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        Artificial Intelligence in the Prediction of Gastrointestinal Stromal Tumors on Endoscopic Ultrasonography Images: Development, Validation and Comparison with Endosonographers

        Lu Yi,Wu Jiachuan,Hu Minhui,Zhong Qinghua,Er Limian,Shi Huihui,Cheng Weihui,Chen Ke,Liu Yuan,Qiu Bingfeng,Xu Qiancheng,Lai Guangshun,Wang Yufeng,Luo Yuxuan,Mu Jinbao,Zhang Wenjie,Zhi Min,Sun Jiachen 거트앤리버 소화기연관학회협의회 2023 Gut and Liver Vol.17 No.6

        Background/Aims: The accuracy of endosonographers in diagnosing gastric subepithelial lesions (SELs) using endoscopic ultrasonography (EUS) is influenced by experience and subjectivity. Artificial intelligence (AI) has achieved remarkable development in this field. This study aimed to develop an AI-based EUS diagnostic model for the diagnosis of SELs, and evaluated its efficacy with external validation. Methods: We developed the EUS-AI model with ResNeSt50 using EUS images from two hospitals to predict the histopathology of the gastric SELs originating from muscularis propria. The diagnostic performance of the model was also validated using EUS images obtained from four other hospitals. Results: A total of 2,057 images from 367 patients (375 SELs) were chosen to build the models, and 914 images from 106 patients (108 SELs) were chosen for external validation. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of the model for differentiating gastrointestinal stromal tumors (GISTs) and non-GISTs in the external validation sets by images were 82.01%, 68.22%, 86.77%, 59.86%, and 78.12%, respectively. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy in the external validation set by tumors were 83.75%, 71.43%, 89.33%, 60.61%, and 80.56%, respectively. The EUS-AI model showed better performance (especially specificity) than some endosonographers. The model helped improve the sensitivity, specificity, and accuracy of certain endosonographers. Conclusions: We developed an EUS-AI model to classify gastric SELs originating from muscularis propria into GISTs and non-GISTs with good accuracy. The model may help improve the diagnostic performance of endosonographers. Further work is required to develop a multi-modal EUS-AI system.

      • KCI등재

        TGF-β promotes pericyte-myofibroblast transition in subretinal fibrosis through the Smad2/3 and Akt/mTOR pathways

        Zhao Zhenzhen,Zhang Yumeng,Zhang Chaoyang,Zhang Jingting,Luo Xueting,Qiu Qinghua,Luo Dawei,Zhang Jingfa 생화학분자생물학회 2022 Experimental and molecular medicine Vol.54 No.-

        Subretinal fibrosis remains a major obstacle to the management of neovascular age-related macular degeneration. Choroidal pericytes were found to be a significant source of subretinal fibrosis, but the underlying mechanisms of pericyte-myofibroblast transition (PMT) remain largely unknown. The goal of this study was to explore the role and potential mechanisms by which PMT contributes to subretinal fibrosis. Choroidal neovascularization (CNV) was induced by laser photocoagulation in transgenic mice with the collagen1α1-green fluorescent protein (Col1α1-GFP) reporter, and recombinant adeno-associated virus 2 (rAAV2)-mediated TGF-β2 (rAAV2-TGF-β2) was administered intravitreally to further induce PMT. Primary mouse choroidal GFP-positive pericytes were treated with TGF-β2 in combination with siRNAs targeting Smad2/3, the Akt inhibitor MK2206 or the mTOR inhibitor rapamycin to examine cell proliferation, migration, and differentiation into myofibroblasts. The involvement of the Akt/mTOR pathway in PMT in subretinal fibrosis was further investigated in vivo. Intraocular TGF-β2 overexpression induced GFP-positive pericyte infiltration and PMT in subretinal fibrosis, which was mimicked in vitro. Knockdown of Smad2/3 or inhibition of Akt/mTOR decreased cell proliferation, PMT and migration in primary mouse pericytes. Combined inhibition of Smad2/3 and mTOR showed synergistic effects on attenuating α-smooth muscle actin (α-SMA) expression and cell proliferation. In mice with laser-induced CNV, the administration of the Akt/mTOR inhibitors suppressed pericyte proliferation and alleviated the severity of subretinal fibrosis. Our results showed that PMT plays a pivotal role in subretinal fibrosis, which was induced by TGF-β2 through the Smad2/3 and Akt/mTOR pathways. Thus, inhibiting PMT may be a novel strategy for the treatment of subretinal fibrosis.

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        Effect of increased dietary crude protein levels on production performance, nitrogen utilisation, blood metabolites and ruminal fermentation of Holstein bulls

        Xia, Chuanqi,Rahman, Muhammad Aziz Ur,Yang, He,Shao, Taoqi,Qiu, Qinghua,Su, Huawei,Cao, Binghai Asian Australasian Association of Animal Productio 2018 Animal Bioscience Vol.31 No.10

        Objective: This study investigated the effect of dietary crude protein (CP) supplementation on nutrient intake, nitrogen (N) utilisation, blood metabolites, ruminal fermentation and growth performance of young Holstein bulls. Methods: Twenty-one young bulls weighing $277{\pm}11.2kg$ were equally divided into three groups and were offered diets formulated with low CP (LCP; 10.21% CP and 4.22% rumen degradable protein [RDP]), medium CP (MCP; 12.35% CP and 5.17% RDP) and high CP (HCP; 14.24% CP and 6.03% RDP). Yellow corn silage was used as a unique forage source and was mixed with concentrate. This mixed feed was given ad libitum to the young bulls included in the study. Results: Results showed that CP intake, blood urea nitrogen, N intake, total N excretion and N balance increased linearly with an increase in dietary CP level (p<0.05). However, no significant difference was observed in nutrient digestibility among the bulls receiving the different diets. Ruminal pH (p<0.05) and ammonia nitrogen ($NH_3-N$) concentration (p<0.01) were significantly higher in the bulls receiving the MCP and HCP diets than in those receiving the LCP diet. The bulls receiving the HCP diet showed significantly higher ruminal bacterial protein level, propionate, acetate and total volatile fatty acid (TVFA) concentrations than bulls receiving the LCP diet (p<0.05). Moreover, dietary CP level exerted a significant positive effect on the final body weight, average daily gain and gain-to-feed ratio of the bulls (p<0.05). Conclusion: High dietary CP level is optimal for achieving maximum growth and high profitability without exerting a negative effect on the physiology of growing Holstein bulls.

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