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 investigate the variations of intestinal flora of common carp in patients with hyperuricemia in Qingdao District.Methods The fecal flora was analyzed by gradient dilution method.The levels of uric acid in blood and feces were detected by enzyme colorimetry method and phosphortungstic acid method,respectively.Results E.coli (7.58 ± 0.34,P ＜ 0.05),the total count of aerobian (7.76 ± 0.67,P ＜ 0.05),and bacteroides (2.75 ± 0.31,P ＜ 0.05) were significantly increased in hyperuricemia patients compared to controls.Bifidobacterium (5.38 ± 0.34,P ＜ 0.05) and lactobacillus (2.69 ± 1.48,P ＜ 0.05) were sig-nificantly decreased compared to controls.Concentrations of uric acid in blood and feces were both significantly higher in the patients relative to healthy controls.Decomposition capability was similar to healthy controls.Decomposition capability of uric acid revealed a close correlation with bifidobacterium and lactobacillus,respectively (r =0.565,0.328,P ＜ 0.05).Conclusions Intestinal dysbacteriosis was found by the analysis of fecal flora in patient with hyperuricemia in Qingdao district.Dysbacteriosis might participate in the process of hyperuricemia onset.

ObjectiveTo observe the effect and safety of arsenic trioxide (ATO) combined with all-trans retinoic acid (ATRA) in treating patients with acute promyelocytic leukemia (APL).Methods Eighty-three cases with APL treated for the first time were divided into two groups by random digits table method:observation group with 48 cases was received combination induction treatment of ATO and ATRA,control group with 35 cases was treated with combination induction treatment of ATRA and chemotherapy.The clinical effect and adverse reaction between two groups were compared.ResultsThe effective rate and early death rate were 100.0％( 48/48 ) and 0 in observation group,97.1％(34/35 ) and 2.9％( 1/35 ) in control group,which had no significant difference between two groups(P ＞ 0.05 ).The incidences of bone marrow suppression,infection,liver and kidney damage,cardiac toxicity and gastrointestinal symptoms were 8.3％ (4/48),10.4％ (5/48),12.5％ (6/48),6.2％ (3/48) and 18.8％ (9/48) in observation group,while 97.1％(34/35),65.7％(23/35),45.7％(16/35),37.1％(13/35) and 100.0％(35/35) in control group,which had significant differences between two groups (P ＜ 0.05).ConclusionCombination treatment of ATO and ATRA in APL has an obvious effect and few adverse reaction,which can be applied in clinic.