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Purpose To investigate the predictive value of 18F-FDG PET/CT radiomic features before treatment for progression free survival(PFS)and overall survival(OS)in diffuse large B-cell lymphoma(DLBCL).Materials and Methods A total of 135 patients with pathologically proven DLBCL in Chinese PLA General Hospital from January 2016 to December 2018 and 18F-FDG PET/CT imaging prior to treatment were retrospectively collected.Patients were randomly divided into training set and test set using 8∶2,and then the training set was divided into training set and verification set using 8∶2 to construct the model.Semi-automatically delineated patients'lymphoma lesions as regions of interest and extracted the features.Univariate COX and least absolute shrinkage and selection operator regression were used to screen the features,and the non-zero radiomic features were obtained and the weight coefficients were used to calculate the Radscore value of each patient,and the predictive value of Radscore on PFS and OS was analyzed.Three models were established using traditional prognostic indicators(metabolic parameters and clinical factors),Radscore and combination.C-index,time-dependent area under the curve and decision curve were used to evaluate the model prediction efficiency.Finally,based on the optimal model,a column diagram was drawn,and the calibration curve was used to verify the efficiency of the column diagram.Results The combined model predicted PFS and OS at 3 and 5 years better than the traditional prognostic index model and Radscore model(Z=0.962 1-2.253 9,all P<0.05).Decision curve showed that the combined model achieved the greatest clinical net benefit.The calibration curve showed that the predicted values of the nomogram were in good agreement with the observed values.Conclusion Radscore is an independent prognostic factor for survival in DLBCL patients.The combined model has great application value in guiding the formulation of clinical individualized treatment plan.
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ObjectiveTo analyze the suicidal behavior in hospitalized patients with major depression and its influencing factors. MethodsA total of 1 000 patients with major depression admitted to our hospital from January 2017 to July 2021 were selected as the research subjects to investigate the status quo of suicidal behavior of the enrolled patients. According to the survey results, the patients were divided into suicidal behavior group and non-suicidal behavior group, and the related factors affecting their suicidal behavior. ResultsA total of 511 cases (51.10%) of the patients with major depression committed suicide in hospital, including 271 cases (27.10%) of suicidal ideation, 186 cases (18.60%) of attempted suicide, and 54 cases (5.40%) of suicide death. 489 patients (48.90%) did not commit suicide. Univariate analysis showed that there were significant differences in age, gender, marital status, loss of interest or pleasure, anxiety, sense of worthlessness or self-guilt, sleep status, personality, depressive episodes and paranoia between the suicidal behavior group and the non-suicidal behavior group (all P<0.05). Logistic multifactorial regression analysis showed that age ≤28 years (OR=1.54), female (OR=1.93), anxiety (OR=1.61), sense of worthlessness or self-guilt (OR=1.85) and paranoia (OR=2.15) were all independent predictors of suicidal behavior in the patients with major depression. ConclusionThe incidence of nosocomial suicide in patients with major depression is high. Early onset age, female, anxiety, sense of worthlessness or self-guilt, more depressive episodes and paranoia are independent risk predictors of suicide in patients with major depression. This finding can be used for clinical intervention to reduce the occurrence of suicide in patients.
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Objective:To evaluate the clinical efficacy of the Chinese herbal medicine compound Kangliu Pill combined with conventional Western medicine therapy in the treatment of patients with malignant glioma after surgery.Methods:A total of 100 patients with malignant glioma (grade Ⅲ-Ⅳ), who met the inclusion criteria and underwent surgery from January 2017 to November 2019, were divided into the treatment group of 48 patients and the control group of 52, according to the treatment method. The control group was treated with conventional surgery plus radiotherapy, and the treatment group was treated with Kangliu Pill on the basis of the control group. The patients were followed up for 1 to 2 years, and the survival rate, progression-free survival and median survival were recorded. The Karnofsky functional status score (KPS) and quality of life score (QOL) were used to evaluate the patients' survival and quality of life, and the adverse reactions during the treatment period were observed.Results:After treatment, the 1-year survival rates [97.92% (47/48) vs. 80.77% (42/52); χ2=5.847, P=0.016] and 2-year survival rates [89.47% (33/48) vs. 42.31% (22/52); χ2=7.051, P=0.008] in the treatment group were significantly higher than those in the control group. After treatment, the progression-free survival [(23.94±13.12) months vs. (15.82±8.65) months; t=3.63, P<0.01] in the treatment group was significantly higher than that of the control group. After treatment, the survival analysis using the life table method yielded a median survival of 21.13 months in the treatment group and 12.00 months in the control group, with statistically significant differences in median survival and cumulative survival rates between two groups ( P=0.001). The KPS and QOL scores in the treatment group were higher than those in the control group, but the differences between the groups were not statistically significant ( P>0.05). There was no serious adverse events occurred during the treatment period in both groups. Conclusion:Adjuvant therapy with Kangliu Pill can improve survival rate, prolong progression-free survival, median survival, improve quality of life, and enhance the efficacy of patients with malignant glioma after surgery.
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Objective:To explore the the predictive value of ultrasound signs of the involvement of the cervix in the clinical grade diagnosis of placenta accreta spectrum(PAS) with placenta previa and adverse pregnancy outcomes.Methods:A retrospective analysis was performed on PAS patients with placenta previa diagnosed during delivery or by cesarean section in Beijing Obstetrics and Gynecology Hospital Affiliated to Capital Medical University from January 2018 to March 2021. According to the signs of cervical involvement on prenatal ultrasound, the patients were divided into cervical involvement group and cervical non-involvement group. Logistic analysis was performed on clinical data between the two groups. The clinical data, hysterectomy rate, intraoperative blood loss and clinical diagnosis were compared between the two groups.Results:There were 1 455 patients with PAS diagnosed by clinical diagnosis or placental pathology, of which 170 were with placenta previa, 24 with incomplete clinical data or non-standard ultrasound images, and the remaining 146 patients were included. In the cervical involvement group, all of 6 cases had placenta percreta. Of the 140 cases in the unaffected cervical group, 89 cases (63.6%) had placental accreta, 48 cases (34.3%) had placental increta, and 3 cases (2.1%) had placenta percreta. There were no significant differences of the age and uterine operation history between the two groups. There was significant difference in the number of cesarean sections between the two groups ( P<0.05). There were significant differences in intraoperative blood loss, hysterectomy rate and placenta accreta grade diagnosis between the two groups(χ 2/ Z=4.203, 11.165, 95.248, all P<0.05). Conclusions:The ultrasonographic signs of cervical involvement have a good predictive value for the pregnancy outcome of PAS.
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Objective:To identify the radiomics features related to the occurrence of radiation pneumonitis based on localized CT images of the chest in lung cancer patients, establish a machine learning model and investigate the value of radiomics technology in predicting the incidence of radiation pneumonitis.Methods:Clinical data of 86 patients with stage Ⅲ non-small cell lung cancer who received radical intensity-modulated radiation therapy (IMRT) were retrospectively analyzed. The radiation pneumonitis was graded by follow-up imaging data and clinical information. The planning CT images were collected. The lung was used as the volume of interest for extraction of radiomics features. The radiomics features, clinical and dosimetric parameters associated with the incidence of radiation pneumonitis were analyzed. Using the support vector machine to construct the model, the prediction performance of the model was evaluated by the five-fold verification method.Results:A total of 1029 radiomics features were extracted from CT images and 5 features were selected by ANOVA and LASSO. Two validation sets showed differences between adopting radiomics features alone and incorporating clinical and dosimetric parameters and radiomics features (AUC=0.67 and 0.71, respectively).Conclusions:The radiomics model constructed by planning CT images of lung cancer patients has the potential to predict the occurrence of radiation pneumonitis. Addition of clinical and dosimetric parameters can further improve the prediction performance of the model.
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Objective:To investigate the distribution features of anti-neutrophil cytoplasmic antibody (ANCA) in patients with cardiovascular and cerebrovascular diseases and the clinical characteristics of the patients.Methods:Clinical data of 6 759 patients who were treated in Baoding No.1 Central Hospital for cardiovascular and cerebrovascular diseases during January 2015 to July 2019 were collected and analyzed. ANCA was detected by indirect immunofluorescence (IIF). Antibodies against myeloperoxidase (MPO) and protease 3 (PR3) were detected by enzyme-linked immunosorbent assay (ELISA).Results:IIF showed that 558 out of the 6 759 cases tested positive for ANCA with a positive rate of 8.26%. Among them, 382 (68.46%) were positive for perinuclear ANCA (p-ANCA) and 176 (31.54%) were positive for cytoplasmic ANCA (c-ANCA). Anti-MPO and anti-PR3 antibodies were detected in 69 ANCA-positive cases, while the antibodies against other target antigens were detected in 489 cases. The ratio between the two groups was 1∶7.09. The incidence of recurrent respiratory tract infection and pulmonary interstitial lesions in ANCA-positive cases was 69.35% (387/558) and 64.52% (360/558), respectively, which was significantly higher than that in ANCA-negative patients [40.51% (2 512/6 201) and 33.17% (2 057/6 201)].Conclusions:Anti-MPO and anti-PR3 antibody detection could not replace IIF to detect total ANCA for a high rate of missed diagnosis would be caused. Early detection of ANCA would be of great significance to patients with chronic cardiovascular and cerebrovascular diseases.
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OBJECTIVE: To explore the detection of autoantibodies in serum of patients with coal workers' pneumoconiosis( CWP).METHODS: Eight hundred and three cases of stage Ⅰ CWP patients were selected as study subjects by random sampling method.Anti-nuclear antibody and anti-neutrophil cytoplasmic antibody( ANCA) in serum were detected by indirect immunofluorescence assay; myeloperoxidased efficiency( MPO) antibody,anti-mitochondrial M2 antibody( AMA-M2) and anti-cyclic citrullinated peptide( CCP) antibody were detected by enzyme-linked immunosorbent assay;rheumatoid factor( RF) was detected by enhanced immunoturbidimetry of latexa.Group analysis was conducted according to age,lung function,length of dust exposure and the nature of dust exposure collection.RESULTS: In the serum of 803 CWP patients,the positive rate of anti-nuclear antibody,AMA-M2,RF,anti-CCP antibody,ANCA and MPO antibody were 9.7%,7.5%,7.3%,4.0%,2.6% and 0.8% respectively; the karyotype distribution of 78 cases of anti-nuclear antibody positive specimens was spotted( 43.6%), cytoplasmic( 20.5%), homogenous( 7.7%) and nucleolus( 5.1%),with a titer of 1:100.The positive rate of anti-nuclear antibody in the > 70.0 years group was higher than that of ≤60.0 and ≤70.0 years group( P < 0.017); the positive rate of anti-nuclear antibody in the abnormal lung function group was lower than that of the normal group( P < 0.01); the positive rate of anti-CCP antibody in the dust exposure length > 30.0 years group was higher than that of ≤30.0 years group( P < 0.017); the positive rate of anti-CCP antibody in silica-exposed group was lower than that in the coal-exposed group( P < 0.01).CONCLUSION: The positive rate of antinuclear antibody,AMA-M2,RF and anti-CCP antibody in CWP patients were high.The positive rate of anti-nuclear antibody is associated with age and lung function.The positive rate of anti-CCP antibody is related to the duration and nature of dust exposure.
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OBJECTIVE: To explore the changes of serum levels and significance of surfactant protein( SP) A and SP-D in patients with stage Ⅰ coal workers' pneumoconiosis( CWP). METHODS: A random sampling method was used to select 88 cases of stage Ⅰ CWP patients as the CWP group,50 cases of healthy underground miners with similar dust exposure history as the dust exposure group and 38 cases of ground workers without dust exposure history as the control group. The serum levels of SP-A and SP-D in 3 groups were detected by enzyme-linked immunosorbent assays. RESULTS: The levels of serum SP-A and SP-D in the CWP group and the dust exposure group were higher than that of the control group( P <0. 05). The serum level of SP-D in the CWP group was higher than that of the dust exposure group( P < 0. 01). The serum level of SP-D in the smoking CWP subgroup was lower than that of the non-smoking CWP subgroup( P < 0. 05).CONCLUSION: The abnormal serum levels of SP-A and SP-D were related to the development of stage Ⅰ CWP. Smoking might affect the serum level of SP-D in stage Ⅰ CWP patients.
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Objective To evaluate the left ventricular synchrony after myocardial infarction (MI) by ultrasound targeted microbubbles destruction (UTMD)-mediated angiogenin 1 (Ang1) gene transfection in canine.Methods Twenty-one dogs were divided into three groups (n =7 in each group):①control group (healthy dogs);②MI group (MI dogs without treatment);③UTMD group (MI dogs with UTMD treatment).One month later,the size and systolic function of heart were measured by echocardiography.The synchronization parameters derived from two dimensional-speckle tracking imaging(2D-STI) included the standard deviation and maximum difference of time to peak strain for all left ventricular segments (Tls-SD,Trs-SD,Tcs-SD,Tls-Dif,Trs-Dif and Tcs-Dif).CD31 and α-SMA were applied for quantifying capillary and arteriolar density.The Ang1,SERCA2a and PLB protein were detected by Western blotting.Results ① One month later,the conventional ultrasonic parameters were compared among three groups,the LVEDD,LVESD and E/e'increased and LVEF,e'and E/A reduced in MI group than those in control group,all of them partially recovered in UTMD group than those in MI group,but were still lower than those in control group (P <0.05);②The left ventricular synchrony parameters of Tls-SD,Tls-Dif and Trs-SD showed significant differences among the three groups(P <0.05),the degree of dyssynchrony increased in MI group than control group,they were lower in UTMD group than those in MI group.The Tcs-SD,Tcs-Dif and Trs-Dif showed no significant difference among three groups (P > 0.05);③ The immunohistochemistry showed the higher blood vessel density in UTMD group than that in MI group(P < 0.05);④The relative quantity of Ang1 was significantly higher in UTMD group.The relative quantity of SERCA2a protein was lower in MI group than that in control group,increased in UTMD group,the trend of PLB was contrary to it.The differences were statistically significant (all P <0.05).Conclusions The UTMD-mediated Ang1 gene transfection can promote angiogenesis after MI,reverse left ventricular remodeling and improve left ventricular synchrony.The myocardial synchrony may be related to the expression of calcium ions key protein SERCA2a and PLB.
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Objective To improve the canines myocardial infarction curative effect by using ultrasound targeted microbubble destruction (UTMD) combining with nuclear localization signal(NLS) peptide to increase hAng-1 gene transfection efficiency.Methods Forty-six canines were randomly divided into 4 groups (n=10 in each group) after the models of myocardial infarction were prepared.Group A were untreated control;Group B were transfected with hAng-1;Group C were transfected with UTMD+hAng-1;Group D were transfected with UTMD+NLS nuclear localization signal+hAng-1.The therapeutic agents were intravenously injected at one week after myocardial infarction in each group,and the ultrasound were irradiated at the precardium in group C and D.①Echocardiography was used before and at one week after myocardial infarction and 28 days after gene transfection.Two-dimensional echocardiography was used to detect cardiac function,the left ventricular ejection fraction,the left ventricular wall motion and the myocardial contrast echocardiography were used to detect myocardial perfusion of all canines in the four groups.②On twenty-eight days after gene transfection,mRNA and Western Blot were used to detect the expression of hAng-1.Immunohistochemistry was used to detect capillary density of peri-infarct area and microvessel density (MVD).Masson′s trichromatic staining and gross specimen were used to evaluate the degree and the area of myocardial fibrosis.The gene transfection efficiency and the curative effect of all the four groups were evaluated and compared.Results ①Before myocardial infarction,in four groups canine ventricular wall motion and cardiac function were normal,and myocardial filling defect was not showed by myocardial contrast echocardiography.At one week after myocardial infarction,the left ventricular anterior and interval walls motion and the left ventricular ejection fraction in the four groups were significantly decreased.Myocardial contrast echocardiography showed anterior and interval walls myocardial filling defect.There was no significant difference among the four groups(P>0.05);On 28 days after gene transfection the left ventricular ejection fraction in the four group were increased in an order of group A,B,C,D,there was significant difference when comparing group C and D with other groups separately(P<0.05).Myocardial contrast echocardiography showed much contrast filling in the infarction and surrounding area in group D,a little contrast filling in group C and filling defect in group A and group B,there was significant difference when comparing group C and D with other groups separately(P<0.05).②RT-PCR and Western Blot showed the hAng-1 mRNA and protein expression in group D were higher than those in the other group.There was significant difference when comparing group C and group D with other groups separately(P<0.05).③Immunofluorescence showed the capillary densities were(4.7±1.6)/mm2,(11.2±2.8)/mm2,(70.0±6.4)/mm2 and (85.3±7.0)/mm2 in group A,group B,group C and group D.The differences were statistically significant compared group C and group D with other groups (P<0.05).④Masson′s trichromatic staining and cardiac gross specimen showed that the degree and area of myocardial fibrosis were gradually reduced in an order of group A,B,C,D.Conclusions UTMD and NLS peptide could effectively transfect hAng-1 gene and it provided a novel strategy of gene treatment for ischemic heart disease.
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Objective To evaluate the effect of ultrasound guided via chest puncture injection and ultrasound targeted microbubble destruction(UTMD) mediated the angiogenin 1 (Ang1) gene therapy in myocardial infarction (MI) canines.Methods Thirty nine dogs were divided into three groups (each group 13 dogs):① MI group (MI dogs without treatment);② intravenous injection group (MI dogs with intravenous injection and UTMD treatment);③ myocardial injection group (MI dogs with myocardial injection and UTMD treatment).Four weeks later,the safety and incidence of complications were compared.The dimensions and systolic function of left ventricular were measured by echocardiography.The percentage of collagen fiber was assessed by Masson.CD31 was applied for quantifying capillary density.The Ang1 protein was detected by Western blotting.Results ①The survival and complications showed no significant difference among the 3 groups(allP >0.05).②Compared with MI group,the left ventricular end systolic dimension (LVESD)reduced and the left ventricular ejection fraction (LVEF) increased in intravenous injection group;the left ventricular end-diastolic dimension (LVEDD) and LVESD were both reduced in myocardial injection group,the LVEF was increased significantly(all P <0.05).③ The immunohistochemistry showed lower collagen fiber percentage and higher blood vessel density in myocardial injection group than those in the other groups(P <0.05).④The relative quantity of Ang1 was significantly higher in myocardial injection group than those of the other groups.The differences were statistically significant (P <0.05).Conclusions The combination of ultrasound guided via chest puncture injection and UTMD is a safe and effective method for gene transfection.It mediates Ang1 gene transfection that can promote angiogenesis after MI and improve left ventricular systolic function.
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Objective To explore the clinical value of a new tactic with novel dodecafluoropentane (C5F12,DDFP)acoustic vaporizable nano-droplets for the therapy of coronary micro-circulation thrombolysis.Methods Group A was poly butylene succinate buffer solution as blank control;group B was SonoVue microbubbles;group C was DDFP acoustic vaporizable nano-droplets,which were produced with emulsion process by ultrasonic oscillation instrument and rotary evaporator.The size of the nano-droplet was tested by Malvern laser particle size detector and observed with fluorescence microscope.The stability and efficiency of cavitation effect of group C for thrombolysis were tested in an in-vitro artificial vascular system with arterial thrombus model,comparing with group A and B.Weights and pathological sections of the inserted thrombus before and after the thrombolysis in these groups were compared for the thrombolytic efficiency.Results The average size of DDFP nano-droplets were(424.7±30.2)nm.More than 75% of the nano-droplets were ranged from 300-750 nm.The fluorescence microscope showed the DDFP nano-droplets were uniformed round-shaped and stable-structured with favorable dispersity;the nano-droplets had gradually turned into over 3 μm microbubbles under ultrasound irradiation.The thrombus weight loss after thrombolysis in group C[(199.0±35.8)mg,(32.1 ±4.4)%]was significantly larger than those in group A[(30.2 ± 17.8)mg,(5.0 ± 2.4)%]and B[(72.6 ± 20.7)mg,(12.7 ± 2.8)%](all P <0.01). Conclusions DDFP vaporizable nano-droplets with ultrasound irradiation is effective for thrombus elimination in coronary micro-circulation through lasting and stable cavitation effect.
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Superparamagnetic iron oxide nanoparticles(SPION) as a new type of nano-materials have been widely studied. Because of their superparamagnetic property, targeting, biocompatibility, easy observability, and plasticity, etc., SPION have been used not only as magnetic resonance imaging (MRI) contrast agents in the early diagnosis of clinical cancer, but also as targeting drug carrier to selectively deliver the drugs especially anti-cancer drugs to target lesion, and therefore, improve the bioavailability of the drugs. For these reasons, the research on contrast agents and magnetic targeting drug carrier has attracted widespread attention. This paper reviews the research progress of SPION application in MRI and targeted drug delivery through consulting a number of relevant publications.
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Objective To understand and evaluate the early breastfeeding behaviors in preterm infants,and to analyze the evolution process of early breastfeeding behaviors in preterm infants,and therefore to provide a theoretical basis for preterm infant breastfeeding.Methods A continuous evaluation of early breastfeeding behaviors in 38 preterm infants was performed commencing on the beginning of breastfeeding and finishing on the attainment of breastfeeding.Results The earliest breastfeeding was initiated from a postmenstrual age (PMA) of 30 weeks.Obvious rooting,efficient areolar grasp,repeated short sucking bursts and irregular swallowing were noted from 31 weeks; The maximum number of consecutive sucks was limited to between 6 and 24 sucks,with a median of 18 sucks.Full breastfeeding was attained at a median of 36 weeks,between 33 and 38 weeks.Conclusions The early breastfeeding capacity in preterm infants is enhanced and becomes perfect gradually with the implementation of breastfeeding,and that is sufficient and practical for establishment of full breastfeeding at a low postmenstrual age of preterm infants.
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ObjectiveTo observe the influence of Songling Xuemaikang on the hypertension and hemorheology of hyperlipoidemia patients.Methods40 hyperlipoidemia patients randomly divided into Songling Xuemaikang group and jiao gu la zong dai group as a control.The blood lipid and the improvement of hemorheology before and after treatment were compared.ResultsThe efficiency of lipoidemia decrease of treatment and control group is 86.5%and 82.4%,respectively.There was no significant difference between two groups ( P > 0.05 ).The difference of whole blood high shear viscosity,whole blood low shear viscosity,plasma viscosity,whole blood reduced viscosity and fibrinogen between two groups had significant ( P < 0.05 ).ConclusionSongling Xuemaikang had effect on both regulating blood lipid and improving the several indexes of hemorheology.It could be an effective and safe drug for prevention and cure cardiovascular and cerebrovascular disease.