BACKGROUND Pathologists are grappling with high workloads and uneven resource distribution, which can impede professional development and the delivery of quality patient care. The advent of generative large language models (LLMs) has the potential to revolutionize pathological field, where efficiency and resource accessibility are paramount. OBJECTIVE This study aimed to investigate the perceptions and willingness of Chinese pathologists to adopt generative LLMs. METHODS We conducted a questionnaire survey at the National Pathology Academic Annual Conference in April 2024, involving 339 certified Chinese pathologists. Participant responses were measured with a 5-point Likert scale for the performance of generative LLMs in clinical, research, and educational settings, with statistical analysis using mean and standard deviation (SD). Multivariable logistic regression models were employed to explore factors associated with the adoption of generative LLMs, reporting odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS A total of 339 valid questionnaires were returned. The results revealed that pathologists generally supported the performance of generative LLMs in clinical (mean 3.87, SD 0.96), research (mean 3.88, SD 1.09), and educational (mean 4.04, SD 0.82) contexts. Positive attitudes towards the use of generative LLMs were prevalent. Notably, pathologists practicing in less developed urban areas (OR=1.99, 95% CI=1.07 to 3.69, p=0.030), those with higher caseloads (>5000 cases/year; OR=2.12, 95% CI=1.01 to 4.44, p=0.047), and those engaged in research (OR=2.94, 95% CI=1.61 to 5.34, p<0.001) and teaching (OR=2.37, 95% CI=1.42 to 3.96, p=0.001) activities, as well as those with prior experience with generative LLMs (OR=2.45, 95% CI=1.38 to 4.37, p=0.002), showed a greater inclination towards future adoption. CONCLUSIONS Chinese pathologists are receptive to generative LLMs, showing a positive inclination for their application. The study advocates for fostering the adoption of generative LLMs to improve the efficiency and accuracy of diagnosis, reduce the burden on pathologists, and improve the overall service level in the field of pathology.
Circulating tumor cells (CTCs) or CTC clusters are considered as suitable and relevant targets for liquid biopsy as they more accurately indicate cancer progression, the therapeutic effects of treatment and allows for monitoring of cancer metastasis in real‑time. Among the various methods for isolating CTCs, size‑based filtration is one of the most convenient methods. However, cell clogging makes the filtration process less efficient. In the present study, an electromagnetic vibration‑based filtration (eVBF) device was developed that efficiently isolated rare CTCs and CTC clusters from clinical blood samples of patients with gastric cancer. Using human blood samples spiked with human gastric cancer cells, the parameters of this device such as vibrating amplitude and flow rate were optimized. Putative CTCs were detected using a conventional filtration method and the eVBF device from the peripheral blood samples of patients with gastric cancer. Continuous flow isolation of CTCs was evaluated by a simulated blood flow system. The eVBF device utilized the electromagnetic force to generate a periodic vibration that prevented the cell clogging and improved the filtering efficiency. The optimized eVBF device with the high‑amplitude vibration exhibited a recovery efficiency of 80‑90% from whole blood samples spiked with 100 or 1,000 gastric cancer cells per ml. Using the eVBF device, CTCs were detected in 100% of patients (10/10) with gastric cancer, and the positive detection rate of the eVBF device was 30% higher compared with the conventional filtration method. Furthermore, CTC clusters were detected in 40% (4/10) of CTC‑positive patient samples, and the integrity of CTC clusters was preserved using the eVBF device. The eVBF device allowed for high‑throughput (1 ml/min) and continuous flow isolation of CTCs without the addition of any antibodies, any chemical reagents or any pretreatment processes. Thus, the eVBF device provides an efficient tool for isolating rare CTCs and CTC clusters from patients with cancer, highlighting its potential for use in cancer diagnosis, treatment and cancer biology research.
Objective The value of the transformation zone (TZ) is often overlooked in clinical settings. This study aims to assess TZ distribution, associated factors, and its impact on colposcopic diagnosis. Methods χ 2 tests were used to analyze demographics, clinical history, and tissue samples to examine the differences in TZ distribution. Factors affecting the TZ were explored using logistic regression, and diagnostic indicators were calculated. Results A total of 5,302 individual datasets were finally included. TZ1, TZ2, and TZ3 accounted for 31.6%, 38.5%, and 30.0%, respectively. Age is the most important factor that influences the location of the TZ. The proportion of TZ3 steadily increased with age, comprising over 55% in women over 50. The colposcopic diagnostic performance shows that high-grade squamous intraepithelial lesion or worse (HSIL+) sensitivity of TZ3 (58.1%, 95% confidence interval [CI] = 52.9–63.4) is significantly lower than that of TZ1 (69.8%, 95% CI = 65.5–74.1) and TZ2 (73.2%, 95% CI = 69.7–76.8). The HSIL+ specificity of TZ3 (96.3, 95% CI = 95.3–97.4) was higher than that of TZ1 (96.3, 95% CI = 95.2–97.3) and TZ2 (92.5, 95% CI = 91.1–93.9). The HSIL+ positive predictive value (81.3%, 95% CI = 76.4–86.2) and negative predictive value (89.3%, 95% CI = 87.6–90.9) for TZ3 are high, with no significant differences when compared with TZ1 and TZ2. Conclusions Age predominantly influences TZ location, with TZ3 being most frequently found in women over 50. While TZ3 poses a higher risk of missed diagnosis during colposcopy, it remains clinically valuable in identifying diseased and nondiseased status. Increasing colposcopists' awareness of TZ importance is needed in clinical practice.
The androgen receptor (AR) has a crucial role in prostate cancer. RNA‑binding protein‑mediated post‑transcriptional regulation is important in the initiation and development of cancer. The present study attempted to elucidate the mutual association of AR and RNA‑binding protein quaking (QKI) in the development of prostate cancer. Dual‑luciferase reporter demonstrated that AR can positively regulate the expression of QKI in prostate cancer cell lines due to its effective transcription regulating function. In addition, QKI may increase expression of AR by heat shock protein 90, which is a coactivator of AR, and silencing QKI can increase the sensitive of Casodex, which is an antagonist of AR in castration‑resistant prostate cancer. This may be a new strategy for advanced prostate cancer.
To investigate age and type-specific prevalences of high-risk human papillomavirus (hrHPV) and cervical intraepithelial neoplasia (CIN) in hrHPV+ women referred to colposcopy. This is a retrospective, multicenter study. Participants were women referred to one of seven colposcopy clinics in China after testing positive for hrHPV. Patient characteristics, hrHPV genotyping, colposcopic impressions, and histological diagnoses were abstracted from electronic records. Main outcomes were age-related type-specific prevalences associated with hrHPV and CIN, and colposcopic accuracy. Among 4419 hrHPV+ women referred to colposcopy, HPV 16, 52, and 58 were the most common genotypes. HPV 16 prevalence was 39.96%, decreasing from 42.57% in the youngest group to 30.81% in the eldest group. CIN3+ prevalence was 15.00% and increased with age. As lesion severity increases, HPV16 prevalence increased while the prevalence of HPV 52 and 58 decreased. No age-based trend was identified with HPV16 prevalence among CIN2+, and HPV16-related CIN2+ was less common in women aged 60 and above (44.26%) compared to those younger than 60 years (59.61%). Colposcopy was 0.73 sensitive at detecting CIN2+ (95% confidence interval[CI]: 0.71, 0.75), with higher sensitivity (0.77) observed in HPV16+ women (95% CI: 0.74, 0.80) compared to HPV16- women (0.68, 95% CI: 0.64, 0.71). Distributions of hrHPV genotypes, CIN, and type-specific CIN in Chinese mainland hrHPV+ women referred to colposcopy were investigated for the first time. Distributions were found to be age-dependent and colposcopic performance appears related to HPV genotypes. These findings could be used to improve the management of women referred to colposcopy.
To establish a reversed-phase high-performance liquid chromatographic (RP-HPLC) method for determination of phloridzin content.A RP-HPLC method was established for determination of phloridzin using an Inertsil ODS-3 (4.6×150 mm, 5 µm) column with the detection wavelength of 288 nm, flow rate of 1.0 ml/min, and column temperature of 25 degrees celsius;.The result showed that the phloridzin had a good linear relationship when its concentration ranged between 0.5988 and 89.72 µg/ml. The regression equation was Y=46.370 X-0.6728 (r=0.9999, n=3). The average recovery of phloridzin was 99.40% with the relative standard deviations (RSD) of 0.67%.This method is simple, quick and accurate for determination of phloridzin content.
Abstract The risk associated with single and multiple human papillomavirus (HPV) infections in cervical intraepithelial neoplasia (CIN) remains uncertain. This study aims to explore the distribution and diagnostic significance of the number of high‐risk HPV (hr‐HPV) infections in detecting CIN, addressing a crucial gap in our understanding. This comprehensive multicenter, retrospective study meticulously analyzed the distribution of single and multiple hr‐HPV, the risk of CIN2+, the relationship with CIN, and the impact on the diagnostic performance of colposcopy using demographic information, clinical histories, and tissue samples. The composition of a single infection was predominantly HPV16, 52, 58, 18, and 51, while HPV16 and 33 were identified as the primary causes of CIN2+. The primary instances of dual infection were mainly observed in combinations such as HPV16/18, HPV16/52, and HPV16/58, while HPV16/33 was identified as the primary cause of CIN2+. The incidence of hr‐HPV infections shows a dose–response relationship with the risk of CIN ( p for trend <0.001). Compared to single hr‐HPV, multiple hr‐HPV infections were associated with increased risks of CIN1 (1.44, 95% confidence interval [CI]: 1.20–1.72), CIN2 (1.70, 95% CI: 1.38–2.09), and CIN3 (1.08, 95% CI: 0.86–1.37). The colposcopy‐based specificity of single hr‐HPV (93.4, 95% CI: 92.4–94.4) and multiple hr‐HPV (92.9, 95% CI: 90.8–94.6) was significantly lower than negative (97.9, 95% CI: 97.0–98.5) in detecting high‐grade squamous intraepithelial lesion or worse (HSIL+). However, the sensitivity of single hr‐HPV (73.5, 95% CI: 70.8–76.0) and multiple hr‐HPV (71.8, 95% CI: 67.0–76.2) was higher than negative (62.0, 95% CI: 51.0–71.9) in detecting HSIL+. We found that multiple hr‐HPV infections increase the risk of developing CIN lesions compared to a single infection. Colposcopy for HSIL+ detection showed high sensitivity and low specificity for hr‐HPV infection. Apart from HPV16, this study also found that HPV33 is a major pathogenic genotype.
'/%3e%3cuse xlink:href='%23a' transform='rotate(23.036 .093 25.536)'/%3e%3cuse xlink:href='%23a' transform='rotate(45.87 1.273 16.18)'/%3e%3cuse xlink:href='%23a' transform='rotate(69.945 .996 12.078)'/%3e%3cuse xlink:href='%23a' transform='rotate(20.66 -19.689 31.932)'/%3e%3c/svg%3e)