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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 *** study aimed to develop a deep learning model based on contrast-enhanced computed tomography(CT)images to assist radiologists in identifying ***: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)*** deep learning model was developed based on ResNet50 *** and clinical models were built based on support vector machine(SVM)*** comprehensively compared the performance of deep learning,radiomics,clinical models,and three ***: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 *** 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 *** 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 *** sensitivity of deep learning model was the highest both in the training[90%(95%CI:82%-96%)]and validation[85%(95%CI:68%-95%)]***: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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Washed microbiota transplantation for Crohn’s disease:A metagenomic,metatranscriptomic,and metabolomic-based study

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World Journal of Gastroenterology 2024年第11期30卷 1572-1587页

作者： Shi-Ju Chen Da-Ya Zhang Xia Wu Fa-Ming Zhang Bo-Ta Cui Yi-Hao Huang Zu-Lun Zhang Rui Wang Fei-Hu Bai Graduate School Hainan Medical UniversityHaikou 571199Hainan ProvinceChina Department of Microbiota Medicine&medical Center for Digestive Diseases The Second Affiliated Hospital of Nanjing Medical UniversityNanjing 210011Jiangsu ProvinceChina Department of Gastroenterology The Second Affiliated Hospital of Hainan Medical UniversityHaikou 570216Hainan ProvinceChina

BACKGROUND Fecal microbiota transplantation(FMT)is a promising therapeutic approach for treating Crohn’s disease(CD).The new method of FMT,based on the automatic washing process,was named as washed microbiota transplantation(WMT).Most existing studies have focused on observing the clinical ***,the mechanism of action of FMT for the effective management of CD-particularly in-depth multi-omics analysis involving the metagenome,metatranscriptome,and metabolome-has not yet been *** To assess the efficacy of WMT for CD and explore alterations in the microbiome and metabolome in response to *** We conducted a prospective,open-label,single-center clinical *** CD patients underwent *** clinical responses(defined as a decrease in their CD Activity Index score of>100 points)and their microbiome(metagenome,metatranscriptome)and metabolome profiles were evaluated three months after the *** Seven of the 11 patients(63.6%)showed an optimal clinical response three months *** microbiome diversity significantly increased after WMT,consistent with improved clinical *** of the metagenome and metatranscriptome analyses revealed consistent alterations in certain strains,such as Faecalibac-terium prausnitzii,Roseburia intestinalis,and Escherichia *** addition,metabolomics analyses demonstrated that CD patients had elevated levels of various amino acids before treatment compared to the ***,levels of vital amino acids that may be associated with disease progression(e.g.,L-glutamic acid,gamma-glutamyl-leucine,and prolyl-glutamine)were reduced after *** WMT demonstrated therapeutic efficacy in CD treatment,likely due to the effective reconstruction of the patient’s ***-omics techniques can effectively help decipher the potential mechanisms of WMT in treating CD.

关键词： Crohn’s disease Clinical trials Fecal microbiota transplant Metagenome Metatranscriptome Metabolome

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Multifaceted functions of Drp1 in hypoxia/ischemia- induced mitochondrial quality imbalance: from regulatory mechanism to targeted therapeutic strategy

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Military medical Research 2024年第4期11卷 589-615页

作者： Shuai Hao He Huang Rui-Yan Ma Xue Zeng Chen-Yang Duan Department of Anesthesiology the Second Affiliated Hospital of Chongqing Medical UniversityChongqing 400010China Research Institute of General Surgery Jinling HospitalAffiliated Hospital of Medical SchoolNanjing UniversityNanjing 210002China Department of Cardiovascular Surgery Xinqiao HospitalArmy Medical UniversityChongqing 400037China Institute for Brain Science and Disease Chongqing Medical UniversityChongqing 400010China

Hypoxic-ischemic injury is a common pathological dysfunction in clinical *** are sensitive organelles that are readily damaged following ischemia and ***-related protein 1(Drp1)regulates mitochondrial quality and cellular functions via its oligomeric changes and multiple modifications,which plays a role in mediating the induction of multiple organ damage during hypoxic-ischemic ***,there is active controversy and gaps in knowledge regarding the modification,protein interaction,and functions of Drp1,which both hinder and promote development of Drp1 as a novel therapeutic ***,we summarize recent findings on the oligomeric changes,modification types,and protein interactions of Drp1 in various hypoxic-ischemic diseases,as well as the Drp1-mediated regulation of mitochondrial quality and cell functions following ischemia and ***,potential clinical translation prospects for targeting Drp1 are *** review provides new ideas and targets for proactive interventions on multiple organ damage induced by various hypoxic-ischemic diseases.

关键词： Dynamin-related protein 1(Drp1) Hypoxic-ischemic injury Mitochondrial quality imbalance Cell dysfunction Organ damage

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Effect of the extrahepatic bile duct anatomy on choledocholithiasis and its clinical significance

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World Journal of Gastrointestinal Surgery 2024年第5期16卷 1363-1370页

作者： Zheng Cao Jia Zhou Li Wei Hai-Yu He Jun Li Department of Gastroenterology The Second Affiliated Hospital of Kunming Medical UniversityKunming 650000Yunnan ProvinceChina

BACKGROUND A comprehensive understanding of the extrahepatic bile duct anatomy is vital to guide surgical procedures and perform endoscopic retrograde *** irregularities within the extrahepatic bile duct may increase susceptibility to bile duct *** To investigate the anatomical risk factors associated with extrahepatic bile ducts in patients diagnosed with choledocholithiasis,with a specific focus on preventing stone recurrence after surgical intervention and endoscopic *** We retrospectively analyzed the medical records of 124 patients without choledocholithiasis and 108 with confirmed choledocholithiasis who underwent magnetic resonance cholangiopancreatography examinations at our center between January 2022 and October *** regression analyses were conducted to identify the anatomical risk factors influencing the incidence of common bile duct *** Multivariate logistic regression analysis revealed that several factors independently contributed to choledocholithiasis *** independent risk factors for choledocholithiasis were diameter of the common hepatic[adjusted odds ratio(aOR)=1.43,95%confidence interval(CI):1.07-1.92,adjusted P value=0.016]and common bile(aOR=1.68,95%CI:1.27-2.23,adjusted P value<0.001)ducts,length of the common hepatic duct(aOR=0.92,95%CI:0.84-0.99,adjusted P value=0.034),and angle of the common bile duct(aOR=0.92,95%CI:0.89–0.95,adjusted P value<0.001).The anatomical features of the extrahepatic bile duct were directly associated with choledocholithiasis *** risk factors include an enlarged diameter of the common hepatic and bile ducts,a shorter length of the common hepatic duct,and a reduced angle of the common bile duct.

关键词： Bile ducts Extrahepatic Choledocholithiasis Cholangiopancreatography Magnetic resonance Cholangiopancreatography Endoscopic retrograde

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Potential impact of specific therapy on pregnant women with pulmonary arterial hypertension without cardiac shunt:a descriptive study in northern China

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Emergency and Critical Care Medicine 2024年第2期4卷 60-66页

作者： Weida Lu Min Li Fuqing Ji Hua Feng Guo Li Qiushang Ji Hongyu Zhang Xiaopei Cui Department of Geriatric Medicine&shandong Key Laboratory Cardiovascular Proteomics Qilu Hospital of Shandong UniversityJinanShandongChina Intensive Care Unit of Cardiac Surgery Shandong Provincial Qianfoshan Hospitalthe First Hospital Affiliated with Shandong First Medical UniversityAffiliated Hospital of Shandong UniversityJinanShandongChina Department of Cardiology Linyi Central HospitalLinyiShandongChina Department of Gastroenterology Shandong Provincial Hospital Affiliated to Shandong First Medical UniversityJinanShandongChina Department of Pulmonary and Critical Care Medicine the Affiliated Hospital of Qingdao UniversityQingdaoShandongChina Department of Cardiology Qilu Hospital of Shandong UniversityJinanShandongChina

Background:Pregnancy in women with pulmonary arterial hypertension(PAH)is a fatal condition,despite the effectiveness of PAH-specific *** coverage status and effect of specific therapies in pregnant patients with PAH without cardiac shunts in China remain *** investigate this issue,we conducted a multicenter retrospective study in northern ***:The study included 85 patients who were admitted to 4 clinical centers in shandong Province between October 2010 and August *** endpoint events included(1)maternal death and/or(2)major adverse cardiac events,both occurring during pregnancy or within 6 weeks ***:Although the overall mortality rate was encouraging(11.8%),the number of patients receiving PAH-specific therapies was extremely low(28.2%).Moreover,only 15.3%of patients received adequate duration of PAH-specific therapy(≥4 weeks)before delivery,and this subgroup showed the lowest major adverse cardiac events rate(7.7%)compared with that in the untreated(19.7%)and short-time treated groups(<4 weeks;54.5%).Conclusion:Pregnant patients with PAH without cardiac shunts face significantly increased mortality ***-term PAH-specific therapy does not guarantee favorable maternal *** screening,early identification,and timely intervention are expected to improve maternal outcomes in pregnant women with PAH.

关键词： Major adverse cardiac events Maternal mortality Pregnancy outcome Pulmonary arterial hypertension Specific therapy

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Robotic-assisted low anterior resection for rectal cancer shows similar clinical efficacy to laparoscopic surgery: A propensity score matched study

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World Journal of Gastrointestinal Surgery 2024年第6期16卷 1558-1570页

作者： Shen-Xiang Long Xin-Ning Wang Shu-Bo Tian Yu-Fang Bi Shen-Shuo Gao Yu Wang Xiao-Bo Guo Department of Gastrointestinal Surgery Shandong Provincial Hospital Affiliated to Shandong First Medical UniversityJinan 250021Shandong ProvinceChina Department of Endocrinology Shandong Provincial Hospital Affiliated to Shandong First Medical UniversityJinan 250021Shandong ProvinceChina Department of Nursing The People’s Hospital of Zhangqiu AreaJinan 250200Shandong ProvinceChina medical Center for Gastrointestinal Surgery Weifang People’s HospitalWeifang 261000Shandong ProvinceChina

BACKGROUND Rectal cancer ranks as the second leading cause of cancer-related mortality worldwide,necessitating surgical resection as the sole treatment *** the years,there has been a growing adoption of minimally invasive surgical techni-ques such as robotic and laparoscopic *** surgery represents an innovative modality that effectively addresses the limitations associated with traditional laparoscopic *** previous studies have reported favo-rable perioperative outcomes for robot-assisted radical resection in rectal cancer patients,further evidence regarding its oncological safety is still *** To conduct a comparative analysis of perioperative and oncological outcomes between robot-assisted and laparoscopic-assisted low anterior resection(LALAR)*** The clinical data of 125 patients who underwent robot-assisted low anterior resection(RALAR)and 279 patients who underwent LALAR resection at shandong Provincial hospital affiliated to shandong First medical university from December 2019 to November 2022 were retrospectively *** performing a 1:1 propensity score matching,the patients were divided into two groups:The RALAR group and the LALAR group(111 cases in each group).Subsequently,a comparison was made between the short-term outcomes within 30 d after surgery and the 3-year survival outcomes of these two *** Compared to the LALAR group,the RALAR group exhibited a significantly earlier time to first flatus[2(2-2)d vs 3(3-3)d,P=0.000],as well as a shorter time to first fluid diet[4(3-4)d vs 5(4-6)d,P=0.001].Additionally,the RALAR group demonstrated reduced postoperative indwelling catheter time[2(1-3)d vs 4(3-5)d,P=0.000]and decreased length of hospital stay after surgery[5(5-7)d vs 7(6-8)d,P=0.009].Moreover,there was an observed increase in total cost of hospitalization for the RALAR group compared to the LALAR group[10777(10780-11850)dollars vs 10550(8766-11715)dollars,P=0.012].No signi

关键词： Rectal cancer Robotic surgical procedures Laparoscopy Low anterior resection Clinical efficacy

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Designing Bioorthogonal Reactions for Biomedical Applications

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Research 2024年第3期2023卷 625-650页

作者： Qingfei Zhang Gaizhen Kuang Li Wang Ping Duan Weijian Sun Fangfu Ye Wenzhou Institute University of Chinese Academy of SciencesWenzhou 325001China Beijing National Laboratory for Condensed Matter Physics Institute of PhysicsChinese Academy of SciencesBeijing 100190China. Department of Obstetrics and Gynecology The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical UniversityWenzhouZhejiang 325027China. Department of Gastrointestinal Surgery The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical UniversityWenzhou325027China.

Bioorthogonal reactions are a class of chemical reactions that can be carried out in living organisms without interfering with other reactions, possessing high yield, high selectivity, and high efficiency. Since the first proposal of the conception by Professor Carolyn Bertozzi in 2003, bioorthogonal chemistry has attracted great attention and has been quickly developed. As an important chemical biology tool, bioorthogonal reactions have been applied broadly in biomedicine, including bio-labeling, nucleic acid functionalization, drug discovery, drug activation, synthesis of antibody–drug conjugates, and proteolysis-targeting chimeras. Given this, we summarized the basic knowledge, development history, research status, and prospects of bioorthogonal reactions and their biomedical applications. The main purpose of this paper is to furnish an overview of the intriguing bioorthogonal reactions in a variety of biomedical applications and to provide guidance for the design of novel reactions to enrich bioorthogonal chemistry toolkits.

关键词： orthogonal summarized chemistry

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Esophageal cancer screening,early detection and treatment:Current insights and future directions

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World Journal of Gastrointestinal Oncology 2024年第4期16卷 1180-1191页

作者： Hong-Tao Qu Qing Li Liang Hao Yan-Jing Ni Wen-Yu Luan Zhe Yang Xiao-Dong Chen Tong-Tong Zhang Yan-Dong Miao Fang Zhang Department of Emergency Yantai Mountain HospitalYantai 264000Shandong ProvinceChina Cancer Center Yantai Affiliated Hospital of Binzhou Medical UniversityThe 2nd Medical College of Binzhou Medical UniversityYantai 264100Shandong ProvinceChina

Esophageal cancer ranks among the most prevalent malignant tumors globally,primarily due to its highly aggressive nature and poor survival *** to the 2020 global cancer statistics,there were approximately 604000 new cases of esophageal cancer,resulting in 544000 *** 5-year survival rate hovers around a mere 15%-25%.Notably,distinct variations exist in the risk factors associated with the two primary histological types,influencing their worldwide incidence and *** cell carcinoma displays a high incidence in specific regions,such as certain areas in China,where it meets the cost-effect-iveness criteria for widespread endoscopy-based early diagnosis within the local ***,adenocarcinoma(EAC)represents the most common histological subtype of esophageal cancer in Europe and the United *** role of early diagnosis in cases of EAC originating from Barrett's esophagus(BE)remains a subject of *** effectiveness of early detection for EAC,particularly those arising from BE,continues to be a debated *** variations in how early-stage esophageal carcinoma is treated in different regions are largely due to the differing rates of early-stage cancer *** areas with higher incidences,such as China and Japan,early diagnosis is more common,which has led to the advancement of endoscopic methods as definitive *** techniques have demonstrated remarkable efficacy with minimal complications while preserving esophageal *** screening,prompt diagnosis,and timely treatment are key strategies that can significantly lower both the occurrence and death rates associated with esophageal cancer.

关键词： Esophageal cancer Screening Early detection Treatment Endoscopic mucosal resection Endoscopic submucosal dissection

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Subclinical impairment of left ventricular myocardium function in type 2 diabetes mellitus patients with or without hypertension

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World Journal of Diabetes 2024年第6期15卷 1272-1279页

作者： Zeng-Guang Chen Guang-An Li Jun Huang Li Fan Department of Cardiology The Affiliated Changzhou Second People’s Hospital with Nanjing Medical UniversityChangzhou 213000Jiangsu ProvinceChina Department of Echocardiography The Affiliated Changzhou Second People’s Hospital with Nanjing Medical UniversityChangzhou 213000Jiangsu ProvinceChina

BACKGROUND Cardiovascular disease has been the leading cause of morbidity and mortality for type 2 diabetes mellitus(T2DM)patients over the last *** To determine whether layer-specific global longitudinal strain(GLS)combined with peak strain dispersion(PSD)can be used to assess left ventricle(LV)myocardium systolic dysfunction in T2DM patients or without hypertension(HP).METHODS We enrolled 97 T2DM patients,70 T2DM+HP patients and 101 healthy ***-specific GLS and PSD were calculated by EchoPAC software in apical three-,four-and two-chamber *** of the epimyocardial,middle-layer and endomyocardial(GLSepi,GLSmid,and GLSendo)were measured and *** operating characteristic analysis was performed to detect LV myocardium systolic dysfunction in T2DM *** There were significant differences in GLSepi,GLSmid,GLSendo,and PSD between healthy subjects,T2DM patients and T2DM patients with HP(PT2DM patients>T2DM with HP patients in the absolute values of GLSepi,GLSmid and GLSendo(P<0.001),while PSD was ranked healthy subjects

关键词： Type 2 diabetes mellitus Hypertension Speckle tracking echocardiography Global longitudinal strain Peak strain dispersion

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Lymphatic plastic bronchitis and primary chylothorax: A study based on computed tomography lymphangiography

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World Journal of Clinical Cases 2024年第14期12卷 2350-2358页

作者： Xing-Peng Li Yan Zhang Xiao-Li Sun Kun Hao Meng-Ke Liu Qi Hao Ren-Gui Wang Department of Radiology Beijing Shijitan Hospital Affiliated to Capital Medical UniversityBeijing 100038China Department of Radiology Qilu HospitalShandong UniversityJinan 250063Shandong ProvinceChina Department of Lymph Surgery Beijing Shijitan Hospital Affiliated to Capital Medical UniversityBeijing 100038China Department of Radiology People's Hospital of Peking UniversityThe Second School of Clinical Medicine of Peking UniversityBeijing 100034China

BACKGROUND This study presents an evaluation of the computed tomography lymphangio-graphy(CTL)features of lymphatic plastic bronchitis(PB)and primary chylotho-rax to improve the diagnostic accuracy for these two *** To improve the diagnosis of lymphatic PB or primary chylothorax,a retrospective analysis of the clinical features and CTL characteristics of 71 patients diagnosed with lymphatic PB or primary chylothorax was *** The clinical and CTL data of 71 patients(20 with lymphatic PB,41 with primary chylothorax,and 10 with lymphatic PB with primary chylothorax)were collected *** was performed in all *** clinical manifestations,CTL findings,and conventional chest CT findings of the three groups of patients were *** chi-square test or Fisher's exact test was used to compare the differences among the three groups.A difference was considered to be statistically significant when P<***(1)The percentages of abnormal contrast medium deposits on CTL in the three groups were as follows:Thoracic duct outlet in 14(70.0%),33(80.5%)and 8(80.0%)patients;peritracheal region in 18(90.0%),15(36.6%)and 8(80.0%)patients;pleura in 6(30.0%),33(80.5%)and 9(90.0%)patients;pericardium in 6(30.0%),6(14.6%)and 4(40.0%)patients;and hilum in 16(80.0%),11(26.8%)and 7(70.0%)patients;and(2)the abnormalities on conven-tional chest CT in the three groups were as follows:Ground-glass opacity in 19(95.0%),18(43.9%)and 8(80.0%)patients;atelectasis in 4(20.0%),26(63.4%)and 7(70.0%)patients;interlobular septal thickening in 12(60.0%),11(26.8%)and 3(30.0%)patients;bronchovascular bundle thickening in 14(70.0%),6(14.6%)and 4(40.0%)patients;localized mediastinal changes in 14(70.0%),14(34.1%),and 7(70.0%)patients;diffuse mediastinal changes in 6(30.0%),5(12.2%),and 3(30.0%)patients;cystic lesions in the axilla in 2(10.0%),6(14.6%),and 2(20.0%)patients;and cystic lesions in the chest wall in 0(0%),2(4.9%),and 2(4.9%)*** CTL is

关键词： Lymphatic Plastic bronchitis Primary chylothorax Direct lymphangiography Computed tomography lymphangiography

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