Publications by authors named "Jing Qin"

643 Publications

Automatic Schizophrenia Detection Using Multimodality Media via a Text Reading Task.

Front Neurosci 2022 14;16:933049. Epub 2022 Jul 14.

College of Biomedical Engineering, Sichuan University, Chengdu, China.

Schizophrenia is a crippling chronic mental disease that affects people worldwide. In this work, an automatic schizophrenia detection algorithm is proposed based on the reading deficit of schizophrenic patients. From speech and video modalities, the automatic schizophrenia detection algorithm illustrates abnormal speech, head movement, and reading fluency during the reading task. In the speech modality, an acoustic model of speech emotional flatness in schizophrenia is established to reflect the emotional expression flatness of schizophrenic speech from the perspective of speech production and perception. In the video modality, the head-movement-related features are proposed to illustrate the spontaneous head movement caused by repeated reading and unconscious movement, and the reading-fluency-related features are proposed to convey the damaged degree of schizophrenic patients' reading fluency. The experimental data of this work are 160 segments of speech and video data recorded by 40 participants (20 schizophrenic patients and 20 normal controls). Combined with support vector machines and random forest, the accuracy of the proposed acoustic model, the head-movement-related features, and the reading-fluency-related features range from 94.38 to 96.50%, 73.38 to 83.38%, and 79.50 to 83.63%, respectively. The average accuracy of the proposed automatic schizophrenia detection algorithm reaches 97.50%. The experimental results indicate the effectiveness of the proposed automatic detection algorithm as an auxiliary diagnostic method for schizophrenia.
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http://dx.doi.org/10.3389/fnins.2022.933049DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9331283PMC
July 2022

Novel Self-Assembled Micelles With Increased Tumor Penetration and Anti-Tumor Efficiency Against Breast Cancer.

Pharm Res 2022 Jul 29. Epub 2022 Jul 29.

Department of Pharmaceutics, School of Pharmacy, Fudan University & Key Laboratory of Smart Drug Delivery, Ministry of Education, Shanghai, 201203, People's Republic of China.

Purpose: Recently, docetaxel (DTX) micelles based on retinoic acid derivative surfactants showed lower systemic toxicity and bioequivalence to polysorbate-solubilized docetaxel (Taxotere®) in a phase II clinical study. However, the poor stability of these surfactants in vitro and in vivo led to extremely harsh storage conditions with methanol, and the formed micelles were quickly disintegrated with rapid drug burst release in vivo. To further enhance the stability and accumulation in tumors of DTX micelles, a novel surfactant based on acitretin (ACMeNa) was synthesized and used to prepare DTX micelles to improve anti-tumor efficiency.

Methods: Novel micelle-forming excipients were synthesized, and the micelles were prepared using the thin film hydration technique. The targeting effect in vitro, distribution in the tumor, and its mechanism were observed. Pharmacokinetics and anti-tumor effect were further investigated in rats and tumor-bearing female mice, respectively.

Results: The DTX-micelles prepared with ACMeNa (ACM-DTX) exhibited a small size (21.9 ± 0.3 nm), 39% load efficiency, and excellent stability in vitro and in vivo. Long circulation time, sustained and steady accumulation, and strong penetration in the tumor were observed in vivo, contributing to a better anti-tumor effect and lower adverse effects.

Conclusions: The micelles formed by ACMeNa showed a better balance between anti-tumor and adverse effects. It is a promising system for delivering hydrophobic molecules for cancer therapy.
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http://dx.doi.org/10.1007/s11095-022-03338-3DOI Listing
July 2022

XIST as a valuable biomarker for prognosis and clinical parameters in diverse tumors: a comprehensive meta- and bioinformatics analysis.

Neoplasma 2022 Jul 29. Epub 2022 Jul 29.

Department of General Surgery, Changhai Hospital, Second Military Medical University, Shanghai, China.

Long non-coding RNA (lncRNA) X inactivate-specific transcript (XIST) has been found dysregulated in a variety of human tumors and influenced the clinicopathologic characteristics in cancer patients. Therefore, we systematically searched relevant literature that has identified the correlation of lncRNA XIST expression and clinical outcomes of tumor patients and conducted this meta-analysis to elucidate the clinical prognostic value of long noncoding RNA XIST in human tumors. A comprehensive literature search was performed from PubMed, Web of Science, EMBASE, and Cochrane library databases up to August 1, 2019. Pooled hazard ratios (HRs) or odds ratios (ORs) with 95% confidence interval (95% Cl) were calculated to evaluate the prognosis, as well as the clinicopathological parameters of XIST, respectively. We also further validated this meta-analysis using The Cancer Genome Atlas (TCGA) dataset. Results The outcome revealed that XIST overexpression in tumor tissue was interacted to a poor overall survival (OS) (HR = 0.52, 95% CI: 0.44-0.61, p < 0.0001), disease-free survival (DFS) (HR = 0.50; 95% CI: 0.36-0.69, p < 0.0001), tumor type (digestive system malignancies, HR = 0.53; 95% CI: 0.44-0.63, p < 0.0001); nondigestive system malignancies, HR = 0.48; 95% CI: 0.34-0.67, p < 0.0001), lymph node metastasis(LNM) (OR = 0.61, 95% CI: 0.37-1.00; p = 0.048), differentiation (OR = 1.46; 95% CI 0.94-2.29; p=0.096), distant metastasis (DM) (OR=0.48, 95% CI: 0.31-0.75; p = 0.001), tumor size (OR = 0.59, 95% CI: 0.38-0.92; p = 0.019), and tumor stage (OR = 2.36; 95% CI: 1.62-3.43; p < 0.001). Conclusions XIST could have potential value in early diagnosis and result in prediction and provided a novel view for the therapeutic target in clinical application.
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http://dx.doi.org/10.4149/neo_2022_220329N352DOI Listing
July 2022

Comparison of the efficacy and safety of first-line treatments based on clinicopathological characteristics for patients with advanced epidermal growth factor receptor mutated non-small-cell lung cancer: A systematic review and network meta-analysis.

Crit Rev Oncol Hematol 2022 Jul 21;177:103760. Epub 2022 Jul 21.

Department of Medical Oncology, Qilu Hospital of Shandong University, 107 Wenhuaxi Road, Jinan, Shandong, 250012, China. Electronic address:

Background: A growing number of regimens have been approved as first-line treatments for patients with advanced epidermal growth factor receptor (EGFR) mutated non-small cell lung cancer. However, the optimal regimen has not been determined, especially for patients with different clinicopathological characteristics. Therefore, we performed this meta-analysis to compare the efficacy and safety of first-line treatments for patients with EGFR-mutated NSCLC based on clinicopathological characteristics, thereby providing evidence for individual patient clinical decision-making.

Methods: The PubMed, Embase, Cochrane Library databases, and abstracts of ASCO, ESMO, and WCLC were searched from inception to 3 June 2021 to identify eligible randomized controlled trials (RCTs). The outcomes of progression-free survival (PFS), overall survival (OS), objective response rate (ORR), and grade 3 or higher adverse events (≥3AEs) were compared and ranked based on various clinicopathological characteristics among 14 regimens by network meta-analysis (NMA) and the surface under the cumulative ranking curve (SUCRA), respectively.

Results: 25 RCTs were included, with a total of 6965 patients and 14 treatment regimens. The primary endpoint of all RCTs was PFS, and OS, ORR, and ≥3AEs were secondary endpoints. Regarding overall patients, the most distinct PFS benefit was observed in osimertinib (OSI), with the fewest ≥3AEs, whereas gefitinib plus pemetrexed-based chemotherapy (GEF+PB) provided the greatest benefit for OS. When considering EGFR mutation type, aumolertinib (AUM) and GEF+PB could be the optimal regimens in terms of PFS for patients with EGFR 19DEL and EGFR 21L858R, respectively. Notably, the efficacy of the 14 regimens for PFS varied across clinicopathological characteristics, with GEP+PB ranking first in Eastern Cooperative Oncology Group performance status (ECOG PS)= 1, Asian, age<65 and smoking subgroups, with AUM ranking first in ECOG PS= 0 and female subgroups, with ICO+PB ranking first in age ≥65 and no smoking subgroups, and with AFA+CET ranking first in the male subgroup. In terms of brain metastases, third-generation EGFR-TKI showed obvious superiority, with AUM and OSI optimally prolonging PFS in patients with and without brain metastases, respectively. In addition, GEF+PB is a superior alternative, ranking second in terms of PFS regardless of the presence of brain metastases.

Conclusions: OSI and GEF+PB were the most two effective first-line regimens for overall patients, ranking first in PFS and OS, respectively. GEF+PB ranked first in terms of PFS in subgroups of EGFR 21L858R, ECOG PS= 1, Asian, age <65, and smoking. Meanwhile, AUM in subgroups of EGFR 19DEL, ECOG PS= 0, female, brain metastasis, OSI in the subgroup of without brain metastasis, ICO+PB in no smoking subgroup, and AFA+CET in male subgroup were the best options as for their evident superiority in PFS.
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http://dx.doi.org/10.1016/j.critrevonc.2022.103760DOI Listing
July 2022

Offset-decoupled deformable convolution for efficient crowd counting.

Sci Rep 2022 Jul 18;12(1):12229. Epub 2022 Jul 18.

Department of Educational Technology, Ocean University of China, Qingdao, 266100, China.

Crowd counting is considered a challenging issue in computer vision. One of the most critical challenges in crowd counting is considering the impact of scale variations. Compared with other methods, better performance is achieved with CNN-based methods. However, given the limit of fixed geometric structures, the head-scale features are not completely obtained. Deformable convolution with additional offsets is widely used in the fields of image classification and pattern recognition, as it can successfully exploit the potential of spatial information. However, owing to the randomly generated parameters of offsets in network initialization, the sampling points of the deformable convolution are disorderly stacked, weakening the effectiveness of feature extraction. To handle the invalid learning of offsets and the inefficient utilization of deformable convolution, an offset-decoupled deformable convolution (ODConv) is proposed in this paper. It can completely obtain information within the effective region of sampling points, leading to better performance. In extensive experiments, average MAE of 62.3, 8.3, 91.9, and 159.3 are achieved using our method on the ShanghaiTech A, ShanghaiTech B, UCF-QNRF, and UCF_CC_50 datasets, respectively, outperforming the state-of-the-art methods and validating the effectiveness of the proposed ODConv.
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http://dx.doi.org/10.1038/s41598-022-16415-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9293988PMC
July 2022

A Theoretical Review on the Role of English as a Foreign Language Teachers' Self-Disclosure in Shaping Classroom Climate and Immediacy.

Authors:
Jing Qin

Front Psychol 2022 1;13:945046. Epub 2022 Jul 1.

School of Foreign Languages, Xinxiang Medical University, Xinxiang, China.

Teachers' interpersonal communication skills and strategies have been widely considered effective pedagogical tools in academia. Despite the growing research in this area, unraveling the power of English as a foreign language (EFL) teachers' self-disclosure in shaping classroom climate and immediacy has been relatively left intact. To fill the gap and provide new insights into this strand of research, the present article was an effort to present a theoretical analysis of the interplay of self-disclosure, classroom climate, and immediacy. In so doing, the definitions, conceptualizations, dimensions, underlying theories, and empirical evidence in support of the interaction among these three constructs were presented. Moreover, practical implications for EFL teachers, teacher trainers, and L2 scholars were provided to raise their awareness of interpersonal communication skills and their outcomes in academia. Finally, the study provided some suggestions for further research in this line of inquiry.
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http://dx.doi.org/10.3389/fpsyg.2022.945046DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9284208PMC
July 2022

PLOD3 contributes to HER-2 therapy resistance in gastric cancer through FoxO3/Survivin pathway.

Cell Death Discov 2022 Jul 14;8(1):321. Epub 2022 Jul 14.

Department of General Surgery, Gastric Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai, 200032, China.

Human epidermal growth factor receptor 2 (HER-2), a famous therapeutic target for breast cancer, is also associated with an increased risk of recurrence and poor outcomes of other malignancies, including gastric cancer. Yet the mechanism of HER-2 therapy resistance remains controversial due to the heterogeneity of gastric adenocarcinoma. We know, Procollagen-Lysine,2-Oxoglutarate 5-Dioxygenase 3 (PLOD3), a key gene coding enzymes that catalyze the lysyl hydroxylation of extracellular matrix collagen, plays an important contributor to HER-2 targeting agent Trastuzumab resistance in gastric cancer. Herein, we analyzed clinical samples of gastric cancer patients and gastric cancer cell lines and identified PLOD3, unveiled that depletion of PLOD3 leads to decreased cell proliferation, tumor growth and Trastuzumab sensitivity in these Trastuzumab resistant GC cell lines. Clinically, increased PLOD3 expression correlates with decreased Trastuzumab therapy responsiveness in GC patients. Mechanistically, we show that PLOD3 represses tumor suppressor FoxO3 expression, therefore upregulating Survivin protein expression that contributes to Trastuzumab resistance in GC. Therefore, our study identifies a new signaling axis PLOD3-FoxO3- Survivin pathway that may be therapeutically targeted in HER-2 positive gastric cancer.
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http://dx.doi.org/10.1038/s41420-022-01103-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9283410PMC
July 2022

Online Education Satisfaction Assessment Based on Machine Learning Model in Wireless Network Environment.

Authors:
Jing Qin

Comput Math Methods Med 2022 29;2022:7958932. Epub 2022 Jun 29.

Criminal Investigation Police University of China, Shenyang, 110854 Liaoning, China.

With the development of wireless network technology, the transformation of educational concepts, the upgrading of users' educational needs, and the transformation of lifestyles, online education has made great strides forward. However, due to the rapid growth of online education in my country, many regulatory systems have not kept pace with the development of online education, resulting in low user experience and satisfaction with online education. The establishment of a user satisfaction model is beneficial for attracting attention and thinking about research in the field of online education service quality, assisting enterprises in recognizing the specific impact of various factors in services, accelerating service quality improvement, and assisting in the formulation of industry norms and improving enterprise competitiveness, all of which help students acquire knowledge more easily. In the era of big data, traditional satisfaction evaluation methods have many drawbacks, so more and more machine learning methods are applied to satisfaction evaluation models. This paper takes the research of machine learning algorithm as the core to carry out the research work, uses the cost-sensitive idea to improve the decision tree, considers the cost of different types of classification errors, and uses the random forest principle to integrate the generated decision tree, thereby improving the accuracy of the model. The model has better stability, and the validity of the model is verified by experiments. For a follow-up in-depth investigation of online education satisfaction rating technology, the linked work of this paper has certain reference and reference value.
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http://dx.doi.org/10.1155/2022/7958932DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9259360PMC
July 2022

[Imaging in the Diagnosis of Breast Cancer in Elderly Women].

Zhongguo Yi Xue Ke Xue Yuan Xue Bao 2022 Jun;44(3):478-483

Department of Ultrasound,PUMC Hospital,CAMS and PUMC,Beijing 100730,China.

The breast cancer diagnosed in the women at or above age 70 is defined as breast cancer in the elderly.As the population keeps aging,breast cancer in the elderly presents increasing incidence and high mortality.Early detection,early diagnosis,and early treatment might improve the prognosis of these patients. Comprehensively evaluating the functional age of elderly patients is essential for the individualized treatment. Medical imaging plays a key role in the screening,early diagnosis,therapy selection,evaluation of neoadjuvant therapy efficacy,and postoperative follow-up.We reviewed the current literature and focused on the role of medical imaging in the diagnosis and treatment recommendations for breast cancer in the elderly.
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http://dx.doi.org/10.3881/j.issn.1000.503X.13733DOI Listing
June 2022

Development and validation of bone-suppressed deep learning classification of COVID-19 presentation in chest radiographs.

Quant Imaging Med Surg 2022 Jul;12(7):3917-3931

Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hong Kong, China.

Background: Coronavirus disease 2019 (COVID-19) is a pandemic disease. Fast and accurate diagnosis of COVID-19 from chest radiography may enable more efficient allocation of scarce medical resources and hence improved patient outcomes. Deep learning classification of chest radiographs may be a plausible step towards this. We hypothesize that bone suppression of chest radiographs may improve the performance of deep learning classification of COVID-19 phenomena in chest radiographs.

Methods: Two bone suppression methods (Gusarev and Rajaraman ) were implemented. The Gusarev and Rajaraman methods were trained on 217 pairs of normal and bone-suppressed chest radiographs from the X-ray Bone Shadow Suppression dataset (https://www.kaggle.com/hmchuong/xray-bone-shadow-supression). Two classifier methods with different network architectures were implemented. Binary classifier models were trained on the public RICORD-1c and RSNA Pneumonia Challenge datasets. An external test dataset was created retrospectively from a set of 320 COVID-19 positive patients from Queen Elizabeth Hospital (Hong Kong, China) and a set of 518 non-COVID-19 patients from Pamela Youde Nethersole Eastern Hospital (Hong Kong, China), and used to evaluate the effect of bone suppression on classifier performance. Classification performance, quantified by sensitivity, specificity, negative predictive value (NPV), accuracy and area under the receiver operating curve (AUC), for non-suppressed radiographs was compared to that for bone suppressed radiographs. Some of the pre-trained models used in this study are published at (https://github.com/danielnflam).

Results: Bone suppression of external test data was found to significantly (P<0.05) improve AUC for one classifier architecture [from 0.698 (non-suppressed) to 0.732 (Rajaraman-suppressed)]. For the other classifier architecture, suppression did not significantly (P>0.05) improve or worsen classifier performance.

Conclusions: Rajaraman suppression significantly improved classification performance in one classification architecture, and did not significantly worsen classifier performance in the other classifier architecture. This research could be extended to explore the impact of bone suppression on classification of different lung pathologies, and the effect of other image enhancement techniques on classifier performance.
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http://dx.doi.org/10.21037/qims-21-791DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9246721PMC
July 2022

circEPSTI1 promotes tumor progression and cisplatin resistance via upregulating MSH2 in cervical cancer.

Aging (Albany NY) 2022 07 2;14(13):5406-5416. Epub 2022 Jul 2.

Department of Obstetrics and Gynecology, Nanfang Hospital of Southern Medical University, Guangzhou, Guangdong, China.

CircRNAs (circRNAs) are a kind of non-coding RNAs which are extensively distributed in tissues. Previous investigations reported that circRNAs harbor indispensable roles in modulating the progress of multiple cancers. Nevertheless, the function along with the molecular mechanism of most circRNAs in cervical cancer progression was still not clear. Herein, we illustrated that circEPSTI1 is a remarkably upregulated circRNA, which we validated in tissues with cervical cancer along with cell lines. The biological role of circEPSTI1 in the advancement of cervical cancer was probed via loss-of function assessments. Silencing circEPSTI1 could diminish the proliferative capacity of the cervical cancer cells to spread. In cervical cancer cells, silencing circEPSTI1 dramatically elevated drug responsivity to cisplatin. Mechanically, RNA immuno-precipitation experiments and dual luciferase enzyme reporter experiments were conducted to reveal the molecular mechanism of circEPSTI1 in cervical cancer. In conclusion, this research premise identified the biological function of circEPSTI1-miR-370-3p-MSH2 axis in cervical cancer progression. Our result is significant for slowing the progress of and overcoming drug resistance of cervical cancer.
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http://dx.doi.org/10.18632/aging.204152DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9320557PMC
July 2022

Preparation, characterization and immunoregulatory activity of derivatives of polysaccharide from Atractylodes lancea (Thunb.) DC.

Int J Biol Macromol 2022 Jun 23;216:225-234. Epub 2022 Jun 23.

School of Food and Pharmaceutical Engineering, Nanjing Normal University, Nanjing 210023, PR China. Electronic address:

A polysaccharide (ALP-1) extracted from Atractylodes lancea (Thunb.) DC. was carboxymethylated (C-ALP-1), phosphorylated (P-ALP-1) and acetylated (A-ALP-1) to improve its physicochemical properties and bioactivities. The solubility of all derivatives was increased, and the solubility of A-ALP-1 increased to 137.5 mg/mL, which was much higher than the solubility of ALP-1 (15.0 mg/mL). The results of HPSEC-MALLS-RID showed that the molecular weight of polysaccharides was slightly increased after the modification, and the root mean square radius of rotation (Rz) and morphology of polysaccharides in solution were also changed. The scanning electron microscopy (SEM) and X-ray diffraction (XRD) results confirmed that the surface morphology of ALP-1 changed dramatically and the crystallinity decreased after structural modification. From thermal analysis results, the T of ALP-1, C-ALP-1, P-ALP-1 and A-ALP-1 were 281.34, 292.14, 333.75 and 298.70 °C, which showed that derivatives had stronger thermal stability than ALP-1. The immunomodulatory activity studies displayed that P-ALP-1 showed the best ability to stimulate RAW264.7 macrophages to release NO, and A-ALP-1 showed the best capacity to stimulate TNF-α and IL-6 releasing. These results indicated that chemical modification could enhance the solubility, the thermal stability and immunomodulatory activity of polysaccharides, which is beneficial for the development and utilization of natural polysaccharides.
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http://dx.doi.org/10.1016/j.ijbiomac.2022.06.122DOI Listing
June 2022

Effect of Y on Recrystallization Behavior in Non-Oriented 4.5 wt% Si Steel Sheets.

Materials (Basel) 2022 Jun 15;15(12). Epub 2022 Jun 15.

School of Mechanical and Electrical Engineering, Jiangxi University of Science and Technology, Ganzhou 341000, China.

4.5 wt% Si steel sheets with four different yttrium (Y) contents (0, 0.006, 0.012 and 0.016 wt%) were fabricated by hot rolling, normalizing, warm rolling and a final annealing process. Y addition greatly weakened the γ -fiber (⟨111⟩//ND) texture and enhanced the {001} ⟨130⟩ and {114} ⟨481⟩ texture components, and the magnetic properties were improved related to the effects of Y on the recrystallized grain nucleation. Y segregation at the grain boundaries inhibited the nucleation of {111} oriented grains at grain boundaries, which was beneficial to the nucleation and growth of other oriented grains elsewhere. At the same rolling reduction, YOS inclusion caused more stress concentration than AlO inclusion. YOS in deformed grains with low energy storage provided more preferential nucleation sites for {001} ⟨130⟩ and {114} ⟨481⟩ grains. Strong {001} ⟨130⟩ and {114} ⟨481⟩ recrystallization textures due to the high mobility were obtained in samples containing 0.012 wt% Y.
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http://dx.doi.org/10.3390/ma15124227DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9230852PMC
June 2022

Ca-based neural activity recording for rapidly screening behavioral correlates of the claustrum in freely behaving mice.

Biomed Res 2022 ;43(3):81-89

Center for Neurointelligence, School of Medicine, Chongqing University.

The claustrum has been hypothesized to participate in high-order brain functions, but experimental studies to demonstrate these functions are currently lacking. Neural activity recording of the claustrum in freely-behaving animals allows for correlating claustral activities with specific behaviors. However, previously utilized methods for studying the claustrum make it difficult to monitor neural activity patterns of freely-behaving animals in real time. Here we applied fiber photometry to monitor Ca activity in the claustrum of freely-behaving mice. Using this method, we were able to achieve Ca activity recording in both anesthetized and freely-behaving mice. We found that the dynamics of Ca activity depended on anesthesia levels. As compared to the use of genetically encoded Ca indicators that requires a few weeks of virus-dependent expression, we used a synthetic fluorescent Ca-sensitive dye, Oregon green 488 BAPTA-1, that allows for rapidly screening neural activity of interest within a few hours that relates to certain behaviors. In this way, we found the correlation between Ca activity and specific behaviors, such as approaching an object. Our work offers an effective method for recording neural activity in the claustrum and thus for rapidly screening any behavioral relevance of the claustrum in freely-behaving mice.
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http://dx.doi.org/10.2220/biomedres.43.81DOI Listing
June 2022

Can Pre-biopsy Second-Look Breast Ultrasound Affect Clinical Management? Experience From a Single Tertiary Hospital.

Front Oncol 2022 31;12:901757. Epub 2022 May 31.

Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.

Objectives: Interpretation discrepancy is a major disadvantage of breast imaging. This study aimed to determine the clinical benefit of the pre-biopsy second-look breast ultrasound (US).

Methods: Patients with suspicious breast masses referred to our tertiary hospital for US-guided breast biopsy were retrospectively reviewed between August 2017 and November 2019. Here, second-look assessments were performed by experienced specialized breast radiologists performing a bilateral breast US scan plus reviewing former imaging studies, and results were compared with the initial assessment. Interpretation changes in terms of biopsy recommendation and surgical management (i.e., lumpectomy to mastectomy) were analyzed.

Results: A total of 537 patients were enrolled in this study. Interpretation discrepancies occurred in 109 patients (20%; 95% CI, 17%-24%). Among them, there were 84 patients (16%; 95% CI, 13%-19%) whose masses were re-classified as BI-RADS 3 by the second-look US and underwent 2-year follow-up, showing 82 benign, 1 malignant, and 1 high-risk lesions. On the other hand, 16 patients (3%; 95% CI, 2%-5%) undertook biopsy at an additional site, identifying 10 new malignant lesions, 3 high-risk lesions, and 3 benign lesions, resulting in surgical management changes in 12 patients. In addition, nine (2%; 95% CI, 1%-3%) patients received discrepant disease ranges, which also altered surgical management. Overall, 21 patients (4%; 95% CI, 3%-6%) got their surgical management altered by the second-look US.

Conclusion: Pre-biopsy second-look assessment of breast US can reduce unnecessary biopsies in 16% of patients and alter surgical management in 4% of patients, suggesting it is a practical and valuable method for patient care improvement.
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http://dx.doi.org/10.3389/fonc.2022.901757DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9192959PMC
May 2022

Empagliflozin modulates CD4 T-cell differentiation via metabolic reprogramming in immune thrombocytopenia.

Br J Haematol 2022 Jun 8. Epub 2022 Jun 8.

Department of Hematology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.

Immune thrombocytopenia (ITP) is an acquired autoimmune disease, in which the imbalance of CD4 T cell subsets play a key role in the pathogenesis. Since T cells highly depend on metabolism for their function, we hypothesized that T cell dysfunction may be due to intracellular metabolic reprogramming. We found that in ITP, T cell metabolism shifts from oxidative phosphorylation to glycolysis. Empagliflozin, a sodium-glucose cotransporter 2 inhibitor, has shown regulatory metabolic effects on proximal tubular epithelial cells and cardiac cells beyond glucose lowering. However, the effects of empagliflozin on T cells remain unknown. To further investigate the metabolic dysfunction of CD4 T cells in ITP, we explored the effect of empagliflozin on CD4 T-cell differentiation in ITP. Our results are the first to show that increased glycolysis in CD4 T cells resulted in an unbalanced CD4 T-cell population. Furthermore, empagliflozin can affect the differentiation of CD4 T-cell subsets by inhibiting Th1 and Th17 cell populations while increasing Tregs. Empagliflozin appears to regulate CD4 T cells through inhibiting the mTOR signal pathway. Considering these results, we propose that empagliflozin could be used as a potential therapeutic option for ITP by modulating metabolic reprogramming in CD4 T cells.
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http://dx.doi.org/10.1111/bjh.18293DOI Listing
June 2022

A cationic iridium(III) complex containing a thiosemicarbazide unit: Synthesis and application for turn-on chemiluminescent detection of Hg.

Spectrochim Acta A Mol Biomol Spectrosc 2022 Oct 22;279:121396. Epub 2022 May 22.

Key Laboratory of Green-Chemistry Materials in University of Yunnan Province, National and Local Joint Engineering Research Center for Green Preparation Technology of Biobased Materials, School of Chemistry & Environment, Yunnan Minzu University, Kunming 650500, China.

A novel cationic iridium(III) complex [(ppy)Ir(bPCPC)]PF (ppy: 2-phenylpyridine; bPCPC: 2-([2,2'-bipyridine]-4-carbonyl)-N-phenylhydrazinecarbothioamide) containing a thiosemicarbazide unit was designed and synthesized. The thiosemicarbazide unit was a sensitive functional group to Hg, when it reacted with Hg, it was desulphurized and thus led to the formation of 1,3,4-oxadiazole, [(ppy)Ir(bPCPC)]PF resultantly was used as a "turn-on" chemodosimeter for luminescent detection of Hg in DMF/PBS buffer solution at pH = 7-11. Except for Ag, recognition capability of [(ppy)Ir(bPCPC)]PF to Hg was not interfered by other common metal ions (Co, Li, Zn, Pb, K, Al, Na, Mn, Cu, Fe, Fe, Cr, Ba, Mg, Ni and Ca). The detection limit was 1.83 × 10 mol∙L (0.37 ppb), which indicated the complex was a highly sensitive chemiluminescent detection reagent of Hg.
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http://dx.doi.org/10.1016/j.saa.2022.121396DOI Listing
October 2022

Glucagon-like peptide-1 (GLP-1) receptor agonists and cardiovascular events in patients with type 2 diabetes mellitus: a meta-analysis of double-blind, randomized, placebo-controlled clinical trials.

Authors:
Jing Qin Li Song

BMC Endocr Disord 2022 May 12;22(1):125. Epub 2022 May 12.

Department of Emergency, The Second hospital of Lanzhou University, Lanzhou, China.

Background: The cardiovascular effects of glucagon-like peptide-1 (GLP-1) receptor agonists are still controversial in the treatment of type 2 diabetes mellitus (T2DM) patients. The purpose of this study was to evaluate the risk of cardiovascular events of GLP-1 (albiglutide, exenatide, liraglutide, semaglutide, lixisenatide and dulaglutide) receptor agonists in T2DM patients.

Methods: PubMed and Embase were searched to find relevant randomized controlled trials (RCTs) from inception to June 2019 that evaluated the effect of GLP-1 receptor agonists on cardiovascular events in patients with T2DM. The T2DM patients of all the eligible trials received either GLP-1 therapy or placebo, and the cardiovascular outcomes included death from cardiovascular causes, fatal or non-fatal myocardial infarction and fatal or non-fatal stroke.

Results: We included 6 multinational double-blind randomized placebo-control trials that included a total of 52821 T2DM patients. The results indicated that GLP-1 receptor agonists reduced the risk of death from cardiovascular causes (RR: 0.90; 95% CI: 0.83-0.97; P = 0.004) and fatal or non-fatal stroke (RR: 0.85; 95% CI: 0.77-0.94; P = 0.001) compared with the placebo controls. But GLP-1 receptor agonists did not significantly alter the fatal or non-fatal myocardial infarction compared with the placebo (RR: 0.91; 95% CI: 0.82 - 1.01; P = 0.06).

Conclusion: We concluded that GLP-1 receptor agonist therapy could reduce the risk of death from cardiovascular causes and fatal or non-fatal stroke compared with the placebo in the treatment of T2DM patients in trials with cardiovascular outcomes.
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http://dx.doi.org/10.1186/s12902-022-01036-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9097124PMC
May 2022

pH sensing and bioimaging using green synthesized carbon dots from black fungus.

RSC Adv 2021 Sep 27;11(50):31791-31794. Epub 2021 Sep 27.

Department of Chemistry, Chemical Engineering and Resource Utilization, Northeast Forestry University 26 Hexing Road Harbin 150040 PR China

Biomass is regarded as an excellent candidate for the preparation of carbon nanomaterials. A pH sensor was established based on carbon dots synthesized from black fungus, and possesses good fluorescence response and reversibility for pH detection. Meanwhile, the CDs can also be applied to intra-cellular bioimaging, showing potential for bioimaging.
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http://dx.doi.org/10.1039/d1ra05199gDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9041562PMC
September 2021

IL-27 Modulates the Cytokine Secretion in the T Cell-Osteoclast Crosstalk During HIV Infection.

Front Immunol 2022 5;13:818677. Epub 2022 Apr 5.

Department of Microbiology and Immunology, Georgetown University School of Medicine, Washington, DC, United States.

In People with HIV (PWH), chronic immune activation and systemic inflammation are associated with increased risk to develop comorbidities including bone loss. Numerous cells of the immune system, namely, T cells are involved in the regulation of the bone homeostasis and osteoclasts (OCs) activity. IL-27, a cytokine that belongs to the IL-12 family can regulate the secretion of pro- and anti-inflammatory cytokines by T cells, however its role in the setting of HIV is largely unknown. In the present study, we determined the impact of OCs in T cell secretion of cytokines and whether IL-27 can regulate this function. We found that the presence of OCs in the T cell cultures significantly enhanced secretion of IFNγ, TNFα, IL-17, RANKL, and IL-10 in both PWH and healthy controls. In PWH, IL-27 inhibited IL-17 secretion and downregulated surface expression of RANKL in CD4 T cells. All together these results suggest that in the context of HIV infection IL-27 may favor IFNγ and TNFα secretion at the sites of bone remodeling.
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http://dx.doi.org/10.3389/fimmu.2022.818677DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9037094PMC
April 2022

PolypSeg+: A Lightweight Context-Aware Network for Real-Time Polyp Segmentation.

IEEE Trans Cybern 2022 Apr 13;PP. Epub 2022 Apr 13.

Automatic polyp segmentation from colonoscopy videos is a prerequisite for the development of a computer-assisted colon cancer examination and diagnosis system. However, it remains a very challenging task owing to the large variation of polyps, the low contrast between polyps and background, and the blurring boundaries of polyps. More importantly, real-time performance is a necessity of this task, as it is anticipated that the segmented results can be immediately presented to the doctor during the colonoscopy intervention for his/her prompt decision and action. It is difficult to develop a model with powerful representation capability, yielding satisfactory segmentation results and, simultaneously, maintaining real-time performance. In this article, we present a novel lightweight context-aware network, namely, PolypSeg+, attempting to capture distinguishable features of polyps without increasing network complexity and sacrificing time performance. To achieve this, a set of novel lightweight techniques is developed and integrated into the proposed PolypSeg+, including an adaptive scale context (ASC) module equipped with a lightweight attention mechanism to tackle the large-scale variation of polyps, an efficient global context (EGC) module to promote the fusion of low-level and high-level features by excluding background noise and preserving boundary details, and a lightweight feature pyramid fusion (FPF) module to further refine the features extracted from the ASC and EGC. We extensively evaluate the proposed PolypSeg+ on two famous public available datasets for the polyp segmentation task: 1) Kvasir-SEG and 2) CVC-Endoscenestill. The experimental results demonstrate that our PolypSeg+ consistently outperforms other state-of-the-art networks by achieving better segmentation accuracy in much less running time. The code is available at https://github.com/szu-zzb/polypsegplus.
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http://dx.doi.org/10.1109/TCYB.2022.3162873DOI Listing
April 2022

Rapid and stable achievement of mainstream nitritation at low temperature using the competitive inhibition caused by the organics.

Bioresour Technol 2022 May 26;352:127060. Epub 2022 Mar 26.

College of Ecology and Environment, Zhengzhou University, Zhengzhou 450001, China. Electronic address:

The unstability of mainstream nitritation at low temperature has always been a limiting factor for the nitrogen removal from domestic wastewater by anammox. In this study, the competitive inhibition caused by the organics has been demonstrated as an effective strategy to rapidly and stably achieve mainstream nitritation. This strategy was based on our novel discovery that nitrite-oxidizing bacteria (NOB) was more susceptible to the organics inhibition than ammonia-oxidizing bacteria (AOB). Batch tests showed while NOB activity gradually decreased by 66.5%, AOB activity only decreased by 31.6% with the initial C/N ratio raising from 0.0 to 3.0. Furthermore, treating the actual domestic wastewater at 14-18 °C, mainstream nitritation was rapidly established within 12 days and then the nitrite accumulation ratio was stable at ∼92.1% during a long-term operation. This strategy could be easily and effectively applied in urban WWTPs through modifying the operation mode.
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http://dx.doi.org/10.1016/j.biortech.2022.127060DOI Listing
May 2022

Monoamine oxidase A drives neuroendocrine differentiation in prostate cancer.

Biochem Biophys Res Commun 2022 05 23;606:135-141. Epub 2022 Mar 23.

Division of Cancer Biology, Laboratory Animal Center, Fourth Military Medical University, 710032, Xi'an, Shaanxi, China. Electronic address:

Neuroendocrine transdifferentiation (NED) of prostate cancer (PCa) is the main cause of failure of androgen receptor inhibitor treatment. However, the molecular mechanisms underlying the development of NEPC, especially treatment-induced NEPC, remain unclear. Emerging evidence indicates that elevated monoamine oxidase A (MAOA) contribute to the proliferation, cell stemness, and bone metastasis in PCa. Here, we generated an enzalutamide-induced NED cell model to assess the role of MAOA during NED. Overall, MAOA expression was significantly increased upon Enz long-term exposure and was required for neuroendocrine marker expression. In particular, Enz was found to induce NED via the MAOA/mTOR/HIF-1α signaling axis. Further analyses revealed that the MAOA inhibitor clorgyline(CLG) may bring multiple benefits to CRPC patients, including better therapeutic effect and delays NED. These findings suggest that MAOA may be an important target for the development of anti-NED therapies, thereby providing a novel strategy for the combined application of CLG and AR inhibitors in the clinic.
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http://dx.doi.org/10.1016/j.bbrc.2022.03.096DOI Listing
May 2022

H-ProSeg: Hybrid ultrasound prostate segmentation based on explainability-guided mathematical model.

Comput Methods Programs Biomed 2022 Jun 17;219:106752. Epub 2022 Mar 17.

Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hong Kong, China. Electronic address:

Background And Objective: Accurate and robust prostate segmentation in transrectal ultrasound (TRUS) images is of great interest for image-guided prostate interventions and prostate cancer diagnosis. However, it remains a challenging task for various reasons, including a missing or ambiguous boundary between the prostate and surrounding tissues, the presence of shadow artifacts, intra-prostate intensity heterogeneity, and anatomical variations.

Methods: Here, we present a hybrid method for prostate segmentation (H-ProSeg) in TRUS images, using a small number of radiologist-defined seed points as the prior points. This method consists of three subnetworks. The first subnetwork uses an improved principal curve-based model to obtain data sequences consisting of seed points and their corresponding projection index. The second subnetwork uses an improved differential evolution-based artificial neural network for training to decrease the model error. The third subnetwork uses the parameters of the artificial neural network to explain the smooth mathematical description of the prostate contour. The performance of the H-ProSeg method was assessed in 55 brachytherapy patients using Dice similarity coefficient (DSC), Jaccard similarity coefficient (Ω), and accuracy (ACC) values.

Results: The H-ProSeg method achieved excellent segmentation accuracy, with DSC, Ω, and ACC values of 95.8%, 94.3%, and 95.4%, respectively. Meanwhile, the DSC, Ω, and ACC values of the proposed method were as high as 93.3%, 91.9%, and 93%, respectively, due to the influence of Gaussian noise (standard deviation of Gaussian function, σ = 50). Although the σ increased from 10 to 50, the DSC, Ω, and ACC values fluctuated by a maximum of approximately 2.5%, demonstrating the excellent robustness of our method.

Conclusions: Here, we present a hybrid method for accurate and robust prostate ultrasound image segmentation. The H-ProSeg method achieved superior performance compared with current state-of-the-art techniques. The knowledge of precise boundaries of the prostate is crucial for the conservation of risk structures. The proposed models have the potential to improve prostate cancer diagnosis and therapeutic outcomes.
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http://dx.doi.org/10.1016/j.cmpb.2022.106752DOI Listing
June 2022

Optimal configuration of a three-rod ortho-bridge system in the treatment of Vancouver type B1 periprosthetic femoral fractures: A finite element analysis.

J Orthop 2022 Mar-Apr;30:120-126. Epub 2022 Feb 26.

Department of Orthopedic Surgery, Yan'an Hospital Affiliated to Kunming Medical University, Panlong District, Kunming City, Yunnan Province, People's Republic of China.

Introduction And Aim: Periprosthetic femoral fractures (PFF) represent an increasing clinical and economic burden. This study aims to determine the optimal configuration of a bridge-combined internal fixation system in the treatment of Vancouver type B1 PFF, using finite element analysis.

Materials And Methods: A three-rod ortho-bridge system (OBS) fixation model was used to evaluate the optimal configuration of four target parameters: position of the third rod; intersection angle between the proximal screws; connecting rod diameter; and number of screws used. Femoral displacement and the maximum von Mises stress of the OBS were used as the evaluation indices, to analyze the PFF and to determine the optimal use of an OBS. For each parameter, various candidate options were tested.

Results: Finite element analysis revealed that the rate of femoral displacement and the maximum von Mises stress of the OBS were at a minimum when there was a 35 mm downward movement of the third rod from the baseline. Therefore, the optimal position of third rod fixation was 35 mm below the fovea capitis of the femur. The optimal intersection angles between the proximal screws were found to be 71.92° or 84°. A 6 mm diameter connecting rod proved to be most effective. Configuration d, utilizing 7 screws, represented the most clinically appropriate screw number configuration, despite configuration f, utilizing 9 screws, eliciting the best evaluation indices.

Conclusion: An OBS used in the above-described configuration is well suited to the characteristics of PFF and provides an effective and reliable means for their treatment.
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http://dx.doi.org/10.1016/j.jor.2022.02.020DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8907548PMC
February 2022

Semi-supervised segmentation of echocardiography videos via noise-resilient spatiotemporal semantic calibration and fusion.

Med Image Anal 2022 05 25;78:102397. Epub 2022 Feb 25.

Centre for Smart Health, School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong.

We present a novel model for left ventricle endocardium segmentation from echocardiography video, which is of great significance in clinical practice and yet a challenging task due to (1) the severe speckle noise in echocardiography videos, (2) the irregular motion of pathological heart, and (3) the limited training data caused by high annotation cost. The proposed model has three compelling characteristics. First, we propose a novel adaptive spatiotemporal semantic calibration method to align the feature maps of consecutive frames, where the spatiotemporal correspondences are figured out based on feature maps instead of pixels, thereby mitigating the adverse effects of speckle noise in the calibration. Second, we further learn the importance of each feature map of neighbouring frames to the current frame from the temporal perspective so as to distinctively rather than uniformly harness the temporal information to tackle the irregular and anisotropic motions. Third, we integrate these techniques into the mean teacher semi-supervised architecture to leverage a large amount of unlabeled data to improve the segmentation accuracy. We extensively evaluate the proposed method on two public echocardiography video datasets (EchoNet-Dynamic and CAMUS), where the average dice coefficient on the left ventricular endocardium segmentation achieves 92.87% and 93.79%, respectively. Comparisons with state-of-the-art methods also demonstrate the effectiveness of the proposed method by achieving a better segmentation performance with a faster speed.
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http://dx.doi.org/10.1016/j.media.2022.102397DOI Listing
May 2022

A mixture distribution approach for assessing genetic impact from twin study.

Stat Med 2022 06 7;41(14):2513-2522. Epub 2022 Mar 7.

Biostatistics Research Branch, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, Maryland, USA.

It is challenging to evaluate the genetic impacts on a biologic feature and separate them from environmental impacts. This is usually achieved through twin studies by assessing the collective genetic impact defined by the differential correlation in monozygotic twins vs dizygotic twins. Since the underlying order in a twin, determined by latent genetic factors, is unknown, the observed twin data are unordered. Conventional methods for correlation are not appropriate. To handle the missing order, we model twin data by a mixture bivariate distribution and estimate under two likelihood functions: the likelihood over the monozygotic and dizygotic twins separately, and the likelihood over the two twin types combined. Both likelihood estimators are consistent. More importantly, the combined likelihood overcomes the drawback of mixture distribution estimation, namely, the slow convergence. It yields correlation coefficient estimator of root-n consistency and allows effective statistical inference on the collective genetic impact. The method is demonstrated by a twin study on immune traits.
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http://dx.doi.org/10.1002/sim.9367DOI Listing
June 2022

Microscale gratings patterned in perovskite films to promote the electron-optical conversion efficiency of perovskite light-emitting diodes.

Appl Opt 2022 Jan;61(1):35-40

In this paper, we investigated an enhancement of luminance in a perovskite light-emitting diode (PeLED) by inserting periodic microscale gratings. Soft imprinting was employed to pattern the gratings onto the surface of perovskite film in the annealing process. It was found that the grain-refining effect deeply influenced the morphology and crystallinity of the perovskite film. The finite-element analysis was utilized to confirm the light extraction enhancement arising from the inserted microscale gratings. Additionally, the introduction of microscale gratings led to a 1.33 enhancement of the device's optoelectrical field intensity. Thus, the patterned PeLED obtained an enhancement of 2.96 and 2.1 of the luminance and external quantum efficiency, respectively.
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http://dx.doi.org/10.1364/AO.443005DOI Listing
January 2022

Febrile neutropenia management and outcomes in hematopoietic cell transplantation for chronic granulomatous disease.

Transpl Infect Dis 2022 Apr 10;24(2):e13815. Epub 2022 Mar 10.

National Institute of Allergy and Infectious Diseases/National Institutes of Health, Bethesda, Maryland, USA.

Objective: We analyzed events and therapies related to febrile neutropenia in patients receiving hematopoietic cell transplantation (HCT) for chronic granulomatous disease (CGD).

Methods: Three protocols for HCT were used to extract the relation between conditioning and infectious complications during transplantation for CGD, especially the relation of fever and neutropenia to microbiological events and antibiotic therapy.

Results: Sixty-nine recipients received either reduced intensity conditioning with matched related or unrelated donors or conditioning specific to haploidentical-related donors utilizing posttransplant cyclophosphamide. Fever prior to neutropenia was common (52) and in eight recipients, Gram negative bacterial infection occurred prior to neutropenia, and in nine during neutropenia. Alemtuzumab as conditioning was associated with preneutropenic infection. Empiric therapy (noncarbapenem) by institutional guideline was given in 40. Carbapenems were given before neutropenia (8) or as empiric therapy in neutropenia (18), or a switch to a carbapenem (n = 22) occurred in 48 cases. No deaths related to infection associated with neutropenia occurred.

Conclusion: The management of febrile neutropenia in HCT for CGD led to no deaths related to infection associated with neutropenia. Bacteremias occurred both prior to neutropenia and during neutropenia. Bacteria isolated may have represented the recrudescence of prior infection, representing the population transplanted and the platform for HCT. The treatment of prior infections may have had an influence on the necessity of carbapenem use as either empiric or directed therapy for bacterial infections.
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http://dx.doi.org/10.1111/tid.13815DOI Listing
April 2022

The value of contrast-enhanced ultrasound enhancement patterns for the diagnosis of sentinel lymph node status in breast cancer: systematic review and meta-analysis.

Quant Imaging Med Surg 2022 Feb;12(2):936-948

Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

Background: The sentinel lymph node (SLN) can represent the metastasis status of axillary lymph nodes and is a prognostic factor of breast cancer. Preoperative imaging provides information for axillary surgery decision-making, and this meta-analysis evaluated the diagnostic value of contrast-enhanced ultrasound (CEUS) for SLN status in breast cancer patients.

Methods: The PubMed, Embase, Medline, Google Scholar, Clinical Trails gov. and Cochrane Library databases were searched from inception until 31 March 2020. Two review authors independently screened and selected the relevant studies and extracted data, and the assessment of the methodological quality of studies was according to the QUADAS-2 tool. The diagnostic value of CEUS was assessed by calculating the pooled sensitivity, specificity, area under the curve, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio, and a summary receiver operating characteristic curve and hierarchical modeling method was used to conduct the meta-analysis.

Results: Five studies with 771 breast cancer patients were included, and the results showed CEUS could provide additional information for SLN preoperative diagnosis. A homogeneous or uniform enhancement pattern suggested a benign lymph node, and a heterogeneous, no pattern, or weak enhancement pattern suggested a node was malignant, demonstrating high sensitivity of 0.960 (95% CI: 0.856, 0.989) and moderate specificity of 0.807 (0.581, 0.926). The pooled positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio were 4.987 (2.104, 11.822) and 0.049 (0.014, 0.168), and 101.294 (31.202, 328.837), respectively.

Conclusions: A homogeneous enhancement pattern was highly suggestive of benign lymph nodes with high sensitivity. CEUS could effectively identify the SLN, and facilitate the diagnosis of its metastatic status.

Registration Number: PROSPERO protocol CRD42020176828.
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http://dx.doi.org/10.21037/qims-21-416DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8739145PMC
February 2022
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