1.Identification of paraglottic space invasion in enhanced CT scans of hypopharyngeal cancer by 3D super-resolution reconstruction technology and deep learning
Wenlun WANG ; Zhiwei LIU ; Jing′ao LI ; Chenyang XU ; Dongmin WEI ; Ye QIAN ; Wenming LI ; Dapeng LEI
Chinese Journal of Otorhinolaryngology Head and Neck Surgery 2025;60(10):1232-1242
Objective:To develop a deep learning model based on 3D super-resolution reconstruction technology and to analyze its feasibility and effectiveness in predicting paraglottic space invasion in hypopharyngeal cancer.Methods:A retrospective study was conducted involving 382 patients with hypopharyngeal squamous cell carcinoma treated at Qilu Hospital of Shandong University between January 2014 and December 2020. The cohort included 364 males and 18 females, with a mean age of 62±7 years. Patients were divided into a training set ( n=300) and a test set ( n=82) based on enrollment time. A generative adversarial network was used to perform 3D super-resolution reconstruction on contrast-enhanced CT images, improving spatial resolution by 16 times. A 2.5D deep learning strategy was employed to construct Resnet-NR and Resnet-SR models based on conventional and super-resolution images, respectively, to predict whether the paraglottic space was invaded. Model performance was evaluated using receiver operating characteristic (ROC) curves and area under the curve (AUC). A multi-reader multi-case study was conducted to assess the impact of the artificial intelligence (AI) model on clinicians′ diagnostic capabilities. Results:The super-resolution model Resnet-SR achieved the highest accuracy in both the training set (AUC=0.87, 95% CI: 0.84-0.90) and the test set (AUC=0.88, 95% CI: 0.81-0.96), significantly outperforming traditional clinical indicators (T stage, N stage, tumor diameter, and pathological differentiation degree) (AUC range: 0.55-0.70, all P<0.05). In comparison, the conventional-resolution model Resnet-NR achieved AUCs of 0.81 (95% CI: 0.77-0.84, P=0.005) and 0.80 (95% CI: 0.71-0.89, P=0.184) in the training and test sets, respectively. Using Resnet-SR to assist clinical decision-making improved the diagnostic accuracy of junior physicians (AUC=0.793 without AI assistance vs. AUC=0.871 with AI assistance, P=0.012) and significantly reduced diagnosis time for clinicians of all experience levels (86.5 s without AI assistance vs. 82.5 s with AI assistance, t=2.01, P=0.032). Conclusion:This study successfully develops a deep learning model based on 3D super-resolution reconstruction technology, which can assist in preoperative prediction of paraglottic space invasion in hypopharyngeal cancer. The AI-assisted tool improves diagnostic accuracy for junior physicians and enhances diagnostic efficiency for clinicians across all experience levels.
2.Identification of paraglottic space invasion in enhanced CT scans of hypopharyngeal cancer by 3D super-resolution reconstruction technology and deep learning
Wenlun WANG ; Zhiwei LIU ; Jing′ao LI ; Chenyang XU ; Dongmin WEI ; Ye QIAN ; Wenming LI ; Dapeng LEI
Chinese Journal of Otorhinolaryngology Head and Neck Surgery 2025;60(10):1232-1242
Objective:To develop a deep learning model based on 3D super-resolution reconstruction technology and to analyze its feasibility and effectiveness in predicting paraglottic space invasion in hypopharyngeal cancer.Methods:A retrospective study was conducted involving 382 patients with hypopharyngeal squamous cell carcinoma treated at Qilu Hospital of Shandong University between January 2014 and December 2020. The cohort included 364 males and 18 females, with a mean age of 62±7 years. Patients were divided into a training set ( n=300) and a test set ( n=82) based on enrollment time. A generative adversarial network was used to perform 3D super-resolution reconstruction on contrast-enhanced CT images, improving spatial resolution by 16 times. A 2.5D deep learning strategy was employed to construct Resnet-NR and Resnet-SR models based on conventional and super-resolution images, respectively, to predict whether the paraglottic space was invaded. Model performance was evaluated using receiver operating characteristic (ROC) curves and area under the curve (AUC). A multi-reader multi-case study was conducted to assess the impact of the artificial intelligence (AI) model on clinicians′ diagnostic capabilities. Results:The super-resolution model Resnet-SR achieved the highest accuracy in both the training set (AUC=0.87, 95% CI: 0.84-0.90) and the test set (AUC=0.88, 95% CI: 0.81-0.96), significantly outperforming traditional clinical indicators (T stage, N stage, tumor diameter, and pathological differentiation degree) (AUC range: 0.55-0.70, all P<0.05). In comparison, the conventional-resolution model Resnet-NR achieved AUCs of 0.81 (95% CI: 0.77-0.84, P=0.005) and 0.80 (95% CI: 0.71-0.89, P=0.184) in the training and test sets, respectively. Using Resnet-SR to assist clinical decision-making improved the diagnostic accuracy of junior physicians (AUC=0.793 without AI assistance vs. AUC=0.871 with AI assistance, P=0.012) and significantly reduced diagnosis time for clinicians of all experience levels (86.5 s without AI assistance vs. 82.5 s with AI assistance, t=2.01, P=0.032). Conclusion:This study successfully develops a deep learning model based on 3D super-resolution reconstruction technology, which can assist in preoperative prediction of paraglottic space invasion in hypopharyngeal cancer. The AI-assisted tool improves diagnostic accuracy for junior physicians and enhances diagnostic efficiency for clinicians across all experience levels.
3.Progress in research of incidence of co-infection of HIV and Mycobacterium tuberculosis and influencing factors
Ruzhuo LIU ; Rong SU ; Dongmin LI
Chinese Journal of Epidemiology 2025;46(1):166-174
The co-infection of HIV and Mycobacterium tuberculosis (MTB) poses a severe challenge for the prevention and control of infectious disease, resulting in poor clinical outcomes of the patients and risk for wide spread. As steady progress in global health, the co-infection of HIV/MTB has been basically controlled, and the new cases are generally declining. However, its incidence remained high in resource-limited areas. The incidence of the co-infection of HIV/MTB is associated with the interaction among individual, social, health service, and natural factors. Comprehensive measures are needed to reduce this disease burden. This paper summarized the epidemiological characteristics of the co-infection of HIV/MTB and influencing factors both at home and abroad to provide evidence for the identifications of high-risk populations and areas and development of targeted prevention measures for the purpose of reduce the incidence of co-infection of HIV/MTB.
4.Progress in research on the effect of AIDS prevention services on high risk behaviors for HIV infection in men who have sex with men
Chinese Journal of Epidemiology 2025;46(9):1704-1710
Men who have sex with men (MSM) represent a key population in the prevention and control of HIV/AIDS. Despite the remarkable advancements in AIDS prevention and treatment, the HIV infection prevalence and incidence in MSM with high risk behaviors remain higher. In recent years, the utilization of novel AIDS prevention services, such as HIV self-testing, pre-exposure prophylaxis and post-exposure prophylaxis (PrEP/PEP) in MSM gradually increased. However, the promotion of these services still faces dual challenges: insufficient support from the health system and low individual acceptance. HIV prevention services can not only provide direct biomedical protection for MSM but also reshape their behavior patterns by influencing their risk perception. These services have dual impacts on MSM's behaviors. On one hand, they might lead to an increase in high risk behaviors. On the other hand, these services improve MSM's health awareness and reduce high risk behaviors. This paper summarizes the epidemiology of HIV/AIDS and related high risk behaviors in MSM, with a focus on the utilization of HIV self-testing,PrEP/PEP, as well as their impact on high risk behaviors of MSM for the further promotion of HIV prevention services and improvement of intervention strategies.
5.Progress in research on the effect of AIDS prevention services on high risk behaviors for HIV infection in men who have sex with men
Chinese Journal of Epidemiology 2025;46(9):1704-1710
Men who have sex with men (MSM) represent a key population in the prevention and control of HIV/AIDS. Despite the remarkable advancements in AIDS prevention and treatment, the HIV infection prevalence and incidence in MSM with high risk behaviors remain higher. In recent years, the utilization of novel AIDS prevention services, such as HIV self-testing, pre-exposure prophylaxis and post-exposure prophylaxis (PrEP/PEP) in MSM gradually increased. However, the promotion of these services still faces dual challenges: insufficient support from the health system and low individual acceptance. HIV prevention services can not only provide direct biomedical protection for MSM but also reshape their behavior patterns by influencing their risk perception. These services have dual impacts on MSM's behaviors. On one hand, they might lead to an increase in high risk behaviors. On the other hand, these services improve MSM's health awareness and reduce high risk behaviors. This paper summarizes the epidemiology of HIV/AIDS and related high risk behaviors in MSM, with a focus on the utilization of HIV self-testing,PrEP/PEP, as well as their impact on high risk behaviors of MSM for the further promotion of HIV prevention services and improvement of intervention strategies.
6.Progress in research of incidence of co-infection of HIV and Mycobacterium tuberculosis and influencing factors
Ruzhuo LIU ; Rong SU ; Dongmin LI
Chinese Journal of Epidemiology 2025;46(1):166-174
The co-infection of HIV and Mycobacterium tuberculosis (MTB) poses a severe challenge for the prevention and control of infectious disease, resulting in poor clinical outcomes of the patients and risk for wide spread. As steady progress in global health, the co-infection of HIV/MTB has been basically controlled, and the new cases are generally declining. However, its incidence remained high in resource-limited areas. The incidence of the co-infection of HIV/MTB is associated with the interaction among individual, social, health service, and natural factors. Comprehensive measures are needed to reduce this disease burden. This paper summarized the epidemiological characteristics of the co-infection of HIV/MTB and influencing factors both at home and abroad to provide evidence for the identifications of high-risk populations and areas and development of targeted prevention measures for the purpose of reduce the incidence of co-infection of HIV/MTB.
7.Expert consensus on the bi-directional screening for Mycobacterium tuberculosis and human immunodeficiency virus
Xin SHEN ; Yinzhong SHEN ; Eryong LIU ; Dingyong SUN ; Dongmin LI ; Yun HE ; Jinge HE ; Lin XU ; Bin CHEN ; Chengliang CHAI ; Lianguo RUAN ; Yong GAO ; Aihua DENG ; Zhen NING ; Jing CHEN ; Xiaofeng LIU ; Kaikan GU ; Lixin RAO
Shanghai Journal of Preventive Medicine 2024;36(4):327-336
Tuberculosis (TB) and human immunodeficiency virus infection / acquired immune deficiency syndrome (HIV/AIDS) are both serious global public health threats. Early detection of infected persons and/or patients through TB/HIV bi-directional screening is crucial for prevention and control strategy in China and globally. In recent years, with the promotion and application of new TB and HIV detection technologies worldwide, TB/HIV bi-directional screening technologies and strategies have made remarkable changes. This expert consensus introduces the significance and challenges of TB/HIV bi-directional screening, summarizes important progress of research and applications, and makes recommendations on screening measures and procedures to further strengthen TB/HIV bi-directional screening in China.
8.Analysis of cardiovascular disease prevention indicators among residents with intra-urban migration in Central China
HUANG Tianshu ; TIAN Yuan ; ZHANG Xingyi ; LI Chenhui ; ZHAO Yun ; ZHAO Dongyuan ; CHEN Xianhua ; ZHU Mengyao ; JIAO Guanqi ; GUO Dongmin ; LI Xi ; CUI Jianlan
Journal of Preventive Medicine 2024;36(5):451-456
Objective:
To investigate cardiovascular disease (CVD) prevention status among residents with intra-urban migration in Central China, so as to provide insights into targeted prevention and control of CVD.
Methods:
Basic data of residents aged 35 to 75 years who participated in Early Screening and Comprehensive Intervention Project for CVD high-risk populations in Central China from September 2015 to August 2020 were collected. According to birth place, type of registered residence and current residence, residents were divided into four groups: local residents in old urban area, local residents in new urban area, other urban migrants and other rural migrants. The status of CVD primary and secondary prevention, were analysed by using a robust Poisson regression model.
Results:
A total of 76 513 residents were recruited, including 29 420 males (38.45%) and 47 093 females (61.55%), and had a mean age of (56.36±9.84) years. There were 45 087 (58.93%) local residents in old urban area, 23 868 (31.19%) local residents in new urban area, 5 668 (7.41%) other urban migrants and 1 890 (2.47%) other rural migrants. After adjusting for variables such as age, gender and educational level, the results of robust Poisson regression analysis showed that compared with local residents in old urban area, local residents in new urban area had lower compliance rates of non- or moderate-drinking (RR=0.987, 95%CI: 0.975-1.000) and healthy diet (RR=0.535, 95%CI: 0.365-0.782), lower proportion of using aspirin as primary prevention in CVD high-risk population (RR=0.616, 95%CI: 0.511-0.741), lower awareness (RR=0.873, 95%CI: 0.782-0.974) and control rates (RR=0.730, 95%CI: 0.627-0.849) of hypertension; other urban migrants had higher compliance rate of non-smoking (RR=1.045, 95%CI: 1.017-1.075); other rural migrants had lower proportion of using aspirin as primary prevention in CVD high-risk population (RR=0.826, 95%CI: 0.707-0.966).
Conclusion
The CVD primaryprevention among local residents in new urban area is relatively poor among four groups of residents in Central China, and key interventions are needed.
9.Analysis on the use of HIV post-exposure prophylaxis and related factors in men who have sex with men in Qingdao
Rong SU ; Limin ZHU ; Guihua HUANG ; Peilong LI ; Lin GE ; Meizhen LIAO ; Yong FU ; Xin SONG ; Dongmin LI
Chinese Journal of Epidemiology 2024;45(1):134-138
Objective:To understand the use of post-exposure prophylaxis (PEP) and analyze related factors among men who have sex with men (MSM) in Qingdao, and provide a reference for the AIDS prevention and control in this population.Methods:A cross-sectional survey conducted from April 2022 to February 2023. Relying on MSM social groups in Qingdao, a snowball sampling method was applied to recruit research subjects who met the inclusion criteria of age ≥18 years old, having had homosexual anal or oral sex in the past six months, and HIV-negative or infection status unknown. The sample size was estimated at 566. Data on demographic characteristics, sexual behavior characteristics, PEP use, and others of the research subjects was collected through on-site questionnaires. The logistic regression model was used to analyze the factors associated with using PEP.Results:A total of 811 participants were recruited, mainly aged 25-34 (53.6%, 435/811), unmarried (74.7%, 606/811), with an average monthly income of ≥5 000 yuan (52.2%, 423/811), and having lived in Qingdao for ≥10 years (75.6%, 613/811). The proportion of those who knew the HIV status of their sexual partners in the last six months was 67.1% (544/811), and those with HIV-positive partners were 3.6% (29/811). In the last six months, the proportion of participants who had group sex (86.4%, 701/811), unprotected anal sex (98.2%, 796/811), and use of club drugs (80.3%, 651/811) was high. Moreover, 28.4% (230/811) had used PEP. The multivariate logistic regression analysis showed that the factors related to the use of PEP included divorced or widowed (a OR=5.46,95% CI:1.96-15.17), average monthly income ≥5 000 yuan (a OR=2.04,95% CI:1.44-2.89), same-sex sexual orientation (a OR=0.40,95% CI:0.22-0.71), having HIV-positive sexual partners in the last six months (a OR=2.54,95% CI:1.13-5.71) and having been tested for HIV ≥3 times in the last six months (a OR=1.46,95% CI:1.04-2.06). Conclusions:The prevalence of risk behaviors among MSM in Qingdao was high, and the use of PEP was low. In the future, it is essential to increase HIV/AIDS prevention education among MSM, promote MSM to know the HIV status of their sexual partners, and reduce the prevalence of risk behaviors among this population. Additionally, explore medical insurance reimbursement plans for PEP to reduce utilization costs and promote the use of PEP by MSM after HIV exposure occurs as soon as possible.
10.Current status of monkeypox cognition and related factors among men who have sex with men in China
Peilong LI ; Houlin TANG ; Dongmin LI ; Lin GE ; Maohe YU ; Fan LYU
Chinese Journal of Epidemiology 2023;44(2):257-262
Objective:To understand the current status of monkeypox knowledge and related factors among men who have sex with men (MSM) in China.Methods:The survey was conducted in 30 provinces from September 5 to 10, 2022. With the assistance of social organizations of MSM, MSM respondents were recruited one-to-one by investigators through a convenient sampling method. Respondents log in to the questionnaire star to participate in the anonymous online survey. The sample size was estimated at 5 070 based on China's population infectious disease prevention literacy level of 25%. The self-administered online questionnaire collected information on sociodemographic, behavioral, HIV infection status, attention to monkeypox, and knowledge of monkeypox. The logistic regression model was used to analyze the factors associated with knowledge awareness of monkeypox.Results:Among 5 780 MSM subjects, the awareness rate of monkeypox knowledge was 31.8% (1 840/5 780). The results of multivariate logistic regression analysis showed that the related factors with higher awareness rate of monkeypox knowledge in MSM included the current address was in the eastern region ( OR=1.26, 95% CI: 1.01-1.56), college education level or above ( OR=1.50, 95% CI:1.14-1.97), the number of anal-sex partners in the last month was ≥3 ( OR=1.71, 95% CI: 1.28-2.28) or 2 ( OR=1.36, 95% CI:1.07-1.73), and there was no homosexual group sex in the last month ( OR=1.20, 95% CI:1.01-1.43), they had no heterosexual behavior ( OR=1.28, 95% CI:1.02-1.62), were HIV negative ( OR=1.85, 95% CI:1.44-2.36) or HIV positive ( OR=1.65, 95% CI:1.27-2.16), and paid frequent attention to monkeypox information ( OR=7.08, 95% CI: 5.28-9.48), occasional attention ( OR=4.52, 95% CI: 3.49-5.86) or minimal attention ( OR=2.55, 95% CI: 1.93-3.37). Conclusions:MSM has some attention and understanding of monkeypox in China, but the awareness rate of monkeypox knowledge is not high. It is necessary to strengthen the awareness of monkeypox knowledge among the MSM population with junior middle school education or below, who ignore the epidemic of monkeypox, have not been tested for HIV, and have had homosexual group sex or heterosexual sex to promote monkeypox prevention and self monitoring among MSM.


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