Clinical Value In Diagnosis Research Articles

"Gold-plated" PCN-222(Fe) and superconductive carbon black-based sandwich-type immunosensor for detecting CYFRA21-1.

Cytokeratin 19 fragment antigen 21-1 (CYFRA21-1) is a protein fragment dissolved in the blood after apoptosis of lung epithelial cells, which is a predictive biomarker for the diagnosis of non-small cell lung cancer (NSCLC). Detection of serum CYFRA21-1 has a significant clinical value in diagnosis, monitoring and prognosis of NSCLC. Herein, a novel electrochemical immunosensor was constructed for the sensitive detection of CYFRA21-1. First, superconductive carbon black (KB) functionalized polyethyleneimine (PEI)-gold nanoparticles (AuNPs) were covered on the surface of methylene blue (MB) and used as substrate materials to immobilize the CYFRA21-1 antibody. Then, target CYFRA21-1 was successfully detected using an electrochemical immunosensor through specific recognition of antigen and antibody. The zirconium-based metal organic framework of PCN-222(Fe) with a large pore size and three-dimensional (3D) structure can absorb abundant AuNPs through strong electrostatic interaction, which enhances the conductive properties of PCN-222(Fe) and prevents the self-aggregation of AuNPs. However, PCN-222(Fe) with peroxidase-like activity can catalyze the generation of hydroxyl free radicals (˙OH) from H2O2, which oxidized MB, leading to a decrease in the current signal. The signal response to the degradation of MB was recorded using differential pulse voltammetry (DPV). This indirect method of immunosensor offered a new strategy to address the limitations imposed by the poor conductivity of PCN-222(Fe), further enabling the amplification of the signal through the oxidative degradation of MB. Compared with traditional electrochemical immunosensors, this method has the advantages of a stable current signal and good reproducibility, providing a promising reference for the broad application of PCN-222(Fe) in electrochemical biosensors.

1D Convolutional Neural Network for Detecting Heart Diseases using Phonocardiograms

According to estimations made by World Health Organization, heart disease is the largest cause of mortality throughout the globe, and it is safe to assume that diagnosing heart diseases in their earliest stages is very essential. Diagnosis of cardiovascular disease may be carried out by detection of interference in cardiac signals, one of which is called phonocardiography, and it can be accomplished in a number of various ways. Using phonocardiogram (PCG) inputs and deep learning, the researchers aim to develop a classification system for different types of heart illness. The slicing and normalization of the signal served as the first step in the study's signal preprocessing, which was subsequently followed by a wavelet based transformation method that employs mother wavelet analytic morlet. The results of the decomposition are first shown with the use of a scalogram, afterwards, they are utilized as input for the deep CNN. In this investigation, the analyzed PCG signals were separated into categories, denoting normal and pathological heart sounds. The entire utilized data was divided into two categories as training and test data as 80% to 20%. The developed model demonstrates the degree of clinical diagnosis, sensitivity, specificity and AUC-ROC value. As a result, it has been determined that the proposed method was superior to the mother wavelet as well as other classifier approaches. Consequently, we were able to acquire an electronic stethoscope that has a diagnostic accuracy of more than 90% when it comes to identifying cardiac problems. To be more specific, the proposed deep CNN model has an accuracy of 93.25% in identifying aberrant heart sounds and 93.50% in identifying regular heartbeats. In addition, given the fact that an examination may be completed in only 15 seconds, speed is the primary advantage offered by the suggested stethoscope.

Dual-Signal Colorimetric and Electrochemical Sensor of Dopamine Based on Nanocomposite of Cobalt Oxyhydroxide/Carbon Black

In this report, a novel electrochemical and colorimetric dual-mode sensing system was developed for the sensitive and selective detection of DA. The large surface area of CoOOH and the excellent conductivity of CB endow the electrochemical sensing system with high sensitivity. CoOOH with oxidase-like activity will convert the colorless TMB into the blue oxidation product OXTMB, appearing an absorption peak at 652 nm correspondingly. And the addition of DA will inhibit the activity of oxidase followed by a reducing in the absorption. Our device provided a wider detection range for DA from 1 to 30 μM and 1 to 950 μM through colorimetric and electrochemical methods, respectively. Furthermore, this biosensor with good biocompatibility has been successfully used for in-vitro tracking of DA efflux from live PC12 cell after being stimulated, which has important scientific and practical value for clinical diagnosis and monitoring.

Biocompatible ratiometric fluorescent chemosensor for ultrasensitive detection of endogenous aminopeptidase N In Vitro and In Vivo

Aminopeptidase N (APN) plays an important role in promoting the circulation of amino acids and influences many important physiological functions of organisms. Monitoring of APN level is of great value for the early clinical diagnosis and prognosis of diseases and certain cancers. In this study, we designed a ratiometric APN fluorescent chemosensor NB-APN by using Nile blue derivative as a fluorophore and alanyl as a recognition unit. After APN was recognized by alanyl of NB-APN, the NB previously blocked by the alanyl group was released, causing the inverse evolution trend of fluorescence intensitis of signal peaks at 675 nm and 610 nm. The ratiometric signal sensitively responded to the concentration of APN, and the detection limit was as low as 15 pg/mL. This chemosensor was successfuly applied for quantitative detection of APN in urine samples. Moreover, the chemosensor realized ratiometric fluorescence imaging of APN in in vitro and in vivo, and demonstrated the potential value of APN in the diagnosis and treatment of liver diseases in a drug-induced liver injury model. Therefore, the proposed chemosensor can potentially be applied in diagnosis of APN-related diseases.

The relevance of electrocardiographic abnormalities and prognosis in patients with paraquat poisoning

Objective: To investigate the relationship between electrocardiographic (ECG) changes and prognosis of paraquat poisoning patients, so as to provide evidence for the condition assessment in paraquat poisoning patients. Methods: In January 2022, The clinical data of paraquat poisoning patients were retrospectively analyzed in the First Affiliated Hospital of Wenzhou Medical University from January 1, 2016 to December 31, 2021. The patients' basic information (age, sex, underlying disease, and occupation) and the ECG within 24 hours were collected, and the data were statistically analyzed by SPSS 22.0. One variable analysis and multivariable logistic regression analysis were used to analyze the risk factors related to prognosis determine in their ECG. The receiver operating characteristic (ROC) curve were used to evaluate the diagnostic value of ECG indexes in patients with paraquat poisoning. Results: A total of 145 patients with paraquat poisoning were finally enrolled in this study, there were 84 patients survived and 60 patients died. One variable analysis revealed that heart rate (P=0.000) , QTc changes (P=0.000) , and ST-T changes (P=0.007) of ECG had statistically significant differences in the prognosis of paraquat poisoning patients between the survival group and the death group. Multifactorial logistic results showed that heart rate (OR=1.059, 95%CI: 1.033~1.086) and QTc (OR=1.015, 95%CI: 1.000~1.029) were independent risk factors for death diagnosis of patients with paraquat poisoning (P<0.05) . ROC curve analysis revealed that the area under the cure (AUC) of the prediction model constructed based on heart rate and QTc was 0.832 (95%CI: 0.765~0.899) , with the best diagnostic efficacy. Conclusion: Heart rate, QTc and the prediction model constructed based on both can be used as prognostic indicators for the diagnosis of patients with paraquat poisoning, and which have reference value for clinical prognosis diagnosis.

Rapid Derivatization of Phenolic and Oxime Hydroxyl with Isonicotinoyl Chloride under Aqueous Conditions and Its Application in LC–MS/MS Profiling Multiclass Steroids

Quantification of steroids possesses a crucial clinical value in early diagnosis and prognosis evaluation of various endocrine diseases. However, it is still challenging to realize feasible analysis of estrogens, androgens, progestogens, and corticoids within one single workflow. In this study, two derivatization reactions were newly designed for improvement: (1) acylation of phenolic hydroxyl on estrogens with isonicotinoyl chloride (INC) under the catalysis of 4-dimethylaminopyridine and (2) post-modification of oxime hydroxyl on hydroxylamine-pretreated ketosteroids with INC. Both reactions could conduct instantaneously at room temperature under aqueous conditions. Moreover, the resulting phenolic-INC and oxime-INC esters exhibited favorable MS responses. Through integrating these derivatization strategies with cold-induced phase separation technology, a feasible LC-MS/MS method was developed for simultaneous quantification of 15 multiclass steroids with proper sample consumption (50 μL serum), satisfying sensitivity (lower limit of quantitation at 0.01-5.00 ng/mL) and high throughput (40 min for sample-preparation). The practical applicability was tested by detecting 30 real samples from pregnant and non-pregnant women. The obtained results showed a good agreement with a previous validated methodology.

Chest imaging-based artificial intelligence in the diagnosis of coronavirus disease 2019 and prospects for future research

Artificial intelligence (AI) has been applied increasingly in the medical field during the past 5 years. Within respiratory medicine, chest imaging AI is one of the relevant hotspots, commonly trained to identify pulmonary nodules/lung tumors, tuberculosis, pneumonia, interstitial lung disease, chronic obstructive pulmonary disease, pulmonary embolism and other pathologies. Due to the non-specific clinical manifestations and the low detection rate of pathogens, precise diagnosis and treatment of pneumonia remain challengeable. Since the outbreak of coronavirus disease 2019 (COVID-19), chest imaging AI has demonstrated its clinical value in accurate diagnosis and quantitative measurements of COVID-19. Moreover, an AI system can assist the clinicians to identify the high-risk COVID-19 patients who warrant close monitoring and timely intervention. However, there are still some limitations in the existing studies, such as small sample size, lack of multi-modal assessment of the AI model, and rough classification of pneumonia. Therefore, some suggestions for future research were put forward in this paper. Most of all, more attention should be paid to the collection of high-quality datasets, standardization of image annotation, technology innovation, algorithm optimization and model verification. Besides, the application of imaging AI on other types of pneumonia including viral pneumonia, bacterial pneumonia and pneumomycosis deserves further study. In conclusion, chest imaging AI is expected to play a vital role in decision-making for pneumonia in the future.

Evaluation of (sdLDLc*HCYc)/HDLc ratio in clinical auxiliary diagnosis of primary cerebral infarction

BackgroundTimely detection of cerebral infarction is of vital importance in planning intervention effect of rapid rehabilitation. The clinical auxiliary diagnosis value of single biomarker, including small dense low-density lipoprotein concentration (sdLDLc), homocysteine concentration (HCYc) and high-density lipoprotein cholesterol concentration (HDLc) for cerebral infarction has been confirmed by many studies. Whether the use of three biomarkers in combination by calculating (sdLDLc*HCYc)/HDLc ratio could improve the diagnosis ability for primary cerebral infarction remains to be unclear. In the present study, we conducted a cross-sectional study to evaluate the value of (sdLDLc*HCYc)/HDLc ratio in clinical auxiliary diagnosis of primary cerebral infarction.MethodsA total of 583 participants, including 299 healthy participants as control group and 284 participants diagnosed with first cerebral infarction as experiment group, were included in this respective study. The serum sdLDLc, HDLc and HCYc were measured by peroxidase method, enzyme‐linked immunosorbent assay and an enzymatic method, respectively.ResultsThe average concentration of sdLDL and HCY (0.69 ± 0.29 mmol/L and 18.14 ± 6.62 μmol/L) in experiment group was significantly higher than those in the control group (0.55 ± 0.22 mmol/L and 10.77 ± 2.67 μmol/L, P < 0.05). However, the average concentration of HDL (1.47 ± 0.25 mmol/L) in the control group was higher than that in the experiment group (1.33 ± 0.28 mmol/L, P < 0.05). Spearman correlation coefficient showed the three indicators are independent of each other. The positive predictive value of (sdLDLc*HCYc)/HDLc ratio (61.27%, 95% CI: 55.31–66.92) is higher than that in single biomarker (sdLDLc: 6.69 95% CI: 4.19–10.42, HCYc: 38.38%, 95% CI: 32.75–44.33, HDLc: 3.87%, 95% CI: 2.05–7.02). Receiver-operating characteristic curve (ROC) analysis illustrated that predictive power of (sdLDLc*HCYc)/HDLc was higher than single biomarker, including sdLDLc, HCYc and HDLc, in primary cerebral infarction.ConclusionsTherefore, (sdLDLc*HCYc)/HDLc ratio might be a better new indicator in clinical auxiliary diagnosis of primary cerebral infarction, which could be contributed to predicting cerebral infarction occurrence and provide a scientific basis for early prevention.

Deciphering a mitochondria-related signature to supervise prognosis and immunotherapy in hepatocellular carcinoma.

Hepatocellular carcinoma (HCC) is a major public health problem in humans. The imbalance of mitochondrial function has been discovered to be closely related to the development of cancer recently. However, the role of mitochondrial-related genes in HCC remains unclear. The RNA-sequencing profiles and patient information of 365 samples were derived from the Cancer Genome Atlas (TCGA) dataset. The mitochondria-related prognostic model was established by univariate Cox regression analysis and LASSO Cox regression analysis. We further determined the differences in immunity and drug sensitivity between low- and high-risk groups. Validation data were obtained from the International Cancer Genome Consortium (ICGC) dataset of patients with HCC. The protein and mRNA expression of six mitochondria-related genes in tissues and cell lines was verified by immunohistochemistry and qRT-PCR. The six mitochondria-related gene signature was constructed for better prognosis forecasting and immunity, based on which patients were divided into high-risk and low-risk groups. The ROC curve, nomogram, and calibration curve exhibited admirable clinical predictive performance of the model. The risk score was associated with clinicopathological characteristics and proved to be an independent prognostic factor in patients with HCC. The above results were verified in the ICGC validation cohort. Compared with normal tissues and cell lines, the protein and mRNA expression of six mitochondria-related genes was upregulated in HCC tissues and cell lines. The signature could be an independent factor that supervises the immunotherapy response of HCC patients and possess vital guidance value for clinical diagnosis and treatment.

Dual-Channel Detection of Breast Cancer Biomarkers CA15-3 and CEA in Human Serum Using Dialysis-Silicon Nanowire Field Effect Transistor.

Breast cancer (BC) is the most common malignant tumors and the leading cause of cancer deaths among women. The early diagnosis and treatment of BC are effective measures that can increase survival rates and reduce mortality. Carbohydrate antigens 15-3 (CA15-3) and carcinoma embryonic antigens (CEA) have been regarded as the most two valuable tumor markers of BC. The combined detection of CA15-3 and CEA could improve the sensitivity and accuracy of early diagnosis for BC. The multi-channel double-gate silicon nanowire field effect transistor (SiNW-FET) biosensors were fabricated by using the top-down semiconductor manufacturing technology. By surface modification of the different SiNW surfaces with monoclonal CA15-3 and CEA antibodies separately, the prepared SiNW-FET was processed into biosensor for dual-channel detection of CA15-3 and CEA. The prepared SiNW-FET biosensors were proved to have high sensitivity and specificity for the dual-channel detection of CA15-3 and CEA, and the detection limit is as low as 0.1U/mL CA15-3 and 0.01 ng/mL CEA. Moreover, the SiNW-FET biosensors were able to detect CA15-3 and CEA in serum by connecting a miniature hemodialyzer. The present study reported a SiNW-FET biosensor for dual-channel detection of breast cancer biomarkers CA15-3 and CEA in serum, which has potential clinical application value for the early diagnosis and curative effect observation of BC.

Cross‐sectional and longitudinal comparison of 18F‐MK6240 and 18F‐Flortaucipir in populations matched for centiloid, age and MMSE

AbstractBackgroundLongitudinal tau quantification may provide a useful outcome measure in disease‐specific therapeutic trials. Different tau PET tracers may have different sensitivity to longitudinal changes, but without a head‐to‐head comparison, equating results from different cohorts using different tracers can be biased. In this study, we aim to minimise this bias by matching participants in two cohorts imaged using 18F‐MK6240 and 18F‐Flortaucipir (FTP).MethodA subset of 93 participants from AIBL and 93 from ADNI, imaged at baseline and 1 year later using 18F‐MK6240 and 18F‐FTP, respectively, were matched based on baseline clinical diagnosis, MMSE, age, and Centiloid value (CL). PET images were analysed with CapAIBL. Amyloid positivity (+/‐) was defined based on a threshold of 25CL. Subjects were grouped as 34 cognitively unimpaired amyloid negative (CU‐) and 24 positive (CU+), 18 mild cognitive impairment positive (MCI+) and 17 Alzheimer’s disease positive (AD+). Tracer retention was measured in the mesial temporal (Me), meta‐temporal (MT), temporoparietal (Te) and rest of the cortex (R). T‐tests were employed to assess group separation at baseline using SUVR and longitudinally using SUVR/Yr.ResultAs per selection criteria, there were no significant differences in age, MMSE or Centiloid between the cohorts using 18F‐MK6240 or 18F‐FTP in each subgroups. Baseline SUVR were significantly different between CU‐/CU+, CU+/MCI+ and CU+/AD+ in all regions for both tracers, except for CU‐/CU+ in R for 18F‐MK6240 (Figure 1). Using 18F‐MK6240, rate of change in CU+ was significantly higher than CU‐ in MT and Te, and both MCI+ and AD+ were higher than CU+ in R (Figure 2.Left). Using 18F‐FTP, rate of change in MCI+ was significantly higher than CU+ in Te, and AD+ higher than CU+ in MT, Te and R (Figure 2.Right).ConclusionIn our matched cohorts using 18F‐MK6240 or 18F‐FTP, we found that, at baseline, both tracers can detect significant differences between clinical groups. However, 18F‐MK6240 was able to detect higher rates of accumulation at preclinical stages (CU+). These results in well‐matched cohorts indicate that 18F‐MK6240 might be a more sensitive tracer to detect early accumulation. Longitudinal head‐to‐head comparison will be required to confirm these results.

The meaning and indication of "Rou Ji"

"Rou Ji", as a name of disease syndrome, played an important role with its relevant theories and clinical experiences in historical recordings. However, it was treasured neither in modern archives nor by clinical physicians. The concept of "Rou Ji" started in the Spring and Autumn Period and the Warring States Period (770 B.C. - 221 B.C.), and its name was first found in Shan Fan Fang in the Southern and Northern Dynasties (420-589). The symptoms of this disease mainly suggested weakness of limbs caused by exogenous factors. It was gradually developed into following symptoms, such like emaciation or muscle atrophy, fatigue, skin color change, abnormal skin sensation, poor digestion and absorption function of spleen and stomach. Its etiology was changed from exogenous factors into internal injuries and deficiency of congenital Qi. Its treatment was also changed with the change of the understanding of diseases. The dialectical thinking in its treatment in ancient medical materials may have reference value for current clinical diagnosis and treatment.

Study on the expression of TRIM7 in peripheral blood mononuclear cells of patients with sepsis and its early diagnostic value

BackgroundThe early diagnosis of sepsis is beneficial to put forward a reasonable clinical treatment plan as soon as possible. This study was to explore the expression of Tripartite Motif 7 (TRIM7) in peripheral blood mononuclear cells (PBMCs) of patients with sepsis and its diagnostic value.MethodsThis is a cross-sectional study. A total of 69 patients with infectious diseases were enrolled in the emergency room. They were divided into the sepsis group (34 cases) and the non-sepsis infection group (35 cases). There were 25 healthy subjects who were selected as the control group. The expression of TRIM7 in PBMCs was observed by immunofluorescence staining. The correlation between the expression of TRIM7 mRNA and acute physiology and chronic health evaluation II (APACHE II) score, sequential organ failure assessment (SOFA) score, white blood cell (WBC), C-reactive protein (CRP), procalcitonin (PCT), tumor necrosis factor (TNF)-α and interleukin (IL)-6 was discussed. The receiver operating characteristic (ROC) curve was utilized for evaluating the value of TRIM7 expression for the early diagnosis of sepsis.ResultsThe fluorescence intensity representing the expression level of TRIM7 in PBMCs of patients in the sepsis group was the lowest among three groups. The TRIM7 mRNA expression in PBMCs of the sepsis group was greatly decreased in comparison with that of the non-sepsis infection group and control group (P < 0.05). Spearman correlation analysis indicated that TRIM7 mRNA expression was negatively correlated with APACHE II score, SOFA score, WBC, CRP, PCT, TNF-α and IL-6. ROC curve analysis revealed that the area under curve (AUC) of TRIM7 mRNA expression in PBMCs for the diagnosis of sepsis was 0.798, with a 95% confidence interval of 0.691- 0.905, a sensitivity of 73.5%, and a specificity of 77.1%.ConclusionThe expression of TRIM7 in PBMCs of patients with sepsis is significantly down-regulated, which has certain clinical value for early diagnosis of sepsis.

Diagnosis and treatment of 46 patients with oblique vaginal septum syndrome

The purpose of this study was to improve the understanding of different types of oblique vaginal septum syndrome (OVSS), and to explore the efficacy of combined hysteroscopy-laparoscopic surgery and hysteroscopy in the treatment of OVSS, in order to provide a certain reference value for clinical diagnosis and treatment. The types, clinical manifestations, treatment methods and efficacies of 46 patients with OVSS who were treated in our hospital were retrospectively analysed. Forty-six patients underwent ultrasonography with a diagnostic accuracy of 100%. Among the 46 cases, 18 cases were type I, 20 were type II, five were type III and three were type IV. The postoperative VAS scores in both groups were significantly lower than those before surgery, indicating that postoperative abdominal pain symptoms were effectively relieved after surgery, and the remission rate was 100%. Of the 43 surgically treated patients, 26 had fertility requirements, of which 17 (65.4%) had a successful pregnancy. There are many types of OVSS, which should be diagnosed by ultrasound, magnetic resonance imaging (MRI) and hysteroscopy before surgery based on the clinical symptoms of patients. Besides, hysteroscopic trapezoidal septum resection is the most minimally invasive, simple and effective surgical method for the treatment of OVSS. Impact Statement What is already known on this subject? Oblique vaginal septum syndrome (OVSS) is a congenital malformation of the female reproductive tract with a low incidence. The appearance of the external genitalia and normal menstruation before puberty made the diagnosis of OVSS difficult and the rate of misdiagnosis and missed diagnosis is high. What do the results of this study add? Dysmenorrhoea or abdominal pain were the main reasons for the first diagnosis in patients with types I and IV OVSS, while vaginal discharge and abnormal menstruation were the main reasons for the first diagnosis in patients with types II and III OVSS. The combined hysteroscopic–laparoscopic surgery and hysteroscopic surgery can significantly alleviate OVSS. What are the implications of these findings for clinical practice and/or further research? There are many types of OVSS, which should be diagnosed by ultrasound, magnetic resonance imaging (MRI) and hysteroscopy before surgery based on the clinical symptoms of patients. Besides, hysteroscopic trapezoidal septum resection is the most minimally invasive, simple and effective surgical method for the treatment of OVSS.

Clinical Value of Gene Copy Number Variation Detection in Peripheral Blood in the Diagnosis and Treatment of Lymphoma

Objective To investigate the consistency between the results of gene copy number variation (CNA) in peripheral blood and bone marrow or tissue samples of lymphoma patients with curative and its clinical value in diagnosis and treatment. Methods A total of 5 patients with lymphoma were selected. Case 1 was diffuse large B-cell lymphoma (DLBCL) without bone marrow invasion. Tissue samples and peripheral blood samples were collected at the same time point before treatment. Case 2 was high-grade B-cell lymphoma (HGBL) stage IV, tissue samples were collected before treatment at the initial diagnosis and peripheral blood samples were collected after treatment. Case 3 was DLBCLIV, tissue samples were collected at initial diagnosis and peripheral blood samples were collected during remission after treatment. Case 4 was DLBCL-IV B stage. Peripheral blood samples were collected before treatment at initial diagnosis and bone marrow samples were collected during remission after treatment. Case 5 was a case of hepatosplenic T-cell lymphoma (HSTL). Tissue samples before treatment and peripheral blood samples after treatment were collected at initial diagnosis and analyzed in combination with clinical efficacy. Results 2p -, 2q-, 3p-, 4p -, 6q-, 9p+, 10q-, 11q+, 19p + and 19q+ chromosome abnormalities were detected in the tissues and peripheral blood CNA of case 1, and the 3p -, 6q-, 9p +, 11q+ and 19q+ abnormalities were consistent. In case 2, 4p -, 9P +, 9p-, 16p+, 16q- and +X gene variants were detected in peripheral blood CNA than in tissue CNA at initial diagnosis. In case 3, obvious abnormal signals were detected in tissues at initial diagnosis, but no abnormal signals were detected in peripheral blood samples during remission. In case 4, obvious abnormal signals were detected in peripheral blood at initial diagnosis, but no abnormal signals were detected in bone marrow during remission. In case 5, obvious abnormal signals were detected in tissues at initial diagnosis, and a small amount of abnormal signals were detected in peripheral blood after treatment. The results of CNA detection in 5 patients were consistent with the clinical efficacy. All 3 DLBCL patients showed 6q-chromosome abnormalities in CNA test before treatment. Conclusion The results of CNA detection in peripheral blood are consistent with those in tissue and bone marrow. The dynamic monitoring results of in peripheral blood CNA can be used as a basis for monitoring the curative effect of lymphoma.

TSE DeepLab: An efficient visual transformer for medical image segmentation

Medical image segmentation is the key research of precision medicine. The existing models often ignore some important pixel features and fail to effectively extract global correlation features, which causes poor performance of segmentation. In this paper, we propose TSE DeepLab, which retains the original atrous convolution for extraction of local feature on the basis of DeepLabv3 framework, converts the feature maps after backbone into visual tokens, and further feeds them into Transformer module to enhance the ability of global feature extraction. At the same time, squeeze and excitation components are added to sort the importance of channels after Transformer module, so that the model pays attention to the important pixel features of each channel. In this paper, we apply 5-fold cross-validation to study the clinical sinus instances of Shanghai Tongji Hospital affiliated to Tongji University and the patellar fracture instances of the Sixth People's Hospital affiliated to Shanghai Jiao Tong University. The average of evaluation measures achieves Accuracy of 99.74%, Precision of 93.67%, IOU of 88.10%, Specificity of 99.87%, Fl-score of 93.63%, Sensitivity of 93.82% on sinus dataset and Accuracy of 99.53%, Precision of 85.64%, IOU of 78.47%, Specificity of 99.72%, Fl-score of 87.15%, Sensitivity of 89.95% on patellar fracture dataset. Compared with various typical segmentation models, the proposed model attains better segmentation accuracy and generalization performance, and has better reference value for clinical medical diagnosis.

Endoscopic resection of upper gastrointestinal lymphangioma: A single-center experience.

Lymphagioma, which in most cases as benign tumors, occurs in head, neck, axilla, and mediastinum. Lymphangioma is exceedingly rare in the upper gastrointestinal tract including esophagus, stomach, and duodenum. However, the clinical characteristics, natural history, and recurrence rate after endoscopic resection remain unclear. This study aims to evaluate the characteristic findings and assess the efficacy of endoscopic techniques in the management of this disease. In this systematic retrospective analysis, we evaluated all 24 cases of upper gastrointestinal lymphangioma resected by endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD) and diagnosed by histopathology at our hospital from January 2012 to May 2021. We analyzed the results of endoscopy, endoscopic ultrasonography (EUS), CT, histologic examination, and follow-up assessments. 9 male and 15 female patients with esophageal lymphangioma were enrolled in this study, with a mean age of 54.17 ± 11.60 years (range 30-71 years). The lesions' size varied from 2.20 to 40.10 mm, with the median size of 7.83 mm. All patients were evaluated preoperatively, whose endoscopic appearance typically appears as dilated lymphatic channels beneath the surface epithelium of the protrude mucosal or sub-mucosal lesion. Endoscopic ultrasonography revealed the presence of a honeycomb-like or grid-like mass with a heterogeneous echo pattern, and a clear boundary between the lesion and the muscularis propria layer may be helpful for the primary diagnosis of this disease. 22 patients underwent EMR and 2 patient were treated with ESD. Histologic examination revealed that the lesions contained many dilated lymphatic vessels, which confirmed the initial diagnosis of lymphangioma in all patients. No major adverse events were found during the operation or a median follow-up of 43 months (range 13-92). Endoscopic ultrasonography has important clinical value for the primary diagnosis of lymphangioma in the upper gastrointestinal tract. This study also suggests that endoscopic resection should be considered as a more minimally invasive, safe, feasible, and effective therapeutic option comparing to laparoscopic surgery.

Endoscopic Ultrasound Localization Microscopy for the Evaluation of the Microvasculature of Gastrointestinal Tract Tumors in Rabbits.

The morphological and hemodynamic characterization of the microvascular network around the gastrointestinal (GI) tract can be of significant clinical value for the early diagnosis and treatment of GI tract cancer. Ultrasound localization microscopy (ULM) imaging has been demonstrated to be capable of resolving the microvascular network. However, the endoscopic application of ULM imaging techniques is still unknown. In this study, an endoscopic ultrasound localization microscopy (e-ULM) imaging technique was developed to evaluate the changes of microvasculature during GI tract tumor growth. A customized circular array transducer (center frequency: 6.8 MHz) and the coherent diverging wave compounding method were used to generate B-mode images. Spatiotemporal singular value decomposition processing was used to eliminate the background signals before signal localizations. The centroids of spatially isolated signals were localized and summed to generate the final super-resolution image. The final microvasculature map of a rabbit GI tract tumor reveals that e-ULM can be used to surpass the diffraction limit in traditional endoscopic ultrasound (EUS) imaging. Furthermore, it is observed that data from different stages of tumor growth exhibit significant differences in microvascular pattern and density. Our study demonstrated the implementation and application of an in vivo e-ULM imaging technique for the evaluation of the microvasculature of GI tumors. The efficient e-ULM imaging technique shows potential for use in the detection of GI tract tumor microcirculation changes and subsequent diagnosis of GI tract cancer.

Three-dimensional ultrasound integrating nomogram and the blood flow image for prostate cancer diagnosis and biopsy: A retrospective study.

Prostate cancer (PCa) is the second most common male cancer in the world and based on its high prevalence and overwhelming effect on patients, more precise diagnostic and therapeutic methods are essential research topics. As such, this study aims to evaluate the value of three-dimensional transrectal ultrasound (3D-TRUS) in the detection, diagnosis and biopsy of PCa, and to provide a basis for clinical practice of PCa. Retrospective analysis and comparison of a total of 401 male patients who underwent prostate TRUS in our hospital from 2019 to 2020 were conducted, with all patients having prostate biopsy. Nomogram was used to estimate the probability of different ultrasound signs in diagnosing prostate cancer. The ROC curve was used to estimate the screening and diagnosis rates of 3D-TRUS, MRI and TRUS for prostate cancer. A total of 401 patients were randomly divided into two groups according to different methods of prostate ultrasonography, namely the TRUS group (251 patients) and the 3D-TRUS group (150 patients). Of these cases, 111 patients in 3D-TRUS group underwent MRI scan. The nomogram further determined the value of 3D-TRUS for prostate cancer. The ROC AUC of prostate cancer detected by TRUS, MRI and 3D-TRUS was 0.5580, 0.6216 and 0.6267 respectively. Biopsy complications were lower in 3D-TRUS group than TRUS group, which was statistically significant (P<0.005). The accuracy of 3D-TRUS was higher in diagnosis and biopsy of prostate cancer. Meanwhile, the positive rate of biopsy could be improved under direct visualization of 3D-TRUS, and the complications could be decreased markedly. Therefore, 3D-TRUS was of high clinical value in diagnosis and biopsy of prostate cancer.

Establishment of Personalized Finite Element Model of Crystalline Lens Based on Sweep-Source Optical Coherence Tomography

The virtual lens model has important value in ophthalmic research, clinical diagnosis, and treatment. However, the establishment of personalized lens models and the verification of accommodation accuracy have not been paid much attention. We proposed a personalized lens model establishment and the accommodation accuracy evaluation method based on sweep-source optical coherence tomography (SS-OCT). Firstly, SS-OCT is used to obtain a single lens image in the maximum accommodation state. After refraction correction, boundary detection, and curve fitting, the central curvature radius, thickness, and lens nucleus contour of the anterior and posterior surfaces of the lens were obtained. Secondly, a personalized finite element model improved from Burd’s model was established using these individual parameters, and the adaptation process of the lens model was simulated by pulling the suspensory ligament. Finally, the shape and refractive power changes of the real human lens under different accommodation stimuli were collected and compared with the accommodation process of the finite element model. The results show that the accommodation process of the finite element model is highly consistent with that of the real lens. From the un-accommodation state to the maximum-accommodation state, the difference rate of all geometric and refractive parameters between the two is less than 5%. Thus, the personalized lens finite element model obtained by the calibration and correction of the existing model can accurately simulate the regulation process of a specific human lens. This work helps to provide a valuable theoretical basis and research ideas for the study of clinical diagnosis and treatment of related diseases.