Objective To investigate the clinical application value of colorectal double contrast-enhanced ultrasonography in diagnosing colorectal lesions and TN staging of colorectal cancer.Methods The clinical data of 479 patients with positive colorectal doulble contrast-enhanced ultrasonography results admitted to some hospital from November 2019 to December 2022 were selected retrospectively.The distributions of colorectal lesions and TN stages of colorectal cancer diagnosed by colorectal double contrast-enhanced ultrasonography were counted using the pathological results as the gold standard.The clinical diagnostic efficacy of colorectal double contrast-enhanced ultrasonography for TN staging of colorectal cancer was analyzed,and the ROC curves of the T and N staging models for diagnosing colorectal cancer were plotted by applying the 1VSRest strategy.SAS 9.4 statistical software was used to analyze the data.Results Among the 479 patients included,there were 462 cases in which the pathological diagnosis and ultrasound diagnosis were consistent with each other,with a compliance rate of 96.5％;there were 427 cases of colorectal cancer,accounting for 89.1％.Colorectal double contrast-enhanced ultrasonography had the accuracies being 96％,82％,63％,79％and 97％respectively for T1,T2,T3,T4a and T4b stages of colorectal cancer,with the micro-mean value of the accuracy being 83％.The accuracies were 62％,68％and 80％for NO,N1 and N2 stages of colorectal cancer,with the micro-mean value of the accuracy being 70％.The micro-mean value for T staing model to diagnose colorectal cancer was 0.92,and the macro-mean value was 0.84;the micro-mean value for N staing model to diagnose colorectal cancer was 0.88,and the macro-mean value was 0.85.Conclusion Colorectal doube contrast-enhanced ultrasonography is effective for diagnosing colorectal lesions,and provides references for TN staging of colorectal cancer.[Chinese Medical Equipment Journal,2024,45(7):62-66]

Background/Aims: The accuracy of endosonographers in diagnosing gastric subepithelial lesions (SELs) using endoscopic ultrasonography (EUS) is influenced by experience and subjectivity. Artificial intelligence (AI) has achieved remarkable development in this field. This study aimed to develop an AI-based EUS diagnostic model for the diagnosis of SELs, and evaluated its efficacy with external validation. Methods: We developed the EUS-AI model with ResNeSt50 using EUS images from two hospitals to predict the histopathology of the gastric SELs originating from muscularis propria. The diagnostic performance of the model was also validated using EUS images obtained from four other hospitals. Results: A total of 2,057 images from 367 patients (375 SELs) were chosen to build the models, and 914 images from 106 patients (108 SELs) were chosen for external validation. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of the model for differentiating gastrointestinal stromal tumors (GISTs) and non-GISTs in the external validation sets by images were 82.01%, 68.22%, 86.77%, 59.86%, and 78.12%, respectively. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy in the external validation set by tumors were 83.75%, 71.43%, 89.33%, 60.61%, and 80.56%, respectively. The EUS-AI model showed better performance (especially specificity) than some endosonographers.The model helped improve the sensitivity, specificity, and accuracy of certain endosonographers. Conclusions We developed an EUS-AI model to classify gastric SELs originating from muscularis propria into GISTs and non-GISTs with good accuracy. The model may help improve the diagnostic performance of endosonographers. Further work is required to develop a multi-modal EUS-AI system.

OBJECTIVES: To investigate the incidence of extrauterine growth retardation (EUGR) and its risk factors in very preterm infants (VPIs) during hospitalization in China. METHODS: A prospective multicenter study was performed on the medical data of 2 514 VPIs who were hospitalized in the department of neonatology in 28 hospitals from 7 areas of China between September 2019 and December 2020. According to the presence or absence of EUGR based on the evaluation of body weight at the corrected gestational age of 36 weeks or at discharge, the VPIs were classified to two groups: EUGR group (n=1 189) and non-EUGR (n=1 325). The clinical features were compared between the two groups, and the incidence of EUGR and risk factors for EUGR were examined. RESULTS: The incidence of EUGR was 47.30% (1 189/2 514) evaluated by weight. The multivariate logistic regression analysis showed that higher weight growth velocity after regaining birth weight and higher cumulative calorie intake during the first week of hospitalization were protective factors against EUGR (P<0.05), while small-for-gestational-age birth, prolonged time to the initiation of total enteral feeding, prolonged cumulative fasting time, lower breast milk intake before starting human milk fortifiers, prolonged time to the initiation of full fortified feeding, and moderate-to-severe bronchopulmonary dysplasia were risk factors for EUGR (P<0.05). CONCLUSIONS It is crucial to reduce the incidence of EUGR by achieving total enteral feeding as early as possible, strengthening breastfeeding, increasing calorie intake in the first week after birth, improving the velocity of weight gain, and preventing moderate-severe bronchopulmonary dysplasia in VPIs.
Female ; Fetal Growth Retardation ; Gestational Age ; Hospitalization ; Humans ; Incidence ; Infant ; Infant, Newborn ; Infant, Premature ; Infant, Very Low Birth Weight ; Prospective Studies ; Risk Factors

Background: The development of auditory and speech perception ability of children with hearing loss is affected by many factors after they undergo cochlear implantation (CI). Age at CI (CI age) appears to play an important role among these factors. This study aimed to evaluate the development of auditory and speech perception ability and explore the impact of CI age on children with prelingual deafness present before 3 years of age. Methods: Two hundred and seventy-eight children with pre-lingual deafness (176 boys and 102 girls) were included in this study, and the CI age ranged from 6 to 36 months (mean age, 19 months). Categorical auditory performance (CAP) was assessed to evaluate auditory ability, and the speech intelligibility rating was used to evaluate speech intelligibility. The evaluations were performed before CI and 1, 3, 6, 12, 18, 24, 36, 48, and 60 months after CI. Results: The auditory ability of the pre-lingually hearing-impaired children showed the fastest development within 6 months after CI (k = 0.524, t = 30.992, P < 0.05); then, the progress started to decelerate (k = 0.14, t = 3.704, P < 0.05) and entered a plateau at the 24th month (k = 0.03, t = 1.908, P < 0.05). Speech intelligibility showed the fastest improvement between the 12th and 24th months after CI (k = 0.138, t = 5.365, P < 0.05); then, the progress started to decelerate (k = 0.026, t = 1.465, P < 0.05) and entered a plateau at the 48th month (k = 0.012, t = 1.542, P < 0.05). The CI age had no statistical significant effect on the auditory and speech abilities starting at 2 years after CI (P < 0.05). The optimal cutoff age for CI was 15 months. Conclusions Within 5 years after CI, the auditory and speech ability of young hearing-impaired children continuously improved, although speech development lagged behind that of hearing. An earlier CI age is recommended; the optimal cutoff age for CI is at 15 months.

OBJECTIVETo discuss the impacts of moxibustion for regulating spleen and stomach function on the survival quality of the patients of end stage renal disease (ESRD) with maintenance hemodialysis (MHD).

METHODSOne hundred and nine cases of uremia with MHD from 3 hemodialysis centers were randomized into an observation group (58 cases) and a control group (51 cases). The regular hemodialysis and conventional medication were used in the two groups. In the observation group, on the basis of the common treatment, moxibustion was applied to Zusanli (ST 36) and Sanyinjiao (SP 6), 2-3 times a day, the treatment of 4 weeks made one session. Totally, 3 sessions were required and the follow-up lasted for 3 months. KDQOL-SF (kidney disease quality of life short form,KDQOL-SFTM 1. 3) was adopted for the questionnaire investigation on survival quality before treatment, after treatment and at the end of follow-up separately in the two groups.

RESULTSAfter treatment, the survival quality scores in terms of physical functioning (83.62+/-13.27 vs 79.32+/- 22. 17), general health (58. 88+/- 20.24 vs 48.82+/-20.89) and vitality (77.07+/-15.56 vs 70. 59+/-22.61) in the observation group were higher than those in the control group (all P<0. 05). In comparison before and after treatment in the same group, the survival quality scores in terms of physical functioning, general health, vitality and symptoms/problems were all improved in the observation group (all P<0. 05). At the end of follow-up, the survival quality scores in terms of physical functioning, general health, mental health, social functioning, vitality, effects of kidney disease and cognitive function were higher in the observation group as compared with those in the control group (all P<0. 05). In comparison of the results at the end of follow-up with those before treatment, the survival quality scores in terms of vitality, symptoms/problems and cognitive function in the observation group were improved (all P< 0. 05). The differences were not significant in all of the 19 fields of survival quality evaluation before and after treatment, and after follow-up in the control group (all P>0. 05).

CONCLUSIONMoxibustion for regulating spleen and stomach function improves the survival quality of the patients with hemodialysis in terms of physical functioning, general health and vitality, which benefits the psychological condition of the patients, resulting in the improvements of the survival quality in the fields of mental health, social functioning, effects of kidney disease and cognitive function.

Adult ; Aged ; Female ; Humans ; Kidney Failure, Chronic ; physiopathology ; therapy ; Male ; Middle Aged ; Moxibustion ; Quality of Life ; Renal Dialysis ; Spleen ; physiopathology ; Stomach ; physiopathology

OBJECTIVE: To explore the forensic pathological features of death caused by anaphylactic shock. METHODS: One hundred and forty-two death cases of anaphylactic shock were retrospectively analyzed. The IgE level in the serum of anaphylactic shock cases were statistically compared with that of 62 non-anaphylactic shock cases. RESULTS: Most cases (77.46%) of anaphylactic shock death occurred in the medical institutes, with intravenous drug administration accounting for 53.53% of anaphylactic shock death. β-Lactam antibiotics, glucocorticoid and herbal medications were responsible for a significant proportion of such cases. Although characteristic histopathological changes were absent in vast majority of these anaphylactic shock cases, the differences of IgE levels in the serum between anaphylactic shock group and non-anaphylactic shock group were statistically significant (P<0.05). CONCLUSION Combined information including clinical data, autopsy results, IgE level, and other specific test results should be evaluated together in the forensic pathological diagnosis of anaphylactic shock.
Anaphylaxis ; Autopsy ; Cause of Death ; Forensic Pathology ; Humans ; Infusions, Intravenous ; Retrospective Studies ; Serum

OBJECTIVETo investigate the impact of energy metabolism at the cellular level on the expression of the water channel protein aquaporin 1 (AQP1).

METHODSBalb/c mouse fibroblasts were incubated with iodoacetamide (IA) in vitro, and the changes in AQP1 expression were detected by immunoblotting and immunohistochemistry at 0, 4, and 6 h.

RESULTSIA induced the expression of AQP1 at 4 and 6 h accompanied with cell death. Reverse transcription PCR showed an increased expression of AQP1 mRNA in the cells. AQP1 expression was also upregulated by the inhibitor of microtubule and cytochrome C oxidase.

CONCLUSIONA pretranslational regulation occurs in IA-induced AQP1 expression in mouse fibroblasts, and the up-regulated AQP1 accumulation is characterized by mitochondria-related energy dependence.

Animals ; Aquaporin 1 ; genetics ; metabolism ; Cells, Cultured ; Energy Metabolism ; Fibroblasts ; cytology ; metabolism ; Iodoacetamide ; pharmacology ; Mice ; Mice, Inbred BALB C ; Mitochondria ; metabolism ; RNA, Messenger ; genetics ; metabolism ; Up-Regulation ; drug effects

Objective To evaluate the safety of the split influenza vaccine Anflu.Methods A total of 198 subjects were enrolled in this open clinical trial.Of which,97 aged 18-60 years old and 101 aged 61 years old.28 of the subjects had history of chronic disease,while all the subjects were under stable health condition.After being infoma consented,each subject was vaccinated with one dose of split influeza vaccine and observed for 7 days for adverse reactions.Results A total of 17 subjects reported adverse reactions and the adverse reactions occurrence rate was 8.6%.The adverse reactions occurrence rate was 13.4%in the adult group and 4.0%in the elderly group(x2=5.620,P=0.018).Local adverse reactions occurrence rate was 5.5%and pain at the iniection site was the major symptom.System adverse reactions rate was 3.5% and fever was the most frequently reported symptom.None of the subjects with chronic disease history reported adverse reactions.Conclusion The results showed that the vaccine did not cause new adverse reaction,serious adverse event or rare adverse reaction.The split influenza vaccine was safe.

Objective To evaluate the safety of the split influenza vaccine Anflu.Methods A total of 198 subjects were enrolled in this open clinical trial.Of which,97 aged 18-60 years old and 101 aged 61 years old.28 of the subjects had history of chronic disease,while all the subjects were under stable health condition.After being infoma consented,each subject was vaccinated with one dose of split influeza vaccine and observed for 7 days for adverse reactions.Results A total of 17 subjects reported adverse reactions and the adverse reactions occurrence rate was 8.6%.The adverse reactions occurrence rate was 13.4%in the adult group and 4.0%in the elderly group(x2=5.620,P=0.018).Local adverse reactions occurrence rate was 5.5%and pain at the iniection site was the major symptom.System adverse reactions rate was 3.5% and fever was the most frequently reported symptom.None of the subjects with chronic disease history reported adverse reactions.Conclusion The results showed that the vaccine did not cause new adverse reaction,serious adverse event or rare adverse reaction.The split influenza vaccine was safe.

OBJECTIVETo analyse sonographical features of epididymis tuberculosis with caseous necrosis and improve the accuracy of ultrasonic diagnosis.

METHODSUltrasonic features of 12 cases with epididymis tuberculosis with caseous necrosis, confirmed by surgical pathology, was retrospectively analysed: size, location, echogenicity, degree of blood flow in the lesion.

RESULTSIn all 12 patients, the number of purified protein derivative test (PPD) presenting the positive reached to 67%, while cases with the pulmonary tuberculosis was 42%. The epididymal tuberculosis with caseous necrosis could present images of the whole or focal epididymal enlargement and abnormal shape. The lesions internal echoes were irregular, inhomogeneous increased isoechoic echogenicity or hypoechoic, including bad-defined, irregular, homogeneous hypoechoic or anechoic. In lesional location, 4 out of 12 patients (33%) possessed richly color blood flow in Color Doppler Power Imaging(CDPI). The testicular enlargement with increased internal echoes and the testicular hydroceles were partly (58%, 7/12) observed by ultrasound. There was no varicocele, scrotal wall thickening and inguinal lymph node enlargement.

CONCLUSIONThe High Frequency Color Doppler images is helpful for the diagnosis and differential diagnosis of epididymis tuberculosis with caseous necrosis.

Adult ; Diagnosis, Differential ; Epididymitis ; diagnostic imaging ; pathology ; Humans ; Male ; Middle Aged ; Necrosis ; Retrospective Studies ; Tuberculosis, Male Genital ; diagnostic imaging ; pathology ; Ultrasonography, Doppler, Color