The principal breast cancer treatment approach has long been surgical removal of the primary breast lesions and regional lymph nodes,particularly the axillary lymph nodes.However,the advent of minimally invasive diagn...The principal breast cancer treatment approach has long been surgical removal of the primary breast lesions and regional lymph nodes,particularly the axillary lymph nodes.However,the advent of minimally invasive diagnostic techniques,such as sentinel lymph node biopsy(SLNB),has markedly diminished the extent of surgery required for regional lymph nodes.展开更多
Accurately identifying key nodes is essential for evaluating network robustness and controlling information propagation in complex network analysis. However, current research methods face limitations in applicability ...Accurately identifying key nodes is essential for evaluating network robustness and controlling information propagation in complex network analysis. However, current research methods face limitations in applicability and accuracy. To address these challenges, this study introduces the K-GCN model, which integrates neighborhood k-shell distribution analysis with Graph Convolutional Network(GCN) technology to enhance key node identification in complex networks. The K-GCN model first leverages neighborhood k-shell distributions to calculate entropy values for each node, effectively quantifying node importance within the network. These entropy values are then used as key features within the GCN, which subsequently formulates intelligent strategies to maximize network connectivity disruption by removing a minimal set of nodes, thereby impacting the overall network architecture. Through iterative interactions with the environment, the GCN continuously refines its strategies, achieving precise identification of key nodes in the network. Unlike traditional methods, the K-GCN model not only captures local node features but also integrates the network structure and complex interrelations between neighboring nodes, significantly improving the accuracy and efficiency of key node identification.Experimental validation in multiple real-world network scenarios demonstrates that the K-GCN model outperforms existing methods.展开更多
BACKGROUND The log odds of positive lymph nodes(LODDS)are correlated with survival outcomes in gastric cancer(GC)patients.However,the prognostic value across different tumor differentiation levels remains unclear.AIM ...BACKGROUND The log odds of positive lymph nodes(LODDS)are correlated with survival outcomes in gastric cancer(GC)patients.However,the prognostic value across different tumor differentiation levels remains unclear.AIM To evaluate the independent prognostic value of LODDS and the stratified predictive efficacy in GC patients with different histologic differentiations.METHODS We conducted a retrospective analysis of 2103 GC patients who underwent radical gastrectomy at Zhejiang Cancer Hospital.The prognostic value of LODDS was compared with that of other lymph node-based metrics,including the pathologic N stage,number of positive lymph nodes,number of total lymph nodes,and lymph node ratio,stratified by tumor differentiation.RESULTS LODDS was identified as an independent prognostic factor for overall survival in moderately to poorly differentiated GC patients.LODDS demonstrated superior predictive accuracy over other lymph node metrics.A nomogram incorporating LODDS,age,carbohydrate antigen(CA)125,carcinoembryonic antigen,and tumor differentiation showed good predictive accuracy(C-index=0.703).A higher LODDS was significantly associated with an increased risk of recurrence or metastasis,poorly differentiated tumors,advanced cancer,mucinous gastric adenocarcinoma,nerve invasion,and vascular tumor thrombus.Additionally,LODDS was positively correlated with the tumor markers CA19-9,CA72-4,CA125,and CA242(all P<0.05).CONCLUSION LODDS is an independent prognostic indicator for patients with moderately and poorly differentiated GC,and its predictive performance is superior to that of other models.展开更多
Identifying critical nodes is a pivotal research topic in network science,yet the efficient and accurate detection of highly influential nodes remains a challenge.Existing centrality measures predominantly rely on loc...Identifying critical nodes is a pivotal research topic in network science,yet the efficient and accurate detection of highly influential nodes remains a challenge.Existing centrality measures predominantly rely on local or global topological structures,often overlooking indirect connections and their interaction strengths.This leads to imprecise assessments of node importance,limiting practical applications.To address this,we propose a novel node centrality measure,termed six-degree gravity centrality(SDGC),grounded in the six degrees of separation theory,for the precise identification of influential nodes in networks.Specifically,we introduce a set of node influence parameters—node mass,dynamic interaction distance,and attraction coefficient—to enhance the gravity model.Node mass is calculated by integrating K-shell and closeness centrality measures.The dynamic interaction distance,informed by the six-degrees of separation theory,is determined through path searches within six hops between node pairs.The attraction coefficient is derived from the difference in K-shell values between nodes.By integrating these parameters,we develop an improved gravity model to quantify node influence.Experiments conducted on nine real-world networks demonstrate that SDGC significantly outperforms nine existing classical and state-of-the-art methods in identifying the influential nodes.展开更多
Background:Metastasis to the infraclavicular and supraclavicular lymph nodes(ISLNs)is an important factor that predicts poor survival in patients with breast cancer;however,pathological nodal staging does not traditio...Background:Metastasis to the infraclavicular and supraclavicular lymph nodes(ISLNs)is an important factor that predicts poor survival in patients with breast cancer;however,pathological nodal staging does not traditionally include ISLNs because of their non-routine surgical dissection.This study aimed to evaluate the prognostic impact of ISLN metastasis and propose a refined nodal staging system tailored for patients undergoing neoadjuvant chemotherapy(NAC).Methods:We retrospectively reviewed 1,072 patients with breast cancer with or without ISLN metastasis who received NAC at two institutions(Fujian cohort and Hebei cohort)from 2010 to 2022.We conducted detailed survival analysis to evaluate the diagnostic consistency and prognostic significance of ISLNs.Results:There were no survival differences among patients with ISLN involvement across different assay method-ologies and patient cohorts.Among 887 patients in the Fujian cohort,238 patients(26.8%)with positive ISLNs had significantly inferior 3-year progression-free survival(PFS,75.9%vs.90.4%,P<0.001)and overall survival(OS,90.6%vs.95.9%,P<0.001).After adjusting for potential confounders,ISLN involvement persisted as an independent predictor of both PFS and OS.We propose a refined axillary classification that combines pathologi-cal axillary staging post-NAC with ISLN involvement,revealing 3-year PFS rates of 95.3%,87.6%,73.4%,and 64.5%for the respective four groups defined by this refined classification combining axillary stage and ISLN status.Conclusions:Involvement of the ISLNs was associated with a worse prognosis,underscoring their prognostic value.This finding highlights the potential of ISLN status to influence decisions regarding adjuvant treatment in patients with breast cancer.展开更多
This study examines the development of painting techniques of Chinese ink wash landscape paintings,pays attention to its unique brush and ink language and features of the representation of elements,and deeply analyzes...This study examines the development of painting techniques of Chinese ink wash landscape paintings,pays attention to its unique brush and ink language and features of the representation of elements,and deeply analyzes the artistic characteristics of digital ink wash texture materials.The research focuses on key aspects such as the ink brushstrokes with the combination of emptiness and reality,the profound and serene ink wash space,and the extremely ingenious position layout.It proposes a construction path of digital ink wash texture materials based on the Blender material node system.This method makes use of the flexibility of the Blender material node system to successfully simulate highly realistic digital ink wash textures.It can not only construct static ink wash textures but also realize the dynamic transformation of static ink wash works through animation nodes and procedural control,thereby enhancing the artistic expression of digital ink wash works.The proposal and implementation of this method expand the application scope of the Blender material node system,help deeply explore the potential of digital ink wash art,and open up a brand new research path for constructing digital ink wash textures.展开更多
Hypergraphs can accurately capture complex higher-order relationships,but it is challenging to identify their important nodes.In this paper,an improved PageRank(ImPageRank)algorithm is designed to identify important n...Hypergraphs can accurately capture complex higher-order relationships,but it is challenging to identify their important nodes.In this paper,an improved PageRank(ImPageRank)algorithm is designed to identify important nodes in a directed hypergraph.The algorithm introduces the Jaccard similarity of directed hypergraphs.By comparing the numbers of common neighbors between nodes with the total number of their neighbors,the Jaccard similarity measure takes into account the similarity between nodes that are not directly connected,and can reflect the potential correlation between nodes.An improved susceptible–infected(SI)model in directed hypergraph is proposed,which considers nonlinear propagation mode and more realistic propagation mechanism.In addition,some important node evaluation methods are transferred from undirected hypergraphs and applied to directed hypergraphs.Finally,the ImPageRank algorithm is used to evaluate the performance of the SI model,network robustness and monotonicity.Simulations of real networks demonstrate the excellent performance of the proposed algorithm and provide a powerful framework for identifying important nodes in directed hypergraphs.展开更多
BACKGROUND The number of tumor deposits(TDs)does not play a part in the current tumor node metastasis staging.Negative lymph node(NLN)status is associated with the prognosis of colorectal cancer(CRC),but its clear rol...BACKGROUND The number of tumor deposits(TDs)does not play a part in the current tumor node metastasis staging.Negative lymph node(NLN)status is associated with the prognosis of colorectal cancer(CRC),but its clear role in N1c stage remains to be defined.AIM To evaluate the combination of TDs and NLNs as potential prognostic indicators in N1c CRC.METHODS We retrospectively identified 107 consecutive patients who had N1c CRC radically resected at China-Japan Friendship Hospital.The combination of TDs and NLNs was calculated by the formula NLNTD=NLN/(TD+1).Cutoff values of NLNs and NLNTD were determined using the R package“survminer”.Disease-free survival(DFS),overall survival(OS)and cancer-specific survival(CSS)were determined using the Kaplan-Meier method to assess the impact of NLNTD on prognosis.Results were compared using the log-rank test.RESULTS The median follow-up time was 63.17(45.33-81.37)months for DFS,with 33.64%(36/107)of patients experiencing recurrence during follow-up.Five-year DFS was 66.0%(57.3%-76.0%).There was no significant difference in prognosis between patients with>12 and≤12 NLNs(P=0.058)for DFS.Similar results were seen according to the number of TDs.The definition of NLNTD=NLN/(TD+1)with a cutoff value of 6 divided patients into two groups with different DFS(P=0.005).Five-year DFS for patients with NLNTD>6 was 73.5%(63.6%-85.0%),compared with 50.0%(35.7%-70.0%)for those with NLNTD≤6.These two groups had different prognosis without perineural invasion(P=0.012)or lymphovascular invasion(P=0.002)even neither(P=0.053).Similar results were seen for OS and CSS.CONCLUSION NLNTD could serve as important prognostic factor for outcomes in N1c CRC patients.These patients could be stratified for prognosis through NLNTD and the high-risk should be given more attention during treatment.展开更多
BACKGROUND Colorectal cancer is a malignancy with a high risk of lymph node metastasis and poor prognosis,and thus requires an accurate diagnosis.AIM To assess the diagnostic value of combined magnetic resonance T2-we...BACKGROUND Colorectal cancer is a malignancy with a high risk of lymph node metastasis and poor prognosis,and thus requires an accurate diagnosis.AIM To assess the diagnostic value of combined magnetic resonance T2-weighted imaging(T2WI)and diffusion-weighted imaging(DWI)in colorectal cancer.METHODS We included 120 patients with suspected colorectal cancer who underwent magnetic resonance imaging.Surgical pathology was used as the gold standard for comparison.Combined T2WI and DWI showed higher diagnostic efficacy than either of the two methods used individually.RESULTS The combined method achieved 94.74%sensitivity,95.45%specificity,95.00%accuracy,94.74%positive predictive value,and 95.45%negative predictive value in qualitative diagnosis.It showed 94.44%sensitivity,95.00%specificity,94.74%accuracy,94.44%positive predictive value,and 95.00%negative predictive value in clinical staging.Finally,it showed 94.74%sensitivity,94.59%specificity,94.74%accuracy,94.74%positive predictive value,and 94.59%negative predictive value in diagnosing lymph node metastasis.These results were highly consistent with that of the gold standard.CONCLUSION This study combined T2WI and DWI for accurate diagnosis of colorectal cancer,aiding clinical staging and lymph node metastasis assessment.This approach is promising for clinical application.展开更多
This paper focuses on applying the barycentric Lagrange interpolation collocation method(BLICM)for solving 2D time-fractional diffusion-wave equation(TFDWE).In order to obtain the discrete format of the equation,we co...This paper focuses on applying the barycentric Lagrange interpolation collocation method(BLICM)for solving 2D time-fractional diffusion-wave equation(TFDWE).In order to obtain the discrete format of the equation,we construct the multivariate barycentric Lagrange interpolation approximation function and process the integral terms by using the Gauss-Legendre quadrature formula.We provide a detailed error analysis of the discrete format on the second kind of Chebyshev nodes.The efficacy of the proposed method is substantiated by some numerical experiments.The results of these experiments demonstrate that our method can obtain high-precision numerical solutions for fractional partial differential equations.Additionally,the method's capability to achieve high precision with a reduced number of nodes is confirmed.展开更多
Rack-level loop thermosyphons have been widely adopted as a solution to data centers’growing energy demands.While numerous studies have highlighted the heat transfer performance and energy-saving benefits of this sys...Rack-level loop thermosyphons have been widely adopted as a solution to data centers’growing energy demands.While numerous studies have highlighted the heat transfer performance and energy-saving benefits of this system,its economic feasibility,water usage effectiveness(WUE),and carbon usage effectiveness(CUE)remain underexplored.This study introduces a comprehensive evaluation index designed to assess the applicability of the rack-level loop thermosyphon system across various computing hub nodes.The air wet bulb temperature Ta,w was identified as the most significant factor influencing the variability in the combination of PUE,CUE,and WUE values.The results indicate that the rack-level loop thermosyphon system achieves the highest score in Lanzhou(94.485)and the lowest in Beijing(89.261)based on the comprehensive evaluation index.The overall ranking of cities according to the comprehensive evaluation score is as follows:Gansu hub(Lanzhou)>Inner Mongolia hub(Hohhot)>Ningxia hub(Yinchuan)>Yangtze River Delta hub(Shanghai)>Chengdu Chongqing hub(Chongqing)>Guangdong-Hong Kong-Macao Greater Bay Area hub(Guangzhou)>Guizhou hub(Guiyang)>Beijing-Tianjin-Hebei hub(Beijing).Furthermore,Hohhot,Lanzhou,and Yinchuan consistently rank among the top three cities for comprehensive scores across all load rates,while Guiyang(at a 25%load rate),Guangzhou(at a 50%load rate),and Beijing(at 75%and 100%load rates)exhibited the lowest comprehensive scores.展开更多
In this editorial,we proceed to comment on the article by Chua et al,addressing the management of metastatic lateral pelvic lymph nodes(mLLN)in stage II/III rectal cancer patients below the peritoneal reflection.The t...In this editorial,we proceed to comment on the article by Chua et al,addressing the management of metastatic lateral pelvic lymph nodes(mLLN)in stage II/III rectal cancer patients below the peritoneal reflection.The treatment of this nodal area sparks significant controversy due to the strategic differences followed by Eastern and Western physicians,albeit with a higher degree of convergence in recent years.The dissection of lateral pelvic lymph nodes without neoadjuvant therapy is a standard practice in Eastern countries.In contrast,in the West,preference leans towards opting for neoadjuvant therapy with chemoradiotherapy or radiotherapy,that would cover the treatment of this area without the need to add the dissection of these nodes to the total mesorectal excision.In the presence of high-risk nodal characteristics for mLLN related to radiological imaging and lack of response to neoadjuvant therapy,the risk of lateral local recurrence increases,suggesting the appropriate selection of strategies to reduce the risk of recurrence in each patient profile.Despite the heterogeneous and retrospective nature of studies addressing this area,an international consensus is necessary to approach this clinical scenario uniformly.展开更多
Objective: To explore the value of percutaneous ultrasonography combined with transvenous ultrasonography for accurate localization of sentinel lymph nodes and diagnosis of metastatic lymph nodes in patients with brea...Objective: To explore the value of percutaneous ultrasonography combined with transvenous ultrasonography for accurate localization of sentinel lymph nodes and diagnosis of metastatic lymph nodes in patients with breast cancer. Methods: 18 cases of patients with breast cancer attending the Hainan General Hospital from May 2022 to June 2024 who were proposed to undergo axillary lymph node dissection were selected, and the ultrasonographic agent was injected subcutaneously through the areola on the 1st day before the operation, and the marker localization of the manifestation of the Sentinel lymph nodes and draw the lymphatic vessel alignment for drainage on the body surface, and record the manifestation of SLN by conventional ultrasound and dual ultrasonography. At the time of surgery, intraoperative melphalan localization was used to identify the SLN, the difference between the number of ultrasound and melphalan localization was observed, and resection was performed for pathological examination to determine whether they were metastatic or not. Results: There were 8 metastatic lymph nodes and 18 non-metastatic lymph nodes among 31 SLN. A total of 62 SLN were localized by intraoperative melphalan, of which 31 were consistent with ultrasound localization and 31 were not identified by ultrasound. The diagnostic sensitivity of SLN metastasis diagnosed by transcutaneous ultrasonography was 62.50%, specificity was 91.30%, positive predictive value was 71.43%, negative predictive value 87.50%, accuracy was 83.87%, and the AUC was 0.769;the diagnostic sensitivityof transvenous ultrasonography diagnosed was 75.00%, specificity was 75.00%, and the accuracy was 83.87%, 75.00%, specificity 91.30%, positive predictive value 75.00%, negative predictive value 91.30%, accuracy 87.10%, AUC 0.832;dual ultrasonography diagnostic sensitivity 87.50%, specificity 91.30%, positive predictive value 77.78%, negative predictive value 95.45%, accuracy 90.32%. The AUC was 0.894. Conclusion: Transcutaneous ultrasonography combined with transvenous ultrasonography can accurately localize sentinel lymph nodes and improve the sensitivity and accuracy of the diagnosis of metastatic SLN.展开更多
Enhancing the security of Wireless Sensor Networks(WSNs)improves the usability of their applications.Therefore,finding solutions to various attacks,such as the blackhole attack,is crucial for the success of WSN applic...Enhancing the security of Wireless Sensor Networks(WSNs)improves the usability of their applications.Therefore,finding solutions to various attacks,such as the blackhole attack,is crucial for the success of WSN applications.This paper proposes an enhanced version of the AODV(Ad Hoc On-Demand Distance Vector)protocol capable of detecting blackholes and malfunctioning benign nodes in WSNs,thereby avoiding them when delivering packets.The proposed version employs a network-based reputation system to select the best and most secure path to a destination.To achieve this goal,the proposed version utilizes the Watchdogs/Pathrater mechanisms in AODV to gather and broadcast reputations to all network nodes to build the network-based reputation system.To minimize the network overhead of the proposed approach,the paper uses reputation aggregator nodes only for forwarding reputation tables.Moreover,to reduce the overhead of updating reputation tables,the paper proposes three mechanisms,which are the prompt broadcast,the regular broadcast,and the light broadcast approaches.The proposed enhanced version has been designed to perform effectively in dynamic environments such as mobile WSNs where nodes,including blackholes,move continuously,which is considered a challenge for other protocols.Using the proposed enhanced protocol,a node evaluates the security of different routes to a destination and can select the most secure routing path.The paper provides an algorithm that explains the proposed protocol in detail and demonstrates a case study that shows the operations of calculating and updating reputation values when nodes move across different zones.Furthermore,the paper discusses the proposed approach’s overhead analysis to prove the proposed enhancement’s correctness and applicability.展开更多
This paper studies the target controllability of multilayer complex networked systems,in which the nodes are highdimensional linear time invariant(LTI)dynamical systems,and the network topology is directed and weighte...This paper studies the target controllability of multilayer complex networked systems,in which the nodes are highdimensional linear time invariant(LTI)dynamical systems,and the network topology is directed and weighted.The influence of inter-layer couplings on the target controllability of multi-layer networks is discussed.It is found that even if there exists a layer which is not target controllable,the entire multi-layer network can still be target controllable due to the inter-layer couplings.For the multi-layer networks with general structure,a necessary and sufficient condition for target controllability is given by establishing the relationship between uncontrollable subspace and output matrix.By the derived condition,it can be found that the system may be target controllable even if it is not state controllable.On this basis,two corollaries are derived,which clarify the relationship between target controllability,state controllability and output controllability.For the multi-layer networks where the inter-layer couplings are directed chains and directed stars,sufficient conditions for target controllability of networked systems are given,respectively.These conditions are easier to verify than the classic criterion.展开更多
As industrialization and informatization becomemore deeply intertwined,industrial control networks have entered an era of intelligence.The connection between industrial control networks and the external internet is be...As industrialization and informatization becomemore deeply intertwined,industrial control networks have entered an era of intelligence.The connection between industrial control networks and the external internet is becoming increasingly close,which leads to frequent security accidents.This paper proposes a model for the industrial control network.It includes a malware containment strategy that integrates intrusion detection,quarantine,and monitoring.Basedonthismodel,the role of keynodes in the spreadofmalware is studied,a comparisonexperiment is conducted to validate the impact of the containment strategy.In addition,the dynamic behavior of the model is analyzed,the basic reproduction number is computed,and the disease-free and endemic equilibrium of the model is also obtained by the basic reproduction number.Moreover,through simulation experiments,the effectiveness of the containment strategy is validated,the influence of the relevant parameters is analyzed,and the containment strategy is optimized.In otherwords,selective immunity to key nodes can effectively suppress the spread ofmalware andmaintain the stability of industrial control systems.The earlier the immunization of key nodes,the better.Once the time exceeds the threshold,immunizing key nodes is almost ineffective.The analysis provides a better way to contain the malware in the industrial control network.展开更多
BACKGROUND Owing to the advancement in bacterial identification techniques,the detection rate of non-tuberculous mycobacterium(NTM)has been on the rise.Different from Mycobacterium tuberculosis,the clinical symptoms o...BACKGROUND Owing to the advancement in bacterial identification techniques,the detection rate of non-tuberculous mycobacterium(NTM)has been on the rise.Different from Mycobacterium tuberculosis,the clinical symptoms of NTM are not easily detected,and the clinical efficacy and prognosis are somewhat heterogeneous.To report a case of Mycobacterium gordoniasis of cervical lymph node diagnosed in Anhui Chest Hospital in July 2022.CASE SUMMARY Upon examination,the patient who weighed 67.5 kg,was human immunodeficiency virus negative,healthy,without hypertension,diabetes,heart disease and other basic diseases microscopic analysis revealed granulomatous inflammation with coagulation necrosis in the lymphocyte,and tuberculosis was not ruled out.Plain computed tomography scans of the neck and chest indicated the presence of a single grayish-yellow and grayish-brown tissue,the dimensions of which was top of form 10.5 cm×3.0 cm×1.5 cm.After pathological consultation in our hospital,the diagnosis was confirmed as NTM infection.CONCLUSION This case report and the clinical epidemiological research on improving NTM have important guiding significance for improving decision-making in clinical treatments.展开更多
The aim of the study was to identify the relationship between molecular subtypes of breast cancer (BC) and the morphological characteristics of axillary lymph nodes (ALN) and metastatic risk in BC patients to clarify ...The aim of the study was to identify the relationship between molecular subtypes of breast cancer (BC) and the morphological characteristics of axillary lymph nodes (ALN) and metastatic risk in BC patients to clarify danger degree and justification of removal before metastases appear. Material and methods. Tumor molecular subtypes of 116 female BC patients aged 24 - 75 (53.9 ± 0.8) were determined by tumor tissue immunohistological examination (obtained by tru-cut biopsy), and the BC was classified as Luminal A, Luminal B/HER2−, Luminal B/HER2+, TNBC, and HER2+ subtypes. To interpret the results for the BC receptor status, immunohistochemical analysis was performed and interpreted according to the Allred scale. Lymph node size, shape, structure and conglomerates availability were recorded according to ultrasonography (USG) examination evaluated on “LOGIQ C5-Premium” (2012). Blood CA-15-3 levels were analyzed using a COBAS-e 411 automated analyzer. Statistical analysis of the obtained results was carried out using the SPSS-26 software package, and based on the t-Student-Bonferroni and H-Kruskal-Wallis criteria. The sensitivity and specificity of the indicators studied were determined using ROC statistical analysis. Results showed a significant association of some subtypes, as well as receptor expression, with tumor metastasis to ALN. Conclusion: 1) The HER2+ subtype is the most aggressive in terms of ALN metastasis. Although TNBC is the most aggressive subtype in general, it is characterized by fewer metastases to the ALN than the HER2+ subtype. 2) Metastatic ALNs can be distinguished based on their cortical structure before tumor tissue biopsy, which is economically profitable. These LNs can be removed without biopsy.展开更多
Objective: To explore the prognostic value of log odds of positive lymph nodes (LODDS) in patients with gastroenteropancreatic neuroendocrine tumors (GEPNET) and to develop nomograms based on LODDS for predicting 1-ye...Objective: To explore the prognostic value of log odds of positive lymph nodes (LODDS) in patients with gastroenteropancreatic neuroendocrine tumors (GEPNET) and to develop nomograms based on LODDS for predicting 1-year, 3-year, and 5-year overall survival (OS) and cancer-specific survival (CSS). Methods: This retrospective cohort study was based on the Surveillance, Epidemiology, and End Results (SEER) Program. Demographic data, clinical data, and survival status were extracted, with endpoints of OS and CSS. Multivariate Cox proportional hazards regression analysis assessed predictors associated with OS and CSS, with hazard ratios (HRs) and 95% confidence intervals (CIs) evaluated. Nomogram performance was assessed by calculating the area under the receiver operating characteristic (ROC) curve (AUC). Results: A total of 1,673 patients were included and divided into a training set (n = 1,172) and a testing set (n = 501). Multivariate Cox proportional hazards regression analyses identified LODDS as an independent prognostic factor for OS (HR = 1.79, 95% CI: 1.44-2.24) and CSS (HR = 1.81, 95% CI: 1.41-2.31). The OS and CSS nomograms, developed from multivariate Cox regression analyses, showed good performance, with AUCs of 0.858, 0.878, and 0.852 for predicting 1-year, 3-year, and 5-year OS, and AUCs of 0.859, 0.887, and 0.865 for 1-year, 3-year, and 5-year CSS in the testing set. The nomograms are accessible online (OS: https://zhmte.shinyapps.io/DynNomapp/;CSS: https:// zhmty.shinyapps.io/DynNomapp/). Conclusions: LODDS serves as an independent prognostic factor in GEPNET. Online nomograms based on LODDS demonstrated effective performance in predicting OS and CSS in GEPNET patients, providing a convenient tool for clinical application.展开更多
BACKGROUND Lymph node(LN)staging in rectal cancer(RC)affects treatment decisions and patient prognosis.For radiologists,the traditional preoperative assessment of LN metastasis(LNM)using magnetic resonance imaging(MRI...BACKGROUND Lymph node(LN)staging in rectal cancer(RC)affects treatment decisions and patient prognosis.For radiologists,the traditional preoperative assessment of LN metastasis(LNM)using magnetic resonance imaging(MRI)poses a challenge.AIM To explore the value of a nomogram model that combines Conventional MRI and radiomics features from the LNs of RC in assessing the preoperative metastasis of evaluable LNs.METHODS In this retrospective study,270 LNs(158 nonmetastatic,112 metastatic)were randomly split into training(n=189)and validation sets(n=81).LNs were classified based on pathology-MRI matching.Conventional MRI features[size,shape,margin,T2-weighted imaging(T2WI)appearance,and CE-T1-weighted imaging(T1WI)enhancement]were evaluated.Three radiomics models used 3D features from T1WI and T2WI images.Additionally,a nomogram model combining conventional MRI and radiomics features was developed.The model used univariate analysis and multivariable logistic regression.Evaluation employed the receiver operating characteristic curve,with DeLong test for comparing diagnostic performance.Nomogram performance was assessed using calibration and decision curve analysis.RESULTS The nomogram model outperformed conventional MRI and single radiomics models in evaluating LNM.In the training set,the nomogram model achieved an area under the curve(AUC)of 0.92,which was significantly higher than the AUCs of 0.82(P<0.001)and 0.89(P<0.001)of the conventional MRI and radiomics models,respectively.In the validation set,the nomogram model achieved an AUC of 0.91,significantly surpassing 0.80(P<0.001)and 0.86(P<0.001),respectively.CONCLUSION The nomogram model showed the best performance in predicting metastasis of evaluable LNs.展开更多
基金supported by grants from the National Natural Science Foundation of China(Grant Nos.81672638 and W2421095)National Natural Science Foundation of Shandong Province(Grant No.ZR2024LMB011)Collaborative Academic Innovation Project of Shandong Cancer Hospital(Grant No.GF003)。
文摘The principal breast cancer treatment approach has long been surgical removal of the primary breast lesions and regional lymph nodes,particularly the axillary lymph nodes.However,the advent of minimally invasive diagnostic techniques,such as sentinel lymph node biopsy(SLNB),has markedly diminished the extent of surgery required for regional lymph nodes.
基金Supported by the National Natural Science Foundation of China(Grant No.12031002)。
文摘Accurately identifying key nodes is essential for evaluating network robustness and controlling information propagation in complex network analysis. However, current research methods face limitations in applicability and accuracy. To address these challenges, this study introduces the K-GCN model, which integrates neighborhood k-shell distribution analysis with Graph Convolutional Network(GCN) technology to enhance key node identification in complex networks. The K-GCN model first leverages neighborhood k-shell distributions to calculate entropy values for each node, effectively quantifying node importance within the network. These entropy values are then used as key features within the GCN, which subsequently formulates intelligent strategies to maximize network connectivity disruption by removing a minimal set of nodes, thereby impacting the overall network architecture. Through iterative interactions with the environment, the GCN continuously refines its strategies, achieving precise identification of key nodes in the network. Unlike traditional methods, the K-GCN model not only captures local node features but also integrates the network structure and complex interrelations between neighboring nodes, significantly improving the accuracy and efficiency of key node identification.Experimental validation in multiple real-world network scenarios demonstrates that the K-GCN model outperforms existing methods.
基金Supported by the National Natural Science Foundation of China,No.82473195 and No.32370797the Natural Science Foundation of Zhejiang Province,No.LTGY23H160018+3 种基金the Zhejiang Medical and Health Science and Technology Program,No.2024KY789 and No.2023KY615the National Research Center for Translational Medicine at Shanghai Program,No.NRCTM(SH)-2025-07the Beijing Science and Technology Innovation Medical Development Foundation,No.KC2023-JX-0270-07the Key Laboratory of Prevention,Diagnosis and Therapy of Upper Gastrointestinal Cancer of Zhejiang Province,No.2022E10021.
文摘BACKGROUND The log odds of positive lymph nodes(LODDS)are correlated with survival outcomes in gastric cancer(GC)patients.However,the prognostic value across different tumor differentiation levels remains unclear.AIM To evaluate the independent prognostic value of LODDS and the stratified predictive efficacy in GC patients with different histologic differentiations.METHODS We conducted a retrospective analysis of 2103 GC patients who underwent radical gastrectomy at Zhejiang Cancer Hospital.The prognostic value of LODDS was compared with that of other lymph node-based metrics,including the pathologic N stage,number of positive lymph nodes,number of total lymph nodes,and lymph node ratio,stratified by tumor differentiation.RESULTS LODDS was identified as an independent prognostic factor for overall survival in moderately to poorly differentiated GC patients.LODDS demonstrated superior predictive accuracy over other lymph node metrics.A nomogram incorporating LODDS,age,carbohydrate antigen(CA)125,carcinoembryonic antigen,and tumor differentiation showed good predictive accuracy(C-index=0.703).A higher LODDS was significantly associated with an increased risk of recurrence or metastasis,poorly differentiated tumors,advanced cancer,mucinous gastric adenocarcinoma,nerve invasion,and vascular tumor thrombus.Additionally,LODDS was positively correlated with the tumor markers CA19-9,CA72-4,CA125,and CA242(all P<0.05).CONCLUSION LODDS is an independent prognostic indicator for patients with moderately and poorly differentiated GC,and its predictive performance is superior to that of other models.
基金supported by the National Natural Science Foundation of China(Grant No.62173065)the Natural Science Foundation of Beijing(Grant No.4242040)+1 种基金the Intelligent Policing and National Security Risk Management Laboratory Open Topics for the year 2025(Grant No.ZHKFYB2503)the Intelligent Policing and National Security Risk Management Laboratory Open Topics for the year 2024(Grant No.ZHKFZD2401).
文摘Identifying critical nodes is a pivotal research topic in network science,yet the efficient and accurate detection of highly influential nodes remains a challenge.Existing centrality measures predominantly rely on local or global topological structures,often overlooking indirect connections and their interaction strengths.This leads to imprecise assessments of node importance,limiting practical applications.To address this,we propose a novel node centrality measure,termed six-degree gravity centrality(SDGC),grounded in the six degrees of separation theory,for the precise identification of influential nodes in networks.Specifically,we introduce a set of node influence parameters—node mass,dynamic interaction distance,and attraction coefficient—to enhance the gravity model.Node mass is calculated by integrating K-shell and closeness centrality measures.The dynamic interaction distance,informed by the six-degrees of separation theory,is determined through path searches within six hops between node pairs.The attraction coefficient is derived from the difference in K-shell values between nodes.By integrating these parameters,we develop an improved gravity model to quantify node influence.Experiments conducted on nine real-world networks demonstrate that SDGC significantly outperforms nine existing classical and state-of-the-art methods in identifying the influential nodes.
基金supported by the Fujian Key Laboratory of Intelligent Imaging and Precision Radiotherapy for Tumors(Fujian Medical University)and Clinical Research Center for Radiology and Radiotherapy of Fujian Province(Digestive,Hematological and Breast Malignancies).
文摘Background:Metastasis to the infraclavicular and supraclavicular lymph nodes(ISLNs)is an important factor that predicts poor survival in patients with breast cancer;however,pathological nodal staging does not traditionally include ISLNs because of their non-routine surgical dissection.This study aimed to evaluate the prognostic impact of ISLN metastasis and propose a refined nodal staging system tailored for patients undergoing neoadjuvant chemotherapy(NAC).Methods:We retrospectively reviewed 1,072 patients with breast cancer with or without ISLN metastasis who received NAC at two institutions(Fujian cohort and Hebei cohort)from 2010 to 2022.We conducted detailed survival analysis to evaluate the diagnostic consistency and prognostic significance of ISLNs.Results:There were no survival differences among patients with ISLN involvement across different assay method-ologies and patient cohorts.Among 887 patients in the Fujian cohort,238 patients(26.8%)with positive ISLNs had significantly inferior 3-year progression-free survival(PFS,75.9%vs.90.4%,P<0.001)and overall survival(OS,90.6%vs.95.9%,P<0.001).After adjusting for potential confounders,ISLN involvement persisted as an independent predictor of both PFS and OS.We propose a refined axillary classification that combines pathologi-cal axillary staging post-NAC with ISLN involvement,revealing 3-year PFS rates of 95.3%,87.6%,73.4%,and 64.5%for the respective four groups defined by this refined classification combining axillary stage and ISLN status.Conclusions:Involvement of the ISLNs was associated with a worse prognosis,underscoring their prognostic value.This finding highlights the potential of ISLN status to influence decisions regarding adjuvant treatment in patients with breast cancer.
基金Research results of the General Scientific Research Project of Zhejiang Education Department in 2024,“Research on the Digitalization of Song Yun Ink Painting-Taking the Ten Scenes of West Lake as an Example”(Project No.:Y202455200).
文摘This study examines the development of painting techniques of Chinese ink wash landscape paintings,pays attention to its unique brush and ink language and features of the representation of elements,and deeply analyzes the artistic characteristics of digital ink wash texture materials.The research focuses on key aspects such as the ink brushstrokes with the combination of emptiness and reality,the profound and serene ink wash space,and the extremely ingenious position layout.It proposes a construction path of digital ink wash texture materials based on the Blender material node system.This method makes use of the flexibility of the Blender material node system to successfully simulate highly realistic digital ink wash textures.It can not only construct static ink wash textures but also realize the dynamic transformation of static ink wash works through animation nodes and procedural control,thereby enhancing the artistic expression of digital ink wash works.The proposal and implementation of this method expand the application scope of the Blender material node system,help deeply explore the potential of digital ink wash art,and open up a brand new research path for constructing digital ink wash textures.
基金Project supported by the National Natural Science Foundation of China(Grant No.62166010)the Guangxi Natural Science Foundation(Grant No.2023GXNSFAA026087).
文摘Hypergraphs can accurately capture complex higher-order relationships,but it is challenging to identify their important nodes.In this paper,an improved PageRank(ImPageRank)algorithm is designed to identify important nodes in a directed hypergraph.The algorithm introduces the Jaccard similarity of directed hypergraphs.By comparing the numbers of common neighbors between nodes with the total number of their neighbors,the Jaccard similarity measure takes into account the similarity between nodes that are not directly connected,and can reflect the potential correlation between nodes.An improved susceptible–infected(SI)model in directed hypergraph is proposed,which considers nonlinear propagation mode and more realistic propagation mechanism.In addition,some important node evaluation methods are transferred from undirected hypergraphs and applied to directed hypergraphs.Finally,the ImPageRank algorithm is used to evaluate the performance of the SI model,network robustness and monotonicity.Simulations of real networks demonstrate the excellent performance of the proposed algorithm and provide a powerful framework for identifying important nodes in directed hypergraphs.
基金Supported by the National High Level Hospital Clinical Research Funding,No.2023-NHLHCRF-BQ-32 and No.2023-NHLHCRFYYPPLC-ZR-13National Key Research and Development Program of China,No.2024YFE0198300Beijing Municipal Natural Science Foundation,No.7222316.
文摘BACKGROUND The number of tumor deposits(TDs)does not play a part in the current tumor node metastasis staging.Negative lymph node(NLN)status is associated with the prognosis of colorectal cancer(CRC),but its clear role in N1c stage remains to be defined.AIM To evaluate the combination of TDs and NLNs as potential prognostic indicators in N1c CRC.METHODS We retrospectively identified 107 consecutive patients who had N1c CRC radically resected at China-Japan Friendship Hospital.The combination of TDs and NLNs was calculated by the formula NLNTD=NLN/(TD+1).Cutoff values of NLNs and NLNTD were determined using the R package“survminer”.Disease-free survival(DFS),overall survival(OS)and cancer-specific survival(CSS)were determined using the Kaplan-Meier method to assess the impact of NLNTD on prognosis.Results were compared using the log-rank test.RESULTS The median follow-up time was 63.17(45.33-81.37)months for DFS,with 33.64%(36/107)of patients experiencing recurrence during follow-up.Five-year DFS was 66.0%(57.3%-76.0%).There was no significant difference in prognosis between patients with>12 and≤12 NLNs(P=0.058)for DFS.Similar results were seen according to the number of TDs.The definition of NLNTD=NLN/(TD+1)with a cutoff value of 6 divided patients into two groups with different DFS(P=0.005).Five-year DFS for patients with NLNTD>6 was 73.5%(63.6%-85.0%),compared with 50.0%(35.7%-70.0%)for those with NLNTD≤6.These two groups had different prognosis without perineural invasion(P=0.012)or lymphovascular invasion(P=0.002)even neither(P=0.053).Similar results were seen for OS and CSS.CONCLUSION NLNTD could serve as important prognostic factor for outcomes in N1c CRC patients.These patients could be stratified for prognosis through NLNTD and the high-risk should be given more attention during treatment.
文摘BACKGROUND Colorectal cancer is a malignancy with a high risk of lymph node metastasis and poor prognosis,and thus requires an accurate diagnosis.AIM To assess the diagnostic value of combined magnetic resonance T2-weighted imaging(T2WI)and diffusion-weighted imaging(DWI)in colorectal cancer.METHODS We included 120 patients with suspected colorectal cancer who underwent magnetic resonance imaging.Surgical pathology was used as the gold standard for comparison.Combined T2WI and DWI showed higher diagnostic efficacy than either of the two methods used individually.RESULTS The combined method achieved 94.74%sensitivity,95.45%specificity,95.00%accuracy,94.74%positive predictive value,and 95.45%negative predictive value in qualitative diagnosis.It showed 94.44%sensitivity,95.00%specificity,94.74%accuracy,94.44%positive predictive value,and 95.00%negative predictive value in clinical staging.Finally,it showed 94.74%sensitivity,94.59%specificity,94.74%accuracy,94.74%positive predictive value,and 94.59%negative predictive value in diagnosing lymph node metastasis.These results were highly consistent with that of the gold standard.CONCLUSION This study combined T2WI and DWI for accurate diagnosis of colorectal cancer,aiding clinical staging and lymph node metastasis assessment.This approach is promising for clinical application.
基金Supported by the Scientific Research Foundation for Talents Introduced of Guizhou University of Finance and Economics(Grant No.2023YJ16)the Institute of Complexity Science,Henan University of Technology(Grant No.CSKFJJ-2025-33)the International Science and Technology Cooperation Project of Henan Province(Grant No.252102520007).
文摘This paper focuses on applying the barycentric Lagrange interpolation collocation method(BLICM)for solving 2D time-fractional diffusion-wave equation(TFDWE).In order to obtain the discrete format of the equation,we construct the multivariate barycentric Lagrange interpolation approximation function and process the integral terms by using the Gauss-Legendre quadrature formula.We provide a detailed error analysis of the discrete format on the second kind of Chebyshev nodes.The efficacy of the proposed method is substantiated by some numerical experiments.The results of these experiments demonstrate that our method can obtain high-precision numerical solutions for fractional partial differential equations.Additionally,the method's capability to achieve high precision with a reduced number of nodes is confirmed.
基金supported by the Natural Science Foundation of Hunan Province,China(Grant Nos.2023JJ50178 and 2023JJ50194)the Excellent Youth Project of Hunan Provincial Department of Education(Grant No.23B0542).
文摘Rack-level loop thermosyphons have been widely adopted as a solution to data centers’growing energy demands.While numerous studies have highlighted the heat transfer performance and energy-saving benefits of this system,its economic feasibility,water usage effectiveness(WUE),and carbon usage effectiveness(CUE)remain underexplored.This study introduces a comprehensive evaluation index designed to assess the applicability of the rack-level loop thermosyphon system across various computing hub nodes.The air wet bulb temperature Ta,w was identified as the most significant factor influencing the variability in the combination of PUE,CUE,and WUE values.The results indicate that the rack-level loop thermosyphon system achieves the highest score in Lanzhou(94.485)and the lowest in Beijing(89.261)based on the comprehensive evaluation index.The overall ranking of cities according to the comprehensive evaluation score is as follows:Gansu hub(Lanzhou)>Inner Mongolia hub(Hohhot)>Ningxia hub(Yinchuan)>Yangtze River Delta hub(Shanghai)>Chengdu Chongqing hub(Chongqing)>Guangdong-Hong Kong-Macao Greater Bay Area hub(Guangzhou)>Guizhou hub(Guiyang)>Beijing-Tianjin-Hebei hub(Beijing).Furthermore,Hohhot,Lanzhou,and Yinchuan consistently rank among the top three cities for comprehensive scores across all load rates,while Guiyang(at a 25%load rate),Guangzhou(at a 50%load rate),and Beijing(at 75%and 100%load rates)exhibited the lowest comprehensive scores.
文摘In this editorial,we proceed to comment on the article by Chua et al,addressing the management of metastatic lateral pelvic lymph nodes(mLLN)in stage II/III rectal cancer patients below the peritoneal reflection.The treatment of this nodal area sparks significant controversy due to the strategic differences followed by Eastern and Western physicians,albeit with a higher degree of convergence in recent years.The dissection of lateral pelvic lymph nodes without neoadjuvant therapy is a standard practice in Eastern countries.In contrast,in the West,preference leans towards opting for neoadjuvant therapy with chemoradiotherapy or radiotherapy,that would cover the treatment of this area without the need to add the dissection of these nodes to the total mesorectal excision.In the presence of high-risk nodal characteristics for mLLN related to radiological imaging and lack of response to neoadjuvant therapy,the risk of lateral local recurrence increases,suggesting the appropriate selection of strategies to reduce the risk of recurrence in each patient profile.Despite the heterogeneous and retrospective nature of studies addressing this area,an international consensus is necessary to approach this clinical scenario uniformly.
文摘Objective: To explore the value of percutaneous ultrasonography combined with transvenous ultrasonography for accurate localization of sentinel lymph nodes and diagnosis of metastatic lymph nodes in patients with breast cancer. Methods: 18 cases of patients with breast cancer attending the Hainan General Hospital from May 2022 to June 2024 who were proposed to undergo axillary lymph node dissection were selected, and the ultrasonographic agent was injected subcutaneously through the areola on the 1st day before the operation, and the marker localization of the manifestation of the Sentinel lymph nodes and draw the lymphatic vessel alignment for drainage on the body surface, and record the manifestation of SLN by conventional ultrasound and dual ultrasonography. At the time of surgery, intraoperative melphalan localization was used to identify the SLN, the difference between the number of ultrasound and melphalan localization was observed, and resection was performed for pathological examination to determine whether they were metastatic or not. Results: There were 8 metastatic lymph nodes and 18 non-metastatic lymph nodes among 31 SLN. A total of 62 SLN were localized by intraoperative melphalan, of which 31 were consistent with ultrasound localization and 31 were not identified by ultrasound. The diagnostic sensitivity of SLN metastasis diagnosed by transcutaneous ultrasonography was 62.50%, specificity was 91.30%, positive predictive value was 71.43%, negative predictive value 87.50%, accuracy was 83.87%, and the AUC was 0.769;the diagnostic sensitivityof transvenous ultrasonography diagnosed was 75.00%, specificity was 75.00%, and the accuracy was 83.87%, 75.00%, specificity 91.30%, positive predictive value 75.00%, negative predictive value 91.30%, accuracy 87.10%, AUC 0.832;dual ultrasonography diagnostic sensitivity 87.50%, specificity 91.30%, positive predictive value 77.78%, negative predictive value 95.45%, accuracy 90.32%. The AUC was 0.894. Conclusion: Transcutaneous ultrasonography combined with transvenous ultrasonography can accurately localize sentinel lymph nodes and improve the sensitivity and accuracy of the diagnosis of metastatic SLN.
文摘Enhancing the security of Wireless Sensor Networks(WSNs)improves the usability of their applications.Therefore,finding solutions to various attacks,such as the blackhole attack,is crucial for the success of WSN applications.This paper proposes an enhanced version of the AODV(Ad Hoc On-Demand Distance Vector)protocol capable of detecting blackholes and malfunctioning benign nodes in WSNs,thereby avoiding them when delivering packets.The proposed version employs a network-based reputation system to select the best and most secure path to a destination.To achieve this goal,the proposed version utilizes the Watchdogs/Pathrater mechanisms in AODV to gather and broadcast reputations to all network nodes to build the network-based reputation system.To minimize the network overhead of the proposed approach,the paper uses reputation aggregator nodes only for forwarding reputation tables.Moreover,to reduce the overhead of updating reputation tables,the paper proposes three mechanisms,which are the prompt broadcast,the regular broadcast,and the light broadcast approaches.The proposed enhanced version has been designed to perform effectively in dynamic environments such as mobile WSNs where nodes,including blackholes,move continuously,which is considered a challenge for other protocols.Using the proposed enhanced protocol,a node evaluates the security of different routes to a destination and can select the most secure routing path.The paper provides an algorithm that explains the proposed protocol in detail and demonstrates a case study that shows the operations of calculating and updating reputation values when nodes move across different zones.Furthermore,the paper discusses the proposed approach’s overhead analysis to prove the proposed enhancement’s correctness and applicability.
基金supported by the National Natural Science Foundation of China (U1808205)Hebei Natural Science Foundation (F2000501005)。
文摘This paper studies the target controllability of multilayer complex networked systems,in which the nodes are highdimensional linear time invariant(LTI)dynamical systems,and the network topology is directed and weighted.The influence of inter-layer couplings on the target controllability of multi-layer networks is discussed.It is found that even if there exists a layer which is not target controllable,the entire multi-layer network can still be target controllable due to the inter-layer couplings.For the multi-layer networks with general structure,a necessary and sufficient condition for target controllability is given by establishing the relationship between uncontrollable subspace and output matrix.By the derived condition,it can be found that the system may be target controllable even if it is not state controllable.On this basis,two corollaries are derived,which clarify the relationship between target controllability,state controllability and output controllability.For the multi-layer networks where the inter-layer couplings are directed chains and directed stars,sufficient conditions for target controllability of networked systems are given,respectively.These conditions are easier to verify than the classic criterion.
基金Scientific Research Project of Liaoning Province Education Department,Code:LJKQZ20222457&LJKMZ20220781Liaoning Province Nature Fund Project,Code:No.2022-MS-291.
文摘As industrialization and informatization becomemore deeply intertwined,industrial control networks have entered an era of intelligence.The connection between industrial control networks and the external internet is becoming increasingly close,which leads to frequent security accidents.This paper proposes a model for the industrial control network.It includes a malware containment strategy that integrates intrusion detection,quarantine,and monitoring.Basedonthismodel,the role of keynodes in the spreadofmalware is studied,a comparisonexperiment is conducted to validate the impact of the containment strategy.In addition,the dynamic behavior of the model is analyzed,the basic reproduction number is computed,and the disease-free and endemic equilibrium of the model is also obtained by the basic reproduction number.Moreover,through simulation experiments,the effectiveness of the containment strategy is validated,the influence of the relevant parameters is analyzed,and the containment strategy is optimized.In otherwords,selective immunity to key nodes can effectively suppress the spread ofmalware andmaintain the stability of industrial control systems.The earlier the immunization of key nodes,the better.Once the time exceeds the threshold,immunizing key nodes is almost ineffective.The analysis provides a better way to contain the malware in the industrial control network.
文摘BACKGROUND Owing to the advancement in bacterial identification techniques,the detection rate of non-tuberculous mycobacterium(NTM)has been on the rise.Different from Mycobacterium tuberculosis,the clinical symptoms of NTM are not easily detected,and the clinical efficacy and prognosis are somewhat heterogeneous.To report a case of Mycobacterium gordoniasis of cervical lymph node diagnosed in Anhui Chest Hospital in July 2022.CASE SUMMARY Upon examination,the patient who weighed 67.5 kg,was human immunodeficiency virus negative,healthy,without hypertension,diabetes,heart disease and other basic diseases microscopic analysis revealed granulomatous inflammation with coagulation necrosis in the lymphocyte,and tuberculosis was not ruled out.Plain computed tomography scans of the neck and chest indicated the presence of a single grayish-yellow and grayish-brown tissue,the dimensions of which was top of form 10.5 cm×3.0 cm×1.5 cm.After pathological consultation in our hospital,the diagnosis was confirmed as NTM infection.CONCLUSION This case report and the clinical epidemiological research on improving NTM have important guiding significance for improving decision-making in clinical treatments.
文摘The aim of the study was to identify the relationship between molecular subtypes of breast cancer (BC) and the morphological characteristics of axillary lymph nodes (ALN) and metastatic risk in BC patients to clarify danger degree and justification of removal before metastases appear. Material and methods. Tumor molecular subtypes of 116 female BC patients aged 24 - 75 (53.9 ± 0.8) were determined by tumor tissue immunohistological examination (obtained by tru-cut biopsy), and the BC was classified as Luminal A, Luminal B/HER2−, Luminal B/HER2+, TNBC, and HER2+ subtypes. To interpret the results for the BC receptor status, immunohistochemical analysis was performed and interpreted according to the Allred scale. Lymph node size, shape, structure and conglomerates availability were recorded according to ultrasonography (USG) examination evaluated on “LOGIQ C5-Premium” (2012). Blood CA-15-3 levels were analyzed using a COBAS-e 411 automated analyzer. Statistical analysis of the obtained results was carried out using the SPSS-26 software package, and based on the t-Student-Bonferroni and H-Kruskal-Wallis criteria. The sensitivity and specificity of the indicators studied were determined using ROC statistical analysis. Results showed a significant association of some subtypes, as well as receptor expression, with tumor metastasis to ALN. Conclusion: 1) The HER2+ subtype is the most aggressive in terms of ALN metastasis. Although TNBC is the most aggressive subtype in general, it is characterized by fewer metastases to the ALN than the HER2+ subtype. 2) Metastatic ALNs can be distinguished based on their cortical structure before tumor tissue biopsy, which is economically profitable. These LNs can be removed without biopsy.
文摘Objective: To explore the prognostic value of log odds of positive lymph nodes (LODDS) in patients with gastroenteropancreatic neuroendocrine tumors (GEPNET) and to develop nomograms based on LODDS for predicting 1-year, 3-year, and 5-year overall survival (OS) and cancer-specific survival (CSS). Methods: This retrospective cohort study was based on the Surveillance, Epidemiology, and End Results (SEER) Program. Demographic data, clinical data, and survival status were extracted, with endpoints of OS and CSS. Multivariate Cox proportional hazards regression analysis assessed predictors associated with OS and CSS, with hazard ratios (HRs) and 95% confidence intervals (CIs) evaluated. Nomogram performance was assessed by calculating the area under the receiver operating characteristic (ROC) curve (AUC). Results: A total of 1,673 patients were included and divided into a training set (n = 1,172) and a testing set (n = 501). Multivariate Cox proportional hazards regression analyses identified LODDS as an independent prognostic factor for OS (HR = 1.79, 95% CI: 1.44-2.24) and CSS (HR = 1.81, 95% CI: 1.41-2.31). The OS and CSS nomograms, developed from multivariate Cox regression analyses, showed good performance, with AUCs of 0.858, 0.878, and 0.852 for predicting 1-year, 3-year, and 5-year OS, and AUCs of 0.859, 0.887, and 0.865 for 1-year, 3-year, and 5-year CSS in the testing set. The nomograms are accessible online (OS: https://zhmte.shinyapps.io/DynNomapp/;CSS: https:// zhmty.shinyapps.io/DynNomapp/). Conclusions: LODDS serves as an independent prognostic factor in GEPNET. Online nomograms based on LODDS demonstrated effective performance in predicting OS and CSS in GEPNET patients, providing a convenient tool for clinical application.
基金Supported by the National Natural Science Foundation of China,No.81602145 and No.82072704Jiangsu Province TCM Science and Technology Development Plan Monographic Project,No.ZT202118+6 种基金Jiangsu Provincial Natural Science Foundation,No.BK20171509China Postdoctoral Science Foundation,No.2018M632265The“333 Talents”Program of Jiangsu Province,No.BRA2020390Key R&D Plan of Jiangsu Provincial Department of Science and Technology,No.BE2020723Nanjing Medical University Project,No.NMUC2020046Nanjing Science and Technology Project,No.202110027Elderly Health Research Project of Jiangsu Provincial Health Commission,No.LR2022006.
文摘BACKGROUND Lymph node(LN)staging in rectal cancer(RC)affects treatment decisions and patient prognosis.For radiologists,the traditional preoperative assessment of LN metastasis(LNM)using magnetic resonance imaging(MRI)poses a challenge.AIM To explore the value of a nomogram model that combines Conventional MRI and radiomics features from the LNs of RC in assessing the preoperative metastasis of evaluable LNs.METHODS In this retrospective study,270 LNs(158 nonmetastatic,112 metastatic)were randomly split into training(n=189)and validation sets(n=81).LNs were classified based on pathology-MRI matching.Conventional MRI features[size,shape,margin,T2-weighted imaging(T2WI)appearance,and CE-T1-weighted imaging(T1WI)enhancement]were evaluated.Three radiomics models used 3D features from T1WI and T2WI images.Additionally,a nomogram model combining conventional MRI and radiomics features was developed.The model used univariate analysis and multivariable logistic regression.Evaluation employed the receiver operating characteristic curve,with DeLong test for comparing diagnostic performance.Nomogram performance was assessed using calibration and decision curve analysis.RESULTS The nomogram model outperformed conventional MRI and single radiomics models in evaluating LNM.In the training set,the nomogram model achieved an area under the curve(AUC)of 0.92,which was significantly higher than the AUCs of 0.82(P<0.001)and 0.89(P<0.001)of the conventional MRI and radiomics models,respectively.In the validation set,the nomogram model achieved an AUC of 0.91,significantly surpassing 0.80(P<0.001)and 0.86(P<0.001),respectively.CONCLUSION The nomogram model showed the best performance in predicting metastasis of evaluable LNs.
