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Objective:To explore the diagnostic value of C-TIRADS combined with artificial intelligence-assisted diagnosis S-Detect technology in the differential diagnosis of thyroid nodules.Methods:A total of 237 thyroid nodules patients (237 thyroid nodules)with ultrasound examination and definitive pathologic results in Henan Cancer Hospital from April to September 2020 were retrospectively analyzed. The nodules were diagnosed according to C-TIRADS guidelines, and then by S-Detect technology combined with C-TIRADS guidelines. The ROC curve was plotted with the pathological results as the gold standard, and the area under the ROC curve, sensitivity, specificity and accuracy of the diagnosis results between the two groups were compared.Results:Among the 237 thyroid nodules, 105 were benign and 132 were malignant.The area under the ROC curve of C-TIRADS diagnosis alone and C-TIRADS diagnosis combined with artificial intelligence were 0.869 and 0.942 respectively, the difference between the two groups was statistically significant (χ 2=36.11, P<0.001); When Category 4A was used as the cutoff value of benign and malignant differential diagnosis, the specificity and accuracy of C-TIRADS classification of artificial intelligence-assisted diagnosis was significantly higher than that of C-TIRADS alone, and the difference was statistically significant(83.81% vs 47.62%, 90.72% vs 75.53%, all P<0.05). Conclusions:C-TIRADS combined with artificial intelligence-assisted diagnosis S-Detect technology has a high efficiency in the diagnosis of thyroid nodules and can improve the specificity and accuracy of thyroid nodules diagnosis and reduce unnecessary biopsy.
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Objective:To explore the clinical application value of S-Detect intelligent assistant diagnosis technology in the diagnosis of suspicious thyroid nodules.Methods:A total of 153 patients who were diagnosed as TI-RADS 3-4 according to the ACR TI-RADS standard by ultrasound examination in Henan Provincial Cancer Hospital from September 2019 to December 2019 were included in the study. Differential diagnosis of benign and malignant thyroid nodules were made by senior doctors, junior doctors and S-Dectect technology, respectively. Then using pathological results as the standard, receiver operating charateric curve(ROC) curves were plotted to compare the area under curve (AUC), sensitivity, specificity and accuracy of S-Detect, senior and junior doctor groups, as well as their combinations.Results:Of the 153 patients with thyroid nodules, 108 cases(108 nodules) were comfirmed benign and 45 cases(45 nodules) were malignant afeer operation. The diagnostic sensitivity, specificity and accuracy of S-Detect were 77.78%, 87.04%, 84.31%. They were higher than junior doctors(68.89%, 79.63%, 76.47%), but lower than senior doctors(84.44%, 94.44%, 91.50%). The diagnostic sensitivity, specificity and accuracy in junior doctors combined with S-Detect were significantly improved(77.78%, 85.18%, 83.01%). The area under curve of S-Detect diagnosis was higher in the group of junior doctors combined with S-Detect (0.815) than that in the group of junior doctors (0.743), and the difference was statistically significant (χ 2=8.332, P=0.004). There was no statistically significant difference (χ 2=0.095, P=0.756) in the AUC of diagnosis between the group of senior doctors combined with S-Detect(0.901) and senior doctors(0.894). Using pathological results as the "gold standard" , the highest consistency of diagnosis was found in the senior doctors combined with S-Detect(Kappa=0.797). Conclusions:S-Detect technology has a high accuracy in the differential diagnosis of thyroid nodules. With the aid of this technology, it can improve the specificity and accuracy of diagnosis for the junior doctors.
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Objective:To explore prenatal ultrasound diagnostic clues of congenital dislocation of the knee(CDK).Methods:The prenatal ultrasonographic features of 13 CDK fetuses diagnosed from January 2013 to December 2018 in the Third Affiliated Hospital of Zhengzhou University were retrospectively analyzed, combined with the results of gene detections and pathological findings.Results:Thirteen fetuses were diagnosed by prenatal ultrasound during the second trimester. Two-dimensional and three-dimensional ultrasound showed dislocation of the knee(unilateral in 3 cases and bilateral in 10 cases). All cases were accompanied with multiple abnormalities, including talipes(5 cases), overlapping fingers(2 cases), short nasal bone(1 case), thicken nuchal fold(1 case), narrow thorax(1 case), abnormal vertebral development(1 case), etc. Ultrasound diagnosis included Larsen syndrome in 2 cases, arthrogryosis multiplex congenital in 3 cases, asphyxiating thoracic dysplasia in 1 case, and congenital dislocation of the knee in 7 cases. CDK was confirmed in all fetuses after termination of pregnancy. Three of them were known to undergo chromosome examinations with normal chromosomal microarray analysis (CMA). One case was confirmed to be Larsen syndrome by further second-generation sequencing combined with first-generation sequencing screening, suggesting there was FLNB gene mutation.Conclusions:CDK can exist isolated, and it can also be a common manifestation of various diseases. Therefore, attention should be paid to other associated abnormalities in the prenatal detection of knee flexion, and further detection of related genes can provide valuable information for genetic counseling.
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Objective To investigate the correlation between nonalcoholic fatty liver disease (NAFLD)fibrosis score(NFS)and unstable plaques of carotid in elderly NAFLD patients.Methods The clinical and carotid plaques data of 191 elderly(≥ 60 years old)admitted into our department between July 2016 and January 2018 were retrospectively collected.With NFS 0.676 as a cut-off point,the patients were divided into a liver fibrosis group(NFS ≥0.676,n=65)and a non-liver fibrosis group (NFS＜0.676,n=126).Based on quartiles of NFS,the patients were divided into four groups..the Q1 group(NFS＜-0.865,n=48),the Q2 group(0.865≤NFS＜0.100,n=48),the Q3 group(0.1≤ NFS＜ 1.070,n=47),the Q4 group (NFS≥ 1.070,n =48).The correlation of NFS with the property of carotid plaques was analyzed.Results The detection rate of unstable carotid plaques was increased along with the increase of NFS(F--8.573,P =0.004).The detection rate of unstable carotidplaques was higher in the liver fibrosis group than in the non-liver fibrosis group(78.5％ or 51/65 vs.60.3 ％ or 76/126,x2 =5.883,P--0.015).Multiple logistic regression analysis showed that liver fibrosis(NFS≥0.676)was independently correlated with unstable carotid plaques(β=0.816,95％CI:.1.110～4.607,OR=2.261,P=0.025)after adjusting for possible confounding factors including age,gender,diabetes mellit us,hypertension,total cholesterol,triglyceride,high-density lipoprotein,lowdensity lipoprotein.Conclusions NFS is correlated with unstable carotid plaques in elderly NAFLD patients,and the higher NFS is the independent risk factor for unstable carotid plaques for elderly NAFLD patients with NFS higher than 0.676.We should pay more attention to the evaluation of unstable carotid plaques.
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Objective@#To investigate the correlation between nonalcoholic fatty liver disease(NAFLD)fibrosis score(NFS)and unstable plaques of carotid in elderly NAFLD patients.@*Methods@#The clinical and carotid plaques data of 191 elderly(≥60 years old)admitted into our department between July 2016 and January 2018 were retrospectively collected.With NFS 0.676 as a cut-off point, the patients were divided into a liver fibrosis group(NFS ≥0.676, n=65)and a non-liver fibrosis group(NFS<0.676, n=126). Based on quartiles of NFS, the patients were divided into four groups: the Q1 group(NFS<-0.865, n=48), the Q2 group(-0.865≤NFS<0.100, n=48), the Q3 group(0.1≤NFS<1.070, n=47), the Q4 group(NFS≥1.070, n=48). The correlation of NFS with the property of carotid plaques was analyzed.@*Results@#The detection rate of unstable carotid plaques was increased along with the increase of NFS(F=8.573, P=0.004). The detection rate of unstable carotid plaques was higher in the liver fibrosis group than in the non-liver fibrosis group(78.5% or 51/65 vs.60.3% or 76/126, χ2=5.883, P=0.015). Multiple logistic regression analysis showed that liver fibrosis(NFS≥0.676)was independently correlated with unstable carotid plaques(β=0.816, 95%CI: 1.110~4.607, OR=2.261, P=0.025)after adjusting for possible confounding factors including age, gender, diabetes mellitus, hypertension, total cholesterol, triglyceride, high-density lipoprotein, low-density lipoprotein.@*Conclusions@#NFS is correlated with unstable carotid plaques in elderly NAFLD patients, and the higher NFS is the independent risk factor for unstable carotid plaques for elderly NAFLD patients with NFS higher than 0.676.We should pay more attention to the evaluation of unstable carotid plaques.
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Objectives To investigate the correlation between the triglyceride and glucose (TyG) index and nonalcoholic fatty liver disease (NAFLD) and to evaluate the predictive value of TyG for NAFLD.Methods This retrospective study included 279 individuals aged 60 or over (115 with NAFLD and 164 without NAFLD).Clinical data including height and weight (for body mass index,BMI),presence of diabetes mellitus,lipid-regulating medications,glucose-lowering medications,alanine aminotransferase (ALT),aspartate transaminase (AST),gamma-glutamyltransferase (GGT),albumin,fasting plasma glucose (FPG),serum lipid profiles,serum uric acid,glycosylated hemoglobin,and serum creatinine were collected and analyzed.The TyG index was calculated according to FPG and fasting serum trig[ycerides.Binary logistic regression was carried out to determine the correlation between TyG and NAFLD.Receiver operating characteristic (ROC) curve analysis was used to test the predictive value of TyG and TyG combined with ALT and BMI for NAFLD.Results According to the quartiles of TyG,the subjects were divided into four groups:Q1 (TyG≤ 7.40)、Q2 (TyG≤ 7.80)、Q3(TyG≤＜≤8.31)、Q4(TyG≤8.13).The rates of NAFLD were 16.2％ in Q1,29.6％ in Q2,53.7％ in Q3,and 65.3％ in Q4 (P ＜0.0001).Logistic regression showed that TyG was independently associated with NAFLD;Compared with Group Q1,the adjusted odds ratios (ORs) and 95％ confidence intervals (CIs) for NAFLD of Q2,Q3,and Q4 were 1.677 (95％ CI:0.641-4.384),3.279 (95％ CI:1.285-8.364),and 5.447 (95％ CI:2.172-13.658),respectively.The ROC analysis indicated that the area under the ROC curve (AUC) was 0.730 (95％ CI:0.67-0.79) and that,with the cut-off point at 7.78,the largest Youden's index value was 0.402,with a sensitivity of 74.6％ and a specificity of 65.6％ for NAFLD.When combining TyG with BMI and ALT,the AUC could reach 0.822 (95％ CI:0.771-0.872).Conclusions TyG is correlated with NAFLD in the elderly.Besides,TyG combined with BMI and ALT is effective to predict NAFLD in the elderly.
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Objective To summarize and analyze the prenatal ultrasonic manifestations of 17q12 microdeletion syndrome ,so as to provide help for prenatal diagnosis . Methods It carried out a retrospective analysis of 21 cases of 17q12 microdeletion syndrome prenatally confirmed by chromosomal microarray analysis(CMA) in the third affiliated hospital of Zhengzhou University from 2015 .01 to 2018 .05 . Prenatal ultrasound findings were collected . A close follow-up was given for the cases . Results Of the 21 fetus ,20 cases were presented with bilateral hyperechogenic kidneys ,and 1 case showed duodenal obstruction . There were 4 cases accompanied with polyhydramnios ,8 cases with mild polyhydramnio ,and 9 cases with normal amniotic fluid index . Parents of 6 fetus underwent chromosomal examination ,of which 2 cases were inherited from the mother and 4 cases had new chromosomal mutations;Seven cases had a family history of diabetes and 3 cases had a family history of kidney disease;Twelve cases performed induced labor ,2 cases lost follow-up and 1 case was unborn . Six cases were born ,of the 6 cases ,1 case associated with mild dysmorphic facial features , and 1 case associated with bilateral renal cysts . Conclusions 17q12 microdeletion syndrome has specific prenatal ultrasound characteristics ,while echogenic kidneys are of great value in the diagnosis of 17q12 microdeletion syndrome prenatally .
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Objective To analyze the difference and correlation of the evaluation of the medical students' communication ability between the examiners,standardized patients (SP) and medical students themselves in objective structured clinical examination (OSCE),and to provide scientific basis for the appropriate evaluation method of medical students' communication ability.Methods OSCE was used to evaluate the communication ability of 90 medical students in Daping Hospital,Chongqing,and the three parties were evaluated by the examiners,SP and medical students themselves.Excel and SPSS 17.0 statistical analysis software were used,through Friendman M.test,t test and correlation analysis to analyze the differences and correlation of the three parties evaluations.Results The different evaluation between the three parties on the communication ability of medical students was as follows.Examiner's evaluation was the lowest (8.39 ± 1.18),SP's evaluation was the highest (9.62 ± 0.73),Medical students themselves' evaluation was higher (9.28± 1.09);The examiner's evaluation of Medical students' empathy,verbal communication ability,nonverbal communication ability and etiquette was lower (P=0.00).The correlation analysis of the three parties' evaluation showed that there was a significant correlation between the three parties on the connnunication ability,empathy and nonverbal communication ability (P＜0.05).The evaluation of SP and medical students themselves on medical students' language communication ability and etiquette was significantly correlated (P＜0.05).Conclusions Using examiner or SP or medical students themselves only to evaluate the communication ability of medical students is not accurate,The Examiner and SP as the main trial test personnel should collaborate to evaluate medical students' communication ability.The examiner can evaluate three projects such as what is medical ethics and law,empathy,nonverbal communication ability,while the SP can evaluate the two projects:what is language communication ability and etiquette.The collaborative evaluation of the two sides can be more accurate to reflect the doctor-patient communication ability of medical students.
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Objective To explore the relationship between serum 25-hydroxy vitamin D level and prostatic hyperplasia in elderly men.Methods Totally 95 male patients aged over 60 years were included.Blood pressure,body weight,body height,body mass index (BMI) were measured and calculated.Venous blood samples were obtained to determine fasting serum levels of 25-hydroxy vitamin D3 and blood glucose (FBG),total cholesterol (TC),triglycerides (TG),low-density lipoprotein cholesterol (LDL-C),high-density lipoprotein cholesterol (HDL-C),calcium and prostate specific antigen (PSA),total prostate volume(PV) and annual prostate growth rate were measured and calculated by ultrasound.Results The serum 25 (OH) D3 levels were varied from 12.1 nmol/L to 83.9 nmol/L,with an average of (35.5±15.2) nmol/L in elderly male patients.PV growth rate were significantly lower in elderly men with 25 (OH) D3 ＞ 50 nmol/L than in elderly men with 25 (OH) D3≤50nmol/L[(31.5± 6.0) mlvs.(39.9 ± 14.5) ml,(0.4± 0.2) ml/yvs.(0.5 ± 0.4) ml/y,P＜0.001 or 0.01].PV was negatively correlated with serum 25-hydroxy vitamin D3 level (r=-0.207,P＜0.05),and positively correlated with BMI and PSA (r=0.297,0.958,P＜0.05 or and P＜0.001).While annual prostate growth rate was positively correlated with BMI and PSA (r=0.316,0.464,P＜0.01 or ＜0.001),and positively correlated with serum 25-hydroxy vitamin D3 level,but the difference was not statistically significant (P＞0.05).Conclusions Low serum 25-hydroxy vitamin D3 level may play a role in the pathogenesis of prostatic hyperplasia.
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Objective To investigate the association between bone mineral density (BMD) and left ventricular mass index (LVMI) in elderly men in Beijing.Methods Totally 370 elderly men with an average age of (76.6±9.3) years from the departments of gerontology were included.BMD,echocardiography measurements as well as blood chemistry were analyzed.LVMI was obtained by echocardiography.All the subjects were divided into two groups:non-LVH group (n=231) and LVH group (n =139).Differences in quantitative variables were tested by independent-sample t test.Multiple stepwise linear regression analysis were performed to identify determinants of LVMI.Results The serum creatinine concentration was significantly higher in LVH group than in non-LVH group [(97.1±43.0) μmol/L,(88.2±21.1) μmol/L (P＜0.05)].Compared with non-LVH group,LVH group showed that the lumbar spine BMD (L1-L4) were significantly lower[L1:(0.90±0.16) g/cm2 vs.(0.95±0.21) g/cm2,P=0.05; L2:(0.95±0.17) g/cm2 vs.(1.01±0.20) g/cm2,P＜0.01 ; L3:(0.99±0.19) g/cm2 vs.(1.06±0.28) g/cm2,P＜0.01] as well as the lumbar spine totalBMD [(0.97±0.18) g/cm2 vs.(1.03-1-0.26) g/cm2,P＜0.05].The femur BMD was lower in theLVH group than in non-LVH group [trochiter:(0.64±0.11) g/cm2 vs.(0.67±0.17) g/cm2,P＜0.05; inter area:(1.00±0.17) g/cm2 vs.(1.05±0.22) g/cm2,P＜0.05].Multiple stepwise linear regression analysis demonstrated that BMI (r=0.27,P＜0.01),the lumbar spine BMD (r=-0.20,P＜0.01),age (r=0.16,P＜0.05),serum creatinine (r=0.15,P＜0.05) were independently correlated with LVMI.Conclusions In elderly men in Beijing,the lumbar spine BMD is an independent correlative factor for LVMI.
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Objective To evaluate the relationship between insulin resistance and benign prostatic hyperplasia (BPH).Methods Totally 150 male patient from the Department of Geriatrics in Peking University Hospital were included in this study.Blood pressure,body weight,body height,body mass index (BMI) were measured and calculated.Biochemical analyses including serum fasting levels of insulin(FINS),glucose,total cholesterol,triglycerides,low-density lipoprotein cholesterol,high density lipoprotein cholesterol,and prostate-specific antigen (PSA) were performed.Total prostate volume (PV) were measured by ultrasound.Results PV and annual prostate growth rate were more increased in insulin resistance group(40 cases) compared with insulin sensitivity group(110 cases) (t=2.91,3.71 respectively,both P＜0.01).Along with the levels of FINS,HOMA-IR and PSA were increased,the prostate volume was enhanced (t=-3.02,-2.88,-2.84 respectively;all P ＜0.05).PV was positively correlated with insulin resistance,serum fasting insulin and PSA (r=0.16,0.16,0.35;all P＜0.05),while annual prostate growth rate was positively related with insulin resistance,serum fasting insulin,PSA and BMI (r =0.22,0.21,0.24,0.19 ; all P ＜ 0.05).Conclusions Insulin resistance and fasting insulin plays roles in the pathogenesis of prostatic hyperplasia.
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BACKGROUND: As a primary clinical predictor of fracture risk, bone mineral density (BMD) is partly genetically determined. Osteoprotegerin (OPG) is one important candidate gene in the pathogenesis of osteoporosis. OBJECTIVE: To investigate the association between T245G polymorphisms in the OPG gene and BMD. METHODS: A total of 281 elderly men and postmenopausal women, 182 males and 99 females, who received routine examinations at Peking University People's Hospital between September 2008 and April 2010 were included in this study. T245G polymorphisms in the OPG gene was detected by polymerase chain reaction-restriction fragment length polymorphism together with DNA sequencing. The BMD of the lumbar spine, Ward's triangle, and forearrm was determined by dual energy X-ray absorptiometry. Clinical variables and biochemical measurements were collected simultaneously. The association between T245G polymorphisms and each detection index was analyzed using analysis of variance. RESULTS AND CONCLUSION: The distribution of T245G genotype (alleles T, G) had no difference in elderly men or postmenopausal women (P > 0.05). The GG genotype and TG genotype had higher lumbar spine BMD and TT genotype had lower lumbar spine BMD (P < 0.05). There was no difference in BMD of the Ward's triangle or forearm among different genotypes (P > 0.05). Association between T245G polymorphism and BMD was not found in postmenopausal women. These findings indicate that OPG gene is related to lumbar spine BMD in elderly men.