目的:拟采用超微血管成像技术(superb microvascular imaging,SMI)和超声造影(contrast-enhanced ultrasound,CEUS)相结合的方法,对甲状腺4a及4b级结节进行TI-RADS(thyroid imaging reporting and data system)分级。方法:对27例超声造...目的:拟采用超微血管成像技术(superb microvascular imaging,SMI)和超声造影(contrast-enhanced ultrasound,CEUS)相结合的方法,对甲状腺4a及4b级结节进行TI-RADS(thyroid imaging reporting and data system)分级。方法:对27例超声造影证实的甲状腺结节进行回顾性分析,术前分别行2 D灰阶超声、超微血管显像和超声造影,并对其进行分组、定量计分,得到各组的工作特性曲线(receiver operating characteristic,ROC)。结果:(1)27例行超声造影检查的甲状腺结节中:TI-RADS分级联合超微血管成像与TI-RADS分级联合超声造影曲线下面积相比较(Z=-0.206,P=0.175),诊断效能差异无统计学意义(P>0.05),表明SMI与CEUS诊断效能近似;(2)27例行超声造影检查的甲状腺结节中:TI-RADS分级联合超微血管成像和超声造影与TI-RADS分级曲线下面积相比较(Z=-1.242,P=0.011),诊断效能差异有统计学意义(P<0.05)。结论:TI-RADS分级联合超微血管成像结合超声造影能够提高甲状腺结节诊断的准确性,能够为临床诊治提供较为准确指导;超微血管成像与超声造影在鉴别诊断甲状腺结节良恶性方面具有较高一致性。展开更多
Traditional psychiatric diagnosis relies on subjective symptom assessment,lacking objective biomarkers that hinder early detection and personalized treatment.Plasma proteins and polygenic risk score(PRS),as potential ...Traditional psychiatric diagnosis relies on subjective symptom assessment,lacking objective biomarkers that hinder early detection and personalized treatment.Plasma proteins and polygenic risk score(PRS),as potential predictive tools,hold promise for advancing early diagnosis of mental disorders.This study aims to evaluate the predictive potential of proteomic features and PRS in multiple mental illnesses(depression,schizophrenia,and post-traumatic stress disorder(PTSD)).Using participant data from the UK Biobank-Pharma Proteomics Project,we screen protein associations with mental disorders through least absolute shrinkage and selection operator(LASSO)analysis and construct a Cox regression risk prediction model by integrating the PRS.Additionally,we evaluate predictive performance using 6 machine learning methods and Kaplan-Meier survival curves.Our findings reveal distinct predictive patterns across dis-orders.For depression,integrating plasma proteins with PRS significantly improves prediction beyond the clinical model(C-index=0.6322).For schizophrenia,adding plasma proteins enhances predictive performance,whereas PRS provides no significant improvement.For PTSD,neither plasma proteins nor PRS add substantial predictive value beyond clinical variables.Risk stratification analysis demonstrat that all three mental disorders models can clearly distinguish high-risk from low-risk groups(depression:HR=2.34,P<0.001;schizophrenia:HR=5.47,P<0.001;PTSD:HR=3.02,P<0.001).Al-though it shows good performance in short-term prediction,its long-term prediction ability has decreased,and it needs to be further optimized in the future.This study underscores the differential utility of biomarkers across mental disorders and provides a rationale for disorder-specific predictive modeling in precision psychiatry.展开更多
目的:评价甲状腺影像报告与数据系统(thyroid imaging reporting and data system,TI-RADS)联合剪切波弹性成像(shear wave elastography,SWE)对甲状腺结节良恶性鉴别诊断的价值。方法:术前对209例患者的209个甲状腺结节行TI-RADS风险...目的:评价甲状腺影像报告与数据系统(thyroid imaging reporting and data system,TI-RADS)联合剪切波弹性成像(shear wave elastography,SWE)对甲状腺结节良恶性鉴别诊断的价值。方法:术前对209例患者的209个甲状腺结节行TI-RADS风险评估和SWE参数测定,以手术病理诊断结果为金标准,评估以TI-RADS特征和SWE参数进行诊断的有效性,确定预测恶性结节SWE平均值的最佳界值,比较单独TI-RADS以及TI-RADS联合SWE的诊断效能。结果:209个甲状腺结节中,良性55个(占26.32%),恶性154个(占73.68%)。恶性结节的SWE参数明显高于良性结节(P<0.01),低回声或极低回声(P<0.001)和SWE平均值(≥15.65 kPa,P<0.01)是甲状腺恶性结节相关的预测指标。相比于单独TI-RADS诊断,TI-RADS联合SWE评价甲状腺良恶性结节的受试者工作特征曲线下面积明显增大(P<0.001);联合诊断的敏感度为96.75%,特异度为63.64%,准确度为88.04%,阳性预测值为88.17%,阴性预测值为87.50%。结论:SWE平均值是甲状腺恶性结节的独立预测因子,而且TI-RADS联合SWE能明显提高甲状腺良恶性结节的鉴别诊断效能。展开更多
基金The National Natural Science Foundation of China-Regional Science“Identification of novel drug targets for lung cancer via Mendelian randomization analysis based on blood proteomics”(62362062)The 2025 Xinjiang University Excellent Graduate Innovation Project“Research on identification of therapeutic targets and predictive factors for mental disorders based on proteomics”(XJDX2025YJS151)。
文摘Traditional psychiatric diagnosis relies on subjective symptom assessment,lacking objective biomarkers that hinder early detection and personalized treatment.Plasma proteins and polygenic risk score(PRS),as potential predictive tools,hold promise for advancing early diagnosis of mental disorders.This study aims to evaluate the predictive potential of proteomic features and PRS in multiple mental illnesses(depression,schizophrenia,and post-traumatic stress disorder(PTSD)).Using participant data from the UK Biobank-Pharma Proteomics Project,we screen protein associations with mental disorders through least absolute shrinkage and selection operator(LASSO)analysis and construct a Cox regression risk prediction model by integrating the PRS.Additionally,we evaluate predictive performance using 6 machine learning methods and Kaplan-Meier survival curves.Our findings reveal distinct predictive patterns across dis-orders.For depression,integrating plasma proteins with PRS significantly improves prediction beyond the clinical model(C-index=0.6322).For schizophrenia,adding plasma proteins enhances predictive performance,whereas PRS provides no significant improvement.For PTSD,neither plasma proteins nor PRS add substantial predictive value beyond clinical variables.Risk stratification analysis demonstrat that all three mental disorders models can clearly distinguish high-risk from low-risk groups(depression:HR=2.34,P<0.001;schizophrenia:HR=5.47,P<0.001;PTSD:HR=3.02,P<0.001).Al-though it shows good performance in short-term prediction,its long-term prediction ability has decreased,and it needs to be further optimized in the future.This study underscores the differential utility of biomarkers across mental disorders and provides a rationale for disorder-specific predictive modeling in precision psychiatry.
文摘目的:评价甲状腺影像报告与数据系统(thyroid imaging reporting and data system,TI-RADS)联合剪切波弹性成像(shear wave elastography,SWE)对甲状腺结节良恶性鉴别诊断的价值。方法:术前对209例患者的209个甲状腺结节行TI-RADS风险评估和SWE参数测定,以手术病理诊断结果为金标准,评估以TI-RADS特征和SWE参数进行诊断的有效性,确定预测恶性结节SWE平均值的最佳界值,比较单独TI-RADS以及TI-RADS联合SWE的诊断效能。结果:209个甲状腺结节中,良性55个(占26.32%),恶性154个(占73.68%)。恶性结节的SWE参数明显高于良性结节(P<0.01),低回声或极低回声(P<0.001)和SWE平均值(≥15.65 kPa,P<0.01)是甲状腺恶性结节相关的预测指标。相比于单独TI-RADS诊断,TI-RADS联合SWE评价甲状腺良恶性结节的受试者工作特征曲线下面积明显增大(P<0.001);联合诊断的敏感度为96.75%,特异度为63.64%,准确度为88.04%,阳性预测值为88.17%,阴性预测值为87.50%。结论:SWE平均值是甲状腺恶性结节的独立预测因子,而且TI-RADS联合SWE能明显提高甲状腺良恶性结节的鉴别诊断效能。
文摘目的:探讨实时剪切波弹性成像(shear wave elastography,SWE)在不同大小甲状腺TI-RADS 3~4类结节鉴别诊断中的应用。方法:常规超声观察164例患者(共197个结节)甲状腺结节的边界、内部回声、是否合并钙化、纵横比、内部及周边血流情况等,依据甲状腺TI-RADS分类方法对相应的甲状腺状腺结节进行分类,同时进行剪切波弹性成像,记录结节杨氏模量最大值(Emax),绘制ROC曲线,获得鉴别诊断甲状腺良恶性结节的Emax最佳界值。其中TI-RADS 3~4类结节186个,分直径≤10 mm组(Ⅰ组)和直径>10 mm组(Ⅱ组)。以病理结果为金标准,分别绘制ROC曲线,评价Emax值在Ⅰ、Ⅱ组病变中的应用价值。结果:杨氏模量Emax界值为52.5 k Pa。Ⅰ组和Ⅱ组的敏感性、准确性及特异性分别为57.4%、66.2%及90.0%和87.5%、79.5%及68.8%,ROC曲线下面积(area under the curve,AUC)分别为0.810和0.842。结论:SWE界值鉴别诊断甲状腺良恶性结节差异有统计学意义;SWE对>10 mm甲状腺结节良恶性鉴别诊断更有应用价值;SWE对≤10 mm甲状腺结节应用价值有限。
