Evolution and correlation of CT imaging signs and clinical features of non-severe COVID-19 patients / 西安交通大学学报(医学版)

【Objective】 To evaluate the evolution and correlation of CT imaging signs and clinical features of non-severe coronavirus disease 2019 (COVID-19). 【Methods】 We retrospectively analyzed CT images and clinical features of 24 non-severe COVID-19 patients from the onset at a 5-day interval. We recorded CT image signs, clinical manifestations and laboratory results at each stage, and analyzed their dynamic changes and correlations. Categorical variables were presented by rates. The correlation of the total CT score and the total number of lesions with clinical manifestations was analyzed. P20 days. The main CT signs of COVID-19 patients were subpleural and ground-glass opacity; the accompanying CT signs included paving stone sign, thickened blood vessels, fibrous cord shadow, air bronchial sign, leaflet center nodule, halo sign, reversed halo sign, bronchial wall thickening, and lung volume shrinking. On days 0-5, the number of lesions was the largest, acute symptoms were the most severe, the lymphocyte count and ratio were the lowest, and the concentration of high-sensitivity C-reactive protein (H-sCRP) was the highest. On days 5-10, the total CT score, the concentration of C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were the highest, and the white blood cell count was the lowest. There were a positive correlation between the CT score and the number of lesions with temperature, ESR, CRP, H-sCRP, and negative correlation with WBC count. 【Conclusion】 CT imaging signs were similar to the change of the clinical features on days 0-10. The total CT score and the number of lesions had correlation with the clinical manifestations.

Prediction models for clear cell renal cell carcinoma ISUP/WHO grade: comparison between CT radiomics and conventional contrast-enhanced CT.

OBJECTIVE: Comparing the prediction models for the ISUP/WHO grade of clear cell renal cell carcinoma (ccRCC) based on CT radiomics and conventional contrast-enhanced CT (CECT). METHODS: The corticomedullary phase images of 119 cases of low-grade (I and II) and high-grade (III and IV) ccRCC based on 2016 ISUP/WHO pathological grading criteria were analyzed retrospectively. The patients were randomly divided into training and validation set by stratified sampling according to 7:3 ratio. Prediction models of ccRCC differentiation were constructed using CT radiomics and conventional CECT findings in the training setandwere validated using validation set. The discrimination, calibration, net reclassification index (NRI) and integrated discrimination improvement index (IDI) of the two prediction models were further compared. The decision curve was used to analyze the net benefit of patients under different probability thresholds of the two models. RESULTS: In the training set, the C-statistics of radiomics prediction model was statistically higher than that of CECT (p < 0.05), with NRI of 9.52% and IDI of 21.6%, both with statistical significance (p < 0.01).In the validation set, the C-statistics of radiomics prediction model was also higher but did not show statistical significance (p = 0.07). The NRI and IDI was 14.29 and 33.7%, respectively, both statistically significant (p < 0.01). Validation set decision curve analysis showed the net benefit improvement of CT radiomics prediction model in the range of 3-81% over CECT. CONCLUSION: The prediction model using CT radiomics in corticomedullary phase is more effective for ccRCC ISUP/WHO grade than conventional CECT. ADVANCES IN KNOWLEDGE: As a non-invasive analysis method, radiomics can predict the ISUP/WHO grade of ccRCC more effectively than traditional enhanced CT.

Clinical observation of valsartan on chronic pulmonary heart disease with heart failure / 中国生化药物杂志

Objective To study and analyze the clinical effect of valsartan on chronic pulmonary heart disease. Methods 100 cases of heart failure patients with pulmonary heart disease treated in our hospital from January 2015 to October 2016 were selected and randomly divided into the control group and the experimental group,50 cases in each group.Two groups of patients were given the basic treatment of diuretics,low salt diet, digitalis and nitrates,so as to ensure that the patients had enough rest.Patients in the control group were treated with benazepril,and the patients in the experimental group were treated with valsartan.The clinical indexes of the experimental group and the control group were compared and analyzed. Results After corresponding treatment,the number of effective treatment was 48 cases.In the control group,the total effective number was 41 cases. The effective rate of the control group (82.0％) was significantly lower than the experimental group(96.0％) (P<0.05).The incidence of adverse reactions in the experimental group was 8.0％, and the fatality rate was 10.0％. The incidence of adverse reactions in the control group was 10.0％, and the fatality rate was 12.0％.There was no significant difference between two groups.After treatment,the indexes of LVEDD and LVESD in the experimental group were better than those in the control group,with statistical significance(P<0.05).Conclusion Valsartan was effective in the treatment of chronic pulmonary heart disease with heart failure.It can improve the treatment efficiency and security in a certain extent,and has the significance of further popularization and application.

Strengthen the Key Position of Teaching Relying on the Construction of Excellent Courses / 中华医学教育探索杂志

The construction of excellent courses is one important measure of carrying out the teaching quality project in university.To improve the quality of the construction of excellent courses,we must emphasize some basic operation strategies such as practical results,innovation,digital processing and integration.We should adopt workable measures to carry out the teaching quality project in university and strengthen the key position of teaching.