MRI-Based Kinetic Heterogeneity Evaluation in the Accurate Access of Axillary Lymph Node Status in Breast Cancer Using a Hybrid CNN-RNN Model.

BACKGROUND: Accurate evaluation of the axillary lymph node (ALN) status is needed for determining the treatment protocol for breast cancer (BC). The value of magnetic resonance imaging (MRI)-based tumor heterogeneity in assessing ALN metastasis in BC is unclear. PURPOSE: To assess the value of deep learning (DL)-derived kinetic heterogeneity parameters based on BC dynamic contrast-enhanced (DCE)-MRI to infer the ALN status. STUDY TYPE: Retrospective. SUBJECTS: 1256/539/153/115 patients in the training cohort, internal validation cohort, and external validation cohorts I and II, respectively. FIELD STRENGTH/SEQUENCE: 1.5 T/3.0 T, non-contrast T1-weighted spin-echo sequence imaging (T1WI), DCE-T1WI, and diffusion-weighted imaging. ASSESSMENT: Clinical pathological and MRI semantic features were obtained by reviewing histopathology and MRI reports. The segmentation of the tumor lesion on the first phase of T1WI DCE-MRI images was applied to other phases after registration. A DL architecture termed convolutional recurrent neural network (ConvRNN) was developed to generate the KHimage (kinetic heterogeneity of DCE-MRI image) score that indicated the ALN status in patients with BC. The model was trained and optimized on training and internal validation cohorts, tested on two external validation cohorts. We compared ConvRNN model with other 10 models and the subgroup analyses of tumor size, magnetic field strength, and molecular subtype were also evaluated. STATISTICAL TESTS: Chi-squared, Fisher's exact, Student's t, Mann-Whitney U tests, and receiver operating characteristics (ROC) analysis were performed. P < 0.05 was considered significant. RESULTS: The ConvRNN model achieved area under the curve (AUC) of 0.802 in the internal validation cohort and 0.785-0.806 in the external validation cohorts. The ConvRNN model could well evaluate the ALN status of the four molecular subtypes (AUC = 0.685-0.868). The patients with larger tumor sizes (>5 cm) were more susceptible to ALN metastasis with KHimage scores of 0.527-0.827. DATA CONCLUSION: A ConvRNN model outperformed traditional models for determining the ALN status in patients with BC. LEVEL OF EVIDENCE: 3 TECHNICAL EFFICACY: Stage 2.

Feasibility analysis of magnetic resonance imaging-based radiomics features for preoperative prediction of nuclear grading of ductal carcinoma in situ.

Background: The nuclear grading of ductal carcinoma in situ (DCIS) affects its clinical risk. The aim of this study was to investigate the possibility of predicting the nuclear grading of DCIS, by magnetic resonance imaging (MRI)-based radiomics features. And to develop a nomogram combining radiomics features and MRI semantic features to explore the potential role of MRI radiomic features in the assessment of DCIS nuclear grading. Methods: A total of 156 patients (159 lesions) with DCIS and DCIS with microinvasive (DCIS-MI) were enrolled in this retrospective study, with 112 lesions included in the training cohort and 47 lesions included in the validation cohort. Radiomics features were extracted from Dynamic contrast-enhanced MRI (DCE-MRI) phases 1st and 5th. After feature selection, radiomics signature was constructed and radiomics score (Rad-score) was calculated. Multivariate analysis was used to identify MRI semantic features that were significantly associated with DCIS nuclear grading and combined with Rad-score to construct a Nomogram. Receiver operating characteristic curves were used to evaluate the predictive performance of Rad-score and Nomogram, and decision curve analysis (DCA) was used to evaluate the clinical utility. Results: In multivariate analyses of MRI semantic features, larger tumor size and heterogeneous enhancement pattern were significantly associated with high-nuclear grade DCIS (HNG DCIS). In the training cohort, Nomogram had an area under curve (AUC) of 0.879 and Rad-score had an AUC of 0.828. Similarly, in the independent validation cohort, Nomogram had an AUC value of 0.828 and Rad-score had an AUC of 0.772. In both the training and validation cohorts, Nomogram had a significantly higher AUC value than Rad-score (P<0.05). DCA confirmed that Nomogram had a higher net clinical benefit. Conclusions: MRI-based radiomic features can be used as potential biomarkers for assessing nuclear grading of DCIS. The nomogram constructed by radiomic features combined with semantic features is feasible in discriminating non-HNG and HNG DCIS.

Combined treatment with dihydrotestosterone and lipopolysaccharide modulates prostate homeostasis by upregulating TNF-α from M1 macrophages and promotes proliferation of prostate stromal cells.

Androgens and chronic inflammation, which play essential roles in the development of benign prostatic hyperplasia (BPH), are considered to be important factors in disorders of prostate homeostasis. These two factors may lead to pathological hyperplasia in the prostate transition zone of patients with BPH. However, few studies have examined the mechanism of how dihydrotestosterone (DHT) affects chronic inflammation in prostate tissue during the progression of BPH. This study examined the performance of DHT in lipopolysaccharide-treated M1 macrophages and the subsequent effects on the proliferation of prostate stromal and epithelial cells. We found that DHT increased secretion of the pro-inflammatory factor tumor necrosis factor (TNF)-α from M1 macrophages differentiated from THP-1 cells. The supernatant of M1 macrophages promoted the proliferation of WPMY-1 prostate stromal cells by upregulating B-cell lymphoma-extra large (Bcl-xL) and cellular Myc (c-Myc) levels by activating TNF-α-mediated nuclear factor-kappa B (NF-κB) and mitogen-activated protein kinase (MAPK) pathways. Moreover, this supernatant increased the expression of androgen receptor in WPMY-1 cells, which was TNF-α-independent. Additionally, TNF-α protein expression was significantly higher in patients with BPH and a large prostate volume than that in those with a small prostate volume. Further analysis showed that higher serum testosterone combined with prostate-specific androgen concentrations was related to TNF-α expression. This study suggests that DHT modulates the inflammatory environment of BPH by increasing TNF-α expression from lipopolysaccharide-treated M1 macrophages and promotes the proliferation of prostate stromal cells. Targeting TNF-α, but not DHT, may be a promising strategy for patients with BPH.

Zhengyuan capsule for the treatment of cancer-related fatigue in lung cancer patients undergoing operation: a study protocol for a randomized controlled trial.

OBJECTIVE: To evaluate the efficacy and safety of Zhengyuan capsule () when treating Cancer-related fatigue (CRF) in lung cancer patients undergoing surgical operation. METHODS/DESIGN: This is a single-center, double-blinded, prospective, and randomized controlled trial in the Department of Integrated Chinese and Western Medicine, Shanghai Chest Hospital Shanghai JiaoTong University, Shanghai. Eligible participants will be randomly allocated into two groups: a treatment group receiving an 8-week Zhengyuan capsule regimen therapy and a control group receiving an 8-week placebo capsule regimen therapy. Evaluation will be carried out at four timelines: the participants' screening period, baseline period, the middle of the intervention period, and the end of the intervention period. The primary outcome assessment is fatigue scoring using the Cancer Fatigue Scale (CFS) measurement system. Secondary measurements include fatigue severity assessment using the Multidimensional Fatigue Symptom Inventory-Short Form (MFSI-SF) measurement system, Traditional Chinese Medicine syndrome pattern differentiation, levels of immunologic indicators (TNF-α, IL-6, IL-1, T lymphocytes subsets and B lymphocyte subsets), patient's pulmonary function, performance status scale (PS), self-rating scale of sleep (SRSS), and adverse events (AEs). DISCUSSION: The trial results can provide efficacy and safety data of Zhengyuan capsule when treating CRF in clinic. The data can also be imported into the management and treatment guidelines for CRF in lung cancer patients undergoing operation throughout China.

Tumor- and Osteoblast-Derived Periostin in Prostate Cancer bone Metastases.

Exploring the biological function of periostin (POSTN) in prostate cancer (PCa) bone metastasis is of importance. It was observed that the expression of POSTN was high in PCa, especially highest in PCa metastasized to bone. In this study, we found that inhibiting POSTN in PCa cells could significantly alleviate PCa bone metastasis in vivo, suggesting POSTN is a promising therapeutic target. Since, due to the secreted expression of POSTN in osteoblasts and PCa, we hypothesized the positive feedback loop between osteoblasts and PCa mediated by POSTN in PCa bone metastasis. The in vitro experiments demonstrated that osteoblast-derived POSTN promoted PCa cell proliferation and invasion and PCa cell-derived POSTN promotes proliferation of osteoblasts. Furthermore, we found that POSTN regulated PCa and osteoblast function through integrin receptors. Finally, 18F-Alfatide II was used as the molecule probe of integrin αvß3 in PET-CT, revealing high intake in metastatic lesions. Our findings together indicate that targeting POSTN in PCa cells as well as in the osteoblastic may be an effective treatment for PCa bone metastasis.

Single Step Stone-Wales Transformation Linking Two Thermodynamically Stable Sc2O@C78 Isomers.

Among the very recently reported dimetallic oxide fullerenes Sc2O@C2n (n = 35-47), a representative Sc2O@C78 still lacks of further characterizations. Herein, a systematical investigation on Sc2O@C78 has been performed by density functional theory combined with statistical thermodynamic studies. Two isolated pentagon rule (IPR) satisfying isomers, Sc2O@D3h(24109)-C78 and Sc2O@C2v(24107)-C78, are disclosed to possess prominent thermodynamic stabilities at the temperature region of fullerene formation. Significantly, these two structures are related by a single Stone-Wales transformation. Moreover, bonding critical points, bond orders, and delocalization indices have been analyzed to uncover covalent interactions in both isomers. In addition, (13)C NMR spectra and UV-vis-NIR adsorptions of the two stable structures are introduced to assist experimental identification and characterization in the future.

Theoretical Insight into Sc2O@C84: Interplay between Small Cluster and Large Carbon Cage.

Very recently, a series of endohedral fullerenes Sc2O@C2n (n = 35-47) were facilely produced. However, only two of them have been further characterized so far. Theoretically, we studied another discandium oxide endohedral fullerene without any characterizations, Sc2O@C84, which is the second most-abundant species in terms of relative heights of all mass spectrum peaks. Two thermodynamically stable isomers with isolated pentagon rule-obeying cages were found, namely, Sc2O@C2v(51575)-C84 and Sc2O@C1(51580)-C84. This is the first case that an endohedral fullerene containing the C2v(51575)-C84 cage acts as the lowest-energy isomer, and it is the first report of a clusterfullerene containing the C1(51580)-C84 cage. The endohedral Sc2O cluster can keep its ideal structure after encapsulation, while both C84 cages have deformed dramatically. Orbital analysis suggests that nucleophilic and oxidization reactions of both isomers should take place on the cage, while regioselectivity of Sc2O@C2v(51575)-C84 and Sc2O@C1(51580)-C84 is different due to their different characteristics of the highest occupied orbital distribution. Two-dimensional electron localization function and Laplacian of electron density maps unambiguously indicate strong electrostatic interactions exist between one scandium atom and the oxygen one. Meanwhile, overlaps of occupied metal atom orbitals and the cage ones along with Mayer bond order analysis identify that covalent interactions between a scandium atom and each C84 cage cannot be neglected. At last, (13)C NMR, UV-vis-NIR, and IR spectra of both Sc2O@C84 isomers were simulated theoretically. Because of their structural difference, all spectra between two isomers are significantly divergent. Consequently, these spectra are helpful to distinguish Sc2O@C2v(51575)-C84 and Sc2O@C1(51580)-C84 in further experimental characterizations.

Theoretical Insight into the Ambiguous Endohedral Metallofullerene Er3C74: Covalent Interactions among Three Lanthanide Atoms.

All of C74-based endohedral metallofullerenes (EMFs) are found to be monometallofullerenes with the same D3h(14246)-C74 cage so far. An opening question is whether other C74 cages could survive during the production of some novel C74-EMFs. Theoretically, we studied the trimetallic endohedral fullerene Er3C74, the existence of which had been proven without any further characterizations. Two thermodynamically stable Er3C74 isomers were obtained, both of which could be expressed as Er3@C74, meaning that previously synthesized Er3C74 is indeed an endohedral trierbium fullerene. Besides the isomer with well-known D3h(14246)-C74 cage which obeys isolated pentagon rule (IPR), another one possesses the C1(13771)-C74 cage with two adjacent pentagons. Notably, it is the first time an endohedral metallofullerene containing the C1(13771)-C74 cage has been reported. Frontier orbitals analysis, bonding analysis in terms of quantum theory of atoms-in-molecule (QTAIM) and Mayer bond order, together with two-dimensional maps of electron localization function (ELF) and Laplacian of electron density of Er3@D3h(14246)-C74 and Er3@C1(13771)-C74 show obvious covalent interactions not only between metallic atoms and carbon cage but also among three erbium atoms. Finally, simulated IR spectra of Er3@D3h(14246)-C74 and Er3@C1(13771)-C74 were simulated, which should be useful to distinguish those two isomers.

Theoretical prediction of the host-guest interactions between novel photoresponsive nanorings and C60: a strategy for facile encapsulation and release of fullerene.

A series of photoresponsive-group-containing nanorings hosts with 12∼14 Šin diameter is designed by introducing different number of azo groups as the structural composition units. And the host-guest interactions between fullerene C60 and those nanoring hosts were investigated theoretically at M06-2X/6-31G(d)//M06-L/MIDI! and wB97X-D/6-31G(d) levels. Analysis on geometrical characteristics and host-guest binding energies revealed that the designed nanoring molecule (labeled as 7) which is composed by seven azo groups and seven phenyls is the most feasible host for encapsulation of C60 guest among all candidates. Moreover, inferring from the simulated UV-vis-NIR spectroscopy, the C60 guest could be facilely released from the cavity of the host 7 via configuration transformation between trans-form and cis-form of the host under the 563 nm photoirradiation. Additionally, the frontier orbital features, weak interaction regions, infrared, and NMR spectra of the C60@7 host-guest complex have also been investigated theoretically.

A novel photo-responsive azobenzene-containing nanoring host for fullerene-guest facile encapsulation and release.

Azobenzenes in particular have been proved to have a robust photo-response, in which their configuration can transform between the trans- and cis-form upon UV-visible irradiation. Accordingly, azobenzene-containing molecules are frequently applied in the design of the guests, involving so-called host-guest chemistry. In this paper, a novel photo-responsive nanoring host molecule ([4]AB) has been designed by introducing four azobenzene groups onto the ring, and interactions between the designed nanoring host and fullerenes C60 and C70 guests were investigated at both the M06-L/MIDI! as well as M06-2X/6-31G(d) level of theory. By analyzing the geometric characteristics and host-guest binding energies, it is revealed that the designed [4]AB with diameter ca. 13.4 Å is an ideal host molecule for the encapsulation of guests C60 and C70 fullerene. Meanwhile, inferred from UV-vis-NIR spectroscopy, the guest C60 and C70 could be facilely released from the cavity of the [4]AB via configuration transformation between trans- and cis-form of the host under 474 and 506 nm photo-irradiation, respectively. Frontier orbital features, weak interaction regions, infrared spectroscopy and (1)H NMR spectra have also been theoretically simulated. The present work would provide a new strategy for facile reversible encapsulation and release of fullerene guest by a novel nanoring host.

Dimetallic sulfide endohedral metallofullerene Sc2S@C76: density functional theory characterization.

In terms of density functional theory combined with statistic mechanics computations, we investigated a dimetallic sulfide endohedral fullerene Sc2S@C76 which has been synthesized without any characterization in experiments. Our theoretical study reveals that Sc2S@Td(19151)-C76 which satisfies the isolated-pentagon rule (IPR) possesses the lowest energy, followed by three non-IPR structures (Sc2S@C2v(19138)-C76, Sc2S@Cs(17490)-C76, and Sc2S@C1(17459)-C76). To clarify the relative stabilities of those isomers at high temperatures, enthalpy-entropy interplay has been taken into consideration. Calculation results indicate that three species Sc2S@Td(19151)-C76, Sc2S@C2v(19138)-C76, and Sc2S@C1(17459)-C76 have noticeable molar fractions at the fullerene-formation temperature region (500-3000K), and the Sc2S@C1(17459)-C76 with one pentagon pair becomes the most predominant isomer above 1800 K, suggesting that the unexpected non-IPR structure is thermodynamically favorable at elevated temperatures. In addition, the structural characteristics, electron features, UV-vis-NIR adsorptions, and (13)C NMR spectra of those three stable structures are introduced to assist experimental identification and characterization in future.

Sc2S@C68: an obtuse di-scandium sulfide cluster trapped in a C(2v) fullerene cage.

The spectrum-detected smallest sulfide clusterfullerene Sc2S@C68 has not been characterized yet. Herein, we explored a series of Sc2S@C68 species to determine which could be the most promising isomer. The results suggest that a sulfide cluster encapsulated in the C2v(6073)-C68 cage which violates the isolated pentagon rule (IPR) with two opposite pentalenes has the lowest energy and an overwhelming thermodynamic stability. Two scandium atoms coordinate with the two opposite pentalenes, leading to an obtuse Sc-S-Sc angle of 151°. The bond lengths of the two Sc-S bonds are equivalent. Frontier molecular orbital distributions exhibit substantial overlaps between metallic orbitals and cage orbitals, indicating that covalent interactions cannot be ignored, which have been unambiguously identified in terms of Mayer bond order and bonding critical point (BCP) indicator methods. Electrochemical properties as well as (13)C NMR, UV-vis-NIR, and IR spectra of Sc2S@C2v(6073)-C68 have been theoretically studied to assist further experimental characterization.

Carbide clusterfullerene Gd2C2@C92 vs dimetallofullerene Gd2@C94: a quantum chemical survey.

The geometric, electronic structure, and thermodynamic stability of Gd2C94 species, including dimetallofullerenes Gd2@C94 and carbide clusterfullerenes Gd2C2@C92, have been systematically investigated by a density functional theory approach combined with statistical mechanics calculations. Although the Gd2@C2(153480)-C94 is determined to possess the lowest energy, its molar fraction at the temperature region of fullerene formation is extremely low if the temperature effect is taken into consideration. Meanwhile, three C92-based carbide clusterfullerene species, Gd2C2@D3(126408)-C92, Gd2C2@C1(126390)-C92, and Gd2C2@C2(126387)-C92, with some higher energy are exposed to possess considerable thermodynamic stabilities within a related temperature interval, suggesting that carbide clusterfullerenes rather than dimetallofullerenes could be isolated experimentally. Although one isomer, Gd2C2@D3(126408)-C92, has been indeed obtained experimentally, a novel structure, Gd2C2@C1(126390)-C92, behaving as the most abundant isomer at more elevated temperatures with the largest SOMO-LUMO gap, is predicted for the first time to be another proper isomer isolated in the experiment. Moreover, in order to further analyze the interaction between gadolinium atoms and carbon atoms in either a carbide cluster or a fullerene cage, frontier molecular orbital, natural bond orbital, and Mayer bond order analyses have been employed, and the results show that the covalent interaction cannot be neglected. The IR spectra of Gd2C2@C92 have been simulated to provide some valuable guidance for future experiments.

Isolation of a fruit ripening-related tonoplast aquaporin (GjTIP) gene from Gardenia jasminoides.

Aquaporins are membrane water channels that play critical roles in controlling the water content of cells and tissues. In this work, a full-length cDNA encoding putative aquaporins was isolated from Gardenia jasminoides fruit cDNA library. The GjTIP cDNA is 1188 bp, contains a predicted 774 bp open reading frame that encodes 257 amino acids. A phylogenetic analysis conducted with previously characterized aquaporins from other plant species indicates that the cDNA encode putative tonoplast aquaporins (TIPs), and proposed that GjTIP has a tendency to be a mixed function aquaporin similar to the TIP1s from Arabidopsis and Gossypium raimondii. A typical "hourglasses" three-dimensional model of GjTIP was built. The expression of the GjTIP transcripts at fruits during maturation was conducted by RT-PCR analysis. The data revealed that the transcript levels of GjTIP have increased during fruit maturation.

Prognosis analysis and risk factors related to progressive intracranial haemorrhage in patients with acute traumatic brain injury.

BACKGROUND: Since progressive intracranial haemorrhage (PIH) was introduced in neurosurgical literatures, several studies have been performed. PIH has been shown to be associated with a high increase in the risk of clinical worsening and related to morbidity and mortality as well. So, early detection and prediction of PIH is practically important in a clinical situation. OBJECTIVES: To investigate the risk factors related to PIH in patients with acute traumatic brain injury (TBI) and analyse their clinical significances. METHODS: PIH was confirmed by comparing the first and repeated CT scans. Data compared included gender, age, mechanism of injury, Glasgow Coma Score (GCS) at admission, timing from injury to the first CT, the signs of the initial CT scan, prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (Fg), thrombin time (TT), platelet (PLT) and D-dimer (D-D) values. Logistic regression analysis was used to show the risk factors related to PIH. RESULTS: A cohort of 498 patients with TBI was evaluated, and there were 139 (27.91%) patients who suffered from PIH. The differences between PIHs and non-PIHs were significant in age, GCS at admission, the signs of the initial CT scan (fracture, subarachnoid haemorrhage, brain contusion and primary haematoma), PT, Fg and D-D values (p < 0.001). Logistic regression analysis was used to identify that CT scans (subarachnoid haemorrhage, brain contusion and primary haematoma) and plasma D-D values as the most important predictors of PIH (p < 0.001). CONCLUSIONS: For patients with the initial CT scan showing subarachnoid haemorrhage, brain contusion and primary haematoma with abnormal D-D levels, an earlier and dynamic CT scan should be performed, for the detection of PIH as early as possible and the medical intervention would be enforced in time.

Early CT signs of progressive hemorrhagic injury following acute traumatic brain injury.

INTRODUCTION: Since progressive hemorrhagic injury (PHI) was introduced in neurosurgical literatures, several studies have been performed, the results of which have influenced doctors but do not define guidelines for the best treatment of PHI. PHI may be confirmed by a serial computerized tomography (CT) scan, and it has been shown to be associated with a fivefold increase in the risk of clinical worsening and is a significant cause of morbidity and mortality as well. So, early detection of PHI is practically important in a clinical situation. METHODS: To analyze the early CT signs of progressive hemorrhagic injury following acute traumatic brain injury (TBI) and explore their clinical significances, PHI was confirmed by comparing the first and repeated CT scans. Data were analyzed and compared including times from injury to the first CT and signs of the early CT scan. Logistic regression analysis was used to show the risk factors related to PHI. RESULTS: A cohort of 630 TBI patients was evaluated, and there were 189 (30%) patients who suffered from PHI. For patients with their first CT scan obtained as early as 2 h post-injury, there were 116 (77.25%) cases who suffered from PHI. The differences between PHIs and non-PHIs were significant in the initial CT scans showing fracture, subarachnoid hemorrhage (SAH), brain contusion, epidural hematoma (EDH), subdural hematoma (SDH), and multiple hematoma as well as the times from injury to the first CT scan (P < 0.01). Logistic regression analysis showed that early CT scans (EDH, SDH, SAH, fracture, and brain contusion) were predictors of PHI (P < 0.01). CONCLUSION: For patients with the first CT scan obtained as early as 2 h post-injury, a follow-up CT scan should be performed promptly. If the initial CT scan shows SAH, brain contusion, and primary hematoma with brain swelling, an earlier and dynamic CT scan should be performed for detection of PHI as early as possible and the medical intervention would be enforced in time.