Computed tomography (CT) and magnetic resonance imaging (MRI) scans of 11 patients with histologically proven cervical chordoma were retrospectively evaluated. Imaging features assessed included location, morphology, association with adjacent structures, vertebral destruction, status of cortical bone, periosteal reaction, attenuation and calcification by CT, and signal intensity and enhancement pattern by MRI. Of 7 cases with CT, 6 exhibited lytic-sclerotic bone destruction. A total of 5 cases exhibited pressure erosion of outer cortex, 3 of which had spiculated periosteal reaction. Calcification was observed in 3 cases. All cases were heterogeneous and hypodense. MRI T2-weighted images (n=10) revealed heterogeneous hyperintense (n=5), intermediate (n=2) and intermediate-hyperintense signal intensity (n=3). Hypointense septa between lobules (n=5) and stripes (n=3) were observed on T2-weighted images. Post-contrast magnetic resonance images (n=6) demonstrated marked heterogeneous (n=3) and ring-like (n=3) enhancement. CT scanning is valuable in revealing the lytic-sclerotic bone destruction, pressure erosion of outer cortex and calcification. MRI is useful in demonstrating the results of soft tissue mass. The two examinations are necessary for differential diagnosis of patients with suspected cervical chordoma.
Background Preoperative prediction of the grade of soft tissue sarcomas (STSs) is important because of its effect on treatment planning. Purpose To assess the value of radiomics features in distinguishing histological grades of STSs. Study Type Retrospective. Population In all, 113 patients with pathology‐confirmed low‐grade (grade I), intermediate‐grade (grade II), or high‐grade (grade III) soft tissue sarcoma were collected. Field Strength/Sequence The 3.0T axial T 1 ‐weighted imaging (T 1 WI) with 550 msec repetition time (TR); 18 msec echo time (TE), 312 × 312 matrix, fat‐suppressed fast spin‐echo T 2 WI with 4291 msec TR, 85 msec TE, 312 × 312 matrix. Assessment Multiple machine‐learning methods were trained to establish classification models for predicting STS grades. Eighty STS patients (18 low‐grade [grade I]; 62 high‐grade [grades II–III]) were enrolled in the primary set and we tested the model with a validation set with 33 patients (7 low‐grade, 26 high‐grade). Statistical Tests 1) Student's t ‐tests were applied for continuous variables and the χ 2 test were applied for categorical variables between low‐grade STS and high‐grade STS groups. 2) For feature subset selection, either no subset selection or recursive feature elimination was performed. This technology was combined with random forest and support vector machine‐learning methods. Finally, to overcome the disparity in the frequencies of the STS grades, each machine‐learning model was trained i) without subsampling, ii) with the synthetic minority oversampling technique, and iii) with random oversampling examples, for a total of 12 combinations of machine‐learning algorithms that were assessed, trained, and tested in the validation cohort. Results The best classification model for the prediction of STS grade was a combination of features selected by recursive feature elimination and random forest classification algorithms with a synthetic minority oversampling technique, which had an area under the curve of 0.9615 (95% confidence interval 0.8944–1.0) in the validation set. Data Conclusion Radiomics feature‐based machine‐learning methods are useful for distinguishing STS grades. Level of Evidence: 3 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2020;51:791–797.
Objective
To investigate the effects of early mobilization therapy on gastrointestinal function and respiratory mechanics in mechanical ventilation patients with chronic obstructive pulmonary disease (COPD).
Methods
A prospective randomized controlled study was used. Eighty-five patients with COPD who had stable hemodynamics and required invasive mechanical ventilation from January to December 2017 were enrolled. The patients were divided into treatment group with 43 cases and control group with 42 cases according to the random number table method. The patients in both groups received conventional basic treatment, but the treatment group received early mobilization therapy. The conditions of acute gastrointestinal injury (AGI), incidence of ventilator-associated pneumonia (VAP), duration of mechanical ventilation, 28-day mortality and respiratory mechanics indexes before and after treatment including airway resistance (Raw), lung dynamic compliance (Cd), lung static compliance (Cs), intrinsic positive end expiratory pressure (PEEPi) were compared between 2 groups.
Results
There were no statistical difference in Raw, Cd, Cs and PEEPi before treatment between 2 groups (P>0.05). The PEEPi and Raw after treatment in treatment group were significantly lower than those in control group: (6.51 ± 1.46) cmH2O (1 cmH2O= 0.098 kPa) vs. (7.30 ± 1.61) cmH2O and (19.23 ± 2.62) cmH2O/(L·s) vs. (20.54 ± 2.50) cmH2O/(L·s), the Cs and Cd were significantly higher than those in control group: (53.14 ± 5.07) ml/cmH2O vs. (49.16 ± 5.10) ml/cmH2O and (26.63 ± 3.28) ml/cmH2O vs. (24.54 ± 1.97) ml/cmH2O, and there were statistical differences (P 0.05).
Conclusions
The incidence of AGI in mechanical ventilation patients with COPD is high. Early mobilization therapy can reduce the incidence and duration of AGI in mechanically ventilated patients with COPD, and reduce airway resistance, increase Cd and Cs, reduce PEEPi, improve respiratory function, shorten mechanical ventilation time, and reduce the incidence of VAP, which is worthy of clinical promotion.
Key words:
Pulmonary disease, chronic obstructive; Respiration, artificial; Exercise therapy; Respiratory mechanics; Prospective studies
Mobile computing techniques have facilitated our life greatly, but it is rarely used in medical computing. The automatic diagnosis of benign and malignant pulmonary nodules is of great significance for the further treatment of patients. Therefore, taking the three-dimensional nature of clinical pulmonary nodules into account, in a mobile computing environment, an algorithm that combines three-dimensional deep and visual features (CTDDV) is proposed to achieve the classification of benign and malignant pulmonary nodules. In the new framework, deep features, visual features as well as shape descriptors were extracted using different three-dimensional algorithms. Then, Multiple Kernel Adaboost (MKAdaboost) classifiers were trained for each type of feature, and the results of the three classifiers were combined to distinguish lung nodules. We compared the four most advanced nodule classification methods on the LIDC-IDRI dataset. The results showed that our proposed CTDDV algorithm has achieved higher classification performance.
Shear wave elastography (SWE) is used to quantitatively analyze the hardness of the tissue by Young′s modulus. The hardness of the tissue is visualized in the form of color coding to distinguish the benign and malignant tissue detected. SWE has higher sensitivity, accuracy and specificity compared with traditional color doppler, which is more objective than elastography, safer, cheaper and simpler than MRI. SWE has a good application prospect in the diagnosis, clinical staging and curative effect monitoring of cervical cancer.
Key words:
Uterine cervical neoplasms; Diagnosis; Neoplasm staging; Shear wave elastography
Objective
To investigate the effect of early mobilization on gastrointestinal function and delirium in patients with mechanical ventilation of chronic obstructive pulmonary disease(COPD).
Methods
A total of 87 mechanically ventilated patients with COPD who met the inclusion criteria were selected as subjects from April 2017 to March 2018 in intensive care unit(ICU) of Huxi Hospital Affiliated to Jining Medical College.The patients were divided into treatment group (44 cases) and control group (43 cases) by the random number table method.On the basis of the same conventional treatment, the treatment group received early mobilization.The incidence of acute gastrointestinal injury(AGI), duration of AGI, incidence of delirium, duration of delirium, days of mechanical ventilation and 28-day mortality were compared between the two groups.
Results
The incidence rate of AGI in the treatment group was lower than that in the control group[40.9%(18/44) vs. 62.7%(27/43)], and the duration in the treatment group was shortened[(3.95±1.62)d vs. (5.23±2.03)d], and the incidence rate of delirium in the treatment group was lower[54.5%(24/44) vs. 76.7%(33/43)], the duration of delirium in the treatment group was shortened[(2.36±0.9)d vs. (3.25±1.27)d], the mechanical ventilation time in the treatment group was decreased[(6.39±1.76)d vs. (7.56± 1.49)d], the differences were statistically significant(χ2=4.17, t=-2.280, χ2=4.744, t=-2.919, -3.358, all P 0.05].
Conclusion
Early mobilization can reduce the incidence and duration of AGI and delirium in COPD patients with mechanical ventilation, reduce the severity of AGI, and shorten the time of mechanical ventilation.
Key words:
Pulmonary disease, chronic obstructive; Respiration, artificial; Ventilators, mechanical; Early ambulation; Gastrointestinal motility; Delirium
A radiomics-based explainable eXtreme Gradient Boosting (XGBoost) model was developed to predict central cervical lymph node metastasis (CCLNM) in patients with papillary thyroid carcinoma (PTC), including positive and negative effects.A total of 587 PTC patients admitted at Binzhou Medical University Hospital from 2017 to 2021 were analyzed retrospectively. The patients were randomized into the training and test cohorts with an 8:2 ratio. Radiomics features were extracted from ultrasound images of the primary PTC lesions. The minimum redundancy maximum relevance algorithm and the least absolute shrinkage and selection operator regression were used to select CCLNM positively-related features and radiomics scores were constructed. Clinical features, ultrasound features, and radiomics score were screened out by the Boruta algorithm, and the XGBoost model was constructed from these characteristics. SHapley Additive exPlanations (SHAP) was used for individualized and visualized interpretation. SHAP addressed the cognitive opacity of machine learning models.Eleven radiomics features were used to calculate the radiomics score. Five critical elements were used to build the XGBoost model: capsular invasion, radiomics score, diameter, age, and calcification. The area under the curve was 91.53% and 90.88% in the training and test cohorts, respectively. SHAP plots showed the influence of each parameter on the XGBoost model, including positive (i.e., capsular invasion, radiomics score, diameter, and calcification) and negative (i.e., age) impacts. The XGBoost model outperformed the radiologist, increasing the AUC by 44%.The radiomics-based XGBoost model predicted CCLNM in PTC patients. Visual interpretation using SHAP made the model an effective tool for preoperative guidance of clinical procedures, including positive and negative impacts.
Abstract Background To investigate the metabolite changes in the frontal lobe of the end-stage renal disease (ESRD) patients with depression using proton magnetic resonance spectroscopy ( 1 H-MRS). Methods All subjects were divided into three groups: ESRD patients with depression (30 cases), ESRD patients without depression (27 cases) and 32 normal subjects. ESRD with depression patients were further divided into two groups according to the severity of depression: 14 cases of ESRD with severe depression group (Hamilton Depression Rating Scale (HAMD) score ≥ 35) and 16 cases of ESRD with mild to moderate depression group (20 ≤ HAMD score<35). 1 H-MRS was used in brain regions of all subjects to measure N-acetylaspartate/creatine (NAA/Cr), choline-containing compounds/creatine (Cho/Cr) and myo-inositol/creatine (MI/Cr) ratios of the frontal lobe. Correlations between the metabolite ratio and HAMD score as well as clinical finding were confirmed, respectively. Results ESRD patients with depression showed lower NAA/Cr ratio and higher Cho/Cr ratio compared with ESRD patients without depression and normal subjects. NAA/Cr ratio was negatively correlated with the HAMD score. Cho/Cr ratio was positively correlated with the HAMD score. There were positive correlations between NAA/Cr ratio and blood urea notrogen (BUN) as well as creatinine (CRE) concentration, respectively. There was a negative correlation between Cho/Cr ratio and sodium concentration. The Cho/Cr ratio was positively correlated with the potassium concentration. Conclusions MR spectroscopy identified some metabolite changes in ESRD patients with depression.
Abstract Biodistribution, pharmacokinetics, and efficacy of prostate‐cancer‐targeted HPMA copolymer/DTX conjugates are evaluated in nude mice bearing prostate cancer C4‐2 xenografts. PSMA‐specific monoclonal antibodies 3F/11 are used as the targeting moiety. Control conjugates contain either non‐specific IgG or no IgG. The ratios of tumor accumulation to total background organs (heart, lung, kidney, liver, spleen and blood) accumulation increase substantially with time for the targeted conjugate, and the ratio at 48 h is 7‐fold higher than that at 6 h. Preliminary evaluation of the efficacy of the conjugates in vivo show tumor growth inhibition for all HPMA copolymer/DTX conjugates. magnified image
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