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A deep learning model based on contrast-enhanced computed tomography for differential diagnosis of gallbladder carcinoma

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Hepatobiliary & Pancreatic Diseases International 2024年第4期23卷 376-384页

作者： Fei Xiang Qing-Tao Meng Jing-Jing Deng Jie Wang Xiao-Yuan Liang Xing-Yu Liu sheng yan Department of Hepatobiliary Pancreatic Surgery Second Affiliated HospitalZhejiang University School of MedicineHangzhou 310003China Department of Radiology Affiliated Chuzhou First People’s HospitalAnhui Medical UniversityChuzhou 239000China

Background:Gallbladder carcinoma(GBC)is highly malignant,and its early diagnosis remains difficult.This study aimed to develop a deep learning model based on contrast-enhanced computed tomography(CT)images to assist radiologists in identifying GBC.Methods:We retrospectively enrolled 278 patients with gallbladder lesions(>10 mm)who underwent contrast-enhanced CT and cholecystectomy and divided them into the training(n=194)and validation(n=84)datasets.The deep learning model was developed based on ResNet50 network.Radiomics and clinical models were built based on support vector machine(SVM)method.We comprehensively compared the performance of deep learning,radiomics,clinical models,and three radiologists.Results:Three radiomics features including LoG_3.0 gray-level size zone matrix zone variance,HHL firstorder kurtosis,and LHL gray-level co-occurrence matrix dependence variance were significantly different between benign gallbladder lesions and GBC,and were selected for developing radiomics model.Multivariate regression analysis revealed that age≥65 years[odds ratios(OR)=4.4,95%confidence interval(CI):2.1-9.1,P37 U/mL(OR=4.0,95%CI:1.6-10.0,P=0.003)were significant clinical risk factors of GBC.The deep learning model achieved the area under the receiver operating characteristic curve(AUC)values of 0.864(95%CI:0.814-0.915)and 0.857(95%CI:0.773-0.942)in the training and validation datasets,which were comparable with radiomics,clinical models and three radiologists.The sensitivity of deep learning model was the highest both in the training[90%(95%CI:82%-96%)]and validation[85%(95%CI:68%-95%)]datasets.Conclusions:The deep learning model may be a useful tool for radiologists to distinguish between GBC and benign gallbladder lesions.

关键词： Gallbladder carcinoma Computed tomography Deep learning Radiomics

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Xuebijing improves intestinal microcirculation dysfunction in septic rats by regulating the VEGF-A/PI3K/Akt signaling pathway

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World Journal of Emergency Medicine 2024年第3期15卷 206-213页

作者： A-ling Tang yan Li Li-chao Sun Xiao-yu Liu Nan Gao sheng-tao yan Guo-qiang Zhang Department of Emergency China-Japan Friendship HospitalBeijing 100029China Graduate School Beijing University of Chinese MedicineBeijing 100105China

BACKGROUND:This study aims to explore whether Xuebijing(XBJ) can improve intestinal microcirculation dysfunction in sepsis and its mechanism.METHODS:A rat model of sepsis was established by cecal ligation and puncture(CLP).A total of 30 male SD rats were divided into four groups:sham group,CLP group,XBJ + axitinib group,and XBJ group.XBJ was intraperitoneally injected 2 h before CLP.Hemodynamic data(blood pressure and heart rate) were recorded.The intestinal microcirculation data of the rats were analyzed via microcirculation imaging.Enzyme-linked immunosorbent assay(ELISA) kits were used to detect the serum levels of interleukin-6(IL-6),C-reactive protein(CRP),and tumor necrosis factor-α(TNF-α) in the rats.Histological analysis and transmission electron microscopy were used to analyze the injury of small intestinal microvascular endothelial cells and small intestinal mucosa in rats.The expression of vascular endothelial growth factor A(VEGF-A),phosphoinositide 3-kinase(PI3K),phosphorylated PI3K(p-PI3K),protein kinase B(Akt),and phosphorylated Akt(p-Akt) in the small intestine was analyzed via Western blotting.RESULTS:XBJ improved intestinal microcirculation dysfunction in septic rats,alleviated the injury of small intestinal microvascular endothelial cells and small intestinal mucosa,and reduced the systemic inflammatory response.Moreover,XBJ upregulated the expression of VEGF-A,p-PI3K/total PI3K,and p-Akt/total Akt in the rat small intestine.CONCLUSION:XBJ may improve intestinal microcirculation dysfunction in septic rats possibly through the VEGF-A/PI3K/Akt signaling pathway.

关键词： Sepsis Xuebijing Vascular endothelial growth factor A Microcirculation Rat Phosphoinositide 3-kinase Protein kinase B

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Dietary fiber intake and its association with diabetic kidney disease in American adults with diabetes:A cross-sectional study

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World Journal of Diabetes 2024年第3期15卷 475-487页

作者： Xin-Hua Jia sheng-yan Wang Ai-Qin Sun Department of Critical Care Medicine Dezhou People’s HospitalDezhou 253000Shandong ProvinceChina Emergency Intensive Care Unit Dezhou People’s HospitalDezhou 253000Shandong ProvinceChina

BACKGROUND Dietary fiber(DF)intake may have a protective effect against type 2 diabetes(T2D);however,its relationship with diabetic kidney disease(DKD)remains unclear.AIM To investigate the potential association between DF intake and the prevalence of DKD in individuals diagnosed with T2D.METHODS This cross-sectional study used data from the National Health and Nutrition Examination Survey collected between 2005 and 2018.DF intake was assessed through 24-h dietary recall interviews,and DKD diagnosis in individuals with T2D was based on predefined criteria,including albuminuria,impaired glomerular filtration rate,or a combination of both.Logistic regression analysis was used to assess the association between DF intake and DKD,and comprehensive subgroup and sensitivity analyses were performed.RESULTS Among the 6032 participants,38.4%had DKD.With lower DF intake-T1(≤6.4 g/1000 kcal/day)-as a reference,the adjusted odds ratio for DF and DKD for levels T2(6.5-10.0 g/1000 kcal/day)and T3(≥10.1 g/1000 kcal/day)were 0.97(95%CI:0.84-1.12,P=0.674)and 0.79(95%CI:0.68-0.92,P=0.002),respectively.The subgroup analysis yielded consistent results across various demographic and health-related subgroups,with no statistically significant interactions(all P>0.05).CONCLUSION In United States adults with T2D,increased DF intake may be related to reduced DKD incidence.Further research is required to confirm these findings.

关键词： Dietary fiber Diabetic kidney disease Type 2 diabetes National Health and Nutrition Examination Survey Crosssectional study

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Development of a prognostic scoring system for hepatic vena cava Budd-Chiari syndrome with hepatocellular carcinoma

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Hepatobiliary & Pancreatic Diseases International 2024年第4期23卷 370-375页

作者： sheng-yan Liu Lu-Hao Li Zhao-Chen Liu Su-Xin Li Xiao-Wei Dang Department of Hepatopancreatobiliary Surgery the First Affiliated Hospital of Zhengzhou UniversityZhengzhou 450052China Budd-Chiari Syndrome Diagnosis and Treatment Center of Henan Province Zhengzhou 450052China

Background:Hepatocellular carcinoma(HCC)is a serious complication of hepatic vena cava Budd-Chiari syndrome(HVC-BCS)that significantly reduces the survival time of patients.Our study aimed to analyze the prognostic factors influencing the survival of HVC-BCS patients with HCC and to develop a prognostic scoring system.Methods:The clinical and follow-up data of 64 HVC-BCS patients with HCC who received invasive treatment at the First Affiliated Hospital of Zhengzhou University between January 2015 and December 2019 were retrospectively analyzed.Kaplan-Meier curves and log-rank tests were used to analyze the survival curve of patients and the difference in prognoses between the groups.Univariate and multivariate Cox regression analyses were performed to analyze the influence of biochemical,tumor,and etiological characteristics on the total survival time of patients,and a new prognostic scoring system was developed according to the regression coefficients of the independent predictors in the statistical model.The prediction efficiency was evaluated using the time-dependent receiver operating characteristics curve and concordance index.Results:Multivariate analysis showed that serum albumin level7 cm(HR=8.623,95%CI:3.771-19.715,P<0.001),and inferior vena cava stenosis(HR=3.612,95%CI:1.646-7.928,P=0.001)were independent predictors of survival.A prognostic scoring system was developed according to the above-mentioned independent predictors,and patients were classified into grades A,B,C and D.Significant differences in survival were found among the four groups.Conclusions:This study successfully developed a prognostic scoring system for HVC-BCS patients with HCC,which is helpful for clinical evaluation of patient prognosis.

关键词： Budd-Chiari syndrome Hepatocellular carcinoma Prognostic factors Inferior vena cava stenosis Prognostic scoring system

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Successful treatment of pancreatic accessory splenic hamartoma by laparoscopic spleen-preserving distal pancreatectomy:A case report

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World Journal of Gastrointestinal Oncology 2022年第5期14卷 1057-1064页

作者： Shao-yan Xu Bo Zhou Shu-Mei Wei Ya-Nan Zhao sheng yan Division of Hepatobiliary and Pancreatic Surgery Department of SurgeryThe Second Affiliated HospitalSchool of MedicineZhejiang UniversityHangzhou 310000Zhejiang ProvinceChina Department of Pathology The Second Affiliated HospitalSchool of MedicineZhejiang UniversityHangzhou 310000Zhejiang ProvinceChina Department of Ultrasound The Second Affiliated HospitalSchool of MedicineZhejiang UniversityHangzhou 310000Zhejiang ProvinceChina

BACKGROUND Pancreatic accessory spleen(PAS)is an uncommon congenital abnormality of the spleen.Spleen hamartoma(SH)is also rare.Moreover,hamartoma in the PAS has not been reported thus far.We report the first case here.CASE SUMMARY A 26-year-old male presented with a one-month history of left upper quadrant abdominal pain,and computerized tomography(CT)examination suggested a mass in the pancreas tail.The patient then attended our hospital for diagnosis and treatment.Ultrasonography,CT,and magnetic resonance imaging revealed a solid mass with cystic degeneration growing from the tail of the pancreas.The tumor marker carbohydrate antigen 19-9(CA19-9)increased to 96.7 U/mL(normal range 0-37 U/mL).An epidermoid cyst in a PAS was considered preoperatively.However,a malignant tumor cannot be ruled out.We performed laparoscopic surgery,and two pancreatic masses were found growing from the pancreatic tail.The two masses were so closely connected that preoperative imaging examinations suggested only one mass.We carefully isolated the masses from the splenic artery and vein.A laparoscopic spleen-preserving distal pancreatectomy was successfully performed.On pathological examination,the masses were well-defined,homogeneous red-tan,4×3,and 4.5×1.5 in size,respectively.One of them was cystically degenerated.On microscopical examination,the mass contained unorganized small slit-like vascular channels enclosing red blood cells and lined with plump endothelial cells.No area of cytologic atypia was identified.Focal lymphoid aggregates were found in the intravascular areas.White pulp or fibrosis was not observed.The final diagnosis was pancreatic accessory SH with cystic degeneration.After the operation,CA19-9 was reduced to normal.The patient recovered well,and the 34-mo follow-up period was uneventful.CONCLUSION Here,we report the first case of pancreatic accessory SH.A laparoscopic spleen-preserving distal pancreatectomy was successfully performed.The patient recovered well and had a good prognosis.

关键词： Pancreatic accessory spleen Splenic hamartoma Cystic degeneration Laparoscopic spleenpreserving distal pancreatectomy Case report

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Primordial black hole mass functions as a probe of cosmic origin

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Science China(Physics,Mechanics & Astronomy) 2024年第5期67卷 164-171页

作者： Yi-Fu Cai Chengfeng Tang Geyu Mo sheng-Feng yan Chao Chen Xiao-Han Ma Bo Wang Wentao Luo Damien A.Easson Antonino Marcianò Deep Space Exploration Laboratory/School of Physical Sciences University of Science and Technology of ChinaHefei 230026China CAS Key Laboratory for Researches in Galaxies and Cosmology/Department of Astronomy School of Astronomy and Space ScienceUniversity of Science and Technology of ChinaHefei 230026China Istituto Nazionale di Fisica Nucleare(INFN) Sezione di MilanoMilano 20146Italy DiSAT Universitàdegli Studi dell'InsubriaComo 22100Italy Jockey Club Institute for Advanced Study The Hong Kong University of Science and TechnologyHong KongChina Department of Physics Arizona State UniversityTempe 85287-1504USA Department of Physics&Center for Field Theory and Particle Physics Fudan UniversityShanghai 200433China Laboratori Nazionali di Frascati INFN Via Enrico Fermi 541 Frascati(Roma)00044Italy INFN sezione Roma Tor Vergata Rome I-00133Italy School of Physics University of Electronic Science and Technology of ChinaChengdu11731China

We discuss a novel window to probe the origin of our universe via the mass functions of primordial black holes(PBHs).The mass functions of PBHs are simply estimated using the conventional Press-Schechter formalism for two paradigms of cosmic origin,including inflationaryΛCDM and bounce cosmology.The standard inflationaryΛCDM model cannot generate an appreciable number of massive PBHs;however,non-trivial inflation models with blue-tilted power spectra at small scales and matter bounce cosmology provide formation mechanisms for heavy PBHs,which in turn,may seed the observed supermassive black holes(SMBHs).By fitting the SMBH mass functions at high redshift(z~6)derived from Sloan Digital Sky Survey(SDSS)and Canada-France High-z Quasar Survey(CFHQS)quasars,for two paradigms of cosmic origin,we derive constraints on the PBH density fraction fPBHat z~6 and the characteristic mass M_(★),with the prior assumption that all SMBHs stem from PBHs.We demonstrate that this newly proposed procedure,relying on astronomical measurements that utilize deep-field surveys of SMBHs at high redshift,can be used to constrain models of cosmic origin.Additionally,although not the main focus of this paper,we evolve the mass function from z~6 to z~0 through an assumption of 3×10^(8)-year Eddington’s accretion,and give a rough estimation of fPBHat z~0.

关键词： origin cosmic massive

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Effects of Zishen Yutai Pills on in vitro Fertilization-Embryo Transfer Outcomes in Patients with Diminished Ovarian Reserve:A Prospective,Open-Labeled,Randomized and Controlled Study

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Chinese Journal of Integrative Medicine 2023年第4期29卷 291-298页

作者： LI Xiu-fang WANG Zhong-qing XU Hai-yan LIU Hong sheng yan XU Jin LI Yuan-mei LIAN Fang The First Clinical College Shandong University of Traditional Chinese MedicineJinan 250014China Center for Reproductive Medicine Shandong UniversityJinan 250021China Medical College of Optometry and Ophthalmology Shandong University of Traditional Chinese MedicineJinan 250014China Department of Traditional Chinese Medicine Jinan Golden Time Health Nursing HospitalJinan 250000China Reproductive and Genetic Center of Integrated Traditional and Western Medicine Affiliated Hospital of Shandong University of Traditional ChineseJinan 250011China Medicine

Objective:To explore the effects of Zishen Yutai Pills(ZYPs)on the quality of oocytes and embryos,as well as pregnancy outcomes in patients with diminished ovarian reserve(DOR)receiving in vitro fertilizationembryo transfer(IVF-ET).The possible mechanisms,involving the regulation of bone morphogenetic protein 15(BMP15)and growth differentiation factor 9(GDF9),were also investigated.Methods:A total of 120 patients with DOR who underwent their IVF-ET cycle were randomly allocated to 2 groups in a 1:1 ratio.The patients in the treatment group(60 cases)received ZYPs from the mid-luteal phase of the former menstrual cycle by using gonadotropin-releasing hormone(Gn RH)antagonist protocol.The patients in the control group(60 cases)received the same protocol but without ZYPs.The primary outcomes were the number of oocytes retrieved and high-quality embryos.Secondary outcomes included other oocyte or embryo indices as well as pregnancy outcomes.Adverse events were assessed by comparison of the incidence of ectopic pregnancy,pregnancy complications,pregnancy loss,and preterm birth.Contents of BMP15 and GDF9 in the follicle fluids(FF)were also quantified with enzymelinked immunosorbent assay.Results:Compared with the control group,the numbers of oocytes retrieved and high-quality embryos were significantly increased in the ZYPs group(both P0.05).The administration of ZYPs did not increase the incidence of adverse events.The expressions of BMP15 and GDF9 in the ZYPs group were significantly up-regulated compared with the control group(both P<0.05).Conclusions:ZYPs exhibited beneficial effects in DOR pa

关键词： Zishen Yutai Pills diminished ovarian reserve in vitro fertilization-embryo transfer oocytes embryos

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Network Pharmacology and Experimental Study of MomordicineⅠand MomordicineⅡfrom Bitter Melon Saponins in Inhibiting Fat Accumulation

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Biomedical and Environmental Sciences 2024年第5期37卷 526-530页

作者： HUANG Shi Ting LI Shang Yuan LI Xin Yu ZHU Ying ZHU Lin ZHANG Jia yan ZHAO yan sheng DAGLIA Maria XIAO Xiang BAI Juan School of Food and Biological Engineering Jiangsu UniversityZhenjiang 212013JiangsuChina Department of Pharmacy University of Napoli FedericoⅡVia D.Montesano 4980131 NaplesItaly International Research Center for Food Nutrition and Safety Jiangsu UniversityZhenjiang 212013JiangsuChina

Bitter melon(Momordica Charania L.),a member of the Cucurbitaceae family,is widely distributed across tropical and subtropical regions.Saponin,an important functional component of bitter melon,has been proven to exert hypoglycemic effects similarly to insulin,and also possesses lipid-lowering properties inhibiting preadipocyte differentiation and fat synthesis^([1]).

关键词： melon Momordica subtropical

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Length-based separation of Bacillus subtilis bacterial populations by viscoelastic microfluidics

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Microsystems & Nanoengineering 2022年第1期8卷 149-159页

作者： Ping Liu Hangrui Liu Lucie Semenec Dan Yuan sheng yan Amy K.Cain Ming Li Suqian University Suqian 223800China School of Engineering Macquarie UniversitySydneyNSW 2109Australia Department of Physics and Astronomy Macquarie UniversitySydneyNSW 2109Australia ARC Centre of Excellence in Synthetic Biology Department of Molecular ScienceMacquarie UniversitySydneyNSW 2109Australia Centre for Regional and Rural Futures Deakin UniversityGeelongVIC 3216Australia Institute for Advanced Study Shenzhen UniversityShenzhen 518060China Biomolecular Discovery Research Centre Macquarie UniversitySydneyNSW 2109Australia

In this study,we demonstrated the label-free continuous separation and enrichment of Bacillus subtilis populations based on length using viscoelastic microfluidics.B.subtilis,a gram-positive,rod-shaped bacterium,has been widely used as a model organism and an industrial workhorse.B.subtilis can be arranged in different morphological forms,such as single rods,chains,and clumps,which reflect differences in cell types,phases of growth,genetic variation,and changing environmental factors.The ability to prepare B.subtilis populations with a uniform length is important for basic biological studies and efficient industrial applications.Here,we systematically investigated how flow rate ratio,poly(ethylene oxide)(PEO)concentration,and channel length affected the length-based separation of B.subtilis cells.The lateral positions of B.subtilis cells with varying morphologies in a straight rectangular microchannel were found to be dependent on cell length under the co-flow of viscoelastic and Newtonian fluids.Finally,we evaluated the ability of the viscoelastic microfluidic device to separate the two groups of B.subtilis cells by length(i.e.,1-5μm and>5μm)in terms of extraction purity(EP),extraction yield(EY),and enrichment factor(EF)and confirmed that the device could separate heterogeneous populations of bacteria using elasto-inertial effects.

关键词： viscoelastic separation straight

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Use of veno-arterial extracorporeal membrane oxygenation in the fi rst successful combined lung-liver transplantation patient in China

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World Journal of Emergency Medicine 2022年第5期13卷 412-414页

作者： Man Huang Yong-shan Xu sheng yan yan-jun Shi Sai-bo Pan Yi-bing Chen Chen-yang Gao Jing-yu Chen Wei-lin Wang Department of General Intensive Care Unit the Second Affi liated Hospital of Zhejiang University School of MedicineHangzhou 310009China Department of Hepatobiliary and Pancreatic Surgery the Second Affi liated HospitalZhejiang University School of MedicineHangzhou 310009China Department of Lung Transplantation the Second Affi liated Hospital of Zhejiang University School of MedicineHangzhou 310009China

Dear editor,Extracorporeal membrane oxygenation(ECMO)is a modality of extracorporeal life support that allows for temporary support in pulmonary and/or cardiac failure refractory to conventional therapy.[1]ECMO use has been exponentially increasing over the last decade and is now considered a mainstream lifesaving treatment modality in critical care medicine.Many studies report ECMO use in patients with acute respiratory distress syndrome refractory to conventional clinical support,in-hospital cardiac arrest,and cardiogenic refractory shock.[1-3]Herein,we report the use of veno-arterial ECMO(VA-ECMO)in the first successful combined lung-liver transplantation(CLLT)patient in China.

关键词： arterial modality extracorporeal

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