Objective:To explore the value of different radiomics models based on machine learning in predicting the risk of distant recurrence and metastasis of triple-negative breast cancer after neoadjuvant therapy.Methods:The clinical and imaging data of 150 patients with triple-negative breast cancer (TNBC) confirmed by histopathology were retrospectively analyzed. All patients underwent neoadjuvant chemotherapy and surgical resection from August 2011 to May 2017 in Fudan University Shanghai Cancer Center and Ruijin Hospital, Shanghai Jiao Tong University School of Medicine. One hundred and nine patients from Shanghai Fudan University Shanghai Cancer Center were used as the training group, and 41 patients from Ruijin Hospital, Shanghai Jiao Tong University School of Medicine were used as the validation group. The features were extracted from dynamic contrast-enhanced MRI (DCE-MRI) before treatment and were added with time domain features innovatively. Least absolute shrinkage and selection operator cross validation and recursive feature elimination were applied to select features. Six different supervised machine learning algorithms (logistic regression, linear discriminant analysis, k-nearest neighbor, naive bayesian, decision tree, support vector machine) were used to predict the prognosis. ROC curve, accuracy and F1 measure were used to evaluate the performance of the six algorithms, and also verified by the validation group.Results:The support vector machine algorithm had the best predictive effect in the recurrence and metastasis model based on 15 features, with the highest area under curve (training group was 0.917, validation group was 0.859), and the highest accuracy rate (training group was 87.5%, validation group was 82.9%) and the highest F1 measure (training group was 0.800, validation group was 0.741). In addition, of the 15 imaging features, 12 were the time domain features and 3 were spatial features.Conclusion:With the help of the time domain features and machine learning algorithms, radiomics signatures based on preoperative DCE-MRI can help predict the distant prognosis for TNBC after neoadjuvant chemotherapy and provide support for clinical decision making and follow-up management.

Objective:To summarize the clinical features and pathological changes of peripheral tissues from patients with neuronal intranuclear inclusion disease (NIID) diagnosed by genetic tests.Methods:Repeat-primed polymerase chain reaction was used to confirm the GGC repeated expansion in the 5′ untranslated region of the NOTCH2NLC gene in patients with suspected NIID who had visited the Department of Neurology of Peking University First Hospital from January 2018 to February 2020. The clinical data and pathological changes of peripheral tissues from patients with genetically diagnosed NIID were collected retrospectively and analysed. Immunostaining with anti-p62 and anti-ubiquitin antibody was performed on peripheral biopsy specimens.Results:Totally nine patients with NIID who had GGC repeated expansion in the NOTCH2NLC gene were found. Five patients were familial (from three faimilies), and four patients were sporadic. The age of onset was 36-61(51.33±7.12) years. The most common symptoms in this NIID group were episodic emotion and personality change (8/9), paroxysmal disturbance of consciousness (6/9) and intermitant head discomfort (6/9). Other symptoms included cognitive dysfunction, limb weakness, limb sensory disturbance, bladder dysfunction, ataxia, seizures and psychiatric symptoms. Brain magnetic resonance imaging showed high signals along the corticomedullary junction on diffusion-weighted image in eight out of nine patients. Skin biopsied samples from nine patients demonstrated the presence of eosinophilic intranuclear inclusions (IIs), appearing in the nucleus of fibroblasts, fat cells and ductal epithelial cells of sweat glands on hematoxylin-eosin staining. IIs were positive on anti-p62 and anti-ubiquitin immunostaining. Electron microscopy indicated the IIs were composed of a pile of filament materials without membrane. Muscle biopsies from two patients showed no obvious neurogenic or myogenic pathologic changes, except in one patient several rimmed vacuoles fibers were found. In one patient sural nerve biopsy showed severe demyelinating pathological changes. No IIs were found in the muscles and peripheral nerve tissue either by histological examination or by immunohistochemical staining with anti-p62 or anti-ubiquitin, while IIs were found by immunofluorescence staining with both anti-p62 and anti-ubiquitin in three patient′s tissue. Conclusions:The phenotype of this NIID patient group is adult-onset NIID, with episodic encephalopathy as the main clinical manifestation. Skin biopsy has high pathological diagnostic value for NIID. The immunofluorescence staining with anti-p62 and anti-ubiquitin is easier to detect the presence of IIs than histological staining and immumohistochemical staining.

Objective:To explore the evaluation of transesophageal echocardiography(TEE) in patients with massive regurgitation of posterior mitral valve prolapse undergoing transapical off-pump NeoChord repair.Methods:Eight patients from April to July 2019 in the Second Affilliated Hospital of Zhejiang Univerity with massive regurgitation of posterior mitral valve prolapse underwent NeoChord repair mitral valve morphology, prolapse position and regurgitation degree were evaluated before NeoChord implantation by TEE. Under TEE guidance, the puncture site was identificated, the position and length of artificial chordae were adjusted during implantation. NeoChord′s function and positon after implantation were observed. The complications were monitored during the operation.Results:Mitral valve repair by NeoChord system was successfully performed with implantation of 2 to 4 artificial chordaes in eight patients respectively. Intraoperative TEE and pre-discharge transthoracic echocardiography(TTE) showed moderate MR in two patients, mild to moderate MR in one patient, mild MR in the remaining five patients. Reexaminations with TTE at 1 month after operation showed moderate MR in six patients, and mild to moderate MR in two patients. And no postoperative complications were noted.Conclusions:NeoChord system is a safe, effective and feasible treatment method for patient with mitral valve prolapse, TEE plays an important role during NeoChord implantation.

Objective To investigate the genotyping characteristics of Han and Uygur patients with hepatitis C virus(HCV) in Urumqi and other area of Xinjiang ,and provide information for diagnosis and treatment .Methods Totally 380 samples of Han and Uygur patients virus load were detected by real - time PCR ,with the load greater than 1 × 103 copies/mL ,HCV genotyping was carried out by PCR - reverse dot blot hybridization .Results A total of 355 samples(93 .4% ) was genotyped successful .Type 1b of Han and Uygun were 59 .91% ,69 .92% ,type 2a were 30 .17% ,12 .20% ,type 3a were 5 .60% ,8 .13% and type 3b were 3 .88% , 8 .94% .In Urumqi and other areas ,significant difference of patient distribution ,male and female were found between Han and Uygur patients(all P< 0 .05) ,In Urumqi ,type 2a had significant difference between Uygur and Han male patients ,type 1b ,3b had significant difference in female patients(P< 0 .05) .In other areas except Urumqi ,type 2a had significant difference between Uygur and Han man(P< 0 .05) ,other genotypes were not found difference(P> 0 .05) .Conclusion HCV genotyping of Uygur and Han patients in Xinjiang is different with the majority areas in China ,type 1b and 2a are the main infectious virus in Han ,and type 1b is the main infectious virus in Uygur ,followed by type 2a ,3a ,3b .

After health information push service on Internet was investigated ,suggestions were put forward for impro-ving the health information service by making use of the Wechat public platform according to the incomplete and non-professional health information service , rampant advertisements and unaccessible personal information on Internet .

Objective To investigate psychosocial factors for post-stroke depression (PSD). Methods 405 in-pa-tients with stroke were first screened for depression using Comprehensive International Diagnostic Interview-3.0. 22 pa-tients with depression were recruited as the depression group. From 383 patients without depression, 44 patients were se-lected and served as the non depression controlled group according to the sex and age paired with 1:2. Both groups were measured by using questionnaires including Life Event Scale, Simplified Coping Style Questionnaire, Social Support Rat-ing Scale, Activities of Daily Living Scale and Quality of Life Enjoyment and Satisfaction Questionnaire, Short Form. Re-sults The score of passive coping was significantly higher in depression group than in non depression group [(1.2 ± 0.5) vs. (0.8±0.7), P<0.05]. The score of subjective support was significantly lower in depression group than in non depression group [(17.5±4.0) vs. (20.7±4.6), P<0.05]. Logistic regression analysis showed, minority nationality (OR=2.564, 95%CI:1.039~6.327) and passive coping style (OR=2.223, 95%CI:1.052~5.192) were risk factors for PSD, while subjective sup-port was protective factor for PSD (OR=0.884, 95%CI:0.793~0.986). Conclusions Passive coping style and low subjec-tive support may be the important psychosocial factors of PSD.

Objectives To track bone marrow stem cells (BMSCs) labeled by enhanced green fluorescent protein (EGFP) and superparamagnetic iron oxide ( SPIO ) -poly-L-lysine (PLL) compound by MRI in vitro for autotransplantation into pancreas of type 1 diabetes miniature pigs. Methods The BMSCs were isolated by density gradient centrifugation and attachment culture from type 1 diabetes minipigs' bone marrow. Expressional intensity of EGFP in BMSCs transfected lentivirus-EGFP with a multiplicity of infection Different magnetic resonance scanning protocols were carried out on various density BMSCs labeled by different concentration of SPIO in various time-point in vitro. Results When SPIO concentration was 25mg/L (count in Fe3 + ), the positive Fe3+ -labeling rate of BMSCs was 93. 1%. Most of SPIO particles in BMSCs' cytoplasm were observed in secondary lysosomes, but they were not detected in important organelle as cell nucleus. Comparing with gelatin the MRI of BMSCs labeled with SPIO in the condition with 1 ×104/ml cells density and 25 mg/L Fe3+ concentration in vitro, the signal intensity changes (△SI) after BMSCs labeled with SPIO 3 weeks and 6 weeks in TSE T1WI, TSE T2WI and FLASH T2 * WI sequences were 12%, 41%, 63% and 7%, 28%, 46% respectively (P ＜ 0.01 and P ＜ 0.05, respectively).Conclusions The data showed that the porcine BMSCs labeled with SPIO and EGFP could be traced successfully in vitro by MRI in the suitable sequences.

OBJECTIVE: Intraocular lens are applied in trigeminal operations of cataract extraction and comeal transplantation, and the selection of artificial lens is modified. This paper evaluated the application of colodzed polymethyl methacrylate (PMMA) intraocular lens in interlaced non-phacoemulsification cataract extraction with intraocular lens implantation and keratoplasty (trigeminal operation).METHODS: A computer-based online search of CNKI (200312007) and Medline database (1974/2004) was performed for related articles with the key words "colorized intraocular lens, corneal transplantation, cataract, combination operation" in Chinese and "PMMA intraocular lens, cataract extraction, corneal transplantation" in English. Articles related to PMMA intraocular lens in cataract and corneal transplantation trigeminal operation was selected. Meta analysis and repetitive articles were excluded. A total of 11 articles were included and summarized.RESULTS: A total of 21 cases (21 eyes) of corneal leukoma and cataract caused by various trauma or ophthalmopathy underwent colorized PMMA intraocular lens implantation. During the follow-up for 10 months, visual acuities of naked eyes in 92% cases were significantly improved. Two weeks after operations, visual acuities of 9 cases (42.9%) were over 4.7, 10 cases over 4.5, and 2 cases (9.5%) over 4.0. At days 7 to 14 after operation, corneal grafts of 21 cases were completely transparent; 10 months after operation, corneal grafts of 16 cases were completely transparent, 3 cases were semitransparent, and 2 cases were turbid, who underwent second penetrable corneal transplantation.CONCLUSION: The application of colodzed PMMA intraocular lens in penetrable corneal transplantation combined cataract extraction can cure the refracting media turbidity of forepart eye. Compared with traditional operations, trigeminal operation reduces complications, increases safety and improves visual acuity.

Objective To observe the clinical efficacy of psoriasis treated with avermectin A and astragalus and detect the changes of TNF-a in serum. Preliminarily study the anti-inflammatory and immunomodulatory mechanism of avermectin A and astragalus in the treatment of psoriasis. Methods 20 patients were randomly recruited into a control group (9 cases) and a treatment group (11 cases). Another 20 healthy people were recruited for comparison. The control group was administrated with avermectin A orally, 0.2±0.6 mg/kg·d, with the symptoms turning better, reduced the dosage till the recovery, the treatment group was injected with astragalus injection on the therapeutic basis of the control group. Detect and compare the levels of TNF-α in the serum of the patients with psoriasis before and after the treatment in both groups, then make a contrast to the healthy people. Results 20 patients got clinical cure. The level of TNF-α in the serum of healthy persons is 11.7± 6.7 ng/L, and the level of TNF-α in the serum of psoriasis patients before treatment is (45.4±12.4) ng/L and (46.4±16.9) ng/L in the treatment group and the control group respectively. Compared with healthy control group, the difference is significant. After treatment, is the TNF-αlevels dropped to (13.8± 5.4) ng/L and (20.9±6.3) ng/L in the treatment group and the control group respectively, showing no significant difference compared with healthy control group. The difference between the two group is also significant. Conclusion The efficacy of treating psoriasis with avermectin A and astragalus is better than using avermectin A exclusively. The mechanism may lie in its inhibiting the formation of TNF-α and so thus exerting the anti-inflammatory and immune regulatory functions.

Objective To discuss the values of three screening methods for the detection of early breast cancer,and to analyze the features of the screening cancer.Methods The first screening of breast cancer were performed in 5307 women who aged from 20 to 76 years with median age of 49 years.The three screening methods included physical examination with ultrasound and mammography,physical examination with mammography and mammography only.The rate of recall,biopsy,cancer detection of three methods were analyzed and the mammographic findings were reviewed Chi-square test or Fisher's exact test were used for the statistics.Results The recall rates were 4.90% (49/1001),6.90%(166/2407)and 4.48% (85/1899) in three methods respectively,the biopsy rates were 1.60% (16/1001),1.04% (25/2407) and 0.63%(12/1899),the cancer detection rates were 0.50% (5/1001),0.17% (4/2407) and 0 (0/1899).There were statistical differences among the three groups (X2=12.99,6.264,8.764,P < 0.05).Physical examination with ultrasound and mammnography had the highest cancer detection rate,ten breast cancers were detected and 8 were early stage breast cancer.Of seven cancers detected by mammography,only two were found by ultrasound.A cluster of calcifications were found in 2 cases,linear calcifications in 2 cases.One case presented as a asymmetric density,one as a asymmetric density with calcifications,one as multiple nodules with a duster of calcifications.Two breast cancers presented as asymmetric density were missed on mammography and diagnosed correctly after retrospective review.Conclusion Physical examination with ultrasound and mammography is the best method for breast cancer screening.The breast cancer can be detected by mammography earlier than other methods.