Application of task-driven teaching on general medical students in the internship of rehabilitation medicine / 中华医学教育探索杂志

Objective:To explore the application and influence of task-driven teaching in the internship of rehabilitation medicine among general medical students.Methods:A total of 256 students of the same grade from the fifth clinical college of Chongqing Medical University were included in this study. 128 students were selected as the experimental group to receive task-driven teaching, and another 128 students were selected as the control group to receive traditional teaching. Course design for students in the experimental group was evaluated, and the learning effects were compared between the two groups.Results:In the experimental group, more than 88% students were relatively satisfied with the tasks designed. The ability of self-study and independent thinking of students in the experimental groups was better than those in the control group ( P<0.05). In the aspect of problem solving, expression, cooperation, modern information utilization and creative thinking ability, students in the experimental group did a significantly better performance than those in the control group ( P=0.000), and students' learning motivation was significantly increased in the experimental group than in the control group ( P=0.000). Conclusion:In the internship of rehabilitation medicine, task-driven teaching was highly accepted among students and received fair satisfaction. It improves the learning effect of students majoring in general medicine and promotes the understanding for rehabilitation medicine, which lays a foundation for the work of primary hospitals in the future.

Comparison of ultrasound radiomics with conventional imaging models: diagnosis of central cervical lymph node metastasis in papillary thyroid carcinoma / 中华超声影像学杂志

Objective@#To compare the difference of diagnostic ability between ultrasound radiomics (USR) and different conventional imaging models of central neck (Ⅵ) lymph node metastasis in papillary thyroid carcinoma (PTC).@*Methods@#A training set of 609 cases was set up. USR features were extracted and screened by USR method. A weighted formula was established to calculate the USR score of each patient by ultrasound image. The USR score of the best diagnostic ability was obtained by statistical method and set as the diagnostic criterion. A test set of 326 cases was established to compare the diagnostic ability of USR score with ultrasound (US), computed tomography (CT) and US combined CT.@*Results@#The accuracy, sensitivity, specificity, area under ROC curve and Youden index of USR score in test set were 0.804, 0.867, 0.770, 0.766, 0.533, respectively, which were significantly higher than the corresponding values of US, CT and US combined CT(all P=0.000).@*Conclusions@#USR score obtained with USR method can effectively predict lymph node metastasis in Ⅵ region of PTC. The diagnostic efficiency and clinical value of USR score were significantly higher than those of conventional medical imaging models.

Comparison of ultrasound radiomics with conventional imaging models :diagnosis of central cervical lymph node metastasis in papillary thyroid carcinoma / 中华超声影像学杂志

Objective To compare the difference of diagnostic ability between ultrasound radiomics ( USR) and different conventional imaging models of central neck ( Ⅵ ) lymph node metastasis in papillary thyroid carcinoma ( PTC) . Methods A training set of 609 cases was set up . USR features were extracted and screened by USR method . A weighted formula was established to calculate the USR score of each patient by ultrasound image . T he USR score of the best diagnostic ability was obtained by statistical method and set as the diagnostic criterion . A test set of 326 cases was established to compare the diagnostic ability of USR score with ultrasound ( US ) ,computed tomography ( CT ) and US combined CT . Results T he accuracy ,sensitivity ,specificity ,area under ROC curve and Youden index of USR score in test set were 0 .804 ,0 .867 ,0 .770 ,0 .766 ,0 .533 ,respectively ,which were significantly higher than the corresponding values of US ,CT and US combined CT ( all P ＝ 0 .000 ) . Conclusions USR score obtained with USR method can effectively predict lymph node metastasis in Ⅵ region of PTC . T he diagnostic efficiency and clinical value of USR score were significantly higher than those of conventional medical imaging models .

Relationship between c-kit mRNA expression and prognosis in patients with rectal carcinoma / 中华肿瘤杂志

Objective@#To investigate the correlation between c-kit mRNA expression and prognosis in patients with rectal carcinoma.@*Methods@#The expression of c-kit mRNA in rectal carcinoma tissues(n=66) was detected by multiplex branched-DNA liquid chip method. According to the expression level, the patients were classified into the c-kit mRNA high expression group and the low group. We analyzed the relationship between the c-kit mRNA expression and the clinicopathological characteristics of patients, as well as the factors affecting patients′prognosis.@*Results@#Of the 66 rectal carcinoma patients, 18(27.3%)cases were c-kit mRNA high expression. No significant correlation was found between the c-kit mRNA expression and gender, age, preoperative carcinoembryonic antigen, preoperative hemoglobin, distance to verge, lymph node metastasis, tumor thrombus, T stage, TNM stage and tumor differentiation (P>0.05). In follow-up, 34 patients died, 32 patients and 36 patients were recurrence or metastasis. The 1-, 3-, 5-year overall survival(OS) of c-kit mRNA high expression group were 100.0%, 77.8%, 77.8%, respectively, while those of the low one were 93.8%, 56.3%, 45.8%, respectively. The difference was statistically significant(P=0.025). Lymph node metastasis, T stage and TNM stage were also significant associated with OS(P<0.05). The 1-, 3-, 5-year disease free rate (DFS)of the c-kit mRNA high expression group were 100.0%, 77.8% and 77.8%, respectively, while those of the low one were 77.1%、43.8% and 41.7%, respectively, and the difference between the two groups was significant (P=0.044). As a reslut, c-kit mRNA expression (P=0.038) and TNM stage (P=0.039) were the independent prognostic factors affecting the OS in rectal cancer patients.@*Conclusions@#Low expression of c-kit was associated with poor prognosis of rectal carcinoma. And the mechanism underlying this phenomenon deserves further exploration.

Shear wave elastography guided biopsy in diagnosis of tuberculous peritonitis / 中国介入影像与治疗学

Objective To assess the clinical value of ultrasound shear wave elastography (SWE) guided biopsy for diagnosis of tuberculous peritonitis.Methods Clinical data of 25 tuberculous peritonitis patients who underwent SWE guided biopsy (SWE guided group) and other 25 tuberculous peritonitis patients who underwent conventional ultrasound guided biopsy (conventional ultrasound guided group) were retrospectively analyzed.The successful rate of biopsy and the complication occurrence were compared between the two groups.Results The success rate of SWE guided group was 100％(25/25),and the rate of complication occurrence was 8.00％ (2/25).The successful rate and complication occurrence in conventional ultrasound guided group was 84.00％ (21/25) and 32.00％ (8/25),respectively.There were statistical differences of success rate of biopsy (x2=4.348,P=0.037) and the complication occurrence (x2=4.500,P=0.034) between the two groups.Conclusion Compared with conventional ultrasound,SWE guidance can improve the success rate and reduce the complication occurrence of biopsy.

The application of fusion imaging in patients who received initial prostate biopsy / 中华医学超声杂志（电子版）

Objective To investigate the application of fusion imaging in the initial prostate biopsy.Methods Retrospective analysis was made on 40 patients who underwent initial ultrasound-guided prostate biopsy in Shanghai Jiao Tong University Affiliated 6th People's Hospital from August 2014 to May 2015.All patients underwent preoperative magnetic resonance imaging (MRI) scans one week prior to surgery and the results showed that all patients had suspicious positive prostate cancer lesions,while there were no positive findings in the same area in sonography.All patients with prostate cancer have been confirmed by pathologic examination.Image fusion technology was used to guide the biopsy of lesions which were suspected as prostate cancer by MRI,and then the prostate underwent systematic biopsy by 10 needles under the guide of ultrasound.R× C Chi-square test was used to compare the positive ratio among imaging fusion biopsy,systematic biopsy and combined method in the diagnosis of prostate cancer.Fourfold table Chi-square test was used to compare to undetected rate between fusion imaging biopsy and systematic biopsy in the diagnosis of prostate cancer.The differences of detection rate in the Gleason score more than 7 points of prostate cancer between fusion imaging biopsy and systematic biopsy was compared by Fisher exact test.Results In this group of 40 patients with prostate biopsy,14 cases (35.0％) were diagnosed prostate cancer by systematic biopsy,19 cases (47.5％) were diagnosed prostate cancer by image fusion biopsy,and 22 cases (55.0％) were diagnosed prostate cancer by systematic biopsy combined with image fusion.The difference of diagnostic positive rate among combined method of biopsy,image fusion biopsy and systematic biopsy had not statistically significant (P ＞ 0.05).Three cases (13.6％,3/22) of prostate cancer patients were missed in image fusion method group,and 8 cases (36.4％,8/22) of prostate cancer patients have not been diagnosed by systematic biopsy,which indicated the umdetected rate of systematic biopsy is higher than that of image fusion biopsy in prostate cancer diagnosis,and there was a statistical difference between the two groups (x2=8.338,P=0.005).Among 19 cases of prostate cancer patients who were diagnosed by image fusion biopsy method,Gleason score were greater than 7 points in 15 cases (78.9％,15/22).Among 14 cases of prostate cancer patients who were diagnosed by systematic biopsy method,Gleason score were greater than 7 points in 6 cases (42.9％,6/14).The positive rate of Gleason score ≥ 7 points in fusion imaging biopsy was higher than that of systematic biopsy,which had a statistical difference (Fisher exact probability method,P=0.039).Conclusion Image fusion method can be used to reduce the tndetected rate of prostate cancer and improve the detection rate of the high-grade prostate cancer.

The distribution of gene polymorphism of methylenetetrahydrofolate reductase and methionine synthase among Han women in Zhangjiagang city / 基础医学与临床

Objective To explore the 5,10-methylenetetrahydrofolate reductase (MTHFR) and 5-methyltetrahydro-folate-homocysteine methyltransferase reductase ( MTRR ) gene polymorphisms among the Han women in Zhangjiagang city .Methods A total of 4008 Han women were recruited .Their oral epithelial cells were collected to extract genome DNA in order to detect gene polymorphisms of MTHFR and MTRR using fluorescence quantitative PCR.Then the results were compared with those in other cities in China .Results The genotype frequencies of MTHFR C677T CC, CT and TT among Zhangjiagang women are 32.2%, 49.5%and 18.3%, respectively.The C allele frequency is 64.3%, T allele frequency is 35.7%.The genotype frequencies of MTHFR A1298 C AA, AC and CC are 68.7%,28.7% and 2.5%, respectively .The A allele frequency is 80.8%, C allele frequency is 19.2%.The genotype frequencies of MTRR A66 G AA, AG and GG are 54.4%, 38.5%and 7.1%, respectively . The A allele frequency is 76.3%, G allele frequency is 26.4%.Conclusions The MTHFR, MTRR polymorphism distribution of Han women in Zhangjiagang city is region specific.

Preliminary study of high frequency ultrasound in sciatic nerve of rat with diabetic neuropathy / 中华超声影像学杂志

Objective To evaluate the value of high frequency ultrasound in sciatic nerve of rat with diabetic neuropathy.Methods Fifty male Sprague-Dawley rats were divided into 4 groups:Diabetic animals were induced by intravenous injection of streptozotocin after high fat feed for 1 month,after which rats were grouped as 3-month (n =12) and 5-month (n =20) diabetes.Control group were received the streptozotocin vehicle and were classified as 3-month group (n =8) and 5-month group (n =10).Ultrasounic study of cross sectional area (CSA) and pathologic study including number and area of nerve fiber were performed at 3 and 5 months according to the disigned.Results The CSA,number and area of nerve fiber in 5 month diabetes were significantly reduced than 5-month control group (t =5.121,P ＜ 0.05; t =7.113,P ＜0.05; t =6.328,P ＜0.05).The CSA were statistically with the number and area of nerve fiber in 5 month diabetic group (r =0.732,P ＜0.05 ; r =0.715,P ＜0.05).However,the CSA had no significant correlation with the number and area of nerve fiber between 3-month diabetes and control group (P ＞0.05).Conclusions The CSA of sciatic nerve can evaluate the diabetic neuropathy of rat,which might be regarded as a potential index in diagnose of diabetic neuropathy.