1.Risk factor analysis and nomogram model construction of pulmonary hemorrhage complicating lung nodule localization with a new type of 4-hook localization needle
Wenli HUO ; Xuechun KOU ; Yonghao DU ; Ting LIANG ; Chenguang GUO ; Gang NIU ; Jin SHANG
Journal of Xi'an Jiaotong University(Medical Sciences) 2025;46(6):1028-1036
Objective To construct a nomogram model for predicting pulmonary hemorrhage associated with the positioning of pulmonary nodules with the new four-hook positioning needle based on clinical-CT imaging features and evaluate its predictive efficacy.Methods We made a retrospective analysis of the clinical,imaging and pathological data of 449 patients with pulmonary nodules positioned by the new four-hook positioning needle.According to the random number table method(7∶3),they were divided into a training set of 314 cases and a validation set of 135 cases.Each data set was further divided into positive group and negative group for pulmonary hemorrhage according to the presence or absence of pulmonary hemorrhage.We evaluated the CT imaging features of pulmonary nodules,including nodule nature(pure ground-glass density,mixed ground-glass density,solid nodule),nodule diameter,distance from the nodule to the pleural surface(hereinafter referred to as length),nodule positioning time,and association with pulmonary hemorrhage.Independent sample t-test,Mann-Whitney U test and x2 test were used to compare the correlations of clinical and CT features of pulmonary nodules with pulmonary hemorrhage.LASSO regression and multivariate Logistic regression were employed to screen the independent risk factors related to pulmonary hemorrhage and construct a nomogram model.The receiver operating characteristic(ROC)curve was used to evaluate the predictive efficacy of the model,and the calibration curve and decision curve were respectively used for the verification of the nomogram model and evaluation of the clinical net benefit.Results The results of LASSO regression showed that the nature of pulmonary nodules,underlying diseases,smoking and length were the characteristic variables related to pulmonary hemorrhage.Based on the minimum akaike information criterion(AIC),the screened characteristic variables were included in the multivariate Logistic backward stepwise regression analysis.The results showed that the nature of pulmonary nodules,underlying diseases,smoking and length were all independent risk factors related to pulmonary hemorrhage.A nomogram was established according to the above independent risk factors and the ROC curve was drawn.The AUC of the training set was 0.86(95%CI:0.80-0.91),and the AUC of the validation set was 0.88(95%CI:0.80-0.96),with no statistically significant difference(P>0.05).The calibration curve suggested that the predicted values of the nomogram were close to the actual values,and the decision curve analysis showed that the net benefit of the model was good.Conclusion The nomogram model established by combining clinical-CT features such as the nature of pulmonary nodules,underlying diseases,smoking and length can effectively predict pulmonary hemorrhage associated with the positioning of pulmonary nodules with the new four-hook positioning needle.
2.Relationship Between Epicardial Adipose Tissue Assessed by Computed Tomography Angiography and Left Atrial Related Structure Indicators and Left Atrial Appendage Thrombosis in Patients With Non-valvular Atrial Fibrillation
Yafei HUANG ; Guojing MA ; Jie HU ; Chenguang KOU ; Caiying LI ; Xiaowei LIU
Chinese Circulation Journal 2025;40(8):787-794
Objectives:To explore the relationship between epicardial adipose tissue(EAT),left atrium and left atrial appendage(LAA)structures and LAA thrombosis in patients with non-valvular atrial fibrillation.Methods:Clinical data from non-valvular atrial fibrillation patients who underwent cardiac computed tomography angiography(CTA)and transesophageal echocardiography(TEE)at the Second Hospital of Hebei Medical University between November 2019 and October 2024,were retrospectively collected.Twenty-eight patients diagnosed with LAA thrombus by both CTA and TEE were enrolled as the LAA thrombus group(20 males,8 females,average age[65±9]years).Using an individual matching method,56 non-valvular atrial fibrillation patients without LAA thrombus,matched for gender and age(±3 years),were sequentially enrolled at a ratio of 1:2 as the no-thrombus group(40 males,16 females,average age[65±8]years).CTA was used to measure the epicardial adipose tissue volume(EATV),left atrial epicardial adipose tissue volume(LA-EATV),and structural parameters of the left atrium and LAA in both groups.The correlation between EAT,structural parameters of the left atrium/LAA and LAA thrombosis was evaluated.Results:In the LAA thrombus group,the proportions of patients with persistent atrial fibrillation and atrial fibrillation rhythm were significantly higher than in the no-thrombus group(both P<0.001).There were no statistically significant differences between the two groups in terms of age,gender composition,body mass index,duration of atrial fibrillation,and the proportions of patients with hypertension,diabetes,dyslipidemia,coronary heart disease,ischemic stroke,heart failure,vascular disease,and CHA2DS2-VASc scores(all P>0.05).Compared to the no-thrombus group,the EATV,LA-EATV,left atrial volume(LAV),LAA volume(LAAV),and LAA orifice area were significantly higher in the LAA thrombus group(all P<0.05).There was no significant difference between the two groups in the LAA depth(P=0.076).Conditional logistic regression analysis showed that LA-EATV(OR=1.092,95%CI:1.004-1.187,P=0.040)and LAV(OR=1.022,95%CI:1.003-1.041,P=0.025)were independent predictors of LAA thrombosis in non-valvular atrial fibrillation patients.The LA-EATV threshold for predicting LAA thrombosis was 27.16 cm3,with an area under the receiver operating characteristic curve(AUC)of 0.843(sensitivity 85.7%,specificity 76.8%);the LAV predictive threshold was 118.45 ml(AUC=0.853,sensitivity 82.1%,specificity 80.4%).Conclusions:LA-EATV and LAV measured by cardiac CTA are independent predictors of LAA thrombosis in patients with non-valvular atrial fibrillation.
3.Relationship Between Epicardial Adipose Tissue Assessed by Computed Tomography Angiography and Left Atrial Related Structure Indicators and Left Atrial Appendage Thrombosis in Patients With Non-valvular Atrial Fibrillation
Yafei HUANG ; Guojing MA ; Jie HU ; Chenguang KOU ; Caiying LI ; Xiaowei LIU
Chinese Circulation Journal 2025;40(8):787-794
Objectives:To explore the relationship between epicardial adipose tissue(EAT),left atrium and left atrial appendage(LAA)structures and LAA thrombosis in patients with non-valvular atrial fibrillation.Methods:Clinical data from non-valvular atrial fibrillation patients who underwent cardiac computed tomography angiography(CTA)and transesophageal echocardiography(TEE)at the Second Hospital of Hebei Medical University between November 2019 and October 2024,were retrospectively collected.Twenty-eight patients diagnosed with LAA thrombus by both CTA and TEE were enrolled as the LAA thrombus group(20 males,8 females,average age[65±9]years).Using an individual matching method,56 non-valvular atrial fibrillation patients without LAA thrombus,matched for gender and age(±3 years),were sequentially enrolled at a ratio of 1:2 as the no-thrombus group(40 males,16 females,average age[65±8]years).CTA was used to measure the epicardial adipose tissue volume(EATV),left atrial epicardial adipose tissue volume(LA-EATV),and structural parameters of the left atrium and LAA in both groups.The correlation between EAT,structural parameters of the left atrium/LAA and LAA thrombosis was evaluated.Results:In the LAA thrombus group,the proportions of patients with persistent atrial fibrillation and atrial fibrillation rhythm were significantly higher than in the no-thrombus group(both P<0.001).There were no statistically significant differences between the two groups in terms of age,gender composition,body mass index,duration of atrial fibrillation,and the proportions of patients with hypertension,diabetes,dyslipidemia,coronary heart disease,ischemic stroke,heart failure,vascular disease,and CHA2DS2-VASc scores(all P>0.05).Compared to the no-thrombus group,the EATV,LA-EATV,left atrial volume(LAV),LAA volume(LAAV),and LAA orifice area were significantly higher in the LAA thrombus group(all P<0.05).There was no significant difference between the two groups in the LAA depth(P=0.076).Conditional logistic regression analysis showed that LA-EATV(OR=1.092,95%CI:1.004-1.187,P=0.040)and LAV(OR=1.022,95%CI:1.003-1.041,P=0.025)were independent predictors of LAA thrombosis in non-valvular atrial fibrillation patients.The LA-EATV threshold for predicting LAA thrombosis was 27.16 cm3,with an area under the receiver operating characteristic curve(AUC)of 0.843(sensitivity 85.7%,specificity 76.8%);the LAV predictive threshold was 118.45 ml(AUC=0.853,sensitivity 82.1%,specificity 80.4%).Conclusions:LA-EATV and LAV measured by cardiac CTA are independent predictors of LAA thrombosis in patients with non-valvular atrial fibrillation.
4.Risk factor analysis and nomogram model construction of pulmonary hemorrhage complicating lung nodule localization with a new type of 4-hook localization needle
Wenli HUO ; Xuechun KOU ; Yonghao DU ; Ting LIANG ; Chenguang GUO ; Gang NIU ; Jin SHANG
Journal of Xi'an Jiaotong University(Medical Sciences) 2025;46(6):1028-1036
Objective To construct a nomogram model for predicting pulmonary hemorrhage associated with the positioning of pulmonary nodules with the new four-hook positioning needle based on clinical-CT imaging features and evaluate its predictive efficacy.Methods We made a retrospective analysis of the clinical,imaging and pathological data of 449 patients with pulmonary nodules positioned by the new four-hook positioning needle.According to the random number table method(7∶3),they were divided into a training set of 314 cases and a validation set of 135 cases.Each data set was further divided into positive group and negative group for pulmonary hemorrhage according to the presence or absence of pulmonary hemorrhage.We evaluated the CT imaging features of pulmonary nodules,including nodule nature(pure ground-glass density,mixed ground-glass density,solid nodule),nodule diameter,distance from the nodule to the pleural surface(hereinafter referred to as length),nodule positioning time,and association with pulmonary hemorrhage.Independent sample t-test,Mann-Whitney U test and x2 test were used to compare the correlations of clinical and CT features of pulmonary nodules with pulmonary hemorrhage.LASSO regression and multivariate Logistic regression were employed to screen the independent risk factors related to pulmonary hemorrhage and construct a nomogram model.The receiver operating characteristic(ROC)curve was used to evaluate the predictive efficacy of the model,and the calibration curve and decision curve were respectively used for the verification of the nomogram model and evaluation of the clinical net benefit.Results The results of LASSO regression showed that the nature of pulmonary nodules,underlying diseases,smoking and length were the characteristic variables related to pulmonary hemorrhage.Based on the minimum akaike information criterion(AIC),the screened characteristic variables were included in the multivariate Logistic backward stepwise regression analysis.The results showed that the nature of pulmonary nodules,underlying diseases,smoking and length were all independent risk factors related to pulmonary hemorrhage.A nomogram was established according to the above independent risk factors and the ROC curve was drawn.The AUC of the training set was 0.86(95%CI:0.80-0.91),and the AUC of the validation set was 0.88(95%CI:0.80-0.96),with no statistically significant difference(P>0.05).The calibration curve suggested that the predicted values of the nomogram were close to the actual values,and the decision curve analysis showed that the net benefit of the model was good.Conclusion The nomogram model established by combining clinical-CT features such as the nature of pulmonary nodules,underlying diseases,smoking and length can effectively predict pulmonary hemorrhage associated with the positioning of pulmonary nodules with the new four-hook positioning needle.
5.MRI Diagnosis of Fetal Intracranial Hemorrhage
Lixia ZHOU ; Chenguang KOU ; Jingying BO ; Duo GAO ; Caiying LI ; Zuojun GENG
Chinese Journal of Medical Imaging 2018;26(4):252-257
Purpose To investigate the diagnostic value of prenatal MRI in fetal intracranial hemorrhage (FICH). Materials and Methods The imaging and clinical data of 41 cases of FICH accepting MRI diagnosis were retrospectively analyzed. The hemorrhage location, signal characteristics and the associated intracranial abnormalities were observed. The pregnancy outcomes and clinical data after birth were followed up. The correlation between periventricular hemorrhage/intraventricular hemorrhage (PVH/IVH) classification and clinical outcomes was analyzed by combining prenatal risk factors. Results Forty-one cases of FICH were evaluated. There were 23 cases of multifocal cerebral hemorrhage and 18 cases of single focal hemorrhage. According to the bleeding site, the 41 cases were classified into PVH/IVH (33 cases), cerebral hemispheres near cortex hemorrhage (3 cases), cerebellar hemorrhage (2 cases), subdural hemorrhage (2 cases) and subarachnoid hemorrhage (1 case). Most of the FICH cases were in subacute period (36/41) and a few were in chronic period or forming encephalomalacia (5/41). The associated changes included ventriculomegaly, vascular malformation, agenesis of corpus callosum, agenesis of vermis, etc. Follow-up results showed that there were 25 cases of labor induction (autopsy after labor induction was performed in 3 cases), 16 cases were followed-up after birth. Among the 16 newborn, there was 1 case of PVH/IVH grade II fetus showing left ear hearing loss after birth, 1 case of grade II fetus showed dyskinesia within one year after birth, and 1 case of grade IV fetus showed unilateral limb movement disorder. The other 13 cases had no obvious neurological sequelae. Spearman correlation test of ranked data indicated that PVH/IVH classification was moderately correlated with birth outcome (r=0.689, P<0.05). Conclusion Prenatal MRI can evaluate the type and severity of fetal intracranial hemorrhage, and provide references for clinical diagnosis and treatment.
6.Advances in the research of hemodynamics of the pathogenesis of intracranial aneurysms
Dan ZHANG ; Caiying LI ; Bulang GAO ; Fangying JIA ; Chenguang KOU ; Cen WANG
Journal of Interventional Radiology 2017;26(4):378-382
Hemodynamics is a discipline that studies the effects of blood flow,blood flow volume and other factors on the arterial wall.Intracranial aneurysm is the main cause of death due to non-traumatic subarachnoid hemonhage,which has brought a heavy burden on society.Therefore,it is very important to make an intensive study of the pathogenesis of aneurysm.With the development of medical imaging technology and fluid mechanics software in recent years,it becomes possible to make the precise and scientific studies of the hemodynamics of intracranial aneurysms.In this paper,the hemodynamic factors inducing the formation of intracranial aneurysm that are proposed by medical experts at home and abroad are reviewed,and the hemodynamic mechanism is discussed.
7.Relationship Between Paracardial Adipose Tissue Volume, Body Mass Index and Severe Coronary Artery Stenosis in Young People
Qibin LIAO ; Caiying LI ; Tong PAN ; Dan ZHANG ; Chenguang KOU ; Cen WANG ; Fangying JIA ; Cairui ZHENG
Chinese Circulation Journal 2017;32(1):46-49
Objective:To evaluate the relationship betweenparacardial adipose tissue (PAT) volume, body mass index (BMI) and severe coronary artery stenosis in young people by quantitative measurement of 256-slice spiral CT.
Methods: A total of 150 patients younger than 45 years and received coronary angiography (CAG) in our hospital were divided into 2 groups:Lesion group, the patients with severe main coronary branch stenosis and Control group, patients with normal coronary artery. n=75 in each group. The height, body weight and BMI were recorded in all patients;imaging data was uploaded to the workstation to calculate the volumes ofepicardiumadipose tissue (EAT) volume,pericardial outsideadipose tissue volume and PAT volume, the correlation among 3 parameters were analyzed respectively.
Results:Compared with Control group, Lesion group had increased BMI (28.169±2.203) kg/m2 vs (24.960±3.041) kg/m2 and PAT volume (178.676±3.041) ml vs (99.0616±3.041) ml, all P<0.05. Compared with Control group,no matter male or female, Lesion group had larger PAT volume, P<0.01.EAT volume was related to pericardial outside adipose tissue volume (r=0.837, P<0.001) and PAT volume (r=0.971, P<0.001);pericardial outside adipose tissue volume was related to PAT volume (r=0.944, P<0.001).
Conclusion:PAT volume and BMI were obviously correlated to severe coronary artery stenosis in young people.
8.Recent Advances in Vaccines and Drugs Against the Ebola Virus.
Xiang ZHU ; Chenguang YAO ; Yanhong WEI ; Zheng KOU ; Kanghong HU
Chinese Journal of Virology 2015;31(3):287-292
The Ebola virus belongs to the Filovirus family, which causes Ebola hemorrhagic fever (mortality, 25%-90%). An outbreak of infection by the Ebola virus is sweeping across West Africa, leading to high mortality and worldwide panic. The Ebola virus has caused a serious threat to public health, so intensive scientific studies have been carried out. Several vaccines (e.g., rVSV-ZEBOV, ChAd3-ZEBOV) have been put into clinical trials and antiviral drugs (e.g., TKM-Ebola, ZMAPP) have been administered in the emergency setting to patients infected by the Ebola virus. Here, recent advances in vaccines and drugs against the Ebola virus are reviewed.
Animals
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Antiviral Agents
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administration & dosage
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Ebola Vaccines
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administration & dosage
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genetics
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immunology
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Ebolavirus
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drug effects
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genetics
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immunology
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physiology
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Hemorrhagic Fever, Ebola
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drug therapy
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prevention & control
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virology
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Humans
9.Clinical value of carbon nanoparticle in gastrectomy of stomach neoplasms
Huiming LIU ; Rongmei MA ; Honghua DING ; Suqin YU ; Chenguang KOU ; Cuiyun LIU
Chinese Journal of Postgraduates of Medicine 2014;37(26):12-14
Objective To evaluate the clinical application value of local injections of carbon nanoparticle in gastrectomy of stomach neoplasms.Methods Forty cases of stomach neoplasms with local injections of carbon nanoparticle in gastrectomy of stomach neoplasms were as experimental group,and 40 cases of stomach neoplasms with conventional gastrectomy of stomach neoplasms were as control group.The number of removed tiny lymph node and transferred tiny lymph node was compared.Results There was significant difference in the average number of removed tiny lymph node N1,N2,N3 between experimental group and control group (5.120 ± 0.455 vs.2.900 ± 0.245,3.890 ± 0.367 vs.1.750 ± 0.256,1.790 ± 0.224 vs.0.590 ± 0.054)(P < 0.01).There was significant difference in the average number of transferred tiny lymph node N1,N2,N3 between experimental group and control group (1.090 ±0.087 vs.0.430 ± 0.044,0.550 ± 0.052 vs.0.340 ± 0.027,0.410 ± 0.044 vs.0.130 ± 0.013)(P < 0.05).There was no significant difference in postoperative complications,mortality and length of hospital stay(P> 0.05).Conclusion Carbon nanoparticle in gastrectomy of stomach neoplasms is a simple,safe,easy method,and it has certain supplementary role in conventional gastrectomy of stomach neoplasms.

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