Objective To evaluate the imaging features of hepatic epithelioid hemangioendothelioma (HEHE). Methods The imaging data of 15 patients with HEHE proved by surgery and pathology who reeived treatment in West China Hospital from Jul. 2012 to Aug. 2018, were retrospectively analyzed. The location, boundary, density/signal, and enhanced features of tumor were observed. Results Among 15 cases, there were 3 cases of single, 5 cases of multiple, and 6 cases of fusion. Thirteen cases were distributed under the capsular of liver, accompanied by the capsule retraction sign, 14 cases had lollipop sign, 7 cases had core pattern sign. On plain CT images, the lesions manifested as low density. On plain MR images, the lesions had hypointense on T1-weighted images and hyperintense on T2-weighted images. The enhanced scanning could be characterized by mild enhancement, rim-like enhancement at early phase, and progressive centripetal fill-in enhancement during dynamic phase imaging. Conclusions CT and MRI imagings of HEHE are different, and there are certain characteristics of capsule retraction sign, lollipop sign, and core pattern sign.
Objective To determine feasibility of texture analysis of CT images for the discrimination of hepatic epithelioid hemangioendothelioma (HEHE) and liver metastases of colon cancer. Methods CT images of 9 patients with 19 pathologically proved HEHEs and 18 patients with 38 liver metastases of colon cancer who received treatment in West China Hospital of Sichuan University from July 2012 to August 2016 were retrospectively analyzed. Results Thirty best texture parameters were automatically selected by the combination of Fisher coefficient (Fisher)+classification error probability combined with average correlation coefficients (PA)+mutual information (MI). The 30 texture parameters of arterial phase (AP) CT images were distributed in co-occurrence matrix (22 parameters), run-length matrix (1 parameter), histogram (4 parameters), gradient (1 parameter), and autoregressive model (2 parameters). The distribution of parameters in portal venous phase (PVP) were co-occurrence matrix (18 parameters), run-length matrix (2 parameters), histogram (7 parameters), gradient (2 parameters), and autoregressive model (1 parameter). In AP, the misclassification rates of raw data analysis (RDA)/K nearest neighbor classification (KNN), principal component analysis (PCA)/KNN, linear discriminant analysis (LDA)/KNN, and nonlinear discriminant analysis, and nonlinear discriminant analysis (NDA)/artificial neural network (ANN) was 38.60% (22/57), 42.11% (24/57), 8.77% (5/57), and 7.02% (4/57), respectively. In PVP, the misclassification rates of RDA/KNN, PCA/KNN, LDA/KNN, and NDA/ANN was 26.32% (15/57), 28.07% (16/57), 15.79% (9/57), and 10.53% (6/57), respectively. The misclassification rates of AP and PVP images had no statistical significance on the misclassification rates of RDA/KNN, PCA/KNN, LDA/KNN, and NDA/ANN between AP and PVP (P>0.05). Conclusion The texture analysis of CT images is feasible to identify HEHE and liver metastases of colon cancer.
ObjectiveTo investigate the effects of continuous positive airway pressure (CPAP) ventilation on blood pressure and related inflammatory factors in patients with obstructive sleep apnea hypopnea syndrome (OSAHS) and refractory hypertension, and explore the correlation between respiratory function and related inflammatory factors.MethodsPatients with OSAHS and refractory hypertension who visited Shenzhen Nanshan People’s Hospital between January 2014 and September 2018 were randomly divided into a CPAP group and a control group. The control group received routine treatment. The CPAP group received CPAP on the basis of conventional treatment. Each intervention lasted for 7 days. The changes of systolic and diastolic blood pressure were measured before and after 1, 3, 5, and 7 days, respectively. The respiratory function and related inflammatory factors were measured after 7 days of intervention.ResultsAfter 7 days of treatment in the CPAP group, the levels of apnea hyperpnoea index (AHI), lowest oxygen saturation and oxygen desaturation index were significantly better than those before intervention, with the improvement of respiratory function significantly higher than that of the control group after 7 days. Meanwhile the systolic and diastolic blood pressure levels were significantly lower in the CPAP group than those of the control group at 1, 3, 5, and 7 days, and lower than the pre-intervention after 7 days of intervention. After 7 days of intervention, the inflammatory factors in both groups were significantly improved (all P<0.05). However, the serum levels of high sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α) and endothelin-1 (ET-1) in the CPAP group were significantly lower than those of the control group after 7 days of treatment (P<0.05). There was a significant positive correlation between AHI level and hs-CRP, IL-6, TNF-α and ET-1 in the CPAP group after intervention (P<0.001).ConclusionsCPAP can significantly improve the blood pressure of patients with OSAHS and refractory hypertension. CPAP may improve the related inflammatory factors by improving the respiratory function of patients, thus reduce the patient’s blood pressure.
Objective To evaluate the effects of delicacy management applied in branch health management sub-center. Methods From July 2013 to December 2015, integrated delicacy management was applied throughout the whole process of the preparation for the establishment and the running of the branch health management sub-center. The strengths and weaknesses of the management, the management of the details and the control of the emphasis were analyzed. And the medical visits and incomes after the application of delicacy management were also analyzed. Results From July 2013 to December 2015, the monthly average medical visits were 1 870.17±609.93, 2 842.50±1 247.60 and 3 717.92±1 257.98, while the monthly average incomes were (2 136.0±585.1) thousand yuan, (3 620.5±1 559.9) thousand yuan and (4 921.1±1 837.2) thousand yuan, which increased significantly. Conclusion The application of delicacy management in the branch health management sub-center could ensure the quality of service, promote the steady growth of performance, and improve the understanding of the surrounding population of health management, thus we can improve the economic and social benefits of the health management sub-center.
ObjectiveTo explore the clinical value of low-dose contrast agnet in CT angiography (CTA) for head and neck by SOMATOM Definition Flash CT.MethodsSixty consecutive patients with head and neck vessel diseases examined by CTA in the head and neck were chosen from West China Hospital of Sichuan University from March to July 2015, and then were randomly divided into two groups (the experimental group: n=30, 30 mL contrast medium; the control group: n=30, 50 mL contrast medium). Imaging post processing techniques included curved plannar reconstruction, volume rendering, and maximal intensity projection. CT values of the different level of carotid arteries (aortic arch, carotid bifuracation, and M1 segment of middle cerebral artery) were measured. The artifact of the remaining contract in the jugular vein and overall quality of the image were observed by two senior doctors using double blind method.ResultsAll the patients in the two groups completed CTA for head and neck successfully. The image qualities of the two groups satisfid clinical diagnostic requirements, and there was no difference in the image qualities between the two groups (P>0.05). The evaluation of venous pollution in the experimental group was lighter than that in the control group (P<0.05). The CT values of aortic arch, carotid bifuracation, and M1 segment of middle cerebral artery in the experimental group [(341.3±89.5), (391.0±103.7), (305.0±62.0) HU] were slightly lower than those in the control group [(437.3±83.7), (532.5±113.3), (396.6±93.1) HU], which were statistically significant (P<0.05).ConclusionLow-dose contrast in CTA for head and neck by SOMATOM Definition Flash CT can satisfy the clinical diagnostic requirements, and reduce the dose of contrast agent and venous pollution, with a good clinical value.
Real-world data is been increasingly valued nowadays. This paper combined with related requirements of clinical evaluation of medical devices in China, studied the role of real-world evidence in pre-marketing clinical evaluation of medical devices in terms of technical evaluation, in aim of providing reference for the future application of China's real-world evidence in pre-marketing clinical evaluation.
Objective To investigate antimicrobial resistance profiles of carbapenem-resistant Enterobacter spp. (CREn) and the bactericidal effects of aztreonam combined with avibactam. Methods The CREn strains isolated from the West China Hospital of Sichuan University between 2016 and 2021 were identified by gyrB gene amplification and subsequent sequencing. The drug sensitivity results, sample types and distribution of relevant patient departments of these strains were summarized. Colistin-resistant and -intermediate strains were selected to carry out the bactericidal test of colistin and aztreonam combined with avibactam. Results A total of 110 clinical strains of CREn were included. The most common strain was Enterobacter xiangfangensis (91 strains), the highest proportion was in the intensive care unit (27.27%), and the proportion of respiratory tract samples was more than 40%. The antimicrobial sensitivity results showed that CREns were all resistant to carbapenems, the resistance rate to colistin was 23.64%, and the resistance rate to aztreonam combined with avibactam was 0. Among other antimicrobial agents, the antimicrobial resistance rate of amikacin and tigecycline were less than 10%. The time-kill curve showed that for colistin-intermediate strains, colistin could achieve bactericidal effect in a shorter time than aztreonam combined with avibactam. However, whether the strain was resistant to colistin or not, the bactericidal rate of 2 μg/mL aztreonam combined with avibactam in 24 hours could exceed 99%. Conclusion CREn is resistant to most commonly used clinical antibacterial drugs, but remains sensitive to aztreonam combined with avibactam, and aztreonam combined with avibactam has bactericidal effect on it.