Feasibility of constructing the intelligent detection model for foreign bodies on chest X-ray based on Faster R-convolutional neural network / 中华放射学杂志

Objective:To construct an intelligent foreign bodies detection model based on Faster R-convolutional neural network in posterior-anterior chest X-ray and evaluate the performance of the model.Methods:Totally 5 567 adult posterior-anterior DR chest radiographs from Zhejiang Provincial People′s Hospital and Chun′an County People′s Hospital from June 2019 to March 2020, with 4 247 foreign body-containing chest radiographs were analyzed retrospectively. All data were randomly divided into training set (2 911 foreign body-containing), validation set ( n=1 456, 733 foreign body-containing, 723 free of foreign body) and testing set ( n=1 200, 603 foreign body-containing, 597 free of foreign body). The reference gold standard was set as the results of each chest radiography with foreign body annotated by two radiology residents and reviewed and corrected by a senior radiographer. The receiver operating characteristic (ROC) curve and the area under the curve were used to analyze the efficiency of the deep learning model to distinguish the presence or absence of foreign bodies on chest radiography in the testing set. The precision-recall curve and mean precision (mAP) were used to analyze the stability of the model at different levels. Finally, the influence of different locations, patient gender, and patient age on the foreign body recall of the deep learning model were analyzed. Results:In the testing set, the sensitivity of the deep learning model in diagnosing whether chest radiograph contained foreign bodies was 93.2%(562/603), the specificity was 92.6%(553/597), and the F1 score was 0.94. The area under the ROC curve was 0.97, and the mAP value was 0.69. For foreign bodies in different locations, the recall rates of foreign bodies in lung field and outside lung field were 91.2% (674/739) and 89.0% (1 411/1 585), respectively. For different genders, the recall rates for male and female foreign body detection were 87.3% (337/386) and 90.0%(1 745/1 938), respectively. For different age ranges, the recall rate of foreign body detection was 92.5% (1 041/1 126) for 18-38 years old, 89.7%(505/563) for 39-58 years old, 83.5%(335/401) for 59-78 years old and 85.9% (201/234) for patients ≥79 years old.Conclusion:The constructed deep learning-based foreign body detection model for adult posterior-anterior chest X-ray provides high sensitivity and stability, which can identify foreign bodies in chest radiography quickly and accurately.

Combined Laparoscopic spleen-preserving distal pancreatectomy and autologous islet transplantation: report of one case and literature review / 中华器官移植杂志

Objective:To Eveluate the safty and clinical efficacy of combined laparoscopic spleen-preserving distal pancreatectomy and autologous islet transplantation in the treatment of solid pseudopapillary neoplasm.Methods:A 22 years old solid pseudopapillary neoplasm female patient who underwent distal pancreatectomy and an autologous islet transplantation at Tianjin First Central Hospital, clinical date for 6 months follow up was collected and analyzed.Results:The patient was well recovered after surgery, and during the post-operative follow up, the fasting blood glucose was 5.72 mmol/L, HbA1c was 6.1%, remained insulin independent, the liver function was kept well.Conclusions:Combined Laparoscopic spleen-preserving distal pancreatectomy and autologous islet transplantation can effectively prevent diabetes after distal pancreatectomy.

Progress of genome-wide association studies in bladder cancer / 国际外科学杂志

Genome-wide association studies use high-throughput genotyping technologies to scan thousands of nucleotides of the entire human genome to investigate the relation of clinical conditions and measurable phenotypes.Bladder cancer is the result of the interaction between genetic variants and environmental factors.Many progresses have been acquired from genome-wide association studies.New genetic regions have been discovered to provide us new strategies for the etiology investigation of bladder cancer.

DNA location embB 306 regarded as the molecular marker for drug resistant Mycobacterium tuberculosis / 中华检验医学杂志

Objective To investigate the prevalence of mutation in the locus 306 of embB gene in multi-drug resistant (MDR) Mycobacterium tuberculosis (TB) and evaluate the prospects for using it as a molecular marker to detect MDR-TB.Methods The 291 strains enrolled in this study were from the reference laboratory of Shanghai municipal centers for disease control and prevention, all of which had been tested for drug susceptibility.Mutation in embB 306 was screened both by amplification refractory mutation system (ARMS) and DNA sequencing.The mutation frequencies of embB 306 in the sample groups varied in drug resistance were statistically analyzed.Results 38(51.4% ) of the 74 MDR-TB were embB 306-mutant (X2 =93.8,P＜0.01).Of the 24 TB resistant to at least two drugs but not MDR, 9(37.5% ) were embB 306 mutant (X2 =60.1 ,P＜0.01 ).But only two(4.9% ) embB 306-mutant strains were found in 41 strains resistant to only one drug (X2 =6.8,P=0.0093).None embB 306-mutant strains were found in 152 pansensitive strains.The specificity of using embB 306 as a molecular marker for detecting multi-drug resistant TB was 94.9% (206/217).Conclusions As a molecular marker for screening drug resistant TB,especially MDR-TB, the gene locus embB 306 shows a relatively high sensitivity and specificity, promising a sound future for its application in clinics to realize fast screening of patients infected with MDR-TB and to provide evidence for appropriate medication.