Objective:To investigate the diagnostic performance of MRI Liver Imaging Reporting and Data System version 2018 in high-risk hepatocellular carcinoma (HCC) patients with intrahepatic parenchymal substantial lesions ≤3.0 cm.Methods:A retrospective analysis was conducted in hospitals between September 2014 to April 2020. 131 pathologically confirmed non-HCC cases with lesions ≤3.0 cm in diameter were randomly matched with 131 cases with lesions ≤3.0 cm in diameter and divided into benign (56 cases), other hepatic malignant tumor (OM, 75 cases), and HCC group (131 cases) in a 1:1 ratio. MRI features of the lesions were analyzed and classified according to LI-RADS v2018 criteria (tie-break rule was applied to lesions with both HCC and LR-M features). Taking the pathological results as the gold standard, the sensitivity and specificity of the LI-RADS v2018 classification criteria and the more stringent LR-5 criteria (with three main signs of HCC at the same time) were calculated for HCC, OM or benign lesions diagnosis. Mann -Whitney U test was used to compare the classification results. Results:The number of cases classified as LR-M, LR-1, LR-2, LR-3, LR-4, and LR-5 in HCC group after applying the tie-break rule were 14, 0, 0, 12, 28, and 77, respectively. There were 40, 0, 0, 4, 17, 14 and 8, 5, 1, 26, 13, 3 cases in benign and OM group, respectively. There were 41 (41/77), 4 (4/14) and 1 (1/3) lesion case in the HCC, OM and benign group, respectively, that met the more stringent LR-5 criteria. The sensitivity of LR-4 combined with LR-5 (LR-4/5) criteria, LR-5 criteria and more stringent LR-5 criteria for HCC diagnosis were 80.2% (105/131), 58.8% (77/131) and 31.3% (41/131), respectively, and the specificity were 64.1% (84/131), 87.0% (114/131) and 96.2% (126/131), respectively. The sensitivity and specificity of LR-M were 53.3% (40/75) and 88.2% (165/187), respectively. The sensitivity and specificity using LR-1 combined with LR-2 (LR-1/2) criteria for the diagnosis of benign liver lesions were 10.7% (6/56) and 100% (206/206), respectively.Conclusions:LR-1/2, LR-5, and LR-M criteria have high diagnostic specificity for intrahepatic lesions with a diameter of ≤3.0 cm. Lesions classified as LR-3 are more likely to be benign. The specificity of LR-4/5 criteria is low, while the more stringent LR-5 criteria has a high specificity for HCC diagnosis.

Background The tobacco epidemic as one of the most serious public health problems in the world contributes great harm to human health. It is urgent to develop tobacco control strategy. Civil servants' behaviors as a role model for society have a great influence on the rest of society. Thus, it is important to promote tobacco control program on helping civil servants to quit smoking. Objective To understand the smoking and second-hand smoking exposures status, the awareness of knowledge of tobacco hazards, and the attitudes to tobacco control policies of civil servants in Minhang District, Shanghai. Furthermore, to explore the related strategies and measures for tobacco control, to provide a basis for the development and revision of relevant intervention measures and policies. Methods A total of 20 government agencies with newly installed smoking-free programs from 10 subdistricts and towns in Minhang District, including Xinzhuang, Wujing, Maqiao, Qibao, Meilong, Hongqiao, Zhuanqiao, Jiangchuan, Gumei, and Xinhong were selected as study sites.A questionnaire survey was conducted to investigate all civil servants (n=801) of selected agencies. The questionnaire included general characteristics, smoking and second-hand smoking exposure status, knowledge of tobacco hazard, and attitudes to tobacco control policies. Results A total of 794 civil servants returned valid questionnaires. The awareness rate of tobacco hazards in the smoking group was lower than that in the non-smoking group (P<0.05). Relatively high smoking rates were reported in those being male (17.08%), age ≥51 years old (25.61%), divorced or widowed (12.50%), technical secondary school or below education level (22.81%), having more than 10 years of working years (11.57%), being willing to dissuade indoor smoking (24.54%), having no punishment or warning measures for violation of smoking regulations in workplaces (18.37%), and having no dedicated smoking spot at home (15.38%). The results of multiple logistic regression analysis showed that age 31-40 years old (OR=3.446, 95%CI: 1.236-9.609) and to avoid confronting indoor smoking (OR=3.686, 95%CI: 1.041-13.049) were risk factors for smoking in civil servants. Conclusion Civil servants aged 31-40 years old who deliberately avoid confronting indoor smoking behaviors are the key intervention population of smoking control in Minhang District, Shanghai.

High-risk human papillomavirus (HR-HPV) infection is the main cause of cervical cancer. Current research shows that other factors work together with HPV to affect the occurrence and development of cervical cancer. Under normal circumstances, the vaginal microbiota can play a fundamental role in maintaining the balance of the vaginal microenvironment and anti-inflammatory and anti-tumor together with the host immune system. Once the body is infected with HPV in synergy with other factors, it will accelerate the progression of cervical cancer. This article reviews the changes in the vaginal microenvironment and local immune response of cervical cancer.

Objective:To study the relations of human papillomavirus (HPV) infection, vaginal micro-environmental disorder with cervical lesion.Methods:A total of 1 019 women including 623 with normal cervical (NC), 303 with low-grade cervical lesion (CIN Ⅰ) and 93 with high-grade cervical lesion (CIN Ⅱ/Ⅲ) were enrolled in this study from the communities in Shanxi province, China. Case-control method was adopted, with NC as the control group and CIN as the case group. Related information was collected including demographic characteristics and relevant factors related to cervical lesions. HPV genotypes were detected by flow-through hybridization technology. Vaginal pH was detected by the pH test paper. Vaginal H 2O 2 was detected by the combined detection kit of aerobic vaginitis and bacterial vaginosis. Vaginal cleanliness was detected by smear method. Results:Data from the unconditional logistic regression analysis showed that HPV infection (CINⅠ: a OR=1.39, 95 %CI: 1.01-1.90; CINⅡ/Ⅲ: a OR=11.74, 95 %CI: 6.96-19.80), H 2O 2 (CINⅠ: a OR=2.09, 95 %CI: 1.47-2.98; CINⅡ/Ⅲ: a OR=4.12, 95 %CI: 2.01-8.43), cleanliness (CIN Ⅱ/Ⅲ: a OR=2.62, 95 %CI: 1.65-4.14), and composite indicators (CINⅠ: a OR=1.67, 95 %CI: 1.24-2.25; CINⅡ/Ⅲ: a OR=4.24, 95 %CI: 2.30-7.81) all had increased the risk of cervical lesion and the trend on the severity ( P<0.001) of cervical lesions. Additionally, we observed a synergic effect between HPV infection and vaginal micro-environmental composite indicator in CINⅡ/Ⅲ. With or without HPV infection, the ORs value of CINⅠ caused by vaginal micro-environment disorder remained close. Conclusions:Results from our study revealed that vaginal micro-environmental composite indicator could increase the risk for cervical lesion, in particular with the high-grade ones which all posed stronger risks when combined with HPV infection. However, the role of vaginal micro-environment disorder in the occurrence of CIN Ⅰ should not be ignored.

Space reduction after the premature loss of the second primary molars is one of the important factors affecting the occurrence of malocclusion, often increasing the demand for orthodontic treatment. It has great significance to select and apply appropriate appliances to maintainthe space soon after the premature loss of the second primary molars. The space should be maintained until the adjacent teeth and the successors erupt successfully. This review summarizes the selection and clinical application of the space maintainer for the premature loss of the second primary molars in different periods, to improve dentists′ awareness of the importance of space maintainers and to provide advises for clinical choices.

Objective To investigate the effects of global registry of acute coronary events (GRACE) and Can Rapid risk stratification of unstable angina patients suppress adverse outcomes with early implementation of the ACC/AHA guidelines(CRUSADE) score in the nursing care for patients with acute coronary syndrome (ACS).Methods A total of 128 patients with ACS undergoing percutaneous coronary intervention (PCI) who were admitted from March 2015 to May 2016 were enrolled in this study and divided into usual care group (63 cases) and optimized care group (65 cases). Patients in the usual care group received usual care according to the guidelines, while patients in the optimized care group received optimized care according to GRACE and CRUSADE score. The major adverse cardiac events, the incidence of bleeding complications, average hospitalization and hospitalization costs were recorded and compared between the two groups. Results The characteristics of angiography (multiple vessel rate and target vessel distribution) and procedures of PCI (position, number, length and diameter of stents, coronary blood flow classification after the implantation of stents) were similar (all P>0.05). There were tendencies of reduction in the incidence of MACE, bleeding complications and average hospitalization time in patients of optimized care group compared to the usual care group, with no statistically significant differences between the two groups (P>0.05). The hospitalization costs in the optimized care group (33491±1982)RMB were significantly less than those in the usual care group (36562±2395)RMB. The difference was statistically significant (t=-7.914,P<0.001).Conclusions Optimized care according to GRACE and CRUSADE can improve the treatment effects of ACS patients undergoing PCI and decrease the cost.

Objective To investigate the expression of the connective tissue growth factor (CTGF) and integrin β1 in vaginal anterior wall of the model rats with stress urinary incontinence. Methods Twenty-four healthy female SD rats were randomly divided into three groups, group A rats as control group without any treatment;group B rats only with vaginal expansion;group C rats with vaginal expansion and bilateral ovaries removed. At postoperative four weeks to determine the maximum bladder capacity (MBC)and abdominal pressure leakage point pressure (ALPP), to establish detection model for stress urinary incontinence. Modeling successfully executed in rats after four weeks after vaginal anterior wall tissue,immunohistochemical staining method and real-time fluorescent quantitative RT-PCR technique to detect the expression of CTGF and integrinβ1. Results The urine flow dynamic detection(MBC,ALPP)B and C group was significantly lower than group A, there were statistically significant differences (P<0.05);CTGF mRNA and protein expression in group C was significantly lower than group A(P<0.05),there were no statistical significance between group A and group B (P>0 . 05);integrin β1 mRNA and protein in group C expression was low er than that in group A and B(P<0.05), and differences between A and B were statistically significant(P<0.05). Conclusion The anterior wall vaginal CTGF in rats in SUI and low expression of integrin β1 may be related to stress urinary incontinence and other pelvic floor support structure there is a close relationship of the occurrence of degenerative diseases of the pelvic floor support degenerative diseases.

OBJECTIVETo detect structural changes in the brain in fetuses with agenesis of the corpus callosum (ACC) and holoprosencephaly (HPE) in the first trimester.

METHODSThe ultrasound data were analyzed retrospectively in 620 normal singleton fetuses between 11 and 13(+6) gestational weeks, 5 fetuses diagnosed to have ACC, and 13 fetuses with HPE. The midbrain diameter (MD) and falx diameter (FD) were measured and their ratio (MD/FD) was calculated for comparative analysis.

RESULTSNo significant difference was found in the MD, FD, and MD/FD ratio between fetuses with ACC and HPE (P>0.05). Compared to the normal fetuses, all the fetuses with ACC and HPE showed significantly increased mean MD and MD/FD ratio (P<0.05); 4 (80%) fetuses with ACC and 11 (84.6%) with HPE had a reduced FD. All the fetuses with ACC and HPE had MD/FD ratios greater than 1, which were below 1 in all the normal fetuses.

CONCLUSIONIn the first trimester, fetuses with ACC and HPE have measurable abnormalities in the midbrain and falx area of the brain, and these changes, represented by abnormal midsagittal MD, FD and their ratio, can be of value in detecting ACC or HPE in fetuses in the first trimester.

Agenesis of Corpus Callosum ; diagnosis ; Corpus Callosum ; diagnostic imaging ; Female ; Fetus ; Gestational Age ; Humans ; Pregnancy ; Pregnancy Trimester, First ; Retrospective Studies ; Ultrasonography, Prenatal

OBJECTIVE: To investigate the CT virtual endoscopy (CTVE) shows the display method of the normal structure of the middle ear, and evaluation of middle ear disease, particularly in the value and significance of the connection status of the ossicular chain, established display ossicular chain and middle ear structure methods. METHOD: Volume scanning with a spiral CT unit was performed in forty normal cases and thirty patients with suspected lesions of middle ear. Respectively, with Germany's Siemens (Siemens SOMATOM Sensation 16) spiral CT the Inner Ear scanner patients with axial scanning, reconstruction of the original image, the software selected Fly-through A, B, C the point approach CTVE imaging studies. Focus ossicular chain connection status, and chronic otitis media shown the results of surgery in exploratory image control. RESULT: Normal group CTVE in the hammer bone, incus promontory, facial nerve, the lateral semicircular canal display rate was 100%; stapes, the two arch of the display rate in three display levels, respectively, to 57.5%, 70.0%, 97.5%; round window, oval window was 90.0%, 93.0%, 97.5%. Ossicular injury, displacement, interruption, deletion, deformity in cases of otitis media, trauma, temporal bone malformations. CONCLUSION CTVE link relations between the three ossicles (such as interrupt, etc.) have a certain advantage. By choosing the appropriate approach, CTVE has a considerable advantage in the ossicles and their connections, relations as well as pathological state. By comparing CTVE in three different display levels,the technique of CTVE is considered to be an advantageous supplement of tomography.
Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Ear Ossicles ; diagnostic imaging ; Female ; Humans ; Imaging, Three-Dimensional ; Male ; Middle Aged ; Temporal Bone ; diagnostic imaging ; Tomography, X-Ray Computed ; Young Adult

OBJECTIVE: This study aimed to investigate the relationship between CD14 gene rs2569192(C/G), rs3138078 (--1359G/T) and allergic rhinitis (AR) in Xinjiang Uygur and Han populations as well as to determine characteristics of polymorphisms. METHOD: A total of 300 AR and 300 healthy controls subjects were included. The frequencies of genotypes and alleles were detected as well as the levels of tIgE in different genotypes were compared. RESULT: (1) The distribution of genotypes or alleles of CD14 gene rs2569192 (C/G), rs3138078 (--1359G/T) had no differences between the Xinjiang Uygurs and Hans (P > 0.05). The highest frequency of alleles was C, G. (2) The frequencies of genotypes and alleles were not different between the AR and control group in Uygur and Han (P > 0.05). The frequencies of genotypes and alleles of rs2569192 were different between the Uygur AR and Han AR group (P < 0.05). (3) The distribution of genotype frequencies and allele of rs 2569192 in the Xinjiang Uygur and Han population were quite different from Chinese Beijing Han populations, Japanese, European and African (P < 0.05). (4) The serum total IgE level in AR group was higher than that in healthy control group (P < 0.05). CONCLUSION (1) rs2569192 (C/G), rs3138078 (--1359G/T) polymorphisms were not different between the Chinese Xinjiang Uygur and Han population. The major allele were both C and G. rs2569192 of CD14 in Xinjiang populations was different from that in the other populations. (2) No relationship between rs2569192, rs3138078 and AR was found. (3) The serum total IgE level in AR group was higher than that in healthy control group. No relationship between CD14 two SNP and serum total IgE level was found.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Alleles ; Case-Control Studies ; Child ; Child, Preschool ; China ; epidemiology ; Ethnic Groups ; genetics ; Female ; Gene Frequency ; Genotype ; Humans ; Hypersensitivity ; epidemiology ; genetics ; Lipopolysaccharide Receptors ; genetics ; Male ; Middle Aged ; Polymorphism, Single Nucleotide ; Rhinitis ; epidemiology ; genetics ; Young Adult