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%.     

沙苑子本草考证

沙苑子为我国常用中药,药用历史悠久。通过查阅本草文献,对沙苑子名称、基原、功效、产地及伪品5个方面进行考证,得知其名称演变大致经过"白蒺藜""沙苑蒺藜""沙苑子"3个阶段;历代本草记载沙苑子基原为扁茎黄芪的干燥成熟种子,古今应用品种基本一致;沙苑子补肾固精功效的记载自宋《本草衍义》起逐渐清晰明确;沙苑子道地产区自宋时起为陕西沙苑,明清时期产地逐渐转到陕西潼关、山西等地,建国后以陕西省为主向北扩散,以陕西潼关为佳;沙苑子建国前有马薸子、色微绿伪品及紫云英子等混伪品,建国后有紫云英、猪屎豆、华黄芪和直立黄芪的种子等混伪品。为沙苑子正本清源,并为其进一步深入开发提供参考。     

Insight towards Nucleation Mechanism and Change in Morphology for Nanostructured Platinum Thin Film Directly Grown on Carbon Substrate via Electrochemical Deposition

Nanocrystalline platinum with different morphologies is synthesized via electrochemical deposition technique. The nucleation mechanism and its structural effect over the electrodeposited Pt on carbon electrodes have been systematically studied. Powder X-ray diffraction, X-ray photoelectron spectroscopy, and field-emission scanning electron microscopy are employed to study nucleation, oxidation states, and Pt structure growth on a carbon electrode. This study reports significant development of Pt metal nanoparticles with different morphologies such as a sphere, flower, core-flower, and rod-like structure directly fabricated on carbon electrode while tuning the deposition parameters such as current density, time, temperature, pH during the deposition process. The proposed electrochemical route represents a superior fabrication procedure for large-scale electrode fabrication compared to a conventional method for preparing membrane electrode assemblies for fuel cell stacks.     

不同手术方法治疗复杂胫骨平台骨折临床疗效观察

目的探讨不同手术方法治疗复杂胫骨平台骨折临床疗效。方法选择2016年1月—2018年12月84例复杂胫骨平台骨折患者,随机分组。单侧锁定钢板内固定组选择单侧锁定钢板内固定手术,双侧切口双侧解剖钢板内固定组选择双侧切口双侧解剖钢板内固定。分析手术操作时间、手术失血、平均住院天数以及复杂胫骨平台骨折愈合时间;治疗前后患者视觉模拟评分和Rasmussen膝关节功能评分;膝关节僵硬发生率。结果双侧切口双侧解剖钢板内固定组视觉模拟评分和Rasmussen膝关节功能评分、手术操作时间、手术失血、平均住院天数以及复杂胫骨平台骨折愈合时间、膝关节僵硬发生率和单侧锁定钢板内固定组比较有优势,P<0.05。结论复杂胫骨平台骨折患者实施双侧切口双侧解剖钢板内固定可获得较好效果。     

四氯化碳两种途径亚急性实验染毒时某些肝酶指标的对比研究

本文用CCl_41.356g/kg和5.87g/kg分别对大鼠进行皮下和呼吸道静式染毒,为期8周亚急性中毒试验,研究临床常用血清肝酶指标的变化。结果发现:CCl_4除使大鼠体重增长减慢外,第1周起出现肝细胞脂变、浊肿,进而坏死、纤维增生和肝硬化;肝糖元及SHD酶活性减少或消失,G-6-P酶活性先升高后降低的病理形态和组织化学的改变。与此同时或稍后出现SGPT和SGOT活性升高,持续至第8周。停药两周,肝病理改变趋于恢复,SGPT和SGOT活性也恢复至接近正常,两肝酶与病理改变相平行。AKP酶活性第4周后才升高;ChE酶似有先升高后降低趋势,但无明显差异性;γ-GT酶变化不规则。提示CCl_4亚急性中毒时,SGPT和SGOT酶活性升高与肝损关系较密切,可作临床早期诊断指标。血清AKP和ChE酶亦一定程度反映肝损的发展情况,可供作临床观察病情发展的辅助指标。     

狂犬病蛰伏数年后卷土重来的警示

[目的]警示各级政府务必重视和坚持“预防为主”的方针,采取有力措施,加强对犬类的管理,从根本上控制住“狂犬病”疫情。[方法]广泛地开展防治狂犬病健康教育,提高群众的防范意识和自我保护能力;加强部门协作,对犬只实行“管、免、灭、测”的综合性防疫措施;通过多渠道、多途径全面掌握犬伤人员的伤口处理与疫苗注射情况,对经济困难的犬伤者由政府报销疫苗费等措施保障犬伤人员得到及时处理。[结果]2005年犬伤人员伤口处置与疫苗注射率达99.67%;犬只免疫87320只,免疫率占58.21%;农村捕杀野犬、恶犬22408只、城镇限养区捕杀1189只;随机对3只家犬进行了带毒检测,带毒率达66.67%;2005年1～7月发病数10例,8～12月发病2例。[结论]政府重视,部门协作,措施具体,宣传到位,犬伤人员能及时得到正确处置是控制和降低狂犬病发病的关键。     

河南食管癌高、低发区无症状人群食管固有膜血管乳头的变化

目的：探讨食管癌高、低发区无症状居民食管上皮固有膜血管乳头（简称乳头）增生特征（乳头密度和高度）及其与病变分布的关系，加深对食管癌变早期形态学变化特征的了解。方法：2480例无症状人群食管粘膜活检组织，采用食管癌高低发区食管纤维内镜检查，粘膜活检，组织病理学检查和形态学测量技术对食管乳头的分布特征及其与病变的关系进行分析。结果：食管癌高低发区居民食管中、下段乳头升高（≥上皮厚度的1／2）发生率之间差异并不明显（P＞0．05），但是，高发区居民食管中段乳头密度（乳头数目／mm)明显高于下段，并高于低发区居民食管中段的乳头密度（P＜0．05）；高发区居民食管上皮乳头升高伴基底细胞过度增生患者明显高于正常人（P＜0．05），而低发区未观察到类似情况。结论：乳头增生表现为乳头数目增多和乳头升高是食管癌高发区人群食管上皮特征性形态学变化，高分区居民上皮乳头升高伴明显基底细胞过度增生，提示乳头增生可能是食管癌变极早期阶段的重要形态学变化，反映了上皮细胞的增生状态。     

两厂头孢米诺钠治疗泌尿系感染成本-效果分析

目的:分析不同厂生产的头孢米诺钠治疗泌尿系感染的疗效和用药费用,从而指导临床更合理选择和应用药物。方法:将64例随机分为A组和B组各32例,分别给予静脉滴注进口的头孢米诺钠1g和国产的头孢米诺钠1g,bid,连续用药7d。结果:A组临床有效率为93.8%,B组为90.6%,两组安全性较好;A组药费为1 820.0元,B组药费为1 030.4元,B组要比A组节省789.6元。结论:在两组治疗效果无显著性差异情况下,B组治疗泌尿系感染是一种经济有效的治疗方案。     

脾脏切除对胸腺和淋巴结免疫功能的影响

报道脾脏切除（脾切）对动物胸腺和淋巴结免疫功能的影响，脾切后３ｗ大鼠胸腺细胞自发增殖及ＣｏｎＡ诱导增殖均无明显变化，ＣｏｎＡ诱导淋巴结细胞增殖脾切组明显高于假手术对照组，脾切后３ｗ再用ＳＲＢＣ免疫，５ｄ后小鼠腹腔淋巴结数量脾切明显高于对照组，用ＱＨＳ法测定淋巴结细胞对ＳＲＢＣ初次抗体产生脾切组则明显低于对照组。