With the rising incidence of breast cancer among women, neoadjuvant chemotherapy (NAC) is becoming increasingly crucial as a preoperative treatment modality, enabling tumor downstaging and volume reduction. However, its efficacy varies significantly among patients, underscoring the importance of predicting pathological complete response (pCR) following NAC. Early research relied on statistical methods to integrate clinical data for predicting treatment outcomes. With the advent of artificial intelligence (AI), traditional machine learning approaches were subsequently employed for efficacy prediction. Deep learning emerged to dominate this field, and demonstrated the capability to automatically extract imaging features and integrate multimodal data for pCR prediction. This review comprehensively examined the applications and limitations of these three methodologies in predicting breast cancer pCR. Future efforts must prioritize the development of superior predictive models to achieve precise predictions, integrate them into clinical workflows, enhance patient care, and ultimately improve therapeutic outcomes and quality of life.
Humans ; Breast Neoplasms/pathology* ; Neoadjuvant Therapy ; Artificial Intelligence ; Female ; Machine Learning ; Deep Learning ; Chemotherapy, Adjuvant ; Treatment Outcome

OBJECTIVE To standardize the strategies for prevention and control of Chikungunya(CHIK)in healthcare in-stitutions so as to reduce the risk of transmission in the institutions.METHODS A working group comprising the ex-perts in hospital infection control,infectious diseases,and microbiology systematically reviewed domestic and international evidence and current guidelines,integrated China's vector ecology and healthcare realities,conducted two rounds of Delphi to achieve expert consensus,and graded the evidence and recommendation strength using the Oxford Centre for Evidence Based Medicine system.RESULTS The consensus issues 18 actionable recommendations on triage,patient mosquito-proof isolation,integrated vector control,protection of susceptible populations,environmental cleaning and disinfection,specimen management,medical textile handling,and outbreak emergency response,with each statement assigned an evi-dence level and recommendation strength.CONCLUSION This consensus is for the first time in China to provide evidence-graded strategies for control of CHIK in healthcare institutions,offering work flow-oriented,implementable guidance for clinicians,laboratorians,and infection-control personnel under different risk scenarios and enhancing the comprehensive coping capacity of the healthcare institutions.

Objective:To investigate the neural function and Insulin-like growth factor-1 (IGF-1) in post-stroke depression (PSD) model rats. The effect of IGF-1 on mitogen activated protein kinase (MAPK) signaling pathway.Methods:15 male SD rats were selected as sham-operation group. PSD rat model was prepared by Longa method and chronic unpredictability mild stress method with 70 rats. The successfully constructed PSD rats were divided into model group, fluoxetine group (2.31 mg/kg fluoxetine, gavage), electroacupuncture group [stimulation of "Baihui"(GV20), "Fengfu"(GV16), "Shenting"(GV24) and "Taichong"(LR3) acupoints by electroacupuncture]and positive drug group [stimulation of "Baihui"(GV20), "Fengfu"(GV16), "Shenting"(GV24) and "Taichong"(LR3) acupoints by electroacupuncture + 5 μl of Sb202190 solution was injected into the lateral ventricle with a concentration of 10 μmol/L]. According to random number table method, with 15 rats in each group. Each group received relevant administration, and the rats' body mass was measured at the end of treatment. mNSS scale was used to evaluate the neurological impairment of rats; the behavioral function of rats was evaluated by sugar water preference test and forced swimming test; Nissl and TUNEL staining were used to observe the number of NissL bodies and the apoptosis rate of neurons in hippocampus; the level of serum IGF-1 was Nissl by enzyme-linked immunosorbent assay (ELISA); Western blot was used to detect the expressions of Caspase-3, Bax, Bcl-2, brain-derived neurotrophic factor (BDNF), cyclic adenosine monophosphate response element binding protein (CREB), p-CREB, IGF-1, mitogen activated protein kinase (MEK), p-MEK, ERK, p-ERK, JNK, p-JNK, p38 mitogen activated protein kinase (p38), p-p38 protein in brain tissue.Results:Compared with the model group, the weight of rats increased in the fluoxetine, electroacupuncture, and positive drug groups ( P<0.05); mNSS and forced swim test immobility time decreased ( P<0.05). Sucrose consumption percentage and struggling time in the forced swim test were markedly elevated ( P<0.05); Nissl body counts in hippocampal neurons increased ( P<0.05), accompanied by reduced neuronal apoptosis rates ( P<0.05); serum IGF-1 level significantly increased ( P<0.05); the protein expressions of Caspase-3 and Bax in hippocampus decreased ( P<0.05), while the protein expressions of Bcl-2, p-CREB/CREB, BDNF, IGF-1, p-MEK/MEK, p-ERK/ERK, p-JNK/JNK and p-p38/p38 increased ( P<0.05). Conclusions:Electroacupuncture can improve neural function and depressive behavior in rats, reduce pathological damage in hippocampus, increase the number of Nissl bodies, and inhibit apoptosis. The mechanism of electroacupuncture may be related to the increase of IGF-1 and the activation of MAPK signaling pathway.

OBJECTIVE To standardize the strategies for prevention and control of Chikungunya(CHIK)in healthcare in-stitutions so as to reduce the risk of transmission in the institutions.METHODS A working group comprising the ex-perts in hospital infection control,infectious diseases,and microbiology systematically reviewed domestic and international evidence and current guidelines,integrated China's vector ecology and healthcare realities,conducted two rounds of Delphi to achieve expert consensus,and graded the evidence and recommendation strength using the Oxford Centre for Evidence Based Medicine system.RESULTS The consensus issues 18 actionable recommendations on triage,patient mosquito-proof isolation,integrated vector control,protection of susceptible populations,environmental cleaning and disinfection,specimen management,medical textile handling,and outbreak emergency response,with each statement assigned an evi-dence level and recommendation strength.CONCLUSION This consensus is for the first time in China to provide evidence-graded strategies for control of CHIK in healthcare institutions,offering work flow-oriented,implementable guidance for clinicians,laboratorians,and infection-control personnel under different risk scenarios and enhancing the comprehensive coping capacity of the healthcare institutions.

Objective:To investigate the efficacy, safety and possible mechanisms of celecoxib as an adjunctive treatment for schizophrenia.Methods:90 schizophrenic inpatients at the second affiliated hospital of Xinxiang Medical College from April 2019 to October 2020 were recruited and randomly assigned to a placebo group or the celecoxib adjunctive treatment group using a random number table. In the placebo group, 46 patients (29 males, 17 females; aged 21-34, mean age 27.46±6.50 years) completed a 6-week follow-up. In the celecoxib group, 44 patients (32 males, 12 females; aged 21-39, mean age 30.52±8.69 years) completed a 6-week follow-up. The Positive and Negative Syndrome Scale (PANSS) was used to assess psychiatric symptoms in both groups. Changes in PANSS score at the end of the treatment were compared to evaluate the efficacy of celecoxib. Metabolic indicators such as weight, body mass index, waist circumference and plasm glucolipid, as well as cardiovascular indicators like blood pressure, electrocardiogram and routine blood tests, and adverse events were collected for the safety evaluation. Serum tumor necrosis factor-α (TNF-α), Interleukin-4 (IL-4) and interferon-γ (IFN-γ) were also tested. Pearson correlation analysis was used to explore the relationship between cytokine levels, PANSS score, PANSS reduction rate [(pre-treatment score-post-treatment score)/pre-treatment score×100%], and the safety measurements in the two groups, analyzing the role of inflammation in celecoxib adjunctive therapy.Results:The change of PANSS positive score at the end of the 6th week was significantly higher in the celecoxib adjuvant treatment group than in the placebo group (-8.00±6.12 vs -4.78±5.19, H=-0.55, P=0.009). The weight changes, body mass index, total cholesterol, and triglycerides over 6 weeks were significantly lower in the celecoxib group compared to the placebo group ( F=-7.37, -7.30, 2.56, -2.54; all P<0.05). No serious adverse events were found in celecoxib adjuvant therapy. In the placebo group, baseline TNF-α levels were positively correlated with baseline negative symptoms and PANSS reduction rate ( r=0.260 and 0.330, both P<0.05), and negatively correlated with the 6-week weight ( r=-0.311, P<0.05); baseline IL-4 levels were positively correlated with the 6-week PANSS total score and the 6-week PANSS negative score ( r=0.320 and 0.397, both P<0.05), and negatively correlated with PANSS reduction rate and 6-week blood glucose ( r=-0.316 and -0.331, both P<0.05); Six-week IFN-γ levels were negatively correlated with low-density lipoprotein levels ( r=-0.306, P<0.05). And no such correlation was found in celecoxib adjuvant group. Conclusion:Celecoxib adjunctive therapy can improve positive symptoms of schizophrenia without causing adverse reactions. Inflammatory state is related to schizophrenia symptoms, treatment efficacy and metabolic abnormalities.

Objectives:To investigate the association between single nucleotide polymorphisms (SNP) of indoleamine 2,3-dioxygenase( IDO) genes and schizophrenia (SZ) in a Chinese Han population. Methods:Using a case-control study method, 3 700 in-patients with SZ were recruited from January 2010 to December 2021 at the Second Affiliated Hospital of Xinxiang Medical University, and 8 580 healthy controls were recruited from surrounding communities in Xinxiang City. The patient group and control group were matched in gender and age. After collecting peripheral blood from all subjects and extracting genomic DNA, the sample DNA was genotyped using methods such as gene chips and amplification refractory mutation system. The association analysis between IDO gene SNPs and SZ was conducted using the online analysis tool SHEsis. The differences in IDO gene SNP genotype and allele frequency between the two groups were compared using chi-square test. Linkage disequilibrium analysis, haplotype analysis, and Hardy Weinberg equilibrium test were performed using Haploview v4.2 software. A multifactor dimensionality reduction software was used to evaluate the interaction between SNPs and SNP frequencies. Results:In the four SNP loci of IDO gene, there was a significant difference in genotype and allele frequency between the SZ patient and the health control at rs9657182 locus (χ 2=11.81, P=0.003;χ 2=5.54, P=0.019). After Bonferroni correction, the genotype difference at rs9657182 locus still showed statistical significance ( P=0.011). There were no statistically significant differences in genotype and allele frequency among the three SNP locis (rs7820268, rs4503083, and rs10109853). Further stratified by gender, there was no significant difference in genotype frequency between the two groups at the rs9657182. Haplotype analysis revealed that the haplotype of CC and TC (rs9657182 and rs7820268) were significantly different between the two groups (χ 2=3.93,4.78, P=0.048, 0.029). Conclusion:The rs9657182 locus of IDO gene may be a susceptible locus for SZ. The haplotype of CC and TC may be associated with the onset of SZ.

Objective:To analyze the evaluation of the application effect and deficiency of nurses acting as standardized parents in the graduation examination of standardized residency training of pediatrics and further improve and promote the level of standardized parents.Methods:A questionnaire survey was used to collect the scores of nurse standardized parents by students and examiners who took part in the graduation examination of standardized residency training of pediatrics in 2021. And the self-evaluation scores of standardized parents were collected. Counting data were represented by the number of cases and composition ratio. A Chi-square test was used to compare the rates.Results:A total of 125 questionnaires from students and 37 questionnaires from nurse standardized parents were collected, and the overall satisfaction (very satisfied + satisfied) of standardized parents reached 121 (96.80%). In the three dimensions of simulation ability, compliance with question-and-answer rules, and simulated attitude, students believed that the consistency between standardized parents and actual parents in simulated altitude was lower than that in the simulation ability and compliance with question-and-answer rules ( P=0.007, P=0.001). The overall satisfaction of standardized parents (very satisfied + satisfied) reached 87.38% (388/444). There were 26 (70.27%) nurse standardized parents who had the lowest satisfaction with their own performance ability, followed by 28 (75.68%) cases of imitation ability and 30 (81.08%) cases of adaptability. Conclusions:It is feasible to adopt nurse standardized parents in the assessment of standardized residency training of pediatrics, and both students and examiners have higher satisfaction. The next step is to improve the training of nurses standardized parents in the attitude of simulation and, at the same time, enhance the training of imitation ability and adaptability, so as to further expand the construction of standardized parents.

Objective:To investigate the impact of non-high-density lipoprotein cholesterol (non-HDL-C) level on major adverse cardiovascular and cerebrovascular events (MACCE) and all-cause mortality in the Kailuan Study cohort undergoing revascularization.Methods:This is a prospective cohort study, with participants from the Kailuan Study cohort who participated in physical examinations from 2006 to 2020 and received revascularization therapy for the first time. According to the level of non-HDL-C, the study subjects were divided into 3 groups:<2.6 mmol/L group, 2.6-<3.4 mmol/L group, and≥3.4 mmol/L group. Annual follow-up was performed, and the endpoint events were MACCE and all-cause mortality. Cox proportional regression model was implemented to estimate the impact on MACCE and all-cause mortality associated with the different non-HDL-C groups. The partial distributed risk model was used to analyze the impact of different non-HDL-C levels on MACCE event subtypes, and death was regarded as a competitive event. The restricted cubic spline regression model was used to explore the dose-response relationship between non-HDL-C level and all-cause mortality, MACCE and its subtypes.Results:A total of 2 252 subjects were enrolled in the study, including 2 019 males (89.65%), aged (62.8±8.3) years, the follow-up time was 5.72 (3.18, 8.46) years. There were 384 cases(17.05%) of MACCE and 157 cases(6.97%) of all-cause mortality. Compared with patients with non-HDL-C≥3.4 mmol/L, patients with non-HDL-C<2.6 mmol/L were associated with a 38% reduced risk of MACCE after revascularization [ HR=0.62(95% CI: 0.48-0.80)]. Every 1 mmol/L decrease in non-HDL-C was associated with a 20% reduction in the risk of MACCE [ HR=0.80(95% CI: 0.73-0.88)]. The results of restricted cubic spline also showed that non-HDL-C levels after revascularization therapy were positively correlated with MACCE events (overall association P<0.001, non-linear association P=0.808). For all-cause mortality, compared to the non-HDL-C≥3.4 mmol/L group, the HR for all-cause mortality after revascularization in non-HDL-C<2.6 mmol/L group was 0.67(95% CI: 0.46-1.01). Every 1 mmol/L decrease in non-HDL-C was associated with a 15% reduction in the risk of all-cause mortality [ HR=0.85(95% CI: 0.73-0.99)]. The restricted cubic spline results showed a linear association between non-HDL-C levels after revascularization therapy and the risk of all-cause mortality (overall association P=0.039, non-linear association P=0.174). Conclusion:The decrease in non-HDL-C levels after revascularization were significantly associated with a reduced risk of MACCE and all-cause mortality.

Objective:To investigate the efficacy, safety and possible mechanisms of celecoxib as an adjunctive treatment for schizophrenia.Methods:90 schizophrenic inpatients at the second affiliated hospital of Xinxiang Medical College from April 2019 to October 2020 were recruited and randomly assigned to a placebo group or the celecoxib adjunctive treatment group using a random number table. In the placebo group, 46 patients (29 males, 17 females; aged 21-34, mean age 27.46±6.50 years) completed a 6-week follow-up. In the celecoxib group, 44 patients (32 males, 12 females; aged 21-39, mean age 30.52±8.69 years) completed a 6-week follow-up. The Positive and Negative Syndrome Scale (PANSS) was used to assess psychiatric symptoms in both groups. Changes in PANSS score at the end of the treatment were compared to evaluate the efficacy of celecoxib. Metabolic indicators such as weight, body mass index, waist circumference and plasm glucolipid, as well as cardiovascular indicators like blood pressure, electrocardiogram and routine blood tests, and adverse events were collected for the safety evaluation. Serum tumor necrosis factor-α (TNF-α), Interleukin-4 (IL-4) and interferon-γ (IFN-γ) were also tested. Pearson correlation analysis was used to explore the relationship between cytokine levels, PANSS score, PANSS reduction rate [(pre-treatment score-post-treatment score)/pre-treatment score×100%], and the safety measurements in the two groups, analyzing the role of inflammation in celecoxib adjunctive therapy.Results:The change of PANSS positive score at the end of the 6th week was significantly higher in the celecoxib adjuvant treatment group than in the placebo group (-8.00±6.12 vs -4.78±5.19, H=-0.55, P=0.009). The weight changes, body mass index, total cholesterol, and triglycerides over 6 weeks were significantly lower in the celecoxib group compared to the placebo group ( F=-7.37, -7.30, 2.56, -2.54; all P<0.05). No serious adverse events were found in celecoxib adjuvant therapy. In the placebo group, baseline TNF-α levels were positively correlated with baseline negative symptoms and PANSS reduction rate ( r=0.260 and 0.330, both P<0.05), and negatively correlated with the 6-week weight ( r=-0.311, P<0.05); baseline IL-4 levels were positively correlated with the 6-week PANSS total score and the 6-week PANSS negative score ( r=0.320 and 0.397, both P<0.05), and negatively correlated with PANSS reduction rate and 6-week blood glucose ( r=-0.316 and -0.331, both P<0.05); Six-week IFN-γ levels were negatively correlated with low-density lipoprotein levels ( r=-0.306, P<0.05). And no such correlation was found in celecoxib adjuvant group. Conclusion:Celecoxib adjunctive therapy can improve positive symptoms of schizophrenia without causing adverse reactions. Inflammatory state is related to schizophrenia symptoms, treatment efficacy and metabolic abnormalities.

Objectives:To investigate the association between single nucleotide polymorphisms (SNP) of indoleamine 2,3-dioxygenase( IDO) genes and schizophrenia (SZ) in a Chinese Han population. Methods:Using a case-control study method, 3 700 in-patients with SZ were recruited from January 2010 to December 2021 at the Second Affiliated Hospital of Xinxiang Medical University, and 8 580 healthy controls were recruited from surrounding communities in Xinxiang City. The patient group and control group were matched in gender and age. After collecting peripheral blood from all subjects and extracting genomic DNA, the sample DNA was genotyped using methods such as gene chips and amplification refractory mutation system. The association analysis between IDO gene SNPs and SZ was conducted using the online analysis tool SHEsis. The differences in IDO gene SNP genotype and allele frequency between the two groups were compared using chi-square test. Linkage disequilibrium analysis, haplotype analysis, and Hardy Weinberg equilibrium test were performed using Haploview v4.2 software. A multifactor dimensionality reduction software was used to evaluate the interaction between SNPs and SNP frequencies. Results:In the four SNP loci of IDO gene, there was a significant difference in genotype and allele frequency between the SZ patient and the health control at rs9657182 locus (χ 2=11.81, P=0.003;χ 2=5.54, P=0.019). After Bonferroni correction, the genotype difference at rs9657182 locus still showed statistical significance ( P=0.011). There were no statistically significant differences in genotype and allele frequency among the three SNP locis (rs7820268, rs4503083, and rs10109853). Further stratified by gender, there was no significant difference in genotype frequency between the two groups at the rs9657182. Haplotype analysis revealed that the haplotype of CC and TC (rs9657182 and rs7820268) were significantly different between the two groups (χ 2=3.93,4.78, P=0.048, 0.029). Conclusion:The rs9657182 locus of IDO gene may be a susceptible locus for SZ. The haplotype of CC and TC may be associated with the onset of SZ.