临床诊疗

噻托溴铵/奥达特罗治疗 C、D 组慢性阻塞性肺疾病稳定期患者的效果

:100-103
 
目的 探讨噻托溴铵/奥达特罗对C、D组慢性阻塞性肺疾病(COPD)稳定期患者的临床治疗效果。方法 选取2021年1月—2021年10月期间本院收治的C、D 组COPD稳定期患者70例,按照随机数字表达均分为研究组(35例)和对照组(35例)。研究组给予噻托溴铵/奥达特罗雾化吸入治疗,对照组采取规律吸入布地奈德/福莫特罗粉治疗。均持续6个月治疗。比较2组一般资料、治疗前后肺功能指标、住院时间、mMRC评分、CAT评分、急性发作和糖皮质激素使用时间,以及不良反应。结果 治疗6个月后,研究组的肺功能指标包括第1秒用力呼气容积(FEV1)、FEV1%预计值(FEV1%pred)、用力肺活量(FVC)以及FEV1/ FVC比值相比对照组均改善(均P< 0.05)。且相比对照组,研究组患者住院时间更短、治疗后mMRC评分和CAT评分更低、急性发作和糖皮质激素使用时间>30 d的例数更少(均P< 0.05)。此外,研究组患者治疗期间口干、恶心/呕吐、声音嘶哑和口腔感染的不良反应总发生率相比对照组更低。结论 噻托溴铵/奥达特罗能有效改善C、D 组COPD稳定期患者肺功能和临床症状,缩短住院时间和激素使用时间,减少急性发作和不良反应发生率,降低患者的治疗费用。
论著

广州市白云区男性年龄因素与精液质量现况研究

Study on male age and semen quality in Baiyun District of Guangzhou

:83-86
 
目的 了解并分析白云区不同年龄段男性精液质量现状。方法 选取2020年1月—2021年12月在我中心就诊的已婚孕前体检男性为研究对象,开展常规精液检测,采集精液标本进行分析。结果 白云区育龄男性精液各项指标均在正常范围仅有3 176例(占比57.52%),随年龄的增加,精液指标总活力、存活率和精子前向运动指标逐渐降低(P<0.05)。结论 26~30岁年龄段男性的精液质量各项指标正常率较其他年龄组更好(P<0.05),是男性生育的黄金年龄。
Objective To understand and analyze the status of semen quality in men of different ages in Baiyun District of Guangzhou. Methods From January 2020 to December 2021,married men who received pre-pregnant physical examination in our center were selected as the research subjects.Routine semen testing was conducted,and samples were collected for semen analysis. Results Only 3176 cases(57.52%)of male semen data of childbearing age in Baiyun District were within the normal range.With the increase of age,total semen motility,survival rate and sperm forward motility decreased gradually(P < 0.05). Conclusions Men in the age group of 26-30 years had higher normal rates of all indicators of semen quality than other age groups(P < 0.05),which is the golden age of male fertility.
论著

广州市白云区医护人员艾滋病歧视现况调查

Investigation on AIDS discrimination among medical staff in Guangzhou Baiyun District

:76-82
 
目的 了解广州市白云区医护人员对艾滋病感染者/患者(PLWHA)的歧视态度情况,分析其影响因素,并为降低医护人员对PLWHA的歧视态度提供建议。方法 以Lau等设计的AIDS歧视态度量表和张燕等研制的医护人员对PLWHA治疗意愿量表为主设计的调查问卷,对广州市白云区的医护人员进行随机抽样调查,对结果进行描述,研究两量表得分与HIV知识水平的相关性。结果 广州市白云区7家医疗机构并接受培训议会的医护人员AIDS歧视态度量表和治疗意愿量表平均得分分别为(46.66±10.23)分和(32.74±5.89)分,医护人员性别和接受HIV培训的AIDS歧视量表得分存在统计学差异(P<0.01),单位、性别和接受HIV培训与否的治疗意愿量表得分存在统计学差异(P<0.05);HIV知识水平与AIDS歧视量表得分和治疗意愿量表得分存在相关性,相关系数值rs分别为-0.301(P<0.001)和-0.219(P<0.001)。结论 广州市白云区医护人员的性别、接受培训与否和HIV知识水平对AIDS歧视量表和治疗意愿量表得分均有影响。应加强白云区医护人员的艾滋病知识培训和各人群的权益保护,以降低医护人员对PLWHA的歧视态度。
Objective To understand the discriminatory attitudes of medical staff to people living with HIV/AIDS(PLWHA)in Guangzhou Baiyun District,analyze the influencing factors,and provide suggestions for reducing the discriminatory attitudes of medical staff to PLWHA.Methods Based on Lau's AIDS Discrimination Attitude Scale and Zhang Yan's Medical Personnel's Adjustment Questionnaire for PLWHA Treatment Willingness Scale,the questionnaire was designed to do a random sampling survey among medical personnel in Guangzhou Baiyun District,and the results were described by regression analysis,to study the correlation between the scores of the two scales and the level of HIV knowledge.Results The average scores of AIDS Discrimination Attitude Scale and Treatment Willingness Scale of medical staff in 7 medical institutions with training in Guangzhou Baiyun District were(46.66±10.23)and(32.74±5.89)respectively.There were statistical differences in AIDS discrimination scale scores of medical staff's gender and whether they received training or not(P< 0.01),and there were statistical differences in Treatment Willingness Scale scores among institutions,gender and whether they received training or not(P< 0.05).HIV knowledge level was correlated with the scores of AIDS Discrimination Scale and Treatment Willingness Scale,and the correlation coefficients were -0.301(P < 0.001)and -0.219(P < 0.001).Conclusions Gender,training or not,and HIV knowledge level of medical staff in this area have an impact on the scores of the AIDS Discrimination Scale and the Treatment Willingness Scale.In order to reduce the discriminatory attitude of medical staff towards PLWHA,the AIDS knowledge and the protection of rights and interests of all groups should be strengthened.
论著

容积调强在全脊柱骨多发转移瘤放疗中应用研究

Research on the application of volumetric modulated arc therapy in the radiotherapy for multiple bone metastases in the whole spine

:69-75
 
目的 探讨容积调强(VMAT)在全脊柱骨多发转移瘤放疗中的运用,观察疗效及安全性。方法 选取 2018年1月—2021年1月本科室收治的50例全脊柱骨多发转移瘤姑息止痛放疗的临床资料,分别对全脊柱靶区设计适形放疗(CRT)和VMAT多中心计划,运用剂量体积直方图及所对应的统计表评估靶区及危及器官剂量覆盖情况,放疗结束后通过1-8周视觉模拟评分法评价近期疗效,每3个月复查全脊柱MRI观察放疗不良反应。结果 采用VMAT技术放疗靶区剂量覆盖度、靶区适形指数和剂量均匀指数均优于CRT技术(P<0.01),照射野重叠区未见明显剂量热点和冷点。采用VMAT技术危及器官V5 Gy受照体积高于CRT(P<0.01),除了胃、胰腺和小肠,危及器官V10 Gy受照体积高于CRT(P<0.01或P<0.05),危及器官V20 Gy受照体积则低于CRT(P<0.01),除了肾,危及器官V30 Gy受照体积也低于CRT(P<0.01)。采用VMAT技术时危及器官的最大受照量低于CRT(P<0.01或P<0.05),但除了心脏、胰腺和小肠,VMAT技术的危及器官平均受照量高于CRT(P<0.01或P<0.05)。采用VMAT技术较CRT出束时间增加(P<0.01),采用CRT时技师摆位时间较VMAT增加(P<0.05),对于总治疗时间VMAT较CRT增加(P<0.01)。8周后评估疼痛完全缓解16例,部分缓解 22例,轻度缓解8例,无效4例,总有效率为76%。随访日期截至2021年 12月,所有配合随诊的患者3、6、9、12个月全脊柱MRI复查结果显示,VMAT技术照射野内重叠处均未见脊髓及其他组织急慢性损伤情况。结论 VMAT技术对长靶区多中心放疗剂量分布均匀,近期疗效显著,安全性良好。
Objective To investigate the application of volumetric modulated arc therapy(VMAT) in the radiotherapy for multiple bone metastases in the whole spine,and observe of efficacy and evaluation of safety.Methods The clinical data were selected from 50 patients who were treated in our department between January 2018 and January 2021 with palliative analgesic radiotherapy for multiple metastases of the whole spine.Conformal radiotherapy(CRT)and multicenter VMAT plans were respectively applied to target areas of whole spine,and dose volume histogram was used to evaluate the dose coverage of target area and organ at risk(OAR). After radiotherapy,the short-term efficacy was evaluated by visual analog scale in between 1-8 weeks,and the whole spine MRI was reviewed every 3 months to observe the adverse reactions of radiotherapy.Results The dose coverage,target conformality index and homogeneity index of VMAT treatment were significantly better than those of CRT treatment(P<0.01),and no obvious dose hotspots and cold spots were observed in the overlapping area of irradiation field. When VMAT treatment was applied,the exposure volume of V5 Gy in OAR was significantly higher when compared with CRT treatment(P<0.01).Except for stomach,pancreas and small intestine,the exposure volume of V10 Gy in OAR was significantly higher for VMAT treatment when compared with CRT treatment (P<0.01 or P<0.05).When VMAT treatment was applied,the exposure volume of V20 Gy in OAR was significantly lower when compared with CRT treatment(P<0.01),and except for kidney,the exposure volume of V30 Gy in OAR was significantly lower when compared with CRT treatment(P<0.01).When VMAT treatment was applied,the maximum exposure of OAR was significantly lower than that of CRT(P<0.01 or P<0.05),however,except for the heart,pancreas and small intestine,the average exposure of VMAT treatment to OAR was higher than that of CRT (P<0.01 or P<0.05).Compared with CRT,VMAT treatment had significantly increased beam-out time(P<0.01),the therapist setting time of CRT was increased when compared with that of VMAT(P<0.05),and the total treatment time of VMAT was increased when compared with that of CRT(P<0.01). In the assessment 8 weeks after the treatments,16 patients had complete pain relief,22 had partial relief,8 had mild relief,and 4 had no effect,which total effective rate was 76%.The follow-up was ended in December 2021.There was no acute or chronic injury to the spinal cord and other tissues in the overlapping areas of the irradiation fields observed for all follow-up patients in the 3rd,6th,9th and 12th month whole-spine MRI re-examination.Conclusions VMAT has uniform dose distribution in multi-center radiotherapy for long target areas,with significant short-term efficacy and safety.
论著

TIMELESS、RAB2A、ASPM在乳腺癌组织中的表达及与临床特征相关性

Expression of TIMELESS,RAB2A and ASPM in breast cancer and their correlation with clinical features

:80-86
 
目的 分析TIMELESS、鼠肉瘤病毒家族相关蛋白2A(RAB2A)、异常纺锤体样小头畸形相关基因(ASPM)在乳腺癌组织中的表达及与临床特征相关性。方法 选取2019年2月—2021年2月我院乳腺癌组织标本84例作为研究组、正常乳腺组织标本53例作为对照组,采用荧光定量聚合酶测定TIMELESS、ASPM,采用Western blot检测RAB2A蛋白表达情况,分析上述三个指标在乳腺癌中表达及与临床特征相关性。结果 对比对照组,研究组TIMELESS、ASPM表达较高,RAB2A较低(P<0.05)。TIMELESS、RAB2A、ASPM与乳腺癌淋巴结浸润、TNM分期、分化程度相关(P<0.05)。TIMELESS、RAB2A、ASPM为影响乳腺癌发生的危险因素(P<0.05)。TIMELESS、RAB2A负相关(r=-0.383、P=0.001);TIMELESS、ASPM正相关(r=0.397、P=0.001);RAB2A、ASPM负相关(r=-0.257、P=0.018)。对比TIMELESS、RAB2A、ASPM单一检测,三者联合检测对乳腺癌的诊断价值较高(P<0.05)。结论 乳腺癌患者TIMELESS、ASPM呈高表达,RAB2A呈低表达,上述三个指标与乳腺癌高度相关,可作为乳腺癌发生的检测指标。
Objective To analyze the expression of TIMELESS,murine sarcoma virus family related protein 2A(RAB2A)and abnormal spindle like microcephaly related gene(ASPM)in breast cancer tissues and their correlation with clinical features.Methods A total of 84 breast cancer tissue samples from our hospital from February 2019 to February 2021 were selected as the study group and 53 normal breast tissue samples were selected as the control group.Time,ASPM and RAB2A protein expression were determined by fluorescent quantitative polymerase,and RAB2A protein expression was detected by Western blot.The expression of the above three indicators in breast cancer and their correlation with clinical characteristics were analyzed.Results Compared with the control group,the study group had higher TIMELESS and ASPM expression levels and lower RAB2A level(P<0.05).TIMELESS,RAB2A and ASPM expressions were correlated with lymph node infiltration,TNM stage and differentiation of breast cancer(P<0.05).TIMELESS,RAB2A and ASPM were the risk factors of breast cancer(P<0.05).TIMELESS and RAB2A were negatively correlated(r=-0.383,P=0.001);TIMELESS and ASPM were positive correlated(r=0.397、P=0.001);RAB2A and ASPM were negatively correlated(r=-0.257,P=0.018).Compared with the single detection of TIMELESS,RAB2A and ASPM,the combined detection had higher diagnostic value for breast cancer(P<0.05).Conclusions Patients with breast cancer had high expression of TIMELESS and ASPM,and low expression of RAB2A.The above three indicators were highly correlated with breast cancer and can be detection indicators for breast cancer.
论著

消肿化瘀膏治疗骨性关节炎的临床疗效

Clinical effect of Xiaozhonghuayu ointment in the treatment of osteoarthritis

:75-79
 
目的 探讨消肿化瘀膏治疗骨性关节炎的临床疗效。方法 选择2017年5月—2022年1月在本院诊治的骨性关节炎患者124例作为研究对象,根据简单分配原则把患者分为消肿化瘀膏组与传统药物组各62例。传统药物组给予传统药物治疗,消肿化瘀膏组给予消肿化瘀膏治疗,判定2组患者治疗总显效率、疼痛评分、关节评分、血清中炎症因子水平变化。结果 消肿化瘀膏组治疗后的总显效率为98.4%,高于传统药物组的83.9%(P<0.05)。治疗后,2组的疼痛评分都低于治疗前(P<0.05),且消肿化瘀膏组低于传统药物组(P<0.05)。2组治疗后的关节评分都高于治疗前(P<0.05),且消肿化瘀膏组与传统药物组相比升高(P<0.05)。2组治疗后的血清白介素-1β、白介素-6水平都低于治疗前(P<0.05),且消肿化瘀膏组较传统药物组降低更多(P<0.05)。结论 消肿化瘀膏治疗骨性关节炎能有效抑制血清炎症因子的表达,缓解疼痛,改善关节功能,提高患者的总体治疗效果。
Objective To explore the clinical efficacy of Xiaozhonghuayu ointment in the treatment of osteoarthritis.Methods From May 2017 to January 2022,124 patients with osteoarthritis who diagnosed and treated in our hospital were selected as the research subjects.According to the simple allocation principle,the patients were divided into the Xiaozhonghuayu ointment group and the traditional medicine group with 62 cases each.The traditional medicine group was treated with traditional medicine,and the Xiaozhonghuayu ointment group was treated with Xiaozhonghuayu ointment.The total therapeutic efficiency,pain score,joint score,and the changes of serum inflammatory factors were compared in the two groups.Results The total efficiency of Xiaozhonghuayu ointment group after treatment were 98.4%,which were higher than 83.9% in the traditional medicine group(P<0.05).The pain scores in both groups after treatment were lower than those before treatment(P<0.05),and that in the Xiaozhonghuayu ointment group were lower than the traditional medicine group(P<0.05).The joint scores of the two groups after treatment were higher than those before treatment(P<0.05),and that in the Xiaozhonghuayu ointment group were higher than the traditional medicine group(P<0.05).After treatment,the levels of serum interleukin-1β and interleukin-6 in the two groups were significantly lower than those before treatment(P<0.05),compared with the traditional medicine group,those levels in the Xiaozhonghuayu ointment group also decreased significantly after treatment(P<0.05).Conclusions Xiaozhonghuayu ointment in the treatment of osteoarthritis can effectively inhibit the expressions of serum inflammatory factors,promote pain relief,improve joint function,and improve the overall therapeutic effect of patients.
论著

精神分裂症患者不同肾功能水平与血清酶水平的关系研究

Relationship between different levels of renal function and serum enzymes in patients with schizophrenia

:56-60
 
microglobulin')">β2 microglobulin,intercellular adhesion molecules,schizophrenia,acute kidney injury" split="">serum creatine kinase microglobulin')">β2 microglobulin,intercellular adhesion molecules,schizophrenia,acute kidney injury" split="">myoglobin microglobulin')">β2 microglobulin,intercellular adhesion molecules,schizophrenia,acute kidney injury" split="">2 microglobulin')
目的 分析精神分裂症患者体内的肌酸激酶(CK)、肌红蛋白(MYO)、β2微球蛋白(β2-MG)、细胞间黏附分子(ICAM)水平随患者精神状态及肾功能损害程度的变化,探讨其对患者早期急性肾损伤(AKI)可能的作用机制。方法 根据肾功能水平将 80例精神分裂症患者分为4组,并设立健康对照组(同期我院门诊健康体检者)20例。采用酶联免疫吸附法检测血清CK、MYO 、ICAM,采用放射免疫法检测β2-MG水平,分析其与患者精神状态变化及肾功能损害程度的关联。结果 精神分裂症患者中肾功能损害组的血清CK、MYO、ICAM、β2-MG值高于健康对照组及肾功能正常组,差异具有统计学意义(F=623.534,30.437,636.776,88.283,P<0.05),精神分裂症AKI 1期组到AKI 3期组CK、MYO、β2-MG、ICAM数值均比对照组升高(P<0.05),3组之间如上指标的比较差异有统计学意义(P<0.05)。结论 精神分裂症肾功能损害患者的血清CK、MYO、ICAM、β2-MG的异常升高能反映出患者的精神状态及肾功能损害程度,提示临床可通过检测如上血清指标来监测患者的精神状态及肾功能。
Objective To study the changes of serum creatine kinase(CK),myoglobin(MYO),β2 microglobulin(β2-MG),intercellular adhersion molecule(ICAM)with the mental state and the degree of renal function damage of patients,to explore the possible mechanism of their effects on early acute kidney injury(AKI)in patients with schizophrenia.Methods A total of 80 schizophrenic patients were divided into 4 groups according to their renal function level,and 20 healthy controls(who underwent physical examination during the same period)were included.At the same time,enzyme linked apta-sorbent assay was used to detect serum CK,MYO and ICAM levels in each group,and radioimmunoassay was used to detect serum β2-MG level in each group.The correlation between the above indexes and the changes of mental state and the degree of renal function damage was analyzed.Results The serum CK,MYO,ICAM and β2-MG values in schizophrenia renal impairment groups were higher than those in healthy control group,and the differences were statistically significant(F=623.534,30.437,636.776,88.283,P<0.05),and the comparison of the above indexes among the three groups was statistically significant(P<0.05).Conclusions The abnormal increase of serum CK,MYO,ICAM and β2-MG can reflect the patient's mental state and the degree of renal function damage,it suggesting that the clinical staff can monitor the patient's mental state and renal function through daily serum collection and analysis.
论著

艾司氯胺酮对剖宫产术后镇痛及RAAS系统、产后抑郁的影响

Effects of esketamine on postoperative analgesia and RAAS system and postpartum depression after cesarean delivery

:51-55
 
目的 分析艾司氯胺酮对剖宫产术后镇痛及肾素-血管紧张素-醛固酮系统(RAAS)、产后抑郁情况发生的影响。方法 研究对象为2020年5月—2021年6月在我院行剖宫产的96例孕产妇,根据麻醉药物的不同分为研究组50例和对照组46例,2组孕产妇均给予腰硬联合麻醉行剖宫产术,研究组于手术切皮前5 min静脉注射艾司氯胺酮0.2 mg/kg,对照组静脉注射等量生理盐水。比较2组孕产妇术后疼痛评分(VAS评分)、肾素活性(PRA)、血管紧张素-II(AT-II)、醛固酮(ALD)、爱丁堡产后抑郁量表(EPDS)、不良反应的发生情况。结果 与对照组比较,术后各时间点研究组孕产妇VAS评分均明显较低,差异具有统计学意义(P<0.01)。2组T1、T2、T3各时间点RAAS各指标均明显低于T0时间点(P<0.05);研究组在T1、T2时间点RAAS各指标均明显低于对照组,差异具有统计学意义(P<0.05)。研究组术后3 d、术后6周EPDS评分均明显低于对照组(P<0.01)。2组不良反应总发生率比较无差异(P>0.05)。结论 艾司氯胺酮用于剖宫产术后镇痛效果显著,对产妇RAAS影响较小,并可缓解产妇抑郁症状,且不良反应发生率较低。
Objective To analyze the effect of esketamine on analgesia and renin angiotensin aldosterone system(RAAS)and the occurrence of postpartum depression after cesarean delivery.Methods The subjects were 96 pregnant women who underwent cesarean section in our hospital from May 2020 to June 2021,they were divided into 50 cases in the study group and 46 cases in the control group.Both groups of pregnant women were given combined spinal epidural anesthesia for cesarean section.The patients in study group were injected with esmketamine 0.2 mg/kg intravenously 5 minutes before skin incision,and those in control group were injected with the same amount of saline intravenously.The postoperative pain scores(VAS score),plasma renin activity(PRA),angiotensin-II(AT-II),aldosterone(ALD),Edinburgh Postpartum Depression Scale(EPDS),and the occurrence of adverse effects were compared between the two groups.Results Compared with the control group,maternal VAS scores were significantly lower in the study group at all postoperative time points,and the differences were statistically significant(P<0.01).The indexes of RAAS were significantly lower in both groups at T1,T2 and T3 time points than at T0 time point(P<0.05);the indexes of RAAS were significantly lower in the study group at T1 and T2 time points than in the control group,and the differences were statistically significant(P<0.05).The postoperative EPDS scores in the study group were significantly lower than those in the control group at 3 d and 6 weeks(P<0.01).There was no difference in the overall incidence of adverse reactions between the two groups(P>0.05).Conclusions Esketamine is effective for postoperative analgesia after cesarean section,with less effect on maternal RAAS,and can relieve maternal depressive symptoms,and has a low incidence of adverse reactions.
论著

MSCT增强扫描期相及VOI的选择在基于影像组学方法预测原发性肝细胞癌微血管侵犯中的价值

The value of contrast-enhanced MSCT with phases and VOI strategies in the prediction of microvascular invasion in primary hepatocellular carcinoma based on radiomics

:36-43
 
目的 基于影像组学方法,探讨多层螺旋CT(MSCT)四期增强扫描单一/不同期相及不同容积感兴趣区(VOI)的选择,在术前预测原发性肝细胞癌(HCC)微血管侵犯(MVI)中的价值。方法 回顾性收集88例经手术病理证实为HCC并行术前MSCT四期增强扫描的患者,其中包括47例MVI阳性患者和41例MVI阴性患者。在MSCT增强扫描的动脉早期、动脉晚期、门静脉期及延迟期图像中手动逐层勾画肿瘤ROI,获得瘤体容积感兴趣区VOI(Vt),然后基于计算机自动膨胀算法将Vt外扩10 mm获得瘤体及瘤周VOI(Vt+Vp)。使用Pyradiomics软件分别从Vt和Vt+Vp中提取影像组学特征,随后采用15种特征选择方法和10种分类器构建150个预测模型,并通过十折交叉检验以验证模型的效能。使用准确度、敏感度、特异度、受试者工作特性曲线下面积(AUC)评估模型的效能,并比较性能最优的前三个预测模型。结果 MSCT四期增强扫描图像中预测HCC MVI状态的影像组学模型在门静脉期的表现优于其它期相及各期相的不同组合,其中最大的AUC值在Vt和Vt+Vp两种ROI中分别为0.768和0.782。此外,基于Vt+Vp的影像组学模型对MVI的预测效能优于基于Vt的影像组学模型,基于Vt+Vp性能最优的预测模型的AUC值、准确度、敏感度和特异度分别0.782、0.728、0.745和0.705。结论 采用影像组学方法术前无创性预测HCC MVI状态首选增强扫描的门静脉期,ROI首选瘤体联合瘤周10 mm区域。
Objective To investigate the value of single or different phases of contrast-enhanced multi-slice spiral CT(MSCT)in different volumetric regions of interest(ROI)to preoperatively predict the state of microvascular invasion in primary hepatocellular carcinoma(HCC)based on radiomics methods.Methods A total of 88 patients with HCC confirmed by surgical pathology who underwent preoperative MSCT quadruple-enhanced scan were retrospectively recruited,including 47 MVI-positive patients and 41 MVI-negative patients.The ROI was manually delineated slice-by-slice in the early arterial phase,late arterial phase,portal venous phase,and equilibrium phase of enhanced MSCT images to obtain the volume of tumor VOI(Vt),and then Vt was expanded by 10 mm through the computer expansion algorithm automatically to obtain the volume of tumor and peritumor(Vt+Vp).Pyradiomics software was used to extract radiomic features from Vt and Vt+Vp,followed by 150 discriminant models constructed with 150 feature selection methods and 10 classifiers,and then 10-fold cross-validation was used to evaluate the performance of these models.Using accuracy,sensitivity,specificity,area under the receiver operating characteristic curve(AUC)to assess model performance.The top three predictive models with the best performance were also compared.Results The radiomics model for predicting HCC MVI status in portal venous phase among quadruple-enhanced MSCT images outperformed other phases and different combinations of phases,achieving the highest AUC values of 0.768 and 0.782 in Vt and Vt+Vp respectively.In addition,the prediction performance of the radiomics model based on Vt+Vp was superior to models based on Vt.AUC value,accuracy,sensitivity,and specificity of the model with the best performance based on Vt+Vp were 0.782,0.728,0.745 and 0.705 respectively.Conclusions Radiomics models based on the portal venous phase of contrast-enhanced MSCT and tumor combined with the 10mm peritumoral area were more recommended to be employed to preoperative non-invasively predict the state of HCC MVI.
论著

度普利尤单抗对瘙痒性皮肤病的效果及对嗜酸粒细胞恢复和生活质量的影响

Effect of Dupilumab on pruritic dermatosis,eosinophil recovery and quality of life

:74-77
 
目的 探讨度普利尤单抗对瘙痒性皮肤病的效果及对嗜酸粒细胞(EOS)恢复和生活质量的影响。方法 选取2021年2月—2022年1月期间,我院收治的瘙痒性皮肤病患者96例。根据治疗方式不同分为对照组(48例)和观察组(48例)。对照组给予传统激素治疗,观察组给予度普利尤单抗治疗。比较治疗前后2组血清炎症因子、免疫球蛋白水平情况;比较治疗前后2组症状积分下降指数(SSRI 评分)、神经激肽/速激肽受体1(NK1R)及EOS情况。观察2组疗效情况。采用皮肤病生活质量问卷(DLQI)对2组生活质量进行评价,并观察2组复发率情况。结果 治疗后,2组血清IFN-γ(干扰素-γ)、IL-2(白介素2)、IgA、IgG、IgM、NK1R、EOS水平升高,IL-4、IL-13、IgE水平及SSRI 评分降低,且观察组更明显(P<0.05)。观察组治疗有效率高于对照组(P<0.05)。随访6个月,观察组DLQI评分及复发率低于对照组(P<0.05)。结论 度普利尤单抗可减轻瘙痒性皮肤病患者瘙痒症状,增强机体防御力,促进嗜酸粒细胞恢复,提高其生活质量,值得临床推广应用。
Objective To investigate the effect of Dupilumab on pruritic dermatosis,eosinophil(EOS)recovery and quality of life.Methods From February 2021 to January 2022,96 patients with pruritic dermatosis were selected.According to different treatment methods,they were divided into control group(48 cases)and observation group(48 cases).The control group was treated with traditional hormone,and the observation group was treated with Dupilumab.The levels of serum inflammatory factors and immunoglobulin in the two groups were compared before and after treatment.The symptom score reduce index(SSRI score),neurokinin/tachykinin receptor 1(NK1R)and EOS were compared between the two groups before and after treatment.The curative effect of the two groups was observed.The quality of life of the two groups was evaluated with Dermatology Quality of Life Questionnaire(DLQI),and the recurrence rate of the two groups was observed.Results After treatment,levels of serum IFN-γ,IL-2,IgA,IgG,IgM,NK1R and EOS of two groups increased,while the levels of IL-4,IL-13,IgE and SSRI scores decreased,especially in the observation group(P<0.05).The effective rate of the observation group was higher than that of the control group(P<0.05).The DLQI score and recurrence rate in the observation group were lower than those in the control group(P<0.05)in 6 months follow-up.Conclusions Dupilumab can alleviate the itching symptoms of patients with pruritic dermatosis,enhance the body's defense,promote eosinophil recovery,and improve their quality of life,which is worthy of clinical application.
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