Objective:To study the safety and efficiency of endovascular treatment in pediatric severe cerebral venous sinus thrombosis(CVST).Methods:This was a case series study.Data of pediatric severe CVST patients who received endovascular treatment in the Department of Neurointerventional, the First Affiliated Hospital of Zhengzhou University from January 2016 to December 2023 were retrospectively analyzed.The technical success rate, periprocedural complications, neurologic and radiologic outcomes were collected to study the safety and efficacy of endovascular treatment in pediatric severe CVST.Results:A total of 15 patients were included in this study, including 6 males(40.0%) and 9 females(60.0%) with a mean age of(14.60±2.26) years.The modified Rankin Scale score(mRS) before endovascular treatment was(3.47±1.06) points, and the time from onset to endovascular treatment was 17(12-26) days.Thirteen patients(86.7%) received mechanical thrombectomy through catheter aspiration and/or stent-retriever thrombectomy followed or not followed by intrasinus thrombolysis(IST), and 2 patients(13.3%) received IST only.The technical success rate was 100%.Three patients(20.0%) had periprocedural complications.Ten patients(66.7%) had mRS≤2 points at discharge.Twelve patients(80.0%) had valuable neurologic and radiologic follow-ups with a duration of 9.5(3.5-19.0) months, and they all had mRS≤2 points.Among the 12 patients, 8(66.7%) had good cerebral venous recanalization.Conclusions:Endovascular treatment is technically feasible in pediatric severe CVST patients, with acceptable safety and efficacy.

Objective:To evaluate the necessity, safety and efficacy of endovascular treatment for cerebral infarction caused by middle cerebral artery (MCA) stenosis with hypoperfusion in the blood supply area of the lenticulostriate artery.Methods:The clinical and surgical data of patients with MCA atherosclerotic disease who underwent endovascular treatment in the First Affiliated Hospital of Zhengzhou University from January 2014 to October 2021 were retrospectively analyzed. A total of 6 patients with cerebral infarction caused by MCA stenosis with hypoperfusion in the blood supply area of the lenticulostriate artery were selected. The preoperative and postoperative clinical imaging characteristics, perioperative complications and follow-up of these 6 patients were summarized and evaluated.Results:After the endovascular treatment, the imaging of the lenticulostriate artery in all the 6 patients was clearer than that before the operation, and the number of main trunks of the lenticulostriate artery shown by imaging in 2 patients was more than that before operation. The computer tomography perfusion of 6 patients after the endovascular treatment showed that perfusion in the supply area of the lenticulostriate artery was significantly improved compared with pre-operation. No stroke, transient ischemic attack (TIA) and death occurred during the perioperative period. The time of clinical follow-up was 360 (322, 495) days, and there were no stroke, TIA or death occurring in the corresponding artery. All the 6 patients underwent imaging follow-up, of which 3 patients underwent digital subtraction angiography and 3 underwent CT angiography. The lumen of the target vessels showed patency in all patients.Conclusions:With rigorous imaging evaluation, endovascular treatment may be safe and effective for cerebral infarction caused by MCA stenosis with hypoperfusion in the blood supply area of the lenticulostriate artery.

Objective:To observe the effect of Yi Jin Jing(Sinew-transforming Qigong Exercises)intervention on anxiety in asymptomatic patients with Corona Virus Disease 2019(COVID-19)infection during quarantine.Methods:A total of 160 asymptomatic patients with COVID-19 infection were stratified by gender and divided into an observation group and a control group by the stratified randomization method,with 80 cases in each group.The control group was given basic nursing in the cabin,and the observation group was given additional Yi Jin Jing exercises once a day,20 min each time,and trained continuously until 1 d before leaving the cabin.The Hamilton anxiety scale(HAMA)score was compared between the two groups.Results:A total of 154 cases were included for data analysis in this study,including 74 cases in the observation group and 80 cases in the control group.After intervention,the HAMA scores in both groups increased(P<0.05),while the score in the observation group was lower than that in the control group(P<0.05).In the control group,the HAMA score of females after intervention was higher than that of males.The scores of mental anxiety and somatic anxiety in both groups were higher than those before intervention,while the score of mental anxiety in the observation group was significantly lower than that in the control(P<0.05).However,there was no statistical difference in the somatic score between the two groups(P>0.05).Conclusion:Patients with COVID-19 infection will get anxious during quarantine.Yi Jin Jing exercise can effectively reduce the aggravation of anxiety in asymptomatic patients with COVID-19 infection during concentrated quarantine.

Heart sound signal is a kind of physiological signal with nonlinear and nonstationary features. In order to improve the accuracy and efficiency of the phonocardiogram (PCG) classification, a new method was proposed by means of support vector machine (SVM) in which the complete ensemble empirical modal decomposition with adaptive noise (CEEMDAN) permutation entropy was as the eigenvector of heart sound signal. Firstly, the PCG was decomposed by CEEMDAN into a number of intrinsic mode functions (IMFs) from high to low frequency. Secondly, the IMFs were sifted according to the correlation coefficient, energy factor and signal-to-noise ratio. Then the instantaneous frequency was extracted by Hilbert transform, and its permutation entropy was constituted into eigenvector. Finally, the accuracy of the method was verified by using a hundred PCG samples selected from the 2016 PhysioNet/CinC Challenge. The results showed that the accuracy rate of the proposed method could reach up to 87%. In comparison with the traditional EMD and EEMD permutation entropy methods, the accuracy rate was increased by 18%-24%, which demonstrates the efficiency of the proposed method.
Entropy ; Heart Sounds ; Signal Processing, Computer-Assisted ; Signal-To-Noise Ratio ; Support Vector Machine

Objective:To investigate the ability of superb-microvascular imaging (SMI) to detect microvascular characteristics of focal liver lesions (FLLs) and analyze the relationship between vascular index (VI) and microvascular density (MVD) and Ki-67 levels.Methods:The imaging data of patients diagnosed as FLLs at Tianjin Medical University Cancer Hospital in 2018 were collected. A total of 166 FLLs patients were divided into non-hepatocellular liver cancer (non-HCC group, 96) and HCC group (70), respectively. The whole group of patients were subjected to color Doppler blood flow imaging (CDFI) and SMI examination. The patient′s Adler′s semi-quantitative grading (0 to 3 levels) and vascular morphological characteristics (a-f type) were analyzed. The receiver operating characteristic (ROC) curve was used to evaluate the detection ability of HCC with SMI and CDFI blood flow characteristics, The Pearson correlation analysis was used to evaluate the correlation between HCC patients VI and MVD and the Spearman correlation analysis was used to evaluate the correlation between VI and Ki-67.Results:In HCC group, SMI detected 50 cases of high-level blood flow (Adler′s semi-quantitative grade 2 to 3) patients, higher than 22 cases of CDFI ( P=0.033). In HCC group, SMI detected 52 cases of blood-rich mode (e, f type), higher than 18 cases of CDFI ( P<0.001). In non-HCC group, the difference of blood flow characteristics detection between CDFI and SMI was not statistically significant. In HCC group, SMI detected 52 cases of rich blood supply patterns, which was higher than 14 cases of non-HCC group ( P<0.001). The area under the ROC curve of SMI was 0.760 (sensitivity was 74.3%, specificity was 85.4%), and the SMI rich blood supply mode had the best diagnostic effect on HCC based on the blood-rich mode as the HCC diagnostic standard. In HCC group, VI was positively correlated with MVD and Ki-67 ( r=0.698 and r=0.669, respectively, P<0.05). Conclusions:SMI has better detection ability than CDFI for HCC microvascular characteristics, HCC has more blood-rich mode than non-HCC. In HCC, VI is positively correlated with MVD and Ki-67 expression levels.

Objective:To investigate the ability of superb-microvascular imaging (SMI) to detect microvascular characteristics of focal liver lesions (FLLs) and analyze the relationship between vascular index (VI) and microvascular density (MVD) and Ki-67 levels.Methods:The imaging data of patients diagnosed as FLLs at Tianjin Medical University Cancer Hospital in 2018 were collected. A total of 166 FLLs patients were divided into non-hepatocellular liver cancer (non-HCC group, 96) and HCC group (70), respectively. The whole group of patients were subjected to color Doppler blood flow imaging (CDFI) and SMI examination. The patient′s Adler′s semi-quantitative grading (0 to 3 levels) and vascular morphological characteristics (a-f type) were analyzed. The receiver operating characteristic (ROC) curve was used to evaluate the detection ability of HCC with SMI and CDFI blood flow characteristics, The Pearson correlation analysis was used to evaluate the correlation between HCC patients VI and MVD and the Spearman correlation analysis was used to evaluate the correlation between VI and Ki-67.Results:In HCC group, SMI detected 50 cases of high-level blood flow (Adler′s semi-quantitative grade 2 to 3) patients, higher than 22 cases of CDFI ( P=0.033). In HCC group, SMI detected 52 cases of blood-rich mode (e, f type), higher than 18 cases of CDFI ( P<0.001). In non-HCC group, the difference of blood flow characteristics detection between CDFI and SMI was not statistically significant. In HCC group, SMI detected 52 cases of rich blood supply patterns, which was higher than 14 cases of non-HCC group ( P<0.001). The area under the ROC curve of SMI was 0.760 (sensitivity was 74.3%, specificity was 85.4%), and the SMI rich blood supply mode had the best diagnostic effect on HCC based on the blood-rich mode as the HCC diagnostic standard. In HCC group, VI was positively correlated with MVD and Ki-67 ( r=0.698 and r=0.669, respectively, P<0.05). Conclusions:SMI has better detection ability than CDFI for HCC microvascular characteristics, HCC has more blood-rich mode than non-HCC. In HCC, VI is positively correlated with MVD and Ki-67 expression levels.

Objective:To evaluate the clinical and ultrasonographic features for early diagnosis and prediction of lateral cervical lymph node metastasis of medullary thyroid microcarcinoma.Methods:From Jan 2010 to Jan 2020 233 patients undergoing primary surgery were categorized as "medullary thyroid microcarcinoma" and "medullary thyroid macrocarcinoma". The preoperative clinical and ultrasonographic characteristics, the diagnostic positive rate of preoperative serum calcitonin and fine needle aspiration (FNA) were investigated between two groups. All patients with medullary thyroid microcarcinoma were divided on the basis of wether there was lateral cervical lymph node metastasis.Results:There were statistically significant differences in initial diagnostic method(χ 2=32.290, P=0.000), TNM staging(χ 2=50.300, P=0.000) between medullary thyroid microcarcinoma and medullary thyroid macrocarcinoma. Medullary thyroid microcarcinoma showed more malignant ultrasonic features. The diagnostic accuracy of preoperative serum calcitonin was higher than FNA for medullary thyroid micro carcinoma(χ 2=47.933, P=0.000). Multivariate regression analysis demonstrated that the abutment/perimeter ≥1/4( OR=25.475, 95%CI: 2.320-279.771), preoperative serum calcitonin >65 ng/L( OR=32.663, 95%CI:2.433-438.409) were the independent factor for lateral cervical lymph node metastases of medullary thyroid microcarcinoma. Conclusions:The combination of ultrasonography and serum calcitonin helps establish early diagnosis of medullary thyroid microcarcinoma. Medullary thyroid microcarcinoma with the abutment/perimeter ≥1/4, serum calcitonin >65 ng/L predicts lateral cervical lymph node metastases.

Objective:To explore the efficacy of flow diversion combined with coil embolization in treatment of intracranial aneurysms.Methods:The clinical data of 110 patients with intracranial aneurysms treated by flow diversion in our hospital from April 2015 to September 2019 were retrospectively analyzed. In these patients, 48 were treated by flow diversion combined with coil embolization and 62 were treated by flow diversion alone; the efficacy and safety of patients from the two groups were compared.Results:Blood flow diversion was successfully implanted into all 110 patients, with technical success rate of 100%. Immediate complete occlusion rate in the flow diversion combined with coil embolization group (16.7%) was significantly higher than that in the flow diversion group (1.6%, P<0.05). There was no significant difference in the incidence of perioperative complications between flow diversion combined with coil embolization group and flow diversion group (4.17% vs. 4.84%, P>0.05). During the mean follow-up of 6.72±3.80 months, modified Rankin scale (mRS) scores of patients in the flow diversion combined with coil embolization group were all 0; one patient had mRS score of 1, one patients had mRS scores of 2, and 60 patients had mRS score of 0 in patients from the flow diversion group; no significant difference was noted between the two groups ( P>0.05). Patients in the flow diversion combined with coil embolization group had significantly higher rate of complete aneurysm occlusion than those in the flow diversion group (88.3% vs. 66.1%, P<0.05). Conclusions:Flow diversion is an effective and safe strategy in treatment of intracranial aneurysms. Flow diversion combined with coil embolization can effectively promote early healing of aneurysms in selective patients.

Kidney tumor is one of the diseases threatening human health. Ultrasound is widely applied in kidney tumor diagnosis due to its high popularization, low price and no radiation. Accurate segmentation of kidney tumor is the basis of precise treatment. Kidney tumors often grow in the middle of cortex, so that segmentation is easy disturbed by nearby organs. Besides, ultrasound images own low contrast and large speckle, leading to difficult segmentation. This paper proposed a novel kidney tumor segmentation method in ultrasound images using adaptive sub-regional evolution level set models (ASLSM). Regions of interest are firstly divided into subareas. Secondly, object function is designed by integrating inside and outside energy and gradient, in which the ratio of these two parts are adjusted adaptively. Thirdly, ASLSM adapts convolution radius and curvature according to centroid principle and similarity inside and outside zero level set. Hausdorff distance (HD) of (8.75 ± 4.21) mm, mean absolute distance (MAD) of (3.26 ± 1.69) mm, dice-coefficient (DICE) of 0.93 ± 0.03 were obtained in the experiment. Compared with traditional ultrasound segmentation method, ASLSM is more accurate in kidney tumor segmentation. ASLSM may offer convenience for doctor to locate and diagnose kidney tumor in the future.
Algorithms ; Fetal Growth Retardation ; Humans ; Image Processing, Computer-Assisted ; Kidney Neoplasms ; Osteochondrodysplasias ; Ultrasonography

Objective: To investigate the correlation between cervical lymph node skip metastasis with ultrasonographic characteristics of papillary thyroid micro- carcinoma (PTMC). Methods: We reviewed ultrasonographic features of 385 primary PTMC and cervical lymph node metastasis, confirmed by pathology in Tianjin Medical University Cancer Institute and Hospital, to evaluate the efficacy of ultrasonography in the diagnosis of cervical lymph node metastasis of PTMC patients. The relationship between ultrasonographic features of primary lesions and skip metastasis of cervical lymph nodes was analyzed by χ² test and multiple factor Cox regression. Results: Among the 385 cases of PTMC patients with cervical lymph node metastasis, 231 cases were central lymph node metastasis alone, 31 cases were lateral cervical lymph node metastasis alone, 123 cases were both central and lateral cervical lymph node metastasis. Among the 354 cases without skip metastasis of cervical lymph nodes, 48 cases were level Ⅱ, 92 cases were level Ⅲ, 83 cases were level Ⅳ, 9 cases were level Ⅴ, 354 cases were level Ⅵ. Among the 31 cases with skipping metastasis of cervical lymph nodes, 12 cases were level Ⅱ, 14 cases were level Ⅲ, 14 cases were level Ⅳ, 1 case was level Ⅴ. The sensitivity and specificity of preoperative ultrasonography in the diagnosis of central cervical lymph node metastasis were 46.3% and 66.7%, respectively, and those of lateral cervical lymph node were 91.0% and 87.8%, respectively. Univariate analysis showed that the abutment/perimeter, diameter and location of PTMC were significantly associated with skip metastasis (P<0.05), multivariate analysis showed that abutment/perimeter and location of PTMC were significantly associated with skip metastasis (P<0.05). Conclusions The sensitivity and specificity of preoperative ultrasound diagnosis for lateral cervical lymph node metastasis of PTMC is higher than that of central metastasis. PTMC with abutment/perimeter ≥1/4 and upper portion location are prone to skip metastasis.