Objective To investigate the values of CT radiomics combined with machine learning algorithms for discriminating tumor deposits(TDs),lymph node metastasis(LNM)and their simultaneous occurrence in colorectal cancer(CRC).Methods Totally 261 CRC patients treated at some hospital from January 2017 to December 2023 had their clinical data analyzed retrospectively,who were classified into a TDs-positive group(TDs+group,64 cases),a LNM-positive group(LNM+group,99 cases)and a TDs-positive combined with LNM-positive group(TDs+combined with LNM+group,98 cases)according to A JCC 8th Edition:Colorectal Cancer.MaZda version 4.6 software was used to outline the region of interest,and then the texture feature parameters with the most discriminative value were selected by the screening method coming with this software.Texture feature parameters with statistically significant differences in one-way analysis(P＜0.05)were included to draw ROC curves,and the diagnostic efficacy of the included parameters was evaluated.The diagnostic efficacy of four machine learning algorithms such as Bayesian,decision tree,random forest and Logistic regression for the TDs+group,the LNM+group and the TDs+combined with LNM+group was assessed based on the included parameters and ten-fold cross-validation.Statistical analysis was performed using SPSS 26.0,MedCalc 19.1.3,Weka 3.8.6 and R language software.Results Texture feature parameters with statistically significant(P＜0.05)one-way ANOVA differences among the 3 groups included skewness,S(2,-2)and mean value,S(0,4)correlation,S(3,3)difference variance and S(0,4)inverse moments.The S(3,3)difference variance had the highest diagnostic efficacy in the TDs+group and the LNM+group,and the skewness did in the TDs+combined with LNM+group.Random forest algorithm behaved the best in diagnostic efficacy when compared with Bayesian,decision tree and Logistic regression algorithms,which had the accuracy rates being 0.897,0.830 and 0.861 and the AUCs being 0.951,0.957 and 0.958 respectively in the TDs+group,the LNM+group and the TDs+combined with LNM+group.Conclusion CT radiomics combined with random forest algorithm is of high value for discriminating TDs,LNM and their simultaneous occurrence in CRC patients,and thus can provide comprehensive diagnosis information for clinicians and help to formulate accurate treatment strategies for patients.[Chinese Medical Equipment Journal,2024,45(11):60-66]

Purpose: To investigate the effect of androgen deprivation therapy (ADT) on health-related quality of life (HRQOL) in Asian men with all stages of prostate cancer. Materials and Methods: READT (real-life evaluation of the effect of ADT in prostate cancer patients in Asia) was a multi-center, prospective observational study involving six sites across four Asian populations. We enrolled eligible prostate cancer patients, who opted for ADT alone or in combination without prior neoadjuvant or adjuvant ADT within 12 months. The EuroQoL-5 dimensions, 5 level scale (EQ-5D-5L) utility index scores and visual analog scale (VAS) were evaluated at baseline, month 6 and month 12. Results: A total of 504 patients were recruited into READT between September 2016 and May 2020 with 52.9% diagnosed with metastatic prostate cancer. The EQ-5D-5L was evaluable in 442/504 (87.7%) of patients. Overall baseline EQ-5D-5L utility index score was 0.924 (interquartile range [IQR] 0.876–1.000). We observed a statistically significant difference in baseline EQ-5D-5L utility index score among different populations with a median EQ-5D-5L utility index score of 1 for Taiwan & Hong Kong, 0.897 for China and 0.838 for Malaysia. Similar trend was observed throughout multiple treatment time-points. Stage IV prostate cancer were significantly associated with a lower baseline EQ-5D-5L utility index score compared to stage I–III prostate cancer, producing a median disutility value of -0.080. Participants had a high median VAS (80, IQR 70–90), indicating good overall health on average during ADT initiation. Conclusions The study highlights the differences in health state utility index scores among various Asian prostate cancer patients receiving ADT at real-world setting. Our findings will be informative and useful in cost-effectiveness evaluation and policy decision making.

Humans ; Consensus ; Hypersensitivity ; Desensitization, Immunologic/adverse effects* ; Immunotherapy/adverse effects* ; Injections, Subcutaneous ; Allergens

Objective: To explore the prognostic factors of extracellular NK/T cell lymphoma (ENKTL) treated with pegaspargase/L-asparaginase. Methods: The clinical data of 656 ENKTL patients diagnosed at 11 medical centers in the Huaihai Lymphoma Working Group from March 2014 to April 2021 were retrospectively analyzed. The patients were randomly divided into two groups: a training set (460 cases) and a validation set (196 cases) at 7∶3, and the prognostic factors of the patients were analyzed. A prognostic scoring system was established, and the predictive performance of different models was compared. Results: Patients' median age was 46 (34, 57) years, with 456 males (69.5% ) and 561 nasal involvement (85.5% ). 203 patients (30.9% ) received a chemotherapy regimen based on L-asparaginase combined with anthracyclines, and the 5-year overall survival rate of patients treated with P-GEMOX regimen (pegaspargase+gemcitabine+oxaliplatin) was better than those treated with SMILE regimen (methotrexate+dexamethasone+cyclophosphamide+L-asparaginase+etoposide) (85.9% vs 63.8% ; P=0.004). The results of multivariate analysis showed that gender, CA stage, the Eastern Cooperative Oncology Group performance status (ECOG PS) score, HGB, and EB virus DNA were independent influencing factors for the prognosis of ENKTL patients (P<0.05). In this study, the predictive performance of the prognostic factors is superior to the international prognostic index, Korean prognostic index, and prognostic index of natural killer lymphoma. Conclusion: Gender, CA stage, ECOG PS score, HGB, and EB virus DNA are prognostic factors for ENKTL patients treated with pegaspargase/L-asparaginase.
Male ; Humans ; Middle Aged ; Asparaginase/therapeutic use* ; Prognosis ; Retrospective Studies ; Lymphoma, Extranodal NK-T-Cell/drug therapy* ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use* ; Etoposide ; Cyclophosphamide ; Methotrexate/therapeutic use* ; DNA/therapeutic use* ; Treatment Outcome

Objective    To investigate the radiological and clinicopathological factors affecting the postoperative recurrence of early lung adenocarcinoma with micropapillary/solid structure. Methods    A total of 198 patients undergoing surgical resection for early stage lung adenocarcinoma in the First Affiliated Hospital of Nanjing Medical University from January 2016 to August 2019 were enrolled, including 100 males and 98 females, aged 28-82 (53.5±9.5) years. All patients were allocated to a recurrence group (n=21) and a non-recurrence group (n=177) according to postoperative recurrence status. Correlations of imaging and clinical features and clinical outcomes were analyzed to determine prognostic significance. Results    The mean follow-up time was 27.0±11.2 months. There was no statistical difference in the imaging features of tumor maximum diameter in mediastinal window (P=0.014), C/T ratio (P=0.001), bronchial positive sign (P=0.015), pathological features of vascular invasion (P=0.024) and postoperative chemotherapy (P<0.001) between the two groups. In multivariate analysis, vascular invasion was the only independent prognostic factor (OR=0.146, P=0.047). Conclusion    Vascular invasion is an independent risk factor for postoperative recurrence of early-stage lung adenocarcinoma with micropapillary/solid structure.

Objective: To develop effective alternatives to natural enzymes, it is crucial to develop nanozymes that are economical, resource efficient, and environmentally conscious. Carbon nanomaterials that have enzyme-like activities have been extensively developed as substitutes for traditional enzymes. Methods: Carbide-derived carbons (CDCs) were directly synthesized via a one-step electrochemical method from a MAX precursor using an ammonium bifluoride electrolyte at ambient conditions. The CDCs were characterized by systematic techniques. Results: CDCs showed bienzyme-like activities similar to that of peroxidase and superoxide dismutase. We systematically studied the dependence of CDC enzyme-like activity on different electrolytes and electrolysis times to confirm activity dependence on CDC content. Additionally, the synthesis mechanism and CDC applicability were elaborated and demonstrated, respectively. Conclusion The demonstrated synthesis strategy eliminates tedious intercalation and delamination centrifugation steps and avoids using high concentrations of HF, high temperatures, and halogen gases. This study paves the way for designing two-dimensional material-based nanocatalysts for nanoenzyme and other applications.
Ammonium Compounds/chemical synthesis* ; Carbon/chemistry* ; Electrochemical Techniques ; Enzymes ; Fluorides/chemical synthesis* ; Humans ; Nanostructures ; Oxidation-Reduction

Osteoporotic vertebral compression fracture (OVCF) can lead to lower back pain and may be even accompanied by scoliosis, neurological dysfunction and other complications, which will affect the daily activities and life quality of patients. Vertebral augmentation is an effective treatment method for OVCF, but it cannot correct unbalance of bone metabolism or improve the osteoporotic status, causing complications like lower back pain, limited spinal activities and vertebral refracture. The post-operative systematic and standardized rehabilitation treatments can improve curative effect and therapeutic efficacy of anti-osteoporosis, reduce risk of vertebral refracture, increase patient compliance and improve quality of life. Since there still lack relevant clinical treatment guidelines for postoperative rehabilitation treatments following vertebral augmentation for OVCF, the current treatments are varied with uneven therapeutic effect. In order to standardize the postoperative rehabilitation treatment, the Spine Trauma Group of the Orthopedic Branch of Chinese Medical Doctor Association organized relevant experts to refer to relevant literature and develop the "Guideline for postoperative rehabilitation treatment following vertebral augmentation for osteoporotic vertebral compression fracture (2022 version)" based on the clinical guidelines published by the American Academy of Orthopedic Surgeons (AAOS) as well as on the principles of scientificity, practicality and advancement. The guideline provided evidence-based recommendations on 10 important issues related to postoperative rehabilitation treatments of OVCF.

OBJECTIVE: To observe the efficacy of METHODS: A total of 58 participants were included. Of them, 29 patients with insomnia were included into an observation group, and 29 healthy participants were included into a control group. The patients in the observation group were treated with RESULTS: The total effective rate was 89.7% (26/29) in the observation group. In the observation group, the scores of PSQI, ISI and DISS, the A, B speed of NCT were all decreased after treatment ( CONCLUSION The
Acupuncture Therapy ; Brain/diagnostic imaging* ; Emotions ; Humans ; Magnetic Resonance Imaging ; Sleep Initiation and Maintenance Disorders/therapy*

BACKGROUND: Colorectal cancer (CRC) is the second most common cause of cancer-related deaths and has the third highest incidence in the world. Almost half of the patients with CRC have metastases at the time of diagnosis. However, the treatment for patients with metastatic CRC that progresses after approved conventional chemotherapy is still controversial. Chinese medicine (CM) has unique characteristics and advantages in treating metastatic CRC. OBJECTIVE: To assess the effectiveness and safety of CM in patients with metastatic CRC after failure of conventional chemotherapy. METHODS: The study is a multicenter prospective cohort study. A total of 384 patients with documented metastatic CRC after failure of conventional chemotherapy will be included from 9 hospitals among Beijing, Shanghai, Nanjing, and Guizhou, and assigned to three groups according to paitents' wishes: (1) integrated Chinese and Western medicine (ICM) group receiving CM herbal treatment combined with Western medicine (WM) anti-tumor therapy, (2) Chinese medicine (CM) group receiving only CM herbal treatment, and (3) WM group receiving only WM anti-tumor therapy. The primary endpoint is the overall survival (OS). Secondary endpoints include the progression free survival (PFS), quality of life (QOL) assessed by the Functional Assessment of Cancer Therapy-Colorectal (FACT-C) questionnaire, tumor control, and CM symptom score. DISCUSSION This prospective study will assess the effectiveness and safety of CM in treating metastatic CRC after conventional chemotherapy failure. Patients in the ICM group will be compared with those in the WM group and CM group. If certified to be effective, national provision of CM treatment in metastatic CRC will probably be advised. (Registration No. NCT02923622 on ClinicalTrials.gov).

Objective:To observe the effect of water-based pulmonary rehabilitation on stable chronic obstructive pulmonary disease (COPD). Methods:From February, 2020 to February, 2021, 50 patients with stable COPD in our hospital were divided into control group (n = 25) and experimental group (n = 25), who accepted pulmonary rehabilitation training on land and in water, for eight weeks. They were measured forced expiratory volume in first second (FEV₁), percents of forced expiratory volume in first second for prediction (FEV_l%) and ratio of forced expiratory volume in first second in forced vital capacity (FEV₁/FVC) with pulmonary function instrument; measured root mean square (RMS) of electromyogram of diaphragm and right transversus abdominis with surface electromyography; and assessed with modified breathlessness measurement of British Medical Research Council (mMRC), 6-minute walk test (6MWT) and quality of life scale for COPD adults (COPD-QOL) before and after treatment. Results:FEV₁, FEV_l%, FEV₁/FVC, RMS of diaphragm and transversus abdominis, and 6MWT distance and COPD-QOL score increased in both group (t > 2.08, P < 0.05), and increased more in the experimental group than in the control group (t > 2.27, P < 0.05); while mMRC score decreased (t > 2.09, P < 0.05), and decreased more in the experimental group than in the control group (t = 2.13, P < 0.05). Conclusion:Water-based pulmonary rehabilitation training can further improve lung function, strength of respiratory muscles, dyspnea, tolerance and quality of life for patients with COPD.