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Objective To observe the value of quality control system based on artificial intelligence(AI)for improving imaging quality of chest CT.Methods Totally 1 726 CT images obtained from 415 patients were retrospectively collected,among which 1 414 images were used for convolutional neural network(CNN)training and the rest 312 images were used for validation.Precision,Recall,F1-Score,mean average precision(mAP)and intersection over union(IOU)of quality control system based on AI for chest CT scanning were calculated.Meanwhile,21 patients with unsatisfactory chest CT who would undergo re-examination were prospectively enrolled,and chest CT scanning with quality control system based on AI were performed.The results of 2 examinations were compared.Results Precision,Recall,F1-Score,mAP and IOU of quality control system based on AI for chest CT were all good.All 21 cases were diagnosed correctly with re-examination CT based on quality control system.Among 21 cases,the first CT misdiagnosed 19 cases,the displaying of the area,volume and display quality of pulmonary nodules were not significantly different,but the morphology,boundaries,spiny protrusions,vacuolar signs,inflatable bronchial signs of nodules as well as the thickened and twisted blood vessels were obviously different between 2 times examination.The first CT missed 1 case while correctly diagnosed 1 case.Conclusion The quality control system based on AI was helpful for improving imaging quality of chest CT and increasing diagnostic efficacy.
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Objective:To evaluate the clinical efficacy of ultrasound-guided radiofrequency ablation therapy for patients with papillary thyroid microcarcinoma (PTMC).Methods:A retrospective analysis was conducted on the clinical data of 80 PTMC patients admitted to Zhongshan Hospital of Traditional Chinese Medicine(Zhongshan Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Traditional Chinese Medicine) from January 2018 to September 2020. All cases were divided into two groups according to different treatment methods, with 40 cases in each group. The control group received PTMC radical surgery, while the observation group received ultrasound guided radiofrequency ablation. The situation of new tumors and cervical lymph node metastasis in both groups was observed through follow-up, the relative indexes of operation and safety of the two groups were compared.Results:There was no significant difference in the incidence of situation of new tumors and cervical lymph node metastasis between the two groups ( P>0.05). The operation time, intraoperative blood loss and hospital stay in the observation group were less than those in the control group: (20.23 ± 5.07) min vs. (54.51 ± 12.13) min, (1.68 ± 0.28) ml vs.(13.68 ± 2.31) ml, (1.82 ± 0.32) d vs. (5.43 ± 0.57) d, there were statistical differences ( P<0.05). The incidence of complications in the observation group was lower than that in the control group: 5.00%(2/40) vs. 25.00%(10/40), there was statistical difference ( P<0.05). Conclusions:Ultrasound guided radiofrequency ablation for the treatment of PTMC is safe and effective, minimally invasive in beauty, and can effectively reduce the incidence of complications.
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Objective:To establish a reasonable and effective formative evaluation system based on the characteristics of practical teaching of medical laboratory to evaluate the effect of practical teaching and improve the quality and level of teaching.Methods:A survey and research method was used to screen the elements needed for the formative evaluation system, so as to construct the framework and evaluation indicators of the practice teaching of this specialty. The students from Batch 2016 were scored before and after implementing formative evaluation, and the results were statistically analyzed by paired t test with SPSS 20.0 software. Results:The survey results of a total of 30 teachers (experts) and 121 students in this major were counted. According to the practical characteristics of this major, the evaluation system included two first-level indicators, five second-level indicators, and corresponding third-level and fourth-level indicators. After statistical analysis, students' learning interest, practical ability, self-learning ability, team assistance ability and knowledge development ability were all significantly improved after the implementation of formative evaluation ( P<0.01- P<0.05), and students' enthusiasm for class also increased ( P<0.05). Conclusion:It proves that the constructed formative evaluation system conforms to the characteristics of practical teaching of medical laboratory, which helps to improve the effect of practical teaching and lays a foundation for its application in the practical teaching of this professional course.
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IMPORTANCECOVID-19-infected pneumonia patients with severe immune abnormalities and risk of cytokine release syndrome. The definition, prevention, and treatment of COVID-19-infected pneumonia in critically ill patients with cytokine release syndrome symptoms is an important problem. OBJECTIVETo define the cytokine release syndrome-like (CRSL) in COVID-19-infected pneumonia in critically ill patients and study the risk factors and therapeutic strategies. DESIGN, SETTING, AND PARTICIPANTSThis is a retrospective, single center case study of 11 COVID-19-infected pneumonia patients with acute respiratory distress syndrome (ARDS) from The First Affiliated Hospital of Guangzhou Medical University in China from January 26, 2020 to February 18, 2020. The follow-up termination date was February 19, 2020. EXPOSERESEleven COVID-19-infected pneumonia patients with ARDS in the ICU. Some of these patients also had cytokine release syndrome-like (CRSL). Immunologic detection, clinical characteristics, and clinical treatment analysis were carried out to define the CRSL in these COVID-19-infected pneumonia patients. MAIN OUTCOMES AND MEASURESClinical, radiological, immunology (including immune cell subsets and cytokines analysis), laboratory, and clinical treatment data were collected and analyzed. The critically ill patients with CRSL were defined. Prevention and control strategies were studied. RESULTSOf 11 critically ill patients in the ICU, the median age was 58 (Inter-Quartile Range{IQR}, 49-72; range, 26-72 years), and 10 (83.3%) were males. Ten (83.3%) patients had extensive pulmonary inflammation and ARDS (the median time from the first symptom to ARDS was 10.0 d), fever, and hypoxia; four (28.6%) patients experienced shock. The lymphocyte subpopulations including CD3 (CD3 + CD45+), CD4 (CD3 + CD4+), CD8 (CD3 + CD8+), NK (CD3-CD16 + CD56 +), Tregs (CD4 + CD25 + CD127 low), B lymphocyte (CD3-CD19 +) cells; and cytokines including IL-2, IL-4, IL-6, IL-10, TNF-, IFN-{gamma} were detected at different time points. All of the patients had a decrease of CD3 (IQR,169-335; range, 50-635 cells/L), CD4 (IQR,101-303; range, 27-350 cells/L), CD8 (IQR, 33-141; range, 21-277 cells/L); ten (90.9%) patients have a decrease in NK immune cells (IQR,8-72; range, 5-170 cells/L); both of Tregs (IQR,3.3-7.8;rang,2.3-9.4%) and B immune cells (IQR,61-146; rang,44-222 cells/L)were decreased in two (18.2%) patients. And nine patients were increase in CD4 / CD8 (IQR,3.3-7.8%; range, 2.3-9.7%). All patients had a significant increase of IL-6 (IQR,14.26-92.2; range, 4.58-1182.91ng/L). Eight (72.7%) patients were determined to have CRSL characteristics, including pulmonary inflammation, fever, a decrease of CD4, CD8, and NK cells; an increase of CD4/CD8, a significant increase of IL-6, and the dysfunction of non-pulmonary organs. The numbers of CD4, CD8, and NK cells and the level of IL-6 in peripheral blood were correlated with the area of pulmonary inflammation in CT images (P<0.05). Mechanical-ventilation used to increase blood oxygen concentration could increased the numbers of CD4 (after Vs before ventilation=259{+/-}53 VS 507{+/-}101; P=0.013, and CD8 (after Vs before ventilation=193{+/-}38 VS 279{+/-}63; P=0.048), while decreasing the level of IL-6 (after Vs before ventilation=223.2{+/-} 89.9 VS 26.8{+/-}10; P=0.041). The increased of IL-6 was occurred earlier than the decrease of CD4{middle dot}, CD8 in the patients with rapidly worsened after ICU. CONCLUSIONS AND RELEVANCEIn this retrospective analysis of 11 critically ill pneumonia patients infected with COVID-19, we defined and identified eight patients (72.7%) with cytokine release syndrome-like (CRSL). We found that a large area of lung injury ([≥]50%) with an decrease of CD4, CD8 (Lower than 50% minimum normal range) and increase of IL-6 in peripheral blood was the highest risk factor of CRSL. IL-6 was a early indicators of CRSL in COVID-19-infected pneumonia. We also found that reduce injury to the lung is a useful method to prevent and improve COVID-19-infected pneumonia-related CRSL in critically ill pneumonia patients.
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In recent years, Krebs von den Lungen-6 (KL-6) has attracted clinical attention as a serum non-invasive biomarker of interstitial lung disease (ILD), which are complex and diverse.The level change of KL-6 is related to the activity and therapeutic effect of ILD.The clinical significance of KL-6 in the diagnosis, monitoring and evaluation of interstitial lung disease is summarized.
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Objective To evaluate clinical performance on dry chemistry method of Vitros 350 for the determination of serum bilirubin in order to ensure the quality of examination.Methods Evaluation protocols were employed to evaluate the precision,the trueness and the linearity of total bilirubin(TBIL),unconjugated bilirubin (Bu)and conjugated bilirubin (Bc)by dry chemistry method,to verify the reference ranges of TBIL,Bu and Bc simultaneously.Results The precision and trueness of TBIL,Bu and Bc were within the allowable ranges of Clinical and Laboratory Ltandards Institute (CLSI).The linear range of TBIL,Bu and Bc in our laboratory were 6.57-428.83 μmol/L,4.5-320.1 μmol/L and 4.5-364.9 μmol/L respectively.Conclusion Both technical per-formance evaluation and diagnostic performance verification of bilirubin by dry chemical detection system could meet the needs of the clinic.
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10.3969/j.issn.2095-4344.2013.23.013
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BACKGROUND: The study about the multiple differentiation potentials of the mesenchymal stem cells is still on the stage of the animal experimentation. Can mesenchymal stem cells have the ability to differentiate into certain tissues and develop the corresponding functions after they are transplanted into certain tissues?OBJECTIVE: To observe the differentiation of the bone marrow mesenchymal stem cells into the nerve and its effect on the nerve functional recovery after they are transplanted into the peripheral zone of the ischemic infarction focus of the cerebral cortex.DESIGN: A randomized controlled study.SETTING: The Department of Anatomy of the School of Basic Medical College of Sun Yat-sen University; the Department of Neurology of the First Hospital of Sun Yat-sen University; Department of Pathology of the Medical College of Jinan University.MATERIALS: The experiment was conducted at the Medical College of Sun Yat-sen University from November 2002 to November 2003. Forty-eight male SD rats were chosen and randomly divided into two groups, with 32 rats in cerebral infarction model group and 16 in the non-model control group. In the cerebral infarction group, the rats were randomly divided again into two groups: 16 rats in the transplantation group and 16 in the phosphate buffered fluid group. The anterior fontanel taken as the reference point, 5 μL(5 × 104 L-1) of the bone marrow mesenchymal stem cells or the phosphate buffered fluid was respectively transplanted at the site 3 mm away on the caudal side and 1.5 mm aside at the depth of 2. 0 - 3. 0 mm.METHODS: The bone marrow mesenchymal stem cells were obtained through the separation and purification of the bone marrow of the ribs taken away in the thoracic surgery from the patients without the hematological diseases, and then the cells underwent in vitro culture, the amplification and the identification. At the 2nd and 6t1 weekend after the transplantation,the rats of every group were anesthetized, and the samples were taken from the transplantation site and made into the 25 μm of continuous frozen section. Then, the immunohistochemical method was used for the detection of the expressions of neuron specific enolase, neurofibril protein, glial fibrillary acidic protein, and nidogen to evaluate the ability of the bone marrow mesenchymal stem cells to differentiate into neurons and glial cells. Eight rats of the transplantation group and 8 rats of the phosphate buffered fluid group were randomly taken out, and 2 and 6 weeks before and after the transplantation the bar walking test evaluation method was used to identify the general status and reaction ability of the rats. Sixteen rats of the control group were assessed at the same time.enolase, neurofibril protein, glial fibrillary acidic protein and nidogen in the bar walking test.2nd weekend after the transplantation, there were positive expressions of glial fibrillary acidic protein and nidogen at the transplantation site of the bone marrow mesenchymal stem cells. At the 6th weekend there were positive expressions of neuron specific enolase and neurofibril protein at the transplantation site of the bone marrow mesenchymal stem cells. While in the phosphate buffered fluid group, there were negative expressions of neuron specific enolase, neurofibril protein, glial fibrillary acidic protein and nidosymptoms in the control group and the evaluation scores were all 9. 2 weeks after the transplantation, and the evaluation scores of the motor function in the transplantation group were higher than the ones in the phosphate buffered fluid group, [(6.7±0.9), (5.3-±1.0), (P ＜0.05)]. Six weeks after the transplantation, the evaluation scores of the motor function in the transplantation group were also higher than those in the phosphate buffered fluid group[(8.9±1. 1),(7.2±0.8),(P ＜0.05)].CONCLUSION: After their transplantation into the central nervous system,the bone marrow mesenchymal stem cells showed the ability to differentiate into neurons and glial cells, in which the characteristics of some neurons and glial cells were found. Bar walking test found that the evaluation scores of the motor function in the transplantation group were higher than those in the phosphate buffered fluid group, which suggests that the bone marrow mesenchymal stem cells have a significant effect on restoration of the functions of the nerves.
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The pivotal characteristics, the current situation, the challenge being faced with and the potential solution related to the automatized flow line of the clinical laboratory is introduced in order to provide the reference for the healthy development of the full automatization of the clinical laboratories in China.
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AIM: To explore the differentiation and the functional behavior of marrow mesenchymal stem cells (MSC) transplanted into the cerebral infarction area after cerebral middle artery ischemia in rats. METHODS: MSC were isolated from human rib marrow and cultured in L DMEM medium in vitro. The model of rat cerebral infarction by cerebra middle artery occlusion was established, and the identified MSC were transplanted intracerebrally 10 days later. Immunohistochemistry technique was used to identify the cell survivor and its differentiation to the neurogenesis in the transplantation site, and at 2 weeks and 6 weeks after transplantation, the functional tests were comparatively studied. RESULTS: The results showed that the survivor of transplanted MSC was differentiated to neural phenotype cells, and the functional behavior of the injury rats was recovered significantly after MSC transplantation (P