Search

Objective: This research aimed to evaluate the impact of grading and zoning nursing management on traumatic brain injury (TBI) patients' emergency treatment outcomes., Methods: This randomized controlled trial included 200 TBI patients. They were treated with a conventional care (control group, n  = 100) and a novel grading and zoning approach (study group, n  = 100), respectively. This innovative model organized care into levels based on urgency and complexity, facilitating targeted medical response and resource allocation. Key metrics compared included demographic profiles, consultation efficiency (time metrics and emergency treatment rates), physiological parameters (HR, RR, MAP, SpO 2 , RBS), and patient outcomes (hospital and ICU stays, complication rates, and emergency outcomes)., Results: The study group demonstrated significantly improved consultation efficiency, with reduced times for physician visits, examinations, emergency stays, and specialist referrals (all p  < 0.001), alongside a higher emergency treatment rate (93% vs. 79%, p  = 0.004), notably better physiological stability, improved HR, RR, MAP, SpO 2 and RBS ( p  < 0.001), shorter hospital and ICU stays, fewer complications, and superior emergency outcomes., Conclusion: Grading and zoning nursing management substantially enhances TBI patients' emergency care efficiency and clinical outcomes, suggesting a viable model for improving emergency treatment protocols.

Objective: The aim of this study was to explore the laboratory results in severe as asthma patients with omalizumab therapy and provide evidence for estimating omalizumab efficacy., Methods: Retrospective study of 18 patients with severe asthma received omalizumab therapy in Shanghai General Hospital from 2020 to 2022 was performed. The basic data of patients were collected. The absolute number and the percentage of basophil and eosinophil in peripheral blood, total IgE level in serum, and as pulmonary function were detected at the beginning of treatment and 4 months after treatment. Differences between two groups were analyzed using Paired T test., Results: The most common allergens collected from patients with moderate to severe asthma were dust mite (positive ratio 55.56%), mixed mold (16.67%), cat and dog dander, and Aspergillus fumigatus (11.11%). There was no significant difference in eosinophil and basophil counts in peripheral blood between the two groups. However, serum total IgE levels increased from (437.55±279.35) KU/L to (1071.42±721.28) KU/L (P=0.004), and FEV1/FVC ratio increased from (65.53±14.15)% to (73.91±13.63)% (P=0.005) after 4 months of treatment., Conclusions: The existing laboratory indicators for evaluation of omalizumab efficacy are still very limited, and new biomarkers need to be further developed. Elevated serum IgE levels at four weeks of treatment and FEV1/FVC may be potential indicators for omalizumab monitoring., Competing Interests: None., (AJCEI Copyright © 2024.)

Background: To explore the effect of calcium dobesilate combined with hypoglycemic drugs in the treatment of cataract complicated with non-proliferative diabetic retinopathy (NPDR) and its effects on fundus microcirculation, intercellular adhesion molecule 1 (ICAM-1), mono - cyte chemoattractant protein 1 (MCP-1), and macrophage migration inhibitory factor (MIF)., Methods: From March 2019 to January 2021, a total of 114 patients with cataract and NPDR were included, and the patients were assigned into the control and the observation groups by random number table method, with 57 cases/group. The control was given hypoglycemic drugs, and the observation was given calcium dobesilate combined therapy. The therapeutic efficacy, blood glucose and blood lipid levels, fluorescein fundus angiography results, fundus microcirculation indexes, retinal neovascularizationrelated factors, and ICAM-1, MCP-1, and MIF levels before and after treatment were compared between the two groups., Results: The total effective rate of treatment in the observation was higher vs. the control (P < 0.05); Fasting blood glucose (FBG), 2 h postprandial blood glucose (2hPG), glycosylated hemoglobin (HbA1c), triglyceride (TG), total cholesterol (TC) and low density lipoprotein (LDL) in the observation after treatment were reduced vs. the control (P < 0.05); The number of micro-hemangiomas in the observation after treatment was less vs. the control, and the area of hemorrhage, the area of exudation and the thickness of the yellow plate were smaller vs. the control (P < 0.05); The resistance index (RI) value of the observation after treatment was lower than the control, and the end-diastolic blood flow velocity (EDV) and the peak systolic blood flow velocity (PSV) of the observation were higher vs. the control (P < 0.05). ICAM-1, MCP-1, MIF, vascular endothelial growth factor (VEGF) and insulin-like growth factor-1 (IGF1) in the observation after treatment were reduced vs. the control, but pigment epithelium-derived factor (PEDF) were higher vs. the control (P < 0.05); one case of gastrointestinal reaction took place in the observation, but no adverse reaction occurred in the control, and no clear difference exhibited in the incidence of adverse reactions between the two groups (P > 0.05)., Conclusions: Calcium dobesilate combined with hypoglycemic drugs has good clinical efficacy in the treatment of cataract complicated with NPDR, which can effectively reduce the level of blood glucose and blood lipids, reduce inflammation, and mitigate the microcirculation of branch retinal vein occlusion lesions., Competing Interests: All the authors declare that they have no conflict of interest in this work.Conflict of Interest: The authors stated that they have no conflicts of interest regarding the publication of this article., (2023 XiaoMan Wang, Zhao Zhang, Yi Qing Ge, Xia Wu, Yin Chao Ma, published by CEON/CEES.)

Objective: To assess changes of nutritional status by comprehensive nutrition assessment including nutritional risk screening, dietary assessment, blood biochemical index, and body composition in acute leukemia patients who had undergone chemotherapy., Methods: A total of 169 patients with acute leukemia treated at The First Affiliated Hospital of Soochow University from June 2018 to August 2019 were recruited for this study. Before and after chemotherapy, the NRS-2002 and PG-SGA scales, dietary intake, blood biochemical index and body composition were evaluated to compare the changes of nutritional status., Results: NRS-2002 score and PG-SGA score after chemotherapy were significantly increased than those before chemotherapy (P<0.001). Many patients had insufficient nutritional intake during chemotherapy, and the dietary intake score of patients with induction chemotherapy was significantly lower than that of patients with consolidation chemotherapy (P=0.043). The results of multivariate analysis showed that induction chemotherapy was the independent risk factor for the increase of PG-SGA scores and the decrease of dietary intake (all P<0.05). After chemotherapy, the white blood cell count, hemoglobin, and platelet count were significantly decreased (P<0.001), the prealbumin was significantly increased (P<0.001), and the blood glucose was increased (P=0.04), but albumin was not significantly changed. The weight, body mass index, fat-free mass, skeletal muscle mass and intracellular water were all significantly decreased (P<0.001), and visceral fat area was increased significantly after chemotherapy (P<0.05), especially in newly-diagnosed acute lymphoblastic leukemia patients after the induction of chemotherapy., Conclusion: The nutritional status of patients with acute leukemia has undergone significant changes after chemotherapy. A single indicator has limited significance for nutritional status assessment. Comprehensive assessment of nutritional status by multiple tools is worthy of clinical application.

Objective: The purpose of this study was to develop a combined radiomics model to predict coronary plaque texture using perivascular fat CT radiomics features combined with clinical risk factors., Methods: The data of 200 patients with coronary plaques were retrospectively analyzed and randomly divided into a training group and a validation group at a ratio of 7:3. In the training group, The best feature set was selected by using the maximum correlation minimum redundancy method and the least absolute shrinkage and selection operator. Radiomics models were built based on different machine learning algorithms. The clinical risk factors were then screened using univariate logistic regression analysis. and finally a combined radiomics model was developed using multivariate logistic regression analysis to combine the best performing radiomics model with clinical risk factors and validated in the validation group. The efficacy of the model was assessed by a receiver operating characteristic curve, the consistency of the nomogram was assessed using calibration curves, and the clinical usefulness of the nomogram was assessed using decision curve analysis., Results: Twelve radiomics features were used by different machine learning algorithms to construct the radiomics model. Finally, the random forest algorithm built the best radiomics model in terms of efficacy, and this was combined with age to construct a combined radiomics model. The area under curve for the training and validation group were 0.98 (95% confidence interval, 0.95-1.00) and 0.97 (95% confidence interval, 0.92-1.00) with sensitivities of 0.92 and 0.86 and specificities of 0.99 and 1, respectively. The calibration curve demonstrated that the nomogram had good consistency, and the decision curve analysis demonstrated that the nomogram had high clinical utility., Conclusions: The combined radiomics model established based on CT radiomics features and clinical risk factors has high value in predicting coronary artery calcified plaque and can provide a reference for clinical decision-making., (© 2022. The Author(s).)

Background Pancreatic fibrosis and fatty infiltration are associated with postoperative pancreatic fistula (POPF), but accurate preoperative assessment remains a challenge. Iodine concentration (IC) and fat fraction derived from dual-energy CT (DECT) may reflect the amount of fibrosis and steatosis, potentially enabling the preoperative prediction of POPF. Purpose To identify multiphasic DECT-derived IC and fat fraction that improve the prediction of POPF risks compared with contrast-enhanced CT attenuation values and to evaluate the underlying histopathologic changes. Materials and Methods This retrospective study included patients who underwent pancreatoduodenectomy and DECT (including pancreatic parenchymal, portal venous, and delayed phase scanning) between January 2020 and December 2020. The relationships of the quantitative DECT-derived IC and fat fraction, along with CT attenuation values from enhanced images with POPF risk, were analyzed with logistic regression analysis. The predictive performance of the IC was compared with that of the CT values. The histopathologic underpinnings of IC were evaluated with multivariable linear regression analysis. Results A total of 107 patients (median age, 65 years; interquartile range, 57-70 years; 56 men) were included. Of these, 23 (21%) had POPF. The pancreatic parenchymal-to-portal venous phase IC ratio (adjusted odds ratio [OR], 13; 95% CI: 2, 162; P < .001) was an independent predictor of POPF occurrence. The accuracy of the pancreatic parenchymal-to-portal venous phase IC ratio in predicting POPF was higher than that of the CT value ratio in the same phases (78% vs 65%, P < .001). The pancreatic parenchymal-to-portal venous phase IC ratio was independently associated with pancreatic fibrosis (β = -1.04; 95% CI: -0.44, -1.64; P = .001). Conclusion A higher pancreatic parenchymal-to-portal venous phase IC ratio was associated with less histologic fibrosis and greater risk of POPF. © RSNA, 2022 Online supplemental material is available for this article . See also the editorial by Lee and Yoon in this issue.

Purpose: To develop and validate a radiomic nomogram based on texture features from out-of-phase T1W images and clinical biomarkers in prediction of liver fibrosis., Materials and Methods: Patients clinically diagnosed with chronic liver fibrosis who underwent liver biopsy and noncontrast MRI were enrolled. All patients were assigned to the nonsignificant fibrosis group with fibrosis stage <2 and the significant fibrosis group with stage ≥2. Texture parameters were extracted from out-of-phase T1-weighted (T1W) images and calculated using the Artificial Intelligent Kit (AK). Boruta and LASSO regressions were used for feature selection and a multivariable logistic regression was used for construction of a combinational model integrating radiomics and clinical biomarkers. The performance of the models was assessed by using the receiver operator curve (ROC) and decision curve., Results: ROC analysis of the radiomics model that included the most discriminative features showed AUCs of the training and test groups were 0.80 and 0.78. A combinational model integrating RADscore and fibrosis 4 index was established. ROC analysis of the training and test groups showed good to excellent performance with AUC of 0.93 and 0.86. Decision curves showed the combinational model added more net benefit than radiomic and clinical models alone., Conclusions: The study presents a combinational model that incorporates RADscore and clinical biomarkers, which is promising in classification of liver fibrosis., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2022 Ru Zhao et al.)

Background and Purpose: Accurate prediction of extrathyroidal extension and subsequent recurrence is crucial in papillary thyroid cancer clinical management. Our aim was to conduct iodine map-based radiomics to predict extrathyroidal extension and to explore its prognostic value for recurrence-free survival in papillary thyroid cancer., Materials and Methods: A total of 452 patients with papillary thyroid cancer were retrospectively recruited between June 2017 and June 2020. Radiomics features were extracted from noncontrast images, dual-phase mixed images, and iodine maps, respectively. Random forest and least absolute shrinkage and selection operator (LASSO) were applied to build 6 radiomics scores (noncontrast radiomics score&#95;random forest; noncontrast rad-score&#95;LASSO; mixed rad-score&#95;random forest; mixed rad-score&#95;LASSO; iodine radiomics score&#95;random forest; iodine radiomics score&#95;LASSO) respectively. Logistic regression was used to construct 6 radiomics models incorporating 6 radiomics scores with clinical risk factors and to compare them with the clinical model. A radiomics model that achieved the highest performance was presented as a nomogram and assessed by discrimination, calibration, clinical usefulness, and prognosis evaluation., Results: Iodine radiomics scores performed significantly better than mixed radiomics scores. Both of them outperformed noncontrast radiomics scores. Iodine map-based radiomics models significantly surpassed the clinical model. A radiomics nomogram incorporating size, capsule contact, and iodine radiomics score&#95;random forest was built with the highest performance (training set, area under the curve = 0.78; validation set, area under the curve  = 0.84). Stratified analysis confirmed the nomogram stability, especially in group negative for CT-reported extrathyroidal extension (area under the curve  = 0.69). Nomogram-predicted extrathyroidal extension risk was an independent predictor of recurrence-free survival. A high risk for extrathyroidal extension portended significantly lower recurrence-free survival than low risk ( P  < .001)., Conclusions: Iodine map-based radiomics might be a supporting tool for predicting extrathyroidal extension and subsequent recurrence risk in patients with papillary thyroid cancer, thus facilitating clinical decision-making., (© 2022 by American Journal of Neuroradiology.)

Rationale and Objectives: To develop and validate 2 iodine maps based radiomics nomograms for preoperatively predicting cervical lymph node metastasis (LNM) and central lymph node metastasis (CLNM) in papillary thyroid cancer (PTC)., Materials and Methods: A total of 346 patients with PTC were enrolled and allocated to training (242) and validation (104) sets. Radiomics features were extracted from arterial and venous phase iodine maps, respectively. Aggregated machine-learning strategy was applied for features selection and construction of 2 radiomics scores (LN rad-score; CLN rad-score). Logistic regression model was employed to establish two radiomics nomograms (nomogram 1: predicting LNM; nomogram 2: predicting CLNM) after incorporating LN or CLN rad-score with clinical predictors. Nomograms performance was determined by discrimination, calibration and clinical usefulness., Results: Nomogram 1 incorporated LN rad-score, age (categorized by 55) and CT reported LN status; Nomogram 2 incorporated CLN rad-score, capsule contact >25% and CT reported CLN status. 2 nomograms both showed good discrimination and calibration in the training (AUC = 0.847; AUC = 0.837) and validation cohorts (AUC = 0.807; AUC = 0.795). Significant improved AUC, net reclassification index (NRI) and integrated discriminatory improvement (IDI) confirmed additional great predictive value of 2 rad-scores, compared with clinical models without radiomics. Decision curve analysis indicated clinical utility of nomograms. 2 nomograms both demonstrated favorable predictive efficacy in CT reported LN or CLN negative subgroup (AUC = 0.766; AUC = 0.744)., Conclusion: The presented 2 radiomics nomograms are useful tools for preoperative prediction of LNM and CLNM in PTC., (Copyright © 2021 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.)

Objective: This study aims to explore the value of magnetic resonance imaging (MRI) and texture analysis (TA) in the differential diagnosis of ovarian granulosa cell tumors (OGCTs) and thecoma-fibrothecoma (OTCA-FTCA)., Methods: The preoperative MRI data of 32 patients with OTCA-FTCA and 14 patients with OGCTs, confirmed by pathological examination between June 2013 and August 2020, were retrospectively analyzed. The texture data of three-dimensional MRI scans based on T2-weighted imaging and clinical and conventional MRI features were analyzed and compared between tumor types. The Mann-Whitney U -test, χ 2 test/Fisher exact test, and multivariate logistic regression analysis were used to identify differences between the OTCA-FTCA and OGCTs groups. A regression model was established by using binary logistic regression analysis, and receiver operating characteristic curve analysis was carried out to evaluate diagnostic efficiency., Results: A multivariate analysis of the imaging-based features combined with TA revealed that intratumoral hemorrhage (OR = 0.037), log-sigma-20mm-3D&#95;glszm&#95;SmallAreaEmphasis (OR = 4.40), and log-sigma-2-0mm-3D&#95;glszm&#95;SmallAreaHighGrayLevelEmphasis (OR = 1.034) were independent features for discriminating between OGCTs and OTCA-FTCA ( P < 0.05). An imaging-based diagnosis model, TA-based model, and combination model were established. The areas under the curve of the three models in predicting OGCTs and OTCA-FTCA were 0.935, 0.944, and 0.969, respectively; the sensitivities were 93.75, 93.75, and 96.87%, respectively; and the specificities were 85.71, 92.86, and 92.86%, respectively. The DeLong test indicated that the combination model had the highest predictive efficiency ( P < 0.05), with no significant difference among the three models in differentiating between OGCTs and OTCA-FTCA ( P > 0.05)., Conclusions: Compared with OTCA-FTCA, intratumoral hemorrhage may be characteristic MR imaging features with OGCTs. Texture features can reflect the microheterogeneity of OGCTs and OTCA-FTCA. MRI signs and texture features can help differentiate between OGCTs and OTCA-FTCA and provide a more comprehensive and accurate basis for clinical treatment., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Li, Shi, Chen, Wang, Wang, Chen, Ge, Dong and Wei.)

Purpose: To evaluate the predictive value of routine CT features combined with 3D texture analysis for prediction of BRCA gene mutation status in advanced epithelial ovarian cancer., Method: Retrospective analysis was performed on patients with masses occupying the pelvic space confirmed by pathology and complete preoperative images in our hospital, including 37 and 58 cases with mutant type and wild type BRCA, respectively (total: 95 cases). The enrolled patients' routine CT features were analyzed by two radiologists. Then, ROIs were jointly determined through negotiation, and the ITK-SNAP software package was used for 3D outlining of the third-stage images of the primary tumor lesions and obtaining texture features. For routine CT features and texture features, Mann-Whitney U tests, single-factor logistic regression analysis, minimum redundancy, and maximum correlation were used for feature screening, and the performance of individual features was evaluated by ROC curves. Multivariate logistic regression analysis was used to further screen features, find independent predictors, and establish the prediction model. The established model's diagnostic efficiency was evaluated by ROC curve analysis, and the histogram was obtained to conduct visual analysis of the prediction model., Results: Among the routine CT features, the type of peritoneal metastasis, mesenteric involvement, and supradiaphragmatic lymph node enlargement were correlated with BRCA gene mutation (P < 0.05), whereas the location of the peritoneal metastasis (in the gastrohepatic ligament) was not significantly correlated with BRCA gene mutation (P > 0.05). Multivariate logistic regression analysis retained six features, including one routine CT feature and five texture features. Among them, the type of peritoneal metastasis was used as an independent predictor (P < 0.05), which had the highest diagnostic efficiency. Its AUC, accuracy, specificity, and sensitivity were 0.74, 0.79, 0.90, and 0.62, respectively. The prediction model based on the combination of routine CT features and texture features had an AUC of 0.86 (95% CI: 0.79-0.94) and accuracy, specificity, and sensitivity of 0.80, 0.76, and 0.81, respectively, indicating a better performance than that of any single feature., Conclusions: Both routine CT features and texture features had value for predicting the mutation state of the BRCA gene, but their predictive efficiency was low. When the two types of features were combined to establish a predictive model, the model's predictive efficiency was significantly higher than that of independent features., Competing Interests: YQG is employed by General Electric Co. Ltd. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Li, Liu, Ge, Zhou and Wei.)

Background: In this study, we tested whether a combination of radiomic features extracted from baseline pre-immunotherapy computed tomography (CT) images and clinicopathological characteristics could be used as novel noninvasive biomarkers for predicting the clinical benefits of non-small cell lung cancer (NSCLC) patients treated with immune checkpoint inhibitors (ICIs)., Methods: The data from 92 consecutive patients with lung cancer who had been treated with ICIs were retrospectively analyzed. In total, 88 radiomic features were selected from the pretreatment CT images for the construction of a random forest model. Radiomics model 1 was constructed based on the Rad-score. Using multivariate logistic regression analysis, the Rad-score and significant predictors were integrated into a single predictive model (radiomics nomogram model 1) to predict the durable clinical benefit (DCB) of ICIs. Radiomics model 2 was developed based on the same Rad-score as radiomics model 1.Using multivariate Cox proportional hazards regression analysis, the Rad-score, and independent risk factors, radiomics nomogram model 2 was constructed to predict the progression-free survival (PFS)., Results: The models successfully predicted the patients who would benefit from ICIs. For radiomics model 1, the area under the receiver operating characteristic curve values for the training and validation cohorts were 0.848 and 0.795, respectively, whereas for radiomics nomogram model 1, the values were 0.902 and 0.877, respectively. For the PFS prediction, the Harrell's concordance indexes for the training and validation cohorts were 0.717 and 0.760, respectively, using radiomics model 2, whereas they were 0.749 and 0.791, respectively, using radiomics nomogram model 2., Conclusions: CT-based radiomic features and clinicopathological factors can be used prior to the initiation of immunotherapy for identifying NSCLC patients who are the most likely to benefit from the therapy. This could guide the individualized treatment strategy for advanced NSCLC.

Background: To establish and validate a high-resolution magnetic resonance imaging (HRMRI)-based radiomic nomogram for prediction of preoperative perineural invasion (PNI) of rectal cancer (RC)., Methods: Our retrospective study included 140 subjects with RC (99 in the training cohort and 41 in the validation cohort) who underwent a preoperative HRMRI scan between December 2016 and December 2019. All subjects underwent radical surgery, and then PNI status was evaluated by a qualified pathologist. A total of 396 radiomic features were extracted from oblique axial T2 weighted images, and optimal features were selected to construct a radiomic signature. A combined nomogram was established by incorporating the radiomic signature, HRMRI findings, and clinical risk factors selected by using multivariable logistic regression., Results: The predictive nomogram of PNI included a radiomic signature, and MRI-reported tumor stage (mT-stage). Clinical risk factors failed to increase the predictive value. Favorable discrimination was achieved between PNI-positive and PNI-negative groups using the radiomic nomogram. The area under the curve (AUC) was 0.81 (95% confidence interval [CI], 0.71-0.91) in the training cohort and 0.75 (95% CI, 0.58-0.92) in the validation cohort. Moreover, our result highlighted that the radiomic nomogram was clinically beneficial, as evidenced by a decision curve analysis., Conclusions: HRMRI-based radiomic nomogram could be helpful in the prediction of preoperative PNI in RC patients.

Objectives: To investigate the efficacy of multi-parametric MRI-based radiomics nomograms for preoperative distinction between benign and malignant sinonasal tumors., Methods: Data of 244 patients with sinonasal tumor (training set, n=192; test set, n=52) who had undergone pre-contrast MRI, and 101 patients who underwent post-contrast MRI (training set, n=74; test set, n=27) were retrospectively analyzed. Independent predictors of malignancy were identified and their performance were evaluated. Seven radiomics signatures (RSs) using maximum relevance minimum redundancy (mRMR), and the least absolute shrinkage selection operator (LASSO) algorithm were established. The radiomics nomograms, comprising the clinical model and the RS algorithms were built: one based on pre-contrast MRI (RNWOC); the other based on pre-contrast and post-contrast MRI (RNWC). The performances of the models were evaluated with area under the curve (AUC), calibration, and decision curve analysis (DCA) respectively., Results: The efficacy of the clinical model (AUC=0.81) of RNWC was higher than that of the model (AUC=0.76) of RNWOC in the test set. There was no significant difference in the AUC of radiomic algorithms in the test set. The RS-T1T2 (AUC=0.74) and RS-T1T2T1C (RSWC, AUC=0.81) achieved a good distinction efficacy in the test set. The RNWC and the RNWOC showed excellent distinction (AUC=0.89 and 0.82 respectively) in the test set. The DCA of the nomograms showed better clinical usefulness than the clinical models and radiomics signatures., Conclusions: The radiomics nomograms combining the clinical model and RS can be accurately, safely and efficiently used to distinguish between benign and malignant sinonasal tumors., Competing Interests: Author Y-QG was employed by company GE Healthcare China. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Bi, Zhang, Wang, Ge, Zhang, Wang and Hao.)

Purpos e. To compare the diagnostic value of texture analysis- (TA-) derived parameters from out-of-phase T1W, in-phase T1W, and T2W images in the classification of the early stage of liver fibrosis. Methods . Patients clinically diagnosed with hepatitis B infection, who underwent liver biopsy and noncontrast MRI scans, were enrolled. TA parameters were extracted from out-of-phase T1-weighted (T1W), in-phase T1W, and T2-weighted (T2W) images and calculated using Artificial Intelligent Kit (AK). Features were extracted including first-order, shape, gray-level cooccurrence matrix, gray-level run-length matrix, neighboring gray one tone difference matrix, and gray-level differential matrix. After statistical analyses, final diagnostic models were constructed. Receiver operating curves (ROCs) and areas under the ROC (AUCs) were used to assess the diagnostic value of each final model and 100-time repeated cross-validation was applied to assess the stability of the logistic regression models. Results . A total of 57 patients were enrolled in this study, with 27 in the fibrosis stage < 2 and 30 in stages ≥ 2. Overall, 851 features were extracted per ROI. Eight features with high correlation were selected by the maximum relevance method in each sequence, and all had a good diagnostic performance. ROC analysis of the final models showed that all sequences had a preferable performance with AUCs of 0.87, 0.90, and 0.96 in T2W and in-phase and out-of-phase T1W, respectively. Cross-validation results reported the following values of mean accuracy, specificity, and sensitivity: 0.98 each for out-of-phase T1W; 0.90, 0.89, and 0.90 for in-phase T1W; and 0.86, 0.88, 0.84 for T2W in the training set, and 0.76, 0.81, and 0.72 for out-of-phase T1W; 0.74, 0.72, and 0.75 for in-phase T1W; and 0.63, 0.64, and 0.63 for T2W for the test group, respectively. Conclusion . Noncontrast MRI scans with texture analysis are viable for classifying the early stages of liver fibrosis, exhibiting excellent diagnostic performance., Competing Interests: The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article., (Copyright © 2021 Ru Zhao et al.)

Purpose: To establish and validate two predictive radiomics models for preoperative prediction of lymph node metastases (LNMs) and tumor deposits (TDs) respectively in rectal cancer (RC) patients., Methods: A total of 139 RC patients (98 in the training cohort and 41 in the validation cohort) were enrolled in the present study. High-resolution magnetic resonance images (HRMRI) were retrieved for tumor segmentation and feature extraction. HRMRI findings of RC were assessed by three experienced radiologists. Two radiomics nomograms were established by integrating the clinical risk factors, HRMRI findings and radiomics signature., Results: The predictive nomogram of LNMs showed good predictive performance (area under the curve [AUC], 0.90; 95% confidence interval [CI] 0.83-0.96) which was better than clinico-radiological (AUC, 0.83; 95% CI 0.74-0.93; Delong test, p = 0.017) or radiomics signature-only model (AUC, 0.77; 95% CI 0.67-0.86; Delong test, p = 0.003) in training cohort. Application of the nomogram in the validation cohort still exhibited good performance (AUC, 0.87; 95% CI 0.76-0.98). The accuracy, sensitivity and specificity of the combined model in predicting LNMs was 0.86,0.79 and 0.91 in training cohort and 0.83,0.85 and 0.82 in validation cohort. As for TDs, the predictive efficacy of the nomogram (AUC, 0.82; 95% CI 0.71-0.93) was not significantly higher than radiomics signature-only model (AUC, 0.80; 95% CI 0.69-0.92; Delong test, p = 0.71). Radiomics signature-only model was adopted to predict TDs with accuracy=0.76, sensitivity=0.72 and specificity=0.94 in training cohort and 0.68, 0.62 and 0.97 in validation cohort., Conclusion: HRMRI-based radiomics models could be helpful for the prediction of LNMs and TDs preoperatively in RC patients.

Objective: To assess the feasibility of using virtual non-contrast (VNC) images derived from dual-energy computed tomography (DECT) to replace true non-contrast (TNC) images of papillary thyroid carcinoma (PTC) patients., Methods: Images of 96 PTC patients were retrospectively analyzed. TNC images were acquired under the single-energy mode of DECT after the plain scanning. The arterial and venous phase VNC (VNC-a and VNC-v) images were generated by the post-processing algorithm from the arterial phase and venous phase of contrast-enhanced CT images, respectively. Mean attenuation values, image noise, number and length of calcification were measured. Radiation dose was also calculated. Last, subjective score of image quality was evaluated by a 5-point scale., Results: Signal-to-noise ratio (SNR) of each tissue in TNC images is significantly higher than that of VNC images (p<0.050). Contrast-to-noise ratio (CNR) of fat, muscle, thyroid nodules and internal carotid artery in TNC images is significantly higher than that of VNC images, while CNR in TNC images is lower for cervical vertebra (p<0.001). Calcification is detected on TNC images of 44 patients, while it is omitted on VNC images of 14 patients (31.8%). The subjective score of TNC images is higher than VNC images (p<0.001). The effective dose reduction is 47.6% by avoiding plain scanning., Conclusions: Considering the different attenuation value, SNR, CNR and especially reduced detection rate of calcification, we deem that VNC images cannot be directly used to replace TNC images in PTC patients, despite the reduced radiation dose.

Introduction: This study aims to analyze the permeability of intra- and peri-meningiomas regions and compare the microvascular permeability between peritumoral brain edema (PTBE) and non-PTBE using DCE-MRI., Methods: This was a retrospective of patients with meningioma who underwent surgery. The patients were grouped as PTBE and non-PTBE. The DCE-MRI quantitative parameters, including volume transfer constant (Ktrans), rate constant (Kep), extracellular volume (Ve), and mean plasma volume (Vp), obtained using the extended Tofts-Kety 2-compartment model. Logistic regression analysis was conducted to explore the risk factor of PTBE., Results: Sixty-three patients, diagnosed as fibrous meningioma, were included in this study. They were 17 males and 46 females, aged from 32 to 88 years old. Kep and Vp were significantly lower in patients with PTBE compared with those without (Kep: 0.1852 ± 0.0369 vs. 0.5087 ± 0.1590, p = 0.010; Vp: 0.0090 ± 0.0020 vs. 0.0521 ± 0.0262, p = 0.007), while there were no differences regarding Ktrans and Ve (both p > 0.05). The multivariable analysis showed that tumor size ≥10 cm3 (OR = 4.457, 95% CI: 1.322-15.031, p = 0.016) and Vp (OR = 0.572, 95%CI: 0.333-0.981, p = 0.044) were independently associated with PTBE in patients with meningiomas., Conclusion: DCE-magnetic resonance imaging·Meningioma·Blood vessel MRI can be used to quantify the microvascular permeability of PTBE in patients with meningioma., (© 2021 S. Karger AG, Basel.)

Objective: To investigate the value of conventional magnetic resonance imaging (MRI) based radiomic model in predicting the texture of pituitary macroadenoma. Methods: The complete data of 101 patients with pituitary macroadenoma confirmed by surgery and pathology in Yijishan Hospital of Wannan Medical College from December 2014 to December 2019 were retrospectively analyzed. According to the texture of the intraoperative pituitary tumor, patients were divided into soft group ( n= 58) and hard group ( n= 43). They were randomly divided into training group ( n= 72) and validation group ( n= 29) at a ratio of 7∶3. All patients underwent conventional MRI scan of the pituitary gland. Itk-snap software was used to manually outline the T(1)-weighted image (T(1)WI), T(2)-weighted image (T(2)WI) and enhanced T(1)WI image section by section on tumor area of interest (ROI) and perform three-dimensional fusion. Then AK software was imported to extract texture features. The regression analysis methods of minimum redundancy maximum relevance (mRMR) and least absolute shrinkage and selection operator (LASSO) were used for feature selection and radiomic signature establishment. The reliability of the model was verified by 100 leave-group-out cross validation (LGOCV), and the predictive ability of the model was evaluated by drawing the receiver operating characteristic (ROC) curve. The decision curve analysis (DCA) was used to evaluate the clinical application value of the model. Results: The AUC (Area Under the ROC Curve) (95 %CI ) values of T1WI, T2WI, enhanced T1WI, and the combined sequence model to predict the texture of pituitary macroadenomas in the training and validation groups were 0.91 (0.84-0.98) and 0.90 (0.78-1.00), 0.86 (0.78-0.95) and 0.83 (0.64-1.00), 0.90 (0.83-0.97) and 0.89 (0.77-1.00),0.92 (0.85-0.98) and 0.91 (0.79-1.00), respectively. DCA demonstrated that T(1)WI, T(2)WI, enhanced T(1)WI, and combined sequence model all had good net benefits in clinical practice. Conclusions: T(1)WI, T(2)WI, enhanced T(1)WI, and combined sequence model of conventional MRI all had high efficacy in predicting the texture of pituitary macroadenoma, which provided a new quantitative method for predicting the texture of pituitary macroadenoma.

Objective: To explore the value of CT texture analysis (CTTA) for determining coronavirus disease 2019 (COVID-19) severity., Methods: The clinical and CT data of 81 patients with COVID-19 were retrospectively analyzed. The texture features were extracted using LK2.1. The two-sample t test or Mann-Whitney U test was used to find the significant features. Minimum redundancy and maximum relevance (MRMR) method was performed to find the features with maximum correlation and minimum redundancy. These features were then used to construct a radiomics texture model to discriminate the severe patients using multivariate logistic regression method. Besides, a clinical model was also built. ROC analyses were conducted to evaluate the performance of two models. The correlations of clinical features and textural features were analyzed using the Spearman correlation analysis., Results: Of the total cases included, 60 were common and 21 were severe. (1) For textural features, 20 radiomics features selected by MRMR showed good performance in discriminating the two groups (AUC > 70%). (2) For clinical features, chi-square tests or Mann-Whitney U tests identified 16 clinical features as significant, and 12 were discriminative (p < 0.05) between two groups analyzed by univariate logistic analysis. Of these, 10 had an AUC > 70%. (3) Prediction models for textural features and clinical features were established, and both showed high predictive accuracy. The AUC values of textural features and clinical features were 0.93 (0.86-1.00) and 0.95 (0.95-0.99), respectively. (4) The Spearman correlation analysis showed that most textural and clinical features had above-moderate correlations with disease severity (> 0.4)., Conclusion: Texture analysis can provide reliable and objective information for differential diagnosis of COVID-19., Key Points: • CT texture analysis can well differentiate common and severe COVID-19 patients. • Some textural features showed above-moderate correlations with clinical factors. • CT texture analysis can provide useful information to judge the severity of COVID-19.

Aims: This study was aimed at investigating whether a machine learning (ML)-based coronary computed tomographic angiography (CCTA) derived fractional flow reserve (CT-FFR) SYNTAX score (SS), 'Functional SYNTAX score' (FSSCTA), would predict clinical outcome in patients with three-vessel coronary artery disease (CAD)., Methods and Results: The SS based on CCTA (SSCTA) and ICA (SSICA) were retrospectively collected in 227 consecutive patients with three-vessel CAD. FSSCTA was calculated by combining the anatomical data with functional data derived from a ML-based CT-FFR assessment. The ability of each score system to predict major adverse cardiac events (MACE) was compared. The difference between revascularization strategies directed by the anatomical SS and FSSCTA was also assessed. Two hundred and twenty-seven patients were divided into two groups according to the SSCTA cut-off value of 22. After determining FSSCTA for each patient, 22.9% of patients (52/227) were reclassified to a low-risk group (FSSCTA ≤ 22). In the low- vs. intermediate-to-high (>22) FSSCTA group, MACE occurred in 3.2% (4/125) vs. 34.3% (35/102), respectively (P < 0.001). The independent predictors of MACE were FSSCTA (OR = 1.21, P = 0.001) and diabetes (OR = 2.35, P = 0.048). FSSCTA demonstrated a better predictive accuracy for MACE compared with SSCTA (AUC: 0.81 vs. 0.75, P = 0.01) and SSICA (0.81 vs. 0.75, P < 0.001). After FSSCTA was revealed, 52 patients initially referred for CABG based on SSCTA would have been changed to PCI., Conclusion: Recalculating SS by incorporating lesion-specific ischaemia as determined by ML-based CT-FFR is a better predictor of MACE in patients with three-vessel CAD. Additionally, the use of FSSCTA may alter selected revascularization strategies in these patients., (Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2020. For permissions, please email: journals.permissions@oup.com.)

Objective: To investigate the value of radiomics analysis of dual-energy computed tomography (DECT)-derived iodine maps for preoperative diagnosing cervical lymph nodes (LNs) metastasis in patients with papillary thyroid cancer (PTC)., Methods: Two hundred and fifty-five LNs (143 non-metastatic and 112 metastatic) were enrolled and allocated to training and validation sets (7:3 ratio). Radiomics features were extracted from arterial and venous phase iodine maps, respectively. Radiomics signature was constructed based on reproducible features using the least absolute shrinkage and selection operator (LASSO) logistic regression algorithm with 10-fold cross-validation. Logistic regression modeling was employed to build models based on CT image features (model 1), radiomics signature (model 2), and the combined (model 3). A nomogram was plotted for the combined model and decision curve analysis was applied for clinical use. Diagnostic performance was assessed and compared. Internal validation was performed on an independent set containing 78 LNs., Results: Model 3 showed optimal diagnostic performance in both training (AUC = 0.933) and validation set (AUC = 0.895), followed by model 2 (training set, AUC = 0.910; validation set, AUC = 0.847). Both these two models outperformed model 1 in both training (AUC = 0.763) (p < 0.05) and validation set (AUC = 0.728) (p < 0.05)., Conclusion: Radiomics analysis of DECT-derived iodine maps showed better diagnostic performance than qualitative evaluation of CT image features in preoperative diagnosing cervical LN metastasis in PTC patients. Radiomics signature integrated with CT image features can serve as a promising imaging biomarker for the differentiation., Key Points: • Conventional CT image features have limited value for the diagnosis of metastatic LNs in PTC patients. • Radiomics analysis of dual-energy CT-derived iodine maps significantly outperformed qualitative CT image features in differentiating metastatic from non-metastatic LNs. • Radiomics signature integrated with qualitative CT image features can serve as a useful tool in judging LNs status, thus aiding clinical decision-making.

Background: The optimization of myocardial CT perfusion (CTP) assessment remains inconsistent and uncertain. Our aim was to explore the superior analysis selection and incremental improvement of myocardial blood flow (MBF) assessment on CTP in diagnosing hemodynamically significant coronary artery disease (CAD)., Methods: Sixty patients (43 men and 17 women; 61.38 ± 8.01 years) were prospectively recruited and underwent stress dynamic myocardial CTP examinations. Absolute and relative MBF was used for ischemia evaluation with the invasive coronary angiography and fractional flow reserve were used as the reference standard. Areas under the receiver operating characteristic curves (AUCs) and cutoff values were calculated and compared., Results: There were 151 vessels in 60 patients finally enrolled for analysis. The sensitivity, specificity, PPV, NPV and diagnostic accuracy for the absolute MBF value and relative MBF ratio were 82.76%, 98.92%, 97.96%, 90.20%, and 92.72% and 74.14%, 93.56%, 87.76%, 85.29%, and 86.09%, respectively. The absolute MBF value was superior than the relative MBF ratio in detecting ischemia (AUC, 0.955 [95%CI: 0.919-0.990] vs.0.906 [95%CI:0.857-0.954])(P = 0.02). For territories with both sensitivity and specificity ≤90%, the diagnostic accuracy increased from 79.1% to 88.4% when the specific data were assessed using the absolute MBF value instead of the relative MBF ratio., Conclusions: The absolute MBF value from the endocardial myocardium on stress dynamic myocardial CTP showed superior diagnostic performance compared to the relative MBF ratio for the detection of myocardial ischemia in intermediate-to-high risk patients. The absolute MBF value provides an incremental benefit toward diagnostic performance for the relative MBF ratio evaluation., Competing Interests: Declaration of competing interest All the other authors have no conflict of interest to disclose., (Copyright © 2020 Society of Cardiovascular Computed Tomography. Published by Elsevier Inc. All rights reserved.)

Background: To investigate whether radiomic features from ( 18 F)-fluorodeoxyglucose positron emission tomography/computed tomography [( 18 F)-FDG PET/CT] can predict epidermal growth factor receptor ( EGFR ) mutation status and prognosis in patients with lung adenocarcinoma., Methods: One hundred and seventy-four consecutive patients with lung adenocarcinoma underwent ( 18 F)-FDG PET/CT and EGFR gene testing were retrospectively analyzed. Radiomic features combined with clinicopathological factors to construct a random forest (RF) model to identify EGFR mutation status. The mutant/wild-type model was trained on a training group (n=139) and validated in an independent validation group (n=35). The second RF classifier predicting the 19/21 mutation site was also built and evaluated in an EGFR mutation subset (training group, n=80; validation group, n=25). Radiomic score and 5 clinicopathological factors were integrated into a multivariate Cox proportional hazard (CPH) model for predicting overall survival (OS). AUC (the area under the receiver characteristic curve) and C-index were calculated to evaluate the model's performance., Results: Of 174 patients, 109 (62.6%) harbored EGFR mutations, 21L858R was the most common mutation type [55.9% (61/109)]. The mutant/wild-type model was identified in the training (AUC, 0.77) and validation (AUC, 0.71) groups. The 19/21 mutation site model had an AUC of 0.82 and 0.73 in the training and validation groups, respectively. The C-index of the CPH model was 0.757. The survival time between targeted therapy and chemotherapy for patients with EGFR mutations was significantly different (P=0.03)., Conclusions: Radiomic features based on ( 18 F)-FDG PET/CT combined with clinicopathological factors could reflect genetic differences and predict EGFR mutation type and prognosis., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/tlcr-19-592). The authors have no conflicts of interest to declare., (2020 Translational Lung Cancer Research. All rights reserved.)

Pituitary adenomas (PA) is one of the most frequent types of intracranial neoplasms. Long noncoding RNAs (lncRNAs) played important roles in the progression of human cancers, including PA. However, the roles of lncRNAs in PA remained to be further investigated. We performed analysis of GSE26966 dataset to identify differently expressed lncRNAs in PA. Co-expression network, lncRNA-RNA binding proteins network, and competing endogenous RNA networks were constructed. Moreover, we performed RT-qPCR assay to validate four key lncRNAs expression in PA. This study identified differently expressed mRNAs and lncRNAs by using GSE26966 database. Furthermore, we constructed lncRNA-mRNA co-expression, lncRNA-RBP interaction and ceRNA networks. Bioinformatics analysis showed these lncRNAs were involved in regulating mechanical stimulus, gene expression, JAK-STAT cascade, cell cycle arrest, FoxO signaling, HIF-1 signaling, Insulin signaling, Oxytocin signaling, and MAPK signaling. We also showed KCNQ1OT1, SNHG7, MEG3, and SNHG5 were down-regulated in PA. Our findings could provide a novel insight to understand the mechanisms of lncRNAs underlying PA pathogenesis and identify new biomarkers for PA.

The combination of morphological characteristics and DNA barcodes was used to a systematic study of Hippocampus spinosissimus,laying the foundation for rapid and accurate identification for the medical seahorse species. According to the reported literature and observation on seahorse samples,the typical characteristics of the H. spinosissimus include highly developed spiny,much short nose,single or double cheeks and strongly developed spines bordering pouch. Genomic DNAs of H. spinosissimus and other related seahorse species were extracted using the TIANamp Marine Animals DNA Kit. The COⅠ and ATP6 genes were amplified and sequenced in both directions. After the verification by Blast,the GC content,intraspecific and interspecific genetic distance,and the Neighbor joining( NJ) phylogenetic trees were analyzed by MEGA 7. The lengths of the COⅠ and ATP6 genes were 649 bp and 602-603 bp,respectively,with the average GC content of 39. 96% and 35. 37%. The maximum intraspecific genetic distances in H. spinosissimus based on COⅠ and ATP were both far less than the minimum interspecific genetic distance between H. spinosissimus and other seahorses,suggesting a significant barcoding gap. NJ analysis results of COⅠ and ATP6 exhibited that all H. spinosissimus species clustered together,indicating that the two DNA barcode could identify H. spinosissimus from other seahorses accurately and quickly. In addition,H. spinosissimus shared a close genetic relationship between H. kelloggi according to the NJ tree. Furthermore,there exits three stable subgroup structure of H. spinosissimus,indicating that COⅠ and ATP6 barcodes could be applied the indicator for the geographical ecology research of H. spinosissimus. The results obtained the typical morphological and molecular identification characteristics of H. spinosissimus,which played central roles for the development of species identification. This study provides an important basis data for expanding the medical seahorse resources and ensuring the safety of clinical medicine.

Introduction: Adverse histopathological status (AHS) decreases outcomes of gastric cancer (GC). With the lack of a single factor with great reliability to preoperatively predict AHS, we developed a computational approach by integrating large-scale imaging factors, especially radiomic features at contrast-enhanced computed tomography, to predict AHS and clinical outcomes of patients with GC., Methods: Five hundred fifty-four patients with GC (370 training and 184 test) undergoing gastrectomy were retrospectively included. Six radiomic scores (R-scores) related to pT stage, pN stage, Lauren & Borrmann (L&B) classification, World Health Organization grade, lymphatic vascular infiltration, and an overall histopathologic score (H-score) were, respectively, built from 7,000+ radiomic features. R-scores and radiographic factors were then integrated into prediction models to assess AHS. The developed AHS-based Cox model was compared with the American Joint Committee on Cancer (AJCC) eighth stage model for predicting survival outcomes., Results: Radiomics related to tumor gray-level intensity, size, and inhomogeneity were top-ranked features for AHS. R-scores constructed from those features reflected significant difference between AHS-absent and AHS-present groups (P < 0.001). Regression analysis identified 5 independent predictors for pT and pN stages, 2 predictors for Lauren & Borrmann classification, World Health Organization grade, and lymphatic vascular infiltration, and 3 predictors for H-score, respectively. Area under the curve of models using those predictors was training/test 0.93/0.94, 0.85/0.83, 0.63/0.59, 0.66/0.63, 0.71/0.69, and 0.84/0.77, respectively. The AHS-based Cox model produced higher area under the curve than the eighth AJCC staging model for predicting survival outcomes. Furthermore, adding AHS-based scores to the eighth AJCC staging model enabled better net benefits for disease outcome stratification., Discussion: The developed computational approach demonstrates good performance for successfully decoding AHS of GC and preoperatively predicting disease clinical outcomes.

Considering the excellent photochemical properties of ruthenium(II) complexes, two new ruthenium(II) complexes, RuL 1 -DNBS and RuL 2 -DNBS, have been developed as phosphorescence probes for detection of biothiols in 100:1 (v/v) Hepes buffer (20 mM, pH = 7.2)/CH 3 CN solution. The response rate was highly improved of these two probes toward biothiols because the steric interactions between 1H-imidazo [4, 5-f] [1,10] phenanthroline group and ortho-2, 4-dinitrobenzensulfonate resulted in a relatively rapid thiol-induced S N Ar substitution reaction. RuL 1 -DNBS and RuL 2 -DNBS were weakly phosphorescent owing to the effectual photoinduced electron transfer from ruthenium(II) luminophore to the sensing group, 2,4-dinitrobenzenesulfonyl. After reacting with biothiols, the 2,4-dinitrobenzenesulfonyl group of RuL 1 -DNBS and RuL 2 -DNBS were cleavaged and the RuL 1 and RuL 2 were obtained. Meanwhile, the phosphorescence were "turn-on". Both of these two probes can detect biothiols sensitively and selectively under physiological conditions with submicromolar detection limits. Furthermore, application of RuL 2 -DNBS for detecting of intracellular biothiols has been successfully performed in living Glioma cells., (Copyright © 2019. Published by Elsevier B.V.)

Pancreatic cancer is the most common digestive tract tumor with an increasing incidence in recent years. The poor prognosis of pancreatic cancer is mainly because of the inability of detecting tumor at an early stage,its high potential for early dissemination,and its relatively poor sensitivity to chemotherapy. Most patients have lost the opportunity for surgery when they are diagnosed,which resulted in an urgent need for the development of more effective and safe therapies for pancreatic cancer. However,the current clinical cancer chemotherapy based on gemcitabine leads to poor prognosis in pancreatic patients. With the continuous research on the biological and cellular signaling pathways of pancreatic cancer,there have emerged a great many of novel agents,including new chemotherapeutic,targetable and immune-modulatory drugs,and some drugs have achieved encouraging results. Furthermore,as an alternative and supplementary method,traditional Chinese medicine has shown good application prospects in the field of pancreatic cancer treatment. This article reviews the current status of drug therapy for pancreatic cancer,summarizes the strength and weakness of existing therapeutic drugs in the application process,gives prospects of possible breakthroughs for the pharmacotherapy in the future,and provides certain new ideas and lessons for subsequent drug development.

Few-layer bismuthene is an emerging two-dimensional material in the fields of physics, chemistry, and material science. However, its nonlinear optical property and the related photonics device have been seldom studied so far. Here, we demonstrate a sub-200 fs soliton mode-locked erbium-doped fiber laser (EDFL) using a microfiber-based bismuthene saturable absorber for the first time, to the best of our knowledge. The bismuthene nanosheets are synthesized by the sonochemical exfoliation method and transferred onto the taper region of a microfiber by the optical deposition method. Stable soliton pulses centered at 1561 nm with the shortest pulse duration of about 193 fs were obtained. Our findings unambiguously imply that apart from its fantastic electric and thermal properties, few-layer bismuthene may also possess attractive optoelectronic properties for nonlinear photonics, such as mode-lockers, Q-switchers, optical modulators and so on.

Two new junior synonymies in Lispe are proposed herein: L. bivittata Stein, 1909 = L. guizhouensis Wei, 2006 syn. nov. and L. nicobarensis Schiner, 1868 = L. leigongshana Wei Yang, 2007 syn. nov. Both species are diagnosed with photographs and terminalia illustrations. The identity of L. subbivittata Mou, 1992, a former subspecies of L. bivittata, is discussed.

A new species, Wohlfahrtia spinisternum Pape Zhang sp. nov., is described based on one male specimen collected from the arid steppe habitat of Kalamaili Nature Reserve, Xinjiang, China. The species shares with W. aschersoni (Enderlein, 1934) a reduction of the distal posteroventral row of flattened, spiny bristles ('ctenidium') on the male mid femur, and has male sternite 5 gradually raised posteriorly into a pointed process, which is a unique feature in the entire subfamily Paramacronychiinae. Lectotypes are designated for Wohlfahrtia musiva Séguy, 1953 and Wohlfahrtia triquetra Séguy, 1933, and three new synonymies are proposed: Wohlfahrtia longicorpuris Mawlood Abdul-Rassoul, 2001 syn. nov. of W. nuba (Wiedemann, 1830), Wohlfahrtia musiva Séguy, 1953 syn. nov. of W. villeneuvi Salem, 1938, and Wohlfahrtia triquetra Séguy, 1933 syn. nov. of W. indigens (Wiedemann, 1830). A pictorial synopsis of male terminalia of the 24 recognized species of Wohlfahrtia Brauer Bergenstamm, 1889 is provided.

Platycodin D(PD) has a significantly inhibitory effect on multiple malignant tumors, and can inhibit the proliferation of leukemia cells K562 and induce apoptosis. However, its effect in improving the sensitivity of drug-resistant cells to imatinib and their molecular mechanism remained unclear. To investigate the effect and mechanism of PD alone or combined with imatinib (IM) in inhibiting CML imatinib resistant cell line K562/R, the cell proliferation was examined by CCK8 assay to reveal the effect of PD on the inhibitory function of imatinib. Cell apoptosis was detected by Annexin V-FITC/PI double staining. Protein expressions of cleaved caspase-3, cleaved caspase-9, PARP, cleaved PARP, Bcr/abl, p-AKT and p-mTOR were detected by Western blot. The results showed that the inhibitory effect of PD combined with imatinib on the proliferation and apoptosis of K562/R cells was significantly higher than that of the control group and the single drug group. Protein expressions of cleaved caspase-3, cleaved caspase-9 and cleaved PARP were significantly up-regulated in the combination group, and protein expressions of PARP, Bcr/abl, p-AKT and p-mTOR were down-regulated. The results indicated that PD increased the sensitivity of drug-resistant cells to imatinib, and the inhibitory effect of PD combined with imatinib was significantly better than the single drug on cell proliferation, induction of apoptosis, inhibition of Bcr/abl protein and PI3K/AKT/mTOR signaling pathway., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Chinese Pharmaceutical Association.)

Leukemia stem cells (LSC) that were found in chronic myeloid leukemia (CML) responsible for the abnormal proliferation with the potential of self-renewal and multi-directional differentiation are involved in the pathophysiological process for drug resistance and relapse of CML. Autophagy, a conservative lysosomal degradation process that mediates cell degradation and recycling process, plays crucial roles in maintaining the homeostasis and function of intracellular environment. Recent studies suggested that autophagy is involved in the regulation of LSC differentiation and also closely related to the chemo-sensitivity of CML. In this review, we focused on the role of autophagy on chemotherapy sensitivity of CML as well as the leukemia stem cell function for the development of new anti-leukemia drugs., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Chinese Pharmaceutical Association.)

Foodborne shrimp allergy events have occurred in recent years. To illustrate the mechanism of high hydrostatic pressure technology to change the allergenicity of shrimp, the major allergen tropomyosin was separated and purified from Litopenaeus vannamei, and indentified with matrix assisted laser desorption ionization time of flight mass spectrometry (MALDI-TOF-MS). The effect of temperature factor under high hydrostatic pressure was measured with indirect ELISA method, CD and fluorescence spectrum. The results showed that the antigenicity of TM protein had an increase after being heated at 35 or 45 ℃ when treated at 300 MPa for 15 minutes, while the antigenicity decreased at 55, 65, and 75 ℃. With the increase of heat temperature, the secondary structure of TM also changed. The mutual transformation happened between the alpha-helix and beta-sheet, beta-turn, and the random coil. The tertiary structure of TM was observed dynamic changes from the extended state to the folded state, and then re-extended state to re-folded state. These results suggested that high hydrostatic pressure combined with temperature could influence the antigenicity of TM by the change of conformation which would be useful as theoretical guidance on developing new methods or technologies for producing hypoallergenic shrimp products.

Metabolic defects and neuronal apoptosis initiated by traumatic brain injury (TBI) contribute to subsequent neurodegeneration. They are all regulated by mechanisms centered around mitochondrion. Type-1 cannabinoid receptor (CB1) is a G-protein coupled receptor (GPCR) enriched on neuronal plasma membrane. Recent evidences point to the substantial presence of CB1 receptors on neuronal mitochondrial outer membranes (mtCB1) and the activation of mtCB1 influences aerobic respiration via inhibiting mitochondrial cyclic adenosine monophosphate (cAMP)/protein kinase A (PKA)/complex I pathway. The expression and role of neuronal mtCB1 under TBI are unknown. Using TBI models of cultured neurons, wild type and CB1 knockout mice, we found mtCB1 quickly upregulated after TBI. Activation of mtCB1 promoted metabolic defects accompanied with ATP shortage but protected neurons from apoptosis. Selective activation of plasma membrane CB1 showed no effects on neuronal metabolism and apoptosis. Activation of mtCB1 receptors inhibited mitochondrial cAMP/PKA/complex I and resulted in exacerbated metabolic defects accompanied with a higher ratio of ATP reduction to oxygen consumption decrease as well as neuronal apoptosis. Further research found the remarkable accumulation of protein kinase B (AKT) on neuronal mitochondria following TBI and the activation of mtCB1 upregulated mitochondrial AKT/complex V activity. Upregulation of mitochondrial AKT/complex V activity showed anti-apoptosis effects and alleviated ATP shortage in metabolic defects. Taken together, we have identified mtCB1 quickly upregulate after TBI and a dual role the mtCB1 might play in metabolic defects and neuronal apoptosis initiated by TBI: the inhibition of mitochondrial cAMP/PKA/complex I aggravates metabolic defects, energy insufficiency as well as neuronal apoptosis, but the coactivation of mitochondrial AKT/complex V mitigates energy insufficiency and neuronal apoptosis.

Species of Lispe caesia-group from Palaearctic and adjacent regions are reviewed. Diagnostic characters of this group are updated. One new synonymy is established: L. frontalis Zielke, 1972, syn. nov. for L. leucocephala Loew, 1856. Key to males of ten species (with two subspecies) from Palaearctic, Oriental and Ethiopian regions is given. Nine species (with two subspecies) are photographed. Six species and one subspecies are redescribed. More detailed ultrastructural or external characters for male swollen hind tarsi and the wing interference patterns are also provided.

Hypoderma lineatum (Villers, 1789) (Diptera: Oestridae) is a hypodermosis fly that has resulted in great economic losses worldwide. The antennae of cattle grub males and females were examined through stereoscopic microscopy and scanning electron microscopy to reveal the general morphology, combined with distribution, type, size, and ultrastructure of the antennal sensilla. All of the three antennal segments (antennal scape, pedicel, and funiculus) possess microtrichiae on their surface. Mechanoreceptors only exist on the antennal scape and pedicel. The antennal funiculus presents four types of antennal sensilla: trichoid, basiconic, coeloconic, and clavate sensilla. Three distinctive characters of H. lineatum are obvious: (1) the relatively slender, flexible, and equal-height mechanoreceptors; (2) the enlarged antennal pedicel, and numerous antennal sensory pits and pit sensilla on the antennal funiculus; and (3) all types of antennal sensilla clustered in sensory pits, respectively. Additionally, the enlarged antennal pedicel and abundant sensory pits and pit sensilla might facilitate odor detection, enhance olfactory sensitivity and accuracy, and also protect the fragile antennal sensilla from mechanical irritation or damage.

Cryptotanshinone (CPT), a lipid soluble active compound in Salvia miltiorrhiza, has a significant inhibitory effect on multiple malignant tumors, e. g. chronic myeloid leukemia (CML) cells and can effectively enhance imatinib's chemotherapeutic effect. However, its functional molecular mechanism remained unclear. In this experiment, the authors conducted a systematic study on the effect of CPT on the imatinib sensitivity and P-glycoprotein (P-gp) expression in CML cells by using CML cells K562 and imatinib persister K562-R. The MTT assays were performed to determine CPT's impact on the inhibitory effect of imatinib. Annexin V-FITC/PI staining analysis was used to detect the changes in the cell apoptosis rate. The active changes in apoptosis regulatory proteins Caspase-3, Caspase-9 and PARP were determined by Western blot. After the cells were pretreated with the gradient concentration of CPT, the expression of P-gp was analyzed by Western blot and flow cytometry. The changes in intracellular concentrations of imatinib were determined by HPLC analysis. The results indicated that the pretreatment with CPT significantly increased the proliferation inhibiting and apoptosis inducing effects of imatinib on K562 and K562-R cells as well as the degradation product expression of pro-apoptotic proteins Caspase-3, Caspase-9 and PARP, with a significant difference with the control group (P < 0.01). However, CPT showed no impact on the P-gp expression in CML cells and the intracellular concentrations of imatinib. In summary, the findings suggested that CPT enhanced the sensitivity of CML cells to imatinib. Its mechanism is not dependent on the inhibition in P-gp expression and the increase in intracellular drug concentration.

A series of novel 2-acyl-6-aryl substituted indolizine derivatives was synthesized by a novel tandem reaction between 4-acyl-pyrrole-2-carbaldehyde derivatives and ethyl 4-bromo-3-arylbut-2-enoate under mild conditions. The compounds were characterized using IR, (1)H NMR (13)C NMR and HRMS. The crystal structure of 7a was determined using single crystal X-ray crystallography. The absorption results showed that compounds 7a-e presented their absorption maxima at ca. 270 nm, while compounds 7f and 7g with a larger conjugation system exhibited red-shifted absorption character (ca. 280 nm). Fluorescence spectra revealed that these compounds exhibited blue fluorescence (434-456 nm) in dilute solutions and showed quantum yields of fluorescence between 0.02 and 0.39 in dichloromethane., (Copyright © 2014 Elsevier B.V. All rights reserved.)

We report results of numerical simulations on the various initial conditions for dark soliton generation in an all-normal-dispersion fiber laser. All the dark solitons generated are odd dark solitons. Differently from the dark soliton generation in fibers, where an arbitrary dip could evolve into a dark soliton, it is found that the dark soliton can originate only from an initial dip with a certain parameter requirement. A bright pulse with either a hyperbolic secant square, Gaussian, or Lorentz profile can be developed into a dark soliton, provided that the parameters of the initial bright pulse are selected. Dark solitons can be generated in fiber lasers only if there is a phase jump, and this phase jump can be maintained and evolve to π during the pulse evolution.

Bagging is a useful method to improve fruit quality by altering its exposure to light, whereas its effect on fruit volatiles production is inconsistent, and the genes responsible for the observed changes remain unknown. In the present study, single-layer yellow paper bags were used to study the effects of bagging treatment on the formation of C6 aldehydes in peach fruit (Prunus persica L. Batsch, cv. Yulu) over two succeeding seasons. Higher concentrations of n-hexanal and (E)-2-hexenal, which are characteristic aroma volatiles of peach fruit, were induced by bagging treatment. After bagging treatment, peach fruit had significantly higher LOX and HPL enzyme activities, accompanying increased contents of C6 aldehydes. The gene expression data obtained through real-time PCR showed that no consistent significant differences in transcript levels of LOX genes were observed over the two seasons, but significantly up-regulated expression was found for PpHPL1 after bagging treatment In addition, bagging-treated fruit produced more (E)-2-hexenal and had higher expression levels of PpHPL1 during postharvest ripening at room temperature. The regulatory role of the LOX-HPL pathway on the biosynthesis of n-hexanal and (E)-2-hexenal in response to bagging treatment during peach fruit development is discussed in the text.

A series of novel imidazo[1,5-a]pyridine-hydrazone derivatives were synthesized and characterized by infrared spectroscopy (IR), 1H NMR, 13C NMR and high resolution mass spectrometer (HRMS). Typically, the spatial structure of compound 3j was determined using X-ray diffraction analysis. The UV-vis absorption and fluorescence spectral characteristics of the compounds in dichloromethane and acetonitrile were investigated. Absorption peaks could be observed in the wavelength range 290-450 nm. It can also be seen that they display very similar maximum emission. The group attached to hydrazone hardly influenced the maximum emission. Furthermore, all the compounds were evaluated for antibacterial activity and were found to be more effective against Staphylococcus aureus, Listeria monocytogenes, Escherichia coli, Salmonella typhimurium, Pseudomonas aeruginosa and Shigella compared with chloramphenicol., (Copyright © 2013 John Wiley & Sons, Ltd.)

A series of novel 5-(3-aryl-1H-pyrazol-5-yl)-2-(3-butyl-1-chloroimidazo[1,5-a]- pyridin-7-yl)-1,3,4-oxadiazole derivatives has been synthesized from 3-butyl-1-chloroimidazo[1,5-a]pyridine-7-carboxylic acid and ethyl 3-aryl-1H-pyrazole-5-carboxylate. The compounds were characterized using IR, (1)H NMR, HRMS and UV-vis absorption. The fluorescence spectral characteristics of the compounds in dichloromethane were investigated. The results showed that absorption λmax and emission λmax was less correlated with substituent groups on N-1 position of pyrazole moiety and para position of benzene moiety. The calculated molecular orbital correlates well with their absorption., (Copyright © 2013 Elsevier B.V. All rights reserved.)

Background: Saponins are a major active component for the traditional Chinese medicine, Rubus parvifolius L., which has shown clear antitumor activities. However, the specific effects and mechanisms of saponins of Rubus parvifolius L. (SRP) remain unclear with regard to human chronic myeloid leukemia cells. The aim of this study was to investigate inhibition of proliferation and apoptosis induction effects of SRP in K562 cells and further elucidate its regulatory mechanisms., Materials and Methods: K562 cells were treated with different concentrations of SRP and MTT assays were performed to determine cell viability. Apoptosis induction by SRP was determined with FACS and DAPI staining analysis. Western blotting was used to detect expression of apoptosis and survival related genes. Specific inhibitors were added to confirm roles of STAT3 and AMPK pathways in SRP induction of apoptosis., Results: Our results indicated that SRP exhibited obvious inhibitory effects on the growth of K562 cells, and significantly induced apoptosis. Cleavage of pro-apoptotic proteins was dramatically increased after SRP exposure. SRP treatment also increased the activities of AMPK and JNK pathways, and inhibited the phosphorylation expression level of STAT3 in K562 cells. Inhibition of the AMPK pathway blocked the activation of JNK by SRP, indicating that SRP regulated the expression of JNK dependent on the AMPK pathway. Furthermore, inhibition of the latter significantly conferred resistance to SRP pro- apoptotic activity, suggesting involvement of the AMPK pathway in induction of apoptosis. Pretreatment with a STAT3 inhibitor also augmented SRP induced growth inhibition and cell apoptosis, further confirming roles of the STAT3 pathway after SRP treatment., Conclusions: Our results demonstrated that SRP induce cell apoptosis through AMPK activation and STAT3 inhibition in K562 cells. This suggests the possibility of further developing SRP as an alternative treatment option, or perhaps using it as adjuvant chemotherapeutic agent for chronic myeloid leukemia therapy.

A biosensor based on high spatial resolution imaging ellipsometry has been studied to examine its role in the rapid detection and analysis of the tropomyosin allergen existing in crustaceans. This methodology has been established for detection of the tropomyosin allergen and includes ligand screening, the determination of sensitivity, and a comparison with traditional detection methods. Three kinds of monoclonal antibodies (2F9, 4C7, and 2H6) known to have a high bioactivity against the tropomyosin allergen were screened and separately immobilized as ligands on a silicon wafer surface, thus allowing them to capture the tropomyosin allergen. Resulting changes on the wafer surface were visualized in gray scale variation on an ellipsometry image. Images showed that these antibodies are able to recognize the presence of the tropomyosin allergen in shrimp and crab with sensitivity of 1 mg L(-1), and at a detecting time of approximately 30 min for an extracted sample. This preliminary study has shown that the detection of the tropomyosin allergen is rapid and specific when using this type of assay on products containing shrimp and crab. When compared with the enzyme-linked immunosorbent assay, the biosensor based on imaging ellipsometry is able to perform a fast label-free analysis.

In this work, the flow field in the existing fermentor with radial-flow impellers (C1) was studied using the computational fluid dynamics (CFD) software package Fluent, then the fermentor with radial-axial flow impellers (C2) was constructed and was compared with the C1 fermentor by CFD and experimental research. The simulation results revealed that the flow field in C2 fermentor had characteristics such as higher turbulent kinetic energy, gas holdup and shear rates. Metabolic variables of Streptomyces lincolnensis in the two fermentors such as carbon and nitrogen source consumption rates, specific growth rates (μ), hyphae morphologies, and lincomycin productivities were further explored. The correlation analysis between the experimental measurements and the simulation results indicated that the hyphae clustering and dry cell weight (DCW) decreasing at production stage were eliminated in C2 fermentor, which had higher gas volumetric mass transfer coefficient (K(L)a), dissolved oxygen (DO) concentration and consumption rates of nutrient materials. When C2 was employed in the fermentor, the specific growth rate of S. lincolnensis at growth stage was higher, and the maintenance metabolism together with secondary metabolism at production stage was kept at higher levels. As a result, the yield of lincomycin was achieved 7039 μg ml(-1) when the 60 m(3) industrial fermentor was equipped with C2, which was increased by 46% compared to that obtained in the C1 fermentor., (Copyright © 2012 The Society for Biotechnology, Japan. Published by Elsevier B.V. All rights reserved.)

A series of novel 5-aryl-3-benzimidazolyl-1-phenyl-pyrazoline derivatives were synthesized by the reaction of benzimidazolyl chalcone and phenylhydrazine in 41-72% yields. The compounds were characterized using IR, (1)H NMR and HRMS. Absorption and fluorescence spectra were measured in different organic solvent. An intense absorption maxima was noted at ca. 370 nm and emission maxima was noted at ca. 460 nm. The absorption spectra of the pyrazoline derivatives reveal that 5-aryl group attached to the pyrazoline ring hardly influenced the maximum absorption. The fluorescence spectra of these compounds indicated the emission wavelength was red shifted and the fluorescence intensity was decreased with the increase in solvent polarity., (Copyright © 2012 Elsevier B.V. All rights reserved.)

In the title compound, C16H14N2O, the benzimidazole ring system is essentially planar. The planes of the benzene rings make a dihedral angle of 85.92 (8)°. In the crystal, neighbouring molecule are connected into paris along the c axis by weak C-H⋯O interactions and the connected pairs are expanded through C-H⋯N hydrogen bonds and C-H⋯π interactions along the b axis.