Objective To explore the value of radiomics model and deep learning model based on unenhanced MRI in predicting microvascular invasion(MVI)of hepatocellular carcinoma(HCC)preoperatively.Methods A total of 189 patients with postopera-tive pathologically confirmed HCC from two centers were retrospectively selected,of which 119 cases from Zhujiang Hospital of Southern Medical University were used as the training set[60 cases with negative MVI,59 cases with positive MVI],and 70 cases from Shenzhen People's Hospital were used as the external test set[38 cases with negative MVI and 32 cases with positive MVI].Clinical indicators were analyzed by univariate and multivariate logistic regression analysis and the independent predictors of positive MVI were screened.Deep transfer learning(DTL)and traditional radiomics methods were used to construct radiomics model and deep learning model based on unenhanced MRI.The predictive performances of each model were compared using receiver operating charac-teristic(ROC)curves and area under the curve(AUC).DeLong test was employed to compare statistical differences in performance of the models.Results Alkaline phosphatase(ALP)and prothrombin time(PT)were independent predictors of positive MVI(P<0.05).The deep learning model based on T2WI had the best predictive efficacy,with AUC of 0.779[95%confidence interval(CI)0.696-0.863]and 0.741(95%CI 0.620-0.861)in the training set and external test set,respectively,and there were statistically significant differences compared with the radiomics model and the clinical model based on T1WI(P<0.05).Conclusion Deep learning model based on T2WI has a certain application value in preoperative noninvasive prediction of MVI status in HCC patients.

Objective To explore the value of radiomics model and deep learning model based on unenhanced MRI in predicting microvascular invasion(MVI)of hepatocellular carcinoma(HCC)preoperatively.Methods A total of 189 patients with postopera-tive pathologically confirmed HCC from two centers were retrospectively selected,of which 119 cases from Zhujiang Hospital of Southern Medical University were used as the training set[60 cases with negative MVI,59 cases with positive MVI],and 70 cases from Shenzhen People's Hospital were used as the external test set[38 cases with negative MVI and 32 cases with positive MVI].Clinical indicators were analyzed by univariate and multivariate logistic regression analysis and the independent predictors of positive MVI were screened.Deep transfer learning(DTL)and traditional radiomics methods were used to construct radiomics model and deep learning model based on unenhanced MRI.The predictive performances of each model were compared using receiver operating charac-teristic(ROC)curves and area under the curve(AUC).DeLong test was employed to compare statistical differences in performance of the models.Results Alkaline phosphatase(ALP)and prothrombin time(PT)were independent predictors of positive MVI(P<0.05).The deep learning model based on T2WI had the best predictive efficacy,with AUC of 0.779[95%confidence interval(CI)0.696-0.863]and 0.741(95%CI 0.620-0.861)in the training set and external test set,respectively,and there were statistically significant differences compared with the radiomics model and the clinical model based on T1WI(P<0.05).Conclusion Deep learning model based on T2WI has a certain application value in preoperative noninvasive prediction of MVI status in HCC patients.

Objective To observe the value of radiomics models based on gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid(Gd-EOB-DTPA)enhanced hepatobiliary phase(HBP)MRI for assessing clinical pathological stage of hepatic fibrosis(HF).Methods Data of 240 patients with pathologically/clinically diagnosed and clinical pathological staged HF who underwent Gd-EOB-DTPA enhanced MR examination were retrospectively analyzed.The liver-to-muscle signal intensity ratio(SIR1)and liver-to-spleen signal intensity ratio(SIR2)were measured based on HBP images.Radiomics features of HBP images were extracted and screened to construct radiomics models.The signal intensity ratio(SIR)-radiomics combined models were constructed based on SIR and radiomics signatures.Receiver operating characteristic(ROC)curves were drawn to evaluate the efficacy of each model for assessing clinical pathological stage of HF.Results The area under the curve(AUC)of SIR1 and SIR2 models for assessing clinical pathological stage of HF were 0.63-0.70 and 0.65-0.71,respectively.The most effective radiomics model for assessing HF,significant HF,advanced HF and early cirrhosis was support vector machine(SVM),SVM,light gradient boosting machine and K-nearest neighbor model,respectively,with the AUC in validation set of 0.87,0.82,0.81 and 0.80,respectively,while the AUC of SIR-radiomics combined models in validation set of 0.88,0.82,0.82 and 0.81,respectively.Conclusion The radiomics models based on Gd-EOB-DTPA enhanced HBP MRI were helpful for assessing clinical pathological stage of HF.Combining with HBP SIR could improve their efficacy.

Background::Arterial stiffening increases with age and blood pressure and is associated with cardiovascular disease (CVD), but the relationship between blood pressure lowering and arterial stiffening is still uncertain, especially in older people. This study aimed to evaluate the effect of intensive blood pressure treatment on the progression of arterial stiffness and risk of CVD in older patients with hypertension.Methods::The Strategy of Blood Pressure Intervention in the Elderly Hypertensive Patients (STEP) trial was a multicenter, randomized, controlled trial performed at 42 clinical centers throughout China, and 8511 patients aged 60–80 years with essential hypertension were enrolled and randomly assigned to systolic blood pressure (SBP) target of 110 mmHg to <130 mmHg (intensive treatment) or 130 mmHg to <150 mmHg (standard treatment). Patients underwent repeated examinations of the brachial-ankle pulse wave velocity (baPWV) and ankle-brachial index (ABI) at baseline, and the arterial stiffness was evaluated at the 3-year follow-up. A total of 5339 patients who had twice repeated measurements were included in this study. Changes in arterial stiffness between the intensive and standard treatment groups were analyzed using a multivariate linear regression model. The Cox proportional hazard regression model was used to evaluate the effect of intensive treatment on primary CVD outcomes.Results::The changes in baPWV were 61.5 cm/s (95% confidence interval [CI]: 49.8–73.2 cm/s) in the intensive treatment group and 98.4 cm/s (95% CI: 86.7–110.1 cm/s) in the standard treatment group ( P <0.001). Intensive treatment significantly delayed the progression of arterial stiffness, with an annual change of 23.1 cm·s –1·year –1vs. 36.7 cm·s –1·year -1 of baPWV in the intensive and standard treatment groups, respectively. During a median follow-up period of 3.36 years, primary CVD outcomes occurred in 77 (2.9%) patients in the intensive treatment group compared with 93 (3.5%) in the standard treatment group. Intensive treatment resulted in a significantly lower CVD risk in patients aged 70–80 years or with SBP <140 mmHg. Conclusion::Intensive blood pressure control with an SBP target of 110 mmHg to <130 mmHg could delay the progression of arterial stiffness and reduce the risk of CVD in older patients with hypertension.Clinical trial registration::http://www.clinicaltrials.gov; No. NCT03015311.

This paper reports a case of adult-onset autoimmune enteropathy (AIE) diagnosed and treated at the Department of Gastroenterology in Zhongnan Hospital of Wuhan University. The patient had intermittent abdominal pain with diarrhea and weight loss as the main clinical manifestations. Laboratory examination results showed increased IgG and IgE, and positive antinuclear antibody (ANA) . Obvious villous atrophy of duodenum and ileum was observed under endoscopy. The intestinal biopsy showed villous atrophy of duodenum, reduction of goblet cells, lymphocyte infiltration of the lamina propria and flattening and blunting of villous of ileum mucosa. The patient was comprehensively diagnosed as AIE. Prednisone therapy is effective and the patients is being followed up closely. Adult-onset AIE is rare. Summarizing the diagnosis and treatment experience of this patient is helpful to improve clinicians′ understanding of diagnosis and differential diagnosis of AIE.

This paper reports a case of adult-onset autoimmune enteropathy (AIE) diagnosed and treated at the Department of Gastroenterology in Zhongnan Hospital of Wuhan University. The patient had intermittent abdominal pain with diarrhea and weight loss as the main clinical manifestations. Laboratory examination results showed increased IgG and IgE, and positive antinuclear antibody (ANA) . Obvious villous atrophy of duodenum and ileum was observed under endoscopy. The intestinal biopsy showed villous atrophy of duodenum, reduction of goblet cells, lymphocyte infiltration of the lamina propria and flattening and blunting of villous of ileum mucosa. The patient was comprehensively diagnosed as AIE. Prednisone therapy is effective and the patients is being followed up closely. Adult-onset AIE is rare. Summarizing the diagnosis and treatment experience of this patient is helpful to improve clinicians′ understanding of diagnosis and differential diagnosis of AIE.

ABSTRACT: Meningiomas are the most common primary intracranial neoplasm with diverse pathological types and complicated clinical manifestations. The fifth edition of the WHO Classification of Tumors of the Central Nervous System (WHO CNS5), published in 2021, introduces major changes that advance the role of molecular diagnostics in meningiomas. To follow the revision of WHO CNS5, this expert consensus statement was formed jointly by the Group of Neuro-Oncology, Society of Neurosurgery, Chinese Medical Association together with neuropathologists and evidence-based experts. The consensus provides reference points to integrate key biomarkers into stratification and clinical decision making for meningioma patients. REGISTRATION Practice guideline REgistration for transPAREncy (PREPARE), IPGRP-2022CN234.
Humans ; Meningioma/pathology* ; Consensus ; Neurosurgical Procedures ; Meningeal Neoplasms/pathology*

OBJECTIVE：To provide reference f or the qualit y sta ndard establishment of Amaranthus retroflexus. METHODS ： Taking 7 batches of A. retroflexus medicinal materials as the research object ，the appearance properties of the medicinal materials were investigated ，and the microscopic characteristics of the medicinal powders were observed. TLC method was adopted to qualitatively identify rutin ，valine and leucine in A. retroflexus medicinal materials. According to the relevant methods of the 2015 edition of Chinese Pharmacopoeia （part Ⅳ），water content ，total ash content ，acid-insoluble ash content and water-soluble extract content were determined. HPLC method was used to determine the content of rutin in the medicinal material of A. retroflexus . The determination was performed on Agilent 5 TC-C18（2）column with mobile phase consisted of methanol- 0.3％ phosphoric acid solution（40∶60，V/V），at the flow rate of 1.0 mL/min. The detection wavelength was set at 358 nm，and the column temperature was 30 ℃. The sample size was 10 μL. RESULTS：The appearance and microstructure characteristics of the medicinal materials were consistent with the existing description. The identification results of TLC meth od showed that 7 batches of medicinal materials and each reference substance （rutin，valine，leucine）showed spots of the same color at the same position. The moisture content of 7 batches of A. retroflexus medicinal materials was 7.43％-8.72％，the total ash content was 11.82％-13.78％，the acid-insoluble ash content was 0.15％-0.55％，and the water-soluble extract content was 17.27％-24.74％. The linear range of rutin was 10-200 μg/mL（R 2＝1.000 0）. RSDs of precision test ，stability test （24 h）and repeatability test were all less than 2.0％ （n＝6）. The average recovery rates of rutin were 99.14％，97.98％ and 98.80％ in low ，medium and high concentration of samples，and RSDs were 0.97％，0.95％，0.96％（n＝3）. The contents of rutin in 7 batches of A. retrophylla were 0.314-1.102 mg/g. CONCLUSIONS：In this study ，character observation ，microscopic identification ，moisture content ，total ash content ，acid- insoluble ash content and water-soluble extract content of A. retroflexus are investigated ；TLC method was established for qualitative identification of leucine ，valine and rutin in A. retroflexus ，and the HPLC method was established for content determination of rutin. It provides reference for the quality standard establishment of A. retroflexus .

Objective:To compare the efficacy of fusion and non-fusion hybrid operation with Dynesys system with the traditional fusion operation with rigid instrumentation in the patients with multi-segment lumbar degenerative disease.Methods:A total of 30 patients with multi-segment lumbar degenerative disease who were subjected to operation from January 2017 to October 2019 in Shenzhen People's Hospital were included in the study. There were 13 males and 17 females, age: 60.8±13.2 years, range: 25 to 83 years. 28 patients with two segments, 1 with three segments, and 1 with four segments. The patients were divided into two groups, i.e the hybrid operation group (13 cases, 9 males and 4 females, average age: 56.6 years, range: 25 to 83 years) versus the traditional fusion group (17 cases, 4 males and 13 females, average age: 63.9 years, range: 46 to 80 years). The main outcome measures were visual analogue scale (VAS), Oswestry disability index (ODI), range of motion (ROM), adjacent segment degeneration (ASD) and complications.Results:There were no statistically significant differences in operation data, such as operation time, intraoperative blood loss, postoperative drainage volume and length of hospitalization, between the two groups. There were no significant differences for ROM in the surgical segments between the two groups before operation (hybrid group and traditional group were 9.6°±4.9° vs. 8.9°±6.1°, t=0.341, P=0.736, respectively). However, after 12 months follow-up, the ROM disappeared in the traditional group and was partially preserved in the hybrid group, with statistically significant differences (hybrid group and traditional group were 5.4°±2.7° vs. 0°, t=9.104, P=0.001, respectively). There was a statistical difference in intervertebral disc height between the two groups at 12 months post-operation, though no statistical difference was found before operation (8.8±1.9 mm vs. 10.5±1.7 mm, t=2.927, P=0.006). There was no statistically significant difference in the intervertebral disc height of the upper adjacent vertebrae between the two groups before and after operation. There were statistically significant differences in ODI scores before operation (63.4%±11.0% vs. 71.3%±9.2%, t=2.146, P=0.041), and 12 months post-operation (17.2%±2.1% vs. 15.5%±2.3%, t=2.091, P=0.046), while no statistical difference was found in VAS scores. Conclusion:The fusion and non-fusion hybrid operation with Dynesys system has comparable clinical efficacy with the traditional fusion operation with rigid instrumentation in the treatment of multisegment lumbar degenerative disease. Meanwhile, the hybrid surgery can preserve the motion of surgical segments and provide a dynamic stability of the vertebral body. The hybrid surgery can be used as a new surgical method for multi-segment lumbar degenerative disease.

Objective To investigate the trend of early neural development in premature infants. Methods At the age of 12 months and 24 months, Bayley Scales of Infant Development were used to assess the mental development index (MDI) and the psychomotor development index (PDI) in preterm (corrected age) and full-term infants. Results At 12 months, there was no significant difference in corrected age PDI scores among different gestational age groups (<32 , 32–33+6 and 34–36+6 weeks) (P=0.820). The actual age MDI and PDI scores of full-term infants and premature infants in 34~36+6 weeks group were significantly higher than those of premature infants in <32 and 32-33+6 weeks groups, and the PDI score of full-term infants was significantly higher than that of premature infants in 34-36+6 weeks group (P<0.05). There was no significant difference in actual age PDI scores among different birth weight groups (P=0.166). The actual age MDI and PDI of full-term infants and premature infants in birth weight≥2500 g group were significantly higher than those of premature infants in <1500 g, 1500~1999 g and 2000~2499 g groups (P<0.05). At 24 months, the actual age MDI scores of full-term infants were significantly higher than those of premature infants in different gestational age and birth weight groups (P<0.05). The actual age MDI curve of premature infants in birth weight <1500g group showed a downward trend, while the actual age PDI curve showed a significant upward trend. Conclusion The neurodevelopment of preterm infants at the corrected age of 12 and 24 months reaches the level of full-term infants.