A comparative study of two force perception skill learning approaches for robot‐assisted spinal surgery,the impedance model method and the imitation learning(IL)method,is presented.The impedance model method develops...A comparative study of two force perception skill learning approaches for robot‐assisted spinal surgery,the impedance model method and the imitation learning(IL)method,is presented.The impedance model method develops separate models for the surgeon and patient,incorporating spring‐damper and bone‐grinding models.Expert surgeons'feature parameters are collected and mapped using support vector regression and image navi-gation techniques.The imitation learning approach utilises long short‐term memory networks(LSTM)and addresses accurate data labelling challenges with custom models.Experimental results demonstrate skill recognition rates of 63.61%-74.62%for the impedance model approach,relying on manual feature extraction.Conversely,the imitation learning approach achieves a force perception recognition rate of 91.06%,outperforming the impedance model on curved bone surfaces.The findings demonstrate the potential of imitation learning to enhance skill acquisition in robot‐assisted spinal surgery by eliminating the laborious process of manual feature extraction.展开更多
Objective:To provide real-world evidence for the application of first-line dacomitinib treatment for epidermal growth factor receptor(EGFR)21L858R mutant non-small cell lung cancer(NSCLC)patients in China and to explo...Objective:To provide real-world evidence for the application of first-line dacomitinib treatment for epidermal growth factor receptor(EGFR)21L858R mutant non-small cell lung cancer(NSCLC)patients in China and to explore the factors influencing the efficacy and safety.Methods:A longitudinal,consecutive case-series,multicenter study with mixed prospective and retrospective data was conducted.The primary endpoint was progression-free survival(PFS),and the secondary endpoints included duration of treatment(DOT),overall survival(OS),objective response rate(ORR),disease control rate(DCR)and safety.Results:A total of 155 EGFR 21L858R mutant patients treated with first-line dacomitinib were included.The median follow-up time for these patients was 20.4 months.Among 134 patients with evaluable lesions,the ORR was 70.9%and the DCR was 96.3%.The median PFS was 16.3[95%confidence interval(95%CI),13.7−18.9]months.Multivariate Cox regression analysis suggested that the baseline brain metastasis(BM)status[with vs.without BM:hazard ratio(HR),1.331;95%CI,0.720−2.458;P=0.361]and initial doses(45 mg vs.30 mg:HR,0.837;95%CI,0.427−1.641;P=0.604)did not significantly affect the median PFS.The median DOT was 21.0(95%CI,17.5−24.6)months and the median OS was not reached.Genetic tests were performed in 64 patients after progression,among whom 29(45.3%)patients developed the EGFR 20T790M mutation.In addition,among the 46 patients who discontinued dacomitinib treatment after progression,31(67.4%)patients received subsequent third-generation EGFR-tyrosine kinase inhibitors.The most common grade 3−4 adverse events were rash(10.4%),diarrhea(9.1%),stomatitis(7.1%)and paronychia(4.5%).The incidence of grade 3−4 rash was significantly higher in the 45 mg group than that in the 30 mg group(21.9%vs.7.5%,P=0.042).Conclusions:First-line dacomitinib treatment demonstrated promising efficacy and tolerable adverse events among EGFR 21L858R mutant NSCLC patients in China.展开更多
Lung cancer is the top cause of cancer deaths globally.Advances in immune checkpoint inhibitors(ICIs)have transformed cancer treatment,but their use in lung cancer has led to more side effects.This study examined if p...Lung cancer is the top cause of cancer deaths globally.Advances in immune checkpoint inhibitors(ICIs)have transformed cancer treatment,but their use in lung cancer has led to more side effects.This study examined if past pulmonary tuberculosis(TB)affects ICIs’effectiveness and safety in lung cancer treatment.We reviewed lung cancer patients treated with ICIs at Beijing Chest Hospital from January 2019 to August 2022.展开更多
AIM： To explore the molecular events taking place during human colon cancer development and progression through high-throughput tissue microarray analysis. METHODS： We constructed two separate tissue microarrays con...AIM： To explore the molecular events taking place during human colon cancer development and progression through high-throughput tissue microarray analysis. METHODS： We constructed two separate tissue microarrays containing 1.0 mm or 1.5 mm cylindrical samples acquired from 112 formalin-fixed and paraffinembedded blocks, including carcinomas （n = 85）, adenomatous polyps （n = 18）, as well as normal paracancerous colon tissues （n = 9）. Immunohistochemical staining was applied to the analysis of the consecutive tissue microarray sections with antibodies for 11 different proteins, including p53, p21, bcl-2, bax, cyclin D1, PTEN, p-Aktl, β-catenin, c-myc, nm23-h1 and Cox-2. RESULTS： The protein expressions of p53, bcl-2, bax, cyclin D1, β-catenin, c-myc, Cox-2 and nm23-h1 varied significantly among tissues from cancer, adenomatous polyps and normal colon mucosa （P = 0.003, P = 0.001, P = 0.000, P = 0.000, P = 0.034, P = 0.003, P = 0.002, and P = 0.007, respectively）. Chi-square analysis showed that the statistically significant variables were p53, p21, bax, β-catenin, c-myc, PTEN, p-Aktl, Cox-2 and nm23-h1 for histological grade （P = 0.005, P = 0.013, P = 0.044, P = 0.000, P = 0.000, P = 0.029, P = 0.000, P = 0.008, and P = 0.000, respectively）, β-catenin, comyc and p-Akt1 for lymph node metastasis （P = 0.011, P =0.005, and P = 0.032, respectively）, β-catenin, c-myc, Cox-2 and nm23-h1 for distance metastasis （P = 0.020, P = 0.000, P = 0.026, and P = 0.008, respectively）, and cyclin D1, β-catenin, c-myc, Cox-2 and nm23h1 for clinical stages （P = 0.038, P = 0.008, P = 0.000, P = 0.016, and P = 0.014, respectively）. CONCLUSION： Tissue microarray immunohistochemical staining enables high-throughput analysis of genetic alterations contributing to human colon cancer development and progression. Our results implicate the potential roles of p53, cyclin D1, bcl-2, bax, Cox-2, β-catenin and c-myc in development of human colon cancer and that of bcl-2, nm23-h1, PTEN and p-Akt1 in progression of human colon cancer.展开更多
In real life,a large amount of data describing the same learning task may be stored in different institutions(called participants),and these data cannot be shared among par-ticipants due to privacy protection.The case...In real life,a large amount of data describing the same learning task may be stored in different institutions(called participants),and these data cannot be shared among par-ticipants due to privacy protection.The case that different attributes/features of the same instance are stored in different institutions is called vertically distributed data.The pur-pose of vertical‐federated feature selection(FS)is to reduce the feature dimension of vertical distributed data jointly without sharing local original data so that the feature subset obtained has the same or better performance as the original feature set.To solve this problem,in the paper,an embedded vertical‐federated FS algorithm based on particle swarm optimisation(PSO‐EVFFS)is proposed by incorporating evolutionary FS into the SecureBoost framework for the first time.By optimising both hyper‐parameters of the XGBoost model and feature subsets,PSO‐EVFFS can obtain a feature subset,which makes the XGBoost model more accurate.At the same time,since different participants only share insensitive parameters such as model loss function,PSO‐EVFFS can effec-tively ensure the privacy of participants'data.Moreover,an ensemble ranking strategy of feature importance based on the XGBoost tree model is developed to effectively remove irrelevant features on each participant.Finally,the proposed algorithm is applied to 10 test datasets and compared with three typical vertical‐federated learning frameworks and two variants of the proposed algorithm with different initialisation strategies.Experi-mental results show that the proposed algorithm can significantly improve the classifi-cation performance of selected feature subsets while fully protecting the data privacy of all participants.展开更多
Immune checkpoint blockade(ICB)has achieved durable clinical responses and has significantly improved the overall survival of cancer patients1.Among the ICB agents,programmed death 1(PD-1)/programmed death ligand 1(PD...Immune checkpoint blockade(ICB)has achieved durable clinical responses and has significantly improved the overall survival of cancer patients1.Among the ICB agents,programmed death 1(PD-1)/programmed death ligand 1(PD-L1)antibodies are used to treat various human tumors by blocking PD-1/PD-L1 signaling.Impressive response rates with low autoimmune toxicity have been reported in 20%–30%of non-selected patients1;however,most patients fail to respond to PD-1/PD-L1 blockade or acquire resistance during therapy through unknown mechanisms1.展开更多
Vertebral lamina milling task is one of the high-risk operations in spinal surgeries. The operation is to remove part of vertebral lamina and release the pressure on the spinal nerve. Because many important vessels an...Vertebral lamina milling task is one of the high-risk operations in spinal surgeries. The operation is to remove part of vertebral lamina and release the pressure on the spinal nerve. Because many important vessels and nerves are under the vertebral lamina, any incorrect operation may cause irreparable damage to patients. To improve the safety of lamina milling task, a fuzzy force control strategy is proposed in this paper. Primary experiments have been conducted on bone samples from different animals. The results show that, with the fuzzy force control strategy, the bone milling system can recognize all surgery states and halt the tool at the proper location, achieving satisfactory surgery performance.展开更多
In some complicated tabletop object manipulation task for robotic system, demonstration based control is an efficient way to enhance the stability of execution. In this paper, we use a new optical hand tracking sensor...In some complicated tabletop object manipulation task for robotic system, demonstration based control is an efficient way to enhance the stability of execution. In this paper, we use a new optical hand tracking sensor, LeapMotion, to perform a non-contact demonstration for robotic systems. A Multi-LeapMotion hand tracking system is developed. The setup of the two sensors is analyzed to gain a optimal way for efficiently use the informations from the two sensors. Meanwhile, the coordinate systems of the Mult-LeapMotion hand tracking device and the robotic demonstration system are developed. With the recognition to the element actions and the delay calibration, the fusion principles are developed to get the improved and corrected gesture recognition. The gesture recognition and scenario experiments are carried out, and indicate the improvement of the proposed Multi-LeapMotion hand tracking system in tabletop object manipulation task for robotic demonstration.展开更多
AIM:To study the HER-2/neu protein expression and gene amplification in gastric carcinoma and their relation.METHODS:One hundred and forty-five formalin-fixed and paraffin-embedded tumor tissue samples from Chinese ga...AIM:To study the HER-2/neu protein expression and gene amplification in gastric carcinoma and their relation.METHODS:One hundred and forty-five formalin-fixed and paraffin-embedded tumor tissue samples from Chinese gastric carcinoma patients were studied with immunohistochemistry(IHC)and fluorescence in situ hybridization(FISH)methods.Clinicopathologic data about all patients were collected.RESULTS:The levels of HER-2 3+,HER-2 2+and HER21+were measurable in 6.9%,8.3%and 17.2%of the samples,respectively.No HER-2 was stained in 67.6% of the samples.FISH showed that HER-2 gene was amplified in 18 samples,10 HER-2 3+samples,5 HER-2 2+samples,and 3 HER-2 1+samples with IHC staining.HER-2 status was not correlated with the sex and age of patients,and tumor size,location or differentiation,but with the depth of invasion,TNM stage,lymph node and distant metastasis as well as histopathological classification of gastric cancer(P<0.05).CONCLUSION:All samples with IHC as HER-2 expression should be analyzed with FISH.Detection of HER-2 gene amplification can assess the malignant biological behaviors and prognosis of gastric cancer.展开更多
Objective：The programmed cell death-1 receptor/programmed cell death-1 ligand （PD-1/PD-L1） pathway plays a crucial role in tumor evasion from host immunity.This study was designed to evaluate the association betwee...Objective：The programmed cell death-1 receptor/programmed cell death-1 ligand （PD-1/PD-L1） pathway plays a crucial role in tumor evasion from host immunity.This study was designed to evaluate the association between circulating PD-L1 expression and prognosis in patients with advanced gastric cancer.Methods：Totally 80 advanced gastric cancer patients and 40 health controls from Beijing Cancer Hospital were enrolled in the present study.Circulating PD-L1 expression was tested by enzymelinked immunosorbent assay （ELISA）.The associations between the expression level of PD-L1 and clinicopathological features and prognosis were analyzed statistically.Results：Expression of PD-L1 in advanced gastric cancer patients was significandy up-regulated compared with health people （P=0.006）.The expression of PD-L1 was significantly correlated with differentiation and lymph node metastasis （P=0.026 and P=0.041,respectively）.Although we didn＇t find significant difference in all advanced gastric cancer patients with different PD-L1 expression,the adenocarcinoma patients with higher up-regulated PD-L1 expression had much better prognosis than low expression patients （65.6％ vs.44.7％,P=0.028）.Conclusions：PD-L1 was elevated in advance gastric cancer patients and may play an important role in tumor immune evasion and patients prognosis.展开更多
基金National Key Research and Development Program of China,Grant/Award Number:2022YFB4700701National Natural Science Foundation of China,Grant/Award Numbers:52375035,U21A20489+1 种基金CAMS Innovation Fund for Medical Sciences,Grant/Award Number:2022‐I2M‐C&T‐A‐005Shenzhen Science and Technology Program,Grant/Award Numbers:JSGG20220831100202004,JCYJ20220818101412026。
文摘A comparative study of two force perception skill learning approaches for robot‐assisted spinal surgery,the impedance model method and the imitation learning(IL)method,is presented.The impedance model method develops separate models for the surgeon and patient,incorporating spring‐damper and bone‐grinding models.Expert surgeons'feature parameters are collected and mapped using support vector regression and image navi-gation techniques.The imitation learning approach utilises long short‐term memory networks(LSTM)and addresses accurate data labelling challenges with custom models.Experimental results demonstrate skill recognition rates of 63.61%-74.62%for the impedance model approach,relying on manual feature extraction.Conversely,the imitation learning approach achieves a force perception recognition rate of 91.06%,outperforming the impedance model on curved bone surfaces.The findings demonstrate the potential of imitation learning to enhance skill acquisition in robot‐assisted spinal surgery by eliminating the laborious process of manual feature extraction.
文摘Objective:To provide real-world evidence for the application of first-line dacomitinib treatment for epidermal growth factor receptor(EGFR)21L858R mutant non-small cell lung cancer(NSCLC)patients in China and to explore the factors influencing the efficacy and safety.Methods:A longitudinal,consecutive case-series,multicenter study with mixed prospective and retrospective data was conducted.The primary endpoint was progression-free survival(PFS),and the secondary endpoints included duration of treatment(DOT),overall survival(OS),objective response rate(ORR),disease control rate(DCR)and safety.Results:A total of 155 EGFR 21L858R mutant patients treated with first-line dacomitinib were included.The median follow-up time for these patients was 20.4 months.Among 134 patients with evaluable lesions,the ORR was 70.9%and the DCR was 96.3%.The median PFS was 16.3[95%confidence interval(95%CI),13.7−18.9]months.Multivariate Cox regression analysis suggested that the baseline brain metastasis(BM)status[with vs.without BM:hazard ratio(HR),1.331;95%CI,0.720−2.458;P=0.361]and initial doses(45 mg vs.30 mg:HR,0.837;95%CI,0.427−1.641;P=0.604)did not significantly affect the median PFS.The median DOT was 21.0(95%CI,17.5−24.6)months and the median OS was not reached.Genetic tests were performed in 64 patients after progression,among whom 29(45.3%)patients developed the EGFR 20T790M mutation.In addition,among the 46 patients who discontinued dacomitinib treatment after progression,31(67.4%)patients received subsequent third-generation EGFR-tyrosine kinase inhibitors.The most common grade 3−4 adverse events were rash(10.4%),diarrhea(9.1%),stomatitis(7.1%)and paronychia(4.5%).The incidence of grade 3−4 rash was significantly higher in the 45 mg group than that in the 30 mg group(21.9%vs.7.5%,P=0.042).Conclusions:First-line dacomitinib treatment demonstrated promising efficacy and tolerable adverse events among EGFR 21L858R mutant NSCLC patients in China.
基金supported by the Beijing Hospitals Authority Clinical Medicine Development of Special Funding(ZYLX202122)Beijing Key Clinical Specialty Project(20201214)+1 种基金Tongzhou Lianggao Talents Project(No.YHLJ202005)Beijing Nova Program(20220484169&20230484295).
文摘Lung cancer is the top cause of cancer deaths globally.Advances in immune checkpoint inhibitors(ICIs)have transformed cancer treatment,but their use in lung cancer has led to more side effects.This study examined if past pulmonary tuberculosis(TB)affects ICIs’effectiveness and safety in lung cancer treatment.We reviewed lung cancer patients treated with ICIs at Beijing Chest Hospital from January 2019 to August 2022.
基金Supported by grant from the National 863 Project about Functional Genomic and Biochip, No. 2002AA2Z2021 and 135 Medical Important Talent Foundation of Jiangsu Province, No. 37RC2002037
文摘AIM： To explore the molecular events taking place during human colon cancer development and progression through high-throughput tissue microarray analysis. METHODS： We constructed two separate tissue microarrays containing 1.0 mm or 1.5 mm cylindrical samples acquired from 112 formalin-fixed and paraffinembedded blocks, including carcinomas （n = 85）, adenomatous polyps （n = 18）, as well as normal paracancerous colon tissues （n = 9）. Immunohistochemical staining was applied to the analysis of the consecutive tissue microarray sections with antibodies for 11 different proteins, including p53, p21, bcl-2, bax, cyclin D1, PTEN, p-Aktl, β-catenin, c-myc, nm23-h1 and Cox-2. RESULTS： The protein expressions of p53, bcl-2, bax, cyclin D1, β-catenin, c-myc, Cox-2 and nm23-h1 varied significantly among tissues from cancer, adenomatous polyps and normal colon mucosa （P = 0.003, P = 0.001, P = 0.000, P = 0.000, P = 0.034, P = 0.003, P = 0.002, and P = 0.007, respectively）. Chi-square analysis showed that the statistically significant variables were p53, p21, bax, β-catenin, c-myc, PTEN, p-Aktl, Cox-2 and nm23-h1 for histological grade （P = 0.005, P = 0.013, P = 0.044, P = 0.000, P = 0.000, P = 0.029, P = 0.000, P = 0.008, and P = 0.000, respectively）, β-catenin, comyc and p-Akt1 for lymph node metastasis （P = 0.011, P =0.005, and P = 0.032, respectively）, β-catenin, c-myc, Cox-2 and nm23-h1 for distance metastasis （P = 0.020, P = 0.000, P = 0.026, and P = 0.008, respectively）, and cyclin D1, β-catenin, c-myc, Cox-2 and nm23h1 for clinical stages （P = 0.038, P = 0.008, P = 0.000, P = 0.016, and P = 0.014, respectively）. CONCLUSION： Tissue microarray immunohistochemical staining enables high-throughput analysis of genetic alterations contributing to human colon cancer development and progression. Our results implicate the potential roles of p53, cyclin D1, bcl-2, bax, Cox-2, β-catenin and c-myc in development of human colon cancer and that of bcl-2, nm23-h1, PTEN and p-Akt1 in progression of human colon cancer.
基金supported by the two funding sources:Scientific Innovation 2030 Major Project for New Generation of AI,Ministry of Science and Technology of the Peoples Republic of China(2020AAA0107300)National Natural Science Foundation of China(62133015).
文摘In real life,a large amount of data describing the same learning task may be stored in different institutions(called participants),and these data cannot be shared among par-ticipants due to privacy protection.The case that different attributes/features of the same instance are stored in different institutions is called vertically distributed data.The pur-pose of vertical‐federated feature selection(FS)is to reduce the feature dimension of vertical distributed data jointly without sharing local original data so that the feature subset obtained has the same or better performance as the original feature set.To solve this problem,in the paper,an embedded vertical‐federated FS algorithm based on particle swarm optimisation(PSO‐EVFFS)is proposed by incorporating evolutionary FS into the SecureBoost framework for the first time.By optimising both hyper‐parameters of the XGBoost model and feature subsets,PSO‐EVFFS can obtain a feature subset,which makes the XGBoost model more accurate.At the same time,since different participants only share insensitive parameters such as model loss function,PSO‐EVFFS can effec-tively ensure the privacy of participants'data.Moreover,an ensemble ranking strategy of feature importance based on the XGBoost tree model is developed to effectively remove irrelevant features on each participant.Finally,the proposed algorithm is applied to 10 test datasets and compared with three typical vertical‐federated learning frameworks and two variants of the proposed algorithm with different initialisation strategies.Experi-mental results show that the proposed algorithm can significantly improve the classifi-cation performance of selected feature subsets while fully protecting the data privacy of all participants.
基金supported by the National Nature Science Foundation(Grant Nos.82150115,82025027,and 32000517)the National Key R&D Program of China(Grant No.2022YFA1105200).
文摘Immune checkpoint blockade(ICB)has achieved durable clinical responses and has significantly improved the overall survival of cancer patients1.Among the ICB agents,programmed death 1(PD-1)/programmed death ligand 1(PD-L1)antibodies are used to treat various human tumors by blocking PD-1/PD-L1 signaling.Impressive response rates with low autoimmune toxicity have been reported in 20%–30%of non-selected patients1;however,most patients fail to respond to PD-1/PD-L1 blockade or acquire resistance during therapy through unknown mechanisms1.
文摘Vertebral lamina milling task is one of the high-risk operations in spinal surgeries. The operation is to remove part of vertebral lamina and release the pressure on the spinal nerve. Because many important vessels and nerves are under the vertebral lamina, any incorrect operation may cause irreparable damage to patients. To improve the safety of lamina milling task, a fuzzy force control strategy is proposed in this paper. Primary experiments have been conducted on bone samples from different animals. The results show that, with the fuzzy force control strategy, the bone milling system can recognize all surgery states and halt the tool at the proper location, achieving satisfactory surgery performance.
基金This research is funded by National Natural Science Foundation of China under Project no. 61210013, Science and Technology Planning Project of Guangdong Province under no. 2014A020215027.
文摘In some complicated tabletop object manipulation task for robotic system, demonstration based control is an efficient way to enhance the stability of execution. In this paper, we use a new optical hand tracking sensor, LeapMotion, to perform a non-contact demonstration for robotic systems. A Multi-LeapMotion hand tracking system is developed. The setup of the two sensors is analyzed to gain a optimal way for efficiently use the informations from the two sensors. Meanwhile, the coordinate systems of the Mult-LeapMotion hand tracking device and the robotic demonstration system are developed. With the recognition to the element actions and the delay calibration, the fusion principles are developed to get the improved and corrected gesture recognition. The gesture recognition and scenario experiments are carried out, and indicate the improvement of the proposed Multi-LeapMotion hand tracking system in tabletop object manipulation task for robotic demonstration.
基金Supported by National Natural Science Foundation of China, No.81071888
文摘AIM:To study the HER-2/neu protein expression and gene amplification in gastric carcinoma and their relation.METHODS:One hundred and forty-five formalin-fixed and paraffin-embedded tumor tissue samples from Chinese gastric carcinoma patients were studied with immunohistochemistry(IHC)and fluorescence in situ hybridization(FISH)methods.Clinicopathologic data about all patients were collected.RESULTS:The levels of HER-2 3+,HER-2 2+and HER21+were measurable in 6.9%,8.3%and 17.2%of the samples,respectively.No HER-2 was stained in 67.6% of the samples.FISH showed that HER-2 gene was amplified in 18 samples,10 HER-2 3+samples,5 HER-2 2+samples,and 3 HER-2 1+samples with IHC staining.HER-2 status was not correlated with the sex and age of patients,and tumor size,location or differentiation,but with the depth of invasion,TNM stage,lymph node and distant metastasis as well as histopathological classification of gastric cancer(P<0.05).CONCLUSION:All samples with IHC as HER-2 expression should be analyzed with FISH.Detection of HER-2 gene amplification can assess the malignant biological behaviors and prognosis of gastric cancer.
文摘Objective：The programmed cell death-1 receptor/programmed cell death-1 ligand （PD-1/PD-L1） pathway plays a crucial role in tumor evasion from host immunity.This study was designed to evaluate the association between circulating PD-L1 expression and prognosis in patients with advanced gastric cancer.Methods：Totally 80 advanced gastric cancer patients and 40 health controls from Beijing Cancer Hospital were enrolled in the present study.Circulating PD-L1 expression was tested by enzymelinked immunosorbent assay （ELISA）.The associations between the expression level of PD-L1 and clinicopathological features and prognosis were analyzed statistically.Results：Expression of PD-L1 in advanced gastric cancer patients was significandy up-regulated compared with health people （P=0.006）.The expression of PD-L1 was significantly correlated with differentiation and lymph node metastasis （P=0.026 and P=0.041,respectively）.Although we didn＇t find significant difference in all advanced gastric cancer patients with different PD-L1 expression,the adenocarcinoma patients with higher up-regulated PD-L1 expression had much better prognosis than low expression patients （65.6％ vs.44.7％,P=0.028）.Conclusions：PD-L1 was elevated in advance gastric cancer patients and may play an important role in tumor immune evasion and patients prognosis.
