基于检验组学及机器学习的乳腺癌诊断模型研究

目的:以常规临床检验大数据为基础,使用机器学习算法构建乳腺癌诊断模型。以探讨临床检验组学在乳腺癌诊断中的应用价值。方法:采用回顾性研究方法,收集6089例乳腺癌患者及6830例乳腺良性疾病患者临床信息和检验数据。分别运用极限梯度提升、神经网络、支持向量机、随机森林、最近邻算法、逻辑回归、线性判别分析算法、朴素贝叶斯、梯度提升机算法和C5.0决策树等机器学习算法建立乳腺癌诊断模型。采用10折交叉验证进行模型训练,应用准确度、AUC、平均准确度、特异度、灵敏度、阳性预测值、阴性预测值及Kappa值评估各模型性能。结果:从28项常规临床检验指标中筛选出GLU、DBIL、RDW-CV、MONO、TG、ALB、RBC、LYMPH、UREA等9项指标再加上age用于模型构建。通过10种机器学习算法进行模型评估,发现梯度提升机算法相较其它算法具有最优的诊断性能。梯度提升机算法诊断乳腺癌准确度为0.80、AUC为0.80、平均准确度为0.80、特异度为0.77、灵敏度为0.82、阳性预测值为0.78、阴性预测值为0.81、Kappa值为0.59。结论:以常规临床检验数据为基础,使用机器学习算法构建乳腺癌诊断模型,可以为乳腺癌的辅助诊断提供决策支持。

检验组学在精准医疗中的应用价值

随着多组学时代的到来,检验组学这一综合性科学应运而生。检验组学是综合基因组学、蛋白组学、代谢组学、免疫组学及药物基因组学等多组学的检验数据结果,并利用大数据的计算方法对各个组学的数据指标进行分析、筛选、分类、整合的多领域交叉学科。通过大数据、高通量的数据分析方法,可得到更加精准的病理指标置信区间,完善疾病的早期预警诊断体系,形成个体化的生物医学信息库,以满足精准诊断、精准治疗的要求。尽管检验组学大数据分析在实际应用中处于起步阶段,但通过与相关科学技术的结合发展,检验组学将会成为临床检验医学领域的重要发展方向。

基于AI的多组学分析方法鉴别新型冠状病毒感染和社区获得性肺炎的价值

目的:旨在评估基于影像组学特征和常规临床信息(包括临床症状及临床检验数据)的多组学模型在区分新型冠状病毒感染(COVID-19)和社区获得性肺炎(CAP)方面的分类性能。方法:收集奥密克戎(Omicron)变异株引起的COVID-19确诊患者和其他病毒感染引起的CAP确诊患者临床及胸部CT影像资料,基于数据集构建影像组学模型、临床特征模型、多组学模型,通过受试者工作特性曲线(ROC)分析评估每个模型的分类性能。结果:选择8个影像组学特征和7个临床特征来构建影像组学模型、临床特征模型、多组学模型。在测试集中,影像组学模型受试者工作特征曲线下面积(AUC)为0.759,临床特征模型AUC为0.853,多组学模型AUC为0.9。结论:基于AI的多组学分析方法构建的多组学模型分类性能高于影像组学模型和临床特征模型,对COVID-19和CAP的鉴别诊断具有可行性。

Diagnosis of intestinal tuberculosis using a monoclonal antibody to Mycobacterium tuberculosis

AIM:To investigate the utility of immunohistochemical(IHC) staining with an antibody to Mycobacterium tuberculosis(M.tuberculosis) for the diagnosis of intestinal tuberculosis(TB).METHODS:We retrospectively identified 10 patients(4 males and 6 females;mean age = 65.1 ± 13.6 years) with intestinal TB.Clinical characteristics,including age,gender,underlying disease,and symptoms were obtained.Chest radiograph and laboratory tests,including sputum Ziehl-Neelsen(ZN) staining,M.tuberculosis culture,and sputum polymerase chain reaction(PCR) for tubercle bacilli DNA,as well as Tuberculin skin test(TST) and QuantiFERON-TB gold test(QFT),were examined.Colonoscopic records recorded on the basis of Sato's classification were also reviewed,in addition to data from intestinal biopsies examined for histopathological findings,including hematoxylin and eosin staining,and ZN staining,as well as M.tuberculosis culture,and PCR for tubercle bacilli DNA.For the present study,archived formalin-fixed paraffin-embedded(FFPE) intestinal tissue samples were immunohistochemically stained using a commercially available species-specific monoclonal antibody to the 38-kDa antigen of the M.tuberculosis complex.These sections were also stained with the pan-macrophage marker CD68 antibody.RESULTS:From the clinical data,we found that no patients were immunocompromised,and that the main symptoms were diarrhea and weight loss.Three patients displayed active pulmonary TB,six patients(60%) had a positive TST,and 4 patients(40%) had a positive QFT.Colonoscopic findings revealed that all patients had type 1 findings(linear ulcers in a circumferential arrangement or linear ulcers arranged circumferentially with mucosa showing multiple nodules),all of which were located in the right hemicolon and/or terminal ileum.Seven patients(70%) had concomitant healed lesions in the ileocecal area.No acid-fast bacilli were detected with ZN staining of the intestinal tissue samples,and both M.tuberculosis culture and PCR for tubercle bacilli DNA were negative in all samples.The histopathological data revealed that tuberculous granulomas were present in 4 cases(40%).IHC staining in archived FFPE samples with anti-M.tuberculosis monoclonal antibody revealed positive findings in 4 patients(40%);the same patients in which granulomas were detected by hematoxylin and eosin staining.M.tuberculosis antigens were found to be mostly intracellular,granular in pattern,and primarily located in the CD68 + macrophages of the granulomas.CONCLUSION:IHC staining with a monoclonal antibody to M.tuberculosis may be an efficient and simple diagnostic tool in addition to classic examination methods for the diagnosis of intestinal TB.

Study on Microstructure and Properties of TIG Welded Joint of TC2 Titanium Alloy and Quality Inspection

TIG welding experiments of TC2 titanium alloy sheet was carried out,and the well-formed weld was obtained.After welding process,the cross-section microstructure,mechanical properties,fracture morphology and quality inspection of the joint were studied.The results show that the microstructure of the weld consists of a large number of acicularα′andβblock.The microhardness curve shows that the microhardness value in the fusion zone(FZ)of the joint is significantly higher than that in the heat affected zone(HAZ)and the base metal(BM),and the microhardness of the base metal is the lowest.The tensile strength of the joint is equivalent to that of the base metal,and the fracture morphology shows that the fracture mechanism of the joint is mixed ductile-brittle fracture mode.The weld quality is excellent through chemical inspection,penetrant inspection and X-ray inspection.

Experimental research of pulmonary injury on irradiation combined with pemetrexed

Objective: The aim of our study was to examine whether irradiation combined with pemetrexed can exacerbate pulmonary injury. Methods: Two groups of male Wister Rats were subjected to bilateral apex of lungs irradiation(a single dose of 12 Gy), with or without pemetrexed(20 mg/kg) by intraperitoneal injection at the same time; a third group of weightand age- matched animals were treated with pemetrexed alone, as the same dose scheme, time and root of injection. The fourth group served as control. The whole lung mounts were dissected to histological evaluation, while serum cytokine transforming growth factor-β1(TGF-β1) analysis were compared at 1, 7, 21, 35, 49 days post-irradiation after irradiation. Results: Histological examination showed a thickening of alveolar septal, accumulation of inflammatory cells. The irradiation treatment group and the radiation-chemo treatment group showed a statistically significant higher level of TGF-β1(P < 0.05) than other two groups, but there were no differences between these two irradiation groups. Conclusion: These results demonstrated that pemetrexed can not aggravate pulmonary injury and it could be safely used in concurrent or sequential radio-chemotherapy in lung adenocarcinoma.

Secondary hyperparathyroidism associated with multiple brown tumor:a case report

Brown tumour represents a serious complication of hyperparathyroidism.Definitive diagnosis is based on histological examination,clinical,radiological and laboratory data.Here we report a case of multiple brown tumours localised in collarbone,rib and in the distal ulna due to secondary hyperparathyroidism in a 37-year-old women with chronic renal failure.The clinical management of brown tumour aimed primarily to reduce the elevated parathyroid hormone levels by pharmacological treatment.In our experience,clinicians usually consider brown tumor of hyperparathyroidism is caused by giant cell lesions in maintenance hemodialysis recipients,and multiple brown tumours are rarely seen in these patients.

Changes of balance between proteinase and their inhibitors in blood of pigs with high-velocity missile wounds

Objective: To study the effect of imbalance between lysosomal enzymes and their inhibitors in blood on disturbance of the local and whole body after trauma.Methods: The dynamic changes of lysosomal enzymes and proteinase inhibitors were studied in 12 pigs with femoral comminuted fractures in both hind limbs caused by high velocity missiles. Four normal pigs served as controls.Results: After injury, the activity of Cathepsin D in arterial plasma increased gradually and reached the highest level at 8 hours, acid phosphatase in serum began to increase at 12 hours and the value of serum elastase did not change significantly. The level of αl-antitrypsin, a proteinase inhibitor in plasma, decreased significantly in the early stage after injury [ 73.5% ±6.4% and 81.0% ±5.1% of the baseline value (1.67 μmol · ml-1 · min-1 ± 0.29 μmol · ml-1 · min-1) at 1 and 2 hours after injury, respectively, P < 0.05 ], then increased gradually and was higher than the baseline value at 12 hours after injury.Conclusions: Imbalance between lysosomal enzymes and proteinase inhibitors occurs soon after injury, which might result in continuous tissue damage and play an important role in the disturbance of general reaction after injury.