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Liu PM, Feng B, Shi JF, Feng HJ, Hu ZJ, Chen YH, Zhang JP. A deep-learning model using enhanced chest CT images to predict PD-L1 expression in non-small-cell lung cancer patients. Clin Radiol 2023; 78:e689-e697. [PMID: 37460338 DOI: 10.1016/j.crad.2023.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 05/11/2023] [Accepted: 05/18/2023] [Indexed: 09/03/2023]
Abstract
AIM To develop a deep-learning model using contrast-enhanced chest computed tomography (CT) images to predict programmed death-ligand 1 (PD-L1) expression in patients with non-small-cell lung cancer (NSCLC). MATERIALS AND METHODS Preoperative enhanced chest CT images and immunohistochemistry results for PD-L1 expression (<1% and ≥1% were defined as negative and positive, respectively) were collected retrospectively from 125 NSCLC patients to train and validate a deep-learning radiomics model (DLRM) for the prediction of PD-L1 expression in tumours. The DLRM was developed by combining the deep-learning signature (DLS) obtained from a convolutional neural network and clinicopathological factors. The indexes of the area under the curve (AUC), integrated discrimination improvement (IDI), and decision curve analysis (DCA) were used to evaluate the efficiency of the DLRM. RESULTS DLS and tumour stage were identified as independent predictors of PD-L1 expression by the DLRM. The AUCs of the DLRM were 0.804 (95% confidence interval: 0.697-0.911) and 0.804 (95% confidence interval: 0.679-0.929) in the training and validation cohorts, respectively. IDI analysis showed the DLRM had better diagnostic accuracy than DLS (0.0028 [p<0.05]) in the validation cohort. Additionally, DCA revealed that the DLRM had more net benefit than the DLS for clinical utility. CONCLUSION The proposed DLRM using enhanced chest CT images could function as a non-invasive diagnostic tool to differentiate PD-L1 expression in NSCLC patients.
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Affiliation(s)
- P M Liu
- Cancer Center, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, 030032, China; Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - B Feng
- School of Electronic Information and Automation, Guilin University of Aerospace Technology, Guilin, Guangxi, 541004, China
| | - J F Shi
- School of Electronic Information and Automation, Guilin University of Aerospace Technology, Guilin, Guangxi, 541004, China
| | - H J Feng
- Cancer Center, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, 030032, China; Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Z J Hu
- School of Electronic Information and Automation, Guilin University of Aerospace Technology, Guilin, Guangxi, 541004, China
| | - Y H Chen
- School of Electronic Information and Automation, Guilin University of Aerospace Technology, Guilin, Guangxi, 541004, China
| | - J P Zhang
- Cancer Center, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, 030032, China; Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
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Zou YW, Li QH, Gao JW, Pan J, Ma JD, Chen LF, Lin J, Mo Y, Zhang X, Liu PM, Dai L. AB0276 COMPARISON OF METABOLIC DYSFUNCTION-ASSOCIATED FATTY LIVER DISEASE WITH NON-ALCOHOLIC FATTY LIVER DISEASE IN IDENTIFYING CARDIOVASCULAR RISK IN CHINESE INDIVIDUALS WITH RHEUMATOID ARTHRITIS. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundThe nomenclature from non-alcoholic fatty liver disease (NAFLD) to metabolic dysfunction-associated fatty liver disease (MAFLD) is considered to identify more cardiovascular disease (CVD) risk in general population, and patients with rheumatoid arthritis (RA) carry an excess risk for CVD.ObjectivesTo compare MAFLD with NAFLD in identifying CVD risk in RA patients.MethodsClinical data from a Chinese RA cohort were retrospectively analyzed. Hepatic steatosis was defined by abdominal ultrasound examination. CVD risk in RA patients was estimated by the Prediction for Atherosclerotic Cardiovascular Disease Risk in China.ResultsAmong 513 included RA patients, 78.4% were female and the mean ± SD age was 51.8 ± 12.6 years. The prevalence of MAFLD and NAFLD was 21.4% and 20.5%, respectively. 10.9% RA patients concomitated with CVD events and 32.4% had a high 10-year CVD risk. Multivariate logistic regression analysis showed that both MAFLD and NAFLD were associated with an increase in CVD events (MAFLD: AOR = 2.303 [95% CI 1.197, 4.429]; NAFLD: AOR = 2.478 [95% CI 1.185, 4.779] and high 10-year CVD risk (MAFLD: AOR = 3.184 [95% CI 1.777, 5.705]; NAFLD: AOR = 2.870 [95% CI 1.597, 5.156]; all p < 0.05). The NRI and IDI was -0.011 (95% CI -0.025, 0.003) and -0.002 (95% CI -0.007, 0.002) for CVD events, and 0.012 (95% CI -0.014, 0.038) and 0.005 (95% CI -0.003, 0.013; all p > 0.05) for high 10-year CVD risk, which indicated no additional CVD events and high 10-years CVD risk were identified when replacing NAFLD with MAFLD in RA patients.ConclusionBoth MAFLD and NAFLD are associated with an increased CVD risk which implies the importance of early detection and management of MAFLD or NAFLD in RA patients. However, new nomenclature of MAFLD identify no additional CVD risk in RA patients.Financial support:National Natural Science Foundation of China (No. 81971527, 82171780 and 82101892), Science and Technology Program of Guangzhou (No. 202102010188 and 201904010088), and Guangdong Basic and Applied Basic Research Foundation (No. 2019A1515011928 and 2020A1515110061).Figure 1.The prevalence of MAFLD and NAFLD in RA patients with different stratification.The prevalence in different genders (A) and ages groups (B); The prevalence in different disease activity groups (C) and disease duration (D); remission (CDAI ≤ 2.8); active (CDAI > 2.8).Disclosure of InterestsNone declared
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Han JJ, Gao JW, Liu PM, Wang JF. [Research progress on the association between the use of non-vitamin K antagonist oral anticoagulants and vascular calcification]. ZHONGHUA XIN XUE GUAN BING ZA ZHI 2021; 49:1267-1271. [PMID: 34905910 DOI: 10.3760/cma.j.cn112148-20211102-00945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Affiliation(s)
- J J Han
- Department of Cardiology, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou 510000, China
| | - J W Gao
- Department of Cardiology, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou 510000, China
| | - P M Liu
- Department of Cardiology, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou 510000, China
| | - J F Wang
- Department of Cardiology, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou 510000, China
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Luo NS, Zhang HF, Liu PM, Lin YQ, Huang TC, Yang Y, Wang JF. [Diagnostic value of combining serum soluble ST2 and interleukin-33 for heart failure patients with preserved left ventricular ejection fraction]. Zhonghua Xin Xue Guan Bing Za Zhi 2017; 45:198-203. [PMID: 28316175 DOI: 10.3760/cma.j.issn.0253-3758.2017.03.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: Diagnostic efficacy of serum markers is low for heart failure patients with preserved left ventricular ejection fraction (HF-pEF) as compared to heart failure patients with reduced left ventricular ejection fraction.We sought to explore the diagnostic value of serum levels of soluble ST2 (sST2) combined with interleukin-33 (IL-33) for the diagnosis of HF-pEF in this study. Methods: A total of 376 patients with HF-pEF (HF group), 376 matched-control patients without heart failure who shared similar clinical characteristics (non-HF group) were included in the study.Another 500 healthy individuals were recruited for assessing the normal ranges of IL-33 and sST2.Serum levels of NT-proBNP were measured by chemi-luminescence assay, while IL-33 and sST2 were measured by enzyme linked immunosorbent assay. Results: Serum levels of IL-33 and sST2 were not normally distributed in healthy population.Serum concentrations of IL-33 and sST2 were significantly higher in HF-pEF patients than in patients in non-HF group (median, IL-33: 0.437 μg/L vs. 0.127 μg/L, P<0.01; sST: 0.118 μg/L vs. 0.067 μg/L, P<0.01). The area under receiver operating characteristic curve (AUC) of sST2 for detecting HF-pEF was 0.763 (95%CI 0.729-0.795, P<0.01), with 71.01% sensitivity and 66.75% specificity, the AUC was 0.884 (95%CI 0.859-0.908, P<0.01), with 80.05% sensitivity and 81.91% specificity in patients with serum IL-33 higher than 0.117 μg/L (median level of serum IL-33 in healthy individuals, n=306). The AUC of NT-proBNP for detecting HF-pEF was 0.83, with 74.73% sensitivity and 84.57% specificity.The AUC of sST2 for detecting HF-pEF was significantly higher than NT-proBNP in population with high serum IL-33 (AUC: 0.88 vs. 0.83, P<0.01). Conclusion: Serum sST2 could serve as a satisfactory biomarker for HF-pEF diagnosis, especially for patients with high serum IL-33 concentrations.
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Affiliation(s)
- N S Luo
- Department of Cardiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangdong Province Key Laboratory of Arrhythmia and Electrophysiology, Guangzhou 510120, China
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Deng YJ, Zhang SL, Liu PM, Mai LF, Tang JY, Yan L. [Comparison on metabolic disorders and uric acid levels between patients with primary aldosteronism and essential hypertension]. Zhonghua Xin Xue Guan Bing Za Zhi 2016; 44:743-749. [PMID: 27667270 DOI: 10.3760/cma.j.issn.0253-3758.2016.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To compare the incidence of metabolic disorders and uric acid (UA) levels between patients with primary aldosteronism (PA) and essential hypertension (EH), and to explore factors associated with UA levels in these patients. Methods: A total of 117 PA and 117 EH patients individually matched by sex, age, blood pressure and duration of hypertension were recruited from in-hospital patients who were hospitalized in our department because of suspicion of secondary hypertension from January 2008 to December 2014. Clinical data including metabolic disorders and UA levels were analyzed. Results: (1) Body mass index (BMI), waist circumference, plasma triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), free fatty acid (FFA) were significantly higher in EH than in PA group (all P<0.05). Prevalence of diabetes mellitus or impaired glucose tolerance (DM+ IGT) was significantly higher in EH than in PA group (41.9% (49/117) vs. 17.1% (20/117), P<0.01). The prevalence of metabolic syndrome (MS) was also significantly higher in EH than in PA group (51.3% (60/117) vs. 24.8% (29/117), P<0.01). (2) EH patients had higher homeostasis model assessment for insulin resistance (HOMA-IR) and lower insulin sensitivity index composite (ISI comp) than PA patients, but basic insulin secretion index (HOMA-β) and modified β cell function index (MBCI) were significantly lower in PA than in EH group (P<0.05). (3) With regard to target organs damages, PA patients revealed higher 24-hour urinary protein, urinary albumin excretion rate (UAER), urinary IgG, urinary α-1 microglobulin, left ventricular mass index and lower urine specific gravity than EH patients (all P<0.05). There was no significant difference in estimated glomerular filtration rate (eGFR) between two groups (P=0.103). (4) UA level was significantly lower in PA group than in EH group ((314.00±89.52) μmol/L vs. (379.16±101.25) μmol/L, P<0.01). Higher plasma aldosterone concentration and lower plasma renin activity were associated with lower UA level in PA group. Conclusions: Compared with sex, age and hypertension duration matched EH patients, PA patients revealed lower UA level and less severe abnormalities of glucose and lipid metabolism, but are associated with severer renal and cardiac damages. The reduced UA level in PA patients is possibly due to the high plasma aldosterone concentration and low plasma renin activity.
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Affiliation(s)
- Y J Deng
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China
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Chong Tou TJ, Liu PM, Wang JF, Sio Cham ZC, O U YF, Lei Sio ZW, Lei Put PZ, Lei Sok SM, Zhou SX, Wu W. [Impact of novel P2Y12 receptor inhibitors on platelet reactivity in acute coronary syndrome patients undergoing percutaneous coronary intervention]. Zhonghua Xin Xue Guan Bing Za Zhi 2016; 44:138-43. [PMID: 26926507 DOI: 10.3760/cma.j.issn.0253-3758.2016.02.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To investigate the impact of novel P2Y(12) receptor inhibitors including prasugrel or ticagrelor on platelet reactivity in patients with acute coronary syndrome (ACS) receiving percutaneous coronary intervention (PCI), and provide clinical data for novel oral P2Y(12) receptor inhibitors use among Chinese patients. METHODS Between October 2011 to February 2014, 174 consecutive patients (135 males; (67.8±11.8) years old) with ACS undergoing PCI in Kiang Wu Hospital, Macau were prospectively enrolled in this study. Oral aspirin and one P2Y(12) receptor inhibitor were administered for 5 days or above after PCI, patients were divided into clopidogrel, prasugrel and ticagrelor groups in accordance with the agent administered. Platelet reactivity of the patients was detected by VerifyNow P2Y(12) reaction unit (PRU); and the high on-treatment platelet reactivity (HPR) and non-HPR were defined as PRU≥208 and PRU<208 respectively. Patients with HPR during clopidogrel therapy were switched either to prasugrel or ticagrelor, or continued the same treatment; and then the platelet reactivity was monitored again. RESULTS There were 113 clopidogrel cases (64.9%), 20 prasugrel cases (11.5%) and 41 ticagrelor cases (23.6%). Fifty-seven cases (32.8%) were defined as HPR post P2Y(12) receptor inhibitor use, in which 55 cases (55/113, 48.7%) were treated with clopidogrel. The degree of inhibition of platelet reactivity was significantly different in patients on clopidogrel, prasugrel and ticagrelor therapy, percent inhibition assayed by the VerifyNow P2Y(12) system was 28.2%±23.5%, 61.4%±26.7% and 81.3%±19.8% respectively (P<0.05). Different degree of platelet reactivity was achieved by the 3 P2Y(12) receptor inhibitors at multiple time points. The among-group differences in platelet reactivity became apparent at the early treatment stage (P<0.05). Platelet aggregation decreased significantly in patients switched from clopidogrel to prasugrel or ticagrelor (P<0.05). CONCLUSION Novel oral P2Y(12) receptor inhibitors are more effective in inhibiting platelet reactivity in ACS patients, and our results show that novel oral P2Y(12) receptor inhibitors provide a new option for ACS patients with HPR post clopidogrel or high-risk features of ischemic complications, including stent thrombosis and post-PCI ischemic events.
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Affiliation(s)
- T J Chong Tou
- Department of Cardiology, Kiang Wu Hospital, Macau 999078, China
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Yin HC, Liu XY, Liu PM, Zhang H, Liang P, Wang ZL, She MP. [Effect of mm-LDL on NF-kB activation in endothelial cell]. Zhongguo Yi Xue Ke Xue Yuan Xue Bao 2001; 23:312-6. [PMID: 12940066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
Abstract
OBJECTIVE To investigate the signal transduction pathway of NF-kB activated by minimally modified low density lipoprotein (mm-LDL) in endothelial cells and the effect of NF-kB on platelet derived growth factor b (PDGFb) mRNA expression. METHODS mm-LDL was prepared through iron oxidation by dialyzing the native LDL against FeSO4 in PBS. Endothelial cells were incubated in a medium containing mm-LDL, TNF, and IL-1 respectively and electrophoretic mobility shift assay (EMSA) was displayed to check on the activation of NF-kB. Luciferase reporter gene was analysed to investigate the effect of nuclear factor inducing kinase (NIK), inhibitor of NF-kB kinase alpha (IKK alpha) and inhibitor of NF-kB kinase beta (IKK beta) on NF-kB activation. In addition, endothelial cells were transfected using PDGFb promoter-luciferase for reporter gene analysis or transfected with mut-NIK for slot blot analysis to study the effect of NF-kB on PDGFb mRNA expression. RESULTS mm-LDL was able to activate NF-kB in endothelial cells. mut-NIK and mut-IKK beta inhibited luciferase activity induced by mm-LDL. mm-LDL could also enhance luciferase activity controlled by upstream sequence of PDGFb promoter which contains element interacting with NF-kB. Result of slot blot showed inhibition of PDGFb mRNA expression by mut-NIK in the endothelial cells stimulated by mm-LDL. CONCLUSION mm-LDL may activate NF-kB through NIK-IKK beta pathway and promote PDGFb mRNA expression in endothelial cells.
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Affiliation(s)
- H C Yin
- Department of Pathology, Institute of Basic Medical Sciences, CAMS and PUMC, Beijing 100005, China
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Wu W, Zhang XM, Liu PM, Li JM, Wang JF. Effects of Panax notoginseng saponin Rg1 on cardiac electrophysiological properties and ventricular fibrillation threshold in dogs. Zhongguo Yao Li Xue Bao 1995; 16:459-63. [PMID: 8701769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
AIM To study the effects of Rg1 isolated from saponins of Panax notoginseng on cardiac electrophysiological properties and ventricular fibrillation threshold (VFT). METHODS Seventeen open-chest dogs were randomly allocated into a Rg1 group (20 mg kg-1, iv) and a control group. The electrophysiological variables and VFT were evaluated by standard electric stimuli and monophasic action potential (MAP) recording. RESULTS Rg1 prolonged sinus node recovery time (SNRT) by 19.1%, AV conduction Wenckebach cycle length (AVWCL) by 7.1%, and ventricular effective refractory period (VERP) by 7.9%. It prolonged ventricular MAPD30, MAPD50, and MAPD90 by 25.5%, 24.2%, and 13.5%, respectively. VFT was increased by 19.2%. CONCLUSION Rg1 prolonged ventricular refractoriness and repolarization, and increased VFT. It was indicated that cardiac electrophysiological effects of Rg1 were similar to those of amiodarone.
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Affiliation(s)
- W Wu
- Department of Internal Medicine, Sun Yat-Sen University of Medical Sciences, Guangzhou, China
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Abstract
The dramatic improvement in smooth pursuit performance seen while analyzing the pursuit target has been ascribed to attention enhancement. With a periodic constant velocity target trajectory we ran a concurrent listening condition instead, to see if this mild distraction would degrade performance. Performance improved somewhat with the listening task, suggesting that displacing attentional effort from pursuit accuracy, rather than increasing it, brings better pursuit performance. Catch-up saccades were evenly distributed across tracking, listening, and target analysis conditions, but anticipatory and overshooting saccades were almost eliminated with target analysis. Thus the poor pursuit seems to have been caused by anticipatory and overshooting saccades, produced erroneously in the attempt to perform purposive smooth pursuit. Pursuit velocity immediately following anticipatory saccades was reduced such that the target would catch up with the point of gaze when it reached the endpoint of its trajectory, indicating a predictive goal other than instantaneous target foveation and velocity match.
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Affiliation(s)
- P Van Gelder
- Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY 10962
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Kinukawa N, Sheikh A, Liu PM, Moriuchi M, Honye J, Saito S, Kanmatsuse K, Sakurai I. Comparative evaluation of atherosclerotic lesions. Intravascular ultrasound imaging and pathomorphology. Ann N Y Acad Sci 1995; 748:494-7. [PMID: 7695192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Affiliation(s)
- N Kinukawa
- Second Department of Pathology, Nihon University School of Medicine, Tokyo, Japan
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Liu PM, Zhang XM, Wu W, Li JM, Tang Y. Comparison of cardiac electrophysiologic effects of experimental hypothyroidism and chronic oral amiodarone administration in dogs. Chin Med J (Engl) 1994; 107:375-9. [PMID: 7924581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
A comparative study on ventricular electrophysiologic effects of experimental hypothyroidism and chronic oral amiodarone administration was made in canine models, with the application of electrical stimulation and monophasic action potential recording. The results showed similar effects possessed by hypothyroidism and amiodarone, which included prolongations in ventricular repolarization and refractoriness, an increase in ventricular fibrillation threshold, and a decrease in the incidence of reperfusion ventricular fibrillation. The differences were that hypothyroidism primarily lengthened phase 2 repolarization and had no effects on intraventricular conduction time, whereas amiodarone lengthened both phase 2 and phase 3 repolarization and suppressed myocardial conduction velocity.
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Affiliation(s)
- P M Liu
- Department of Medicine, Sun Yat-sen Memorial Hospital, Sun Yat-sen University of Medical Sciences, Guangzhou
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