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Objective: To investigate the application value of relaxation time quantitative technique from synthetic magnetic resonance imaging (MRI) in the diagnosis and invasion assessment of prostate cancer. Methods: A total of 119 patients with prostate diseases [122 regions of interest(ROI)] who underwent routine MRI scan and magnetic resonance image compilation (MAGiC) sequence of prostate from March 2020 to March 2021 in General Hospital of Ningxia Medical University were retrospectively collected, they were divided into prostate cancer group(58 cases, 61 ROI) and non-prostate cancer group(61 cases, 61 ROI) according to the pathological results. In the prostate cancer group, those patients with an age of 48 to 85(69.8±5.9) years, and further divided into two subgroups according to the location of occurrence: peripheral zone cancer group (43 cases, 45 ROI) and transitional zone cancer group (15 cases, 16 ROI). The non-prostate cancer group consisted of patients with benign prostatic hyperplasia or complicated with chronic prostatitis, with an age of 41 to 81(68.6±7.0) years, and they were further divided into two subgroups according to the location of occurrence: non-cancerous peripheral zone group (45 cases, 45 ROI) and transitional zone benign prostatic hyperplasia group(16 cases, 16 ROI). Prostate cancer lesions were classified as low risk (Gleason score ≤6) or intermediate/high risk (Gleason score ≥7). After the post-processing of MAGiC images, T1, T2 and proton density(PD) values of prostate cancer group and non-prostate cancer group were obtained. At the same time, relevant software were used for image post-processing to generate apparent diffusion coefficient (ADC) value, the data between the two groups were analyzed by the Independent sample t-test or Mann-Whitney U-test, and the diagnostic effectiveness of each quantitative parameter in diagnosing prostate cancer and discriminating low risk prostate cancer from intermediate/high risk prostate cancer was analyzed by using receiver operating characteristic curve (ROC) analysis, the correlation between each quantitative parameter and Gleason score were assessed by Spearman correlation analysis. Results: The T1 value and T2 value of the peripheral zone cancer group were lower than those in non-cancerous peripheral zone group [1 201.3 (1 103.5, 1 298.2) ms vs 2 274.0 (1 620.9, 2 776.5) ms; 78.0 (74.0, 83.8) ms vs (160.6±54.9) ms] (all P<0.001), there was no statistically significant in PD value between the two groups (P>0.05). The T1 value and T2 value of the transitional zone cancer group were lower than those in transitional zone benign prostatic hyperplasia group [1 073.3 (1 003.9, 1 164.9) ms vs 1 340.8 (1 208.5, 1 502.8) ms; 76.9 (74.8, 82.8) ms vs 95.1(82.8, 103.4) ms] (all P<0.001), there was no statistically significant in PD value between the two groups (P>0.05). The area under the curve (AUC) of T2 value was similar with the ADC value in discriminating peripheral zone cancer group from non-cancerous peripheral zone group(0.963 vs 0.991, P=0.105), while in discriminating transitional zone cancer group from transitional zone benign prostatic hyperplasia group, the AUC of T2 valueãT1 value and ADC value were similar(0.867, 0.930 vs 0.938, all P>0.05). ADC value, T2 value all were negatively correlated with Gleason score (r=-0.747,-0.453, all P<0.001). T2 value and ADC value demonstrated equivalent diagnostic performance in discriminating low risk from intermediate/high risk prostate cancer, and there were no statistically significant (AUC: 0.787 vs 0.943, P=0.069). Conclusions: Quantitative relaxation time T1 and T2 values derived from synthetic MRI can discriminate prostate cancer from other benign pathologies, and T2 value have the equivalent diagnostic performance compared to ADC value. Synthetic MRI has high clinical application value, and T2 value can distinguish low risk prostate cancer from intermediate/high risk prostate cancer.
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Hiperplasia Prostática , Neoplasias da Próstata , Adulto , Idoso , Idoso de 80 Anos ou mais , Imagem de Difusão por Ressonância Magnética/métodos , Humanos , Imageamento por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Gradação de Tumores , Neoplasias da Próstata/diagnóstico por imagem , Neoplasias da Próstata/patologia , Estudos RetrospectivosRESUMO
Objective: To observe the clinical efficacy, safety, compliance, and cost-effectiveness of rush immunotherapy (RIT) and conventional immunotherapy (CIT) in patients with allergic rhinitis (AR), so as to evaluate the clinical significance of CIT and preliminarily explore its economic value. Methods: A study was conducted on 72 AR patients who had received specific immunotherapy from Oct 2019 to Jun 2020 in the Department of Otorhinolaryngology, the First Affiliated Hospital of Chongqing Medical University, including 39 males and 33 females, aging 8 to 60 years. RIT or CIT was performed respectively according to the patients' wishes. There were 35 cases in the RIT group and 37 cases in the CIT group, all subjects were followed up for 1 year. Visual analysis scale (VAS) and effectiveness were used to evaluate the clinical efficacy. Systemic adverse reactions were used to assess safety. Failure rate was calculated to evaluate the compliance. The cost and cost-effectiveness ratio (CER) were conducted to evaluate the health economics preliminarily. Results: After half a year and one year's treatment, both RIT and CIT groups had significant clinical efficacy and RIT group had more significant clinical efficacy than CIT group at half a year (76.67% vs 46.67%, χ2=7.37, P=0.007). During the dose accumulation phase, there was no significant difference in the incidence of systemic adverse reactions between the two groups (8.57% vs 8.10%, χ2=0.05, P=0.943), while the drop-out rate in the RIT group was significantly lower than that in the CIT group (0 vs 13.51%, χ2=5.08, P=0.024). After one year, the costs in RIT group were significantly higher ((8 163.08±452.67) yuan vs (7 385.87±369.92) yuan, t=-2.78, P=0.009), while there was no statistical differences in CER between the two groups ((3 298.06±1 374.09) yuan/point vs (3 154.38±1 532.51) yuan/point, t=-0.36, P=0.418). Conclusions: Both RIT and CIT are beneficial for AR, and they have similar clinical efficacy, safety, and CER. RIT is more effective in the early stage, with higher patient compliance. Thus, RIT is worth promoting and exploring in clinic.
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Alérgenos , Rinite Alérgica , Masculino , Feminino , Humanos , Dessensibilização Imunológica/efeitos adversos , Rinite Alérgica/terapia , Rinite Alérgica/etiologia , Imunoterapia , Resultado do Tratamento , Cooperação do PacienteRESUMO
Impacts of climate change on the hydrologic processes under future climate change conditions were assessed over Muda and Dungun watersheds of Peninsular Malaysia by means of a coupled regional climate and physically-based hydrology model utilizing an ensemble of future climate change projections. An ensemble of 15 different future climate realizations from coarse resolution global climate models' (GCMs) projections for the 21st century was dynamically downscaled to 6km resolution over Peninsular Malaysia by a regional climate model, which was then coupled with the watershed hydrology model WEHY through the atmospheric boundary layer over Muda and Dungun watersheds. Hydrologic simulations were carried out at hourly increments and at hillslope-scale in order to assess the impacts of climate change on the water balances and flooding conditions in the 21st century. The coupled regional climate and hydrology model was simulated for a duration of 90years for each of the 15 realizations. It is demonstrated that the increase in mean monthly flows due to the impact of expected climate change during 2040-2100 is statistically significant from April to May and from July to October at Muda watershed. Also, the increase in mean monthly flows is shown to be significant in November during 2030-2070 and from November to December during 2070-2100 at Dungun watershed. In other words, the impact of the expected climate change will be significant during the northeast and southwest monsoon seasons at Muda watershed and during the northeast monsoon season at Dungun watershed. Furthermore, the flood frequency analyses for both watersheds indicated an overall increasing trend in the second half of the 21st century.
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BACKGROUND AND PURPOSE: Although previous animal studies have shown structural changes in ocular hypertension such as atrophy of the LGN, such changes have not been thoroughly studied in human glaucoma patients nor correlation made with clinical stage. Our aim was to investigate prospectively LGN atrophy in patients with POAG using 3T MR imaging and correlation with the clinical stage of disease. MATERIALS AND METHODS: Twenty-six patients with known POAG and 26 age-matched healthy volunteers were included in this institutional review board-approved study. All subjects underwent imaging on a 3T MR imaging system with a PD and GM sequence. LGN height and volume were measured by 2 blinded neuroradiologists. Measurements were compared and correlated with clinical glaucoma severity as assessed by static threshold visual field parameters. RESULTS: Average maximum LGN height in patients with glaucoma on PD images was 4.36 ± 0.61 mm (right) and 4.31 ± 0.61 mm (left), significantly less (P < 10⻳) than respective measurements of 5.05 ± 0.41 and 4.99 ± 0.41 mm in volunteers. With the GM sequences, such respective measurements were also less (P < 10⻳) in patients with glaucoma (4.20 ± 0.71 mm right, 4.00 ± 0.85 mm left) versus respective measurements in volunteers (4.88 ± 0.51 mm right, 4.77 ± 0.47 mm left). Average LGN volumes in the patient group were 98.0 ± 27.2 mm³ (right) and 93.7 ± 25.8 mm³ (left) with the PD sequence versus respective measurements of 85.2 ± 27.1 and 80.5 ± 23.6 mm³ with the GM sequence. All height and volume measurements were greater in volunteers (P < 10⻳). In the patient group, both maximum height and volume of the LGN with both sequences were significantly correlated with cumulative clinical glaucoma stage (P < .05). CONCLUSIONS: MR imaging measurements of LGN height and volume are diminished in patients with glaucoma, with the extent of atrophy correlating to clinical stage, suggesting a novel imaging marker of disease severity.