Whole Slide Imaging (WSI) technology, as a revolutionary digital technology in the field of pathology, is gradually changing the traditional clinical pathological diagnosis model. By converting traditional glass patho...Whole Slide Imaging (WSI) technology, as a revolutionary digital technology in the field of pathology, is gradually changing the traditional clinical pathological diagnosis model. By converting traditional glass pathological sections into complete digital images through high-resolution scanning, it provides a new method for pathological diagnosis. Based on this, this paper studies the application of WSI technology in clinical pathological diagnosis, elaborates on its application value, analyzes the current application status, and proposes corresponding application countermeasures, aiming to provide reference for the standardized and popularized development of this technology in clinical pathological diagnosis.展开更多
Small intestinal villi are essential for nutrient absorption,and their impairment can lead to malabsorption.Small intestinal villous atrophy(VA)encompasses a heterogeneous group of disorders,including immune-mediated ...Small intestinal villi are essential for nutrient absorption,and their impairment can lead to malabsorption.Small intestinal villous atrophy(VA)encompasses a heterogeneous group of disorders,including immune-mediated conditions(e.g.,celiac disease,autoimmune enteropathy,inborn errors of immunity),lymphoproliferative disorders(e.g.,enteropathy-associated T-cell lymphoma),infectious causes(e.g.,tropical sprue,Whipple’s disease),iatrogenic factors(e.g.,Olmesartanassociated enteropathy,graft-vs-host disease),as well as inflammatory and idiopathic types.These disorders are often rare and challenging to distinguish due to overlapping clinical,serological,endoscopic,and histopathological features.Through a systematic literature search using keywords such as small intestinal VA,malabsorption,and specific enteropathies,this review provides a comprehensive overview of diagnostic clues for VA and malabsorption.We systematically summarize the pathological characteristics of each condition to assist pathologists and clinicians in accurately identifying the underlying etiologies.Current studies still have many limitations and lack broader and deeper investigations into these diseases.Therefore,future research should focus on the development of novel diagnostic tools,predictive models,therapeutic targets,and mechanistic molecular studies to refine both diagnosis and management strategies.展开更多
Uveal melanoma(UM)is the most common intraocular cancer,with approximately 5.2 individuals per million affected annually in the United States.It represents approximately 3%of the global malignant melanoma cases,accoun...Uveal melanoma(UM)is the most common intraocular cancer,with approximately 5.2 individuals per million affected annually in the United States.It represents approximately 3%of the global malignant melanoma cases,accounting for 80%of the overall noncutaneous melanomas.Clinically,it remains silent in about 30%of the cases;when symptomatic,it generally causes metamorphopsia(painless loss or distortion of vision)and/or photopsia(flashing or flickering of light in the visual field).Discoloration of the iris,astigmatism,glaucoma,and even blindness are other,less common clinical manifestations.Several pathophysiological mechanisms underlie the development of UM.Genetic mutations,involving especially the G protein subunit alpha q(GNAQ),guanine nucleotide-binding protein subunit alpha-11(GNA11),BRCA1 associated deubiquitinase 1(BAP1),splicing factor 3b subunit 1(SF3B1),and eukaryotic translation initiation factor 1A,X-linked(EIF1AX)genes as well as the MAPK/ERK signaling pathway genes,have been largely associated with the development of UM.Chromosomal aberrations,inflammatory and immunological alterations are often concurrent factors for the development and progression of UM.Therapies targeting specific genetic alterations and immunotherapy agents have been recently developed and introduced in clinical practice for the management of advanced-stage UMs.This review aims to present the latest advances in the clinical molecular pathology of UM,along with the resulting targeted,immunological,and other therapies that have been introduced or are currently under investigation.展开更多
Objective:Accurate detection of PIK3CA mutations is essential for guiding PI3K-targeted therapies in breast cancer,yet sequencing is not universally accessible,and single-modality prediction models have limited perfor...Objective:Accurate detection of PIK3CA mutations is essential for guiding PI3K-targeted therapies in breast cancer,yet sequencing is not universally accessible,and single-modality prediction models have limited performance.This study developed a multimodal deep learning framework integrating whole-slide imaging(WSI)and structured clinical data to improve mutation prediction.Methods:A total of 1,047 patients from TCGA and 166 patients from 3 external centers were included.The histopathology model used a transformer-based pretrained encoder(H-optimus-0)and a clustering-constrained attention multiple instance learning(CLAM-SB MIL)classifier to generate WSI-level representations.The clinical model incorporated engineered clinical variables and an extreme gradient boosting(XGBoost)model.A decision-level late fusion strategy(Multimodal PIK3CA Model,MPM)combined probabilistic outputs from both branches.Performance was evaluated with the area under the curve(AUC)and secondary metrics.Interpretability was assessed via attention heatmaps and shapley additive explanations(SHAP)analysis.Results:MPM outperformed single-modality models.It achieved an AUC of 0.745 on TCGA and maintained stable performance across external cohorts(0.695,0.690,and 0.680).SHAP analysis identified molecular subtype as the most influential clinical feature,whereas attention maps highlighted mutation-associated morphological regions.Conclusions:The developed multimodal framework effectively integrates complementary morphological and clinical information,and provides a robust and generalizable method for predicting PIK3CA mutation status.Strong multicenter adaptability and biological interpretability support its potential use as a clinical decision-support tool and an accessible alternative to molecular testing.展开更多
Alzheimer’s disease(AD)remains an incurable neurodegenerative disorder with devastating societal and personal impacts.Despite decades of intensive research,therapeutic efforts targeting the clinical stages of AD have...Alzheimer’s disease(AD)remains an incurable neurodegenerative disorder with devastating societal and personal impacts.Despite decades of intensive research,therapeutic efforts targeting the clinical stages of AD have largely failed to halt or reverse disease progression.This has prompted a critical shift in focus toward the earlier,preclinical stages of AD,where interventions may hold greater promise for altering the disease trajectory.展开更多
BACKGROUND Chronic hepatitis B virus(HBV)infection acquired in childhood frequently presents with mild or nonspecific symptoms,yet a distinct subset of pediatric patients develops rapid progression to liver cirrhosis(...BACKGROUND Chronic hepatitis B virus(HBV)infection acquired in childhood frequently presents with mild or nonspecific symptoms,yet a distinct subset of pediatric patients develops rapid progression to liver cirrhosis(LC)before adulthood.AIM To identify clinical and pathological characteristics of pediatric HBV-related LC.METHODS A total of 1332 pediatric patients with chronic HBV infection from the Fifth Medical Center of PLA General Hospital from January 2010 to January 2023 were included in this study.We identified 62 pediatric HBV-related LC by liver biopsy from the group.Subsequently,we described the clinical and pathological characteristics of pediatric LC.And 64 pediatric chronic hepatitis B(CHB;age and sex were matched with pediatric LC group)and 69 adult HBV-related LC(sex were matched with pediatric LC group)were enrolled to further demonstrate clinical and pathological differences between pediatric LC,pediatric CHB and adult LC.RESULTS We enrolled 62 pediatric LC,including 54(87.1%)males and 8(12.9%)females.The median age was 11(4-14)years old.The pediatric LC group showed significantly lower median quantitative HBV DNA loads(log10IU/mL:6.3 vs 17.4,P<0.001),reduced HBsAg titers(log10IU/mL:3.11 vs 8.956,P<0.0001),and diminished hepatitis B e antigen-positive positive rate(81.4%vs 93.8%,P<0.05)compared with pediatric CHB.A higher proportion of pediatric patients were asymptomatic(77.4%)compared to adult patients(11.6%)as they first diagnosed as LC,pediatric LC showed milder initial symptoms compared with adult patients such as fatigue(4.8%vs 27.5%),abdominal discomfort(9.7%vs 23.2%),nausea(0%vs 10.1%),and poor appetite(6.5%vs 8.7%;all P<0.0001).Notably,pediatric LC can achieve a significant percentage of functional cure compared with adult LC as 17.4%and 0%.The incidence of progression of LC in children after antiviral therapy continues to be much lower than that in adult LC(hazard ratio=6.102,95%confidence interval:1.72-21.65,P=0.00051).While the incidence of LC remission in children after antiviral therapy continues to be much higher than that in adult LC(hazard ratio=0.055,95%confidence interval:0.07128-0.2802,P<0.0001).CONCLUSION Pediatric patients with HBV-related cirrhosis exhibit elevated virological parameters and heightened transaminase levels than adult patients.However,the frequent paucity of overt clinical symptoms contributes to diagnostic challenges.Notably,early initiation of antiviral therapy in this population substantially improved clinical outcomes.展开更多
Alzheimer’s disease(AD),as the predominant form of neurodegenerative disorders,exerts a profound impact on the health of the global elderly population.For decades,the elucidation of AD pathogenesis and the developmen...Alzheimer’s disease(AD),as the predominant form of neurodegenerative disorders,exerts a profound impact on the health of the global elderly population.For decades,the elucidation of AD pathogenesis and the development of diagnostic and therapeutic approaches have been the focus of extensive research.Over recent years,a fundamental shift has occurred in AD diagnostics—transitioning from reliance on clinical diagnosis alone to biomarker-supported frameworks.AD biomarker research has transitioned from postmortem histopathology to in vivo detection paradigms,enabling precision diagnosis and intervention.This review synthesizes recent advances in molecular biomarkers across three domains:Fluid biomarkers,Molecular imaging and Innovative detection platforms,and also evaluates the challenges and prospects of the clinical transformation of molecular markers for AD.展开更多
Compared with female breast cancer, male breast cancer is a rare disease, and the relationship between clinical/pathologic features and prognosis is controversial, or even largely unknown. In this study, we performed ...Compared with female breast cancer, male breast cancer is a rare disease, and the relationship between clinical/pathologic features and prognosis is controversial, or even largely unknown. In this study, we performed a retrospective analysis using clinical and pathologic data from 109 nonmetastatic operable male breast cancer patients treated from January 1996 to December 2011 at Tianjin Medical University Cancer Institute and Hospital. Log-rank test showed that lower tumor stage, no lymph node involvement, and positive estrogen/progesterone receptor status were good predictors of both disease-free survival and overall survival on univariate analysis. However, hormonotherapy is only a good predictive factor of disease-free survival, and not of overall survival. In addition, based on a Cox proportional hazard regression model, only lymph node involvement, and estrogen/progesterone receptor status were statistically significant predictive factors on multivariate analysis. Our results demonstrated that although adjuvant systemic therapy is used extensively in male breast cancer patients and prognosis has improved over the last few decades, lymph node involvement, and estrogen/progesterone receptor status are still the most important prognostic factors. A prospective multi-center study with a larger sample size is urgently needed to further understand male breast cancer.展开更多
Objective:Carcinosarcoma of esophagus is an infrequent disease. Here, the pathologic data of larger specimens of this disease are reviewed and analyzed for studying its clinical characteristics in order to provide sup...Objective:Carcinosarcoma of esophagus is an infrequent disease. Here, the pathologic data of larger specimens of this disease are reviewed and analyzed for studying its clinical characteristics in order to provide support information for clinical diagnosis. Methods: To review and study the clinical data of 20 patients of esophageal carcinosarcoma. Results: Most of esophageal carcinosarcoma grew like pileus or polypus in esophagus, a few of them were infiltrating. Microscopic examination of the resected specimens indicated that the tumor is composed of sarcomatous element and carcinomatous element (the main element), and the surface of such tumor was covered mostly by carcinoma tissues. The result of biopsy showed that the tumor is squamous cell carcinoma. X-ray examination indicated that there was polypus-like smooth and tidy filling defect in the esophagus of such patient, and its mucous membrane showed “daubing-trace” like characteristics. Conclusion: Carcinosarcoma of esophagus is a tumor of low invasion, which grows mainly in the esophageal lumen. The clinical symptoms of this tumor are different from those of esophagus carcinoma in certain degree. The “daubing-trace” like characteristics is typical of X-ray picture. The results of most endoscopic biopsies demonstrate squamous cell carcinoma or lower differentiation carcinoma, which are difficult for confirmed diagnosis before operation.展开更多
Objective To investigate the prevalence and clinical significance of the centromere protein-F-like(CENP-F-like)immunofluorescence staining pattern in a large patient cohort and through literature review.Methods We ret...Objective To investigate the prevalence and clinical significance of the centromere protein-F-like(CENP-F-like)immunofluorescence staining pattern in a large patient cohort and through literature review.Methods We retrospectively analyzed antinuclear antibody(ANA)immunofluorescence assay results from 191274 patients at West China Hospital of Sichuan University between March 2018 and November 2020.Specific immunological markers were tested in sera with CENP-F-like patterns.Additionally,a narrative review of seven relevant studies was performed for comparison.Results In Southwest China,ANA positivity was found in 32.09%of patients,with the CENP-F-like pattern detected in 0.015%of all cases and 0.05%of ANA-positive individuals.The CENP-F-like pattern appeared predominantly at titers≥1∶320,most often in isolation(68.97%),but also mixed with cytoplasmic speckled patterns.Patients with cancers accounted for the highest proportion(31.03%),including solid tumors and hematologic malignancies.Metastasis was observed in patients with solid tumors,while graft-versus-host disease(GVHD)occurred in those with hematologic malignancies post-transplantation.Autoimmune diseases(AIDs)were diagnosed in 20.69%of cases,all showing disease-specific autoantibodies.These findings were broadly consistent with previous reports and suggest a possible association between the CENP-F-like pattern and malignancies.Conclusion The CENP-F-like pattern is rare in ANA tests but may be associated with clinically important conditions,particularly cancers and AIDs.The occurrence of metastasis and GVHD in patients with this pattern highlights its potential clinical relevance,and concurrent autoantibodies may assist in diagnosing AIDs.展开更多
The respiratory-circulatory system, including organs such as the nose, pharynx, larynx, trachea, bronchi, and heart, is an organic community responsible for ventilation and gas exchange. The integrity of its anatomica...The respiratory-circulatory system, including organs such as the nose, pharynx, larynx, trachea, bronchi, and heart, is an organic community responsible for ventilation and gas exchange. The integrity of its anatomical structure directly affects the evolution of pathological processes, and the analysis of their correlation is a core entry point for clinical disease diagnosis, treatment, and mechanism research. Based on this, this paper mainly explores the correlation between the anatomical and pathological characteristics of the respiratory-circulatory system, aiming to provide anatomical and pathological theoretical support for clinical accurate diagnosis, targeted therapy, and prognosis evaluation.展开更多
Knee osteoarthritis(KOA)is a chronic degenerative disease.Monosodium iodoac-etate(MIA)induction is the most commonly used therapeutic effect evaluation and mechanism of action research model;we observed a lack of stan...Knee osteoarthritis(KOA)is a chronic degenerative disease.Monosodium iodoac-etate(MIA)induction is the most commonly used therapeutic effect evaluation and mechanism of action research model;we observed a lack of standardization and uni-formity in current model building methods,which led us to conduct this study.Background:The aim was to investigate the time-and dose-related changes in the behavioral and pathological characteristics in the MIA-induced KOA model rat.Methods:MIA(40,50,and 60 mg/mL)was injected into the left joint of male Sprague-Dawley rats.After 2 weeks,the changes in the KOA rat model were observed by be-havioral evaluation,imaging-level evaluation,and histological-level evaluation.The changes were also compared after 40-mg/mL MIA injection for 2 and 6 weeks.Results:MIA-induced bone surface defects,osteophyte hyperplasia around the artic-ular rim,increased subchondral bone density,thinning of the sparse trabecular bone,structural disorder,and local clustering were observed.The degree of injury gradually increased with the increase in MIA concentration.After 6 weeks,subchondral bone density and sparse trabecular bone increased in the KOA model.Conclusions:The severity of the model also increased significantly with the changes in dose and time.In dose-dependent experiments,this study revealed that 40 mg/mL was the optimal dose to induce significant pathological changes without causing undue discomfort or death in animals.This dose may induce pathological changes stably and is suitable for long-term observation.展开更多
The learning and inferencing capabilities of large language models(LLMs)that underlie generative artificial intelligence(GenAI)can be exploited to optimize cancer treatments and improve patient outcomes.The ability of...The learning and inferencing capabilities of large language models(LLMs)that underlie generative artificial intelligence(GenAI)can be exploited to optimize cancer treatments and improve patient outcomes.The ability of these models to learn from large amounts of clinical,molecular,and radiomic data on cancer patients and their treatments is driving research interest in their application to treatment decision-making.The learning and predictive power of LLMs make them uniquely suitable for supporting adaptive cancer therapy.However,the clinical validation of GenAI support for clinical decisions in oncology needs to address the complexity and unique challenges of GenAI clinical interventions.The United States Food and Drug Administration(FDA)guidelines on the clinical evaluation of software as a medical device(SaMD)are explored as a basis for the clinical evaluation of GenAI-assisted adaptive cancer therapy.Metrics are proposed to address clinical associations and analytical validation along with an outlook on randomized clinical trials.This article provides a much-needed and timely perspective on the clinical evaluation of GenAI-assisted cancer treatments and provides insights into overcoming the inherent challenges of GenAI in its acceptance and adoption in real-world clinical settings.展开更多
BACKGROUND Inappropriate selection of patients with early gastric cancer(EGC)for endoscopic submucosal dissection(ESD)may lead to non-curative resection,necessitating additional gastrectomy.Conversely,inappropriate se...BACKGROUND Inappropriate selection of patients with early gastric cancer(EGC)for endoscopic submucosal dissection(ESD)may lead to non-curative resection,necessitating additional gastrectomy.Conversely,inappropriate selection for gastrectomy may result in overtreatment,adversely affecting patients’quality of life.Few have systematically evaluated the concordance between therapeutic indications under current Japanese guidelines and pathological criteria in EGC.To minimize noncurative resection risks while sparing unnecessary surgery for low-risk patients’,we specifically assess the suitability of Japanese guidelines in non-Japanese populations.This work aims to optimize clinical practice by refining endoscopic treatment criteria for adoption beyond Japan.AIM To evaluate EGC clinical decision accuracy by comparing therapeutic indication with postoperative pathological criteria and analyzing factors influencing discrepancies.METHODS A retrospective analysis was conducted on 796 EGC cases diagnosed at Peking University Third Hospital between January 2010 and December 2022.Cases were categorized into three groups:Same-estimated(preoperative therapeutic indication with postoperative pathological criteria matched),underestimated(preoperative ESD indication but postoperative surgical criteria),and overestimated(preoperative surgical indication but postoperative ESD criteria).The rate of discrepancy and associated risk factors were assessed.RESULTS The accuracy rates of preoperative evaluation for ESD and gastrectomy indications were 73.0%(321/430)and 76.0%(278/366),respectively.The overall discrepancy rate was 25.6%(204/796).Multivariate analysis identified tumor location in the upper-third stomach(odds ratio=2.158,95%confidence interval:1.373-3.390,P=0.001)was significantly associated with a higher likelihood of being underestimated and undifferentiated histologic type on preoperative biopsy(odds ratio=2.005,95%confidence interval:1.036-3.879,P=0.039)was more likely to be overestimated.Significant differences were observed in tumor diameter(P<0.001),depth of infiltration(P<0.001),ulcerative findings(P<0.001),and histologic type(P<0.001)between preoperative and postoperative evaluations.CONCLUSION The accuracy of preoperative EGC indications is 74.4%.Upper-third stomach and undifferentiated histology are primary discrepancy predictors.Upper-third tumors are prone to underestimation,while undifferentiated tumors are prone to overestimation.展开更多
Background:Artificial intelligence medical diagnostic devices(AIMDDs)show strong potential but face barriers to clinical use,emphasizing the need for rigorous clinical research.Objective:We assessed current AIMDD rese...Background:Artificial intelligence medical diagnostic devices(AIMDDs)show strong potential but face barriers to clinical use,emphasizing the need for rigorous clinical research.Objective:We assessed current AIMDD research,key challenges,and future directions.Methods:A scoping review followed Arksey and O'Malley's methodological framework and the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews guidelines.PubMed,Web of Science Core Collection,and the Cochrane Database of Systematic Reviews(January 2020-December 2024)were searched on AIMDD design,implementation,and evaluation.Two independent researchers screened and extracted data from the literature using predefined criteria.Results:Ninety-seven articles met the inclusion criteria.Machine learning and deep learning approaches dominated across diverse disease fields,with oncology being the most frequent(41%).The key challenges identified include insufficient quantity,quality,representativeness,and diversity of data;research designs that do not adequately address clinical needs;poor patient selection;poorly defined gold standards;lack of external and prospective validation;and a disconnect between validation strategies and clinical practice.Additionally,issues such as the“black box”phenomenon,overfitting,and data privacy concerns hinder clinical translation.Completeness and standardization of reporting were also found to be lacking.Conclusions:Significant challenges remain in the development and clinical application of AIMDD.To facilitate their clinical translation,improvements are needed in dataset optimization,clinically driven research design,development of evaluation frameworks,enhanced interpretability,and standardized reporting and validation of algorithms.展开更多
Objectives This study aimed to analyse the benefits of a gamified clinical supervision strategy during hospital-based training,particularly regarding the development of critical and reflective thinking among undergrad...Objectives This study aimed to analyse the benefits of a gamified clinical supervision strategy during hospital-based training,particularly regarding the development of critical and reflective thinking among undergraduate nursing students.Methods From April to July 2023,second-year nursing students who undertaking a nine-week clinical placement in a cardiology ward in northern Portugal were selected.Following a two-week diagnostic phase,students participated in a six-week gamified supervision programme comprising weekly 60-min sessions:infection-control decision-making;technical-procedural reasoning;guided emotional and ethical reflection;and clinical reasoning quiz on cardiology topics.Students completed weekly Structured Reflection Guide entries;supervisors recorded structured field notes after each session;and,after the intervention,students answered a post-intervention questionnaire and participated in focus groups.Qualitative data(reflections,field notes,open-ended questionnaire items,and focus-group transcripts)were analyzed using Bardin’s content analysis;quantitative questionnaire items were summarized descriptively.Results All seven students completed the six gamified sessions and submitted weekly reflection entries.Five students(71.4%)completed the questionnaire.Across data sources,students reported that gamified activities supported knowledge consolidation,teamwork,and clinical reasoning.Questionnaire data showed that all respondents(n=5,100%)strongly agreed that gamification enhanced their learning and should be maintained in clinical training.Reflections and focus groups revealed recurring themes related to emotional expression,sense of belonging,and difficulties using structured reflection tools,particularly in terms of comprehension and timing.Conclusion The gamified supervision strategy integrated into clinical training provided structured opportunities for practical engagement,collaborative work,and guided reflection.These findings suggest that gamification may support the development of reflective and critical-thinking processes in authentic clinical environments.展开更多
[Objectives]To analyze the clinical symptoms and epidemiological characteristics of 188 hospitalized pertussis cases in Jingzhou City.[Methods]Clinical data from 188 patients diagnosed with pertussis and admitted to t...[Objectives]To analyze the clinical symptoms and epidemiological characteristics of 188 hospitalized pertussis cases in Jingzhou City.[Methods]Clinical data from 188 patients diagnosed with pertussis and admitted to two tertiary hospitals in Jingzhou City between March and August 2024 were collected.Patients were randomly divided into three groups:<3-year-old,3—17-year-old,and≥18-year-old.A retrospective analysis was performed on their clinical features(including laboratory findings,disease course,and imaging characteristics)and epidemiological characteristics.[Results]In the<3-year-old group,28 cases(36.4%)were unvaccinated and 22 cases(28.6%)had received only one dose of the pertussis vaccine.In the 3—17-year-old group,91 cases(94.8%)had received four doses.Vaccination history was unknown for the≥18-year-old adult group.The<3-year-old group exhibited significantly higher incidences of cough with wheezing/dyspnea,paroxysmal spasmodic cough,cough with cyanosis or facial flushing,wheezes,and moist rales in the lungs compared to both the 3—17-year-old and≥18-year-old groups.Post-tussive vomiting was less frequent in the<3-year-old group than in the 3—17-year-old group but more frequent than in the≥18-year-old group;these differences were statistically significant(P<0.05).The≥18-year-old group had significantly lower incidences of cough with wheezing/dyspnea,paroxysmal spasmodic cough,cough with cyanosis or facial flushing,wheezes,and moist rales in the lungs compared to both the<3-year-old and 3—17-year-old groups(P<0.05).The proportion of cases with pneumonia and increased lung markings was higher in the<3-year-old group than in the 3—17-year-old group but lower than in the≥18-year-old group,showing statistically significant differences(P<0.05).The proportion of cases with pulmonary nodules and fibrotic foci was lower in the<3-year-old group than in both the 3—17-year-old and≥18-year-old groups,and these differences were also statistically significant(P<0.05).The proportion of pneumonia cases in the 3—17-year-old group was lower than in both the<3-year-old and≥18-year-old groups.The proportion of cases with increased lung markings was lower than in the<3-year-old group but higher than in the≥18-year-old group;these differences were statistically significant(P<0.05).The proportion of cases with pulmonary nodules and fibrotic foci in the 3—17-year-old group was higher than in the<3-year-old group but lower than in the≥18-year-old group,with statistically significant differences(P<0.05).The proportion of cases with pulmonary nodules and fibrotic foci was higher in the≥18-year-old group than in both the<3-year-old and 3—17-year-old groups,and these differences were also statistically significant(P<0.05).[Conclusions]Analysis of the clinical symptoms and epidemiological characteristics of 188 hospitalized pertussis cases in Jingzhou City contributes to enhancing the prevention and control of pertussis within the city.展开更多
Objective:For patients with hypertension complicated with diabetes mellitus,their health risks are not a simple sum but present complex interactive effects.Clarifying the clinical characteristics of such patients is t...Objective:For patients with hypertension complicated with diabetes mellitus,their health risks are not a simple sum but present complex interactive effects.Clarifying the clinical characteristics of such patients is the key to solving this medical problem.Methods:From June 2023 to June 2024,this study conducted a comparative study on 100 patients with hypertension complicated with diabetes mellitus and 100 patients with hypertension alone.By retrospectively analyzing clinical data of patients,the differences in disease manifestations,complication occurrence,and treatment effects between the two groups were explored in depth,and the unique challenges and treatment difficulties faced by patients with hypertension complicated with diabetes mellitus were identified.Results:Hypertensive patients with concurrent diabetes had more difficult blood glucose and blood pressure control,and were more prone to severe complications such as cardiovascular lesions and renal damage.Conclusion:The clinical characteristics and treatment needs of patients with hypertension complicated with diabetes mellitus are different from those with hypertension alone,and disease management should be more refined and personalized.展开更多
Objective To develop a prognostic prediction model for early-stage triple-negative breast cancer(TNBC)using H&E-stained pathological images and to investigate its underlying biological interpretability.Methods A d...Objective To develop a prognostic prediction model for early-stage triple-negative breast cancer(TNBC)using H&E-stained pathological images and to investigate its underlying biological interpretability.Methods A deep learning model was trained on 340 WSIs and externally validated using 81 TCGA cases.Image-derived features extracted through convolutional neural networks were integrated with clinicopathological variables.Model performance was assessed using ROC curve analysis,and interpretability was evaluated by correlating image features with mRNA-seq data and characteristics of the immune microenvironment.Results The model achieved AUCs of 0.86 and 0.75 in the training and validation cohorts,respectively.Analysis using HoVer-Net indicated that lymphocyte abundance was associated with recurrence risk.Texture-related features showed significant correlations with immune cell infiltration and prognostic gene expression profiles.Conclusion This study demonstrates that deep learning can enable accurate prognostic prediction in early-stage TNBC,with interpretable image features that reflect the tumor immune microenvironment and gene expression profiles.展开更多
Portable ratiometric fluorescent platforms have emerged as promising tools for multifarious detection,yet remain unexplored for point-of-care monitoring doxorubicin(DOX),one of clinically antineoplastic drugs.To this ...Portable ratiometric fluorescent platforms have emerged as promising tools for multifarious detection,yet remain unexplored for point-of-care monitoring doxorubicin(DOX),one of clinically antineoplastic drugs.To this end,we herein develop a portable self-calibrating platform namely carbon dots(C-dots)-embedded hydrogel sensors with a smartphone-assisted high-throughput imaging device,for DOX sensing.The prepared green-emitting(λ_(em)=508 nm)and negatively-charged C-dots(−11.40±1.21 mV),which have sufficient spectral overlap with the absorption band of DOX(∼500 nm),can strongly bind with positively-charged DOX molecules by electrostatic attraction effects.As a result,DOX molecules are selectively and rapid(20 s)determined with a detection limit of 10.26 nmol/L via Förster resonance energy transfer processes,demonstrating a remarkably chromatic shift from green to red.Further integrated with a 3D-printed smartphone-assisted device,the platform enabled high-throughput quantification,achieving recoveries of 96.40%-101.85%in human urine/serum(RSDs<2.94%,n=3).Notably,the dual linear detection ranges of the platform align with the reported clinical DOX concentrations in urine and plasma(0-4 h post-administration),validating their capability for direct quantification of DOX in clinical samples without special pre-treatment processes.By virtue of attractive analytical performances and robust feasibility,this platform bridges laboratory precision and point-of-care testing needs,offering promising potential for personalized chemotherapy and multiplexed analyte screening.展开更多
文摘Whole Slide Imaging (WSI) technology, as a revolutionary digital technology in the field of pathology, is gradually changing the traditional clinical pathological diagnosis model. By converting traditional glass pathological sections into complete digital images through high-resolution scanning, it provides a new method for pathological diagnosis. Based on this, this paper studies the application of WSI technology in clinical pathological diagnosis, elaborates on its application value, analyzes the current application status, and proposes corresponding application countermeasures, aiming to provide reference for the standardized and popularized development of this technology in clinical pathological diagnosis.
基金Supported by National High-Level Hospital Clinical Research Funding,No.2022-PUMCH-B-022,and No.2022-PUMCH-D-002CAMS Innovation Fund for Medical Sciences,No.CIFMS 2021-1-I2M-003Undergraduate Innovation Program,No.2024dcxm025.
文摘Small intestinal villi are essential for nutrient absorption,and their impairment can lead to malabsorption.Small intestinal villous atrophy(VA)encompasses a heterogeneous group of disorders,including immune-mediated conditions(e.g.,celiac disease,autoimmune enteropathy,inborn errors of immunity),lymphoproliferative disorders(e.g.,enteropathy-associated T-cell lymphoma),infectious causes(e.g.,tropical sprue,Whipple’s disease),iatrogenic factors(e.g.,Olmesartanassociated enteropathy,graft-vs-host disease),as well as inflammatory and idiopathic types.These disorders are often rare and challenging to distinguish due to overlapping clinical,serological,endoscopic,and histopathological features.Through a systematic literature search using keywords such as small intestinal VA,malabsorption,and specific enteropathies,this review provides a comprehensive overview of diagnostic clues for VA and malabsorption.We systematically summarize the pathological characteristics of each condition to assist pathologists and clinicians in accurately identifying the underlying etiologies.Current studies still have many limitations and lack broader and deeper investigations into these diseases.Therefore,future research should focus on the development of novel diagnostic tools,predictive models,therapeutic targets,and mechanistic molecular studies to refine both diagnosis and management strategies.
文摘Uveal melanoma(UM)is the most common intraocular cancer,with approximately 5.2 individuals per million affected annually in the United States.It represents approximately 3%of the global malignant melanoma cases,accounting for 80%of the overall noncutaneous melanomas.Clinically,it remains silent in about 30%of the cases;when symptomatic,it generally causes metamorphopsia(painless loss or distortion of vision)and/or photopsia(flashing or flickering of light in the visual field).Discoloration of the iris,astigmatism,glaucoma,and even blindness are other,less common clinical manifestations.Several pathophysiological mechanisms underlie the development of UM.Genetic mutations,involving especially the G protein subunit alpha q(GNAQ),guanine nucleotide-binding protein subunit alpha-11(GNA11),BRCA1 associated deubiquitinase 1(BAP1),splicing factor 3b subunit 1(SF3B1),and eukaryotic translation initiation factor 1A,X-linked(EIF1AX)genes as well as the MAPK/ERK signaling pathway genes,have been largely associated with the development of UM.Chromosomal aberrations,inflammatory and immunological alterations are often concurrent factors for the development and progression of UM.Therapies targeting specific genetic alterations and immunotherapy agents have been recently developed and introduced in clinical practice for the management of advanced-stage UMs.This review aims to present the latest advances in the clinical molecular pathology of UM,along with the resulting targeted,immunological,and other therapies that have been introduced or are currently under investigation.
基金financially supported by the Hebei Natural Science Foundation(Grant No.H2024206504)the Medical Science Research Project of Hebei(Grant No.20260484,20260530)the Fundamental Research Funds for the Central Universities(Grant No.20822041J4123).
文摘Objective:Accurate detection of PIK3CA mutations is essential for guiding PI3K-targeted therapies in breast cancer,yet sequencing is not universally accessible,and single-modality prediction models have limited performance.This study developed a multimodal deep learning framework integrating whole-slide imaging(WSI)and structured clinical data to improve mutation prediction.Methods:A total of 1,047 patients from TCGA and 166 patients from 3 external centers were included.The histopathology model used a transformer-based pretrained encoder(H-optimus-0)and a clustering-constrained attention multiple instance learning(CLAM-SB MIL)classifier to generate WSI-level representations.The clinical model incorporated engineered clinical variables and an extreme gradient boosting(XGBoost)model.A decision-level late fusion strategy(Multimodal PIK3CA Model,MPM)combined probabilistic outputs from both branches.Performance was evaluated with the area under the curve(AUC)and secondary metrics.Interpretability was assessed via attention heatmaps and shapley additive explanations(SHAP)analysis.Results:MPM outperformed single-modality models.It achieved an AUC of 0.745 on TCGA and maintained stable performance across external cohorts(0.695,0.690,and 0.680).SHAP analysis identified molecular subtype as the most influential clinical feature,whereas attention maps highlighted mutation-associated morphological regions.Conclusions:The developed multimodal framework effectively integrates complementary morphological and clinical information,and provides a robust and generalizable method for predicting PIK3CA mutation status.Strong multicenter adaptability and biological interpretability support its potential use as a clinical decision-support tool and an accessible alternative to molecular testing.
基金supported by the Canadian Institutes of Health Research Project grant (PJT-169197) to QYsupported by a CGS-M fellowship from the Canadian Institutes of Health Research
文摘Alzheimer’s disease(AD)remains an incurable neurodegenerative disorder with devastating societal and personal impacts.Despite decades of intensive research,therapeutic efforts targeting the clinical stages of AD have largely failed to halt or reverse disease progression.This has prompted a critical shift in focus toward the earlier,preclinical stages of AD,where interventions may hold greater promise for altering the disease trajectory.
基金Supported by National Key R&D Program of China,No.2023YFC2308104Beijing Hospitals Authority Clinical Medicine Development of Special Funding Support,No.ZLRK202301National Natural Science Foundation of China,No.92159305.
文摘BACKGROUND Chronic hepatitis B virus(HBV)infection acquired in childhood frequently presents with mild or nonspecific symptoms,yet a distinct subset of pediatric patients develops rapid progression to liver cirrhosis(LC)before adulthood.AIM To identify clinical and pathological characteristics of pediatric HBV-related LC.METHODS A total of 1332 pediatric patients with chronic HBV infection from the Fifth Medical Center of PLA General Hospital from January 2010 to January 2023 were included in this study.We identified 62 pediatric HBV-related LC by liver biopsy from the group.Subsequently,we described the clinical and pathological characteristics of pediatric LC.And 64 pediatric chronic hepatitis B(CHB;age and sex were matched with pediatric LC group)and 69 adult HBV-related LC(sex were matched with pediatric LC group)were enrolled to further demonstrate clinical and pathological differences between pediatric LC,pediatric CHB and adult LC.RESULTS We enrolled 62 pediatric LC,including 54(87.1%)males and 8(12.9%)females.The median age was 11(4-14)years old.The pediatric LC group showed significantly lower median quantitative HBV DNA loads(log10IU/mL:6.3 vs 17.4,P<0.001),reduced HBsAg titers(log10IU/mL:3.11 vs 8.956,P<0.0001),and diminished hepatitis B e antigen-positive positive rate(81.4%vs 93.8%,P<0.05)compared with pediatric CHB.A higher proportion of pediatric patients were asymptomatic(77.4%)compared to adult patients(11.6%)as they first diagnosed as LC,pediatric LC showed milder initial symptoms compared with adult patients such as fatigue(4.8%vs 27.5%),abdominal discomfort(9.7%vs 23.2%),nausea(0%vs 10.1%),and poor appetite(6.5%vs 8.7%;all P<0.0001).Notably,pediatric LC can achieve a significant percentage of functional cure compared with adult LC as 17.4%and 0%.The incidence of progression of LC in children after antiviral therapy continues to be much lower than that in adult LC(hazard ratio=6.102,95%confidence interval:1.72-21.65,P=0.00051).While the incidence of LC remission in children after antiviral therapy continues to be much higher than that in adult LC(hazard ratio=0.055,95%confidence interval:0.07128-0.2802,P<0.0001).CONCLUSION Pediatric patients with HBV-related cirrhosis exhibit elevated virological parameters and heightened transaminase levels than adult patients.However,the frequent paucity of overt clinical symptoms contributes to diagnostic challenges.Notably,early initiation of antiviral therapy in this population substantially improved clinical outcomes.
基金funded by the Science and Technology Plan Project in the Medical and Health Field of Maanshan City(YL-2023-43).
文摘Alzheimer’s disease(AD),as the predominant form of neurodegenerative disorders,exerts a profound impact on the health of the global elderly population.For decades,the elucidation of AD pathogenesis and the development of diagnostic and therapeutic approaches have been the focus of extensive research.Over recent years,a fundamental shift has occurred in AD diagnostics—transitioning from reliance on clinical diagnosis alone to biomarker-supported frameworks.AD biomarker research has transitioned from postmortem histopathology to in vivo detection paradigms,enabling precision diagnosis and intervention.This review synthesizes recent advances in molecular biomarkers across three domains:Fluid biomarkers,Molecular imaging and Innovative detection platforms,and also evaluates the challenges and prospects of the clinical transformation of molecular markers for AD.
基金ACKNOWLEDGMENTS This study was supported by the National Natural Science Foundation of China （Grants 81472683 and 81202275）, Tianjin Natural Science fund （Grant 13JCQNJC 11000） and Research Seed Foundation of Tianjin Medical University Gancer Hospital and Institute （Grant 1421）.
文摘Compared with female breast cancer, male breast cancer is a rare disease, and the relationship between clinical/pathologic features and prognosis is controversial, or even largely unknown. In this study, we performed a retrospective analysis using clinical and pathologic data from 109 nonmetastatic operable male breast cancer patients treated from January 1996 to December 2011 at Tianjin Medical University Cancer Institute and Hospital. Log-rank test showed that lower tumor stage, no lymph node involvement, and positive estrogen/progesterone receptor status were good predictors of both disease-free survival and overall survival on univariate analysis. However, hormonotherapy is only a good predictive factor of disease-free survival, and not of overall survival. In addition, based on a Cox proportional hazard regression model, only lymph node involvement, and estrogen/progesterone receptor status were statistically significant predictive factors on multivariate analysis. Our results demonstrated that although adjuvant systemic therapy is used extensively in male breast cancer patients and prognosis has improved over the last few decades, lymph node involvement, and estrogen/progesterone receptor status are still the most important prognostic factors. A prospective multi-center study with a larger sample size is urgently needed to further understand male breast cancer.
文摘Objective:Carcinosarcoma of esophagus is an infrequent disease. Here, the pathologic data of larger specimens of this disease are reviewed and analyzed for studying its clinical characteristics in order to provide support information for clinical diagnosis. Methods: To review and study the clinical data of 20 patients of esophageal carcinosarcoma. Results: Most of esophageal carcinosarcoma grew like pileus or polypus in esophagus, a few of them were infiltrating. Microscopic examination of the resected specimens indicated that the tumor is composed of sarcomatous element and carcinomatous element (the main element), and the surface of such tumor was covered mostly by carcinoma tissues. The result of biopsy showed that the tumor is squamous cell carcinoma. X-ray examination indicated that there was polypus-like smooth and tidy filling defect in the esophagus of such patient, and its mucous membrane showed “daubing-trace” like characteristics. Conclusion: Carcinosarcoma of esophagus is a tumor of low invasion, which grows mainly in the esophageal lumen. The clinical symptoms of this tumor are different from those of esophagus carcinoma in certain degree. The “daubing-trace” like characteristics is typical of X-ray picture. The results of most endoscopic biopsies demonstrate squamous cell carcinoma or lower differentiation carcinoma, which are difficult for confirmed diagnosis before operation.
文摘Objective To investigate the prevalence and clinical significance of the centromere protein-F-like(CENP-F-like)immunofluorescence staining pattern in a large patient cohort and through literature review.Methods We retrospectively analyzed antinuclear antibody(ANA)immunofluorescence assay results from 191274 patients at West China Hospital of Sichuan University between March 2018 and November 2020.Specific immunological markers were tested in sera with CENP-F-like patterns.Additionally,a narrative review of seven relevant studies was performed for comparison.Results In Southwest China,ANA positivity was found in 32.09%of patients,with the CENP-F-like pattern detected in 0.015%of all cases and 0.05%of ANA-positive individuals.The CENP-F-like pattern appeared predominantly at titers≥1∶320,most often in isolation(68.97%),but also mixed with cytoplasmic speckled patterns.Patients with cancers accounted for the highest proportion(31.03%),including solid tumors and hematologic malignancies.Metastasis was observed in patients with solid tumors,while graft-versus-host disease(GVHD)occurred in those with hematologic malignancies post-transplantation.Autoimmune diseases(AIDs)were diagnosed in 20.69%of cases,all showing disease-specific autoantibodies.These findings were broadly consistent with previous reports and suggest a possible association between the CENP-F-like pattern and malignancies.Conclusion The CENP-F-like pattern is rare in ANA tests but may be associated with clinically important conditions,particularly cancers and AIDs.The occurrence of metastasis and GVHD in patients with this pattern highlights its potential clinical relevance,and concurrent autoantibodies may assist in diagnosing AIDs.
文摘The respiratory-circulatory system, including organs such as the nose, pharynx, larynx, trachea, bronchi, and heart, is an organic community responsible for ventilation and gas exchange. The integrity of its anatomical structure directly affects the evolution of pathological processes, and the analysis of their correlation is a core entry point for clinical disease diagnosis, treatment, and mechanism research. Based on this, this paper mainly explores the correlation between the anatomical and pathological characteristics of the respiratory-circulatory system, aiming to provide anatomical and pathological theoretical support for clinical accurate diagnosis, targeted therapy, and prognosis evaluation.
基金Construction Project of High-Level Traditional Chinese Medicine Key Discipline of National Administration of Traditional Chinese Medicine,Grant/Award Number:zyyzdxk-2023022Key Team of Scientific and Technological Innovation Talents of Shanxi Province with Integrated Traditional Chinese and Western Medicine for Preventing and Treating Rheumatological Diseases,Grant/Award Number:202204051002033+4 种基金Traditional Chinese Medicine+Stem Cell Innovation Project,Grant/Award Number:2024KJZY0062023 Shanxi Graduate Research Practice Project,Grant/Award Number:2023KY6762023 Graduate Innovation and Entrepreneurship Project of Shanxi University of Traditional Chinese Medicine,Grant/Award Number:2023CX023 and 2023CX027Science and Technology Innovation Project for University in Shanxi Province,Grant/Award Number:2022L358Key Laboratory of Rheumatological and Immunological Diseases Treated by Integrated Chinese and Western Medicine,Grant/Award Number:zyyyjs2024021。
文摘Knee osteoarthritis(KOA)is a chronic degenerative disease.Monosodium iodoac-etate(MIA)induction is the most commonly used therapeutic effect evaluation and mechanism of action research model;we observed a lack of standardization and uni-formity in current model building methods,which led us to conduct this study.Background:The aim was to investigate the time-and dose-related changes in the behavioral and pathological characteristics in the MIA-induced KOA model rat.Methods:MIA(40,50,and 60 mg/mL)was injected into the left joint of male Sprague-Dawley rats.After 2 weeks,the changes in the KOA rat model were observed by be-havioral evaluation,imaging-level evaluation,and histological-level evaluation.The changes were also compared after 40-mg/mL MIA injection for 2 and 6 weeks.Results:MIA-induced bone surface defects,osteophyte hyperplasia around the artic-ular rim,increased subchondral bone density,thinning of the sparse trabecular bone,structural disorder,and local clustering were observed.The degree of injury gradually increased with the increase in MIA concentration.After 6 weeks,subchondral bone density and sparse trabecular bone increased in the KOA model.Conclusions:The severity of the model also increased significantly with the changes in dose and time.In dose-dependent experiments,this study revealed that 40 mg/mL was the optimal dose to induce significant pathological changes without causing undue discomfort or death in animals.This dose may induce pathological changes stably and is suitable for long-term observation.
文摘The learning and inferencing capabilities of large language models(LLMs)that underlie generative artificial intelligence(GenAI)can be exploited to optimize cancer treatments and improve patient outcomes.The ability of these models to learn from large amounts of clinical,molecular,and radiomic data on cancer patients and their treatments is driving research interest in their application to treatment decision-making.The learning and predictive power of LLMs make them uniquely suitable for supporting adaptive cancer therapy.However,the clinical validation of GenAI support for clinical decisions in oncology needs to address the complexity and unique challenges of GenAI clinical interventions.The United States Food and Drug Administration(FDA)guidelines on the clinical evaluation of software as a medical device(SaMD)are explored as a basis for the clinical evaluation of GenAI-assisted adaptive cancer therapy.Metrics are proposed to address clinical associations and analytical validation along with an outlook on randomized clinical trials.This article provides a much-needed and timely perspective on the clinical evaluation of GenAI-assisted cancer treatments and provides insights into overcoming the inherent challenges of GenAI in its acceptance and adoption in real-world clinical settings.
基金Supported by China Health&Medical Development Foundation,No.M2021551.
文摘BACKGROUND Inappropriate selection of patients with early gastric cancer(EGC)for endoscopic submucosal dissection(ESD)may lead to non-curative resection,necessitating additional gastrectomy.Conversely,inappropriate selection for gastrectomy may result in overtreatment,adversely affecting patients’quality of life.Few have systematically evaluated the concordance between therapeutic indications under current Japanese guidelines and pathological criteria in EGC.To minimize noncurative resection risks while sparing unnecessary surgery for low-risk patients’,we specifically assess the suitability of Japanese guidelines in non-Japanese populations.This work aims to optimize clinical practice by refining endoscopic treatment criteria for adoption beyond Japan.AIM To evaluate EGC clinical decision accuracy by comparing therapeutic indication with postoperative pathological criteria and analyzing factors influencing discrepancies.METHODS A retrospective analysis was conducted on 796 EGC cases diagnosed at Peking University Third Hospital between January 2010 and December 2022.Cases were categorized into three groups:Same-estimated(preoperative therapeutic indication with postoperative pathological criteria matched),underestimated(preoperative ESD indication but postoperative surgical criteria),and overestimated(preoperative surgical indication but postoperative ESD criteria).The rate of discrepancy and associated risk factors were assessed.RESULTS The accuracy rates of preoperative evaluation for ESD and gastrectomy indications were 73.0%(321/430)and 76.0%(278/366),respectively.The overall discrepancy rate was 25.6%(204/796).Multivariate analysis identified tumor location in the upper-third stomach(odds ratio=2.158,95%confidence interval:1.373-3.390,P=0.001)was significantly associated with a higher likelihood of being underestimated and undifferentiated histologic type on preoperative biopsy(odds ratio=2.005,95%confidence interval:1.036-3.879,P=0.039)was more likely to be overestimated.Significant differences were observed in tumor diameter(P<0.001),depth of infiltration(P<0.001),ulcerative findings(P<0.001),and histologic type(P<0.001)between preoperative and postoperative evaluations.CONCLUSION The accuracy of preoperative EGC indications is 74.4%.Upper-third stomach and undifferentiated histology are primary discrepancy predictors.Upper-third tumors are prone to underestimation,while undifferentiated tumors are prone to overestimation.
基金supported by the National Key R&D Program of China(2022YFC3501000,2022YFC3502300)National Natural Science Foundation of China(82374627)+2 种基金Fundamental Research Funds for the Central public welfare research institutes(Z0876)Fundamental Research Funds for the Central Universities(2024-JYB-KYPT-01)Beijing Municipal Science and Technology Commission(Z241100007724010).
文摘Background:Artificial intelligence medical diagnostic devices(AIMDDs)show strong potential but face barriers to clinical use,emphasizing the need for rigorous clinical research.Objective:We assessed current AIMDD research,key challenges,and future directions.Methods:A scoping review followed Arksey and O'Malley's methodological framework and the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews guidelines.PubMed,Web of Science Core Collection,and the Cochrane Database of Systematic Reviews(January 2020-December 2024)were searched on AIMDD design,implementation,and evaluation.Two independent researchers screened and extracted data from the literature using predefined criteria.Results:Ninety-seven articles met the inclusion criteria.Machine learning and deep learning approaches dominated across diverse disease fields,with oncology being the most frequent(41%).The key challenges identified include insufficient quantity,quality,representativeness,and diversity of data;research designs that do not adequately address clinical needs;poor patient selection;poorly defined gold standards;lack of external and prospective validation;and a disconnect between validation strategies and clinical practice.Additionally,issues such as the“black box”phenomenon,overfitting,and data privacy concerns hinder clinical translation.Completeness and standardization of reporting were also found to be lacking.Conclusions:Significant challenges remain in the development and clinical application of AIMDD.To facilitate their clinical translation,improvements are needed in dataset optimization,clinically driven research design,development of evaluation frameworks,enhanced interpretability,and standardized reporting and validation of algorithms.
文摘Objectives This study aimed to analyse the benefits of a gamified clinical supervision strategy during hospital-based training,particularly regarding the development of critical and reflective thinking among undergraduate nursing students.Methods From April to July 2023,second-year nursing students who undertaking a nine-week clinical placement in a cardiology ward in northern Portugal were selected.Following a two-week diagnostic phase,students participated in a six-week gamified supervision programme comprising weekly 60-min sessions:infection-control decision-making;technical-procedural reasoning;guided emotional and ethical reflection;and clinical reasoning quiz on cardiology topics.Students completed weekly Structured Reflection Guide entries;supervisors recorded structured field notes after each session;and,after the intervention,students answered a post-intervention questionnaire and participated in focus groups.Qualitative data(reflections,field notes,open-ended questionnaire items,and focus-group transcripts)were analyzed using Bardin’s content analysis;quantitative questionnaire items were summarized descriptively.Results All seven students completed the six gamified sessions and submitted weekly reflection entries.Five students(71.4%)completed the questionnaire.Across data sources,students reported that gamified activities supported knowledge consolidation,teamwork,and clinical reasoning.Questionnaire data showed that all respondents(n=5,100%)strongly agreed that gamification enhanced their learning and should be maintained in clinical training.Reflections and focus groups revealed recurring themes related to emotional expression,sense of belonging,and difficulties using structured reflection tools,particularly in terms of comprehension and timing.Conclusion The gamified supervision strategy integrated into clinical training provided structured opportunities for practical engagement,collaborative work,and guided reflection.These findings suggest that gamification may support the development of reflective and critical-thinking processes in authentic clinical environments.
文摘[Objectives]To analyze the clinical symptoms and epidemiological characteristics of 188 hospitalized pertussis cases in Jingzhou City.[Methods]Clinical data from 188 patients diagnosed with pertussis and admitted to two tertiary hospitals in Jingzhou City between March and August 2024 were collected.Patients were randomly divided into three groups:<3-year-old,3—17-year-old,and≥18-year-old.A retrospective analysis was performed on their clinical features(including laboratory findings,disease course,and imaging characteristics)and epidemiological characteristics.[Results]In the<3-year-old group,28 cases(36.4%)were unvaccinated and 22 cases(28.6%)had received only one dose of the pertussis vaccine.In the 3—17-year-old group,91 cases(94.8%)had received four doses.Vaccination history was unknown for the≥18-year-old adult group.The<3-year-old group exhibited significantly higher incidences of cough with wheezing/dyspnea,paroxysmal spasmodic cough,cough with cyanosis or facial flushing,wheezes,and moist rales in the lungs compared to both the 3—17-year-old and≥18-year-old groups.Post-tussive vomiting was less frequent in the<3-year-old group than in the 3—17-year-old group but more frequent than in the≥18-year-old group;these differences were statistically significant(P<0.05).The≥18-year-old group had significantly lower incidences of cough with wheezing/dyspnea,paroxysmal spasmodic cough,cough with cyanosis or facial flushing,wheezes,and moist rales in the lungs compared to both the<3-year-old and 3—17-year-old groups(P<0.05).The proportion of cases with pneumonia and increased lung markings was higher in the<3-year-old group than in the 3—17-year-old group but lower than in the≥18-year-old group,showing statistically significant differences(P<0.05).The proportion of cases with pulmonary nodules and fibrotic foci was lower in the<3-year-old group than in both the 3—17-year-old and≥18-year-old groups,and these differences were also statistically significant(P<0.05).The proportion of pneumonia cases in the 3—17-year-old group was lower than in both the<3-year-old and≥18-year-old groups.The proportion of cases with increased lung markings was lower than in the<3-year-old group but higher than in the≥18-year-old group;these differences were statistically significant(P<0.05).The proportion of cases with pulmonary nodules and fibrotic foci in the 3—17-year-old group was higher than in the<3-year-old group but lower than in the≥18-year-old group,with statistically significant differences(P<0.05).The proportion of cases with pulmonary nodules and fibrotic foci was higher in the≥18-year-old group than in both the<3-year-old and 3—17-year-old groups,and these differences were also statistically significant(P<0.05).[Conclusions]Analysis of the clinical symptoms and epidemiological characteristics of 188 hospitalized pertussis cases in Jingzhou City contributes to enhancing the prevention and control of pertussis within the city.
文摘Objective:For patients with hypertension complicated with diabetes mellitus,their health risks are not a simple sum but present complex interactive effects.Clarifying the clinical characteristics of such patients is the key to solving this medical problem.Methods:From June 2023 to June 2024,this study conducted a comparative study on 100 patients with hypertension complicated with diabetes mellitus and 100 patients with hypertension alone.By retrospectively analyzing clinical data of patients,the differences in disease manifestations,complication occurrence,and treatment effects between the two groups were explored in depth,and the unique challenges and treatment difficulties faced by patients with hypertension complicated with diabetes mellitus were identified.Results:Hypertensive patients with concurrent diabetes had more difficult blood glucose and blood pressure control,and were more prone to severe complications such as cardiovascular lesions and renal damage.Conclusion:The clinical characteristics and treatment needs of patients with hypertension complicated with diabetes mellitus are different from those with hypertension alone,and disease management should be more refined and personalized.
基金Supported by Capital’s Funds for Health Improvement and Research(CFH2024-1-4021)。
文摘Objective To develop a prognostic prediction model for early-stage triple-negative breast cancer(TNBC)using H&E-stained pathological images and to investigate its underlying biological interpretability.Methods A deep learning model was trained on 340 WSIs and externally validated using 81 TCGA cases.Image-derived features extracted through convolutional neural networks were integrated with clinicopathological variables.Model performance was assessed using ROC curve analysis,and interpretability was evaluated by correlating image features with mRNA-seq data and characteristics of the immune microenvironment.Results The model achieved AUCs of 0.86 and 0.75 in the training and validation cohorts,respectively.Analysis using HoVer-Net indicated that lymphocyte abundance was associated with recurrence risk.Texture-related features showed significant correlations with immune cell infiltration and prognostic gene expression profiles.Conclusion This study demonstrates that deep learning can enable accurate prognostic prediction in early-stage TNBC,with interpretable image features that reflect the tumor immune microenvironment and gene expression profiles.
基金supported by the National NaturalScience Foundation of China(No.22274001)the Key Project of Natural Science Research of the Education Department of Anhui Province(No.2022AH051032)the Excellent Research and Innovation Team of Universities in Anhui Province(No.2024AH010016).
文摘Portable ratiometric fluorescent platforms have emerged as promising tools for multifarious detection,yet remain unexplored for point-of-care monitoring doxorubicin(DOX),one of clinically antineoplastic drugs.To this end,we herein develop a portable self-calibrating platform namely carbon dots(C-dots)-embedded hydrogel sensors with a smartphone-assisted high-throughput imaging device,for DOX sensing.The prepared green-emitting(λ_(em)=508 nm)and negatively-charged C-dots(−11.40±1.21 mV),which have sufficient spectral overlap with the absorption band of DOX(∼500 nm),can strongly bind with positively-charged DOX molecules by electrostatic attraction effects.As a result,DOX molecules are selectively and rapid(20 s)determined with a detection limit of 10.26 nmol/L via Förster resonance energy transfer processes,demonstrating a remarkably chromatic shift from green to red.Further integrated with a 3D-printed smartphone-assisted device,the platform enabled high-throughput quantification,achieving recoveries of 96.40%-101.85%in human urine/serum(RSDs<2.94%,n=3).Notably,the dual linear detection ranges of the platform align with the reported clinical DOX concentrations in urine and plasma(0-4 h post-administration),validating their capability for direct quantification of DOX in clinical samples without special pre-treatment processes.By virtue of attractive analytical performances and robust feasibility,this platform bridges laboratory precision and point-of-care testing needs,offering promising potential for personalized chemotherapy and multiplexed analyte screening.
