Clinical characteristics and MRI based radiomics nomograms can predict iPFS and short-term efficacy of third-generation EGFR-TKI in EGFR-mutated lung adenocarcinoma with brain metastases.

BACKGROUND: Predicting short-term efficacy and intracranial progression-free survival (iPFS) in epidermal growth factor receptor gene mutated (EGFR-mutated) lung adenocarcinoma patients with brain metastases who receive third-generation epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) therapy was of great significance for individualized treatment. We aimed to construct and validate nomograms based on clinical characteristics and magnetic resonance imaging (MRI) radiomics for predicting short-term efficacy and intracranial progression free survival (iPFS) of third-generation EGFR-TKI in EGFR-mutated lung adenocarcinoma patients with brain metastases. METHODS: One hundred ninety-four EGFR-mutated lung adenocarcinoma patients with brain metastases who received third-generation EGFR-TKI treatment were included in this study from January 1, 2017 to March 1, 2023. Patients were randomly divided into training cohort and validation cohort in a ratio of 5:3. Radiomics features extracted from brain MRI were screened by least absolute shrinkage and selection operator (LASSO) regression. Logistic regression analysis and Cox proportional hazards regression analysis were used to screen clinical risk factors. Single clinical (C), single radiomics (R), and combined (C + R) nomograms were constructed in short-term efficacy predicting model and iPFS predicting model, respectively. Prediction effectiveness of nomograms were evaluated by calibration curves, Harrell's concordance index (C-index), receiver operating characteristic (ROC) curves and decision curve analysis (DCA). Kaplan-Meier analysis was used to compare the iPFS of high and low iPFS rad-score patients in the predictive iPFS R model and to compare the iPFS of high-risk and low-risk patients in the predictive iPFS C + R model. RESULTS: Overall response rate (ORR) was 71.1%, disease control rate (DCR) was 91.8% and median iPFS was 12.67 months (7.88-20.26, interquartile range [IQR]). There were significant differences in iPFS between patients with high and low iPFS rad-scores, as well as between high-risk and low-risk patients. In short-term efficacy model, the C-indexes of C + R nomograms in training cohort and validation cohort were 0.867 (0.835-0.900, 95%CI) and 0.803 (0.753-0.854, 95%CI), while in iPFS model, the C-indexes were 0.901 (0.874-0.929, 95%CI) and 0.753 (0.713-0.793, 95%CI). CONCLUSIONS: The third-generation EGFR-TKI showed significant efficacy in EGFR-mutated lung adenocarcinoma patients with brain metastases, and the combined line plot of C + R can be utilized to predict short-term efficacy and iPFS.

Ultrasonic Diagnosis of Intestinal Obstruction in Neonates-Original Article.

BACKGROUND: Intestinal obstruction in neonates is a common problem that requires prompt diagnosis and treatment, and ultrasound could be a potential tool for it. The purpose of this study was to investigate the accuracy of ultrasonography in diagnosing and identifying the cause of intestinal obstruction in neonates, the corresponding ultrasonic manifestations, as well as to utilize the diagnostic method. METHODS: We conducted a retrospective study of all neonatal intestinal obstruction in our institute between 2009 and 2022. The accuracy of ultrasonography in the diagnosis of intestinal obstruction and the identification of its etiology was compared with the results of operation as the gold standard. RESULTS: The accuracy of the ultrasonic diagnosis of intestinal obstruction was 91%, and the accuracy of the ultrasonic etiological diagnosis of intestinal obstruction was 84%. The main ultrasound findings for the neonatal intestinal obstruction were dilation and high tension of the proximal bowel and collapse of the distal intestinal. Other major manifestations were the presence of corresponding diseases causing intestinal obstruction at the junction of the dilated and collapsed bowel. CONCLUSIONS: Ultrasound has the advantages of being a flexible multi-section dynamic evaluation and a valuable tool to diagnose and identify the cause of intestinal obstruction in neonates.

Pollution characteristics, spatial distribution, and source identification of heavy metals in road dust in a central eastern city in China: a comprehensive survey.

Road dust enriched with heavy metals (HMs) is detrimental to ecosystems and human health in urban environments. In this study, it is to explore the concentrations, spatial distribution, contaminated levels, and source identification of six HMs (lead (Pb), zinc (Zn), copper (Cu), cobalt (Co), chromium (Cr), and nickel (Ni)) based on 130 road dusts in Xinyang urban area. The results indicated that the contents of Pb, Zn, Cu, and Co were higher than the background values in more than 99% of the samples, and their average concentrations were 15.2, 9.2, 8.6, and 6.3 times the background value, respectively. The spatial distribution of high-value areas for Pb, Zn, Cu, Cr, and Ni was more similar, which was associated with traffic density near major roads and population and settlement patterns. Co was relatively different from the five elements, which was distributed in the areas of residence, commerce, and industry. Furthermore, the investigated HMs were clearly polluted, with Pb, Zn, Cu, and Co indicating high levels of contamination, while Cr and Ni were moderately polluted. The comprehensive pollution of the six HMs was mostly moderate to heavy in this study. Moreover, three sources of HMs designated by correlation analysis (CA) and principal component analysis (PCA) were mixed traffic emissions and industrial waste for Cu and Cr; automotive emissions for Pb, Ni, and Zn; and mixed domestic waste and industrial activities for Co, with contributions of 42.3%, 46.4%, and 11.3% via the principal component analysis-multiple linear regression (PCA-MLR) model. The multi-factor index for pollution assessment combined with source identification is extremely effective and practical for providing reliable data support and a theoretical reference for pollution monitoring and governance.

Diatom-based water-table reconstruction in Sphagnum peatlands of northeastern China.

Peatlands are important ecosystems for biodiversity conservation, global carbon cycling and water storage. Hydrological changes due to climate variability have accelerated the degradation of global and regional ecosystem services of peatlands. Diatoms are important producers and bioindicators in wetlands, but comprehensive diatom-based inference models for palaeoenvironmental reconstruction in peatlands are scarce. To explore the use of diatoms for investigating peatland hydrological change, this study established a training set consisting of diatom composition and twelve environmental factors from 105 surface samples collected from five Sphagnum peatlands in northeastern China. Diatom communities were dominated by Eunotia species. Ordination analyses showed that depth to the water table (DWT) was the most important factor influencing diatom distribution, independently accounting for 4.99% of total variance in diatom data. Accordingly, a diatom-based DWT transfer function was developed and thoroughly tested. The results revealed that the best-performing model was based on weighted averaging with inverse deshrinking (R2 = 0.66, RMSEP = 8.8 cm with leave-one-out cross validation). Quantitative reconstruction of DWT on a short peat core collected from the Aershan Peatland (Inner Mongolia) recorded climate-mediated hydrological changes over the last two centuries. This study presents the first diatom-water table transfer function in Sphagnum peatlands, and highlights the potential of diatoms as a powerful tool to assess the magnitude of past hydrological changes in peatlands of northeastern China, as well as similar peaty environments worldwide.

Targeted nanobubbles in low-frequency ultrasound-mediated gene transfection and growth inhibition of hepatocellular carcinoma cells.

The use of SonoVue combined with ultrasound exposure increases the transfection efficiency of short interfering RNA (siRNA). The objective of this study was to prepare targeted nanobubbles (TNB) conjugated with NET-1 siRNA and an antibody GPC3 to direct nanobubbles to hepatocellular carcinoma cells. SMMC-7721 human hepatocellular carcinoma cells were treated with six different groups. The transfection efficiency and cellular apoptosis were measured by flow cytometry. The protein and messenger RNA (mRNA) expression were measured by Western blot and quantitative real-time PCR, respectively. The migration and invasion potential of the cells were determined by Transwell analysis. The results show that US-guided siRNA-TNB transfection effectively enhanced gene silencing. In summary, siRNA-TNB may be an effective delivery vector to mediate highly effective RNA interference in tumor treatment.