Machine learning-based radiomics for predicting outcomes in cervical cancer patients undergoing concurrent chemoradiotherapy.

PURPOSES: To investigate the value of machine learning-based radiomics for predicting disease-free survival (DFS) and overall survival (OS) undergoing concurrent chemoradiotherapy (CCRT) for patients with locally advanced cervical cancer (LACC). MATERIALS AND METHODS: In this multicentre study, 700 patients with IB2-IVA cervical cancer who underwent CCRT with ongoing follow-up were retrospectively analyzed. Three-dimensional radiomics features of primary lesions and its surrounding 5 mm region in T2WI sequences were collected. Six machine learning methods were used to construct the optimal radiomics model for accurate prediction of DFS and OS after CCRT in LACC patients. Eventually, TCGA and GEO databases were used to explore the mechanisms of radiomics in predicting the progression and survival of cervical cancer. This study adhered CLEAR for reporting and its quality was assessed using RQS and METRICS. RESULTS: In the prediction of DFS, the RSF model combined tumor and peritumor radiomics demonstrated the best predictive efficacy, with the AUC for predicting 1-year, 3-year, and 5-year DFS in the training, validation, and test sets of 0.986, 0.989, 0.990, and 0.884, 0.838, 0.823, and 0.829, 0.809, 0.841, respectively. In the prediction of OS, the GBM model best performer, with AUC of 0.999, 0.995, 0.978, and 0.981, 0.975, 0.837, and 0.904, 0.860, 0.905. Differential genes in TCGA and GEO suggest that the prediction of radiomics model may be associated with KDELR2 and HK2. CONCLUSION: Machine learning-based radiomics models help to predict DFS and OS after CCRT in LACC patients, and the combination of tumor and peritumor information has higher predictive efficacy, which can provide a reliable basis for therapeutic decision-making in cervical cancer patients.

Machine Learning-Based Models for Assessing Postoperative Risk Factors in Patients with Cervical Cancer.

RATIONALE AND OBJECTIVES: To investigate the value of machine learning-based radiomics, intravoxel incoherent motion (IVIM) diffusion-weighted imaging and its combined model in predicting the postoperative risk factors of parametrial infiltration (PI), lymph node metastasis (LNM), deep muscle invasion (DMI), lymph-vascular space invasion (LVSI), pathological type (PT), differentiation degree (DD), and Ki-67 expression level in patients with cervical cancer. MATERIALS AND METHODS: The data of 180 patients with cervical cancer were retrospectively analyzed and randomized 2:1 into a training and validation group. The IVIM-DWI and radiomics parameters of primary lesions were measured in all patients. Seven machine learning methods were used to calculate the optimal radiomics score (Rad-score), which was combined with IVIM-DWI and clinical parameters to construct nomograms for predicting the risk factors of cervical cancer, with internal and external validation. RESULTS: The diagnostic efficacy of the nomograms based on clinical and imaging parameters was significantly better than MRI assessment alone. The area under the curve (AUC) of nomograms and MRI for the assessment of PI, LNM, and DMI were 0.981 vs 0.868, 0.848 vs 0.639, and 0.896 vs 0.780, respectively. Nomograms also performed well in the assessment of LVSI, PT, DD, and Ki-67 expression levels, with AUC of 0.796, 0.854, 0.806, 0.839 and 0.840, 0.856, 0.810, 0.832 in the training and validation groups. CONCLUSION: Machine learning-based nomograms can serve as a useful tool for assessing postoperative risk factors in patients with cervical cancer.

Clinical features and outcomes of 2019 novel coronavirus-infected patients with high plasma BNP levels

AimsTo explore clinical features and outcome of 2019 novel coronavirus(2019-nCoV)-infected patients with high BNP levels Methods and resultsData were collected from patients medical records, and we defined high BNP according to the plasma BNP was above > 100 pg/mL. In total,34 patients with corona virus disease 2019(COVID-19)were included in the analysis. Ten patients had high plasma BNP level. The median age for these patients was 60.5 years(interquartile range, 40-80y), and 6/10 (60%) were men. Underlying comorbidities in some patients were coronary heart disease (n=2, 20%), hypertesion (n=3,30%), heart failure (n=1,10%)and diabetes (n=2, 20%). Six (60%) patients had a history of Wuhan exposure. The most common symptoms at illness onset in patients were fever (n=7, 70%), cough (n=3, 30%), headache or fatigue(n=4,40%). These patients had higher aspartate aminotransferase(AST), troponin I, C reactive protein and lower hemoglobin, and platelet count,compared with patients with normal BNP, respectively. Compared with patients with normal BNP, patients with high BNP were more likely to develop severe pneumonia, and receive tracheal cannula, invasive mechanical ventilation, continuous renal replacement therapy, extracorporeal membrane oxygenation, and be admitted to the intensive care unit. One patient with high BNP died during the study. ConclusionHigh BNP is a common condition among patients infected with 2019-nCoV. Patients with high BNP showed poor clinical outcomes

Modulating nitric oxide signaling in the CNS for Alzheimer's disease therapy.

Nitric oxide (NO)/solube GC (sGC)/cGMP signaling is important for modulating synaptic transmission and plasticity in the hippocampus and cerebral cortex, which are critical for learning and memory. Physiological concentrations of NO also elicit anti-apoptotic/prosurvival effects against various neurotoxic challenges and brain insults through multiple mechanisms. Depression of the NO/sGC pathway is a feature of Alzheimer's disease (AD), attributed to amyloid-ß neuropathology, and altered expression and activity of NOS, sGC and PDE enzymes. Different classes of NO-releasing hybrid drugs, including nomethiazoles, NO-NSAIDs and NO-acetylcholinesterase inhibitors were designed to deliver low concentrations of exogenous NO to the CNS while targeting other underlying disease mechanisms, such as excitotoxicity, neuro-inflammation and acetylcholine deficiency, respectively. Incorporating a NO-donating moiety may also reduce gastrointestinal and liver toxicity of the parent drugs. Progress has also been made in targeting downstream sGC and PDE enzymes. The PDE9 inhibitor PF-04447943 has completed Phase II clinical trials for AD. The search for effective NO-donating hybrid drugs, CNS-targeting sGC stimulators/activators and selective PDE inhibitors is an important goal for pharmacotherapy that manipulates NO biochemical pathways involved in cognitive function and neuroprotection. Rigorous preclinical validation of target engagement, and optimization of pharmacokinetic and toxicity profiles are likely to advance more drug candidates into clinical trials for mild cognitive impairment and early stage AD.

Preliminary Study on the Ecology of Trichobilharzia Cercariae in the Huaihe River System / 中国寄生虫学与寄生虫病杂志

Objective To investigate the ecological habit and characteristics of Trichobilharzia cercariae in the Huaihe river system. Methods During June of 2002-May of 2003, Radix auricularia snails were collected monthly in Yaohe Fishery of the branch of the Huaihe River. The cercariae, released from the positive snails and collected by Shade Drop Bottle, were examined by direct press. Ducklings were infected by cercariae with different ages and examined for the infection by miracidia hatching method.Results The results showed a typical seasonal fluctuation in infection rate of the snails, i.e. the cercariae detection rate was 0.81% in July, 0.65% in June, 0.07%-0.26% in April, May, August, September and October respectively, with a significant difference (? 2=26.73, P

Study on effects of Lymnaeidae size on infection of Trichobil-harzia living in Huaihe River system / 中国血吸虫病防治杂志

F0.01(1,5)=16. 30,P0. 05). Conclusion Laboratory results thus suggest that infection intensity is related to snail size per se, whereas prevalence in the field is related to snail size only through the correlation between size and age. In addition, under these experimental conditions, infected snails were no larger than uninfected snails, so the gigantism snails observed in the field might not be attributable to Trichobilharzia-induced effect.

Survey on Natural Nidus of Metorchis orientalis in Huaihe River Basin / 中国寄生虫学与寄生虫病杂志

Parafossarulus striatulus, Pseudorasbora parva and brood ducks are involved in the lifecycle of Metorchis orientalis. Natural nidi of M.orientalis are confirmed in Huaihe River Basin.