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1.
Wang-Shu Zhu Si-Ya Shi Ze-Hong Yang Chao Song Jun Shen 《World journal of gastroenterology : WJG》2020,26(11):1208-1220
BACKGROUND Postoperative liver failure is the most severe complication in cirrhotic patients with hepatocellular carcinoma(HCC) after major hepatectomy. Current available clinical indexes predicting postoperative residual liver function are not sufficiently accurate.AIM To determine a radiomics model based on preoperative gadoxetic acid-enhanced magnetic resonance imaging for predicting liver failure in cirrhotic patients with HCC after major hepatectomy.METHODS For this retrospective study, a radiomics-based model was developed based on preoperative hepatobiliary phase gadoxetic acid-enhanced magnetic resonance images in 101 patients with HCC between June 2012 and June 2018. Sixty-one radiomic features were extracted from hepatobiliary phase images and selected by the least absolute shrinkage and selection operator method to construct a radiomics signature. A clinical prediction model, and radiomics-based model incorporating significant clinical indexes and radiomics signature were built using multivariable logistic regression analysis. The integrated radiomics-based model was presented as a radiomics nomogram. The performances of clinical prediction model, radiomics signature, and radiomics-based model for predicting post-operative liver failure were determined using receiver operating characteristics curve, calibration curve, and decision curve analyses.RESULTS Five radiomics features from hepatobiliary phase images were selected to construct the radiomics signature. The clinical prediction model, radiomics signature, and radiomics-based model incorporating indocyanine green clearance rate at 15 min and radiomics signature showed favorable performance for predicting postoperative liver failure(area under the curve: 0.809-0.894). The radiomics-based model achieved the highest performance for predicting liver failure(area under the curve: 0.894; 95%CI: 0.823-0.964). The integrated discrimination improvement analysis showed a significant improvement in the accuracy of liver failure prediction when radiomics signature was added to the clinical prediction model(integrated discrimination improvement = 0.117, P =0.002). The calibration curve and an insignificant Hosmer-Lemeshow test statistic(P = 0.841) demonstrated good calibration of the radiomics-based model. The decision curve analysis showed that patients would benefit more from a radiomics-based prediction model than from a clinical prediction model and radiomics signature alone.CONCLUSION A radiomics-based model of preoperative gadoxetic acid–enhanced MRI can be used to predict liver failure in cirrhotic patients with HCC after major hepatectomy. 相似文献
2.
M.F. Werner A. López-Rueda F.X. Zarco J. Blasco L. San Román S. Amaro E. Carrero R. Valero L. Oleaga J.M. Macho N. Bargalló 《Radiologia》2019,61(2):143-152
Purpose
Endovascular treatment with mechanical thrombectomy devices demonstrated high recanalization rates but functional outcome did not correlate with high rates of recanalization obtained. Patient selection prior to the endovascular treatment is very important in the final outcome of the patient. The primary aim of our study was to evaluate the prognostic value of posterior circulation Alberta Stroke Program Early CT Score (pc-ASPECTS) and Pons-Midbrain Index (PMI) scores in patients with Basilar Artery Occlusion (BAO) treated with successful angiographic recanalization after mechanical thrombectomy.Methods
Retrospective single-center study including 18 patients between 2008 and 2013 who had acute basilar artery occlusion managed with endovascular treatment within 24 hours from symptoms onset and with successful angiographic recanalization. The patients were initially classified into two groups according to clinical outcome and mortality at 90 days. For analysis we also divided patients into groups based on pc-ASPECTS (≥8vs.< 8) and PMI (≥3vs.< 3) on non-contrast CT (NCCT) and CT Angiography Source Images (CTASI). Imaging data were correlated to clinical outcome and mortality rate.Results
CTASI pc-ASPECTS, dichotomized at < 8 versus≥8, was associated with a favorable outcome (RR: 2.6; 95% CI: 1.3-5.2) and a reduced risk of death (RR: 6.5: 95% CI: 7.8-23.3). All patients that survived and were functionally independent had pc-ASPECTS score≥8. None of the 5 patients with CTASI pc-ASPECTS score less than 8 survived.Conclusion
PC-ASPECTS on CTASI is helpful for predicting functional outcome after BAO recanalization with endovascular treatment. These results should be validated in a randomized controlled trial in order to decide whether or not to treat a patient with BAO. 相似文献3.
4.
目的:探讨电视胸腔镜(VATS)解剖性肺段切除术与肺叶切除术治疗Ia 期非小细胞肺癌(NSCLC)患者的手术情况及对患者肺功能的影响。方法:选取我院手术治疗的Ⅰa期NSCLC患者,收集时间2014年1月至2016年12月,根据术式不同分为两组,均采用VATS手术治疗,A组(54例)患者采用解剖性肺段切除术、B组(60例)采用肺叶切除术治疗,对比两组患者的手术效果及术后肺功能变化。结果:A组患者的手术时间、清扫淋巴结数目与B组比较差异无统计学意义(P>0.05);A组患者的手术出血量、术后胸腔引流量、术后拔管时间、术后住院时间均显著的低于B组患者(P<0.05);术前,A组和B组患者的FEV1%、FVC%、MVV%测定值差异无统计学意义(P>0.05),术后3个月复查,A组患者的FEV1%、FVC%、MVV%测定值均显著高于B组患者(P<0.05);手术后,A组患者的并发症发生率(7.41%)低于B组患者(13.33%),但是差异无统计学意义(P>0.05)。结论:VATS解剖性肺段切除术治疗Ⅰa期NSCLC患者具有手术创伤小、术后恢复快、对患者肺功能影响更小的优势。 相似文献
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7.
Y.R. Song B. Wu Y.T. Yang J. Chen L.J. Zhang Z.W. Zhang H.Y. Shi C.L. Huang J.X. Pan P. Xie 《Brazilian journal of medical and biological research》2015,48(11):973-982
Bipolar disorder (BD) is a common psychiatric mood disorder affecting more than 1-2%
of the general population of different European countries. Unfortunately, there is no
objective laboratory-based test to aid BD diagnosis or monitor its progression, and
little is known about the molecular basis of BD. Here, we performed a comparative
proteomic study to identify differentially expressed plasma proteins in various BD
mood states (depressed BD, manic BD, and euthymic BD) relative to healthy controls. A
total of 10 euthymic BD, 20 depressed BD, 15 manic BD, and 20 demographically matched
healthy control subjects were recruited. Seven high-abundance proteins were
immunodepleted in plasma samples from the 4 experimental groups, which were then
subjected to proteome-wide expression profiling by two-dimensional electrophoresis
and matrix-assisted laser desorption/ionization-time-of-flight/time-of-flight tandem
mass spectrometry. Proteomic results were validated by immunoblotting and
bioinformatically analyzed using MetaCore. From a total of 32 proteins identified
with 1.5-fold changes in expression compared with healthy controls, 16 proteins were
perturbed in BD independent of mood state, while 16 proteins were specifically
associated with particular BD mood states. Two mood-independent differential
proteins, apolipoprotein (Apo) A1 and Apo L1, suggest that BD pathophysiology may be
associated with early perturbations in lipid metabolism. Moreover, down-regulation of
one mood-dependent protein, carbonic anhydrase 1 (CA-1), suggests it may be involved
in the pathophysiology of depressive episodes in BD. Thus, BD pathophysiology may be
associated with early perturbations in lipid metabolism that are independent of mood
state, while CA-1 may be involved in the pathophysiology of depressive episodes. 相似文献
8.
9.
目的探讨舒芬太尼在肾母细胞瘤患儿术后镇痛中的应用效果及对患儿免疫功能的影响。方法采用随机数字表法将42例肾母细胞瘤患儿分为低剂量、中剂量和高剂量组,每组14例,低剂量组、中剂量组、高剂量组患儿术后舒芬太尼镇痛剂量分别为1.0、2.5、4.0μg/kg。术后6、24、48 h,采用中文版儿童疼痛行为量表(FLACC)评估三组患儿的镇痛效果,以及不良反应发生情况;麻醉前和术后1、24、72 h,检测三组患儿免疫功能指标,包括免疫球蛋白(Ig)G、IgA、IgM。结果术后6、24、48 h,中剂量组、高剂量组患儿FLACC评分均低于低剂量组患儿,差异均有统计学意义(P﹤0.05)。术后1、24、72 h,低剂量组患儿IgG、IgA、IgM水平均低于本组麻醉前,差异均有统计学意义(P﹤0.05);术后1、24 h,中剂量组和高剂量组患儿IgG、IgA、IgM水平均低于本组麻醉前,差异均有统计学意义(P﹤0.05),但术后72 h,中剂量组和高剂量组患儿IgG、IgA、IgM水平与麻醉前比较,差异均无统计学意义(P﹥0.05)。低剂量组患儿未发生不良反应,中剂量组患儿发生恶心1例,高剂量组患儿发生恶心5例、呕吐3例。结论2.5μg/kg的舒芬太尼在肾母细胞瘤患儿术后镇痛中效果明显,且对患儿的免疫系统发挥一定的保护作用,可以减轻患儿术后免疫功能抑制。 相似文献
10.
Xin Yi Wong Andrew Qi Jun Lim Qianyu Shen John Whay Kuang Chia Min Hoe Chew Wah Siew Tan 《Current medical research and opinion》2020,36(10):1677-1686
Abstract