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 evaluate the effect of propofol on proliferation of neural stem cells (NSCs) in mice and the role of specificity protein-1 (Sp-1)-epidermal growth factor receptor (EGFR)-protein kinase B (Akt) signaling pathway.Methods:Primary NSCs harvested from both the cortices and hippocampus of C57BL/6 mouse embryos were identified by immunofluorescent staining of Nestin.NSCs at passages 3-6 were divided into 3 groups ( n=21 each) using a random number table method: normal saline control group (C group), propofol group (P group) and propofol plus Sp1 inhibitor plicamycin group (PP group). Propofol at a final concentration of 10 μmol/L was added in group P. Propofol at a final concentration of 10 μmol/L and plicamycin at a final concentration of 100 nmol/L were added in group PP.The equal volume of normal saline was added in group C. The medium was replaced after 6 h of incubation and the cells were continuously incubated.The proliferation of NSCs was assessed by direct cell counting at 24, 36, 48, 60 and 72 h after the end of treatment with drugs.At 6 h after the end of treatment with drugs, the expression of Sp1 and EGFR mRNA was detected by real-time fluorescent quantitative polymerase chain reaction, and the expression of Sp1, Akt and phosphorylated Akt (p-Akt) by Western blot. Results:Compared with group C, the count of NSCs was significantly increased at 48, 60 and 72 h after treatment with drugs, and the expression of EGFR mRNA, Sp1 protein and mRNA and p-Akt was up-regulated in group P ( P<0.05 or 0.01), and no significant change was found in each parameter in group PP ( P>0.05). Compared with group P, the count of NSCs was significantly decreased at 48 and 60 h after treatment with drugs, and the expression of EGFR protein and mRNA and p-Akt was down-regulated in group PP ( P<0.05 or 0.01). Conclusions:Propofol can promote the proliferation of NSCs, and the mechanism may be related to activation of Sp1-EGFR-Akt signaling pathway in mice.

Objective:To develop overgeneral autobiographical memory questionnaire(OGMQ) and test its reliability and validity.Methods:Through literature search, expert opinions and group discussion the initial items of the questionnaire were formed. A random cluster method was adopted to select 1 911 college students for the preliminary test.Totally 1 840 valid questionnaires were obtained, and 920 of which were assessed for exploratory factor analyses and 920 of which were assessed for confirmatory factor analyses and reliability and validity analysis. Thirty subjects with depression and 30 normal subjects were selected to test its criterion validity.Results:The questionnaire consisted of 19 items, two dimensions (construction, elaboration) and four factors (spatial-temporal factor, control factor, context factor, emotion factor). Exploratory analysis extracted 4 factors and 19 items, KMO (Kaiser-Meyer-Olkin) = 0.905, Bartlett test: χ 2=4 728.134, df=171, P<0.001.Confirmatory analysis showed that the factor loads of spatio-temporal factor and control factor in the construction dimension were 0.770 and 0.539 respectively, while the factor loads of context factor and emotional factor in the elaboration dimension were 0.911 and 0.800 respectively. The questionnaire had good internal consistency reliability (Cronbach α=0.870), structural validity (χ 2/ df=3.550, RMSEA=0.053, GFI=0.944, CFI=0.970, NFI=0.958, IFI=0.970) and criterion validity ( r(OGMQ, AMT)=0.870, r(OGMQ, BDI)=0.507), and it was able to effectively distinguish between depressed and normal groups (AUC=0.795). Conclusion:The OGMQ has satisfactory validity and reliability, and meets the needs of psychometrics, which can be used in depression-related research and practice.

OBJECTIVE: To explore the treatment of malignant arrhythmia induced by acute poisoning. METHODS: To analyze the treatment of 11 cases of malignant arrhythmia caused by acute poisoning. The therapeutic effect of malignant arrhythmia treated by drug, electrical cardioversion and detoxification was observed. RESULTS: The arrhythmias in the patients included premature ventricular beats, ventricular tachycardia, ventricular fibrillation, sinus tachycardia, sinus bradycardia, atrial premature beats, and ST-T changes. After treatment with cardioerter drug such as amiodarone, lidocaine, esmolol and other drugs, electric defibrillation, removeing poisons with hemoperfusion and specific antidotes, and multiple organ protection symptomatic treatment, 10 cases were successfully rescued and 1 case died. CONCLUSION: Malignant arrhythmias caused by acute poisoning could be given combined treatment with anti-arrhythmias and relief of etiology.

Objective To investigate the effect of miR-132-3p on the proliferation of endothelial progenitor cells and its regulatory mechanism in order to provide a new theoretical basis for the treatment of deep venous thrombosis. Methods Real-time quantitative PCR (qPCR) was used to detect the expression of miR-132-3p in the plasma and endothelial progenitor cells of 27 healthy volunteers and 22 thrombus patients, and in endothelial progenitor cells under normoxic and hypoxic conditions. The miR-132-3p analogue and the specific siRNA were transferred into endothelial progenitor cells by the electroporation method. The effect of miR-132-3p on the proliferation of endothelial progenitor cells was detected using MMT and Cell Counting Kit-8 (CCK-8) methods. The effects of miR-132-3p on the expression of FOXO1 in endothelial cells were analyzed using the luciferase assay and western blots. Results The expression of miR-132-3p in clinical patients with thrombosis was significantly decreased to 0.45 ± 0.05 times of that of the healthy volunteers (P＜0.05). The expression of miR-132-3p in endothelial progenitor cells under hypoxia was down-regulated to (0.23 ± 0.13) times of that of under normoxia (P＜0.05). The expression of miR-132-3p of experiment group under hypoxia was up-regulated to (15.72 ± 2.06) times of that of control group (P＜0.05). MMT assay showed that the proliferation of cells in the experimental group under hypoxic condition was up-regulated to (7.79 ± 1.37) times of that in the control group (P＜0.01). CCK-8 assay showed that cell proliferation in experimental group was up-regulated to (6.46 ± 0.38) times of that in the control group (P＜0.01). Software analysis showed that FOXO1 was a direct target of miR-132-3p. Luciferase activity of miR-132-3p mimics transfected endothelial progenitor cells under hypoxic conditions were 0.47 times of that in siRNA treatment group. Western blot showed that the expression of FOXO1 protein in endothelial progenitor cells transfected with miR-132-3p mimics in hypoxia was 0.18 times of that in siRNA treatment group. Conclusions Compared with healthy volunteers, miR-132-3p expression in the blood of patients with thrombosis was significantly reduced that can promote transcription of the FOXO1 gene (and protein expression) and inhibit the proliferation of endothelial progenitor cells. It could be closely related to the formation of venous thrombosis.

Objective To examine the adaptability of Carver and White' s behavioral activation/in-hibition scales(BIS/BAS Scales)in a large sample of Chinese military-man,and to revise the instrument and validate its factor structure. Methods A total of 2 921 Chinese military-men completed four subscales:one for the Behavioral Inhibition System,and three for the Behavioral Approach System(drive,reward re-sponsiveness,fun seeking).Data were analyzed using exploratory and confirmatory factor analysis.The internal consistency of the subscales and the complete scale were examined. Results The findings did not support Carver and White's 4-factor structure which was validated in a sample of Chinese college students.A 3-factor structure(behavioral inhibition,reward responsiveness,drive)in Chinese military-man were extracted and validated using confirmatory factor analysis(CFA)(KMO=0.87,CFI=0.94,RMSEA=0.06).The Cronbach α of behavioral inhibition,drive and reward responsiveness were 0.78,0.71 and 0.67 respectively.The internal consistencies of behavioral inhibition and drive were higher than four-factor model of Chinese college students and the internal consistencies of drive and reward responsiveness were less than American young adults.Be-havioral inhibition and drive positively predicted depressive symptoms(βBIS=0.332,βDrive=0.076,P<0.001),and reward responsiveness negatively predicted depressive symptoms(βRRS=-0.140,P<0.001). Conclusion The BIS/BAS Scales(revised Chinese military version)has acceptable reliability and validi-ty,and can be utilized as a measurement tool for assessing the approach/avoidance motivation of Chinese ser-vicemen.

OBJECTIVETo determine the tricuspid annular plane systolic excursion (TAPSE) using M-mode echocardiography, and to evaluate the right ventricular systolic function in patients with pneumoconiosis.

METHODSOne hundred and eighty-three patients with pneumoconiosis were enrolled as subjects, and one hundred and ninety-nine healthy volunteers were used as controls. According to the types of ventilation dysfunction, patients were divided into four groups: normal type, obstructive type, restrictive type, and mixed type. In the apex four-chamber sections, the displacement of tricuspid annular plane on the right ventricular free wall side was measured from end-diastole to end-systole using M-mode echocardiography.

RESULTSThe average TAPSE in the pneumoconiosis group was significantly lower than that in the control group (18.61 ± 3.08 vs 22.38 ± 3.03 mm, P < 0.01). Along with the progression of pneumoconiosis, the TAPSE values in patients with stage I, II, and III pneumoconiosis were significantly decreased compared with those in the control group (P < 0.01). The TAPSE values in patients diagnosed with normal, obstructive, restrictive, and mixed types of pneumoconiosis in pulmonary function tests were all significantly lower than those in the control group (P < 0.01). Among all patients, patients with mixed type of pneumoconiosis had the most significant reduction in the TAPSE.

CONCLUSIONThe TAPSE is substantially decreased in patients with pneumoconiosis and further decreased along with the progression of pneumoconiosis. Measurement of the TAPSE is an easy way to evaluate the right ventricular systolic function in patients with pneumoconiosis.

Objective:To translate the Attention to Positive and Negative Inventory(APNI)and analyze the validity and reliability in Chinese undergraduates sample,to offer a convenient and reliable tool of measuring the cognitive bias for national researchers. Methods:The English-version APNI went through translation into Chinese, retroversion into English,translation into Chinese again,and revision several stages. Two parts of samples (1450 Chinese college students)were surveyed. Sample one (n=1000)was used for item analysis,exploratory factor a-nalysis (EFA),concurrent validity and reliability analysis,while sample 2 (n=450)was used for confirmatory fac-tor analysis (CFA). Totally 68 subjects of sample 1 were randomly chosen and resurveyed with an interval of one week. Beck depression inventory (BDI-II)and patient health questionnaire (PHQ-9)was used for concurrent validi-ty. Results:Item analysis indicated that the 22 items of Chinese APNI had good discriminability. EFA focused onattention to positive information(API)and attention to negative information(ANI)two factors. CFA showed good model fit (χ2 =1376,RMESA=0. 09,CFI=0. 94). Concurrent validity result showed that the total scores of BDI-II and PHQ-9 was negatively correlated with total scores of API (r=-0. 24,-0. 29,Ps<0. 01 ),and posi-tively correlated with total scores of ANI (r=0. 36,0. 31,Ps<0. 01). The Cronbach'αcoefficients of API and ANI sub-scale were 0. 86 and 0. 82,while the retest reliability coefficients were 0. 79 and 0. 62. Conclusion:It suggests that the Chinese APNI has good validity and reliability in a sample of college students,which could be used to eval-uate the cognitive bias of Chinese college students.

Objective To investigate the relationship among stressful life events ,social support and depression through researc‐hing a large number of Chinese army men ,then discovered the social psychological mechanism of the depression .Methods 11 ,400 officers and soldiers were tested with three scales ,the center for epidemiologic studies depression scale ,life events scale and social support scale .The differences between groups were determined with the variance ,SPSS 18 .0 software and AMOS7 .0 were used to analyse and build model .In addition ,we built the path model of life events and social support on depression with AMOS 7 .0 soft‐ware .Results (1)There is a significant positive correlation between Chinese soldiers depression levels and life events (r=0 .382 , P<0 .01) .(2) There is a significant negative correlation between Chinese soldiers depression levels and the social support (r= -0 .379 ,P<0 .01) .(3) It was established the path model of life events ,the social support and depressive symptom level .Con‐clusion Depressive symptom is related to the military life events ,which may predict the occurrence of the depression .Moreover ,so‐cial support ,a protective factor for mental health ,can relieve the depression of officers and men .

Objective To investigate the incidence of depression in patients with advanced malignancy and its effect on quality of life.Methods Patients with advanced malignancy were evaluated with Beck depression and quality of life questionnaires.The correlation of Beck depression scoring with quality of life was analyzed.Results A total of 230 in-patients with advanced malignancy were enrolled in this study and 213 copies of valid questionnaire were collected.95.3 ％ (203/213) patients had depression.The Beck depression scoring had positive correlation with body,role,mood,cognition,society,vomiting,pain,dyspnea,agrypnia and appetite (all P ＜ 0.05),and had negative correlation with total health factors (r =-0.296,P ＜ 0.01).Conclusion Depression is prevalent in patients with advanced malignancy and correlated with quality of life.Therefore,psychological interventions are needed to relief depression and improve quality of life.