Magnetic resonance imaging-radiomics evaluation of response to chemotherapy for synchronous liver metastasis of colorectal cancer

BACKGROUND Synchronous liver metastasis(SLM)is an indicator of poor prognosis for colorectal cancer(CRC).Nearly 50%of CRC patients develop hepatic metastasis,with 15%-25%of them presenting with SLM.The evaluation of SLM in CRC is crucial for precise and personalized treatment.It is beneficial to detect its response to chemotherapy and choose an optimal treatment method.AIM To construct prediction models based on magnetic resonance imaging(MRI)-radiomics and clinical parameters to evaluate the chemotherapy response in SLM of CRC.METHODS A total of 102 CRC patients with 223 SLM lesions were identified and divided into disease response(DR)and disease non-response(non-DR)to chemotherapy.After standardizing the MRI images,the volume of interest was delineated and radiomics features were calculated.The MRI-radiomics logistic model was constructed after methods of variance/Mann-Whitney U test,correlation analysis,and least absolute shrinkage and selection operator in feature selecting.The radiomics score was calculated.The receiver operating characteristics curves by the DeLong test were analyzed with MedCalc software to compare the validity of all models.Additionally,the area under curves(AUCs)of DWI,T2WI,and portal phase of contrast-enhanced sequences radiomics model(Ra-DWI,Ra-T2WI,and Ra-portal phase of contrast-enhanced sequences)were calculated.The radiomicsclinical nomogram was generated by combining radiomics features and clinical characteristics of CA19-9 and clinical N staging.RESULTS The AUCs of the MRI-radiomics model were 0.733 and 0.753 for the training(156 lesions with 68 non-DR and 88 DR)and the validation(67 lesions with 29 non-DR and 38 DR)set,respectively.Additionally,the AUCs of the training and the validation set of Ra-DWI were higher than those of Ra-T2WI and Ra-portal phase of contrast-enhanced sequences(training set:0.652 vs 0.628 and 0.633,validation set:0.661 vs 0.575 and 0.543).After chemotherapy,the top four of twelve deltaradiomics features of Ra-DWI in the DR group belonged to gray-level run-length matrices radiomics parameters.The radiomics-clinical nomogram containing radiomics score,CA19-9,and clinical N staging was built.This radiomics-clinical nomogram can effectively discriminate the patients with DR from non-DR with a higher AUC of 0.809(95%confidence interval:0.751-0.858).CONCLUSION MRI-radiomics is conducive to predict chemotherapeutic response in SLM patients of CRC.The radiomics-clinical nomogram,involving radiomics score,CA19-9,and clinical N staging is more effective in predicting chemotherapeutic response.

Coxsackievirus A6 was the most common enterovirus serotype causing hand,foot,and mouth disease in Shiyan City,central China

BACKGROUND Hand,foot,and mouth disease(HFMD)has become one of the most common infectious diseases in China.Before 2016,the primary causal serotypes were enterovirus A71(EV-A71)and coxsackievirus A16(CV-A16).Following the introduction of EV-A71 vaccines in China since 2016,the situation could change.CV-A6 has recently replaced EV-A71 and CV-A16 in some areas of China.However,the epidemiological characteristics of central China remain unknown.AIM To investigate the clinical symptoms and pathogen spectrum of HFMD in Shiyan City,central China,in recent years.METHODS The epidemiological,clinical,and laboratory data from HFMD cases reported to the Shiyan Center for Disease Control and Prevention between January 2016 and December 2020 were analyzed.196 throat swab specimens were collected from hospitalized HFMD patients between January 2018 and December 2020.To detect and genotype enteroviruses,real-time reverse transcription-polymerase chain reaction and sequencing of the 5'-untranslated region were used.In Shiyan,168 laboratory-confirmed HFMD cases were studied using a logistic regression model to determine the effect of predominant enterovirus serotypes.Based on the logistic regression model,the least absolute shrinkage and selection operator model was used to analyze the correlation between CV-A6 infection and various clinical characteristics in HFMD patients in Shiyan.RESULTS From 2016 to 2020,35840 HFMD cases were reported in Shiyan.The number of cases decreased by 48.4%from 2016 to 2017.Approximately 1.58-fold increases were found in 2018 and 2019 when compared to the previous year,respectively.In 2020,a decrease of about 85.5%was reported when compared to 2019.The most common serotypes shifted from EV-A71 and CV-A16(about 60%-80%in 2016 and 2018)to others(more than 80.0%in 2017,2019,and 2020).EV-A71 lost its dominance in 2017 in Shiyan.Among 196 confirmed HFMD cases,85.7%tested positive for enterovirus,with CV-A6 being the most common serotype(121/168,72.0%).The positive rates for CV-A16 and CVA10 were 4.8%and 3.0%,respectively.There was no EV-A71 discovered.Infection with CV-A6 was linked to fever,myocardial damage,increased creatine kinase MB isoenzyme,and lactate dehydrogenase levels.CONCLUSION CV-A6 was the most common enterovirus serotype in Shiyan City,replacing EV-A71 and CV-A16 as the HFMD pathogen.Developing vaccines against CV-A6 or multiple pathogens,as well as rising CV-A6 surveillance,will help prevent HFMD in central China.

Synthesis of （S）-2-Ethoxy-3-Phenylpropanoic Acid Derivatives and Their Insulin-Sensitizing Activity

A series of （S）-2-ethoxy-3-phenylpropanoic acid derivatives were synthesized and their insulin-sensitizing activities were evaluated in 3T3-L1 cells. Compounds 1b, 1d, 1e and 1f exhibited more potent insulin-sensitizing activity than rosiglitazone.