Diagnosis of primary clear cell carcinoma of the liver based on Faster region-based convolutional neural network / 中华医学杂志(英文版)

BACKGROUND@#Distinguishing between primary clear cell carcinoma of the liver (PCCCL) and common hepatocellular carcinoma (CHCC) through traditional inspection methods before the operation is difficult. This study aimed to establish a Faster region-based convolutional neural network (RCNN) model for the accurate differential diagnosis of PCCCL and CHCC.@*METHODS@#In this study, we collected the data of 62 patients with PCCCL and 1079 patients with CHCC in Beijing YouAn Hospital from June 2012 to May 2020. A total of 109 patients with CHCC and 42 patients with PCCCL were randomly divided into the training validation set and the test set in a ratio of 4:1.The Faster RCNN was used for deep learning of patients' data in the training validation set, and established a convolutional neural network model to distinguish PCCCL and CHCC. The accuracy, average precision, and the recall of the model for diagnosing PCCCL and CHCC were used to evaluate the detection performance of the Faster RCNN algorithm.@*RESULTS@#A total of 4392 images of 121 patients (1032 images of 33 patients with PCCCL and 3360 images of 88 patients with CHCC) were uesd in test set for deep learning and establishing the model, and 1072 images of 30 patients (320 images of nine patients with PCCCL and 752 images of 21 patients with CHCC) were used to test the model. The accuracy of the model for accurately diagnosing PCCCL and CHCC was 0.962 (95% confidence interval [CI]: 0.931-0.992). The average precision of the model for diagnosing PCCCL was 0.908 (95% CI: 0.823-0.993) and that for diagnosing CHCC was 0.907 (95% CI: 0.823-0.993). The recall of the model for diagnosing PCCCL was 0.951 (95% CI: 0.916-0.985) and that for diagnosing CHCC was 0.960 (95% CI: 0.854-0.962). The time to make a diagnosis using the model took an average of 4 s for each patient.@*CONCLUSION@#The Faster RCNN model can accurately distinguish PCCCL and CHCC. This model could be important for clinicians to make appropriate treatment plans for patients with PCCCL or CHCC.

Effect of statins on prognosis of senile diabetes mellitus complicated with cerebral infarction / 中国基层医药

Objective@#To investigate the effect of statins on the prognosis of senile diabetic patients with cerebral infarction.@*Methods@#Sixty-two elderly patients with diabetes mellitus and cerebral infarction admitted to Shantou Central Hospital from June 2016 to June 2017 were selected.Thirty patients who took atorvastatin(10 mg/d) six months before onset were selected as observation group.At the same time, 32 cases of cerebral infarction who were not given statins were selected as control group.The risk factors on admission to hospital, fasting glucose, glycosylated hemoglobin, blood lipid levels and neural function defect were compared between the two groups.The nerve function defect was evaluated after treatment for 2 weeks.@*Results@#In the observation group, the rates of drinking, smoking, coronary heart disease, hyperlipidemia, previous stroke and hypertension were 20.00%, 63.34%, 50.00%, 73.33%, 40.00%, 70.00%, respectively, compared with the control group (28.00%, 65.63%, 56.25%, 71.88%, 34.38%, 75.00%), there were no statistically significant differences (χ2=0.121, 0.213, 0.197, 0.195, 0.142, 0.139, P=0.327, 0.644, 0.542, 0.530, 0.475, 0.453). The triglyceride, total cholesterol, low density lipoprotein cholesterol and high density lipoprotein cholesterol in the observation group were (3.68±0.81)mmol/L, (1.35±0.46)mmol/L, (2.65±1.36)mmol/L, (1.38±0.56)mmol/L, respectively, which in the control group were (5.45±1.24)mmol/L, (1.83±0.76)mmol/L, (3.89±1.51)mmol/L, (0.92±0.33)mmol/L, respectively, the differences were statistically significant between the two groups (t=5.621, 5.825, 4.916, 5.103, P=0.012, 0.013, 0.022, 0.020). The levels of blood glucose and glycosylated hemoglobin in the observation group were (6.58±2.87)mmol/L, (7.18±1.48)%, respectively, which in the control group were (6.84±3.14)mmol/L, (7.05±1.49)%, respectively, the differences were statistically significant (t=1.049, 1.199, P=0.301, 0.362). The national institutes of health stroke scale (NIHSS) scores of the control group before and after treatment were (15.2±4.3)points and (4.9±0.8)points, respectively, which were higher than those of the observation group [(14.8±3.8)points and (7.1±0.7)points], and the differences were statistically significant (t=4.879, 5.268, P=0.028, 0.016).@*Conclusion@#The primary prevention of statins can improve the blood lipid level and nerve function of senile diabetic patients with cerebral infarction, as well as reduce the degree of disability.

Effect of statins on prognosis of senile diabetes mellitus complicated with cerebral infarction / 中国基层医药

Objective To investigate the effect of statins on the prognosis of senile diabetic patients with cerebral infarction.Methods Sixty-two elderly patients with diabetes mellitus and cerebral infarction admitted to Shantou Central Hospital from June 2016 to June 2017 were selected.Thirty patients who took atorvastatin(10 mg/d) six months before onset were selected as observation group.At the same time,32 cases of cerebral infarction who were not given statins were selected as control group.The risk factors on admission to hospital,fasting glucose,glycosylated hemoglobin,blood lipid levels and neural function defect were compared between the two groups.The nerve function defect was evaluated after treatment for 2 weeks.Results In the observation group,the rates of drinking,smoking,coronary heart disease,hyperlipidemia,previous stroke and hypertension were 20.00％,63.34％,50.00％,73.33％,40.00％,70.00％,respectively,compared with the control group (28.00％,65.63％,56.25％,71.88％,34.38％,75.00％),there were no statistically significant differences (x2 =0.121,0.213,0.197,0.195,0.142,0.139,P =0.327,0.644,0.542,0.530,0.475,0.453).The triglyceride,total cholesterol,low density lipoprotein cholesterol and high density lipoprotein cholesterol in the observation group were (3.68 ±0.81) mmol/L,(1.35 ±0.46) mmol/L,(2.65 ± 1.36) mmol/L,(1.38 ± 0.56) mmol/L,respectively,which in the control group were (5.45 ± 1.24) mmol/L,(1.83 ± 0.76) mmol/L,(3.89 ± 1.51) mmol/L,(0.92 ± 0.33) mmol/L,respectively,the differences were statistically significant between the two groups (t =5.621,5.825,4.916,5.103,P =0.012,0.013,0.022,0.020).The levels of blood glucose and glycosylated hemoglobin in the observation group were (6.58 ± 2.87)mmol/L,(7.18 ±1.48)％,respectively,which in the control group were (6.84 ± 3.14) mmol/L,(7.05 ± 1.49) ％,respectively,the differences were statistically significant (t =1.049,1.199,P =0.301,0.362).The national institutes of health stroke scale (NIHSS) scores of the control group before and after treatment were (15.2 ± 4.3) points and (4.9 ± 0.8) points,respectively,which were higher than those of the observation group [(14.8 ± 3.8)points and (7.1 ± 0.7)points],and the differences were statistically significant (t =4.879,5.268,P =0.028,0.016).Conclusion The primary prevention of statins can improve the blood lipid level and nerve function of senile diabetic patients with cerebral infarction,as well as reduce the degree of disability.

Thevalueof3.0T MRreducedfield-of-viewIVIM diffusionweightedimaging ondistinguishingprostatecancerandprostatehypertrophy / 实用放射学杂志

Objective Toinvestigatethevalueof3.0T MRreducedfield-of-view (rFOV)IVIM-DWIondistinguishingprostate cancerandprostatehypertrophy.Methods 30patientswithpathologicallyprovenprostatecancerand38patientswithprostatehypertrophy accordingtotheresultsofbiopsywereanalyzedretrospectively,whounderwent3.0T MRrFOV multipleb-valueDWIscanpreoperatively.The DWIscanwasperformedusing11b-valuesof0,30,50,100,150,200,400,800,1000,1500and2000s/mm2.ADC,slowdiffusion coefficient(D),fastdiffusioncoefficient(D?)andperfusionfraction(f)weremeasuredoncancerousfociandprostatehyperplasiafoci.Allofthe datawereanalyzed.Results TheADC,D,D?andfvaluesoftheprostatecancerwere(0.61±0.12)×10-3 mm2/s,(0.41±0.08)×10-3 mm2/s, (88.0±40.3)×10-3mm2/s,289.3%±29.4%,respectively,and(09.0±01.7)×10-3mm2/s,(05.4±01.3)×10-3mm2/s,(46.1±15.3)×10-3 mm2/s, 474.3%±10.85%,respectively,forprostatehypertrophy.Thedifferencesamongthefourparameterswerestatisticallysignificant(P<0.05).The areasofADC,D,D?andfvaluesunderROCcurvestodistinguishbetweenprostatecancerandprostatehypertrophywere09.32,08.27,01.58,0.976, respectively.Conclusion 3.0T MRrFOVIVIM-DWIcanreflectthetruewaterdiffusion motionandperfusionintheprostate,and maycontributetothedifferentialdiagnosisofprostatecancerandbenignprostatehyperplasia.

Quantitative analysis of dynamic contrast-enhanced MRI in distinguishing different grades of prostate cancer / 中国医学影像技术

Objective To investigate the value of quantitative analysis parameters of dynamic contrast-enhanced MRI (DCE-MRI) in distinguishing low or high grade prostate cancer.Methods Data of DCE-MRI in 26 patients with prostate cancer confirmed by surgical pathology following radical prostatectomy were retrospectively analyzed.These patients were divided into low grade prostate cancer (n=10) group or high grade prostate cancer group (n=16).The parameters,including transport constant (K trans),rat constant (Kep) and extravascular extracellular volume fraction (Vc.) were measured and compared between the two groups.ROC curve was used to determine the efficacy of the parameters in distinguishing low or high grade prostate cancer.The correlation between the parameters and Gleason score were assessed.Results Ktrans,Kep and Ve values in the low grade prostate cancer group was (0.22± 0.07)/min,(1.24 ± 0.57)/min and 0.21±0.08 respectively,and (0.36±0.10)/min,(1.82±0.66)/min,0.21±0.10 respectively in the high grade prostate cancer group.The differences of K trans and Kep were statistically significant between the two groups (both P＜0.05),while of Vc.was not statistically significant (P=0.994).The area under ROC curves of K trans and keapvalues for distinguishing low or high grade prostate cancers was 0.872 and 0.737,respectively.No correlation was found between any parameters nor Gleason scores (all P＞0.05).Conclusion K trans and Kep,the quantitative analysis parameters of DCE-MRI,contribute to the differential diagnosis of low and high grade prostate cancer.

Molecular characterization of Capra hircus lysosomal α-mannosidase and potential mutant site for the therapy of locoweed poisoning.

Lysosomal α-Mannosidase (LAM) belongs to the glycoside hydrolyzing enzymes family 38 and is involved in the biosynthesis and turnover of N-linked glycoproteins process. Locoweeds, which contain swainsonine (SW) that inhibits LAM, are the main poisoning plants in many regions of the world, and thereby resulting in animal poisoning or even death. Based on regions of protein sequence conservation between LAM from Bos taurus and Homo sapiens, we cloned cDNA encoding Capra hircus LAM (chLAM). Expression of cDNA in Pichia pastoris resulted in the secretion of aLAM activity into the culture medium. The recombinant chLAM was activated 1.6 and 1.2-fold with Zn(2+) and Ca(2+), respectively. By homology modeling, molecular docking and mutant analysis, we obtained the probable binding modes of SW at the allosteric sites of chLAM, and the potential mutant sites for the resistance to SW. Prediction of SW sensitivity to A28 W/G, D58 Y/G mutant chLAM is lower than wild type chLAM. The obtained results lead to a better understanding of not only interactions between substrate/SW and chLAM, but also of a potential strategy for a novel therapy for locoweed poisoning.

Three-stage installment correction for severe rigid scoliosis / 中国组织工程研究

BACKGROUND:The treatment of severe rigid idiopathic scoliosis is the difficulty of clinical treatment. The studies in recent years have shown that the three-stage correction is a safe and effective treatment method. OBJECTIVE:To explore the efficacy of three-stage correction in the treatment of severe rigid scoliosis. METHODS:Retrospective analysis was performed on 10 severe rigid scoliosis patients undergoing three-stage correction, the mean age of the patients was 12 years. The average Cobb angle in the coronal plane was 140° (ranged 110°-180°), the average Cobb angle in the sagittal plane was 75° (ranged 50°-100°). The treatment was divided three stages:anterior release, Halo-plevic traction and third step with posterior osteotomy and fixation. RESULTS AND CONCLUSION:Al of the patients underwent the surgery safely without severe complications. After anterior release and Halo-plevic traction, the Cobb angle in the coronal plane was 90°, and the mean correction rate was 35.7%;the Cobb angle in the sagittal plane was 50° with correction rate of 33.3%. The mean Cobb angle in the coronal plane was 40° with the correction rate of 71.4%after osteotomy, and the Cobb angle in the sagittal plane was 35° with the correction rate of 53.3%. The results show that three-stage correction is a safe and effective method for the treatment of severe rigid scoliosis.

Effects of benazepril on peritoneal fibrosis in rats with peritoneal dialysis / 中国组织工程研究

BACKGROUND: It has confirmed that angiotensin converting enzyme inhibitor benazepril can delay fibrosis of varied organs. However, whether benazepril has inhabited effect on peritoneal fibrosis in the process of peritoneal dialysis is poorly understood. OBJECTIVE: It is assumed that benazepril could inhabit peritoneal fibrosis of peritoneum with peritoneal dialysis, in addition, to compare the effect to other mehods. METHODS: All rats were randomly and evenly divided into 4 groups. There was no intervention in the control group; saline solution, and 20 mL 42.5 g/L Dianeal solution, was injected into rats in the saline solution and peritoneal dialysis groups; in the combination group, 20 mL 42.5 g/L Dianeal solution was injected combined with oral taken benazepril 20 mg/(kg·d). The intraperitoneal injection performed once a day, for 4 successive weeks. The ultrafiltration function was performed 4 weeks later. Meantime, Paraffin sections were cut and stained by Van Gieson to measure peritoneal thickness. RESULTS AND CONCLUSION: Two rats in the peritoneal dialysis group and 1 rat in the combination group were dead. The remained 37 rats were included in the final analysis. Compared to the control and saline solution groups, the ultrafiltration volume of the peritoneal dialysis and combination groups were obviously decreased (P_(all)< 0.05), especially notably decreased in the combination group (P< 0.05). Compared to the control group end saline solution groups, the peritoneal thickness was significantly elevated in the combination group, but not as much as in the peritoneal dialysis group (P < 0.05). In the long-term peritoneal dialysis rats, administration of benazepril can effectively protect the ultrofiltration function of peritoneum and delay the progression of peritoneal fibrosis.

Surgical treatment of coronal shear fracture of the capitellum humeri of adults / 中国矫形外科杂志

[Objective]To evaluate the clinical result of surgical treatment of coronal shear fracture of the capitellum humeri of adults.[Method]From January 2001 to July 2005,6 cases of 2 males and 4 females with coronal fractures capitulum humeri were chosen open reduction and internal fixation utilizing screws.The fractures were terated under direct vision and were fixed with screws.The left arms in 4,right in 2,the age of the group were from 27 to 48 years old,with the average of 38 years.The operative time was from 3 days to 9 days after injury.All cases were fresh and close fractures.[Result]All operations were successful,no nerves and blood vessels injury was found,the incisions were all healed by first intention.The X-ray films showed that the fractures were anatomic reduction.The healing time was 7 weeks in average with 6 to 9 weeks range.All cases were followed up from 12 to 52 months with an average of 32 months,no postoperative complications such as myositis ossificans or avascular necrosis of capitulum humeri was found.According to BrobergMorrey Scale,there were 5 caese of excellent,1case of good.[Conclusion]The coronal shear fracture of the capitellum humeri of adults are suitable for opening reduced direct vision and fixing with screws,prompt treatment with anatomic reduction and internal fixation and early rehabilitation could lead to excellent or good outcomes.