A Straightforward Bifurcation Pattern-Based Fundus Image Registration Method.

Fundus image registration is crucial in eye disease examination, as it enables the alignment of overlapping fundus images, facilitating a comprehensive assessment of conditions like diabetic retinopathy, where a single image's limited field of view might be insufficient. By combining multiple images, the field of view for retinal analysis is extended, and resolution is enhanced through super-resolution imaging. Moreover, this method facilitates patient follow-up through longitudinal studies. This paper proposes a straightforward method for fundus image registration based on bifurcations, which serve as prominent landmarks. The approach aims to establish a baseline for fundus image registration using these landmarks as feature points, addressing the current challenge of validation in this field. The proposed approach involves the use of a robust vascular tree segmentation method to detect feature points within a specified range. The method involves coarse vessel segmentation to analyze patterns in the skeleton of the segmentation foreground, followed by feature description based on the generation of a histogram of oriented gradients and determination of image relation through a transformation matrix. Image blending produces a seamless registered image. Evaluation on the FIRE dataset using registration error as the key parameter for accuracy demonstrates the method's effectiveness. The results show the superior performance of the proposed method compared to other techniques using vessel-based feature extraction or partially based on SURF, achieving an area under the curve of 0.526 for the entire FIRE dataset.

Multiple Preprocessing Hybrid Level Set Model for Optic Disc Segmentation in Fundus Images.

The accurate segmentation of the optic disc (OD) in fundus images is a crucial step for the analysis of many retinal diseases. However, because of problems such as vascular occlusion, parapapillary atrophy (PPA), and low contrast, accurate OD segmentation is still a challenging task. Therefore, this paper proposes a multiple preprocessing hybrid level set model (HLSM) based on area and shape for OD segmentation. The area-based term represents the difference of average pixel values between the inside and outside of a contour, while the shape-based term measures the distance between a prior shape model and the contour. The average intersection over union (IoU) of the proposed method was 0.9275, and the average four-side evaluation (FSE) was 4.6426 on a public dataset with narrow-angle fundus images. The IoU was 0.8179 and the average FSE was 3.5946 on a wide-angle fundus image dataset compiled from a hospital. The results indicate that the proposed multiple preprocessing HLSM is effective in OD segmentation.

Design, synthesis, and LFA-1/ICAM-1 antagonist activity evaluation of Lifitegrast analogues.

The interaction between Lymphocyte function-associated antigen 1 (LFA-1) and intercellular-adhesion molecule-1 (ICAM-1) plays important roles in the cell-mediated immune response and inflammation associated with dry eye disease. LFA-1/ICAM-1 antagonists can be used for the treatment of dry eye disease, such as Lifitegrast which has been approved by the FDA in 2016 as a new drug for the treatment of dry eye disease. In this study, we designed and synthesized some new structure compounds that are analogues to Lifitegrast, and their biological activities were evaluated by in vitro cell-based assay and also by in vivo mouse dry eye model. Our results demonstrated that one of these analogues of Lifitegrast (compound 1b) showed good LFA-1/ICAM-1 antagonist activity in in vitro assay; meanwhile, it also significantly reduced ocular surface epithelial cells damage, increased goblet cell density in dry eye mouse and highly improved the symptoms of dry eye mouse. Graphical abstract.

Lung Nodule Segmentation with a Region-Based Fast Marching Method.

When dealing with computed tomography volume data, the accurate segmentation of lung nodules is of great importance to lung cancer analysis and diagnosis, being a vital part of computer-aided diagnosis systems. However, due to the variety of lung nodules and the similarity of visual characteristics for nodules and their surroundings, robust segmentation of nodules becomes a challenging problem. A segmentation algorithm based on the fast marching method is proposed that separates the image into regions with similar features, which are then merged by combining regions growing with k-means. An evaluation was performed with two distinct methods (objective and subjective) that were applied on two different datasets, containing simulation data generated for this study and real patient data, respectively. The objective experimental results show that the proposed technique can accurately segment nodules, especially in solid cases, given the mean Dice scores of 0.933 and 0.901 for round and irregular nodules. For non-solid and cavitary nodules the performance dropped-0.799 and 0.614 mean Dice scores, respectively. The proposed method was compared to active contour models and to two modern deep learning networks. It reached better overall accuracy than active contour models, having comparable results to DBResNet but lesser accuracy than 3D-UNet. The results show promise for the proposed method in computer-aided diagnosis applications.

Alternative polyadenylation coordinates embryonic development, sexual dimorphism and longitudinal growth in Xenopus tropicalis.

RNA alternative polyadenylation contributes to the complexity of information transfer from genome to phenome, thus amplifying gene function. Here, we report the first X. tropicalis resource with 127,914 alternative polyadenylation (APA) sites derived from embryos and adults. Overall, APA networks play central roles in coordinating the maternal-zygotic transition (MZT) in embryos, sexual dimorphism in adults and longitudinal growth from embryos to adults. APA sites coordinate reprogramming in embryos before the MZT, but developmental events after the MZT due to zygotic genome activation. The APA transcriptomes of young adults are more variable than growing adults and male frog APA transcriptomes are more divergent than females. The APA profiles of young females were similar to embryos before the MZT. Enriched pathways in developing embryos were distinct across the MZT and noticeably segregated from adults. Briefly, our results suggest that the minimal functional units in genomes are alternative transcripts as opposed to genes.

Upregulation of PD-L1 by SPP1 mediates macrophage polarization and facilitates immune escape in lung adenocarcinoma.

Tumor-associated macrophages (TAMs) polarization represents a key regulatory process of tumor progression. However, the underlying mechanisms are unclear. This study aimed to investigate the relationship between secreted phosphoprotein 1 (SPP1) and TAMs in lung adenocarcinoma cells. THP-1 monocytes were differentiated into macrophages using PMA. PMA-treated THP-1 cells were co-cultured with human A549 cells culture supernatant. SPP1 expression in TAMs isolated from lung adenocarcinoma tissues and PMA-treated THP-1 cells were measured. Macrophage polarization was identified by flow cytometric analysis. Cell migration and apoptosis were assessed by Transwell migration assays and flow cytometric analysis, respectively. SPP1 is highly expressed in tumor tissues and TAMs isolated from patients with an advanced TNM stage, and also in PMA-treated THP-1 cells. Co-culture with A549 cells strongly induced SPP-1 expression as well as M2 polarization of THP-1 cells, but it had little effect on short hairpin SPP1 (shSPP1)-transfected THP-1 cells. Interestingly, programmed death ligand 1 (PD-L1), a critical regulator of M2 polarization, was downregulated in SPP1 knockdown THP-1 cells. Inhibition of PD-L1 induced a greater decline of the M2 markers IL-10 and Arg-1 but an increase in the M1 markers IL-12 and TNF-α. In addition, SPP1 knockdown in THP-1 cells can mitigate migration but promote apoptosis of A549 cells, and PD-L1 inhibition can further enhance this effect. THP-1 cells co-cultured with A549 cells attenuated CD4+ T-cell activation, whereas SPP1 inhibition restored T-cell activation. These results highlight the importance of SPP1 in mediating macrophage polarization and lung cancer evasion, suggesting a potential therapeutic target for lung cancer.

Molecular mechanism of G1 arrest and cellular senescence induced by LEE011, a novel CDK4/CDK6 inhibitor, in leukemia cells.

BACKGROUND: Overexpression of cyclin D1 dependent kinases 4 and 6 (CDK4/6) is a common feature of many human cancers including leukemia. LEE011 is a novel inhibitor of both CDK4 and 6. To date, the molecular function of LEE011 in leukemia remains unclear. METHODS: Leukemia cell growth and apoptosis following LEE011 treatment was assessed through CCK-8 and annexin V/propidium iodide staining assays. Cell senescence was assessed by ß-galactosidase staining and p16INK4a expression analysis. Gene expression profiles of LEE011 treated HL-60 cells were investigated using an Arraystar Human LncRNA array. Gene ontology and KEGG pathway analysis were then used to analyze the differentially expressed genes from the cluster analysis. RESULTS: Our studies demonstrated that LEE011 inhibited proliferation of leukemia cells and could induce apoptosis. Hoechst 33,342 staining analysis showed DNA fragmentation and distortion of nuclear structures following LEE011 treatment. Cell cycle analysis showed LEE011 significantly induced cell cycle G1 arrest in seven of eight acute leukemia cells lines, the exception being THP-1 cells. ß-Galactosidase staining analysis and p16INK4a expression analysis showed that LEE011 treatment can induce cell senescence of leukemia cells. LncRNA microarray analysis showed 2083 differentially expressed mRNAs and 3224 differentially expressed lncRNAs in LEE011-treated HL-60 cells compared with controls. Molecular function analysis showed that LEE011 induced senescence in leukemia cells partially through downregulation of the transcriptional expression of MYBL2. CONCLUSIONS: We demonstrate for the first time that LEE011 treatment results in inhibition of cell proliferation and induction of G1 arrest and cellular senescence in leukemia cells. LncRNA microarray analysis showed differentially expressed mRNAs and lncRNAs in LEE011-treated HL-60 cells and we demonstrated that LEE011 induces cellular senescence partially through downregulation of the expression of MYBL2. These results may open new lines of investigation regarding the molecular mechanism of LEE011 induced cellular senescence.

Gut microbiome for predicting immune checkpoint blockade-associated adverse events.

BACKGROUND: The impact of the gut microbiome on the initiation and intensity of immune-related adverse events (irAEs) prompted by immune checkpoint inhibitors (ICIs) is widely acknowledged. Nevertheless, there is inconsistency in the gut microbial associations with irAEs reported across various studies. METHODS: We performed a comprehensive analysis leveraging a dataset that included published microbiome data (n = 317) and in-house generated data from 16S rRNA and shotgun metagenome samples of irAEs (n = 115). We utilized a machine learning-based approach, specifically the Random Forest (RF) algorithm, to construct a microbiome-based classifier capable of distinguishing between non-irAEs and irAEs. Additionally, we conducted a comprehensive analysis, integrating transcriptome and metagenome profiling, to explore potential underlying mechanisms. RESULTS: We identified specific microbial species capable of distinguishing between patients experiencing irAEs and non-irAEs. The RF classifier, developed using 14 microbial features, demonstrated robust discriminatory power between non-irAEs and irAEs (AUC = 0.88). Moreover, the predictive score from our classifier exhibited significant discriminative capability for identifying non-irAEs in two independent cohorts. Our functional analysis revealed that the altered microbiome in non-irAEs was characterized by an increased menaquinone biosynthesis, accompanied by elevated expression of rate-limiting enzymes menH and menC. Targeted metabolomics analysis further highlighted a notably higher abundance of menaquinone in the serum of patients who did not develop irAEs compared to the irAEs group. CONCLUSIONS: Our study underscores the potential of microbial biomarkers for predicting the onset of irAEs and highlights menaquinone, a metabolite derived from the microbiome community, as a possible selective therapeutic agent for modulating the occurrence of irAEs.

Characterization of sulfur in raw and anaerobically digested municipal wastewater treatment sludges.

A microwave-enhanced acid digestion method that was integrated with inductively coupled plasma-atomic emission spectrometry was developed and validated for determining total, soluble, and precipitated sulfur in wastewater treatment sludges. The coefficient of variation of this method was less than 4.0%. The recovery of dosed sulfur from sludge samples was between 97.1% and 100.5%. The composition of sulfur in primary and waste-activated sludge (WAS) before and after anaerobic digestion at 35 and 55 degrees C was characterized by employing this developed method. There was not an apparent relationship between the precipitated sulfur and nonsoluble iron concentrations in sludges. Raw WAS had a more consistent organic sulfur fractionation because of its relatively homogeneous composition. The organic-sulfur-containing components (proteins) of WAS had reduced degradability as compared with that in primary sludge during anaerobic digestion. Digestion at 55 degrees C increased solubilization but not ultimate conversion of organic sulfur in sludge.

Lineage switch in a pediatric patient with KMT2A-MLLT3 from acute megakaryoblastic leukemia to T cell acute lymphoblastic leukemia at the fourth relapse after allo-HSCT: with literature review.

We present a patient with acute megakaryoblastic leukemia (AMKL) harboring KMT2A-MLLT3 that converted to T cell acute lymphoblastic leukemia (T-ALL) at her fourth relapse. A 4-year-old girl developed AMKL with multiple swollen lymph nodes. She exhibited several recurrences in the bone marrow and died of septic shock after her fourth relapse. Bone marrow cells at the initial diagnosis and at all four relapses had the same KMT2A-MLLT3 fusion transcript. She also developed a somatic mutation (c.7177C > T p.Q2393X) of NOTCH1 at the fourth relapse. This sequential phenotypic and cytogenetic study may yield valuable insights into the mechanism of AMKL to T-ALL lineage switch and possible implications for treatment selection.

Decoding SEC24 Homolog D, COPII coat complex component accuracy as a signature gene in three human cancers.

Although an increasing body of evidence supports the crucial role of the SEC24 Homolog D, COPII Coat Complex Component (SEC24D) gene in the initiation and progression of cancer, a comprehensive pan-cancer analysis of this gene is still lacking. In this study, we conducted an extensive investigation of SEC24D, aiming to elucidate its potential role and underlying mechanisms across multiple human tumors. Our analysis relied on data from The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) databases. To validate our findings, we employed RNA sequencing (RNA-seq), targeted bisulfite sequencing (bisulfite-seq) molecular techniques. Our findings revealed elevated mRNA (Messenger RNA) and protein levels of SEC24D in different tumor tissues. However, the up-regulation of SEC24D was significantly correlated with shorter overall survival (OS), metastasis, and various clinical parameters in esophageal cancer (ESCA), lung adenocarcinoma (LUAD), and kidney renal papillary cell carcinoma (KIRP). Expression validation analysis via RNA-seq and targeted bisulfite-seq analyses, further confirmed the higher expression of SEC24D in LUAD cancer cell lines as compared to normal controls. The DNA methylation level of SEC24D was found to be decreased in ESCA, LUAD, and KIRP samples. DNA methylation analysis via bisulfite-seq analysis also validate the lower promoter methylation level of SE24D in LUAD cell lines relative to controls. Moreover, we observed a significant association between the elevated expression of SEC24D and the levels of infiltrating cells, such as B cells, neutrophils, macrophages, CD8+ T cells, and CD4+ T cells. Analysis of SEC24-related genes revealed that "Protein processing in endoplasmic reticulum, SNARE interaction in vesicular transport, Legionellosis, Pathogenic Escherichia coli infection" were mainly involved in the functional mechanism of SEC24D in ESCA, LUAD, and KIRP. Moreover, we also suggested a few valuable drugs (Acetaminophen, Acteoside, Cyclosporine, Polydatin, Estradiol, Estradiol, Quercetin) for treating ESCA, LUAD, and KIRP patients with respect to overexpressed SEC24D. To summarize, this comprehensive pan-cancer study investigated the association between SEC24D expression and clinical parameters in ESCA, LUAD, KIRP. The study provides valuable insights for further exploring the functional and therapeutic aspects of SEC24D and underscores its predictive significance in the carcinogenesis and prognosis of these specific cancer types.

[Safety and the Short-Term Efficacy of Venetoclax Combined with Azacitidine Followed by Cladribine in Children with Refractory/Relapsed Acute Myeloid Leukemia].

OBJECTIVE: To investigate the safety and the short-term efficacy of venetoclax combined with azacitidine followed by cladribine (VAC regimen) in children with refractory/ relapsed acute myeloid leukemia (AML). METHODS: The clinical data, treatment outcomes, complications, and blood product consumption of 6 children with refractory/relapsed AML treated with VAC regimen in the Children's Hospital of Soochow University from August 2021 to December 2021 were retrospectively analyzed. RESULTS: Among the 6 children, there were 1 male and 5 females. 5 cases were refractory AML, and 1 case was relapsed AML, which recurred again 16 months after allogeneic hematopoietic stem cell transplantation. 4 children were accompanied by chromosomes or genes that predicted poor prognosis, such as RUNX1, FLT3-ITD, KMT2A exon 2-exon 8 dup, MLL-AF6, 7q-, KMT2A exon 2-exon 10 dup, etc. After received VAC regimen, 4 cases achieved CR+CRi, 1 case achieved PR (only MRD did not relieve, MRD was 0.59%), and 1 case was NR (but the proportion of bone marrow blasts decreased). All 6 patients had grade Ⅳ neutropenia, and 4 patients had grade Ⅳ thrombocytopenia. During the period of neutropenia, none of the 6 children developed symptoms of infection such as fever, cough, and diarrhea. No treatment-related death occurred. CONCLUSION: Venetoclax combined with azacitidine followed by cladribine provides a new treatment option for patients with relapsed/refractory AML who have poor efficacy in early induction remission theragy, showing good efficacy and safety.

Occupational exposure influences on gender differences in respiratory health.

BACKGROUND: The aim of this study was to evaluate gender differences in the respiratory health of workers exposed to organic and inorganic dusts. METHODS: Meta-analysis techniques incorporating logistic regression were applied to a combined file of 12 occupational health studies. RESULTS: Meta-analysis of data on 1,367 women and 4,240 men showed that women had higher odds of shortness of breath whether exposed to inorganic dust or having no occupational exposure, with an overall odds ratio (OR) of 2.07 (95% confidence interval [CI] = 1.57-2.73) adjusted for smoking status, age, body mass index (BMI), ethnic status, atopy, and job duration. Inorganic dust exposure was associated with the highest odds of asthma (adjusted OR = 8.38, 95% CI = 1.72-40.89) for women compared to men, but no differences were found for unexposed workers. With organic dust exposure, men had elevated odds for occasional wheeze and worse lung function compared to women. CONCLUSION: Within the limitations of this analysis, gender differences in respiratory health, as suggested by population-based studies, were confirmed in our analysis of occupational health studies, with the general type of exposure, organic or inorganic, generally determining the extent of differences. The higher risks for women compared to men for shortness of breath were robust regardless of work exposure category, with the highest odds ratios found for asthma.

Liquid-gas partitioning of selected volatile organic sulfur compounds in anaerobically digested sludges.

The gas phase partitioning of volatile organic sulfur compounds (VOSCs) in anaerobic sludge digesters contributes to odors and can impact upon the suitability of biogases for use in alternative energy recovery technologies. In the present study, effective Henry's law coefficients (H') were estimated for methyl mercaptan (MM), dimethyl sulfide (DMS), and dimethyl disulfide (DMDS) in both deionized water and deactivated digested sludge. It was found that the complex matrix of digested sludge did not significantly affect the partitioning of VOSCs. Therefore, partitioning of VOSCs in digesters could be represented by their partitioning in clean water. A regression model was developed for the linear relationship between ln H' and 1/T in the gas-water system. The H' values of MM, DMS, and DMDS were able to be calculated over a temperature range of 12-58 °C.

[Investigation of occupational hazards of ultraviolet radiation and protective measures for workers in electric welding].

OBJECTIVE: To investigate and analyze the occupational hazards of ultraviolet radiation, protective measures and related factors for typical symptoms among workers in electric welding, and to provide basic information for revision of the occupational standards of UV. METHODS: Questionnaires and physical examinations were used in this investigation. A total of 828 workers from four vehicle manufacturers in Beijing and Guangdong Province were selected. Corresponding analyses were conducted with SPSS 16.0 statistic software. RESULTS: The top three injuries of faces and hands were burning tingling (48.7% & 41.3%), itch of skin (39% & 34.9%) and pigmentation (31.9% & 24.5%).The major injuries of eyes were ophthalmodynia (61.5%) , photophobia and tearing (61.4%), and blurred vision (50.2%). The incidences of facial and hands burning tingling, hands flushing, hands macula and papula were significantly different between the welders and auxiliary workers (P<0.05). The differences of facial and hands burning tingling, flushing, facial disesthesia and anaesthesia, symptoms and signs of eyes were significant in different working years groups (P<0.05). The top three usages of protective measures were welding masks (87.2%), gloves (84.3%) and glasses (65.9%). Except for UV cut cream, the usages of other protective equipments in the auxiliary workers were significantly lower than those in the welders (P<0.05). The logistic regression analysis showed that prolonged exposure to arc welding, using argon arc welding and CO(2) gas shielded arc welding, not wearing welding masks, and not using UV cut cream was significantly associated with the increased risk of face burning tingling, and the ORs were 3.894 (6 h to 8 h), 2.665 (4 h to 6 h), 2.052, 1.765, 1.759, 1.833, respectively; working years might be a protective factor, and the OR was 0.440, respectively. CONCLUSION: The study suggested that the UV radiation produced during welding operations not only caused harm to welders, but also to the auxiliary workers. Protection should be strengthened,for example, wearing welding masks, glasses, etc. Meanwhile automatic welding machines should be adopted by the factories to reduce the exposure time for workers.

[The assessment of reliability and validity of musculoskeletal questionnaire].

OBJECTIVE: To evaluate the reliability and validity of musculoskeletal questionnaire. METHODS: A self-administered modified musculoskeletal questionnaire was used to investigate 12 098 workers from eight occupations, i.e. coal mining, petroleum, metallurgical, mechanical manufacturing, chemical, garment and railroad transportation industries and education. The Cronbach's α coefficient, analysis of covariance and multiple logistic regression were used to assess the reliability and validity of musculoskeletal questionnaire. RESULTS: The consistent test between total items of Musculoskeletal Questionnaire and each factor showed that the range of Cronbach's α was 0.52 ∼ 0.92, except from vibration factor, other Cronbach's α was more than 0.7. All 55 items of Musculoskeletal Questionnaire were subjected to factor analysis, and ten latent factors were identified, which explained 55.17% of the total variance. The potentially hazardous working conditions could be categorized into seven dimensions (force, dynamic load, static load, repetitive load, climate factors, vibration exposure and environmental ergonomic factor), which consisted with the theory model. The results of covariance analysis indicated that there were significant difference among 7 dimension indices in different jobs (P < 0.01). CONCLUSION: The modified Musculoskeletal Questionnaire is a valid and reliable tool for measuring musculoskeletal workload.

Analysis of the interaction between A1 R and A2A R proteins in living cells based on FRET imaging and batch processing method.

The quantitative FRET analysis of living cells is a tedious and time-consuming task for freshman lacks technical training. In this study, FRET imaging and batch processing method were combined to analyze reagents-induced interactions of A1 R and A2A R on cell membranes. Results showed that the method had taken less time than if cell-by-cell was analyzed. The accuracy and repeatability of FRET efficiency values were likewise improved by removing the interference from anthropogenic factors. Then this method was applied to rapidly analyze acetaldehyde-induced interactions, which analyzed hundreds of single-cell trends by one operation, and the results revealed that interactions were consistently attenuated in LX-2 cells, and statistical differences appeared after 30 min. Combined with batch processing method, procedures of cells FRET analysis have been greatly simplified without additional technical work, which has broad prospects in large-scale analysis of cellar protein interaction.

Exposure parameters and health risk of Cryptosporidium and Giardia in the recreational water activities for urban residents in China.

Knowledge gaps in the exposure parameters for recreational water activities make quantitative risk assessment related to water recreation difficult. Therefore, the annual exposure frequency and single exposure duration for the recreational water activities of residents from ten cities in the North and South of China were investigated. Questionnaire interviews were carried on recreational water activities comprising swimming (SW), boating (BA), playing in interactive fountains (PF), and watching fountains (WF). Quantitative microbial risk assessment for the exposure of urban residents to Cryptosporidium and Giardia was also performed. For the four recreational water activities, the participation rates of urban residents in SW and WF were higher than the others. For SW and BA, the mean annual exposure frequency and single exposure duration for males were significantly higher than those for females. PF and WF showed the opposite. The annual exposure frequency for above 35-year-old residents was higher than that for young residents (18-35 years). However, the single exposure duration for young residents was highest in SW, BA, and PF. The mean annual exposure frequency and single exposure duration for North China residents were higher than those for South China residents in all recreational water activities, except for SW. Overall, the annual exposure frequency and single exposure duration in recreational water activities for all urban residents followed a lognormal distribution. In the four recreational water activities, the total annual infection risk of male exposure to Cryptosporidium was 1.0 × 10-2, with the confidence intervals between 95 and 5% of [4.3 × 10-4, 3.7 × 10-2], whereas that for females was 6.8 × 10-3 and [4.2 × 10-4, 2.4 × 10-2]. Also, the annual infection risk of males to Giardia was 8.8 × 10-3 and [5.1×10-4, 3.2×10-2], and that of females was 5.3 × 10-3 and [4.0 × 10-4, 1.8 × 10-2]. These results demonstrated that SW and PF made the highest contribution to the total annual infection risk. Sensitivity analysis highlighted that the characterization of exposure parameters plays a critical role in health risk assessment, which may provide a scientific basis for recreational water quality standards formulation.

Submucosal protuberance caused by a fish bone in the absence of preoperative positive signs: A case report.

BACKGROUND: Submucosal protuberance caused by fish bone insertion into the digestive tract has rarely been reported. These cases usually include patients with clear signs such as a history of fish intake, pain, and dysphagia, as well as positive findings on endoscopy and imaging. Here, we report a case of a fish bone hidden in the submucosal protuberance of the gastric antrum during endoscopic submucosal dissection without preoperative obvious positive signs. CASE SUMMARY: A 58-year-old woman presented with epigastric pain for the past 20 d and a submucosal protuberance. Abdominal computed tomography and endoscopic ultrasonography did not indicate the presence of a fish bone. We assumed the cause to be an ordinary submucosal eminence and performed an endoscopic submucosal dissection to confirm its essence. During the operation, a fish bone approximately 20 mm in length was found incidentally. CONCLUSION: Our report could potentially prevent the oversight of embedded fish bones and associated adverse effects in patients with similar presentation.

Label-free detection of bladder cancer and kidney cancer plasma based on SERS and multivariate statistical algorithm.

In this study, we mainly aimed to investigate the diagnostic potential of surface-enhanced Raman spectroscopy for bladder cancer and kidney cancer which are the most common cancers of the urinary system, and evaluate the classification ability of three statistical algorithms: principal component analysis-linear discriminate analysis (PCA-LDA), partial least square-random forest (PLS-RF), and partial least square-support vector machine (PLS-SVM). The plasma of 26 bladder cancer patients, 38 kidney cancer patients and 39 normal subjects was mixed with the same volume of silver nanoparticles, respectively, and then high-quality SERS signal was obtained. The SERS spectra in the range of 400-1800 cm-1 were compared and analyzed. There were some significant differences in SERS peak intensity, which may reflect the changes in the content of some biomacromolecules in the plasma of cancer patients. Based on the three algorithms of PCA-LDA, PLS-RF and PLS-SVM, the classification accuracy of SERS spectra of plasma from cancer patients and normal subjects was 98.1%, 100% and 100%, respectively. In addition, the classification accuracy of the three diagnostic algorithms to classify the SERS spectra of bladder cancer and kidney cancer was 81.3%, 91.7%, and 98.4%, respectively. This exploratory work demonstrates that SERS combined with PLS-SVM algorithm has superior performance for clinical screening of bladder cancer and kidney cancer through peripheral plasma.