Objective To explore the effect of smoking on pulmonary function parameters of male patients with chronic obstructive pulmonary disease (COPD) and to analyze the correlation between smoking and pulmonary function parameters. Methods From January 2014 to October 2015, the pulmonary function parameters of 223 male outpatients or hospitalized patients with COPD in the Department of Respiratory Medicine were retrospectively analyzed by using SPSS 17.0 software. The patients were randomly divided into smoking group (n=98), smoking cessation group (n=82) and non-smoking group (n=43). Results Various degrees of damage or abnormality of lung capacity, ventilatory function, gas exchange function and airway resistance (Raw) existed in the patients with COPD. Compared with smoking cessation group and non-smoking group, residual volume/ total lung capacity (RV/TLC) and Raw were significantly higher (P< 0.05), maximum ventilatory volume, ventilation reserve percent, forced vital capacity, the percent of first second forced expiratory volume compared its predicted value (FEV1%pred), maximum mid-expiratory flow (MMEF), forced expiratory flow 50%, forced expiratory flow 75% and diffusing capacity of carbon monoxide were significantly lower (P<0.05) in the smoking group. There was a negative relationship between MMEF, FEV1%pred and smoking index (r=–0.352, –0.381, P<0.05), and a positive relationship between Raw, RV/TLC and smoking index (r=0.403, 0.378, P<0.05). Conclusions Most of the male COPD patients smoke or used to smoke. Smoking leads to ventilation and gas exchange function decrease, small airway limitation aggravation, airway resistance and emphysema degree increase in COPD patients. Smoking index has a negative relationship with MMEF, FEV1%pred and a positive relationship with Raw and RV/TLC.
ObjectiveTo analyze the results of the preliminary application of the breast cancer ultrasound intelligent diagnostic system (DeepBC) in primary-level breast cancer screening. MethodsWomen who underwent breast ultrasound screening at Shifang Maternal and Child Health Hospital in Sichuan Province and at Wanzhou Maternal and Child Health Hospital in Chongqing from January 2023 to August 2024 were retrospectively included. DeepBC performed an independent risk assessment using static breast ultrasound (BUS) lesion images acquired by sonographers and did not independently detect lesions. The distributions of Breast Imaging Reporting and Data System (BI-RADS) categories and risk-stratification results between DeepBC and sonologists were compared. BI-RADS categories 1–3 were defined as low risk, category 4 or higher as high risk, and category 0 or indeterminate results as uncertain. The agreement rate and patterns of risk upgrading and downgrading between DeepBC and sonographers were evaluated. ResultsA total of 16 750 women were included, and BUS detected 6 812 breast lesions in 4 496 participants. Sonologists classified 5 932 lesions (87.08%) as low risk, 863 (12.67%) as high risk, and 17 (0.25%) as uncertain; the corresponding numbers classified by DeepBC were 2 517 (36.95%), 4 104 (60.25%), and 191 (2.80%), respectively. Three-category agreement analysis of all 6 812 lesions yielded a Cohen Kappa of 0.135 [95%CI (0.115, 0.155)], with an overall agreement rate of 47.94% (3 266/6 812). Of the 5 932 lesions initially classified as low-risk by sonologist, DeepBC upgraded 3 308 (55.77%) to high-risk. Conversely, among the 863 high-risk lesions classified by sonologists, DeepBC concurred on 791, yielding a high-risk agreement rate of 91.66%. In a subgroup of 3 781 hypoechoic lesions, a three-class agreement analysis was performed. The Cohen Kappa between the DeepBC and sonologists was 0.215 [95%CI (0.188, 0.242)], with an overall agreement rate of 53.45% (2 021/3 781). Specifically, within this subgroup, DeepBC upgraded 1 636 (54.95%) of the 2 977 sonologist-defined low-risk lesions, and for the 798 lesions originally deemed high-risk by sonologists, DeepBC matched 740, corresponding to a concordance rate of 92.73%. ConclusionsDeepBC shows a high concordance with BUS performed by sonologists in the classification of high-risk lesions; however, the overall agreement between the two in risk stratification is low, and DeepBC frequently upgrades lesions classified as low risk by sonologists. Because complete histopathological or long-term imaging reference standards were unavailable in this study, these findings primarily reflect differences in risk stratification between the two approaches and cannot be interpreted as evidence of the diagnostic accuracy of DeepBC. Further studies incorporating histopathological confirmation, standardized imaging follow-up, and multicenter external validation are needed to evaluate its clinical value.
Objective To investigate the biomechanical characteristics of self-developed distraction reduction fixation system (DRFS) and to evaluate its cl inical effect on thoracolumbar vertebrate fracture. Methods Twelve fresh porcine spines were prepared for the biomechanical test. The stiffness of each intact specimen were recorded on forward bending (20°),backward bending (10°), lateral bending (30°) and axial rotation (20°), and then specimens of fracture dislocation were made by cuneiform osteotomy of L3 vertebral body and excision of posterior facet joints. Finally, DRFS internal fixation was performed on each specimen. The stiffness of specimens in fracture dislocation and after DRFS fixation were measured during the same movements mentioned above, respectively. The cl inical effect of DRFS on thoracolumbar vertebrate fracture in 31 patients (aged 17-46 years with an average of 32.1) from April 1998 to October 2002 was summarized. Fracture types were classified according to Denis classification: 2 patients suffered simple compressed fracture, 16 burst fracture, and 13 fracture dislocation, including 2 cases of T11, 11 cases of T12, 14 cases of L1 and 4 cases of L2. Frankel and X-ray examination were adopted to assess the results. Results The stiffness during forward bending, backward bending, lateral bending and axial rotation in the fracturedislocation state was markedly lower than that of the corresponding movements of the intact porcine spines (P lt; 0.05). After DRFS, the stiffness during various movements increased to the level that significantly higher than that in the fracture-dislocation state (P lt; 0.05), and the stiffness during backward bending was of significant difference (P lt; 0.05), but without significant difference during the rest three movements (P gt; 0.05) when compared to that in intact spines. Regarding cl inical observation, the operation time was 2.2-4.1 hours (2.7 hours on average) and blood loss was 250-600 mL (450 mL on average). The patients were followed up for 5-20 months (10.2 months on average). The heal ing time for fracture was 5-11months (8 months onaverage). The mean anterior and posterior heights of the injured vertebrate recovered from 46.2% ± 7.5% and 76.4% ± 2.4% preoperatively to 89.8% ± 4.6% and 94.1% ± 1.5% postoperatively (P lt; 0.05).The median point height also raised from 60.8% ± 6.4% to 90.7% ± 2.9% (P lt; 0.05). The Cobb’s angle decreased from (26.3 ± 5.9)° to (5.2 ± 1.8)° (P lt; 0.05), and all the sl ipped vertebrates were well repositioned. Spine function was assessed by Frankel classification as follows: 2 of 5 Class A preoperatively improved to Class B postoperatively, and the other 3 remained unchanged ; 4 of 6 from B to C, and the other 2 to D; 6 of 13 from C to D, and the other 7 to E; and 7 from D to E. Conclusion DRFS is capable of providing sufficient stabil ity, meeting the requirement of the spine physical activity without any obvious side effect. DRFS, as a handy, safe and effective technique in cl inical practice, is featured by satisfying functions of distraction, reposition and fixation.