1.Diagnostic Significance of Modified Lung Ultrasound Score in Pediatric Bacterial and Viral Pneumonia
Wen XIE ; Guorong LV ; Junxian RUAN ; Qiuxia JIANG ; Jingyang ZHENG ; Weiru LIN
Chinese Journal of Medical Imaging 2025;33(4):370-374
Purpose To investigate the diagnostic significance of modified lung ultrasound score(MPUS)for pediatric bacterial and viral pneumonia.Materials and Methods A total of 93 eligible children with suspected community-acquired pneumonia in Quanzhou Maternal and Child Care Hospital(Quanzhou Children’s Hospital)from December 2022 to June 2023 were elected as the study subjects.All these children received lung ultrasound and the MLUS was recorded according to the ultrasound manifestations of A line,B line and lung consolidation.According to the etiological results,the children were divided into a bacterial pneumonia group and a viral pneumonia group.According to disease severity,the children were divided into the mild group and the severe group.The MLUS was used to analyze the diagnostic significance of pediatric bacterial and viral pneumonia.Results The MLUS in the mild pneumonia group was 7(4,13)points and the MLUS in the severe pneumonia group was 20(14,30)points,and MLUS scores of pneumonia in the two groups were different(Z=-5.205,P<0.05).By drawing receiver operating characteristic curve,MLUS score of 14.5 was used as the cut-off point,the sensitivity for diagnosing severe pneumonia was 75.9%,the specificity was 82.8%.Area under the curve was 0.838.There was no significant differences in MLUS of 8.00(4.00,16.00)between the bacterial pneumonia group and 13.00(7.00,21.75)between the viral pneumonia group(Z=-1.981,P>0.05).The MLUS of 10.00(5.25,17.75)in the mild bacterial pneumonia group and 5.00(4.00,9.50)in the mild viral pneumonia group were significantly different(Z=-3.403,P<0.05).There was no significant differences in MLUS between the severe bacterial pneumonia group and the severe viral pneumonia group(t=0.017,P>0.05).In mild pneumonia,the cut-off value for the modified lung ultrasound score of 10.5 predicted moderate diagnostic efficacy of mild bacterial pneumonia,the area under the curve was 0.747,sensitivity was 50%and specificity was 87.5%.Large-area lung consolidation was more common in the bacterial pneumonia group than in the viral pneumonia group(χ2=8.360,P<0.05).Conclusion The modified lung ultrasound score can effectively evaluate the severity of pediatric bacterial pneumonia and viral pneumonia.For the identification of the two,MLUS may be a certain guiding significance.
2.Diagnostic Significance of Modified Lung Ultrasound Score in Pediatric Bacterial and Viral Pneumonia
Wen XIE ; Guorong LV ; Junxian RUAN ; Qiuxia JIANG ; Jingyang ZHENG ; Weiru LIN
Chinese Journal of Medical Imaging 2025;33(4):370-374
Purpose To investigate the diagnostic significance of modified lung ultrasound score(MPUS)for pediatric bacterial and viral pneumonia.Materials and Methods A total of 93 eligible children with suspected community-acquired pneumonia in Quanzhou Maternal and Child Care Hospital(Quanzhou Children’s Hospital)from December 2022 to June 2023 were elected as the study subjects.All these children received lung ultrasound and the MLUS was recorded according to the ultrasound manifestations of A line,B line and lung consolidation.According to the etiological results,the children were divided into a bacterial pneumonia group and a viral pneumonia group.According to disease severity,the children were divided into the mild group and the severe group.The MLUS was used to analyze the diagnostic significance of pediatric bacterial and viral pneumonia.Results The MLUS in the mild pneumonia group was 7(4,13)points and the MLUS in the severe pneumonia group was 20(14,30)points,and MLUS scores of pneumonia in the two groups were different(Z=-5.205,P<0.05).By drawing receiver operating characteristic curve,MLUS score of 14.5 was used as the cut-off point,the sensitivity for diagnosing severe pneumonia was 75.9%,the specificity was 82.8%.Area under the curve was 0.838.There was no significant differences in MLUS of 8.00(4.00,16.00)between the bacterial pneumonia group and 13.00(7.00,21.75)between the viral pneumonia group(Z=-1.981,P>0.05).The MLUS of 10.00(5.25,17.75)in the mild bacterial pneumonia group and 5.00(4.00,9.50)in the mild viral pneumonia group were significantly different(Z=-3.403,P<0.05).There was no significant differences in MLUS between the severe bacterial pneumonia group and the severe viral pneumonia group(t=0.017,P>0.05).In mild pneumonia,the cut-off value for the modified lung ultrasound score of 10.5 predicted moderate diagnostic efficacy of mild bacterial pneumonia,the area under the curve was 0.747,sensitivity was 50%and specificity was 87.5%.Large-area lung consolidation was more common in the bacterial pneumonia group than in the viral pneumonia group(χ2=8.360,P<0.05).Conclusion The modified lung ultrasound score can effectively evaluate the severity of pediatric bacterial pneumonia and viral pneumonia.For the identification of the two,MLUS may be a certain guiding significance.
3.Development and Validation of a Pathomics Model Using Machine Learning to Predict CXCL8 Expression and Prognosis in Head and Neck Cancer
Weihua WANG ; Suyu RUAN ; Yuhang XIE ; Shengjian FANG ; Junxian YANG ; Xueyan LI ; Yu ZHANG
Clinical and Experimental Otorhinolaryngology 2024;17(1):85-97
Objectives:
. The necessity to develop a method for prognostication and to identify novel biomarkers for personalized medicine in patients with head and neck squamous cell carcinoma (HNSCC) cannot be overstated. Recently, pathomics, which relies on quantitative analysis of medical imaging, has come to the forefront. CXCL8, an essential inflammatory cytokine, has been shown to correlate with overall survival (OS). This study examined the relationship between CXCL8 mRNA expression and pathomics features and aimed to explore the biological underpinnings of CXCL8.
Methods:
. Clinical information and transcripts per million mRNA sequencing data were obtained from The Cancer Genome Atlas (TCGA)-HNSCC dataset. We identified correlations between CXCL8 mRNA expression and patient survival rates using a Kaplan-Meier survival curve. A retrospective analysis of 313 samples diagnosed with HNSCC in the TCGA database was conducted. Pathomics features were extracted from hematoxylin and eosin–stained images, and then the minimum redundancy maximum relevance, with recursive feature elimination (mRMR-RFE) method was applied, followed by screening with the logistic regression algorithm.
Results:
. Kaplan-Meier curves indicated that high expression of CXCL8 was significantly associated with decreased OS. The logistic regression pathomics model incorporated 16 radiomics features identified by the mRMR-RFE method in the training set and demonstrated strong performance in the testing set. Calibration plots showed that the probability of high gene expression predicted by the pathomics model was in good agreement with actual observations, suggesting the model’s high clinical applicability.
Conclusion
. The pathomics model of CXCL8 mRNA expression serves as an effective tool for predicting prognosis in patients with HNSCC and can aid in clinical decision-making. Elevated levels of CXCL8 expression may lead to reduced DNA damage and are associated with a pro-inflammatory tumor microenvironment, offering a potential therapeutic target.
4.Migration characteristics among HIV/AIDS patients reported in Yiwu City from 2016 to 2020
Jun JIANG ; Junxian CHEN ; Lianjuan LOU ; Bixiang ZHU ; Lianqi ZHA ; Jianjun RUAN
Journal of Preventive Medicine 2023;35(1):21-26
Objective:
To investigate the migration characteristics and follow-up treatment among HIV/AIDS patients after HIV confirmation in Yiwu City, Zhejiang Province from 2016 to 2020, so as to provide insights into the optimization of the HIV/AIDS control strategy among floating populations.
Methods:
The reported HIV/AIDS patients' demographics, follow-up and treatment data in Yiwu City from 2016 to 2020 were captured from the HIV/AIDS Prevention and Control Information System of Chinese Disease Control and Prevention Information System. The migration characteristics, antiretroviral therapy and outcomes of HIV/AIDS patients were analyzed after HIV confirmation, and the factors affecting the migration of HIV/AIDS patients after HIV confirmation were identified using a Cox proportional hazard regression model.
Results:
A total of 1 189 HIV/AIDS patients were enrolled, including 988 men (83.10%) and 806 cases without Zhejiang provincial household registration (67.79%). There were 441 patients (37.09%) migrating out of Yiwu City after HIV confirmation, with a migration rate of 17.73/100 person-years, and there were 366 patients migrating out of Zhejiang Province, with a cross-province migration rate of 30.78%. Among participants without Zhejiang provincial household registration, 395 patients (49.01%) migrated out of Yiwu City, including 337 patients (85.32%) returning to their household registration provinces, which mainly included Yunnan, Sichuan, Guizhou and Hunan. Cox proportional hazard regression analysis showed a high risk of migration among minority ethnic populations (HR=1.375, 95%CI: 1.044-1.811), retires (HR=3.605, 95%CI: 1.771-7.335), students (HR=8.969, 95%CI: 4.095-19.645), patients without Zhejiang provincial household registration (HR=4.545, 95%CI: 3.164-6.529) and patients identified through physical examination of floating populations or employees (HR=1.318, 95%CI: 1.006-1.727), and a low risk among married patients with spouses (HR=0.721, 95%CI: 0.569-0.913) and with an educational level of junior high school and above (HR: 0.428~0.753, 95%CI: 0.280-0.952). Among all floating HIV/AIDS patients, there were 26 cases lost to follow-up (5.90%) and 49 deaths (11.11%). In addition, the proportion of absence of antiretroviral therapy, HIV infection progressing into AIDS patients and failure in HIV inhibition were all greater among floating HIV/AIDS patients than among non-floating patients (P<0.05).
Conclusions
A high risk of migration was found among HIV/AIDS patients without Zhejiang provincial household registration, unmarried patients, patients with a low education level, retirees, students, and patients identified through physical examination of floating populations or employees in Yiwu City from 2016 to 2020, and migration does not facilitate the sustainability of antiretroviral therapy and follow-up, which may affect the prognosis of HIV/AIDS.
5.Awareness of HIV testing results before sex among men who have sex with men
Wanjun CHEN ; Jianjun RUAN ; Bixiang ZHU ; Lianjuan LOU ; Junxian CHEN ; Lianqi ZHA ; Qiaoqin MA ; Lin CHEN ; Tingting JIANG ; Mingyu LUO
Journal of Preventive Medicine 2019;31(1):1-4
Objective:
To understand the awareness of HIV testing results before having sex among men who have sex with men (MSM) .
Methods:
The MSM from a gay bar in Zhejiang Province were recruited through convenience sampling method. A questionnaire survey was conducted to collect the information about demographic characteristics,sexual behaviors,awareness of HIV status between sexual partners and HIV testing results during August of the year 2016. The awareness of HIV testing results before having sex among MSM and the influencing factors were analyzed .
Results:
A total of 124 MSM were recruited in this study,56.56% of whom aged from 25 to 39 years,and 61.29% were single,divorced or widowed. The number of sexual partners they had in the last year ranged from 1 to 40,with median of 8. The MSM who had casual sexual partners accounted for 70.97%. The MSM who had regular HIV testing accounted for 90.32%,yet who would like to share the HIV testing reports with partners only accounted for 18.55%. Whether asking about the HIV status before having sex or not was associated with age,marriage status,the number and characters of sexual partners(P<0.05). The MSM who were informed of the HIV status of commercial partners,casual partners and regular partners accounted for 0,5.10% and 19.77%,respectively. The main reasons for MSM not knowing about the HIV status of their sexual partners were“condom use would prevent HIV infection”(78.38%),“never thought about HIV infection”(53.15%),and “there was no need to ask as the partner looked healthy”(36.94%) .
Conclusion
The proportion of MSM who were aware of HIV testing results before having sex was not high and was associated with age,marriage status,the number and characters of sexual partners. Lack of knowledge about HIV infection might contributed to this low proportion.
6.Ultrasonography quantitative indicator for position of fetal conus medullaris
Shaozheng HE ; Guorong LYV ; Junxian RUAN ; Jiaxiang WU ; Yunping LIU
Chinese Journal of Perinatal Medicine 2015;18(10):770-773
Objective To determine the normal position of the fetal conus medullaris and assess its clinical significance.Methods A total of 550 singleton pregnant women who were examined by fetal ultrasonography in the Department of Ultrasound at the Second Hospital of Fujian Medical University from June 1, 2013 to September 31, 2014 were included.Inclusion criteria were pregnancies with regular menstruation cycle and known last menstrual period, gestational age (GA) confirmed by ultrasonographic examinations, and neonate abnormality excluded by pediatrician after born.Routine obstetric ultrasound examinations were performed to measure the biparietal diameter (BPD), femur length (FL), head circumference (HC) and abdominal circumference (AC).The conus distance (CD) was determined by measuring the distance between the distal end of the conus medullaris and the caudal end of the last vertebra.The average value was calculated for each group according to GA.Fifty normal fetuses were randomly selected for quality control.For inter-observer reliability assessment, the same data were collected and analyzed by two different operators.For intra-observer reliability assessment, the data were collected and analyzed twice by the same operator with an interval of half an hour.Linear regression correlation analysis was performed to analyze the relationship between CD and GA, BPD, FL, HC and AC.Intraclass correlation coefficient (ICC) and Bland-Altman analysis were used to analyze the repeatability of the analysis.Results In 518 (94.2%) of 550 fetuses, the CD was successfully measured.Positively correlations between the conus distance and the gestational age was observed.The CD was (10.0± 3.3) mm at > 14-≤ 15 weeks (n=17), (27.7±3.8) mm at > 20-≤ 21 weeks of gestation (n=18), (41.5±2.4) mm at > 26-≤ 27 weeks (n=8), (54.7±3.0) mm at > 32-≤ 33 weeks (n=17), and (71.9±2.7) mm at > 41-≤ 42 weeks (n=6).Linear regression correlations between CD (mm) and FL, AC, HC, BPD and GA were:CD=1.04× FL (mm)-8.71, CD=0.23 × AC (mm)-10.11, CD=0.28× HC (mm)-18.10, CD=0.90× BPD (mm)-17.65, CD=2.34× GA (weeks)-20.94 (r=0.990, 0.985, 0.978, 0.974 and 0.973, respectively, all P < 0.01).The measurement of the conus distance exhibited good reproducibility between different operators (ICC=0.984, 95%CI: 0.972-0.991) and for the same operator (ICC=0.992, 95%CI: 0.985-0.995) with the 95% limits of agreement of-1.8 to 3.5 mm and-4.3 to 2.1 mm.Bland-Altman analysis showed that most of the measured values were within 95% confidence interval suggesting good consistency.Conclusions The distance, between the end of the conus medullaris and the end of the last vertebral body under ultrasound scan, is positively correlated with FL and other ultrasonographic indicators, which implies that it could be used as a new index for position of fetal conus medullaris.


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