Using a CT-based scale to evaluate disease extension and the resectability of locally advanced thyroid cancer.

OBJECTIVES: To establish a computed tomography (CT)-based scale to evaluate the resectability of locally advanced thyroid cancer. METHODS: This twin-centre retrospective study included 95 locally advanced thyroid cancer patients from the 1st centre as the training cohort and 31 patients from the 2nd centre as the testing cohort, who were categorised into the resectable and unresectable groups. Three radiologists scored the CT scans of each patient by evaluating the extension to the recurrent laryngeal nerve (RLN), trachea, oesophagus, artery, vein, soft tissue, and larynx. A 14-score scale (including all comprised structures) and a 12-score scale (excluding larynx) were developed. Receiver-operating characteristic (ROC) analysis was used to evaluate the performance of the scales. Stratified fivefold cross-validation and external verification were used to validate the scale. RESULTS: In the training cohort, compromised RLN (p < 0.001), trachea (p = 0.001), oesophagus (p = 0.002), artery (p < 0.001), vein (p = 0.005), and soft tissue (p < 0.001) were predictors for unresectability, while compromised larynx (p = 0.283) was not. The 12-score scale (AUC = 0.882, 95%CI: 0.812-0.952) was not inferior to the 14-score scale (AUC = 0.891, 95%CI: 0.823-0.960). In subgroup analysis, the AUCs of the 12-score scale were 0.826 for treatment-naïve patients and 0.976 for patients with prior surgery. The 12-score scale was further validated with a fivefold cross-validation analysis, with an overall accuracy of 78.9-89.4%. Finally, external validation using the testing cohort showed an AUC of 0.875. CONCLUSIONS: The researchers built a CT-based 12-score scale to evaluate the resectability of locally advanced thyroid cancer. Validation with a larger sample size is required to confirm the efficacy of the scale. CLINICAL RELEVANCE STATEMENT: This 12-score CT scale would help clinicians evaluate the resectability of locally advanced thyroid cancer. KEY POINTS: • The researchers built a 12-score CT scale (including recurrent laryngeal nerve, trachea, oesophagus, artery, vein, and soft tissue) to evaluate the resectability of locally advanced thyroid cancer. • This scale has the potential to help clinicians make treatment plans for locally advanced thyroid cancer.

Value of Dynamic Contrast-Enhanced (DCE) MRI in Predicting Response to Foam Sclerotherapy of Venous Malformations.

BACKGROUND: Preoperative imaging assessment of venous malformations (VMs) and prediction of foam sclerotherapy efficacy might be achievable by DCE-MRI but elaborate quantitive analysis was absent. PURPOSE: To evaluate the value of DCE-MRI in predicting the effectiveness of foam sclerotherapy in VMs. STUDY TYPE: Retrospective. POPULATION: Fifty-five patients (M:F = 17:38; mean age ± SD, 15.4 ± 13.0 years) with VMs. FIELD STRENGTH/SEQUENCE: Three Tesla MRI with 3D T1 -weighted volume interpolated body examination. ASSESSMENT: Patients who underwent pretreatment DCE-MRI were divided into "effective" and "ineffective" groups according to the response to foam sclerotherapy. Clinical characteristics and morphologic features were assessed. The semiquantitative parameters, such as maximum intensity time ratio (MITR), enhancement ratio (ER), and Slope, were obtained from ROI and volume of interest (VOI). The quartile and mean values of these parameters were acquired from VOI, while mean values denoted as Mean# were acquired from ROI. Establishment of two predictive models was based on ROI and VOI respectively. Model 1 was based on morphologic parameters and ROI semiquantitative parameters, while model 2 was based on morphologic parameters and VOI semiquantitative parameters. STATISTICAL ANALYSIS: Mann-Whitney U-test, Cohen's kappa, multivariate logistic regression analysis (backward stepwise), and ROC analyses. RESULTS: The lesion classification, presence of phlebolith, semiquantitative parameters of VOI (quartile and mean of MITR), and semiquantitative parameters of ROI (Slopemean# , MITRmean# ) were significantly different between two groups. Lesion classification (P = 0.002) and MITRmean# (P = 0.027) were independent predictors for poor efficacy in model 1 as determined by multivariate binary logistic regression analysis. For model 2, lesion classification (P = 0.006) and MITR25 (P = 0.001) were independent predictors. The predictive model based on VOI (AUC = 0.961) performed better than that based on ROI (AUC = 0.909) in predicting therapeutic response. DATA CONCLUSION: DCE-MRI is promising in predicting the response to foam sclerotherapy for VMs. The whole lesion VOI-based model showed better performance and could instruct surgical approach in the future. EVIDENCE LEVEL: 3 TECHNICAL EFFICACY: Stage 4.

Histogram analysis of dynamic contrast-enhanced magnetic resonance imaging in the differential diagnosis of parotid tumors.

OBJECTIVE: Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) histograms were used to investigate whether their parameters can distinguish between benign and malignant parotid gland tumors and further differentiate tumor subgroups. MATERIALS AND METHODS: A total of 117 patients (32 malignant and 85 benign) who had undergone DCE-MRI for pretreatment evaluation were retrospectively included. Histogram parameters including mean, median, entropy, skewness, kurtosis and 10th, 90th percentiles were calculated from time to peak (TTP) (s), wash in rate (WIR) (l/s), wash out rate (WOR) (l/s), and maximum relative enhancement (MRE) (%) mono-exponential models. The Mann-Whitney U test was used to compare the differences between the benign and malignant groups. The diagnostic value of each significant parameter was determined on Receiver operating characteristic (ROC) analysis. Multivariate stepwise logistic regression analysis was used to identify the independent predictors of the different tumor groups. RESULTS: For both the benign and malignant groups and the comparisons among the subgroups, the parameters of TTP and MRE showed better performance among the various parameters. WOR can be used as an indicator to distinguish Warthin's tumors from other tumors. Warthin's tumors showed significantly lower values on 10th MRE and significantly higher values on skewness TTP and 10th WOR, and the combination of 10th MRE, skewness TTP and 10th WOR showed optimal diagnostic performance (AUC, 0.971) and provided 93.12% sensitivity and 96.70% specificity. After Warthin's tumors were removed from among the benign tumors, malignant parotid tumors showed significantly lower values on the 10th TTP (AUC, 0.847; sensitivity 90.62%; specificity 69.09%; P < 0.05) and higher values on skewness MRE (AUC, 0.777; sensitivity 71.87%; specificity 76.36%; P < 0.05). CONCLUSION: DCE-MRI histogram parameters, especially TTP and MRE parameters, show promise as effective indicators for identifying and classifying parotid tumors. Entropy TTP and kurtosis MRE were found to be independent differentiating variables for malignant parotid gland tumors. The 10th WOR can be used as an indicator to distinguish Warthin's tumors from other tumors.

Influence of in ovo thermal manipulation on lipid metabolism in embryonic duck liver.

The growth and development of poultry embryos are easily affected by environmental factors, such as the incubation temperature and humidity. Metabolism, including lipid metabolism, during the embryonic stage is also important for the growth and development of poultry. Our study aimed to investigate the effects of incubation temperature on embryonic lipid metabolism in the liver of ducks. To fully evaluate the effects, thermal treatment was given between embryonic ages 11 and 24 days with a 1 °C higher incubation temperature than the control group, and lipid metabolism parameters in the liver and blood serum were analyzed both at embryonic stage day 20 and 2 weeks post-hatching. Our results showed no significant changes in the embryonic stage in total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) in the blood serum (P>0.05). Additionally, the mRNA expression levels and enzyme activities of fatty acid synthase (FAS), acetyl CoA carboxylase (ACC), and elongase of very long chain fatty acids (ELOVL) did not show significant changes either in the embryonic stage or at hatching day 20 (P>0.05). However, there were significant changes in the gene expression and enzyme activities of TC, LDL-C and FAS at post-hatching stages (P≤0.05). These results may indicate that the thermal treatment has less influence on lipid metabolism in the embryonic stage but has a much stronger effect in the post-hatching stage.

Lightweight colon polyp segmentation algorithm based on improved DeepLabV3.

To address the problems that the current polyp segmentation model is complicated and the segmentation accuracy needs to be further improved, a lightweight polyp segmentation network model Li-DeepLabV3+ is proposed. Firstly, the optimized MobileNetV2 network is used as the backbone network to reduce the model complexity. Secondly, an improved simple pyramid pooling module is used to replace the original Atrous Spatial Pyramid Pooling structure, which improves the model training efficiency of the model while reducing the model parameters. Finally, to enhance the feature representation, in the feature fusion module, the low-level feature and the high-level feature are fused using the improved Unified Attention Fusion Module, which applies both channel and spatial attention to enrich the fused features, thus obtaining more boundary information. The model was combined with transfer learning for training and validation on the CVC-ClinicDB and Kvasir SEG datasets, and the generalization of the model was verified across the datasets. The experiment results show that the Li-DeepLabV3+ model has superior advantages in segmentation accuracy and segmentation speed, and has certain generalization abilities.

Silver-Catalyzed Direct Nucleophilic Cyclization: Enantioselective De Novo Synthesis of C-C Axially Chiral 2-Arylindoles.

Atropisomeric indoles widely exist in natural products, pharmaceuticals, functional materials, and catalysts for their featured biological activities, photoelectric properties, and catalytic activities, while facile and de novo construction of this motif remains underexplored. Herein, we report a chiral silver phosphate-catalyzed direct 5-endo-dig nucleophilic cyclization of 2-alkynylanilins under mild conditions, affording various C-C axially chiral 2-arylindoles in high to excellent yields and enantioselectivities. Control experiments implied the cooperative catalysis of AgOAc and chiral phosphoric acid, wherein the former accelerated the desired transformation while the latter improved the enantioselectivity. In addition, as the first example of silver-catalyzed enantioselective de novo synthesis of C-C axially chiral indole skeletons, synthetic applications and products' thermal stability have been investigated.

Applying multisequence MRI radiomics of the primary tumor and lymph node to predict HPV-related p16 status in patients with oropharyngeal squamous cell carcinoma.

Background: Human papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma (OPSCC) is currently rising in incidence; however, a noninvasive approach to predicting HPV status that strongly correlates with p16 expression is lacking. This study aimed to develop a radiomics model based on multisequence magnetic resonance imaging (MRI) of primary tumor (PT) and lymph node (LN)-fused imaging features for the prediction of p16 status in OPSCC. Methods: In this retrospective study, 141 patients (comprising 116 patients in the training cohort and 25 patients in the testing cohort) with histopathologically confirmed (OPSCC) were enrolled consecutively from Fudan University Shanghai Cancer Center and Shanghai Ninth People's Hospital between January 2011 and December 2020. HPV status was determined by p16 immunohistochemistry analysis. A total of 2092 radiomics features were initially computed and extracted from the 3D-segmented PT and largest LN based on contrast-enhanced T1-weighted imaging (CE-T1WI) and T2-weighted imaging (T2WI). A support vector machine classifier was employed to build the machine learning-based classification models dependent on p16 status. The models were validated in the testing cohort. The area under the receiver operating characteristic curve (AUC) was computed to assess the performance of each model. This diagnostic study was not registered on the clinical trial platform. Results: In the testing cohort, fusion models yielded better performance (AUC) compared with models based on a sole PT/LN [CE-T1WI: 0.80 (95% CI: 0.55-0.94) vs. 0.71 (95% CI: 0.47-0.88)/0.73 (95% CI: 0.48-0.90); T2WI: 0.74 (95% CI: 0.51-0.95) vs. 0.64 (95% CI: 0.38-0.85)/0.71 (95% CI: 0.48-0.88)]. Models based on multisequence imaging outperformed single CE-T1WI/T2WI models [PT: 0.74 (95% CI: 0.46-0.91) vs. 0.71 (95% CI: 0.47-0.88)/0.64 (95% CI: 0.38-0.85); LN: 0.78 (95% CI: 0.55-0.75) vs. 0.73 (95% CI: 0.48-0.90)/0.71 (95% CI: 0.48-0.88)]. Finally, the PT-LN fusion model based on multisequencing yielded the best classification performance with the highest AUC value of 0.91 (95% CI: 0.72-0.98) for the prediction of p16 expression. The differences between the performance of the final model and the other 8 models were significant (all P values <0.05). Conclusions: The results demonstrated that (I) the PT-LN fusion radiomics models improved the classification performance of the sole use of PT or LN for the prediction of p16 status, (II) the radiomics models based on multisequences outperformed the single-sequence models in the prediction of p16 status, and (III) the PT-LN fusion model based on multisequence MRI radiomics features could serve as a noninvasive method for acquiring the molecular information of patients with OPSCC, potentially assisting oncologists with their clinical decision-making.

PSegNet: Simultaneous Semantic and Instance Segmentation for Point Clouds of Plants.

Phenotyping of plant growth improves the understanding of complex genetic traits and eventually expedites the development of modern breeding and intelligent agriculture. In phenotyping, segmentation of 3D point clouds of plant organs such as leaves and stems contributes to automatic growth monitoring and reflects the extent of stress received by the plant. In this work, we first proposed the Voxelized Farthest Point Sampling (VFPS), a novel point cloud downsampling strategy, to prepare our plant dataset for training of deep neural networks. Then, a deep learning network-PSegNet, was specially designed for segmenting point clouds of several species of plants. The effectiveness of PSegNet originates from three new modules including the Double-Neighborhood Feature Extraction Block (DNFEB), the Double-Granularity Feature Fusion Module (DGFFM), and the Attention Module (AM). After training on the plant dataset prepared with VFPS, the network can simultaneously realize the semantic segmentation and the leaf instance segmentation for three plant species. Comparing to several mainstream networks such as PointNet++, ASIS, SGPN, and PlantNet, the PSegNet obtained the best segmentation results quantitatively and qualitatively. In semantic segmentation, PSegNet achieved 95.23%, 93.85%, 94.52%, and 89.90% for the mean Prec, Rec, F1, and IoU, respectively. In instance segmentation, PSegNet achieved 88.13%, 79.28%, 83.35%, and 89.54% for the mPrec, mRec, mCov, and mWCov, respectively.

Role of Canonical Wnt/ß-Catenin Pathway in Regulating Chondrocytic Hypertrophy in Mesenchymal Stem Cell-Based Cartilage Tissue Engineering.

In the past 3 decades, the cartilage repair potential of mesenchymal stromal cells, or mesenchymal stem cells (MSCs), has been widely examined in animal studies. Unfortunately, the phenotype and physical properties of MSC-derived cartilage tissue are not comparable to native hyaline cartilage. In particular, chondrocytic hypertrophy, a phenotype that is not observed in healthy hyaline cartilage, is concomitant with MSC chondrogenesis. Given that hypertrophic chondrocytes potentially undergo apoptosis or convert into osteoblasts, this undesired phenotype needs to be prevented or minimized before MSCs can be used to repair cartilage injuries in the clinic. In this review, we first provide an overview of chondrocytic hypertrophy and briefly summarize current methods for suppressing hypertrophy in MSC-derived cartilage. We then highlight recent progress on modulating the canonical Wnt/ß-catenin pathway for inhibiting hypertrophy. Specially, we discuss the potential crosstalk between Wnt/ß-catenin with other pathways in regulating hypertrophy. Lastly, we explore future perspectives to further understand the role of Wnt/ß-catenin in chondrocytic hypertrophy.

[Clinical observation on cake-separated mild-warm moxibustion for treatment of knee osteoarthritis].

OBJECTIVE: To observe clinical therapeutic effect of monkshood cake-separated mild-warm moxibustion at Zusanli (ST 36) and Xiyan (EX-LE 5) on knee osteoarthritis. METHODS: The patients of monkshood cake-separated mild-warm moxibustion group were treated with monkshood cake-separated mild-warm moxibustion at Dubi (ST 35), Zusanli (ST 36) and Neixiyan (EX-LE 4) on the affected side, and the medication group with oral administration of Xianling Gubao Capsules. After treatment for 4 weeks, VAS and index of severity of osteoarthritis (ISOA scale) were used for assessment of clinical therapeutic effect. RESULTS: After treatment, the arthralgia and the index of severity significantly improved in the two groups (P < 0.01), and the analgesic effect and improvement of ISOA in the monkshood cake-separated mild-warm moxibustion group were better than those in the medication group (P < 0.05). The basic clinical cured rate was 80.0% and the effect-producing time was (10.91 +/- 4.17) days in the monkshood cake-separated mild-warm moxibustion group, and 53.3% and (12.28 +/- 4.60) days in the medication group, respectively, with a significant difference between the two groups (P < 0.05). CONCLUSION: Therapeutic effect of monkshood cake-separated mild-warm moxibustion on knee osteoarthritis is better than that of oral administration of Xianling Gubao Capsules.

[Clinical observation on treatment of rheumatoid arthritis with cake-separated mild moxibustion combined with Western medicine].

OBJECTIVE: To observe the effect-increasing action of cake-separated mild moxibustion on rheumatoid arthritis (RA), and to probe a new method for RA. METHODS: Sixty cases were randomly divided into 2 groups. The control group (n=30) were treated with oral administration of methotrexate (MTX) as basic treatment, and non-steroid anti-inflammatory agents (NSAIDs) according to conditions of the patient. The treatment group (n=30) were treated with the same treatment as the control group, and Fuzi case-separated moxibustion at Guanyuan (CV 4) and Zusanli (ST 36) was added. They were treated for 3 months. RESULTS: After treatment of 3 months, the total effective rate was 83.3% in the treatment group, which was higher than 60.0% in the control group (P < 0.05); there were significant differences before and after treatment in all indexes in the two groups (P < 0.05 or P < 0.01); the ratio of the patients who completely withdrew NSAIDs in the treatment group was significantly higher than that in the control group (P < 0.05); the rate of adverse reaction in the treatment group was significantly lower than that in the control group (P < 0.05). CONCLUSION: Fuzi cake-separated mild moxibustion can increase clinical therapeutic effect on RA and reduce dosage of NSAIDs.