Objective To construct a quality control model for cervical liquid-based thin cell smears using two different artificial intelligence(AI)techniques and to compare the total use of the two methods to improve the level of quality control of cervical liquid-based thin cell smears through the assistance of hybrid AI.Methods In this study,105 cervical liquid-based thin cell smear samples were used.Convolutional neural network(CNN)algorithm and Transformer network algorithm were used as specific AI algorithms in the AI model.The labeled features included the number of cells in the slice,excessive red blood cells,excessive inflammatory cells,and air bubbles.The smear samples were pre-processed and digitized by smear,followed by image segmentation and feature extraction.Using the labeled feature data,machine learning models were trained and optimized.Statistical AI and physician QC results were analyzed by calculating KAPPA index,sensitivity,specificity,area under the curve(AUC),and other indexes for AI QC results.Results CNN algorithm QC results in normal smear,inflammatory background and bloody background were significantly different from the expert review QC results(P＜0.001).Transformer algorithm QC results were similar to the expert review results,with no statistical difference(P＞0.05).General practitioner QC results were statistically different from the expert review QC results in normal smear detection rate and bloody background(P＜0.001).CNN algorithm Kappa value was 0.567,which had medium consistency with expert review results.Transformer algorithm Kappa value was 0.890,with the best consistency with expert review results.General practitioner Kappa value was 0.675,which had better consistency with expert review results.Using the expert review results as a reference standard,the predictive efficacy of the Transformer algorithm and the general practitioners' QC results was evaluated,and the predictive efficacy of the Transformer algorithm was higher than that of the general practitioners in detecting hemorrhagic backgrounds and normal smears(inflammatory backgrounds:AUC=1.000;normal smears:AUC=0.768)(hemorrhagic backgrounds:AUC=0.849;normal smears:AUC=0.849;normal smear:AUC=0.500).Conclusion In this study,we found that the Transformer algorithm was effective in improving the quality control of cervical liquid-based thin-layer cell smears by assisting doctors to perform smear quality control scoring and improving the efficiency and accuracy of smear sample quality control.It can be used as a new quality control method for cervical cancer cytological screening and has potential clinical applications.

Glucagonoma is a rare neuroendocrine tumor derived from the pancreatic α cells, and alopecia is an uncommon clinical manifestation. We report a case of glucagonoma presenting with marked alopecia, aiming to raise clinicians′ awareness of this rare presentation.

Objective To construct a quality control model for cervical liquid-based thin cell smears using two different artificial intelligence(AI)techniques and to compare the total use of the two methods to improve the level of quality control of cervical liquid-based thin cell smears through the assistance of hybrid AI.Methods In this study,105 cervical liquid-based thin cell smear samples were used.Convolutional neural network(CNN)algorithm and Transformer network algorithm were used as specific AI algorithms in the AI model.The labeled features included the number of cells in the slice,excessive red blood cells,excessive inflammatory cells,and air bubbles.The smear samples were pre-processed and digitized by smear,followed by image segmentation and feature extraction.Using the labeled feature data,machine learning models were trained and optimized.Statistical AI and physician QC results were analyzed by calculating KAPPA index,sensitivity,specificity,area under the curve(AUC),and other indexes for AI QC results.Results CNN algorithm QC results in normal smear,inflammatory background and bloody background were significantly different from the expert review QC results(P＜0.001).Transformer algorithm QC results were similar to the expert review results,with no statistical difference(P＞0.05).General practitioner QC results were statistically different from the expert review QC results in normal smear detection rate and bloody background(P＜0.001).CNN algorithm Kappa value was 0.567,which had medium consistency with expert review results.Transformer algorithm Kappa value was 0.890,with the best consistency with expert review results.General practitioner Kappa value was 0.675,which had better consistency with expert review results.Using the expert review results as a reference standard,the predictive efficacy of the Transformer algorithm and the general practitioners' QC results was evaluated,and the predictive efficacy of the Transformer algorithm was higher than that of the general practitioners in detecting hemorrhagic backgrounds and normal smears(inflammatory backgrounds:AUC=1.000;normal smears:AUC=0.768)(hemorrhagic backgrounds:AUC=0.849;normal smears:AUC=0.849;normal smear:AUC=0.500).Conclusion In this study,we found that the Transformer algorithm was effective in improving the quality control of cervical liquid-based thin-layer cell smears by assisting doctors to perform smear quality control scoring and improving the efficiency and accuracy of smear sample quality control.It can be used as a new quality control method for cervical cancer cytological screening and has potential clinical applications.

Glucagonoma is a rare neuroendocrine tumor derived from the pancreatic α cells, and alopecia is an uncommon clinical manifestation. We report a case of glucagonoma presenting with marked alopecia, aiming to raise clinicians′ awareness of this rare presentation.

Objective To clarify whether the use of dynamic coronary artery roadmap(DCR)technology in a low-dose mode with 7.5 frames per second during coronary intervention can further reduce the total radiation dose,fluoroscopy time,and contrast agent usage.Methods A total of 94 patients,who received coronary angiography at the Shanghai Tongji Hospital of China between July 2022 and December 2022,were enrolled in this study.The patients were randomly divided into DCR group(n=53)and control group(n=41).DCR technology was used in the DCR group to guide the performance of percutaneous coronary intervention(PCI),while low-dose mode coronary angiography was adopted in the control group.The total air kerma(AK),dose-area product(DAP),intraoperative fluoroscopy time,and contrast agent usage were compared between the two groups.Results In the DCR group AK was(597.9±222.8)mGy,which was significantly lower than(717.0±326.8)mGy in the control group(P=0.039);DAP was(33.2±13.3)Gycm2/s,which was also remarkably lower than(41.3±21.5)Gycm2/s in the control group(P=0.027).In the DCR group and the control group,the intraoperative fluoroscopy time was(9.8± 3.3)min and(12.1±4.3)min respectively(P＜0.01),and the contrast agent usage was(122.3±19.0)mL and(130.5± 28.5)mL respectively(P=0.116).Conclusion In a low-dose mode during coronary intervention,the use of DCR technology can further reduce radiation dose,fluoroscopy time,and contrast agent usage.(J Intervent Radiol,2024,33:236-239)

Objective:To analyze the short-term clinical efficacy and safety of arsenic trioxide (ATO) combined with a modified N7 induction regimen in the treatment of children with high-risk neuroblastoma (NB).Methods:This study was a prospective, single-arm, multicenter phase Ⅱ clinical study. Sixty-seven high-risk NB children from eight units of Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Wuhan Children′s Hospital of Tongji Medical College of Huazhong University of Science and Technology, First Affiliated Hospital of Guangxi Medical University, Hainan General Hospital, Affiliated Hospital of Guangdong Medical University, Kunming Children′s Hospital, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, and Guangdong Provincial Agricultural Reclamation Center Hospital were enrolled from January 2019 to August 2023 and were treated with ATO combined with a modified N7 induction regimen. The efficacy and adverse effects at the end of induction chemotherapy were assessed and analyzed, and the differences in the clinical characteristics were further compared between the treatment-responsive and treatment-unresponsive groups by using the Fisher′s exact test.Results:Among 67 high-risk NB children, there were 40 males (60%) and 27 females (40%), with the age of disease onset of 3.5 (2.6, 4.8) years. Primary NB sites were mostly in retroperitoneum (including adrenal gland) (56/67, 84%) and the common metastases sites at initial diagnosis were distant lymph node in 25 cases (37%),bone in 48 cases (72%),bone marrow in 56 cases (84%) and intracalvarium in 3 cases (4%). MYCN gene amplification were detected in 28 cases (42%). At the end of induction, 33 cases (49%) achieved complete remission, 29 cases (43%) achieved partial remission, 1 case (1%) with stable disease, and 4 cases (6%) were assessed as progressive disease (PD). The objective remission rate was 93% (62/67) and the disease control rate was 94% (63/67). The percentage of central system metastases at the initial diagnosis was higher in the treatment-unresponsive group than in the treatment-responsive group (2/5 vs. 2% (1/62), P=0.013), whereas the difference in MYCN gene amplification was not statistically significant between two groups (3/5 vs.40% (25/62), P=0.786). Grade Ⅲ or higher adverse reactions during the induction chemotherapy period were myelosuppression occurred in 60 cases (90%), gastrointestinal symptoms occurred in 33 cases (49%), infections occurred in 20 cases (30%), hepatotoxicity occurred in 4 cases (6%), and cardiovascular toxicity occurred in 1 case (2%). There were no chemotherapy-related deaths. Conclusion:ATO combined with N7-modified induction regimen had a superiority in efficacy and safety, which deserved further promotion in clinical practice.

Objective To prepare paclitaxel-natural borneol complex,and to explore the prescription and preparation process of paclitaxel-natural borneol complex drug-loaded submicroemulsion,and its in vitro anti-tumor effect.Methods The Paclitaxel-natural borneol complex was prepared by grinding method and identified by Fourier Transform infrared spectroscopy(FT-IR)and differential scanning calorimetry(DSC).The compound drug-loaded submicroemulsion was prepared using a two-step high-pressure emulsification method.The single-factor investigation and the orthogonal experimental design were applied to optimize the formulation and preparation process.MTT assay,cell cloning assay,and cell scratch assay were used to evaluate the effect of this preparation on HCT-116 cells.Results The infrared spectral absorption peaks of taxol-natural borneol complex at 3 312.76 cm-1 and 3 513.92 cm-1 disappeared,and DSC analysis showed that a new absorption peak of taxol-natural borneol complex appeared at 154.56 ℃,indicating that taxol be coupled with natural borneol to form a new complex.The optimal prescription was 0.44％active pharmaceutical ingredient[paclitaxel-natural borneol(1∶3)],10％medium chain triglyceride,3％emulsifier[egg yolk lecithin-Poloxam 188(1∶2)],2％glycerol,0.3％oleate.The optimal process was emulsification at 80 ℃,60 MPa high pressure homogenization 10 times.The half inhibitory concentration(IC50)was 0.75 μg·mL-1 by MTT asssy in cell.In the cell cloning assay,the scratch healing area of blank control group,paclitaxel raw material and paclitaxel/natural borneol submicroemulsion were(36.44±3.35)％,(13.59±9.28)％,(8.30±4.09)％,respectively.The results were statistically significant(P＜0.05).In the plate cloning experiment,the cell cloning rates of blank control group,paclitaxel bulk drug group and submicroemulsion group were(37.92±0.729)％,(9.16±1.335)％and(3.36±1.065)％,respectively,the differents were statistically significant(P＜0.05).Conclusion This submicroemulsion has reasonable prescription,feasible process and good stability.Cell experiments showed that the submicronemulision effectively inhibits the proliferation and migration of HCT-116 cells,suggesting its potential as a promising antitumor agent.

Hepatocellular carcinoma (HCC) is one of the most common malignancies and a leading cause of cancer-related death worldwide. Surgery remains the primary and most successful therapy option for the treatment of early- and mid-stage HCCs, but the high heterogeneity of HCC renders prognostic prediction challenging. The construction of relevant prognostic models helps to stratify the prognosis of surgically treated patients and guide personalized clinical decision-making, thereby improving patient survival rates. Currently, the prognostic assessment of HCC is based on several commonly used staging systems, such as Tumor-Node-Metastasis (TNM), Cancer of the Liver Italian Program (CLIP), and Barcelona Clinic Liver Cancer (BCLC). Given the insufficiency of these staging systems and the aim to improve the accuracy of prognostic prediction, researchers have incorporated further prognostic factors, such as microvascular infiltration, and proposed some new prognostic models for HCC. To provide insights into the prospects of clinical oncology research, this review describes the commonly used HCC staging systems and new models proposed in recent years.
Humans ; Carcinoma, Hepatocellular/pathology* ; Liver Neoplasms/pathology* ; Prognosis ; Neoplasm Staging ; Survival Rate ; Retrospective Studies

In the past, the use of neoadjuvant androgen deprivation therapy (ADT) for prostate cancer did not exhibit survival benefits and was not recommended by the practicing guidelines. In recent years, with the emergence of novel hormonal therapeutics such as Abiraterone, Enzalutamide, Apalutamide and Darolutamide, the interest for neoadjuvant therapy has been reignited. Here, we summarize the four categories of neoadjuvant therapy with new hormonal agents, and discuss how to evaluate the efficacy and explore the molecular mechanism after neoadjuvant therapy.

To investigate the effect of long-term indwelling gastric tube on the prevention and treatment of esophageal stenosis after endoscopic submucosal dissection (ESD) for esophageal circumferential superficial cancer, data of patients with esophageal circumferential superficial cancer who underwent ESD in the First Affiliated Hospital of Nanjing Medical University from January 2018 to December 2021 were retrospectively analyzed. There were 15 patients with gastric tube placement (GTP) after ESD (the GTP group ), and 23 patients without GTP (the non-GTP group). The general information, lesion location, pathological stage, postoperative complications, degree of esophageal stenosis (water intake), pain conditions, number of hospitalizations and medical expenses were compared between the two groups. The results showed that there was no significant difference in age, gender, lesion location or postoperative pathological stage between the two groups ( P>0.05). Compared with the non-GTP group, the rate of water intake in the GTP group was significantly higher (11/15 VS 6/23, P<0.05), the frequency of pain was less in the GTP group (7.3±3.1 times VS 10.7±3.6 times, t=3.00, P<0.05), and the number of hospitalizations and the medical expenses after ESD to before and after stent placement were significantly lower in the GTP group than those in the non-GTP group ( P<0.05). There were no significant differences in the incidence of delayed bleeding and perforation, or time of the first stenosis after ESD between the two groups ( P>0.05). The results of the study initially showed that long-term indwelling gastric tube after ESD can reduce the degree of esophageal stenosis with good safety for esophageal circumferential superficial lesions.