Prediction model of radiation pneumonitis after chemoradiotherapy for esophageal cancer based on dosiomics / 中华放射肿瘤学杂志

Objective:To study the risk factors and prediction model of radiation pneumonitis (RP) after radical chemoradiotherapy for locally advanced esophageal cancer based on dosiomics.Methods:Clinical data of 105 patients with esophageal cancer undergoing radical chemoradiotherapy at Zhejiang Cancer Hospital between January 2020 and August 2021 were retrospectively analyzed. RP was scored using the National Cancer Institute's Common Terminology Criteria for Adverse Events version 5.0 (CTCAE 5.0). Clinical factors, traditional dosimetric features and dosiomics features were collected, respectively. The features for predicting PR were analyzed by limma package. Support vector machine, k-nearest neighbor, decision tree, random forest and extreme gradient boosting were used to establish the prediction model, and the ten-fold cross-validation method was employed to evaluate the performance of the model. The differences of this model when different features were chosen were analyzed by delong test.Results:The incidence of RP in the whole group was 21.9%. One clinical factor, 6 traditional dosimetric features and 42 dosiomics features were significantly correlated with the occurrence of RP (all P<0.05). Support vector machine using linear kernel function yielded the optimal prediction performance, and the area under the receiver operating characteristic (ROC) without and with dosiomics features was 0.72 and 0.75, respectively. The models established by support vector machine, random forest and extreme gradient boosting were significantly different with and without dosiomics features (all P<0.05). Conclusion:The addition of dosiomics features can effectively improve the performance of the prediction model of RP after radiotherapy for esophageal cancer.

Application of body temperature rinse in percutaneous transforaminal endoscopic lumbar discectomy through intervertebral approach / 中国骨伤

OBJECTIVE@#To investigate the effects of two types of temperature rinses on body temperature, inflammatory cytokine levels, and bleeding volume in percutaneous endoscopic lumbar discectomy.@*METHODS@#Eighty patients underwent percutaneous endoscopic lumbar discectomy from January 2018 to December 2020 were selected and divided into experimental group (40 cases) and control group(40 cases). In experimental group, there were 19 males and 21 females, aged (38.8±9.8) years old;7patients on L4,5 and 33 patients on L5S1;Body msss index(BMI) was (27.8±7.2) kg·m-2. In contral group, there were 18 males and 22 females, aged (41.5±10.9) years old, 5 patients on L4,5 and 35 patients on L5S1;BMI was (26.4±6.2) kg·m-2. The patients in the control group were received normal saline rinse at room temperature, and the patients in the experimental group were received normal saline rinse heated to 37 ℃. Body temperature, chills, nausea, vomiting, and other adverse reactions were recorded. The levels of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) and interleukin-10 (IL-10) in two groups were recorded before and 2 hours after operation. Visual analogue scale (VAS) was used to evaluate the degree of lumbar pain in two groups before and 2 hours after surgery. Fibrinolytic-coagulation indexes with preoperative and 2 hours after surgery, including the D-dimer (DD), fibrinogen degradation products (FDP), activated partial thrombin time (APTT) and prothrombin time (PT) were recorder. Operation time and blood loss in two groups were recorded.@*RESULTS@#The body temperature of both groups showed a downward trend, while the body temperature of the control group was lower than that of the experimental group. The levels of TNF-α, IL-6 and IL-10 in two groups were increased 2 hours after surgery compared with those before surgery(P<0.05), while the levels in experimental group were lower than those in control group(P<0.05). Postoperative VAS in experimental group 2.19±1.13 was significantly lower than that in the control group 3.38±1.35(P<0.05). The levels of DD and FDP at 2 hours after surgery in both groups were higher than those before surgery (P<0.05), while the levels of DD and FDP in the experimental group were higher than those in the control group (P<0.05). There was no significant difference in APTT and PT levels between two groups after operation (P>0.05). The blood loss in the experimental group of (45.2±14.1) ml was lower than that in the control group of (59.52±15.6) ml. The operation time of experimental group (46.7±13.8) min was less than that of control group (58.3±15.2) min(P<0.05).@*CONCLUSION@#Body temperature rinse can reduce the incidence of adverse reactions, alleviate local inflammatory reactions, reduce intraoperative blood loss and shorten the operation time.

Analysis of macrophage marker genes and their functions in triple negative breast cancer based on single cell sequencing / 医学研究生学报

ObjectiveAs the search for effective tumor markers has been the focus of current research, this paper aims to identify the macrophage marker genes in triple negative breast cancer (TNBC) tissue by single cell sequencing, and to analyze its biological processes and the key genes involved.MethodsFirstly, the GEO database was used to download the data set GSE118389 to obtain the required single cell data, and the dimension reduction of PCA and T-SNE was used to obtain 15 subsets of cells, and the marker genes of different subsets of cells were obtained. Then, gene ontology (GO) and KEGG enrichment analysis was performed on the macrophage marker genes to analyze the biological processes in which these genes may be involved. Finally, a protein-protein interaction (PPI) network was constructed to find key genes in each network, and the Kaplan-Meier Plotter database was used to analyze the prognosis of key genes, and the tumor immune assessment (TIMER) database was used to analyze the correlation between the expression level of key genes and the infiltration state of macrophages in TNBC cancer tissues.ResultsA total of 244 macrophage marker genes were obtained, mainly in the processes of neutrophil degranulation, neutrophil activation, amide binding, peptide binding and cell adhesion molecule binding, and four key genes CSF-1R, HLA-DQA1, OLR1 and LAPTM5 were further obtained. The overall survival rate of TNBC patients with high expression of CSF-1R, HLA-DQA1 and OLR1 was higher than those with low expression. Moreover, the expression levels of CSF-1R, LAPTM5 and OLR1 were positively correlated with the immune infiltration of macrophages.ConclusionMarkers may be an important target for conquering tumors in the future. In addition, CSF-1R, HLA-DQA1 and OLR1 can be used as an effective biomarker to predict the prognosis of TNBC patients and provide ideas for targeted therapy and immunotherapy for them.

Effects of Cistanche deserticola extract on penis erectile response in castrated rats

Cistanche deserticola [CD] has been considered as a tonic agent on reproductive function for thousands of years. The effects of CD extract on penis erectile response were investigated in present study. After castration surgery, rats were treated intragastrically with CD extract [0.45, 0.90 and 1.8 g/kg] daily for four weeks. Penis erectile response was measured and the serum hormones were assayed at the end of the experiment. It was evaluated that the erectile latency became longer and the erectile duration shorter significantly in castrated rats compared to sham operated controls. However, CD extract shortened the erectile latency and prolonged the erectile duration to minimize the negative effects of castration. At the dosage of 0.9g/kg, CD extract regulated the serum luteinizing hormone concentration approach to normal level in castrated rats. These findings indicated that CD facilitated the penis erectile response and modulated the serum hormone level to some extent

Clinical features and follow-up study of neonatal asymmetric crying facies / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To evaluate the clinical characteristics and short-term outcomes of neonatal asymmetric crying facies (ACF), in order to improve recognition of the disease.</p><p><b>METHODS</b>The clinical data of 11 infants with ACF between January 2010 and February 2012 were retrospectively studied. Physical and neurological development were followed up at correct gestational age 44 weeks and 3 months.</p><p><b>RESULTS</b>Of the 11 infants with ACF, 4 had ipsilateral ear malformation, 2 had congenital heart disease and 1 had syndactyly and polydactyly. Of the 11 infants, 8 were male and 3 were female. Eight infants presented with lesions on the left side and 3 presented with lesions on the right. The fathers were aged over 35 in 8 cases and the mothers were over 30 in 7 cases. Eight mothers had a history of at least 3 pregnancies and 2 infants were born to mothers with diabetes mellitus. Physical index was below P10 in 1 case and 2 cases showed a low NBNA score and mild abnormal GMs (poor repertoire PR) during the writhing period at correct gestational age 44 weeks. Physical index was between P10-P90 and GM assessment during the fidgety period showed normal movements in all infants at correct gestational age 3 months, but they still had ACF.</p><p><b>CONCLUSIONS</b>ACF is associated with a high rate of other congenital malformations. The short-term outcomes of ACF infants are satisfactory, but long-term follow-up and interdisciplinary cooperation are necessary to improve prognosis.</p>

Studies on isolation and identification of flavonoids in herbs of Agrimonia pilosa / 中国中药杂志

<p><b>OBJECTIVE</b>To study the chemical constituents in Agrimonia pilosa.</p><p><b>METHOD</b>The compounds were isolated and purified by various column chromatographic methods and elucidated on the basis of chemical and spectroscopic evidences.</p><p><b>RESULT</b>Nine flavonoids were obtained and identified as tiliroside (1), kaempferol 3-O-alpha-L-rhampyranoside (2), quercetin 3-O-alpha-L-rhampyranoside (3), quercetin 3-O-beta-D-glucopyranoside (4), kaempferol 3-O-beta-D-glucopyranoside (5), kaempferol (6), apigenin (7), luteolin (8), quercetin (9).</p><p><b>CONCLUSION</b>Compounds 1-3, 5, 6 and 8 were isolated from this plant for the first time.</p>

Real-time Three-Dimensional Color Doppler Flow Imaging: An Improved Technique for Quantitative Analysis of Aortic Regurgitation / 华中科技大学学报（医学）（英德文版）

The recently introduced real-time three-dimensional color Doppler flow imaging (RT-3D CDFI) technique provides a quick and accurate calculation of regurgitant jet volume (RJV) and fraction. In order to evaluate RT-3D CDFI in the noninvasive assessment of aortic RJV and regurgitant jet fraction (RJF) in patients with isolated aortic regurgitation, real-time three-dimensional echocardiographic studies were performed on 23 patients with isolated aortic regurgitation to obtain LV end-diastolic volumes (LVEDV), end-systolic volumes (LVESV) and RJV, and then RJF could be calculated. The regurgitant volume (RV) and regurgitant fraction (RF) calculated by two-dimensional pulsed Doppler (2D-PD) method served as reference values. The results showed that aortic RJV measured by the RT-3D CDFI method showed a good correlation with the 2D-PD measurements (r=0.93, Y=0.89X+3.9, SEE=8.6 mL, P＜0. 001) ; the mean (SD) difference between the two methods was -1.5 (9.8) mL. % RJF estimated by the RT-3D CDFI method was also correlated well with the values obtained by the 2D-PD method (r=0.88, Y=0.71X+14. 8, SEE=6.4 %, P＜0. 001) ; the mean (SD) difference between the two methods was - 1.2 (7.9) %. It was suggested that the newly developed RT-3D CDFI technique was feasible in the majority of patients. In patients with eccentric aortic regurgitation, this new modality provides additional information to that obtained from the two-dimensional examination, which overcomes the inherent limitations of two-dimensional echocardiography by depicting the full extent of the jet trajectory. In addition, the RT-3D CDFI method is quick and accurate in calculating RJV and RJF.

Real-time three-dimensional color Doppler flow imaging: an improved technique for quantitative analysis of aortic regurgitation / 华中科技大学学报（医学）（英德文版）

The recently introduced real-time three-dimensional color Doppler flow imaging (RT-3D CDFI) technique provides a quick and accurate calculation of regurgitant jet volume (RJV) and fraction. In order to evaluate RT-3D CDFI in the noninvasive assessment of aortic RJV and regurgitant jet fraction (RJF) in patients with isolated aortic regurgitation, real-time three-dimensional echocardiographic studies were performed on 23 patients with isolated aortic regurgitation to obtain LV end-diastolic volumes (LVEDV), end-systolic volumes (LVESV) and RJV, and then RJF could be calculated. The regurgitant volume (RV) and regurgitant fraction (RF) calculated by two-dimensional pulsed Doppler (2D-PD) method served as reference values. The results showed that aortic RJV measured by the RT-3D CDFI method showed a good correlation with the 2D-PD measurements (r = 0.93, Y = 0.89X + 3.9, SEE = 8.6 mL, P < 0.001); the mean (SD) difference between the two methods was--1.5 (9.8) mL. % RJF estimated by the RT-3D CDFI method was also correlated well with the values obtained by the 2D-PD method (r = 0.88, Y = 0.71X + 14.8, SEE = 6.4%, P < 0.001); the mean (SD) difference between the two methods was--1.2 (7.9) %. It was suggested that the newly developed RT-3D CDFI technique was feasible in the majority of patients. In patients with eccentric aortic regurgitation, this new modality provides additional information to that obtained from the two-dimensional examination, which overcomes the inherent limitations of two-dimensional echocardiography by depicting the full extent of the jet trajectory. In addition, the RT-3D CDFI method is quick and accurate in calculating RJV and RJF.

Quantitative assessment of myocardial perfusion defects with real-time three-dimensional myocardial contrast echocardiography / 中国医学科学杂志(英文版)

<p><b>OBJECTIVE</b>To evaluate the feasibility and accuracy of measurement of myocardial perfusion defects with intravenous contrast-enhanced real-time three-dimensional echocardiography (CE-RT3DE).</p><p><b>METHODS</b>RT3DE was performed in 21 open-chest mongrel dogs undergoing acute ligation of the left anterior descending artery (LAD, n = 14) or distal branch of the left circumflex artery (LCX, n = 7). A perfluorocarbon microbubble contrast agent was injected intravenously to assess the resulting myocardial perfusion defects with Philips Sonos-7500 ultrasound system. Evans blue dye was injected into the occluded coronary artery for subsequent anatomic identification of underperfused myocardium. In vitro anatomic measurement of myocardial mass after removal of the animal's heart was regarded as the control. Blinded off-line calculation of left ventricular mass and perfusion defect mass from RT3DE images were performed using an interactive aided-manual tracing technique.</p><p><b>RESULTS</b>Total left ventricular (LV) myocardial mass ranged from 38.9 to 78.5 (mean +/- SD: 60.0 +/- 10.1) g. The mass of perfusion defect ranged from 0 to 21.4 (mean +/- SD: 12.0 +/- 5.0) g or 0 to 27% of total LV mass (mean +/- SD: 19% +/- 6%). The RT3DE estimation of total LV mass (mean +/- SD: 59.8 +/- 9.9 g) strongly correlated with the anatomic measurement (r = 0.98; y = 2.01 + 0.96x). The CE-RT3DE calculation of the mass of underperfused myocardium (mean +/- SD: 12. 3 +/- 5.3 g) also strongly correlated with the anatomic measurement (r = 0. 96; y = - 0.10 + 1.04x) and when expressed as percentage of total LV mass (r = 0.95; y = -0.20 + 1.04x).</p><p><b>CONCLUSIONS</b>RT3DE with myocardial contrast opacification could accurately estimate underperfused myocardial mass in dogs of acute coronary occlusion and would play an important role in quantitative assessment of myocardial perfusion defects in patients with coronary artery disease.</p>

Validation of real-time three-dimensional echocardiography for quantifying left and right ventricular volumes: an experimental study / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Assessment of the left ventricular (LV) and the right ventricular (RV) volumes and their functions is important for prognostic prediction and clinical decision making. We compared the accuracy for quantifying the LV and the RV volumes in vitro between conventional two-dimensional echocardiography (2DE) and real-time three-dimensional echocardiography (RT3DE).</p><p><b>METHODS</b>The volumes of 37 rubber-models (10 regularly shaped to simulate normal LV, 7 shaped to simulate LV with symmetric aneurysm, 8 shaped to simulate LV with asymmetric aneurysm, and 12 irregularly shaped to simulate normal RV) and 10 excised canine hearts were measured by RT3DE and 2DE. On RT3DE "full volume" imaging, the inner-surfaces of the rubber-models and canine LV and RV were outlined and the volumes were measured using 2-, 4-, 8- and 16-plane methods with the RT3DE analysis software. On 2DE imaging, the volumes were measured by the Simpson method. The LV and RV volumes measured by drained water were served as reference values, with which we compared RT3DE and 2DE data.</p><p><b>RESULTS</b>In rubber models mimicking normal LV and LV with symmetric aneurysms, RT3DE results were strongly correlated with reference values (r = 0.795 - 0.998) and there was a good correlation between 2DE estimates and reference values (r = 0.715 - 0.729). There were no significant differences between RT3DE estimates, 2DE results and reference values (P > 0.05). In rubber models mimicking the RV and LV with asymmetric aneurysm, RT3DE strongly correlated with reference values (r = 0.765 - 0.988), but 2DE weakly correlated with reference values (r = 0.518 - 0.592). There were no differences between RT3DE and reference values (P > 0.05), but a significant difference between 2DE and reference values occurred (P < 0.05). For excised canine hearts, there was a strong correlation between RT3DE and reference values (r = 0.728 - 0.914), while 2DE showed a less obvious correlation (r = 0.502 - 0.615). Again, there were no significant differences between RT3DE and reference values (P > 0.05), but there was a significant difference between 2DE and reference values (P < 0.05).</p><p><b>CONCLUSIONS</b>RT3DE can accurately quantify LV and RV volumes and provides a new tool to evaluate LV and RV function. For LV and RV measurements by RT3DE, 8-plane strategy is the optimum choice for accuracy and convenience.</p>

Real-time three-dimensional myocardial contrast echocardiography in assessment of myocardial perfusion defects / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Both real-time three-dimensional echocardiography (RT3DE) and myocardial contrast echocardiography (MCE) are novel imaging techniques. The purpose of this study was to confirm the feasibility and accuracy of RT3DE combined with MCE for quantitative evaluation of myocardial perfusion defects.</p><p><b>METHODS</b>Thirteen dogs underwent ligation of the left anterior descending artery (LAD, n = 6) or distal branch of the left circumflex artery (LCX, n = 7) under general anaesthesia. Three to four ml of a perfluoropropane (C3F8) microbubble contrast agent was injected intravenously to assess the resulting myocardial perfusion defects with a commercially available Philips SONOS-7500 ultrasound system. After removal of the dog hearts, Evans blue dye was injected via the left and right coronary arteries to stain the myocardium at risk. In vitro anatomic measurements of myocardial mass after removal of the animals' hearts were used as controls.</p><p><b>RESULTS</b>Left ventricular (LV) mass determined by RT3DE ranged 36.7 - 68.9 g [mean, (54.6 +/- 9.6) g] before coronary artery ligation, and correlated highly (r = 0.99) with in vitro measurement of LV mass [range, 38.9 - 71.1 g; mean, (55.6 +/- 9.3) g]. There was no significant difference between RT3DE and in vitro measurements of LV mass [range, 36.7 - 68.9 g; mean, (51.3 +/- 12.5) g. Or range, 38.9 - 71.1 g; mean, (53.7 +/- 12.3) g, respectively] and under-perfused mass [range, 0 - 21.4 g; mean, (12.0 +/- 6.9) g. Or range, 0 - 19.8 g; mean, (10.8 +/- 6.3) g, respectively] after the LAD ligation (P > 0.05). Likewise, no significant difference was present between RT3DE and in vitro measurements of LV mass [range, 50.1 - 65.4 g; mean, (57.5 +/- 5.9) g. Or range, 51.5 - 65.8 g; mean, (57.3 +/- 6.4) g, respectively] and under-perfused mass [range, 0 - 25.6 g; mean, (13.3 +/- 9.6) g. Or range, 0 - 22.7 g; mean, (12.8 +/- 8.1) g, respectively] after the LCX ligation (P > 0.05). For all the animals with coronary ligation, LV mass measured by RT3DE ranged 35.9 - 68.6 g [mean, (54.8 +/- 10.0) g] and there was no significant difference between RT3DE and in vitro measurements of LV mass and under-perfused mass (P > 0.05, r = 0.99). Further, the under-perfused mass derived from RT3DE [range, 0 - 25.6 g; mean, (12.7 +/- 8.2) g] correlated strongly with the in vitro measurements [range, 0 - 22.7 g; mean, (11.9 +/- 7.2) g] (r = 0.96).</p><p><b>CONCLUSION</b>RT3DE with MCE is a rapid and accurate method for estimating LV myocardial mass and quantifying perfusion defects.</p>

Real-time three-dimensional echocardiography for quantifying left ventricular mass / 中国医学科学杂志(英文版)

<p><b>OBJECTIVE</b>To test the accuracy of real-time three-dimensional echocardiography (RT3DE) imaging system for evaluating left ventricular mass (LVM) in phantom and excised canine heart.</p><p><b>METHODS</b>Ten left ventricular (LV) wall phantoms made of two rubber-bursas, ten excised canine hearts underwent RT3DE and two-dimensional echocardiography (2DE). In RT3DE "full volume" imaging, the myocardial volume was measured using 2, 4, 8, and 16-plane method with the analysis software of RT3DE. Mass was then calculated by multiplying the resulting myocardial volume by specific density of myocardial tissue. In 2DE the masses were measured by area-length method. The true LV wall phantom mass was measured by water displacement and the canine LVM was weighed by anatomy, which served as a reference standard. We compared RT3DE or 2DE with true mass.</p><p><b>RESULTS</b>In LV wall phantoms, RT3DE correlated with true masses strongly (r = 0.813-0.994) and weakly correlated between 2DE and true masses (r = 0.628). In excised canine hearts, there is an excellent correlation between RT3DE and true masses (r = 0.764-0.991), while 2DE value showed a lesser correlation (r = 0.514). There are no difference between RT-3DE and true masses (P > 0.05) but different between 2DE and true masses (P < 0.05). In different planes, there was no difference between 8-plane and 16-plane (P > 0.05) but different between 8-plane and 2, 4-plane (P < 0.05).</p><p><b>CONCLUSION</b>RT3DE can accurately quantify LVM and provide a new tool to evaluate LV function. For LVM by RT3DE, 8-plane measurement method is the best choice for accuracy and convenience.</p>