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Objective:To investigate the value of machine learning model based on MRI in predicting the abundance of tumor infiltrating CD 8+ T cell and prognosis of pancreatic cancer patients. Methods:The clinical data of 156 patients with pathological confirmed pancreatic cancer who underwent pre-operative MRI within 7 days before surgery in the First Affiliated Hospital of Naval Medical University from January 2017 to April 2018 was retrospectively analyzed. According to the international consensus on the predictive model, a total of 116 patients from January to December 2017 were included in the training set, and a total of 40 patients from January to April 2018 were included in the validation set. With the overall survival of patients as the outcome variable, X-Tile software was used to obtain cut-off values of the percentage of CD 8+ T cells, and all patients were divided into CD 8+ T-high and -low groups. The clinical, pathological and radiological features were compared between two groups. 3D slicer software was used to draw the region of interest in each layer of the primary MR T 1- and T 2-weighted imaging, arterial phase, portal venous phase, and delayed phase images for tumor segmentation. Python package was applied to extract the radiomics features of pancreatic tumors after segmentation and the extracted features were reduced and chosen using the least absolute shrinkage and selection operator (Lasso) logistic regression algorithm. Lasso logistic regression formula was applied to calculate the rad-score. The extreme gradient boosting (XGBoost) were used to construct the machine learning predicted model. The models′ performances were determined by area under the ROC curve (AUC), sensitivity, specificity, accuracy, positive predictive value, and negative predictive value. Results:The cut-off value of the CD 8+ T-cell level was 19.09% as determined by the X-tile program. Patients in the high CD 8+ T cell group had a longer median survival than those in the low CD 8+ T cell group (25.51 month vs 22.92 month, P=0.007). The T stage in the training set and tumor size in the validation set significantly differed between the groups (all P value <0.05). A total of 1 409 radiomics features were obtained, and 19-selected features associated with the level of CD 8+ T cell were determined after being reduced by the Lasso logistic regression algorithm. The rad-score was significantly lower in the CD 8- high group (median: -0.43; range: -1.55 to 0.65) than the CD 8- low group (median: 0.22; range: -0.68 to 2.54, P<0.001). The prediction model combined the radiomics features and tumor size. In the training set, the AUC, sensitivity, specificity, accuracy, and positive and negative predictive value were 0.90 (95% CI 0.85-0.95), 75.47%, 90.48%, 0.84, 0.87, and 0.81. In the validation set, the AUC, sensitivity, specificity, accuracy, and positive and negative predictive value were 0.79 (95% CI 0.63-0.96), 90.00%, 80.00%, 0.85, 0.82, and 0.89. The predictive model can accurately distinguish patients with high and low CD 8+ T cells in pancreatic cancer. Conclusions:The radiomics-based machine learning model is valuable in predicting the CD 8+ T cells infiltrating level in pancreatic cancer patients, which could be useful in identifying potential patients who can benefit from immunotherapies.
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Objective:To summarize the MRI features of intrapancreatic accessory spleen (IPAS) and G1 grade pancreatic neuroendocrine neoplasms (PNENs), and clarify the radiological features for differential diagnosis.Methods:The data of 11 patients with IPAS confirmed by surgical pathology or 99mTc thermal denatured red blood cell imaging and 9 patients with G1 grade PNENs confirmed by surgical pathology in the tail of pancreas from January 2013 to December 2019 admitted in First Affiliated Hospital of Navy Medical University were retrospectively analyzed. MRI features of IPAS group and PNENs group, including shape, size, whether it protruded beyond the contour of the pancreas, cystic degeneration, plain scan of T 2WI, DWI signal, multistage enhancement mode, false capsule, etc. were studied and compared. Results:There was significantly statistical difference between the two groups in the terms of contour protrusion, T 2WI and DWI signals, multistage enhancement, and pseudomembrane (all P< 0.05). Protruded lesion was more common in the PNENs group (9/9 cases) than in the IPAS group (3/11). The T 2WI and DWI signals of lesions in the PNENs group were slightly higher than those in the IPAS group, and the proportion of high T 2WI and DWI signal lesions in the PNENs group was 6/9 cases and 4/9 cases, respectively, while the proportion of high T 2WI and DWI signal lesions in the IPAS group was 0/11 cases. Multistage enhancement of lesions in the PNENs group was more likely to be consistent (6/9), while lesions in the IPAS group were more inconsistent (10/11). In the PNENs group, all lesions showed false envelope after enhancement (9/9), while in the IPAS group, no false envelope was observed after enhancement (0/11). Conclusions:The presence of protruded lesions, the characteristics of T 2WI and DWI signals, the mode of multiphase enhancement and the false envelope were essential signs for differentiating IPAS and G1 grade PNENs.
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Objective To investigate the protective effect of propofol on neurological function in rats after traumatic brain injury (TBI) and its possible mechanism.Methods A total of 96 SD rats were randomly divided into sham operation group,sham operation + propofol group,TBI group and TBI +propofol group,with 24 rats in each group.The TBI model was prepared by modified Feeney method.The sham operation + propofol group and the TBI + propofol group were given 50 mg/kg of propofol once daily.The sham operation group and the TBI group were injected with the same amount of normal saline.Modified neurobehavioral functional scores (mNSS) were evaluated at 1,3,7 and 14 days after injury;dry-wet specific gravity method was used to detect brain water content in injured area;TUNEL staining was used to detect neuronal apoptosis;chemiluminescence was used to detect activity of Oxygen cluster (ROS) content;Western blot was used to determine the expressions of inositol requirement enzyme 1 (IRE-1),enhancer binding protein homolog protein (CHOP),heme oxygenase 1 (HO-1,quinone oxidoreductase 1 (NQO1) and nuclear factor E2 related factor 2 (Nrf2) protein.Results Compared with the sham operation group and the sham operation + propofol group,the mNSS,brain tissue water content,apoptosis number and ROS increased at 1,3,7 and 14 days after TBI in the TBI group and TBI + propofol group (P < 0.05).Compared with TBI group,mNSS in TBI + propofol group decreased significantly [(9.3 ± 1.4) points ∶ (10.9 ± 1.2) points] 7 days after injury (P < 0.05);the brain tissue water content decreased significantly [(81.0 ± 0.8) % ∶ (82.1 ± 0.8) %] 3 days after injury (P < 0.05);the number of apoptotic cells decreased significantly 7 days after injury [(14.1 ± 1.4) % ∶ (15.6 ± 1.6) %],with the most significant decrease at 14 days after injury [(10.4 ± 1.5) % ∶ (13.2 ± 1.4) % (P < 0.05);and ROS decreased significantly 7 days after injury [(61.5 ± 4.0) RFU∶ (77.3 ± 5.5) RFU] (P < 0.05).Compared with the sham operation group and the sham operation + propofol group,the expressions of IRE-1 and CHOP were significantly up-regulated in the TBI group and the TBI + propofolgroup (P < 0.05);the expressions of HO-1,NQO1 and Nrf2 in the TBI group were significantly decreased (P <0.05);the expressions of HO-1 and NQO1 in TBI + propofol group were increased (P <0.05) while the expression of Nrf2 were decreased slightly (P < 0.05).Compared with the TBI group,the expressions of IRE-1 and CHOP in TBI + propofol group were decreased (P < 0.05),while the expressions of HO-1,NQO1 and Nrf2 were significantly increased (P < 0.05).Conclusion After TBI in rats,propofol can reduce oxidative stress by activating the Nrf2-antioxidant element (ARE) pathway,reduce brain edema,and inhibit neuronal apoptosis,thus playing a neuro-protective role.
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Objective@#To investigate the protective effect of propofol on neurological function in rats after traumatic brain injury (TBI) and its possible mechanism.@*Methods@#A total of 96 SD rats were randomly divided into sham operation group, sham operation+ propofol group, TBI group and TBI + propofol group, with 24 rats in each group. The TBI model was prepared by modified Feeney method. The sham operation+ propofol group and the TBI+ propofol group were given 50 mg/kg of propofol once daily. The sham operation group and the TBI group were injected with the same amount of normal saline. Modified neurobehavioral functional scores (mNSS) were evaluated at 1, 3, 7 and 14 days after injury; dry-wet specific gravity method was used to detect brain water content in injured area; TUNEL staining was used to detect neuronal apoptosis; chemiluminescence was used to detect activity of Oxygen cluster (ROS) content; Western blot was used to determine the expressions of inositol requirement enzyme 1 (IRE-1), enhancer binding protein homolog protein (CHOP), heme oxygenase 1 (HO-1), quinone oxidoreductase 1 (NQO1) and nuclear factor E2 related factor 2 (Nrf2) protein.@*Results@#Compared with the sham operation group and the sham operation + propofol group, the mNSS, brain tissue water content, apoptosis number and ROS increased at 1, 3, 7 and 14 days after TBI in the TBI group and TBI + propofol group (P<0.05). Compared with TBI group, mNSS in TBI+ propofol group decreased significantly [(9.3±1.4)points ∶(10.9±1.2)points] 7 days after injury (P<0.05); the brain tissue water content decreased significantly [(81.0±0.8)%∶(82.1±0.8)%] 3 days after injury (P<0.05); the number of apoptotic cells decreased significantly 7 days after injury[(14.1±1.4)%∶(15.6±1.6)%], with the most significant decrease at 14 days after injury [( 10.4±1.5)%∶(13.2±1.4)% (P<0.05); and ROS decreased significantly 7 days after injury [(61.5±4.0)RFU∶(77.3±5.5)RFU](P<0.05). Compared with the sham operation group and the sham operation+ propofol group, the expressions of IRE-1 and CHOP were significantly up-regulated in the TBI group and the TBI+ propofol group (P<0.05); the expressions of HO-1, NQO1 and Nrf2 in the TBI group were significantly decreased (P<0.05); the expressions of HO-1 and NQO1 in TBI+ propofol group were increased (P<0.05) while the expression of Nrf2 were decreased slightly (P<0.05). Compared with the TBI group, the expressions of IRE-1 and CHOP in TBI+ propofol group were decreased (P<0.05), while the expressions of HO-1, NQO1 and Nrf2 were significantly increased (P<0.05).@*Conclusion@#After TBI in rats, propofol can reduce oxidative stress by activating the Nrf2-antioxidant element (ARE) pathway, reduce brain edema, and inhibit neuronal apoptosis, thus playing a neuro-protective role.
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Objective To investigate the imaging features in CT/MR of pancreatic neuroendocrine tumors(PNETs) with multiple lesions and further deepen the understanding of this disease .Methods A retrospective review of 12 PNETs patients′radiological data with pancreatic tumors′numbers≥2 and confirmed by surgery or fine needle aspiration biopsy in Changhai Hospital were conducted .Five cases underwent pancreatic CT plain and enhanced scan , 2 cases underwent MRI plain and enhanced scan , and 5 cases underwent both CT and MRI scan .Results There were totally 46 lesions in 12 patients.There were 29 (63.0%) lesions located in the pancreatic head and neck , and 17(37.0%) lesions located in body and tail of pancreas.The sizes of the lesions ranged from 0.8 to 9.5 cm,and the median size was 2.9 cm.Forty-four (95.7%) of the tumors was round or oval , and 2 ( 4.3%) was lobulated;44 ( 95.7%) mass solid and 2 (4.3%) was cystic.CT plain scan detected punctate , crescent or nodular calcification in 8(17.4%) lesions;enhanced scan found 42 lesions(91.4%) were markedly enhanced in the arterial phase , 2 lesions (4.3%) were markedly enhanced in the pancreatic phase;2 lesions (4.3%) were slightly enhanced and the degree of enhancement was lower than that of the normal pancreas .Four cases (33.3%) had dilatation of pancreatic duct and/or the bile duct, 4 cases (33.3%) had distant organ metastasis, 2 cases (16.7%) had lymph node metastasis, and 3 cases (25.0%) had vascular invasion .Conclusions PNETs can be multiple and vary in the size.Most of the lesions are round or oval solid lesions and the malignant signs for organ metastasis can be found occasionally .In dynamic enhanced scanning , the obvious enhancement of the solid portion in the tumor and the higher enhancement degree than that of normal pancreas is the main characteristic .
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Objective To observe the targeted function of a mesothelin antibody modified nanoprobe in human pancreatic cancer BxPC3 cell.Methods The Fe3O4@SiO2 nanoprobe was prepared by St(o)ber method,and then quantum dots (CdTe) and mesothelin antibody was crosslinked to obtain the properties of targeting and fluorescent.Fluorescent nano Fe3O4@SiO2 probes and BxPC3 cells were incubated in vitro for 30 min.Its targeting performance was tested by the CCD imaging system and magnetic separation technology.HepG-2 and K562 cells with low expression of mesothelin were selected as reference cells.Results This preparation method of nanoprobe could produce a uniform and narrow distribution particle with particle size mainly ranging from 120 to 140 nm.The cell adsorption experiments showed that the adsorption efficiency of BxPC3,HepG-2 and K562 by nanoprobe without crosslinking antibody were less than 20%,as a non-specific adsorption; and the adsorption efficiency of BxPC3,HepG-2 and K562 by crosslinking mesothelin antibody nanoprobe were (53.9 ± 1.8) %,(8.0 ± 2.1) % and (8.9 ± 2.3) % respectively,and the adsorption capacity with BxPC3 was significantly increased.Conclusions The nanoprobe modified by mesothelin antibody can effectively recognize BxPC3 cells which highly expressing mesothelin.
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Objective To investigate the CT radiological features of pancreatic cystadenomas and cystadenocarcinomas. Methods The CT scans from 39 patients with pathologically proven cystic pancreatic tumors (21 cases of serous cystadenomas, 12 cases of mucinous cystadenomas, and 6 cases of mucinous cystadenocarcinomas) were retrospectively analyzed. Tumor location, the number of cyst (polycystic or not) , diameter of the largest cyst, features of the cyst wall, partition within cyst, border of tumor, and the relationship between tumors and pancreatic duct were recorded. Results In 21 patients with serous cystadenomas, tumors were located at the pancreatic head and neck areas in 17 cases, at the pancreatic body and tail areas in 5 cases, and 1 case was multiple. All 21 cases were polycystic; the median diameter of the largest cyst was 1.77 cm; calcification was seen in cyst wall or partition in 4 cases and soft tissue was seen in 7 cases; mild pancreatic duct dilatation was found in 10 cases. In 12 patients with mucinous cystadenomas, tumors were located at the pancreatic head and neck areas in 6 cases, at the pancreatic body and tail areas in6 cases; 4 cases were polycystic; the median diameter of the largest cyst was 4.88cm; calcification was seen in 1 case and soft tissue was seen in 6 cases; pancreatic duct dilatation was found in 2 cases and mild duct dilatation was found in 3 cases. In 6 patients with mucinous cystadenocarcinomas, tumors were located at the pancreatic body and tail areas in 5 cases, tumor was located at the pancreatic head and neck areas in 1 case; 4 cases were polycystic; the median diameter of the largest cyst was 5.09 cm; calcification was seen in 1 case and soft tissue was seen in 5 cases; duct dilatation was found in 1 case. In all cases, there was no pancreatic duct communication. After enhancement, the soft tissue and partition of lesion was enhanced to gome extent. Conclusions There are CT radiological features of pancreatic cystadenomas and cystadenocarcinomas. However, there are still some atypical CT appearances that may challenge the diagnosis.
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Objective To investigate the CT and MRI features of the autoimmune pancreatitis (ALP).Methods CT and MRI data of fourteen patients with AIP who were confirmed by histology and/or steroid therapy were retrospectively analyzed.Ten patients underwent CT examination, and seven patients underwent MRI, while three patients underwent both CT and MRI examinations.Results It was showed that diffuse (n =11 ) or local ( n = 3 ) enlargement of pancreas.CT features showed that the hypoattenuation pancreatic lesions on unenhanced CT (n = 10);segmental pancreatic duct could be seen in five patients;stenosis of common bile duct in the head of pancreas was observed in 5 patients;the capsule-like structure around lesions was seen in seven patients.Delayed homogeneous enhancement was showed on enhanced CT.MRI features included homogeneous ( n = 3) and heterogeneous ( n = 4) hyperintense on T1 WI with fat-suppression images and homogeneous ( n = 3 )and heterogeneous (n =4) hyperintense on T2WI with fat-suppression images.Pancreatic duct could be seen in four patients.MRCP showed pancreatic duct stenosis in the head of pancreas ( n = 1 ) and segmental pancreatic duct (n = 2).Stenosis of common bile duct in the head of pancreas was showed in 5 cases.The capsule-like structure around lesions was showed in seven patients.No pancreatic calcification was revealed, and no significant pancreatic duct dilation was detected ( >3 mm) in all 14 patients.Conclusions The CT and MRI manifestations of AIP had characteristic features such as sausage-like changes of the pancreas, capsule-like structure around the lesions, diffuse or local pancreatic duct stricture, and stenosis of common bile duct in the bead of pancreas.
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Objective To analyze atypical 64-slice spiral CT imaging finings of pancreatic cancer and to improve the ability to identify CT manifestations of pancreatic cancer. Methods A retrospective analysis was performed on the atypical 64-slice spiral CT imaging findings of 12 eases of pancreatic cancer confirmed by pathology after surgery. Results All the twelve cases were pancreatic ductal adenocarcinoma.Among them, 7 cases were moderately differentiated ductal adenocarcinoma, 1 case was well-differentiated ductal adenocarcinoma, 1 case was mucinous adenocarcinoma, 3 cases were adenosquamous carcinoma. Among 8 cases with ductal adenocarcinoma, the lesions were located in the pancreatic head and (or) uncinate process in 7 cases, and in the pancreatic neck of 1 case. Tumors were expressed as isodense or low-density or cysticsolid lesions, the masses showed no enhancement in the enhanced scanning phase. Tumors were clearly exogenous or exogenous tendencies in 5 cases. Five cases had no distal pancreatic duct dilation, 2 patients had common bile duct and intrahepatic biliary dilation, and only 1 patient had atrophy of distal pancreas. There was one case of mucinous carcinoma, plain CT scan showed a cystic lesion in head of pancreas about 5cm in diameter, the solid part below the cystic lesion was slightly enhamced in the enhanced scanning phase and the body and tail pancreatic duct was moderately dilated (7 mm). There was no common bile duct and adjacent blood vessels invasion. Among 3 cases of adenosquamous carcinoma, lesions were located in the pancreatic head of 2 cases and in pancreatic body of 1 case. The maximal diameter of mass ranged 3.0 cm ~ 4.5 cm.Cystic necrotic area was observed within the lesions in 3 cases in enhanced pancreatic parenchymal phase of CT scan. Distal pancreatic duct were mildly dilated (4 ~ 5 mm) in 3 cases. There was no common bile duct and intrahepatic bile duct dilation. Conclusions Pancreatic cancer may show atypical CT imaging findings and great cautions are needed for differential diagnosis.
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Objective To investigate the CT imaging features of solid pseudopapillary tumor of the pancreas (SPTP) and to improve the preoperative diagnostic accuracy. Methods A retrospective analysis was performed on the CT manifestations of 21 cases of SPTP confirmed by pathology and surgery. Results In the 21 cases of SPTP, 19 were young and middle-aged female (range: 9~29 years old). The lesions were located in the pancreatic head and neck in 13 cases, and in the pancreatic body and tail in 4 cases each. The maximum diameter of tumor was 3 ~ 15 cm (mean 7.5cm). CT showed a single, round-like, cystic and solid mass in the pancreas. Eighteen cases had a complete capsule, and 3 cases had poorly defined margin with surrounding tissue. 5 cases of tumor were encapsulated or appeared scattered calcification in the center, only 1 case had pancreatic duct dilation (about 5mm in diameter), and no patient had bile duct changes. After enhanced scanning, the tumor capsule and the solid part were mildly to moderately enhanced during arterial phase, and they were significantly enhanced during portal venous phase and equilibrium phase. The cystic part was not enhanced, but the capsule was significantly enhanced. Conclusions CT manifestations of solid pseudopapillary tumor of the pancreas have certain characteristics, and when combined with clinical and imaging manifestations, accurate diagnosis generally can be made.
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BACKGRoUND:The clinical manipulation properties of light-cured composite resin,such as flowing property.filling capacity,shaping and stability has not unified definition in dental materials notwithstanding more studies of rheological behaviors were undertook.OBJECTIVE:To explore the dynamic viscoelasticity difference of unpolymerized light.cured composite resins with retentive filler or normal filler,and to investigate effect on the clinical manipulation properties of rheological behaviors in two light-cured composite resins to define an ideal resin.DESIGN,TIME AND SETTING:This controlled study is a correlation study of integrating the base study and clinical use.Basic study was performed in January 2003 at Key Laboratory of Engineering Plastics of Chinese Academy of Sciences in Beijing.The clinical observation study was conducted at the Stomatology Center,Haikou People's Hospital until December 2006.MATERIALS:Light-cured composites employed in this study were reinforced with RF(experimental composite resin I,ECR-Ⅰ)or NF(experimental composite resin Ⅱ,ECR-Ⅱ),which were supplied by Dental Materials Laboratory.Medical College of Stomatology of Peking University.They contained different types of fillers,but had the same resin matrix and volume percent of filler.METHODS:The dynamic viscoelastic properties of ECR-Ⅰ or ECR-Ⅱ were measured respectively with the dynamic stress rheometer DSR-200 in a room maintained 25℃.Flowing property,filling capacity,shaping and stability property were employed to assess the clinical manipulation property of ECR.MAIN OUTCOME MEASURES:Viscoelasticity(G',G",tan δ)and clinical manipulation of two kinds of compound resins.RESULTS:The dynamic viscoelastic behavior of the two composites was sensitive to changes in frequency.ECR-Ⅰhad significantly higher G'than ECR-Ⅱ.ECR-Ⅰ had a greater ability of stability and shaping.and a lower potential for deformation clinically.ECR-Ⅱ had significantly higher G"than ECR-Ⅰ.and ECR-Ⅱ had a higher flowing ability clinically.ECR-Ⅱ had significantly higher tan δ than ECR-Ⅰ.ECR-Ⅱ was found to be more viscous and better filling capacity,with a good adaptation to the cavity of the tooth clinically.CONCLUSION:The dynamic viscoelasticity(G',G",tan δ)and clinical manipulation properties of ECR-ⅠI or ECR-Ⅱ are compared.The ideal composites should have higher G'and lower tan δ
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Objective To study the relationship between the activity of GSP ?, intestinal metaplasia(IM) of gastric mucosa, and proliferation typing.Method Immunohistochemical method was used to detect GSP ? in 167 cases undergoing biopsy or surgery ,among them slices of 112 pathology proved chronic atrophic gastritis(CAG) were counter stained by mucohistochemistry.Results[WT5”BZ] The result showed that the positive rates of GSP ? in gastric adenocarcinoma, CAG with IM or gastric dysplasia were significantly higher than in chronic superficial gastritis (CSG).The positive rate of GSP ? in high proliferation typing (HPT) was significantly higher than in middle or low proliferation typing ( MPT or LPT).Conclusion GSP ? activity could be used as a marker of precancerous lesions and HPT highly correlates to the occurence of gastric cancer.
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Purpose:To study the expressions of p16 and CDK4 in human lung carcinoma. Methods:By using S-P immunohistochemical methods, the expressions of p16 and CDK4 in 62 cases of human lung carcnoma were studied. Results:The postive expressions for p16 and CDK4 protein were 58.1% and 48.4% respectively. A significant correlation was found between CDK4 overexpression and lymph node metastasis (P<0.01). A significant correlation between the under expression of p16 and overexpression of CDK4 was found.Conclusions:The results suggested that CDK4 overexpression plays an important role in metastasis of lung carcinoma.
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Objective To study the significance of expression of hypoxia-inducible factor 1 alpha(HIF-1?) in gastric mucosal diseases. Methods Using tissue chip technique to creat tissue chip in 120 cases of vary gastric mucosal disease,and using S-P immunohistochemical methods to detect the expressions of HIF-1? in these tissue chips. Results The positive rates of HIF-1? was 28.3% in 120 tissue chips of gastric mucosal diseases. The positive rates of HIF-1? was 0, 10.0%, 40.0% and 63.3% in chronic superficial gastritis, chronic atrophic gastritis with intestinal metaplasia, chronic atrophic gastritis with dysplasia and intestinal type gastric cancer, respectively. The positive rates of HIF-1? of intestinal type gastric cancer and chronic atrophic gastritis with dysplasia were significantly higher than that in chronic superficial gastritis and chronic atrophic gastritis with intestinal metaplasia(P