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Objective:To investigate the application value of CT and MRI imageomics based on machine learning method in the diagnosis of pancreatic cancer.Methods:The clinical data of 62 patients with surgically resected and pathologically confirmed pancreatic cancer, who underwent enhanced CT scan, MRI plain or enhanced scan in Shanghai General Hospital between January 2014 and December 2021 were collected. According to the chronological order of surgery, 49 patients from January 2014 to December 2020 were enrolled in the training set and 13 patients from January 2021 to December 2021 were enrolled in the validation set. 3D-slicer 4.8.1 software was used to draw the region of interest in each layer of CT and MRI images for cancerous and paracancerous tissue segment. Image features were extracted by Python and the optimal feature set from the training set data was obtained by using Lasso regression model. The machine learning decision tree model was constructed. The receiver operating characteristic curve(ROC) curve was drawn, and the area under the curve (AUC) was calculated to evaluate the value of these three kinds of imageomics models in the diagnosis of pancreatic cancer.Results:The 1 767 CT features and 1 674 MRI features were obtained from enhanced CT scan, MRI plain scan and enhanced MRI scan, respectively. For the differential diagnosis model of cancerous tissue and paracancerous tissue, the enhanced CT scan data model obtained the optimal feature set involving 6 features, the MRI plain scan model obtained the optimal feature set involving 16 features, and the enhanced MRI scan model obtained the optimal feature set involving 15 features. The diagnostic model based on enhanced CT scan had an AUC of 0.98 in the training set and 1 in the verification group. The AUC of the MRI plain scan and enhanced MRI scan models in both the training set and the validation set was 1. The specificity and sensitivity of machine learning decision tree model based on the three kinds of imageomics models in the diagnosis of cancerous tissue and paracancerous tissue were 100%. For the differential diagnosis model of splenic artery wrapping, the enhanced CT scan model didn′t obtain the optimal features and had no diagnostic efficacy. The MRI plain scan model and enhanced MRI scan model obtained the optimal feature set involving 5 and 4 features, respectively. The AUC of the MRI plain scan model in the training set and the validation set were 0.862 and 0.750, respectively, with diagnostic sensitivity of 93.8% and 50.0%, and specificity of 78.6% and 100%, respectively. The AUC of the enhanced MRI scan model in the training set and the validation set were 0.950 and 0.861, respectively, with diagnostic sensitivity of 90.0% and 93.6%, and specificity of 100% and 78.6%, respectively.Conclusions:Based on the radiomics of CT enhanced, MRI plain scan and enhanced MRI scan, the machine learning diagnostic model has an accuracy of more than 90% in differentiating pancreatic cancer from paracancerous tissue. For the differentiation of splenic artery wrapping in pancreatic cancer, the diagnostic model based on enhanced MRI scan haS the best diagnostic efficiency.
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Objective To analyze the adverse events in patients diagnosed with oligometastasized castration resistant prostate carcinoma (CRPC) receiving radiotherapy for the primary and metastatic prostate carcinomas.Methods Twenty patients with oligometastasized CRPC admitted to our hospital between 2011 and 2015 were treated with image-guided volumetric modulated arc therapy (VMAT).The dose for prostate+ seminal vesicle was 76 Gy/38 f,46 Gy/23 f for the pelvic lymph node and the median dose for the metastatic lesions was 60 Gy (52-66)/23 f.Relevant clinical data and adverse events were analyzed.Results All patients completed the radiotherapy.Only 1 patient showed grade Ⅲ urinary obstruction and received catheterization.In terms of acute adverse events of ≥ grade Ⅱ,urinary tract was observed in 4 cases (20％),rectum in 2 (10％) and blood system in 2(10％).The rectal V50 was correlated with acute adverse events of ≥ grade Ⅱ.The median follow-up time was 24.2 months.No patient suffered from late adverse events of ≥ grade Ⅱ.All cases showed a decline in the level of prostate specific antigen (PSA) after radiotherapy.The median PSA reduction rate was 99％.Among them,16 cases (80％) had a PSA reduction rate of over 90％.Conclusions It is safe and efficacious to perform radical dosage radiotherapy for primary and metastatic prostate carcinomas in patients with oligometastasized CRPC.
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Objective Using middle cerebral artery occlusion (MCAO) model to observe protective effect of effective components of bezoar on brain damage.To discuss the anti-cerebral ischemia mechanism and compare the efficacy of effective components of bezoar from the endoplasmic reticulum stress intervention angle.Methods Rats were stratified randomly divided into sham group,model group,Qingkailing group (positive drug,3 mL/kg),taurine group,ursodeoxycholic acid (UDCA,78 mg/kg) group,taurine-conjugated ursodeoxycholic acid (TUDCA,100 mg/kg) group.Through establish MCAO model in rats,observed the scores of the neurologic impairment,measured infarct volume by TTC.Immunohistochemistry and Western blotting were Used to detect the content of P-PERK,P-EIF2α,and ATF4.Results Compared with sham group,neurologic impairment scores of model group significantly reduced (P ＜ 0.01).Compared with model group,Qingkailing group,UDCA group,and TUDCA group significantly improved neurological function in rats (P ＜ 0.05,0.01).Compared model group,all the treatment groups could significantly reduce the volume of cerebral infarction (P ＜ 0.01).Compared with sham group,expression of P-PERK,P-EIF2α,and ATF4 was significantly increased (P ＜ 0.01).Compared with model group,all the treatment groups reduced the expression of P-PERK,P-EIF2α,and ATF4 in varying degrees,effect of Qingkailing and TUDCA were more obvious.Conclusion The effective components ofbezoar alleviate cerebral ischemia reperfusion injury in rats by inhibiting endoplasmic reticulum stress,the effect of TUDCA is better than that of taurine and UDCA.
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Objective: To observe and analyze the application effect of ultrasound-guided modified Seldinger technique [MST] in Peripherally Inserted Central Catheter [PICC] catheterization
Methods:Two hundred patients treated with PICC catheterization from January 2013 to December 2015 were selected and randomly divided into two groups, namely, observation group and control group. The observation group adopted ultrasound-guided MST for catheterization while the control group applied traditional puncture technique for catheterization. Then efficacy of catheterization, success rate of catheterization and incidence rates of complications were compared between two groups
Results:Various indicators of catheterization effects of the observation group were better than those of the control group, and the differences were statistically significant [P<0.05]; one-time success rate of puncture and catheterization of the observation group was both higher than the control group [P<0.05];. Moreover, the incidence of puncture points bleeding, phlebitis and thrombus were all lower than those of the control group [P<0.05]
Conclusion:Implementing PICC catheterization based on ultrasound-guided modified Seldinger puncture technique can increase success rate of puncture, improve the effect of catheterization, lower incidence rate of adverse effects of catheterization and improve satisfaction and comfort level of patients
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Objective To evaluate the value of linear array ultrasonic with high-frequency in the diagnosis of renal artery stenosis (RAS).Methods 1 828 patients who were doubted with RAS were studied.All of them were checked by ultrasonic with convex array probe and linear array probe.Results The sensitivity,specificity,false positive rate,false negative rate of convex array probe were 8.20％,97.10％,2.90％,21.80％.The sensitivity,specificity,false positive rate,false negative rate of linear array probe were 91.13％,99.80％,0.20％,8.87％.Conclusion Linear array with high-frequency can keep the measurement angle less than 60°,and can show the plaque,nature of the plaque and narrow rate of renal artery.It may be more helpful in the diagnosis of RAS.
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[Objective]For revealing the definition of the concept of the Yin of liver and the Yang of liver ,and its historical evolution. [Method]The definition of the concept of the Yin of liver and the Yang of liver and the mainstream view of Yin and Yang of before the Song Dynasty, Song Dynasty and modern is investigated in this paper. The definition of the concept of the Yin of liver and the Yang of liver of different periods, different ideological background and different mainstream view of Yin and Yang is clarified by historical investigation. [Result]Because of the influence of Confucius studies, there is not the definition of the concept of the Yin of liver and the Yang of liver based on the object of liver in the TCM theory of Han and Tang dynasties. The Yin of liver and the Yang of liver mainly refer to the yin qi and yang qi in the liver. Because of the influence of neo-confucianism, the concept of the Yin of liver and the Yang of liver based on the object of liver was established in the TCM theory of Song and Ming dynasties. The Yin of liver and the Yang of liver mainly refer to the body and function of liver. Under the background of modernization of TCM, the concept of the Yin of liver and the Yang of liver based on the object of liver was established in the basic theories of TCM. However, there is a controversy of the concept of the Yin of liver and the Yang of liver, because of the effect of modern philosophy and science, ignoring the change of Chinese philosophy. [Conclusion]The clear concept of the Yin of liver and the Yang of liver of different periods, different ideological background and different mainstream views of Yin and Yang will reduce the influence of the fictional historical. Whether in ancient literature research, the liver like zang-fu theory of TCM theory, research, or the modern liver zang-fu theory of TCM, and establishing the theory of Chinese medicine has a positive meaning.
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Objective To compare the clinical value of hepatitis C virus (HCV)antibody(HCV-Ab),hepatitis C virus core anti-gen (HCV-cAg),hepatitis C virus ribonucleic acid (HCV-RNA)in diagnosis for hepatitis C.Methods A total of 258 patients with hepatitis C were recruited in this study,HCV-RNA was detected by fluorescence quantitative PCR detection,HCV-Ab and HCV-cAg were detected by the double antigen sandwich ELISA statutory,and the test data was analyze.Results The result of HCV-Ab detection was significant difference with those of HCV-cAg and HCV-RNA detection respectively(P 0.05).Conclusion The coincidence rate of HCV-cAg detection and HCV-RNA detection was high,and complement with HCV-Ab,the early detection could be done to prevent the omission of HCV infection and to improve the detection rate.
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Objective To study the relationship between changes in prostate volume and neoadjuvant hormone therapy ( NHT) duration in prostate cancer radiotherapy. Methods Fifty patients with prostate cancer who received NHT were enrolled in the study continuously. The diameters along the x?, y?, and z?axes of the prostate were measured, and the volume of prostate was calculated weekly during radiotherapy. The relationship of prostate volume reduction with NHT duration, prostate volume before radiotherapy, and prostate cancer risk groups was analyzed during radiotherapy. Results The prostate volume in all patients decreased after radiotherapy. Patients with short NHT duration had larger changes in prostate volume and diameters than those with long NHT duration. Compared with those with a large prostate volume, patients with a normal prostate volume had larger changes in prostate volume and diameters long three axes after 7 weeks of radiotherapy, shorter NHT duration before radiotherapy, and lower risk of prostate cancer. In patients with low?and medium?risk prostate cancer, the prostate volumes were significantly reduced to 68?10% and 78?70%, respectively, of those before radiotherapy after no more than 4 months of NHT ( P=0?002) , but remained similar after more than 4 months of NHT. In patients with high?risk and more severe prostate cancer, the prostate volumes were significantly reduced to 76?59% and 85?46%, respectively, of those before radiotherapy after no more than 6 months of NHT (P=0?001), but remained similar after more than 6 months of NHT. Conclusions The changes in prostate volume and diameters along three axes during radiotherapy become smaller with longer NHT duration. Patients with low?or medium?risk prostate cancer have slight changes in prostate volume after more than 4 months of NHT, while patients with high?risk or locally advanced prostate cancer have slight changes in prostate volume after more than 6 months of NHT.
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Resveratrol synthase (RS) plays a key role in resveratrol (Res) biosynthesis. RS gene has been formerly reported to be transformed into many plant species and microorganisms, and to play certain roles in metabolic and regulation processes. In this paper, the transformations of RS gene in plants, and the related changes of biological properties, such as metabolites, anti-pathogen activities, anti-radical properties, and developmental characters in transgenic plants, as well as the production of resveratrol in microbes by utilizing RS gene were summarized. Moreover, the application prospects of RS gene in bioengineering were also addressed.
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Acyltransferases , Genetics , Genetic Engineering , Plants, Genetically Modified , Genetics , Stilbenes , MetabolismABSTRACT
Purpose To probe into the value of M-mode echocardiography and spectral Doppler echocardiography in diagnosing fetal atrial premature beats.Materials and Methods Echocardiography examinations were given to the seventy-three fetuses around 16-40 gestational weeks which were found suffering from fetal arrhythmia in the clinical examinations by using M-mode echocardiography and spectral Doppler. Thirty-two of them were screened out with fetal atrial premature beats, and their ultrasonic cardiograms were analyzed. The follow-up visits were later conducted.Results Among the thirty-two cases with fetal atrial premature beats, fourteen were attacked frequently, and the other eighteen were attacked accidentally. Two cases were documented with muscular ventricular septal defect. Apart from two missing cases, the rest thirty cases were found to be recovered from arrhythmia before or after birth in the follow-up visits. The disappearance rate of atrialpremature beats in the fetuses attacked frequently by the disease before birth was clearly lower than that in those attacked accidentally (P<0.05). Muscular ventricular septal defect in the two cases were found closed after birth. Conclusion M-mode echocardiography and spectral Doppler echocardiography, as non-invasive imagining techniques to take antenatal examination of fetal arrhythmia, have advantages such as reliable, direct, convenient and can be used repetitively, therefore can provide important information for clinical treatment and prognosis.
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Objective To investigate the value of laboratory testing in kidney diseases and to assess whether these marks can predict the renal histological lesions for screening the best clinical test combination.Methods The main clinical data,pathological types and laboratory examination indexes in 117 patients with renal biopsy in our hospital from December 2010 to March 2014 were collected and graded according to the WHO renal pathological classification standard and the Katafuchi semi-quantitative score standard classification (Ⅰ,Ⅱ,Ⅲ,Ⅳ).The differences in serum CysC,urine NAG,urine alpha 1-MG,urine mAlb and 24 h urine total protein (24h-UTP)level were compared among the various groups and their relations with the glomerulus was analyzed;the correlation and the statistical significance of each index in different groups was analyzed.Results NAG,alpha 1-MG and CysC had statistical differences between in the grade Ⅳgroup and the gradeⅠ,Ⅱ,Ⅲ groups (P <0.05),24h-UTP and mAlb had significant correlation in reflecting the kidney diseases (r=0.565,P =0.000);NAG and alpha 1-MG also had significant correlation in reflec-ting renal tubular interstitial disease (r=0.509,P =0.000).Conclusion The detection results of various detection indicators when rising to a certain height can be used for judging the progression of the patients clinical and pathological condition,illustrating the serious condition of illness;at the same time according to the correlation among the indexes and the detection efficiency,three indi-cators of Cys C,mAlb,alpha 1 - MG are screened out for conducting the combination detection,the detection efficiency could be greatly improved.
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Objective]This paper is for the theoretical formation of clear livering factors development process . [Method]Adopt the method of literature investigation, explore the meaning of liver governing smoothing and dispersing Qi. [Result]It has three meanings: Like smooth doesn't like depression;dredge(The ascending and descending of Qi);spread. The support theory behind it is:Five elements theory;The movement theory of Qi;Zhu Zhenheng ’ s theory of“Liver Governs Smoothing and Dispersing”. Relationships between three meanings and support theory is:With five elements theory explaining the function of the liver governing smoothing and dispersing Qi ,it eventual y uses the movement theory of Qi; With Zhu Zhenheng ’s theory of“Liver Governs Smoothing and Dispersing”, explain the function of the liver governing smoothing and dispersing Qi is different from the the movement theory of Qi. [Conclusion]Liver governing smoothing and dispersing Qi is a new theory of reconstruction by modern scientific theories and methods.
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To define the weighting coefficients of the symptoms and signs in the diagnosis of corresponding traditional Chinese medicine (TCM) syndrome elements of ulcerative colitis based on expert questionnaire investigation.
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ObjectiveTo define the maximum tolerated dose (MTD) of weekly cisplatin in concurrent chemoradiotherapy for Chinese cervical carcinoma.MethodsCervical carcinoma of stage ⅠB2- ⅣA were eligible for the study.PhaseⅠstudy was dose-escalation trial with 15 patients.All patients received whole pelvic radiotherapy with three dimentional conformal radiotherapy technique. Concurrent cisplatin started from the dose of 20 mg/m2 to 25 mg/m2,30 mg/m2,35 mg/m2,40 mg/m2 for the weekly schedule ( ≥3 patients per dose group) and the doses were steadily escalated to 40 mg/.m2.If the dose was increased to 40 mg/m2 without dose-limiting toxicity ( DLT),40 mg/m2 would be the maximum tolerated dose (MTD).According to the MTD dose from Phase Ⅰ study,we conducted phase Ⅱ clinical trial with 36 patients.ResultsIn Phase Ⅰ study,cisplatin dose was escalated to 40 mg/m2 and DLT had not been reached.Thirty-six patients in Phase Ⅱ study included 9 inpatients and 27 outpatients.All 9 inpatients completed 6 cycles of chemotherapy. In 27 outpatients,18 patients (66％) completed 6 cycles of chemotherapy,19 patients (70％) completed 5 cycles and 25 patients (92％) completed 4 cycles of chemotherapy.All patients completed radiotherapy.Major adverse effects were grade 1 and 2 gastrointestinal toxicities and neutropenia.ConclusionsWeekly 40 mg/m2 cisplatin concurrent with radiotherapy is well tolerated when given to Chinese patients with cervical carcinoma. For outpatients with poor performance status,the cisplatin dose needs to be reduced.
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To screen common traditional Chinese medicine (TCM) syndrome factors of chronic renal failure (CRF) via questionnaire investigation among experts.
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Objective: To select the common syndrome factors of menopausal syndrome through questionnaire investigation among experts. Methods: Firstly, a questionnaire was constructed on the basis of our previous research, and then investigation of the experts by the questionnaire was carried out. The experts came from twelve tertiary hospitals (6 cities) in China, and engaged in clinical practice of gynecology of traditional Chinese medicine (TCM) or integrated traditional Chinese and Western medicine. The common TCM syndrome factors of menopausal syndrome were selected based on consent degree of the experts in mean value, full marks ratio, rank sum and variation coefficient. Results: One hundred sets of the questionnaires were sent out and ninety-eight sets were returned back. The callback rate was 98%. In accordance with cumulative percentage of expert agreement and complete agreement more than 50% and the coefficient variation less than 0.25, we confirmed the common TCM syndrome factors of menopause syndrome. The syndrome factors related to disease location were kidney, liver, heart, and spleen, and those related to the nature of disease were yin deficiency, deficiency of essence, yang deficiency, hyperactivity of yang, qi deficiency, qi stagnation, blood deficiency, and blood stasis. Conclusion: Expert consultation questionnaire can collect consensus opinions of experts and is effective for identifying common TCM syndrome factors of a disease. The TCM syndrome factors acquired through the study may provide the evidence for establishment of TCM syndrome diagnosis criteria for the disease in future.
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Syndrome differentiation treatment is the traditional model of diagnosis and treatment of diseases in traditional Chinese medicine (TCM). To establish scientific diagnostic criteria of TCM syndrome is one of the key points in TCM study. In this paper, the basic models of the relevant diagnostic criteria of TCM syndrome and existed problems were reviewed. The authors pointed out the advantages of establishing diagnostic criteria of TCM syndrome based on TCM syndrome factors and combination of disease in Western medicine system and TCM syndrome, in which not only the characteristics of the disease in Western medicine were considered, but also the complexity and flexibility of syndrome identification and convenient application in clinical practice were resolved. The basic model and frame of the above diagnostic criteria and the procedures and methods used in developing the diagnostic criteria were also described and discussed.
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To compare the distribution characteristics of common syndrome types and syndrome elements of menopause syndrome in perimenopausal and postmenopausal women on the basis of standardized syndrome differentiation extracted by experts' experiences.
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Objective To investigate the activation of apoptotic genes of the brain with hypoxia- ischemia (HI) in newborn SD rats, and MRI changes and memory and learning ability in adulthood. Methods HI was induced by right carotid artery ligation followed by 2.5 h of hypoxia (6% O2) on 3-day-old SD rats (n=36). Control pups were sham-operated (n = 27). Right brain hemisphere was collected at 12 h and 7 d after HI and subjected to an apoptosis Oligo GEArrayR. MRI and Morris water maze test were performed on both groups at 42 and 44 days old, respectively. Results Comparing to 12 h after HI, up-regulated apoptotic genes included TNF, Caspase and pro-apoptotit genes of Bcl2 families, whereas the anti-apoptotic genes of Bcl2 family were down-regulated at 7 d after HI. The MRI assessment of the rats in HI group demonstrated that the area of the right cerebra l cortex was significantly smaller than the left side and control [periventricular layer: (23.5±3.6) mm2 vs (33.0±4.3) mm2, (34.5±3.9) mm2; hippocampus layer: (18.9±4.4) mm2 vs (29.1±5.0) mm2,(30.8±4.5) mm2, both P<0.01]. During the navigation trial, the HI rats demonstrated longer escape latency (4th day: (52.7±35.9) vs (17.8±8. 9) s, P<0.01). HI rats passed the platform less times than the control ones (T= 292.5, P<0.05) in space probe trial. Conclusions The activation of apoptotic genes induced by HI brain injury remains until 7 days later, involving intrinsic and extrinsic apoptotic pathway. The apoptosis of neural cells may lead to poor development of the cortex and impair the memory and learning ability in the adult rats after neonatal hypoxia- ischemia injury.
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Objective To investigate the diagnostic value of conventional and dynamic gadolinium-enhanced T1-weighted (T1W) MRI in benign and malignant endometrial polypoid lesions. The pathologic basis of MRI features was also evaluated. Methods The conventional and dynamic contrast enhanced MRI features in 48 cases with clinicopathologically-proved endometrial polypoid lesions were retrospectively analyzed, including 26 cases with malignant tumors (23 eases with endometrial carcinoma and 3 cases with endometrial sarcoma) and 22 cases with benign polypoid lesions (12 cases with endothehal polyps and 10 cases with submucons leiomyomas). The occurrence probability of central fibrous core, intratumoral cysts and intact junctional zone were evaluated by Fisher's exact test. Results Benign and malignant endometrial polypoid lesions had specific characteristics on MRL Endometrial carcinomas usually appeared as homogeneous intermediate or slightly high signal-intensity masses on T2-weighted images, and relatively homogeneous hypedense masses on contrast-enhanced images with myometrial invasion (P < 0.05). An irregular central fthrous core and small non-enhanced intratumoral cysts were seen more frequently in endometrial polyps (P < 0.05) than others. All 3 cases with uterine sarcomas showed obviously inhomageneous intensity on T2WI and demonstrated areas of early and persistent marked enhancement.Submucous leiomyomas demonstrated isodense or slightly low-density masses with defined outline on T2 WI and the endomerium was displaced. The diagnostic sensitivity, specificity and accuracy of malignant polypoid masses were 92.3% (24/26), 83.3% (20/24) and 95.8% (46/48) respectively. Conclusion Conventional and dynamic contrast-enhanced MRI are valuable in characterizing the benign and malignant endometrial polypoid lesions.