Purpose
To investigate the role of computed tomography (CT) radiomics for the preoperative prediction of lymph node (LN) metastasis in gastric cancer.
Materials and methods
This retrospective study ...included 247 consecutive patients (training cohort, 197 patients; test cohort, 50 patients) with surgically proven gastric cancer. Dedicated radiomics prototype software was used to segment lesions on preoperative arterial phase (AP) CT images and extract features. A radiomics model was constructed to predict the LN metastasis by using a random forest (RF) algorithm. Finally, a nomogram was built incorporating the radiomics scores and selected clinical predictors. Receiver operating characteristic (ROC) curves were used to validate the capability of the radiomics model and nomogram on both the training and test cohorts.
Results
The radiomics model showed a favorable discriminatory ability in the training cohort with an area under the curve (AUC) of 0.844 (95% CI, 0.759 to 0.909), which was confirmed in the test cohort with an AUC of 0.837 (95% CI, 0.705 to 0.926). The nomogram consisted of radiomics scores and the CT-reported LN status showed excellent discrimination in the training and test cohorts with AUCs of 0.886 (95% CI, 0.808 to 0.941) and 0.881 (95% CI, 0.759 to 0.956), respectively.
Conclusions
The CT-based radiomics nomogram holds promise for use as a noninvasive tool in the individual prediction of LN metastasis in gastric cancer.
Key Points
• CT radiomics showed a favorable performance for the prediction of LN metastasis in gastric cancer.
• Radiomics model outperformed the routine CT in predicting LN metastasis in gastric cancer.
• The radiomics nomogram holds potential in the individualized prediction of LN metastasis in gastric cancer.
Background
Biopsy Gleason score (GS) is crucial for prostate cancer (PCa) treatment decision‐making. Upgrading in GS from biopsy to radical prostatectomy (RP) puts a proportion of patients at risk of ...undertreatment.
Purpose
To develop and validate a radiomics model based on multiparametric magnetic resonance imaging (mp‐MRI) to predict PCa upgrading.
Study Type
Retrospective, radiomics.
Population
A total of 166 RP‐confirmed PCa patients (training cohort, n = 116; validation cohort, n = 50) were included.
Field Strength/Sequence
3.0T/T2‐weighted (T2W), apparent diffusion coefficient (ADC), and dynamic contrast enhancement (DCE) sequences.
Assessment
PI‐RADSv2 score for each tumor was recorded. Radiomic features were extracted from T2W, ADC, and DCE sequences and Mutual Information Maximization criterion was used to identify the optimal features on each sequence. Multivariate logistic regression analysis was used to develop predictive models and a radiomics nomogram and their performance was evaluated.
Statistical Tests
Student's t or chi‐square were used to assess the differences in clinicopathologic data between the training and validation cohorts. Receiver operating characteristic (ROC) curve analysis was performed and the area under the curve (AUC) was calculated.
Results
In PI‐RADSv2 assessment, 67 lesions scored 5, 70 lesions scored 4, and 29 lesions scored 3. For each sequence, 4404 features were extracted and the top 20 best features were selected. The radiomics model incorporating signatures from the three sequences achieved better performance than any single sequence (AUC: radiomics model 0.868, T2W 0.700, ADC 0.759, DCE 0.726). The combined mode incorporating radiomics signature, clinical stage, and time from biopsy to RP outperformed the clinical model and radiomics model (AUC: combined model 0.910, clinical model 0.646, radiomics model 0.868). The nomogram showed good performance (AUC 0.910) and calibration (P‐values: training cohort 0.624, validation cohort 0.294).
Data Conclusion
Radiomics based on mp‐MRI has potential to predict upgrading of PCa from biopsy to RP.
Level of Evidence
3
Technical Efficacy
Stage 5 J. Magn. Reson. Imaging 2020;52:1239–1248.
Thermochromic smart windows technology can intelligently regulate indoor solar radiation by changing indoor light transmittance in response to thermal stimulation, thus reducing energy consumption of ...the building. In recent years, with the development of new energy-saving materials and the combination with practical technology, energy-saving smart windows technology has received more and more attention from scientific research. Based on the summary of thermochromic smart windows by Yi Long research groups, this review described the applications of thermal responsive organic materials in smart windows, including poly(N-isopropylacrylamide) (PNIPAm) hydrogels, hydroxypropyl cellulose (HPC) hydrogels, ionic liquids and liquid crystals. Besides, the mechanism of various organic materials and the properties of functional materials were also introduced. Finally, opportunities and challenges relating to thermochromic smart windows and prospects for future development are discussed.
Group 2 innate lymphoid cells (ILC2s) are recently reported to play a more critical role in allergic diseases. We previously identified that mesenchymal stromal cells (MSCs) elicited therapeutic ...effects on allergic airway inflammation. Small extracellular vesicles (sEV) derived from MSCs possess striking advantages including low immunogenicity and high biosafety, and is extremely promising cell-free therapeutic agents. However, the effects of MSC-sEV on ILC2s are still unclear. Additionally, scalable isolation protocols are required for the mass production of homogenous MSC-sEV especially in clinical application. We previously reported that induced pluripotent stem cells-derived MSCs were the ideal cellular source for the large preparation of MSC-sEV. Here we developed a standardized scalable protocol of anion-exchange chromatography for isolation of MSC-sEV, and investigated the effects of MSC-sEV on ILC2 function from patients with allergic rhinitis and in a mouse ILC2-dominant asthma model. The characterization of MSC-sEV was successfully demonstrated in terms of size, morphology and specific markers. Using flow cytometry and human Cytokine Antibody Array, MSC-sEV but not fibroblasts-sEV (Fb-sEV) were found to significantly inhibit the function of human ILC2s. Similarly, systemic administration of MSC-sEV but not Fb-sEV exhibited an inhibition of ILC2 levels, inflammatory cell infiltration and mucus production in the lung, a reduction in levels of T helper 2 cytokines, and alleviation of airway hyperresponsiveness in a mouse model of asthma. Using RNA sequencing, miR-146a-5p was selected as the candidate to mediate the above effects of MSC-sEV. We next revealed the uptake of ILC2s to MSC-sEV, and that transfer of miR-146a-5p in MSC-sEV to ILC2s in part contributed to the effects of MSC-sEV on ILC2s in vitro and in a mouse model. In conclusion, we demonstrated that MSC-sEV were able to prevent ILC2-dominant allergic airway inflammation at least partially through miR-146a-5p, suggesting that MSC-sEV could be a novel cell-free strategy for the treatment of allergic diseases.
Due to excellent biological-functionality, unique/suitable elastic-modulus as well as spontaneous degradation behaviors, Mg alloys acted as medical implants have shown enormous potential in surgical ...operation and bone-fixation fields. Unfortunately, the extreme mass loss and unmarked-fracture could easily induce the implant failure. In the present study, the microstructure characteristics and degradation behaviors of the Mg-10.6Gd-0.3Ag-x(Y/Zn) alloys were investigated through the XRD, TEM, EPMA, XPS, 3D/CLSM and SECM. Results revealed that with the increment of Y/Zn contents, the amount of Mg24(Gd/Y)5 precipitates increased, which were mainly distributed in grains and on grain boundaries. The addition of Zn and Y increased the undercooling and Y had a large mismatch degree with Mg atoms, which could promote the precipitation of second phases. Additionally, the corrosion rates of Mg-10.6Gd-0.3Ag-x(Y/Zn) increased firstly and then reduced. Also, the best corrosion resistance was achieved in the Mg-10.6Gd-0.3Ag-Y-Zn, with the current intensities of 58.49 μA/cm2, attributed to the formation of continuous reticular structure oxide film, which can act as physical barriers and impede the corrosion process.
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•Corrosion rate of studied alloys were increased firstly and then reduced.•Y and Zn addition provide nucleation cites to form compact surface protective layer.•The evolution of corrosion current densities was analyzed by SECM.•Y and Zn addition promote the precipitation of Mg24(Gd, Y, Zn)5 phase.
In this study, the phytohormone gibberellin was evaluated for its effect on lipid and docosahexaenoic acid (DHA) accumulation in Aurantiochytrium sp.YLH70. It was found that 4 mg/mL of gibberellin ...increased biomass, lipid and DHA yield of Aurantiochytrium sp.YLH70 by 14.4%, 43.6% and 79.1%, respectively. Moreover, a GC-MS metabolomics method combined with a multivariate analysis was applied to reveal the metabolic mechanisms responsible for the increased lipid and DHA accumulation. The principal component analysis (PCA) revealed that metabolomics profiles from all groups were discriminated. 38 metabolites identified by the partial least-squares-discriminant analysis (PLS-DA) were responsible for responding to gibberellin treatment. Metabolic pathway analysis showed that gibberellin accelerated the rate of utilization of glucose, and metabolites in fatty acids biosynthesis and mevalonate pathway were increased, while metabolites in glycolysis and TCA cycle were decreased in Aurantiochytrium sp.YLH70. Moreover, the anti-stress mechanism in Aurantiochytrium sp.YLH70 might be induced by gibberellin.
Background
Amide proton transfer‐weighted (APTw) imaging has shown great potential in the diagnosis of cancer, but has yet not been well studied in cervical cancer.
Purpose
To evaluate the image ...quality and clinical feasibility of APTw MRI for cervical cancer.
Study Type
Prospective.
Population
In all, 75 patients with cervical lesions and 49 healthy volunteers.
Field Strength/Sequence
3.0 T, 3D turbo spin echo (TSE) APTw sequence.
Assessment
Three radiologists, blinded to the clinical data, independently evaluated APTw image quality with a 5‐point Likert scale on 64 patients with pathologically confirmed cervical cancer. APT values, calculated based on asymmetry of acquired Z‐spectrum with respect to water frequency, using 3D turbo spin echo volume acquisition with B0 correction, were independently measured by two radiologists, twice for each observer, on 52 cervical cancer lesions and 49 normal cervical stroma with a mean region of interest area of 638.6 mm2 and 557.5 mm2, respectively.
Statistical Tests
Interobserver agreement was evaluated by Kendall's W test. Intra‐ and interobserver interclass correlation coefficients (ICC) were computed. Student's t‐test was used to compare the differences of APT values between cervical cancer and normal cervix; receiver operating characteristic analysis was performed.
Results
Most cases revealed good APTw image quality with excellent agreement (Kendall's W = 0.850, P < 0.001). APT values of cervical cancer and normal cervical stroma were 2.745 ± 0.065 and 1.853 ± 0.059, respectively, with a significant difference (P < 0.0001). Intraobserver ICCs were 0.963 and 0.960 for two readers. Interobserver ICC was 0.993. Area under the curve (AUC) for differentiating cervical cancer from normal cervical stroma was 0.927. The feasible threshold value for AUC was determined as 2.221 with sensitivity of 84.62% and specificity of 83.66%.
Data Conclusion
3D TSE APTw MRI is feasible in cervical cancer. Cervical cancer showed significantly higher APT values than normal cervix.
Level of Evidence: 2
Technical Efficacy: Stage 2
J. Magn. Reson. Imaging 2019;50:1318–1325.
The Parkland Grading Scale (PGS) is an intraoperative grading scale to stratify gallbladder disease severity during laparoscopic cholecystectomy (LC). We evaluated the usefulness of the PGS in ...predicting the difficulty levels of LC procedures using a novel approach.
A total of 261 patients diagnosed with cholelithiasis and cholecystitis who underwent LC were assessed. The PGS and the surgical difficulty grading system were used to evaluate surgical procedures by reviewing the operation videos. Clinical baseline characteristics and post-treatment outcomes were also recorded. Differences between the five PGS grades in terms of surgical difficulty scores were analyzed using the Jonckheere-Terpstra test. The relationship between PGS grades and surgical difficulty scores was assessed using Spearman's Rank correlation. Finally, the linear trends between morbidity scores and PGS grades were evaluated using the Mantel-Haenszel test.
There was a significant difference in the surgical difficulty scores for the five PGS grades (p < 0.001). In pairwise comparison, each grade (1-5) was significantly different from the others (p < 0.05) in terms of surgical difficulty, except Grade 2 vs. 3 (p = 0.07) and Grade 3 vs. 4 (p = 0.08). There was a significant correlation between PGS grades and surgical difficulty scores (r
= 0.681, p < 0.001). There was also a significant linear association between morbidity and PGS grades (p < 0.001). Spearman's R value was 0.176 (p = 0.004).
The PGS can accurately assess the surgical difficulty level of LC. The precision and conciseness of the PGS make it suitable for use in future research.
Background
Primary gastric linitis plastica (GLP) is a distinct phenotype of gastric cancer with poor survival. Comprehensive molecular profiles and putative therapeutic targets of GLP remain ...undetermined.
Methods
We subjected 10 tumor-normal tissue pairs to whole exome sequencing (WES) and whole transcriptome sequencing (WTS). 10 tumor samples were all GLP which involves 100% of the gastric wall macroscopically. TCGA data were compared to generate the top mutated genes and the overexpressed genes in GLP.
Results
Our results reveal that GLP has distinctive genomic and transcriptomic features, dysfunction in the Hippo pathway is likely to be a key step during GLP development. 6 genes were identified as significantly highly mutated genes in GLP, including AOX1, ANKRD36C, CPXM1, PTPN14, RPAP1, and DCDC1). MUC6, as a previously identified gastric cancer driver gene, has a high mutation rate (20%) in GLP. 20% of patients in our GLP cohort had CDH1 mutations, while none had RHOA mutations. GLP exhibits high immunodeficiency and low AMPK pathway activity. Our WTS results showed that 3 PI3K-AKT pathway-related genes (PIK3R2, AKT3, and IGF1) were significantly up-regulated in GLP. Two genes were identified using immunohistochemistry (IHC), IGF2BP3 and MUC16, which specifically expressed in diffuse-type-related gastric cancer cell lines, and its knockdown inhibits PI3K-AKT pathway activity.
Conclusions
We provide the first integrative genomic and transcriptomic profiles of GLP, which may facilitate its diagnosis, prognosis, and treatment.
A hybrid graphene-ZIF-8（G-ZIF-8） nanocomposite modified electrode was prepared in our work. SEM characterization shows that nanocrystals of zeolitic imidazolate frameworks（ZIF-8） were homogeneously ...well-intergrown on the surface of graphene and thus the graphene sheets were refrained from restacking, which implies the high accessible surface area. The BET results further testifies that G-ZIF-8composites had a larger surface area than 3D graphene. G-ZIF-8 modified electrode exhibited excellent electroanalytical performance for dopamine. The linear concentration range was from 3.0 mmol/L to1.0 mmol/L with the detection sensitivity of 0.34 m A/mmol/L and the detection limit of 1.0 mmol/L was obtained. The interference study, electrode stability and reproducibility were carried out. In addition, the prepared sensor was applied to the detection of DA in serum sample with recoveries from 96.8% to100.7%. It is believable that the structure characteristic of G-ZIF-8 nanocomposite is favorable for using MOFs to fabricate highly sensitive electrochemical sensor
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