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Progress and Perspective of Artificial Intelligence and Machine Learning of Prediction in Anesthesiology

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Journal of Shanghai Jiaotong university(Science) 2022年第1期27卷 112-120页

作者： XIA Ming XU Tianyi JIANG Hong Department of Anesthesiology Shanghai Ninth People’s HospitalShanghai Jiao Tong University School of MedicineShanghai 200011China

Artificial intelligence(AI)has long been an attractive topic in medicine,especially in light of the rapid developments in digital and information *** has already provided some breakthroughs in *** the assistance of AI,more precise models have been used for clinical predictions,diagnoses,and *** review defines the basic concepts of AI and machine learning(ML),and provides a simple introduction to certain frequently used algorithms in AI and *** addition,the review discusses the current common applications of AI and ML in the prediction of anesthesia conditions,including those for preoperative predictions of difficult airways,intraoperative predictions of adverse events and anesthetic effects,and postoperative predictions of vomiting and *** use of AI in anesthesiology remains in development,even without extensive promotion and clinical application;moreover,it has immense potential to maintain further development in the ***,the limitations and challenges of AI development for anesthesia are also discussed,along with considerations regarding ethics and safety.

关键词： artificial intelligence(AI) machine learning(ML) anesthesiology prediction models

Effects of lighting conditions and accommodation on the three-dimensional position of Visian implantable collamer lens

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Eye and Vision 2024年第3期10卷 31-40页

作者： Lingling Niu Zhe Zhang Huamao Miao Jing Zhao Xiaoying Wang Ji C.He Xingtao Zhou Department of Ophthalmology and Optometry Eye&ENT HospitalFudan UniversityShanghaiChina NHC Key Laboratory of Myopia(Fudan University) ShanghaiChina Key Laboratory of Myopia Chinese Academy of Medical SciencesShanghaiChina Shanghai research Center of Ophthalmology and Optometry ShanghaiChina New England College of Optometry MABostonUSA

Background To investigate the effects of lighting conditions and accommodation on the three-dimensional position of Visian implantable collamer lens(ICL V4c).Methods This observational study recruited 62 eyes of 31 myopia patients underwent ICL V4c *** segment optical coherence tomography(AS-OCT)assessed the anterior chamber depth(ACD),ACD-ICL(distance from the corneal endothelium to anterior surface of the ICL V4c),vault(distance between the posterior ICL V4c surface and anterior crystalline lens surface),and crystalline lens tilt under various lighting conditions and accommodation relative to the corneal topographic axis at one year after ICL V4c *** was defined as the scotopic condition,which was also the non-accommodative stimulus *** ICL V4c tilt was analyzed using *** significance level was set at P<*** The ACD-ICL values were similar under various lighting conditions(P=0.978)but decreased during accommodation(P<0.001).The vault was significantly smaller under mesopic and photopic conditions than the baseline(P=0.044 and P<0.001,respectively)but remained unchanged during accommodation(P=0.058).The inferotemporal proportion of ICL V4c(88.7%,55 eyes)and crystalline lens(74.2%,46 eyes)tilts were not significantly different(P=0.063).Crystalline lens under various lighting conditions and accommodation exhibited similar *** vertical tilt of ICL V4c was significantly larger under photopic conditions than the baseline(P=0.038).The horizontal and total tilts were significantly decreased during accommodation(P=0.043 and 0.013,respectively).Conclusions The axial position of ICL V4c in the anterior chamber was stable under various lighting *** conditions and accommodation may influence vertical,horizontal and total tilts of ICL V4c.

关键词： Implantable collamer lens Anterior segment optical coherence tomography Myopia Tilt

Simplified algorithm for genetic subtyping in diffuse large B-cell lymphoma

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Signal Transduction and Targeted Therapy 2023年第5期8卷 2304-2314页

作者： Rong Shen Di Fu Lei Dong Mu-Chen Zhang Qing Shi Zi-Yang Shi Shu Cheng Li Wang Peng-Peng Xu Wei-Li Zhao Shanghai Institute of Hematology State Key Laboratory of Medical GenomicsNational Research Center for Translational Medicine at ShanghaiRuijin Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghaiChina Department of Pathology Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghaiChina Pôle de Recherches Sino-Français en Science du Vivant et Génomique Laboratory of Molecular PathologyShanghaiChina

Genetic classification helps to disclose molecular heterogeneity and therapeutic implications in diffuse large B-cell lymphoma(DLBCL).Using whole exome/genome sequencing,RNA-sequencing,and fluorescence in situ hybridization in 337 newly diagnosed DLBCL patients,we established a simplified 38-gene algorithm(termed‘LymphPlex’)based on the information on mutations of 35 genes and rearrangements of three genes(BCL2,BCL6,and MYC),identifying seven distinct genetic subtypes:TP53Mut(TP53 mutations),MCD-like(MYD88,CD79B,PIM1,MPEG1,BTG1,TBL1XR1,PRDM1,IRF4 mutations),BN2-like(BCL6 fusion,NOTCH2,CD70,DTX1,BTG2,TNFAIP3,CCND3 mutations),N1-like(NOTCH1 mutations),EZB-like(BCL2 fusion,EZH2,TNFRSF14,KMT2D,B2M,FAS,CREBBP,ARID1A,EP300,CIITA,STAT6,GNA13 mutations,with or without MYC rearrangement),and ST2-like(SGK1,TET2,SOCS1,DDX3X,ZFP36L1,DUSP2,STAT3,IRF8 mutations).Extended validation of 1001 DLBCL patients revealed clinical relevance and biological signature of each genetic ***53Mut subtype showed poor prognosis,characterized by p53 signaling dysregulation,immune deficiency,and PI3K ***-like subtype was associated with poor prognosis,activated B-cell(ABC)origin,BCL2/MYC double-expression,and NF-κB ***2-like subtype showed favorable outcome within ABC-DLBCL and featured with NF-κB activation.N1-like and EZB-like subtypes were predominated by ABC-DLBCL and germinal center B-cell(GCB)-DLBCL,***-like-MYC+subtype was characterized by an immunosuppressive tumor microenvironment,while EZB-like-MYC-subtype by NOTCH ***2-like subtype showed favorable outcome within GCB-DLBCL and featured with stromal-1 *** subtype-guided targeted agents achieved encouraging clinical response when combined with ***,LymphPlex provided high efficacy and feasibility,representing a step forward to the mechanism-based targeted therapy in DLBCL.

关键词： lymphoma algorithm representing

Immunosuppressive tumor microenvironment contributes to tumor progression in diffuse large B-cell lymphoma upon anti-CD19 chimeric antigen receptor T therapy

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Frontiers of Medicine 2023年第4期17卷 699-713页

作者： Zixun Yan Li Li Di Fu Wen Wu Niu Qiao Yaohui Huang Lu Jiang Depei Wu Yu Hu Huilai Zhang Pengpeng Xu Shu Cheng Li Wang Sahin Lacin Muharrem Muftuoglu Weili Zhao Shanghai Institute of Hematology State Key Laboratory of Medical GenomicsNational Research Center for Translational Medicine at ShanghaiRuijin Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghai 200025China Institute of Hematology The First Affiliated Hospital of Soochow UniversitySuzhou 215000China Institute of Hematology Union HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430000China Tianjin Medical University Cancer Institute&Hospital Tianjin 300070China University of Texas MD Anderson Cancer Center HoustonTexas 77030USA Laboratory of Molecular Pathology Pôle de Recherches Sino-Français en Science du Vivant et GénomiqueShanghai 200025China

Anti-CD19 chimeric antigen receptor(CAR)-T cell therapy has achieved 40%–50%long-term complete response in relapsed or refractory diffuse large B-cell lymphoma(DLBCL)***,the underlying mechanism of alterations in the tumor microenvironments resulting in CAR-T cell therapy failure needs further investigation.A multi-center phase I/II trial of anti-CD19 CD28z CAR-T(FKC876,ChiCTR1800019661)was *** 22 evaluable DLBCL patients,seven achieved complete remission,10 experienced partial remissions,while four had stable disease by day ***-cell RNA sequencing results were obtained from core needle biopsy tumor samples collected from long-term complete remission and early-progressed patients,and compared at different stages of treatment.M2-subtype macrophages were significantly involved in both in vivo and in vitro anti-tumor functions of CAR-T cells,leading to CAR-T cell therapy failure and disease progression in *** tumor microenvironments persisted before CAR-T cell therapy,during both cell expansion and disease progression,which could not be altered by infiltrating CAR-T *** metabolism profile of M2-subtype macrophages and those of dysfunctional T cells also contributed to the immunosuppressive tumor ***,our findings provided a clinical rationale for targeting tumor microenvironments and reprogramming immune cell metabolism as effective therapeutic strategies to prevent lymphoma relapse in future designs of CAR-T cell therapy.

关键词： anti-CD19 chimeric antigen receptor T immunotherapy diffuse large B cell lymphoma tumor microenvironment tumor-associated macrophage metabolism

Advances in Medicine-Engineering Crossover in Automated Anesthesia

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Journal of Shanghai Jiaotong university(Science) 2022年第2期27卷 137-143页

作者： Xu Tianyi Xia Ming Jiang Hong Department of Anesthesiology Shanghai Ninth People’s HospitalShanghai Jiao Tong University School of MedicineShanghai200011China

Medicine-engineering crossover refers to the cross-fertilization of multiple disciplines to meet clinical needs through various means,including engineering,which greatly promotes medical *** the development of anesthesiology,improvements in anesthesia equipment and continuous innovation of anesthesia technology are all closely related to the integration of medicine and *** recent years,the exploration and development of automated anesthesia equipment has led to closer integration of medicine,engineering,and other disciplines,including the development of robots in anesthesia,automated monitoring and alarm technology,automated perioperative management,and remote ***,the current status of applications and development of medicine-engineering crossover in the field of automated anesthesia are discussed.

关键词： medicine-engineering crossover automation anesthesia robotics

Application of contrast-enhanced ultrasound in minimally invasive ablation of benign thyroid nodules

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Journal of Interventional Medicine 2022年第1期5卷 32-36页

作者： Jiaying Cao Peili Fan Feihang Wang Shuainan Shi Lingxiao Liu Zhiping Yan Yi Dong Wenping Wang Department of Ultrasound Zhongshan HospitalFudan UniversityShanghaiChina Department of Interventional Radiology Zhongshan HospitalFudan UniversityShanghaiChina Shanghai Institute of Medical Imaging ShanghaiChina

Objective:This study aimed to investigate the application value of contrast-enhanced ultrasound(CEUS)before and after minimally invasive ablation procedures for benign thyroid nodule(s)(BTN).Methods:This prospective study included patients with BTNs scheduled to undergo ultrasound-guided minimally invasive ablation *** was performed before and after ablation(at 1 day,and 1,6,and 12 months after ablation).Changes in microvascular perfusion and the volume of BTNs were noted and ***:Sixty-two patients(62 BTNs),who underwent ablation procedures between June 2016 and August 2020,were *** lesions were confirmed by biopsy,and histopathological results were obtained before ablation *** preoperative CEUS,the lesions exhibited hyperenhancement(53.23%)or iso-enhancement(46.77%)during the arterial phase,and all lesions exhibited iso-enhancement in the venous and late *** day after ablation,none of the BTNs exhibited obvious enhancement on ***(1.61%)lesion was retreated due to a nodule-like enhancement area detected by CEUS at the 6-month *** mean nodular volume reduction rate(VRR)at 1,6,and 12 months follow-up demonstrated no significant difference between the two ablation groups(microwave ablation versus radiofrequency ablation).Twelve months after ablation,the mean(±SD)VRR of all BTNs was 60.3±10.3%.Conclusion:CEUS helped guide treatment decisions for BTNs before ablation ***,it could also be used to accurately and noninvasively evaluate treatment efficacy.

关键词： Ultrasound Contrast agent Thyroid Microwave ablation Radiofrequency ablation

Repeatability and reproducibility of corneal higher-order aberrations measurements after small incision lenticule extraction using the Scheimpfug-Placido topographer

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Eye and Vision 2024年第1期10卷 1-9页

作者： Rui Ning Rongrong Gao David PPiñero Jun Zhang Qingyi Gao Yili Jin Yiran Wang Chenxiao Wang Jinhai Huang Eye Hospital and School of Ophthalmology and Optometry Wenzhou Medical UniversityWenzhouZhejiangChina Eye Institute and Department of Ophthalmology Eye and ENT HospitalFudan UniversityShanghaiChina Group of Optics and Visual Perception Department of OpticsPharmacology and AnatomyUniversity of AlicanteAlicanteSpain NHC Key Laboratory of Myopia(Fudan University) Key Laboratory of MyopiaChinese Academy of Medical SciencesShanghaiChina Shanghai research Center of Ophthalmology and Optometry ShanghaiChina

Background:To evaluate the precision of corneal higher-order aberrations measurements after small incision lenticule extraction(SMILE)using the Sirius Scheimpfug-Placido topographer(CSO,Italy).Methods:Seventy-fve eyes from 75 postoperative subjects were included in this prospective *** consecutive corneal aberrometric measurements were obtained with the Scheimpfug-Placido topographer by two experienced operators to assess intra-and inter-observer *** within-subject standard deviation(Sw),test-retest repeatability(TRT)and the intraclass correlation coefcient(ICC)were ***:For intraobserver repeatability of anterior and total corneal aberrations,all ICCs were more than 0.922,except for trefoil(0.722 to 0.768).The ICCs of total root mean square(RMS),coma Z(3,±1),and spherical aberration Z(4,0)were over 0.810 while higher-order RMS,trefoil Z(3,±3),and astigmatism II Z(4,±2)were below 0.634 for posterior corneal surface *** Sw values for all types of aberrations were equal to or below 0.07μ*** interobserver reproducibility,all TRT values were no more than 0.12μm,0.05μm,and 0.11μm for anterior,posterior,and total corneal aberrations,*** ICC values ranged from 0.875 to 0.989,from 0.686 to 0.976 and over 0.834 for anterior,posterior,and total corneal aberrations,***:The repeatability of measurements of anterior and total corneal aberrations with the Sirius system in corneas after SMILE surgery was high,except for *** was some variability in posterior corneal aberrometric *** reproducibility of corneal aberrometric measurements was observed between measurements of both examiners,except for trefoil,with poor to moderate reproducibility.

关键词： Sirius Higher-order aberrations Repeatability Reproducibility Small incision lenticule extraction

Importance of incorporating systemic cerebroarterial hemodynamics into computational modeling of blood flow in intracranial aneurysm

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Journal of Hydrodynamics 2020年第3期32卷 510-522页

作者： Zhi-qiang Zhang Li-jian Xu Rong Liu Xiao-sheng Liu Bing-Zhao Fu-you Liang School of Naval Architecture Ocean and Civil EngineeringShanghai Jiao Tong UniversityShanghai 200240China Collaborative Innovation Center for Advanced Ship and Deep-Sea Exploration(CISSE) Shanghai 200240China Institute of Textiles and Clothing The Hong Kong Polytechnic UniversityHong KongChina Department of Radiology Ren Ji HospitalShanghai Jiao Tong University School of MedicineShanghai 200127China Department of Neurosurgery Ren Ji HospitalShanghai Jiao Tong University School of MedicineShanghai 200127China Institute for Personalized Medicine Sechenov UniversityMoscow 119991Russia

The importance of properly treating boundary conditions (BCs) in numerical simulation of hemodynamics in intracranial aneurysm (IA) has been increasingly recognized. In this study, we constructed three types of computational model for each IA to investigate how the outcome of numerical simulation is affected by the treatment of BCs. The first type of model (i.e., Type-A model) was obtained by applying 3-D hemodynamic modeling to the entire cerebral arterial network, with its solution being taken as the reference for evaluating the performance of the other two types of model (i.e., Type-B and Type-C models) in which 3-D modeling was confined to the aneurysm region. In addition, patient-specific 1-D models of the cerebral arterial network were developed to provide hemodynamic information for setting the inflow/outflow BCs of the 3-D models. Numerical tests on three IAs revealed that prescribing the outflow BCs of a localized 3-D aneurysm model based on 1-D model-simulated outflow division (i.e., Type-B model) instead of imposing the free outflow BC on all outlets (i.e., Type-C model) helped to improve the fidelity of the simulation of intra-aneurysmal hemodynamics, but could not guarantee a complete reproduction of the reference solution obtained by the Type-A model. Moreover, it was found that the outcome of hemodynamic simulation was more sensitive to the treatment of BCs when an aneurysm was located at arterial bifurcation rather than sidewall. These findings highlight the importance of taking into account systemic cerebroarterial hemodynamics in computational modeling of hemodynamics in IAs, especially those located at bifurcations.

关键词： Intracranial aneurysm systemic cerebroarterial hemodynamics boundary conditions computational model

Chinese expert consensus on clinical application of molecularly targeted drugs for hepatocellular carcinoma (2022 edition)

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中华医学杂志(英文版) 2024年第21期137卷 2630-2632页

作者： Sun Juxian Li Qiu Bai Xueli Cai Jianqiang Chen Yajin Chen Minshan Dai Chaoliu Fang Chihua Jia Weidong Li Xiangcheng Wen Tianfu Xia Jinglin Ying Mingang Zhang Zhiwei Zhang Xuewen Zeng Zhaochong Cheng Shuqun Department of Hepatic Surgery VI Eastern Hepatobiliary Surgery Hospital Naval Medical University Shanghai China Department of Medical Oncology Cancer Center West China Hospital Sichuan University Chengdu Sichuan China Department of Hepatobiliary and Pancreatic Surgery The First Affiliated Hospital Zhejiang University School of Medicine Hangzhou Zhejiang China Department of Hepatobiliary Surgery Cancer Hospital Chinese Academy of Medical Sciences Beijing China Department of Hepatobiliopancreatic Surgery Sun Yat-Sen Memorial Hospital Sun Yat-Sen University Guangzhou Guangdong China Department of Hepatobiliary Surgery Sun Yat-sen University Cancer Center Guangzhou Guangdong China Department of Hepatobiliary and Spleenary Surgery The Affiliated Shengjing Hospital China Medical University Shenyang Liaoning China Department of Hepatobiliary Surgery Zhujiang Hospital First Military Medical University Guangzhou Guangdong China Department of General Surgery Anhui Key Laboratory of Hepatopancreatobiliary Surgery Anhui Provincial Hospital The First Affiliated Hospital of USTC University of Science and Technology of China Hefei Anhui China Hepatobiliary Center The First Affiliated Hospital of Nanjing Medical University Key Laboratory of Living Donor Liver Transplantation Nanjing Jiangsu China Department of Liver Surgery West China Hospital of Sichuan University Chengdu Sichuan China The First Affiliated Hospital of Wenzhou Medical University Wenzhou Zhejiang China Liver Cancer Institute & Zhongshan Hospital Fudan University Shanghai China Department of Gastrointestinal Oncological Surgery Fujian Provincial Cancer Hospital Fujian Medical University Teaching Hospital Fuzhou Fujian China Department of Surgery Hepatic Surgery Center Institute of HBP Surgery Tongji Hospital Tongji Medical College Huazhong University of Science and Technology Wuhan Hubei China Department of Hepatobiliary and Pancreas Surgery The Second Hospital of Jilin University Changc

Primary liver cancer is one of the most common malignant tumors in China. In 2020, 410,038 new cases of liver cancer and 391,152 deaths due to liver cancer were reported in China, which places liver cancer as the second most common cancer-related cause of death in China; of these cancers, hepatocellular carcinoma(HCC) accounts for 85-90%. HCC poses a significant threat to the lives and health of Chinese people.

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