Search

Background Digestive tract reconstruction is required after the surgical resection of a colorectal malignant tumor. Some patients may have concomitant anastomotic complications, such as anastomotic stenosis with fistula (ASF), postoperatively. Therefore, we evaluated the efficacy and safety of endoscopic fully covered self-expandable metal stent and homemade vacuum sponge-assisted drainage (FSEM-HVSD) for the treatment of ASF following the radical resection of colorectal cancer. Methods Patients treated with FESM-HVSD were prospectively analyzed and followed up for ASF following colorectal cancer treatment in our medical center from 2017 to 2021 for the observation and evaluation of its safety and efficacy. Results Fifteen patients with a mean age of 55.80 ± 11.08 years were included. Nine patients (60%) underwent protective ileostomy. All 15 patients were treated with endoscopic FSEM-HVSD. The median time from the index operation to the initiation of FSEM-HVSD was 80 ± 20.34 days in patients who underwent protective ileostomy versus 11.4 ± 4.4 days in those who did not. The average number of endoscopic treatments per patient was 5.70 ± 1.25 times. The mean length of hospital stay was 27.60 ± 4.43 days. FSEM-HVSD treatment was successful in 13 patients, and no patients had any complications. The follow-up time was 1 year. Twelve of 15 (80%) patients achieved prolonged clinical success after FSEM-HVSD treatment, 1 experienced anastomotic tumor recurrence and underwent surgery again, and 1 patient required balloon dilation for anastomotic stenosis recurrence. Conclusions FSEM-HVSD is an effective, safe, and minimally invasive treatment for ASF following colorectal cancer treatment. This technique could be the preferred treatment strategy for patients with ASF.

Background: It is of great importance to predict the early recurrence (ER) of hepatocellular carcinoma (HCC) after hepatectomy using preoperative imaging modalities. Nevertheless, no comparative studies have been conducted to determine which modality, CT or MRI with radiomics analysis, is more effective. Methods: We retrospectively enrolled 119 HCC patients who underwent preoperative CT and MRI. A total of 3776 CT features and 4720 MRI features were extracted from the whole tumor. The minimum redundancy and maximum relevance algorithm (MRMR) and least absolute shrinkage and selection operator (LASSO) regression were applied for feature selection, then support vector machines (SVMs) were applied for model construction. Multivariable logistic regression analysis was employed to construct combined models that integrate clinical–radiological–pathological (CRP) traits and radscore. Receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis (DCA) were used to compare the efficacy of CT, MRI, and CT and MRI models in the test cohort. Results: The CT model and MRI model showed no significant difference in the prediction of ER in HCC patients (p = 0.911). RadiomicsCT&MRI demonstrated a superior predictive performance than either RadiomicsCT or RadiomicsMRI alone (p = 0.032, 0.039). The combined CT and MRI model can significantly stratify patients at high risk of ER (area under the curve (AUC) of 0.951 in the training set and 0.955 in the test set) than the CT model (AUC of 0.894 and 0.784) and the MRI model (AUC of 0.856 and 0.787). DCA demonstrated that the CT and MRI model provided a greater net benefit than the models without radiomics analysis. Conclusions: No significant difference was found in predicting the ER of HCC between CT models and MRI models. However, the multimodal radiomics model derived from CT and MRI can significantly improve the prediction of ER in HCC patients after resection.

Background Tumour perineural invasion (PNI) is a predictor of poor prognosis, but its effect on the prognosis of patients with colorectal cancer (CRC) has not yet been elucidated. Methods This retrospective study used propensity score matching (PSM). The clinical case data of 1470 patients with surgically treated stage I–IV CRC at Wuhan Union Hospital were collected. PSM was used to analyse and compare the clinicopathological characteristics, perioperative outcomes, and long-term prognostic outcomes of the PNI(+) and PNI(-) groups. The factors influencing prognosis were screened using Cox univariate and multivariate analyses. Results After PSM, 548 patients were included in the study (n = 274 in each group). Multifactorial analysis showed that neurological invasion was an independent prognostic factor affecting patients’ OS and DFS (hazard ratio [HR], 1.881; 95% confidence interval [CI], 1.35–2.62; P = 0.0001; HR, 1.809; 95% CI, 1.353–2.419; P Conclusions PNI significantly affects the long-term survival and prognosis of patients with CRC undergoing surgery and is an independent risk factor for OS and DFS in patients with CRC undergoing surgery. Postoperative chemotherapy significantly improved the OS of PNI(+) patients.

Background This study aims to construct radiomics models based on [18F]FDG PET/CT using multiple machine learning methods to predict the EGFR mutation status of lung adenocarcinoma and evaluate whether incorporating clinical parameters can improve the performance of radiomics models. Methods A total of 515 patients were retrospectively collected and divided into a training set (n = 404) and an independent testing set (n = 111) according to their examination time. After semi-automatic segmentation of PET/CT images, the radiomics features were extracted, and the best feature sets of CT, PET, and PET/CT modalities were screened out. Nine radiomics models were constructed using logistic regression (LR), random forest (RF), and support vector machine (SVM) methods. According to the performance in the testing set, the best model of the three modalities was kept, and its radiomics score (Rad-score) was calculated. Furthermore, combined with the valuable clinical parameters (gender, smoking history, nodule type, CEA, SCC-Ag), a joint radiomics model was built. Results Compared with LR and SVM, the RF Rad-score showed the best performance among the three radiomics models of CT, PET, and PET/CT (training and testing sets AUC: 0.688, 0.666, and 0.698 vs. 0.726, 0.678, and 0.704). Among the three joint models, the PET/CT joint model performed the best (training and testing sets AUC: 0.760 vs. 0.730). The further stratified analysis found that CT_RF had the best prediction effect for stage I–II lesions (training set and testing set AUC: 0.791 vs. 0.797), while PET/CT joint model had the best prediction effect for stage III–IV lesions (training and testing sets AUC: 0.722 vs. 0.723). Conclusions Combining with clinical parameters can improve the predictive performance of PET/CT radiomics model, especially for patients with advanced lung adenocarcinoma.

BACKGROUND: To explore the association between the glucose metabolism level of lung ground-glass nodules (GGNs), as revealed by (18)F-flurodeoxyglucose positron emission tomography/computed tomography ((18)F-FDG PET/CT) imaging, and the invasive pathological growth pattern of early lung adenocarcinoma. METHODS: We retrospectively analyzed patients who underwent PET/CT examination and surgical resection due to persistent GGNs, which were confirmed to be early lung adenocarcinoma by postoperative pathology examination. After adjusting for confounding factors and performing stratified analysis, we explored the association between the maximum standard uptake value of PET (SUVmax) and the invasive pathological growth pattern of early stage lung adenocarcinoma. RESULTS: The proportions of invasive adenocarcinoma (INV) in the SUVmax of Tertile 1, Tertile 2, and Tertile 3 were 52.7%, 73.3%, and 87.1%, respectively. After adjusting for potential confounding factors, the risk of INV gradually increased as the GGN SUVmax increased [odds ratio (OR): 1.520, 95% confidence interval (CI): 1.044–2.213, P=0.029]. This trend was statistically significant (OR: 1.678, 95% CI: 1.064–2.647, P=0.026), especially in Tertile 3 vs. Tertile 1 (OR: 4.879, 95% CI: 1.349–17.648, P=0.016). Curve fitting showed that the SUVmax and INV risk were linearly and positively associated. The association was consistent in different subgroups based on GGN number, type, shape, edge, bronchial sign, vacuole sign, pleural depression sign, diameters, and consolidation-to-tumor ratio, suggesting that there was no significant interaction between different grouping parameters and the association (P for interaction range = 0.129–0.909). CONCLUSIONS: In FDG PET, the glucose metabolism level (SUVmax) of lung GGNs is independently associated with INV risk, and this association is linear and positive.

Gastrointestinal cancer (GIC) is a common malignant tumour of the digestive system that seriously threatens human health. Due to the unique organ structure of the gastrointestinal tract, endoscopic and MRI diagnoses of GIC in the clinic share the problem of low sensitivity. The ineffectiveness of drugs and high recurrence rates in surgical and drug therapies are the main factors that impact the curative effect in GIC patients. Therefore, there is an urgent need to improve diagnostic accuracies and treatment efficiencies. Nanotechnology is widely used in the diagnosis and treatment of GIC by virtue of its unique size advantages and extensive modifiability. In the diagnosis and treatment of clinical GIC, surface-enhanced Raman scattering (SERS) nanoparticles, electrochemical nanobiosensors and magnetic nanoparticles, intraoperative imaging nanoparticles, drug delivery systems and other multifunctional nanoparticles have successfully improved the diagnosis and treatment of GIC. It is important to further improve the coordinated development of nanotechnology and GIC diagnosis and treatment. Herein, starting from the clinical diagnosis and treatment of GIC, this review summarizes which nanotechnologies have been applied in clinical diagnosis and treatment of GIC in recent years, and which cannot be applied in clinical practice. We also point out which challenges must be overcome by nanotechnology in the development of the clinical diagnosis and treatment of GIC and discuss how to quickly and safely combine the latest nanotechnology developed in the laboratory with clinical applications. Finally, we hope that this review can provide valuable reference information for researchers who are conducting cross-research on GIC and nanotechnology. Graphical Abstract

BACKGROUND: To develop and verify a prediction model for distinguishing malignant from benign ground-glass nodules (GGNs) combined with clinical characteristics and (18)F-fluorodeoxyglucose (FDG) positron emission tomography-computed tomography (PET/CT) parameters. METHODS: We retrospectively analyzed 170 patients (56 males and 114 females) with GGNs who underwent PET/CT and high-resolution CT examination in our hospital from November 2011 to December 2019. The clinical and imaging data of all patients were collected, and the nodules were randomly divided into a derivation set and a validation set. For the derivation set, we used multivariate logistic regression to develop a prediction model for distinguishing benign from malignant GGNs. A receiver operating characteristic (ROC) curve was used to evaluate the diagnostic efficacy of the model, and the data in the validation set were used to verify the prediction model. RESULTS: Among the 170 patients, 197 GGNs were confirmed via postoperative pathological examination or clinical follow-up. There were 21 patients with 27 GGNs in the benign group and 149 patients with 170 GGNs in the adenocarcinoma group. A total of five parameters, including the patient’s sex, nodule location, margin, pleural indentation, and standardized uptake value (SUV) index (the ratio of nodule SUVmax to liver SUVmean), were selected to develop a prediction model for distinguishing benign from malignant GGNs. The area under the curve (AUC) of the model was 0.875 in the derivation set, with a sensitivity of 0.702 and a specificity of 0.923. The positive likelihood ratio was 9.131, and the negative likelihood ratio was 0.322. In the validation set, the AUC of the model was 0.874, which was not significantly different from the derivation set (P=0.989). CONCLUSIONS: This study developed and validated a prediction model based on (18)F-FDG PET/CT imaging and clinical characteristics for distinguishing malignant from benign GGNs. The model showed good diagnostic efficacy and high specificity, which can improve the preoperative diagnosis of high-risk GGNs.

Background Renal surface nodularity (RSN) is a subclinical biomarker of renal injury and may be associated with arterial hypertension. Purpose To explore the association of RSN with arterial hypertension compared to normotensive patients. Material and Methods A total of 205 inpatients with or without high blood pressure (HBP vs. control group) who underwent abdominal computed tomography (CT) scans were included. Their clinical characteristics included age, sex, HBP course, HBP grade, history of diabetes mellitus (DM), and renal function (estimated glomerular filtration rate [eGFR]). The HBP group included HBP/+DM and HBP/–DM based on the presence or absence of DM. The CT-based RSN grade was scored from 0 to 2 by two radiologists, respectively, where RSN grade 0 indicated smooth renal surface, grade 1 was mild RSN, and grade 2 was marked RSN. Results The inter-rater agreement on RSN was good (Kappa = 0.76). The age-specific rate of RSN grade 1–2 was bigger in the HBP group than in the control group (42.86% [40%–49.22%] vs. 2.18% [0.00%–22.5%]; P = 0.005). RSN grade was associated with HBP course ( P 0.05). The eGFR was similar among the RSN grades in HBP or between the HBP and control groups ( P > 0.05). Conclusion RSN was associated with HBP compared to normotensive patients.

Chemotherapy is not recommended for patients with deficient mismatch repair (dMMR) in colorectal cancer (CRC); therefore, assessing the status of MMR is crucial for the selection of subsequent treatment. This study is aimed at building predictive models to accurately and rapidly identify dMMR. A retrospective analysis was performed at Wuhan Union Hospital between May 2017 and December 2019 based on the clinicopathological data of patients with CRC. The variables were subjected to collinearity, least absolute shrinkage and selection operator (LASSO) regression, and random forest (RF) feature screening analyses. Four sets of machine learning models (extreme gradient boosting (XGBoost), support vector machine (SVM), naive Bayes (NB), and RF) and a conventional logistic regression (LR) model were built for model training and testing. Receiver operating characteristic (ROC) curves were plotted to evaluate the predictive performance of the developed models. In total, 2279 patients were included in the study and were randomly divided into either the training or test group. Twelve clinicopathological features were incorporated into the development of the predictive models. The area under curve (AUC) values of the five predictive models were 0.8055 for XGBoost, 0.8174 for SVM, 0.7424 for NB, 8584 for RF, and 0.7835 for LR (Delong test, P value < 0.05). The results showed that the RF model exhibited the best recognition ability and outperformed the conventional LR method in identifying dMMR and proficient MMR (pMMR). Our predictive models based on routine clinicopathological data can significantly improve the diagnostic performance of dMMR and pMMR. The four machine learning models outperformed the conventional LR model.

Objective Thromboangiitis obliterans is a nonatherosclerotic segmental inflammatory disease, and miR-100 plays an anti-inflammatory role in chronic inflammation. Therefore, we hypothesized that miR-100 might alleviate the inflammatory damage and apoptosis of H2O2-induced ECV304 cells and aimed to investigate the relationship between miR-100 and thromboangiitis obliterans and the related molecular mechanism. Methods Cell counting kit-8 was used to detect cell viability, and the expression of inflammatory factors and oxidative stress was measured by ELISA. TUNEL assay was used to detect the apoptosis of human umbilical vein endothelial cells after induction by H2O2. Furthermore, the interaction between miR-100 and matrix metalloproteinase-9 was verified by dual-luciferase assay. Quantitative reverse transcription polymerase chain reaction and western blot were used to detect the expression of the adhesion factors, apoptosis-related proteins and Notch pathway-related protein. Results The results revealed that miR-100 was decreased in H2O2-induced human umbilical vein endothelial cells. Overexpression of miR-100 attenuated inflammatory response and cell apoptosis in H2O2-induced human umbilical vein endothelial cells. The overexpression of miR-100 inhibited matrix metalloproteinase-9 expression in H2O2-induced human umbilical vein endothelial cells. miR-100 inhibited H2O2-induced human umbilical vein endothelial cell inflammation, oxidative stress, and cell apoptosis via inactivation of Notch signaling by targeting matrix metalloproteinase. Conclusions Our study demonstrated that miR-100 reduced the inflammatory damage and apoptosis of H2O2-induced human umbilical vein endothelial cells via inactivation of Notch signaling by targeting matrix metalloproteinase. These findings suggested that miR-100 might be a novel therapeutic target for the prevention of thromboangiitis obliterans.

Background Hepato-pulmonary metastasis of colorectal cancer (CRC) is a rare disease with poor prognosis. This study aims to establish a highly efficient nomogram model to predict overall survival (OS) and cancer-specific survival (CSS) in patients with colorectal cancer hepato-pulmonary metastasis (CRCHPM). Methods We retrospectively analyzed the data of patients with CRCHPM from SEER database and Wuhan Union Hospital Cancer Center (WUHCC). A total of 1250 CRCHPM patients were randomly assigned to the training, internal validation, and external validation cohorts from 2010 to 2016.Univariate and multivariate cox analysis were performed to identify independent clinicopathological predictors of OS and CSS, and a nomogram was constructed to predict OS and CSS in CRCHPM patients. Results A nomogram of OS was constructed based on seven independent predictors of age, degree of differentiation, T stage, chemotherapy, number of lsampled lymph nodes, number of positive lymph nodes, and tumor size. Nomogram showed favorable sensitivity in predicting OS at 1, 3 and 5 years, with area under the receiver operating characteristic curve (AUROC) values of 0.802, 0.759 and 0.752 in the training cohort;0.814, 0.769 and 0.716 in the internal validation cohort;0.778, 0.756 and 0.753 in the external validation cohort, respectively. A nomogram of CSS was constructed based on three independent predictors of T stage, chemotherapy, and tumor size. The AUROC values of 1, 3 and 5 years were 0.709,0.588,0.686 in the training cohort; 0.751, 0.648,0.666 in the internal validation cohort;0.781,0.588,0.645 in the external validation cohort, respectively. Calibration curves, Concordance index (C-index), and decision curve analysis (DCA) results revealed that using our model to predict OS and CSS is more efficient than other single clinicopathological characteristics. Conclusion A nomogram of OS and CSS based on clinicopathological characteristics can be conveniently used to predict the prognosis of CRCHPM patients.

Background To establish and validate 18F-fluorodeoxyglucose (18F-FDG) PET/CT-based radiomics model and use it to predict the intermediate-high risk growth patterns in early invasive adenocarcinoma (IAC). Methods Ninety-three ground-glass nodules (GGNs) from 91 patients with stage I who underwent a preoperative 18F-FDG PET/CT scan and histopathological examination were included in this study. The LIFEx software was used to extract 52 PET and 49 CT radiomic features. The least absolute shrinkage and selection operator (LASSO) algorithm was used to select radiomic features and develop radiomics signatures. We used the receiver operating characteristics curve (ROC) to compare the predictive performance of conventional CT parameters, radiomics signatures, and the combination of these two. Also, a nomogram based on conventional CT indicators and radiomics signature score (rad-score) was developed. Results GGNs were divided into lepidic group (n = 18) and acinar-papillary group (n = 75). Four radiomic features (2 for PET and 2 for CT) were selected to calculate the rad-score, and the area under the curve (AUC) of rad-score was 0.790, which was not significantly different as the attenuation value of the ground-glass opacity component on CT (CTGGO) (0.675). When rad-score was combined with edge (joint model), the AUC increased to 0.804 (95% CI [0.699–0.895]), but which was not significantly higher than CTGGO (P = 0.109). Furthermore, the decision curve of joint model showed higher clinical value than rad-score and CTGGO, especially under the purpose of screening for intermediate-high risk growth patterns. Conclusion PET/CT-based radiomics model shows good performance in predicting intermediate-high risk growth patterns in early IAC. This model provides a useful method for risk stratification, clinical management, and personalized treatment.

An experimental investigation on the disturbance effect of jet-type active vibration suppression device on vortex-induced vibration of deep-sea riser was carried out in the wave-flow combined flume. The vibration suppression device was designed in which the jet pipe was horizontally fixed to the front end of the riser. By varying three different excitation spacings and multi-stage outflow velocities, the influence law of the dominant frequency, dimensionless displacement and other dynamic response parameters was studied under different excitation spacings, and the mechanism and sensitive characteristics of the disturbance suppression were explored. The results indicate that the variation of excitation spacing makes gas curtain enter the strong disturbed flow region at different velocities and angles, and the coupling relationship between excitation spacing and reduced velocity is the key factor to enter the strong disturbed flow region to achieve the optimal disturbance suppression. In the strong disturbed flow region, the influence of gas curtain on the dominant frequency is obviously affected by the flow velocity, while the vibration displacement is stable at the same amplitude and is weakly affected by the flow velocity. Gas curtain can effectively disturb the formation of vortex shedding, destroy the strong nonlinear coupled vibration of the riser, and achieve better vibration suppression effect. In the weak disturbed flow region, the vortex length of the riser tail is prolonged, the strong nonlinear coupled vibration of the riser is gradually restored, and the vibration suppression effect of the device gradually decreases.

To investigate whether the maximum standardized uptake value (SUVmax) of 18F-deoxyglucose (FDG) PET imaging can increase the diagnostic efficiency of CT radiomics-based prediction model in differentiating benign and malignant pulmonary ground-glass nodules (GGNs). We retrospectively collected 190 GGNs from 165 patients who underwent 18F-FDG PET/CT examination from January 2012 to March 2020. Propensity score matching (PSM) was performed to select GGNs with similar baseline characteristics. LIFEx software was used to extract 49 CT radiomic features, and the least absolute shrinkage and selection operator (LASSO) algorithm was used to select parameters and establish the Rad-score. Logistic regression analysis was performed combined with semantic features to construct a CT radiomics model, which was combined with SUVmax to establish the PET + CT radiomics model. Receiver operating characteristic (ROC) was used to compare the diagnostic efficacy of different models. After PSM at 1:4, 190 GGNs were divided into benign group (n = 23) and adenocarcinoma group (n = 92). After texture analysis, the Rad-score with three CT texture features was constructed for each nodule. Compared with the Rad-score and CT radiomics model (AUC: 0.704 (95%CI: 0.562-0.845) and 0.908 (95%CI: 0.842-0.975), respectively), PET + CT radiomics model had the best diagnostic efficiency (AUC: 0.940, 95%CI: 0.889-0.990), and there was significant difference between each two of them (P = 0.001-0.030). SUVmax can effectively improve CT radiomics model performance in the differential diagnosis of benign and malignant GGNs. PET + CT radiomics might become a noninvasive and reliable method for differentiating of GGNs.

Purpose This work aims to train, validate, and test a dual-stream three-dimensional convolutional neural network (3D-CNN) based on fluorine 18 (18F)-fluorodeoxyglucose (FDG) PET/CT to distinguish benign lesions and invasive adenocarcinoma (IAC) in ground-glass nodules (GGNs). Methods We retrospectively analyzed patients with suspicious GGNs who underwent 18F-FDG PET/CT in our hospital from November 2011 to November 2020. The patients with benign lesions or IAC were selected for this study. According to the ratio of 7:3, the data were randomly divided into training data and testing data. Partial image feature extraction software was used to segment PET and CT images, and the training data after using the data augmentation were used for the training and validation (fivefold cross-validation) of the three CNNs (PET, CT, and PET/CT networks). Results A total of 23 benign nodules and 92 IAC nodules from 106 patients were included in this study. In the training set, the performance of PET network (accuracy, sensitivity, and specificity of 0.92 ± 0.02, 0.97 ± 0.03, and 0.76 ± 0.15) was better than the CT network (accuracy, sensitivity, and specificity of 0.84 ± 0.03, 0.90 ± 0.07, and 0.62 ± 0.16) (especially accuracy was significant, P-value was 0.001); in the testing set, the performance of both networks declined. However, the accuracy and sensitivity of PET network were still higher than that of CT network (0.76 vs. 0.67; 0.85 vs. 0.70). For dual-stream PET/CT network, its performance was almost the same as PET network in the training set (P-value was 0.372–1.000), while in the testing set, although its performance decreased, the accuracy and sensitivity (0.85 and 0.96) were still higher than both CT and PET networks. Moreover, the accuracy of PET/CT network was higher than two nuclear medicine physicians [physician 1 (3-year experience): 0.70 and physician 2 (10-year experience): 0.73]. Conclusion The 3D-CNN based on 18F-FDG PET/CT can be used to distinguish benign lesions and IAC in GGNs, and the performance is better when both CT and PET images are used together.

Thromboangiitis obliterans is a nonatherosclerotic segmental inflammatory disease, and miR-100 plays an anti-inflammatory role in chronic inflammation. Therefore, we hypothesized that miR-100 might alleviate the inflammatory damage and apoptosis of HCell counting kit-8 was used to detect cell viability, and the expression of inflammatory factors and oxidative stress was measured by ELISA. TUNEL assay was used to detect the apoptosis of human umbilical vein endothelial cells after induction by HThe results revealed that miR-100 was decreased in HOur study demonstrated that miR-100 reduced the inflammatory damage and apoptosis of H

BACKGROUND: Susceptibility weighted imaging (SWI) could reflect tissue blood oxygen levels, and then whether it could be used to evaluate renal injury remains to be further studied. This study aimed to examine the performance of SWI parameters and SWI-based texture features in evaluating renal dysfunction of type 2 diabetes mellitus (T2DM). METHODS: Forty-five patients with T2DM were included. With the estimated glomerular filtration rate (eGFR), the patients were divided into non-moderate-severe renal injured group (non-msRI, eGFR >60 mL/min/1.73 m(2)) and moderate-severe renal injured group (msRI, eGFR ≤60 mL/min/1.73 m(2)). The 3 SWI parameters and 16 SWI-based texture features between non-msRI and msRI were compared. The correlation between the parameters and BUN, Scr was analyzed. RESULTS: The signal intensity ratio of the medulla to psoas muscle (MPswi) was significantly lower than the signal intensity ratio of the cortex to psoas muscle (CPswi) in non-msRI and msRI group (t=8.619, 3.483, respectively, P0.05), and AUCs were 0.703–0.854. CMswi was an independent protective factor for msRI (OR =0.026, P=0.003). MPswi and CMswi were correlated with BUN (r=0.416, −0.545, P

Background To establish and validate 18F-fluorodeoxyglucose (18F-FDG) PET/CT-based radiomics model and use it to predict the intermediate-high risk growth patterns in early invasive adenocarcinoma (IAC). Methods Ninety-three ground-glass nodules (GGNs) from 91 patients with stage I who underwent a preoperative 18F-FDG PET/CT scan and histopathological examination were included in this study. The LIFEx software was used to extract 52 PET and 49 CT radiomic features. The least absolute shrinkage and selection operator (LASSO) algorithm was used to select radiomic features and develop radiomics signatures. We used the receiver operating characteristics curve (ROC) to compare the predictive performance of conventional CT parameters, radiomics signatures, and the combination of these two. Also, a nomogram based on conventional CT indicators and radiomics signature score (rad-score) was developed. Results GGNs were divided into lepidic group (n = 18) and acinar-papillary group (n = 75). Four radiomic features (2 for PET and 2 for CT) were selected to calculate the rad-score, and the area under the curve (AUC) of rad-score was 0.790, which was not significantly different as the attenuation value of the ground-glass opacity component on CT (CTGGO) (0.675). When rad-score was combined with edge (joint model), the AUC increased to 0.804 (95% CI [0.699–0.895]), but which was not significantly higher than CTGGO (P = 0.109). Furthermore, the decision curve of joint model showed higher clinical value than rad-score and CTGGO, especially under the purpose of screening for intermediate-high risk growth patterns. Conclusion PET/CT-based radiomics model shows good performance in predicting intermediate-high risk growth patterns in early IAC. This model provides a useful method for risk stratification, clinical management, and personalized treatment.

Introduction Sclerostin has been reported to be a novel biomarker associated with the bone-vascular axis. In this study, we determined the relationships between serum sclerostin and all-cause mortality, the prevalence of cardiovascular events (CVEs), and coronary artery calcifications (CACs) in dialysis patients. Methods A total of 165 dialysis patients (84 hemodialysis [HD] and 81 peritoneal dialysis [PD]) were enrolled in this study. We performed multivariable linear regression analysis to test the relationships between serum sclerostin levels and demographics and clinical parameters. We also performed Cox proportional hazard regression analysis to determine independent predictors of overall survival and CVEs. Results The median serum sclerostin level was 250.9 pg/mL in dialysis patients. Kaplan–Meier analysis showed that both overall and CVE-free survival rates were significantly lower in the high serum sclerostin group (serum sclerostin level >250.9 pg/mL) compared to the low serum sclerostin group (serum sclerostin level ≤250.9 pg/mL) in patients with PD (p 0.05). Conclusions A low serum sclerostin was associated with better overall survival and lower prevalence of CVEs in patients with PD, but had no relationships in patients with HD. We found that serum sclerostin level was not correlated with CACs in either patients with HD or PD.

Rationale and Objectives To evaluate qualitative and quantitative indicators generated from Dual-energy computed tomography (DECT) for preoperatively differentiating between invasive adenocarcinoma (IAC) and preinvasive or minimally invasive adenocarcinoma (MIA) lesions manifesting as ground-glass opacity-predominant (GGO-predominant) nodules. Materials and Methods We retrospectively enrolled 143 cases of completely resected GGO-predominant lung adenocarcinoma with DECT examinations between December 2017 and July 2019. Qualitative and quantitative parameters of GGO-predominant nodules were compared after grouping nodules into IAC and preinvasive-MIA groups. A multivariate logistic regression models were used for analyzing these parameters. The diagnostic performance of different parameters was compared by receiver operating characteristic (ROC) curves and Z tests. Results This study included 137 patients (58 years ± 11; male: female = 52:91) with 143 GGO-predominant nodules. The proportion of margins, internal dilated/distorted/cut-off bronchi, internal thickened/stiff/distorted vasculature, pleural indentation, and vascular convergence were higher in the IAC group than in the preinvasive-MIA group, as were the maximum diameter (Dmax), the diameter of the solid component (Dsolid) and the enhanced monochromatic CT value at 40 keV-190 keV (CT40 keV-190 keV) (p range: 0.001–0.019). Logistic regression analyses revealed that margin, Dmax, and CT60 keV values were independent predictors of the IAC group. The area under the curve (AUC) for the combination of margin, Dmax, and CT60 keV was 0.896 (90.2% sensitivity, 70.7% specificity, 84.6% accuracy), which was significantly higher than that for each two of them (all p Conclusion The combined prediction model generated from DECT allows for effective preoperative differentiation between IAC and preinvasive-MIA in GGO-predominant lung adenocarcinomas.

Supplementary material 2. Significance of PET/CT texture features between lepidic group and acinar-papillary group

Supplementary material 1. Report on image processing and radiomic features extraction

During the operation of coiled tubing drilling, the power motor will produce reactive torque when it works, which will affect the drilling process. A torque reducing device is designed to counteract the torque by injecting drilling fluid. The device is designed as a short section, connected with cardan shaft and drive shaft, the nozzle of which can be automatically adjusted according to the pump pressure. The flow model of the device is established by SolidWorks software, and then leaded in FLUENT software for simulation. The standard k-epsilon model is used to simulate the operating conditions of 5 nozzle diameters and 2 outlet diameters respectively, and the parameters such as pressure drop, torque and flow rate are obtained. The designed torque reducing device can offset about 30% of the torque generated by the screw drill, and the reactive force of single jet is about 152N. If the jet direction is perpendicular to the axis, it can produce the drilling pressure about 3.4kN. If the direction of the nozzle is aligned with the axis, the effect of pressurization and torsion reduction can be produced simultaneously.

OBJECTIVE. The purpose of this study was to explore the value of FDG PET combined with high-resolution CT (HRCT) in predicting the pathologic subtypes and growth patterns of early lung adenocarcinoma. MATERIALS AND METHODS. A retrospective analysis was conducted on the PET/CT data on ground-glass nodules (GGNs) resected from patients with stage IA lung adenocarcinoma. The efficacy of PET maximum standardized uptake value (SUVmax) combined with HRCT signs in prediction of histopathologic subtype and growth pattern of lung adeno-carcinoma was evaluated. RESULTS. SUVmax was significantly higher in GGNs with invasive HRCT signs. The diameter of GGN (odds ratio, 1.660; p = 0.000) and the difference in attenuation value (odds ratio, 1.012; p = 0.011) between ground-glass components and adjacent lung tissues were independent predictors of FDG uptake by GGNs. SUVmax was higher in invasive adenocarcinoma than in adenocarcinoma in situ (AIS)-minimally invasive adenocarcinoma (MIA) (median SUVmax, 2.0 vs 1.1; p = 0.008). An SUVmax of 2.0 was the optimal cutoff value for differentiating invasive adenocarcinoma from AIS-MIA. Acinar-papillary adenocarcinoma had a higher SUVmax than lepidic adenocarcinoma (median SUVmax, 2.1 vs 1.3; p = 0.037). An SUVmax of 1.4 was the optimal cutoff value for differentiating the growth pattern of adenocarcinoma. Use of PET/CT with HRCT significantly improved efficacy for differentiating invasive adeno-carcinoma from AIS-MIA. However, use of HRCT cannot significantly improve the diagnostic efficacy of FDG PET in the evaluation of tumors with different growth patterns. CONCLUSION. FDG PET can be used to predict the histopathologic subtypes and growth patterns of early lung adenocarcinoma. Combined with HRCT, it has value for predicting invasive histopathologic subtypes but no significance for predicting invasive growth patterns.

Purpose To compare the predictive models that can incorporate a set of CT image features for preoperatively differentiating the high grade (Fuhrman III–IV) from low grade (Fuhrman I–II) clear cell renal cell carcinoma (ccRCC). Material and methods One hundred and fourteen patients with ccRCC treated with a partial or radical nephrectomy were enrolled in the training cohort. The six non-texture features, including Pseudocapsule, Round mass, maximal tumor diameter (Diametermax), intratumoral artery (Arterytumor), enhancement value of the tumor (TEV) and relative TEV (rTEV), were assessed for each tumor. The texture features were extracted from the CT images of the section with the largest area of renal mass at both corticomedullary and nephrographic phases. The least absolute shrinkage and selection operator (LASSO) was used to screen the most valuable texture features to calculate a texture score (Texture-score) for each patient. A logistic regression model was used in the training cohort to discriminate the high from low grade ccRCC at nephrectomy. The predictors would include all non-texture features in Model 1, all non-texture features and Texture-score in Model 2, and Texture-score in Model 3. The performance of the predictive models were tested and compared in an independent validation cohort composed of 92 cases with ccRCC. Results Inter-rater agreement was good for each non-texture feature and Texture-score (the concordance correlation coefficient or Kappa coefficient > 0.70). The Texture-score was calculated via a linear combination of the 4 selected texture features. The three models shown good discrimination of the high from low grade ccRCC in the training cohort and the area under receiver operating characteristic curve (AUC) was 0.826 in Mode 1, 0.878 in Model 2 and 0.843 in Model 3, and a significant different AUC was found between Model 1 and Model 2. Application of the predictive models in the validation cohort still gave a discrimination (AUC > 0.670), and the Texture-score based models with or without the non-texture features (Model 2 and 3) showed a better discrimination of the high from low grade ccRCC (P Conclusion This study presented the Texture-score based models can facilitate the preoperative discrimination of the high from low grade ccRCC.

Aquilaria sinensis is one of the most important agarwood-producing trees but critically endangered at present. In this study, we produced the complete chloroplast (cp) genome of A. sinensis via genome survey analysis. The assembled genome is 174,914 base-pairs (bp) in length, with one large single-copy region of 87,361 bp and one small single-copy region of 3347 bp separated by two inverted repeats of 42,103 bp. The genome contains a total of 142 genes, including 96 protein-coding genes, 8 rRNAs, and 38 tRNAs. The phylogenomic tree strongly supports Aquilaria as a monophyly and A. sinensis sister to A. yunnanensis.

Acer saccharum is one ecologically and economically important tree species cultivated widely across the world. In this study we generated the complete chloroplast (cp) genome of A. saccharum via genome-skimming method. The assembled genome is 155,684 base-pairs (bp) in size, with one large single copy region of 85,393 bp and one small single copy region of 18,033 bp separated by two inverted repeats of 26,129 bp. The genome contains a total of 133 genes, including 85 protein-coding genes, 8 rRNAs and 40 tRNAs. Furthermore, phylogenomic estimation strongly supported A. saccharum as a distinct lineage within the monophyletic Acer.

In recent years, with the rapid development of large-length ultra-high-pressure voltage extrusion insulated submarine cable technology, the cable system in the medium-length offshore power grid interconnection project has been gradually replaced by XLPE insulation by traditional oil-paper insulation. There are many large cross-section conductors used in long-distance power transmission cables, and according to the IEC 60287-1-1, it is recommended to use Milliken conductors to reduce the AC resistance of conductors, at the same time, in submarine cables, there is a high requirement on the water-blocking performance of conductors and the water resistance of Milliken conductors is poor, so it is not used in submarine cable conductors. This paper puts forward a layering enamelled stranded conductor and a calculation method of AC / DC resistance ratio for it. The validity of the calculation method is verified by experimental tests. At the same time, the calculation shows that the AC / DC resistance of the conductor at 1800 mm2 nominal cross section can be reduced by 16% compared with the conventional round compacted conductor in the prior art. The effectiveness of this conductor in reducing AC resistance is verified by finite element simulation.

Triple helical strakes have been proved to be highly effective in suppressing the vortex-induced vibration (VIV) of isolated riser. Nevertheless, when risers work in clusters, interference effect can give rise to more complicated flow-induced vibration (FIV) behaviors, which in turn will largely compromise the suppression efficiency of triple helical strakes. In this paper, an experimental investigation on the VIV of two side-by-side risers in a uniform flow was carried out in a combined wave–current water flume. The riser models, with an effective length of 2.0 m and an aspect ratio of 111.11, were placed in the flume with 40% of their lengths immersed in water. The smooth riser was arranged side by side with the triple helical strakes vibration suppression riser with pitch/height of 17.5D/0.25D. By varying the structure and hydrodynamic parameters such as flow velocity and spacing ratio of the straked riser under interference effect and its dynamic feedbacks to the smooth riser for cases of side-by-side configuration are analyzed base on the observed dimensionless displacement, dominant frequency, and modal weight distribution of the risers. The results show that the interference effect of the straked riser on the smooth riser is significant, and the smooth riser with high velocities and large spacing arrangement is more likely to generate higher-order modes; under the influence of interference effect, the dominant frequency of straked riser is close to that of smooth riser, and this phenomenon disappears at high reduced velocities; the interference effect has a significant effect on the vibration suppression efficiency of the three triple helical strakes vibration suppression device. The maximum reduction of CF direction is 14.64%, and that of IL direction is 35.41%.

In this paper, a Strouhal-Reynolds number evolution region for the pipe groups within the subcritical Reynolds number range is established and a Strouhal-Reynolds number relation curve in root mean square terms is yielded for the first time. A Strouhal-Reynolds number model for flow around flexible pipes under 180 sets of test is presented. The least squares method is used to fit the Strouhal numbers among the pipes within their flow velocity intervals; isolated pipe is introduced as reference cases for examining how the Strouhal numbers of the pipes vary with Reynolds number. The results indicate that, when in tandem arrangement, the Strouhal number of the three-pipe group showed a gradual reduction from upstream to downstream whereas both vortex shedding enhancement and suppression occurred in the five-pipe group; interferences contributed to the vortex shedding in the wake flow of the pipes in side-by-side arrangement. It is also found that interferences significantly changed the vortex shedding frequencies on both rear sides of the pipes; only 16.9% of the Strouhal numbers of the three-pipe and five-pipe group fell within [0.185,0.20], which is largely different from conventional cognition of the Strouhal number within the subcritical Reynolds number range.

Materials with high insulating composition of (1–x)Bi0.47Na0.47Ba0.06TiO3–xBaZrO3 abbreviated as (NBBT–xBZ) (x = 0, 0.02, 0.04, 0.06, 0.08, 0.1) and NBBT–0.04BZ–z%BBS (0.96Bi0.47Na0.47Ba0.06TiO3–0.04BaZrO3; z wt%BaO–B2O3–SiO2) (z = 20, 30, 40, 50) were prepared by using a conventional, solid-state reaction route. X-ray diffraction analysis of the samples revealed that the crystal structure was a pseudo-cubic structure with change of unit cell. Effects of BZ (BaZrO3) and further BaO–B2O3–SiO2 (BBS) content on the microstructures, phase evolution, dielectric properties, breakdown characteristics, and discharged energy storage were investigated, respectively. In pace with the raising of BZ amount, the grain size of the ceramics increased, and the permittivity of dielectric and dielectric loss decreased. Dielectric relaxation behaviors were observed in dielectric constant versus temperature plots. The breakdown strength showed a trend of first increase and then decrease with the increase of BZ. Furthermore, adding enough BBS additive resulted in an ascent of energy–storage capability and an enhancement of energy efficiency. As a result, the improved structure of NBBT–xBZ ceramics resulted in an increase of up to 62 % in the breakdown strength, yielding an enhanced discharged energy density of 0.883 J/cm3 which were achieved from 80 kv/cm at x = 4 mol%, and an energy density of 1.05 J/cm3 was generated at an electric field of 110 kV/cm of NBBT–0.04BZ–z%BBS (z = 40) glass ceramic.

The aim of the study was to investigate the potential of T2* histogram (HIST) in the analysis of blood oxygen level-dependent magnetic resonance imaging for differentiating a renal dysfunction group from a control group.This study consisted of 13 control subjects and 20 patients with renal dysfunction. T2* maps were analyzed using both HIST and the conventional method. For the HIST, each region of interest covering renal parenchyma was applied to T2* map to generate a T2* HIST. The T2* HISTs were classified into type 1, 2, 3, and 4 on the basis of their morphologies. In each T2* HIST, the parameters were acquired from the peak with the smallest mean T2* values, which acted as the medullary T2* values, and from the peak with largest mean T2* values, which acted as the cortical T2* values. For the conventional method, small regions of interest were placed in the cortex and medulla for the quantitative analysis of the cortical and medullary T2* values, respectively.The type distribution of the T2* HISTs was significantly different between the 2 groups (control group: type 1, 0; 2, 4; 3, 5; and 4, 17 vs renal dysfunction group: type 1, 4; 2, 1; 3, 33; and 4, 2; P0.05). The medullary T2* values measured using both methods were significantly higher in the renal dysfunction group than that in the control group (29.38 [6.44] vs 22.79 [4.22] milliseconds for HIST, 30.61 [8.65] vs 21.37 [4.88] milliseconds for conventional method; P0.05). The area under the receiver operating characteristic curve for the medullary T2* measured using HIST was not greater than that using the conventional method (0.89 vs 0.82, P0.05).Histogram can automatically characterize the T2* map of renal parenchyma, thereby reducing the tediousness of placing ROIs and making it comparable with the conventional method in its ability to distinguish the renal dysfunction group from the control group.

Ethylene-propylene-diene terpolymer (EPDM) is widely used in HVDC cable accessories. However, the mismatch of DC conductivity between EPDM and cross-linked polyethylene (XLPE), and the effect of space charge accumulation at different insulating interfaces, will distort the electric field distribution and seriously affect the performance of insulating material. In this paper, EPDM was developed for ±535 kV HVDC cable accessories, and the conductivity, XLPE/EPDM space charge distribution and DC breakdown electric field were tested respectively. The electric field distribution of cable accessories was calculated by COMSOL analysis software. It is shown that electric field of the stress cone is far less than the DC breakdown electric field when the EPDM conductivity is close to XLPE; Furthermore, there is a small amount of space charge accumulation at XLPE/EPDM interface and in XLPE, but little space charge in EPDM. As a consequence, the research will make a potential application for ±535 kV HVDC cable accessories.

In this paper, the appropriate expression on resistivity and electric field for the DC cable insulation is proposed based on the available experimental data. It is indicated that there is e index relationship between resistivity and temperature, and there is power exponent relationship between resistivity and electric field. The effect of conductor temperature, the temperature difference of insulation etc. on the electric field distributio of DC cable insulation is analysed. It is shown that the high conductor temperature and the large temperature difference in insulation make not only the insulation property decline but also the electric field distortion. There is no effect of resistivity coefficient on the distribution of electric field, but the low coefficient leads to the decrease of DC cable ampacity. Based on the electric field expression, the life expression and effect of space charge, the method on design of DC cable insulation is proposed.

To explore the value of texture analysis based on diffusion-weighted imaging (DWI), blood oxygen level–dependent MRI (BOLD), and susceptibility-weighted imaging (SWI) in evaluating renal dysfunction. Seventy-two patients (mean age 53.72 ± 13.46 years) underwent MRI consisting of DWI, BOLD, and SWI. According to their estimated glomerular filtration rate (eGFR), the patients were classified into either severe renal function impairment (sRI, eGFR

Background: Blood oxygen level-dependent (BOLD)-MRI is a novel and noninvasive tool that can assess renal oxygenation. The R2* value is a parameter of tissue deoxyhemoglobin concentration detected by BOLD-MRI. The purpose of the current study was to determine the relationships between renal R2* values and clinical parameters and to determine whether renal R2* values were associated with the risk for progression of chronic kidney disease (CKD). Methods: Sixty patients with CKD were enrolled in this prospective observational study in China from March 2013 to August 2014. A region of interest-based BOLD-MRI was performed to obtain cortical and medullary R2* (CR2* and MR2*) values. Data on demographics and clinical characteristics were collected. The primary end point (CKD progression) was defined as an absolute 30% decline in the estimated glomerular filtration rates (eGFR; CKD-Epidemiology Collaboration equations) or initiation of dialysis during follow-up. Results: The CR2* and MR2* values in patients with CKD were significantly higher compared with those of healthy controls. The CR2* levels were positively associated with 24-h urinary protein excretion, blood urea nitrogen, creatinine, and uric acid but negatively associated with baseline eGFR, 24-h creatinine clearance, eGFR slope, serum albumin, and the use of angiotensin II type 1 receptor blockade. The CR2* levels had the highest areas under the curve during follow-up compared with the MR2* levels and medullary cortical ratios. The Kaplan-Meier survival analysis showed that patients with CKD in the lowest tertile of the CR2* levels had the best prognosis compared with the other 2 tertiles. Moreover, baseline eGFR and CR2* tertiles were associated with the progression of CKD in Cox proportional hazard regression models. Only CR2* tertiles correlated negatively with the eGFR slope. Conclusion: We have demonstrated that the clinical feasibility of BOLD-MRI to evaluate renal oxygenation and cortex hypoxia aggravates with the decline of renal function, and cortex hypoxia was a prognostic marker in the progression of CKD.

Ultra high voltage(UHV) power cable system is an economical, safe and reliable power transmission mode. In recent years, the concern about the traditional fossil energy pollution in the world and the determination to using clean energy have promote the medium distance UHV submarine power cable system. This paper designs and tests one kind of energy saving and loss reducing conductor applied to large cross-section submarine cable. Through reasonable process control, the paint film on the enamelled wire surface can be avoided being scraped during the process of twisting. According to the measured AC / DC resistance ratio, the optimized design for the subsequent conductor is put forward. Compared with the traditional conductor, the current carrying capacity of the conductor is improved, and it has a positive and practical significance for reducing the Joule loss of the cable system.

To investigate whether low b-factors-based apparent diffusion coefficient (ADC) is helpful in assessing renal dysfunction.Forty-four subjects were recruited, and classified as having severe renal injury group (sRI) or not (non-sRI) according to a threshold of estimated glomerular filtration rate (eGFR) = 30 ml/min/1.73 m(2). A free-breathing DWI with 7 b-factors (0, 20, 40, 80, 200, 400, and 800 s/mm(2)) was performed. After choosing an anatomical section that covered the largest part of right kidney, the regions of interest covered the renal parenchyma. For each subject, two apparent diffusion coefficients based on all b-factors less than 400 s/mm(2) (ADC0-400) and 800 s/mm(2) (ADC0-800) were calculated by fitting the signal intensity at different b-factors to a mono-exponential decay, respectively. It was found that the examination time of the free-breathing DWI sequence in this study can be reduced from 3.27 to 2.55 min if the b-factor (800 s/mm(2)) is removed.ADC0-400 was larger than ADC0-800 in each group (P0.05). Both ADC0-400 and ADC0-800 were smaller in the sRI group than those in the non-sRI group (P0.01), and they were linearly related with eGFR (P0.05). While a significant difference was not found between the two coefficients to differentiate sRI from non-sRI participants (P0.05), a strong correlation was present between ADC0-400 and ADC0-800 (r = 0.856, P0.001).The low b-factors-based ADC was an economical option for reducing the examination time without sacrificing its diagnostic performance.

Background Because renal dysfunction is a worldwide problem, accurate assessment is required for planning treatment and follow-up. Intra-voxel incoherent motion (IVIM) can isolate fast from slow water motion in well-perfused organs and may be helpful in assessing renal dysfunction. Purpose To determine the clinical value of IVIM in the assessment of renal dysfunction compared with a mono-exponential model. Material and Methods Fifty-four consecutive participants (mean age, 53.13 ± 13.96 years) were recruited into this study. The estimated glomerular filtration rate (eGFR) was calculated to classify the participants as having severe renal injury (sRI, eGFR ≤ 30 mL/min/1.73 m2) or not (non-sRI). DWI with seven b-factors was performed. Image analysis was performed by a radiologist to generate an apparent diffusion coefficient map (ADCmon) by mono-exponential model, diffusion coefficient (Dslow and Dfast), and fraction of fast diffusion (Ffast) maps by IVIM. The circular regions of interest were placed at the interface between the cortex and medulla for parameter measurements. Results The ADCmon, Dslow, Dfast, and Ffast were less in sRI than non-sRI ( P mon and Dslow were positively related with eGFR ( P 0.05). Furthermore, the correlation was 0.93 between ADCmon and Dslow, followed by 0.57 between Dfast and Ffast, 0.48 between ADCmon and Dfast, and 0.34 between ADCmon and Ffast ( P Conclusion The IVIM model contributed little to improving the assessment of renal dysfunction compared with a mono-exponential model.

Although soft tissue and vascular calcifications are common in CKD and progress as an independent risk factor of all-cause mortality, tumour calcification and calciphylaxis are uncommon in patients with end-stage renal disease (ESRD). Here, we discuss a rare case of a patient with tumour calcification complicated with calciphylaxis developed septic shock from infection. Our patient is a 57-year-old man in his late stage of renal disease who presented with a huge mass at the right hip and necrotic cutaneous ulcers on the lower legs followed by local and systemic infection and death due to septic shock.