1.The status,problems,and countermeasures of clinical diagnosis and treatment of Chinese medicine enabled by artificial intelligence
Xiaoli YANG ; Zhiping GONG ; Kexue PU ; Caifeng DONG
Chongqing Medicine 2024;53(4):613-616
Traditional Chinese medicine has been paid more and more attention in the development of modern healthcare,and its clinical diagnosis and treatment have broad prospects and enormous potential.However,the current traditional Chinese medicine diagnosis and treatment model have serious shortcomings in service capacity and,diagnosis,and treatment effect.The rapid development of big data and artificial intelli-gence technology provides an opportunity for the iterative upgrade of traditional Chinese medicine diagnosis and treatment models.This article reviewed the current situation of artificial intelligence empowering tradi-tional Chinese medicine clinical diagnosis and treatment,clarified the problems and challenges faced by artifi-cial intelligence technology in data integration,data quality,and data analysis in traditional Chinese medicine clinical diagnosis and treatment,and proposed to empower from the aspects of disciplinary integration,data quality optimization,data privacy protection,and promotion and application,so as to provide reference for im-proving the effectiveness of traditional Chinese medicine clinical diagnosis and treatment.
2.Systemic chemotherapy for patients with advanced biliary tract cancer: a single-center retrospective study
Xiaofan LI ; Wen ZHANG ; Yongkun SUN ; Yan SONG ; Caifeng GONG ; Qiaofeng ZHONG ; Lin YANG ; Chi YIHEBALI ; Honggang ZHANG ; Jing HUANG ; Aiping ZHOU
Chinese Journal of Hepatobiliary Surgery 2021;27(4):283-286
Objective:To study the efficacy of different systemic chemotherapy regimens as first-line and second-line therapy and to determine the prognostic factors for patients with advanced biliary tract cancer.Methods:The clinical data of patients with advanced biliary tract cancer who underwent systemic chemotherapy in Cancer Hospital of Chinese Academy of Medical Sciences from January 2011 to December 2018 were studied. The efficacy of chemotherapy on objective response rate (ORR) and disease control rate (DCR) were evaluated. Potential prognostic factors for survival were studied using the Cox proportional hazards models.Results:Of 151 patients enrolled into this study, there were 75 males and 76 females, with ages ranging from 31 to 77 years (median 58 years). Two treatment protocols were used: (1) 104 patients received a gemcitabine-based regimen (combined with platinums or fluorouracils) or a combination of platinums and fluorouracils, while (2) 47 patients received a combination of albumin-bound paclitaxel and S-1. The corresponding ORR for each group were 15.4%(16/104) and 27.6%(13/47), respectively, and the DCR were 65.4%(68/104) and 72.3%(34/47), respectively. Of 58 evaluable patients who received chemotherapy as a second-line therapy, 31 patients received the regimen containing gemcitabine, platinums or fluorouracils with an ORR of 3.2% (1/31) and a DCR of 35.5%(11/31); a total of 18 patients received the taxanes-based regimen with an ORR of 11.1%(2/18) and a DCR of 38.9%(7/18); 9 patients received the irinotecan-based regimen with an ORR of 22.2%(2/9) and a DCR of 44.4%(4/9). Univariate analysis showed positive liver metastasis and elevated carbohydrate antigen (CA)19-9 level to be significantly correlated with worse survival outcomes ( HR=1.540, 95% CI: 1.019-2.328, P=0.040 and HR=1.892, 95% CI: 1.123-3.188, P=0.017). Conclusion:For patients with advanced biliary tract cancer, in addition to the conventional regimens containing gemcitabine, platinums and fluorouracils, the combination of albumin-bound paclitaxel and S-1 was shown to be an effective chemotherapeutic regimen for these patients. Second-line chemotherapy was insufficient and ineffective, and an irinotecan-based regimen deserves to be further investigated. Liver metastasis and elevated CA19-9 level were worse prognosis after chemotherapy for patients with advanced biliary tract cancer.
3.The role played by human epidermal growth factor receptor 2 amplification/overexpression in gallbladder cancer and its association with clinico-pathology and prognosis
Xiaofan LI ; Caifeng GONG ; Yun LING ; Lei GUO ; Jianming YING ; Aipping ZHOU
Chinese Journal of Hepatobiliary Surgery 2022;28(8):603-608
Objective:To study the amplification / overexpression of human epidermal growth factor receptor 2 (HER2) in patients with gallbladder cancer, and to analyze the correlation between amplification/overexpression of HER2 with clinicopathological features and survival in patients after R 0 resection. Methods:There were 14 males and 26 females, aged (60.3±8.7) years old and treated at the Cancer Hospital of Chinese Academy of Medical Sciences from January 2011 to December 2016 who met the inclusion criteria of the study. Immunohistochemistry and fluorescence in situ hybridization were used to detect amplification / expression of HER2 in resected tumor tissues. Patients were divided into two groups according to the HER2 gene expression: the HER2-negative group ( n=40) and the HER2-positive group ( n=10). The Chi-square test was used to analyze the relationship between amplification/expression of HER2 and clinicopathological parameters. Patients were followed up by telephone for prognosis. The Kaplan-Meier method was used for survival analysis. The Cox proportional hazard model was used to explore factors affecting prognosis of gallbladder cancer patients. Results:HER2 amplification/overexpression was found in 10 patients with gallbladder cancer, with a positive rate of HER2 being 20.0% (10/50). There was a significant difference in the proportion of patients with vascular tumor thrombus between the HER2 negative group and the HER2 positive group [7.5%(3/40) vs. 30.0%(3/10), P<0.05]. On follow-up, data of 46 patients was available. There were 36 patients in the HER2-negative group and 10 patients in the HER2-positive group. Compared with the HER2-negative group, the median recurrence-free survival (10.10 vs. 75.07 months) and the median overall survival (16.77 vs. 83.07 months) of the HER2-positive group were both significantly lower (both P<0.05) than the HER2-negative group. Univariate analysis showed HER2 positivity to be a risk factor for recurrence-free and overall survival in patients with gallbladder cancer after radical resection. Cox multivariable analysis revealed that lymph node metastasis was an independent risk factor for both recurrence-free ( HR=4.31, 95% CI: 1.92-9.68, P<0.001) and overall survival ( HR=3.44, 95% CI: 1.08-11.00, P=0.037). Conclusion:Amplification / overexpression of HER2 was associated with venous invasion and worse prognosis in patients with gallbladder cancer.