Differentiating autoimmune pancreatitis from pancreatic ductal adenocarcinoma with CT radiomics features

PurposeThe purpose of this study was to determine whether computed tomography (CT)-based machine learning of radiomics features could help distinguish autoimmune pancreatitis (AIP) from pancreatic ductal adenocarcinoma (PDAC).Materials and MethodsEighty-nine patients with AIP (65 men, 24 women; mean age, 59.7 ± 13.9 [SD] years; range: 21–83 years) and 93 patients with PDAC (68 men, 25 women; mean age, 60.1 ± 12.3 [SD] years; range: 36–86 years) were retrospectively included. All patients had dedicated dual-phase pancreatic protocol CT between 2004 and 2018. Thin-slice images (0.75/0.5 mm thickness/increment) were compared with thick-slices images (3 or 5 mm thickness/increment). Pancreatic regions involved by PDAC or AIP (areas of enlargement, altered enhancement, effacement of pancreatic duct) as well as uninvolved parenchyma were segmented as three-dimensional volumes. Four hundred and thirty-one radiomics features were extracted and a random forest was used to distinguish AIP from PDAC. CT data of 60 AIP and 60 PDAC patients were used for training and those of 29 AIP and 33 PDAC independent patients were used for testing.ResultsThe pancreas was diffusely involved in 37 (37/89; 41.6%) patients with AIP and not diffusely in 52 (52/89; 58.4%) patients. Using machine learning, 95.2% (59/62; 95% confidence interval [CI]: 89.8–100%), 83.9% (52:67; 95% CI: 74.7–93.0%) and 77.4% (48/62; 95% CI: 67.0–87.8%) of the 62 test patients were correctly classified as either having PDAC or AIP with thin-slice venous phase, thin-slice arterial phase, and thick-slice venous phase CT, respectively. Three of the 29 patients with AIP (3/29; 10.3%) were incorrectly classified as having PDAC but all 33 patients with PDAC (33/33; 100%) were correctly classified with thin-slice venous phase with 89.7% sensitivity (26/29; 95% CI: 78.6–100%) and 100% specificity (33/33; 95% CI: 93–100%) for the diagnosis of AIP, 95.2% accuracy (59/62; 95% CI: 89.8–100%) and area under the curve of 0.975 (95% CI: 0.936–1.0).ConclusionsRadiomic features help differentiate AIP from PDAC with an overall accuracy of 95.2%.     

钩虫病感染者免疫球蛋白水平、临床特点及胃肠镜下形态分析

目的分析钩虫病感染者血清免疫球蛋白(Ig)A、IgG、IgM和IgE水平,临床特点及胃肠镜下形态。方法分析16例钩虫病感染者的临床资料,观察患者的临床表现、Ig水平、血常规检查结果、胃肠镜检查结果及治疗结果。结果 16例患者的IgE水平明显高于正常参考上限值;IgA、IgG、IgM水平与正常参考上限值比较,差异不明显。经诊断患者的钩虫分布情况:十二指肠降部8例(50.00%),十二指肠球部5例(31.25%),回肠末端3例(18.75%),升结肠1例(6.25%),其中十二指肠及回肠末端均见钩虫者1例(6.25%)。所有患者均予阿苯达唑片驱虫治疗,治疗后1个月复查见贫血得到纠正,消化道症状得以缓解,复查胃肠镜未见虫体,均治愈。结论钩虫病感染者的IgE水平明显升高,胃肠镜检查是确诊钩虫病的重要手段,尤其是要加强对十二指肠降部的检查,并在确诊后及时给予正规治疗措施。     

Differential role for the striatum and cerebellum in response to novel movements using a motor learning paradigm.

The aim of this pilot study was to examine the role of the striatum and cerebellum in the adaptation to a novel movement within a sequence of practiced movements using a motor learning paradigm. The performance of patients in the early or advanced stages of Parkinson's disease (PD) and of patients with damage to the cerebellum (CE) was compared, respectively to a group of aged and young matched controls on an adapted version of the Mirror-Tracing Test. In this task, subjects were required to trace a series of complex figures in two conditions: (1) a Practiced condition, in which the figures were composed of the juxtaposition of three simple designs that were extensively practiced before; and (2) a Mixed condition in which triads were created by replacing the last simple figure of the triads in the Practiced condition by a new simple figure that had never been traced individually before. Results showed that all clinical groups were slower than controls at tracing the Practiced triads. Most interestingly, however, only patients in the advanced stages of PD showed increased completion time to trace the triads in the Mixed condition. This suggests that a bilateral striatal dysfunction affects the ability to adapt to a novel motion within a sequence of practiced movements. Although exploratory, these results support a functional dissociation between the striatum and cerebellum in acquiring visuomotor skilled behaviors.     

鄂托克前旗马场井村改水降氟15年病情防治效果分析

目的：了解改水降氟后地氟病的防治效果。方法：水氟，尿氟测定均为电极法，氟斑牙诊断为Dean‘s法。结果：该村自1985年改饮低氟水，水氟含量由改水前的6.05mg/L降至改水后的0.48mg/L。改水后未出现新的氟骨症患者，8-12岁儿童氟斑牙患病率呈逐年下降趋势，改水后7-15年间氟斑牙病率均已稳定，表明病情得到有效控制，且达到稳定控制状态，结论：坚持长年饮用低氟水，地方性氟中毒就能得到有效控制。     

现阶段县级卫校在初级卫生保健中的作用探析

依据乡村医生人力结构现状调查结果,就现阶段县级卫校在初级卫生保健中的作用及今后面向乡村医生办学的可行性作了具体的分析和探讨。结论是:提高质量,加强对在岗乡医进行系统化正规中专层次的职后复训,应是县级卫校今后1O年的最主要的任务。     

A study of the relationship between ambient lead and blood lead among lead battery workers

 Objective: To examine the relationship between ambient lead levels and blood lead levels and to explore the modifiers of the relationship between ambient lead and blood lead. Method: A cross-sectional study was conducted in two lead battery factories. Blood lead level and ambient lead concentration were measured for each participant concurrently. A structured questionnaire was administered to collect sociodemographic characteristics and occupational history. Design: Biological and personal environmental measurements of 219 lead-exposed workers were analyzed by both simple and multiple linear regression. A regression model was selected for interpretation. Results: A high correlation (r=0.62) between ambient lead (PbA) and blood lead (PbB) was observed. In addition, numerous factors, including age, sex, alcohol consumption, personal hygiene practice and type of lead exposure, were also found to influence blood lead levels. Although PbB was highly correlated with PbA, blood lead level may not be effectively lowered by reducing ambient lead level. Based on the regression coefficients, improvement of hygienic practice was more effective at lowering PbB than reducing ambient lead level. Good hygienic practice may be the preferential way to reduce lead exposure in current conditions. Conclusion: Education of correct work practice may be more important than engineering control in the developing countries to lower blood lead levels in lead battery factories. Received: 28 May 1996/Accepted: 30 August 1996     

电脑控制连续式料位仪的研制

论述了电脑控制连续式料位仪的原理及性能，研制了一种先进可靠的物料料位测量工具。     

不同年龄,职业及文化程度人群心身健康特点的研究

探讨我国不同年龄、职业及文化程度的心身健康特点。方法根据我国人口学资料分层抽样，采用标准化的中国心身健康量表进行人群心身健康测查。结果（１）以５５～６４，２５～３４及４５～５４岁年龄组，离退休人员、干部及技术人员的心身健康量表分均较高，工人及军人次之，而农民心身健康各量表分最低；（２）初、高中者心身健康各量表分较高，大学次之，小学最低。结论我国不同年龄、职业及文化程度的心身健康状况不同。