Yiwen Tao

Background: Lung adenocarcinoma (LUAD) is the most prevalent subtype of non-small cell lung cancer (NSCLC), and immunochemotherapy is widely utilized in its treatment. However, there are several drawbacks, including immune escape, immune-related adverse events (irAEs), a significant economic burden, and unfavorable outcomes. Therefore, it is crucial to identify patients who are likely to respond to non-immunotherapy. Methods: Differentially expressed gene (DEG) analysis and functional enrichment analysis were performed on the transcript profile of responders and non-responders from The Cancer Genome Atlas (TCGA). LUADnet model was developed using gene expression data, which integrates the global feature extraction module (GFEM), the local feature extraction module (LFEM), and the channel selection module (CSM), followed by the classifier module. Results: We identified 814 upregulated and 492 downregulated DEGs. Functional enrichment analysis revealed that the upregulated DEGs were enriched in pathways related to immune activation, transmembrane transport, and G protein-coupled receptor (GPCR) signaling, while the downregulated DEGs were primarily associated with the cell cycle pathway. The LUADnet demonstrated superior performance compared to state-of-the-art models, achieving an overall F1-score of 0.9193 and an accuracy of 0.9206. Additionally, ablation experiments indicate that the combination of LFEM, GFEM, and CSM enhances overall classification performance. Conclusions: This study explored the tumor microenvironment of responding and non-responding LUAD patients following non-immunotherapy and developed a robust deep learning model to stratify these patients, which will facilitate therapeutic strategies and alleviate economic burdens.

A reaction-diffusion-advection glucose metabolism model is proposed to describe the spatiotemporal behaviors of glucose in the pancreatic islet. The global existence and boundedness of the solution to the model are proved, and the existence and uniqueness of the positive steady state are established. Spatiotemporal sensitivity index and correlation index are proposed to identify high-impact physiological factors and illustrate parameter interdependency. Additionally, different stages of glucose metabolism such as hyperinsulinemia, hypoglycemia, euglycemia, and diabetes are simulated to demonstrate the system’s dynamics under varying physiological conditions. These findings provide valuable guidance in the therapeutic process, aiding in the development of effective interventions.

Depression is recognized as the second most significant health threat to humanity. Using data from the Global Burden of Disease Study 2019, we conduct a comprehensive analysis of global trends in depression. By employing Joinpoint regression models, we examine long-term and segmented trends in depression incidence rates across different genders and age groups from 1990 to 2019. The results reveal an upward trend in the incidence rates since 2015 among both males and females, particularly among individuals in their mid-20s and early 40s. Furthermore, through an age-period-cohort model, we assess the effects of age, period, and cohort on the incidence rates. The findings indicate a gradual decline in incidence risk among males over time, a modest post-2015 increase among females, and a decreasing risk trend for cohorts born after 1965. Together, these results illuminate the evolving global patterns of depression incidence, thereby emphasizing gender and age disparities as well as the complex interactions among age, period, and cohort effects.

The dislocation of ring segments in shield tunnels poses adverse effects on tunnel structural stability and waterproofing. Current methods can only detect limited types of dislocation from circular tunnels, posing challenges in meeting practical requirements. This article introduces a dislocation detection method that is applicable to shield tunnels of various shapes, enabling the detection of both inter-ring and intra-ring dislocations. First, a point cloud lossless unfolding method is introduced, allowing for the unfolding of tunnel point clouds of any cross-sectional shape without compromising point cloud features. Subsequently, a subway tunnel point cloud segmentation workflow is proposed, enabling the direct application of image deep learning (DL) networks to tunnel point clouds. The bolts are then identified as markers for dislocation measurement, and a method for bolt area of interest (AOI) positioning and pairing is introduced. This method calculates dislocation value through fitting reference surfaces from AOI. A series of experiments conducted on circular and quasi-rectangular shield tunnels totaling 2.45 km and containing 20 billion points demonstrate that the proposed segmentation workflow, coupled with an image semantic segmentation model, achieves a maximum mean intersection over union (mIoU) of 90.2%, which is 10% higher than directly segmenting tunnel point clouds. The proposed method went through repeated accuracy tests and was compared with other methods, including total station measurement, RANSAC plane fitting, and scanline method. The results of our proposed method demonstrate high precision and stability, with a measurement accuracy RMSE of 0.89 mm, an MAE of 0.69 mm, and an efficiency of 20 times higher compared to total station measurement.

Objective: To investigate the value of reconstruction of pelvic floor with biological products to prevent and treat empty pelvic syndrome after pelvic exenteration (PE) for locally advanced or recurrent rectal cancer. Methods: This was a descriptive study of data of 56 patients with locally advanced or locally recurrent rectal cancer without or with limited extra-pelvic metastases who had undergone PE and pelvic floor reconstruction using basement membrane biologic products to separate the abdominal and pelvic cavities in the Department of Anorectal Surgery of the Second Affiliated Hospital of Naval Military Medical University from November 2021 to May 2022. The extent of surgery was divided into two categories: mainly inside the pelvis (41 patients) and including pelvic wall resection (15 patients). In all procedures, basement membrane biologic products were used to reconstruct the pelvic floor and separate the abdominal and pelvic cavities. The procedures included a transperitoneal approach, in which biologic products were used to cover the retroperitoneal defect and the pelvic entrance from the Treitz ligament to the sacral promontory and sutured to the lateral peritoneum, the peritoneal margin of the retained organs in the anterior pelvis, or the pubic arch and pubic symphysis; and a sacrococcygeal approach in which biologic products were used to reconstruct the defect in the pelvic muscle-sacral plane. Variables assessed included patients' baseline information (including sex, age, history of preoperative radiotherapy, recurrence or primary, and extra-pelvic metastases), surgery-related variables (including extent of organ resection, operative time, intraoperative bleeding, and tissue restoration), post-operative recovery (time to recovery of bowel function and time to recovery from empty pelvic syndrome), complications, and findings on follow-up. Postoperative complications were graded using the Clavien-Dindo classification. Results: The median age of the 41 patients whose surgery was mainly inside the pelvis was 57 (31-82) years. The patients comprised 25 men and 16 women. Of these 41 patients, 23 had locally advanced disease and 18 had locally recurrent disease; 32 had a history of chemotherapy/immunotherapy/targeted therapy and 24 of radiation therapy. Among these patients, the median operative time, median intraoperative bleeding, median time to recovery of bowel function, and median time to resolution of empty pelvic syndrome were 440 (240-1020) minutes, 650 (200-4000) ml, 3 (1-9) days, and 14 (5-105) days, respectively. As for postoperative complications, 37 patients had Clavien-Dindo < grade III and four had ≥ grade III complications. One patient died of multiple organ failure 7 days after surgery, two underwent second surgeries because of massive bleeding from their pelvic floor wounds, and one was successfully resuscitated from respiratory failure. In contrast, the median age of the 15 patients whose procedure included combined pelvic and pelvic wall resection was 61 (43-76) years, they comprised eight men and seven women, four had locally advanced disease and 11 had locally recurrent disease. All had a history of chemotherapy/ immunotherapy and 13 had a history of radiation therapy. The median operative time, median intraoperative bleeding, median time to recovery of bowel function, and median time to relief of empty pelvic syndrome were 600 (360-960) minutes, 1600 (400-4000) ml, 3 (2-7) days, and 68 (7-120) days, respectively, in this subgroup of patients. Twelve of these patients had Clavien-Dindo < grade III and three had ≥ grade III postoperative complications. Follow-up was until 31 October 2022 or death; the median follow-up time was 9 (5-12) months. One patient in this group died 3 months after surgery because of rapid tumor progression. The remaining 54 patients have survived to date and no local recurrences have been detected at the surgical site. Conclusion: The use of basement membrane biologic products for pelvic floor reconstruction and separation of the abdominal and pelvic cavities during PE for locally advanced or recurrent rectal cancer is safe, effective, and feasible. It improves the perioperative safety of PE and warrants more implementation.