Objective:To investigate the prognostic value of deep learning-based automated quantification of tumor-stroma ratio (TSR) in patients undergoing neoadjuvant therapy (NAT) for breast cancer.Methods:Specimens were collected from 209 breast cancer patients who received NAT at Renmin Hospital of Wuhan University from October 2019 to June 2023. TSR levels in pre-NAT biopsy specimens were automatically computed using a deep learning algorithm and categorized into low stroma (TSR≤30%), intermediate stroma (TSR 30% to ≤60%), and high stroma (TSR>60%) groups. Residual cancer burden (RCB) grading of post-NAT surgical specimens was determined to compare the relationship between TSR expression levels and RCB grades. The correlation of TSR with NAT efficacy was analyzed, and the association between TSR expression and patient prognosis was further investigated.Results:There were 85 cases with low stroma (TSR≤30%), 93 cases with intermediate stroma (TSR 30% to ≤60%), and 31 cases with high stroma (TSR>60%). Different TSR expression levels showed significant differences between various RCB grades ( P<0.05). Logistic univariate and multivariate analyses showed that TSR was a risk factor for obtaining a complete pathological remission from neoadjuvant therapy for breast cancer when it was used as a continuous variable ( P<0.05); COX regression and survival analyses showed that the lower the percentage of tumorigenic mesenchyme was, the better the prognosis of the patient was ( P<0.05). Conclusions:The deep learning-based model enables automatic and accurate quantification of TSR. A lower pre-treatment tumoral stroma is associated with a lower RCB score and a higher rate of pathologic complete response, indicating that TSR can predict the efficacy of neoadjuvant therapy in breast cancer and thus holds prognostic significance. Therefore, TSR may serve as a biomarker for predicting therapeutic outcomes in breast cancer neoadjuvant therapy.

Objective:To investigate the prognostic value of deep learning-based automated quantification of tumor-stroma ratio (TSR) in patients undergoing neoadjuvant therapy (NAT) for breast cancer.Methods:Specimens were collected from 209 breast cancer patients who received NAT at Renmin Hospital of Wuhan University from October 2019 to June 2023. TSR levels in pre-NAT biopsy specimens were automatically computed using a deep learning algorithm and categorized into low stroma (TSR≤30%), intermediate stroma (TSR 30% to ≤60%), and high stroma (TSR>60%) groups. Residual cancer burden (RCB) grading of post-NAT surgical specimens was determined to compare the relationship between TSR expression levels and RCB grades. The correlation of TSR with NAT efficacy was analyzed, and the association between TSR expression and patient prognosis was further investigated.Results:There were 85 cases with low stroma (TSR≤30%), 93 cases with intermediate stroma (TSR 30% to ≤60%), and 31 cases with high stroma (TSR>60%). Different TSR expression levels showed significant differences between various RCB grades ( P<0.05). Logistic univariate and multivariate analyses showed that TSR was a risk factor for obtaining a complete pathological remission from neoadjuvant therapy for breast cancer when it was used as a continuous variable ( P<0.05); COX regression and survival analyses showed that the lower the percentage of tumorigenic mesenchyme was, the better the prognosis of the patient was ( P<0.05). Conclusions:The deep learning-based model enables automatic and accurate quantification of TSR. A lower pre-treatment tumoral stroma is associated with a lower RCB score and a higher rate of pathologic complete response, indicating that TSR can predict the efficacy of neoadjuvant therapy in breast cancer and thus holds prognostic significance. Therefore, TSR may serve as a biomarker for predicting therapeutic outcomes in breast cancer neoadjuvant therapy.

Objective:To comprehensively evaluate the skin thickness, blood flow grades, skin stiffness, and post-treatment changes in ultrasound indices in patients with different clinical types of port-wine stains (PWS) by multimodal ultrasound, and to explore the application value of multimodal ultrasound in the quantitative evaluation of and efficacy assessment for PWS.Methods:An observational study was conducted, including 298 patients with PWS. High-frequency ultrasound was used to measure the thickness of and blood flow signals in skin lesions, and shear wave elastography to measure the maximum Young's modulus (Emax) and maximum shear wave propagation velocity (Cmax) of the skin layers. Differences in various ultrasound indices were analyzed between skin lesions and surrounding normal skin. After photodynamic therapy, ultrasound re-evaluation was performed on 124 patients to analyze changes in ultrasound indices before and after treatment. Statistical analysis was conducted using t test, analysis of variance, and rank sum test. Results:In 106 patients with pink PWS, the skin thickness was 1.41 ± 0.28 mm, the blood flow was mainly rated as grade 0 (81%), the Emax was 16.24 ± 1.82 kPa, and the Cmax was 2.28 ± 0.09 m/s. There were no significant differences in the above indices between normal skin and treated skin (all P > 0.05). In the 121 patients with purplish red PWS, the skin thickness was 1.86 ± 0.23 mm; the blood flow was mainly rated as grade 1 (45%), which was higher than that of normal skin; after treatment, both the skin thickness and blood flow grades were decreased ( P < 0.05) ; there were no significant differences in the Emax and Cmax between purplish red PWS lesions (16.41 ± 1.82 kPa, 2.32 ± 0.13 m/s, respectively) and normal skin or treated skin (all P > 0.05). In the 71 patients with thickened PWS, the skin thickness was 2.51 ± 0.32 mm, the blood flow was mainly trated as grade 3 (55%), the Emax was 22.22 ± 2.46 kPa, and the Cmax was 2.75 ± 0.11 m/s, which were all significantly higher than those of normal skin (all P < 0.05) ; all the indices were decreased after treatment. Conclusions:Multimodal ultrasound can be used for the quantitative assessment of different clinical types of PWS and their treatment outcomes. Purplish red PWS and thickened PWS showed thicker skin layers and higher blood flow grades, and thickened PWS showed higher skin stiffness values. All ultrasound indices were decreased after treatment.

H 1-antihistamines are widely used in the treatment of various allergic diseases, but there are still many challenges in the safe and rational use of H 1-antihistamines in pediatrics, and there is a lack of guidance on the prescription review of H 1-antihistamines for children.In this paper, suggestions are put forward from the indications, dosage, route of administration, pathophysiological characteristics of children with individual difference and drug interactions, so as to provide reference for clinicians and pharmacists.

Objective To investigate the clinical effect of amiodarone combined with psychological intervention in the treatment of senile rapid arrhythmia.Methods 120 cases of elderly patients with rapid arrhythmia diagnosed and treated in our hospital from January 2015 to January 2017 were divided into two groups: the control group was treated with the system, the observation group was treated with the system combined with amiodarone+The clinical data of amiodarone combined with psychological intervention in the treatment of senile rapid arrhythmia were discussed and compared with the data obtained from the two groups.Results The clinical effect of the observation group (system synthesis+amiodarone+psychological intervention) in the treatment of elderly patients with tachyarrhythmia was better than that of the control group (systematic synthesis).The clinical symptoms improved significantly and the adverse reactions were few Statistically significant (P<0.05).Conclusion The clinical effect of prescription system combined with amiodarone+psychological intervention in patients with rapid arrhythmia is significant, which can effectively improve the clinical symptoms and less adverse reactions.It is widely used in the treatment of elderly patients with rapid arrhythmia.

ObjectiveTo explore the value of differential diagnosis between pigmented villonodular synovitis (PVNS) and rheumatoid arthritis (RA) in active stage with clinic and ultrasound. MethodsWe analyzed retrospectively the characters of clinic and ultrasound of sixteen patients with PVNS and sixteen patients with rheumatoid arthritis inactive stage.ResultsIn aspects of patient’s age (T=185), pain scores (T=136) history of trauma (P=0.029), functionally uncompensated conditions (P=0.001) type (P=0.000) and sum (P=0.000) of involved joints、bright spot-echoes in hydrops (P=0.001) tendons nearby involved (P=0.001) and the Adler’s grade of Doppler ultrasound blood flow (P=0.009), the differences between PVNS and RA in active stage had statistical significance (P<0.05). Clinic characters: patients with PVNS were younger, often had a history of trauma. But patients with RA in active stage had a higher pain score and functionally uncompensated condition. Ultrasound characters: big and single joints were often involved in patients with PVNS, and tiny bright spot echoes could be detected in hydrops. Instead, big and small, multiple joints, tendons nearby were often involved in patients with RA, who had a higher ratio of gradeⅢ Doppler ultrasound blood flow. And in aspects of sex, the presence of hydrops and synovium thickness, the differences between the two had no statistical significance (P>0.05).ConclusionThe clinical characters including Patient’s age, pain scores, history of trauma, functionally uncompensated conditions, and the characters of ultrasound including type and sum of involved joints, bright spot echoes in hydrops, tendons nearby involved and the Adler’s grade of Doppler ultrasound blood flow, are helpful for the differential diagnosis of PVNS and RA in active stage.