AIM To determine the role of intravoxel incoherent motion(IVIM) diffusion-weighted(DW) magnetic resonance imaging(MRI) using a bi-exponential model in chemotherapy response evaluation in a gastric cancer mouse model.M...AIM To determine the role of intravoxel incoherent motion(IVIM) diffusion-weighted(DW) magnetic resonance imaging(MRI) using a bi-exponential model in chemotherapy response evaluation in a gastric cancer mouse model.METHODS Mice bearing MKN-45 human gastric adenocarcinoma xenografts were divided into four treated groups(TG1, 2, 3 and 4, n = 5 in each group) which received Fluorouracil and Calcium Folinate and a control group(CG, n = 7). DW-MRI scans with 14 b-values(0-1500 s/mm2) were performed before and after treatment on days 3, 7, 14 and 21. Fast diffusion component(presumably pseudo-perfusion) parameters including the fast diffusion coefficient(D*) and fraction volume(f p), slow diffusion coefficient(D) and the conventional apparent diffusion coefficients(ADC) were calculated by fitting the IVIM model to the measured DW signals. The median changes from the baseline to each posttreatment time point for each measurement(ΔADC, ΔD* and Δf p) were calculated. The differences in the median changes between the two groups were compared using the mixed linear regression model by the restricted maximum likelihood method shown as z values. Histopathological analyses including Ki-67, CD31, TUNEL and H&E were conducted in conjunction with the MRI scans. The median percentage changes were compared with the histopathological analyses between the pre-and post-treatment for each measurement.RESULTS Compared with the control group, D* in the treated group decreased significantly(ΔD*treated% =-30%,-34% and-20%, with z =-5.40,-4.18 and-1.95. P = 0.0001, 0.0001 and 0.0244) and f p increased significantly(Δfptreated% = 93%, 113% and 181%, with z = 4.63, 5.52, and 2.12, P = 0.001, 0.0001 and 0.0336) on day 3, 7 and 14, respectively. Increases in ADC in the treated group were higher than those in the control group on days 3 and 14(z = 2.44 and 2.40, P = 0.0147 and P = 0.0164). CONCLUSION Fast diffusion measurements derived from the biexponential IVIM model may be more sensitive imaging biomarkers than ADC to assess chemotherapy response in gastric adenocarcinoma.展开更多
目的:本研究旨在比较肝内胆管细胞癌(intrahepatic cholangiocarcinoma,ICC)患者手术治疗与手术后联合放疗的生存期,探讨手术后辅助放疗的可行性,为ICC的临床治疗提供依据。方法:提取美国TheSurveillance,Epidemiology,and End Results(...目的:本研究旨在比较肝内胆管细胞癌(intrahepatic cholangiocarcinoma,ICC)患者手术治疗与手术后联合放疗的生存期,探讨手术后辅助放疗的可行性,为ICC的临床治疗提供依据。方法:提取美国TheSurveillance,Epidemiology,and End Results(SEER)数据库2004至2015年间诊断为ICC患者的临床资料,根据手术后是否放疗,将患者分为手术组(surgery)和手术后放疗组(radiation after surgery),采用Kaplan-Meier方法比较两组总体生存期(overall survival,OS)和肝癌特异性生存期(liver cancer specific survival,LCSS)的差异。在进行了1∶1倾向评分匹配(propensity score matching,PSM)之后,再次比较OS与LCSS的差异。然后进行亚组分析比较手术组与手术后放疗组的疗效。最后收集本院数据对数据库结果进行验证。结果:共有470例患者纳入研究,其中手术组患者410例,手术后放疗组患者60例。PSM前手术组与手术后放疗组的中位OS(19.00个月vs 26.00个月,P=0.268)和中位LCSS(19.00个月vs 26.00个月,P=0.591)无明显差异,PSM后手术组与手术后放疗组的中位OS(25.50个月vs 26.00个月,P=0.531)和中位LCSS(27.00个月vs 26.00个月,P=0.302)亦无明显差异。在亚组分析中,手术后放疗并不是ICC患者总体生存的保护因素。本院数据结果与数据库结果一致。结论:ICC患者手术后辅助放疗相较于手术治疗并不会延长患者生存。展开更多
AIM：To analyze the influences of different genotypes（G11778A,T14484 C and G3460A） of Leber hereditary optic neuropathy（LHON） on visual prognosis. METHODS： After a systematic literature search,all relevant studie...AIM：To analyze the influences of different genotypes（G11778A,T14484 C and G3460A） of Leber hereditary optic neuropathy（LHON） on visual prognosis. METHODS： After a systematic literature search,all relevant studies evaluating the association between the three primary mutations of LHON and visual prognosis were included.All statistical tests were calculated with Revman 5.2 and STATA 12.0. RESULTS： Ten independent studies were included finally.A significant association between the three primary mutations and prognostic vision over 0.3 were found in G11778 A versus T14484 C [odds ratio（OR） =0.10,95% confidence interval（CI） =0.05-0.17,P 〈0.001],G11778 A versus G3460A（OR=0.18,95%CI=0.09-0.37,P 〈0.001） and T14484 C versus G3460A（OR =2.45,95% CI =1.10-5.48,P 〈0.05）.In addition,obtained by pairwise comparison,the vision during onset,age of onset and sex ratio of these three kinds of patients,have no statistical significance（P 〉0.05）.CONCLUSION： From pairwise comparison,we conclude that these three different genotypes of LHON are related to patients＇ visual prognosis.The T14484 C patients might have a best prognostic vision,G3460 A second,and G11778 A worst.And there is little relation between the three different genotypes and patients＇ vision,age of onset and sex ratio.展开更多
Medical imaging is involved in all processes of clinical practice.Approximately 70%of diagnostic information originates from radiologic images,which also account for 90%of the digital data volume of a hospital.However...Medical imaging is involved in all processes of clinical practice.Approximately 70%of diagnostic information originates from radiologic images,which also account for 90%of the digital data volume of a hospital.However,the number of physicians has increased only modestly compared to the rapid growth in the number of medical images.In China,data from medical imaging increases by 30%every year,whereas the number of radiologists increases by only 4%annually.Artificial intelligence(AI),which is representative technology of the fourth industrial revolution,may alleviate the increasing pressure and job burnout,and further improve the diagnostic efficiency of radiology services[1].Despite the urgent and realistic demand for AI technology,many challenges remain in the development and translation of AI products.The rate of the scientific translation of AI research into clinical applications is extremely low.Furthermore,AI models that are applied in clinical settings exhibit unreliable performance and are often impractical[2].Therefore,radiologists may not have access to suitable medical imaging AI models to solve specific clinical problems.This paper analyzes and discusses this problem according to two aspects:the data sources and the AI algorithm(Fig.1).展开更多
Abstract With the increasing number of immunocompromised hosts, the epidemiological characteristics of fungal infections have undergone enormous changes worldwide, including in China. In this paper, we reviewed the ex...Abstract With the increasing number of immunocompromised hosts, the epidemiological characteristics of fungal infections have undergone enormous changes worldwide, including in China. In this paper, we reviewed the existing data on mycosis across China to summarize available epidemiological profiles. We found that the general incidence of superficial fungal infections in China has been stable, but the incidence of tinea capitis has decreased and the transmission route has changed. By contrast, the overall incidence of invasive fungal infections has continued to rise. The occurrence of candidemia caused by Candida species other than C. albicans and including some uncommon Candida species has increased recently in China. Infections caused by Aspergillus have also propagated in recent years, particularly with the emergence of azole-resistant Aspergillusfumigatus. An increasing trend of cryptococcosis has been noted in China, with Cryptococcus neoformans var. grubii ST 5 genotype isolates as the predominant pathogen. Retrospective studies have suggested that the epidemiological characteristics of Pneumocystis pneumonia in China may be similar to those in other developing countries. Endemic fungal infections, such as sporotrichosis in Northeastern China, must arouse research, diagnostic, and treatment vigilance. Currently, the epidemiological data on mycosis in China are variable and fragmentary. Thus, a nationwide epidemiological research on fungal infections in China is an important need for improving the country＇s health.展开更多
Background：Intravoxel incoherent motion （IVIM） has the potential to provide both diffusion and perfusion information without an exogenous contrast agent,its application for the brain is promising,however,feasibilit...Background：Intravoxel incoherent motion （IVIM） has the potential to provide both diffusion and perfusion information without an exogenous contrast agent,its application for the brain is promising,however,feasibility studies on this are relatively scarce.The aim of this study is to assess the feasibility of IVIM perfusion in patients with acute ischemic stroke （AIS）.Methods：Patients with suspected AIS were examined by magnetic resonance imaging within 24 h of symptom onset.Fifteen patients （mean age was 68.7 ± 8.0 years） who underwent arterial spin labeling （ASL） and diffusion-weighted imaging （DWI） were identified as having AIS with ischemic penumbra were enrolled,where ischemic penumbra referred to the mismatch areas of ASL and DWI.Eleven different b-values were applied in the biexponential model.Regions of interest were selected in ischemic penumbras and contralateral normal brain regions.Fast apparent diffusion coefficients （ADCs） and ASL cerebral blood flow （CBF） were measured.The paired t-test was applied to compare ASL CBF,fast ADC,and slow ADC measurements between ischemic penumbras and contralateral normal brain regions.Linear regression and Pearson＇s correlation were used to evaluate the correlations among quantitative results.Results：The fast ADCs and ASL CBFs of ischemic penumbras were significantly lower than those of the contralateral normal brain regions （1.93 ± 0.78 μm2/ms vs.3.97 ± 2.49 μm2/ms,P =0.007;13.5 ± 4.5 ml· 100 g-1 ·min-1 vs.29.1 ± 12.7 ml·100 g-1 ·min-1,P ＜ 0.001,respectively）.No significant difference was observed in slow ADCs between ischemic penumbras and contralateral normal brain regions （0.203 ± 0.090 μm2/ms vs.0.198 ± 0.100 μm2/ms,P =0.451）.Compared with contralateral normal brain regions,both CBFs and fast ADCs decreased in ischemic penumbras while slow ADCs remained the same.A significant correlation was detected between fast ADCs and ASL CBFs （r =0.416,P ＜ 0.05）.No statistically significant correlation was observed between ASL CBFs and slow ADCs,or between fast ADCs and slow ADCs （r =0.111,P =0.558;r =0.200,P =0.289,respectively）.Conclusions：The decrease in cerebral blood perfusion primarily results in the decrease in fast ADC in ischemic penumbras;therefore,fast ADC can reflect the perfusion situation in cerebral tissues.展开更多
Regenerative medicine(RM)is one of the most promising disciplines for advancements in modern medicine,and regenerative ophthalmology(RO)is one of the most active fields of regenerative medicine.This review aims to pro...Regenerative medicine(RM)is one of the most promising disciplines for advancements in modern medicine,and regenerative ophthalmology(RO)is one of the most active fields of regenerative medicine.This review aims to provide an overview of regenerative ophthalmology,including the range of tools and materials being used,and to describe its application in ophthalmologic subspecialties,with the exception of surgical implantation of artificial tissues or organs(e.g.,contact lens,artificial cornea,intraocular lens,artificial retina,and bionic eyes)due to space limitations.In addition,current challenges and limitations of regenerative ophthalmology are discussed and future directions are highlighted.展开更多
In recent years,with the development of artificial intelligence,especially deep learning technology,researches on automatic detection of cerebrovascular diseases on medical images have made tremendous progress and the...In recent years,with the development of artificial intelligence,especially deep learning technology,researches on automatic detection of cerebrovascular diseases on medical images have made tremendous progress and these models are gradually entering into clinical practice.However,because of the complexity and flexibility of the deep learning algorithms,these researches have great variability on model building,validation process,performance description and results interpretation.The lack of a reliable,consistent,standardized design protocol has,to a certain extent,affected the progress of clinical translation and technology development of computer aided detection systems.After reviewing a large number of literatures and extensive discussion with domestic experts,this position paper put forward recommendations of standardized design on the key steps of deep learning-based automatic image detection models for cerebrovascular diseases.With further research and application expansion,this position paper would continue to be updated and gradually extended to evaluate the generalizability and clinical application efficacy of such tools.展开更多
文摘AIM To determine the role of intravoxel incoherent motion(IVIM) diffusion-weighted(DW) magnetic resonance imaging(MRI) using a bi-exponential model in chemotherapy response evaluation in a gastric cancer mouse model.METHODS Mice bearing MKN-45 human gastric adenocarcinoma xenografts were divided into four treated groups(TG1, 2, 3 and 4, n = 5 in each group) which received Fluorouracil and Calcium Folinate and a control group(CG, n = 7). DW-MRI scans with 14 b-values(0-1500 s/mm2) were performed before and after treatment on days 3, 7, 14 and 21. Fast diffusion component(presumably pseudo-perfusion) parameters including the fast diffusion coefficient(D*) and fraction volume(f p), slow diffusion coefficient(D) and the conventional apparent diffusion coefficients(ADC) were calculated by fitting the IVIM model to the measured DW signals. The median changes from the baseline to each posttreatment time point for each measurement(ΔADC, ΔD* and Δf p) were calculated. The differences in the median changes between the two groups were compared using the mixed linear regression model by the restricted maximum likelihood method shown as z values. Histopathological analyses including Ki-67, CD31, TUNEL and H&E were conducted in conjunction with the MRI scans. The median percentage changes were compared with the histopathological analyses between the pre-and post-treatment for each measurement.RESULTS Compared with the control group, D* in the treated group decreased significantly(ΔD*treated% =-30%,-34% and-20%, with z =-5.40,-4.18 and-1.95. P = 0.0001, 0.0001 and 0.0244) and f p increased significantly(Δfptreated% = 93%, 113% and 181%, with z = 4.63, 5.52, and 2.12, P = 0.001, 0.0001 and 0.0336) on day 3, 7 and 14, respectively. Increases in ADC in the treated group were higher than those in the control group on days 3 and 14(z = 2.44 and 2.40, P = 0.0147 and P = 0.0164). CONCLUSION Fast diffusion measurements derived from the biexponential IVIM model may be more sensitive imaging biomarkers than ADC to assess chemotherapy response in gastric adenocarcinoma.
文摘目的:本研究旨在比较肝内胆管细胞癌(intrahepatic cholangiocarcinoma,ICC)患者手术治疗与手术后联合放疗的生存期,探讨手术后辅助放疗的可行性,为ICC的临床治疗提供依据。方法:提取美国TheSurveillance,Epidemiology,and End Results(SEER)数据库2004至2015年间诊断为ICC患者的临床资料,根据手术后是否放疗,将患者分为手术组(surgery)和手术后放疗组(radiation after surgery),采用Kaplan-Meier方法比较两组总体生存期(overall survival,OS)和肝癌特异性生存期(liver cancer specific survival,LCSS)的差异。在进行了1∶1倾向评分匹配(propensity score matching,PSM)之后,再次比较OS与LCSS的差异。然后进行亚组分析比较手术组与手术后放疗组的疗效。最后收集本院数据对数据库结果进行验证。结果:共有470例患者纳入研究,其中手术组患者410例,手术后放疗组患者60例。PSM前手术组与手术后放疗组的中位OS(19.00个月vs 26.00个月,P=0.268)和中位LCSS(19.00个月vs 26.00个月,P=0.591)无明显差异,PSM后手术组与手术后放疗组的中位OS(25.50个月vs 26.00个月,P=0.531)和中位LCSS(27.00个月vs 26.00个月,P=0.302)亦无明显差异。在亚组分析中,手术后放疗并不是ICC患者总体生存的保护因素。本院数据结果与数据库结果一致。结论:ICC患者手术后辅助放疗相较于手术治疗并不会延长患者生存。
文摘AIM：To analyze the influences of different genotypes（G11778A,T14484 C and G3460A） of Leber hereditary optic neuropathy（LHON） on visual prognosis. METHODS： After a systematic literature search,all relevant studies evaluating the association between the three primary mutations of LHON and visual prognosis were included.All statistical tests were calculated with Revman 5.2 and STATA 12.0. RESULTS： Ten independent studies were included finally.A significant association between the three primary mutations and prognostic vision over 0.3 were found in G11778 A versus T14484 C [odds ratio（OR） =0.10,95% confidence interval（CI） =0.05-0.17,P 〈0.001],G11778 A versus G3460A（OR=0.18,95%CI=0.09-0.37,P 〈0.001） and T14484 C versus G3460A（OR =2.45,95% CI =1.10-5.48,P 〈0.05）.In addition,obtained by pairwise comparison,the vision during onset,age of onset and sex ratio of these three kinds of patients,have no statistical significance（P 〉0.05）.CONCLUSION： From pairwise comparison,we conclude that these three different genotypes of LHON are related to patients＇ visual prognosis.The T14484 C patients might have a best prognostic vision,G3460 A second,and G11778 A worst.And there is little relation between the three different genotypes and patients＇ vision,age of onset and sex ratio.
基金This work was supported by the Scientific and Technological Innovation 2030—a Major Project of New Generation Artificial Intelligence(2020AAA0109503)the Beijing Science and Technology Planning Project(Z201100005620008 and Z211100003521007)+1 种基金the National Natural Science Foundation(82171934)the National Key Research and Development Program of China(2021ZD0111105).
文摘Medical imaging is involved in all processes of clinical practice.Approximately 70%of diagnostic information originates from radiologic images,which also account for 90%of the digital data volume of a hospital.However,the number of physicians has increased only modestly compared to the rapid growth in the number of medical images.In China,data from medical imaging increases by 30%every year,whereas the number of radiologists increases by only 4%annually.Artificial intelligence(AI),which is representative technology of the fourth industrial revolution,may alleviate the increasing pressure and job burnout,and further improve the diagnostic efficiency of radiology services[1].Despite the urgent and realistic demand for AI technology,many challenges remain in the development and translation of AI products.The rate of the scientific translation of AI research into clinical applications is extremely low.Furthermore,AI models that are applied in clinical settings exhibit unreliable performance and are often impractical[2].Therefore,radiologists may not have access to suitable medical imaging AI models to solve specific clinical problems.This paper analyzes and discusses this problem according to two aspects:the data sources and the AI algorithm(Fig.1).
基金This study was funded in part by grants from the Severe Infectious Diseases Specific Projects from China＇s Ministry of Health （No. 2013ZX10004612-7）, the 973 Program （Nos. 2013CB531601 and 2013CB531606）, and the National Natural Science Foundation of China （No. 81201269）.
文摘Abstract With the increasing number of immunocompromised hosts, the epidemiological characteristics of fungal infections have undergone enormous changes worldwide, including in China. In this paper, we reviewed the existing data on mycosis across China to summarize available epidemiological profiles. We found that the general incidence of superficial fungal infections in China has been stable, but the incidence of tinea capitis has decreased and the transmission route has changed. By contrast, the overall incidence of invasive fungal infections has continued to rise. The occurrence of candidemia caused by Candida species other than C. albicans and including some uncommon Candida species has increased recently in China. Infections caused by Aspergillus have also propagated in recent years, particularly with the emergence of azole-resistant Aspergillusfumigatus. An increasing trend of cryptococcosis has been noted in China, with Cryptococcus neoformans var. grubii ST 5 genotype isolates as the predominant pathogen. Retrospective studies have suggested that the epidemiological characteristics of Pneumocystis pneumonia in China may be similar to those in other developing countries. Endemic fungal infections, such as sporotrichosis in Northeastern China, must arouse research, diagnostic, and treatment vigilance. Currently, the epidemiological data on mycosis in China are variable and fragmentary. Thus, a nationwide epidemiological research on fungal infections in China is an important need for improving the country＇s health.
文摘Background：Intravoxel incoherent motion （IVIM） has the potential to provide both diffusion and perfusion information without an exogenous contrast agent,its application for the brain is promising,however,feasibility studies on this are relatively scarce.The aim of this study is to assess the feasibility of IVIM perfusion in patients with acute ischemic stroke （AIS）.Methods：Patients with suspected AIS were examined by magnetic resonance imaging within 24 h of symptom onset.Fifteen patients （mean age was 68.7 ± 8.0 years） who underwent arterial spin labeling （ASL） and diffusion-weighted imaging （DWI） were identified as having AIS with ischemic penumbra were enrolled,where ischemic penumbra referred to the mismatch areas of ASL and DWI.Eleven different b-values were applied in the biexponential model.Regions of interest were selected in ischemic penumbras and contralateral normal brain regions.Fast apparent diffusion coefficients （ADCs） and ASL cerebral blood flow （CBF） were measured.The paired t-test was applied to compare ASL CBF,fast ADC,and slow ADC measurements between ischemic penumbras and contralateral normal brain regions.Linear regression and Pearson＇s correlation were used to evaluate the correlations among quantitative results.Results：The fast ADCs and ASL CBFs of ischemic penumbras were significantly lower than those of the contralateral normal brain regions （1.93 ± 0.78 μm2/ms vs.3.97 ± 2.49 μm2/ms,P =0.007;13.5 ± 4.5 ml· 100 g-1 ·min-1 vs.29.1 ± 12.7 ml·100 g-1 ·min-1,P ＜ 0.001,respectively）.No significant difference was observed in slow ADCs between ischemic penumbras and contralateral normal brain regions （0.203 ± 0.090 μm2/ms vs.0.198 ± 0.100 μm2/ms,P =0.451）.Compared with contralateral normal brain regions,both CBFs and fast ADCs decreased in ischemic penumbras while slow ADCs remained the same.A significant correlation was detected between fast ADCs and ASL CBFs （r =0.416,P ＜ 0.05）.No statistically significant correlation was observed between ASL CBFs and slow ADCs,or between fast ADCs and slow ADCs （r =0.111,P =0.558;r =0.200,P =0.289,respectively）.Conclusions：The decrease in cerebral blood perfusion primarily results in the decrease in fast ADC in ischemic penumbras;therefore,fast ADC can reflect the perfusion situation in cerebral tissues.
基金Supported by a grant from the Strategic Priority Research Program of the Chinese Academy of Sciences (XDA16040201).
文摘Regenerative medicine(RM)is one of the most promising disciplines for advancements in modern medicine,and regenerative ophthalmology(RO)is one of the most active fields of regenerative medicine.This review aims to provide an overview of regenerative ophthalmology,including the range of tools and materials being used,and to describe its application in ophthalmologic subspecialties,with the exception of surgical implantation of artificial tissues or organs(e.g.,contact lens,artificial cornea,intraocular lens,artificial retina,and bionic eyes)due to space limitations.In addition,current challenges and limitations of regenerative ophthalmology are discussed and future directions are highlighted.
基金Project supported by the Key Program of the National Natural Sci-ence Foundation of China(Grant Nos.81830057 and 82230068)the Young Scientists Fund of the National Natural Science Foundation of China(Grant No.82102155).
文摘In recent years,with the development of artificial intelligence,especially deep learning technology,researches on automatic detection of cerebrovascular diseases on medical images have made tremendous progress and these models are gradually entering into clinical practice.However,because of the complexity and flexibility of the deep learning algorithms,these researches have great variability on model building,validation process,performance description and results interpretation.The lack of a reliable,consistent,standardized design protocol has,to a certain extent,affected the progress of clinical translation and technology development of computer aided detection systems.After reviewing a large number of literatures and extensive discussion with domestic experts,this position paper put forward recommendations of standardized design on the key steps of deep learning-based automatic image detection models for cerebrovascular diseases.With further research and application expansion,this position paper would continue to be updated and gradually extended to evaluate the generalizability and clinical application efficacy of such tools.
