Abstract Objectives To investigate the diagnostic performance of the apparent diffusion coefficient (ADC) for low to intermediate-risk prostate cancer (PCa), as well as its correlation with the prognostic Gleason score (GS). Materials and methods Retrospective analysis of MRI images and relevant clinical data from patients with prostate disease. The differences in ADC between different GS groups were compared, and the efficacy of ADC in PCa diagnosis were analyzed. Furthermore, the diagnostic performance of the mean ADC (ADCmean) and minimum ADC (ADCmin) values was compared. Results There were 1414 patients with 1631 lesions. In terms of GS, both ADCmin and ADCmean values of the GS 4 + 3 group were significantly lower than those of the GS 3 + 4 group, GS 3 + 3 group, and the benign group, with all differences being statistically significant (p < 0.01). The AUC values for diagnosing PCa based on ADCmin and ADCmean were 0.914 and 0.944, respectively. The corresponding diagnostic thresholds were 0.703 × 10− 3 mm2/s for ADCmin and 0.927 × 10−3 mm2/s for ADCmean. The magnitudes of ADCmin and ADCmean values exhibited a negative correlation with GS values (ρ = −0.750, p < 0.001; ρ = −0.752, p < 0.001). Conclusions ADC values demonstrate an inverse relationship with the invasiveness of PCa, indicating that higher invasiveness is associated with lower ADC values. Additionally, ADC values exhibit high diagnostic potential, sensitivity, and specificity for distinguishing between GS 3 + 4 and GS 4 + 3 lesions. Moreover, the diagnostic value of ADCmean is even more significant, highlighting its crucial role in the diagnosis of low to intermediate-risk PCa. Critical relevance statement ADC values are a valuable tool for distinguishing different levels of aggressiveness in PCa. They help in the preoperative assessment of the biological characteristics of PCa, allowing clinicians to develop personalized treatment strategies, effectively mitigating the risk of unnecessary interventions. Key Points The preoperative GS is crucial for planning the clinical treatment of PCa. The invasiveness of PCa is inversely correlated with ADC values. ADC values play a crucial role in the accurate preoperative evaluation of low to intermediate-risk PCa, thus aiding clinicians in developing tailored treatment plans. Graphical Abstract
电刺激技术作为一种现代电生理学的治疗方法,通过电流刺激的方式对神经反射性刺激或对神经肌肉直接刺激,因其不易引起肌肉疲劳及不适感等诸多优势,目前已被广泛应用于妇产科、心内科、中医科、康复科及围手术期快速康复治疗.作者从电刺激技术的分类及其在中西医临床应用等方面进行系统的归纳和阐述.
目的:初步调查银屑病患者对远程护理服务的使用意愿与内容需求,分析影响使用意愿的相关因素.方法:2022年6月至12月,采用目的抽样选取南京市某三甲皮肤病专科医院的128例银屑病患者,使用一般资料调查表和自行设计的"银屑病患者对远程护理服务使用意愿和内容需求"问卷进行调查.结果:128例银屑病患者中,57.81％的患者表示若有条件和能力愿意使用远程护理服务,年龄、文化程度、职业、医疗费用支付方式、有无合并慢性疾病和使用手机熟练程度是影响患者愿意使用远程护理服务的因素.排在前5的服务内容需求分别是"远程皮肤护理(95.31％)""远程用药护理(92.97％)""在线建立电子健康档案(91.41％)""远程用药提醒(91.41％)"和"远程咨询(91.41％)".结论:银屑病患者对远程护理服务的使用意愿和内容需求较高,应积极探索以银屑病患者需求为导向的远程护理服务,为今后开展银屑病远程护理服务模式提供理论依据.
目的:探讨急性再生障碍性贫血患者输血不良反应的影响因素,构建预测模型,为临床实践提供最佳评估工具,以便及时准确制定防治措施.方法:选取2021年6月至2022年6月梧州市红十字会医院、梧州市工人医院、广西壮族自治区桂东人民医院3家医院388例急性再生障碍性贫血患者作为研究对象,按照7∶3比例随机分为建模人群(n=271)和验证人群(n=117),统计输血不良反应、人口学特征、凝血指标、血栓弹力图,采用Logistic回归方程分析输血不良反应的影响因素,构建输血不良反应发生风险列线图预测模型,绘制受试者工作特征(ROC)曲线分析模型区分度,校准曲线分析模型准确度,临床决策曲线(DCA)评价模型有效性.结果:(1)急性再生障碍性贫血患者输血不良反应发生率为9.02％(35/388);(2)Logistic回归方程显示,输血史、过敏史、血小板储存时间、纤维蛋白原(FIB)、活化部分凝血酶时间(APTT)、凝血酶原时间(PT)、凝血最终强度(MA)是急性再生障碍性贫血患者输血不良反应的影响因素(P＜0.05);(3)根据Logistic回归结果建立急性再生障碍性贫血患者输血不良反应列线图预测模型,在建模人群和验证人群中曲线下面积(AUC)分别为0.914、0.914,与实际观察结果之间有很好相关性,且净获益率较好;(4)依据模型中位评分(4分)将建模人群和验证人群分为高危人群(≥4分)和低危人群(＜4分),高危人群输血不良反应发生率(17.39％)高于低危人群(4.97％,P＜0.05).结论:基于输血史、过敏史、血小板储存时间、FIB、APTT、PT、MA构建的列线图模型可有效预测急性再生障碍性贫血患者输血不良反应发生风险,帮助医护人员实现风险预警前移,采取个体化精准干预.
目的:分析神经内科中文核心期刊2018-2022年发文的知识图谱,展示该领域的整体状况并挖掘神经内科中文期刊报道的研究热点.方法:应用CiteSpace软件分析中国知网数据库和万方数据库收录的10本神经内科中文核心期刊于2018-2022年发文量、作者、机构及关键词的变化.结果:研究共纳入8 842篇文献.吕佩源、刘新峰、方琪、徐运、张杰文、于炎冰、何志义等作者发文量较多;首都医科大学附属北京天坛医院是发文量最多的机构;近5年神经内科中文核心期刊研究重点集中于脑卒中、癫痫、阿尔茨海默病、帕金森病、阻塞性睡眠呼吸暂停、重症肌无力等主题;动脉瘤性蛛网膜下腔出血、脑膜瘤、微小RNA可能是国内神经内科领域未来的研究热点.结论:使用CiteSpace软件行可视化分析可以直观地展现神经内科领域科研演化的关键路径、发展趋势及前沿热点.
