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Consensus statement on the epidemiology,diagnosis,prevention,and management of cow's milk protein allergy in the Middle East:a modified Delphi-based study

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World Journal of Pediatrics 2021年第6期17卷 576-589页

作者： Moustafa A.El-Hodhod Mortada H.F.El-Shabrawi Ahmed AIBadi Ahmed Hussein AM Almehaidib Basil Nasrallah Ebtsam Mohammed AIBassam Hala El Feghali Hasan M.Isa Khaled Al Saraf Maroun Sokhn Mehdi Adeli Najwa Mohammed Mousa Al-Sawi Pierre Hage Suleiman Al-Hammadi Department of Pediatrics Faculty of MedicineAin Shams UniversityCairoEgypt Faculty of Medicine October 6 UniversityGizaEgypt Faculty of Medicine Cairo UniversityCairoEgypt International Pediatric Association(IPA) MarengoUSA International Society of Tropical Pediatrics(ISTP) ManilaPhilippines DRC Hospital MuscatOman Al Amiri and Al Adan Hospitals KuwaitKuwait Pediatric Gastroenterology Department of PediatricsKing Faisal Specialist Hospital and Research Center RiyadhRiyadhSaudi Arabia American Hospital Dubai DubaiUnited Arab Emirates Nutrition Service Department King Faisal Specialist and Research Center RiyadhRiyadhSaudi Arabia CHU Notre Dame de Secours ByblosLebanon Pediatric Department Salmaniya Medical ComplexManamaBahrain Pediatric department Arabian Gulf UniversityManamaBahrain Pediatrics Department Dar Al Shifa HospitalKuwaitKuwait Pediatric Gastroenterology Hepatologyand Nutrition DepartmentSaint George University Medical CenterUniversity of BalamandBeirutLebanon Sidra Medicine DohaQatar Department of Pediatrics Doctor Sulaiman Alhabib Medical GroupAlrryan BranchRiyadhSaudi Arabia Pediatric Pulmonology and Allergology University of BalamandBeirutLebanon College of Medicine Mohanuned Bin Rashid University of Medicine and Health SciencesBuilding 14505055 DubaiUnited Arab Emirates

Background This study aimed to develop an expert consensus regarding the epidemiology,diagnosis,and management of cow’s milk protein allergy(CMPA)in the Middle *** A three-step modified Delphi method was utilized to develop the *** specialized pediatricians participated in the development of this *** statement was considered a consensus if it achieved an agreement level of>80%.Results The experts agreed that the double-blind placebo-controlled oral challenge test(OCT)should be performed for 2-A weeks using an amino acid formula(AAF)in formula-fed infants or children with suspected ***-fed infants with confirmed CMPA should be offered a therapeutic *** panel stated that an extensively hydrolyzed formula(eHF)is indicated in the absence of red flag *** the same time,the AAF is offered for infants with red flag signs,such as severe anaphylactic *** panel agreed that infants on an eHF with resolved symptoms within 2-4 weeks should continue the eHF with particular attention to the growth and nutritional *** the other hand,an AAF should be considered for infants with persistent symptoms;the AAF should be continued if the symptoms resolve within 2-4 weeks,with particular attention to the growth and nutritional *** cases with no symptomatic improvements after the introduction of an *** measures should be *** panel developed a management algorithm,which achieved an agreement level of 90.9%.Conclusion This consensus document combined the best available evidence and clinical experience to optimize the management of CMPA in the Middle East.

关键词： Consensus Cow's milk protein allergy Infant formula Middle East Milk hypersensitivity

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Studies on the inhibitory effect of different surfactants on ammonium chloride corrosion

International Journal of Fluid Engineering

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International Journal of Fluid Engineering 2024年第2期1卷 61-68页

作者： Dexiao Fu Xishui Yu Xin Huang Guofu Ou Tongzao Zhou Zhenqian He School of Mechanical Engineering and Rail Transit Changzhou UniversityChangzhouJiangsu 213164China Comprehensive Department Changqing Petrochemical Branch CompanyXianyangShanxi 712042China Shanghai Innovation Institute for Smart Process Manufacturing Co. Ltd.LingangShanghai 201306China

Corrosion of heat exchangers by ammonium chloride(NH_(4)Cl)is a common occurrence in the refineries.A variety of methods have been adopted to prolong the service life of equipment in such circumstances,such as the use of various additives such as surfactants or by washing with *** this paper,a series of experiments are performed to investigate the effects of different surfactants(cationic,anionic,amphoteric,and nonionic)on NH_(4)Cl corrosion using the sessile drop technique and electrochemical *** results show that the presence of a surfactant can increase the wettability of an NH_(4)Cl solution,decreasing the contact angle between the solution and a test *** surface tension of an NH_(4)Cl solution containing an anionic surfactant is the lowest,but the self-corrosion potential of such a solution is the *** addition of a cationic surfactant has no inhibitory effect on corrosion,and indeed increases the corrosion ***,with a nonionic surfactant,it is possible to significantly decrease the corrosion rate of an NH_(4)Cl solution,although the inhibitory effect decreases with increasing temperature.

关键词： corrosion surfactant effect

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Hepatitis B and C virus-induced hepatitis: Apoptosis, autophagy, and unfolded protein response

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World Journal of Gastroenterology 2015年第47期21卷 13225-13239页

作者： Behzad Yeganeh Adel Rezaei Moghadam Javad Alizadeh Emilia Wiechec Seyed Moayed Alavian Mohammad Hashemi Bita Geramizadeh Afshin Samali Kamran Bagheri Lankarani Martin Post Payam Peymani Kevin M Coombs Saeid Ghavami Department of Physiology and Experimental Medicine Hospital for Sick Children Research Institute University of Toronto Young Researchers and Elite Club Ardabil Branch Islamic Azad University Department of Human Anatomy and Cell Science College of Medicine Faculty of Health Sciences University of Manitoba The Children's Hospital Research Institute of Manitoba University of Manitoba Department of Clinical and Experimental Medicine Division of Otorhinolaryngology Link?ping University Baqiyatallah Research Center for Gastroenterology and Liver Diseases (BRCGL) Department of Clinical Biochemistry School of Medicine Zahedan University of Medical Sciences Department of Pathology and Organ Transplant Research Center Shiraz University of Medical Sciences Department of Biochemistry National University of Ireland Galway Health Policy Research Centre Shiraz University of Medical Sciences Manitoba Center for Proteomics and Systems Biology University of Manitoba Department of Medical Microbiology and Infectious Diseases The Children's Hospital Research Institute of Manitoba University of Manitoba

AIM: To investigate the co-incidence of apoptosis, autophagy, and unfolded protein response(UPR) in hepatitis B(HBV) and C(HCV) infected ***: We performed immunofluorescence confocal microscopy on 10 liver biopsies from HBV and HCV patients and tissue microarrays of HBV positive liver samples. We used specific antibodies for LC3β, cleaved caspase-3, BIP(GRP78), and XBP1 to detect autophagy, apoptosis and UPR, respectively. AntiHCV NS3 and anti-HBs antibodies were also used to confirm infection. We performed triple blind counting of events to determine the co-incidence of autophagy(LC3β punctuate), apoptosis(cleaved caspase-3), and unfolded protein response(GRP78) with HBV and HCV infection in hepatocytes. All statistical analyses were performed using SPSS software for Windows(Version 16 SPSS Inc, Chicago, IL, United States). P-values test to compare incidence rates for autophagy, apoptosis, and UPR in HBV- and HCV-infected cells and adjacent noninfected ***: Our results showed that infection of hepatocytes with either HBV and HCV induces significant increase(P 0.05). Furthermore, our evaluation of patients with HBV and HCV infection based on stage and grade of the liver diseases revealed no correlation between these pathological findings and induction of apoptosis, autophagy,

关键词： Cell fate Cell death Hepatocyte Viralinfection Endoplasmic reticulum stress

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Effect of human umbilical cord-derived mesenchymal stem cells on lung damage in severe COVID-19 patients:a randomized,double-blind,placebo-controlled phase 2 trial

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Signal Transduction and Targeted Therapy 2021年第3期6卷 888-896页

作者： Lei Shi Hai Huang Xuechun Lu Xiaoyan Yan Xiaojing Jiang Ruonan Xu Siyu Wang Chao Zhang Xin Yuan Zhe Xu Lei Huang Jun-Liang Fu Yuanyuan Li Yu Zhang Wei-Qi Yao Tianyi Liu Jinwen Song Liangliang Sun Fan Yang Xin Zhang Bo Zhang Ming Shi Fanping Meng Yanning Song Yongpei Yu Jiqiu Wen Qi Li Qing Mao Markus Maeurer Alimuddin Zumla Chen Yao Wei-Fen Xie Fu-Sheng Wang Department of Infectious Diseases Fifth Medical Center of Chinese PLA General HospitalNational Clinical Research Center for Infectious DiseasesBeijingChina Wuhan Huoshenshan Hospital WuhanChina Department of Respiratory Changzheng HospitalSecond Military Medical UniversityShanghaiChina Optical Valley branch of Maternal and Child Hospital of Hubei Province WuhanChina Department of Hematology Second Medical Center of Chinese PLA General HospitalBeijingChina Peking University Clinical Research Institute Peking University First HospitalBeijingChina Department of Infectious Disease General Hospital of Central Theater CommandWuhanChina VCANBIO Cell&Gene Engineering Corp. LtdTianjinChina National Industrial Base for Stem Cell Engineering Products TianjinChina Department of Hematology Union HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina Key Laboratory of Cancer Center Fifth Medical Center of Chinese PLA General HospitalBeijingChina Department of Endocrinology and Metabolism Changzheng HospitalSecond Military Medical UniversityShanghaiChina Department of Radiology Union HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina Nursing Department Fifth Medical Center of Chinese PLA General HospitalBeijingChina immunotherapy Programme Champalimaud Centre for the UnknownLisbonPortugal Med Clinic University of MainzMainzGermany Center for Clinical Microbiology Division of Infection and ImmunityUniversity College Londonand UCL Hospitals NIHR Biomedical Research CentreLondonUK Department of Gastroenterology Changzheng HospitalSecond Military Medical UniversityShanghaiChina

Treatment of severe Coronavirus Disease 2019(COVID-19)is *** performed a phase 2 trial to assess the efficacy andsafety of human umbilical cord-mesenchymal stem cells(UC-MScs)to treat severe coViD-19 patients with lung damage,based onour phase 1 *** this randomized,double-blind,and placebo-controlled trial,we recruited 101 severe coVID-19 patients withlung *** were randomly assigned at a 2:1 ratio to receive either UC-MSCs(4×10^(7)cells per infusion)or placebo on day 0,3,and *** primary endpoint was an altered proportion of whole lung lesion volumes from baseline to day *** imagingoutcomes,6-minute walk test(6-MWT),maximum vital capacity,diffusing capacity,and adverse events were recorded and *** all,100 COVID-19 patients were finally received either UC-MSCs in=65)or placebo(n=35).UC-MSCs administrationexerted numerical improvement in whole lung lesion volume from baseline to day 28 compared with the placebo(the mediandifference was-13.31%,95%Cl-29.14%,2.13%,P=0.08).UC-MSCs significanty reduced the proportions of solid componentlesion volume compared with the placebo(median difference:-15.45%;95%CI-30.82%,-0.39%;P=0.043).The 6-MWT showedan increased distance in patients treated with UC-MSCs(difference:27.00 m;95%CI 0.00,57.00;P=0.057).The incidence of adverseevents was similar in the two *** results suggest that UC-MSCs treatment is a safe and potentially effective therapeuticapproach for COVID-19 patients with lung damage.A phase 3 trial is required to evaluate effects on reducing mortality andpreventing long-term pulmonary disability.

关键词： damage patients double

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中文迁延悲伤量表修订版的效度和信度

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中国心理卫生杂志 2022年第5期36卷 411-416页

作者：霍平乐李然立孙芸陈新英 PRIGERSON Holly G CHOU S Patricia 陈光东禚传君黄春海天津市安定医院神经影像与共病实验室天津市安定医院护理部天津300222 Epidemiology and Biometry branch National Institute on Alcohol Abuseand AlcoholismRockvilleMD 20852United States Cornell Center for Researchon End-of-Live Care Weill Cornell MedicineNew York218313United States 温州市第七人民医院精神医学心理测查中心浙江温州325000 南开大学附属天津市第四中心医院精神疾病多器官损害重点实验室天津市第四中心医院天津300140

目的:评价中文迁延悲伤量表修订版(PG-13-R)的效度和信度。方法:招募符合DSM-5-TR迁延悲伤障碍(PGD)诊断标准的患者200例为研究对象,进行迁延悲伤量表修订版评定,计算组内相关系数(ICC)评价评定者之间的一致性;计算Cronbachα系数评价... 详细信息

目的:评价中文迁延悲伤量表修订版(PG-13-R)的效度和信度。方法:招募符合DSM-5-TR迁延悲伤障碍(PGD)诊断标准的患者200例为研究对象,进行迁延悲伤量表修订版评定,计算组内相关系数(ICC)评价评定者之间的一致性;计算Cronbachα系数评价量表的内部一致性,采取主成份方法计算条目的因子载荷考评量表的结构效度。通过计算PG-13-Revised量表的评分与社会适应量表(WSAS)评分和自评抑郁量表(SDS)的相关性来考察PG-R-13效标效度。以DSM-5-TR诊断标准为依据,计算受试者可接受曲线下面积(AUC)来判断量表的区分效度以及划定量表的划界分。结果:评定者一致性系数ICC为0.97;各个分条目之间的相关系数在0.85~0.99之间。量表总Cronbachα系数为0.85。在PG-13-R的13个条目中,采用主成分分析法算出1个主因子,贡献率达78.98%,高于结构效度检验的标准50%。以临床评估标准为参考,在区分轻度迁延悲伤障碍时划界分为≥25时灵敏度和特异度最好,分别为93.3%和78.2%,AUC为0.82,区分中度迁延悲伤障碍,划界分≥37时灵敏度和特异度最高,分别为92.5%、90.7%,AUC为0.92;在区分重度迁延悲伤障碍时,划界分≥46时灵敏度和特异度最高,分别为95.47%、92.18%,AUC为0.96。结论:中文迁延悲伤量表修订版(PG-13-R)有良好的效度和信度,能够早期测评迁延悲伤障碍的严重程度。

关键词：迁延悲伤量表效度信度

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中国宣威家庭炉灶改造与慢性阻塞性肺病的风险——回顾性队列研究

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英国医学杂志中文版 2006年第6期9卷 338-341页

作者： Robert S Chapman 何兴舟 Aaron E Blair 蓝青许军 College of Public Health Chulalongkorn University Institute Building 3 10th Floor Soi Chulalongkorn 62 Phyathai RoadPatumwan Bangkok 10330 Thailand lecturer 中国预防医学科学院环境卫生与卫生工程研究所 Occupational and Environmental Epidemiology branch Division of Cancer Epidemiology and Genetics National Cancer Institute NIH DHHS MSC 7240 6120 Executive Blvd EPS 8111 Bethesda MD 20892 USA senior investigator

目的验证中国宣威县家庭燃煤炉的改造对慢性阻塞性肺病（COPD）发病率的影响。设计方法回顾性队列研究（随访时问1976至1992年），比较有烟囱组和无烟囱组COPD发病率的差异。研究对象 20453名参与者出生在没有安装排烟系统的家庭中，其... 详细信息

目的验证中国宣威县家庭燃煤炉的改造对慢性阻塞性肺病（COPD）发病率的影响。设计方法回顾性队列研究（随访时问1976至1992年），比较有烟囱组和无烟囱组COPD发病率的差异。研究对象 20453名参与者出生在没有安装排烟系统的家庭中，其中16606人（81．2％）后来家中的燃煤炉安装了烟囱。干预在既往没有安装排风系统的家庭中安装烟囱。结果给燃煤炉加装烟囱与COPD的发病率降低显著相关。与家中没有安装烟囱的参与者相比，Cox模型计算的男性相对危险度（RR）为0．58（95％可信区问0．49～0．70，P〈0．001）；女性相对危险度为0．75（95％可信区间0．62～0．92，P=0．005）。Cox模型的设定不同，计算出的相对危险度也是不同的。改炉改灶的年限越长，COPD的相对危险度越低。无论男性和女性，改灶后10年内COPD发病危险陛下降都非常明确。结论宣威居民COPD的发病率随着家庭燃煤炉改造后年限增加而显著降低。

关键词：慢性阻塞性肺病队列研究宣威县家庭中国相对危险度 COPD Cox模型

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Molecular Detection and Association of QnrA, QnrB, QnrSand BlaCMYResistance Genes among Clinical Isolates of Salmonellaspp. in Iran

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Advances in Microbiology 2014年第1期4卷 63-68页

作者： Raheleh Saboohi Bahareh Rajaei Nahid Sepehri Rad Mohamad Reza Razavi Mohammad Reza Aghasadeghi Arfa Moshiri Ahmad Reza Bahremand Keivan Kave Peiman Kave Mehrangiz Zangeneh Mohammad Rahbar Sara Khorami Sarvestani Seyed Davar Siadat Department of Infectious Diseases Islamic Azad University Tehran Medical Branch Tehran Iran Department of Microbiology Iranian References Laboratory Research Center Ministry of Health and Medical Education Tehran Iran Department of Microbiology Pasteur Institute of Iran Tehran Iran Department of Microbiology Pasteur Institute of Iran Tehran Iran Department of Mycobacteriology & Lung Research Pasteur Institute of Iran Tehran Iran Department of Microbiology Pasteur Institute of Iran Tehran Iran Department of Stem Cells Division of Nanobiomaterials and Tissue Engineering National Institute of Genetic Engineering and Biotechnology Tehran Iran Department of Microbiology Pasteur Institute of Iran Tehran Iran Research Institute for Endocrine Sciences Shahid Beheshti University of Medical Sciences Tehran Iran Department of Mycobacteriology & Lung Research Pasteur Institute of Iran Tehran Iran Department of Veterinary Medicine Kermanshah University of Medical Sciences Kermanshah Iran Hope Generation Foundation Tehran Iran School of Management and Medical Informatics Isfahan University of Medical Sciences Isfahan Iran

Prevalence of three plasmid-mediated quinolone resistance determinant qnrA, qnrB, qnrS and extended spectrum Cephalosporins determinant blaCMY, among eighty-five isolates of Salmonella spp. collected in the community between 2008 and 2010 was determined by PCR. Not only qnr genes but also bla genes were positive in twenty-four different isolates. PCR assay detected that 22 of 85 (25.8%) Salmonella spp. carried the qnrA, 1 (1.17%) of 85 isolates harbored the qnrB, 1 (1.17%) of them contained the qnrS, 1 (1.17%) isolate carried all the three qnrA, qnrB, qnrS genes, 24 of 85 (28.2%) Salmonella carried blaCMY and 5 (5.88%) isolates carried qnrA and blaCMY. Antimicrobial susceptibility patterns of isolates were as follows: 49 (57.6%) exhibited resistance to Nalidixic acid and none of them to Ciprofloxacin. 33 (38.82%) isolates exhibited resistance to Cephalosporins and 2 (2.35%) of them exhibited ESBL phenotype and 12 (14.1%) isolates resistance to Ampicilin. These results were confirmed by MIC determination test as well. Having detected qnr and bla genes suggested that these genes spread antibiotic resistance among pathogenic bacteria.

关键词： QnrA QnrB QnrS ESBL (Extended-Spectrum Beta-Lactamase) BlaCMY

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Risk of gestational diabetes recurrence and the development of type 2 diabetes among women with a history of gestational diabetes and risk factors: a study among 18 clinical centers in China

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Chinese Medical Journal 2022年第6期135卷 665-671页

作者： Yumei Wei Juan Juan Rina Su Geng Song Xu Chen Ruiqin Shan Ying Li Shihong Cui Shangrong Fan Ling Feng Zishan You Haixia Meng Yan Cai Cuilin Zhang Huixia Yang Department of Obstetrics and Gynecology Peking University First HospitalBeijing 100034China Department of Obstetrics Tianjin Central Obstetrics and Gynecology HospitalTianjin 300199China Department of Obstetrics Jinan Maternal and Child Health HospitalJinanShandong 250000China Department of Obstetrics Dalian Maternity HospitalDalianLiaoning 116033China Department of Obstetrics and Gynecology The Third Affiliated Hospital of Zhengzhou UniversityZhengzhouHenan 450052China Department of Obstetrics Shenzhen Peking University HospitalShenzhenGuangdong 518036China Department of Obstetrics and Gynecology Tongji Hospital Affiliated to Huazhong University of Science and TechnologyWuhanHubei 430030China Department of Obstetrics and Gynecology Suzhou Jiulong Hospital Affiliated to Shanghai Jiaotong UniversitySuzhouJiangsu 320571China Department of Obstetrics Affiliated Hospital of Inner Mongolia Medical UniversityHuhhotInner Mongolia 010050China Department of Obstetrics and Gynecology The Fourth Affiliated Hospital of Harbin Medical UniversityHarbinHeilongjiang 150001China Epidemiology branch Division of Intramural Population Health ResearchEunice Kennedy Shriver National Institute of Child Health and Human DevelopmentNational Institutes of HealthBethesdaMD 20817USA

Background:Gestational diabetes mellitus(GDM)brings health issues for both mothers and offspring,and GDM prevention is as important as GDM *** was shown that a history of GDM was significantly associated with a higher maternal risk for GDM *** incidence of GDM recurrence was unclear because of the incidence of second-child was low before 2016 in *** aim to investigate the prevalence of GDM recurrence and its associated high-risk factors which may be useful for the prediction of GDM recurrence in ***:A retrospective study was conducted which enrolled participants who underwent regular prenatal examination and delivered twice in the same hospital of 18 research *** participants were enrolled from January 2018 to October 2018,where they delivered the second baby during this period.A total of 6204 women were enrolled in this study,and 1002 women with a history of GDM were analyzed *** participants enrolled in the study had an oral glucose tolerance test(OGTT)result at 24 to 28 weeks and were diagnosed as GDM in the first pregnancy according to the OGTT value(when any one of the following values is met or exceeded to the 75-g OGTT:0 h[fasting],≥5.10 mmol/L;1 h,≥10.00 mmol/L;and 2 h,≥8.50 mmol/L).The prevalence of GDM recurrence and development of type 2 diabetes mellitus were calculated,and its related risk factors were ***:In 6204 participants,there are 1002 women(1002/6204,16.15%)with a history of GDM and 5202 women(5202/6204,83.85%)without a history of *** are significant differences in age(32.43±4.03 years vs.33.00±3.34 years vs.32.19±3.37 years,P<0.001),pregnancy interval(4.06±1.44 years vs.3.52±1.43 years vs.3.38±1.35 years,P=0.004),prepregnancy body mass index(BMI)(27.40±4.62 kg/m^(2)vs.23.50±3.52 kg/m^(2)vs.22.55±3.47 kg/m^(2),P<0.001),history of delivered macrosomia(22.7%vs.11.0%vs.6.2%,P<0.001)among the development of diabetes mellitus(DM),recurrence of GDM,and normal ***,it seems

关键词： Gestational diabetes mellitus Recurrence Risk factors Multipara Primipara

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Improved diagnosis of thyroid cancer aided with deep learning applied to sonographic text reports: a retrospective, multi-cohort, diagnostic study

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Cancer Biology & Medicine 2022年第5期19卷 733-741页

作者： Qiang Zhang Sheng Zhang Jianxin Li Yi Pan Jing Zhao Yixing Feng Yanhui Zhao Xiaoqing Wang Zhiming Zheng Xiangming Yang Lixia Liu Chunxin Qin Ke Zhao Xiaonan Liu Caixia Li Liuyang Zhang Chunrui Yang Na Zhuo Hong Zhang Jie Liu Jinglei Gao Xiaoling Di Fanbo Meng Wei Ji Meng Yang Xiaojie Xin Xi Wei Rui Jin Lun Zhang Xudong Wang Fengju Song Xiangqian Zheng Ming Gao Kexin Chen Xiangchun Li Department of Maxillofacial and Otorhinolaryngology Oncology National Clinical Research Center for Cancer Key Laboratory of Molecular Cancer Epidemiology of Tianjin Key Laboratory of Cancer Prevention and Therapy of Tianjin Tianjin Medical University Cancer Institute and Hospital Tianjin Medical University Department of Diagnostic and Therapeutic Ultrasonography National Clinical Research Center for Cancer Key Laboratory of Molecular Cancer Epidemiology of Tianjin Key Laboratory of Cancer Prevention and Therapy of Tianjin Tianjin Medical University Cancer Institute and Hospital Tianjin Medical University Department of Ultrasonography Weihai Municipal Hospital Cheeloo College of Medicine Shandong University Department of Pathology National Clinical Research Center for Cancer Key Laboratory of Molecular Cancer Epidemiology of Tianjin Key Laboratory of Cancer Prevention and Therapy of Tianjin Tianjin Medical University Cancer Institute and Hospital Tianjin Medical University Department of Ultrasonography Affiliated Hospital of Chifeng University Department of Ultrasonography Integrated Traditional Chinese and Western Medicine Hospital of Jilin city Jilin Province Department of Ultrasonography Dezhou Municipal Hospital Department of Ultrasound Room of Functions branch Affiliated Hospital of Hebei University Department of Thyroid and Breast Surgery Weihai Municipal Hospital Cheeloo College of Medicine Shandong University Department of General Surgery Tianjin Medical University General Hospital Department of Thyroid and Breast Surgery Tianjin 4th Centre Hospital Department of Thyroid Surgery Affiliated Hospital of Chengde Medical University Department of Pathology The Second Hospital of Tianjin Medical University Department of Ultrasonography The Second Hospital of Tianjin Medical University Department of Thyroid the Second Hospital of Jilin University Department of Head and Neck Thyroid Surgery Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine of Hebei Province De

Objective: Large volume radiological text data have been accumulated since the incorporation of electronic health record(EHR) systems in clinical practice. We aimed to determine whether deep natural language processing algorithms could aid radiologists in improving thyroid cancer ***: Sonographic EHR data were obtained from the EHR database. Pathological reports were used as the gold standard for diagnosing thyroid cancer. We developed thyroid cancer diagnosis based on natural language processing(THCa Dx NLP) to interpret unstructured sonographic text reports for thyroid cancer diagnosis. We used the area under the receiver operating characteristic curve(AUROC) as the primary metric to measure the performance of the THCa Dx NLP. We compared the performance of thyroid ultrasound radiologists aided with THCa Dx NLP vs. those without THCa Dx NLP using 5 independent test ***: We obtained a total number of 788,129 sonographic radiological reports. The number of thyroid sonographic data points was 132,277, 18,400 of which were thyroid cancer patients. Among the 5 test sets, the numbers of patients per set were 439, 186, 82, 343, and 171. THCa Dx NLP achieved high performance in identifying thyroid cancer patients(the AUROC ranged from 0.857–0.932). Thyroid ultrasound radiologists aided with THCa Dx NLP achieved significantly higher performances than those without THCa Dx NLP in terms of accuracy(93.8% vs. 87.2%; one-sided t-test, adjusted P = 0.003), precision(92.5% vs. 86.0%; P = 0.018), and F1 metric(94.2% vs. 86.4%; P = 0.007).Conclusions: THCa Dx NLP achieved a high AUROC for the identification of thyroid cancer, and improved the accuracy, sensitivity, and precision of thyroid ultrasound radiologists. This warrants further investigation of THCa Dx NLP in prospective clinical trials.

关键词： Thyroid cancer deep learning natural language process sonographic text report

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