ChatRadio-Valuer: A Chat Large Language Model for Generalizable Radiology Report Generation Based on Multi-institution and Multi-system Data

Radiology report generation, as a key step in medical image analysis, is critical to the quantitative analysis of clinically informed decision-making levels. However, complex and diverse radiology reports with cross-source heterogeneity pose a huge generalizability challenge to the current methods under massive data volume, mainly because the style and normativity of radiology reports are obviously distinctive among institutions, body regions inspected and radiologists. Recently, the advent of large language models (LLM) offers great potential for recognizing signs of health conditions. To resolve the above problem, we collaborate with the Second Xiangya Hospital in China and propose ChatRadio-Valuer based on the LLM, a tailored model for automatic radiology report generation that learns generalizable representations and provides a basis pattern for model adaptation in sophisticated analysts' cases. Specifically, ChatRadio-Valuer is trained based on the radiology reports from a single institution by means of supervised fine-tuning, and then adapted to disease diagnosis tasks for human multi-system evaluation (i.e., chest, abdomen, muscle-skeleton, head, and maxillofacial $\&$ neck) from six different institutions in clinical-level events. The clinical dataset utilized in this study encompasses a remarkable total of \textbf{332,673} observations. From the comprehensive results on engineering indicators, clinical efficacy and deployment cost metrics, it can be shown that ChatRadio-Valuer consistently outperforms state-of-the-art models, especially ChatGPT (GPT-3.5-Turbo) and GPT-4 et al., in terms of the diseases diagnosis from radiology reports. ChatRadio-Valuer provides an effective avenue to boost model generalization performance and alleviate the annotation workload of experts to enable the promotion of clinical AI applications in radiology reports

Synchronous Closure of A Large Medial Perforator-Based Superficial Circumflex Iliac Artery Perforator Free Flap Donor Site Using an Ipsilateral Lateral Perforator-Based Superficial Circumflex Iliac Artery Perforator Propeller Flap.

A superior advantage of the superficial circumflex iliac artery perforator flap is that any donor site residue can easily be hidden by clothing. Usually designed as narrow or moderate-sized flaps based on medial perforators of the superficial branch, this readily allows primary donor site closure. However, for larger flaps, tension-free closure requires that the thigh remain flexed or even a skin graft used. Another alternative would be to use an adequate lateral perforator of the deep branch, if available, as the vascular hub of a propeller flap that extended into the adjacent flank, that could then be rotated into the medial groin to facilitate simultaneous direct closure of both flap donor sites

Complete mitochondrial genome of the longicorn Anoplophora horsfieldi Hope (Coleoptera: Cerambycidae)

The chinaberry yellow-banded longhorn beetle, Anoplophora horsfieldi Hope 1842 (Coleoptera: Cerambycidae) is an important pest on many economic tree species. In this study, the complete mitochondrial genome of A. horsfieldi was determined, which was 15,837 bp in length and contained 37 genes, including 13 protein-coding genes (PCGs), two rRNA, 22 tRNA genes, and a non-coding A + T-rich region. The phylogenetic analysis based on mitochondrial genomes showed that A. horsfieldi is sister to a clade formed by A. chinensis and A. glabripennis

Perihilar Hepatectomy for Hepatolithiasis with Compressed Hilar Bile Duct Induced by Perihilar Hyperplasia of Liver

Background: Stone recurrence is a major problem limiting the effects of surgical treatment for hepatolithiasis. It was showed that hyperplasia of perihilar liver may compress the hepatic portal and cause deficient bile flow because of compressed hilar bile duct, thereby leading to the formation of bile stasis and precipitating stone recurrence. This retrospective study aimed to evaluate the efficiency of perihilar hepatectomy for hepatolithiasis with compressed hilar bile duct induced by perihilar hyperplasia of liver. Methods: 135 patients with compressed hilar bile duct induced by hypertrophied perihilar liver were included in this study from January 2011 to July 2016. Among these patients, 77 underwent conventional operation procedure (control group) and 58 underwent conventional operation procedure added by perihilar hepatectomy (perihilar hepatectomy group). Clinical data containing preoperative data, intraoperative data, operation complications, and short-term and long-term outcomes were collected. Results: The demographic and disease-related characteristics of the two groups were comparable. The two groups were not remarkably different in operation-related characteristics. The incidence of bile leakage in the perihilar hepatectomy group was substantially higher than that in the control group. Other postoperative complications were not remarkably different between the two groups. In the long-term postoperative follow-up period, the incidence of the recurrence of stones and cholangitis in the control group was considerably higher than that in the perihilar hepatectomy group. Conclusions: Based on conventional operation procedure, additional perihilar hepatectomy is a reliable intervention with definite clinical effects for hepatolithiasis with compressed hilar bile duct induced by hypertrophied perihilar liver

Trends and Variability in Aerosol Optical Depth over North China from MODIS C6 Aerosol Products during 2001–2016

This study analyzed the variability and trend in aerosol optical depth (AOD) over North China using the latest MODIS/Terra C6 merged Dark Target/Deep Blue AOD monthly data at 550 nm from 2001 to 2016. The spatial distribution of the annual mean AOD was generally characterized by two prominent high-value centers located in the industrially and economically developed areas of the North China Plain and East China, and the dust aerosol-dominated areas of southern Xinjiang. The seasonally averaged AOD reached its maximum in spring (0.430 ± 0.049), followed by summer (0.356 ± 0.035) and winter (0.282 ± 0.039), with the minimum occurring in autumn (0.219 ± 0.022). There were notable long-term annual trends in AOD in different regions over North China during 2001–2016: a decreasing AOD trend was found in Qinghai Tibet (−0.015 ± 0.010/decade), Northwest China (−0.059 ± 0.013/decade at 99% confidence level), and the North China Plain (−0.007 ± 0.021/decade), but a positive increasing trend was identified in northern Xinjiang (0.01 ± 0.006/decade), southern Xinjiang (0.002 ± 0.013/decade), East China (0.053 ± 0.042/decade), and Northeast China (0.016 ± 0.029/decade). Seasonal patterns in the AOD regional long-term trend were evident. The AODs in spring over all the study regions, except East China, exhibited a decreasing trend, with the maximum trend value observed in Northwest China (−0.099 ± 0.029/decade at 99% confidence level); whereas AODs in autumn, except in Northwest China, showed an increasing trend, with the maximum trend value occurring in East China (0.073 ± 0.038/decade). Geographically, we also examined the annual and seasonal spatial patterns of AOD trends over North China. The annual spatial trends in AOD revealed a dominance of positive trends in most regions over the whole of North China from 2001 to 2016, but especially in East and Northeast China (AOD trend value of about 0.16/decade); whereas a negative trend was observed over northern Inner Mongolia (AOD trend value of about −0.12/decade). In addition, seasonal spatial trend analyses indicated that a continual clear upward trend occurred in East China in the autumn and winter seasons during the study period, with the maximum average increase occurring in winter (about 0.20/decade)

Contributions of T Lymphocyte Abnormalities to Therapeutic Outcomes in Newly Diagnosed Patients with Immune Thrombocytopenia

<div><p>T cell abnormalities have been reported to play an important role in pathogenesis of immune thrombocytopenia (ITP) besides specific autoantibodies towards platelet. The aim of this study was to explore the clinical importance of T lymphocyte subsets in adult patients with newly diagnosed ITP before and after first-line treatment. Elderly ITP patients were also studied and we tried to analyze the relationships between these items and therapeutic outcomes. The patients were treated with intravenous immunoglobulin (IVIG) plus corticosteroids and therapeutic responses were evaluated. As a result, compared with the controls, absolute lymphocyte counts in ITP patients decreased significantly before treatment. After treatment, lymphocyte counts restored to control level regardless of their treatment outcomes. In addition, we observed increased IgG and CD19⁺ cell expression and decreased CD4⁺/CD8⁺ cell ratio in both whole ITP group and elderly group before treatment. After treatment, the increased IgG and CD19⁺ cell expression could be reduced in both respond and non-respond group regardless of patient age, while CD4⁺/CD8⁺ cell ratio could not be corrected in non-respond ITP patients. In non-respond ITP patients, increased CD8⁺ cell expression was noticed and could not be corrected by first-line treatment. Furthermore, even lower NK cell expression was found in non-respond elderly patients after treatment when compared with that in controls. Our findings suggest that ITP patients usually had less numbers of peripheral lymphocytes and patients with higher levels of CD8⁺ cells or lower levels of CD4⁺/CD8⁺ cell ratio were less likely to respond to first-line treatment. Lower levels of NK cells made therapies in elderly ITP patients even more difficult.</p></div

Absolute lymphocyte counts in different analyzing groups before and after treatment (×10⁹/L).

<p>*** P<0.001 compared with that before treatment.</p><p>* P<0.05 compared with that before treatment.</p><p>Absolute lymphocyte counts in different analyzing groups before and after treatment (×10⁹/L).</p

Single-Cell Transcriptome Analysis Reveals Estrogen Signaling Coordinately Augments One-Carbon, Polyamine, and Purine Synthesis in Breast Cancer

Summary: Estrogen drives breast cancer (BCa) progression by directly activating estrogen receptor α (ERα). However, because of the stochastic nature of gene transcription, it is important to study the estrogen signaling pathway at the single-cell level to fully understand how ERα regulates transcription. Here, we performed single-cell transcriptome analysis on ERα-positive BCa cells following 17β-estradiol stimulation and reconstructed the dynamic estrogen-responsive transcriptional network from discrete time points into a pseudotemporal continuum. Notably, differentially expressed genes show an estrogen-stimulated metabolic switch that favors biosynthesis but reduces estrogen degradation. Moreover, folate-mediated one-carbon metabolism is reprogrammed through the mitochondrial folate pathway and polyamine and purine synthesis are upregulated coordinately. Finally, we show AZIN1 and PPAT are direct ERα targets that are essential for BCa cell survival and growth. In summary, our study highlights the dynamic transcriptional heterogeneity in ERα-positive BCa cells upon estrogen stimulation and uncovers a mechanism of estrogen-mediated metabolic switch. : Zhu et al. perform single-cell RNA-seq to reveal a dynamic transcriptional network in ERα+ breast cancer cells following estrogen stimulation and show that estrogen signaling promotes breast cancer cell survival and growth by mediating a metabolic switch in which folate-mediated one-carbon metabolism is reprogrammed via the mitochondrial folate pathway. Keywords: breast cancer, single-cell RNA sequencing, estrogen receptor α, metabolic switc