1.Application of deep learning models based on super-resolution endorectal ultrasound in predicting perineural invasion in rectal cancer
Yajiao GAN ; Qiping HU ; Xinyi WANG ; Yixi SU ; Qingling SHEN ; Minling ZHUO ; Yi TANG ; Xiaodong LIN ; Yue YU ; Youjia LIN ; Qingfu QIAN ; Zhikui CHEN
Chinese Journal of Ultrasonography 2025;34(10):848-857
Objective:To develop a deep learning model based on super-resolution endorectal ultrasound(ERUS)images for the preoperative prediction of perineural invasion(PNI)in patients with rectal cancer,thereby providing a reference for risk stratification and individualized treatment planning.Methods:A retrospective analysis was conducted on 382 patients with rectal cancer who underwent total mesorectal excision at Fujian Medical University Union Hospital between June 2019 and February 2024. Patients were randomly divided into a training set( n=305)and a test set( n=77)at a ratio of 8∶2,and further grouped into PNI-negative group and PNI-positive group subgroups based on pathological results. Super-resolution ultrasound images were generated from original ERUS images using a generative adversarial network(GAN). Deep convolutional neural networks were developed based on features from intratumoral and peritumoral regions to identify the optimal region of interest(ROI). The dSR5_ResNet18 and dSR5_ResNet50 models were constructed using the super-resolution images with a 5-pixel peritumoral extension. Representative clinical features were selected for subgroup analysis based on sample size and intergroup statistical differences between PNI-positive and PNI-negative patients. Forest plots were used to evaluate model applicability and robustness across subgroups. Results:The dSR5_ResNet18 model,built using super-resolution images of the tumor combined with a 5-pixel peritumoral region,achieved the best predictive performance,with an AUC of 0.867(95% CI=0.782 - 0.952)in the test set. Decision curve analysis demonstrated that the dSR5_ResNet18 model provided the greatest net clinical benefit. Forest plot analysis indicated strong generalizability of the models across subgroups such as pathological N stage,maximum lesion length,and lymph node enlargement,though relatively weaker performance was observed in the carcinoembryonic antigen(CEA)subgroup. Among all models,dSR5_ResNet18 exhibited the most consistent performance across subgroups,with the narrowest confidence intervals and highest robustness. Conclusions:The deep learning model incorporating ERUS-based super-resolution reconstruction demonstrated excellent performance in the preoperative prediction of PNI in rectal cancer. It offers significant advantages in image quality and generalizability,and may serve as a valuable tool to assist clinicians in formulating personalized treatment strategies.
2.Application of deep learning models based on super-resolution endorectal ultrasound in predicting perineural invasion in rectal cancer
Yajiao GAN ; Qiping HU ; Xinyi WANG ; Yixi SU ; Qingling SHEN ; Minling ZHUO ; Yi TANG ; Xiaodong LIN ; Yue YU ; Youjia LIN ; Qingfu QIAN ; Zhikui CHEN
Chinese Journal of Ultrasonography 2025;34(10):848-857
Objective:To develop a deep learning model based on super-resolution endorectal ultrasound(ERUS)images for the preoperative prediction of perineural invasion(PNI)in patients with rectal cancer,thereby providing a reference for risk stratification and individualized treatment planning.Methods:A retrospective analysis was conducted on 382 patients with rectal cancer who underwent total mesorectal excision at Fujian Medical University Union Hospital between June 2019 and February 2024. Patients were randomly divided into a training set( n=305)and a test set( n=77)at a ratio of 8∶2,and further grouped into PNI-negative group and PNI-positive group subgroups based on pathological results. Super-resolution ultrasound images were generated from original ERUS images using a generative adversarial network(GAN). Deep convolutional neural networks were developed based on features from intratumoral and peritumoral regions to identify the optimal region of interest(ROI). The dSR5_ResNet18 and dSR5_ResNet50 models were constructed using the super-resolution images with a 5-pixel peritumoral extension. Representative clinical features were selected for subgroup analysis based on sample size and intergroup statistical differences between PNI-positive and PNI-negative patients. Forest plots were used to evaluate model applicability and robustness across subgroups. Results:The dSR5_ResNet18 model,built using super-resolution images of the tumor combined with a 5-pixel peritumoral region,achieved the best predictive performance,with an AUC of 0.867(95% CI=0.782 - 0.952)in the test set. Decision curve analysis demonstrated that the dSR5_ResNet18 model provided the greatest net clinical benefit. Forest plot analysis indicated strong generalizability of the models across subgroups such as pathological N stage,maximum lesion length,and lymph node enlargement,though relatively weaker performance was observed in the carcinoembryonic antigen(CEA)subgroup. Among all models,dSR5_ResNet18 exhibited the most consistent performance across subgroups,with the narrowest confidence intervals and highest robustness. Conclusions:The deep learning model incorporating ERUS-based super-resolution reconstruction demonstrated excellent performance in the preoperative prediction of PNI in rectal cancer. It offers significant advantages in image quality and generalizability,and may serve as a valuable tool to assist clinicians in formulating personalized treatment strategies.
3.Preparation of berberine-naringin dual drug-loaded composite microspheres and evaluation of their antibacterial-osteogenic properties.
Wei XIONG ; Lingmei YUAN ; Liangxia WANG ; Guowen QIAN ; Chaoyi LIANG ; Bin PAN ; Ling GUO ; Wenqiang WEI ; Xunxiang QIU ; Wenfang DENG ; Zhikui ZENG
Chinese Journal of Reparative and Reconstructive Surgery 2023;37(12):1505-1513
OBJECTIVE:
To develop a drug-loaded composite microsphere that can simultaneously release the berberine (BBR) and naringin (NG) to repair infectious bone defects.
METHODS:
The NG was loaded on mesoporous microspheres (MBG) to obtain the drug-loaded microspheres (NG-MBG). Then the dual drug-loaded compound microspheres (NG-MBG@PDA-BBR) were obtained by wrapping NG-MBG with polydopamine (PDA) and modifying the coated PDA with BBR. The composite microspheres were characterized by scanning electron microscopy, X-ray diffraction, specific surface area and pore volume analyzer, and Fourier transform infrared spectroscopy; the drug loading rate and release of NG and BBR were measured; the colony number was counted and the bacterial inhibition rate was calculated after co-culture with Staphylococcus aureus and Escherichia coli for 12 hours to observe the antibacterial effect; the biocompatibility was evaluated by live/dead cell fluorescence staining and cell counting kit 8 assay after co-culture with rat's BMSCs for 24 and 72 hours, respectively, and the osteogenic property was evaluated by alkaline phosphatase (ALP) staining and alizarin red staining after 7 and 14 days, respectively.
RESULTS:
NG-MBG@PDA-BBR and three control microspheres (MBG, MBG@PDA, and NG-MBG@PDA) were successfully constructed. Scanning electron microscopy showed that NG-MBG@PDA-BBR had a rough lamellar structure, while MBG had a smooth surface, and MBG@PDA and NG-MBG@PDA had a wrapped agglomeration structure. Specific surface area analysis showed that MBG had a mesoporous structure and had drug-loading potential. Low angle X-ray diffraction showed that NG was successfully loaded on MBG. The X-ray diffraction pattern contrast showed that all groups of microspheres were amorphous. Fourier transform infrared spectroscopy showed that NG and BBR peaks existed in NG-MBG@PDA-BBR. NG-MBG@PDA-BBR had good sustained drug release ability, and NG and BBR had early burst release and late sustained release. NG-MBG@PDA-BBR could inhibit the growth of Staphylococcus aureus and Escherichia coli, and the antibacterial ability was significantly higher than that of MBG, MBG@PDA, and NG-MBG@PDA ( P<0.05). But there was a significant difference in biocompatibility at 72 hours among microspheres ( P<0.05). ALP and alizarin red staining showed that the ALP positive area and the number of calcium nodules in NG-MBG@PDA-BBR were significantly higher than those of MBG and NG-MBG ( P<0.05), and there was no significant difference between NG-MBG@PDA and NG-MBG@PDA ( P>0.05).
CONCLUSION
NG-MBG@PDA-BBR have sustained release effects on NG and BBR, indicating that it has ideal dual performance of osteogenesis and antibacterial property.
Rats
;
Animals
;
Osteogenesis
;
Delayed-Action Preparations/pharmacology*
;
Microspheres
;
Berberine/pharmacology*
;
Anti-Bacterial Agents/pharmacology*
;
Escherichia coli
4.Prolonged prothrombin time caused by the combination of iguratimod and warfarin
Adverse Drug Reactions Journal 2023;25(2):122-125
A 59-year-old female patient received treatments of improvement of heart function, anti-rheumatism (oral total glucoside of white paeony capsules 0.6 g twice daily, oral iguratimod 25 mg twice daily), and anti-infection, etc. due to rheumatic heart disease, acute exacerbation of chronic cardiac dysfunction, rheumatoid arthritis, and pulmonary infection. Before medication, the prothrombin time (PT) was 15.5 s, and the international normalized ratio (INR) was 1.2. Considering that the patient had valvular heart disease and mural thrombus in the left atrium, oral warfarin 2.5 mg once daily was added the next day. PT was prolonged and INR increased. On the 10th day of warfarin application, her PT was 45.0 s and INR was 4.8. Warfarin was discontinued and the dose of iguratimod was reduced to 25 mg orally once daily. On the 2nd day of warfarin discontinuation, PT was 53.2 s and INR was 5.9; on the 3rd day, PT was 80.8 s and INR was 10.1. Then iguratimod was stopped and vitamin K 1 was given. After 3 days, the PT was 22.4 s and INR was 2.0. Later, oral warfarin 2 mg once daily was added due to the disease condition. The PT was 19.8 to 27.4 s and INR was 2.1 to 2.9. It was considered that the prolonged PT in the patients might be related to the combination of iguratimod and warfarin.
5.Prolonged prothrombin time caused by the combination of iguratimod and warfarin
Adverse Drug Reactions Journal 2023;25(2):122-125
A 59-year-old female patient received treatments of improvement of heart function, anti-rheumatism (oral total glucoside of white paeony capsules 0.6 g twice daily, oral iguratimod 25 mg twice daily), and anti-infection, etc. due to rheumatic heart disease, acute exacerbation of chronic cardiac dysfunction, rheumatoid arthritis, and pulmonary infection. Before medication, the prothrombin time (PT) was 15.5 s, and the international normalized ratio (INR) was 1.2. Considering that the patient had valvular heart disease and mural thrombus in the left atrium, oral warfarin 2.5 mg once daily was added the next day. PT was prolonged and INR increased. On the 10th day of warfarin application, her PT was 45.0 s and INR was 4.8. Warfarin was discontinued and the dose of iguratimod was reduced to 25 mg orally once daily. On the 2nd day of warfarin discontinuation, PT was 53.2 s and INR was 5.9; on the 3rd day, PT was 80.8 s and INR was 10.1. Then iguratimod was stopped and vitamin K 1 was given. After 3 days, the PT was 22.4 s and INR was 2.0. Later, oral warfarin 2 mg once daily was added due to the disease condition. The PT was 19.8 to 27.4 s and INR was 2.1 to 2.9. It was considered that the prolonged PT in the patients might be related to the combination of iguratimod and warfarin.
6.Design of wearable auxiliary device based on upper limb lifting workers and ergonomics simulation analysis
Linhui SUN ; Jiao WU ; Jian WU ; Zhikui ZHANG ; Wenqin LI ; Mingyang WANG
Chinese Journal of Industrial Hygiene and Occupational Diseases 2022;40(6):454-458
In order to solve the problem of high incidence of work-related musculoskeletal disorders (WMSDs) in upper limb lifting workers, a wearable auxiliary device which could be used in upper limb lifting operation was designed. The auxiliary device could be used in upper limb lifting through torsion spring device to reduce the tension of the arm muscles. The back bracket could be adjusted to adapt to the wearers of different height. The 3D model of the auxiliary device was constructed by using SoildWorks software. And the relative position and constraint between the auxiliary device and the digital simulation human were adjusted by using Jack as the main simulation tool. And then the virtual model of upper limb lifting were simulated and analyzed. Through the comparison of Rapid Upper Limb Assessment (RULA) scale, Krist comfort score and simulation results of two-handed reachable domain before and after wearing the auxiliary device, which proved that the wearable auxiliary device could reduce the risk of WMSDs in upper limb lifting workers.
7.Design of wearable auxiliary device based on upper limb lifting workers and ergonomics simulation analysis
Linhui SUN ; Jiao WU ; Jian WU ; Zhikui ZHANG ; Wenqin LI ; Mingyang WANG
Chinese Journal of Industrial Hygiene and Occupational Diseases 2022;40(6):454-458
In order to solve the problem of high incidence of work-related musculoskeletal disorders (WMSDs) in upper limb lifting workers, a wearable auxiliary device which could be used in upper limb lifting operation was designed. The auxiliary device could be used in upper limb lifting through torsion spring device to reduce the tension of the arm muscles. The back bracket could be adjusted to adapt to the wearers of different height. The 3D model of the auxiliary device was constructed by using SoildWorks software. And the relative position and constraint between the auxiliary device and the digital simulation human were adjusted by using Jack as the main simulation tool. And then the virtual model of upper limb lifting were simulated and analyzed. Through the comparison of Rapid Upper Limb Assessment (RULA) scale, Krist comfort score and simulation results of two-handed reachable domain before and after wearing the auxiliary device, which proved that the wearable auxiliary device could reduce the risk of WMSDs in upper limb lifting workers.
8.Tomography Study on Total Flavonoids from Rhizoma Drynariae in Promoting New Bone Formation in Distraction Osteogenesis Rat Model
Ziwei JIANG ; Jingqi ZENG ; Feng HUANG ; Fan WANG ; Yue LI ; Qunsheng HU ; Zhikui ZENG ; Xiang YU ; Haifeng ZHU
Journal of Guangzhou University of Traditional Chinese Medicine 2017;34(3):390-393
Objective To establish a distraction osteogenesis SD rat model for exploring the effect of total flavonoids from Rhizoma Drynariae on the quality of rat bone formation in the process of distraction osteogenesis from the perspective of tomography.Methods Twenty-four rats were randomly divided into experimental group and control group after successful modeling,and were respectively given intragastric administration with total flavonoids from Rhizoma Drynariae(in dose of 77.125 mg/kg) and saline for 8 weeks.Seven days after operation,the tibias of all the rats were given distraction at the speed of 0.2 mm for 20 days.Eight weeks after the operation,X-ray examination for all the rats was performed,and then the rats were killed for obtaining the tibia samples for Micro-CT scanning.The differences of X-ray Lane-Sandhu scores,the bone mineral density and bone mineral content were compared between the two groups.Results The X-ray Lane-Sandhu scores,the bone mineral density and bone mineral contents showed by Micro-CT scanning in the experimental group were higher than those in the control group,and the differences were statistically significant (P < 0.05).Conclusion The total flavonoids from Rhizoma Drynariae can improve the quality of bone formation in the process of distraction osteogenesis in rats.
9.Emergency decontamination technology and equipment against chemical agents:research advances
Zhiyong NIE ; Haipeng SUN ; Xiaohong SUN ; Zhikui YANG ; Yongan WANG
Military Medical Sciences 2016;40(4):267-271
As an important measure to reduce casualties and prevent secondary pollution, decontamination is an impor-tant link in the process of emergency response during chemical accidents.The decontamination effect is closely related to decontamination technology and equipment.Decontamination agent selection and development are an important part of a decontamination technology.In this paper, the development and use of cleaning agents, such as alkaline, oxidation and chlorination, adsorption (degradation), metal oxide and oxygen acid salt, chemical compounds, biological (enzymatic), and individual disinfection package, light decontamination equipment, multifunctional integrated large-scale decontamination equipment at home or abroad, are reviewed.By laying bare the gap between China and advanced countries in the related field, we hope to raise the concern of relevant professional counterparts and promote the development of domestic decontami-nation technology and equipment with decontaminant agents at the core.
10.Emergency disposal experience and enlightenment of chemical defense in″Tianjin Port 8·12 Explosion Accident″
Zhiyong NIE ; Rigao DING ; Hanbin WANG ; Zheng YONG ; Shiyong FAN ; Zhikui YANG ; Yongan WANG
Chinese Journal of Pharmacology and Toxicology 2015;(5):842-846
″Tianjin Port 8 · 12 Catastrophic Explosion Accident″ affected the national people′s heart. After the disaster,the chemical defense,medical,explosion and so on various relevant profes?sional experts and rescue teams responded to the national call. Taking the bull by the horns,pooling the wisdom and efforts,the experts and rescue teams carried out and implemented the decision spirit of ″it should not hurt one man,and should not appear serious secondary disasters in the late treat?ment″which put forward by the Party Central Committee and State Council. In order to better learn and sum up experience,the cause of the disaster,the disaster rescue and disposal process,the enlighten?ment brought by the disaster and the recommendations deal with unexpected chemical incidents in the future was discussed in this paper.

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