IntroductionPerineural invasion (PNI) occurs in the majority of pancreatic ductal adenocarcinoma (PDAC) cases and is strongly associated with local recurrence, neuropathic pain, and poor survival, yet no reliable method exists for its preoperative identification. Here, we developed and externally validated a multi-sequence MRI-based intratumoral heterogeneity (ITH) scoring framework integrated with machine learning for the non-invasive prediction of PNI in PDAC.MethodsUsing preoperative T2-weighted, diffusion-weighted, and contrast-enhanced T1-weighted MRI from 205 surgically resected patients across four medical centers (100 training, 43 internal test, and 28 and 34 external validation patients), we extracted two-dimensional and three-dimensional ITH features via K-means clustering-based subregion partitioning and incorporated independent clinical predictors tumor location and clinical T-stage to construct combined predictive models. Eleven machine learning algorithms were systematically evaluated.ResultsThe combined clinical-ITH model achieved an area under the curve (AUC) of 0.907 in the internal test set and AUCs of 0.860 and 0.869 in the two external validation cohorts. Corresponding AUCs were 0.881, 0.860, and 0.850 for the ITH model and 0.758, 0.342, and 0.700 for the clinical logistic regression model.DiscussionSHAP analysis ranked three T2WI-derived features as the largest contributors to the combined model output, feature effects varied in direction and were not uniformly monotonic. These findings demonstrate that multi-sequence MRI-based ITH quantification provides an interpretable approach to preoperative PNI assessment with consistent discrimination across the two external surgical cohorts, offering a potential tool to guide surgical planning and adjuvant therapy selection in pancreatic cancer.
[Objective] To comprehensively analyze the clinical and pathological characteristics of nevus lipomatosus cutaneous superficialis. [Methods] We retrospectively analyzed the clinical and pathological data of patients with nevus lipomatosus cutaneous superficialis who were treated at our outpatient clinic from January 2018 to August 2024. [Results] Among the 47 patients, 6 were male and 41 were female, with a male-to-female ratio of 1∶6.83. The ages ranged from 14 to 69 years, with an average of 41.74±13.79 years. The majority of cases occurred in the 20-40 age group (19 patients, accounting for 40.43%), and in the 41-59 age group (22 patients, 46.81%). Regarding the lesion sites, the buttocks (15 cases), thighs (10 cases), and back (8 cases) were the common sites. Clinical diagnoses were consistent with pathological diagnoses in 10 cases, resulting in a coincidence rate of 21.28%. The most common misdiagnosis was acrochordon, accounting for 9 cases (19.15%). The main histopathological feature was the presence of a large number of mature adipocytes between the collagen bundles in the dermis. [Conclusions] Nevus lipomatosus cutaneous superficialis predominantly occurs on the buttocks, thighs, and back. The number of cases in females is much higher than that in males. It may easily be misdiagnosed. Most cases present as a single lesion. Clinicians should strengthen their knowledge to further improve the accuracy of clinical diagnoses.
·AIM:To investigate the alterations in corneal aberration and relative refractive power following the reduction of back optic zone diameters(BOZD)of orthokeratology lenses. ·METHODS:Myopic children aged 8-12 years,deemed suitable and willing to wear orthokeratology lenses,were randomly allocated to wear lenses with a 6.0 mm BOZD or a 5.0 mm BOZD.Data collection included changes in higher-order aberrations,relative refractive power and the treatment zone diameter of the two groups after wearing lenses for 1 d,1 wk,1,and 3 mo.The correlation of increase in corneal higher-order aberrations with refractive power was analyzed. ·RESULTS:The increases in total higher-order aberrations,spherical aberrations and coma aberrations varied overtime following lens wear(all P＜0.001),and there were no statistically significant differences in the changes of total higher-order aberrations and coma aberrations between the two groups of patients(all P＞0.05).A significant difference was observed in the increment of spherical aberrations in the 5 mm range between the two groups of patients,which varied over time(Ftime=40.179,Ptime＜0.001;Fgroup=11.948,Pgroup=0.001;Finteraction=3.262,Pinteraction=0.03).A significant difference was observed in the increment of spherical aberrations in the 4 mm range between the two patient groups(Ftime=34.462,Ptime＜0.001;Fgroup=13.094,Pgroup＜0.001;Finteraction=1.372,Pinteraction=0.25).There was no statistically significant distinction in relative refractive power between the two groups(Fgroup=0.048,Pgroup=0.83;Finteraction=1.208,Pinteraction=0.31);however,relative refractive power changed over time(Ftime=40.030,Ptime＜0.001).The difference in treatment zone diameter between the two groups was statistically significant,with changes overtime(Ftime=11.212,Ptime＜0.001;Fgroup=74.073,Pgroup＜0.001;Finteraction=0.312,Pinteraction=0.82).The total higher-order aberrations,spherical aberrations,and coma aberrations in 4,5 and 6 mm range showed a positive correlation with relative refractive power values(all P＜0.001).Statistically significant difference was observed in the axial length between the two groups after wearing lenses for 3,6 and 12 mo(Ftime=185.398,Ptime＜0.001;Fgroup=5.618,Pgroup=0.02;Finteraction=2.315,Pinteraction=0.11). ·CONCLUSION:Orthokeratology lenses leaded to elevated higher-order aberrations.Orthokeratology lenses with smaller BOZD produced significantly greater spherical aberrations at 4 and 5 mm range and smaller treatment zone diameters.The corneal total higher-order aberration was positively correlated with relative refractive power.Wearing orthokeratology lenses with a smaller BOZD can cause slower axial growth and better myopia control.
Objective To explore the mechanism of notoginsenoside Rg1 in preventing and treating Alzheimer's disease(AD).Methods Rat model of AD was established by injecting amyloid beta peptide 1-42(Aβ1-42)into the lateral ventricle of SD rats.Then the animals were randomly divided into three groups:sham-operated group,model group and Rg1 treatment group.The treatment group was treated with Rg1 gavage and the sham-operated group was treated with saline gavage.Learning and memory capacity of rats were examined by Morris water maze experiment(MWM).Moreover,the contents of MDA and SOD in cerebral cortex were detected by chemical colorimetry;immuno-histochemistry was used to detect caspase-3 protein in the cerebral cortex and Western blot was employed to detect the expression of p38 and p-p38 proteins.Results Compared with the sham-operated group,the model group had a prolonged escape latency,reduced stay time in the target quad-rant and reduced frequency of leaping over platform;increased MDA and decreased SOD in cerebral cortex;increased caspase-3 protein-positive neurons.The difference of p38 expression was not statistically significant and the phosphorylation of p38 was upregulated(P＜0.05).The rats in Rg1 treatment group had a shorter es-cape latency,increased stay time in quadrant Ⅲ,increased frequency of leaping over platform,decreased caspase-3 positive neurons and the phosphorylation level of p38,decreased MDA and increased SOD compared with the model group(P＜0.05).Conclusions Rg1 significantly improves learning and memory capacities,increases antioxidant capacity and plays neuro-protective effect in AD rat model by inhibition of p38 activation.
