二维超声心动图对主动脉瓣关闭不全病变鉴别诊断价值

本文报道用二维超声心动图对主动脉瓣关闭不全124例进行病变鉴别诊断。就其图象特征结合X线所见,心音图等进行了鉴别诊断的探讨。其中,有风湿性心脏病111例;感染性心内膜炎4例;冠状动脉粥样硬化性心脏病5例;马凡氏综合征2例;左室假腱索2例。认为此项检查对主动脉瓣关闭不全病变鉴别诊断有一定的价值。     

Classification of hepatic cavernous hemangioma or hepatocellular carcinoma using a convolutional neural network model

BackgroundComputed tomography (CT) is a common imaging technique for diagnosis of liver tumors. However, the intensity similarity on non-contrast CT images is small, making it difficult for radiologists to visually identify hepatic cavernous hemangioma (HCH) and hepatocellular carcinoma (HCC). Recently, convolutional neural networks (CNN) have been widely used in the study of medical image classification because more discriminative image features can be extracted than the human eye. Therefore, this study focused on developing a CNN model for identifying HCH and HCC.MethodsThis study is a retrospective study. A dataset consisting of 774 non-contrast CT images was collected from 50 patients with HCC or HCH, and the ground truth was given by three radiologists based on contrast-enhanced CT. Firstly, the non-contrast CT images dataset were randomly divided into a training set (n=559) and a test set (n=215). Then, we performed preprocessing of the non-contrast CT images using pseudo-color conversion, and the proposed CNN model developed using training set. Finally, the following indicators (accuracy, precision, recall) were used to quantitatively analyze the results.ResultsIn the test set, the proposed CNN model achieved a high classification accuracy of 84.25%, precision of 81.36%, and recall of 82.18%.ConclusionsThe CNN model for identifying HCH and HCC improves the accuracy of diagnosis on non-contrast CT images.     

A cross-sectional study of obstructive sleep apnea in patients with colorectal cancer

BackgroundThe association between colorectal cancer (CRC) and obstructive sleep apnoea (OSA) has been attracting increasing attention. several studies had confirmed that OSA increases the risk of CRC onset. However, the findings of studies on the morbidity of OSA in patients with CRC were unclear. Therefore, this study aimed to investigate the morbidity of OSA in patients with CRC as well as the association between the clinicopathological characteristics of OSA and CRC.MethodsA total of 414 patients with a pathological diagnosis of CRC from 1 January, 2020 to 30 December, 2020 were included in this study. Demographic characteristics, clinical information, and tumor characteristics of participants were collected; sleep was monitored using a wearable oximeter and via sleep quality questionnaire. The oxygen desaturation index (ODI) was used to classify OSA severity so that the diagnostic criteria for OSA were set based on the ODI as 0–5 (normal) and ≥5 (abnormal). After correcting for confounding factors, a logistic regression analysis was performed to calculate the odds ratio (OR) and 95% confidence interval (CI) for the factors affecting the tumor lymph node stage (N stage).ResultsA total of 402 patients with CRC were included in this study, including 225 (55.97%) men and 177 (44.03%) women. The mean ODI value of participants was 3.40±8.17. The morbidity of OSA among the patients with CRC having ODI ≥5 was 16.17%. A comparison between the normal and abnormal ODI value groups revealed that the high proportion of abnormal ODI was related to higher N stage (P<0.05). Logistic regression analysis revealed a correlation of ODI values and age to the N stage. Specifically, CRC patients with an abnormal ODI had a higher risk of lymph node metastasis compared to those with normal ODI (OR =1.915, 95% CI: 1.025 to 3.579). Moreover, patients with CRC aged ≥65 years had a higher risk of lymph node metastasis compared to those aged <65 years (OR =2.190, 95% CI: 1.163 to 4.125).ConclusionsCRC patients with abnormal ODI are susceptible to OSA. Additionally, abnormal ODI and age ≥65 years are relevant factors for the N2 stage.     

MiR-21 mediates the radiation resistance of glioblastoma cells by regulating PDCD4 and hMSH2

The purpose of this study was to investigate the molecular mechanism by which miR-21 and its target genes mediate radiation resistance of glioblastoma cells.Real-time PCR was employed to detect miR-21 expression in normal brain tissues,glioblastoma tissues and glioblastoma cell lines (A172,T98G and U87MG).T98G cells were transfected with anti-miR-21 oligonucleotides,or plasmids containing PDCD4 or hMSH2 (PDCD4-pcDNA3 and hMSH2-pcDNA3).The survival curve was obtained to investigate the sensitivity of T98G cells to radiation.Cell apoptosis was measured by using the Caspase-3/7 kit and cell cycle by flow cytometry.Western blotting was performed to detect the expression of hMSH2 and PDCD4 in miR-21-inhibiting T98G cells.The results showed that miR-21 expression in glioblastoma cells and tissues was conversely associated with the radiation sensitivity.Over-expression of miR-21 resulted in radiation resistance,while knockdown of miR-21 led to higher sensitivity of glioblastma cells to radiation.After miR-21 knockdown,the apoptosis of T98G cells was significantly increased and the G2 phase arrest was more significant.In addition,miR-21 knockdown increased the expression of endogenous PDCD4 and hMSH2,which contributed to the apoptosis and G2 arrest of T98G cells.The findings suggested that miR-21 may mediate the resistance of glioblastoma cells against radiation via its target genes PDCD4 and hMSH2.MiR-21 and its target genes may be used as potential molecular targets for clinical radiotherapy sensitization in the future.     

肾移植受者术后焦虑抑郁情况及其对生存质量的影响

目的：探讨肾移植受者术后焦虑抑郁情况并分析其对生存质量的影响。方法：采用 STAI 和 BDI 量表调查87例在我院进行肾移植手术的受者焦虑抑郁情况,采用 SF-36量表调查其生活质量,同时将85例健康体检者作为对照组一并调查。结果：肾移植受者的状态焦虑、特质焦虑评分明显劣于对照组,肾移植受者抑郁发生率高达25.59%。肾焦虑状态得分、抑郁程度、术后生存时间、再就业是影响生存质量的关键因素。结论：肾移植受者存在较为严重的焦虑抑郁等负性情绪,严重影响了其术后生存质量。     

维微肝宝营养餐预防乙肝肝硬化并发症的作用

[目的]对维微肝宝营养餐预防乙肝肝硬化并发症的疗效进行探讨分析。[方法]选取2013年1月至2019年1月某医院收治的120例乙肝肝硬化患者,随机分为治疗组与对照组,每组患者60例。对照组患者应用普通营养的方法进行支持治疗,治疗组患者用维微肝宝营养餐进行预防治疗。经规律治疗1～3 mon后,对两组患者肝功能中的总蛋白和白蛋白的改善情况进行对比分析。[结果]治疗组总蛋白和白蛋白有明显改善,其改善率均显著高于对照组(P<0.05)。[结论]维微肝宝营养餐对乙肝肝硬化患者进行治疗,安全有效,并且优于其他普通的支持疗法,应予临床推广。     

过量氟化物摄入对实验大鼠胫骨骺板软骨细胞分化的影响

目的：观察及分析过量氟化物对大鼠骺板软骨生长发育的毒性作用。方法：SD大鼠分为对照组,低过量氟组和高过量氟组,分别于实验10周和20周观察大鼠胫骨骺板软骨光镜,电镜下组织形态学变化。结果：与对照组比较,光镜下过量氟组大鼠骺板软骨增厚,增殖层软骨细胞和肥大层软骨细胞滞留和堆积,排列紊乱,并出现软骨半岛,软骨岛和原纤维显露,且骺板软骨损伤随染氟剂量和时间延长而明显加重,电镜下骺板软骨细胞坏死增加,存活细胞功能活跃,可继续合成和分泌胶原蛋白。结论：过量氟对大鼠骺板软骨细胞分化有明显的损伤作用,可进一步干扰软骨内化骨。     

压力接种训练对改善社区留守老年糖尿病患者低血糖恐惧的效果

目的 探讨压力接种训练在社区留守老年糖尿病患者低血糖恐惧中的应用效果。 方法 将长春市6个社区中存在低血糖恐惧的留守老年糖尿病患者126例随机分为对照组与观察组各63例,对照组给予常规心理干预,观察组在常规心理干预的基础上实施压力接种训练。比较两组干预前及干预8周后的低血糖恐惧评分及血糖水平。 结果 干预后观察组低血糖恐惧得分及空腹血糖、餐后2 h血糖、糖化血红蛋白显著低于对照组（均P＜0.01）。 结论 压力接种训练可降低社区留守老年糖尿病患者低血糖恐惧,改善患者血糖水平。     

自噬在张力诱导终板软骨细胞退变过程中的变化

 目的 探讨自噬在张力诱导终板软骨细胞退变过程中的变化及作用。方法 取10只清洁级SD大鼠腰椎终板软骨进行细胞培养。对P1代终板软骨细胞分别加载间歇循环张力（10%伸长率,0.5 Hz）0 h、3 h、12 h、24 h、48 h。以倒置相差显微镜观察细胞形态学变化,实时PCR与蛋白印迹法检测软骨标志基因Ⅱ型胶原、转录因子SOX-9及蛋白多糖转录因子、Beclin-1和LC3基因表达的变化,以单丹磺酰戊二胺染色观察自噬小体。MTT（3-2,5-二苯基四氮唑溴盐染色）法检测3-甲基腺嘌呤（自噬抑制剂）刺激前后的细胞存活率。结果 间歇循环张力诱导后0 h组与3 h组为正常终板软骨细胞形态,呈多角形;12 h组略呈不规则形;24 h组和48 h组呈梭形改变。实时PCR显示24 h组和48 h组中Ⅱ型胶原、转录因子SOX-9及蛋白多糖的表达量降低;自噬相关基因LC3和Beclin-1表达量呈时间依赖性增加。单丹磺酰戊二胺染色显示24 h组和48 h组自噬发生率呈时间依赖性增加。MTT结果显示细胞存活率呈降低趋势;添加3-甲基腺嘌呤刺激后细胞活性减弱、存活率降低。结论 间歇循环张力刺激下终板软骨细胞表型逐渐丧失;自噬相关基因LC3与Beclin-1表达明显上调,但细胞活性降低;抑制自噬水平可降低细胞存活率,提示自噬参与了间歇循环张力诱导的终板软骨细胞退变过程。