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Evaluating the Pros and Cons of Evening and Weekend Outpatient Medical Imaging: Implications for Patients and Radiology Professionals 评估夜间和周末门诊医学成像的利弊:对患者和放射科专业人员的影响
Pub Date : 2024-08-08 DOI: 10.29328/journal.jro.1001069
Cohen Lucas, Cohen Ethan
Evening and weekend imaging services at outpatient radiology centers offer extended access to diagnostic imaging, potentially increasing patient satisfaction and accessibility, especially for underserved populations. This review explores the benefits and challenges associated with these after-hours operations, focusing on health equity, patient satisfaction, economic considerations, energy and cost savings, and the impact on healthcare professionals. Findings indicate that while after-hours operations can enhance patient satisfaction and access, they also pose challenges such as increased operational costs and staff fatigue. Strategies for improvement include optimizing shift schedules, leveraging technology for better scheduling and communication, and enhancing patient-centered care. Collaborative efforts among imaging centers can further improve service delivery and efficiency.
门诊放射中心的晚间和周末影像服务为患者提供了更多的影像诊断机会,有可能提高患者的满意度和可及性,尤其是对服务不足的人群而言。本综述探讨了与下班后运营相关的益处和挑战,重点关注健康公平、患者满意度、经济因素、能源和成本节约以及对医疗专业人员的影响。研究结果表明,虽然下班后运营可以提高患者满意度和就医机会,但也带来了运营成本增加和员工疲劳等挑战。改进策略包括优化排班、利用技术改善排班和沟通,以及加强以患者为中心的护理。影像中心之间的合作可以进一步改善服务的提供和效率。
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引用次数: 0
Post-catheterization Common Femoral Artery Pseudoaneurysm in a Patient with a Mechanical Mitral Valve Requiring Anticoagulation: A Case Report 需要抗凝的机械二尖瓣患者导管术后股总动脉假性动脉瘤:病例报告
Pub Date : 2024-07-15 DOI: 10.29328/journal.jro.1001068
Aromiwura Afolasayo, Gandhi Pooja, Khan Muhammad, Mattumpuram Jishanth
Iatrogenic femoral pseudoaneurysms are a rare complication of transfemoral vascular access. We present a case of a 65-year-old woman with a mechanical mitral valve requiring warfarin, who developed a femoral pseudoaneurysm four days after cardiac catheterization with femoral access. The patient developed a 17 x 10 x 17 cm rectus sheath hematoma and was treated with ultrasound-guided thrombin injection. Anticoagulation was held for three days while the patient was monitored for further bleeding and later restarted based on shared decision-making, given the risk of valve thrombosis. There are few guidelines regarding the re-initiation of anticoagulation in high-risk bleeding patients with mechanical mitral valves. Non-invasive coronary computed tomography angiography should be considered in patients on anticoagulation who require non-emergent cardiac ischemic evaluation.
先天性股骨假动脉瘤是经股血管入路的一种罕见并发症。我们报告了一例 65 岁女性患者的病例,她患有机械二尖瓣,需要服用华法林,在使用股动脉通路进行心导管手术四天后出现股骨假性动脉瘤。患者出现了一个 17 x 10 x 17 厘米的直肠鞘血肿,并接受了超声引导下的凝血酶注射治疗。在监测患者有无进一步出血的同时,将患者的抗凝治疗保留了三天,后来考虑到瓣膜血栓形成的风险,根据共同决策重新开始了抗凝治疗。关于机械二尖瓣高危出血患者重新开始抗凝治疗的指南很少。对于需要进行非紧急心脏缺血评估的抗凝患者,应考虑进行无创冠状动脉计算机断层扫描血管造影。
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引用次数: 0
From Ashes to Life - The Indestructible D. radiodurans 从灰烬到生命--坚不可摧的 D. radiodurans
Pub Date : 2024-07-15 DOI: 10.29328/journal.jro.1001067
Arruda-Neto João DT, Righi Henriette, Lacerda Amanda M
Deinococcus radiodurans (D. radiodurans) was accidentally discovered in 1956 when cans of ground meat were exposed to massive doses of ionizing gamma radiation, intended to kill dangerous bacteria. The bacterium can survive doses of radiation, even up to 1,000 times that which is deadly to humans. Among biologists and biophysicists, D. radiodurans is often humorously called “Conan the Bacterium.” This extreme radioresistance of the bacterium has been attributed to its ability to protect the proteome from ROS, which originates from water radiolysis, and also to carry out the effective repair of a large amount of DNA damage.
Deinococcus radiodurans(D. radiodurans)是在 1956 年被意外发现的,当时一罐碎肉被暴露在大剂量的电离伽马辐射下,目的是杀死危险的细菌。这种细菌可以在辐射剂量下存活,甚至可以存活1000倍于对人类致命的辐射剂量。生物学家和生物物理学家经常幽默地称 D. radiodurans 为 "细菌柯南"。这种细菌之所以具有极强的抗辐射能力,是因为它能够保护蛋白质组免受源于水辐射分解的 ROS 的伤害,还能对大量 DNA 损伤进行有效修复。
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引用次数: 0
Radiomics by Quantitative Diffusion-weighted MRI for Predicting Response in Patients with Extremity Soft-tissue Undifferentiated Pleomorphic Sarcoma 通过定量弥散加权核磁共振成像预测四肢软组织未分化多形性肉瘤患者反应的放射组学方法
Pub Date : 2024-07-09 DOI: 10.29328/journal.jro.1001066
Valenzuela Rf, Duran-Sierra E, Canjirathinkal M, Amini B, Torres Ke, Benjamin Rs, Ma J, Wang Wl, Hwang Kp, Stafford Rj, Wu C, Zarzour Am, Bishop Aj, Lo S, Madewell Je, Kumar R, M. Wa, Costelloe Cm
Purpose: This study aimed to determine the relevance of first- and high-order radiomic features derived from Diffusion-Weighted Imaging (DWI) and Apparent Diffusion Coefficient (ADC) maps for predicting treatment response in patients with Undifferentiated Pleomorphic Sarcoma (UPS). Methods: This retrospective study included 33 extremity UPS patients with pre-surgical DWI/ADC and surgical resection. Manual volumetric tumor segmentation was performed on DWI/ADC maps acquired at Baseline (BL), Post-Chemotherapy (PC), and Post-Radiation Therapy (PRT). The percentage of pathology-assessed treatment effect (PATE) in surgical specimens categorized patients into responders (R; PATE ≥ 90%; 16 patients), partial-responders (PR; 89% - 31% PATE; 10 patients), and non-responders (NR; PATE ≤ 30%; 7 patients). 107 radiomic features were extracted from BL, PC, and PRT ADC maps. Statistical analyses compared R vs. PR/NR. Results: Pseudo-progression at PC and universal stability at PRT were observed in R and PR/NR based on RECIST, WHO, and volumetric assessments. At PRT, responders displayed a 35% increase in ADC mean (p = 0.0034), a 136% decrease in skewness (p = 0.0001), and a 363% increase in the 90th percentile proportion (p = 0.0009). Comparing R vs. PR/NR at BL, statistically significant differences were observed in glrlm_highgraylevelrunemphasis (p = 0.0081), glrlm_shortrunhighgraylevelemphasis (p = 0.0138), gldm_highgraylevelemphasis (p = 0.0138), glcm_sumaverage (p = 0.0164), glcm_jointaverage (p = 0.0164), and glcm_autocorrelation (p = 0.0193). At PC, firstorder_meanabsolutedeviation (p = 0.0078), firstorder_interquartilerange (p = 0.0109), firstorder_variance (p = 0.0109), and firstorder_robustmeanabsolutedeviation (p = 0.0151) provided statistically significant differences. Conclusion: Observing a high post-therapeutic ADC mean, low skewness, and high 90th percentile proportion with respect to baseline is predictive of successfully treated UPS patients presenting > 90% PATE. Highly significant higher-order radiomic results include glrlm-highgraylevelrunemphasis (BL) and first-order-mean absolute deviation (PC).
目的:本研究旨在确定由弥散加权成像(DWI)和表观弥散系数(ADC)图得出的一阶和高阶放射学特征与预测未分化多形性肉瘤(UPS)患者治疗反应的相关性。方法:这项回顾性研究纳入了33例四肢UPS患者,这些患者均在手术前接受了DWI/ADC检查和手术切除。在基线(BL)、化疗后(PC)和放疗后(PRT)获得的 DWI/ADC 图上进行手动肿瘤体积分割。根据手术标本中病理评估治疗效果(PATE)的百分比将患者分为应答者(R;PATE ≥ 90%;16 例患者)、部分应答者(PR;PATE 89% - 31%;10 例患者)和无应答者(NR;PATE ≤ 30%;7 例患者)。从BL、PC和PRT ADC图中提取了107个放射学特征。统计分析比较了 R 与 PR/NR。结果显示根据RECIST、WHO和容积评估结果,R和PR/NR在PC时均出现假性进展,在PRT时普遍稳定。在 PRT 时,应答者的 ADC 平均值增加了 35%(p = 0.0034),偏度降低了 136%(p = 0.0001),第 90 百分位数比例增加了 363%(p = 0.0009)。比较 BL 时的 R 与 PR/NR,在 glrlm_highgraylevelrunemphasis(p = 0.0081)、glrlm_shortrunhighgraylevelemphasis(p = 0.0138)、gldm_highgraylevelemphasis(p = 0.0138)、glcm_sumaverage(p = 0.0164)、glcm_jointaverage(p = 0.0164)和 glcm_autocorrelation(p = 0.0193)。在个人计算机上,一阶均值折减方差(p = 0.0078)、一阶等差数列(p = 0.0109)、一阶方差(p = 0.0109)和一阶稳健均值折减方差(p = 0.0151)在统计上具有显著差异。结论与基线相比,治疗后 ADC 平均值高、偏度低、第 90 百分位数比例高,可预测治疗成功的 UPS 患者的 PATE > 90%。高度显著的高阶放射学结果包括 glrlm-highgraylevelrunemphasis (BL) 和一阶平均绝对偏差 (PC)。
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引用次数: 0
Fatal Immune Checkpoint Inhibitor-associated Myocarditis Mimicking Infiltrative Cardiomyopathy in a 54-year-old Woman with Metastatic Melanoma 一名患有转移性黑色素瘤的 54 岁女性因模仿浸润性心肌病而患上致命的免疫检查点抑制剂相关心肌炎
Pub Date : 2024-06-04 DOI: 10.29328/journal.jro.1001063
Sakhi Hichem, Chevance Virgile, Kalifa Laurette, Arana Riad, Laparra Ariane, Reverdito Guillaume, Salem Fares Ben, Pottier Charles, Lambotte Olivier, Azarine Arshid, Smaali Sondes
Introduction: Immune checkpoint inhibitors (ICI) have significantly improved cancer treatment outcomes, but cardiovascular complications such as ICI-associated myocarditis are a major concern. Diagnosing myocarditis requires integrating biomarkers, electrocardiogram (EKG), cardiac imaging, and endomyocardial biopsy. We present a case illustrating these diagnostic challenges, involving a female patient treated with pembrolizumab who developed fatal acute myocarditis mimicking infiltrative cardiomyopathy. Case report: A 54-year-old woman with mucosal melanoma, treated with pembrolizumab, was hospitalized in May 2023 due to dyspnea and elevated troponin levels. Initial cardiac workups were normal, but subsequent tests revealed borderline cardiac magnetic resonance imaging findings. In late May 2023, the patient was admitted with worsening dyspnea, elevated NT-pro-BNP, and severe hyperlactatemia. Imaging and endomyocardial biopsy confirmed acute myocarditis with atypical presentation, mimicking infiltrative cardiomyopathy. Despite aggressive immunosuppressive therapy, the patient’s condition deteriorated, resulting in cardiogenic shock and death seven days post-admission. Conclusion: This case underscores the diagnostic and management challenges of ICI-associated myocarditis, particularly with atypical presentations. It highlights the need for vigilant, comprehensive monitoring and further research to improve diagnostic and therapeutic strategies for managing these severe side effects in patients undergoing ICI therapy.
简介免疫检查点抑制剂(ICI)大大改善了癌症治疗效果,但ICI相关心肌炎等心血管并发症也是一个主要问题。诊断心肌炎需要结合生物标记物、心电图(EKG)、心脏成像和心内膜活检。我们提供了一个病例来说明这些诊断难题,该病例涉及一名接受 pembrolizumab 治疗的女性患者,她患上了模仿浸润性心肌病的致命性急性心肌炎。病例报告:一名 54 岁的女性患者患有粘膜黑色素瘤,曾接受过 pembrolizumab 治疗,因呼吸困难和肌钙蛋白水平升高于 2023 年 5 月入院。最初的心脏检查结果正常,但随后的检查发现心脏磁共振成像结果呈边缘性。2023 年 5 月下旬,患者因呼吸困难加重、NT-pro-BNP 升高和严重的高乳酸血症入院。影像学检查和心内膜活检证实患者患有急性心肌炎,表现不典型,酷似浸润性心肌病。尽管患者接受了积极的免疫抑制治疗,但病情仍不断恶化,最终导致心源性休克,入院七天后死亡。结论:本病例强调了 ICI 相关性心肌炎在诊断和治疗方面的挑战,尤其是非典型性表现。它强调了对接受 ICI 治疗的患者进行警惕性全面监测和进一步研究以改进诊断和治疗策略的必要性,从而控制这些严重的副作用。
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引用次数: 0
A Prospective Observational Study on Neurotoxicity of Chemotherapy - A Critical Analysis 化疗神经毒性的前瞻性观察研究--批判性分析
Pub Date : 2024-04-02 DOI: 10.29328/journal.jro.1001061
Hussaini Syeda Zaineb Kubra, Jilla Swapna, V. Gumdal, Pallavardhan Peddapalegani, Deekshita Kalidindi, Rashmitha Kashadatla, C. Kavuri, Kathyayani Kommu
Background: Cancer treatment frequently depends on the intricate and potent effects that are acknowledged for their potential to save lives. Chemotherapy can have adverse effects on both the central and peripheral nervous systems, posing significant challenges. Objective: • To assess the causative agent, development, and timing of occurrence. • To improve management of neurological complications. • To discriminate the iatrogenic effects of cancer therapy and neurological progression. Method: A prospective observational study was conducted in a hospital setting, focusing on the neurotoxic effects of chemotherapy in cancer patients over a span of six months. The research involved participants from both the oncology in-patient and daycare departments. After obtaining informed consent, individuals in the study population were interviewed to gather information about any neurological symptoms they encountered following their chemotherapy sessions. Results and discussion: Within our study population, a predominant 67% comprised female patients, while male patients constituted 33%. Of the total participants, 66% reported experiencing neurological symptoms. Among these symptoms, the majority of patients encountered sensations such as tingling, numbness, and a burning sensation. Other reported symptoms included headaches, distal weakness, myalgia, seizures, and ataxia. Conclusion: In this current study, 66% of the study population encountered neurological side effects. Generally, the presence of comorbidities, vitamin deficiencies, and advanced age can significantly contribute to the development of peripheral neuropathy. Depending on the severity of neuropathy, recommendations for interventions include the prescription of vitamin supplements, calcium supplements, duloxetine, and pregabalin.
背景:癌症治疗经常依赖于复杂而有效的疗效,这些疗效被公认为具有挽救生命的潜力。化疗会对中枢神经系统和外周神经系统产生不良影响,从而带来重大挑战。研究目的- 评估致病因素、发展和发生时间。- 改善神经系统并发症的管理。- 区分癌症治疗的先天性影响和神经系统进展。研究方法在医院环境中开展前瞻性观察研究,重点关注癌症患者在六个月内化疗对神经系统的毒性影响。参与研究的人员来自肿瘤住院部和日间护理部。在获得知情同意后,研究人员对研究对象进行了访谈,以收集他们在化疗后出现的任何神经症状的相关信息。结果与讨论在我们的研究人群中,女性患者占 67%,男性患者占 33%。在所有参与者中,66%的人表示出现过神经系统症状。在这些症状中,大多数患者会感到刺痛、麻木和灼烧感。其他症状包括头痛、远端无力、肌痛、癫痫发作和共济失调。结论在本次研究中,66% 的研究对象出现了神经系统副作用。一般来说,合并症、维生素缺乏症和高龄都是导致周围神经病变的重要原因。根据神经病变的严重程度,干预建议包括处方维生素补充剂、钙补充剂、度洛西汀和普瑞巴林。
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引用次数: 0
Contrast-enhanced Susceptibility Weighted Imaging (CE-SWI) for the Characterization of Musculoskeletal Oncologic Pathology: A Pictorial Essay on the Initial Five-year Experience at a Cancer Institution 对比增强型感性加权成像(CE-SWI)用于描述肌肉骨骼肿瘤病理学:一家癌症机构最初五年经验的图解文章
Pub Date : 2024-04-02 DOI: 10.29328/journal.jro.1001062
Valenzuela Raul F, Duran-Sierra E, Canjirathinkal Ma, Amini B, Ma J, Hwang Kp, Stafford Rj, Torres Keila E, Zarzour Ma, Livingston Ja, Madewell Je, Murphy Wa, Costelloe Cm
Susceptibility-weighted imaging (SWI) is based on a 3D high-spatial-resolution, velocity-corrected gradient-echo MRI sequence that uses magnitude and filtered-phase information to create images. It SWI uses tissue magnetic susceptibility differences to generate signal contrast that may arise from paramagnetic (hemosiderin), diamagnetic (minerals and calcifications) and ferromagnetic (metal) molecules. Distinguishing between calcification and blood products is possible through the filtered phase images, helping to visualize osteoblastic and osteolytic bone metastases or demonstrating calcifications and osteoid production in liposarcoma and osteosarcoma. When acquired in combination with the injection of an exogenous contrast agent, contrast-enhanced SWI (CE-SWI) can simultaneously detect the T2* susceptibility effect, T2 signal difference, contrast-induced T1 shortening, and out-of-phase fat and water chemical shift effect. Bone and soft tissue lesion SWI features have been described, including giant cell tumors in bone and synovial sarcomas in soft tissues. We expand on the appearance of benign soft-tissue lesions such as hemangioma, neurofibroma, pigmented villonodular synovitis, abscess, and hematoma. Most myxoid sarcomas demonstrate absent or just low-grade intra-tumoral hemorrhage at the baseline. CE-SWI shows superior differentiation between mature fibrotic T2* dark components and active enhancing T1 shortening components in desmoid fibromatosis. SWI has gained popularity in oncologic MSK imaging because of its sensitivity for displaying hemorrhage in soft tissue lesions, thereby helping to differentiate benign versus malignant soft tissue tumors. The ability to show the viable, enhancing portions of a soft tissue sarcoma separately from hemorrhagic/necrotic components also suggests its utility as a biomarker of tumor treatment response. It is essential to understand and appreciate the differences between spontaneous hemorrhage patterns in high-grade sarcomas and those occurring in the therapy-induced necrosis process in responding tumors. Ring-like hemosiderin SWI pattern is observed in successfully treated sarcomas. CE-SWI also demonstrates early promising results in separating the T2* blooming of healthy iron-loaded bone marrow from the T1-shortened enhancement in bone marrow that is displaced by the tumor. SWI and CE-SWI in MSK oncology learning objectives: SWI and CE-SWI can be used to identify calcifications on MRI. Certain SWI and CE-SWI patterns can correlate with tumor histologic type. CE-SWI can discriminate mature from immature components of desmoid tumors. CE-SWI patterns can help to assess treatment response in soft tissue sarcomas. Understanding CE-SWI patterns in post-surgical changes can also be useful in discriminating between residual and recurrent tumors with overlapping imaging features.
磁感应强度加权成像(SWI)基于三维高空间分辨率、速度校正梯度回波磁共振成像序列,使用幅度和滤波相位信息来创建图像。SWI 利用组织的磁感应强度差异产生信号对比度,这种对比度可能来自顺磁性(血色素)、二磁性(矿物质和钙化)和铁磁性(金属)分子。通过滤波相位图像可区分钙化和血液产物,有助于观察成骨细胞和溶骨性骨转移瘤,或显示脂肪肉瘤和骨肉瘤中的钙化和类骨生成。如果结合注射外源性造影剂进行采集,造影剂增强 SWI(CE-SWI)可同时检测 T2* 感度效应、T2 信号差、造影剂引起的 T1 缩短以及相外脂肪和水的化学位移效应。骨骼和软组织病变的 SWI 特征已被描述,包括骨骼中的巨细胞瘤和软组织中的滑膜肉瘤。我们将进一步探讨良性软组织病变的外观,如血管瘤、神经纤维瘤、色素性绒毛滑膜炎、脓肿和血肿。大多数肌样肉瘤在基线时没有或仅有低度瘤内出血。CE-SWI能很好地区分脱模性纤维瘤中成熟的纤维化T2*深色成分和活跃的增强T1缩短成分。SWI 在肿瘤 MSK 成像中越来越受欢迎,因为它能灵敏地显示软组织病变中的出血,从而帮助区分良性和恶性软组织肿瘤。将软组织肉瘤有活力、增强的部分与出血/坏死的部分分开显示的能力也表明它可作为肿瘤治疗反应的生物标记物。了解和认识高级别肉瘤的自发性出血模式与有反应的肿瘤在治疗诱导坏死过程中出现的出血模式之间的差异至关重要。在治疗成功的肉瘤中可观察到环状血色素 SWI 模式。CE-SWI 在区分健康的铁负荷骨髓的 T2* 增厚和被肿瘤移位的骨髓的 T1 缩短增强方面也显示出早期的良好效果。MSK 肿瘤学中的 SWI 和 CE-SWI 学习目标:SWI 和 CE-SWI 可用于识别 MRI 上的钙化。某些 SWI 和 CE-SWI 模式与肿瘤组织学类型相关。CE-SWI可鉴别脱模瘤的成熟和未成熟成分。CE-SWI 模式有助于评估软组织肉瘤的治疗反应。了解手术后变化的CE-SWI模式还有助于区分具有重叠成像特征的残留肿瘤和复发肿瘤。
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引用次数: 0
Effect of TAK242 on MCP-1 and TGF-β in COPD Rats TAK242 对慢性阻塞性肺病大鼠 MCP-1 和 TGF-β 的影响
Pub Date : 2024-03-13 DOI: 10.29328/journal.jro.1001060
Ruicheng Deng, Mingyu Duan, Xiaoyong Ma, Juanxia Chen, Huifang Zhang, Meifang Liu, Chen Jian, Chen Lijun
Objective: To investigate the mechanism of MCP-1 and TGF-β regulation by TAK242 in COPD rats. Methods: Thirty-six SD rats were randomly divided into normal, COPD control, and TAK242 groups. The normal group was freely fed, and the other groups used the method of fumigation plus lipopolysaccharide tracheal drip to establish an experimental animal model of COPD. After successful modeling, each experimental group received 0.9% NaCl solution and corresponding drugs by intraperitoneal injection for 7 d. After drug administration, lung function was examined; pathological changes in lung tissue were observed by light microscopy with hematoxylin-eosin staining; mRNA expression of MCP-1 and TGF-β was detected by q-PCR; and protein expression of MCP-1 and TGF-β in lung tissue was detected by Western blot and IHC, TGF-β protein expression in rat lung tissue. Results: Compared with the normal group, rats in the COPD control group showed signs and symptoms of COPD, decreased lung function, and increased expression of MCP-1 and TGF-β. The TAK242 group showed decreased expression of MCP-1 and TGF-β compared to the COPD control group. Conclusion: MCP-1, and TGF-β played a crucial role in the early stage of COPD fibrosis. TAK242 could ameliorate airway inflammation and inhibit the progression of COPD lung fibrosis in pre-existing rats in COPD model rats.
目的研究 TAK242 对慢性阻塞性肺病大鼠 MCP-1 和 TGF-β 的调节机制。方法:将 36 只 SD 大鼠随机分为正常组、COPD 对照组和 TAK242 组:将 36 只 SD 大鼠随机分为正常组、COPD 对照组和 TAK242 组。正常组自由采食,其他各组采用熏蒸加脂多糖气管滴注法建立 COPD 实验动物模型。给药后检查肺功能,光镜下苏木精-伊红染色观察肺组织病理变化,q-PCR检测MCP-1和TGF-β的mRNA表达,Western blot和IHC检测大鼠肺组织中MCP-1和TGF-β的蛋白表达。结果与正常组相比,慢性阻塞性肺病对照组大鼠表现出慢性阻塞性肺病的症状和体征,肺功能下降,MCP-1和TGF-β表达增加。与慢性阻塞性肺病对照组相比,TAK242组的MCP-1和TGF-β表达量有所下降。结论MCP-1和TGF-β在慢性阻塞性肺病纤维化的早期阶段起着至关重要的作用。TAK242 可改善 COPD 模型大鼠的气道炎症并抑制其 COPD 肺纤维化的进展。
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引用次数: 0
Exploring the Prognostic Efficacy of Machine Learning Models in Predicting Adenocarcinoma of the Esophagogastric Junction 探索机器学习模型在预测食管胃交界处腺癌中的预后效果
Pub Date : 2024-03-07 DOI: 10.29328/journal.jro.1001059
Gao Kaiji, Tonghui Yang, Changbing Wang, Jianguang Jia
Objective: To investigate the value of machine learning and traditional Cox regression models in predicting postoperative survivorship in patients with adenocarcinoma of the esophagogastric junction (AEG). Methods: This study analyzed clinicopathological data from 203 patients. The Cox proportional risk model and four machine learning models were constructed and internally validated. ROC curves, calibration curves, and clinical decision curves (DCA) were generated. Model performance was assessed using the area under the curve (AUC), while calibration curves determined the fit and clinical significance of the model. Results: The AUC values of the 3-year survival in the validation set for the Cox regression model, extreme gradient boosting, random forest, support vector machine, and multilayer perceptron were 0.870, 0.901, 0.791, 0.832, and 0.725, respectively. The AUC values of 5-year survival in the validation set for each model were 0.915, 0.916, 0.758, 0.905, and 0.737, respectively. The internal validation AUC values for the four machine learning models, extreme gradient boosting, random forest, support vector machine, and multilayer perceptron, were 0.818, 0.772, 0.804, and 0.745, respectively. Conclusion: Compared with Cox regression models, machine learning models do not need to satisfy the assumption of equal proportionality or linear regression models, can include more influencing variables, and have good prediction performance for 3-year and 5-year survival rates of AEG patients, among which, XGBoost models are the most stable and have significantly better prediction performance than other machine learning methods and are practical and reliable.
目的研究机器学习和传统 Cox 回归模型在预测食管胃交界处腺癌(AEG)患者术后存活率方面的价值。方法:本研究分析了203名患者的临床病理数据。构建了 Cox 比例风险模型和四个机器学习模型,并进行了内部验证。生成了 ROC 曲线、校准曲线和临床决策曲线 (DCA)。使用曲线下面积(AUC)评估模型性能,校准曲线则确定模型的拟合度和临床意义。结果:在验证集中,Cox 回归模型、极梯度提升、随机森林、支持向量机和多层感知器的 3 年生存率 AUC 值分别为 0.870、0.901、0.791、0.832 和 0.725。每个模型在验证集中的 5 年生存率 AUC 值分别为 0.915、0.916、0.758、0.905 和 0.737。极梯度提升、随机森林、支持向量机和多层感知器这四种机器学习模型的内部验证 AUC 值分别为 0.818、0.772、0.804 和 0.745。结论与Cox回归模型相比,机器学习模型不需要满足等比例假设或线性回归模型,可以包含更多的影响变量,对AEG患者3年和5年生存率具有良好的预测效果,其中XGBoost模型最为稳定,预测效果明显优于其他机器学习方法,实用可靠。
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引用次数: 0
“Thyroid”: Letter to the Editor, Radioactive Iodine: A Living History "甲状腺致编辑的信》,《放射性碘》:活生生的历史
Pub Date : 2024-03-07 DOI: 10.29328/journal.jro.1001058
Hertz Barbara
The history of the origin of the medical uses of Radioiodine (RAI) has been compromised by false narratives as recently as June 2023 in the “Thyroid “article “Radioactive Iodine: A Living History”. Primary sources document Dr. Saul Hertz (1905 - 1950) as solely conceiving of the medical uses of RAI, being the first and foremost to develop the experimental data, bringing RAI from bench to bedside, and extending the use of radionuclides to diagnose and/or treat cancer and other conditions. Dr Hertz predicted and worked toward conquering cancer with other radionuclides. Saul Hertz overcame the racism of his time, a world war interrupting his first clinical study, a strong pushback from the surgeons, and unethical medical publishing practices. Today, Nuclear Medicine, Radiopharmacy, Medical Physics, and other specialties are collaborating and actively building on Saul Hertz’s enduring foundational work.
关于放射性碘(RAI)医疗用途的起源历史,最近在 2023 年 6 月的 "甲状腺"(Thyroid)杂志上发表的文章 "放射性碘:活生生的历史 "一文中的虚假叙述。据原始资料记载,索尔-赫兹博士(1905-1950 年)是唯一构想出放射性碘医疗用途的人,他是第一个也是最先开发出实验数据的人,他将放射性碘从工作台带到了床边,并将放射性核素的用途扩展到诊断和/或治疗癌症及其他疾病。赫兹博士预测并致力于用其他放射性核素征服癌症。索尔-赫兹克服了当时的种族主义、世界大战中断了他的首次临床研究、外科医生的强烈反对以及不道德的医学出版行为。如今,核医学、放射药学、医学物理学和其他专业正在索尔-赫兹经久不衰的奠基工作的基础上开展合作,积极进取。
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Journal of radiology and oncology
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