Research progress on the application of artificial intelligence technology in the diagnosis of oral and maxillofacial tumors / 口腔疾病防治

@#With the improvement of computer computing capability and the accumulation of a large amount of medical data, artificial intelligence is gradually being applied in the diagnosis of oral and maxillofacial tumors. Artificial intelligence technology can assist doctors in clinical diagnosis and improve the efficiency of clinical work and the accuracy of diagnosis. In recent years, researchers have focused primarily on the recognition of medical images. The commonly used method is to annotate a large number of images by experts for learning image features by machines. The available literature has been able to utilize artificial intelligence technology to diagnose tumors by analyzing medical images, pathological sections, and tumor photos. The main issues in the current research are uneven labeling data quality, small data size, limited research problems, and single data modalities. These problems need to be solved through the continuous improvement of algorithms and the accumulation of high-quality data. The future direction of artificial intelligence applications should be to integrate medical data from multiple sources, assist doctors in diagnosis, and explore a variety of noninvasive and easy-to-use new methods for the early diagnosis of tumors. This may completely change the existing diagnosis and treatment model of oral and maxillofacial tumors.

Prevalence and influencing factors of metabolic syndrome among different age groups in Tianjin / 中华健康管理学杂志

Objective:To investigate the prevalence the influencing factors of metabolic syndrome among different age groups in Tianjin district.Methods:According to the ‘2015 Chinese Adult Chronic Disease and Nutrition Surveillance Program’, multi-stage cluster random sampling method was used to extract 42 communities from 7 districts in Tianjin. A total of 1 753 adult residents in the 42 communities were selected as the research subjects to analyze the relationship between the influencing factors and metabolic syndrome with descriptive epidemiological analysis. The χ2 test, non-conditional logistic regression and classification tree models were used to analyze the data. Results:The prevalence rate of metabolic syndrome in Tianjin was 30.6%, and the standardized rate was 24.5%. The prevalence rate of metabolic syndrome in Tianjin was increased with age, which was the highest in elderly people (38.9%, ≥60 years). According to the classification tree model, in youth group (18―44 years old), gender, smoking, subjective feeling of health, annual household income and sleep duration were important influencing factors of metabolic syndrome, And the standardized importance was 100%, 95.59%, 22.55%, 20.94% and 9.89%, respectively. In the middle-aged group (45―59 years old), secondhand smoke exposure, subjective feeling of health, sleep duration, the Chinese Food Pagoda (CHFP) score and living region were important influencing factors of metabolic syndrome, and the standardized importance was 100%, 98.08%, 91.04%, 45.74% and 20.15%, respectively. In the elderly group (≥60 years old), sleep duration, secondhand smoke exposure, gender, the CHFP score and living region were important influencing factors of metabolic syndrome, and the standardized importance was 100%, 46.75%, 41.87%, 41.82% and 7.60%, respectively.Conclusions:The prevalence rate of metabolic syndrome is quite high in Tianjin. Tobacco hazard (smoking and secondhand smoke exposure) and sleep duration are the common influencing factors of metabolic syndrome in all age groups. There are different emphases among different age groups in the distributions of those influencing factors, so pointed interventions should be adopted accordingly.

Research progress on the neck management of oral squamous cell carcinoma with clinically node-positive neck / 口腔疾病防治

@#Oral squamous cell carcinoma (OSCC) is the most common malignant tumor in the oral and maxillofacial regions. Cervical lymph node metastasis is not only an important biological behavior of oral cancer but also an important factor affecting the prognosis of oral cancer patients. As neck dissection is the most commonly used method of neck management, the appropriate choice of surgical procedure is very important. The current view is that radical neck dissection or modified radical neck dissection can be used for patients with clinically node-positive neck (cN+), while selective neck dissection can be used for patients with clinically node-negative neck (cN0). In recent years, selective neck dissection has been increasingly popularized and applied. Its implications are also gradually expanding from cN0 to cN+. However, there is still no consensus on whether selective neck dissection can also be used in patients with cN+ necks. This article reviews the clinical studies on the neck management of cN+ OSCC patients in recent years, analyzes the effects of different neck dissections on the prognosis of cN+ OSCC patients, and summarizes the treatment principles of neck management.

Four new dammarane-type triterpenoid saponins from Gynostemma longipes C.Y.Wu / 药学学报

Dammarane-type triterpenoid saponins are regarded as the main active constituents of Gynostemma longipes C.Y.Wu. By using MCI and silica gel column chromatography, as well as preparative HPLC, we isolated four new dammarane-type triterpenoid saponins from the polar saponin fraction of G. longipes C.Y.Wu. Their structures were determined by comprehensive analyses of NMR and MS data and identified as (20S)-3β,20,21-trihydroxydammar-19-oxo-24-ene-3-O-{[α-L-rhamnopyranosyl(1→2)]-[β-D-xylopyranosyl(1→3)]-α-L-arabinopyranosyl}-21-O-β-D-glucopyranosyl(1→6)-β-D-glucopyranoside (1), (20S)-3β,20,21-trihydroxydammar-24-ene-19-oxo-3-O-[α-L-rhamnopyranosyl(1→2)]-[β-D-xylopyranosyl(1→3)]-α-L-arabinopyranosyl-21-O-α-L-rhamnopyranosyl(1→6)-β-D-glucopyranoside (2), (20S)-3β,19,20,21-terahydroxydammar-24-ene-3-O-{[α-L-rhamnopyranosyl(1→2)]-[β-D-xylopyranosyl(1→3)]-α-L-arabinopyranosyl}-21-O-[β-D-glucopyranosyl(1→6)]-β-D-glucopyranoside (3), (20S)-3β,20,21-trihydroxydammar-24-ene-3-O-{[α-L-rhamnopyranosyl(1→2)]-[β-D-glucopyranosyl(1→3)]-β-D-glucopyranosyl}-21-O-[β-D-glucopyranosyl(1→6)]-β-D-glucopyranoside (4). Compounds 1-4 are new dammarane-type triterpenoid saponins which contain five glycosyl residues.

Classification and reconstruction of complex defects after lateral facial tumor surgery / 中华耳鼻咽喉头颈外科杂志

Objective: To explore the classification and reconstruction strategy of defects in lateral face region after operation of malignant tumors. Methods: Eighteen cases with the reconstruction of complicated defects after resection of tumors in the region of lateral face from January 2015 to January 2018 in Hunan Cancer Hospital were retrospectively reviewed. There were 14 males and 4 females, aged from 32 to 68 years. According to the presence or absence of bony scaffold, complicated defects were divided into two main categories: soft tissue perforating defects and soft tissue defects combined with bony scaffold defects. All soft tissue perforating defects in 5 cases were repaired with free anterolateral femoral flaps. Among 13 cases with soft tissue plus bony scaffold defects, 3 were repaired with free fibular flaps, 6 with free fibular flaps combined with free anterolateral femoral flaps, and 4 with chimeric deep circumflex iliac artery perforator flaps combined with anterolateral femoral flaps. Results: All flaps survived well. Two patients complicated with fistula in floor of mouth, but the wound healed after dressing change. Transoral feeding was resumed within 2 weeks after surgery in all patients. One year follow-up evaluation showed that 14 cases had symmetrical face and 10 cases had mouth opening more than 3 transverse fingers. After 36-50 months of follow-up, 6 patients died, with an overall 3-year survival rate of 66.7%. Conclusion: The classification of defects with or without bony stent loss is conducive to the overall repair design, the recovery of facial contour stent, the effective fill of dead space and the maintain of residual occlusal relationship. Good reconstruction results require a multi flap combination of osteocutaneous and soft tissue flaps.

Prediction of Pathological Subtypes of Lung Adenocarcinoma with Pure Ground Glass Nodules by Deep Learning Model / 中国医学科学院学报

To make a preliminary pathological classification of lung adenocarcinoma with pure ground glass nodules(pGGN)on CT by using a deep learning model. CT images and pathological data of 219 patients(240 lesions in total)with pGGN on CT and pathologically confirmed adenocarcinoma were collected.According to pathological subtypes,the lesions were divided into non-invasive lung adenocarcinoma group(which included atypical adenomatous hyperplasia and adenocarcinoma in situ and micro-invasive adenocarcinoma)and invasive lung adenocarcinoma group.First,the lesions were outlined and labeled by two young radiologists,and then the labeled data were randomly divided into two datasets:the training set(80%)and the test set(20%).The prediction Results of deep learning were compared with those of two experienced radiologists by using the test dataset. The deep learning model achieved high performance in predicting the pathological types(non-invasive and invasive)of pGGN lung adenocarcinoma.The accuracy rate in pGGN diagnosis was 0.8330(95% =0.7016-0.9157)for of deep learning model,0.5000(95% =0.3639-0.6361)for expert 1,0.5625(95% =0.4227-0.6931)for expert 2,and 0.5417(95% =0.4029-0.6743)for both two experts.Thus,the accuracy of the deep learning model was significantly higher than those of the experienced radiologists(=0.002).The intra-observer agreements were good(Kappa values:0.939 and 0.799,respectively).The inter-observer agreement was general(Kappa value:0.667)(=0.000). The deep learning model showed better performance in predicting the pathological types of pGGN lung adenocarcinoma compared with experienced radiologists.

Overview of Experimental Methods for Antimicrobial Activity of Natural Drugs / 中国实验方剂学杂志

The antibiotics have obvious antibacterial and anti-inflammatory effects, but their toxic side effect, secondary infection and bacterial resistance have become a global problem. Traditional Chinese medicine(TCM) has always been the treasure of traditional culture and national characteristics in China since ancient times. It also has remarkable effect on inhibiting the growth of bacteria and killing pathogenic bacteria. The research on bacteriostatic experiment of TCM has gradually become a hot topic. Sensitivity experiments for such natural medicines have gradually become a research hotspot, but the complexity and particularity of natural medicines will vary with different methods. Therefore, different methods of drug sensitivity experiments should be matched with different natural drugs. By collecting and sorting out the relevant literature at home and abroad, this paper systematically summarizes the commonly used in vitro, in vivo and their combination bacteriostasis experimental methods of natural medicine activity, analyses the advantages and disadvantages of each method in the process of application, finds that different kinds of natural drugs have different applicable methods, and puts forward suggestions for the operation of each experimental method, in order to provide ideas for the selection of antibacterial susceptibility research experiments of natural medicines. It also provides a reliable reference method for solving the problem of antibiotic abuse and the development and utilization of natural medicines.

Dietary intake of sodium and potassium among adult inhabitants and evaluation of survey methods in Tianjin in 2015 / 中华预防医学杂志

Objective@#To understand the status and food sources of daily dietary intake of sodium and potassium among adult inhabitants in Tianjin city, and to compare the consistence of sodium and potassium intake determined by combination of 3 consecutive 24-hour recalls and weighing family condiments (3 d dietary survey method) with 24 h urine sodium and potassium determination. @*Methods@#Multistage cluster sampling method was applied to select 1 955 adult inhabitants from 840 households of 7 districts in Tianjin in 2015. Questionnaire survey was used to obtain basic information, 3 d dietary method was used to obtain dietary information, and 450 subjects was selected by systematic random sampling method for 24 h urine collection and determination of sodium and potassium, and 153 complete 24 h urine samples were selected by the coefficient of urinary creatinine excretion, then the consistence of the determination was compared with 3 d dietary survey method. @*Results@#1 828 subjects were enrolled in this study with age of (54.6±14.7) years, among which 858 were male (46.9%). The average standard intake of sodium and potassium per people per day were (5 631.2±3 372.1) mg and (1 662.1±750.5) mg, while the average actual daily intake were (5 315.8±3 196.5) mg and (1 560.7±696.8) mg. 98.7% (1 804/1 828) of the subjects had dietary sodium intake exceeding the recommended adequate intake of China residents(1 300-1 500 mg/d), while 78.5% (1 435/1 828) consumed dietary potassium below the recommended adequate intake(2 000 mg/d). The main resource of sodium was condiments, among which cooking salt accounted for 61.5%, soy sauce accounted for 11.2%. Potassium mainly came from cereals (32.4%) and vegetables (18.1%). Compared with the 24 h urine sodium method, 3 d dietary method overestimated the sodium intake with a gap [median (P25, P75)] as 401.7 (-1 130.6, 1 939.5) mg/d with statistical difference (P<0.05). The gap [median (P25-P75)] for potassium between the two methods was 79.1 (-577.5, 565.2) mg/d, without statistical difference (P>0.05). @*Conclusion@#The dietary intake of sodium is high while potassium is low among adults inhabitants in Tianjin city. Compared with the 24 h urine sodium and potassium determination, the 3 d dietary method has a good consistency in evaluating the dietary potassium intake level of the population, but overestimates the dietary sodium intake.

Clinical Application of Detecting Serum PPAR-γ mRNA,MMP-9 mRNA in the Diagnosis of Ruptured Intracranial Aneurysm / 现代检验医学杂志

Objective To investigate the clinical application of detecting serum PPAR-γmRNA,MMP-9mRNA in the diagnosis of ruptured intracranial aneurysm.Methods The expression of serum PPAR-γmRNA,MMP-9mRNA were detected for 87 cases of patients with intracranial aneurysm,including ruptured group and non-ruptured group,respectively,with 57 cases and 30 cases of patients.The control group should be established to compare the changes of the above indicators.Results The expression of serum PPAR-γmRNA in the ruptured group,the non-ruptured and the controls group were 0.23±0.03,0.59±0.11 and 0.87±0.15,which of MMP-9mRNA were 0.93±0.17,0.63±0.13 and 0.25±0.05.Compared with those in the controls group,the expression of serum PPAR-γmRNA in the ruptured group significantly lowered (t=23.79,P＜0.01),which of MMP-9mRNA raised (t=25.63,P＜0.01).There were statistically significant differences.The expression of PPAR γmRNA in the ruptured group were lower than those in the unruptured group,which of MMP-9 mRNA were higher (t=15.32,16.27,P＜0.01).To establishing the receiver-operating characteristic curve (ROC curve) in evaluating the clinical significances of the two markers to use the rupture group and non-ruptured group as the dependent variable,the AUC of the expression of serum PPAR-ymRNA,MMP-9mRNA were 0.858 (95 ％ CI:0.775 ～ 0.940,P =0.000),0.842 (95 ％CI:0.756～0.929,P=0.000).As the dependent variable in the control group and unruptured group,the AUC of the expression of serum PPAR-γmRNA,MMP-9mRNA were 0.827 (95％CI:0.734～0.920,P=0.000);0.818 (95％CI:0.722 ～0.914,P=0.000).Conclusion Detection of serum PPAR-γ mRNA,MMP-9 mRNA can be applied in assessment of occurrence and progression for the intracranial aneurysm,and to provide evidences for the early detection of ruptured intracranial aneurysm.

Application of digital surgical techniques in mandibular reconstruction / 口腔疾病防治

@#The mandible is the most important bony support in the lower 1/3 skeleton of the face which is critical for both esthetics and function. Mandibular defects, resulting from tumor resection, can cause severe functional and cosmetic deformities. Nowadays, vascularized bony tissue transfer such as free fibula flap has been widely used for mandibular reconstruction. However, traditional mandibular reconstruction based on clinical experience may hawe some problems in accuracy and efficiency because of lacking individualized design. In recent years, digital surgical techniques such as computer-aided design, rapid prototyping and surgical navigation have been used for mandibular reconstruction surgery. Accurate design for tumor resection as well as individualized design for mandibular reconstruction can be performed with computer preoperatively which help to turn the virtual plan into reality by using surgical guide or navigation. Many studies suggested that digital surgical techniques could significantly improve the clinical outcome of mandibular reconstruction. In this article, we summarized the application of digital surgical techniques for mandibular reconstruction based on our own experience and literatures review.

Mechanism of IL-35 inhibition of inflammatory response and T cell response in alleviate of allergic rhinitis / 中国免疫学杂志

Objective:To investigate the effect of IL-35 on inflammatory response and T cell response in allergic rhinitis.Methods: 37 patients(observation group) with allergic rhinitis and 35 healthy volunteers(control group) after allergen detection of allergic rhinitisin in our hospital from Jan 2012 to Jan 2016 were selected as study subjects.The peripheral blood of observation group and control group were collected,and the serum levels of IL-35 were detected by ELISA.The animal model of allergic rhinitis in mice was established,the peripheral blood of mice was collected,and the serum level of IL-35 and IgE were detected by ELISA.The eosinophils that infiltrated in nasal mucosa were detected after tissue biopsy in mice.The mouse spleen cells were isolated and the ovalbumin antigen was added in the culture medium,IL-35 was or was not added into the culture medium,the ovalbumin specific T cell responses was detected.The cytokines IL-2,IL-4,IL-5,IL-10,IL-13,IL-17,IL-23,IL-27 and TNF-α in culture supernatant of ovalbumin specific T cells were detected by ELISA.The expression of IL-2,IL-4,IL-5,IL-10,IL-13,IL-17,IL-23,IL-27 and TNF-α in ovalbumin specific T cells were detected by Real-time PCR.The activation of JNK,Erk1/2 and p38 signal pathway in ovalbumin specific T cells were detected by Western blot.Results: The serum level of IL-35 in observation group was significantly lower than control group(P<0.05).The results showed that the number of eosinophils which infiltrated in AR mice nasal mucosa was significantly higher than normal mice(P<0.05),while the serum level of IL-35 in AR mice was significantly lower than normal mice(P<0.05).Ovalbumin specific T cell reactivity assay showed that IL-35 could significantly inhibit the T cell response.ELISA and Real-time PCR results showed that IL-35 could significantly down regulate the expression of IL-4,IL-5,IL-13,IL-17,IL-23 and TNF-α,and up regulate the expression of IL-2,IL-10 and IL-27.The Western blot results showed that IL-35 can inhibit the activation of JNK,Erk1/2 and p38 signal pathway of ovalbumin specific T in cells.Conclusion: IL-35 can regulate the expression of inflammatory cytokines in inflammatory response and inhibit T cell response,thus reducing allergic rhinitis,the mechanism may be through regulation of JNK,Erk1/2 and p38 signal pathway activation.

Pilot study on MRI of human colon adenocarcinoma cells labeled with superparamagnetic iron oxide in vitro / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To study the feasibility of MRI of human colon adenocarcinoma cell line (Lovo) labeled with superparamagnetic iron oxide(SPIO) nanoparticles in vitro.</p><p><b>METHODS</b>Lovo cells (5 × 10(5) and 1 × 10(6)) were cultured in medium containing different SPIO nanoparticles (50 microl and 500 microl). Transmission electron microscopy was used to observe cellular ultrastructure and to determine the uptake and distribution of particles in Lovo cells at 1-, 3-, 6-hours. MRI of Lovo cells was performed with T1WI, T2WI sequences. Unlabeled cells were used as controls.</p><p><b>RESULTS</b>Uptake of SPIO nanoparticles occurred within 6 hours. On T1 weighted imaging, there was no significant difference in signal intensity between the experimental groups and the control group. On T2 weighted imaging, there was no significant difference in signal intensity between the experimental groups and the control group after culture of 1 h. Signal intensity began to decrease in 1 × 10(6) Lovo cells labeled with 500 microl SPIO nanoparticle after 3 hours culture. Signal intensity decreased in all the experimental groups after 6 hours culture.</p><p><b>CONCLUSION</b>Human colon adenocarcinoma cell line (Lovo) can be labeled with SPIO nanoparticles, and the labeled cells can be imaged with MRI equipment.</p>

The clinical study of circumferential ablation around orifice of pulmonary vein by radiofrequency energy with chronic atrial fibrillation undergoing rheumatic valvular heart surgery / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the clinical efficiency of circumferential ablation around orifice of pulmonary vein by radiofrequency (RF) energy in the cure of chronic atrial fibrillation (AF) in patients with rheumatic valvular disease.</p><p><b>METHODS</b>Radiofrequency catheter ablation was performed in 20 patients with rheumatic valvular disease and chronic AF who underwent heart valve surgery. The ablation temperature was 50 - 60 degrees C and the linear RF ablations were performed encircling the four openings of pulmonary veins and connecting the posterior mitral annulus with the probe made by ourselves especially for this ablative procedure. And amiodarone was given from the third day before the surgery and lasted for 3 months thereafter. Twenty patients with chronic AF who underwent valvular surgery but refused RF ablation were considered as the control group.</p><p><b>RESULTS</b>Sinus rhythm (SR) restored in 19 patients either spontaneously or after intraoperative direct current cardioversion, immediately after the operation, as compared with 16 patients in the control group. During the follow-up (24 +/- 3) months, 16 of 20 patients (80%) remained in sinus rhythm in patients received ablation, but in control group, SR was presented in only 7 of 20 patients (35%).</p><p><b>CONCLUSIONS</b>Circumferential ablation around orifice of pulmonary vein by RF energy is safe and effective in restoration and maintenance of SR in patients with rheumatic valvular disease and chronic AF.</p>

Clinical Value and Detection of Myocardial Bridge by Multi-slice Spiral CT Coronary Angiography / 实用放射学杂志

Objective To explore the characteristic and clinical meaning of myocardial bridge in patients with multi-slice spiral CT(MSCT) coronary angiography.Methods 875 patients with suspected or diagnosed coronary artery disease were studied with MSCT coronary angiography,579 cases were male and 296 cases were female,ranged from 30~87 years old in age with average of 60 years old.The heart was scanned with retrospectively ECG-gated,reconstruction from phase for all original tomographic source images at 30%~40% R-R phase interval according to heart rate ≥75 bpm and at 40%~50% R-R phase interval according to heart rate ≤75 bpm.The images of maximum intensity projection,multiplanar reconstruction and vulume reconstruction were gained to show left and right main coronary artery and their main branchs on mulliple angle.Results The myocardial bridges were detected in 89 cases,the positive rate was 10.2%,36 cases(40.5%)had different grade stenosis(≤50%).The myocardial bridges located at middle segment of anterior descending artery(79.8%),the thickness of myocardial bridge was 0.06~0.55 cm,the atherosclerosis plaques were found in 20 cases,the vascular stenosis was approximate to 50%.39 cases with simple myocardial bridges had angina,21 cases hadn’t angina.23 cases with myocardial bridges accompanied by coronary artery atherosclerosis had angina.Conclusion MSCT coronary angiography may clearly detect the myocardial bridge,which can provide more worthy information for clinical diagnosis and treatment.