1.A convergent mixed-methods study on the maternal influenza vaccination willingness among pregnant and postpartum women in Shanghai and Liaoning Province
Fanyu ZENG ; Honghong YANG ; Hong JIANG ; Chunyi GU ; Fengyun YANG ; Longmei JIN ; Changhui LI ; Haiqi WANG ; Xu QIAN
Shanghai Journal of Preventive Medicine 2025;37(9):781-787
ObjectiveTo investigate the current status and related factors of maternal influenza vaccination willingness among pregnant and postpartum women in Shanghai and Liaoning Province, China, and to explore the facilitators and barriers affecting vaccination uptake, so as to provide references for future practices in promoting maternal influenza immunization in China. MethodsA convergent mixed-methods research was conducted. From January to March 2024, a questionnaire survey was conducted among women attending prenatal and postnatal care at 7 medical institutions in Shanghai and Dalian, Liaoning Province, which aimed to assess pregnant women’s knowledge about influenza vaccine and their willingness to vaccination during pregnancy, as well as to identify the related factors. In addition, purposive sampling method was used to conduct in-depth interviews with pregnant women and perinatal healthcare service providers to explore their perspectives on influenza vaccination during pregnancy, including the reasons for their willingness or unwillingness to receive ( or recommend) the vaccine, and the relevant facilitators and barriers to vaccination. ResultsA total of 366 pregnant and postpartum women participated in the questionnaire survey, and 9.56% (35/366) of them were willing to receive the influenza vaccine during pregnancy. The results of multivariate logistic stepwise regression analyses showed that primipara (aOR=0.158, 95%CI: 0.037‒0.671, P=0.012), family members’ support for influenza vaccination during pregnancy (aOR=0.015, 95%CI: 0.003‒0.082, P<0.001) were associated with higher willingness to receive influenza vaccine during pregnancy. Absence of influenza infection during pregnancy (aOR=5.383, 95%CI: 1.801‒16.092, P<0.001), and lack of knowledge regarding influenza vaccination during pregnancy (aOR=11.294, 95%CI: 3.593‒35.496, P<0.01) were associated with lower willingness to receive influenza vaccine during pregnancy. Qualitative findings indicated that the facilitators to vaccination willingness among pregnant and postpartum women included the recommendation of healthcare service providers, adequate knowledge of influenza vaccine information and family members’ support for vaccination. Conversely, the barriers to vaccination willingness included low recommendation from the healthcare service providers, lack of knowledge about the safety of influenza vaccine during pregnancy and inadequate attention to influenza and influenza vaccine. ConclusionThe willingness to receive influenza vaccination among pregnant and postpartum women in Shanghai and Liaoning Province is relatively low. It is recommended that China should promptly improve the evidence-based system for the safety and efficacy of influenza vaccines for pregnant and postpartum women, along with an establishment of the mechanism for addressing adverse reactions. Furthermore, it is essential to enhance educational outreach to pregnant and postpartum women, their families, and healthcare service providers, thereby increasing the accessibility of information regarding influenza vaccination, which are expected to enhance the willingness of pregnant and postpartum women to receive the vaccine.
2.Construction of a predictive model for extracapsular extension after radical prostatectomy in clinically localized prostate cancer based on SEER database
Zhiheng HUANG ; Changbao XU ; Han XU ; Tianhe ZHANG ; Haiyang WEI ; Junfeng GAO ; Changhui FAN
Chinese Journal of Urology 2025;46(3):180-187
Objective:To explore the independent factors influencing extraprostatic extension (EPE) after radical prostatectomy(RP) in patients with clinically localized prostate cancer by utilizing the Surveillance, Epidemiology, and End Results (SEER) database. A nomogram model was developed and externally validated.Methods:Clinical and pathological data of 20 916 clinically localized prostate cancer patients (T 1-2N 0M 0) who underwent RP between 2010 and 2021 were extracted from the SEER database. The mean age was (61.71±7.09) years old, and a total of 17 835 patients (85.3%) were married.There were 2 243 patients (10.7%) with prostate-specific antigen (PSA) <4 ng/ml, 14 831 patients (70.9%) with ≥4 and <10 ng/ml, and 2 965 patients (14.2%) with ≥10 and <20 ng/ml. There were 14 870 patients (71.1%) with clinical staging of stage T 1, and 6 046 patients (28.9%) with T 2. There were 48 patients (0.2%) with pathological staging of stage T 1, 15 794 (75.5%) with T 2, 5 001(23.9%) with T 3, and 73 (0.3%) with T 4 stage after radical surgery.The patients of SEER database were divided into training and internal validation groups in a 7∶3 ratio by using stratified sampling. Additionally, data were collected for 75 clinically localized prostate cancer patients who underwent RP at the Second Affiliated Hospital of Zhengzhou University from September 2019 to September 2024, serving as the external validation group.The mean age was(65.39±7.45) years old. Among them, 73 (97.3%) were married. There were 2 patients (2.7%) with PSA <4 ng/ml, 17 patients (22.7%) with ≥4 and <10 ng/ml, and 34 patients (45.3%) with ≥10 and <20 ng/ml. There were 47 patients (62.7%) with clinical staging of stage T 1, and 28 patients (37.3%) with T 2. There were 7 patients (9.3%) with pathological staging of stage T 1, 48 patients (64.0%)with T 2, 18 patients (24.0%) with T 3, and 2 patients (2.7%) with T 4 stage after radical surgery. All patients were categorized into organ-confined (OC) and EPE groups based on post-surgical pathology. Univariate and multivariate logistic regression analyses, with a stepwise backward selection, were performed on the training group to identify independent risk factors of EPE, which were used to construct a nomogram model. Model performance was assessed using receiver operating characteristic (ROC) curve area under the curve (AUC), calibration curves, and decision curve analysis (DCA) for the training group, internal validation group, and external validation group. Results:EPE was observed in 3 585 cases (24.5%), 1 489 cases (23.8%), and 20 cases (26.7%) in the training, internal validation, and external validation groups, respectively. Logistic regression analyses identified preoperative age ( OR=1.026, P<0.001), PSA levels (≥10 and <20 ng/ml: OR=1.790, P<0.001; ≥20 ng/ml: OR=2.683, P<0.001), tumor maximum diameter (10-20 mm: OR=2.051, P<0.001; >20 mm: OR=3.937, P<0.001), biopsy Gleason score (score 7: OR=1.911, P<0.001; score 8: OR=2.906, P<0.001; score 9: OR = 5.278, P<0.001; score 10: OR=4.421, P=0.003), number of positive biopsy cores (≥4 cores: OR=1.260, P<0.001), and their proportion of total cores ( OR=1.012, P<0.001) as independent predictors of EPE. The nomogram model demonstrated good predictive performance, with AUC of 0.741, 0.748, and 0.724 in the training, internal validation, and external validation groups, respectively. Calibration and DCA curves confirmed the model’s excellent stability and generalizability. Conclusions:Age, PSA levels, maximum tumor diameter, biopsy Gleason score, number of positive biopsy cores, and their proportion of total cores are independent predictors of EPE after RP in clinically localized prostate cancer. The constructed model effectively predicts the risk of EPE occurrence.
3.Construction of a predictive model for extracapsular extension after radical prostatectomy in clinically localized prostate cancer based on SEER database
Zhiheng HUANG ; Changbao XU ; Han XU ; Tianhe ZHANG ; Haiyang WEI ; Junfeng GAO ; Changhui FAN
Chinese Journal of Urology 2025;46(3):180-187
Objective:To explore the independent factors influencing extraprostatic extension (EPE) after radical prostatectomy(RP) in patients with clinically localized prostate cancer by utilizing the Surveillance, Epidemiology, and End Results (SEER) database. A nomogram model was developed and externally validated.Methods:Clinical and pathological data of 20 916 clinically localized prostate cancer patients (T 1-2N 0M 0) who underwent RP between 2010 and 2021 were extracted from the SEER database. The mean age was (61.71±7.09) years old, and a total of 17 835 patients (85.3%) were married.There were 2 243 patients (10.7%) with prostate-specific antigen (PSA) <4 ng/ml, 14 831 patients (70.9%) with ≥4 and <10 ng/ml, and 2 965 patients (14.2%) with ≥10 and <20 ng/ml. There were 14 870 patients (71.1%) with clinical staging of stage T 1, and 6 046 patients (28.9%) with T 2. There were 48 patients (0.2%) with pathological staging of stage T 1, 15 794 (75.5%) with T 2, 5 001(23.9%) with T 3, and 73 (0.3%) with T 4 stage after radical surgery.The patients of SEER database were divided into training and internal validation groups in a 7∶3 ratio by using stratified sampling. Additionally, data were collected for 75 clinically localized prostate cancer patients who underwent RP at the Second Affiliated Hospital of Zhengzhou University from September 2019 to September 2024, serving as the external validation group.The mean age was(65.39±7.45) years old. Among them, 73 (97.3%) were married. There were 2 patients (2.7%) with PSA <4 ng/ml, 17 patients (22.7%) with ≥4 and <10 ng/ml, and 34 patients (45.3%) with ≥10 and <20 ng/ml. There were 47 patients (62.7%) with clinical staging of stage T 1, and 28 patients (37.3%) with T 2. There were 7 patients (9.3%) with pathological staging of stage T 1, 48 patients (64.0%)with T 2, 18 patients (24.0%) with T 3, and 2 patients (2.7%) with T 4 stage after radical surgery. All patients were categorized into organ-confined (OC) and EPE groups based on post-surgical pathology. Univariate and multivariate logistic regression analyses, with a stepwise backward selection, were performed on the training group to identify independent risk factors of EPE, which were used to construct a nomogram model. Model performance was assessed using receiver operating characteristic (ROC) curve area under the curve (AUC), calibration curves, and decision curve analysis (DCA) for the training group, internal validation group, and external validation group. Results:EPE was observed in 3 585 cases (24.5%), 1 489 cases (23.8%), and 20 cases (26.7%) in the training, internal validation, and external validation groups, respectively. Logistic regression analyses identified preoperative age ( OR=1.026, P<0.001), PSA levels (≥10 and <20 ng/ml: OR=1.790, P<0.001; ≥20 ng/ml: OR=2.683, P<0.001), tumor maximum diameter (10-20 mm: OR=2.051, P<0.001; >20 mm: OR=3.937, P<0.001), biopsy Gleason score (score 7: OR=1.911, P<0.001; score 8: OR=2.906, P<0.001; score 9: OR = 5.278, P<0.001; score 10: OR=4.421, P=0.003), number of positive biopsy cores (≥4 cores: OR=1.260, P<0.001), and their proportion of total cores ( OR=1.012, P<0.001) as independent predictors of EPE. The nomogram model demonstrated good predictive performance, with AUC of 0.741, 0.748, and 0.724 in the training, internal validation, and external validation groups, respectively. Calibration and DCA curves confirmed the model’s excellent stability and generalizability. Conclusions:Age, PSA levels, maximum tumor diameter, biopsy Gleason score, number of positive biopsy cores, and their proportion of total cores are independent predictors of EPE after RP in clinically localized prostate cancer. The constructed model effectively predicts the risk of EPE occurrence.
4.The value of PI-RADS score combined with SII in predicting pathological upgrading in patients with localized prostate cancer post-radical prostatectomy
Changhui FAN ; Zhiheng HUANG ; Changbao XU ; Han XU ; Haiyang WEI ; Tianhe ZHANG ; Junfeng GAO
Chinese Journal of Urology 2024;45(12):905-911
Objective:To investigate the application value of combining Prostate Imaging Reporting and Data System (PI-RADS v2.1) score and Systemic Immune-Inflammation Index (SII) in predicting pathological upgrading in patients with localized prostate cancer after radical prostatectomy(RP).Methods:A retrospective analysis was conducted on clinical data from 76 patients with localized prostate cancer who underwent prostate biopsy and radical prostatectomy at the Second Affiliated Hospital of Zhengzhou University between September 2019 and May 2024. The median age was 68 (65, 71) years. Total prostate-specific antigen (tPSA) was 17.4 (8.4, 30.9) ng/ml, and prostate volume was 43.1 (29.9, 58.9) ml. PI-RADS scores were ≤3 in 22 cases (28.9%) and >3 in 54 cases (71.1%). According to the International Society of Urological Pathology (ISUP) grading of biopsy specimens, 31 patients (40.8%) were classified as Group <3 and 45 patients (59.2%) as Group ≥3. Postoperatively, 25 patients (32.9%) were classified as ISUP Group <3, and 51 patients (67.1%) as Group ≥3. Pathological upgrading was defined as either: ①a higher ISUP grade in postoperative specimens compared to biopsy specimens or; ②benign prostate tissue identified in biopsy specimens but confirmed as prostate cancer postoperatively. Clinical data were compared between the pathological upgrade and non-upgrade groups. Univariate and multivariate logistic regression analyses were performed to identify independent risk factors for pathological upgrading and to construct a nomogram model. Receiver operating characteristic (ROC) curves were used to evaluate the predictive performance of individual indicators (PI-RADS, SII, %PSA, and the proportion of tumor tissue in biopsy specimens) and the combined nomogram model. Internal validation was conducted using cross-validation, and calibration and decision curves were generated to assess the nomogram′s accuracy and clinical net benefit.Results:Among the 76 patients included, 10 (13.2%) experienced pathological downgrading, 36 (47.4%) had consistent grading, and 30 (39.5%) experienced pathological upgrading. The platelet-to-lymphocyte ratio (PLR) [118.2(93.5, 139.1) vs. 95.2(79.3, 116.4), P=0.021], SII [394.8(331.0, 513.6) vs. 338.8(217.2, 407.8), P=0.002], and the number of cases with a PI-RADS score >3 [26 cases(86.7%) vs. 28 cases(60.9%), P=0.015] were significantly higher in the pathological upgrade group than in the non-upgrade group. Conversely, the percentage of positive biopsy cores [35.9%(12.6%, 51.8%) vs. 43.8%(21.0%, 92.1%), P=0.045], the proportion of tumor tissue in biopsy specimens [6.9%(1.3%, 20.1%) vs. 19.3%(9.1%, 58.4%), P<0.01], and the number of cases in ISUP biopsy Group ≥3 [12 cases (40.0%) vs. 33 cases (71.7%), P=0.006] were significantly lower in the upgrade group (all P < 0.05). Univariate and multivariate logistic regression analyses showed that PI-RADS score( OR=17.111, 95% CI 2.388-122.592, P<0.01), SII( OR=1.009, 95% CI 1.001-1.016, P=0.028), %PSA ( OR=0.003, 95% CI 0.002-0.004, P<0.01), and the proportion of tumor tissue in biopsy specimens ( OR=0.899, 95% CI 0.837-0.966, P<0.01) were independent predictors of pathological upgrading. The area under the ROC curve (AUC) for PI-RADS, SII, %PSA, and the proportion of tumor tissue in biopsy specimens were 0.607, 0.711, 0.618, and 0.778, respectively. The combined AUC for %PSA and the proportion of tumor tissue was 0.791, while the combined AUC of the four-indicator nomogram model was 0.914. The DeLong test indicated a statistically significant difference in diagnostic performance between the two models ( P<0.01). Calibration and decision curves demonstrated good accuracy and clinical net benefit for the nomogram model. Conclusions:The PI-RADS v2.1 score and SII have significant predictive value for pathological upgrading after radical prostatectomy in prostate cancer. A nomogram model combining PI-RADS, SII, %PSA, and the proportion of tumor tissue in biopsy specimens shows excellent predictive performance.
5.The value of PI-RADS score combined with SII in predicting pathological upgrading in patients with localized prostate cancer post-radical prostatectomy
Changhui FAN ; Zhiheng HUANG ; Changbao XU ; Han XU ; Haiyang WEI ; Tianhe ZHANG ; Junfeng GAO
Chinese Journal of Urology 2024;45(12):905-911
Objective:To investigate the application value of combining Prostate Imaging Reporting and Data System (PI-RADS v2.1) score and Systemic Immune-Inflammation Index (SII) in predicting pathological upgrading in patients with localized prostate cancer after radical prostatectomy(RP).Methods:A retrospective analysis was conducted on clinical data from 76 patients with localized prostate cancer who underwent prostate biopsy and radical prostatectomy at the Second Affiliated Hospital of Zhengzhou University between September 2019 and May 2024. The median age was 68 (65, 71) years. Total prostate-specific antigen (tPSA) was 17.4 (8.4, 30.9) ng/ml, and prostate volume was 43.1 (29.9, 58.9) ml. PI-RADS scores were ≤3 in 22 cases (28.9%) and >3 in 54 cases (71.1%). According to the International Society of Urological Pathology (ISUP) grading of biopsy specimens, 31 patients (40.8%) were classified as Group <3 and 45 patients (59.2%) as Group ≥3. Postoperatively, 25 patients (32.9%) were classified as ISUP Group <3, and 51 patients (67.1%) as Group ≥3. Pathological upgrading was defined as either: ①a higher ISUP grade in postoperative specimens compared to biopsy specimens or; ②benign prostate tissue identified in biopsy specimens but confirmed as prostate cancer postoperatively. Clinical data were compared between the pathological upgrade and non-upgrade groups. Univariate and multivariate logistic regression analyses were performed to identify independent risk factors for pathological upgrading and to construct a nomogram model. Receiver operating characteristic (ROC) curves were used to evaluate the predictive performance of individual indicators (PI-RADS, SII, %PSA, and the proportion of tumor tissue in biopsy specimens) and the combined nomogram model. Internal validation was conducted using cross-validation, and calibration and decision curves were generated to assess the nomogram′s accuracy and clinical net benefit.Results:Among the 76 patients included, 10 (13.2%) experienced pathological downgrading, 36 (47.4%) had consistent grading, and 30 (39.5%) experienced pathological upgrading. The platelet-to-lymphocyte ratio (PLR) [118.2(93.5, 139.1) vs. 95.2(79.3, 116.4), P=0.021], SII [394.8(331.0, 513.6) vs. 338.8(217.2, 407.8), P=0.002], and the number of cases with a PI-RADS score >3 [26 cases(86.7%) vs. 28 cases(60.9%), P=0.015] were significantly higher in the pathological upgrade group than in the non-upgrade group. Conversely, the percentage of positive biopsy cores [35.9%(12.6%, 51.8%) vs. 43.8%(21.0%, 92.1%), P=0.045], the proportion of tumor tissue in biopsy specimens [6.9%(1.3%, 20.1%) vs. 19.3%(9.1%, 58.4%), P<0.01], and the number of cases in ISUP biopsy Group ≥3 [12 cases (40.0%) vs. 33 cases (71.7%), P=0.006] were significantly lower in the upgrade group (all P < 0.05). Univariate and multivariate logistic regression analyses showed that PI-RADS score( OR=17.111, 95% CI 2.388-122.592, P<0.01), SII( OR=1.009, 95% CI 1.001-1.016, P=0.028), %PSA ( OR=0.003, 95% CI 0.002-0.004, P<0.01), and the proportion of tumor tissue in biopsy specimens ( OR=0.899, 95% CI 0.837-0.966, P<0.01) were independent predictors of pathological upgrading. The area under the ROC curve (AUC) for PI-RADS, SII, %PSA, and the proportion of tumor tissue in biopsy specimens were 0.607, 0.711, 0.618, and 0.778, respectively. The combined AUC for %PSA and the proportion of tumor tissue was 0.791, while the combined AUC of the four-indicator nomogram model was 0.914. The DeLong test indicated a statistically significant difference in diagnostic performance between the two models ( P<0.01). Calibration and decision curves demonstrated good accuracy and clinical net benefit for the nomogram model. Conclusions:The PI-RADS v2.1 score and SII have significant predictive value for pathological upgrading after radical prostatectomy in prostate cancer. A nomogram model combining PI-RADS, SII, %PSA, and the proportion of tumor tissue in biopsy specimens shows excellent predictive performance.
6.Clinical features of 4 pedigrees with transthyretin related familial amyloid polyneuropathy
Juan KANG ; Changhui LEI ; Chao LIU ; Yuqiao XU ; Bo WANG ; Liwen LIU ; Yanchun DENG
Chinese Journal of Neuromedicine 2021;20(3):250-257
Objective:To explore the clinical manifestations of 4 pedigrees with transthyretin related familial amyloid polyneuropathy (TTR-FAP).Methods:The clinical data were collected and analyzed from 4 pedigrees with TTR-AFP, admitted to our hospital from July 2017 to May 2019; 20 patients and 2 asymptomatic carriers of the TTR mutation gene were included. In particular, the detailed data of the 4 probands affected with TTR-FAP came from the 4 different pedigrees were collected. Results:In these 20 patients, the age of onset ranged from 30 to 65; the first symptoms of diarrhea, constipation, alternating episodes of constipation and diarrhea were found; there were damaged peripheral nerve and inexplicable weight loss; cardiomyopathy was noted in 9 patients; orthostatic hypotension was noted in 9 patients, sexual dysfunction in 5, abnormal urination in 6, and blurred vision or corestenoma in 3. TTR mutation gene was confirmed in 7 patients and pathological diagnosis was found in 3 patients. Diflunisal was used in one patient and tafamidis was used 2 patients. Twelve died and 8 patients survived among 20 patients with disease progression. All the 4 probands were male, with an average age of 49.3 years; all patients had different degrees of sensorimotor peripheral neuropathy, autonomic neuropathy and cardiomyopathy; electrophysiological examination suggested length dependent sensory motor peripheral neuropathy of the extremities, with axonal damage as the evidence; and cardiac hypertrophy was noted in echocardiography. The sural nerve biopsy of the 3 probands showed positive Congo red staining. Medical whole exon sequencing indicated that 2 probands had pathogenic mutations (TTR-E74K and TTR-A140S), and 1 proband had likely pathogenic mutation (TTR-S70R). Two asymptomatic carriers of the TTR gene mutation remained normal condition. Conclusion:The clinical manifestations of TTR-FAP include progressive sensorimotor and autonomic neuropathy, and multi-system disorders, such as combining with gastrointestinal problems, hypertrophic myocardium, inexplicable weight loss and blurred vision or corestenoma, which might be important reminders for diagnosis of TTR-FAP.
7.The role of three-dimensional speckle tracking imaging in the diagnosis of immunoglobulin light-chain cardiac amyloidosis with normal left ventricular ejection fraction
Changhui LEI ; Lei ZUO ; Yan WANG ; Xiaoli ZHU ; Mengyao ZHOU ; Qianli YANG ; Hanxi XU ; Liwen LIU
Chinese Journal of Ultrasonography 2020;29(3):213-218
Objective:To explore the value of three-dimensional speckle tracking imaging (3D-STI) in the diagnosis of immunoglobulin light-chain cardiac amyloidosis(AL-CA) patients with normal left ventricular ejection fraction (LVEF).Methods:A total of 92 consecutive patients diagnosed with systemic immunoglobulin light chain amyloidosis(sAL) and with normal LVEF from October 2014 to January 2018 in Xijing Hospital were enrolled.Based on the diagnostic criteria of cardiac involvement, the patients were divided into AL-CA group (52 cases) and immunoglobulin light chain amyloidosis (AL) group (40 cases). The clinical data and serological markers of the patients were collected, the conventional echocardiography and full-volume three dimensional dynamic images were acquired, left ventricular global longitudinal strain (GLS), global radial strain (GRS), global circumferential strain (GCS), and global area strain (GAS) were analyzed using off-line TomTec software. The differences between the two groups were compared.Results:Compared with the AL group, the NT-proBNP of AL-CA group was significantly higher ( P<0.05) and there were no significant differences of the other serological indexes between the two groups(all P>0.05). Compared with the AL group, the maximal left ventricular wall thickness, left ventricular mass index, left atrial volume index, and E/e′ in the AL-CA group were significantly increased (all P<0.05). There were no significant differences of other conventional echocardiographic measurements between the two groups(all P>0.05). Compared with the AL group, GLS, GAS, and GRS were significantly lower in AL-CA group (all P<0.05); but there was no significant difference of GCS between the two groups( P>0.05). The ROC curve analysis showed that the cut-off values discriminating cardiac involvement were 16.09% for GLS, 36.54% for GAS and 31.90% for GRS. Conclusions:3D-STI measurements of left ventricular myocardial mechanics could detect cardiac involvement in patients with sAL amyloidosis, and provides a new method for diagnosis of AL-CA.
8.Application of delayed-enhancement MRI in lumpectomy cavity delineation for patients after breast-conserving surgery in prone radiotherapy using deformable image registration
Changhui ZHAO ; Jianbin LI ; Wei WANG ; Guanzhong GONG ; Liang XU ; Yingjie ZHANG ; Fengxiang LI ; Qian SHAO ; Jinzhi WANG ; Xijun LIU ; Min XU
Chinese Journal of Radiation Oncology 2020;29(12):1054-1058
Objective:To assess the feasibility of delayed-enhancement MRI in contouring the lumpectomy cavity (LC) for patients with invisible seroma or a low cavity visualization score (CVS≤2) in the excision cavity after breast-conserving surgery (BCS).Methods:Twenty-six patients with stage T 1-2N 0M 0 who underwent prone radiotherapy after BCS were recruited. The LC delineated on CT simulation images was denoted as LC CT. The LCs delineated on T 2WI, as well as on different delayed phases (2-, 5-and 10-minute) of delayed-enhancement T 1WI were defined as LC T2, LC 2T1, LC 5T1 and LC 10T1, respectively. Subsequently, the volumes and locations of the LCs were compared between CT simulation images and different sequences of MR simulation images using deformable image registration. Results:The volumes of LC T2, LC 2T1, LC 5T1 and LC 10T1 were all larger than that of LC CT. A statistical significance was found between the volume of LC CT and those of LC 2T1 or LC 5T1, respectively (both P<0.05). The conformal index (CI), degree of inclusion (DI), dice similarity coefficient (DSC) and the distance between the center of mass of the targets (COM) of LC CT-LC 10T1 were better than those of LC CT-LC T2, LC CT-LC 2T1 and LC CT-LC 5T1, however, there was no statistical difference among them (all P>0.05). Conclusions:It is feasible to delineate the LC based on prone delayed-enhancement MR simulation images in patients with low CVS after BCS. Meanwhile, the LCs derived from prone delayed-enhancement T 1WI of 10-minute are the most similar with those derived from prone CT simulation scans using titanium clips, regardless of the volumes and locations of LCs.
9.Characteristics on molecular epidemiology of Brucella melitensis in Jiangxi province
Jun ZONG ; Sheng DING ; Guozhong TIAN ; Guanghui XIA ; Changhui XIONG ; Peng WANG ; Xiaoqian XU ; Jianmin XU
Chinese Journal of Epidemiology 2020;41(8):1341-1344
Objective:To understand the molecular characteristics and correlation among isolated strains of Brucella melitensis (BM) so as to improve the strategies on prevention and control of the disease in Jiangxi province. Methods:A total of 25 strains of BM isolated from human in 17 counties of Jiangxi province were analyzed by multiple locus variable-number tandem repeat analysis (MLVA) method.Results:A total of 25 strains of BM were classified into 24 independent genotypes with similarities between 67.00% and 100.00% and Simpson index between 0.000 and 0.773. There were 3 genotypes in MLVA8, including 60.00% (15/25) as 42 genotype, 32.00% (8/25) as 43 genotype, and 8.00% (2/25) as 63 genotype, respectively. There were 7 genotypes in MLVA11 identified, with 116 genotype and 125 genotype the main genotypes, accounting for 56.00% (14/25) of all the identified strains.Conclusions:Genes from all the 25 strains of BM that isolated from human being were with high genetic diversities, and various, genotypes. However, no obvious epidemiological correlation was noticed among these strains, indicating the complexity of the source of infection on Brucella in Jiangxi province.
10.An echocardiographic study of left ventricular torsion in patients with latent obstructive hypertrophic cardiomyopathy
Lei ZUO ; Jing WANG ; Xin MENG ; Changhui LEI ; Qianli YANG ; Nan KANG ; Fan YANG ; Lei XU ; Liwen LIU
Chinese Journal of Ultrasonography 2019;28(4):277-282
Objective To explore the changes of left ventricular torsion function in patients with latent obstructive hypertrophic cardiomyopathy ( HCM ) ,and provide quantitative informations for clinical evaluation of cardiac function . Methods A total of 49 consecutive patients with HCM without left ventricular outflow tract obstruction at rest were enrolled . All subjects underwent exercise stress echocardiography . After exercise left ventricular outflow tract pressure gradient ( LVO T‐PG ) ≥30 mm Hg was positive for exercise stress test ( latent obstruction) ,w hile LVO T‐PG< 30 mm Hg was negative for exercise stress test ( non‐obstruction) . An ultrasound system obtained two‐dimensional ultrasound images of resting and moving peaks . The global longitudinal strain ( GLS ) ,global circumferential strain ( GCS ) , global radial strain ( GRS) of the left ventricle 16 segments and left ventricular rotation ,twist were analysis using off‐line EchoPAC software . T he differences of the above parameters were compared between the two groups . Results T here were no significant differences in GLS ,GRS ,GCS and Rotation‐B between the two groups in resting and peak period of exercise ( all P > 0 .05 ) ,GRS in both groups were significantly increased compared with that before exercise ( all P < 0 .05 ) . Compared with the negative exercise stress group ,the left ventricular twist and Rotation‐A were significantly increased in resting and peak period of exercise in the positive exercise stress test group( all P <0 .05) . Compared with before exercise ,Rotation‐A and left ventricular twist were significantly decreased in the positive exercise stress test group ( all P <0 .05) ,while no significantly difference was found in the negative exercise stress group ( all P > 0 .05 ) . Conclusions Left ventricular torsion function is significantly changed in rest and after exercise in latent obstructive HCM patients ,providing valuable quantitative information for clinical comprehensive evaluation of cardiac function .

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