Surgical method choice and coincidence rate of pathological diagnoses in transduodenal ampullectomy: A retrospective case series study and review of the literature

BACKGROUND Transduodenal ampullectomy(TDA) is not in wide clinical use due to its low radical effect and a high recurrence rate of tumors. However,TDA is still an effective treatment method; it has great clinical value in cases of duodenal benign tumors,precancerous lesions,and benign and malignant borderline tumors,and can avoid the risks associated with pancreaticoduodenectomy with larger resection range and greater thoroughness than endoscopic papillectomy.AIM To investigate the surgical method choice and the coincidence rate of pathological diagnoses in TDA for ampullary neoplasms.METHODS Ten patients with ampullary neoplasms underwent TDA based on the fact that their endoscopic biopsy results suggested benign lesions,and the endoscopic ultrasound(EUS)-assessed tumors were resectable. All cases underwent duodenal ampullary lesion endoscopic biopsy,intraoperative frozen-section pathological examination,and postoperative pathological examination.RESULTSThis study included seven patients with benign tumors and three with malignant tumors(1 pTis,2 pT1),according to the postoperative pathology results. The coincidence rate of the postoperative pathology results with the intraoperative frozen-section biopsy results was 100%(10/10),and the coincidence rate with the endoscopic biopsy results was 70%(7/10) based on pathological characteristics.The endoscopic biopsy false-negative rate was 30%(3/10). All patients were followed for 6 to 70 mo without tumor recurrence or metastasis.CONCLUSION The coincidence rate of postoperative pathology results,intraoperative frozensection pathology results,and endoscopic biopsy results is the restraining factor of TDA clinical application. Endoscopic biopsy results and EUS have importance relevance to surgical planning. Intraoperative frozen-section pathology results have a significant influence on the choice of surgical procedure.

Equilibrium Reconstruction and Integration of EFIT with Diagnoses in J-TEXT Tokamak

The EFIT program is integrated with the high resolution laser polarimeter interferometer system（POLARIS）, the soft X-ray imaging diagnostic system（SXR） and the electron cyclotron emission radiometer（ECE） in the J-TEXT tokamak. Then some internal information about Faraday angle and the position of safety factor q=1 can be obtained as a constraint to EFIT. The modified EFIT code is used to calculate the internal parameters such as flux function, safety factor q, pressure and current density.

Improvement of NIR models for quality parameters of leech and earthworm medicines using outlier multiple diagnoses

Leeches and earthworms are the main ingredients of Shuxuetong injection compositions,whichare natural biomedicines.Near infrared(NIR)diffuse reflection spectroscopy has been used forquality assurance of Chinese medicines.In the present work,NIR spectroscopy was proposed as arapid and nondestructive technique to assess the moisture content(MC),soluble solid content(SSC)and hypoxanthine content(HXC)of leeches and earthworms.This study goal was toimprove NIR models for accurate quality control of leech and earthworm using outlier multiplediagnoses(OMD).OMD was composed of four outlier detection methods:spectrum outlier di-agnostic(MD),leverage diagnostic(LD),principal component scores diagnostic(PCSD)andfactor loading diagnostic(FLD),Conventional outlier diagnoses(MD,LD)and OMD werecompared,and the best NIR models were those based on OMD.The correlation coefficients(R)for leech were 0.9779,0.9616 and 0.9406 for MC,SSC and HXC,respectively.The values ofrelative standard error of prediction(RSEP)for leech were 2.3%,5.1%and 9.0%for MC,SSC and HXC,respectively.The values of R for earthworm were 0.9478,0.9991 and 0.9605 for MC,SSC and HXC,respectively.The values of RSEP for earthworm were 8.8%,2.4%and 12%for MC,SSC and HXC,respectively.The performance of the NIR models was certainly improved by OMD.

Clinical algorithm for preventing missed diagnoses of occult cervical spine instability after acute trauma: A case report

BACKGROUND Missed or delayed diagnosis of cervical spine instability after acute trauma can have catastrophic consequences for the patient,resulting in severe neurological impairment.Currently,however,there is no consensus on the optimal strategy for diagnosing occult cervical spine instability.Thus,we present a case of occult cervical spine instability and provide a clinical algorithm to aid physicians in diagnosing occult instability of the cervical spine.CASE SUMMARY A 57-year-old man presented with cervical spine pain and inability to stand following a serious fall from a height of 2 m.No obvious vertebral fracture or dislocation was found at the time on standard lateral X-ray,computed tomography,and magnetic resonance imaging(MRI).Subsequently,the initial surgical plan was unilateral open-door laminoplasty(C3-7)with alternative levels of centerpiece mini-plate fixation(C3,5,and 7).However,the intraoperative C-arm fluoroscopic X-rays revealed significantly increased intervertebral space at C5-6,indicating instability at this level that was previously unrecognized on preoperative imaging.We finally performed lateral mass fixation and fusion at the C5-6 level.Looking back at the preoperative images,we found that the preoperative T2 MRI showed non-obvious high signal intensity at the C5-6 intervertebral disc and posterior interspinous ligament.CONCLUSION MRI of cervical spine trauma patients should be carefully reviewed to detect disco-ligamentous injury,which will lead to further cervical spine instability.In patients with highly suspected cervical spine instability indicated on MRI,lateral X-ray under traction or after anesthesia and muscle relaxation needs to be performed to avoid missed diagnoses of occult cervical instability.

Reliability Assessment of a New General Matching Composed Network

The reliability of a network is an important indicator for maintaining communication and ensuring its stable operation. Therefore, the assessment of reliability in underlying interconnection networks has become an increasingly important research issue. However, at present, the reliability assessment of many interconnected networks is not yet accurate,which inevitably weakens their fault tolerance and diagnostic capabilities. To improve network reliability,researchers have proposed various methods and strategies for precise assessment. This paper introduces a novel family of interconnection networks called general matching composed networks(gMCNs), which is based on the common characteristics of network topology structure. After analyzing the topological properties of gMCNs, we establish a relationship between super connectivity and conditional diagnosability of gMCNs. Furthermore, we assess the reliability of g MCNs, and determine the conditional diagnosability of many interconnection networks.

Non-coding RNA as future target for diagnose and treatment of perineural invasion in cancers

Perineural invasion(PNI),a particularly insidious form of tumor metastasis distinct from hematogenous or lymphatic spread,has the capacity to extend well beyond the primary tumor site,infiltrating distant regions devoid of lymphatic or vascular structures.PNI often heralds a decrease in patient survival rates and is recognized as an indicator of an unfavorable prognosis across a variety of cancers.Despite its clinical significance,the underlying molecular mechanisms of PNI remain elusive,complicating the development of specific and efficacious diagnostic and therapeutic strategies.In the realm of cancer research,non-coding RNAs(ncRNAs)have attracted considerable attention due to their multifaceted roles and cancer-specific expression profiles,positioning them as promising candidates for applications in cancer diagnostics,prognostics,and treatment.Among the various types of ncRNAs,microRNAs(miRNAs),long non-coding RNAs(lncRNAs),and circular RNAs(circRNAs)have emerged as influential players in PNI.Their involvement is increasingly recognized as a contributing factor to tumor progression and therapeutic resistance.Our study synthesizes and explores the diverse functions and mechanisms of ncRNAs in relation to PNI in cancer.This comprehensive review aims to shed light on cutting-edge perspectives that could pave the way for innovative diagnostic and therapeutic approaches to address the challenges posed by PNI in oncology.

Intra-thyroid esophageal duplication cyst:A case report

BACKGROUND Esophageal cysts are relatively rare in clinical practice,with most of the literature comprising case reports.Esophageal cysts protruding into the thyroid gland are easily misdiagnosed as thyroid tumors.No such cases have been reported so far.CASE SUMMARY This article reports the case of a 31-year-old adult male diagnosed with thyroid nodules before admission.The patient underwent left thyroidectomy and isthmusectomy.During the surgery,esophageal cysts were identified in the esophageal muscle and thyroid glands.The pathology results confirmed a nodular goiter combined with esophageal cysts.Postoperatively,the patient developed a neck infection and underwent another operation and broad-spectrum antibiotic treatment for recovery.CONCLUSION We report the first clinical case of an esophageal cyst located within the thyroid gland that was successfully treated surgically.Esophageal cyst located within the thyroid gland cause difficulties in diagnosis.In the present study,the contents of the esophageal cysts were calcified foci,and a small amount of fluid mixture,which were easily misdiagnosed as thyroid nodules and misled the surgical methods.

Construction of the underlying circRNA-miRNA-mRNA regulatory network and a new diagnostic model in ulcerative colitis by bioinformatics analysis

BACKGROUND Circular RNAs(circRNAs)are involved in the pathogenesis of many diseases through competing endogenous RNA(ceRNA)regulatory mechanisms.AIM To investigate a circRNA-related ceRNA regulatory network and a new predictive model by circRNA to understand the diagnostic mechanism of circRNAs in ulcerative colitis(UC).METHODS We obtained gene expression profiles of circRNAs,miRNAs,and mRNAs in UC from the Gene Expression Omnibus dataset.The circRNA-miRNA-mRNA network was constructed based on circRNA-miRNA and miRNA-mRNA interactions.Functional enrichment analysis was performed to identify the biological mechanisms involved in circRNAs.We identified the most relevant differential circRNAs for diagnosing UC and constructed a new predictive nomogram,whose efficacy was tested with the C-index,receiver operating characteristic curve(ROC),and decision curve analysis(DCA).RESULTS A circRNA-miRNA-mRNA regulatory network was obtained,containing 12 circRNAs,three miRNAs,and 38 mRNAs.Two optimal prognostic-related differentially expressed circRNAs,hsa_circ_0085323 and hsa_circ_0036906,were included to construct a predictive nomogram.The model showed good discrimination,with a C-index of 1(>0.9,high accuracy).ROC and DCA suggested that the nomogram had a beneficial diagnostic ability.CONCLUSION This novel predictive nomogram incorporating hsa_circ_0085323 and hsa_circ_0036906 can be conveniently used to predict the risk of UC.The circRNa-miRNA-mRNA network in UC could be more clinically significant.

DIFFERENTIAL ULTRASONIC DIAGNOSES OF PULMONARY BENIGN AND MALIGNANT SPACE-OCCUPIED LESIONS OF THE PERIPHERAL TYPE

87 patients with pulmonary space-occupied lesions of the peripheral type which were either adhesive of close to pleura were examined using ultuasonography.Of them,64 cases of lung cancers and 23 of bening lesions were then confirmed by

Perivascular epithelioid cell tumors of the liver misdiagnosed as hepatocellular carcinoma:Three case reports

BACKGROUND Hepatic perivascular epithelioid cell neoplasms(PEComas)are rare.Diagnostic and treatment experience with hepatic PEComa remains insufficient.CASE SUMMARY Three hepatic PEComa cases are reported in this paper:One case of primary malignant hepatic PEComa,one case of benign hepatic PEComa,and one case of hepatic PEComa with an ovarian mature cystic teratoma.During preoperative imaging and pathological assessment of intraoperative frozen samples,patients were diagnosed with hepatocellular carcinoma(HCC),while postoperative pathology and immunohistochemistry subsequently revealed hepatic PEComa.Patients with hepatic PEComa which is misdiagnosed as HCC often require a wider surgical resection.It is easy to mistake them for distant metastases of hepatic PEComa and misdiagnosed as HCC,especially when it’s combined with tumors in other organs.Three patients eventually underwent partial hepatectomy.After 1-4 years of follow-up,none of the patients experienced recurrence or metastases.CONCLUSION A clear preoperative diagnosis of hepatic PEComa can reduce the scope of resection and prevent unnecessary injuries during surgery.

A Validated Model for the Imaging Diagnosis of Cystic Lung Disease

Rationale and Objectives: Cystic lung disease may be accurately diagnosed by imaging interpretation of specialist radiologists, without other information. We hypothesized that with minimal training non-specialists could perform similarly to specialist physicians in the diagnosis of cystic lung disease. Methods: 72 cystic lung disease cases and 25 cystic lung disease mimics were obtained from three sources: 1) a prospective acquired diffuse lung disease registry, 2) a retrospective search of medical records and 3) teaching files. Cases were anonymized, randomized and interpreted by 7 diffuse lung disease specialists and 15 non-specialist radiologists and pulmonologists. Clinical information other than age and sex was not provided. Prior to interpretation, non-specialists viewed a short PDF training document explaining cystic lung disease interpretation. Results: Correct first choice diagnosis of 85%-88% may be achieved by high-performing specialist readers and 71%-80% by non-specialists and lower-performing specialists, with mean accuracies in the diagnosis of LAM (91%, p Conclusion: With specific but limited training, non-specialist physicians can diagnose cystic lung diseases from CT appearance alone with similar accuracy to specialists, correctly identifying approximately 75% of cases.

Eosinophilic fasciitis difficult to differentiate from scleroderma:A case report

BACKGROUND Eosinophilic fasciitis(EF)is a rare connective tissue disease that can cause swelling and sclerosis of the extremities,and special attention is needed to differentiate EF from systemic sclerosis.Misdiagnosis or omission markedly delays treatment of EF,and severe skin sclerosis in advanced stages can cause joint contracture and tendon retraction,worsening the patient's prognosis and quality of life.CASE SUMMARY We report a case of EF in a young woman diagnosed by tissue biopsy,confirming the difficulty of differential diagnosis with scleroderma.CONCLUSION Focusing on skin manifestations,completing tissue biopsy and radiography can help diagnose EF effectively.Clinicians should enhance their understanding of the differences between EF and scleroderma,and early diagnosis and standardized treatment can improve the prognosis of patients with EF.

Prediction System for Diagnosis and Detection of Coronavirus Disease-2019(COVID-19):A Fuzzy-Soft Expert System

In early December 2019,a new virus named“2019 novel coronavirus(2019-nCoV)”appeared in Wuhan,China.The disease quickly spread worldwide,resulting in the COVID-19 pandemic.In the currentwork,we will propose a novel fuzzy softmodal(i.e.,fuzzy-soft expert system)for early detection of COVID-19.Themain construction of the fuzzy-soft expert systemconsists of five portions.The exploratory study includes sixty patients(i.e.,fortymales and twenty females)with symptoms similar to COVID-19 in(Nanjing Chest Hospital,Department of Respiratory,China).The proposed fuzzy-soft expert systemdepended on five symptoms of COVID-19(i.e.,shortness of breath,sore throat,cough,fever,and age).We will use the algorithm proposed by Kong et al.to detect these patients who may suffer from COVID-19.In this way,the present system is beneficial to help the physician decide if there is any patient who has COVID-19 or not.Finally,we present the comparison between the present system and the fuzzy expert system.

COVID TCL:A Joint Metric Loss Function for Diagnosing COVID-19 Patient in the Early and Incubation Period

Convolution Neural Networks(CNN)can quickly diagnose COVID-19 patients by analyzing computed tomography(CT)images of the lung,thereby effectively preventing the spread of COVID-19.However,the existing CNN-based COVID-19 diagnosis models do consider the problem that the lung images of COVID-19 patients in the early stage and incubation period are extremely similar to those of the non-COVID-19 population.Which reduces the model’s classification sensitivity,resulting in a higher probability of the model misdiagnosing COVID-19 patients as non-COVID-19 people.To solve the problem,this paper first attempts to apply triplet loss and center loss to the field of COVID-19 image classification,combining softmax loss to design a jointly supervised metric loss function COVID Triplet-Center Loss(COVID-TCL).Triplet loss can increase inter-class discreteness,and center loss can improve intra-class compactness.Therefore,COVID-TCL can help the CNN-based model to extract more discriminative features and strengthen the diagnostic capacity of COVID-19 patients in the early stage and incubation period.Meanwhile,we use the extreme gradient boosting(XGBoost)as a classifier to design a COVID-19 images classification model of CNN-XGBoost architecture,to further improve the CNN-based model’s classification effect and operation efficiency.The experiment shows that the classification accuracy of the model proposed in this paper is 97.41%,and the sensitivity is 97.61%,which is higher than the other 7 reference models.The COVID-TCL can effectively improve the classification sensitivity of the CNN-based model,the CNN-XGBoost architecture can further improve the CNN-based model’s classification effect.

Pulmonary arterial hypertension confirmed by right heart catheterization following COVID-19 pneumonia: A case report and review of literature

BACKGROUND Pulmonary arterial hypertension(PAH)is a disease of the arterioles resulting in an increased resistance in pulmonary circulation with associated high pressures in the pulmonary arteries,causing irreversible remodeling of the pulmonary arterial walls.Coronavirus disease 2019(COVID-19)has been associated with development of new onset PAH in the literature leading to symptoms of dyspnea,cough and fatigue that persist in spite of resolution of acute COVID-19 infection.However,the majority of these cases of COVID related PAH were diagnosed using echocardiographic data or via right heart catheterization in mechanically ventilated patients.CASE SUMMARY Our case is the first reported case of COVID related PAH diagnosed by right heart catheterization in a non-mechanically ventilated patient.Right heart catheterization has been the gold standard for diagnosis of pulmonary hypertension.Our patient had right heart catheterization four months after her initial COVID-19 infection due to persistent dyspnea.CONCLUSION This revealed new onset PAH that developed following her infection with COVID-19,an emerging sequela of the infection.

Infantile hepatic hemangioendothelioma:A clinicopathologic study in a Chinese population

AIM:To investigate whether the clinicopathologic features of infantile hemangioendothelioma(IHE) of the liver in a Chinese population are similar to the features observed in other races.METHODS:The clinical data,radiological findings,histopathological changes and outcome of 12 cases of IHE diagnosed by the Department of Pathology,West China Hospital over the last 10 years were analyzed retrospectively.Immunohistochemical studies were carried out using antibodies against CD31,CD34,Factor Ⅷ,cytokeratin 8 and cytokeratin 18.RESULTS:The 12 patients were aged from fetal to 5 years(three males and nine females).The tumor was presented with different clinical manifestations,mainly as an asymptomatic,palpable,upper abdominal mass,except for the two fetuses who were detected antena-tally by ultrasound.In one patient,this presentation was accompanied by an initial severe pneumothorax.No symptoms of congestive heart failure were present and neither congenital abnormalities nor vascular tumors in the skin or other organs were found.Laboratory abnormalities included leukocytosis(40%),anemia(60%),thrombocytosis(60%),hyperbilirubinemia(16.7%),abnormal liver function(50%) and increased α-fetoprotein(80%).Based on radiological findings and gross specimens,the tumor presented as a solitary lesion or a multifocal space-occupying lesion.The tumor size ranged from 5.0 cm × 3.5 cm × 2.0 cm to 13.8 cm × 9.0 cm × 7.7 cm,and the 0.2-1.1 cm nodules were diffusely distributed within the multifocal tumor.Seven cases were surgically resected,three cases underwent biopsy and the two fetuses were aborted.Histologically,nine cases were classified as typeⅠ and three as type Ⅱ,presenting aggressive morphologic features,immature vessels,active mitosis and necrosis.An inflammatory component,predominantly eosinophilic granulocytes,sometimes obscured the nature of the tumor.Ten patients are alive after a follow-up of 1-9 years.Based on immunohistochemistry,the endothelial cells in all cases were positive for CD31,CD34 and polyclonal factor Ⅷ antigen,whereas the scattered hyperplasia bile ducts were positive for cytokeratin 8 and cytokeratin 18.CONCLUSION:The clinical manifestations of IHE are non-specific.There is no significant correlation between histological type and prognosis.The clinicopathologic features of IHE in Chinese patients may provide a clue to further evidence-based studies.

A Review of Major Progresses in Mesoscale Dynamic Research in China since 1999

Mesoscale research conducted by Chinese meteorologists during the past four years is reviewed. Advances in theoretical studies include (a) mesoscale quasi-balanced and semi-balanced dynamics, derived through scale analysis and the perturbation method which are suitable for describing mesoscale vortices; (b) subcritical instability and vortex-sheet instability; (c) frontal adjustment mechanism and the effect of topography on frontgenesis; and (d) slantwise vorticity development theories, the slantwise vortex equation, and moist potential vorticity (MPV) anomalies with precipitation-related heat and mass sinks and MPV impermeability theorem. Prom the MPV conservation viewpoint, the transformation mechanism between different scale weather systems is analyzed. Based on the data analysis, a new dew-point front near the periphery of the West Pacific subtropical high is identified. In the light of MPV theory and Q-vector theory, some events associated with torrential rain systems and severe storms are analyzed and diagnosed. Progress in mesoscale numerical simulation has been made in the development of meso-α, meso-β vortices, meso-γ-scale downbursts and precipitation produced by deep convective systems with MM5 and other mesoscale models.

Intelligent Transformation and Upgrading of Oil Refining & Petrochemical Industries in China:Investigation & Application

The oil refining and petrochemical industry in China has made great achievements after decades of development, and its capacity has already ranked second in the world. However, the refining industry is suffering some challenges, such as severe overcapacity at present, and has entered a new economic normal, in which the technological progress develops rapidly, the demand for green and low-carbon development is stricter, the market competition is increasingly fiercer and the profit margins are gradually narrowing. In such a situation, informatization and its new technologies are driving the significant reforming of manufacturing patterns, marketing patterns, management and decision-making patterns. Intelligent development is the inevitable choice for the transformation and upgrading of oil refining and petrochemical industry. It is suggested that the intelligent evaluating model and method should be adopted to enterprise’s intelligentializing transformation and upgrading by laying a solid foundation of digital refinery and implemenation of digital upgrading.

The Application of the Edge Sharpening Operator to the Breast Near-Infrared Imaging

The principles of Gradient operator, Laplacian operator, LOG operator and Sobel operator are discussed. Certain features of breast can be extracted in different degrees and aspects from original images by applying four edge sharpening operators to the breast near-infrared imaging. A great number of cases prove that compared with the other three operators, the improved Sobel operator can effectively extract the structural features of the breast from an original image. It can be concluded that the improved Sobel operator can assist in diagnosing breast diseases.

A note on the Galilean invariance of aerodynamic force theories in unsteady incompressible flows

As a basic principle in classical mechanics,the Galilean invariance states that the force is the same in all inertial frames of reference.But this principle has not been properly addressed by most unsteady aerodynamic force theories,if the partial force contributed by a local flow structure is to be evaluated.In this note,we discuss the Galilean-invariance conditions of the partial force for several typical theories and numerically test what would happen if these conditions do not hold.