Development and validation of a CT-based radiomics nomogram for preoperative prediction of tumor histologic grade in gastric adenocarcinoma

Objectives:To develop and validate a radiomics nomogram for preoperative prediction of tumor histologic grade in gastric adenocarcinoma(GA).Methods:This retrospective study enrolled 592 patients with clinicopathologically confirmed GA(low-grade:n=154;high-grade:n=438)from January 2008 to March 2018 who were divided into training(n=450)and validation(n=142)sets according to the time of computed tomography(CT)examination.Radiomic features were extracted from the portal venous phase CT images.The Mann-Whitney U test and the least absolute shrinkage and selection operator(LASSO)regression model were used for feature selection,data dimension reduction and radiomics signature construction.Multivariable logistic regression analysis was applied to develop the prediction model.The radiomics signature and independent clinicopathologic risk factors were incorporated and presented as a radiomics nomogram.The performance of the nomogram was assessed with respect to its calibration and discrimination.Results:A radiomics signature containing 12 selected features was significantly associated with the histologic grade of GA(P<0.001 for both training and validation sets).A nomogram including the radiomics signature and tumor location as predictors was developed.The model showed both good calibration and good discrimination,in which C-index in the training set,0.752[95%confidence interval(95%CI):0.701-0.803];C-index in the validation set,0.793(95%CI:0.711-0.874).Conclusions:This study developed a radiomics nomogram that incorporates tumor location and radiomics signatures,which can be useful in facilitating preoperative individualized prediction of histologic grade of GA.     

嵌合型等臂双着丝粒Y染色体一例

孕妇 30岁, G5P1A3, 孕26+周, 因外院发现胎儿羊水染色体异常, 超声提示胎儿右侧肾上腺囊性包块, 体重偏小, 要求再次进行羊水穿刺。本研究通过我院伦理委员会审查(202201246), 在签署知情同意书后, 穿刺采集羊水标本30 mL, 分别用于羊水细胞原位培养和单核苷酸多态性微阵列分析(single nucleotide polymorphism array, SNP-array)。SNP-array提示Y染色体p11.32-q11.221区存在约17 Mb的嵌合缺失(缺失比例约20%), Yq11.221-q11.23区存在约9.2 Mb的缺失(图1)。羊水细胞存在三种染色体核型, 分别为45, X/46, X, idic(Y)(q11.22)/46, X, del(Y)(q11.22), 提示为嵌合型等臂双着丝粒Y染色体(图2)。夫妻双方染色体核型均未见异常。用18/X/Y染色体着丝粒探针对备份羊水进行荧光原位杂交(fluorescencein situ hybridization, FISH)验证, 提示胎儿为X/XYY/XY嵌合, 比例分别为43%、32%和2...     

脑缺血再灌注损伤中前体神经生长因子和成熟体神经生长因子及其受体的表达

实验观察脑缺血再灌注损伤中,前体神经生长因子和成熟体神经生长因子在缺血区皮质和非缺血区皮质的表达。结果发现在缺血区和非缺血区皮质中,前体神经生长因子表达在细胞外和胞浆,成熟体神经生长因子极低少量表达在细胞外。缺血侧皮质前体神经生长因子表达显著下降,至1d时达到最低值,成熟体神经生长因子在4h时表达增加,至3d时达到最低值,神经生长因子受体(p75NTR)在缺血后表达明显降低,至3d时达到峰值。证实脑缺血再灌注损伤的病理过程中：①前体神经生长因子是神经生长因子存在的主要形式。②脑缺血再灌注损伤影响了前体神经生长因子向成熟体神经生长因子的转化过程。③ 前体神经生长因子/p75NTR可能参与了缺血后的再灌注损伤。     

地塞米松促进卵巢癌细胞系p21/WAF1和TβR-II的表达

探讨人工合成糖皮质激素地塞米松 (Dex)抑制人卵巢癌细胞系HO 8910增殖的分子机理。采用RT PCR测定细胞周期蛋白依赖性激酶抑制剂p2 1 WAF1,转化生长因子 β1 (TGF β1 )及其I型受体 (TβR I)和II型受体 (TβR II)的mRNA表达水平 ,免疫细胞化学方法分析TβR II的蛋白表达水平。发现Dex能够诱导HO 8910细胞p2 1 WAF1mR NA的表达 ,10 - 7mol LDex处理细胞 8h组比对照组p2 1 WAF1mRNA表达增加 2 84倍 (P <0 0 1)。并且证明Dex亦可上调TβR IImRNA的表达水平 ,10 - 7mol LDex处理 8h使TβR IImRNA的表达量比对照升高 1 2倍 (P <0 0 1) ;Dex也引起TβR II蛋白表达的增加。这些效应均可被糖皮质激素受体 (GR)拮抗剂RU4 86逆转。而TGF β1 和TβR ImRNA的表达不受Dex的影响。以上结果提示 ,Dex通过GR介导而促进p2 1 WAF1和TβR II的表达 ,可能参与其抑制人卵巢癌细胞HO 8910增殖过程     

不同枇杷叶药材中三萜和黄酮类成分含量的比较

目的:比较枇杷成年生长叶和落叶中三萜和黄酮类成分含量的差异.方法:采用高效液相方法测定两种叶子中齐墩果酸和熊果酸的含量,采用紫外分光光度法测定两种叶子中总黄酮的含量.结果:两种叶子中的三萜和黄酮类成分含量有显著差异.结论:落叶中的齐墩果酸和熊果酸含量高于成年生长叶,总黄酮含量低于成年生长叶.     

Entinostat,a class Ⅰ selective histone deacetylase inhibitor,plus exemestane for Chinese patients with hormone receptor-positive advanced breast cancer: A multicenter,randomized, double-blind,placebo-controlled,phase 3 trial

Entinostat plus exemestane in hormone receptor-positive(HR+) advanced breast cancer(ABC) previously showed encouraging outcomes. This multicenter phase 3 trial evaluated the efficacy and safety of entinostat plus exemestane in Chinese patients with HR + ABC that relapsed/progressed after ≥1 endocrine therapy. Patients were randomized(2:1) to oral exemestane 25 mg/day plus entinostat(n = 235) or placebo(n = 119) 5 mg/week in 28-day cycles. The primary endpoint was the independent radiographic com...     

Discovery of novel covalent selective estrogen receptor degraders against endocrine-resistant breast cancer

Endocrine-resistance remains a major challenge in estrogen receptor a positive(ERa⁺)breast cancer(BC) treatment and constitutively active somatic mutations in ERa are a common mechanism. There is an urgent need to develop novel drugs with new mode of mechanism to fight endocrineresistance. Given aberrant ERa activity, we herein report the identification of novel covalent selective estrogen receptor degraders(cSERDs) possessing the advantages of both covalent and degradation strategies...     

Relationship between time in range and corneal nerve fiber loss in asymptomatic patients with type 2 diabetes

Background: Corneal confocal microscopy (CCM) is a noninvasive technique to detect early nerve damage of diabetic sensorimotor polyneuropathy (DSPN). Time in range (TIR) is an emerging metric of glycemic control which was reported to be associated with diabetic complications. We sought to explore the relationship between TIR and corneal nerve parameters in asymptomatic patients with type 2 diabetes (T2DM).Methods: In this cross-sectional study, 206 asymptomatic inpatients with T2DM were recruite...     

Leukocyte angiotensin II levels inpatients with essential hypertension:relation to insulin resistance

Insulin resistance is involved in the pathogenesis of type 2 diabetes, hypertension, and atherosclerosis. Angiotensin (Ang) converting enzyme inhibitors and Ang II type 1 receptor antagonists improve insulin resistance in patients with essential hypertension, which suggest that tissue Ang II is involved in insulin resistance in patients with hypertension. To investigate the participation of tissue Ang II in insulin resistance associated with hypertension, we evaluated the Ang II-generating system in leukocytes and its relation to insulin resistance in patients with essential hypertension. Eighteen patients with essential hypertension participated in this study. Ang II was separated from leukocytes by reversed-phase high-performance liquid chromatography and measured by radioimmunoassay. Insulin resistance was evaluated by determining the steady-state of plasma glucose (SSPG) concentration. The Ang I- and Ang II-generating activities were evaluated in human leukocytes. Human leukocytes have Ang I- and Ang II-generating activities. The Ang II-generating activity was significantly inhibited by pepstatin A. Leukocyte Ang II level does not correlate with BP or plasma Ang II level in patients with essential hypertension. Leukocyte Ang II level strongly correlates with SSPG concentration, and significantly correlates with body mass index and plasma insulin, and with leptin levels in patients with essential hypertension. Leukocyte Ang II may be directly associated with insulin resistance.     

胃肠道癌患者生命质量影响因素初探

背景与目的:生命质量测评已广泛应用在肿瘤研究中,而癌症患者生命质量研究对于推动癌症治疗的进步也起着越来越重要的作用.本研究旨在评估胃癌、大肠癌患者的生命质量,探讨与之相关的影响因素.方法:自2005年2月1日至2006年8月31日,采用癌症患者生命质量测定量表核心量表EORTC QLQ C30调查了52例胃癌患者和50例大肠癌患者.各影响生命质量凶素的差异程度经t检验及方差分析处理.最优尺度回归分析和判别方程了解生命质量各个子量表与临床分期的关系.多重线性回归分析整体生命质量与功能量表、症状量表及单项量表的关系.结果:临床分期较早期、高文化程度、经过综合治疗后的患者显示较高的功能量表得分和整体生命质量得分,以及较低的症状量表及单项量表得分,因而生命质量较好.年龄、性别等对生命质量影响不大.胃癌组整体生命质量量表得分低于大肠癌组,提示胃癌患者相对于大肠癌患者生命质量较差.结论:临床分期、文化程度和治疗方法是影响胃肠道癌患者生命质量的最重要因素.