Background: Accurate preoperative prediction of cervical lymph node (LN) metastasis in patients with papillary thyroid carcinoma (PTC) provides a basis for surgical decision-making and the extent of tumor resection. This study aimed to develop and validate an ultrasound radiomics nomogram for the preoperative assessment of LN status. Methods: Data from 147 PTC patients at the Wuhan Tongji Hospital and 90 cases at the Hunan Provincial Tumor Hospital between January 2017 and September 2019 were included in our study. They were grouped as the training and external validation set. Radiomics features were extracted from shear-wave elastography (SWE) images and corresponding B-mode ultrasound (BMUS) images. Then, the minimum redundancy maximum relevance algorithm and the least absolute shrinkage and selection operator regression were used to select LN status-related features and construct the SWE and BMUS radiomics score (Rad-score). Multivariate logistic regression was performed using the two radiomics scores together with clinical data, and a nomogram was subsequently developed. The performance of the nomogram was assessed with respect to discrimination, calibration, and clinical usefulness in the training and external validation set. Results: Both the SWE and BMUS Rad-scores were significantly higher in patients with cervical LN metastasis. Multivariate analysis indicated that the SWE Rad-scores, multifocality, and ultrasound (US)-reported LN status were independent risk factors associated with LN status. The radiomics nomogram, which incorporated the three variables, showed good calibration and discrimination in the training set (area under the receiver operator characteristic curve [AUC] 0.851 [CI 0.791-0.912]) and the validation set (AUC 0.832 [CI 0.749-0.916]). The significantly improved net reclassification improvement and index-integrated discrimination improvement demonstrated that SWE radiomics signature was a very useful marker to predict the LN metastasis in PTC. Decision curve analysis indicated that the SWE radiomics nomogram was clinically useful. Furthermore, the nomogram also showed favorable discriminatory efficacy in the US-reported LN-negative (cN0) subgroup (AUC 0.812 [CI 0.745-0.860]). Conclusions: The presented radiomics nomogram, which is based on the SWE radiomics signature, shows a favorable predictive value for LN staging in patients with PTC.

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Background Acute pancreatitis is a common and potentially lethal gastrointestinal disease, but literatures for the disease burden are scarce for many countries. Understanding the current burden of acute pancreatitis and the different trends across various countries is essential for formulating effective preventive intervenes. We aimed to report the incidence, mortality, and disability-adjusted life-years (DALYs) caused by acute pancreatitis in 204 countries and territories between 1990 and 2019. Methods Estimates from the Global Burden of Disease Study 2019 (GBD 2019) were used to analyze the epidemiology of acute pancreatitis at the global, regional, and national levels. We also reported the correlation between development status and acute pancreatitis’ age-standardized DALY rates, and calculated DALYs attributable to alcohol etiology that had evidence of causation with acute pancreatitis. All of the estimates were shown as counts and age-standardized rates per 100,000 person-years. Results There were 2,814,972.3 (95% UI 2,414,361.3–3,293,591.8) incident cases of acute pancreatitis occurred in 2019 globally; 1,273,955.2 (1,098,304.6–1,478,594.1) in women and 1,541,017.1 (1,307,264.4–1,814,454.3) in men. The global age-standardized incidence rate declined from 37.9/100,000 to 34.8/100,000 during 1990–2019, an annual decrease of 8.4% (5.9–10.4%). In 2019, there were 115,053.2 (104,304.4–128,173.4) deaths and 3,641,105.7 (3,282,952.5–4,026,948.1) DALYs due to acute pancreatitis. The global age-standardized mortality rate decreased by 17.2% (6.6–27.1%) annually from 1.7/100,000 in 1990 to 1.4/100,000 in 2019; over the same period, the age-standardized DALY rate declined by 17.6% (7.8–27.0%) annually. There were substantial differences in the incidence, mortality and DALYs across regions. Alcohol etiology attributed to a sizable fraction of acute pancreatitis-related deaths, especially in the high and high-middle SDI regions. Conclusion Substantial variation existed in the burden of acute pancreatitis worldwide, and the overall burden remains high with aging population. Geographically targeted considerations are needed to tailor future intervenes to relieve the burden of acute pancreatitis in specific countries, especially for Eastern Europe.

Background: Early identification and timely therapeutic strategies for potential critical patients with coronavirus disease 2019 (COVID-19) are of crucial importance to reduce mortality. We aimed to develop and validate a prediction tool for 30-day mortality for these patients on admission.Methods: Consecutive hospitalized patients admitted to Tongji Hospital and Hubei Xinhua Hospital from January 1 to March 10, 2020, were retrospective analyzed. They were grouped as derivation and external validation set. Multivariate Cox regression was applied to identify the risk factors associated with death, and a nomogram was developed and externally validated by calibration plots, C-index, Kaplan-Meier curves and decision curve.Results: Data from 1,717 patients at the Tongji Hospital and 188 cases at the Hubei Xinhua Hospital were included in our study. Using multivariate Cox regression with backward stepwise selection of variables in the derivation cohort, age, sex, chronic obstructive pulmonary disease (COPD), as well as seven biomarkers (aspartate aminotransferase, high-sensitivity C-reactive protein, high-sensitivity troponin I, white blood cell count, lymphocyte count, D-dimer, and procalcitonin) were incorporated in the model. An age, biomarkers, clinical history, sex (ABCS)-mortality score was developed, which yielded a higher C-index than the conventional CURB-65 score for predicting 30-day mortality in both the derivation cohort {0.888 [95% confidence interval (CI), 0.869-0.907] vs. 0.696 (95% CI, 0.660-0.731)} and validation cohort [0.838 (95% CI, 0.777-0.899) vs. 0.619 (95% CI, 0.519-0.720)], respectively. Furthermore, risk stratified Kaplan-Meier curves showed good discriminatory capacity of the model for classifying patients into distinct mortality risk groups for both derivation and validation cohorts. Conclusions:The ABCS-mortality score might be offered to clinicians to strengthen the prognosis-based clinical decision-making, which would be helpful for reducing mortality of COVID-19 patients.

Bovine liver-derived mesenchymal stem cells (bLMSCs) were isolated from the liver tissue of 4-6 months old fetal calf, and then characterized by immunofluorescence and RT-PCR. We found that primary bLMSCs could be subcultured to 44 passages, the total culture time in vitro was 192 days. The results of surface antigen detection showed that bBMSCs expressed CD29, CD44, CD73, CD90, CD106 and CD166 but not expressed endothelial cells and hematopoietic cells specific marker CD34, CD45 and BLA-DR. The results of growth kinetics, colony-forming cell assay and cell cycle analysis indicated that the fetal bovine LMSCs had good proliferation ability in vitro. The cells from passages 7 were successfully induced to differentiate into osteoblasts, adipocytes and chondrocytes. The results indicate the potential for multi-lineage differentiation of bLMSCs that may represent an ideal candidate for cellular transplantation therapy.