Objective To explore the diagnostic value of the quantitative detection of serum miRNA-193a in pulmonary adenocarcinoma.Methods 40 pulmonary adenocarcinoma patients and 40 healthy people were recruited to receive quantitative detection of serum miRNA-193a and CEA.And then the relationship between the concentration of miRNA-193a and CEA was analyze by spearman correlation analysis.12 of the 40 patients underwent operation and the different levels of miRNA-193a expression among pulmonary adenocarcinoma tissues,adjacent tissues and normal tissues was detected by qRT-PCR.The different miRNA-193a levels were compared among groups of by t-test.The diagnostic performance of miRNA-193a was evaluated with receiver operating characteristic curves(ROC) and the area under the curve (AUC) and its 95%CI were calculated.Results The relative expressions of miRNA-193a in pulmonary adenocarcinoma tissues,adjacent tissues and normal tissues were 1.07±0.16;0.80±0.10;0.11±0.07.miRNA-193a expression in pulmonary adenocarcinoma tissues was significantly lower than that in other two groups(P<0.05).The expression of serum miRNA-193a in pulmonary adenocarcinoma group was significantly lower than that in healthy group(P<0.05).There was no correlation between miRNA-193a and CEA(r=0.079,P=0.618).The detection of miRNA-193a yielded a ROC AUC of 0.829(0.741-0.917) in discriminating pulmonary adenocarcinoma from healthy group.Conclusion The relative expression of miRNA-193a in pulmonary adenocarcinoma was significantly lower than that in healthy controls no matter in tissue or serum,serum miRNA-193a may prove to be a non-invasive biomarker for the auxiliary diagnosis of pulmonary adenocarcinoma.

Objective To analyze the risk factors of pancreatic fistula after pancreaticoduodenectomy,in order to provide evidence to reduce post-operative complication in clinical practice.Methods The clinical data of 352 patients with malignancy who received pancreaticoduodenectomy at the Shanghai Renji Hospital from September 2009 to September 2012 were retrospectively analyzed.The patients were divided into pancreatic fistula group and non-pancreatic fistula group.Peri-operative risk factors of pancreatic fistula after pancreaticoduodenectomy were analyzed by univariate and multivariate logistic regression analysis.Results Forty-nine cases of pancreatic fistula occurred,and the incidence rate of pancreatic fistula was 13.9％ (49/352).Univariate and multivariate logistic regression analysis showed sex,age,history of diabetes,operation time,intra-operative blood loss,vessel reconstruction,pancreatic tube placement,anastomosis time,type of digestive tract reconstruction were not risk factors of pancreatic fistula; however,brittle pancreatic tissue,diameter of pancreatic duct ＜3 mm,pre-operative total bilirubin level ＞ 171 μmol/l,duration of preoperative jaundice ＞ 8 weeks,pre-operative albumin level ＜30 g/L were the independent risk factors of pancreatic fistula (P ＜ 0.05).Conclusions Brittle pancreatic tissue,small pancreatic duct,high level of serum bilirubin,long duration of preoperative jaundice,low level of serum albumin are the independent risk factors of pancreatic fistula after pancreaticoduodenectomy.

Objective:To investigate the level of radiation doses to adults caused by CT examination in Huai′an, and explore the local CT diagnostic reference levels (DRLs).Methods:Totally 45 CT scaners were selected to investigate the information on hospitals, equipment, scanning parameters, and radiation doses. Empirical formula were used to estimate the effective dose to adults. Nonparametric rank sum tests were used to analyze differences in radiation dose level between CT service age and hospital grade.Results:A total of 3 483 patients were collected, including 890 for head examinations, 890 for chest, 846 for abdomen, and 857 for lumbar spine. The 75% percentile values of CTDI vol to adult patients from CT scanning for head, chest, abdomen, lumbar spine examinations were 63.0, 12.4, 20.0 and 24.0 mGy, respectively. The 75% percentile values of DLP were 858.6, 416.0, 620.7 and 559.2 mGy·cm, respectively. The 75% percentile values of DLP for males was higher than those for females. There were significant statistical differences in radiation doses dependent on equipment service (head: U =10 326.00, P<0.05; chest: U=36 094.50, P<0.05; abdomen: U= 7 859.00, P<0.05; lumbar spine: U=42 408.00, P<0.05), and hospital grade (head: H=14.280, P<0.05; chest: H=17.85, P<0.05; abdomen: H=97.18, P<0.05; lumbar spine: H=138.94, P<0.05). Conclusions:The CT radiation dose levels in Huai′an city is basically consistent with standard-reommended values, which is in line with the current status of CT equipment dose levels in the country. It is necessary to strengthen the quality control and maintenance of CT equipment.

OBJECTIVETo study the clinical and pathologic features of gliosarcoma of cerebral hemispheres.

METHODSThe clinicopathologic features of 10 cases of gliosarcoma involving cerebral hemispheres were reviewed. Immunohistochemical study was carried out using EnVision method.

RESULTSThe mean age of the patients was 54 years and the male-to-female ratio was 6 to 4. Clinical symptoms included headache (6/10), nausea/vomiting (5/10), and sensory or motor impairment (4/10). Nine of the cases were primary gliosarcoma, with maximum diameter ranging from 2.4 to 5.5 cm (mean = 4.2 cm). The remaining case represented secondary gliosarcoma involving skull base and extracranial tissues. Histologic examination showed a biphasic pattern in all cases. Regarding the glial component, there were 9 cases of pleomorphic glioblastoma and 1 case of giant cell glioblastoma. Reticulin stain was positive in all cases. Immunohistochemical study showed that the tumor cells variably expressed GFAP (10/10), p16 (4/10), EGFR (1/10), CD68 (1/10) and p53 (6/10). The Ki-67 index ranged from 15% to 70% (mean = 34%). Six patients had follow-up data available. One patient was disease-free for 45 months and 5 patients died of the disease at 3 to 17 months after the operation (mean duration of survival = 9 months).

CONCLUSIONSGliosarcoma is a highly aggressive tumor, often locates in the deeper part cerebral hemispheres and has a relatively short duration of symptoms. It carries a poor prognosis. GFAP immunostain and reticulin stain are helpful in confirming the diagnosis. p53 and p16 are also expressed in some cases.

Adult ; Brain Neoplasms ; metabolism ; pathology ; Cerebrum ; pathology ; Female ; Glioblastoma ; metabolism ; pathology ; Gliosarcoma ; metabolism ; pathology ; Humans ; Male ; Middle Aged ; Neuroglia ; pathology

Objective:To investigate the current status of the radiodiagnosis and radiotherapy resources and medical exposure frequencies in Huai′an City.Methods:According to the monitoring data in the " Radiological Health Information Management Platform of Jiangsu Province" in 2020, a descriptive analysis was conducted on the personnel, equipment, and exposure frequencies in the institutes engaged in radiation-based diagnosis and treatment in Huai′an.Results:A total of 181 hospitals were investigated in 2020, including 7 tertiary hospitals(3.9%), 24 secondary hospitals(13.3%), 126 primary hospitals(69.6%), and 24 ungraded hospitals(13.3%). There were 1 397 radiation workers, including 948 males and 449 females, and 459 pieces of radiation equipment, including 420 for radio diagnosis, 13 for radiotherapy, 4 for nuclear medicine, and 22 for interventional radiology. The hospitals of different grades greatly differed in the number of radiation workers and equipment. There were 80.1, 20.9, 2.2, and 2.0 radiation workers and 15.7, 5.5, 1.4, and 1.6 pieces of radiation equipment in the tertiary hospitals, secondary hospitals, primary hospitals, and ungraded hospitals, respectively on average. There were 2 903 246, 27 648, 8 087, and 17 874 receiving radiodiagnosis, radiotherapy, nuclear medicine, and interventional radiology, respectively in 2020. The medical exposure frequencies in the whole city were calculated to be 599.50 per 1 000 population, including 334.59 treated with conventional X-rays, 239.82 receiving CT scan, 14.18 for breast and dentistry, 3.62 receiving interventional radiology, 5.61 treated with radiotherapy, and 1.69 receiving nuclear medicine.Conclusions:The radiodiagnosis and radiotherapy resources are unbalanced in the hospitals of different grades in Huai′an City. Therefore, it is necessary to pay more attention to the reasonable allocation of medical resources. Meanwhile, radiation workers in secondary hospitals may be more prone to job burnout. Facing the normalization of the prevention and control of COVID-19 epidemic, the supervision and management of radiological health should be strengthened to ensure the legitimacy of radiological diagnosis and radiotherapy and theoptimization of protection. The frequencies of medical exposure are consistent with the local economic level. To analyze the differences in medical exposure frequencies and predict the developmental trends in different regions, it is necessary to establish a more accurate prediction model.

Objective:To estimate the frequencies of medical X-ray diagnositic examinations and analyze their distribution in Huai′an City.Methods:Stratified random sampling was used to select 2 tertiary hospitals including 1 general hospital and 1 MCH hospital, 4 secondary hospitals, 20 primary and unclassified hospitals to investigate medical X-ray examination frequencies in the 26 hospitals in 2017.Results:The average number of X-ray diagnostic equipment were 13.5 pieces in tertiary hospitals, 7.3 in second-level hospitals and 1.6 in primary and ungraded hospitals. The fraction of imported equipment accounted for 85.2%, 69.0% and 9.4%, respectively. The higher the hospital level, the greater the proportion of equipment with five years of service history. The number of examinations in 2017 in the 26 hospitals were X-ray photography 350 221, fluoroscopy 71 597, CT 327 404, dental 23 820 and breast 12 849, respectively. The number of examinations per 1 000 population were estimated to be 444.22 by conventional X-ray and 236.40 by CT.Conclusions:The frequency of conventional X-ray examinations in the city is slightly lower than the average level in Jiangsu province in 2016 and the CT examination frequency is roughly same as in Jiangsu province.

Focus on the inconsistency of the shape, location and size of brain glioma, a dual-channel 3-dimensional (3D) densely connected network is proposed to automatically segment brain glioma tumor on magnetic resonance images. Our method is based on a 3D convolutional neural network frame, and two convolution kernel sizes are adopted in each channel to extract multi-scale features in different scales of receptive fields. Then we construct two densely connected blocks in each pathway for feature learning and transmission. Finally, the concatenation of two pathway features was sent to classification layer to classify central region voxels to segment brain tumor automatically. We train and test our model on open brain tumor segmentation challenge dataset, and we also compared our results with other models. Experimental results show that our algorithm can segment different tumor lesions more accurately. It has important application value in the clinical diagnosis and treatment of brain tumor diseases.
Brain Neoplasms ; diagnostic imaging ; Glioma ; diagnostic imaging ; Humans ; Image Processing, Computer-Assisted ; Magnetic Resonance Imaging ; Neural Networks (Computer)

OBJECTIVETo investigate the epidemiological and clinical characteristics of norovirus infection on diarrhea patients from the enteric clinics in Beijing.

METHODSFrom April 2013 to March 2014, 1 892 fecal specimens and related epidemiological information were collected among diarrhea patients visiting the enteric clinics in Beijing. Norovirus was detected by real time RT-PCR, and data was analyzed under the descriptive epidemiological method.

RESULTSA total of 269 positive cases were found among 1 892 diarrhea patients, with a positive rate as 14.2%. Norovirus caused diarrhea mainly occurred in seasons with lower temperature. Higher positive rates of norovirus were found in northwest mountainous area. Norovirus diarrhea was more commonly seen in children between 6 month and 5 years old, with differences between the two groups statistically significant (P = 0.006). Compared with other occupation, a higher infection rate was identified in children, with differences between the two groups statistically significant (P = 0.025). Nausea and vomiting appeared more common in diarrhea patients with norovirus infection, with differences between the two groups statistically significant (P < 0.05).

CONCLUSIONNorovirus was an important pathogen which causing diarrhea in patients visiting the enteric clinics in Beijing. The virus was seen more in patients aged between 6 months and 5 years old. Nausea and vomiting were the common symptoms seen in patients with norovirus diarrhea.

Caliciviridae Infections ; complications ; epidemiology ; Child, Preschool ; China ; epidemiology ; Diarrhea ; virology ; Humans ; Infant ; Nausea ; virology ; Norovirus ; isolation & purification ; Real-Time Polymerase Chain Reaction ; Seasons ; Vomiting ; virology

Objective To investigate and analyze the current situation of nuclear technology utilization and radiation workers' occupational health management in non-medical institutions in Huai'an City, and to strengthen the prevention and control of occupational radiation diseases. Methods 37 non-medical institutions of nuclear technology utilization in Huai'an City were surveyed by questionnaire, including radioisotope and radiation apparatus, personal dose monitoring of radiation workers, implementation of occupational health examination, protective equipment, etc. Results The industry covers manufacturing industry, transportation, warehousing and postal industry, scientific research and technical service industry, residential service, repair and other service industries, 0 class I radiation device, 15 class II radiation devices, 67 class III radiation devices; 0 class I and II radiation sources, 1 class III radiation device, 16 class IV radiation sources, 51 class V radiation sources, 1 unsealed radioactive material Class B workplace; 493 radiation workers, 90.5% with certificates, 85.4% with personal dose monitoring rate, rate of 37.8% with radiation protection monitoring equipment, and 68.0% with occupational health examination rate. It has 13 institutions equipped with personal protective equipment, 23 with dose alarming devices and 14 with radiation protection monitors. 30 radiation workplace tests have been carried out in the past two years. Conclusion The occupational health management of radiation workers in non-medical institutions is weak. At present, the responsibility of occupational health supervision has been assigned to the health department. Therefore, the health administrative department should strengthen the supervision of non-medical nuclear technology utilization institutions and improve the emergency mechanism of radiation emergencies in Huai'an city.

OBJECTIVETo evaluate the pancreaticojejunostomy procedures selection strategy in pancreaticoduodenectomy and to analyze risk factors of pancreatic fistula.

METHODSClinical data of 352 patients who received pancreaticoduodenectomy from September 2009 to September 2012 were retrospectively analyzed. For patients with soft pancreas, binding pancreaticojejunostomy was applied to 153 patients. For patients with hard pancreas, duct-to-mucosa pancreaticojejunostomy (DMPJ) was applied (199 cases). The clinical efficacy and incidence of postoperative complications were compared among 2 groups. Risk factors of pancreatic fistula were screened out from many factors by univariate and multivariate analysis.

RESULTSThe overall incidence of pancreatic leakage was 13.9% (49/352). There were no significant difference in incidences of pancreatic leakage (χ(2) = 0.512), peritoneal bleeding (χ(2) = 0.784), abdominal infection (χ(2) = 1.161), digestive dysfunction rate (χ(2) = 4.753) and mean duration of hospital stay (t = 2.13) among 2 groups (all P > 0.05). The results of multivariate analysis showed pancreatic tube diameter < 3 mm (OR = 5.748), preoperative total bilirubin level > 171 µmol/L (OR = 5.112), duration of preoperative jaundice > 8 weeks (OR = 5.090), preoperative albumin level < 30 g/L (OR = 4.464) were independent risk factors of pancreatic fistula (all P < 0.05).

CONCLUSIONSBunding pancreatojejunostomy was as good as soft pancreatic; for duct diameter ≥ 3 mm suggested using duct-to-mucosa pancreaticojejunostomy. For the risk factors for pancreatic leakage actively cooperate with preoperative nutritional support and timely treatment of jaundice, the incidence of postoperative pancreatic leakage will be further reduced.

Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Middle Aged ; Pancreatic Fistula ; Pancreaticoduodenectomy ; Pancreaticojejunostomy ; methods ; Postoperative Complications ; Retrospective Studies ; Risk Factors