A comparative study of the diagnostic performance of gadoxetic acid-enhanced hepatic MRI and multislice CT in the evaluation of colorectal liver metastases / 西安交通大学学报(医学版)

【Objective】 To compare the diagnostic performance of gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB) enhanced magnetic resonance imaging (MRI) and multi-detector computed tomography (MDCT) in detecting liver metastases from metastatic colorectal cancer (mCRC). 【Methods】 We made a retrospective collection of 128 patients diagnosed with mCRC from May 2019 to June 2022 at Haikou Hospital, Xiangya School of Medicine, Central South University and Xijing Hospital, Air Force Military Medical University. All patients underwent Gd-EOB MRI and MDCT imaging. Three radiologists judged the accuracy, sensitivity, specificity, positive predictive value and negative predictive value of the two modalities for colorectal liver metastases, respectively. 【Results】 Of the 128 patients diagnosed with mCRC, a total of 462 lesions were obtained, with 424 positive and 38 negative metastases confirmed by pathology. In the interpretation of physician A, Gd-EOB MRI judged 404 positive and 38 negative liver metastases, with accuracy of 95.67%, sensitivity of 95.28%, specificity of 100.00%, a positive predictive value of 100%, and a negative predictive value of 65.52%. MDCT judged 337 positive and 37 negative liver metastases, with accuracy of 80.95%, sensitivity of 79.48% and specificity of 97.37%, a positive predictive value of 99.70%, and a negative predictive value of 29.84%. In the interpretation of physician B, Gd-EOB MRI judged 403 positive and 36 negative liver metastases, with accuracy of 95.02%, sensitivity of 95.05%, specificity of 94.74%, a positive predictive value of 99.51%, and a negative predictive value of 64.91%. MDCT judged 335 positive and 35 negative liver metastases, with accuracy of 80.09%, sensitivity of 79.01%, specificity of 92.11%, a positive predictive value of 99.11%, and a negative predictive value of 28.23%. In the interpretation of physician C, Gd-EOB MRI judged 406 positive and 38 negative liver metastases, with accuracy of 96.10%, sensitivity of 95.75%, specificity of 100.00%, a positive predictive value of 100.00%, and a negative predictive value of 67.86%. MDCT judged 352 positive and 34 negative liver metastases, with accuracy of 83.55%, sensitivity of 83.02%, specificity of 89.47%, a positive predictive value of 98.88%, and a negative predictive value of 32.08%. Gd-EOB MRI judged the nature of liver metastases with higher accuracy, sensitivity and negative predictive value than MDCT, and had better agreement with pathological examination results in the judgment of physician A and physician C (Kappa=0.770, 0.788). In physician B’s judgment, the agreement with pathological findings was fair (Kappa=0.731), while the agreement between the results of MDCT examination and pathological findings was poor (Kappa=0.379, 0.378 and 0.400). 【Conclusion】 Gd-EOB MRI has higher accuracy, sensitivity and positive predictive rate than MDCT in diagnosing colorectal liver metastasis, and has higher diagnostic performance. Therefore, it can provide more valuable reference information for clinical differential diagnosis. Subcapsular lesions, peribiliary metastases and hepatic steatosis can reduce the diagnostic performance of MDCT, while Gd-EOB MRI detection can provide more accurate results than MDCT.

Clinical study of intensity-modulated radiation therapy combined with camrelizumab in the treatment of advanced hepatocellular carcinoma / 局解手术学杂志

Objective To investigate the efficacy and safety of intensity-modulated radiation therapy combined with camrelizumab in the treatment of advanced hepatocellular carcinoma(HCC).Methods A total of 84 patients with advanced HCC admitted to our hospital from January to December 2020 were selected as the study objects,and were randomly divided into the observation group and the control group,with 42 cases in each group.Patients in the observation group received intensity-modulated radiation therapy combined with carrelli-zumab,and patients in the control group received intensity-modulated radiation therapy.The short-term efficacy,immune function and long-term survival rate of patietns in the two groups were compared,and the incidence of adverse reactions was recorded.Results The total effec-tive rates of the observation group 1 month and 3 months after treatment were significantly higher than those of the control group(P<0.05).The levels of CD3+,CD4+ and CD4+/CD8+ 1 month and 3 months after treatment were all increased in the two groups,while the levels of CD8+ in both two groups were decreased(P<0.05),and the levels of CD3+,CD4+ and CD4+/CD8+ in the observation group were higher than those in the control group(P<0.05),and the levels of CD8+ in the observation group were lower than those in the control group(P<0.05).The median survival time of patients in the observation group was significantly longer than that of patients in the control group(P<0.05).The incidence of cutaneous capillary hyperplasia in the observation group was higher than that in the control group(P<0.001),and there was no significant difference in the incidence of other adverse reactions between the two groups(P>0.05),and all of adverse reactions were grades 1 to 2.Conclusion Intensity-modulated radiation therapy combined with camrelizumab has a good effect on HCC,it can improve the immune function of the body,and control the development of the disease,with good safety.

Mediating effect of emotion regulation on relationship between occupational stress and job burnout of nurses / 中国实用护理杂志

Objective To explore whether emotion regulation mediates the relationship between occupational stress and job burnout in a large sample of nurses, in order to provide a targeted intervention. Methods Chinese Nurses Stressor Scale, Maslach Burnout Inventory-Human Services Survey, Emotion Regulation Questionnaire and Ruminative Responses Scale were used to investigate 602 nurses working in three tertiary hospitals in Jinan. SPSS 16.0 and AMOS 17.0 software were used to analyze the data. Results Job burnout were positively correlated with stressors, expression suppression and rumination (r=0.112–0.576, P<0.01), and negatively correlated with cognitive reappraisal (r=-0.277, P<0.01). Stressors were positively correlated with expression suppression and rumination (r = 0.140–0.403, P <0.01), and negatively correlated with cognitive reappraisal (r =-0.110, P < 0.01). Occupational stress could make a positive role on job burnout directly. Moreover, in the indirect approach, occupational stress could make a positive role on job burnout through the mediating role of cognitive reappraisal and ruminative, but not expression suppression. Conclusions Cognitive reappraisal and ruminative partially mediated the relationship between occupational stress and job burnout.

Sequence and phylogenetic analysis of the haemagglutinin genes of H9N2 avian influenza viruses isolated in central China during 1998-2008 / 病毒学报

The purpose of this study is to explore the effects of the HA sequence variation on the pathogenicity and antigenicity of avian influenza virus(AIV). Haemagglutinin (HA) genes from, 6 of 25 avian influenza viruses (AIVs) H9N2 strains with different pathogenicity isolated in central China during last 10 years were amplified by reverse transcriptase PCR (RT-PCR), completely sequenced and phylogenetically analyzed. The purpose of this study was to explore the effects of the HA sequence variation on the pathogenicity and antigenicity of AIV. The results showed that all 6 representative H9N2 isolates belong to low pathogenic AIVs, since none of the amino acid sequences at the cleavage site of the HA of the isolates possessed the basic motif required for highly pathogenic viruses (R-X-R/K-R). There were eight potential glycosylation sites in HA of the isolates, except that 3# and 12# had an extra one. The higher pathogenicity of 3# and 12# was probably due to the extra glycosylation site (145aa-147aa) in HA1, which might alter the conformational structure of HA resulting in the mutation or deletion of the binding sites of anti-HA antibody, and has effects on receptor binding sites thus changed the antigenicity of the virus. Our results suggested that attention should be paid to the transmission and natural evolution of H9N2 AIV in order to control AIV H9N2.

Analysis of clinical characteristics of cornual pregnancy / 대한산부인과학회지

OBJECTIVE: To determine the efficacy of ultrasonogram in the detection of cornual pregnancy and the factors that might be affected on early diagnosis. METHOD: We studied 26 cases which were diagnosed as a cornual pregnancy from Jan, 1, 2000 to Dec, 31, 2004 at department of Obstetrics and Gynecology, St. Vincent's Hospital, the Catholic University of Korea. We compared two groups about clinical characteristics and outcomes. One group (A group) was diagnosed as cornual pregnancy before beginning of treatment, another group (B group) was not diagnosed as cornual pregnancy until operation. RESULTS: A group was 8 cases (30.8%) and B group was 18 cases (69.2%). There were no significant differences in age (33.0+/-6.21 years : 31.0+/-5.82 years), duration of amenorrhea (7.32+/-1.07 weeks : 8.90+/-5.44 weeks), previous cesarian section history (25.0% : 27.8%), present myoma (12.5% : 11.1%) and abdominal pain (50% : 77.78%), vaginal bleeding (50% : 55.6%), shock (0% : 27.8%) between two groups. There were significant differences in parity (1.63+/-0.74 : 1.0+/-0.77, p=0.032), number of abortions (2.25+/-1.16 : 1.11+/-1.18, p=0.016), previous history of ectopic pregnancy (37.5% : 0%, p=0.022). Of the method of treatments, only cornual resection (50% : 94.4%) showed significant differences between two groups. CONCLUSION: 30.8% of cornual pregnancy was early diagnosed by ultrasonogram. The important early detective factors for cornual pregnancy might be parity, previous ectopic pregnancy history and abortion history. Therefore if the patient has the previous ectopic pregnancy and abortion history, she can visit early to the hospital and the doctors do pay attention to the possibility of cornual pregnancy.