Purpose: To intelligently diagnose whether there is bladder outlet obstruction (BOO) in female with decent detrusor contraction ability by focusing on urodynamic study (UDS) data. Materials and Methods: We retrospectively reviewed the UDS data of female patients during urination. Eleven easily accessible urinary flow indicators were calculated according to the UDS data of each patient during voiding period. Eight diagnosis models based on back propagation neural network with different input feature combination were constructed by analyzing the correlations between indicators and lower urinary tract dysfunction labels. Subsequently, the stability of diagnostic models was evaluated by five-fold cross-validation based on training data, while the performance was compared on test dataset. Results: UDS data from 134 female patients with a median age of 51 years (range, 27–78 years) were selected for our study.Among them, 66 patients suffered BOO and the remaining were normal. Applying the 5-fold cross-validation method, the model with the best performance achieved an area under the receiver operating characteristic curve (AUC) value of 0.949±0.060 using 9 UDS input features. The accuracy, sensitivity, and specificity for BOO diagnosis model in the testing process are 94.4%, 100%, and 89.3%, respectively. Conclusions The 9 significant indicators in UDS were employed to construct a diagnostic model of female BOO based on machine learning algorithm, which performs preferable classification accuracy and stability.

Objective To establish a prognostic nomogram based on preoperative serum prealbumin levels for predicting overall survival(OS)in patients with unresectable hepatocellular carcinoma(HCC)treated with transcatheter arterial chemoembolization(TACE).Methods A total of 1 041 patients with unresectable HCC,who received TACE treatment at five medical centers in Suzhou city of China between January 2007 and December 2018,were divided into a training cohort(n=768)and a validation cohort(n=273).Cox regression analysis was used to analyzed the independent factors affecting one-,2-,and 3-year OS,based on which the nomogram was constructed,and validation of the nomogram was conducted in an internal test sequence.The performance of the nomogram was evaluated by concordance index(C-index),area under the receiver operating characteristic curve(AUC),calibration curve,and judgment curve analysis(DCA).Results COX regression analysis showed that AFP,BCLC,HBV,intrahepatic vascular invasion,number of tumors,PALB,PS,and tumor size were the independent risk factors affecting OS in patients with unresectable HCC treated with TACE.The C-index in the nomogram was 0.739(95％CI:0.719-0.759)for the training cohort and 0.715(95％CI:0.678-0.752)for the verification cohort.The AUCs of one-,2-,and 3-year OS in the training cohort were 0.877,0.794,and 0.799 respectively,which in the verification cohort were 0.840,0.741,and 0.671 respectively.The AUC-ROC values of the nomogram were higher than those of other traditional scoring systems,indicating that the nomogram had a good discriminatory power.The calibration curves demonstrated that a strong agreement existed between the predicted values of the nomogram and the actual observed values,and the DCA showed that the nomogram had high potential clinical utilization.The nomogram risk score revealed that the survival rate of patients in the low-risk group was significantly higher than that of patients in the high-risk group.Conclusion The nomogram based on preoperative serum prealbumin levels has excellent ability in predicting the prognosis of patients with unresectable HCC treated with TACE.

Objective·To analyze the imaging characteristics and diagnostic value of 18F-fluorodeoxyglucose positron emission tomography-computed tomography(18F-FDG PET/CT)in mantle cell lymphoma(MCL)and explore its application to distinguishing between classic and aggressive variants of MCL.Methods·A retrospective analysis was conducted on the 18F-FDG PET/CT images and clinical data of 116 pathologically confirmed,newly diagnosed MCL patients.The imaging features of intra-and extra-nodal lesions were summarized.The accuracy of 18F-FDG PET/CT in diagnosing bone marrow and gastrointestinal involvement in MCL was evaluated.Furthermore,differences in 18F-FDG PET/CT findings and clinical characteristics between the classic and aggressive variants of MCL were analyzed.Results·Among the 116 patients,100.0%showed positive findings on 18F-FDG PET/CT,with 99.1%exhibiting abnormal lymph nodes and 85.3%having extra-nodal involvement.The most common extra-nodal sites were the spleen,Waldeyer's ring,bone marrow,and gastrointestinal tract.Compared with bone marrow aspiration results,the sensitivity,specificity,and accuracy of 18F-FDG PET/CT for detecting bone marrow involvement in MCL were 43.4%,91.5%,and 66.0%,respectively.When compared with endoscopic biopsy results,the sensitivity of 18F-FDG PET/CT for detecting gastric and intestinal involvement was 100.0%and 94.1%,respectively,with specificity of 75.0%and 100.0%,and accuracy of 92.9%and 94.7%,respectively.There were significant differences in the highest maximum standardized uptake value(SUVmax)and Ki-67 index between the classic and aggressive variants of MCL,with SUVmax positively correlated with Ki-67 index.By using SUVmax>10.4 as the diagnostic threshold,the sensitivity and specificity for differentiating between the classic and aggressive variants of MCL were 73.9%and 77.4%,respectively,with an AUC value of 0.797.Conclusion·18F-FDG PET/CT demonstrates a high detection rate for both intra-and extra-nodal lesions in MCL patients.It exhibits high specificity in diagnosing bone marrow involvement and high sensitivity and specificity in diagnosing gastrointestinal involvement,providing reliable non-invasive diagnostic information for MCL bone marrow and gastrointestinal involvement.However,it is not a substitute for pathological examination.Additionally,the positive correlation between SUVmax and Ki-67 index allows SUVmax to effectively differentiate between the classic and aggressive variants of MCL,with a higher SUVmax(>10.4)indicating a higher likelihood of the aggressive variant.These findings have clinical implications for treatment planning and prognosis assessment.

Objective·To analyze the imaging characteristics and diagnostic value of 18F-fluorodeoxyglucose positron emission tomography-computed tomography(18F-FDG PET/CT)in mantle cell lymphoma(MCL)and explore its application to distinguishing between classic and aggressive variants of MCL.Methods·A retrospective analysis was conducted on the 18F-FDG PET/CT images and clinical data of 116 pathologically confirmed,newly diagnosed MCL patients.The imaging features of intra-and extra-nodal lesions were summarized.The accuracy of 18F-FDG PET/CT in diagnosing bone marrow and gastrointestinal involvement in MCL was evaluated.Furthermore,differences in 18F-FDG PET/CT findings and clinical characteristics between the classic and aggressive variants of MCL were analyzed.Results·Among the 116 patients,100.0%showed positive findings on 18F-FDG PET/CT,with 99.1%exhibiting abnormal lymph nodes and 85.3%having extra-nodal involvement.The most common extra-nodal sites were the spleen,Waldeyer's ring,bone marrow,and gastrointestinal tract.Compared with bone marrow aspiration results,the sensitivity,specificity,and accuracy of 18F-FDG PET/CT for detecting bone marrow involvement in MCL were 43.4%,91.5%,and 66.0%,respectively.When compared with endoscopic biopsy results,the sensitivity of 18F-FDG PET/CT for detecting gastric and intestinal involvement was 100.0%and 94.1%,respectively,with specificity of 75.0%and 100.0%,and accuracy of 92.9%and 94.7%,respectively.There were significant differences in the highest maximum standardized uptake value(SUVmax)and Ki-67 index between the classic and aggressive variants of MCL,with SUVmax positively correlated with Ki-67 index.By using SUVmax>10.4 as the diagnostic threshold,the sensitivity and specificity for differentiating between the classic and aggressive variants of MCL were 73.9%and 77.4%,respectively,with an AUC value of 0.797.Conclusion·18F-FDG PET/CT demonstrates a high detection rate for both intra-and extra-nodal lesions in MCL patients.It exhibits high specificity in diagnosing bone marrow involvement and high sensitivity and specificity in diagnosing gastrointestinal involvement,providing reliable non-invasive diagnostic information for MCL bone marrow and gastrointestinal involvement.However,it is not a substitute for pathological examination.Additionally,the positive correlation between SUVmax and Ki-67 index allows SUVmax to effectively differentiate between the classic and aggressive variants of MCL,with a higher SUVmax(>10.4)indicating a higher likelihood of the aggressive variant.These findings have clinical implications for treatment planning and prognosis assessment.

Objective To investigate the value of triglyceride-glucose index (TyG) and body mass index (BMI) in predicting nonalcoholic fatty liver disease (NAFLD) in type 2 diabetes mellitus (T2DM). Methods A retrospective analysis was performed for the clinical data of 349 patients with T2DM who were treated in Shengjing Hospital of China Medical University from May 2020 to July 2021, and according to the presence or absence of NAFLD, they were divided into T2DM+NAFLD group with 213 patients and simple T2DM group with 136 patients. The t -test or the Mann Whitney U test was used for comparison of continuous data between two groups, and the chi-square test was used for comparison of categorical data between two groups. A logistic regression analysis was used to investigate the association of TyG and BMI with T2DM+NAFLD, and the receiver operating characteristic (ROC) curve was plotted to evaluate the prediction efficiency of TyG alone, BMI alone, and TYG combined with BMI for NAFLD in T2DM. The Kappa coefficient was used to analyze the consistency of prediction results. Results Compared with the simple T2DM group, the T2DM+NAFLD group had significantly higher BMI, diastolic pressure, fasting blood glucose, HbA1c, alanine aminotransferase, aspartate aminotransferase, gamma-glutamyl transpeptidase, triglyceride, total cholesterol, low-density lipoprotein cholesterol, and TyG (all P < 0.05) and a significantly lower high-density lipoprotein cholesterol ( P < 0.05), while there were no significant differences between the two groups in systolic pressure, total bilirubin, direct bilirubin, and indirect bilirubin (all P > 0.05). The logistic regression analysis showed that TyG (odds ratio [ OR ]=6.513, 95% confidence interval [ CI ]: 1.884-22.517, P < 0.001) and BMI ( OR =1.369, 95% CI : 1.191-1.575, P < 0.001) were independent risk factors for NAFLD in T2DM. The ROC curve analysis showed that TyG had an area under the ROC curve (AUC) of 0.875 in predicting NAFLD in T2DM, with a sensitivity of 80.3%, a specificity of 80.1%, a positive predictive value of 86.36%, and a negative predictive value of 72.19% at the optimal cut-off value of 9.41; BMI had an AUC of 0.787, with a sensitivity of 78.9%, a specificity of 64.0%, a positive predictive value of 77.36%, and a negative predictive value of 64.23% at the optimal cut-off value of 24.22; TyG combined with BMI had an AUC of 0.910, a sensitivity of 81.2%, a specificity of 88.2%, a positive predictive value of 91.53%, and a negative predictive value of 75.00% in predicting NAFLD in T2DM. TyG alone, BMI alone, and TyG combined with BMI had a Kappa coefficient of 0.592, 0.416, and 0.673, respectively, in predicting NAFLD in T2DM. Conclusion TyG and BMI can be used to predict the onset of NAFLD in T2DM, and the combination of TyG and BMI can improve the predictive value.

Objective:To observe any effect of intermittent theta burst stimulation (iTBS) on the spatially-delayed responses of working memory using cynomolgus macaques.Methods:The working memory of six male cynomolgus macaques (8-9 years old) was trained using a spatially-delayed response task. They were then randomly divided into an iTBS group and a control group, each of 3. The iTBS group was given iTBS at an intensity of 35% of the maximum output, with 2 seconds of stimulation followed by 8 seconds of rest with trains of 50Hz bursts repeated at a frequency of 5Hz over a period of 192 seconds once daily for 5 days, while the control group was given sham iTBS. Before and after the 5 days, the body weight and working memory of each animal were evaluated. The total number of effective feeding episodes, and of effective feeding episodes with short and long delay periods were recorded.Results:There was no significant change in the average body weight of either group before and after the modeling and iTBS intervention. After the intervention the number of total effective feeding cases and those with a short delay period were both significantly higher in the iTBS group than in the control group. However, no significant inter-group differences in the effective feeding cases with a long delay period were observed.Conclusions:iTBS is effective in improving the spatially-delayed responses of working memory, at least in cynomolgus macaques.

Objective:To investigate the epidermal growth factor receptor (EGFR) mutation rate, mutation characteristics and distribution characteristics of different mutation types in patients with non-small cell lung cancer (NSCLC) in Fuyang of Yunnan province, to provide the clinical individualized targeted therapy of NSCLC in this region.Methods:A total of 328 NSCLC patients whose native place were Fuyuan and who underwent EGFR test in Fuyuan County People's Hospital in Yunnan Province from January 2018 to August 2020 were selected, and their clinical data such as gender, age, ethnicity, pathological type and the results of EGFR test were collected for statistical analysis.Results:The EGFR mutation rate of NSCLC patients was 40.55% (133/328). The EGFR mutation rate of female patients was higher than that of males ( P < 0.01). The EGFR mutation rate showed a downward trend with age, the EGFR mutation rate of patients ≤ 60 years old was higher than that of patients > 60 years old ( P = 0.014). The EGFR mutation rate in ethnic minority was not statistically different from Han nationality ( P = 0.789). The EGFR mutation rate of patients without smoking history was higher than that of patients with smoking history ( P<0.01). Patients with adenocarcinoma had a higher EGFR mutation rate than squamous cell carcinoma ( P = 0.002). The EGFR mutation rate in patients with stage Ⅰ-Ⅱwere higher than that in patents with stage Ⅲ-Ⅳ ( P = 0.013). The EGFR mutation rate in tissue samples were higher than that in peripheral blood samples ( P = 0.009). In 328 patients the EGFR single-point mutation rate was 24.70% (81/328), and the compound mutation rate was 15.85% (52/328); the common mutation rate was 17.07% (56/328), and the rare mutation rate was 23.48% (77/328). The top 5 mutation types were L858R (10.06%), G719X+S768I (7.32%), 19-Del (7.01%), G719X+L861Q (6.40%), and G719X (4.21%). In 133 patients with EGFR mutation, the proportion of patients with rare mutation [57.89% (77/133)] was higher than the proportion of patients with common mutation [42.11% (56/133)]. Conclusion:The EGFR mutation rates of female, adenocarcinoma, non-smoking and young NSCLC patients in Fuyuan area are high, and the rare mutation rate is high.

Objective To investigate the correlation between synovial inflammatory changes (synovial blood signals,synovial thickness,joint effusion) and cartilage injury,meniscus prominence of knee osteoarthritis (KOA) under energy Doppler ultrasound and further to assess the value of ultrasound for prognostic judgment in KOA.Methods A total of 291 KOA patients from our hospital from 2016 to 2018 were collected.The patients with rheumatoid arthritis (RA) with knee joints involved were recruited as control group.The data that conform to the normal distribution were expressed by mean±SD,and others were represented by M (P25,P75).The t test,the rank test and Chi-square test were used between the two groups,and ANOVA or K-W test was used to compare the data between the multiple groups,Spearman correlation analysis was used for correlation analysis.Results ① The proportion of synovial blood flow signal in KOA group was lower than RA group (19.6％ vs 47.7％,x2=286.2,P＜0.01),as well as the typical synovial thickness [2.6(0,3.95) mm vs 3.43 (1.85,6) mm,Z=-3.674,P＜0.01] and popliteal cyst (11.5％ vs 18.5％,x2=4.484,P=0.04).② In KOA group,no significant difference was found between ESR and hs-CRP among different synovial blood signals (H=7.213,H=0.883,all P＞0.05).ESR from KOA group were both significantly lower than controls but the synovial blood signals was the same except for power Doppler signal-2 group (Z=-8.414,Z=-4.991,t=-3.428,all P＜0.05);hs-CRP from KOA group were both significantly lower than controls but the synovial blood signals was the same.③ A total of 489 knee joints were detected in 291 patients with KOA,of which synovial blood flow signals were found in 96 joints,the power Doppler signal-I group was the most frequent in KOA (80/96,83.3％).In addition,joint effusion and synovial thickening were positively correlated with the synovial blood signals,(r=0.277,r=0.411,all P＜0.05).④ At last,the degrees of ultrasound blood flow signal in KOA group was positively associated with the WOMAC score,the Lequsne index and US-1 score (r=0.352,r=0.424,r=0.59,all P＜0.05).Conclusion Energy Doppler ultrasonography can be used to detect the KOA synovitis.Synovitis is not rare in KOA patients,and which is associated with disease activity.However,KOA and RA cannot be differentiated by energy Doppler ultrasonography.

Objective To explore the correlation between serum uric acid ( SUA) and non alcohol fatty liver disease(NAFLD). Methods From October 2015 to December 2016,two hundred and forty?nine cases of NAFLD in Shengjing Hospital of China Medical University and 144 N?NAFLD patients were included in the study,to analyze their general data ( sex, height, weight, blood pressure ) , liver function, blood lipid and SUA. SUA was divided into four groups by four point method,group Q1 ( 99 cases) ,group Q2 ( 98 cases) ,group Q3 ( 98 cases ) , group Q4 ( 98 cases ) . The proportion of NAFLD in each group was compared and the relationship between SUA and NAFLD was analyzed by Logistic regression. Results There were statistically significant differences between the NAFLD group and the N?NAFLD group in gender,age,DBP,BMI,ALT,AST,γ?GT,SUA,TG,TC,HDL?C,LDL?C (P<0. 05),the differences in SBP,Tbil,Dbil and UDbil had no statistical significance ( P>0. 05);the proportion of NAFLD in group Q1,group Q2,group Q3 and group Q4 was 41. 41％(41/99),57. 14％(56/98),71. 43％(70/98),83. 67％(82/98),respectively,the differences between groups were statistically significant ( P=<0. 05); Logistic regression analysis showed that SUA was a risk factor for NAFLD (OR=1. 016,P<0. 05),after the adjustment of age,gender,BMI,diastolic blood pressure,TG,TC,HDL?C and LDL?C,OR=1. 008,P=0. 001. Conclusion SUA is an independent risk factor of NAFLD.

Objective To investigate the expression of Smad4 in gastric carcinoma and its relationship with clinicopathological characteristics. Methods Immunohistochemistry method was used to detect the expression of Smad4 in 85 gastric carcinoma tissue and 36 normal gastric mucosa from January 2014 to December 2016. Results (1)The positive expression rate of Smad4 in gastric carcinoma tissues was 35. 29% (30/ 85), which was significantly lower than that in normal gastric mucosa (91. 67% (33/ 36)),and the difference was statistically significant (χ2=32. 201,P<0. 001). (2) The expression of Smad4 was correlated with the depth ofinvasion(χ2=13. 626,P<0. 001),lymph nodes metastasis(χ2=7. 267,P=0. 007),TNM staging(χ2=18. 226,P<0. 001) and tumor differentiation level (χ2 = 9. 134, P= 0. 010) . ( 3) Multivariate unconditional logistic regression analysis showed that depth of invasion(OR=7. 892,95CI 1. 649-37. 790,P=0. 010),TNM staging ( OR=15. 042, 95CI 0. 026-0. 977, P=0. 005 ) and tumor differentiation level ( OR=15. 042, 95CI2. 292-98. 751, P = 0. 005 ) may be independent influencing factors for Smad4 expression in gastric carcinoma. Conclusion Smad4 may performed an important role during the progression of gastric carcinoma and may be a new biological marker of gastric carcinoma.