Background::Computer-aided detection (CAD) software has been introduced to automatically interpret digital chest X-rays. This study aimed to evaluate the performance of CAD software (JF CXR-1 v3.0, which was developed by a domestic Hi-tech enterprise) in tuberculosis (TB) case finding in China.Methods::In 2019, we conducted an internal evaluation of the performance of JF CXR-1 v3.0 by reading standard images annotated by a panel of experts. In 2020, using the reading results of chest X-rays by a panel of experts as the reference standard, we conducted an on-site prospective study to evaluate the performance of JF CXR-1 v3.0 and local radiologists in TB case finding in 13 township health centers in Zhongmu County, Henan Province.Results::Internal assessment results based on 277 standard images showed that JF CXR-1 v3.0 had a sensitivity of 85.94% (95% confidence interval [CI]: 77.42%, 94.45%) and a specificity of 74.65% (95% CI: 68.81%, 80.49%) to distinguish active TB from other imaging conditions. In the on-site evaluation phase, images from 3705 outpatients who underwent chest X-ray detection were read by JF CXR-1 v3.0 and local radiologists in parallel. The imaging diagnosis of local radiologists for active TB had a sensitivity of 32.89% (95% CI: 22.33%, 43.46%) and a specificity of 99.28% (95% CI: 99.01%, 99.56%), while JF CXR-1 v3.0 showed a significantly higher sensitivity of 92.11% (95% CI: 86.04%, 98.17%) ( p < 0.05) and maintained high specificity at 94.54% (95% CI: 93.81%, 95.28%). Conclusions::CAD software could play a positive role in improving the TB case finding capability of township health centers.

Background::Computer-aided detection (CAD) software has been introduced to automatically interpret digital chest X-rays. This study aimed to evaluate the performance of CAD software (JF CXR-1 v3.0, which was developed by a domestic Hi-tech enterprise) in tuberculosis (TB) case finding in China.Methods::In 2019, we conducted an internal evaluation of the performance of JF CXR-1 v3.0 by reading standard images annotated by a panel of experts. In 2020, using the reading results of chest X-rays by a panel of experts as the reference standard, we conducted an on-site prospective study to evaluate the performance of JF CXR-1 v3.0 and local radiologists in TB case finding in 13 township health centers in Zhongmu County, Henan Province.Results::Internal assessment results based on 277 standard images showed that JF CXR-1 v3.0 had a sensitivity of 85.94% (95% confidence interval [CI]: 77.42%, 94.45%) and a specificity of 74.65% (95% CI: 68.81%, 80.49%) to distinguish active TB from other imaging conditions. In the on-site evaluation phase, images from 3705 outpatients who underwent chest X-ray detection were read by JF CXR-1 v3.0 and local radiologists in parallel. The imaging diagnosis of local radiologists for active TB had a sensitivity of 32.89% (95% CI: 22.33%, 43.46%) and a specificity of 99.28% (95% CI: 99.01%, 99.56%), while JF CXR-1 v3.0 showed a significantly higher sensitivity of 92.11% (95% CI: 86.04%, 98.17%) ( p < 0.05) and maintained high specificity at 94.54% (95% CI: 93.81%, 95.28%). Conclusions::CAD software could play a positive role in improving the TB case finding capability of township health centers.

Objective To investigate the relationship between the different ambulatory arterial stiffness index and the markers of renal impairment in order to provide a scientific method for detecting the renal impairment of essential hypertension. Methods Three hundred essential hypertensive patients without overt proteinuria were enrolled. The ABPM was performed and the blood pressure parameters were analyzed in order to estimate the symmetrical ambulatory arterial stiffness index (S-AASI) and ambulatory arterial stiffness index (AASI) . Microproteinuria was measured by urine microalbumin to creatinine (mAlb/Cr)as well as n-acetyl-β-D-glucosaminidase (NAG)to creatinine rate (NAG/Cr). Creatinine clearance (Ccr) and Glomerular filtration rate (eGFR) were estimated from serum creatinine (sCr) . Linear correlations were performed to confirm the independent predictive power of S-AASI and AASI for renal lesion. Results Correlation test showed a significant positively relationship of S-AASI with urine mAlb/Cr (0.708, <0.001), urine NAG/Cr (0.700, <0.001) and sCr (0.229, <0.05) . Ccr (0.601, <0.001) and eGFR (0.309, <0.05) were negatively correlated with S-AASI. On the other hand, AASI was also correlated with urine mAlb/Cr (0.489, <0.001),urine NAG/Cr (0.470, <0.001) and Ccr (0.311, <0.05),but not with the sCr (0.064, >0.05) and eGFR (-0.135, >0.05) . S-AASI seems to get an independent relationship with all of the parameters of renal impairment which could not be detected with AASI. Conclusion This results suggested that S-AASI may be a better approach than AASI to estimate hypertensive renal impairment.

ObjectiveTo investigate the correlation between recent cardiac events and the score of myocardial infarction by delayed-enhancement MRI (DE-MRI).Methods DE-MRI was performed in 40 subjects with coronary artery disease.The score of myocardial infarction by DE-MRI,the ejection fraction (EF) by echocardiography,recent cardiac events (the number of weekly nitroglycerin,the number of weekly angina episodes and the onset number of heart failure in the last year),6-minute walking distance,as well as the Seattle angina questionnaire (SAQ) score were assessed.The Spearman correlation test and Kruskal-Wallis test,Mann-Whitney test were used for the statistics.ResultsThere were negative correlation between the myocardial infarction score by DE-MRI (median 12,inter-quartile range:6.0-19.8) and the 6-minute walking distance(378.93 ± 100.53 ),SAQ score (74.55 ± 11.40 ) (r was 0.66 and 0.54,P ＜0.05).The myocardial infarction score by DE-MRI was strongly correlated with the number of weekly nitroglycerin ( median 1 ; inter-quartile range:0-2.8),the number of weekly angina episodes ( median 3,inter-quartile range:1-6.5 ) and the onset number of heart failure in the last year ( median 0,inter-quartile range:0-2) (r was 0.87,0.85 and 0.89,P ＜0.05).EF [(49.2 ± 13.72)％] was negative correlation with the number of weekly nitroglycerin,the number of weekly angina episodes and the onset number of heart failure in the last year (r were 0.67,0.73 and 0.73,P ＜0.05).ConclusionDE-MRI can be used for evaluation and prediction of future cardiac events.

Objective To explore the role in the localization of vascular puncture points with dynamic contrast-enhanced magnetic resonance angiography (DCE-MRA) before transjugular intrahepatic portosystemic shunt (TIPS). Methods MRA images of 46 patients with portal hypertension were measured. The patients were then punctured according to the measurement Results The supero-inferior distant from the puncture point of hepatic vein to plane of right branch of portal vein (AA') was (22.63±10.21)mm, the anteroposterior distant from the puncture point of hepatic vein to plane of right branch of portal (A'A'') was (13.93±1.07)mm, the angle of sag was (31.64±9.23)°. The distant from puncture point of hepatic vein (AS) and right branch (BS) were (23.51±2.12)mm and (38.51±5.36)mm. The angle of cor was (33.57±8.93)°. Forty-five patients were successful punctured, and the time of puncture decreased. Conclusion The location of portal vein puncture point during TIPS are changeable, therefore individualized location of positioning is needed. DCE-MRA is a valuable non-invasive method of localization, playing an important role in localization of vascular puncture points of TIPS.

Objective To analyze and summarize the experiences in diagnosis and treatment of patients with severe traumatic brain injury (sTBI) so as to increase the cure rate and survival rate. Methods A retrospective study was made on the diagnoses and treatment of 4 462 cases of sTBI inclu-ding 3 298 males (73.9%) and 1 164 females (26.1%). The most frequent cause for injury was traffic accident, accounting for 35.5% (1 583/4 462). Closed bead injury ocurred in 3 654 cases (81.9%) and open head injury in 808 (18.1%). The most commen clinical manifestations included unconscious-ness, changes of pupils and life signs. Of all, 1 158 cases (26.0%) were found with combined injury and 1 356 (30.4%) with complications. Treatment measures included first aid, surgery or conventional treatment. Emphasis was put on the treatment of secondary insults. Results Surgery was performed in 3 023 cases (67.7%) including craniotomy for hematoma clearance in 856 cases and hematoma clearance plus decompression in 2 167, with mortality rate of 17.9%. Conventional treatment was carried out in 1 439 cases (32.3%), with mortality rate of 23.7%. There were 2 462 eases (55.2%) with fair recov-ery, 508 (11.4%) with mild disability, 339 (7.6%) with severe disability, 272 (6.1%) under vege-tative state and 881 (19.7%) deaths on discharge according to the Glasgow Outcome Scale. Conelu-sions Active diagnoses and treatment, strict medication rules and prevention and treatment of secondary insults may be key to higher eure rate as well as lower morbidity and mortality of sTBI.

Objective To evaluate the effect of endovascular stent-graft exclusion used in of thoracic aortic dissection aneurysm. Methods by retrospectively study the clinical collections of 34 Stanford B aortic dissection cases which were treated by endovascular stent-graft exclusion in the condition of full anaesthesia from 2002 to 2005.Results 34 patients were successfully stened but one patient failed because the guide-wire could not get into the real vascular and no perioperative death.The range of postoperative follow-up was form 3 months to 29 months,the average of which was 15 months.24 of the patients accepted a reexamination of CT,9 of them were performed DSA at the same time.Conclusion Endovascular stent-graft exclusion is safe and efficient for Stanford B aortic dissection aneurysm.Further follow-up is necessary to evaluate its long-term effectives.