Rural domestic sewage treatment is critical for environmental protection.This study defines the spatial pattern of villages from the perspective of rural sewage treatment and develops an integrated decision-making sys...Rural domestic sewage treatment is critical for environmental protection.This study defines the spatial pattern of villages from the perspective of rural sewage treatment and develops an integrated decision-making system to propose a sewage treatment mode and scheme suitable for local conditions.By considering the village spatial layout and terrain factors,a decision tree model of residential density and terrain type was constructed with accuracies of 76.47%and 96.00%,respectively.Combined with binary classification probability unit regression,an appropriate sewage treatment mode for the village was determined with 87.00%accuracy.The Analytic Hierarchy Process(AHP),combined with the Technique for Order Preference(TOPSIS)by Similarity to an Ideal Solution model,formed the basis for optimal treatment process selection under different emission standards.Verification was conducted in 542 villages across three counties of the Inner Mongolia Autonomous Region,focusing on the standard effluent effect(0.3773),low investment cost(0.3196),and high standard effluent effect(0.5115)to determine the best treatment process for the same emission standard under different needs.The annual environmental and carbon emission benefits of sewage treatment in these villages were estimated.This model matches village density,geographic feature,and social development level,and provides scientific support and a theoretical basis for rural sewage treatment decision-making.展开更多
Background:Multiparametric magnetic resonance imaging(mpMRI)has significantly advanced prostate cancer(PCa)detection,yet decisions on invasive biopsy with moderate prostate imaging reporting and data system(PI-RADS)sc...Background:Multiparametric magnetic resonance imaging(mpMRI)has significantly advanced prostate cancer(PCa)detection,yet decisions on invasive biopsy with moderate prostate imaging reporting and data system(PI-RADS)scores remain ambiguous.Methods:To explore the decision-making capacity of Generative Pretrained Transformer-4(GPT-4)for automated prostate biopsy recommendations,we included 2299 individuals who underwent prostate biopsy from 2018 to 2023 in 3 large medical centers,with available mpMRI before biopsy and documented clinical-histopathological records.GPT-4 generated structured reports with given prompts.The performance of GPT-4 was quantified using confusion matrices,and sensitivity,specificity,as well as area under the curve were calculated.Multiple artificial evaluation procedures were conducted.Wilcoxon’s rank sum test,Fisher’s exact test,and Kruskal-Wallis tests were used for comparisons.Results:Utilizing the largest sample size in the Chinese population,patients with moderate PI-RADS scores(scores 3 and 4)accounted for 39.7%(912/2299),defined as the subset-of-interest(SOI).The detection rates of clinically significant PCa corresponding to PI-RADS scores 2-5 were 9.4%,27.3%,49.2%,and 80.1%,respectively.Nearly 47.5%(433/912)of SOI patients were histopathologically proven to have undergone unnecessary prostate biopsies.With the assistance of GPT-4,20.8%(190/912)of the SOI population could avoid unnecessary biopsies,and it performed even better[28.8%(118/410)]in the most heterogeneous subgroup of PI-RADS score 3.More than 90.0%of GPT-4-generated reports were comprehensive and easy to understand,but less satisfied with the accuracy(82.8%).GPT-4 also demonstrated cognitive potential for handling complex problems.Additionally,the Chain of Thought method enabled us to better understand the decision-making logic behind GPT-4.Eventually,we developed a ProstAIGuide platform to facilitate accessibility for both doctors and patients.Conclusions:This multi-center study highlights the clinical utility of GPT-4 for prostate biopsy decision-making and advances our understanding of the latest artificial intelligence implementation in various medical scenarios.展开更多
Transient acantholytic dermatosis (TAD, Grover disease) is a benign skin disease with a nonspecific rash that may present as a reddish-brown, dermatomal edematous papule or herpetiform rash with a partially central ho...Transient acantholytic dermatosis (TAD, Grover disease) is a benign skin disease with a nonspecific rash that may present as a reddish-brown, dermatomal edematous papule or herpetiform rash with a partially central horny plug. This disease is usually self-limiting and can subside within weeks or months, but it may also have a chronic progression with a trend towards long-term recurrence. The patient is an 80-year-old male who visited the clinic due to recurring erythema and blisters all over his body that had been present for over 2 years. Based on the patient’s course, laboratory tests and histopathological findings were consistent with the diagnosis. The final diagnosis was transient acantholytic dermatosis. The patient has a long course of the disease, a wide range of skin lesions and he has the different subtypes of pathological manifestations. This case and corresponding literature review help us have a clear understanding of Grover’s disease, which has received reference value for the diagnosis and treatment of this disease in clinical work.展开更多
BACKGROUND: Selection of drugs for antiviral therapy of patients with hepatitis B virus (HBV)-related acute-on-chronic liver failure (ACLF) remains difficult. This study was undertaken to evaluate the short-term effic...BACKGROUND: Selection of drugs for antiviral therapy of patients with hepatitis B virus (HBV)-related acute-on-chronic liver failure (ACLF) remains difficult. This study was undertaken to evaluate the short-term efficacy of entecavir versus lamivudine on hepatitis B e antigen (HBeAg)-negative patients with ACLF. METHODS: The data of 182 HBeAg-negative patients with ACLF were retrospectively collected from patient profiles of the hospital. In these patients, 93 HBeAg-negative patients with ACLF were treated orally with 0.5 mg of entecavir and 89 were treated orally with 100 mg of lamivudine every day. The gender and age were matched between the two groups. Biochemical items, the model for end-stage liver disease (MELD) score, and HBV DNA level were matched at baseline between the two groups and monitored during treatment. The 3-month mortalities of the two groups were compared. RESULTS: No significant differences were found in biochemical items, MELD score, and HBV DNA level at baseline (P】0.05). HBV DNA level decreased within 3 months in both groups (P【0.05), regardless of the pretreatment MELD score. In patients with the same range of pretreatment MELD scores, treatment duration, posttreatment HBV DNA levels, percentage of HBV DNA level 【2.7 lg copies/mL, biochemical items, MELD scores and 3-month mortality were similar in the two groups (all P】0.05). Pretreatment MELD score was not related to posttreatment HBV DNA levels (P】0.05), but related to a 3-month mortality in both groups (both P【0.001).CONCLUSIONS: In HBeAg-negative patients with ACLF, the short-term efficacy of entecavir versus lamivudine was similar. The degree of pretreatment liver failure significantly affected the outcome of treatment.展开更多
Objective： To investigate the efficacy and safety of capecitabine maintenance therapy（MT） after initial capecitabine plus docetaxel（XT） chemotherapy in patients with metastatic triple-negative breast cancer（m T...Objective： To investigate the efficacy and safety of capecitabine maintenance therapy（MT） after initial capecitabine plus docetaxel（XT） chemotherapy in patients with metastatic triple-negative breast cancer（m TNBC）.Methods： Fifty-five m TNBC patients treated with XT chemotherapy between May 2007 and June 2013 were retrospectively analyzed. When initial disease control was achieved by the combination chemotherapy, capecitabine was continued for 32 patients（MT）, while 23 patients remained without any treatment（nonMT）. We compared progression-free survival（PFS） and safety of both groups.Results： The median PFS of 55 patients was 8.1 months, overall median PFS time of 32 patients in the capecitabine MT group and 23 in the non-MT group was 10.1 vs. 6.7 months（P=0.032）, respectively. When compared PFS time of maintenance treatment, single-agent capecitabine prolonged PFS by 7.1 months, for non-MT patients, the PFS without any treatment was 3.1 months, and this between-group difference was statistically significant（P=0.003）. Adverse events, including of hematologic toxicity, gastrointestinal toxicities, hand-foot syndrome and abnormal liver function were not significantly different between two groups.Conclusions： After initial disease control was achieved with the XT combination chemotherapy, capecitabine MT can significantly prolong PFS time with a favorable safety profile in m TNBC patients.展开更多
Objective： Although the development of trastuzumab has improved the outlook for women with human epidermal growth factor receptor 2 （HER2）-positive breast cancer, the resistance to anti-HER2 therapy is a growing cl...Objective： Although the development of trastuzumab has improved the outlook for women with human epidermal growth factor receptor 2 （HER2）-positive breast cancer, the resistance to anti-HER2 therapy is a growing clinical dilemma. We aim to determine whether HER2-specific T cells generated from dendritic cells （DCs） modified with HER2 gene could effectively kill the HER2-positive breast cancer cells, especially the trastuzumab-resistant cells. Methods： The peripheral blood mononuclear cells （PBMCs） from healthy donors, whose HLA haplotypes were compatible with the tumor cell lines, were transfected with reconstructive human adeno-association virus （rhAAV/HER2） to obtain the specific killing activities of T cells, and were evaluated by lactate dehydrogenase （LDH） releasing assay. Results： Trastuzumab produced a significant inhibiting effect on SK-BR-3, the IC50 was 100ng/ml. MDA-MB-453 was resistant to trastuzumab even at a concentration of 10,000 ng/ml in vitro. HER2-specific T lymphocytes killed effectively SK-BR-3 [（69.86±13.41）%] and MDA-MB-453 [（78.36±10.68）%] at 40：1 （effector：target ratio, E：T）, but had no significant cytotoxicity against HER2-negative breast cancer cell lines MDA-MB-231 or MCF-7 （less than 10%）. Conclusion： The study showed that HER2-specific T lymphocytes generated from DCs modified by rhAAV/HER2 could kill HER2-positive breast cancer cell lines in a HER2-dependent manner, and result in significantly high inhibition rates on the intrinsic trastuzumab-resistant cell line MDA-MB-453 and the tastuzumab-sensitive cell line SK-BR-3. These results imply that this immunotherapy might be a potential treatment to HER2-positive breast cancer.展开更多
基金supported by the Central Government Guiding Local Science and Technology Development Fund Project(No.2024SZY0343)the Joint Research Program for Ecological Conservation and High Quality Development of the Yellow River Basin(No.2022-YRUC-01-050205)+2 种基金the Higher Education Scientific Research Project of Inner Mongolia Autonomous Region(No.NJZZ23078)the project of Inner Mongolia"Prairie Talents"Engineering Innovation Entrepreneurship Talent Team,the Major Projects of Erdos Science and Technology(No.2022EEDSKJZDZX015)the Innovation Team of the Inner Mongolia Academy of Science and Technology(No.CXTD2023-01-016).
文摘Rural domestic sewage treatment is critical for environmental protection.This study defines the spatial pattern of villages from the perspective of rural sewage treatment and develops an integrated decision-making system to propose a sewage treatment mode and scheme suitable for local conditions.By considering the village spatial layout and terrain factors,a decision tree model of residential density and terrain type was constructed with accuracies of 76.47%and 96.00%,respectively.Combined with binary classification probability unit regression,an appropriate sewage treatment mode for the village was determined with 87.00%accuracy.The Analytic Hierarchy Process(AHP),combined with the Technique for Order Preference(TOPSIS)by Similarity to an Ideal Solution model,formed the basis for optimal treatment process selection under different emission standards.Verification was conducted in 542 villages across three counties of the Inner Mongolia Autonomous Region,focusing on the standard effluent effect(0.3773),low investment cost(0.3196),and high standard effluent effect(0.5115)to determine the best treatment process for the same emission standard under different needs.The annual environmental and carbon emission benefits of sewage treatment in these villages were estimated.This model matches village density,geographic feature,and social development level,and provides scientific support and a theoretical basis for rural sewage treatment decision-making.
基金supported by the Beijing Key Clinical Specialty Project(20240930)the National Natural Science Foundation of China(NSFC 82373436)+7 种基金the Beijing Hospitals Authority’Youth Program(BHAYP,QML20230114)the Beijing Natural Science Foundation(BNSF Z200027)the Beijing Chaoyang Hospital Multi-disciplinary Team Program(CYDXK202204),the NSFC(62331001)the BNSF(Z200027)the NSFC(82202097)the BHAYP(QML20230113)the Training Fund for Open Projects at Clinical Institutes and Departments of Capital Medical University(CCMU2022ZKYXY010)the Beijing Scholars Program(No.[2015]160).
文摘Background:Multiparametric magnetic resonance imaging(mpMRI)has significantly advanced prostate cancer(PCa)detection,yet decisions on invasive biopsy with moderate prostate imaging reporting and data system(PI-RADS)scores remain ambiguous.Methods:To explore the decision-making capacity of Generative Pretrained Transformer-4(GPT-4)for automated prostate biopsy recommendations,we included 2299 individuals who underwent prostate biopsy from 2018 to 2023 in 3 large medical centers,with available mpMRI before biopsy and documented clinical-histopathological records.GPT-4 generated structured reports with given prompts.The performance of GPT-4 was quantified using confusion matrices,and sensitivity,specificity,as well as area under the curve were calculated.Multiple artificial evaluation procedures were conducted.Wilcoxon’s rank sum test,Fisher’s exact test,and Kruskal-Wallis tests were used for comparisons.Results:Utilizing the largest sample size in the Chinese population,patients with moderate PI-RADS scores(scores 3 and 4)accounted for 39.7%(912/2299),defined as the subset-of-interest(SOI).The detection rates of clinically significant PCa corresponding to PI-RADS scores 2-5 were 9.4%,27.3%,49.2%,and 80.1%,respectively.Nearly 47.5%(433/912)of SOI patients were histopathologically proven to have undergone unnecessary prostate biopsies.With the assistance of GPT-4,20.8%(190/912)of the SOI population could avoid unnecessary biopsies,and it performed even better[28.8%(118/410)]in the most heterogeneous subgroup of PI-RADS score 3.More than 90.0%of GPT-4-generated reports were comprehensive and easy to understand,but less satisfied with the accuracy(82.8%).GPT-4 also demonstrated cognitive potential for handling complex problems.Additionally,the Chain of Thought method enabled us to better understand the decision-making logic behind GPT-4.Eventually,we developed a ProstAIGuide platform to facilitate accessibility for both doctors and patients.Conclusions:This multi-center study highlights the clinical utility of GPT-4 for prostate biopsy decision-making and advances our understanding of the latest artificial intelligence implementation in various medical scenarios.
文摘Transient acantholytic dermatosis (TAD, Grover disease) is a benign skin disease with a nonspecific rash that may present as a reddish-brown, dermatomal edematous papule or herpetiform rash with a partially central horny plug. This disease is usually self-limiting and can subside within weeks or months, but it may also have a chronic progression with a trend towards long-term recurrence. The patient is an 80-year-old male who visited the clinic due to recurring erythema and blisters all over his body that had been present for over 2 years. Based on the patient’s course, laboratory tests and histopathological findings were consistent with the diagnosis. The final diagnosis was transient acantholytic dermatosis. The patient has a long course of the disease, a wide range of skin lesions and he has the different subtypes of pathological manifestations. This case and corresponding literature review help us have a clear understanding of Grover’s disease, which has received reference value for the diagnosis and treatment of this disease in clinical work.
文摘BACKGROUND: Selection of drugs for antiviral therapy of patients with hepatitis B virus (HBV)-related acute-on-chronic liver failure (ACLF) remains difficult. This study was undertaken to evaluate the short-term efficacy of entecavir versus lamivudine on hepatitis B e antigen (HBeAg)-negative patients with ACLF. METHODS: The data of 182 HBeAg-negative patients with ACLF were retrospectively collected from patient profiles of the hospital. In these patients, 93 HBeAg-negative patients with ACLF were treated orally with 0.5 mg of entecavir and 89 were treated orally with 100 mg of lamivudine every day. The gender and age were matched between the two groups. Biochemical items, the model for end-stage liver disease (MELD) score, and HBV DNA level were matched at baseline between the two groups and monitored during treatment. The 3-month mortalities of the two groups were compared. RESULTS: No significant differences were found in biochemical items, MELD score, and HBV DNA level at baseline (P】0.05). HBV DNA level decreased within 3 months in both groups (P【0.05), regardless of the pretreatment MELD score. In patients with the same range of pretreatment MELD scores, treatment duration, posttreatment HBV DNA levels, percentage of HBV DNA level 【2.7 lg copies/mL, biochemical items, MELD scores and 3-month mortality were similar in the two groups (all P】0.05). Pretreatment MELD score was not related to posttreatment HBV DNA levels (P】0.05), but related to a 3-month mortality in both groups (both P【0.001).CONCLUSIONS: In HBeAg-negative patients with ACLF, the short-term efficacy of entecavir versus lamivudine was similar. The degree of pretreatment liver failure significantly affected the outcome of treatment.
文摘Objective： To investigate the efficacy and safety of capecitabine maintenance therapy（MT） after initial capecitabine plus docetaxel（XT） chemotherapy in patients with metastatic triple-negative breast cancer（m TNBC）.Methods： Fifty-five m TNBC patients treated with XT chemotherapy between May 2007 and June 2013 were retrospectively analyzed. When initial disease control was achieved by the combination chemotherapy, capecitabine was continued for 32 patients（MT）, while 23 patients remained without any treatment（nonMT）. We compared progression-free survival（PFS） and safety of both groups.Results： The median PFS of 55 patients was 8.1 months, overall median PFS time of 32 patients in the capecitabine MT group and 23 in the non-MT group was 10.1 vs. 6.7 months（P=0.032）, respectively. When compared PFS time of maintenance treatment, single-agent capecitabine prolonged PFS by 7.1 months, for non-MT patients, the PFS without any treatment was 3.1 months, and this between-group difference was statistically significant（P=0.003）. Adverse events, including of hematologic toxicity, gastrointestinal toxicities, hand-foot syndrome and abnormal liver function were not significantly different between two groups.Conclusions： After initial disease control was achieved with the XT combination chemotherapy, capecitabine MT can significantly prolong PFS time with a favorable safety profile in m TNBC patients.
基金supported by the grant from the National"973"Basic Research Program of China(No.2009CB521703)Medical Oncology Leadership of Beijing Municipal Government Health Burean(No.2009-2-16)
文摘Objective： Although the development of trastuzumab has improved the outlook for women with human epidermal growth factor receptor 2 （HER2）-positive breast cancer, the resistance to anti-HER2 therapy is a growing clinical dilemma. We aim to determine whether HER2-specific T cells generated from dendritic cells （DCs） modified with HER2 gene could effectively kill the HER2-positive breast cancer cells, especially the trastuzumab-resistant cells. Methods： The peripheral blood mononuclear cells （PBMCs） from healthy donors, whose HLA haplotypes were compatible with the tumor cell lines, were transfected with reconstructive human adeno-association virus （rhAAV/HER2） to obtain the specific killing activities of T cells, and were evaluated by lactate dehydrogenase （LDH） releasing assay. Results： Trastuzumab produced a significant inhibiting effect on SK-BR-3, the IC50 was 100ng/ml. MDA-MB-453 was resistant to trastuzumab even at a concentration of 10,000 ng/ml in vitro. HER2-specific T lymphocytes killed effectively SK-BR-3 [（69.86±13.41）%] and MDA-MB-453 [（78.36±10.68）%] at 40：1 （effector：target ratio, E：T）, but had no significant cytotoxicity against HER2-negative breast cancer cell lines MDA-MB-231 or MCF-7 （less than 10%）. Conclusion： The study showed that HER2-specific T lymphocytes generated from DCs modified by rhAAV/HER2 could kill HER2-positive breast cancer cell lines in a HER2-dependent manner, and result in significantly high inhibition rates on the intrinsic trastuzumab-resistant cell line MDA-MB-453 and the tastuzumab-sensitive cell line SK-BR-3. These results imply that this immunotherapy might be a potential treatment to HER2-positive breast cancer.
