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Accurate lymph node staging is important for the diagnosis and treatment of patients with bladder cancer. We aimed to develop a lymph node metastases diagnostic model (LNMDM) on whole slide images and to assess the clinical effect of an artificial intelligence-assisted (AI) workflow. In this retrospective, multicentre, diagnostic study in China, we included consecutive patients with bladder cancer who had radical cystectomy and pelvic lymph node dissection, and from whom whole slide images of lymph node sections were available, for model development. We excluded patients with non-bladder cancer and concurrent surgery, or low-quality images. Patients from two hospitals (Sun Yat-sen Memorial Hospital of Sun Yat-sen University and Zhujiang Hospital of Southern Medical University, Guangzhou, Guangdong, China) were assigned before a cutoff date to a training set and after the date to internal validation sets for each hospital. Patients from three other hospitals (the Third Affiliated Hospital of Sun Yat-sen University, Nanfang Hospital of Southern Medical University, and the Third Affiliated Hospital of Southern Medical University, Guangzhou, Guangdong, China) were included as external validation sets. A validation subset of challenging cases from the five validation sets was used to compare performance between the LNMDM and pathologists, and two other datasets (breast cancer from the CAMELYON16 dataset and prostate cancer from the Sun Yat-sen Memorial Hospital of Sun Yat-sen University) were collected for a multi-cancer test. The primary endpoint was diagnostic sensitivity in the four prespecified groups (ie, the five validation sets, a single-lymph-node test set, the multi-cancer test set, and the subset for a performance comparison between the LNMDM and pathologists). Between Jan 1, 2013 and Dec 31, 2021, 1012 patients with bladder cancer had radical cystectomy and pelvic lymph node dissection and were included (8177 images and 20 954 lymph nodes). We excluded 14 patients (165 images) with concurrent non-bladder cancer and also excluded 21 low-quality images. We included 998 patients and 7991 images (881 [88%] men; 117 [12%] women; median age 64 years [IQR 56–72]; ethnicity data not available; 268 [27%] with lymph node metastases) to develop the LNMDM. The area under the curve (AUC) for accurate diagnosis of the LNMDM ranged from 0·978 (95% CI 0·960–0·996) to 0·998 (0·996–1·000) in the five validation sets. Performance comparisons between the LNMDM and pathologists showed that the diagnostic sensitivity of the model (0·983 [95% CI 0·941–0·998]) substantially exceeded that of both junior pathologists (0·906 [0·871–0·934]) and senior pathologists (0·947 [0·919–0·968]), and that AI assistance improved sensitivity for both junior (from 0·906 without AI to 0·953 with AI) and senior (from 0·947 to 0·986) pathologists. In the multi-cancer test, the LNMDM maintained an AUC of 0·943 (95% CI 0·918–0·969) in breast cancer images and 0·922 (0·884–0·960) in prostate cancer images. In 13 patients, the LNMDM detected tumour micrometastases that had been missed by pathologists who had previously classified these patients' results as negative. Receiver operating characteristic curves showed that the LNMDM would enable pathologists to exclude 80–92% of negative slides while maintaining 100% sensitivity in clinical application. We developed an AI-based diagnostic model that did well in detecting lymph node metastases, particularly micrometastases. The LNMDM showed substantial potential for clinical applications in improving the accuracy and efficiency of pathologists' work. National Natural Science Foundation of China, the Science and Technology Planning Project of Guangdong Province, the National Key Research and Development Programme of China, and the Guangdong Provincial Clinical Research Centre for Urological Diseases. [ABSTRACT FROM AUTHOR]

Ethnopharmacological relevance Cichorium glandulosum Boiss. et Huet was used historically in Uyghur folk medicine. Its roots, seeds, and aerial parts are extensively used by Uyghur residents in Xinjiang to eliminate savda typhoid, dredge and cure obstructive jaundice variety liver disorders. Aim of the study To evaluate the hepatoprotective activity of total flavonoids (TFs) obtained from C. glandulosum seeds against carbon tetrachloride (CCl 4 )-induced liver damage in vitro and in vivo . To investigate the mechanisms of hepatoprotective effects for TFs. Materials and methods The dried seeds of C. glandulosum were extracted with 70% aqueous ethanol, and the extract was chromatographed with D101 macroporous resin. In vitro the antioxidant capacity against lipid peroxidation (LPO) was evaluated using ferrothiocyanate, thiobarbituric acid, β-carotene bleaching, and LPO inhibition assay. The cytotoxicity and hepatoprotective activity of TFs were evaluated in human liver hepatoma cells (HepG2). MTT assay, hepatic injury markers aspartate aminotransferase (AST), alanine aminotransaminase (ALT), lactate dehydrogenase (LDH) leakage, malondialdehyde (MDA), and glutathione (GSH) were performed. In vivo the hepatoprotective activity of TFs against CCl 4 -induced acute liver injury was evaluated in rats. A series of biochemical and antioxidant parameter levels were measured in liver homogenate. The suppressive effect on pancreatic lipase activity was determined. Results Results indicated that TFs showed antioxidant capacity against lipid peroxidation (LPO). Administrating CCl 4 (1%, v/v) caused a significant decrease in HepG2 viability. Treatment with TFs at doses (62.5, 125, and 250 μg/ml) could significantly ameliorate the cytotoxicity and decline the levels of AST, ALT, and LDH induced by CCl 4 . The markers including MDA and GSH, which were close to oxidative damage, were restored. Oral treatment with TFs in vivo at doses of 100, 200, and 400 mg/kg significantly reduced the levels of AST, ALT, alkaline phosphatase (ALP), total bilirubin (TB), and thiobarbituric acid reactive substances (TBARs) in the serum compared with CCl 4 -induced acute liver injury in rats. TFs showed dose-dependent suppressive effects on pancreatic lipase activity, and the IC 50 was 1.318±0.164 mg/ml. Conclusion TFs from C. glandulosum seeds demonstrated significant hepatoprotection against CCl 4 -induced hepatotoxicity. TFs exhibited significant suppression of LPO and pancreatic lipase capacity, which may be the mechanisms of hepatoprotective effects against CCl 4 . Our results contribute towards validation of the traditional use of C. glandulosum seeds in the treatment of liver disorders. [ABSTRACT FROM AUTHOR]

Abstract: Lotus (Nelumbo nucifera) is an extensively cultivated vegetable in eastern Asia, particularly in China. Both lotus rhizome knot (LRK) and lotus leaf (LL) are waste products of the lotus industry. Extracts from LRK and LL are proposed as antioxidants for meat. Porcine and bovine ground meat samples were subjected to three treatments: CONTROL (with no additives), LRK (lotus rhizomes knot extract 3% w/w), and LL (lotus leaf extract 3% w/w). Raw and cooked samples were stored at 4°C and the antioxidant activity was determined at 1, 3, 6 and 10days. Antioxidant activity was significantly increased in all meat samples with the addition of both LRK and LL, but LRK was more effective against lipid oxidation. The results show the potential for using LRK and LL extracts in the meat industry to prolong shelf life. [ABSTRACT FROM AUTHOR]

Halenia elliptica, a medicinal herb of Tibetan origin, was commonly used in folk medicine to treat hepatitis. The aim of the present study is to evaluate the hepatoprotective and antioxidant activity of Halenia elliptica against experimentally induced liver injury. Materials and methods: The antioxidant property of methanolic extract (ME) of Halenia elliptica was investigated by employing various established in vitro systems. The ME of Halenia elliptica was studied here for its hepatoprotective effects against CCl4-induced liver toxicity in rats. Activity was measured by monitoring the levels of alanine aminotransferase (ALT), aspartate transaminase (AST), alkaline phosphatase (ALP), and total bilirubin. Results: The ME possessed strong antioxidant activity in vitro. The results of CCl4-induced liver toxicity experiment showed that rats treated with the ME of Halenia elliptica (100mg/kg and 200mg/kg), and also the standard treatment, silymarin (50mg/kg), showed a significant decrease in ALT, AST, ALP, and total bilirubin levels, which were all elevated in the CCl4 group (p <0.01). The results observed after administration of 100mg/kg ME were comparable to those of silymarin at 50mg/kg (p >0.05). The ME did not show any mortality at doses up to 2000g/kg body weight. Conclusion: These results seem to support the traditional use of Halenia elliptica in pathologies involving hepatotoxicity, and the possible mechanism of this activity may be due to strong free radical-scavenging and antioxidant activities of ME. [Copyright &y& Elsevier]