[Value of artificial intelligence in the improvement of diagnostic consistency of radiology residents].

OBJECTIVE: To explore the value of artificial intelligence (AI) in improving the detection rate of traumatic rib fractures by radiologist residents and the consistency among different readers. METHODS: Chest CT images of 393 patients with acute trauma from China-Japan Union Hospital of Jilin University (hospital 02) and Shanghai Ninth People' s Hospital (hospital 03) were collected in this research. The consensus achieved by three radiology experts was regarded as the reference standard. All the images assigned to three hospitals: Peking University First Hospital (hospital 01), hospital 02 and hospital 03, and were then randomly divided into two groups (group A and group B: group A included 197 patients, and group B included 196 patients). Each group was read by one radiologist resident from each hospital for rib fracture detection. Each case was read twice by the same radiologist, with and without the assistance of the AI ["radiologist-only" reading and "radiologist + AI" reading]. The detection rates of different types of rib fractures (displaced fractures and occult fractures) were compared between "radiologist-only" reading and "radiologist + AI" reading. The consistencies of different radiologists with different reading methods were evaluated. RESULTS: The detection rates of displaced rib fractures and occult rib fractures by "radiologist + AI" reading were significantly higher than those read by "radiologist-only" reading (94.56% vs. 78.40%, 76.60% vs. 49.42%, P < 0.001). For "radiologist-only reading", the Kappa coefficients of the radiologists between hospital 01 and hospital 03 were slightly greater than 0.4 (indicating moderate consistency), the coefficients of the radiologists between hospital 01/hospital 02 and hospital 02/hospital 03 were less than 0.4 (indicating poor consistency). The Phi coefficients of the radiologists among different hospitals were all less than 0.6 (indicating moderate correlation). With "radiologist + AI" reading, the Kappa and Phi coefficient among the radiologists in dif-ferent hospitals were greater than or equal to 0.6 (indicating good consistency and correlation). CONCLUSION: AI software can be used to automatically detect suspected rib fracture lesions, which helps to improve the detection rate of fracture lesions and the consistency among different readers.

Association between a single nucleotide polymorphism of the XRCC1 gene and hepatocellular carcinoma susceptibility in the Chinese Han population.

The human X-ray repair cross-complementing protein 1 (XRCC1) gene is a potentially gene determining hepatocellular carcinoma (HCC) susceptibility. The purpose of this study was to evaluate the association between XRCC1 and susceptibility to HCC. The association of XRCC1 polymorphisms with HCC susceptibility was investigated in 460 HCC patients and 463 controls using the created restriction site-polymerase chain reaction method. Our results indicate that the c.1471G>A variant could be detected and that the allele and genotype frequencies were statistically different between cases and controls. The AA genotype was strongly associated with increased HCC susceptibility as compared with the GG wild genotype (OR = 2.214, 95%CI = 1.493-3.283, χ(2) = 15.97, P < 0.0001). In addition, significantly increased HCC susceptibility was also found in a dominant and recessive model (P < 0.01). The allele A could contribute to HCC susceptibility compared with the G allele (OR = 1.480, 95%CI = 1.224-1.789, χ(2) = 16.44, P = 0.0001). Results from this study indicate that the XRCC1 c.1471G>A polymorphism is associated with HCC susceptibility in the Chinese Han population. Future studies on larger populations are essential to confirm this association.

LncDBH-AS1 knockdown enhances proliferation of non-small cell lung cancer cells by activating the Wnt signaling pathway via the miR-155/AXIN1 axis.

OBJECTIVE: Dys-regulated long noncoding RNAs (lncRNAs) are involved in the cell growth of several malignancies and their aggressive phenotypes. LncRNA DBH-AS1 plays an important role in the advancement of various malignant tumors, but its contribution to non-small cell lung cancer (NSCLC) is still unexplored. This study intends to elucidate the role of the regulatory network of lncRNA DBH-AS1 in NSCLC progression. PATIENTS AND METHODS: The LncDBH-AS1 expression in 32 paired NSCLC patients' tissue samples and NSCLC cell lines were determined by quantitative reverse transcription-polymerase chain reaction (qRT-PCR). The role of LncDBH-AS1 in NSCLC was investigated through cell counting kit-8 (CCK-8) assay and colony formation assay in vitro. Besides, the interaction between LncDBH-AS1 and miR-155 was also analyzed. RESULTS: The DBH-AS1 expression was significantly down-regulated in NSCLC cell lines and tissue samples. Decreased DBH-AS1 levels promoted the in vitro proliferation of the NSCLC cells. The mechanism was that DBH-AS1 regulated AXIN1 expression by sponging miR-155 in NSCLC cell lines. Importantly, LncDBH-AS1 might inhibit WNT/ß-CATENIN activation in NSCLC cells. CONCLUSIONS: The progression of NSCLC is facilitated by DBH-AS1 via miR-155 interaction and up-regulation of AXIN1 expression.

[Clinical features of pulmonary thromboembolism of eight children].

Objective: To improve the diagnosis and therapy of childhood pulmonary thromboembolism (PTE) by analyzing the clinical features of this rare condition. Methods: A total of 8 pediatric patients (4 males, 4 females) with PTE diagnosed in the Children's Hospital of Zhejiang University School of Medicine from March, 2014 to March, 2019 were enrolled. The clinical manifestation, laboratory results, imaging findings, diagnosis and treatment were summarized. Results: Among these 8 cases, aged from 9 hours to 14 years and 10 months. Fever was found in 4 cases, cough aggravation in 4, short of breath in 3, chest pain in 2, abdominal and back pain in one, hemoptysis in 2, cyanosis in 1, and edema of lower extremities in 2. Physical examination found decreased breath sound in 2 cases, phlegm rale in 3, and pleural friction rub in one. Pleural effusion was found in 5 cases by ultrasound. Plasma D-dimer increased in 6 cases (0.66-9.96 mg/L) and hypersensitive C-reactive protein elevated in 5 cases (10.78-78.00 mg/L). Chest enhanced CT showed pulmonary artery or venous filling defects, including pulmonary artery embolism in 7 cases and pulmonary vein embolism in one. The primary disease of these patients included Mycoplasma Pneumoniae pneumonia in 4 cases, nephritis in 2 and postoperative congenital heart disease in 2. Apart from one case who withdrew the treatment and was discharged, the other 7 patients received anticoagulant treatment had good outcome. Conclusions: For children with Mycoplasma pneumoniae pneumonia, immune disorders, long-term hormone therapy, cardiovascular invasive operation or other high-risk factors, PTE should be considered when fever, cough aggravation, short of breath, chest and back pain with pleural effusion are present. Chest enhanced CT scan should be performed as soon as possible, and anticoagulation should be started once the diagnosis is confirmed.

Rosette-forming glioneuronal tumour of the fourth ventricle with previous intratumoural haemorrhage: case report and review of the literature.

The case is reported of a rosette-forming glioneuronal tumour of the fourth ventricle (RGTFV) in a 27-year-old male. Symptoms included headache, severe vomiting and clumsy walking that had progressively worsened over 14 days. Computed tomography and magnetic resonance imaging indicated a 3.0 x 2.5 x 2.0 cm solid-cystic mass in the fourth ventricle and obstructive hydrocephalus. The tumour showed evidence of previous intra-tumour haemorrhage, with heterogeneous enhancement after contrast administration. Complete excision of the lesion was performed. Signs of previous intra-tumoural haemorrhage were seen intra-operatively. The detailed clinical, radiological and pathological features in this patient are described and compared with existing literature on this type of tumour. Despite benign histological features and a reported favourable post-operative course, there is still limited clinical experience with this type of tumour, however intratumoural haemorrhage may result in morbidity and mortality. This report will help provide better characterization of this entity, improving the diagnosis and potentially reducing mortality in RGTFV.

Strain study of gold nanomaterials as HR-TEM calibration standard.

This work presents the use of high resolution electron microscopy (HREM) and geometric phase analysis (GPA) to measure the interplanar spacing and strain distribution of three gold nanomaterials, respectively. The results showed that the {111} strain was smaller than the {002} strain for any kind of gold materials at the condition of same measuring method. The 0.65% of {111} strain in gold film measured by HREM (0.26% measured by GPA) was smaller than the {111} strains in two gold particles. The presence of lattice strain was interpreted according to the growth mechanism of metallic thin film. It is deduced that the {111} interplanar spacing of the gold thin film is suitable for high magnification calibration of transmission electron microscopy (TEM) and the gold film is potential to be a new calibration standard of TEM.