Clinical Application Value Research Articles

Prediction model establishment of prognosis factors for distant metastasis of hepatocellular carcinoma based on the SEER database.

Distant metastasis in hepatocellular carcinoma (HCC) is an important indicator of poor patient prognosis. Identifying patients who are at high risk of metastasis early on is essential for creating personalized treatment plans, yet currently, there is a scarcity of effective predictive tools. To investigate the effects of different factors on distant metastasis in HCC patients and to establish a clinical prediction model for predicting distant metastasis in HCC patients. Our study retrospectively examined 22,318 patients diagnosed with confirmed HCC from the SEER database. Prognostic factors for developing distant metastases in HCC patients were identified by univariate and multivariate logistic regression analyses. Utilizing data from a multivariate logistic regression analysis, we created a nomogram. Its predictive precision was evaluated by analyzing the calibration curve, the area under the curve (AUC) of the receiver operating characteristic curve, decision curve assessment (DCA), and Kaplan-Meier (KM) curve analysis of overall survival. Finally,the nomogram was visualized with an online calculator. We identified six independent prognostic factors: ethnicity, marital status, tumor size, survival time, surgery, and radiotherapy. The nomogram constructed from these six factors showed good calibration, discrimination, and clinical application value after calibration curve analysis, receiver operating characteristic curve analysis and DCA curve analysis. Besides, KaplanMeier survival curves also demonstrated that this nomogram had predictive accuracy. In this research, a nomogram model was created to accurately predict distant metastasis risk in patients with HCC. This study provides guidance for optimizing individual therapies and making better clinical decisions.

Head-to-Head Comparison of 68 Ga-DOTATATE and 18 F-FDG PET in EBV-Positive Nonkeratinizing Nasopharyngeal Carcinoma.

The aim of this study was to compare the clinical application value of 68 Ga-DOTATATE and 18 F-FDG PET/CT in Epstein-Barr virus (EBV)-positive nonkeratinizing nasopharyngeal carcinoma. Patients underwent 18 F-FDG and 68 Ga-DOTATATE PET scans. The lesion numbers, tracer parameters, and primary tumor volume derived from contrast-enhanced MRI, 18 F-FDG, and 68 Ga-DOTATATE PET were compared. The correlation between clinical characteristics and PET parameters as well as the predictive value of PET parameters were analyzed. The median maximum standard uptake values (SUV max ) of 18 F-FDG and 68 Ga-DOTATATE in all 26 primary tumors was 15.00 and 9.73, respectively ( P = 0.001). 68 Ga-DOTATATE PET was superior to 18 F-FDG PET in detecting intracranial and skull base involvement. The primary tumor volume of 68 Ga-DOTATATE with 35% SUV max as the threshold had the highest consistency with that of contrast-enhanced MRI. 68 Ga-DOTATATE and 18 F-FDG PET/CT detected 103/108 (95.4%) and 101/108 (93.5%) regional lymph nodes metastases ( P = 0.552), and the median SUV max was 6.05 and 10.81, respectively ( P < 0.001). Furthermore, 68 Ga-DOTATATE PET/CT detected more distant metastases than 18 F-FDG (89/92 [96.7%] vs 54/92 [58.7%], respectively, P < 0.001). The plasma EBV DNA was positively correlated with the total metabolic tumor volume, lesion glycolysis, somatostatin receptor-expressing tumor volume, and lesion somatostatin receptor expression (all P values <0.05). The PET parameters in the non-objective response rate group were higher than those in the objective response rate group (all P values >0.05). 68 Ga-DOTATATE PET/CT is a promising imaging modality for detecting primary and metastatic EBV-positive nonkeratinizing nasopharyngeal carcinoma and delineating primary tumor boundary.

Interactive segmentation for accurately isolating metastatic lesions from low-resolution, large-size bone scintigrams.

Bone is a common site for the metastasis of malignant tumors, and Single Photon Emission Computed Tomography (SPECT) is widely used to detect these metastases. Accurate delineation of metastatic bone lesions in SPECT images is essential for developing treatment plans. However, current clinical practices rely on manual delineation by physicians, which is prone to variability and subjective interpretation. While computer-aided diagnosis (CAD) systems have the potential to improve diagnostic efficiency, fully automated segmentation approaches frequently suffer from high false positive rates, limiting their clinical utility.&#xD;Approach: This study proposes an interactive segmentation framework for SPECT images, leveraging the deep convolutional neural networks (DCNN) to enhance segmentation accuracy. The proposed framework incorporates a U-shaped backbone network that effectively addresses inter-patient variability, along with an interactive attention module that enhances feature extraction in densely packed bone regions.&#xD;Main results: Extensive experiments using clinical data validate the effectiveness of the proposed framework. Furthermore, a prototype tool was developed based on this framework to assist in the clinical segmentation of metastatic bone lesions and to support the creation of a large-scale dataset for bone metastasis segmentation.&#xD;Significance: In this study, we proposed an interactive segmentation framework for metastatic lesions in bone scintigraphy to address the challenging task of labeling low-resolution, large-size SPECT bone scans. The experimental results show that the model can effectively segment the bone metastases of lung cancer interactively. In addition, the prototype tool developed based on the model has certain clinical application value.

Exploring heart failure treatment via calf &amp; inner thigh electroacupuncture from cell molecular biomechanics perspective within “Three Yin Theories” framework

Object: To guide meridian external treatment based on the “Three Yin Theories” of Water Warmth, Earth Harmony, and Wood Reaching, and to observe from a cell molecular biomechanics perspective the clinical efficacy of electroacupuncture at the calf (Chuai) and inner thigh in the treatment of heart failure. This involves analyzing how the electroacupuncture might influence cellular and molecular events within cardiomyocytes and related cardiovascular tissues. Methods: Chronic heart failure patients hospitalized in general wards were selected, and the efficacy indices before and after treatment in patients, as well as the differences between groups, were comparatively observed and studied. To explore the mechanism, not only the correlation between the reduction of neuro-endocrine hormone levels and symptom improvement was analyzed through correlation studies, but also the impact on cell molecular biomechanics was investigated. This includes examining changes in the biomechanical properties of the extracellular matrix surrounding cardiomyocytes, as well as alterations in the molecular forces and interactions that govern cell adhesion and communication within the heart tissue. Results: There was a significant difference between the treatment and control groups before and after the treatment (Sig. (two-tailed) &lt; 0.05), and the intergroup difference was not statistically significant (Sig. (two-tailed) &gt; 0.05), failing the significance test. There was a significant positive correlation between the decrease in aldosterone and the decrease in NYHA classification scores and BNP levels; Conclusion: Electroacupuncture at the calf and inner thigh has a better therapeutic effect on heart failure and has certain clinical promotion and application value. From a cell molecular biomechanics standpoint, the treatment appears to modulate key cellular and molecular processes within the heart, potentially providing a new avenue for understanding and enhancing the treatment of heart failure.

Quantitative Evaluation of the Effectiveness of Erbium Glass Laser Therapy for Acne Scars

Background: Acne scarring presents a significant esthetic and psychological concern, commonly classified into atrophic and hypertrophic types. Effectively managing these lesions often involves the use of therapeutic strategies such as laser treatments, dermabrasion, and fillers. This study investigates the efficacy of 1550 nm erbium glass laser therapy in the treatment of atrophic acne scars through a quantitative assessment. Material and Methods: Participants with mild to moderate atrophic acne scars received two sessions of fractional erbium glass laser therapy at one-month intervals. Skin density and epidermal thickness were measured using a high-frequency ultrasound device (DUB SkinScanner), while the Antera 3D imaging system facilitated a comprehensive analysis of skin parameters, including texture, volumetric depressions, and pigmentation. Results: The use of this therapy led to significant improvements across multiple parameters. Skin density and epidermal thickness increased. Significant reductions were observed in fold depth, pore volume, and depression volume, indicating enhanced smoothness and minimized scar appearance. Improvements in texture roughness and pigmentation contributed to a visually coherent skin surface. Conclusions: Fractional erbium glass laser therapy effectively ameliorates the appearance of atrophic acne scars by increasing skin density, reducing dermal depressions, and improving texture and pigmentation uniformity. The Antera 3D system and high-frequency ultrasound device demonstrated high efficacy in capturing subtle changes, supporting its value in clinical applications for optimizing treatment parameters.

New Advances in Drug Research for Myopia Control in Adolescents.

Myopia is one of the most common eye diseases worldwide, with an increasing incidence observed in recent years. Globally, effective treatments for myopia have been extensively explored. In recent years, research on drugs for the treatment of myopia has become a popular topic in ophthalmology, with some breakthroughs having been achieved. Compared with surgical treatment, drug treatment is easier for people to accept. Although the efficacy of some drugs in delaying the development of myopia has been confirmed, the mechanism and site of action of some drugs are still not completely clear. In this study, we review the recent related research on drug therapy for myopia at home and abroad, describe the mechanism of various drugs in treating myopia, evaluate their clinical application value, and identify existing problems. These drugs include atropine, a series of anticholinergic drugs, dopamine agonists, 7- methylxanthine, and intraocular pressure-lowering drugs. Results highlight the efficacy of atropine in myopia treatment with minimal side effects. Anticholinergic medications, such as atropine, have demonstrated efficacy in managing the progression of myopia with a reduced incidence of adverse effects. The emphasis is placed on achieving better long-term effectiveness and minimizing the rebound effect after treatment is stopped. Furthermore, participating in outdoor activities and reducing eye strain are proven strategies for preventing myopia.

Evaluating the effectiveness of handheld ultrasound in primary blast lung injury: a comprehensive study

The incidence of blast injuries has been rising globally, particularly affecting the lungs due to their vulnerability. Primary blast lung injury (PBLI) is associated with high morbidity and mortality rates, while early diagnostic methods are limited. With advancements in medical technology, and portable handheld ultrasound devices, the efficacy of ultrasound in detecting occult lung injuries early remains unclear. This study evaluates the effectiveness of immediate lung ultrasound in diagnosing PBLI. The study involved 25 healthy male Bama mini-pigs subjected to BST-I-type biological shock wave tubes. The pigs were randomly assigned to non-injured and injured groups with driving pressures of 4.0 MPa, 4.5 MPa, and 4.8 MPa. Four PBLI models were created: no injury, minor, moderate, serious and severe. Immediate lung ultrasound following the BLUE-PLUS protocol and arterial blood gas analysis were conducted pre-injury and 0.5 h, 3 h, 6 h, 12 h, and 24 h post-injury, respectively. The study analyzed lung ultrasound score differences and their correlations with lung function parameters, using ROC analysis to determine early diagnostic standards and mortality prediction efficacy. The study found that in cases of moderate and severe PBLI, lung ultrasound scores and AaDO2 significantly increased at 0.5 h post-injury, while PaO2 decreased. There was good consistency between left and right lung ultrasound results at all times. Lung ultrasound scores were significantly correlated with PaO2 and AaDO2 but not with PaCO2. The scores accurately predicted injury severity at various time points within 24 h post-injury, and the 0.5 h lung ultrasound score predicted 24 h mortality with 95.8% efficiency. PBLI exhibits hidden severity, necessitating improved early diagnostics. Immediate lung ultrasound provides effective differentiation for moderate and severe PBLI at multiple time points within 24 h post-injury, is easy to implement, and offers effective mortality risk prediction as early as 0.5 h post-injury. These findings underscore lung ultrasound’s significant clinical application value in pre-hospital early treatment settings for PBLI.

Activation of the cGAS-sting Pathway Mediated by Nanocomplexes for Tumor Therapy.

cGAS (cyclic GMP-AMP synthase)-STING (stimulator of interferon genes) pathway is an natural immune response signaling pathway in the human body that is essential for sensing abnormal DNA aggregation in the cell. When the cGAS protein senses abnormal or damaged DNA, it forms a second messenger called cyclic dinucleotide (cGAMP). The cycled dinucleotide will activate the downstream STING protein, thereby inducing the expression of inflammatory cytokines such as type I interferon, which binds to receptors on its own cell membrane and ultimately initiates multiple immune response pathways. This signaling pathway plays an important immune role in antimicrobial and antitumor functions, etc. so the development of drugs targeting this signaling pathway has important clinical application value. In recent years nanocomplexes based cGAS-STING signaling pathway activation and inhibition treatments have been gradually developed. In this review, on the basis of elaborating the main activation mechanism of the cGAS-STING pathway, we further introduced the nanocomplexes that effectively activate the cGAS-STING pathway, focusing on the composition, types and applications of the nanocomplexes. In addition, we discussed the key challenges and future research directions of the way that stimulating the cGAS-STING signaling pathway in the form of nanocomplexes to activate immuno-tumor therapy. Our work aims to provide a better understanding of the progress of nanotherapeutics in the cGAS-STING pathway, providing a promising anti-tumor therapeutic strategy.

Risk factors for plastic bronchitis in children with macrolide-unresponsive Mycoplasma pneumoniae pneumonia and establishment of a nomogram model

To investigate the risk factors for plastic bronchitis (PB) in children with macrolide-unresponsive Mycoplasma pneumoniae pneumonia (MUMPP) and to establish a nomogram prediction model. A retrospective analysis was conducted on 178 children with MUMPP who underwent bronchoscopy from January to December 2023. According to the presence or absence of PB, the children were divided into a PB group (49 children) and a non-PB group (129 children). The predictive factors for the development of PB in children with MUMPP were analyzed, and a nomogram prediction model was established. The model was assessed in terms of discriminatory ability, accuracy, and clinical effectiveness. The multivariate logistic regression analysis showed that older age and higher levels of lactate dehydrogenase and fibrinogen were closely associated with the development of PB in children with MUMPP (P<0.05). A nomogram model established based on these factors had an area under the receiver operating characteristic curve of 0.733 (95%CI: 0.651-0.816, P<0.001) and showed a good discriminatory ability. The Hosmer-Lemeshow goodness-of-fit test indicated that the predictive model had a good degree of fit (P>0.05), and the decision curve analysis showed that the model had a good clinical application value. The risk nomogram model established based on age and lactate dehydrogenase and fibrinogen levels has good discriminatory ability, accuracy, and predictive efficacy for predicting the development of PB in children with MUMPP.

A deep learning model for carotid plaques detection based on CTA images: a two stepwise early-stage clinical validation study.

To develop a deep learning (DL) model for carotid plaque detection based on CTA images and evaluate the clinical application feasibility and value of the model. We retrospectively collected data from patients with carotid atherosclerotic plaques who underwent continuous CTA examinations of the head and neck at a tertiary hospital from October 2020 to October 2022. The model combined ResUNet with the Pyramid Scene Parsing Network (PSPNet) to enhance plaque segmentation. Patient plaques were divided into training, validation, and testing sets in a ratio of 7:1.5:1.5. We analyzed recall (lesion-level sensitivity), sensitivity (patient-level), and precision to evaluate the model's diagnostic performance for carotid plaques. The two stepwise early-stage clinical validation study (Comparison study and Model-human study) was used to simulate real clinical plaque diagnostic scenarios. In total, 647 patients were included in the dataset, including 475 for training, 86 for validation, and 86 for testing. The DL model based on CTA images showed good precision in plaque diagnosis (validation set: precision = 80.49%, sensitivity = 90.70%, recall = 84.62%; test set: precision = 78.37%, sensitivity = 91.86%, recall = 84.58%). In addition, subgroup analysis of the plaque was carried out in the test set. The model had high accuracy in identifying plaques at different locations (Recall: 83.72, 76.32, 89.25, and 83.02%) and with different morphologies (Recall: 86.03, 79.17%). This model also analyzed the results of different types of plaques and showed good to moderate plaque diagnostic accuracy for different plaque types (Recall: 70.00, 86.87, 84.29%). Especially, in the clinical application scenario analysis, the model's diagnostic results for plaques were found to be higher than those of 4 out of 6 radiologists (p < 0.001). Furthermore, in Model-human Real Clinical Scenarios study, we found that the model improved the radiologists' sensitivity in diagnosing plaques. Additionally, the model's diagnostic time for plaques (6 s) was found to be significantly shorter than that all of radiologists (p < 0.001). This AI model demonstrated strong clinical potential for carotid plaque detection with improved clinician diagnostic performance, shortening time, and practical implementation in real-world clinical cases.

Comparison of safety and effectiveness of medical adhesive and metal spring coil in preoperative localization of peripheral pulmonary nodules.

Accurate preoperative positioning is the key to the success of thoracoscopic surgery for small pulmonary nodules. There are many methods for locating pulmonary nodules in clinical practice, but there are currently few research reports on the value of medical adhesive localization. To compare the clinical value of two positioning methods, medical adhesive and metal spring coil, in the preoperative application of VATS through retrospective analysis. A total of 288 patients who underwent thoracoscopic surgery in our hospital from January 2021 to June 2024 due to the discovery of solitary pulmonary nodules during chest CT examination were included in this study. Preoperative patients were randomly divided into two groups, with 205 patients undergoing preoperative medical adhesive positioning (Group A) and 83 patients undergoing metal spring coil positioning (Group B). After the positioning was completed, record the positioning time of each group of patients and the immediate pain score 15 min after the positioning was completed, the complications located in each group of patients, and whether there was positioning failure or not. The localization success rate of the medicine adhesive positioning group [99.5% (204/205)] was higher than that of the metal spring coil positioning group [91.6% (76/83)] (P = 0.001). The positioning time of the medical adhesive positioning group was 12.00 (10.00, 14.00) min, which was shorter than the 13.00 (11.00, 16.00) min of the micro coil group (P = 0.001). The immediate pain score (2.32 ± 0.79) of the medical adhesive positioning group 15 min after positioning was significantly lower than that of the metal spring coil positioning group (3.97 ± 0.54) (P < 0.001). The incidence of complications such as pneumothorax [15.7% (13/83) vs 5.4% (11/205), P = 0.004], pulmonary hemorrhage/hemoptysis [20.5% (17/83) vs 4.9 (10/205), P < 0.001] was significantly higher in the metal coil positioning group than in the medical adhesive positioning group. Preoperative medical adhesive positioning for pulmonary nodules is safe, reliable, and effective. Compared with metal spring coil positioning, it has shorter positioning time, milder pain after positioning, lower incidence of positioning related complications, and more flexible arrangement of surgical timing after positioning. It has high clinical application value.

Feasibility study for evaluating cervical intervertebral disc degeneration using axial diffusion tensor imaging.

Intervertebral disc (IVD) degeneration is the main cause of neck pain. Although conventional magnetic resonance imaging can detect morphological changes in intervertebral disc degeneration, it cannot provide accurate and objective evaluations. Magnetic resonance diffusion tensor imaging (DTI) reflects the microstructural changes in tissues by describing the diffusion of water molecules. It was initially applied to the evaluation of lumbar disc degeneration; however, no study has used DTI to evaluate cervical disc degeneration. To conduct a prospective study to evaluate the efficacy and feasibility of DTI in quantifying cervical disc degeneration by correlating the main parameters of axial DTI of intervertebral discs, namely fractional anisotropy (FA) and mean diffusivity (MD) values, using the Pfirrmann grade. The cervical discs of 30 symptomatic volunteers with neck pain and 20 asymptomatic volunteers were assessed using a 3.0 T magnetic resonance scanner. We evaluated intervertebral discs from C3/4 to C6/7 in each volunteer. The Pfirrmann grades, FA value, and MD value on the conventional magnetic resonance imaging were evaluated. The Kruskal-Wallis test and Wilcoxon rank-sum test were used to compare the FA and MD values of subjects with different degeneration levels. Statistical analysis showed that the FA value of the nucleus pulposus in patients group was significantly higher than that in the asymptomatic volunteers, and the MD value of the nucleus pulposus was significantly lower than that in the asymptomatic volunteers, and the difference was significant (P < 0.05). In the study group, with an increase in cervical intervertebral disc grade, the FA value of the nucleus pulposus also showed a gradual upward trend, and this difference was significant (P < 0.05). The MD value of the nucleus pulposus showed a gradual downward trend, except between grades I and II, which indicates that the axial FA value can better show the early pathological changes of the cervical intervertebral disc. The FA and MD values of the cervical intervertebral disc can quantitatively evaluate the degree of degeneration of the cervical intervertebral disc; axial DTI imaging technology can provide a good theoretical basis for the imaging diagnosis of cervical intervertebral disc degeneration and has important clinical application value.

Detection and prognostic relevance of PLA2R epitopes in idiopathic membranous nephropathy: a simultaneous quantitative multiplex suspension array detection method

Abstract Objective This study aimed to develop a multiplex suspension assay for the simultaneous quantitative detection of anti-cysteine-rich domain (anti-CysR)/C-type lectin domain 1 (CTLD1)/C-type lectin domain 6–8 (CTLD678)-IgG4 antibodies of M-type phospholipase A2 receptor (PLA2R) in the serum samples of patients to evaluate the clinical application value of PLA2R epitope spreading in disease prognosis. Methods CysR, CTLD1, and CTLD678 antigen domains were coupled to three types of microspheres. The optimal dilution ratio of biotinylated anti-human IgG4 was identified, and a multiplex suspension assay was evaluated in terms of linearity, sensitivity, precision, specificity, and recovery rate. Lastly, the relationship between epitope spreading and the severity of idiopathic membranous nephropathy (IMN) was evaluated. Results The content of all three epitopes could be detected simultaneously within two hours. The intra-assay precision ranged from 4.74% to 9.48% , and the inter-assay precision was between 5.13% and 13.92% . Specific experiments showed that the human IgA antibody did not cause a cross-reaction. The recovery rates ranged between 90% and 100%. The cut-off values of epitopes CysR, CTLD1 and CTLD678 between healthy individuals and patients were 6.30, 12.38, and 10.06 Ru/mL, respectively. Among them, the positive rates of epitopes CysR, CTLD1 and CTLD678 were 100%, 34%, and 75%, respectively. In addition, group 3 (CTLD1 response) accounted for 73% of the twelve patients who were not in remission. Meanwhile, When the concentration of CTLD1 exceeds 42.76 Ru/mL, the patient's prognosis may be poorer. Conclusion A multiplex suspension assay was developed for the simultaneous quantitative detection of anti-CysR/CTLD1/CTLD678-IgG4 antibodies. The epitope migration sequence of PLA2R molecules during disease progression may not follow a simple linear rule. Among them, the epitope CTLD1 is likely to exert the most significant influence on patient remission.

Serologic detection of regenerating protein I alpha by time-resolved fluoroimmunoassay and its clinical value in gastric cancer.

Regenerating protein I alpha (REG Iα) plays a key role in the progression of gastric cancer (GC). However, the clinical application value of serum REG Iα in GC remains largely unknown. Serum REG Iα levels were analyzed through time-resolved fluoroimmunoassay (TRFIA) in healthy controls (HCs) and patients with benign gastric disease (BGD) and GC. The REG Iα levels of patients with GC were significantly higher than those of HCs and patients with BGD (P < .0001). The REG Iα levels were higher in patients with GC with poor pathological differentiation type; tumor, node, and metastasis stages III-IV; deep tumor invasion (T3-T4); and distant metastasis (P < .05). The diagnostic efficiency of the combined REG Iα, carcinoembryonic antigen (CEA), and carbohydrate antigen 19-9(CA19-9) tests improved compared with that of the single-indicator test for the diagnosis of patients with GC. REG Iα-TRFIA may facilitate the ancillary diagnosis of GC and have a monitoring role for further progression of GC. It can also help elucidate the possible diagnostic role of serum REG Iα as a noninvasive tool.

Utility of Multiparametric Breast MRI Radiomics to Predict Cyclin D1 and TGF-β1 Expression.

To develop a machine learning model that integrates clinical features and multisequence MRI radiomics for noninvasively predicting the expression status of prognostic-related factors cyclin D1 and TGF-β1 in breast cancer, providing additional information for the clinical development of personalized treatment plans. A total of 123 breast cancer patients confirmed by surgical pathology were retrospectively enrolled in our Hospital from January 2016 to July 2022. The patients were randomly divided into a training group (87 cases) and a validation group (36 cases). Preoperative routine and dynamic contrast-enhanced magnetic resonance imaging scans of the breast were performed for treatment subjects. The region of interest was manually outlined, and texture features were extracted using AK software. Subsequently, the LASSO algorithm was employed for dimensionality reduction and feature selection to establish the MRI radiomics labels. The diagnostic efficacy and clinical value were assessed through receiver operating characteristic (ROC) curve analysis and decision curve analysis (DCA). In the cyclin D1 cohort, the area under the receiver operating characteristic (ROC) curve in the clinical prediction model training and validation groups was 0.738 and 0.656, respectively. The multisequence MRI radiomics prediction model achieved an AUC of 0.874 and 0.753 in these respective groups, while the combined prediction model yielded an AUC of 0.892 and 0.785. In the TGF-β1 cohort, the ROC AUC for the clinical prediction model was found to be 0.693 and 0.645 in the training and validation groups, respectively. For the multiseries MRI radiomics prediction model, it achieved an AUC of 0.875 and 0.760 in these respective groups; whereas for the combined prediction model, it reached an AUC of 0.904 and 0.833. Decision curve analysis (DCA) demonstrated that both cohorts indicated a higher clinical application value for the combined prediction model compared with both individual models-clinical prediction model alone or radiomics model. The integration of clinical features and multisequence MRI radiomics in a combined modeling approach holds significant predictive value for the expression status of cyclin D1 and TGF-β1. The model provides a noninvasive, dynamic evaluation method that provides effective guidance for clinical treatment.

Correlation analysis of DLG5 and PD-L1 expression in triple-negative breast cancer

BackgroundTriple-negative breast cancer (TNBC) is among the most aggressive forms of breast cancer, characterized by a dismal prognosis. In the absence of drug-targetable receptors, chemotherapy remains the sole systemic treatment alternative. Recent advancements in immunotherapy, particularly immune checkpoint inhibitors (ICIs) that target programmed death 1/programmed death ligand 1 (PD-1/PD-L1) and cytotoxic T lymphocyte associated antigen 4 (CTLA-4), have provided renewed optimism for the treatment of patients with TNBC. Prior research has indicated that the expression level of the cell polarity protein discs large homolog 5 (DLG5) correlates with the malignant progression and prognosis of breast cancer; nevertheless, its influence on PD-L1 expression and its function in immunotherapy for TNBC require further investigation.MethodsThe hypoxia cell model was established by simulating the cell hypoxic microenvironment in the human SUM159 and MDA-MB-231 cell lines using cobalt II chloride (CoCl2). A combination of PD-L1 inhibitors and DLG5 RNA interference techniques was used, along with various methods including cell counting kit-8 (CCK-8), colony formation, wound healing, transwell migration, reverse transcription-quantitative real-time PCR (RT-qPCR), immunofluorescence, immunohistochemical staining (IHC), expression analysis from datasets and western blotting. These methods were employed to evaluate changes in cell proliferation, migration, and the expression levels of PD-L1 and DLG5. Additionally, the correlation between the expression of PD-L1 and DLG5 in clinical samples was analyzed.Results(1) In vitro experiments, a cellular hypoxia model was effectively established utilizing 150 µM CoCl₂. Under these conditions, cell clone formation, invasiveness, and migration rate were all significantly inhibited. (2) The expression levels of DLG5 and PD-L1 were significantly increased in both MDA-MB-231 and SUM159 cells following treatment with 150 µM CoCl₂. (3) Silencing DLG5 resulted in a considerable upregulation of PD-L1 expression in MDA-MB-231 and SUM159 cells under normoxic circumstances, but it was markedly downregulated under hypoxic settings. Inhibition of PD-L1 expression resulted in a considerable increase in DLG5 expression under normoxic conditions, but it decreased under hypoxic conditions. Correlation research demonstrated an inverse association between the expression of DLG5 and PD-L1 in TNBC tissues.ConclusionThis study provides new theoretical evidence and potential therapeutic targets for the immunotherapy strategies of TNBC, holding significant clinical application value.

Construction of a nomogram model to predict the risk of retinopathy of prematurity reactivate after intravitreal anti-vascular endothelial growth factor therapy: a retrospective study.

To explore the risk factors for the reactivate of retinopathy of prematurity (ROP) after intravitreal injection of anti-vascular endothelial growth factor (VEGF) and to construct a nomogram model to predict the risk of ROP reactivate. A retrospective analysis was conducted on 185 ROP children who underwent anti-VEGF treatment at the First Affiliated Hospital of Zhengzhou University from January 2017 to October 2023. They were randomly divided into a training set (129 cases) and a validation set (56 cases) at a ratio of 7:3. The training set was further divided into a reactivate group (n = 18) and a non-reactivate group (n = 111) based on whether ROP recurred after treatment. Multivariable logistic regression analysis was used to screen for risk factors for ROP reactivate. A nomogram model was constructed using R software and validated using the validation set. The discrimination, calibration, and clinical net benefit of the model were evaluated using the receiver operating characteristic curve (ROC curve), calibration curve, and decision curve analysis, respectively. Multivariable logistic regression analysis showed that the number of red blood cell transfusions, use of pulmonary surfactant (PS) 2 times or more, and preoperative fundus hemorrhage were independent risk factors for ROP reactivate (P < 0.05). The area under the ROC curve (AUC) of the training set was 0.810 (95% CI: 0.706-0.914), and that of the validation set was 0.756 (95% CI: 0.639-0.873). The Hosmer-Leme show goodness-of-fit test indicated a good fit of the model (P = 0.31). Calibration curve analysis and decision curve analysis suggested high predictive efficacy and clinical application value of the model. The number of red blood cell transfusions, use of PS 2 times or more, and preoperative fundus hemorrhage are independent risk factors for ROP reactivate. The nomogram model constructed based on these factors has high predictive efficacy and clinical application value.

Meta-analysis of the clinicopathologic features of endometrial cancer molecular staging.

The 2013 TCGA identified four molecular subgroups of endometrial cancer; however, the data results for most of the pathological features were varied and of low value for clinical application. Therefore, a meta-analysis of articles related to the clinicopathological features of molecular typing was performed to observe how the prevalence of the four subgroups varied across different pathological features and whether they were associated with certain specific pathological features and to understand how molecular typing may influence current pathological assessments. PubMed, Embase, Web of Science, CNKI, Wanfang, and VIP were searched from the time of library construction until May 2024, and the following data were extracted: histological type, FIGO grade, FIGO stage, LVSI, depth of muscularis propria infiltration, and lymph node status of each TCGA group. Two reviewers used the Cochrane Diagnostic Research Scale assessment, and the data were analyzed using Review Manager 5.4.1 and Stata 14.0. Fourteen diagnostic research papers were included in this study, with a total of 4,776 patients with endometrial cancer. Non-estrogen-related endometrial carcinoma (NEEC) vs. estrogen-related endometrial carcinoma (EEC) was low in polymerase epsilon (POLE) (OR = 0.49), microsatellite instability (MSI) (OR = 0.45), and copy number low (CNL) (OR = 0.11), while it was high in CNH (OR = 26.76). G3 EEC vs. G1-2 EEC POLE (OR = 1.98), MSI (OR = 1.74), and CNH (OR = 5.57) were high, whereas it was low in CNL (OR = 0.23), low in FIGO II-IV vs. FIGO I in POLE (OR = 0.39) and CNH (OR = 0.64), and high in FIGO II-IV vs. FIGO I in CNH (OR = 3.05). There was no difference in MSI prevalence in FIGO II-IV vs. FIGO I. POLE (OR = 0.64) and CNL (OR = 0.75) were low in myometrial invasion depths ≥50% and lower in myometrial invasion depths <50%, and CNL (OR) was higher in CNH (OR) than in myometrial invasion depths <50%. There was no difference in MSI between different myometrial invasion depths. MSI (OR = 1.69) and CNH (OR = 2.12) were higher in lymphatic vascular infiltration (LVSI) vs. no LVSI; CNL (OR = 0.39) was lower in LVSI than in no LVSI. There was no difference in POLE in the presence or absence of LVSI. Lymph node metastasis with and without lymph node metastasis in POLE (OR = 0.25) and CNL (OR = 0.31) were lower, and CNH (OR = 3.06) was higher in lymph node metastasis than in no lymph node metastasis. There was no difference in MSI in the presence or absence of lymph node metastasis. POLE patients predominated in pathological features of early-stage endometrial cancer and had better prognosis. MSI patients were more likely to be found in EEC and G3 EEC as well as LVSI. Nearly half of G3 EEC as well as LVSI were present in MSI patients, and CNH patients were more likely to be found to have pathological features of advanced endometrial cancer and poor prognosis, providing evidence that CNH is a high-risk cancer. Patients with CNL were more likely to be found to have pathological features of early-stage endometrial cancer and good prognosis, and CNL was present in large numbers in both early-stage and late-stage endometrial cancers. CNL does not yet have a precise prognostic value. https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42024563661.

Ultrasound Detection of Fetal Palate Development in the Early Stages of the Second Trimester and Its Clinical Application.

To establish normal values of palatal bone growth in fetuses at different gestational weeks in the early stages of the second trimester and to explore the clinical application value of the four-step ultrasound screening method for fetal cleft lip and palate. A prospective study of prenatal ultrasound screening. Secondary maternal and child health institutions. 300 fetuses of 12 to 20 +6 weeks gestation without cleft lip and/or palate; 8538 fetuses at high risk of cleft lip and palate with malformations or karyotypic abnormalities. None. palatomandibular diameter (PMD) and transverse palatal diameter was measured and establish their typical values. (1) There is a typical "superimposed line" sign in the median sagittal section of the typically developing fetal face from 12 to 20+6 weeks of gestation. (2) The PMD and hard palate transverse diameter of fetuses from 12 to 20+6 weeks of gestation increased linearly with time. (3) Among 8538 high-risk fetuses, 21 cases of cleft lip and palate were diagnosed by the four-step ultrasound screening method in the early stages of the second trimester. The median sagittal section of the typically developing fetal face in the early stages of the second trimester presents a typical "superimposed line" sign, and the PMD and transverse palatal diameter increase with time. The four-step ultrasound screening method for fetal cleft lip and palate in the early stages of the second trimester has high clinical application value.

Development and validation of a clinical features-based nomogram for predicting neonatal cerebral microbleeds.

Neonatal cerebral microbleeds (CMBs) occur infrequently, and during the initial phase, they often present without noticeable clinical symptoms, which can result in delays in both diagnosis and treatment. There has been relatively little research conducted on neonatal CMBs, with even less focus on their related risk factors. However, identifying risk factors and proactively preventing microbleeds is particularly crucial for effective treatment. Therefore, we aimed to develop and validate a nomogram based on clinical characteristics and to assess its efficacy in predicting neonatal CMBs. This study included 230 neonates who were treated at The First Hospital of Tsinghua University and underwent a 1.5-T magnetic resonance imaging (MRI). There were 115 neonates with CMBs and 115 sex-matched healthy controls. The clinical and MRI data were collected, including gender, term or premature birth, mode of delivery, gestational age, days after birth, adjusted gestational age, birth weight, Apgar score, history of asphyxia, neonatal pneumonia, metabolic acidosis, mechanical ventilation, gestational hypertension and diabetes, intraventricular hemorrhage, subdural hemorrhage, ischemic infarction, with or without CMBs, and the number and grading of CMBs. All neonates were randomly divided into a training and validation cohort at a ratio of 7:3. Significant variables were selected to construct a nomogram based on multivariate logistic regression analysis results. The model's performance was assessed by receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis. Spontaneous delivery [odds ratio (OR) =7.88; 95% confidence interval (CI): 3.27-19.00; P<0.001], neonatal pneumonia (OR =2.63; 95% CI: 1.16-6.25; P=0.020), gestational hypertension (OR =4.69; 95% CI: 1.35-16.26; P=0.015), and gestational diabetes (OR =3.60; 95% CI: 1.24-10.40; P=0.018) were independent risk factors for neonatal CMBs. The models' area under the curve (AUC), corresponding optimal threshold, specificity, and sensitivity were 0.811 (95% CI: 0.746-0.877), 0.630, 0.872, and 0.627 in the training cohort and were 0.780 (95% CI: 0.667-0.892), 0.366, 0.649, and 0.875 in the validation cohort, respectively. The calibration and decision curve analysis showed that the model had high calibration and clinical application value. We also constructed a combined prediction model for moderate-to-severe CMBs based on clinical and MRI data. The results revealed that the presence of ischemic infarction (OR =5.00; 95% CI: 1.51-16.60; P=0.009) was an independent risk factor for moderate-to-severe CMBs; the models' AUC, optimal threshold, specificity, and sensitivity were 0.731 (95% CI: 0.574-0.888), 0.187, 0.786, and 0.706, respectively. The model based on these independent risk factors could effectively predict the occurrence of neonatal CMBs and may aid in early diagnosis and treatment.