1.Huanglian Jiedutang Improves Cognitive Impairment after Schemic Stroke by Regulating Neuron via NF-κB Signaling Pathway
Mengying SUN ; Lizhen WANG ; Tong LI ; Leilei WANG ; Shiyan JIA ; Tingting WANG ; Yanwen YANG ; Kaiqiang SI ; Youxiang CUI ; Zhilong LIU
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(11):68-76
ObjectiveTo investigate the effects of Huanglian Jiedutang (HLJDT) on cognitive function in mice with ischemic stroke (IS) and to elucidate whether its neuroprotective effects are mediated by inhibition of the nuclear factor-κB (NF-κB) signaling pathway and subsequent suppression of NF-κB-regulated neuronal apoptosis. MethodsAn IS model was established using middle cerebral artery occlusion (MCAO). Sixty C57BL/6J mice were randomly assigned to five groups (n =12 per group), i.e., sham operation, model, HLJDT low-dose (3.9 g·kg-1·d-1), HLJDT high-dose (7.8 g·kg-1·d-1), and Ginkgo biloba extract (GBE, 31.2 mg·kg-1·d-1). Post-operatively, neurological deficit scores (Longa score), cerebral infarct volume assessed by 2,3,5-triphenyltetrazolium chloride (TTC) staining, and brain water content were evaluated. Learning and memory were assessed using new object recognition (NOR) and fear conditioning (FC) tests. Hippocampal pathology was examined via hematoxylin and eosin (HE) staining. Immunofluorescence detected expression of glial fibrillary acidic protein (GFAP, astrocyte marker), cellular oncogene Fos (c-Fos, neuronal activation marker), and glutamate decarboxylase 65 (GAD65). Western blot measured nuclear factor-κB inhibitor protein α (IκBα), phosphorylated IκBα (p-IκBα), NF-κB p65, phosphorylated NF-κB p65 (p-NF-κB p65), ionic calcium binding adapter molecule 1 (Iba-1), tumor necrosis factor (TNF)-α, interleukin (IL)-1β, and apoptosis-related proteins, such as cleaved cysteinyl aspartate-specific protease 3 (Caspase-3), B-cell lymphoma 2 (Bcl-2), and Bcl-2-associated X protein (Bax). Real-time quantitative PCR (Real-time PCR) was used to assess mRNA levels of Iba-1, TNF-α, IL-1β, NF-κB p65, cleaved Caspase-3, Bax, and Bcl-2. ResultsCompared with the sham group, the model group exhibited significantly increased neurological deficit scores, brain water content, and cerebral infarct volume (P<0.01). Hippocampal CA1 neurons were disorganized, showing nuclear pyknosis and karyolysis. NOR exploration time and FC freezing time were significantly reduced (P<0.01). GFAP and c-Fos expression were increased, while GAD65 expression was decreased (P<0.01). Cleaved Caspase-3 and Bax were upregulated, Bcl-2 was downregulated, and the Bax/Bcl-2 ratio was elevated (P<0.01). Expression levels of p-IκBα, p-NF-κB p65, IL-1β, TNF-α, and Iba-1 were significantly increased (P<0.01). Compared with the model group, HLJDT high-dose, low-dose, and GBE groups showed significant improvements in all parameters (P<0.01). Among them, the HLJDT high-dose group showed the most pronounced neuronal structural recovery and superior performance in NOR and FC tests (P<0.01). In this group, GFAP and c-Fos decreased, GAD65 increased (P<0.01), apoptosis-related protein expression was reversed, and NF-κB signaling and related inflammatory factor expression were suppressed (P<0.01). ConclusionHLJDT ameliorates cognitive dysfunction in mice after IS, potentially by inhibiting the NF-κB signaling pathway, thereby reducing neuroinflammation and hippocampal neuronal apoptosis.
2.Quality control standards for biological specimens from patients with oral and maxillofacial tumors
CHEN Wantao ; PAN Xinhua ; HE Yue ; YAN Ming ; WANG Lizhen ; WANG Yan&rsquo ; an ; LI Siyi ; LI Zhihui ; ZHANG Zhen ; DU Mengxuan
Journal of Prevention and Treatment for Stomatological Diseases 2026;34(9):833-842
Quality control (QC) of biospecimens from oral and maxillofacial tumors patients constitutes a critical foundation for the prevention, diagnosis, treatment, and precision medicine research of these diseases. Biospecimen quality directly governs the discovery and validation of disease biomarkers, the elucidation of pathogenesis, and the efficacy of clinical translation. QC spans the entire biospecimen lifecycle—encompassing collection, processing, storage, transportation, and utilization. Its primary objectives are to ensure sample integrity, reliability, traceability, and consistency, thereby guaranteeing the robustness of research data; the accuracy of molecular subtyping, biomarker identification, and treatment response prediction; and the precision of clinical decision-making. However, current QC frameworks for these biospecimens remain underdeveloped. Drawing on domestic and international technical standards, regulatory guidelines, and recent research advances, this paper elaborates on the importance of implementing a QC management system throughout the biospecimen lifecycle. It focuses on QC methodologies tailored to diverse biospecimen types, examining how standardized sampling procedures, regulated preprocessing workflows, and optimized long-term storage conditions influence sample quality. We aim to provide concrete guidance and a transferable paradigm for establishing standardized QC protocols and an informatics-enabled traceability system specific to oral and maxillofacial tumors. Such efforts are intended to enhance the research value and clinical utility of these biospecimens, furnishing reliable sample resources and technical support for the development of precision diagnostics and therapeutics. Furthermore, we advocate for a dual-track “QC plus Ethics” management framework within biobanks. This approach would reinforce ethical and legal safeguards, establishing a robust barrier to support safe scientific innovation and clinical translation.
3.Action mechanisms and application pathways of biomaterials in promoting corneal alkali burn repair
Hui XIAO ; Dongyan LI ; Jing JI ; Lizhen WANG
Chinese Journal of Tissue Engineering Research 2025;29(10):2162-2170
BACKGROUND:Traditional treatments for corneal alkali burns are limited,especially in controlling inflammation,preventing neovascularization,and inhibiting corneal scarring.Natural,synthetic,or composite materials provide a wide range of treatment options.However,the mechanism by which biomaterials promote corneal alkali burn repair has not yet been systematically understood. OBJECTIVE:To summarize the current research on biomaterials in promoting corneal alkali burn repair in and outside China,and review the mechanism and application of biomaterials in repairing corneal alkali burn. METHODS:The first author searched"cornea,alkali burn,amniotic membrane,hyaluronic acid,collagen,chitosan,polymer materials"as Chinese keywords and"amniotic membrane,hyaluronic acid,collagen,chitosan,polymer,cornea,alkali burn"as English keywords in PubMed,Web of Science,CNKI,and WanFang databases.According to inclusion and exclusion criteria,76 eligible articles were finally included for review. RESULTS AND CONCLUSION:(1)In the field of corneal alkali burn repair,biomaterials such as amniotic membrane,hyaluronic acid,collagen,chitosan,and degradable polymer materials have been widely studied and applied.Each of these biomaterials has its own characteristics,advantages,and disadvantages,and stands out in different aspects.(2)First and foremost,amniotic membranes are considered one of the most promising biomaterials due to their abundance of bioactive factors.They are biocompatible and can regulate the corneal inflammatory response.However,there are issues with donor shortages and susceptibility to infectious diseases.(3)Hyaluronic acid has good moisturizing properties and biocompatibility,and is able to improve the survival rate of corneal cells and increase corneal transparency.(4)The good biocompatibility and scaffold structure of collagen enable the promotion of corneal cell adhesion and proliferation,as well as the reconstruction of corneal tissue structure.(5)Chitosan is recognized for its good biocompatibility and degradability,making it suitable as a carrier for drug delivery and cell transplantation.(6)Degradable polymer materials have good controllability over degradation and can provide a good support and delivery platform for the repair of corneal alkali burns,but further research is needed on their stability and biocompatibility.(7)Overall,there is currently no single biomaterial that can completely address the repair problem of corneal alkali burns,and each biomaterial has its own specific application scenarios and limitations.(8)Future research directions should focus on further improving the properties and structure of biomaterials,exploring more effective combination applications,and deeply understanding the interaction mechanism between biomaterials and corneal tissue,in order to enhance the therapeutic effect of corneal alkali burns and the quality of life of patients.
4.Study on Graded Quantitative Diagnosis of Lung Qi Deficiency Syndrome in Chronic Obstructive Pulmonary Disease Based on Latent Class Analysis Combined with Hidden Structure Model
Weike LI ; Mingyang YI ; Yuanyuan NI ; Lizhen YAN ; Jianxin GUAN ; Shihao WANG ; Huijie WANG ; Zhiwan WANG
Journal of Traditional Chinese Medicine 2025;66(7):710-716
ObjectiveTo clarify the graded quantitative diagnostic characteristics of lung qi deficiency syndrome in chronic obstructive pulmonary disease (COPD) based on latent class analysis combined with a hidden structure model. MethodsClinical data, including the four diagnostic methods of traditional Chinese medicine (TCM), were collected from 745 COPD patients with lung qi deficiency syndrome. Latent class modeling was performed using R 4.1.2 software, and each patient was classified into one of three severity categories (mild, moderate, or severe) based on probabilistic parameterization, parameter estimation, and model fitting. A database was established for different severity levels of lung qi deficiency syndrome. Based on this, Lantern 5.0 software was used to construct hidden structure models for mild, moderate, and severe lung qi deficiency syndrome, and syndrome differentiation rules were developed through comprehensive clustering. ResultsA latent class model was constructed using 28 symptoms and signs with a frequency greater than 10%. Considering TCM theory and model simplicity, the optimal model was determined when the number of latent classes was three, categorizing lung qi deficiency syndrome into mild (298 cases), moderate (164 cases), and severe (283 cases). Hidden structure models were separately developed for each severity level, and syndrome differentiation rules were established. A comparison of common symptoms in the syndrome differentiation rules for mild and moderate lung qi deficiency syndrome showed no statistically significant differences in diagnostic values and weights (P>0.05), leading to their combined analysis and the development of a unified syndrome differentiation rule. Value and weight of quantitative diagnosis of mild-to-moderate lung qi deficiency syndrome were as followed: shortness of breath (diagnostic value 9.3, diagnostic weight 86.92%), dyspnea on exertion (8.2, 76.64%), low voice and reluctance to speak (6.7, 62.62%), poor appetite (4.0, 37.38%), loose stools (4.0, 37.38%), weak cough sound (2.9, 27.10%), wheezing (2.3, 21.50%), fatigue (1.8, 16.82%), spontaneous sweating (1.7, 15.89%), susceptibility to colds (1.6, 14.95%), swollen tongue (1.4, 13.08%), teeth marks on the tongue edge (1.2, 11.21%), deep pulse (1.6, 14.95%), with a diagnostic threshold of 10.3. Value and weight of quantitative diagnosis of severe lung qi deficiency syndrome were as followed: weak cough sound (15.1, 61.13%), soreness and weakness of the waist and knees (12.6, 51.01%), shortness of breath (11.1, 44.94%), low voice and reluctance to speak (8.3, 33.60%), frequent nocturia (6.1, 24.70%), spontaneous sweating (3.7, 14.98%), susceptibility to colds (3.5, 14.17%), teeth marks on the tongue edge (7.8, 31.58%), pale tongue body (1.9, 7.69%), white tongue coating (5.5, 22.27%), thin pulse (1.5, 6.07%), with a diagnostic threshold of 23.7. ConclusionThe combination of latent class analysis and a hideen structure model effectively clarified the graded quantitative diagnostic characteristics of lung qi deficiency syndrome, providing a reference for the quantitative diagnosis of other fundamental syndromes in TCM.
5.Characteristics of cardiopulmonary exercise testing and analysis of risk factors for decreased aerobic capacity in children with non-acute bronchial asthma exacerbations
Pengli WANG ; Lizhen HUANG ; Wujun JIANG ; Wenjing GU ; Lina XU ; Pengyun LI ; Xuena XU ; Qianying YU ; Xiaoyan SHI ; Chuangli HAO
Chinese Journal of Applied Clinical Pediatrics 2025;40(8):595-602
Objective:To investigate the characteristics of cardiopulmonary exercise testing and risk factors for decreased aerobic capacity in children with non-acute asthma exacerbations, to assess their cardiopulmonary health and to provide a basis for improvement.Methods:A case-control study.Sixty-one children with non-acute asthma exacerbations treated at the Outpatient Department of Children′s Hospital of Soochow University from October 2022 to December 2023 and 22 control children during the same period were included.Binary Logistic regression was employed to assess risk factors for decreased aerobic capacity in children with asthma.Results:Among the included 61 children with non-acute asthma exacerbations, there were 33 cases in the chronic persistent phase (chronic persistent phase group) and 28 in the clinical remission phase(clinical remission group).There were 22 children in the control group.During the peak exercise phase of the cardiopulmonary exercise testing, the mean kilogram body weight oxygen uptake (VO 2/kg), the percentage of predicted kilogram body weight oxygen uptake, and metabolic equivalents (Met) in the chronic persistent phase group were lower than those in the control and clinical remission phase groups.The mean VO 2/kg recovery from the cardiopulmonary exercise testing in the first minute in the chronic persistent phase group was lower than that in the control and clinical remission phase groups.The median Met and ventilation per minute recovery in the chronic persistent phase group were lower than those in the control group.The median heart rate recovery in asthma children was lower than that in control children.The percentage of cardiopulmonary exercise testing abnormalities was higher in asthma children with symptoms after excise than that in asthma children without symptoms after excise.The percentage of decreased ventilation efficiency in asthma children with symptoms after excise was higher than that in asthma children without symptoms after excise.Multivariate regression analysis showed that a higher body mass index (BMI) ( OR=1.577, 95% CI: 1.113-2.235, P=0.010) and a higher peak respiratory reserve ( OR=1.103, 95% CI: 1.018-1.195, P=0.017) were risk factors of decreased aerobic capacity.The risk of decreased aerobic capacity in the chronic persistent phase was 7.949 times higher than that in the clinical remission phase ( OR=7.949, 95% CI: 1.290-48.996, P=0.025). Conclusions:The aerobic capacity is decreased and ventilatory recovery is slower in children with chronic persistent asthma than those in healthy children.The heart rate recovery in asthma children is slower than that in healthy children.A high BMI, a high peak respiratory reserve, and chronic persistence of asthma are independent risk factors for decreased aerobic capacity in children with non-acute asthma exacerbations.asthma.
6.Analysis of the effectiveness of technology transfer of research-oriented hospital:a case study of an af-filiated hospital of a university in Guangdong province
Yi WEI ; Shiying CHEN ; Lizhen LI ; Cuiwei CHEN ; Guiping LIN ; Xiuying CUI
Modern Hospital 2025;25(1):143-147
Objective This study aims to explore effective approaches for the transfer of medical scientific and techno-logical achievements to promote the development of research-oriented hospitals.Methods The technology transfer achievements of an affiliated hospital of a university in Guangdong Province over the past six years(2018-2023)were statistically analyzed.The challenges faced during the transfer process,the measures taken,and the current achievements were discussed.Results The number of patent authorizations and authorized departments in the hospital has increased year by year.The transfer rate has risen from 0%in 2019 to 6.69%in 2023.Currently,46 projects have been successfully transferred,with a total transfer amount exceeding 30 million yuan,indicating significant effectiveness in the transfer of medical scientific and technological achievements.Conclusion The hospital attaches great importance to and overall manages the transfer process,establishing a sound manage-ment structure,improving incentive and support systems,and regularly conducting special lectures,training,and guidance.These efforts guide researchers to start from clinical problems and ultimately serve clinical diagnosis and treatment,creating a fa-vorable environment for technology transfer,improving the transfer rate,and promoting the development of research-oriented hos-pitals.
7.The significance of preoperative neck enhanced multidetector computed tomography in predicting the recurrent veins and classifying their courses of the submental flap reflux vein for repair in pharyngeal cancer
Qian SHI ; Jugao FANG ; Qi ZHONG ; Lizhen HOU ; Hongzhi MA ; Ling FENG ; Shizhi HE ; Meng LIAN ; Yanming ZHAO ; Ru WANG ; Yunxia LI ; Xixi SHEN ; Yifan YANG ; Lingwa WANG
Chinese Journal of Otorhinolaryngology Head and Neck Surgery 2025;60(10):1208-1214
Objective:To evaluate preoperative high-resolution thin-layer cervical enhanced CT used to predict the venous route of the submental flap reflux vein and its relationship with adjacent structures in order to guide the anatomical understanding and protection of submental flap in pharyngeal cancer surgery.Methods:Sixty consecutive patients with pharyngeal cancer who underwent submental flap repair surgery in our department from March 2022 to December 2024, as well as 60 patients who were accepted neck dissection suffering other cancers, were selected. Before surgery, high-resolution cervical enhanced CT scans were performed, and the position of the transverse section of the facial vein in the venous phase horizontal image gradually variation tendency was focused layer by layer. The direction and adjacent relationship of the submental flap reflux veins were determined and recorded. Combined with 60 patients with other head and neck tumors who underwent neck dissection in our department during the same period (a total of 120 cases, 240 sides), the classification and management of the draining veins of Fang′s mental flap were conducted. Type Ⅰ mainly drains into the internal jugular vein; Type Ⅱ mainly drains into the external jugular vein and Type Ⅲ mainly drains into the anterior jugular vein (often accompanied by an external jugular draining branch). The status and proportion of venous drainage were analyzed.Results:Vascular predictive coincidence rate was 98.3% (59/60) among the 60 patients with pharyngeal cancer. Only one patient was predicted to have a simple return to the external jugular vein. However, during the operation, in addition to the main return to the external jugular vein, a small portion also returned to the internal jugular vein. Submental flap reflux vessels were classified into three types based on intraoperative submental flap venous return in 60 cases of laryngopharyngeal cancer, in conjunction with the analysis of venous return patterns from 240 cervical CT scans. Type Ⅰ mainly refluxed to the internal jugular vein, accounting for 42.1%. Type Ⅱ mainly refluxed to the external jugular vein (47.9%). Type Ⅲ mainly refluxed to the anterior jugular vein (10.0%). The total detection rate of CT reading of 240 venous reflux was 98.7% (237/240). Vascular predictive coincidence rate was 97.9%(235/240).Conclusion:The detailed analysis of submental venous return vessels can accurately predict the direction of reflux veins and its surrounding areas by preoperative high-resolution enhanced CT scan. This provides reliable guidance for the anatomy and protection of the submental flap reflux veins during surgery.
8.Efficacy comparison of subsequent treatment modalities for locally advanced hypopharyngeal cancer with partial response to neoadjuvant chemotherapy
Ru WANG ; Zheng LI ; Jugao FANG ; Junfang XIAN ; Qi ZHONG ; Yang ZHANG ; Lizhen HOU ; Hongzhi MA ; Ling FENG ; Shizhi HE ; Qian SHI ; Yifan YANG ; Haiyang LI ; Lingwa WANG ; Xinyu LI
Chinese Journal of Otorhinolaryngology Head and Neck Surgery 2025;60(10):1223-1231
Objective:To compare the survival outcomes of different subsequent treatment regimens in patients with locally advanced hypopharyngeal squamous cell carcinoma (HPSCC) who achieved partial response (PR) after neoadjuvant chemotherapy based on the gross tumor volume regression rate (GTVRR).Methods:This retrospective study included patients with locally advanced HPSCC treated at the Department of Head and Neck Surgery, Beijing Tongren Hospital, from January 2011 to December 2023. The cohort included 135 males and 3 females, aged from 35 to 77 years. All patients received 2-3 cycles of TPF regimen (paclitaxel+cisplatin+5-fluorouracil) neoadjuvant chemotherapy. Subsequent treatments included concurrent chemoradiotherapy or surgery combined with postoperative adjuvant radiotherapy. The impacts of different subsequent treatment modalities on the survivals and prognoses of patients were compared based on GTVRR thresholds of 50% and 70%. The χ 2 test was used to analyze influencing factors; survival analysis and intergroup comparisons were performed using the Kaplan-Meier method and Log-rank test; prognostic factors were assessed using univariate and multivariate Cox regression analyses. Results:The 5-year OS and PFS rates were 56.5% and 47.9%, respectively, while, the 10-year OS and PFS rates were 25.8% and 21.2%, respectively. The median OS was 75 months, and the median PFS was 48 months. The laryngeal function preservation rate for the entire cohort was 83.3%. The patients who underwent surgery combined with postoperative radiotherapy had significantly better OS and PFS outcomes than those treated with concurrent chemoradiotherapy ( P<0.05). Stratification based on GTVRR revealed that the surgery plus postoperative radiotherapy regimen was particularly effective for PR patients with a GTVRR of 30%-70%, showing significantly better OS and PFS compared to the concurrent chemoradiotherapy group ( P<0.05). Conclusion:The optimal subsequent treatment for PR-HPSCC may be surgery-based comprehensive treatment, particularly for patients with a GTVRR of 30%-70%. This study offers valuable insights for the stratified treatment of HPSCC, which could contribute to improving overall patient prognosis.
9.Relationship between levels of serum SOCS3,GDF-15 and liver fibrosis in patients with type 2 diabetes complicated with non-alcoholic fatty liver disease
Liang LI ; Yamei LI ; Lizhen TIAN ; Wei YAN ; Xiaomei HU ; Yongfang YANG
International Journal of Laboratory Medicine 2025;46(22):2769-2773,2778
Objective To investigate the relationship between the levels of serum suppressor of cytokine signaling 3(SOCS3),growth differentiation factor-15(GDF-15)and liver fibrosis in patients with type 2 dia-betes mellitus(T2DM)combined with non-alcoholic fatty liver disease(NAFLD).Methods A total of 320 patients with T2DM combined with NAFLD who were hospitalized in this hospital from May 2023 to May 2024 were selected as the study group,and another 320 patients with simple T2DM admitted during the same period were selected as the control group.The levels of serum SOCS3 and GDF-15 were determined by en-zyme-linked immunosorbent assay(ELISA).Pearson correlation analysis was used to analyze the correlation between SOCS3,GDF-15 levels and liver fibrosis indicators.Logistic regression analysis was used to analyze the factors affecting the degree of liver fibrosis.The receiver operating characteristic(ROC)curve was used to analyze the diagnostic value of serum SOCS3 and GDF-15 for the degree of liver fibrosis in patients.Results Compared with the control group,the levels of serum SOCS3,GDF-15,5,type Ⅲ procollagen peptide,laminin and type Ⅳ col-lagen in the study group were significantly increased(P<0.05).There were statistically significant differ-ences in the levels of type Ⅲ procollagen peptide,laminin and type Ⅳ collagen between the mild to moderate group and the severe group(P<0.05).Compared with the mild to moderate group,the levels of serum SOCS3 and GDF-15 in the severe group were significantly increased(P<0.05).The results of Pearson corre-lation analysis showed that serum SOCS3 and GDF-15 in patients with T2DM combined with NAFLD were positively correlated with type Ⅲ procollagen peptide,laminin,and type Ⅳ collagen(P<0.05).Serum SOCS3,GDF-1 5,type Ⅲ procollagen peptide,laminin and type Ⅳ collagen are risk factors affecting the degree of liver fibrosis in patients with T2DM combined with NAFLD(P<0.05).The results of the ROC curve showed that the combined diagnosis of serum SOCS3 and GDF-15 for the degree of liver fibrosis in patients with T2DM complicated with NAFLD had the highest area under the curve(AUC),which was superior to the individual diagnosis of each(both P<0.05),with a corresponding sensitivity of 69.08%and a specificity of 85.71%.The combined diagnosis of the degree of liver fibrosis in patients with T2DM complicated with NAFLD by serum SOCS3,GDF-15,type Ⅲ procollagen peptide,laminin,and type Ⅳ collagen had the highest AUC,which was superior to the individual diagnosis of each index(all P<0.001),with a corresponding sensi-tivity of 89.47%and a specificity of 97.02%.Conclusion The levels of serum SOCS3 and GDF-15 are elevated in patients with T2DM combined with NAFLD,.The combined diagnosis of serum SOCS3,GDF-15,type Ⅲ procolla-gen peptide,laminin,and type Ⅳ collagen has a high value in the degree of liver fibrosis in patients.
10.Clinical value of enhanced magnetic resonance imaging-based deep learning model in pre-operative prediction of proliferative hepatocellular carcinoma
Lizhen LIU ; Jie CHENG ; Fengxi CHEN ; Yiman LI ; Yang XU ; Wei CHEN ; Ping CAI ; Qingrui LI ; Xiaoming LI
Chinese Journal of Digestive Surgery 2025;24(7):912-920
Objective:To investigate the clinical value of enhanced magnetic resonance imaging (MRI)-based deep learning model in preoperative prediction of proliferative hepatocellular carcinoma (HCC).Methods:The retrospective cohort study was conducted. The clinical data of 906 HCC patients who were admitted to The First Affiliated Hospital of Army Medical University and The Second Affiliated Hospital of Chongqing Medical University from May 2017 to October 2022 were collected. There were 769 males and 137 females, aged (53.2±10.9)years. Of the 906 patients, 815 cases who were admitted to The First Affiliated Hospital of Army Medical University were divided into the training set of 634 patients and the internal validation set of 181 patients using a random number table method with a ratio of 8:2, and 91 patients who were admitted to The Second Affiliated Hospital of Chongqing Medical University were divided into the external validation set. The training set was used to construct the prediction model, while the validation set was used to validate the prediction model. Observation indicators: (1) analysis of factors influencing the pathological classification of HCC patients; (2) deep learning imaging features of HCC patients; (3) evaluation of the efficacy of prediction model for proliferative HCC; (4) validation of the prediction model for proliferative HCC; (5) prognosis of HCC patients. Comparison of measurement data with normal distribution between groups was conducted using the independent sample t test. Comparison of measurement data with skewed distribution between groups was conducted using the Mann-Whitney U test. Comparison of count data between groups was conducted using the chi-square test. Multivariate analysis was conducted using the binary Logistic regression model. The model perfor-mance was evaluated through five-fold cross-validation, and receiver operating characteristic (ROC) curve was plotted to assess the diagnostic value of the model based on the area under curve (AUC), sensitivity, and specificity. The Delong test was used to compare the diagnostic performance of models. The Hosmer-Lemeshow test was employed to evaluate the calibration of models. The optimal cutoff value of the prediction model was determined by the maximum Youden index, with the value >0.175 indicating high-risk patients and value ≤0.175 indicating low-risk patients.The Kaplan-Meier method was used to calculate the survival rate and the Log-rank test was used for survival analysis. Results:(1) Analysis of factors influencing the pathological classification of HCC patients. Of 634 patients in the training set, there were 190 cases of proliferative HCC and 444 cases of non-proliferative HCC. Results of multivariate analysis showed that alpha fetoprotein (AFP) ≥400 μg/L and tumor diameter >5 cm were independent risk factors for pathological type of HCC as proli-ferative [ odds ratio=1.73, 1.88, 95% confidence interval ( CI) as 1.19-2.50, 1.30-2.71, P<0.05]. (2) Deep learning imaging features of HCC patients. In the training set of 634 patients, the probability predicted by MRI-based deep learning model was 84.8%(30.5%,95.4%) for proliferative HCC and 5.8%(3.2%,12.5%) for non-proliferative HCC, showing a significant difference between them ( Z=-16.01, P<0.05). (3) Evaluation of the efficacy of prediction model for proliferative HCC. In the training set, the AUC of clinical prediction model for proliferative HCC was 0.63(95% CI as 0.59-0.68, P<0.05), with sensitivity of 54.74% and specificity of 64.19%. The AUC of MRI-based deep learning prediction model was 0.90(95% CI as 0.87-0.93, P<0.05), with sensitivity of 80.53% and specificity of 86.94%. The AUC of combined MRI-based deep learning with clinical prediction model was 0.90 (95% CI as 0.87-0.93, P<0.05), with sensitivity of 83.16% and specificity of 86.04%. Results of Delong test showed that there was a significant difference between the combined MRI-based deep learning with clinical prediction model and the clinical prediction model ( P<0.05), and there was no signifi-cant difference between the combined MRI-based deep learning with clinical prediction model and the MRI-based deep learning prediction model ( P>0.05). Results of Hosmer-Lemeshow test showed good calibration for the clinical prediction model, the MRI-based deep learning prediction model and the combined MRI-based deep learning with clinical prediction model ( χ2=0.84, 6.38, 3.93, P>0.05), indicating that the predicted probabilities of these three prediction models matched the actual risk well. (4) Validation of the prediction model for proliferative HCC. Results of validation of the prediction model in internal validation set showed the AUC of MRI-based deep learning prediction model for proliferative HCC was 0.84(95% CI as 0.77-0.91, P<0.05), with sensitivity of 82.35% and specificity of 77.69%. Results of validation of the prediction model in external validation set showed the AUC of MRI-based deep learning prediction model for proliferative HCC was 0.81(95% CI as 0.71-0.92, P<0.05), with sensitivity of 70.00% and specificity of 81.69%. (5) Prognosis of HCC patients. Of the 906 patients, the 1-, 3-, and 5-year recurrence-free survival rates for 645 proliferative HCC patients were 56.9%, 31.4%, and 29.1%, respectively, and the 1-, 3-, and 5-year recurrence-free survival rates for 261 non-proliferative HCC patients were 88.8%, 68.6%, and 56.0%, respectively. There were significant differences in recurrence-free survival time between proliferative HCC and non-proliferative HCC patients of the training set, internal validation set and external validation set ( P<0.05). The 1-, 3-, 5-year recurrence-free survival rates for 331 high-risk HCC patients were 64.6%, 50.4%, 43.6%, versus 88.5%, 71.9%, 62.7% for 575 low-risk HCC patients. There were significant differences in recurrence-free survival time between high-risk HCC patients and low-risk HCC patients of the training set, internal validation set and external validation set ( P<0.05). Conclusion:The MRI-based deep learning model can effectively predict proliferative HCC and recurrence-free survival of patients before the surgery.


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