Trying to provide ultrasonic image-aid measures for quantitative diagnosis and dynamic monitoring of liver fibrosis, we propose two scoring methods for liver fibrosis tissue in vivo , based on ultrasound radio frequency (RF) time series in this paper. Firstly, RF echo signals of human liver were recorded in this study. Then one of the recorded frame RF data was demodulated to be B model image. After that, a region of interest (ROI) in the B model image was selected. For each point in the ROI, its all frame data were acquired so that RF time series were formed. An SMR (size measure relationship) fractal dimension and six spectral features were extracted from RF time series in the ROI. With relative deviation and Fisher's discriminant ratio, seven features were weighted and summed so that the liver tissues' scores were obtained, Score-rd and Score-fisher, respectively. Area under ROC curve (AUC) and a support vector machine (SVM) were used to evaluate whether these scoring methods would be useful in distinguishing normal and cirrhosis tissues. Experimental results are shown as follows: Score-rd's AUC was 0.843, while Score-fisher was 0.816, SVM classification accuracies were both up to 87.5%. This proved that our proposed scoring methods were effective in distinguishing normal and cirrhosis tissues. Score-rd and Score-fisher have potential for clinical applications. They can also provide quantitative references for liver fibrosis diagnosis.
Area Under Curve ; Fractals ; Humans ; Liver Cirrhosis ; classification ; diagnostic imaging ; Radio Waves ; Support Vector Machine ; Ultrasonography

Objective:To evaluate the spiral CT in the diagnosis of esophageal neoplasm by comparing it with conventional CT and barium meal examination.Methods:Spiral CT contrast enhancement scanning and image processing with MPR an d CTVE were performed in 15 cases.A comparison was made between the images of spiral CT and the ones of conventional CT and the images of barium meal examinat ion.Results:① On axial images with spiral CT,all lesions of 15 patients showed almo s t the same pictures as seen with conventional CT.Images clearly showed the posit ion,size,shape of the esophageal neoplasm with local extension and the relation with the adjacent structures as well as lymth node metastases.②MPR could we ll display esophageal structure through different angle and direction.The appea rances of inner wall and lesions on CTVE of esophageal neoplasm were similar to those of fiberaptic endoscopy.③Barium meal examinatiuon was a very effective sc reening method.Conclusion:Compared with conventional CT and barium meal examination,application of spiral CT provides clinicians with more useful informations.

Objective To investigate the expression of TGF-β activated kinase1 (TAK1),phosphoryted TAK1 (p-TAK1) and the density of tumor associated macrophages (TAM) in human pancreatic carcinoma tissues and pairing adjacent normal pancreatic tissues,and explore their relationship.Methods The expression of TAK1,p-TAK1,CD68 (the marker of tumor associated macrophages) proteins in 57 samples of pancreatic cancer tissues and 35 samples of pairing adjacent normal pancreatic tissues were detected by immunohistochemical method,then the density of TAM was evaluated.The relationship between the protein expression and TAM,and the relationship between them and clinicopathologic parameters were examined using SPSS 18.0 software,and the independent risk factors of TNM staging were analyzed by multivariate logistic regression.Results TAK1 and p-TAK1 were positively expressed in 42.1％ (24/57) and 40.4％ (23/57) pancreatic carcinoma tissues,significantly higher than adjacent normal pancreatic tissues [14.3 ％ (5/35) and 11.4％ (4/35)];the proportion of pancreatic carcinoma tissues with high density TAM was 38.6％ (22/57),higher than that of adjacent pancreatic tissues [8.6％ (3/35)],the differences were statistically significant (P＜0.05).TAK1 expression was positively related to tumor size,tumor differentiation,lymph node metastasis,distant metastasis and clinical staging;p-TAK1 expression was positively related to tumor differentiation,lymph node metastasis,distant metastasis and clinical staging;the density of TAM was positively related tumor differentiation,lymph node metastasis,distant metastasis and clinical staging (all the P values were less than 0.05).The expression of TAK1 and p-TAK1were positively correlated with the density of TAM (P ＜0.001).Multivariate logistic regression analysis showed that high density of TAM was independently associated with advanced clinical staging (P =0.002,OR =129.5,95％ CI 6.2 ～2718.6).Conclusions TAK1 pathway and TAM may play an important role in the pathogenesis and progression of pancreatic cancer,and there may be synergy effect between them.

Objective To analyze the clinical characteristics of twin reversed arterial perfusion sequence (TRAP),and investigate its prenatal evaluation and clinical management.Methods Karyotype results and ultrasound data of 25 TRAP cases were retrospectively reviewed,including estimated weight and umbilical blood flow of acardiac twin,cardiac function and middle cerebral artery peak systolic velocity of pump twin.Various managements and the outcomes were analyzed.Results (1) Karyotype of amniotie fluid were tested in 16 pump twins.Mosaicism was found in 1 case (46,XX[36]/46,XY [14]).(2) According to the ultrasound evaluation,large acardia accounted for 87.0％ (20/23) cases.Abundant blood perfusion (inter-twin difference of umbilical resistance index ≤0.20) was indicated in 86.4％ (19/22) cases.Decompensation of cardiac function was suggested in 66.7％ (10/15) pump twins.Fetal anemia of pump twin indicated by middle cerebral artery peak systolic velocity＞1.5 multiples of the median was diagnosed in 75.0％ (12/16) cases.(3) The acardiac twin with abundant blood perfusion was more likely to be a large acardia than those without [94.7％(18/19) vs 1/3,Fisher exact test,P=0.04]; More pump twin with large acardia tended to have cardiac decompensation than non-large acardia pump twins [83.3 ％ (10/12) vs 0/3,Fisher exact test,P=0.02].(4) Eleven patients chose to terminate their pregnancies after being diagnosed.In 14 cases who continue the pregnancies,the survival rate of pump twin was 64.3％ (9/14).In 3 cases of non-large acardia without cardiac decompensation of pump twin,the patients selected conservative observation resulting in 2 term deliveries and 1 termination of pregnancy due to for exacerbation.Among 11 cases with large acardia,which the pump twins were complicated by cardiac decompensation or anemia,five cases selected conservative observation.One ended in spontaneous abortion; three exacerbated (one termination and two cesarean section before term with living births) ; one was stable until delivery.Another 6 cases received bipolar cord coagulation,and successful interruptions of acardiac blood flow were achieved in 5 cases among which 4 pump twins survived.Conclusions Prenatal diagnosis,cardiac function and fetal anemia of pump twin,together with the growth and blood supply of acardia are important indexes for prenatal evaluation of TRAP,on which our prompt management should be based.

ObjectiveTo investigate the family adaptability, cohesion and their relationship with symptoms of chronic outpatients with schizophrenia.Methods51 outpatients with schizophrenia were assessed with Family Adaptability and Cohesion Scales, Second Edition, Chinese Version(FACE II-CV) and Positive and Negative Syndrome Scale(PANSS ).ResultsThe level of family adaptability of chronic outpatients with schizophrenia was lower than that of the normal control(u<0.05 or u<0.01);the ratio of the balance category of family decreased significantly and that of the extreme category of family increased significantly;the score of real cohesion negatively correlated with scores of PANSS, Positive Subscale and General Psychopathology Subscale (P<0.05);the score of real adaptability negatively correlated with score of Positive Subscale (P<0.05). ConclusionsFamily adaptability and cohesion of outpatients with schizophrenia close correlate to symptoms of chronic outpatients with schizophrenia and level of family adaptability decreases.

Objective To compare the clinical efficacy of nasal intermittent positive pressure ventilation (NIPPV) and heated humidified high flow nasal cannula (HHHFNC) in the treatment of respiratory distress syndrome (RDS) among low-birth-weight premature infants.Method From May to December 2015,low-birth-weight premature infants with RDS who were born and treated in our hospital were randomly assigned into NIPPV group and HHHFNC group according to their initial ventilation mode.The incidence of initial treatment failure,the usage of pulmonary surfactant (PS),the parameters of respiratory support treatment and the incidence of complications were analyzed.Result A total of 70 cases with grade Ⅰ ～ llⅢ of RDS were included,including 33 males and 37 females.The birth weight ranged from 1 020 to 2 450 g,with a average of (1 845 ± 475) g.NIPPV and HHHFNC group each had 35 cases.No significant differences existed between the two group in the following items:the rate of mechanical intubation within 72 h (5.7％ vs.11.4％),use of PS (0％ vs.8.6％),incidence of severe apnea (11.4％ vs.14.3％),pneumonia (11.4％ vs.14.3％),the duration of invasive mechanical ventilation [76.3 (30.8,150.4) h vs.97.6 (56.2,142.6) h],non-invasive ventilation [65.0 (43.0,119.0) h vs.96.0 (65.0,134.0) h] and the duration of oxygen therapy [154.0 (47.0,340.0) h vs.148.0 (72.0,327.0) h,it was no (P ＞ 0.05).Also,no significant differences in the incidence of bronchopulmonary dysplasia,necrotizing enterocolitis,retinopathy of prematurity,patent ductus arteriosus,intra-ventricular hemorrhage,nose injury,pneumothorax between the two groups.Conclusion As an initial respiratory support for the treatment of low-birth-weight RDS preterm infants,HHHFNC has similar efficacy and safety with NIPPV,and further clinical research is needed.

Objective To determine the prevalence and genotype profiles of urogenital Chlamydia trachomatis and their related factors in patients attending sexually transmitted diseases (STD) clinics in Guangxi Zhuang Autonomous Region. Methods C. trachomatis was screened by a plasmid PCR in 598 patients attending STD clinics. Then, positive specimens underwent nested-PCR to amplify the major outer membrane protein 1 (ompl) gene. The amplicons of ompl gene were digested by restriction endonucleases Alu I plus Hinf I and Cfol . C. trachomatis was differentiated according to the restriction fragment length polymorphism (RFLP) patterns. Results Out of the 598 samples, 83 were positive for plasmid-PCR. The prevalence of chlamydial infection was 13.9% with no significant difference between male and female patients. Nested-PCR based RFLP analysis showed that genotype E amounted to 27.7% (23/83), F 20.5% (17/83), D 13.2%(11/83), G 12.0%(10/83), K 7.2%(6/83), H 4.8%(4/83), I 3.6% (3/83), J 3.6%(3/83)and uncertain types 7.2% (6/83). Visible symptoms were observed less frequently in infections with C. trachomatis genotypes E and F compared with the other genotypes, while low abdominal pain occurred in 80% of infections with type G. Conclusions A certain proportion of out-patients attending STD clinic are infected with various types of C. trachomatis in Guangxi Zhuang Autonomous Region. The polymorphism of ompl gene may serve as a useful tool in molecular epidemiological studies of C. trachomatis.

Objective To analyze the relationship between fasting plasma glucose (FPG) level and complexity of coronary artery lesions in patients with coronary stenosis by angiography. Methods The data of clinic and coronary angiogram (CAG) were retrospectively collected in 929 patients with established coronary stenosis by coronary angiography at Peking University Third Hospital from January 2009 to January 2011. The patients were grouped according to SYNTAX score, and the relationship between FPG level and SYNTAX score were analyzed using bivariate, Multivariate stepwise regression and logistic regression analysis. Results ①929 patients were devided into three groups:47 cases into low risk group (score<22), 189 into moderate risk group (score≥22 and<33) and 639 into high risk group (score≥33). Intergroup analysis showed that age (P=0.000), FPG level [5.20 (4.70,6.30) mmol/L, 5.70 (4.90,7.15) mmol/L, 5.80 (5.30,7.60) mmol/L, P=0.000], proportions of FPG abnormality [283 (40.8%), 100(52.9%), 28(59.6%), P=0.001] and patients with diabetes history (P=0.003) were increased along with SYNTAX score elevated.②Correlation analysis showed correlativity (r=0.167, P=0.000) between SYNTAX score and FPG. In non-diabetes history subgroup, correlation between SYNTAX score and FPG remained signiifcant (r=0.149, P=0.000). However, in diabetes history subgroup, the correlation was not significant. ③ Multivariate stepwise regression analysis showed an independent correlation between FPG and SYNTAX score (β=0.452, P=0.002). In non-diabetes history subgroup, the correlation remained significant (β=1.039, P=0.000).④ When moderate-high risk group serve as dependent variable, and age, gender, CAD risk factors and FPG serve as independent variables, logistic regression analysis screened out two variables:age (whole group:OR 1.033, 95%CI 1.017 ~ 1.049, P=0.000;non-diabetes history subgroup:OR 1.039, 95%CI 1.020 ~ 1.059, P=0.000) and FPG (whole group: OR 1.114, 95% CI 1.038 ~ 1.195, P=0.003; non-diabetes history subgroup:OR 1.299, 95%CI 1.088 ~ 1.387, P=0.001). Conclusions FPG is likely to relfect complexity of coronary artery lesions and predict SYNTAX score in patients with coronary stenosis, especially in patients without diabetes history.

Objective:To explore the cancer incidence and mortality in registration areas of Shanxi Province in 2014.Methods:The data of 12 cancer registration areas of Shanxi Province in 2014 were taken to analyze the characteristics of cancer incidence and mortality for patients with different age and gender in different areas. And then the results were compared with the malignant cancer incidence and mortality in the nationwide.Results:There were 11 703 new cases, including 6 559 males and 5 144 females in registration areas of Shanxi Province in 2014, and the incidence rate was 221.21/10 5, while the age-standardized incidence rate of Chinese population and world population was 163.91/10 5 and 163.25/10 5, respectively. The cancer incidence rate in urban areas was 247.02/10 5 and the age-standardized incidence rate of Chinese population was 171.35/10 5. In rural areas, the cancer incidence rate was 205.98/10 5 and the age-standardized incidence rate of Chinese population was 159.03/10 5. The common cancer sites were stomach, lung, esophagus, liver and colorectum for males. And breast, cervix, lung, esophagus, stomach were the common cancer sites for females. There were 7 283 malignant death cases, including 4 548 males and 2 735 females. The crude cancer mortality rate was 137.66/10 5, and the age-standardized mortality rate of Chinese population was 99.67/10 5 and world population was 100.11/10 5. The crude cancer mortality rate in urban areas was 141.03/10 5 and the age-standardized incidence rate of Chinese population was 92.84/10 5. In rural areas, the crude cancer mortality rate was 135.68/10 5 and the age-standardized mortality rate of Chinese population was 103.69/10 5. Male common malignant tumor deaths included lung cancer, gastric cancer, liver cancer, esophageal cancer and colorectal cancer, while lung, stomach, liver, esophagus and cervix were the common cancer death sites for females. Conclusions:The incidence and mortality of malignant tumors in registration areas in Shanxi Province are mainly lung cancer, upper gastrointestinal cancer and cervix uteri cancer. The incidence rates of stomach cancer and cervical cancer are high.

Objective: To determine the early recognizable factors related to patients with fulminant myocarditis. Methods: Medical records from 60 adult patients who were diagnosed with acute viral myocarditis from January 2003 to September 2016 in our hospital were retrospectively reviewed, and divided into the fulminant group (n=9) and the non-fulminant group (n=51). Clinical presentations, biochemical markers, electrocardiography and echocardiography features on admission were analyzed. Results: Prevalence of syncope (33.3%(3/9) vs. 2.0% (1/51), P=0.009) and fatigue (77.8% (7/9) vs. 21.6% (11/51) , P=0.002) was significantly higher, while the duration from flu-like syndromes to chest discomfort was shorter ((2.0±1.8) days vs. (4.5±3.5) days, P=0.041) in the fulminant group than that in the non-fulminant group. Systolic blood pressare (SBP) ((94±14) mmHg(1 mmHg=0.133 kPa) vs. (117±12)mmHg, P=0.001) and left ventricular ejection fraction((49±12)% vs. (60±13)%, P=0.016) were significantly lower, while heart rate ((99±20)bpm vs. (84±19)bpm, P=0.040) and NT-proBNP concentration ((7 962 (1 470, 23 849) ng/L vs. 1 771 (45, 2 380) ng/L, P=0.000) were significantly higher in the fulminant group than those in the non-fulminant group. PR interval was longer (199 (140, 416) ms vs. 156 (112, 204) ms, P=0.021), QRS complex was wider ((127±14)ms vs. (95±13)ms, t=-6.647, P<0.001) in the fulminant group than those in the non-fulminant group. Prolonged QRS duration≥120 ms was more often in fulminant group (77.8%(7/9) vs. 5.9%(3/51), P=0.000). Multivariate analysis revealed that PR interval (adjusted odd ratio 1.044, 95%CI 1.005-1.084, P=0.025) and QRS complex width (adjusted odd ratio 1.252, 95%CI 1.045-1.501, P=0.015) were the independent risk factors significantly associated with fulminant myocarditis. Conclusions The risk of a fulminant course of acute myocarditis is higher in patients with elevated NT-proBNP, reduced left ventricular ejection fraction, and conduction disturbances at admission. Prolonged PR interval and widened QRS complex on admission are independent risk factors for developing fulminant myocarditis in adult patients with acute viral myocarditis.