Contrast-Enhanced CT-Based Deep Learning Radiomics Nomogram for the Survival Prediction in Gallbladder Cancer Postoperative.

RATIONALE AND OBJECTIVES: An accurate prognostic model is essential for the development of treatment strategies for gallbladder cancer (GBC). This study proposes an integrated model using clinical features, radiomics, and deep learning based on contrast-enhanced computed tomography (CT) images for survival prediction in patients with GBC after surgical resection. METHODS: A total of 167 patients with GBC who underwent surgical resection at two medical institutions were retrospectively enrolled. After obtaining the pre-treatment CT images, the tumor lesions were manually segmented, and handcrafted radiomics features were extracted. A clinical prognostic signature and radiomics signature were built using machine learning algorithms based on the optimal clinical features or handcrafted radiomics features, respectively. Subsequently, a DenseNet121 model was employed for transfer learning on the radiomics image data and as the basis for the deep learning signature. Finally, we used logistic regression on the three signatures to obtain the unified multimodal model for comprehensive interpretation and analysis. RESULTS: The integrated model performed better than the other models, exhibiting the highest area under the curve (AUC) of 0.870 in the test set, and the highest concordance index (C-index) of 0.736 in predicting patient survival rates. A Kaplan-Meier analysis demonstrated that patients in high-risk group had a lower survival probability compared to those in low-risk group (log-rank p < 0.05). CONCLUSION: The nomogram is useful for predicting the survival of patients with GBC after surgical resection, helping in the identification of high-risk patients with poor prognosis and ultimately facilitating individualized management of patients with GBC.

Donor hepatic artery reconstruction based on human embryology: A case report.

BACKGROUND: Embryonic hepatic artery anatomy simplifies its identification during liver transplantation. Injuries to the donor hepatic artery can cause complications in this process. The hepatic artery's complex anatomy in adults makes this step challenging; however, during embryonic development, the artery and its branches have a simpler relationship. By restoring the embryonic hepatic artery anatomy, surgeons can reduce the risk of damage and increase the procedure's success rate. This approach can lead to improved patient outcomes and lower complication rates. CASE SUMMARY: In this study, we report a case of donor liver preparation using a donor hepatic artery preparation based on human embryology. During the preparation of the hepatic artery, we restored the anatomy of the celiac trunk, superior mesenteric artery, and their branches to the state of the embryo at 5 wk. This allowed us to dissect the variant hepatic artery from the superior mesenteric artery and left gastric artery during the operation. After implanting the donor liver into the recipient, we observed normal blood flow in the donor hepatic artery, main hepatic artery, and variant hepatic artery, without any leakage. CONCLUSION: Donor hepatic artery preparation based on human embryology can help reduce the incidence of donor hepatic artery injuries during liver transplantation.

Monoterpenoid indole alkaloid dimers from Kopsia arborea inhibit cyclin-dependent kinase 5 and tau phosphorylation.

Three undescribed monoterpenoid indole alkaloid dimers (kopoffines A-C, which are connected via a methylene unit) and with nine known alkaloids were isolated and identified from the fruits of Kopsia arborea Blume. Their structures, including their absolute configurations, were established by HRESIMS, NMR, single-crystal X-ray diffraction, and ECD analyses. Kopoffines A-C showed significant inhibition against cyclin-dependent kinase 5 (IC50: 0.34-2.18 µM). Western blotting analyses showed that kopoffines A-C significantly decreased the protein levels of CDK5 and phospho-CDK5 (Tyr15) (pCDK5) at concentrations of 2.5 and 10 µM. The levels of phospho-Tau (Thr217) (pTau217, a new biomarker of AD), and phospho-Tau (Ser396) (pTau396), which play major roles in the formation of neurofibrillary tangles , were decreased by the kopoffines A-C treatment. Molecular docking studies indicated that kopoffines A-C could form stable interactions with CDK5.

Perforalactones D and E, two new C-20 quassinoids with potential activity to induce lysosomal biogenesis from the twigs of Harrisonia perforata (Blanco) Merr.

Two new quassinoids (1 and 2) were isolated from the twigs of Harrisonia perforata (Blanco) Merr. Perforalactone E (2) possesses an uncommon hexacyclic 1α,12α:5α,13α-dicyclo-9ßH-picrasane skeleton. Its structure was determined based on spectroscopic data and X-ray crystallography. Compounds 1 and 2 could significantly induce lysosomal biogenesis through transcriptional activation of lysosomal genes.

Ameliorative effects of glycine in an experimental nonalcoholic steatohepatitis and its correlation between TREM-1 and TREM-2.

Inflammation plays an important role in Nonalcoholic Steatohepatitis (NASH), triggering receptor expressed on myeloid cells-1 and 2 (TREM-1 and TREM-2) modulates inflammatory and innate immune, they have been investigated in various inflammatory diseases, but not in NASH. Meanwhile we added glycine in HFO (HFOG) to investigate if the liver pathologic relief is related with TREM-1 and TREM-2. Liver tissue staining and serum indexes showed that the NASH was successful from the 4(th) weekend and glycine can improved many features of NASH. Results from Q-PCR and ELISA study showed that compareaded with control, TREM-1 is upregulated and TREM-2 is downregulated respectively in 4 and 8-week NASH model (TREM-1: p < 0.001; TREM-2: p < 0.001).Compared with HFO group, HFOG group with an extra 5% Glycine into the diet of NASH, we found that all model liver pathologic and serum indexes ameliorated in this group. Furthermore, Results from Q-PCR and ELISA study showed that compareaded with HFO group, TREM-2 of this group is upregulated and TREM-1 is downregulated respectively from the 4(th) weekend, which is more significant at the 8(th) weekend (TREM-1: p <0.001; TREM-2: p =0.048). Pearson correlation showed that TREM-1 and TREM-2 were closely associated with serum ET, TNF-α, TLR-4 and PC III. Besides, using multiple-stepwise regression analysis, we found that the ameliorative effects of glycine in HFOG was mainly related to its counteraction of PC III, TREM-1 and upregulation of TREM-2. Furthermore, we detected the expression of TREM-1 and TREM-2 in gall stone patients without drinking excessively before undergoing cholecystectomy, and found that the rise of TREM-1 and reduction of TREM-2 was close associated with the severity of fatty liver. To conclude, our results support the concept that TREM-1 and TREM-2 were close strongly linked to NASH and NALFD. Glycine can relieve NASH by its anti-fibrosis effect, and this ameliorative effect is related to the expression change of TREM-1/2 to some extent.