Objective To explore the feasibility of radiomics features combined with different machine learning methods based on CT scans to predict lymphovascular and perineural invasion in patient with gastric cancer.Methods A total of 142 patients with gas-tric cancer lymphovascular confirmed by operative pathological examination were retrospectively selected.Among all patients,there were 96 positive cases and 46 negative cases.Among 137 patients with perineural invasion,there were 76 positive cases and 61 nega-tive cases.The 3D-Slicer package was used for delineation,and the Pyradiomics package was used to extract radiomics features.All data were randomly divided into training set and test set in an 8∶2 ratio.Intraclass correlation coefficient(ICC),Pearson correla-tion analysis,least absolute shrinkage and selection operator(LASSO)algorithm were used for feature selection.Support vector machine(SVM),K-nearest neighbor(KNN),decision tree(DT),random forest(RF),extreme tree(ET),extreme gradient boosting(XGBoost),and LightGBM were used to compare the models of lymphovascular and perineural invasion,respectively.Receiver operating characteris-tic(ROC)curve and area under the curve(AUC)were used to evaluate the predictive performance of these models.Results The lymphovascular group AUC of SVM,KNN,DT,RF,ET,XGBoost,and LightGBM in the training set were 0.926,0.753,1.000,0.999,1.000,1.000,and 0.917,and the AUC in the test set were 0.894,0.692,0.456,0.678,0.753,0.650,and 0.650,respectively.The perineural invasion group AUC of SVM,KNN,DT,RF,ET,XGBoost,and LightGBM in the training set were 0.864,0.794,1.000,1.000,1.000,1.000,and 0.866,and the AUC in the test set were 0.861,0.706,0.700,0.672,0.731,0.667,and 0.678,respectively.Conclusion Based on venous phase CT radiomics features combined with machine learning methods,it is feasible to predict lymphovascu-lar and perineural invasion of gastric cancer preoperatively.Among the variousmachine learning methods,SVM shows the best predictive performance for lymphovascular and perineural invasion in patient with gastric cancer.

Objective:Application study of outcome-based education teaching model in practice teaching Of clinical medical laboratory.Methods:According to the teaching model, A total of 60 interns from the First Affiliated Hospital of the University of South China from June 2021 to May 2022 were selected as the research objects and they were randomly number table method divided into two groups, the traditional teaching group is 30 cases and the OBE group is 30 cases.The Self-regulated Learning Effectiveness Evaluation Scale is used to evaluate the effectiveness of self-regulated learning. The assessment scores (skill operation, case analysis, clinical communication, exit examination,each 50 points) and teaching model satisfaction were compared between the two groups.Results:The results of the two groups were compared to find out the score of the examination ( P>0.05).After practice, the OBE group was significantly better than the traditional teaching group in skill operation test, morphological recognition test, case analysis test aspects ( P<0.05). According to the evaluation of students′ independent learning effectiveness, it can be seen that the OBE group has independent learning ability, self-confidence, ability to acquire knowledge, and logical thinking ability etc. The OBE group scored higher than the traditional teaching group ( P<0.05). There was no significant significance in teachers′ teaching enthusiasm effect score ( P>0.05). Scoring teaching content, teaching difficulties, teaching design, teaching satisfaction etc, the OBE group was significantly higher than the traditional teaching group ( P<0.05). Conclusion:Application study of outcome-based education teaching model in practice teaching of clinical medical laboratory. It can effectively improve the clinical practice and clinical communication ability of students, so as to more effectively improve the social adaptability and post competence of clinical medical laboratory graduates.

Objective To discuss the feasibility of Mongolian medicine pulse diagnosis in assessment of the disease situation of acute critically ill patients. Methods The clinical data of acute critically ill patients admitted in the Department of Emergency of Inner Mongolia International Mongolian Medical Hospital from December 2015 to December 2017 were retrospectively analyzed, and the role of Mongolian medicine pulse diagnosis in the evaluation of disease situations of patients with acute critical illness was observed. Results The improved early warning score (MEWS) at admission was carried out for all the patients in the Emergency Department of this hospital, 996 critically ill patients with their MEWS score ≥ 5 scores in accord with the inclusion criteria were allowed to undergo the Mongolian medicine pulse diagnosis, and of them, 654 patients showed specific changes in pulse condition. Shock appeared rapid pulse, microphygmia in pulse diagnosis of Mongolian medicine, severe anemia appeared the slippery pulse and rapid pulse in pulse diagnosis of Mongolian medicine, severe arrhythmia appeared rapid pulse and slow pulse in pulse diagnosis of Mongolian medicine, acute myocardial infarction appeared rapid pulse, weak pulse and slow pulse in pulse diagnosis of Mongolian medicine, insufficiency of heart function appeared rapid pulse and weak pulse in pulse diagnosis of Mongolian medicine, hypertension complicated with cerebral hemorrhage with forceful pulse and pulsus pulse are all suggestive of critical condition. Conclusions The specific changes in pulse condition of patients with acute critical illness in Mongolian medicine are helpful to the assessment of the patient's condition. This method can also be used as one of the tools for rapid assessment of disease situation in critical patients before going to hospital or in the hospital.

Objective To investigate the prevalence of A2058G or A2059G mutation within 23S rRNA in Treponema pallidum (Tp) from primary syphilis patients chancre samples. Methods Simple PCR was used to screen the positive samples containing Tp DNA. Nested PCR was adopted to amplify the region of the Tp 23S rRNA and the purified amplicons were digested by restriction endonuclease MboⅡand Bsa I respectively and sequenced. Results 39 qualified samples were obtained from 43 chancre samples and all of them were found harboring the A2058G mutation, whereas the A2059G was not detected. Conclusion High frequency of the A2058G mutation within 23S rRNA implicated in macrolide resistance emerges in the circulating Tp in Hengyang. Therefore, macro-lide antibiotics such as azithromycin should be cautiously used as an optional therapy for syphilis.

Objective Toinvestigatetheriskoflong-termrecurrenceofstrokeanditspredictorsin youngpatientswithischemicstroke/transientischemicattack(TIA).Methods Theclinicaldataofthe consecutive young patients (18-45 years)with ischemic stroke/TIA (within 2 weeks after onset)admitted to the department of neurology in the First Affiliated Hospital of Sun Yat-Sen University between August 2008 and July 2013 were enrolled prospectively. All patients were regularly followed up for a long time (The patients were followed up at the 1 st,6 th,and 12 th month after onset;then they were followed up once for every 6 months)in order to investigate stroke recurrence. The Kaplan-Meier curves were used to analyze the cumulative stroke recurrence rate of all patients. The last contact time for patients lost to follow was used as censored data to be enrolled in the analysis. The univariate analysis of the related risk factors for stroke recurrence using Log-rank test. Multivariate Cox proportional hazard regression was used to detect the related risk factors associated with stroke recurrence (adjusting for age and sex). The variables of the results of Log-ranktestP≤0.1wasselectedandenrolledinthemultivariateregressionanalysis.Results Atotalof 312 patients were enrolled in the analysis,including 294 with ischemic stroke and 18 with TIA. Their mean follow-up time was 34 ± 19 months. Thirty-four patients had recurrent stroke,including 23 with ischemic stroke,7 with TIA,and 4 with cerebral hemorrhage. The cumulative recurrence rates of stroke at 1 ,3 , and 6 years after onset were 6. 2%,10. 3%,and 16. 4%,respectively. The results of multivariate Cox proportional hazards regression analysis showed that hypertension (risk ratio [RR]2. 159;95% confidence interval [CI]1. 048-4. 447,P=0. 037)and cardioembolism (RR,2. 869;95%CI 1. 119-7. 357,P=0.028)weretheindependentpredictorsforstrokerecurrence.Conclusion Theoverall6-yearriskof recurrent stroke is not high in the Chinese young patients with ischemic stroke/TIA,but the risk of stroke recurrence is relatively higher in the first year. Hypertension and cardioembolism are the potential predictors of stroke recurrence;therefore,attention should be paid in clinical practice.

Objective To analyze the characteristics of clinical manifestations, risk factors, therapies and acute outcomes in patients with cerebral venous sinus thrombosis complicated by cerebral hemorrhage. Methods Seventy-five patients with cerebral venous sinus thrombosis were included in the study. According to the radiological findings on the brain image, patients were divided into two subgroups:cerebral hemorrhage group and non-hemorrhage group. The demo?graphic data, potential risk factors, clinical manifestations, radiological features, therapeutic strategies and acute out?comes were compared between two subgroups, and high risk factors were also analyzed. Results There were seventy-five patients with cerebral venous sinus thrombosis in the present study. Twenty-eight patients of them (37.2%) had cerebral hemorrhage whereas the remaining forty-seven patients (62.7%) did not have cerebral hemorrhage. Pregnancy/puerperi?um were significantly higher in patients with cerebral hemorrhage (with vs without;28.6%vs. 6.4%, P=0.015), while in?fection was markedly higher in patients without cerebral hemorrhage (with vs without;7.1% vs. 29.8%, P=0.021). Head?ache (92.9% vs. 70.2%, P=0.021), unconsciousness (25.0% vs. 6.4%,P=0.034), seizures (53.6% vs. 19.1%, P=0.002) and motor deficits (35.7% vs. 12.8%, P=0.019) were more common in patients with cerebral hemorrhage. Moreover, mul?tiple sinus involvement (1.4% vs. 44.7%, P=0.024) was significantly higher and the acute outcomes(mRS≥3: 46.4%vs.17.0%, P=0.006)were poorer in patients with cerebral hemorrhage. Binary Logistic analysis showed that pregnancy/pu?erperium (P=0.004) and multiple sinus involvement were positively, whereas infection was negatively correlated with cere?bral venous sinus thrombosis and hemorrhage ( P=0.007;P=0.03). Conclusions Pregnancy/puerperium, headache, uncon?sciousness, seizures, motor deficits and multiple sinus involvement are more frequently in patients with cerebral venous sinus thrombosis and hemorrhage, and the acute outcomes are poorer in patients with cerebral venous sinus thrombosis complicated by cerebral hemorrhage.

Objective To investigate the risk factors, diagnostic evaluation, etiology, and treatment in young patients with ischemic stroke. Methods The clinical data of young patients (age range 18 - 45 years) with ischemic stroke (within 2 weeks of stroke onset) admitted to the Stroke Center, the First Affiliated Hospital of Sun Yat-sen University from August 2008 to July 2013 were registered prospectively. Results A total of 300 patients were enroled, their age was 37. 8 ± 6. 8 years. There were 227 males (75. 7% ). The age of 84 patients (28. 0% ) was ≤35 years. The most common risk factors were smoking (43. 3% ), hypertension (38. 7% ), and hypercholesterolemia (38. 0% ). The positive result detection rates were lower in the antinuclear antibody (8/278), anticardiolipin antibody (34/250), 24-h Holter monitoring (2/60 ), and transthoracic echocardiography (38/232). According to the MRI findings, the detection rate of the white matter changes, old infarcts, single acute infarcts, and multiple acute cerebral infarcts were 40/282, 77/282, 145/282, and 137/282, respectively. The stroke subtypes of TOAST: large artery atherosclerosis (26. 7% ), smal artery occlusion (18. 0% ), cardioembolism (10. 0% ), other determined etiology (23. 0% ), and undetermined etiology (22. 3% ). Large artery atherosclerosis was mainly involved in anterior circulation (69/80) and intracranial arteries (75/80). In other definite causes, cerebral artery dissection was most common (36/69), and other causes included moyamoya disease (7/69) and infectious vasculitis (7/69), etc. The average length of hospital stay was 15. 4 d. The mean National Institutes of Health Stroke Scale score on admission was 7. 0, and the mean modified Rankin scale score at discharge was 2. 5. The complication rate during hospitalization was 9. 7% . 80. 3% and 48. 3% of patients received anti-platelet drugs and statins therapy during hospitalization.Conclusions This study used a prospective single-center method. It conducted a comprehensive analysis of risk factors, diagnostic evaluation, treatment, and etiology in current Chinese young patients with ischemic stroke. Its research data wil provide useful information for establishing a diagnostic strategy of high performance cost ratio, in-depth understanding of its pathophysiological mechanisms, and improving treatment strategies in Chinese young patients with ischemic stroke.

Objective To clone, express, purify and evaluate the immunoreactivity of the recombinant protein Tp0844 of Treponema pallidum (Tp), and to screen major Tp proteins with high host reactivity. Methods The Tp0844 gene sequence was obtained through bioinformatics analysis. A prokaryotic expression vector of the Tp0844 gene was constructed and transformed into E. coli BL21 followed by isopropyl-1-thio-β-D-galactopyranoside (IPTG)induction for the expression of the recombinant protein Tp0844. Nickel-NTA affinity chromatography columns were utilized to purify the recombinant protein, and Western blotting was performed to evaluate the reactivity of the recombinant protein with sera positive or negative for anti-Tp IgG antibodies. Results The recombinant prokaryotic expression vector PET-30a (+)-Tp0844 was successfully constructed. After IPTG induction, a soluble recombinant protein with a relative molecular mass of about 43 000 was highly expressed, and purified by affinity chromatography. Western blotting showed that the Tp0844 recombinant protein specifically reacted with anti-Tp IgG antibody-positive sera, but not with anti-Tp IgG antibody-negative sera. Conclusions The soluble recombinant protein Tp0844 has good immunoreactivity, and can serve as a candidate antigen for investigation into the pathogenesis of syphilis.

OBJECTIVETo investigate the expressions of Engrailed-2 (EN2) and β-catenin in bladder urothelial carcinoma and explore their significance.

METHODSSixty bladder urothelial carcinoma samples of different grades and stages and 10 normal bladder mucosal tissues were examined for expressions of EN2 and β-catenin proteins and mRNA using immunochemistry, Western blotting and RT-PCR. RESULTS Compared to normal bladder mucosa, bladder urothelial carcinoma tissues showed significantly increased expressions of EN2 and β-catenin proteins (P<0.05), and the high-grade carcinoma tissues exhibited significantly stronger expressions than the low-grade ones (P<0.05); the expressions of the proteins increased also significantly with advanced pathological stages of bladder urothelial carcinoma (P<0.05). The expressions of EN2 and β-catenin mRNAs showed a consistent pattern of changes with their protein expressions.

CONCLUSIONThe expressions of EN2 and β-catenin are significantly increased in bladder urothelial carcinoma. EN2 may contribute to the development and progression of bladder urothelial carcinoma by activating Wnt/β-catenin signal pathway.

Adult ; Aged ; Aged, 80 and over ; Carcinoma ; metabolism ; pathology ; Female ; Homeodomain Proteins ; metabolism ; Humans ; Male ; Middle Aged ; Nerve Tissue Proteins ; metabolism ; Urinary Bladder Neoplasms ; metabolism ; pathology ; beta Catenin ; metabolism

Objective To create a large samples digital database of breast ultrasound imaging (DDBUI),which is open and can be used for scientific research,clinical training and diagnose in order to improve early diagnostic rate of breast cancer by using the database.Methods The database applies structured query language (SQL) to record the integrated resources of patients with breast masses and utilizes Brower/Server (B/S) technology to achieve universal data access.Results The database consists of 853 cases and 5780 images.So far,researchers in home and abroad have done many researches with the images in DDBUI.For example,the speckle reduction,enhancement,segmentation and classification algorithms for computer aided diagnosis (CAD).The database provides a complete shared operation platform for clinical diagnosis and teaching.Conclusions The first public database of breast ultrasound images is created which provides comprehensive information for the development and verification different CAD algorithms,and is helpful for researches,ultrasound diagnosis learning,and improving the breast cancer diagnosis.