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Objective: To explore the efficacy of SPECT/CT pulmonary perfusion imaging for evaluation on therapeutic effect of balloon dilatation (BPA) for chronic thromboembolic pulmonary hypertension (CTEPH). Methods: A total of 18 patients with CTEPH underwent SPECT/CT pulmonary perfusion imaging before and 1-3 months after BPA. Perfusion defect and perfusion improvement were observed before and after BPA taken catheter pulmonary angiography as standards. Results: The sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) of SPECT/CT pulmonary perfusion imaging in detecting pulmonary perfusion defect was 90.42%(302/334), 99.05%(418/422), 95.24%(720/756), 98.69%(302/306), 92.89%(418/450), respectively before BPA, while perfusion improvement after BPA was 77.78%(56/72), 80.00%(24/30), 78.43%(80/102), 90.32%(56/62) and 60.00%(24/40), respectively. Conclusion: SPECT/CT pulmonary perfusion imaging has good clinical value in evaluating pulmonary segment perfusion and improvement in patients with CTEPH after BPA.
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Objective To assess the value of shear-wave elastic modulus for differential diagnosis of benign and malignant breast lesions using Meta-analysis.Methods Relevant Chinese and foreign articles about shear-wave elastography for differentiating benign and malignant breast lesions were collected from the literatures published before Apr.2016.Meta-analysis was conducted to assess the overall ability of the shear wave elastic modulus including Emax,Emea,Eratio and Esd.Results Totally 31 studies were brought into the Meta-analysis.The summarized sensitivity (SSEN) and summarized specificity (SSPE) of Emax were 0.87(95％CI [0.83,0.91]) and 0.91 (95％CI [0.87,0.93]).The SSEN and SSPE of Emea were 0.84 (95％CI [0.77,0.89]) and 0.88 (95％CI [0.84,0.91]),The SSEN and SSPE of Eratio were 0.88(95％CI [0.83,0.91]) and 0.87 (95％CI [0.80,0.91],the SSEN and SSPE of gsd were 0.85 (95％CI [0.80,0.89]) and 0.90 (95％CI [0.85,0.94]).The summarized receiver operator characteristic analysis showed that the area under the curve of E E Eratio and Esd were 0.95,0.93,0.93 and 0.93.Conclusion The shear wave elastic modulus contribute to differentiate benign and malignant breast lesions.Among these indices,Emax is the best one.
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Objective To systematically analyze and assess the overall value of transrectal shear wave elastograpy in diagnosis of prostate cancer (PCa) using Meta-analysis.Methods Relevant Chinese and foreign papers diagnosing PCa with transrectal shear wave elastograpy published before December 2016 were searched.The references were evaluated and screened according to the criteria of diagnostic research.The selected references were analyzed by Meta-Disc 1.4 and Stata 12.0 statistical software.Results Eight articles were included in the present Meta-analysis.Five of these literatures were about transrectal shear wave elastograpy in diagnosis of PCa,the summarized sensitivity (SEN) and summarized specificity (SPE) in diagnosis of PCa were 0.80 (95％CI [0.75,0.84]) and 0.75 (95％CI [0.71,0.79]),respectively;the positive likelihood ratios (PLR) and negative likelihood ratios (NLR) were 3.60 (95 ％ CI [2.57,5.05]) and 0.17 (95 ％ CI[0.08,0.37]),respectively;the area under SROC curves was 0.895.Five of these literatures were about transrectal shear wave elastograpy supplemental prostatic biopsy in diagnosis of PCa,the summarized SEN and SPE were 0.86 (95％ CI [0.83,0.88]) and 0.84 (95％CI [0.82,0.85]) respectively;the PLR and NLR were 5.81 (95％CI [3.07,10.99]) and 0.14 (95％CI [0.04,0.49]) respectively;the area under SROC curves were 0.924.Conclusion Transrectal shear wave elastograpy has better clinical value in detection of PCa and can be used to supplemental prostatic biopsy.
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Objective To observe the efficacy and side effect of olanzapine combined with tropisetron, dexamethasone for the pre-vention of highly emetogenic chemotherapy-induced nausea and vomiting ( CINV) . Methods A total of 78 patients with highly emetogen-ic single day chemotherapy were randomly divided into two groups:trial group ( olanzapine combined with tropisetron, dexamethasone n=40) and control group (Tropisetron Combined with Dexamethasone n=38). The control of acute CINV, delayed CINV and adverse reac-tions were observed. Results The control rates of acute vomiting in trial group and control group were 87. 5% vs 81. 6%, 65. 0% vs 57. 9% in acute nausea, 75. 0% vs 52. 6% in delayed vomiting, 32. 5% vs 13. 2% in delayed nausea. The trial group was better than the control group in delayed vomiting and delayed nausea which there was difference between them (P 0. 05). Conclusion Olanzapine combined with tropisetron, dexa-methasone for the prevention was significantly better than tropisetron combined with dexamethasone in the control of delayed CINV in pa-tients received highly emetogenic chemotherapy.
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Objective To compare the functional profiles of organ transplant patients using the International Classification of Functioning,Disability,and Health (ICF) core set.Methods The patients were enrolled 5 to 10 days after discharge following an organ transplant.The Functional Independence Measure (FIM),Barthel Index (BI) and the ICF core set were used to assess them.Analysis was conducted by grouping the kidney transplant patients (group A) separately from the heart,lung and liver transplant patients (group B).The prevalence of sevcre impairment in each group was calculated and compared.Results Average FIM and BI secores were both significantly higher in group A than in group B.No severe or total impairment was observed in group A,but in group B,the prevalence of 5 categories (ie.b455,b730,s430,d415 and d450) was significantly greater than in group A.The most prevalent were poor exercise tolerance (b455,56.8％),low muscle power (b730,54.5％),difficulty in maintaining a body position (d415,54.5％),and impaired walking (d450,45％) With regard to the environment factors,the prevalence of e110 (products or substances for personal consumption) and e120 (products and technology for personal use in daily living) were both significantly different in the two groups.Conclusion Heart,lung and liver transplant patients transplant demonstrated more impairments than the kidney transplant patients.All the organ transplant patients deserve early evaluation for detecting any possible impairment.
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Objective To evaluate content validity and construct validity of International Classification of Functioning,Disability and Health(ICF)Core Set for patients with organ transplantation.Methods Patients with kidney,liver,heart,or lung transplantation were assessed with ICF Core Set questionnaire,Functional Independence Measure(FIM)and Barthel Index(BI).Content validity was evaluated with frequency and percentage of patients with a problem for each ICF category,while construct validity was evaluated with Spearman correlation between ICF categories with FIM and BI.Results A consecutive sample of 102 patients completed this study.In body functions,10 categories were reported as a problem by more than 30% of the patients,of which 22 categories correlated significantly with FIM or BI.In body structures,structure areas of skin(s810)were reported as a problem by 30% of the patients,of which 3 categories correlated significantly with FIM or BI.In activities and participation,3 categories were reported as a problem by 30% of the patients,of which 15 categories correlated significantly with FIM and BI.In environmental factors,8 categories were reported as a facilitator by 30% of the patients,of which 8 categories correlated significantly with FIM or BI.Conclusion The content validity and construct validity of ICF Core Set for patients early after organ transplantation were good.
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BACKGROUND: Functional magnetic stimulation (FMS) is characterizedby safe, unwounded and non-side effect. At present, it has been used incentral nervous conduction, recovery from nervous exhaustion, bone healing, treatment of neural disorder, research of brain function, and so on;meanwhile, it also can improve urination dysfunction.OBJECTIVE: To pursue investigating the effect of FMS on the treatment of neurogenic bladder.DESIGN: Self controlled study pre- and post-treatment.SETTING: Department of Rehabilitation Medicine, Tongji Hospital,Tongji Medical College, Huazhong University of Science and Technique.PARTICIPANTS: Twenty patients with neurogenic bladder were recruited in the Department of Rehabilitation Medicine, Tong ji Hospital, Tongji Medical College, Huazhong University of Science and Technique from June 2003 to June 2004. Of them, 12 patients with neurogenic bladder were caused by spinal cord injury and 8 by other reasons under urinary dynamic examinations.METHODS: Twenty patients with neurogenic bladder underwent S3 never root and bladder FMS by MagLite magnetic stimulation system (Dantec Company, Denmark), for 20 successive times, twice a day, five days a week and 4-6 weeks as a course. The interval was 2 seconds and the frequency was 5 minutes for once. Parameters were designed as the following: intensity: 70％-80％maximal magnetic intensity; frequency: 5 Hz; impulse length: 1 ms.MAIN OUTCOME MEASURES: Parameters were observed pretreatment, post-treatment immediately and at 1 and 3 months: ① Urine frequency: the mean voided volume and the maximal voided volume; ②Scores of quality of life (QOL): Scores ranged from 0 to 6 points. The higher the scores were, the poorer the QOL was. ③ International lower urinary tract symptoms (LUTS) scores: There were 7 questions with the scores of 0-35. The higher the scores were, the severer the symptoms were.RESULTS: All 20 patients were involved in the final analysis. ① Effect of urination on QOL scores: Scores were decreased post-treatment as compared with those pretreatment (3.17±1.53, 4.58±1.00, P ＜ 0.01), and scores were increased within 1 and 3 months post treatment but were still lower than those pretreatment (P ＜ 0.01). ② LUTS scores: Scores were decreased post-treatment as compared with those pretreatment (21.42±5.00,28.08±1.51, ,P ＜ 0.01), and scores were increased within 1 and 3 months post-treatment but were still lower than those pretreatment (P ＜ 0.01). ③Times of urination were decreased, but the mean voided volume and themaximal voided volume were increased (P ＜ 0.05); in 1 month post-treatment, each parameter was decreased but was still superior to that pretreatment (P ＜ 0.05); at 3 months post-treatment, each parameter was still decreased, but there was no significant difference of mean voided volume from that pretreatment (P ＞ 0.05), and other parameters were superior to those pretreatment (P ＜ 0.05); there was no significant difference at eachtime point post-treatment (P ＞ 0.05).CONCLUSION: FMS can partly improve the symptoms of voiding dys-function and improve the quality of life.
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BACKGROUND: The autonomous neurogenic bladder(ANB) is one of the common problems and difficulty in rehabilitation of patients with spine injury. Having the advantages of safety, non-invasion and no side-effects,functional magnetic stimulation(FMS) has been applied in central nervous system(CNS) neurotransmission, recovery from nervous exhaustion, bone healing, treatment of neural disorders and research of brain function, and so on. But the studies on treatment of ANB after spine injury are not as profound and systematic as they were needed.OBJECTIVE: To investigate the therapeutic effect of FMS in patients with ANB caused by spine injury.DESIGN: A longitudinal observation based on patients.SETTING: Department of Rehabilitative Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology.PARTICIPANTS: From May 2003 to May 2004, 12 patients with ANB hospitalized in the Rehabilitative Medicine Department of Tongji Hospital,Tongji Medical College, Huazhong University of Science and Technology were selected, 9 were male and 3 were female.METHODS: By using MagLite FMS Devices(made by Dantec, Danmark),a FMS therapy was employed at the sacral 3(S3) nerve root region and the bladder region, twice a day, 5 days a week, and a duration of 4 - 8 weeks.MAIN OUTCOME MEASURES: The pre-and post-treatment dynamics of urine flow variables(such as, residual urine volume, maximum urethral closure pressure(MUCP), the maximum bladder capacity, the bladder pressure, and the maximum urine flow rate), the frequency of urination, the average daily amount of urine, the maximum urine volume(V max), influence of urinary symptoms on the quality of life scale and the symptom score of lower urinary tract syndrome(LUTS) were selected as main outcomes measurements.RESULTS: Nearly all of the pre-and post-treatment dynamics of urine flow variables(such as, residual urine volume, MUCP, the maximum bladder capacity, the bladder pressure and the maximum urine flow rate) exhibited significant difference( P ＜ 0. 01 - 0. 001 ), except for the bladder pressure ( P ＞ 0.05); After FMS therapy, the frequency of urination decreased and the daily amount of urine and the V max increased significantly(P ＜ 0.01-0. 001); Also, the influence of urinary symptoms on the quality of life scale and the symptom score of LUTS changed significantly( P ＜ 0. 001 ).CONCLUSION: FMS therapy can greatly and partly ameliorate the bladder function of the patients with ANB after spine injury, and it can also improve their quality of life significantly.
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BACKGROUND: To predict the functional outcome basing on hospitalization data as earlier as possible has important significance for evaluating the prognosis and discharged recovery. In recent years, researches on the balance function of stroke patients has drew more and more attentions, but less related reports about the relationship between balance and discharge functional outcome are available.OBJECTIVE: To predict the discharg functional outcomes of stoke patients basing on hospitalization data, as well as the relationship between it and scores for Fugl-Meyer balance(FMB) and Berg balance scale(BBS).DESIGN: Multiple factors and multi-variable study based on patient' s clinical presentation.SETTING: Rehabilitative department in a college hospital.PARTICIPANTS: Between August 2002 and May 2003, 40 patients with stoke for the first time were hospitalized in Rehabilitative and Neurological Department of Tongji Hospital, who accorded with the enrolling standards.METHODS: The available hospitalization data and discharge functional outcomes were subjected to single factor and multiple factor analysis, and collected data includes the history of disease, physical examination, scores for FMB and BBS when hospitalization, scores for daily life ability(ADL)and functional independence measure(FIM) . Functional outcome was presented by the discharge FIM.MAIN OUTCOME MEASURES: Simple correlative analysis of BBS, FMB and FIM, regressive analysis of discharge FIM influencing factors.RESULTS: Simple liner correlative analysis indicted that scores for BBS and FMB was strongly correlated with the scores for FIM at hospitalization and discharge( P ＜ 0. 001 or P ＜ 0.05), regressive analysis revealed that scores for FIM, ADL and BBS at hospitalization could be used for predicting the discharge functional outcomes of stroke patients.CONCLUSION: Predictors for discharge functional outcomes includes scores for FIM, ADL and BBS when hospitalization, which are closely correlated with BBS.
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Objective To assess the efficacy of functional magnetic stimulation (FMS) in treatment of neurogenic dysfunction of bladder and urethra in patients with spinal cord injury. Methods A total of 12 patients accepted FMS to the sacral nerves at S 3 and bladder area. The study variables included urodynamic parameters,the quality of life and international lower urinary tract syndrome (LUTS)symptoms. Results There were significant improvements in 10 patients with respect to the number of voiding,volume voided and degree of frequency,urgency and incontinence. Only 2 patients were failed to make any progress. Conclusion FMS is an effective,safe therapy for the spinal cord injury patients complicated with neurogenic dysfunction of bladder and urethra and improve the patients' quality of life.