Deep convolutional neural network based on CT images of pulmonary nodules in the lungs of adolescent and young adult patients with osteosarcoma.

The aim of the present study was to explore the diagnostic value of a deep convolutional neural network (DCNN) model for the diagnosis of pulmonary nodules in adolescent and young adult patients with osteosarcoma. For the present study, 675 chest CT images were retrospectively collected from 109 patients with clinically confirmed osteosarcoma who underwent chest CT examination at Hangzhou Third People's Hospital (Hangzhou, China) from March 2011 to February 2022. CT images were then evaluated using the DCNN and manual models. Subsequently, pulmonary nodules of osteosarcoma were divided into calcified nodules, solid nodules, partially solid nodules and ground glass nodules using the DCNN model. Those patients with osteosarcoma who were diagnosed and treated were followed up to observe dynamic changes in the pulmonary nodules. A total of 3,087 nodules were detected, while 278 nodules were missed compared with those determined using the reference standard given by the consensus of three Experienced radiologists., which was analyzed by two diagnostic radiologists. In the manual model group, 2,442 nodules were detected, while 657 nodules were missed. The DCNN model showed significantly higher sensitivity and specificity compared with the manual model (sensitivity, 0.923 vs. 0.908; specificity, 0.552 vs. 0.351; P<0.05). In addition, the DCNN model yielded an area under the curve (AUC) value of 0.795 [95% confidence interval (CI), 0.743-0.846], outperforming that of the manual model (AUC, 0.687; 95% CI, 0.629-0.732; P<0.05). The film reading time of the DCNN model was also significantly shorter compared with that of the manual model [mean ± standard deviation (SD); 173.25±24.10 vs. 328.32±22.72 sec; P<0.05)]. The AUC of calcified nodules, solid nodules, partially solid nodules and ground glass nodules was calculated to be 0.766, 0.771, 0.761 and 0.796, respectively, using the DCNN model. Using this model, the majority of the pulmonary nodules were detected in patients with osteosarcoma at the initial diagnosis (69/109, 62.3%), and the majority of these were found with multiple pulmonary nodules instead of a single nodule (71/109, 65.1% vs. 38/109, 34.9%). These data suggest that, compared with the manual model, the DCNN model proved to be beneficial for the detection of pulmonary nodules in adolescent and young adult patients with osteosarcoma, which may reduce the time of artificial radiograph reading. In conclusion, the proposed DCNN model, developed using data from 675 chest CT images retrospectively collected from 109 patients with clinically confirmed osteosarcoma, may be used as an effective tool to evaluate pulmonary nodules in patients with osteosarcoma.

New monoterpenoid oxindole alkaloid derivatives from the stems of Uncaria hirsuta Havil. and their cytotoxicity and tandem mass spectrometric fragmentation.

Four new alkaloids, comprising three 3-oxo-3,7-seco-oxindole alkaloids (hirsutanine D-F, 1-3) and one oxindole alkaloid N-oxide (uncarine B N-oxide, 4), together with four known heteroyohimbine-type oxindole alkaloids, were isolated from the stems of Uncaria hirsuta Havil. Structures of 1-4 were elucidated by extensive NMR and HR-ESIMS data analyses. Compound 3 is the first 3-oxo-3,7-seco-oxindole alkaloid with ring B opened and degraded isolated from the Uncaria genus. Compounds 1-3 exhibited slight inhibition effect on the proliferation of the breast cancer cell MDA-MB-231. The positive mode collision-induced dissociation of the 3-oxo-3,7-seco-oxindole alkaloids (1-3) was featured by the ß-cleavage and α-cleavage of the amido bond, while the N-oxide (4) showed characteristic neutral eliminations of ·OH and H2O.

Venenum Bufonis induces rat neuroinflammation by activiating NF-κB pathway and attenuation of BDNF.

ETHNOPHARMACOLOGICAL RELEVANCE: Venenum Bufonis (VB), also called toad venom, has been widely used in clinic as a cardiotonic, anohyne and antineoplastic agents both in China and other Asian countries. However, its neurotoxicity and cardiotoxicity limit its wide clinical application. Compared with extensive attention attracted with cardiotoxicity, the toxic effect of VB on Central Nervous System (CNS) is much less studied. AIM OF THE RESEARCH: This study was performed to examine the neurotoxicity caused by VB on Sprague Dawley (SD) rats, then to clarify the mechanism in vivo by investigating its action on the neuroinflammation which possibly attributed to the activation of nuclear factor κB (NF-κB) pathway and the attenuation of brain-derived neurotrophic factor (BDNF). MATERIALS AND METHODS: Rats administrated with 0.5% carboxymethyl cellulose sodium salt (CMC-Na) aqueous solution and VB (100mg/kg, 200mg/kg and 400mg/kg) were sacrificed at 2h, 4h, 6h, 8h, 24h and 48h. The brain level of neurotransmitters and their corresponding receptors, pro-inflammatory cytokines, BDNF/TrkB and NF-κB pathway-related proteins were examined, respectively. RESULTS: VB administration induced severe neurologic damage and neuroinflammation, as indicated by the disordered 5-hydroxytryptamine (5-HT), dopamine (DA) and their corresponding receptors, together with the over production of inflammatory cytokines including interleukin-6 (IL-6), interleukin-1ß (IL-1ß) and tumor necrosis factor-α (TNF-α). VB also notably promoted the expression of p-NF-κBp65, p-IκBα, p-IKKα and p-IKKß and down-regulated the expression of BDNF and TrkB. CONCLUSION: This study demonstrates that VB triggers neurotoxicity which probably is induced by neuroinflammation via activating of NF-κB pathway and attenuating the expression of BDNF.

Comparison of distraction osteogenesis versus costochondral graft in reconstruction of temporomandibular joint condylectomy with disc preservation.

PURPOSE: This study compared transport distraction with costochondral graft in the reconstruction of temporomandibular joint (TMJ) with disc preservation. MATERIALS AND METHODS: Bilateral condylectomies with disc preservation were conducted in 12 adult goats. Transport distraction of the mandibular ramus was performed on 1 side and costochondral graft on the other side. Jaw movements, TMJ healing, and condylar remodeling were assessed by clinical, radiologic, and histologic examinations. RESULTS: Transport distraction and costochondral graft established a new condyle separating from the preserved disc with a joint space. Both techniques showed no significant difference in ankylosis scores up to 24 weeks. Signs of calcification were not noted in the transport distraction or costochondral graft side. No significant change of maximal jaw movements was found at any time point from 2 to 24 weeks. CONCLUSIONS: Distraction osteogenesis is an effective reconstruction method for TMJ reconstruction. No significant difference between these 2 techniques in reconstruction of the TMJ was noted.

Transport distraction versus costochondral graft for reconstruction of temporomandibular joint ankylosis: which is better?

OBJECTIVE: This study compared the methods of transport distraction and costochondral graft in reconstruction of temporomandibular joint (TMJ) ankylosis. STUDY DESIGN: Bilateral bony TMJ ankylosis was induced in 12 adult goats. Transport distraction of the mandibular ramus was performed on one side, whereas costochondral graft was performed on the other side. Jaw movements, TMJ healing, condylar remodeling, and recurrence of ankylosis were assessed by clinical, radiological, and histological examinations. RESULTS: Both transport distraction and costochondral graft established a neo-condyle separating from the pseudo-disc with a joint space. The ankylosis scores were higher in the distraction side in the first 12 weeks. Both techniques showed no significant difference in the calcification scores and recurrence of ankylosis in the long term. The maximal jaw movements in 3 directions returned to the pre-ankylosis stage by both methods. CONCLUSIONS: Distraction osteogenesis is an effective reconstruction method for TMJ ankylosis, matching the gold standard of costochondral grafting.

[Clinical analysis of 182 cases with facial nerve injury].

OBJECTIVE: To investigate the recovery patterns and the influencing factors of facial nerve injury in maxillofacial surgery by retrospective analysis of a serial clinical data. METHODS: A total of 182 patients with facial nerve injury were reviewed. The cause of injury, the initial facial nerve function after trauma, the treatment, the initial recovery time of facial nerve function and the total recovery time were recorded. The factors that influenced the outcome of facial nerve function were analyzed. RESULTS: The facial nerve branch injury was common in maxillofacial injury. The injury pattern, location, age and reconstruction time all had effects on the function recovery of the facial nerve. Within 6 months, 45 of 49 (92%) anatomic injured patients completely recovered in 6 months; 53 of 59 patients (90%) began to recover when nerve had been ruptured. In 12 months, 33 of 35 patients (94%) after nerve anastomosed and 5 of 8 patients (62%) with nerve transplantation got complete recovery. CONCLUSIONS: Preserving the facial nerve during surgery is very important. If the facial nerve is injured, reconstructive surgery should be applied as soon as possible.

beta-catenin expression pattern in primary oral squamous cell carcinoma.

BACKGROUND: Beta-catenin, a 92 kDa protein that binds to the cytoplasmic tail of E-cadherin, has an essential role in intercellular adhesion and signal transduction. Aberrant expression of beta-catenin has been associated with progression and metastasis of various human cancers. The aim of this study was to elucidate the expression pattern of beta-catenin in primary oral squamous cell carcinoma and examine the correlation between beta-catenin expression and tumor differentiation, histological grade and lymph node status as well as its clinical significances. METHODS: Seventy-six patients with oral squamous cell carcinoma and sixteen metastatic lymph nodes were studied. The beta-catenin expression was determined by immunohistochemical staining. The correlation with clinical, histological data was analyzed statistically. RESULTS: Normal oral epithelium showed strong beta-catenin expression at the cell membrane, but no cytoplasmic or nuclear expression. Different degrees of reduced expression of beta-catenin at the cell membrane were found in 54 cases with squamous cell carcinoma (71%). Cytoplasmic beta-catenin expression was found in 17 tumors (22.4%). Three cases were found with nuclear beta-catenin expression. In sixteen lymph nodes with metastatic squamous cell carcinoma, negative beta-catenin expression at the cell membrane was seen in 13 tumors (81.2%) and weak expression in 3 tumors (18.8%). Statistical analysis showed that there was an inverse correlation between beta-catenin expression and lymph node status and histological grade of tumors. CONCLUSIONS: Reduced beta-catenin expression at the cell membrane is clearly associated with lymph node metastasis. A reduced expression of beta-catenin may constitute a hallmark of aggressive biological behavior of squamous cell carcinoma.

Surgical induction of temporomandibular joint ankylosis: an animal model.

PURPOSE: The aim of this study was to develop an animal model of temporomandibular joint (TMJ) bony ankylosis for future evaluation of surgical reconstructive methods. MATERIALS AND METHODS: An animal model was selected on the basis of 2 sequential experiments. Four goats and 4 minipigs were used in the first experiment, in which 1 goat and 1 minipig served as control animals. Condylectomy with disc preservation was performed on 1 side of 3 animals in each group. On the contralateral TMJ, condylectomy with discectomy was performed, and the arthroplasty gap was filled with the autogenous bone chips. In the second experiment, TMJ ankylosis was induced bilaterally in 3 additional animals of the species that achieved better ankylosis results in the first experiment. All animals were killed postoperatively at 3 months, and the TMJ complexes were examined by plain radiography, computed tomography, and histological evaluation. RESULTS: In the first experiment, only fibrous ankylosis was observed in the bone-grafted side of 2 goats and 3 minipigs, whereas fibro-osseous ankylosis was achieved in the remaining goat. The extent of ankylosis was found to be more severe in the goats than the minipigs. Hence, goats were selected for bilateral surgery in the second experiment, which achieved consistent bony ankylosis of the TMJ in all animals. CONCLUSIONS: Goats provide a better TMJ bony ankylosis model than minipigs. Consistent bony ankylosis can be induced by bilateral condylectomy, disectomy, and bone grafting of the arthroplasty gap.