BACKGROUND: Over 20 million colonoscopies are performed in China annually. An automatic clinical decision support system (CDSS) with accurate semantic recognition of colonoscopy reports and guideline-based is helpful to relieve the increasing medical burden and standardize the healthcare. In this study, the CDSS was built under a hierarchical-label interpretable classification framework, trained by a state-of-the-art transformer-based model, and validated in a multi-center style. METHODS: We conducted stratified sampling on a previously established dataset containing 302,965 electronic colonoscopy reports with pathology, identified 2041 patients' records representative of overall features, and randomly divided into the training and testing sets (7:3). A total of five main labels and 22 sublabels were applied to annotate each record on a network platform, and the data were trained respectively by three pre-training models on Chinese corpus website, including bidirectional encoder representations from transformers (BERT)-base-Chinese (BC), the BERT-wwm-ext-Chinese (BWEC), and ernie-3.0-base-zh (E3BZ). The performance of trained models was subsequently compared with a randomly initialized model, and the preferred model was selected. Model fine-tuning was applied to further enhance the capacity. The system was validated in five other hospitals with 3177 consecutive colonoscopy cases. RESULTS: The E3BZ pre-trained model exhibited the best performance, with a 90.18% accuracy and a 69.14% Macro-F1 score overall. The model achieved 100% accuracy in identifying cancer cases and 99.16% for normal cases. In external validation, the model exhibited favorable consistency and good performance among five hospitals. CONCLUSIONS The novel CDSS possesses high-level semantic recognition of colonoscopy reports, provides appropriate recommendations, and holds the potential to be a powerful tool for physicians and patients. The hierarchical multi-label strategy and pre-training method should be amendable to manage more medical text in the future.
Humans ; Colonoscopy/methods* ; Deep Learning ; Decision Support Systems, Clinical ; Female ; Male

Purpose To evaluate the short-term efficacy of Gefitinib based on the non-contrast CT radiomics model in patients with advanced lung adenocarcinoma before treatment.Materials and Methods Seventy-one patients with advanced lung adenocarcinoma and treated with Gefitinib in the First Affiliated Hospital of Harbin Medical University from January 2020 to May 2022 were retrospectively analyzed,the efficacy of the treatment was evaluated in the third month after receiving the treatment,and all patients were divided into the treatment-effective group(n=41)and the treatment-ineffective group(n=30)according to the criteria for evaluating the efficacy of solid tumors.All patients were randomized into the training group and the validation group according to 7∶3,the least absolute shrinkage and selection operator were used in the training group to screen the best radiomics features,and eight models were established,including K-proximity,Logistic regression,support vector machine,adaptive enhancement,gradient boosting,random forest,ensemble algorithm and Gaussian naive Bayes.The optimal model was selected by comparing the area under the receiver operating characteristic curve(AUC)and accuracy.The optimal model performance was tested in the validation group,the clinical usability of the best model was tested using decision curves,the accuracy of the predictive models was visualized using calibration curves.Results The seven best radiomics features were obtained by least absolute shrinkage and selection operator regression screening,the best model Logistic regression was selected in a variety of models,the AUC value of Logistic regression in the validation group was 0.774(95%CI 0.536-0.951),with a sensitivity of 0.846,a specificity of 0.556,an accuracy of 0.727,a recall of 0.846,and an F1-score of 0.733.Conclusion It is possible to screen out the sensitive population of advanced lung adenocarcinoma for targeted therapy based on CT radiomics models.

It is difficult to treat severe burn combined injury caused by high voltage. This paper reports the successful treatment of a patient with large cranial area third degree burn, skull exposure, local skull carbonization combined with cerebrospinal fluid leakage caused by ten thousand volts high voltage current. Vacuum sealing drainage was given to protect the wounds from infection after multiple limited debridement in the early stage. The external of the inactivated skull was cleaned in the later stage. Finally, the bilateral anterolateral thigh flap combined with multiple burr holes was used to repair the wound. There were no severe postoperative complications, and the therapeutic effect was satisfactory.

It is difficult to treat severe burn combined injury caused by high voltage. This paper reports the successful treatment of a patient with third degree burn of extra large cranial area, skull exposure, local skull carbonization combined with cerebrospinal fluid leakage caused by ten thousand volts high voltage current. Vacuum sealing drainage was given to protect the wounds from infection after multiple limited debridement in the early stage. The external plate of the inactivated skull was cleaned in the later stage. Finally, the bilateral anterolateral thigh flap combined with multiple burr holes was used to repair the wound. There were no severe postoperative complications, and the therapeutic effect was satisfactory.

It is difficult to treat severe burn combined injury caused by high voltage. This paper reports the successful treatment of a patient with large cranial area third degree burn, skull exposure, local skull carbonization combined with cerebrospinal fluid leakage caused by ten thousand volts high voltage current. Vacuum sealing drainage was given to protect the wounds from infection after multiple limited debridement in the early stage. The external of the inactivated skull was cleaned in the later stage. Finally, the bilateral anterolateral thigh flap combined with multiple burr holes was used to repair the wound. There were no severe postoperative complications, and the therapeutic effect was satisfactory.

It is difficult to treat severe burn combined injury caused by high voltage. This paper reports the successful treatment of a patient with third degree burn of extra large cranial area, skull exposure, local skull carbonization combined with cerebrospinal fluid leakage caused by ten thousand volts high voltage current. Vacuum sealing drainage was given to protect the wounds from infection after multiple limited debridement in the early stage. The external plate of the inactivated skull was cleaned in the later stage. Finally, the bilateral anterolateral thigh flap combined with multiple burr holes was used to repair the wound. There were no severe postoperative complications, and the therapeutic effect was satisfactory.

OBJECTIVE: To describe the clinical and genetic characteristics of a child with 14q12q13.1 deletion involving the FOXG1 gene. METHODS: Clinical manifestation of the child was analyzed. Peripheral blood sample of the patient was subjected to chromosomal karyotyping and single nucleotide polymorphism array (SNP-array) analysis. RESULTS: The male infant has developed feeding difficulty, poor sucking, lower limb tremor, and frontal bruising 8 days after birth. Magnetic resonance imaging revealed significant enlargement of bilateral ventricles and corpus callosum dysplasia. Chromosomal analysis revealed a karyotype of 46,XY,del(14)(q12q13.1), and SNP-array confirmed that there was a 9.6 Mb deletion in 14q11.2q13.1, which encompassed the FOXG1 gene. CONCLUSION For patients with brain development abnormalities, dyskinesia, cognitive impairment, speech disorder and other manifestations, copy number variation of the FOXG1 gene should be excluded. SNP-array should be carried out as early as possible to attain the diagnosis.
Child ; Chromosome Deletion ; DNA Copy Number Variations ; Forkhead Transcription Factors/genetics* ; Heterozygote ; Humans ; Infant ; Karyotyping ; Male ; Nerve Tissue Proteins/genetics* ; Polymorphism, Single Nucleotide

Non-occupational post-exposure prophylaxis (nPEP), a biological means to block the transmission of HIV, is recommended by European countries, USA and WHO to use in HIV high-risk groups, but its utilization rate is still very low. The information-motivation-behavioral skills model (IMB) can accurately explain the prevalence and change of health behaviors. Based on this model, this paper summarizes the progress in research of the influencing factors for nPEP use to provide a basis for further research to promote the use of nPEP.

Occult hepatitis C infection (OCI) is defined as HCV RNA not detected in serum or plasma but in hepatocytes and peripheral blood mononuclear cells (PBMCs). OCI exists in general population and voluntary blood donors, and its infectivity and risk of transmission by transfusion has been confirmed. HCV RNA in PBMCs could not be detected in plasma or serum by blood screening in transfusion services, neither by enzyme-linked immunosorbent assay nor by nucleic acid amplification testing. OCI has become a potential threat to transfusion safety, therefore effective detection technologies and transmission blocking strategies need to be further developed.

Objective:To establish VSV-G qPCR assay for detection of replication competent lentivirus(RCL) and verify its application.Methods:A real-time fluorescent quantitative PCR for VSV-G envelope gene was developed. Several parameters including specificity, linear, amplification efficiency, precision, trueness, dynamic range, limit of detection, limit of quantification and robustness were verified. Preliminary application on CAR-T cells, end of production cells and the harvest of lentivirus vector was performed by using the method developed.Results:The real-time fluorescent quantitative PCR assay for VSV-G was specific for the detection VSV-G without specific amplification on 293T, PBMC and C8166 cells. The linear range of the assay was 1×10 2 copies/test-1×10 9 copies/test with a R2 value more than 0.998 and amplification efficiency between 93% and 98%. The precision (relative standard deviation) of the assay was less than 12% and the trueness (the rate of recovery) of the assay was between 85% and 106%. The limit of detection (LOD) and limit of quantification (LOQ) of the assay was 5 copies/test and 40 copies/test. In addition, the robustness of the assay was also well. All the results of validation illustrated that the assay could meet the detection requirements. All of the 54 samples including CAR-T cells, lentivirus vector and end of product cells after amplification and passage on C8166 cells were negative of RCL by using the established assay. Conclusions:The real-time fluorescent quantitative PCR for VSV-G were established successfully. All of the validation results illustrated that the assay could meet the detection requirements. The application of the assay was conducive to further enhance the safety of the lentivirus vector related products.