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Objective@#To investigate the prognostic utility of radiomics features extracted from 18 F-fluorodeoxyglucose (FDG) PET/CT combined with clinical factors and metabolic parameters in predicting progression-free survival (PFS) and overall survival (OS) in individuals diagnosed with extranodal nasal-type NK/T cell lymphoma (ENKTCL). @*Materials and Methods@#A total of 126 adults with ENKTCL who underwent 18 F-FDG PET/CT examination before treatment were retrospectively included and randomly divided into training (n = 88) and validation cohorts (n = 38) at a ratio of 7:3.Least absolute shrinkage and selection operation Cox regression analysis was used to select the best radiomics features and calculate each patient’s radiomics scores (RadPFS and RadOS). Kaplan–Meier curve and Log-rank test were used to compare survival between patient groups risk-stratified by the radiomics scores. Various models to predict PFS and OS were constructed, including clinical, metabolic, clinical + metabolic, and clinical + metabolic + radiomics models. The discriminative ability of each model was evaluated using Harrell’s C index. The performance of each model in predicting PFS and OS for 1-, 3-, and 5-years was evaluated using the time-dependent receiver operating characteristic (ROC) curve. @*Results@#Kaplan–Meier curve analysis demonstrated that the radiomics scores effectively identified high- and low-risk patients (all P < 0.05). Multivariable Cox analysis showed that the Ann Arbor stage, maximum standardized uptake value (SUVmax), and RadPFS were independent risk factors associated with PFS. Further, β2-microglobulin, Eastern Cooperative Oncology Group performance status score, SUVmax, and RadOS were independent risk factors for OS. The clinical + metabolic + radiomics model exhibited the greatest discriminative ability for both PFS (Harrell’s C-index: 0.805 in the validation cohort) and OS (Harrell’s C-index: 0.833 in the validation cohort). The time-dependent ROC analysis indicated that the clinical + metabolic + radiomics model had the best predictive performance. @*Conclusion@#The PET/CT-based clinical + metabolic + radiomics model can enhance prognostication among patients with ENKTCL and may be a non-invasive and efficient risk stratification tool for clinical practice.
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Objective:To evaluate the accuracy of serum surfactant protein concentration in predicting postoperative pulmonary complications (PPCs) in the patients at moderate risk for PPCs undergoing abdominal surgery.Methods:Fifty-eight patients of both sexes, with the predicted ARISCAT score of 26-44 points, scheduled for elective abdominal gastrointestinal surgery, were studied.Central venous blood samples were collected before operation (T 0), at 30 min after extubation (T 1) and at 1 day after surgery (T 2) for determination of serum surfactant protein A (SP-A) and surfactant protein B (SP-B) in serum by enzyme-linked immunosorbent assay.The occurrence of PPCs during the postoperative hospitalization was recorded.The patients were divided into PPCs group and non-PPCs group according to whether PPCs occurred. The receiver operating characteristic curve was used to analyze the accuracy of serum SP-A and SP-B concentrations in predicting PPCs. Results:Compared with the baseline value at T 0, the serum SP-B concentrations were significantly increased at T 1 in group PPCs, and the concentrations of serum SP-A and SP-B were significantly decreased at T 2 in both groups ( P<0.05). The concentrations of serum SP-A and SP-B were significantly decreased at T 2 than at T 1 in both groups ( P<0.05). Compared with non-PPCs group, the serum concentrations of SP-A at T 0 and SP-B at T 1 were significantly increased in group PPCs ( P<0.05). The area under the receiver operating characteristic curve of serum SP-B concentrations in predicting PPCs at T 1 was 0.908 (95% confidence interval 0.821-0.996), and the cut-off value was 26.3 ng/ml, sensitivity 0.90, and specificity 0.81. Conclusion:The accuracy of serum SP-B concentrations measured at 30 min after extubation in predicting PPCs is higher in the patients at moderate risk for PPCs undergoing abdominal surgery.
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Objective This retrospective,single-center study evaluated short-and mid-term results of minimally invasive surgery to occlude ventricular septal defects(VSDs) through right subaxillary approach.Methods The procedure was performed on 624 children,224 boys and 205 girls;aged(2.4 ± 2.2) years;mean weight(12.3 ± 10.2)kg between January 2014 to December 2017 at the Children' s Heart Center of Henan Province People' s Hospital.An approximately 2 cm right subaxillary incision was made between the third and fifth ribs.The right atrium or ventricle was punctured under the guidance of transencephalographic echocardiography(TEE).The VSD was occluded under TEE guidance.Results The mean size of VSDs was(4.2 ±0.9)mm,and the occluder measured(5.2 ± 1.2)mm.Asymmetrical occluders were used in 28 patieuts and symmetrical occluders in 596 patients.The operative time was(58.5 ± 20.2) minutes,and the time in the intensive care unit (ICU) was(19.4 ±6.7) h.Blood loss was(10.4 ±9.5) ml.There were no deaths among these patients.Occluder displacement occurred in two cases.The complications such as Ⅲ degree atrioventricular block,new aortic regurgitation,reoperation foi massive bleeding,and serious infection were not observed.All patients were followed up for 6-48 months.There were 15 cases of residual shunt after operation.Eight cases were self-closed during follow-up,and 5 cases were still followed up.No complications such as reoperation,aortic regurgitation,atrioventricular block or occluder abscission was observed during the follow-up period.Conclusion Occluding VSDs using the right subaxillary approach is safe and effective.Short-term and midterm results are satisfactory.Further follow-up is required regarding long-term results.
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Objective: To evaluate the value of computed tomography (CT) multi-planner reconstruction (MPR)in the treatment of lung cancer with percutaneous argon-helium cryoablation.Method:A total of 66 patients with stage T2 or T3 non-small cell lung can-cer who had complete follow-up data were treated with percutaneous argon-helium cryoablation with conventional axial CT(conven-tional group)or MPR guidance(MPR group)between January 2013 and 2016.There were 31 patients in the conventional group and 35 in the MPR group.The total number of punctures,the total time of operation,and the incidence of complications,tumor residual rates,and local control rates were compared between the two groups.Results:When the number of needles was the same,the aver-age number of punctures and puncture errors in the two groups were significantly lower in the MPR group than in the conventional group(P<0.05).Comparing the average operation time,there was no statistical difference between the MPR group and the conven-tional scan group(P>0.05).The incidence of postoperative complications was significantly lower in the MPR group than in the conven-tional scan group.Among them,the incidence of puncture combined hemorrhage was 1.52% vs.13.64%,and pneumothorax second-ary to puncture was 3.03% vs.19.70%(P<0.05).During the follow-up period to 12 months after surgery,the therapeutic benefit indica-tors such as local residual rate and total effective rate in the MPR group were also significantly better than those in the conventional group,which were 1.52% vs.10.61 and 51.52% vs.36.36%(P<0.05),respectively.Conclusions:Using MPR technology to guide percuta-neous argon-helium cryoablation treatment for lung cancer confers a small puncture error,low incidence of complications,and signifi-cant treatment benefits.This method is worthy of clinical promotion.
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Objective To explore the association between inducible nitric oxide synthase (iNOS) gene polymorphisms and ischemic stroke in Uygur population of Xinjiang.Methods A case-control study was performed,included 316 patients with ischemic stroke,admitted to our hospital from June 2007 to December 2013,and 316 age-and gender-matched healthy subjects in Uygur population of Hami.The genotypes ofrs2779248(C/T) and rs1137933(C/T) were determined by Taqman probe fluorescent quantitative PCR.Results The distribution frequencies of rs2779248 (CC,CT and TT) were 51.9%,42.1% and 6.0% in the patient group,ands 61.7%,30.1% and 8.2% in the controls,respectively.As compared with those with rs2779248 CC genotype,individuals with CT+TT genotype and CT genotype had higher risk ofischemic stroke,the odds ratio was 1.49 (95%CI:1.09-2.05,P=0.013)and 1.66 (95%CI:1.19-2.32,P=0.003).The distribution frequencies ofrs1137933 (CC,CT and TT) were 66.8%,28.5% and 4.7% in the patient group,ands 66.8%,27.8% and 5.4% in the controls,respectively;no significant difference was noted between the patient group and controls in the distribution frequencies (P>0.05).Multi-factor Logistic regression analysis indicated that mutation of genotype C>T in rs2779248was the independent risk factor of ischemic stroke in Uygur population of Hami after adjusting related risk factors (OR=1.55,95%CI:1.00-2.40,P=0.049).Conclusion The polymorphisms ofrs2779248 in iNOS gene may modify the risk of ischemic stroke in Uygur population of Hami,but no association is found in rs1137933.
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Objective To explore the method of establishing the value of TSH in the diagnosis of neonatal congenital hypothyroidism in Shantou area.Methods Time resolved fluorescence was conducted to detect the level of heel blood thyrotropin(TSH)in 90 798 neonatal from January 2013 to December 2015 in Shantou area.Percentile method and ROC curve were used to establish the value of TSH screening.Results The frequency of TSH screening in 90 798 cases of neonatal showed normal distribution.The average content of TSH was(2.38-t-2.12)mU/L,ranging 0.0-324.2 mU/L;P90 for 3.46 mU/L;P95 for 4.63 mU/L and P99 for 8.88 mU/L.CH incidence rate in Shantou was 1/2 974;the P99 percentile method TSH diagnostic cut-off value was 8.88 mU/L,and the ROC curve diagnostic cut-off value was 8.49 mU/L.Besides,the recall rate analyzed by chi square test showed no significant difference between the P99 percentile method and ROC curves (χa =0.965,P =0.326).While,a significant difference were found between P99 percentile method and kit(χ2 =10.861,P=0.001),ROC curve and kit(χ2 =5.450,P =0.020).The sensitivity of P99 percentile method and ROC curve method was 100.0 %.The Youden index of P99 percentile method was 96.9 %.Conclusion The P99 percentile method is more suitable for clinical neonatal diseases of TSH screening.
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Aim To observe the correlation between the TPL's suppression on myofibrolbasts(MFBs)activation and TGF-β1/ERK/Smad3 pathway by performing in vivo and in vitro experiments.Methods In vitro model of MFBs activation was set up by stimulating fibroblasts with TGF-β1,and in vivo model of MFBs activation in radiated lung tissue was built by thoracic radiation on C57BL/6 mice.MFBs activation was analyzed by detecting the expression of α-SMA(using RT-PCR and Western blot)and Col Ⅰ(using RT-PCR and ELISA methods).The levels of p-ERK,p-Smad3(Ser208)and p-Smad3(Ser423)were measured by Western blot.ERK siRNA and Smad3 siRNA were used to observe the status of ERK and Smad3 in MFBs activation.Results TGF-β1 activated p-ERK/p-Smad3(Ser208)and p-Smad3(Ser423),increased the expression of α-SMA and synthesis of Col Ⅰ,which indicated MFBs activation.siRNA knockdown assay showed that both ERK and Smad3 were involved in regulating the levels of α-SMA and Col Ⅰ,and ERK influenced MFBs transformation possibly through its phosphorylation of Smad3(Ser208).TPL treatment inhibited the phosphorylation activation of ERK,Smad3(Ser208),Smad3(Ser423)in vitro and in vivo,therefore significantly reduced the level of α-SMA and Col Ⅰ,and the number of activated MFBs was decreased.Conclusion TPL mitigates radiation-induced pulmonary fibrosis by inhibiting the activation of MFBs,which is partly through suppressing TGF-β1/ERK/Smad3 pathway.
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Objective To verify the correlation between rs17118 polymorphism of xyluloknase homolog (XYLB) gene and risk of ischemic stroke in a Chinese Han population.Methods A case-control study design was used.The case group was the patients with first-ever ischemic stroke and the control group was the healthy subjects from hospital physical examination.Taqman probe fluorescence quantitative polymerase chain reaction technique was used to detect the genotype distribution of rs17118 C/A polymorphisms.Results A total of 475 patients with ischemic stroke and 483 controls were enrolled in the study.The proportion of hypertension (67.9% vs.22.2%;x2 =292.982,P < 0.001) and diabetes (24.2% vs.7.3%;x2 =25.864,P < 0.001),as well as the levels of triacylglycerol (1.649 ± 1.126 mmol/L vs.1.157 ±1.480 mmol/L;t=3.592,P<0.001),and low-density lipoprotein cholesterol (3.499 ± 1.163 mmol/L vs.3.105 ± 0.627 mmol/L;t =-6.227,P < 0.001) in the case group were significantly higher than those in the control group,but the total cholesterol level was significantly lower than that in the control group (5.144 ± 1.296 mmol/L vs.5.491 ± 1.335 mmol/L;t =4.650,P < 0.001).The AA genotyp e (11.4% vs.7.5 %;x2 =6.136,P =0.016) and A allele (32.3 % vs.26.4%;x2 =8.093,P =0.005) frequencies in the case group were significantly higher than those in the control group.Multivariatelogistic regression analysis showed that after adjusting for traditional risk factors,the risk of ischemic stroke in AA genotype carriers was 1.97 times of the CC genotype carriers (odds ratio 1.971,95% confidence interval 1.040-3.736,P=0.038).Conclusions The rsl7118C/A polymorphism of XYLB gene may be associated with the risk of ischemic stroke in the Chinese Han population.
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Objective To investigate the risk factors for ischemic stroke in Uygur population in Xinjiang, China. Methods Using a case-control study mode, 504 Uygur patients with first-ever ischemic stroke and 507 Uygur healthy subjects w ere investigated in accordance w ith the principle of the ethnic, sex, and age matching. The risk factors for ischemic stroke w ere screened. Results Multivariate logistic regres-sion analysis showed that the obesity (odds ratio [OR] 4.82, 95% confidence interval [CI] 1.80-12.94;P=0.002), hypertension ( OR 8.20, 95%CI 4.93-13.51; P<0.001), and heart disease ( OR 2.40, 95%CI 1.07-5.39;P=0.033) w ere the independent risk factors for ischemic stroke in Uygurs. While the education level of junior high school or above ( OR 0.38, 95%CI 0.18-0.81;P=0.012), tea drinking habit ( OR 0.22, 95%CI0.06-0.70; P=0.021), siesta habit ( OR 0.38, 95%CI 0.24-0.59; P<0.001), high levels of high-density lipoprotein cholesterol ( OR 0.34, 95%CI 0.20-0.59; P<0.001), and apolipoprotein A ( OR 0.23, 95%CI 0.07-0.77; P=0.017) were the protective factors for ischemic stroke. Conclusions The risk factors for ischemic stroke are more and typical in Uygur population in Xinjiang, China. Adjusting the diet structure of Uygurs, less taking meats and high-salt diet, intaking high fiber foods and fish, and appropriate physical exercise w il play an important role for the prevention of stroke in Uygur population.
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Objective To investigate changes of spontaneous brain activity in patients with type 2 diabetes mellitus (T2DM) by fractional amplitude of low-frequency fluctuations (fALFF) on subbands, and the possible relationship between these changes and cognitive impairment caused by T2DM.Methods Twenty-two T2DM patients and twenty-three healthy control subjects were involved in this study between December 2013 and June 2014 and the demographic and clinical data (fasting plasma glucose and HbA1c level) were obtained in all subjects.General cognition was assessed by MMSE in all subjects, and memory performance was assessed by Auditory Verbal Learning Test (AVLT) in T2DM group.3D-T1 structural and resting-state functional MRI data were collected by MR scanner.Then fALFF value on slow-5 (0.010-0.027 Hz) and slow-4 (0.027-0.073 Hz) were calculated respectively using DPARSF V2.3.Intra-group and inter-group t-tests were conducted by REST V1.8.Partial correlation among fALFF values extracted from significantly different brain regions, clinical data and AVLT score of T2DM patients were calculated , using age as covariate.Results Compared to the healthy controls, T2DM patients showed increased fALFF values in bilateral anterior cingulate gyrus (cluster=130, t=4.4487, P<0.05) and partial left cerebelum areas (cluster=89, t=3.8409, P<0.05) in frequency band slow-5.Moreover, the T2DM patients showed decreased fALFF values in bilateral middle occipital gyrus and precuneus (Left: cluster=102, t=-3.4806.Right: cluster=151, t=-5.1355.All P<0.05) in frequency band slow-5.While in frequency band slow-4, the T2DM patients showed increased fALFF values in left inferior temporal gyrus (cluster=104, t=4.8631, P<0.05), and decreased fALFF values in right lingual gyrus (cluster=91, t=-3.7146, P<0.05).There was positive correlation between fALFF values of middle occipital gyrus and precuneus and AVLT immediate memory score (r=0.456, P=0.038).Conclusions T2DM patients exhibit abnormal spontaneous activity among brain regions associated with cognition, including brain regions related to default mode network on slow-5, and brain regions related to semantic cognition and visual information processing on slow-4.The abnormal regions exhibit different spatial patterns depending on the subbands of low-frequency fluctuations.
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Objective To investigate the correlation between inducible nitric oxide synthase (iNOS) gene polymorphism and ischemic stroke in Chinese Han population.Methods Patients with first-ever stroke and the age-and sex-matched healthy controls were enrolled in the study.Taqman probe fluorescence quantitative polymerase chain reaction technique was used to detect the genotype distribution of rs2779248 C/T and rs1137933 C/T polymorphisms.Results A total of 246 patients with ischemic stroke and 246 controls were enrolled.The distribution frequencies of rs2779248 CC,CT and TT genotypes in the patient group were 57.7%,36.6%,and 5.7%,respectively,and in the control group were 68.7%,28.0%,and 3.3%,respectively.The T allele frequency of the patient group was significantly higher than that of the control group (24.0% vs.17.3%;P =0.015).Multivariate logistic regression analysis showed that after adjusting for the risk factors including age,sex,hypertension,and diabetes,the risk of ischemic stroke in the CT + TT genotype carriers was 1.64 times of the CC genotype carriers (odds ratio 1.64,95% confidence interval 1.07-2.51;P=0.022).The distribution frequencies of rs1137933 CC,CT and TT in the patient group were 58.1%,37.8%,and 4.1%,respectively and in the control group were 68.3%,29.3%,and 2.4%,respectively.The T allele frequency of the patient group was significantly higher than that of the control group (23.0% vs.17.1%;P =0.013).Multivariate logistic regression analysis showed that after adjusting for traditional risk factors,the risk of ischemic stroke of patients with the TT + CT genotype carriers was 1.60 times of the CC genotype carriers (odds ratio 1.60,95% confidence interval 1.05-2.46;P=0.030).Conclusions The rs2779248 C/T and rs1137933 C/T polymorphisms in iNOS gene may be associated with the risk of onset of ischemic stroke in Chinese Han population.
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Background and purpose:For patients with advanced lung adenocarcinoma harboring an activating EGFR gene mutation, the current standard of care is EGFR-TKI alone. This study aimed to compare efficacy and safety of gefitinib plus chemotherapy with gefitinib or chemotherapy alone for treating advanced lung adenocarcinoma with an activatingEGFR gene mutation.Methods:This study included 61 patients with lung adenocarcinoma harboring an acti-vatingEGFR gene mutation (19 exons deletion and exon 21 L858R mutations) whose ECOG performance status was 0 or 1. Patients were randomly divided into 3 groups. Group A (n=20) were given carboplatin/pemetrexed of a 4-week cycle, six cycles at most, plus gefitinib (pemetrexed 500 mg/m2, d1; carboplatin AUC 5, d1; gefitinib 250 mg/d, d 5-21), and then re-ceived pemetrexed of a 4-week cycle plus gefitinib as maintenance therapy; Group B (n=20) were given carboplatin/peme-trexed of a 4-week cycle, six cycles at most (pemetrexed 500 mg/m2, d1; carboplatin AUC 5, d1), then received pemetrexed as maintenance therapy; Group C (n=21) were given gefitinib (gefitinib 250 mg/d). Patients continued to receive therapy until disease progression or unacceptable toxicity or death. The primary end point was middle PFS and 12 months PFS rate. The secondary end points included objective response rate and adverse events.Results:Groups A and C both lost 1 case during follow-up. Median PFS for patients was 20.1 months (95%CI:18.0-22.2) in group A, 5.5 months (95%CI:3.9-7.2) in group B, and 9.8 months (95%CI:6.8-12.8) in group C. PFS rates of 12 months for groups A, B and C were 78.9%, 15.0% and 40.0%, respectively. The overall objective response rates for groups A, B and C were 84.2%, 35.0% and 65.0%, respectively. Serious adverse events were reported by 36.8% for group A, 30.0% for group B, and 5.0% for group C. The most common grade 3/4 adverse events were neutropenia (3 cases in group A, 4 cases in group B), fatigue (2 cases in group A, 2 cases in group B) and liver function impairment (2 cases in group A, 1 case in group C).Conclusion:Among patients withEGFR mutant lung adenocarcinoma, combination of chemotherapy with gefitinib as first-line treatment demonstrates an improvement in PFS. Long-term survival results will be further followed up.
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Objective To investigate the effect and safety of transcutaneous electrical stimulation at Zusanli acupoint for elimination of gastrointestinal poison in patients with oral organophosphorus pesticide poisoning. Methods A prospective study was conducted, including 62 patients with oral organophosphorus pesticide poisoning from September 2013 to February 2015 in the Department of Emergency of Xingtai People's Hospital of Hebei Province. The patients were divided into a observation group and a control group (each, 31 cases) in accord with the principle of simple random sampling. All the patients in two groups were given comprehensive treatment according to the diagnosis and treatment of the guide for organic phosphorus pesticide poisoning. In addition, the transcutaneous electrical stimulation at bilateral Zusanli acupoints was carried out in the observation group, once therapeutic time 30 minutes and every 8 hours once, and stopped until the discharge of melena. The incidence of vomiting after application of cathartics, the first stool time, the time of melena discharge, daily defecation frequency, the time of reaching atropinization, the total amount of atropine used, the time of cholinesterase (ChE) activity returning to its 1/2 normal activity, the length of stay in hospital, cure rate and mortality were observed in both groups. The changes in hemodynamics and pulse blood oxygen saturation (SpO2) were observed before and after transcutaneous electrical acupoint stimulation, and the occurrence of adverse reactions in the therapeutic course were observed in the observation group.Results After application of cathartics, the incidence of vomiting in control group was significantly higher than that in the observation group [32.2% (10/31) vs. 9.7% (3/31),P < 0.05]. In the observation group, the first stool time (hours: 9.3±3.6 vs. 11.6±5.2) and the time of melena discharge (hours: 11.3±5.3 vs. 14.5±6.8) were significantly shorter than those in the control group (both P < 0.05); while the frequency of bowel movements during catharsis was higher than that of the control group (times/d: 4.3±0.5 vs. 3.1±0.4,P < 0.01). In the observation group, the time reaching atropinization (hours: 66.3±22.8 vs. 84.6±24.2), the total amount of atropine used (mg: 66.3±22.8 vs. 84.6±24.2), and the time of ChE activity returning to its 1/2 normal range (days: 6.1±2.4 vs. 8.3±3.9) were significantly shorter than those in the control group (allP < 0.01). At the end of treatment, the average length of stay in hospital was shorter (days: 11.3±2.8 vs. 13.4±4.2,P < 0.05) and the cure rate was higher [96.8% (30/31) vs. 83.9% (26/31),P < 0.05] in the observation group than those in the control group; in observation group, the hemodynamics and SpO2 before and after acupoint electrical stimulation did not change significantly; in the course of treatment, no adverse reactions occurred.Conclusion The addition of transcutaneous electric stimulation at bilateral Zusanli acupoints in patients with oral organophosphorus pesticide poisoning has following advantages: lowering the incidence of vomiting during catharsis, enhancing the cathartic effect, promoting gastrointestinal poisoning discharge as soon as possible, reducing total atropine used during hospitalization, shortening the time reaching atropinization, shortening the duration of hospitalization, promoting the recovery of cholinesterase activity and elevating clinical therapeutic effects.
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Objective To explore the efficacy and safety of dyclonine hydrochloride mucilage applied as a lubricant for orotracheal intubation. Methods A prospective study was conducted,144 patients with respiratory failure(RF)and clear consciousness admitted into Emergency Department of Xingtai People's Hospital in December 2010 to June 2013 for orotracheal intubation were randomly divided into experimental and control groups(each, 72 cases). Topical spray anesthesia onto the throat wall was applied for all the patients before orotracheal intubation. In the experimental group,the patients received 1%hydrochloric acid dyclonine mucilage as a lubricant,while in the control group,they received paraffin oil as a lubricant before the insertion of tracheal tube. The operating procedure of the insertion was in accord to the rules of orotracheal intubation in both groups. The changes of heart rate,systolic blood pressure,diastolic blood pressure,pulse oxygen saturation(SpO2),success rate of once tracheal intubation,incidence of choking cough,the time of tracheal intubation and dyclonine adverse reactions were observed. Results The heart rate,systolic and diastolic blood pressures were significantly higher and SpO2 was obviously lower after the intubation in both groups than those before the procedure,and the changes were more significant in the control group〔heart rate(bpm):135.2±9.9 vs. 98.1±8.1,systolic blood pressure(mmHg,1 mmHg=0.133 kPa):145.6±20.8 vs. 138.8±22.1,diastolic blood pressure(mmHg):96.1±17.6 vs. 82.9±22.8,SpO2:0.643±0.128 vs. 0.749±0.102, all P<0.05〕;the success rate of once tracheal intubation in experimental group was significantly higher than that in the control group〔98.6%(71 cases)vs. 84.7%(61 cases),P<0.01〕,the incidence of choking cough was obviously lower than that in the control group〔36.1%(26 cases)vs. 52.8%(38 cases),P<0.05〕,the time for insertion of tracheal tube in experimental group was also significantly shorter than that of control group(minutes:1.9±0.9 vs. 2.3±1.1,P<0.05). No drug adverse reactions occurred. Conclusion Compared with paraffin oil,dyclonine hydrochloride mucilage as a lubricant for tracheal intubation is a simpler and easier operation which has the advantages of having better anesthesia,effectively reducing the irritation of the throat wall,improving the success rate of intubation,being more tolerable by the patients,reducing the adverse reaction rate during insertion of tube and having no occurrence of drug adverse reactions,therefore dyclonine can be applied in tracheal intubation.
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Background and purpose:Multiple primary lung cancers (MPLC) is a rare entity, but recently there has been a gradual increase in the number of patients diagnosed with MPLC. The aim of this study is to investigate the diagnosis, treatment and prognosis of MPLC through analyzing the clinical data.Methods:Forty-one patients were diagnosed MPLC by Martini-Melamed criteria. Their clinicopathological data were retrospectively reviewed. Results:There were 3 patients with triple primary lung cancer and 38 patients with double primary lung cancer. There were 13 patients with synchronous MPLC, 26 patients with metachronous MPLC, 2 patients with synchronous and metachronous MPLC. Of 85 lesions, the surgical procedures were mainly lobectomy (78.8%, 67/85). Lesions (41.2%, 35/85) were frequently in right upper lobe. Pathological type was mainly adenocarcinoma (70.6%, 60/85),followed by squamous cell carcinoma (17.6%, 15/85). Of 60 adenocarcinoma specimens, the papillary predominant subtype was more common (50%, 30/60). Eighty percent (68/85) of the lesions were stage I. As to the initial cancer and repeated cancer, patients who shared the same pathological type (68.3%, 28/41) were more than the different (31.7%, 13/41), of which adenocarcinoma-adenocarcinoma was most common(82.1%, 23/28). Lesions located in contralateral lobes were in 37 patients (90.2%), and located in ipsilateral different lobes were in 4 patients (9.8%). The 2-year overall survival (OS) of them was 87.8%. Survival analysis showed that the prognosis of patients with same pathological type was better than patients with different pathological type (P=0.037), the prognosis of patients with no lymph node metastasis was better than patients with N1,N2 metastasis (P=0.02).Conclusion:Lesions in patients with multiple primary lung cancers are more frequently in the right upper lobes. The pathology type is mainly adenocarcinoma, of which the papillary predominant subtype was most common. Early diagnosis improves continuously, active treatment with operation can achieve better prognosis.
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Objective To explore the differential diagnosis value of DWI ADC for breast lumps,improve the diagnosis of breast cancer specificity.Methods 93 patients with 105 breast tumors were performed with routine MR series and DWI,and the ADC values were measured.Results Lesions ADC values:average ADC value 43 benign lesions in 37 cases was(1.37±0.36)×10-3 mm2/s,the different value between max and min was(0.63±0.19)×10 -3s/mm2.Average ADC value of 62 malignant lesions in 58 patients was(0.90±0.53) × 10 -3 mm2/s,the different value between max and min was(0.91±0.27)×10-3 mm2/s.By statistical analysis,both average ADC values and the max and the min ADC difference value were very significantly different(P<0.01).Draw diagnosis benign and malignant lesions ROC curves,with ADC values 0.11×10 -3 mm2/s for critical value to judge benign and malignant standard,sensitivity was 67%,specificity was 72%.With 1.0×10- 3 mm2/s for critical value,specificity can raise to 84%,and sensitivity came to 60%.With the maximum and minimum ADC difference value 0.75 × 10-3s/mm2 for critical value,sensitivity was 67%,specificity was 68%.If with 0.80 for critical value,sensitivity was 53% and specificity 82%.Conclusion The average ADC values of DWI were significant for the identification of benign and malignant lesions.
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Research in lymph node imaging has made great progress in recent years. With the increasing in-depth researches and clinical applications of MRI, PET and molecular imaging, the sensitivity, specificity and accuracy of detecting lymph node metastases have also been improved. Incorporating techniques such as various pulse sequences, contrast enhancement and lymph-node contrast agents has made MRI a superior method for detecting lymph node metastasis of breast cancer in clinical settings.
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Objective To observe the effect of Huazhuo-Jiedu-Huoxue Tongluo recipe on local inflammation of cerebral ischemia reperfusion injury in mice. Method Fifty Kunming Mice were randomly divided into five groups: model group, high-dose group of TCM, low-dose group of TCM, nimodiping group and sham operation group. Each group had 10 mice. Mice models of the right middle cerebral artery CIRI in the first four groups were established through thread embolism method. Physiological saline was given to the mice in the model group and sham operation group. Nimodipine solution was given to the mice in the Nimodipine group. High and low dose of Huazhuo-Jiedu-Huoxue-Tongluo Chinese medicine decoction were given to the mice in the high dose of TCM group and low dose of TCM group respectively after the models were successfully established. To assess the expression level of IL-6 and TNF-α by radioimmunoassay after the treatment. Results Compared with model group [(219.29±39.28) pg/ml, (1.325 ± 0.236) ng/ml] , the level of IL-6 and TNF-α of high dose of TCM group[(120.69±49.23)pg/ml, (1.086±0.178)ng/ml], low dose of TCM group[(173.97±49.03)pg/ml, (0.937 ± 0.105)ng/ml]and nimodipine group[(170.88± 47.06)pg/ml, (1.092±0.184) ng/ml]decrease (P0.05). Conclusion Huazhuo-Jiedu-Huoxue-Tongluo recipe can restrain the expression of inflammatory cytokines and reduce the infiltrating of leukocytes in mice with cerebral ischemia reperfusion injury.
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Objective To explore the relationship between MR enhancement signs with MVD and VEGF expression in early breast carcer or benign lesion,improve the correct diagnosis rate of breast mass.Methods The MR enhancement signs(early enhmcement rate,eurve type of enhancement)of 31 patients with breast cancer and 19 benign lesions were analyzed retrospectively.Results Mean early enhancement rate of 31 neoplasm(20 invasive duet csncer,6 invasive lobule cancer,2 mucous cancer,3 situ lobule caner)were(68.4±14.7)%,enhancement curve type of which manifested as 18 type Ⅰ curve,11 typeⅡcurve and 2 type Ⅲ curve.Mean early enhancement rate of 19 benign mass(11 fibre adenoma,6 cystic hyperplasia,1 angioma,lobular tumor,1 infecmd cyst)were(47.6 ±15.2)%,of which 2 were typeⅠcurve,10 type Ⅱ cnrve and 7 type Ⅲ curve.In early cancer focus,mean MVD and VEGF expression index were 48.2±5.6 and 1.8 ±0.3,while in benign mass they were 30.8 ±6.1,0.9 ±0.3 respectivdy.Condusion Early enhancement rate,MVD and VEGF expression index in malignant focus were higher than those in benign mass,type Ⅰ curves were predominate in malignant lesions,by which early breast cancer could be diagnosed in time.
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To some problems on imaging teaching in traditional Chinese medical university,the countermeasures are as follows: the teacher team constructions and research work were perfected;the teaching contents were compiled by full time teachers;carefully preparing,supervising and guiding teachers could improve class teaching.The clinic should face to practice,society and future,the objective of which is to cultivate practical graduates with knowledge,skill and creativity who can adapt to clinic fast.The various examination forms were applied.By above means,imaging teaching quality has been improved perfectly.