Advances in artificial intelligence for the diagnosis and treatment of ovarian cancer (Review).

Artificial intelligence (AI) has emerged as a crucial technique for extracting high­throughput information from various sources, including medical images, pathological images, and genomics, transcriptomics, proteomics and metabolomics data. AI has been widely used in the field of diagnosis, for the differentiation of benign and malignant ovarian cancer (OC), and for prognostic assessment, with favorable results. Notably, AI­based radiomics has proven to be a non­invasive, convenient and economical approach, making it an essential asset in a gynecological setting. The present study reviews the application of AI in the diagnosis, differentiation and prognostic assessment of OC. It is suggested that AI­based multi­omics studies have the potential to improve the diagnostic and prognostic predictive ability in patients with OC, thereby facilitating the realization of precision medicine.

A new machine learning-based prediction model for subtype diagnosis in primary aldosteronism.

Introduction: Unilateral primary aldosteronism (UPA) and bilateral primary aldosteronism (BPA) are the two subtypes of PA. Discriminating UPA from BPA is of great significance. Although adrenal venous sampling (AVS) is the gold standard for diagnosis, it has shortcomings. Thus, improved methods are needed. Methods: The original data were extracted from the public database "Dryad". Ten parameters were included to develop prediction models for PA subtype diagnosis using machine learning technology. Moreover, the optimal model was chose and validated in an external dataset. Results: In the modeling dataset, 165 patients (71 UPA, 94 BPA) were included, while in the external dataset, 43 consecutive patients (20 UPA, 23 BPA) were included. The ten parameters utilized in the prediction model include age, sex, systolic and diastolic blood pressure, aldosterone to renin ratio (ARR), serum potassium, ARR after 50 mg captopril challenge test (CCT), primary aldosterone concentration (PAC) after saline infusion test (SIT), PAC reduction rate after SIT, and number of types of antihypertensive agents at diagnosis. The accuracy, sensitivity, specificity, F1 score, and AUC for the optimal model using the random forest classifier were 90.0%, 81.8%, 96.4%, 0.878, and 0.938, respectively, in the testing dataset and 81.4%, 90.0%, 73.9%, 0.818 and 0.887, respectively, in the validating external dataset. The most important variables contributing to the prediction model were PAC after SIT, ARR, and ARR after CCT. Discussion: We developed a machine learning-based predictive model for PA subtype diagnosis based on ten clinical parameters without CT imaging. In the future, artificial intelligence-based prediction models might become a robust prediction tool for PA subtype diagnosis, thereby, might reducing at least some of the requests for CT or AVS and assisting clinical decision-making.

lncRNA DSCAM-AS1 facilitates the progression of endometrial cancer via miR-136-5p.

Previous studies have indicated that long non-coding RNA (lncRNA) down syndrome cell adhesion molecule antisense 1 (DSCAM-AS1) serves an oncogenic role in numerous cancer types. However, its role in endometrial cancer (EC) remains largely unknown. In the present study, DSCAM-AS1 expression levels in EC tissues and cells and their normal counterparts were analyzed using reverse transcription-quantitative. In vitro and in vivo experiments were conducted to validate the functions of DSCAM-AS1 in EC. It was revealed that DSCAM-AS1 was expressed at a high level in EC tissues and cells after analyzing patient data and data obtained from The Cancer Genome Atlas. Notably, it was also revealed that high DSCAM-AS1 expression was associated with a less favorable overall survival in patients with EC. Knockdown of DSCAM-AS1 was able to suppress EC cell proliferation by upregulating cell apoptosis in vitro. Furthermore, it was revealed that DSCAM-AS1 acted as a microRNA (miR)-136-5p sponge to exert its oncogenic roles in EC. Collectively and to the best of our knowledge, the current results provided first evidence that DSCAM-AS1 stimulated EC progression by regulating miR-136-5p, which may improve the understanding of the roles of ncRNAs in EC, and may help identify novel targets for anticancer treatment.

Exploration of standardized clinical skills instruction video based on QR code management in clinical hospital teaching.

OBJECTIVE: To explore the application effect of standardized clinical skills instruction video based on QR code management in clinical teaching to promote the information reform and innovation of clinical teaching and seek a new practice method with a higher teaching efficiency. METHODS: A total of 150 clinical, medical-technical, and nursing interns who completed their internship in our hospital by June 2021 after being enrolled in 2020 were assigned to the experimental group, and 84 interns who completed their internship by June 2020 after being recruited in 2019 were retrospectively included in the control group. The experimental group received standardized clinical skills instruction videos based on QR code management to clinical teaching, while the control group was given the traditional teaching method. The costs of teaching models, materials management, and human resources in the clinical skills center that were eventually consumed by the two groups were counted, and the satisfaction of the interns and teachers towards teaching activities was investigated by a satisfaction questionnaire. In addition, the scores of the final exam of internship skills and the pass rate of the enrollment skill exam for residency training were compared between the two groups. RESULTS: After the application of standardized clinical skills instruction videos based on QR code management to clinical teaching, the cost of running the clinical skills center was significantly reduced ($800 vs. $10,000), and the intern trainees (χ2=10.088, P=0.0064) and teachers (χ2=6.1138, P=0.0470) who received these videos expressed higher satisfaction than those given the traditional teaching model, with better performance on the final exam of internship skills (t=11.952, P=0.0000) and a higher pass rate of the enrollment skills exam for residency training (χ2=6.402, P=0.0114). CONCLUSION: The standardized clinical skills instruction video based on QR code management can realize the synchronization of classroom teaching and network teaching and the decentralized network-independent learning, which promotes the information reform and innovation of clinical hospital teaching based on the integration of multimedia teaching and network learning and provides a novel practice method with a higher effect for clinical hospital teaching.

How to evaluate the adequacy of staging for nodal-negative epithelial ovarian cancer? Use of nodal staging score.

OBJECTIVE: No guideline has been provided to assess the minimal number of lymph nodes (LNs) that should be dissected for accurate staging in patients with epithelial ovarian cancer (EOC). The aim of the study was to develop a nodal staging score (NSS) as an index to assess whether a pathologic (p)N0 EOC patient is indeed free of a nodal disease. METHODS: A total of 16,361 EOC patients staged I-III between 2004 and 2013 were identified from the Surveillance, Epidemiology and End Result database. With a ß-binomial model, NSS was calculated to assess the probability of true-negative findings of LN status. RESULTS: With an increased number of LNs examined, the probability of missing a nodal disease decreased and varied among different pT stages. Given 1 LN examined, an NSS of 93.76% calculated could ensure a high adequacy of nodal-negative classification for pT1N0 EOC patients. For pT2N0 patients, 5 LNs examined could guarantee an NSS of 90% for adequate staging. Likewise, 11 and 29 LNs examined in pT3N0 patients could maintain NSS at the level of 80% and 90%, respectively. Our study suggested the optimal number of LNs that could be examined and stratified by the pT stages for EOC patients based on this statistical model derived from large pathologic data of clinical surgery patients. CONCLUSION: NSS, as an auxiliary tool, not only could assist the International Federation of Gynecology and Obstetrics staging more precisely, but also would provide a statistical basis for postoperative evaluation for further clinical decision-making.

Histone deacetylase inhibitor, Romidepsin (FK228) inhibits endometrial cancer cell growth through augmentation of p53-p21 pathway.

OBJECTIVE: Romidepsin (FK228), a Histone Deacetylase (HDAC) inhibitor, has been used for anti-cancer therapies. However, the anti-cancer effect of FK228 and its underlying mechanism in endometrial carcinoma (EC) have not been studied. The aime of this study was to investigate the anti-cancer effects of FK228 and the associated mechanism(s) in EC. METHODS: Ishikawa and HEC-1-A endometrial cancer cells were treated with 8nM concentration of FK228 and cell growth was measured by XTT assay. The cell cycle distribution and cell death were measured by flow cytometry, immunofluorescence, respectively. The mNRA and protein expressions were analyzed by quantitative RT-PCR and western blot, respectively. RESULTS: Based on assays carried out in EC cell lines, it was observed that FK228 inhibited EC cell proliferation in a dose and time-dependent manner. Furthermore, following treatment with FK228 for 48h, there were significant induction of apoptosis and cell cycle arrest at G0/G1 phase in EC cells. Moreover, FK228 treatment significantly increased the mRNA and protein expressions of p53, p21, cleaved caspases such as 3, 7 and 8 and PARP. Further, FK228 treatment increased the levels of acetylated histone H3 and H4 that confirms the HDAC inhibition. CONCLUSION: In conclusion, FK228 inhibits EC tumor cell proliferation and induces apoptosis by activation caspase/PARP via the induction of p53/p21 signaling cascades, suggesting that FK228 is a potential therapeutic agent for EC.

Renalase gene polymorphism in patients with hypertension and concomitant coronary heart disease.

BACKGROUND/AIMS: This study aimed to investigate renalase gene polymorphism in patients with hypertension and concomitant coronary heart disease (CHD) and to evaluate the risk for CHD in hypertensive patients from the view of genetics. METHODS: NCBI and HapMap genome database were employed to screen the Single nucleotide polymorphisms (SNP). These SNPs were detected in hypertensive and CHD patients (n=791), hypertensive patients (n=802) and healthy controls (n=812), and the genotypes were recorded. Haploview 4.2 software was used to determine the genotypes, allele frequency, haplotypes, linkage disequilibrium and Hardy-Weinberg (HWE) equilibrium, and odds ratio (OR) was calculated with non-conditioned logistic regression analysis. RESULTS: The frequency of allele A of rs2576178 in patients with hypertensive and CHD was markedly higher than that in hypertensive patients (p=0.001, OR=1.625,95% CI 1.221-2.160). The frequency of allele C of rs2296545 in hypertensive patients was significantly higher than that in healthy controls (P=0.009, OR=1.436, 95% CI 1.095-1.883). CONCLUSION: The allele A of rs2576178 may be a predisposing factor of CHD in hypertensive patients, and hypertensive patients with AA genotype are susceptible to develop CHD. The allele C of rs2296545 may be a predisposing factor of hypertension and patients with CC genotype are susceptible to develop hypertension.

[Impact of renal denervation on expression of renalase and tyrosine hydroxylase in adult rats with spontaneous hypertension].

OBJECTIVE: To investigate the impact of renal denervation on the blood pressure, plasma renalase content and expression of renalase and tyrosine hydroxylase (TH) in the idney of spontaneous hypertensive (SH) rats and to explore the role of renal denervation in lowering the blood pressure. METHODS: SH rats were randomly assigned into a baseline group, a surgery (renal denervation) group, a sham group and a control group (n=48). WKY rats matched in age (n=12) served as a baseline control group. All rats were housed until 12 weeks old. Then, the rats in the baseline group and the WKY group were sacrificed whose blood and kidney were collected for examination. In the renal denervation group, the sham group and the control group, the blood pressure was monitored continuously. One week and 6 weeks after the renal denervation, 6 rats in each group were sacrificed whose blood and kidney were collected. ELISA was employed to measure the plasma renalase and Western blot assay done to detect the expression of TH and renalase in the kidney. RESULTS: Compared with WKY rats, blood pressure significantly increased and TH protein expression markedly elevated (P<0.05) in SH rats in the baseline group, but plasma renalase content and protein expression of renalase in the kidney dramatically reduced (P<0.05). One week after the surgery, the mean arterial pressure and TH protein expression in the surgery group were lowered compared with the baseline group and dramatically reduced compared with the sham group and the control group (P<0.05). In the surgery group, the renalase level was markedly increased compared with the baseline group, the sham group, and the control group (P<0.05). Six weeks after the renal denervation, the mean arterial pressure and TH level in the surgery group were significantly increased but the renalase content and expression markedly reduced compared with those 1 week, but there were no marked differences among the surgery group, the sham group, and the control group (P>0.05). No pronounced differences in the above variables were found between the sham group and the control group at any time point (P>0.05). CONCLUSION: Renal denervation can lower the blood pressure, which may attribute to the suppression of sympathetic nerves, increase in plasma renalase content and renalase expression in the kidney.