科杂志

Objective:To investigate hemodynamic characteristics of the modified Blalock-Taussig shunt (MBTS) with the preservation or ligation of ductus arteriosus (DA) based on computational fluid dynamics (CFD), thus to help preoperative surgery design and postoperative prediction.Methods:A patient with pulmonary atresia and patent ductus arteriosus was included. Patient-specific three-dimensional model was reconstructed and virtual surgeries of shunt insertion and ductus ligation or preservation were performed via computer-aided design (CAD). CFD was utilized to analyze hemodynamic parameters preoperatively and postoperatively based on patient-specific anatomy and physiologic data.Results:The preservation of DA competitively reduced the shunt flow but increased total pulmonary perfusion. The shunt flow and ductal flow collided with each other, causing large and complicated turbulence in pulmonary artery where lower wall shear stress and higher oscillatory shear index were distributed, as well as higher energy loss.Conclusion:The preservation of DA is riskier in hemodynamics which may lead to pulmonary over-perfusion, inadequate systemic perfusion and heavier cardiac burden, thus increasing the risk of heart failure and it seems to bring no benefit in terms of reducing risks of thrombosis.

XGBoost model in predicting recurrence of patients with laparoscopic hepatectomy for hepatocellular carcinoma / 国际外科学杂志

Objective:This study aimed to establish an eXtreme Gradient Boosting(XGBoost) model that can predict the recurrence of hepatocellular carcinoma(HCC)patients after laparoscopic hepatectomy (LH) surgery.Methods:A total of 440 patients with primary HCC who received LH treatment for the first time from January 2013 to September 2016 in Affiliated Hospital of Chengde Medical University were selected as the research objects. The diagnosis method was pathological diagnosis. Research objects were divided into training group ( n=88) and verification group ( n=352) at a ratio of 2∶8 by random number table method. The Kaplan-Meier method was used to draw the recurrence-free survival curve, and the Log-rank test was used to compare the survival of the two groups; the training group was used to establish the COX regression model and the XGBoost model to screen independent predictors of recurrence after LH; receiver operating characteristic(ROC) curve was used to analyze the predictive abilities of the two models, and conducted internal verification in the verification group; Hosmer and Lemeshow Test was used to evaluate the calibration of the two models, and P>0.05 was used as a good fit between the model and the actual situation. Results:Both the COX regression model and the XGBoost model screened out tumor thrombus, low degree of differentiation, tumor microvascular infiltration (MVI), number of tumors, large tumors, and positive hepatitis B surface antigen were independent predictors of tumor recurrence( HR=2.477, 0.769, 1.786, 1.905, 1.544, 1.805; 95% CI: 1.465-4.251, 0.619-0.819, 1.263-2.546, 1.354-2.704, 1.272-1.816, 1.055-2.555). The XGboost model scores were 32 points, 29 points, 24 points, 18 points, 16 points, 11 points, respectively. In the training group, the area under the curve (AUC) of the COX regression model and XGBoost model for predicting recurrence were 0.746 (0.730-0.762) and 0.802 (0.785-0.818), respectively. The XGBoost model had strong predictive ability and was confirmed in the validation cohort. Conclusions:This study had established and verified the XGBoost model that can predict the recurrence of HCC patients after receiving LH for the first time. It can be used in clinics to assist doctors in formulating personalized postoperative monitoring programs for patients. Early detection, early diagnosis and early treatment of tumors and strengthening of postoperative follow-up are important measures to improve the prognosis of patients.

Epidemiological characteristics of acute paraquat poisoning in children in southwest Shandong and related factors of pulmonary interstitial fibrosis / 中国小儿急救医学

Objective@#To analyze the epidemiological characteristics of acute paraquat(PQ)poisoning in children in southwest Shandong, and the risk factors for pulmonary interstitial fibrosis.@*Methods@#This retrospective study was performed on the clinical data of children with acute PQ poisoning admitted from January 2013 to December 2017 in 12 hospitals in southwest Shandong.All participants were divided into pulmonary interstitial fibrosis group and no pulmonary interstitial fibrosis group on the basis of the chest CT 14 days after poisoning.The epidemiological characteristics and risk factors of pulmonary interstitial fibrosis were analyzed.@*Results@#During the study period, a total of 307 children with acute PQ poisoning were admitted to 12 hospitals, of which 61 (19.87%) were suffering from acute PQ poisoning.Forty-nine cases with complete clinical data were analyzed, including 26 male and 23 female patients poisoned by oral.The age distribution ranged from 8 months to 14 years.Poisoning mainly occured from July to September of each year.The mortality of acute PQ poisoning was 8.2%(4/49), and the incidence of pulmonary interstitial fibrosis in survival patients was 44.4%(20/45). Statistical differences (P<0.05) were found between the pulmonary interstitial fibrosis and no pulmonary interstitial fibrosis, with regard to the times of blood purification, the time from poison exposure to blood purification, the application rate of glucocorticoids, the concentration of PQ in urine, the pediatric critical illness score, the time from poison exposure to gastric lavage, the white blood count at admission, serum creatinine, arterial blood lactate, PaO2, PaCO2, and PaO2/FiO2; however, there was no significant difference in the proportion of blood purification treatment, the mode of blood purification treatment, alanine aminotransferase, aspartate aminotransferase, urea nitrogen, creatine kinase and troponin.Stepwise logistic regression analysis showed that the time from exposure to poison to gastric lavage(OR=0.683, 95%CI 0.210-2.222)and to blood purification(OR=0.0133, 95%CI 0.004-0.042), the times of blood purification(OR=2.862, 95%CI 1.450-5.648), concentration of PQ in urine(OR=1.435, 95%CI 1.085-1.898), and the use of glucocorticoids(OR=0.190, 95%CI 0.048-0.757) were the risk factors for pulmonary interstitial fibrosis(P<0.05).@*Conclusion@#Early gastric lavage and blood purification, increasing the frequence of adminitrating purification appropriately, using low-dose glucocorticoids can reduce the incidence of pulmonary interstitial fibrosis of children with acute PQ poisoning.

Design of Integrated Suction Detection System for Pediatric Oral Secretion / 中国医疗器械杂志

According to the actual requirements of pediatric intensive care, a suction detection system of pediatric oral secretions integrated with monitoring function is designed. The system has the function of adjustable intermittent attraction. The duration and proportion of intermittent attraction can be adjusted according to the individualized needs of pediatric intensive care. The suction head of pacifier can reduce the mechanical damage to pediatric oral mucosa as much as possible. Meanwhile, the system can detect and monitor the real-time biochemical indexes of the collected oral secretions, which can be used to help the judgement of aspiration and quantitatively evaluate the microcirculation dysfunction.

Effect of general anesthesia on microelectrode recording during deep brain stimulation of subthalamic nucleus in patients with primary Parkinson′s disease / 中华麻醉学杂志

Objective:To evaluate the effect of general anesthesia on microelectrode recording (MER) during deep brain stimulation (DBS) of subthalamic nucleus (STN) in the patients with primary Parkinson′s disease (PD).Methods:Forty-four patients of both sexes with primary PD (duration of disease ≥ 5 yr and/or obvious symptom fluctuation), undergoing bilateral STN DBS from March 2008 to March 2018, aged<80 yr, were selected and divided into 2 groups by a random number table method: awake group ( n=26) and general anesthesia group ( n=18). In awake group, 0.5% ropivacaine was used for incision infiltration at skin incision.Patients in GA group received propofol and remifentanil by target-controlled infusion with Narcotrend to monitor the depth of anesthesia, and 0.5% ropivacaine was used for incision infiltration at skin incision.The total number of trajectories and length of STN were recorded during MER.Movement disorders were evaluated at 1 week before surgery and 6 months after surgery, and the improvement rate of dyskinesia was calculated.The postoperative anesthesia-, hardware- and stimulation-related complications were recorded. Results:There were no significant differences between the two groups in the total number of trajectories, length of STN and improvement rate of postoperative movement disorders ( P>0.05). Conclusion:General anesthesia does not affect the MER during STN DBS in the patients with primary PD.

Epidemiological characteristics of acute paraquat poisoning in children in southwest Shandong and related factors of pulmonary interstitial fibrosis / 中国小儿急救医学

Objective:To analyze the epidemiological characteristics of acute paraquat(PQ)poisoning in children in southwest Shandong, and the risk factors for pulmonary interstitial fibrosis.Methods:This retrospective study was performed on the clinical data of children with acute PQ poisoning admitted from January 2013 to December 2017 in 12 hospitals in southwest Shandong.All participants were divided into pulmonary interstitial fibrosis group and no pulmonary interstitial fibrosis group on the basis of the chest CT 14 days after poisoning.The epidemiological characteristics and risk factors of pulmonary interstitial fibrosis were analyzed.Results:During the study period, a total of 307 children with acute PQ poisoning were admitted to 12 hospitals, of which 61 (19.87%) were suffering from acute PQ poisoning.Forty-nine cases with complete clinical data were analyzed, including 26 male and 23 female patients poisoned by oral.The age distribution ranged from 8 months to 14 years.Poisoning mainly occured from July to September of each year.The mortality of acute PQ poisoning was 8.2%(4/49), and the incidence of pulmonary interstitial fibrosis in survival patients was 44.4%(20/45). Statistical differences ( P<0.05) were found between the pulmonary interstitial fibrosis and no pulmonary interstitial fibrosis, with regard to the times of blood purification, the time from poison exposure to blood purification, the application rate of glucocorticoids, the concentration of PQ in urine, the pediatric critical illness score, the time from poison exposure to gastric lavage, the white blood count at admission, serum creatinine, arterial blood lactate, PaO 2, PaCO 2, and PaO 2/FiO 2; however, there was no significant difference in the proportion of blood purification treatment, the mode of blood purification treatment, alanine aminotransferase, aspartate aminotransferase, urea nitrogen, creatine kinase and troponin.Stepwise logistic regression analysis showed that the time from exposure to poison to gastric lavage( OR=0.683, 95% CI 0.210-2.222)and to blood purification( OR=0.0133, 95% CI 0.004-0.042), the times of blood purification( OR=2.862, 95% CI 1.450-5.648), concentration of PQ in urine( OR=1.435, 95% CI 1.085-1.898), and the use of glucocorticoids( OR=0.190, 95% CI 0.048-0.757) were the risk factors for pulmonary interstitial fibrosis( P<0.05). Conclusion:Early gastric lavage and blood purification, increasing the frequence of adminitrating purification appropriately, using low-dose glucocorticoids can reduce the incidence of pulmonary interstitial fibrosis of children with acute PQ poisoning.

Hemodynamic Characteristics of Pulmonary Arterial Hypertension Related to Congenital Heart Disease / 医用生物力学

Objective Hemodynamic disorder of the pulmonary artery (PA) is the main cause of pulmonary arterial hypertension related to congenital heart disease (PAH-CHD). To study the hemodynamic characteristics of PA, so as to understand biomechanical factors in the occurrence and development of PAH-CHD. Methods Clinical and imaging data were collected in five PAH-CHD patients and five matched controls (Non-PAH) to reconstruct subject-specific three-dimensional (3D) PA models. Computational fluid dynamics (CFD) was performed to compare the hemodynamic difference of flow patterns, wall shear stress (WSS) and normalized energy loss (E·) in the two groups. Results Hemodynamics-related parameters showed that the velocity and WSS were higher in the left and right PA branches of PAH-CHD patients, with significantly lower WSS in the main PA. The E· significantly increased in PAH-CHD patients and positively correlated with normalized PA diameter and inflow. Conclusions Compared with Non-PAH subjects, PAH-CHD patients have obviously higher velocity and WSS in PA branches, lower WSS in main PA and greater E·, indicating these hemodynamic parameters are related with the PAH-CHD, which can be used as potential biomechanical factors for the clinical evaluation of PAH-CHD.

Research Progress on Computational Hemodynamics of Pulmonary Hypertension / 医用生物力学

Pulmonary hypertension (PH) is a devastating disease caused by different etiology and characterized by the progressive elevation of pulmonary vascular resistance and pulmonary artery pressure. As a new method that applied to clinical studies, computational fluid dynamics (CFD) gradually becomes a powerful tool for in-depth understanding of the disease progression. It can noninvasively obtain the patient-specific hemodynamic parameters at any point of the vessel and present them through the visualization technology. In this paper, an overall review of CFD with the focus on PH, including the numerical simulation method, boundary conditions, blood characteristics and relevant hemodynamic parameters was presented.

Evaluation of prognostic factors for liposarcoma / 中华肿瘤杂志

Objective@#To investigate the relevant prognostic factors of liposarcoma (LPS).@*Methods@#The data of 78 patients with LPS treated in our hospital from July 2009 to March 2017 were reviewed. The 78 patients included 41 males and 37 females, and the average age was (60.5 ±13.4) years (ranged from 18 to 85 years). Among the 78 LPS patients, 27 were well-differentiated LPS, 13 were myxoid LPS, 35 were dedifferentiated LPS and 3 were pleomorphic LPS.The distribution of lesion location included 40 cases of extremities and 38 cases of retroperitoneal. 21 cases were treated with radical excision, 57 cases were treated with marginal resection. 7 patients were treated with postoperative radiotherapy and 9 patients with postoperative chemotherapy. Progression free survival (PFS) and overall survival (OS) of LPS patients were analyzed as clinical outcomes. Prognostic factors were analyzed by univariate and multivariate analyses.@*Results@#43 patients had local recurrence (9 of extremities/ 34 of retroperitoneal), 18 patients with metastasis (4 of extremities/ 14 of retroperitoneal). The 5-year PFS rate was 31.4% and 5-year OS rate was 44.3%. Univariate analysis showed that the histological subtype and the tumor location were related with PFS (P<0.05), while the histological subtype, the tumor location, the tumor size, the recurrence and metastasis were related with OS (P<0.05). Multivariate cox regression analysis showed that the tumor location was the independent prognostic factor of PFS (P<0.05), while the histological subtype and metastasis were the independent prognostic factors of OS (P<0.05). The median PFS of patients with myxoid LPS treated with radiotherapy was 34.6 months, which was significantly longer than 28.3 months of myxoid LPS patients without radiotherapy (P<0.05).@*Conclusions@#The tumor location is an independent prognostic factor of PFS in LPS patients.Retroperitoneal LPS is more prone to relapse and metastasize. OS is affected by pathological subtype and metastasis. Radiotherapy can improve the PFS of patients with myxoid LPS.

The effects of glucocorticoid and continuous blood purification on cellular immune function and prognosis in children with severe sepsis/septic shock / 中国小儿急救医学

Objective To investigate the effects of glucocorticoid and blood purification on cellular immune function and prognosis in children with severe sepsis/septic shock. Methods Fifty-five pediatric patients with severe sepsis/septic shock admitted to PICU of Shandong Provincial Hospital between January 2015 and June 2017 were enrolled in the study and were divided into control group,hormone group and con-tinuous blood purification group according to treatment. PCIS,PICU stay,immune function,3\7\28-day mor-tality rate,the level of HLA-DR/CD14,TNF-α and IL-10 of pre-treatment,24 h and 72 h post-treatment were studied and compared among three groups. Results (1) Three-day (26. 7% vs. 20. 0% vs. 20. 0%) and 7-day mortality rates in blood purification group,hormone group,and control group were 4/15,4/20,4/20 and 5/15,5/20,5/20,respectively,which were the highest in blood purification group,but 28-day mortality rate(5/15 vs.7/20 vs.8/20)was the lowest in blood purification group. (2) PCIS,the expressions of HLA-DR/CD14,CD4 +,CD8 +and CD4 +/CD8 +increased in all groups while they increased significantly in blood purification group(P<0. 05). The levels of TNF-α and IL-10 in peripheral blood of children decreased gradually in each group,especially in blood purification group. Conclusion Comparing with hormone group, continuous blood purification therapy can remove inflammatory mediators more quickly and effectively,reduce cytokine level and improve cellular immune function in children with severe sepsis/septic shock,and reduce their 28-day mortality.

The Expression of Speckle-type POZ protein-like(SPOPL)in Brain Glioma / 中国神经精神疾病杂志

Objective To explore the expression of Speckle-type POZ protein-like(SPOPL)in human glioma tis?sues and its relationship with clinical pathological parameters and prognosis. Methods Immunohistochemical and west?ern blotting method were used to detect SPOPL expression in glioma tissues and tumor peripheral tissues in 68 cases of glioma patients including 32 cases of low grade gliomas (WHO I- II), and 36 cases of high grade gliomas (WHO III-IV). T test,χ2 test, Kaplan-Meier method and the Cox regression model were used to analyze the relationship between the expression and clinical indicators. Results The expression of SPOPL was significantly lower in gliomas than in tumor pe?ripheral tissues (t=-8.754, P<0.05), the expression of SPOPL was lower in high pathological grade tissues than in low grade of glioma tissues (t=-13.552, P<0.05). SPOPL expression was associated with pathological grade ( χ2=4.023, P<0.05). Cox regression model showed that the tumor pathological grade and different SPOPL protein expression were inde?pendent risk factors for the prognosis of patients with glioma. Conclusions SPOPL may be a biomarkers of human brain gliomas and can help to evaluate the prognosis of brain glioma.

The early-phase prognostic role of preoperative evaluation in congenital tracheal stenosis / 中华胸心血管外科杂志

Objective To explore the preoperative assessment of airway morphology affecting the early-phase prognosis by observing congenital tracheal stenosis survival after surgical treatment.Methods Totally 52 cases of CTS surgically treated in the Shanghai children's Medical Center,from April 2007 to June 2013,were retrospectively analyzed to study their clinical characteristics,survival condition and related factors influencing the early-phase prognosis.Using log-rank test and Cox multiple factors analysis for statistical analysis.Results Overall postoperative survival rate of 3 months was 73.1％.There were 14 deaths among 48 patients.Single factor and multiple factors analysis showed that the cross-sectional area(CSA) of stenosis and Anton-Pacheco classification were both associated with early-phase prognosis as independent factors(P ＜0.05).Long CPB duration was a prognostic factor for the outcome of surgical treatment for CTS(P ＜ 0.05).CPB time was significantly longer in death cases than in surviving cases.Conclusion CSA and Anton-Pacheco classification were significant prognostic factors for CTS.The proper utilization of radiologic imaging allow for improved patient care.

Acupuncture and tuina clinical thoughts of "treating the back from abdomen" for low back pain / 中国针灸

In clinical treatment, it is found that certain patients always have some positive reaction points those are relevant with low back pain in the abdomen area. When the simple treatment on the low back is ineffective, the efficacy could be significantly improved if acupuncture or tuina is performed at the abdomen areas, which is called "regulating yin to treat yang", or "treating the back from abdomen". In this paper, with the diagnosis and treatment method of "treating the back from abdomen" for low back pain as principal line, the detailed manipulation is explained for low back pain that is induced by TCM meridian diseases or modern anatomy, which could open the methods for clinical treatment of low back pain and enrich the therapeutic options.

The study and diagnostic value of MRI sequences in patients with trigeminal neuralgia / 中华放射学杂志

ObjectiveTo investigate the capacity and diagnostic value of various MRI seguences in patients with trigeminal neuralgia.Methods MR images of 60 patients with trigeminal neuralgia were analyzed retrospectively.The sensitivity,specificity and diagnostic value of various MRI sequences were evaluated comparing with clinical data and operation results.All patients were scanned with conventional sequences including SE-T1WI,T2WI,FLAIR of head.Among them,9 cases were injected with contrast agent,49 cases were scanned with 3D-TOF and 3D-TSE sequences on cerebellopontine angle additinally.The sensitivity,specificity and accuracy of the 3D-TOF and 3D-TSE sequences were analyzed by using the x2 test.Results Six cases with tumor,3 cases with radiculitis and meningitis,1 case with multiple sclerosis and 1 case with pons infarction were diagnosed by conventional MR sequences.MRI of 49 cases with 3D-TOF and 3D-TSE showed neurovascular compress proved by operation.The sensitivity,specificity and accuracy of 3D-TOF and 3D-TSE were 95.3％ (41/43)vs.95.6％ (43/45),66.7％ (4/6)vs.50.0％(2/4) and 91.8％ (45/49)vs.91.8％ (45/49),and no significantly difference was found between the two sequences (x2 =0.13,0.19 and 0.17,P ＞0.5).ConclusionsMRI plays an important role in displaying the causes and diagnosis of trigeminal neuralgia.The conventional head MR sequences should be recommended for diagnosis of secondary TN caused by tumor and inflammation et al,and further 3D-TOF and 3D-TSE with high sensitivity and accuracy should be applied in patients with primary TN to display the neurovascular relationship.