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Background Vessels encapsulating tumor clusters (VETC) pattern is a novel microvascular pattern associated with poor outcomes of hepatocellular carcinoma (HCC). Preoperative estimation of VETC has potential to improve treatment decisions. Purpose To develop and validate a nomogram based on gadoxetate disodium‐enhanced MRI for estimating VETC in HCC and to evaluate whether the estimations are associated with recurrence after hepatic resection. Study Type Retrospective. Population A total of 320 patients with HCC and histopathologic VETC pattern assessment from three centers (development cohort:validation cohort = 173:147). Field Strength/Sequence A3.0  T/turbo spin‐echo T2‐weighted, spin‐echo echo‐planar diffusion‐weighted, and 3D T1‐weighted gradient‐echo sequences. Assessment A set of previously reported VETC‐ and/or prognosis‐correlated qualitative and quantitative imaging features were assessed. Clinical and imaging variables were compared based on histopathologic VETC status to investigate factors indicating VETC pattern. A regression‐based nomogram was then constructed using the significant factors for VETC pattern. The nomogram‐estimated VETC stratification was assessed for its association with recurrence. Statistical Tests Fisher exact test, t‐test or Mann–Whitney test, logistic regression analyses, Harrell's concordance index (C‐index), nomogram, Kaplan–Meier curves and log‐rank tests. P value < 0.05 was considered statistically significant. Results Pathological VETC pattern presence was identified in 156 patients (development cohort:validation cohort = 83:73). Tumor size, presence of heterogeneous enhancement with septations or with irregular ring‐like structures, and necrosis were significant factors for estimating VETC pattern. The nomogram incorporating these indicators showed good discrimination with a C‐index of 0.870 (development cohort) and 0.862 (validation cohort). Significant differences in recurrence rates between the nomogram‐estimated high‐risk VETC group and low‐risk VETC group were found (2‐year recurrence rates, 50.7% vs. 30.3% and 49.6% vs. 31.8% in the development and validation cohorts, respectively). Data Conclusion The nomogram integrating gadoxetate disodium‐enhanced MRI features was associated with VETC pattern preoperatively and with postoperative recurrence in patients with HCC. Evidence Level 4 Technical Efficacy Stage 2

Feature analysis and classification detection of abnormal cells from images for pathological analysis are an important issue for the realization of computer assisted disease diagnosis. This paper studies a method for cervical squamous epithelial cells. Based on cervical cytological classification standard and expert diagnostic experience, expressive descriptors are extracted according to morphology, color, and texture features of cervical scales epithelial cells. Further, quantificational descriptors related to cytopathology are derived as well, including morphological difference degree, cell hyperkeratosis, and deeply stained degree. The relationship between quantified value and pathological feature can be established by these descriptors. Finally, an effective method is proposed for detecting abnormal cells based on feature quantification. Integrated with clinical experience, the method can realize fast abnormal cell detection and preliminary cell classification.

Background: Scientist have been facing numerous challenges in the development of an effective therapeutic strategy for the treatment of COVID-19 pneumonia. Several studies have suggested that improving patient immunity and reducing lung injury induced by COVID -19 could be effective in treating the patients with COVID-19. Methods: A pilot trial of nebulization therapy for COVID-19 pneumonia with exosomes of MSCs was performed on seven patients with COVID-19 infected pneumonia. Exosomes were collected and purified from secretion of MSCs using multiple ultrafiltration. All patients was treated with nebulization of MSC-derived exosomes. The primary safety and efficacy outcome were observed.Results: Our clinical study demonstrated that nebulization mesenchymal stem cell (MSCs)-derived exosomes is a novel method that could be utilized in the treatment of COVID-19 pneumonia. Nebulization of MSC-derived exosomes did not induce acute allergic and secondary allergic reactions. It could promote the absorption of pulmonary lesions, and reduce the time of hospitalization for minor cases of COVID-19 pneumonia.Conclusions: Nebulization of MSC-derived exosomes is a safe, effective, and simple method. Nebulization of MSC-derived exosomes from the beginning of the treatment could be more beneficial to the patients. Trial registration: Chinese Clinical Trial Registry, ChiCTR2000030261. Registered on 26 February 2020.

The anatomy of the superior mesenteric vessels is complex, yet important, for right-sided colorectal surgery. The usefulness of three-dimensional (3D) printing of these vessels in right hemicolon cancer surgery has rarely been reported. In this prospective clinical study, 61 patients who received laparoscopic surgery for right hemicolon cancer were preoperatively randomized into 3 groups: 3D-printing (20 patients), 3D-image (19 patients), and control (22 patients) groups. Surgery duration, bleeding volume, and number of lymph node dissections were designed to be the primary end points, whereas postoperative complications, post-operative flatus recovery time, duration of hospitalization, patient satisfaction, and medical expenses were designed to be secondary end points. To reduce the influence of including different surgeons in the study, the surgical team was divided into 2 groups based on surgical experience. The duration of surgery for the 3D-printing and 3D-image groups was significantly reduced (138.4 ± 19.5 and 154.7 ± 25.9 min vs. 177.6 ± 24.4 min, P = 0.000 and P = 0.006), while the number of lymph node dissections for the these 2 groups was significantly increased (19.1 ± 3.8 and 17.6 ± 3.9 vs. 15.8 ± 3.0, P = 0.001 and P = 0.024) compared to the control group. Meanwhile, the bleeding volume for the 3D-printing group was significantly reduced compared to the control group (75.8 ± 30.4 mL vs. 120.9 ± 39.1 mL, P = 0.000). Moreover, patients in the 3D-printing group reported increased satisfaction in terms of effective communication compared to those in the 3D-image and control groups. Medical expenses decreased by 6.74% after the use of 3D-printing technology. Our results show that 3D-printing technology could reduce the duration of surgery and total bleeding volume and increase the number of lymph node dissections. 3D-printing technology may be more helpful for novice surgeons. Trial registration: Chinese Clinical Trial Registry, ChiCTR1800017161. Registered on 15 July 2018. With the introduction of the concept of complete mesocolic excision (CME), lymph node dissection in laparoscopic surgery has become more standardized, and the effect of surgical treatment on colon cancer has improved 1,2. However, CME is a challenging procedure for the surgeon 3. Indeed, CME surgery for right colon cancer requires clear dissection of the superior mesenteric artery and vein (SMA and SMV) and their branches 4-6. Moreover, the Henle trunk and right colonic and ileocolic artery and vein present important anatomical differences 7-9. This increases the difficulty of the surgery, and, consequently, the time required for a novice surgeon to learn the surgical technique. Therefore, we propose a new method to determine the course of the mesenteric vessels, and devise an appropriate surgical plan prior to the need for surgery.

Background Scientists have been facing numerous challenges in the development of an effective therapeutic strategy for the treatment of COVID-19 pneumonia. Several studies have suggested that improving patient immunity and reducing lung injury induced by SARS-CoV-2 may be effective for treating patients with COVID-19. Methods A pilot trial of nebulization therapy with exosomes of mesenchymal stem cells (MSCs) was performed on seven patients with COVID-19 pneumonia. Exosomes secreted from MSCs were collected and purified using multiple ultrafiltration steps. All patients were treated with nebulization of MSC-derived exosomes, and primary safety and efficacy outcomes were evaluated. Results Our clinical study demonstrated that nebulization of MSC-derived exosomes is a novel method that might be utilized in the treatment of COVID-19 pneumonia. Nebulization of MSC-derived exosomes did not induce acute allergic or secondary allergic reactions but did promote the absorption of pulmonary lesions and reduce the duration of hospitalization for mild cases of COVID-19 pneumonia. Conclusions Nebulization of MSC-derived exosomes is a safe, effective, and simple method, and their application at the beginning of treatment may be more beneficial. Trial Registration Chinese Clinical Trial Registry, ChiCTR2000030261. Registered on 26 February 2020. Graphical Abstract

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