Trans-PRK for recurrent epithelial corneal erosion induced by cooking oil accidentally after EVO ICL

Dear Editor,We report a case with trans-photorefractive keratectomy(PRK)for recurrent epithelial corneal erosion caused by cooking oil after EVO-implantable contact lens(ICL)(EVO Visian ICL;STAAR Surgical AG,Switzerland),which should be distinguished from postoperative complications of EVO-ICL.Most corneal burns are classified as chemical and thermal burns,referring to direct contact injury to the cornea.

Global research landscape of Peutz-Jeghers syndrome and successful endoscopic management of intestinal intussusception in patients with recurrent laparotomies

BACKGROUND Peutz-Jeghers syndrome(PJS)has brought significant physical,psychological and economic burdens on the patients and their families due to its early onset,diagnostic and therapeutic challenges and increased recurrence risk.AIM To explore the current research status and emerging hotspots of PJS.METHODS Studies on PJS published during 1994-2023 were gathered based on Web of Science Core Collection.Additionally,a case of PJS-induced intestinal intussusception,successfully treated with endoscopic methods despite three laparotomies,was highlighted.Comprehensive bibliometric and visual analysis were conducted with VOSviewer,R and CiteSpace.RESULTS Altogether 1760 studies were identified,indicating a steady increase in the publication number.The United States had the highest influence,whereas the University of Helsinki emerged as the leading institution,and Aaltonen LA from the University of Helsinki was the most prolific author.Cancer Research,Oncogene and Endoscopy were the top three journals based on H-index.Keyword burst direction analysis revealed that"cancer risk","management","surveillance"and"familial pancreatic cancer"were the potential hotspots for investigation.Additionally,"early detection","capsule endoscopy","clinical management","double-balloon endoscopy","familial pancreatic cancer"and"molecular genetic basis"were identified as the key clusters of co-cited references.Endoscopic polypectomy remained effective on resolving intestinal intussusception in patients who underwent three previous laparotomies.CONCLUSION In the last three decades,global publications related to PJS show a steadily increasing trend in number.Endoscopic management is currently a research hotspot.

International experts consensus guidelines on robotic liver resection in 2023

The robotic liver resection(RLR)has been increasingly applied in recent years and its benefits shown in some aspects owing to the technical advancement of robotic surgical system,however,controversies still exist.Based on the foundation of the previous consensus statement,this new consensus document aimed to update clinical recommendations and provide guidance to improve the outcomes of RLR clinical practice.The guideline steering group and guideline expert group were formed by 29 international experts of liver surgery and evidence-based medicine(EBM).Relevant literature was reviewed and analyzed by the evidence evaluation group.According to the WHO Handbook for Guideline Development,the Guidance Principles of Development and Amendment of the Guidelines for Clinical Diagnosis and Treatment in China 2022,a total of 14 recommendations were generated.Among them were 8 recommendations formulated by the GRADE method,and the remaining 6 recommendations were formulated based on literature review and experts’opinion due to insufficient EBM results.This international experts consensus guideline offered guidance for the safe and effective clinical practice and the research direction of RLR in future.

Controlled attenuation parameter for non-invasive assessment of hepatic steatosis in Chinese patients

AIM: To evaluate the performance of a novel non-invasive controlled attenuation parameter (CAP) to assess liver steatosis.

Gut microbiota dysbiosis in patients with nonalcoholic fatty liver disease

BACKGROUND: Gut microbiota plays a significant role in the pathogenesis of non-alcoholic fatty liver disease (NAFLD). This study aimed to assess the contribution of gut microbiota dysbiosis to the pathogenesis of NAFLD. METHODS: Forty-seven human feces samples (25 NAFLD patients and 22 healthy subjects) were collected and 16S rDNA amplicon sequencing was conducted on Hiseq 2000 platform. Discrepancy of species composition between controls and NAFLD group was defined by Metastats analysis under P value <0.01. RESULTS: NAFLD patients harbored lower gut microbiota diversity than healthy subjects did. In comparison to the control group, the Proteobacteria (13.50%) and Fusobacteria (2.76%) phyla were more abundant in NAFLD patients. Additionally, the Lachnospiraceae (21.90%), Enterobacteriaceae (12.02%), Erysipelotrichaceae (3.83%), and Streptococcaceae (1.39%) families, as well as the Escherichia_Shigella (10.84%), Lachnospiraceae_Incertae_Sedis (7.79%), and Blautia (4.95%) genera were enriched in the NAFLD group. However, there was a lower abundance of Prevotella in the NAFLD group than that in the control group (5.83% vs 27.56%, P<0.01). The phylum Bacteroidetes (44.63%) also tended to be more abundant in healthy subjects, and the families Prevotellaceae (28.66%) and Ruminococcaceae (26.44%) followed the same trend. Compared to those without non-alcoholic steatohepatitis (NASH), patients with NASH had higher abundance of genus Blautia (5.82% vs 2.25%; P=0.01) and the corresponding Lachnospiraceae family (24.33% vs 14.21%; P<0.01). Patients with significant fibrosis had a higher abundance of genus Escherichia_Shigella (12.53% vs 1.97%; P<0.01) and the corresponding Enterobacteriaceae family (13.92% vs 2.07%; P<0.01) compared to those with F0/F1 fibrosis. CONCLUSIONS: NAFLD patients and healthy subjects harbor varying gut microbiota. In contrast to the results of previous research on children, decreased levels of Prevotella might be detrimental for adults with NAFLD. The increased level of the genus Blautia, the family Lachnospiraceae, the genus Escherichia_Shigella, and the family Enterobacteriaceae may be a primary contributor to NAFLD progression.

Robot-assisted one-stage resection of rectal cancer with liver and lung metastases

The Da Vinci Surgical System may help to overcome some of the difficulties of laparoscopy for complicated abdominal surgery.The authors of this article present a case of robot-assisted, one-stage radical resection of three tumors, including robotic anterior resection for rectal cancer, segmental hepatectomy for liver metastasis, and wedge-shaped excision for lung metastasis.A 59-year-old man with primary rectal cancer and liver and lung metastases was operated upon with a one-stage radical resection approach using the Da Vinci Surgical System.Resection and anastomosis of rectal cancer were performed extracorporeally afterundocking the robot.The procedure was successfully completed in 500 min.No surgical complications occurred during the intervention and postoperative period, and no conversion to laparotomy or additional trocars were required.To the best of our knowledge, this is the first case of simultaneous resection for rectal cancer with liver and lung metastases using the Da Vinci Surgery System to be reported.The procedure is feasible and safe and its main advantages for patient are avoiding repeated operation, reducing surgical trauma, shortening recovery time, and early implementation of postoperative adjuvant therapy.

International consensus statement on robotic hepatectomy surgery in 2018

The robotic surgical system has been applied in liver surgery. However,controversies concerns exist regarding a variety of factors including the safety,feasibility, efficacy, and cost-effectiveness of robotic surgery. To promote the development of robotic hepatectomy, this study aimed to evaluate the current status of robotic hepatectomy and provide sixty experts' consensus and recommendations to promote its development. Based on the World Health Organization Handbook for Guideline Development, a Consensus Steering Group and a Consensus Development Group were established to determine the topics, prepare evidence-based documents, and generate recommendations. The GRADE Grid method and Delphi vote were used to formulate the recommendations. A total of 22 topics were prepared analyzed and widely discussed during the 4 meetings. Based on the published articles and expert panel opinion, 7 recommendations were generated by the GRADE method using an evidence-based method, which focused on the safety, feasibility, indication,techniques and cost-effectiveness of hepatectomy. Given that the current evidences were low to very low as evaluated by the GRADE method, further randomized-controlled trials are needed in the future to validate these recommendations.

Preparation of high-strength Al-Mg-Si-Cu-Fe alloy via heat treatment and rolling

An Al-Mg-Si-Cu-Fe alloy was solid-solution treated at 560℃ for 3 h and then cooled by water quenching or furnace cooling. The alloy samples which underwent cooling by these two methods were rolled at different temperatures. The microstructure and mechanical properties of the rolled alloys were investigated by optical microscopy, scanning electron microscopy, transmission electron microscopy, X-ray diffraction analysis, and tensile testing. For the water-quenched alloys, the peak tensile strength and elongation occurred at a rolling temperature of 180℃. For the furnace-cooled alloys, the tensile strength decreased initially, until the rolling temperature of 420℃, and then increased;the elongation increased consistently with increasing rolling temperature. The effects of grain boundary hardening and dislocation hardening on the mechanical properties of these rolled alloys decreased with increases in rolling temperature. The mechanical properties of the 180℃ rolling water-quenched alloy were also improved by the presence ofβ″phase. Above 420℃, the effect of solid-solution hardening on the mechanical properties of the rolled alloys increased with increases in rolling temperature.

Implantable collamer lens for residual refractive error after corneal refractive surgery

AIM：To assess the safety,efficacy,predictability and stability of implantable collamer lens（ICL） for residual refractive error after corneal refractive surgery.METHODS： This study evaluated 19 eyes of 12 patients who underwent ICL implantation after corneal refractive surgeries.They were followed up for 1y to 5y of uncorrected distance visual acuity（UDVA）,corrected distance visual acuity（CDVA）,manifest refractive error,flat and steep K value,axial length,intraocular pressure,corneal endothelial cell density,adverse events after ICL surgery.RESULTS： The mean follow-up period was 39.05 ±19.22 mo（range,1-5y）.Spherical equivalent refractive error changed from-7.45±3.02 D preoperatively to-0.85±1.10 D 1wk to 1mo after ICL implantation,with the safety and efficacy indices being 1.12 and 1.15,respectively.A total of 52.63% of eyes were within ±0.5 D of the predicted spherical equivalents,73.68% were within ±1.0 D.A trend of mild regression towards myopia with axial elongation after 5y was observed.One eye with mild anterior capsule opacity and retinal detachment 1y after surgery were observed.CONCLUSION： ICL implantation is safe and effective for the correction of residual refractive error after corneal refractive surgeries,especially in moderate to high residual myopia.

Two new tirucallane triterpenoids from Aphanamixis grandifolia

Two new tirucallane triterpenoids,2a-ethoxy-2,3-secotirucalla-2,29-epoxy-7-ene-23-oxo-3-oic acid(1)and(23E)-2a-hydroxytirucalla-7,23,25-triene-3-one(2),along with the known 2,3-secotirucalla-2,3;2,29-diepoxy-7-ene-3,23-dione(3),were isolated from the leaves and twigs of Aphanamixis grandifolia.Their structures were elucidated by extensive NMR and MS data,and compound 3 was further confirmed by X-ray crystal diffraction analysis.Antimicrobial activities and insecticidal activities of these three compounds were also evaluated.Compound 1 showed good antimicrobial activity against Staphylococcus aureus with the MIC value of 1.56μg/mL,while compounds 1 and 2 showed insecticidal activity at 100 ppm,with the corrected mortality 79.1%and 60.6%,respectively.

CT manifestations and features of solid cystic tumors of the pancreas

Objective: To study retrospectively the manifestations and characteristics of solid cystic tumor of the pan- creas(SCTP) on CT. Methods: Nine patients with solid cystic tumor of the pancreas underwent resection with pathological and immunohistochemical confirmation. All the patients were female, aged 27.7 years on average at onset of the disease. CT scan was performed in patients with or without intravenous injection of contrast medium; it was also performed in the arterial phase in 4 pa- tients. Results: Solid and cystic structures were observed in tumors of the pancreas. Solid structure demonstrated low or iso-density on unenhanced CT, poor enhance- ment in the arterial phase and marked enhancement in the portal venous phase on contrast material-en- hanced CT. Cystic structure showed low density on both pre- and pro-contrast views. The CT findings of tumors with predominantly cystic or equal propor- tion of solid and cystic structure: mural nodules for solid structure, 'floating cloud' signs, or solid and cystic crossing distributions. Cystic structure of tumors predominately solid presenting as a beading appearance under capsule. In round, oval and com- pletely encapsulated tumors in the pancreas, the greater vessel enhanced with well-defined margins on pro-contrast images. No dilatation was observed of the common bile and pancreatic ducts. Conclusion: The characteristics of solid cystic tumor of the pancreas revealed by CT could confirm the di- agnosis of the disease in combination with onset age and sex of patients.

Significance of serum glucagon-like peptide-1 and matrix Gla protein levels in patients with diabetes and osteoporosis

BACKGROUND Osteoporosis is a systemic bone disease characterized by decreased bone mass,impaired bone mass,and reduced bone strength that leads to increased bone fragility and fracture.Type 2 diabetes mellitus(T2DM)complicated with osteoporosis is a common systemic metabolic bone disease,and reduced bone mass and bone strength are considered the main clinical features;however,the pathogenesis of this disease has not been fully clarified.Its occurrence is considered related to sex,age,and genetic factors.There are many risk factors for diabetes complicated with osteoporosis.Therefore,exploring these risk factors will help prevent it.AIM To investigate the relationships among serum glucagon-like peptide-1(GLP-1)levels,matrix Gla protein(MGP)levels,and diabetes with osteoporosis.METHODS Sixty patients with T2DM complicated with osteoporosis confirmed by the endocrinology department of our hospital were selected as the case group.Sixty T2DM patients with bone loss were selected as the control group.Sixty healthy participants were selected as the healthy group.The general data,bone mineral density index,and bone metabolic markers of the three groups were compared.The relationships among GLP-1 levels,MGP levels,and the bone mineral density index of the case group were analyzed using linear correlation analysis and a logistic regression model.RESULTS Differences in sex,smoking,and drinking among the case group,control group,and healthy group were not statistically significant(P>0.05).The mean age of the case group was older than those of the control and healthy groups(P<0.05).The body mass index,fasting plasma glucose level,HbA1c level,hypertension rate,and coronary heart disease rate of the case and control groups were higher than those of the healthy group(P<0.05).The serum GLP-1 and MGP levels of the case group were lower than those of the control and healthy groups;these differences were statistically significant(P<0.05).The serum GLP-1 and MGP levels of the control group were lower than those of the healthy group;these differences were statistically significant(P<0.05).The serum GLP-1 and MGP levels of the case group were significantly positively correlated with the bone mineral density values of the hip and lumbar spine(P<0.05).The results of the logistic regression model showed that age and duration of diabetes were independent risk factors for osteoporosis in diabetic patients(P<0.05)and that increased GLP-1 and MGP values were protective factors against osteoporosis in diabetic patients(P<0.05).CONCLUSION Serum GLP-1 and MGP levels of diabetic patients with osteoporosis were significantly decreased and positively correlated with bone mineral density and were independent risk factors for osteoporosis in diabetic patients.

Using CT imaging to delineate the prostatic apex for radiation treatment planning

Background and Objective: In computed tomography (CT)-based radiotherapy planning for prostate cancer, it is difficult to precisely delineate the prostatic apex because of its relationship with the urogenital diaphragm and bulbospongiosus musculature. In this retrospective study, we analyzed the magnetic resonance imaging (MRI) and CT scans of the patients with prostate cancer to investigate the relationship between the prostatic apex and the anatomic structure visible on CT, and to provide evidence for localizing the prostatic apex in radiotherapy planning. Methods: MRI and CT scans of 108 patients with prostate cancer were analyzed to measure the distances between the prostatic apex and the bottom of ischial tuberosities, the bottom of obturator foramen, the bottom of pubic symphysis, and the bulb of the penis. The volume of the prostate was measured to analyze its relationship with the localization of the prostatic apex. Results: The prostatic apex was located (13.1 ± 3.3) mm above the bulb of the penis, (11.0 ± 5.4) mm above the bottom of the obturator foramen, (31.3 ± 5.5) mm above the ischial tuberosities, and (7.1 ± 4.7) mm above the bottom of the symphysis pubis. There was no correlation between the size of the prostate and the localization of the prostatic apex. Conclusions: The variance of the distance between the prostatic apex and the bulb of the penis is smaller than that of the distance between the apex and bony anatomy. Delineating the target to 6 mm above the bulb of the penis can cover the prostatic apex in 95% of the patients with prostate cancer, delineating to the bottom of obturator foramen can cover the prostatic apex in 100% of the patients.

One-step viscoelastic agent technique for ICL V4c implantation for myopia

AIM:To investigate the safety and efficacy of using a onestep viscoelastic agent technique for posterior chamber phakic implantable collamer lens with a central hole(ICL V4 c)implantation for myopia correction.METHODS:The one-step viscoelastic agent technique for ICL V4 c implantation was used in 100 eyes of 52 patients.Refractive outcomes,intraocular pressure(IOP),corneal endothelial cell,and corneal densitometry values were evaluated at 1 d,1 wk,1 and 3 mo postoperatively.RESULTS:All the surgeries were uneventful.No corrected distance visual acuity was lost after 3 mo.IOP was 16.12±3.18 mm Hg before surgery,and 14.74±3.08 mm Hg at 1d and 14.50±2.56 mm Hg at 3 mo after surgery(P<0.05).Corneal endothelial cell density was 2580±242 cell/mm^(2),the coefficient of variation in cell size was 42.11%±7.92%,and the percentage of hexagonal cells was 40.98%±9.46%before surgery.No significant difference was found when these outcomes were compared between the studied time points(P>0.05).The corneal densitometry values of the central 2 mm and 2 to 6 mm areas showed similar regularities.After surgery,the values significantly increased at 1 d,then decreased to the preoperative values at 1 wk,and then continued to decrease at 3 mo(P<0.05).CONCLUSION:The one-step viscoelastic agent technique for ICL V4c implantation is found to be safe and effective for myopia correction and causes little disturbance to the cornea.

Delivery room resuscitation and short-term outcomes of extremely preterm and extremely low birth weight infants: a multicenter survey in North China

Background:Delivery room resuscitation assists preterm infants,especially extremely preterm infants(EPI)and extremely low birth weight infants(ELBWI),in breathing support,while it potentially exerts a negative impact on the lungs and outcomes of preterm infants.This study aimed to assess delivery room resuscitation and discharge outcomes of EPI and ELBWI in China.Methods:The clinical data of EPI(gestational age[GA]<28 weeks)and ELBWI(birth weight[BW]<1000 g),admitted within 72 h of birth in 33 neonatal intensive care units from five provinces and cities in North China between 2017 and 2018,were analyzed.The primary outcomes were delivery room resuscitation and risk factors for delivery room intubation(DRI).The secondary outcomes were survival rates,incidence of bronchopulmonary dysplasia(BPD),and risk factors for BPD.Results:A cohort of 952 preterm infants were enrolled.The incidence of DRI,chest compressions,and administration of epinephrine was 55.9%(532/952),12.5%(119/952),and 7.0%(67/952),respectively.Multivariate analysis revealed that the risk factors for DRI were GA<28 weeks(odds ratio[OR],3.147;95%confidence interval[CI],2.082–4.755),BW<1000 g(OR,2.240;95%CI,1.606–3.125),and antepartum infection(OR,1.429;95%CI,1.044–1.956).The survival rate was 65.9%(627/952)and was dependent on GA.The rate of BPD was 29.3%(181/627).Multivariate analysis showed that the risk factors for BPD were male(OR,1.603;95% CI,1.061–2.424),DRI(OR,2.094;95% CI,1.328–3.303),respiratory distress syndrome exposed to≥2 doses of pulmonary surfactants(PS;OR,2.700;95%CI,1.679–4.343),and mechanical ventilation≥7 days(OR,4.358;95% CI,2.777–6.837).However,a larger BW(OR,0.998;95% CI,0.996–0.999),antenatal steroid(OR,0.577;95%CI,0.379–0.880),and PS use in the delivery room(OR,0.273;95%CI,0.160–0.467)were preventive factors for BPD(all P<0.05).Conclusion:Improving delivery room resuscitation and management of respiratory complications are imperative during early management of the health of EPI and ELBWI.

Impacts of transgenic Bt cotton on the stylet penetration behaviors of Bemisia tabaci biotype B Evidence from laboratory experiments

Stylet penetration behaviors of Bemisia tabaci biotype B on two transgenic cotton lines ＂GK12＂ and ＂GK19＂ expressing Bt toxic protein CrylA （Bt cotton） and a non-Bt conventional cotton line ＂Simian-3＂ （CK cotton） were recorded with the direct current electrical penetration graph （DC-EPG） technique. Our results suggested that EPG waveform patterns, types and characteristics [non-probe （NP）, pathway （C）, potential drops （pd） and phloem phase （E（pd））] ofBemisia tabaci biotype B were very similar on the three cotton lines. There were no obvious differences of pathway variables among whiteflies on the three cotton lines. Some phloem variables related to E（pd）l differed. Duration of 1st E（pd）l and mean duration of E（pd）l on both GK12 and GK19 were significantly shorter than that on CK cotton （P 〈 0.05）. Fewer whiteflies on GK have long E（pd）l. Other phloem variables including total duration of E（pd） summed, mean E（pd） duration and percentage of whiteflies reaching the phloem phase were similar among the three cotton lines.

The applied research of simultaneous image acquisition of T2-weighted imaging(T2WI)and diffusion-weighted imaging(DWI)in the assessment of patients with prostate cancer

We aimed to evaluate the feasibility of simultaneous image acquisition of multiple instantaneous switchable scan(MISS)for prostate magnetic resonance imaging(MRI)on 3T.Fifty-three patients were scanned with MRI due to suspected prostate cancer.Twenty-eight of them got histological results.First,two readers assessed the structure delineation and image quality based on images of conventional T2-weighted imaging(T2WI)and diffusion-weighted imaging(DWI)(CTD).Second,two readers identified the index lesion together,and then,reader one evaluated the contrast of index lesion on T2WI and signal ratio on apparent diffusion coefficient map.Third,they assigned Prostate Imaging Reporting and Data System(PI-RADS)score in consensus for the index lesion.After 4 weeks,the images of MISS were reviewed by the same readers following the same process.Finally,two readers gave preference for image interpretation,respectively.Kappa coefficient,Wilcoxon signed-rank test,paired-sample t-test,Bland-Altman analysis,and receiver operating characteristic(ROC)analysis were used for statistical analysis.The acquisition time of CTD was 6 min and 10 st while the acquisition time of MISS was 4 min and 30 s.Interobserver agreements for image evaluation were k=0.65 and k=0.80 for CTD and MISS,respectively.MISS-T2WI showed better delineation for seminal vesicles than CTD-T2WI(reader 1:P<0.001,reader 2:P=0.001).The index lesion demonstrated higher contrast in MISS-T2WI(P<0.001).The FI-RADS scores based on CTD and MISS exhibited high ability in predicting clinically significant cancer(area under curve[AUC]=0.828 vs 0.854).Readers preferred to use MISS in 41.5%-47.2%of cases.MISS showed comparable performance to conventional technique with less acquisition time.

Stylet penetration behaviors of the cotton aphid Aphis gossypfi on transgenic Bt cotton

Stylet penetration behaviors of cotton aphids Aphis gossypii Glover on a transgenic cotton line ＂GK-12＂ expressing Bt toxic protein of Cry 1A （Bt cotton） and a non- Bt conventional cotton line ＂Simian-3＂ （CK cotton） were recorded with the direct current electrical penetration graph （DC-EPG） technique. Cotton aphids reared on Bt cotton （abbreviated as Bt-aphids） and its parental non-Bt control line （CK-aphids） for more than 20 generations each, were used for recordings on two cotton lines. Among 47 selected parameters reflecting the activities of aphid stylets within plant tissues, there were eight parameters of CK-aphids showing significant differences between the performances of CK- aphids on Bt cotton and CK cotton, while for Bt-aphids, all the parameters were statistically equal between the performances on the two cotton lines. All parameters with significant differences indicated that CK-aphids could penetrate into Bt cotton more easily, but the phloem saps of Bt cotton were not as good as those of regular cotton for CK-aphids. Based on the present results, we concluded that there were some factors in Bt cotton affecting penetration behaviors of CK-aphids, but it just took several generations for CK-aphids to completely adapt Bt cotton, and Bt-aphids could feed on two cotton lines without difficulty.

Automatic extraction of imaging observation and assessment categories from breast magnetic resonance imaging reports with natural language processing

Background:Structured reports are not widely used and thus most reports exist in the form of free text.The process of data extraction by experts is time-consuming and error-prone,whereas data extraction by natural language processing (NLP) is a potential solution that could improve diagnosis efficiency and accuracy.The purpose of this study was to evaluate an NLP program that determines American College of Radiology Breast Imaging Reporting and Data System (BI-RADS) descriptors and final assessment categories from breast magnetic resonance imaging (MRI) reports.Methods:This cross-sectional study involved 2330 breast MRI reports in the electronic medical record from 2009 to 2017.We used 1635 reports for the creation of a revised BI-RADS MRI lexicon and synonyms lists as well as the iterative development of an NLP system.The remaining 695 reports that were not used for developing the system were used as an independent test set for the final evaluation of the NLP system.The recall and precision of an NLP algorithm to detect the revised BI-RADS MRI descriptors and BI-RADS categories from the free-text reports were evaluated against a standard reference of manual human review.Results:There was a high level of agreement between two manual reviewers,with a κ value of 0.95.For all breast imaging reports,the NLP algorithm demonstrated a recall of 78.5% and a precision of 86.1% for correct identification of the revised BI-RADS MRI descriptors and the BI-RADS categories.NLP generated the total results in <1 s,whereas the manual reviewers averaged 3.38 and 3.23 min per report,respectively.Conclusions:The NLP algorithm demonstrates high recall and precision for information extraction from free-text reports.This approach will help to narrow the gap between unstructured report text and structured data,which is needed in decision support and other applications.

Antibacterial mechanism of high-mobility group nucleosomalbinding domain 2 on the Gram-negative bacteria Escherichia coli

Objective： To investigate the antibacterial mechanism of high-mobility group nucleosomal-binding domain 2 （HMGN2） on Escherichia coil K12, focusing on the antibacterial and antibiofilm formation effects. Its chemotactic activity on human neutrophils was also investigated. Methods： Human tissue-derived HMGN2 （tHMGN2） was extracted from fresh uterus fiber cystadenoma and purified by HPl100 reversed-phase high-performance liquid chromatography （RP-HPLC）. Recombinant human HMGN2 （rHMGN2） was generated in E. coil DE3 carrying PET-32a- c（＋）-HMGN2. Antibacterial activity of HMGN2 was determined using an agarose diffusion assay and minimum inhibitory concentration （MIC） of HMGN2 was determined by the microdilution broth method. Bacterial membrane permeability assay and DNA binding assay were performed. The antibiofilm effect of HMGN2 was investigated using a crystal violet assay and electron microscopy scanning. The activating effect and chemotactic activity of HMGN2 on neutrophils were determined using a nitroblue tetrazolium （NBT） reduction assay and Transwell chamber cell migra- tion assay, respectively. Results： HMGN2 showed a relatively high potency against Gram-negative bacteria E. coli and the MIC of HMGN2 was 16.25 μg/ml. Elevated bacterial membrane permeability was observed in HMGN2-treated E. coil K12. HMGN2 could also bind the bacterial plasmid and genomic DNA in a dose-dependent manner. The antibiofilm effect of HMGN2 on E. coil K12 was confirmed by crystal violet staining and scanning electron microscopy. However, the activating effects and chemotactic effects of HMGN2 on human neutrophils were not observed. Con- clusions： As an antimicrobial peptide （AMP）, HMGN2 possessed a good capacity for antibacterial and antibiofilm activities on E. coil K12. This capacity might be associated with disruption of the bacterial membrane and combination of DNA, which might affect the growth and viability of E. coil.