BACKGROUND: Lung cancer is one of the most common malignant tumors worldwide and a major cause of cancer-related deaths. Early-stage lung cancer is often manifested as pulmonary nodules, and accurate assessment of the malignancy risk is crucial for prolonging survival and avoiding overtreatment. This study aims to construct a model based on image feature parameters automatically extracted by artificial intelligence (AI) to evaluate its effectiveness in predicting the malignancy of part-solid nodule (PSN). METHODS: This retrospective study analyzed 229 PSN from 222 patients who underwent pulmonary nodule resection at Lanzhou University Second Hospital between October 2020 and February 2025. According to pathological results, 45 cases of benign lesions and precursor glandular lesion were categorized into the non-malignant group, and 184 cases of pulmonary malignancies were categorized into the malignant group. All patients underwent preoperative chest computed tomography (CT), and AI software was used to extract imaging feature parameters. Univariate analysis was used to screen significant variables; variance inflation factor (VIF) was calculated to exclude highly collinear variables, and LASSO regression was further applied to identify key features. Multivariate Logistic regression was used to determine independent risk factors. Based on the selected variables, five models were constructed: Logistic regression, random forest, XGBoost, LightGBM, and support vector machine (SVM). Receiver operating characteristic (ROC) curves were used to assess the performance of the models. RESULTS: The independent risk factors for the malignancy of PSN include roughness (ngtdm), dependence variance (gldm), and short run low gray-level emphasis (glrlm). Logistic regression achieved area under the curves ( AUCs) of 0.86 and 0.89 in the training and testing sets, respectively, showing good performance. XGBoost had AUCs of 0.78 and 0.77, respectively, demonstrating relatively balanced performance, but with lower accuracy. SVM showed an AUC of 0.93 in the training set, which decreased to 0.80 in the testing set, indicating overfitting. LightGBM performed excellently in the training set with an AUC of 0.94, but its performance declined in the testing set, with an AUC of 0.88. In contrast, random forest demonstrated stable performance in both the training and testing sets, with AUCs of 0.89 and 0.91, respectively, exhibiting high stability and excellent generalizability. CONCLUSIONS The random forest model constructed based on independent risk factors demonstrated the best performance in predicting the malignancy of PSN and could provide effective auxiliary predictions for clinicians, supporting individualized treatment decisions.
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Humans ; Male ; Female ; Lung Neoplasms/pathology* ; Middle Aged ; Retrospective Studies ; Artificial Intelligence ; Aged ; Tomography, X-Ray Computed ; Adult ; Solitary Pulmonary Nodule/diagnostic imaging* ; ROC Curve

Objective To investigate the correlation between neuropeptide S receptor(NPSR)single nucleotide polymorphism(SNP)(rs323917,rs323920,rs323922,rs2530547,rs324957)and primary insomnia(PI).Methods A total of 157 patients diagnosed with PI in the outpatient department of Center of Sleep Medicine,Gansu Provincial People's Hospital from December 2016 to May 2019 were selected as PI group,and 133 healthy physical examination subjects during the same period were selected as control group.Venous blood samples were collected and DNA,polymerase chain reaction(PCR)amplification and agarose gel electrophoresis were extracted.rs323917,rs323920,rs323922,rs2530547,rs324957 single nucleotide loci were genotypized by target site sequencing.Meanwhile,standard polysomnosis monitoring was performed to analyze the correlation between gene polymorphism and PI.Results There were no significant differences in the genotype distribution of NPSR SNP sites(rs323917,rs323920,rs323922,rs2530547)and allele frequency and rs324957 allele frequency between two groups(P＞0.05).There was significant difference in genotype distribution of rs324957(P=0.034).There was no significant difference in the frequency of different haplotypes between two groups(P＞0.05).Conclusion The expression of rs324957 SNP genotypes in NPSR may be related to PI,and AG genotype is dominant.

Objective To investigate the diagnostic value of serum homocysteine in the diagnosis of colon cancer.Methods The performance rate method was used to detect the level of serum homocysteine(Hcy) in colon cancer group(50 cases) who were treated in Beijing Tiantan Hospital Affiliated to Capital Medical University from March 2011 to June 2016 and control group(50 cases).The expression of independent samples t test was used to analysis of the difference of the Hcy levels between the two groups.The ROC curve was used to evaluate the value of Hcy in diagnosis of colon cancer.Results The serum Hcy level in colon cancer group was (18.6±8.9) μmol/L,in healthy control group was (10.7±4.3) μmol/L,colon cancer group serum Hcy levels were significantly higher than those of healthy control group,there was significant difference(t=5.627,P<0.01).AUC of ROC curve was 0.775,cut-off value of 18.5 μmol/L,sensitivity was 0.50,specificity was 0.94,95%CI was 0.682-0.868(P<0.01).Conclusion Serum Hcy can be used as a reference index of the diagnosis of colon cancer.

Objective To investigate the clinical significance of serum pepsinogen (PG) in gastric cancer screening. Methods The clinical data of 930 patients underwent colonoscopy were retrospectively analyzed. Among them, non chronic atrophic gastritis was in 550 cases (chronic atrophic gastritis group), chronic atrophic gastritis in 300 cases (chronic atrophic gastritis group), gastric cancer in 80 cases (gastric cancer group). The patients in chronic atrophic gastritis group were divided into mild chronic atrophic gastritis subgroup (100 cases), moderate chronic atrophic gastritis subgroup (120 cases) and severe chronic atrophic gastritis subgroup (80 cases) according to the severity of the atrophy. The levels of serum PGⅠand PGⅡwere detected by enzyme linked immunosorbent assay (ELISA) method, and the ratio of PGⅠand PGⅡ(PGR) was calculated. Results There was no statistical difference in PGⅡ among the 3 groups (F = 1.226, P>0.05). The PG Ⅰand PGR in gastric cancer group were significantly lower than those in chronic atrophic gastritis and non chronic atrophic gastritis:(70.41 ± 39.42)μg/L vs. (83.10 ± 30.08) and (165.5 ± 41.40)μg/L, 3.76 ± 2.03 vs. 5.08 ± 1.82 and 6.84 ± 1.88, those in chronic atrophic gastritis were significantly lower than those in non chronic atrophic gastritis group, there were statistical differences (P<0.05). The PG Ⅰand PGR in mild and moderate chronic atrophic gastritis subgroup were significantly higher than those in severe chronic atrophic gastritis subgroup and gastric cancer group:(95.50 ± 30.80) and (82.10 ± 31.42)μg/L vs. (70.12 ± 20.12) and (70.41 ± 39.42) μg/L, 5.84 ± 2.88 and 5.08 ± 1.89 vs. 3.90 ± 2.78 and 3.76 ± 2.03, there were statistical differences (P<0.05), but there was no statistical difference between severe chronic atrophic gastritis subgroup and gastric cancer group (P>0.05), and there was no statistical difference between mild chronic atrophic gastritis subgroup and moderate chronic atrophic gastritis subgroup (P>0.05). The receiver operating characteristic (ROC) curve was used, the optimal critical value of PG Ⅰ was 74.8μg/L, the area under curve (AUC) was 0.842, the sensitivity was 90%, specificity was 75%;the optimal critical value of PGR was 4.46, AUC was 0.837, the sensitivity was 75%, specificity was 82%;the AUC of combined detection of PG Ⅰ and PGR was 0.906, the sensitivity was 88%, specificity was 85%. Conclusions Detection of PG Ⅰ combined with PGR can be used as gastric cancer screening, the recommended level of PGⅠ≤74.80μg/L and PGR≤4.46.

Objective:To study the anatomical correlation between dental arch and the volume of upper airway in patients with obstruc-tive sleep apnea hypoventilation syndrome(OSAHS). Methods: Dental arch architecture and upper airway volume were measured by cone beam CT(CBCT) in the subjects with OSAHS(n=22) and without OSAHS(n=19). The correlation between dental arch and the supper airway volume in OSAHS patients was analyzed. Results:The length of the upper dental arch and the height of palate in OSAHS patients were larger than those of the controls(All, P<0. 05). Cross-sectional area of nasopharynx and retropalatal and the total volume of upper airway were negatively correlated with the palatal height and upper dental arch length(P<0. 05), while positively correlated with upper dental arch of molar regions(P<0. 05). Conclusion:The abnormal shape of upper dental arch is related to the airway vol-ume of nasopharynx and retropalatal region in patients with OSAHS.

OBJECTIVE: To investigate the significance of tumor necrosis factor-alpha (TNF-α) and plasma endothelium (ET) in pathophysiologic process of patients with obstructive sleep apnea hypopnea syndrome(OSAHS) with type 2 diabetes mellitus (T2DM). METHOD: All observed subjects were divided into 4 groups. A number of 80 patients with OSAHS, 65 cases of OSAHS with T2DM patients, 20 patients with T2DM, and 32 cases of healthy control group were observed in this study. The serum levels of TNF-α and ET were detected by double antibody sandwich ELISA, the content of TNF-α and ET were compared between OSAHS group and OSAHS + T2DM group. It were also compared before and after treatment of CPAP or surgery. RESULT: TNF-α level is higher in OSAHS+T2DM group than that in the OSAHS group, T2DM group and the control group (P < 0.05); TNF-α level in OSAHS group and the T2DM group are higher than that in the control group (P < 0.05), but there was no difference in TNF-α level between the OSAHS group and the T2DM group. There was also no difference in ET level of the four groups. There were significant differences of TNF-α before and after treatment of CPAP or surgery in OSAHS group and OSAHS+T2DM group (P < 0.05). But there was no significant differences of ET before and after treatment of CPAP or surgery in the OSAHS+T2DM group (P > 0.05). CONCLUSION TNF-α may be involved in the development of OSAHS and T2DM, while ET may have little effect on the occurrence and development of OSAHS and T2DM.
Antibodies ; Diabetes Mellitus, Type 2 ; blood ; complications ; Endothelins ; blood ; Enzyme-Linked Immunosorbent Assay ; Humans ; Sleep Apnea, Obstructive ; blood ; complications ; Tumor Necrosis Factor-alpha ; blood

[ABSTRACT]OBJECTIVETo assess the sleep body position's effects on AHI and ODI during sleep in obstructive sleep apnea hypopnea syndrome (OSAHS) patients with different severity.METHODSThe clinical data of 113 subjects who had been diagnosed OSAHS or normal by polysomnography (PSG) between 2013 and 2014 in our department were retrospectively studied. They were divided into normal control group (AHI<5/h, 41 patients), mild to moderate OSAHS group (5/h30/h, 40 patients). PSG data of AHI and ODI in different body position in each group were further analyzed.RESULTSIn normal group, The AHI and ODI in supine position were significantly higher than that in the left or right lateral position, and the difference between the left and right lateral position was not significant. In the mild to moderate OSAHS group, the AHI and ODI in supine were higher than that in the left lateral position slightly, while the data in supine was higher than that in the right lateral position significantly. In the severe group, the data between the supine and the left lateral position was not statistically different, while the supine position data was higher compared with that of the right lateral position. CONCLUSIONAHI and ODI were higher in supine position than that in lateral position, while the AHI and ODI in right lateral position is higher than that in left lateral position in OSAHS patients with different severity. The ODI and AHI are consistent in reflecting the severity of the OSAHS.

OBJECTIVE: To evaluate the curative effect of continuous positive airway pressure(CPAP) combined with modified oral appliance (MOA) in the treatment of severe OSAHS. METHOD: The research chose 120 male patients with severe OSAHS. They were treated with CPAP and MOA (30 cases), CPAP (30 cases), and MOA (30 cases) respectively. At the same time, the rest 30 cases without any treatment were in control group (matching factors: age, gender, IBM). After 3 months treatment, the characteristics of PSG and respiratory machine wear condition were observated in four groups. RESULT The ESS score in CPAP and MOA group was significantly lower than that in other groups (P < 0.05); After 3 months treatment, the AHI, awake index (AI), and Ni (non-rapid eyemovement sleep1, N1) and N2 (non-rapid eye movement sleep2, N2) period of total sleep time (TST) percentage in CPAP assisted MOA group and CPAP group were significantly lower than that in MOA group and control group (P < 0.05); Sleep efficiency, ESS score, average blood oxygen saturation (MSaO₂), the lowest oxygen saturation (LSaO₂), slow wave sleep phases (SWS) and rapid eyemovement sleep (REM) accounted for the proportion of TST increased significantly (P < 0.05); There was no significant difference between CPAP assisted MOA group and CPAP group in AHI, MSaO₂, AI, sleep efficiency, N1, N2, SWS and REM percentage of TST and ESS score. The LSaO₂ and average machine time in CPAP assisted MOA group were significantly greater than that in CPAP group (P < 0.05), but 90% pressure and average air leakage were significantly lower in the CPAP group (P < 0.05) CONCLUSION: The curative effect of CPCR combined with modified oral appliance was better than CPCR or MOA alone in the treatment of severe OSAHS.
Continuous Positive Airway Pressure ; Humans ; Male ; Oximetry ; Sleep ; Sleep Apnea, Obstructive ; therapy

OBJECTIVE: To explore the changes of serum interleukin-6 (IL-6) level in patients with obstructive sleep apnea hypopnea syndrome (OSAHS) and OSAHS associated type 2 diabetes mellitus (T2DM) and their significance. METHOD: All observed subjects were divided into 3 groups: 20 cases of normal subjects, 35 cases of simple OSAHS patients, 48 cases of OSAHS associated T2DM patients, IL-6 concentrations of serum were measured by the enzyme-linked immunosorbent. RESULT: IL-6 level was higher in the group of OSAHS with T2DM than the group of OSAHS and the healthy control group (P < 0.05); IL-6 level was higher in the simple OSAHS group than the healthy controls. CONCLUSION IL-6 and other inflammatory factors may involved pathological physiological process in OSAHS patients sugar metabolic abnormalities; and is associated with the development of OSAHS associated with type 2 diabetes.
Case-Control Studies ; Diabetes Mellitus, Type 2 ; blood ; complications ; Humans ; Interleukin-6 ; blood ; Sleep Apnea, Obstructive ; blood ; complications

OBJECTIVE: To observe the clinical effect of nasal surgical expansion as basical surgical treatment of patients with OSAHS. METHOD: A total of 320 patients with OSAHS were retrospectively analyzed. The patient was diagnosed by PSG. The electronic nasopharyngolarygnoscope exam airway CT, and MRI were applied to determining the nasal plane block. According to the concrete reasons, the nasal endoscopic nasal septum corrective surgery and open surgery were carried out, respectively. Nasal sinus neoplasm resection of off shoring, inferior turbinate fracture surgery or inferior turbinate back-end 1/3 line expansion and low temperature plasma ablation of nasal surgery, respectively. Pittsburgh sleep quality index (PSQI), snore outcome survey (SOS), epworth sleepiness score (ESS), the lowest arterial oxygen saturation (LSaO2) and AHI, time and ratio of slow wave sleep (SWS) stage and rapid eye movement (REM) stage were applied to comparing the curative effect between pre-operation and post-operation periods. RESULT: Snoring, sleep apnea, subjective mental symptoms of all patients with OSAHS were improved after operation; PSQI, SOS and ESS score were improved compared to pretreatment (P < 0.05); according to the 2009 OSAHS diagnosis and curative effect evaluation standard, 38 cases cured, 189 cases had obvious effect, 93 cases effective, and the total effective rate was 100%; there was statistical difference between the pre-operative period and 6 months post-operative in PSQI, SOS and ESS, LSaO2, AHI and proportion of REM (P < 0.05); sleep structure was improved, time and proportion of SWS were increased after the operation (P < 0.05). CONCLUSION Solving the problem of nasal airway obstruction is the first step in surgical treatment of patients with OSAHS.
Endoscopy ; Humans ; Nasal Obstruction ; Nasal Septum ; surgery ; Nasal Surgical Procedures ; Oximetry ; Paranasal Sinus Neoplasms ; surgery ; Paranasal Sinuses ; pathology ; Reconstructive Surgical Procedures ; Retrospective Studies ; Sleep Apnea, Obstructive ; surgery ; Sleep Stages ; Sleep, REM ; Snoring ; Turbinates ; surgery