[Analysis of the diagnotic results and complications of pneumoconiosis patients with different insurance types]

Objective: By comparing the diagnotic results and complications of pneumoconiosis patients with work-related injury insurance and non-work-related injury insurance, to provide reference for improving the medical insurance of pneumoconiosis patients. Methods: In May 2019, the diagnotic results and complications of 3204 patients with pneumoconiosis who were hospitalized in the second department of Hunan Prevention and Treatment Institute for Occupational Diseases from January 2017 to March 2019 were retrospectively analyzed. Results: Among the 3204 patients, 896 cases (28.0%) were in stage I, 790 cases (24.6%) were in stage II, and 1518 cases (47.4%) were in stage III. 1490 cases (46.5%) of pneumoconiosis patients have complications, mainly chronic obstructive pulmonary disease (COPD) (42.3%, 1354/3204) and lung infection (23.6%, 755/3204) . 584 cases (18.2%) were covered by work-related injury insurance, and the diagnosis of pneumoconiosis patients was mainly in the stage I (61.0%, 356/584) . 2620 cases (81.8%) were covered by non-work-related injury insurance, and the diagnosis of pneumoconiosis patients was mainly in the stage III (56.0%, 1466/2620) . The complication rate of non-work-related injury insurance patients (50.1%, 1312/2620) was higher than that of work-related injury insurance patients (30.5%, 178/584) (χ(2)=73.72, P<0.01) . Conclusion: The inpatients with pneumoconiosis in Hunan Province are still mainly covered by non-work-related injury insurance, and the diagnotic period and complication rate are significantly higher than those of work-related injury insurance patients. Therefore, pneumoconiosis patients should be provided with medical security, early diagnosis and early intervention, to prevent and delay the occurrence of complications.

Search for Axionlike Particles Produced in e^{+}e^{-} Collisions at Belle II

We present a search for the direct production of a light pseudoscalar a decaying into two photons with the Belle II detector at the SuperKEKB collider. We search for the process e^{+}e^{-}→γa, a→γγ in the mass range 0.2<m_{a}<9.7  GeV/c^{2} using data corresponding to an integrated luminosity of (445±3)  pb^{-1}. Light pseudoscalars interacting predominantly with standard model gauge bosons (so-called axionlike particles or ALPs) are frequently postulated in extensions of the standard model. We find no evidence for ALPs and set 95% confidence level upper limits on the coupling strength g_{aγγ} of ALPs to photons at the level of 10^{-3}  GeV^{-1}. The limits are the most restrictive to date for 0.2<m_{a}<1  GeV/c^{2}.

Radiomics Based on Multiparametric Magnetic Resonance Imaging to Predict Extraprostatic Extension of Prostate Cancer

Background: To develop a radiomics model based on multiparametric MRI (mpMRI) for preoperative prediction of extraprostatic extension (EPE) in patients with prostate cancer (PCa). Methods: Ninety-five pathology-confirmed PCa patients with 115 lesions (49 positive and 66 negative) were retrospectively enrolled. A 3.0T MR scanner was used to perform T2-weighted imaging (T2WI), diffusion-weighted imaging (DWI), and dynamic contrast-enhanced imaging (DCE). Radiomics features extracted from T2WI, DWI, apparent diffusion coefficient (ADC), and DCE were used to build a radiomics model. Patients' clinical and pathological variables were also obtained to build a clinical model. The radiomics model and clinical model were further integrated to build a combined nomogram. All lesions were randomly divided into the training group (82 lesions) and the validation group (33 lesions). A least absolute shrinkage and selection operator (LASSO) regression algorithm was applied to build the radiomics model. The diagnostic performance of different models was assessed by calculating the area under the curve (AUC) and compared using the Delong test. The calibration curve and decision curve analyses were used to assess the calibration and clinical usefulness of the radiomics model. Results: The AUC values for the radiomics model in the training and validation group were 0.919 and 0.865, respectively, with a good calibration performance. The decision curve analysis confirmed the clinical utility of the radiomics model. The accuracy, sensitivity, and specificity were 81.8, 71.4, and 89.5% in the validation group. In the validation group, the radiomics model outperformed the clinical model (AUC = 0.658, P = 0.020), and was comparable with the combined nomogram (AUC = 0.857, P = 0.644). Conclusion: The radiomics model based on mpMRI could different EPE and non-EPE lesions with satisfactory diagnostic performance, and this model might assist in predicting EPE before prostatectomy.

Tumor characteristics, treatments, and survival outcomes in prostate cancer patients with a PSA level < 4 ng/ml: a population-based study

BACKGROUND

To examine the tumor characteristics, treatments and survival outcomes of prostate cancer (PCa) patients with a prostate-specific antigen (PSA) level < 4 ng/ml.

METHODS

Of 205,913 men with primary prostate adenocarcinoma in the Surveillance, Epidemiology and End Results (SEER) database (2010 to 2015), 24,054 (11.68%) patients were diagnosed with a PSA level < 4 ng/ml. Comparisons of categorical variables among different groups were performed by using the Chi square test. Multivariate Cox regression analysis was adjusted for age, ethnicity, marital status, insurance status, TNM stage, Gleason grade, treatment and survival. Kaplan-Meier survival curves were constructed for overall mortality and tested by the log-rank test.

RESULTS

PCa patients with a PSA level < 4 ng/ml generally had more favorable tumor characteristics: younger, lower T stage, lower Gleason grade and lower lymph node metastasis rate. However, there were more patients in stage M1 in the group of PSA level < 4 ng/ml than that in the groups of PSA level of 4-10 ng/ml, 10-20 ng/ml and > 20 ng/ml. The multivariate Cox regression model revealed that overall mortality was associated with age, marital status, race, Gleason grade, M stage and treatment approach.

CONCLUSIONS

In conclusion, PCa patients with a PSA level < 4 ng/ml have more favorable tumor characteristics at diagnosis and receive more benefit from active treatment. However, those patients with advanced TNM stage and high Gleason grade should be paid more attention in clinical application.

Search for an Invisibly Decaying Z^{'} Boson at Belle II in e^{+}e^{-}→μ^{+}μ^{-}(e^{±}μ^{∓}) Plus Missing Energy Final States

Theories beyond the standard model often predict the existence of an additional neutral boson, the Z^{'}. Using data collected by the Belle II experiment during 2018 at the SuperKEKB collider, we perform the first searches for the invisible decay of a Z^{'} in the process e^{+}e^{-}→μ^{+}μ^{-}Z^{'} and of a lepton-flavor-violating Z^{'} in e^{+}e^{-}→e^{±}μ^{∓}Z^{'}. We do not find any excess of events and set 90% credibility level upper limits on the cross sections of these processes. We translate the former, in the framework of an L_{μ}-L_{τ} theory, into upper limits on the Z^{'} coupling constant at the level of 5×10^{-2}-1 for M_{Z^{'}}≤6  GeV/c^{2}.

Tetramethylpyrazine reduces prostate cancer malignancy through inactivation of the DPP10‑AS1/CBP/FOXM1 signaling pathway

Tetramethylpyrazine (TMP), a Chinese herbal medicine, has been reported to possess anticancer effects. Emerging evidence suggests that various long noncoding RNAs (lncRNAs) serve important roles in cancer initiation and progression. In the present study, the tumor‑suppressive effects of TMP in human PCa cells was examined and the underlying mechanisms of its actions were determined. The data showed that TMP treatment reduced cell viability and increased apoptosis in a dose‑dependent manner. Reverse transcription‑quantitative PCR showed TMP treatment increased the expression of lncRNA DPP10‑AS1 in PCa cells. Furthermore, DPP10‑AS1 was also upregulated in TMP‑resistant PCa cells. Knockdown of DPP10‑AS1 reversed TMP resistance, whereas increased expression of DPP10‑AS1 abrogated the TMP‑mediated cytotoxicity in PCa cells. In addition, forkhead box M1 (FOXM1) was verified as the functional target of DPP10‑AS1, and knockdown of FOXM1 reversed the TMP/DPP10‑AS1‑induced cell cytotoxicity. Mechanistically, DPP10‑AS1 was associated with CREB binding protein, thereby induced H3K27ac enrichment at the promoter region of the FOXM1 gene. In conclusion, the present study showed that TMP may be a promising treatment agent for PCa and lncRNA DPP10‑AS1 may be a promising therapeutic target for TMP treatment.

Comparison of biparametric and multiparametric MRI in the diagnosis of prostate cancer

PURPOSE

To compare the diagnostic accuracy of biparametric MRI (bpMRI) and multiparametric MRI (mpMRI) for prostate cancer (PCa) and clinically significant prostate cancer (csPCa) and to explore the application value of dynamic contrast-enhanced (DCE) MRI in prostate imaging.

METHODS AND MATERIALS

This study retrospectively enrolled 235 patients with suspected PCa in our hospital from January 2016 to December 2017, and all lesions were histopathologically confirmed. The lesions were scored according to the Prostate Imaging Reporting and Data System version 2 (PI-RADS V2). The bpMRI (T2-weighted imaging [T2WI], diffusion-weighted imaging [DWI]/apparent diffusion coefficient [ADC]) and mpMRI (T2WI, DWI/ADC and DCE) scores were recorded to plot the receiver operating characteristic (ROC) curves. The area under the curve (AUC), accuracy, sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV) for each method were calculated and compared. The patients were further stratified according to bpMRI scores (bpMRI ≥3, and bpMRI = 3, 4, 5) to analyse the difference in DCE MRI between PCa and non-PCa lesions (as well as between csPCa and non-csPCa).

RESULTS

The AUC values for the bpMRI and mpMRI protocols for PCa were comparable (0.790 [0.732-0.840] and 0.791 [0.733-0.841], respectively). The accuracy, sensitivity, specificity, PPV and NPV of bpMRI for PCa were 76.2, 79.5, 72.6, 75.8, and 76.6%, respectively, and the values for mpMRI were 77.4, 84.4, 69.9, 75.2, and 80.6%, respectively. The AUC values for the bpMRI and mpMRI protocols for the diagnosis of csPCa were similar (0.781 [0.722-0.832] and 0.779 [0.721-0.831], respectively). The accuracy, sensitivity, specificity, PPV and NPV of bpMRI for csPCa were 74.0, 83.8, 66.9, 64.8, and 85.0%, respectively; and 73.6, 87.9, 63.2, 63.2, and 87.8%, respectively, for mpMRI. For patients with bpMRI scores ≥3, positive DCE results were more common in PCa and csPCa lesions (both P = 0.001). Further stratification analysis showed that for patients with a bpMRI score = 4, PCa and csPCa lesions were more likely to have positive DCE results (P = 0.003 and P < 0.001, respectively).

CONCLUSION

The diagnostic accuracy of bpMRI is comparable with that of mpMRI in the detection of PCa and the identification of csPCa. DCE MRI is helpful in further identifying PCa and csPCa lesions in patients with bpMRI ≥3, especially bpMRI = 4, which may be conducive to achieving a more accurate PCa risk stratification. Rather than omitting DCE, we think further comprehensive studies are required for prostate MRI.

Multiparametric MRI-Based Radiomics for Prostate Cancer Screening With PSA in 4-10 ng/mL to Reduce Unnecessary Biopsies

BACKGROUND

Whether men with a prostate-specific antigen (PSA) level of 4-10 ng/mL should be recommended for a biopsy is clinically challenging.

PURPOSE

To develop and validate a radiomics model based on multiparametric MRI (mp-MRI) in patients with PSA levels of 4-10 ng/mL to predict prostate cancer (PCa) preoperatively and reduce unnecessary biopsies.

STUDY TYPE

Retrospective.

SUBJECTS

In all, 199 patients with PSA levels of 4-10 ng/mL.

FIELD STRENGTH/SEQUENCE

3T, T₂ -weighted, diffusion-weighted, and dynamic contrast-enhanced MRI.

ASSESSMENT

Lesion regions of interest (ROIs) from T₂ -weighted, diffusion-weighted, and dynamic contrast-enhanced MRI were annotated by two radiologists. A total of 2104 radiomic features were extracted from the ROI of each patient. A random forest classifier was used to build the radiomics model for PCa in the primary cohort. A combined model was constructed using multivariate logistic regression by incorporating the radiomics signature and clinical-radiological risk factors.

STATISTICAL TESTS

For continuous variables, variance equality was assessed by Levene's test and Student's t-test, and Welch's t-test was used to assess between-group differences. For categorical variables, Pearson's chi-square test, Fisher's exact test, or the approximate chi-square test was used to assess between-group differences. P < 0.05 was considered statistically significant.

RESULTS

The combined model incorporating the multi-imaging fusion model, age, PSA density (PSAD), and the PI-RADS v2 score yielded area under the curve (AUC) values of 0.956 and 0.933 on the primary (n = 133) and validation (n = 66) cohorts, respectively. Compared with the clinical-radiological model, the combined model performed better on both the primary and validation cohorts (P < 0.05). Furthermore, the use of the combined model to predict PCa could identify more negative PCa patients than the use of the clinical-radiological model by 18.4%.

DATA CONCLUSION

The combined model was developed and validated to provide potential preoperative prediction of PCa in men with PSA levels of 4-10 ng/mL and might aid in treatment decision-making and reduce unnecessary biopsies.

LEVEL OF EVIDENCE

3 Technical Efficacy Stage: 3 J. Magn. Reson. Imaging 2020;51:1890-1899.

Long noncoding RNA LINC01510 is highly expressed in colorectal cancer and predicts favorable prognosis

OBJECTIVE

Long noncoding RNAs (lncRNAs) have recently emerged as important regulators in governing fundamental biological processes, as well as in tumorigenesis. LncRNA LINC01510 (LINC01510) was recently shown to be involved in colorectal cancer (CRC); however, its role in CRC remains unknown. The objective of this study was to evaluate LINC01510 expression and its relevance to the prognosis of CRC.

PATIENTS AND METHODS

LINC01510 expression was detected in CRC tissues and cell lines by using quantitative real-time PCR (qRT-PCR). The correction between LINC01510 expression and clinical characteristics was evaluated with x2-test. Survival curves and log-rank test were used to analyze patients' survival. A Cox proportional hazard model was constructed to evaluate the association of LINC01510 expression with overall survival and disease-free survival, respectively.

RESULTS

Here, we found that the levels of LINC01510 in CRC tissues were significantly higher than those in matched tumor-adjacent tissues. Moreover, high LINC01510 expression was observed to be closely correlated with histology/differentiation (p = 0.001), depth of invasion (p = 0.004) and TNM stage (p = 0.003). From the Kaplan-Meier survival curves, it was observed that patients with high expression of LINC01510 had shorter overall survival (p = 0.004) and disease-free survival (p = 0.000) as compared with the LINC01510-low group. In the multivariate analysis, high LINC01510 expression was an independent prognostic factor for both overall survival (p = 0.001) and disease-free survival (p = 0.001).

CONCLUSIONS

We demonstrated that low LINC01510 expression was associated with the progression of CRC and could serve as a potential independent prognostic biomarker for patients with CRC.

Grey matter changes in patients with vestibular migraine

AIM

To identify structural changes in the brain regions of patients with vestibular migraine (VM) so as to better understand its pathophysiology.

MATERIAL AND METHODS

The differences in grey matter (GM) in patients with VM, patients with migraine without aura (MWoA), and healthy controls (HC) were investigated. Using a GE Signa 3 T magnetic resonance imaging (MRI) system, 3D structural images were acquired from 18 VM, 21 MWoA, and 21 age-, gender-, and education level-matched HC using a T1-weighted magnetization-prepared rapid acquisition gradient-echo (MPRAGE) sequence. The volumetric abnormalities of GM were estimated by voxel-based morphometry. Analysis of variance and Bonferroni multiple comparisons were applied.

RESULTS

Compared with HC, patients with VM had significantly increased GM volume of the right medial superior frontal gyrus (p=0.008) and the right angular gyrus (p=0.009). Compared to patients with MWoA, patients with VM also had significantly increased volume of the right medial superior frontal gyrus (p=0.001), the right angular gyrus (p=0.008), and the left middle frontal gyrus (p=0.001).

CONCLUSIONS

The GM volume of some brain regions of patients with VM is significantly larger than the other two groups. The increased GM volume in these brain regions in patients with VM may be related to self-adaptation of the nervous system, leading to an abnormal brain sensitization. Some of the brain regions with increased GM volume identified in this study were involved in assessment, integration, and expectations of pain and were strongly related to mood and anxiety.

Prognostic significance of a novel indicator (PSApostd3/PSApre) for PSA recurrence in patients after radical prostatectomy

Purpose

Radical prostatectomy (RP) is a common treatment for prostate cancer, but a fraction of patients may experience PSA recurrence after surgery, manifesting as an elevation in prostate specific antigen (PSA). Vast literature has reported different prognostic factors for PSA recurrence without reaching a consensus. This retrospective study investigated the efficacy of a new indicator in predicting PSA recurrence in patients after RP.

Patients and methods

From October 2000 to December 2015, 102 PCa patients who underwent laparoscopic prostatectomy in the Urology Department of Peking Union Medical College Hospital were analyzed. We calculated PSA_postd3/PSA_pre, defined as the ratio of the PSA on day 3 postop as the numerator and the pre-operative PSA as the denominator, in these patients to represent PSA decrement after surgery, and investigated its relationship with PSA recurrence during follow-up.

Results

The receiver operating characteristic (ROC) curve of PSA_postd3/PSA_pre derived a cut-off at 0.453 (sensitivity=0.704, specificity=0.853, P<0.0001), suggesting an increased risk of PSA recurrence in patients whose PSA on day 3 postop did not decrease to approximately half of their preoperative levels. Among several factors, PSA_postd3/PSA_pre (P<0.0001), pathological T stage (P=0.042) and Gleason Grade (P=0.021) were determined to be significantly associated with PSA recurrence by Fisher’s exact test, while only PSA_postd3/PSA_pre (P<0.001) was significantly related to PSA recurrence-free survival (PRFS) by multivariate logistic regression analysis.

Conclusion

These results imply that PSA_postd3/PSA_pre could provide substantial information for PSA recurrence prediction in patients after RP.

lncRNA SNHG20 promotes prostate cancer migration and invasion via targeting the miR-6516-5p/SCGB2A1 axis

Accumulating evidence has demonstrated the vital roles of long noncoding RNA (lncRNA) in prostate cancer (PCa). However, the function of small nucleolar RNA host gene 20 (SNHG20) in PCa is still unclear. This study aimed to investigate the expression and biological roles of SNHG20 in PCa. SNHG20 expression in PCa tissues and cell lines was measured by quantitative real-time PCR. Gain and loss-of-function experiments were conducted to examine the biological roles of SNHG20. Bioinformatic analysis and dual luciferase activity reporter assay were conducted to establish the SNHG20/secretoglobin family 2A member 1 (SCGB2A1)/microRNA-6516-5p (miR-6516-5p) axis. SHNG20 expression was found markedly elevated in PCa tissues and cell lines. Overexpression of SNHG20 increased PCa cell proliferation and invasion but decreased cell apoptosis. However, the knockdown of SNHG20 will cause the opposite effects on PCa cell behaviors. Mechanical investigation found that SNHG20 could relive the SCGB2A1 protein expression via sponging the miR-6516-5p, acting as miRNA sponge. In conclusion, this finding suggests the SNHG20/miR-6516-5p/SCGB2A1 axis in PCa tumorigenesis, providing the novel insight for the molecular mechanism of PCa.

Diagnostic value of fecal B cell activating factor in patients with abdominal discomfort

Fecal calprotectin has successfully been widely recommended as a sensitive biomarker of inflammatory bowel diseases (IBD). Recently, we have identified an excellent new fecal biomarker, B cell activating factor (BAFF), as being as effective as fecal calprotectin for diagnosing intestinal inflammation. In this study, a total of 230 patients with abdominal discomfort were prospectively enrolled and fecal samples were collected within 24 h before the endoscopic examinations. We show that fecal BAFF levels were significantly higher in patients with ulcerative colitis (median = 1549 pg/g, P < 0·0001), Crohn's disease (median = 735 pg/g, P < 0·0001), gastric cancer (median = 267 pg/g, P < 0·0001) and colorectal cancer (median = 533 pg/g, P < 0·0001) than those in healthy groups (median = 61 pg/g), while the values of which in patients with gastric polyps, colorectal polyps, esophagitis/gastritis/duodenitis and peptic ulcer were in the range of healthy individuals (P > 0·05). An optimal cut-off value at 219·5 pg/g of fecal BAFF produced sensitivity, specificity, positive predictive and negative predictive values of 85, 91, 84 and 92%, respectively, for IBD or carcinoma. Our results therefore indicate a potential role for fecal BAFF as a sensitive screening parameter for IBD and gastrointestinal carcinoma, as well a useful tool to select patients with abdominal discomfort for further endoscopic examinations.

Validity of discharge ICD-10 codes in detecting the etiologies of endogenous Cushing's syndrome

OBJECTIVE

To investigate the validity of discharge ICD-10 codes in detecting the etiology of endogenous Cushing's syndrome (CS) in hospitalized patients.

METHODS

We evaluated the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of CS etiology-related ICD-10 codes or code combinations by comparing hospital discharge administrative data (DAD) with established diagnoses from medical records.

RESULTS

Coding for patients with adrenocortical adenoma (ACA) and those with bilateral macronodular adrenal hyperplasia (BMAH) demonstrated disappointingly low sensitivity at 78.8% (95% CI: 70.1-85.6%) and 83.9% (95% CI: 65.5-93.9%), respectively. BMAH had the lowest PPV of 74.3% (95% CI: 56.4-86.9%). In confirmed ACA patients, the sensitivity for ACA code combinations was higher in patients initially admitted to the Department of Endocrinology before surgery than that in patients directly admitted to the Department of Urology (90.0 vs 73.1%, P = 0.033). The same phenomenon was observed in the PPV for the BMAH code (100.0 vs 60.9%, P = 0.012). Misinterpreted or confusing situations caused by coders (68.1%) and by the omission or denormalized documentation of symptomatic diagnosis by clinicians (26.1%) accounted for the main source of coding errors.

CONCLUSIONS

Hospital DAD is an effective data source for evaluating the etiology of CS but not ACA and BMAH. Improving surgeons' documentation, especially in the delineation of symptomatic and locative diagnoses in discharge abstracts; department- or disease-specific training for coders and more multidisciplinary collaboration are ways to enhance the applicability of administrative data for CS etiologies.