1.Logistic regression analysis of multi-mode ultrasonography in the diagnosis of thyroid carcinoma
Zhenpeng, LENG ; Jingchun, YANG ; Huijuan, MA ; Jia, MA ; Meijie, REN ; Ying, CHANG ; Hua, KANG ; Lianghong, TENG
Chinese Journal of Medical Ultrasound (Electronic Edition) 2016;13(12):918-924
Objective To evaluate the diagnostic value of gray-scale ultrasonography (GSU) combined with contrast-enhanced ultrasonography (CEUS) and real-time elastography imaging (EI) in solid thyroid nodules.Methods A total of 124 solid nodules were collected from Xuanwu Hospital of Capital Medical University from September 2011 to November 2014, including 49 benign nodules and 75 malignant nodules conifrmed by surgical pathology. The data of multimodal imaging were retrospectively analyzed and compared with the pathological results. The parameters among the groups were compared byχ2 test. Four diagnostic models including the statistically signiifcant independent variables were established accord to different combinations of routine ultrasound examination. The binary Logistic regression equation using the pathological results as the dependent variable Y and the ultrasound features of thyroid nodules as independent variableX was established for calculating the area under the receiver operator curve (ROC) and multiple regression analysis furthermore.Results There were statistically significant differences in aspect ratio, margin condition, echo type, CEUS features, elastic imaging score and elastic strain rate of benign and malignant thyroid nodules(χ2=13.966, 7.106, 24.215, 17.250 and 27.158,P<0.05).The four Logistic regression models were statistically signiifcant (χ2=5.37, 5.37, 8.155, 8.155, allP<0.05). By using modelⅠ,Ⅱ,Ⅲ andⅣ, the diagnostic sensitivity, speciifcity and accuracy of malignant nodules were (73.8%, 75.9%, 79.7%, 83.3%), (67.5%, 70.7%, 85.2%, 86.7%), and (71.8%, 74.2% 81.8%, 84.4%) respectively. The area under the ROC of logistic equation predicted values were (0.778, 0.809, 0.875 and 0.898, allP<0.01). Multivariate categorical analysis showed that aspect ratio, margin condition and the elastic strain rate ratio (χ2=13.73, 7.541 and 11.461, allP<0.05) of thyroid nodules were effective diagnostic indicators. Conclusions Our study indicated that CEUS and EI could be helpful modality for GSU to improve the diagnostic accuracy of thyroid nodules. The combined application of multi mode ultrasound examination has a high diagnostic value.
2.Value of contrast enhanced ultrasound combined with elastography in differential diagnosis of thyroid imaging reporting and data system 4 thyroid nodules
Huijuan, MA ; Jingchun, YANG ; Zhenpeng, LENG ; Jia, MA ; Hua, KANG ; Lianghong, TENG
Chinese Journal of Medical Ultrasound (Electronic Edition) 2016;13(12):911-917
Objective To assess the diagnostic value of contrast enhanced ultrasound (CEUS),elastography and their combined use in diagnosing thyroid nodules of thyroid imaging reporting and data system (TI-RADS) 4. Methods From November 2011 to August 2016, 159 TI-RADS 4 nodules diagnosed by conventional ultrasound were prospectively enrolled and examined by CEUS and elastography before surgery. Multivariate logistic regression models were established for CEUS and CEUS combined with elastography to diagnose thyroid malignancy. The diagnostic performances of CEUS, elastography and their combined use were evaluated with the receiver operating characteristic (ROC) curve. The sensitivity,specificity, accuracy, positive predictive value, negative predictive value and omission diagnostic rate of CEUS, elastography and their combined use were compared by Chi-square test. Results The CEUS features significantly predicting malignancy were heterogeneous enhancement, hypoenhancement, without or incomplete ring-enhancement and later time to peak than the surrounding parenchyma (χ2=24.378, 69.194,29.434 and 7.375, all P < 0.01). Furthermore, the multivariate logistic regression for CEUS combined with elastography showed that heterogeneous enhancement, ring enhancement and elasticity score were the independent predictors of thyroid malignancy. The area under the ROC curve of CEUS combined with elastography was (0.921±0.023) which was higher than that of CEUS and elatography (0.88±0.029 and 0.80±0.038, respectively; both P < 0.05). Moreover, the sensitivity, accuracy and negative predictive value of CEUS combined with elastography were 92.1%, 86.2% and 84.6%, respectively. The omission diagnostic rate of CEUS combined with elastography (7.9%) was reduced. And the diagnostic accuracy of CEUS combined with elastography was significantly higher than that of CEUS and elastography (P < 0.05). While the diagnostic accuracy of CEUS was close to the elastography, the difference was not statistically significant (P > 0.05). Conclusion The diagnostic value of CEUS combined with elastography was remarkably significant in the differential diagnosis of TI-RADS 4 nodules.
3.Identification of Epmedii Folium and its counterfeit leaf of Quercus variabilis.
Shuai KANG ; Chao ZHOU ; Yi HE ; Ji ZHANG ; Ai-hua WEI ; Jing LU ; Shuang-cheng MA
China Journal of Chinese Materia Medica 2015;40(9):1676-1680
Epmedii Folium is a commonly used traditional Chinese drug, and is beneficial for the "liver" and "kidney" s function in Chinese medicine. Recently, the origin of this drug is more complex. Most of the identification studies are emphasized on the species certified by the pharmacopoeia and other related species from the same genus of Epimedium, but few was emphasized on the counterfeit. In this paper, one counterfeit of Epmedii Folium, identified as the dried leaf of Quercus variabilis (Fam. Fagaceae), has been reported based on field investigation, comparing specimen of Epmedii Folium and Q. variabilis,using the macroscopic, microscopic and TmC methods. It is resulted that they could be identified clearly not only by the macroscopic features, such as the vein character and the tooth apex, but also by the microscopic features, such as the vascular bundles of the midrib, the non-glandular hair, the anticlinal wall of the epidermis cell and the calcium oxalate crystal. Furthermore their TLC chromatograms showed also difference. This study will give reference for the identification of Epmedii Folium and the related supervision and inspection work.
China
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Discriminant Analysis
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Epimedium
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anatomy & histology
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chemistry
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Plant Leaves
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anatomy & histology
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chemistry
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Plants, Medicinal
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anatomy & histology
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chemistry
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Quercus
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anatomy & histology
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chemistry
4.Study on in vitro metabolic rate and metabolites or 9-dehydro-17-dehydro-andrographolide.
Jun SHAO ; Wei-kang CHEN ; Dong-kun ZHENG ; Shuang-cheng MA ; Yue-hua LUO
China Journal of Chinese Materia Medica 2015;40(5):971-977
To investigate the metabolic rate and metabolites of 9-dehydro-17-dehydro-andrographolide, which is the main active ingredient in Xiyanping injection, by using the in vitro rat liver microsome incubation system. 9-dehydro-17-dehydro-andrographolide was incubated together with liver microsome mixed with NADPH. Its metabolic rate was studied by determining its residual concentrations with the UHPLC-MS/MS method; Its metabolites were identified by the UPLC-TOF-MS(E) method. The results showed that 9-dehydro-17-dehydro-andrographolide was metabolized faster than rat liver microsomes mixed with coenzymes, with t½ and CL of (19.7 ± 0.5) min and (35.1 ± 0.8) mL x min(-1) x g(-1) (protein), respectively. Based on the high resolution mass spectrum data and information from literatures, altogether nine metabolites of 9-dehydro-17-dehydro-andrographolide were identified in the incubation system, particularly hydroxylated and dehydrogenized products. The results of identification would provide a basis for screening out more active andrographolide derivatives.
Animals
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Chromatography, High Pressure Liquid
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Diterpenes
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chemistry
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metabolism
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Drugs, Chinese Herbal
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chemistry
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metabolism
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Microsomes, Liver
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chemistry
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metabolism
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Molecular Structure
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Rats
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Tandem Mass Spectrometry
5.Effect of cattle encephalon glycoside and ignotin injection on brain protection in rats with traumatic brain injury
Liang TAN ; Kang MA ; Rongwei LI ; Jun TANG ; Qianwei CHEN ; Xin LIU ; Hua FENG
Chinese Journal of Trauma 2015;31(12):1118-1123
Objective To investigate the neuroprotective effect of cattle encephalon glycoside and ignotin injection on the rat model of traumatic brain injury (TBI).Methods Three hundred and six SD rats were randomly divided into sham group,TBI group,high dose group,middle dose group and low dose group according to the random number table.Rats received 1.8,0.6 and 0.2 ml/kg of cattle encephalon glycoside and ignotin injection for 28 days in high,middle and low dose groups,respectively.TBI was induced by the modified Feeney' s weight-drop method.Rat mortality,neurological function score and learning and memory ability were recorded.Brain morphological changes were evaluated with 7.0 T small animal nuclear magnetic resonance and HE staining.Evans blue was applied to assess blood brain barrier (BBB) permeability and hydrocephalus was evaluated by the brain water content.Results Mortality in high dose group decreased significantly compared to that in TBI group (22.40% vs.28.14%,P < 0.05).Defects in neurological function and learning and memory induced by TBI were significantly mitigated in middle and high dose groups (P < 0.05).Pathological damage and contralateral hippocampal atrophy in middle and high dose groups were reduced significantly compared to TBI group (P < 0.05).Hippocampus neuroapoptosis in middle and high dose groups was significantly improved compared to TBI group (P < 0.05).BBB damage was less severe in middle and high dose groups than in TBI group (P < 0.05).The treatment was preventive against secondary hydrocephalus.Conclusion Middle or high dose cattle encephalon glycoside and ignotin injection over a 28-day period has significant neuroprotective effect on the TBI rats.
6.Serum metabolic profiling and screening of characteristic metabolites before and after partial hepatectomy for HBV-related liver cancer
Li ZHANG ; Yanan MA ; Lei ZHANG ; Yufan WANG ; Jing WU ; Ya HUANG ; Hua KANG ; Shuye LIU
Chinese Journal of Hepatobiliary Surgery 2013;(2):81-87
Objectives To investigate the characteristics of changes in serum metabolic profile before and after resection of carcinoma tissues to establish a disease distinguishing model,to analyze the changing trend of characteristic metabolites,and to determine the molecular mechanism and potential clinical value of characteristic metabolic markers for HBV-related liver cancer.Methods Ultraperformance liquid chromatography-mass spectrometry (UPLC-MS) was used to analyze the serum metabolites of 15 patients with hepatocellular carcinoma (HCC) before and after partial hepatectomy and on 25 healthy volunteers.The pattern recognition method and nonparametric test analyzes were used to analyze the data and to identify the specific metabolites and their changes after resection of carcinoma tissues.Results We established the principal component analysis (PCA) and orthogonal partial least squares-discriminant analysis (OPLS-DA) disease distinguishing model for HCC patients before and after operation as against the healthy volunteers.To distinguish between the liver cancer group and the normal control group,27 characteristic metabolites were selected from the patients before and after resection of carcinoma tissues.Eight moved towards the normal control after resection of carcinoma tissues.This indicated that liver carcinoma was an important impacting factor for these metabolites.Finally,7 metabolites were identified,and these metabolites had high diagnostic value as shown on ROC curves.Conclusions Through serum metabolic profiling of patients before and after resection of carcinoma tissues,a high correlation between metabolism and hepatocellular carcinoma was found.Researches on endogenous metabolites and pathways in liver diseases will provide a better understanding of the molecular mechanisms and provide further directions for clinical diagnosis and treatment.
7.Effect of Hexue mingmu tablets in the treatment of hyphema
Hai-Fang, ZHANG ; Jie, KANG ; Qing-Min, MA ; Zhi-Hua, ZHAO ; Zhi-Yang, JIA
International Eye Science 2014;(9):1710-1712
To evaluate the effect of Hexue mingmu tablets on traumatic hyphema caused by blunt ocular trauma.
●METHODS: Totally 150 patients of traumatic hyphema were divided into seven types by using ultrasound biomicroscopy combining with anterior segment abnormalities, each type was randomly classified as trial group and control group. The trial group was administered Hexue mingmu tablets, control group was treated by hemocoagulase.
●RESULTS: The absorbing time of trial group was shorter than that of the control group. And there was statistical significance between the two groups (P<0. 05).
● CONCLUSlON: Hexue mingmu tablets is an effective medicine to treat traumatic hyphema. Ultrasound biomicroscopy can be used as a routine examination method in traumatic hyphema.
8.Current situation and analysis of influencing factors of telephone cardiopulmonary resuscitation in China
Kang ZHENG ; Xiaodan LI ; Junhong WANG ; Hua ZHANG ; Jinjun ZHANG ; Qingbian MA
Chinese Journal of Emergency Medicine 2021;30(1):37-42
Objective:To investigate the current situation of telephone cardiopulmonary resuscitation (T-CPR) in China, and analyze the reasons for the low implementation rate of T-CPR.Methods:This was a multicenter cross-sectional survey. Twenty cities were selected from six geographical regions of China by convenient sampling method. Anonymous online electronic questionnaires were sent to emergency medical service staffs in each city. All respondents were divided into the routine T-CPR group and control group. Student's t test and Chi-square test were used to analyze the difference between groups. Multivariate logistic regression was used to analyze the influencing factors of T-CPR. Results:⑴A total of 1 191 questionnaires were collected. 80.94% of respondents knew T-CPR. Nine hundred and sixty respondents, who knew T-CPR and completed the questionnaires, were included in the study, and were divided into the routine T-CPR group ( n=401) and control group ( n=559). Nine hundred and thirty-nine (97.81%) responders believed that T-CPR should be implemented for cardiac arrest patients that could be confirmed by telephone.⑵Four hundred and one (41.77%) responders routinely implemented T-CPR. Among them, 237 (24.68%) responders always did and 164 (17.08%) responders often did. ⑶Multivariate logistic regression analysis showed that male ( OR=1.787, 95% CI: 1.235-2.587, P=0.002), age ( OR=1.025, 95% CI: 1.004-1.047, P=0.020), clinical medicine background ( OR=2.926, 95% CI: 1.387-6.171, P =0.005), dispatcher ( OR=5.305, 95% CI: 3.463-8.126, P<0.01), using medical priority dispatch system (MPDS) system ( OR=1.941, 95% CI: 1.418-2.656, P<0.01), and T-CPR policy or procedure ( OR=3.879, 95% CI: 2.652-5.674, P<0.01) were favorable factors for T-CPR. ⑷The top three reasons for implementing T-CPR in the routine T-CPR group were that they had received T-CPR training (67.08%), believed that T-CPR could improve survival rate (63.59%), and had standard T-CPR process (63.09%). The top three reasons for not implementing T-CPR in the control group were that worrying about bystander compliance (42.04%), worrying about the quality of bystander cardiopulmonary resuscitation (CPR) (38.28%), and worrying about medical dispute (36.14%). Conclusions:The awareness and implementation of T-CPR among emergency medical service staffs need to be improved. The implementation of T-CPR depend on telephone dispatchers with clinical medicine background, clear T-CPR policy, standardized operation procedure, and professional assistant tools. To improve the public's awareness of cardiac arrest and cardiopulmonary resuscitation, and to improve the supporting legal system are also conducive to the implementation of T-CPR.
9.Study on HPLC fingerprint of Callicarpa nudiflora and determination of ten components.
Dong-kun ZHENG ; Wei-kang CHEN ; Shuang-cheng MA ; Jie WANG ; Chen-xuan LUO ; Yue-hua LUO
China Journal of Chinese Materia Medica 2015;40(9):1776-1782
This study is to establish the HPLC fingerprint and determine eight components of Callicarpa nudiflora, and provide a scientific basis for the identification and quality control. The Waters sunfire C18 column (4.6 mm x 250 mm, 5 µm) was used and the detection wavelength was 330 nm . The column temperature was 30 °C. The mobile phases were acetonitrile (A) and 0.1% formic acid (B) eluting in a gradient program at a flow rate of 1.0 mL · min(-1). The chromatographic fingerprint similarity evaluation system for tradition Chinese medicine(2012) was used for analysis. C. nudiflora from different samples were of high similarity in fingerprint and the separation of ten components was good. There was an obvious difference between other samples and C. nudiflora leaves. In quantitative analysis, the ten components showed good regression(R2 > 0 999 0) with linear ranges, and their recoveries were in the range of 96.0%-105.0%. The established qualitative and quantitative methods are highly specific, simple and accurate, which can be used for the identification and quality control of C. nudiflora.
Callicarpa
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chemistry
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Chromatography, High Pressure Liquid
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methods
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Drugs, Chinese Herbal
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analysis
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isolation & purification
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Plants, Medicinal
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chemistry
10.Efficacy analysis of comprehensive treatment in small cell esophageal carcinoma following resection.
Xiao-zheng KANG ; Shao-hua MA ; Zhen LIANG ; Ke-neng CHEN
Chinese Journal of Gastrointestinal Surgery 2012;15(6):611-614
OBJECTIVETo summarize the surgical outcome of patients with small cell esophageal carcinoma(SCEC).
METHODSClinical data of patients with esophageal carcinoma were retrospectively collected from March 2000 to March 2011 at the Thoracic Surgery Department of the Peking University Cancer Hospital. Data included tumor characteristics, staging, treatment, response, short-term outcome, and long-term survival.
RESULTSA total of 546 patients with esophageal carcinoma were identified, among whom there were 15 patients with SCEC(2.7%). Fourteen cases received multimodality treatment based on operation and one underwent operation alone. Four patients had preoperative chemotherapy and 10 had postoperative chemotherapy. Four patients had postoperative radiation. After excluding one case of postoperative death within 3 months, the median overall survival was 14.3 months(range, 4 to 99 months), significantly worse than those with non-SCEC(42.2 months, P<0.05).
CONCLUSIONSCEC is rare and the outcomes are poor. It should be considered as a systematic disease.
Adult ; Aged ; Carcinoma, Small Cell ; surgery ; therapy ; Combined Modality Therapy ; Esophageal Neoplasms ; surgery ; therapy ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome