BACKGROUND Because of the powerful abilities of self-learning and handling complex biological information,artificial neural network(ANN)models have been widely applied to disease diagnosis,imaging analysis,and prognos...BACKGROUND Because of the powerful abilities of self-learning and handling complex biological information,artificial neural network(ANN)models have been widely applied to disease diagnosis,imaging analysis,and prognosis prediction.However,there has been no trained preoperative ANN(preope-ANN)model to preoperatively predict the prognosis of patients with gastric cancer(GC).AIM To establish a neural network model that can predict long-term survival of GC patients before surgery to evaluate the tumor condition before the operation.METHODS The clinicopathological data of 1608 GC patients treated from January 2011 to April 2015 at the Department of Gastric Surgery,Fujian Medical University Union Hospital were analyzed retrospectively.The patients were randomly divided into a training set(70%)for establishing a preope-ANN model and a testing set(30%).The prognostic evaluation ability of the preope-ANN model was compared with that of the American Joint Commission on Cancer(8th edition)clinical TNM(cTNM)and pathological TNM(pTNM)staging through the receiver operating characteristic curve,Akaike information criterion index,Harrell's C index,and likelihood ratio chi-square.RESULTS We used the variables that were statistically significant factors for the 3-year overall survival as input-layer variables to develop a preope-ANN in the training set.The survival curves within each score of the preope-ANN had good discrimination(P<0.05).Comparing the preope-ANN model,cTNM,and pTNM in both the training and testing sets,the preope-ANN model was superior to cTNM in predictive discrimination(C index),predictive homogeneity(likelihood ratio chi-square),and prediction accuracy(area under the curve).The prediction efficiency of the preope-ANN model is similar to that of pTNM.CONCLUSION The preope-ANN model can accurately predict the long-term survival of GC patients,and its predictive efficiency is not inferior to that of pTNM stage.展开更多
Objective:To explore the impact of visceral fat area(VFA)on the short-and long-term efficacy of indocyanine green(ICG)-guided D2 lymphadenectomy for gastric cancer(GC).Methods:A post hoc analysis was performed in pati...Objective:To explore the impact of visceral fat area(VFA)on the short-and long-term efficacy of indocyanine green(ICG)-guided D2 lymphadenectomy for gastric cancer(GC).Methods:A post hoc analysis was performed in patients who participated in a phase 3 randomized clinical trial of ICG-guided laparoscopic radical gastrectomy vs.conventional laparoscopic radical gastrectomy from November 2018 to July 2019.The VFA was calculated based on preoperative computed tomography images.Short-term efficacy included the quality of lymph node(LN)dissection and surgical outcomes,while long-term efficacy included overall survival(OS)and recurrence-free survival(RFS).Results:This study included 126 patients each in the ICG(high-VFA,n=43)and non-ICG groups(high-VFA,n=38).Compared with the non-ICG group,the ICG group had significantly more retrieved LNs(low-VFA:50.1 vs.43.9,P=0.001;high-VFA:49.6 vs.37.5,P<0.001)and a significantly lower LN noncompliance rate(low-VFA:32.5%vs.50.0%,P=0.020;high-VFA:32.6%vs.73.7%,P<0.001),regardless of the VFA.The ICG group had a shorter postoperative hospital stay and fewer intra-abdominal infections than the ICG group in the high-VFA patients(P=0.025 and P=0.020,respectively)but not in the low-VFA patients.Regardless of the VFA,the 3-year OS(RFS)was better in the ICG group than in the non-ICG group[low-VFA:83.1%(76.9%)vs.73.9%(67.0%);high-VFA:90.7%(90.7%)vs.73.7%(73.5%);P for interaction=0.474(0.547)].Conclusions:The short-and long-term efficacies of ICG tracing were not influenced by visceral obesity.展开更多
The upcoming 2020 Beijing Winter Olympics is exciting Chinese people’s interest in ice and snow sport and speeding up the development of ice and snow tourism in China.Bing Dwen Dwen,a giant panda with a suit of ice,i...The upcoming 2020 Beijing Winter Olympics is exciting Chinese people’s interest in ice and snow sport and speeding up the development of ice and snow tourism in China.Bing Dwen Dwen,a giant panda with a suit of ice,is the official mascot of the 2022 Beijing Olympic Winter Games.“Bing”means ice and symbolizes purity and strength.展开更多
目的观察GPR120基因对脓毒症进展的作用,探索GPR120基因对胞内多蛋白复合物—NLRP3(NOD-,LRR-and pyrin domain-containing protein 3)及巨噬细胞极化的调控作用。方法收集临床脓毒症患者血液及胸水样本后,采用流式及ELISA实验检测炎症...目的观察GPR120基因对脓毒症进展的作用,探索GPR120基因对胞内多蛋白复合物—NLRP3(NOD-,LRR-and pyrin domain-containing protein 3)及巨噬细胞极化的调控作用。方法收集临床脓毒症患者血液及胸水样本后,采用流式及ELISA实验检测炎症因子及炎症小体相关蛋白表达。利用细菌脂多糖(lipopolysaccharide,LPS)处理C57BL/6小鼠及单核-巨噬细胞株Raw264.7构建体内外脓毒症模型,并通过GPR120基因激动剂TUG891的干预,观察对照组和脓毒症组间GPR120基因、NLRP3炎症小体蛋白及巨噬细胞极化蛋白的表达差异。结果在临床标本中检测发现,与对照组相比脓毒症患者血清中IL-1β等炎症因子表达明显升高(P<0.001),胸水中NLRP3、Caspase-1及IL-1β等炎症小体蛋白的表达水平也明显升高(P均<0.05)。体内实验发现LPS诱导的急性肺损伤动物模型中肺组织内重度炎症表现,肺组织内GPR120基因表达下降,小鼠血清中炎症因子表达上调(P<0.01),炎症小体激活相关蛋白的表达增强,巨噬细胞M1型极化增强。通过TUG891激活GPR120基因,可减轻小鼠及细胞的炎症反应,抑制NLRP3炎症小体激活,促进巨噬细胞M2极化(P<0.01)。体外实验证实了LPS可抑制细胞内GPR120蛋白的表达并促进炎症蛋白的分泌,而TUG891促进GPR120蛋白水平的上调表达并对炎症因子的分泌具有缓解作用(P<0.05)。结论在脓毒症中,GPR120基因激活可抑制NLRP3炎症小体的活化,促进巨噬细胞修复型极化,减轻组织炎症损伤,从而延缓脓毒症的快速进展。展开更多
基金the Scientific and Technological Innovation JointCapital Projects of Fujian Province,No.2016Y9031the Construction Project of Fujian Province Minimally Invasive Medical Center,No.[2017]171+4 种基金the General Project of Miaopu Scientific Research Fund of Fujian Medical University,No.2015MP021the Youth Project of Fujian Provincial Health and Family Planning Commission,No.2016-1-41the Fujian Province Medical Innovation ProjectChinese Physicians Association Young Physician Respiratory Research Fund,No.2015-CXB-16the Fujian Science and Technology Innovation Joint Fund Project,No.2017Y9004
文摘BACKGROUND Because of the powerful abilities of self-learning and handling complex biological information,artificial neural network(ANN)models have been widely applied to disease diagnosis,imaging analysis,and prognosis prediction.However,there has been no trained preoperative ANN(preope-ANN)model to preoperatively predict the prognosis of patients with gastric cancer(GC).AIM To establish a neural network model that can predict long-term survival of GC patients before surgery to evaluate the tumor condition before the operation.METHODS The clinicopathological data of 1608 GC patients treated from January 2011 to April 2015 at the Department of Gastric Surgery,Fujian Medical University Union Hospital were analyzed retrospectively.The patients were randomly divided into a training set(70%)for establishing a preope-ANN model and a testing set(30%).The prognostic evaluation ability of the preope-ANN model was compared with that of the American Joint Commission on Cancer(8th edition)clinical TNM(cTNM)and pathological TNM(pTNM)staging through the receiver operating characteristic curve,Akaike information criterion index,Harrell's C index,and likelihood ratio chi-square.RESULTS We used the variables that were statistically significant factors for the 3-year overall survival as input-layer variables to develop a preope-ANN in the training set.The survival curves within each score of the preope-ANN had good discrimination(P<0.05).Comparing the preope-ANN model,cTNM,and pTNM in both the training and testing sets,the preope-ANN model was superior to cTNM in predictive discrimination(C index),predictive homogeneity(likelihood ratio chi-square),and prediction accuracy(area under the curve).The prediction efficiency of the preope-ANN model is similar to that of pTNM.CONCLUSION The preope-ANN model can accurately predict the long-term survival of GC patients,and its predictive efficiency is not inferior to that of pTNM stage.
基金supported by the Construction Funds for“High-level Hospitals and Clinical Specialties”of Fujian Province(No.[2021]76)。
文摘Objective:To explore the impact of visceral fat area(VFA)on the short-and long-term efficacy of indocyanine green(ICG)-guided D2 lymphadenectomy for gastric cancer(GC).Methods:A post hoc analysis was performed in patients who participated in a phase 3 randomized clinical trial of ICG-guided laparoscopic radical gastrectomy vs.conventional laparoscopic radical gastrectomy from November 2018 to July 2019.The VFA was calculated based on preoperative computed tomography images.Short-term efficacy included the quality of lymph node(LN)dissection and surgical outcomes,while long-term efficacy included overall survival(OS)and recurrence-free survival(RFS).Results:This study included 126 patients each in the ICG(high-VFA,n=43)and non-ICG groups(high-VFA,n=38).Compared with the non-ICG group,the ICG group had significantly more retrieved LNs(low-VFA:50.1 vs.43.9,P=0.001;high-VFA:49.6 vs.37.5,P<0.001)and a significantly lower LN noncompliance rate(low-VFA:32.5%vs.50.0%,P=0.020;high-VFA:32.6%vs.73.7%,P<0.001),regardless of the VFA.The ICG group had a shorter postoperative hospital stay and fewer intra-abdominal infections than the ICG group in the high-VFA patients(P=0.025 and P=0.020,respectively)but not in the low-VFA patients.Regardless of the VFA,the 3-year OS(RFS)was better in the ICG group than in the non-ICG group[low-VFA:83.1%(76.9%)vs.73.9%(67.0%);high-VFA:90.7%(90.7%)vs.73.7%(73.5%);P for interaction=0.474(0.547)].Conclusions:The short-and long-term efficacies of ICG tracing were not influenced by visceral obesity.
文摘The upcoming 2020 Beijing Winter Olympics is exciting Chinese people’s interest in ice and snow sport and speeding up the development of ice and snow tourism in China.Bing Dwen Dwen,a giant panda with a suit of ice,is the official mascot of the 2022 Beijing Olympic Winter Games.“Bing”means ice and symbolizes purity and strength.
文摘目的观察GPR120基因对脓毒症进展的作用,探索GPR120基因对胞内多蛋白复合物—NLRP3(NOD-,LRR-and pyrin domain-containing protein 3)及巨噬细胞极化的调控作用。方法收集临床脓毒症患者血液及胸水样本后,采用流式及ELISA实验检测炎症因子及炎症小体相关蛋白表达。利用细菌脂多糖(lipopolysaccharide,LPS)处理C57BL/6小鼠及单核-巨噬细胞株Raw264.7构建体内外脓毒症模型,并通过GPR120基因激动剂TUG891的干预,观察对照组和脓毒症组间GPR120基因、NLRP3炎症小体蛋白及巨噬细胞极化蛋白的表达差异。结果在临床标本中检测发现,与对照组相比脓毒症患者血清中IL-1β等炎症因子表达明显升高(P<0.001),胸水中NLRP3、Caspase-1及IL-1β等炎症小体蛋白的表达水平也明显升高(P均<0.05)。体内实验发现LPS诱导的急性肺损伤动物模型中肺组织内重度炎症表现,肺组织内GPR120基因表达下降,小鼠血清中炎症因子表达上调(P<0.01),炎症小体激活相关蛋白的表达增强,巨噬细胞M1型极化增强。通过TUG891激活GPR120基因,可减轻小鼠及细胞的炎症反应,抑制NLRP3炎症小体激活,促进巨噬细胞M2极化(P<0.01)。体外实验证实了LPS可抑制细胞内GPR120蛋白的表达并促进炎症蛋白的分泌,而TUG891促进GPR120蛋白水平的上调表达并对炎症因子的分泌具有缓解作用(P<0.05)。结论在脓毒症中,GPR120基因激活可抑制NLRP3炎症小体的活化,促进巨噬细胞修复型极化,减轻组织炎症损伤,从而延缓脓毒症的快速进展。
