Objective To retrospectively review 19 cases of renal epithelioid angiomyolipoma(REAML)and to ex-plore the clinical characteristics and diagnostic methods in order to optimize diagnosis and clinical treatment.Methods Clinical data of 19 patients with REAML admitted to the hospital from June 2020 to March 2024 were re-viewed for clinical characteristics of the disease,surgical procedure and follow-up outcomes.Results All 19 pa-tients received successful laparoscopic surgery.Among them,16 cases received retroperitoneal laparoscopic partial nephrectomy and 3 cases received retroperitoneal laparoscopic radical nephrectomy.Post-operative pathological diag-noses indicated that all cases were classified as renal epithelioid angiomyolipoma.After 4-45 months of follow-up,no tumor recurrence or metastasis was observed.Conclusions Renal epithelioid angiomyolipoma is a rare clinical disease with potential malignant transformation as recurrence and metastasis.Complete resection of the tumor by sur-gery is an effective treatment.Retroperitoneal laparoscopic partial nephrectomy is the first choice.

Objective To evaluate the value of radiomics models and comprehensive models based on multiparametric magnetic resonance imaging(mpMRI)in predicting the expression of human epidermal growth factor receptor 2(HER2)in bladder cancer(BCa).Methods A total of 76 pathologically confirmed BCa patients undergoing pelvic mpMRI during Jan.2022 and Nov.2024 at the Affiliated Zhongda Hospital of Southeast University were retrospectively included.After the volume of interest(VOI)was sketched,7 modal features were obtained,including T2WI,DWI,DCE,T2WI+DWI,T2WI+DCE,DWI+DCE,and T2WI+DWI+DCE,which were analyzed with logistic regression to obtain the predictive values.After that,the best sequences were screened with receiver operating characteristic(ROC)curves,and then combined with support vector machine,logistic regression,K-nearest neighbor,plain Bayes and adaptive enhancement,to construct the radiomics prediction models.Logistic regression analysis was used to screen the predictors of high HER 2 expression and to construct a comprehensive prediction model and a nomogram.Finally,decision curve analysis(DCA)was used to quantify the clinical benefits.Results Among the radiomics models based on the T2WI+DWI+DCE sequence,the AdaBoost model demonstrated the best predictive performance,with area under the ROC curve(AUC)being 0.863(95％CI:0.807-0.920)in the training set and 0.716(95％CI:0.601-0.830)in the validation set.Based on radiomics features and clinical imaging characteristics,logistic regression analysis identified tumor pedicle and risk group as the predictors of high HER2 expression.The comprehensive prediction model based on the two factors achieved the AUC of 0.869(95％CI:0.772-0.965)in the training set and 0.875(95％CI:0.712-0.986)in the validation set.Conclusion The radiomics model based on the T2WI+DWI+DCE sequence has high accuracy in predicting HER2 expression,outperforming single-sequence models.The nomogram based on the comprehensive prediction model has high clinical decision-making efficacy and is useful for non-invasive identification of HER2 expression.

Objective To study the efficacy and safety of flexible ureteroscopy holmium laser lithotripsy(FURS)in the treatment of urinary tract stones of different sizes and positions.Methods A retrospective analysis was conducted on the clinical data of 121 patients with upper urinary tract stones from January 2021 to December 2023.According to the size of the stones,they were divided into the diameter ≤20 mm group(n=98)and the 20 mm＜diameter ≤40 mm group(n=23).According to the location of the stones,19 cases were divided into the renal pelvis stone group and 102 cases were non renal pelvis stones.The surgical related indicators and incidence of complications were compared between the groups.Result The operation time of the group with diameter ≤20 mm and the group with diameter 20 mm＜diameter ≤40 mm was(44.13±12.6)minutes and(57.52±20.98)minutes,respectively.The hospitalization periods were(4.55±1.54)days and(5.74±2.00)days,respectively.There were statistically significant differences between the two groups(P＜0.05).The stone clearance rates in the group with diameter ≤ 20 mum and the group with 20 mum＜diameter ≤ 40 mum were 84.69％and 78.26％,respectively.There was no statistically significant difference between the two groups(P＞0.05).The operation time of the subcalyx kidney stone group and the non-subcalyx kidney stone group was(44.05±11.08)minutes and(47.17±16.19)minutes respectively,the hospital stay was(4.74±1.52)days and(4.78±1.73)days respectively,and the ESWL selection rates after the operation were 5.26％and 10.78％respectively.The stone recurrence rates were 15.79％and 4.90％respectively,and there was no statistically significant difference between the two groups(P＞0.05).The stone clearance rates in the subcalyx kidney stone group and the non-subcalyx kidney stone group were 63.16％and 87.25％,respectively.There was a statistically significant difference between the two groups(P＜0.05).There was no statistically significant difference in the incidences of urosepsis,fever,low back pain,hematuria and total complications between the 20 mm＜diameter ≤40 mm group and the diameter ≤20 mm group(P＞0.05).There was no statistically significant difference in the incidences of urosepsis,fever,low back pain,hematuria and total complications between the non-inferior calyx stone group and the inferior calyx stone group(P＞0.05).Conclusion FURS treatment for upper urinary tract stones with a diameter of≤20 mm has shorter surgical and hospitalization times compared to patients with a diameter of≤40 mm.ESWL and lower stone recurrence rates are also preferred after surgery.FURS treatment for non lower renal calyx stones has a higher stone clearance rate compared to lower renal calyx stones.The safety of FURS treatment for upper urinary tract stones of different sizes and positions is equivalent.

Objective To evaluate the value of radiomics models and comprehensive models based on multiparametric magnetic resonance imaging(mpMRI)in predicting the expression of human epidermal growth factor receptor 2(HER2)in bladder cancer(BCa).Methods A total of 76 pathologically confirmed BCa patients undergoing pelvic mpMRI during Jan.2022 and Nov.2024 at the Affiliated Zhongda Hospital of Southeast University were retrospectively included.After the volume of interest(VOI)was sketched,7 modal features were obtained,including T2WI,DWI,DCE,T2WI+DWI,T2WI+DCE,DWI+DCE,and T2WI+DWI+DCE,which were analyzed with logistic regression to obtain the predictive values.After that,the best sequences were screened with receiver operating characteristic(ROC)curves,and then combined with support vector machine,logistic regression,K-nearest neighbor,plain Bayes and adaptive enhancement,to construct the radiomics prediction models.Logistic regression analysis was used to screen the predictors of high HER 2 expression and to construct a comprehensive prediction model and a nomogram.Finally,decision curve analysis(DCA)was used to quantify the clinical benefits.Results Among the radiomics models based on the T2WI+DWI+DCE sequence,the AdaBoost model demonstrated the best predictive performance,with area under the ROC curve(AUC)being 0.863(95％CI:0.807-0.920)in the training set and 0.716(95％CI:0.601-0.830)in the validation set.Based on radiomics features and clinical imaging characteristics,logistic regression analysis identified tumor pedicle and risk group as the predictors of high HER2 expression.The comprehensive prediction model based on the two factors achieved the AUC of 0.869(95％CI:0.772-0.965)in the training set and 0.875(95％CI:0.712-0.986)in the validation set.Conclusion The radiomics model based on the T2WI+DWI+DCE sequence has high accuracy in predicting HER2 expression,outperforming single-sequence models.The nomogram based on the comprehensive prediction model has high clinical decision-making efficacy and is useful for non-invasive identification of HER2 expression.

Objective To study the efficacy and safety of flexible ureteroscopy holmium laser lithotripsy(FURS)in the treatment of urinary tract stones of different sizes and positions.Methods A retrospective analysis was conducted on the clinical data of 121 patients with upper urinary tract stones from January 2021 to December 2023.According to the size of the stones,they were divided into the diameter ≤20 mm group(n=98)and the 20 mm＜diameter ≤40 mm group(n=23).According to the location of the stones,19 cases were divided into the renal pelvis stone group and 102 cases were non renal pelvis stones.The surgical related indicators and incidence of complications were compared between the groups.Result The operation time of the group with diameter ≤20 mm and the group with diameter 20 mm＜diameter ≤40 mm was(44.13±12.6)minutes and(57.52±20.98)minutes,respectively.The hospitalization periods were(4.55±1.54)days and(5.74±2.00)days,respectively.There were statistically significant differences between the two groups(P＜0.05).The stone clearance rates in the group with diameter ≤ 20 mum and the group with 20 mum＜diameter ≤ 40 mum were 84.69％and 78.26％,respectively.There was no statistically significant difference between the two groups(P＞0.05).The operation time of the subcalyx kidney stone group and the non-subcalyx kidney stone group was(44.05±11.08)minutes and(47.17±16.19)minutes respectively,the hospital stay was(4.74±1.52)days and(4.78±1.73)days respectively,and the ESWL selection rates after the operation were 5.26％and 10.78％respectively.The stone recurrence rates were 15.79％and 4.90％respectively,and there was no statistically significant difference between the two groups(P＞0.05).The stone clearance rates in the subcalyx kidney stone group and the non-subcalyx kidney stone group were 63.16％and 87.25％,respectively.There was a statistically significant difference between the two groups(P＜0.05).There was no statistically significant difference in the incidences of urosepsis,fever,low back pain,hematuria and total complications between the 20 mm＜diameter ≤40 mm group and the diameter ≤20 mm group(P＞0.05).There was no statistically significant difference in the incidences of urosepsis,fever,low back pain,hematuria and total complications between the non-inferior calyx stone group and the inferior calyx stone group(P＞0.05).Conclusion FURS treatment for upper urinary tract stones with a diameter of≤20 mm has shorter surgical and hospitalization times compared to patients with a diameter of≤40 mm.ESWL and lower stone recurrence rates are also preferred after surgery.FURS treatment for non lower renal calyx stones has a higher stone clearance rate compared to lower renal calyx stones.The safety of FURS treatment for upper urinary tract stones of different sizes and positions is equivalent.

It is very important for epilepsy treatment to distinguish epileptic seizure and non-seizure. In this study, an automatic seizure detection algorithm based on dual density dual tree complex wavelet transform (DD-DT CWT) for intracranial electroencephalogram (iEEG) was proposed. The experimental data were collected from 15 719 competition data set up by the National Institutes of Health (NINDS) in Kaggle. The processed database consisted of 55 023 seizure epochs and 501 990 non-seizure epochs. Each epoch was 1 second long and contained 174 sampling points. Firstly, the signal was resampled. Then, DD-DT CWT was used for EEG signal processing. Four kinds of features include wavelet entropy, variance, energy and mean value were extracted from the signal. Finally, these features were sent to least squares-support vector machine (LS-SVM) for learning and classification. The appropriate decomposition level was selected by comparing the experimental results under different wavelet decomposition levels. The experimental results showed that the features selected in this paper were different between seizure and non-seizure. Among the eight patients, the average accuracy of three-level decomposition classification was 91.98%, the sensitivity was 90.15%, and the specificity was 93.81%. The work of this paper shows that our algorithm has excellent performance in the two classification of EEG signals of epileptic patients, and can detect the seizure period automatically and efficiently.
Algorithms ; Electroencephalography ; Epilepsy/diagnosis* ; Humans ; Seizures/diagnosis* ; Signal Processing, Computer-Assisted ; Support Vector Machine ; Wavelet Analysis

ObjectiveTo investigate the clinical value of acoustic radiation force impulse (ARFI) elastography in predicting esophageal variceal bleeding in patients with liver cirrhosis. MethodsA retrospective analysis was performed for the clinical data of 271 patients with liver cirrhosis who attended the Fifth Medical Center of Chinese PLA General Hospital from October 2014 to May 2017, and ARFI elastography was performed for all patients to measure the elasticity of the liver and the spleen. According to the presence or absence of esophageal variceal bleeding, the patients were divided into bleeding group and non-bleeding group, and related indices were compared between the two groups. The receiver operating characteristic (ROC) curve was used to evaluate the value of ARFI elasticity in the diagnosis of esophageal variceal bleeding in liver cirrhosis. The t-test was used for comparison of normally distributed continuous data between two groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups; the chi-square test was used for comparison of categorical data between two groups. ResultsThe bleeding group had a significantly higher ARFI elasticity of the spleen than the non-bleeding group ［3.89(349-4.11) m/s vs 3.46(2.93-3.80) m/s, Z=-4.941, P＜0.001］, and there was no significant difference in the ARFI elasticity of the liver between the bleeding group and the non-bleeding group ［2.08 (1.57-2.74) m/s vs 1.98 (1.49-2.70) m/s, Z=-1.025, P=0.305］. The areas under the ROC curve for ARFI elasticity values of the spleen and the liver were 0.714 and 0.544, respectively, in predicting esophageal variceal bleeding in patients with liver cirrhosis (P=0.002 5). At the cut-off value of 3.71 m/s, the ARFI elasticity of the spleen had a sensitivity of 0.68 and a specificity of 0.69 in predicting esophageal variceal bleeding. ConclusionThe ARFI elasticity value of the spleen has a better value than that of the liver in predicting the risk of esophageal variceal bleeding and thus holds promise for clinical application.

Objective To investigate the clinical value of the acoustic radiation force impulse imaging (ARFI) in the quantitative evaluation of fibrosis staging in chronic hepatitis B .Methods A total of 373 patients with chronic hepatitis B were grouped in accordance with the depth of the right anterior lobe and posterior lobe of the liver and underwent ARFI to measure ARFI values .Liver biopsy was performed in all patients to investigate the relationship between liver fibrosis stages and ARFI values in different groups . Results The ARFI values in different pathological grades with the same depth of the right anterior and right posterior lobe of the liver were statistically significant ( P < 0 0.01);the ARFI values between the middle and deep parts of the right anterior lobe and the same location of the right posterior lobe were statistically significant ( P <0 0.1);for the right anterior lobe ,the ARFI value of the shallow part showed statistical significance from that of the middle and the deep part ( P < 0 0.5 ) .Receiver operating characteristic (ROC) curve analysis for different sampling locations showed that the largest area under the ROC curve ,which was 0 8.18 ,existed in the middle part of the right anterior lobe ,indicating that it could be the optimal sampling location for the measurement of ARFI values .Liver stiffness at ARFI imaging was significantly correlated with liver fibrosis stage in chronic hepatitis B and spearman coefficient of correlation was 0 5.30 ( P <0 0.01) .The areas under the ROC curves for the chronic hepatitis B patients with severe liver fibrosis (≥ S3) and early cirrhosis (= S4) were 0 8.18 and 0 8.60 ,respectively .Conclusions ARFI imaging was promising for clinical application and could be utilized as a noninvasive method for the quantitative evaluation of fibrosis staging in chronic hepatitis B .

Objective:To detect the degree of oxidative stress in the process when Porphyromonas gin-givalis ( P. gingivalis) stimulates human vascular endothelium, And to investigate the effect of peroxi-some proliferator-activated receptor(PPAR)γ on oxidative stress during this process. Methods:Human vascular endothelial cells ( HVECs) line EA. hy926 ( American Type Culture Collection ,United States) was cultured in high glucose Dulbecco' s modified eagle medium ( DMEM) . Four groups were designed:control group, P. gingivalis infected group, PPARγactivated group and PPARγblocked group. In con-trol group HVECs were cultured with only DMEM. In P. gingivalis infected group, HVECs were time-dependently stimulated by P. gingivalis W83 from 0 to 12 h. In PPARγ activated group or PPARγblocked group, PPARγ was pre-activated or blocked by a representative PPARγ agonist(15d-PGJ2 10μmol/L) or antagonist ( GW966210μmol/L) 30 minutes before the cells were stimulated by P. gingiva-lis. At 0, 0. 5, 1, 1. 5, 2, 4, 8, and 12 h, the culture medium was collected individually and centri-fuged, and the supernatant was stored for assay. Glutathione peroxidase (GSH-PX) and malondialdehyde( MDA) were analysed by enzyme-linked immunosorbent assay. Cellular reactive oxygen species ( ROS) were detected through 2',7'-dichlorofluorescin diacetate (DCFA-DA) fluorescent probe at various time points of the different groups. Results:In P. gingivalis infected group, the levels of GSH-PX [(5. 56 ± 0. 97) μmol/L] and MDA [(0. 84 ± 0. 18) nmol/L] were significantly higher than those in control group [GSH-PX(4. 71 ± 0. 64) μmol/L, MDA (0. 59 ± 0. 18) nmol/L)]. The levels of GSH-PX and MDA in PPARγactivated group [GSH-PX (5. 38 ± 0. 84) μmol/L, MDA (0. 84 ± 0. 22) nmol/L] and in PPARγblocked group [GSH-PX (5. 37 ± 0. 76) μmol/L, MDA (0. 85 ± 0. 14) nmol/L] were signi-ficantly higher than those in control group (P <0. 05). In the PPARγ activated group, the levels of GSH-PX at 0 . 5 and 8 h were significantly higher than those from 1 . 5 h to 4 h ( P<0 . 05 ) , while no difference was observed on the MDA levels at different time points. There was no significant difference at various time points for the levels of GSH-PX and MDA in PPARγ blocked group. The level of cellular ROS detected by DCFH-DA in P. gingivalis infected group was significantly higher than that in control group (10 108. 65 ± 1 805. 18 vs. 6 049. 06 ± 1 199. 19,P<0. 05). No difference was observed be-tween PPARγ activated group (7 120. 94 ± 1 447. 30) or PPARγblocked group (6 727. 35 ± 1 483. 68) and control group. Conclusion:Oxidative stress happens when P. gingivalis stimulates human vascular endothelium. PPARγ may involve in modulating oxidative stress during this process.