The correlation between time-intensity curve parameters of transrectal contrast-enhanced ultrasound and pathological prognostic factors in rectal adenocarcinoma.

AIMS: To investigate the correlation between time-intensity curve (TIC) parameters obtained from transrectal contrast-enhanced ultrasound (TR-CEUS) and important pathological prognostic factors in rectal adenocarcinoma. MATERIAL AND METHODS:  We retrospectively included 477 patients with pathologically confirmed rectal adenocarcinoma. TIC parameters were derived from preoperative dynamic TR-CEUS images. These parameters included peak intensity (PI), time to peak (TTP),mean transit time (MTT), slope (S), and area under the curve (AREA). Pathological prognostic factors included TN stage, tumor diameter, lymphovascular invasion (LVI), perineural invasion, and tumor differentiation. Spearman's correlation analysis and binary logistic regression were used to analyze the association between TIC parameters and pathological prognostic factors. RESULTS: pT1-2 stages rectal carcinomas exhibited higher PI-max, PI-min, S-max, S-min, AREA-max, and AREA-min than pT3-4 stages (all p<0.05). pN0 stage rectal adenocarcinomas displayed higher PI-max, S-max, AREA-max, PI-ratio, Sratio, and AREA-ratio than pN1-2 stage (all p<0.05). PI-ratio and S-ratio were higher in the LVI-negative and tumor diameter ≥4cm group compared to the LVI-positive and tumor diameter <4cm group, respectively (p<0.05). Well-differentiated rectal adenocarcinomas displayed higher PI-max, AREA-max, PI-ratio, S-ratio, and AREA-ratio than the moderate-poor differentiated group (all p<0.05). PI-max, S-max, AREA-max, PI-ratio, S-ratio, and AREA-ratio were negatively correlated with pN stage (all p<0.05). PI-ratio and S-ratio were independent predictive factors for the pN stage (OR=0.774, OR=1.048). S-ratio and AREA-ratio were independent predictive factors for tumor differentiation (OR=1.071, OR=0.911). CONCLUSIONS: TIC parameters derived from TR-CEUS exhibit correlations with specific pathological prognostic factors in rectal adenocarcinomas. This non-invasive method may hold promise for preoperatively assessing the prognosis of rectal adenocarcinoma patients.

Construction of machine learning models based on transrectal ultrasound combined with contrast-enhanced ultrasound to predict preoperative regional lymph node metastasis of rectal cancer.

Purpose: Constructing a machine learning model based on transrectal ultrasound (TRUS) combined with contrast-enhanced ultrasound (CEUS) to predict preoperative regional lymph node metastasis (RLNM) of rectal cancer and provide new references for decision-making. Materials and methods: 233 patients with rectal cancer were enrolled and underwent TRUS and CEUS prior to surgery. Clinicopathological and ultrasound data were collected to analyze the correlation of RLNM status, clinical features and ultrasound parameters. A 75% training set and 25% test set were utilized to construct seven machine learning algorithms. The DeLong test was used to assess the model's diagnostic performance, then chose the best one to predict RLNM of rectal cancer. Results: The diagnostic performance was most dependent on the following: MMT difference (36), length (30), location (29), AUC ratio (27), and PI ratio (24). The prediction accuracy, sensitivity, specificity, precision, and F1 score range of KNN, Bayes, MLP, LR, SVM, RF, and LightGBM were (0.553-0.857), (0.000-0.935), (0.600-1.000), (0.557-0.952), and (0.617-0.852), respectively. The LightGBM model exhibited the optimal accuracy (0.857) and F1 score (0.852). The AUC for machine learning analytics were (0.517-0.941, 95% CI: 0.380-0.986). The LightGBM model exhibited the highest AUC (0.941, 95% CI: 0.843-0.986), though no statistic significant showed in comparison with the SVM, LR, RF, and MLP models (P > 0.05), it was significantly higher than that of the KNN and Bayes models (P < 0.05). Conclusion: The LightGBM machine learning model based on TRUS combined with CEUS may help predict RLNM prior to surgery and provide new references for clinical treatment in rectal cancer.

Spatiotemporal Changes of Cultivated Land System Health Based on PSR-VOR Model-A Case Study of the Two Lake Plains, China.

Cultivated land resources are the material basis of sustainable agricultural development. Climate change, food security, land pollution, and other issues highlight the value of sustainable agricultural development, and the health of the cultivated land system has attracted much attention. By constructing "PSR-VOR" cultivated land system health evaluation framework under the 5 km grid scale and using GIS spatial analysis and mathematical statistics to comprehensively evaluate the health status of the cultivated land system in the two lake plains from 2000 to 2019. The major results have shown that: (1) Over the past 20 years, both the highest and average values of the health index of the cultivated land system have gone down, and the health status of the cultivated land system has changed and gotten worse over time. (2) The health status in the two lake plains has been generally good, mainly in Class I and Class II areas. However, the area of cultivated land with general and poor health status has increased rapidly. On the whole, the health level presents the characteristic of gradually decreasing from the northeast to the southwest and southeast. (3) During the study period, the global Moran's I value of the cultivated land system health index in the two lake plains increased from 0.686 to 0.729, with significant spatial positive autocorrelation, and the spatial heterogeneity of the cultivated land system health index gradually increased. As shown by the spatial distribution characteristics of high in the north, low in the south, and decreasing from the middle to the outside, the distribution of the high-value cluster area and the low-value cluster area of the cultivated land system health index in the two lake plains has not changed significantly over the past 20 years. (4) The two lake plains are divided into five areas: a moderate optimization area, a collaborative optimization area, a potential improvement area, a key improvement area, and a priority improvement area. The urgency of regulating the health status from the moderate optimization area to the priority improvement area has gradually increased, and the differentiated utilization and management of cultivated land resources need to be carried out according to local conditions.

Contribution of the Ultrasound Techniques in the Evaluation of Knee Joint Damage in the Case of Pigmented Villonodular Synovitis and Rheumatoid Arthritis.

OBJECTIVES: This is a prospective study to evaluate the clinical value of high-frequency ultrasound (HFUS), superb microvascular imaging (SMI), and contrast-enhanced ultrasound (CEUS) in differentiation of pigmented villonodular synovitis (PVNS) and highly active rheumatoid arthritis (RA). METHODS: Twenty PVNS patients and 24 active RA patients were selected to undergo HFUS, SMI, and CEUS examinations. The characteristics of HFUS, SMI, and CEUS in PVNS and RA were compared, and the differential diagnosis performances of HFUS, SMI, and CEUS in PVNS and RA were evaluated by receiver operating characteristic (ROC) analysis. RESULTS: There were statistically significant in joint effusion, synovial thickness, synovial morphology, synovial echo, synovial vessel shape, synovial enhanced direction, and enhanced pattern between PVNS and RA (P < .05). However, no statistically significant were found in bone erosion, synovial boundary, blood signal grading of synovium, synovial enhanced strength, and CEUS quantitative parameters (including PI, TTP, S, MTT, and AUC) (P > .05). The AUC of HFUS, SMI, and CEUS for differential diagnosis PVNS and RA were 0.832, 0.675, and 0.817, respectively. The AUC of HFUS + SMI, HFUS + CEUS, SMI + CEUS, HFUS + SMI + CEUS were 0.923, 0.940, 0.817, and 0.940, respectively. The AUC of HFUS + SMI and HFUS + CEUS was higher than that of each alone (P < .05). CONCLUSIONS: HFUS, SMI, and CEUS can be used as supplementary methods for diagnosis and differential diagnosis in PVNS and active RA. What is more, the combination of HFUS + SMI and HFUS + CEUS was suggested.

The Spatiotemporal Evolution Characteristics of Cultivated Land Multifunction and Its Trade-Off/Synergy Relationship in the Two Lake Plains.

The material foundation of sustainable agricultural development is cultivated land resources, and their sustainable use is critical to fostering agricultural sustainability and guaranteeing national food security. In this paper, the multifunctional evaluation framework of the cultivated land system based on the "GESEL" model at the grid scale (5 km × 5 km) is constructed to explore the spatiotemporal evolution characteristics of a multifunctional cultivated land system in two lake plains and the trade-off and synergy between the functions. The five functions are all unstable in time scales, and their spatial distribution characteristics are also different. The trade-off and synergy between the multiple functions of the cultivated land system in the two lake plains from 2000 to 2019 showed significant spatial heterogeneity. Most of the functions were mainly collaborative, and a few were trade-offs. The two lake plains can be divided into four multi-functional cultivated land zones: a grain production leading zone, a distinctive agricultural planting zone, a high-efficiency agricultural development zone, and an ecological agricultural construction zone. This research puts forward some countermeasures and suggestions to promote the sustainable utilization of cultivated land resources.

Clinical evaluation of vascular normalization induced by recombinant human endostatin in nasopharyngeal carcinoma via dynamic contrast-enhanced ultrasonography.

BACKGROUND: The present study confirmed the presence and exact range of "vascular normalization window" induced by recombinant human endostatin (RHES) in patients with nasopharyngeal carcinoma (NPC) by analyzing the variation of dynamic contrast-enhanced ultrasonography (DCE-US) quantitative parameters. Also, the clinical application of DCE-US in the evaluation of vascular normalization was assessed. MATERIALS AND METHODS: A total of 30 previously untreated patients with stage III-IVA NPC were enrolled in the present study and were randomly but equally divided into RHES (endostar [ES]) and normal saline (NS) groups. The patients in the ES group were administered RHES intravenously, while the patients in the NS group were administered normal saline daily for 5 days prior to intensity modulated radiotherapy coupled with concurrent chemotherapy. All patients underwent DCE-US on the day before the administration and on days 3 and 5 subsequently. The Audio Video Interleave of each DCE-US examination was analyzed quantitatively using the CHI-Q software. Several parameters were investigated, such as peak intensity (PI), time to peak (TTP), and mean transit time (MTT). RESULTS: The PI, TTP, and MTT differed significantly at the three time points in the ES group (all P<0.001) but not in the NS group (all P>0.05). In the ES group, PI increased and subsequently decreased, whereas TTP, as well as MTT, lessened initially and then increased within the 5 days after administration of RHES. The maximum value of PI and the minimum value of TTP, as well as MTT, occurred on day 3 (all P<0.05). Furthermore, the values of PI, TTP, and MTT were similar prior to the administration of RHES in both groups (all P>0.05). However, the PI of the ES group was significantly higher (P<0.05), whereas the TTP and the MTT were significantly lower following administration of RHES (all P<0.05) compared with the corresponding parameters of the NS group. CONCLUSION: DCE-US is a suitable method for the clinical evaluation of vascular normalization induced by antiangiogenic agents. The "vascular normalization window" induced by RHES occurs in patients with NPC, and the exact range is within about 5 days post-administration, which contributes towards optimizing the modality of RHES combined with radiotherapy and chemotherapy for NPC patients.

[Analysis of CX32 gene mutation and related clinical features in Chinese Han Charcot-Marie-Tooth families].

OBJECTIVE: To analyze the mutation of CX32 gene and related clinical features in Chinese Han patients with Charcot-Marie-Tooth (CMT) disease. METHODS: Thirty-four CMT families, from 2004 to 2011 at Departments of Neurology, Xiangya Hospital, Third Xiangya Hospital and National Key Laboratory of Medical Genetics, were selected for CX32 mutation screening after the exclusion of the PMP22 duplication and male-to-male transmission. Mutation analysis was carried out by polymerase chain reaction (PCR) plus direct sequencing. Analyses of clinical, electrophysiological and pathological features in 11 patients from 6 CMTX1 families were performed by 2 neurologists. RESULTS: Five CX32 gene mutations were detected in 6 CMT families: c.37G > A, c.65G > A, c.246C > G, c.256A > G and c.533A > G. Among them, c.246C > G and c.533A > G were firstly reported. The clinical manifestations included progressive distal muscle atrophy and weakness, areflexia, sensory abnormalities and pes vacus. Nerve conduction velocity ranged from 21.7 to 49.3 m/s. Both demyelination and axonal degeneration were detected in nerve biopsy. CONCLUSIONS: CMT1X has a frequency of around 9% in our study. The male patients tend to have more serious clinical features and their electrophysiological and pathological changes are intermediate. CX32 mutation analysis helps to confirm the genetic diagnosis of CMT so as to provide genetic counseling and reproductive guidance and elucidate its pathogenesis.

Rapid genetic screening of Charcot-Marie-Tooth disease type 1A and hereditary neuropathy with liability to pressure palsies patients.

We used the allele-specific PCR-double digestion method on peripheral myelin protein 22 (PMP22) to determine duplication and deletion mutations in the proband and family members of one family with Charcot-Marie-Tooth disease type 1 and one family with hereditary neuropathy with liability to pressure palsies. The proband and one subclinical family member from the Charcot-Marie-Tooth disease type 1 family had a PMP22 gene duplication; one patient from the hereditary neuropathy with liability to pressure palsies family had a PMP22 gene deletion. Electron microscopic analysis of ultrathin sections of the superficial peroneal nerve from the two probands demonstrated demyelination and myelin sheath hyperplasia, as well as an 'onion-like' structure in the Charcot-Marie-Tooth disease type 1A patient. We observed an irregular thickened myelin sheath and 'mouse-nibbled'-like changes in the patient with hereditary neuropathy with liability to pressure palsies. In the Charcot-Marie-Tooth disease type 1A patient, nerve electrophysiological examination revealed moderate-to-severe reductions in the motor and sensory conduction velocities of the bilateral median nerve, ulnar nerve, tibial nerve, and sural nerve. Moreover, the compound muscle action potential amplitude was decreased. In the patient with hereditary neuropathy with liability to pressure palsies, the nerve conduction velocity of the bilateral tibial nerve and sural nerve was moderately reduced, and the nerve conduction velocity of the median nerve and ulnar nerve of both upper extremities was slightly reduced.