Objective:To investigate the value of intratumoral and peritumoral radiomics models based on 18F-FDG PET-CT in predicting epidermal growth factor receptor (EGFR) mutation status in lung adenocarcinoma and interpret peritumoral radiomics features. Methods:This study was a cross-sectional study. Patients with lung adenocarcinoma who underwent 18F-FDG PET-CT at the Third Affiliated Hospital of Soochow University between January 2018 and April 2022 were retrospectively collected and samplied into a training set (309 cases) and a test set (206 cases) in a 6∶4 ratio randomly. Radiomics features were extracted from the intratumoral and peritumoral regions of interest based on PET and CT images, respectively, and the optimal feature sets were selected. Radiomics models were established using the XGBoost algorithm, and radiomics scores (intratumoral CT label, peritumoral CT label, intratumoral PET label, peritumoral PET label) were calculated. Logistic regression analysis was used to construct a clinical model and a combined model (incorporating PET-CT intratumoral and peritumoral radiomics, clinical features, and CT semantic features). The predictive performance of the models was evaluated using receiver operating characteristic curves and the area under the curve (AUC). Unsupervised clustering, Spearman correlation analysis, and visualization methods were used for the interpretability of peritumoral radiomics features. Results:In both the training and test sets, the AUC value of CT peritumoral labels was greater than that of CT intratumoral labels for predicting EGFR mutation status in lung adenocarcinoma (training set: Z=3.84, P<0.001; test set: Z=1.99, P=0.046). In the test set, the AUC value of PET intratumoral labels (0.684) was slightly higher than that of PET peritumoral labels (0.672) for predicting EGFR mutation status, but the difference was not statistically significant ( P>0.05). The combined model had the highest AUC value for predicting EGFR mutation status of lung adenocarcinoma in both the training and test sets and was significantly better than the clinical model (training set: Z=6.52, P<0.001; test set: Z=2.31, P=0.021). Interpretability analysis revealed that CT peritumoral radiomics features were correlated with CT shape features, and there were significant differences in CT peritumoral features between different EGFR mutation statuses. Conclusions:The value of CT peritumoral labels is superior to that of CT intratumoral labels in predicting EGFR mutation status in lung adenocarcinoma. The predictive performance of the model can be improved by combining PET-CT intratumoral and peritumoral radiomics, clinical features, and CT semantic features.

Objective: To understand the current status of diagnosis and treatment of chronic lymphocytic leukemia (CLL) /small lymphocytic lymphoma (SLL) among hematologists, oncologists, and lymphoma physicians from hospitals of different levels in China. Methods: This multicenter questionnaire survey was conducted from March 2021 to July 2021 and included 1,000 eligible physicians. A combination of face-to-face interviews and online questionnaire surveys was used. A standardized questionnaire regarding the composition of patients treated for CLL/SLL, disease diagnosis and prognosis evaluation, concomitant diseases, organ function evaluation, treatment selection, and Bruton tyrosine kinase (BTK) inhibitor was used. Results: ①The interviewed physicians stated that the proportion of male patients treated for CLL/SLL is higher than that of females, and the age is mainly concentrated in 61-70 years old. ②Most of the interviewed physicians conducted tests, such as bone marrow biopsies and immunohistochemistry, for patient diagnosis, in addition to the blood test. ③Only 13.7% of the interviewed physicians fully grasped the initial treatment indications recommended by the existing guidelines. ④In terms of cognition of high-risk prognostic factors, physicians' knowledge of unmutated immunoglobulin heavy-chain variable and 11q- is far inferior to that of TP53 mutation and complex karyotype, which are two high-risk prognostic factors, and only 17.1% of the interviewed physicians fully mastered CLL International Prognostic Index scoring system. ⑤Among the first-line treatment strategy, BTK inhibitors are used for different types of patients, and physicians have formed a certain understanding that BTK inhibitors should be preferentially used in patients with high-risk factors and elderly patients, but the actual use of BTK inhibitors in different types of patients is not high (31.6%-46.0%). ⑥BTK inhibitors at a reduced dose in actual clinical treatment were used by 69.0% of the physicians, and 66.8% of the physicians had interrupted the BTK inhibitor for >12 days in actual clinical treatment. The use of BTK inhibitors is reduced or interrupted mainly because of adverse reactions, such as atrial fibrillation, severe bone marrow suppression, hemorrhage, and pulmonary infection, as well as patients' payment capacity and effective disease progression control. ⑦Some differences were found in the perceptions and behaviors of hematologists and oncologists regarding the prognostic assessment of CLL/SLL, the choice of treatment options, the clinical use of BTK inhibitors, etc. Conclusion: At present, a gap remains between the diagnosis and treatment of CLL/SLL among Chinese physicians compared with the recommendations in the guidelines regarding the diagnostic criteria, treatment indications, prognosis assessment, accompanying disease assessment, treatment strategy selection, and rational BTK inhibitor use, especially the proportion of dose reduction or BTK inhibitor discontinuation due to high adverse events.
Female ; Humans ; Male ; Aged ; Middle Aged ; Leukemia, Lymphocytic, Chronic, B-Cell/drug therapy* ; Prognosis ; Lymphoma, B-Cell ; Immunohistochemistry ; Immunoglobulin Heavy Chains/therapeutic use*

Objective: To analyze the course of disease and epidemiological parameters of COVID-19 and provide evidence for making prevention and control strategies. Methods: To display the distribution of course of disease of the infectors who had close contacts with COVID-19 cases from January 1 to March 15, 2020 in Guangdong Provincial, the models of Lognormal, Weibull and gamma distribution were applied. A descriptive analysis was conducted on the basic characteristics and epidemiological parameters of course of disease. Results: In total, 515 of 11 580 close contacts were infected, with an attack rate about 4.4%, including 449 confirmed cases and 66 asymptomatic cases. Lognormal distribution was fitting best for latent period, incubation period, pre-symptomatic infection period of confirmed cases and infection period of asymptomatic cases; Gamma distribution was fitting best for infectious period and clinical symptom period of confirmed cases; Weibull distribution was fitting best for latent period of asymptomatic cases. The latent period, incubation period, pre-symptomatic infection period, infectious period and clinical symptoms period of confirmed cases were 4.50 (95%CI:3.86-5.13) days, 5.12 (95%CI:4.63-5.62) days, 0.87 (95%CI:0.67-1.07) days, 11.89 (95%CI:9.81-13.98) days and 22.00 (95%CI:21.24-22.77) days, respectively. The latent period and infectious period of asymptomatic cases were 8.88 (95%CI:6.89-10.86) days and 6.18 (95%CI:1.89-10.47) days, respectively. Conclusion: The estimated course of COVID-19 and related epidemiological parameters are similar to the existing data.
COVID-19 ; Cohort Studies ; Contact Tracing ; Humans ; Incidence ; Prospective Studies

TSCI have dyskinesia and sensory disturbance that can cause various life-threaten complications. The patients with traumatic spinal cord injury (TSCI), seriously affecting the quality of life of patients. Based on the epidemiology of TSCI and domestic and foreign literatures as well as expert investigations, this expert consensus reviews the definition, injury classification, rehabilitation assessment, rehabilitation strategies and rehabilitation measures of TSCI so as to provide early standardized rehabilitation treatment methods for TSCI.

Alzheimer's disease (AD)and type 2 diabetes mellitus (T2DM),causing by population ageing and changing lifestyles,have become latest threats to human health.Recent basic researches and clinical studies suggested that T2DM was a risk factor for cognitive impairment and dementia.Brain insulin signaling impairment and insulin metabolic disorders are often associated with patients with AD,indicating T2DM and AD share similar signaling pathways during pathological development.Therefore,the underlying mechanism involved in cognitive improvement of antidiabetic drugs (including insulin,glucagon-like peptide-1,thiazolidinediones and dipeptidyl peptidase-4 inhibitors) for AD patients are discussed in this review.

OBJECTIVETo develvp a RP-HPLC method for the determination of flavonoids in fifteen kinds of flowers such as Iris lacteal pall, prunus persica and rosa chinensis.

METHODThe contents of quercetin, kaempferol and isorhamntin in fifteen kinds of flowers were extracted with methanol. The analysis was performed on a Kromasil C18 column (4.6 mm x250 mm, 5 microm) with methanol-0.1% phosphoric acid (50:50) as mobile phase.

RESULTThe quercetin, kaempferol and isorhamntin were separated well, and the result shows that the content of quercetin in the Iris lactea Pall was the highest (1.536%), the contene of kaempferol in Persica persice was the highest (0.572%), and the content of isorhamntin in chrysamthemum morifolium was up to 0.290%.

CONCLUSIONThe contents of flavonoids in these flowers were by determined RP-HPLC for the first time and the method can be used for quantitative determination of flavonoids in the flowers.

Chromatography, High Pressure Liquid ; methods ; Drugs, Chinese Herbal ; chemistry ; Flavonoids ; chemistry ; Flowers ; chemistry ; Iris Plant ; chemistry ; Kaempferols ; chemistry ; Prunus ; chemistry ; Quercetin ; chemistry ; Rosa ; chemistry

Objective To investigate the clinical features of unexpected sudden death (SUD) clustered in families in Yunnan province.Methods This retrospective study analyzed the clinical features of SUD occurred between July to September 2005 in 7 families in Yunnan province.Results All 16 SUD patients shared common clinical features such as fatigue and repeated syncope and one group of SUD patients (n = 8 from 4 families) presented with the gastric intestinal tract manifestations including nausea, vomiting, abdominal pain and diarrhea with suspected dietary history and abnormal laboratory enzyme findings (GOT/ GPT,CK/CKMB,LDH/LDH1 etc.).In SUD patients without gastric intestinal tract manifestations (n = 8 from 3 families), there were no clear symptoms before death and repeated ventricular tachycardia and ventricular fibrillation were recorded in one survivor.There was no clear evidence for the involvements of hereditary and infectious factors for observed SUD.conclusion The reason for the unexpected sudden death clustered in 7 families in Yunnan remains unclear.Repeated syncope and fatigue served as the common clinical features in the presence or absence of gastric intestinal tract manifestations in all SUD cases.Further studies are needed to clarify the pathology and detailed clinical manifestations of SUD occurred in this area.

OBJECTIVETo observe the relationship between protein sythesis and cardiomyocyte viability in neonatal rats.

METHODSThe protein sythesis in neonatal rat cardiomyocytes was measured according to Brandford's method, the absorbance at 490 nm (A(490 nm)) of the cells was measured with MTT assay and the cell viability evaluated by the ratio of A(490 nm) to the total cell number.

RESULTSET-1 increased cardiomyocyte protein synthesis dose-dependently, and this effect was attenuated by the application of lacidipine and tetramethylpyrazines Higher doses of ET-1 resulted in lower A(490 nm)/total cell number ratio, which was further lowered by larcidipine and tetramethylpyrazine.

CONCLUSIONThe status of protein synthesis is not associated with the viability of neonatal rat cardiomyocytes.

Animals ; Animals, Newborn ; Calcium Channel Blockers ; pharmacology ; Cell Survival ; drug effects ; Cells, Cultured ; Dihydropyridines ; pharmacology ; Dose-Response Relationship, Drug ; Endothelin-1 ; pharmacology ; Myocytes, Cardiac ; cytology ; drug effects ; metabolism ; Protein Biosynthesis ; Pyrazines ; pharmacology ; Rats ; Rats, Sprague-Dawley

OBJECTIVETo investigate the effect of specific blockage of mutant p53 gene by individualized antisense RNA in vitro.

METHODSMutation status of p53 in human breast cancer cell lines was determined by immunocytochemical staining, PCR-SSCP and sequencing. Single strand antisense transcription system targeting specific p53 mutation site (mt-p53) was constructed, and corresponding antisense RNA was prepared. The hybridization of antisense RNA with its corresponding mt-p53 gene was confirmed by in-situ hybridization. Human breast cancer cells were transfected with antisense RNA by cationic liposome-mediated method. Time course of effects of antisense RNA was investigated by immunocytochemical staining and cell growth inhibiting assay. Expression of mt-p53 protein was examined by Western blot. Cell proliferation was evaluated by MTT assay and cell cycle distribution was determined by flow cytometry (FCM). Apoptosis was determined by TUNEL assay.

RESULTSMutation of p53 exon 8 was found in MDA-MB-231 cells and antisense transcription system (pGEM3zf (+/-) p53exon8) was then constructed successfully. In transfected MDA-MB-231 cells, hybridization signals were observed in cytoplasm. Fourth-eight hours after transfection, the antisense RNA (ASp53exon8'RNA) had a significant retarding effect on p53 related proliferation inhibition, along with a decrease of p53 protein expression.

CONCLUSIONSASp53exon8'RNA specifically blocks mt-p53 gene expression, resulting in an inhibition of MDA-MB-231 cell proliferation. Such an approach may be used as a therapeutic option against human malignancy.

Apoptosis ; Base Sequence ; Breast Neoplasms ; metabolism ; pathology ; Cell Line, Tumor ; Cell Proliferation ; Codon ; Female ; Gene Expression Regulation, Neoplastic ; Humans ; Molecular Sequence Data ; Mutation ; Plasmids ; RNA, Antisense ; Recombinant Proteins ; metabolism ; Transfection ; Tumor Suppressor Protein p53 ; genetics ; metabolism

OBJECTIVETo investigate the safety of autologous bone marrow mononuclear cell (BM-MNCs) transplantation by intracoronary infusion in patients with acute myocardial infarction (AMI).

METHODSOne hundred and eighty-four patients with AMI treated with percutaneous coronary intervention (PCI) were randomized in a 1:1 way to either intracoronary transplantation of autologous BM-MNCs (n = 92) right after PCI or to sodium chloride concluding heparin (controlled, n = 92) via a micro infusion catheter. In the process of the intracoronary infusion of BM-MNCs, the complications should be recorded, which were aberration reflect (including of pale, syncope, nausea, hypotension and shock), deterioration of angina or heart failure, arrhythmias (including of bradycardia, sinus arrest or atrial ventricular block or ventricular fibrillation), embolism etc. Body temperature, blood pressure and heart rates should be monitored during the first week after transplantation. Holter, coronary angiography and ultrasonic cardiography were performed at the designed time points. Main heart accidents, restenosis and tumor were recorded during 2-years follow up.

RESULTSDuring the period of bone marrow puncture and intracoronary infusion of BM-MNCs, few patients occurred pale, dizziness, bradycardia and hypotension, which were transient and due to vagus reflect. No stem cell-related arrhythmias, deterioration of angina were noted. In BM-MNCs group one patient developed in-stent reocclusion in one week after transplantation, five developed in-stent restenosis during further follow-up 30 months, which were similar with control group. There were no deaths, major adverse cardiac events, tumor and other late adverse events during follow-up period in both groups.

CONCLUSIONIntracoronary transplantation of autologous BM-MNCs in the acute phase after AMI is feasible and seems safe in the 30 months of follow-up.

Adult ; Aged ; Bone Marrow Transplantation ; methods ; Coronary Vessels ; Female ; Follow-Up Studies ; Humans ; Male ; Mesenchymal Stem Cell Transplantation ; methods ; Middle Aged ; Myocardial Infarction ; surgery ; Transplantation, Autologous