The value of CT features in predicting visceral pleural invasion in clinical stage ⅠA peripheral lung adenocarcinoma under the pleura / 中华放射学杂志

Objective:To investigate the value of CT features in predicting visceral pleural invasion (VPI) in clinical stage ⅠA peripheral lung adenocarcinoma under the pleura.Methods:The CT signs of 274 patients with clinical stage ⅠA peripheral lung adenocarcinoma under the pleura diagnosed in Changzheng Hospital of Naval Medical University from January 2015 to November 2021 were retrospectively analyzed. According to the ratio of 6∶4, 164 patients collected from January 2015 to August 2019 were used as the training group, and 110 patients collected from August 2019 to November 2021 were used as the validation group. The maximum diameter of the tumor (T), the maximum diameter of the consolidation part (C), and the minimum distance between the lesion and the pleura (DLP) were quantitatively measured, and the proportion of the consolidation part was calculated (C/T ratio, CTR). The CT signs of the tumor were analyzed, such as the relationship between the tumor and the pleura classification, the presence of a bridge tag sign, the location of the lesion, density type, shape, margin, boundary and so on. Variables with significant difference in the univariate analysis were entered into multivariate logistic regression analysis to explore predictors for VPI, and a binary logistic regression model was established. The predictive performance of the model was analyzed by receiver operating characteristic curve in the training and validation group.Results:There were 121 cases with VPI and 153 cases without VPI among the 274 patients with lung adenocarcinoma. There were 79 cases with VPI and 85 cases without VPI in the training group. Univariate analysis found that the maximum diameter of the consolidation part, CTR, density type, spiculation sign, vascular cluster sign, relationship of tumor and pleura and bridge tag sign between patients with VPI and those without VPI were significantly different in the training group( P<0.05). Multivariate logistic regression analysis found the relationship between tumor and pleura [taking type Ⅰ as reference, type Ⅱ (OR=6.662, 95%CI 2.364-18.571, P<0.001), type Ⅲ (OR=34.488, 95%CI 8.923-133.294, P<0.001)] and vascular cluster sign (OR=4.257, 95%CI 1.334-13.581, P=0.014) were independent risk factors for VPI in the training group. The sensitivity, specifcity, and area under curve (AUC) for the logistic model in the training group were 62.03%, 89.41% and 0.826, respectively, using the optimal cutoff value of 0.504. The validation group obtained an sensitivity, specifcity, and AUC of 92.86%, 47.06%, and 0.713, respectively, using the optimal cutoff value of 0.449. Conclusion:The relationship between the tumor and the pleura and the vascular cluster sign in the CT features can help to predict visceral pleural invasion in the clinical stage ⅠA peripheral lung adenocarcinoma under the pleura.

Family-centered task-oriented training can significantly improve the functional independence and life quality of children with spastic cerebral palsy / 中华物理医学与康复杂志

Objective:To observe the effect of a family-centered task-oriented training (TOT) program on the functional independence and life quality of children with spastic cerebral palsy.Methods:A total of 62 children with spastic cerebral palsy were randomly divided into a control group ( n=31) and a TOT group ( n=31). The children in the control group were given family rehabilitation training according to the discharge instruction manual, while the children in the TOT group received family-centered TOT. Both groups trained for 1 hour once a day, 5 days a week for 6 months. The mobility, functional independence and life quality of the two groups were evaluated with the pediatric evaluation of disability inventory (PEDI), functional independence measures for Chinese children (WeeFIM) and a pediatric quality of life inventory (PedsQL) before and after 3 and 6 months of treatment. Results:After 6 months there was significant improvement in the average mobility, WeeFIM and PedsQL scores of both groups. The average mobility, WeeFIM and PedsQL scores of the TOT group were then significantly better than those of the control group.Conclusion:Family-centered TOT training can significantly improve the functional independence and life quality of children with spastic cerebral palsy.

Simultaneous determination of the contents of eight chemical components in Huaiqin Salve by QAMS / 国际中医中药杂志

Objective:To determine the content of albiflorin, paeoniflorin, benzoylpaeoniflorin, sophoricoside, prim-O-glucosylcimifugin, cimifugin, 5-O-methylvisammioside and sec-O-glucosylhamaudol in Huaiqin Salve with high performance liquid chromatography-quantitative analysis of multi-components by single-marker (HPLC-QAMS) method. Methods:The samples were separated with ZORBAX Eclipse XDB-C18 column by a gradient elution using methanol-acetonitrile (1:2) (A)-0.1% phosphoric acid solution (B) as mobile phase and the flow rate was 1.0 ml/min. The detection wavelength was 230 nm for albiflorin, paeoniflorin and benzoylpaeoniflorin, and 254 nm for sophoricoside, prim-O-glucosylcimifugin, cimifugin, 5-O-methylvisammioside and sec-O-glucosylhamaudol. The column temperature was 30 ℃. Using sophoricoside as an internal standard, the relative correction factors (RCFs) of albiflorin, paeoniflorin, benzoylpaeoniflorin, prim-O-glucosylcimifugin, cimifugin, 5-O-methylvisammioside and sec-O-glucosylhamaudol were calculated. The method was validated by comparison of the quantitative results between external standard method (ESM) and HPLC-QAMS method.Results:Albiflorin, paeoniflorin, benzoylpaeoniflorin, sophoricoside, prim-O-glucosylcimifugin, cimifugin, 5-O-methylvisammioside and sec-O-glucosylhamaudol showed good linear relationship within the range of 0.034 7-0.867 5, 0.063 6-1.590 0, 0.006 9-0.172 5, 0.198 6-4.965 0, 0.092 8-2.320 0, 0.026 6-0.665 0, 0.042 7-1.067 5, 0.020 9-0.522 5 μg ( r ≥ 0.999 1); whose average recoveries ( RSDs) were 98.85% (1.02%), 100.04% (0.67%), 96.92% (1.14%), 100.06% (0.85%), 99.31% (1.39%), 99.16% (1.22%), 98.59% (1.33%) and 97.58% (1.41%), respectively. No significant differences were found in the quantitative analysis of the components with ESM and HPLC-QAMS method. Conclusion:The HPLC-QAMS method could provide the reference for themulti-index component evaluation for Huaiqin Salve.

The epidemiology of thoracic aorta and coronary calcification in lung cancer screening using low dose chest CT / 实用放射学杂志

Objective To investigate the epidemiological characteristics of thoracic aorta and coronary calcification,and to analyze the effects of common risk factors on thoracic aorta and coronary calcification.Methods Low dose chest CT was performed in 2 393 asymptomatic subjects who underwent lung cancer screening.The chi-square test and Logistic regression analysis were used.Results The frequency of aortic calcification was 24.73％ in total 2 393 subjects.And the frequency of calcification was the highest in the arch.The frequency of aortic calcification was 8.82％,and the frequency of calcification was higher in the left coronary artery than the right coronary artery.The frequency of thoracic aorta and coronary calcification were increasing with age,and the frequency of calcification was higher in male than female (P ＜0.05).The frequency of calcification was higher in smokers than non-smokers,and the frequency of calcification was higher in smokers (≥30 capsules) than the smokers (＜30 capsules) (P＜0.05).The age,smoking and chronic bronchitis were associated with thoracic aorta and coronary calcification.Conclusion The detection of calcification of thoracic aorta and coronary in lung cancer screening using low dose chest CT can assess the epidemiological characteristics of atherosclerosis in healthy screening population.

Application and significance of coronary artery calcification score evaluated with low-dose chest computed tomography in cardiovascular risk screening / 中华健康管理学杂志

The coronary artery calcification score(CACS)is used for risk stratification independent of traditional risk factors,and can effectively predict the incidence of cardiovascular events.As part of a lung cancer screening project, subjects undergoing low-dose chest computed tomography (CT) can also be evaluated for the CACS to determine the risk of cardiovascular disease.These measures can help strengthen public health management. This paper focused on the pathological basis of coronary calcification, the significance of the calcification score,and the application and significance of CACS evaluated with low-dose chest CT in cardiovascular risk screening.

Impact of reconstruction parameter settings of knowledge-based iterative model technique on image quality of low-dose hepatic contrast-enhanced CT / 中国医学影像技术

Objective To evaluate the impact of different reconstruction parameter setting of knowledge-based iterative model reconstruction (IMR) technique on image quality of low-dose hepatic contrast-enhanced CT.Methods Forty patients underwent hepatic contrast-enhanced CT scanning were enrolled.Plain CT and triphasic contrast-enhanced CT scans,including hepatic arterial phase,portal-venous phase and delayed phase were performed.Low-dose scan was used in delayed phase,with tube voltage of 80 kV and tube current of 150 mAs.Images of delayed phase were reconstructed with both filtered back projection (FBP) and IMR techniques.Parameter setting applied in IMR reconstructions consisted of body routine and body soft tissue modes with three levels (Level 1-3),so 6 subgroups (R1,R2,R3,S1,S2,S3) were included.Subjective and objective evaluations of image quality were compared among those groups.Subjective evaluations included the scores of low contrast detectability (LCD),image distortion (ID) and diagnostic confidence (DC).Objective evaluations included image noise,signal to noise ratio (SNR) and contrast to noise ratio (CNR).Results There were statistical differences of scores in LCD,ID and DC among all the reconstruction parameter setting groups (all P＜0.01).The noise,SNR and CNR among different parameter setting groups had statistically significant differences (all P＜0.01).Except for subgroup S1 and subgroup R2,subgroup S2 and subgroup R3 (all P＞0.05),the other multiple comparisons showed significant differences (all P＜0.01).Conclusion IMR can improve image quality of low-dose hepatic contrast-enhanced CT.IMR reconstruction parameter setting of S1 and R2 are optimal for low-dose hepatic contrast-enhanced CT protocal.

Therapeutic effect of endoscope-guided bougie dilatation on benign esophageal stricture in children / 中华消化内镜杂志

Objective To investigate therapeutic effect of endoscope?guided bougie dilatation on children with benign esophageal stricture. Methods Data of 71 patients with benign esophageal stricture were retrospective analyzed.Patients were divided into group A (reflux stricture),B (congenital esophageal atresia stricture) and C ( caustic injuries stricture) ,based on different causes. The expansion effectiveness and factors of the three groups were analyzed. Results A total of 885 expansions were performed on 71 patients with the total efficacy rate 94?37%( 67/71) . No statistic differences were shown in expansion effectiveness among the 3 groups; group C ( 14?9 times/case, P < 0?05 ) showed more expansion frequencies than group A (9?1 times/case,P<0?05)and group B(10?7 times/case, P<0?05),more complications than group A(1?22%VS 0,P<0?05) and group B(1?22% VS 0?31%,P<0?05). Conclusion Endoscope?guided bougie dilatation is safe and effective for childrens′ benign esophageal stricture. Caustic injuries, refractory benign esophageal stricture,need more expansions and may be accompanied with more complications.