Ultrasound-based deep learning radiomics nomogram for risk stratification of testicular masses: a two-center study.

OBJECTIVE: To develop an ultrasound-driven clinical deep learning radiomics (CDLR) model for stratifying the risk of testicular masses, aiming to guide individualized treatment and minimize unnecessary procedures. METHODS: We retrospectively analyzed 275 patients with confirmed testicular lesions (January 2018 to April 2023) from two hospitals, split into training (158 cases), validation (68 cases), and external test cohorts (49 cases). Radiomics and deep learning (DL) features were extracted from preoperative ultrasound images. Following feature selection, we utilized logistic regression (LR) to establish a deep learning radiomics (DLR) model and subsequently derived its signature. Clinical data underwent univariate and multivariate LR analyses, forming the "clinic signature." By integrating the DLR and clinic signatures using multivariable LR, we formulated the CDLR nomogram for testicular mass risk stratification. The model's efficacy was gauged using the area under the receiver operating characteristic curve (AUC), while its clinical utility was appraised with decision curve analysis(DCA). Additionally, we compared these models with two radiologists' assessments (5-8 years of practice). RESULTS: The CDLR nomogram showcased exceptional precision in distinguishing testicular tumors from non-tumorous lesions, registering AUCs of 0.909 (internal validation) and 0.835 (external validation). It also excelled in discerning malignant from benign testicular masses, posting AUCs of 0.851 (internal validation) and 0.834 (external validation). Notably, CDLR surpassed the clinical model, standalone DLR, and the evaluations of the two radiologists. CONCLUSION: The CDLR nomogram offers a reliable tool for differentiating risks associated with testicular masses. It augments radiological diagnoses, facilitates personalized treatment approaches, and curtails unwarranted medical procedures.

Organic binding iron formation and its mitigation in cation exchange resin assisted anaerobic digestion of chemically enhanced primary sedimentation sludge.

Fe based chemically enhanced primary sedimentation (CEPS) is an effective method of capturing the colloidal particles and inorganic phosphorous (P) from wastewater but also produces Fe-CEPS sludge. Anaerobic digestion is recommended to treat the sludge for energy and phosphorus recovery. However, the aggregated sludge flocs caused by the coagulation limited sludge hydrolysis and P release during anaerobic digestion process. In this study, cation exchange resin (CER) was employed during anaerobic digestion of Fe-CEPS sludge with aims of prompting P release and carbon recovery. CER addition effectively dispersed the sludge flocs. However, the greater dispersion of sludge flocs could not translate to higher sludge hydrolysis. The maximum hydrolysis and acidification achieved at lower CER dosage of 0.5 g CER/g TS. It was observed that the extents of sludge hydrolysis and acidification had a strongly negative correlation with the organic binding iron (OBI) concentration. The presence of CER during anaerobic digestion favored Fe(III) reduction to Fe(II), and then further induced iron phase transformation, leading to the OBI formation from the released organic matters. Meanwhile, higher CER dosage resulted in higher P release efficiency and the maximum efficiency at 4 g CER/g TS was four times than that of the control. The reduction of BD-P, NaOH-P and HCl-P in solid phase contributed most P release into the supernatant. A new two-stage treatment process was further developed to immigrate the OBI formation and improve the carbon recovery efficiency. Through this process, approximately 45% of P was released, and 63% of carbon was recovered as methane from Fe-CEPS sludge via CER pretreatment.

Highly efficient degradation of 2,2',4,4'-tetrabromodiphenyl ether through combining surfactant-assisted Zn0 reduction with subsequent Fenton oxidation.

2,2',4,4'-tetrabromodiphenyl ether (BDE47) was difficult to be rapidly degraded by common reductive debromination or oxidative decomposition. In this study, the debromination via surfactant-assisted zero valent zinc (Zn0) reduction and subsequent Fenton oxidation was combined to completely degrade BDE47. Firstly, Zn0 integrated with surfactants including cetyltrimethylammonium chloride (CTAC), polyethylene glycol dodecyl ether (Brij35), or 1-dodecanesulfonic acid sodium salt (SDS) were evaluated for their reactivity to debrominate BDE47. CTAC-assisted Zn0 system presented the highest removal efficiency of 98.6% for BDE47 (C0 = 5 mg/L) under the optimized conditions including 0.3 g/L of Zn0 particles and 0.05 g/L of CTAC at 25 °C and pH 4.0 during 1-h reaction. Subsequently, the debromination products as low-brominated BDEs were attacked by hydroxyl radicals (•OH) from Fenton reagent, which were decomposed into short-chain carboxylic acids and even mineralized within 2-h oxidation. In addition, HPLC, GC-MS, LC-MS/MS, and IC were employed to detect intermediates during this reaction/oxidation process and the pathways of debromination and oxidation were proposed according to carbon and bromine balance. The above combination achieved the complete degradation of BDE47 via a relative low-cost method to rapidly remove PBDEs, which provide a new approach for the effective treatment of halogenated organic pollutants.

Synchronous Hodgkin lymphoma and gastric adenocarcinoma: A rare case report and literature review.

Hodgkin lymphoma (HL) is a lymphoproliferative disease arising in the lymphoid tissue, which is characterized by Reed-Sternberg cells. Adenocarcinoma is the most frequent pathological type of stomach cancer. Improved survival in HL patients leads to the development of secondary malignancies. However, synchronous occurrence of these 2 malignancies is extremely rare. Here, we present a 45-year-old male complaining of a lymph node mass in the neck, without any abdominal symptoms, diagnosed as HL and gastric adenocarcinoma with hepatitis B carrier status. We treated the patient with 8 courses of pirarubicin bleomycin, vincristine, and dacarbazine (modified ABVD), and 4 courses of capecitabine therapy concurrently along with oral entecavir, as the patient survived longer than 20 months.The prognosis of multiple primary malignancies is poor because therapy is difficult, without a standard treatment. The frequency of multiple primary malignancies is increasing in recent years, and second malignancies in patients with cancer should be taken into consideration.

Prostate ultrasound imaging: evaluation of a two-step scoring system in the diagnosis of prostate cancer.

RATIONALE AND OBJECTIVES: This study aims to investigate the feasibility and performance of a two-step scoring system of ultrasound imaging in the diagnosis of prostate cancer. MATERIAL AND METHODS: 75 patients with 888 consecutive histopathologically verified lesions were included in this study. Step 1, an initial 5-point scoring system was developed based on conventional transrectal ultrasound (TRUS). Step 2, a final scoring system was evaluated according to contrast-enhanced transrectal ultrasound (CE-TRUS). Each lesion was evaluated using the two-step scoring system (step 1 + step 2) and compared with only using conventional TRUS (step 1). RESULTS: 888 lesions were histologically verified: 315 of them were prostate cancer from 46 patients and 573 were benign prostatic hypertrophy (BPH) from 29 patients. According to the two-step scoring system, 284 lesions were upgraded and 130 lesions were downgraded from step 1 to step 2 (this means using step 2 to assess the results by step 1). However, 96 cases were improperly upgraded after step 2 and 48 malignant lesions were still missed after step 2 as score-1. For the two-step scoring system, the sensitivity, specificity, and accuracy were 84.7%, 83.2%, and 83.7%, respectively, versus 22.8%, 96.6%, and 70.4%, respectively, for conventional TRUS. The area under the ROC curve (AUC) for lesion diagnosis was 0.799-0.952 for the two-step scoring system, versus 0.479-0.712 for conventional TRUS. The difference in the diagnostic accuracy of the two-step scoring system and conventional TRUS was statistically significant (P<0.0001). CONCLUSION: The two-step scoring system was straightforward to use and achieved a considerably accurate diagnostic performance for prostate cancer. The application of the two-step scoring system for prostate cancer is promising.

[Effects of arsenic trioxide combined with bortezomib on proliferation and apoptosis of K562 cells and their mechanism].

This study was aimed to investigate the effect of arsenic trioxide (As(2)O(3)) alone and in combination with bortezomib (Bor) on proliferation and apoptosis of leukemia cell line K562, and to analyze the potential mechanism. K562 cells were treated with different concentrations of As(2)O(3) or Bor (alone or combination) for 24, 48 h. MTT method was used to detect the cell proliferation. After K562 cells were treated with 0.5 µmol/L As(2)O(3) alone or in combination with 10 nmoL/L Bor, the apoptosis rate and cell cycle were measured by flow cytometry, and the activity of NF-κB was analyzed by SP immunohistochemistry. The results indicated that the different concentrations of As(2)O(3) and Bor could inhibit the K562 cell proliferation in a time- and dose-dependent manners (P < 0.05). The IC(50) of Bor and As(2)O(3) in 48 h were 20 nmol/L and 0.6 µmol/L respectively. When K562 cells were treated with As(2)O(3) or Bor alone for 24 h, the apoptotic rate of K562 cells increased, and the apoptotic rate in combination group was higher than that in As(2)O(3) or Bor group. The cells were apparently arrested in G(2)/M phase in Bor group and G(0)/G(1) phase in As(2)O(3) group. The activity of NF-κB decreased significantly in As(2)O(3) or Bor group (P < 0.05), this effect was most significant in the combination group (P < 0.01). It is concluded that both As(2)O(3) and Bor can inhibit the proliferation and induce apoptosis of K562 cells, a synergistic effect can be observed when a low dose of As(2)O(3) combined with low dose of Bor. The different cell cycle block site and the decrease of activity of NF-κB may be one of the mechanisms underlying their synergic effect.

[Effects of hyperbaric oxygenation combined with As(2)O(3) on proliferation of K562 cells and associated mechanism].

This study was aimed to explore the effects of hyperbaric oxygenation (HBO) alone or combined with As(2)O(3) on proliferation, apoptosis and expression of HIF-1a, VEGF, caspase-3 mRNA of K562 cells, and the molecular mechanism of As(2)O(3) enhancing the anti-leukemic effect of HBO so as to provide a scientific basis for clinical treatment of chronic myeloid leukemia. The effects of drugs on proliferation of K562 cells was assayed by MTT method, the apoptosis rate of K562 cells was detected by flow cytometry with Annexin V/PI double staining, the expressions of HIF-1a, VEGF, caspase-3 mRNA of K562 cells were determined by real-time quantitative PCR. The results showed that as compared with As(2)O(3) alone, HBO combined with As(2)O(3) could increase inhibitory rate of K562 cell proliferation, and enhance apoptotic effect, obviously down-regulate expressions of HIF-1a and VEGF mRNA, up-regulate expression of caspase-3 mRNA. The effect of HBO combined with As(2)O(3) was higher then effect of As(2)O(3) alone, and their effects were synergistic (P < 0.05). It is concluded that HBO combined with As(2)O(3) can increase the expression of caspase 3 mRNA and decrease the expression of HIF-1a and VEGF mRNA, which may be one of molecular mechanisms underlying their synergistic antileukemia efficacy.