Artificial intelligence system of faster region-based convolutional neural network surpassing senior radiologists in evaluation of metastatic lymph nodes of rectal cancer / 中华医学杂志(英文版)

BACKGROUND@#An artificial intelligence system of Faster Region-based Convolutional Neural Network (Faster R-CNN) is newly developed for the diagnosis of metastatic lymph node (LN) in rectal cancer patients. The primary objective of this study was to comprehensively verify its accuracy in clinical use.@*METHODS@#Four hundred fourteen patients with rectal cancer discharged between January 2013 and March 2015 were collected from 6 clinical centers, and the magnetic resonance imaging data for pelvic metastatic LNs of each patient was identified by Faster R-CNN. Faster R-CNN based diagnoses were compared with radiologist based diagnoses and pathologist based diagnoses for methodological verification, using correlation analyses and consistency check. For clinical verification, the patients were retrospectively followed up by telephone for 36 months, with post-operative recurrence of rectal cancer as a clinical outcome; recurrence-free survivals of the patients were compared among different diagnostic groups, by methods of Kaplan-Meier and Cox hazards regression model.@*RESULTS@#Significant correlations were observed between any 2 factors among the numbers of metastatic LNs separately diagnosed by radiologists, Faster R-CNN and pathologists, as evidenced by rradiologist-Faster R-CNN of 0.912, rPathologist-radiologist of 0.134, and rPathologist-Faster R-CNN of 0.448 respectively. The value of kappa coefficient in N staging between Faster R-CNN and pathologists was 0.573, and this value between radiologists and pathologists was 0.473. The 3 groups of Faster R-CNN, radiologists and pathologists showed no significant differences in the recurrence-free survival time for stage N0 and N1 patients, but significant differences were found for stage N2 patients.@*CONCLUSION@#Faster R-CNN surpasses radiologists in the evaluation of pelvic metastatic LNs of rectal cancer, but is not on par with pathologists.@*TRIAL REGISTRATION@#www.chictr.org.cn (No. ChiCTR-DDD-17013842).

Effect of early oral enteral nutrition on clinical outcomes after gastric cancer surgery / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the effect of early oral feeding with enteral nutrition preparation after surgery on clinical outcomes in patients with gastric cancer.</p><p><b>METHODS</b>Sixty patients with gastric cancer undergoing radical operation between July 2010 and May 2011 were randomly divided into two groups using random digit table: experimental group(n=30, administration of water and enteral nutrition early after surgery) and control group(n=30, conventional postoperative care protocol). Clinical outcomes, immune function, and nutritional status between the two groups were compared.</p><p><b>RESULTS</b>As compared to the control group, duration of fever was significantly shorter in the experimental group [(81.1±6.4) h vs. (87.3±8.0) h, P<0.05], as were postoperative time of flatus [(79.9±9.5) h vs. (86.6±8.7) h, P<0.05] and postoperative hospital stay [(7.83±2.23) d vs. (9.57±1.96) d, P<0.01]. The medical cost [(30,220±3,220) RMB vs.(34,600±32,120) RMB, P<0.01] was lower than that in the control group. There was no significant difference in morbidity between the two groups[13.3%(4/30) vs. 16.7%(5/30), P>0.05]. The levels of CD3(+)T, CD4(+)T, NK cell, CD4(+)T/CD8(+)T, albumin, and prealbumin were higher in the experimental group as compared to the control group on postoperative day 3 and 7(P<0.05).</p><p><b>CONCLUSION</b>Early oral feeding with enteral nutrition preparation after surgery can improve the nutritional status and immune function, and accelerate the rehabilitation for patients with gastric cancer.</p>

Association of interleukin-10 gene polymorphism with cachexia in patients with gastric cancer / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To investigate whether the single nucleotide polymorphisms (SNPs) at -1082, -819 and -592 of interleukin-10 gene and its haplotype are associated with cachexia in patients with gastric cancer.</p><p><b>METHODS</b>Radioimmunoassay was used to examine the serum levels of IL-10 in 223 patients with gastric cancer. The single nucleotide polymorphisms (SNPs) of IL-10 gene -1082G/A, -819T/C and -592A/C were analyzed using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP).</p><p><b>RESULTS</b>The serum levels of IL-10 were significantly higher in patients with cachexia than those without (P < 0.001). An increased frequency of -1082G allele was noted in patients with cachexia (P = 0.049). The frequencies of -1082AG and -819CC genotypes were elevated in patients with cachexia than those without (P = 0.036, 0.024). In a logistic regression analysis adjusted for actual weight, carcinoma location and stage, the -1082AG genotype was associated with an odds ratio of 1.989 (95%CI, 1.041 - 3.802, P = 0.037), and the -819CC genotype with an odds ratio of 3.393 (95%CI, 1.298 - 8.871, P = 0.013) for cachexia. Furthermore, haplotype analysis revealed that G1082C819C592 haplotype was associated with a significantly increased risk of cachexia (OR = 2.21; 95%CI, 1.14 - 4.30; P = 0.02).</p><p><b>CONCLUSION</b>Our results suggest that the gene haplotype of IL-10 contributes to the occurrence of cachexia in patients with gastric cancer in Chinese population.</p>

Discussion of new classification of epididymal malformation in cryptorchidism of children / 中华男科学杂志

<p><b>OBJECTIVES</b>To discuss the new classification of epididymal malformation in cryptorchidism.</p><p><b>METHODS</b>One hundred and fifty-three boys who were two to four year old underwent orchidopexy for cryptorchidism and 144 hydroceles who were two to eight year old were enrolled into control. Based on the observation of the status between testis and epididymia, the length of epididymis and the configuration of epididymis as well as spermaduct, we divided epididymal malformations in cryptorchidism into three types. Type I: obstruction of sperm transport, including I A, I B and I C; Type II: possible obstruction of sperm transport, defined by II A and II B; Type III: no obstruction of sperm transport, classified into III A and III B.</p><p><b>RESULTS</b>There were 47 (23.4%) out of 201 undescended testes with malformation of epididymides and 16 (10.3%) out of 155 testes in the control(P < 0.05). 11 of 48 cases of bilateral cryptorchidism had the same malformations, with 2 cases of type IB, 2 of IC, 1 of II A, 4 of III A and 2 of IV B underwent orchidopexy or orchiectomy.</p><p><b>CONCLUSIONS</b>These data showed that the incidence of epididymal abnormalities in cryptorchidism was higher than that in the hydroceles and it's not essential to have orchiectomy unlimitedly to serious epididymal abnormalities.</p>