Real-time prediction of organ failures in patients with acute pancreatitis using longitudinal irregular data.

It is extremely important to identify patients with acute pancreatitis who are at high risk for developing persistent organ failures early in the course of the disease. Due to the irregularity of longitudinal data and the poor interpretability of complex models, many models used to identify acute pancreatitis patients with a high risk of organ failure tended to rely on simple statistical models and limited their application to the early stages of patient admission. With the success of recurrent neural networks in modeling longitudinal medical data and the development of interpretable algorithms, these problems can be well addressed. In this study, we developed a novel model named Multi-task and Time-aware Gated Recurrent Unit RNN (MT-GRU) to directly predict organ failure in patients with acute pancreatitis based on irregular medical EMR data. Our proposed end-to-end multi-task model achieved significantly better performance compared to two-stage models. In addition, our model not only provided an accurate early warning of organ failure for patients throughout their hospital stay, but also demonstrated individual and population-level important variables, allowing physicians to understand the scientific basis of the model for decision-making. By providing early warning of the risk of organ failure, our proposed model is expected to assist physicians in improving outcomes for patients with acute pancreatitis.

Comparison of the predictive value of the modified CADILLAC, GRACE and TIMI risk scores for the risk of short-term death in patients with acute ST segment elevation myocardial infarction after percutaneous coronary intervention / 中华危重病急救医学

Objective:To establish a modified controlled abciximab and device investigation to lower late angioplasty complication (CADILLAC) score, and to compare the predictive value of modified CADILLAC score, the global registry of acute coronary event (GRACE) score and the thrombolysis in myocardial infarction (TIMI) score in predicting the risk of short-term death after percutaneous coronary intervention (PCI) in patients with acute ST segment elevation myocardial infarction (STEMI).Methods:A retrospective study was conducted. The clinical data of 169 STEMI patients under going PCI admitted to the department of cardiology of Guizhou Provincial People's Hospital from September 2019 to December 2020 through emergency chest pain fast track were enrolled. A multivariate Logistic regression analysis was used to screen the factors closely related to the mortality risk within 30 days of STEMI, and a modified CADILLAC scoring system was established by referring to CADILLAC scoring settings. The score of modified CADILLAC, GRACE and TIMI scores of patients were calculated after admission, and the number of deaths due to cardiovascular disease (CVD) within 30 days after onset was recorded. The receiver operating characteristic curve (ROC curve) was used to evaluate the predictive value of three scoring systems on the risk of death within 30 days after PCI in patients with STEMI.Results:In 169 STEMI patients, 16 patients died of CVD within 30 days after PCI, and the actual case mortality was 9.47%. Multivariate Logistic regression analysis showed that age > 75 years old, cardiac function Killip ≥ Grade Ⅲ, ventricular arrhythmia, ST segment elevation ≥ 0.2 mV, cardiac troponin I (cTnI) increase, systolic blood pressure (SBP) < 90 mmHg (1 mmHg ≈ 0.133 kPa) were all independent predictors of death after PCI in STEMI patients. The improved CADILLAC scoring system was constructed based on the above predictive factors combined with left ventricular ejection fraction (LVEF) less than 0.40. The GRACE, TIMI and modified CADILLAC scores of dead patients were significantly higher than those of survival patients (GRACE score: 197.60±31.83 vs. 149.81±36.72, TIMI score: 11.21±2.13 vs. 7.27±1.97, modified CADILLAC score: 12.60±2.52 vs. 6.96±2.17, all P < 0.05). The higher the risk stratification of the three scores, the higher the mortality of patients with CVD within 30 days after PCI [the mortality of patients with low, medium and high risk in GRACE score were 2.41% (2/83), 9.61% (5/52) and 26.47% (9/34); the mortality of patients with low, medium and high risk in TIMI score were 3.12% (3/96), 12.82% (5/39) and 23.53% (8/34); and the mortality of patients with low, medium and high risk in modified CADILLAC score were 3.19% (3/94), 7.69% (4/52) and 39.13% (9/23), respectively, all P < 0.01]. The area under the ROC curve (AUC) of the GRACE, TIMI and the modified CADILLAC scores predicting the risk of death 30 days after PCI in STEMI patients were 0.855 [95% confidence interval (95% CI) was 0.702-0.923], 0.725 (95% CI was 0.666-0.812) and 0.882 (95% CI was 0.732-0.936), respectively, all P = 0.000; the sensitivity of its prediction accuracy were 81.59%, 78.65% and 89.26%, and the specificity were 78.62%, 57.12% and 75.54%, respectively. Conclusions:The GRACE and the modified CADILLAC scores have predictive value for the short-term mortality risk of STEMI patients after PCI, and the modified CADILLAC score is more accurate. But the TIMI score has a poor predictive effect on the short-term mortality risk of STEMI patients after PCI.

Retrospective study of "integrated prevention strategy" in preventing nipple and areola ischemia after single-port endoscopic subcutaneous mastectomy / 国际外科学杂志

Objective:To explore the preventive value of "integrated prevention strategy" for nipple and areola ischemia after single-port endoscopic subcutaneous mastectomy.Methods:The clinical data of 72 patients with breast cancer who received single-port endoscopic subcutaneous mastectomy in Beijing Friendship Hospital, Capital Medical University from July 2019 to July 2021 were retrospectively analyzed, they were all female. The follow-up period was up to July 2022. According to the perioperative treatment methods, the patients were divided into observation group ( n=40) and control group ( n=32). The patients in the observation group who adopted the "integrated prevention strategy" scheme, and patients in the control group who adopted the conventional treatment scheme. The incidence of postoperative nipple and areola ischemic was compared between the two groups, and the postoperative cosmetic effect, quality of life and satisfaction of patients were evaluated. Measurement data were expressed as mean ± standard deviation ( ± s), and t-test was used for comparison between groups; the Chi-square test was used to compare the data groups. Results:The postoperative drainage volume in the observation group was significantly lower than that in the control group [(632.40±226.37) mL vs (774.91±239.85) mL], and the difference was statistically significant ( P=0.013). Two weeks after operation, there was 1 case of nipple and areola ischemia in the observation group, and 7 cases in the control group, the difference was statistically significant between the two groups ( P=0.019). Twelve months after operation, the score of breast satisfaction (83.93±11.64 vs 67.28±11.52), chest satisfaction (89.63±8.06 vs 83.03±9.49) and psychosocial well-being (89.43±12.42 vs 78.88±10.40) in the observation group were better than those in the control group, the differences were statistically significant ( P<0.05). Conclusion:"Integrated prevention strategy" can effectively prevent the occurrence of nipple and areola ischemic after single-port endoscopic subcutaneous mastectomy and improve patient satisfaction, which has certain promotion value.

Disease burden of multidrug-resistant tuberculosis in China and regions with different income levels in the world / 公共卫生与预防医学

Objective To analyze the disease burden of multidrug-resistant tuberculosis (MDR-TB) in China and regions with different income levels in the world from 1990 to 2019. Methods Using the Global Burden of Disease Study 2019 (GBD2019) results, the changes of the disease burden of MDR-TB in China and regions with different income levels in the world were described and analyzed using the Joinpoint Regression Program 4.8.0.1 software. Results From 1990 to 2019, the age standardized incidence, mortality and DALY rates in China and other areas with different income levels in the world basically showed a trend of first rising and then decreasing at the turning point of the late 20th century and early 21st century, except for low-income areas where the age standardized incidence rate showed an overall upward trend. In 2019, the incidence rate, mortality and DALY rate of MDR-TB in China were 9 times, 6.67 times and 6.89 times higher than those in high-income areas, respectively. The incidence rate in China was 6 times lower than that in low and middle-income areas, while the mortality and DALY rate in China were 26 times and 32.53 times lower than those in low-income areas, respectively. The age standardized incidence, mortality rate and DALY rate of MDR-TB in men were higher than those in women. Risk factors for the burden of MDR-TB disease included alcohol consumption, smoking, and high fasting blood glucose. Conclusion From 1990 to 2019, there are significant regional and gender differences in the disease burden of multidrug-resistant tuberculosis in China and regions with different income levels in the world. Multidrug-resistant tuberculosis is still a major challenge for tuberculosis control in the world. It is necessary to develop more effective control strategies and health care systems to deal with multidrug-resistant tuberculosis.

Epidemic status and model analysis of cardiovascular and cerebrovascular diseases attributed to renal insufficiency in elderly Chinese / 公共卫生与预防医学

Objective To analyze the changing trend of disease burden attributable to renal insufficiency in cardiovascular disease (CVD) among the elderly in China from 1990 to 2019, and to forecast the disability-adjusted life years (DALY) in the next 10 years, so as to provide a reference basis for accurate prevention and control of CVD attributable to renal insufficiency in China. Methods Data were obtained from the Global Health Data Exchange (GHDx) database to describe the current status of CVD prevalence attributable to renal insufficiency. The joinpoint model was used to estimate the annual percentage change and average annual percentage change to assess the temporal trend of CVD attributable to renal insufficiency in China. An autoregressive moving average model was created by R4.0.2 software to predict the disease burden of CVD attributable to renal insufficiency in China. Results Compared with 1990, CVD mortality and DALY rates attributed to renal insufficiency increased in the male elderly population and decreased in women. Mortality and DALY rates attributed to ischemic heart disease, ischemic stroke, and peripheral arterial disease attributed to renal insufficiency showed an increasing trend, and mortality and DALY rates for cerebral hemorrhage decreased. There was an overall increasing trend in the attribution of CVD due to renal insufficiency. Conclusion The burden of diseases attributable to renal insufficiency in Chinese elderly with CVD is relatively high, and the impact on each disease is different, which requires the attention of relevant authorities.

Distinguish bipolar and major depressive disorder in adolescents based on multimodal neuroimaging: Results from the Adolescent Brain Cognitive Development study®.

Background: Major depressive disorder and bipolar disorder in adolescents are prevalent and are associated with cognitive impairment, executive dysfunction, and increased mortality. Early intervention in the initial stages of major depressive disorder and bipolar disorder can significantly improve personal health. Methods: We collected 309 samples from the Adolescent Brain Cognitive Development study, including 116 adolescents with bipolar disorder, 64 adolescents with major depressive disorder, and 129 healthy adolescents, and employed a support vector machine to develop classification models for identification. We developed a multimodal model, which combined functional connectivity of resting-state functional magnetic resonance imaging and four anatomical measures of structural magnetic resonance imaging (cortical thickness, area, volume, and sulcal depth). We measured the performances of both multimodal and single modality classifiers. Results: The multimodal classifiers showed outstanding performance compared with all five single modalities, and they are 100% for major depressive disorder versus healthy controls, 100% for bipolar disorder versus healthy control, 98.5% (95% CI: 95.4-100%) for major depressive disorder versus bipolar disorder, 100% for major depressive disorder versus depressed bipolar disorder and the leave-one-site-out analysis results are 77.4%, 63.3%, 79.4%, and 81.7%, separately. Conclusions: The study shows that multimodal classifiers show high classification performances. Moreover, cuneus may be a potential biomarker to differentiate major depressive disorder, bipolar disorder, and healthy adolescents. Overall, this study can form multimodal diagnostic prediction workflows for clinically feasible to make more precise diagnose at the early stage and potentially reduce loss of personal pain and public society.

Prediction of the trajectories of depressive symptoms among children in the adolescent brain cognitive development (ABCD) study using machine learning approach.

BACKGROUND: Depression often first emerges during adolescence and evidence shows that the long-term patterns of depressive symptoms over time are heterogeneous. It is meaningful to predict the trajectory of depressive symptoms in adolescents to find early intervention targets. METHODS: Based on the Adolescent Brain Cognitive Development Study, we included 4962 participants aged 9-10 who were followed-up for 2 years. Trajectories of depressive symptoms were identified by Latent Class Growth Analyses (LCGA). Four types of machine learning models were built to predict the identified trajectories and to obtain variables with predictive value based on the best performance model. RESULTS: Of all participants, 536 (10.80%) were classified as increasing, 269 (5.42%) as persistently high, 433 (8.73%) as decreasing, and 3724 (75.05%) as persistently low by LCGA. Gradient Boosting Machine (GBM) model got the highest discriminant performance. Sleep quality, parental emotional state and family financial adversities were the most important predictors and three resting state functional magnetic resonance imaging functional connectivity data were also helpful to distinguish trajectories. LIMITATION: We only have depressive symptom scores at three time points. Some valuable predictors are not specific to depression. External validation is an important next step. These predictors should not be interpreted as etiology and some variables were reported by parents/caregivers. CONCLUSION: Using GBM combined with baseline characteristics, the trajectories of depressive symptoms with two years among adolescents aged 9-10 years can be well predicted, which might further facilitate the identification of adolescents at high risk of depressive symptoms and development of effective early interventions.

Risk Factors and Prognosis in Patients With Anti-N-Methyl-D-Aspartate Receptor Encephalitis Requiring Prolonged Mechanical Ventilation.

BACKGROUND: Mechanical ventilation (MV) is commonly used in anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis patients with serious conditions. However, little is known about the potential risk factors and long-term outcomes of anti-NMDAR encephalitis requiring MV, especially prolonged MV. METHODS: The data collected prospectively from 305 patients with anti-NMDAR encephalitis were retrospectively reviewed. The functional outcome was assessed using a modified Rankin scale (mRS) every 3 months. RESULTS: We identified 62 (20.3%) patients who required MV. The most common reasons for MV were decreased consciousness and/or status epilepticus (SE). Among 60 patients analyzed, 27 patients required prolonged MV (>15 days). Prolonged MV primarily was based on the younger age, coma, tumor, and severe pneumonia. During the follow-up (median: 28 months, range: 3-87 months), 77% of patients required MV that exhibited a good outcome. In univariate analysis, prolonged MV, higher levels of C-reactive protein (CRP), and neutrophil-to-lymphocyte ratio (NLR) were found to be associated with poor neurological outcome at 6 months. Although the prolonged MV group exhibited a longer time to achieve a good outcome as compared to the short MV group (median duration 6 months vs. 3 months, p = 0.004), no significant difference was observed between the two groups about long-term outcomes. CONCLUSION: It is important to recognize that most anti-NMDAR encephalitis patients who required MV will achieve a favorable long-term outcomes, despite the longer duration of MV. Our results may help clinicians in the ventilator management of severe anti-NMDAR encephalitis patients.

Application of Internet diversified rehabilitation medicine education in newly diagnosed breast cancer patients / 国际外科学杂志

Objective:To explore the influence of Internet diversified rehabilitation medicine education on self-efficacy and quality of life in newly diagnosed breast cancer patients.Methods:A prospective study was performed in 130 newly diagnosed breast cancer patients admitted to Beijing Friendship Hospital, Capital Medical University from February 2020 to February 2021. According to the method of randomly number table, these patients were divided into control group and intervention group, 65 cases in each group.The control group was treated with routine treatment scheme, and the intervention group added the intervention of Internet diversified education of rehabilitation medicine on the basis of routine treatment scheme. Compared the general data of the two groups, the General Self-Efficacy Scale (GSES) and the cancer patients′ Quality of Life Questionnaire-Core 30 (QLQ-C30) were used to compare the self-efficacy levels of the two groups before operation, 4 months and 8 months after operation, evaluate the quality of life. Measurement data were expressed as mean ± standard deviation ( ± s), and t-test was used for comparison between groups; Chi-square test was used for comparison of enumeration data between groups. Results:Before operation, there was no significant difference in general data, GSES score and QLQ-C30 score between the two groups ( P> 0.05). Four months after operation, GSES scores [(27.39±4.68) score vs (25.91±3.18)score], somatic function [(65.50±4.34) score vs (63.07±5.42) score], cognitive function [(67.63±10.32) score vs (63.29 ± 11.36) score], role function [(50.82±10.80) score vs (45.59±13.94) score], and total quality of life [(63.47 ± 6.98) score vs (59.26±7.98)score] were compared between the intervention group and the control group, the difference was statistically significant ( P< 0.05). There was no significant difference in the scores of emotional function [(57.60±11.72) score vs (55.53±10.61) score] and social function [(49.86±12.11) score vs (46.13±10.25) score] ( P> 0.05). Eight months after operation, the GSES score [(28.82±3.31) score vs (26.73 ± 3.06) score] of patients in the intervention group and the control group, and the scores of functional areas and overall quality of life in QLQ-C30 score were significantly different ( P< 0.01). Conclusion:the Internet diversified rehabilitation medicine education has a significant effect on improving the self-efficacy of new breast cancer patients, and can improve the quality of life of patients.

Clinical analysis of breast reconstruction with single-port inflatable endoscopic prepectoral prosthesis implantation / 国际外科学杂志

Objective:To investigate the surgical method and clinical application value of single-port inflatable endoscopic prepectoralis prosthesis implantation for breast reconstruction (external prosthesis wrapping Off-Label).Methods:From September 2021 to February 2022, 7 breast cancer patients who underwent single-port inflatable endoscopic prepectoralis prosthesis implantation breast reconstruction (Off-Label) in Beijing Friendship Hospital, Capital Medical University were retrospectively analyzed. Statistical analysis of surgical complications, postoperative movement deformities, postoperative chest wall pain, postoperative quality of life and satisfaction scores of patients were conducted.Results:All 7 patients successfully completed the operation. There were no complications such as postoperative bleeding, infection, ischemic necrosis of nipple-areola complex or skin flap, postoperative movement deformity, postoperative chest wall pain, capsular contracture, prosthesis exposure or removal. The BREAST-Q scale was used to evaluate the quality of life and satisfaction after breast reconstruction. Postoperative breast satisfaction (55-100 points), chest wall status (52-89 points), and social psychological status (62-100 points) can be compared High rating.Conclusion:The single-port inflatable endoscopic prepectoral prosthesis implantation breast reconstruction (Off-Label) can achieve better radical effect and cosmetic effect through a shorter operation time, and the postoperative quality of life and satisfaction of patients are higher.

Application of parathyroid test paper in identifying parathyroid gland in thyroid surgery / 国际外科学杂志

Objective:To compare the diagnostic efficiency of colloidal gold dipstick method (PTH dipstick method) with that of doctors’ experience method based on nano-carbon method for rapid identification of parathyroid gland in thyroidectomy of thyroid cancer.Methods:From March to July 2020, 90 patients underwent thyroid surgery in the Friendship Hospital, Capital Medical University participated in the experimental study, and 155 samples underwent empirical judgment, parathyroid dipstick and pathological examination. All operations were performed by senior specialists. SPSS statistics 17.0 software was used for statistical analysis.Results:Seventy-four cases of parathyroid gland confirmed by both pathology and empirical judgment, and 81 cases of non-parathyroid gland confirmed by pathology; 130 cases of parathyroid glands confirmed by both PTH dipstick method and pathology, and 22 cases of non-parathyroid glands confirmed by pathology. The accuracy rate of PTH dipstick method was 85.53% which was much higher than that of empirical judgment method (47.74%). The data were statistically significant ( χ2=49.14, P<0.05). The sensitivity of PTH method was 95.89%, the specificity of PTH method was 75.94%, and the Youden index was 0.7183. The sensitivity of empirical judgment method was 81.3%, the specificity of empirical judgment method was 47.74%, and the Youden index was 0.2904. Conclusions:The diagnostic efficiency of the PTH method is higher than that of empirical judgment method to identify parathyroid gland in thyroid surgery. The two methods can be used together to increase the protection of parathyroid gland during operation.

Significance of endoscopic exposure of circummammary ligament under endoscopy and the effect of membrane anatomy in breast reconstruction / 国际外科学杂志

Objective:To explore the significance of exposing the circummammary ligament under endoscopy and the effect of membrane anatomy in breast reconstruction.Methods:The case data of 49 breast cancer patients who underwent endoscopic nipple-sparing mastectomy combined with one-stage breast reconstruction with prosthesis implantation in Beijing Friendship Hospital, Capital Medical University from February 2014 to December 2021 were retrospectively analyzed, there were 44 cases of posterior pectoralis prosthesis implantation, 5 cases of anterior pectoralis prosthesis implantation. The anatomical structure of the circummammary ligament was observed under endoscopy during operation, and the annular mammary ligament was used as an anatomical marker to complete subcutaneous glandectomy and prosthesis implantation for breast reconstruction, the BREAST-Q scales were used to evaluate the postoperative effect.Results:The medial sternal ligament, sub clavicular ligament, lateral confluence ligament and triangular ligament condensation could be clearly exposed in all 49 cases. Breast reconstruction module of BREAST-Q were used to evaluate the surgery effect after breast cancer surgery, the scores of postoperative breast satisfaction, chest wall status, psychosocial status and sexual health status were 81.43±12.57, 88.39±10.61, 88.04±13.70, 74.82±15.93.Conclusion:The endoscopic technique is beneficial to expose the circummammary ligament during operation, and surgical resection and reconstruction can better restore the appearance of the breast and improve postoperative satisfaction according to the principle of membrane anatomy.

Changes in psychological status of initial-diagnosed breast cancer patients before and after surgical treatment / 国际外科学杂志

Objective:To study the effect of surgical treatment on the psychological status of initial-diagnosed breast cancer patients.Methods:Using a prospective study method, 73 initial-diagnosed breast cancer patients who received surgical treatment in Beijing Bo′ai Hospital from March 2015 to June 2017 were selected. The self-rating anxiety scale (SAS), the self-rating depression scale (SDS) and the symptom checklist-90 (SCL-90) were used to evaluate the psychological health status before and after surgery by face-to-face conversation. The measurement data were described as mean±standard deviation( ± s), and the scores of SAS, SDS and SCL-90 before and after surgery were analyzed by paired t-test. Chi-square test was used to compare count data before and after surgery. Results:After surgical treatment, the anxiety and depression scores were 38.03±8.53 and 42.17±10.93, which were significantly lower than that in the pre-operation (46.47±11.47 and 51.01±14.22), the differences were statistically significant ( P<0.001). The scores of somatization, obsessive-compulsive symptoms, interpersonal sensitivity, anxiety, depression, hostility, phobia, paranoid and psychotic disorder of initial-diagnosed breast cancer patients in SCL-90 were 4.52±4.71, 6.15±5.49, 3.51±3.26, 4.52±4.44, 7.12±6.23, 1.55±2.03, 3.18±3.36, 0.99±1.36 and 2.85±3.59 after surgical treatment, which were significantly lower than that in the pre-operation (6.88±6.36, 10.08±6.77, 5.99±5.57, 10.03±8.00, 12.59±9.78, 4.12±5.25, 4.92±4.46, 2.59±3.60) and (5.84±5.43), the differences were statistically significant ( P=0.002 in somatization, others P<0.001). Conclusion:Surgical treatment can improve the psychological status of initial-diagnosed breast cancer patients, which has important significance for the psychological rehabilitation of patients who were initial-diagnosed breast cancer.

Clinical outcomes of single-port insufflation endoscopic subcutaneous nipple-sparing mastectomy in early breast cancer / 国际外科学杂志

Objective:To discuss the oncologic safety, aesthetic outcome, and upper extremity function of single-port insufflation endoscopic nipple-sparing mastectomy (SIE-NSM) in the treatment of early breast cancer.Methods:From January 2014 to August 2019, a total of 80 patients with stage Ⅰ and Ⅱ breast cancer underwent SIE-NSM, at Beijing Friendship Hospital, Capital Medical University were retrospectively analyzed and followed up. Estimated the oncologic safety, aesthetic outcome, and upper extremity function.Results:SIE-NSM was performed successfully on all 80 patients.There was no serious complication after surgery.The follow-up time was 16-82 months and the median follow-up time was 42 months. Local recurrence occurred in two patients, and there was no distant metastases. Four (5%) patients developed grade 1-3 nipple-areola complex ischemia. There were no cases of subcutaneous effusion.The satisfaction with breasts, chest well-being, psychosocial well-being, and sexual well-being scores were confirmed to be highly rated by Breast-Q scale. Upper extremity function score confirmed that good upper limb function was preserved after surgery. The mean length of incision was (3.6±0.8) cm, and the blood loss was (24.7±19.3) mL.Conclusions:SIE-NSM can achieve a higher cosmetic score and a better recovery of upper limb function on the premise of ensuring the safety of the tumor.This novel method is an appropriate surgical option for patients with early breast cancer.

Clinical application of ultrasound-guided fine needle aspiration in the diagnosis and treatment of thyroid diseases / 中国基层医药

Objective:To investigate the clinical effect of ultrasound-guided fine needle aspiration in the diagnosis and treatment of thyroid diseases.Methods:A retrospective analysis was conducted in 300 cases who received ultrasound-guided thyroid fine needles from January 2014 to April 2017 in the First People's Hospital of Xiaoshan District.The clinicopathological data of the puncture cells were compared with the histopathological results of 15 patients who agreed to undergo surgery.Results:The results of pathologically diagnosed as suspected malignant lesions, thyroiditis, cystic thyroid cysts, benign thyroid adenomas, the proportion of positive cell components were 7.67%, 20.00%, 12.67%, 1.33% and 46.67%, respectively.The overall positive cell rate was 88.33%.The sensitivity of US-FNAB for the diagnosis of malignant diseases was 50.00%(3/6), the specificity was 55.56%(5/9), the positive predictive value was 42.86%(3/7), and the negative predictive value was 62.50%(5/8), the false positive rate was 57.14%, and the false negative rate was 37.50%.Conclusion:Ultrasound-guided thyroid fine needle aspiration technology has an irreplaceable importance in the clinical diagnosis and treatment of thyroid disease.Because of its high accuracy and safety, which is worthy of promoting in medicine.

Clinical observation of radiofrequency ablation in breast-conserving surgery after neoadjuvant chemotherapy / 国际外科学杂志

Objective@#To evaluate the efficacy of radiofrequency ablation in breast-conserving surgery followed neoadjuvant chemotherapy.@*Methods@#Retrospective analysis of 30 cases of breast cancer patients admitted to Beijing Friendship Hospital, Capital Medical University from April 2015 to September 2018. The average age was 54.3 years and the range was 28 to 70 years. For breast invasive ductal cancer, patients underwent breast-conserving surgery after neoadjuvant chemotherapy, and then received radiofrequency ablation. The clinical and pathological characteristics, postoperative complications, recurrence and metastasis, and cosmetic effects were observed.@*Results@#All 30 patients with breast-conserving surgery successfully completed radiofrequency ablation. The average outpatient follow-up was 22.5 months, ranging from 2 to 43 months, without local recurrence or metastasis; skin burns occurred in 2 cases (6.67%), and solid nodules formed in situ in 6 cases (20.00%); cosmetic satisfaction rate was 86.67% (26/30).@*Conclusions@#The radiofrequency ablation techniques applied in breast-conserving surgery have a high rate of technical success with relative low complication rates. And the radiofrequency ablation techniques may improve the cosmetic results after breast-conserving surgery and enhance local control.

Application effect of fine needle aspiration cytology and sentinel lymph nodes stain assisted by contrast-enhanced ultrasound in early breast cancer / 国际外科学杂志

Objective@#To explore the application effect of fine needle aspiration cytology and sentinel lymph nodes stain assisted by contrast-enhanced ultrasound in early breast cancer.@*Methods@#A patient with early breast cancer enrolled in Beijing Friendship Hospital, Capital Medical University received fine needle aspiration cytology assisted by contrast-enhanced ultrasonography and the sentinel lymph nodes were stained with blue dye before a standard sentinel lymph nodes biopsy traced with indocyanine green. The axillary status accessed by these two methods were compared.@*Results@#Three sentinel lymph nodes were found and aspirated assisted by contrast-enhanced ultrasonography. Seven sentinel lymph nodes were obtained in sentinel lymph nodes biopsy surgery. All of these sentinel lymph nodes were negative. The stained sentinel lymph nodes could be recognized and dissected in open lymph nodes biopsy surgery.@*Conclusions@#Fine needle aspiration cytology assisted by contrast-enhanced ultrasonography could be a substitute for open sentinel lymph nodes biopsy. More related researches should be carry out to further compare these two methods.

Significance of breast cancer stem cell surface markers in predicting chemotherapy sensitivity and recurrence / 国际外科学杂志

Objective:To analyze how the surface marker of breast cancer stem cell related to chemotherapy resistance and postoperative recurrence.Methods:The GEO public database GSE25066 and GSE32603 were used to extract clinical data including pathological evaluation of neoadjuvant chemotherapy, postoperative follow-up recurrence and recurrence time, and the expression levels of the following 18 breast cancer stem cell marker genes were extracted: CD44, CD24, EPCAM, CD49f, PROM1, CD61, ALDH1A1, CD10, ALDH1A3, ABCG2, RANK, CD47, CD166, SLUG, SOX2, SXO9, SOX10, MYC. A total of 488 patients with GSE25066 were divided into pathology compete response(pCR) group ( n=99) and residual disease (RD) group ( n=389) according to the pathological analysis. Another 418 patients with complete recurrence data was divided into recurrence group ( n=111) and non-recurrence group ( n=307), they were used for prognosis analysis. The effects of each tumor stem cell marker on chemotherapy sensitivity and tumor recurrence were analyzed by logistic, lasso and COX regression. The gene expression level of GSE32603 before and after neoadjuvant chemotherapy were used to analyze the changes after neoadjuvant chemotherapy in 166 patients, to determine the enrichment effect of chemotherapy on stem cells. Results:In chemotherapy response analysis, tumor stem cell markers CD44( OR=0.78, 95% CI: 0.63-0.98) and SANI2 ( OR=0.80, 95% CI: 0.68-0.93) were negatively correlated with neoadjuvant chemotherapy sensitivity, and CD24( OR=1.18, 95% CI: 0.97-1.47) was positively correlated with chemosensitivity. In the recurrence correlation analysis, the patients with CD44 + ( OR=1.22, 95% CI: 0.98-1.51), CD24 low( OR=0.94, 95% CI: 0.79-1.11) and SANI2( OR=1.17, 95% CI: 1.00-1.37) expression have a high recurrence rate. As chemotherapy progressed, the MME, CD49f, SOX10, MYC, and SOX9 ( P<0.05) showed an enrichment process. Conclusions:Breast cancer stem cell markers CD44 + CD24 - and SLUG can be used to predict the efficacy of neoadjuvant chemotherapy and recurrence after tumor treatment. They are relatively stable marker for studying breast cancer stem cells.

Application analysis of radiofrequency ablation in breast conserving surgery with breast carcinoma / 国际外科学杂志

Objective:To explore the application of radiofrequency ablation in breast conserving surgery with breast carcinoma.Methods:With retrospective research methods, a total of 230 patients who were treated with radiofrequency ablation after breast conserving surgery in Beijing Friendship Hospital, Capital Medical University from January 2016 to September 2018 were selected, patients were all females, the median age was 56 yecers, ranged from 27 to 91 years, and the postoperative efficacy, patients′ satisfaction with their appearance and complications were outpatient follow-up.Results:Follow-up for 18 months showed that 2 (0.87%) patients had postoperative recurrence and metastasis, 217 (94.35%) patients were satisfied with the postoperative breast appearance, and 8 patients (3.48%) had skin burns and in- situ sclerosing. Conclusions:Radiofrequency ablation is used in breast conserving surgery, which is simple to operate and has a low incidence of complications. It can strengthen local tumor control and improve the cosmetic effect of breast after conserving surgery, worthy of clinical promotion.

Clinical observation of radiofrequency ablation in breast-conserving surgery after neoadjuvant chemotherapy / 国际外科学杂志

Objective To evaluate the efficacy of radiofrequency ablation in breast-conserving surgery followed neoadjuvant chemotherapy.Methods Retrospective analysis of 30 cases of breast cancer patients admitted to Beijing Friendship Hospital,Capital Medical University from April 2015 to September 2018.The average age was 54.3 years and the range was 28 to 70 years.For breast invasive ductal cancer,patients underwent breast-conserving surgery after neoadjuvant chemotherapy,and then received radiofrequency ablation.The clinical and pathological characteristics,postoperative complications,recurrence and metastasis,and cosmetic effects were observed.Results All 30 patients with breast-conserving surgery successfully completed radiofrequency ablation.The average outpatient follow-up was 22.5 months,ranging from 2 to 43 months,without local recurrence or metastasis;skin burns occurred in 2 cases (6.67％),and solid nodules formed in situ in 6 cases (20.00％);cosmetic satisfaction rate was 86.67％ (26/30).Conclusions The radiofrequency ablation techniques applied in breast-conserving surgery have a high rate of technical success with relative low complication rates.And the radiofrequency ablation techniques may improve the cosmetic results after breast-conserving surgery and enhance local control.