High-resolution microendoscopy for esophageal cancer screening in China: A cost-effectiveness analysis

AIM:To study the cost-effectiveness of high-resolution microendoscopy(HRME)in an esophageal squamous cell carcinoma(ESCC)screening program in China.METHODS:A decision analytic Markov model of ESCC was developed.Separate model analyses were conducted for cohorts consisting of an averagerisk population or a high-risk population in China.Hypothetical 50-year-old individuals were followed until age 80 or death.We compared three different strategies for both cohorts:(1)no screening;(2)standard endoscopic screening with Lugol’s iodine staining;and(3)endoscopic screening with Lugol’s iodine staining and an HRME.Model parameters were estimated from the literature as well as from GLOBOCAN,the Cancer Incidence and Mortality Worldwide cancer database.Health states in the model included non-neoplasia,mild dysplasia,moderate dysplasia,high-grade dysplasia,intramucosal carcinoma,operable cancer,inoperable cancer,and death.Separate ESCC incidence transition rates were generated for the average-risk and high-risk populations.Costs in Chinese currency were converted to international dollars(I$)and were adjusted to 2012dollars using the Consumer Price Index.RESULTS:The main outcome measurements for this study were quality-adjusted life years(QALYs)and incremental cost-effectiveness ratio(ICER).For the average-risk population,the HRME screening strategy produced 0.043 more QALYs than the no screening strategy at an additional cost of I$646,resulting in an ICER of I$11808 per QALY gained.Standard endoscopic screening was weakly dominated.Among the high-risk population,when the HRME screening strategy was compared with the standard screening strategy,the ICER was I$8173 per QALY.For both the high-risk and average-risk screening populations,the HRME screening strategy appeared to be the most cost-effective strategy,producing ICERs below the willingness-topay threshold,I$23500 per QALY.One-way sensitivity analysis showed that,for the average-risk population,higher specificity of Lugol’s iodine(>40%)and lower specificity of HRME(<70%)could make Lugol’s iodine screening cost-effective.For the high-risk population,the results of the model were not substantially affected by varying the follow-up rate after Lugol’s iodine screening,Lugol’s iodine test characteristics(sensitivity and specificity),or HRME specificity.CONCLUSION:The incorporation of HRME into an ESCC screening program could be cost-effective in China.Larger studies of HRME performance are needed to confirm these findings.

Observations on the Diagnostic Effects of CT Examination(Enhanced Scan)on Hemorrhage Corpus Luteum Cyst

Objective:To investigate the diagnostic effects of enhanced CT scan on hemorrhage corpus luteum cyst(HCLC).Methods:The clinical data of 24 patients with hemorrhage corpus luteum cyst diagnosed by surgery and pathology in our hospital were collected.All patients received enhanced CT scan to evaluate the diagnostic value of CT.Results:The average diameter of the cysts in this group of patients was 5.1cm by CT.Further detection of the ruptured cyst wall showed that there was a liquid lowdensity shadow.Some of the cysts were accompanied by signs of increased density,indicating the presence of blood clots;all patients received surgical treatment.Intraoperative ultrasound examination of the cysts had an average diameter of 5.2cm and a wall of 0.2~0.4mm.Among them,19 cases of cysts contained"coffee-colored"liquid with varying degrees of blood clots,and 5 cases had no blood clots in the cysts but there were a lot of blood clots beside the cysts.Conclusion:The application of enhanced CT scan in patients with hemorrhage corpus luteum cyst is of great value.It can provide accurate data reference for clinical treatment and is worthy of promoting its clinical application.

The Effectiveness of a Multidisciplinary Collaborative Model for the Diagnosis and Treatment of Vertigo

Objective:To investigate the effectiveness of applying a multidisciplinary collaborative model for the diagnosis and treatment of patients with vertigo.Methods:The study was carried out in Xianyang Hospital of Yan’an University,in which 100 patients with vertigo were selected from April 2021 to April 2022 and were divided into two groups:the control group was under the single diagnosis and treatment model,whereas the experimental group was under the multidisciplinary collaborative diagnosis and treatment model,with 50 cases in each group.The diagnostic effects of the two groups were compared.Results:The diagnostic and therapeutic efficiency of the patients in the experimental group were 94%and 98%,respectively,while those of the patients in the control group were 78%and 82%,respectively,with a significant difference between the two groups(p<0.05).The balance scores of the patients in both groups were low before the treatment,in which the difference was not significant(p>0.05);after the treatment,the scores improved,with those of the patients in the experimental group being significantly higher than those in the control group(p<0.05).Moreover,the satisfaction rate of patients in the experimental group(98%)was significantly higher than that of the control group(80%)(p<0.05).Conclusion:The application of the multidisciplinary collaborative diagnosis and treatment model in the diagnosis of patients with vertigo is effective.The multidisciplinary model can improve clinical diagnosis,enhance the treatment effect,improve the clinical symptoms of patients,and increase the satisfaction of patient care.Hence,it is of high clinical application value.

Effective Dose Levels from Computed Tomography of the Head during Contrast Studies in Nigeria

Background: Diagnostic reference levels for a number of common diagnostic radiological examinations against which individual centres could compare their performance have been recommended by relevant international agencies. Due to variations in different populations globally, local and national diagnostic reference levels are more reliable. To the best of our knowledge, no centre-specific study has been carried out and national surveys are not available. Objective: To establish a preliminary local and national diagnostic reference level in Nigeria. Methods: A pro-spective and cross-sectional study involving 30 conscious paediatrics and adult patients referred for head computed tomography scan. They were positioned supine and scanned according to the standard protocol for head computed tomography with manual mA selection. The total dose-length products were recorded at the end of the pre-contrast and post-contrast sequences respectively. The pre-contrast dose was taken into cognizance in the determination of the post-contrast value. The effective dose was established by multiplying the dose-length product by 0.0023 mSv.mGy-1.cm-1, a conversion coefficient for brain tissue adopted from the European Commission. Statistical Package for Social Sciences version 17.0 was used to analyze the data. Results: 30 paediatrics and adult patients of mixed gender participated in the study. Their ages ranged from 1 to 74 years with a mean age of 41.47 ± 23.30 years. The pre-contrast effective dose ranged from 1.93 mSv to 3.32 mSv with mean of 2.56 ± 0.51 mSv and 75th percentile of 3.11 mSv while the post-contrast effective dose ranged from 4.06 mSv to 6.97 mSv with mean of 5.27 ± 0.97 mSv and 75th percentile of 6.13 mSv. The mean effective dose from this work and two other isolated studies was 3.0 mSv. Conclusion: Although our quantified doses are below threshold limits for occupational exposures they are higher than the recommended level for the public. A further optimization of scanning protocols by the radiographers could lower the effective dose for patients undergoing contrast head computed tomography in our centre and in the country.

Estimation of the Lyman-α signal of the EFILE diagnostic under static or radiofrequency electric field in vacuum

The electric field induced Lyman-a emission diagnostic aims to provide a non intrusive and precise measurement of the electric field in plasma, using a beam of hydrogen atoms prepared in the metastable 2s state. The metastable particles are obtained by means of a proton beam extracted from a hydrogen plasma source, and neutralised by interaction with vaporised caesium. When a 2s atom enters a region where an electric field is present, it undergoes a transition to the 2p state （Stark mixing）. It then quickly decays to the ground level, emitting Lyman-a radiation, which is collected by a photomultiplier. The 2s → 2p transition rate is proportional to the square of the magnitude of the electric field, and depends on the field oscillation frequency （with peaks around l GHz）. By measuring the intensity of the Lyman-a radiation emitted by the beam it is possible to determine the magnitude of the field in a defined region. In this work, an analysis of the behaviour of the diagnostic under static or radiofrequency electric field is presented. Electric field simulations obtained with a finite element solver of Maxwell equations, combined with theoretical calculations of the Stark mixing transition rate, are used to develop a model for the interpretation of photomultiplier data. This method shows good agreement with experimental results for the static field case, and allows to measure the field magnitude for the oscillating case.

断点回归方法及应用实现

目的完整、系统介绍断点回归设计(RDD)原理及统计方法,为其在公共卫生领域应用提供参考。方法在介绍断点回归设计原理基础上,用室内甲醛干预的实例演示了利用Stata软件实现断点回归统计方法的过程,介绍和比较属于参数法的多项式回归和属于非参数法的局部线性回归的分析方法和结果。结果RDD是一种准实验设计,对研究对象没有随机分组,而是选择一个与干预措施有关的变量,根据该变量的取值选择切点划分干预组和对照组。RDD在内部有效性方面优于其他准实验设计,但外部有效性受到一定限制。基于观察性资料的RDD不仅可控制可观测的混杂因素,还可控制无法观测的混杂因素,也更符合伦理道德。在本文实例中,多项式回归和局部线性回归两种分析方法的结果基本一致。结论RDD在公共卫生领域的真实世界研究中有广阔的应用前景,为科学评估干预政策和提供高质量决策依据提供新的思路和方法。

基于慕课的混合式教学模式在心电图教学中的应用

目的探索基于慕课的混合式教学模式在心电图教学中的应用效果。方法选择2021年3—7月暨南大学第一临床医学院2018级临床医学专业本科生为研究对象,共91名。在诊断学心电图章节的教学中,采用以心电图慕课为基础的线上自学和线下面授课相结合的混合式教学模式,分析期末心电图理论和阅图考试成绩和问卷结果。结果理论和阅图成绩分别为(21.00±3.89)分和(19.33±4.63)分。理论考试中,一些心电图基础知识的准确率低于50%,仅有50%的学生能识别心室颤动。阅图考试结果显示,大部分图形节律、心率等基本参数的准确率较高,可达90%以上,而心电图结论的准确率均较低。超过75%的学生认为心电图慕课对学习心电图有很大帮助,阅图训练的15个问题可以帮助理清心电图分析思路;83.15%的学生认为基本掌握了心电图分析要点,8.99%的学生是熟练掌握。结论基于慕课的混合式教学模式对学生掌握心电图分析要点很有帮助,学生对心电图基本参数掌握较好,对于异常心电图特征的记忆和分析有待加强。

经阴道联合经腹部超声检查诊断异位妊娠效果

目的:分析经阴道超声、经腹部超声及联合检测对异位妊娠临床诊断价值。方法:选取本院2020年6月-2023年6月收治的110例疑似异位妊娠患者临床资料,均接受病理检查、行经阴道超声和经腹部超声检测。对比不同超声方式检测诊断结果,不同超声检测对不同类型异位妊娠诊断符合率,不同超声检测的图像特征;受试者工作特征曲线(ROC)分析不同超声方式检测对异位妊娠诊断价值。结果:6例失访,最终104例参与研究,其中病理诊断阳性95例,阴性9例;经阴道超声阳性检出率为75.8%,阴性检出率为22.2%;经腹部超声阳性检出率为77.9%,阴性检出率为22.2%;两种超声方式联合检测阳性检出率89.5%,阴性检出率88.9%,联合检测阳性、阴性检出率高于经阴道超声和经腹部超声检测(均P<0.05);与经阴道超声和经腹部超声检测相比,联合检测对不同类型异位妊娠的诊断符合率提升,对附件包块、宫内假孕囊、盆腔积液、心管搏动、胎芽、胎心和卵黄囊检出率提升(P<0.05);联合检测诊断异位妊娠的曲线下面积(AUC)为0.892,高于经阴道超声检测的AUC(0.510)和经腹部超声检测的AUC(0.501)(P<0.05)。结论:经阴道超声和经腹部超声联合检测诊断异位妊娠效能提高。

考虑互补效应的城市群多模式客运网络鲁棒性

为了分析城市群客运网络对突发事件的应对能力,从多种交通模式互补视角,基于复杂网络理论构建城市群多模式客运网络模型,应用引力模型建立节点失效后网络性能计算的规则,对城市群多模式客运网络的鲁棒性进行测度.引入基于鲁棒性的动态互补强度指标,对客运网络间的互补效应(CE)进行量化.对是否考虑CE时的鲁棒性进行对比,分析CE对鲁棒性的提升程度.以关中平原城市群为例进行实例研究,结果表明,在城市群多模式客运网络中,普铁网应对突发事件时的鲁棒性最强,公路网最弱.无论在何种攻击策略下,考虑CE时,城市群多模式客运网络的鲁棒性均有明显的提升,高铁网、普铁网和公路网的敏感度分别下降了19.1%、29.3%和22.0%.

北京医院体外诊断试剂基于绩效管理的全流程闭环管理设计和效果评估

目的构建体外诊断试剂(in vitro diagnostic reagents,IVD reagent)全流程闭环管理方案并实施,优化IVD管理工作。方法基于北京医院IVD管理现状,设计IVD全流程闭环管理方案,包括IVD申请、IVD遴选、IVD申购、IVD采购、IVD领取、IVD入出库和IVD使用等环节。选择关键指标建立评估框架,运用访谈法、查阅相关信息系统的方法收集和统计方案实施前(2020年)和实施后(2023年)的管理数据、采购数据和检测数据,对流程管理、质量管理和成本管理进行评估。结果优化了管理流程,IVD申购时间平均缩短了约60%,IVD采购无需人工处理,实时拆分订单并发送至对应的供应商,IVD领取时间平均缩短了约75%;IVD和检测质量管理满意,供货商资质完善度达到100%,室间质评得到满分,无IVD相关不良事件;成本管理有效,IVD采购成本降低了约15%,分别建立了人免疫缺陷病毒抗体测定、丙型肝炎抗体测定、梅毒螺旋体抗体测定和乙型肝炎表面抗原定量测定四个项目的IVD成本精细化管理模型,IVD损耗的平均值为0.07%~1.21%,标准差为0.07%~0.66%。结论IVD全流程闭环管理方案切实可行,提高了IVD管理工作效率,保证了IVD质量和检测质量,降低了IVD成本,细化了成本管理工作。

“双一流”学科建设成效评价方法:从学科监测到学科分析

“双一流”学科建设将学科监测作为其建设成效的主要评价方法,具备常态化、数据密集型等特点和优势。为进一步明确院系作为建设单位的主体责任和自主性,需要加强监测与评估的一体化,突出评价方法的问题导向和需求导向。“双一流”学科建设成效评价方法从学科监测到学科分析的优化路径是:在教育部层面改革顶层设计,在高校层面下沉资源配置,在院系层面强化组织能力。

MRI动态增强与扩散加权成像在乳腺癌诊断中的影像特点及效能分析

目的:针对MRI动态增强(DCE-MRI)与扩散加权成像(DWI)在乳腺癌诊断中的影像特点及效能进行分析。方法:本研究所选取的60例研究对象源于2021年2月至2023年1月本院收治的乳腺病变患者,均接受DWI、DCE-MRI和病理检查。记录并比较DWI、DCE-MRI及二者联合检查的检出结果、诊断效能,并对典型病例图片进行分析。结果:60例乳腺病变患者通过病理检查共检出47例恶性病变、13例良性病变。DWI、DCE-MRI单独及联合诊断乳腺恶性和良性病变分别26例、28例、43例和2例、1例、11例;二者联合检查下的特异度、灵敏度、准确度分别为84.62%、91.49%、90.00%,较DWI、DCE-MRI单独检查均处于较高水平,数据结果存在显著差异(P<0.05)。结论:DWI、DCE-MRI联合检查可显著提高对乳腺癌的诊断效能,存在较高的应用价值,值得广泛应用与推广。

核磁共振联合多模态超声检查鉴别诊断乳腺肿瘤良恶性的临床价值

目的探讨核磁共振(MRI)联合多模态超声在乳腺肿瘤良恶性中的鉴别诊断效能。方法选取92例女性乳腺占位性病变患者为研究对象。对所有患者施行MRI与多模态超声检查,以病理检查结果为“金标准”,探究MRI+多模态超声联合检查对诊断乳腺肿瘤良恶性的应用价值。结果92例乳腺占位性病变患者经病理检查证实为恶性有31例(33.70%),良性有61例(66.30%);MRI联合多模态超声共检查出30例为恶性,MRI共检查出25例为恶性,而多模态超声共检查出23例为恶性;MRI联合多模态超声检查在鉴别诊断乳腺肿瘤良恶性的灵敏度[93.55%(29/31)]、准确度[96.74%(89/92)]、阴性预测值[96.77%(60/62)]高于MRI、多模态超声单独检查,差异有统计学意义(P<0.05);MRI、多模态超声单独及联合检查的特异度、阳性预测值相比,差异无统计学意义(P>0.05)。kappa检验显示:MRI联合多模态超声检查结果与“金标准”的一致性极好(kappa值=0.926,P=0.000);MRI与多模态超声单独检查与“金标准”的一致性较为理想(kappa值=0.636、0.642,P=0.000、0.000)。结论MRI联合多模态超声鉴别诊断乳腺肿瘤良恶性的效果显著,可有效提高恶性肿瘤诊断灵敏度与准确度,临床应用价值较高,值得大力推行。

Bakri球囊治疗胎盘植入产妇自然分娩严重大出血的临床结局

目的:探究Bakri球囊治疗胎盘植入产妇自然分娩产后严重大出血的临床结局。方法:连续收集2016年01月至2020年12月期间在某院自然分娩产后严重大出血产妇170例,所有产妇均给予Bakri球囊止血。收集基线和围产期结局指标,并比较Bakri球囊止血失败和成功产妇、胎盘植入与非胎盘植入产妇的临床围产期结局。结果:在纳入的所有自然分娩产后严重大出血患者中,胎盘植入产妇占比达51.8%(88/170),Bakri球囊止血成功率为87.65%(149/170);而胎盘植入患者止血有效率显著低于非胎盘植入患者(χ^(2)=5.73;P=0.017)。与止血失败患者相比,止血成功组填塞术前出血量、填塞术后出血量较低,而填塞术间隔时间、球囊置留时间较长(均P<0.05)。与非胎盘植入患者相比,胎盘植入组患者在球囊填塞术前出血量、球囊生理盐水量较高;而分娩至填塞术间隔时间较短(均P<0.05)。结论:胎盘植入是引起自然分娩产后严重大出血的主要原因。Bakri球囊在胎盘植入患者止血效果稍逊于非胎盘植入患者,但分娩后及早、精准地使用Bakri球囊可能有利于胎盘植入患者止血。

增强乳腺X线摄影和超声对致密型乳腺良恶性病变的诊断效能对比分析

目的:探讨增强乳腺X线摄影(CEM)与彩色多普勒超声对致密型乳腺良恶性病变的诊断价值。方法:回顾性分析2019年10月至2021年08月我院临床怀疑乳腺病变的105例致密型乳腺患者资料。所有患者均行乳腺CEM、超声检查。以手术病理结果为“金标准”,采用Z检验绘制受试者工作特征(receiver operating characteristic,ROC)曲线,计算曲线下面积(area under curve,AUC),采用χ^(2)检验,比较两种单独检查和联合诊断致密型乳腺良恶性病变的诊断效能。结果:105例致密型乳腺患者中,经病理诊断确诊恶性肿瘤48例,良性57例。CEM、超声、联合检查诊断乳腺癌的敏感度分别为87.50%、87.50%、97.92%,特异度分别为77.19%、78.95%、85.96%,准确度分别为81.90%、82.86%、91.43%。CEM、超声及联合检查在诊断致密型乳腺良恶性疾病的敏感度、特异度、准确率、阳性预测值、阴性预测值方面比较,差异无统计学意义(P> 0.05)。两两比较,联合检查敏感度高于CEM、超声单项检查,联合检查准确度及阴性预测值均高于CEM单项检查,差异均具有统计学意义(P均<0.05)。CEM、超声、联合诊断对致密型乳腺中乳腺癌的AUC分别为0.823、0.832、0.919。两两比较,CEM与超声比较,差异无统计学意义(P> 0.05),CEM、超声分别与联合检查比较,差异具有统计学意义(P均<0.05)。不同乳腺腺体组织分类比较:CEM、超声诊断乳腺疾病敏感度、特异度在不均匀致密型中均明显高于极度致密型,差异具有显著统计学意义(P均<0.05)。结论:CEM在致密型乳腺良恶性疾病诊断中与超声均具有较高的诊断效能,CEM联合超声检查可提高敏感度、特异度及准确率,有助于致密型乳腺疾病的临床诊断。

3.0 T磁共振DWIBS技术在淋巴瘤诊断中的应用价值

目的重点观察3.0 T磁共振全身背景信号抑制弥散加权成像(DWIBS)技术在淋巴瘤患者诊断中的效能分析,以期提高临床淋巴瘤检出率。方法回顾性分析,采集医院2020年1月至2022年12月收治的100例淋巴瘤患者的基线资料,入组患者均行术中快速病理检查与3.0 T磁共振DWIBS技术检查,将术中快速病理检查作为金标准,分析3.0 T磁共振DWIBS技术的诊断效能。结果纳入对象经病理检出,结内病灶72例,占比72.00%,结外病灶28例,占比28.00%。诊断结内病灶效能:阳性检出率69.00%,敏感度90.28%,特异度85.71%,准确度89.00%,将术中快速病理结果作为金标准,3.0 T磁共振DWIBS检查结内病灶与金标准一致性检验K值=0.736(P<0.001)。诊断结外病灶效能:阳性检出率31.00%,敏感度92.86%,特异度93.06%,准确度93.00%,3.0 T磁共振DWIBS技术检查结外病灶与金标准一致性检验K值=0.832(P<0.001)。该技术诊断淋巴瘤结内病灶总准确率为75.00%,诊断淋巴瘤结外病灶总准确率为75.00%。结论3.0 T磁共振DWIBS技术可提高淋巴瘤及其分期检出率,针对临床高度疑似淋巴瘤患者,可通过采取3.0 T磁共振DWIBS技术,旨在提高临床淋巴瘤检出率。

肌骨超声诊断儿童闭合性胫腓骨远端骨折的临床价值

目的研究肌骨超声诊断在儿童闭合性胫腓骨远端骨折中的临床价值。方法前瞻性选取2021年3月至2023年5月入中国人民解放军南部战区总医院的80例急性踝关节外伤患儿为观察对象。所有患儿均进行肌骨超声、X线检查、多层螺旋CT检查,将多层螺旋CT检查结果作为临床诊断参考标准,分析并对比肌骨超声、X线以及二者联合检查在胫腓骨远端骨折中的诊断效果、骨折类型、骨折分型,总结儿童闭合性胫腓骨远端骨折肌骨超声的直接表现。结果80例急性踝关节外伤患儿中,多层螺旋CT诊断闭合性胫腓骨远端骨折患儿67例,非闭合性胫腓骨远端骨折13例。联合检查与多层螺旋CT检查结果趋于一致(Kappa=1.000),肌骨超声检查结果与多层螺旋CT检查结果一致性较好(Kappa=0.932),X线检查结果与多层螺旋CT检查结果一致性一般(Kappa=0.501)。联合检查的诊断效能明显最优,但单项检查中肌骨超声灵敏度、准确度优于X线检查。对67例确诊闭合性胫腓骨远端骨折患儿开展进一步骨折类型诊断,肌骨超声检出所有骨折,但存在1例误诊,X线检查存在17例误诊,肌骨超声准确度明显高于X线检查,差异有统计学意义(P<0.05)。67例闭合性胫腓骨远端骨骺骨折参考Salter-Harris分型诊断,结果显示肌骨超声与X线检查在分型诊断中差异无统计学意义(P>0.05)。闭合性胫腓骨远端骨折的肌骨超声直接表现为:骨骺板有增宽现象,连续的骨皮质存在中断现象,骨折部断端有轻微分离、移位情况,略宽的骨折线可渗入液体或者血肿,周围组织水肿,滑膜增厚。结论在儿童闭合性胫腓骨远端骨折的诊断中,相对于X线检查而言,肌骨超声诊断效能更高,但二者联合效果最佳。肌骨超声在骨折类型诊断中效果优越,可作为儿童闭合性胫腓骨远端骨折筛查的首选方式,但在区分骨折分型中只能作为辅助手段。

功能磁共振成像联合CT配合AI诊断系统鉴别诊断肺结节良恶性的价值观察

目的分析功能磁共振成像(MRI)联合CT配合人工智能(AI)诊断系统在肺结节良恶性中的诊断效能。方法选取2021年1月-2022年7月本院收治的60例肺结节患者,对所有患者行功能MRI、CT检查,并予以专业医师阅片诊断及AI诊断。以病理检查为金标准,分析功能MRI联合CT配合AI诊断系统在肺结节良恶性中的诊断效果。结果60例肺结节患者,经病理检查证实为恶性的有45例,良性的有15例;功能MRI联合CT配合AI诊断系统对恶性肺结节的检出率高于功能MRI联合CT,差异有统计学意义(P<0.05);功能MRI联合CT配合AI诊断系统检查的灵敏度为95.56%(43/45)、准确度为95.00%(43+14)/60,均高于功能MRI联合CT检查的80.00%(36/45)、81.67%(36+13)/60,差异有统计学意义(P<0.05);而两者的特异度相当,差异无统计学意义(P>0.05)。kappa检验显示:功能MRI联合CT配合AI诊断系统的检查结果与“金标准”检查结果的一致性较为理想(kappa值=0.822,P=0.000)。结论功能MRI联合CT配合AI诊断系统在肺结节良恶性的诊断中效能显著,可有效诊断出恶性肺结节,为临床医师提供可靠的参考信息,进而做到及时治疗,改善患者预后。

FN1、PROS1在甲状腺乳头状癌合并桥本甲状腺炎中的表达意义

目的探讨FN1、PROS1在甲状腺乳头状癌(PTC)合并桥本甲状腺炎(HT)中的表达意义。方法应用免疫组化方法检测FN1、PROS1在114例PTC合并HT组织与81例仅为HT组织中表达情况、临床病理特征关系及二者表达相关性。采用受试者工作特性(ROC)曲线分析FN1、PROS1及二者联合对合并HT的PTC诊断价值。结果在合并HT的PTC组织中,FN1、PROS1表达阳性率显著高于HT组织(P<0.001)。FN1、PROS1表达均与淋巴结转移相关(均P<0.05)。Spearman分析结果示,在合并HT的PTC组织中FN1、PROS1表达水平成正相关(r=0.398,P<0.001)。ROC曲线分析显示,FN1、PROS1及二者联合检测合并HT的PTC敏感度分别为95.06%、88.89%和90.12%,特异度分别为91.23%、92.11%和95.61%。结论FN1、PROS1在合并HT的PTC组织中高表达,且阳性表达与淋巴结转移有关,对合并HT的PTC具有较高的辅助诊断价值。

DCE-MRI辅以DWI对直肠癌患者术前分期的诊断价值

目的探究DCE-MRI辅以DWI对直肠癌患者术前分期的诊断价值。方法对155例直肠癌患者实施DCE-MRI辅以DWI诊断,分析其对术前分期的诊断效果。结果将手术病理检查结果作为诊断金标准,DWI、DCE-MRI以及DWI+DCE-MRI术前分期诊断符合率分别为73.55%、74.84%、96.13%,组间相比,差异有统计学意义(P<0.05)。在不同分期DCE-MR参数中,N_(0)期K^(trams)、K_(ep)、V_(e)值和N_(1)~N_(2)期相比较小,差异有统计学意义(P<0.05);T_(1)~T_(2)期K^(trams)、K_(ep)、V_(e)值与T_(3)~T_(4)期相比较小,差异有统计学意义(P<0.05)。结论DCE-MRI辅以DWI对直肠癌患者术前分期的诊断效果显著,能够提高患者治愈率,值得研究和推广。