Establishment and validation of a predictive model for the progression of pancreatic cystic lesions based on clinical and CT radiological features / 中华胰腺病杂志

Objective:To construct a machine-learning model for predicting the progression of pancreatic cystic lesions (PCLs) based on clinical and CT features, and to evaluate its predictive performance in internal/external testing cohorts.Methods:Baseline clinical and radiological data of 200 PCLs in 177 patients undergoing abdominal thin slice enhanced CT examination at Peking Union Medical College Hospital from July 2014 to December 2022 were retrospectively collected. PCLs were divided into progressive and non-progressive groups according to whether the signs indicated for surgery by the guidelines of the European study group on PCLs were present during three-year follow-up. 200 PCLs were randomly divided into training (150 PCLs) and internal testing cohorts (50 PCLs) at the ratio of 1∶3. 15 PCLs in 14 patients at Jinling Affiliated Hospital of Medical School of Nanjing University from October 2011 to May 2020 were enrolled as external testing cohort. The clinical and CT radiological features were recorded. Multiple feature selection methods and machine-learning models were implemented and combined to identify the optimal machine-learning model based on the 10-fold cross-validation method. Receiver operating characteristics (ROC) curve was drawn and area under curve (AUC) was calculated. The model with the highest AUC was determined as the optimal model. The optimal model's predictive performance was evaluated on testing cohort by calculating AUC, sensitivity, specificity and accuracy. Permutation importance was used to assess the importance of optimal model features. Calibration curves of the optimal model were established to evaluate the model's clinical applicability by Hosmer-Lemeshow test.Results:In training and internal testing cohorts, the progressive and non-progressive groups were significantly different on history of pancreatitis, lesions size, main pancreatic duct diameter and dilation, thick cyst wall, presence of septation and thick septation (all P value <0.05) In internal testing cohort, the two groups were significantly different on gender, lesion calcification and pancreatic atrophy (all P value <0.05). In external testing cohort, the two groups were significantly different on lesions size and pancreatic duct dilation (both P<0.05). The support vector machine (SVM) model based on five features selected by F test (lesion size, thick cyst wall, history of pancreatitis, main pancreatic duct diameter and dilation) achieved the highest AUC of 0.899 during cross-validation. SVM model for predicting the progression of PCLs demonstrated an AUC of 0.909, sensitivity of 82.4%, specificity of 72.7%, and accuracy of 76.0% in the internal testing cohort, and 0.944, 100%, 77.8%, and 86.7% in the external testing cohort. Calibration curved showed that the predicted probability by the model was comparable to the real progression of PCLs. Hosmer-Lemeshow goodness-of-fit test affirmed the model's consistency with actual PCLs progression in testing cohorts. Conclusions:The SVM model based on clinical and CT features can help doctors predict the PCLs progression within three-year follow-up, thus achieving efficient patient management and rational allocation of medical resource.

Preliminary application of artificial intelligence in the pathological diagnosis of periapical cysts / 口腔疾病防治

Objective@#To study the effect of artificial intelligence in the pathological diagnosis of periapical cysts and to explore the application of artificial intelligence in the field of oral pathology.@*Methods@#Pathological images of eighty-seven periapical cysts were selected as subjects to read, and a neural network with a U-net structure was constructed. The 87 HE images and labeled images of periapical cysts were divided into a training set (72 images) and a test set (15 images), which were used in the training model and test model, respectively. Finally, the target level index F1 score, pixel level index Dice coefficient and receiver operating characteristic (ROC) curve were used to evaluate the ability of the U-net model to recognize periapical cyst epithelium.@*Results @# The F1 score of the U-net network model for recognizing periapical cyst epithelium was 0.75, and the Dice index and the areas under the ROC curve were 0.685 and 0.878, respectively.@*Conclusion@#The U-net network model constructed by artificial intelligence has a good segmentation result in identifying periapical cyst epithelium, which can be preliminarily applied in the pathological diagnosis of periapical cysts and is expected to be gradually popularized in clinical practice after further verification with large samples.

Effect of febuxostat on vascular endothelial function and elasticity in patients with asymptomatic hyperuricemia / 中华内分泌代谢杂志

Objective:To evaluate the effect of febutostat on vascular endothelial function, intima-media thickness(C-IMT) and elasticity of the carotid artery in patients with asymptomatic hyperuricemia.Methods:This study was a randomized controlled clinical trial that enrolled asymptomatic hyperuricemia patients from the outpatient and inpatient departments of Huai′an First People′s Hospital from October 2018 to October 2020. The participants were randomly divided into two groups: the Febuxostat group and the control group. Serum triglyceride(TG), total cholesterol(TC), low-density lipoprotein cholesterol(LDL-C), high-density lipoprotein cholesterol(HDL-C), fasting blood glucose(FBG), fasting insulin(FINS), nitric oxide(NO), endothelin-1(ET-1), malondialdehyde(MDA), and superoxide dismutase(SOD) were measured at baseline and 1, 3, and 6 months after treatment, and brachial artery flow-mediated dilation(FMD) was quantified by color Doppler ultrasound. The following parameters of the common carotid artery were detected at baseline and 12 months after treatment: C-IMT, arterial compliance(AC), one-point pulse wave velocity(PWV), stiffness index(β), and pressure-strain elasticity modulus(Ep). The differences before and after treatment and between the two groups were compared. Pearson correlation was used to analyze the correlation between ΔUA and ΔNO, ΔET-1, ΔC-IMT, ΔAC, Δβ, ΔEp, and ΔPWVβ after treatment with febuxostat. Results:Compared with baseline, TG, HOMA-IR, ET-1 and MDA were significantly lower, while FMD, NO and SOD were significantly higher after 3-months treatment with febuxostat. After 12-months treatment, there was no significant difference in C-IMT or Ep, but there was an increase in AC and a decrease in PWVβ or β compared with baseline. There was a negative correlation between ΔFMD and ΔUA( r=-0.403, P=0.004), but there were no correlations between ΔNO and ΔUA( r=-0.187, P=0.194), ΔET-1 and ΔUA( r=0.038, P=0.791) after 6-months treatment. And ΔUA was an independent factor for ΔFMD( F=2.94, P=0.003, adjusted R2=0.139). After 12-months treatment, there was a negative correlation between ΔAC and ΔUA, and a positive correlation between ΔPWVβ and ΔUA, but there were no correlations between the following indicators: ΔC-IMT and ΔUA( r=0.169, P=0.240), Δβ and ΔUA( r=-0.214, P=0.136), ΔEp and ΔUA( r=-0.077, P=0.597). In the control group, there were no differences among the above indicators between each follow-up time and baseline. Conclusion:Febuxostat improves vascular endothelial function and elasticity in patients with asymptomatic hyperuricemia, which may be related to the decreased oxidative stress response.

Chelidonine reduces IL-1β-induced inflammation and matrix catabolism in chondrocytes and attenuates cartilage degeneration and synovial inflammation in rats

Chondrocyte inflammation and catabolism are two major features in the progression of osteoarthritis (OA). Chelidonine, a principal alkaloid extracted from Chelidonium majus, is suggested to show anti-inflammation, anti-apoptosis, and anti-oxidation activities in various diseases. However, its potential effects on OA cartilage degeneration remains unclear. To evaluate the effect of chelidonine on OA and its underlying mechanism, we incubated chondrocytes with interleukin (IL)-1β and chelidonine at varying concentrations. Then, we performed the CCK-8 assay, fluorescence immunostaining, reverse transcription PCR, ELISA, and western blotting to evaluate cell viability, catabolic/inflammatory factors, levels of extracellular matrix (ECM)-related proteins, and the involved pathways. H&E and Safranin-O staining and ELISA were performed to measure cartilage degradation and synovial inflammation. Chelidonine suppressed the IL-1β-mediated catabolism and inflammation of chondrocytes. Chelidonine suppressed the NF-κB pathway activation. Similarly, our in vivo experiment showed that chelidonine partially attenuated cartilage degradation while inhibiting synovial inflammation. Chelidonine inhibited inflammation and catabolism through modulation of NF-κB pathways in vitro, thereby avoiding rat cartilage degeneration and synovial inflammation within OA.

Clinicopathological characteristics and risk factors on hepatocellular carcinoma differentiation / 公共卫生与预防医学

Objective To investigate the clinicopathological characteristics and independent risk factors of hepatocellular carcinoma (HCC) differentiation.  Methods A total of 108 HCC patients who underwent operation and treatment were reviewed and classified into low differentiation group (n= 29, 26.85%), medium differentiation group (n=53, 49.07%) and high differentiation group (n=26, 24.07%) according to pathological diagnosis. The clinicopathological characteristics and the expression levels of Ki67 and P53 in each group were compared and analyzed. Logistic regression model was used to analyze the risk factors for low differentiation of HCC.  Results The proportion of cirrhosis, the positive rate of P53 and Ki67 expression level in different degrees of HCC differentiation were statistically significant (P0.05). Multivariate logistic analysis showed that cirrhosis (OR=3.408), high expression of Ki67 (OR=11.113) and positive P53 (OR=9.711) were the main risk factors for poorly differentiated HCC.  Conclusion There are differences in clinical characteristics and expressions of Ki67 and P53 in HCC patients with different degrees of differentiation. Logistic regression analysis can identify clinicopathological risk factors affecting the degree of differentiation of HCC, which can provide criterion support for accurate diagnosis and prognostic treatment.

Oral Chinese Patent Medicines for Breast Cancer：A Scoping Review of Clinical Evidence / 中国实验方剂学杂志

To clarify the research progress and existing problems in the clinical research on oral Chinese patent medicine in the treatment of breast cancer. National drug catalogs and databases were searched for oral Chinese patent medicines against breast cancer. Chinese and English databases were searched for clinical trials on oral Chinese patent medicines in the treatment of breast cancer. The main functions，drug composition，literature basic characteristics，intervention measures， and outcome indicators of Chinese patent medicines were comprehensively analyzed and evaluated by a scoping review based on visual charts. In 68 Chinese patent medicines included，53% of them were potent in activating blood， resolving stasis， tonifying the kidney， and strengthening the spleen. In terms of frequency， the top drugs were Ligustri Lucidi Fructus， Astragali Radix， Moutan Cortex， Poria， and Olibanum，indicating the importance of the therapeutic principles of activating blood， resolving stasis， tonifying the kidney， and strengthening the spleen for breast cancer treatment. In 161 included clinical trials，70.71% of the intervention measures were Chinese patent medicine combined with chemotherapy. Literature studies mainly reported Xihuang pills and Huaier granules，which may be related to the combination of chemotherapy and the inclusion in the medical insurance. The outcome evaluation was mainly based on immune indexes，tumor markers，Karnofsky score，safety report and objective response rate，while the survival time and characteristic outcome indicators of traditional Chinese medicine （TCM） were insufficient. The application and research on oral Chinese patent medicine in the treatment of breast cancer have advanced in recent years，but most of the clinical research evidence is not robust，and the evaluation of outcome indicators is not standardized，which needs to be improved.

Physical fitness of college freshmen in one college in Xi an during 2005-2018 / 中国学校卫生

Objective@#To understand changes of physical fitness, among college freshmen in one college in Xi an from 2005 to 2018.@*Methods@#Body mass index (BMI), vital lung capacity and cardiorespiratory endurance test data from 47 047 freshmen from 2005 to 2018 were included and analyzed. BMI, vital lung capacity, and cardiorespiratory endurance were classified according to the National Student Physical Fitness and Health Standard. Descriptive statistics, t test was used in the data analysis.@*Results@#Mean BMI, vital lung capacity and cardiorespiratory endurance for male and female were (21.69±3.26) (20.88±2.65) kg/m 2, (4 189.87±788.57) (2 815.06±572.07) mL, (246.17±24.09) (239.97±20.23) s, respectively, all of which had significant statistical differences (t=29.48, 218.87, 28.70, P<0.05). Physical fitness indicators showed significant differences over the years (F=104.82, 185.43, 40 891.99, P<0.05). Mean BMI and vital lung capacity in male and female freshmen showed nonlinear increase trend across the past 14 years, while endurance showed a "V"shaped change with a significant inflection point in the year of 2009.@*Conclusion@#From 2005 to 2018, BMI and vital lung capacity showed an upward trend, and cardiorespiratory endurance quality continued to decline since 2009 among college freshmen.

Research progress on the abnormal brain structure and function of patients with strabismus / 国际眼科杂志(Guoji Yanke Zazhi)

@#Strabismus is a common type of eye movement disorders, which is characterized by ocular misalignment and binocular visual dysfunction. Alignment relies on the normal structure and function of the visual and oculomotor systems. Any abnormalities of these regions may lead to strabismus. With the application of neurophysiological techniques and radioautography in the early years, the impairment of primary visual cortex was found, including decreased number of binocular neurons and metabolic changes of ocular dominant column. In recent years, the progress of functional magnetic resonance imaging has promoted to find more functional changes in human strabismic brains, especially in extrastriate cortex. In addition to the structural impairment of cerebral cortex and intercortical connections, functional remodeling of cerebral cortex was also observed in patients with strabismus. Besides, studies based on voxel-based morphometry and diffusion tensor imaging provided more precise anatomical evidence for human brain abnormalities. To provide reference for further studies, we review the current literature on functional and morphological deficits within brain regions in strabismus.

Application of the logistic regression model for the analysis of accuracy related influencing factors on HPLC measurement of preservatives / 公共卫生与预防医学

Objective To employ Logistic regression modeling to analyze the related factors influencing the accuracy of the high performance liquid chromatography (HPLC) determination of preservatives in beverages. Methods The HPLC separation was performed on a Zorbax Eclipse Plus C18 column with methanol-ammonium acetate solution as mobile phase. The external standard method was used to determine 5 beverage preservatives. The influencing factors on the measurement accuracy were statistically evaluated with univariate and multivariate analysis. Results Univariate analysis showed that the recovery rate of the added standard in the determination of coffee beverage preservatives by HPLC was affected by the pretreatment method, and the difference was statistically significant (P<0.05). Multivariate analysis showed that the main influencing factors on the accuracy of determination of sorbic acid was the pretreatment method (OR=5.406, P<0.05), while the sample type was a protective factor (OR=0.134, P<0.05). For the determination of benzoic acid, the main factor influencing the accuracy was the sample type (OR=1.112, P<0.05), while the pretreatment method was a protective factor (OR=0.447, P<0.05). Conclusion Logistic regression analysis can identify risk factors for the accuracy of the determination, and provide statistical modeling support for the experimental optimization.

Current status and correlation analysis of occupational commitment and job burnout in nurses / 四川精神卫生

ObjectiveTo analyze the current status and correlation of occupational commitment and job burnout in nurses. MethodsOccupational commitment scale and Maslach Burnout Inventory General Survey （MBI-GS） were used to survey 695 nurses in 4 hospitals in Nanchong， and the assessment results were compared among nurses with different demographic characteristics， thereafter， Pearson correlation analysis was conducted to discuss the correlation between occupational commitment and job burnout in nurses. ResultsThe total scores of occupational commitment scale and MBI-GS of nurses were （78.38±12.33） and （37.05±9.61）， respectively. The total occupational commitment scale score showed significant differences among nurses of different hospitals， departments， working years and genders （P<0.05 or 0.01）， and the total MBI-GS score showed statistical differences among nurses of different hospitals， departments， ages， professional titles， working years， educational level and marital status （P<0.05 or 0.01）. Pearson correlation analysis showed that the total score and each dimension score of MBI-GS were negatively correlated with the total score of occupational commitment scale， as well as the scores of affective commitment， normative commitment and economic cost commitment （r=-0.517~-0.075，P<0.05 or 0.01）. The emotional cost commitment score was negatively correlated with the the total MBI-GS score， along with the scores in professional efficacy and depersonalization dimensions （r=-0.172~-0.098， P<0.01）. The score of opportunity commitment was positively correlated with the score of professional efficacy （r=0.106， P<0.01）， and negatively correlated with the score of emotional exhaustion and depersonalization （r=-0.156， -0.123， P<0.01）. ConclusionThe hospital， department and working years of the nurses are the common factors influencing occupational commitment and job burnout. The occupational commitment is higher in female nurses than that in male nurses， and the job burnout is more severe in the unmarried than that in the married， moreover， the job burnout of the nurses is negatively correlated with occupational commitment.

The application of an end-effector-based lower limb robot to the gait training of stroke survivors / 中华物理医学与康复杂志

Objective:To observe the effect of gait training assisted by an end-effector-based robot on the gait, balance, walking and general lower limb motor functioning of stroke survivors.Methods:Thirty-nine stroke survivors were randomized into a training group ( n=21) and a control group ( n=18). In addition to routine hemiplegia rehabilitation, the control group was given medium frequency electrical stimulation while the training group underwent 20 minutes of gait training assisted by an end-effector-based robot six days a week for 4 weeks. Before and after the intervention, both groups were evaluated using the functional ambulatory categories (FAC), the Fugl-Meyer lower extremity assessment, the Wisconsin Gait Scale and the Berg balance scale (BBS). Results:There were no significant differences between the groups before the intervention. Afterward significant improvement was observed in both groups in all measurements, with the training group scored better in terms of FAC and BBS.Conclusion:Using an end-effector-based robot in gait training might be more advantageous for improving the gait, balance, walking and general lower limb functioning of stroke survivors.

Evaluation of the clinical efficacy of muscle regions of meridians needling method for refractory facial paralysis based on infrared thermal imaging technology / 针灸推拿医学（英文版）

Objective: To explore the clinical efficacy of muscle regions of meridians needling method for refractory facial paralysis affecting different locations.Methods: A total of 110 participants were randomized into an observation group and a control group, with 55 cases in each group. The observation group was treated with muscle regions of meridians needling method, and the control group was treated with conventional facial three-line needling method. The clinical efficacy was evaluated four weeks after the treatment. And the infrared imaging spectra of the two groups were examined. Results: The total effective rate of the observation group was higher than that of the control group (P<0.05), and its curative effect for refractory facial paralysis located above the geniculate ganglion was better than that of the control group (P<0.05). The color scale distribution of different disease locations in the two groups varied significantly (P<0.05), the higher the disease location, the higher the occurrence rate of cool zone and low temperature zone. After treatment, the reductions of the facial and periotic temperature difference between the healthy side and the affected side in the observation group were statistically different from those in the control group (P<0.05). Conclusion: Muscle regions of meridians needling method has a better effect than facial three-line needling method for refractory facial paralysis. It can promote the microcirculation of the affected side of the face, improve the blood and oxygen supply to local tissues, and thus promote the repair of the peripheral facial nerve.

One family with osteosclerosis caused by D111Y mutation in the low-density lipoprotein receptor-related protein 5 gene / 中华内分泌代谢杂志

Objective:To investigate the clinical features and pathogenic genes of a family with osteosclerosis.Methods:Six patients and six family members from a family in Jiangsu were tested for biochemical parameters, bone metabolic markers, bone mineral density, thoracolumbar anterior lateral slices, skull positive lateral radiographs, and pelvic plain films. Meanwhile, Sanger sequencing was performed to detect gene mutations of the proband and five other family members with high bone mass. The conformation of the mutational low-density lipoprotein receptor-related protein 5 (LRP5) protein was predicted by SWISS-MODEL.Results:Four adult patients (one male and three females) were tall, with mandibular enlargement and kyphosis in the center of the lower jaw, and none of the four had fractures. Their X ray examination revealed that the skull and long bone cortex was thickened, while the sella and mandible was enlarged. In addition, the absolute values of bone mineral density at each site of all patients were significantly higher as compared with the standard age- and sex-matched adults or adolescent mean reference values, with Z scores of L2-4, femoral neck and total hip being (6.31±4.03) SD, (6.56±2.36) SD, and (7.19±2.03) SD, respectively. The results of genetic sequencing revealed that all six patients carried a heterozygous mutation (c.331G>T; D111Y) in exon 2 of LRP5 gene, while other family members showed wild type (c.331G>G; D111D). Functional prediction indicated that this mutation was located at the amino acid terminal of exon 2 of LRP5 gene, which encodes the first β-helix-generating region of LRP5 protein.Conclusion:The D111Y mutation in LRP5 gene leads to a clinical phenotype characterized by benign increased bone mineral density without increasing the risk of fracture. This mutation may further affect the downstream Wnt signaling pathway by altering the spatial structure of LRP5 protein, thereby promoting maturation and differentiation of osteoblasts and resulting in osteosclerosis.

One family with osteosclerosis caused by D111Y mutation in the low-density lipoprotein receptor-related protein 5 gene / 中华内分泌代谢杂志

Objective@#To investigate the clinical features and pathogenic genes of a family with osteosclerosis.@*Methods@#Six patients and six family members from a family in Jiangsu were tested for biochemical parameters, bone metabolic markers, bone mineral density, thoracolumbar anterior lateral slices, skull positive lateral radiographs, and pelvic plain films. Meanwhile, Sanger sequencing was performed to detect gene mutations of the proband and five other family members with high bone mass. The conformation of the mutational low-density lipoprotein receptor-related protein 5 (LRP5) protein was predicted by SWISS-MODEL.@*Results@#Four adult patients (one male and three females) were tall, with mandibular enlargement and kyphosis in the center of the lower jaw, and none of the four had fractures. Their X ray examination revealed that the skull and long bone cortex was thickened, while the sella and mandible was enlarged. In addition, the absolute values of bone mineral density at each site of all patients were significantly higher as compared with the standard age- and sex-matched adults or adolescent mean reference values, with Z scores of L2-4, femoral neck and total hip being (6.31±4.03) SD, (6.56±2.36) SD, and (7.19±2.03) SD, respectively. The results of genetic sequencing revealed that all six patients carried a heterozygous mutation (c.331G>T; D111Y) in exon 2 of LRP5 gene, while other family members showed wild type (c.331G>G; D111D). Functional prediction indicated that this mutation was located at the amino acid terminal of exon 2 of LRP5 gene, which encodes the first β-helix-generating region of LRP5 protein.@*Conclusion@#The D111Y mutation in LRP5 gene leads to a clinical phenotype characterized by benign increased bone mineral density without increasing the risk of fracture. This mutation may further affect the downstream Wnt signaling pathway by altering the spatial structure of LRP5 protein, thereby promoting maturation and differentiation of osteoblasts and resulting in osteosclerosis.

Pharmacology and Clinical Evaluation of Ensartinib Hydrochloride Capsule / 中国肺癌杂志

Lung cancer is one of the most common malignancies with the highest incidence rate and mortality rate worldwide, and non-small cell lung cancer (NSCLC) accounts for about 85%. Only 5% NSCLC patients are anaplastic lymphoma kinase (ALK) rearrangement positive NSCLC, but the prognosis of these patients is poor, and treatment is urgent. Ensartinib (X-396), a next-generation ALK tyrosine kinase inhibitor (ALK-TKI), has shown greater potency on inhibiting ALK activity and controlling brain metastases than crizotinib, which is indicated for the treatment of crizotinib-resistant, ALK-positive NSCLC patients. Several phase I to III clinical trials included both healthy volunteers and NSCLC patients have been conducted both in China and abroad. In this review, we briefly summarized the results of these trials, and preliminary efficacy, safety, pharmacology and pharmacokinetics/pharmacodynamics of ensartinib were discussed.

Research progress on the mutual effects between brown adipose tissue and bone / 中华内分泌代谢杂志

Brown adipose tissue (BAT) increases energy consumption by directly dissipating stored energy in the form of heat through the role of uncoupling protein (UCP1). Recent studies have found that brown adipocytes may also regulate metabolism through autocrine, paracrine, and endocrine mechanisms. A growing body of evidences have shown that the BAT has a close relationship with bone metabolism, in which BAT secretes a variety of factors to regulate bone metabolism, while bone also secretes a variety of bioactive substances to control BAT function. In addition, BAT may indirectly participate in bone metabolism through muscle-mediated regulation or SNS activity and improvement of body metabolism, thus forming a BAT-skeletal axis. In this paper, we try to explain the relationship between brown adipose tissue and bone, and to discuss their interactive mechanisms.

The effectiveness of deep learning techniques in differentiating benign and malignant lung nodules on target CT scans / 中华放射学杂志

Objective@#To evaluate the effectiveness of deep learning model trained on routine CT scans when identity the malignant and benign lung nodule on target CT scans dataset.@*Methods@#This retrospective study enrolled 923 patients with lung nodules found by chest CT scan in Shanghai Chest Hospital from January 2016 to December 2018. A total of 969 nodules with pathological report were analyzed. The deep learning based pulmonary malignant prediction method in a fine-grained classification manner was used to make the prediction, and the AUC (the area under the curve), accuracy, sensitivity and specificity of routine CT scans and target CT scans were compared, and Delong test and IDI (Integrated Discrimination Improvement) were employed to provide statistical results. Furthermore, statistical methods were used to investigate the differences between the benign and malignant classification of nodules on routine CT and on target CT.@*Results@#In the benign and malignant discrimination task, AUC, accuracy, sensitivity and specificity on the routine scans were 0.81, 82.0%, 86.0% and 56.6% respectively, while the AUC, accuracy, sensitivity and specificity on the target scans were 0.84, 85.0%, 88.8% and 60.5% respectively. The IDI was 0.056 (Z test, P<0.05), and there was statistically significant difference in ROC (Delong test, P=0.01).@*Conclusions@#The deep learning model trained on the data set of routine CT scans can achieve better diagnostic efficiency in target CT scans data.

Predicting the malignancy of pulmonary nodules using baseline chest CT: an application study of deep learning model / 中华放射学杂志

Objective@#To investigate whether a deep learning-based model using unenhanced computed tomography (CT) at baseline could predict the malignancy of pulmonary nodules.@*Methods@#A deep learning model was trained and applied for the discrimination of pulmonary nodule in Dr. Wise Lung Analyzer. This study retrospectively recruited 130 consecutive participants with pulmonary nodules detected on CT who undergoing biopsy or surgery from May 2009 to June 2017 in Jinling hospital. A total of 136 pulmonary nodules were included in this study, including 86 malignant nodules and 50 benign ones. All patients underwent CT scans 2 times at least, the first scan was defined as baseline and the last scan before the pathological results was defined as final scan. The ROC curve of deep learning model was plotted and the AUCs were calculated. Delong test was used to examine the difference of AUCs baseline and final scan. The nodules were further divided into subsolid nodule group (pure ground-glass nodule and part solid nodule) (n=87) and solid nodule group (n=49). The difference of AUCs at baseline and final scans was evaluated intra two groups.@*Results@#The AUCs of the deep learning model at final and baseline scans were 0.876 and 0.819, respectively. There was no significant difference between them (P=0.075). The result indicated that the model could predict the consequences of pulmonary nodules well at baseline. In small nodules (longest diameter ≤10mm), the AUC at final scan (0.847) was better than it at baseline scan (0.734), but there was no significant difference between them (P=0.058). In solid nodule group, The AUC at final scan (0.932) was better than it at baseline scan (0.835), but there was no significant difference between them (P=0.066). In subsolid nodule group, the deep learning model exhibited consistent performance at final scan (AUC, 0.759) with the baseline scan (AUC, 0.728, P=0.580).@*Conclusions@#The deep learning model could predict the malignancy of pulmonary nodules including small ones at baseline, and the model exhibited consistent performance between baseline and final scans in subsolid nodules.

Effect of Au(III) complex with oxymatrine and matrine on proliferation of tumor cells in vitro and its mechanisms / 中草药

Objective: To synthesize metal complexes of Au(III) with matrine (MT-Au) and oxymatrine (OMT-Au), compare their inhibitory effect on the proliferation of tumor cells in vitro, and discuss the mechanism and structure-activity relationship. Methods: The metal complexes were synthesized by solvothermal method and characterized by X-ray single crystal diffraction. The in vitro cytotoxicity of complexes with different doses towards 10 selected tumor cell lines was evaluated by MTT method. The effects of complex on cell apoptosis and cell cycle were investigated by flow cytometer. Agarose gel electrophoresis was used to study the effects of complex on topoisomerase I (TOPO I) activity. Results: Complex OMT-Au obviously inhibited the proliferation of MGC803 tumor cells, blocked cell cycle of MGC803 in G2/M phase, and suppressed TOPO I mediated untwisting of pUC19 DNA plasmid with a dose-dependence manner. And the inhibited effects of complex OMT-Au were all stronger than MT-Au complex. Conclusion: The antitumor activity of complex OMT-Au is stronger than that of MT-Au, which could be attributed to the variation in the molecular conformation of ligand.

Clinical Analysis of Serum Calcium Level in 86 Cases of Newly Diagnosed Multiple Myeloma / 中国实验血液学杂志

OBJECTIVE@#To investigate the serum calcium level in 86 patients with newly diagnosed multiple myeloma (MM) and its correlation with clinical features.@*METHODS@#The clinical data of 86 patients with newly diagnosed multiple myeloma in our hospital from 2009 to 2016 were retrospectively analyed. Clinical data of sex, age, hemoglobin, albumin, globulin, creatinine, uric acid, serum phosphorus, β2-microglobulin, immunophenotyping and disease staging were collected. After the serum calcium level was corrected, the patients were grouped into low serum calcium (2.60 mmol/L). The correlation between the clinical characteristics and the serum calcium level was analysed, the clinical characteristics between the low and non-low calcium group were compared.@*RESULTS@#The number of cases in low, normal and high serum cnlcium groups before correction was 58 (67.4%), 18 (20.9%) and 10 (11.6%) respactively, while the number of cases in 3 group after correction was 34 (39.5%), 36 (41.9%) and 16 (18.6%) respectively. The age, globulin, creatinine, uric acid and serum phosphorus levels were positively correlated with serum calcium level in patients with multiple myeloma, while the sex, hemoglobin,albumin and β2-microglobulin levels did not correlated with serum calcium level. There was significant difference in the age, globulin, creatinine and serum phosphorus between low calcium and non-low calcium group (P0.05).@*CONCLUSION@#Multiple myeloma patients suffered from both hypercalcemia and hypocalcemia, and the incidence of hypocalcemia is not low. The levels of serum calcium in patients with multiple myeloma correlate with age, globulin, creatinine, uric acid, serum phosphorus level and other factors, thus it is necessary to correct the level of ionized calcium with physiological activity.