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Purpose To investigate the value of a radiomics model based on dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)in the differential diagnosis of granulomatous mastitis and breast cancer.Materials and Methods The MRI data of 82 patients with granulomatous mastitis or breast cancer confirmed by pathology in Xiyuan Hospital of China Academy of Chinese Medical Sciences from February 2019 to January 2022 were retrospectively collected.Based on the first phase of DCE-MRI,the regions of interest(ROI)were delineated layer by layer by semi-automatic segmentation method and manual segmentation method,respectively.99 ROI were randomly assigned to 69 in training groups and 30 in test groups.The consistency difference between the two methods was compared.The original data extracted by the semi-automatic segmentation method were screened by correlation analysis and multi-factor Logistic regression.Six kinds of classifiers(Logistic regression,support vector machine,naive Bayes,decision tree,random forest,K nearest neighbor)were used to construct prediction models,and the differences in diagnostic efficiency,accuracy,sensitivity and specificity of each model were evaluated.Results A total of 99 lesions(n=37 cases with granulomatous mastitis and n=62 cases with breast cancer)were segmented from 82 patients.The radiomics data extracted by the two ROI segmentation methods had poor consistency between groups[Intraclass correlation coefficient=0.68(0.51,0.78)].Among the six prediction models constructed from the data extracted by the semi-automatic segmentation method,the diagnostic performance of the Logistic regression model and the support vector machine model was significantly better than those of other models,and the Logistic regression model had the best diagnostic performance and stability(training group:area under the curve 0.928,accuracy rate 0.855,sensitivity 0.837,specificity 0.885;test group:area under the curve 0.933,accuracy 0.833,sensitivity 0.895,specificity 0.727,respectively).Conclusion Radiomics based on DCE-MRI can provide high value for the differential diagnosis of granulomatous mastitis and breast cancer.The semi-automatic segmentation method is more recommended for the segmentation method of ROI.The prediction model constructed by Logistic regression and support vector machine shows better diagnostic efficiency and stability.
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OBJECTIVE@#To explore the change of plasma level of chemerin in chronic obstructive pulmonary disease (COPD) patients and its relationship with lipid metabolism. @*METHODS@#A total of 150 COPD patients were randomly selected and set as the COPD group and 30 healthy persons were set as the control group. The COPD group was further divided into a thin group (BMI<18.5 kg/m2, n=116) and a normal weight group (BMI≥18.5 kg/m2, n=34) according to their body mass index (BMI). Enzyme-linked immunosorbent (ELISA) was used in detection of plasma chemerin, total cholesterol (TC), triglyceride (TG), low density lipoprotein (LDL), and high-density lipoprotein (HDL). The hospitalization rate in a half year and the mortality was statistically analyzed. Pearson correlation analysis was applied to analyze the relationship between plasma level of chemerin and levels of blood lipids, and Spearman rank correlation method was used to analyze the relationship between the plasma levels of chemerin or lipids and the prognosis. @*RESULTS@#Compared with the control group, plasma levels of TC, TG and HDL in the COPD group in acute exacerbation and remission stage were reduced, while plasma levels of chemerin and LDL was elevated; compared with the thin group, plasma levels of TC, TG and HDL in the normal weight group were elevated, while plasma levels of chemerin and LDL were decreased. The hospitalization rate in half year and the mortality in the thin group were higher than that in the normal weight group, and the plasma levels of TC, TG and HDL in the COPD patients with hospitalization in half year or death were lower than that in COPD patients without hospitalization, while the plasma levels of chemerin and LDL was increased (P<0.05). Pearson correlation analysis showed that plasma level of chemerin in COPD patients was negatively correlated with plasma levels of TC, TG and HDL (r=-0.695, -0.748, -0.695, P<0.05), while positively correlated with plasma levels of LDL (r=0.668, P<0.05). Spearman rank correlation analysis showed that plasma levels of TC, TG and HDL in COPD patients and hospitalization rate in half year as well as the mortality were negatively correlated (TC: r=-0.716, -0.737; TG: r=-0.748, -0.753; HDL: r= -0.736, -0.728, P<0.05), while the plasma level of chemerin or LDL and hospitalization rate in half year and the mortality were positively correlated (chemerin: r=0.753, 0.766; LDL: r=0.742, 0.755, P<0.05). @*CONCLUSION@#Plasma levels of chemerin in the COPD patients are correlated with lipid metabolism. Plasma levels of chemerin and lipid are related to prognosis of COPD. The plasma levels of chemerin in patients with COPD may reflect the lipid metabolism and could be served as the index for prognostic evaluation.
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Humans , Body Mass Index , Chemokines , Cholesterol , Intercellular Signaling Peptides and Proteins , Lipid Metabolism , Lipoproteins, HDL , Lipoproteins, LDL , Pulmonary Disease, Chronic Obstructive , TriglyceridesABSTRACT
To investigate the correlations between lipid ratio/oxidative stress status in chronic obstructive pulmonary disease (COPD) patients and pulmonary hypertension as well as the prognosis. Methods: A total of 120 patients with COPD were randomly selected and served as the COPD group and 30 healthy persons were selected as the control group. The ratios of low density lipoprotein (LDL)/high-density lipoprotein (HDL), triglyceride (TG)/HDL and total cholesterol (TC)/HDL were measured. The superoxide dismutase (SOD) activity, malondialdehyde (MDA) content and total antioxidant capacity (T-AOC) level in the control group and COPD patients were detected. Pulmonary hypertension incidence and 3-year survival rate for COPD patients were statistically analyzed. Spearman rank correlation method was used to analyze relationship between lipid ratio /oxidative stress status and pulmonary hypertension. Results: Compared with control group, the ratios of LDL/HDL, TG/HDL and TC/HDL, and the serum MDA level in the COPD group were increased, while the serum SOD and T-AOC level in the COPD group were decreased; compared with stable period, lipid ratios and MDA levels in the acute period were elevated, while serum SOD and T-AOC levels were reduced (P<0.05). Pulmonary hypertension incidence and 3-year survival rates in the COPD group were 56.67% and 81.67% respectively; the lipid ratios and serum MDA levels in COPD patients with pulmonary hypertension were elevated compared with that in COPD patients without pulmonary hypertension; the serum SOD and T-AOC levels in COPD patients with pulmonary hypertension were reduced compared with that in patients without pulmonary hypertension (P<0.05). Spearman rank correlation analysis showed that ratios of LDL/HDL, TG/HDL and TC/HDL, and the serum MDA levels in COPD patients were positively correlated with 3-years pulmonary hypertension incidence (r=0.752, 0.748, 0.752, 0.748; P<0.05), and negatively correlated with 3-years survival rate (r=-0.722, -0.751, -0.736, -0.748; P<0.05); serum SOD and T-AOC levels in COPD patients were negatively correlated with 3-years pulmonary hypertension (r=-0.711, -0.734; P<0.05), and positively correlated with 3-year survival rate (r=0.726, 0.733; P<0.05). Conclusion: Blood lipid ratio and oxidative stress levels in COPD patients are elevated while antioxidant abilities were attenuated. The lipid ratio and oxidative stress status in COPD patients is closely related to the prognosis of pulmonary hypertension. Therefore, blood lipid ratio and oxidative stress status may be used in evaluation of pulmonary hypertension and prognosis for COPD patients.
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Female , Humans , Male , Biomarkers , Blood , Cholesterol , Blood , Physiology , Hypertension, Pulmonary , Lipids , Lipoproteins, HDL , Blood , Physiology , Lipoproteins, LDL , Physiology , Malondialdehyde , Oxidative Stress , Physiology , Prognosis , Pulmonary Disease, Chronic Obstructive , Blood , Mortality , Superoxide Dismutase , Triglycerides , Blood , PhysiologyABSTRACT
Objective: To explore the relationships between blood levels of osteopontin (OPN), brain natriuretic peptide (BNP) and cardiac function in patient with degenerative heart valve disease (DHVD). Methods: Our research included in 2 groups: DHVD group,n=120 relevant patients treated in our hospital from 2013-12 to 2015-02 and Control group,n=30 healthy subjects from physical examination in the same period of time. Based on blood levels of OPN, DHVD patients were further divided into 2 sub-groups as Normal OPN sub-group, the patients with 18.8 ng/ml ≤OPN≤ 30.0 ng/ml,n=35 and High OPN sub-group, the patients with OPN>30.0 ng/ml,n=85. OPN levels at prior treatment (T0) and 3 days (T1), 1 week (T2), 2 weeks (T3) after treatment were compared between DHVD group and Control group; BNP levels, cardiac outcome (CO), cardiac index (CI) and left ventricular ejection fraction (LVEF) were also compared. The relationships between blood levels of OPN, BNP and cardiac function in DHVD patients were studied by Pearson correlation analysis. Results: Compared with Control group at T0 time point, High OPN sub-group showed increased blood levels of OPN and BNP, while decreased CO, CI and LVEF. Compared with Normal OPN sub-group, High OPN sub-group had the higher levels of OPN and BNP at all 4 time points, while lower levels of CO, CI and LVEF. In DHVD group, compared with T0 time point, OPN and BNP levels were decreased at T2 and T3 time points, while CO, CI and LVEF were increased, allP<0.05. Pearson correlation analysis presented that in DHVD patients, blood levels of OPN were positively related to BNP (r=0.936,P=0.00) and negatively related to CO, CI and LVEF (r=-0.869,r=-0.884 andr=-0.858 respectively, allP=0.00). Conclusion: DHVD patients had increased blood level of OPN which is related to BNP level and cardiac function; this might be because of OPN promoting heart valve calciifcation, inlfammatory reaction and myocardial injury. OPN could be used as a reference index for evaluating the cardiac function in DHVD patients.
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Objective To explore the clinical feature and diagnosis of the X linked adrenal hypoplasia congenital (X-AHC). Methods The clinical data and gene detection results of one case of AHC were retrospectively analyzed. The related literatures were reviewed. Results Two-month-old male infant was suffered with slow weight gain, vomiting, and salt craving of adrenal insufifciency after birth. Gene detection found a new missense mutation on NROB 1 gene. The diagnosis of X-AHC was conifrmed. Conclusions X-AHC is a kind of rare disease and is diagnosed by clinical manifestation, laboratory testing, and NROB 1 gene detection.
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ObjectiveTo investigate the diagnosis and treatment of Crohn disease in neonates.Methods The clinical data of one case of neonatal onset Crohn disease were retrospectively analyzed.Results Male infant had intermittent fever, recurrent oral ulcers, skin impetigo and intermittent diarrhea with increased WBC counts from ifve days after birth. He had been diagnosed as sepsis, bacterial enteritis, Behcet's disease, immunodeifciency disease, nutritional anemia, milk intolerance, and inlfammatory bowel disease. Finally he was diagnosed as Crohn disease by rectal mucosa pathology and postoperative bowel pa-thology. He died of intestinal perforation on 8 months.ConclusionsThe infants who have recurrent oral ulcers, skin impetigo, perianal ulcers and fever from neonatal should undergo colonoscopy for the diagnosis.
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Objective To raise the awareness of congenital ornithine transcarbamylase deficiency (OTCD) by analyzing the clinical features and the family pedigree in a child with OTCD.Methods Clinical characteristics were analyzed in a child with OTCD.The genetic analysis was performed in ten exons and nine intron-exon boundaries in the ornithine transcarbamylase (OTC) gene of the case and his family by direct sequencing of PCR-DNA from peripheral blood.Family history including his grandparents and uncle was registered.Results The onset age of the case was 6 months old,the clinical picture was characterized by recurrent episodes of vomiting,low spirits,hyperammonemia,and abnormal liver function.His brother died of the similar performance at 6 months old.His sister was healthy.IVS1-2A>G intron mutation of OTC gene was found in the case,while his mother and sister were the carriers and his father revealed no mutation.His maternal grandparents and his uncle's family were healthy.Conclusion OTCD is a kind of congenital genetic disease,and is one of the main causes of hyperammonemia.Misdiagnosis is very common because clinical symptoms of this disease are variable.IVS1-2A>G mutation in OTC gene is the pathogeny of this case.The family genealogy indicates that this case is a kind of X-linked recessive hereditary disease.
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BACKGROUND: To establish experimental animal model for rapid evaluation of combined wound with seawater immersion so as to benefit wound healing and recovery.OBJECTIVE: To explore the plan of simple evaluation of combined wound with seawater immersion.DESIGN: Group division and controlled experiment was designed.SETTING: Second Department of Orthopaedics, the 113 Hospital of Chinese PLA; Research Institute of Surgery, Daping Hospital, Third Military Medical University of Chinese PLA MATERIALS: Totally 32 health hybridized adult dogs were employed,mass weighted varied from 12 to 15 kg, of either sex.METHODS: The experiment was performed partially in the specific sea area of the Fifth and Sixth Room , Research Institute of Surgery of Daping Hospital of the Third Military Medical University of Chinese PLA from October 2001 to June 2002. The dogs were randomized into burn-blast combined wound group and projectile-burn combined wound group and each group was subdivided into immersion group (10 dogs) and the control (6 dogs). Burn-blast combined wound group: The model of burn and mild blast injury was prepared. In the control, the dogs were put in a room at 25 ℃ directly after injury; But in immersion group, the dogs were immersed immediately in simulated seawater with holder. Projectile-burn combined wound group: The model of burn and mild projectile injury was prepared. The managements were same as the previous after injury in the control and immersion group. The change of physiologic indexes was observed in 28 hours after injury. The indexes related to death were picked up for correlative analysis and establishing wound scoring scale, inducing body temperature, heart rate, mean arterial pressure (MAP), chloride concentration, PaO2 and causative factor, 0-5 score were designed, the higher the score was, the higher mortality would be.MAIN OUTCOME MEASURES: ① Analysis of dead cases in each group. ② Wound scoring. ③ Verification of wound in scoring scale.RESULTS: 32 dogs all entered result analysis. ① Analysis of dead cases and relationship: Totally, 12 dogs were died. The peak of death was in 10-12hours, no matter the immersion happened or not. 5 indexes were associated significantly with death, named body temperature, heart rate, MAP, PaO2 and chloride concentration (P < 0.05). ② Comparison of wound scoring, predictive mortality and actual mortality in each group: The results in burn-blast control were (5.89±3.25) score, 0 and 17% successively. Those in projectileburn control were (6.78±2.02), 25% and 33% successively. Those in burn blast immersion group were (9.50±4.20) scores, 50% and 30% and those in projectile-burn immersion group were (11.13±3.57) scores, 50% and 60%.CONCLUSION: ① The established scoring scale is apt to obtain common physiological indexes so as to evaluate the wound rapidly, which is applica ble for either seawater immersed cases or non-immersed cases, indicating extensively applications. ② The correction of evaluation is acceptable with verification. ③ The scale is based on animal experimental data, for which,it is still different from the one of real wound evaluation.
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<p><b>OBJECTIVE</b>To study the clinico pathologic factors influencing postoperative survival rate in mucoepidermoid carcinoma of salivary glands.</p><p><b>METHODS</b>A retrospective study of seventy patients with mucoepidermoid carcinoma of salivary glands has been carried out. All cases underwent primary surgical resection in our hospital were followed up and clinicopathologic factors influencing the postoperative survival rate of patients were investigated. Statistical analysis was conducted using a computer program (SPSS). The data were statistically treated according to the Kaplan-Meier method. The Log rank tests were employed to assess the statistical significance of various groups.</p><p><b>RESULTS</b>The 3-, 5- and 10-year overall survival rate were 90.66%, 88.85% and 86.63%, respectively. The patients with tumors' diameter less than 4 cm, early clinical stage (stage I and II), well differentiated tumor cells, without lymph nodes involvement, without local recurrence and metastasis after primary surgical resection had a long survival term. The patients with tumors' diameter more than 4 cm, with lymph nodes involvement, advanced clinical stage (stage III and IV), poor differentiated, with local recurrence and metastasis after primary surgical resection demonstrated a short survival term.</p><p><b>CONCLUSION</b>TNM and clinical stage, the degree of differentiation, with or without local recurrence and metastasis after primary surgical resection are the important factors influencing the postoperative survival time.</p>
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Adolescent , Adult , Aged , Aged, 80 and over , Child , Female , Humans , Male , Middle Aged , Carcinoma, Mucoepidermoid , Pathology , General Surgery , Follow-Up Studies , Neoplasm Recurrence, Local , Postoperative Period , Retrospective Studies , Salivary Gland Neoplasms , Pathology , General Surgery , Survival RateABSTRACT
Objective To observe and analyze the standards of the normal vivo renal multi-slice spiral CT(MSCT) imaging to provide relevant normal range for clinic and teaching.Methods 123 cases with normal kidneys were undergone abdominal MSCT,then 3D imaging was performed,the position of kidney distance between two poles of kidney and the central line of the spine,renal length and short axis,the angels between the renal length axis and sagittal segment(LS) and the coronal segment(LC),the angel between coronal segment and the longest distance line from the midpoint of the renal gate to the same kidney's out edge(CL) were observed and measured with statistics analysis.Results Mostly the position of left kidney was higher than that of the right.Almost kidney's upper poles located at the T12 level.The number of left kidney was more than the right kidney in the renal upper pole located higher than T11.Almost kidney's inferior poles located at from the L2 inferior edge level to the L3 inferior edge level.In the statistic results,the values measured on CT of left kidney were large or equal to the right except for CL and LC in men,LC in women,total LC and LS.The width in men,total length and width and total upper distance were of significant statistics meaning(P