Abstract Background Esophagogastroduodenoscopy (EGD) is a prerequisite for detecting upper gastrointestinal lesions especially early gastric cancer (EGC). An artificial intelligence system has been shown to monitor blind spots during EGD. In this study, we updated the system (ENDOANGEL), verified its effectiveness in improving endoscopy quality, and pretested its performance in detecting EGC in a multicenter randomized controlled trial. Methods ENDOANGEL was developed using deep convolutional neural networks and deep reinforcement learning. Patients undergoing EGD in five hospitals were randomly assigned to the ENDOANGEL-assisted group or to a control group without use of ENDOANGEL. The primary outcome was the number of blind spots. Secondary outcomes included performance of ENDOANGEL in predicting EGC in a clinical setting. Results 1050 patients were randomized, and 498 and 504 patients in the ENDOANGEL and control groups, respectively, were analyzed. Compared with the control group, the ENDOANGEL group had fewer blind spots (mean 5.38 [standard deviation (SD) 4.32] vs. 9.82 [SD 4.98]; P < 0.001) and longer inspection time (5.40 [SD 3.82] vs. 4.38 [SD 3.91] minutes; P < 0.001). In the ENDOANGEL group, 196 gastric lesions with pathological results were identified. ENDOANGEL correctly predicted all three EGCs (one mucosal carcinoma and two high grade neoplasias) and two advanced gastric cancers, with a per-lesion accuracy of 84.7 %, sensitivity of 100 %, and specificity of 84.3 % for detecting gastric cancer. Conclusions In this multicenter study, ENDOANGEL was an effective and robust system to improve the quality of EGD and has the potential to detect EGC in real time.
Objective To study the expression of E-Cadherin and analyze the relationship between E-Cadherin expression and the clinicopathological features of human breast cancer.Methods Immunohistochemical technique [streptavid-in-peroxidase (SP) method] was applied to detect the expression of E-Cadherin in 110 cases of breast cancer tissue specimens,and the relationship between E-Cadherin expression and the clinicopathological features was retrospectively analyzed.Results The positive rate of E-Cadherin in all cases was 59.1％,and its expression level was lower in the young patients than in the older patients (42.9％ vs.64.6％,x2 =4.736,P ＜ 0.05％).The expression of E-cadherin was negatively correlated with the histological grades and human epidermalgrowth factor receptor-2 (Her-2) expression in breast cancer tissues (rs =-0.279,P ＜ 0.05 ; rs =-0.311,P ＜ 0.05).Lymph node metastasis rate was significantly higher in E-cadherin negative expression cases than in positive expression ones (75.6％ vs.35.4％,x2 =17.187,P ＜0.05).The 5-years survival rate in the E-Cadherin positive cases was increased evidently as compared with the negative E-Cadherin ones (76.9％ vs.40.0％).Conclusion The expression of E-cadherin may provide some reference to assess the biological characteristics and prognosis of breast cancer.
Key words:
Breast cancer; E-Cadherin
In this paper, we selected a kind of trimaran model to study its rapidity by theoretical research, ship model test and numerical simulation. Based on the rapidity test and ISIGHT-FD software platform, we set up mathematical model, selected the genetic algorithm method as system identification method. According to ship resistance and ship propelling, we analyzed the effect to its rapidity performance, hull, host, propeller match situation by lateral hulls arrangement. Finally, we made the residual resistance curve and open water efficiency curve, verified identify results and gave a prediction.
Cucumber plant growth and the fate of N in the plant-soil system are influenced by fertilization practices, the strengths of which may vary among soils. Three soils with different years of greenhouse vegetable cultivation (0, 2, and 18 years) were fertilized differently (CK, no N fertilizer applied; CF, chemical NPK fertilizers applied; RCF, reduced chemical NPK fertilizers applied, with N, P, and K reduced by 46.5%, 68.6%, and 54.7%; RCF+CM, 75% of the total N derived from chemical fertilizer and the rest from chicken manure in the case of reduced fertilization) in a pot experiment to study the changes in cucumber (Cucumis sativus L.) growth, N uptake, residue, and losses. The original N in soil was insufficient to maintain leaf growth and chlorophyll synthesis at later growth stages, even in soil with 18 years of greenhouse vegetable cultivation, where the original N content was the highest (total N 1.73 g kg−1). However, the CF treatment with excessive N fertilization inhibited leaf growth at the early growing stage and accelerated leaf senescence later, especially in soil with longer years of greenhouse vegetable cultivation. Therefore, reduced fertilizer application (RCF and RCF+CM) is appropriate to improve cucumber growth and productivity in greenhouse cultivation with different planting years. Although the same amount of N was applied, the RCF+CM treatment performed better than the RCF treatment in terms of increasing plant N uptake (by 30.5%) and soil N pool storage (by 25.0%) while decreasing N losses (by 16.6%) in soil with 0 years of greenhouse vegetable cultivation. In soil with 2 and 18 years of greenhouse vegetable cultivation, the soil itself functions much better in exogenous N retention and supply, with the N storage and losses not significantly different between the RCF and RCF+CM treatments. We conclude that reduced fertilization with the co-application of chicken manure is optimal for plant growth promotion, output-input ratio increase, soil N fertility improvement, and environmental risk mitigation.
Nitrogen accumulation reached the peak around 45 days after silking stage and high population was helpful to nitrogen accumulation.Total N content of the plant was positively correlated with yield and it got closer in higher density.Grain nitrogen content and nitrogen harvest index were significantly positively correlated with yield in higher density.Nitrogen application high ratio in silking stage was beneficial to N accumulation in leaf and ear,as well nitrogen translocation in stem and sheath,nitrogen application high ratio in earlier stage delayed nitrogen metabolism.Nitrogen uptake peak was from silking stage to 15 days after silking stage,nitrogen uptake rate increased in later growth stages under nitrogen application high ratio in silking stage and moved forward in higher population.It was advantaged for nitrogen fertilizer efficiency on condition that nitrogen application was moved backward.Accumulating too much nitrogen in earlier stages had inhibition on nitrogen uptake in later periods.
Background: The purpose of this study was to explore the clinical diagnostic values of serum tumor markers (TMs) including squamous cell carcinoma antigen (SCCAg), cytokeratin 19 fragment (CYFRA21-1), neuron specific enolase (NSE), alpha-L-fucosidase (AFU), carbohydrate antigen (CA)72-4, CA125, CA19-9, carcinoembryonic antigen (CEA) and ferritin (FER) in nasopharyngeal carcinoma (NPC).Methods: Two hundred and two newly diagnosed NPC patients and seventy-two benign nasopharyngeal diseases (BND) patients were retrospective reviewed. The levels of serum CA72-4, CYFRA21-1, SCCAg, NSE, AFU, FER, CEA, CA125 and CA19-9 were measured by chemiluminescent assay. AFU serum levels were detected by using continuous monitoring method. The non-parametric Mann-Whitney U test was used to compare median levels of TMs between the benign group and NPC group. Logistic stepwise regression analysis and the receiver operating characteristic (ROC) curve were firstly used in screening TMs in NPC, and then the decision tree was applied to evaluate the diagnostic value of TMs in NPC.Results: The levels of serum CA72-4, CYFRA21-1, NSE and FER in patients with NPC were significantly higher than those with the BND (P<0.05). For CEA, SCCAg, AFU, CA19-9 and CA125, there is no significant difference in the serum of NPC and benign control (P>0.05). AFU and CA72-4 were eliminated by Logistic regression stepwise analysis. Logistic regression showed that CA72-4, CYFRA21-1, NSE, CA125, CA19-9, CEA and FER OR (95% CI) of risk of NPC events were 1.09 (0.96–1.24, P=0.176), 2.42 (1.66–3.68, P<0.001), 1.30 (1.16–1.46, P<0.001), 0.96 (0.92–1, P=0.043), 1.042 (0.994–1.0994, P=0.099), 0.67 (0.47–0.94, P=0.022) and 1.003 (1.0007–1.005, P=0.014). NSE and CYFRA21-1 were selected for the conditional inference tree (CTree). When NSE >15.90, the positive predictive value was 93.9%. In the lower NSE group, when the CYFRA21-1 was greater than 3.3, the positive predictive value was 92.3%.Conclusions: The combination of CYFRA21-1 and NSE will be beneficial for distinguishing NPC from BND.
Purpose: The aims of this study are to establish a new method for simultaneously detecting the interactions between cancer cells and immunocytes in malignant ascites (MA) and to propose a new model for MA classification. Methods: A quantum dot (QD)-based multiplexed imaging technique was developed for simultaneous in situ imaging of cancer cells, lymphocytes, and macrophages. This method was first validated in gastric cancer tissues, and then was applied to MA samples from 20 patients with peritoneal carcinomatosis from gastrointestinal and gynecological origins. The staining features of MA and the interactions between cancer cells and immunocytes in the ascites were further analyzed and correlated with clinical features. Results: The QD-based multiplexed imaging technique was able to simultaneously show gastric cancer cells, infiltrating macrophages, and lymphocytes in tumor tissue, and the technique revealed the distinctive features of the cancer tumor microenvironment. When this multiplexed imaging protocol was applied to MA cytology, different features of the interactions and quantitative relations between cancer cells and immunocytes were observed. On the basis of these features, MA could be classified into immunocyte-dominant type, immunocyte-reactive type, cancer cell-dominant type, and cell deletion type; the four categories were statistically different in terms of the ratio of cancer cells to immunocytes ( P <0.001). Moreover, in the MA, the ratio of cancer cells to immunocytes was higher for patients with gynecological and gastric cancers than for those with colorectal cancer. Conclusion: The newly developed QD-based multiplexed imaging technique was able to better reveal the interactions between cancer cells and immunocytes. This advancement allows for better MA classification and, thereby, allows for treatment decisions to be more individualized. Keywords: gastric cancer, malignant ascites, quantum dots, classification, multiplexed imaging
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