Radiomics and Clinical Characters Based Gaussian Naive Bayes (GNB) Model for Preoperative Differentiation of Pulmonary Pure Invasive Mucinous Adenocarcinoma From Mixed Mucinous Adenocarcinoma.

Objective: To develop and validate predictive models based on clinical parameters, and radiomic features to distinguish pulmonary pure invasive mucinous adenocarcinoma (pIMA) from mixed mucinous adenocarcinoma (mIMA) before surgery. Method: From January 2017 to December 2022, 193 pIMA and 111 mIMA were retrospectively analyzed at our hospital in this retrospective study. From contrast-enhanced computed tomography, 1037 radiomic features were extracted. The patients were randomly divided into a training group and a test group (n = 213 and 91, respectively) in a 7:3 ratio. The least absolute shrinkage and selection operator algorithm was used to select radiomic features. In this study, 9 machine learning radiomics prediction models were applied. The radiomics score was then calculated based on the best-performing machine learning model adopted. The clinical model was developed using the same machine learning model of radiomics. In the end, a combined model based on clinical factors and radiomics features was developed. The area under the receiver operating characteristic curve (AUC) value and decision curve analysis (DCA) were used to evaluate the clinical usefulness of the prediction model. Results: The combined model established by the Gaussian Naive Bayes machine learning method exhibited the best performance. The AUC of the combined model, clinical model, and radiomics model were 0.81, 0.80, and 0.68 in the training group and 0.91, 0.80, and 0.81 in the test group, respectively. The Brier scores of the combined model were 0.171 and 0.112. The DCA curve also showed that the combined model was beneficial to clinical settings. Conclusion: The combined model integration of radiomics features and clinical parameters may have potential value for the preoperative differentiation of pIMA from mIMA.

Prediction of lymph node metastasis in advanced gastric adenocarcinoma based on dual-energy CT radiomics: focus on the features of lymph nodes with a short axis diameter ≥6 mm.

Objective: To explore the value of the features of lymph nodes (LNs) with a short-axis diameter ≥6 mm in predicting lymph node metastasis (LNM) in advanced gastric adenocarcinoma (GAC) based on dual-energy CT (DECT) radiomics. Materials and methods: Data of patients with GAC who underwent radical gastrectomy and LN dissection were retrospectively analyzed. To ensure the correspondence between imaging and pathology, metastatic LNs were only selected from patients with pN3, nonmetastatic LNs were selected from patients with pN0, and the short-axis diameters of the enrolled LNs were all ≥6 mm. The traditional features of LNs were recorded, including short-axis diameter, long-axis diameter, long-to-short-axis ratio, position, shape, density, edge, and the degree of enhancement; univariate and multivariate logistic regression analyses were used to establish a clinical model. Radiomics features at the maximum level of LNs were extracted in venous phase equivalent 120 kV linear fusion images and iodine maps. Intraclass correlation coefficients and the Boruta algorithm were used to screen significant features, and random forest was used to build a radiomics model. To construct a combined model, we included the traditional features with statistical significance in univariate analysis and radiomics scores (Rad-score) in multivariate logistic regression analysis. Receiver operating curve (ROC) curves and the DeLong test were used to evaluate and compare the diagnostic performance of the models. Decision curve analysis (DCA) was used to evaluate the clinical benefits of the models. Results: This study included 114 metastatic LNs from 36 pN3 cases and 65 nonmetastatic LNs from 28 pN0 cases. The samples were divided into a training set (n=125) and a validation set (n=54) at a ratio of 7:3. Long-axis diameter and LN shape were independent predictors of LNM and were used to establish the clinical model; 27 screened radiomics features were used to build the radiomics model. LN shape and Rad-score were independent predictors of LNM and were used to construct the combined model. Both the radiomics model (area under the curve [AUC] of 0.986 and 0.984) and the combined model (AUC of 0.970 and 0.977) outperformed the clinical model (AUC of 0.772 and 0.820) in predicting LNM in both the training and validation sets. DCA showed superior clinical benefits from radiomics and combined models. Conclusion: The models based on DECT LN radiomics features or combined traditional features have high diagnostic performance in determining the nature of each LN with a short-axis diameter of ≥6 mm in advanced GAC.

Comparative study of imaging staging and postoperative pathological staging of esophageal cancer based on smart medical big data.

Esophageal cancer has become a malignant tumor disease with high mortality worldwide. Many cases of esophageal cancer are not very serious in the beginning but become severe in the late stage, so the best treatment time is missed. Less than 20% of patients with esophageal cancer are in the late stage of the disease for 5 years. The main treatment method is surgery, which is assisted by radiotherapy and chemotherapy. Radical resection is the most effective treatment method, but a method for imaging examination of esophageal cancer with good clinical effect has yet to be developed. This study compared imaging staging of esophageal cancer with pathological staging after operation based on the big data of intelligent medical treatment. MRI can be used to evaluate the depth of esophageal cancer invasion and replace CT and EUS for accurate diagnosis of esophageal cancer. Intelligent medical big data, medical document preprocessing, MRI imaging principal component analysis and comparison and esophageal cancer pathological staging experiments were used. Kappa consistency tests were conducted to compare the consistency between MRI staging and pathological staging and between two observers. Sensitivity, specificity and accuracy were determined to evaluate the diagnostic effectiveness of 3.0T MRI accurate staging. Results showed that 3.0T MR high-resolution imaging could show the histological stratification of the normal esophageal wall. The sensitivity, specificity and accuracy of high-resolution imaging in staging and diagnosis of isolated esophageal cancer specimens reached 80%. At present, preoperative imaging methods for esophageal cancer have obvious limitations, while CT and EUS have certain limitations. Therefore, non-invasive preoperative imaging examination of esophageal cancer should be further explored.Esophageal cancer has become a malignant tumor disease with high mortality worldwide. Many cases of esophageal cancer are not very serious in the beginning but become severe in the late stage, so the best treatment time is missed. Less than 20% of patients with esophageal cancer are in the late stage of the disease for 5 years. The main treatment method is surgery, which is assisted by radiotherapy and chemotherapy. Radical resection is the most effective treatment method, but a method for imaging examination of esophageal cancer with good clinical effect has yet to be developed. This study compared imaging staging of esophageal cancer with pathological staging after operation based on the big data of intelligent medical treatment. MRI can be used to evaluate the depth of esophageal cancer invasion and replace CT and EUS for accurate diagnosis of esophageal cancer. Intelligent medical big data, medical document preprocessing, MRI imaging principal component analysis and comparison and esophageal cancer pathological staging experiments were used. Kappa consistency tests were conducted to compare the consistency between MRI staging and pathological staging and between two observers. Sensitivity, specificity and accuracy were determined to evaluate the diagnostic effectiveness of 3.0T MRI accurate staging. Results showed that 3.0T MR high-resolution imaging could show the histological stratification of the normal esophageal wall. The sensitivity, specificity and accuracy of high-resolution imaging in staging and diagnosis of isolated esophageal cancer specimens reached 80%. At present, preoperative imaging methods for esophageal cancer have obvious limitations, while CT and EUS have certain limitations. Therefore, non-invasive preoperative imaging examination of esophageal cancer should be further explored.

TIMP3 attenuates cerebral ischemia/reperfusion-induced apoptosis and oxidative stress in neurocytes by regulating the AKT pathway.

Ischemic stroke seriously threatens human health and creates a large social burden. The present study investigated whether tissue inhibitor of metalloproteinases-3 (TIMP3) prevented cerebral ischemia/reperfusion (I/R), with the aim to explore the underlying mechanism. A transient middle cerebral artery occlusion model was conducted in mice, and oxygen glucose deprivation and reoxygenation (OGD/R) was investigated in PC12 cells to mimic cerebral ischemia-reperfusion injury (CIRI). Western blotting was used to determine the expression of TIMP3, Bax, Bcl-2 and AKT. TUNEL was used to detect apoptosis in cerebral tissues or cultured PC12 cells. Expression levels of reactive oxygen species (ROS), superoxide dismutase (SOD) and malondialdehyde (MDA) were detected to reveal oxidative stress. The results demonstrated that TIMP3 expression was significantly decreased after I/R in vivo or OGD/R in vitro, and the number of TUNEL-positive cells was reduced by the overexpression of TIMP3. The attenuation of Bax/Bcl-2 ratio in OGD/R-induced PC12 cells suppressed the expression levels of ROS and MDA; while also elevating SOD activity in the OGD/R-induced neurocytes in vitro. In addition, TIMP3-overexpression reversed the downregulation of phosphorylated-AKT (Thr308 and Ser473) in OGD/R-treated PC12 cells. However, the anti-apoptotic and anti-oxidative stress roles of TIMP3 in OGD/R-induced PC12 cells were partially abolished after treatment with the AKT inhibitor, AZD5363. Overall, TIMP3 exerted an anti-apoptotic and anti-oxidative stress role in CIRI through the AKT pathway, which may be a potential therapeutic target for the treatment of CIRI.

Prediction of Survival and Analysis of Prognostic Factors for Patients With Combined Hepatocellular Carcinoma and Cholangiocarcinoma: A Population-Based Study.

BACKGROUND: Combined hepatocellular carcinoma and cholangiocarcinoma (CHC) is an uncommon subtype of primary liver cancer. Because of limited epidemiological data, prognostic risk factors and therapeutic strategies for patients with CHC tend to be individualized. This study aimed to identify independent prognostic factors and develop a nomogram-based model for predicting the overall survival (OS) of patients with CHC. METHODS: We recruited eligible individuals from the Surveillance, Epidemiology, and End Results (SEER) database between 2004 and 2015 and randomly divided them into the training or verification cohort. Univariate and multivariate analyses were performed to identify independent variables associated with OS. Based on multivariate analysis, the nomogram was established, and its prediction performance was evaluated using the consistency index (C-index) and calibration curve. RESULTS: In total, 271 patients with CHC were included in our study. The median OS was 14 months, and the 1-, 3-, and 5-year OS rates were 52.3%, 27.1%, and 23.3%, respectively. In the training cohort, multivariate analysis showed that the pathological grade (hazard ratio [HR], 1.26; 95% confidence interval [CI]: 0.96-1.66), TNM stage (HR, 1.21; 95% CI: 1.02 - 1.44), and surgery (HR, 0.26; 95% CI: 0.17 - 0.40) were independent indicators of OS. The nomogram-based model related C-indexes were 0.76 (95% CI: 0.72 - 0.81) and 0.72 (95% CI: 0.66 - 0.79) in the training and validation cohorts, respectively. The calibration of the nomogram showed good consistency of 1-, 3-, and 5-year OS rates between the actual observed survival and predicted survival in both cohorts. The TNM stage (HR, 1.23; 95% CI: 1.01 - 1.49), and M stage (HR, 1.87; 95% CI: 1.14 3.05) were risk factors in the surgical treatment group. Surgical resection and liver transplantation could significantly prolong the survival, with no statistical difference observed. CONCLUSIONS: The pathological grade, TNM stage, and surgery were independent prognostic factors for patients with CHC. We developed a nomogram model, in the form of a static nomogram or an online calculator, for predicting the OS of patients with CHC, with a good predictive performance.

Development and validation of a nomogram for predicting varices needing treatment in compensated advanced chronic liver disease: A multicenter study.

BACKGROUND: Only a small proportion of patients with compensated advanced chronic liver disease (cACLD) had varices needing treatment (VNT) after recommended esophagogastroduodenoscopy (EGD) screening. We aimed to create a non-invasive nomogram based on routine tests to detect VNT in cACLD patients. METHODS: The training cohort included 162 cACLD patients undergoing EGD in a university hospital, between January 2014 and September 2019. A nomogram was developed based on the independent predictors of VNT, selected using a multivariate logistic regression analysis. Thirty-three patients from eight university hospitals were prospectively enrolled as validation cohort between December 2018 and December 2019. RESULTS: The prevalence of VNT was 32.7% (53/162) and 39.4% (13/33) in training and validation cohorts, respectively. The univariate analysis identified six risk factors for VNT. On the multivariate analysis, four of them, i.e., gallbladder wall thickness (odds ratio [OR]: 1.23; 95% confidence interval [CI]: 0.98-1.56), spleen diameter (OR: 1.02; 95% CI: 1.00-1.04), platelet count (OR: 0.98; 95% CI: 0.97-0.99), and international normalized ratio (OR: 0.58; 95% CI: 0.06-5.84) were independently associated with VNT. Thus, a nomogram based on the four above - mentioned variables was developed, and showed a favorable performance for detecting VNT, with an area under receiver operating characteristic curve of 0.848 (95% CI: 0.769-0.927) in training cohort. By applying a cut-off value of 105 in validation cohort, 31.0% of EGD were safely spared with 3.4% of missed VNT. CONCLUSION: A nomogram based on routine clinical parameters was developed for detecting VNT and avoiding unnecessary EGD in cACLD patients.

Neuroimaging diagnosis of intraventricular Central neurocytoma.

OBJECTIVE: To study the CT and MRI imaging manifestations of central and intraventricular central neurocytoma in the ventricle. METHODS: In this paper, 39 patients with central nervous cell tumour treated in our hospital from August 2015 to June 2018 were selected. All patients were performed plain CT scans using GE Highspeed CT; GE signa Twin speed 1.5 T superconducting magnet Resonance scanners were used to perform MRI plain scans on all patients. Observe the specific location, size, and morphology of tumours in the supra- and sub-ventricular ventricles of 39 central nervous cell tumour patients, and compare the performance of CT examination with the performance of MRI examination. RESULTS: Of the 39 patients with central neurocytoma, 13 were in the right lateral ventricle, 9 were in the left lateral ventricle, 11 patients had tumours in both lateral ventricles, and 6 patients had bilateral ventricles and bilateral ventricles. There were tumours in the third ventricle; 39 patients had an average tumour size of 52 mm; 36 patients had irregular lobes, and 3 patients had blurred tumour boundaries; some tumours had different degrees of calcification. CONCLUSIONS: The location and characteristics of the imaging manifestations of central nervous cell tumours are typical. Both CT scans and MRI scans can effectively detect central neuroblastomas, and MRI imaging examinations can effectively improve the diagnosis accuracy of tumour is better than that of CT.

Functional magnetic resonance imaging-based assessment of terlipressin vs. octreotide on renal function in cirrhotic patients with acute variceal bleeding (CHESS1903): study protocol of a multicenter randomized controlled trial.

BACKGROUND: Acute variceal bleeding is one of the critical complications in patients with liver cirrhosis. Severe renal vasoconstriction in consequence of low peripheral vascular resistance triggers the reduction of glomerular filtration rate (GFR), and thus induces acute kidney injury (AKI)/hepato-renal syndrome (HRS). Terlipressin and octreotide have been used in the management of cirrhotic patients with variceal bleeding. Also, terlipressin has been recommended as the international first-line pharmacological therapy for the treatment of HRS. In addition, the use of renal functional magnetic resonance imaging (fMRI) has become increasingly prevalent in research and clinical applications. However, the renal function-protective effect of terlipressin and octreotide and the value of fMRI in monitoring renal function remains unclear in patients with cirrhosis undergoing acute variceal bleeding. METHODS: This is a multicenter, randomized controlled trial (RCT). Participants will be 1:1 assigned randomly into either terlipressin or octreotide groups. Sixty participants with clinically and/or pathologically diagnosed cirrhosis and active gastroesophageal variceal bleeding (GVB) will be recruited in several sites in China. Participants will receive either the treatment of terlipressin or octreotide after assigned into each group. The primary end point for the trial is the renal function. The secondary end points are (I) renal perfusion; (II) renal blood oxygenation; (III) failure to control bleeding; (IV) intra-hospital rebleeding; (V) intra-hospital mortality; (VI) adverse events (AE); (VII) overall survival. Statistical analysis including multivariate Cox regression, Kaplan-Meier analysis with log-rank test, etc. will be conducted. DISCUSSION: The study will provide new insight into the protection of renal function in the process of the treatment of variceal bleeding in patients with cirrhosis. TRIAL REGISTRATION NUMBER: NCT04028323.

miR-143 inhibits proliferation and metastasis of nasopharyngeal carcinoma cells via targeting FMNL1 based on clinical and radiologic findings.

Mounting evidence has reported that microRNA-143 (miR-143) is involved in the development of multiple cancers. To investigate the underlying mechanisms of miR-143 regulating proliferation and metastasis in nasopharyngeal carcinoma (NPC) cells, we evaluated the levels of miR-143 and formin-like protein 1 (FMNL1) in NPC tissues. The results of qRT-PCR and Western blot analysis showed that the expression of miR-143 was decreased, while FMNL1 was increased in NPC tissues. The expression of miR-143 was significantly elevated in NPC cells compared with that of human nasopharyngeal epithelial cells. The results of MiRcode prediction, dual-luciferase reporter, and Western blot analysis assays indicated that miR-143 negatively regulated the expression of FMNL1 (r2 = 0.4365P = 0.0001). Overexperssion of miR-143 or FMNL1 knockdown inhibited cell proliferation, migration, and invasion in NPC cells (P < 0.05). Ectopic expression of FMNL1 undermined the inhibition effect of miR-143 on proliferation, migration, and invasion in NPC cells. The findings of this study revealed that miR-143 functioned as a tumor suppressor and inhibited the NPC progression by targeting FMNL1.

Film-Spotting chiral miniPEG-γPNA array for BRCA1 gene mutation detection.

Peptide nucleic acids array technology is a method of greatly increasing the throughput of laboratory processes to efficiently perform large-scale genetic tests. Diethylene glycol-containing chiral γPNA (miniPEG-γPNA) is considered to be the best PNA derivative and one of the best candidates for gene detection, because it can hybridize DNA with greater affinity and sequence selectivity than DNA and ordinary aminoethylglycyl PNA (aegPNA). Herein, miniPEG-γPNA probes are synthesized by 9-fluorenylmethyloxycarbonyl (Fmoc) solid phase peptide synthesis (SPPS) in a mild condition, and a new biochip fabrication method "Film-Spotting" is invented, by which γPNA arrays with regular pattern, uniform luminance, and very low fluorescence background are obtained easily and cheaply. The miniPEG-γPNA array can effectively distinguish the full matched and mismatched targets in SSarc buffer, serum and urine, and the detection limit of complementary DNA is less than 5.97 nM. A miniPEG-γPNA array for BRCA1 gene mutation (3099delT) detection is also fabricated with a very good detection performance. This work provides an effective avenue for the diagnosis of breast cancer biomarker and expands the application of miniPEG-γPNA in the field of biochip.

[3.0 T MRI observe the ears and sinus damage degree of patients with acute carbon monoxide poisoning].

OBJECTIVE: Through 3.0 T MRI study the ear and sinus lesions of patients with acute carbon monoxide poisoning. METHOD: From 2012 to 2015 collected the MRI images of the 45 patients with acute carbon monoxide poisoning, observe their changes of middle ear and mastoid and sinus imaging. RESULT: The middle ear injury of mastoid 41 cases (91.1%), 22 cases (48.9%) of maxillary sinus injury, ethmoid sinus injury in 20 cases (44.4%), sphenoid sinus 9 cases (20.0%), 5 cases (11.1%) of frontal sinus injury. Carbon monoxide poisoning patients according to clinical symptoms can be divided into light, medium and heavy 3 groups, observing the ear sinus damage degree for comparison between groups, found to have significant differences (P < 0.05). CONCLUSION: The patients with acute carbon monoxide poisoning ear and sinus injury should cause the attention of the medical staff, MRI can reflect people's ears from the details and the damage degree of the sinuses.