Invasive mucinous adenocarcinoma (IMA) is a rare subtype of pulmonary adenocarcinoma, accounting for approximately 2%-10% of all pulmonary adenocarcinoma cases. IMA is characterized by a high frequency of intrapulmonary metastasis and a generally poor prognosis. Clinically, IMA often presents with nonspecific pneumonia-like symptoms. Radiologically, it manifests as multilobar and multifocal consolidations and ground-glass opacities, which significantly overlap with the radiologic features of pneumonia and other benign or malignant tumors. Consequently, IMA is frequently misdiagnosed in clinical practice, and a definitive diagnosis is nearly impossible upon initial presentation, leading to delayed treatment and a poor prognosis. Currently, there is a lack of systematic reviews correlating the clinical manifestations, pathological characteristics, and radiologic features of IMA. This review aims to systematically elucidate the clinical, pathological, and radiologic features of IMA, and thoroughly analyze its diagnostic challenges and key points for differential diagnosis, in order to provide a theoretical basis and practical guidance for the early diagnosis of this disease.

Invasive mucinous adenocarcinoma (IMA) is a rare subtype of pulmonary adenocarcinoma, accounting for approximately 2%-10% of all pulmonary adenocarcinoma cases. IMA is characterized by a high frequency of intrapulmonary metastasis and a generally poor prognosis. Clinically, IMA often presents with nonspecific pneumonia-like symptoms. Radiologically, it manifests as multilobar and multifocal consolidations and ground-glass opacities, which significantly overlap with the radiologic features of pneumonia and other benign or malignant tumors. Consequently, IMA is frequently misdiagnosed in clinical practice, and a definitive diagnosis is nearly impossible upon initial presentation, leading to delayed treatment and a poor prognosis. Currently, there is a lack of systematic reviews correlating the clinical manifestations, pathological characteristics, and radiologic features of IMA. This review aims to systematically elucidate the clinical, pathological, and radiologic features of IMA, and thoroughly analyze its diagnostic challenges and key points for differential diagnosis, in order to provide a theoretical basis and practical guidance for the early diagnosis of this disease.

Invasive mucinous adenocarcinoma (IMA) is a rare subtype of pulmonary adenocarcinoma, accounting for approximately 2%-10% of all pulmonary adenocarcinoma cases. IMA is characterized by a high frequency of intrapulmonary metastasis and a generally poor prognosis. Clinically, IMA often presents with nonspecific pneumonia-like symptoms. Radiologically, it manifests as multilobar and multifocal consolidations and ground-glass opacities, which significantly overlap with the radiologic features of pneumonia and other benign or malignant tumors. Consequently, IMA is frequently misdiagnosed in clinical practice, and a definitive diagnosis is nearly impossible upon initial presentation, leading to delayed treatment and a poor prognosis. Currently, there is a lack of systematic reviews correlating the clinical manifestations, pathological characteristics, and radiologic features of IMA. This review aims to systematically elucidate the clinical, pathological, and radiologic features of IMA, and thoroughly analyze its diagnostic challenges and key points for differential diagnosis, in order to provide a theoretical basis and practical guidance for the early diagnosis of this disease.

Objective:To explore the value of four-dimensional flow (4D Flow) MRI in evaluating hemodynamic changes of transplant renal artery stenosis (TRAS).Methods:The study was a cross-sectional study. A retrospective analysis of 67 patients after renal transplantation was performed in Third Affiliated Hospital of Soochow University from January 2021 to October 2022. All patients were examined with non-contrast enhanced magnetic resonance angiography (NCE-MRA) and 4D Flow MRI. After NCE-MRA assessment, the patients were divided into a non stenosis group (39 cases), non-obvious stenosis group (stenosis degree<50%, 13 cases) and obvious stenosis group (stenosis degree≥50%, 15 cases). The 4D Flow MRI data were analyzed using the post-processing software CVI42 (Canada) to measure hemodynamic parameters of the transplanted renal artery in the non-stenosis group, as well as the proximal, central, and distal regions of the stenosis in the non-obvious stenosis group and obvious stenosis group. The parameters included net flow rate, maximum flow rate, average velocity, peak velocity, average wall shear stress, and maximum wall shear stress. One way analysis of variance and least significant difference (LSD) were used to test the differences of hemodynamic parameters among the three groups and between the proximal, central and distal regions of the stenosis. Pearson correlation coefficient was used to evaluate the correlation between hemodynamic parameters of transplant renal artery and estimated glomerular filtration rate (eGFR).Results:The net flow, maximum flow and average velocity at the proximal region of stenosis in the group with obvious stenosis of transplanted renal artery were significantly lower than those in the non-stenosis group and the non-obvious stenosis group (all P<0.05). The net flow and maximum flow at the distal region of stenosis in both obvious stenosis group and non-obvious stenosis group were lower than those in non-stenosis group, and the differences were statistically significant (both P<0.001). The mean velocity and peak velocity at the distal region of stenosis in the obvious stenosis group were higher than those in the non-stenosis group, and the differences were statistically significant (both P<0.05). The maximum and average wall shear stress at the distal region of stenosis in the obvious stenosis group were lower than those in the non-stenosis group and the non-obvious stenosis group, and the differences were statistically significant (both P<0.05). The net flow and maximum flow in the center region of stenosis were lower than those in the proximal region of stenosis, and the differences were statistically significant (both P<0.05). The peak velocity in the center region and distal region of stenosis was higher than those in the proximal region of stenosis, and the difference was statistically significant (both P<0.05). There was a positive correlation between the net flow and eGFR at the TRAS patients proximal, center, and distal stenosis ( r=0.270, 0.260, 0.320, respectively, P=0.044, 0.041, 0.036, respectively). There was a positive correlation between the maximum flow and eGFR at the TRAS patients proximal, center, and distal stenosis ( r=0.306, 0.276, 0.269, respectively, P=0.037, 0.041, 0.043, respectively). Conclusion:After TRAS, there is a significant change in blood flow status. The 4D Flow MRI can provide quantitative hemodynamic parameters to reflect the hemodynamic changes of TRAS.

Objective:To explore the value of four-dimensional flow (4D Flow) MRI in evaluating hemodynamic changes of transplant renal artery stenosis (TRAS).Methods:The study was a cross-sectional study. A retrospective analysis of 67 patients after renal transplantation was performed in Third Affiliated Hospital of Soochow University from January 2021 to October 2022. All patients were examined with non-contrast enhanced magnetic resonance angiography (NCE-MRA) and 4D Flow MRI. After NCE-MRA assessment, the patients were divided into a non stenosis group (39 cases), non-obvious stenosis group (stenosis degree<50%, 13 cases) and obvious stenosis group (stenosis degree≥50%, 15 cases). The 4D Flow MRI data were analyzed using the post-processing software CVI42 (Canada) to measure hemodynamic parameters of the transplanted renal artery in the non-stenosis group, as well as the proximal, central, and distal regions of the stenosis in the non-obvious stenosis group and obvious stenosis group. The parameters included net flow rate, maximum flow rate, average velocity, peak velocity, average wall shear stress, and maximum wall shear stress. One way analysis of variance and least significant difference (LSD) were used to test the differences of hemodynamic parameters among the three groups and between the proximal, central and distal regions of the stenosis. Pearson correlation coefficient was used to evaluate the correlation between hemodynamic parameters of transplant renal artery and estimated glomerular filtration rate (eGFR).Results:The net flow, maximum flow and average velocity at the proximal region of stenosis in the group with obvious stenosis of transplanted renal artery were significantly lower than those in the non-stenosis group and the non-obvious stenosis group (all P<0.05). The net flow and maximum flow at the distal region of stenosis in both obvious stenosis group and non-obvious stenosis group were lower than those in non-stenosis group, and the differences were statistically significant (both P<0.001). The mean velocity and peak velocity at the distal region of stenosis in the obvious stenosis group were higher than those in the non-stenosis group, and the differences were statistically significant (both P<0.05). The maximum and average wall shear stress at the distal region of stenosis in the obvious stenosis group were lower than those in the non-stenosis group and the non-obvious stenosis group, and the differences were statistically significant (both P<0.05). The net flow and maximum flow in the center region of stenosis were lower than those in the proximal region of stenosis, and the differences were statistically significant (both P<0.05). The peak velocity in the center region and distal region of stenosis was higher than those in the proximal region of stenosis, and the difference was statistically significant (both P<0.05). There was a positive correlation between the net flow and eGFR at the TRAS patients proximal, center, and distal stenosis ( r=0.270, 0.260, 0.320, respectively, P=0.044, 0.041, 0.036, respectively). There was a positive correlation between the maximum flow and eGFR at the TRAS patients proximal, center, and distal stenosis ( r=0.306, 0.276, 0.269, respectively, P=0.037, 0.041, 0.043, respectively). Conclusion:After TRAS, there is a significant change in blood flow status. The 4D Flow MRI can provide quantitative hemodynamic parameters to reflect the hemodynamic changes of TRAS.

Objective To investigate the feasibility of developing a grading diagnostic model for schistosomiasis-induced liver fibrosis based on B-mode ultrasonographic images and clinical laboratory indicators. Methods Ultrasound images and clinical laboratory testing data were captured from schistosomiasis patients admitted to the Second People’s Hospital of Duchang County, Jiangxi Province from 2018 to 2022. Patients with grade I schistosomiasis-induced liver fibrosis were enrolled in Group 1, and patients with grade II and III schistosomiasis-induced liver fibrosis were enrolled in Group 2. The machine learning binary classification tasks were created based on patients’radiomics and clinical laboratory data from 2018 to 2021 as the training set, and patients’radiomics and clinical laboratory data in 2022 as the validation set. The features of ultrasonographic images were labeled with the ITK-SNAP software, and the features of ultrasonographic images were extracted using the Python 3.7 package and PyRadiomics toolkit. The difference in the features of ultrasonographic images was compared between groups with t test or Mann-Whitney U test, and the key imaging features were selected with the least absolute shrinkage and selection operator (LASSO) regression algorithm. Four machine learning models were created using the Scikit-learn repository, including the support vector machine (SVM), random forest (RF), linear regression (LR) and extreme gradient boosting (XGBoost). The optimal machine learning model was screened with the receiver operating characteristic curve (ROC), and features with the greatest contributions to the differentiation features of ultrasound images in machine learning models with the SHapley Additive exPlanations (SHAP) method. Results The ultrasonographic imaging data and clinical laboratory testing data from 491 schistosomiasis patients from 2019 to 2022 were included in the study, and a total of 851 radiomics features and 54 clinical laboratory indicators were captured. Following statistical tests (t = −5.98 to 4.80, U = 6 550 to 20 994, all P values < 0.05) and screening of key features with LASSO regression, 44 features or indicators were included for the subsequent modeling. The areas under ROC curve (AUCs) were 0.763 and 0.611 for the training and validation sets of the SVM model based on clinical laboratory indicators, 0.951 and 0.892 for the training and validation sets of the SVM model based on radiomics, and 0.960 and 0.913 for the training and validation sets of the multimodal SVM model. The 10 greatest contributing features or indicators in machine learning models included 2 clinical laboratory indicators and 8 radiomics features. Conclusions The multimodal machine learning models created based on ultrasound-based radiomics and clinical laboratory indicators are feasible for intelligent identification of schistosomiasis-induced liver fibrosis, and are effective to improve the classification effect of one-class data models.

Objective: To determine the spatiotemporal distribution of Schistosoma (S.) japonicum infections in humans, livestock, and Oncomelania (O.) hupensis across the endemic foci of China. Methods: Based on multi-stage continuous downscaling of sentinel monitoring, county-based schistosomiasis surveillance data were captured from the national schistosomiasis surveillance sites of China from 2005 to 2019. The data included S. japonicum infections in humans, livestock, and O. hupensis. The spatiotemporal trends for schistosomiasis were detected using a Joinpoint regression model, with a standard deviational ellipse (SDE) tool, which determined the central tendency and dispersion in the spatial distribution of schistosomiasis. Further, more spatiotemporal clusters of S. japonicum infections in humans, livestock, and O. hupensis were evaluated by the Poisson model. Results: The prevalence of S. japonicum human infections decreased from 2.06% to zero based on data of the national schistosomiasis surveillance sites of China from 2005 to 2019, with a reduction from 9.42% to zero for the prevalence of S. japonicum infections in livestock, and from 0.26% to zero for the prevalence of S. japonicum infections in O. hupensis. Analysis using an SDE tool showed that schistosomiasis-affected regions were reduced yearly from 2005 to 2014 in the endemic provinces of Hunan, Hubei, Jiangxi, and Anhui, as well as in the Poyang and Dongting Lake regions. Poisson model revealed 11 clusters of S. japonicum human infections, six clusters of S. japonicum infections in livestock, and nine clusters of S. japonicum infections in O. hupensis. The clusters of human infection were highly consistent with clusters of S. japonicum infections in livestock and O. hupensis. They were in the 5 provinces of Hunan, Hubei, Jiangxi, Anhui, and Jiangsu, as well as along the middle and lower reaches of the Yangtze River. Humans, livestock, and O. hupensis infections with S. japonicum were mainly concentrated in the north of the Hunan Province, south of the Hubei Province, north of the Jiangxi Province, and southwestern portion of Anhui Province. In the 2 mountainous provinces of Sichuan and Yunnan, human, livestock, and O. hupensis infections with S. japonicum were mainly concentrated in the northwestern portion of the Yunnan Province, the Daliangshan area in the south of Sichuan Province, and the hilly regions in the middle of Sichuan Province. Conclusions: A remarkable decline in the disease prevalence of S. japonicum infection was observed in endemic schistosomiasis in China between 2005 and 2019. However, there remains a long-term risk of transmission in local areas, with the highest-risk areas primarily in Poyang Lake and Dongting Lake regions, requiring to focus on vigilance against the rebound of the epidemic. Development of high-sensitivity detection methods and integrating the transmission links such as human and livestock infection, wild animal infection, and O. hupensis into the surveillance-response system will ensure the elimination of schistosomiasis in China by 2030.

After decades of development,protein and peptide drugs have now grown into a major drug class in the marketplace.Target identification and validation are crucial for the discovery of protein and peptide drugs,and bioinformatics prediction of targets based on the characteristics of known target proteins will help improve the efficiency and success rate of target selection.However,owing to the developmental history in the pharmaceutical industry,previous systematic exploration of the target spaces has mainly focused on traditional small-molecule drugs,while studies related to protein and peptide drugs are lacking.Here,we systematically explore the target spaces in the human genome specifically for protein and peptide drugs.Compared with other proteins,both suc-cessful protein and peptide drug targets have many special characteristics,and are also significantly different from those of small-molecule drugs in many aspects.Based on these features,we develop separate effective genome-wide target prediction models for protein and peptide drugs.Finally,a user-friendly web server,Predictor Of Protein and Peptide drugs'therapeutic Targets(POPPIT)(http://poppit.ncpsb.org.cn/),is established,which provides not only target prediction specifically for protein and peptide drugs but also abundant annotations for predicted targets.

Whether in the world or China,lung cancer is a malignant tumor which is harmful to human health.There were studies showed that lung cancer is tightly related to the environment factors and life style.The epidemiology study found that eating more fruits and vegetables can prevent lung cancer.Vegetables and fruits are rich in phytochemicals such as isothiocyanates,indoles,flavonoids and so on.These phytochemicals reduce the risk of lung cancer by modulating antitumorrelated pathways such as inhibition of cell proliferation,induction of apoptosis,and the like.The aim of this review is to summarize the mechanisms of phytochemicals in vegetables and fruits in the pathogenesis and progression of lung cancer,so as to provide theoretical basis and direction for the prevention and treatment of lung cancer.

Objective To explore the relationship of MDR1 and its encoded product P-gp expressions with clinical efficacy of transcatheter arterial chemoembolization (TACE)in primary liver cancer and their clinical significance.Methods We selected 108 patients with primary liver cancer who came to our hospital between June 2010 and June 2013 as observation subjects.Meanwhile 50 healthy people in our hospital for liver biopsy were selected as controls.MDR1 mRNA level in observation group and control group was determined by real-time quantitative PCR.P-gp protein level was analyzed by immunohistochemistry.According to P-gp level,the 108 patients were divided into drug-resistance groups and non-resistance group;the relationship between P-gp expression level and clinical efficacy was analyzed.Results MDR1 mRNA level in liver tissues significantly enhanced in observation group compared with that in control group (P <0.05).In observation group 32 patients had the ratio of MDR1 mRNA level-normal level of more than 2 and 76 patients had the ratio of MDR1 mRNA level-normal level of less than 2. Immunohistochemistry revealed that MDR1 encoded product P-gp was brownish yellow, mainly expressed in the cell surface of liver cancer cells.There were 35 P-gp protein-negative patients (non-resistance group)and 73 positive patients (resistance group).Clinical efficacy was significantly higher in non-resistance group (74.28%)than in resistance group (43.28%)(P <0.05).The 1 year and 2-year cumulative survival rates were 54. 12% and 27.40% in resistance group and 77.14% and 42.86%% in non-resistance group.They were significantly higher in the latter group (P <0.05 ).Conclusion The overexpressed MDR1 encoded product P-gp in primary liver cancer is associated with multidrug resistance in tumor chemotherapy,suggesting that P-gp can be used as one of the guiding clinical markers of chemotherapy.