Retrieving keyframes most relevant to text from small intestine videos with given labels can efficiently and accurately locate pathological regions. However, training directly on raw video data is extremely slow, while learning visual representations from image-text datasets leads to computational inconsistency. To tackle this challenge, a small bowel video keyframe retrieval based on multi-modal contrastive learning (KRCL) is proposed. This framework fully utilizes textual information from video category labels to learn video features closely related to text, while modeling temporal information within a pretrained image-text model. It transfers knowledge learned from image-text multimodal models to the video domain, enabling interaction among medical videos, images, and text data. Experimental results on the hyper-spectral and Kvasir dataset for gastrointestinal disease detection (Hyper-Kvasir) and the Microsoft Research video-to-text (MSR-VTT) retrieval dataset demonstrate the effectiveness and robustness of KRCL, with the proposed method achieving state-of-the-art performance across nearly all evaluation metrics.
Humans ; Video Recording ; Intestine, Small/diagnostic imaging* ; Machine Learning ; Image Processing, Computer-Assisted/methods* ; Algorithms

Objective:To investigate the value of midtreatment 18F-FDG PET/CT metabolic parameters for predicting the pathological response in patients with locally advanced gastric cancer (LAGC) after neoadjuvant immunochemotherapy (NICT). Methods:Twenty-five LAGC patients (19 males, 6 females, age: (64.8±8.6) years) who underwent 18F-FDG PET/CT after NICT in Henan Cancer Hospital from August 2019 to June 2024 were retrospectively analyzed. The lesion′s ROI was delineated, then the SUV max and metabolic tumor volume (MTV) were measured, and the SUV max was divided by SUV mean of the descending aorta to obtain the tumor-to-background ratio (TBR). Patients underwent surgery after PET/CT imaging. Based on the tumor regression grade (TRG) system by the American Joint Committee on Cancer (AJCC) criteria on surgical specimen, patients were divided into responders (TRG0+ 1) and non-responders (TRG2+ 3). Independent-sample t test, Mann-Whitney U test, one-way analysis of variance, and Kruskal-Wallis rank-sum test were used to compare the differences of data. The predictive efficacy of PET/CT metabolic parameters was assessed by the ROC curve analysis. Results:Postsurgical pathology showed that 9 patients were responders and 16 were non-responders. The SUV max (3.10±1.95) and TBR (2.44±1.54) of primary lesions in responders were lower than those in non-responders (7.40±4.68, 5.85±3.74; t values: -2.61, -2.59, both P<0.05), while the MTV of primary tumors and short diameter and metabolic parameters of positive lymph nodes were not significantly different between those 2 groups ( t=-1.50, Z values: -1.09 to -0.75, all P>0.05). No significant relation was found between PET/CT parameters and pathological differentiation or Lauren classification, or other pathological features ( t values: -1.55 to 1.38, Z values: -1.84 to 0, F values: 0.12-2.43, H values: 0.13-0.98, all P>0.05). ROC curve showed that the cut-off value of SUV max for predicting postoperative TRG was 5.40, and the AUC reached 0.77 (95% CI: 0.56-0.91), with the sensitivity and specificity of 9/16, 9/9, respectively. With TBR=3.54 as the cut-off value, its AUC reached 0.77 (95% CI: 0.56-0.91), and the sensitivity and specificity were 11/16, 8/9, respectively. The sensitivity and specificity of PET/CT for predicting lymph node positivity of patients were 8/12 and 13/13, respectively. Conclusion:Interim 18F-FDG PET/CT metabolic parameters can accurately predict the pathological response of LAGC patients after NICT.

Objective To investigate the value of cranial CT cisternal grading combined with D-dimer(D-D)and Glasgow Coma Scale(GCS)score in predicting the short-term postoperative prog-nosis of patients with severe traumatic brain injury.Methods A total of 165 patients with severe trau-matic brain injury who were treated in the hospital from January 2019 to May 2024 were selected as study subjects,all underwent craniotomy surgery.Postoperative follow-up was conducted for 3 months to analyze the differences in clinical data and preoperative indicators such as cranial CT cisternal grad-ing,D-D levels,and GCS scores between patients with poor and good prognosis.The value of cranial CT cisternal grading,D-D levels,and GCS scores in predicting short-term postoperative poor prognosis in patients with severe traumatic brain injury was also analyzed.Results Compared with patients with good prognosis,patients with poor prognosis had higher proportion of age,cranial CT cisternal grading of Ⅰ to Ⅱ,D-D levels,and GCS scores＜6(P＜0.05).There were no statistically significant differences in C-reactive protein,prothrombin time,activated partial thromboplastin time,international normalized ratio,total cholesterol,triglycerides,high-density lipoprotein cholesterol,and low-density lipoprotein cholesterol levels between patients with poor and good prognosis(P＞0.05).Cranial CT cisternal grading,D-D levels,and GCS scores were influencing factors for short-term postoperative poor prognosis in patients with severe traumatic brain injury(P＜0.05).The area under the curve for poor prognosis by three indicators in combination was 0.941(95％CI,0.906 to 0.975),which was higher than the area under the curve for the individual predictions of cranial CT cisternal grad-ing,D-D levels,and GCS scores(P＜0.05).Conclusion The influencing factors for short-term postoperative prognosis in patients with severe traumatic brain injury include cranial CT cisternal grading,D-D levels,and GCS scores.The model based on these three indicators has certain appli-cation value in predicting patient prognosis.

Objective To investigate the correlation between maternal serum folic acid(FA),monocyte chemoattractant protein-1(MCP-1),progesterone-induced blocking factor(PIBF)levels and embryonic development cessation in early pregnancy.Methods From December 2021 to December 2023,98 pregnant women with embryonic development cessation in early pregnancy admitted to the Second Hospital of Jingzhou were regarded as the cessation group,and 50 normal early pregnancy pregnant women who underwent pregnancy examinations during the same period were as the control group.General clinical data was collected and analyzed.Enzyme-linked immunosorbent assay(ELISA)was applied to detect serum levels of FA,MCP-1 and PIBF.Multivariate logistic regression was applied to analyze the influencing factors of early pregnancy embryo cessation of development.Receiver operating characteristic(ROC)curve was plotted to analyze the predictive value of serum FA,MCP-1,and PIBF for early embryonic development cessation in pregnancy.Pearson method was applied to analyze the correlation between serum FA,MCP-1,PIBF,progesterone(PROG),estradiol(E2)and β-human chorionic gonadotropin(β-HCG).Results Compared with the control group,the serum FA(9.51±1.21 nmol/L vs 11.32±1.56 nmol/L)and PIBF(295.46±30.22 ng/ml vs 342.14±36.97 ng/ml)levels in the cessation group were greatly reduced,while the serum MCP-1(1.02±0.15 mg/ml vs 0.82±0.11 mg/ml)level was greatly increased,and the differences were statistically significant(t=7.785,8.347,8.229,all P＜0.001).There were great statistical differences in the history of embryonic development cessation(75.64%vs 25.36%),PROG(13.32±1.81 ng/ml vs 23.65±2.74 ng/ml),E2(221.34±25.69 pmol/L vs 298.65±31.64 pmol/L),and β-HCG levels(5 323.62±536.85U/L vs 8 562.31±924.55 U/L)between the two groups(t/χ2=6.548～27.428,all P<0.05).Pregnant women's history of embryonic development cessation and elevated level of MCP-1 were risk factors for embryonic development cessation in early pregnancy(Wald χ2=4.239,4.613,all P<0.05),while elevated levels of β-HCG,FA and PIBF were protective factors for embryonic development cessation in early pregnancy(Wald χ2=4.476,4.423,5.974,all P<0.05).The AUC of FA,MCP-1,PIBF,and their combination in predicting early embryonic development cessation in pregnancy was 0.811,0.805,0.816 and 0.908,respectively.The combined prediction was greatly better than that of individual diagnosis of FA MCP-1,and PIBF(Z=2.749,2.381,1.993,all P<0.05).FA and PIBF were positively correlated with PROG,E2 and β-HCG(r=0.433～0.512,all P<0.05),while MCP-1 was negatively correlated with PROG,E2 and β-HCG(r=-0.432,-0.487,-0.458,all P<0.05).Conclusion The serum levels of FA and PIBF in pregnant women with embryonic development cessation in early pregnancy decrease,while the level of MCP-1 increases.These three factors are all influencing factors for embryonic development cessation in pregnant women,and have certain auxiliary predictive value for embryonic development cessation in early pregnancy.

Objective To investigate the correlation between maternal serum folic acid(FA),monocyte chemoattractant protein-1(MCP-1),progesterone-induced blocking factor(PIBF)levels and embryonic development cessation in early pregnancy.Methods From December 2021 to December 2023,98 pregnant women with embryonic development cessation in early pregnancy admitted to the Second Hospital of Jingzhou were regarded as the cessation group,and 50 normal early pregnancy pregnant women who underwent pregnancy examinations during the same period were as the control group.General clinical data was collected and analyzed.Enzyme-linked immunosorbent assay(ELISA)was applied to detect serum levels of FA,MCP-1 and PIBF.Multivariate logistic regression was applied to analyze the influencing factors of early pregnancy embryo cessation of development.Receiver operating characteristic(ROC)curve was plotted to analyze the predictive value of serum FA,MCP-1,and PIBF for early embryonic development cessation in pregnancy.Pearson method was applied to analyze the correlation between serum FA,MCP-1,PIBF,progesterone(PROG),estradiol(E2)and β-human chorionic gonadotropin(β-HCG).Results Compared with the control group,the serum FA(9.51±1.21 nmol/L vs 11.32±1.56 nmol/L)and PIBF(295.46±30.22 ng/ml vs 342.14±36.97 ng/ml)levels in the cessation group were greatly reduced,while the serum MCP-1(1.02±0.15 mg/ml vs 0.82±0.11 mg/ml)level was greatly increased,and the differences were statistically significant(t=7.785,8.347,8.229,all P＜0.001).There were great statistical differences in the history of embryonic development cessation(75.64%vs 25.36%),PROG(13.32±1.81 ng/ml vs 23.65±2.74 ng/ml),E2(221.34±25.69 pmol/L vs 298.65±31.64 pmol/L),and β-HCG levels(5 323.62±536.85U/L vs 8 562.31±924.55 U/L)between the two groups(t/χ2=6.548～27.428,all P<0.05).Pregnant women's history of embryonic development cessation and elevated level of MCP-1 were risk factors for embryonic development cessation in early pregnancy(Wald χ2=4.239,4.613,all P<0.05),while elevated levels of β-HCG,FA and PIBF were protective factors for embryonic development cessation in early pregnancy(Wald χ2=4.476,4.423,5.974,all P<0.05).The AUC of FA,MCP-1,PIBF,and their combination in predicting early embryonic development cessation in pregnancy was 0.811,0.805,0.816 and 0.908,respectively.The combined prediction was greatly better than that of individual diagnosis of FA MCP-1,and PIBF(Z=2.749,2.381,1.993,all P<0.05).FA and PIBF were positively correlated with PROG,E2 and β-HCG(r=0.433～0.512,all P<0.05),while MCP-1 was negatively correlated with PROG,E2 and β-HCG(r=-0.432,-0.487,-0.458,all P<0.05).Conclusion The serum levels of FA and PIBF in pregnant women with embryonic development cessation in early pregnancy decrease,while the level of MCP-1 increases.These three factors are all influencing factors for embryonic development cessation in pregnant women,and have certain auxiliary predictive value for embryonic development cessation in early pregnancy.

Objective:To investigate the value of midtreatment 18F-FDG PET/CT metabolic parameters for predicting the pathological response in patients with locally advanced gastric cancer (LAGC) after neoadjuvant immunochemotherapy (NICT). Methods:Twenty-five LAGC patients (19 males, 6 females, age: (64.8±8.6) years) who underwent 18F-FDG PET/CT after NICT in Henan Cancer Hospital from August 2019 to June 2024 were retrospectively analyzed. The lesion′s ROI was delineated, then the SUV max and metabolic tumor volume (MTV) were measured, and the SUV max was divided by SUV mean of the descending aorta to obtain the tumor-to-background ratio (TBR). Patients underwent surgery after PET/CT imaging. Based on the tumor regression grade (TRG) system by the American Joint Committee on Cancer (AJCC) criteria on surgical specimen, patients were divided into responders (TRG0+ 1) and non-responders (TRG2+ 3). Independent-sample t test, Mann-Whitney U test, one-way analysis of variance, and Kruskal-Wallis rank-sum test were used to compare the differences of data. The predictive efficacy of PET/CT metabolic parameters was assessed by the ROC curve analysis. Results:Postsurgical pathology showed that 9 patients were responders and 16 were non-responders. The SUV max (3.10±1.95) and TBR (2.44±1.54) of primary lesions in responders were lower than those in non-responders (7.40±4.68, 5.85±3.74; t values: -2.61, -2.59, both P<0.05), while the MTV of primary tumors and short diameter and metabolic parameters of positive lymph nodes were not significantly different between those 2 groups ( t=-1.50, Z values: -1.09 to -0.75, all P>0.05). No significant relation was found between PET/CT parameters and pathological differentiation or Lauren classification, or other pathological features ( t values: -1.55 to 1.38, Z values: -1.84 to 0, F values: 0.12-2.43, H values: 0.13-0.98, all P>0.05). ROC curve showed that the cut-off value of SUV max for predicting postoperative TRG was 5.40, and the AUC reached 0.77 (95% CI: 0.56-0.91), with the sensitivity and specificity of 9/16, 9/9, respectively. With TBR=3.54 as the cut-off value, its AUC reached 0.77 (95% CI: 0.56-0.91), and the sensitivity and specificity were 11/16, 8/9, respectively. The sensitivity and specificity of PET/CT for predicting lymph node positivity of patients were 8/12 and 13/13, respectively. Conclusion:Interim 18F-FDG PET/CT metabolic parameters can accurately predict the pathological response of LAGC patients after NICT.

Objective:To investigate the effects of RNA binding protein 15(RBM15)on the malignant biological behaviors of cervical cancer cells by regulating the Wnt/β-catenin pathway through ATPase family AAA-domain containing 3A(ATAD3A).Methods:TCGA database was used to analyze the expression level of RBM15 mRNA in cervical cancer tissues and its relationship with patient prognosis.32 samples of cervical cancer tissues and adjacent para-cancerous tissues surgically removed in Ganzhou People's Hospital between January and October 2024,as well as cervical cancer cells HeLa,MS-751,C-33A,and SiHa,were collected.The expression levels of RBM15 in cervical cancer tissues and cells were detected by immunohistochemistry and WB assay.m6A modification sites in ATAD3A mRNA were screened by the SRAMP online database.The interaction between RBM15 and ATAD3A mRNA were identified by RNA immunoprecipitation assay,RNA decay assay,and salvage assay.Knockdown or overexpression of RBM15 and ATAD3A in cervical cancer HeLa and SiHa cells were conducted by RNA interference and viral infection.The expressions of mRNA and protein were detected by qPCR and WB methods,while the proliferation,migration,and invasion abilities of cells in each group were assessed by CCK-8 method,scratch assay,and Transwell assay.Results:The positivity rates of RBM15 mRNA and protein in cervical cancer tissues were significantly higher than those in adjacent para-cancerous tissues(both P<0.001).The protein expression levels of RBM15 in cervical cancer cell lines HeLa,MS-751,C-33A,and SiHa were significantly higher than those in normal cervical cell lines Ect1/E6E7(all P<0.001).The 5-year progression free survival rate of the RBM15 mRNA high expression group was lower than that of the low expression group(P<0.001).Compared with that in adjacent para-cancerous tissues,the expression level of ATAD3A was significantly upregulated in cervical cancer tissues(P<0.001).RBM15 mRNA was positively correlated with ATAD3A mRNA(r=0.601,P<0.05).There were highly reliable m6A modification sites at position 501,5 312,12 137 in ATAD3A mRNA.Overexpression of RBM15 in HeLa and SiHa cells led to an increase in ATAD3A mRNA and protein expressions,while knockdown of RBM15 resulted in a decrease in ATAD3A mRNA and protein expression(all P<0.001).RNA immunoprecipitation experiment showed that compared with the IgG group,ATAD3A mRNA was significantly enriched in the immunoprecipitation of RBM15 antibody(both P<0.001).MeRIP-qPCR experiment showed that there was significant m6A methylation enrichment at positions ATAD3A mRNA 501,5 312 and 12 137(all P<0.001).RNA decay experiments showed that knocking down RBM15 in HeLa and SiHa cells could reduce the half-life and stability of ATAD3A mRNA(all P<0.001).Knocking down the expression of RBM15 in HeLa and SiHa cells could significantly inhibit the proliferation,migration,and invasion of cancer cells and significantly reduce the expressions of Wnt/β-catenin pathway related proteins Wnt3,β-catenin,and vimentin,while overexpression of ATAD3A could completely reverse the above inhibiting effects(all P<0.001).Conclusion:RBM15 can modify ATAD3A mRNA and regulate the Wnt/β-catenin pathway through m6A,and thus promote the proliferation,migration and invasion of cervical cancer cells.

OBJECTIVES: To evaluate the immunogenicity and osteogenic ability of animal-derived bone graft material decellularized with supercritical carbon dioxide. METHODS: Porcine femurs were randomly divided into two groups after preliminary treatment, and decellularized with conventional method (control group) or supercritical carbon dioxide (experimental group). Allogenic demineralized bone matrix was used as positive control. Clearance rate of galactose-α-1, 3-galactose (α-Gal) antigen was determined by enzyme-linked immunosorbent assay and residual DNA was detected by a fluorescence method. Nine SPF-grade male athymic nude mice of 6 weeks old were randomly divided into experimental, control and positive control groups. Samples were implanted over biceps femoris muscle of athymic nude mice. The explants were collected 4 weeks post implantation. Hematoxylin and eosin (HE) staining and immunohistochemistry were applied to determine the osteogenic ability and bone tissue-associated protein expressions of the implants. RESULTS: The clearance rates of α-Gal antigen in the experimental group and the control group were (99.09±0.26)% and (30.18±2.02)%, respectively (t=58.67, P<0.01). The residual DNA of the experimental, control and positive control groups were (13.49±0.07), (15.20±0.21) and (14.70±0.17) ng/mg. The residual DNA in the experimental group was significantly lower than that in the control group (t=－13.41, P<0.01) and positive control group (t=－11.30, P<0.01). HE staining results showed that multiple bone formation centers with active osteogenesis and rich bone marrow were observed in experimental group 4 weeks after implantation, but only a small number of bone formation centers were observed in the control and positive control groups, with no obvious osteoblasts present. Immunohistochemistry results indicated that the expressions of alkaline phosphatase, Runt-related transcription factor 2, collagen typeⅠand osteocalcin in the experimental group showed an increasing trend compared with those in the control and positive control groups. CONCLUSIONS Compared with clinically used allogenic demineralized bone matrix and bone graft material decellularized with conventional method, bone graft material decellularized with supercritical carbon dioxide exhibits lower immunogenicity and better osteogenic ability.
Animals ; Mice ; Swine ; Male ; Bone Transplantation/methods* ; Mice, Nude ; Carbon Dioxide ; Osteogenesis/drug effects* ; Femur ; Bone Substitutes ; Tissue Engineering/methods*

Benign anastomotic stenosis remains a common complication after bilojejunal anastomosis. Its pathogenesis includes the histology of bile duct, bile erosion, and inappropriate choice of surgical anastomosis or suture materials. Biliojejunal anastomotic stenosis can be determined preoperatively by MRCP, CT, and three-dimensional image reconstruction. Surgery remains treatment of choice for most cases, including surgical reconstruction and minimally invasive treatment, while the incidence of restenosis, residual stone, and reoperation is still high. Surgeons are still in search of optimal treatment modality to avoid anastomotic stenosis. In this article, we review the literature and summarize the latest clinical progress in the diagnosis and treatment of biliojejunal anastomotic stenosis combined with hepatic ductal stones.

Objective:To investigate the changing trends in cardiac function following xenogeneic heterotopic heart transplantation of multi-gene edited pig hearts and assess the impact of recipient immune responses on donor heart, laying experimental groundwork for the clinical application of gene editing technology.Methods:On December 16, 2023, xenogeneic heterotopic heart transplantation was performed between pigs and rhesus monkeys. Functional status of the graft under post-transplantation load conditions and recipient immune indicators were observed.Results:The recipient monkeys survived for 40 days with satisfactory functionality of both donor and recipient hearts, and no hyperacute or acute immune rejection reactions were observed.Conclusion:Multi-gene editing technology provides potential for xenotransplantation, yet further exploration is needed for its clinical application.