Objective: To investigate the related factors on effects of uterine artery embolization(UAE)in the treatment of dysmenorrhea in patients with adenomyosis, and to construct and validate the efficacy prediction model. Methods: A total of 127 cases of adenomyosis patients with symptoms of dysmenorrhea in Guangzhou No.1 People's Hospital and Nanfang Hospital of Southern Medical University from June 1999 to December 2009 were reviewed. The evaluation standard was to improve the degree of dysmenorrhea, the related factors of efficacy were analysed. Combined with artificial neural network theory, the effect prediction model was constructed, and the effectiveness of the model was evaluated using receiver operating characteristic(ROC)curve, and the effectiveness of the cut-off point was calculated. The model was validated by 68 cases of patients with adenomyosis in the Nanfang Hospital from January 2010 to November 2014. Results: (1)In 127 cases of dysmenorrhea patients, UAE treatment was effective in 98 cases, effective rate was 77.2%(98/127).(2)Age was an independent predictor of effective UAE treatment(HR= 1.129, P=0.026); in the range of this study, the greater the age, the higher the UAE treatment efficiency.(3)The developing situation of ovary branches of uterine artery was an independent predictor of effective UAE treatment(HR=0.460, P=0.020), the efficiency of patients whose intraoperative bilateral uterine artery ovarian branch did not develop was 89.7%(35/39), the efficiency of patients whose unilateral uterine artery ovarian branch was developing was 84.1%(37/44)and the efficiency of patients whose bilateral uterine artery ovarian branch were developing was 59.1%(26/44).(4)Blood supply of adenomyosisis was an independent predictor of effective UAE treatment(HR=0.313, P=0.001). Type Ⅰ(bilateral predominated)patients, efficiency was 93.5%(43/46); type Ⅱ(bilateral balanced)patients, efficiency was 78.0%(39/50); type Ⅲ(unilateral predominated)patients, efficiency was 51.6%(16/31).(5)UAE for the treatment of adenomyosis efficacy of artificial neural network prediction model was constructed, the model's area under the ROC curve was 0.808, the optimal cut-off point was 0.669 13. Actual verification of the model, sensitivity was 96.5%, specificity was 81.8%, positive predictive value was 96.5% and negative predictive value was 81.8%, the total accuracy was 94.1%. Conclusions: (1)Age, the developing situation of ovary branches and blood supply of adenomyosis are the independent predictors of effective UAE treatment.(2)The artificial neural network prediction model is satisfied with the accuracy and the accuracy of prediction.
To investigate the relationship between obstructive sleep apnea hypopnea syndrome complicated with various traditional Chinese medicine syndromes of hypertension and plasma homocysteine level, patients were divided into liver-fire excess syndrome, yin deficiency and yang excess syndrome, phlegm-blood stasis syndrome, yin deficiency and yang deficiency syndrome based on the traditional Chinese medicine syndrome type standard of hypertension complicated obstructive sleep apnea hypopnea syndrome. General data, body mass index values, apnea and hypopnea index, oxyhemoglobin saturation, Epworth sleepiness scale scores and homocysteine of patients were extracted and analyzed. The results revealed that the number of males was greater than that of females with a proportion of 1.5:1. The number of patients with body mass index ≥24.00 kg/m2 was obviously greater than that of patients with body mass index <24.00 kg/m2. The proportion of patients with body mass index >28.00 kg/m2 reached 59.18 %. In terms of the comparison of traditional Chinese medicine syndrome types, the proportion of patients suffering from phlegm-blood stasis syndrome was the highest, reaching 27.89 % and the proportion of patients suffering from yin deficiency and yang deficiency syndrome is the lowest, amounting to 22.45 %. In homocysteine examination, the homocysteine of syndrome was increased in order of yin deficiency and yang excess, phlegm-blood stasis, yin deficiency and yang deficiency and liver-fire excess. The results revealed that the syndrome type of phlegm-blood stasis was significant among patients with obstructive sleep apnea hypopnea syndrome in the distribution of traditional Chinese medicine syndrome types. This syndrome type showed significant statistical meaning in age, neck circumference, apnea and hypopnea index, average oxyhemoglobin saturation, triglyceride and overall difference in blood glucose fasting state. The severity of obstructive sleep apnea hypopnea syndrome was positively correlated with homocysteine and apnea, and hypopnea index was also positively correlated with homocysteine and was negatively correlated with lowest oxygen saturation. Lowest oxygen saturation was negatively correlated with homocysteine.
The 'Fuji' line includes many varieties with a similar genetic background and consistent inducement factors with epigenetic occurrence, thus it may be considered an ideal candidate for epigenetic research. In this study, 91 bud mutations of 'Fuji' apple were used as the test materials. Using the genetic variation within 'Fuji' as the control, the characteristics of epigenetic variation at different levels in both varieties and mutant groups were examined. The results showed that: (1) the global genomic DNA methylation level of the 91 bud mutants of 'Fuji' ranged from 29.120%-45.084%, with an average of 35.910%. Internal cytosine methylation was the main DNA methylation pattern. Regarding the variation of methylation patterns of 'Fuji' mutants, the vast majority of loci maintained the original methylation pattern existed in 'Fuji'. CHG methylation variation was the main type of variation; (2) the variation in methylation patterns between the mutant groups was greater than that of methylation levels. Among these patterns, the variation in CHG methylation patterns (including CHG hypermethylation and CHG demethylation) was expected to be dominant. The observed variation in methylation levels was more important in the Color mutant group; however, the variation in methylation patterns was more obvious in both the early maturation and Spur mutant groups. Moreover, the range of variation in the Early-maturation group was much wider than that in the Spur mutant group; (3) epigenetic diversity and genetic diversity were both low between the mutant groups. In the 'Fuji' mutant groups, there was few correlation between genetic and epigenetic variation, and epigenetic differentiation resulted in more loci with moderate or greater differentiation; (4) the purifying selection seemed to play a major role in the differentiation of different groups of 'Fuji' mutants (65.618%), but epigenetic diversity selection still occurred at nearly 35% of loci. Sixteen epigenetic outlier loci were detected.
2528 Background: HB0028 is a bifunctional fusion protein consisting of an anti-PD-L1 IgG1 single domain antibody and TGF-β RII receptor extracellular domain (TGFβRII-ECD). This is the first dose escalation and expansion phase I/II study to evaluate the safety and preliminary anti-tumor activity of HB0028 in advanced solid tumors. Methods: In the phase I portion of the study, the patients (pts) with advanced solid tumor were enrolled, and an accelerated titration followed by a standard 3+3 design was applied to dose escalation. The objectives were toxicity evaluation, maximum tolerable dose (MTD), and recommended phase 2 dose (RP2D). Eligible pts with advanced solid cancers of any histologic subtype, and ECOG performance status ≤ 1 were treated with HB0028 (0.3mg, 1mg, 3mg, 10mg, 20mg, Q3W), until unacceptable toxicity or disease progression. Radiologic tumor assessments (by RECIST v1.1) were performed every 6 weeks while on treatment. Results: 16 pts [12 females and 4 males; ECOG 0/1, 9/7; median age 52 years (range 36 – 60)] were enrolled in phase I (0.3 mg/kg [n = 1], 1 mg/kg [n = 3], 3 mg/kg [n = 3], 10 mg/kg [n = 3], 20 mg/kg [n = 6]). Median number of prior lines of systemic therapy was 2 (range 1-4). 8(50%) pts received and progressed upon prior anti-PD-1/L1 therapy. All pts had measurable metastatic disease. No DLT and Death occurred. MTD was not reached. As of DEC 25,2023, among 16 patients' safety data are evaluable for toxicity. Any grade treatment‐related adverse events (TRAEs) occurred in 15 subjects (93.8%), with 2 subjects (12.5%) reported with ≥ Grade 3 (G3 Anemia and G3 γ-glutamyltransferase). The most common TRAEs (all grades) were AST increased (n = 4, 25%), anemia (n = 7, 43.8%) and infusion-related response (n = 5, 31.3%). Two SAEs (G2 AST increased and G3 Neoplastic fevers) were reported, only AST increased was considered as possibly related to study drug, but recovered shortly. The efficacy data cutoff date of DEC 25,2023, 16 patients are evaluable for radiologic response. 1 subject with cervical cancer in HB0028 20 mg/kg group had a partial response (PR), 3 subjects (liver cancer, lung cancer, left submandibular gland cancer) had stable disease (SD) and 12 subjects had progressive disease (PD). The ORR per RECIST 1.1 by investigator was 6.25% (1/16; 95% CI, 0%-30.2%), and the DCR was 25% (4/16; 95% CI, 7.3%-52.4%). Durable clinical benefit (SD for > 32 weeks) was seen in 1 subject with malignant tumor in the left submandibular gland. To date, 2 responders are still on treatment. Conclusions: HB0028 was generally well tolerated, and therapy provided modest antitumor activity in patients with heavily pretreated advanced solid tumors. Based on these data, a phase II prospective clinical trial is being planned in specific cancer. Clinical trial information: NCT06223308 .
Background: Because neurofibromatosis type I (NF1) is a cancer predisposition disease, it is important to distinguish between benign and malignant lesions, especially in the craniofacial area. Purpose: The purpose of this study is to improve effectiveness in the diagnostic performance in discriminating malignant from benign craniofacial lesions based on computed tomography (CT) using a Keras-based machine-learning model. Methods: The Keras-based machine learning technique, a neural network package in the Python language, was used to train the diagnostic model on CT datasets. Fifty NF1 patients with benign craniofacial neurofibromas and six NF1 patients with malignant peripheral nerve sheath tumors (MPNSTs) were selected as the training set. Three validation cohorts were used: validation cohort 1 (random selection of 90% of the patients in the training cohort), validation cohort 2 (an independent cohort of 9 NF1 patients with benign craniofacial neurofibromas and 11 NF1 patients with MPNST), and validation cohort 3 (eight NF1 patients with MPNST, not restricted to the craniofacial area). Sensitivity and specificity were tested using validation cohorts 1 and 2, and generalizability was evaluated using validation cohort 3. Results: A total of 59 NF1 patients with benign neurofibroma and 23 NF1 patients with MPNST were included. A Keras-based machine-learning model was successfully established using the training cohort. The accuracy was 96.99 and 100% in validation cohorts 1 and 2, respectively, discriminating NF1-related benign and malignant craniofacial lesions. However, the accuracy of this model was significantly reduced to 51.72% in the identification of MPNSTs in different body regions. Conclusion: The Keras-based machine learning technique showed the potential of robust diagnostic performance in the differentiation of craniofacial MPNSTs and benign neurofibromas in NF1 patients using CT images. However, the model has limited generalizability when applied to other body areas. With more clinical data accumulating in the model, this system may support clinical doctors in the primary screening of true MPNSTs from benign lesions in NF1 patients.
In order to explore the accuracy of computed tomography (CT) and type-B ultrasonography in the examinations infection of ovarian cyst, the computed tomography and type-B ultrasonography were used for the examinations of 50 patients with infection of ovarian cysts, whose results were analyzed to determine the accuracy. Results have shown that the misdiagnosis rates of CT for patients with infection of ovarian cyst reached 18%, in which the misdiagnosis rate of small lesion 2.1 × 1.5 × 1.8 cm was relatively higher; in addition, the misdiagnosis rates of type-B ultrasonography reached 26%, in which the misdiagnosis rate of large lesion 2.6 × 1.6 × 1.5 cm was relatively higher; however, the misdiagnosis rates of the joint examination of these methods were only 2%. In summary, the deficiencies of CT and type-B ultrasonography may lead to misdiagnosis; therefore, in the clinical practices, the examinations of patients with infection of ovarian cyst should combine CT and type-B ultrasonography together to avoid the misdiagnosis and obtain the most accurate results as much as possible, which is important to both the patients and the development of medical examinations.
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