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Objective:To evaluate the efficacy of T 2* mapping and zoomed imaging with parallel transmission technique (ZOOMit) intravoxel incoherent motion (IVIM) DWI in differentiating benign and malignant thyroid nodules. Methods:The data of 67 patients with thyroid nodules confirmed by surgery and pathology in Ma′anshan People′s Hospital from July 2019 to March 2020 were retrospectively collected. There were a total of 80 nodules, of which 39 were benign nodules and 41 were malignant nodules. All patients underwent MRI including T 2WI, T 2* mapping, and ZOOMit IVIM sequence scans before surgery to measure the T 2*, D, D *, and f values of the nodules. The comparison of the parameters between benign and malignant nodules was evaluated by independent sample t test or Wilcoxon rank sum test. A combined parameter model was established through two-class logistic regression and the predicted probability value was calculated. The ROC curve was used to evaluate the diagnostic efficacy of each parameter and the combined parameter model in differentiating between benign and malignant thyroid nodules. Results:The T 2*, D, f values of benign thyroid nodule group were higher than that in malignant group, and the difference was statistically significant ( P<0.05). The difference of D * value between two groups was not statistically significant ( Z=1.258, P= 0.215). The area under ROC curve (AUC) of T 2*, D, and f values for identifying benign and malignant nodules was 0.703, 0.892, and 0.743, the diagnostic sensitivity was 80.2%, 84.1%, and 80.0%, and the specificity was 65.6%, 81.3%, and 75.0%, respectively. The AUC of T 2*combined with D, T 2*with D * and T 2* with f was 0.925, 0.709, and 0.743, the diagnostic sensitivity was 96.2%, 80.4%, and 80.0%, and the specificity was 81.2%, 65.6%, and 75.0%, respectively. Conclusion:D, f and T 2* derived from ZOOMit IVIM have good value in differentiating between benign and malignant thyroid nodules, and the combination of T 2* and D parameters has the higher diagnostic efficacy.
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Traumatic brain injury (TBI) is a common disease in neurosurgery.Cognitive impairment is one of the most common and long-lasting complications after TBI.Recent studies have shown that computer-assisted cognitive rehabilitation has become an important means for the rehabilitation of cognitive impairment.The authors intend to review the status of computer-assisted cognitive rehabilitation training for cognitive dysfunction after TBI.
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Objective To investigate the appropriate time of the skull reconstruction of skull defect,and explore the changes of intracmnial pressure,cerebral hemodynamic parameters,clinical symptoms and signs before and after cranioplasty with digital shaping titanium mesh.Methods The clinical data included parameter variations of noninvasive intracranial pressure (ICP),cerebral blood flow velocity,and improvement of skull defect syndrome and cognitive function were retrospectivly analyzed in 69 patients with skull defect received cranioplasty with digital shaping titanium mesh in our hospital from June 2009 to May 2014.The preoperative ICP less than 80 mmH2O was recorded in 53 patients and that more than or equal to 80 mmH2O was recorded in 16 patients.The interval time from the skull defects to cranioplasty was as follows:11 patients were within 3-6 months,25 were in 6-9 months,24 were in 9-12 months,and 9 were more than one year.Results The ICP after cranioplasty was in the normal range,which was statistically different as compared with that before cranioplasty (P＜0.05).The mean blood flow velocity two weeks after cranioplasty was improved significantly as compared with that before cranioplasty (P＜0.05).All 69 patients were recovered well postoperatively;14 patients with preoperative sensory and movement disorders got improvement of different degrees after cranioplasty;in the four patients with epilepsy,three were seizure-free,and the left one had obviously reduced epileptic seizure;two patients with speech disorders got improvement postoperatively.Skull defect syndrome symptoms in the 54 patients were disappeared.Significant differences of Glasgow outcome scale (GOS) and function independent measurement (FIM) scores were noted between before cranioplasty and three months after cranioplasty (2.48±0.67 vs.3.56±0.35;77.91±10.32 vs.93.78±6.51;P＜0.05).The GOS and FIM scores in patients performed cranioplasty at early stage (interval time from the skull defects to cranioplasty within 12 months) were significantly improved as compared with those before cranioplasty (P＜0.05).Conclusion The digital shaping titanium mesh skull reconstruction of skull defect could stabilize the ICP,and improve the dynamic state of pathological cerebral blood flow and cognition impairment,and is conducive to the recovery of nervous function;and early cranioplasty can have a good prognosis.
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Acetylcholinesterase (AChE) plays a key role in the pesticide determination. However, the extraction of AChE from natural materials has the disadvantages of low yield, complex purification and poor stability. Therefore, the preparation of recombinant AChE with high performance becomes the hot topic of researchers in recent years. In this article we summarize the progress in the expression of recombinant AChE and the improvement of its analytical characteristic. Finally, we point out that the directed evolution strategy combined with surface display technology is the future trend on improving recombinant AChE activity.