AIM To compare intravoxel incoherent motion(IVIM)-derived parameters with conventional diffusion-weighted imaging(DWI) parameters in predicting the histological grade of hepatocellular carcinoma(h CC) and to evaluate ...AIM To compare intravoxel incoherent motion(IVIM)-derived parameters with conventional diffusion-weighted imaging(DWI) parameters in predicting the histological grade of hepatocellular carcinoma(h CC) and to evaluate the correlation between the parameters and the histological grades.METHODS A retrospective study was performed. Sixty-two patients with surgically confirmed h CCs underwent diffusion-weighted magnetic resonance imaging with twelve b values(10-1200 s/mm^2). The apparent diffusion coefficient(ADC), pure diffusion coefficient(D), pseudo-diffusion coefficient(D*), and perfusion fraction(f) were calculated by two radiologists. The IVIM and conventional DWI parameters were compared among the different grades by using analysis of variance(ANOVA) and the Kruskal-Wallis test. Receiver operating characteristic(ROC) analysis was performed to evaluate the diagnostic efficiency of distinguishing between low-grade(grade 1, G1) and high-grade(grades 2 and 3, G2 and G3) hC C. The correlation between the parameters and the histological grades was assessed by using the Spearman correlation test. Bland-Altman analysis was used to evaluate the reproducibility of the two radiologists' measurements.RESULTS The differences in the ADC and D values among the groups with G1, G2, and G3 histological grades of HCCs were statistically significant(P < 0.001). The D* and f values had no significant differences among the different histological grades of h CC(P > 0.05). The ROC analyses demonstrated that the D and ADC values had better diagnostic performance in differentiating the low-grade h CC from the high-grade h CC, with areas under the curve(AUCs) of 0.909 and 0.843, respectively, measured by radiologist 1 and of 0.911 and 0.852, respectively, measured by radiologist 2. The following significant correlations were obtained between the ADC, D, and D~* values and the histological grades: r =-0.619(P < 0.001), r =-0.628(P < 0.001), and r =-0.299(P = 0.018), respectively, as measured by radiologist 1; r =-0.622(P < 0.001), r =-0.633(P < 0.001), and r =-0.303(P = 0.017), respectively, as measured by radiologist 2. The intra-class correlation coefficient(ICC) values between the two observers were 0.996 for ADC, 0.997 for D, 0.996 for D*, and 0.992 for f values, which indicated excellent interobserver agreement in the measurements between the two observers.CONCLUSION The IVIM-derived D and ADC values show better diagnostic performance in differentiating high-grade hC C from low-grade hC C, and there is a moderate to good correlation between the ADC and D values and the histological grades.展开更多
AIM To investigate the importance of a three-tiered histologic grade on outcomes for patients with mucinous appendiceal adenocarcinoma(MAA).METHODS Two hundred and sixty-five patients with MAA undergoing cytoreductive...AIM To investigate the importance of a three-tiered histologic grade on outcomes for patients with mucinous appendiceal adenocarcinoma(MAA).METHODS Two hundred and sixty-five patients with MAA undergoing cytoreductive surgery and hyperthermic intraperitoneal chemotherapy were identified from a prospective database from 2004 through 2014. All pathology was reviewed by our gastrointestinal subspecialty pathologists and histological grade was classified as well-differentiated, moderately differentiated, and poorly differentiated. Survival analysis was performed using Cox proportional hazards regression.RESULTS There were 201(75.8%) well-, 45(16.9%) moderatelyand 19(7.2%) poorly-differentiated tumors. Histological grade significantly stratified the 5-year overall survival(OS), 94%, 71% and 30% respectively(P < 0.001) as well as the 5-year disease-free survival(DFS) 66%, 21% and 0%, respectively(P < 0.001). Independent predictors of DFS included tumor grade(HR = 1.78, 95%CI: 1.21-2.63, P = 0.008), lymph node involvement(HR = 0.33, 95%CI: 0.11-0.98, P < 0.02), previous surgical score(HR = 1.31, 95%CI: 1.1-1.65, P = 0.03) and peritoneal carcinomatosis index(PCI)(HR = 1.05, 95%CI: 1.02-1.08, P = 0.002). Independent predictors of OS include tumor grade(HR = 2.79, 95%CI: 1.26-6.21, P = 0.01), PCI(HR = 1.10, 95%CI: 1.03-1.16, P = 0.002), and complete cytoreduction(HR = 0.32, 95%CI: 0.11-0.92, P = 0.03). Tumor grade and PCI were the only independent predictors of both DFS and OS. Furthermore, histological grade and lymphovascular invasion stratified the risk of lymph node metastasis into a low(6%) and high(40%) risk groups. CONCLUSION Our data demonstrates that moderately differentiated MAA have a clinical behavior and outcome that is distinct from well-and poorly-differentiated MAA. The threetier grade classification provides improved prognostic stratification and should be incorporated into patient selection and treatment algorithms.展开更多
目的系统评价补肾方剂改善高龄女性自然妊娠结局的临床疗效和安全性。方法检索中国知网、万方数据库、维普数据库、SinoMed、PubMed、Web of Science、Cochrane Library、Embase等数据库建库至2022年6月收录的补肾方剂改善高龄女性自然...目的系统评价补肾方剂改善高龄女性自然妊娠结局的临床疗效和安全性。方法检索中国知网、万方数据库、维普数据库、SinoMed、PubMed、Web of Science、Cochrane Library、Embase等数据库建库至2022年6月收录的补肾方剂改善高龄女性自然妊娠结局的随机对照研究(RCT)。运用偏倚风险工具进行质量评估,使用RevMan软件进行Meta分析。结果共纳入14篇RCT。Meta分析结果显示:补肾方剂联合西药治疗在提高妊娠率[RR=1.71,95%CI(1.45,2.01),P<0.00001]、降低卵泡刺激素(FSH)水平[SMD=-1.63,95%CI(-2.84,-0.43),P=0.008]、提高雌二醇(E_(2))水平[SMD=3.97,95%CI(1.76,6.17),P=0.0004]、增加排卵期子宫内膜厚度[SMD=2.12,95%CI(1.07,3.18),P<0.0001]方面均优于西药组;且补肾方剂单独使用在提高妊娠率[RR=1.94,95%CI(1.31,2.88),P=0.001]、降低FSH水平[SMD=-0.48,95%CI(-0.74,-0.22),P=0.0003]方面也具有显著疗效。结论与西医治疗比较,补肾方剂可以显著改善高龄女性自然妊娠结局,且不良反应较少,但仍需更多高质量、大样本、多中心的RCT予以验证。展开更多
目的运用循证医学方法对腕踝针干预术后疼痛的疗效和安全性进行系统评价和Grade评价。方法计算机检索中国知网、万方、维普、中国生物医学文献数据库、PubMed、Embase、Web of Science、Cochrane Library中关于腕踝针干预术后疼痛的随...目的运用循证医学方法对腕踝针干预术后疼痛的疗效和安全性进行系统评价和Grade评价。方法计算机检索中国知网、万方、维普、中国生物医学文献数据库、PubMed、Embase、Web of Science、Cochrane Library中关于腕踝针干预术后疼痛的随机对照试验,检索时限为建库至2023年10月。采用RevMan 5.4软件进行Meta分析。结果纳入23篇文献,共计1968例患者,Meta分析结果显示,与常规治疗相比,腕踝针能够提高术后疼痛患者的总有效率[OR=4.42,95%CI(2.60,7.50),P<0.001],术后镇痛泵药量使用减少[MD=-9.03,95%CI(-12.09,-5.98),P<0.001],术后疼痛评分降低[MD=-1.39,95%CI(-1.68,-1.09),P<0.001],可减少不良反应发生率[RR=0.40,95%CI(0.32,0.48),P<0.001]以及临床满意度[OR=3.94,95%CI(2.40,6.48),P<0.001]。Grade证据分级结果显示:总有效率、不良反应发生率和临床满意度3项结局指标为中等质量证据,VAS评分指标为低质量证据,镇痛泵药量使用指标为极低质量证据。结论腕踝针可提高总有效率,减少术后镇痛药用量,不良反应少,安全性高,为患者提供了一种安全有效的镇痛方式。展开更多
The importance of the accuracy of preparing biological specimen as histological sections that can be examined under a microscope lies in reflecting a true image of the tissue that includes all its components, which ar...The importance of the accuracy of preparing biological specimen as histological sections that can be examined under a microscope lies in reflecting a true image of the tissue that includes all its components, which are used in scientific research or for the purpose of diagnosing various diseases of the body. Despite this, some cellular structures within the tissue may suffer from some alterations that result from the appearance of defects during any stage of preparing these microscopic sections, which alter or interfere with the precise cellular structures and morphology that constitute the tissue and thus give a different image for tissue features and cause confusion in the work histopathologist in the diagnosis. There are several reasons that can cause a misdiagnosis of the sample that occurs during the surgical separation process or after separation during the stages of microscopic preparation techniques from fixation stage, tissue processing, embedding or microtomy, staining until mounting procedures. The constant need to identify these defects and their causes in addition to try to reduce them is one of the biggest challenges evident in pathology laboratories. Therefore, this study aims to review the most common defects that occur in any stage of tissue processing, with an explanation of their causes and appropriate ways to avoid them.展开更多
Gibberellin(GA)is one of the major plant hormones that promote parthenocarpy,a highly valuable agronomic trait.Here,we demonstrated that exogenous GA3application triggered the formation of parthenocarpic fruits with s...Gibberellin(GA)is one of the major plant hormones that promote parthenocarpy,a highly valuable agronomic trait.Here,we demonstrated that exogenous GA3application triggered the formation of parthenocarpic fruits with smaller size but unchanged shape in tomato(Solanum lycopersicum).These fruits exhibited a thicker pericarp,undeveloped ovules,and few jelly tissues,leading to smaller locules with empty cavities.Histological investigation showed that GA treatment produced more cell layers with larger cells in the pericarp,suggesting its promotion in both cell division and expansion.Transcriptomic analyses between GA-3and mock-treated unpollinated ovaries/fruits identified a large number of differentially expressed genes related to hormones,cell division,cell expansion,and transcription factors,implying that they coordinately regulated parthenocarpy conferred by GA.In particular,the downregulation of five reported repressors of tomato parthenocarpy,including two auxin signaling components,AUXIN RESPONSE FACTOR5(SlARF5)and Sl ARF7,and three MADS-box genes,TOMATO APETALA3(TAP3),TOMATO PISTILLATA(TPI),and AGAMOUS-LIKE6(SlAGL6),after GA treatment might play a key role in this process.Furthermore,we found that the knockdown of a GA signaling factor SlMYB33,which was depressed by GA treatment,induced parthenocarpic fruit set in tomato,an effect that might have been achieved by enhancing GA biosynthesis and decreasing the expression of some repressors of tomato parthenocarpy.Thus,our results provide a basis for understanding the regulatory mechanism of GA in tomato parthenocarpy.展开更多
Distraction spinal cord injury is caused by some degree of distraction or longitudinal tension on the spinal cord and commonly occurs in patients who undergo corrective operation for severe spinal deformity.With the i...Distraction spinal cord injury is caused by some degree of distraction or longitudinal tension on the spinal cord and commonly occurs in patients who undergo corrective operation for severe spinal deformity.With the increased degree and duration of distraction,spinal cord injuries become more serious in terms of their neurophysiology,histology,and behavior.Very few studies have been published on the specific characteristics of distraction spinal cord injury.In this study,we systematically review 22 related studies involving animal models of distraction spinal cord injury,focusing particularly on the neurophysiological,histological,and behavioral characteristics of this disease.In addition,we summarize the mechanisms underlying primary and secondary injuries caused by distraction spinal cord injury and clarify the effects of different degrees and durations of distraction on the primary injuries associated with spinal cord injury.We provide new concepts for the establishment of a model of distraction spinal cord injury and related basic research,and provide reference guidelines for the clinical diagnosis and treatment of this disease.展开更多
Through equilibrium and non-equilibrium molecular dynamics simulations,we have demonstrated the inhibitory effect of composition graded interface on thermal transport behavior in lateral heterostructures.Specifically,...Through equilibrium and non-equilibrium molecular dynamics simulations,we have demonstrated the inhibitory effect of composition graded interface on thermal transport behavior in lateral heterostructures.Specifically,we investigated the influence of composition gradient length and heterogeneous particles at the silicene/germanene(SIL/GER)heterostructure interface on heat conduction.Our results indicate that composition graded interface at the interface diminishes the thermal conductivity of the heterostructure,with a further reduction observed as the length increases,while the effect of the heterogeneous particles can be considered negligible.To unveil the influence of composition graded interface on thermal transport,we conducted phonon analysis and identified the presence of phonon localization within the interface composition graded region.Through these analyses,we have determined that the decrease in thermal conductivity is correlated with phonon localization within the heterostructure,where a stronger degree of phonon localization signifies poorer thermal conductivity in the material.Our research findings not only contribute to understanding the impact of interface gradient-induced phonon localization on thermal transport but also offer insights into the modulation of thermal conductivity in heterostructures.展开更多
Based on the generalized Hamilton's principle,the nonlinear governing equation of an axially functionally graded(AFG)pipe is established.The non-trivial equilibrium configuration is superposed by the modal functio...Based on the generalized Hamilton's principle,the nonlinear governing equation of an axially functionally graded(AFG)pipe is established.The non-trivial equilibrium configuration is superposed by the modal functions of a simply supported beam.Via the direct multi-scale method,the response and stability boundary to the pulsating fluid velocity are solved analytically and verified by the differential quadrature element method(DQEM).The influence of Young's modulus gradient on the parametric resonance is investigated in the subcritical and supercritical regions.In general,the pipe in the supercritical region is more sensitive to the pulsating excitation.The nonlinearity changes from hard to soft,and the non-trivial equilibrium configuration introduces more frequency components to the vibration.Besides,the increasing Young's modulus gradient improves the critical pulsating flow velocity of the parametric resonance,and further enhances the stability of the system.In addition,when the temperature increases along the axial direction,reducing the gradient parameter can enhance the response asymmetry.This work further complements the theoretical analysis of pipes conveying pulsating fluid.展开更多
Introduction: The frequent late-stage diagnosis of chronic kidney disease (CKD) constrains the treatment choices for nephrologists. Renal biopsy (RB) is crucial for accurately identifying renal lesions. This key nephr...Introduction: The frequent late-stage diagnosis of chronic kidney disease (CKD) constrains the treatment choices for nephrologists. Renal biopsy (RB) is crucial for accurately identifying renal lesions. This key nephrological procedure, however, is invasive and not without potential complications. The purpose of this study was to evaluate the indications, frequency, and histological lesion profiles of renal biopsies in Togo. Materials and Methods: We conducted a descriptive cross-sectional study encompassing all renal biopsies performed in Togo from the inception of nephrology services to the present. Data were compiled from the medical records of the patients. Results: From 2015 to 2023, 68 high-quality renal biopsies were executed in Togo. The patients had an average age of 30.6 years, with a predominance of males (69.1%). The most common indication was nephrotic syndrome, accounting for 66.2% of cases. Histologically, glomerulopathies were predominant, representing 61.8% of lesions, followed by vascular nephropathies (25%) and tubulointerstitial nephropathies (13.2%). The most frequently observed primary glomerulopathy was focal segmental glomerulosclerosis (FSGS). Gross hematuria was the sole complication, occurring in 1.4% of the cases. Conclusion: RB is an evolving practice in Togo. Glomerulopathies are the most commonly observed lesions. The histological categorization of renal lesions is vital for clinicians in their diagnostic reasoning and approach.展开更多
Natural fibers have been extensively researched as reinforcement materials in polymers on account of their environmental and economic advantages in comparison with synthetic fibers in the recent years.Bamboo fibers ar...Natural fibers have been extensively researched as reinforcement materials in polymers on account of their environmental and economic advantages in comparison with synthetic fibers in the recent years.Bamboo fibers are renowned for their good mechanical properties,abundance,and short cycle growth.As beams are one of the fundamental structural components and are susceptible to mechanical loads in engineering applications,this paper performs a study on the free vibration and buckling responses of bamboo fiber reinforced composite(BFRC)beams on the elastic foundation.Three different functionally graded(FG)layouts and a uniform one are the considered distributions for unidirectional long bamboo fibers across the thickness.The elastic properties of the composite are determined with the law of mixture.Employing Hamilton’s principle,the governing equations of motion are obtained.The generalized differential quadrature method(GDQM)is then applied to the equations to obtain the results.The achieved outcomes exhibit that the natural frequency and buckling load values vary as the fiber volume fractions and distributions,elastic foundation stiffness values,and boundary conditions(BCs)and slenderness ratio of the beam change.Furthermore,a comparative study is conducted between the derived analysis outcomes for BFRC and homogenous polymer beams to examine the effectiveness of bamboo fibers as reinforcement materials,demonstrating the significant enhancements in both vibration and buckling responses,with the exception of natural frequencies for cantilever beams on the Pasternak foundation with the FG-◇fiber distribution.Eventually,the obtained analysis results of BFRC beams are also compared with those for carbon nanotube reinforced composite(CNTRC)beams found in the literature,indicating that the buckling loads and natural frequencies of BFRC beams are lower than those of CNTRC beams.展开更多
The ex-situ incorporation of the secondary SiC reinforcement,along with the in-situ incorporation of the tertiary and quaternary Mg_(3)N_(2) and Si_(3)N_(4) phases,in the primary matrix of Mg_(2)Si is employed in orde...The ex-situ incorporation of the secondary SiC reinforcement,along with the in-situ incorporation of the tertiary and quaternary Mg_(3)N_(2) and Si_(3)N_(4) phases,in the primary matrix of Mg_(2)Si is employed in order to provide ultimate wear resistance based on the laser-irradiation-induced inclusion of N_(2) gas during laser powder bed fusion.This is substantialized based on both the thermal diffusion-and chemical reactionbased metallurgy of the Mg_(2)Si–SiC/nitride hybrid composite.This study also proposes a functional platform for systematically modulating a functionally graded structure and modeling build-direction-dependent architectonics during additive manufacturing.This strategy enables the development of a compositional gradient from the center to the edge of each melt pool of the Mg_(2)Si–SiC/nitride hybrid composite.Consequently,the coefficient of friction of the hybrid composite exhibits a 309.3%decrease to–1.67 compared to–0.54 for the conventional nonreinforced Mg_(2)Si structure,while the tensile strength exhibits a 171.3%increase to 831.5 MPa compared to 485.3 MPa for the conventional structure.This outstanding mechanical behavior is due to the(1)the complementary and synergistic reinforcement effects of the SiC and nitride compounds,each of which possesses an intrinsically high hardness,and(2)the strong adhesion of these compounds to the Mg_(2)Si matrix despite their small sizes and low concentrations.展开更多
By analyzing the correlation between courses in students’grades,we can provide a decision-making basis for the revision of courses and syllabi,rationally optimize courses,and further improve teaching effects.With the...By analyzing the correlation between courses in students’grades,we can provide a decision-making basis for the revision of courses and syllabi,rationally optimize courses,and further improve teaching effects.With the help of IBM SPSS Modeler data mining software,this paper uses Apriori algorithm for association rule mining to conduct an in-depth analysis of the grades of nursing students in Shandong College of Traditional Chinese Medicine,and to explore the correlation between professional basic courses and professional core courses.Lastly,according to the detailed analysis of the mining results,valuable curriculum information will be found from the actual teaching data.展开更多
This study focuses on the analysis of the Chinese composition writing performance of fourth,fifth,and sixth grade students in 16 selected schools in Longhua District,Shenzhen during the spring semester of 2023.Using L...This study focuses on the analysis of the Chinese composition writing performance of fourth,fifth,and sixth grade students in 16 selected schools in Longhua District,Shenzhen during the spring semester of 2023.Using LIWC(Linguistic Inquiry and Word Count)as a text analysis tool,the study explores the impact of LIWC categories on writing performance which is scaled by score.The results show that the simple LIWC word categories have a significant positive influence on the composition scores of lower-grade students;while complex LIWC word categories have a significant negative influence on the composition scores of lower-grade students but a significant positive influence on the composition scores of higher-grade students.Process word categories have a positive influence on the composition scores of all three grades,but the impact of complex process word categories increases as the grade level rises.展开更多
The COVID-19 pandemic caused significant disruptions in the field of education worldwide,including in the United Arab Emirates.Teachers and students had to adapt to remote learning and virtual classrooms,leading to va...The COVID-19 pandemic caused significant disruptions in the field of education worldwide,including in the United Arab Emirates.Teachers and students had to adapt to remote learning and virtual classrooms,leading to various challenges in maintaining educational standards.The sudden transition to remote teaching could have a negative impact on students’reading abilities,especially in the Arabic language.To gain insight into the unique challenges encountered by Arabic language teachers in the UAE,a survey was conducted to explore their assessment of teaching quality,student-teacher interaction,and learning outcomes amidst the COVID-19 pandemic.The results of the survey revealed a significant decline of student reading abilities and identified several major issues in online Arabic language teaching.These issues included limited interaction between students and teachers,challenges in monitoring students’class participation and performance,and challenges in effectively assessing students’reading skills.The results also demonstrated some other challenges faced by Arabic language teachers,including a lack of preparedness,a lack of subscription to relevant platforms,and a lack of resources for online learning.Several solutions to these challenges are proposed,including reevaluating the balance between depth and breadth in the curriculum,integrating language skills into the curriculum more effectively,providing more comprehensive teacher professional development,implementing student grouping strategies,utilizing retired and expert teachers in specific content areas,allocating time for interventions,and improving support from both teachers and parents to ensure the quality of online learning.展开更多
Background:Pre-operative non-invasive histological evaluation of hepatocellular carcinoma(HCC)remains a challenge.Tumor perfusion is significantly associated with the development and aggressiveness of HCC.The purpose ...Background:Pre-operative non-invasive histological evaluation of hepatocellular carcinoma(HCC)remains a challenge.Tumor perfusion is significantly associated with the development and aggressiveness of HCC.The purpose of the study was to evaluate the clinical value of quantitative liver perfusion parameters and corresponding histogram parameters derived from traditional triphasic enhanced computed tomography(CT)scans in predicting histological grade of HCC.Methods:Totally,52 patients with HCC were enrolled in this retrospective study and underwent triple-phase enhanced CT imaging.The blood perfusion parameters were derived from triple-phase CT scans.The relationship of liver perfusion parameters and corresponding histogram parameters with the histological grade of HCC was analyzed.Receiver operating characteristic(ROC)curve analysis was used to determine the optimal ability of the parameters to predict the tumor histological grade.Results:The variance of arterial enhancement fraction(AEF)was significantly higher in HCCs without poorly differentiated components(NP-HCCs)than in HCCs with poorly differentiated components(P-HCCs).The difference in hepatic blood flow(HF)between total tumor and total liver flow(ΔHF=HFtumor-HFliver)and relative flow(rHF=ΔHF/HF_(liver))were significantly higher in NP-HCCs than in P-HCCs.The difference in portal vein blood supply perfusion(PVP)between tumor and liver tissue(ΔPVP)and theΔPVP/liver PVP ratio(rPVP)were significantly higher in patients with NP-HCCs than in patients with P-HCCs.The area under ROC(AUC)ofΔPVP and rPVP were both 0.697 with a high sensitivity of 84.2%and specificity of only 56.2%.TheΔHF and rHF had a higher specificity of 87.5%with an AUC of 0.681 and 0.673,respectively.The combination of rHF and rPVP showed the highest AUC of 0.732 with a sensitivity of 57.9%and specificity of 93.8%.The combined parameter ofΔHF and rPVP,rHF and rPVP had the highest positive predictive value of 0.903,and that of rPVP andΔPVP had the highest negative predictive value of 0.781.Conclusion:Liver perfusion parameters and corresponding histogram parameters(includingΔHF,rHF,ΔPVP,rPVP,and AEFvariance)in patients with HCC derived from traditional triphasic CT scans may be helpful to non-invasively and pre-operatively predict the degree of the differentiation of HCC.展开更多
Background:Prediction models for the histological grade of hepatocellular carcinoma(HCC)remain unsatisfactory.The purpose of this study is to develop preoperative models to predict histological grade of HCC based on g...Background:Prediction models for the histological grade of hepatocellular carcinoma(HCC)remain unsatisfactory.The purpose of this study is to develop preoperative models to predict histological grade of HCC based on gadolinium-ethoxybenzyl diethylenetriamine pentaacetic acid(Gd-EOB-DTPA)-enhanced magnetic resonance imaging(MRI)radiomics.And to compare the performance between artificial neural network(ANN)and logistic regression model.Methods:A total of 122 HCCs were randomly assigned to the training set(n=85)and the test set(n=37).There were 242 radiomic features extracted from volumetric of interest(VOI)of arterial and hepatobiliary phases images.The radiomic features and clinical parameters[gender,age,alpha-fetoprotein(AFP),carcinoembryonic antigen(CEA),carbohydrate antigen 19-9(CA19-9),alanine aminotransferase(ALT),aspartate transaminase(AST)]were selected by permutation test and decision tree.ANN of arterial phase(ANN-AP),logistic regression model of arterial phase(LR-AP),ANN of hepatobiliary phase(ANN-HBP),logistic regression mode of hepatobiliary phase(LR-HBP),ANN of combined arterial and hepatobiliary phases(ANN-AP+HBP),and logistic regression model of combined arterial and hepatobiliary phases(LR-AP+HBP)were built to predict HCC histological grade.Those prediction models were assessed and compared.Results:ANN-AP and LR-AP were composed by AST and radiomic features based on arterial phase.ANN-HBP and LR-HBP were composed by AFP and radiomic features based on hepatobiliary phase.ANN-AP+HBP and LR-AP+HBP were composed by AST and radiomic features based on arterial and hepatobiliary phases.The prediction models could distinguish between high-grade tumors[Edmondson-Steiner(E-S)grade III and IV]and low-grade tumors(E-S grade I and II)in both training set and test set.In the test set,the AUCs of ANN-AP,LR-AP,ANN-HBP,LR-HBP,ANN-AP+HBP and LR-AP+HBP were 0.889,0.777,0.941,0.819,0.944 and 0.792 respectively.The ANN-HBP was significantly superior to LR-HBP(P=0.001).And the ANN-AP+HBP was significantly superior to LR-AP+HBP(P=0.007).Conclusions:Prediction models consisting of clinical parameters and Gd-EOB-DTPA-enhanced MRI radiomic features(based on arterial phase,hepatobiliary phase,and combined arterial and hepatobiliary phases)could distinguish between high-grade HCCs and low-grade HCCs.And the ANN was superior to logistic regression model in predicting histological grade of HCC.展开更多
目的系统评价前列舒通胶囊联合坦索罗辛治疗慢性前列腺炎(Chronic prostatitis,CP)的临床疗效。方法在线检索中国知识资源总库(CNKI)、万方数据、维普网、Sinomed、PubMed、Web of Science、Cochrane Library、Embase数据库建库至2023年...目的系统评价前列舒通胶囊联合坦索罗辛治疗慢性前列腺炎(Chronic prostatitis,CP)的临床疗效。方法在线检索中国知识资源总库(CNKI)、万方数据、维普网、Sinomed、PubMed、Web of Science、Cochrane Library、Embase数据库建库至2023年4月1日期间前列舒通胶囊联合坦索罗辛治疗CP的随机对照研究,采用Cochrane风险偏倚评估工具对文献进行质量评价,运用RevMan 5.3软件进行Meta分析,并对结局指标进行GRADE质量分级。结果共纳入10篇RCT,涉及1013例受试者。Meta分析结果显示:相较于单用坦索罗辛,前列舒通胶囊联合坦索罗辛治疗CP能够显著提高临床有效率[RR=1.23,95%CI(1.16~1.30),P<0.00001],降低NIH-CPSI评分[MD=-5.09,95%CI(-6.84~-3.34),P<0.00001],降低NIH-CPSI疼痛症状评分[MD=-3.17,95%CI(-4.12~-2.23),P<0.00001]、NIH-CPSI排尿症状评分[MD=-2.11,95%CI(-2.55~-1.67),P<0.00001]、NIH-CPSI生活质量评分[MD=-1.79,95%CI(-1.87~-1.71),P<0.00001]、前列腺液白细胞计数[MD=-2.73,95%CI(-4.13~-1.34),P<0.00001],且联合用药不会增加不良反应发生。GRADE证据分级显示:前列舒通胶囊联合坦索罗辛质量在有效率和NIH-CPSI生活质量评分指标为中级,NIH-CPSI评分、NIH-CPSI疼痛症状评分、NIH-CPSI排尿症状评分和前列腺液白细胞计数指标为低级。结论与单用坦索罗辛治疗比较,前列舒通胶囊联合坦索罗辛可以显著改善CP患者临床疼痛、排尿不适等临床症状,且不增加不良反应的发生,但仍需更多高质量、大样本、多中心的RCT予以验证。展开更多
文摘AIM To compare intravoxel incoherent motion(IVIM)-derived parameters with conventional diffusion-weighted imaging(DWI) parameters in predicting the histological grade of hepatocellular carcinoma(h CC) and to evaluate the correlation between the parameters and the histological grades.METHODS A retrospective study was performed. Sixty-two patients with surgically confirmed h CCs underwent diffusion-weighted magnetic resonance imaging with twelve b values(10-1200 s/mm^2). The apparent diffusion coefficient(ADC), pure diffusion coefficient(D), pseudo-diffusion coefficient(D*), and perfusion fraction(f) were calculated by two radiologists. The IVIM and conventional DWI parameters were compared among the different grades by using analysis of variance(ANOVA) and the Kruskal-Wallis test. Receiver operating characteristic(ROC) analysis was performed to evaluate the diagnostic efficiency of distinguishing between low-grade(grade 1, G1) and high-grade(grades 2 and 3, G2 and G3) hC C. The correlation between the parameters and the histological grades was assessed by using the Spearman correlation test. Bland-Altman analysis was used to evaluate the reproducibility of the two radiologists' measurements.RESULTS The differences in the ADC and D values among the groups with G1, G2, and G3 histological grades of HCCs were statistically significant(P < 0.001). The D* and f values had no significant differences among the different histological grades of h CC(P > 0.05). The ROC analyses demonstrated that the D and ADC values had better diagnostic performance in differentiating the low-grade h CC from the high-grade h CC, with areas under the curve(AUCs) of 0.909 and 0.843, respectively, measured by radiologist 1 and of 0.911 and 0.852, respectively, measured by radiologist 2. The following significant correlations were obtained between the ADC, D, and D~* values and the histological grades: r =-0.619(P < 0.001), r =-0.628(P < 0.001), and r =-0.299(P = 0.018), respectively, as measured by radiologist 1; r =-0.622(P < 0.001), r =-0.633(P < 0.001), and r =-0.303(P = 0.017), respectively, as measured by radiologist 2. The intra-class correlation coefficient(ICC) values between the two observers were 0.996 for ADC, 0.997 for D, 0.996 for D*, and 0.992 for f values, which indicated excellent interobserver agreement in the measurements between the two observers.CONCLUSION The IVIM-derived D and ADC values show better diagnostic performance in differentiating high-grade hC C from low-grade hC C, and there is a moderate to good correlation between the ADC and D values and the histological grades.
文摘AIM To investigate the importance of a three-tiered histologic grade on outcomes for patients with mucinous appendiceal adenocarcinoma(MAA).METHODS Two hundred and sixty-five patients with MAA undergoing cytoreductive surgery and hyperthermic intraperitoneal chemotherapy were identified from a prospective database from 2004 through 2014. All pathology was reviewed by our gastrointestinal subspecialty pathologists and histological grade was classified as well-differentiated, moderately differentiated, and poorly differentiated. Survival analysis was performed using Cox proportional hazards regression.RESULTS There were 201(75.8%) well-, 45(16.9%) moderatelyand 19(7.2%) poorly-differentiated tumors. Histological grade significantly stratified the 5-year overall survival(OS), 94%, 71% and 30% respectively(P < 0.001) as well as the 5-year disease-free survival(DFS) 66%, 21% and 0%, respectively(P < 0.001). Independent predictors of DFS included tumor grade(HR = 1.78, 95%CI: 1.21-2.63, P = 0.008), lymph node involvement(HR = 0.33, 95%CI: 0.11-0.98, P < 0.02), previous surgical score(HR = 1.31, 95%CI: 1.1-1.65, P = 0.03) and peritoneal carcinomatosis index(PCI)(HR = 1.05, 95%CI: 1.02-1.08, P = 0.002). Independent predictors of OS include tumor grade(HR = 2.79, 95%CI: 1.26-6.21, P = 0.01), PCI(HR = 1.10, 95%CI: 1.03-1.16, P = 0.002), and complete cytoreduction(HR = 0.32, 95%CI: 0.11-0.92, P = 0.03). Tumor grade and PCI were the only independent predictors of both DFS and OS. Furthermore, histological grade and lymphovascular invasion stratified the risk of lymph node metastasis into a low(6%) and high(40%) risk groups. CONCLUSION Our data demonstrates that moderately differentiated MAA have a clinical behavior and outcome that is distinct from well-and poorly-differentiated MAA. The threetier grade classification provides improved prognostic stratification and should be incorporated into patient selection and treatment algorithms.
文摘目的系统评价补肾方剂改善高龄女性自然妊娠结局的临床疗效和安全性。方法检索中国知网、万方数据库、维普数据库、SinoMed、PubMed、Web of Science、Cochrane Library、Embase等数据库建库至2022年6月收录的补肾方剂改善高龄女性自然妊娠结局的随机对照研究(RCT)。运用偏倚风险工具进行质量评估,使用RevMan软件进行Meta分析。结果共纳入14篇RCT。Meta分析结果显示:补肾方剂联合西药治疗在提高妊娠率[RR=1.71,95%CI(1.45,2.01),P<0.00001]、降低卵泡刺激素(FSH)水平[SMD=-1.63,95%CI(-2.84,-0.43),P=0.008]、提高雌二醇(E_(2))水平[SMD=3.97,95%CI(1.76,6.17),P=0.0004]、增加排卵期子宫内膜厚度[SMD=2.12,95%CI(1.07,3.18),P<0.0001]方面均优于西药组;且补肾方剂单独使用在提高妊娠率[RR=1.94,95%CI(1.31,2.88),P=0.001]、降低FSH水平[SMD=-0.48,95%CI(-0.74,-0.22),P=0.0003]方面也具有显著疗效。结论与西医治疗比较,补肾方剂可以显著改善高龄女性自然妊娠结局,且不良反应较少,但仍需更多高质量、大样本、多中心的RCT予以验证。
文摘目的运用循证医学方法对腕踝针干预术后疼痛的疗效和安全性进行系统评价和Grade评价。方法计算机检索中国知网、万方、维普、中国生物医学文献数据库、PubMed、Embase、Web of Science、Cochrane Library中关于腕踝针干预术后疼痛的随机对照试验,检索时限为建库至2023年10月。采用RevMan 5.4软件进行Meta分析。结果纳入23篇文献,共计1968例患者,Meta分析结果显示,与常规治疗相比,腕踝针能够提高术后疼痛患者的总有效率[OR=4.42,95%CI(2.60,7.50),P<0.001],术后镇痛泵药量使用减少[MD=-9.03,95%CI(-12.09,-5.98),P<0.001],术后疼痛评分降低[MD=-1.39,95%CI(-1.68,-1.09),P<0.001],可减少不良反应发生率[RR=0.40,95%CI(0.32,0.48),P<0.001]以及临床满意度[OR=3.94,95%CI(2.40,6.48),P<0.001]。Grade证据分级结果显示:总有效率、不良反应发生率和临床满意度3项结局指标为中等质量证据,VAS评分指标为低质量证据,镇痛泵药量使用指标为极低质量证据。结论腕踝针可提高总有效率,减少术后镇痛药用量,不良反应少,安全性高,为患者提供了一种安全有效的镇痛方式。
文摘The importance of the accuracy of preparing biological specimen as histological sections that can be examined under a microscope lies in reflecting a true image of the tissue that includes all its components, which are used in scientific research or for the purpose of diagnosing various diseases of the body. Despite this, some cellular structures within the tissue may suffer from some alterations that result from the appearance of defects during any stage of preparing these microscopic sections, which alter or interfere with the precise cellular structures and morphology that constitute the tissue and thus give a different image for tissue features and cause confusion in the work histopathologist in the diagnosis. There are several reasons that can cause a misdiagnosis of the sample that occurs during the surgical separation process or after separation during the stages of microscopic preparation techniques from fixation stage, tissue processing, embedding or microtomy, staining until mounting procedures. The constant need to identify these defects and their causes in addition to try to reduce them is one of the biggest challenges evident in pathology laboratories. Therefore, this study aims to review the most common defects that occur in any stage of tissue processing, with an explanation of their causes and appropriate ways to avoid them.
基金supported by the Key Program of Natural Science Basic Research Plan in Shaanxi Province of China(Grant No.2021JZ-13)。
文摘Gibberellin(GA)is one of the major plant hormones that promote parthenocarpy,a highly valuable agronomic trait.Here,we demonstrated that exogenous GA3application triggered the formation of parthenocarpic fruits with smaller size but unchanged shape in tomato(Solanum lycopersicum).These fruits exhibited a thicker pericarp,undeveloped ovules,and few jelly tissues,leading to smaller locules with empty cavities.Histological investigation showed that GA treatment produced more cell layers with larger cells in the pericarp,suggesting its promotion in both cell division and expansion.Transcriptomic analyses between GA-3and mock-treated unpollinated ovaries/fruits identified a large number of differentially expressed genes related to hormones,cell division,cell expansion,and transcription factors,implying that they coordinately regulated parthenocarpy conferred by GA.In particular,the downregulation of five reported repressors of tomato parthenocarpy,including two auxin signaling components,AUXIN RESPONSE FACTOR5(SlARF5)and Sl ARF7,and three MADS-box genes,TOMATO APETALA3(TAP3),TOMATO PISTILLATA(TPI),and AGAMOUS-LIKE6(SlAGL6),after GA treatment might play a key role in this process.Furthermore,we found that the knockdown of a GA signaling factor SlMYB33,which was depressed by GA treatment,induced parthenocarpic fruit set in tomato,an effect that might have been achieved by enhancing GA biosynthesis and decreasing the expression of some repressors of tomato parthenocarpy.Thus,our results provide a basis for understanding the regulatory mechanism of GA in tomato parthenocarpy.
基金supported by the National Natural Science Foundation of China,No.81772421(to YH).
文摘Distraction spinal cord injury is caused by some degree of distraction or longitudinal tension on the spinal cord and commonly occurs in patients who undergo corrective operation for severe spinal deformity.With the increased degree and duration of distraction,spinal cord injuries become more serious in terms of their neurophysiology,histology,and behavior.Very few studies have been published on the specific characteristics of distraction spinal cord injury.In this study,we systematically review 22 related studies involving animal models of distraction spinal cord injury,focusing particularly on the neurophysiological,histological,and behavioral characteristics of this disease.In addition,we summarize the mechanisms underlying primary and secondary injuries caused by distraction spinal cord injury and clarify the effects of different degrees and durations of distraction on the primary injuries associated with spinal cord injury.We provide new concepts for the establishment of a model of distraction spinal cord injury and related basic research,and provide reference guidelines for the clinical diagnosis and treatment of this disease.
基金Project supported by the National Natural Science Foundation of China (Grant No.12104291)。
文摘Through equilibrium and non-equilibrium molecular dynamics simulations,we have demonstrated the inhibitory effect of composition graded interface on thermal transport behavior in lateral heterostructures.Specifically,we investigated the influence of composition gradient length and heterogeneous particles at the silicene/germanene(SIL/GER)heterostructure interface on heat conduction.Our results indicate that composition graded interface at the interface diminishes the thermal conductivity of the heterostructure,with a further reduction observed as the length increases,while the effect of the heterogeneous particles can be considered negligible.To unveil the influence of composition graded interface on thermal transport,we conducted phonon analysis and identified the presence of phonon localization within the interface composition graded region.Through these analyses,we have determined that the decrease in thermal conductivity is correlated with phonon localization within the heterostructure,where a stronger degree of phonon localization signifies poorer thermal conductivity in the material.Our research findings not only contribute to understanding the impact of interface gradient-induced phonon localization on thermal transport but also offer insights into the modulation of thermal conductivity in heterostructures.
基金Project supported by the National Natural Science Foundation of China (Nos.12002195 and 12372015)the National Science Fund for Distinguished Young Scholars of China (No.12025204)the Program of Shanghai Municipal Education Commission of China (No.2019-01-07-00-09-E00018)。
文摘Based on the generalized Hamilton's principle,the nonlinear governing equation of an axially functionally graded(AFG)pipe is established.The non-trivial equilibrium configuration is superposed by the modal functions of a simply supported beam.Via the direct multi-scale method,the response and stability boundary to the pulsating fluid velocity are solved analytically and verified by the differential quadrature element method(DQEM).The influence of Young's modulus gradient on the parametric resonance is investigated in the subcritical and supercritical regions.In general,the pipe in the supercritical region is more sensitive to the pulsating excitation.The nonlinearity changes from hard to soft,and the non-trivial equilibrium configuration introduces more frequency components to the vibration.Besides,the increasing Young's modulus gradient improves the critical pulsating flow velocity of the parametric resonance,and further enhances the stability of the system.In addition,when the temperature increases along the axial direction,reducing the gradient parameter can enhance the response asymmetry.This work further complements the theoretical analysis of pipes conveying pulsating fluid.
文摘Introduction: The frequent late-stage diagnosis of chronic kidney disease (CKD) constrains the treatment choices for nephrologists. Renal biopsy (RB) is crucial for accurately identifying renal lesions. This key nephrological procedure, however, is invasive and not without potential complications. The purpose of this study was to evaluate the indications, frequency, and histological lesion profiles of renal biopsies in Togo. Materials and Methods: We conducted a descriptive cross-sectional study encompassing all renal biopsies performed in Togo from the inception of nephrology services to the present. Data were compiled from the medical records of the patients. Results: From 2015 to 2023, 68 high-quality renal biopsies were executed in Togo. The patients had an average age of 30.6 years, with a predominance of males (69.1%). The most common indication was nephrotic syndrome, accounting for 66.2% of cases. Histologically, glomerulopathies were predominant, representing 61.8% of lesions, followed by vascular nephropathies (25%) and tubulointerstitial nephropathies (13.2%). The most frequently observed primary glomerulopathy was focal segmental glomerulosclerosis (FSGS). Gross hematuria was the sole complication, occurring in 1.4% of the cases. Conclusion: RB is an evolving practice in Togo. Glomerulopathies are the most commonly observed lesions. The histological categorization of renal lesions is vital for clinicians in their diagnostic reasoning and approach.
文摘Natural fibers have been extensively researched as reinforcement materials in polymers on account of their environmental and economic advantages in comparison with synthetic fibers in the recent years.Bamboo fibers are renowned for their good mechanical properties,abundance,and short cycle growth.As beams are one of the fundamental structural components and are susceptible to mechanical loads in engineering applications,this paper performs a study on the free vibration and buckling responses of bamboo fiber reinforced composite(BFRC)beams on the elastic foundation.Three different functionally graded(FG)layouts and a uniform one are the considered distributions for unidirectional long bamboo fibers across the thickness.The elastic properties of the composite are determined with the law of mixture.Employing Hamilton’s principle,the governing equations of motion are obtained.The generalized differential quadrature method(GDQM)is then applied to the equations to obtain the results.The achieved outcomes exhibit that the natural frequency and buckling load values vary as the fiber volume fractions and distributions,elastic foundation stiffness values,and boundary conditions(BCs)and slenderness ratio of the beam change.Furthermore,a comparative study is conducted between the derived analysis outcomes for BFRC and homogenous polymer beams to examine the effectiveness of bamboo fibers as reinforcement materials,demonstrating the significant enhancements in both vibration and buckling responses,with the exception of natural frequencies for cantilever beams on the Pasternak foundation with the FG-◇fiber distribution.Eventually,the obtained analysis results of BFRC beams are also compared with those for carbon nanotube reinforced composite(CNTRC)beams found in the literature,indicating that the buckling loads and natural frequencies of BFRC beams are lower than those of CNTRC beams.
基金supported by the Learning&Academic Research Institution for Master’s and Ph.D.Students and Postdocs(LAMP)Program of the National Research Foundation of Korea(NRF)grant funded by the Ministry of Education(No.RS-2023-00285353)In addition,this work was supported by the National Research Foundation of Korea(NRF)grant funded by the Korean government(MSIP)(NRF-2021R1A2C3006662,NRF-2022R1A5A1030054,and 2021R1A2C1091301).
文摘The ex-situ incorporation of the secondary SiC reinforcement,along with the in-situ incorporation of the tertiary and quaternary Mg_(3)N_(2) and Si_(3)N_(4) phases,in the primary matrix of Mg_(2)Si is employed in order to provide ultimate wear resistance based on the laser-irradiation-induced inclusion of N_(2) gas during laser powder bed fusion.This is substantialized based on both the thermal diffusion-and chemical reactionbased metallurgy of the Mg_(2)Si–SiC/nitride hybrid composite.This study also proposes a functional platform for systematically modulating a functionally graded structure and modeling build-direction-dependent architectonics during additive manufacturing.This strategy enables the development of a compositional gradient from the center to the edge of each melt pool of the Mg_(2)Si–SiC/nitride hybrid composite.Consequently,the coefficient of friction of the hybrid composite exhibits a 309.3%decrease to–1.67 compared to–0.54 for the conventional nonreinforced Mg_(2)Si structure,while the tensile strength exhibits a 171.3%increase to 831.5 MPa compared to 485.3 MPa for the conventional structure.This outstanding mechanical behavior is due to the(1)the complementary and synergistic reinforcement effects of the SiC and nitride compounds,each of which possesses an intrinsically high hardness,and(2)the strong adhesion of these compounds to the Mg_(2)Si matrix despite their small sizes and low concentrations.
文摘By analyzing the correlation between courses in students’grades,we can provide a decision-making basis for the revision of courses and syllabi,rationally optimize courses,and further improve teaching effects.With the help of IBM SPSS Modeler data mining software,this paper uses Apriori algorithm for association rule mining to conduct an in-depth analysis of the grades of nursing students in Shandong College of Traditional Chinese Medicine,and to explore the correlation between professional basic courses and professional core courses.Lastly,according to the detailed analysis of the mining results,valuable curriculum information will be found from the actual teaching data.
文摘This study focuses on the analysis of the Chinese composition writing performance of fourth,fifth,and sixth grade students in 16 selected schools in Longhua District,Shenzhen during the spring semester of 2023.Using LIWC(Linguistic Inquiry and Word Count)as a text analysis tool,the study explores the impact of LIWC categories on writing performance which is scaled by score.The results show that the simple LIWC word categories have a significant positive influence on the composition scores of lower-grade students;while complex LIWC word categories have a significant negative influence on the composition scores of lower-grade students but a significant positive influence on the composition scores of higher-grade students.Process word categories have a positive influence on the composition scores of all three grades,but the impact of complex process word categories increases as the grade level rises.
文摘The COVID-19 pandemic caused significant disruptions in the field of education worldwide,including in the United Arab Emirates.Teachers and students had to adapt to remote learning and virtual classrooms,leading to various challenges in maintaining educational standards.The sudden transition to remote teaching could have a negative impact on students’reading abilities,especially in the Arabic language.To gain insight into the unique challenges encountered by Arabic language teachers in the UAE,a survey was conducted to explore their assessment of teaching quality,student-teacher interaction,and learning outcomes amidst the COVID-19 pandemic.The results of the survey revealed a significant decline of student reading abilities and identified several major issues in online Arabic language teaching.These issues included limited interaction between students and teachers,challenges in monitoring students’class participation and performance,and challenges in effectively assessing students’reading skills.The results also demonstrated some other challenges faced by Arabic language teachers,including a lack of preparedness,a lack of subscription to relevant platforms,and a lack of resources for online learning.Several solutions to these challenges are proposed,including reevaluating the balance between depth and breadth in the curriculum,integrating language skills into the curriculum more effectively,providing more comprehensive teacher professional development,implementing student grouping strategies,utilizing retired and expert teachers in specific content areas,allocating time for interventions,and improving support from both teachers and parents to ensure the quality of online learning.
文摘Background:Pre-operative non-invasive histological evaluation of hepatocellular carcinoma(HCC)remains a challenge.Tumor perfusion is significantly associated with the development and aggressiveness of HCC.The purpose of the study was to evaluate the clinical value of quantitative liver perfusion parameters and corresponding histogram parameters derived from traditional triphasic enhanced computed tomography(CT)scans in predicting histological grade of HCC.Methods:Totally,52 patients with HCC were enrolled in this retrospective study and underwent triple-phase enhanced CT imaging.The blood perfusion parameters were derived from triple-phase CT scans.The relationship of liver perfusion parameters and corresponding histogram parameters with the histological grade of HCC was analyzed.Receiver operating characteristic(ROC)curve analysis was used to determine the optimal ability of the parameters to predict the tumor histological grade.Results:The variance of arterial enhancement fraction(AEF)was significantly higher in HCCs without poorly differentiated components(NP-HCCs)than in HCCs with poorly differentiated components(P-HCCs).The difference in hepatic blood flow(HF)between total tumor and total liver flow(ΔHF=HFtumor-HFliver)and relative flow(rHF=ΔHF/HF_(liver))were significantly higher in NP-HCCs than in P-HCCs.The difference in portal vein blood supply perfusion(PVP)between tumor and liver tissue(ΔPVP)and theΔPVP/liver PVP ratio(rPVP)were significantly higher in patients with NP-HCCs than in patients with P-HCCs.The area under ROC(AUC)ofΔPVP and rPVP were both 0.697 with a high sensitivity of 84.2%and specificity of only 56.2%.TheΔHF and rHF had a higher specificity of 87.5%with an AUC of 0.681 and 0.673,respectively.The combination of rHF and rPVP showed the highest AUC of 0.732 with a sensitivity of 57.9%and specificity of 93.8%.The combined parameter ofΔHF and rPVP,rHF and rPVP had the highest positive predictive value of 0.903,and that of rPVP andΔPVP had the highest negative predictive value of 0.781.Conclusion:Liver perfusion parameters and corresponding histogram parameters(includingΔHF,rHF,ΔPVP,rPVP,and AEFvariance)in patients with HCC derived from traditional triphasic CT scans may be helpful to non-invasively and pre-operatively predict the degree of the differentiation of HCC.
基金This study has received funding by Outstanding Youth supported by Medical Science and Technology Development Foundation Nanjing(JQX16022)Jiangsu Province Key Medical Young Talents,“13th Five-Year”Health Promotion Project of Jiangsu Province(QNRC2016041)+2 种基金The study was conducted in accordance with the Declaration of Helsinki(as revised in 2013)The study was approved by local institutional review board(No.2019AE01036)informed consent from patients was waived due to its retrospective nature。
文摘Background:Prediction models for the histological grade of hepatocellular carcinoma(HCC)remain unsatisfactory.The purpose of this study is to develop preoperative models to predict histological grade of HCC based on gadolinium-ethoxybenzyl diethylenetriamine pentaacetic acid(Gd-EOB-DTPA)-enhanced magnetic resonance imaging(MRI)radiomics.And to compare the performance between artificial neural network(ANN)and logistic regression model.Methods:A total of 122 HCCs were randomly assigned to the training set(n=85)and the test set(n=37).There were 242 radiomic features extracted from volumetric of interest(VOI)of arterial and hepatobiliary phases images.The radiomic features and clinical parameters[gender,age,alpha-fetoprotein(AFP),carcinoembryonic antigen(CEA),carbohydrate antigen 19-9(CA19-9),alanine aminotransferase(ALT),aspartate transaminase(AST)]were selected by permutation test and decision tree.ANN of arterial phase(ANN-AP),logistic regression model of arterial phase(LR-AP),ANN of hepatobiliary phase(ANN-HBP),logistic regression mode of hepatobiliary phase(LR-HBP),ANN of combined arterial and hepatobiliary phases(ANN-AP+HBP),and logistic regression model of combined arterial and hepatobiliary phases(LR-AP+HBP)were built to predict HCC histological grade.Those prediction models were assessed and compared.Results:ANN-AP and LR-AP were composed by AST and radiomic features based on arterial phase.ANN-HBP and LR-HBP were composed by AFP and radiomic features based on hepatobiliary phase.ANN-AP+HBP and LR-AP+HBP were composed by AST and radiomic features based on arterial and hepatobiliary phases.The prediction models could distinguish between high-grade tumors[Edmondson-Steiner(E-S)grade III and IV]and low-grade tumors(E-S grade I and II)in both training set and test set.In the test set,the AUCs of ANN-AP,LR-AP,ANN-HBP,LR-HBP,ANN-AP+HBP and LR-AP+HBP were 0.889,0.777,0.941,0.819,0.944 and 0.792 respectively.The ANN-HBP was significantly superior to LR-HBP(P=0.001).And the ANN-AP+HBP was significantly superior to LR-AP+HBP(P=0.007).Conclusions:Prediction models consisting of clinical parameters and Gd-EOB-DTPA-enhanced MRI radiomic features(based on arterial phase,hepatobiliary phase,and combined arterial and hepatobiliary phases)could distinguish between high-grade HCCs and low-grade HCCs.And the ANN was superior to logistic regression model in predicting histological grade of HCC.
