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Machine learning model using immune indicators to predict outcomes in early liver cancer

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World Journal of Gastroenterology 2025年第5期31卷 43-56页

作者： Yi Zhang Ke Shi Ying Feng Xian-Bo Wang center of integrative Medicine Beijing Ditan HospitalCapital Medical UniversityBeijing 100015China

BACKGROUND Patients with early-stage hepatocellular carcinoma(HCC)generally have good survival rates following surgical ***,a subset of these patients experience recurrence within five years *** To develop predictive models utilizing machine learning(ML)methods to detect early-stage patients at a high risk of *** Eight hundred and eight patients with HCC at Beijing Ditan Hospital were randomly allocated to training and validation cohorts in a 2:1 *** models were generated using random survival forests and artificial neural networks(ANNs).These ML models were compared with other classic HCC scoring systems.A decision-tree model was established to validate the contri-bution of immune-inflammatory indicators to the long-term outlook of patients with early-stage *** Immune-inflammatory markers,albumin-bilirubin scores,alpha-fetoprotein,tumor size,and International Normalized Ratio were closely associated with the 5-year survival *** various predictive models,the ANN model gene-rated using these indicators through ML algorithms exhibited superior perfor-mance,with a 5-year area under the curve(AUC)of 0.85(95%CI:0.82-0.88).In the validation cohort,the 5-year AUC was 0.82(95%CI:0.74-0.85).According to the ANN model,patients were classified into high-risk and low-risk groups,with an overall survival hazard ratio of 7.98(95%CI:5.85-10.93,Pliver cancer,accounting for half of global cases[3,4].The Barcelona Clinic liver Cancer(BCLC)Staging System is the most widely used framework for diagnosing and treating HCC[5].The optimal candidates for surgical treatment are those with early-stage HCC,classified as BCLC stage 0 or *** with early-stage liver cancer typically hav

关键词： Hepatocellular carcinoma Inflammation Machine learning Prognosis Artificial neural networks Immune biomarkers

Machine learning-based models for advanced fibrosis in nonalcoholic steatohepatitis patients:A cohort study

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World Journal of Gastroenterology 2025年第9期31卷 30-42页

作者： Fei-Xiang Xiong Lei Sun Xue-Jie Zhang Jia-Liang Chen Yang Zhou Xiao-Min Ji Pei-Pei Meng Tong Wu Xian-Bo Wang Yi-Xin Hou center of integrative Medicine Beijing Ditan HospitalCapital Medical UniversityBeijing 100015China Department of Pathology Beijing Ditan HospitalBeijing 100015China

BACKGROUND The global prevalence of non-alcoholic steatohepatitis(NASH)and its associated risk of adverse outcomes,particularly in patients with advanced liver fibrosis,underscores the importance of early and accurate *** To develop a machine learning-based diagnostic model for advanced liver fibrosis in NASH *** A total of 749 patients who underwent liver biopsy at Beijing Ditan Hospital,Capital medical University,between January 2010 and January 2020 were *** were randomly divided into training(n=522)and validation(n=224)*** machine learning models were applied to predict advanced liver fibrosis,with feature selection based on Shapley Additive Explanations(SHAP).The diagnostic performance of these models was compared to traditional scores such as the aspartate aminotransferase to platelet ratio index(APRI)and fibrosis index based on the 4 factors(FIB-4),using metrics including the area under the receiver operating characteristic curve(AUROC),decision curve analysis(DCA),and calibration *** The Extreme Gradient Boosting(XGBoost)model outperformed all other machine learning models,achieving an AUROC of 0.934(95%CI:0.914-0.955)in the training cohort and 0.917(95%CI:0.880-0.953)in the validation cohort(Pliver stiffness measurement into the model further improved its performance,with an AUROC of 0.977(95%CI:0.966-0.980)in the training cohort and 0.970(95%CI:0.950-0.990)in the validation cohort,significantly surpassing APRI and FIB-4 scores(Pliver fibrosis in NASH patients,outperforming traditional *** online tool based on this model has been developed to assist clinicians in evaluating the risk of advanced liver fibrosis.

关键词： Machine learning Advanced fibrosis Non-alcoholic steatohepatitis Extreme Gradient Boosting Non-invasive

Application of large language models in disease diagnosis and treatment

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中华医学杂志(英文版) 2025年第2期138卷 130-142页

作者： Yang Xintian Li Tongxin Su Qin Liu Yaling Kang Chenxi Lyu Yong Zhao Lina Nie Yongzhan Pan Yanglin State Key Laboratory of Holistic integrative Management of Gastrointestinal Cancers and National Clinical Research center for Digestive diseases Xijing Hospital of Digestive Diseases Fourth Military Medical University Xi’an Shaanxi China Department of Radiotherapy Xijing Hospital Fourth Military Medical University Xi’an Shaanxi China

Large language models (LLMs) such as ChatGPT, Claude, Llama, and Qwen are emerging as transformative technologies for the diagnosis and treatment of various diseases. With their exceptional long-context reasoning capabilities, LLMs are proficient in clinically relevant tasks, particularly in medical text analysis and interactive dialogue. They can enhance diagnostic accuracy by processing vast amounts of patient data and medical literature and have demonstrated their utility in diagnosing common diseases and facilitating the identification of rare diseases by recognizing subtle patterns in symptoms and test results. Building on their image-recognition abilities, multimodal LLMs (MLLMs) show promising potential for diagnosis based on radiography, chest computed tomography (CT), electrocardiography (ECG), and common pathological images. These models can also assist in treatment planning by suggesting evidence-based interventions and improving clinical decision support systems through integrated analysis of patient records. Despite these promising developments, significant challenges persist regarding the use of LLMs in medicine, including concerns regarding algorithmic bias, the potential for hallucinations, and the need for rigorous clinical validation. Ethical considerations also underscore the importance of maintaining the function of supervision in clinical practice. This paper highlights the rapid advancements in research on the diagnostic and therapeutic applications of LLMs across different medical disciplines and emphasizes the importance of policymaking, ethical supervision, and multidisciplinary collaboration in promoting more effective and safer clinical applications of LLMs. Future directions include the integration of proprietary clinical knowledge, the investigation of open-source and customized models, and the evaluation of real-time effects in clinical diagnosis and treatment practices.

关键词： Large language models Artificial intelligence Diagnosis Treatment planning Clinical decision support

Mechanism study of the molluscicide candidate PBQ on Pomacea canaliculata using a viscosity-sensitive fluorescent probe

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Chinese Chemical Letters 2025年第1期36卷 447-452页

作者： Lanyun Zhang Weisi Wang Yu-Qiang Zhao Rui Huang Yuxun Lu Ying Chen Liping Duan Ying Zhou Yunnan Characteristic Plant Extraction Laboratory College of Chemical Science and TechnologyYunnan UniversityKunming 650091China National Institute of Parasitic diseases Chinese Center for Disease Control and PreventionChinese Center for Tropical Diseases ResearchWHO Centre for Tropical DiseasesNational Key Laboratory of Inteligent Tracking and Forecasting for Infectious DiseasesKey Laboratory on Parasite and Vector Biology MinistryofHealthShanghai200025China

PBQ[1-(4-chlorophenyl)-3-(pyridin-3-yl)urea],an enormous potent molluscicide,showed excellent Pomacea canaliculata(***)control activity and low toxicity for other aquatic organisms,but its snail-killing mechanisms are still not fully *** employed an optical method to elucidate PBQ action via a novel fluorescent viscosity probe,*** the viscosity in the test solutions increased,compared with that in pure ethanol,a 54-fold fluorescence intensity enhancement of NCV was observed in 310 cP of 90%***,NCV successfully exhibited a selective fluorescence response towards monensin-induced cellular viscosity changes in HepG2 *** liver,stomach,and foot plantar of the tested snails were frozen and sectioned for fluorescent imaging experiments after the treatment with different PBQ concentrations over various times.A significant fluorescent increase in the snail's liver was observed upon exposure to 0.75 mg/L PBQ for 72 h,which highlighted an increase in *** and eosin(HE)staining further supported PBQ-induced liver damage with a viscosity increase in *** study provides a new rapid optical visualization method to study the killing mechanisms of PBQ and may help discover new chemicals that control snail populations.

关键词： Fluorescence sensor Viscosity Pomacea canaliculata Molluscicide mechanisms Bio-imaging

Sequential living donor liver transplantation after liver resection optimizes outcomes for patients with high-risk hepatocellular carcinoma

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Hepatobiliary & Pancreatic diseases International 2025年第1期24卷 50-56页

作者： Itsuko Chih-Yi Chen Leona Bettina P Dungca Chee-Chien Yong Chao-Long Chen liver Transplantation center Department of SurgeryKaohsiung Chang Gung Memorial Hospital123 Ta-Pei RoadNiao-SungKaohsiungTaiwanChina

Background:Hepatocellular carcinoma (HCC) is a leading cause of cancer-related mortality. While liver transplantation (LT) provides the best long-term survival, it is constrained by organ scarcity and strict criteria. liver resection (LR) is often the initial treatment for patients with solitary tumors and preserved liver function. The high recurrence rates associated with LR has prompted the exploration of sequential living donor liver transplantation (seq LDLT) after LR as a strategy for HCC patients with high-risk of ***:We analyzed data from 27 adult patients who underwent seq LDLT after LR for HCC at Kaohsiung Chang Gung Memorial Hospital (KCGMH) between June 1994 and December 2023. Patients were selected based on high-risk histopathological features post-LR or as part of downstaging strategy. Outcomes measured included overall survival (OS) and disease-free survival (DFS).Results:Among 765 HCC patients who underwent LDLT, 204 received LR before LDLT, and 27 underwent seqL DLT. Five patients (19%) underwent living donor liver transplantation (LDLT) following LR as a downstaging strategy while the rest received seqL DLT as a preemptive strategy. The median age was 53.5 years with 85%males. Chronic hepatitis B was the predominant underlying disease (74%). The 1-, 3-, and 5-year OS and DFS rates were 100%, 96.0%, 96.0%and 100%, 96.2%, 96.2%, respectively, with two patients experiencing HCC recurrence. One patient died from HCC recurrence. High-risk histopathological features included microvascular invasion (52%), satellite nodules (15%), multiple tumors (26%), tumors> 5 cm(19%), and a total tumor diameter> 10 cm (7%).Conclusions:Seq LDLT offers a promising, tailored approach for managing HCC with adverse histopathologic features. Combining seq LDLT, downstaging strategies, and multidisciplinary treatments can achieve satisfactory OS and DFS in carefully selected patients, highlighting the need for refined criteria to identify the best candidates.

关键词： Living donor liver transplantation liver resection High-risk hepatocellular carcinoma Sequential living donor liver transplantation Salvage living donor liver transplantation

Managing virus diseases in citrus:Leveraging high-throughput sequencing for versatile applications

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Horticultural Plant Journal 2025年第1期11卷 57-68页

作者： Hongming Chen Zhiyou Xuan Lu Yang Song Zhang Mengji Cao integrative Science center of Germplasm Creation in Western China(Chongqing)Science City Citrus Research InstituteSouthwest UniversityChongqing 400712China National Citrus Engineering Research center Citrus Research InstituteSouthwest UniversityChongqing 400712China

In this review,the advantages and advances in applying high-throughput sequencing(HTS)in the management of viral diseases in citrus,along with some challenges,are discussed to provide perspectives on future *** the initial implementation of HTS in citrus virology,a substantial number of citrus viruses have been identified,with a notable increase in the last 7 *** acquisition of viral genomes and various HTS-based omics analyses serve as crucial pillars for advancing research in the etiology,epidemiology,pathology,evolution,ecology,and biotechnology of citrus *** has notably contributed to disease diagnosis,such as the diagnoses of concave gum and impietratura,as well as to the surveillance of new virus risks and the preparation of virus-free ***,certain inherent defects in HTS and coupled bioinformatics analysis,such as challenges with sequence assembly and the detection of viral dark matter,require improvement to enhance practical *** addition,the utilization of HTS for the systematic management of citrus viral diseases remains limited,and drawing insights from other virus-plant pathosystems while integrating emerging compatible techniques and ideas may broaden its specific applications.

关键词： Deep sequencing Virus epidemics Functional genomics CRISPR/Cas Virus-host interactions

liver transplantation for hepatocellular carcinoma: Current status in Hong Kong, China

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Hepatobiliary & Pancreatic diseases International 2025年第1期24卷 45-49页

作者： Karin Ho Albert Chan liver Transplant center Queen Mary HospitalDepartment of SurgeryThe University of Hong KongHong KongChina

With the advances in transplant oncology in recent years, the role of liver transplantation has expanded to make curative treatment a possibility for a wider patient population. We highlight strategies in Hong Kong, China that have enabled preoperative prognostication for judicious patient selection, downstaging therapy to definitive treatment, and postoperative therapies that have provided a growing role for liver transplantation in patients with more advanced hepatocellular carcinoma.

关键词： Living donor liver transplantation Downstaging Conversion therapy Transplant oncology

Xiangshao Granules Ameliorate Post-stroke Depression by Inhibiting Activation of Microglia and IDO1 Expression in Hippocampus and Prefrontal Cortex

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Chinese Journal of integrative Medicine 2025年第1期31卷 28-38页

作者： LI Cheng-gang XU Lu-shan SUN Liang XU Yu-hao CAO Xiang ZHAO Chen-chen XIA Sheng-nan ZHANG Qing-xiu XU Yun Department of Neurology Nanjing Drum Tower HospitalAffiliated Hospital of Medical SchoolNanjing UniversityNanjing210008China State Key Laboratory of Pharmaceutical Biotechnology and Institute of Translational Medicine for Brain Critical diseases Nanjing UniversityNanjing210008China Jiangsu Key Laboratory for Molecular Medicine Medical School of Nanjing UniversityNanjing210008China Nanjing Neurology medical center Nanjing210008China

Objective To investigate the therapeutic effect of Xiangshao Granules(XSG)on post-stroke depression(PSD)and explore the underlying *** Forty-three C57BL/6J mice were divided into 3 groups:sham(n=15),PSD+vehicle(n=14),and PSD+XSG(n=14)groups according to a random number *** PSD models were constructed using chronic unpredictable mild stress(CUMS)after middle cerebral artery occlusion(MCAO).The sham group only experienced the same surgical operation,but without MACO and CUMS *** XSG group received XSG(60 mg/kg per day)by gavage for 4 *** mice in the sham and vehicle groups were given the same volume of 0.9%saline at the same *** body weight and behavior tests including open field test,sucrose preference test,tail suspension test,and elevated plus-maze test,were used to validate the PSD mouse ***-time fluorescence quantitative polymerase chain reaction(RT-qPCR),enzyme-linked immunosorbent assay(ELISA),and immunofluorescence staining were used to evaluate the anti-inflammatory effects of *** potential molecular mechanisms were explored and verified through network pharmacology analysis,Nissl staining,Western blot,ELISA,and RT-qPCR,*** The body weight and behavior tests showed that MCAO combined with CUMS successfully established the PSD *** alleviated neuronal damage,reduced the expressions of pro-apoptotic proteins Caspase-3 and B-cell lymphoma-2(BCL-2)-associated X(BAX),and increased the expression of anti-apoptotic protein BCL-2 in PSD mice(P<0.05 or P<0.01).XSG inhibited microglial activation and the expressions of pro-inflammatory cytokines including tumor necrosis factor-α,interleukin(IL)-1β,and IL-6 via the toll-like receptor 4/nuclear factor kappa-B signaling pathway in PSD mice(P<0.05 or P<0.01).Furthermore,XSG decreased the expression of indoleamine 2,3-dioxygenase1(IDO1)and increased the concentration of 5-hydroxytryptamine in PSD mice(P<0.05 or P<0.01).Conclusion XSG could reverse

关键词： post-stroke depression Xiangshao Granules indoleamine 2,3-dioxygenase 1 Chinese medicine

The N-terminal domain of gasdermin D induces liver fibrosis by reprogrammed lipid metabolism

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Animal Models and Experimental Medicine 2025年第1期8卷 114-125页

作者： Xue Wang Chunyou Ning Xingyi Cheng Zhengzhong Wu Dongbo Wu Xuemei Ding Cunxiang Ju Zhihang Zhou Lingfeng Wan Wei Zhao Peiliang Shi GemPharmatech Chengdu Co. Ltd.ChengduChina center of Infectious diseases West China HospitalSichuan UniversityChengduChina Gempharmatech Shanghai Co. Ltd.ShanghaiChina Department of Gastroenterology the Second Affiliated Hospital of Chongqing Medical UniversityChongqingChina Fatty liver Disease center of Integrated Chinese and Western Medicine Affiliated Hospital of Nanjing University of Chinese MedicineNanjingChina School of Clinical Medicine and The First Affiliated Hospital of Chengdu medical College ChengduChina Department of Clinical Biochemistry School of Laboratory MedicineChengdu Medical CollegeChengduChina GemPharmatech Co. Ltd.GuangdongChina

Background:The emerging incidence of pathogenic liver conditions is turning into a major concern for global *** of pyroptosis in hepatocytes instigates cel-lular disintegration,which in turn liberates substantial quantities of pro-inflammatory intracellular substances,thereby accelerating the advancement of liver ***,directing therapeutic efforts towards inhibiting pyroptosis could po-tentially serve as an innovative approach in managing inflammation related chronic hepatic ***:GSDMD-NT^(ki/wt)mice and Alb-cre^(ki/wt)mice were generated using CRISPR/Cas9 *** crossing the two strains together,we induced conditional cell death by doxycycline to construct a mouse model of liver *** analyzed differ-entially expressed genes by RNA sequencing and explored their biological *** efficacy of obeticholic acid(OCA)in the treatment of liver fibrosis was ***:Doxycycline-treated GSDMD-NT^(ki/wt)×Alb-cre^(ki/wt)mice showed severe liver damage,vacuolation of hepatocytes,increased collagen fibers,and accumulation of lipid *** expression of liver fibrosis related genes was greatly increased in the doxycycline-treated mouse liver compared with untreated mouse ***-sequencing showed that upregulated differentially expressed genes were involved in inflammatory responses,cell activation,and metabolic *** with OCA alleviated the liver fibrosis,with reduced ALT and AST levels seen in the GSDMD-NT^(ki/wt)×Alb-cre^(ki/wt)***:We successfully constructed a novel mouse model for liver *** GSDMD-NT-induced fibrosis may be mediated by abnormal lipid *** re-sults demonstrated that we successfully constructed a mouse model of liver fibrosis,and GSDMD-NT induced fibrosis by mediating lipid metabolism.

关键词： GSDMD-NT lipid metabolism liver fibrosis NASH pyroptosis