Objective To explore the application value of artificial intelligence (AI) pulmonary artery assisted diagnosis software for suspected pulmonary embolism patients. Methods The data of 199 patients who were clinically suspected of pulmonary embolism and underwent pulmonary artery CT angiography (CTA) from June 2016 to December 2021 were retrospectively analyzed. Images of pulmonary artery CTA diagnosed by radiologists with different experiences and judged by senior radiologists were compared with the analysis results of AI assisted diagnostic software for pulmonary artery CTA, to evaluate the diagnostic efficacy of this software and low, medium, and senior radiologists for pulmonary embolism. The agreement of pulmonary embolism based on pulmonary artery CTA between the AI software and radiologists with different experiences was evaluated using Kappa test. Results The agreement of the AI software and the evaluation of pulmonary embolism lesions by senior radiologists based on pulmonary artery CTA was high (Kappa=0.913, P<0.001), while the diagnostic results of pulmonary artery CTA AI software was good after judged by senior radiologists based on pulmonary artery CTA (Kappa=0.755, P<0.001). Conclusions The AI software based on pulmonary artery CTA diagnosis of pulmonary embolism has good consistency with diagnostic images of radilogists, and can save a lot of reconstruction and diagnostic time. It has the value of daily diagnosis work and worthy of clinical promotion.
Objective To explore the safety and efficacy of lenvatinib in combination with transarterial chemoembolization (TACE) and programmed death receptor 1 (PD-1) antibody in the treatment of recurrent liver cancer. Method The clinical data of 22 patients with unresectable recurrent liver cancer admitted to Department of Liver Surgery and Liver Transplantation Center, West China Hospital, Sichuan University and received the conversion therapy of lenvatinib+TACE+PD-1 antibody between January 2019 and January 2022 were retrospectively analyzed. Results All 22 patients experienced some degree of adverse events, with a grade 3 adverse event rate of 18.2% (4/22) and no grade 4 or higher adverse events. At 4 months of treatment, according to the modified response evaluation criteria solid tumors (mRECIST), 2 cases were in complete response (CR), 5 cases were in partial response (PR), and 6 cases were in stable disease (SD), 9 cases were in progressive disease (PD), and the objective response (CR+PR) rate (ORR) was 31.8% (7/22). At the last follow-up, there was 1 case in CR, 5 cases in PR, 1 case in SD, and 15 cases in PD, with an ORR of 27.3% (6/22). The 1-year overall survival (OS) rate was 83.8% and the 1-year progression-free survival (PFS) rate was 38.2%. In the subgroup analysis, the 1-year OS rate for patients with recurrent liver cancer with intrahepatic lesions (n=16) only was 86.2% [95%CI (77.1%, 95.3%)], the 1-year PFS rate was 46.9% [95%CI (34.0%, 59.8%)], and the ORR based on mRECIST criteria was 43.8% (7/16). Patients with intrahepatic combined with extrahepatic lesions (n=6) had a 1-year OS rate of 75.0% [95%CI (53.3%, 96.7%)] and a 1-year PFS rate of 16.7% [95%CI (15.0%, 31.9%)], and the ORR based on mRECIST criteria was 0% (0/6). There were no significant differences in OS (P=0.864) and PFS (P=0.125) between the two subgroups. The ORR of intrahepatic combined with extrahepatic lesions group was worse compared to the intrahepatic lesion group (P=0.049). Conclusion Lenvatinib in combination with TACE and PD-1 antibody is safe and effective in the treatment of unresectable recurrent liver cancer, but there are still many issues that deserve further exploration.
【摘要】目的 观察介入灌注化疗栓塞后手术切除直肠癌的临床疗效。方法 本组31例患者于术前先行区域性动脉灌注化疗加栓塞术，然后多在3～7 d内限期行直肠癌根治术，其中行Dixon术23例， Miles术7例， Hartmann术1例。结果 本组患者术中出血少，肿瘤剥离容易，一般无须输血； 患者术后的肿瘤复发率、转移率和死亡率均优于我科同期术前未行区域性动脉灌注化疗加栓塞术而直接接受手术治疗者。结论 先行区域性动脉灌注化疗栓塞术后再行直肠癌根治性切除，近期疗效好，不失为直肠癌综合治疗的一种新的有效方法。
A large amount of research evidence has shown a correlation between cerebral infarction and malignant tumors, and malignant-tumor-related embolic stroke is the main type of malignant-tumor-related cerebral infarction. Hypercoagulation is considered to be the main mechanism. However, due to the complexity of the pathogenesis, the optimal diagnosis, treatment, and prevention strategies remain unclear. This review summarizes the published literature on the concepts, mechanisms, clinical manifestations, laboratory and imaging examinations, treatment and prevention of malignant-tumor-related embolic cerebral infarction, to clearly understand this disease and provide ideas for early recognition, reasonable diagnosis and treatment, improvement of prognosis, and further research of this disease.
OBJECTIVE To investigate the mechanism of electrothrombosis by copper needle, in order to supply the referential data for clinical treatment of vessel deformity. METHODS The mechanism and condition of thrombus formation by copper needle were studied in vivo and in vitro using electrophysics, atom absorption spectrophtometry, histological, and histochemical methods. RESULTS Great deal of copper ion was dissociated, and agglutination of red blood cells(RBC) in blood could be observed in vitro after the current applied by copper needles. Formation of stable thrombus was related to voltage and time of application of electric current. CONCLUSION Dissociation of copper ion and agglutination of RBC are the basic principle of electrothrombosis with copper needle. A 4V direct current and 17.5 minutes are the safe and effective conditions for thrombus formation in the blood vessels.
ObjectiveTo summarize the experience of combined treatment of conventional transcatheter arterial chemoembolization (cTACE) and drug-eluting-bead chemoembolization(D-TACE) in a case of advanced hepatocellular carcinoma with intrahepatic metastasis.MethodsA patient with advanced hepatocellular carcinoma who was admitted to The Second Affiliated Hospital of Chongqing Medical University in October 2018 was treated with TACE for three times.ResultsAfter MDT discussion, three interventional operations were performed on this patient in The Second Affiliated Hospital of Chongqing Medical University. CT examination after the first treatment with cTACE showed that lipiodol deposited in liver lesions and the lesions were more stable than before; after the second treatment with cTACE and D-TACE, CT examination showed more lipiodol deposited in the tumors, and the tumors were more limited and significantly reduced; after the third treatment with cTACE, CT examination showed that the tumors were effectively controlled and no progress was made. This patient was followed-up for 2 months after the fourth cTACE, tumors were effectively controlled and no progress occurred.ConclusionsIn advanced hepatocellular carcinoma with intrahepatic metastasis, TACE is the best treatment. Combination of D-TACE and cTACE can achieve better clinical efficacy.