1.Value of PET/CT Radiomics Combined with Machine Learning in Differentiating Primary Central Nervous System Lymphoma from Brain Metastases
Jingyu FU ; Yuxi ZHANG ; Fan YANG
Journal of Medical Research 2025;54(7):96-102
Objective This study aimed to investigate the value of PET/CT radiomics combined with machine learning in differentia-ting primary central nervous system lymphoma(PCNSL)from brain metastases(BM).Methods Sixty-nine patients with 127 lesions(including 43 PCNSL lesions and 84 BM lesions)who attended the Department of Nuclear Medicine of Lanzhou University Second Hospi-tal from January 2019 to November 2024 were selected and divided into a training set(n=88)and a validation set(n=39)in a 7∶3 rati-o.Radiomics features of PET and CT were extracted using the 3D slicer,and feature dimensionality reduction was performed using least absolute shrinkage and selection operator(LASSO)regression combined with 5-fold cross-validation to construct three classical machine learning models-Logistic regression(LR),decision tree(DT),and support vector machine(SVM),and the diagnostic efficacy of each model was evaluated using receiver operating characteristic(ROC)curves and confusion matrices.Results The SVM model based on PET imaging performed best in the validation set[area under the curve(AUC)=0.917,sensitivity=84.6%,specificity=92.3%]and was significantly better than the CT model(AUC=0.787,sensitivity=73.1%,specificity=76.9%).Conclusion The support vector machine model constructed based on PET radiomics metabolic features demonstrated high diagnostic value in the preoperative differentia-tion between PCNSL and BM,showing potential for clinical application as a non-invasive auxiliary diagnostic tool.
2.Research on the development of entrustable professional activity indicators for residents in China: a systematic review
Jingyu ZHONG ; Yue XING ; Liangjing LÜ ; Qinghua MIN ; Zhengguang XIAO ; Caisong ZHU ; Dandan SHI ; Xiaoyu FAN ; Jingshen CHU ; Huan ZHANG ; Yi JIANG ; Weiwu YAO
Chinese Journal of Medical Education Research 2025;24(6):728-735
Objective:To systematically evaluate the current status of research on the development of indicators for entrustable professional activities (EPAs) of residents in China.Methods:We searched the China National Knowledge Infrastructure, Wanfang Data, Airiti Library, PubMed, Embase, and Web of Science databases for literature on the development of EPA indicators for residents in China published between January 1, 2005 and February 28, 2025. Two researchers independently screened the literature and extracted data, followed by descriptive analysis. The quality of the studies was assessed using the Joanna Briggs Institute critical appraisal tool for expert opinion. Quantitative data were presented as medians (ranges) and qualitative data were presented as frequencies (percentages).Results:A total of eight articles were included, in which two general EPA indicator systems and six specialty-specific EPA indicator systems were developed for residents. The overall quality of the research was high, with the main shortcomings related to the methods used in the process of constructing the consensus indicators. The number of experts recruited ranged from 22 to 45, with 100.00% response rate, high authority coefficients (0.820-0.914), and high coordination coefficients (0.157-0.741). Most of the studies used literature reviews as one source for the indicator pool (8 studies, 100.00%), employed the Delphi method to reach consensus (6 studies, 75.00%), and provided inclusion criteria for the indicators (7 studies, 87.50%). However, only one study (12.50%) explored the practical application of the developed indicators, and none of the studies set indicator weights or conducted quality assessments. The number of EPA indicators developed ranged from 10 to 38 per study. The reporting of EPA indicators was included in most studies regarding titles (8 studies, 100.00%) and the expected levels of entrustment at various stages of training (6 studies, 75.00%), but the reporting on other aspects was lacking. Among the specialty-specific EPA indicators, 38.39% overlapped with the general EPAs indicators.Conclusions:The research on the development of EPA indicators for residents in China is still in its early stages, and there is room for improvement in methodological quality and reporting coverage. There is partial overlap between specialty-specific and general EPA indicators, failing to fully reflect the unique characteristics of different specialties.
3.Accuracy and quality of answer reasoning of Chinese large language model in Chinese middle level professional qualification examination of radiology
Jingyu ZHONG ; Yue XING ; Yangfan HU ; Qinghua MIN ; Caisong ZHU ; Dandan SHI ; Xiaoyu FAN ; Jingshen CHU ; Huan ZHANG ; Weiwu YAO
Chinese Journal of Medical Education Research 2025;24(2):145-149
Objective:To compare the accuracy of a Chinese large language model (LLM) and radiologists in Chinese middle level professional qualification examination of radiology, and evaluate the quality of answer reasoning provided by the Chinese LLM.Methods:In this study, 100 high-quality questions were selected using stratified random sampling to form a test set. We asked the ERNIE Bot by dialogues on the website to provide the correct answers and answer reasoning for these questions. These questions were also answered by 15 radiologists with different levels of experience. The accuracy of Chinese LLM and that of radiologists were compared. Two radiologists evaluated the quality of answer reasoning using a 5-point semi-quantitative scale.Results:The accuracy of ERNIE Bot was 60.00%, which was lower than the median (interquartile) accuracy of 67.00% (64.00%, 73.00%) for radiologists, and the difference was statistically significant ( W=2.47, P=0.013). The word count of the reasoning provided by Ernie Bot was (196.44±99.25) words, with no significant difference in word count between correct and incorrect answer reasoning, which were (211.03±107.53) words and (174.55±81.84) words, respectively ( t=1.82, P=0.072). Among the correct answers, the quality of reasoning was scored as follows: 1 point for 3 questions, 2 points for 9 questions, 3 points for 12 questions, and 4 points for 36 questions. No reasoning received a score of 5. Conclusions:Chinese LLM demonstrates a certain level of medical knowledge and clinical reasoning ability, which can assist clinical teachers in educational activities. However, it is not yet able to independently tutor residents and lacks the ability of invitational and heuristic teaching.
4.An investigation of the current status of Chinese-foreign cooperative education programs for medical majors
Jingyu ZHONG ; Yue XING ; Qinghua MIN ; Zhengguang XIAO ; Caisong ZHU ; Dandan SHI ; Xiaoyu FAN ; Jingshen CHU ; Huan ZHANG ; Yi JIANG ; Weiwu YAO
Chinese Journal of Medical Education Research 2025;24(5):577-582
Objective:To investigate the current status of Chinese-foreign cooperative education programs for medical majors, and to discuss the potential problems and development trends of this field.Methods:Related data were collected from the information platform of Chinese-Foreign Cooperation in Running Schools by Ministry of Education of the People's Republic of China, and the characteristics of Chinese-foreign cooperative education programs for medical majors were extracted for analysis. Categorical data were expressed as frequency (percentage), and continuous data were expressed as mean±standard deviation.Results:A total of 83 Chinese-foreign cooperative education programs for medical majors were included in the study, accounting for only 3.45% (83/2 406) of all programs. Chinese partners in these cooperative programs were mainly from East China (41 programs, 49.40%), while foreign partners were mainly from Europe (39 programs, 46.99%). The mean duration of these programs was (3.61±0.88) years, with an enrollment of (87.08±35.52) students. Most of the students were included in National General Higher Education Enrollment Plan (79 programs, 95.18%), and the main majors included nursing (39 programs, 46.99%), medical technology (19 programs, 22.89%), and clinical medicine (11 programs, 13.25%), with the main enrollment level of junior college (45 programs, 54.22%). Chinese partners in the cooperative programs mainly issued academic certificate (45 programs, 54.22%) or academic certificate plus degree certificate (36 programs, 43.37%), while most foreign partners did not issue such certificates (44 programs, 53.01%).Conclusions:There are several problems in Chinese-foreign cooperative education programs for medical majors, such as a limited number of programs, a significant regional difference, an imbalanced distribution of specialties, a low level of education, and inconsistency in issuance of certificates, which still requires further improvement and standardization. However, there are also high-level and high-quality programs for reference.
5.Chaperone protein facilitates soluble expression of Mannheimia haemolytica PlpE protein in Escherichia coli
Yuemei ZHANG ; Na WANG ; Lingli DAI ; Fan ZHANG ; Yue SONG ; Shihua ZHAO ; Jingyu SHI ; Wenhua GUO ; Shengjie SU ; Fan BAI
Chinese Journal of Veterinary Science 2025;45(7):1388-1393
To verify whether chaperones can promote the soluble expression of PlpE in Escherichia coli and whether the expressed protein is active,prokaryotic expression and Western blot detection were performed.The results showed that:The PlpE prokaryotic expression vector pET-32a(+)-plpE was expressed as inclusion body,and the expression form was not changed by changing the concentration of inducer,induction time and temperature.The companion proteins pG-KJE8,pGro7,pKJE7 and pG-Tf2 were co-expressed with pET-32a(+)-plpE in Eschierichia coli expres-sion system,respectively.When the final concentration of IPTG of 0.5 mmol/L,L-arabinose of 0.5 g/L or tetracycline of 5.0 μg/L were added as inducers and induced at 37 ℃ for 8 h,the results showed that the molecular companion pGro7 could change the expression of rp-PlpE from inclu-sion body to soluble expression.pG-KJE8,pKJE7 and pG-Tf2 had no effect on the expression of rp-PlpE.The soluble rp-PlpE can react specifically with the positive serum of Mannheimia haemolyti-ca.Therefore,the study showed that the co-expression of the chaperone protein pGro7 can make the rp-PlpE protein express in a soluble form,and the purified protein exhibits reactogenicity.These findings lay the foundation for the establishment of a subunit vaccine and serological diagno-sis methods for Mannheimia haemolytica.
6.Value of PET/CT Radiomics Combined with Machine Learning in Differentiating Primary Central Nervous System Lymphoma from Brain Metastases
Jingyu FU ; Yuxi ZHANG ; Fan YANG
Journal of Medical Research 2025;54(7):96-102
Objective This study aimed to investigate the value of PET/CT radiomics combined with machine learning in differentia-ting primary central nervous system lymphoma(PCNSL)from brain metastases(BM).Methods Sixty-nine patients with 127 lesions(including 43 PCNSL lesions and 84 BM lesions)who attended the Department of Nuclear Medicine of Lanzhou University Second Hospi-tal from January 2019 to November 2024 were selected and divided into a training set(n=88)and a validation set(n=39)in a 7∶3 rati-o.Radiomics features of PET and CT were extracted using the 3D slicer,and feature dimensionality reduction was performed using least absolute shrinkage and selection operator(LASSO)regression combined with 5-fold cross-validation to construct three classical machine learning models-Logistic regression(LR),decision tree(DT),and support vector machine(SVM),and the diagnostic efficacy of each model was evaluated using receiver operating characteristic(ROC)curves and confusion matrices.Results The SVM model based on PET imaging performed best in the validation set[area under the curve(AUC)=0.917,sensitivity=84.6%,specificity=92.3%]and was significantly better than the CT model(AUC=0.787,sensitivity=73.1%,specificity=76.9%).Conclusion The support vector machine model constructed based on PET radiomics metabolic features demonstrated high diagnostic value in the preoperative differentia-tion between PCNSL and BM,showing potential for clinical application as a non-invasive auxiliary diagnostic tool.
7.Research on the development of entrustable professional activity indicators for residents in China: a systematic review
Jingyu ZHONG ; Yue XING ; Liangjing LÜ ; Qinghua MIN ; Zhengguang XIAO ; Caisong ZHU ; Dandan SHI ; Xiaoyu FAN ; Jingshen CHU ; Huan ZHANG ; Yi JIANG ; Weiwu YAO
Chinese Journal of Medical Education Research 2025;24(6):728-735
Objective:To systematically evaluate the current status of research on the development of indicators for entrustable professional activities (EPAs) of residents in China.Methods:We searched the China National Knowledge Infrastructure, Wanfang Data, Airiti Library, PubMed, Embase, and Web of Science databases for literature on the development of EPA indicators for residents in China published between January 1, 2005 and February 28, 2025. Two researchers independently screened the literature and extracted data, followed by descriptive analysis. The quality of the studies was assessed using the Joanna Briggs Institute critical appraisal tool for expert opinion. Quantitative data were presented as medians (ranges) and qualitative data were presented as frequencies (percentages).Results:A total of eight articles were included, in which two general EPA indicator systems and six specialty-specific EPA indicator systems were developed for residents. The overall quality of the research was high, with the main shortcomings related to the methods used in the process of constructing the consensus indicators. The number of experts recruited ranged from 22 to 45, with 100.00% response rate, high authority coefficients (0.820-0.914), and high coordination coefficients (0.157-0.741). Most of the studies used literature reviews as one source for the indicator pool (8 studies, 100.00%), employed the Delphi method to reach consensus (6 studies, 75.00%), and provided inclusion criteria for the indicators (7 studies, 87.50%). However, only one study (12.50%) explored the practical application of the developed indicators, and none of the studies set indicator weights or conducted quality assessments. The number of EPA indicators developed ranged from 10 to 38 per study. The reporting of EPA indicators was included in most studies regarding titles (8 studies, 100.00%) and the expected levels of entrustment at various stages of training (6 studies, 75.00%), but the reporting on other aspects was lacking. Among the specialty-specific EPA indicators, 38.39% overlapped with the general EPAs indicators.Conclusions:The research on the development of EPA indicators for residents in China is still in its early stages, and there is room for improvement in methodological quality and reporting coverage. There is partial overlap between specialty-specific and general EPA indicators, failing to fully reflect the unique characteristics of different specialties.
8.Accuracy and quality of answer reasoning of Chinese large language model in Chinese middle level professional qualification examination of radiology
Jingyu ZHONG ; Yue XING ; Yangfan HU ; Qinghua MIN ; Caisong ZHU ; Dandan SHI ; Xiaoyu FAN ; Jingshen CHU ; Huan ZHANG ; Weiwu YAO
Chinese Journal of Medical Education Research 2025;24(2):145-149
Objective:To compare the accuracy of a Chinese large language model (LLM) and radiologists in Chinese middle level professional qualification examination of radiology, and evaluate the quality of answer reasoning provided by the Chinese LLM.Methods:In this study, 100 high-quality questions were selected using stratified random sampling to form a test set. We asked the ERNIE Bot by dialogues on the website to provide the correct answers and answer reasoning for these questions. These questions were also answered by 15 radiologists with different levels of experience. The accuracy of Chinese LLM and that of radiologists were compared. Two radiologists evaluated the quality of answer reasoning using a 5-point semi-quantitative scale.Results:The accuracy of ERNIE Bot was 60.00%, which was lower than the median (interquartile) accuracy of 67.00% (64.00%, 73.00%) for radiologists, and the difference was statistically significant ( W=2.47, P=0.013). The word count of the reasoning provided by Ernie Bot was (196.44±99.25) words, with no significant difference in word count between correct and incorrect answer reasoning, which were (211.03±107.53) words and (174.55±81.84) words, respectively ( t=1.82, P=0.072). Among the correct answers, the quality of reasoning was scored as follows: 1 point for 3 questions, 2 points for 9 questions, 3 points for 12 questions, and 4 points for 36 questions. No reasoning received a score of 5. Conclusions:Chinese LLM demonstrates a certain level of medical knowledge and clinical reasoning ability, which can assist clinical teachers in educational activities. However, it is not yet able to independently tutor residents and lacks the ability of invitational and heuristic teaching.
9.An investigation of the current status of Chinese-foreign cooperative education programs for medical majors
Jingyu ZHONG ; Yue XING ; Qinghua MIN ; Zhengguang XIAO ; Caisong ZHU ; Dandan SHI ; Xiaoyu FAN ; Jingshen CHU ; Huan ZHANG ; Yi JIANG ; Weiwu YAO
Chinese Journal of Medical Education Research 2025;24(5):577-582
Objective:To investigate the current status of Chinese-foreign cooperative education programs for medical majors, and to discuss the potential problems and development trends of this field.Methods:Related data were collected from the information platform of Chinese-Foreign Cooperation in Running Schools by Ministry of Education of the People's Republic of China, and the characteristics of Chinese-foreign cooperative education programs for medical majors were extracted for analysis. Categorical data were expressed as frequency (percentage), and continuous data were expressed as mean±standard deviation.Results:A total of 83 Chinese-foreign cooperative education programs for medical majors were included in the study, accounting for only 3.45% (83/2 406) of all programs. Chinese partners in these cooperative programs were mainly from East China (41 programs, 49.40%), while foreign partners were mainly from Europe (39 programs, 46.99%). The mean duration of these programs was (3.61±0.88) years, with an enrollment of (87.08±35.52) students. Most of the students were included in National General Higher Education Enrollment Plan (79 programs, 95.18%), and the main majors included nursing (39 programs, 46.99%), medical technology (19 programs, 22.89%), and clinical medicine (11 programs, 13.25%), with the main enrollment level of junior college (45 programs, 54.22%). Chinese partners in the cooperative programs mainly issued academic certificate (45 programs, 54.22%) or academic certificate plus degree certificate (36 programs, 43.37%), while most foreign partners did not issue such certificates (44 programs, 53.01%).Conclusions:There are several problems in Chinese-foreign cooperative education programs for medical majors, such as a limited number of programs, a significant regional difference, an imbalanced distribution of specialties, a low level of education, and inconsistency in issuance of certificates, which still requires further improvement and standardization. However, there are also high-level and high-quality programs for reference.
10.Chaperone protein facilitates soluble expression of Mannheimia haemolytica PlpE protein in Escherichia coli
Yuemei ZHANG ; Na WANG ; Lingli DAI ; Fan ZHANG ; Yue SONG ; Shihua ZHAO ; Jingyu SHI ; Wenhua GUO ; Shengjie SU ; Fan BAI
Chinese Journal of Veterinary Science 2025;45(7):1388-1393
To verify whether chaperones can promote the soluble expression of PlpE in Escherichia coli and whether the expressed protein is active,prokaryotic expression and Western blot detection were performed.The results showed that:The PlpE prokaryotic expression vector pET-32a(+)-plpE was expressed as inclusion body,and the expression form was not changed by changing the concentration of inducer,induction time and temperature.The companion proteins pG-KJE8,pGro7,pKJE7 and pG-Tf2 were co-expressed with pET-32a(+)-plpE in Eschierichia coli expres-sion system,respectively.When the final concentration of IPTG of 0.5 mmol/L,L-arabinose of 0.5 g/L or tetracycline of 5.0 μg/L were added as inducers and induced at 37 ℃ for 8 h,the results showed that the molecular companion pGro7 could change the expression of rp-PlpE from inclu-sion body to soluble expression.pG-KJE8,pKJE7 and pG-Tf2 had no effect on the expression of rp-PlpE.The soluble rp-PlpE can react specifically with the positive serum of Mannheimia haemolyti-ca.Therefore,the study showed that the co-expression of the chaperone protein pGro7 can make the rp-PlpE protein express in a soluble form,and the purified protein exhibits reactogenicity.These findings lay the foundation for the establishment of a subunit vaccine and serological diagno-sis methods for Mannheimia haemolytica.

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