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ObjectiveTo investigate the willingness of middle school students to engage in medicine and its influencing factors during COVID-19 pandemic in Lanzhou， so as to provide references for the early career planning education on middle school students. MethodsConvenient sampling method was used to choose 1 795 middle school students from 5 schools in Lanzhou from July 21 to July 31， 2022 for this study where an online questionnaire survey was distributed to collect data. A self-compiled questionnaire was used to gather the general information， assess the willingness to engage in medicine and seek the underlying reasons. The psychological resilience level of students was assessed using Resilience Scale for Adolescents. Then multivariate Logistic regression analysis was conducted to screen the factors associated with the willingness of middle school students to engage in medicine. ResultsAfter the local outbreak of COVID-19 in Lanzhou， 835 （46.52%） middle school students demonstrated their willingness to engage in medicine， and the top three reasons for their willingness were being affected by medical staff during the pandemic （75.69%）， having interests in medical sciences （67.31%）， and the potential increase of attention to national medical development after the epidemic （43.23%）. Logistical regression analysis showed that female gender （OR=1.438， P<0.01）， family members engaged in the medical and health industry （OR=1.574， P<0.01） and having a high psychological resilience score （OR=1.011， P<0.01） were related to the clear willingness to engage in medicine， while studying in senior middle school （OR=0.473， P<0.01） and excessive exposure （≥50%） to negative information during the epidemic （OR=0.797， P<0.05） were related to declining willingness to engage in medicine. ConclusionAfter the COVID-19 outbreak in Lanzhou， a large proportion of local middle school students show their willingness to engage in medicine， especially among those of female gender， having family members engaged in the medical and health industry and having high level of psychological resilience. Whereas students studying in senior middle school and with excessive exposure to negative information during the outbreak indicate low willingness to engage in medicine.
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OBJECTIVE@#To assess the value of chromosomal microarray analysis (CMA) and fluorescence in situ hybridization (FISH) for the prenatal diagnosis of chromosomal mosaicisms.@*METHODS@#A total of 775 pregnant women who had visited the Prenatal Diagnosis Center of Yancheng Maternal and Child Health Care Hospital from January 2018 to December 2020 were selected as study subjects. Chromosome karyotyping analysis and CMA were carried out for all women, and FISH was used to validate the suspected mosaicism cases.@*RESULTS@#Among the 775 amniotic fluid samples, karyotyping has identified 13 mosaicism cases, which yielded a detection rate of 1.55%. Respectively, there were 4, 3, 4 and 2 cases for sex chromosome number mosaicisms, abnormal sex chromosome structure mosaicisms, abnormal autosomal number mosaicisms and abnormal autosomal structure mosaicisms. CMA has only detected only 6 of the 13 cases. Among 3 cases verified by FISH, 2 cases were consistent with the karyotyping and CMA results, and clearly showed low proportion mosaicism, and 1 case was consistent with the result of karyotyping but with a normal result by CMA. Eight pregnant women had chosen to terminate the pregnancy (5 with sex chromosome mosaicisms and 3 with autosomal mosaicisms).@*CONCLUSION@#For fetuses suspected for chromosomal mosaicisms, CMA, FISH and G-banding karyotyping should be combined to determine the type and proportion of mosaicisms more precisely in order to provide more information for genetic counseling.
الموضوعات
Female , Pregnancy , Humans , Mosaicism , In Situ Hybridization, Fluorescence , Chromosome Disorders/genetics , Prenatal Diagnosis/methods , Chromosome Aberrations , Sex Chromosome Aberrations , Microarray Analysis/methods , Chromosomesالملخص
To determine the value of radiomics in identifying lymph node (LN) metastasis in patients with rectal nonmucinous adenocarcinoma. Methods: Imaging data of 91 patients were retrospectively analyzed (61 in the training set and 30 in the test set). A total of 1 301 radiomics features were extracted from high-resolution T2-weighted images of the whole primary tumor. The least absolute shrinkage and selection operator (LASSO) logistic regression was performed to choose the optimal features and construct a radiomics classifier in the training set. Its discrimination performance was compared with that of morphological criteria by receiver operating characteristic (ROC) curve analysis, which was validated in the test set. Results: The radiomics classifier combined with five key features was significantly associated with LN metastasis, which distinguished LN metastasis with an area under curve (AUC) at 0.874 (95% CI 0.787 to 0.960) in the training set, and the performance was similar in the test set (AUC 0.878, 95% CI 0.727 to 1.000). The AUCs according to the morphological criteria in the training set and test set were 0.619 (95% CI 0.487 to 0.752) and 0.556 (95% CI 0.355 to 0.756), respectively. Discrimination of the radiomics classifier was superior to that of morphological criteria in both the two datasets (both P <0.05). Conclusion: The radiomics classifier provides individualized risk estimation for LN metastasis in rectal nonmucinous adenocarcinoma patients and it has the advantage over the morphological criteria.
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Humans , Adenocarcinoma , Lymph Nodes , Lymphatic Metastasis , Rectal Neoplasms , Retrospective Studiesالملخص
One hundred and forty-five patients with primary aldosteronism (PA) admitted from 2006 to 2013 were enrolled in the study. The diagnosis of PA was confirmed by upright furosemide test and all patients met the following criteria: ① round-or oval-shaped lesion of low density with diameter>1 cm in one adrenal gland shown in contrast CT scan; ② no lesion or abnormality in contralateral adrenal gland; ③serum potassium level<3.5 mmol/L. Of 145 patients, 106 underwent total adrenalectomy, 36 partial adrenalectomy and 3 tumor enucleation. Serum potassium was (2.75±0.55) mmol/L before and (4.03±0.46) after surgery. Potassium was normalized after treatment in 141 cases (97.2％) with correction or improvement in hypertension; 4 patients (2.8％) remained hypokalemic and received spironolactone. Patients with normalized potassium were followed up for a medium period of 74 months (22—103 months), of whom 32 (22.7％) dropped off; the remaining 109 (77.3％) patients did not have hypokalemia. Multivariate linear correlation analysis showed that serum potassium level was negatively correlated with tumor diameter (r=?0.273,95％ CI:?0.086—?0.564, P=0.026) and basal serum aldosterone level (r=?0.261,95％ CI:?0.047— ?0.514, P=0.036). In PA patients with unilateral adrenal macroadenoma and hypokalemia, satisfactory surgical resolution can be achieved without adrenal venous sampling in majority of patients.
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Objective To investigate the MSCT manifestations of hepatic fat-poor perivascular epithelioid cell tumor (PEComa). Methods CT and pathological findings of 8 patients with hepatic fat-poor PEComa confirmed by surgery were assessed retrospectively.Results 8 cases had solitary lesion,all lesions with round or round-like shape.The largest diameter ranged 20-110 mm.The fat density was not measured by CT scan.6 lesions composed of solid component,and solid part showed obviously enhancement on arterial phase.On portal venous phase and parenchymal phase,the tumors showed equal or low or slightly high density.2 lesions showed cystic necrosis,peripheral enhancement on arterial phase,1 lesion showed continuous enhancement and the enhancement degree increased,and another lesion showed reduced enhancement.All lesions had tortuous vascular in the center of lesions or at the peripheral.Immunohistochemistry examinations showed that HMB45,Melan-A and SMA were positive in all cases,CD31,CD34 and S-100 expressed positive in partial cases. Conclusion The CT findings of hepatic fat-poor PEComa are lack of specificity.When the enhancement and clearance pattern of liver mass is similar to hepatocellular carcinoma or adenoma,the clinical history does not support the diagnosis,may consider the possibility of PEComa when tortuous vascular in the center of lesions or at the peripheral on arterial phase.
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<p><b>OBJECTIVE</b>To determine the nature of genomic copy number variations (CNVs) in two fetuses with congenital heart defects (CHD) and explore the correlation between 3q microdeletions and CHD.</p><p><b>METHODS</b>Genomic DNA was extracted from fetal umbilical cord tissue, and chromosome copy number variations were detected by low coverage whole genome sequencing.</p><p><b>RESULTS</b>Both fetuses had microdeletions of the long arm of chromosome 3. Fetus 1 had ventricular septal defect, cleft lip and palate, and a 1.66 Mb deletion on 3q29. The deleted region encompassed all of the critical genes for 3q29 microdeletion syndrome. Fetus 2 had overriding aorta, ventricular septal defect, and a novel 240 kb deletion on 3q28.</p><p><b>CONCLUSION</b>3q29 microdeletion may result in CHD in combination with cleft lip and palate. Genomic CNVs can be detected by low coverage whole genome sequencing.</p>
الموضوعات
Female , Humans , Pregnancy , Chromosome Deletion , Chromosomes, Human, Pair 3 , DNA Copy Number Variations , Genetic Testing , Heart Defects, Congenital , Genetics , Prenatal Diagnosisالملخص
Objective To investigate the value of MSCT in assessing bowel ischemia of small-bowel obstruction .Methods CT images and electronic medical records of 40 patients with small-bowel obstruction were retrospectively evaluated.Patients were treated by surgery.The CT signs of bowel ischemia were recorded.Relationship between CT signs and bowel ischemia were tested by Fisher exact andχ2 test.Sensitivity and specificity of MSCT for ischemia were also assessed.Results Bowel ischemia was confirmed at surgery and/or pathological examination in 21 of 40 patients.Diminished enhancement after contrast agent injection was the most common sign in bowel ischemia patients.The signs of increased bowel-wall attenuation on non enhanced images and diminished enhancement after contrast agent injection were significantly associated with ischemia (P <0.000 1).The signs of increased bowel-wall attenuation on non enhanced images and pneumatosis intestinalis had high sensitivity(100%).The sign of diminished enhancement after contrast agent injection had high sensitivity(95.2%)and specificity(94.7%).Conclusion MSCT is accurate in assessing bowel ischemia of small-bowel obstruction, and improves the timeliness and diagnosis for this disease.
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BACKGROUND:Intertrochanteric fracture is one of the common fracture, and accompanied by osteoporosis and high energy injury. The fracture line often descended, and induced A3 intertrochanteric fracture. This type of fracture is difficult to treat. Common intramedulary fixation includes proximal femoral nail anti-rotation and InterTan, which have high stability, are minimaly invasive, and have been extensively used. OBJECTIVE: To compare the biomechanical stability of A3 intertrochanteric fracture fixed with proximal femoral nail anti-rotation and InterTan by finite element analysis. METHODS:Three three-dimensional finite element models of the AO3.1, AO3.2 and AO3.3 intertrochanteric fracture fixed with proximal femoral nail anti-rotation and InterTan were established. Fixation was completed according to the requirement of Department of Orthopedics. Stress distribution of femur and fixator of different models was observed. Stress peak at different areas was compared in femur and fixation models. Biomechanical stability was analyzed. RESULTS AND CONCLUSION: The maximum pressure concentration area in AO3.1 intertrochanteric fracture with proximal femoral nail anti-rotation was located in the lateral proximal femur, and with Intertan was located in the medial proximal femur. The AO3.2 had little differences between two types of nails. The AO3.3 intertrochanteric fracture with proximal femoral nail anti-rotation was located in the medial proximal femur and the medial distal implant. There was no significant pressure concentration with InterTan. The von Mises pressure of six models was concentrated in the medial distal implant, and higher maximum von Mises pressure was found in the proximal femoral nail anti-rotation. There was significant difference of von Mises distribution between the lateral and medial implant with proximal femoral nail anti-rotation. Except the AO3.3 intertrochanteric fracture with proximal femoral nail anti-rotation, the maximum pressures of remaining models were located in the main nail and interlocking nail infal. These results concluded that the fracture fixed with InterTan exhibited fine fixation stability in the AO3.1 and AO3.3 intertrochanteric fracture. There was no significant difference of fixation stability between proximal femoral nail anti-rotation and InterTan in AO3.2. The von Mises distribution of InterTan for intertrochanteric fracture is more reasonable.
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Objective To investigate the psychological situation on people who experienced after earthquake in yushu ,the rela-tives far away from the earthquake ,rescue workers ,the general population far away from the earthquake zone .From investigation to provide powerful evidence for the crisis intervention .Methods PTSD Checklist (PCL-C) ,Self-Rating Anxiety Scale(SAS) ,Self-Rating Depression Scale (SDS) ,Symptom Checklist 90(SCL-90)were used on the victims to survey different groups of people in different stages .Results The detection rate of PTSD ,anxiety ,depression about different groups of people in different stages were different ,The detection rate of PTSD ,anxiety ,depression and SCL-90 factor scores in the same crowd as the time went on showed a downward trend .The detection rate of PTSD ,anxiety ,depression and SCL-90 factor scores in different people showed a downward trend with the increase of distance from the hypocenter .Conclusion There are different degrees of psychological problems to differ-ent groups of people in different stages ,we should strengthen psychological intervention efforts to improve the ability to stress e-vents .
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Objective To investigate the value of renal CT arteriography in the preoperation evaluation of patients with renal tumors.Methods From Jan 2007 to June 2012,372 patients with renal tumors took renal CT arteriography (with Philips Brilliance 16) to evaluate the variations of their renal arteries.We executed plain scan first,then artery phase,venous phase scan and delaying scan by turns after injections of Omnipaque.All images were delivered to imaging workstation and reconstructed to 3D views of renal arteries to supply imageological supports for surgeons.Results Tumors in solitary kidneys were detected in 21 patients,and masses in both kindneys were detected in 4 cases.We collected data of 376 kidneys finally.We found premature branching renal arteries on 46 kidneys (12.2％) and accessory renal arteries on 74 kidneys (19.7％).Double accessory renal arteries were seen on 10 kidneys (2.7％),and there were 84 accessory renal arteries in summary.7 accessory renal arteries (7.2％) came from arteria phrenica and 77 (91.7％) came from abdominal aorta (x2 =65.68,P ＜ 0.01).We found the regions where the accessory renal arteries entered kidneys:65.5％ (55/84) in upper poles,19.0％ (16/84) in central regions and 15.5％ (13/84)in inferior poles.Routine CT scans found 44 variations of renal arteries in 218 cases who underwent surgeries,and then renal CT arteriography found 63 variations in the same cases (20.2％ vs 28.9％,x2 =4.47,P ＜ 0.05).Finally,surgeons found 60 variations of renal artries in operations in the 63 cases with variations found by renal CT arteriography before surgeries.Conclusions There is limitations of routine CT scan (plain scan and with contrast medium) in detection of renal artery variations.Renal CT arteriography can supply reliable supports for establishment of surgical plans for renal tumors.
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Objective To investigate dynamically characteristics of apparent diffusion coefficient (ADC) of MR diffusion-weighted imaging (DWI) in the rabbit VX-2 tumor model.Methods Forty New Zealand rabbits were included in the study and forty-seven rabbit VX-2 tumor models were raised by implanting directly and intrahepatically after abdominal cavity was opened.DWI was carried out periodically and respectively on seventh,fourteenth,and twenty-first day after implantation.Part samples of VX-2 tumors were studied by pathology.The distinction of VX-2 tumors on DWI was assessed by their ADC values.The statistical significance between different time groups,different area groups,or different b-value groups was calculated using SPSS12.0 software,respectively.Results ADC values of 47 VX-2 tumors in the area of tumor periphery,tumor center,and normal parenchyma around tumor were greater when b-value was 100 s/mm2 than those when b-value was 300 s/mm2 and the distinction of VX-2 tumor ADC in the area of tumor periphery,tumor center,and normal parenchyma around tumor between different b-value groups was significant,respectively( F =17.964,P ＜0.01 ; F =13.986,P ＜0.01 ; F =128.681,P ＜0.01 ).The ADC values in the area of normal liver parenchyma around tumor were greater than those in the area of VX-2 tumor periphery and tumor center when the b-value was 100 or 300 s/mm2.When b-value was the same( 100 or 300 s/mm2),the distinction of VX-2 tumor ADC between different areas was significant( F =176.586,P ＜0.01 ; F =55.089,P ＜0.01 ).The ADC of VX-2 tumor in the area of tumor periphery and tumor center became gradually low from seventh to fourteenth or twenty-first day after implantation and the distinction of ADC between different time groups but the area same (?) was significant( b =100 s/mm2,F =48.211,P ＜0.01 ;b =300 s/mm2,F =20.955,P ＜0.01 ).There were not obvious cellular necrosis in VX-2 tumors on seventh and fourteenth day after implantation but ADC of VX-2 tumor decreased unobviously because of cellular edemata in or around tumors.There were obvious cellular necrotic areas in VX-2 tumors on the twenty-first day after implantation.ADC of viable tumor cells in VX-2 tumors were lower on DWI than that in the area of normal liver parenchyma around tumor and ADC of dead tumor cells in VX-2 tumors were unequal,including high values,equal values,and low values but they were higher than that in the area of normal liver parenchyma around tumor after dead tumor cells had been liquified or had become cystic.Conclusions ADC is able to reflect objectively the diffusion of water molecules in the tumor and to reflect indirectly the degree of the growth and liquified necrosis of a tumor.ADC has an important and potential value in monitoring dynamical tumor growth and in evaluating malignant degree and therapeutic effect.
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ObjectiveTo investigate its dynamic characteristics and pathological mechanism on magnatic resonance diffusion weighted imaging (DWI) after chemoembolization in rabbit liver VX-2 tumor model.MethodsForty New Zealand rabbits were included in the study and forty-seven rabbit VX-2 tumor models were raised by implanting directly and intrahepatically after abdominal cavity was opened.Forty VX-2 tumor models from them were divided into four groups.DWI was performed periodically and respectively for each group after chemoembolization.All VX-2 tumor samples of each group were studied by pathology.The distinction of VX-2 tumors on DWI was assessed by their apparent diffusion coefficient (ADC) values.The statistical significance between different time groups,different area groups,or different b-value groups was calculated using SPSS 12.0 software.ResultsWhen b-value was 100 s/mm2,ADC values in the area of VX-2 tumor periphery,VX-2 tumor central,or normal liver parenchyma around tumor became gradually low in sixteen hours after chemoembolization,and were the lowest at sixteenth hour,and then they increased gradually from sixteenth hour to fourty-eighth hour after chemoembolization.The distinction of ADC between different time groups was significant,respectively ( F =7.325,P ＜ 0.01 ; F =2.496,P ＜ 0.05 ; F =6.856,P ＜0.01 ).Cellular edema in the area of VX-2 tumor periphery or normal liver parenchyma around tumor increased quickly in sixteen hours after chemoembolization; however,from sixteenth hour to forty-eighth hour,cellular edema in the area of normal liver parenchyma around tumor decreased gradually and that in the area of VX-2 tumor periphery decreased lightly at first and then increased continually.Cellular necrosis in the area of VX-2 tumor periphery after chemoembolization was more significant than that before chemoembolization.The areas of dead cells in VX-2 tumors manifested low signal and high ADC value while the areas of viable cells manifested high signal and low ADC value.ConclusionsDWI is able to detect and discriminate tumor necrotic areas from viable cellular areas before and after chemoembolization.ADC of normal liver parenchyma and VX-2 tumor are influenced by intracellular edema,tissue cellular death,and microcirculation disturbance after chemoembolization.
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Objective To evaluate the prevalence of low bone mineral density in patients with inflammatory bowel disease(IBD) and to identify its risk factors. Methods A cross-sectional survey was carried out in IBD patients. Anthropemetric measures, biochemical markers of nutrition and bone mineral density measurement were completed for these patients as well as healthy control subjects. Results Seventy-seven Crohn's disease (CD) and 43 ulcerative colitis(UC) patients were enrolled, and 37 healthy volunteers were recruited as healthy controls(HC). The T value of CD patients, UC patients and HC was -1.72±1.20,-1.26±1.12 and-0.62±0.87 respectively and the T value of CD patients was significantly lower than that of HC (P=0.000). The prevelance of osteoporosis in CD, UC and HC was 23.3%, 14.0% and 0 respectively. The prevelance of osteoporosis in CD was higher than that in HC (P=0.003). Logistic regression analysis indicated that low BMI(BMI≤18.4 kg/m~2) was an independent risk factor for osteoporosis both in CD (OR=11.25,95% CI 3.198-39.580, P=0.000) and in UC (OR= 14. 50,95% CI 1.058-88.200, P=0.045) patients. Age, disease duration, clinical activity active index (CDAI), oral steroid therapy, immunosuppressant treatment and serum vitamin D concentration were not found to be correlated with osteoperosis in IBD patients. Conclusions Low bone mineral density is common in both CD and UC patients and low BMI is an independent risk factor for osteoporosis in IBD patients.
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Objective To evaluate MR Dual echo imaging in the differential diagnosing liver lesions.Methods:MR Dual echo features in 80 patients with different liver lesions,including 40 cases of benign lesions and 40 cases of malignant lesions,were analyzed,and comparison with MR Dual echo imaging was made.Results MR Dual echo sensitivity and specificity were 85% and 95% in the benign lesions,80% and 94% in the malignant lesions respectively.Conclusion MR Dualecho imaging is a useful MR technique,which is helpful in differentiating benign from malignant lesions.
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0.05). Both Bosu and Enalapril could lower blood pressure remarkably (P
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AIM: Centrifuge training can improve forward acceleration (+Gz) endurance. This study was to analyzed the gene expression of rat heart affected by centrifuge, and to research the molecular mechanism of improving +Gz endurance by centrifuge training. METHODS: Differential expressed genes between high+Gz endurance (+16Gz) rats, of test group after trained 12 d and control were screened using suppression subtractive hybridization (SSH) and dot blot hybridization. The obtained expressed sequence tags (ESTs)were used as probes to perform RNA slot hybridization with heart total RNA isolated from each gruop of centrifuge training and high+Gz endurance and low+Gz endurance (+12Gz) rats, respectively. The positive ESTs were sequenced and analyzed using BLAST(nr) at NCBI.RESULTS: Three down-regulated ESTs were obtained from heart samples, all of them are new, and their expression levels were decreasing during centrifuge training. CONCLUSION: Centrifuge training can significantly affect the special gene expressions of rat heart, and the expression changes of these genes may be ralated to the mechainism that +Gz endurance can be improved by centrifuge training.
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Objective To explore the protection effects of the reduced form of nicotinamide-adenine denucleotid(NADH) on cardiac fibroblasts apoptosis induced by hydrazine in vitro.Methods Cardiac fibroblasts isolated from neonate rats were divided into four groups.In NADH pretreatment before hydrazine treatment group,the cardiac fibroblasts were cultured first in the medium containing 400?g/ml NADH for 2 hours,and then cultured in the medium containing 400?g/ml NADH plus 2mmol/L hydrazine for 72 hours;in hydrazine treatment group,the cardiac fibroblasts were cultured first in normal medium containing 400?g/ml NADH for 2 hours and then cultured in the medium containing 2mmol/L hydrazine for 72 hours;in control group,the cardiac fibroblasts were cultured only in normal medium for 72 hours;and in NADH pretreatment control group,the cardiac fibroblasts were cultured in medium containing 400?g/ml NADH for 72 hours.After the treatments mentioned above,the changes in nuclear of apoptotic cardiac fibroblasts as stained by Hoechst33258 were observed under fluorescence microscope,the apoptotic and necrosis rates of cardiac fibroblasts stained by AnnexinⅤ/PI were assayed by flow cytometry,the mitochondria membrane potential of cells stained by rhodamine123 was also assayed by flow cytometry.Results Hydrazine could induce apoptosis of the cardiac fibroblasts.After NADH pretreatment,the number of apoptotic cardiac fibroblasts with pyknosis of nuclear was lowered,the rates of apoptosis and necrosis decreased,and the mitochondria membrane potential of cells was elevated.Conclusion NADH pretreatment could reduce the apoptosis induced by hydrazine by improving the function of mitochondria.