1.Synovial chondromatosis of the hip was misdiagnosed as rice body bursitis: a case report
Peng ZHANG ; Qinghe YE ; Kaikai LIU ; Hongxun ZHU
Chinese Journal of Orthopaedics 2023;43(6):399-403
This study shows a case of a patient with synovial chondromatosis of the hip misdiagnosed as rice body bursitis. The patient complained of pain and limited activity in his left hip. He was diagnosed with synovial chondromatosis of the hip by medical history, physical examination, imaging examination and postoperative pathology. Based on literature review, the characteristics and differential diagnosis of the disease in epidemiology, imaging and pathology were discussed in detail, so as to improve the understanding of the disease and avoid misdiagnosis. He was treated with hip arthroscopy and obtained satisfactory therapeutic effect. The patient was followed up for 1 year without recurrence.
2.Construction and internal validation of a predictive model for early acute kidney injury in patients with sepsis
Shan RONG ; Jiuhang YE ; Manchen ZHU ; Yanchun QIAN ; Fenfen ZHANG ; Guohai LI ; Lina ZHU ; Qinghe HU ; Cuiping HAO
Chinese Journal of Emergency Medicine 2023;32(9):1178-1183
Objective:To construct a nomogram model predicting the occurrence of acute kidney injury (AKI) in patients with sepsis in the intensive care unit (ICU), and to verify its validity for early prediction.Methods:Sepsis patients admitted to the ICU of the Affiliated Hospital of Jining Medical University from April 2015 to December 2021 were retrospectively included, and those who met the inclusion criteria were randomly divided into training and validation sets at a ratio of 7:3. Univariate and multivariate logistic regression models were used to identify independent risk factors for AKI in patients with sepsis, and a nomogram was constructed based on the independent risk factors. Calibration curve, receiver operating characteristic (ROC) curve, and decision curve analysis (DCA) were used to evaluate the nomogram model.Results:741 patients with sepsis were included in the study, 335 patients developed AKI within 7 d of ICU admission, with an AKI incidence of 45.1%. Randomization was performed in the training set ( n=519) and internal validation set ( n=222). Multivariate logistic analysis revealed that acute physiology and chronic health status score Ⅱ, sequential organ failure score, serum lactate, calcitoninogen, norepinephrine dose, urea nitrogen, and neutrophil percentage were independent factors influencing the occurrence of AKI, and a nomogram model was constructed by combining these variables. In the training set, the AUC of the nomogram model ROC was 0.875 (95% CI: 0.767-0.835), the calibration curve showed consistency between the predicted and actual probabilities, and the DCA showed a good net clinical benefit. In the internal validation set, the nomogram model had a similar predictive value for AKI (AUC=0.871, 95% CI: 0.734-0.854). Conclusions:A nomogram model constructed based on the critical care score at admission combined with inflammatory markers can be used for the early prediction of AKI in sepsis patients in the ICU. The model is helpful for clinicians early identify AKI in sepsis patients.
3.Cumulative dosimetric investigation based on image deformable registration in radiotherapy for cervical cancer
Qinghe PENG ; Shili ZHANG ; Yinglin PENG ; Hui LIU ; Weijun YE
Chinese Journal of Radiation Oncology 2020;29(6):451-454
Objective:To evaluate the differences in the cumulative doses for cervical cancer between two different methods, and analyze the correlation between the severity of radiation proctitis and the cumulative dose of the rectum.Methods.:Clinical data of 278 patients with cervical cancer treated with radiotherapy were retrospectively analyzed. The total dose of radiotherapy was calculated by simple dose volume histogram parameter accumulation method (S-DVH group) and dose accumulation by deformation image registration (DIR group) in 49 patients with radiation proctitis. The rectal cumulative dose of the 278 patients with S-DVH was counted(D 2.0cm 3/D 1.0cm 3/D 0.1cm 3). The correlation analysis was performed by Spearman’s correlation analysis. Results:The average cumulative dose(D 90%) difference of high-risk clinical target volume (HRCTV) between the S-DVH and DIR groups was 2 Gy (EQD 2Gy)[(88.66±5.75) vs. (86.66±5.54) Gy, P<0.05], and the average cumulative dose difference(D 2.0cm 3 and D 1.0cm 3) of bladder was 2.13 Gy[(82.46±6.91) vs.(80.33±6.86) Gy, P<0.05] and 2.35 Gy[(88.46±4.37) vs.(86.11±3.93) Gy, P<0.05], and the average cumulative dose difference(D 2.0cm 3 and D 1.0cm 3) of rectum was 1.99 Gy[(72.49±5.17) vs.(70.50±5.03) Gy, P<0.05] and 2.71 Gy[(78.87±4.50) vs.(76.16±4.14) Gy, P<0.05]. The rectal cumulative dose(D 2.0cm 3/D 1.0cm 3/D 0.1cm 3) was positively associated with the grade of radiation proctitis. Conclusions:The cumulative doses differ between two groups, and are equally in an acceptable range. S-DVH method is a relatively simple method to evaluate the cumulative exposure dose. The cumulative doses of the rectum(D 2.0cm 3/D 1.0cm 3/D 0.1cm 3) can be used to predict the incidence of radiation proctitis.