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【Objective】 To understand the current situation of blood components distribution in domestic prefecture-level blood stations through analyzing the components distribution data of 24 prefecture-level blood stations in China. 【Methods】 The data of components distribution of 24 blood stations from 2017 to 2020 as well as the data of blood deployment of 24 blood stations from 2019 to 2020 were collected and analyzed. 【Results】 From 2017 to 2020, positive annual growth in red blood cells, plasma and cryoprecipitate was observed in 22, 19 and 15 out of the 24 blood stations, and the annual growth median rate of above three components was 5.24%, 3.80% and 3.25%, respectively. Among the 24 prefecture-level blood stations, 23 carried out the preparation of cryoprecipitate. 【Conclusion】 The distribution of red blood cells, cryoprecipitate and plasma in prefecture-level blood stations is increasing year by year. However, there is a overstock of plasma, and most blood stations need blood employment.
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Objective:To develop a novel posterior circulation score (PCS) based on pretreatment diffusion-weighted imaging (DWI) for predicting futile recanalization (FR) of acute basilar artery occlusion (BAO) after endovascular therapy (EVT).Methods:A prospectively registered consecutive cohort of BAO patients treated with EVT in Beijing Tiantan Hospital, Capital Medical University during a six-year period was reviewed. This novel DWI-based PCS (DWI-PCS) was calculated according to the characteristics of acute infarction at four sites (pons, midbrain, thalamus and cerebellum), with a normal score of 0 point and a full score of 16 points. FR was defined as the occurrence of poor outcome (modified Rankin Scale score>3) at 90 days despite successful recanalization (modified Thrombolysis In Cerebral Infarction ≥ 2b) at final angiogram after EVT. The independent association of DWI-PCS with FR was evaluated by multivariable Logistic regression, and the predictive discrimination of DWI-PCS was measured by the area under the receiver operating characteristic (ROC) curve. Additionally, the effects of DWI-PCS on FR in different subgroups stratified by age, time window, stroke severity and etiology were explored.Results:Of 109 patients in this study, 48 (44.0%) suffered from FR. The multivariable Logistic analysis showed that DWI-PCS was significantly associated with FR (adjusted OR=1.31, 95% CI 1.07-1.62, P=0.01). The ROC curve analysis demonstrated that the area under the curve of DWI-PCS for predicting FR was 0.74 (95% CI 0.65-0.83), and the optimal cut-off value was ≥ 3 points (sensitivity 0.75, specificity 0.66, accuracy 0.70). Finally, the effects of DWI-PCS on FR were not found to be different across all subgroups ( P>0.10 for all interactions). Conclusions:The novel DWI-PCS may be a valid and reliable predictor of FR in BAO patients treated with EVT. Nevertheless, external validation with blinded outcome is still needed to confirm its performance before clinical application.
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Objective:To explore the clinical value of 99Tc m-methylene diphosphonate (MDP) SPECT/CT imaging in Langerhans cell histiocytosis (LCH) in children. Methods:From June 2018 to October 2019, the imaging characteristics of 99Tc m-MDP SPECT/CT imaging in 13 children (8 males, 5 females; age: 1-11 (4.2±2.8) years) with LCH confirmed by pathology and immunohistochemistry in Wuhan Children′s Hospital were analyzed retrospectively. The location, number, imaging manifestations, and maximum standardized uptake value (SUV max) of the lesions were evaluated. Results:There were 18 lesions (8 in the vertebral body, 3 in the femur, 3 in the skull, 2 in the rib, 1 in the shoulder blade, 1 in the sciatic and pubic bone) in 13 children, including 9 with single lesion and 4 with multiple lesions. Of 18 lesions, 17 showed different degrees of osteolytic bone destruction, 15 presented as soft tissue masses, and 3 showed marginal sclerosis on CT imaging. All lesions showed increased 99Tc m -MDP uptake (SUV max: 1.22-15.57 (8.67±3.19)). Conclusion:99Tc m-MDP SPECT/CT has the advantage of combining functional and morphological imaging, and is helpful in the early diagnosis, clinical classification and evaluation of curative effect of children′s LCH, which provides objective basis for clinical practice.
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Cerebrovascular disease has caused serious harm to the health and life of the population in China. The current epidemic situation of stroke in China is still at its peak and it causes a huge burden of disease. According to the current situation, the most effective way to reduce the damage and burden of cerebrovascular disease is to strengthen primary prevention before the first onset of stroke, which is promoting actively intervention on the risk factors of cerebrovascular disease to reduce the incidence of stroke in the population. In the middle of 2019, the Chinese Society of Neurology, Chinese Stroke Society completed and issued the fourth revised version of the "Guidelines for the primary prevention of cerebrovascular diseases in China 2019". Here we will briefly explain the key and updated content of the "Guidelines", and introduce the recommendations to provide guidance for the neurologists, clinicians and health care workers.
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Objective To evaluate the efficacy of the traditional Chinese medicine NAOAN capsule in primary prevention of stroke in high?risk populations. Methods A multicenter, randomized controlled study was performed in community setting, involving 1 088 individuals at high risk of stroke, with cerebrovascular function scores<75 and 10?year Framingham stroke risk ≥6%. Subjects were recruited in communities at Beijing, Shanghai, Changsha, and Chengdu communities, through resident committees or the village unit. A total of 559 subjects were randomized into a group treated with the NAOAN capsule, and 529 subjects in an aspirin treatment group. Follow?up was performed every 2 months for 2 years. At the mid?point and end of the intervention, we compared cerebrovascular function differences between the 2 groups. Results During the 2?year community trial, 531 subjects in the NAOAN capsule group and 465 in the aspirin group followed the protocol. Cerebrovascular function scores increased from 45.2±19.7 at baseline to 61.7±26.5 after the 2?year trial (t=－12.931, P<0.001) in the NAOAN capsule group, and from 47.2±18.9 at baseline to 53.7 ± 25.1 (t=－5.058, P<0.001) in the aspirin group; greater increases in cerebrovascular function scores were found in the NAOAN capsule group than that in the aspirin group (t=4.906, P<0.001). Conclusions Cerebrovascular function in individuals at high risk of stroke was improved by taking NAOAN capsule. Cerebrovascular function scores improved more with NAOAN capsules than with aspirin.
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Objective@#To investigate the comprehensive nutritional status and diet behavior of middle aged and elderly women with osteoporosis, and thereby to explore the relationship between diet behavior and comprehensive nutritional status.@*Methods@#311 middle-aged and elderly women with osteoporosis in Chengdu were included in this study. Mini Nutritional Assessment (MNA) was applied to assess their comprehensive nutritional status. Information of social-demographic characteristics and diet behavior (about meals, snacks and water drinking, etc.) of the subjects was collected by questionnaire. Chi square test was used to assess the differences in nutritional status among patients who have different eating behaviors. Logistic regression analysis was performed to evaluate the relationship between diet behaviors and comprehensive nutritional status.@*Results@#The mean MNA score of subjects was 25.8±2.5. 20.3% (63/311) of the subjets were at risk of potential malnutrition, but there was no malnourished subjects found. 46.9% (46/311) of the subjects were in good appetite. 95.2% (296/311) of them had a fixed food intake each meal. 65.8% (198/311) of them had snacks every day, and the most common choice was fruit (86.4% (248/287)). 54.8% (165/311) of them had initiative drinking water habits, and the most common choice was plain boiled water (79.9%, 246/308). 76.5% (238/311) of them had daily portable water less than 1 500 ml. After adjusting the effects of age, occupation and education level, bad appetite (OR=3.50, 95%CI: 1.18-10.62), unfixed food intake (OR=7.27, 95%CI: 1.40-35.83), and seldom or never intake of snack (OR=3.71, 95%CI: 1.42-9.72) were risk factors for malnutrition risk, while tea drinking was protective factor(OR=0.31, 95%CI: 0.11-0.93).@*Conclusion@#Risk of potential malnutrition and unhealthy diet behavior among the middle aged and elderly women with osteoporosis should be paid more attention. Unhealtghy diet behavior has a negative effect on their comprehensive nutritional status.
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Background and purpose:Gastric cancer impacts human health seriously. Accurate preoperative assessment of T staging and metastatic lymph nodes of gastric cancer was beneifcial to patients’ treatment options and their prognosis. The purpose of this study was to evaluate the diagnostic performance of diffusion-weighted magnetic resonance imaging for preoperative assessment of T staging and metastatic lymph nodes in patients with gastric cancer. Methods:This study selected 35 gastric cancer patients met the criteria for this prospective study. They all underwent gastric 3.0 T MRI+DWI imaging scan. These patients’ T stage and metastatic lymph nodes were evaluated before the surgery, with the reference of post-operative histopathological ifndings. Kappa consistency test was used to assess the consistency of T staging between the two methods. This study analyzed short axis diameter, long axis diameter and apparent diffusion coeffcient (ADC) values of lymph nodes, relative of muscle’s ADC (rADCm) values (rADCm=ADC values of lymph nodes/ADC values of right erector spinae), and relative of primary tumor’s ADC (rADCp) values (rADCp=ADC values of lymph nodes/ADC values of primary tumor) on MRI image. Independent samples test was used to assess the difference between metastatic lymph nodes and benign lymph nodes. The receiver operating characteristic(ROC) curve was generated to evaluate the accuracy of diffusion-weighted magnetic resonance imaging (MRI) for preoperative assessment of metastatic lymph nodes of gastric cancer.Results:The accuracy of diffusion-weighted MRI for T stages was 77.14%, 75% for T1, 100% for T2, 76.47% for T3 and 75.00% for T4 and respectively. There were statistically signiifcant differences in the long axis diameter, the short axis diameter, ADC value, rADCm and rADCp between metastatic lymph nodes and benign lymph nodes (P<0.05). The area under the ROC curve of rADCm was greater than thats of other criteria, so rADCm was the most signiifcant parameter. The best discriminative cut-off value of long axis, short axis, ADC value, rADCm value and rADCp value were 9.55 mm, 6.05 mm, 0.934×10-3mm2/s, 0.60 and 1.083, respectively. The sensitivity and speciifcity were 59.00% and 73.10%, 59.00% and 69.80%, 82.60% and 88.50%, 83.70% and 84.60%, 78.20% and 80.80%, respectively.Conclusion:Diffusion-weighted MRI has great signiifcance for preoperative assessment of T staging and metastatic lymph nodes of gastric cancer.
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Objective To evaluate the applicability and effectiveness of the model for managing patients with convulsive epilepsy in rural China.Methods The model is under leadership of the government departments and medical institutions at all levels organized primary physicians for treatment and management.People with convulsive epilepsy in 24 rural areas were screened by local physicians and confirmed by neurologists.Patients diagnosed with convulsive epilepsy and agreed with managing were recruited into study.They were managed at primary care level and provided with phenobarbital monotherapy.Efficacy was assessed from the changes in seizure frequencies from baseline.Results There were 408 town hospitals and 979 trained primary care physicians participating in our study.Five thousand and thirty-eight patients were enrolled in 2 years,and 90％ patients with good compliance.Among the people who were treated with phenobarbital monotherapy,3 170 were managed for 12 months,and 2 005 (63.3％) of whom had a 50％ or greater reduction in seizure frequency and 1 246 (39.3％)patients remained seizure free;651 patients were managed for 24 months,and 491 (75.4％) of whom had a 50％ or greater reduction in seizure frequency and 202(31.0％)patients remained seizure free.Three hundred and forty-three (6.8％) patients withdrew from the study,and only 35 (0.7％) patients discontinued treatment because of side effects.Sixty-nine (1.4％) patients were dead and 8 (11.6％) of them were caused by status epilepticus.Conclusion This study confirms that this model is beneficial to patients with epilepsy and is suitable to the rural areas of China.
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Objective To analyze efficacy and its influencing factors of phenobarbital treatment for epilepsy management in rural China.Methods Total 3 315 patients with convulsive epilepsy from rural areas of 24 counties were enrolled in this joint epilepsy management program.All patients received phenobarbital monotherapy for 1 year during November 2011 to November 2013.The efficacy and potential influencing factors including sex,age,duration of epilepsy,number of seizures in the 12 months before management(≥2),previous treatment,daily dose of phenobarbital,taking other antiepileptic drugs and compliance of patients were studied with multivariate analysis.Results Among 3 315 patients,38.9％ were seizure-free during the entire management period.The rates of seizure-free in 15 to 39 y age group (35.2％,495/1 405)and in patients receiving irregular treatment previously (34.6％,625/1 808)were lower.The rates of seizure-free were higher in patients taking phenobarbital 60-90 mg everyday (49.4％,988/2 000) and those with good compliance(42.3％,1 160/2 744).Patients taking other antiepileptic drugs in 12 months had lower seizure-free rate (31.0％,45/145).Univariate analysis showed that gender of patients was not related to seizure-free rate (P ＞ 0.1).Multivariate analysis showed that the longer duration of epilepsy(OR =0.015,95％ CI:1.008-1.021,P ＜ 0.001),more seizures in the 12 months (OR =0.005,95％ CI:1.002-1.007,P =0.002) and the irregular treatment before management were the risk factors for low seizure-free rate (P ＜ 0.05).Patients received formal treatment or untreated had a lower risk of seizure compare with the irregular treatment (OR =0.737,95％ CI:0.611-0.889,P =0.001;OR =0.566,95％ CI:0.469-0.683,P ＜0.001).Patients with good compliance and with a daily dose of 60-89 mg phenobarbital(OR =0.107,95％ CI:0.013-0.905,P =0.040) were associated with high seizurefree rate;in contrast the poor compliance was a risk factor for not being seizure-free(OR =2.038,95％ CI:1.634-2.541,P ＜ 0.001).Conclusion Regular medication of phenobarbital with good compliance is effective for convulsive epilepsy management in rural China.
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@#Ocotillol(3)and its epimer(4)have been synthesized from 20(S)-protopanaxatriol ［20(S)-PPT］ via two routes, and their formation mechanism has been speculated. Route 1: Compounds 3 and 4 were obtained from 20(S)-PPT by oxidation with m-CPBA at the yield of 44. 1% and 28. 6%, respectively. Route 2: Compounds 3 and 4 were prepared from 20(S)-PPT by acetylation, oxidation and saponification at the yield of 16. 4% and 16. 2%, respectively. The formation mechanism of compounds 3 and 4 is speculated as below: 1)The chemical environments of both sides of C24(25)double bond in 20(S)-PPT are different due to the existence of intramolecular hydrogen bond, which led to the different oxidation ratio of the two sides, and the different yields of compounds 3 and 4. 2)There is not intramolecular hydrogen bond in acetylated 20(S)-PPT, and the chemical environments of both sides of C24(25)double bond are similar, which resulted in almost equal yields of compounds 3 and 4 synthesized through oxidation with m-CPBA, intramolecular SN2 and saponification.
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Objective To assess the clinical value of 18 F-FDG PET/CT for the patients with ascites of unknown causes.Methods A total of 106 patients with ascites undergoing 18 F-FDG PET/CT examination was retrospectively studied and 18F-FDG PET/CT imaging was interpreted by two ways.(1)PET/CT(localization):Diagnostic results of PET/CT depended on the degree of 18 F-FDG uptake in peritoneum with CT was trecoted as anatomical localization,and high 18F-FDG uptake in peritoneum was regarded as malignancy.(2)PET/CT(mor-phology):Morphological changes of peritoneum on CT imaging and the degree of 18 F-FDG uptake on PET ima-ging were simultaneously considered when interpreting the diagnostic results of PET/CT.Results In the differen-tial diagnosis of ascites of unknown cause,the sensitivity,specificity and accuracy of PET/CT( localization) were 90.2%,71.1%and 82.1%,respectively.These values of PET/CT(morphology)were 95.1%,93.3% and 94. 3%,and 85.2%of malignant ascites were found primary lesion.The specificity and accuracy of PET/CT( mor-phology)were higher than those of PET/CT(localization)(P=0.002,P<0.001).Statistical difference was not found in both sensitivities.Conclusion PET/CT( morphology) had higher clinical value than PET/CT( localiza-tion) in the differential diagnosis of ascites with unknown cause,and had important significance in detecting pri-mary cause of malignant ascites.
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<p><b>OBJECTIVE</b>To determine the risk factor of HCC in Guizhou.</p><p><b>METHODS</b>A group case-control study design was conducted between 762 cases and 798 controls in Guizhou province. The main related-factors were analyzed with unconditional logistic regression model and evaluated by odds ratio (OR) and 95% confidence interval (95% CI).</p><p><b>RESULTS</b>There are significant differences between cases and controls in regarding to cigarette smoking 210 (27.6%),non-alcoholic fatty liver disease 336 (44.1%), alcoholic liver disease 245 (32.2%), family history of HCC 141 (16.5%), alcohol consumption 300 (39.4%), HBV infection 436 (57.2%), pickled food 290 (38.1%), and economic status 5 years ago 420 (55.1%) in cases,and cigarette smoking 116 (14.5%),non-alcoholic fatty liver disease 160 (20.1%), alcoholic liver disease 101 (12.7%), family history of HCC 40 (5.0%), alcohol consumption 180 (22.6%), HBV infection 82 (10.3%), pickled food 225 (28.2%), and economic status 5 years ago 647 (81.1%) in controls, with OR of each variable was 3.520, 2.464, 4.330, 2.219, 2.451, 19.245, 6.212, 0.174 respectively, P less than 0.01.</p><p><b>CONCLUSION</b>HBV infection and pickled food were the most common risks for HCC in Guizhou. Alcohol consumption excessively and cigarette smoking may increase the risk too.</p>
الموضوعات
Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Young Adult , Alcohol Drinking , Carcinoma, Hepatocellular , Epidemiology , Case-Control Studies , China , Epidemiology , Feeding Behavior , Hepatitis B , Epidemiology , Liver Neoplasms , Epidemiology , Risk Factorsالملخص
Objective To investigate the relationship between body mass index (BMI) and blood pressure in non-stroke population with over 50 years old from Dongcheng District and Shijingshan District of Beijing.Methods A total of 9 524 of non-stroke population with over 50 years old were selected as our subject,which were sampled from Dongcheng District and Shijingshan District of Beijing by using stratified cluster random sampling method.Investigation and physical inventory check were conducted on all subbjects conduct,and the results was statistical analyzed by using SPSS 17.0 software.Results Systolic blood pressure and diastolic blood pressure of all subjects increased with the increasing of BML The prevalence of hypertension of three age groups were significant different between male and female (Z =-50.47,P ＜ 0.001).The prevalence of hypertension in males with 50-59 years old was considerably higher than that of females (x2 =14.74,P ＜0.001).However,the prevalence of hypertension in females with 60-69 years old and ≥70 years old group were higher than that of males (x2 =12.39,P ＜ 0.001 ; x2 =10.36,P =0.001).Overall,the prevalence of hypertension between males and females was no significant (male for 37.9％,female 37.3％,x2 =0.31,P =0.578).BMI increased with the increasing blood pressure levels and prevalence of hypertension,taking the people with BMI ＜ 18.5 kg/m2 as reference,OR values of the risk for male people with BMI 18.5-24.0kg/m2,24.0-28.0 kg/m2,and ≥ 28.0 kg/m2 to get hypertension people were 1.622 (95％ CI:0.653 -4.029),2.405 (95％ CI:0.940-5.940),4.248 (95％ CI:1.709-10.559) respectively,while for female people were 2.212 (95％ CI:1.193-4.104),3.870 (95％ CI:2.092-7.157),6.603 (95％ CI:3.557 -12.258) respectively.Conclusion Overweight and obesity are risk factors of hypertension.Obesity control contributes to the prevention and treatment of hypertension in middle-aged and elderly population.
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Objective To investigate the diagnostic value of nuron specific enolase( NSE),S100βprotein,glial fibrillary acidic protein( GFAP)and myelin basic protein( MBP)in patients with early brain contusion and laceration. Methods One hundred and twelve cases with brain contusion and laceration diagnosed by CT or MRI were selected as our subjects who hospitalized Harrison international peace hospital from Apr. 2012 to Jul. 2013. Of them,68 cases with mild head injury were served as mild group and 44 cases of severe traumatic brain injury were served as severe group. And 83 healthy people without lung disease and nervous system diseases were served as control group. Electro chemiluminescence assay and ELISA methods were used to measure the level of NSE,S100β,GFAP,MBP. Results the level of serum NSE,S100β protein,GFAP and MBP in mild group were(18. 14 ± 6. 83),(0. 92 ± 0. 45),(0. 78 ± 0. 37))(4. 37 ± 1. 84)μg/ L,respectively, and(32. 11 ± 12. 48),(1. 58 ± 0. 94),(4. 26 ± 1. 96),(14. 72 ± 6. 77)μg/ L,respectively in severe group, and(8. 94 ± 3. 49),(0. 12 ± 0. 08),(0. 13 ± 0. 09),(1. 98 ± 0. 89)μg/ L,respectively in control group. There were significant differences among three groups( F = 137. 520,120. 083,283. 727,205. 569 respectively;P< 0. 01). All indexes were different between control and mild groups( q = 10. 599,13. 296,5. 881,6. 018;P< 0. 01),as well as between the mild and severe groups(q = 13. 600,9. 249,26. 639,22. 029;P < 0. 01),and between control and severe group(q = 23. 408,21. 258,32. 797,28. 134;P < 0. 01). Conclusion The level of serum NSE,S100β,GFAP,MBP can be used as early indicators of brain injury secondary diagnosis and secondary index for evaluating damage degree.
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Objective To investigate the diagnostic value of the combined detection of serum glial fibrillary acidic protein (GFAP)and myelin basic protein (MBP)in the patients with early brain contusion and laceration.Methods ELISA was adopted to detect serum GFAP and MBP.The one-way ANOVA analysis was adopted to conduct the comparison among groups and the q test was adopted to conduct the pairwise comparison for analyzing the differences between the brain contusion and laceration patients with the healthy population.Results The serum GFAP and MBP levels had statistically significant differences among the mild craniocerebral injury group,severe craniocerebral injury group and the healthy control (P <0.05);which had statistically signifi-cant differences between the control group and the mild craniocerebral injury group(P <0.05);which had statistically significant differences between the mild craniocerebral injury group and the severe craniocerebral group (P <0.05 );which had statistically significant differences between the control group and the severe craniocerebral injury group (P <0.05).The serum GFAP and MBP levels in the early stage of brain contusion and laceration were significantly higher than those in the control group,moreover,the more severe the injury,the more obvious the increase of serum GFAP and MBP.Conclusion The combined detection of serum GFAP and MBP can be regarded as the auxiliary indexes for the early diagnosis of early brain contusion and laceration and the eval-uation of the injury degree.
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Objective To investigate the common risk factors of primary hepatocellular cancer (PHC) in Guizhou province . Methods The group case-control study was adopted .The main related-factors of primary PHC in Guizhou provincial population and the relation between drinking combined hepatitis B viral infection with the PHC occurrence were analyzed by the unconditional Logistic regression analysis and the stratification analysis .Results Drinking(OR=2 .948 ,95% CI 2 .096-4 .146 ,P=0 .000) ,eco-nomic status 5 years ago(OR=0 .386 ,95% CI 0 .279 -0 .534 ,P= 0 .000) ,family history of PHC(OR= 2 .402 ,95% CI 1 .372 -4 .206 ,P=0 .002) ,cigarette smoking (OR=3 .468 ,95% CI 2 .265 -5 .311 ,P=0 .000) ,chronic liver disease(OR= 1 .502 ,95% CI 1 .054-2 .141 ,P=0 .024) ,HBV infection(OR=31 .999 ,95% CI 19 .318 -53 .002 ,P=0 .000) and diabetes mellitus(OR=4 .750 , 95% CI 2 .761-8 .171 ,P=0 .000) ,the differences between the patients group and the control group had statistical significance ;the OR value of drinking combined with HBV infection was 96 .903(95% CI 35 .265-266 .275 ,P=0 .000) .Conclusion HBV infection is still the common risk factor of PHC in Guizhou provincial population .Drinking can increase the risk in the individuals infected with HBV .
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Objective To explore the diagnostic performance and the distributive characteristics of me-diastinal lymph nodes in lung tumor with PET/CT examination .Methods Thirty-three cases of preoperative whole-body 18 F-FDG PET/CT examination revealed pulmonary lesions ,a radical surgery and lymph node dis-section patients were included in this study .PET/CT doctors read the image of PET/CT and recorded the lymph node short diameter,CT value,SUVmax,and analysed the patient′s visual graphics.The application of PET/CT a-nalysis was used for diagnosis of the mediastinal lymph nodes ,and compared with the pathological findings .Re-sul ts The diagnostic accuracy of mediastinal lymph nodes with the conventional CT method alone was 84 .1%, with the conventional PET method alone was 82.8%,with the conventional PET/CT analysis was 91.7%,with the PET/CT comprehensive analysis was 95.2%;Five benign lymph nodes were mis -diagnosed.In this study, there were eight cases of lung cancer with mediastinal or hilar lymph node metastasis ,all of the lymph nodes loca-ted in the right lung ,and in which five cases were in the inner zone .Conclusion The PET/CT comprehensive a-nalysis of lymph node performs better than either the CT method alone or the PET method alone (χ2 =9.10,P<0.05);The lesions in the inner zone are more prone to occur mediastinal lymph node metastasis .
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Objective To investigate the diagnostic value of 18F-FDG PET/CT for thyroid nodules.Methods From January 2008 to May 2012,34 patients (13 males,21 females; age range:21-73 years,mean (53.00± 12.57) years) with thyroid nodules on 18 F-FDG PET/CT and with histopathological results were retrospectively analyzed.From January 2011 to December 2011,20 cases (9 males,11 females; age range:40-55 years,mean (45.00±4.72) years) were selected as control group.Wilcoxon rank sum test and ROC analysis (AUC ≥0.7 was considered the standard of medium-high accuracy) were used.PET/CT features taken to suggest malignant thyroid nodules were:focally high uptake on PET,indistinct boundary or heterogeneous density on CT with punctuate,round or curved calcifications,or with hypermetabolic cervical lymph nodes as ancillary supportive findings of metastasis.The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of PET/CT for diagnosing thyroid nodules were calculated.Results (1) There were 18 patients with malignant and 16 with benign thyroid nodules.The SUVmax of benign,malignant nodules and normal controls were 7.59±8.69,5.75±4.48 and 1.38±0.57,respectively.The differences between malignant thyroid nodules and controls,between benign nodules and controls were significant (u=3.553,3.408,both P＜0.01).There was no significant difference between benign and malignant thyroid nodules (u =0.207,P＞0.05).(2) The AUC for the differentiation of benign and malignant thyroid nodules by ROC analysis was 0.557 (＜0.70).(3) The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of 18F-FDG PET/CT for the differentiation of benign and malignant thyroid nodules were 72.2％ (13/18),75.0％ (12/16),76.5％ (13/17),70.6％ (12/17) and 73.5％ (25/34),respectively.Conclusions 18F-FDG PET/CT has limited value for the differentiation between benign and malignant thyroid nodules based alone on the degree of metabolic intensity.It may have improved diagnostic certainty if combined with the morphological features on CT.
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Stroke is a type of neurological disease with high morbidity,disability,and mortality.It has become a global public health problem.At present,the stroke burden in countries around the world has shown an upward trend.This article reviews the extent of population health hazards caused by stroke,as well as the evaluation of economic burden of the disease.
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Objective To observe the efficacy and the side-effects of sodium valproate (VPA) in patients with epilepsy in rural China. Methods Epilepsy patients were selected from rural areas of Tianmen in Hubei province and Tiandong county in Guangxi province according to the inclusion and exclusion criteria.Efficacy evaluation standard depending on the change of seizure frequency compared with the situation prior to entering the treatment group. Among the treated patients, no seizures, seizure reduced ＞ 75%, seizure reduced 50%-75% sums for the total effective rate. Results All 607 patients with epilepsy were treated and followed up, the male were 395 (65. 1% ) female 212 (34. 9% ), and 579 patients were treated for 12 months. Patients with generalized tonic-clonic seizures were 517 (85.2%), absence seizures 20 (3. 3% )and the other types of seizures 70 (11.5% ) including simple partial seizures, tonic, clonic, myoclonic or atonic seizures etc. The completed control of seizures ( without any seizures) during the period after taking 3 months, 6 months, 12 months were 270 (45.5%), 249 (42. 3% ) and 238 (41.1%) respectively. The total effective rates in the three periods were 65.2% , 75.4% and 85.5% respectively. The 58 patients in the total group showed side-effects during the follow-up period, mainly including drowsiness, lethargy,fatigue, dizziness, headache and tremor. Nineteen patients (3. 1% ) quitted the treatment group.Conclusions The VPA is an effective antiepileptic drug and no more severe side-effects. It is the same as Phenobarbital and suitable to be used in rural areas of China.