Deep learning applied to two-dimensional color Doppler flow imaging ultrasound images significantly improves diagnostic performance in the classification of breast masses: a multicenter study / 中华医学杂志(英文版)

BACKGROUND@#The current deep learning diagnosis of breast masses is mainly reflected by the diagnosis of benign and malignant lesions. In China, breast masses are divided into four categories according to the treatment method: inflammatory masses, adenosis, benign tumors, and malignant tumors. These categorizations are important for guiding clinical treatment. In this study, we aimed to develop a convolutional neural network (CNN) for classification of these four breast mass types using ultrasound (US) images.@*METHODS@#Taking breast biopsy or pathological examinations as the reference standard, CNNs were used to establish models for the four-way classification of 3623 breast cancer patients from 13 centers. The patients were randomly divided into training and test groups (n = 1810 vs. n = 1813). Separate models were created for two-dimensional (2D) images only, 2D and color Doppler flow imaging (2D-CDFI), and 2D-CDFI and pulsed wave Doppler (2D-CDFI-PW) images. The performance of these three models was compared using sensitivity, specificity, area under receiver operating characteristic curve (AUC), positive (PPV) and negative predictive values (NPV), positive (LR+) and negative likelihood ratios (LR-), and the performance of the 2D model was further compared between masses of different sizes with above statistical indicators, between images from different hospitals with AUC, and with the performance of 37 radiologists.@*RESULTS@#The accuracies of the 2D, 2D-CDFI, and 2D-CDFI-PW models on the test set were 87.9%, 89.2%, and 88.7%, respectively. The AUCs for classification of benign tumors, malignant tumors, inflammatory masses, and adenosis were 0.90, 0.91, 0.90, and 0.89, respectively (95% confidence intervals [CIs], 0.87-0.91, 0.89-0.92, 0.87-0.91, and 0.86-0.90). The 2D-CDFI model showed better accuracy (89.2%) on the test set than the 2D (87.9%) and 2D-CDFI-PW (88.7%) models. The 2D model showed accuracy of 81.7% on breast masses ≤1 cm and 82.3% on breast masses >1 cm; there was a significant difference between the two groups (P < 0.001). The accuracy of the CNN classifications for the test set (89.2%) was significantly higher than that of all the radiologists (30%).@*CONCLUSIONS@#The CNN may have high accuracy for classification of US images of breast masses and perform significantly better than human radiologists.@*TRIAL REGISTRATION@#Chictr.org, ChiCTR1900021375; http://www.chictr.org.cn/showproj.aspx?proj=33139.

Effect of Forsythionin A on Gastrointestinal Motility Disorders in Mice Treated with Chemotherapy / 中国实验方剂学杂志

Objective:To observe the effect of forsythiaside A on gastrointestinal motility disorder induced by chemotherapy in mice， and explore the mechanism of forsythiaside A regulating gastrointestinal motility. Method:The 60 KM mice were randomly divided into normal group， model group， metoclopramide group （5 mg·kg-1） and forsythiaside A low， medium and high-dose groups （30， 60， 120 mg·kg-1）， 10 for each group， which include half male and half female. The above dose was given once a day for 4 consecutive days， which the intragastric volume was 10 mL·kg-1. One hour after 1rd day administration， equal volume of saline was intraperitoneally injected to the normal group， 2 mg·kg-1 cisplatin was intraperitoneally injected to the other groups with daily for 4 consecutive days. Observing the effects of forsythiaside A on gastric emptying and small intestinal propulsion on mice models， serum gastrin （GAS） and somatostatin （SS）， motilin （MTL）， vasoactive intestinal peptide （VIP） levels were examined by enzyme-linked immunosorbent assay （ELISA）. Activities of acetylcholinesterase （AChE） and total nitric oxide synthase （tNOS） in gastric antrum and ileum were detected by ELISA. The expression of AChE and inducible nitric oxide synthase （iNOS） in gastric antrum and ileum were detected by Western blot. Result:Compared with normal group， the gastric retention rate and small intestinal propulsion rate of the model group were significantly increased （P<0.01）， serum levels of MTL， GAS， SS and VIP， the AChE activity in the homogenate of ileum in the model group were significantly reduced （P<0.05，P<0.01）， while the tNOS activities in gastric antrum and ileum were significantly increased （P<0.05，P<0.01）. Protein expression of AChE in gastric antrum and ileum were significantly decreased （P<0.05）， and the expression level of iNOS protein was significantly increased in the model group （P<0.05）. Compared with model group， different doses of forsythiaside A can reduce the gastric residual rate and small intestinal propulsion rate of mice to varying degrees. Meanwhile forsythiaside A can increase the serum levels of MTL， GAS， SS， and VIP， and the AChE activity and protein expression levels in gastric antrum and ileum tissues were also increased， while tNOS activity and iNOS protein expression were decreased in gastric antrum and ileum （P<0.05，P<0.01）. Conclusion:Forsythiaside A can significantly ameliorate the delayed gastric emptying and small intestine hyperfunction induced by cisplatin in mice. Its mechanism to ameliorate gastrointestinal dysfunction caused by chemotherapy is related to the regulation of gastrointestinal AChE and NOS activity in gastric antrum and ileum and the regulation of gastrointestinal hormone levels.

Analysis of PM2.5 components during winter in Xinxiang city and their inflammatory effects on human type Ⅱ alveolar epithelial cells / 新乡医学院学报

Objective To analyze the PM2.5 components collected during winter in Xinxiang city and their inflammatory effects on human type lⅡ alveolar epithelial cells.Methods Fine particulate matter (PM2.5) was collected during winter in Xinxiang using a high-volume air sampler.The composition and mass concentration of soluble anions and metal elements in PM2.5 were determined with ion chromatography and inductive coupled plasma emission spectrometer,respectively.3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2-H-tetrazolium bromide assay was used to examine the effect of PM2.5 on viability of human type Ⅱ alveolar epithelial cell line A549;enzyme-linked immunosorbent assay was used to examine the expression of interleukin-1β(IL-1β) and interleukin-8 (IL-8) in A549 cells.Results Airborne PM2.5 contained higher levels of NOx and SO42-during winter in Xinxiang city.The amount of PM2.5-derived metal elements in PM2.5 varied significantly,with higher levels of Ca,Mg,Zn and Al.The inhibition ratio of 12.5,25.0,50.0,100.0,200.0,400.0 mg · L-1 pM2.5 group on A549 of human type Ⅱ alveolar epithelial cell was higher than that of 0.0 mg · L-1 PM2.5 group (P ＜ 0.05).The inhibition ratio of 200.0,400.0 mg · L-1 PM2.5 group on A549 of human type Ⅱ alveolar epithelial cell was higher than that of 12.5,25.0,50.0,100.0 mg · L-1 PM2.5 group(P ＜ 0.05).There was no significant difference in the inhibition ratio in the 12.5,25.0,50.0,100.0 mg · L-1 PM2.5 group (P ＞ 0.05),and there was no significant difference in the inhibition ratio between 200.0 mg · L-1 PM2.5 group and 400.0 mg · L-1 PM2.5 group(P ＞ 0.05).Compared with 0.0 mg · L-1 pM2.5 group,the IL-1βand IL-8 protein expression of the human type Ⅱ alveolar epithelial cells culture supernatants in the 25.0,50.0,100.0 mg · L-1PM2.5 group was higher(P ＜0.05).But there was no significant difference in the IL-1β and IL-8 protein expression of human type Ⅱ alveolar epithelial cell culture supernatants among 25.0,50.0,100.0 mg · L-1 pM2.5 group (P ＞ 0.05).Conclusion Analysis of source apportionment suggests that construction and automobiles are main sources of ambient PM2.5 air pollution.Moreover,exposure to PM2.5 can cause damage and pro-inflammatory response of human type Ⅱalveolar epithelial cells.

Alisol B inhibited complement 3a-induced human renal tubular epithelial to mesenchymal transition / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To study whether alisol B could inhibit complement 3a (C3a) induced renal tubular epithelial-mesenchymal transition (EMT).</p><p><b>METHODS</b>The in vitro cultured human renal tubular epithelial HK-2 cells were intervened with 5 ng/mL transforming growth factor-beta (TGF-beta), 0.1 micromol C3a, and 0.1 micromol C3a + 10 micromol alisol B, respectively. The mRNA and protein expressions of alpha-SMA, E-cadherin, and C3 were detected using RT-PCR, Western blot, and immunofluorescence, respectively.</p><p><b>RESULTS</b>The mRNA and protein expressions of C3 in HK-2 cells were up-regulated after intervention of C3a (P < 0.01), the mRNA and protein expressions of alpha-SMA in HK-2 cells were obviously enhanced (P < 0.01), the mRNA and protein expressions of E-cadherin obviously decreased (P < 0.01). When compared with the group intervened by exogenous C3a, after intervention of alisol B, the mRNA and protein expressions of alpha-SMA in HK-2 cells were obviously reduced (P < 0.01), the mRNA and protein expressions of E-cadherin obviously increased (P < 0.05).</p><p><b>CONCLUSIONS</b>Exogenous C3a could induce renal tubular EMT. Alisol B was capable of suppressing C3a induced EMT.</p>

A mutation 1633-26(C-->A) in EXT1 gene causes multiple exostoses / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To study the gene mutation in a patient with multiple exostoses, identify the disease-causing gene mutation.</p><p><b>METHODS</b>Polymerase chain reaction and DNA sequencing were used to screen the EXT1 or EXT2 gene mutation, while mismatch primer amplification and restriction endonuclease digestion were performed to confirm the mutation.</p><p><b>RESULTS</b>By DNA sequencing, a mutation in the seventh intron was detected and located at 26 bp of 3' splice site upstream in EXT1 gene, which was unreported before. Mismatch primer amplification and restriction fragment length polymorphism analysis suggested that this mutation was not detected in the normal control.</p><p><b>CONCLUSION</b>The mutation 1633-26(C-->A) may be the disease-causing mutation in this patient with multiple exostoses.</p>

Continuous vs intermittent infusion of fluorouracil in advanced colorectal cancer / 中国癌症杂志

Purpose:To compare the therapeutic and adverse effects between continuous and intermittent infusion of fluorouracil(5-FU) in advanced colorectal cancer.Methods:17 patients of advanced colorectal cancer were treated with continuous intravenous infusion of 5-FU 2.5g in 100 ml of 5% glucose in a continuous infusions pump,for 120 h (Group A).16 patients of similar severity were treated with 5-FU 500 mg in 500 ml of 5% glucose 2 h iv daily for 5 d (Group B). Total of 33 patients were treated with calcium folinate (CF) 200 mg in 100 ml of 5% glucose 1 h iv daily for 5 d and HCPT 10 mg in 250 ml of 5% glucose 2 h iv daily for 6d.The therapeutic and adverse effects were evaluated according to the cri- teria recommended by WHO.Results:Effectiveness was noted in 9 patients in Group A and 3 patients in group B.(x~2 test P

Ultrasonic Characteristics of Urinary Calculus in Infants with History of Feeding Melamine Contaminated Milk Powder / 实用儿科临床杂志

Objective To summarize the ultrasonic characteristics of urinary calculus in infants who had history of feeding melamine contaminated milk powder.Methods A total of 163 children[aged(19.4?10.9)months] with urolithiasis,who had feeding melamine contaminated milk powder,were retrospectively analyzed using ultrasonography.Twenty children [aged(16.7?9.9)months] with urolit-hiasis,who had no feeding history of melamine contaminated milk powder,were chosen as controls.Ultrasonic characteristics were compared between the 2 groups.Results For melamine calculus cases,sporadic spot or hyperechic mass with different size and shape in the collecting system,partly without acoustic shadow,was found in 65 cases;dense echo and luminous belt with obscured acoustic shadow under a band without echo was found in 48 ureteral calculus cases;irregular strong echo mass or small spot with thick acoustic shadows without side lobe artifact in the dark liquid areas was found in 8 cases with bladder calculus.There was significant difference in morphology of the calculus(P0.05).Conclusions The unique ultrasonic characteristics in infants with melamine calculus had become a very useful tool to diagnose the pediatric urinary melamine calculus.J Appl Clin Pediatr,2009,24(1):67-69