肿瘤数智诊疗研究的现状及前景

肿瘤是威胁人类健康的重大疾病。随着科技的进步,数智技术与肿瘤诊疗日趋融合,不仅推动了诊疗方法的创新,还为疾病预后分析提供了新的视角。本综述聚焦肿瘤数智诊疗研究的现状及前景,概述肿瘤数智诊疗模型的构建流程,并对其所依赖的深度学习和机器学习技术进行梳理,重点介绍数智诊疗模型在肿瘤的诊疗决策、疗效预测以及疾病预后评估等关键领域的应用;分析肿瘤数智诊疗目前存在的问题及应对策略。本文明确了肿瘤数智诊疗技术在当今医疗领域的地位,提出数据驱动与知识引导相结合的研究范式将进一步提升肿瘤的整体诊疗水平。

Tailoring mechanical properties of PμSL 3D-printed structures via size effect

Projection micro stereolithography(PμSL)has emerged as a powerful three-dimensional(3D)printing technique for manufacturing polymer structures with micron-scale high resolution at high printing speed,which enables the production of customized 3D microlattices with feature sizes down to several microns.However,the mechanical properties of as-printed polymers were not systemically studied at the relevant length scales,especially when the feature sizes step into micron/sub-micron level,limiting its reliable performance prediction in micro/nanolattice and other metamaterial applications.In this work,we demonstrate that PμSL-printed microfibers could become stronger and significantly more ductile with reduced size ranging from 20μm to 60μm,showing an obvious size-dependent mechanical behavior,in which the size decreases to 20μm with a fracture strain up to~100%and fracture strength up to~100 MPa.Such size effect enables the tailoring of the material strength and stiffness of PμSL-printed microlattices over a broad range,allowing to fabricate the microlattice metamaterials with desired/tunable mechanical properties for various structural and functional applications.

Antioxidative and hepatoprotective activities of a novel polysaccharide (LSAP) from Lepista sordida mycelia

A novel alkali-soluble polysaccharide from Lepista sordida(LSAP)mycelia with antioxidative and hepatoprotective activities was characterized.The weight-average molecular weight and number-average molecular weight of LSAP were 1.442×10^(3) and 6.05×10^(2) kDa,respectively.LSAP was consisted of glucose(57.9%),xylose(31.8%),and small amounts of rhamnose,arabinose,galactose,glucuronic acid,and galacturonic acid(1.2%–3.1%).The FT-IR and 2D NMR confi rmed that LSAP was composed of Xylp,Araf,4-O-Me-α-D-GlcpA,(1→4)-linkedβ-D-Glcp,and(1→4)-α-D-GalA,andβ-glycosidic linkages between these sugar units.LSAP displayed notable effects on 1,1-dephenyl-2-picryhydrazyl(DPPH)radical scavenging,hydrogen peroxide scavenging,lipid peroxidation inhibitory ability,reducing power and Fe^(2+)chelating property.These biological effects were further verifi ed by suppressing CCl_(4)-induced oxidative liver damage in mice at doses of 100 and 200 mg/kg.Administration of LSAP in mice prior to CCl_(4) signifi cantly prevented the CCl_(4)-induced elevation in serum alanine aminotransferase,aspartate aminotransferase,and hepatic malondialdehyde.Mice treated with LSAP demonstrated to increase activities in superoxide dismutase(SOD)and glutathione peroxidase(GSH-Px)in the liver.We also found out that LSAP prevented CCl_(4)-induced oxidative liver histological alteration.LSAP may exert hepatoprotective effects against CCl_(4)-induced damage through antioxidant mechanisms in model mice.

A clinical study on salvage hepatectomy for treating recurrent liver cancer after radiofrequency ablation

Objective We studied the efficacy of salvage hepatectomy for treating recurrent hepatic cancer after radiofrequency ablation （RFA）. Methods A retrospective analysis of 67 patients who had recurrent liver cancer after RFA treatment and received salvage hepatectomy in the Department of Hepatobiliary Surgery, Southwest Hospital, Third Mili- tary Medical University （China）, from January 2006 to January 2014, was performed. The analysis included patient gender, age, hepatitis type, alpha-fetoprotein （AFP）, and TNM stage prior to RFA and salvage hepatectomy, overall survival rates, and tumor-free survival rates after salvage hepatectomy. Results Among the 67 patients, there were 57 cases of hepatitis B, two cases of hepatitis C, and eight cases did not have hepatitis. AFP levels in patients ranged from 3 to 4521 ng/mL （median 33 ng/mL）. Before RFA, 54 cases were stage I tumors, and 13 were stage II tumors. Tumor sizes varied from 0.82 to 4.83 cm （median 3.0 cm）. In 20 cases, one RFA was performed, and for 47 cases, RFA was repeated. RFA- ablated region diameters ranged from 3.8 to 5.2 cm （median 4.5 cm）. The interval between the salvage surgical resection and RFA was 3-37 months. Before salvage hepatectomy, 23 stage I tumors, 12 stage II tumors, and 32 stage III tumors were present （size ranged 4.83-11.84 cm; median 6.3 cm）. For salvage hepatectomy, laparotomy was performed for 56 cases, and laparoscopy was performed for 28 cases. Inflow clamping was performed for 39 cases （15-45 rain）. Surgery was 219-370 rain and intraoperative blood loss was 100-2100 mL. For 13 cases, intraoperative blood transfusion was required. Tumor pathological data revealed 31,35, and 1 poorly, moderately, and well differentiated tumors, respectively. No patients died due to operative complications, and hospital stays were 8-10 days. Overall and tumor-free survival rates were 85% and 79% for 1 year, 50% and 20% for 3 years, and 39% and 19% for 5 years, respectively. Kaplan- Meier analysis and Cox regression confirmed that tumor number and size prior to salvage liver cancer were risk factors affecting survival. Conclusion Patients who received RFA to treat early-stage liver cancer with postoperative recurrent stage I tumors have satisfactory outcomes with salvage hepatectomy.

Optimizing film thickness to delay strut fracture in high-entropy alloy composite microlattices

Incorporating high-entropy alloys(HEAs) in composite microlattice structures yields superior mechanical performance and desirable functional properties compared to conventional metallic lattices. However, the modulus mismatch and relatively poor adhesion between the soft polymer core and stiff metallic film coating often results in film delamination and brittle strut fracture at relatively low strain levels(typically below 10%). In this work, we demonstrate that optimizing the HEA film thickness of a CoCrNiFe-coated microlattice completely suppresses delamination,significantly delays the onset of strut fracture(~100% increase in compressive strain),and increases the specific strength by up to 50%. This work presents an efficient strategy to improve the properties of metal-composite mechanical metamaterials for structural applications.

Development and prospect of telemedicine

With the continuous improvement and development of modern network information technology and the continuous improvement of people’s demands for health care,the traditional health care model has evolved,giving birth to a new telemedicine health care model.Telemedicine refers to the comprehensive application of information technology for medical information transmission and long-distance communication between different places.It integrates medicine,computer technology,and communication technology for remote monitoring,diagnosis,consultation,case discussion,teaching,and surgery as well as a series of medical activities.With the continuous development of communication technology,telemedicine is also constantly changing.As a relatively novel technology,telemedicine is sought after by major hospitals.With the advancement of internet technology,digitization and informatization have been gradually applied in telemedicine,but due to various factors,telemedicine still has great limitations.This paper summarized the development status of telemedicine;discussed in detail the development of telemedicine at home and abroad;reviewed the application of telemedicine as well as the feasibility and limitations of its promotion and development;and put forward an outlook for the future development of telemedicine.

Dense dislocations induced ductile SnTe thermoelectric semiconductor over a wide range of temperatures

Most inorganic thermoelectric semiconductors are intrinsically brittle,restricting the application of ther-moelectric materials.Therefore,developing ductile thermoelectric materials is crucial to thermoelectric technology applications.In this work,single-phase SnTe bulks with dense dislocations were prepared by melting quenching combined with spark plasma sintering.The resulting SnTe thermoelectric materials exhibited a large compressive strain of∼7.5%at room temperature,originating from high-density pre-existing mobile dislocations.The initiation of localized slip bands and preferred slip system were also identified by first-principles simulation.Detail microstructural characterizations reveal that the thermal activated dislocation emission and migration lead to higher compressive strains at intermediate tem-peratures.At 673 K,the deformation mechanism changed from dislocation mediated to grain boundary mediated plasticity,resulting in an ultra-high compressive strain of∼42%.In sum,new insights into the mechanical behavior of SnTe thermoelectric material over a wide range of temperatures were provided.This work offers the dislocation engineering strategy to design ductile thermoelectric materials for flexi-ble electronics and energy systems.

A 7-year-old girl with giant congenital biliary dilatation

A 7-year-old girl presented to our out-patient clinic with complaints of abdominal mass and pain with yellowish skin for over 3 months.The patient was also accompanied by clinical manifestations such as nausea and vomiting,skin itching and clay-colored stools.She denied any past history of gastrointestinal bleeding or trauma.Examination revealed a non-tender swelling as it moved with breathing(Panel A).

High elasticity of CsPbBr_(3) perovskite nanowires for flexible electronics

Due to the enhanced ambient structural stability and excellent optoelectronic properties, all-inorganic metal halide perovskite nanowires have become one of the most attractive candidates for flexible electronics, photovoltaics and optoelectronics. Their elastic property and mechanical robustness become the key factors for device applications under realistic service conditions with various mechanical loadings. Here, we demonstrate that high tensile elastic strain (∼ 4% to ∼ 5.1%) can be achieved in vapor-liquid-solid-grown single-crystalline CsPbBr_(3) nanowires through in situ scanning electron microscope (SEM) buckling experiments. Such high flexural elasticity can be attributed to the structural defect-scarce, smooth surface, single-crystallinity and nanomechanical size effect of CsPbBr_(3) nanowires. The mechanical reliability of CsPbBr_(3) nanowire-based flexible photodetectors was examined by cyclic bending tests, with no noticeable performance deterioration observed after 5,000 cycles. The above results suggest great application potential for using all-inorganic perovskite nanowires in flexible electronics and energy harvesting systems.

Analysis for Multiple Cracks in 2D Piezoelectric Bimaterial Using the Singular Integral Equation Method

A singular integral equation method is proposed to analyze the two-dimensional(2D)multiple cracks in anisotropic piezoelectric bimaterial.Using the Somigliana formula,a set of singular integral equations for the multiple crack problems are derived,in which the unknown functions are the derivatives of the generalized displacement discontinuities of the crack surfaces.Then,the exact analytical solution of the extended singular stresses and extended stress intensity factors near the crack tip is obtained.Singular integrals of the singular integral equations are computed by the Gauss-Chebyshev collocation method.Finally,numerical solutions of the extended stress intensity factors of some examples are presented and discussed.

Application of informatics in cancer research and clinical practice:Opportunities and challenges

Cancer informatics has significantly progressed in the big data era.We summarize the application of informatics approaches to the cancer domain from both the informatics perspective(e.g.,data management and data science)and the clinical perspective(e.g.,cancer screening,risk assessment,diagnosis,treatment,and prognosis).We discuss various informatics methods and tools that are widely applied in cancer research and practices,such as cancer databases,data standards,terminologies,high‐throughput omics data mining,machine‐learning algorithms,artificial intelligence imaging,and intelligent radiation.We also address the informatics challenges within the cancer field that pursue better treatment decisions and patient outcomes,and focus on how informatics can provide opportunities for cancer research and practices.Finally,we conclude that the interdisciplinary nature of cancer informatics and collaborations are major drivers for future research and applications in clinical practices.It is hoped that this review is instrumental for cancer researchers and clinicians with its informatics‐specific insights.