Background:Gallbladder carcinoma(GBC)is highly malignant,and its early diagnosis remains difficult.This study aimed to develop a deep learning model based on contrast-enhanced computed tomography(CT)images to assist r...Background:Gallbladder carcinoma(GBC)is highly malignant,and its early diagnosis remains difficult.This study aimed to develop a deep learning model based on contrast-enhanced computed tomography(CT)images to assist radiologists in identifying GBC.Methods:We retrospectively enrolled 278 patients with gallbladder lesions(>10 mm)who underwent contrast-enhanced CT and cholecystectomy and divided them into the training(n=194)and validation(n=84)datasets.The deep learning model was developed based on ResNet50 network.Radiomics and clinical models were built based on support vector machine(SVM)method.We comprehensively compared the performance of deep learning,radiomics,clinical models,and three radiologists.Results:Three radiomics features including LoG_3.0 gray-level size zone matrix zone variance,HHL firstorder kurtosis,and LHL gray-level co-occurrence matrix dependence variance were significantly different between benign gallbladder lesions and GBC,and were selected for developing radiomics model.Multivariate regression analysis revealed that age≥65 years[odds ratios(OR)=4.4,95%confidence interval(CI):2.1-9.1,P<0.001],lesion size(OR=2.6,95%CI:1.6-4.1,P<0.001),and CA-19-9>37 U/mL(OR=4.0,95%CI:1.6-10.0,P=0.003)were significant clinical risk factors of GBC.The deep learning model achieved the area under the receiver operating characteristic curve(AUC)values of 0.864(95%CI:0.814-0.915)and 0.857(95%CI:0.773-0.942)in the training and validation datasets,which were comparable with radiomics,clinical models and three radiologists.The sensitivity of deep learning model was the highest both in the training[90%(95%CI:82%-96%)]and validation[85%(95%CI:68%-95%)]datasets.Conclusions:The deep learning model may be a useful tool for radiologists to distinguish between GBC and benign gallbladder lesions.展开更多
BACKGROUND Eosinophilic granulomatosis with polyangiitis(EGPA),formerly known as Churg-Strauss syndrome,is a rare form of anti-neutrophil cytoplasmic antibodyassociated vasculitis characterized by asthma,vasculitis,an...BACKGROUND Eosinophilic granulomatosis with polyangiitis(EGPA),formerly known as Churg-Strauss syndrome,is a rare form of anti-neutrophil cytoplasmic antibodyassociated vasculitis characterized by asthma,vasculitis,and eosinophilia.CASE SUMMARY We report an atypical case of EGPA in a 20-year-old female patient.Unlike previously reported cases of EGPA,this patient’s initial symptom was asthma associated with a respiratory infection.This was followed by Loeffler endocarditis and cardiac insufficiency.She received treatment with methylprednisolone sodium succinate,low molecular weight heparin,recombinant human brain natriuretic peptide,furosemide,cefoperazone sodium/sulbactam sodium,and acyclovir.Despite prophylactic anticoagulation,she developed a large right ventricular thrombus.EGPA diagnosis was confirmed based on ancillary test results and specialty consultations.Subsequent treatment included mycophenolate mofetil.Her overall condition improved significantly after treatment,as evidenced by decreased peripheral blood eosinophils and cardiac markers.She was discharged after 17 d.Her most recent follow-up showed normal peripheral blood eosinophil levels,restored cardiac function,and a reduced cardiac mural thrombus size.CONCLUSION This case illustrates the swift progression of EGPA and underscores the significance of early detection and immediate intervention to ensure a favorable prognosis.展开更多
BACKGROUND Abernethy malformation,also known as congenital extrahepatic portosystemic shunt,is an uncommon malformation resulting from aberrant development of the portal venous system.Cystic fibrosis(CF)is an autosoma...BACKGROUND Abernethy malformation,also known as congenital extrahepatic portosystemic shunt,is an uncommon malformation resulting from aberrant development of the portal venous system.Cystic fibrosis(CF)is an autosomal recessive genetic disease caused by mutations in the CFTR gene.It mainly affects the exocrine glands of the respiratory,digestive and reproductive systems.It is considered extremely rare in the Asian population.We present a clinical case involving a pediatric patient of Asian descent who was diagnosed with Abernethy malformation and CF.CASE SUMMARY A 12-year-old girl presented with a medical history of recurring respiratory infections and hemoptysis,and chest computed tomography(CT)showed bronchiectasis.Whole exome sequencing was performed for the patient,yielding findings that revealed a compound heterozygous variant of the CFTR gene:c.233_c.234insT/p.Trp79fsTer3(maternal origin);c.2909G>A/p.Gly970Asp(paternal origin).CF was diagnosed.The physician’s attention was drawn to the presence of splenomegaly during disease progression.Abdominal enhanced CT revealed splenomegaly,compression of the left kidney,and multiple tortuous dilated vascular shadows were seen at the splenic hilum,which flowed back into the left renal vein and portal vein,suggesting Abernethy malformation type II.Intraoperatively,the abnormal blood flow was seen to merge into the inferior vena cava through the left renal vein without hepatic processing,and the pathology of liver biopsy showed hypoplastic,dilated or absent portal vein branches,both of which supported the diagnosis of Abernethy malformation type II.This represents the initial documented instance of Abernethy malformation accompanied by a CFTR gene mutation in the existing body of literature.CONCLUSION Coexisting Abernethy malformation and CF are rare.Detailed medical history information,abdominal enhanced CT,venography and genetic testing contribute to diagnosis as well as differential diagnosis.展开更多
Objective:This study aimed to design an evaluation scale of traditional Chinese medicine(TCM)confidence and then evaluate its validity and reliability.Methods:Three parallel samples with TCM learning experience were i...Objective:This study aimed to design an evaluation scale of traditional Chinese medicine(TCM)confidence and then evaluate its validity and reliability.Methods:Three parallel samples with TCM learning experience were included in this current study.Randomly selected 500 nursing students were included factor analysis and reliability and validity analyses.After 4 weeks,200 nursing students were recruited to retest the reliability.The evaluation tool of TCM confidence included 6 dimensions and 25 entries.Results:Cronbach's a coefficient of the evaluation scale was 0.95 and that of the 6 observed aspects were higher than 0.90,and splithalf reliability was 0.81.For the retest reliability,Cronbach's a coefficient of the evaluation scale was 0.93 and that of the 6 examined aspects was all over 0.80.The index of content validity Scale Content Validity Index(S-CVI)was 0.92 and Item Content Validity Index(I-CVI)was 0.83–1.00.Conclusions:Observed results may indicate that the designed tool can be used to assess the TCM confidence level of students with TCM studied experience and also can evaluate results of TCM education during studying TCM lectures.展开更多
The effect of hydraulic retention time (HRT) and pH on the biooxidation of ferrous iron during simulated acid mine drainage (AMD) treatment was investigated.The simulated AMD was highly acidic (pH 2.5), rich in iron (...The effect of hydraulic retention time (HRT) and pH on the biooxidation of ferrous iron during simulated acid mine drainage (AMD) treatment was investigated.The simulated AMD was highly acidic (pH 2.5), rich in iron (about 1700 mg/L) and copper (about 200 mg/L), and contained high concentrations of sulfate (about 4700 mg/L).The biooxidation of ferrous iron was studied in a laboratory-scale upflow packed bed bioreactor (PBR).The HRT was shortened stepwise from 40 h to 20 h, 13 h, and 8 h under the acidic environment at a pH value of 2.2.Then, the influent pH value was changed from 2.2 to 1.2 at a constant suitable HRT.Physiochemical and microbial community structure analyses were performed on water samples and stuffing collected from the bioreactor under different conditions.The results indicate that the efficiency of ferrous iron oxidation gradually decreased with the decrease of HRT, and when the HRT exceeded 13 h, ferrous iron in AMD was almost completely oxidized.In addition, the best efficiency of ferrous iron oxidation was achieved at the influent pH value of 1.8.Microbial community structure analyses show that Leptospirillum is the predominant genus attached in the bioreactor, and low influent pH values are suitable for the growth of Leptospirillum.展开更多
Pancreatic cancer(PC)is an aggressive human cancer.Appropriate methods for the diagnosis and treatment of PC have not been found at the genetic level,thus making epigenetics a promising research path in studies of PC....Pancreatic cancer(PC)is an aggressive human cancer.Appropriate methods for the diagnosis and treatment of PC have not been found at the genetic level,thus making epigenetics a promising research path in studies of PC.Histone methylation is one of the most complicated types of epigenetic modifications and has proved crucial in the development of PC.Histone methylation is a reversible process regulated by readers,writers,and erasers.Some writers and erasers can be recognized as potential biomarkers and candidate therapeutic targets in PC because of their unusual expression in PC cells compared with normal pancreatic cells.Based on the impact that writers have on the development of PC,some inhibitors of writers have been developed.However,few inhibitors of erasers have been developed and put to clinical use.Meanwhile,there is not enough research on the reader domains.Therefore,the study of erasers and readers is still a promising area.This review focuses on the regulatory mechanism of histone methylation,and the diagnosis and chemotherapy of PC based on it.The future of epigenetic modification in PC research is also discussed.展开更多
The potential use of al ogeneic islet transplantation in curing type 1 diabetes mel itus has been adequately demonstrated, but its large-scale application is limited by the short supply of donor islets and the need fo...The potential use of al ogeneic islet transplantation in curing type 1 diabetes mel itus has been adequately demonstrated, but its large-scale application is limited by the short supply of donor islets and the need for sustained and heavy immunosuppressive therapy. Encapsulation of pig islets was therefore suggested with a view to providing a possible alternative source of islet grafts and avoiding chronic immunosuppression and associated adverse or toxic effects. Nevertheless, several vital elements should be taken into account before this therapy becomes a clinical reality, including cell sources, encapsulation approaches, and implantation sites. This paper provides a comprehensive review of xenotransplantation of encapsulated pig islets for the treatment of type 1 diabetes mel itus, including current re-search findings and suggestions for future studies.展开更多
Different from the established trans-endo-selective cyclization of alkyne-tethered electrophiles that involve an E/Z isomerization process,herein,the authors present a novel strategy to allow trans-exo-selective aryla...Different from the established trans-endo-selective cyclization of alkyne-tethered electrophiles that involve an E/Z isomerization process,herein,the authors present a novel strategy to allow trans-exo-selective arylative cyclization of 1,6-enynes.Through initiation of rhodium(III)-catalyzed C-H activation,a diverse range of N-heterocyclic directing groups,including pyridine,pyrazole,imidazo[1,2-a]pyridine,benzoxazole,benzothiazole,and purine,was feasible for the cascade transformation,exhibiting high efficiency(up to 92%yield),broad substrate scope,and excellent functional group compatibility.Moreover,the modification of natural products and pharmaceutical compounds was also demonstrated to showcase its synthetic utility.Based on density functional theory(DFT)calculations,a key three-membered ring intermediate through the insertion relay,rather than the direct E/Z isomerization of alkenyl rhodium species,controlled the stereochemical outcome for this trans-exo-selective cyclization.The subsequent ring-opening protonation of the more favored rotamer led to exclusive trans-exo-selectivity.展开更多
The scission point model is improved by considering the excitation-dependent liquid drop model to calculate mass distributions for neutron-induced actinide nuclei fission.Excitation energy effects influence the deform...The scission point model is improved by considering the excitation-dependent liquid drop model to calculate mass distributions for neutron-induced actinide nuclei fission.Excitation energy effects influence the deformations of light and heavy fragments.The improved scission point model shows a significant advance with regard to accuracy for calculating pre-neutron-emission mass distributions of neutron-induced typical actinide fission with incident-neutron-energies up to 99.5 MeV.The theoretical frame assures that the improved scission point model is suitable for evaluating the fission fragment mass distributions,which will provide guidance for studying fission physics and designing nuclear fission engineering and nuclear transmutation systems.展开更多
An efficient and straightforward synthetic method has been developed for the preparation of 4-cyanofuran-3-carboxylate derivatives via iodine/potassium carbonate-promoted ring-opening/cyclization/rearrangement domino ...An efficient and straightforward synthetic method has been developed for the preparation of 4-cyanofuran-3-carboxylate derivatives via iodine/potassium carbonate-promoted ring-opening/cyclization/rearrangement domino reaction of 1-cyanocyclopropane-1-carboxylates,which are a wide range of structurally interesting and pharmacologically significant compounds.展开更多
基金the National Natural Science Foundation of China(81572975)Key Research and Devel-opment Project of Science and Technology Department of Zhejiang(2015C03053)+1 种基金Chen Xiao-Ping Foundation for the Development of Science and Technology of Hubei Province(CXPJJH11900009-07)Zhejiang Provincial Program for the Cultivation of High-level Innovative Health Talents.
文摘Background:Gallbladder carcinoma(GBC)is highly malignant,and its early diagnosis remains difficult.This study aimed to develop a deep learning model based on contrast-enhanced computed tomography(CT)images to assist radiologists in identifying GBC.Methods:We retrospectively enrolled 278 patients with gallbladder lesions(>10 mm)who underwent contrast-enhanced CT and cholecystectomy and divided them into the training(n=194)and validation(n=84)datasets.The deep learning model was developed based on ResNet50 network.Radiomics and clinical models were built based on support vector machine(SVM)method.We comprehensively compared the performance of deep learning,radiomics,clinical models,and three radiologists.Results:Three radiomics features including LoG_3.0 gray-level size zone matrix zone variance,HHL firstorder kurtosis,and LHL gray-level co-occurrence matrix dependence variance were significantly different between benign gallbladder lesions and GBC,and were selected for developing radiomics model.Multivariate regression analysis revealed that age≥65 years[odds ratios(OR)=4.4,95%confidence interval(CI):2.1-9.1,P<0.001],lesion size(OR=2.6,95%CI:1.6-4.1,P<0.001),and CA-19-9>37 U/mL(OR=4.0,95%CI:1.6-10.0,P=0.003)were significant clinical risk factors of GBC.The deep learning model achieved the area under the receiver operating characteristic curve(AUC)values of 0.864(95%CI:0.814-0.915)and 0.857(95%CI:0.773-0.942)in the training and validation datasets,which were comparable with radiomics,clinical models and three radiologists.The sensitivity of deep learning model was the highest both in the training[90%(95%CI:82%-96%)]and validation[85%(95%CI:68%-95%)]datasets.Conclusions:The deep learning model may be a useful tool for radiologists to distinguish between GBC and benign gallbladder lesions.
基金Supported by the 2020 National Natural Science Foundation Cultivation Project of Guizhou Medical University Affiliated Hospital,No.gyfynsfc[2020]-14.
文摘BACKGROUND Eosinophilic granulomatosis with polyangiitis(EGPA),formerly known as Churg-Strauss syndrome,is a rare form of anti-neutrophil cytoplasmic antibodyassociated vasculitis characterized by asthma,vasculitis,and eosinophilia.CASE SUMMARY We report an atypical case of EGPA in a 20-year-old female patient.Unlike previously reported cases of EGPA,this patient’s initial symptom was asthma associated with a respiratory infection.This was followed by Loeffler endocarditis and cardiac insufficiency.She received treatment with methylprednisolone sodium succinate,low molecular weight heparin,recombinant human brain natriuretic peptide,furosemide,cefoperazone sodium/sulbactam sodium,and acyclovir.Despite prophylactic anticoagulation,she developed a large right ventricular thrombus.EGPA diagnosis was confirmed based on ancillary test results and specialty consultations.Subsequent treatment included mycophenolate mofetil.Her overall condition improved significantly after treatment,as evidenced by decreased peripheral blood eosinophils and cardiac markers.She was discharged after 17 d.Her most recent follow-up showed normal peripheral blood eosinophil levels,restored cardiac function,and a reduced cardiac mural thrombus size.CONCLUSION This case illustrates the swift progression of EGPA and underscores the significance of early detection and immediate intervention to ensure a favorable prognosis.
文摘BACKGROUND Abernethy malformation,also known as congenital extrahepatic portosystemic shunt,is an uncommon malformation resulting from aberrant development of the portal venous system.Cystic fibrosis(CF)is an autosomal recessive genetic disease caused by mutations in the CFTR gene.It mainly affects the exocrine glands of the respiratory,digestive and reproductive systems.It is considered extremely rare in the Asian population.We present a clinical case involving a pediatric patient of Asian descent who was diagnosed with Abernethy malformation and CF.CASE SUMMARY A 12-year-old girl presented with a medical history of recurring respiratory infections and hemoptysis,and chest computed tomography(CT)showed bronchiectasis.Whole exome sequencing was performed for the patient,yielding findings that revealed a compound heterozygous variant of the CFTR gene:c.233_c.234insT/p.Trp79fsTer3(maternal origin);c.2909G>A/p.Gly970Asp(paternal origin).CF was diagnosed.The physician’s attention was drawn to the presence of splenomegaly during disease progression.Abdominal enhanced CT revealed splenomegaly,compression of the left kidney,and multiple tortuous dilated vascular shadows were seen at the splenic hilum,which flowed back into the left renal vein and portal vein,suggesting Abernethy malformation type II.Intraoperatively,the abnormal blood flow was seen to merge into the inferior vena cava through the left renal vein without hepatic processing,and the pathology of liver biopsy showed hypoplastic,dilated or absent portal vein branches,both of which supported the diagnosis of Abernethy malformation type II.This represents the initial documented instance of Abernethy malformation accompanied by a CFTR gene mutation in the existing body of literature.CONCLUSION Coexisting Abernethy malformation and CF are rare.Detailed medical history information,abdominal enhanced CT,venography and genetic testing contribute to diagnosis as well as differential diagnosis.
文摘Objective:This study aimed to design an evaluation scale of traditional Chinese medicine(TCM)confidence and then evaluate its validity and reliability.Methods:Three parallel samples with TCM learning experience were included in this current study.Randomly selected 500 nursing students were included factor analysis and reliability and validity analyses.After 4 weeks,200 nursing students were recruited to retest the reliability.The evaluation tool of TCM confidence included 6 dimensions and 25 entries.Results:Cronbach's a coefficient of the evaluation scale was 0.95 and that of the 6 observed aspects were higher than 0.90,and splithalf reliability was 0.81.For the retest reliability,Cronbach's a coefficient of the evaluation scale was 0.93 and that of the 6 examined aspects was all over 0.80.The index of content validity Scale Content Validity Index(S-CVI)was 0.92 and Item Content Validity Index(I-CVI)was 0.83–1.00.Conclusions:Observed results may indicate that the designed tool can be used to assess the TCM confidence level of students with TCM studied experience and also can evaluate results of TCM education during studying TCM lectures.
基金supported by the National Natural Science Foundation of China(Grant No.U1402234)the Guangxi Scientific Research and Technology Development Plan(Grants No.GuikeAB16380287 and GuikeAB17129025)+2 种基金the Public Welfare Fund of the Ministry of Environmental Protection of China(Grant No.201509049)the Program of International S & T Cooperation(Grant No.2016YFE0130700)the Fund of the General Research Institute for Nonferrous Metals(Grants No.53321 and 53348)
文摘The effect of hydraulic retention time (HRT) and pH on the biooxidation of ferrous iron during simulated acid mine drainage (AMD) treatment was investigated.The simulated AMD was highly acidic (pH 2.5), rich in iron (about 1700 mg/L) and copper (about 200 mg/L), and contained high concentrations of sulfate (about 4700 mg/L).The biooxidation of ferrous iron was studied in a laboratory-scale upflow packed bed bioreactor (PBR).The HRT was shortened stepwise from 40 h to 20 h, 13 h, and 8 h under the acidic environment at a pH value of 2.2.Then, the influent pH value was changed from 2.2 to 1.2 at a constant suitable HRT.Physiochemical and microbial community structure analyses were performed on water samples and stuffing collected from the bioreactor under different conditions.The results indicate that the efficiency of ferrous iron oxidation gradually decreased with the decrease of HRT, and when the HRT exceeded 13 h, ferrous iron in AMD was almost completely oxidized.In addition, the best efficiency of ferrous iron oxidation was achieved at the influent pH value of 1.8.Microbial community structure analyses show that Leptospirillum is the predominant genus attached in the bioreactor, and low influent pH values are suitable for the growth of Leptospirillum.
文摘Pancreatic cancer(PC)is an aggressive human cancer.Appropriate methods for the diagnosis and treatment of PC have not been found at the genetic level,thus making epigenetics a promising research path in studies of PC.Histone methylation is one of the most complicated types of epigenetic modifications and has proved crucial in the development of PC.Histone methylation is a reversible process regulated by readers,writers,and erasers.Some writers and erasers can be recognized as potential biomarkers and candidate therapeutic targets in PC because of their unusual expression in PC cells compared with normal pancreatic cells.Based on the impact that writers have on the development of PC,some inhibitors of writers have been developed.However,few inhibitors of erasers have been developed and put to clinical use.Meanwhile,there is not enough research on the reader domains.Therefore,the study of erasers and readers is still a promising area.This review focuses on the regulatory mechanism of histone methylation,and the diagnosis and chemotherapy of PC based on it.The future of epigenetic modification in PC research is also discussed.
基金Project supported by the National Natural Science Foundation of China(No.30700772)
文摘The potential use of al ogeneic islet transplantation in curing type 1 diabetes mel itus has been adequately demonstrated, but its large-scale application is limited by the short supply of donor islets and the need for sustained and heavy immunosuppressive therapy. Encapsulation of pig islets was therefore suggested with a view to providing a possible alternative source of islet grafts and avoiding chronic immunosuppression and associated adverse or toxic effects. Nevertheless, several vital elements should be taken into account before this therapy becomes a clinical reality, including cell sources, encapsulation approaches, and implantation sites. This paper provides a comprehensive review of xenotransplantation of encapsulated pig islets for the treatment of type 1 diabetes mel itus, including current re-search findings and suggestions for future studies.
基金Financial support was generously provided by the National Natural Science Foundation of China(nos.21871184,21871284,21702182,and 21873081),the Shanghai Municipal Education Commission(no.2019-01-07-00-10-E00072),the Science and Technology Commission of Shanghai Municipality(no.18401933500),the Strategic Priority Research Program of the Chinese Academy of Sciences(no.XDB 20020100),the Key Research Program of Frontier Science(no.QYZDYSSW-SLH026),the Fundamental Research Funds for the Central Universities(no.2019QNA3009),and the China Postdoctoral Science Foundation(no.2018M640546).Calculations were performed on the high-performance computing system at the Department of Chemistry,Zhejiang University.The authors thank Jie Sun(Shanghai Institute of Organic Chemistry)for X-ray crystallographic analysis.
文摘Different from the established trans-endo-selective cyclization of alkyne-tethered electrophiles that involve an E/Z isomerization process,herein,the authors present a novel strategy to allow trans-exo-selective arylative cyclization of 1,6-enynes.Through initiation of rhodium(III)-catalyzed C-H activation,a diverse range of N-heterocyclic directing groups,including pyridine,pyrazole,imidazo[1,2-a]pyridine,benzoxazole,benzothiazole,and purine,was feasible for the cascade transformation,exhibiting high efficiency(up to 92%yield),broad substrate scope,and excellent functional group compatibility.Moreover,the modification of natural products and pharmaceutical compounds was also demonstrated to showcase its synthetic utility.Based on density functional theory(DFT)calculations,a key three-membered ring intermediate through the insertion relay,rather than the direct E/Z isomerization of alkenyl rhodium species,controlled the stereochemical outcome for this trans-exo-selective cyclization.The subsequent ring-opening protonation of the more favored rotamer led to exclusive trans-exo-selectivity.
基金the NSFC-Nuclear Technology Innovation Joint Fund(U1867213)the NSAF(U1830102)+1 种基金the National Natural Science Foundations of China(12075105,11705071,11875155)the Fundamental Research Funds for the Central Universities(lzujbky-2021-kb09)。
文摘The scission point model is improved by considering the excitation-dependent liquid drop model to calculate mass distributions for neutron-induced actinide nuclei fission.Excitation energy effects influence the deformations of light and heavy fragments.The improved scission point model shows a significant advance with regard to accuracy for calculating pre-neutron-emission mass distributions of neutron-induced typical actinide fission with incident-neutron-energies up to 99.5 MeV.The theoretical frame assures that the improved scission point model is suitable for evaluating the fission fragment mass distributions,which will provide guidance for studying fission physics and designing nuclear fission engineering and nuclear transmutation systems.
基金Financial support of this research by the National Natural Science Foundation of China (NSFC No. 21173181) is gratefully acknowledged by authorsfunded by the Priority Academic Program Development of Jiangsu Higher Education Institutions
文摘An efficient and straightforward synthetic method has been developed for the preparation of 4-cyanofuran-3-carboxylate derivatives via iodine/potassium carbonate-promoted ring-opening/cyclization/rearrangement domino reaction of 1-cyanocyclopropane-1-carboxylates,which are a wide range of structurally interesting and pharmacologically significant compounds.
