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 explore the correlation of distribution pattern of TCM pathological evidence of hypertension with the related indexes of cardiopulmonary function.Methods:From January 2019 to October 2021, the relevant data of 149 patients with grade 3 hypertension who underwent CPET examination in the Department of Cardiology, Qingdao Hospital of Traditional Chinese Medicine were retrospectively collected, and the pathogenic factors were determined according to the relevant content of "Dialectic of Evidence". The Chi-square test was used to analyze the difference of cardiopulmonary function between the pathological factors, and the Spearman correlation analysis was used to explore the correlation between pathological factors and cardiopulmonary function.Results:The pathogenic factors of 149 hypertensive patients from high to low, are as follows were phlegm, yin deficiency, dampness, yang hyperactivity, blood deficiency, blood stasis, qi deficiency, yang deficiency, qi stagnation, heat, food accumulation, moving wind, pus. There was no statistical significance among the pathological factors ( P>0.05). Spearman correlation analysis showed that Yin deficiency syndrome was negatively correlated with Peak O 2 pulse ( r=-0.213, P=0.009), blood stasis was negatively correlated with Peak VO 2 ( r=-0.170, P=0.039) and Peak O 2 pulse ( r=-0.192, P=0.019), and phlegm syndrome hormone was negatively correlated with anaerobic threshold (AT) ( r=-0.192, P=0.019). Conclusions:TCM pathogenic factors in hypertension mainly focus on phlegm, Yin deficiency, dampness and yang hyperactivity. There is a certain correlation between pathogenic factors and cardiopulmonary function-related indicators, which can provide reference for the clinical treatment of hypertension in TCM.

Objective:To investigate the correlation and influence factors of three weak assessment scales in the evaluation of debilitating condition of elderly patients with coronary heart disease (CHD).Methods:120 cases with CHD in our hospital were chosen,the clinical material were collected.The Fried weak score,clinical weak score and EFS were assessed.The correlation of three weak assessment scales were analyzed.Results:Fried score,CFS score and EFS score determined 6 cases,8 cases and 14 cases patients with weak respectively,the incidence rate were 5.0％,6.7％ and 11.7％,which had no significant difference(P＞0.05).The linear correlation analysis indicated the Fried score,CFS score and EFS score had positive correlation(P＜0.05),which had consistency with CHD patients.The CFS score and EFS score had no significant correlation (P＞0.05).Cox regression analysis showed that the cultural level and grade of cardiac function,living conditions and sleep disorders were influencing factors of Fried scores(P＜0.05).Conclusion:Three weak assessment had consistence and different clinical value for the evaluation of weakness in CHD patients,the cultural level and grade of cardiac function,living conditions and sleep disorders were influencing factors of weakness in CHD patients.

Objective To investigate the value of roentgen stereophotogrammetric analysis (RSA) in assessing early migration of femoral implant after total hip arthroplasty (THA) with modular prostheses.Methods From May 2009 to April 2010,37 patients underwent THA with modular prostheses inour hospital,including 25 males and 12 females,aged from 58 to 72 years (average,60.23±5.64 years).There were 32 cases of degenerative osteoarthritis,3 cases of femoral neck fracture and 2 cases of developmental dysplasia of the hip.The Harris hip score and RSA were used to assess the clinical results and the migration of femoral implant at 3,6,12,24 months postoperatively,respectively.Results The average Harris hip score improved from preoperative 26.36 ±10.56 to 78.24±12.72,84.51±16.05,86.72±9.34,and 87.55±8.97 at 3,6,12,and 24 months after operation,respectively,and the differences between pre-and post-operative Harris score were significant.There was no prosthetic revision,and slight thigh pain occurred in 3 patients.According to RSA,the degree of initial migration of femoral implant had large individual differences,and the initial migration was higher from 3 to 6 months after operation.Clinical and biological stabilization was achieved in 36 patients,while progressive migration was found in 1 patient.There was a positive correlation between the distal migration and posterior migration within 24 months after operation (r=0.3,P=0.01).The distal migration and posterior migration/rotation mainly occurred within 3 months after operation.There was no correlation between prosthetic size/offset and degree of migration of implant.Conclusion RSA provides an objective reference for assessing the migration of femoral implant after THA with modular prostheses,which is a reliable method to evaluate early implant stability.