Proactive Semantic Interference (PSI) and failure to recover from PSI (frPSI), are novel constructs assessed by the LASSI-L. These measures are sensitive to cognitive changes in early Mild Cognitive Impairment (MCI) a...Proactive Semantic Interference (PSI) and failure to recover from PSI (frPSI), are novel constructs assessed by the LASSI-L. These measures are sensitive to cognitive changes in early Mild Cognitive Impairment (MCI) and preclinical AD determined by Aβ load using PET. The goal of this study was to compare a new computerized version of the LASSI-L (LASSI-Brief Computerized) to the standard paper-and-pencil version of the test. In this study, we examined 110 cognitively unimpaired (CU) older adults and 79 with amnestic MCI (aMCI) who were administered the paper-and-pencil form of the LASSI-L. Their performance was compared with 62 CU older adults and 52 aMCI participants examined using the LASSI-BC. After adjustment for covariates (degree of initial learning, sex, education, and language of evaluation) both the standard and computerized versions distinguished between aMCI and CU participants. The performance of CU and aMCI groups using either form was relatively commensurate. Importantly, an optimal combination of Cued B2 recall and Cued B1 intrusions on the LASSI-BC yielded an area under the ROC curve of .927, a sensitivity of 92.3% and specificity of 88.1%, relative to an area under the ROC curve of .815, a sensitivity of 72.5%, and a specificity of 79.1% obtained for the paper-and-pencil LASSI-L. Overall, the LASSI-BC was comparable, and in some ways, superior to the paper-and-pencil LASSI-L. Advantages of the LASSI-BC include a more standardized administration, suitability for remote assessment, and an automated scoring mechanism that can be verified by a built-in audio recording of responses.展开更多
AIM:To evaluate the reliability of Photo-Hirschberg screening for global strabismus performed by non-specialized personnel.METHODS:Participants at three sites were enrolled.One person at each site was trained in visua...AIM:To evaluate the reliability of Photo-Hirschberg screening for global strabismus performed by non-specialized personnel.METHODS:Participants at three sites were enrolled.One person at each site was trained in visual acuity measurement and use of the computerized system.Visual acuity was measured,and strabismus testing was performed using two flash photographs.All data from the three primary observers were sent to an experienced assistant researcher,who was blinded to the primary results,for re-evaluation.The primary and re-evaluation results of the Photo-Hirschberg screenings using weighted kappa for agreement were compared.RESULTS:The study included 181 participants(88 males and 93 females)and the results for primary and re-evaluation screenings were corresponded.Ten participants with contrasting results presented with unclear corneal light reflex.Sensitivity and specificity were 100%[95%confidence interval(CI):29.0%-100%]and 99.4%(95%CI:96.6%-100%),respectively,based on the Agresti test of the primary evaluation,considering the re-evaluated classification as true.CONCLUSION:The computerized system can be used for primary strabismus screening by non-specialized personnel,with 98.8%agreement with specialists.However,it cannot be used as a substitute for professional examination.展开更多
BACKGROUND Laparoscopic rectal cancer radical surgery is a complex procedure affected by various factors.However,the existing literature lacks standardized parameters for the pelvic region and soft tissues,which hampe...BACKGROUND Laparoscopic rectal cancer radical surgery is a complex procedure affected by various factors.However,the existing literature lacks standardized parameters for the pelvic region and soft tissues,which hampers the establishment of consistent conclusions.AIM To comprehensively assess 16 pelvic and 7 soft tissue parameters through computerized tomography(CT)-based three-dimensional(3D)reconstruction,providing a strong theoretical basis to address challenges in laparoscopic rectal cancer radical surgery.METHODS We analyzed data from 218 patients who underwent radical laparoscopic surgery for rectal cancer,and utilized CT data for 3D pelvic reconstruction.Specific anatomical points were carefully marked and measured using advanced 3D modeling software.To analyze the pelvic and soft tissue parameters,we emp-loyed statistical methods including paired sample t-tests,Wilcoxon rank-sum tests,and correlation analysis.RESULTS The investigation highlighted significant sex disparities in 14 pelvic bone parameters and 3 soft tissue parameters.Males demonstrated larger measurements in pelvic depth and overall curvature,smaller measurements in pelvic width,a larger mesorectal fat area,and a larger anterior-posterior abdominal diameter.By contrast,females exhibited wider pelvises,shallower depth,smaller overall curvature,and an increased amount of subcutaneous fat tissue.However,there were no significant sex differences observed in certain parameters such as sacral curvature height,superior pubococcygeal diameter,rectal area,visceral fat area,waist circumference,and transverse abdominal diameter.CONCLUSION The reconstruction of 3D CT data enabled accurate pelvic measurements,revealing significant sex differences in both pelvic and soft tissue parameters.This study design offer potential in predicting surgical difficulties and creating personalized surgical plans for male rectal cancer patients with a potentially“difficult pelvis”,ultimately improving surgical outcomes.Further research and utilization of these parameters could lead to enhanced surgical methods and patient care in laparoscopic rectal cancer radical surgery.展开更多
BACKGROUND Patients with schizophrenia may have various disease manifestations,most of which gradually tend toward incurable chronic decline,leading to mental disability.The basic symptoms of the disease can impair so...BACKGROUND Patients with schizophrenia may have various disease manifestations,most of which gradually tend toward incurable chronic decline,leading to mental disability.The basic symptoms of the disease can impair social function,whereas long-term hospitalization produces hospitalization syndrome,causing serious damage to social function.AIM To investigate the effects of Computerized Cognitive Remediation Therapy(CCRT)on cognitive and social functioning in patients with chronic schizophrenia.METHODS A retrospective analysis of 120 patients with chronic schizophrenia in Shanghai Pudong New Area Mental Health Center was performed.They were divided into an intervention group(60 cases treated with CCRT combined with conventional medication)and a control group(60 cases treated with conventional medication).After treatment,effects on cognitive function and social roles were observed in both groups.The Positive and Negative Syndrome Scale(PANSS)was used to assess the patients'psychiatric symptoms.The Wisconsin Card Sorting Test(WCST)was used to assess the patients'cognitive functioning,and the Social Functioning Scale for Psychiatric Inpatients(SSPI)was used to assess the social functioning of the inpatient psychiatric patients.RESULTS No significant differences were observed in the PANSS,WCST,and SSPI intergroup scores before treatment(P>0.05).After 2,4,and 6 wk of therapy,general psychopathological factors,positive symptoms,negative symptoms,and total PANSS scores of PANSS in the intervention group were lower than in the control group(P<0.05).After 2,4,and 6 wk of treatment,the number of false responses,number of persistent bugs,and total responses in the WCST were significantly lower in the intervention group than in the control group(P<0.05),and the amount of completed classification was significantly higher than in the control group(P<0.05).After 2,4,and 6 wk of therapy,the SSPI scores were significantly greater than those of the controls(P<0.05).After 6 wk of treatment,the efficacy rates of the control and intervention groups were 81.67%and 91.67%,respectively.The curative effect in the intervention group was significantly higher than that in the control group(P<0.05).CONCLUSION CCRT can significantly improve cognitive function and social abilities in patients with chronic schizophrenia.展开更多
BACKGROUND Severe acute pancreatitis(SAP),a condition with rapid onset,critical condition and unsatisfactory prognosis,poses a certain threat to human health,warranting optimization of relevant treatment plans to impr...BACKGROUND Severe acute pancreatitis(SAP),a condition with rapid onset,critical condition and unsatisfactory prognosis,poses a certain threat to human health,warranting optimization of relevant treatment plans to improve treatment efficacy.AIM To evaluate the efficacy and safety of computerized tomography-guided the-rapeutic percutaneous puncture catheter drainage(CT-TPPCD)combined with somatostatin(SS)in the treatment of SAP.METHODS Forty-two SAP patients admitted to The Second Affiliated Hospital of Fujian Medical University from June 2020 to June 2023 were selected.On the basis of routine treatment,20 patients received SS therapy(control group)and 22 patients were given CT-TPPCD plus SS intervention(research group).The efficacy,safety(pancreatic fistula,intra-abdominal hemorrhage,sepsis,and organ dysfunction syndrome),abdominal bloating and pain relief time,bowel recovery time,hospital stay,inflammatory indicators(C-reactive protein,interleukin-6,and pro-calcitonin),and Acute Physiology and Chronic Health Evaluation(APACHE)II score of both groups were evaluated for comparison.RESULTS Compared with the control group,the research group had a markedly higher total effective rate,faster abdominal bloating and pain relief and bowel recovery,INTRODUCTION Pancreatitis,an inflammatory disease occurring in the pancreatic tissue,is classified as either acute or chronic and is associated with high morbidity and mortality,imposing a socioeconomic burden[1,2].The pathogenesis of this disease involves early protease activation,activation of nuclear factor kappa-B-related inflammatory reactions,and infiltration of immune cells[3].Severe acute pancreatitis(SAP)is a serious condition involving systemic injury and subsequent possible organ failure,accounting for 20%of all acute pancreatitis cases[4].SAP is also characterized by rapid onset,critical illness and unsatisfactory prognosis and is correlated with serious adverse events such as systemic inflammatory response syn-drome and acute lung injury,threatening the health of patients[5,6].Therefore,timely and effective therapeutic inter-ventions are of great significance for improving patient prognosis and ensuring therapeutic effects.Somatostatin(SS),a peptide hormone that can be secreted by endocrine cells and the central nervous system,is in-volved in the regulatory mechanism of glucagon and insulin synthesis in the pancreas[7].It has complex and pleiotropic effects on the gastrointestinal tract,which can inhibit the release of gastrointestinal hormones and negatively modulate the exocrine function of the stomach,pancreas and bile,while exerting a certain influence on the absorption of the di-gestive system[8,9].SS has shown certain clinical effectiveness when applied to SAP patients and can regulate the severity of SAP and immune inflammatory responses,and this regulation is related to its influence on leukocyte apoptosis and adhesion[10,11].Computerized tomography-guided therapeutic percutaneous puncture catheter drainage(CT-TPPCD)is a surgical procedure to collect lesion fluid and pus samples from necrotic lesions and perform puncture and drainage by means of CT image examination and precise positioning[12].In the research of Liu et al[13],CT-TPPCD applied to pa-tients undergoing pancreatic surgery contributes to not only good curative effects but also a low surgical risk.Baudin et al[14]also reported that CT-TPPCD has a clinical success rate of 64.6%in patients with acute infectious necrotizing pan-creatitis,with nonfatal surgery-related complications found in only two cases,suggesting that this procedure is clinically effective and safe in the treatment of the disease.In light of the limited studies on the efficacy and safety of SS plus CT-TPPCD in SAP treatment,this study performed a relevant analysis to improve clinical outcomes in SAP patients.展开更多
BACKGROUND The data obtained on the anatomical knowledge of the tracheobronchial system can be used for diagnosis,treatment and interventional interventions in areas such as anesthesia,thoracic surgery,pulmonary physi...BACKGROUND The data obtained on the anatomical knowledge of the tracheobronchial system can be used for diagnosis,treatment and interventional interventions in areas such as anesthesia,thoracic surgery,pulmonary physiology.AIM To determine the tracheobronchial branching angles in pediatric and adult populations by using the multislice computed tomography(CT)and minimum intensity projection(MinIP)technique,which is a non-invasive method.METHODS Our study was carried out retrospectively.Patients who underwent contrast and non-contrast CT examination,whose anatomically and pathophysiologically good tracheobronchial system and lung parenchyma images were obtained,were included in the study.Measurements were made in the coronal plane of the lung parenchyma.In the coronal plane,right main bronchus-left main bronchus angle,right upper lobe bronchus-intermedius bronchus angle,right middle lobe bronchus-right lower lobe bronchus angle,left upper lobe bronchus-left lower lobe bronchus angle were measured.RESULTS The study population consisted of 1511 patients,753 pediatric(mean age:13.4±4.3;range:1-18 years)and 758 adults(mean age:54.3±17.3;range:19-94 years).In our study,tracheal bifurcation angle was found to be 73.3°±13.7°(59.6°-87°)in the whole population.In the pediatric group,the right-left main coronal level was found to be higher in boys compared to girls(74.6°±12.9°vs 71.2°±13.9°,P=0.001).In the adult group,the right-left main coronal level was found to be lower in males compared to females(71.9°±12.9°vs 75.8°±14.7°,P<0.001).CONCLUSIONS Our study,with the number of 1511 patients,is the first study in the literature with the largest number of patient populations including pediatric and adult demographic data,measuring the angle values of the tracheobronchial system using multislice CT and MinIP technique.Study data will not only be a guide during invasive procedures,but it can also guide studies to be done with imaging methods.展开更多
G-DINA(the generalizeddeterministic input,noisy and gate)模型限制条件少,应用范围广,满足大量心理与教育评估测验数据的要求。研究提出一种适用于G-DINA等模型的同时标定新题Q矩阵与项目参数的认知诊断计算机化自适应测验(CD-CAT)...G-DINA(the generalizeddeterministic input,noisy and gate)模型限制条件少,应用范围广,满足大量心理与教育评估测验数据的要求。研究提出一种适用于G-DINA等模型的同时标定新题Q矩阵与项目参数的认知诊断计算机化自适应测验(CD-CAT)在线标定新方法SCADOCM,以期促进CD-CAT在实践中的推广与应用。本研究分别基于模拟题库以及真实题库进行研究,结果表明:相比传统的SIE方法,SCADOCM在各实验条件下均具有较为理想的标定精度与标定效率,应用前景较好;SIE方法不适用于饱和的G-DINA等模型,其各实验条件下的Q矩阵标定精度均较低。展开更多
目的比较常规CT征象和直方图参数对腺泡型、非腺泡型肺腺癌的鉴别效能的差异。方法回顾性收集在本院手术的185例患者共195个肺结节,其中腺泡型104个,非腺泡型91个。收集患者的人口学资料、肿瘤标记物。采用单因素分析及二元Logistic回...目的比较常规CT征象和直方图参数对腺泡型、非腺泡型肺腺癌的鉴别效能的差异。方法回顾性收集在本院手术的185例患者共195个肺结节,其中腺泡型104个,非腺泡型91个。收集患者的人口学资料、肿瘤标记物。采用单因素分析及二元Logistic回归分析建立常规CT征象模型、直方图(HA)模型及二者联合模型,通过曲线下面积(AUC)比较三种模型对鉴别腺泡型、非腺泡型肺腺癌的鉴别效能。结果单因素分析显示,腺泡型中,纯磨玻璃结节的占比低于非腺泡型(P=0.040);腺泡型中,病灶的CT平均值(P=0.023)、CT中位数数值(P=0.027)、紧凑度(P=0.003)、球形度(P=0.013)、熵(P<0.001)高于非腺泡型,病灶的峰度(P<0.001)、偏度(P<0.001)低于非腺泡型。二元Logistic回归分析以及ROC曲线显示联合模型及HA模型较常规CT征象模型具有更高的鉴别效能(AUC:直方图VS常规CT:0.763 VS 0.550,P<0.001;联合模型VS常规CT:0.768 VS 0.550,P<0.001);联合模型较HA模型无统计学差异(联合模型VS直方图:0.768 VS 0.763,P=0.768)。结论HA参数较常规CT征象能够更有效的鉴别腺泡型和非腺泡型肺腺癌。展开更多
文摘Proactive Semantic Interference (PSI) and failure to recover from PSI (frPSI), are novel constructs assessed by the LASSI-L. These measures are sensitive to cognitive changes in early Mild Cognitive Impairment (MCI) and preclinical AD determined by Aβ load using PET. The goal of this study was to compare a new computerized version of the LASSI-L (LASSI-Brief Computerized) to the standard paper-and-pencil version of the test. In this study, we examined 110 cognitively unimpaired (CU) older adults and 79 with amnestic MCI (aMCI) who were administered the paper-and-pencil form of the LASSI-L. Their performance was compared with 62 CU older adults and 52 aMCI participants examined using the LASSI-BC. After adjustment for covariates (degree of initial learning, sex, education, and language of evaluation) both the standard and computerized versions distinguished between aMCI and CU participants. The performance of CU and aMCI groups using either form was relatively commensurate. Importantly, an optimal combination of Cued B2 recall and Cued B1 intrusions on the LASSI-BC yielded an area under the ROC curve of .927, a sensitivity of 92.3% and specificity of 88.1%, relative to an area under the ROC curve of .815, a sensitivity of 72.5%, and a specificity of 79.1% obtained for the paper-and-pencil LASSI-L. Overall, the LASSI-BC was comparable, and in some ways, superior to the paper-and-pencil LASSI-L. Advantages of the LASSI-BC include a more standardized administration, suitability for remote assessment, and an automated scoring mechanism that can be verified by a built-in audio recording of responses.
文摘AIM:To evaluate the reliability of Photo-Hirschberg screening for global strabismus performed by non-specialized personnel.METHODS:Participants at three sites were enrolled.One person at each site was trained in visual acuity measurement and use of the computerized system.Visual acuity was measured,and strabismus testing was performed using two flash photographs.All data from the three primary observers were sent to an experienced assistant researcher,who was blinded to the primary results,for re-evaluation.The primary and re-evaluation results of the Photo-Hirschberg screenings using weighted kappa for agreement were compared.RESULTS:The study included 181 participants(88 males and 93 females)and the results for primary and re-evaluation screenings were corresponded.Ten participants with contrasting results presented with unclear corneal light reflex.Sensitivity and specificity were 100%[95%confidence interval(CI):29.0%-100%]and 99.4%(95%CI:96.6%-100%),respectively,based on the Agresti test of the primary evaluation,considering the re-evaluated classification as true.CONCLUSION:The computerized system can be used for primary strabismus screening by non-specialized personnel,with 98.8%agreement with specialists.However,it cannot be used as a substitute for professional examination.
基金2021 Zhejiang Province Public Welfare Technology Application Research Funding Project,No.LGC21H160002Basic Scientific Research Projects in Wenzhou City in 2022,No.Y20220885Wenzhou Medical University 2021 Higher Education Teaching Reform Project,No.JG2021167.
文摘BACKGROUND Laparoscopic rectal cancer radical surgery is a complex procedure affected by various factors.However,the existing literature lacks standardized parameters for the pelvic region and soft tissues,which hampers the establishment of consistent conclusions.AIM To comprehensively assess 16 pelvic and 7 soft tissue parameters through computerized tomography(CT)-based three-dimensional(3D)reconstruction,providing a strong theoretical basis to address challenges in laparoscopic rectal cancer radical surgery.METHODS We analyzed data from 218 patients who underwent radical laparoscopic surgery for rectal cancer,and utilized CT data for 3D pelvic reconstruction.Specific anatomical points were carefully marked and measured using advanced 3D modeling software.To analyze the pelvic and soft tissue parameters,we emp-loyed statistical methods including paired sample t-tests,Wilcoxon rank-sum tests,and correlation analysis.RESULTS The investigation highlighted significant sex disparities in 14 pelvic bone parameters and 3 soft tissue parameters.Males demonstrated larger measurements in pelvic depth and overall curvature,smaller measurements in pelvic width,a larger mesorectal fat area,and a larger anterior-posterior abdominal diameter.By contrast,females exhibited wider pelvises,shallower depth,smaller overall curvature,and an increased amount of subcutaneous fat tissue.However,there were no significant sex differences observed in certain parameters such as sacral curvature height,superior pubococcygeal diameter,rectal area,visceral fat area,waist circumference,and transverse abdominal diameter.CONCLUSION The reconstruction of 3D CT data enabled accurate pelvic measurements,revealing significant sex differences in both pelvic and soft tissue parameters.This study design offer potential in predicting surgical difficulties and creating personalized surgical plans for male rectal cancer patients with a potentially“difficult pelvis”,ultimately improving surgical outcomes.Further research and utilization of these parameters could lead to enhanced surgical methods and patient care in laparoscopic rectal cancer radical surgery.
基金Supported by Shanghai Pudong New Area Science and Technology Development and Livelihood Research Special Fund Support Project,No.PKJ2023-Y80Integrated Traditional Chinese and Western Medicine Specialized Disease Diagnosis and Treatment Center Project,No.PDZY-2022-05-01.
文摘BACKGROUND Patients with schizophrenia may have various disease manifestations,most of which gradually tend toward incurable chronic decline,leading to mental disability.The basic symptoms of the disease can impair social function,whereas long-term hospitalization produces hospitalization syndrome,causing serious damage to social function.AIM To investigate the effects of Computerized Cognitive Remediation Therapy(CCRT)on cognitive and social functioning in patients with chronic schizophrenia.METHODS A retrospective analysis of 120 patients with chronic schizophrenia in Shanghai Pudong New Area Mental Health Center was performed.They were divided into an intervention group(60 cases treated with CCRT combined with conventional medication)and a control group(60 cases treated with conventional medication).After treatment,effects on cognitive function and social roles were observed in both groups.The Positive and Negative Syndrome Scale(PANSS)was used to assess the patients'psychiatric symptoms.The Wisconsin Card Sorting Test(WCST)was used to assess the patients'cognitive functioning,and the Social Functioning Scale for Psychiatric Inpatients(SSPI)was used to assess the social functioning of the inpatient psychiatric patients.RESULTS No significant differences were observed in the PANSS,WCST,and SSPI intergroup scores before treatment(P>0.05).After 2,4,and 6 wk of therapy,general psychopathological factors,positive symptoms,negative symptoms,and total PANSS scores of PANSS in the intervention group were lower than in the control group(P<0.05).After 2,4,and 6 wk of treatment,the number of false responses,number of persistent bugs,and total responses in the WCST were significantly lower in the intervention group than in the control group(P<0.05),and the amount of completed classification was significantly higher than in the control group(P<0.05).After 2,4,and 6 wk of therapy,the SSPI scores were significantly greater than those of the controls(P<0.05).After 6 wk of treatment,the efficacy rates of the control and intervention groups were 81.67%and 91.67%,respectively.The curative effect in the intervention group was significantly higher than that in the control group(P<0.05).CONCLUSION CCRT can significantly improve cognitive function and social abilities in patients with chronic schizophrenia.
基金Supported by 2022 Fujian Medical University Qihang Fund General Project Plan,No.2022QH1120。
文摘BACKGROUND Severe acute pancreatitis(SAP),a condition with rapid onset,critical condition and unsatisfactory prognosis,poses a certain threat to human health,warranting optimization of relevant treatment plans to improve treatment efficacy.AIM To evaluate the efficacy and safety of computerized tomography-guided the-rapeutic percutaneous puncture catheter drainage(CT-TPPCD)combined with somatostatin(SS)in the treatment of SAP.METHODS Forty-two SAP patients admitted to The Second Affiliated Hospital of Fujian Medical University from June 2020 to June 2023 were selected.On the basis of routine treatment,20 patients received SS therapy(control group)and 22 patients were given CT-TPPCD plus SS intervention(research group).The efficacy,safety(pancreatic fistula,intra-abdominal hemorrhage,sepsis,and organ dysfunction syndrome),abdominal bloating and pain relief time,bowel recovery time,hospital stay,inflammatory indicators(C-reactive protein,interleukin-6,and pro-calcitonin),and Acute Physiology and Chronic Health Evaluation(APACHE)II score of both groups were evaluated for comparison.RESULTS Compared with the control group,the research group had a markedly higher total effective rate,faster abdominal bloating and pain relief and bowel recovery,INTRODUCTION Pancreatitis,an inflammatory disease occurring in the pancreatic tissue,is classified as either acute or chronic and is associated with high morbidity and mortality,imposing a socioeconomic burden[1,2].The pathogenesis of this disease involves early protease activation,activation of nuclear factor kappa-B-related inflammatory reactions,and infiltration of immune cells[3].Severe acute pancreatitis(SAP)is a serious condition involving systemic injury and subsequent possible organ failure,accounting for 20%of all acute pancreatitis cases[4].SAP is also characterized by rapid onset,critical illness and unsatisfactory prognosis and is correlated with serious adverse events such as systemic inflammatory response syn-drome and acute lung injury,threatening the health of patients[5,6].Therefore,timely and effective therapeutic inter-ventions are of great significance for improving patient prognosis and ensuring therapeutic effects.Somatostatin(SS),a peptide hormone that can be secreted by endocrine cells and the central nervous system,is in-volved in the regulatory mechanism of glucagon and insulin synthesis in the pancreas[7].It has complex and pleiotropic effects on the gastrointestinal tract,which can inhibit the release of gastrointestinal hormones and negatively modulate the exocrine function of the stomach,pancreas and bile,while exerting a certain influence on the absorption of the di-gestive system[8,9].SS has shown certain clinical effectiveness when applied to SAP patients and can regulate the severity of SAP and immune inflammatory responses,and this regulation is related to its influence on leukocyte apoptosis and adhesion[10,11].Computerized tomography-guided therapeutic percutaneous puncture catheter drainage(CT-TPPCD)is a surgical procedure to collect lesion fluid and pus samples from necrotic lesions and perform puncture and drainage by means of CT image examination and precise positioning[12].In the research of Liu et al[13],CT-TPPCD applied to pa-tients undergoing pancreatic surgery contributes to not only good curative effects but also a low surgical risk.Baudin et al[14]also reported that CT-TPPCD has a clinical success rate of 64.6%in patients with acute infectious necrotizing pan-creatitis,with nonfatal surgery-related complications found in only two cases,suggesting that this procedure is clinically effective and safe in the treatment of the disease.In light of the limited studies on the efficacy and safety of SS plus CT-TPPCD in SAP treatment,this study performed a relevant analysis to improve clinical outcomes in SAP patients.
文摘BACKGROUND The data obtained on the anatomical knowledge of the tracheobronchial system can be used for diagnosis,treatment and interventional interventions in areas such as anesthesia,thoracic surgery,pulmonary physiology.AIM To determine the tracheobronchial branching angles in pediatric and adult populations by using the multislice computed tomography(CT)and minimum intensity projection(MinIP)technique,which is a non-invasive method.METHODS Our study was carried out retrospectively.Patients who underwent contrast and non-contrast CT examination,whose anatomically and pathophysiologically good tracheobronchial system and lung parenchyma images were obtained,were included in the study.Measurements were made in the coronal plane of the lung parenchyma.In the coronal plane,right main bronchus-left main bronchus angle,right upper lobe bronchus-intermedius bronchus angle,right middle lobe bronchus-right lower lobe bronchus angle,left upper lobe bronchus-left lower lobe bronchus angle were measured.RESULTS The study population consisted of 1511 patients,753 pediatric(mean age:13.4±4.3;range:1-18 years)and 758 adults(mean age:54.3±17.3;range:19-94 years).In our study,tracheal bifurcation angle was found to be 73.3°±13.7°(59.6°-87°)in the whole population.In the pediatric group,the right-left main coronal level was found to be higher in boys compared to girls(74.6°±12.9°vs 71.2°±13.9°,P=0.001).In the adult group,the right-left main coronal level was found to be lower in males compared to females(71.9°±12.9°vs 75.8°±14.7°,P<0.001).CONCLUSIONS Our study,with the number of 1511 patients,is the first study in the literature with the largest number of patient populations including pediatric and adult demographic data,measuring the angle values of the tracheobronchial system using multislice CT and MinIP technique.Study data will not only be a guide during invasive procedures,but it can also guide studies to be done with imaging methods.
文摘目的探讨短程团体认知行为治疗(Group Cognitive Behavioral Therapy,GCBT)对青少年抑郁症患者的疗效,观察短程GCBT和计算机化认知行为治疗(Computerized Cognitive Behavioral Therapy,CCBT)联合对青少年抑郁治疗疗效。方法随机选取2022年8月—2023年8月福建省福州神经精神病防治院精神科门诊及医学心理咨询中心门诊收治的90例青少年抑郁症患者为研究对象,通过随机数表法分为CCBT组(n=30,因未完成5次治疗脱落19例,最终11例)、GCBT组(n=30,因未完成5次团体治疗脱落3例,最终27例)及CCBT+GCBT组(n=30)。在服用抗抑郁药物基础上,CCBT组合并5周的CCBT,GCBT组合并5周的GCBT,CCBT+GCBT组合并5周的GCBT及CCBT。治疗频率均为1次/周。比较3组治疗前、后汉密尔顿抑郁量表(24 Items Hamilton Depression Scale,HAMD-24)评分及减分率,中学生心理健康量表(Mental Health Scale for Middle School Students,MSSMHS)总均分及各因子分。结果5周治疗后,3组HAMD-24评分[CCBT组16(9,18)分、GCBT组18(13,21)分、CCBT+GCBT组13.5(8,20.25)分]均有明显下降,差异有统计学意义(Z=-2.847、-4.545、-4.784,P均<0.05)。3组HAMD减分率比较,差异无统计学意义(P=0.069)。CCBT+GCBT组MSSMHS总均分及强迫、敌对、人际关系敏感、抑郁、焦虑、情绪不平衡及心理不平衡等因子分与治疗前比较,差异有统计学意义(P均<0.05);GCBT组MSSMHS总均分及强迫、敌对、抑郁及情绪不平衡等因子分与治疗前比较,差异有统计学意义(P均<0.05)。CCBT+GCBT组MSSMHS人际关系敏感及心理不平衡因子分较GCBT组明显改善,差异有统计学意义(P均<0.05)。结论短程CCBT及GCBT等治疗能有效改善青少年患者的抑郁症状,且CCBT与GCBT联合治疗疗效更优于单纯GCBT,且能有效降低CCBT高脱失率。
文摘G-DINA(the generalizeddeterministic input,noisy and gate)模型限制条件少,应用范围广,满足大量心理与教育评估测验数据的要求。研究提出一种适用于G-DINA等模型的同时标定新题Q矩阵与项目参数的认知诊断计算机化自适应测验(CD-CAT)在线标定新方法SCADOCM,以期促进CD-CAT在实践中的推广与应用。本研究分别基于模拟题库以及真实题库进行研究,结果表明:相比传统的SIE方法,SCADOCM在各实验条件下均具有较为理想的标定精度与标定效率,应用前景较好;SIE方法不适用于饱和的G-DINA等模型,其各实验条件下的Q矩阵标定精度均较低。
文摘目的比较常规CT征象和直方图参数对腺泡型、非腺泡型肺腺癌的鉴别效能的差异。方法回顾性收集在本院手术的185例患者共195个肺结节,其中腺泡型104个,非腺泡型91个。收集患者的人口学资料、肿瘤标记物。采用单因素分析及二元Logistic回归分析建立常规CT征象模型、直方图(HA)模型及二者联合模型,通过曲线下面积(AUC)比较三种模型对鉴别腺泡型、非腺泡型肺腺癌的鉴别效能。结果单因素分析显示,腺泡型中,纯磨玻璃结节的占比低于非腺泡型(P=0.040);腺泡型中,病灶的CT平均值(P=0.023)、CT中位数数值(P=0.027)、紧凑度(P=0.003)、球形度(P=0.013)、熵(P<0.001)高于非腺泡型,病灶的峰度(P<0.001)、偏度(P<0.001)低于非腺泡型。二元Logistic回归分析以及ROC曲线显示联合模型及HA模型较常规CT征象模型具有更高的鉴别效能(AUC:直方图VS常规CT:0.763 VS 0.550,P<0.001;联合模型VS常规CT:0.768 VS 0.550,P<0.001);联合模型较HA模型无统计学差异(联合模型VS直方图:0.768 VS 0.763,P=0.768)。结论HA参数较常规CT征象能够更有效的鉴别腺泡型和非腺泡型肺腺癌。
