Prediction of glypican-3 expression in hepatocellular carcinoma using multisequence magnetic resonance imaging-based histology nomograms.

Background: Hepatocellular carcinoma (HCC) is often associated with the overexpression of multiple proteins and genes. For instance, patients with HCC and a high expression of the glypican-3 (GPC3) gene have a poor prognosis, and noninvasive assessment of GPC3 expression before surgery is helpful for clinical decision-making. Therefore, our primary aim in this study was to develop and validate multisequence magnetic resonance imaging (MRI) radiomics nomograms for predicting the expression of GPC3 in individuals diagnosed with HCC. Methods: We conducted a retrospective analysis of 143 patients with HCC, including 123 cases from our hospital and 20 cases from The Cancer Genome Atlas (TCGA) or The Cancer Imaging Archive (TCIA) public databases. We used preoperative multisequence MRI images of the patients for the radiomics analysis. We extracted and screened the imaging histologic features using fivefold cross-validation, Pearson correlation coefficient, and the least absolute shrinkage and selection operator (LASSO) analysis method. We used logistic regression (LR) to construct a radiomics model, developed nomograms based on the radiomics scores and clinical parameters, and evaluated the predictive performance of the nomograms using receiver operating characteristic (ROC) curves, calibration curves, and decision curves. Results: Our multivariate analysis results revealed that tumor morphology (P=0.015) and microvascular (P=0.007) infiltration could serve as independent predictors of GPC3 expression in patients with HCC. The nomograms integrating multisequence radiomics radiomics score, tumor morphology, and microvascular invasion had an area under the curve (AUC) value of 0.989. This approach was superior to both the radiomics model (AUC 0.979) and the clinical model (AUC 0.793). The sensitivity, specificity, and accuracy of 0.944, 0.800, and 0.913 for the test set, respectively, and the model's calibration curve demonstrated good consistency (Brier score =0.029). The decision curve analysis (DCA) indicated that the nomogram had a higher net clinical benefit for predicting the expression of GPC3. External validation of the model's prediction yielded an AUC value of 0.826. Conclusions: Our study findings highlight the close association of multisequence MRI imaging and radiomic features with GPC3 expression. Incorporating clinical parameters into nomograms can offer valuable preoperative insights into tailoring personalized treatment plans for patients diagnosed with HCC.

Study on Improved Computed Tomography Scanning Parameters for Patients with Nasal Bone Fracture Based on ITK Three-dimensional Labelling.

OBJECTIVE: To investigate the influence of improved exposure parameters on the image quality of multi-slice spiral computed tomography in nasal bone fracture imaging. METHODS: Fifty patients with optimised parameters combined with coronal scanning were allocated to the modified group and 50 patients with routine scanning parameters to the routine group. The image quality and nasal bone display of the two groups were assessed and statistically analysed, and the quality of scanned images before and after parameter optimisation was compared. RESULTS: The optimised image quality was better than that of conventional scanning parameters. The parameters used were 120 kv, 180 mA, a layer thickness of 0.625 mm, a layer spacing of 0.312 mm, a pitch of 0.516:1, a frame speed of 1 s, a scanning field of 12 cm and a reconstructed layer thickness for scanning of 0.625 mm; the scanned image was clear, and the parameter optimisation was achieved. This ensures that the annotation data in ITK labelling is more accurate. CONCLUSION: The optimised parameters and scanned coronal plane show the nasal bone and its surrounding structures more comprehensively, which is of high diagnostic value for nasal bone fractures. The three-dimensional annotation data based on ITK is more standardised, laying a foundation for the subsequent research of artificial intelligence modelling.

The ideal treatment timing for diabetic retinopathy: the molecular pathological mechanisms underlying early-stage diabetic retinopathy are a matter of concern.

Diabetic retinopathy (DR) is a prevalent complication of diabetes, significantly impacting patients' quality of life due to vision loss. No pharmacological therapies are currently approved for DR, excepted the drugs to treat diabetic macular edema such as the anti-VEGF agents or steroids administered by intraocular route. Advancements in research have highlighted the crucial role of early intervention in DR for halting or delaying disease progression. This holds immense significance in enhancing patients' quality of life and alleviating the societal burden associated with medical care costs. The non-proliferative stage represents the early phase of DR. In comparison to the proliferative stage, pathological changes primarily manifest as microangiomas and hemorrhages, while at the cellular level, there is a loss of pericytes, neuronal cell death, and disruption of components and functionality within the retinal neuronal vascular unit encompassing pericytes and neurons. Both neurodegenerative and microvascular abnormalities manifest in the early stages of DR. Therefore, our focus lies on the non-proliferative stage of DR and we have initially summarized the mechanisms involved in its development, including pathways such as polyols, that revolve around the pathological changes occurring during this early stage. We also integrate cutting-edge mechanisms, including leukocyte adhesion, neutrophil extracellular traps, multiple RNA regulation, microorganisms, cell death (ferroptosis and pyroptosis), and other related mechanisms. The current status of drug therapy for early-stage DR is also discussed to provide insights for the development of pharmaceutical interventions targeting the early treatment of DR.

Study on Rock-Electric Characteristics of Cracked Porous Rocks by the Novel Multifactor Conductivity Model.

Due to the influence of multiple factors on the conductive properties of rocks, the Archie's formula, considering only a single factor, makes it difficult to reasonably explain rock-electric characteristics of cracked porous rocks. In order to better describe the conductive mechanism of cracked porous rocks, a generalized multifactor conductivity model was proposed by considering and introducing multiple influencing factors such as the series-parallel structure, conductive matrix, cracks, and fluids, which is conducive to more accurate research on the conductive mechanism of rocks. It should be noted that the developed model is not only applicable to cracked porous rocks but also useful for porous rocks. Through the study and analysis of various influencing factors, it is demonstrated by the simulation results that both the conductive matrix and cracks improve the conductive ability, which are crucial factors resulting in the non-Archie behavior and low-resistivity pay zone, and rock conductivity is more sensitive to the conductive matrix and cracks in tight reservoirs with porosity below 10%. Furthermore, experimental data are available to validate the novel multifactor conductivity model, and the comparison results show its advantages in predicting and explaining the conductive properties of cracked porous rocks.

Assessment of artificial intelligence-aided reading in the detection of nasal bone fractures.

BACKGROUND: Artificial intelligence (AI) technology is a promising diagnostic adjunct in fracture detection. However, few studies describe the improvement of clinicians' diagnostic accuracy for nasal bone fractures with the aid of AI technology. OBJECTIVE: This study aims to determine the value of the AI model in improving the diagnostic accuracy for nasal bone fractures compared with manual reading. METHODS: A total of 252 consecutive patients who had undergone facial computed tomography (CT) between January 2020 and January 2021 were enrolled in this study. The presence or absence of a nasal bone fracture was determined by two experienced radiologists. An AI algorithm based on the deep-learning algorithm was engineered, trained and validated to detect fractures on CT images. Twenty readers with various experience were invited to read CT images with or without AI. The accuracy, sensitivity and specificity with the aid of the AI model were calculated by the readers. RESULTS: The deep-learning AI model had 84.78% sensitivity, 86.67% specificity, 0.857 area under the curve (AUC) and a 0.714 Youden index in identifying nasal bone fractures. For all readers, regardless of experience, AI-aided reading had higher sensitivity ([94.00 ± 3.17]% vs [83.52 ± 10.16]%, P< 0.001), specificity ([89.75 ± 6.15]% vs [77.55 ± 11.38]%, P< 0.001) and AUC (0.92 ± 0.04 vs 0.81 ± 0.10, P< 0.001) compared with reading without AI. With the aid of AI, the sensitivity, specificity and AUC were significantly improved in readers with 1-5 years or 6-10 years of experience (all P< 0.05, Table 4). For readers with 11-15 years of experience, no evidence suggested that AI could improve sensitivity and AUC (P= 0.124 and 0.152, respectively). CONCLUSION: The AI model might aid less experienced physicians and radiologists in improving their diagnostic performance for the localisation of nasal bone fractures on CT images.

Development of Dipolarophiles for Catalytic Asymmetric Cycloadditions through Pd-π-Allyl Zwitterions.

The development of new and efficient methodology for the construction of optically active molecules is of great interest in both synthetic organic and medicinal chemistry fields. To this end, the personal account summarizes our studies on the development of electron-deficient alkenes, allenes, and alkynes containing single activator as new dipolarophiles for Pd-catalyzed asymmetric cycloaddition reactions. These new dipolarophiles can participate in Pd-catalyzed asymmetric [3+2] and [4+2] cycloadditions through Pd-π-allyl 1,3- and 1,4-zwitterions in-situ generated by the reaction of Pd(0) catalyst with vinyl aziridines, vinyl epoxides, vinyl cyclopropanes, 4-vinyl-1,3-dioxan-2-ones, and vinyl benzoxazinanones. These [3+2] and [4+2] cycloadditions provide efficient approaches to a wide range of enantiomerically enriched five- and six-membered ring compounds containing contiguous chiral centers with high to excellent chemo-, diastereo-, and enantioselectivities. The utilities of these protocols are demonstrated by transformation of the cycloadducts into other useful chiral building blocks. DFT calculations reveal the dissimilar reactivity of different electron deficient alkenes and rationalize the mechanism and stereo-control of the reaction. A Pd-catalyzed inverse [3+2] cycloaddition is disclosed.

Clinical effect of sequential therapy with azithromycin in children mycoplasma pneumoniae pneumonia.

In the present study, the clinical effect of Sequential Therapy with Azithromycin in children mycoplasma pneumoniae pneumonia is observed and analyzed. The 160 children who were diagnosed as mycoplasma pneumoniae pneumonia were selected as subjects. They were randomly divided into two groups: study group and reference group and each group with 80 cases. Among them, the children in study group were carried out sequential therapy of erythromycin and the sequential therapy of azithromycin in reference group. The overall treatment efficiency, the incidence of adverse reactions, the time of symptom recovery and hospitalization were compared between the two groups. Through comparing the efficiency of overall treatment between two groups, the study group has more significant advantages than reference group: P<0.05; through comparing the time of symptoms recovery and hospitalization, study group is significantly less than reference group: P<0.05; in addition, through comparing the incidence of adverse reactions, the difference between two groups is not obvious: P>0.05. For sequential therapy of azithromycin in children mycoplasma pneumoniae pneumonia, it can achieve good therapeutic effect and has no serious adverse reactions, which has tremendous applied values.

The Electrophysiological Features in X-Linked Charcot-Marie-Tooth Disease With Transient Central Nervous System Deficits.

Background: Electrophysiological examination plays an important role in the diagnosis of X-linked Charcot-Marie-Tooth disease (CMTX1) with transient central nervous system deficits. However, the electrophysiological features are seldom reported. Methods: We reviewed and analyzed published reports to determine the electrophysiological features of CMTX1 patients with transient central nervous system deficits. Results: A total of 21 CMTX1 patients with transient central nervous system deficits were found in 17 published case reports/series. The age of onset ranged from 0.5 to 18 years (mean 12.02 ± 0.78 years). All patients were male. Recurrent episodes of central nervous system deficits were reported in all 21 cases and resolved in periods ranging from several minutes to 3 days. All 20 patients who had MRIs at presentation had bilaterally symmetrical abnormal T2/Diffusion signals in the white matter without enhancement of gadolinium. All subsequent MRIs showed improvement or were within normal limits. The median motor nerve conduction velocity (MNCV), motor latencies, and compound muscle action potential (CMAP) amplitude were the most commonly measurable electrophysiological parameters (85.7%). All cases that had MNCV at presentation had slower and significantly decreased MNCV compared with the normal value (34.1 ± 1.10 m/s vs. 46.8±2.05 m/s, P < 0.0001; 95% CI, -17.4 to -7.92). The average variations of MNCV in median nerve, ulnar nerve, peroneal nerve, and tibial nerve were 22.0 ± 5.96%, 27.6 ± 11.9%, 25.9 ± 4.36%, and 27.3 ± 4.30%, respectively. All cases with measured sensory nerve conduction velocity (SNCV) at presentation had slower and significantly decreased SNCV compared with the normal value (35.3 ± 1.33 m/s vs. 47.7 ± 2.40 m/s, P < 0.001; 95% CI -18.2 to -6.46). The average variations of SNCV in median nerve, ulnar nerve, and sural nerve were 19.9 ± 8.24%, 25.2 ± 7.75%, and 23.2 ± 3.95%, respectively. Conclusion: This case series serves as a reminder that electrophysiological examination should be included in the diagnosis of recurrent and episodic neurological deficit with white matter lesions. Median MNCV is a sensitive and valuable parameter to support the diagnosis of CMTX1 with transient central nervous system deficits.

Effects of probiotics on the growth performance and intestinal micro flora of broiler chickens.

Antibiotics have been used in poultry industry for decades to promote growth and protect animals from diseases, followed by various side effects. In efforts of searching for a better alternative, probiotic is of extensive attention. We investigated the effects of Bacillus subtitles, Rhodopseudomonas palustris, Candida utilis and Lactobacillus acidophilus as 0.1% (W/W) feed additives on broiler growth performance and intestinal microflora. The results showed the probiotics treatments significantly improved growth of broilers. Broilers supplemented with B. subtilis and L. acidophilus weighed 18.4% and 10.1% more than birds in control group at 42 days of age. Furthermore the feed conversion ratios of the birds in the two groups were also improved, decreasing 9.1% and 12.9%, respectively. Further study indicated a significant increase of cecal Lactobacilli concentration in briolers supplemented with probiotics, expecially in L. acidophilus treatment group. Meanwhile, the count of cecal Actinomyces in birds treated with probiotics was significantly lower compared with the control group. In conclusion, probiotics such as B. subtitles and L. acidophilus are good alternatives to antibiotics in promoting growth resulting from a beneficial modulation of the intestinal micro flora, which leads to increased efficiency of intestinal digestion in the host animal.

OsDREB2A, a rice transcription factor, significantly affects salt tolerance in transgenic soybean.

The dehydration responsive element binding (DREB) transcription factors play an important role in regulating stress-related genes. OsDREB2A, a member of the DREBP subfamily of AP2/ERF transcription factors in rice (Oryza sativa), is involved in the abiotic stress response. OsDREB2A expression is induced by drought, low-temperature and salt stresses. Here, we report the ability of OsDREB2A to regulate high-salt response in transgenic soybean. Overexpressing OsDREB2A in soybeans enhanced salt tolerance by accumulating osmolytes, such as soluble sugars and free proline, and improving the expression levels of some stress-responsive transcription factors and key genes. The phenotypic characterization of transgenic soybean were significantly better than those of wild-type (WT). Electrophoresis mobility shift assay (EMSA) revealed that the OsDREB2A can bind to the DRE core element in vitro. These results indicate that OsDREB2A may participate in abiotic stress by directly binding with DRE element to regulate the expression of downstream genes. Overexpression of OsDREB2A in soybean might be used to improve tolerance to salt stress.

Identification of wild soybean miRNAs and their target genes responsive to aluminum stress.

BACKGROUND: MicroRNAs (miRNAs) play important regulatory roles in development and stress response in plants. Wild soybean (Glycine soja) has undergone long-term natural selection and may have evolved special mechanisms to survive stress conditions as a result. However, little information about miRNAs especially miRNAs responsive to aluminum (Al) stress is available in wild soybean. RESULTS: Two small RNA libraries and two degradome libraries were constructed from the roots of Al-treated and Al-free G. soja seedlings. For miRNA identification, a total of 7,287,655 and 7,035,914 clean reads in Al-treated and Al-free small RNAs libraries, respectively, were generated, and 97 known miRNAs and 31 novel miRNAs were identified. In addition, 49 p3 or p5 strands of known miRNAs were found. Among all the identified miRNAs, the expressions of 30 miRNAs were responsive to Al stress. Through degradome sequencing, 86 genes were identified as targets of the known miRNAs and five genes were found to be the targets of the novel miRNAs obtained in this study. Gene ontology (GO) annotations of target transcripts indicated that 52 target genes cleaved by conserved miRNA families might play roles in the regulation of transcription. Additionally, some genes, such as those for the auxin response factor (ARF), domain-containing disease resistance protein (NB-ARC), leucine-rich repeat and toll/interleukin-1 receptor-like protein (LRR-TIR) domain protein, cation transporting ATPase, Myb transcription factors, and the no apical meristem (NAM) protein, that are known to be responsive to stress, were found to be cleaved under Al stress conditions. CONCLUSIONS: A number of miRNAs and their targets were detected in wild soybean. Some of them that were responsive to biotic and abiotic stresses were regulated by Al stress. These findings provide valuable information to understand the function of miRNAs in Al tolerance.

Long-term outcomes of transvestibular vaginoplasty with pelvic peritoneum in 182 patients with Rokitansky's syndrome.

OBJECTIVE: To evaluate the technical feasibility and anatomical and functional outcomes of one-stage transvestibular vaginoplasty with pelvic peritoneum for the patients with Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome. DESIGN: A retrospective review of prospectively collected data. SETTING: A university hospital. PATIENT(S): A total of 182 women with MRKH syndrome. INTERVENTION(S): Undergoing transvestibular vaginoplasty with pelvic peritoneum. MAIN OUTCOME MEASURE(S): The perioperative results, complications, and anatomical and functional outcomes of transvestibular vaginoplasty with pelvic peritoneum. RESULT(S): The mean operative time was 72.2 minutes (range 55-150 minutes). Average blood loss was 78.5 mL (range 40-170 mL). The only perioperative complication was one case of rectal-vaginal fistula. Thirty-four patients had vault granulation at the neovagina, which healed after trimming and the mean length of the neovagina was 9 cm (range 7-12 cm) without any shrinkage at the follow-up of 3 months after operation. The neovaginal introitus admitted two fingers in width in all patients. Good functional outcomes were found in the patients at follow-up 15 years after surgery with 80% of the cumulative proportion of sexual satisfactory activity. CONCLUSION(S): Transvestibular vaginoplasty with pelvic peritoneum is an effective and feasible approach for women with MRKH syndrome. The procedure has satisfactory long-term anatomical and functional results.

[Imaging study of lumbar intervertebral disc herniation and asymptomatic lumbar intervertebral disc herniation].

OBJECTIVE: Using regional assignment to forked method to study lumbar intervertebral disc hemiation (bugle, hernia, prolapse) dependablity and reason of lumbar intervertebral disc herniation and asymptomatic lumbar intervertebral disc herniation. METHODS: From March 2005 to October 2006, 120 patients of match condition from orthopaedics dept and rehabilitative dept of the Boai hospital of Longyan were studied. All patients were equally divided into two groups according to whether or not accompany with symptom of lumbar intervertebral disc herniation. There was not statistical difference in sex, age, course of disease, segment of intervertebral disc between two groups. Sixty patients of symptomatic lumbar intervertebral disc herniation were equally divided into three groups according to (bugle, hernia, prolapse) image on CT. Sixty patients of asymptomatic lumbar intervertebral disc herniation were equally divided into three groups according to (bugle, hernia, prolapse) image on CT. The age was 20-59 years old with an average of 38.5 years. Using regional assignment to give a mark respectively for every group. The sagittal diameter index (SI), anterior diastema of flaval ligaments, the width of superior outlet of latero-crypt, anteroposterior diameter of dura sac were respectively measured by sliding caliper. CT value and protrusible areas were respectively evaluated by computer tomography. Adopting mean value to measure three times. RESULTS: (1) There were not statistical difference in SI, CT value, hernia areas, anteroposterior diameter of dura sac between two groups (symptomatic lumbar intervertebral disc herniation and asymptomatic lumbar intervertebral disc herniation). There were statistical difference in the width of superior outlet of latero-crypt, anterior diastema of flaval ligaments between two groups (symptomatic lumbar intervertebral disc herniation and asymptomatic lumbar intervertebral disc herniation). (2) There were statistical difference in protrusible type,protrusible segment between two groups (symptomatic lumbar intervertebral disc herniation and asymptomatic lumbar intervertebral disc herniation). CONCLUSION: There were not necessary relationship between in protrusible size, location, type, compression degree and clinical symptom. This paper may support the mechanism of lumbar intervertebral dise herniation that associated with the following the three aspects: (1) spinal reserve capacity (SRC); (2) involved nerve roots escaping from herniated disc compression and its elastic lengthening function; (3) hypoxia symptosis and anti-ischemia injury compensation of involved nerve roots.

[Study of correlation between Helicobacter pylori infection and hyperammonemia and hepatic encephalopathy in cirrhotic patients].

OBJECTIVE: To evaluate the relationship among helicobacter pylori (HP) infection, blood ammonia concentrations, and hepatic encephalopathy (HE) status, and to investigate the effect of HP eradication on blood ammonia levels and HE status in cirrhotic patients. METHODS: Three hundred and sixty-eight cirrhotic patients were enrolled. Patients were evaluated for the demographic profile, number connection test (NCT), HP infection, Child-Pugh degree of liver dysfunction, blood ammonia concentration and status of mentation. Patients with HP infection were given one week therapy with omeprazole plus clarithromycin and amoxicillin. (13)C urea breath test was performed, and the mental symptoms and blood ammonia levels were reassessed after the eradication therapy. RESULTS: (1) The overall HP infection rate was 70.1% (258/368 cases), and HE positive in 51.4%(189/368 cases). Subclinical hepatic encephalopathy (SHE) was diagnosed in 85 out of 19(47.5%) cirrhotics patients. (2) Blood ammonia concentrations in HP negative and HP positive cirrhotics were (52.7+/-49.8)micromol/L and (79.3+/-61.8)micromol/L, respectively (P<0.01), and it was significantly reduced to (52.6+/-36.5) micromol/L after HP eradication therapy (P<0.01). HE was more frequently found in patients with HP infection than without it (59.6% vs. 31.8%, P<0.01). HE rate were significantly dropped to 32.8% after HP eradication (P<0.01). (3)HP prevalence rate was significantly different among cirrhotics with HE (81.5%),those with SHE (68.5%), or without HE (53.9%)(P<0.05). The level of blood ammonia had significantly difference among the cirrhotics with HE [(96.6+/-78.2)micromol/L], those with SHE [(60.5+/-50.4)micromol/L], or without HE[(46.8+/-36.4)micromol/L, both P<0.05]. CONCLUSION: HP infection aggravates elevated blood ammonia concentration and hepatic encephalopathy in cirrhotic patients. HP eradication may be helpful in the treatment and prevention of HE in cirrhotic patients.