BACKGROUND: Epidermal growth factor receptor (EGFR) sensitive mutation is one of the effective targets of targeted therapy for non-small cell lung cancer (NSCLC). However, due to the difficulty of obtaining some primary tissues and the economic factors in some underdeveloped areas, some patients cannot undergo traditional genetic testing. The aim of this study is to establish a machine learning (ML) model using non-invasive peripheral blood markers to explore the biomarkers closely related to EGFR mutation status in NSCLC and evaluate their potential prognostic value. METHODS: 2642 lung cancer patients who visited Jiangsu Cancer Hospital from November 2016 to May 2023 were retrospectively enrolled and finally 175 NSCLC patients with complete follow-up data were included in the study. The ML model was constructed based on peripheral blood indicators and divided into training set and test set according to the ratio of 8:2. Unsupervised learning algorithms were used for clustering blood features and mutual information method for feature selection, and an ensemble learning algorithm based on Shapley value was designed to calculate the contribution of each feature to the model prediction result. The receiver operating characteristic (ROC) curve was used to evaluate the predictive ability of the model. RESULTS: Through the feature extraction and contribution analysis of the predictive results of the interpretable ML model based on the Shapley value, the top ten indicators with the highest contribution were: pathological type, phosphorus, eosinophils, monocyte count, activated partial thromboplastin time, potassium, total bilirubin, sodium, eosinophil percentage, and total cholesterol. The area under the curve (AUC) of the model was 0.80. In addition, patients with hyponatremia and squamous cell carcinoma group had a poor prognosis (P<0.05). CONCLUSIONS The interpretable model constructed in this study provides a new approach for the prediction of EGFR mutation status in NSCLC patients, which provides a scientific basis for the diagnosis and treatment of patients who cannot undergo genetic testing.
Humans ; Carcinoma, Non-Small-Cell Lung/diagnosis* ; Machine Learning ; Lung Neoplasms/diagnosis* ; Male ; Female ; Mutation ; Middle Aged ; ErbB Receptors/genetics* ; Prognosis ; Aged ; Retrospective Studies ; Adult ; Biomarkers, Tumor/genetics*

OBJECTIVES: To investigate the synergistic mechanism of the traditional Chinese medicine Rosa laevigata Michx. (RLM) for treatment of pulmonary arterial hypertension (PAH). METHODS: Network pharmacological analysis was carried out to screen the active ingredients of RLM and PAH disease targets and construct the "component-target-disease" interaction network, followed by gene enrichment analysis and molecular docking studies. In the cell experiments, primary cultures of rat pulmonary arterial smooth muscle cells were exposed to hypoxia for 24 h and treated with solvent or 100, 200 and 300 mg/mL RLM, and the changes in cell proliferation were detected using Western blotting for PCNA and immunofluorescence staining. In the animal experiment, male SD rats were randomized into 5 control group, monocrotaline (MCT) solvent group, and MCT with RLM (100, 200 and 300 mg/mL) treatment groups. HE staining and immunofluorescence staining were used to observe histopathological changes in the pulmonary blood vessels of the rats. RESULTS: Seven core active ingredients (including β-sitosterol and kaempferol) in RLM and 39 key disease targets were identified, and molecular docking showed that SRC was a high-affinity target. KEGG enrichment analysis showed that the differential genes were significantly enriched in calcium signaling and PI3K-AKT pathways. In rat pulmonary arterial smooth muscle cells, hypoxic exposure significantly up-regulated cellular expression of PCNA and phosphorylation levels of Src and AKT1, which were obviously lowered by RLM treatment. In RLM-treated rat models, the mean pulmonary artery pressure and right ventricular hypertrophy index (Fulton index) were significantly reduced, the tricuspid annular plane systolic excursion (TAPSE) was improved, and pulmonary vascular wall thickening and fibrosis were obviously ameliorated. CONCLUSIONS RLM inhibits pulmonary arterial smooth muscle cell proliferation in rat models of hypertension possibly by regulating the Src-AKT1 axis, suggesting the potential of RLM as a new natural drug for treatment of pulmonary hypertension.
Animals ; Cell Proliferation/drug effects* ; Proto-Oncogene Proteins c-akt/metabolism* ; Rats, Sprague-Dawley ; Pulmonary Artery/cytology* ; Male ; Rats ; Myocytes, Smooth Muscle/cytology* ; Hypertension, Pulmonary/pathology* ; Drugs, Chinese Herbal/pharmacology* ; Signal Transduction/drug effects* ; Muscle, Smooth, Vascular/cytology* ; src-Family Kinases/metabolism* ; Cells, Cultured

Objective: To evaluate and compare the accuracy of responses to pediatric preventive dentistry-related questions between the domestic large language model, ChatGLM-6B, and the international large language model, ChatGPT-3.5, in order to provide insights for further research and development of domestic language models in the field of oral medicine. Methods: A total of 100 common pediatric preventive dentistry questions of varying difficulty levels [basic (n = 35), intermediate (n = 35), and advanced (n = 30) ] were provided by pediatric preventive dentistry experts. Two doctors independently registered these questions with ChatGPT-3.5 and ChatGLM-6B and collected the answers. A cohort of 16 dentists assessed responses generated by ChatGLM-6B and ChatGPT-3.5 using a predefined 3-point Likert scale. The average score of the ratings from 16 doctors was taken as the answer score. If the answer score was higher than 2.8, it was accepted as a accurate answer; if the score was lower than 1.4, it was accepted as an inaccurate answer; if the score was between 1.4 and 2.8, it was accepted as a partially accurate answer. Comparative analysis was conducted on the accuracy rates and evaluation outcomes between the two groups. Consistency analysis of the ratings was conducted Results: The answer accuracy rates of ChatGPT-3.5 and ChatGLM-6B for 100 pediatric preventive dentistry questions were comparable: ChatGPT-3.5 demonstrated 68% accurate, 30% partially accurate, and 2% inaccurate responses, while ChatGLM-6B showed 67% accurate, 31% partially accurate, and 2% inaccurate responses, with no statistically significant differences (P>0.05). Both models exhibited equivalent accuracy across questions of varying difficulty levels (basic, intermediate, advanced), showing no statistical differences (P>0.05). The overall average scores for ChatGPT3.5 and ChatGLM-6B in answering all questions were both 2.65, with no statistically significant difference (P>0.05). For questions of different difficulty levels, ChatGPT3.5 had an average score of 2.66 for basic questions while ChatGLM-6B had an average score of 2.70. For intermediate questions, ChatGPT3.5 had an average score of 2.63 and ChatGLM-6B had an average score of 2.64. For advanced questions, ChatGPT3.5 had an average score of 2.68, and ChatGLM-6B had an average score of 2.61. No statistically significant differences were observed across any difficulty category (P>0.05). The consistency of the experts’ grading ranged from fair to moderate. Conclusion This study demonstrates the potential of both ChatGLM-6B and ChatGPT-3.5 in answering pediatric preventive dentistry questions. ChatGLM-6B performed similarly to ChatGPT-3.5 in this field, but the accuracy rates of both models fell short of expectations and are not suitable for clinical use. Future efforts should focus on improving the accuracy and consistency of large language models in providing medical information, as well as developing specialized medical models for the field of oral medicine.

Objective To construct an intelligent segmentation and T-stage diagnostic model for esophageal cancer based on the DAEUnet and ConvNeXt networks using transfer learning.Methods Dicom raw data from 126 patients diagnosed with esophageal cancer between January 2018 and April 2022 were collected,including 100 cases from Department of Thoracic Surgery at the First Affiliated Hospital of Army Medical University and 26 cases from the Department of Thoracic Surgery at Shanxi Cancer Hospital.After data augmentation,a total of 60 275 images were obtained.The DAEUnet esophageal cancer intelligent segmentation network was built,and on this basis,3 classification networks,ConvNeXt,Swin Transformer,and ResNet were constructed for T-stage diagnosis of esophageal cancer.Results The Dice similarity coefficient(DSC)for esophageal cancer intelligent segmentation using the DAEUnet network was 0.82,and the DSC value of the esophagus,aorta,normal esophagus,mediastinal lymph nodes,and heart was 72.4％,87.5％,79.3％,60.5％ and 96.8％,respectively.Among the 3 T-stage diagnosis models for esophageal cancer,the ConvNeXt model performed the best,with a precision value for T1～T4 stages of 0.65,0.727,0.889 and 0.92,respectively,and an AUC value of 0.892,which were superior to the ResNet and Swin Transformer networks.Conclusion The proposed DAEUnet and ConvNeXt-based intelligent segmentation and T-stage diagnosis model for esophageal cancer improves T-stage accuracy and treatment efficiency.

Hydrosalpinx is one of the common causes of female infertility and a more common type of chronic tubal inflammation. Hydrosalpinx may reduce the success of assisted reproductive technology (ART) through a variety of mechanisms, including mechanical flushing of the embryo, embryo toxicity, reduced endometrial receptivity, and suppression of ovarian function. The effect of hydrosalpinx and its treatment strategy on ovarian response during controlled superovulation is controversial in existing studies, and there are fewer studies on the effect of hydrosalpinx on embryo quality. In this article, we clarify the pathophysiological mechanisms of hydrosalpinx, analyze its potential impact on ovarian response and embryo quality, and further explore the impact of therapeutic strategies for tubal hydrosalpinx on ART outcomes.

Hydrosalpinx is one of the common causes of female infertility and a more common type of chronic tubal inflammation. Hydrosalpinx may reduce the success of assisted reproductive technology (ART) through a variety of mechanisms, including mechanical flushing of the embryo, embryo toxicity, reduced endometrial receptivity, and suppression of ovarian function. The effect of hydrosalpinx and its treatment strategy on ovarian response during controlled superovulation is controversial in existing studies, and there are fewer studies on the effect of hydrosalpinx on embryo quality. In this article, we clarify the pathophysiological mechanisms of hydrosalpinx, analyze its potential impact on ovarian response and embryo quality, and further explore the impact of therapeutic strategies for tubal hydrosalpinx on ART outcomes.

Objective To explore the electroencephalography(EEG)characteristics of patients with knee osteoarthritis(KOA)which are different from those of healthy subjects during dynamic balance tests,and study the connection and influence between brain activity and KOA.Methods Fifteen patients with KOA and 17 healthy subjects performed the timed up and go test(TUGT)and five times sit-to-stand test(5STS).The EEG characteristics of the 4 frequency bands,namely δ(0.5-4 Hz),θ(4-8 Hz),α(8-14 Hz)and β(14-30 Hz)of 9 electrodes including CZ,C3,C4 in the central region,PZ,P3,P4 in the parietal lobe,and OZ,O1,O2 in the occipital lobe of the cerebral cortex of the subjects were recorded.Time and frequency domain analysis were conducted.Results During 5STS,the time-domain amplitudes of electrodes C4,P3,and P4 in the δ band,electrodes C4,P3,and P4 in the θ band,and electrodes P3 and P4 in the β band of KOA patients were significantly higher than those of healthy subjects(P<0.05);the power of EEG signals of electrodes P3,P4,and O2 in the β band was significantly higher than that of healthy subjects.During TUGT,except that the time-domain amplitude of electrode PZ in the θ band of KOA patients was significantly lower than that of healthy subjects(P<0.05),there was no significant difference in all electrodes in other frequency bands;the power of EEG signals of electrodes C3,CZ,C4,PZ,P4,O1,OZ,O2 in the δ band and electrodes CZ,P3,PZ,and OZ in the α band and electrodes CZ,P4,OZ,and O2 in the β band was significantly lower than that of healthy subjects(P<0.05).Conclusions Compared with healthy subjects,the activity in the parietal lobe area of the brain of KOA patients during 5STS was stronger,while the brain activity in the central region,parietal lobe,and occipital lobe areas of KOA patients during TUGT was weaker than that of healthy subjects.This study may provide some references for clinicians in the prevention and treatment of KOA.

Objective:To investigate the clinical manifestation, therapy, and prognosis of Susac syndrome and enhance the understanding of this disease.Methods:A case summary was made.The clinical data of two siblings with Susac syndrome treated at Children′s Medical Center, Peking University First Hospital in January 2024 were summarized.Reported cases of pediatric Susac syndrome were reviewed.Results:The onset of the disease in the two siblings was at the age of 3.00 and 6.75 years, with recurrent headaches, tinnitus, hearing loss and encephalopathy symptoms.Cranial magnetic resonance imaging showed multiple cerebral microbleeding and microinfarction lesions, " snowball like" in the corpus callosum and diffuse white matter edema in the brain.Audiometry revealed sensorineural hearing loss.In one case, ophthalmic fluorescein angiography revealed ischemic changes due to branch retinal artery occlusions.No pathogenic variants were detected in gene testing.This child was diagnosed with Susac syndrome, and the symptoms were improved after treatment with Corticosteroids and Rituximab.No relapse was observed during the 9-month follow-up.A total of 20 pediatric cases of Susac syndrome were retrieved, including 18 reported previously and 2 cases from this study.There were 2 boys and 18 girls, with the age of onset ranging from 2.5 to 17.0 years.The common initial symptoms included headache (19 cases), vertigo and tinnitus or hearing loss (9 cases), and vision impairment or visual field defect (4 cases). The symptoms were improved after immunotherapy.Conclusions:With a low incidence, Susac syndrome is rare in children and difficult to diagnose.There may be a genetic predisposition in such disease.Early diagnosis and immunotherapy can low the relapse and improve the prognosis.

Objective To explore the electroencephalography(EEG)characteristics of patients with knee osteoarthritis(KOA)which are different from those of healthy subjects during dynamic balance tests,and study the connection and influence between brain activity and KOA.Methods Fifteen patients with KOA and 17 healthy subjects performed the timed up and go test(TUGT)and five times sit-to-stand test(5STS).The EEG characteristics of the 4 frequency bands,namely δ(0.5-4 Hz),θ(4-8 Hz),α(8-14 Hz)and β(14-30 Hz)of 9 electrodes including CZ,C3,C4 in the central region,PZ,P3,P4 in the parietal lobe,and OZ,O1,O2 in the occipital lobe of the cerebral cortex of the subjects were recorded.Time and frequency domain analysis were conducted.Results During 5STS,the time-domain amplitudes of electrodes C4,P3,and P4 in the δ band,electrodes C4,P3,and P4 in the θ band,and electrodes P3 and P4 in the β band of KOA patients were significantly higher than those of healthy subjects(P<0.05);the power of EEG signals of electrodes P3,P4,and O2 in the β band was significantly higher than that of healthy subjects.During TUGT,except that the time-domain amplitude of electrode PZ in the θ band of KOA patients was significantly lower than that of healthy subjects(P<0.05),there was no significant difference in all electrodes in other frequency bands;the power of EEG signals of electrodes C3,CZ,C4,PZ,P4,O1,OZ,O2 in the δ band and electrodes CZ,P3,PZ,and OZ in the α band and electrodes CZ,P4,OZ,and O2 in the β band was significantly lower than that of healthy subjects(P<0.05).Conclusions Compared with healthy subjects,the activity in the parietal lobe area of the brain of KOA patients during 5STS was stronger,while the brain activity in the central region,parietal lobe,and occipital lobe areas of KOA patients during TUGT was weaker than that of healthy subjects.This study may provide some references for clinicians in the prevention and treatment of KOA.

Objective:To investigate the clinical manifestation, therapy, and prognosis of Susac syndrome and enhance the understanding of this disease.Methods:A case summary was made.The clinical data of two siblings with Susac syndrome treated at Children′s Medical Center, Peking University First Hospital in January 2024 were summarized.Reported cases of pediatric Susac syndrome were reviewed.Results:The onset of the disease in the two siblings was at the age of 3.00 and 6.75 years, with recurrent headaches, tinnitus, hearing loss and encephalopathy symptoms.Cranial magnetic resonance imaging showed multiple cerebral microbleeding and microinfarction lesions, " snowball like" in the corpus callosum and diffuse white matter edema in the brain.Audiometry revealed sensorineural hearing loss.In one case, ophthalmic fluorescein angiography revealed ischemic changes due to branch retinal artery occlusions.No pathogenic variants were detected in gene testing.This child was diagnosed with Susac syndrome, and the symptoms were improved after treatment with Corticosteroids and Rituximab.No relapse was observed during the 9-month follow-up.A total of 20 pediatric cases of Susac syndrome were retrieved, including 18 reported previously and 2 cases from this study.There were 2 boys and 18 girls, with the age of onset ranging from 2.5 to 17.0 years.The common initial symptoms included headache (19 cases), vertigo and tinnitus or hearing loss (9 cases), and vision impairment or visual field defect (4 cases). The symptoms were improved after immunotherapy.Conclusions:With a low incidence, Susac syndrome is rare in children and difficult to diagnose.There may be a genetic predisposition in such disease.Early diagnosis and immunotherapy can low the relapse and improve the prognosis.