AIM To describe magnetic resonance(MR) imaging features of pancreatic neuroendocrine neoplasms(Pan NENs) according to their grade and tumor-nodes-metastases stage by comparing them to histopathology and todetermine th...AIM To describe magnetic resonance(MR) imaging features of pancreatic neuroendocrine neoplasms(Pan NENs) according to their grade and tumor-nodes-metastases stage by comparing them to histopathology and todetermine the accuracy of MR imaging features in predicting their biological behavior.METHODS This study was approved by our institutional review board; requirement for informed patient consent was waived due to the retrospective nature of the study. Preoperative MR examinations of 55 Pan NEN patients(29 men, 26 women; mean age of 57.6 years, range 21-83 years) performed between June 2013 and December 2015 were reviewed. Qualitative and quantitative features were compared between tumor grades and stages determined by histopathological analysis.RESULTS Ill defined margins were more common in G2-3 and stage Ⅲ-Ⅳ PanN ENs than in G1 and low-stage tumors(P < 0.001); this feature had high specificity in the identification of G2-3 and stage Ⅲ-Ⅳ tumors(90.3% and 96%, 95%CI: 73.1-97.5 and 77.7-99.8). The mean apparent diffusion coefficient value was significantly lower in G2-3 and stage Ⅲ-Ⅳ lesions compared to well differentiated and low-stage tumors(1.09 × 10-3 mm2/s vs 1.45 × 10-3 mm2/s and 1.10 × 10-3 mm2/s vs 1.53 × 10-3 mm2/s, P = 0.003 and 0.001). Receiving operator characteristic analysis determined optimal cutoffs of 1.21 and 1.28 × 10-3 mm2/s for the identification of G2-3 and stage Ⅲ-Ⅳ tumors, with sensitivity and specificity values of 70.8/80.7% and 64.5/64%(95%CI: 48.7-86.6/60-92.7 and 45.4-80.2/42.6-81.3).CONCLUSION MR features of PanN ENs vary according to their grade of differentiation and their stage at diagnosis and could predict the biological behavior of these tumors.展开更多
目的:探讨肾透明细胞癌(clear cell renal cell carcinoma,CCRCC)64排多层螺旋CT直接征象与病理学分级之间的相关性,并进行对比分析。方法:收集2015年2月—2018年5月期间安徽省黄山市人民医院经手术切除后病理学检查证实为CCRCC的34例患...目的:探讨肾透明细胞癌(clear cell renal cell carcinoma,CCRCC)64排多层螺旋CT直接征象与病理学分级之间的相关性,并进行对比分析。方法:收集2015年2月—2018年5月期间安徽省黄山市人民医院经手术切除后病理学检查证实为CCRCC的34例患者,分析其术前64排多层螺旋CT平扫及多期增强扫描图像。CCRCC的直接征象包括肿瘤形态、大小、密度、强化方式、强化程度及是否有假包膜等,并与术后病理学分级进行对比。根据世界卫生组织(World Health Organization,WHO)/国际泌尿病理学会(International Society of Urological Pathology,ISUP)病理学分级标准,将CCRCC分为Ⅰ～Ⅳ级,其中Ⅰ～Ⅱ级定义为低级别组(n=28),Ⅲ～Ⅳ级定义为高级别组(n=6),采集相关数据,进行分析。结果:与低级别组CCRCC相比,高级别组CCRCC病灶形状更不规则(高级别组中不规则形肿块3例,占50.0%;低级别组中不规则肿块2例,占7.1%);平扫时肿瘤密度更高(高级别组中5例呈稍高密度,占83.3%;低级别组中仅3例呈稍高密度,占10.7%);增强扫描皮髓交界期肿瘤强化程度较弱[高级别组强化值与同侧正常肾皮质强化值平均差为(-16.1±12.3)HU,低级别组强化值与同侧正常肾皮质强化值平均差为(7.0±7.5)HU];实质期强化衰减程度较低[高级别组肿瘤平均强化衰减值为(-7.7±5.4)HU,低级别组肿瘤平均强化衰减值为(-17.3±7.3)HU]。两组间差异有统计学意义(P<0.05)。结论:CCRCC的64排多层螺旋CT直接征象中,肿瘤形态、平扫密度、皮髓交界期肿瘤强化程度及实质期肿瘤强化减退程度等对判断其WHO/ISUP病理学分级具有一定价值,能为术前确定CCRCC治疗方案提供帮助。展开更多
此麻醉安全国际标准由世界麻醉医师学会联盟(World Federation of Societies of Anaesthesiologists,WFSA)和世界卫生组织(World Health Organization,WHO)联合制订。WFSA是由150个国家的麻醉医师组成的非营利组织。本文所推荐的标准已...此麻醉安全国际标准由世界麻醉医师学会联盟(World Federation of Societies of Anaesthesiologists,WFSA)和世界卫生组织(World Health Organization,WHO)联合制订。WFSA是由150个国家的麻醉医师组成的非营利组织。本文所推荐的标准已获得WHO和WFSA成员支持,此标准适用于世界各地的麻醉工作者,旨在为麻醉工作者、专业组织、医院、机构管理者和政府提供指导和帮助,以维持和提高麻醉安全和质量。此标准涵盖专业内容、设施设备、用药及静脉输液、监测和麻醉实施等方面。高度推荐标准与强制标准作用等同,包括(但不仅限于):训练有素的、警惕的麻醉工作者持续在场,通过临床观察及脉搏血氧饱和度持续监测组织氧合及灌注;间断监测血压;通过听诊和二氧化碳检测确认气管内插管(如果有)的正确位置;应用WHO手术安全核查单;麻醉结束时完善交接系统。此国际标准仅为最低标准,而我们的目标是以所能达到的最高标准来实施麻醉,所以实际标准最好超过本文所介绍的标准。展开更多
Since ancient times medical profession has typically dealt with physical disorders,because they are visible, palpable, and audible. The diagnosis is relatively direct. Mental health problems are hidden in the brain an...Since ancient times medical profession has typically dealt with physical disorders,because they are visible, palpable, and audible. The diagnosis is relatively direct. Mental health problems are hidden in the brain and we did not know what was going on inside the skull. We could only infer, by observing the patient's behaviors and making assumptions. Even now, we have to largely rely on this indirect approach.That is why psychology and psychiatry are classified as behavioral sciences. They are abstract, and we do not understand the structural changes causing the problem,except for obvious vascular or neoplastic lesions. Now, due to the introduction of new technologies, many mental health problems can be visualized through hi-tech equipment, albeit they are not yet palpable or audible. This direct approach has made the diagnosis much more secure. Now, we know that the problem of dementia starts from the hippocampal formation, and we can see it on magnetic resonance imaging(MRI) and functional MRI(f MRI). Therefore, a new era of mental health care is emerging. Dementia has become a burden for the patient, family members,caregivers, and the entire society. With ageing population, the number of patients with dementia will increase sharply not only in the developed but also in the developing world. The care of patients with dementia involves not only biology, but also sociology, including politics, and humanities. In 2012, in collaboration with the UK-based Alzheimer's Disease International, the World Health Organization(WHO)published "Dementia: a public health priority" report. A year later, in 2013, the problem was raised at the G8 summit meeting in London. In 2014, the UK-based Alzheimer's Society estimated that by 2015, there would be 850,000 sufferers of dementia. Finally, in 2015, the First WHO Ministerial Conference on Global Action Against Dementia took place in Geneva and a document calling for action was published. Every UN member state has a responsibility to take action in response to this solemn call to save the human race.展开更多
文摘AIM To describe magnetic resonance(MR) imaging features of pancreatic neuroendocrine neoplasms(Pan NENs) according to their grade and tumor-nodes-metastases stage by comparing them to histopathology and todetermine the accuracy of MR imaging features in predicting their biological behavior.METHODS This study was approved by our institutional review board; requirement for informed patient consent was waived due to the retrospective nature of the study. Preoperative MR examinations of 55 Pan NEN patients(29 men, 26 women; mean age of 57.6 years, range 21-83 years) performed between June 2013 and December 2015 were reviewed. Qualitative and quantitative features were compared between tumor grades and stages determined by histopathological analysis.RESULTS Ill defined margins were more common in G2-3 and stage Ⅲ-Ⅳ PanN ENs than in G1 and low-stage tumors(P < 0.001); this feature had high specificity in the identification of G2-3 and stage Ⅲ-Ⅳ tumors(90.3% and 96%, 95%CI: 73.1-97.5 and 77.7-99.8). The mean apparent diffusion coefficient value was significantly lower in G2-3 and stage Ⅲ-Ⅳ lesions compared to well differentiated and low-stage tumors(1.09 × 10-3 mm2/s vs 1.45 × 10-3 mm2/s and 1.10 × 10-3 mm2/s vs 1.53 × 10-3 mm2/s, P = 0.003 and 0.001). Receiving operator characteristic analysis determined optimal cutoffs of 1.21 and 1.28 × 10-3 mm2/s for the identification of G2-3 and stage Ⅲ-Ⅳ tumors, with sensitivity and specificity values of 70.8/80.7% and 64.5/64%(95%CI: 48.7-86.6/60-92.7 and 45.4-80.2/42.6-81.3).CONCLUSION MR features of PanN ENs vary according to their grade of differentiation and their stage at diagnosis and could predict the biological behavior of these tumors.
文摘目的:探讨肾透明细胞癌(clear cell renal cell carcinoma,CCRCC)64排多层螺旋CT直接征象与病理学分级之间的相关性,并进行对比分析。方法:收集2015年2月—2018年5月期间安徽省黄山市人民医院经手术切除后病理学检查证实为CCRCC的34例患者,分析其术前64排多层螺旋CT平扫及多期增强扫描图像。CCRCC的直接征象包括肿瘤形态、大小、密度、强化方式、强化程度及是否有假包膜等,并与术后病理学分级进行对比。根据世界卫生组织(World Health Organization,WHO)/国际泌尿病理学会(International Society of Urological Pathology,ISUP)病理学分级标准,将CCRCC分为Ⅰ～Ⅳ级,其中Ⅰ～Ⅱ级定义为低级别组(n=28),Ⅲ～Ⅳ级定义为高级别组(n=6),采集相关数据,进行分析。结果:与低级别组CCRCC相比,高级别组CCRCC病灶形状更不规则(高级别组中不规则形肿块3例,占50.0%;低级别组中不规则肿块2例,占7.1%);平扫时肿瘤密度更高(高级别组中5例呈稍高密度,占83.3%;低级别组中仅3例呈稍高密度,占10.7%);增强扫描皮髓交界期肿瘤强化程度较弱[高级别组强化值与同侧正常肾皮质强化值平均差为(-16.1±12.3)HU,低级别组强化值与同侧正常肾皮质强化值平均差为(7.0±7.5)HU];实质期强化衰减程度较低[高级别组肿瘤平均强化衰减值为(-7.7±5.4)HU,低级别组肿瘤平均强化衰减值为(-17.3±7.3)HU]。两组间差异有统计学意义(P<0.05)。结论:CCRCC的64排多层螺旋CT直接征象中,肿瘤形态、平扫密度、皮髓交界期肿瘤强化程度及实质期肿瘤强化减退程度等对判断其WHO/ISUP病理学分级具有一定价值,能为术前确定CCRCC治疗方案提供帮助。
文摘此麻醉安全国际标准由世界麻醉医师学会联盟(World Federation of Societies of Anaesthesiologists,WFSA)和世界卫生组织(World Health Organization,WHO)联合制订。WFSA是由150个国家的麻醉医师组成的非营利组织。本文所推荐的标准已获得WHO和WFSA成员支持,此标准适用于世界各地的麻醉工作者,旨在为麻醉工作者、专业组织、医院、机构管理者和政府提供指导和帮助,以维持和提高麻醉安全和质量。此标准涵盖专业内容、设施设备、用药及静脉输液、监测和麻醉实施等方面。高度推荐标准与强制标准作用等同,包括(但不仅限于):训练有素的、警惕的麻醉工作者持续在场,通过临床观察及脉搏血氧饱和度持续监测组织氧合及灌注;间断监测血压;通过听诊和二氧化碳检测确认气管内插管(如果有)的正确位置;应用WHO手术安全核查单;麻醉结束时完善交接系统。此国际标准仅为最低标准,而我们的目标是以所能达到的最高标准来实施麻醉,所以实际标准最好超过本文所介绍的标准。
文摘Since ancient times medical profession has typically dealt with physical disorders,because they are visible, palpable, and audible. The diagnosis is relatively direct. Mental health problems are hidden in the brain and we did not know what was going on inside the skull. We could only infer, by observing the patient's behaviors and making assumptions. Even now, we have to largely rely on this indirect approach.That is why psychology and psychiatry are classified as behavioral sciences. They are abstract, and we do not understand the structural changes causing the problem,except for obvious vascular or neoplastic lesions. Now, due to the introduction of new technologies, many mental health problems can be visualized through hi-tech equipment, albeit they are not yet palpable or audible. This direct approach has made the diagnosis much more secure. Now, we know that the problem of dementia starts from the hippocampal formation, and we can see it on magnetic resonance imaging(MRI) and functional MRI(f MRI). Therefore, a new era of mental health care is emerging. Dementia has become a burden for the patient, family members,caregivers, and the entire society. With ageing population, the number of patients with dementia will increase sharply not only in the developed but also in the developing world. The care of patients with dementia involves not only biology, but also sociology, including politics, and humanities. In 2012, in collaboration with the UK-based Alzheimer's Disease International, the World Health Organization(WHO)published "Dementia: a public health priority" report. A year later, in 2013, the problem was raised at the G8 summit meeting in London. In 2014, the UK-based Alzheimer's Society estimated that by 2015, there would be 850,000 sufferers of dementia. Finally, in 2015, the First WHO Ministerial Conference on Global Action Against Dementia took place in Geneva and a document calling for action was published. Every UN member state has a responsibility to take action in response to this solemn call to save the human race.
