Application of artificial intelligence remote screening system for diabetic retinopathy in Yinchuan community of Ningxia / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To evaluate the application effect of artificial intelligence(AI)assisted diagnosis system in screening diabetic retinopathy(DR)in Yinchuan Community, Ningxia Hui Autonomous Region.METHODS:From July 2020 to July 2021, fundus photograph of 2 707 eyes from 1 358 diabetic patients with type 2 diabetes in two communities of Ningxia and Yinchuan were included in this study. The Eye Wisdom AI assisted screening and diagnosis system was used to analyze automatically and detect the characteristic changes of DR, such as hemorrhage, microaneurysms and retinal microvascular abnormalities. The results of fundus photograph were automatically graded according to the standard of DR international stage standard. The manual analysis group gave feedback after image interpretation, analyzed the sensitivity, specificity, misdiagnosis rate and missed diagnosis rate of the AI-assisted screening system for DR diagnosis, and compared the consistency between AI and manual analysis. Kappa consistency test was performed for the results of AI screening system and manual analysis.RESULTS:Compared with manual analysis, the sensitivity, specificity, missed diagnosis rate and misdiagnosis rate of AI were 91.84%, 99.06%, 8.16% and 0.94% respectively. The Kappa value of consistency analysis of the two diagnosis results was 0.817(P<0.001). Compared with manual analysis, the sensitivity and specificity of AI group to diagnose non-DR were 99.06% and 91.84% respectively. The sensitivity and specificity of mild NPDR were 85.36% and 98.52% respectively. The sensitivity and specificity of moderate NPDR were 81.53% and 98.55% respectively. The sensitivity and specificity of severe NPDR were 70% and 99.51% respectively. The sensitivity and specificity of PDR were 86.67% and 99.63% respectively. The Kappa value of the consistency analysis of DR staging diagnosis was 0.878(P<0.01).CONCLUSION: The AI remote screening system adopted in this study showed good consistency with the results of manual analysis, which can meet the needs of DR screening and provide a new effective prevention and treatment mode for DR patients in the community.

A prediction model of pathological complete response in patients with locally advanced rectal cancer after PD-1 antibody combined with total neoadjuvant chemoradiotherapy based on MRI radiomics / 中华胃肠外科杂志

Objective: To construct a prediction model of pathologic complete response (pCR) in locally advanced rectal cancer patients who received programmed cell death protein-1 (PD-1) antibody and total neoadjuvant chemoradiotherapy by using radiomics based on MR imaging data and to investigate its predictive value. Methods: A clinical diagnostic test study was carried out. Clinicopathalogical and radiological data of 38 patients with middle-low rectal cancer who received PD-1 antibody combined with total neoadjuvant chemoradiotherapy and underwent TME surgery from January 2019 to September 2021 in our hospital were retrospectively collected. Among 38 patients, 23 were males and 15 were females with a median age of 68 (47-79) years and 13 (34.2%) a chieved pCR. These 38 patients were stratified and randomly divided into the training group (n=26) and test group (n=12) for modeling. All the patients underwent rectal MRI before treatment. The clinical, imaging and radiomics features of all the patients were collected, and the clinical feature model and radiomics model were constructed. The receiver operating characteristic (ROC) curves of each model were drawn, and the constructed model was evaluated through the area under the curve (AUC), accuracy, sensitivity, specificity, positive predictive value and negative predictive value. Results: There were no significant differences in age, gender, primary location of tumor and postoperative pathology between the two groups (all P>0.05). Forty-one features were extracted from region of interest in each modality, including 9 first-order features, 24 gray level co-occurrence matrix features and 8 shape features. From 38 patients, 41 features were extracted from each imaging modality of baseline and preoperative DWI and T2WI images, totally 164 features. Only 4 features were preserved after correlation analysis between each pair of features and t-test between pCR and non-pCR subjects. After LASSO cross validation, only the first-order skewness of the baseline DWI image before treatment and the volume in the baseline T2WI image before treatment were retained. The area under the curve, sensitivity, specificity, positive and negative predictive values of the prediction model established by applying these two features in the training group and the test group were 0.856 and 0.844, 77.8% and 100.0%, 88.2% and 75.0%, 77.8% and 66.7%, 88.2% and 100.0%, respectively. The decision curve analysis of the radiomics model showed that the strategy of this model in predicting pCR was better than that in treating all the patients as pCR and that in treating all the patients as non-pCR. Conclusion: The pCR prediction model for rectal cancer patients receiving PD-1 antibody combined with total neoadjuvant radiochemotherapy based on MRI radiomics has the potential to be used in clinical screening or rectal cancer patients who can be spared from radical surgery.

Application of CT subtraction technique in evaluating residual hepatocelluar carcinoma activity after transcatheter arterial chemoembolization / 介入放射学杂志

Objective To discuss the application of enhanced CT subtraction technique in evaluating residual hepatocelluar carcinoma activity after transcatheter arterial chemoembolization (TACE).Methods A total of consecutive 22 patients with clinically-confirmed hepatocellular carcinoma (HCC),who received TACE,were retrospectively collected.Multi-phase enhanced CT examination of liver was performed in all patients after the initial TACE,and the presence or absence of residual active tumor was determined at the second time of TACE.The enhanced arterial phase CT images were used to subtract the corresponding plain scan images,and the subtraction images were thus obtained.The post-subtraction CT values of the lesions that showed iodine oil deposit were measured,which were compared with angiography findings performed at the second time of TACE.The residual tumor activity indicated by post-subtraction images was statistically analyzed.Results In 22 HCC patients receiving TACE,a total of 37 lesions showed iodine oil deposit after the initial TACE.Assessment of tumor activity indicated that 34 lesions had tumor activity and 3 lesions had no tumor activity.The mean post-subtraction CT value of the lesions in the tumor activity group was (79±68) HU,while it was (1 ±1) HU in the tumor non-activity group;the difference between the two groups was statistically significant (P=0.007).Analysis with receiver operating characteristic (ROC) curve indicated that when the post-subtraction CT value of the lesion was greater than one HU,the sensitivity and specificity for diagnosing residual tumor were 97.06％ and 100％ respectively,and the area under the ROC curve was up to 0.975.Conclusion The subtraction images obtained by subtracting the enhanced arterial phase CT images from the plain scan images can accurately and intuitively determine the presence or absence of residual active HCC lesions after TACE.

Protective effect of essential oils from Blumea balsamifera on sunburn induced by UVB in mouse skin / 中成药

AIM To study the protective effect of essential oils from Blumea balsamifera (L.) DC.(BBO) on UVB-induced sunburn in mouse skin and its mechanism of action.METHODS The model for sunburned mouse skin was established by acute UVB irradiation.Essential oils from B.balsamifera were applied to the surface of wound for external use.The pathological changes of sunburned skin tissue were observed by hematoxylin-eosin HE) staining.The activity of superoxide dismutase (SOD),and the contents of malondialdehyde (MDA) and glutathione (GSH) were measured.The levels of 8-hydroxy-desoxyguanosine (8-OHdG),interleukin-6 (IL-6) and nuclear factor kappa-B (NF-κB) in epidermis were detected by ELISA.Additionally,the expressions of tumor necrosis factor-alpha (TNF-α),P53 tumor suppressor protein and proliferation cell nuclear antigen (PCNA) were evaluated by immunohistochemistry (IHC).RESULTS Compared with the model group,treatment with essential oils from B.balsamifera significantly reduced the thickness of epidermis,and the activity of SOD and the contents of MDA,GSH in mouse skin were restored.In addition,the essential oils from B.balsamifera resulted in a significant decrease in levels of 8-OHdG,IL-6 and NF-κB,and an inhibition in expressions of P53 and PCNA.CONCLUSION The essential oils from B.balsamifera can alleviate UVB-induced sunburn.Its mechanism is related to enhanced antioxidant power,inhibited NF-κB signal passway,down-regulated release of IL-6 and reduced levels of 8-OHdG,PCNA.

Preoperative staging of rectal carcinoma with high-resolution MRI: correlation with histopathologic findings / 中华外科杂志

<p><b>OBJECTIVE</b>To assess the correlation of preoperative high-resolution-MRI with histopathologic findings in tumor staging of rectal carcinoma.</p><p><b>METHODS</b>From January 2005 to December 2008, 245 cases of pathologically confirmed rectal cancer, who received preoperative scan by a 1.5 T high-resolution-MRI were included in this retrospective study. To extract image signs from high-resolution MRI, and made a diagnosis for tumor staging classification. Assessment for diagnostic accuracy of high-resolution MRI was extract made with comparison of histopathological classification.</p><p><b>RESULTS</b>The overall diagnostic accuracy of T-stage was 83.7% (205/245). The consistency coefficient (κ) between the MRI and histopathologic T-stage was 0.693 (95%CI: 0.611 - 0.776), which was considered good. For the 97 cases with preoperative chemoradiotherapy, the agreement rate between the post-chemoradiotherapy MRI and histopathologic T-stage was 73.2% (71/97, κ = 0.563, 95%CI: 0.428 - 0.698). For the 148 cases without preoperative chemoradiotherapy, the agreement rate between the MRI and histopathologic T-stage was 90.5% (134/148, κ = 0.794, 95%CI: 0.692 - 0.896). The histopathologic T-stage and diameter infringement were in moderate related degree (ρ = 0.619, P < 0.01).</p><p><b>CONCLUSIONS</b>High-resolution MRI is proved to have a high degree of diagnostic accuracy for T-stage of rectal carcinoma. Preoperative MRI is helpful in treatment planning. Patients undergoing preoperative chemoradiotherapy should receive MRI scan again after neoadjuvant therapy for restaging. The assessment of circumference violation make sense for the accurate diagnosis for tumor staging.</p>

Genetic polymorphism of glutathione- S- trausferase M1 and T1: a systematic review in Chinese population and a pilot study in smear-positive pulmonary tuberculosis cases of Jilin province / 中华流行病学杂志

Objective To investigate the distribution of ghitathione-S-transferase M1 (GSTM1) and T1 (GSTT1) genes polymorphisms in Chinese population and smear-positive pulmonary tuberculosis cases of Jilin province. Methods Articles about GSTM1 and GSTT1 genes polymorphisms published before 2009 in China were searched. The study population was obtained from fourteen counties (or districts) of Jilin province, which included all cases from November, 2007 to May, 2008, totally 1120. The genotypes of GSTM1 and GSTT1 were detected by multiplex PCR technique. Results The frequencies of GSTM1 and GSTT1 'null' genotypes and combination M1-T1 'null' genotype acquired from systematic review were 54.2%, 46.8% and 26.2%, respectively, in Chinese Hans they were 53.4%, 44.9% and 25.5%, and in our research they are 57.2%, 20.4% and 13.7%, respectively. No significant differences between the frequencies of males and females as well as among that of different age groups were observed(P>0.05). The frequency of GSTM1 'null' genotype in our research is slightly higher than that in systematic review (P=0.016) , and the frequencies of GSTT1 'null' genotype and combination M1-T1 'null' genotype and are significantly lower than those in systematic review (both P<0.001). Conclusion The frequencies of GSTM1 and GSTTI 'null' genotypes were different among ethnics. The statistical difference between systematic review and our research may due to our large sample size and mostly Soutbern people in previous studies.