Background To date, insertable cardiac monitors (ICM) have been implanted in the hospital without critical evaluation of other potential settings. Providing alternatives to in-hospital insertion may increase access to ICM, decrease waiting times for patients awaiting diagnosis, and reduce hospital resources. Methods This was a prospective, non-randomized, clinical trial involving nine clinical sites throughout the United States designed to assess the feasibility of ICM implants in a non-hospital setting. Other than the Reveal® ICM, implant supplies and techniques were left to physician discretion in patients who met indications. Patients were followed up to 90 days post-implant. The primary objective was to characterize the number of procedure-related adverse events that required surgical intervention within 90 days. Results Sixty-five patients were implanted at nine out-of-hospital sites. The insertion procedure was well tolerated by all patients. There were no deaths, systemic infections or endocarditis. There were two (3%) procedure-related adverse events requiring device explant and four (6%) adverse events not requiring explant. ICM use led to 16 diagnoses (24.6%) with 9 patients proceeding to alternate cardiac device implants during the course of the 90-day follow up. Conclusion Out-of-hospital ICM insertion can be accomplished with comparable procedural safety and represents a reasonable alternative to the in-hospital setting. Clinicaltrials.gov registration number: NCT01168427
Objective
To evaluate the diagnostic efficacy of Kwak and ACR(2017) thyroid imaging reporting and data systems(TI-RADS) for thyroid nodules.
Methods
Cases of thyroid nodule who underwent surgery from January 2015 to March 2018 in 15 hospitals in Sichuan province were collected and the ultrasonographic features of thyroid nodules were retrospectively analyzed by trained senior ultrasound physicians using Kwak and ACR TI-RADS classification methods. Totally, 12 712 thyroid nodules were observed, 7 023 thyroid nodules in 7 023 cases with complete ultrasound and surgical and pathological data were eventually enrolled in the study. Thyroid nodules with solid, hypoechoic or very hypoechoic, tall/wide ratio ≥1, margin ill-defined and microcalcification were classified as malignant signs of ultrasound. Malignant percentage was calculated and diagnostic tests were performed.
Results
①There was a statistical difference between the benign and malignant nodules in the two types of TI-RADS classification (P<0.01). ②The area under ROC curve of Kwak and ACR in the diagnosis of malignant nodules were 0.89 and 0.84, respectively. The Youden index of Kwak and ACR were 0.66 and 0.57, respectively. ③Taking Kwak TI4B and ACR TR4 as critical points for malignancy, the sensitivity, specificity, positive predictive value and negative predictive value of Kwak TI4B were 75.0%, 90.9%, 83.2%, and 85.9%, respectively. The accuracy of Kwak TI4B was 84.9%; The sensitivity, specificity, positive predictive value and negative predictive value of ACR TR4 were 88.2%, 68.9%, 62.9%, and 90.8%, respectively. The accuracy of ACR TR4 was 76.2%. The Kappa value of Kwak TI4B and ACR TR4 was 0.52. The χ2 value of Kwak TI4B and ACR TR4 was 2 174.6 (P<0.01).
Conclusions
The diagnostic values of two TI-RADS classification methods for thyroid malignant nodules are high. The overall efficiency of Kwak TI-RADS classification method is better than that of ACR TI-RADS classification method.
Key words:
Ultrasonography; Thyroid nodule; Thyroid imaging reporting and data system; Kwak TI-RADS; ACR TI-RADS; Diagnostic efficiency
Objective To compare the efficacy and safety of Ruitongli(chemical called reteplase) and Urokinase in acute ST-segment elevation myocardial infarction(STEMI) in patients with thrombolytic therapy.Methods Sixty patients from August 2007 to September 2011 with STEMI admitted to our hospital were randomly divided into group A(Ruitongli) 30 cases,B group(Urokinase),30 cases were observed in the total patency rate of vascular,within 3 h and 3 h after in the incidence of recanalization after thrombolysis,mortality,complications such as bleeding and the incidence of arrhythmia,and 120 d left ventricular ejection fraction(LVEF).Results The overall recanalization rate:A group(86.66%) than in group B(63.33%)(P0.05),significant difference;the two groups in within 3 h and 3 h after thrombolytic recanalization rate was significantly increase,but the difference was not statistically significant(P0.05);A group of mortality,complications,and 120 d LVEF and B group,the difference was not statistically significant(P0.05).Conclusion Thrombolytic therapy in Ruitongli establish more effective than Urokinase,the coronary thrombolysis reperfusion incidence of the two groups within 3 h were higher than the 3 h after.
This is the first presentation of the cytological features of metastatic ceruminous adenocarcinoma (NOS) in a pleural effusion sample. Positive expression of SOX‐10 aided diagnosis in this case.
OBJECTIVE: To detect the expression of CCR5 and c-erbB-2 in breast cancer tissues,and analyze the relationship between CCR5 and c-erbB-2 and lymph nodes metastasis.METHODS: Expressions of CCR5 and c-erbB-2 in 72 breast cancer tissues were detected with immunohistochemistry SP.RESULTS: CCR5 was detected in 61 of 72 cases;the CCR5 positive incidence was 84.7%,in which there were 46 cases with positive lymphatic metastasis.There was positive correction between CCR5 and lymphnode metastasis(χ2=4.982,P=0.026),c-erbB-2 over-expressions(χ2=4.583,P0.05).CONCLUSION: CCR5 may be a new biological marker to suggest the development and prognosis of breast cancer.
To explore the impact of various exercise doses on depressive symptoms among hemodialysis patients and offer valuable guidance for the selection of optimal exercise doses in clinical practice settings. A comprehensive systematic review was conducted across four major databases, namely, PubMed, Embase, Web of Science, and Cochrane Library, covering the period from their inception until August 2024. Exercise interventions were classified based on adherence to American College of Sports Medicine (ACSM) recommendations, dividing studies into groups with high and low/uncertain ACSM adherence. A meta-analysis was performed utilising Review Manager5.4.1 to assess the effects of ACSM adherence on depression in hemodialysis patients. This meta-analysis incorporated a total of 19 randomized controlled trials, involving 1,285 patients. The mean age of the patients ranged from 33.2 to 70 years, and the average body mass index (BMI) fluctuated between 23.3 and 28.81 kg/m2. Males accounted for a relatively larger proportion of the participants. Among these trials, 14 were classified as having high ACSM adherence, while 5 were categorized as having low or uncertain adherence. Overall, exercise markedly improved depression in hemodialysis patients (SMD: -0.63, 95% CI: -0.87, -0.39; p < 0.05). The high ACSM adherence group showed greater improvement relative to the low/uncertain adherence group (SMD: -0.66 vs. -0.56). No notable disparities were noted in the effects of exercise duration or patient age on depression outcomes between the subgroups (p = 0.86, p = 0.48). Exercise interventions that exhibit high adherence to the ACSM guidelines prove to be more efficacious in alleviating depression among hemodialysis patients as compared to those with low or uncertain adherence levels. https://www.crd.york.ac.uk/prospero/#myprospero.
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