BACKGROUND: Neoadjuvant chemoradiotherapy followed by radical surgery has been a common practice for patients with locally advanced rectal cancer, but the response rate varies among patients. This study aimed to develop a ResNet-Vision Transformer based magnetic resonance imaging (MRI)-endoscopy fusion model to precisely predict treatment response and provide personalized treatment. METHODS: In this multicenter study, 366 eligible patients who had undergone neoadjuvant chemoradiotherapy followed by radical surgery at eight Chinese tertiary hospitals between January 2017 and June 2024 were recruited, with 2928 pretreatment colonic endoscopic images and 366 pelvic MRI images. An MRI-endoscopy fusion model was constructed based on the ResNet backbone and Transformer network using pretreatment MRI and endoscopic images. Treatment response was defined as good response or non-good response based on the tumor regression grade. The Delong test and the Hanley-McNeil test were utilized to compare prediction performance among different models and different subgroups, respectively. The predictive performance of the MRI-endoscopy fusion model was comprehensively validated in the test sets and was further compared to that of the single-modal MRI model and single-modal endoscopy model. RESULTS: The MRI-endoscopy fusion model demonstrated favorable prediction performance. In the internal validation set, the area under the curve (AUC) and accuracy were 0.852 (95% confidence interval [CI]: 0.744-0.940) and 0.737 (95% CI: 0.712-0.844), respectively. Moreover, the AUC and accuracy reached 0.769 (95% CI: 0.678-0.861) and 0.729 (95% CI: 0.628-0.821), respectively, in the external test set. In addition, the MRI-endoscopy fusion model outperformed the single-modal MRI model (AUC: 0.692 [95% CI: 0.609-0.783], accuracy: 0.659 [95% CI: 0.565-0.775]) and the single-modal endoscopy model (AUC: 0.720 [95% CI: 0.617-0.823], accuracy: 0.713 [95% CI: 0.612-0.809]) in the external test set. CONCLUSION The MRI-endoscopy fusion model based on ResNet-Vision Transformer achieved favorable performance in predicting treatment response to neoadjuvant chemoradiotherapy and holds tremendous potential for enabling personalized treatment regimens for locally advanced rectal cancer patients.
Humans ; Rectal Neoplasms/diagnostic imaging* ; Magnetic Resonance Imaging/methods* ; Male ; Female ; Middle Aged ; Neoadjuvant Therapy/methods* ; Aged ; Adult ; Chemoradiotherapy/methods* ; Endoscopy/methods* ; Treatment Outcome

Objective To investigate the effect of nano carbon tracer for protecting parathyroid function in the surgery of thyroid cancer.Methods A total of 178 patients with thyroid cancer admitted in our hospital from Jun.2014 to Mar.2016 were collected and divided into the control group and the observation group according to the random number table method,89 cases in each group.The control group received routine surgery,while the observation group received nanocarbon suspension during surgery.The levels of serum parathyroid hormone and serum calcium in the 2 groups were measured at 3 days after surgery,and the patients with low parathyroid hormone,normal parathyroid hormone and low calcium were counted.Results The rate of ormal serum calcium in the observation group was 91.01％(81/89),significantly higher than 67.42％(60/89) in the control group (P＜ 0.05).The rate of normal parathyroid hormone in observation group was 94.38％ (84/89),significantly higher than 64.04％ (57/89) in the control group (P＜0.05).Conclusion The nano carbon tracer is helpful for protection of parathyroid function in the surgery of thyroid cancer.

Objective To perform the bibliometric research on the literatures of the endoscopic retrograde cholangio pancreatog-raphy(ERCP) in the last ten years to provide reference for accurately grasping the international research situation and selecting the cutting-edge technological topics .Methods The literatures of ERCP in the database Web of Science from 2001 to 2011 were collect-ed .The CiteSpace software was adopted to analyze the distribution characteristics ,key point literature ,hotspots fields and research frontier of articles of ERCP .Results 2 921 citations of the research articles were retrieved .The analysis showed that America was strongest in the ERCP research field ;10 key point articles were detected .The high frequency keywords were complications ,manage-ment ,sphincterotomy ,etc .,the concentricity ranged 0 .06-0 .24 .The high frequency burst words were gold standard ,procedure-re-lated-complications ,biliary-stents ,but the concentricity was 0 .Conclusion The research hotspots of ERCP field are the occurrence rate of ERCP postoperative complications ,diagnosis and treatment ,but no obvious research cutting-edge is formed .