[A comparative study of artificial intelligence nasal polyp classification based on whole-slide imaging and JESREC diagnostic criteria].

Objective: To explore the types and clinical characteristics of chronic rhinosinusitis with nasal polyps (CRSwNP) based on artificial intelligence and whole-slide imaging (WSI), and to explore the consistency of the diagnostic criteria of the Japanese epidemiological survey of refractory eosinophilic chronic rhinosinusitis (JESREC) in Chinese CRSwNP patients. Methods: The data of 136 patients with CRSwNP (101 males and 35 females, aging 14 to 70 years) who underwent endoscopic sinus surgery from 2018 to 2019 in the Department of Otorhinolaryngology Head and Neck Surgery, the Third Affiliated Hospital of Sun Yat-sen University were analysed retrospectively. The preoperative clinical characteristics of patients were collected, such as visual analogue scale (VAS) of nasal symptoms, peripheral blood inflammatory cell count, total immunoglobulin E (IgE), Lund-Kennedy score and Lund-Mackay score. The proportion of inflammatory cells such as eosinophils, lymphocytes, plasma cells and neutrophils were calculated on the WSI of each patient through artificial intelligence chronic rhinosinusitis evaluation platform 2.0 (AICEP 2.0), and the specific type of nasal polyps was then obtained as eosinophilic CRSwNP (eCRSwNP) or non-eosinophilic CRSwNP (non-eCRSwNP). In addition, the JESREC diagnostic criteria was used to classify the nasal polyps, and the classification results were compared with the current gold standard for nasal polyps diagnosis (pathological diagnosis based on WSI). The accuracy, sensitivity and specificity of the diagnostic criteria of JESREC were evaluated. The data were expressed in M (Q1, Q3) and statistically analyzed by SPSS 17.0. Results: There was no significant difference between eCRSwNP and non-eCRSwNP in age distribution, gender, time of onset, total VAS score, Lund-Kennedy score or Lund-Mackay score. However, there was a significant difference in the ratio of nasal polyp inflammatory cells (eosinophils 40.5% (22.8%, 54.7%) vs 2.5% (1.0%, 5.3%), neutrophils 0.3% (0.1%, 0.7%) vs 1.3% (0.5%, 3.6%), lymphocytes 49.9% (39.3%, 65.9%) vs 82.0% (72.8%, 87.5%), plasma cells 5.1% (3.6%, 10.5%) vs 13.0% (7.4%, 16.3%), χ2 value was 9.91, 4.66, 8.28, 5.06, respectively, all P<0.05). In addition, eCRSwNP had a significantly higher level of proportion of allergic symptoms (nasal itching and sneezing), asthma, peripheral blood eosinophil and total IgE (all P<0.05). The overall accuracy, sensitivity and specificity of the JESREC diagnostic criteria was 74.3%, 81.3% and 64.3%, respectively. Conclusions: The eCRSwNP based on artificial intelligence and WSI has significant high level of allergic symptoms, asthma, peripheral blood eosinophils and total IgE, and the percentages of inflammatory cells in nasal polyps are different from that of non-eCRSwNP. The JESREC diagnostic criteria has good consistency in our research.

[Using the big data of internet to understand the characteristics of coronavirus disease 2019: a big data study].

Objective: To analyze the symptom characteristics of Coronavirus Disease 2019(COVID-19) and to improve its prevention by using big data. Methods: Using Baidu Index Platform (http://index.baidu.com) and the website of Chinese Center for Disease Control and Prevention as data resources, we obtained the search volume (SV) of keywords for symptoms associated with COVID-19 from January 1 to February 20 in each year from 2017 to 2020, in Hubei province and other top 10 impacted provinces in China and the epidemic data. Data of 2020 were compared with the previous three years. Data of Hubei province were compared with confirmed cases. The differences and characteristics of the SV of COVID-19-related symptoms, and the correlation between the SV of COVID-19 and new confirmed or suspected cases were analyzed and the hysteresis effects were discussed. R3.6.2 software was used to analyze the data. Results: Compared the data from January 1 to February 20, 2020, with the SV for the same period of previous three years, Hubei's SV for cough, fever, diarrhea, chest tightness, dyspnea and other symptoms were significantly increased. The total SV of lower respiratory symptoms was significantly higher than that of upper respiratory symptoms (P<0.001). The SV of COVID-19 in Hubei province was significantly correlated with new confirmed or suspected cases (r(confirmed)=0.723, r(suspected)=0.863, all P<0.001). The results of the distributed lag model suggested that the patients who retrieved relevant symptoms on the internet may begin to see a doctor in 2-3 days later and be diagnosed in 3-4 days later. Conclusions: The total SV of lower respiratory symptoms is higher than that of upper respiratory symptoms, and the SV of diarrhea also increases significantly. It warns us to pay attention to not only the symptoms of lower respiratory tract, but also the gastrointestinal symptoms, especially diarrhea in patients with COVID-19. There is a relationship between internet retrieval behavior and the number of new confirmed or suspected cases. Big data have a certain role in the early warning of infectious diseases.

Pygo2 activates MDR1 expression and mediates chemoresistance in breast cancer via the Wnt/ß-catenin pathway.

The Wnt/ß-catenin pathway has important roles in chemoresistance and multidrug resistance 1 (MDR1) expression in some cancers, but its involvement in breast cancer and the underlying molecular mechanism are undefined. In this study, we demonstrated that the Wnt/ß-catenin pathway is activated in chemoresistant breast cancer cells. Using a Wnt pathway-specific PCR array screening assay, we detected that Pygo2, a newly identified Wnt/ß-catenin pathway component, was the most upregulated gene in the resistant cells. Additional experiments indicated that Pygo2 activated MDR1 expression in the resistant cells via the Wnt/ß-catenin pathway. Moreover, the inhibition of Pygo2 expression restored the chemotherapeutic drug sensitivity of the resistant cells and reduced the breast cancer stem cell population in these cells in response to chemotherapy. Importantly, these activities induced by Pygo2 were mediated by MDR1. We also determined the effect of Pygo2 on the sensitivity of breast tumors resistant to doxorubicin in a mouse model. Finally, RNA samples from 64 paired patient tumors (before and after chemotherapy) highly and significantly overexpressed Pygo2 and/or MDR1 after treatment, thus underlining a pivotal role for the Pygo2-mediated Wnt/ß-catenin pathway in the clinical chemoresistance of breast cancer. Our data represent the first implication of the Wnt/ß-catenin pathway in breast cancer chemoresistance and identify potential new targets to treat the recurrence of breast cancer.

Association of TIM4 promoter polymorphism -1419G>A with childhood asthma in a Chinese Han population.

TIM4, which is expressed on dendritic cells and macrophages, plays an important role in the proliferation of T helper type 2 (Th2) cells. Asthma, as a complex genetic disease, is thought to arise from the development of a Th2-lymphocyte-predominant immune response. To evaluate the effects of the promoter polymorphisms (-1419G>A and -1609G>A) in TIM4 on asthma susceptibility, case-control and family-based association studies were conducted by polymerase chain reaction and restriction fragment length polymorphism. Our results showed that TIM4 -1419G>A polymorphism was associated with asthma susceptibility in our study population (chi(2)= 9.88, P < 0.001, OR = 1.91, 95% CI 1.37-2.64). The -1419A/A and -1419A/G genotypes were observed more common in asthmatic group (6.3%, 41.8%) than in control group (1.7%, 29.3%). No significant difference was found in genotype and allele frequencies of TIM4 -1619G>A polymorphism between asthmatic and control groups. No association between the two SNPs and total serum IgE levels, lung function was observed. In conclusion, the present findings suggest that TIM4 -1419G>A polymorphism might be the genetic factor for the risk of childhood asthma in Chinese Han population.

Detection of chromosome over- and underrepresentations in hyperdiploid acute lymphoblastic leukemia by comparative genomic hybridization.

Chromosomal analysis of acute lymphoblastic leukemia (ALL) is often difficult because of the suboptimal in vitro growth of the immature lymphoid cell and the poor morphology obtained. In this study, we describe the application of comparative genomic hybridization (CGH) to investigate the genomic abnormalities in 14 patients with ALL, all of whom had cytogenetically identified numerical aberrations or gross chromosomal structural alteration. With the use of CGH, regional or whole chromosome overrepresentation or both were found to be more frequent than underrepresentation (52 gains vs. 6 losses), the most common gains being chromosomes 21 and X. The results of the comparison between CGH and conventional R-banding analysis could be classified into three categories: (1) in three cases, including two with trisomy, CGH and banding analysis gave identical results; (2) in six cases with hyperdiploidy and two cases presenting chromosome structural abnormalities, the results were consistent but with minor discrepancies; (3) in three cases, including two with triploidy and tetraploidy and one with chimeric karyotype together with +22, the data from CGH and cytogenetical analysis were discrepant. CGH could not find the triploidy and tetraploidy. Our results suggest that CGH has certain value in the detection of gains or losses of chromosome materials in hyperdiploid ALL. Nevertheless, the combination of CGH and conventional karyotyping provides more precise information on the genomic imbalance in ALL.

Quantitative analysis of technetium 99m 2-methoxyisobutyl isonitrile single-photon emission computed tomography and isosorbide dinitrate infusion in assessment of myocardial viability before and after revascularization.

BACKGROUND: Assessment of viable myocardium in territories of hypoperfused myocardium is important for predicting functional recovery after revascularization. This study was designed to evaluate quantitative analysis of 99mTc-labeled 2-methoxyisobutyl isonitrile (MIBI) myocardial perfusion imaging combined with isosorbide dinitrate (ISDN) infusion to detect myocardial viability in patients with chronic coronary artery disease before and after revascularization. METHODS AND RESULTS: Twenty-seven consecutive patients with previous myocardial infarction and left ventricular dysfunction (left ventricular ejection fraction 35.2% +/- 13.5%) referred for coronary artery bypass (CABG) were studied with 99mTc-labeled MIBI single-photon emission computed tomography at rest and during ISDN infusion before CABG followed by resting imaging after CABG. Quantitative analysis was performed with circumferential profiles. Left ventricular function (global and regional) was assessed by radionuclide ventriculography before and after CABG. Out of 212 abnormal perfusion segments with resting 99mTc-labeled MIBI SPECT, 99 segments (47%) showed improved uptake of 99mTc-labeled MIBI during ISDN infusion. The mean ratio of myocardial uptake was 0.58 +/- 0.25 (resting 0.53 +/- 0.23; p < 0.05). After CABG, of 212 segments with hypoperfusion, 108 segments (51%; p > 0.05 vs ISDN) showed improved uptake of 99mTc-labeled MIBI. The mean ratio of myocardial uptake was 0.60 +/- 0.26 (resting 0.53 +/- 0.23; p < 0.05). The concordance between the improvement of post-CABG wall motion and that of pre-CABG ISDN perfusion imaging was 83%, between the improvement of wall motion and perfusion imaging after CABG 94%, and between the improvement of pre-CABG ISDN and post-CABG perfusion imaging 83%, respectively. CONCLUSION: ISDN infusion can improve the uptake of 99mTc-labeled MIBI in hypoperfused myocardium and increase the efficiency of 99mTc-labeled MIBI in the detection of viable myocardium in patients with previous myocardial infarction and left ventricular dysfunction.

[Clinical and experimental study of kidney tonics plus whole embryo extract in treatment of renal anemia].

According to the therapeutic principles, reinforcing Kidney-Qi and nourishing the blood were used in treating renal anemia, Renal Anemia Granule No. I and No. II (RAG I and II) were applied in treating patients of renal anemia, the former was a Yin reinforcing agent and the latter a Yang tonics principally. Thirty patients were treated according to the Syndrome Differentiation of TCM and divided into two groups: (1) The combined group, oral liquid of the whole embryo extract was given additionally. (2) The discombined group, no additional drug was given. Patients after treatment all showed significant improvements in serum erythropoietin and hemoglobin (P < 0.05). Experimental study in animal models also displayed the hemoglobin of treated group increased more than that of control group (P < 0.05), which might be related to the enhancement of hematopoietic function of bone marrow.

The value of Tc-99m MIBI SPECT during isosorbide dinitrate infusion in assessment of viable myocardium in patients with myocardial infarction.

Tc-99m MIBI myocardial SPECT has shown promise for evaluation of coronary artery disease. But its role in predicting myocardial viability is still under investigation. The purpose of this study was to evaluate the value of Tc-99m MIBI myocardial SPECT during isosorbide dinitrate (ISDN) infusion in the assessment of myocardial viability. Thirty-seven patients with previous myocardial infarction (the infarct age ranged from < or = 30 days to 900 days) were studied, of them 13 patients had Tc-99m MIBI studies before and after coronary artery bypass grafting (CABG). The results showed that out of 134 segments with hypoperfusion at resting SPECT, 56 segments (41.8%) had an increase in Tc-99m MIBI uptake during ISDN infusion. Among them, 17 segments (30.4%) were normalized, 6 segments (10.7%) were significantly improved and 33 segments (58.9%) were improved. The degree of improvement in perfusion was related to the age of the myocardial infarction. In 13 patients with CABG, of 31 segments with improvement in perfusion post CABG, 25 segments (80.6%) showed perfusion improvement during ISDN infusion, and of 28 segments with improved wall motion post CABG, 23 segments (82.1%) showed improvement in perfusion during ISDN infusion. Tc-99m MIBI SPECT during ISDN infusion may therefore be a useful approach for assessing myocardial viability.

Clinical evaluation of the 99mTc-CPI myocardial perfusion imaging.

99mTc-CPI myocardial perfusion scintigraphy including planar images in 35 patients and SPECT images in 16 patients has been studied. Scintigraphic data revealed that high quality 99mTc-CPI myocardial perfusion images were obtained. The sensitivity and specificity of 99mTc-CPI planar images in detecting CAD was 92% and 80% respectively. There was no significant difference in sensitivity for detecting CAD between planar and SPECT. However, the specificity of SPECT was much better than that of planar imaging.