目的基于胸部CT图像,探讨新型冠状病毒感染(COVID-19)患者肺部病灶体积与甲状腺、脾脏、心血管、胸椎及腹部脂肪改变的相关性。方法回顾性分析2020年2月至2021年1月首都医科大学附属北京地坛医院230例COVID-19患者的基线影像资料,经人...目的基于胸部CT图像,探讨新型冠状病毒感染(COVID-19)患者肺部病灶体积与甲状腺、脾脏、心血管、胸椎及腹部脂肪改变的相关性。方法回顾性分析2020年2月至2021年1月首都医科大学附属北京地坛医院230例COVID-19患者的基线影像资料,经人工智能(AI)肺炎辅助诊断软件定量测算全肺病灶体积。根据病程将患者分为三组(<4周、4~6周、>6周)。应用ITK-SNAP 3.8.0软件测量甲状腺左/右叶与脾脏的最大横截面积、甲状腺与脾脏的平均密度和体积、脾厚径及脾最长径;应用RadiAnt Dicom Viewer 2021.2软件测算心胸比、肺动脉主干、升主动脉主干、降主动脉直径及下腔静脉最大径、主肺动脉比,应用GE公司smart score 4.0软件定量测定冠状动脉、主动脉、颈动脉钙化积分;应用QCT PRO Model 4软件测定并计算胸椎平均骨密度、腹部皮下及腹腔内脂肪面积。采用Spearman秩相关对上述指标与肺部病灶体积之间的关系进行统计学分析。结果所有患者中,冠状动脉、主动脉及颈动脉的钙化积分均与病灶体积间存在相关性(r=0.22,P<0.001;r=0.31,P<0.001;r=0.16,P=0.018),心胸比、肺动脉主干直径、升主动脉主干直径与病灶体积间有相关性(r=0.41,P<0.001;r=0.23,P<0.001;r=0.28,P<0.001);降主动脉短径、下腔静脉短径、下腔静脉/降主动脉直径比与病灶体积间有相关性(r=0.40,P<0.001;r=0.14,P=0.035;r=-0.19,P=0.003);甲状腺平均密度与病灶体积间有相关性(r=-0.27,P<0.001);脾脏厚径、脾脏平均密度与病灶体积间有相关性(r=0.15,P=0.022;r=-0.18,P=0.007);胸椎平均骨密度、腹部皮下脂肪面积、腹腔内脂肪面积、肝脏平均脂肪分数与病灶体积间有相关性(r=-0.31,P<0.001;r=0.26,P<0.001;r=0.35,P<0.0001;r=0.45,P<0.001)。病灶体积与脾脏平均密度在<4周和>6周组患者中均存在明显差异。结论肺部病灶体积与多个肺外器官存在相关关系,阐明了COVID-19是全身性疾病,在COVID-19展开更多
OBJECTIVE: To evaluate the efficacy and safety of MK-801 and its effect on lesion volume in rat models of acute brain injury.DATA SOURCES: Key terms were "stroke","brain diseases","brain injur...OBJECTIVE: To evaluate the efficacy and safety of MK-801 and its effect on lesion volume in rat models of acute brain injury.DATA SOURCES: Key terms were "stroke","brain diseases","brain injuries","brain hemorrhage, traumatic","acute brain injury","dizocilpine maleate","dizocilpine","MK-801","MK801","rat","rats","rattus" and "murine". PubMed, Cochrane library, EMBASE, the China National Knowledge Infrastructure, WanFang database, the VIP Journal Integration Platform(VJIP) and SinoMed databases were searched from their inception dates to March 2018.DATA SELECTION: Studies were selected if they reported the effects of MK-801 in experimental acute brain injury. Two investigators independently conducted literature screening, data extraction, and methodological quality assessments.OUTCOME MEASURES: The primary outcomes included lesion volume and brain edema. The secondary outcomes included behavioral assessments with the Bederson neurological grading system and the water maze test 24 hours after brain injury.RESULTS: A total of 52 studies with 2530 samples were included in the systematic review. Seventeen of these studies had a high methodological quality. Overall, the lesion volume(34 studies, n = 966, MD =-58.31, 95% CI:-66.55 to-50.07;P < 0.00001) and degree of cerebral edema(5 studies, n = 75, MD =-1.21, 95% CI:-1.50 to-0.91;P < 0.00001) were significantly decreased in the MK-801 group compared with the control group. MK-801 improved spatial cognition assessed with the water maze test(2 studies, n = 60, MD =-10.88, 95% CI:-20.75 to-1.00;P = 0.03) and neurological function 24 hours after brain injury(11 studies, n = 335, MD =-1.04, 95% CI:-1.47 to-0.60;P < 0.00001). Subgroup analysis suggested an association of reduction in lesion volume with various injury models(34 studies, n = 966, MD =-58.31, 95% CI:-66.55 to-50.07;P = 0.004). Further network analysis showed that 0–1 mg/kg MK-801 may be the optimal dose for treatment in the middle cerebral artery occlusion animal model.CONCLUSION: MK-801 effectively reduces b展开更多
Accurate prognosis in patients with lung cancer is important for clinical decision making and treatment selection. The TNM staging system is currently the main method for establishing prognosis. Using this system, pat...Accurate prognosis in patients with lung cancer is important for clinical decision making and treatment selection. The TNM staging system is currently the main method for establishing prognosis. Using this system, patients are grouped into one of four stages based on primary tumor extent, nodal disease, and distant metastases. However, each stage represents a range of disease extent and may not on its own be the best reflection of individual patient prognosis. 18F-fluorodeoxyglucose_positron emission tomography （18F-FDG-PET） can be used to evaluate the metabolic tumor burden affecting the whole body with measures such as metabolic rumor volume （MTV） and total lesion glycolysis （TLG）. MTV and TLG have been shown to be significant prognostic factors in patients with lung cancer, independent of TNM stage. These metabolic tumor burden measures have the potential to make lung cancer staging and prognostication more accurate and quantitative, with the goal of optimizing treatment choices and outcome predictions.展开更多
文摘目的基于胸部CT图像,探讨新型冠状病毒感染(COVID-19)患者肺部病灶体积与甲状腺、脾脏、心血管、胸椎及腹部脂肪改变的相关性。方法回顾性分析2020年2月至2021年1月首都医科大学附属北京地坛医院230例COVID-19患者的基线影像资料,经人工智能(AI)肺炎辅助诊断软件定量测算全肺病灶体积。根据病程将患者分为三组(<4周、4~6周、>6周)。应用ITK-SNAP 3.8.0软件测量甲状腺左/右叶与脾脏的最大横截面积、甲状腺与脾脏的平均密度和体积、脾厚径及脾最长径;应用RadiAnt Dicom Viewer 2021.2软件测算心胸比、肺动脉主干、升主动脉主干、降主动脉直径及下腔静脉最大径、主肺动脉比,应用GE公司smart score 4.0软件定量测定冠状动脉、主动脉、颈动脉钙化积分;应用QCT PRO Model 4软件测定并计算胸椎平均骨密度、腹部皮下及腹腔内脂肪面积。采用Spearman秩相关对上述指标与肺部病灶体积之间的关系进行统计学分析。结果所有患者中,冠状动脉、主动脉及颈动脉的钙化积分均与病灶体积间存在相关性(r=0.22,P<0.001;r=0.31,P<0.001;r=0.16,P=0.018),心胸比、肺动脉主干直径、升主动脉主干直径与病灶体积间有相关性(r=0.41,P<0.001;r=0.23,P<0.001;r=0.28,P<0.001);降主动脉短径、下腔静脉短径、下腔静脉/降主动脉直径比与病灶体积间有相关性(r=0.40,P<0.001;r=0.14,P=0.035;r=-0.19,P=0.003);甲状腺平均密度与病灶体积间有相关性(r=-0.27,P<0.001);脾脏厚径、脾脏平均密度与病灶体积间有相关性(r=0.15,P=0.022;r=-0.18,P=0.007);胸椎平均骨密度、腹部皮下脂肪面积、腹腔内脂肪面积、肝脏平均脂肪分数与病灶体积间有相关性(r=-0.31,P<0.001;r=0.26,P<0.001;r=0.35,P<0.0001;r=0.45,P<0.001)。病灶体积与脾脏平均密度在<4周和>6周组患者中均存在明显差异。结论肺部病灶体积与多个肺外器官存在相关关系,阐明了COVID-19是全身性疾病,在COVID-19
基金supported by the National Natural Science Foundation of China,No.81822050(to QQL),81873321(to HX),81673990(to QQL),81330085(to QS),81730107(to YJW)the Shanghai Municipal Health and Family Planning Commission TCM Research Project of China,No.2018JP014(to HX)+4 种基金the Three-Year Action Plan to Promote Clinical Skills and Clinical Innovation in Municipal Hospitals of China,No.16CR1017A(to YJW)the Shanghai Traditional Chinese Medicine Chronic Disease [Malignant Tumor,Bone Degenerative Disease] Clinical Medical Center of China,No.2017ZZ01010(to YJW)the National Ministry of Education Innovation Team of China,No.IRT1270(to YJW)the Innovation Team of Key Fields of the Ministry of Science and Technology of China,No.2015RA4002(to YJW)the Outstanding Principle Investigator Project of Guanghua Hospital,Changning District,Shanghai,China,No.2016-01(to QS),2016-06(to YJW)
文摘OBJECTIVE: To evaluate the efficacy and safety of MK-801 and its effect on lesion volume in rat models of acute brain injury.DATA SOURCES: Key terms were "stroke","brain diseases","brain injuries","brain hemorrhage, traumatic","acute brain injury","dizocilpine maleate","dizocilpine","MK-801","MK801","rat","rats","rattus" and "murine". PubMed, Cochrane library, EMBASE, the China National Knowledge Infrastructure, WanFang database, the VIP Journal Integration Platform(VJIP) and SinoMed databases were searched from their inception dates to March 2018.DATA SELECTION: Studies were selected if they reported the effects of MK-801 in experimental acute brain injury. Two investigators independently conducted literature screening, data extraction, and methodological quality assessments.OUTCOME MEASURES: The primary outcomes included lesion volume and brain edema. The secondary outcomes included behavioral assessments with the Bederson neurological grading system and the water maze test 24 hours after brain injury.RESULTS: A total of 52 studies with 2530 samples were included in the systematic review. Seventeen of these studies had a high methodological quality. Overall, the lesion volume(34 studies, n = 966, MD =-58.31, 95% CI:-66.55 to-50.07;P < 0.00001) and degree of cerebral edema(5 studies, n = 75, MD =-1.21, 95% CI:-1.50 to-0.91;P < 0.00001) were significantly decreased in the MK-801 group compared with the control group. MK-801 improved spatial cognition assessed with the water maze test(2 studies, n = 60, MD =-10.88, 95% CI:-20.75 to-1.00;P = 0.03) and neurological function 24 hours after brain injury(11 studies, n = 335, MD =-1.04, 95% CI:-1.47 to-0.60;P < 0.00001). Subgroup analysis suggested an association of reduction in lesion volume with various injury models(34 studies, n = 966, MD =-58.31, 95% CI:-66.55 to-50.07;P = 0.004). Further network analysis showed that 0–1 mg/kg MK-801 may be the optimal dose for treatment in the middle cerebral artery occlusion animal model.CONCLUSION: MK-801 effectively reduces b
文摘Accurate prognosis in patients with lung cancer is important for clinical decision making and treatment selection. The TNM staging system is currently the main method for establishing prognosis. Using this system, patients are grouped into one of four stages based on primary tumor extent, nodal disease, and distant metastases. However, each stage represents a range of disease extent and may not on its own be the best reflection of individual patient prognosis. 18F-fluorodeoxyglucose_positron emission tomography （18F-FDG-PET） can be used to evaluate the metabolic tumor burden affecting the whole body with measures such as metabolic rumor volume （MTV） and total lesion glycolysis （TLG）. MTV and TLG have been shown to be significant prognostic factors in patients with lung cancer, independent of TNM stage. These metabolic tumor burden measures have the potential to make lung cancer staging and prognostication more accurate and quantitative, with the goal of optimizing treatment choices and outcome predictions.
