0.05),while the changes in the serum levels of AST and ALT in the recipients in of treatment group were obviously lower(P

BACKGROUND:Clinical resection of thoracolumbar spinal tumor has a great impact on the spinal stability. Positive internal fixation is required clinicaly in order to maintain the spinal stability. The use of titanium mesh implantation can provide a firm internal fixation folowing resection of tumors. OBJECTIVE:To explore the spinal stability undergoing titanium mesh implantation with internal fixation folowing thoracolumbar tumor resection. METHODS:Twenty-four patients with thoracolumbar tumor admitted at the Central Hospital of Suining City from September 2013 to September 2014 were randomly selected and given tumor resection folowed by titanium mesh implantation with internal fixation. After treatment, patients were folowed up for 1-12 months to observe and analyze the neural functional recovery and spinal stability of the patients. RESULTS AND CONCLUSION:Al the 24 patients successfuly completed the operation treatment, and there was no case of death at the end of folow-up. During the folow-up, patient's clinical symptoms and neural function were significantly relieved, and Frankel classification was significantly improved after treatment. Regular X-ray examination showed that there was no change in the position of titanium mesh and anterior internal fixation system. There was also no titanium mesh colapse, internal fixation fracture and loosening, and the spinal stability was stil excelent. These findings indicate that patients were not changed, and did not appear because the amount of loose, good spinal stability. Resection of thoracolumbar tumors showed that the thoracolumbar spinal reconstruction with titanium mesh implantation combined with internal fixation folowing tumor resection can obtain good clinical effect and excelent biocompatiblity.

Objective To summarise the perioperative features of orthotopic liver transplantations(OLTs) in miniature porcine,to establish mature、stable OLT models.Methods In order to observe hemodynamics and blood changes and improved perioperative management and summarise the perioperative characteristics,8 preliminary experiments(group A) and 18 experiments(group B) of OLTs were performed without veno-venous bypass(VVB) in Chinese inbred miniature porcine.Results The mean operation time was(179.6?14.3)min in our 18 OLTs,and the mean anhepatic phase time was(27.3?3.4)min.Dramatic hemodynamic and metabolic changes were identified during anhepatic phase.The oneweek survival rate was 88.9% in group B,but all the 8 pigs in group A died.The experiment group pigs urinated after 3～5hours and had normal diet after 3days.Conclusions Decreasing the operation time and stability of hemodynamics in anhepatic phase are the keys for success in OLTs without VVB.

Objective To observe whether hepatitis B vaccine enhance the treating effect of cyto-kine induced kill(CIK) cells on hepatitis B virus transgenic(HBV-Tg) mice. Methods The HBV-Tg mice were treated with CIK cells by peritoneal injection and hepatitis B vaccine by hypodermic injection. The HBV DNA level were tested by real-time PCR,T lymphocyte subgroup were detected by flow cytometry and the pathological diversify of hepatic tissue were observed by HE staining. Results The HBV DNA loading in peripheral blood of HBV-Tg mice decreased after CIK cells were treated and CD3~+ , CD4~+ and CD8~+ cells increased which were enhanced after CIK cells combined with hepatitis B vaccine. Conclusion Hepa-titis B vaccine enhanced the treating effect of CIK on HBV-Tg mice which may be implemented by increased the blood level of CD3~+, CD4~+ and CD8~+ cells, especially CD8~+ cells level.

Objective To investigate the biological effects of Wnt gene in kidney cancer Caki?2 cells. Methods The Wnt gene was silenced in kidney cancer Caki?2 cells by lentivirus vector. The cell proliferate ability of cells in each group were assayed by CCK?8 kit at different time points. The apoptosis of Caki?2 cells was observed after silencing Wnt gene by transmission electron microscope. The invasion ability of each group cells was tested using Transwell chambers. The genes expression changes of Wnt/β?catenin signaling pathway and apoptosis related gene were determined by realtime PCR. Results Compared with the other two groups,the cell proliferate ability of the cells after silencing Wntgene was suppressed,and the difference was statistically significant(P<0.05). Apoptosis increased significantly in shRNA+Caki?2+Wnt group cells with silencing of Wntgene, and apoptotic body appeared in these cells. In invasive experiment,the number of emigrated cells in shRNA+Caki?2+Wnt group were significantly lower than other groups(P<0.05). The expression of Wnt mRNA,β?catenin mRNA and Bcl?2 mRNA in shRNA+Caki?2+Wnt group cells was lower than other groups(P<0.05). Conclusion Silencing of Wnt gene of kidney cancer Caki?2 cells can affect the proliferation rate of the cells, promote the cell apoptosis,and inhibit the invasion ability,which provide certain theoretical basis for the research and development of new drugs and new therapeutic targets.

Objective:To evaluate the differential diagnostic efficacy of a predictive model of breast imaging reporting and data system (BI-RADS) classification combined with mammography radiomics classifier for various X-ray phenotype of breast lesions.Methods:A retrospective analysis was performed on 2 055 female patients who underwent mammography examination and were confirmed by pathology from May 2013 to August 2020 in Zhongda Hospital, Southeast University. Breast lesion was classified into mass or non-mass according to the fifth edition of BI-RADS. The mass was further divided into small mass (maximum diameter ≤ 2 cm) and large mass (maximum diameter>2 cm), the non-mass was further divided into asymmetric, calcification and structural distortions. By manually segmenting the region of interest of the lesion, the radiomics features were extracted and the model was constructed. Receiver operating characteristic curve and area under the curve (AUC) were used to assess the diagnostic efficacy of the BI-RADS classification, the radiomics model and the combined model for various phenotypes of breast lesions. Differences among the AUC were analyzed by the DeLong test.Results:The AUCs based on the BI-RADS classification, the radiomics model and the combined model were 0.924±0.006, 0.827±0.009 and 0.947±0.005 respectively. Compared with BI-RADS classification and the radiomics model, AUC of the combined model was the highest, and the differences were statistically significant ( Z=9.29, 14.94, P<0.001). For large mass, small mass and non-mass, combined model (AUC=0.958±0.007, 0.933±0.013, 0.939±0.008) showed the best performance when compared to the BI-RADS classification (AUC=0.937±0.010, 0.896±0.020, 0.916±0.011; Z=5.32, 3.90, 5.08, P<0.001) or the radiomics model (AUC=0.872±0.012, 0.851±0.021, 0.758±0.016; Z=7.86, 4.53, 12.13, P<0.001). The AUC of the combined model for benign and malignant asymmetric breast lesions (0.897±0.017) was higher than that of the BI-RADS classification (AUC=0.866±0.020, Z=4.27, P<0.001) and the radiomics model (AUC=0.633±0.029, Z=7.44, P<0.001); however, the AUC of the combined model for benign and malignant calcification and structural distortion of breast lesions (0.971±0.010, 0.811±0.057, respectively) was only higher than that of the radiomics model (AUC=0.827±0.021, 0.586±0.075, Z=7.40, 3.15, P<0.001), and there was no significant difference with the BI-RADS classification (AUC=0.959±0.012, 0.800±0.061, Z=1.87, 0.39, P>0.05). Conclusion:The combined model shows better differential diagnostic performance, which is valued in the clinical application.

BACKGROUND:With the rapid development of minimally invasive spinal surgery and enhanced recovery after surgery,endoscopic intervertebral fusion techniques have gradually emerged and been widely used in clinical practice in recent years. OBJECTIVE:To analyze the early clinical efficacy of uniaxial spinal endoscopic intervertebral fusion combined with posterior percutaneous pedicle screw fixation in the treatment of lumbar degenerative diseases. METHODS:135 patients with lumbar degenerative diseases treated by uniaxial spinal endoscopic intervertebral fusion combined with posterior percutaneous pedicle screw fixation in the Suining Central Hospital from October 2020 to December 2021 were enrolled in this study.There were 59 males and 76 females,aged 47-79 years.The lower limb and lumbar pain was evaluated by visual analog scale and lumbar function was assessed by Oswestry disability index before the operation,1 week,1,and 6 months after the operation,and at the end of follow-up.The overall pain recovery of patients was evaluated by the scoring criteria for low back pain surgery of Spine Group of Chinese Orthopedic Association and the lumbar physiological curvature and intervertebral fusion were evaluated on lumbar lateral X-ray preoperatively and at the end of follow-up. RESULTS AND CONCLUSION:(1)The 135 patients were followed up for(17.8±3.0)months after surgery.There was 1 case of endplate injury,1 case of cerebrospinal fluid leakage,1 case of nerve root injury,1 case of intervertebral cage subsidence and displacement,1 case of chronic infection,and 1 case of pedicle screw rupture.The complication rate was 5.2%.(2)The lumbar visual analog scale score and Oswestry disability index significantly decreased in the waist and lower limbs at various time points postoperatively compared with those preoperatively in 135 patients(P<0.05).The scoring criteria for low back pain surgery of the Spine Group of the Chinese Orthopedic Association were significantly better at the last follow-up than that preoperatively in 135 patients(P<0.05).(3)At the last follow-up,there was no significant difference in physiological curvature of lumbar vertebra as compared with that preoperatively in 135 patients(P>0.05),with a fusion rate of 95.8%.(4)It is concluded that uniaxial spinal endoscopic intervertebral fusion combined with posterior percutaneous pedicle screw fixation in the treatment of lumbar degenerative diseases has shown satisfactory early clinical results and is a highly safe minimally invasive spinal surgery mode.

Objective To evaluate the clinical and esophageal dynamics characteristics, and initial treatment effect of patients with untreated achalasia using high resolution manometry. Methods From January 2012 to June 2016, patients newly diagnosed with achalasia were retrospectively recruited. Clinical information, endoscopy and X-ray findings, manometric variables and treatment outcomes were collected and compared among manometric subtypes. Results Among 133 patients with achalasia, 32 ( 24. 0%) were classified as type Ⅰ, 84 ( 63. 2%) as typeⅡ and 17 ( 12. 8%) as typeⅢ. Compared with the typeⅢ, the symptom of regurgitation was more common in the types I and typeⅡachalasia patients ( P=0. 020) . While compared with the type Ⅰ, the score of chest pain was higher in the patients with type Ⅱ and type Ⅲ ( P=0. 006) , as well as the basal lower esophageal sphincter pressure ( P=0. 015, P=0. 023 for type Ⅱ and type Ⅲ, respectively) . Integrated relaxation pressure was similar among the 3 subtypes ( P=0. 158) . Forty-five and 47 patients received pneumatic dilation ( PD ) and peroral endoscopic myotomy ( POEM ) respectively, and all of the patients were followed-up for at least 6 months. The success rate was higher in the POEM group than that of the PD group in all the 3 manometric subtypes, but only the difference between POEM and PD in the type Ⅲ was statistically significant ( 90. 0% VS 40. 0%, P = 0. 041 ) . Conclusion The clinical characteristics and treatment response are different among the 3 achalasia subtypes. Patients with type Ⅲ achalasia are probably the best candidates for POEM.

Objective:To compare the efficacy of oral sulfate solution (OSS) and polyethylene glycol (PEG) electrolyte powder for colonoscopy bowel preparation.Methods:A total of 283 randomized patients from 9 centers in China taking OSS ( n=143) or PEG ( n=140) using two-day split bowel preparation regimen received colonoscopy and assessment. The primary index was the bowel preparation success rate [global Boston bowel preparation scale (BBPS)≥ 6 by independent assessment center]. Secondary indices included BBPS global and segmental scores, investigator satisfaction (5-point Likert scale) with the quality of bowel preparation, patient satisfaction assessed by questionnaires, and patient tolerance assessed by Sharma scale. Compliance and safety were compared between the two groups. Results:The bowel preparation success rates were 100.0% for OSS and 99.3% for PEG [adjusted difference 0.7% (95% CI: -5.3% - 6.7%), P<0.001 for non-inferiority]. The BBPS global score in OSS group was significantly higher than that in PEG group (8.1 VS 7.7, P<0.001). The segment BBPS scores were also higher in OSS group than those in PEG group for all 3 segments (right colon: 2.4 VS 2.3, P=0.002; transverse colon: 2.8 VS 2.7, P=0.018; left colon: 2.8 VS 2.7, P=0.007). Investigator Likert score in the OSS group was significantly higher than that in the PEG group (2.6 VS 2.3, P<0.001). There was no significant difference in compliance between OSS and PEG, except for the second dose (90.9% VS 82.6%, P=0.039). There was no significant difference in patient satisfaction, Sharma score or proportion of patients with tolerance-related symptoms between the two groups. Safety was comparable between the two groups, and all adverse events were mild to moderate. Conclusion:OSS has comparable efficacy with PEG, with higher BBPS scores in all segments, better investigator satisfaction, better compliance in split dose, and comparable patient tolerance and safety.

BACKGROUND: The detection of pulmonary nodules is a key step to achieving the early diagnosis and therapy of lung cancer. Deep learning based Artificial intelligence (AI) presents as the state of the art in the area of nodule detection, however, a validation with clinical data is necessary for further application. Therefore, the aim of this study is to evaluate the performance of AI in the detection of malignant and non-calcified nodules in chest CT. METHODS: Two hundred chest computed tomography (CT) data were randomly selected from a self-built nodule database from Tianjin Medical University General Hospital. Both the pathology confirmed lung cancers and the nodules in the process of follow-up were included. All CTs were processed by AI and the results were compared with that of radiologists retrieved from the original medical reports. The ground truths were further determined by two experienced radiologists. The size and characteristics of the nodules were evaluated as well. The sensitivity and false positive rate were used to evaluate the effectiveness of AI and radiologists in detecting nodules. The McNemar test was used to determine whether there was a significant difference. RESULTS: A total of 889 non-calcified nodules were determined by experts on chest CT, including 133 lung cancers. Of them, 442 nodules were less than 5 mm. The cancer detection rates of AI and radiologists are 100%. The sensitivity of AI on nodule detection was significantly higher than that of radiologists (99.1% vs 43%, P<0.001). The false-positive rate of AI was 4.9 per CT and decreased to 1.5 when nodules less than 5 mm were excluded. CONCLUSIONS AI achieves the detection of all malignancies and improve the sensitivity of pulmonary nodules detection beyond radiologists, with a low false positive rate after excluding small nodules.
Artificial Intelligence ; Deep Learning ; Humans ; Lung Neoplasms ; diagnosis ; diagnostic imaging ; Multiple Pulmonary Nodules ; diagnosis ; diagnostic imaging ; Tomography, X-Ray Computed